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Richard Parker: Encouraging the next generation of nurses

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Posted on 23 May 2016 by Amy Lee
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Every year International Nurses Day (May 12) celebrates Florence Nightingale’s birthday,who, alongside other key figures such as Mary Secole, made nursing care safer.

While we rightly remember these individuals’ towering contributions to health, this has meant that we, as a society, traditionally connect nursing with gender.

Although we are seeing a growth in population and a demand for more nurses, men still only make up just over 10 per cent of staff and this is something that needs to change to ensure a stable workforce in the future.

In recent years we have seen a steady rise in men entering nursing, more than in past generations. But unlike medicine, a perception still lingers that nursing is a female occupation, and it can still be hard for the opposite sex to say “I’m going into nursing”.

My career began more than 30 years ago in 1982 as my girlfriend, now wife, suggested I enter the profession. Being a male nurse at that time was more out-of-the-ordinary than now, with my nursing class only consisting of two males (myself included) out of 40 students.

Since qualifying in 1985 I’ve worked in a variety of roles and specialised in intensive care nursing. As a clinical nurse, each shift brings a new challenge but looking after patients and making a difference to people’s lives makes the hard work worthwhile.

Now as director of nursing, midwifery and quality at the Trust, I have responsibility for the quality of care we deliver to our patients and provide leadership to more than 4,000 members of staff. My time with patients is more limited than before, but I feel honoured and privileged to work alongside the dedicated men and women who make up our nursing staff who go that extra mile every day.

I want to encourage Doncaster’s next generation of nurses that this is a career which shouldn’t be confined to stereotypes. Today’s nurses can now be found in a number of roles across primary care (GP practices, community care, nursing homes, health visiting and community midwifery), as well as acute (hospital-) based care.

And it doesn’t stop at the bedside, nurses now influence legislation, change how health care is delivered, they educate about preventing disease, are involved in health promotion, drive research and participate at an executive level within the NHS. It really is a wide and varied job with lots of opportunities.

So if you’re just about to leave school and looking to the future, or if you’re ready for a career change, why not consider nursing? This is a rewarding and hugely important profession that makes a difference to people’s lives every single day. If my experience is anything to go by, it’ll be one of the best decisions you will ever make.

Supporting the Freedom to Speak Up

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Posted on 13 Feb 2015 by Amy Lee
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Thank you

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Posted on 16 Jan 2015 by Alison Parker
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As I’m sure you are aware many hospitals across the country are experiencing high demand for emergency care due to the additional pressures that winter time brings, and this too has been the case at Doncaster and Bassetlaw hospitals.  As Chief Executive, I wanted to express my sincere appreciation to our staff, volunteers and partner agencies all of whom have gone that extra mile to make sure that all our patients have been seen and are receiving the right care, by the right team.

The sheer determination of our staff to give patients the highest standards of care under such pressure has been exceptional. I am very proud to be part of such a dedicated and talented team.

The whole health and social care community pulled together and all played their part in keeping services running effectively. Thank you to DMBC Social Services, Nottinghamshire County Social Services, Doncaster and Bassetlaw CCGs, Local GPs, Bassetlaw Health Partnerships and Rotherham Doncaster and South Humber NHS Foundation Trust for all your support to help ease the pressure on our Emergency Departments during this busy time.

I am conscious, however, that winter has many more weeks to run and therefore it remains essential that you continue to Choose Wisely and seek advice from general practitioners, pharmacies and the NHS Advice Line 111, which helps our emergency staff concentrate on the seriously ill patients.

Mike Pinkerton
Chief Executive – Doncaster and Bassetlaw Hospitals NHS Foundation Trust

FINDING A SOLUTION TO PREVENTING FALLS IN HOSPITAL

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Posted on 07 Apr 2014 by Gillian Pickersgill
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Go easy on the salt and prevent stroke

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Posted on 19 Jun 2013 by Gillian Pickersgill
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We have all heard the saying take with a pinch of salt, and although a small amount of salt is fine as part of a healthy diet, too much can increase your chances of having a stroke.  Despite being a largely preventable condition, stroke is still the third most common cause of death in the UK, with around 150,000 strokes and mini-strokes (TIAs) each year.  Making small life-style changes, like cutting down on the amount of salt you eat, will go a long way towards protecting yourself against having a stroke in the future.

Reducing the amount of salt we eat is not as easy as you might think.  A staggering 75-80% of our total daily salt intake is already hidden in the everyday foods we buy.  Foods like canned and packet soups, sauces, baked beans, pork pies, pizzas and ready-made meals all contain high levels of salt.  Adults need less than 6g of salt, about a teaspoon, a day but we are eating far more than we need: around 7 to 10g a day.

Why is salt so bad for us?  Too much salt can increase our risk of developing high blood pressure which can lead to a stroke, heart attack or heart failure.  Salt slowly raises our blood pressure and as we get older our blood pressure tends to rise anyway.  Going easy on the amount of salt you eat will greatly help to lower your blood pressure and reduce your chances of having a stroke.  The same is true for children because blood pressure first starts to rise in childhood.

So, the next time you are in the supermarket, take a minute or two to look at the salt content on the food labels.  You know you are eating too much if the label says 1.5g or more.  A small amount of salt is 0.3g or less.  Salt often appears as sodium on food labels, so 6g of salt is the same as 2.5g of sodium.

Here are some tips to help you to reduce the levels of salt in your diet:

Try to avoid salty toppings when eating out or having a takeaway, for example cheese, pepperoni or bacon on pizzas and burgers. 
• Go for plain rice: it is actually lower in salt than egg-fried rice or pilau rice.  It is not easy to break the salt habit. 
• Try not to add salt to your food while cooking or at the table; instead add mixed herbs or spices to give your food more flavour.  If you must season your food use black pepper: you can try it on pasta, scrambled egg, fish and soups. 
• Avoid salty snacks like crisps and opt for healthier options like fruit. 
• Go easy with the soy sauce, mayonnaise and ketchup as these can be high in salt too.  Try the unsalted or low salt options in the foods you buy. 

Salt is also found in some breads, breakfast cereals and in cakes and biscuits too.  Ideally you should try and have a balanced diet containing fresh fruit, vegetables, starchy foods like potatoes, pasta and rice and less fat, salt and sugar.

Give yourself time to adjust to your new lower salt levels.  This is because during the first couple weeks you may find that foods tend to taste bland, but you will soon start to taste the real and delicious flavour of natural food.

On a final note, remember it is YOU who have the power to minimise your chances of getting a stroke.  So go easy with the salt and you really will be doing yourself a big favour.  You can find further information about salt and its impact on your health on the Consensus Action on Salt and Health website http://www.actiononsalt.org.uk/.


Barbara Kitson
Stroke Specialist Dietitian
Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Creating a dementia-friendly environment for patients

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Posted on 24 May 2013 by Heather Akroyd
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Dementia is a condition that affects the memory, personality, behaviour and mood of a growing number of mostly older people in society.  One in three people over 65 will develop dementia and this number is increasing as we live longer.  Currently there are over 800,000 people living with dementia in the UK and this number will double in the next 25 years.  

Dementia can develop slowly over many years, as with Alzheimer’s disease, or it can happen more suddenly through a series of tiny strokes as in vascular dementia.  Although both forms of dementia become worse over time and are incurable, much can be done to prevent the physical and psychological decline that frequently accompanies the disease.   

Maintaining social contacts, physical activity, good diet and outside interests are all ways to help people with dementia retain as much of their independence as possible.  In Doncaster and Bassetlaw there are a number of ‘dementia cafes’ that people with dementia, their family and carers can visit to socialise and learn different coping strategies.  

For those who need hospital care, Doncaster and Bassetlaw Hospitals is taking part in a major programme to improve the quality of care given to people with dementia.  We’re doing this in collaboration with Doncaster Metropolitan Borough Council, Rotherham Doncaster and South Humber NHS Foundation Trust, Age UK, The Alzheimer’s Society and the Yorkshire Wildlife Park to name but a few.   

In January 2013, we opened the first specialist delirium and dementia unit in South Yorkshire, called the Mallard Ward.  On the ward, we treat patients who have delirium as well as those with dementia.  Delirium differs from dementia because it is acute state of confusion, which usually lasts for short periods, often caused by an infection, dehydration or medications.    

The Mallard Ward is part of the Gresley Unit at Doncaster Royal Infirmary and it aims to prove that excellent, high-quality care is achievable in the NHS in a safe, low-cost and sustainable way.  Simple improvements in lighting and signage on a ward and some additional training for staff go a long way to improve the experiences of people with dementia, helping them to keep their independence for as long as possible.  

We are very proud that since opening, the Mallard Ward has had no cases of C difficile or hospital-acquired infection and it has the lowest rate of antibiotic prescribing in the Trust.  The ward also has a low rate of falls and pressure ulcers.    

The Mallard Ward’s dementia-friendly environment is clutter-free with bright, clear signs.  There are pictures on the walls and all the rooms have clocks with dates.  There are also ‘reminiscence’ books on the ward for patients to read.   

Meal times are sociable occasions with patients eating their meals together in a dining area with china cups and coloured beakers.  Old time music is played throughout the ward giving it a more relaxed atmosphere with a home-from-home feel.  Patients and their families are welcomed onto the ward.  Staff are trained in good communication skills, making sure that patients with dementia are treated with courtesy.   

The whole ward philosophy is to make patients with dementia feel valued and good about themselves.  This is very important because when a person with dementia finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support.     

For more information about dementia, visit www.alzheimers.org.uk and www.scie.org.uk. 

Rod Kersh

Consultant Physician in Medicine for Older People / Clinical Director for the Care of Older People, Rehab and End of Life Care

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Our £7m investment in extra beds and staff

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Posted on 16 May 2013 by Gillian Pickersgill
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Hospitals across the country have been busier than ever this year as the number of people needing emergency treatment or admission to a ward keeps rising.

Although some could have been treated elsewhere for minor or non-urgent conditions, there’s been a notable rise in the number of seriously unwell patients who really do need hospital care. The majority are frail older people, often with long-term conditions like heart or lung disease.

This has placed pressure on most English hospitals and, at times, patients have waited longer than they should for a bed. Only 18 of the 143 English hospital trusts achieved the national target for treating 95% of A&E patients within four hours in January to March 2013.

Doncaster has been no exception, which is why we’re so determined to take action. These aren’t empty words: we’re putting our money where our mouth is and investing £7m this year in additional nursing and capital schemes to increase capacity and provide better quality facilities for patients.

The £7m comes on top of investment this winter in purchasing new equipment and increasing bed numbers. We’ve analysed changes in the number and nature of hospital admission and identified how we can increase capacity and pay for the extra staff to care for these patients.

By autumn we’ll have about 60 more beds at DRI. Significantly, our Trust headquarters are being converted into a 19-bed ward – my office, like those of the other directors, will be occupied by patients.

We’re recruiting lots more nurses between now and autumn. Nurse-to-patient ratios are also being reviewed, as many patients now have more complex needs – for example, a number have dementia and require one-to-one care.

The money is coming from cash reserves and capital, thanks to the way we’ve reined in spending on areas other than patient care and improved efficiency. Our local GP-led clinical commissioning groups have been very supportive throughout.

Hospitals don’t operate in isolation – we’re part of the wider network of health and social care and are working closely with them on ways for people in Doncaster to access support outside hospital, as well as in it.

We’ll need to keep adapting our services in response to changing demands and new treatments and technologies but our £7m investment should make a tangible difference to patients by reducing waiting times, increasing nursing numbers and improving the whole experience of being in hospital. 

Mike Pinkerton
Chief Executive
Doncaster and Bassetlaw Hospitals NHS Foundation Trust

 

Research and Development - Why it's so important

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Posted on 25 Apr 2013 by Gillian Pickersgill
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Ovarian cancer - Remember the symptoms

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Posted on 25 Apr 2013 by Gillian Pickersgill
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In the UK one in every 50 women will develop ovarian cancer during their lifetime, but only 4% of women in the UK actually know what the symptoms are.  In the Doncaster, Worksop and Retford areas around 40 women are diagnosed with the disease each year.  We want to reduce this number even further and this is why during the recent Ovarian Cancer Awareness Month staff at Doncaster Royal Infirmary put together an information stand located in the Women’s and Children’s Hospital to help raise awareness of this disease and the signs to look out for.   

Ovarian cancer is a cancerous growth arising from the ovary and in some cases the fallopian tubes.  It usually occurs in women over 40, but sometimes younger women can develop it, and this is why women of all ages should be aware of the symptoms of this disease.  The problem with ovarian cancer is that more often than not there are no symptoms or signs early on.  Even when they are present they may be so vague that they go unnoticed for several months. 

So if you have any of the following on most days, which are not normal for you, it’s important to see your GP to get them checked out. 

Here’s what to look out for: a swollen tummy, the need to wee more, tummy pain and always feeling full.  It’s also important to remember that some of the signs of ovarian cancer are very similar to those in more common conditions, such as irritable bowel syndrome.  This is why it’s hard to diagnose.  However research has shown that when these occur frequently, for example on most days or more than 12 days a month - this may suggest ovarian cancer.   So if you are experiencing persistent pelvic or stomach pain, increased stomach size, frequent bloating, (but not the bloating that comes and goes), difficulty eating and feeling full quickly, then ask your GP about ovarian cancer.  Your doctor will arrange for you to have a blood test and an ultrasound scan of the reproductive organs and ovaries.  

It’s easy to forget how often these signs occur and it’s handy to keep a symptom diary to record exactly the type and frequency when they occur.  It just makes it a lot easier to explain to the GP.  You can download a symptom diary from the Ovarian Cancer Action’s website at www.ovarian.org.uk/download/symptom_diary.pdf or call them on 0300 456 4700 for a copy.

If you are worried about any of the symptoms we have mentioned and want advice please call us at Doncaster Royal Infirmary on 01302 366666 extension 4673. 

Jo Mann

Clinical Nurse Specialist, Maternity and Gynaecology Services

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Sandra Nevett

Staff Nurse, Gynaecology

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

 

 

 

Focus on Montagu Hospital

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Posted on 25 Apr 2013 by Gillian Pickersgill
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Harmfree care for all our patients

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Posted on 25 Apr 2013 by Gillian Pickersgill
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FOCUS ON DONCASTER ROYAL INFIRMARY

HARMFREE CARE FOR ALL OUR PATIENTS

We’re into the second week of our first ever Harmfree Care Month and it’s certainly creating a lot of enthusiasm among our staff, who are busily sharing best practice to promote safe, effective, harmfree care in our hospitals.

What do we mean by harm? When patients come into hospital, they usually expect excellent treatment that makes them feel better. They don’t expect to pick up an infection, or get a pressure ulcer or blood clot or even injure themselves as a result of a fall in hospital. All these things cause unnecessary harm and most are avoidable and that’s why we decided to hold a Harmfree Care Month, running from 12 November to 14 December, to raise awareness with our staff.

Harmfree Care Month builds on the good work done during our previous campaign to tackle pressure ulcers, called the ‘100 days to make a difference’ campaign. As well as raising awareness of how to prevent, identify and manage pressure ulcers, we also carried out work to ensure pressure-relieving equipment that helps prevent them occurring is in the right place at the right time. We have also introduced a new electronic tool to streamline pressure ulcer reporting and to automatically trigger a referral to our tissue viability team where appropriate.

Now during Harmfree Care Month we are pulling out all the stops and sharing best practice, guidance and information between staff, patients and visitors, further raising awareness of how to prevent avoidable harm. We are holding study days, workshop and roadshows on topics ranging from the common stomach bug norovirus (sometimes known as winter vomiting disease), to ‘intentional rounding’, where nurses do ‘rounds’ of their ward at regular intervals to check how each patient is feeling), to making sure staff understand when to escalate care because a patient is deteriorating.

Our tissue viability team (who specialise in pressure ulcers) and link nurses have been out and about promoting key messages on how to prevent pressure ulcers and we have been holding drop-in sessions across our hospitals in support of the World Wide STOP pressure ulcer day (16 November). Similarly, our Infection, Prevention and Control team have been busy spreading the word about the importance of hand-hygiene, which is the single most important thing you can do to prevent the spread of norovirus and C difficile.

Over the last month, we have been deep-cleaning our wards at DRI and Bassetlaw with hydrogen peroxide vapour to reduce the risk of patients developing C difficile by killing any spores of this very harmful bug that might be in the environment. This goes hand in hand with rigorous day-to-day cleaning, good hand hygiene and other steps such as ensuring antibiotics are prescribed appropriately.

We are also a member of NHS Quest, a group of leading hospitals that are committed to improving safety and quality of care by sharing their expertise and learning from each other.  In addition to our senior team’s involvement with NHS Quest, we are encouraging all staff to access the tips and guidance on the NHS Quest website.

Harmfree Care Month runs until 14 December and it has really created a buzz around our hospitals, which is just the start of our increased focus to strive for harmfree care for all our patients.

Deborah Oughtibridge

Deputy Director of Nursing & Quality

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Mike Pinkerton, Chief Executive

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Posted on 25 Apr 2013 by Gillian Pickersgill
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Mike PInkerton for Retford Times

Life in the NHS is never dull.  You’re working alongside colleagues who are committed to doing their best for patients, people caring for patients at some of the most joyful and sad times in their lives.  Continuous advances in medicine mean we can treat conditions that would have been fatal just a decade or so ago, and there are fresh challenges and opportunities each day.

As a local resident, I care passionately about the quality of all NHS services in this area.  As the ‘chief executive-to-be’ of Doncaster & Bassetlaw Hospitals NHS Foundation Trust, which provides much of this care, I have the responsibility of making sure we deliver that high quality.

I’ve worked in this area for many years – firstly, at Bassetlaw Hospital, then at Doncaster & Bassetlaw Hospitals, and most recently at Rotherham, before returning to Doncaster & Bassetlaw this June – so I know it well and have some understanding of local health needs.

Following the firm commitment we made last year to maintaining and developing services at Bassetlaw Hospital, we invested heavily in improving facilities there, including a total refurbishment of the Emergency Department incorporating special facilities for children.

We’re now looking ahead and thinking about how we will care for the people in Bassetlaw, Doncaster and the surrounding areas over the next five years.

We’re looking at our principles and how we provide safe, effective care; how we develop our staff and their skills and expertise; how we use innovation to improve services; and, given the increasing demand for healthcare with an ageing population in a climate of financial austerity, how we can make the best use of taxpayers’ money.

Our vision is to be recognised as one of the best healthcare providers in our class (i.e. a large district general and associate teaching hospital), consistently performing in the top 10 per cent nationally across a range of quality measures. 

We plan to provide more services in community settings and health centres and to work much more closely with other agencies involved in a patient’s care – for example, district nursing and social services – and support general practitioners in their existing role as providers and their new role as commissioners.

We want more patients to benefit from research so we will increase our research activity to help develop innovative treatments that can transform care.

Most of all, though, we want to ensure that every one of our patients gets the same level of care, respect and compassion that we would want for our own families and friends.  We may not get that right 100 per cent of the time, but if we make it the core principle underpinning everything we do, then we will go a long way towards achieving it.  Caring for patients is the reason we exist and we must never forget that.

Mike Pinkerton
Chief Executive (Designate)
Doncaster & Bassetlaw Hospitals NHS Foundation Trust

Your Maternity Services

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Posted on 25 Apr 2013 by Gillian Pickersgill
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In a single year over 5,000 babies are successfully delivered by our Maternity units at Bassetlaw Hospital and Doncaster Royal Infirmary.  With such a large number of babies being born, it’s good to know that the quality and safety of care given has got the seal of approval by the Care Quality Commission (CQC).

The CQC play a very important role in making sure that all health and adult social care meets sixteen national standards of quality and safety.  They have the power to issue fines or warnings and even stop admissions into a care service if these standards are not being met.  That’s why passing CQC inspections is the best way of confirming that your services are of the highest standard.

The way the CQC decides on the quality and safety of a service is by carrying out unannounced visits.  In December of last year, two teams of inspectors from the CQC sprung surprise visits on both our maternity units in Worksop and Doncaster at the same time.   The inspectors rigorously checked all areas of the Trust’s maternity services.  They visited the antenatal clinics, labour wards and postnatal wards, observing the level of care given and speaking at length to both women and staff on the units.

We are pleased to say that both maternity units passed the inspections with flying colours, and what’s more, no improvements were needed.  Having such a positive result is certainly very gratifying for the staff working on the units.  If you’d like to read the CQC reports in full, you can find them on the CQC website at www.cqc.org.uk.

At Doncaster Royal Infirmary the inspectors focused on the way women were treated with dignity and respect.  They found that the care was planned and delivered in a way that ensured the women’s safety and welfare.  The women spoke very highly of their care.  The staffing levels in the unit were safe and met the patients’ need.  The inspectors were impressed with the specialist services available to support teenage pregnancy, antenatal screening, substance misuse and mental health services.

At Bassetlaw Hospital, the inspectors found that the women spoke very highly of their care and support, in particular of the choices and information available to help them make informed decisions about their pregnancy and birth.  It was confirmed that the unit’s staff were well qualified, skilled and experienced to meet the women’s needs. The care and treatment on the unit ensured patients’ safety and welfare, and that staff effectively assessed and monitored the quality of the service.

Having received such excellent feedback from the CQC is a great boost for the staff on both maternity units.  It’s also a reassurance to the women who use the units that their care meets the national standards of quality and safety.

As well as providing maternity services in Bassetlaw Hospital and Doncaster Royal Infirmary, we have services available in the local communities, for example in health venues and children’s centres.   

Women today have a vast array of choices for their labour and delivery.  Our midwives support and give advice on the option best suitable for individual women based on their health needs.  If a woman is fit and well and has a straightforward pregnancy, then they can have the choice of a home birth, fully supported by midwives.  However, if a hospital birth is preferred, our midwives do their utmost to make sure it’s a ‘home-from-home’ experience, with options available for aromatherapy and the birthing pool to bring a sense of wellbeing and relaxation during the birthing experience.  

Helen Burroughs                                                Andrea Squires

General Manager – Compliance                        Patient Safety Midwife

Doncaster and Bassetlaw Hospitals             Doncaster and Bassetlaw Hospitals

 

 

 

 

 

Community Midwifery

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Posted on 13 Mar 2013 by Gillian Pickersgill
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You may have seen the television programme Call the Midwife and witnessed the trials and tribulations of community midwives working during the 1950s. The programme is based on the book written by Jennifer Worth, who worked in the London docklands in the 1950s, and it has certainly caused many mothers and grandmothers to remember their own birth experiences – recalling in detail how the midwife arrived, sometimes on her bicycle, to support them during their home births.

Times have certainly changed since the 1950s when around 35 per cent of women in the UK had their babies at home. Today it’s fewer than four per cent and in our own local Doncaster and Bassetlaw communities there are less than two per cent of women who choose to have their babies at home.

The role of our community midwife remains the same.  They are there to support women in their right to choose to have their babies where they feel most comfortable.  There is evidence to suggest that, for second or third pregnancies, it’s just as safe for women to deliver their babies at home as it is in hospital.  Women who are fit and healthy and who are expecting their first baby can also choose to have a home birth.

These days the midwife is more likely to arrive in a car than on a bicycle, but the same principle applies – they are there to support women giving birth at home and a home birth is a great privilege for any midwife.  The following story highlights this privilege and we wanted to share it with you.

Community Midwife Sarah who was on-call was contacted in the early hours of the morning by the Labour Ward.  Expectant mum Ivy*, who was booked to have a water birth at home, had contacted the Labour Ward to say that she was having contractions every four minutes and they were getting stronger. 

Sarah quickly got ready and arrived at Ivy’s house to be greeted by her husband, Mark*, at the door.  He welcomed her in and Sarah entered the living room to find Ivy sat on her birthing ball in the midst of a contraction.  Sarah assessed both Ivy and her baby’s wellbeing and confirmed that Ivy was in labour.  She then contacted the second midwife on-call to attend and encouraged Ivy to get into the birthing pool.

Ivy managed her contractions very well; soft music was playing in the background and she described feeling very relaxed in the water between contractions. Shortly after the second midwife arrived, Ivy gave birth to a baby boy who they named Ethan.  Sarah passed Ethan* immediately to Ivy where he nestled against her warm skin, and found his way to her breast for his first feed.  A few minutes later, having heard a baby cry, their daughter, Sophie*, came rushing down the stairs to meet her new baby brother.  After making sure that mother and baby were well, both midwives left the new family together to become acquainted.  

A homebirth can be a wonderful and beneficial experience for many women and their families.  If you would like more information about home births, please contact your community midwife or Debby McKnight, Community Midwifery Manager, at debby.mcknight@dbh.nhs.uk.

Women who choose to breastfeed their babies will receive support from the community midwives and maternity support workers either at home, or at their local children’s centre following birth.  Breastfeeding helps women to give their babies loads of health benefits, including protecting them from infections and diseases, and helping to build a strong and emotional bond between mother and baby.

If you would like further information about the maternity services in Doncaster and Bassetlaw, please use the following link at http://www.dbh.nhs.uk/our_services/Womens_and_Maternity/maternity_obstetrics.aspx 

*Names have been changed to protect patient confidentiality.

Debby McKnight

Community Midwifery Manager

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Breastcare Unit

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Posted on 13 Mar 2013 by Gillian Pickersgill
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October is breast cancer awareness month, and it is just over a year ago that the newly-modernised Diana, Princess of Wales Mammography Unit at Bassetlaw Hospital reopened its doors to patients, following the generous contributions from the public Breastcare Appeal of £350,000 towards the £1.2million development.

Affectionately known as the Breastcare Unit, we provide a regular routine screening service to local women between the ages of 50-70. We are starting to expand this age range to include all women between the ages of 47-73, in line with the National Breast Screening programme. We invite women to have a three-yearly mammogram (a breast x-ray) to detect any early cancer or pre-cancerous problems, which are too small to notice yourself. Once detected, we can treat these problems quickly, resulting in excellent outcomes. Since opening, we have screened around 5,500 women and expect to screen 18,000 women over a three-year period.

We also see ladies who are referred by their GP with a problem to our clinics. These clinics not only detect early breast problems but also help to support and reassure worried women.

We use the triple assessment protocol, which consists of a clinical examination, a mammogram, and/or ultrasound and needle tests if necessary. Please remember that not all breast problems turn out to be cancer, some are benign (not cancer). It’s best just to make sure and that’s why we provide a triple assessment so that women get the best possible care.

Breast cancer is one of the most common cancers affecting women all over the world and there is strong evidence that early detection and early treatment is improving the survival rate. In Bassetlaw, we have found that although the number of new cases of breast cancer diagnosed is the same as in other parts of the country, the survival rate one year on is lower. We think this is probably due to women waiting too long to see their GP if there is a change in their breast. This is why it’s important to be breast aware. Being breast-aware means getting to know your breasts – how they look and feel – so if an unusual change happens you will notice it sooner and be more confident about going to see your doctor.

After gender, the biggest risk factor is increasing age with around 81 per cent of breast cancers occurring over the age of 50. Men can also get breast cancer and although it’s very rare, they too need to get any changes checked out by a doctor.

If you notice any changes in your breasts don’t delay – please see your GP immediately. If you are within the age range for breast screening, I urge you to make the time to attend your screening appointment; early detection gives a better chance of successful treatment and full recovery. Don’t worry if you have missed your last breast screening appointment or if you are over the age of 70 years, and haven’t been screened within the last three years and want to self-refer. Just telephone the unit on 01909 502193 to make an appointment.

Mr Kadappa Kolar

Consultant Surgeon/ Lead Clinician Breast

Doncaster and Bassetlaw Hospitals

MUSCULO-SKELETAL SERVICE

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Posted on 13 Mar 2013 by Gillian Pickersgill
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Experiencing discomfort from aches and pains in your muscles and joints can be very frustrating. These ‘musculo-skeletal’ problems – including lower back pain, knee pain, tennis elbow, shoulder pain and carpal tunnel syndrome – may develop through sports activities, gardening or even playing a musical instrument. They can also develop over time in your work place or from an injury due to an accident.

The health problems they cause can range from mild discomfort to severe pain that seriously affects someone’s ability to do simple everyday things, as well as their quality of life.

At times, they may need to see a specialist, such as an orthopaedic physiotherapy practitioner – a physiotherapist who has undergone additional postgraduate training and is therefore qualified to work in an extended role, including referring patients for scans or to see consultant surgeons.

That’s where our Musculo-Skeletal Clinical Assessment & Treatment Service – called MSK CATs for short – can help.  Since launching a year ago, we have been successfully seeing, assessing and treating people at Bassetlaw Hospital and Retford and Harworth Primary Care Centres and currently see around 48 new patients each week. 

Our waiting times are very short – most patients are seen within two weeks of referral from their GP and we offer some early morning appointments (from 7.45am) and evening slots (5.45pm) as well as during the usual office hours, Monday to Friday. 

The team consists of three orthopaedic physiotherapy practitioners and a GP with a special interest in orthopaedics. We also work closely with the consultant orthopaedic surgeons and discuss cases so we can make sure patients see the right person the first time.

Every new patient referred to us has an initial 30-minute assessment so they can fully explain their problem. Trying to describe something you can’t see, like an ache or pain, can be difficult so it’s really important we spend this time at the beginning with patients so we can fully understand the nature of their condition. 

It also means we can then advise them of the likely diagnosis, treatment and anything they can do themselves to help – for example, exercises to strengthen and support the joints, losing weight or stopping smoking. 

We can also provide corticosteroid injections except spinal ones.

If patients need an X-ray, MRI, ultrasound scan or nerve conduction studies, we will refer them for these tests. We can also refer patients to other specialist health services – for example the musculo-skeletal outpatient physiotherapy team, podiatry, occupational therapy and to consultant doctors in orthopaedics, rheumatology, neurology and other specialties. It truly is a seamless service.

We know you can’t always change your job or stop doing the things you like, and of course accidents will happen. However, if you have already seen your GP and your musculo-skeletal problem doesn’t seem to be responding to the usual care, don’t grin and bear it. Ask your GP if they think you’re suitable for referral to the MSK CATS clinics.

Heather Jackson

Clinical Lead, Physiotherapy Practitioner Services/MSK CATS

Doncaster and Bassetlaw Hospitals

Specialist diabetic foot clinic

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Posted on 13 Mar 2013 by Gillian Pickersgill
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Are you one of the three million people with diabetes in the UK? It’s a fact that diabetes is on the increase both nationally and globally. In the last year alone, 117,000 individuals were found to have diabetes in the UK.

If you have diabetes, then as well as reducing the risks to other organs, you need to pay special attention to your feet. As a consultant physician with a special interest in diabetes, I cannot tell you how difficult it is to warn someone that they may be at risk of losing a foot because of diabetes.

That’s why I want to tell you about a new service at Bassetlaw Hospital, the specialist Diabetic Foot Clinic. It’s aimed at people who have diabetes and are at risk of foot problems, including ulcerations and deformities. With careful monitoring and treatment, the clinic helps to prevent amputations.

We’ve been running the clinic since the end of last year. So far 75 patients have benefited from the service, and they have told us how much they value it.

I am very proud to be part of this exciting team providing a ‘one-stop’ diabetic foot service to the people of Worksop and the surrounding areas. The clinic team consists of a podiatrist, orthotist (a specialist in braces, splints and custom shoe insoles), diabetes specialist nurse, clinic nurse, a consultant and our receptionist. Having all these specialist health professionals in one place means a faster and more efficient service for patients, fewer hospital appointments and more professional input into their treatment. For us as health professionals, we can quickly consult each other and make decisions about the patient’s care and treatment. It’s a win, win situation.

You may be thinking ‘why I should worry about my feet?’ Well, over time high blood sugar can damage the nerve endings, leading to a loss of sensation or feeling in the feet. Imagine not being able to feel pain caused by something in your shoe or your shoes rubbing; this is what happens to people with diabetes. The damage caused quickly leads to ulcerations that take longer to heal; it can also result in foot deformities. Diabetes can lead to narrowing of the blood vessels causing poor circulation. This is one of the reasons why it can take some time for the ulcers to heal.

By keeping a watchful eye on your feet, you can quickly spot any signs of damage before they develop into something more serious.

We want to prevent patients experiencing the devastating physical and emotional effect of having a foot amputated and that’s why the clinic targets those patients at high risk of possible amputation. So, if you have diabetes and notice any cuts or damage to your feet please see your GP immediately.

Here are some helpful tips to keep your feet healthy.  Firstly, please do not walk around in bare feet; this is where most damage is caused.  Always remember to check your shoes carefully for foreign objects before putting them on and turn your socks inside out to prevent the seams rubbing against your toes. Most importantly, you must remember to check your feet regularly, especially the bottom of your soles. If you have trouble lifting your leg, place a mirror on the floor; it’s an easy way to see the soles of your feet – it really does work.

Dr Ram Kela

Consultant Physician with a special interest in Diabetes and Endocrinology

Doncaster and Bassetlaw Hospitals

Just a cough?

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Posted on 13 Mar 2013 by Gillian Pickersgill
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The Government’s hard-hitting ‘Be clear on Cancer’ campaign focuses on the importance of getting any unexplained cough lasting more than three weeks checked out by a doctor quickly.

In this country, very few people are aware of the symptoms of lung cancer; this is a real concern, especially when you learn that lung cancer is the biggest cancer killer in the UK for men and women.  Here, in our local communities, we are 50% over the national average for people with lung cancer, so you can understand why this is a top health priority for us. These high numbers reflect our smoking rates over the years but even non-smokers are at risk. Lung cancer is also quite rare in younger people, with most patients being older than 50.

Unfortunately many cases are not curable when they come to attention and this may be because people don’t recognise the early, mild symptoms as a cause for concern. One of the earliest symptoms of lung cancer is a cough. There is evidence that people acting on a cough and getting a chest X-ray have a much better outlook compared to those who see us with other symptoms.

So back in 2009, we began working with NHS Doncaster in a groundbreaking public awareness campaign, called the ‘Cough, Cough’ campaign – which has now been adopted by the Government in their national lung cancer awareness campaign.

The ‘Cough, Cough’ campaign targeted both the public and GPs. It raised public awareness of the symptoms of lung cancer and the benefits of early detection. It also encouraged people with a cough to ask their doctors for a chest X-ray.  For GPs, the campaign focused on encouraging GPs to refer the right people for chest X-rays.

Most people would go to their GP if they were coughing up small spots of blood, but there are other signs - for example, a cough that lingers for three weeks or longer, or a change in a cough - which are less obvious. If you have any of these, it’s best to get it checked out by a doctor. Also, did you know that if you are concerned about your cough, you can ask your GP for a chest X-ray? It’s safe, and if we do find lung cancer, the sooner we know about it, the earlier and easier we can treat it. On the other hand, most coughs turn out to be benign and a normal chest X-ray can be reassuring.

Here are some statistics to think about - the UK has a five-year survival rate of just 9%, compared to 11-16% in other Western European countries. A massive 65% of people diagnosed with lung cancer are already in the advanced stages of the disease.  In the year following the 2009 ‘Cough, Cough’ campaign, the number of chest X-rays increased by 20% and new lung cancer diagnosis went up by 27%. We also found more cases with curable disease. This is a great reflection of people working within your local health services to make sure that you continue to receive high quality services that match your needs. The Trust has led the way nationally in this groundbreaking work.

Remember, don’t delay if you’ve had a cough for over three weeks, please see your doctor, and ask for a chest X-ray too. If we know about it, then we can do something about it – together.

Dr Trevor Rogers

Consultant Chest Physician

Doncaster and Bassetlaw Hospitals

Anti-Psychotic Medicines and older people

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Posted on 13 Mar 2013 by Gillian Pickersgill
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Many people will have watched the 1975 film, One Flew Over the Cuckoo’s Nest, starring Jack Nicholson as a disturbed man admitted to a psychiatric hospital in America during the 1950s.

It was during the 1950s that medicines called anti-psychotics were discovered in Europe and America. The medicines were revolutionary at the time in helping people suffering from psychotic conditions such as schizophrenia and bipolar disorder. The movie demonstrates the potential negatives with Jack Nicholson’s character ultimately receiving a frontal lobotomy to control his symptoms.

Thankfully, healthcare has progressed massively since that time, with better understanding and treatment of mental disorders in hospitals and more particularly in the community.

We also know that our society has changed; this is especially so with the increased number of people suffering from mental health disorders linked to non-psychotic illness. Better health and social care means that people are living longer, resulting in an increase in conditions associated with ageing, in particular dementia. Today, approximately 700,000 people are living with dementia in the UK, and this number is set to double over the next 30 years.

Some of the fantastic work undertaken by the Alzheimer’s Society and other voluntary organisations has helped both patients and their carers significantly. Unfortunately, however, there can still be a lack of understanding within the health and social care communities as well as the population at large as to the causes, symptoms and options for supporting people with dementia.

Every year in the UK, it’s estimated that 180,000 people receive powerful anti-psychotic medicines to treat agitation and distress that can be symptoms of dementia. Not only can unnecessary prescription of these medicines mean that symptoms of pain, anxiety and distress can be masked, they have also been shown to significantly increase the chances of both stroke and death in older people.

At Doncaster and Bassetlaw Hospitals, we are working closely with colleagues from Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) to reduce the numbers of patients receiving these medicines in the community and in hospital.

We have redesigned the treatment pathway for patients and regularly carry out audits to improve patient care and outcomes. Education of staff is a key priority, giving them the insight and capability of interpreting symptoms quickly. We have also developed the clinical service unit for older people, and together with RDaSH, have appointed a team of five full-time older people’s mental health nurses. All these initiatives play an important role in significantly reducing the use of anti-psychotics for our patients.

Dr Rod Kersh

Clinical Director Older People, Rehabilitation and End of Life Care

Emergency Department

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Posted on 13 Mar 2013 by Gillian Pickersgill
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You may have noticed the improvements to Bassetlaw Hospital’s Emergency Department, as part of an extensive development to provide 21st century services.

My name is Juan Ballesteros. I am the Clinical Director for Accident and Emergency, and I want to let you know about these exciting improvements, which started last October, and are due for completion this summer.

The Department was originally designed to treat around 15,000 new patient attendances a year, but now that figure is more like 48,000. It was apparent that significant investment was needed to improve the environment and facilities for our patients. The first phase of the development cost £900,000 and saw the completion of a brand new emergency entrance and ambulance canopy, and a bigger and brighter waiting area for patients. Leading off from the waiting area, we now have three ‘See and Treat’ rooms where patients with minor injuries are seen, assessed and if necessary treated – this is a much more efficient service.

Also included in the first phase of the development was the creation of a three-bay Resuscitation Room, consisting of a dedicated paediatric bay, a critical care bay and a trauma bay.  All these bays are used flexibly to accommodate ill or injured patients of any age. This is vitally important because of the nature of the work that we do, and we now have the ability to adapt more quickly to the clinical needs of the patient. Another advantage of the new Resuscitation Room is its lead lined walls and lead curtains between the bays, which allows staff to view X-rays and the results in the room rather than moving the patient to the X-ray Department. Again, time is a critical factor and all these facilities contribute to achieving the best possible outcomes for critically ill patients.

We can now look forward to starting the second phase of this exciting development following the approval of a further £145,000 for a purpose-designed children’s area. Work is due to start on a separate children’s waiting area, play area, toilets and three examination rooms. Coming into the Emergency Department can be traumatic for children and their parents, and having this dedicated children’s area will help to reduce the anxiety that children and their parents can feel.

All these improvements are designed with the aim of achieving the maximum clinical benefits for our patients. To help us improve this still further, I am asking for your continued support in choosing wisely before coming to the Department. Ask yourself if the Emergency Department the best place to go with cold and flu symptoms or other mild conditions. In a typical day, my staff can see around 60 majors (life threatening cases) and this is our top priority, so please consider other alternatives, for example GP Surgeries, Walk-in Centres or pharmacies for advice on treatment.

As Clinical Director, I am pleased to be part of the Trust’s Emergency team and this development gives Bassetlaw Hospital and local residents a 21st century Emergency service to be proud of.

Mr Juan Ballesteros

Clinical Director/Consultant in Emergency Medicine

A&E, Unplanned Care Centre, Out of Hours Clinical Service Unit

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