GP Round Up Introduction by Alistair Flowerdew Medical Director

Transcription

1 GP Round Up Issue 55 October 2014 Contents GP Round Up Introduction by Alistair Flowerdew Medical Director... 1 Observation ward opens in Emergency Department... 2 Orthopaedic Elective Centre to open in January... 2 Virtual Fracture Clinics... 3 New Breast Radiotherapy Technique- Deep Inspiration Breathe Hold (DIBH)... 4 Ensuring Privacy and Dignity during Breast Radiotherapy... 4 Rapid assessment of suspected TIA/minor stroke... 5 Please do not ask patients to ring for pathology results... 6 GP pages on Trust website... 6 How to Raise a Query or Concern... 7 GP Round Up Introduction by Alistair Flowerdew Medical Director Dear Colleagues Welcome to the October edition of GP Round Up. This month I am delighted to announce the opening of 8 observation beds in the Emergency Department for patients who require care for more than 4 hours but do not but do not need to be admitted. We hope that this resource will help us to meet the increase in demand expected over the coming winter months. This edition also includes information about our Orthopaedic Elective Care Centre (which is scheduled to open in January and will have 30 additional beds and 2 theatres), developments in breast radiotherapy and a reminder about our TIA service. This GP Round Up newsletter is sent out to Practice Managers in the local area - please can you forward it on to the GPs in your practice or surgery. 1

2 Observation ward opens in Emergency Department The Emergency Department at the Royal Berkshire Hospital opened a new observation ward on Wednesday. This new facility has 8 observation beds, an interview room suitable for mental health patients, and a seating area. The Emergency Care Unit will continue to function as an ambulatory care area for patients with a NEWS score <5 who we expect to stay less than 24 hours. The new observation ward will be an invaluable asset during the coming winter months when a rise in demand for our emergency services is expected. Orthopaedic Elective Centre to open in January We are pleased to announce that in January 2015 we will open an Elective Orthopaedic Centre consisting of a 30 bedded ward and two additional orthopaedic theatres with recovery area. The Elective Orthopaedic Centre is a brand new facility with a well designed and modern ward consisting of light and airy small bays each with their own bathrooms, for elective orthopaedic patients requiring an inpatient stay after surgery, we will also have a few individual rooms. Royal Berkshire Hospital elective orthopaedic patients will be admitted into an admission lounge and taken directly to the new theatre suite. Following surgery the patients are taken directly to the ward via a lift from the new theatre suite and orthopaedic recovery room located above the ward, thus creating a hermetically sealed facility thereby greatly reducing the chances of post surgery infection. Post surgery the patients will continue their enhanced recovery programme in the new centre supported by our nurses and the newly increased physiotherapist and occupational therapist teams. This is an exciting development for patients and staff alike, providing them with an opportunity to be in a modern facility and be part of an efficient approach for patients undergoing planned surgery and has provided an opportunity to recruit new staff to join our existing experienced teams. Extra elective theatre capacity will help to continue further reduce waiting times for surgery and compliment the very short waiting times for patients accessing our outpatient services. 2

3 The additional laminar flow theatres have provided an opportunity for the department and theatre team to realign theatre allocation within our South Wing Theatre Complex to also provide additional daily emergency theatre capacity to manage patients who have been admitted with a hip fracture. We have also rescheduled our theatres to provide more emergency theatre capacity specifically for upper limb injuries and hand trauma. The Elective Orthopaedic Centre is currently under construction and on target to open at the end of January If you would like to visit the department to see this new facility, please contact the Directorate Manager on direct dial: Virtual Fracture Clinics In April the orthopaedic department launched a Virtual Fracture Clinic in conjunction with the opening of the Urgent Care Centre at Bracknell. This is an innovative approach to managing mobile patients with fractures and is based on the award winning process and protocols developed by the Royal Glasgow Infirmary. Patients attending a Minor Injury Unit, Urgent Care Centre or Emergency Department can be directly discharged from the emergency treatment facility if their fracture is 1 of 6 specific fractures following treatment of the patient s fracture within the Emergency facility and then discharged with written information about their fracture to enable self-care. However for other mobile patients with fractures other than the 6 fractures, their clinical assessments and images are made available to the Orthopaedic Virtual Fracture Clinic MDT at RBFT which is led by an Orthopaedic Consultant. The team review the clinical information and the images and then contact the patient on the day of the review to inform them of next steps. The virtual fracture clinic has worked well for following up patients attending the Urgent Care Centre at Bracknell and we are hoping to extend the service to Berkshire West patients in the near future; we will update you on progress and also let you know when we are able to launch this service for patients in Reading. Next steps Discharge with information to support the patient at home 3

4 Patient booked directly into a specialist clinic (e.g. hand fractures will be booked to see a hand consultant), booked to attend a fracture clinic or directly listed for surgery. This streamlined approach means that patients access the right pathway to manage their injury. Letters sent to both the patient and the GP with the outcome of the Virtual Fracture Clinic assessment. New Breast Radiotherapy Technique- Deep Inspiration Breathe Hold (DIBH) We are currently developing a new technique, primarily aimed at patients receiving radiotherapy to the left breast in the first instance, to reduce cardiac dose. Patients are coached to hold their breath during the planning process and subsequent treatments; the heart is then moved away from the treatment field arrangement during inspiration and the treatment delivered only during this phase of the respiration cycle. Ensuring Privacy and Dignity during Breast Radiotherapy Ladies receiving radiotherapy to their breast will soon be able to wear specially designed gowns that expose only the breast being treated rather than being completely bare from the waist up using traditional gowns. Funding from a charitable donation has made it possible for us to order the new gowns and we hope to have them in use by Christmas. 4

5 Rapid assessment of suspected TIA/minor stroke The Royal Berkshire Hospital operates a daily fast-track Transient Ischaemic Attack (TIA) Service for rapid assessment of suspected TIA/minor stroke cases. We aim to see all high risk cases by the next working day and carry out imaging at the same visit if indicated. Please do not refer other neurological emergencies to this clinic. Patients with persisting monocular visual symptoms should be referred to ophthalmology in the first instance, even if the onset was sudden. Referral Criteria Adult patients (without age restriction), who have had a suspected TIA or minor stroke (including amaurosis fugax). How to Refer Telephone TIA co-ordinator (a senior nurse) on or via RBH switchboard and ask for the TIA co-ordinator. We need to know the patients name, contact details and a brief clinical history (enough for us to establish an ABCD2 score). We will tell you when and where the patient should attend. No referral letter is needed but a printed summary of the medication and patient episodes is very helpful. The TIA co-ordinator will ring the surgery and give the secretary or receptionist a fax number to send this information to. Please do not fax until asked to do so. If the phone goes to voic (the nurse may be in A&E thrombolysing) please leave a message with details and a patient contact number we will call the patient on the same or next day with instructions. Pathway Consultant-delivered clinic with high risk patients seen 7 days a week Brain scan and carotid imaging (usually MRI/MRA) straightaway if indicated Results given and medication prescribed the same day. Vascular surgery opinion as inpatient if carotid endarterectomy indicated The patient should be instructed NOT to drive until they have been reviewed in the TIA clinic 5

6 Please do not ask patients to ring for pathology results This is a reminder that our Pathology Department are not able to give results to anyone other than a healthcare professional. We receive several calls every day from patients who have been told by their surgery to telephone the laboratory directly to obtain results and we have to inform the patient that we are not able to do this. We recognise the drive to make results available to patients themselves but this must be through the surgery IT system. If there is a problem with access to a result please ask your practice staff to call the relevant pathology department so that we can answer the query or resolve any reporting problem enabling you to answer your patient. GP pages on Trust website The Trust website has a new layout and resources for GPs are all in one place under the blue GP tab at the top of the main page. The following links may be found in the GP section: Directory of outpatient services GP secure online resources Clinical and referral guidelines Consultant directory GP query form GP Newsletter Choose & Book Continuing professional development for GPs Patient information leaflets Infection control information 6

7 How to Raise a Query or Concern We welcome feedback from GPs and Practice Managers, so please let us know if you experience any problems with our services. You can get in touch via to [email protected] or by using our simple web form that can be found on the Trust website: Alternatively you can our GP Liaison Manager: [email protected]. or telephone If you wish to send us patient identifiable information with your concern please to: [email protected]. Our Patient Advice and Liaison Team (PALS) focus on providing support and on the spot help to patients, relatives and carers and can be contacted via [email protected] The PALS Team also investigate serious patient complaints. 7