June 2019
Hello and welcome to H1, named after our new hospital bus route - a briefing designed to make sure that you and your colleagues are kept up to date with the latest news and activities at Epsom and St Helier.
A welcome from Chief Executive Daniel Elkeles
I am delighted to be able to report that in June the Trust received news that it was named in a national  BBC report  as one of the top 10 trusts for providing cancer care within the expected 62 days. Over the course of the last financial year, we achieved all of the cancer waiting time standards - including seeing patients with suspected cancer within two weeks of referral, providing first treatment within 31 days after diagnosis and ensuring that patients receive treatment within 62 days from the moment they  are referred to us by a GP. 

There was never any doubting that this  was a really strong performance, but this national picture makes the achievement even clearer. Seeing patients with confirmed or suspected cancer in a timely way is absolutely vital, and it makes a very real difference to our patients and their worried loved ones. 
Improving Healthcare Together
You may have already been notified but as we are sending out this Partnership Update, I was delighted to see that the Improving Healthcare Together programme has published the report from the independent Clinical Senates of London and the South East, following their review of the proposals for Epsom and St Helier hospitals, and the second phase of the draft independent interim Integrated Impact Assessment. I welcome both reports as these provide a great deal of evidence which the clinical commissioning groups and programme can consider as the draft pre-consultation business case  is further developed. 

The Clinical Senates independent advice and recommendations  will help clinical teams shape the proposals for major acute services at Epsom and St Helier. The Senates have commended the programme for our drive and initiative in developing such an innovative solution to the three key challenges facing Epsom and St Helier hospitals - workforce, estates and financial sustainability. 

The clinical model proposed  will mean we keep the majority of care as local as possible, at both St Helier and Epsom hospitals. The Senates stated clearly that there are significant benefits to bringing together the six acute hospital services (A&E, emergency surgery, critical care, paediatrics, maternity and acute medicine) into a new purpose built facility located on one of the three hospital sites. 

You can read the report on the  Improving Healthcare Together website here

The Integrated Impact  Assessment is focused on four impact assessment areas: 
  • Equality impact
  • Health impact
  • Travel and access impact
  • Wider sustainability impact. 
What is clear from this  work to date is that there are positive impacts across all options for change, as opposed to the do nothing option. Patients are likely to experience improved outcomes arising from:
  • The achievement of workforce standards which promote consultant delivered care
  • Reducing variation through the establishment of seven-day services
  • A model which allows for a critical mass of cases to be undertaken and provides opportunities for sub-specialisation
  • Timely access to co-dependent services as a result of their co-location, in fit for purpose facilities.
However, the interim report also closely considers the particular needs of our patients across the catchment, and has highlighted two groups of patients who have particular needs that must be taken into account by the Improving Healthcare Together Programme. They are the more deprived population within parts of Sutton and Merton and the older population who are more concentrated in the Epsom part of the catchment. The report sets out the particular needs these population groups have.

You can read the report  on the Improving Healthcare Together website  here.
Organ donation
As we entered the month we received a letter from Anthony Clarkson, Director of Organ Donation and Transplantation for NHS Blood and Transplant (NHSBT), thanking us for helping the UK with the ambition of becoming world class in the area of organ donation and transplantation. In 2018/19 from four consented donors, we facilitated two actual solid organ donations resulting in five patients receiving a transplant during the time period. This is in comparison to 2017/18 when we facilitated two actual solid organ donors from three consented donors. We referred 44 patients to NHSBT's Organ Donation Services Team and missed no opportunities to follow best practice. This is something we will be continuing to promote and support as whilst we played our part in 2018/19, there are many more people needing help.
Estates update s
This month has seen periods of extreme weather conditions - persistent heavy rain, weather warnings and localised flooding, as well as heatwave warnings. Although the hospitals have not been as badly affected as in the past, we did not quite make it through unscathed. Following heavy rain earlier in the month we had to close areas at St Helier on A6 and B1 because rainwater entered through the ceiling and ITU was also affected.
Adverse weather was not the only thing keeping the Estates and Facilities Team busy in June; our new vacuum insulated evaporator (effectively a large vacuum flask for storing liquid oxygen) was craned into place at Epsom.

Also at St Helier, the £20 million project to reduce the amount of energy used and to transform the hospital environment for patients took a step forward, as scaffolding to install new ductwork to serve A2 theatres went up between Ferguson House and A block.
Last year we spent a record £49.7 million on improving our facilities and equipment and this year looks to be as busy. In last month's update we focused on the investments being made at Epsom Hospital.  We have an equally demanding programme of improvements taking place at St Helier Hospital - some of which have already been completed and others underway:  
Already completed:
  • New diabetes department (opened July 2018)
  • Expanded nuclear medicine (opened October 2018)
  • New Surgical Assessment Unit (opened November 2018)
  • Expanded A&E department (opened December 2018)
  • External refurbishment of our main Ward blocks (B&C Blocks completed February 2019)
  • Improvements to emergency x-ray department (opened March 2019)
  • Improvements to Endoscopy department (completed April 2019)
  • New renal dialysis department (opened April 2019)
  • New outpatient building (Davis Unit opened June 2019) 
Coming soon:
  • Replacement of old-style internal lights with LED fittings (ongoing- July 2019)
  • New cardiology investigations department (October 2019)
  • Improvements to main x-ray department (December 2019)
  • New green main boilers and combined heat and power plant (ongoing- 2020)
  • New blood-taking department (2020)
  • New renal inpatient ward (2020)
  • New intensive care and high dependency unit (2020)
From next month the Trust will start to receive the first of our new ambulances.  We have invested £2 million into the 48 new vehicles, which will provide our patients and staff with state of the art facilities.
June's news in brief
  • The Renal Team has appointed five clinical matrons
  • The pathology labs have all passed the final United Kingdom Accreditation Service (UKAS) inspection.  UKAS is the sole national accreditation body and recognised by government, to assess against internationally agreed standards, organisations that provide certification, testing, inspection and calibration services.
  • The first Advanced Nurse Practitioner trainee in A&E and AMU has started and we have secured the course fees to train 15 ANPs across the hospital and community for courses starting in the autumn.
  • Our seven day services audit showed that we exceed the national standard for 14 hour reviews (whereby patients must be seen and have a thorough clinical assessment by a suitable consultant within 14 hours from the time of admission) during weekdays and weekends, and we received a note from NHS England to say well done.
  • Renal Services has been nominated for a charter mark for our great training for GPs.
The launch of Surrey Downs Health and Care
1 30 staff from Surrey Downs Health and Care, including GPs, matrons, nurses, therapies and social care, came together at the end of May in a special celebration, acknowledging all we have achieved in the past and what we want to achieve in the future by coming together.
United in the belief that integrated care will be beneficial to the local community, there was a real buzz in the room with people discussing how we can make a difference and the steps we can take to achieve this. All of the ideas and feedback from attendees will be used to help us develop our vision and values as an organisation. 
Inclusivity and learning from our patients
We are committed to working patients and relatives to continue to develop our services. As part of this programme in June we hosted the second of our trans awareness training and development sessions for staff, led by trans awareness and inclusion specialist Jo Lockwood (who you might have seen on Channel 4's The Making of Me) and supported by the wife of one of our patients, Avril. These sessions were arranged after Avril's wife Lucy was an inpatient with us and Avril got in touch and shared their experience. Recognising that there were lessons to be learned, we enlisted her and Jo's help to shape and improve our services.
On the topic of inclusivity, we have held two planning events for the re-introduction of our staff LGBTQI+ network. This complements our Black, Asian and Minority Ethnic (BAME) and disability networks which are already active in hearing from staff on how we can improve and make the organisation a great place to work for everyone.

Celebrating our volunteers
This month we took time out to say a huge thank you to our army of 552 volunteers. During national Volunteer's Week we celebrated their priceless hard work and commitment to our organisation and our patients. You can see our messages of thanks on Twitter, including videos. 
A welcome shelter for Woodcote
Anyone who has ever been caught in the wind and rain while waiting for the 293 bus at the back of Epsom Hospital can breathe a sigh of relief, as the bus stop on Woodcote Road finally has a shelter. The shelter comes courtesy of Epsom and Ewell Borough Council and is thanks to a bid from Cllr Liz Frost.