InTouch - June 2012

intouchDEPARTMENT OF HEALTH

Rheynn Slaynt

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Department’s ‘Red Devil’ takes to the skies 9

Your move - Who helps? 17

Small changes make a big difference 21

Issue 92 - June 2012

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Rheynn Slaynt

Editor’s Comment Welcome to the Summer edition.....

Summer is finally upon us, and what better way to celebrate than with an ice cream, a nice cold drink and the summer edition of InTouch. Soon we will be watching the Olympic Opening Ceremony for London 2012 which has been devised by the Oscar winning director, Danny Bole. Then there's the summers biggest event - The World Tin Bath Championships in Castletown. There's of course also a lot going on closer to home within the Department of Health. In this issue you will give you an insight into to the enhancements being made to the Island's Breast Care Service. There's an all important budget update from Simon Jackson. And a theme which runs through this issue is the significant donations made by various charities and trusts over the past few months and the charity work which the Department has been involved in. There's the £358,000 for the redevelopment of Andreas Ward at Ramsey and District Cottage Hospital and an equally generous donation of £120,000 to the Department’s Ambulance Service. Not forgetting our own staff's hard work and dedication to raise funds for some very worthy causes. There are, of course, many more articles jam packed into this summer edition of InTouch - Enjoy.

Jonathan Davies Editor

Aaron Peters Administrator Front Cover: Supplied by Chief Secretary's Office

Autumn 2012 issue: Articles needed by: 24th August 2012

As I write this, a largely wet and miserable TT week is giving way to other dramatic endeavours; England play their opening Euro 2012 fixture against the French and the first of the SLT "Roadshows" will take place a

little earlier this same afternoon. Let's hope with the latter that tension will be lower and everybody leaves satisfied by the result! I hope you will find the time and opportunity to visit one of the Roadshows. Despite some very distinctly non-motorcycling weather - your fair-weather biker CEO ventured out on the mighty Triumph only once - there was no shortage of casualties for the Ambulance Service and Noble’s, together with other parts of the Department, to pick up and

put back together. As ever, my sincere thanks to those of you who achieved that with your customary skill and good humour. Also, tangential but related, I received an e-mail from a TT visitor who was admitted to Noble’s suffering from chest pain, happily only for one night, who in glowing terms expressed the excellence of the service that he received. Again; well done to all involved. So, if like me you will be glued to Euro 2012 or, if it's your idea of hell and you will be hiding out on South Barrule, I hope that summer actually begins and gives you the opportunity for downtime in decent weather. You will need to recharge your batteries.... we've the drama of the Olympics to cope with! Warmest regards David Killip

Message from the Chief Executive

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The Senior Leadership Roadshow

The Senior Leadership Roadshow is coming to a place near you! We have announced a series of tours which will give you a opportunity to meet the Department’s senior figures. You will have the chance to meet and ask questions to David Killip, Chief Executive; Lesley Keenan, Deputy Chief Executive; Simon Jackson, Director of Finance, Legislation and Corporate Services; Norman McGregor Edwards, Director of Health Care Delivery; and Dr Parameswaran Kishore, Director of Public Health.

There are four presentations remaining Keyll Darree Friday, 13th July 14:30 - 16:00 Thursday, 19th July 20:15 - 21:45 Ramsey and District Cottage Hospital Monday, 16th July 15:30 - 17:00 Tuesday, 24th July 19:00 - 20:00

Front; David Killip and Lesley Keenan - Back L-R; ; Norman McGregor Edwards, Simon Jackson and Dr Parameswaran Kishore.

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Everyone will be aware of the considerable public and political interest about hospital waiting times so it is a good time to share a view ‘from the inside’ on what the situation is, and what we are doing about excessive waiting times. The first thing to bear in mind is, that our hospital waiting times and numbers vary greatly. Not all are excessive or lengthy and thus many are already at an acceptable level. For example, any patient requiring urgent care is treated immediately and does not wait for treatment. At a presentation to Tynwald Members on 13 December 2011, we explained that the Department is striving to reduce waiting lists where they are excessive by ensuring our lists contain only those who still require surgery, that we re-design our services to ensure efficiency, and that adequate resources are available to undertake the

necessary procedures. We are working towards one-stop clinics, introducing triage systems, reducing Did-Not-Attends and actively introducing new ways of working. Regrettably, the waiting time targets set in the UK over many years were not always reflective of clinical need, were not supported by doctors and other clinical staff, seemed more related to satisfying political needs, and in some cases distracted from the proper provision of clinical care, which is why in many areas these targets are being removed. We have maintained that it is not appropriate to set arbitrary targets for all treatments. It is most important to ensure that the patients with a suspected or confirmed cancer diagnosis are treated within a strict timeline and for other conditions to ensure that treatments are provided within an appropriate clinical timescale.

In the near future, once we are happy that the data is accurate, we intend to publish waiting list data on a regular basis. In the meantime, all General Practitioners are provided with indicative current waiting list information to aid their decision when referring a patient to hospital. The time from a referral by a General Practitioner to receiving treatment will vary dependant on the specialty but urgent referrals are seen extremely quickly. Of course, there remain areas – such as Ear, Nose and Throat services – where we have continuing concerns but, we are working hard to reduce inappropriately long waiting times. Norman McGregor Edwards Director of Healthcare Delivery

It doesn’t seem five minutes since I presented the budget to budget-holders back in February, and since then we have finished the year-end processes and nearly completed the budget submission for 2012-2013. In relation to the year-end, the budget was able to remain on target – the actual amount of under spend was £18,215 or to put this in another context – 58 minutes and thirty three seconds of spending. This is the third year that the Department of Health have remained within budget. The financial management expertise that exists in the Department is recognised across Government – we have been referred to as examples of best practice on a number of occasions. This enormous achievement and the recognition we now receive is really a reflection of the professionalism of you all and I find myself yet again thanking you all for your commitment. Whilst it is comforting to look back on what has been achieved, we must look forward to the challenges ahead. We are about to enter a new era in budgeting within the Isle of Man Government whereby, instead of having one year budgets, we have three year budgets.

This has the benefit of having some certainty over funding, which will assist in planning, but the exacting challenge will be consistently providing all services within that budget over the three years. We have however, demonstrated our capabilities in the past and I am certain that we will continue to be seen as a Department that delivers. Finally, I have been in post as

Director of Finance for just over five years now and it doesn’t seem like yesterday since I joined the Department back in 2007 – so much has changed and improved that it just wouldn’t be recognisable now. Well done! If, having read this article, you have any questions or queries in relation to the budget or indeed any aspect of Government finance please contact me on [email protected]. Government Accounts: www.gov.im/treasury/finance/AccountsArchive/accounts201112. Government Budget: www.gov.im/treasury/budget/ Simon Jackson Director of Finance, Legislation and Corporate Services

Your budget update

Waiting List at Noble’s Hospital

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Noble’s ‘leaning’ on non attending hospital patients A multi point Action Plan to reduce the number of patients who fail to attend outpatient appointments at Noble’s Hospital (DNA’s) is being implemented, following a Lean Management inspired ‘Rapid Improvement Event’ held in February.

The group that undertook the work, over two days, was broadly based, and included nurses, secretaries, administrators, a consultant and patient representatives. Some of the many issues which were identified as contributing to the DNA rate included; not recording patient cancellations correctly; appointing patients too early, so they simply forget; issuing multiple letters when appointments are changed, which cause confusion; different way of dealing with DNA’s across the hospital, and even patients not being aware that they have been referred to Noble’s Hospital, by their GP, in the first place. The plan has a number of distinct work streams which should progress rapidly, over the summer:- �� Creating an Appointments Bureau which will handle all

contacts regarding cancellations, and rescheduling, of patients who cannot attend, and will also deal with outpatients arriving at, and leaving the hospital

�� Confirming to all newly referred patients that they have

been referred to the hospital

�� Piloting (in Diabetes and Respiratory Physiology) the concept that patients actively ‘opt in’ to attending the hospital for treatment

�� Reviewing all the routine correspondence sent to patients

to remove confusing letters, and also to limit the advance notice given to patients to seven months

�� Pilot (in Women and Children’s Division) standardised

processes and procedures for dealing with DNA’s in a consistent way, and also looking at how clinic capacity is planned and managed

�� Communicating plans, and progress, both internally and,

when appropriate, externally, to help everyone understand what the hospital is doing, and how they can help.

In a separate, but related activity, a pilot programme of sending SMS text reminders to patients, a few days before their appointment, will be extended across the whole hospital, later this year.

Adam Horne, E-Business Officer, explained that the pilot, in Obstetrics and Gynaecology, had halved the DNA rates in some clinics. “During the summer, we will be publicising this initiative and making determined efforts to routinely capture patients’ mobile phone numbers, so we can provide them with this new service.”

Bev Critchlow, Chief Nurse said: “Although our DNA rate across the hospital, 11%, is not out of line with experiences elsewhere, it still represents a significant loss of productive clinical time, added administration, and impacts adversely on waiting times.”

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I am eighteen months into the End of Life Care Project and shortly the End of Life Care Steering Group will be able to present the complete Framework and Implementation Plan. The End of Life Care Steering Group has made concerted efforts to include Primary Care, Secondary Care and the Third Sector in preparing the Framework and Implementation Plan. This is a comprehensive plan to develop and improve care at the end of life for all those in the last year of life. The Framework also does not forget carers. One unexpected but very welcome result of the work we have done so far, is that we have discovered that it encourages people to think and speak about death with their friends and relations, and to plan ahead. The results of our survey and the research I carried out, plus input from professional and interested community groups and the comments of individuals has provided the core information for the creation of the Isle of Man’s first ever End of Life Care Framework. Of course, frameworks, plans and strategies are of no use at

all if they simply sit on a shelf and are never implemented. We are determined that this Framework will be implemented and the End of Life Care Steering Group will morph into an implementation group. It therefore contains an Implementation Plan which will guide the development of End of Life Care Services for the next three years. Not surprisingly, within the current financial climate we will primarily be looking for ‘quick wins’ which will provide rapid benefits to patients, carers and staff. I hope that as many people as possible, both professional and public, will read this Framework as it contains not only information for the Department of Health and other Government Departments, but also members of the public themselves. The public have probably the most important role of all in End of Life Care – thinking, planning and making others aware of what End of Life Care they want for their relatives, friends and – most important of all – themselves. Kirstie Turner End of Life Care Project Facilitator

End of Life Care project finalises framework

Bev Critchlow added:“This is actually an easy area in which to engage the public, and get them working to help us, but we also need to make sure that our systems and procedures are appropriate and robust, and that is the first stage of our plan.”

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20 years later – Chief Ambulance Officer retires The Department of Health’s Chief Ambulance Officer, Steve Sieling has retired after 20 years with the Isle of Man Ambulance Service. Steve, who retired on 31st May 2012, took up a post as an Ambulance Training Officer with Noble's Hospital in October 1992, having joined Bedfordshire Ambulance in 1983 where he progressed from Patient Transport Service to Paramedic with additional qualifications as tutor and driving instructor. He progressed with the Isle of Man Ambulance Service to Chief Ambulance Officer in 2005. There has been much change from when Steve started, with only one ambulance on duty all day for emergencies as well as The Patient Transport Service, to four in-service ambulances providing emergency care across the Island. Steve set up full training for Paramedics including drug administration. This along with continuing changes to equipment and vehicles has meant that the Isle of Man Ambulance Service is ready to meet the changing demands, which have

seen emergency call attendances grow from 2,000 per year in the early 1990s, to over 7,000 last year (2011).

Steve Sieling, reflecting on his time in the Isle of Man Ambulance Service, said: “Working as part of a fantastic dedicated team makes me proud, with special mention for all the commitment and productivity from Russell Thornhill, Raymond Beattie and Peter Smith, not forgetting the mentorship from Mike Whiteside in the early days.” Steve continued:“I remember my first TT fortnight, back in 1993, as a shock. I had to put all my training to good use, working from very early mornings to late nights for most of the fortnight. The Ambulance Service used to provide cover for all practice and race sessions, which the Island’s Volunteer Services have now taken up, freeing the ambulances to continue their invaluable work providing emergency care across the Island.”

David Killip, Chief Executive said: “It has been a pleasure working with Steve, who has met the varying challenges in his career with great enthusiasm and dedication. I am sure that Steve will enjoy retirement with the freedom to spend time with the family and continue to nurture his love of vintage cars. I wish him all the best in his future endeavours.”

The Crookall House Charity Committee The Charity Committee at Crookall House has had a very successful year so far raising money for Rushen Ambulance, which funds equipment for the Southern Community First Responders, and Guide Dogs (IOM). Back in December 2011, we had a festive day that included dressing down, a raffle, guessing games and a lucky dip. On this occasion, we raised £157.71 for Rushen Ambulance. In 2012, we have held four dress-down days, an Easter Charity Event and Staff Get Together. Staff took part in an Easter quiz that included a “yellow fluffy chick hunt”. There was also a chicken and egg hunt, an Easter bonnet competition and a raffle. In total, we raised £123.53 for Guide Dogs (IOM). In the last six months, we have raised £225.51 for First Responders and £177.61 for Guide Dogs (IOM). Our thanks go to all the kind staff at Crookall House for their contributions. Nominations of charities that we could raise money for and interesting fundraising ideas are always welcome, and extra pairs of hands to help on event days are always welcome! Charity Committee Crookall House Danni Kirkham

Kirstie Turner, Danni Kirkham and Bev Wilson

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The Department of Health is extremely pleased to announce an exceptionally generous donation from the Ramsey and District Cottage Hospital League of Friends, which will enable the refurbishment of the hospital’s old Andreas Ward to create a combined Wound Management and Podiatry facility. The refurbished facility will consist of two Podiatry clinic rooms, three Wound Management treatment rooms, a shared access bariatric treatment room, plus office space and a reception area. The Ramsey League of Friends has kindly donated £358,000 that will enable Ramsey and District Cottage Hospital to carry out the development of the old Andreas Ward. The renovation will ensure that the Hospital maintains the high level of care and services it provides and the purpose adapted Wound Management/Podiatry facility will provide much improved clinical environments for the Wound Management and Community Podiatry services.

Both services will benefit from the increased capacity and ultra modern facilities that will be provided in their new locations. Currently, the Community Podiatry facility based in Cummal Mooar has only one clinic room; this will increase to two within the new facility. The Wound Management Clinic

will also increase from the current two treatment rooms to three clinic rooms, plus an additional bariatric clinic room, which can be accessed by either of the services.

In addition to the environmental benefits that the refurbished Andreas Ward location will provide, through the generosity of the League of Friends, the planned combined location for the Wound Management and Community Podiatry services will also enhance the multidisciplinary working between both services, which is essential in the care of high-risk patients. Work began in early April, and to coincide with the completion of the renal unit in the north of the Island, building work is due to be finished in December.

Donation enables the redevelopment of Andreas Ward

Handing over the cheque, Chair of the Ramsey and District Cottage Hospital League of Friends, Leonard Singer MHK said: “To be able to give this significant amount of money to the Ramsey and District Cottage Hospital is a true privilege. I firmly believe that this donation, which is possible because of the continuing support and generosity of the public, will enable the excellent hospital staff to work in the most up to date facilities which will clearly be a benefit of patients not only from the north but the whole of the Island. Friends ‘committee’ are delighted that these proposals are now to be implemented.”

On receiving the generous donation, Minister for Health, David Anderson MHK said: “To be able to receive yet another extremely generous gift from the Ramsey and District Cottage Hospital League of Friends is overwhelming. This donation will not only improve the hospital environment, it will also strengthen services provided by the Hospital and will enable the enhancement of the Podiatry and the Wound Management services.”

Janet Grib, Hospital Manager, said: “We are extremely grateful to the Ramsey League of Friends for their generosity, which will enable us to provide these much needed and increasingly utilised services in the most modern setting, where clinical staff can work more effectively as a team.”

Amanda’s article gets published nationwide Congratulations go to Amanda Phillips, Deputy Prison Health Care Lead, who has recently had her article entitled “Assessment and Management of Older Prisoners” published in the Nursing Older People Journal – April 2012 Vol 23 (3). Amanda’s article discusses the development of an assessment she has devised for prisoners

over 65, which aims to gather information on physical, social and mental health needs. The growing ageing population is being reflected in our prison, hence the requirement for healthcare staff to respond to meet their needs. Amanda is an experienced Prison Nurse who has recently been promoted to Deputy Prison Health Care Lead. Very well done Amanda. Cath Quilliam Director of Community Nursing

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Amanda, on the front of Nursing Older people

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Dr Wardle retires after distinguished career

Dr Wardle, Consultant Clinical Pathologist and Microbiologist at Noble’s Hospital, retired on 31st March 2012. He took up this post in January 1995 and was the first specialist medical microbiologist in the Isle of Man. In addition to covering clinical microbiology, Dr Wardle was Director of Infection Prevention and Control, Director of the Isle of Man Blood Transfusion Service and initially acted as Coroner’s Pathologist. Shortly after his arrival, he started the Annual Infection Control Conference, in collaboration with Ann Oxenforth, the Infection Control Nurse, and this meeting has since continued to be a great success every year.

He has facilitated the expansion, enhancement and improvement of the Island’s Pathology Service. He was fully involved during all stages in the planning and commissioning of Noble’s Hospital, enabling many state-of-the-art features to be incorporated that have allowed the Island to maintain high standards in the prevention and control of healthcare-associated infection. Dr Wardle has maintained his passion for teaching by giving regular lectures on a vast range of subjects at Noble’s Hospital and to the public generally. His retirement was marked by the Pathology and Infection Control staff with the presentation of a watercolour painting, by local artist David Byrne, showing a view across the south of the Island where Dr Wardle lives. David Killip, Chief Executive, presented him with an engraved glass plaque to commemorate the 17 Annual Infection Control Conferences in which Dr Wardle had been involved.

On the 21st April, Dr Wardle hosted a celebratory party at Mount Murray, to which his colleagues past and present were invited, and on 4th May the Medical Staff Committee held a retirement dinner, where he was presented with another painting, a detailed natural history watercolour, highlighting Dr Wardle’s interests outside medicine.

Margaret Knight Lead Nurse, Infection Prevention and Control

Feeling out of the loop? Then get “IN THE KNOW” with our weekly current awareness bulletin which not only gives you the low down on local health and social care news but keeps you up to date with national and international developments too. Our bulletin has the following sections: �� Manx Skeet - to keep you up to date with current health and social care news in the local press, what’s under discussion in

the Keys and Tynwald and the Department of Health and Department of Social Care generally

�� Hot off the Press - which, as its name suggests, aims to keep you abreast of current health news via the BBC Health News Service; included in the section we also have “Behind the Headlines” which assesses the reliability and quality of the research evidence on which such stories are based

�� Staff Health and Well-being – build on the recent Department initiative to keep yourself mentally and physically well

�� Public Health – all things related to health education/lifestyle and protection advice, screening programmes, awareness months, etc

�� Evidence-Based Practice” – covers systematic reviews into the effectiveness of treatment and also includes new clinical guidelines from bodies such as NICE (National Institute of Clinical Excellence) and other professional organisations

�� NHS Evidence – the one-stop shop for electronic evidence-based health information resources

�� Health and Social Care management reports, documents, etc

�� UK Department of Health publications including various bulletins from Chief Officers, Press Releases, Dear Colleague letters, etc

�� Library “Bits and Pieces” – to keep you informed about new developments and services within the library e.g. scheduled teaching sessions, new resources purchased etc.

If you would like to be added to the mailing list for “IN THE KNOW” please contact the library on 642993 or e-mail [email protected]

Dr Wardle said: “I will be busy pursuing my interests in learning more about botany and natural history, astronomy and photography. I am particularly fascinated in lichens and in 2010, as a member of the British Lichen Society, I helped to catalogue many of the extraordinary 511 species found in the Isle of Man. I will also be spending valuable time with my two daughters and beautiful granddaughter.”

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The Island’s ‘LookAhead’ service, which supports people affected by hair loss due to chemotherapy, has recently been enhanced with the addition of a new volunteer to the team, Robert Kinsman of The Worx Hair and Beauty Studio in Douglas. Robert self funded his attendance at a course run by ‘My New Hair’ a charity founded by celebrity hair stylist Trevor Sorbie MBE, which provides advice, support and a national network of independent salons and professionals who provide a wig styling service for people suffering from cancer and medical hair loss.

Following his completion of the course, Robert decided to volunteer for the Macmillan Cancer Information Centre at Noble’s Hospital, completing his training in January 2012. Robert is the only ‘My New Hair’ qualified consultant on the Island and can provide guidance in the cutting and styling of wigs, as well as advice when a client’s hair begins to grow back.

The LookAhead service provides those fighting cancer and suffering hair loss because of their treatment with access to professionally trained staff and volunteers who are able to offer personal and practical advice on how to use headscarves, hairpieces and hats. All consultations are on a one-to-one basis and held after hours in the private environment of a hairdressing salon. The impact on a patient of losing their hair can be profound. The difference that a professionally cut wig can make should not be underestimated. Whilst wigs now look much more realistic, it is possible to transform an ‘obvious wig’ into an individual’s ‘new hair’. Many people are unaware that this is possible and assume that a wig cannot be cut and styled further. However, with the addition of Robert to the team, those who require the LookAhead service can now discuss headscarves, hats and wigs in a single consultation. For more information about ‘My New Hair’ or to book a LookAhead appointment, contact the Macmillan Cancer Information Centre on 650735 or e-mail [email protected].

New LookAhead is a boost for the Island

The Resuscitation Department is responsible for training in excess of 3,400 staff from Department of Health, Department of Social Care and Mental Health Services across all Island settings and to varying levels of competency. Because of recent changes within the Resuscitation Department at Noble’s Hospital, with Paul Ellis as Lead Resuscitation Officer and I appointed as Resuscitation Officer, we have undertaken a review of courses and services provided and required in the Isle of Man. Following this review, we have developed a five-year strategic plan for the Resuscitation Department. The plan outlines the future direction of the department, with the focus on improving patient safety with earlier detection and treatment of acutely unwell patients, providing appropriate training to appropriate staff and ultimately reducing cardiac arrests. This obviously has to be achieved with the best possible use of resources whilst complying with the most up

to date national guidance and recommendations. The document sets out all services to be delivered by the department over the next five years, including audit, policy reviews and administration together with training and clinical resuscitation equipment. Included is a résumé of each of the nine accredited courses available and a training matrix to enable staff to easily identify their specific training requirements, which are dependant on their current level of practice, speciality and area of work. If you would like further information regarding the Resuscitation Department Strategic Plan 2012-2017 it is available to view at the ‘Noble’s Clinical Governance Document Centre’ via your favourites or alternatively you can contact the Resuscitation Department at [email protected] Kate Gaunt Resuscitation Officer

Strategic Resuscitation Plan

Robert said: “I’ve been styling hair professionally for 24 years, and running my own business for the past 18 years. My decision to undertake the training course really came about from the experiences of my friends, family and clients. I heard about the LookAhead service that Macmillan run on the Island and wanted to get involved and put my skills to use for the benefit of the community.”

Minister for Health, David Anderson MHK said: “Self image and self esteem can suffer as a result of cancer treatment, especially where hair loss is concerned. That is why the Department recognises the value in supporting Macmillan Cancer Support, which administers the LookAhead service and is kindly funded by the Isle of Man Anti Cancer Association. Robert’s enthusiasm is to be commended. His time, effort and commitment in financing his attendance at the course is testament to the huge role volunteers play in the Island’s healthcare system.”

Jonathan ties the knot Jonathan Davies, Business and Public Relations Executive, married Toni West at a beautiful ceremony on 19th May. The happy couple honeymooned in the Seychelles.

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Department’s ‘Red Devil’ takes to the skies

As many of you may know, I threw myself out of a plane on Wednesday 23rd May to raise funds for Help for Heroes(H4H). Something that not everyone will know, is that my brother (who is a Royal Marine) was hit by a suicide bomber in Afghanistan in 2010 and thankfully survived. As soon as he was airlifted to Camp Bastion and transported home, Help for Heroes, Troop Aid and other charities, cleaned him up, gave him new clothes and made him presentable for my Mum and Dad to visit him. Help for Heroes gave him whatever he needed, socks, shaving kits, games and any support he required. When I visited him at Queen Elizabeth Hospital in Birmingham, the morale on the ward was phenomenal, all the lads who were injured had high spirits and I think that contributed to his speedy recovery.

The support that both my brother and my family received from H4H is the reason my dad had the idea that my mum and I could jump out of a plane at 14,000ft. I have always wanted to do a parachute jump, but my mum on the other hand, hasn’t. She is petrified of heights but absolutely loved the experience. 23rd May was a nice clear day, perfect for the jump. We had to be there at 8:00am to sign in, meet the Red Devils and mentally prepare for what we were about to do. Because we had raised a significant amount of money, (£2,700) we had a slightly different experience from the rest of those who were jumping on that day. We were given something called a ‘Special’ where two Red Devil instructors held on to my arms in mid-air and let smoke off as we fell. Travelling at 120mph and free-falling for 45 seconds was an unbelievable experience, It took about eight minutes to land back on solid ground and when I did the guys handed me a bottle of champagne for my efforts, or maybe to calm me down. We are still accepting donations, which are all gratefully received. I would like to thank everyone who has donated to this extremely worthy cause and hope the support will continue. Aaron Peters Corporate Services Officer

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On May 24th the first skills workshop of the new updated Venepuncture and Cannulation learning programme took place. Venepuncture and cannulation are the most commonly performed invasive procedures. Many patients find the procedures psychologically traumatic. Poor technique or lack of time taken to find suitable veins can lead to complications such as haematoma, pain or damage to adjacent structures. Therefore, these procedures should be carried out by skilled practitioners, in such a way that the patients' anxiety and discomfort are minimised; complications are avoided and good venous access is preserved. A problem had been identified that staff were attending a training day and then

not practising afterwards. To try and address this problem a group was set up to review the training and assessment of venepuncture and cannulation. The new learning programme provides a standardised approach to the required theory and practical skills necessary when undertaking these procedures. Additionally, it also provides a structured approach to the assessment of the practitioner by an appropriate supervisor/assessor, prior to independent practice occurring. The Learning Programme has three components: �� A pre-course workbook �� Attendance at a skills workshop �� Supervised practice and competency

assessment

Good training is vital - ensuring that the practitioner has theoretical knowledge, based on up to date evidence, and a high standard of practical skills. There is also greater emphasis on the need to have thought about carrying out the role with the agreement of their manager and to have identified a supervisor / mentor in practice before commencing the learning programme. The course leaders are Cathie Quine, Graham Lloyd-Brandrick, Jayne Kerruish and Lesley Jones. For further information please contact Cathie Quine or Jayne Kerruish on 650234 or 650763.

Venepuncture and Cannulation learning programme

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Donation enables new addition to Ambulance Team - LUCAS The Department has been able to purchase 13 LUCAS Chest Compression devices for use across the Island, thanks to generous donations totalling £120,000 from six local charities. The LUCAS devices can be used as part of cardio pulmonary resuscitation (CPR) efforts when someone’s heart has stopped. The LUCAS devices operate electronically and are far superior to manual methods.

The latest UK resuscitation guidelines recommend that generally people need to push harder and faster to a rate of 100 – 120 compressions a minute when providing chest compressions in an attempt to save life. Rescuers who are providing chest compressions tire after only one minute and compressions can diminish to only 80% efficiency after this time, dropping to 20% after five minutes.

The LUCAS Chest Compression Device is driven by battery or mains power and operates by pushing and pulling a piston attached to a suction cup on a person’s chest to provide mechanical compressions in line with latest guidelines for resuscitation. This project has been made possible due to the generosity of the following charities: �� Henry Bloom Noble Healthcare Trust �� Isle of Man Branch of the British Heart Foundation �� League of Friends of Noble’s Hospital �� League of Friends of Ramsey and District Cottage Hospital �� Ramsey Cottage Hospital Welfare Trustees �� Microgaming Health and Care Trust.

The 13 LUCAS Chest Compression Devices will be in use across the Island throughout the Ambulance Service, Noble’s Hospital and Ramsey and District Cottage Hospital, to provide quality chest compressions during the most critical time in the chain of survival during a cardiac arrest (when a person’s heart stops beating).

During a recent survey on the Island, Ambulance crews spent 33 minutes providing chest compressions on average at scene and during the transport phase; not even the strongest of staff can sustain quality CPR for periods like this. The LUCAS unit never tires and is consistent, and by using battery power means there are minimal interruptions to chest compressions reducing the time off the chest during transport. It is estimated that the units will assist in at least 100 cardiac arrests per year on the Island, both on the scene, en-route to hospital and in hospital. Staff training commenced during the last week in March. It is anticipated around 100 people will be trained to use the LUCAS within the Department of Health, and rollout began being phased in from 1st April 2012.

Minister for Health, David Anderson MHK said: “This generous donation from six local healthcare charities have enabled the Department to purchase the latest state of the art equipment in the field of resuscitation. Many people will be familiar with the campaign with footballer Vinnie Jones that has been running over the past few months, to push ‘hard and fast’ when resuscitating someone whose heart has stopped. Of course, pushing ‘hard and fast’ can take a great deal of effort, and people can quickly become tired during this critical period. These LUCAS machines perform the same function but obviously do not tire and can provide exactly right pressure and number of compressions required. Thank you to the charities involved, those who have fundraised and the families of those who have left bequests, enabling the charities to grant these funds to the Department. Congratulations to the team who presented such a successful business case to the charities and secured the donations.”

Paramedic Clinical Supervisor Steve Crowe, said: “My plea was ‘When a heart needs a helping hand lets beat together hard and fast!’. I am delighted that it’s been answered by six very generous charities. A presentation with an accompanying business case was made to various charities on the Island in January with an aim to raise just over £100,000 to purchase 11 LUCAS Chest Compression Devices and consumables. So generous were the charities, however, that we have been able to purchase 13 units at a cost of almost £120,000!”

Steve Sieling, Chief Ambulance Officer commented: “This project is typical of the good work that is undertaken by local charities in connection with Government Departments in providing vital resources as and when they are needed. With the generosity of the named charities we continue to ensure that the best equipment is available to treat life threatening emergencies. At the same time this creates a safer working environment for our crews.”

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The Isle of Man now has a significantly enhanced breast care service, following the successful implementation of a three-phase development plan, first outlined by the Department of Health in 2010. The three phases, which were designed to significantly enhance the scope of breast care available on-Island, were as follows: �� Fund and appoint a permanent Consultant Breast Surgeon �� Introduce an on-Island sentinel node biopsy service �� Introduce an on-Island planned breast reconstruction

service

Ms Millie Bello, Consultant General Surgeon with a special interest in Oncoplastic Breast Surgery and Breast Care took up post at Noble’s Hospital on 1st February 2012. Ms Bello is highly qualified and experienced in oncoplastic and reconstructive breast surgery and breast care. In line with the Department’s plans, Ms Bello has already been able to perform sentinel node biopsies (using the blue dye method – the radioisotope method will be introduced in the coming months), with breast reconstruction patients already booked-in over the coming weeks - all provided on-Island at Noble’s Hospital.

Sentinel node biopsies have the benefit of requiring the removal of far less tissue to diagnose the extent and stage of cancer. The provision of on-Island breast reconstruction not only reduces the costs of referring patients to hospitals in the UK, but also ensures that patients do not have to undergo the inconvenience and disruption of travel, instead being treated closer to home, with family and friends available for support. As well as meeting its commitment to implement these three key developments, the Department has also been able to make additional advancements and improvements: �� The appointment of a permanent Consultant Radiologist

with a special interest in breast care �� The appointment of a second Consultant Histopathologist

with an interest in breast disease, commenced work on 1st March 2012

�� An increase in the hospital middle grade doctor support for the breast service with the allocation of a full time Associate Specialist and a Specialty Doctor to the breast team

�� An increase in outpatient clinic capacity resulting in reduced waiting times for urgent and non-urgent breast referrals

�� An increase in the number of theatre sessions and the availability of an all day theatre list to allow complex breast surgery and reconstructions to take place on-Island. This also enables the removal of a tumour and subsequent breast reconstruction to be done in a single procedure.

Since July 2011 both the overall inpatient and outpatient waiting lists have gone down. These figures include non-urgent and routine referrals that are not cancer related; suspected and confirmed cancer cases are classed as urgent and seen much faster than this average time. Where breast cancer is suspected, patients are given an appointment in the next available clinic and are seen within days. If cancer is confirmed, patients are admitted for treatment within 30 days, this is in line with national standards. As at 14th July 2011, 88 patients on the outpatient waiting list had been waiting an average of 21 days for their appointment. As at 14th February 2012, 69 patients on the outpatient waiting list had been waiting an average of 17 days for their appointment. The number of patients waiting on the inpatient lists and the length of time they were waiting for admission were 26 patients waiting on average 226 days as at 14th July 2011 and 27 patients waiting on average 158 days as at 14th February 2012.

Enhancement for Island’s breast service

Minister for Health, David Anderson MHK said: “The Island has a truly exceptional breast service of which we can be very proud. The appointment of our new Consultant Surgeon, Consultant Radiologist and Consultant Histopathologist; not to mention the provision of additional clinic and theatre time and the introduction of on-Island breast reconstruction and sentinel node biopsy all provide a huge leap forward for what was already an excellent breast care service. For the size of our population, our breast care service really punches above its weight. I’m delighted that the Department has not only been able to go far beyond maintaining the services provided under the previous locum surgeon, but also significantly enhance them for women who suffer from this disease. “The team at Noble’s Hospital is to be commended for their tireless efforts to develop and enhance our breast service and provide the very highest standards of care for the people of the Isle of Man. We also need to remember of course that in addition to this Ms Bello also provides out of hours general surgical cover on a one in four basis, meaning that the Department now meets the requirements in this regard as laid out by the Royal College of Surgeons – so excellent news all-round. “We also mustn’t forget the important role of prevention, by ensuring we all lead healthy lifestyles, whilst continuing to offer screening where we can to catch any signs of cancer at the earliest opportunity. This theme of prevention and screening lies at the heart of our Health Strategy. Although a review into breast screening is currently underway in the UK by Sir Mike Richards, the Department’s advice in this regard currently remains unchanged. Women between the age of 50 and 70 are routinely called for breast screening, every two years. This short diagnostic procedure can save lives, so it’s important that women attend when called.”

Ms Millie Bello

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An additional four members of the Management Information and Technology (MI&T) Directorate have recently passed Prince2 examinations. Prince2 is an internationally recognised project management methodology which was created by the UK Government and is used by both private and public organisations the world over. It is also the methodology used by the Isle of Man Government and the Department of Economic Development’s Information Systems Division (ISD). Shaun Montgomery, IT Support Manager and Gordon Gledhill, Business Analyst, passed the Foundation examination and Nicholas Winstanley, IT Support Officer and Lynn MacLeod, Community Systems Administration Manager, passed the Foundation and Practitioner examinations in March.

The course, which was arranged and held at 2e2’s Freeport Headquarters in Ballasalla, lasted for five days and was intensive. There was a lot of studying required both during the day and in the evenings to prepare for the examinations. It was also necessary to undertake a considerable amount of pre-course preparation in the four weeks prior to the formal training course and examinations. Nick, Shaun, Gordon and Lynn all take their place alongside colleagues in the Directorate who have previously been successful in achieving these accolades to date.

Further PRINCE2 successes for MI&T Directorate

Stroke Awareness Month at Noble’s Hospital

May was Stroke Awareness Month and marked the launch of the Stroke Association’s new logo. The Stroke Unit at Noble’s Hospital has been raising awareness of Stroke and identifying support systems for those people who have been affected by Stroke. The awareness campaign also aims to educate people about lifestyle changes they can make to reduce their chances of suffering from Stroke and promotes the FAST (Face, Arms, Speech, Time) advertising campaign developed by the NHS in the UK. This advertisement gives information to people about how to recognise Stroke symptoms and what they should do if they suspect that they or somebody else is suffering from a Stroke. Ward 7, the Acute Stroke Unit at Noble’s Hospital, was decorated to raise the profile of the FAST campaign. The posters are visible and all visitors to the ward have had FAST explained and information leaflets provided. During the 14th – 20th May a poster display was available on the mezzanine floor of Noble’s Hospital foyer with information about Stroke recognition, prevention and support. It drew lots of interest and positive feed back. Finally Noble’s Hospital staff held a drive to raise awareness of high blood pressure and its relationship with Stroke. Untreated high blood pressure is the single biggest risk

factor for Stroke, and lifestyle changes and the right medication can help to reduce high blood pressure.

A ’Know Your Blood Pressure’ event was held at Thie Bee on 22nd May with free blood pressure checks for all staff. The

event was extremely well attended and the blood pressure of nearly 100 members of staff was checked. Staff from the Stroke Unit liaised with their colleagues and offered appropriate advice about smoking cessation, exercise, diet, alcohol intake and weight. The leaflet store was cleaned out and the FAST campaign spread to a wide audience. The Stroke Unit would like to thank all who attended and supported the event. For more information contact either Ward 7 on 650027 or the Stroke Association on 616885.

Gill Horsey, Ward 7 Sister, said: “Stroke is the third most common cause of death in the UK and the single most common cause of severe disability. We can all help lower our risk of Stroke by following simple lifestyle changes and the guidance and advice offered to staff, patients and their families during Stroke Awareness Month has hopefully been helpful in empowering people to make these small changes. I would also like to thank the Manx Stroke Foundation for supporting the event and for their generous supply of leaflets.”

Shaun Montgomery, Lynn MacLeod, Nick Winstanley and Gordon Gledhill

Helena Christosorou, Registered Nurse and Dr Darryl Duncan, ENT Consultant

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Paul Harper, Director of MI&T commented “Having staff trained in PRINCE2 means that MI&T can help DH colleagues who are involved with business change projects which are underpinned by IT, or IT projects generally, in a more meaningful way. The course is both theoretical and practical and I would personally congratulate the staff on their achievements.”

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Harry gains PICC certificate On the 29th of February Graham Lloyd-Brandrick signed off Harry Whitehead as competent in placing Peripherally Inserted Central Catheter (PICC) lines in the angio-suite on his own. This was the inaugural sign-off for Foundation Year Doctor PICC competency and Graham and Harry are both delighted about their achievement. Harry said “Graham is the ultimate teacher: he sets

himself high standards and expects you to reach them too; moreover, he’s exceedingly approachable, patient in teaching, and great fun to work with. I feel privileged to work with and alongside Graham.” Graham said “We are very proud of Harry. He is the first! Many congratulations.”

Top Team..........The Winners Circle Hazardous Area Response Team (HART) has triumphed in becoming the Department’s Top Team for 2011/2012. HART is specifically designed to maintain patient care in hazardous conditions, such as a cliff fall or aiding a search and rescue mission. This project insured that paramedics were able to attend the site of the accident and see to the casualty as in the past they have only received basic first aid. Before this initiative, paramedics had to wait for the patient to be rescued from the hazardous area before treating them.

Formed by a small group of dedicated paramedics, the Isle of Man’s HART has gone through extensive and intense training alongside the Isle of Man’s Fire and Rescue Service to ensure that the best proficiencies from all areas are taken advantage of. Although HART has been implemented in the UK for a number of years, the Ambulance Service on the

Island has specifically tailored their training to meet the unique requirements of the Isle of Man. The day consisted of four shortlisted teams who competed for the prestigious Top Team title. The runners up of the Top Team Award were: �� The Martin Ward Project at Ramsey and District �� Isle of Man Breastfeeding Peer Support Group – �� Introduction of Ante Natal Screening to UK Standards

Following a written submission of 2000 words, four teams were then shortlisted from the pool of entries by three esteemed judges; Ann Clayton, Director and Business Consultant; Jan Brooks, President of Breakthrough Breast Cancer Isle of Man, and Helen Summerscales, Managing Director of Isle of Man Advertising and Public Relations. The short listed teams then made a short 10 minute presentation to show why their project should win the title of Top Team.

Another happy couple Congratulations go out to Acting Community Health Administration Manager, Ruth Hogg (previously Ruth Davies) and husband Dave Hogg who were recently ‘Wed’ on 7th April 2012, and recently returned from their road trip honeymoon in North America. Love and best wishes go out to them both, wishing them all the best for the future, from friends and colleagues within Crookall House.

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Mark Kelly, Ambulance Training Supervisor and Team Leader of HART said: “The team was delighted to win this year’s Top Team Award considering the strength of all other entrants. We feel that everyone concerned deserves a big pat on the back for jobs well done. It has been a hard slog for all our team to progress the programme this far and we would like to extend our thanks to all who have assisted us, in particular our sponsor, Microgaming Health and Care Trust, the Isle of Man’s Fire and Rescue Service for providing us with such thorough and professional training and the A&E Department for assisting with the reciprocal training initiative. The programme will continue to grow upon our already strong foundations with our focus being to provide patients in hazardous areas with the best standards of care possible.”

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Ever been asked these types of questions? Wouldn’t have a clue where to start? Don’t know who to ask? Drowning in Google references?

Help is at hand – Keyll Darree library and information service can handle these types of enquiries. Clinical staff are one of our largest user groups, but we feel we have the expertise to help with managerial, business and quality information queries to assist organisational decision making. Providing this information service fits in with current Department initiatives such as Lean Thinking and Fit 4Future which emphasise becoming more efficient in the way services and working practices are delivered. The benefits of providing this service can be grouped under three main headings: Patient Care/Patient Experience: Improved patient care is our goal – obtaining a correct diagnosis, facilitating best practice by following clinical guidelines, care pathways and protocols; minimising medication errors and incorrect treatment and thus reducing patient complaints and avoiding costly litigation. We can help achieve this objective by providing current, accurate, reliable and relevant information to facilitate good decision making; we can ensure evidence based information is placed at the heart of organisational decision making within the Department; decisions wouldn’t be based on a personal, historical or knee jerk reaction.

Saving Time and Money: We can help save manager’s time to release them to do their job – of efficiently and effectively running departments, reviewing how they are run and implementing any necessary changes. It may identify more cost effective ways of delivering services and perhaps, more importantly, using evidence based information should reduce and help prevent wrong decisions being taken and/or implemented, which in itself costs money. Accessing information once found can sometimes be a problem – it’s no good if you are unable to get hold of a document, report, etc. As information professionals, we can usually overcome these problems through knowledge and networking. Information could be packaged according to the wishes of the manager, with evidence appraised and summarised so managers could easily identify key salient points instead of having to sift through a huge volume of information, read and digest information in many different formats from many different sources. The library could also assist in identifying relevant current awareness services/evidence-based information sources for managers and set feeds up if necessary, with training offered on searching techniques. Knowledge Sharing/Organisational Learning: A management information service could help foster the culture of continuous learning and knowledge sharing within the Department. Managers could be sent timely and appropriately packaged information in their particular areas of interest. This would ensure that they are kept up to date professionally and give “food for thought” in that this type of current awareness service would provide insights and identify trends which should help in anticipating and planning of future service needs. Please ring either Christine Sugden or Anita Gould on 642974 if you would like more information on this service.

Management information service

Noble’s Hospital becomes IMPACT course centre IMPACT is a nationally accredited course, which was designed by senior doctors to assist trainee or junior doctors and senior nurse observers with the recognition and treatment of seriously unwell patients. The focus of this course is prevention of cardiac arrest and the appropriate referral of unwell patients for more specialist treatment. The IMPACT course is endorsed by the Royal Colleges of Physicians, Surgeons and Anaesthetists as well as being supported by the Intensive Care Society and the Resuscitation Council in the UK. This new course now also compliments the multi-professional ALERT course that was introduced to Noble's Hospital last year. In January, Medical Education and the Resuscitation Department arranged for Dr Magnus Garrioch, National Director of IMPACT and Mike Davis, Academic Educator to

visit Noble’s Hospital and provide an instructor day for 12 senior medical staff. The instructor day enabled senior doctors from anaesthetics, medicine, cardiology and emergency medicine to become IMPACT instructors. Following this course, Noble’s Hospital has now become an accredited IMPACT training centre and ran an extremely successful pilot course at the end of February. It is anticipated that IMPACT will now run twice yearly. For further information or to book a place on the next course, 17th and 18th September 2012, please contact The Resuscitation Department at [email protected] or Medical Education. Kate Gaunt Resuscitation Officer

Examples of Care in the Home schemes which aim to prevent hospital admission, facilitate hospital discharge and also demonstrate cost savings?

Could we speed up the delivery of medicines to patients on acute hospital wards to aid patient discharge?

How do we prevent patients falling in hospital?

Can we reduce acute alcohol related hospital admissions and readmissions?

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The story continues... Since the agreement, in September 2011, to run this training 51 staff have now completed the course and on Tuesday 15th May 2012 some of the successful staff were presented with their certificates by Dr Jacqueline Yates, Head of Learning, at Keyll Darree. The presentation was quite informal with tea and cake provided, giving staff the chance to catch up on how things were going since they had received the training. The common thought was that the training had been beneficial to all regardless of the area in which they worked and that more staff should avail themselves of the opportunity to attend. Staff who have attended so far represent quite a diverse range of employees and include staff from both the Department of Health and Department of Social Care. There have been representatives from nursing staff, hospital porters, administrative staff, podiatry, the ambulance service, community nursing, health visitors, support services, GP

practice staff, visiting officers, housing and social security staff, residential staff and social workers. This diverse mix of attendees on the sessions adds to the value of the course. In March 2012 Nicola Shaw from Department of Health, and Amy Hogg from DSC, were successful in achieving their Instructor Certification through the Crisis Prevention Institute; the need for further Instructors soon became apparent due to the high demand for the training. The success of these two staff in achieving their Instructor Status has allowed extra training sessions to be scheduled throughout the year, enabling the opportunity for an extra 80 staff to be trained. It is predicted that by the end of November 2012 that approximately 160 staff will have undertaken this training. If you would like further information about the training or would like to be added to the list for future courses please contact :- Nina Hogan, Appraisal and Development Facilitator on [email protected] or 642925

Non-violent crisis intervention (de-escalation) training

Noble’s Hospital celebrate International Nurses Day The Island’s nurses marked Nurses’ Day to celebrate the work of the nursing profession throughout history and in modern times. Nurses’ Day fell on 12th May, the anniversary of Florence Nightingale’s birth, and nurses throughout the Island marked the celebration with a schedule of events running from 8th – 11th May 2012. The Nurses’ Day theme was ‘Celebrate Nursing’ with nurses and patients invited to share their experiences of nursing care at its best. Memory and Comment Books were circulated to all wards and departments at Noble’s Hospital, Ramsey and District Cottage Hospital as well as being available to those being treated in the community, such as those visited by a District Nurse. The Royal College of Nursing provided Nurses’ Day branded bunting, tea bags, cake toppers, coasters, posters and stickers.

Noble’s Hospital Dining Room was involved in the celebration, with a ‘Nursing’ themed menu and Nurses’ Day bunting. Hospital nurses were invited to the Dining Room for ‘5 minutes of wisdom’ on 11th May to share ‘inspiring examples of excellent patient care’. The Director for Community Nursing had tea and cakes with nurses and patients at Ramsey and District Cottage Hospital on the 11th May. A session was held at Crookall House for other nursing staff who work in the community setting to celebrate and share their experiences of nursing.

Afternoon cakes for patients were served with special Nurses’ Day toppings and ward staff encouraged to gather patients in the ward dining room, where possible, for tea and cake. On 10th May, afternoon tea for the patients on Ward 20 at Noble’s Hospital was served by the Chief Nurse, Bev Critchlow; the Minister for Health, David Anderson MHK; and Department of Health Chief Executive, David Killip. Bev Critchlow, said: “Nurses’ Day is a wonderful way to celebrate the work our nurses and midwives do each and every day - caring for our patients and their families. I am in contact with nurses and midwives from every sector, from the Hospital to Community and Mental Health to Midwifery, and I never fail to be impressed with their level of care, dedication and professionalism. The Island’s Nurses and Midwives play a pivotal role in the delivery of quality care to our residents and we are proud of what they do.”

Minister for Health, David Anderson MHK, said: “The 12th May is an important day for nurses and offers the opportunity to celebrate the many achievements made by the profession in the past as well as highlighting plans for the future. I want to take the opportunity to thank all of our nurses on the Island for the dedicated care and commitment they give to patients and their families. I’m sure I speak for many when I say we are proud and very fortunate to have them.”

Cath Quilliam, Director of Community Nursing, said: “We can forget that our nurses, midwives and health visitors work tirelessly often in unusual and sometimes difficult circumstances in many venues around the Island, including in people’s homes, hospitals, health centres, homeless centres and residential care settings. Nurses day was an opportunity to recognise and celebrate the contribution and commitment of our nursing workforce in consistently delivering high quality care for patients, clients and their carers and families.”

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David Killip, Bev Critchlow and Minister for Health David Anderson MHK with two patients

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Allen Moore, Deputy Chief Pharmacist, leaves Noble’s Allen Moore, Deputy Chief Pharmacist, retired on 22nd May this year having worked in the organisation since qualification in 1979. Most staff will have encountered Allen in his role as Lead Pharmacist (Mental Health Services) and in fact he was Staff Pharmacist-in-Charge of the Pharmacy at the former Ballamona Hospital from 1987 until its

demolition to make way for the present Noble’s Hospital. Allen was Deputy to Brian Woosey for many years and has been Acting Chief Pharmacist since Brian’s untimely death in 2010. The Pharmacy Department join with all other staff who worked with Allen over the years in wishing him a healthy and fulfilling retirement – knowing Allen, this will probably involve extensive foreign travel, “tramping” over the hills and the occasional foray to the Whitehouse in Peel! Dr Alan Pearson Acting Chief Pharmacist

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News ‘Principles of Nursing Practice’ on Island

The Department recently supported an on-Island event at which the Royal College of Nursing’s new ‘Principles of Nursing Practice’ were rolled-out to nurses based in the Isle of Man. Put simply, the eight principles describe what everyone can expect from nursing. The event, held at the Department of Health’s Learning and Education Centre - Keyll Darree - was chaired by Department Chief Executive, David Killip. The session detailed how the principles were produced, how they can be implemented at a local level and how nurses can champion the principles. Minister for Health, David Anderson MHK said: “The Royal College of Nursing has clearly defined its core values and beliefs, centred around these eight principles. I’m delighted that the Royal College has facilitated a workshop in the Isle of Man as part of its UK road shows; and I know that this development will help to further focus the minds of our dedicated nursing staff, ensuring that we continue to excel at

providing excellent patient-centred care.” The workshop comes shortly after the appointment of a new Royal College of Nursing (RCN) Isle of Man Branch Executive Committee, chaired by Verna Phillips, staff nurse on Ward 11 at Noble’s Hospital. Verna is a Union Learning Representative and, along with fellow Union Learning Representative Cathie Quine, will be developing future educational events. Sandra Pressley, retired Senior Nurse, has taken over as Branch Secretary, and Janet Thommeny, a Mental Health Practitioner, is Branch Treasurer. Janet is a Steward and will be leading on Employment Relations matters, as well as representing the RCN on joint negotiating meetings with management representatives from the Departments of Health and Social Care. Jeanette Hogg, Student Nurse, has also joined the Committee. Jeanette will act as a Student Information Officer, working with students and the Branch on matters affecting them. Members of the RCN had the opportunity to meet the new Branch

Officers in a recent event at Keyll Darree, where the new Executive Committee were looking for ideas for events, and people to join the RCN, with a view to making the Branch much more active in 2012. Representatives and members were welcomed by Paul Gardner, RCN Officer from Bolton, who was present to talk about the roles of stewards, health and safety representatives and union learning representatives, as well as the work of the RCN planned for the coming year. Verna said: “We are really keen to get as many representatives and members involved in the work of the RCN as we can. Working with nurses for the benefit of the profession and our patients is at the heart of what we do. We want to make a difference to the quality of care and to the working lives of our nursing colleagues.” Bev Critchlow, Chief Nurse, said: “We are really pleased that the RCN Isle of Man Branch is taking such a proactive approach and we welcome the opportunity to work together. As a professional body, the RCN is pivotal to the development of nursing and is an invaluable resource to our nurses. The profession continues to develop, as the launch of the new principles demonstrates; and nursing continues to have a bright future in the Isle of Man with a continued role in caring for those in our close-knit community.” Anyone wanting more information or who is interested in getting involved with the work of the Branch should contact Verna Phillips on 650031 or [email protected].

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What happens when a vulnerable person has to move because they are no longer able to live where they are and they have all the worry and work of clearing their home? This was the subject

for the Multi-Professional Forum on

Wednesday, 16th May when Age Isle of Man, Crossroads and the Department of Social Care Adult Services Team presented details of how they can support people in that difficult position. Often the difficulties of sorting out family treasures, taking unwanted items to the civic amenity site, charity shops and even an auction house can be daunting and hard for a person suffering with illness, disability or frailty. Members of the Multi-Professional Forum Planning Group have experience of supporting family members who have needed to move and cope with all the challenges. The practical issues alone are daunting – sorting possessions, packing things up, lifting, carrying, and keeping track of where everything is. On top of this is the emotional wrench of having to leave the family home and the psychological impact of having to accept that one is no longer able to be independent. A series of videos of residents at Marathon Court showed the experiences they’d had of moving into residential care.

Maureen Cowbourne interviewed the residents and Mark Burrows, Arts Co-ordinator at Noble’s Hospital filmed and edited the material. Most residents were stoical about their experiences and recognised that they really had no choice but to accept what had come along. One interviewee still had all of her home contents intact after a year at Marathon Court, whilst another described the experience of leaving all her things behind in the house as “dreadful”. George Quayle, Chief Executive Age Isle of Man described their services in general but also explained that they would provide legal services, financial support, benefits advice and practical help. This would go as far as the charity taking out an Enduring Power of Attorney if necessary, for example, when someone had no family at all. They would clear homes, arrange for valuation of contents, dispose of unwanted items and prepare the house for sale. Julie Kelly, Adult Services Officer at Crossroads Care explained their emphasis on supporting those who care for others and how they could offer respite to enable busy carers to get on with whatever they need to do. David Griffiths, Senior Social Worker in the Community Social Work team emphasised that wherever possible they would seek to support someone enabling them to remain in their home and explained the assessments which they carry out to determine need and support packages. The slides and information presented at the event are available on request from Jacqueline Yates, Head of Learning at Keyll Darree. Dr Jacqueline Yates Head of Learning

Your move – Who helps?

New RIS and PACS for Radiology The Radiology Department is continuing to work with the Management, Information and Technology Directorate to implement the new Radiology Information System (RIS) and Picture Archive Communication System (PACS). The go-live for the new integrated system is on track to take place over the bank holiday weekend in July. Much of the groundwork has been completed and the system has been installed on a test server within the Radiology Department. There has been extensive testing of this system to ensure it meets our needs and will fit in with our workflow. This has proved invaluable as we have been able to make various changes not only to the system itself, but also to the way we work in the Department which will improve patient care. One big benefit is the ability to go ‘paper-light’ and become electronically

orientated with our workflow. In effect, this means that request forms must be entered onto the system at reception before being discussed with a Radiologist. If this does not happen, it will not be possible to continue the workflow including taking the image of the patient in an effective manner. Training for Radiology staff has commenced and covers both the RIS and PACS systems. The supplier has provided on-site training for designated key users, who will then cascade training to others in the Department. This will continue right through to go-live. Running parallel with this, training for staff outside of Radiology on the PACS system will take place in June with key users will be arranging sessions throughout the Hospital in addition to a lunchtime session in Keyll Darree on the 29th June. The go-live weekend is set for the 5th –

8th July. We are in a unique position, as this is a long bank-holiday weekend, meaning less disruption to patients and a day or two extra for staff to get used to the new system before normal working hours resume. Manual procedures will come into effect whilst data is migrated and the new system fully tested in a live environment. As with any migration, it is not possible to transfer everything and staff will spend time over the weekend manually entering information onto the new system so that it is ready for Monday morning. There will of course be clear e-mail communication to keep everyone abreast of developments and to advise when the new system is operational. Karen Hawkins PACS Manager

George Quayle; Julie Kelly and David Griffiths

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A new patient sling is being piloted on an Orthopaedic ward at Noble’s Hospital, with significant cost-saving benefits, thanks to the initiative and inventiveness of a member of staff and her mother! Linda Swales is a Healthcare Assistant on Ward 11 (Orthopaedic Ward) at Noble’s Hospital. During the course of her duties on the ward, she became aware that the ‘single patient use’ slings to keep a patient’s arms elevated, were on occasions being used for a very short period of time before being thrown away, with significant cost implications. Linda spoke to her Mum (89-year-old Mrs Swales, a keen needle-worker) about her concerns and together they created a prototype from recycled sheeting, which was ably put together by Mrs Swales senior. Linda introduced the new sling to her colleagues who thought it was very versatile and innovative. Sue Ogden, Ward Clerk became the driving force in helping her to progress the initiative to the appropriate departments. Following a presentation to the Product Approval Group (PAG), it was agreed that the sling could be piloted in Ward 11 and theatres for a trial period with Mrs Swales making the initial batch of slings in accordance to Hospital requirements using her original prototype. Linda and Sue said that feedback from patients and colleagues has been very encouraging, with patients finding

the sling comfortable, adaptable and easier to wear than the previous version. The trial is still underway and with the excellent feedback from patients and staff. The sewing room at Noble’s Hospital has recently taken over the production of the slings. It is envisaged that they will be on general issue shortly, following review of the trial period. As the ‘Mama Swales’ slings are made from recycled sheets, they are washable and reusable. Once they are fully adopted, it is estimated that using them in place of the previous sling will save approximately £8,500 per year, which is an excellent result! Very well done to Linda and Sue for their initiative and effort! Vivienne Edge Senior Sister Patient Safety and Governance

Releasing time to care Ward 11 new sling initiative

Work began on Releasing Time to Care, The Productive Ward, at Noble’s Hospital in 2009 in response to the Departments of Health’s lean working ‘Fit 4 Future’ vision. Since its inception in two pilot

areas in January 2010, the project has gradually extended across 20 Wards and Departments of Noble’s Hospital.

Tangible results are being achieved in many areas because of teams looking closely at what they were doing, reorganising care and systems, to improve things for patients and their families. The ultimate goal of the process is an increase in the time clinical staff spend with patients providing safe and reliable care, improving the quality of what we do and our daily working life. The focus for the next year will be on audit to ensure sustainability of the project. It is expected that all wards and relevant departments will have started work on their Vision, the first stage of the process, by Autumn 2012. Following Sandra Pressley’s retirement in December 2011, Viv Edge transferred to the Patient Safety and Governance Directorate to take on the role of project lead for Noble’s Hospital.

Viv was previously Senior Sister on Ward 20 and Day Assessment Treatment Unit. She has been involved in several projects for Transforming Care at Noble's Hospital and led the Housekeeping Review in 2008. Viv can be contacted on Tel: 650467 or by email at [email protected]

The Productive Ward

Linda Swales and Sue Ogden

Viv said: “I’m excited to be taking on this new and challenging role and continuing the excellent work already done by Sandra and the Releasing Time to Care Steering Group. Although I miss my colleagues on Ward 20 and DATU and the daily contact with patients, I welcome and embrace this opportunity to contribute to and influence nursing by supporting the teams at Noble’s Hospital with the project and its ultimate aim of releasing time to care for patients.”

What do we really see? Sometimes we’re so focussed on one thing we can’t see what’s obvious to others!

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Pre-Registration Nursing Adult and Mental Health

On 27th March the Pre-Registration Nursing Adult and Mental Health field programmes, which will be delivered in partnership with the Health and Social Care Teaching Team on Island and the University of Chester, were successfully endorsed for the next five years for delivery within the Department of Health. The programmes have had several major changes to ensure the structure met all the new professional quality and standards from the Nursing and Midwifery Council for pre registration programmes. This required extensive

collaboration between the Health and Social Care Teaching Teams with the University of Chester to design a three-year degree programme. Key features of the new programme enable successful students to register as qualified nurses with the UK Nursing and Midwifery Council. Depending on entry criteria, students will either undertake the Bachelors in Nursing (Honours) Nursing or

the Master in Nursing (MN) route, for either Adult or Mental Health Nursing. The level of entry to the professional register will be the same for both routes as qualified nurses. However, students who already have a degree will be able to build on their academic standing to study the nursing theory component at Master’s level. The Chair of the endorsement event also made three commendations, which acknowledged the strategic and collaborative nature, which underpins the manner in which the work is carried out to secure a successful validation.

�� The commitment of Chief Nurse Bev Critchlow in supporting the programme to develop qualified nurses on Island

�� The support and quality of resources

offered to students from the Keyll Darree multi-professional library

�� The relationship between the Health

and Social Care Teaching Team on Island and their colleagues from the University of Chester

We are now looking forward to the programme commencing in September 2012. Anyone wishing further information about Pre-Registration nursing should contact Ronnie Paton on 651422, Bernadette Devlin on 642927 or Julie Bailey McHale on 642928. John Struthers Nursing and Higher Education Manager

Linda Firth says her farewells

April saw the retirement of Linda Firth, Anticoagulant Nurse Specialist after nearly 40 years at Noble’s Hospital. Linda commenced employment at 17 years of age after being interviewed by the then Matron Corteen, Bette Wild. Linda has taken on various roles throughout her career including Matron’s Cadet and Sister on Private Wing. She worked in Blood Clinic, which led to her current role in Blood Donors and Anticoagulation. Linda has enjoyed her busy and varied career, only taking short periods of time out for the births of her two children. A party in Day Assessment Treatment Unit arranged by the staff she had worked with, marked her retirement. The staff and various invited guests, including Bette Wild and Bev Critchlow attended. Susan Harrison, Clinical General Manager – Medical Directorate and Mr Tony McMaster, Manager of Pathology Department, and Anticoagulation Nurse, Tracey Tuck gave votes of thanks to Linda for her lifetime of valuable dedicated work for Noble's Hospital. Linda received several gifts including flowers, jewellery and replied with a short reminisce of her career and how much she had enjoyed her time at Noble's Hospital. Staff and

patients wish her a long and happy semi-retirement, as Linda will still be working part-time managing the Isle of Man Blood Donor Service, which is the work she really enjoys. Fiona Killey Sister, Day Assessment Treatment Unit

Linda Firth and Bettie Wild

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A Consultation Day on the education and training of Social Workers took place on Thursday, 10th May at Keyll Darree. The Department of Social Care Operational Learning and Development Group who set up a working group to discuss the best way forward in the professional development of social workers initiated the event. A team made up of academic staff from the Learning Team and senior representatives of the social work profession identified the purpose of the day and invited speakers. The aim of the day was to raise awareness of the changes in Social Work Training, Post-Qualifying education, the Capabilities Framework and Continuing Professional Development because of recommendations of the Social Work Reform agenda and to seek views on the best way forward for the Isle of Man. The audience were treated to a presentation from Pat Higham, a UK based consultant and academic specialising in professional Social Work practice. Pat took us through the development of the Social Work profession and explained how the education and training of social workers had changed over time finishing off with a very clear exposition of the developing capabilities framework in England and the way that Higher Education is responding. Pat drew on her extensive experience of working in policy-making at the highest levels combined with her well-researched academic viewpoint to both inform and enlighten us. Marion O’Rourke, Professional Manager on the Northern Ireland Social Care Council provided us with a thorough

account of the way that Northern Ireland has tackled the question of education and training for Social Workers. Their approach, which is recognised as being in the vanguard of Social Work development, emphasises a culture of recognition of professional development where individual social workers can attend programmes of study from an accredited range but which can be a very individualised route depending on their needs. Inspired by these very well informed speakers, the audience went on to discuss the best way forward for the Isle of Man and these views will now be fed back to all involved. Programmes of study already available and in development on Island will also form part of the discussion, not least the MSc Professional Practice, which is currently in development and will provide an important platform for social work graduates to gain Master’s level qualifications and apply their learning to their work in a very direct and individual manner. Those who do not already have a degree will be able to plug in to existing under-graduate programmes and go from there to build their personal route. Whichever way we go forward, consultation and involvement is the watchword. All views on the development of social work staff are welcome and can be fed to any member of the working group: Jim Riley, Susan Coyle, Donna Hart, Julie Bailey-McHale, Mike Williamson and Jacqueline Yates. We will be hoping to involve all social workers across the Island and will be in contact about further developments. Dr Jacqueline Yates Head of Learning

How can we develop Social Workers?

International Day of the Midwife The Department’s Jane Crookall Maternity Unit midwives held a cake sale on 4th May at the Staff Restaurant of Noble’s Hospital, to celebrate International Day of the Midwife and to raise money for Save the Children, in particular the Isle of Man branch, which sponsors a maternity unit in Rwanda, Africa. Minister for Health, David Anderson MHK, said: “I would like to congratulate the midwives of the Jane Crookall Maternity Unit for raising awareness of maternal mortality through this fundraising event for the Isle of Man branch of Save the Children. We are fortunate in the Isle of Man to have links with charities providing support all over the world and it is very gratifying to mark International Day of the Midwife in this way.” Since 1991, the International Day of the Midwife has provided an annual focal point for midwives, midwifery associations and partners around the

world, celebrating midwifery and bringing awareness of the importance of midwives' work to as many people as possible. It helps raise awareness of midwifery and extend the influence of midwives in order to lobby and advocate for policy changes relating to maternal, newborn and reproductive healthcare nationally and internationally. Jane Sloane, Head of Midwifery said: “This is our way of celebrating International Day of the Midwife on 5th May and drawing awareness to the preventable issue of maternal mortality. Worldwide, it is also being marked with walks, street parades and other activities. We are pleased to have raised £600 for a very important cause. Thank you to all the staff at Noble’s Hospital who supported us.” Bev Critchlow, Director of Nursing, Midwifery and Therapies said: “The International Day of the Midwife is a celebration of the work of midwives all over the world. At Noble's Hospital, we

want to demonstrate our commitment to tackling maternal and newborn mortality by raising money and awareness for midwives and mothers everywhere. I am so proud of what our midwives have achieved today.” Over 340,000 women die each year, with millions more suffering infection and disability, because of preventable maternal illness during or around the time of childbirth. The International Congress of Midwives is committed to reducing inequality, through greater access to essential midwifery care worldwide, particularly in developing countries where 90% of maternal deaths occur. The team of midwives in the Isle f Man wanted to play their part. For more about International Day of the Midwife visit www.internationalmidwives.org For further information about “Save the Children Fund”, visit www.savethechildren.org

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‘Bloom-ing marvelous’ donation for Noble’s Hospital Once again, the Henry Bloom Noble Healthcare Trust has provided generous funding for the purchase of equipment to improve the comfort and safety of Noble’s Hospital patients with the donation of equipment to the value of approximately £145,000. �� A Lifeport Patient Utility Loading System, which will

assist with the movement of patients on and off the Air Ambulance. In addition to improving the comfort and safety of patients and staff by reducing the need for excessive moving and handling of patients, the system also enables the Air Ambulance Service to be more independent because the system is compatible with all aircraft. As an added benefit, the existing Aerosled system has been installed in one of the Isle of Man Post Office aircraft, which can now act as a contingency between 11:00hrs and 17:00hrs each day, should a second Air Ambulance be required.

�� A ‘Mini C Arm’ X-Ray system. This piece of

equipment enables Orthopaedic Surgeons to take x-rays of patients during surgical procedures in the Operating Theatre, without a Radiographer being present. This allows Radiography staff to be available to other departments, especially Accident and Emergency, thereby reducing the amount of time these patients would have to wait for an x-ray.

�� Four additional Neonatal Patient Monitors for Neonatal Resuscitaires, which monitor oxygen saturation in newborn babies who have been resuscitated. A dedicated monitor is now available for each resuscitaire, with the four new monitors bringing the total number in the Neonatal Unit to six.

�� Six Transcutaneous Bilirubinometers which detect

jaundice in newborn babies, without having to take blood samples from them. The early detection of jaundice is important so that treatment can be commenced as soon as possible and detection and treatment can now be carried out at the mother’s bedside or in the home. The equipment reduces the workload of the Biochemistry Department, since no blood samples need to be sent for analysis. The process of detection is also non-invasive and so is more comfortable for the baby.

�� Two Neonatal Phototherapy Units for the treatment

of jaundice in newborn babies. Phototherapy (light therapy) is a safe and accepted treatment for neonatal jaundice and this equipment enables treatment to be delivered to babies at the mother’s bedside, without having to admit the baby to the Neonatal Unit.

I am always inspired to see some of the small changes and innovations that nurses make to practice, which make a very big difference to patients and their families. We are constantly trying to battle with the challenge of how we keep our patients and visitors fully informed and aware of what is going on around them. Patients tell us that we don’t always communicate well and if we have informed them about situations regarding their condition they would understand. It is with this in mind that one of our Senior Ward Sisters, Tracy Kelly, has introduced a small but very effective initiative into her ward. When her staff are having handover, patients often think that because the nurses are not visible, they are not there. The same applies sometimes with relatives. They will see the nurses sitting in handover and will not fully appreciate the importance of this activity. Tracy has introduced a number of notices, which advise patients, their families and other healthcare professionals about activities that are going on in the ward at a particular time. These include ‘Nursing Handover’ and ‘Protected Mealtimes’, two critically important aspects of Ward activity, and if we keep people informed, then we know we’ve got a better chance of them understanding and observing the importance of these practices.

Well done to Tracy and her team and well done to all the nurses and midwives who continue to make small changes with a big impact. Bev Critchlow Chief Nurse

Small changes make a big difference

Tracy Kelly

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The Walking Competition As part of the Wellbeing at Work Week, 20 willing volunteers from the Department agreed to wear pedometers to record the number of steps they took during work time. The aim of the initiative was to raise awareness about how active, or not, we are in the workplace and to encourage staff to think about how they can incorporate more physical activity in their working day. The advice is that we should all aim to walk 10,000 steps each day – many of us who drive to work and sit at a computer all day followed by sitting watching television or checking Facebook at home in the evening struggle to achieve this. For the person with average stride length 2,000 steps is about a mile so 10,000 would be close to five miles. The pedometers arrived with one day to spare and were distributed just in time with instructions of how to set the step length and a record sheet for staff to note the number of steps they managed each day at work. Some staff recorded steps taken both in and out of work during the week, which showed how much work activity contributes to total exercise activity. Those in more sedentary roles felt that wearing the pedometer had made them move about more than usual.

We had the first pedometer casualty within 1 hour of starting on the Monday morning as one disappeared without trace. Another ended up in a toilet but the participants kept going despite the technical hitches and 18 returned their record sheets. The overall winner is Lorna Carron who was a last minute substitute, working at Noble’s Hospital as a General Porter that week. She recorded a staggering 135,119 steps for the week, which equates to 67 miles. Lorna’s prize will be pedometers for everyone in the Porters Team. Runners up were another porter, Andrew Cowin, Barry Knipe from the Laundry and Margaret Chalk, Health Care Assistant from Ward 5. It appears that as far as walking is concerned, being a Chief Executive is not good for your health as David Killip’s total was almost, but not quite the lowest. Colleagues were invited to vote on the intranet for who they thought would walk the most and the winner drawn out of the hat, who guessed a porter would win, is Bernie Humphries. Her ‘prize’ is a pedometer for everyone in the Day Procedures Team. Dr Carole Astbury Director of Occupational Health and Safety Service

Working for Better Health - Wellbeing Week The last week in April saw the launch of health and wellbeing at work initiatives by the Departments of Health; and Social Care. The main aim of these plans is to improve work culture as well as to encourage staff to improve their physical health and general wellbeing. The week’s events included displays and roadshows at eight venues across both Departments. Staff were asked to complete feedback questionnaires if they attended a roadshow or taster session, which will be used to identify future priorities. A series of presentations at Keyll Darree included sessions on Safe Handling, Back Care, Choosing Footwear, Stress, Life Change, New Ways to Keep Fit and Mental Wellbeing. A day of presentations for Managers and Union representatives from both Departments took place on the Wednesday to ensure that they have information to help drive the initiative forwards. Over 200 staff attended taster sessions on Tai Chi, Meditation, Yoga, and Pilates organised throughout the week. Feedback from these sessions will be used to see if there is enough interest to organise ongoing sessions at lunchtime or at the end of the working day. A range of comments, both positive and negative has been received from staff and all the feedback will be collated along

with staff survey results. Many of those who attended said they would make lifestyle changes because of the information they had received. Some staff comments about changes they would make after Wellbeing Week: �� ‘Be more aware of my behaviour on the wellbeing of

others’ �� ‘Try to encourage others to make face to face contact

rather than sending emails’ �� ‘Seek help from Occupational Health re: stress’ �� ‘Be more proactive at dealing with stress in my staff’ �� ‘Be more positive and supportive in managing my staff

returning to work’ �� ‘Walk to work more often’ �� ‘Reduce portion sizes!!’ �� ‘Try to improve and increase my sleep’ �� ‘Reduce caffeine intake’ �� ‘Attend a regular Pilates Class’ �� ‘Practice Core Back Exercises’ �� ‘Stop playing out on a school night!’ The most frequently reported changes related to losing weight and increasing fitness. Recommendations from this initiative will be taken forward by the Working for Better Health Steering Group.

David Killip, Chief Executive, took part in the "taster session" for Tai Chi, said: "I had actually done Tai Chi and it was just as relaxing and beneficial as I remembered. The other participants on the taster session really seemed to enjoy it too...in fact they all looked a good deal more skilful and professional than I did! Several of my Crookall House colleagues also tried the yoga sessions. I'm envious of them; I'm too old and creaky for that.”

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Nutrition Action Group - Volunteer Dining Companions The Department is currently expanding the ‘Dining Companion’ service. These volunteers offer help and companionship during mealtimes, assisting the patient whilst they eat their meal and offering encouragement. Volunteers need to be able to give an hour at lunchtime or teatime to spend on the ward. The volunteer dining companion scheme was set up in 2010, by the Nutrition Action Group, in response to concerns about nutritional care of patients at Noble's Hospital. The Nutrition Action Group has worked on a number of strategies since the group first met in 2003.

Josie Wade, Advanced Specialist Dietician and Alison Lester, Volunteer Services Manager are working together to recruit volunteer dining companions who will assist those patients who need a little more attention at mealtimes. Josie explained the importance of the scheme in the context of nutritional monitoring: “People who are malnourished have a longer stay in hospital, are less mobile, fall more easily and

are weaker. Lack of adequate nutrition delays recovery, and increases the risk of infection.” The Department of Health is also looking at how the Malnutrition Universal Screening Tool can be implemented into other parts of the Department and the wider community. The tool can detect over-nutrition (overweight and obesity) as well as under-nutrition and is linked to a flexible care plan. All patients at Ramsey and District Cottage Hospital have their nutritional status assessed by nurses fully trained in using the Malnutrition Universal Screening Tool (MUST). The consequences of poor nutrition and hydration are well documented and include increased risk of infection, poor skin integrity and delayed wound healing, decreased muscle strength, constipation, depression and, sadly, premature death. Poor nutrition and hydration causes harm, often leading to increased and prolonged hospital admissions and increased costs to the Department of Health. A 2011 report from the British Association for Parenteral and Enteral Nutrition, which aims to raise awareness of malnutrition in healthcare settings, showed the results of a survey of 185 hospitals across the UK. They discovered that one in four patients were at a high risk of malnutrition.

CD of Relaxation Techniques aids cardiac recovery

The Cardiac Rehabilitation team within the Occupational Therapy Service has released a CD of relaxation techniques for use by patients undergoing treatment and recovery after cardiac illness.

Recorded by Dave Armstrong of DAM Productions Ltd and produced by Duke Videos, the CD teaches patients and their families to recognise and alleviate stress by providing them with some ‘taster’ techniques such as progressive muscular relaxation, passive muscular relaxation, breathing techniques and visualisation. The CD comes with a booklet, which explains the benefits of relaxation, as well as providing some more information about each of the techniques. Patients undergoing Cardiac Rehabilitation had approached members of the Occupational Therapy team, asking whether

the techniques being taught at the treatment sessions could be recorded for them to use at home, and to benefit other patients, or anyone in need of a structured guide to relieving stress. The Rheumatology Department will also use the product with their patients, to reduce stress and improve pain symptoms. Plans are already afoot for the production a second CD, focussing specifically on visualisation techniques. There is evidence that guided relaxation can reduce reliance on medication, alcohol and cigarettes, improve sleep patterns, reduce blood pressure and help with pain management.

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Alison Lester, said: “Dining Companion volunteers are trained to support our healthcare professionals by providing encouragement and companionship to patients during mealtimes, and we need more people to come forward and volunteer for this role. Our next training session will be on Saturday 30th June so if you are a good communicator and have the time to help, please contact Noble’s Hospital Volunteer Service.”

Josie commented: “The report showed that all age groups are affected, not the elderly as first assumed. The aim of the Nutrition Action Group, the use of the MUST tool in certain settings and the rolling out of the Volunteer Dining Companions across Noble's Hospital, will ensure we continue to recognise people at risk and do something to minimise the cases of malnutrition.”

Julie Alanachmead, Occupational Therapist of the Cardiac Rehabilitation Service said: “This CD is a very exciting development. Both patients and their families will benefit from having these techniques available to use whenever they need them, and in the comfort of their own homes. It has taken a little bit of time to bring everything together, and I would like to thank the external agencies for all their help with making this project a reality.”

Bev Critchlow, Director of Nursing, Midwifery and Therapies, said: “I would like to congratulate the Cardiac Rehabilitation team for producing this CD. At Noble’s Hospital, we are always striving to find new, innovative ways of improving our patient care and the patient experience both within the Hospital and after discharge. We are always pleased when patients suggest how we can improve things for them, and where possible we will put these suggestions into practice.”

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On Monday the 12th of March 2012, the Department launched its new Internal Mediation Service ‘Mediators for Health’ for staff employed within the Department of Health and the Department of Social Care’s Social Services Division. The launch follows a period of training and assessment for a group of 15 members of staff from both Departments who have now received accreditation to provide a Mediation Service to fellow staff from these Departments, within the workplace. UK Company TCM Ltd (Total Conflict Management Ltd) provided the training and assessment. At the launch, the Minister for Health presented the staff with their certificates. The event held at Keyll Darree was the culmination of a vision, by Sandra Pressley, which was born out of the recognition of a need for more informal, less stressful ways to resolve conflict in the workplace. This ‘vision’ saw several months of negotiation, planning and training resulting in the formation of the new service. The ‘Mediators for Health’ is one of the first Internal Mediation schemes to be implemented within the Isle of Man Government and it is hoped that it will be of benefit to enable workplace conflict to be resolved more informally and lessen the impact of conflict for all parties involved. In his opening speech, Minister for Health, David Anderson said: “Mediation is widely recognised as a successful and acceptable way of resolving conflict and is currently growing in the UK. The UK Government backs the growth of this sector and has recently spent £25m in support of mediation services. It is therefore an honour to be

associated with the development of one of the first schemes of its kind within the Isle of Man Government; the Department of Health’s new internal mediation service ‘Mediators for Health’.” Mediation uses a different approach to resolving differences that involves neutral third party

mediators who act as facilitators. The mediators are not there to offer solutions but rather they are there to try to help both parties come to a mutually acceptable agreement. Mediation involves the two parties talking, engaging and listening to one another in a safe neutral environment. The process is purely voluntary and wholly confidential.

An awareness campaign explained to staff and managers the concept and benefits of workplace mediation will be as well as providing details of how the service can be accessed. If you would like further information please contact Nina Hogan, Appraisal and Development Facilitator e-mail on 642925 or email [email protected]

‘Mediators for Health’ – Internal Mediation Service

An important element of performance management is the ability to effectively manage documents, for example, easy identification and access to the current version of a document and enhanced security of paper documents (scanned and) stored electronically. To achieve this, we need to adopt a Department wide format for naming and saving management/administrative documents and those documents which don’t form part of a ‘bespoke system’ such as Medway or Rio. The standardised format, commonly called a ‘naming convention’, is already being applied to all DH web and Intranet material. We are now ready to introduce the standardised document naming convention Department wide, to support the effective electronic storage and

retrieval of documents in all areas of the Department. Can you therefore please ensure that the naming convention as illustrated below, is applied to all DH management/administrative documents and those documents which don’t form part of a ‘bespoke system’, as from now. The naming convention is: (document name) DD-MMM-YYYY for example: �� budgetbriefing15-Jan-2012 �� frontofnobleshospital 24-Jun-

2011 Please note: No more than three characters should be used to denote the month e.g. ‘Oct’, ‘Feb’, ‘Nov’. Documents being submitted to the Department of Health HQ, for example,

Department meeting papers, news releases, business cases, reports etc, must also meet the correct naming convention from this date, so that our secretarial team can save and easily retrieve documents using their established e-document management system. Introducing this change to the way we manage certain groups of documents, will support efforts to introduce an e-business (paperless office) environment where possible, reducing secretarial/administrative support costs and improving overall performance, with the added benefit of reducing expensive office consumable costs and physical storage. Lesley Keenan Deputy Chief Executive

Standardised document naming convention

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Bev Critchlow, Director of Nursing, Midwifery and Therapies, said: “We are very aware of both the emotional and financial costs of unresolved conflict in the workplace and the provision of a Mediation Service is a huge step forward to helping our staff to work in an environment that is healthy and safe. It is important for staff to be happy in work for both their own sakes and so that they can provide the very best care to our patients and their families. I would like to congratulate our team of Mediators for successfully completing this very comprehensive training and assessment programme and wish them every success.”