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GP Bulletin January 2012

In this issue

1. Key performance measures

2. Clinical articles and referral protocols

  • Community Neurology Specialist Nurse Service
  • 2 Week Wait Cancer Bureau
  • Minor Injury Unit numbers change
  • Cervical Cytology requests and HPV testing
  • New Rapid Assessment Unit
  • Maternity Ultrasound has moved
  • Changes to Orthotics Services

3. Consultant appointments

4. Trust news and service developments

  • New renal dialysis unit at the Horton General Hospital
  • Delayed transfers of care
  • Director of the Horton retires
  • Foundation Trust update
  • NICU extension

1. Key performance measures

The goal of seeing, treating, discharging or admitting 95 percent of patients within four hours effectively remains as a performance indicator.

Read our latest Performance Report

Healthcare associated infections

MRSA and C.difficile: latest figures

2. Clinical articles and referral protocols

Oxfordshire Community Neurology Specialist Nurse Service

The Oxfordshire Neurology Specialist Nurse Service is a new service developed to support individuals and their families with long term neurological conditions who live in Oxfordshire. The conditions include Multiple Sclerosis, Parkinson's Disease, Epilepsy and Huntington's Disease along with other neurological conditions not currently supported by an established service. The service is community based, but works closely with both community health and social care services and also the acute services at the Oxford University Hospital NHS Trust and neighbouring Trusts where some GP practices and patients are situated near the Oxfordshire borders. We have close links with the hospital-based Specialist Neurology Nurses, Neurologists and Geratologists at the OUH NHS Trust and also RBH NHS Trust.

Our aim is to support individuals and their families to live as independently as possible within the limitations of their conditions, when they need it, and closer to home. This support may include symptom management, advice and information on their neurological condition, support with medications and providing specialist support and guidance to other health and social care professionals who are involved in the persons care. We will also support health professionals and carers with education and training on specific neurological conditions. There are currently three Community Neurology Specialist Nurses who can see patients in community based clinics around Oxfordshire or at home if appropriate.

The Specialist Nurse Team can be contacted on: 01865 425202.

More information, referral forms, referral criteria and information leaflets can be found here.

Wrong number for 2 Week Wait Cancer Bureau

A member of the public has contacted the OUH switchboard recently to say that he is receiving quite a few calls from people, to his home, asking for the 2 Week Wait Cancer Bureau. May we please remind you of the correct telephone number for this service 01865 231404. We have checked the information on the Trust website and have also confirmed the information with our switchboard. The problem could simply be that people are either mishearing or misdialling the number but we would be grateful if you could please check your records to make sure that this is the number you are giving out to patients. Thank you for your assistance.

Minor Injury Units - changes to telephone numbers

The telephone numbers for the Minor Injuries Units (MIU) and First Aid Units (FAU) have changed.

This is a reminder of the new numbers:

  • Abingdon Community Hospital MIU: 01865 425161
  • Bicester Community Hospital FAU: 01869 604122
  • Wallingford Community Hospital FAU: 01865 425200
  • Witney Community Hospital MIU: 01608 648262

No change to telephone number for: the MIU at Townlands Community Hospital, Henley: 01491 637435 or the FAU (run by South Central Ambulance Service) at Chipping Norton War Memorial Community Hospital: 01608 648233.

Cervical Cytology requests and HPV testing

As you will all be aware it is now recognised that high risk Human Papilloma Viruses are responsible for cervical cancer and that the NHS Cervical Screening Programme is moving over to the use of HPV testing as part of the national cervical screening system in the UK. This will take place in two phases and is due to be implemented in Oxfordshire within the next few months. We are currently waiting for the final clearance from national office to proceed with procuring the necessary equipment. As part of this new testing process ALL cervical sample takers are required to undergo further training on the implications of the HPV test results that will be issued in conjunction with the cytology report - the HPV status of the woman will affect how her repeat tests are managed which will naturally cause some distress for patients. This training is being rolled out across Oxfordshire, Berkshire and Buckinghamshire during January to March this year and those sample takers that attend the training session can then cascade train others in the practice.

Cervical cytology requests and HPV testing at the John Radcliffe Hospital

New Rapid Assessment Unit

The Rapid Assessment Unit (RAU) is a new service provided by the Cardiac, Vascular and Thoracic Division. The Unit is located on Level 0, Oxford Heart Centre, in the John Radcliffe Hospital (previously occupied by CTU). Patients will be assessed within 24/48 hours and go on to treatment in cardiology or cardiac surgery. Access to the Unit is via the main lifts (D3 and D4) in the Oxford Heart Centre, following signs to the Cardiology Ward. On arrival at Level 0 of the Oxford Heart Centre there are signs to the RAU.

Contact details:

RAU Staff Base: 01865 72955 / 572953

The senior nursing staff for the area are:

Maternity Ultrasound has moved

Maternity ultrasound has recently moved from Level 2 to Level 4, Women's Centre. The facility on Level 4 is a new refurbished area to accommodate Ultrasound. Prenatal Diagnosis Unit has moved from Level 2 to Level 6, Women's Centre. The Prenatal Diagnosis Unit is amalgamating with the Fetal Medicine Unit. The contact numbers for Ultrasound and Prenatal Diagnosis Unit remain the same:

  • Ultrasound: 01865 221715
  • Prenatal Diagnosis Unit: 01865 221716

For further information, please contact Rosalie Wright: 01865 857828

Changes to Orthotics Services

For GPs in the area that refer to Horton Orthotics:

Please note that the administration for the Orthotic outpatient clinic at the Horton General Hospital will transfer to the Admin team at the NOC with immediate effect. The Orthotic clinical service will remain as it is currently at the Horton, all day clinic on Fridays. Please can the referrals be marked clearly that an appointment at the Horton is preferred. The administrative lead for this at the NOC will be: Jabeen Alam, Administration Supervisor, Orthotics, NOC. Andrew Dodds remains as the Senior Orthotist at this clinic.
All referrals for this clinic should now be sent to:

Orthotic Department
Nuffield Orthopaedic Centre
Windmill Road
Oxford OX3 7HE

Tel: 01865 227575 / 227760
Fax for urgent only referrals: 01865 227943

3. Consultant appointments

  • Dr Arjune Sen has been appointed as a Consultant in Neurology with a special interest in Epilepsy
  • Mr Shailendra Ashok Magdum has been appointed as a Consultant in Paediatric Neurosurgery
  • The following have been appointed as Consultants in General Internal Medicine:
    • Dr Josephine Lightowler, Dr Druin Burch and Dr Smith
  • The following have been appointed as Consultants in Obstetrics and Gynaecology:
    • Miss Veronica Miller, currently consultant at Buckinghamshire Hospitals NHS Trust (maternal medicine) and
    • Mr Sujay Chakravarti, currently local consultant at the Chelsea and Westminster Hospital (Clinical Lead for Ambulatory care

4. Trust news and service developments

New Renal dialysis unit at the Horton General Hospital

A new renal dialysis unit will be opening at the Horton General Hospital. It has long been an aim of the Trust to provide a more local service for patients from the North of Oxfordshire and from South Northamptonshire who currently travel to the Churchill Hospital in Oxford for their treatment. This means that 20 patients who currently travel to Oxford should be able to be treated in Banbury. The new unit will consist of five dialysis stations to treat up to 20 patients. Space for the new unit has been identified in the old Medical Assessment Unit at the Horton.

Delayed transfers of care

Delayed transfers of care remain high with 119 patients in our hospitals in December waiting to move on to their next stage of care. There has also been an increase in the number of patients remaining in hospital beyond 21 days. The new Supported Discharge Service is helping people make the transition from hospital to home. A joint action plan has been agreed across NHS and Social Care representatives called the ACE Programme (Appropriate Care for Everyone). This is chaired by Dr Stephen Richards, GP lead of the Oxfordshire Clinical Commissioning Group. The Programme has membership from all four Oxfordshire organisations responsible for patient care: NHS Oxfordshire and Buckinghamshire PCT Cluster, Oxford Health, the OUH and Oxfordshire County Council.

Initiatives undertaken at the OUH to reduce delayed transfers include:

  • Post Acute Unit (PAU) - a 36 bedded unit at the John Radcliffe for patients from Geratology and acute medicine wards assessed as clinically ready to discharge
  • Supported Discharge Scheme - introduced at the John Radcliffe on 28 November and at the Horton in December - to help people make the transition from hospital to home
  • Home for Lunch - talking to patients about their discharge to speed the process up

Director of the Horton General retires

Mike Fleming, Director of the Horton General Hospital, will be leaving the Trust on 31 March 2012. By the time Mike leaves he will have completed 40 years' service in the NHS. Mike has made an enormous contribution to both the Trust and the wider Oxfordshire healthcare system. He was the first Board level HR Director at the Trust and became Director of the Horton General Hospital in August 2003. Mike's executive responsibilities at the Horton will be transferred into the Divisional management structure with clear escalation arrangements to Paul Brennan, Director of Clinical Services.

Foundation Trust – the next steps

Work is continuing on the development of the Trust's Foundation Trust application. A strategic review is taking place in preparation for this, within the context of the recent integration and the strengthening of the relationship with the University of Oxford. There will be consultation with our stakeholders and the public in due course on the Trust's vision and strategic direction as part of the process to become a Foundation Trust. The aim is to achieve Foundation Trust status within 2013, with public consultations taking place from May 2012 and an application to the Department of Health planned for January 2013.

Planned extension of NICU

The Trust has submitted a planning application as part of expansion plans for the Newborn Intensive Care Unit (NICU). The plan involves building an extension next to the current unit at the Women's Centre on the John Radcliffe Hospital site. The OUH has been asked by South Central SHA Board of Commissioners to expand the number of newborn intensive care cots at the John Radcliffe Hospital as there is a recognised shortage of cots in the region. The John Radcliffe Hospital is the only designated Neonatal Intensive Care Unit covering the Thames Valley (Oxfordshire, Berkshire and Buckinghamshire).

This expansion is planned to double the intensive care capacity from 10 to 20 cots. Sixteen of the intensive care cots are planned to be in the new extension. If approved, the new facilities will enable the Trust to provide more than twice as much space around each cot, creating an improved environment for baby, parents and staff. There will also be a new secure entrance into the area, a new waiting area for families, a new reception and ward clerk's office; and a couple of small rooms close by for parent waiting.

Electronic Patient Record Update

Technically, the 'go live' for maternity, ED and PAS across the Churchill, John Radcliffe and Horton General hospitals has gone well - and the number of technical problems is relatively small compared to other trusts. Some functions are taking longer than anticipated to bed down however, resulting in delays, particularly for patients and GPs who have experienced difficulties in accessing the Patient Contact Centre to book appointments.

The Patient Contact Centre does have measures in place for urgent matters, including a number for patients to call with late notice appointment cancellations. There is also a dedicated GP phone line and email address for urgent appointments, and the 2 Week Wait Cancer Bureau, which receives faxed referrals from GPs for patients with suspected cancers, is working with no delays.

Phase 2 of the EPR implementation is planned for March 2012, where increased clinical functionalities will be introduced to the system. More detail to follow on this as plans progress.