Trust Matters is our newsletter for people with an interest in Leeds Teaching Hospitals NHS Trust. It shows the ways we are working more closely than ever with our commissioners and our partners locally and nationally to provide excellent health and care services for Leeds and beyond. We are strengthening our relationships with teaching organisations to train the best clinicians and with research partners to develop care and treatments for improved patient outcomes.
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Welcome to Trust Matters - Issue 2
Welcome to the second issue of Trust Matters - our newsletter for people with an interest in Leeds Teaching Hospitals NHS Trust. This time we have focused on a couple of key areas for our Trust, collaboration with our partners and research and innovation; both are strategic priorities.
It is almost too obvious to state - and yet too important not to reaffirm - that working collaboratively with partners in health and social care is absolutely essential if we are to achieve our shared goal to provide timely access to high quality health and care services for the people we serve. Patients and carers expect integrated care, our job is to work together to plan and deliver them.
Our Research and Innovation strategy sets out in detail the areas in which we are investing and the key to understanding why this is mission-critical is the title of the document Translating Research Excellence Into World Class Care. We try to ensure that everyone throughout our hospitals knows they have a role in using new ideas and technology to benefit patients.
So, that's the rationale for the themes reflected in our newsletter this month. Again, I would like to thank you for taking the time to read on and encourage you to contact us if there is anything you would like to know more about.
Finally, on behalf of the Trust Board we would like to wish you a Merry Christmas and Happy New Year.
Dr Linda Pollard CBE DL, Chair
Julian Hartley, Chief Executive
Developing a vision for the Leeds General Infirmary (LGI) site
We are starting to develop our exciting vision for improving the LGI site to enable us to provide services for patients from much more modern and purpose built premises.
Many of you will be aware we have been gradually moving clinical services from older accommodation at the LGI that is no longer fit for purpose and centralising inpatient care into Jubilee Wing and Clarendon Wing. Now we are starting to consider how we can achieve the maximum possible benefit for patients by redeveloping other parts of that site. This work is part of our wider Estates Strategy and is at a very early stage.
Our overall aims are to deliver our clinical strategy to consolidate Leeds Children's Hospital, and to have dedicated day surgery facilities, increased operating and critical care capacity, and modern outpatient services at the LGI.
We have had initial discussions with senior clinicians based on some initial ideas we asked designers to work up but we are obviously at a very early stage. As plans progress we will engage widely with our partners and keep you informed.
West Yorkshire Association of Acute Trusts (WYAAT)
WYAAT brings together NHS acute hospital trusts from West Yorkshire and Harrogate to drive forward the best possible care for our patients. In addition to Leeds, the association includes Airedale, Bradford, Calderdale and Huddersfield, Harrogate and Mid Yorkshire.
We will work with local and regional commissioners to shape plans for new models of care. Working together we can be a strong voice contributing to the development of national policy for acute care as well as share and spread best practice across the collaborative to benefit patients. By thinking and working as a system, we can reduce duplication and work more efficiently.
West Yorkshire has a strong track record in embracing technological innovation to deliver radical change. A key focus of our work is to drive forward a 'model clinical network' that will:
- deliver improved and consistent outcomes for our patients by using the latest technology;
- improve clinical productivity and workflows;
- strengthen quality and improve the experience of our patients and their families.
WYAAT will be holding stakeholder events early in 2016 to help understand the priorities for our organisation.
Working with Harrogate
In conjunction with the WYAAT work, we are talking to our colleagues from Harrogate and District NHS Foundation Trust (HDFT) to look at ways in which we can work together more closely to improve services for our patients.
It is becoming an extremely productive relationship with a number of different strengths we can each bring to a collaborative approach to improving the services and care our patients receive. HDFT is now providing endoscopy services from Wharfedale Hospital and we are working more closely to improve cardiology services.
Last year, we were one of a very few Trusts to meet the Emergency Care Standard and see 95% of patients within four hours. It was a testament to the great work everyone did within our hospitals and working with partners across the health and social care system, particularly through a difficult and extended period of winter pressures.
However, this had an impact on elective and cancer activity, resulting in cancelled operations, poor patient experience and reduced income. We are expecting this year to be as challenging, if not more. Our plans aim to protect planned activity and maintain access for our non-emergency patients.
There are significant risks to patient access and resilient service delivery this winter including a reduced level of additional bed capacity compared to last year, a shortage of nursing staff across the health economy, and large numbers of Delayed Transfers of Care (DTOC).
Throughout the winter our overriding principle is maintaining and optimising patient safety. Our winter plan focuses on five key areas:
- Maximising and increasing assessment capacity/admission avoidance;
- Improving patient flow by optimising system intelligence to reduce delays;
- Improving discharge processes;
- Reducing Delayed Transfers of Care;
- Ensuring bed capacity meets system demand (elective and non-elective).
We are aiming to ensure that not only are our internal processes and systems fit for purpose, but that we also contribute to the health economy winter plan in order to ensure that system wide services and flows meet anticipated levels of demand. The system wide plan is governed through the System Resilience Group (SRG) which is chaired by Leeds North CCG and has representation from all partners, including the third sector.
More details of our shared winter plans can be found at: http://bit.ly/1QW3Oye
Delayed Transfers of Care (DTOCs)
We are currently working hard to reduce the number of people who are medically fit to leave hospital but who are unable to do so when there are no beds in the community for them to be discharged to - we are aiming for a 50% reduction.
Between April 2015 and October 2015, we had 6917 more lost bed days due to delayed transfers of care than the same period the year before and in the month of October 2015 alone, we had 1735 more lost bed days than in October 2014. This is a large increase and creates a significant risk for us in terms of performance and delivery of the best possible care.
Together with CCG commissioners, Leeds Community Healthcare NHS Trust, Leeds City Council Adult Social Care and the NHS Trust Development Authority (TDA) we are reviewing the city-wide approach to discharging patients from hospital and we have made significant improvements recently. The number of bed days lost in October was 3185. We experienced a decrease to a total of 2565 for November and after 10 days of December there were 671 beds days lost so the early signs are positive. However this position remains extremely challenging in terms of hospital capacity - this is a challenge across the whole NHS as evidenced in the recent report by the Nuffield Trust http://www.nuffieldtrust.org.uk/summit/spotlight-ae
It is extremely helpful to have the TDA providing us with an independent perspective about how the health community is operating and where it can improve. They have been extremely impressed by the way staff from health and social care organisations across the city have worked together to improve services for the people of Leeds. We remain optimistic that this work will result in significant reductions in pressure on hospital beds and in the meantime we are working with system partners to manage the immediate winter pressures.
Professor Sir Bruce Keogh Visit
We were privileged to host a visit by NHS England's Medical Director, Professor Sir Bruce Keogh. Sir Bruce joined our monthly Team Brief, where he highlighted to our senior staff the opportunity we have to improve services using the Leeds Improvement Method based on work in partnership with the Virginia Mason Institute in Seattle. Sir Bruce said he believes we have the potential to become one of a handful of outstanding Trusts in the country.
Afterwards, along with our Chair Linda Pollard, Sir Bruce and his party, which included Dr Mike Prentice, the NHS England (North) Regional Medical Director met clinical teams on wards L51 and L47, the children's congenital heart unit and paediatric intensive care unit. Sir Bruce was keen to talk to young patients and their families and he was impressed with what he heard about their positive experiences.
Sir Bruce then opened our new £60,000 hi-tech cardiac wet lab in Jubilee Wing. He praised our adult cardiac surgical team for their role in developing the training facility. Teaching and passing on surgical skills through technology is fundamental to the success of our hospital and high quality clinical outcomes in the NHS.
Yorkshire Cancer Research £5m project into Yorkshire health
We are delighted to let you know that in partnership with Yorkshire Cancer Research and the University of Leeds we are embarking on a five-year research programme worth £5 million. This investment will help the Leeds Cancer Centre achieve its vision of becoming one of the leading centres for cancer treatment in the UK and beyond. We are also confident that patients will benefit as a result of the programme, which should attract some of the country's leading researchers to Yorkshire.
Studies will be carried out to improve diagnostic and screening services so that more people are diagnosed at an early stage, when cancer is easier to treat, and to ensure all patients have equal access to gold standard treatments. The research should also help to tackle the North-South cancer divide and see more people in Yorkshire survive the disease.
Clinical Research Studies at Leeds
For the fourth year running, we have been ranked second in England for the number of clinical research studies we are running. This result underlines our commitment to improving treatments for patients at the Trust and across the NHS. The results are published in a league table compiled by the National Institute for Health Research Clinical Research Network, which supports research in the NHS. It shows that last year, 12,368 patients took part in 468 clinical research studies at LTHT and it means that our hospitals play an important role nationally in developing more effective patient treatment and care. Hospital trusts that are actively involved in high quality research have better outcomes for patients and many of our patients who qualify for a research trial welcome the opportunity to participate.
1000th Course of SABR
Leeds Cancer Centre welcomed BBC Look North in to the hospital recently to film a patient receiving the 1000th course of SABR (Stereotactic Ablative Body Radiotherapy) from our team. We are the national leader in this field and have treated by far the most number of patients with lung cancer using this method of any UK hospital. This work is a great example of multi-disciplinary team working between medical staff, radiographers and medical physics and has made a big difference to hundreds of patients with inoperable lung cancer, using a series of high doses delivered in just 90 seconds with pinpoint accuracy. We are sharing our expertise with other centres and there are exciting plans to expand the scope of the treatment beyond lung cancer in the coming year.
Precision Medicine Catapult
Leeds has been chosen by the Government to be one of six centres in the UK to support the development of precision medicine. This important field uses diagnostic tests and data to help clinicians gain a specific understanding of a patient's illness so they can plan more effective treatments. As part of the Leeds Academic Health Partnership, we will be one of the major partners in this initiative which will have far reaching healthcare benefits for patients in Leeds, the wider region and across the UK.
We are delighted that this week we were approved by NHS England as part of a new Genomic Medicine Centre (GMC) within the national 100,000 Genome Project.
Our joint bid with Sheffield Children's NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust was supported by the other 11 acute trusts in the region along with our major Universities.
This ground breaking project involves looking at the genomes of patients with certain rare diseases and patients with certain cancers. By comparing the genomes from lots of people, the Genomic Medicine Centre (GMC) will help to give a better understanding of the diseases, how they develop and which treatments may provide the greatest help to future patients.
We are extremely proud that joint working with our colleagues in Sheffield and right across the Yorkshire and Humber region has made this centre a reality, allowing us to pool our expertise and set ambitious goals to help transform patient care.
Genomics is key to the future of medicine and the partnership means local patients with inherited genetic disorders and cancer will benefit through the provision of more efficient diagnosis and better patient information and by enabling access to the next generation of targeted therapies.
Understanding DNA and how it can predict and prevent disease, provide a precise diagnosis and direct targeted treatment will play a role in every aspect of medicine, from cancer to cardiology, in the future. The new centre will go live from 4 January 2016.
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