Issue 1: December 2016

Seamless urgent & emergency care for Croydon

Responding to our financial challenges

Improving our care for you

Caring for Croydon this Christmas No-one likes being ill, particularly at Christmas, but our staff are ready 24 hours a day, 365 days a year, to look after you and we are spreading some festive cheer throughout the Trust. Christmas trees have gone up in the main entrance and the wards, and in the Chapel there is a baby Tree of Memory and Hope, and a Blue Christmas tree for those who wish to remember someone they will miss this Christmas time. Our patient experience team are busy planning Christmas activities including festive film showings and a Christmas tea party for our inpatients. Meanwhile, the Children‘s Hospital at Home team are holding a festive party for families of children with cancer in the borough. Our Chaplaincy team are holding carol services on Tuesday December 20, on Christmas Eve and on Christmas Day. Our local community is also helping us spread some good cheer. This Page 1

month, footballers from Crystal Palace and their coach visited children on the Rupert Bear Ward and people on our Acute Care of the Elderly unit. In the week before Christmas, a group of carol singers from Age UK will be visiting our wards and a local women‘s group the Lajna association will be bringing presents for some of our elderly patients.

season, we are also urging people to do all they can to stay well over winter.

On Christmas Day itself, the Salvation Army brass band will be visiting us to play carols for staff, patients and visitors and on the wards and patients will be served a Christmas lunch. As well as helping make it a happy Christmas for those in hospital over the festive

If you need health care over Christmas, choose the right service. You can get advice by calling 111 or using the app ‗Health Help Now‘

Stay well this winter Staying warm and hydrated will help your body to fight off colds and other infections.

For more advice visit

Find out all about our services and news at


Welcome to our first edition of CHS News We are immensely proud of all of our staff – especially their care and compassion to look after our community throughout Croydon. Our dedicated teams care for people not just in hospital, but at home, in schools and community sites across the borough. We want to share their many successes with you – and also discuss how we are overcoming our challenges to keep on improving. Listening into Action, where we give our staff the tools and support to make positive change in their own services, has delivered a multitude of improvements. One of the biggest challenges that many in our community will relate to is how can we

see people more quickly when they need us. Our groundbreaking Edgecombe Unit, which recently celebrated its first birthday, is a great example of this. Nine out of ten patients would now recommend CHS for the care of their friend or relative. This is something that we are immensely proud of, and we‘ll keep working to do even better. We must make sure that our standards of care and clinical performance are the best that they can be – every time, all the time, but also achievable within the resources we have available. At its heart, all of our efforts are focused on providing you, our community, with the best care that we can whenever you need it. From

looking after our patients in hospital over Christmas to caring for the victims - and their families – affected by the tragic tram derailment in November, we are always here for you. So, to end, I‘d like to thank all of our staff who will be working in hospital and in Croydon over Christmas and I hope that all of our community have a healthy and happy festive period.

Mike Bell, Chairman of Croydon Health Services

Trust pulls together for tram incident victims On 9 November, our community was shocked by the derailment of a tram near Sandilands, and the deaths and injuries that this caused. We cared for 38 wounded people in the hours immediately after the event, and supported many of their families. The response from all of our staff was incredible – our colleagues were calm, professional and unified. Page 2

Our deepest sympathies go out to all those who were personally affected by this tragedy.

We are enormously grateful to all of our staff for providing care for the injured and their families. The Evening Standard published an article and a web video about our response and the incredible team effort involved. Thank you to all who helped Croydon at this very sad time for our community.

Meet the team croydon

Tell us your thoughts on this newsletter by emailing us at [email protected]

“Caring for Croydon Together”

Croydon‘s ―revolutionary‖ Edgecombe Unit Across England, A&E attendances are rising. Croydon University Hospital regularly sees more than 350 people a day at its Emergency Department and on-site Urgent Care Centre. That‘s very busy – and can mean long waits. Is there another way? Yes! In 2015 the Trust‘s senior doctors came up with a vision to redesign how emergency care was delivered. The result was the Edgecombe Unit, which opened in November 2015 combining acute elderly care with ‗walk-in‘ urgent medical assessment and treatment - making them immediately available to people from the moment they arrived at hospital. Appropriate patients are fasttracked to the Edgecombe Unit and its experienced team and within four hours they have a consultant review and a treatment and management plan.

Now one year old, the Edgecombe Unit has cared for more than 20,000 patients. The unit has attracted national attention and was included in the most recent healthcare edition of the Parliamentary Review. From November this year, a new pilot has been launched which means some patients are now being brought straight to the Edgecombe Unit by ambulance, without going via A&E.

Dr Reza Motazed, Edgecombe lead consultant, said: ―We wanted to ensure that patients are cared for in the right place and at the right time and so came up with this new approach, which we believe is the first of its kind in the country. ―In many cases some patients don‘t need to be in A&E. Now paramedics are able to identify these patients, discuss them with an Edgecombe consultant over the phone and, if appropriate, bring them directly to the Unit. ―We hope it will help to ease pressure on the A&E Department, and allow them to focus on those who do need emergency care. We also hope it will speed up handovers for some patients, so paramedics can get back on the road as quickly as possible to respond to further 999 calls.‖

What our patients are saying

Our 90 year old mother... who suffers from Advanced Alzheimer‘s was treated with dignity, care and respect.

This is a wonderful unit and a credit to CUH.

I have nothing but praise and gratitude for the staff who looked after me with such care and consideration.

Every day, the unit prevents up to 25 patients being admitted unnecessarily

Connect with us on facebook via our croydonhealthservices page

Page 3


Trust‘s financial recovery on track We have undertaken a fundamental review of the Trust‘s long-standing financial challenges to tighten our budget. Our recovery plan has been carefully developed to reduce costs – without compromising patient care or safety. CHS was one of eight acute trusts to be placed in Financial Special Measures earlier this year, alongside nine Clinical Commissioning Groups, including Croydon CCG. NHS Improvement has set CHS a target to reduce its deficit to £32.8m by March 2017. As well as reducing costs, we must meet national standards for planned and cancer care, along with agreed performance trajectories in

A&E. If we do so, we will qualify for an extra £7.35m of Sustainability and Transformation Funding (STF), which would reduce our deficit to £25.45m. Analysis to October 2016 shows that we are on track to meet this target. Further work is now underway to the Trust back in financial balance within the next three years.

ensure that the actions we take do not reduce the quality, safety or performance of our services. A big part of our financial recovery plan focuses on limiting our use of expensive agency staff by encouraging more of our staff to join the flexible workforce bank. We are also recruiting more substantive staff, and have appointed more than 280 doctors, nurses and therapists over the past three years, despite there being a shortage of trained clinicians across the country.

We will reduce the Trust‘s long-standing deficit while continuing to care for our We are also doing more to community. deliver more co Every one of the Trust‘s savings schemes has been scrutinised by the Clinical Cabinet – a group of our most senior clinicians – to

-ordinated care and make sure our purchasing decisions offer the best value for money.

A sustainable NHS in south-west London In November, the Sustainability and Transformation Plan for south-west London was published; this is the NHS‘s long-term strategic plan for local health services.

the STP does it state that there are any plans to close any hospitals in south-west London.

Clinicians have suggested that we need more clinical The approach is to use existing networking and possibly one funding and resources to build less hospital providing acute our services around the needs services like A&E, obstetrics of local people and investing and specialist paediatrics. more in out-of-hospital services to make it easier to access the right care and support. The details of these plans are still being developed by clinicians and these will be subject to full public consultation, but nowhere in Page 4

Equally, they have not ruled out retaining these services in all five acute hospitals in south west London. Croydon clinicians will be very much involved in the next phase of modelling to ensure that any proposed changes are safe and in the best interests of our patients and community. The STP does not affect the ongoing construction of our new Emergency Department at Croydon University Hospital, which will open in late 2017.

Tweet us and follow us @croydonhealth on twitter

“Caring for Croydon Together”

A day in the life of a Consultant Surgeon You might think surgeons spend all their time in operating theatres. The truth is that surgeons do much more and are there to care for patients before, during and after their treatment. Mr Rhys Thomas, a consultant in Upper Gastrointestinal and General Surgery at the Trust, talks about his typical day. Mr Thomas and his team on the wards

My day starts with a ward round at 8am. My team and I visit the different wards that my patients are on to see how they are. Some will be recovering while some are having tests or are under observation before a procedure.

get them booked in for surgery or, if necessary, extra tests. I also see patients who are recovering, to make sure they are healing well.

I review the notes made by the ward staff and talk to the patients, finding out how they are feeling, answering questions and explaining how their care is going. This is very important – it isn‘t just to be polite and make sure they are happy, it helps me spot changes to their condition and make sure that I don‘t miss any new symptoms.

First thing after lunch I meet with the other senior surgeons, nurses, radiographers and pathologists to discuss our more complicated cases. This means patients will have had their cases reviewed by a group of clinicians with around 200 years of expertise between them!

After the ward round I have an outpatient clinic at CUH or down at Purley from about 9.30am. This is where I meet with new patients and discuss their test results and treatment options,

The afternoon will be a ‗list‘ full of procedures. These are either endoscopies (examination with a camera) or surgery. Our surgical team of

doctors, nurses and care assistants all work together to make sure that patients are treated safely and effective, and are back into the recovery room as quickly as possible.

What is Upper Gastrointestinal surgery?

Upper GI surgery is when doctors perform surgery on the top part of a patient‘s digestive system, including treatment for gall stones, gall bladder disease and pancreatitis.

Did you know? CUH conducts 26,000 surgical operations every year – that‘s more than 70 a day!

Have you or your loved one received good care at CHS? Is there a service whose compassion and expertise impressed you? If so, you may wish to consider donating money to the Trust‘s charitable fund. You can donate to support a specific ward, service, hospital or the Trust as a whole. Any charitable funds are kept entirely separate from operational funds and are not used to pay for day-to-day costs. If you would like to make a donation, details of how to do so are available on the ‗Getting Involved‘ section of our website at Tell our PALS team about your experiences of our services by emailing [email protected]

Page 5


Creating the best emergency and urgent care Making sure our A&E patients receive the highest-quality care is why we are building a new £21.25 million Emergency Department at Croydon University Hospital. As part of this, our Children‘s ED team want the new facility to be welcoming and calming as possible for those who need our care. Coming to hospital can be stressful for children, especially if they are in need of urgent or emergency care. So our team believe that creating a space that is calming and can help distract children while they are being cared for will really help, particularly for children with additional needs. As well as buying interactive play equipment, the team also want to create a sensory treatment room, filled with soft lighting, bubble tubes and projectors to help reduce any anxiety in our young patients. To raise money for this additional equipment, a team of around 20 nurses, managers and other staff embarked on a 23.5 mile walk across London to raise money. Despite some torrential rain and a lot of very sore feet, the team completed the full route between paediatric intensive

care facilities in South London and so far have raised more than £6,100. The team have more activities planned over coming months to help them reach their overall fundraising target of £10k.

something to distract them while we look after them and provide the care they need.

Sarah Mclaggan, Matron in the Paediatric Emergency Department at CUH, said:

If you would like to give money to the appeal, visit crowdfunding/ croydonchildrensed

―It can make a huge difference if a child has

―This is a once-in-a-lifetime opportunity to make a space which is welcoming and meets the need of local children and their families.‖

New alliance to provide seamless urgent care A new team of local GPs working alongside hospital doctors and nurses at CHS, has been chosen by Croydon Clinical Commissioning Group to run a new network of urgent care services across the borough from April 2017. This will make it easier for people of all ages in Croydon to Page 6

access the right care, in the right care setting, first time and deliver more seamless urgent and emergency care.

Croydon‘s‘GP Hubs‘ will be open from 8am to 8pm, 7 days a week

Services include the Urgent Care Centre at Croydon University Hospital as well as GP-led Hubs across the borough, combining care for minor injuries and minor illnesses. The Croydon Urgent Care Alliance includes: CHS with the Croydon GP Collaborative and AT Medics.

Give us feedback on our care via the NHS Choices website

“Caring for Croydon Together”

Providing the best care for patients with cancer Latest published figures show that CHS has met all cancer targets, even seeing many urgent cancer referrals within a week— half the national expected waiting time! Our cancer team are working hard to ensure we always do the best for our patients. Published data for July, August and September show that CHS met all cancer waiting time targets. The Trust was also top in London (September) for Croydon patients beginning their first cancer treatment within two months of being urgently referred by their GP (62 day standard). For urgent referrals for suspected cancer, we are even managing to see 40 per cent of cases within seven days – half the time specified in national standards.

Cancer performance in Croydon Over the last three months: 96.8 to 99% of patients referred with suspected cancer were seen within 14 days – above the national standard of 93%; 96 to 100% of those diagnosed with cancer started treatment within 31 days; 88 to 100% of people with cancer were treated within 62 days of their initial urgent referral by a GP; at 94.6% - the best in London – in September 2016. The national standard is 85%.

After treatment, please fill out an Friends and Family Test card to give your views on our services



Listening into Action to constantly improve our care CHS was one of the first trusts in the country to adopt Listening into Action (LiA) four years ago. Listening to our staff, we can support them in making the changes they want to see. For the second year running, CHS has received Listening into Action (LiA) accreditation for empowering staff to make demonstrable improvements in our care for patients, and make the Trust a better place

to work. Our focus is improving the quality and safety of our care through a valued and empowered workforce. We have seen a ―fundamental shift‖ in our quality of care, culture and performance.

Want to find out more about LiA at Croydon? Our case study on how we have engaged staff and motivated them to improve care through LiA is available here in the blog section of the Listening into Action website.

Our 2016 initiatives include: Sharing best practice and knowledge from one team to the next, and ensure the Trust acts on lessons learned when our care can be improved. Our Adult Community Therapy team are working together to develop more personcentred care that helps people to stay well with greater access to support at home and services out-of-hospital.

Strengthening the consent process that all staff must follow for vulnerable patients who are unable to make their own decisions about their care.

Reducing the use of catheters in hospital by more than 40% to tackle catheterassociated infections.

Improving continuity of care for Croydon mums with named midwives in charge of their care. Raising the profiles of the ‗Modern Matron‘ across the Trust as role models for nursing leadership and champions for the highest-standards of care Closer working with our partners to provide more joined-up care and support for patients who have mental health issues. Page 8

If you receive a survey by post asking you about our care, please do fill it in

“Caring for Croydon Together”

Not just any patient - ‗This is Me‘ We take pride in providing high quality care for all of our patients. Supporting those with dementia is particularly challenging but our staff have come up with a new way to reassure these patients and their families. Without their established routines and familiar surroundings of home, the hospital can be a bewildering and frightening place for people with dementia. We are working on a solution to help make our hospital a more reassuring place.

One of our elderly care wards (Queens 3) have worked with the Workforce Development team to pilot the ‗This is Me‘ Patient Passport system, to enhance care for all patients with a formal diagnosis of dementia. ‗This is Me‘ contains important information on what works best when a person is anxious or upset, can help in both the engagement of our patients and help reduce distress which is often experienced by people with dementia.

The passport can also reassure family members that all efforts are being made to care for their loved ones . We want everyone to have the best experience possible and initiatives such as these really make a difference to our patients‘ stay while in hospital.

Improving your experience of care in hospital We are always striving to improve the experience of people who are in our care. Our Patient Experience team continuously monitors patient feedback from the Friends and Family Test, national patient surveys, comments to the Trust‘s Patient Advice and Liaison Service (PALs), online comments and a variety of other sources. Recently we have launched two new schemes: Our ‗Mystery Shopper‘ programme calls for volunteers to visit services as part of a coordinated process to see how they work on a day-to-day basis, talk to patients about their experiences and report back about what is working well and what could be improved. Lunch Club is a new initiative suggested by our fantastic volunteers, one of whom is profiled on the next page. For many older patients, being in hospital can be a lonely experience, particularly if they have few visitors. The Lunch Club, which takes place

on Monday and Tuesday lunchtimes, is an opportunity for older patients to socialise and eat together in the Trust‘s Oasis Restaurant. Our patients have told us how much they enjoyed interacting with others away from the ward. The team are now looking to expand the Lunch Club across other departments.

In the words of our patients and service users... ―You made me feel at ease and explained everything to me so well.‖ ―We have been especially impressed with the professionalism of the staff and cleanliness of the wards.‖ ―You were fantastic and a great help and we can‘t thank you enough.‖ ―In all my visits to the hospital all the staff went above the call of duty to attend to all patients on the ward in a highly

Rate our services via the website

Page 9

Croydon Health News

A big thank you to all our volunteers We were honoured to host our annual volunteers Christmas dinner on 6 December to thank our incredible team for all of their efforts throughout year.

specially arranged singer and have a chance to win prizes in the free raffle. Trust executives Michael Burden and Michael Fanning also took the time to pop in and thank the volunteers personally.

More than 115 of our volunteers were able to attend the three-course dinner in the Oasis restaurant, listen to the

Volunteer manager Jane Spayne said: ―Our 360 volunteers provide a valuable service to the

Trust all year round at main reception, on our wards and in our offices. Some of them even come in to support A&E on Christmas. It is a privilege to show them our appreciation.‖

If you would like to volunteer at the Trust , please email Jane at [email protected]

News from our partners

What‘s next at CHS

Don‘t worry – be appy! Two new health apps have recently been launched in Croydon by our partners. The first, ‗Health Help Now Croydon‘, is a free NHS app from Croydon Clinical Commissioning Group which Croydon and Sutton residents can download here and use to find the most appropriate treatment for their condition at a touch of a button.

20 December—Trust Carol Service, 1pm, St Barnabas Chapel, Croydon University Hospital

The second, also by Croydon CCG in partnership with Croydon Council, is a healthy living app which can give you a ‗health MOT‘, as well as provide useful information and links to help get health. Download it for free here. The Healthwatch Croydon Forum is ‗the eyes and ears of Croydon,‘ welcoming people from all age groups and backgrounds to give their views on local health and care services. The next Forum is taking place on Tuesday 7th February 2017, 11am-2pm at Mind in Croydon, 10 Altyre Road, East Croydon. For more details, check The Asian Resource Centre Croydon are having their annual dinner and fundraiser on Thursday 5 January 2017, 7pm-10pm at Chak89 in Mitcham. Tickets for the 5 course meal are just £25 each; email [email protected] or call 020 8684 3784 to register your interest.

11 January— Crystal Children‘s Development Centre reopens on new site in Addiscombe 1 February—Trust Board Meeting, 9.30am-12.30pm, Shirley House, Croydon University Hospital 22 February— Listening into Action Patient and Stakeholder Conversation, 5pm-7.30pm, Oasis Restaurant, Croydon University Hospital

Tell us what you think Tweet us @croydonhealth Talk to us via croydonhealthservices Find us at Share your views on NHS Choices or Patient Opinion

Connect with „Croydon Health Services NHS Trust‟ on LinkedIn

Page 10