Welcome from Paul Tisi, Medical Director
Welcome to the Summer 2023 edition of GP Matters. We are thrilled to be relaunching this newsletter following the merger of Bedford Hospital and Luton & Dunstable University Hospital in April 2020.
The World Health Organization (WHO) has announced that COVID-19 is no longer a public health emergency of international concern. However, this does not take away from the huge impact that the disease has had on the Trust and will continue to have for years to come.
Demand for acute care services continues to increase and rising demand means all areas of the hospital feel periods of high pressure. A&E is not always the most appropriate place for patient care and we would welcome your support in raising awareness of other health care services, such as a pharmacy, NHS 111 or attending a local walk-in centre.
The last few months of junior doctor industrial action has taken a huge strain on our services, impacted our already busy waiting lists and taken a toll on our colleagues’ physical and mental wellbeing.
Our junior doctors make up around 50% of our medical workforce and play a vital role in the day-to-day delivery of healthcare, especially in our Emergency Departments and on the wards. Their specialist skills are difficult to replace, and in order to ensure we continued to deliver safe emergency and ward-based care, we had to ask our senior doctors to change the way they worked to undertake some of our junior doctor’s responsibilities, including overnight cover. We also had to make the difficult decision to re-arrange the majority of our routine and non-urgent appointments and procedures, which has had a significant impact on the progress of our backlog recovery plan.
Despite these pressures, our staff and volunteers have once again demonstrated outstanding commitment to their patients, ensuring high-quality care to all that require our services. A lot of hard work has gone into our recovery plan and addressing the backlog caused by COVID-19 and at the end of March, only 6 patients were waiting longer than the government target of 78 weeks for planned care, which is great news.
We were thrilled to hold our first Robotic Assisted Surgeries at both Bedford Hospital and Luton & Dunstable University Hospital recently. This equipment is a huge asset to the Trust and will transform the care we are able to offer to our patients. Read more on this below.
Finally, thank you for your ongoing support. The demand on all healthcare services post-pandemic has been immense and I really appreciate everything you are doing to help us, and keep the people of Bedfordshire safe and healthy.
Best wishes and happy reading!
Robotic assisted surgery to transform care at Bedfordshire Hospitals
Bedfordshire Hospitals has embraced the latest in Robotic Assisted Surgery with the arrival of two da Vinci Xi robots, one at Bedford Hospital and one at Luton & Dunstable University Hospital (L&D), which will bring considerable benefits for both patients and staff.
Unlike in many other hospitals in the UK, the two robots will be used across a variety of different specialties. Already in use in Colorectal Surgery and Gynaecology, over the next few months they will be rolled out to other specialties like Bariatrics, General Surgery, Head & Neck and Urology.
Benefits for patients include reduced post-operative pain, a faster recovery, leading to a shorter stay in hospital, and improved quality of life after surgery.
Miss Katharine Bevan, Colorectal Consultant Surgeon and Clinical Lead for Bedfordshire Hospitals NHS Foundation Trust, was the first surgeon to carry out a robotic assisted procedure on 17 April at Bedford Hospital.
She said: “This is the beginning of a new era of surgery at Bedfordshire Hospitals and we are tremendously excited to have introduced this new technology and improve the care of our patients.”
Colorectal Surgeon Mr Firas Younis carried out the first procedure at the L&D on 2 May.
He said: “I would like to thank the whole team for their hard work in getting this programme off the ground. It really is an immense achievement. Robotic assisted surgery enables us to perform complex procedures with enhanced precision, dexterity and control. This translates to optimised surgical outcomes for our patients.”
David Carter, Chief Executive of Bedfordshire Hospitals, added: “This is fantastic news for our patients, and will future proof our surgical services – the commitment to innovation, and the training, education and research it brings, will help us retain and attract high calibre staff.
“We are incredibly grateful to Bedford Hospital Charity and Friends for their energy, enthusiasm and support with spearheading this project at Bedford Hospital, having contributed £900,000 to the cost of the robot which is phenomenal. Our huge thanks also go to Bedfordshire Hospitals NHS Charity which has raised money for the console element of the robot at the L&D.”
The robots have a modular configuration, with four mechanical arms and a surgical instrument attached to each arm, controlled by a surgeon seated at a computer console near the operating table. The console gives the surgeon a magnified high-definition, 3D view of the area, so they can perform complex procedures with more precision, flexibility and control than conventional techniques. The tiny wristed instruments move like a human hand, but with a greater range of motion, allowing surgeons to perform a variety of different procedures, while only making a few small incisions.
The robot technology and training has been supplied by Intuitive Surgical.
Targeted Lung Health Check Programme (TLHC)
National roll out of lung cancer screening programme
On 26 June 2023 the government announced the national roll out of the new lung cancer screening programme, following the success of a pilot launched in 2021, when 76% of lung cancers in those tested were caught at an early stage.
Due to our poor outcomes for diagnosis and lung cancer survival, Bedfordshire was chosen as a priority area for early testing and so we were one of the first areas to take part in this pilot which was launched under the NHS Long Term Plan in 2021.
The Targeted Lung Health Check programme invited patients aged between 55 and under 74 years old, who have ever smoked and are registered with a GP, to be screened for a lung health check.
Patients assessed as being eligible are offered an immediate low-dose CT scan to rule out any early cancers. The checks may also identify other potentially serious conditions, in which case patients are referred back to their GP for further investigation.
The programme started in February 2021 and we have now completed all surgeries in Luton and Central Bedfordshire where we sent out a total of 34,634 letters to patients across 38 surgeries.
13,014 patients engaged with the service and participated in a lung health check, of whom 5,656 went on to have a low dose CT scan to date (including follow ups).
In total we have identified 41 cancers.
We appreciate that some patients were invited during COVID and for this and other personal reasons they declined to engage with the programme. We are still able to offer the opportunity to take part in a lung health check, further information can be found at www.lutonandthurrocklunghealthcheck.nhs.uk
The initial Lung Health Checks are via a telephone call, although face-to-face checks can be arranged. If a Low Dose CT Scan is required, this will take place on a mobile unit situated in Sainsbury’s Car Park, Dunstable.
Please encourage your patients to call our Targeted Lung Health Check department on 01582 497141. We also have posters available for display in your surgery, which can be obtained from the above number.
Finally, the good news is that we are planning to start inviting patients from Bedford surgeries during the latter part of the year.
We would therefore ask you to talk to your Bedford patients that fit the criteria during the coming weeks and months so that they are aware of the service and encourage engagement with us when they receive their letters of invitation.
You can find details of the new roll out on the Gov.uk website.
Delay in sending L&D Emergency Department discharge summaries
In April, Luton and Dunstable University Hospital sent a letter to GP colleagues to inform them of an issue with sending Emergency Department (ED) discharge summaries from the site.
Rebecca Pheby, General Manager of Acute and Emergency Medicine at Bedfordshire Hospitals NHS Foundation Trust, said: “Due to issues with the system currently in place to send discharge summaries electronically to GP practices, we have a backlog of some 60 days of activity. This equates to approximately 16,000 attendances dating back to January 2023.
“We are aware that this is far from the level of service our patients and colleagues in primary care should expect. For this, I offer my sincere apologies.
“To address the backlog, we are risk assessing all attendances based on their discharge destination and follow-up requirements. We are focusing on sending discharge summaries for patients who were discharged home and had a requirement for follow-up in the community or with primary care in the first instance. This is being clinically-led.
“Going forward, you will continue to receive discharge summaries for all patients who attend our department. We will be prioritising sending letters for our highest risk patients within the next working day following an attendance. The low risk discharge summaries will be dealt with within a slightly longer timeframe.
“Our long-term plan is to upgrade our current ED patient management system to a version that enables the automatic sending of letters to GPs. We expect this to be in place within the next six months.”
It’s an incredibly exciting time for the Trust as we transform huge parts of our sites.
The redevelopment projects will see new buildings erected and some buildings refurbished, providing modern facilities that support staff in delivering the best care in the best environment.
We are pleased to share that the electrical substation project, located outside of Beeden House, is now complete.
This provides electrical capacity to the estate, but also kick-starts our decarbonisation programme as we move from gas towards electricity to heat and power the hospital estate.
Installation of a CT scanner within the Emergency Department
We are delighted to have received delivery of the new CT scanner for the Emergency Department. Work is now underway for the installation of the equipment, which will be followed by staff training, before being operational.
A huge thank you to Bedford Hospital Charity & Friends and Bedfordshire Charitable Trust for funding the scanner, which will allow for rapid diagnostics, improving the care and experience our patients will receive. We acknowledge this incredible generosity by naming the new CT facility ‘The Clifton Ibbett Suite’.
Primary Care Hub (PCH) and community diagnostic hub
We recently received business case approval for the Primary Care Hub (PCH) and Community Diagnostics Centre (CDC). The £23m capital investment will see a transformation of Gilbert Hitchcock House (GHH) and the Enhanced Services Centre (ESC) on the Bedford Health Village Site, providing improved access to healthcare for patients, in modern healthcare facilities.
GHH will be used for community diagnostic provision, therapy services, phlebotomy and retinopathy. The ESC will be used for primary care provision, and will see the co-location of the De Parys GP Group and a number of community services.
Construction work is due to begin in October and will complete at the end of 2024.
Improving access to primary and community care is an important part of ensuring the local population get the right treatment at the right time and should mean that fewer patients need hospital intervention, reducing the pressure on our hospitals.
Acute Services Block and New Ward Block
A topping out ceremony was held to mark the highest point reached for the new acute services block and ward block.
Staff from Bedfordshire Hospitals, Kier Construction Group, and local key partners were joined by Andrew Selous, MP for South West Bedfordshire to celebrate this important milestone.
Work on the acute services block and new ward block started in January 2022, with significant progress made to reach the highest point of the five-storey building.
Once complete at the end of 2024, the £150m building project will provide modern and enhanced facilities for maternity, neonatology, critical care and theatre services.
Dr Glyn Harrison, Clinical Director for Theatres at Luton and Dunstable University Hospital said: “It’s incredible to see how well the acute services block and new ward block is coming along, and this highlights an exciting step in our journey to providing the very best care to patients in the very best environment.”
Emergency Department upgrades
Multiphase work in the Emergency Department has been challenging, however we expect that the main benefits of this project start to show soon.
The new CT scanner for the Emergency Department is now onsite and being installed. Training will then be carried out, ahead of operational use.
The next phase of 13 additional cubicles for paediatrics and adult patients will open within the next month, around the same time that we are due to move to our final phase of the project.
The final phase will focus on the triage area, main entrance and main access to the emergency department.
The final round of major testing on the Energy Centre has taken place, with the building now handed over to the Trust.
The commissioning of the building will take place over the coming months, with the project due to complete later this year.
The Energy Centre replaces all obsolete and out of date heating plant and equipment, reducing carbon emissions by approximately 30%. This supports the Trust’s drive to Net Zero Carbon, and will increase resilience across the site.
Bedford Hospital granted provisional approval to run Advanced Trauma Nursing Course
Bedford Hospital has been granted provisional approval by the Royal College of Surgeons of England to run the Advanced Trauma Nursing Course (ATNC) from 2024.
This will be the only site in the East of England region to offer this.
The ATNC is a three-day course for registered nurses, paramedics and Operating Department Practitioners (ODPs). It allows individuals to develop the knowledge, skill and attitude necessary to care for trauma patients.
It’s also recognised as appropriate preparation for achieving Level 2 National Major Trauma Nursing Competencies. Level 2 training is a National Standard Requirement for all Trauma Units, of which Bedford Hospital is one.
Sally Smith, Emergency Department Matron at Bedford Hospital, spearheaded the application.
She said: “An application to the Royal College of Surgeons of England was made as currently in the Eastern Region there is no ATNC course provision, so for us to be awarded this to run concurrently with the medical staff Advanced Trauma Life Support Course (ATLS) in 2024 is a massive achievement.”
Running the ATNC at Bedford Hospital will allow staff to be trained locally, reducing external usage and cost in the longer term.
Paul Tisi, Medical Director for Bedfordshire Hospitals NHS Foundation Trust, said: “This will allow us to train our own staff from both hospital sites and develop our own training faculty. This is another example of why Bedfordshire Hospitals is an excellent teaching centre.”
Sally added: “It’s a very exciting opportunity. We will be able to improve the quality of nursing knowledge, skill and care given to our trauma patients and improve their journey and experience.”
Children’s Phlebotomy at Bedford Hospital – New patient appointment booking system
Bedford Hospital has a new patient appointment booking system for children’s blood tests.
Blood tests are now by appointment only at Children’s Outpatients Department, Cygnet Wing, Bedford Hospital, Kempston Road, Bedford, MK42 9DJ
Full information can be found at: www.bedfordshirehospitals.nhs.uk/childrens-phlebotomy-at-bedford-hospital-new-patient-appointment-booking-system