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GP Newsletter

Paul Tisi Joint Medical DirectorWelcome from Paul Tisi, Medical Director

Welcome to the Autumn 2023 edition of GP Matters.

Since our last edition, the NHS has continued to be affected by regular industrial action. This brings us increased challenges on an already fragile situation.

Our staff continue to provide excellent support in accelerating discharges for some of our most complex patients to help us cope with the demands on our hospitals and respond to any requests for advice and assistance as quickly as possible.

Alongside this, we are well underway with our winter planning to ensure patients receive safe and effective care during what is an even more challenging time. We anticipate a higher number of admissions relating to flu and Covid, which will place even more pressure on the Trust.

PSIRF Framework

To improve our approach to how we respond to patient safety incidents, we have begun transitioning from the existing Serious Incident Framework to NHS England’s new Patient Safety Incident Response Framework (PSIRF).

PSIRF sets out new guidance on how NHS organisations respond to patient safety incidents, and ensures compassionate engagement with those affected.

Under PSIRF, we will no longer be talking about ‘serious incident investigations’ or ‘root causes’. In their place will be a more flexible, system-focused approach, with improvement and engagement with patients/families/staff taking centre stage, focussing learning on areas where improvement will have the greatest impact.

We have identified six incident types that have been set as our Trust priorities for our Patient Safety Incident Response Investigation Plan for 2023/24. These are:

  • Failure to recognise a deteriorating patient
  • Missed/delayed cancer diagnosis
  • Missed/delayed diagnosis (other than cancer)
  • Lost to follow up
  • Unexpected/unplanned readmission of baby to Maternity
  • Medication incidents

These priorities, along with incidents that have a nationally mandated investigation response, will be investigated either as part of a Patient Safety Incident Investigation (PSII), or using Learning Response Tools such as an After Action Review, MDT Learning Review or Thematic Review.

Best wishes and happy reading!

Paul Tisi
Medical Director

Contacting patients for appointments and surgery

You may already be aware that we are currently undertaking a review of our waiting lists across the Trust. We have begun sending text messages and letters out to patients asking them if they still require treatment and would like to remain on our waiting list. We anticipate another message will be sent on 31 October to a cohort of eligible patients, asking them if they would consider moving hospital to receive earlier care/treatment.

We know some patients have been concerned that these are spam or phishing messages which, we can confirm, is not the case. If any of your patients voice these concerns to you, please feel free to reassure them these are genuine communications from Bedfordshire Hospitals NHS Foundation Trust. By them responding to these messages promptly will help us a great deal in ensuring that we have up to date patient information and are able to better identify alternative ways to improve the patient experience.

If your patients need to get in contact with us about being on our waiting lists, please advise them to use either the email address or telephone number provided on their original hospital letter.

Thank you for your assistance and support on this matter, it is fully appreciated.

Bedfordshire Hospitals carries out first total jaw replacement in East of England

Bedfordshire Hospitals has carried out the first total jaw joint replacement operation in the East of England, one of only five hospitals in England to currently offer the surgery.

The operation is performed on patients who either have arthritis of the jaw – similar to a hip or knee replacement – or for patients with tumours of the jaw, or where the jaw joint needs to be removed.

Although an established procedure, it has not been available for patients in the East of England before – they have previously had to travel to Oxford or Nottingham for appointments and surgery. It is highly specialised surgery which requires individual funding approval from NHS England.

Consultant Oral & Maxillofacial Surgeons Mr. Alan Parbhoo and Mr. Valmiki Sharma carried out the procedure with the help of the maxillofacial theatre team at the Luton & Dunstable University Hospital (L&D) on 18 year old Ivana who had an unusual tumour of the jaw joint.

Mr. Parbhoo said: “Ivana had an aggressive bone cyst of the jaw joint which was expanding, causing her cheek to swell, and she could only eat an extremely soft diet in the few months prior to surgery.

“We were extremely pleased to get the funding to carry out Ivana’s operation and that it went so well. She is making an excellent recovery.”

Talking about her operation, Ivana, who lives in Essex, said: “I first noticed something wasn’t right in April of last year, and it got steadily worse and I had to be extremely careful what I ate. I was so keen to have the operation, and now I have got my life back, and am eating completely normally, which is brilliant.”

Ivana’s mother, Maria, said: “We were extremely worried and scared but Mr Parbhoo and his team were amazing and saved her life and we are so grateful.”

Mr Parbhoo added: “Now that we have carried out our first case successfully I am hopeful that we will be given the funding to set up a full tertiary service at the L&D, enabling us to become the TMJ Centre for the East of England, and treat patients with all types of jaw joint pathology in the region. This type of pathology often goes unrecognised and patients deserve to receive the highest standards of care regardless of where they live.”

The L&D maxillofacial theatre team in their masks and operating uniforms

Developing our Vascular Services

We recently concluded a round of public engagement sessions about development to our Vascular Services. The feedback received from those that attended was incredibly valuable and appreciated. In addition to the feedback received from these sessions, the feedback from our Local Authorities is supportive of our plans to move the vascular hub to the L&D when we have our new state of the art hybrid theatres completed as part of the Acute Services Block development (The hub is part of BLMK vascular services network and currently situated at Bedford).

The movement of the vascular hub will only relate to vascular surgery with all other care such as diagnostics and outpatient appointments all remaining at the patient’s local hospital (Bedford Hospital, L&D or Milton Keynes Hospital). We are still keen to hear from current or ex vascular patients to get their feedback on the service to ensure we are shaping this development in the most effective way. If any of your patients are interested in helping us, please advise them to get in touch with the programme manager, or call 07815 658831.

Full details of these plans can be found on our website.

Redevelopment Update

Acute Services Block and New Ward Block at the L&D

Once complete at the end of 2024, the £150m buildings will provide modern and enhanced facilities for maternity, neonatology, critical care and theatre services.

  • Maternity – Will provide a delivery suite, increased theatre capacity to support higher risk women, midwifery led birthing unit, triage, as well as a dedicated and standalone bereavement suite. The new ward block will provide antenatal and post-natal wards, as well as a pre-operative lounge.
  • Neonatal – Additional cots in intensive care, high dependency care, special care and transitional care for our sickest babies and new rooming in facilities for families to gain additional support before they go home.
  • Critical care – Accommodating patients requiring an increased level of care with an additional capacity of 22 beds, meaning patients will be cared for in one location.
  • Theatres – eight new operating theatres to provide additional capacity, allowing old theatres to be re-purposed. The theatres will feature two hybrid theatres, capable of delivering interventional and specialist services.

Progress made so far:

The teams have been extremely busy working behind the scenes and so far have achieved 100% of the concrete frame, 100% of the steel frame, 70% of the cladding, 10% of the render, 30% of the roof and 30% of the floor latex.

Plans for the rest of 2023 include:

  • Removal of tower cranes
  • Start of the removal of scaffold wrapping the building
  • Completion of the roofs
  • Continuation of internal fit out works from the ground floor working upwards

Our clinical teams have been regularly visiting the site and delighted to see the progress being made.

Acute services block exterior - Sep 2023

Energy Centre at the L&D

The Energy Centre will deliver combined heat and power to the hospital estate and delivers a substantial reduction in energy consumption, supporting the Trust’s drive to Net Zero Carbon.

The Energy Centre building and landscaping around it is now complete and work is now underway to connect the Energy Centre to the whole hospital site, to ensure we have improved resilience. This will also support plans and developments for the future.

Energy Centre exterior - August 2023

Main entrance upgrades at the L&D

The front of the hospital site on Lewsey Road has been transformed to create a new bright, modern and welcoming entrance for staff, patients and visitors.

Within the main entrance we also have two new retail outlets.

The Market is a place for staff, patients and visitors to grab sandwiches, snacks and drinks. There is also a range of personal and electrical items, magazines, newspapers and stationary items.

Costa Coffee located slightly further down the entrance provides a fantastic range of hot and cold drinks, and sells a range of M&S food products.

L&D main entrance

Emergency Department upgrades at the L&D

Many patients are now being treated in a brand new area of the Emergency Department (ED) at the Luton and Dunstable University Hospital (L&D).

This includes a brand new entrance and waiting area, a dedicated paediatric area and nine new major cubicles. A CT scanning facility in the department has also opened and is having a positive impact on patient journeys and care.

The bright, modern and spacious areas make a huge difference to patient dignity and experience when attending ED, and also allow staff to provide outstanding care in the very best environment.

The final phase of works now underway will see the expansion of the department where there will be a further increase in capacity, including assessment and triage rooms and sensitively designed mental health care rooms. This work is due to be complete at the beginning of 2024.

Dr Ahmad Mchaourab, Consultant for Emergency Medicine and Redevelopment Lead at the L&D, said: “Seeing the major improvements and refurbishments in the department over the last few months has been incredible. This work has allowed our staff to provide the best care for our patients in what can be their greatest time of need.”

New patient room and bed within ED New ED waiting area with interactive football game

New CT Scanners for our Emergency Departments

Thanks to generous donations, both hospital Emergency Departments now have operational CT scanners that will help us centralise care for patients coming to the departments, and minimise the need for them to travel across the site.

A huge thank you to Bedford Hospital Charity & Friends and Bedfordshire Charitable Trust who have funded the £2.6m CT scanner at Bedford, and for the generous donation in memory of Clifton Ibbett OBE. We are pleased to acknowledge this incredible generosity by naming the new CT facility ‘The Clifton Ibbett Suite’. An official opening will happen later this year and we look forward to sharing the photos of the event in the next edition of Ambassador.

At the L&D the CT scanner was made possible thanks to a generous donation by a former member of staff, Dr Dhabuwala, through Bedfordshire Hospitals NHS Charity. Dr Dhabulwala originally joined the L&D in 1968 working in the geriatric wards before moving to genitourinary (GU) medicine in 1974 where he worked until his retirement in 2008.

We were delighted to welcome Dr Dhabulwala and his colleagues to the site to officially open the CT scanner, and see the difference this will be make.

Thank you to the CT teams at both sites for their hard work in setting up the service and getting it operational as quickly as possible. All of the team have made a supreme effort to help and support each other during a very fast training programme to ensure the scanner was ready to use as soon as available and have adapted quickly to working in a new environment.

Dr Dhabuwala (seated second from left) alongside his colleagues and members of staff from Bedfordshire Hospitals NHS Foundation Trust

Dr Dhabuwala (seated second from left) alongside his colleagues and members of staff from Bedfordshire Hospitals NHS Foundation Trust

Community diagnostic centre at Gilbert Hitchcock House

We have appointed a contractor to commence the exciting project of transforming the Bedford North Wing site into a one-stop shop for primary and secondary care that will improve access to healthcare and diagnostics for our patients in modern facilities, while reducing the pressure on our hospital sites.

We are creating a community diagnostic centre at Gilbert Hitchcock House (a building owned by the Trust) and this will deliver therapy services, phlebotomy, and a number of diagnostic services including MRI, CT, ultrasound, x-ray and cardiology, amongst others. The new facilities will allow patients to access planned diagnostic care nearer to home without the need to attend our hospital sites, taking some pressure off our acute hospitals and allowing us to focus resources on the emergency cases coming through our doors.

The project will also deliver a primary care hub in the Enhanced Services Centre (ESC) which will see the co-location of the De Parys GP practices and a number of community services that we hope will ensure patients have improved access to high-quality primary care services.

Our enabling works are ongoing in Rye Close to support the move of Moorfields eye services to the South Wing Site at Bedford Hospital from the ESC.

We hope to complete this project by spring 2025.