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Royal Brompton and Harefield NHS Foundation Trust
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Clinical support services 


Our state-of-the-art clinical support systems make a vital contribution to the success of all our clinical teams.


Clinical Support Services

 

2008/09 highlights


Imaging


  • The Trust’s new Agfa PACS (Picture Archiving and Communication System), which allows near instantaneous access to diagnostic images, was installed during 2008-09. The new PACS solution is highly customised but flexible and will represent a substantial improvement on the current system. Other advantages include:

    • Unification of processes that deliver radiology services across the Trust with a single advanced and integrated RIS/PACS.

    • Standardisation of the Trust-wide radiology datasets to improve management and financial reporting.

    • Integration with existing RBHT IT system technologies and the Trust’s contract and financial systems.

    • Web-based RIS (Radiology Information Systems)/PACS architecture that will enable software upgrades to be undertaken with little or no impact on clinical service.

  • A lung tumour radiofrequency ablation service has been set up at both sites. This is an exciting new development which allows clinicians to keep at the forefront of treatments for lung tumours. This treatment allows patients, who are otherwise medically inoperable, access to potentially curative treatment which can be used instead of, or together with, other non-surgical approaches, such as radiotherapy. The service continues to expand month by month.


Pharmacy


  • The Pharmacy Technical Services department has increased the provision of ready-prepared doses of intravenous drugs for adults (adult CIVAS), releasing nursing staff for other duties on the wards and improving the safety of intravenous drug administration.

  • The Pharmacy team has also supported the introduction of electronic prescribing in critical care. This system provides immediately accessible information on medicines and offers an integrated approach to the prescribing and administration of medicines, making it easier to monitor how medicines are being used.

  • Increased specialist pharmacist input into paediatrics is enabling the team to deliver more training to nursing and medical staff and help ensure that the most effective use is made of medicines.

  • The pharmacy department has been involved in the negotiation of a new homecare service for respiratory patients who need long term specialist medicines which General Practitioners (GPs) are unable to provide. This is increasing patient convenience and enabling the team to offer a cost-effective service.

  • In October, the structured training programme offered to rotational pharmacists was formally recognised when the Trust became an accredited site for delivery of the Postgraduate Diploma in General Pharmacy Practice.

  • The Trust governance arrangements for medicines management have been reviewed and a new Medicines Management Board has been created, supported by six sub committees assuring the safe and effective use of medicines throughout the Trust.


Clinical Support Services

Rehabilitation and therapies


  • An in-house representatives service has been established at Royal Brompton. The Reverend Susan Hollins initially ran the service three days a week and the new permanent post holder, reverend Robert Thompson, is now working full-time to ensure that spirituality and pastoral care remain a top priority for the Trust. In order to improve the diversity of the service Muslim and Hindu representatives were appointed.

  • The Speech and Language Therapy service has expanded, especially on the Harefield site, with an increase in videofluoroscopy services reducing the risk of aspiration in vulnerable patients. A paediatric speech and language therapist from the Trust is co-running a national course on dealing with neonatal feeding and swallowing difficulties in premature infants.

  • The paediatric cardiology dietitians have introduced the use of indirect calorimetry to assess the energy requirements of the Paediatric Intensive Care Unit (PICU) patients; only three centres in the UK to have access to this equipment.

  • Director of rehabilitation and therapies, Isabel Skypala, was recognised for her work with a UK Allied Health Professionals and Healthcare Scientists award in February 2009. She was chosen from more than 300 entries. Isabel has also co-written and edited a book called Food Hypersensitivity, which was published in March 2009, and sat on a working group which has produced the BTS (British Thoracic Society) Guidelines for the physiotherapy management of adults with cystic fibrosis.

  • The Adult Psychology team has also enjoyed publishing success with Dr Liz Steed co-editing a book which was published in December 2008, entitled Chronic Physical Illness: Self management and behavioural interventions.

  • A dietetic clinical lead post in cystic fibrosis has been created to provide specialist support to patients.

  • All services continue to have a strong commitment to research and best practice and staff have been invited to speak or present at European and US conferences in the fields of cystic fibrosis, heart transplantation, speech and hearing, respiratory medicine and allergy.

  • The psychiatry service, which was set up in October 2007, has also expanded to provide full out-of-hours cover on both sites.


Laboratory medicine


  • In September a blue plaque commemorating the work of Sir Alexander Fleming was unveiled at Harefield Hospital. Fleming, whose discovery of penicillin revolutionized modern medicine, was appointed regional pathologist at Harefield in 1939 and spent much of his time at the hospital studying the effects of his discovery on a wide variety of infections.

  • Patients and staff at Royal Brompton Hospital are the first in the UK to benefit from a new paperless and wireless electronic patient test requesting system. The new system allows staff to use handheld, wireless flat screens at the bedside, avoiding the need for paper request forms entirely. Labels to identify samples taken are then printed off using mobile handheld printers which communicate with the flat screen devices via Bluetooth technology. The new system improves the efficiency and reliability of test requesting and is being rolled-out Trust-wide.

  • In January the blood bank at Royal Brompton was assessed for the first time against the Blood Safety and Quality Regulations 2005 by the Medicines and Healthcare products Regulatory Agency. The bank received a high level of compliance and very positive feedback from the assessment team.

  • The installation of a pneumatic tube has begun in the Sydney Street wing at Royal Brompton. The computer controlled system will allow rapid transport of samples between the wards, theatres and other departments with a typical transfer time of one minute.

  • Extensive refurbishment of the clinical biochemistry and haematology laboratories has been completed at Royal Brompton with the installation of new and automated analytical equipment underway to develop a blood sciences laboratory. This will enable cross-disciplinary working and more efficient laboratory processes.


Clinical engineering


  • During 2008/09, the Clinical Engineering department, responsible for ensuring that all medical equipment used at the Trust is safe and effective, managed a £4 million programme for the renewal and expansion of medical equipment.

Royal Brompton

Sydney Street,
London SW3 6NP
Tel: +44 (0)20 7352 8121

Harefield