At last the daffodils are out and the days are lighter longer!
I know we are all exhausted and struggling with workforce issues and mounting workload, but we must continue to work together and communicate with each other. Our relationships and communication across primary and secondary care remain vital to help us carry on to provide the best care for our communities and to keep us keeping on!
A big thank you to my GP colleagues for your ongoing support for Whittington Health.
Dr Sarah Humphery
Medical Director for Integrated Care
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Helen Brown has been appointed as our new Chief Executive
After Siobhan Harrington’s announcement that she is to sadly leave us for a new role as Chief Executive of University Hospitals of Dorset NHS Foundation trust, we are delighted to announce our new Chief Executive, Helen Brown.
Helen lived and worked in Haringey for many years, including a short time here at Whittington Health. Her 30-year career in the NHS has spanned acute, community and mental health services. She is currently the Deputy Chief Executive at West Hertfordshire Hospitals NHS Trust, where she was also previously the Director of Strategy and Transformation and for a time the Acting Chief Executive. Helen is expected to join us in June.
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Carol Gillen is retiring
We are sad to say that Carol Gillen, our Chief Operating Officer for the last six years, has announced that she has decided to retire.
Carol had planned to do this a couple of years ago but the emergence of the pandemic meant that she put off her retirement plans in order to support Whittington Health and our staff and services through this difficult time. With the focus now more on bringing our normal services back and with the pandemic causing fewer people to become critically ill, Carol has decided that the time is now right for her long-delayed retirement plans to become a reality. However, she will not be leaving until the end of July and we have already begun looking for her replacement.
Work is already well under way to also recruit a replacement for Michelle Johnson, our Chief Nurse and Executive Director of Allied Health Professionals, who will be leaving us at the end of June.
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Some useful words of wisdom from our Community Nutrition and Dietetic Department
Does your IBS patient need help with their diet?
See below for some common misconceptions and FAQs.
Community dietitians can help in a variety of ways. Reading and following these points will help us see the right patients most quickly.
- Advise patients they are being referred for “IBS management” not “FODMAP Diet” as it is not suitable for everyone. For example, the low FODMAP diet requires a high level of motivation and can be expensive to follow.
- The Low FODMAP diet is a second line dietary intervention; patient must be advised to do first line initially (eg lactose intolerance, fibre, fatty foods, caffeine, spicy food, alcohol intake, eating patterns). We offer advice on both!
- The Low FODMAP diet is a very restrictive elimination (eight weeks maximum duration) and reintroduction diet to identify triggers. Following the elimination phase for too long is unsafe and can lead to nutritional deficiencies.
- Patients should be advised that diet is only one part of the solution; IBS needs a lifestyle approach (stress management, exercise, sleep, medications). The FODMAP diet is up to 70% effective, but unfortunately not a panacea.
- Please check you have followed NCL IBS guidelines before referring, to exclude other diagnoses (eg coeliac disease / IBD / cancer) and document this in referral to us. We need to confirm this before considering the Low FODMAP Diet
I have attached the updated NCL guidance for Consultant to Consultant referrals.
This has been discussed and agreed via the NCL Interface steering group and signed off by CAG. There are no major changes to what we have been doing here at the Whittington for several years. The purpose of updating this guidance was to have all the NCL Trusts aligned and so it is clear for both hospital clinicians and GPs where responsibilities lie.
We are making sure our clinicians are aware and it is included as part of induction for medical staff. We are ensuring work is not pushed back to primary care inappropriately and there is no delay to the patient’s onward care and treatment.
The interface group has been recently started and involves the Clinical Interface Groups (CIG-members include GPs (LMC,CCG,GP Fed) and Trust medical staff) from each Trust (Royal Free Hospital and Barnet Hospital, North Middlesex Hospital, University College London Hospital and Whittington Health). The Chairs of the CIGs, which includes me, attend along with medical representation from each Trust and GP CCG representation.
The main aim of the group along with the support of a North Central London project management office is to align our communications and systems and develop relationships. For example the group is working with the clinical networks reviewing and updating over 50 of the most commonly used clinical pathways, electronic prescribing from outpatients directly to the patient's community pharmacist and looking at having a GP liaison role (admin) in each Trust to support patient queries.
If you have any ideas/issues where you think we can improve communications, relationships and systems between primary care and secondary care across NCL do contact me and I can feed it back to the group.
Occasionally, when a patient attends ED and has a CXR a repeat is needed after six weeks to check an infection has cleared or that there are no ongoing abnormalities.
We have looked at how we can set a system up at the hospital to follow-up with these patients and unfortunately it is not possible. From a safety and pragmatic approach, it is better for the GP to arrange this follow up CXR.
I appreciate we do not want to bounce work back to GPs and whenever possible we do not. We recognise that when GPs receive a request to repeat a CXR in six weeks you are able to arrange this. The X-ray request form can be emailed to the department in the usual way and the patient then can walk in no appointment needed weekdays between 9am - 4:30pm.
Free Webinar: Prescribing Behaviour Change – how to unlock your patients’ potential to self-manage
When: Tuesday 26 April
5:15-6:15pm
Helping patients to change their unhealthy behaviours is at the heart of supporting self-management. Yet influencing patient behaviour can sometimes feel like an uphill struggle.
This interactive webinar, delivered by the Whittington Health Self-Management Support and Behaviour Change Team, will ease that struggle. It will introduce you to key techniques that support behaviour change to help you unlock your patients' potential to self-manage. The team specialise in supporting those with long-term conditions to self-manage.
Paramedics have been a huge asset to Rapid Response and Virtual Ward (RRVW). Their assessment skills are excellent and they are familiar with reacting quickly to new referrals, which is perfect support for RRVW when managing two hour response referrals.
Their particular strength has been with the launch of the falls pathway for Haringey and Islington patients. This involves using lifting equipment which the RRVW were not familiar with, so their education on this has been most valuable. Additionally, they have helped RRVW clinicians with developing their head, spinal and limb assessments which are necessary to eliminate possible fractures. They have also taught many clinicians on completing and reading ECGs - a wealth of valuable and transferable skills now gained.
In return, the RRVW clinicians have helped the paramedics to understand which conditions can be managed by a RRVW service, the benefits of the wider services and specialist clinicians in the community and how accessing their skills will help with admission avoidance (RRV).
Works are progressing at the brand new Community Diagnostic Centre in Wood Green’s The Mall.
The site, which is due to open this summer will offer patients phlebotomy, ultrasound, x-ray and ophthalmology appointments. The CDC is hosted by Whittington Health and it will be open to patients from across north central London. It is one of the first 40 community diagnostic centres opening across England.
We will share further details about how to refer your patients to the CDC over the coming months. Further information will be added to the Wood Green CDC webpage shortly. Please email woodgreencdc.whitthealth@nhs.net if you have any questions.
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Miss Amma Kyei-Mensah (Consultant Obstetrician and Gynaecologist with special interest in maternal medicine) will be retiring after 22 years at Whittington Health NHS Trust at the end of April.
We would like to thank her for all her hard work and dedication in setting up this service and providing excellent care to women with medical problems in pregnancy. This service will be carried forward by Dr Harry Gibson (Consultant O&G with special interest in maternal medicine) with Consultant Obstetric Physician input from Dr Yasmin Jamil and Professor David Williams.
We have a joint clinic every Monday morning, where we see women with medical problems in pregnancy (either pre-existing or arising in pregnancy). Once a month this is a joint haematology clinic with consultant haematologists.
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