Susan Maxwell, Patient Governor

July 2011

It was planned that my first Governor/Senior Nurse Round would start with sitting in on an Infection Control Committee (ICC). Kathryn Mangold, General Manager and Directorate Nurse for Gynaecology and the Assisted Conception Unit, who accompanied me was a little concerned that I would find the meeting a dry affair. She shouldn't have worried because the meeting, chaired by Dr Berge Azadian, the Director of Infection Prevention and Control, proved to be extremely interesting.

I was fascinated and most impressed at just how thoroughly the ICC examines the different data each month. As a patient here, I found it most reassuring that these meetings go into finite detail on every ongoing aspect of infection control. The Infection Control team contribute greatly to the Patient Environmental Action Team (PEAT) auditing results. It doesn't surprise me at all that the Chelsea and Westminster Hospital has attained triple excellence status for the second year running.

The meticulous and accurate collection of data was, in most cases, down to an auditing tool called Synbiotix. After the Infection Control meeting, Anthony Pritchard (who was Acting Chief Nurse at the time) offered me the chance to see a demonstration of the way information on the Trustwide handwashing audits could be viewed and accessed, right down to an individual's performance. From a patient's point of view, this sort of 'immediate' data retrieval is most reassuring as it has the added bonus of being an excellently accurate Care Quality Commission evidence and management system.

Kathryn and I then went to speak to patients on Annie Zunz Ward. Patient Governor Wendie McWatters wrote glowingly of this ward in the April edition of Trust News, so I can only reiterate that it truly lives up to the high reputation it has earned for excellence. This is mainly down to the leadership of Sister Mary Knight and her loyal team of ward staff. They all strive to give the highest possible service to the patients in their care.

I found the atmosphere of the ward to be serene. I spoke to some of the ward staff and they stated how much they liked working there. This has a lot to do with Mary Knight's leadership qualities. She leads by example.

The patients we spoke to all expressed satisfaction with the level of cleanliness, patient dignity and with the level of information about their treatment. They felt easily empowered to ask their consultant questions about upcoming procedures and their ongoing treatment. There were varying comments on the quality of the catering, but for the most part patients felt that overall it wasn't bad.

There were just two instances of patients being disturbed by night noise, mainly from emergency patients being admitted, and it was pointed out that eye masks and earplugs were available on each ward. It was agreed that in future, patients would be made aware of this facility on admission. It will certainly be mentioned in the forthcoming new information booklet for incoming patients.

All in all, I think these Lead Nurse/Governor ward rounds are an interesting factor in improving the patient experience. It is hoped to continue them on a regular basis.

April 2011

Susan Maxwell, Patient Governor

When I was asked if I would like to shadow a member of staff for an hour or two, to get an idea of what their job entailed, I initially misheard. I heard the words 'Site Manager' and, for me, this conjured up an image of a hefty engineer in a hard hat clutching a clipboard. However, the person I was to shadow was, in fact, a 'Clinical' Site Manager (CSM) and believe me, that particular job is a different kettle of fish altogether.

Mari Hayes was the CSM who took me through the job description, and the remit seemed endless. Despite numerous interruptions through telephone calls, bleepers sounding off and emails to be answered immediately, Mari remained calm, efficient and wholly in control of what seemed to be a three-ring circus. She explained patiently that the hospital needed an Operations Room, manned by a CSM, in order to ensure the smooth running of the place.

The CSMs, all of whom have reached at least senior nurse level, are responsible for arranging the allocation to wards of all patients who come into the hospital as either emergencies or planned admissions. The Operations Room runs on a 24/7 basis and out-of-hours the CSM is the most senior nurse on duty in the hospital and is the bleep filter through which all emergency calls are routed.

The CSM is also responsible for the security of the hospital and the safety of patients. Those CSMs who do night duty could be called upon to take on clinical and non-clinical emergencies which could be anything from dealing with a false fire alarm to handling a cardiac arrest.

Quite apart from keeping an ongoing record of what beds are currently available, the CSM is required to update the London Ambulance Service (LAS) on a regular basis of the hospital's emergency intake capacity. This enables the LAS to know which hospital is currently the closest one able to take in accident and emergency patients. It is by such micro-management of detail that the CSMs are able to ensure the smooth and logical flow of patients through the hospital, while anticipating and dealing with myriad problems arising from one minute to the next.

Forward planning is also an important aspect of the job since the hospital has to have a plan in force, in case of a major catastrophe occurring or for the winter when there may be a major flu pandemic. In such emergencies, the CSM is the central figure handling all aspects of the incoming patient pathway.

My poor descriptive powers seem inadequate to describe the complexity of the job but it helps to visualise one of those old 1940 films where the Royal Observer Corps move planes and ships around with long sticks on a huge map of a war zone. As each ship or plane passes through the war zone, it is removed and a new vessel takes its place.

Such is the method of the Operations Room. Whiteboards display all the wards and which beds are occupied and how many are newly vacated. The telephone rings and Mari receives new information about bed availability on one of the wards, so the board is updated.

The atmosphere is akin to Piccadilly Circus as the Operations Room is continually traversed by different staff with varying information to impart. There are daily meetings of ward matrons, infection control, security, etc so that the whole procedure of updating becomes teamwork on a huge scale, and Mari tells me that shortly she will give a briefing to hospital Executives as to the situation as it stands at that time.

We, as patients, never see the work that goes on behind the scenes to ensure our stay is as free from hassle as possible. Most of us are only too grateful that the patient pathway is smooth from the moment of admission to the final discharge. And even then, the CSMs have a duty of care that goes on, arranging transportation where necessary and ensuring that vulnerable patients are discharged into a safe environment with community nursing firmly in place. Their job remit truly does seem endless.

I didn't know this job existed until I shadowed Mari and as I watched her answer bleeps, deal with telephone calls, answer queries from incoming team members, update the LAS, whilst also writing up bed availability, all while continuing to explain the job to me, I found myself in awe of her ability to focus and keep all those balls in the air.
I find I have a deep respect for Clinical Site Managers. They truly are the unsung heroes of the NHS.

November 2010

Susan Maxwell, Patient Governor

A hospital is much more than a building housed within a local community. It is much more than the staff and management who service it. It is much more than the numerous patients who have need of the services provided there. It is the sum of all and as such it is a community in itself.

You can be a powerful voice within this community. You can have a say from the patient's perspective. You can do this by becoming a member of the Foundation Trust.

This can be as simple as filling in an application form and just sitting back and waiting for a bi-annual mailshot or as involved as joining a patient forum, the feedback from which helps to make policy.

The mailshot consists of a copy of the current Trust News and a chance to get involved in whatever feedback the Trust currently needs, by responding to questionnaires. The feedback is optional but it is helpful to the hospital to get as many and as varied views as possible. Your concerns, ideas and suggestions for improvements to the patient experience are all highly prized.

If you've ever been hesitant to put your views to a member of NHS staff—maybe because of timidity or perhaps feeling too ill at the time to act—you might prefer to use your Patient Governors.

We are not NHS staff. We are totally independent lay people. We can listen and be your voice. We can direct your comments to the exact people who can resolve your issue or to those people who can take up your suggestions or ideas for improvement. We are here as your representatives. We are the conduit between you and the Executive Board of your Trust.

Becoming a member also makes you eligible to stand for election as a Governor if you feel you can be a voice for other patients or perhaps for the local community.

The Foundation Trust needs more ethnic minority voices, so if you feel you haven't been represented fully, join us and stand for election.

This hospital is yours and you can use your voice for the good of others.

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Susan Maxwell, Patient Governor