Tuesday, 9 December 2014

Patient Partnership Group blog - December

Trish Cargill ,Chair of the Trust’s Patient Partnership Group, writes:

The Patient Partnership Group (or PPG for short) plays an important function at NUH. It is a group of patients and staff who come together monthly to offer a view on Trust issues, to give a patient voice and support NUH’s journey of continuous improvement. 

This month, by working together with staff we have:

  • Promoted Carers Rights Day by having a stand in main outpatient department at City Hospital where we had conversations with lots of patients and staff about how we can better support carers. Having the right information at the right time can make a significant difference when you are looking after someone. A new Carer Information Pack, developed by carers from across Nottinghamshire in conjunction with Nottinghamshire County Council and Nottinghamshire’s Clinical Commissioning Groups, is now available online. More information is available here.
  • Participated in assessments of the environment at City Hospital. When doing these assessments we walk around areas in the hospital looking at cleanliness, including the curtains, beds and ,floors as well as privacy and dignity. We score and comment on areas and feed this back to our clinical teams so that good practice can be praised and areas for improvement identified.
  • Attended the NUHonours Awards ceremony where it was inspiring to see and hear about the fantastic work of staff, volunteers and members who are each part of the NUH team. I was very honoured and humbled  to have the privilege of receiving  the Public Member of the Year award.

Wednesday, 19 November 2014

Operations Manager Charlene Roe on her path into research

I’m the Operations Manager for the Nottingham Cancer Clinical Trials Team. When I qualified as a staff nurse 11 years ago, I can honestly say this is not where I would have placed myself.

As a newly qualified staff nurse I started out on an acute medical/cardiology ward. I learnt a huge amount. I loved the pace of the ward, the variety, and the patients.

After a short time on the ward I decided to broaden my skills and got a job in the community as a staff nurse. This experience helped me develop a whole new set of skills. I went from the comfort of a ward with people around that you can ask a quick question, to being out on the road in people’s homes making the decisions. It really helped me develop decision making skills and confidence in my abilities as a nurse. 

Soon after moving into the community the cardiac catheter suite was being set up at Kings Mill and posts were available there. The opportunity was fantastic, helping to set up develop and work on a brand new unit and service. I was excited by the prospect and applied after encourage from my old ward sister. I was successful in gaining an ‘e grade’ staff nurse post within 1 year of qualifying, I was thrilled!

It was during my time in the catheter suite when I had my first taste of research, when a secondment opportunity came up as a cardiac research nurse. It involved working on one thrombolysis study. It sounded great, I would be helping to shape future medication and evidence based care. I spent 18 months in the post and loved every minute, the attention to detail required, keeping everything in order, the contact with patients in A&E.

This first taste of research opened a whole new world of fantastic opportunities to me. Not only with the people and networking this post allowed, but also the travel. As with all research the study came to an end and so did my secondment.

I started looking for jobs with a research element in them, and by chance stumbled across a position with the University of Nottingham as a Practitioner Health Lecturer on a secondment basis. I got the job and worked half my time in the University teaching clinical skills and half my time in the catheter suite. This gave a unique chance to mix both the practical nursing with the satisfaction that teaching brought and developing my skills in teaching.

As with my research post this secondment came to an end. But now I really had got the research bug and moved to Derby Hospitals as a band 6 Clinical Trials Nurse. I worked closely with the stroke team and went back to my roots as the research was a thrombolysis trial. I had the chance to develop my case holding skills and become more specialised in research.

After a couple of years I was successfully appointed as Research Team Leader and I moved back to Kings Mill. This post involved growing and developing a research department, and I learnt a lot about research governance. This job also gave me my first taste of corporate management and I loved it, learning and being involved with Dr Foster, NHSLA, and CQC issues.


As part of this role, I worked closely with the Nottingham Cancer Clinical Trial Team, and it’s at this point were I learnt of the Operations Manager post that I have now. I was successfully appointed into the position and the rest as they say is history. I love my job, the challenges it presents and developing myself further. I enjoy managing a large team, and the satisfaction of helping to develop people within my team.

Thursday, 13 November 2014

Patient Partnership Group blog - November

Trish Cargill ,Chair of the Trust’s Patient Partnership Group writes:

The Patient Partnership Group (or PPG for short) has an important role to play at NUH. It is a group of patients and staff who come together monthly to offer a view on Trust issues – to give a patient voice and to support the Trust in making improvements that make a difference to patients, their relatives and carers.

This month, by working together with staff we have:


  • Thanked Danny Mortimer, the Trust’s Director of Workforce and Strategy for his commitment to involving and listening to patients during his time at NUH over the last  7 years. Danny has consistently fought to ensure the patient voice is heard throughout the organisation  Danny attended the PPG meeting this month, with members thanking him for his contributions and wishing him all the best for the future. Danny takes up his new post as Chief Executive of NHS Employers later this month
  • Offered valuable feedback on the Trust’s Cardio – Pulmonary Resuscitation Decision – Making Guidance for Adults suggesting greater prominence is given to the section on communication with patients and or their relatives
  • Used feedback from the Carers surveys to plan further improvements to facilities for carers throughout the Trust, in line with our quality priorities to more effectively and consistently support carers



Tuesday, 4 November 2014

What is a matron?

Who are you and what do you do?
I am Jamie Crew, Matron/Deputy Clinical Lead for the Children’s Hospital.

What do you do in your role?
Fundamentally my priority is always safe care. Digging a bit deeper my role is about providing leadership, direction and support to the nursing staff in the Children’s Hospital.  

Being on the service management team and in this role it’s about leading by example, being visible, setting out clear expectations about safe standards of care and ensuring we provide those standards to the children and families who visit us, all day, every day, and seven days a week. It’s about acknowledging the great work that’s being done and always looking for ways to improve that. Essentially, providing the care that you’d expect to receive yourself and for your own children and family.

What did you do before you were a Matron/Deputy Clinical Lead in the Children’s Hospital?
I qualified as a children’s nurse in 1998 and graduated at Nottingham University. I worked over at the City on various wards for 3 years. I came across to the Queen's Medical Centre in 2001 to work in the Children’s Emergency Department. Working closely with the teams from the wards and caring for critically ill and injured children I always felt part of the Children’s Hospital. 

Service improvement and engaging staff in change has always been a large part of my work ethic. While I hope I have a good sense of humour and am approachable, for those that have worked with me, they know that I have high standards and always strive to achieve those standards. 

When I saw the post advertised in the Children’s Hospital I thought – that sounds like a great challenge and will give me a great opportunity to make positive changes and support the already great work being done here. So in November 2013 I got the job and have really enjoyed the challenge over the last year or so.


What’s the most challenging part of your role?
One of my biggest challenges is probably the way I manage my time. Trying to prioritise what’s urgent, what’s important and out of those things, what needs doing next. I’m blessed with a great team of senior nurses in the Children’s Hospital, and there is a fantastic culture of team work and camaraderie.

What’s the most enjoyable part about your role?
It’s often what might be viewed as the little things that bring me joy at work. There’s not just a sense of enjoyment at seeing a large project being completed on time. Seeing praise and complements given to our nurses and staff in the children’s hospital is enjoyable. I’m overwhelmed by the commitment and hard work of the staff and when that’s acknowledged by families and patients it really does make me proud. 

What advice would you give to anyone wanting to progress to Matron/Deputy Clinical Lead?
You still need to be driven to provide excellent care and not lose sight of that. Our professional practice model at NUH and our values and behaviours really do provide a focus for that. You need to test your resilience, your ability to make decisions (not always popular ones), to manage your time effectively and to raise the bar even through challenging times. 

Self-belief and confidence in your ability to lead and support staff and to really understand what excellent care looks like are also key. The reality is, that becoming a Matron means that you won’t spend as much time on the shop floor as you once did, and making that decision to leave my ward manager role was one which I didn’t rush into.

Monday, 13 October 2014

Patient Partnership Group blog - October

Trish Cargill ,Chair of the Trust’s Patient Partnership Group writes:

The Patient Partnership Group (or PPG for short) has an important role to play at NUH. It is a group of patients and staff who come together monthly to offer a view on Trust issues – to give a patient voice.

This month working together with staff we have:


  • Thanked Jenny Leggott, the Trust’s Director of Nursing & Midwifery and Deputy Chief Executive ahead of her retirement for her commitment and for continuously putting patients at the centre of decision-making. The PPG wished Jenny all the very best on her retirement and thanked her for all she has done to improve patient care and the experience of patients, visitors and carers over many years in Nottingham

  • Received a nomination for NUHonours Awards in the volunteer and public member of the year categories
  • Offered feedback on the Trust’s Advertising on Trust Facilities Policy and Corporate Identity Policy

Tuesday, 9 September 2014

Patient Partnership Group blog - September

Trish Cargill ,Chair of the Trust’s Patient Partnership Group, writes:

The Patient Partnership Group (or PPG for short) has an important role to play at NUH. It’s members are patients and staff who come together monthly to offer a view on Trust issues.

This month working together with staff we have:

• Heard from Carillion – the Trust’s new provider of Estates and Facilities – about the work they are doing to further improve services for patients and developments since the new contract started in July. This includes trialling a new breakfast trolley, new meal service on Children’s Oncology wards and piloting the use of mobile devices at the bedside for patients to order their meals

• Produced some easy to understand carer definitions to help staff identify carers so that in turn, they can be better supported

Thursday, 21 August 2014

Making a difference in Children's Outpatients

Sue Kilar, Deputy Sister in Nottingham Children’s Hospital’s outpatients department

Every year more than 40,000 children will find themselves in our department, so there is a high chance that your child or one of their classmates may well have been through our doors. We are one of the busiest places in the hospital, dealing with everything from broken bones and post-op check-ups to long-term conditions like eczema, diabetes or cystic fibrosis.

Fortunately, the vast majority of children that have contact with the hospital will never need to go any further than our clinic rooms, so for most people we really are the face of the Children’s Hospital.

For those that go on to be admitted to the wards, we will usually be their first port of call in the hospital, so the experience they have here can influence their whole outlook. Our team are experts at ensuring that children and young people feel comfortable in our care, and that they feel fully informed about what their treatment will entail.

We all work really hard to ensure that the environment is as child-friendly as possible. We hold regular themed days and have guest visitors to keep people entertained while they are waiting. Just last week we held a heroes and villains day where staff dressed up and a storyteller came in.

I have worked as a children’s nurse at QMC for 28 years in total, covering a range of areas in that time. What I really enjoy about outpatients is that you have a chance to make a difference to how children view hospital – and hopefully help to keep them out of here as much as possible!

On a ward you are concentrating on getting patients better, but here you are concentrating on them not becoming ill in the first place. Our role is very much about prevention and educating patients and their families. Many have long-term conditions and need to attend hospital once or twice a week, so you get to know them really well. It is great seeing these youngsters grow up and progress, and satisfying to know that our work helps to stop them from needing more serious treatment.

I’m really proud of our team. Working in outpatients is a busy, demanding role and their dedication and commitment makes a difference to the lives of so many people.

Friday, 8 August 2014

Patient Partnership Group blog - August


The Patient Partnership Group (or PPG for short) has an important role to play at NUH. It is made up of a group of patients and staff who come together monthly to offer a view on Trust issues – to give a patient voice.
 
This month working together with staff we have:
 
  • Presented at an NHS England event where we shared good practice and described how we have involved patients in the implementation of the ‘friends and family’ test at NUH. This was a fantastic opportunity to spread of learning and experiences with the wider NHS and enabled me to give the patients’ perspective – click here to view our presentation.
  • Participated in Think Clean inspections, which are an opportunity for patients to get involved in the Trust’s programme of work to ensure high standards of cleanliness as we put the spotlight on the environment in which patients are cared
  • Commented on the essence of care benchmark scores and criteria – this is another way in which patients are involved in ensuring good standards of care and safety are delivered at our local hospitals – by looking at areas such as nutrition and hydration and documentation
  • We are delighted to have been given the opportunity to take part in the ‘events in the tents’ to give our voice. We are pleased to see the way feedback from the events is being communicated and actioned quickly. Click here for a summary of the feedback from the events.
  • Embedding support and involvement of Carers throughout the organisation is one of our areas of focus for improvement this year. So we were very happy to be asked to join a short task and finish group to help make the Carers Policy real and meaningful at NUH to get this work going. At our first meeting we focused on defining and identifying Carers.

Tuesday, 15 July 2014

Patient Partnership Group blog - July

Welcome to the second of our monthly blogs.

Trish Cargill, Chair of the Trust’s Patient Partnership Group, writes:

The Patient Partnership Group (PPG for short) has an important role to play at NUH. It is made up of patients and staff who come together monthly to offer a view on a range of Trust issues – to ensure there is a patient voice in all we do.

This month working together with staff we have:

  • Signed off new Trust guidance for staff on how to best involve patients and public representatives on trust committees and meetings 
  • Contributed to the development of posters that will be displayed in all inpatient wards letting patients, visitors and carers know numbers of nursing staff on duty on each shift, twice daily 
  • Been updated and commented on the new way of recording patient observations using Ipads. This is a pilot project which allows clinical staff to record patient observation such as pulse, blood pressure and temperature at the bedside electronically rather than on a paper chart 

I look forward to updating you next month.

Wednesday, 25 June 2014

A Patient’s Perspective


Trish Cargill, chair of the Trust's Patient Partnership Group, writes:


Welcome to the first of our monthly blogs. The Patient Partnership Group (or PPG for short) has an important role to play at NUH – it is made a group of patients who come together monthly to offer a view on Trust issues – to give a patient voice.

Through these monthly blogs we want to share with wider patients and local community some of the work and activities we are doing to improve patient experience at Nottingham’s hospitals.

This month we:
  • talked to a representative from Carillion, the external provider who will take over the running of the Trust’s Estates and Facilities services 1 July. It was helpful to talk through how Carillion will work with us to ensure the patient voice is heard. There was a commitment from Carillion colleagues to attend future PPG meetings so that the patient input remains high on the agenda
  • worked on guidance for staff on how to better involve patients and all we do at NUH 
  • discussed the need to promote the use and awareness of caring for carers cards with staff  & supported carers week
I look forward to updating you next month.

Tuesday, 27 May 2014

Learning from the Jimma link

A group of Nottingham University Hospitals (NUH) staff recently visited Ethiopia, as part of our link with Jimma Hospital. Here they share what they have learnt from the experience.


Susan Taylor, Clinical Pathology, and Link Co-ordinator

Back home in Nottingham now after a very busy two weeks in Jimma. This visit has had both positive and negative aspects, but it was wonderful to meet up with the hospital and particularly laboratory staff again and to work with them. 

This is the second year of the re-launched NUH-Jimma partnership and it is clear that the link is stronger. There is a commitment from staff in both hospitals and across disciplines to continue with and build on the things we have done together so far. One contribution which NUH may be able to make, is to management training. This was repeatedly quoted as a need for the staff in Jimma as the hospital develops and grows. So we have plenty to work on in the forthcoming year.



Kate Potter, Blood Transfusion

This was my first time in Jimma, and the trip was a wonderful experience. I had been to work in a laboratory in Malawi previously, and therefore knew some of what to expect. But each country has its own special characteristics and so I still found there were lots of things for me to take in upon arriving in Jimma.

We had a very warm welcome in the laboratory and during the two weeks we built great friendships with old and new acquaintances. For me it was reassuring to see that they were keen for us to assist them in developing areas of laboratory practice, and rewarding for us all when could discuss and investigate topics and learn from each other.


The laboratory staff had a very solid knowledge base and a good understanding of theory and practical techniques. Their awareness of their limitations was important, but did not restrict their enthusiasm to achieve further advances in the testing they provide and the interpretations they can give in order to assist the clinicians and ultimately the patients.

My two weeks at Jimma went by very quickly, but the time I spent with the team in the laboratory was thoroughly rewarding. It was something very special that I hope to be a part of again.

Martin Beed, Consultant in Anaesthesia and Critical Care

It has been a good two weeks in Jimma. There are clearly areas where Nottingham and Jimma can work together in the future; for example: providing visiting lectures for the new Anaesthesiology Residency programme, supporting the current Registrar visiting lecturer programme, and perhaps planning potential research collaborations. 

I also personally benefitted from the visit: for example: exposure to unusual or advanced pathologies that are rare in the UK, and learning techniques for how to provide a safe service in situations where resources are limited.

There are also less tangible benefits. The link, and most importantly our Ethiopian friends and colleagues who support the link, have provided me with different perspectives on health care, and renewed enthusiasm for my job.

Kathryn Draper, Practice Development Matron, Specialist Support

Ethiopia is a lush, green and vibrant country. Its people are passionate and proud of their roots, but also enthusiastic about change and developing towards being the best in Africa and the world. 

My personal experience of these exciting changes was the determination within the hospital to develop and educate the nurses, and to make them more confident in communicating about patients’ treatment with the doctors. I was lucky enough to contribute to this work, particularly with the ICU nurses, to provide them with the skills to perform a structured A-E assessment of their patients. They also gained confidence to communicate their findings to the doctors, which was both rewarding and humbling. 

Personally I have learnt about my abilities to be flexible, non-judgmental and remain calm and positive in intense situations. I have also gained confidence in my communication and educational skills, learning how to adapt these to a different culture and situations. I thoroughly enjoyed my experience in Jimma and feel very privileged to have had the opportunity to fulfil a lifelong ambition.



Clare Hepworth, Clinical Nurse Educator in Critical Care, and Link Co-ordinator

As always, it was wonderful to return to Jimma, meeting old friends and making new ones. The team achieved so much – as well as helping to improve laboratory services, Kate will be helping to plan the blood transfusion service for the new hospital in Jimma. Kathryn and I had a fantastic time teaching nurses, mostly from ICU, about A-E assessment. Martin has been helping with the new Anaesthetic Residency program, and is investigating ways in which NUH anaesthetists can work more closely with Jimma. 

Having spent much of our time meeting with colleagues throughout Jimma Hospital, Sue and I are now enjoying the challenge of working out how best to take the work of the link forward to next year.




Wednesday, 21 May 2014

Sara Deakin, practice development matron for older people and dementia, on dementia awareness

This week is dementia awareness week.  So what can we do to help the people we care for and their families live well with dementia?

I have been a nurse for just over 30 years and in that time I have seen massive strides in knowledge and treatment of cancer but more significantly the reduction in stigma associated with the disease.

Celebrities openly share their diagnosis and treatment. Angelina Jolie to name but one appeared in numerous newspapers and celebrity magazines sharing with the world her decision to undergo bilateral mastectomies to reduce he risks of developing breast cancer.

Whilst the tide is changing with dementia it is currently the most feared disease amongst adults over the age of 50years.

Why?

In 1597 Sir Francis Bacon said ‘Knowledge is power’. Without knowledge we struggle to understand and make important decisions. We need to use Dementia Awareness week to inform and improve knowledge of people across society but also to focus on reducing the stigma associated with the disease.

Secondly we need to support and enable our staff to provide dignified, compassionate and truly person centred care.

A significant part of my job focuses on training and education of staff. Not just nurses and allied health professionals but non-clinical front line staff such as porters, ward waitresses, cleaners, phlebotomists, ECG technicians and ward receptionists.

I encourage staff to see every person who has dementia as a unique individual. Someone who is a mother or father, brother or sister, husband or wife.

During his treatment for aggressive terminal cancer in 1995 Kenneth Schwartz said:

“Quiet acts of humanity have felt more healing than the high-dose radiation and chemotherapy that hold hope for cure”

He stated that is was the compassion shown by staff to patients can make all the difference to a patient’s experience of care.

These small acts of humanity are what mater to all our patients regardless of what disease they have but for someone who has dementia and is being cared for in hospital, a frightening and alien place, these acts of compassion are even more important. Being called by their preferred name, a smile and acknowledgement as you go about your work makes a difference. However, I truly believe the most precious gift we can give anyone is time, something we all complain we don’t have enough of.

Tuesday, 15 April 2014

The Nottingham-Jimma link: learning and sharing in Ethiopia

This week five staff from NUH have set off to visit Jimma Hospital, Ethiopia. They will be working with colleagues there as part of the Nottingham-Jimma link project between the two hospitals. Here they share their hopes for the visit.

Susan Taylor, biomedical scientist operational manager in clinical pathology, specialising in immunochemistry and screening services.

I have visited Ethiopia several times over the years as part of the NUH-Jimma link. It is very rewarding to work with people doing the same job as me, but in a very different environment. Some problems are the same, some are unique. I am really looking forward to meeting up with colleagues in Jimma again and working together to initiate direct improvements to the laboratory services provided.

As joint co-ordinator I also expect to be meeting and talking to a wide range of staff in both the hospital and university in Jimma, in order to plan how the link might move forward and grow.

Kate Potter, biomedical scientist specialising in blood transfusion.

I have worked in laboratories in England for 20 years and during this time spent two years working in a laboratory in Malawi.

I am very privileged and excited to be going to Jimma and experience first-hand the great link between Nottingham University Hospitals and Jimma Hospital. It is a wonderful opportunity for me to visit Africa again and work with the staff at the hospital to share knowledge, ideas and expertise.

During the two weeks we are there I hope to give some guidance around blood transfusion techniques and theory, quality control, quality management systems and operating procedure documentation.

Kathryn Draper, practice development matron for specialist support (predominantly based in critical care)
 
I am excited and apprehensive about the trip. It is an amazing opportunity to be involved in and I feel very privileged to be going. I’ve been told how friendly and welcoming everyone is and I'm excited about meeting everyone. I'm also looking forward to dispelling the myths me and my friends and family have of Ethiopia, I am aware it is no longer a country facing famine but I have very little understanding about what the country looks like, and what daily challenges they face. I'm also interested whether people decide to chose nursing as a career for the same reasons as nurses do in the UK and what training they receive. 

Martin Beed, consultant in anaesthesia and critical care

I have known Dr Yemane, consultant anesthetist in Jimma, since 2008, and look forward to seeing him again and assisting with his anaesthetics teaching program.

It will be good to see how the new hospital is progressing. The new buildings will greatly increase theatres and ICU capacity.

Clare Hepworth, clinical nurse educator, critical care

I have been involved with Jimma since 2004, when I went to help train their nurses for their new ICU. I now co-ordinate the link with Susan.

On this visit I will be helping Kathryn deliver a short ICU course to the nurses in Jimma. I will also be working with Susan to see how we can best work with Jimma in the future. Our colleagues in Jimma tell us which areas they would like support in, and we match our staff to what is needed. We work collaboratively, sharing our knowledge and experience - staff in both hospitals benefit from learning from each other.


We are hoping to post articles during our stay in Jimma. Check back to Trust Talk to follow our progress.

Monday, 14 April 2014

Dr Jane Dewar, Respiratory Consultant, on the new Wolfson Cystic Fibrosis Centre at Nottingham City Hospital

This week we will proudly welcome the first patients into our brand new, purpose built, state-of-the-art Wolfson Cystic Fibrosis Centre, based at Nottingham City Hospital.

The £6.6m facility will completely transform the care we can offer to the 150 patients we already treat, with the potential to widening this to even more.

The health care needs of this group are very different to most patients. Cystic fibrosis (CF) is a disease predominantly of young people. It damages many organs of the body and its main effect is repeated chest infections, leading to scarring in the lungs. Sadly, this results over time in respiratory failure and the average survival currently is only 42 years.

When I was appointed as the new consultant in cystic fibrosis around ten years ago, it was clear to me from the outset that this group desperately needed a dedicated facility to address all of their needs. We were only one of two centres in the UK that did not offer this to our CF patients and it was time to put Nottingham and the East Midlands firmly on the map.

We wanted to deliver something innovative, imaginative and inspiring. The NUH charity rapidly signed up to supporting us, recognising that this would be critical in allowing something exceptional to be created. Their support through many generous donors, the Nottingham Post being a key one, has secured this project and enabled this to be a very special facility.

We wanted to create a "home in hospital”, where patients could carry on as many aspects of normal life as possible, whilst accessing gold standard clinical care. We wanted to give patients the skills and motivation and confidence in managing their own health. Physiotherapy, exercise, nutrition, and life-skills will all be addressed in our innovative features: an indoor and outdoor gym; a therapeutic kitchen where patients can learn to cook from our own chef and dietician; and a therapy room for psychological support, crafts, and holistic therapies. A 16 bedded inpatient unit with outpatients on site, we can cater for all aspects of CF now under one roof.

One of the saddest things about CF is that patients carry infections in their lungs, which can spread to other CF patients and so have had to be segregated from one another. For me, the use of videoconferencing throughout our unit is going to open up so many opportunities: friendships and peer support; group treatments such as physio and exercise; and focus group research, discussion and psychological interventions can be undertaken. The possibilities are endless!

The fantastic public, patient and NUH support for this venture means that we have delivered a truly exceptional facility, which will benchmark care for many other chronic health conditions. Certainly nothing I do in my career will ever surpass this.

Tuesday, 8 April 2014

Pearl Pugh, paediatric dietician at Nottingham Children’s Hospital, on getting a good breakfast

Breakfast is an essential start to the day providing a good source of ‘brain fuel’ to help children concentrate at school and have the energy to play.

Many make claims to be healthy – but what does this actually mean? Healthy foods should be nutrient-rich, whilst low in sugar and salt, and provide a source of wholegrain fibre to promote a healthy bowel.

Salt

Many foods display information on the salt content on the front of the packaging. This may be shown as a percentage of your guideline daily amount or a traffic light to show whether the food is low, medium or high in salt. Aim to mainly eat foods that are green or amber.


  • A product is high in salt if there is more than 1.5g (or 0.6g sodium) per 100g
  • A product is low in salt if there is 0.3g or less (or 0.1g sodium) per 100g.
  • As a rule, aim for foods that have low to medium salt content – less than 0.75g salt or 0.3g sodium.  Many cereals contain between 1.25g and 2.25g salt per 100g, that’s the same as eating two to three packets of crisps for breakfast every day in terms of the salt content!

Sugar

Carbohydrates come in two forms –complex carbohydrates such as bread, potatoes, rice, pasta and cereals, or sugars which are either added refined sugars e.g. sugar and high fructose corn starch found in biscuits, or naturally occurring sugars found in fresh, tinned and dried fruits.  

Choosing wholegrain varieties of complex carbohydrates, such as wholemeal bread and cereals, helps to provide a valuable source of dietary fibre. This also helps the body to use the sugar that is released from these foods more slowly.

Eating foods that are high in refined sugars can cause a rapid rise in your blood glucose, which signals to your brain to release insulin from the pancreas, and instead of dampening your appetite, creates a stimulus and craving for more sugar.

A large serving of a sugar-coated breakfast cereal, typically 50g-100g, provides up to 37g of sugar per 100g, that’s up to seven teaspoons in every portion or the sugar equivalent of up to five donuts. 

What does a healthy child’s breakfast look like?


  • Weetabix with banana slices and whole milk
  • Porridge made with full fat milk, topped with sliced strawberries
  • Shredded wheat with blueberries and whole milk
  • Wholegrain toast with cream cheese
  • Wholegrain bagel or toast with scrambled egg with low salt ketchup
  • No added sugar muesli combined with cornflakes with full fat milk or yogurt
All served with a small glass of fresh fruit juice, full fat milk or water. 

Thursday, 27 March 2014

Jackie Gandy, lead midwife for women-centred care at QMC, on the benefits of a water birth

Every year, hundreds of women at Nottingham University Hospitals use a birthing pool during their labour.

The benefits are well-documented. Being in the water is a very effective form of pain relief and can help with relaxation, so we are delighted to have opened two new pools in our labour suite – meaning even more women will be able to try a pool during their labour.

One of the pools is on the consultant-led side of our labour suite, which is a first for us. It means women who may previously not have been able to use a birthing pool are now getting this opportunity.

This might be women with a long–term health condition, or perhaps someone who has had problems during a previous labour.

It may be that some women won’t actually give birth in the pool, but will use it in the early stages of labour to help relieve some of their discomfort. Last year more than 250 women used a pool at some stage of their labour at QMC, and the new pools mean that this figure will continue growing.

Women who have used a birthing pool generally tell us they have had a positive labour experience, and water is recommended by the Royal College of Midwives which states there are “considerable perceived benefits of using immersion in water during labour”.

This includes not only relaxation and pain-relief, but it’s also much easier to move around in the water, without the pressures of gravity, which means women are able to get in the best birthing positions.
More women will now be able to use birthing pools, like this one at the City Hospital
This can result in a quicker labour – meaning less need for the use of drugs, whether that’s for pain relief or to speed things along. This obviously means fewer side effects for mum and baby.
It is particularly effective when used in conjunction with aromatherapy – another service we are able to offer to many women that come in to our labour suite.

My role is all about helping to ensure that women have the best possible birthing experience and, while water is not for everyone, it is great to be able to offer more choice to more women.

Thursday, 20 March 2014

Liz Roper and Will Hadfield took the ration book challenge to raise awareness of Nutrition and Hydration week

This week (17-23 March) is Nutrition and Hydration Week 2014. We wanted to raise awareness of the importance of nutrition and hydration, so last week we decided to take the ration book challenge.

The ration book challenge involves living on post-war rations for a week. Our diet consisted of rationed meat (1s 2d or £2.67 worth), fish (one tin), eggs (one per week, or two if pregnant), milk (3 pints per week) and sweets (3oz 75g). Offal was allowed freely (strange – no one took this offer up!) Anything else had to be taken from our imaginary allotments - meaning if it can be grown, we could have it.

There are two ways of tackling a challenge. Firstly, half-heartedly and eventually giving up. Secondly, with full vigour and gritted teeth. We decided to take the second approach and really give it our all. A couple of days in, we were definitely reconsidering.

Potatoes made up a large part of the diet, featuring frequently in one form or another. Keeping up protein intake through beans and pulses was a challenge, not to mention a test on our relationships. The thought of miraculously getting pregnant overnight just to have that extra egg did cross my mind.

After researching how people ate during rationing it became clear that you had to be very inventive, but also that it was very time consuming. In this busy life we lead now, it would need a lot of planning.

National surveys report that as a nation, we are appalling at reaching our recommended 5-a-day of fruit and vegetables. One positive of the challenge was that the amount of fruit vegetables we ate rocketed. It really is amazing how inventive you can be with all that veg! As the week went on we became very bored of potatoes, even though we were managing to be quite inventive, and bananas seemed an item of luxury.

This was the real-world application of our challenge, but it’s important to remember what nutrition and hydration week is all about – focusing on nutrition and hydration as an important part of quality care, experience and safety improvement in health and social care settings. With that in mind, here’s what we learnt:

  • Relying on quick and easy food has become an integral part of our lives. We need to make more time for our food and actually stop and think about what it is we put in our mouth. No doubt this will save me money as well, as all too often we think of food as a throw away commodity.
  • We have it all too easy these days. With technology and gadgets making everything that bit quicker, we can hardly imagine life in a post-war Britain. If people could make it through life back then (and stay healthy!) then we can do the same today. It’s an attitude adjustment – no more excuses when we reach for that ready meal.
  • We are going to start appreciating food and drink more, including where it’s from and how it got to us. The fact that we are not restricted on a daily basis shouldn’t mean that we take it for granted. Food is an important part of life, and this is what nutrition and hydration week is all about.

We were very grateful when the week was coming to a close, but we did manage it. Some dishes were so tasty that we plan to publish them later in the year and hope to discuss our efforts with anyone that is willing to listen, especially patients and members of the public that actually lived on rations.


This challenge meant we went into Nutrition and Hydration week with a very positive approach. We hope everyone will take notice that when it comes to patient care, food and hydration are as important as medication.

Liz Roper, Chief Technician and Will Hadfield, Diabetes Specialist Dietician, are part of the department of Dietetics and Nutrition at Nottingham University Hospitals.

You can follow Nutrition and Hydration week on Twitter at @NHWeek, or get involved with #NHW2014.