Robots will be performing more operations, including general surgery and gynaecology at a Surrey NHS hospital trust seeking to introduce “significant savings”, a board meeting heard.

The Surrey and Sussex NHS trust held its much delayed annual general meeting on Thursday, March 30, where attendees heard from its chairperson, chief executive, and head of finance.

The afternoon meeting, which board members suggested may have led to its lower than usual attendance, was broken into three sections: a review of the year, a run through of its financial health, and questions from the floor.
Chairperson Richard Shaw led off proceedings explaining the AGM should have taken place in autumn last year but was delayed because of the late filing of its 2021/22 audited accounts.

Chief executive Angela Stevenson told the meeting that the 2021/22 year was heavily influenced by the “significant impact” of covid with “very tired”  staff “having to work under pressure”. This created a backlog the trust was only beginning to get back under control.

She said: “Staff were working with a disease that we didn’t know how to treat. We had high staff absences due to covid or due to family members having covid. Since then we’ve really got to grips with the backlog. We started to work through but at the start of 2022 these numbers were at their peak.”

Post pandemic, she said,  there was a huge increase in patients seeking primary care  compounded by the increase in “baseline complexity” as cases were left untreated during the pandemic.”

Ms Stevenson praised the trust for delivering robotic surgery for the first time and that it would be rolled out further to include general surgery and gynaecology services. They will also be investing in services with a new MRI department on the horizon – including new CT scanners at East Surrey and Crawley hospitals.

The trust also plans to work in partnership with other groups to better manage the health of the population rather than solely focus on its role as an acute hospital.

On finances, the meeting heard how its deficit continues to grow – even  not including the covid years.  It expects to run at a £26.5m deficit  for 2022/23.  This will be the first time the trust has run at a deficit since at least 2013/14 as spending pushes towards £400m a year.

Chief finance officer Paul Simpson said this could be partly attributed to an increase in staff costs. The hospital expects to take on an extra 130 new nurses. He said: “Now we have to recover the growth in costs that has happened and now we are (looking at) a significant savings plan.”

They were, however, quick to say “there should be no reason why we accept any reductions in quality of (care) for patients  and that before any cuts were made there would be full impact assessments on cost improvement plans.”

Image: Nimur at the English-language Wikipedia CC BY-SA 3.0

Surrey County Council’s leader said his focus “for the rest of his life” will be fulfilling a promise made to his daughter before she died to fundraise for brain tumour research.

Emily Oliver was 21 when she died, 18 months after being diagnosed with a diffuse midline glioma, and after seeking medical advice “from across the world”.

Her father, county council leader Councillor Tim Oliver, said the fund the family set up for her 21st birthday was now nearing £150,000 but vowed to continue to raise awareness and money.

He told the LDRS: “We promised Emily that we would do all that we could. We promised her that we would fundraise for what she wanted, specific research into her type of high grade glioblastoma. Hers was a very, very rare form.

“That is our focus and that will be our focus for the rest of our lives, to raise as much as we can and to find a research team that will look at predominantly her type [of brain tumour].”

Cllr Oliver said brain tumours didn’t get the level of attention or funding as other types of cancer, because the number of cases was not as high, but said they were the biggest cause of cancer death for under 40s.

He said he and his wife, Debi, hoped to find a specific research project in the near future to give the money to. “It’s really important to us that we continue to keep that alive and deliver on that promise to her,” he added.

The council leader also has his sights set on creating a Surrey-wide bereavement service and has been having conversations about it with the chief executive at Surrey Heartlands and Surrey hospices.

He said “pulling together” the different organisations that offer support for both before and after death would help people know where to turn.

Cllr Oliver added: “I think that would be a great thing for people to be able to know where to go.” He also praised the work of the Brain Tumour Charity and the support they give to families on what their journey may look like and understanding what their diagnosis actually meant.

He will take part in the Princess Alice Hospice’s “Talk the Walk” event in April which aims to get men, in particular, to talk about bereavement.

Debi said: “The pain of her loss is with us every minute of every day, but Emily was passionate about fundraising to find a cure for brain tumours, and I absolutely know she would be really pleased that what she had started is being continued.”

Cllr Oliver also called on the government to deliver on its promise of delivering £40million for research into brain tumours.

An inquiry by the All-Party Parliamentary Group on Brain Tumours was launched in 2021, and said that as of January 25 2023, just £15 million had been awarded since June 2018.

For advice and support from the Brain Tumour Charity, you can call its Support and Info Line on 0808 800 0004 or go to the website at: https://www.thebraintumourcharity.org/

Image Tim Oliver credit Surrey Live

Epsom & Ewell Borough Council have worked in partnership with national charity Community Heartbeat Trust to install 12 new 24/7 defibrillators across the borough. The project was delivered with funding secured via the Community Infrastructure Levy (CIL).

Defibrillators are designed to be used by members of the public with no previous experience in the event of someone going into cardiac arrest. They can, and do, save lives. The new defibrillators have been installed in the following locations:

• Market Place, Epsom
• Ebbisham Centre, Epsom Square, Epsom
• Town Hall (Rear entrance)
• Harold Bell Solicitors, 174 Kingston Road, Ewell
• St John’s Parish Centre, Station Approach, Stoneleigh
• Auriol Park Café, Salisbury Road, Worcester Park
• The Parade Dental Practice, 177 Kingston Road, Ewell
• Ruxley Chemist, Ruxley Lane, Ewell Court
• Horton Pharmacy, Pelman Way, Epsom
• Horton Country Park, Horton Lane, Epsom
• Londis Convenience Store, Hollymoor Lane, Epsom
• NISA Convenience Store, Ruxley Lane

Councillor Barry Nash, who put forward the CIL bid, said, “After a lot of hard work by all involved, I am so pleased the defibrillator project has now been completed.

“I’d like to thank our partners from the Community Heartbeat Trust who shared their expertise with us, provided and installed all the defibrillators across the borough and will continue to provide a post-rescue counselling service.”

Councillor John Beckett, Chair of the Environment and Safe Communities Committee, added, “You never know when a medical emergency may occur. Time can be extremely limited and having the right equipment on hand will save lives.

“The installation of these 12 new defibrillators will ensure the borough is prepared and our community is safer.”

_{Image: Evacuationchairs – Own work. CC BY-SA 4.0}

Epsom & Ewell Borough Council have renamed their Dementia Daycare Service the Dementia
Hub – and are using the opportunity to remind those living locally about the fantastic service
the Hub offers for the community.

The Dementia Hub, situated in Sefton Road in Epsom, offers specialist respite daycare for
people living with memory loss and dementia. It offers a safe, friendly environment where
clients can enjoy activities, social interaction and develop skills to improve their quality of life.
The Dementia Hub is part of the Community & Wellbeing Centre, a support hub which offers
social and recreational activities for over 55s. The Community & Wellbeing Centre also
provides services including assisted bathing, a community alarm service, foot clinic, meals at
home, a shopping service and transport from home.

The Dementia Hub’s new name and logo will make it easier for people to find information
about the facility online, as well as helping create a stronger identity for the service.
Councillor Alex Coley, Chair of the Community and Wellbeing Committee, said: “We’re
incredibly proud of the work that the Dementia Hub does to help enrich the lives of people
living with memory loss and dementia, and the lives of their carers too.

“The specialist team at the Dementia Hub provide a home-from-home environment where
people can take part in memory therapies, gentle exercise, art therapy and more – whilst also
making friends. “Caring for a loved one with dementia or memory loss can be challenging at times. The
Dementia Hub also enables carers to take precious time to rest and recharge – or simply catch
up with essential tasks.”

People who are interested in finding out more about the Dementia Hub or who’d like to book a
free assessment can call 01372 727583 or visit: www.epsom-ewell.gov.uk/dementia-hub

^{The Dementia Hub is a service offered by Epsom & Ewell Borough Council at the Community & Wellbeing Centre, on Sefton Road in Epsom.
Full and half day sessions are available for people aged 50+ living with memory loss, dementia, confusion due to medical conditions such as a stroke, conditions such as Parkinson’s Disease, and more.
For more information on services offered by Epsom & Ewell Borough Council, visit: https://epsom-ewell.gov.uk/residents/communities-health-and-wellbeing}

The government’s hospitals programme has been called the “HS2 of hospitals” as “quite intense” discussions continue about how to take it forward.

Epsom and St Helier had its plan for a new site agreed by the NHS in 2020, with an original date for opening set at 2025, now pushed back to 2027 “at the earliest”. A health liaison panel at Epsom and Ewell Borough Council heard from James Blythe, managing director at the trust, who said adapting the current buildings to modern healthcare standards was becoming “increasingly difficult year on year”.

The national programme was announced as delivering 40 hospitals by 2030, with Epsom and St Helier one of eight “pathfinder” hospitals due to be at the top of the list, Mr Blythe told the meeting. But he said there were “quite intense discussions” going on at government level about the programme and how to take it forward.
Mr Blythe said: “What the government, the Treasury and the Department [of Health], are working through is basically how do you go about building 40 hospitals? Clearly what don’t you do is say to 40 schemes: ‘Go and design something completely different, go out to the construction market and try and procure it.’

“This has sort of now become the HS2 of hospitals. Let’s think about how we do this as a single scheme. Let’s think about how we do this consistently, how we procure consistently, how we design consistently.”

With St Helier hospital “very evidently crumbling” and problems with buildings at the Epsom site too, the trust plans to build a new specialist emergency care hospital on the old Sutton Hospital site, next to the Royal Marsden Hospital. Mr Blythe said: “We know that if we build a modern hospital to modern standards, we can do better for our patients, including local Epsom residents.”

But he said with the move from one financial year into the next, there were questions about where future works might sit in relation to other capital projects. He added: “Clearly what the construction market can’t take is 40 new hospital schemes trying to do the same thing at the same time.”

The meeting also heard that the trust was expecting feedback on its plans “very soon”, hoping it would then be able to get on with the planning process. Mr Blythe said: “As you can imagine, planning for a hospital which is going on to the land adjacent to Royal Marsden in Belmont in a mature and developed residential area, that planning process will not be insignificant. So we know that that will take some time”

Epsom and Ewell Borough Councillor Liz Frost (Residents’  Association, Woodcote Ward) asked about plans for the new multi-storey car park due to be built at the Epsom site, which was granted planning permission on appeal in December. She said she received a lot of complaints about roads surrounding the hospital being clogged up as people queued for spaces.

Cllr Frost said: “I have in the past spent quite a lot of time at Epsom Hospital when car parking has been horrendous and everybody was turning up late for clinics because they couldn’t actually get in.”

Mr Blythe said work should start in the autumn to build the new car park, and that options being looked at to minimise disruption during the nine-month build included possible park and ride schemes and using town centre car parks.

Saying he would bring back a plan later in the year for how the project would be handled, Mr Blythe also said the “flip side” was parking should be “substantially better once it’s built”.

He added: “We’re hoping that by [building the new car park] we will prevent some of the build-up of traffic from backing up into the town centre, which has sadly been a feature of the hospital for the last few years.”

Related reports:

Pay black hole takes £2.2M Epsom Hospital funds

Epsom Hospital multi-storey car park rises

Epsom Hospital’s multi storey carpark wrong on many levels?

Epsom Hospital car park appeal

Local hospital’s building woes

The Epsom and St Helier Trust board heard the complaint of a patient allergic to nuts given nut oil. LDRS reports:

A hospital patient with a peanut allergy and an epipen was given medication for a nosebleed which contained nut oil. The patient at St Helier hospital was told before going home that the A&E doctor “didn’t think” the cream contained nut oil, a hospital trust board meeting heard. But on returning home and reading the leaflet, the unnamed patient learned there was in fact arachis oil, or peanut oil, in the medication. The patient had gone to the emergency department after a nosebleed, having started on a medication to help reduce blood clots. The patient had told the nursing team on arrival at the hospital and the doctor who prescribed the cream for the nosebleed about their allergy.

On contacting the emergency department, the patient was told there was not an alternative medicine that could be prescribed.

Members of the Epsom and St Helier Trust board heard at a meeting on Friday (March 3) that the patient then contacted their GP for an alternative before making a complaint to the trust so the issue would not affect other patients.

The board meeting, held at Epsom hospital, heard from a registrar and a consultant in the emergency department what steps had since been taken to learn lessons from the incident. These included a safety alert being sent within the team and the individual doctor being spoken to, while board members also asked what more could be done at trust level to help in what was a “very, very busy” department.

Ruth Charlton, the site chief medical officer, said the emergency department was of the only in the trust to use a paper prescription method rather than electronic. She also said that because the emergency department was operating 24/7, and doing things very quickly, patients were not sent to pharmacy for medications, which would be “an extra checking mechanism in place”. She said an electronic system would flag allergens, such as cows’ milk, in a medication and then allow something else to be prescribed instead.

She added: “We need to take away this case and look at what more we could do to address the systems issues.”
The meeting also heard it was not clear what checks were made by the doctor about what was in the medication, or who the patient had spoken to when calling the hospital to ask about alternative medications.

Board chair, Gillian Norton, said the board was impressed with the “rigorous approach to learning” shown by the department and thanked the doctors for sharing the experience. She said: “Keep up the great work. “We are very conscious that you have done all this learning and thought about this while you have got this incredibly busy day job.”

Royal Surrey hospital trust bosses are beginning to plan for three days of junior doctor strikes which could have a “significant impact” on services. A national ballot is currently taking place of members of the BMA Junior Doctors union, which closes on February 20.

If members vote for action, it could mean a possible 72-hour strike taking place in March, a board meeting heard on Thursday (January 26). As yet the trust, which runs Guildford’s Royal Surrey County Hospital as well as the Haslemere hospital, has not been directly impacted by its staff striking, though ambulance strikes in December saw the hospital put measures in place.

Meeting documents said the junior doctors’ strike was more likely than others to meet the 50 per cent threshold needed for members to strike because a national ballot was being held. According to the BMA website, junior doctors have seen their pay cut by more than 25% to their salaries since 2008/09.

Bill Jewsbury, the trust’s medical director, said the three-day strike, which he thought “probably would” go ahead, would have a “significant impact” on various parts of running the trust. The meeting heard that other, more senior doctors, would need to “step down” into the roles, along with non-union members.

Dr Jewsbury added: “That then has an impact beyond that 72 hours because we then have to rest those people.
“What you’re looking at is a much longer period of disruption than just your three days’ of strike.”

According to the documents, a review carried out of the day of ambulance workers’ striking in December had identified one incident that was being investigated of the strike having an impact on patient care. The meeting also heard that the possible junior doctors’ strike would impact on its target to clear the backlog of people waiting more than 78 weeks, a year and a half, for treatment by the end of March, in line with national guidance.

Getting rid of all the people on the waiting list was described in documents as “the biggest operational challenge affecting the trust”, with a peak of 207 patients in the category at the beginning of October, falling to 161 at the end of November and to 155 in the first week in December.

Matt Jarratt, chief operating officer, told the meeting: “That is going to be a major challenge was going forward.”

A woman said she felt like her mum was “a prisoner” when she couldn’t take her home from a Surrey hospital.
The daughter, who we are choosing not to name, said it felt like the family was caught in a “never-concluding circle” when trying to communicate between NHS trusts to get her mum discharged.

Her mum was in hospital for five months, having been admitted to Guildford’s Royal Surrey County Hospital with pain following breast cancer, but the family living in West Sussex meant a lot of communication about release was across different NHS trusts.

By Colin Smith, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=9266476

She told a meeting of the Royal Surrey trust board on Thursday (January 26) that conversations about getting her mum discharged were “awkward” and “difficult” as she tried to negotiate her mum’s release from hospital and whether or not she needed a care plan in place.

Board members apologised for the patient and her daughter’s experience, which included time at Haslemere Hospital, and said the trust would address issues such as communication between themselves and neighbouring trusts. Alexandra Ankrah, NExT director at the trust, sympathised with the woman’s experience, saying she had been through similar with her own mother, though not at Royal Surrey.

Addressing concerns that her mother had felt like a “bed-blocker”, where people who are medically well enough to leave hospital cannot be discharged because there may not be the appropriate social care measures in place at home, she and others in the meeting agreed they did not like the term. Ms Ankrah said: “No one should ever be made to feel that they don’t have a right to our care and services.”

The daughter, who chose not to make a complaint against the trust, said: “I felt like my mum was a prisoner.”
The meeting heard that many patients were in similar situations regarding communication across county borders, and a meeting would be organised using the patient story as a basis to make changes.

The chief executive, Louise Stead, said it came up “every single week” with people caught in “an impossible little maze”. The trust’s medical director, Bill Jewsbury, said getting people home when they were well enough was “really important” because most people wanted to be at home and improved once there. He added: “If we are really honest with ourselves, we are incredibly risk averse around discharge planning.”

Dr Jewsbury said the story was “a classic example” of saying somebody needed a care package in place before they could be discharged but said it would be “quite a powerful driver” for the family to be able to take their relatives home. He said the trust should ask itself: “Have we had that conversation with yourselves as the broader family? [Have we] phrased and pitched it in such a way as: ‘There are going to be some risks involved in perhaps getting your mother home. ‘It isn’t without risk but we can get your mother home.’”

He said it would be “worth trying” and that the hospital could do more to work with families as well as outside groups such as charities and churches in supporting patients.

The hospital’s own virtual wards, where patients can continue to be treated at home and which started late last year, were also raised as one way of helping to tackle the issue.

The daughter told the meeting: “If somebody had presented me with a disclaimer for signing mum out of the hospital, I would have done that.”

Surrey County Council sets out its vision for the care and living of the older generation by 2030. In 2021/2022 Adult Social Care in Surrey spent £506 million to support older people. This money helped over 5,600 older people and their unpaid carers. Money was also spent with voluntary organisations that support people in their community too. Adult Social Care also ensures services for information, advice and guidance are available to help people understand their care options and to make good care-related decisions.

The county of Surrey has a population which is getting older with people living longer than in other parts of the country. These changes mean that many more people are likely to be living alone, without support from their family. By 2030, the number of people aged 75+ predicted to be living alone will have increased by 27%. National reporting states that the number of unpaid carers 65 years old and over will increase by 17% from 2016 to 2025.

Dementia is most common amongst older people and in Surrey it is estimated that between 2020 and 2030 the overall number of people with dementia could increase by 28%, from 17,700 to 22,672.

In building the 2030 strategy SCC stated “We spoke to over 750 people living in Surrey. We worked with many diverse groups of Surrey residents of all ages including unpaid carers, care providers, partners, and colleagues. This took seven months and included workshops and surveys. We wanted to know what works well, what does not work well, what could be improved and what is important to our residents.”

The plan sets out all the ways SCC, working with its partners in the NHS, care sector and districts and boroughs, will support people to live and age well in Surrey over the next decade. At the heart of the plan is a commitment to improving opportunities and care choices in local communities so that older people can be as active and independent as they wish.

The council engaged with residents and their families, as well as staff and partners, to draw up the strategy – and is now seeking input to help shape how it’s put into practice.

The plan is centred around three priorities. They are:

• Prevention – supporting people to lead healthy and independent lives in their local communities for as long as possible
• Living independently – enabling people to live in their own homes with care and support tailored to their strengths, including through planned new extra care housing
• Care homes – making sure that Surrey can offer the right mix of high quality care homes for those who need them

Further details can be found in the summary version of the plan at surreycc.gov.uk/livingwellinlaterlife.

Working with partners, including the NHS in Surrey Heartlands and Frimley, as well as care providers and voluntary organisations across the county, the council has already achieved some key milestones in its plan.

These include:

• signing a new contract for home care services so that people receive even better care in their own homes
• enhancing its reablement service for people needing short-term care, such as after a hospital stay, through linking with specialist care workers
• carrying out in-depth planning to help SCC and its partners meet the growing need for care home places catering for complex and challenging needs

The council’s keen to continue to gather residents’ and partners’ input as it works towards meeting the commitments in the plan. There will be opportunities to take part in workshops and surveys.

Anyone who has an interest in shaping services for older people can sign up via the web page or by calling 0300 200 1005, SMS (for the deaf or hard of hearing) 07527 182 861, text relay 18001 0300 200 1005 or BSL video relay.

Mark Nuti, Surrey County Council’s Cabinet Member for Adults and Health, said: “Our ambition here in Surrey is that no one is left behind – we’re committed to helping those who need us most, and improving quality of life for everyone. We want older people to be able to lead independent and active lives for as long as possible in their own homes and communities and, if they need extra support, to receive tailored and dedicated care. Our Living Well in Later Life plan sets out how we will continue to modernise our services and work with our partners over the rest of the decade to enhance the lives of older people in Surrey. If you have an interest in shaping services for older people, please come forward and help us put our plan into practice.”

Additional reporting from Surrey County Council news service.

Greg Culshaw of Toyota‘s Epsom Head Office (GB), has completed a gruelling 24-hour static bike ride, putting him on course to raise more than £40,000 for the Motor Neurone Disease Association.  Greg is the General Manager, Customer, Network and Quality Support.

Greg began his challenge at 10am on Wednesday 17 November and was joined by a number of colleagues, including Agustin Martin, Toyota (GB) President and Managing Director, who completed stints on static bikes alongside him, to give him encouragement. Paralympic cyclist, Jody Cundy, and Mark Chapman, Director of Finance of the MND Association, helped cheer him on at the start of his marathon.

Toyota (GB) is halfway through a three-year partnership with the MND Association and has so far raised more than £78,000 for the charity, which focuses on improving access to MND care, funding research and campaigning on behalf of the MND community.

Greg was inspired to take on the challenge in memory of a Toyota colleague, Rachel Rollason, who died from motor neurone disease earlier this year. He commented: “Rachel and I spent four years working together in the Customer Services Division and it’s fair to say that she made a lasting impression on me. Her boundless energy and devotion to getting things done were inspiring. She operated on ’no limitology‘ before I had even heard the phrase.”

He added: “This has been a brutal challenge, but at the same time I’ve been focused on completing it for Rachel and the MND Association. The idea started in a conversation with Rachel and in her last text message to me, she told me how proud she was of me for taking it on. She continues to inspire me and in turn, made me proud of her.”

To date, Greg has raised nearly £16,000 through his Just Giving page: https://www.justgiving.com/fundraising/Greg24hrBikeRide. This will remain open for donations until the end of November. 

Toyota (GB) has pledged to fund-match the total raised by Greg, which means the charity should receive around £40,000 to help it keep up the great work it does on its five key promises:

1.    To make MND treatable and ultimately find a cure.
2.    To ensure everyone gets the help they need, when they need it.
3.    To make every day with MND count.
4.    To ensure people with MND are heard
5.    To ensure that nobody with MND faces it alone

Mark Chapman, Director of Finance at the MND Association, commented: “Greg’s challenge is particularly poignant because he’s doing it in memory of his colleague Rachel. It’s brilliant to see so many staff members from Toyota rally behind him to honour her, knowing that every penny raised will make a huge difference to people living with and affected by MND.

Last year we provided £1.4 million of support grants for 2,479 people living with the disease.

The grants provided by the MND Association have helped people living with MND to maintain their independence and improve their quality of life, and we couldn’t do this without partnerships with companies like Toyota.”

Jody Cundy, eight-time Paralympic Champion (three swimming, five track cycling) commented: “It was a pleasure to join Greg for the first hour of his 24hour charity ride for MNDA. It was a tough challenge, but I hope my support and presence helped make it a little easier.”

Agustin Martin said: “Watching Greg complete this challenge while we went about our daily business has been humbling for all of us at Toyota.  We congratulate him for his for raising such a significant sum for the MND Association, our charity partner, and for helping to honour the memory of our much-loved colleague, Rachel Rollason.”