Innovation

Although not a large teaching hospital, the Trust has its fair share of innovative work. Each year these are listed in the Annual Quality Report which can be found here. Those listed on this page consist of those that occurred from April 2012 onwards:

First Operation in the UK

Dr Sauid Ishaq, Consultant Gastroenterologist, recently performed the first flexible endoscopic treatment of Zenker’s Diverticulum in the country.

The patient develops a pharyngeal pouch or Zenker’s Diverticulum (when the lining at the back of the throat ruptures through the muscle wall creating a pouch) which results in food entrapment, persistent coughing, difficulty in swallowing and potentially aspiration pneumonia.

Historically it has been treated by the Ear Nose and Throat (ENT) specialty either by open surgery or stapling by using a rigid endoscope under general anaesthetic.

The new technique, used in leading centres in Europe but not in the UK, entails flexible endoscopy treatment performed as a day case.

Dr Ishaq was trained to undertake the procedure in Amsterdam, Milan and Brussels and had Professor Chris Mulder, from Amsterdam (Gastroenterologist), present during this first case.

Recently Dr Ishaq successfully carried out independently the same procedure on a further patient. He has been in close liaison with our ENT team and Mr Neil Molony, Consultant ENT Surgeon, and had the support of Dr Neil Fisher, the Medical Service Head for Gastroenterology as well as the Trust’s New Interventions Group. Following the operations the symptoms of both patients improved considerably.

Endovascular investigation and treatment

This £1.5m development was opened in March 2012 and allows surgical and radiological teams to perform elective and emergency endovascular aortic aneurysm repairs and in the last 12 months, 68 patients from across the Black Country have benefited from this minimally invasive technique to treat what is a life threatening condition.

The suite comprises state of the art equipment enabling real time three dimensional imaging and allows complex vascular and other interventions to be performed to the highest standards of precision and patient safety whilst ensuring the lowest possible patient radiation dose. In addition to the vascular work, the suite is used for conventional interventional radiology techniques and is also now being used to undertake other major interventions such as vertebroplasty, an imaging guided technique that brings together a multidisciplinary team to treat painful spinal collapse of various causes.

Community Adult Continence Service

The Community Adult Continence Service has been involved in a number of collaborative partnerships to ensure that the patient is seen speedily by the correct expert as close to home as possible. For instance, a clear process is in place for all male patients with lower urinary tract systems so, dependent on the severity

of their symptoms, they are seen and treated by the appropriate experts either in the community or in the hospital. This reduces unnecessary visits to the hospital and allows those with the appropriate symptoms to be seen quicker at the hospital. This has come about due to partnership working between the community clinical nurse specialist, hospital care (Urology service), GPs (Wychbury Medical Centre) and pharmaceutical advisors. Local services from, for example, Wolverhampton and Birmingham have all approached the clinical nurse specialist (CNS) on setting up such a service.

Similar innovative work for those patients with constipation has also been developed. For this service the clinical nurse specialist has worked with the hospital (Gastroenterology) and Worcester St practice. One outcome has been more effective prescribing and the reduction in the use of unnecessary laxatives. Shropshire Trust has approached the CNS for advice in setting up a similar service. The next initiative being developed is looking at more appropriate use of aids for bladder and bowel dysfunction in the hospital.

Outpatient Parenteral Antibiotic Team (OPAT)

In the past, patients requiring intravenous antibiotics always had to come into hospital for their therapy but from January 2012 a joint service between the hospital and community commenced. Patients are now assessed in hospital and then discharged for the community nurses to administer the intravenous antibiotics. Patients sometimes return to hospital for a review in a specialist clinic. The service was initially started for patients with cellulitis but then extended to those with complex urinary tract infections, including pyelonephritis.

A further service for those with diabetic foot problems was also commenced in October 2012 and there are plans to extend this service. During 2012 over 150 patients were successfully treated in the community setting either in the patient’s own home or in the community clinic at Brierley Hill Health and Social Care Centre. This is estimated to have saved over 1,385 bed days, increasing capacity within the hospital for more appropriate patients whilst providing excellent care for patients nearer to home. A survey of the patients treated found they were all satisfied with the service, rating it at 9.2 on a scale of one to 10.