Staff engagement is central to providing quality patient care, and this is at the heart of The Christie Commitment - Victoria Hughes

Victoria Hughes, principal radiographer and Christie Commitment champion

Victoria Hughes

I have been principal radiographer in The Christie radiology department since September 2015. My role involves supporting the radiology services manager, clinical director and business manager with the management of the radiology service, which includes plain film X-ray, interventional radiology, ultrasound, CT and MRI scanning, as well as providing nuclear medicine and PET/CT reporting. 

We undertake over 55,000 examinations and interventional procedures per year, imaging patients for diagnosis or post treatment follow-up, or as part of clinical trials.

I am also departmental lead for governance, ensuring maintenance of quality throughout the department and responding to any clinical incidents or patient concerns, to make sure we learn from these to constantly improve our service and maintain high standards.

I felt lucky to have the opportunity to come back to the Trust, having previously worked here as a diagnostic radiographer from 1996-2007. The radiology service has grown substantially since then. Since returning, it’s been an exciting time with a new purpose built 3 scanner MRI suite opening last summer, vastly improving the patient experience. The opening of the Integrated Procedures Unit (IPU) later this year, incorporating a new two room interventional radiology suite and ultrasound room, will enable us to integrate more closely with other teams to create a more seamless patient service.

Staff numbers have also increased, with over 100 staff including radiologists, diagnostic radiographers, radiology nurses, radiographic aides, porters, clinical trials team, picture archiving and communications systems (PACS) manager, and secretarial/clerical support. Despite this, the department has retained its close knit family feel and team spirit, and what makes both radiology and the wider Trust such a special place to work is the positive atmosphere and motivation to put patients first which remains constant.

The Trust recognises the importance of staff engagement to this sense of team working and patient centeredness, and developed a set of pledges collectively known as The Christie Commitment, aiming to help staff appreciate how much of a difference they make to patients. On starting in post I was asked to submit a monthly report to our divisional board outlining how the radiology department was meeting the commitment. The pledges cover the areas of:

• Achievement and recognition – thanking staff for doing a good job, and rewarding those who go the extra mile
• Learning and development – ensuring opportunities for personal development and career progression
• Healthy workplace – supporting health and wellbeing of staff and promoting a culture where staff feel able to raise concerns
• Communication and engagement – Good communication processes and staff involvement in decisions affecting them or their service
• Proud of The Christie – aims for staff to be advocates of The Christie both as a place to be cared for and to work, sharing patient feedback, the work of The Christie charity and results of research

I thought it important that all department staff had an opportunity to contribute so began sending a monthly e-mail request to all staff for items to include. Staff positively engaged with this which inspired me to find out more about The Christie Commitment and how we could support this within the department. So I volunteered to become a Christie Commitment champion, one of a team of staff from different departments and professions dedicated to raising awareness of the commitment and staff engagement.

Being a champion involves attending a quarterly Christie Commitment forum, as well as informal lunch-time catch ups in between, for updates on staff engagement events and activities, sharing ideas between departments, and promoting these within our own areas.

Although voluntary, this has also helped in my formal role, increasing knowledge of the Trust through networking with staff I may not otherwise have met, promoting engagement between departments, and providing opportunities to become involved with activities in the wider Trust. These include the staff summer garden party, annual health and wellbeing day, and speaking to new staff at Trust induction about The Christie Commitment and values.

I was fortunate that radiology already had effective engagement processes through regular staff meetings, good communication between team leaders and other staff, and an open door policy for staff to come and raise concerns. We have regular lunchtime education sessions and an early morning journal club. These are organised and run by members of staff and are well attended. We also support professional study leave and attendance at study days and courses for staff development at all levels.

Producing monthly Christie Commitment updates have enabled us to build on this further, with it becoming not only a feedback tool to the Trust about engagement in the department, but a document shared back with the radiology team. In the update we celebrate each other’s achievements, advertise any learning and development  or health and well-being events, and one of the most important elements – ensure all staff are aware of compliments and positive patient feedback, as not all can attend staff meetings each month.

It means a huge amount to us to receive positive comments via patient letters, cards or surveys, as it is so rewarding and motivating to know that the commitment of staff really does make a difference.

As managers in radiology we value staff feedback and ideas for improvement and periodically undertake a departmental staff survey. The most recent in May 2016, identified ideas we were able to action, such as employing an additional porter to improve patient flow and reduce delays, and implementing a staff suggestion box.

Kim Jones, Nazir Majeed and Victoria Hughes

We also encourage staff to take part in the ‘One Week, All Staff’ events run by the Trust, to feed back directly at Trust level, as well as the wider NHS staff surveys. We have added a Christie Commitment section to the monthly staff meeting agenda, to enable sharing of feedback on staff suggestions, and engagement events news from the Commitment forum.

Through promoting the role of the Christie Commitment champions we now have two further volunteers from the department, representing different staff groups within radiology – Kim Jones, radiology specialist nurse and Nazir Majeed, radiographic aide, which is further helping us to engage both with the radiology team and other staff across the Trust.

The radiology team were delighted with the Trust’s recent ‘Outstanding’ CQC result and are extremely proud to have been able to contribute towards this, as it reflects the ethos of the Trust and its commitment to its patients, but also to its staff, which is emphasised within the pledges of The Christie commitment.

For further information about The Christie commitment please email thechristiecommitment@christie.nhs.uk or contact Carol Reah on 0161 446 8423.

So what is a TNA? - Claire Barnes

Claire Barnes, Trainee Nursing Associate

Claire Barnes

To me it sounds like the beginning of a cheerleader chant so, combine that with a biscuit coloured uniform and we’re good to go! The irony of a biscuit coloured uniform and the link I made to hobnobs might send you running for a brew however, as anyone familiar with Peter Kay will tell you hobnobs are the hard-core dunking biscuits… persistent and refuse to crumble under pressure. I think that describes TNA’S perfectly. 

TNA is short for Trainee Nursing Associate and out of 1,700 applicants nationally, 240 were appointed, and nine of them are based here at The Christie. I am fortunate to be one of those nine. The TNA role has been introduced to help to meet the needs of a changing population within the modern NHS. 

The Nursing Associate will work under the direction of a fully qualified Registered Nurse (RN). The Nursing Associate is not a Registered Nurse but will undertake some of the duties that a RN currently undertakes, enabling the Registered Nurse to spend more time on the assessment and care associated with both complex needs and advances in treatments.

You might be wondering what prompted me to become a cheerleading biscuit coloured TNA. To answer that we need to rewind a little.

Until a couple of years ago, I had never been to The Christie. Life however is full of curve balls and the one I got thrown came with a diagnosis of ovarian cancer for my mum. 
Unfortunately for mum, her cancer had advanced too far and we lost her in April 2015. At the time, I was a home working admin bod and juggled my work and home life together. 

I had been genuinely amazed (I still am) by the care and support both my mum and our family received during her hospital stay. The Christie is a unique environment where despite the somewhat scary circumstances, patients can feel at ease. To put it simply, the people who work at The Christie are wonderful, caring souls and the hospital is something to be proud to be a part of. 

I decided that if I was going to work in admin I’d like to do it at The Christie and give something back. “I want to become a small cog in a big machine that makes a difference to people’s lives on a daily basis” was exactly what I put on my application form when I applied to work here. 

The small cog theory led me to a clerical role based in the endocrine unit. It was a rewarding job and a very friendly team but I quickly realised that I had a desire to play a more hands on role in patient care. This led me to apply for a role as Health Care Assistant (HCA) or a switch to the dark side as I often joke with my colleagues Jen and Steph on reception. As an HCA in endocrinology I become a mini Dracula (taking lots of blood samples from patients). When one of the nurses on the unit pulled me to one side to show me the TNA role advertisement I was intrigued. It was an amazing opportunity not to be missed. 

If you have ever tried to make yourself sound snazzy in 200 words, you’ll know it can be somewhat mission impossible, however that’s the exact amount I had when completing the expression of interest form to be a TNA. I half debated just writing in big text PICK ME!! but was persuaded against that idea and instead opted for something along the lines of “The Nursing Associate Training programme is an amazing opportunity, not only to expand my clinical skills but also to widen my knowledge of various NHS areas, draw from the knowledge gained and apply it to whichever role I undertake.”

Prior to my interview, I directed so many questions to the ward sister Alex and the diabetes nurse Louise, that I am convinced they cringed every time I popped my head round their office door (they didn’t). Their support and encouragement however proved invaluable and helped me to prepare for the interview. After a wait that seemed like forever, I was still surprised when I got the call to say I had been successful!

On Wednesday 4th January I attended a meeting where I got to meet my fellow TNA’s, all from different areas within the hospital. We introduced ourselves, a little about how we got where we were and then learned more about the role. It is still very much a work in progress. 

As the TNA role is a pilot, some of the finer details are still being worked out, such as the community placements and the colour of our uniform has only just been decided (I am still not sure why pink was unpopular!) 

The TNA role begins on January 30th working full time, with Wednesday allocated for university. We will spend the first six months in our original ‘base’ then rotate through three further placements, each lasting six months, taking us to a total of two years at the end of which we hopefully gain our foundation degree. 

I am looking forward to the programme, not only the prospect of developing my clinical skills but also gaining the knowledge behind the how and why of clinical practice. I would be lying if I said the prospect of university level study is not a little daunting but, I am sure with the support of my colleagues it won’t be as scary as I think. 

Our induction at Manchester Metropolitan University was on 18th of January where we met our tutors prior to commencing our roles. There is no doubt the next two years will be hard, combining work with study and home life, however it is without a doubt an exciting role to undertake and I am incredibly proud that I’ll be a part of it!

The expansion of the interventional service for our patients in 2017 is something we look forward to greatly - Alex Gosling

Alex Gosling, Radiology Lead Nurse

Alex Gosling

I have been working at The Christie, within interventional radiology as the radiology lead nurse for just over a year now and I am very lucky to say I work with such a fantastic team. We are a very small but dedicated team of three nurses who work very closely with our coordinator, radiographers and consultant radiologists with the goal of providing the very best patient care. 

Interventional radiology is where X-rays, ultrasound or CT imaging are used to guide very thin wires and catheters into specific parts of the body. This can be for both diagnostic and treatment purposes and can reduce the need for surgery or more invasive treatments. We are able to undertake a very large range of procedures ranging from ultrasound guided biopsies to vascular procedures that can give radiotherapy treatment directly into liver tumours.

Although the role of the nurses is predominantly to support the patients and assist the doctors in the provision of care during interventional procedures, we also run a unique but very successful drop in clinic with the nutritional nurse for patients who have gastrostomy feeding tubes. Within this clinic we are able to provide practical help but more importantly we are there to give support and advice at any time within the working week. We are very fortunate that we are able to build strong and trusting relationships with our patients through this service.

I have found over the last 11 years working in interventional radiology, that there is often a lack of understanding regarding the speciality, not only for patients and their relatives but also for other staff members within the hospital setting. 

As a team, in 2017, it is our intention to raise the profile of interventional radiology especially as we have a very exciting and anticipated move in April to the new integrated procedures unit (IPU). Interventional radiology will be moving to the new unit along with the procedure team, pain team, day case theatre, endoscopy and plastics. This will be a major step forward for us as a team but also for The Christie as a hospital. 

Interventional radiology nursing team

Presently, we are operating at capacity with just one interventional room. With the opening of two new rooms planned in the IPU, the service will not only expand but will have provision for undertaking more advanced and intricate procedures. The addition of the state of the art advanced 3D interventional suite will mean that we will be a European reference centre with the ability to record and live stream complex cases all over the world. 

The amount of charity work that has been carried out to enable this expansion and improvement is overwhelming and as a team we are delighted to be the subject of this year’s Christie charity ball. This can only enhance the status of interventional radiology.

Our priority is always to provide the very best patient care. We wish for our patients to have as smooth a journey as possible and for optimum outcomes to be achieved. The enormity of what we will potentially be able to achieve with the expansion of the interventional service for our patients in the future is tremendous and something we look forward to greatly. 

To find out how you can help to support the new Interventional Radiology suite please visit our fundraising page or you can help to support The Christie's new Integrated Procedures Unit.