About the Departments
Emergency Services
Ashford & St Peter’s Hospitals NHS Trust operates a fully-fledged A&E Service at St Peter’s. An integral part of delivering emergency care to the local population is focused on recruitment and retention of highly qualified nursing and medical staff across all grades. Detailed below is a summary of information which describes the role of the A&E at St Peter’s Hospital. The Trust is committed to supporting staff and developing their role.
Reconfiguration of Emergency Services at Ashford Hospital
From Wednesday 1st February 2006, Ashford Hospital, Middlesex will no longer provide a full emergency service for seriously ill or injured patients. On the same date, we are opening a new Walk-in Centre at Ashford Hospital that will be open seven days a week, 24 hours a day.
The service will deal with minor injuries and ailments. Patients who are seriously ill or injured, and all children under 2 years, should go direct to St. Peter’s Hospital, Chertsey or another hospital providing full Accident and Emergency services.
The Trust is implementing changes in working practice for emergency medicine, which reflect the implementation of the Reforming Emergency Care agenda. Streaming has been introduced at St Peter’s and this service is supported by ENPs and senior medical staff.
The Clinical Director for A&E is Mr Pradip Rana. The general manager for Emergency Care is Joanne Edwards. Jean Haire is the A&E Service Manager and Modernisation Lead for Emergency Care with responsibility over MAU and SAU.
Clinical Practice
All staff are positively encouraged to undertake continuing education and mandatory training sessions as well as teaching relating to relevant aspects of patient care are offered within the department. The clinical practice development nurse is Annie Nelhams whose role is to lead and facilitate the education and training of the nursing team
A&E Department at St. Peter's
Mission Statement of the A&E Department
- To treat to a very high standard all serious ill and injured patients
- To treat to a very high standard all walking wounded patients and patients with primary care problems
- To provide teaching and training in all aspects of emergency work to doctors and nurses and other healthcare workers in the department
- To liaise with other emergency services; Fire, Police and Ambulance
- To have in place a Major Disaster Plan
- To meet the Government A&E targets
Activities of the Department
- Audit of all x-rays and casualty cards 8am each day (365)
- Dedicated teaching of all SHOs, Clinical Fellows and SpRs (Mondays and Thursdays – 3 hours)
- Hand clinic reviews (Mr Rana – Wednesdays)
- Burns Clinics (Tuesday and Friday mornings)
- Sports Injury and Neck Clinic (Thursday mornings)
- Directorate meetings
- Clinical Governance meetings
Departmental Philosophy
- We aim to ensure that the patient’s experience during their A & E attendance lives up to their expectations.
- The care given to patients and their relatives will be provided by skilled personnel and be of a high standard.
- Staff work as members of a friendly and effective cohesive team.
The department operates a fully-fledged A&E service including Paediatrics. The A&E Department was opened in July 1998 and is divided into 6 sections.
- Minor Injuries
- Trolleys
- Majors
- Resuscitation
- Observation bay
- Paediatrics
The department has a designated minor injuries area and an Emergency Nurse Practitioner (ENP) service to support the management of minor injuries. The Emergency Nurse Practitioner service is a seven-day service running from 10:00 – 20:00 hours daily. Currently 6 whole time equivalent are in post.
A purpose built 4 bedded resuscitation area was opened in January 2002 with dedicated cardiac, trauma and paediatric bays.
Operating Department
The Operating Department at St Peter's Hospital has 8 theatres, and a 12 bed recovery room
St Peters Hospital is the acute site, providing a 24 hour service for trauma and emergency surgery as well as elective surgery. We undertake a wide range of surgery including: general and vascular, urology, gynaecology, orthopaedics/trauma, maxillo facial, ophthalmology, ENT, chronic pain, and the emergency surgery.
The theatre department has recently been refurbished with an extra theatre added (theatre 8), a larger modernised recovery room for up to 12 patients, a new coffee room for the staff, plus storage areas and refurbished changing rooms.
At St Peters Hospitals there are two Sisters/ Team Leaders for surgery and recovery practice and two Team Leaders for the Anaesthetic practice.
Specialist Nurses
A Clinical Practice Educator supports nurses and ODP's at both Ashford and St Peter's Hospitals including Day Surgery and Endoscopy with staff development. There are many opportunities to develop skills, with surgical, anaesthetic, recovery, day surgery care and assistant to the surgeon development portfolios.
Newly qualified staff are encouraged to complete the Interdisciplinary development programme, which covers topics such as infection control, clinical risk and documentation, this programme is linked to the European Institute for Health and Medical Sciences and has been awarded 20 credits at degree level.
We offer many other study days and courses within the Trust, for example the 'Managers Toolkit,' Acute Skills study days etc as well as linking to the European Institute of Health and Medical Sciences for individual modules, diplomas and degrees.
Our Clinical Governance Co-ordinator works closely with the Clinical Governance Lead for Anaesthetics providing support for all staff within the Anaesthetic Business Unit on Governance issues, including incident reporting, audit and effectiveness and complaints.
Root cause analysis training is offered by the trust supported by the Clinical Governance Coordinator for senior members of staff.
The Acute Pain Team provides support and education to patients and staff at both Ashford & St. Peter's Hospitals.
Student Nurse and Student ODP's
In theatres on both sites we support diploma and degree level student Nurses and diploma level student ODP's who are studying with the European Institute of Health and Medical Sciences, University of Surrey.
The Trust also supports students participating in post-registration diploma, degree and other professional course in either anaesthetics, surgery or recovery and day surgery and overseas nurses undertaking a period of supervised practice prior to registration with the NMC. Health Care Assistants (Theatre Assistants) are facilitated to complete NVQ level 3 in Perioperative Support.
Commitment to New Staff
All new employees have a mentor/ preceptor during the initial stages of their employment.
A personalised induction/orientation programme is developed between the new member of staff and the mentor to ensure they can meet the requirements of their job as soon as possible.
The Trust Induction is a 3 day programme which includes a professional nursing day, manual handling, Fire and resuscitation.
A personal professional development plan is agreed to ensure that staff gain the experience required for their job and have the opportunity to pursue any areas of development required for their role.
On one ½ day each month an educational ½ day session is provided for staff, during this time meetings are held followed by relevant lectures to practice and mandatory training.
Maternity
Ashford and St. Peter’s Hospitals NHS Trust’s Maternity Services are contracted by the Surrey and Hounslow PCTs to provide maternity care throughout the Woking, Chertsey, Walton, Ashford, Virginia Water, Hersham, West Byfleetand Weybridge areas.
Care is provided in a variety of settings and based upon clinical need rather than service routines.
Women who live locally but outside of the immediate catchment area can have pregnancy and labour care through the midwifery team based in the antenatal clinic at St. Peter’s Hospital.
The maternity services are provided on both the Ashford Hospital and St. Peter’s Hospital sites. The in-patient service is based at the St. Peter’s Hospital site; however, a range of antenatal services are provided at both sites and in the community setting.
The maternity unit at St. Peter’s is located in Abbey Wing and spread over three floors. The majority of women who have their babies at St. Peter’s Hospital have normal births and are cared for by midwives. A consultant midwife is in place to ensure that the focus for normal midwifery care is enhanced.
Antenatal Services
These services are based on both the Ashford Hospital and St. Peter’s Hospital sites, as well as with GP surgeries and health centres. Services available include:
- Midwife clinics
- Consultant Clinics
- Specialist endocrine clinic (St. Peter’s Hospital only)
A maternity Day Assessment Unit is located within the antenatal clinic on the St. Peter’s Hospital site. It is open Monday to Friday 0900-1700 and a variety of referral systems provide access to this service. We now also provide a 24 hour midwifery service.
Triage
Maternity Triage is a Midwifery Led area open 24 hours a day. This telephone number appears on the Maternity notes therefore is the first point of call for women in labour. They are triaged firstly over the phone and if appropriate asked to attend either LW directly or the triage area. On arrival the women is seen and assessed by the midwife then referred to the appropriate place. Triage is staffed by core staff 08.00hours – 20.00 hours, and community team midwives 20.00 hours - 08.00 hours.
Obstetric Ultrasound
The obstetric ultrasound department at St. Peter’s Hospital is on the ground floor of the Maternity Unit, making it easily accessible for the women. Routine scans include nuchal screening (as part of Combined Screening) and an anomaly scan at 22 weeks. Scans are also performed at Ashford Hospital in conjunction with the midwife antenatal clinics taking place there.
Early Pregnancy Unit
This unit is situated on the ground floor of Abbey Wing and cares for women with early pregnancy problems. This service is provided Monday to Friday 0900-1500 and referrals are made from midwives, GPs and other medical staff.
The Delivery Suite
The delivery suite consists of 9 delivery rooms, of which two are midwifery led rooms and one with a birthing pool. We also have and four high dependency/observation beds and a two bedded assessment bay. There is also a room set aside for parents who have suffered bereavement.
A senior operating department practitioner works in the Delivery Suite and provides support and advice regarding the management of the two obstetric theatres located in the same corridor, and leads theatre skills training for midwives and maternity assistants.
Joan Booker Ward
The antenatal/postnatal ward has a total of thirty eight beds. There is a degree of flexibility in allocating these beds and up to ten can be for antenatal women. There are eight single amenity rooms and although these rooms may be requested, a woman with clinical needs would be given priority.
Working closely with Maternity Services are the Neonatal Intensive Care Unit and the Transitional Care Unit, both of which are an integral part of Children’s Services.
Neonatal Intensive Care Unit
The Neonatal Intensive Care Unit is a recently developed and refurbished unit which has been designated as a Level 3 Intensive Care provider for Surrey. Our cot capacity will be 28 cots which include 8 Intensive Care. The Unit also hosts the Neonatal Transport Team for the Surrey network.
Transitional Care Unit
This 6 bedded Unit is based on the postnatal ward but is part of the service provided by the Neonatal team. Midwives provide the care to the mothers.
Midwives
Midwives are given a full induction/orientation programme when commencing employment. All midwives are encouraged to rotate to all areas including the community thus ensuring maximum utilisation of their midwifery skills. Rotation includes day and night duty.
Newly qualified midwives and those on return to practice or adaptation are offered a rotational programme to enable them to build upon their skills over three months’ allocation which includes:
- Ante/postnatal ward
- Antenatal clinic
- Labour ward
- Community teams
During this time experience is increased in:
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There is a local training policy and all midwives are allocated to the “Bonus Day” training programmes arranged within the Unit. These cover topics such as fetal well-being; CTG interpretation; shoulder dystocia; post partum haemorrhage; record keeping; child protection; maternal and fetal resuscitation; clinical governance and risk management; infant feeding; diversity, domestic abuse, mental health and pregnancy.
The parent education co-ordinator provides support to newly qualified staff, as well as being a valuable resource for more experienced midwives. Separate classes are provided for couples, twin and multiple births, women with special needs and for teenage mothers.
