2014/2015

ANNUAL

We Care

South Yorkshire and Bassetlaw Abdominal Aortic Aneurysm Screening Programme

REPORT

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ContentsForeword 1. Introduction 1.1 WhatisanAbdominalAorticAneurysm? 1.2 SouthYorkshireandBassetlaw 1.3 SouthYorkshireandBassetlawAbdominalAortic AneurysmScreeningProgramme

2. Strategic Direction 2.1 Aims 2.2 Strategy

3. Programme Delivery 3.1 Clinics 3.2 ProgrammeTeam 3.3 ContactDetails

4. Screening Pathway 4.1 Identification 4.2 Invitation 4.3 Inform 4.4 Test 4.5 Surveillance 4.6 Diagnose 4.7 TreatmentandIntervention 4.8 Monitor

5. Programme Performance 5.1HeadlineStatistics 5.2 Data

6. Stakeholder Engagement 6.1 EqualityandEquity 6.2 CommunityandServiceUserEngagement 6.3 HealthProfessionals 6.4 Media 6.5 Significantothers

7. Key Achievements

8. Future Developments

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Section1Foreword ThisreporthighlightstheachievementstodateoftheSouthYorkshireandBassetlawAbdominalAorticAneurysmScreeningProgramme(SYBAAA)andnotesthehighqualityofservicesthathashithertobeenachieved.TheSYBAAAScreeningProgrammehashadasuccessfulyearthroughinnovativeservicedeliveryandhasachievedveryhighpublicsatisfactionratings.

TheprogrammeworksinclosepartnershipwithbothproviderunitsinSouthYorkshireandBassetlawthusenablingeffectivetreatmentofthosewhoseaneurysmshavebeendetectedthroughscreening.

TheSouthYorkshireandBassetlawScreeningTeamisawellknitfocusedandenthusiasticteamwhoseeffortshavecontributedtomaketheSouthYorkshireandBassetlawProgrammeoneofthebestinthecountry.

R J Cuschieri MD,CHM,MEdFRCS

ConsultantVascularSurgeonClinicalDirectorSYBAAA

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Introduction ThisisthefirstAnnualReportoftheSouthYorkshireandBassetlawAbdominalAorticAneurysm(AAA)ScreeningProgramme.Thereportdetailsprogrammeperformanceforthe2014/15screeningyear.Itoutlineskeyachievementsandhighlightshowcurrentactivityandfuturedevelopementswillmaintainthehighstandardofservicedelivery,encouragealleligiblementoattendtobescreenedandcontinuetoworktoremovebarrierstotheuptakeofscreening.

FollowingconsiderationoftherequirementtoreducethenumberofdeathsfromrupturedaorticaneurysmstheUKNationalScreeningCommitteeapprovedtheintroductionoftheNHSAbdominalAorticAneurysmScreeningProgramme(NAAASP).Establishedin2009,thephasedrolloutacrossEnglandwascompletedin2013.TheSYBAAAScreeningProgramme,whichhelditsfirstscreeningclinicinSheffieldon25February2013,representsoneofthefinalprogrammesinEnglandtosuccessfullyimplementthenationalprogramme.

Therearecurrently41localscreeningprogrammesofferingAAAscreeningtomenaged65andoverresidinginEngland.NAAASPalsoworksincollaborationwiththeAAAscreeningprogrammesinWales,ScotlandandNorthernIrelandensuringequityofaccessforAAAscreeningformenthroughouttheUK.

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1.1 What is an Abdominal Aortic Aneurysm?

Anabdominalaorticaneurysm(AAA)isaswellingoftheabdominalaorta.AAAscreeningisaprocessofidentifyingmenwhoappearhealthybutmaybeatriskofhavinganAAA.Aneurysmsintheabdominalsectionoftheaortadevelopmostcommonlyinmenaged65andolder,arepredominantlyasymptomaticandareoftenonlydetectedincidentallyinthecourseofinvestigationsforoftenunrelatedconditions.Thereareanumberofassociatedriskfactorsincludingsmoking,highbloodpressureandhighbloodcholesterol.Havingacloserelativewhohad,orhas,anAAAalsoincreasestheriskofdevelopinganAAA.

LargeAAAs,over5.5cmindiameter,arelesscommon,butastheycarryanincreasedriskofrupturetheycanbeserious.IntheUKrupturedAAAaccountsfor2.1percentofalldeathsinmenaged65andover,withalmostathirdofthesedyinginthecommunitybeforereachinghospital.

Incontrast,throughscreeningandearlydetection,treatmentcanbeofferedatanearlierstage.Opensurgeryorendovascularrepairsurgeryarethetwomostcommontreatmentstorepairlargeaneurysmsandwhenofferedinhighqualityvascularcentresresultinmorethan98percentofpatientssurvivingrepairsurgery.

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1.2 South Yorkshire and Bassetlaw

DoncasterandBassetlawHospitalsNHSFoundationTrustisthelocalprovideroftheSouthYorkshireandBassetlawAAAScreeningProgramme.ComprisedoffiveClinicalCommissioningGroups(CCG’s)theprogrammecoversthelargedemographicareaof:

•Barnsley

•Bassetlaw

•Doncaster

•Rotherham

•Sheffield

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risk factors including smoking, high blood pressure and high blood cholesterol. Having a close relative who had, or has, an AAA also increases the risk of developing an AAA. Large AAAs, over 5.5cm in diameter, are less common, but as they carry an increased risk of rupture they can be serious. In the UK ruptured AAA accounts for 2.1% of all deaths in men aged 65, with almost a third of these dying in the community before reaching hospital. In contrast, through screening and early detection treatment can be offered at an earlier stage. Open surgery or endovascular repair surgery are the two most common treatments to repair large aneurysms and when offered in high quality vascular centres result in more than 98% of patients surviving repair surgery. 1.2 South Yorkshire and Bassetlaw Doncaster and Bassetlaw Hospitals NHS Foundation Trust are the local providers of the South Yorkshire and Bassetlaw AAA Screening Programme. Comprised of five clinical commissioning groups (CCG’s) the programme covers a large demographic area which is:

• Barnsley • Bassetlaw • Doncaster • Rotherham • Sheffield

Image 2: Map of South Yorkshire

Source – bing.com/images (GRAPHICS TO ADVISE IF TO INCLUDE SOURCE)

Source–bing.com/images

MapofSouthYorkshire

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MapofBassetlaw

Source–bing.com/images

Source bing.com/images

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1.3 South Yorkshire and Bassetlaw Abdominal Aortic Aneurysm Screening Programme

TheSouthYorkshireandBassetlawAbdominalAorticAneurysmScreeningProgrammeiscoordinatedandmanagedviaacentrallylocatedscreeningofficesituatedatMontaguHospital,Mexborough,S640AZ.Followingitssuccessfullaunchin2013theprogrammewasoneoftwoservicesatMontaguHospitalvisitedbytheRt.Hon.EdMiliband,theDoncasterNorthMP,tofindouthownewserviceswithinhisconstituencyweresettotransformthehealthofpeopleinSouthYorkshireandBassetlaw.

TheRt.Hon.EdMilibandMPmetpatientsandstaffatMontaguHospitalinMexborough,July2013

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Section2StrategicDirection

2.1 Aim and Mission Statement

ThegoaloftheSYBAAAScreeningProgrammeistoperformwithinthetop10percentnationallyinourcategory.Weplantoachievethisaimbyprovidinghighquality,comprehensivesystematicscreening,surveillanceandvascularreferraltotheeligiblepopulation.Indoingthiswe:

Aspire to Always be the best in delivering Accurate equitable treatment

Specificallywewill:

•PromoteAAAscreeningacrossSouthYorkshireandBassetlaw

•Increaseuptakeofscreeningappointments

•Increasethenumberofself-referralserviceusers

•Reducethenumberofclientswhodonotattendforscreening

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SouthYorkshireandBassetlawAAAStrategicMap

2.2 Strategy

TheservicehasafirmstrategicdirectionwhichisclearlyarticulatedintheSYBAAAStrategicMap.ThemissionandgoalsarealignedtothestrategicdirectionofDoncasterandBassetlawHospitalsNHSFoundationTrust,theaimoftheNAAASPandtheNHSoutcomedomainsforimprovinghealthoutcomesandimprovingquality.

South Yorkshire and Bassetlaw Abdominal Aortic Aneurysm Screening:Strategy 2016 - 2019

Darnall Health Centre2 York Road

SheffieldS9 5DH

QualityAssurance

The SYBAAA Screening Programme aim to be within the top 10 per cent nationally. Achieved by delivering high quality, consistent, comprehensive, systematic screening, surveillance and vascular

referral to the eligible population.

Aspire to be the best in Always delivering Accurate, equitable treatment

In responseto incident root cause analysis

activate quality assurance action

plan

Quality Performance

QualityStandards

and Service Objectives

Robust complianceto NAAASP

standards and objectives

Development

NationalPolicy

Changes

Timelyimplementation

of national policy

changes

Addressing healthinequalities

Eligible Screening

Population

Ensure needs are

reflected for coverage and

uptake

Staff

Serviceappropriate

recruitment tooptimise staff

retention

NationalMetrics/

KPI’s

Timely submission

of outpatient andreferral data

Staff

Raise the profileof the

programmelocally and nationally.

Identificationand Invitation

Monitoridentification in compliance with

national data. Ensureformat and language

Failsafes

Included, implemented and

functioning.Responsive to QA

action plans

SIAG

Timelysubmission of

local and national

reporting

Innovation

Develop in linewith best

practice. Use technology to

improve uptake

Championslocally andnationally

Strategically liaisewith AAA

communicationsto optimise

service promotion.Annual Report

Engagement

Escalate complaints,

embed in QAaction plan.

Bi annualpatient

satisfaction survey

RegionalNetworking

Meeting

Benchmarksperformance

regionally.Network for best

practice

Technology

Equipmentup to date,

quality assuredand electrically

safe

GovernancesupportingEquity anddiversity

Monitor and evaluate diversity of population at

quarterlyintervals

The NHS AAA Screening Programme aims to reduce AAA-related mortality by providing asystematic population-based screening programme for the male population during

their 65th year, and on request, for men over 65

S711TH

Iden

tity

Invi

te In

form

Test

Sur

veill

ance

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Section3ProgrammeDelivery

3.1 Clinics

ProvidingwidespreadaccessacrossSouthYorkshireandBassetlaw,thereare35screeningclinicsiteswithinthefiveCCGcohortboundaries.Thisincludesprovisionatthefollowingtypesofpremises:

•GPpractices

•LIFTbuildings

•Localcommunity hospitals

Tabletoshowavailablescreeningclinicsitevenues

AbdominalAorticAneurysm(AAA)screening

Barnsley Bassetlaw Doncaster Rotherham Sheffield

Hill Brow SurgeryLongCroftMapplewell

BarnsleyS756FH

Bassetlaw DistrictHospitalBlythRoad

WorksopS810BD

Bentley Surgery128HighStreet

BentleyDoncasterDN50AT

Aston Customer Services

WorksopRoadSwallownestS264WD

Baslow Road Surgery148BaslowRoadTotley

SheffieldS174DR

Park Grove Medical Centre

124-126ParkGroveBarnsleyS701QE

Harworth Medical Centre

104ScroobyRoadBircotesDoncaster

DN118JT

ConisboroughMedical CentreTheStoneCastle

CentreGardensLaneConisboroughDN123JW

CliftonMedical CentreDoncasterGateRotherhamS651DA

Crystal PeaksMedical Centre15PeaksMount

SheffieldS207HZ

RoundhouseMedicalCentreWakefieldRoad

AthersleyBarnsleyS711TH

Retford HospitalNorthRoadRetford

DN227XF

Montagu HospitalAdwickRoadMexboroughS640AZ

Maltby Joint Services CentreBraithwellRoad

MaltbyRotherhanS668AB

Darnall Health Centre2YorkRoadSheffieldS95DH

The cudworth centreCarlton Street Cusworth

BarnsleyS728SU

Sandringham Road Health

SandringhamRoadIntake

DoncasterDN25JH

Northern RoadSurgery

2MorthenRoadWickersley

RotherhamS661EU

Dovercourt Surgery3SkyeEdgeAvenueSheffieldS25FX

The Flying Scotsman Centre

StSepulchreGateWestDoncasterDN13AP

Ravenfield Surgery8HollingsRoadRavenfield

RotherhamS654PU

High Green SurgeryThompsonHillHighGreen

SheffieldS354NF

The White Wings Centre

SpaPoolRoadAskern

DoncasterDN60HZ

Rawmarsh Joint Services

CentreBarbersAvenue

RawmarshS626AE

RichmondRoad Surgery400Richmond

RoadSheffieldS138LZ

Tickhill Road HospitalTickhill RoadDoncasterDN48QN

Rotherham Community Health

CentreGreasboroughRoadRotherhamS601RY

Sheffield City GP Medical Centre

RockinghamHouseBroadLane

SheffieldS14BT

Vermuyden Centre32 FieldsideThorne

DoncasterDN84BQ

New York StadiumNewYorkWayRotherham

S60 1AH

Tramways Medical Centre

54 Holme LaneSheffieldS64JQ

The Health Bus

various sites available

Kiveton Park Primary Care

ChapelWay,KivertonParkS266QU

Valley Medical Centre JohnsonStreetStocksbridgeSheffieldS361BX

Dinnington GroupPractice

NewStreetDinningtonS252EZ

Wincobank Medical Centre

205TylerStreetSheffieldS91DJ

South Yorkshire and

Bassetlaw AAA Screening

ProgrammeClinical Venues

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Widespreadprovisionthroughthe35sitesisenhancedbytheuniquelocalinitiativeofamobileclinicdeliveredonthe“HealthBus”,allowingtheservicetoprovideclinicswithin:

•WorkingMen’sClubs

•LocalCommunityCentres

•GolfClubs

TheSouthYorkshireandBassetlawAbdominalAorticAneurysmScreening“HealthBus”

AAAsceeningisofferedanddeliveredtoeligiblemenatlocalprisonsandplacesofdetentionthankstoexcellentliaisonwithhealthcareandadministrativestaffatthecentres.

3.2 Programme Team Theserviceisprovidedbyahighlymotivatedmulti-disciplinaryteamofclinicalandadministrativestaff.Theirdedicatedworkiskeytothelocalprovisionofahighquality,safe,effectiveservice.

IncompliancewithNAAASPrecommendationsallclinicalstaffpossess,asaminimum,thefollowingqualificationandcompetenciesandundertakethemandatorytrainingwithinthenationalframework:

•NAAASPapprovedtrainingandaccreditationcourseforscreeningtechnicians

•NAAASPapproved‘FastTrack’trainingandaccreditationcoursefortheClinicalSkills,TrainerandNursepractitioner

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TheTeam:

MrRayCushieri   HelenMcAlinney AAAClinicalDirector Screening ConsultantVascularSurgeon ProgrammeCo-ordinator

PamelaHinchliffe  SarahPantry Screening AAAScreening ProgrammeAdministrator Technician

SimonLindley Amanda Ford AAAScreening AAAScreeningTechnician Technician

LouiseWalters LyndseyMcCabe AAAClinicalSkillsTrainer NursePractitioner AAAScreeningTechnician

RachelLambert NicolaWilkinson NursePractitioner  TraineeAAA ScreeningTechnician

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3.3 Contact Details

Theprogrammecanbecontactedbytelephone,email,SMStextorbypost.

South Yorkshire and Bassetlaw AAA Screening Programnme MontaguHospital,AdwickRoad Mexborough SouthYorkshire. S640AZ Tel:01709649100 Mobile:07771388783 Email:dbh-tr.dbhaaa@nhs.net Website:aaa.screening.nhs.uk

Section4ScreeningPathwayAbidingbytheNHSPublicHealthFunctionspecification,theserviceandscreeningpathwayprovidedbySYBAAAScreeningProgrammeisdividedintotheeightfollowingstages:

4.1 Identification

Thecohortdetailsofmenwhowillbe65withinthecohortyear1Aprilto31MarchareuploadedannuallyviatheScreeningManagementandRecallTracking(SMaRT)database,theNAAASPapproveddatabaseformanagingcallandrecallofAAAscreeningandsurveillanceclients.Thecohortdetailsarerestrictedtoclientname,dateofbirth,NHSnumber,residentialCCGandaddressplusgeneralpractitionerCCGandaddress.

4.2 Invitation

ComplyingwithNAAASPspecifiedstandardsSYBAAAScreeningProgrammegeneratesandpostsoutinvitationlettersthreeweeksbeforetheclinicappointmentdate.

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4.3 Inform

Theinformationprovidedintheappointmentletterisprovidedinavarietyofformatsincluding:

•Paperformat

•Electronicformat

•Otherlanguagesonrequest.

•Easyreadformat

ClientsarealsosignpostedtocontacttheSYBAAAscreeningofficeshouldtheyrequirefurtherinformationortoaccesstheUKNationalScreeningCommitteedecisionaidatthefollowingwebaddresshttp://sdm.rightcare.nhs.uk/pda/aaa-screening

4.4 Test Uponarrivalattheclinicmenaremetbyascreeningtechnicianwhowillexplainthescreeningprocess,possibleoutcomes,benefitsandanyrisks.Thetechnicianwillalsoaskfortheman’sconsentforthescreeningandforhispersonalinformationtoberetainedbyNAAASPforthepurposeofprogrammeevaluation,auditandresearch.Themanisofferedtheopportunitytoaskanyquestions.

Asimpleultrasoundscanisthencarriedoutwhichproducesanimageoftheabdomenenablingthetechniciantomeasurethewidthoftheaorta.Themeasurementistakenatthewidestpointandrecordedinpaperandelectronicform.

4.3.1.ScreeningOutcomesMenreceiveverbalandwrittenconfirmationoftheirresultatthescreeningclinic.TheirGPisthensentaletterconfirmingtheresult.

Therearefivepossibleoutcomestothescanasfollows:• Normal:theaortameasureslessthan3cmandisnotenlarged,meaningthereisnoaneurysm.Notreatmentormonitoringisrequired,themanwillbeinformedheisdischargedfromscreeningandwillreceivenofurtherinvitationsforscreening.

• Small aneurysm:theaortameasuresbetween3cmand4.4cm.Anymanwithasmall aneurysmisinvitedbackforscanseverytwelvemonthsformonitoring.

• Medium aneurysm:theaortameasuresbetween4.5cmand5.4cm.Menwhoarefoundtohavea mediumaneurysmareinvitedbackeverythreemonthstomonitorthesize.

• Large aneurysm:theaortameasures5.5cmorabove.Thesemenarereferredtoavascularsurgeon forfurtherinvestigationandtodiscusspossibletreatmentwhichisusuallyanoperation.

• Non visualisation:theaortacouldnotbevisualisedatthescreeningattendance.Themanwillbeinvitedtore-attendforanotherappointmentorreferredtoaMedicalImaging departmentforfurtherimaging.

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4.5 Surveillance

Anymanwithascreendetectedsmallormediumaneurysmisinvitedbackforsurveillanceappointmentsasfollows:

•Small(3.0–4.4cm)aneurysmwillbeinvitedforannualsurveillancescans

•Medium(4.5–5.4cm)aneurysmwillbeinvitedforquarterlysurveillancescansatthreemonthly intervals

WhenasmallormediumAAAisdiagnosedmenarealsoofferedahealthpromotionfollow-upappointmentwithoneofSYBAAANursePractitioners.Theseareofferedasafacetofacediscussion.Theappointmentcovers:

•Height

•Weight

•BMI

•Smoking

•Medications–Statins/Aspirins

•Exercise

•AnyConcerns–3monthfollow-upwhererequested

ThemanandhisGPreceiveawrittensummary.

4.6 Diagnose

DetectionofalargeaneurysmtriggerspatientreferraltoaNAAASPapprovedvascularunitforconfirmationofthediagnosisandconsiderationoftreatmentoptions.

MenfromSYBAAAScreeningProgrammearereferredtooneoftwovascularreferralcentres,theyare:

•DoncasterVascularCentre(DVC),DoncasterandBassetlawNHSFoundationTrust

•SheffieldVascularInstitute(SVI),SheffieldTeachingHospitalsNHSFoundationTrust

SYBAAAScreeningProgrammeacknowledgesclientchoiceanddoesnotinfluencethereferralpathway.

Allmenreferredtoavascularunitmustbeseenbyavascularsurgeonwithintwoweeksofthereferralbeingmade.

Thevascularsurgeonthentakesoverthemanagementoftheman’streatmentoftenschedulingfurtherdiagnostictestsandofferingeitherfurthersurveillanceortreatment,whichiseithersurgicalorendovascular.

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Ifafurtherdiagnostictestatthevascularunitshowstheaneurysmtobelessthan5.5cmindiameter,orthepatientisunfitforsurgery,continuedfollowupisarrangedunderthecareofthevascularsurgeon,notthescreeningprogramme.

4.7 Treatment and Intervention

ClinicaldecisionsfortreatmentandinterventionaremadebytheVascularTeam.

4.8 Monitor

SYBAAAScreeningProgrammemonitorsthevascularservicemanagementofreferredclientstoestablishwhethermanagementtimeframescomplywithNAAASPservicespecifications.Thisincludesmonitoringtoensurethat:

•AttendanceataVascularoutpatientappointmentwithin 2 weeks of screen detection has been undertaken.

•Ifclinicallyappropriatesurgicalinterventionisundertakenwithin 8 weeks of screen detection.

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Section5ProgrammePerformance

5.1 Headline Statistics

TabletoshowSouthYorkshireandBassetlawheadlinestatisticsfor2014/2015

5.2 Data

Thereportfocusesonthedataforthescreeningyear2014/2015andincludesreferencestodatafromthescreeningyear2013/2014.

ThedataisderivedfromNAAASPreportspublishedontheScreeningManagementandRecallTracking(SMaRT)database,theNAAASPapprovedcallandrecallsystemtomanagescreening,surveillanceandvascularreferraldata.

5.2.1 WithintheSouthYorkshireandBassetlawcohortboundaries7,997menintheir65thyear,1April2014to31March2015,wereeligibleforAAAscreeningandweresentaninvitationtoattendanAAAscreeningappointment.Fromthiseligiblecohortof7997men,6,641menattendedtheirscreeningappointmentresultinginanuptakeof83percent.

South Yorkshire and Basselaw Abdominal Aortic Anneurysm Screening

2014/2015

Uptake 83%

AAA’sdetected94

(prevalence1.1%)

Referralsmade13

(prevalence0.2%)

Surgeryundertaken 11

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Thegraphbelowshowstheeligiblecohortandthenumbermenwithadefinitivescan result2013/2014and2014/2015.

Graphtoshowpercentageuptake2013/2014and2014/2015

Summary

•Cohortuptakehasremainedover80percent

•Thepercentageofeligiblemenscreenedhasincreasedovertwoyears

WecontinuetoworktounderstandDNA(DidNotAttend)levelsbyfollowinguprandomsamplesof20menonaquarterlybasistoestablishthereasonsbehindnon-attendanceofscreening.

010002000300040005000600070008000900010000

900080007000600050004000300020001000 0

10000

8374 6875 7997 6641

SYBAAAScreeningProgramme2013/14

SYBAAAScreeningProgramme2014/15(SMaRT)database.

Eligiblecohort

Cohortscreening

75

80

85

75

80

85

82.1 83.04

SYBAAAScreeningProgramme2013/14

SYBAAAScreeningProgramme2014/15

SYBAAAScreeningProgramme2013/14

SYBAAAScreeningProgramme2014/15

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Thisresultsinanumberofscreensbeingrebooked.Italsorevealsthereareasmallnumberofmen,whoregardlessofengagementandeducationdonotwishtotakepartinthescreeningprogramme.

5.2.2 Thecohortnumberswereboostedbytheself-referralforscreeningofmenagedover65intheyear1April2014to31March2015.

Piecharts1and2:Piechartstoshowthecontributionofself-referralstooverallnumberofmenscreened2013/14and2014/15

5.2.3 Inthescreeningyear2014/2015,189surveillancescanswereperformedbySYBAAAScreeningProgramme.

5.2.4 Inthescreeningyear2014/2015,13AAA’s≥5.5cmweredetectedandreferred,onthebasisofserviceuserpreferenceandchoice,toDoncasterVascularCentreorSheffieldVascularInstitute.Allserviceusers(100percent)receivedvascularconsultationatthevascularreferralcentreoftheirchoicewithintwoweeksoftheirscreendate.SixserviceusersoptedtorefertoDVCandseventoSVI.

Table3:TabletoshowVascularReferralPatterns

Cohortscreening

Totalselfreferrals

SYBAAA Screening Programme 2013/14 SYBAAA Screening Programme 2014/15

24%

76%

Cohortscreening

Totalselfreferrals

17%

85%

South Yorkshire and Basselaw Abdominal Aortic Anneurysm Screening 2014/2015

Referral ResidentialCCG Size(cm) ReferralCentre123456789

10111213

BassetlawDoncasterDoncasterDoncasterDoncasterRotherhamRotherhamSheffieldSheffieldSheffieldSheffieldSheffieldSheffield

5.55.65.65.766

7.35.55.66.16.66.9

Acceleratedgrowth

DVCDVCDVCDVCDVCSVIDVCSVISVISVISVISVISVI

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5.2.5 Elevenofthethirteenmenwerefoundtobesuitableforsurgeryandhavereceivedopenrepairorendovascularrepair.Twomenhadtheirsurgerycompletedwithineightweeksofthescreendatetriggeringreferral.Fourhadtheirsurgerydelayedforvalidreasons.

5.2.6 Feedbackfromthebi-annualclientsatisfactionsurveysfor2014/2015indicatesserviceusersarehappywiththefacilitiesoffered,theservicedeliveredand100percentofthoserespondingwouldrecommendSYBAAAScreeningProgrammetofamilyandfriends.

Graph3:Graphtoshowclientsatisfactionsurveyresults-facilities

Graph4:Graphtoshowclientsatisfactionsurveyresults-staffandclientexperience

020406080100120140

Environment and Facilities

020406080100120140Numberofpatients

YES

NO

Notanswered

115(99%)

116(100%)

1(1%)

3(2.5%)112(96.5%)

3(3%)

112(97%)

115(99%)

1(1%)

Wastheclinicsiteconvenient?N=116

Wastheclinicmapclear?N=115

Weretheinstructiononwheretositonattendanceattheclinicclear?N=116

Wasthewaitingareapleasanttowaitin?N=116

Wasthereadequateseatinginthewaitingarea?N=116

satisfaction survey results

020406080100120140

Staff and overallexperienceN = 116

YES

NO

020406080100120140Numberofpatients

115(99%)

116(100%)

116(100%)

116(100%)

116(100%)

1(1%)

Didthescreeningtechniciancheckyourname,dateofbirthandfirstlineofaddress?

Werethestaffperformingyourexaminationhelpful?

Werethestaffperformingyourexaminationconsiderate?

Didyoufeelcomfortableaskingquestionsabouttheexamination?

Wereyougivenyourresultsoncompletionoftheexamination?

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Section6StakeholderEngagement

6.1 Equality and Equity

Screeningisavailabletoallmenaged65whoareregisteredwithaGP,andhavenotbeenpreviouslydiagnosedwithanAAA.Allmenover65whohavenotpreviouslybeenscreenedcanself-referdirectlytotheprogramme.

TheSYBAAAScreeningProgrammeiscommittedtoensuringscreeningisequallyavailabletoalleligiblemen.

6.2 Community and Service User Engagement

ThehealthprofileacrossSouthYorkshireandBassetlawisapictureofhighdeprivationwiththelifeexpectancyofmenlowerthannationalaverage.SYBAAAScreeningProgrammeensuresindividuals,orgroupsofindividualsaretreatedfairlyandequally,specifictotheirneeds.Therearevariedcommunitieswithinthecohortboundariesincludinggypsyandtravellergroups,LGBTandBMEcommunities,learningdisabilitygroups,refugeesandasylumseekers,alargeprisonpopulationaswellasanex-miningcommunity.Consequently,SYBAAAScreeningProgrammeemploysavarietyofinnovativescreeningandpromotionalopportunitiestoensureequitableservicedelivery.

InordertoreachalleligiblemembersofourcommunitiesSYBAAAScreeningProgrammehasworkedto:

•Developrelationshipswithorganisationsandinfluentialgroupswhowillcomeinto contactwithSouthYorkshireandBassetlawmenaged65andabove.

•HaveapresenceinareaswhereSouthYorkshireandBassetlawmenaged65and above,theirpartnersandfamilyarelikelytobefound.

•Maximisetheopportunitiestoraiseawarenessthroughthemediabydevelopingcase studiesandorganisinguniquescreeningopportunities.

Toachievethis,in2014/2015serviceswerepromotedandclinicsheldatawidevarietyoflocationsincludingshoppingcentres,footballgrounds,golfclubsandtowncentrelocations.Casestudies,serviceuserchampionsandmembersofparliamentwereutilisedtoraiseawareness.Examplesofthesemethodsareshownintheimageoverleaf.

6.2.1 Barnsley,asmalltownsurroundedbyseveralsmallervillages,containsalargeex-coalminingcommunity.Deprivationishigherthanaverageandthelifeexpectancyformencanbeupto8.5yearslowerthanthenationalaverage.In2014/2015therewere1,219eligibleforscreeningwithinBarnsleyCCG.

AsignificantamountofengagementworkhastakenplaceinBarnsley,rangingfromhavingapresenceatvariousfairsinvillagesacrossthedistrict,healthpromotionstandsatteadancevenuesandinformationtoraiseawarenessincludedontheBarnsleyLGBTForumwebsite.

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Communicationand Engagement

BarnsleyCasestudywith

champion

Health BusMPat

Meadowhall

SheffieldCrystalPeaks

Centre

BassetlawClinicatRetford

GolfClub

DoncasterClinicatIntakeSocialClub

RotherhamRotherhamFootballClub

ImagetoshowthevarietyofmethodsemployedtopromoteSouthYorkshireandBassetlawAAAScreeningServiceswithinthecohortboundaries

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Acasestudyofalocalmanwithanincidentallydetectedaneurysmwhichwasincludedinpublicationsacrosstheboroughandonlocalradiohashelpedraiseawarenessoftheimportanceofscreeningtoothermeninthecommunity.

DavidSalmonaged71ofParkgate,Goldthorpesubsequentlyreceivedvascualarconsultation.

6.2.2 Bassetlawispredominantlyruralwithtwotowns,WorksopandRetford.Itseesdeprivationwhichishigherthanthenationalaverageandrecordsalifeexpectancyat5.9yearslowerformenthanthenationalaverage.Theeligiblepopulationforscreeningin2014/2015was920men.ThescreeningteamheldaneventatRetfordGolfClubresultingascreendetectedsmallAAAforclubmemberDavidMoore.

6.2.3 Doncaster isalargetownwherethehealthofpeopleisgenerallyworsethantheEnglandaverageresultinginlifeexpectancybeing9.4yearslowerthanthenationalaverage.Atotalof2,015menwereeligibleforscreeninginDoncasterCCGin2014/2015.

TherehasbeenasubstantialamountofengagementinthetownandsurroundingareasrangingfromhostingahealthpromotionstandatGoldenYearsRoadshowforover50’sheldattheMansionHousewhereinformationwasofferedandself-referralpacksweredistributedtomenaged65andover,todeliveringscreeningandhealthpromotionatLakesideVillage.

AnAAAscreeningeventhostedbyaSocialClubinMaywasahugesuccess.IntakeSocialClubSecretary,TomForestercollaboratedwithSYBAAAScreeningProgrammetoorganisetheclinicattheclub.

Mr Salmon said:“I couldn’t be more grateful to Helen for finding the AAA; I had no signs or symptoms whatsoever, it’s scary to think the aneurysm could have ruptured at any time! If it wasn’t for Helen, I might not have been here today.”

HelenMcAlinneywithclubmember,DavidMoore

Mr Moore said:“I’m so glad the AAA team held the screeing event at Retford Golf Club, I had the scan and it was no trouble at all. “It picked up a small aneurysm which I had no idea I had got! Visited the nurse the following week, she explained everything and put me at ease; and I can go for my 12 month surveillance appointments at Retford Hospital so it’s not far to go at all.“

DavidSalmonwithHelenMcAlinney

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6.2.4 Rotherhamisacommercialtowninalargelyruraldistrict.Recordeddeprivationishigherthanaverageandmenherehavealifeexpectancy8.9yearslowerformenthanthenationalaverage.Rotherhamsaw1,148meneligibleforscreeningin2014/2015.

Engagementactivitiesfor2014/2015haveincludedanAAAclinichostedontheHealthBusatMorrison’ssupermarketinBramleyandcollaborationwithRotherhamUnitedCommunitySportsTrusttohostapromotionaleventusingtheHealthBusonmatchdaysinadditiontoregularclinicsutilisingthefacilitieswithinthefootballgroundpremises.

Mr Forestor said:

“I was surprised how quick and simple the screening process was and it’s great that within five minutes I had peace of mind of having the all clear.”

AAAteamwithMrForestor

JamieNoblewiththeAAAteam

Head of Community forRotherham United Community SportsTrust, Jamie Noble, said:

“Promoting the AAA Screening Programme to our fans is something we are totally passionate about in order to keep them healthy. I am aware that AAA’s can have no signs or symptoms so it’s paramount that men aged 65 and over have the screening – it can be a life saver.”

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6.2.5 SheffieldisalargegeographicallydiversecityinSouthYorkshire.Againthedeprivationishigherthanaverageandlifeexpectancyformencanbe10yearslowerthanthenationalaverageformeninthemostdeprivedareas.3,382menlivingwithinSheffieldCCGwereeligibleforscreeningin2014/2015.

RelationshipshavebeenestablishedwithcommunityleadersinspecificBMEcommunitiestoeducateandraiseawarenessinSheffieldincludingpromotionalandscreeningsessionsatSheffieldChineseCommunityCentreandSADACCAaregisteredcharitywhichprovidesfortheAfrican-Caribbeancommunity.

6.3 Health Professionals

SYBAAAscreeningteamhaveworkedcloselywithhealthprofessionalsacrossSouthYorkshireandBassetlawtoraisetheprofileoftheAAAscreeningprogramme.AwarenesssessionshavebeendeliveredatGPprotectedlearningeventswithinallfiveCCGs.

InadditionahealthprofessionalsawarenesssessionhasbeenheldatHMPRanbyandahealthdayeventatRotherhamGeneralHospital,whichassistedinservicepromotion.

MPCliveBettswithAAAscreeningteam

A great amount of engagement work has taken place in Sheffield, including AAA screening clinics at Meadowhall and Crystal Peaks Shopping Centres where the AAA team screened Sheffield MP, Clive Betts

RotherhamCCFGPProtectedLearningEvent

Kate Wales, Primary Care Clinical MatronOffender Health, Nottinghamshire Healthcare NHS Trust, HMP Ranby.“The South Yorkshire and Bassetlaw AAA Screening Team attended HMP Ranby Prison to screen the men aged 65 years and above. The morning ran smoothly and the team were professional and responsive. One gentleman was identified as having a medium size AAA and appropriate health advice and education was given regarding follow up and care. The AAA team will be returning in October for quarterly review of the identified patient and any new patients will be seen.”

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6.4 Media

AfterinitialTVcoverageonlocalITVnewsprogramme,Calendaratitslaunchin2013,SYBAAAScreeningProgrammehascontinuedtobuildrelationshipswithlocalmediateamswhichhasbeeninvaluableinordertoraiseawarenessofAAAamongstboththetargetaudienceandthegeneralpublic.ThishasincludedcoverageinlocalnewspapersandradiointerviewsabouttheAAAscreeningonPenistoneFM(Barnsley)andSineFM(Doncaster).

6.5 Significant others

AscreeningclinictookplaceatDoncasterGolfClubinApril.AmongthefirsttoteeoffforAAAscreeningattheclubwas79yearoldDonaldSibson,akeengolferwiththeclubforover30years.SpurredonbyhisdaughterAmandaFord,aScreeningTechnicianwiththeSYBAAAScreeningTeam,Donaldbookedhimselfintothescreeningclinic.

YorkshireMainOfficialsClubinEdlingtonplayedhosttoanAAAscreeningclinic,whichtookplaceasaresultofthestoryoflocalman,JackShawwhoinMarch2014hadtohaveemergencysurgerytorepairananeurysm,foundafterhetookuphisfreescreeninginvitation.

65yearoldEdlingtonman,Jack,wentforhisAAAultrasoundscaninmid-March,thinkinglittleoftheimportanceoftheprocedure,butwentalongatthebehestofhiswife.Duringhisscanhowever,Jackwasfoundtohavelargeaneurysminsidehimthatrequiredamajoroperation.HewassenttoDRIandunderwentsurgeryonthe31March.

AAAScreeningTechnicians,MandyFordwithherfatherDonaldSibsonatDoncasterGolfClub

Mr Sibson said:

“I have always been a strong believer in health screening programmes. My daughter works as a screener for the AAA programme, so I know better than most how important it is to take up the screening offer. When I found out that she was holding a clinic at the clubhouse I made a self-referral. I got my appointment in just a couple of weeks and attended at the clubhouse. Thankfully I got the all clear which is a great relief to the family. I would certainly encourage other men to be screened.”

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ThenewsofJack’ssituationquicklycaughttheattentionofhisfriendsattheYorkshireMainOfficialsClubwho,keentoensurethattheywerecheckedforthesymptomlessconditionthemselves,contactedtheAAAteamaskingthemtovisittheclubtoscanmembers.Asaresult,13menturnedupfortheirscansattheclub.

Jack said: “If it hadn’t been for my wife I would probably have backed out of the scan, but I am glad I went along now! I would encourage every man to have the scan; it saved my life!”

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Section7KeyAchievements

TheAAAscreeningteamwontheprestigiousawardof‘Team of the Year’atDoncasterandBassetlawHospitalsannualawardsnightinSeptember2014.Theywontheawardfortheiroutstandingcontributiontothescreeningprogrammeandtheworktheyundertookinraisingawarenessoftheconditionacrosstheregionwhichresultedthehighest numbers of self-referrals into an AAA Screening Programme nationally.

In2014/15theHealthBusmobilescreeningunithasbecomewellestablished.SYBAAAscreeningteamaretheonlyAAAscreeningteaminthecountrytohaveamobilescreeningfacility,enablingustotakethebusintohardtoreachanddeprivedcommunitieswheretheuptakeofscreeninghaspreviouslybeenpoor.Thecostattachedtousingthehealthbusisminimalandseenasagoodinvestmentpernumberofscreeningsitenablestheservicetocompleteonlocationinthecommunity.

TheAAAScreeningcoordinatoractivelyparticipatesinthenationalprovisionofScreeningTechnicianandClinicalSkillsTrainertheoreticaltrainingandaccreditationattheUniversityofSalford,contributingtoexcellentlocalcompliancetonationalstandards.

Section8FutureDevelopments

FutureplansforthepromotionofSYBAAAScreeningProgrammecontinuetogrowasrelationshipsareestablishedwithspecialisthospitalteamsacrosstheregion,linkswillbemadewithinfluentialmembersofthecommunity,includingsecretariesoffaithgroupsandtravellercommunities,maximisingmediaopportunitiesbypromotinganddevelopingbespokepartnershipevents.

Partnershipworkingisessentialmovingforward,workingwithorganisationssuchasHealthwatch,Mencap,MIND,locallibraries,GPpractices,pharmacies,CCGsandhospitals,localauthorities,prisons,parishcouncilsandthevoluntarysector,allofwhomhaveadutyofcareandwishtolookafterthehealthandwellbeingofpeopleinthewidercommunity.

Our priorities for 2015/2016 are to: •Continuetoimproveaccess,sourcingnewvenuesformobileclinicsutilisingtheHealthBusand ensuringtheSYBAAAservicemodelisfitforpurposetomeetallserviceusers’needs•FurtherpromotetheservicewithinSouthYorkshireandBassetlaw•Enhancestafftrainingandprofessionaldevelopmenttoenableaqualityandsafeservice•Consolidateprisons/placeofdetentionactivity•IncreaseinHomeVisitswheretheclinicalneedarises•DevelopmentofalocalSouthYorkshireandBassetlawprogrammewebsite.

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