NHS Greater Glasgow and Clyde has a range of ways that we listen to staff and use their feedback to improve our services to patients and to make NHSGGC a better place to work. Key mechanisms include iMatter, Investors in People, via Area and Local Partnership Forums and through team meetings, one-to-ones and other engagement activities with leaders and managers locally.
You can read below examples of how staff feedback from our annual iMatter staff satisfaction survey has been used to inform improvements across teams, services, Directorates and Health and Social Care Partnerships (HSCPs), within NHS Greater Glasgow and Clyde.
Advance Nurse Practitioner Team – East Dunbartonshire HSCP
The Advance Nurse Practitioner (ANP) team in East Dunbartonshire HSCP, is a small of team of 6, supporting GP clinics as well as carrying out home visits, all across the Partnership. During our most recent iMatter action planning discussion, we reflected on the agile nature of our roles, and the need for lots of equipment to be transported when out and about at home visits.
We didn’t have a space to call our own for storing equipment, or dedicated desk space, as we’re fully agile. This means that equipment is often stored in our cars as we go back and forth to homes and clinics, which is not ideal for staff as we’re already taking other things, such as our laptops, out and about, so it’s a lot to consider for each trip.
So, we had a discussion with the Facilities Manager at Kirkintilloch Health & Care Centre to see what we could do to improve our experience.
Amazingly, we’ve secured a large double cupboard at the Centre, which is solely for our team, and we can easily access it to pick up just the bits and pieces we need, and store the rest. This is only a small thing but has gone a long way to making the team feel that they are valued, visible and that their needs are being met by the HSCP.
We’re now working with colleagues to look at ways we can use the space at Milngavie Health Clinic too, ensuring that our team can continue to have the same successful, positive experience, across all our sites.
Clyde Sector
Across the Clyde sector, we have seen real benefits of using feedback from iMatter to improve our staff’s experience. The big improvements in iMatter outcomes throughout 2022 demonstrate this, with an increased response to the questionnaire, an improved Employee Engagement score and a 7% increase in action planning.
We achieved this in a range of different ways. We took action before and during the questionnaire stage, to discuss iMatter at key management and partnership meetings, embedding it in business as usual. IMatter is always a key part of our thinking around how we engage with our workforce and use their experiences to improve services and make Clyde Sector a better workplace.
Alongside this, we shared ‘top tips’ during the team confirmation stage to ensure managers felt supported with each step, and staff were aware of the range of ways they could respond, to maximise participation. Maintaining a good working relationship with the iMatter team in HR meant we could quickly identify and resolve any action needed to support teams.
Once we received our results, we quickly shared the information with staff, managers and partnership colleagues, and ensured two-way communication was at the heart of improvement.
We now hold weekly partnership calls in Clyde sector to discuss emerging and live issues to identify solutions together. We’ve also introduced HR ‘Walk rounds’ across all three sites, meaning there are regular opportunities to meet with staff, be visible and discuss any concerns. Similarly, the Senior Charge Nurse (SCN) engagement sessions with senior management give staff the opportunity to discuss ways of improving services, staff morale, health and wellbeing. These allow us to hear directly from staff about how we shape support and drive improvement on an ongoing basis.
In addition to this, Partnership colleagues and HR now have access to daily safety briefings for all sites to keep everyone informed on hospital pressures and staffing. This means that appropriate action and support is given efficiently and based on feedback.
Taking this approach has achieved some really positive outcomes this year, leading to positive action, and we look to replicate and build on this into 2023, to realise continuous improvement for our staff.
Counselling Team (Human Resources and Organisational Development)
Our team always finds the feedback from iMatter a really useful tool to create discussions about how we do more for our staff and also for our clients. This year, the report has allowed us to identify service improvements that we think will deliver excellent performance.
Initially during COVID we were keen to explore the experience of clients using the counselling service, particularly as we moved from face to face to telephone appointments. We did this through a short survey, which we circulated to clients. The feedback was positive, and gave us reassurance that we were still providing a supportive and person-centre service during COVID.
As we moved into 2022 and back to more face to face consultations, our team suggested we expand the survey to allow us to explore ways in which we could celebrate great work, review the service we provide and identify any opportunities for improvement.
This has been going really well, and at our team meetings we always allocate time to look at the feedback together. The comments from the responses we get helps us to build a picture of progress and improvement themes. The information we gather also supports our accreditation with Safe Effective Quality Occupational Health Service (SEQOHS) standards, the benchmark for occupational health services.
One particular benefit of this approach has been helping us to celebrate the successes of the team through the positive experiences of our clients. When we see really great comments in relation to the service provided by an individual staff member, this is highlighted at the team meetings, as well as at TURAS review discussions.
In the team, we’ve used the iMatter process to help keep us on track when it comes to our commitment to positive staff engagement, celebrating success and working as a team. We know that doing this has really helped us to continue to deliver a great service for the people using our service.
COVID Safety and Wellbeing Engagement in Estates and Facilities
Like all services across NHS, the COVID pandemic raised a number of significant challenge for us in Estates and Facilities. One of those challenges was that guidance, including changes to Standard Operating Procedures (SOPs) and Safety instructions, was changing on a regular basis. For us, there was no reliable way to ensure that this information was appropriately circulated across all of our staff because of limited IT access for many staff in our service and the limitations on in-person meetings.
This meant that we were struggling to ensure that the staff on the floor were getting key information timeously, including COVID safety information and resources to support and improve staff wellbeing.
As a consequence, the Senior Management Team and partnership colleagues worked together to identify the best ways to get this essential information to staff reliably. This took the form of a Team Brief, which was initially issued on a weekly basis, and which we now issue on a monthly basis. We developed this based on the positive feedback and the recognition of an ongoing need for supportive engagement and communication with staff.
The detailed Brief is shared verbally with all staff, along with being circulated electronically and displayed on staff noticeboards. This very simple approach has been welcomed by staff, and has been adopted by others throughout the organisation too.
William Hunter, Deputy Director (Facilities & Corporate), says “there has been a positive response to this brief. In very difficult circumstances, we have been able to increase direct communication with our staff, including the provision of key work, wellbeing and safety related information, which I know that staff have found very reassuring and supportive.”
We can see from our 2022 iMatter results that one of the areas which saw the biggest improvement from 2021, was in relation to well-being support from line managers. In addition, improvements were seen around the themes of role clarity, effective team working and seeing the value and contribution made by the roles that staff hold.
This improved engagement and communication with staff, really focussing on well-being and experiences at work, has made a positive impact amongst teams, which we’ll continue to build on and celebrate.
East Renfrewshire HSCP
We were delighted with the iMatter results in East Renfrewshire HSCP, where we saw an increase in response rates and action planning engagement, whilst also maintaining a really positive engagement score.
We were particularly pleased to see that we’d had good feedback from staff against the iMatter wellbeing questions. This was due to the big effort we’ve made in the HSCP in ensuring staff are aware of the wide range of options available to them to support good mental health and overall wellbeing at work.
One way we’ve been showcasing our wellbeing activity is through our regular Staff Wellbeing newsletter with targeted articles on key issues e.g. alcohol awareness, stress at work, financial advice. These kept staff updated on any upcoming classes and sessions, as well as providing access to information and resources which covered a wide range of topics.
During the summer months, we rolled out a programme under our “Summer of Wellness” brand. Creating this brand allowed us to bring together a whole range of opportunities for staff in one place, including yoga, fitness classes, 121 wellbeing conversations etc. The uptake for these was fantastic and feedback from staff was extremely positive. We’re now building on that success and are rolling out a new “Winter of Wellness” programme during November and December.
Something that really helped us maintain the focus on wellbeing over this period has been our newly appointed Wellbeing Officer, Gerry Mitchell, who has led on promoting and improving the mental health and physical wellbeing of our workforce.
Gerry says:
“My role as Health and Wellbeing Lead Officer has been to build a proactive and preventative wellbeing offer across the HSCP for all our staff.
“It’s important for staff to have access to resources that supports holistic wellbeing, with a particular focus on mitigating the effects of work-related stress.
“Recent years have been particularly challenging for health and social care staff and volunteers. During this time, it has been more important than ever that we continue to offer an effective and sustainable approach to staff/volunteer wellbeing so that they feel valued and supported at work.”
Gerry Mitchell, Health and Wellbeing Lead Officer East Renfrewshire HSCP
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Hybrid Working in the Clinical Governance Support Unit
Our 2022 iMatter report showed some really encouraging results, and we were particularly delighted to see positive outcomes relating to engagement, well-being support and leadership. We always aim to apply a person-centred, continuous improvement approach, which focuses on our staff’s experience, as we know this has a positive impact on the work we do.
That person centred approach could clearly be seen through our recent implementation of hybrid working. NHS Greater Glasgow and Clyde (NHSGGC) introduced a Blended Working Guide early in 2022, to support staff to work flexibly and to provide a healthy work and life balance.
The Clinical Governance Support Unit (CGSU) implemented this approach across all teams during Spring/Summer 2022. To do this, working together with staff, we developed a project plan with six key steps for implementation:
A key part of our plan was working with staff to develop an Etiquette Guide. This provided some key principles and supporting guidance and aimed to give consistency to staff in terms of how hybrid working would actually work in our team.
Almost as soon as we had implemented the approach, we held a short workshop at the CGSU Team Session, to gather feedback from staff on their initial experience of hybrid working. Feedback showed us that staff liked the flexibility to choose when it’s appropriate to work from home and when to be working on site. The staff told us they continue to see the benefit of meeting together in person where it’s appropriate. We were really pleased to hear that they found the room booking system really clear and easy to access, allowing them to arrange all the practical requirements when coming into the office.
To keep the focus on staff having a positive experience, we also sought improvement themes from staff, and have taken these forward quickly. An ongoing evaluation is planned on a quarterly basis to continue engagement with staff and determine if the actions are resulting in real improvements, and to consider if there are any new actions we need to take forward.
Pharmacy Services
Hear from Gail Caldwell, Director of Pharmacy for NHS Greater Glasgow and Clyde, talking about the Pharmacy Strategy, which focusses on a culture of empowerment and enablement for all their staff.
Pharmacy Services Celebrates Staff Successes and the Employee Voice
Pharmacy Services celebrated their staff awards on Wednesday 20th of March at the Teaching and Learning Centre, QEUH. While the event was themed around the many successes of our staff, the event also recognised the challenges along the way, a theme reflected by our keynote speaker, Cor Hutton.
“As a pharmacy team, what makes us strong are our people, and our people know how things can change and improve, we are always looking for ways to obtain feedback and empower our teams to make local changes that makes it better for them and our patients.” Andrea Healey, Business Performance & Review Manager, Pharmacy Services
One way Pharmacy Services do this is through the annual iMatter survey. The team has always had a high engagement rate and one they are keen to continue. They took the opportunity to promote iMatter at their staff awards, including highlighting the improvements made locally based on the annual staff feedback. To support the event, the NHSGGC Staff Experience team were on hand to share good practice and give out a pen or two!!
“We were thrilled to be invited along to be able to promote the upcoming iMatter questionnaire at the Pharmacy Services staff awards, and engage with staff at this exciting event. Moreover, it allowed us to encourage colleagues to consider staff experience more widely, and understand how iMatter can be an important enabler for person-centred discussions that explore and improve the experience of everyone at work” Diana Hudson, Staff Experience Adviser and Sabine Bunte, Staff Experience Assistant
Alongside iMatter, the event also showcased the Peer Support service:
“Delighted to have attended the awards ceremony representing Peer support and as part of the Pharmacy Culture Collaborative Group.Peer support simply put is to look after oneself and others and this was very much to the fore in our pharmacy ‘family’ awards ceremony.Our speakers at the event spoke with compassion, empathy and a steadfast commitment to our health service and the patients we serve.It was a privilege to be part of the day and hear the amazing testimony of Dr Corrine Hutton” Donald MacPhail, Controlled Drug Inspection Officer and Peer Supporter NHSGGC
The 2024 iMatter Survey starts from 13 May 2024 and you can find out more information about how to get the best of this for your team on our iMatter page or by contacting the iMatter team on iMatter@ggc.scot.nhs.uk
If you have a positive Staff Experience or Engagement story you would like to share, please get in touch with the team at iMatter@ggc.scot.nhs.uk
During the Action Planning phase of iMatter, we want to share some of the ways in which teams have approached this discussion and how they have used iMatter to support key activity over the next 12 months. Below you’ll see details of stories shared via StaffNet.
Complex Trauma Pathway team
We hear from Lesley Hunter – Nurse Team Lead within the Complex Trauma Pathway team (Specialist Children’s Services), who talks about their approach to iMatter action planning:
“As a team we utilise our business meeting and team away days to discuss and review our iMatter report each year. These take place in June and November so work well in relation to the timing of the reports and allow for a six-monthly review. Following the completed reports, I review the comments and we discuss as a team the outcome and consider what our focus is for the year.
The focus is often on service development i.e. what we do well and need to focus on for our patients in the next year, as well as team cohesion and wellbeing/staff retention. From this, I write it up and we agree it finally as a team.
The pathway is a small team where the ongoing clinical task of working with young people, families with traumatic histories and experiences can be emotionally taxing, therefore team wellbeing, supervision and peer support needs to be central to what we do. The iMatter process allows us to look at this more specifically as a service.”
The most important bit of iMatter is the discussion you now have in your team based on the feedback. This is your chance to discuss and agree as a team how you want to work together to make things better. Please visit HR Connect for more information.
Primary Care Dental Services
This week, we hear from Karen Gallacher, Clinical Services Manager within Primary Care Dental Services:
“Looking at the action planning process with a new team has made me reflect on a number of matters, most significantly that I was, in recent years, part of this team and now, due to promotion, I am in a leadership position with the team and would look to maximise the benefits of the iMatter process.
In the past, in the team I previously led, we would have added iMatter to the agenda of group meetings and had a round table discussion to review our report, looking at what areas we should celebrate and those areas we should seek to develop further.
My previous team were predominantly involved in the management of clinical dental care, therefore would focus their efforts on analysing how to improve patient care while supporting the needs of staff. My new team involves health improvement managers, clinical managers and support services to the wider dental community.
As a consequence of being an original member of the above named group it was easy to identify the commitment of my colleagues to examine our report at our monthly operational meeting and to develop an action plan that would support learning, communication and, as an area for further discussion, review of equality and diversity issues to ensure that we are inclusive as we have a multi-disciplinary roles and responsibilities.
As a result, we will now have iMatter as a standing item on our agenda (an approach I used in my previous position) and ensure that all members have an opportunity to review and reflect on our action plan to support success as we move forward this year.”
The most important part of iMatter is the discussion you now have in your team based on the feedback. This is your chance to discuss and agree as a team how you want to work together to make things better. Please visit HR Connect for more information.
North AHP Team Leads
This week, we hear from Alison Leiper, Interim Chief AHP:
“The North AHP Team Lead group discussed the iMatter report and action plan at one of our monthly team meetings. We set aside approximately 1 hour to discuss the report and to decide on our action plan going forward.
As a group we have started to meet again in person rather than via Teams and we all agreed that this face to face approach led to better engagement, interaction and discussion. We started the process by reviewing this year’s iMatter report as well as looking at the previous year. This gave us some indication of where we have made changes that have had a positive impact and the areas we need to focus on going forward.
We recognised that we hadn’t achieved everything we had hoped to do last year and this led to a very open, honest and meaningful conversation about the reasons why and more importantly what we need to do differently this year. With this in mind our action plan focused on what are our priorities and what we can realistically achieve.
One of our actions concentrated on improving engagement between AHP Team Leads and North senior leader’s team, therefore to support this, we’ve planned a lunch, hosted by Team leads, inviting along members of the North SLT. This will allow an opportunity to provide more information on the key role of the AHP within each clinical area, and help promote the AHP role more generally.”
The most important part of iMatter is the discussion you now have in your team based on the feedback. This is your chance to discuss and agree as a team how you want to work together to make things better. Please visit HR Connect for more information.
The continued learning opportunities of our AHP workforce is of vital importance, in consolidating the services we deliver today, and ensuring our teams are enabled to deliver the services and roles we aspire to in the future.
The NHSGGC AHP Learning and Development Strategic Framework has been designed to support all AHP staff in NHSGGC to access educational opportunities. This being at all levels of practice across the career framework, from Health Care Support Worker to Advanced and Consultant level of practice.
The framework highlights that all staff will have equal access to ongoing learning, training and development within their role. Recognising that AHP capabilities are required of all staff across the four pillars of practice. These being clinical practice, facilitation of learning, leadership and evidence, research and development (including service improvement).
Professional and Service Leads developed the framework following an AHP staff communication exercise. The framework is underpinned by the four pillars of practice and it is aligned to local and national policy drivers. The framework is accessible, easy to understand and key in supporting AHPs to take ownership of their learning and development. It is a live resource to support meaningful role and career conversations.
Welcome to NHSGGC Practice Supervisor and Practice Assessor Portal. This portal has been designed to provide information and support for those who supervise and assess learners in our practice learning environments.
NHSGGC Practice Supervisor and Practice Assessor Portal – Feedback and Suggestions
If you would like to make a suggestion or provide the Practice Education Team with feedback as to how we could improve the PS/PA Portal, please email: ggc.practiceeducation@nhs.scot
This section provides practice supervision / assessment related documents and resources for all those involved in the supervision and assessment of student nurses and midwives within NHSGGC.
Enjoy our audio podcasts at a time that suits you. We offer a series of 5 podcasts giving information on the new NMC standards and a variety of topics to support your CPD in the practice supervisor or practice assessor role.
Communication and relationship management skills – Examples from practice
This resource has been developed to assist you in your role as practice supervisors and practice assessors to support students to achieve Annexe A: Communication and relationship management skills.
Learning Development Support Plans are used to support students to meet specific objectives, particularly if they face challenges in achieving the level of knowledge and/or skills required by their educational programme or if there are concerns regarding their professional practice. These sample plans can be used to help you to write an effective Learning Development Support Plan to support students to progress in their practice learning environment.
This resource will supplement practice supervision / assessment in the workplace for student nurses and midwives. Additionally, it is practice supervisor and practice assessor facing and provides information and guidance on Pharmacology.
These flowcharts illustrate guidance for student nurses and midwives, as well as PS / PAs, on dealing with concerns, although not care concerns, we come across in Practice Learning Environments.
This guidance is designed for use in all audited practice learning environments across Scotland. It aims to describe the process for dealing with instances of poor care witnessed by nursing or midwifery students while on practice. In this case, poor care refers to situations in which one perceives care as inadequate, below an acceptable standard, abusive, or neglectful, based on the premise that one should never accept poor care.
‘Speaking up’ – National Whistleblowing Guidance for Nursing and Midwifery Students in Scotland
This guidance details the process for raising a concern and intends for nursing and midwifery students in Scotland to use it while undertaking PLEs during their pre-registration nursing and midwifery programmes.
Students must have active NHSGGGC accounts to access our healthcare systems needed to participate in Practice Learning Environments. In order to get started with our main hospital systems, guides have been created and these are available on the Learn section of the student external eHealth portal. This additional guide outlines the process for students to register for the student eHealth portal in order to report IT issues and to change their student account to NQP status.
Supplementary factsheets about specific eHealth programmes
The West of Scotland Specialist Virology Centre (WoSSVC) is a United Kingdom Accreditation Service (UKAS) accredited medical laboratory No. 9319. A full list of accredited tests can be found on our schedule of accreditation.
Please note users will be informed if an assay/result lies outside the laboratory’s scope of accreditation.
WoSSVC islocated at Glasgow Royal Infirmary (GRI) and is part of NHS Greater Glasgow and Clyde (NHSGGC).
Clinical advice and urgent testing: email west.ssvc2@nhs.scot during opening times or phone: 0141 242 9656 (internal 29656). Please note during busy times it is easier to email and a member of the clinical team will respond.
To add on tests please email west.ssvc2@nhs.scot with clinical details and tests required. The email is monitored during laboratory opening hours (we aim to reply to your email within 1 hour, however, at busy times this may not be possible).
Results are available on clinical portal, SCI Store, TrakCare and GPICE for NHSGGC patients if a patient’s CHI has been provided on the request form.
For out of hours clinical advice call the Switchboard on 0141 211 1000 (1000 internal) and ask for the on-call virologist.
Leadership is an integral component of all Allied Health Professional (AHP) and AHP Healthcare Support Worker (HCSW) roles across the whole career pathway.
Whatever your role or level of practice, there is information and resources available to support your leadership development.
Offers a range of leadership development programmes, opportunities and support for health, social care and social work leaders to help you make a difference.
Please find attached Interim National Arrangements for Adverse Weather. This has been designed to ensure that in periods of adverse weather NHS Scotland adopts an approach that is consistent at a national level, ensuring that fair and equitable treatment is prioritised and that we remain able to effectively deliver essential services. The guidance has been developed in partnership with NHS Scotland through consultation between Scottish Government Officials, NHS Scotland employers and Trade Unions.
Please contact the HR Support and Advice Unit if you wish clarification on the application of this policy.
Business Travel
NHSGGC is committed to reducing the financial and environmental impact arising from its business travel. Where possible, the aim of this policy is to encourage employees to reduce unnecessary travel and encourage the use of more sustainable forms of transport. However, the Board recognises that sometimes there is no alternative to using a car for business travel and this policy is not intended to impede business travel where it is required nor to restrict car use where it is the most appropriate mode of transport for business purposes. Neither is this policy intended to be applied to the detriment of those employees with restricted mobility. This policy applies to all staff employed by NHSGGC.
Top Tips on using the Business Travel Policy…….
Before undertaking any journey, staff should consider the Business Travel Hierarchy.
Reflect on the need to travel for business purposes.
Walking and cycling are healthy, sustainable and very low cost travel options. Staff should be encouraged to consider alternative travel options if their role can facilitate this approach.
Bus, train and SPT subway travel provide an alternative to car-based business travel for short, medium and long distances.
Many car trips could be avoided if staff coordinated travel plans and shared cars, for example, when attending the same meeting. An additional mileage rate for each passenger is paid.
Please contact the HR Support and Advice Unit if you wish clarification on the use or application of this policy.
Car Parking
Car Parking on Hospital Sites
This policy outlines the arrangements for car parking on hospital sites. These arrangements are designed to balance the needs of staff, patients and visitors and ensure car parks continue to be fairly and effectively managed.
The policy details arrangements for visitor and patient parking, staff with parking permits and other staff parking.
Gartnavel General Hospital Telephone: 0141 232 2140 or (32140)
Queen Elizabeth University Hospital: 0141 452 3587 or (83587)
Glasgow Royal Infirmary: 0141 956 0587 or (60587)
Vascular Access Service. Who are we?
We are a nurse led team. Our service provides the insertion of Peripherally Inserted Central Catheters (PICC lines), Midline Catheters, Non-tunnelled Central Venous Catheters and the insertion and removal of Tunnelled Central Venous Catheters (TCVCs). We also provide advice and support on the care and maintenance of vascular access devices.
Nicola Wyllie – Senior Charge Nurse
Maren Hunter – Advanced Clinical Nurse Specialist
David McGrath – Advanced Clinical Nurse Specialist
Niamh Hughes – Clinical Nurse Specialist
Christian Macdonald – Clinical Nurse Specialist
Gemma Martin – Clinical Nurse Specialist
Isabel Soto Martinez – Clinical Nurse Specialist
Christina Milligan – Clinical Nurse Specialist
Yumiko Shimokawa – Clinical Nurse Specialist
Vascular access referrals
We encourage early referral for a suitable vascular access device to improve patient experience, preserve vessel health and effectively facilitate IV therapy.
Please be aware that this is an extremely busy elective service. We will endeavour to facilitate all referrals as soon as possible. We are not an emergency service, however we will expedite urgent cases if we are able to do so. To discuss referrals please email us on the group email address above.
The Vascular Access Service work Mon-Fri 08:30 – 16:30 and some weekends staff permitting.
Please note : Vascular access is a nurse led service, not all patients are suitable for referral.
Catheter Peripheral Central Venous Catheter (PICC) / Midline Catheter
There is no restrictive exclusion criteria for PICC or midline catheter insertion.
Cuffed Tunnelled Central Venous Catheter (TCVC)
APTT ratio must be equal to or lower than 1.6
PT no higher than 16
Platelets must be above 40 (if platelets between 30-40 VAS will consider placing a catheter with platelets running following discussion with medical staff)
Low molecular weight heparin (LMWH) must be omitted 24 hours prior to procedure if it is a treatment dose, 12 hours for a prophylactic dose.
Patient is able to lie flat
Patients not suitable for Nurse led service
Known venous stenosis, SVC obstruction or central venous stent in situ
Significant mediastinal disease
Recent myocardial infarction (within 2 days)
Pacemaker in situ
Current pneumothorax
If patient has these symptoms please refer to interventional radiology service.
Patient Referral to the Vascular Access Service
All patient referrals are made via TrakCare.
Please follow the process below:
Input the patients community health index (CHI) into trak
Click on Episode Tree
Select current episode
Click on ‘New Request’
Under Imaging:
For PICC line insertion : Input ‘IPICCI’ into item box
For TCVC insertion input ‘ITCVCI’
For TCVC removal ‘ITCVCX’
For TCVC exchange ‘ITCVCG
For Haemo-dialysis insertion ‘ ITUNDI’
For insertion of TCVC – all patients must have a recent Coagulation (Coag) and Full Blood Count (FBC) (within 2 weeks provided they have received no treatment)
Patients will be consented by a vascular access nurse.
Patients must have capacity to consent ( i.e. not given a sedative pre-procedure unless already consented by a member of the vascular access team).
Patients with impaired capacity must have a separate Adults with Incapacity (AWI) form specifically for line insertion/removal completed before being transferred to the department.
Support – Vascular Access Device Care and Maintenance
For queries regarding support and training on the care and maintenance of vascular access devices please email -vasnurseled@ggc.scot.nhs.uk
Aseptic Non Touch Technique ANTT®
When accessing any vascular access device you must always use ANTT®
Always wash hands effectively
Never contaminate key parts/key areas
Touch non-key parts with confidence
Take appropriate infection control precautions
The key principle to preventing infection is to maintain the asepsis of key parts/sites.
Key parts – any part of the device which will come into direct contact with the patients bloodstream.
Key sites – insertion and exit sites
The key parts can be protected by the use of micro fields such as syringe wrappers.
There is no need for the use of sterile dressing packs or sterile gloves, unless you are performing a dressing change when it is impossible to apply the new dressings without touching them and sterile gloves are required.
Advice and Links – Vascular Access Device Care & Maintenance
Dressing changes for all central venous vascular access devices must be done weekly (unless visibly contaminated). The dressing, stabilisation device (if PICC line), CHG impregnated foam dressing and needle-free device must all be changed weekly using an adapted ANTT®. Please see page 17 of the NHSGGC ANTT® Clinical Guideline for step by step guidance.
When accessing a vascular access device to flush, aspirate or change the needle-free device you must always ‘scrub the hub’ for 30 seconds. Whilst scrubbing the hub you should concentrate on the flat connective surface but also scrub around the side using wipes that contain Chlorhexidine 2% and Alcohol 70%.
Preventing catheter blockages
Flush immediately after use, use an ANTT® and scrub the hub for 30 seconds before accessing the device.
When flushing a vascular access device, routinely use Nacl 0.9% in a 10ml luer lock syringe and a brisk ‘push/pause’ technique. This creates a turbulent pulsatile flow which clears the lumen of debris. Ensure that you finish the flush by clamping on positive pressure (whilst you are administering the last push) to prevent blood re-entering the device and thus maintaining patency. Flush before, between and immediately after each use.
Routinely move clamp on PICC and Midline to prevent damage.
Difficultly aspirating catheter
Valsalva Manoeuvre – ask the patient to take a deep breath, hold and attempt to force out air through closed mouth.
Change needle-free device using ANTT
Check the clamp on PICC line, move clamp and massage lumen underneath if crushed. Check to see if the dressing has kinked the catheter near the insertion site.
Please do not remove a blocked PICC until you have spoken to a member of the Vascular Access Team as it may be salvageable.
Quick Guide To Vascular Access Devices
Peripherally Inserted Central Catheter (PICC)
Suitable for the duration of therapy.
No preparation required, no exclusion criteria (although patient must be able to position arm to enable insertion).
Suitable for all IV medications and short term parenteral nutrition (PN)
CT compatible and Non CT compatible depending on the device.
Tunnelled Central Venous Catheter (TCVC)
Suitable for the duration of therapy.
Not all patients are suitable to attend the Nurse led service as we have an exclusion criteria – (please see referrals section).
The TCVCs we insert are cuffed so they require to be removed by an appropriately trained individual under local anaesthetic.
Midline Catheters
4F 12cm Smart Midline peripheral catheter – last up to 29 days. CT Compatible. Please be aware – blood sampling from midline catheters may result in device failure.
These pages provide information on food, fluid and nutritional care within NHS Greater Glasgow & Clyde Health & Social Care Partnerships and Mental Health Services.
Food Fluid and Nutrition is fundamental to health and wellbeing and therefore to quality and safety in healthcare (Healthcare Improvement Scotland 2014). It has been well reported that malnutrition (over and under nutrition) is a public health issue with recent UK figures suggesting malnutrition costs the NHS £23.5 billion (BAPEN 2018). Malnutrition is common in those who access health and social care services, it continues to be under-identified and under treated leading to poorer clinical outcomes and greater healthcare costs.
Food Fluid and Nutrition Oversight Group
The purpose of the Food, Fluid and Nutrition Oversight Group is to provide a strategic, co-ordinated and multidisciplinary approach to drive the quality of and improvements in the nutritional care of the Greater Glasgow and Clyde Population. Specifically addressing the needs of the most nutritionally vulnerable groups who access healthcare through co-operative and collaborative action across the entire Health Board
Health and Social Care Partnerships Group
The Health and Social Care Partnership Group for Food Fluid and Nutrition is established to provide leadership and co-ordination of all aspects of Food, Fluid and Nutrition across the Health and Social Care Partnership, ensuring the process leads to the delivery of excellent nutritional care and a better patient experience. The HSCP groups include representation from District Nursing, Rehabilitation Services, Older People’s Mental Health, Learning Disability, Care at Home, Care Homes, Dietitians, Speech and Language Therapy and Health Improvement.
Mental Health FFN Group
The NHSGGC Mental Health Food, Fluid and Nutritional Group (MH FFN) is a sub group of the NHSGGC Community Food, Fluid and Nutrition Operational Group and is established to provide strategic leadership and co- ordination of all aspects of Food, Fluid and Nutrition across all NHSGGC Mental Health services – Ensuring the process leads to the delivery of excellent nutritional care and an improved patient experience Representation from NHSGGC Mental Health Services includes both mental health in-patient and community services from the Older Adult Mental Health, Adult Mental Health, Forensic, Adolescent, Addictions, the Adult Eating Disorder Service and Learning Disabilities (in patient only)
Acute FFN Operational Group
The Acute Food, Fluid and Nutritional Operational Group (FFNOG) is established to provide strategic leadership and coordination to all aspects of Food, Fluid and Nutrition across adult and paediatric acute inpatient services. This ensures that the process leads to the delivery of safe, effective and person-centred nutritional care and a better patient experience.
Please use the drop downs below to navigate the information related to food, fluid and nutritional care within NHS Greater Glasgow and Clyde Health and Social Care Partnerships, Mental Health and Acute Services:
This manual is pertinent to all NHSGGC mental healthcare workers with a duty of care to provide optimal nutrition for patients within NHSGGC. The purpose of the nutritional manual is to assist all healthcare workers who work within NHSGGC mental health in patient and HSCP services. The delivery of this role is supported by a number of FFN policies and procedures which are explained within this manual.
Section 1 Introduction to Nutritional Care in NHSGGC Mental Health Services
Five short e-learning modules relating to Food, Fluid and Nutrition are available to staff across NHS Greater Glasgow and Clyde on the LearnPro platform. Below indicates the intended staff groups for each module and a short introduction to the module content.
