Introducing West Hertfordshire

Hospitals NHS Trust

Watford General Hospital

Hemel Hempstead Hospital
St Albans City Hospital (SACH)
Contents
Trust Over view 3
Our vision 3
Trust Sites 3&4
Our Values 5
What our patients say about us 5
Our community 5
Our services 5
Celebrating excellence 6
Benefits of working here 6&7
Childcare 8
Contacts 8
Employee assistance helpline 8
Health and Wellbeing 9
Training and development 9
Libraries 10
What makes us different? 10
Watford Health Campus 11
Departmental overview 11
Acute Admission Unit 11
Accident and Emergency 12
Aldenham Ward 12
Cassio Ward 12
Cleves Ward 13
Croxley Ward 13
Dick Edmunds Stroke Unit 14
Elizabeth Ward 14
Flaunden Ward 14
Gade Ward 15
Heronsgate Ward 15
Intensive Therapy Unit 15
Langley Ward 16
Letchmore Ward 16
Ridge Ward 17
Sarratt Ward 17
Theatres 18

Trust Overview

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West Hertfordshire Hospitals NHS Trust provides acute healthcare services to a core catchment
population of approximately half a million people living in West Hertfordshire and the surrounding
area. The Trust also provides a range of more specialist services to a wider population, serving
residents of North London, Bedfordshire, Buckinghamshire and East Hertfordshire. Overall the
population served by the Trust is relatively affluent, but there are some areas of deprivation. With
staff numbering over 4000, the Trust is one of the biggest employers in the area and sees nearly a
million patients each year.

Our vision
The Trust’s vision is to embody in its hospitals all the principles, values and the sense of service that
created the NHS by providing consistently good, safe care, in a friendly, listening and informative
way, as and when people need and want it and always with dignity and respect.

Within the NHS Midlands and East Strategic Health Authority cluster, NHS Hertfordshire is the main
commissioner with over 300 GPs in West Hertfordshire.

Trust Sites
The Trust has undertaken a significant programme of service and estate reconfiguration in the last
few years. This included the development of St Albans City Hospital into a dedicated centre for
elective surgery, the move of A&E and in-patient services from Hemel Hempstead to Watford and
the development of a new Acute Admissions Unit at Watford to provide an innovative model of care
and to accommodate an almost doubling of emergency activity.

The three main hospitals that the Trust operates from are:

Watford Hospital

Watford Hospital is at the heart of the Trust's acute emergency services - the core location for
inpatient emergency care, and for all patients who need the specialist emergency facilities (such as
intensive care) of a major district general hospital. It also provides elective care for higher risk
patients together with a full range of outpatient and diagnostic services. There are approximately
600 beds and nine theatres (including one local theatre).

Watford is also the focus of the Trust's Women's and Children's services, including neonatal care. In
2011/12 the Trust increased capacity on the Watford site with a new Clinical Decision Unit (CDU) and
an eighteen bed 'surge' ward.

The Trust’s Acute Admissions Unit is thought to be one of the largest admissions units within the
country; furthermore it is a part of the biggest change to healthcare in West Hertfordshire in over a
generation.

The Trust's maternity service is amongst the largest in south-east England, with almost 6000
deliveries per annum. A £750k investment in maternity services has delivered an increase in capacity,

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with a new six bedded transitional care unit (step up and down from the Special Care Baby Unit) for
mothers and babies; three extra delivery beds; two antenatal beds; and four additional triage beds.

Watford Hospital is about a 15 minute walk from the town centre.

Hemel Hempstead Hospital

Hemel Hempstead Hospital has a 24/7 urgent care centre and offers other local healthcare facilities
such as diagnostic services, including MRI and cold pathology, and an outpatient service that sees in
excess of 100,00 patients per year. In addition it provides twelve stroke rehabilitation beds.

Hertfordshire Community Trust also operates intermediate care beds on site.

Hemel Hempstead Hospital is situated on Hillfield Road in Hemel Hempstead town centre, minutes
from the main bus station.

Address

Hillfield Road
Hemel Hempstead
Herts
HP2 4AD
01442 213 141

St Albans Hospital

St Albans Hospital is the Trust's elective care centre. It provides a wide range of elective care (both
inpatient low risk surgery and day-case) and a wide range of outpatient and diagnostic services with
in excess of 70,000 outpatient appointments. It has forty beds and six theatres (including one
procedure room for ophthalmology) and a Minor Injuries Unit (MIU), open every day of the week
from 9am to 8pm.

The Breast Care Unit was formed in 2005 from the centralisation of breast services across west
Hertfordshire. The unit sees and investigates around 3000 new patients per year.

Follow us

Visit our website: www.westhertshospitals.nhs.uk

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Our values

1. We involve others - in all that we do our patients, their families and carers are
involved and their voices are clear and influential.

2. We are transparent – it’s safe to admit mistakes and speak out when things don’t seem
right, this helps us learn and improve.

3. We are all leaders - we value our teams and we value each other, investment is made in all
of us because, in our own way, we are all talented and we all lead.

4. We are proud - we are proud of our hospitals and ambitious when it comes to the quality
of our services and calibre of staff we employ.

5. We work in partnership - we work together as part of a bigger team with people within
and outside our hospitals to join things up for individual patients and the wider
community.

6. We add value - through being innovative and spending our time on the things that matter
we each add value and continuously look to improve what we do.

What our patients say about us

"I received excellent patient care throughout an anxious time."

"The care I received from the moment I was admitted was exemplary..."

"Your staff should be congratulated for their standard of care..."

"The Emergency Nurse Practitioner who saw me was wonderful..."

"The staff were so kind and the ward exceptionally clean..."

Our community
The Trust provides acute healthcare services to a core catchment population of approximately
600,000 people and also provides a wide range of specialist services to residents of North London,
Bedfordshire, Buckinghamshire and East Hertfordshire. With staff numbering over 4,000, the Trust is
one of the biggest employers in the area and sees nearly a million patients each year.

Our services
Some of the services provided at the Trust:

 Surgery
 Medicine
 Women and Children’s
 Clinical Support
 Cancer care
 Corporate services

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Departmental Overview

Acute Admissions Unit

AAU opened in March 2009 and is thought to be one of the largest admissions units within the
country; furthermore it is a part of the biggest change to healthcare in West Hertfordshire in over a
generation.

AAU Level 1 has a total of 60 beds. The ward and nursing staff are divided into four teams- Purple
suite, Yellow suite, Blue suite and the Green suite. Level 1 purple and green receives patients from
A&E or GP referrals. Yellow and blue has patients who need an admission and a hospital stay of up
to 72 hours. Green and Yellow suites are equipped with cardiac monitors.

Each suite has two bays that have 6 beds in each (a male bay and a female bay). Each suite also has 3
side rooms that are used for infection control reasons such as patients with MRSA, C difficile or
neutropenia. Also they are used for palliative patients on palliative care pathways, or who may find
being in a bay very distressing.

L1 Purple is also called the triage unit which is staffed by a junior sister, 5 registered nurses and 2
health care assistants. All the other 3 bays are nursed by a junior sister, two registered nurses and a
technician (HCA). The shift leader manages the flow of patients through the unit (which can be
extremely fast at times), they also oversee the whole level. A senior sister is on duty everyday they
work clinically as well as attend to their management duties.

Excellent organisational and communication skills are essential to working in this unit along with
being able to work independently and flexibly. You will need to be self motivated and able to work
under pressure in this busy environment.

Within AAU we offer a developed and highly structured system of supervision and training, and are
committed to supporting suitable post-basic study.

Accident and Emergency

The Accident and Emergency Department has purpose built facilities including a newly refurbished,
modern resuscitation unit with 9 adult bays, including a bay dedicated to stroke telemedicine and

thrombolysis. There is a separate Children’s Emergency Department, with its own resuscitation
room. There is a new Acute Admissions Unit, the largest in the country, with 120 beds, that accepts
most emergency admissions. This encompasses the two cardiac catheterisation labs within the Acute
Admissions Unit. There is a newly developed, 6-bedded, Clinical Decision Unit within the footprint of
the ED. There is also a strong commitment to Ambulatory Care, with a dedicated Unit and staff, who
currently see and discharge about 20% of the acute medical take.

There is a well established team of Emergency Nurse Practitioners working alongside and supporting
the junior medical staff. We are pioneering an Advanced Nurse Practitioner role to assist in the
management of patients in Majors.

The Trust is part of the North West London Trauma Network, and has very close links with St Mary’s
Hospital.

Aldenham Ward

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Aldenham is classified as an adult medical ward, with a particular focus on the acute respiratory
patient. It has 27 beds, divided into 3 single-sexed bays and one mixed-sex respiratory high-
dependency unit (HDU). Each bay contains 6 beds and, in addition, there are 3 isolation rooms.
Typically, patients are admitted to Aldenham due to difficulties in breathing. This could be caused by
a severe chest infection such as pneumonia or pulmonary tuberculosis, a collapsed lung
(pneumothorax) or even cancer. Other common respiratory conditions treated in hospital are
exacerbations of chronic obstructive pulmonary disease (COPD) and asthma.

There is a high-dependency unit on the ward which is mainly for those who require non-invasive
ventilation (NIV) for type 2 respiratory failure and patients with tracheostomies.

The team comprises of 40 nurses and healthcare assistants, physiotherapists, occupational therapist,
discharge co-ordinator, ward clerk, housekeeper, social worker, domestics, medics and other
specialist and support personnel.

Aldenham ward provides non-invasive ventilation training with competency and tracheostomy
training from ITU staff. There are also in-house respiratory training days.

Cassio Ward

Cassio is a twenty bedded Gastroenterology ward with 3 bays of six patients and 2 side rooms.
Usually split into two male bays and one female bay. The patients treated here are Ulcerative colitis,
Chrons, liver patients, and an array of G.I conditions. Some patients are admitted to Cassio for detox
and there is a clear pathway for this. Several patients require Endoscopic procedures therefore the
ward is situated next to Endoscopy to enable our patients to receive the care they require - quickly.
The staff here are friendly, proactive and supportive and work closely to develop each other.

Staffing ratio weekdays 7-15:00 hrs 4 Trained 2 CSW

Senior nurse supervisory 07:15-15.05

07:15- 19:45- 3 Trained 2 CSW

19:45-07:45 – 3 Trained 1 CSW

WEEKENDS:

07:15- 19:45- 3 Trained 2 CSW

19:15- 07:45 – 3 Trained 1 CSW

Cleves Ward

Cleves is a Trauma orthopaedic ward, with a particular focus on fractured neck of femur patients. It
has 22 beds, divided into 3 single-sexed bays. Each bay contains 6 beds and, in addition, there are 4
side rooms’ rooms. Cleves ward mainly consists of elderly patients that have fallen and fractured
their neck of femur. They have joint care with the orthopaedic and care of the elderly teams. There is
a designated fracture neck of femur nurse who assesses all hip fracture patients, ensuring patient
management plans are created and carried out in atimely manner. Trauma orthopaedic patients are
also admitted here.

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The team comprises of nurses and healthcare assistants, fractured neck of femur nurse,
physiotherapists, occupational therapist, discharge co-ordinator, ward clerk, housekeeper, social
worker, domestics, medics and other specialist and support personnel.

Croxley Ward

Croxley Ward is a busy, lively but friendly 22 bedded Care of the Elderly Ward which is divided into
three 6 bedded bays and has 4 side rooms. These side rooms allow for isolation of patients when
required.

The ward cares for both male and female patients and follows and maintains the single sex
accommodation rules providing privacy and dignity to all our patients.

The multidisciplinary team works closely together in order to ensure the patient is treated as a whole
and all aspects of their care needs are met in a safe and timely manner.

The patients on the ward vary from those who require input from our therapy colleagues in the form
of a little physiotherapy to get them back on their feet or occupational therapy to determine what
help the patient would benefit from on discharge. Some patients are more unwell and require
diagnostics and both medical and nursing treatments for their conditions.

We are fortunate as a Trust to be able to use the expertise of specialist colleagues e.g Diabetic
Nurse, Continence Nurse, Tissue Viability Nurse, Falls Nurse and Dementia Nurse to name but a few.

Staff have the opportunity to develop their clinical and nursing knowledge and also their skills. They
can also gain experience of multidisciplinary team working and discharge planning.

Dick Edmunds Stroke Unit

We have 33 beds which includes 4 side rooms. 13 beds are hyper acute stroke beds, 20 beds are
acute beds; these beds are in 3 bays. The ward has two teams of doctors who work on each side of
the ward. We work alongside a large multidisciplinary team. We have physios and OTs based on the
ward as we have our own gym where the therapists can work with our patients. We also have
speech and language therapists, dieticians, early supported discharge co-ordinators, a research nurse
and stroke admin staff based on our ward.

We have MDT board rounds daily. There are two seprate rounds - one for the hyper acute side and
one for the acute side.

Nurses do a range of duties whilst supporting patients through their hyper acute phase to rehab. The
nurses work in a variety of bays which allows many learning opportunities and it also develops the
nurse’s clinical skills and critical thinking. Nurses work long days and nights.

The unit has a specialised nurse lead stroke service and stroke training sessions for staff. There are
also opportunties for staff to attend stroke conferences.

Elizabeth Ward

Registered Nurses with an interest in Gynaecology should come and work with us on Elizabeth Ward.
It is an exciting time for the service as we are opening the first Gynaecology Ambulatory Unit which
will provide the ladies who use our service with a much improved experience.

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We currently have 28 beds on Elizabeth Ward and admit all the Gynaecology Electives and
Emergencies. The Ambulatory Unit will have spaces for 6 women who for example, require hydration
due to Hyperemisis, management of miscarriage and observation whilst waiting for a scan. We are
also the Cancer Centre for gynaecology surgery in Beds & Herts, so admit women from East & North
Hertfordshire and Luton & Dunstable for surgery. This provides a variety of experience for staff and
can be very rewarding.

We also currently look after some Care of the Elderly and surgical patients, as required, during times
of high activity in the Trust.

There will also be an opportunity to experience what happens in the Specialist clinics i.e.
Gynaecology Emergency Dept & Colposcopy, to facilitate your learning and experience.

Flaunden Ward

Flaunden Ward is an acute surgical ward, with a particular focus on colorectal and upper GI patients.
It has 28 beds, divided into 4 single-sexed bays. Each bay contains 6 beds and, in addition, there are
4 side rooms. Patients are admitted here directly from A&E and from our surgical assessment unit.

Flaunden Ward is very acute and can be very busy at times. There are a lot of learning opportunities
from epidurals, PCAs, parental feeding and wound care.

The team comprises of nurses and healthcare assistants, physiotherapists, occupational therapist,
discharge co-ordinator, ward clerk, housekeeper, social worker, domestics, medics and other
specialist and support personnel.

Gade Ward

Gade is a seventeen bedded ward. It is predominantly a medical ward but it specialises in

haematology and rheumatology.

The ward nurses a broad spectrum of medical, haematology and rheumatology patients.

If you have an interest in haematology this is an excellent place to work. Gade ward nurses a wide
range of haematology patients with diagnoses such as myeloma, lymphoma, leukemia, sickle cell and
many other conditions. There are also many complex rheumatology cases treated on this ward.

Gade ward administers cytotoxic therapies and once you have worked on the ward for a year you
may be put forward for a course enabling you to administer chemotherapy.

We nurse many patients through their cancer journey and build fantastic relationships with these
patients.

Overall there are many opportunities within Gade ward to develop your career whether it be within
medicine, haematology, oncology or rheumatology.

Please join our well supported, friendly and interesting team.

For informal visits please contact the Ward Manager Lucy Newland on 01923 217845

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Heronsgate Ward

Heronsgate Ward is a 20 bedded medical ward that specialises in Endocrinology. There are 3 bays of
6 patients and 2 siderooms. The ward complies with single sex guidelines.

There are 4 shift patterns on the ward, they are as follows:-

Long day – 0715-1945 with 2x 30 min breaks

Early – 0715-1505 with 1X 30 min break

Late – 11-1945 with 1x 30 min break

Night – 1945-0715 with x2 30 min breaks

There are a team of Endocrinology consultants who rotate on a monthly basis. There are many
learning opportunities on Heronsgate Ward. There is a specific course called the Sugar and Spice
course about diabetes which is available to all staff.

Intensive Therapy Unit

ITU is an 18 bedded unit with 5 siderooms for isolation. It is a mix of both ITU and HDU patients. ITU
cater for elective and emergency patients. The staff patient ratio is 1-1 for ITU and 1-2 for HDU.
There are many learning and career development opportunities within the unit. The preceptorship
and mentorship course is available and there is also an ITU course available at masters or degree
level, but staff wishing to do this must pass be interviewed and proven to be competent for this
course.

Langley Ward

Langley is a surgical ward; it has 16 beds, divided into 2 single-sexed bays. Each bay contains 6 beds
and, in addition, there are 4 side rooms. Fifteen of these beds are for surgical elective admissions for
operations ranging from urology and vascular surgeries, but specialising in colorectal and upper GI
surgeries; the other bed is used for trauma patients admitted under the orthopaedic team.

Many of the colorectal and upper GI elective patients are nursed on the Enhanced recovery pathway;
we have a Specialised Enhanced Recovery Nurse who works closely with these patients. Her role
begins when she meets them in pre-operative clinic, to talk to them about their admission and the
surgery that will be undertaken. She then works with these patients (on the enhanced recovery
programme) post operatively; they are encouraged to eat straight after surgery and are mobilised
earlier than normal. Evidence shows that these patients have less post operative complications and
are discharged home sooner. She also works with the ward, and specialist nurses to support them in
dealing with new stomas, for example.

The team on Langley comprises nurses and healthcare assistants, medics, physiotherapists,
occupational therapists, a discharge co-ordinator, a ward clerk, a housekeeper, a social worker and
domestic staff.

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Our patients and staff are also supported by specialist nurses dealing with pain management, stoma
care and trauma and where necessary palliative care – these specialist nursing staff also provide
valuable education for the nurses in the clinical environment.

Langley ward offers great opportunities for staff to learn and develop a variety of skills when dealing
with patients after complex surgeries; managing intravenous fluids and medication, parenteral
feeding, enteral feeding, stoma care, wound management, complex discharge planning and
occasionally end of life care.

There are training sessions in pain management, epidural and PCAs via the acute pain team, which
nurses on our ward may get the opportunity to attend. Nurses may also get the opportunity to learn
how to administer chemotherapy agents directly into the bladder for some of our urology patients.
The trust’s stoma nurses provide training on the ward. Staff can also access palliative care training
when it is available.

Student nurses are regularly allocated to Langley ward at various stages of their training. Langley
ward staff take great pride in supporting them during their placement and supporting their learning
and development. Many of the trained nurses are trained to be mentors.

Letchmore Ward

Letchmore Ward is an acute surgical ward; it has 22 beds, divided into 3 single-sexed bays. Each bay
contains 6 beds and, in addition, there are 4 side rooms. Patients are admitted here directly from
Accident and Emergency and from our surgical assessment unit. Letchmore has surgical and
orthopaedic patients. Currently our Emergency surgical assessment unit is attached to Letchmore
where patients are referred direct from their GP or A & E where they are assessed and admitted or
sent home from here. Nurses working in the assessment unit will be able to cannulate and take
blood.

Letchmore has a lot of learning opportunities and scope for progression.

The team comprises of nurses and healthcare assistants, physiotherapists, occupational therapist,
discharge co-ordinator, ward clerk, housekeeper, social worker, domestics, medics and other
specialist and support personnel.

Ridge Ward

Ridge ward is a twenty nine bedded ward comprising of 4 bays and 4 side rooms. Bays 1 and 2 along
with side room 1 and 2 are for trauma orthopaedic patients who are admitted from AAU and A&E.
We work closely with St Mary’s and Queens Square in London who take, treat and send back our
more specialist cases. We are very fortunate to have a Trauma co-ordinator who supports the
patients, families and the nursing staff.

Bays 3 and 4 along with sideroom 3 and 4 are elective general surgery and orthopaedic cases.

The team comprises nurses and healthcare assistants, physiotherapists, an occupational therapist, a
discharge co-ordinator, a ward clerk, a housekeeper, a social worker, domestics, medics and other
specialist and support personnel.

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Sarratt Ward

Sarratt Ward is an acute elderly medical ward with 30 beds. This is divided into 4 bays, two double
side rooms and two single side-rooms. The age range of our patients is variable and based on their
clinical need and dependency. The average stay for patient is between 5-7 days; however, patients
may exceed this limit due to a number of factors (for example, waiting for placement or social
services input).

Our belief:

 As nurses our main aim is to deliver individualised patient care and to enusre that all our
patients are recognised as individuals

Our aim:

 Meet our patients’ physical, social and spiritual needs

 Deliver nursing care with respect and to maintain the patients’ dignity

We enable our patients to:

 Express their feelings

 Be fully informed and involved with their individualised care requirements
 Be fully informed and involved with their care in order to review and update the quality of
care offered on Sarratt Ward

At West Herts Trust we have a wide variety of specialist nurses and practitioners that the care of the
elderly unit liaises with regarding individual patient care. On Sarratt Ward we try and facilitate staff
meeting with different specialist nurses to help their learning and build relations with the
multidisciplinary team.

Theatres

There are 5 main theatres, 4 for planned surgery and 1 for emergency. There is also a trauma list.
There are also 2 maternity theatres and 1 gynaecology theatre. Both nursing students and ODP
students regularly do their placements on theatres and they are rotated throughout all departments.
When you start as a qualified nurse on theatres you will usually stay in one area for 6 months before
moving to the next area. There are many learning and development opportunities on theatre. There
may also be an opportunity to gain the scrub module, recovery module and anaesthetics module at
university.

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