The unsung heroes who keep Warrington Hospital running

That means a lot of work is never seen by patients The Facilities Division at Warrington and Halton Teaching Hospitals NHS Foundation Trust (WHH) contains many of the departments and teams who carry out this vital unseen work behind the scenes.

We look at the teams helping to keep the trust running.

THE CATERING TEAM >

The catering team at Warrington Hospital produce and serve around 1,500 meals per day to patients, including almost 500 hot meals in the evening.

They have to accommodate many different dietary requirements due of allergies, intolerances, lifestyle choices or religious reasons. Then there are patients whose diet or capacity to eat normally is affected by their condition or medical needs.

There are also modified texture menus for those patients whose condition means it is difficult or painful to consume solid foods. These include pureed meals, soft bite-sized menus and minced and moist choices.

Joanne Marshall, catering manager, said the pandemic has had an impact on their work.

She said “In the first wave when elective surgery was reduced we saw a drop in demand for meals but as the hospitals filled with Covid-19 patients the demand was as high as ever.”

As part of a hospital’s daily business new patients are checked in and some patients are discharged. Other patients are transferred from one area to another and due to their treatment a patient’s dietary requirements can change from one meal to the next.

“We constantly chase and update information, working closely with admin and ward staff to ensure we know exactly how many meals - and of what type - are required in each area’” she added. “It can be tricky when patients are moved, admitted or discharged close to meal times. But we do everything we can to make sure no one goes without a meal.”

After cooking/preparation the food orders for each ward are assembled on a production line and stored in a ward identified trolley.

The trolley has a hot side and a cold side – the hot side is plugged into one of a number of large heating pods to ensure food remains at a safe and optimum temperature.

When six of the trolleys are loaded and warmed they are taken off the pods and loaded onto the ‘Caravan’, a trailer towed by a miniature electric tug truck to the service corridor.

There they are met by two more catering assistants who attach three of the trolleys to each of their own tugs to transport the trolleys to the appropriate wards, where each patient receives their selected menu choice.

CAPITAL PROJECTS TEAM >

THE capital projects team contains a building surveyor, an electrical engineer, part time mechanical engineer and a fire safety officer. 

They plan, manage and oversee changes and adaptations to the ‘hospital estate’. 

This can include some very big jobs like managing construction of The Nest – the hospital’s new midwife led birth unit. Or, tiny jobs like installing a new hand hygiene station.

Lee Bushell, head of capital projects, says the number of jobs increased during the pandemic.

He added: “In total we usually quote for around 200 jobs across the trust each year.

This year it’s around 350. There is around £3 million worth of capital work scheduled each year. This year it was £15 million.”

That does include some major one-off capital projects:

•  The Nest – Warrington Hospital’s midwife led birth unit
•  New MRI scanner - providing a 2nd scanner on site and an extension to contain the new entrance, reception, inpatient waiting facilities and staff support areas.
•  Ward B18 – transformed into a Critical Care Unit.

“A lot of it is also Covid -19 related adaptations to buildings, access areas, corridors and wards for improved infection control” Lee explains, “Installing screens and partitions as well as changing the use and capacity of ward spaces. Then there was a huge amount of new signage, one way systems, replacing carpets and installing dozens of new hand hygiene stations.”

A couple of major schemes were held up by Covid-19 response and restrictions. Lee says work on The Nest was paused for two months during Wave 1 as some of our contractors were shielding or reluctant to work on a hot site. 

"Plus we couldn’t have as many contractors on site anyway as we had to ensure social distancing while the work was going on, so it became impractical to continue for a while.

“The team has been stretched but we made it through a really tough year while creating new services, improving infection control and managing safe access for our staff.”

SECURITY >

SECURITY Manager, Sean O’Brien sits in front of dozens of screens, monitoring live CCTV footage from across the Warrington Hospital site.

He added: “I like to think we always made a difference, but we know this past year we’ve been part of an extraordinary effort. 

“The team, the whole trust, it’s felt the like everyone has pulled together. No one worrying about status or titles – everyone mucked in and helped out.”

Damon Fox, a member of the security team as well as being a porter at the hospital, says there have been tough moments.

“When you have team members off, either ill or shielding, we have to work extra shifts or get in agency staff,” he said. “Everyone’s exhausted and morale can take a bit of a dip, but not for long.”

Damon says other duties have become more demanding than usual. 

He added: “It’s part of our job to escort the bodies of deceased patients to the on-site mortuary. Obviously it’s a solemn duty and one you hope you don’t have to do very often. At times this past year we have seen so many more patients sadly passing away and if you allow yourself to think about it, it’s really upsetting – for all the teams that work with patients.”

The security team regularly patrol the site and corridors ensuring the hospital is secure.

They make sure that car parks are being properly used and that patients, visitors and staff aren’t affected by any obstructions or anti-social behaviour.

Security officer Richard Fishwick, says “We’ve have had some new duties this year. We’ve been helping the transfer team move Covid-19 patients around the site. It involves closing off corridors and lifts in a sort of rolling roadblock, to ensure no spread of infection.

“We’ve dealt with more mental health related incidents on site this year too. I think health services have been stretched and people have been under more stress. We’ve been supported by our boss though, had some other duties taken off us to give us time to help with the extra workload.”

Sean says the team is a vital cog in the hospital system.

He added: “We work really well with colleagues across the whole trust, but to most patients and visitors we’re just one of those teams quietly keeping things going. 

“But we take great pride in being proactive to create the safest possible environment for staff to deliver vital patient services”.

WASTE MANAGEMENT >

The hospitals produce tons of waste every day.

The Waste Disposal Team at Warrington Hospital collect waste from all wards, labs and departments four times a day - ensuring it is appropriately secured, stored and collected by specialist contractors.

Like other workplaces, a hospital produces lots of normal domestic waste, food waste and vast amounts of recycling. However there is also a huge amount of waste unique to healthcare which requires specialist handling and infection control procedures. This includes:

Sharps - hypodermic needles, thousands used every week

Purple waste - can include toxic swabs, chemicals and soiled dressings

Orange waste - can include human waste, body fluids and discarded organs

The team make sure all the categories of waste are transported around the site to the large bin areas. They then ensure any potentially toxic, infectious or dangerous waste is properly treated, and stored in locked units. Specialist contractors are scheduled to collect and dispose of it.

DOMESTICS >

Across the Trust there are around 100 domestics working over any 24 hour period with around 150 in total on the team. The Domestics often work in teams of two and form part of a ward team, carrying out the cleaning on the ward.

Bev Chambers one of the Domestic supervisors says the reaction of the team to Covid-19 has been remarkable, “They’ve pulled their guts out. They’re unsung heroes. Imagine having to do some of those fiddly and heavy jobs in full PPE all day. It’s really hard work.

“The cleanliness standards have been incredible. When we do our audits, if they score 96 or 97% they’re dejected, disappointed. The team take such pride in their work and have such concern for patients.”

The domestics’ work on a ward involves cleaning sinks, window ledges and every surface around bed spaces several times a day. They also empty bins, change curtains and clean the floor regularly.

During the pandemic there are extra procedures for infection control on most wards and particularly on the Intensive Care Unit (ICU). These include domestics wearing full ppe, double bagging and sealing of all waste and extra disinfectant cleansing.

Lisa Davies and Carly Gwilliam are two members of the domestic team on Warrington Hospital’s ICU.

Lisa says it’s been tough “It gets to where you can’t switch off even at home”.
Carly agrees, “Yeah, I couldn’t relax, thinking about the patients and the ward team. Then you’re looking round the ward thinking ‘this person is still here, that patient’s still here’.

We had a real positive moment when the first long term Covid patient was applauded off the unit as they left to complete their recovery on another ward. But there’s been real hard moments too it’s been so upsetting.”

Lisa says at first it made her angry to see people who weren’t following all the guidelines, “ I’d think ‘Do they not know what the patients and the staff on this unit are going through. If they did, if they could see it, they’d stay at home’.”

Lisa and Carly have both had Covid.

“I had to isolate in April 2020”, says Lisa, “I had a high temperature and was very weak, even now my body aches sooner.”

Carly, was starting to think it was surprising she hadn’t caught Covid-19 when she returned a positive test, “I wasn’t very ill at the time, but now, weeks later I’m run down all the time.”

Task team – Deep Clean

Chelsea Ryan and Kayley Newell are two members of Warrington Hospital’s Domestic Task Team.

Task Teams carry out Deep Cleans of areas which have had potentially infectious patients in them. This ensures the bed space, side ward, or room is completely disinfected before being used by another patient.

The team have a schedule of work but receive requests to clean urgently needed areas via a beeper system.

Using a chlorine based disinfectant Chelsea and Kayley scrub every single surface in the room. They disassemble the bed to cleanse every element. They remove and replace curtains, pull apart bins and cupboards, scour all the machines and equipment, as well as every piece of lighting and wall furniture. The floor is mopped too. Then all doors and windows are closed and the room is sealed with tape to ensure it is as air tight as possible.

The ‘Fogger’ is then brought into the room. It’s on a timer allowing Chelsea and Hayley to leave the room. The Fogger then releases Hydrogen Peroxide vapour which fills the room, sterilising every surface. After a while the machine then reactivates and its vacuum pumps suck all the vapour into the machine, cleansing the air.

The team have such a practiced, effective system for cleaning, and the Fogger is so effective, that a bed space can be safe and ready for use by a new patient within 60 minutes.