"Outstanding care and treatment from all staff at Canniesburn Plastic Surgery Unit"

About: Canniesburn Hospital Glasgow Royal Infirmary / Plastic Surgery & Burns NHS Greater Glasgow & Clyde

(as the patient),

I am recovering from a long-standing facial paralysis as a result of the Ramsay Hunt Syndrome virus. I want to let you know that I have had the most wonderful and amazing experience from all the staff at the Canniesburn Plastic Surgery Unit (Out patient clinic, Theatre staff and In-patient ward). I am incredibly grateful to NHSGG&C for the support ensuring I have access to the surgeries and treatments that I need to enable me to make the best recovery I possible can from this condition.

In between these surgeries, I have had and continue to have appointments with my surgeon. He is quite simply a world-class surgeon, one of the best plastic surgeons; I have ever had the pleasure of being treated by. I am proud to be a patient of his. Wow, what a surgical experience at each stage of my patient journey, outstanding care and treatment, which is gold standard, and of the highest caliber. When I started my surgery I feel at ease by his highly professional, courteous and personable approach. Being so patent focused; I know that he will be doing his very best to ensure I have the best outcome possible.

From the lovely, personable and highly professional reception staff at Canniesburn outpatient clinic to the wonderful theatre team and all the staff on Ward 48. In total to date, I have had four facial reanimation procedures. Two have been major procedures. I have always received the highest quality of care and treatment.

In-patient Experience (Ward 48)

From admission to discharge, my patient experience has been wonderful, reassuring, sympathetic and very supportive. Just so grateful and appreciate very much the outstanding care and treatment that I have been fortunate to receive. Every single team member on ward 48 is passionate, committed and dedicated to ensure that patients receive the best possible care. The staff are incredibly patient focused, nothing is ever too much trouble and they all go the extra mile to ensure that I was comfortable as possible.

When I was a patient with my gracilis muscle transfer, this was a major operation. I required quite a bit of care and attention. The compassion and empathy shown towards me was amazing – a gold standard service. Maria, Jo and Lynne were just wonderful nurses, the best.

The ward was gleaming, in pristine condition and the hospital food lovely with excellent service.

Not only are the staff highly skilled and knowledgeable healthcare professionals. Wonderful communicators and take the time to listen to a patient’s story. This is incredibly helpful and means a great deal to a patient. There is genuine empathy and compassion from all the staff. I was back on the ward on as recently as last week for another procedure. Felt so happy, comfortable, relaxed and reassured to be back on ward 48. Was looked after incredibly well by Claire and Laura. From my perspective, continuity of care is very important. I was very lucky to receive it. I hold all the staff in the highest regard and cannot recommend any higher.

Theatre Experience

Theatre staff were unbelievable patient focused ensuring that I was as comfortable as possible before going in for surgery. Their highly professional and personable approach put me at ease straight away and made me very comfortable. I have nothing but the highest of praise and respect for all the staff.

Areas of service improvement

From my personal experience of facial palsy, I found that a number of issues urgently need to be addressed in primary and secondary care.

Primary Care

• GP limited awareness of the condition and of what help and information are available;

• Action: raise awareness of facial palsy and its consequences among healthcare professionals and provide signposts for where you can go to get help

Service Redesign of Facial Palsy services across NHSGG&C

• The facial nerve has a very complex anatomy and physiology, which spans an array of systems.

• Management of its dysfunction therefore requires input from consultants in several specialties. With issues that I have experienced with my vision and hearing as result of the facial nerve dysfunction. I experienced multiple and frequent hospital outpatient appointments, each requiring travel and clinical visits

• Multidisciplinary facial function clinic (FFC) approach needs to be estabished to provide a one-stop shop for facial palsy and paralysis patients so that their care could be co-ordinated and they were able to consult the required specialists and undergo treatment with the minimum number of visits and delays. A Centre of Excellence with the expertise for treating facial palsy and paralysis patients from across the country.

• A multi-disciplinary team is lead by a consultant plastic surgeon and includes a consultant maxillofacial surgeon, consultant oculo-plastic surgeon, psychological therapists, specialist physiotherapist and speech and language therapists. Together they use new techniques and expertise to re-animate the face, which are simpller, more effective and less traumatic than traditional methods.

• This allows patients the convenience of a single visit and the possibility of a discussion between health professionals to enable the most appropriate therapy for each individual.

• Centre of Excellent can provide Research and training into different aspects of facial palsy and its psychological effects is ongoing and includes the multidisciplinary approach to patient care, improving symmetry in facial palsy, the impact of treatments / interventions in facial palsy, the impact of treatments / interventions on the psychological effects of facial palsy.

• Follow up care – this is a definite gap in the service. There requires to be specifically a facial rehabilitation specialist. At a follow up appointment therapy will include a comprehensive assessment being carried out. This may include surface electromyography (sEMG) and photography and 3D facial scaning. An individualised treatment plan is then developed specifically for you. Sessions are up to 1 hour long and repeated every 1-3 months depending on your stage of recovery. Treatment plans are based on ongoing assessment and may include comprehensive education, massage, stretching, neuromuscular re-education, sEMG biofeedback as well as adjuncts to treatment such as chemodenervation injections (Botox®) which could be given out by a trained nurse.



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