Ophthalmology Consultant Colin Vize shares his top tips for healthy eyes as part of National Eye Health Week

• Make sure you go for an eye test every two years. This applies to children as well as adults and, if you’re over 40, you might need to go more often
• Know your history. Ask family members about their eye health as some conditions are hereditary. Problems experienced by older relatives may mean you’re at higher risk of developing problems so your optician needs to know
• Watch your diet. Eating a diet rich in fruit and vegetables, especially green leafy veg like spinach, kale and spring greens, is good for eye health. Fish high in omega-3 fatty acids such as fresh tuna and salmon are also ideal for healthy eyes
• Stick to a healthy weight. Being overweight increases your risk of diabetes which can lead to vision loss through diabetic eye disease or glaucoma
• Wear protective safety glasses, goggles, safety shields and eye guards when playing sports or doing DIY and tasks around the house
• Stop smoking. It’s linked to age-related macular degeneration, cataracts and optic nerve damage, all of which can cause blindness
• Wear sunglasses to protect your eyes from UV rays. Ensure they block out both UVA and UVB rays
• If you spend a lot of time in front of a computer screen, adopt the 20-20-20 rule. Every 20 minutes, look away about 20 feet in front of you for 20 seconds to reduce eye strain
• If you wear contact lenses, always wash your hands thoroughly before taking them out or putting them in. Make sure you follow your optician’s advice on insertion and removal.

People are risking blindness by drinking too much and continuing to smoke, a hospital eye surgeon has warned at the start of National Eye Health Week.

Consultant Ophthalmologist Colin Vize of Hull University Teaching Hospitals NHS Trust said changing unhealthy lifestyles now can help prevent sight loss as you grow older.

Mr Vize said smokers and heavy drinkers are more likely to develop age-related macular degeneration, the most common cause of sight loss in the UK.

And smokers are also more likely to develop cataracts sooner than non-smokers.

Mr Vize, based at Hull and East Yorkshire Eye Hospital, said: “We tend to take our sight for granted, with little thought to how blindness or the deterioration in our sight would impact on us.

“But losing your sight is devastating. Taking sensible steps to improve your lifestyle now can mean you’ve got a far reduced chance of developing problems in the future.”

With National Eye Health Week running from September 24 to 30, Mr Vize is advising people to reduce their risk of developing eye disease by stopping smoking.

People should not drink more than 14 units of alcohol a week, spread over three or more days. Having drink-free days in the week can also help cut your alcohol consumption.

The over 60s , people from Afro-Caribbean or South Asian backgrounds, people with a learning disability and those with a history of eye disease in their families are at greater risk of developing conditions such as glaucoma and diabetes.

Mr Vize said everyone should go for an eye test every two years although people over 40 and those from black or minority ethnic groups may require tests more often. Drivers should also get their eyes checked regularly to ensure they can fulfil the legal requirement to read a number plate from 20 metres or face losing their licence.

Eye tests not only alert your optician to your need for glasses or a change in an existing prescription, they can also detect early problems before you’re aware of any other symptoms.

Children should also get their vision checked every two years.

Mr Vize said: “People should visit their optician or GP if they have concerns about their vision at any time, even if they are not due an appointment.

“These are the simple steps people can take to protect their sight and ensure their eyes remain healthy throughout their lives.”

Three new roles have been introduced in Hull where people can earn while they learn to achieve their dreams of careers in nursing.

Hull University Teaching Hospitals NHS Trust is working with the University of Hull and Hull College to promote alternative pathways into nursing alongside the traditional three-year nursing degree course.

Students have just begun a Trainee Nursing Associate programme in conjunction with the University of Hull, combining four days of hospital-based experience with classroom learning while earning a wage.

Other students have also started three-year nurse apprenticeships, a new route into nursing where they will be paid to work at Hull Royal Infirmary and Castle Hill Hospital at the same time as attending university.

Nursing associates outside the Allam Medical Building

Next month, 15 health care support worker apprentices will also earn a salary during an 18-month educational programme run by Hull College, the University of Hull and the trust to gain a Level 3 BTEC in Health Care.

Practice Development Matron Nicola Buckle said: “These new roles allow us to offer an alternative pathway into nursing as the traditional route of a three-year degree is not an option for everyone.

“We’ve worked with the University of Hull and Hull College to create these new routes into nursing so people in our community can achieve their ambitions.

“It’s no secret that the NHS is facing national recruitment challenges so these new pathways will allow us to grow our own nursing staff as well as offer new opportunities to our own workforce.”

Professor Julie Jomeen, Dean, Faculty of Health Sciences at the University of Hull, said: “We are delighted to be working in partnership with Hull & East Yorkshire Hospitals NHS Trust and Hull College on these new innovative career pathways.

“As a university we look for ways to address the needs of the local population and NHS service providers. Accessible courses that guarantee a career on completion do just that and we continue to build our apprenticeship portfolio, working closely with the trust.”

The Trainee Nursing Associate role is a two-year practice-based foundation degree programme and 19 are set to qualify in May after the trust was chosen to pilot the course.

The new intake of 15 students starting this month will work four days a week at the trust, with three of those days on a ward. The fourth day will be spent on placement in an area linked to their chosen specialty.

They will attend university one day a week, qualifying as a registered Band 4 Nursing Associate in September 2020, and will be paid by the trust throughout their studies.

While working in the hospitals, Trainee Nursing Associates will wear navy blue trousers and white tunics with lilac epaulettes to distinguish them from other members of staff.

Upon qualification, they can either join the trust as Band 4 Nursing Associates or continue their studies for a further year to become registered nurses.

Nurse apprentices

The Nurse Apprentices is a new route into nursing. Some of the students beginning the course this month already worked for the trust in different roles, either as health care assistants or administrative staff, but wanted to progress a career in nursing.

Wearing navy blue trousers and white tunics with green epaulettes, they will be paid an apprentice’s salary by the trust while they learn. They will be based on a ward for one day a week and spend three days a week on placement, taking in nine different placements such as surgery, medicine, community and mental health. They will also attend the University of Hull for one day a week.

The Nurse Apprentices will qualify as Band 5 registered staff nurses at the end of the three-year course but without accruing the £27,000 course fees associated with a traditional nursing degree. This makes nursing a more viable option to people already in paid employment who faced the prospect of giving up a salary to study before the new course was introduced.

The Health Care Support Worker Apprenticeship is the third new role and is a partnership between the trust, Hull College and the University of Hull.

Open to school leavers and students over 16, the students, who will also be paid an apprentice’s salary, will be encouraged to use the BTEC qualification in health care as an entry requirement for a nursing degree.

They will wear navy blue trousers and white tunics with grey epaulettes to spend 80 per cent of their course with the trust, learning fundamental nursing care such as assisting patients with their washing, dressing and hygiene needs, food and nutrition and skin integrity. The other 20 per cent of their course will be spent at Hull College.

Practice Development Matron Simon Knopp said: “We look forward to welcoming these 45 students into the trust and supporting them as they work towards their qualifications.

“Our new routes into nursing mean people who felt they couldn’t afford to give up work while studying to become a nurse now have new routes open to them.

“This is a positive development for our staff and our community by ensuring we have a workforce, trained to the highest standards, to provide first-class care for our patients.”

Michelle Swithenbank, CEO and principal of Hull College, said: “As a former nurse, I am passionate about helping young people embark on rewarding and successful careers in healthcare.

“We recognised that there was a need to deliver training linked to employment within the sector which is why we approached both the University of Hull and Hull University Teaching Hospitals NHS Trust.

“This gives students an excellent opportunity to begin an apprenticeship knowing that there is a career opportunity for them at the end of it.”

They’ve been married “a lifetime”, he says, delighting in comfortable bickering which springs from decades of entwined existence.

Not long ago, his wife was diagnosed with dementia. She’s started falling, six times already this year. He might be criticising her “daft shoes”, now replaced with sensible flats, but worry is etched on his face.

Physiotherapist Charlotte Clee has been bleeped to the Rapid Access Clinic, across from the Emergency Department. Being part of the Frailty Intervention Team is just one of the many roles performed by the physiotherapy staff at Hull Royal Infirmary and Castle Hill Hospital.

The FIT team aims to prevent older people being admitted unnecessarily and to stop them coming back to hospital and a physio assessment is a key component.

“We see everyone who is 80 or above and anyone else who is likely to be frail or has a frailty need,” says Charlotte.

“We know that even an overnight stay for a patient over 80 can shorten their life because of deconditioning, muscle wastage and the risk of infection.

“If we can get them home, it’s better for them.”

Getting patients home as soon as they well enough is a central role of hospital physiotherapists. But they will only agree when the correct support is in place.

Physio teams are assigned to all the health groups, working in specialities including orthopaedics, surgery, neurology, respiratory and emergency medicine.

On the Elderly Assessment Unit, clinical lead Bex Redmond and senior therapy assistant Layla Thornton check Cayder for the red circles identifying patients awaiting physio assessments.

On this 20-bed unit alone, there are six new patients and four “work in progress” all requiring their attention.

The women are part of the medicine team assigned to the Department of Medical Elderly, Ward 50, Ward 100 and Ward 70.

They also work closely with patients on the Progression to Discharge Unit on Ward 9 and they’re called to the ED and the Acute Medical Unit whenever support is required.

This morning, Bex and Layla are with a patient who has been in hospital for a few days. Their friendly chatter puts her at ease. They explain what they’re going to do at every stage and she’s happy to do what they ask.

She tells them about her grandchildren and her great grandchildren as they wheel her towards stairs at the side of EAU. They ask her to climb the flight of stairs while they stand either side of her.

She’s not putting her whole foot on the step, balancing precariously on the ball of her foot. Her arm hangs onto the bannister behind her, putting her off-balance.

With gentle instruction, Bex and Layla correct her positioning. At the top, the patient has a rest in a chair before heading back down.

Although she appears perfectly lucid, she tells them she’s still working. She’s well into her 90s. It’s a red flag suggesting that, regardless of her ability to climb stairs, additional home support may be required.

Bex and Layla admire her nail polish but, all the while, take mental notes of how she manages the stairs. Her notes will document both her progress and her needs.

Bex qualified as a physiotherapist in 2012. She doesn’t hesitate when asked what attracted her into the profession. From the age of four, she was surrounded by physiotherapists after her mum developed Choriocarcinoma – a cancer which develops in the uterus.

Her mother suffered three brain haemorrhages but survived. Although she spent a month in a coma at one stage, she made a full recovery thanks to 10 years of physiotherapy. That’s why Bex is a physiotherapist.

Originally from County Durham and studying at Bradford, Bex came to work in Hull as part of her final rotation before qualification and loved it so much here, she didn’t leave.

“I found the nursing staff and the physio team so friendly and the support from management has been fantastic,” she said. “It might be nowhere near home but it feels like home.”

She works her way through her list on EAU, chatting to patients, assessing not just their physical condition and needs but uncovering levels of confusion which may impact on the level of support they require at home.

One patient is asked to walk a few steps with a frame. Another with obvious and painful swelling on her legs is asked if she can pull herself into a standing position. She can’t. Home is not yet an option.

There’s a mini kitchen along the corridor where people can be assessed to see if they can make themselves a hot drink or heat up food safely in the microwave. There are stairs, walking aids and frames, high stools and wheeled trollies which people with mobility problems can use to carry food from one place to another.

Bex says job satisfaction comes from getting a patient back on their feet.

“It’s a really rewarding job,” she says. “We see people at their most vulnerable and then we get them to a point where they are confident in their own abilities and can go home.”

Back in the Rapid Access Clinic, Charlotte has taken a full history from the patient’s husband, the woman happy to let her husband do the talking.

She thinks a walking aid might help the woman’s balance and also give her more confidence when she’s walking outside. Charlotte asks her to walk across the room with the stick. The woman carries it aloft like a prize.

To the woman, in her late 70s, walking aids are for old people. She won’t be using it, she says.

Her husband sighs. “She does what she wants, always,” he says, an exasperated shrug failing to dim the twinkle in his eye.

Charlotte comes up with a plan. The community-based Falls Team will assess the woman at home. Tests are under way to see if there’s a medical reason for the falls and she will be seen by the team at the new Jean Bishop Centre in east Hull.

The woman is sent home, with the walking stick, another patient spared a hospital admission.

Back at her desk in the heart of majors and halfway through her shift, Charlotte consults her list. There’s always another patient to see.

Sarah Bolton, a Nurse Colposcopist at Hull University Teaching Hospitals NHS Trust, answers questions you might have if you are called for a colposcopy.

What is a colposcopy?

You will be asked to attend Hull Women and Children’s for a colposcopy if your smear test shows abnormal cells in your cervix.

Although these cells are not harmful in their own right and often go away on their own, there’s a risk that they could turn into cervical cancer if left untreated.

A colposcopy examines the cells and determines whether you need treatment to remove them. If you do need treatment, you’ll have it there and then.

Why might I need a colposcopy?

You’ll come for a colposcopy if a smear test has revealed changes in your cervix caused by the Human Papilloma Virus (HPV) or if the nurse or doctor carrying out the smear test had concerns about the health of your cervix.

You could also be asked to come to the hospital for a colposcopy if you’ve been experiencing unusual bleeding during or after sex, in between periods or at any time after the menopause.

I usually see women from their late 20s to their early 40s although my youngest patient was a teenager and my oldest was in her 70s.

It’s good to keep in mind that I rarely see cancer during colposcopies. Instead, it’s all about preventing abnormalities progressing to the next stage.

I’ve been asked to come for a colposcopy so does that mean I’ve got cancer?

No. It’s very unlikely that you do. There are other reasons for your cervix to change, such as having a baby or having the coil fitted.

All it means is that further examination is in your best interests. If abnormal cells have been uncovered during a smear test, they won’t get any worse while you wait for your appointment.

Does it mean either my partner or I have been cheating on each other?

No.  Around 80 per cent of people who are sexually active have HPV. Although it is transmitted through sex, you can also catch it through intimate sexual contact so you don’t even need to have full sex to be infected with HPV.

HPV can remain in the body for weeks, years or even since you first started having sex decades before without you even realising.

That means you could have contracted it during a previous relationship and or they could have caught it from another woman, long before you got together, and it’s lain dormant for weeks, months or even years.

It’s only when abnormal cells develop that it becomes an issue.

Isn’t HPV linked to AIDS?

No. HPV is a completely different infection to HIV (human immunodeficiency virus) and is not linked in any way to AIDS.

What happens when I’m called for a colposcopy?

Five doctors and I conduct colposcopies at Hull Women and Children’s Hospital.

I see about 55 women at six clinics each week. Appointments last around 30 minutes but the vast majority of that time is spent explaining the procedure to the woman and answering any questions they may have.

I understand people can be anxious so I think it’s important that I take the time to address their concerns and put their minds at ease.

The actual colposcopy lasts around 10 minutes.

I’ll ask you to undress from the waist down, just like you do for a smear test, and lie down in a special chair with padded supports for your legs.

Just like the smear, I’ll use a speculum to insert into your vagina and use a microscope with a light which remains outside your body to examine your cervix.

I’ll apply acetic acid, otherwise known as medicinal vinegar, and any abnormalities will turn white. I’ll then use iodine to mark out the area of abnormality and then take a biopsy.

This involves taking a piece of skin from the cervix. It’ll feel a bit like low-down period pain.

What happens next?

I’ll be able to tell there and then if your changes require treatment. If they do, we’ll do it there and then. No point in hanging around when you’re already there and in position, after all.

The treatment is called a “loop excision of the transformation zone”. Done under local anaesthetic, all you’ll feel is the initial injection which is over in a matter of seconds, just like the injection you’ll get at the dentist.

Once the area is numb, a thin wire loop heated by an electrical current is used to remove abnormal tissue from what’s known as the transformation zone of the cervix, where cervical cancer develops. But if the area has been removed, cancer can’t develop so that’s why we take it away.

What will happen afterwards?

You’re likely to get some bleeding and discharge which will last around three to four weeks. We ask that you only use sanitary towels during this time and avoid tampons, sex and swimming until the bleeding settles.

The tissue will be sent for further tests to make sure the area of your cervix containing abnormal cells has been removed.

Women with abnormal smear tests are ending relationships because they wrongly believe their partner has cheated on them, a specialist nurse has revealed.

Nurse colposcopist Sarah Bolton said some mistakenly suspect their partners have been unfaithful after discovering they have the Human Papilloma Virus (HPV).

Others fear they have full-blown cancer or a form of HIV because of similarities between the initials despite there being no connection between the two viruses.

Now, Sarah has prepared a list of frequently asked questions to help woman invited for a colposcopy by Hull University Teaching Hospitals NHS Trust as part of the team’s #SmearNotFear campaign.

“My appointments last around 30 minutes and the majority of that time is spent unravelling misconceptions,” said Sarah. “I think it’s important to give the women the facts so they know exactly why they need to come for a colposcopy.

“Some people think they’ve got HIV and lots think they have cancer because they’re convinced they’ve got the symptoms they’ve found on Google.

“I’ve known women to end their relationships because they think their partner has been unfaithful. Others have been accused by their partners of cheating.

“I’ve even had an older woman with HPV who thought it meant her husband, who had died shortly before, had been with someone else without her knowing.”

Hull has high numbers of abnormal smear results thought to be linked to the city’s high smoking rates and because women become sexually active at a younger age than other parts of the country.

The team run a #SmearNotFear campaign on Facebook and Twitter, using the teal colour used to highlight cervical cancer in the same way as pink ribbons highlight breast cancer. The team hand out lollipops at public events to turn tongues teal as part of their campaign to raise awareness and encourage women to attend appointments as part of the National Cervical Screening Programme.

In a survey of patients using the service in June and July, 100 per cent of women who responded said they found the staff polite and helpful, they felt welcome, their privacy and dignity was maintained during their visit and they would recommend the service to their family and friends.

Some smears show up HPV which can cause precancerous cells to develop on the cervix and the women are referred to Hull Women and Children’s Hospital for a colposcopy to prevent the cells mutating into cervical cancer.

HPV is transmitted by sexual intercourse although it can be passed from person to person through intimate contact alone.

However, HPV is a very common infection carried by eight in every 10 people with active sex lives. You can also have it for weeks, months or years without you even realising or experiencing problems.

Sarah said: “You or your partner could have contracted it before you met each other and you wouldn’t know as it can lie dormant for weeks, months and even years.

“It’s only if the virus causes the cells around your cervix to change that it will be picked up during a smear test. However, HPV is not the only reason for the cells to change.

“Having a baby or getting the coil fitted can also cause abnormal cells which require further examination through a colposcopy.”

Sarah Bolton receives her award at the Golden Hearts event earlier this year

Sarah, who became a gynaecology staff nurse in 1994, is one of just 400 Nurse Colposcopists in the country, trained to perform the tests previously only carried out by consultant gynaecologists.

She studied at the University of Huddersfield and gained practical experience at Birmingham Women and Children’s Hospital before qualifying in 2012, working alongside the Hull trust’s team of five consultant gynaecologists.

Sarah’s dedication to her role was recognised in the trust’s Golden Hearts Awards earlier this year when she was named Outstanding Individual of the Year (Nursing and Midwifery).

She sees around 55 women at her six clinics held at Hull Women and Children’s Hospital every week, many of them fearing they have cancer because they’ve been told their smear rest has shown abnormalities.

If the colposcopy does confirm precancerous cells, Sarah is able to remove the abnormality under local anaesthetic to remove the risk of cancer developing in the future.

She said: “It’s very rare that I see women with cervical cancer and what I would say to women is this is all about health prevention.

“It’s essential they come for their appointments to prevent problems developing in the future.

“I always answer any questions to put their minds at ease because I understand how anxious they are feeling.

“But having the correct facts and not leaping to conclusions can make all the difference.”

Hull University Teaching Hospitals NHS Trust has received a Silver Award under the Employer Recognition Scheme (ERS) for its work supporting the Armed Forces.

The ERS was launched to reward employers who support Defence People objectives and encourage others to exhibit the same behaviours.

Now, the trust will be presented with the Silver Award at a ceremony at the Guildhall in Hull in November.

Chief Executive Chris Long said: “I am very proud that our organisation is to be presented with the Silver Award from the Armed Forces.

“Our staff are committed to ensuring Armed Forces personnel, reservists and veterans can access high-quality health care when they need it. We are also proud to have a number of reservists working in the organisation.

“We value what they do for this country and the health care of our Armed Forces will always be a priority for our trust.”

Chief Executive Chris Long

The trust already held the Bronze Award for its commitment to the Armed Forces Covenant and will receive the Silver Award at a black tie ceremony on November 22.

As a Silver Award employer, the trust will be entitled to carry the livery on its stationery and in all its publications.

Operations director Michelle Kemp said: “We were determined to build on the success of the Bronze Award we already held and it’s a great honour to receive the Silver Award.

“Our staff are trained to understand the needs of serving personnel and their families and we will continue to work with our Armed Forces colleagues to ensure we continue to improve our service.”

Tobias Ellwood, Minister for Defence Personnel and Veterans, said the award recognised the “fantastic efforts” of the trust and other employers who had elevated their commitments under the Armed Forces Covenant to provide actual benefit to the Armed Forces Community.

He said: “The winners should all be proud of the life-changing impact and fresh opportunities they are providing to our reservists, veterans, wounded, injured and sick and their families.”

A volunteer helping patients coming for NHS appointments is facing a £300 bill after a thief stole his bike chained up outside Castle Hill Hospital.

David Walker, 66, has given up his Friday afternoons to greet patients arriving at the hospital’s main reception for almost five years.

However, he walked out of the hospital at the end of his shift to discover his bike had been stolen from the cycle shelter outside the main reception.

Mr Walker said: “I often go into town on errands and I suppose I could understand if this had happened in the middle of town.

“But I couldn’t believe that it would happen outside Castle Hill Hospital in the middle of the day.”

Mr Walker started volunteering for Hull University Teaching Hospitals NHS Trust after retiring from his job as a heavy goods mechanic in April 2014.

He cycled the 20-minute journey from his home in Anlaby to help out at the hospital most Fridays, except when bad weather forced him to catch the bus.

He was devastated earlier this year when fellow volunteer and friend John Haines died of cancer, ending a great double act which had entertained visitors, patients and staff arriving at the hospital for years.

Now, he is facing the prospect of shelling out to replace his black Trek 1000 hybrid bike after the thief cut through the security chain attaching it to the rail.

Mr Walker said: “I had walked out about 3.30pm and saw a mountain bike lying on the ground. I thought that was a bit odd and then I noticed my bike was gone.

“I couldn’t believe that someone would steal a bike from right outside a hospital.

“I’ve contacted the police and I know the trust’s security staff is trying to see if there’s any CCTV footage.”

The theft took place on Friday, August 31, sometime between 12 and 3,30pm outside the main entrance to Castle Hill Hospital. Anyone with information or who can help Mr Walker should contact the trust’s communications team on 01482 675556.

Heart patients needing aortic valve replacements will be able to undergo the treatment at Castle Hill Hospital from the start of next year.

Hull University Teaching Hospitals NHS Trust has been commissioned by NHS England to set up Transcatheter Aortic Valve Implantation (TAVI) following a review of services for patients living in Yorkshire and the Humber.

The TAVI service means people in Hull, the East Riding, North Yorkshire and Northern Lincolnshire will be able to undergo the procedure closer to home and will no longer face journeys to Sheffield or Leeds for treatment.

Trust chief executive Chris Long said: “Becoming the third TAVI centre in the region further underlines our reputation for excellence in the field of cardiology and is great news, not just for us but for our patients.

“The centre will be located here after some inequality of access was noted during a review of the service by NHS England. Patients from this area were experiencing delays in accessing treatment compared to those in West and South Yorkshire.

“Having a TAVI centre here means patients will no longer have to travel to other parts of Yorkshire for treatment which can make such a difference to their lives.”

Dr Michael Gregory, NHS England’s Regional Clinical Director for Specialised Commissioning in the North, said: “NHS England is pleased to support the commissioning of a new Transcatheter Aortic Valve Implantation (TAVI) centre in Hull.

“It is the third such centre in Yorkshire and the Humber, alongside Leeds and Sheffield, and will improve access and reduce travel out of the area for local patients who require this specialised service.”

Patients with aortic valve disease can experience angina, shortness of breath, fainting or dizziness although some may not have symptoms at first.

As symptoms worsen, they require aortic valve replacements and those who are not considered suitable for major heart surgery will undergo the TAVI procedure instead.

Performed under a local or general anaesthetic, a catheter or hollow tube with a balloon on the tip is inserted into an artery in the upper leg or chest. The catheter is then passed into the heart and is positioned near the opening of the aortic valve.

The balloon is inflated to create space for a new tissue valve, which is then put in position and expanded.

The procedure puts less strain on the body as the heart does not need to be stopped and placed on bypass. It also avoids people having a large cut on their chests and can mean people recover more quickly than if they had undergone conventional surgery.

The trust is expected to introduce the TAVI service for some patients by January, with the centre becoming fully operational by 2020.

She appears on the ward mid-afternoon, bunting draped over a trolley loaded with brightly coloured plates and trays.

Sandwiches, cut into delicate triangles, a rainbow of fresh fruit, milkshakes, chocolate mousse and cheesecake create a mouth-watering feast. There’s even a cheese board, with the option of hard or soft cheese to enjoy with your crackers.

Afternoon tea at 2pm is ward nutritionist Michelle Priestley’s pride and joy.

Since her appointment in January, Ward 70 has seen its fundamental nursing standard for nutrition improve from red to green in the most recent audit.

“I never got told I was good at anything,” Michelle said. “But since I’ve been doing this, people have been saying ‘Wow’.

“I just really love it. I can see how it is helping patients get better and back home sooner.”

Michelle, 35, originally worked as a porter for almost nine years before leaving to bring up her three children.

Although she got a job in Asda, she wanted to return to the trust and applied in vain for every vacancy she thought might be suitable.

However, in January 2017, she was taken on as a health care assistant helping out on the winter ward, a temporary post for four months.

“It was a bit of a risk to take the job,” she said. “I was giving up a permanent job for a temporary one but I worked really hard and was offered a permanent post at the end.”

A year later, Michelle was asked to take on the role of ward nutritionist, helping to improve Ward 70’s performance in the fundamental standards introduced by Chief Nurse Mike Wright. Michelle leapt at the chance.

Eight months on, the difference Michelle has made to patient care, alongside the passion she has for the role, is obvious, not least because the last audit saw the ward scoring green in the fundamental standard.

It’s approaching 8am and Michelle is an hour into her shift. She’s been in patient handover so she knows who is on the ward and who needs what.

Those with special nutritional needs have red trays and water jugs with red lids, an instant guide for staff. But Michelle also has her special white board.

She’s filling it in on the kitchen wall, marking essential information next to each patient’s name to help catering staff. The woman in that bay needs encouragement to eat, the man in the bay across the way likes big portions. No sugar for that patient because he’s diabetic.

You can see how this plays a part in patient safety and Michelle takes great care to ensure the board is accurate and up-to-date.

She loads up the toaster and stacks the slices on the plate covered by a napkin to keep them warm before heading out onto the ward.

Some of the patients on Ward 70, a general medical ward for diabetes and endocrinology complaints, have been here for a while. One has been here for 100 days and he’s lost a huge amount of weight. He’s Michelle’s “special project”, a man in danger of malnutrition, and she endeavours to tempt his palate every day, just to get him to eat something.

“This man is just fed up with the food because, every two weeks, it goes back to the same thing. I try to see what he would like. I do that with all the patients who say they don’t want to eat anything.”

She goes into his room. He’ll have two triangles of toast, he says. “Three?” asks Michelle. “Oh, go on then,” he says with a smile.

Michelle scours the different menus available in the trust every day, from the gluten-free diets to special diets for patients with kidney problems, to see if there’s anything she can source to tempt patients’ appetite. She even looks for children’s meals, offering plainer food like fish fingers and bangers and mash to older palates not tempted by macaroni Provencal or pasta carbonara.

“I use smaller plates for some patients so they’re not overwhelmed by the amount of food before them,” she says. “Sometimes, they won’t have a full sandwich but they might have a quarter.”

With meticulous attention to detail, Michelle records every drink and every mouthful of food a patient has, essential information for the dieticians, speech therapists and even the doctors.

“Staff nurses fill in the notes that the patient is eating and drinking well but I provide that precise and detailed information which I hope can help,” she says. “The SLT team say I’m good at knowing which patient is likely to require pureed meals now. When I think they’ll agree, I make sure I order in a pureed meal so it’s there for them in the freezer.”

She opens a cupboard to reveal her secret crisp stash. She can also obtain Mars Bars, taking the trouble to chop them up into tiny, bite-size pieces to help a patient improve their calorie intake. It’s all on the afternoon tea trolley.

Despite the pressures on her time during her 7am to 3pm shift, five days a week, Michelle always has time for her patients. A friendly and familiar face on the ward, they greet her by name. They are always pleased to see her.

“It’s hard because sometimes you can be on your knees but then I just think they’re the ones in the hospital bed so it’s for us to put a smile on our face,” she said.

One patient, who has been on the ward for one month, accepts the offer of toast. Michelle knows he’s got a healthy appetite so she makes sure he always has large portions.

“You can tell when she’s not working, especially at the weekend,” he says. “She makes a difference, that’s for sure.”

Michelle takes the orders for the lunches and dinners but her hours mean she’s often asking people with poor appetites what they want for their lunch the next day, seconds after they’ve struggled through that day’s offering.

“I know it’s off-putting for them and I hate doing that,” says Michelle. “As there is only me doing the role at the moment, I like to get the orders in and away before I finish.”

It’s the individualised care Michelle offers that is improving patient care on Ward 70. Not only is she familiar with her patients’ requirements, Michelle sits by their bedside, taking the time and trouble to coax them with every forkful. Sometimes, she works with four patients at a time, flitting from one bed to the next then back again.

As well as providing the nutritional shakes which build up frailer patients, Michelle has used the outside world as her inspiration for her famous afternoon tea trolley.

“I took my Nanna to Morrison’s one day and I saw how the older people seemed to love a smaller sandwich with a few crisps on their plates,” she said. “I thought I’d do that and people seem to like it.”