Health Business 15.4

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VOLUME 15.4 www.healthbusinessuk.net

CATERING

LEADERSHIP

MOBILE TECHNOLOGY

INFECTION CONTROL

KEEPING AHEAD OF THE BUGS Taking infection prevention to the next level and fighting antibiotic resistance PATIENT SAFETY

SEVEN-DAY SERVICES

What are the challenges facing a seven-day NHS?

PROCUREMENT

NHS PENNIES SPENT WISELY

Ways to make purchasing more efficient and cost-effective

PLUS: PARKING • TRANSLATION • SECURITY • DATA DESTRUCTION • EVENT PREVIEWS


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HEALTH BUSINESS MAGAZINE ISSUE 15.4 VOLUME 15.4 www.healthbusinessuk.net

CATERING

LEADERSHIP

Comment

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Manchester gears up for 12‑hour service, 7 days a week

MOBILE TECHNOLOGY

INFECTION CONTROL

KEEPING AHEAD OF THE BUGS

Taking infection prevention to the next level and fighting antibiotic resistance

What the Conservative government hopes will be the future of the NHS is being shaped in Greater Manchester. Devolution has put the city in charge of a £6.2 billion health and social care budget, and it’s now set become the guinea pig to provide seven-day services for all.

PATIENT SAFETY

SEVEN-DAY SERVICES

What are the challenges facing a seven-day NHS?

PROCUREMENT

NHS PENNIES SPENT WISELY

The pilot, covering 500,000 people, reduced attendances at accident and emergency units by three per cent, saving £425,000 in the Central Manchester area.

Ways to make purchasing more efficient and cost-effective

PLUS: PARKING • TRANSLATION • SECURITY • DATA DESTRUCTION • EVENT PREVIEWS

Before the election, the Conservatives pledged to spend a further £500m over five years to ensure every patient in England has seven‑day access to general practice from 8am until 8pm. This is a fair old shift for all concerned. And according to economists from the University of Manchester, seven-day services roll-out could cost around £1.4bn, and is ‘unlikely to be a cost-effective use of resources’. Professor Matt Sutton, who led the study, said: “It is highly unlikely that all additional risks to patients would be eliminated and moving consultants and other resources from some days may just move the problem to a different point in the week.” Most commentary seems to be missing the point – like most businesses, it’s all about the staff. For many in healthcare, especially those in acute or emergency services, 24/7 working is already a reality. Danny Wright

P ONLINE P IN PRINT P MOBILE P FACE TO FACE If you would like to receive all issues of Health Business magazine for £120 a year, please contact Public Sector Information Limited, 226 High Road, Loughton, Essex IG10 1ET. Tel: 020 8532 0055, Fax: 020 8532 0066, or visit the Health Business website at:

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226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: www.psi-media.co.uk EDITOR Angela Pisanu ASSISTANT EDITOR Michael Lyons PRODUCTION EDITOR Richard Gooding EDITORIAL ASSISTANT Tommy Newell PRODUCTION CONTROL Jacqueline Lawford, Jo Golding WEBSITE PRODUCTION Reiss Malone EDITORIAL DIRECTOR Danny Wright ADVERTISEMENT SALES Alexander Baker, Jeremy Cox, Omar Bux, Jake Lacey, Patrick Dunne, Ben Plummer ADMINISTRATION Victoria Leftwich, Vickie Hopkins PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Volume 15.4 | HEALTH BUSINESS MAGAZINE

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CONTENTS

07 NEWS

39 INFECTION CONTROL

13 LEADERSHIP

43 INFECTION PREVENTION

Jeremy Hunt calls for social contract ‘between the public, health and care services’; NHS to review mortality rates of people with learning difficulties

What is needed to take infection prevention to the next level? MRSA Action UK’s Derek Butler shares his views on the problem of antibiotic resistance

A strong relationship between leadership capability and organisational performance can increase a hospitals efficiency, says The NHS Leadership Academy

17 PROCUREMENT

13

Involving clinical staff in decision-making can create a more cost-effective way of buying, writes David Pierpoint of the NHS Supply Chain

25

21 ENERGY

51 DOCUMENT DESTRUCTION The BSIA’s Stephen Ellis explains why hospitals should be aware of the importance of secure patient data as part of a wider hospital security plan

56 CATERING

The British Dietetic Association shares guidance on new allergen rules, which will require hospital catering services to provide information about the use of any of the 14 specified allergens as ingredients in any food that they serve

25 MOBILE TECHNOLOGY

59 EMERGENCY SERVICES

29 PATIENT SAFETY

62 PARKING

33 HEALTH AND CARE INNOVATION EXPO

64 SIGNAGE

Health Business analyses David Cameron’s seven-day NHS plan and what this could potentially mean for patient safety

The Health and Care Innovation Expo returns to Manchester, where 5,000 professionals from the health industry will gather to dicuss health innovation

The Emergency Services Show is one of the key events for anyone involved in emergency planning, response or recovery

The British Parking Association’s Kelvin Reynolds argues that well-designed and properly maintained parking provision is vital to the success of Britain’s hospitals Evidence suggests that a good wayfinding system can lead to cost efficiencies. Chris Girling looks at what makes effective wayfinding

37 SECURITY

The British Security Industry Association’s Judith Denny discusses the measures hospitals can take to ensure the safety of its staff, patients and visitors

64

Health Business previews Infection Prevention 2015 which takes place on 28-30 September at the ACC, Liverpool

The average emissions of existing hospitals could potentially be reduced by 25 per cent if best practice energy measures were applied, writes Chris Hall, BRE’s health sector lead

Health Business investigates the increasing reliance on mobile technology and looks at the latest news from the Integrated Digital Care Fund and Nursing Technology Fund

39

Contents

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Sponsored by

66 TRANSLATION

With over 300 languages spoken in the UK, healthcare communication can often be compromised, writes the Association of Translation Companies

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HEALTH & SOCIAL CARE

Jeremy Hunt calls for social contract ‘between the public, health and care services’ Health Secretary, Jeremy Hunt has called for a ‘new social contract between the public and health and care services’, urging the public to take more personal responsibility for looking after the elderly, for their own health and in using finite NHS resources. Speaking at the Local Government Association (LGA) annual conference, Hunt discussed the issues facing Britain and the NHS due to an ageing population, a budget squeeze and rising consumer expectations. Hunt argued that integration of health and social care will be vital to ensuring the highest standards of health and care, but also stressed that people who use those services need to play their part too, with personal responsibility sitting alongside system accountability. Hunt said: “The best person to manage a long-term condition is the person who has that long term condition. The best person to prevent a long term condition developing is not the doctor - it’s you. Which is why last year, following changes to the GP contract, the number of GPs offering their patients online access to a summary of their medical record has risen from three per cent to 97 per cent. This needs to be the start of a much bigger change where everyone feels firmly in the driving seat for their own health outcomes and an area where the NHS and local government can work together.” Discussing the role of patients in using NHS resources responsibly, Hunt added: “Part of this change in mentality needs to be more personal responsibility for use of precious public resources… There is no such thing as a free health service: everything we are proud of in the NHS is funded by taxpayers and every penny we waste costs patients more through higher taxes or reduced services. “Yet estimates suggest that missed GP appointments cost the NHS £162 million each year and missed hospital appointments as much as £750 million a year. That is nearly £1 billion that could be used for more treatments or the latest drugs. On top of which we spend £300 million a year on wasted medicines. “People who use our services need to know that in the end they pay the price for this waste.” A new scheme will be put in place to mark NHS medicines with ‘funded by the taxpayer’, in an attempt to reduce the waste of NHS resources. Additionally, medicines that cost more than £20 will also be labelled with their price, to emphasise the cost of healthcare treatment. Hunt claims that these new plans “will not just reduce waste by reminding people of the cost of medicine, but also improve patient care by boosting adherence to drug regimes“. Meanwhile, the government has

softened its pre-election pledge to deliver 5,000 new GPs, claiming this was always the ‘maximum’ figure achievable. Speaking at the Health+Care show 2015, Jeremy Hunt cast doubt on the government’s pledge and said that the Department of Health would look to practise nurses and associate physicians to better support primary care. Hunt said: “I talked about recruiting 5,000 more GPs on Friday. In truth, we think that is the maximum that we would be able to increase the GP workforce by, over the next five years. Given the time it takes to train new GPs; given the potential number of people who we can persuade to come back into the profession.” Hunts comments come after a speech on 19 June in which he re-enforced the government’s commitment to providing 5,000 new GPs, as well as 5,000 new support staff. Hunt spoke about offering GPs a ‘new deal’ to ease workload and make the profession more attractive to young doctors. Part of this deal would see GPs offered financial incentives to work in deprived areas, as well as removing bureaucratic hurdles, for those want to return to the profession after a leave of absence or retirement, with better support to work part time. However, based on Hunt’s comments at the Health+Care show, it appears he is not confident these measures will lead to the 5,000 GP target. Dr Chaad Nagpaul, chair of the British Medical Association’s GP Committee, was critical of the proposed target before the election. Responding to Hunt’s comments, he said: “Delivering 5,000 extra GPs in five years, when training a GP takes 10 years, was a practical impossibility that was never going to be achieved.” READ MORE tinyurl.com/olp492c

News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

NEWS IN BRIEF Ombudsman’s report finds poor complaint handling and service failures across the NHS NHS Ombudsman Dame Julie Mellor published a report on 17 June that highlights poor complaint handling and service failures in the NHS and the effect this has on patients and families. The report focusses on a number of case studies where complaints were not resolved locally, which resulted in the complaints being referred to the Ombudsman service. One case study found failings in staff communication at Hospitals Birmingham NHS Foundation Trust that led to a family not being with their mother in her final hours, only being allowed to see her 45 minutes after she died. Another found that a patient with dementia was left in a trolley in A&E for over 33 hours and then left in an assessment unit for 42 hours. The investigation found that an appropriate care plan was not in place to cater for the patients needs, and the North Staffordshire NHS Trust has now acknowledged and apologised for its failings. The aim of the report was to highlight the importance of good complaint handling and to help leaders “recognise the valuable opportunities complaints provide to really improve the service they are delivering”. READ MORE:

tinyurl.com/plq3ego

New research calls for GP receptionists to receive formal training to recognise stroke symptoms New research has prompted calls for receptionists to be properly trained in recognising stroke symptoms, after finding only 14 per cent of receptionists had received formal training. The research, carried out by Oxford University, studied the response of 52 general practices when medical role actors called with one to three symptoms of acute stroke. It found that nearly a third of GP receptionists failed to direct patients with stroke symptoms for immediate help, with receptionists performing well when presented with ‘FAST’ (Face, Arm, Speech, Time) symptoms, but less effective at recognising symptoms relating to posterior circulation stroke, such as vomiting, visual disturbance or vertigo. READ MORE tinyurl.com/old3kuz

Volume 15.4 | HEALTH BUSINESS MAGAZINE

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News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

MORTALITY RATES

NHS to review mortality rates of people with learning difficulties NHS England, the Healthcare Quality Improvement Partnership (HQIP) and the University of Bristol have announced the world’s first national programme to review deaths of people with learning disabilities. The three-year project has been commission by HQIP on behalf of NHS England and will be led by the University of Bristol’s Norah Fry Research Centre, the National Learning Disability Mortality Review Programme. It will support other NHS England programmes designed to ensure that people with learning disabilities get the support and services they need and work to drive up the uptake of Annual Health Checks and cancer screening. The programme will review why people with learning disabilities typically die earlier than average and investigate the inequalities that they face within the health industries. It will also look into improvements that can be made and ultimately reduce the premature deaths. Jane Ingham, CEO at HQIP said: “The Confidential Inquiry into the Premature Deaths of People with Learning Disabilities set out clear evidence in relation to the extent of health inequalities for people with a learning disability. The establishment of this National Learning Disability Mortality Review Programme will provide improved information about the causes of premature mortality for people with a learning

disability and provide the intelligence to drive change in practice, policy and the commissioning of services, particularly at a local level. The University of Bristol has a strong track record in this area and a firm commitment to putting people with learning disabilities at the heart of their work.” Dr Pauline Heslop, who led the CIPOLD work and is programme manager for the mortality review programme said: “We are delighted that health inequalities faced by people with learning disabilities are being put under the spotlight. We have seen encouraging change being made as a result of local reviews of deaths conducted as part of the confidential inquiry.” Dominic Slowie, NHS England’s National Clinical Director for Learning Disability, said: “It is completely unacceptable that this huge inequality exists for people with learning disabilities, and this will be a vital piece of work in helping us to support everyone to lead happier, healthier lives.The original CIPOLD study made a big difference to the way in which professionals and organisations think about issues relating to people with learning disabilities, and has led to important changes in policy and practice at local level. Now we need to replicate this nationally.” READ MORE

tinyurl.com/q4pu7y4

INSPECTION PROCESS

Inspections take too much time away from patients, GPs warn GPs have criticised the current inspection process for GP surgeries, claiming that it is unfit for purpose and requires GPs to take too much time away from patients. The Royal College of General Practitioners (RCGP) are calling for an emergency ‘pause’ in routine inspections of GP practices to relieve pressure on surgeries ‘on the brink of meltdown’. They claim that the current process forces GPs to take time away from ‘where they are needed most - delivering safe care to patients and reducing waiting times for GP appointments’. Delegates at the British Medical Association Annual Conference in Liverpool voted in favour of a motion saying that the current Care Quality Commission regime was ‘unfit for purpose’. They accused the health watchdogs of an ‘overly bureaucratic’ and ‘nitpicking’ approach. Dr Chaand Nagpaul, BMA GP committee chairman, said: “The BMA’s GP committee

has been voicing significant concerns about the CQC’s operation, particularly the overly bureaucratic and often nitpicking assessments that are wasting days of valuable GP and staff time that could be being spent on treating patients.” In an open letter to the Health Secretary, RCGP Chair Dr Maureen Baker said: “In the view of RCGP Council, the current inspection process tends to focus on those things that can be most easily documented and generates considerable additional clinical and administrative activity for practices. We believe that the time has come to conduct an urgent review of the CQC’s regulatory regime, to eliminate unnecessary bureaucracy and to ensure that it reflects the distinctive nature of general practice and focusses on what matters most to patients.” READ MORE:

tinyurl.com/ocam8mv

DRUGS

Pharmacists given access to NHS Summary Care Record Community pharmacists across England will be given access to the NHS Summary Care Record (SCR), the Health and Social Care Information Centre (HSCIC) has announced. The SCR provides clinical information about patients, sourced from their GP records. It has been the subject of debate due to concerns over consent and confidentiality, but was eventually given the go ahead by the former coalition government. The HSCIC conducted a pilot programme at 140 sites, which found that in 92 per cent of encounters where SCR has access, the pharmacists avoided the need to signpost the patient to other NHS care settings and in 18 per cent of encounters the risk of a prescribing error was avoided. Additionally, 85 per cent of pharmacists surveyed agreed that SCR reduced the need for them to contact the patient’s GP. Minister of State for Community and Social Care, Alistair Burt said: “Pharmacists are an untapped resource in our health service - as experts in medicines, they can help people to manage their conditions and take some of the pressure off our GPs. That’s why it makes complete sense to give them the ability to access patients’ summary care records, where appropriate. “So we’re investing up to £7.5 million to give community pharmacists the training and tools they need to access a patient’s summary care record. A pilot has already shown that as a result of this, as many as nine out of ten people can get the help they need from their pharmacist without having to be sent to another service. I encourage all community pharmacists to get involved and further improve the care we can give people in their communities.” READ MORE: tinyurl.com/pt9m75t

Volume 15.4 | HEALTH BUSINESS MAGAZINE

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CANCER GUIDELINES

News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

NEWS IN BRIEF NHS trusts, schools and councils obliged to prevent radicalisation under Counter‑Terrorism and Security Act

NICE publishes new cancer guidelines for GPs The National Institute for Health and Care Excellence (NICE) has updated and redesigned its guidelines to help GPs diagnose cancer earlier and save thousands of lives The updated guideline uses a new approach which focuses on the symptoms that a patient might experience. The guidelines set out clear tables linking signs and symptoms to possible cancers and includes simple recommendations about which tests to perform and the type of referral to specialist services that should be made. NICE has predicted that around 5,000 lives could be saved each year as GPs will now consider the possibility of cancer sooner and refer people for tests quicker. This in turn will mean

more people receive an early diagnosis and subsequently, more cancers could be cured. Professor Mark Baker, clinical practice director at NICE, said: “The best way to successfully treat cancer is to make an early diagnosis. The sooner the disease is identified, the more likely treatment is to be effective. Earlier diagnoses have the potential to save thousands of lives each year. This guideline uniquely amongst guidelines of this type presents the evidence on the way that patients present to their GPs. It reflects real life and we expect it to have a major impact on the success rate for cancer in England.” READ MORE:

tinyurl.com/ntz9bof

Key public bodies across the country will be legally required to take steps to prevent people from being radicalised under new counter-terror measures. The Prevent duty is a part of the Counter-Terrorism and Security Act 2015 and comes into effect on 1 July 2015. Schools, universities, prisons, councils, police and NHS trusts will be expected to have ‘due regard to preventing people from being drawn into terrorism’. These responsibilities will include recognising the signs that someone may be in danger of being radicalised and understanding the proper measures to access help and support. Security Minister John Hayes said: “We have seen all too starkly and tragically the dangers of radicalisation and the devastating impact it can have on individuals, families and communities. The new Prevent duty is about protecting people from the poisonous and pernicious influence of extremist ideas that are used to legitimise terrorism. “Protecting those who are vulnerable and at risk of radicalisation needs to be a job for all of us. The new duty will make sure key bodies across READ MORE: the country play their part tinyurl.com/q2y5kp7 and work in partnership.”

Mental Health Staffing Framework guide published NHS England has launched a new guide which aims to help ensure the right people with the right skills are recruited into the right inpatient mental health settings. The Mental Health Staffing Framework was commissioned as part of NHS England’s ‘Compassion in Practice programme’. It was developed by an independent group of directors of nursing who undertook a rigorous review of the available evidence and drew on their experience. Amongst its objectives is to equip mental health leaders with the skills and knowledge to plan and deliver safe staffing. It will also provide a means READ MORE: of assessing their services tinyurl.com/otgz8t5 against agreed best practice.

RECRUITMENT

New immigration rules could ‘cause chaos for the NHS’, nursing union warns The Royal College of Nursing (RCN) has warned the government that new immigration rules could exacerbate the nursing shortage in the UK and see thousands of foreign nurses forced to return to their home countries. The new rules are set to come into effect in April 2016, and will mean non-EU workers earning less than £35,000 after six years in the UK will be deported. The RCN have urged the Home Office to make nurses

exempt from the new rules and reconsider the salary threshold. Research released by the RCN suggests that up over 3000 nurses, who cost £20.19 million to recruit, could be effected by the new rules. They also suggest that the numbers could more than double by the end of the decade, which could result in nearly £40 million wasted in recruitment costs. READ MORE:

tinyurl.com/q38noaw

General Practice Extraction Service ‘unlikely’ to deliver, says NAO The General Practice Extraction Service (GPES), an IT system designed to improve quality and planning in the NHS, has been criticised for running over budget and behind schedule. A National Audit Office (NAO) report found costs rise from £14 million to £40 million during the planning and procurement stage. The GPES was due to start work in 2010, but delays meant the first data extract did not take place until 2014. The NAO report claims design and development failuresmean the system is unlikely to READ MORE: deliver what it tinyurl.com/nr6a2q3 was set up for.

Volume 15.4 | HEALTH BUSINESS MAGAZINE

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LEADERSHIP TRAINING

Leadership

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

What does good health leadership look like?

The NHS Leadership Academy is committed to developing outstanding leadership in health to improve patient safety, outcomes and experience of care. The strong relationship between leadership capability and organisational performance is well demonstrated in the evidence. Mike Chitty, head of customer relations and learning at NHS Leadership Academy, said: “The definition of leadership that we are working most actively on is that leadership is ‘the act of expressing oneself fully to develop the action of a system and enabling others

Written by The NHS Leadership Academy

In order for a hospital to work at its best, there must be a strong relationship between leadership capability and organisational performance. So what does an effective leader in healthcare look like? The NHS Leadership Academy reports

If leadersople pe are the rely on who weene wisely v to inter tion of these c motivating and engaging in the a ms then we followers and working syste eryone to across organisations systems to deliver need ev leader theandtransformational be a

to do the same.” We are already fully aware that the NHS requires exceptional leadership and even though there are already many fine leaders across the NHS, we need to support them and the new generation to be at their very best. Our Healthcare Leadership Model supports people at every level to become a better leader. Effective leaders need to work with and through others to achieve their objectives,

improvements on which the health care system of the future depends. At an organisational level we support all NHS Trusts and Foundation Trusts, across all healthcare sectors in meeting their challenges. We pay attention both to operational excellence for today and E

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LEADERSHIP TRAINING  planning for a viable future. We work with Clinical Commissioning Groups, Health and Wellbeing Boards and those operating at local, regional and national level on whole systems work. We also work closely with colleagues in social care to develop a shared leadership approach throughout the system. BOARD DEVELOPMENT Our Healthy NHS Board – Principles for Good Governance, serves as a cornerstone for board development. It outlines the importance of staff and patient engagement, of openness, honesty and transparency, and of a ‘good organisational climate’ in trust Boards if sustainable, high performing organisations are to be achieved. Karen Lynas, NHS Leadership Academy deputy managing director, said: “We recognise the crucial importance of effective, engaged, inclusive and accountable board leadership and are therefore very pleased to have commissioned this refreshed edition of the Healthy NHS Board.” Good leadership leads to good organisational climates which through improved staff engagement, satisfaction and loyalty, lead to sustainable, high performing services. Our guide has been enormously enriched by the insights of experienced, thoughtful leaders of NHS, regulatory and patient advocacy organisations who have generously responded to our call to contribute their time and wisdom. BIRMINGHAM CHILDREN’S HOSPITAL One organisation that applied the good governance principles to their work culture is the Birmingham Children’s Hospital (BCH), which has made great strides in their performance in the last six years. Sarah-Jane Marsh, chief executive at Birmingham Children’s Hospital NHS Foundation Trust said: “It’s more about getting under the skin of the organisation and listening to people and asking what makes them happy or sad about their work, and trying to use leadership tools to turn this into a strategy and objectives that are a part of everything.” BCH has improved considerably, developing an enviable reputation for the quality of patient care, leadership and governance and for its commitment to patient and staff engagement. Members of staff now see BCH as a good place to work and the patient feedback is positive. THE IMPACT OF LEADERSHIP At an individual and organisation level the NHS Leadership Academy delivers high quality programmes. Our participants constantly tell us that the quality of leadership development has had a unique and life changing impact. To date over 30,000 people have graduated from our programmes with enhanced skills, self-awareness, performance improvement and impact, to the benefit

Leadership

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Effective leaders need to work with and through others to achieve their objectives, motivating and engaging followers and working across organisations and systems to deliver the transformational improvements on which the health care system of the future depends of our patients and communities. It is essential that we demonstrate the impact of our programmes. Our Nye Bevan programme for newly appointed directors or those who aspire to get there in the next two years is a serious commitment for both the individual and their organisation, timewise and financially. However, the value of the programme to organisations far outweighs the in-year investment – our participants testify to the impact it has had on them, their teams and the patients they serve. One participant mentioned that: “In the last six months I have engaged more with patients than over the previous ten years.” Our leadership development programmes are based on action learning, working with the real problems we face in the NHS and making a difference on the frontline. A Nye Bevan participant commented: “I got involved in a national piece of work on a management accountability framework on workforce KPIs. I did that with five HR directors across the country for NHS Employers. They have asked me back in July to speak on efficiency programmes. The proposals hope to save a few million pounds – it saved £200k in our Trust alone. We are hoping to see if that can be replicated.” Catherine Randell, senior operating officer at East Lancashire Clinical Commissioning Group said: “Nye Bevan gave me the confidence, selfbelief, leadership skills and courage to proceed without always seeking permission. Effective leadership is doing the right thing for patients and public. It is being an NHS ambassador for the delivery of high quality safe compassionate care and by leading by example such as delivering care with a smile, patience, empathy, understanding and awareness, to service users, carers and staff.” COMPASSION CHAMPIONS Catherine says that Nye Bevan provided her with the training, and the confidence to lead the Compassion Champions initiative. Utilising innovation and creativity with the resources available, she developed the concept of local Compassion Champions with the aim of supporting and sustaining the delivery of high quality compassionate care across our provider organisations. The role of the Compassion Champions is to be an ambassador for the delivery of compassionate care within their own organisation Catherine said: “Our patients are our

first priority and they should continue to receive effective care from caring, compassionate and committed staff irrespective of the care setting.” Shahana Ramsden, Senior Co-production Lead at Co4CC and NHS England, said: “As a leader my greatest strength is my ability to nurture the talents of team members, to develop a sense of involvement and ownership of a shared goal – creating a group of empowered and committed staff. I came across the concept of ‘servant leadership’ and was reassured to discover that there is a philosophy and theory behind my preferred leadership approach. It is valuable when enabling co-production with people who use services and patients. My work in the NHS is influenced by my personal experiences and how I was treated with kindness and dignity in a hospital when my second son was stillborn. “These experiences always remind me that we will know we have great leadership when each member of staff feels empowered to make every individual patient feel like they are the most important person in the room. Doing Nye Bevan reminded me why I came into the NHS and why I do my job. So from my learnings, the hardest, but most valuable aspect of leadership has been to give up power and visibility and empower others knowing that ultimately this will lead to a more sustainable and patient-centred NHS.” MOVING FORWARD The evidence of our programmes and our place in the health and social care is clear from what our participants have achieved and how they are leading towards a better future which offers high quality service and compassion in the NHS. Mike Chitty said: “So leadership is the social process that allows people to do their best work and collectively in the maintenance and development of health improving systems. If leaders are the people who we rely on to intervene wisely in the action of these systems then we need everyone to be a leader.” Meanwhile as an organisation we will continue moving forward with the knowledge that we are on the right track as the work we are doing is having a fantastic impact on people in the system and ultimately, our patients. L FURTHER INFORMATION www.leadershipacademy.nhs.uk

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PROCUREMENT

Can the contradictions in NHS procurement ever be addressed?

Procure4 looks at ways the NHS can deliver sustainable savings through recruitment How can it be that one of the largest healthcare organisations in the world is regularly accused of having poor prices for basic items? Why can’t it consolidate and leverage its buying power? Surely, given the pressure on budgets, there must be an opportunity to agree on the ‘NHS specification’; particularly for nonclinical items? Why do they have so many solutions for the same item or service from Trust to Trust? What is going on? CHALLENGES Well of course, scale does not always bring opportunity. Similar challenges exist in major private organisations, where different functions or directors have their personal preference for suppliers and specifications. So the challenge of aligning key stakeholders behind a single sourcing strategy is a perennial problem for procurement professionals everywhere. However in the NHS this is further exasperated by public sector processes, European rules and regulations, political ‘pressure’ and of course the ability to actually implement new initiatives. So the NHS procurement professional is really up against it, trying to satisfy multiple directives, whilst following painstaking process that often erodes their ability to unlock the true value of that famous scale and brand. GOOD NEWS There is however some significant good news amongst all the bad press. Recently, the growing supply chain management business, Procure4, was able to benchmark prices across the biggest healthcare buying group in the US, the NHS and a couple of the UK’s largest private healthcare companies. The results suggested that whilst not one organisation was stand-out across all categories, the NHS scored well in clinical areas including pharma, clinical waste and sutures by way of example. However in other areas the news was less flattering; consumables, transport and agency staff were seen to have inconsistent requirements, with multiple specifications and a resultant spectrum of less-competitive pricing. On the back of this insight, Procure4 was engaged to review costs and deliver savings for an NHS Foundation Trust across a number

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of non-clinical spend areas. Engaging stakeholders and suppliers alike using a tried and tested approach, Procure4 was able to deliver savings of over 20 percent, but what was telling about the engagement was the sheer diversity of results. Success was greatest where stakeholders were committed to change and executive mandate was strong. In these cases savings of such a scale were frequently achievable. Unfortunately where mandate was absent, stakeholders were able to delay decisions and side-step involvement in commercial processes. Subsequent engagements by Procure4 seem to re-affirm this endemic issue of operational “silos” which allow key individuals to detach themselves and their teams from the organisation’s commercial imperatives. Perhaps this may be as a result of overstretched managers being unable to escape their day-to- day pressures due to capacity or potentially capability issues. It is believed that high performing Trusts are addressing this through the recruitment of forward-thinking procurement managers backed by executive mandate, and in the short term supported by expert external assistance as and when a radical catalyst for change is required. FUTURE SAVINGS Taking Procure4’s benchmarking as a barometer for future savings, there remains significant opportunity in non-emotive spend categories alone for the organisation to save money. If over £1.5m can be saved in one Trust alone from a basket of only £10m spend, then Lord Carter’s assertion that a further £5bn could be saved across the whole NHS seems eminently achievable, if not understated. Admittedly this does not resolve the broader and longer term structural needs of the NHS as suggested by Simon Stevens, NHS England Chief Executive, but if this is indicative of opportunities that can be unlocked through better procurement alone, then it is a quick win that cannot be ignored. SO WHAT IS THE ANSWER? Stronger directives from the centre? A more commercial approach to the supplier selection process? Giving procurement more power in supplier selection, particularly in non- clinical

areas? Whatever the answer, it is clear that failing to operate as “One Team” and allowing the continuance of a siloed approach will not support the NHS’s aspirations for a brighter future. Clearly this approach is predicated by the need for highly capable and credible commercial managers guiding the process and challenging budget holders from a position of knowledge. Unfortunately too many procurement managers are engulfed in day to day process and administration to identify with this imperative. It is therefore down to CEOs and CFOs to identify ways to support them, both in the short term with capacity and the longer term through investment in capability development. All in all the future looks bright (if not challenging) as a procurement professional within the NHS. They will be seen as a catalyst for change and a source of funding to support front line services under pressure. However, they cannot do this alone and require support now if they are to live up to the NHS vision of “Better Procurement, Better Value, Better Care.” L FURTHER INFORMATION Contact Chris Mullen, client solutions director at Procure4, if you would like to share your views or discuss how Procure4 can help you deliver sustainable savings through procurement to your organisation: E-mail chris.mullen@procure4. com; telephone 0845 1300 161.


Procurement

Making sure every penny is spent well

Written by David Pierpoint, Customer Engagement Managing Director, NHS Supply Chain

PURCHASING

Streamlining the purchasing of basics and involving clinical staff in decision making all add up to a more efficient and cost-effective way of buying, writes David Pierpoint of the NHS Supply Chain It’s no secret that the health service is under huge financial pressure. With the King’s Fund predicting an end of year deficit of more than £800 million for NHS trusts and foundation trusts – if the NHS was a patient it would not have a healthy outlook. Often overlooked, procurement is an area that commands high spend and still has huge savings potential. As Jeremy Hunt, Secretary of State for Health, said last November in a speech to the King’s Fund: “The NHS spends almost £15 billion each year on medical equipment, devices, office supplies and facilities.” With this scale of spend this is an area where solutions have to be put in place to reduce cost. The Department of Health Procurement Efficiency Programme, led by Lord Patrick Carter, aims to do just that by delivering savings of at least £1.5 billion from the NHS procurement budget next year.

Carter’s Hospital productivity report, which was released in June, talks of the scope of savings that can be made with a better approach to purchasing. The report, which focused on 22 hospitals, found that the NHS could save up to £5 billion every year by 2020 by making better use of staff, using medicines more effectively and getting better value from the huge number of products it buys.

standards of care while reducing costs. NHS Supply Chain is working hard to help trusts maximise their procurement budgets. As David Pierpoint, managing director of customer engagement at NHS Supply Chain explains: “We are committed to reducing our pricing on clinical consumables by 10 per cent and are on track to deliver £150 million of cash releasing savings by March 2016.” These are not small numbers and every trust can have a role in attaining savings and plugging the deficit gap. David Pierpoint continues: “With over £81 million of these savings delivered, E

There r e has nev tter e b been a look at time to rses are what nud find those an buying rtunities to oppo money save

SPENDING PENNIES WISELY Jeremy Hunt is calling on the NHS to ensure every penny is spent in the most effective way for patients to improve

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PURCHASING  our journey doesn’t end here. NHS Supply Chain has with the Department of Health written to all our suppliers to notify them that we will not be accepting price increases and will continue to identify ways in which we can generate savings. But we have to work together to deliver this.” To support the delivery of savings NHS Supply Chain is working closely with procurement and clinical teams in NHS trusts to identify where and how savings can be made. David concludes: “This approach will only work if trusts contribute towards this.” CLINICAL INVOLVEMENT NHS Supply Chain’s ‘Small changes big differences’ campaign jointly run with the Royal College of Nursing (RCN) and the Clinical Procurement Specialist network has highlighted the importance of engaging clinical staff in the procurement process. Dr Peter Carter, chief executive and general secretary of the RCN says: “Procurement is an issue often raised by nurses who are appalled by the waste and inefficiency they sometimes witness. We estimate that nurses working together with procurement managers could save more than £30m per annum – the equivalent of 1,000 nursing jobs – just by streamlining the purchasing of basics such as wipes and incontinence products.” INVOLVING NURSES A recent Nursing Times survey of over 850 nurses showed a real desire from nursing staff to get involved in procurement with over 80 per cent of respondents recognising the scope to save money in their trust. A further 86 per cent believe that patient safety would be improved if nurses had greater involvement in purchasing. And the study went further with 54 per cent of nurses identifying areas where savings could be made by changing the clinical products used - the top five products being: Dressings (75 per cent), Gloves (65 per cent), Disposable Wipes (64 per cent), Incontinence Products (53 per cent) an Syringes (48 per cent). Mandie Sunderland, member of the NHS Supply Chain Customer Board and director of nursing and midwifery at Nottingham University Hospitals NHS Trust played a key role in the campaign focusing on increased patient safety as well as more cost-effective treatment. Mandie said: “There has never been a better time to look at what nurses are buying and find those opportunities to save money, which will at the same time help protect patient safety and reduce the amount of waste in medical products. As the individuals at the heart of this process, we as nurses are in the best possible position to influence it.” The NHS Core List and Compare and Save are two programmes with clinical engagement which enable trusts to make substantial savings. COMPARE AND SAVE In April, NHS Supply Chain re-launched their Compare and Save programme.

Following customer feedback NHS Supply Chain has concentrated on four key areas for 2015 where by moving to comparable lower cost products, or making efficiencies to the way trusts currently buy the products, trusts can make significant savings. The four areas are: dressings and wound care, haemostats, paper, ink and toners and wipes. The key part of this programme is its personalised approach. Trusts can have data on these four key areas that details their story and its realistic potential to drive efficiencies and savings. All the products have been reviewed by the Clinical Procurement Specialists Network and could offer substantial national savings to the NHS. Since NHS Supply Chain first introduced the Compare and Save programme back in 2013 they have supported trusts to save £7,968,822 and in the first quarter of 2015, NHS trusts saved £1,727,961. Over 200 trusts have already taken advantage of this programme and are seeing savings. Of course procurement changes not only bring monetary advantages, they

Procurement

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

pharmacy, procurement and NHS Supply Chain. The proposal was for a centralised scheme for community nurses, GP practices and nursing homes and 90 per cent of products were taken off prescription. Alison Hopkins said: “Having a new scheme that changes the system means that some patients become visible.” It’s been very good to develop this scheme but it can’t just happen. Primarily it has to be a process that everyone buys into and that’s about an attitude change, it’s not just about procurement. We’ve never had to go cheap and cheerful you just have to have a better system and you have to have a system that supports clinicians to make good clinical decisions. There are two bottom lines for me: one is that the patients have been found [and are visible], and secondly that we’ve been able to demonstrate savings of £600,000 over the last five years.” THE NHS CORE LIST The Core List, developed by the Department of Health in partnership with NHS Supply

The £81m cash releasing savings fund for the NHS, could fund 2,400 band 6 nurses; 535,700 outpatient attendances; 740,000 A&E attendances; and 333,000 overnight stays in hospital can also address safety concerns too. Enabling the standardisation of product ranges that support clinicians and nurses to provide the appropriate level of care in each setting involves prioritising safety and being cost effective. CASE STUDY As part of the recently launched ‘small changes, big differences’ campaign NHS Supply Chain recently worked with Alison Hopkins, chief executive of Accelerate CIC to revisit her key learnings from the project to put in place an off-prescription community dressings solution, and to learn more about how, two years on, they are still working to 2010 budgets. In 2009 Alison Hopkins, who was at the time lead nurse for the Wound and Lymphoedema Service, was well aware of the difficulties of the prescription route for dressings. The key challenge was the delays which are part of the prescription route – leading to frustrated clinicians and poor patient care, and wasted dressings piling up in patients’ homes. There was no standard practice across the area as prescriptions were written based on a wide choice of dressings. A business case was developed which outlined a new off prescription route for dressings and it was presented to Practice Based Commissioning to be evaluated for budget allocation. A project team was put together including representatives from key stakeholder groups, commissioning

Chain, aims to achieve best value by reducing the range of like-for-like products that the NHS purchases. This allows the NHS to commit to larger volumes of a smaller range of products which in turn allows suppliers to provide improved prices to the NHS as greater economies of scale in manufacturing can be achieved. Greater competition on price is also being created, as only products that achieve the best value are included in the Core List. For procurement professionals it provides the most straight-forward option for driving out costs when purchasing everyday hospital goods and services, to potentially make more money available for frontline services. All the products have been reviewed by the Clinical Procurement Specialists Network and could offer substantial national savings to the NHS. Following the successful introduction of NHS Supply Chain’s Desk Top Stationery Core Range, which has delivered savings of £432,000 for trusts in its first two months, significant savings opportunities have now been generated on examination gloves (save up to 23 per cent), patient dry wipes (save up to 16 per cent) and underpads (save up to 10 per cent). The £81m cash releasing savings fund for the NHS, could fund 2,400 band 6 nurses; 535,700 outpatient attendances; 740,000 A&E attendances; and 333,000 overnight stays in hospital. L FURTHER INFORMATION www.supplychain.nhs.uk/savings

Volume 15.4 | HEALTH BUSINESS MAGAZINE

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NHS ELECTRICITY USE

Energy

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Decarbonising electricity use in the NHS Estate

In 2012, the NHS carbon footprint represented 40 per cent of public sector emissions. Building energy use accounts for 17 per cent of this figure, with a cost of £636M. Of this, electricity accounts for slightly more than 50 per cent of the emissions, which continue to rise whilst fossil fuel use is falling. Overall the building emissions trend is downwards. The decline in fossil energy emissions is indicative of better insulated, more airtight buildings with heating plant that has a higher seasonal efficiency and less steam use. Electricity use reductions have been achieved through more efficient: motors, mechanical ventilation and cooling systems and lighting. But electrical savings have been offset by an increase in medical and IT equipment, and increased patient numbers indicating that decarbonising electrical consumption is essential to achieve further significant carbon emissions from the NHS Estate. Analysis undertaken for DoH a few years ago by BRE, indicated that the emissions of average existing hospitals was 145KgCO2/m2

Written by Chris Hall , BRE

Analysis undertaken for Department of Health a few years ago by BRE indicated that the emissions of average existing hospitals could potentially be reduced by 25 per cent if all good and best practice energy measures were applied, writes Chris Hall, BRE’s health sector lead

g Reduciny essential part of energ on this process. pti Effective metering consum es a essential: If r i requ of good isyoualsocan’t measure ion t a it you can’t manage n i d b com keeping an it. Identifying house ive energy and delivering savings requires effect gement energy consumption mana to be measured.

and that potentially this could be deduced to 110KgCO2/m2 if all good and best practice energy measures were applied; a potential saving of almost 25 per cent. Other analysis we undertook of smaller non-acute buildings, where the level of energy management tends to be lower, suggested that potential here for savings could average 35 per cent. This analysis did not include opportunities through low and zero carbon technologies.

REDUCING CONSUMPTION So how can these savings be achieved? Reducing energy consumption requires a combination of good housekeeping, effective energy management of existing systems, investing in newer more efficient technologies and using low/zero carbon energy sources. Getting a better understanding of the performance of your buildings through measurement, surveys or modeling is an

An effective automated meter reading system will provide graphical outputs on systems, departments and individual items of plant to identify where energy is being used to enable consumption to be compared with benchmarks to help identify saving opportunities and to provide information to underpin business cases for investment.

FEASIBILITY STUDIES Technical energy surveys/feasibility studies are essential to identify savings and provide fact based information for the business cases. E

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NHS ELECTRICITY USE

The price of PVs has fallen rapidly in recent years – current prices are around one sixth compared with 2008. So, despite that fact that the Feed in Tariffs for new systems is decreasing, the return on investment is around 10-15 per cent, even for small systems

 These make use of experts to review elements in your estate to identify and quantify viable carbon/ energy saving opportunities. LIGHTING Lighting accounts for around 20 per cent of the estate emissions and often provides significant opportunities for cost effective savings. There have been significant gains in lighting efficiency particularly though LED. 3 W/m2 /100 lumens is a reasonable design target and 60 luminaire Lumens/circuit Watt this is half the figure that would have been used 10 years ago. In my experience there are opportunities for improvement in lighting systems even in many new hospitals. COMBINED HEAT AND POWER (CHP) Potentially CHP can deliver significant CO2 savings. BRE reviewed the performance of CHP in the NHS, for the SDU, our findings were: Some CHP plant was running at < 65 per cent efficiency which delivered no CO2 benefits. Most CHP plant were running at around 72 per cent efficiency delivered CO2 savings of around four per cent. The best six per cent of all CHPs in the NHS were achieving sessional efficiencies of 78 per cent delivering CO2 saving of around eight per cent. This illustrates the need for CHP plant to be correctly sized and well maintained to maximise carbon savings. As a revenue earning device CHP plant must also run for long hours typically more than 4500hrs/a to be cost effective.

PHOTOVOLTAICS I estimate that the NHS has around five million m2 of roof area suitable for Photovoltaics (PVs). This potentially could generate around 630,000 MWh/a offsetting over 0.3MTCO2 and around £70m worth of grid based electricity with a cost benefit of £108m/a with current Feed in Tariffs(FiT). The price of PVs has fallen rapidly in recent years – current prices are around one sixth compared with 2008. So, despite that fact that the FiT for new systems is decreasing, the return on investment is around 10-15 per cent, even for small systems. For systems of up to 5mW it is still possible to claim FiT. The FiT is a set rate that is linked to inflation and guaranteed by the government for 20 years. The rate applicable to each system will depend on its size and the energy efficiency rating of the property it is connected to. The UK’s Solar Trade Association has calculated that solar power electricity will be cheaper than that bought from the grid by 2018-2020, when measured over the system lifetime; typically 30 years. With low cost finance available, this means that the perceptions of capital cost barriers are simply no longer valid. This represents a huge sea change in the way solar should be viewed. Now is the time to invest as the government is now encouraging the installation of PVon large roofs, so this could be good news for the NHS. There is also currently a review of planning policy too, which means there may no longer be a requirement to apply for planning permission for any rooftop schemes up to 1MW (6,800m2 of slopped roof).

Energy

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PV CODE OF PRACTICE Over the last two years BRE has worked with the Institute of Engineering and Technology to develop a new Code of Practice for Grid Connected Solar PV Systems above 50kW to provide system owners and operators assurances of safety and performance of systems at design stage and at the point of commissioning. With both construction and solar industries the BRE National Solar Centre is also in the process ofxsetting up a certification scheme to introduce third party validation to improve the quality of PV installed in the UK. The next important thing on the horizon for solar power is the integration of PV products into building structures, thus providing architects with the possibility of new aesthetically pleasing designs and materials with which to create attractive buildings. It is expected that in the future this approach will be the norm, rather than the exception. As well as providing a national focus for PV the BRE National Solar Centre (http://www.bre.co.uk/nsc) provides training and technical consultancy to assist clients looking to get involved with solar, from initial site scoping, through full feasibility studies, up to system specification, technical due diligence and performance monitoring. Steve Pester, of the BRE National Solar Centre, will be presenting on PVs at the Health Estates conference in October. L FURTHER INFORMATION www.bre.co.uk

About the author

Chris Hall AMIMechE, is BRE’s health sector lead. Chris has over 25 years’ experience in engineering, design, construction, training and policy, much of this helping NHS Estates professionals to improve healthcare buildings’ energy and environmental performance. He was also the author of HTM 07-02 Encode – making energy work in healthcare (2006) and contributed to its 2015 update.

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MOBILE TECHNOLOGY

Commissioning data sets why should you outsource? Providing the health sector with innovative technologies, from market-leading clinical management systems to health analytics tools – combined with unrivalled customer support Whether clinical work is carried out in a fixed location or by a mobile health worker, the payment for their work requires the capture and verification of clinical and demographic data before it is submitted to the appropriate funding agency. The Secondary Uses Service (SUS) is a comprehensive data warehouse focused on collecting data to inform planning, commissioning services, payment by results and supporting policies designed to improve public health. Care providers submit Commissioning Data Sets (CDS) to the SUS to secure payment for their services. Delays, errors or omissions in their submission can have a severe adverse impact on an organisation’s revenue and cash flow. So getting the information right and delivered on time is a priority for each organisation’s finance team. Providing internal resource for CDS submission and validation requires capital investment and the application of skilled resource. Two priorities for all CDS submissions are the validation and prompt notification of errors within the submission of data. Errors are not uncommon when collating clinical codes on a large scale and sometimes across multiple static sites and mobile care providers; however the speedy resolution of errors is vital if the care provider wishes to avoid missing their deadline for CDS submission. Serving over 117 care providers around the UK, the EMIS Health Messaging suite has been developed to work across care settings. The company works closely with the Health and Social Care Information Centre (HSCIC), and has become the first supplier to be HSCIC accredited for each new set of CDS (currently version 6.2). MECHANISM OPTIONS Suitable for any NHS organisation and the smaller Any Qualified Providers, EMIS Health offers two different mechanisms for the submission of CDS to the SUS. Care providers who wish to manage their own CDS translation and submission in-house, may purchase Keystone. EMIS Health’s messaging solution, Keystone, enables healthcare organisations to provide the correct information, at the right time, to the appropriate NHS standards bodies. It provides a robust mechanism to manage data flows between hospitals, CCGs, GPs, community care and the SUS. Alternatively, care providers may wish to outsource their CDS submissions to the EMIS Health CDS Translation Service where the

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HEALTH BUSINESS MAGAZINE | Volume 15.4

data is validated, translated and submitted to the SUS on their behalf. A CDS Translation Service with a low annual subscription fee, helps care providers focus resource on their core objectives by outsourcing the validation and submission components of this task. Mark Simms, Deputy Information Manager at Wirral University Teaching Hospital NHS Foundation Trust, said: “It was clear that we were dealing with an efficient, professional company who had great experience.” EMIS Health’s CDS Translation Service offers a professional service and peace of mind. Their record in customer support is highly respected and they provide professional feedback to HSCIC as each new version of CDS is drafted and tested. Ryan Eustice, Systems Administrator for Royal Cornwall Hospitals NHS Trust, said: “EMIS Health’s CDS team set a benchmark for others to meet when it comes to customer support and service.” Moving to EMIS Health for your CDS submission couldn’t be easier. The EMIS Health CDS team will handle any move from your existing CDS transmission solution, handling all interactions with the SUS and HSCIC, including registering your ODS code and EDI Address on your behalf.

data submissions are encrypted and secure and implementation can be completed within three weeks. EMIS Health is a Prince 2 qualified staged project management. Another benefit is that all CDS types and submissions protocols (Net Change and/or Bulk Update) are supported. They provide data validation expertise - with errors being reported in plain English. There is a quick turnaround of data, with data usually processed and sent within two hours, and inhouse staff can be re-utilised for other projects. Keystone also has many features and benefits. It can quickly retrieve messages from many departments and submit all message types such as CDS v6.2. There is an easy translation of messages, and it can quickly identify errors users are alerted by automated email. Keystone receives real-time test messages whilst live messaging continues, and is recognisably scalable and flexible - allowing you to submit unlimited volumes of messages. It improves data quality and tests quality of messages before sending. This in turn reduces errors. Additionally, Keystone meets national standards – working closely with HSCIC.It also improve efficiencies with automatic test checking and submission. L

FEATURES AND BENEFITS There is no capital purchase necessary, free upgrades, no hidden charges. Additionally,

FURTHER INFORMATION secondarycare@emishealth.com www.emishealth.com


TECHNOLOGY INVESTMENT

Mobile technology for data-empowered staff Mobile initiatives can deliver higher quality care at lower costs for the NHS, which encourages quicker and more engaged relationships with patients. Health Business analyses the importance of the technology as well as the latest news from the Integrated Digital Care Fund and Nursing Technology Fund

Following the continuous increase in the use of mobile technology – smartphones, tablets and apps – the importance of mobile technology has never been more important. Speaking at the e-Health Week in March, Secretary of State for Health Jeremy Hunt reinstated that government spend on technology funding has not been cut, more that it would be victim to a ‘staged rollout’. Claims had been made that only £43 million of the initial £240 million originally promised in the technology fund would be allocated to the successful applicants. When the fund was first announced, NHS England said that the £240m would be split over three years, with two-thirds of the money (£160m) being available in 2014/15 and the final third (£80m) being available in 2015/16. Now the split will be of £20m and £23m respectively. However, Hunt insisted that IT and technology remained vital components of the NHS. This is clear in practice, as doctors and practitioners are now being equipped with the technologies that enable them to access instant services and the important information required to deliver immediate care, no matter where they are. This is particularly evident for community health where practitioners work within patients homes rather than hospitals. This level of immediate care has a knock‑on effect on the overall level of care that the

Mobile Technology

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

one contact between practitioner and patient. However, despite initial unease, mobile technology can be proven to provide productivity gains and improve workflow – thus promoting interaction. But how is digital technology funding being accessed and encouraged? THE INTEGRATED DIGITAL CARE FUND Jeremy Hunt and NHS England Medical Director Professor Sir Bruce Keogh launched the Safer Hospitals, Safer Wards Technology Fund in May 2013 to support NHS providers in moving from paper-based systems for patient notes and prescriptions to integrated electronic care records along with the development of e-prescribing and e-referral systems. To reflect the key priority of enabling information flow across care settings, the fund has now been renamed the Integrated Digital Care fund. NHS England is responsible for the delivery, administration and governance of the fund to facilitate the widespread adoption of modern, safe standards of electronic record-keeping. Digital systems have the potential to benefit patients and clinicians by enabling safer, more joined up care through the sharing of comprehensive clinical information. This can lead to reduced prescription errors, improve clinical decision-making and support patients to interact with their own health record. The Safer Hospitals, Safer Wards Technology Fund was open to NHS Trusts to support the rapid progression from paper-based clinical record-keeping to integrated digital care records (IDCRs). The initial wave approved 213 projects from digital clinical records to electronic prescribing and medicines management totalling over £195m. Applications for the Integrated Digital Care Fund closed on 14 July 2014. In total, 226 applications were received and 47 organisations have been awarded funding totalling over £44 million. In the second round, integrated digital records remained a priority but with an emphasis on supporting information flows across organisational boundaries. Consequently, the eligibility criteria was widened to include local authorities. E

are Healthcers provid ountry he c across t nefit from will be this year to lion £78 mil in technology invest ntegrated for i l care digita s record

NHS can offer. Being able to use the right equipment in the right way enables quick care and better decision making. Additionally, using a mobile app to capture information once and then make it consistently available can vastly improve their experience of healthcare. The key is ensuring that all staff are trained thoroughly, not necessarily quickly. In recent weeks, BT spent a day at Humber NHS Foundation Trust to demonstrate how the day would operate before and after the use of mobile working. Healthcare staff were given access to real-time patient information while on the move without needing to return to the office to access records. Beverley Bryant, Director of Strategic Systems and Technology at NHS England, said: “We are committed to a digital strategy to help transform health services through technology and put patients in control of their care and welcome the latest investment in the Integrated Digital Care fund which will help to digitise and integrate patient information across health and social care, enabling safer, more joined up services.” One of the concerns that mobile technology proposes is the disintegration of one to

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TECHNOLOGY INVESTMENT  THE LATEST ROUND It was revealed in March how health and social care providers across the country will have access to £78 million this year to invest in technology and help them move from paperbased clinical records to integrated digital care records. If the cuts that Hunt dismissed turn out to be false then NHS Trusts and local authorities will use £43 million of Integrated Digital Care funding to put in place electronic information systems which make sharing information between care settings easier and ensure that patients only tell their story once. Approval has also been granted for the second tranche of the Nursing Technology Fund which makes £35 million available to Trusts, health charities and community health providers to spend on digital services that will support nurses, midwives and healthcare assistants in their work and help them release time to care. Adrian Byrne, Director of Information Management and Technology at University Hospital Southampton NHS Foundation Trust and successful applicant of the Integrated Digital Care Fund said: “We’re delighted to be the recipient of an award that will allow us to advance paperless working by implementing an electronic document management system. It will also greatly assist us in cutting down costs by moving out of an existing

shared library facility currently holding around one million patient records.” Awards have gone to a range of organisations including Marie Curie Cancer Care – awarded £1million for their Connected Nursing project to enable mobile access to digital care records, digital capture of clinical data at point-of-care; Milton Keynes Hospital NHS Foundation Trust – awarded £646,000 for their Paperless Nurse Observations project to allow nurses, midwives and care staff to capture vital signs and Early Warning Scores at the bedside in real-time; Devon Partnership NHS Trust – awarded £204,000 for their Video Consultations for Nursing Staff project to equip patients and develop proper therapeutic environments for remote consultations in a community mental health care setting. Speaking of the Nursing Technology Fund Jane Cummings, Chief Nursing Officer for England, added: “The Nursing Technology Fund has supported nurses, midwives and care staff to carry out valuable and innovative work, and will continue to empower staff to deliver safer, more effective and more efficient care.” CASE STUDY: UNIVERSITY HOSPITAL SOUTHAMPTON University Hospital Southampton has, over many years, developed the concept of a digital care record that is now used by all staff. It has become a core part of their everyday routine

and usage is standardised across the organisation – there are no separate disconnected ward-level systems. Integration within South West Hampshire means that shared case notes are used across the whole locality. This gives clinicians access to a complete view of patients’ information as and when they need it, helping to reduce unnecessary delays and improve decisionmaking. They also have single click-through context sensitive access to the wider Hampshire Health Record.

Mobile Technology

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CO-ORDINATE MY CARE The ‘Co-ordinate My Care’ scheme lets terminally ill patients in London define how and where their care is delivered. A single digital care record integrated across health and social care gives GPs, ambulance service, NHS 111, the local authority and social services access to these wishes as and when they need them. It has led to a sharp increase in the number of people ending their life in a place of their choosing, boosted patient satisfaction and reduced costs. Plans are underway to extend the scheme to other parts of the country and long-term conditions such as diabetes and mental illness. L FURTHER INFORMATION www.england.nhs.uk

WHY IS DIGITAL IMPORTANT IN HEALTHCARE? PATIENTS

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Volume 15.4 | HEALTH BUSINESS MAGAZINE

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SEVEN-DAY SERVICES

Patient Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Caring round the clock With evidence suggesting that patients face a higher risk of mortality in hospitals at weekends, the Conservative government has outlined plans for a seven-day NHS. But how will this work and what challenges will need to be overcome first? Health Business reports

In October 2013, NHS England’s national medical director Sir Bruce Keogh set out a plan to run NHS services seven days a week to improve the patient care at weekends and tackle the high death rates that occur on Saturdays and Sundays. This came following research from Imperial College London, which showed that patients were 16 per cent more likely to die if they were admitted to hospital on a Sunday and 11 per cent more likely to die if they were admitted on a Saturday. It also found that the risk of death within 30 days of a planned operation increased every day of the week after Monday. Re-visiting this agenda, David Cameron has taken on the seven-day plan as part of the Conservative’s healthcare plans. In his first major speech following the Tory election victory, he said: “While our hospitals are working hard Monday to Friday to get patients better, sometimes it can feel as though Saturdays and Sundays are more about just somehow getting through to Monday. Diseases don’t work weekdays 9 to 5. And neither can we. “When you have sat through a night in the hospital watching a loved one and praying for the morning; when you have spent a weekend longing for the week – you know

ing Deliver that an NHS quality igh offers h ven days a care se ill be down week whe staff to t g such n i r e v i l de care

just how important these changes are.” Whilst details of funding a seven-day NHS were not included in his speech, during its general election campaign the Conservatives pledged an £8 billion increase in spending on the NHS per year above inflation by 2020.

how this would be done, the Conservative’s general election campaign committed to recruiting 5,000 more GPs between now and 2020. What’s more, the government’s GP Access Fund is already underway, where GPs can bid for funds to facilitate extended opening hours.

HOW WILL IT BE ACHIEVED? Cameron’s speech was low on details and specifics of how a seven-day NHS would be implemented, but gave an assurance that it didn’t mean staff being overworked. He said: “This isn’t about NHS staff working 7 days a week. It’s about different shift patterns, so that our doctors and nurses are able to give that incredible care whenever it is needed. “It’s about key decision makers being around at the weekend; junior doctors being properly supported; and resources like scanners up and running wherever they are needed.” One of the major factors towards the plan is improving access to primary care. Cameron pledged that 18 million patients will have access to a GP at mornings, evenings and weekends by the end of this financial year during his speech. While he didn’t say

INDUSTRY FEEDBACK Whilst the seven-day NHS plan is admirable and welcomed by voters, NHS workers and others in the industry have voiced their concern, mainly about the sketchy details about how the plan will be implemented. Even more importantly, how it will be funded. Nigel Edwards from independent researchers the Nuffield Trust has warned that the £8bn will keep current services running, but little else. Staffing is a critical challenge. He said: “We have known for some years that there is a higher risk of mortality in our hospitals at weekends – this needs to be dealt with. Moving to a seven‑day service will help improve the flow of patients though hospital and the problems that result from the surge of demand on Mondays. Whether the E

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Patient Safety

 Government will provide the funding available to achieve this aspiration is a key question though – the extra £8bn it has pledged by the end of 2020/21 will be enough to keep existing services running but little else.” Highlighting the major and complex challenge such a plan involves, Nigel Edwards added: “The government should be under no illusions about the impact a seven-day NHS will have. It will mean significant changes to the way services are run across the country, and it will also require recruiting a critical mass of specialist staff. Making seven-day working a reality may also mean closures or mergers of local services, such as emergency surgery or maternity units. So, this will not only cost additional money beyond the £8bn but it will also require political bravery.” Meanwhile, Paul Briddock, director of policy at the Healthcare Financial Management Association (HFMA), has urged for clear guidance on how the money is to be spent. He said: “The government’s pledges are a step in the right direction. However, these plans will cost additional money in an already stretched system, therefore any extra funds committed should be coupled with guidance on how best to implement these fundamental changes to the way the NHS works at the moment. “Proposals such as seven-day services will need careful financial planning. However, despite having cost implications, the benefits of increased access to primary care provision should also lead to less unnecessary and expensive hospital admissions in the long run. “One immediate practical challenge is a shortage in the number of GPs available to deliver these changes and the need to increase both the intake of doctors coming in the system and training through the GP ranks.” PATIENT SAFETY At the start of the year, the British Medical Association (BMA) warned that the plan for a seven-day NHS was an “unfunded, undefined”

strategy that is “wholly unrealistic” because of existing staff and financial problems in the NHS. It said the plan could threaten patient safety due to the ambitious nature of the plans and lack of detail, which could lead to underfunding and unrealistic handling of demand. This could also lead to routine operations being cancelled on weekdays because of the pressure, it warned. In June, the BMA made a legal request for the government to clarify its seven-day strategy, but this was refused. Commenting on the refusal, BMA council chair Mark Porter said: “Doctors want the care we provide for sick patients to be of the same high standard, seven days a week. “Urgent action on this has been bedevilled by calls for the entire NHS

has already seen a three per cent cut in hospital visits and saved £425,000 in Central Manchester’s NHS area. The scheme will now be expanded so that everyone in need of medical help will get same-day access to a doctor, supported by diagnostic tests, seven days a week. The city will be taking control of its entire £6bn health and social care budget next April as part of the NHS’s devolution plans. RECRUITMENT IS KEY Delivering an NHS that offers high quality care seven days a week will be down to the staff delivering such care. Nigel Edwards concludes: “Getting the right workforce in place will be a critical challenge as the main driver will be

At the start of the year, the British Medical Association warned that the plan for a seven‑day NHS was an “unfunded, undefined” strategy that is “wholly unrealistic” because of existing staff and financial problems in the NHS to be delivered on a seven-day basis without any clear prioritisation. “The government should clearly define what it means when it uses the term ‘seven‑day service’ so that we know how much the additional services would cost, and how many extra doctors, nurses and other NHS staff would be needed to deliver them.” MANCHESTER LEADS THE WAY Greater Manchester is on its way to become the first big city to provide seven-day services. GP appointments, community services and diagnostic tests will be accessible for the local population by the end of the year. A trial of the scheme covering 500,000 patients across Greater Manchester

the need to recruit highly paid medical staff, as well as support staff. General practice in particular is very stretched and it takes time to recruit in extra capacity. In addition, the NHS currently pays a premium for weekend working so negotiations over terms and conditions for staff will need to be handled carefully.” Dr Nav Chana, chairman of the National Association of Primary Care, adds: “Any increase in the number of GPs must be accompanied by more sophisticated approaches to recruitment and retention, as well as a fundamental review of the model of care in which GPs operate.” L FURTHER INFORMATION Read David Cameron’s full speech at tinyurl.com/ma47xu5

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More than patient monitoring

The Patient Status Engine. This precision wireless patient monitoring platform, observes every heartbeat, every breath, continuous oxygen saturation, temperature and blood pressure allowing doctors and nurses to monitor patients better and more efficiently.

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EVENT

PREVIEW

Health and Care Innovation Expo 2015

Health and Care Innovation

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

World experts and UK health leaders head to Health and Care Innovation Expo 2015 Some of the world’s most renowned experts in healthcare are to explore how the NHS Five Year Forward View is being turned into reality. Dr Devi Shetty, India’s leading authority on cardiac treatment, and Dr David Agus, cancer specialist and international leader in genetic research, are just two of the star speakers who will address Health and Care Innovation Expo 2015 – which is hosted by NHS England and is the most significant health and care event of the year. They will be joined by Secretary of State for Health, the Rt Hon Jeremy Hunt MP, and by Minister for Life Sciences George Freeman MP. Jeroen Tas, CEO of Healthcare Informatics, Solutions and Services at technology giant Philips, who has more than 30 years of global experience as a healthcare entrepreneur, will also take to the stage. NHS England’s Chief Executive Simon Stevens, National Medical Director Sir Bruce Keogh, Chief Nursing Officer for England, Jane Cummings, and Tim Kelsey, National Director for Patients and Information will all make keynote speeches. CHALLENGES The event comes as the NHS focusses on how it can continue to deliver some of the finest services anywhere in the world while facing significant health, population and financial challenges. The Health Secretary Jeremy Hunt said: “I’m looking forward to talking directly to hard-working staff from all over the health sector, and seeing first-hand the great progress and groundbreaking innovations being made in the NHS.” Dr Devi Shetty, a world-leading cardiac surgeon and pioneer of “micro-insurance” systems for health in India, will tell Expo 15: “If a solution is not affordable, it is not a solution. It is pointless talking about great developments in heart surgery or cancer care if a common man cannot afford it. “The next big thing in healthcare is not going to be another magic pill or a fastest scanner or a new operation. The next big thing in healthcare is going to be Information Technology which will change everything that we do in healthcare.” Dr David Agus added: “I believe in what the NHS is doing: tackling disease head on through prevention. The conference, which emphasises the team approach between the NHS, patients and care givers is a paramount start to change health.

I hope this becomes a worldwide model. Many health systems and countries have shifted the debate only to health care finance, to the detriment of health.” The event’s provisional agenda demonstrates a sharp focus on where changes are taking place in the NHS, scrutiny of how new care models have already improved patient care, and understanding of where the next steps will happen. The timing of Expo 2015, held at Manchester Central on 2 and 3 September, is significant, coming just four months into

Other major zone areas will focus on Vanguard sites and other new models of care, Integrated Personal Commissioning and Diabetes Prevention Pilots. As well as the packed agenda over two major speaker stages the unique Pop-Up University will return to Expo 2015, with more than 100 interactive workshops focussing on a huge range of different innovations and improvements, and facilitated by national experts and leaders. Major themes this year are future models of delivery, commissioning for outcomes and leadership development. It all adds

Health and Care Innovation Expo 2015 comes as the NHS focusses on how it can continue to deliver some of the finest services anywhere in the world while facing significant health, population and financial challenges a new Government and just under a year after chief executive Simon Stevens and other key health partners set out their vision for the NHS in England. As such, Expo 2015 presents a unique opportunity for the NHS, its partners and patients, to share innovation, knowledge, best practice, experience, plans and goals for implementing change. Delegates will get an exclusive in-depth look at the developments in Greater Manchester as the region embarks on its ambitious health and care devolution project. There will be a two-day programme of learning, discussion and networking from the Greater Manchester reform team in their dedicated exhibition zone.

up to a melting pot of ideas, experiences and plans from across NHS and wider public, private and voluntary sectors. Expo 2015 will also feature the Kate Granger Compassionate Care Awards, with more than 90 nominees fighting it out for the prestigious prizes. FEATURE ZONES Its four major feature zones, each running their individual programmes of events, learning and networking, will dominate the exhibition space and focus on the biggest areas of growth and progress for health and social care improvement. 

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EVENT PREVIEW  Health and Care Devolution in Greater Manchester – an exclusive in-depth look at the exciting developments in Greater Manchester as the region embarks on its ambitious health and care devolution project. See the progress made and the work still to do, as the six‑month countdown to devolution begins. Digital Health – Digital technology is a key enabler of our ambitions for prevention-focused health and social care, integrated services and early identification of those at risk. Take a look at how digital innovation is being supported and try out some of the latest solutions. New Care Models – In March 2015, NHS England announced the first 29 “vanguard” areas that would be supported through the £200 million Transformation Fund to develop and implement innovative new models of care. The vanguards will develop local health and care services to keep people well, and bring home care, mental health and community nursing, GP services and hospitals together. Find out more about how their plans are progressing and what the future might look like in these areas. Diabetes Prevention Pilots – The NHS Diabetes Prevention Programme is a commitment of the NHS Five Year Forward View, and as part of the work to develop the national programme, seven innovative ‘demonstrator’ sites around the country have been running pilot projects in which they see more patients, monitor and test their local programmes and help to co-design and implement the national work. Find out about their progress and insights. POP-UP UNIVERSITY Everyone who registers as a delegate at Expo 2015 is also automatically enrolled in the unique pop-up university. More than 100 engaging, interactive seminars and workshops will be delivered by leaders and experts in their individual fields from all over the UK. You can now register for workshops, tailored to your own interests and learning needs. The most popular courses fill up very quickly, so register now to avoid disappointment! Log

Confirmed speakers in with your registration information to book your workshop places. Workshops include: FIREFIGHTERS AS A HEALTH ASSET Fire and Rescue Services carry out 670,000 home visits each year. Hear how commissioners and clinicians are working together with their local Fire and Rescue Service to protect and improve the health of the people they serve in particular older people, and how to begin to do this in your area. Led by Peter O’Reilly (County Fire Officer and Chief Executive Greater Manchester Fire and Rescue Service), Geoff Harris (Assistant County Fire Officer and Director of Prevention and Protection at Greater Manchester Fire and Rescue), Katie Walkin (Project Delivery Manager for Long Term Conditions (children & adults) at NHS England) and Helen Lyndon (Nurse Consultant for older people, Clinical Lead for Frailty Nursing Division at NHS England. GAINING INSIGHTS INTO PATIENT EXPERIENCE The NHS collects a wealth of information about patient experience. This workshop explores how NHS England has been using data from the National Patient Survey Programme to derive insights from this patient feedback and shares learning for NHS organisations to further develop understanding of their patients’ experiences. Led by Forrest Frankovitch (Head of Analysis at NHS England) and Helen Mercer (Economic Adviser at NHS England). Tears, pizza, teamwork, action – embedding children and young people’s participation in healthcare. Barnardo’s Partnership with North Bristol NHS Trust focusses on valuing views and experiences of CYP and their families. Researcher Louca-Mai Brady included this partnership as a case study in her PHD. We share findings and learning from this process and how health staff and CYP’s engagement in participation has changed. Led by Dawn Ravenhill (Professional Lead for Children’s Physiotherapy at North Bristol Trust), Emily Roberts (Barnardo’s Children’s Services Manager for Bristol and South Gloucestershire)

Simon Stevens, Chief Executive of NHS England Jeremy Hunt MP, Secretary of State for Health Professor Sir Bruce Keogh, NHS England’s Medical Director

Health and Care Innovation

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Jane Cummings, Chief Nursing Officer for England Tim Kelsey, National Director for Patients and Information Sir Malcolm Grant, Chair of NHS England’s board Lord Victor Adebowale, Non‑executive Director at NHS England and Chief Executive and company secretary of Turning Point Beverley Bryant, Director of Digital Technology for NHS England Dr Devi Shetty, Chairman of Narayana Group of Hospitals in India, paediatric cardiac surgeon and philanthropist Jeroen Tas, CEO, Healthcare Informatics Solutions and Services, Philips Dr David Agus, one of the world’s leading cancer doctors and pioneering biomedical researchers Mark Britnell, international healthcare policy expert George Freeman MP, Minister for Life Sciences Eric Low OBE, Chief Executive of Myeloma UK and Louca-Mai Brady (PhD Researcher from University of the West of England).  FURTHER INFORMATION To find out more or to register, visit www.england.nhs.uk/expo/

Precision patient monitor for the next generation With hospitals now busier than ever, demands for improved and more efficient patient monitoring have increased. Today the number of patients per nurse continues to grow due to ever increasing patient numbers and relatively fewer nurses, and healthcare organisations globally now need to focus on improving efficiency and better resource utilisation in order to enable them to maintain their level of service. Isansys Lifecare has developed the Patient Status Engine (PSE), an award-winning digital platform which will significantly improve patient monitoring and allow care providers to continuously and wirelessly capture, collect, interpret and securely store vital sign and other physiological data.

The patient’s care team can then use this real-time data continuum to proactively connect the patient with the right intervention at the right time, whether they are in hospital or in other care settings, including the home.

Incorporating unobtrusive body worn sensors, predictive algorithms and other analytical tools, the PSE provides a means for clinicians and nurses to provide pro‑active care for their patients, including paediatrics, and address the 1.2 million reported care incidents that last year cost the NHS £2.5 billion in additional bed days alone. Patients benefit through improved outcomes, shorter hospital stays and a new sense of security, freedom and comfort. FURTHER INFORMATION Tel: 01235 436225 www.isansys.com

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IFSEC International

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

EVENT REVIEW

Inspiration, innovation and industry excellence

IFSEC International, Europe’s largest security event, closed its doors this June after a jam-packed three days at London’s ExCeL, following three days of technology showcase and expertise A huge highlight for the show this year was the brand new Inspirational Speaker Series, which saw Baroness Karren Brady, Sir Ranulph Fiennes and Sir Chris Hoy take to the stage to deliver keynote speeches that were full of useful advice and thoughtprovoking anecdotes from their own illustrious careers. With a keynote headlining each day, each speaker addressed a packed theatre with many audience members given the opportunity to directly ask them questions in the short Q&A sessions that followed. Another new launch for IFSEC International in 2015 was the Benchmark Innovation Arena which welcomed over 40 finalists for the annual industry awards, each hosting a series of 10 minute pitches including the likes of Bosch Security, Vidicore, UTC Fire & Security and Secure Logiq, to name a few all gave a brief presentation about their shortlisted product and then opened the floor to questions. This exciting new format provided visitors to IFSEC International with a detailed look at these new innovations that are delivering a real benefit to end users, integrators and installers. LATEST TECHNOLOGY There was plenty more on offer for those interested in all the latest technology and gadgets, with the likes of NICE Systems demonstrating their patent-pending awardwinning Suspect Search software that uses the very latest advances in video analytics to not only locate a person within minutes across a large area, but also track how they got there. Safran showcased MorphoWave biometric system which is able to capture from one up to four fingerprints in a complete contactfree way, providing all identification details, the new device can be used to recognise up to ten thousand people, guaranteeing a consistent and high level of accuracy, to name a couple of interesting new products. There was also plenty of insight on offer from a host of expert speakers from across the security and fire industries. A keynote address from Futurologist Dr. Simon Moores attracted a large crowd when he presented on the Wednesday, his session on ‘Safe, Smart and Connected Cities’ looked at emerging trends and technologies and the impact of big data and the Internet of Things. Other speakers of interest included Paul Adams the Director of Strategic Marketing, EMEA at Alcatel Lucent

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Futurologist Dr. Simon Moores attracted a large crowd when he presented on the Wednesday, his session on ‘Safe, Smart and Connected Cities’ looked at emerging trends and technologies and the impact of big data and the Internet of Things hosted a session on ‘Transforming Public Safety with Smart Technologies and Secure Infrastructure’ as well as a presentation from Richard Berkley that explored how the 2011 riots changed the face of CCTV evidence. NEW LAUNCHES Additional highlights from across the show floor included a number of high profile launches from some of the biggest names in the industry, including ImmerVision with the world’s first 360-degree 6k lens, Avigilon’s new 7k high definition surveillance camera, Comelit’s ‘ground-breaking’ home automation range and SICK’s innovative

laser scanner, the LaserGuardian. Capita Technology Solutions launched its Capita CloudVision service, a new hosted video surveillance and analytics service using automated technology to simplify security management and intelligence gathering. These were just some of the new launches and products that were on display at the show this year, reiterating that IFSEC International is the home of security. Next year IFSEC International will return to ExCeL London from 21-23 June. L FURTHER INFORMATION www.ifsec.co.uk


LONE WORKERS

Security

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Protecting the wellbeing of hospital staff

Given the already pressured day-to-day environment hospital workers are asked to undertake duties in on a daily basis, personal security should be the least of their concern. Unfortunately trends show that physical assaults on such workers pose a very real and tangible threat. Hospital Security has been thrown into the forefront of public discussion recently, with a report from the Greater London Authority Conservatives (GLAC) indicating that a chilling 12,386 physical assaults have been reported on staff working in acute services such as hospital emergency departments, maternity wards and medical imaging units. PROTECTING LONE WORKERS Hospital personnel often fall into the category of ‘lone workers’, whether working the night shift, managing a ward alone due to stretched resources, or travelling within the wider community. According to the UK Health and Safety Executive, a lone worker is: “Someone who works by themselves or without close or direct supervision.” Figures from the BSIA

Written by Judith Denny, Brtish Security Industry Assocation

Hospitals can be an emotive place to work. Aggressions can flair, especially within A&E, from both patients and visitors. Judith Denny of the British Security Industry Association writes about staff protection, especially for those involved in lone working

Access control also e can softwar beneficially e integratCTV systems ACCESS CONTROL MEASURES with C an even Despite hospitals being e for v i rehens p a busy environment m o c more urity plan – often open 24 hours sec a day – it is important

suggest that “over six million people in the UK work either in isolation or without direct supervision, often in places or circumstances that put them at potential risk.” In accordance with the Health and Safety at work act (1974), employers should provide support through equipment and procedures to control the risks of working alone. A key suggestion from the GLAC report was that emergency services staff should wear body-worn cameras and panic buttons. According to the author of the report, Roger Evans such technology is essential: “Affordable wearable technology, such as wearable panic buttons and body worn cameras, will help bolster the security and protection of these essential workers.” As well as body-worn equipment, there are a number of measures hospitals can take to optimise security health, such as implementing effective access control measures and CCTV systems.

to monitor who is entering and leaving the hospital in an efficient and intelligent way. Access control provides the ability to control, monitor and restrict the movement of people or assets in, out and around a hospital. Mike Sussman, chairman of the BSIA’s Access Control Section, comments: “Having access control technology in place will not only deter criminals, but can physically prevent them from entering the site, whilst offering a versatile and cost-effective way to regulate entry to premises.” Despite the inherently busy and unpredictable nature of hospitals wherein members of the public often come and go freely, restricting access to specific areas is vitally important. Access control cards that use radio frequency identification (RFID) chips provide a convenient tool for proximity 

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Security

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

LONE WORKERS  reading of card details and the activation of gates, turnstiles and vehicle barriers. The system has a wide range of applications from controlling a single entrance door to a large integrated security network, and can prove invaluable when protecting restricted areas. Other identification devices, which can be used to identify users before granting access include; smart cards and readers; swipe cards and readers; PIN pads; and finally biometric equipment such as fingerprint and iris scanning. DOOR CONTROLLER SOFTWARE Door controller software is another important tool in an access control system. Such systems can be used to differentially grant access at specific times during the day to particular people. This is especially useful when areas shift from being ‘restricted’ to ‘open’ to the public – i.e. during visiting hours. There are several options when it comes to installing this technology including: a standalone door controller linked to a single door with no software; a number of door controllers all linked to a single PC to control one network; or a number of sites all interlinked together over a wide network area. In addition, systems such as Automatic Number Plate Recognition (ANPR) can prove valuable in limiting access and identifying unwanted intruders. ANPR monitors the entry of vehicles on-site using CCTV-style cameras and computer software which identify number plates. Some systems will also store photographs of the driver and vehicle for subsequent analysis. This can prove useful by drawing the attention of hospital security staff to suspicious individuals. Indeed often ANPR can enable the identification of returning criminals. CCTV SYSTEMS Access control software can also integrate beneficially with CCTV systems for an even more comprehensive security plan. One major benefit of this type of integration is pre and post-event video recordings initiated by the access control system. Video recordings can be linked with event information, which makes searching for a particular event on the recording much more efficient. For example, if an intruder has entered the building and attempted to breach an access controlled area by forcing a door, operators can search for ‘Door forced – laboratory 4’ allowing them to easily look at images of the intruder and react accordingly. One particular element of CCTV that is being increasingly employed in a number of sectors is that of Video Content Analysis (VCA). VCA is the name given to the automatic analysis of CCTV images, which is then used to create meaningful information regarding the content. For example, VCA can be used to automatically detect an intruder, or to count the number of people entering or leaving an area – beneficial, for instance, for keeping

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Despite the inherently busy and unpredictable nature of hospitals wherein members of the public often come and go freely, restricting access to specific areas is vitally important track of how many people have entered or left an emergency room during a given period of time. Another element of CCTV that can prove invaluable for the health sector is BS8418, the British Standard for remotely monitored, detector-activated CCTV systems. When deployed, BS8418 compliant solutions consist of cameras and detectors placed strategically around a site, linked together by specialised transmission equipment to a Remote Video Response Centre (RVRC). Here, operators can visually confirm what is happening; call up on‑screen plans of the hospital and even issue verbal warnings to intruders via on-site speakers. If necessary, the RVRC operators can also alert the police. As the incident is confirmed visually and is associated with a URN (Unique Reference Number), should provide a rapid response. The ability to provide a prompt response when incidents occur is a priceless feature within the health sector, allowing situations to be managed effectively and for hospital staff to continue their own vital tasks without being called away. BODY-WORN SAFETY EQUIPMENT As suggested by the GLAC report, body-worn safety equipment can have a positive impact on hospital security health. Indeed Craig Swallow, Managing Director of BSIA member company Connexion2 which specialises in lone worker protection equipment comments: “Unfortunately, attacks on lone workers within the NHS are on the rise. Community and health workers often find themselves in situations where they are subjected to violent and verbal abuse. At times it seems that uniforms alone can act as a trigger for anti‑social behaviour.” “Companies and organisations in both the public and private sector are becoming more astute to the fact that although devices such as body-worn alarms come at an initial

cost, long term, they are vital to mitigate security risks posed to staff members.” One major benefit of body-worn equipment, such as alarms or automatic audio recorders is that they enable employers to compile evidence discreetly which can be used to ensure criminal convictions. Another benefit is that unlike alarms placed inconspicuously under desks, body-worn alarm systems move along with human assets meaning proximity is never an issue. As well as providing valuable footage to be used in court, body-worn video cameras can be connected back to the overall security management platform. This means that a time and date stamp can be associated with the video so that it can be logged as an incident in the same way as footage caught on a CCTV camera would be. While body-worn cameras have been employed by police officers within the UK Craig Swallow comments on their use in the hospitals: “Body-worn video devices produce better quality evidence; however their use in a hospital environment poses certain interesting questions relating to data protection, patient privacy and the use cameras in public spaces.” NEXT GENERATION Whilst historically having the right infrastructure and bandwidth has been an issue for the widespread adoption of these systems, the good news is that this is now being overcome as models are being brought to market that are able to stream video and audio content over advanced next generation IP radio networks.  FURTHER INFORMATION www.bsia.co.uk


Infection Control

HOSPITAL ACQUIRED INFECTIONS

Written by Derek Butler, Chair, MRSA Action UK

Keeping ahead of the bugs Derek Butler, chair of MRSA Action UK, shares his views on what is needed to take infection prevention to the next level, and the problem of antibiotic resistance should such measures fail Much has been spoke of and written about healthcare associated infections (HCAIs) over the past few years yet we still hear about and see problems in our hospitals regarding patients contracting these infections. In fairness the numbers are greatly reduced, but from the monthly statistics released by Public Health England (PHE), the former Health Protection Agency, there is great inconsistency between various hospitals, with some having achieved huge reductions whilst others have rates higher than acceptable. Since 2005 when these types of infections were endemic in our healthcare facilities, and most medical professionals thought that there was little that could be done to reduce them, the government of the day made reducing them a priority through pressure applied by the media and campaigning from patient groups, including MRSA Action UK. Infection prevention and control became every hospital manager’s top priority and resources were allocated to bring about the reductions required by government. MOVING ON FROM SOFT MEASURES Now that we have introduced what I call the ‘soft options’ of infection prevention and control, such as education of medical staff of the importance of hand hygiene, hospital cleaning, universal screening (now changed to targeted screening), and measures to address judicious antibiotic prescribing, the reductions in the reported HCAIs have reached a plateau and are in fact starting to rise. From MRSA Action UK’s point of view, this is no coincidence. We stated in 2005 to the Department of Health that fighting these types of infections has to encompass the whole

healthcare economy which includes social care, because fighting infections has to be an all or nothing affair – there can be no half-way house. All too often medical staff would use the excuse that patients were bringing these infections into the hospital, so in our opinion, it made common sense to prevent this in the first place. Sadly no-one listened to what we were saying. The consequence was that fewer resources were focused in tackling these infections in the community, creating a revolving door with hospital staff having to deal with the consequences as patients are admitted and, in many cases, readmitted. In viewing the latest statistics from PHE it is clear to see that some 70 per cent of these infections are said to have been attributable to contraction in the community, yet not enough is being done to tackle this problem. It is my belief that we may only ever lower these types of infections by 25 per cent. This would be welcomed but MRSA Action UK believe it would still be far too high for a modern healthcare system. I can confidently say this because in some Northern Scandinavian countries their infection rates with these types of bacteria are just one tenth of ours and we really need to look and ask why? In truth these countries have been far more focused in tackling these bacteria from the

start whilst we relied on antibiotics to cure infections contracted whilst in hospital. Unfortunately this was a false presumption that we could always keep ahead of the bugs. What we are now seeing are even more resistant bacteria evolving because we did not take the necessary precautions whilst we could. But it is still not too late to be able to match the best, and in my belief to actually be better if we so wished. What it will take is a complete rethink of the systems we have in our hospitals to take this challenge to the super bugs. It would require the political will and moral duty to ensure we are doing everything possible to ensure there are no gaps in the system, and the design of healthcare adapted to tackle the burgeoning threat of multi-drug resistant bacteria.

We can no olely ely s longer reducation on the ical staff of med portance of im on the hygiene, or hand l cleaning hospita ening scre

THE NEXT LEVEL We can no longer solely rely on the education of medical staff on the importance of hand hygiene, hospital cleaning, targeted screening, and judicious antibiotic prescribing. We need to take this battle of infection prevention and control to a higher level using the tools of other industries. To begin with there would have to be more openness and honesty within the medical profession. Hospitals will state that they are MRSA free, which is E

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HOSPITAL ACQUIRED INFECTIONS  disingenuous of them as this only relates to MRSA bacteraemia. The NHS would be better off dealing with its problems through transparency and honesty, rather than through obfuscation and this deceit. A RE-THINK One aspect that I consider needs to be viewed by the medical profession is a complete system rethink. This is the process of understanding how systems or processes influence one another within a complete entity, or larger system. In organisations such as the NHS, these systems consist of people, structures, processes and patients that work together to make an organisation ‘healthy’ or ‘unhealthy’. And a healthy NHS means a safer environment, for patients and staff. Using other types of processes such as ‘behavioural safety’, focuses on what people do and why they do it, then shifting to a method of working that is safer. This encourages a questioning attitude as to why certain work patterns are performed in a certain way. It looks for improvements not based on ‘it has always been done this way’, but looks for the best practice based on evidence. It must be all inclusive as it must focus on a ‘never-event-free’ performance. NOT REPEATING MISTAKES One of the most important tools in safety driven industry is operational experience

feedback (OEF). This is a process in which the effect of output or an input of a process or action is fed-back to members of staff in the primary organisation, say an NHS Trust, and then is relayed on to other organisations within the same context, to modify the next action, especially if there has been a never-event. It has been proven that using tools such as these prevents the repeat of never-events and this could mean the repeat of the contraction of avoidable healthcare infections, as all too often the same mistakes are repeated. Using these tools can make the NHS safer, reduce costs and make it more efficient which is what we all want for the patients but more importantly it would make the NHS aim for ‘never-event free’ performance. ANTIMICROBIAL RESISTANCE A more pressing reason for wanting to consign avoidable healthcare infections to history is the burgeoning issue of antimicrobial resistance (AMR). Using antibiotics unnecessarily adds to the burden of resistance and accelerates the depletion of our present stock of antibiotics. It would make perfect sense to reduce infections in both our acute hospitals as well as within the community. We need improved diagnostics to target interventions and understand how and why the bacteria respond in the way

they do. There needs to be an acceptance by both healthcare professionals and patients that we need to change attitudes and get smarter at tackling antimicrobial resistance. Unless we learn to adapt to how to respond to infections in general, then healthcare will not be the same for future generations. Multidrug resistant (MDR) bacteria will become endemic, making the present situation pale in to insignificance – and we may cross what we call the ‘Rubicon’ from which there is no point of return. At present we cannot rely on the pharmaceutical companies to deliver the new antibiotics we need; development can take 10 years before any class appear on the market for use. At present there are very few gram negative antibiotics in the pipeline and the new strains of gram negative bacteria are becoming increasingly resistant, and actually surpassing MRSA as the bacteria giving healthcare professionals cause for concern. it will be our children and grandchildren that face an uncertain future in healthcare and this is why we need to take this battle of infection prevention to a new and higher level. Failure to do so will mean many more people dying unnecessarily in the not too distant future. L

Infection Control

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FURTHER INFORMATION www.mrsaactionuk.net

Rapid point of care testing for MRSA to minimise risk, improve patient outcomes and reduce lengths of stay Department of Health guidelines have made MRSA screening mandatory for all emergency and elective admissions to hospital in England, requiring a rapid, point of care solution to minimise the risk of healthcare associated infections and ensure a smooth flow of patients through the hospital. Cepheid’s Xpert® MRSA molecular diagnostic test provides sensitive, ondemand results using real-time PCR, enabling colonised patients to be quickly and easily identified for improved patient outcomes and reduced lengths of stay for all patients. The detection of MRSA carriers is key to infection control. The traditional culture-based methodology for detection is both complex and time consuming and, as with most PCR-based MRSA tests developed in recent years, must be performed in a laboratory. In comparison, Cepheid’s Xpert MRSA, which runs on the GeneXpert system, yields results comparable to laboratory culturing in just 70 minutes. Sample extraction, amplification and detection are all carried out in one single use, self-contained ‘laboratory in a cartridge’. On admission, nursing staff simply collect a nasal swab from the patient, add the swab to the reagent,

vortex, and then dispense the reagent into the cartridge. The cartridge is placed in the instrument and the assay started. As well as being quicker than culture-based screening, testing at the point of care eliminates delays caused through transportation of samples to the laboratory, and is not restricted by laboratory opening hours.

Northern Ireland’s Craigavon Area Hospital has been using the Xpert MRSA test to keep its orthopaedic ward free from MRSA since 2010. Elaine Porter, acting lead biomedical scientist in the microbiology department, explained: “The major benefit of the Xpert MRSA test is speed of diagnosis, which is invaluable as it ensures patients follow the correct pathway. If MRSA is confirmed, patients can be nursed in side rooms, given prophylaxis prior to surgery, and placed at the end of surgical lists to allow deep cleaning of theatres afterwards. This reduces the likelihood of orthopaedic sepsis and possible repeat surgery, reducing costs and protecting all our patients, not just those who are colonised. Equally important, patients that are not colonised can be nursed in four-bedded bays, benefitting from each other’s company, and valuable side rooms are freed up. The system has proved very effective and, five years on, our orthopaedic unit remains MRSA free.” FURTHER INFORMATION Tel: 01480 405333 ideas@kdm-communications.com www.kdm-communications.com

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EVENT PREVIEW

Preparing for Infection Prevention 2015

Infection Prevention 2015

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

This year’s ‘must attend’ infection control event is Infection Prevention 2015 which will be held at the ACC in Liverpool from the 28 – 30 September 2015 Organised by the Infection Prevention Society (IPS), this is the major infection prevention conference and exhibition of the year. The conference has been awarded 14 Continuing Professional Development (CPD) points by the Royal College of Pathologists. There will be in excess of 600 delegates in attendance and over 100 exhibitors. The scientific programme will deliver an array of renowned speakers covering all your infection prevention needs. With an exciting programme on offer, this event promises to offer delegates the latest in infection prevention research, education and expertise, with inspiring speakers and informative sessions. Confirmed speakers include: Carole Fry who will deliver the EM Cottrell lecture, Professor Ziad Memish who will deliver The Ayliffe Lecture, Professor Andreas Voss, Dr Jennifer Gardy, Dr Cliff McDonald, Professor Jan Kluytmans, Professor Peter Hawkey, Mark Gallagher, Peter Hoffman, Jason Tetro, Tim Boswell, Martin Kiernan, Group Captain Andy Green, and many more. This year’s programme also features specialist sessions on Estates, Human Factors, Acute Care, Paediatrics, Community Care and Dentistry.

With ing an excit e, this m programomises to r Health England, event p e latest in h will deliver the EM t r n e off entio v e Cottrell Lecture r p n infectio h, education (named after the nurse appointed researc expertise asfirst an Infection and Control Sister). Carole

MONDAY HIGHLIGHTS Professor Andreas Voss is delivering the Keynote Address which opens Conference entitled ‘CRE, VRE, C. difficile or MRSA: what should be the priority of infection prevention?’ In this session, Professor Voss will express a personal view on where infection control in the year 2015 and beyond should be heading and which priorities should be chosen to best use the available resources. Session 2 at Infection Prevention 2015 is being delivered by Dr Jennifer Gardy, Senior Scientist, British Columbia Centre for Disease Control, and TV host of CBCs ‘The Nature of Things’. Jen will tell ‘The story of an outbreak: Tracking infectious disease transmission with DNA sequencing’. Within this engaging session, delegates will understand how the new technology of whole genome sequencing is being used to identify, understand, and resolve outbreaks of infection disease in settings including hospitals and the community. We are delighted that Carole Fry, from Public

is former Nurse Advisor on Communicable Diseases for the Department of Health and now works with PHE. Carol has been instrumental in providing guidance on personal protective equipment for flu pandemic planning and, more recently, the Ebola crisis. Carole has extensive nursing experience in Infection Control, midwifery, intensive care, HIV/ AIDS and tuberculosis. She sits on several national working parties developing evidence based guidelines and a number of national expert committees, including the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection. She is secretary of the Healthcare Infection Society and regularly peer reviews papers for the Journal of Hospital Infection. The afternoon of the first day of conference features a wealth of speakers. Peter Hoffman of Public Health England, will be looking at ‘Theatre ventilation - a trouble shooters guide’. Theatre ventilation is an area where various engineering parameters have differing significance with regard to infection prevention. This presentation will

outline the purpose of theatre ventilation and how those objectives are achieved. It should equip IPCs to differentiate between important, less important and insignificant ventilation parameters, and give a rational basis for how to respond when those inevitable tricky questions come their way. The New to Infection Prevention Stream will also be held on Monday afternoon. This is a new style of workshop run by Michael Neville from BPAS and Karen Wares from Aberdeen University, for those new to the specialty, to equip them with the basics needed to be an effective infection prevention practitioner. This stream will feature sessions that will provide an overall introduction to the essentials of infection prevention and control. A further session on Monday afternoon includes ‘Non touch disinfectants - Application’ from Dr Tim Boswell, HIS Chairman and Consultant Medical Microbiologist, Nottingham University Hospitals NHS Trust. This session will summarise the evidence that the healthcare environment can be the source of important HCAI pathogen transmission to patients. Dr Boswell will look at the published literature on the use of hydrogen peroxide and ultraviolet systems within healthcare settings and he will discuss the deployment of these systems within Nottingham University Hospitals and discuss the practical advantages of these non-touch disinfectant technologies. E

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Infection Prevention 2015

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

EVENT PREVIEW Public Health Microbiologist PHE, will give ‘An overview of the epidemiology of multidrug-resistant Gram-negative bacteria’. This session will provide an understanding of both the global and UK distribution of significant antibiotic resistance genes in Enterobacteriaceae, and following his session delegates will be able to identify sources and routes of transmission both in the general environment and healthcare setting. Martin Kiernan, visiting Clinical Fellow, Richard Wells Research Centre, University of West London, is looking at ‘Environmental risk from multi-drug resistant gram negatives’. This session is sponsored by an unrestricted educational grant from GAMA Healthcare. Within this session, Martin will review the evidence for the environment presenting a transmission risk for MDR gram-negative organisms. The literature will be reviewed and mitigation strategies, including effective environmental decontamination and gaining assurance of effective risk reduction measures, will be presented. One of the final sessions of the day is a debate on ‘Selective decontamination of the gut’. Debating cons will be Dr Cliff McDonald, Senior Advisor for Science and Integrity, Division of Healthcare Quality Promotion, USA. Debating pros will be Professor Jan Kluytmans, Professor of Microbiology and Infection Control at St Elisabeth Hospital, E

Delegates will understand how the new technology of whole genome sequencing is being used to identify, understand, and resolve outbreaks of infection disease in settings including hospitals and the community  TUESDAY HIGHLIGHTS On Tuesday there is a specialist Dental Stream, which is featured within the main conference programme and can be accessed as a standalone event which can be booked

directly on the conference website. The main programme on Tuesday features three further streams (in addition to the dental stream): Professor Peter Hawkey, Professor of Clinical and Public Health Bacteriology and Lead

Infection control with Haigh Engineering Haigh presented their first Bedpan Disposer, the Sluicemaster, in 1964 and with the introduction of disposable pulp products have contributed greatly towards creating a successful market to transform the way in which dirty utility rooms operate. Over the years, Haigh has designed and manufactured improved models based on knowledge and new technology. The Quattro has been engineered to give you the intuitive, efficient, reliable system you need for disposing of bedpans and all other medical pulp items. This is all directly based on the valued feedback Haigh continue to receive from its customers. Haigh works closely with the NHS Supply chain, pulp product retailers and manufacturers in the UK and all around the world to ensure that all pulp

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products can be properly disposed in your Haigh macerator. Supplementing the choice of warranty periods on offer, the company’s nationwide team of experienced engineers are available to support your operations on an ad‑hoc basis, via annual contracts tailored to suit you, or simply available to ensure that your in-house engineering team have the information and training they feel is necessary to care for your product. The Quattro is engineered to allow you to either choose a standard or to tweak the options to best suit your infection control needs, operating procedures or the particulars of the dirty utility room itself. FURTHER INFORMATION Tel: 01989 763131 www.haigh.co.uk

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DDC Dolphin – Breaking the chain of infection

Valmy protective masks for breathing comfort

DDC Dolphin is dedicated to excellence and innovation in sluice room and dirty utility room design, equipment manufacture, installation, testing and servicing. It specialises in the UK and around the world in sluice rooms and dirty utility rooms in hospitals, hospices, care homes and special needs schools. Over twenty years of experience allows the company to provide comprehensive and meaningful advice and support throughout planning, design and specification processes for new or existing facilities, allowing it to tailor solutions to your requirements and enable you to meet modern infection control standards as efficiently as possible. DDC Dolphin focuses exclusively on the design of effective and hygienic dirty utility rooms and is the only UK manufacturer dedicated to providing complete sluice room solutions and a complete range of state of the art equipment. Its dedicated engineering team

French manufacturer of PPE equipment and medical devices, Valmy, is innovating again with a new universal FFP3 mask, CYRANO. With an innovative technology, CYRANO universal mask provides the best protection on a FFP3 disposable mask, combined with a Type IIR certification tested by Nelson Laboratories. CYRANO universal mask is a perfect option for respiratory protection and prevention at hospitals. Contrary to the old technology of the valve, CYRANO universal mask is light, functional for inhalation and exhalation with a renown low breathing resistance, to help the wearer during intensive use. Forget you are wearing a mask, with only five grams weight for the foldable version, and less than 10 grams for the cup shape. More than this, CYRANO universal mask cupshape is 100

carry out installations, audits, HTM2030 validation and maintenance of all sluice room and dirty utility room equipment. Clients and customers cover the full spectrum of healthcare establishments from large internationally renowned hospitals through to independent care homes. It provides services to everyone involved in the design and ongoing use of healthcare facilities including planning, architects, construction companies, facilities management, estates management and infection control professionals in the UK and around the world. FURTHER INFORMATION Tel: 01202 731555 info@ddcdolphin.co.uk www.ddcdolphin.co.uk

per cent recyclable and offers a nose seal allowing a perfect fit during the entire use. Facilitate your stock management by always providing a FFP3 mask to your staff, and be safe with its Type IIR certification. Stop losing time choosing which mask you need to use, discover the innovation, get a CYRANO, the latest mask of Valmy. Please also see the range of products available through NHSSC on the website and view the complete range online. FURTHER INFORMATION Tel: 01582 563 600 www.valmy.eu

Infection prevention everywhere it matters

Traditional and micro fibre cleaning materials

As the global leader in water, hygiene and energy technologies, Ecolab is at the forefront of infection control, focusing on hand, skin and environmental hygiene, decontamination and sterile draping solutions for surgical equipment. Working in partnership with healthcare professionals, Ecolab’s quality chemistry, innovative dispensing systems, and unrivalled service and support help to prevent the spread of healthcare acquired infection. Ecolab’s products, training and monitoring programmes have been developed to improve patient safety and address staff wellbeing, throughout the

With its complete package, Wecoline is able to supply just the right cleaning materials for every sector - materials with a favourable price/quality ratio that improve pleasure in cleaning and return too. These are the important themes at the core of the development of the Wecoline product range. For the care industry, Wecoline developed the Clean ‘n Easy system. Ready-made cloths, impregnated with a cleaning agent for you to easily and simply clean with. The ideal solution for in-between cleaning jobs and meant to be used by anybody who is not a cleaner but still wants to do a bit of quick and efficient cleaning. In the course of the last few years, the Clean ‘n Easy system has been considerably extended. As a result, there is now a Clean ‘n Easy trolley and, for on the ward, wall holders are available for hanging the dispenser bucket on. It is all meant to make in-between cleaning jobs as simple as possible for the

patient pathway and across all healthcare settings. They have been developed to help each and every customer, everywhere it matters. One example is Ecolab’s unique monitoring system for environmental hygiene, EnCompass, which addresses contamination risk and improves cleaning standards throughout the hospital. Visit Ecolab on stand 20 at the IPS annual conference at ACC, Liverpool on the 28-30 September 2015 to find out more about their products and programmes. FURTHER INFORMATION Tel: +44 (0)113 232 2480 www.uk.ecolab.eu info.healthcare@ecolab.co.uk

HEALTH BUSINESS MAGAZINE | Volume 15.4

nurse, to make sure that as little precious time as possible gets lost on cleaning jobs. Apart from the Clean ‘n easy concept, Wecoline offers other products that are excellently suited for use in care institutes. New in the product range is the disposable micro fibre cloth on a roll. A single-use cloth with the powerful cleaning properties of a micro fibre cloth and the absolute guarantee of a 100 per cent clean cloth combined in one. For more information visit the Wecoline booth at the Infection Prevention Show 2015,in Hall 2, booth number eight. FURTHER INFORMATION Tel: +44 (0)121 717 47 26 www.wecoline.com


EVENT PREVIEW  The Netherlands. The objective of this session is to understand the limitations of selective gut decontamination and other better means to achieve the same or similar ends. WEDNESDAY The third, and final day of conference will open with a presentation from Dr Nikki Maran, Consultant Anaesthetist, Royal Infirmary of Edinburgh, on ‘Culture, behaviour and human factors - beyond the bundle for improvement’. Nikki is a practicing anaesthetist with an interest in how to make infection control work in the clinical environment. Following which Professor Ziad Memish, Saudi Arabia Ministry of Health, will deliver the Ayliffe Lecture on ‘The emergence of MERS: from animal to human, to human’. This topical session will discuss the emergence of MERS-Co V and its spread both locally within Saudi Arabia and globally with an update on progress made in understanding its source, transmission and best preventative strategies. The morning also features an interesting session entitled ‘Ebola outbreak in West Africa and the UK plans to control measures’ from Group Captain Andy Green, Director of Infection Prevention & Control, Defence Consultant Adviser in Communicable Diseases, Royal Centre for Defence Medicine. This session will explain the epidemiology of the Ebola outbreak in West Africa from

December 2013 until the present date. The national response by the UK to the outbreak, including the respective roles played by different government departments and non-governmental organisations, will be described, along with the basic Infection Control principles involved in developing safe working practices when dealing with the Ebola virus disease, including design and function of health care facilities. Within this session, the challenges posed by this mission, and the various lessons identified that might influence current and future practice, will be explored. This session will be complemented by the experiences of Ronald Kremer, Medical Emergency Manager for Médecins Sans Frontières, who will talk about the experience on the front line dealing with Ebola. The penultimate conference session will be delivered by ‘The germ guy’ Jason Tetro, author, researcher, germevangelist, and germs relationship therapist. This session will discuss the profits and perils of public participation, an important topic in light of social media, and also the need to increase the awareness of infection prevention and control. Participants will gain an understanding of the need for public awareness in regard to IPS (policy, improvement of efficacy in light of visitors), an appreciation of the tools available for discussion (social/ traditional media), and an exploration of the

4Es for optimal public relationship (education, enrichment, engagement, entertainment). The Formula 1 broadcaster and journalist, Mark Gallagher, will deliver the final session on ‘Clinical human factors’. Mark will focus on risk management and the lessons he has learned in Formula 1, and will discuss how we all encounter daily risks in both our personnel and work lives and how adapting to these is the key to success. The conference will be brought to a close by IPS President Professor Heather Loveday.

Infection Prevention 2015

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

THE EXHIBITION The Exhibition at Infection Prevention 2015 will feature products and services from over 100 companies working within infection prevention and control. Some of these companies will be long term supporters of IPS, but the exhibition will also feature some new faces, new products and recent innovations. The exhibition offers the ideal opportunity to discuss your particular infection prevention and control requirements with a huge range of specialist companies. For exhibitors, it is the chance to meet a wide range of influential professionals and decision makers who will be attending the main conference event and the specialist one day events. L FURTHER INFORMATION www.ips.uk.net

at Visit us on

ti n Infec ntio e v e r P 015 2 8 Booth

Clean and hygienic in less than no time! Discover how to simply keep your care environment and treatment rooms hygienic and clean with Wecoline Clean ‘n Easy. Impregnated cleaning cloths for responsive spot cleaning. Clean ‘n Easy, the perfect hygienic solution between busy cleaning schedules. www.wecoline.com/en/cleanneasy

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Advertisement Feature Written by Dr Vijay

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

DIGITAL HEALTHCARE

The patient approach The UK government continues to press for a paperless NHS, but Dr Vijay Magon of CCube Solutions argues that simply throwing funds at the issue may well lead to yet another high profile public sector IT disaster Health Secretary Jeremy Hunt wants the NHS to be paperless by 2018 and predicted the move to paperless would ‘save billions.’ Hunt wants patients to have digital records so that their information can follow them. But unlike previous large scale, top-down directives, he wants this driven bottom up and by 2018 any crucial health information should be available to staff at the touch of a button with ease and efficiency. Most NHS sites hold patient related data on a variety of different media platforms, including paper, microfilm and digital. It is currently very difficult to identify exactly what information may be held on a given patient. This has resulted in falling standards for maintaining the patient’s acute medical record, increasing risk and leaving patients and clinicians at a disadvantage. Furthermore, there are many well known issues related to paper-based delivery of care, such as; physical

handling and transport of paper records; lack of audit on who looked at any record; only one person can see a record at any time; cannot easily share records without copying; lost records; escalating costs associated with handling physical records etc. UNREALISTIC AMBITION Yet, health and IT professionals remain deeply sceptical that the NHS can be paperless by 2018. A large percentage of healthcare professionals engaged in this work feel that paperless by 2018 goal is “a great ambition, but unrealistic.” A recent survey completed by 573 people, including healthcare leaders, clinicians and IT professionals, showed that more than seven out of ten supported the paperless NHS concept but felt it was unrealistic. The key concerns expressed included: Lack of joined up working between different parts of the NHS; lack of interoperability

t A recen wed ho survey s re than that mout of ten seven orted the suppo ss NHS paperle ut felt it b conceptnrealistic was u

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between different vendors and systems; the variety and diversity of clinical systems; insufficient information about the potential benefits from improved IT systems. However, on a more positive note, the majority expressed a need to improve their understanding of the key issues and learn from other organisations who have successfully used IT to achieve paper lite healthcare if not paperless healthcare. A number of Trusts took the bold step towards paperless healthcare some years ago. These Trusts achieved paper lite health care using Electronic Document and Records Management (EDRM) technologies, not by simply installing IT, but by paying great attention to the underlying processes. EDRM TECHNOLOGIES Cost effective solutions based on established EDRM technologies offer the chance for Trusts to embrace a culture of compliant information management practice to deliver paper lite or paperless health care. There is no magic bullet solution, just a


common sense approach which focuses the available technologies on specific processes to ensure that the solution delivers what is expected of it. The process is a migratory one which promotes a trustwide information repository with newly created clinical documents being born onto the repository whilst legacy information is scanned and digitised in a staged manner. CORE TECHNOLOGY The core technology has been around for over 35 years, and is in use across many industry sectors. Lessons have been learnt through careful application of EDRM technologies. The returns from investments in EDRM are being realised through careful application of this technology to address the needs of key users who deliver medical care rather than short-term measures to solve paper problems. Key users include clinicians, secretaries, administrators, etc. Each places specific demands on the medical record, and each of these demands must be addressed. Systems have become more affordable and

offers a standard interface for all users will provide limited functionality to most users. WHAT HAVE THE PIONEERS ACHIEVED? Pioneers have reported savings gained through process efficiencies achieved by minimising dependencies on paper, by delivering the electronic patient record to those who provide care, at the right time, every time, and by guaranteeing the accuracy and quality of information delivered. St Helens and Knowsley NHS Trust already has all of its patient records accessible online for doctors, nurses, GPs, and community services Savings have also been gained through the realisation of real estate to provide more treatment facilities and better quality of care. The recently launched e-LGs managed service is a great example of how a very low-tech service is helping GP practices to release much needed space in the surgery for clinical activities without breaking the bank. In addition, digitising patient records makes it easier to control access and sharing. It is both practical and readily manageable.

Savings have also been gained through the realisation of real estate to provide more treatment facilities and better quality of care. The recently launched e-LGs managed service is a great example of how a very low-tech service is helping GP practices to release much needed space in the surgery for clinical activities without breaking the bank are delivering real and measurable benefits. It is vital to understand that simply digitising paper records is not enough, the solution must offer facilities to stop producing new paper through generation, management, and integration of electronic records. This includes catering for specific issues related to “living document,” ie. documents are live and updated over long time spans, such as paediatric growth charts, simply digitising such paper charts is not viable. Patient information resides on many disparate systems within Trusts. The electronic medical record cannot sit in a document management system that remains unconnected with other hospital systems and processes. Information must be exchangeable and shareable amongst all practioners. There is substantial legacy information in many institutions which is not automatically interoperable. Something has to be done to it to make it interoperable. To be optimally effective the electronic record has to be delivered to key users when and where they need it. A solution which

What’s more, advances in IT and the consumerisation of IT mean that rapid progress towards the wider digital revolution can be made within the NHS IT, to help deliver timely and accurate information. Use of electronic forms, for example, to capture, store, manage, and deliver information electronically. Similarly, the vast amount of information locked in paper records is now being transformed into actionable data and systems can understand content and deliver it to those who need it, when and where they need it. ACCREDITED SYSTEMS These are no longer predictions. There is a real track record now, a record that has been established over the last five years, accompanied by real data which is accessible and should be used to learn from. This track record makes the case for going digital very compelling. So, the question is: why isn’t everyone doing it? Not all Trusts are ready for the top end solutions, each must accommodate the technology and its implementation gradually to suit a number of local conditions including

budgets, IT infrastructure, user training, etc. A core application cannot be driven top-down without involving the people who will actually use it and who will be held accountable While it is good to see that the Hunt directive is accompanied by a financial commitment (a £240M fund), each Trust must make its on case for improvement and demonstrate willingness to change. Each Trust has to fight for money for this because there are so many competing demands. Some of the lack of confidence in the NHS to achieve the flagship 2018 target may well be due to a fear that a large chunk of a £240m technology fund has already been raided to finance support for hospitals struggling with their accident and emergency demand. Simply throwing money at a problem will lead to yet another IT failure. The bottom-up approach means that the digital revolution in the NHS is achievable - gradually and over time rather than committing astronomical sums on large scale IT projects.

Advertisement Feature

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CCUBE SOLUTIONS Designed and built with NHS practitioners, CCube’s award-winning solutions deliver electronic health records to clinicians, secretaries and administrators in the format they require, when and where they are needed. CCube is already delivering measurable benefits to over 25 NHS Trusts, helping to deliver paperless healthcare within 18 months. CCube’s suite of Electronic Document & Records Management (EDRM) products can be tailored to suit specific needs and expanded from departmental to Trust-wide solutions. These include EDRM, which has the ability to scan, store and views patient notes, and a Forms Recognition function, which automatically recognises, classifies, indexes, as well as presenting digital health records. CCube’s EDRM solutions also include Connect, which pulls in patient data from third party systems; eForms which allow clinicians to enter structured data in real-time, and Workflow, which configures workflow to support operational processes. INTEGRATION Furthermore CCube’s Portal & Web API solution allows integration with third party applications, and its Mobile product allows access to patient data and data entry using mobile tablet devices. Solutions are supplied by workgroups at departmental level for scanning, storage, management, and access of patient records and also supplied by enterprise trust-wide paperless healthcare, typically in under two years. With an open, client/server architecture, the CCube suite is customisable, fast to deploy, easy to integrate, scalable, standards-based, feature rich and compliant with current legislation and data protection rules.  FURTHER INFORMATION www.ccubesolutions.com

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Scan Your Patient History To Be Paperless By 2018

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DATA MANAGEMENT

Keeping sensitive data out of the wrong hands For the healthcare sector, there are many threats to prepare for on a daily basis, whether it be an unwanted intruder in the building, theft of expensive medical equipment or the theft of medication. However, at the forefront of any healthcare organisation’s security plan should be its commitment and capacity to effectively protect the secure information and data relating to its patients and staff. Personal information stored within the heath care sector can be seen by criminals and cyber criminals as the perfect gateway to committing fraud and identity theft. Such information includes names, addresses, National Insurance information, financial details and even information about a patient’s family. As such, it is absolutely essential that organisations are taking the necessary measures to protect such information.

This protection stems far beyond passwords on a computer system, it extends to what is done with that information once it has been used and no longer needed. After all, if an establishment was found to not be protecting its patient’s information securely, it could have detrimental effects on its reputation and its future. INFORMATION DESTRUCTION DEFINED When it comes to information destruction, the term ‘information’ stems beyond just words on a page, it covers a wide range of materials including: paper, computer hard drives, laptops, hard disks, CDs, DVDs, USBs, credit cards and SIM cards. Branded products are also on the list, such as uniforms

or paper with letter heads – if these products were to fall into the wrong hands, it could prove catastrophic for administrators, allowing unwanted intruders to gain access to areas where they are not wanted. With such a vast array of precious information being needed to be destroyed, it is most important that an organisation employs the use of a trusted and reputable information destruction company. It is not enough just to destroy the information, it needs to be destroyed by a professional company who fits the right credentials. Perhaps one of the biggest security breaches within the healthcare sector was made by the now dissolved NHS Surrey back in 2012. The organisation E

l Personaon ti informahin the it stored ware sector heath c en by cyber e can be snals as the crimi ateway to g perfectand identity fraud heft t

Volume 15.4 | HEALTH BUSINESS MAGAZINE

Written by Stephen Ellis, communications executive, British Security Industries Association

A major part of any healthcare organisation’s security plan should be its commitment and capacity to protect the secure information and data relating to its patients and staff. The BSIA’s Stephen Ellis explains how

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DATA MANAGEMENT is sub-contracted, the sub-contractor should also meet with the standard and the client should be informed if one is used. Any personnel within the business should also be vetted in accordance with a particular standard (BS7858) and must sign a deed of confidentiality prior to their commencement of employment.

 had handed over old computers to an information destruction company that was not compliant with the necessary standards. The computers, which contained confidential files, were then consequently sold on eBay without being wiped of its information – a huge breach of data security. As a result, the Information Commissioner’s Office (ICO) issued the NHS Surrey a £200k fine for their engagements with an unapproved supplier. MEETING THE STANDARD It can be seen that a lack of understanding of key decision makers regarding the core standards that an information destruction supplier should meet, could be the cause of such breaches. Adam Chandler, chairman of the BSIA’s Information Destruction section, commented: “While it’s not just public sector organisations that are prone to data breaches – the average data breach costs private sector firms around £1.9m annually – the sensitive nature of the data held by public sector organisations can expose them to greater reputational and financial risk. “An overarching theme identified by the BSIA’s previous projects is a general lack of understanding when it comes to the standards that should be specified of a professional information destruction supplier. This often leads to organisations specifying unnecessarily stringent requirements with regards to factors such as shred size, transport and destruction processes.” SO WHAT ARE THE STANDARDS? An essential requirement of the Data Protection Act is that an information destruction company must adhere to certain

standards in order to maintain a secure and professional service. The purpose of the company is to ensure that all confidential materials are destroyed to such an extent that they may never be reconstructed. The reputable company will then provide its customer with a full audit trail of the process, which includes a certification of destruction. Companies should also meet with the European Standard for Information Destruction, labelled EN15713. The standard outlines a range of different requirements the company must meet in order to be classified as a reputable supplier. For one, it lays out strict requirements for the premises that the information destruction takes place on, including: having an administration office where records and documentation are kept; being separate from other businesses or activities taking place on the same site;

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CHAIN DESTRUCTION In terms of the chain of destruction, confidential material that has been collected should remain protected from unauthorised access from its collection all the way through to its complete destruction. Such collection should only be made by uniformed and suitably trained staff who carry the necessary photographic identification. The destruction of the confidential material should also take place within one working day of its arrival to the destruction centre if the shredding is taking place off-site. The standard is thorough and goes on to cover all areas of the process, including the security of the vehicles carrying the information, the environmental issues faced by the company and the customer’s due diligence. It is important that the decision makers responsible for procuring an information destruction company within the healthcare sector are familiar with the benchmarks that the company must meet and choose one accordingly. Along with meeting with the key European standard, companies should also comply with the essential British Standard BS8470. This details the secure destruction of information and includes the identification of product specific shredding sizes, guaranteeing that information is destroyed to the point of irreparability. SOURCING A SUPPLIER The BSIA’s Information Destruction Section is the leading authority on information destruction best practice, with all of its members adhering to strict quality standards,

The destruction of the confidential material should also take place within one working day of its arrival to the destruction centre if the shredding is taking place off-site having an effective intruder alarm on-site that meets with EN50131-1 (the European standard or alarms) while being monitored by an alarm receiving centre; and having CCTV systems in place with the recording facilities that monitor the unloading, storage and processing areas of the business. Contracts between the company and the client should cover all existing transactions between the two parties and if the work

especially EN15713 and BS8470. The section aims to raise continued awareness among public and private sectors around the importance of secure information destruction. When it comes to information destruction in the healthcare sector, there is no room for complacency. L FURTHER INFORMATION www.bsia.co.uk

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Advertisement Feature

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

DOCUMENT MANAGEMENT

MISL case study – Royal Free London NHS Foundation Trust MISL has been contracted to carry out one of the largest and most ambitious medical records scanning projects in the NHS for the Royal Free London NHS Foundation Trust

st The Tru that ed identifi ,000 new 30 around of medical pages formation in record re being we ed on a generat basis daily

The project is to scan in a back file of over 550,000 historic paper medical record files together with all paperwork generated each day at the Trust going forward. MISL has completed scanning over 360,000 records to date since commencing scanning in April 2014. The project go live date was November 12th 2014 and by Christmas 2015 all the back scanning of medical records will be completed, a full two years and four months ahead of schedule. MISL is delivering the project from a dedicated scanning facility in Hoddesdon, Hertfordshire with a team of 110 staff working 24 hours a day, 5 days per week over 3 shifts. The project

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is proving to be a huge success and is testament to the way in which MISL has worked with the Trust and other suppliers to design and implement the most effective project process.

THE CHALLENGE The principle challenge for the Royal Free, in light of the call to move to paperless care provision in the NHS was to convert a huge quantity of legacy paper medical records within the Trust so that they could be accessed and viewed securely in tandem with their

Electronic Patient Record System (EPR) Cerner Millennium. The paper records were taking up significant space at the Hospital and making them available digitally would not only free up the space but also ensure that all the correct care record information is viewable when required throughout the patient journey. In addition the Trust identified that around 30,000 new pages of medical record information were being generated on a daily basis which would need to be captured within 24 hours in order for the electronic patient record to have continuity. PROJECT DESIGN At the beginning of the project planning process the Royal Free were quick to introduce the different suppliers and begin intensive


The scanned data is being used on a daily basis within the Trust and has already become integrated into daily clinical care provision. This project, even on the basis of the work completed to date, is an example of how to convert large quantities of medical records paperwork into a digital form in the right way. planning and testing of processes. MISL was very active in this process and was forthright in providing advice and support as to how the production process should be designed. From the tender stage many of the project parameters were defined but there was room for adjustment of specifications to suit particularly the interaction between Cerner and OpenText and the ingesting of scanned documentation from MISL. The most challenging aspect of the planning was designing an approach for the effective gathering and tracking of day forward documentation so as to ensure the Trust’s compliance with the BS10008:2014 process for legal admissibility of information stored electronically. MISL’s technical team helped design a process with barcoded header sheets to enable the automatic indexing of a group of documents that had first been generated by open text, had then been used in a clinical context and had finally been collected by MISL for scanning back into the EDRMS. THE MISL PROCESS MISL designed the project internally to function from a single, secure and dedicated industrial unit. The unit was procured and fitted out to the highest security standards to incorporate the storage of documents pre and post scanning together with the production area. The unit was subject to significant building work and security systems were installed together with 2 dedicated and secured fiber-optic data links to the Trust to enable the transfer of scanned data. MISL also recruited many new staff for the facility to be trained by, and to work alongside, the already experienced core MISL scanning team. Scanning production began in April 2014, a full 6 months in advance of the project go live date to enable the workforce to be fully trained in the standards required and to build up their capability to expected throughput speeds. The headline process involved the following steps: Collection of 2 consignments of medical records per day; Validation of consignment inventories; Document preparation; Scanning of Back file and day forward documentation to 300dpi 24-bit RGB colour multi page TIFF files; 100% on screen QA of scanned pages; A further 10% Page to

Image QA of the scanned records; Data Upload to OpenText; Further QA by the Trust; Secure storage of the scanned paper files by MISL for 3 months post scanning; Secure destruction of authorised batches of scanned files to the BS15713:2009 standard for secure destruction. The scanning is carried out on Kodak i5600 and i5800 manual feed document scanners (8 in total). The scanning task is split into 3 streams of activity. For Back file scanning there are two turnaround times; five days for normal turnaround and 24 hours for on demand scanning. MISL has separated the production teams to service these two turnaround times. In addition all day forward paperwork is scanned to a 24 hour turnaround. MISL’s scanning and validation processes are monitored by a production management system that yields daily reports to the Trust about progress and throughput in forensic detail. This high level of communication and transparency has maintained a very positive working relationship and has kept the project on track. In the early months of the project the MISL project manager was situated at the Royal Free for several weeks so as to be ‘on the ground’ to resolve any issues or last minute changes to processes that were required. Weekly project update meetings have continued throughout the project. On a daily basis the MISL team processes 140 boxes (equating to 350,000 pages or 700,000 page images) of back file paperwork. For the day forward scanning MISL processes on average 11 boxes per day of documents (equating to (27,500 pages or 55,000 page images) The back file scanning portion of the project was originally intended to be completed within a four year period. Records scanned to date indicate it will be completed by the end of December 2015. This projected end date will mean the back file will have been scanned within 20 months. This means that the largest part of the project will be completed two years and four months ahead of schedule. The day forward scanning process will continue for the remainder of the contracted project duration. CONCLUSION The Royal Free scanning project is proving to be a huge success for the Trust and for

MISL. The way in which the project has been managed and designed along with the level of resourcing and dedication that MISL has committed to the resource have resulted in a project that will be completed well ahead of schedule. After being awarded the contract MISL set about the planning process in a flexible and collaborative way acknowledging that a project of this scale would require special treatment and care. The results have been a tremendous amount of paperwork processed for the Trust to date and a high quality output. The independent QA of the scanned documents carried out by the Trust has demonstrated the quality of MISL’s scanning services and have resulted in the Trust authorising past scanned batches to be securely destroyed. The scanned data is being used on a daily basis within the Trust and has already become integrated into daily clinical care provision. This project, even on the basis of the work completed to date, is an example of how to convert large quantities of medical records paperwork into a digital form in the right way. The benefits in terms of freeing up space and also making sure the right information is available at the right time in a clinical setting are significant.

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STATEMENT FROM THE ROYAL FREE LONDON NHS FOUNDATION TRUST “MISL is our strategic partner for the scanning of our legacy case notes as part of our project to digitise medical records across the Trust. The Trust had previously worked with MISL on a smaller scale to archive patient notes, but the scale of this project was bigger than either MISL or the Trust had undertaken before. MISL and the Trust worked together closely to determine the workflows from medical records to the scanning bureau to allow the timely scanning of both historic notes and paper content being generated through clinical contact on a daily basis. As with any large scale project, there were issues, especially at go-live, but MISL were extremely proactive and professional in working with the Trust team to overcome these issues. After 6 months of live running, availability of scanned notes is higher than the availability of paper notes before the system went live, and every day MISL are able to ensure that every set of notes sent to their bureau has been scanned and uploaded to the EDRM system.” Will Smart Director of IM&T at the Royal Free London NHS Foundation Trust FURTHER INFORMATION For further details, please contact Steven Clarke Sales & Marketing Director MISL Limited Tel: +44 (0) 1992 470 060 Email: steven.clarke@misl.co.uk

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Catering Written by the British Dietetic Association

Allergen Toolkit for healthcare catering The British Dietetic Association (BDA) outlines ways to implement an effective allergen management programme – training staff in food allergen risks and communicating accurate and consistent information about allergens to patients and visitors New allergen rules within the EU Food Information to Consumers (FIC) food legislation came into effect on 13 December 2014. These rules effect how allergen information is provided on pre‑packed food labels and introduced a new requirement to provide allergen information for foods sold or provided loose. ALLERGENS Food caterers, such as hospital catering services, are now required to provide information to patients, staff and visitors about the presence or use of any of the allergens outlined in the legislation. This includes any food item served to patients at ward level and any food sold in retail outlets. The allergens outlined in the FIC are: cereals containing gluten, wheat, oats, rye, barley, spelt, Khorasan wheat/Kamut, crustaceans (eg: prawns, crabs, lobster), eggs, fish, peanuts, soya, milk (including lactose), nuts, almonds, hazelnuts, walnuts, cashews, pecan, Brazil nuts, pistachio, macadamia, celery, mustard, sesame seeds, sulphur dioxide (where added at >10mg/kg or 10ml/L inthe finished product), lupin and molluscs (eg: clams, squid, oysters, scallops). To meet allergen obligations, hospital caterers must be able to evidence the exact ingredients used, such as by brand name and pack size, or other information that details what is normally used or that of any replacement. When using pre-packed foods in the preparation of meals, any ingredient containing one of these allergens must be included in the ingredient list and the

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name of the allergen should be emphasised within the ingredient list (eg: in bold, underlined, italics etc.). If the name of the allergen is not within the name of the ingredient, the name of the allergen should appear in brackets. The legislation does not require full ingredient lists for loose foods – the requirement is to declare any allergens when used as an ingredient or processing aid regardless of level of use. Websites and other forms of communication should also identify the names of all the allergens contained in the product in some way, such as an allergy advice line.

full details on the label. If this

is the case, the information Food e needs to be sought by r a s other means such as caterer ired to u specification sheets. q e r now nformation i SAFE STORAGE AND providetients, staff PREVENTING CROSS a t p ou to b a CONTAMINATION s r o it Once the allergen and vis esence or contents of all the pr ny of the ingredients are known a f use o rgens and logged, safe storage alle practices must be used to

PROCUREMENT AND PURCHASING Hospitals should ideally purchase from suppliers who provide product specifications including the full ingredient lists that include allergens. Failing that, they should use the information on the food labels and make a note of them when they are used. All foodstuffs that are brought into the hospital, from complete meals to individual recipe ingredients, should have their ingredients checked and any allergens identified, using either their specifications or food labels. This also applies to meals that are brought in ready made, which may not always have

avoid the cross contamination of foodstuffs: for example sugar could be contaminated by other allergens in the environment if stored near wheat flour and milk powder. Food items need to be kept in sealed containers and accessed using clean utensils to minimise the risk of cross contamination. Where possible, store allergenic ingredients, such as nuts, peanuts or sesame, on bottom shelves to prevent them falling into other foods. Larger kitchens may have quarantine rooms to separate these foodstuffs to prevent cross contamination or may keep nuts or peanuts in a special place. The safe storage of ingredients should be included as part of the food safety management system, or Hazard Analysis Critical Control Points (HACCP) and staff should be trained accordingly.

PREPARATION AND RECIPES To be able to readily inform consumers about the presence or absence of allergens, the use of standard recipes is best practice.


Each standard recipe should list each ingredient, emphasising the allergens and specifying where possible the brand name and pack size. Pack size identification is important as some brands use a different formula in different pack sizes. If a hospital does not use standard recipes with specified ingredients, then it will need to note what ingredients and pack sizes are used each time a dish is made. When dishes are produced, especially dishes that are not served immediately, a system of batch coding, dating, and logging should be used, so that individual portions for a specific batch can be identified if necessary. In situations where a single or bespoke meal is required, eg: for a patient with a specific diet request, the chef will need to be able to provide the allergen information on request for that particular dish. In these cases, the person placing the order, eg: the dietician or nurse, will need to be aware of any allergies that the patients may have and communicate with the staff producing the food if allergen information is going to be required. STORING INFORMATION All food service organisations must supply recipe information regarding the allergens in their dishes. Depending on the size and needs of the individual organisation the allergens in each recipe should then be

listed on a file note, spreadsheet, a log, or a menu software program. This is used as a ready reference to easily show the allergens present in each of the ingredients sourced. SOFTWARE Software is available to support the tracking of ingredients into recipes and is used in many organisations. When this information has been put together, a rigorous system needs to be in place to update the information when it changes. This will include adding new food products into the data when they are sourced, and updating product details when their ingredients change, or when manufacturers change formulations. Audit procedures need to be included at every step and should be a part of the HACCP and safe storage procedure. Allergen information must be readily available, so staff members can provide the information to the consumer accurately and consistently. One method of ensuring this is through verbal communication from an appropriate member of staff, who can find the information on an electronic ordering system at ward level, from the chef, or from the food server. A second method is through ward folders, which can include suppliers’ nutrition booklets, spreadsheets or printed recipes from a central database.

Catering

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

ALLERGY AWARE MENUS ‘Allergy aware’ menus can also be used to highlight foods that don’t use allergens outlined by the FIC. Additionally, labels can be placed on pre packed food for direct sales from deli counters or sandwich bars. For vending machines or other food services where no staff are available, food items must be individually labelled, or a notice with all the allergy information should be placed nearby. Hospitals cannot say they do not know whether or not a food contains major allergens, nor can they say that all food may contain allergens. Inaccurate or incomplete information would be in breach of the FIC regulation. Consumers must be advised that the information is readily available. For patients, a statement on the standard menu outlining that food allergen information is available on request can be used. For retail or vending, a similar statement can be placed on the staff and visitor’s menu, or a conspicuous notice placed in the restaurant. L FURTHER INFORMATION The original toolkit was co-authored by the BDA and the Hospital Caterers Association (HCA) and can be found at tinyurl.com/okpttzd The British Dietetic Association’s website can be found at www.bda.uk.com

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Emergency Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

EVENT PREVIEW

The Emergency Services Show With over 400 exhibitors and over 5,500 visitors attending this event, the Emergency Services Show is one of the key events for anyone involved in emergency planning, response or recovery

In an era of austerity, keeping abreast of the latest developments and building new partnerships can be a real challenge. For these reasons the annual Emergency Services Show has established itself as a key date in the emergency service calendar, particularly for those involved in all aspects of preparedness planning, resilience and recovery. The Emergency Services Show taking place at the NEC, Birmingham on 23 and 24 September brings together a cross-section of organisations involved in resilience and emergency planning. A showcase of technical innovation, expertise, and collaborative practice, this two-day exhibition is centrally located, easy to get to and free to attend. Over 400 companies and organisations have already booked stands. Organisers of the Emergency Services Show have confirmed that the two-day event held at the NEC in Birmingham last year attracted a record number of 5,680 visitors. That represented the eighth consecutive year-on-year increase in visitor growth and a six per cent increase since the event relocated to the NEC in Birmingham.

SEMINAR CONTENT This year’s event will include a series of free seminars covering collaboration and interoperability (organised with the Joint Emergency Services Interoperability Programme and the Emergency Services Collaboration Group), and innovation. The College of Paramedics is also planning another series of free 30-minute lectures and workshops on both days of the show. A new seminar theatre dedicated to training will feature at the Emergency Services Show 2015. The new seminars will be led by experts who run specialist courses for emergency services personnel, and will expand the offering of free learning opportunities already available to visitors. The growing exhibition for emergency responders has already attracted many of

the most respected training providers in the industry including the Tactical Training Centre, NHS Ambulance Service First Aid Training consortia (NASFAT), Fire Training Group, PGI Training, Ferno, University of St Andrews, Coventry University and London Metropolitan University. Meanwhile the indoor and outdoor exhibition will feature over 400 companies and organisations, some of whom will run workshops and live demonstrations on their own stands. John Halfpenny, policing skills trainer, West Mercia and Warwickshire Police described last year’s show as “an invaluable and enjoyable chance to network and appreciate the challenges, strengths and capabilities of partner agencies in the emergency services and

The of Collegeics is d Parame another g plannins of free serie lectures te 30-minurkshops on and wo days of both ow the sh

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Emergency Services

EVENT PREVIEW  With something new around every corner, The Emergency Services Show provides a unique opportunity for emergency responders to learn, network and progress their careers. It is also a showcase for the best examples of industry collaboration and innovation. Event director David Brown said: “The exhibition halls will be buzzing with knowledge and expertise and we urge officers of all ranks, across all emergency services, to take full advantage.” THE EMERGENCY RESPONSE ZONE Aimed at developing relationships and partnerships between voluntary organisations and the blue light services, the Emergency Response Zone is a networking focus of the exhibition and will feature many new exhibitors this year including Fire Brigades Union, Arson Prevention Forum, CFB Risk Management, South Western Ambulance Service NHS Foundation Trust and Road Safety GB Academy. There will be around 70 companies, charities

order to provide an informed and influential voice on all aspects of civil protection and emergency management. It gives members the opportunity to network with practitioners and academics in the fields of civil protection, emergency management, resilience and associated disciplines. The National Inter-Agency Liaison Officers (NILO) was originally initiated within the Fire & Rescue Services and it has now been extended to all responding agencies. The

The National Ambulance Resilience Unit (NARU) works with ambulance trusts to support the development of properly trained, equipped and prepared ambulance responders to deal with hazardous or difficult situations, particularly mass casualty incidents that represent a significant risk and other organisations exhibiting in this area alone ensuring a wealth of opportunities to share and catch up with new developments. RESILIENCE ORGANISATIONS The National Ambulance Resilience Unit (NARU) works with ambulance trusts to support the development of properly trained, equipped and prepared ambulance responders to deal with hazardous or difficult situations, particularly mass casualty incidents that represent a significant risk to public health. NARU, working with the Department of Health, also assists with the effective national coordination and implementation of the pre-hospital health response to government policies that are designed to improve civil contingencies and national resilience across England. The Emergency Planning Society has become the driving force in the world of resilience since its creation in 1993. Through regular consultation with the government it provides a voice for its members to influence change at the highest level. Members come from all areas of the resilience profession and the society provides a forum through its extensive network of regional branches to share experiences and disseminate good practice. The Institute of Civil Protection & Emergency Management (ICPEM) brings together emergency professionals and academics in

aim of the NILO role is to provide a cadre of officers especially trained to ensure cooperation between agencies responding to a terrorist related or public order event. Personnel from the Joint Emergency Services Interoperability Programme (JESIP) and Emergency Services Collaboration Working Group will also be available to talk to visitors about co-operation across the emergency services. TRAINING PROVIDERS The Tactical Training Centre is a unique firearms and multifunctional training facility, working for and with the community, protecting people. It provides UK curriculum compliant training to the police, other law enforcement agencies, blue light services and the military. It delivers firearms, training, coaching as well as advanced medical training. Training4Resilience acknowledges that the first step to becoming resilient is through training and preparation. A recent project of interest to counter terror professionals is the School of Resilience and Emergency Response: a collaboration between the Fire Service College and Training 4 Resilience to create an establishment for the delivery of true wide spectrum multi-agency training; as well as providing the capability to undertake vertical training within individual agencies and

organisations to improve the overall skills‑base and civil contingencies arrangements. Mabway offers realistic training scenarios, managed role-play services, security protection and reality-based training. The Emergency Planning College delivers Cabinet Office-approved emergency planning and crisis management training including real-time simulation exercises. It also provides a central forum for knowledge sharing and focuses on multi-agency working, disseminating best practice nationally and internationally to enhance worldwide resilience against natural disasters, major incidents and malicious attack. MENTAL HEALTH SUPPORT Emergency services personnel have been identified as being at greater risk of experiencing a mental health problem than the general population, but are less likely to get support. Mind has been awarded LIBOR funding to develop the Blue Light Programme for emergency services staff and volunteers across England. Visit their stand in the Emergency Response Zone (Z238) to find out more. VITAL ROLE OF VOLUNTARY SECTOR The emergency response voluntary sector has a substantial resource of trained and skilled people, vehicles, equipment and premises that provide practical and emotional support before, during and after an emergency. This allows the emergency services to concentrate on the immediate needs of a crisis, freeing up vital resource. Within the dedicated Emergency Response Zone at the Emergency Services Show, visitors can meet organisations from across the voluntary sector. TECHNOLOGY AND SOLUTIONS The Emergency Services Show provides a unique opportunity to see the latest technology, ideas and initiatives. Exhibitors include leading names in fire fighting equipment, search and rescue, extrication, first response, communications, IT, protective clothing and uniforms, vehicles and fleet, vehicle equipment, outsourcing, training, community safety, station facilities, water rescue and medical supplies.  FURTHER INFORMATION www.emergencyuk.com

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Healthcare Parking Written by Kelvin Reynolds, director of policy at the British parking Association

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PARKING BEST PRACTICE

How is NHS parking shaping up in 2015? Well designed and properly maintained parking provision is vital to the success of Britain’s hospitals and healthcare facilities. The British Parking Association’s Kelvin Reynolds looks at a healthy approach to good parking practice

The big e c differenarking np betwee itals and at hospor business car park operators and many of the key f parkingisure is that principles contained within the government and le n there guidance is already at ofte hoice the heart of the Charter. c e is littl We are keen for both

Good quality, well designed and properly maintained parking provision is vital to the success of Britain’s hospitals and healthcare facilities through the setting and raising of standards. We, at the British Parking Association (BPA) believe that providing, managing and charging for parking at healthcare facilities needs to be seen in the context of delivering a better and fairer service to users. Parking at hospitals and healthcare services is always going to be a softer target for the media to tell a good story about how not to do it. Healthcare is very personal, second only it seems to finding somewhere to park. In combination, hospital parking is always an opportunity for an emotional ‘headline’. The big difference between parking at hospitals and other healthcare facilities and parking for business and leisure is that often there is little choice. Few people choose to go to hospital and even fewer have a choice of which hospital. These are facilities used most when we are unwell or seeking medical advice or obtaining treatment for long-term conditions. At best we are visiting someone who is unwell. Like so many other places the demand for parking spaces at hospitals exceeds the supply and therefore it needs to be rationed and managed. How best then do we manage it? How do you prioritise allocation of spaces and use? How is it paid for? What is the impact on the community served by the hospital? Is it a good neighbour? These are all topics for debate and resolution. A HEALTHY APPROACH TO PARKING Our Healthcare Parking Charter is aimed at both managers of healthcare facilities and

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car park operators and NHS Trusts to recognise the importance of having a good car parking policy in terms of a wider transport strategy and the need to manage traffic and parking in line with demand and environmental need. Collaboration with local councils, as well being ‘good neighbours’ is important for NHS Hospitals too and can result in integrated transport planning which benefits everyone. There’s no point in having well managed hospital parking which simply results in an overspill of parking into the surrounding streets, annoys the neighbours and adds to the congestion making access to the hospital more difficult for everyone. Paramedic ambulances on a ‘blues and twos’ run won’t be impressed by congested streets caused by a lack of coordination when planning the management of hospital parking facilities. It’s no easy task but it can be done. Earlier this year we’ve been working with the Department of Health in updating parking guidelines for NHS Trusts, which was published in March 2015. The guidelines include case studies of good practice that other NHS Trusts are encouraged to emulate. A GOOD HOSPITAL PARKING STORY I said earlier that collaboration is important to success and we were really pleased to assist the Department of Health in producing these new guidelines. We assembled a team of experts, with a combined

experience of over 250 years in car park operations, traffic management, parking access control and payment technologies, as well as NHS Facilities Managers. Department of Health colleagues were clearly impressed and pleased with our contribution. The outcome is the NHS Car‑Parking Management: Environment And Sustainability, which is an excellent guide to good practice that we recommend to all Trusts and parking operators to ensure they strike the right balance between being fair to patients, visitors and staff and ensuring facilities are managed effectively for the good of everyone. First launched in 2010 the BPA Hospital Parking Charter, sets out the importance of offering a high standard of management and customer service, which reflects the needs of all car park users including patients, visitors and staff and with proper and adequate access controls and fair and reasonable enforcement where this is required. There is of course much more to the Charter and it’s now time to give it a ‘Health Check’. We want to make certain that it’s fit for purpose; we want to encourage more to sign up and to abide by the principles of the Charter. We want to make the Charter easier to understand, simple to promote and above all ensure that its intentions are delivered. The Department of Health guidelines recognise the importance of professionalism in delivering parking services and providing a high standard of customer care, and are much aligned with our Healthcare Parking Charter currently adopted at 16 NHS Trusts. PROFESSIONALISM Speaking of professionalism, our new Professionalism in Parking Accreditation (PiPA) which embraces our Healthcare Parking Charter is being launched later this year. Envisaged as a universal accreditation for organisations in all sectors of the parking profession, PiPA will be launched in parallel with a re-developed and audited Healthcare Parking Charter later in 2015. When we worked with the Department of Health on the development of the new guidelines for parking management published in March 2015, it became clear that in redeveloping our Healthcare Parking Charter we should design it with the intention that NHS Trusts would be able to demonstrate


compliance not only with the Charter which would be aligned with DH Parking Principles and the new Guidelines for Parking Management. This would enable NHS Trusts to ‘prove’ that they were following government guidance and more. We now have a piece of work which is ready for consultation with NHS Trusts to determine its effectiveness and likelihood of acceptance and acceptance testing is now underway across the NHS. Ultimately we would intend to connect our Charter with our PiPA scheme which all NHS Trusts could aspire to if they wished. The BPA has long argued for the adoption by Health Trusts of the BPA Healthcare Parking Charter which encourages good practice in delivering parking services to patients, visitors and staff. If motorists are being asked to pay for their parking, they should receive value for money through better facilities, a safer car park and effective but fair enforcement where it is necessary. Where concessions are available, be it in the form of the NHS Healthcare Travel Costs Scheme or as concessions for patients with a long-term illness or condition that requires ongoing treatment, it is the role of the Trust to communicate this information to patients. Many people attending healthcare facilities, either as patients or visitors and even staff, expect car parking to be free. However, the limits and demands on space and costs

involved means that car parking needs to be shared fairly and properly managed. Free parking at hospitals is the norm in Wales and Scotland as governments pander to the popular demand. Increasingly there is a demand for England to follow suit. None of this is without consequences and it is only too apparent in Scotland and Wales that there is no such thing as a free parking space. Someone is paying for it. FREE FOR ALL OR FAIR FOR ALL? We feel that it must be wrong that healthcare budgets should be used to provide parking facilities for those who choose to drive to hospital; additionally is free parking fare on those who arrive by public transport and continue to pay? We strongly believe that healthcare budgets be used to provide healthcare and that car‑borne visitors should pay for this service. We also believe there should be exceptions where long term or vulnerable patients should receive discounted or free parking. We note that Julie Cooper MP has been successful in the ballot at Westminster for Private Members Bills and has published her Bill entitled ‘Hospital Parking Charges (Exemption for Carers) Bill’ A Bill to make provision for exempting carers from hospital car parking charges; and for connected purposes. To promote good practice, we’ve a very

successful Healthcare Parking Special Interest Group, which brings together people in NHS facilities, with parking operators and service providers to share knowledge and experience. It became very clear to me at a recent meeting of this group that there are some serious challenges and yet also some simple solutions. If only people knew about them. There is best practice ‘out there’; our role in the BPA is to raise standards, and nowhere is this more apparent than in healthcare parking. Balancing the needs of hospital patients and visitors; staff and healthcare professionals to ensure that access to healthcare is fair, and cost-effective requires courage and determination. Parking managers at healthcare sites across the UK face these challenges every day. Working alone they seek to resolve their problems locally – often challenged by local media and indeed their own colleagues. Working together through BPA Healthcare SIG we can collectively share knowledge and best practice; campaign for better recognition of the services provided and the need for them to be properly funded. The health of the nation depends upon the NHS. The NHS depends upon the parking sector to help ensure that access to its facilities is fair and appropriate; properly managed and adequately funded. L

Healthcare Parking

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FURTHER INFORMATION www.britishparking.co.uk

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Signage Written by Chris Girling, head of wayfinding, CCD Design and Ergonomics

WAYFINDING

Navigating the labyrinth A well-designed wayfinding system can not only lead to a better patient and visitor experience, but evidence suggests there are also cost efficiencies to be gained. Chris Girling explores what effective wayfinding should look like In an age of austerity, and with two out of three hospital trusts running a deficit, it seems highly improbable that there is any spare cash floating around. Perhaps, though, the challenge is to agree what is essential, especially in older hospitals which have developed over many decades into almost unfathomable labyrinths. Wayfinding may not seem a priority, but a proper understanding of its role shows that it is a low-cost investment with high returns. Two of the latest hospitals, South Glasgow University Hospital and the Queen Elizabeth Hospital in Welwyn Garden City show what can be done when funds are available. There are floor plans on the web site, so that pre-planning of visits is possible. IMPROVING EFFICIENCY These days the value of involving users in the development of facilities across the NHS estate, whether they are patients, staff, suppliers, or supporters, has been recognised. The importance of this is not just the invaluable insights provided by the people who actually use the facilities, but they can also help achieve better solutions to problems at a lower cost. But how does wayfinding fit into this? Surely signs that have been fine for decades, can continue to serve in the future? And surely they cannot be seen as a priority when there are so many demands on Trust purses. The issue is that whilst new facilities are well designed and planned, the vast majority of NHS facilities are old, and nearly all have evolved to meet changing needs. This means that what worked before, doesn’t necessarily work now. But there continues to be a need for people to enter, traverse and exit any hospital facility. In older facilities, a large amount of signage which lacks any

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consistent use of colour, typeface, design or symbols is not untypical. It is probably fair to say that as wayfinding has not been a priority for many years, if ever, there are a large number of hospitals which have become increasingly difficult to navigate as they have changed or expanded over the decades. Independent studies prove that an inefficient wayfinding system for a hospital can cost up £350 per bed per annum. In a 900 bed hospital, that equates to over £300,000 every year. Imagine what that money could be used for. THE PERSONAL JOURNEY So in considering wayfinding as an investment, with strong returns, hospital authorities need to understand where the best gains can be made with the least outlay. An audit is a sure start: observation can be very effective – are there junctions where people regularly don’t know where to turn, are there areas where staff have to spend an inordinate amount of time providing help and assistance, etc. More formal research using questionnaires and interviews will help gain an understanding of peoples’ journeys, their needs, and how they interact with the architecture and spaces in the facility. Ideally, this will take place in advance of any refurbishment, so the results can be applied as part of that work. In practice that is not always possible, and the audit needs to take place on completion. The output should be revised wayfinding that integrates with the existing system, and doesn’t become something that

is separate and applicable only to the new facilities. Taking this approach will enable staff and visitors to become familiar with the system more quickly, reducing any disruptions where there is an intuitive sense that the wayfinding system is not up to standard. SAFETY CONSIDERATIONS Beyond finances, there are safety issues – ensuring that visitors don’t head to inappropriate areas, and that staff cannot become disorientated in times of high pressure, as well as reducing congestion by managing (people) traffic flows. Efficiency gains come from reducing late appointments and reducing the time taken for people to move around the facility between departments. There are emotional benefits as well with reductions in stress as people are more confident about coming into and moving around the hospital. Good wayfinding can lead to increased patient empowerment and increased inclusivity with signs tailored to the needs of both older and disabled patients. There is also the question of how good wayfinding contributes to the branding of the hospital. In an age where ‘customer experience’ is a key driver for the NHS, such considerations are vital. Hospitals should regard wayfinding as just one ‘touchpoint’ in the broader patient care experience. As it is part of the journey it has to be made to join up with all the other elements and fixing isolated parts often falls short of changing the experience. The opportunities

Despiteis costs,it t to n importand that a underst finding can ay good w ally improve drastic ficiency of the ef spital a ho


for feedback demonstrate that in all areas hospitals must be ready and willing to respond to patient and visitors comments. WAYFINDING STRATEGY Wayfinding starts with three key principles: providing orientation, direction giving and decision making. The wayfinding strategy must help people make sense of a place and use cues to find destinations and achieve various goals, and the implementation will see good signage at key points. But it may be more than just signage – volunteers can form part of a strategy as people like to have a personal touch that volunteers can provide. Colour coding of corridors and different areas can be very effective in providing immediately recognisable and easily understood destination points. Often symbols can be used to break down barriers, and where wording is used, the preference should always be for layman’s language rather than medical terminology. This approach also improves inclusivity by making it easy for everyone regardless of their first language, age, or any disability. The best wayfinding strategies recognise that a journey doesn’t start when someone arrives at the hospital, it starts even before someone leaves home. An optimal wayfinding strategy will adopt a ‘joined up’ approach, taking the person from the start all the way

to the end point. So it is enormously helpful to have floor plans and journey planners on the facility web site – this means that from the outset the visitor has an idea of how to get to where they are going to. Direction signs from local roads guide people in, and then take them to the right car park and onwards to the hospital itself. Naturally, not everyone comes from the same direction, or uses the same entrances but too often, signage can often be located assuming everyone comes in the main entrance. MAKING AN ENTRANCE Entrances to different departments need to be clearly visible, and once inside a hospital there needs to be a balance struck between how much visitors are guided by signage, and how much they interact with reception staff. From the arrival areas, people need to be clearly guided to their destination point, and given reassurance along corridors – and if they happen to make a mistake, given the opportunity to get ‘back on track’ at every relevant stage. For outpatients with an appointment, they need to get from home, through reception and to the right department in a timely fashion. Appointment letters should include not only the time of their appointment, and the department but also provide directions – public transport

Signage

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

routes, the right car park, the best entrance and how to reach their final destination. Even a link to where that information can be found on the website can be very useful. Where texts are sent as reminders, a web link should always be included. FINDING THE RIGHT DIRECTION In the same way, breaking down a journey into manageable elements can be highly effective. So, for example, where someone is navigating across the hospital along numerous corridors, which probably all look the same to them, landmarks can be introduced to help people orientate and for people to be given instructions. These need not be signs, but could be refreshment points, works of art, changes of wall colouring – anything that is describable and can be included in the directions. Getting wayfinding right is more critical in a hospital because they are stressful environments – visitors coming to see a sick friend or relative, staff needing to provide care in a time critical fashion, or even suppliers who have busy schedules to adhere to. No‑one is going to pretend that budgets are easily available, but if good wayfinding can demonstrate its financial benefits, it should move up the list of priorities. L FURTHER INFORMATION www.ccd.org.uk

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Volume 15.4 | HEALTH BUSINESS MAGAZINE

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Translation

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

COMMUNICATION

Written by The Association of Translation Companies

Where conversation is part of the therapy Strong, respectful therapeutic relationships and compassionate patient care are things that are at the forefront of the health sector’s mental health aims. But with over 300 languages spoken in the UK, communication can often be compromised, writes the Association of Translation Companies Empathy, respect and compassion are required to ensure understanding of the patient’s perspective and to accurately communicate. There needs to be appropriate knowledge about maintaining confidentiality and information sharing. Interpreters should have no prior personal relationship with the service user. An interpreter needs to have a clear understanding of their role when participating between the patient and the clinician – their role is to translate information, but not to interject with any personal queries or opinions.” “In the locality in which I work, we have a large Asian community, so we work with languages such as Gujarati, Mirpuri, Punjabi. There is also a growing Polish community. It’s important that interpreters know how to interact with the service users in a culturally appropriate way.”

Greater awareness of psychological health and an increasingly ageing population have led to higher demands on the NHS for psychiatric help. For patients who do not have English as a first language delivering effective treatments can be more complex and, are highly dependent on the intervention of professional language services. With over 300 languages spoken in the UK, communication in the NHS between clinicians and patients can often be compromised as a result – especially for older people who are less likely to speak and understand English, having previously always relied on friends and family. Strong, respectful therapeutic relationships and compassionate patient care is something that is at the forefront of the health sector’s mental health aims. The clinician’s ability to explain, listen and empathise can have a significant effect on functional health outcomes of the patient, as well as patient satisfaction and experience of care. SUPPORTING STANDARDS Dr Valerie Curran, Consultant Psychiatrist for Older Adults, at Black Country Partnership NHS Foundation Trust in West Bromwich outlines how translation and interpreting services can

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ge Langua nsure e servicesatients that p nd the a understts offered n treatmeke sure they and ma nfident on are co s they issue face LEGAL FRAMEWORKS

support these standards of mental health care. She argues the need for good quality interpreting and translation services within her area of work, facilitate a good therapeutic relationship between the service user and the doctor. She said: “In order to interact with patients effectively and compassionately, and to keep patients engaged in their therapy, good quality communication is very important. “Mental health problems can affect people from all backgrounds and cultures, and effective information sharing is a key factor in supporting good communication. Mental health workers understand that the therapeutic conversation that takes place is often the key intervention in itself. “The Equality Act of 2010 mentions 9 personal protected characteristics which should not in themselves reduce or impact on an individual’s right and ability to access the services they may need, including healthcare.” Dr Curran also describes her views on what constitutes good quality interpreting services. She commented: “Services should be easily accessible and available, the providers to be appropriately qualified and experience to act as the intermediary between the clinical staff and the patient.

The Mental Capacity Act and other legal frameworks highlight the importance of the optimising and enabling an individual’s capacity to make decisions and communicate about their care where possible. Providing people with the resources to directly express themselves and communicate about their views and needs, rather than having family members speak on their behalf, is an important means of supporting this principle. I have worked with a large variety of interpreting services, including The Association of Translation Company (ATC) member Absolute Interpreting and Translations, and it is my impression that more consistency in skill and knowledge is required across interpreting service providers”. Communicating with the patient’s members is an important part of Dr Curran’s everyday work, which can bring challenges. Good quality communication is also important in respect of families and carers. Sometimes it is not just the patient who doesn’t have English as their first language but family members and carers too, and if, for example, carers are not able to effectively communicate the patient’s clinical or collateral history or understand the treatment plan agreed, this could negatively impact on the clinical outcome.”


As a Psychiatrist working predominantly but not exclusively with older adults, Dr Curran treats people with a range of mental health issues including dementia, functional mental health problems such as psychosis, depression, and anxiety in old age. She said: “What we tend to find is that younger people (under 65 years old) from ethnic minority groups who have grown up in the UK are likely to have good English language skills especially those who have participated in the education system here. However, older people from BME communities who have grown up abroad may have varied levels of English literacy and language skills linked to their earlier educational opportunities and this group of people will often benefit from specialist language services.” Furthermore, Dr Curran explains why language barriers can interfere with the therapeutic relationship. She said: “Linguistic barriers can impact negatively on the relationship if patients don’t feel like they are being listened to or are being treated in a manner that they feel is not adequately respectful. Patients can disengage if they don’t feel that clinicians are interested in finding out their perspective, and if people disengage, this can impact on treatment outcomes and access to care.” LANGUAGE SERVICES Explaining the necessity for accuracy in the language services procured, Geoffrey

Bowden, general secretary of the ATC explains: “Language services bridge the gap between healthcare professionals and patients whose first language is not English. It ensures that patients understand the treatments that are being offered, and helps make sure they are confident on the issues they face and the options available to them. It is essential for both parties involved that mental health services in the NHS have access to translation and interpreting services to deliver safe and effective healthcare. “As well as ensuring the availability of language services, the health sector needs to be confident it is accessing services that are of the highest quality, to be certain that all languages are delivered professionally and with full regard to patient sensitivity and confidentiality. Geoffrey continues: “The NHS has to be confident that only appropriately qualified interpreters are being supplied through translation companies belonging to professional bodies such as the ATC. ATC members will have put in place rigorous screening processes to ensure that only the best linguists are assigned to work in NHS settings. Patients and clinicians must be confident that interpreters understand the boundaries within which they are working. “Some ATC members specialise in telephone interpreting services which

Translation

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are accessed during consultant and patient assessments. The interpreter acts as the essential intermediary, ensuring everyone understands each other and that no element of the consultation is open to misinterpretation. Working without such high standards not only risks the reputation of the NHS service and the language service industry, but can also be highly detrimental to the patient.” Ameet Gauher at Five Star Interpreting & Translations, another member of the ATC, comments: “There isn’t one area of the public sector where limited or inaccurate language services would not cause detriment, but especially so in healthcare. “Whenever an individual is involved with a life changing decision it is essential that there is clarity of information. Clear language and communication skills are at the centre of good medical practice. Ameet concludes: “When it comes to the reputation of the health sector, there are always potential risks when there is a lack of or limited communication. Language services should, for this reason, never be considered a luxury, but a necessity for the NHS to maintain and improve upon its reputation.” L FURTHER INFORMATION www.atc.org.uk

Welcome Translations: Speaking your language

Welcome Translations is a leader in translation services for the healthcare and medical industries, and our tailored medical translation solutions will help you communicate with your diverse patients. Our linguists have the regulatory knowledge and subject-matter expertise to ensure high-quality, accurate translation and interpreting services for all of your requirements. All our medical translators have proven language proficiency, interpreting ability and knowledge of medical terminology, alongside extensive experience in translating clinical research, regulatory documents, drug development, and medical device documentation.

www.welcometranslations.com

Call: 020 7091 0491 E-mail: info@welcometranslation.com Volume 15.4 | HEALTH BUSINESS MAGAZINE

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Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FACILITIES MANAGEMENT

FACILITIES MANAGEMENT

The Water Management Society (WMSoc) is a not-for-profit membership organisation that provides practical training in water management related subjects, including legionella control and prevention. Training courses are aimed at a wide range of delegates including water suppliers, plumbers, facilities managers and engineers. Courses cover all aspects of water management including legionella risk assessment, cleaning and disinfection and temperature monitoring, sampling and infection. Training courses include prevention and control of Legionnaires’ disease within various water systems, including cooling towers, closed systems and hot and cold water systems. All courses are up to date with water industry legislation and are City & Guilds accredited. Water Management Society’s unique Practical Training Area (PTA) enables course attendees to gain hands on experience. It houses two cooling towers, which are utilised

Bridge Contract Interiors is a dedicated supplier of Fire Retardant curtains and blinds for hospitality and healthcare facilities. The company offers an unrivalled service whether for Procurement manager, contractor or interior designer. Its team is on hand to help you to specify the most suitable products or work to your specification. You can view the huge fabric range online, or they will even create a design bespoke to you. Bridge Interiors products range from budget roller blinds and unlined curtains - for social housing, through to bespoke designs to lift your communal areas. It supplies healthcare specific products as well as being an accredited installer of the Kestrel Anti-ligature system for safety in

Practical solutions to water management

on a number of the courses. The PTA is used to assess the competence of delegates during practical exercised and to certificate that a person has the ability to perform their duties in a competent manner. WMSoc offers bespoke courses too. All delegates receive temporary membership to the Water Management Society incorporating technical question and answer support and access to guidance documents. For further information on training courses, please use the contact details below. FURTHER INFORMATION Tel: 01827 289558 admin@wmsoc.org.uk www.wmsoc.org.uk

Nationwide contract curtain and blind installers

prisons and mental health units. Bridge Interiors only supply Fire Retardant products. The company individually assesses your requirements to ensure you have products suitable for your facilities, and these are backed with their certificate of compliance for your site records. Bridge Interiors service is from manufacture and supply-only through to installation where required, through the company’s CHAS certified fitting team. View the Bridge Interiors website to see its range or why not give the company’s helpful team a call for immediate assistance. FURTHER INFORMATION Tel: 0800 619 6190 www.bridgecontractinteriors.com

Nu Look specialises in all aspects of Industrial, Commercial and Domestic Cleaning. Nu Look tailored cleaning services allow standards to be maintained and deadlines met, with trained and DBS checked operatives if required. We are confident that given the opportunity we have the resources, experiences and competitive attitude to deliver the best services in the industry.

The Grand

Broad Street, Bristol BS1 2EL T F E W

0871 376 9042 0871 376 9142 letsmeet.bristol@thistle.co.uk www.thistle.com

The Grand – an elegant Victorian building in the heart of the city, refurbished to blend Victorian charm with a contemporary feel. A choice of 10 meeting/function rooms to suit any occasion, from one-to-one interviews to a full sit-down banquet for 430. We have an exciting choice of lunch and banqueting menus, including healthy options. We provide a dedicated specialist Meetings & Events team, who will work with you at every stage of your event. The hotel has high speed Wi-Fi free of charge throughout the hotel, and boasts an on-site car park, as well as full leisure facilities, including a swimming pool. All 182 en-suite bedrooms are air-conditioned, with comfortable beds, and furnished to a modern design with a warm restful ambience. The hotel has a choice of restaurants – our Tyrell’s Restaurant and Marlow’s Cellar Bar. The hotel is 1 mile from Bristol Temple Meades train station and is 8 miles from Bristol Airport.

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HEALTH BUSINESS MAGAZINE | Volume 15.4

Summary of our Support Services offer by Nu Look Ltd: Office Cleaning  One-off Cleans  Builders’ Cleans  Window Cleaning High level Cleaning  End of Tenancy Cleans  Washroom Hygiene Services Carpet & Upholstery Cleaning  Clinical Cleans Janitorial Supplies  Insecticide Treatment We are committed to providing the highest standard of work at an affordable price. A very flexible company and therefore able to meet your requirements and provide a complete customer satisfaction. Nu Look recognises that not all businesses have the same requirements so we ensure that each contract or job is assessed on the individual needs of the customer quoting accordingly. 

Head office telephone: 0203 489 0909 www.nu-lookltd.co.uk Nu Look Ltd, 96 Park Lane, Croydon, Surrey, CR0 1JB


SECURITY

IT

Mailsafe is a secure, UK based email archiving software solution from Techne-Comm Limited. The company has developed a strong reputation in the public sector through major success within the NHS and local government. With its largest installation being in excess of 24,000 mailboxes, Mailsafe has been fully tested and verified by the Health and Social Care Information Centre (HSCIC) for secure email archiving with NHSmail. It is available as either an onsite archive or as a secure cloud service. Core features include AES256 bit encryption, single instance archiving, and 50 per cent compression. This enables Mailsafe to deliver significant cost savings for storage and backup processes for sites using Exchange Server, Outlook or with PST file storage issues. The lean Mailsafe infrastructure enables large volumes of email data to be stored efficiently helping

Medxnote is a secure mobile messaging app connecting everyone across the healthcare enterprise. Some people describe it as ‘WhatsApp for Healthcare’. Medxnote solves the problem of outdated pagers and the growing use of consumer messaging apps in the NHS. Doctors and Nurses currently waste 45-60 minutes per day using pagers. Medxnote solves this problem by providing a fast and efficient communication platform. Every message is tracked with a built in closed loop communication feature ensuring timely and safe delivery of messages, freeing up doctors and nurses to spend more time caring for patients. The use of consumer messaging apps such as WhatsApp, Viper and Snapchat by clinical staff is a widespread data protection problem across the NHS. Medical

Secure email archiving and Secure mobile messaging management software for health care services

FURTHER INFORMATION Tel: 01252 758 124 hello@techne-comm.co.uk www.mail-safe.co.uk

DOCUMENT MANAGEMENT

IT

Magenta Technology is a specialist business equipment supplier. Since 1995 it has developed into a specialist print supplier with brands Sharp and Samsung and has an enviable reputation for looking after its clients. Magenta Technology has held the ISO 9001 Certification since 2009 which endorses the company’s commitment to customer care and service support, and it is also members of NAPPS which confirms its commitment to ethical company standards. Magenta Technology’s account managers have a wealth of experience to guide a client through what seems to be a jungle of specifications, prices and finance options to arrive at the right solution for the client. Understanding the client’s needs and targets is why its repeat business ratios are so high, and staff has been supporting some clients for over 30 years. Improvement to client’s costs, workflow, productivity, security,

Sentinel by SCC is the first multi-tenanted Pan-Government Accredited Cloud, keeping your data secure to Official and Official Sensitive (IL2 & IL3) security standards. Hosted in multi award-winning Tier 3+ data centres in the UK, the tenancy is fully managed with support provided 24/7 by SCC staff who are SC-cleared and UKbased. Public sector customers also benefit from Sentinel’s in-house Information Assurance teams who support the delivery of IT solutions into the government marketplace. Sentinel by SCC, a PSN service provider (PSNSP) offers a number of ‘as-a-service’ options, including: Mobility; Remote Access; MDM; Hosted Desktop; Exchange and Lync. All services are underpinned by certification for process and procedures (ISO 9001), environment (ISO 14001), security (ISO 27001), ITIL (20000), and health and safety (OHSAS 18001). SCC’s Network Operation Centre provides configuration,

Magenta - Helping you make the right decision

and providing new features such as mobile device printing and scanning all of which are done through tailoring the correct equipment with the most effective software solution. Magenta Technology has grown through customer referrals and reputation and can supply equipment nationwide, through its network of Sharp and Samsung partner’s to ensure that a multi-location installation is carried out seamlessly. FURTHER INFORMATION Tel: 01432 278296 www.magenta-tech.com

images and video often contain patient identifiers and these images are stored to the photo gallery of the phone and can be uploaded to personal cloud storage. This practice is a serious data protection breach. Medxnote solves this issue by providing a secure messaging platform that is HIPAA compliant and data secure. Clinical conversation and medical images are securely stored in Medxnote and become part of the patient’s health record. Please contact Medxnote via the details below in order to request a demo. FURTHER INFORMATION Tel: 0035385 2896977 info@medxnote.com www.medxnote.com

SCC – Protecting sensitive public sector data by SCC

to fulfil Compliance, Information Governance and Freedom of Information queries instantly. Full integration with Outlook makes it easy to use with minimal or zero user-training being required, whilst the unique feature of Personal Folder Archiving means users retain an exact mirror of their Outlook folders in the archive. If you are interested in a noobligation web demonstration or free trial of Mailsafe please call or visit the website below.

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

management and maintenance for the environment while its Security Operation Centre monitors, assesses and protects customers’ enterprise information systems. With connectivity via the internet, HCF, N3 and PSN Government Networks, Sentinel offers customers real benefits, including the flexibility to grow and release resources as needed, price predictability with lower-cost 30-day contracts, removing ‘lock-ins’, and guaranteed SLA’s that ensure 99.9 per cent or 99.95 per cent availability. FURTHER INFORMATION Tel: 0121 281 8618 www.scc.com

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Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FLEET MANAGEMENT

ACCESS SECURITY

Supporting fleet managers Security consumables for in achieving efficiency gains all of your needs

Improving the quality of services delivered and achieving efficiency targets is paramount for fleet managers and keeping control of fleet costs is a never ending challenge. Civica’s Tranman fleet management software enables improved fleet management, cost savings and operational efficiency. Fleet systems are becoming a data hub, pulling data in from numerous sources, including HR/training systems, GPS tracker/black box systems and organisations such as the Driver and Vehicle Standards Agency. In addition, there is a move towards digitisation and mobilisation of records and workforce. Tranman Touchscreen - Tranman’s touch screen solution - has been enhanced to use the latest

Windows 8 technology. Additional improvements include the ability to edit and update the job header and issue stock items directly from the touch screen. Civica’s touch screen technology provides an intuitive user interface for workshop technicians ensuring rapid data entry and minimal administrative overhead. Tranman E-Forms, a product soon to be unveiled, removes the need for paper inspection sheets. Tranman E-forms offer complete compliance and piece of mind with the dashboard feature giving instant access to vehicle data. FURTHER INFORMATION Tel: 01454 874011 jonathan.roberts@civica.co.uk www.civica.co.uk/tranman

SAFETY & SECURITY

Safety, security and asset management solutions Avonwood is one of the longest serving RFID specialists offering solutions for health and safety, security and asset management applications to both the public and private sectors. With experienced and highly qualified teams of product, software and design engineers, Avonwood’s complete service includes system specification and design, hardware development and integration, software development and data hosting, system installation and servicing. The company’s product range includes, Key Tagging, AssetBase-iD and ZoneSafe. Avonwood’s Key Tagging System helps to prevent the removal of keys from secure environments. Reducing the risk of compromise situations the system ensures greater control of issued keys within environments where round the clock key compromise protection is required. Originally designed for secure environments

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the system is widely used within HM Prisons and secure hospitals. AssetBase-iD offers a complete asset identification and tracking solution. Whatever the requirements, Avonwood’s system will manage assets from any device and location utilising RFID tagging hardware and cloud based services. Keeping a track of fixed and moveable assets, AssetBase-iD will assist with maintenance, task scheduling, compliance and other management functions. ZoneSafe is Avonwood’s leading proximity warning and alert system designed to protect personnel and assets from accidental vehicle collisions. FURTHER INFORMATION Tel: +44 (0) 1202 868000 www.avonwood.co.uk

HEALTH BUSINESS MAGAZINE | Volume 15.4

AccessCards is a one stop shop for all ID management consumables with an e– commerce website and friendly knowledgeable staff to help you. AccessCards provides discounted prices on access control system cards and fobs, printers and ribbons from leading manufacturers, plain and logoed lanyards, yo-yo reels, card holders and visitor pads etc. In addition there is an online printing portal. Cost savings are always high on the health sector agenda. Using AccessCards ensures the best value as it guarantees to be the cheapest online. The company will also respond to last minute requests efficiently with either same day or next

day deliveries to its customers office or directly to new members of staff if required. Using AccessCards can help improve efficiency by keeping all orders in one place and allowing repeat order setup. It can reduce costs by more than 20 per cent. If you’re not sure what cards or fobs you use, AccessCards will identify the card for you. Just call them or send them for identification to AccessCards (40 Bloomsbury Way, London, WC1A 2SE) quoting your name, organisation and email address. FURTHER INFORMATION Tel: +44(0) 203 151 0200 info@accesscards.co.uk www.accesscards.co.uk

RISK MANAGEMENT

Hawkins - Leaders in forensic investigations

Only by establishing the facts clearly and precisely can you make an informed decision on the best way to recover from an incident and to stop it happening again. Hawkins has been carrying out forensic engineering investigations for over thirty years and we have more than 70 Forensic Scientists with a wide range of expertise who are able to form a multi-disciplinary team should an investigation require it. The company investigates a wide range of losses, including equipment failure; personal injury; fires and explosions; engineering losses; road traffic accidents; escapes of water, fluids and gas; slips, trips and falls; personal injury; head protection; civil engineering; power generation & turbines and

contamination assessment. Much of Hawkins’ work comes from insurers, loss adjusters and the legal profession, with a growing proportion now coming from large corporate clients and local authorities, including the health sector. Hawkins is able to provide a rapid response, attending the scene within 24 hours of the event if required. A preliminary report can be produced within three days setting out the most probable cause and a proposed strategy for further investigation. Contact Hawkins via the details printed below. FURTHER INFORMATION Tel: 01223 420400 enquiries@hawkins.biz www.hawkins.biz


CALL CENTRES

PROCUREMENT

No one can question the positive impact mental wellbeing has on health, but how can happiness influence agent performance and reduce costs at NHS contact centres and helpdesks? SJS Solutions Ltd helps transform dull, cluttered contact centres into places where people are happy to help, work hard and be part of a team. SJS specialises in using visual communications to increase employee engagement and accelerate knowledge transfer. The company’s software gives you the tools needed to motivate agents and reduce the costs associated with high attrition rates. With Optymyse, transferring live data, messaging, images and alerts from any source onto any device is easy and affordable. Engage with your agents, create consistent messaging and furnish them with the information they need to perform at their best. SJS have helped

Winning Tenders is a business that does exactly as its name suggests. Established 10 years ago, the company’s mission is to provide expert bid support to smaller and medium-size enterprises enabling them to expand by securing major contracts with public sector and corporate (PLC) organisations. Winning Tenders’ bid writing experts offer an effective way of maintaining a competitive position and winning new business. They help clients to take a winning approach to the most suitable opportunities and to devise the best way of ensuring successful pre-qualification, shortlisting and selection as the preferred bidder. With nearly 30 years experience of successful tendering, Winning Tenders’ founder Ian Smith’s expertise covers all aspects of proposal writing, bid management,

Real-time communication solutions for call centers

Lancashire Police, Cheshire Council, Lewisham Council, Merseyside Police and many more. Two weeks after deployment at Cheshire Council we were told that service level improved 29 per cent and average speed to answer reduced 66 per cent. “Staff motivation has improved which has translated directly to better customer service. For the first time all services have ended the day above targets.” FURTHER INFORMATION Tel: 02036 421842 info@sjssolutions.co.uk www.sjssolutions.co.uk

Winning Tenders - Increase your chances of success

COMMISSIONING

FITNESS

Attain works in partnership with health and social care organisations to transform and continually improve the planning, design and delivery of services. To teh company, this means making the most of finite resources to deliver services that improve people’s quality of life. Attain’s team is united in its values and commitment to person-centered care and wellbeing. Its people and experience bring together the best of the public and private sector. Attain has deep design, implementation, clinical and technical skills, proven through its track record. The company has a clear vision and sense of identity and is delighted to be a place where talented people want to work. Attain is committed to providing value to its customers and cap its profits at 12 per cent. The company is owned by staff, with wide employee share ownership. Attain is an independent provider

All day sitting is the norm in offices. A growing body of evidence reveals this is damaging to our health. A combination of ergonomics for computer use and social convention keeps us seated. Office Fitness looks to break these conventions with a range of office furniture and desk-side exercise equipment designed for active working. The benefits of a fitter, healthier workforce go beyond issues just related to absenteeism. Studies have shown that workers who move are more productive, more engaged and more motivated. Office Fitness believes in the simple idea that physically active workers are happier workers. Company owner Paul Matthews said: “I think it is to do with our four million years of evolution. We work best when we are on our feet and as a species we are designed to move, not to sit still for hours on end. People who have made the transition to standing describe it as a more natural way of working and find the ability

Supporting organisations to improve care

of support services and care passionately about delivering tangible results through effective partnership working. The company has built a strong reputation as a market leader, providing services that drive and transform care. This is underpinned by a shared willingness to take on delivery responsibility for implementing real and lasting change. FURTHER INFORMATION Tel: 0203 435 6590 contacts@attain.co.uk www.attain.co.uk

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

outsourcing and tender evaluation. Compelling bid writing has been fundamental to Ian’s achievements with the emphasis on effective technical proposals. Ian’s perspective and understanding of the bid process is broadened by his experience as a trusted adviser to multinationals and even an EU agency running major procurement exercises. He is thus ideally placed to provide invaluable support for clients with their tendering processes and successful pursuit of key tender opportunities. FURTHER INFORMATION Tel: 01392 247997 info@winningtenders.co.uk www.winningtenders.co.uk

Changing the way the workplace operates

to pace and move liberating.“ The range includes fixed and height adjustable standing desks, treadmillls, table tennis meeting tables, ball chairs and office based fitness equipment that allows ‘little and often’ style activity breaks. FURTHER INFORMATION Tel: 02380 982289 www.officefitness.co.uk

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Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PARKING

HUMAN RESOURCES

Given the diverse needs and concerns of customers, hospital car parking can be a highly sensitive issue and making sure the right balance between being fair to patients, visitors, and staff is managed effectively for the good of everyone can be tricky. This is where Smart Parking comes in. Smart Parking is one of the world’s foremost car parking technology companies and has designed, developed and produced leading edge parking technology solutions for over 10 years. RFID-equipped vehicle detection sensors work alongside an easy-touse mobile application that enables drivers to locate vacant parking spaces in real time. SmartRep software is used to collate and analyse live information on how parking space is being used. This accurate vehicle-byvehicle, minute-by-minute data on actual usage of hospital facilities gives the customer the leading edge in managing any overstays, car park congestion

Busy HR teams can transform productivity, boost effectiveness and ease the pressures of a heavy workload with the help of Workpro HR. This innovative case management software has been specifically designed to help HR professionals manage the timescales, processes and documentation associated with casework. This could be a complex occupational health issue, a flexible working request, a disciplinary procedure or any number of other types of case. Workpro HR guides the HR team through the correct process, reminding staff of deadlines, keeping all documentation confidential and guaranteeing consistency in following company policy. Even a relatively small HR team can as a result provide maximum value and service to a large workforce. Created by Edinburghbased Computer Application

Transforming the parking experience for hospitals

and discourages the small minority of drivers who misuse the spaces. Revenues are maximised through optimum efficiency. David Malone, Transport and Travel Advisor, Newcastle upon Tyne Hospitals NHS Foundation Trust comments on the technology used at Newcastle’s RVI Hospital. “Smart Parking’s system helps us to manage spaces and is also an excellent monitoring tool to show just how spaces are being utilised.” For more information contact Smart Parking via the details below. FURTHER INFORMATION Tel: 0845 230 3081 sales@smartparking.com www.smartparking.com

TRAFFIC MANAGEMENT

FLEET MANAGEMENT

Speed Ramps is the UK’s cheapest supplier of recycled traffic management products. As the exclusive reseller to a UK manufacturer with over 40 years experience, Speed Ramps guarantees to be the cheapest door-to-door supplier. From cable ramps, kerb ramps, speed ramps and traffic cones to vehicle stoppers - Speed Ramps offers same day dispatch with carriage and fixings full operational capability. Speed Ramps offers a personal, professional and reliable service with no hidden costs. It guarantees to beat any genuine like-for-like quote. All of the company’s speed ramps are stamped, made in England and come with a minimum 12 month’s manufacturer’s warranty. SR30/50/75mm Speed Ramps are sold as kits for £24/£30/£36 plus VAT per meter including end caps, fixings and carriage.

Emotive Solutions Ltd is a leading distributor and installer of the Mobileye 560 Advanced Driver Assistance System ( ADAS ). The system helps protect fleets by providing drivers with advanced technology that helps keep them and those around them safe and your fleet experiences tangible measurable advantages that improves your bottom line with proven accident and fuel cost reductions. Many vehicle manufacturers are now implementing Mobileye technology into new vehicles with Headway Monitoring and Lane Departure Warning. But these are just two of the seven safety features available with the Mobileye 560 ADAS system. Other features include Headway Monitoring and Warning, Lane Departure Warning, Forward Collision Warning, Urban Forward Collision Warning, Pedestrian and Cyclist Collision Warning and Speed Limit Indication. Drivers are provided with

Cheapest door to door speed ramps in the UK

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Workpro HR: Case management software

The company also stocks signs and poles in adherence with Highways Agency guidelines, and supplies a user friendly installation guide. Speed Ramps has a network of CHAS and constructionline accredited installers to provide a one-stop shop to any speed ramp requirements. For more information email the company with the details below. Visit the Speed Ramps website to place an order or request a free no obligation quote. FURTHER INFORMATION Tel: 01480 432055 sales@speedrampsuk.co.uk www.speedrampsuk.co.uk

HEALTH BUSINESS MAGAZINE | Volume 15.4

Services, which has more than 40 years of experience, it is a secure and robust product with exceptional functionality. It is ready to use ‘out of the box’ or can be tailored to suit an organisation’s specific requirements. It also helps companies proactively learn from casework, identifying trends, root causes and where savings and improvements can be made. So if your HR team wants to ensure casework is kept on track while simultaneously boosting productivity, Workpro HR may well be the solution. FURTHER INFORMATION Tel: 0131 449 7071 www.workpro.com www.casltd.com

Hazard warning systems for any vehicle

critical reaction time for potentially avoiding a collision or, at a minimum, mitigating its severity. Due to the system’s simplicity, virtually no driving training is needed. Drivers quickly become aware of their own driving habits and behaviours and, as a result, they self-correct and drive more safely. Additionally, data generated by the Mobileye 560 ADAS system can be delivered via the Ituran Telematics System which can provide comprehensive real-time driving and tracking reports. FURTHER INFORMATION Tel: 01706 223 723 www.emotivesolutions.co.uk


ENERGY

ENERGY

Eco-Exmoor was established in 2002 as an Exmoor based Solar Thermal Panel Installation and Renewable Energy Company. In 2003 EcoExmoor incorporated as a limited company. EcoExmoor Ltd. became the first renewable energy company to be accredited under the Clear Skies Renewable Energy Grant Scheme to install Solar Thermal Panels in the UK. With the focus now firmly on energy and carbon saving, both in the home and in business, the company now supplies the wider South West of England from its base in Wellington, Somerset with renewable energy systems: Air Source Heat Pumps, Solar Photovoltaic systems and Solar Thermal hot water. Eco-Exmoor Ltd is fully accredited under the MCS, RECC, Solar Trade Association and NICEIC accreditations. Eco-Exmoor offers clients an

With the uptake of commercial biomass being so high, the inevitable has happened with massive reductions in the renewable heat incentive (RHI). The companies installing free systems have done it again and a market which was designed to last 10 years is over in two. Don’t get me wrong, the returns are still better than money in the bank, but no way near as good as the 25 per cent return on investment when the RHI scheme first started. Back then RHI Log boilers were charging customers 85k for 199kw installations, which are now earning 25k tax free per year for the next 20 years, not to mention saving them thousands of pounds in heating bills. Looking to the future, the company are more excited about combined heat and power (CHP) systems which generate heat and electricity. The returns are better

High quality renewable energy systems

individually tailored service for renewable energy installations. Clients are provided with information and advice based on their unique energy saving requirements to enable them to generate their own green power, substantially reduce their energy requirements and lower their carbon footprint. Eco-Exmoor Ltd was quoted in Which magazine as ‘extremely ethical, reliable and genuine’. FURTHER INFORMATION Tel: 01823 652611 info@ecoexmoor.co.uk www.ecoexmoor.co.uk

Combined heat and power biomass systems

ENERGY

ENERGY

GI is one of the UK’s largest renewable energy solutions providers. The company not only designs, engineers and installs, but it also manages and maintains its installed systems to enhance energy and CO2 savings for the end user. GI Energy has innovative renewable heating and cooling systems, and its blend of skills and experience allow the company to deliver tailored solutions via a diverse technology portfolio. An intelligent control system can be set to optimise either carbon savings, or to optimise energy consumption, depending upon a company’s priorities; for most the latter is currently seen as the most important, although GI Energy is seeing an increase in targeting carbon savings. The company’s partners include blue chip clients such as Costain, Sainsbury’s, and Crossrail, plus many more, where it now has

Hamilton’s has been at the forefront of the External Wall Insulation market for nearly 20 years and has an enviable reputation in the industry. Here, the company focuses on one of its current schemes, a former Navy housing estate with some challenging issues. The properties, which were built in the 1960s for the Navy, have received a full structural External Wall Insulation system, external fabric repairs, new flat roof system and solar panels which are connected to each property, delivering a much needed improvement to the energy efficiency of the building and helping to reduce residents fuel bills by as much as £450 per year. Daniel Mackie, Business Development Director from Hamilton’s said: “As well as dramatically improving the efficiency of the properties, the block has a brand new look which continues the regeneration of the estate.”

The UK’s leading large scale heat pump provider

successful systems in place. With the Kyoto agreement deadline of 2020 looming close, many companies are looking for ways to cut carbon emissions. Integrated renewable heating and cooling systems offer companies many opportunities to do just that. FURTHER INFORMATION Tel: 02476 673131 www.gienergy.net

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

than when the RHI first started, as you get the RHI, Renewables Obligation Certificates and free heating and electricity. This means that the return on investment is typically three years, or 33 per cent, with a system costing 200k earning over 65k per year for the first 20 years, giving a return of over 1.3 million pounds. The future is bright, but not orange, definitely green. FURTHER INFORMATION Tel: 01709853630 info@rhilogboilers.com www.Rhilogboilers.com

Green Deal approved external wall insulation

Daniel continues: “After being appointed by the client to design a solution to improve these properties, we also found the best way to fund this for the client. This is a great project to be involved in as the benefits for everyone are huge and Hamilton’s are delighted to be involved and working with everyone to make such a difference.” FURTHER INFORMATION enquiries@hamiltonfirst.co.uk www.hamiltonfirst.co.uk

Volume 15.4 | HEALTH BUSINESS MAGAZINE

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ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service Abergower 52 Access Security Cards 70 Amlib UK 34 Attain Commissioning 71 Automated Documents & Services 52 AVM Services 40 Avonwood Development 70 BHC Furniture 40 Box-IT UK 52 Bridge Contract Interiors 68 Canon OBC Catering Equipment Solutions 57 Ccube Solutions 48, 49 Civica UK 70 CFH Docmail 10 Computer Application Services 72 Continental Tyres 63 DDC Dolphin 44 Decorative Panels Lamination 6 Dods 33, 35 Eco-Exmoor 73 Ecolab 42

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HEALTH BUSINESS MAGAZINE | Volume 15.4

EMIS Health 24 Emotive Solutions 72 Epson UK 18 Fiat 22 Fitwise Management 43, 45, 47 G.I Energy 73 Gospelware 27 Grand by Thistle Bristol 68 Haigh Engineering 44, 45 Hamilton First 73 Hawkins 40 Henkelman IBC i-Clean Systems 74 isansys Lifecare 32 ISS Mediclean 12 KDM Communications 41 Magenta Technology 69 Mailsafe 69 Medxnote 69 MISL 4, 54, 55 Nexus Industries 20 Nu - Look 68 Office Fitness 71

Olympus Medical 60 Peugeot 58 Phoenix Document Solutions 50 PHS Group IFC Procure4 16 RHI Logboilers 73 SCC 69 Seat 28 SJS Solutions 71 Skoda UK 14 Smart Parking Technology 72 Speed Ramps 72 Static Systems Group 65 Towergate Insurance 8 UBM Information 36 Valmy SAS 45,46 Voice Connect 26 Water Management Society 68 Wecovi BV 46, 47 Welcome Translation 67 Wilo UK 30 Winning Tenders 71


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