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Time management tips to turn around your day HEALTHCARE IT


Can tags and barcodes improve patient safety?



Legal responsibilities of using staff-owned vehicles for work sponsored by





Here comes the weekend As if the NHS wasn’t facing enough challenges – saving vast amounts of money while in the middle of the biggest structural change in its history – it’s now time to start investigating treating patients at the weekend. NHS Commissioning Board chief Sir Bruce Keogh said: “It is time for the NHS to offer more routine services at the weekend, in addition to emergency services. This will be a big cultural change, but our focus should be on convenience and compassion for those seeking our help.” A British Medical Association spokesperson told the Guardian: “The NHS is not Tesco. Dealing with people’s health is far more complex than selling boxes of cornflakes or other products. As doctors, of course we want to improve services we offer patients but there has to be investment in resources that underpin that.” Meanwhile, a new-look NHS Alliance was unveiled in Bournemouth at its national conference this November. It will focus on advising GP members wanting to take advantage of ‘the full effect of clinical commissioning’ by getting together across practice boundaries to deliver additional services as companies or social enterprises. NHS Alliance Conference chair Dr Michael Dixon OBE wrote in his blog recently: “We now hold all the keys from designing health services as commissioners to helping our patients decide which to use when they are with us in our consulting rooms. We could not be in a stronger position to describe the future NHS landscape. Issues such as private/public, market/integration or done in hospital/done in the community are very much in our court. We would have no say if clinical commissioning did not exist.” Read Dr Dixon’s address to the NHS Alliance Conference on P63, and have a great festive break before the rigours of 2013 begin.

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: PUBLISHED BY PUBLIC SECTOR INFORMATION LIMITED

226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: EDITORIAL DIRECTOR Danny Wright ASSISTANT EDITOR Angela Pisanu PRODUCTION EDITOR Karl O’Sullivan DESIGNER Richard Gooding PRODUCTION CONTROLLER Jacqueline Lawford WEBSITE PRODUCTION Reiss Malone ADVERTISEMENT SALES Kylie Glover, Jeremy Cox, Lorena Ward, Grace Banks, AJ Baker, Josephine Martha ADMINISTRATION Victoria Leftwich, Lucy Carter PUBLISHER Karen Hopps GROUP PUBLISHER Barry Doyle REPRODUCTION & PRINT Argent Media

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NAO reports on NHS efficiency savings; Consultant contracts under review; Healthwatch first public meeting

MP calls for hospitals to adopt higher animal welfare standards; National Nutrition Day set for March 20th; James Martin calls for more action over improving hospital food

11 STRESS MANAGEMENT Can a few time management tips and processes turn your day around? Anisha Rawal, consultant at the Stress Management Society, investigates

41 HOSPITAL DIRECTIONS REVIEW Thousands of hospital doctors, managers and directors gathered at Hospital Directions 2012 to get up-to-date with the latest in medical practices


The Government Procurement Service (GPS) is working closely with the healthcare sector to help it save when procuring non-medical and non-clinical goods and services


A visit to Moving & Handling People 2013 will give healthcare staff the information they need to handle patients safely and with dignity and comfort



Can you be sure that the staff-owned vehicles are ‘fit for the purpose’, roadworthy, properly maintained, taxed and insured? asks Roddy Graham, chairman of the Institute of Car Fleet Management


Barcodes and RFID tags can help reduce errors by matching the right patient to the right treatment, track medication and ensure that patients receive the right dose at the right time


55 EHI LIVE 2012 REVIEW EHI Live 2012 brought together everyone involved in healthcare IT – suppliers, healthcare IT professionals and clinicians – for lively and productive discussions about how to use IT to improve the efficiency of health services

The BIFM visits the Forth Valley Royal Hospital to see why its innovative approach to facilities management has won multiple awards



ESTA’s Alan Aldridge explains how smaller health service properties can make energy savings




Healthcare sector events in 2013

Miriam Rodway, secretary of the Air Conditioning and Refrigeration Industry Board reminds hospital facilities managers of the environmental and legal responsibilities of having an air conditioned building




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Addressing the 15th NHS Alliance Conference which took place in Bournemouth this November, Dr Mike Dixon OBE has cause for optimism as the deadline for Clinical Commissioning Groups to be in place approaches sponsored by












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NHS efficiency savings: a good start, but will need ‘building on’ says NAO report

According to a new National Audit Office report, the NHS made a substantial amount of efficiency savings in 2011-12, but these will need to be sustained and built on in future years if the NHS is to generate up to £20 billion of savings in the four years to 2014-15. The Department of Health has reported that the NHS achieved £5.8 billion of savings in 2011-12, virtually all of the forecast total of £5.9 billion. Most of this was generated through pay freezes and reductions in the prices primary care trusts pay for healthcare. NHS bodies also made savings by cutting back-office costs. However, there is limited assurance that all the reported savings were achieved. The chief executives of primary care trusts are required to confirm they are content with the accuracy of their savings data, but the Department does not validate or gain independent assurance about the data reported. An NAO review of the DoH’s analysis of national pay, activity and other data substantiated a total of £3.4 billion in savings. Understandably, the NHS has started by making the easiest savings first. Although the savings made by NHS providers as a percentage of operating costs are increasing,

it is not clear what level of savings is sustainable over time. There is consensus that service transformation, such as expanding community-based care, is fundamental to making future savings but only limited action has been taken so far. Changes to transform services take time to implement and the DoH has always expected that these savings will predominantly come in the latter half of the four-year period. In 2011-12, the NHS performed well against headline indicators of quality, including waiting times and healthcare associated infection rates, but the DoH faces a significant challenge in monitoring quality across the NHS as a whole. Amyas Morse, head of the NAO, said: “The NHS has made a good start in making substantial efficiency savings in the first year of the four-year period when it needs to achieve savings of up to £20bn. To build on these savings and keep pace with the growing demand for healthcare, it will need to change the way health services are provided and to do so more quickly.” DOWNLOAD THE NAO REPORT


Proposed GP contract changes may force senior GPs to walk away from their commissioning commitments Dr Peter Swinyard, chair of the Family Doctor Association (FDA), said the proposed government changes to the 2012/13 GP contract are a “toxic mix” of increasing workload, diminishing resources and rising expectations. He said: “If the government seriously thinks GPs are stupid enough to want to go into clinical commissioning groups (CCGs) when they are under such pressure in their practices, then they are wrong.” “I can see a lot of good GPs and senior GPs who have been helping run their CCGs who are going to have to back away from commissioning to cope with the increased workload they will have in their practices under the new contract.” Dr Michael Dixon, chair of the NHS Alliance and interim president of NHS Clinical Commissioners said while most GPs are happy with the concept that the quality and outcomes framework (QOF) is to be “ratcheted up”, he expressed concern the GP contract is “going down a biomedical route

rather than a patient-led one.” Some of the new clinical indicators proposed will take up an awful lot of time and effort for an agenda that is not patient-led and will not make an awful lot of difference,” said Dr Dixon. “I am worried that GPs will become more focused on getting the figures in place rather than getting involved in improving the health of their population.” The Department of Health is currently consulting on these proposals.


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NEWS IN BRIEF Government prefers David Haslam as new NICE chair One of the country’s most prominent GPs has been named as the government’s preferred candidate to chair the National Institute for Health and Clinical Excellence (NICE). Professor David Haslam is currently the national clinical adviser to the Care Quality Commission, chair of the NICE Evidence Accreditation Advisory Board and an expert member of the NHS National Quality Board. The immediate past president of the British Medical Association, Professor Haslam also served as a president and chair of the Royal College of General Practitioners and was a GP from 1976-2011.

Healthwatch stages first public meeting Healthwatch England is now up and running, and will lead the new Healthwatch network that launches from April 2013. The first public meeting took place in Leeds on December 5 and saw Dr Katherine Rake, chief executive of the Family and Parenting Institute, announced as director. Established under the Health and Social Care Act 2012, the purpose of Healthwatch England is to strengthen the collective voice of consumers and users of health and social care services in England at a national level. To view Healthwatch’s first meeting visit

SDU guidance on carbon footprinting The NHS Sustainable Development Unit (SDU) has published the first ever international guidance on the carbon footprinting of pharmaceuticals and medical devices. Currently it is estimated that 22 per cent of NHS England’s greenhouse gas emissions are associated with pharmaceuticals and eight per cent to medical devices. The guidance, which was commissioned from environmental consultancy ERM, is the first of its kind for the healthcare sector, and the SDU says it may be used as the basis for the creation of product category rules. The World Resources Institute (WRI) is reviewing the guidance to ensure that it meets their international greenhouse gas protocol standard. The guidance is downloadable from the NHS Sustainable Development Unit at





Consultant contracts under review Proposed changes to consultant contracts, including how they are rewarded, have been accepted by the government as a basis for further discussion. Consultants are currently eligible to receive national or local clinical excellence awards for outstanding clinical excellence, ranging up to £75,000 per annum. These awards are pensionable, in addition to a doctor’s regular salary, and currently payment continues until a doctor retires. The Doctors and Dentists Review Board (DDRB), an independent expert pay review body, has recommended that the rewards should be linked to performance including patient feedback and that they should be capped nationally at £40,000 and locally at £35,000. The proposals also sugest that awards should reward current excellence, not past performance and should be awarded for no more than five years nationally

and normally one year locally. A new ‘principal consultant’ grade has also been recommended, paid between £100,000 to £120,000, to reward very senior and outstanding doctors (capped at 10 per cent of consultants across the country). What’s more, progression through the current consultant grade (£74,000 to £100,000) should be based on performance and contribution rather than time served – with progression to the top of the scale at the employer’s discretion. Awards should also continue to recognise excellence in medical education, teaching and research – including work to support the Royal Colleges and NHS system improvement. The report and the Government’s response, will be followed by further discussions with the medical profession before they come into effect.


GMC patient safety hotline The GMC has launched a confidential hotline for doctors wishing to raise concerns about patient safety. The hotline will allow whistleblowers to pass information about individual doctors or organisations to trained advisers who can pass it on to the GMC for investigation. Callers can also be directed to other appropriate organisations, such as the Care Quality Commission. The helpline will operate during normal business hours, but will include the facility to call doctors back at a time of their choice. An online decision aid to help doctors report patient safety concerns has also been launched by the GMC. The flowchart tool can guide doctors through the process of raising concerns and sets out what they need to do if they have concerns about the conduct of colleagues, systems in place, staff shortages and other operational issues that impact on patient safety. It

also includes case studies to illustrate how doctors may handle incidents themselves and more challenging situations that require involvement from a regulator or other external body. GMC chief executive Niall Dickson said: “In the past, many doctors have felt uneasy raising concerns about policies and procedures or about their colleagues. We hope this new service will be useful in helping them navigate their way through the system. We also hope it will give doctors the confidence to act when they have concerns.” Dean Royles, director of NHS Employers, said: “We believe it is important that employers, regulators and other professional bodies work together to reinforce messages to reassure staff that they can speak openly, and we are delighted to support this initiative.” GMC DECISION-MAKING TOOL


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NHS Leadership Academy honours inspiring leaders Eight inspirational leaders and two ground breaking organisations have been named as the best in their field at this year’s prestigious NHS Leadership Recognition Awards. Three doctors, two nurses and a health trainer are among the individuals who have been honoured for their work. Organised by the NHS Leadership Academy, the national awards recognise and celebrate outstanding leadership practice in health, and shine a spotlight on those who have made a significant impact in improving the quality of care for patients. The awards span every level of the healthcare system and have nine categories including ‘NHS Leader of the Year’, ‘NHS Innovator of the Year’ and ‘NHS Mentor of the Year’. Secretary of State for Health, Jeremy Hunt, opened the awards ceremony and NHS Medical Director, Professor Sir Bruce Keogh, hosted the event at St Bartholomew’s Hospital (Barts) in London this week. This year’s winners are as follows: NHS Leader of the Year (joint winners) – Professor Opinder Sahota, a consultant in elderly medicine at Nottingham University Hospitals NHS Trust and Dr Richard Martin, Head of Substance Misuse at NHS Derby City PCT and Derby City Council NHS Mentor of the Year – Michael Woodhouse, at Addenbrookes NHS Trust Hospital – Cambridge University Hospitals NHS Foundation Trust NHS Community Leader of the Year – Natalie Belt, Health Trainer Service Manager at Humber NHS Foundation Trust NHS Quality Champion of the Year – Brigid Stacey, at Derby Hospitals NHS Foundation Trust NHS Award for Inspiration – Paula Vasco-Knight, Chief Executive at South Devon Healthcare NHS Foundation Trust NHS Newcomer of the Year – Dr Darren Kilroy, Clinical Director for acute and emergency services at Stockport NHS Foundation Trust NHS Innovator of the Year – Philip O’Connell, Information Technology Professional at NHS Stoke‑on‑Trent Clinical Commissioning Group NHS Partnership of the Year – Integrated Care Pilot, NHS North West London NHS Board of the Year – York Teaching Hospital NHS Foundation Trust NHS Medical Director, Professor Sir Bruce Keogh, says: “Outstanding leadership is vital to the NHS and can impact greatly on staff morale and patient outcomes. The NHS Leadership Recognition Awards are a wonderful way to showcase individuals and organisations that are leading by example with high quality leadership. The awards are an opportunity to recognise them, celebrate their achievements and share their good practice nationally.” For further details of each winner, visit



Gerflor helping to light up little lives

Caring for patients aged 16 and under, the Children’s Resource Centre at Trafford General Hospital brings together the hospital’s paediatric services under one roof in specially designed facilities. A key feature of the interiors is the fun, decorative theme. This was created using SPM branded wall protection and Gerflor’s flooring products as part of an integrated design involving Gerflor’s Buying Solutions’ Approved Installation Partner, Crown. Both Gerflor and Crown have extensive experience of delivering innovative and cost-effective wall protection and flooring solutions in the healthcare sector and had previously worked with the Trafford Healthcare Trust. In the case of the centre, which includes a 12-

bed day ward for children and young people, a spacious outpatients’ suite, a playroom and teenagers’ area, the brief required a strong decorative design element combined with products that perform to the highest standards. Gerflor illustrated potential solutions using case studies of installations from previous projects. With these in mind, children at a local school were invited to come up with a theme. The designs were then co-ordinated to produce a solution that could be practically delivered by Mike King, Capital Project Manager (Trafford Healthcare Trust). The ideas were exciting and, as a result, the reception desk is shaped like a drum kit and the nursing station has been built in the form of a piano. This musical theme was continued on the walls and door protection through the use of inlaid designs. Working closely with hospital managers, Gerflor’s unique in-house design service used CAD and CNC machines to produce precision-cut decorative frescoes from SPM Decosheet incorporating musical notes and instruments. This facility offered flexibility and fast turnaround times so the finished elements could be delivered to site quickly and efficiently. The resulting scheme is fun, yet highly functional, and has the ultimate objective of helping to aid the recovery of the young patients. In all, 450m2 of Decosheet wall protection was used. Hygienic and durable, it offers high impact and scratch resistance so damage from trolley and bed traffic is minimised and the level of maintenance required is

minimal. Decosheet was employed in conjunction with SPM Protecta 2 corner protection and, in the outpatients’ corridor, with Escort tubular hand rails. The musical theme was also incorporated into the SPM door protection on 16 door leaves in the day ward, while a further 43 door leaves in the outpatients area, were inlaid with room numbers. In addition, 12 SPM bed kits were installed to protect the walls within the wards. Safety, hygiene, ease of maintenance and noise management were all key factors in the choice of Gerflor flooring products. These were selected to complement the wall protection and to differentiate the various areas within the centre. In the corridors, Nera Contract Wood was employed to provide a warm feel with a Taralay Impression Papyrus border giving a modern finish. Taralay Impression was also used to highlight play and waiting areas and to provide coloured feature inlays. The wards were differentiated using Taralay Initial Pacifica with the colours Coast, Seagull and Mout inlaid together. Gerflor’s Tarasafe™ safety flooring provided the ideal solution for the wet areas, the bathrooms and sluice. Importantly, by working directly with the Trust as a partnership to project

manage and offer the complete installation, Gerflor and Crown were able to deliver a reliable and cost effective scheme under the Buying Solutions Framework without the need for expensive consultants - an important consideration when NHS budgets are under pressure.

I’ve used Gerflor’s SPM

and flooring products before so I was aware of its quality and the extensive range of colour schemes. When we took our ideas to Gerflor for this project, they came up to scratch and ticked all the boxes so we’re happy with the result.

Mike King, Manager Capital Projects (Trafford Healthcare Trust)

For further information: Tel: 01926 622600 Visit: Email:



Do you have enough time in the day to get things done? Probably not. Too little time to complete tasks means you will be stressed, and when you’re stressed you can’t work efficiently. Obviously, stress and time are linked and it can become a vicious circle. The most commonly accepted definition of stress is that stress is a condition or feeling experienced when a person perceives that “demands exceed the personal and social resources the individual is able to mobilise.” The Stress Management Society recognises that there is an intertwined instinctive stress response to unexpected events. The stress response inside us is therefore part instinct and part to do with the way we think. Some of the early research on stress (conducted by Walter Cannon in 1932) established the existence of the well-known ‘fight-or-flight’ response. His work showed that when an organism experiences a shock or perceives a threat, it quickly releases hormones that help it to survive. In humans, as in other animals, these hormones help us to run faster and fight harder. They increase heart rate and blood pressure, delivering more oxygen and blood sugar to power important muscles. They increase sweating in an effort to cool these muscles, and help them stay efficient. They divert blood away from the skin to the core of our bodies, reducing blood loss if we are damaged. As well as this, these hormones focus our attention on the threat, to the exclusion of everything else. All of this significantly improves our ability to survive life-threatening events, but its not just life‑threatening events that can trigger this reaction. We experience it almost any time we come across something unexpected, or something that frustrates our goals. When the threat is small, our response is small and we often do not notice it among the many other distractions of a stressful situation. SURVIVAL MODE Unfortunately, this mobilisation of the body for survival also has negative consequences. In this state, we are excitable, anxious, jumpy

and irritable. This actually reduces our ability to work effectively with other people. With trembling and a pounding heart, we can find it difficult to execute precise, controlled skills. The intensity of our focus on survival interferes with our ability to make fine judgments by drawing information from many sources. We find ourselves more accident‑prone and less able to make good decisions. There are very few situations in modern working life where this response is useful. Most situations benefit from a calm, rational, controlled and socially sensitive approach. In the short term, we need to keep this fight‑or‑flight response under control to be effective in our jobs. In the long term, we need to keep it under control to avoid problems of poor health and burnout. LEARNING TO DE-STRESS It is vital that individuals take some time out to avoid situations like these. So what’s our goal? To learn how to de-stress. To get there, you have to start thinking about how you spend your day, and as you can’t buy time, it has to be used wisely. In the meantime, here’s a guide, followed by some relaxation techniques that can be done in as little as five minutes. With the economy taking a battering, how are employees and entrepreneurs holding up? Not too well, according to Neil Shah from The Stress Management Society: “Workplace stress is on the increase during the credit crunch as people are decidedly nervous about their jobs in the foreseeable future. “At the Stress Management Society the last six months have been our busiest ever in terms of the number of enquiries we’ve had, both from individuals needing help and companies wanting to find support for their stressed staff.” The current financial climate means that ‘luxuries’ like holidays or meals out are being cut from people’s budgets. Ironically these are often the very things that help us unwind and alleviate stress, thus

STRESS EFFECTS Under stress, the body thinks it is under attack and switches to ‘fight or flight’ mode and in response it releases a complex mix of hormones and chemicals to prepare the body for physical action. This causes a number of reactions, from blood being diverted to muscles to shutting down unnecessary bodily functions like digestion. When a bridge is carrying too much weight, what is likely to happen? Common answers are: “It’s going to collapse”. Surely you would see the warning signs before this happens, wouldn’t you? The answer could go either way. Similarly, we as humans could be the bridge, with many tasks and stresses placed upon us. Workplace stresses are solved using sophisticated mental and social skills. Having a body pumped full of adrenaline won’t help you if you’re worried about profits, office politics or a frozen PC. It will only make it more complicated to form a measured and appropriate response. Workplace stress is a major problem for business. Not only does it affect productivity and morale, it’s the second biggest occupational health problem in the UK after back problems. It’s also something organisations should be tackling with urgency because as well as reducing productivity, it can lead to legal action. E

Written by Anisha Rawal, consultant, The Stress Management Society

Using a few simple time management tips and processes could turn your day around completely, suggests Anisha Rawal, consultant at the Stress Management Society

compounding the problem. But is this a real cause for concern? Isn’t pressure just part of the job? Within reasonable boundaries pressure is actually a positive driving force that ensures we keep pushing to be the best we can be. However too much, and pressure turns to stress which leads to poor decision making in the short term, and poor health in the longer term.

Stress Management


The current financial climate means that luxuries like holidays or meals out are being cut from people’s budgets. Ironically these are often the very things that help us unwind and alleviate stress. Volume 12.8 | HEALTH BUSINESS MAGAZINE



Register online FREE for the Cleaning Show 2013

For more information on the Cleaning Show visit

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The Dominion Theatre 268-269 Tottenham Court Road London W1T 7AQ

09:00 - 09:45 Registration and Coffee 09:45 - 10:00 Introduction from Chair - Mr Ken Ashley, Independent Consultant, Kenneth Ashley Consultancy Ltd 10:00 - 11:00 In the beginning there was Legionella - Dr Tom Makin, Independent Consultant, Makin & Makin Consultancy Ltd 11:00 - 11:30 Coffee 11:30 - 12:00 qPCR Technology and Experience - Ms Clare Reynolds, Deputy Head Biomedical Scientist, Princess Royal Hospital 12:00 - 12:30 Filtration Solutions - Dr Catherine Whapham, Global Water Portfolio Manager, Pall Medical 12:30 - 12:45 Questions 12:45 - 13:45 Lunch 13:45 - 14:30 Waterborne Infections in High Risk Areas - The Lessons Learned Dr Mike Weinbren, Consultant Microbiologist, University Hospital of Coventry and Warwickshire 14:30 - 15:00 NHS Technology Adoption Centre (NTAC) & the implementation of Innovative Technologies - Mr Lee Panter, Healthcare Business Manager, Inspira Health Solutions 15:00 - 15:30 Coffee 15:30 - 16:00 DH Guidance on Pseudomonas aeruginosa in Augmented Care Units - Dr Jimmy Walker, Principal Investigator, Decontamination & Biosafety, HPA Porton Down 16:00 - 16:15 Questions and close from chair Attendance and refreshmentsare free of charge for NHS staff and those in full time education. Full information and registration forms on our The seminars and catering are supported by educational grants from




7th March 2013


Who should attend?

We welcome any interested parties to these events. Spaces are usually limited so a quick response isappreciated. Please contact us should you require further information. In the meantime, we hope you and members of your team are able to attend our future events. See our website for information:

Conference Secretariat : e: t: 00 44 (0)560 1292805

We have a number of forthcoming events in 2012/13 that may be of interest to you... Save the dates! � �

Dublin - 7th February 2013 Bath - 18th April 2013


Workplace stress is the second biggest occupational health problem in the UK after back problems.  WORKPLACE TRIGGERS In current market conditions, a big cause of stress is the threat of redundancy. In turn, this creates more pressure as people try to perform at top levels all the time. Yet at the very time they feel insecure about the future, they can’t discuss it easily because they don’t want to appear weak. Other factors are unrealistic deadlines, heavy workloads, poor working conditions, unsupportive management or colleagues, and where people feel powerless over their working lives. This can lead to a whole host of symptoms, from feelings of anxiety or depression, loss of interest in work, tense muscles, disturbed sleep, tiredness or poor concentration to loss of sex drive. At work, some might become more aggressive and confrontational and lack patience with colleagues or detailed tasks. Others might become withdrawn and non-communicative. However work habits almost certainly change, with people skipping breaks, working later or taking work home. L FURTHER INFORMATION Launched in 2003, the Stress Management Society is a not‑for-profit organisation dedicated to help people tackle stress at work and home. For more information on its workshops, products and services visit

Is stress affecting your company’s bottom line? Recent research now indicates that stress is the leading reason for long term sickness absence costing employers billions of pounds every year. Invaluable in today’s stress aware society, Affronte Corporate Solutions is accredited in stress management and organisational wellbeing; its team of qualified practitioners specialise in evaluating stress flashpoints and the human factors of the work environment. The company will assist you in getting the best from your staff to bring about positive change of both organisational and personal value. Affronte Corporate Solutions offer expert tailored packages to meet your requirements. These include classroom or one-to-one stress awareness and wellbeing training, team building and coaching, organisational research, analysis and evaluation of the work systems. The company also covers the assessment and design of the physical workplace. Affronte Corporate Solutions is

Advice for individuals

Stress Management


Prioritise. Write lists of your things to do and prioritise them into ‘must dos’ and ‘nice to dos’. Put anything that’s not essential to the bottom of your list, or see if someone else can take it on. Perhaps you could even drop it altogether? Start saying ‘no’. You only have 24 hours in a day, so use them wisely. Turn down things that you don’t have the time for or can’t justify doing. Go step by step. Break large projects into small stages and take it one simple step at a time. This is a great way to start those huge projects that you keep putting off doing. Communicate. If you start to feel stressed on an existing job, tackle it early in a very matter of fact way. Say to the relevant person, “Given the work that’s needed, I need another week” rather than rush in with a frantic “I can’t cope”. Create a good work/life balance. All work and no play is a recipe for stress. So make sure you have a mixture of work and home activities in every week.

Advice for employers Take it seriously. Tackling stress is part of your Health & Safety responsibilities and you are legally obliged to take action if you have such a problem at work. Communicate well. Keep employees in the picture about changes and finances. Be extra clear about job roles and targets, and be sensitive in the way you communicate. Give feedback. When you see someone doing something right, jump in with generous praise. Remember the team. Stressed people zone out others. So focus on creating good team spirit and get everyone involved. Organise company events out, even if it’s a trip to the pub once a week at lunchtime. Being valued and involved like this is a major factor in happiness at work.

a member of the International Stress Management Association; the Chartered Management Institute; the Institute of Leadership and Management, the Ergonomics Society, the National Society of Psychotherapists and Practitioners on the General Hypnotherapy Register. The company uniquely covers all angles of wellbeing to reduce risk, improve performance, and promote a healthier and happier work place. Contact us now, be an employer of choice. FURTHER INFORMATION 0800 1777 267

Ask for opinions. People often feel stress when they are powerless over their job content. So if change is required, consult those involved so they can have a say in work-related decisions.

Three ways to stay stress free Exercise. Endorphins released during physical exercise help burn off the hormones released when you are stressed like adrelaniline or cortisol. Even a brisk walk round the block at lunch time will help, but try to get a total of 30 minutes of aerobic exercise (where you are working hard enough to increase your heart beat or raise a sweat) every day even if you split that into two or three chunks of activity. Take care of your body. Eat quality meals at regular intervals to ensure a steady blood sugar supply. Keep well hydrated with water. Avoid stimulants like nicotine or caffeine (in coffee and chocolate). Get enough sleep to give your body time to repair and regenerate. Find a way to relax. Don’t just watch TV or play on the computer. Find an active way to relax. Try yoga, massage, aromatherapy or just sitting in a quiet room and listening to meditation music. Go to for a free guide to stress management which includes yoga and massage techniques that you can do unobtrusively at your desk.



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The Government Procurement Service (GPS) is working closely with the healthcare sector to help it save when procuring non‑medical and non-clinical goods and services The NHS needs to identify £15-£20bn of efficiency savings by the end of 2013/14. As approximately 50 per cent of the £16bn of non-pay spend is on non-medical, non clinical goods and services, the Government Procurement Service (GPS) is working closely with health customers to ensure they can help them meet this savings target. HISTORY OF THE GPS The Government Procurement Service (GPS) has overall priority to save the UK public sector money on procurement and centralise the way it buys. Previously known as Buying Solutions, it was renamed Government Procurement Service (GPS) following a Strategic Review commissioned by Francis Maude, Minister for the Cabinet Office, in July 2011, to reflect its new role at the heart of government procurement. At the launch event Maude said: “It is bonkers for different parts of government to be paying vastly different prices for exactly the same goods. We are putting a stop to this madness which has been presided over for too long. Until recently, there wasn’t even any proper central data on procurement spending. So, as Sir Philip Green found, major efficiencies are to be found in government buying. The establishment of Government Procurement Service means that the days when there was no strategy and no coherence to the way the government bought goods and services are well and truly at an end.”  Maude continued: “In the last year, we have already made significant changes to drive

down procurement spend by £1 billion, but this new centralised service means we will continue to deliver savings which are expected reach more than £3 billion a year. We are also determined to press ahead with measures to create a more level playing field so that small organisations and businesses can compete fairly with bigger companies for government contracts. SMEs can provide better value and more innovative solutions for government and the actions set out today will support their growth as the economy starts to recover.” The products and services available through the GPS are delivered by more than 2,000 suppliers, of whom more than 50 per cent are SMEs. Working with over 14,500 organisations in central government, health, local government, devolved administrations, education and the not‑for-profit sector, GPS managed over £8.4bn of customer spend through its procurement arrangements and services in the 2011-12 financial year.



HELPING THE NHS As well as a wide range of frameworks for common goods and services, the GPS has a number of frameworks designed specifically with health customers in mind. These include staff – including agency nurses, medical locums, and non-medica/clinical staff – building and maintenance, vehicle conversions, modular buildings, laundry & linen services, and telecare. To get the best results for the health sector, the GPS focuses on working closely with Quality, Innovation Productivity and Prevention (QIPP) to ensure all health customers know how the GPS can help drive down costs. It works closely with NHS Supply Chain and NHS Business Services Authority to explore how it can work together to the benefit of the NHS. The GPS aims to help the NHS to identify savings opportunities and transition spend. It also provides data management to improve visibility to help control spend and monitor compliance. It also delivers savings through arrangements which focus on aggregation of volumes, standardisation of specifications, rationalisation of core product lists and demand management. Healthcare purchasers will benefit from dedicated relationship managers provided by the Department of Health and the NHS with a single point of contact. An NHS Customer E

The NHS needs to identify £15-£20bn of efficiency savings by the end of 2013/14. As approximately 50 per cent of the £16bn of non-pay spend is on non-medical, non-clinical goods and services, the Government Procurement Service (GPS) is working closely with health customers to help them meet this savings target.



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HEALTHCARE PROCUREMENT  Board meets regularly to help ensure engagement at all levels across the NHS. The GPS also provides progress reports on spend, savings, supplier performance and customer satisfaction. NHS TASKFORCE TRAINING Understanding the complex role of procurement within healthcare, the GPS has created a training programme specifically for procurement staff in supplies, pharmacy and estates across the NHS. Delivered by its specially trained network of NHS supplies managers, Basic Operational Purchasing Training includes the CIPS level 2 qualification, which covers basic purchasing and supply issues, fundamental principles and processes, as well as five additional modules covering further topics in operational purchasing. Evaluation is an important part of its Basic Operational Purchasing Training. The GPS has received extremely positive feedback from previous delegates, with an average of 90 per cent scoring the training as having definitely met its objectives. All Basic Operational Purchasing Training courses are provided at no direct cost to the organisation. Courses cover European Procurement, Working with Suppliers, Supply Chain and Materials Management, Contract & Supplier Management, Systems and Procedures in Purchasing, Importance of Purchasing Contracts, Introduction to Negotiation, and Effective Negotiation. ORGANISATIONAL PRIORITIES GPS is committed to improving service delivery through increased customer focus and commercialism, to meet the stretching strategic objectives set and to drive a programme of continuous improvement. Its key areas of focus are: the continued delivery of savings; e-enablement of all operations; operational and financial efficiency; and development and retention of high quality professional staff. Savings are measured in accordance with guidance provided by the Efficiency and Reform Group guide ‘Measuring Up’, which was published

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on 29 November 2010. The guidance aimed to introduce a unified approach to driving savings, and is based on a number of principles. The Government Procurement Service is responsible for validating and reporting all savings for common goods and services procurement. MAKING SAVINGS All benefits are, wherever possible, calculated against a pan-government 2009/10 baseline. The baseline represented actual prices paid by central government for the same product or service during the baseline period, with transactions from 1 April 2010 eligible to generate savings. Benefits must release cash and be net of any implementation costs (including significant whole life costs where relevant) and one‑off savings can be included where they do not represent deferred expenditure. Approved counterfactuals (inflation percentages) can be used where they are appropriate and approved by the savings team. All savings are subject to an approved initiative methodology, supported by a formal sign off route, and must be evidenced by supplier provided transactional Management Information. In 2011-12, GPS implemented a major change programme to transform operations and performance in order to support the delivery of centralised procurement. Fundamental changes were made to clearly focus the organisation on customer service, savings delivery and eEnablement. The aim was to provide exceptional service for its customers across government and the UK public sector. They are fully committed to ensuring all customers are able to take advantage of the benefits of the centralisation programme, driving value in an effective and transparent way. CASE STUDY: PORTSDOWN GROUP PRACTICE The Portsdown Group Practice operates across four surgeries and covers Portsmouth and the surrounding areas. Of the 30,000 patients, 14.5 per cent of the practice population is aged over 65. It procured Telehealth Solutions to provide a fully managed service – including clinical triage, where THSL nurses monitor the results generated by HomePods. The benefits of the service are being analysed in a number of ways and has demonstrated significant benefits to patient outcomes and the health economy as a whole. The delivery model has been developed in partnership with Portsdown in order to create a scaleable model that can be easily replicated. “Working in partnership with Telehealth Solutions has given us the opportunity to support our patients whilst enabling our clinicians to focus on the most complex cases. The fully managed service is the only viable option to ensure high standards of care are met and maintained during this time of efficiencies, and actually represents improved care pathways for long-term conditions through self‑management,” said Dr Julian Neal, senior partner at Portsdown Group Practice. CASE STUDY: THE CROWN PROSECUTION SERVICE The Crown Prosecution Service (CPS) wanted a secure overnight delivery service that could flex and adapt to changing needs, whilst still offering a secure and cost efficient service. The CPS used lot 13, document exchange, of the postal services framework to find a suitable solution. This approach meant that they could focus on the service requirements that were of particular importance to them, whilst being assured of the framework benefits regarding compliance with regulation. Preparation of the further competition, evaluation criteria and contract documents was also quicker and easier than if a full tender had been conducted. The contract was awarded to DX Group as its solution offered a sufficiently flexible service to meet CPS’s requirements, without compromising on security or value for money. For example, CPS expects to make an average saving of 35 per cent on 1st class mail in 2012. Using the framework allowed pre‑agreed service levels and KPI standards to be customised to meet requirements to monitor supplier performance against pre‑agreed criteria. L FURTHER INFORMATION



Cylinder management specialists Cylinder product specialists Cylinder management Cylinder specialists Medicalproduct Gas Audit specialists Medical Gas Audit specialists Anti-bacterial Impregnated cylinder cradles Anti bacterial Impregnated cylinder cradles

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Cylinder management and anti-bacterial impregnated storage solutions aid in reducing infection control issues There are many pressures on the NHS in the current climate and with the increasing pressures on Infection control all areas of patient care are required to be addressed. One area that has been overlooked by many trusts is the area of cylinder transportation and storage. Many of the cylinders being brought in to the wards and departments are transported to site on open-back lorries, kept in external stores which are open to the elements and contamination, and the cylinders are not cleaned prior to distribution to the patients or wards and departments. These are then utilised in patient areas, theatres, anaesthetic rooms and ITU departments. They are often put on to patient beds and wheelchairs and not in the correct bed and wheelchair carriers. The cylinders are often transported on sub-standard and rusty trolleys through the hospitals. The maintenance on the trolleys is at best poor and they are never cleaned between them leaving the wards or departments and returning once they have been to the cylinder storage areas. Once the cylinders reach the wards or departments, they are either kept on these trolleys that are placed by the bedside or stored in many varieties of racks and shelves. These can range from wooden to rusty metal racking in various configurations – all a further source of infection and bacterial breeding grounds. The wooden racks not only provide a breeding ground but also a serious fire risk. Cylinders are commonly stored in wards and departments on wall racks with chains utilising the floors as the base support for the cylinders. This does not enable the floors to be cleaned and attracts a very good breeding ground for the bacteria. The solution to these issues are very simple and cost effective for the Trust, often putting long-term cost savings in place and radically reducing the infection control problems. To enable the start of the process, the number and type of cylinders across the site requires justification, as over time the volume of cylinders being held in the wards and departments historically increases, irrespective of the usage. This requires to be managed by a full site-wide audit of the quantity of cylinders on site and then a check against the volume of cylinders being charged for by the

c. Cylinder transport report on compliance and fit for purpose of the trolleys and carriers. d. Cylinder signage report on compliance and fit for purpose of the door signage and COSH information.

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The points to ensure are that all of the cylinders are stored correctly. The current standards of in ward or department racking require to be seriously considered and the following guidelines should be followed: 1) Restrict cylinders larger than 1000 mm high and 150mm diameter from the wards and patient areas (maximum cylinder sizes to be F or equivalent in the ward areas). 2) All cylinders on trolleys – ensure the trolleys are of a good quality and cleaned. 3) All wall storage to be approx 300mm from the floor to enable cleaning. 4) All cylinders stored in racks/cradles that do not actively encourage bacteria. 5) All wall racks to have the minimum of joints and crevasses to enable cleaning.

supplier. This simple check has shown in many cases large discrepancies and cost savings. This should be managed by the Pharmacy department and Estates as this effects both areas (this should be carried out independently and not by the cylinder suppliers). On completion of the audit, this will also allow the following: a. Ward and department cylinder justification to reduce where possible the number of cylinders. b. Cylinder storage report on compliance and fit for purpose of the ward/department storage.

The introduction of the new medical gas cylinder cradle range by Medical Gas Services Ltd manufactured from a virtually indestructible anti bacterial impregnated single piece composite has revolutionised the capabilities of cylinder storage. This range of products has been developed in conjunction with a number of NHS trusts and private healthcare providers to produce this range of products. “We know Medical Gas Services from its cylinder trolley range where stability and user‑friendly attributes were paramount in their design, they have not let us down in this range of cradle. They are simplicity itself in the installation and have two standard sizes available and a bed/chair mountable portable unit.” The idea of a composite material impregnated with anti-bacterial product is not a new idea but has never been utilised for cylinder management before. Medical Gas Services Ltd have undertaken the above audit works on a number of major NHS sites and this has proven in all cases to have a cost saving to the trust as well as manage the cylinders for infection control benefits and fire reducing measures. L



Don’t let fleet costs drive your business.

‘Sustainable’. A word often used in connection with vehicle fleets, usually in an environmental context. But have you ever thought about your fleet’s financial sustainability? With cost control a major concern for most companies, pressure may be building on you to squeeze more out of your budget. Reshaping costs doesn’t have to mean compromising on the vehicles you can offer your employees. Moving to a whole-life cost model, and working closely with your procurement and HR teams, can bring surprising benefits. At Alphabet, we can offer you expert advice on doing just that. Reshaping your fleet, and ensuring fleet-related costs work harder for you. Find out more: Tel: 0870 50 50 100 Email:


MANAGING THE GREY FLEET The grey fleet should be of concern to all organisations including the NHS. Those privately-owned vehicles used by employees while ‘at work’ are difficult to manage in terms of meeting any organisation’s basic duty of care responsibilities, not to mention corporate social responsibilities (CSR), in terms of the environment. They need to have measures in place to ensure that grey fleet vehicles are ‘fit for the purpose’, roadworthy, properly maintained, taxed and insured, which unfortunately is not always the case. In the public sector alone, the former Office of Government Commerce (OGC), now the Efficiency Reform Group (ERG), estimated a while back that nearly 57 per cent of ‘at work’ mileage was covered by employees in privately-owned vehicles. That equates to around 1.4 billion miles a year covered by vehicles that do not necessarily comply with current law or are ‘fit for the purpose.’ Potentially, therefore, the grey fleet is a problem waiting to happen. As the above figures indicate, the grey fleet may be much larger than imagined, especially if eligible employees have taken ‘cash’ rather than a company car. Historically, this happened at a time when company cars were unfairly taxed as a perk. Now attractive BIK rates linked to low CO2 emissions, allied to wide choice, make this no longer the case. Indeed, many responsible organisations, including numerous NHS Trusts, are taking steps to encourage cash takers back into company cars and introducing attractive car salary sacrifice schemes.

UK ROAD DEATHS AND INJURIES The latest government figures show that the number of deaths on Britain’s roads rose by three per cent overall last year to a record low of 1,901 in 2011. Car drivers and passengers accounted for 46 per cent of deaths, up six per cent, and pedestrians for 24 per cent. These deaths saw the sharpest rise, up 12 per cent. The number of ‘at work’ deaths now account for over a quarter of overall road deaths. The figure of 559 ‘at work’ deaths represents 29 per cent of the total. While, we have yet to see the first successful prosecution under the 2007 Corporate Manslaughter and Corporate Homicide Act involving an ‘at work’ driver, meeting duty of care responsibilities should remain a top priority. Overall, there are three main reasons for tackling grey fleet – health and safety, cost savings and the environment. HEALTH AND SAFETY The two main pieces of current legislation to be mindful of in meeting duty of care responsibilities are the Health and Safety at Work Act 1974 and the UK Corporate Manslaughter (England, Wales and Northern Ireland) and Corporate Homicide (Scotland) Act 2007. The Health and Safety at Work Act 1974 requires employers to ensure the health and safety of all full and part-time workers while ‘at work’, as is reasonably practicable. The Act covers all work-related journeys including drivers in company vehicles, using their own cars or other vehicles for business use, temporary drivers, freelance drivers

ations Organis have need to in place es measur e that grey r to ensuechicles are fleet v purpose’, ‘fit for thy, taxed r roadwo insured and


Written by Roddy Graham, chairman, ICFM

NHS organisations should look to reduce fleet costs and risk through careful management of the grey fleet, explains Roddy Graham, chairman of the Institute of Car Fleet Management

and agency or contract workers. The ‘Driving at Work: Managing work‑related road safety’ guide highlights the legal responsibilities of employers to comply so far as is reasonably practicable with the Health and Safety at Work Act, stresses the benefits of managing work-related road safety and suggests how it should be managed and road risks assessed. Employers, including the NHS, need to consider driver competency and training; driver health; knowledge of basic vehicle checks; vehicle suitability, condition and maintenance; a valid MOT certificate if required; and safety equipment. Other considerations should even include adequate travel time allowance and proper route planning. The HSE guide extends to the use of privately-owned vehicles on business trips. Employers can be liable if employees use an un-roadworthy vehicle on company business. Employers, including the NHS, have a duty of care to ensure they have checked employees hold a valid driving licence, are monitoring the maintenance history of the vehicle and that the vehicle insurance also covers business use. Many organisations still do not check driving licences or that vehicle insurance covers their ‘at work’ grey fleet drivers. Besides conducting a professional risk assessment audit of both vehicles and staff, employers need to have an agreed comprehensive ‘driving at work’ risk management strategy and ensure it is complied with. In the unfortunate event of an ‘at work’ road accident, employers need to be able to provide evidence that they have taken ‘reasonably practicable’ steps to manage their duty of care responsibilities to their employees including grey fleet drivers. Following an accident, employers failing to act on the guide run the risk of facing significant fines under the Health and Safety at Work Act 1974. Directors and senior management can also face large fines and even possible prison sentences. The UK Corporate Manslaughter (England, Wales and Northern Ireland) and Corporate Homicide (Scotland) Act 2007 makes it possible for an employer to be prosecuted as the result of the failings of senior management. Under the Act, all employers have a duty of care to ensure the safety of their ‘at work’ drivers. The Act makes it much easier to E

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GREY FLEET MANAGEMENT  prosecute organisations for manslaughter following a work-related death, than previous legislation. The Crown Prosecution Service (CPS) does not have to rely on an individual being found guilty of gross negligence; it just needs to prove the fatality resulted from a gross breach of the relevant duty of care by the organisation as a whole. Under the Health and Safety at Work Act 1974, the fine will be seldom less than £100,000 and more likely several hundred thousand pounds. Under the UK Corporate Manslaughter (England, Wales and Northern Ireland) and Corporate Homicide (Scotland) Act, a work-related road death will result in an organisation being fined rarely less than half a million pounds and more likely several million pounds. In addition, a publicity order could be imposed on every organisation found guilty. This could range from advertisements to an order for all customers to be informed of the conviction. COST SAVINGS Employers should seriously review what they pay grey fleet drivers to use their own vehicles. The mileage rates may not make financial sense, especially if they have many grey fleet drivers covering high mileages. Sewells and The Energy Saving Trust conducted research which flagged up that just under a third of companies allowed their employees to drive privately‑owned vehicles more than 7,000 miles a year ‘at work’ and reimbursed them nearly £3,500 each. The same research also showed that a quarter of grey fleet vehicles covered more than 10,000 miles per annum on employer business. For many organisations a grey fleet can cost them more than a company car fleet. Many grey fleet drivers see business mileage reimbursement as a potential money-making exercise, costing an organisation unnecessary money. Currently, employees travelling on their behalf ‘at work’ are reimbursed at Approved Mileage Allowance Payments (AMAP) rates – 45 pence per mile. This is significantly higher than typical Advisory Fuel Rate (AFR) payments of 12 to 14 pence per mile for a company car driver. For employers, a practical ceiling for requiring employees to use a daily rental vehicle rather than their own privately-owned vehicle might be a maximum daily distance

of 100 miles at the above standard rates. Above 100 miles, it may cost more for an organisation to reimburse a grey fleet driver. THE ENVIRONMENT Given that the UK Government is committed to halving carbon emissions, the resultant CO2 emissions-based vehicle taxation regime has resulted in an astonishing choice of vehicles available with CO2 emission levels below 120g/km. And the number with emissions below 95g/km is growing daily. Against this backdrop, employers looking to significantly reduce their CO2 emissions as part of their CSR can easily operate a carbon neutral transport policy as a first step towards running a greener fleet. The only obstacle in the way is the grey fleet. The majority of grey fleet vehicles are older than company car vehicles and therefore are higher polluters. In the public sector, the average age of a privately-owned vehicle used ’at work’ is 6.7 years old. In comparison, the average age of a company car is around 18 months based on the current trend of replacing company cars every 37 months. SMMT figures confirm that the average new car sold in the UK in 2011 emitted just 138.1g/km of CO2, 4.2 per cent lower than the 2010 figure and 23 per cent better than in 2000. New technology, improved fuel consumption and better overall consumer awareness are the principal contributors to this continued progress. According to the SMMT, 46.8 per cent of cars had emissions below 130g/km CO2. MANAGING THE GREY FLEET Grey fleet drivers should be made responsible for ensuring that their privately-owned vehicle complies with Road Traffic law; is properly maintained, safe and roadworthy; and is ‘fit for the purpose’ when used ‘at work’. Grey fleet drivers should be responsible for ensuring that their vehicle has a current vehicle registration document, valid vehicle excise duty disc, current MOT Certificate if over three years old, vehicle insurance covering business use and an up-todate service handbook. The fleet policy should lay down that all these documents should be checked at least once per year. To protect itself, the employer should have on file a signed document authorising use of a specified grey

fleet vehicle and covering the above. Going the extra mile, employers could insist on minimum safety standards based on European New Car Assessment Programme (Euro NCAP) ratings and minimum safety equipment (e.g. ABS and ESC). In order to reduce their carbon footprint, employers could specify an upper emissions limit and a maximum engine capacity too. Regular and occasional spot vehicle safety checks on both company cars and grey fleet vehicles should be the norm as part of an employer’s duty of care responsibilities. The fleet policy should state clearly that the grey fleet driver must hold a current driving licence valid in the UK for the type of vehicle used and advise the organisation of any endorsements. Driving licence checks should be undertaken annually, if not more frequently. To encourage safer driving, employers should consider changing driver behaviour and attitude as part of their duty of care responsibilities. By influencing the way drivers actually drive through education, tips, training and awareness they can not only reduce the accident risk but also deliver other savings in the form of reduced fuel consumption. Fleet policy should seek to reduce all ‘at work’ journeys to a minimum by conducting a series of pre-journey assessments, challenging whether the journey is really necessary. If it is, the most economic form of transport should be chosen and car sharing considered.

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CONCLUSION The fleet policy will be ineffectual unless properly communicated and administered. It should also be regularly reviewed. By managing the grey fleet, the NHS can meet duty of care responsibilities while at the same time making significant cost savings and minimising loss of productivity through staff absence, resulting from death or injury in ‘at work’ road accidents. Additionally, they can enhance their corporate social responsibilities, through achieving a lower carbon footprint. L ABOUT THE AUTHOR Roddy Graham is chairman of the Institute of Car Fleet management (ICFM). For further in formation on its work, visit

New parking solution for the NHS from Fast Park Fast Park Group has been providing unique parking solutions to NHS, commercial and retail clients internationally for more than 20 years. The company provides a turnkey solution; from design through to planning approval, project management, installation and final certification. Fast Park® is a modular parking system that can be demounted, altered in size and shape or left in-situ. With no traditional foundations, it can be completely relocated with no disruption to the current parking footprint or left as a permanent parking structure. Fast Park® is supplied and installed within a few weeks from final design approval, causing minimal disruption to existing parking

requirements. As of July 2012, Fast Park Systems UK Branch is able to offer its clients the option of leasing parking decks through its NHS approved financial service provider. This essentially means that we are able to solve parking problems within a short period of time, with minimal disruption or loss of capacity – and it can pay for itself from day one. FURTHER INFORMATION For more information on the Fast Park® system projects undertaken on behalf of the NHS, please visit Email: Tel: 020 7631 2061




A total approach to helping disabled children A unique concept in delivering support for disabled children is addressing all their needs in one place – right down to going to the toilet. Kent County Council has opened three Multi-Agency Specialist Hubs (MASH), one each in Swale, Thanet and Ashford, offering NHS, social, voluntary and educational services all under one roof. The Suites are the first in the country to deliver such a comprehensive range of resources in one place, with the commitment to the users’ needs extending through to toilet facilities. As a result, each MASH has had two hygiene rooms installed. The rooms are based on the Changing Places accessible toilet concept, which are different to standard disabled toilets as they have extra features and more space for people with profound and multiple learning disabilities. They also cater for other people with severe disabilities who need the support of at least one carer. The rooms also include Total Hygiene’s

Clos-o-Mat Palma ‘wash and dry’ toilet with optional touch sensitive operating switch. Looking like, and capable of being used as, a conventional WC, the Clos-o-Mat features integral douching and drying, removing the need for the user or their carer to wipe clean with toilet tissue thus improving hygiene, dignity and independence. After toileting, if the user remains seated and presses either the flush pad or touch-sensitive switch, the unit simultaneously flushes, and warm water douches the user followed by warm air drying. FURTHER INFORMATION Tel 0161 969 1199

T&E Howie: One of Ireland’s premier LED lighting specialists T & E Howie Lighting is one of Ireland’s premier lighting specialists through the provision of perfect lighting solutions for both domestic and commercial customers for over 40 years. The company is dedicated to customer satisfaction offering a full consultancy and design service encompassing best industry practices either on‑site or at its offices. Its sourcing capabilities are extensive with suppliers from all over the globe supplying all periods and styles of superior quality lighting products to suit all budget and tastes. T & E Howie take pride in being advanced and progressive in all aspects of the lighting industry by embracing fast moving technologies which are creating exciting and bright new realms of possibilities in the lighting world. In harnessing these fast moving technologies, the

company is able to offer its customers highly efficient low energy products without compromising on quality of light output. T & E Howie’s aim is to help you convert your old inefficient lighting into low energy and reduce your carbon footprint especially throughout LED technology, which saves your business money and makes it more eco-friendly. T & E Howie transforms the way people interact with their environments by providing inspirational lighting solutions through superior products and services. FURTHER INFORMATION Tel: 028 71302343

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With budgets being cut and belts being tightened, Eurosigns’ solar paddle offers a real solution to illuminating your outdoor signage. With a five year guarantee and your utility bills eliminated, the company’s cost effective solution also offers the benefit of being fitted where electricity is not readily available. Designed to work in the UK, 365 days of the year, the company’s solar paddle stores the energy from daylight for release after dark. Using the company’s solar paddle and lighting arm can also help the environment by lowering your carbon footprint. The solar paddle can eliminate your utility bills, reduce your carbon footprint, reduce your on-going maintenance cost, and be fitted where electricity is not readily available.

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Starbucks, M&S Food, robots working as porters – it’s easy to understand why Forth Valley Royal Hospital’s innovative approach to facilities management has taken home multiple awards, writes the British Institute of Facilities Management Picture a hospital and images of bustling corridors spring to mind, full of patients being wheeled on beds or wheelchairs from A to B, visitors bearing fruit and flowers, nurses wheeling trolleys of medication with FM staff banging trolleys of food and drink, rubbish and dirty linen from end to end. Noise levels are high as people shout to be heard over the din of trolleys trundling up and down and banging into walls. Which is why, when we visited the Forth Valley Royal Hospital in Larbert, Scotland, we could have been forgiven for thinking we were in a corporate HQ or retail environment. Walk through the doors of the £300m PFI/PPP hospital and the first thing the visitor sees is a Starbucks, swiftly followed by a WH Smith and an M&S Simply Food. And while there are a few people milling about and sitting around on the comfy (and stylish) reception sofas, the main entrance doesn’t have that usual hurried feeling of a

hospital, where people dash around looking confused about where they are. Partly that’s because of good signage (each floor has a different colour scheme reflecting the changing seasons) but also because there are several entrances to the facility – the main entrance, an A&E entrance, a separate access to the mother and baby department, the renal

GOING WITH THE FLOW Delve further into the building and that sense of peace pervades. Not just in the circular multi‑faith facility on the ground floor, but throughout the wards and common areas. There is little bustling to be done at Forth Valley because of the decision by NHS Forth Valley at tender stage, to request the segregation of flows. Mackay explains: “The NHS didn’t want the public wandering around areas where patients were going for operations. They wanted to avoid lift lobbies where patients, visitors and FM staff with clinical waste or patient food competed for the lifts, for reasons of privacy, dignity, security and infection control.” Mackay has been with Serco for more than 20 years, working at hospitals in Scotland, Leicester, Norwich and Surrey. That segregation also creates a calmer environment for patients, as you don’t have linen, food and waste trolleys rattling up and down corridors mingling with patients and their visitors, he explains. Visitors can only access patient areas at set times, although they are free to use the hospital’s other facilities throughout the day. And the facilities management traffic is kept completely separate from patients and clinical staff so you will never see trolleys of dirty laundry, clinical waste or food and drink being wheeled around. A segregated lift strategy helps: there are 11 service lifts, six visitor lifts and four beds lifts – two of which go down to the basement to access the mortuary. This is all supported by half a kilometre of subterranean service tunnels allowing FM staff and goods to move unseen, underneath the building, popping up in the lift to certain areas.

Written by the British Institute of Facilities Management

department and mental health department. There is also a discrete blue-light road straight to the A&E department. “The different entrances take the flow of traffic to different parts of the building, which allows the main entrance to retain a sense of calm,” says Mike Mackay, Serco’s contract director who oversees the 31-year PFI/PPP contract for soft and hard FM services.

Facilities Management


MECHANICAL WONDERS While the ‘segregated flows’ strategy is the key success of the hospital, it has been the introduction of automatic guided vehicles which have caught the headlines – and E

The robots page the ward housekeeping staff to let them know the food arrived. When the ward housekeeper places the used food trolley in the robot bay, the system automatically dispatches a robot to collect it; when the robot arrives an electronic card using RFID technology is read by the vehicle, instructing the delivery location. Volume 12.8 | HEALTH BUSINESS MAGAZINE


Facilities Management


ESTATES MANAGEMENT  patients’ imagination. Serco purchased 13 robots, looking a little like small white forklift trucks, which act as unseen porters around the hospital. They take food trolleys from the kitchen in the basement in the FM lifts to one of 30-40 hub areas where it is then collected by housekeeping staff and served to patients. Food is cooked fresh on site, delivered to the wards in bulk heated/chilled Burlodge Trolleys and plated in front of the patients. The robot pages the ward housekeeping staff on their PDA to let them know the food arrived. When the ward housekeeper places the used food trolley in the robot bay, the system automatically dispatches a robot to collect it; when the robot arrives an electronic card using radio-frequency identification (RFID) technology is read by the vehicle, which instructs the delivery location. Other ‘disposal’ hubs contain waste chutes which carry general waste and soiled linen to waiting wheelie bins in the basement. Sensors tell the robots when the bins are full and they carry them along the concrete service tunnels to the waste compound. All cardboard is separated at source but all other waste is taken away by a third party and sorted – around 85 per cent is then recycled. Clinical waste containers are collected from the ‘disposal’ rooms via the lifts by a robot. A mailmatrix Robot also sort mail and a robotic pharmacist dispenses drugs. “The idea is that a robot moves along the tunnel and can go up to any floor without meeting the public or going into any clinical space. This improves privacy and dignity for the patient, reduces the risk of healthcare‑acquired infections, improves FM efficiency as we’re not waiting for lifts and trying to squeeze in among general and clinical traffic, and the patient and visitor experience is calmer,” says MacKay. Importantly, it also frees up support staff time to focus on patients. The robots follow pre-programmed routes and have sensors on their front and sides, but Mackay points out this is more to protect the robot than people – he demonstrates that if you stand in front of the robot it will stop immediately. On the top of the robot sits a revolving laser which triangulates the robot’s position with reflective strips on the walls. The robots are self-charging – when they reach 60 per cent of power they take themselves to the charging area. The robots are part of the hospital’s FM helpdesk system, supplied by SoftSols. The Helpdesk System automatically allocates and dispatches porters based on their location in the hospital, takes food orders, and manages reception, estates maintenance, security and cleaning. AUTOMATIC PILOTS Although Forth Valley Royal Hospital was the first in the UK to install robots, they are a tried‑and-tested technology elsewhere. Before the Forth Valley installation, Mackay visited Ohio State hospital to look at the robots which also move food and waste. The same technology is in use across Europe and Serco was the successful



bidder for the Fiona Stanley hospital in Western Australia, which will also have a fleet of robots. Although the health board had asked for segregation of flows, apparently they were surprised when the consortium of which Serco is part, presented the robot solution. “We are not contracted to provide the robots, we are contracted to provide portering, catering and waste management services. How we do it is our call.” MacKay emphasises that robots are a new build not a retrofit option. “Robots need space. To retrofit robots into a building would be challenging. You need to think about the space and how the robots interface with different systems such as fire and lifts.” The robots work using an advanced wireless network which exists throughout the building and extends into the car park and supports a variety of FM activities such as the real-time data transfer for personal digital assistants (PDAs). For example, housekeeping staff order patients’ food on PDAs, usually at the preceding meal, that information is immediately received by the kitchen and allows them to accurately produce the requested meals. This ensures that food waste is minimised.

A DOSE OF GOOD DESIGN Infection control has been taken very seriously in the design phase – the blinds in every room, for example, are placed within the double glazing; the patient TVs can be fully submerged in water; 50 per cent of the rooms have single beds; and there is a minimum 2.2m between beds (this used to be 2m). Microfibre cleaning, disposable curtains and ozone disinfection are also used to control the risk of infection. The patient areas of most hospitals in the UK face south so the patients can benefit from the sunshine. At Forth Valley, they face north because the sun sets so low in Scotland that it would result in glare and blinds would then be used which would shield the view. It also prevents the patient areas from overheating in summer. Huge windows mean the whole building is infused with light and views across to the Forth Bridges and the Lomond Hills and of the hospital site itself, where there are woodland walks, ponds and landscaped courtyards. The building has also been cleverly designed with all users in mind. Walk down one of the main clinical corridors and windows of different size and shape, looking out over the internal courtyards and atrium, ensure that patients in wheelchairs, on a trolley or walking all get a view of the outside.

s Facilitie ent m manages kept traffic i m patients e fro separat inical staff, so and cl ys of dirty trolle or waste laundry never are AWARD WINNING FM This innovotive approach seen

KEEPING TABS Asset tracking is also a key issue; this includes motion sensor RFID tags so they can tell whether, for example in the case of a wheelchair, it is in use. The tags also have temperature sensitivity so they can monitor temperatures within areas – for example in fridges, so they can be monitored centrally. Eventually, food temperature monitoring will also be done wirelessly. Other technology innovations include one card which acts as a security access control card, opens automated lockers, car park access and provides the staff subsidy in the impressive restaurant. From the outside, the building looks different from more traditional hospitals. Its circular structure is reminiscent of Bexhill’s De La Warr pavilion but owes its shape less to architectural desires than practicality. The hospital was built from the inside out, unlike other buildings which are typically designed the other way around, explains Mackay. The clinical adjacencies took priority over everything else. The theatres are all together in the core of the building with the other services and departments designed around them. This makes for more efficient use of space and it is also very logical from a maintenance perspective. The theatre ceilings are sealed for infection purposes and so the plant is situated on the floor above, all in one place, making it easier to service and maintain. Expansion has been built into the design – it can easily accommodate other wards should the need arise. The existing wards can also be converted to single rooms.

to facilities management has been globally recognised. In October 2012 Serco Healthcare, in partnership with Forth Health and NHS Forth Valley took joint platinum honours in the ‘Global FM Awards for Excellence in Facilities Management’ for the Forth Valley Royal Hospital project. Prior to this win, in 2011 Serco Healthcare Enabling Services at Forth Valley Royal Hospital won the coveted ‘FM Excellence in a Major Project’ Award at the British Institute of Facilities Management (BIFM) Awards. You cannot enter the ‘Global FM Awards for Excellence in FM’ directly; all entries must come through a Global FM Member. In the UK this is the British Institute of Facilities Management (BIFM) – and to be eligible you must have entered the ‘BIFM Awards’ with your project. To enter for the 2013 BIFM Awards go to 2013, email awards@ or call 0141 639 0708. L

A version of this article first appeared in FM World, the magazine of the British Institute of Facilities Management – FURTHER INFORMATION



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Asckey’s powerful FM software functionality gives Trusts a measured, systematic approach to CQC standards management that gives maximum return on investment and long-term peace of mind The relentless tide of uncertainty within the NHS continues to present facilities managers with a number of tough challenges. Trusts are under continuous pressure to rethink their facilities management operations and find a balance between efficiency savings and the implementation of a growing number of compulsory health sector regulatory standards. The 2011 report ‘Preparing the NHS for an Information Revolution’, from the Chartered Institute for IT, points to the increasing importance of technology in support of NHS efficiency savings. It states that `the scale and pace of the productivity challenge faced by the NHS over the next five years cannot be met without much greater and more effective use of information and IT’. It goes on to say that the effective implementation of informatics can `increase productivity and efficiency and make savings at a number of levels, most effective when used to support the application of innovation and the redesign of service and this should be recognised as the priority’. Advocating government standards for the delivery of quality and safety, the Care Quality Commission (CQC) protects the rights of all service users and the level of care they should expect to receive. SHOWING COMPLIANCE With greater public awareness and widespread media interest, the CQC’s profile has been elevated over recent months and now more than ever, Trusts are under pressure to demonstrate compliance. Data collected locally and nationally is constantly monitored and where necessary, used to enforce remedial actions. In order to avoid failure and subsequent `bad press’, Trusts must provide evidence that they are meeting the required standards. In addition to this backdrop of CQC inspections for essential quality and safety standards, preparations are underway for the proposed introduction of PLACE (Patient‑led Assessments of the Care Environment) inspections in 2013. Replacing the existing PEAT inspections, PLACE will focus on rigorous patient based quality assessments and the monitoring of standards regulations, again in affiliation with the CQC. Delivering quality and productivity improvements are paramount and as such require the appropriate application of innovation and technology in the

measurement and publication of performance data. In response to this demand, these same regulatory standards are being closely followed by a number of niche NHS specialist software companies who are working to give back control to facilities managers. Significant advances in CAFM software development now provide a range of data solutions with automated processes and reporting capability developed specifically to support improved efficiency and standards compliance. SUPPORTING CQC IMPLEMENTATION Asckey’s combined 15+ years’ NHS experience and an awareness of the changing face of NHS legislation have informed the development of the fmfirst® product suite. Building on the legacy of early CAFM software such as WIMS, the system has evolved to provide Trusts with simplified functionality and invaluable quantitative, outcome based evidence. Developed in-line with national cleaning standards, PAS 5748 as well as current CQC guidelines, fmfirst® supports the monitoring of designated risk levels including hazard identification, clearly defined deliverable outcomes and subsequent remedial actions, all backed by a robust audit trail. The fmfirst®-product suite supports the implementation of CQC Provider Compliance Assessment outcomes as follows: ‘fmfirst®-cleaning’ deals with Outcome 8 ‘Cleanliness and infection control management’. The module includes risk assessment, task scheduling, scheduled audits and cleaning intensities. It provides essential long-term traceability and evidence of a ‘clean and appropriate environment for the prevention and control of infection’. ‘fmfirst®-estates&facilities’ deals with Outcome 10 ‘Safety and suitability of premises’. The module includes planned maintenance, asset management, risk assessment, implementation of remedial actions and hazards notification. Functionality covers the requirement for Trusts to monitor ‘any relevant design, technical and operational standards’ and management of ‘all risks in relation to the premises’. Flexible reporting functionality provides evidence across a number of required legislative outcomes. fmfirst®-embe covers Outcome 11 ‘Safety, availability and suitability of equipment’. This ebme specific module includes asset

management and planned preventative maintenance. Recording of ‘loaned’ assets is simplified, a key requirement for ebme equipment management. KEEPING ONE STEP AHEAD System flexibility is the key to effective standards management. All fmfirst® modules can be used stand-alone or integrated within the fmfirst® product suite (or external FM software) to provide a cost effective, single-source, targeted estates and facilities management tool. Continuous user feedback and industry research are used to inform system development plans. Keeping one step ahead is crucial for maximum FM operational success. As part of this, Asckey are currently looking to add a patient survey unit to the fmfirst®-cleaning module. This enhancement aims to provide trusts with the ability to consistently record patient feedback for improved service delivery ahead of CQC yearly submissions. This provides vital transparency and the ability to demonstrate awareness of potentially problematic areas. Specifically targeted NHS FM management software is the most effective tool currently available to Trusts looking to control standards compliance. The related efficiency savings, clear audit trails and improved communications improve overall performance. Asckey’s powerful FM software functionality gives Trusts a measured, systematic approach to CQC standards management that gives maximum return on investment and long-term peace of mind. L FOR MORE INFORMATION 0845 270 7747





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Martin Wilkinson of system protection specialists Spirotech UK outlines how effective water control and conditioning are vital in achieving “Hydronic Stability”

Most people are aware of the link between hydronic stability and system performance, but often rely heavily on using chemicals treatment alone to achieve what they perceive as the best means of providing system protection. Chemical dosing certainly has a role to play in hydronic stability, but it is only one part of the treatment process and if used in isolation doesn’t make a significant contribution to system performance. Hydronics is the use of water as the heat transfer medium in heating and cooling systems. Good “Hydronic Stability” is the foundation for a healthy system that will last for years and helps to ensure the highest standards of system performance. It’s vitally important to be mindful of the state of the water that we put into the system and the design, installation and ongoing maintenance regime is paramount to a healthy system. Four key elements must be addressed to provide optimal conditioning of the system water, these being in order of importance. These are Pressurisation; Degasification; Dirt separation; Water analysis & chemical treatment. PRESSURISATION The first - and most important step towards “Hydronic Stability” is achieved by ensuring that control of the system pressures and conditioning of the refill water is correct. Any pressurisation problems will increase problems arising elsewhere within the system. With existing problem systems the roll of the pressurisation unit is frequently overlooked and is often the root cause of the problem. DEGASIFICATION Clearly chemicals alone cannot address the issues of degasification and the onset of cavitation. Using a combined Vacuum Deaerator & Pressurisation Unit provides the opportunity to remove the air from the refill water before it even enters the system. The presence of excess air in the system adds to the system resistance and increases the amount of electrical energy required for the pumps to operate effectively in order to move the fluid around the system. Effective degasification procedures, both at

the commissioning stage and throughout the life of the system will reduce electrical consumption and minimise corrosion. Anyone who considers that they don’t need a degasser, as they believe air vents will do the job for them, is missing an important point. An automatic air vent only allows for the removal of free air when we fill our systems with water, but once the system is full and circulating, no more air can pass out via the vents, so none of the dissolved gasses can be removed in this way. DIRT SEPARATION Effective dirt separation techniques speed up cleaning of the system at commissioning and work to achieve long term protection for major plant and equipment. Unlike traditional Strainers that require considerable effort to clean, Dirt Separators are more likely to receive their annual maintenance as they only require a simple blow down of the unit, subsequently this is less likely to be ignored by the facilities companies. WATER ANALYSIS AND CHEMICAL TREATMENT Chemicals work in conjunction with other aspects of water treatment and their addition can help to provide the best conditions for cleaning systems, whilst affording a degree of corrosion protection. However, the addition of

understanding the interaction between them, can a satisfactory solution be achieved. HYDRONIC STABILITY Hydronic Stability ensures correct pressure throughout the system with air levels reduced to an absolute minimum. It also provides the benefit of system cleanliness and means that expensive chemical treatment can be kept to a minimum. Critically, it contributes greatly to the maximum efficiency of all components within the system, especially the circulating pump(s). Within the H&V sector it’s quite common for different companies to be responsible for the different elements detailed above, so this leads to misunderstanding or disregard for the inter- relationship between these elements. When we come across a problem site, where for instance, there is a constant problem with air in the system, even though correct degasification has been installed, we invariably deduce that there is an underlying error with pressurisation in either the design, the installation. or the maintenance, so it becomes apparent that the presence of air is a symptom of the problem rather than the cause of the problem. Hydronic stability can also lead to impressive energy savings and these can make a major contribution towards payback periods. Where possible, a total solution supplier, such as Spirotech, across

Hydronics is the use of water as the heat transfer medium in heating and cooling systems. Good Hydronic Stability is the foundation for a healthy system that will last for years and helps to ensure the highest standards of system performance. chemicals can only be truly effective if due consideration is given to correct pressurisation and degasification, otherwise the frequent ingress of fresh oxygenated water will render chemical treatment very expensive and useless in the long term. All of the above have a role to play in Hydronic Stability and only by

the four key elements helps to resolve the problems identified and can also avoid any disputes towards the end of the project. L FOR MORE INFORMATION Tel: 020 8451 3344







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Health Business Magazine_Planner_Half_Page_Advert_125_x_178.Wilo_X3_2002_print Monday, December 3, 2012 3:31:04 PM




While GP surgeries and dental practices may not have the operating costs of large hospitals, they still have opportunities to make energy savings, as Alan Aldridge, executive director of the Energy Services and Technology Association (ESTA) explains In these times of austerity, everyone is finding that money has to stretch further and that savings have to be made wherever possible. And energy is one of the first places to look for those savings. Many health service properties are relatively small: surgeries, minor injury units, dental practices, etc. These do not have the ‘big ticket’ energy‑using systems and equipment of the large hospitals, and so will not be looking to invest in sophisticated Building Energy Management Systems (BEMS) or complex control strategies. Yet proportionately these smaller units can probably make as much of an impact on their energy expenditure (and perhaps more) than the larger ones. Many of the larger Hospital Trusts, though, will also have smaller satellite units that – if not integrated into a

remote, multi-site energy management system – will face similar challenges to their smaller, independent colleagues. Aside from staff costs and those associated with maintaining the building and its equipment, energy is likely to be the largest overhead that can be actively managed. Consumers may not be able to do much about the unit price of their energy but they can influence how much is used and when. The European Commission and the UK Government regularly quote a figure of 20 per cent for the average proportion of energy use that could be saved through the implementation of a range of existing, available now, cost‑effective measures. Now it might be assumed that the potential savings would be higher amongst larger energy users, but that is not necessarily the case.

MONITORING AND TARGETING Monitoring & Targeting (M&T) underpins much of energy management. Regular data capture and analysis of the resulting information can identify patterns and trends. There are a wide range of systems on the market to suit all budgets. They vary from the simple, spreadsheet-based packages that work on any PC and require manual data input right up to automatic systems (aM&T) which collect data from meters and produce customised analyses that can point up whatever aspects of your energy profile you want. They can also check the bills for you. And while aM&T may not be applicable for the smallest premises, reducing component costs and economies of scale from increasing sales volumes mean that today, relatively small sites can cost-effectively fit these systems. Over the coming years, all premises will benefit from smart meters. However, right now it is possible to install either wireless energy usage displays or preferably a sub‑meter with an in-built energy management capability that is web enabled (that allows the outputs to be viewed in standard web browsers). We believe that this is economic for sites spending over £5,000 pa on electricity now and this threshold will reduce during the coming years.

Written by Alan Aldridge, ESTA


HOW MUCH AND WHEN It can be very instructive to take a closer look at energy consumption – not just how much is used but when. The first place to look is the bill. Quarterly bills do not give a great deal of information but if the summer quarter and the winter quarter look much the same, then it is a fairly safe bet that there is a problem. Why? Well, heating and lighting should be significantly lower in summer so unless there are special circumstances, then a closer inspection is called for. But how to find out where the wastage is occurring and what to do about it?

Facilities Management


IDENTIFYING AREAS FOR SAVINGS Knowing when energy is being used and how much is being consumed can help the user to identify where likely savings can be made. Of course, the more data you feed in, the more fine-grained the analysis. But even electricity meter readings taken twice a day will tell you whether you are using too much power at night or at weekends. If so, is that because equipment is being left on when it is not required? Has a piece of equipment developed a fault with the result it is running when it should not? The fault may not even be visible: there are plenty of stories of store cupboards being kept at near tropical heat because the thermostat has jammed. Power for lighting, for IT equipment, for drills or even for refrigerators – these account for a significant proportion of overall demand for a surgery/practice. But it is possible to do something about this. For a start, computer equipment should drop to energy-saving E



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ENERGY  mode when not being used. Both the EU and USA insist that computers are fitted with EnergyStar conservation technology, although you may need to check with your supplier/engineer that it is actually enabled.

Facilities Management


LIGHTING: TURNING OFF? It is an oft-repeated fallacy that fluorescent lamps should be left on all the time because switching on and off takes a great deal of energy. Modern low-energy fluorescents and LED lamps are highly efficient and the switchgear does not require large amounts of energy. But once low-energy lamps have been fitted throughout, there are still other things that can be done. After all, even the most efficient lamp will waste energy if left on when not required. It is possible to set an automatic switch-off for all the lighting systems at some point in the evening – with a manual override in case anyone is working late. Also, if the lighting is on automatic start/stop, the settings should be checked regularly and particularly when the clocks change in spring and autumn to ensure that the adjustment has been made. It may be sensible to vary the level of illumination in different areas of a building – areas where fine work if needed will require higher levels of lighting than passageways or some communal areas, although if a significant number of elderly or visually‑impaired patients are using the premises this will have to be taken into account. KEEPING WARM – OR COOL Heating for waiting areas and examination/treatment rooms probably needs to be higher than in other areas of a building. The simplest way to control this where conventional ‘wet’ central heating systems are in use would be by using individual radiator thermostats set for different outputs. Even these ‘simple’ devices have been developed and improved and can, for example, be set remotely or in groups for time and temperature. That makes them eminently suitable for easy installation in small premises. For larger buildings, separate ‘zone controls’ may be called for (and in some cases are required by the building regulations). Stairwells, for example, do not need the same degree of heating. And areas close to windows are likely to have different temperature conditions – and heating requirements – than those in the core of a building. These outer zones are likely to be colder in winter, even with the best double glazing and hotter in summer due to solar gain on south and west facing sides. In buildings where there are both heating and air conditioning (cooling) systems it is important to ensure a ‘dead zone’ on the settings. There should a gap of at least a couple of degrees between the different set points. Otherwise, there is a risk of both systems being in operation at the same time, each fighting the other and wasting energy. A FRESH LOOK It can be very useful to get an independent, expert view of the energy performance of your premises. A walk-through energy audit by an external consultant can identify areas that need attention. These can be prioritised in terms of projected savings and the level of expenditure needed to achieve them. In many cases, the necessary investment is small and payback can be a matter of months. Energy may not seem to be a large item on the balance sheet but it is controllable. In addition, the savings made can go straight into added service provision. From a wider perspective, reducing energy consumption will (unless you buy renewable electricity) reduce carbon emissions. Climate change is expected to have a major impact on health service demand and provision over the coming decades. Small reductions can help mitigate the total impact, especially if enough people make an effort. But perhaps the key point is that there are opportunities to lower energy consumption and so save money, without reducing the levels of comfort or service your patients expect. L

bhsl Toploader with retractable roof bhsl, a specialist company in fully automated materials handling, has unveiled a patented Toploader for storing, moving and dispensing large volumes of biomass and waste fuel products to the boiler. bhsl Toploader which is highly energy-efficient and economical, is driven by two low kW motors, which operate via a programmable logic controller (PLC) using an in-house designed software application. The bhsl Toploader: ● is modular and purpose-built ● is constructed from a flat pack delivery ● is quick and easy to assemble ● is built on a concrete slab ● has a low energy requirement ● has a large storage capacity ● has a retractable roof for easy and fast fuel delivery ● can be customised to your space requirements ● can be designed aesthetically to suit existing surroundings. A choice of conveying systems are available. More information from Find us on LinkedIn & Twitter: @bhslteam UK: LoCall +44 (0) 8445 447 727 On-site visits available at installed operational sites.

ABOUT ESTA The Energy Services and Technology Association (ESTA) represents over 100 major providers of energy management equipment and services across the UK. For more details visit the website at




Facilities Management


Written by Miriam Rodway, secretary, ACRIB

Miriam Rodway, secretary of the Air Conditioning and Refrigeration Industry Board (ACRIB) reminds hospital facilities managers of the environmental and legal responsibilities of having an air conditioned building and suggests ways these can be managed effectively

HOW TO STAY COOL Does your clinic or hospital building use air conditioning or refrigeration? The chances are that it does rely on some sort of refrigeration process for cooling public areas, environmental control of specialist theatres and storage of tissue or pharmaceuticals. This means that the person responsible for controlling the building services facilities will be caught by new and existing environmental legislation dictated by the European Commission. This legislation is designed to tackle emissions from the leakage of refrigerants used in the cooling circuits of air conditioning systems and refrigerators. Some of the most common refrigerants in use in the UK today are subject to environmental legislation to ensure their responsible use and in some cases to restrict their availability, due to their high Global Warming Potential if released from equipment during installation, regular operation, service and maintenance. It is not uncommon for older systems to suffer from leakage rates and require regular work to find and fix leaks followed by addition of extra refrigerant to keep them performing effectively and efficiently. WHICH LEGISLATION SHOULD YOU BE UP TO DATE WITH? The Ozone Depleting Substances Regulations (updated in 2011) introduced a phase out of one of the most common refrigerants

used in building air conditioning – known as R22 which is classified as an HCFC (hydrochloroflourocarbon). It is no longer possible to install new equipment containing this refrigerant but many buildings with air conditioning systems installed before 2003 still contain R22 and if this equipment

included regular refrigerant leak checks, record keeping, labelling and special certification for companies and individuals who can legally carry out work on these systems. The aim of the regulation was to ensure responsible use and track refrigerant consumed.

The proposed legislation restricting the availability of HFC refrigerants has not yet been adopted by the EU or enacted in UK legislation, however as a building manager in the health sector where many systems may be critical to patient care you should monitor developments carefully and keep in regular contact with your FM services provider on these issues. fails for any reason after 2014 replacement fluid will no longer be available for essential service or maintenance. In 2008 the ‘Fluorinated Gases Regulation’ came into force in the UK and this introduced a number of legal obligations for owners and operators of cooling systems containing the very common HFC fluid often used as a replacement for R22. The new requirements

Alongside this additional legislation such as the Building Regulations (Air Conditioning Inspections) brought in regular efficiency inspections and reporting of the energy performance of your existing air conditioning. These were designed to encourage owners to consider how they can reduce the energy use and thus the carbon emissions from buildings. E





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AIR CONDITIONING/REFRIGERATION  WHAT NEXT FOR BUILDING COOLING LEGISLATION? The European Commission is now preparing new legislation likely to come into effect from 2015 which will start restricting the supply of HFC refrigerant gases. If you have recently had old R22 or HCFC systems updated with the HFC gases, or have new systems or newer buildings using these refrigerants, this will affect you. The Commission is also introducing bans relating to the purchase of new equipment or systems containing HFCs in order to encourage building and equipment owners to move to a range of new refrigerant fluids with a significantly lower GWP such as carbon dioxide. In time, the restrictions on supply of refrigerant could lead to increased costs and potentially delays in getting essential equipment repaired. The proposed legislation restricting the availability of HFC refrigerants has not yet been adopted by the EU or enacted in UK legislation, however as a building manager in the health sector where many systems may be critical to patient care you should monitor developments carefully and keep in regular contact with your FM services provider on these issues to assess any potential future impact. The Department for the Environment, Farming and Rural Affairs is responsible for implementing environmental legislation in the UK. Their website outlines a useful strategy for building owners or operators. You can see the Government website at for more information about the responsibilities of air conditioned building owners.

SUGGESTED SOLUTIONS After identifying all systems using HCFC and HFCs refrigerants, each one should be assessed against decision criteria and assigned one of three main solutions. These are: Replace – Some old HCFC R22 systems, including those that are in poor condition, inefficient or not meeting their current (or forecast) cooling load, may need to be replaced with new systems using a different type of refrigerant. This option can have a number of benefits, most importantly the opportunity to significantly improve the building’s energy efficiency. Replacement is however likely to be the most expensive option in up-front cost terms but could offer lifetime savings due to improved efficiency.

input from knowledgeable contractors responsible for your current service and maintenance. These criteria will include: Age – refrigeration and air-conditioning plant over 20 years old are likely to be approaching the end of their natural life and should probably be replaced. The bulk of R22 systems will be between 10 to 20 years old and these should be assessed further. As a further guide, if a system has previously been converted from R12 or R502 to R22, then this should also be replaced and not converted a second time. Fairly new HFC systems are likely to be operating effectively and not require major work in the short term. Condition – if an R22 system has

Facilities Management


A balanced assessment must be made of each criterion for each building or system, with input from knowledgeable contractors responsible for your current service and maintenance.

Convert – For some types of newer R22 systems, which are in good order, it may be possible to recommend a convert Solution. This covers a range of actions, from a relatively simple operation (e.g identifying a new refrigerant designed as a replacement for R22 that is compatible with the system’s existing mineral oil) to a more comprehensive modification which will require a new type of oil at least, and may require additional compressor and/or heat exchanger capacity. roposedFC P MANAGING Whilst a conversion is H new EU rant OLDER EQUIPMENT often a practical option The following is a it must be noted that refrige has not checklist of things to a converted plant n o i t do when managing may have less cooling legisla n adopted, e e older equipment. capacity and/or be s r b e t g e a y n a m Assess the Risk – less efficient than the h t l Identify all systems original system. Also, but hea ld monitor in the building(s), shou pments the conversion must which refrigerants they be carried out by expert develo contain and estimate their contractors to ensure that associated business risk. refrigerant leakage does not Prioritise – identify the most get worse after the conversion. business‑critical systems and address Leave As-Is – This is applicable if the these first. But do not neglect all the other system is fairly new and unlikely to need systems, these must also be managed. major service or extension in the near future Determine the Solution – on a system or represents no business-critical risk, e.g by system basis, identify the most a small non-critical split air-conditioning appropriate solution. These are likely to system in a waiting room or office – this fall within one of three main options: type of system is typically very reliable and Replace, Convert or Leave As-Is. may continue to operate without trouble Planning and Budgeting – develop a Plan, for many years and could be replaced with phased implementation. Depending relatively quickly and cheaply with a new on the size of your building, it is unlikely to system using different type of refrigerant. be possible or desirable to carry out all the actions at once. This will need to be done in EXISTING SYSTEMS: DECISION CRITERIA association with your refrigeration contractor, Unfortunately there is no automatic in order to ensure their commitment. answer and a balanced assessment Implementation – carry out the plan, must be made of each criterion for each with monitoring and regular review. building or system, and ideally with

been well maintained and is in good condition, this would tend to be more suitable for a convert solution. Records of refrigerant leakage are important indicators to the likely success. Meeting Current Cooling Requirements – due to the rapid rate of change in many industries, many refrigeration systems are no longer operating within their original design specification. This is likely to impinge on operating performance, reliability and energy efficiency. This review presents an opportunity to replace the system (or alter it) to meet the current and forecast application requirements. Energy Efficiency – capital costs of air-conditioning systems are typically around 20 per cent of the total lifetime costs. The benefits of replacing an old system with a new energy‑efficient system should be assessed. New options such as free-cooling can be specified to provide significant on-going savings. Availability –Some systems are so “embedded” within the building that replacement may be almost impossible. Alternatively, it may be possible to build a replacement plant alongside the existing plant and then switch‑over with the minimum or disruption. L FURTHER INFORMATION ACRIB is the Air Conditioning and Refrigeration Industry Board, an umbrella organisation for trade associations in the sector and a company limited by guarantee. It helps to inform and advise the industry and users of refrigeration, air conditioning and heat pump equipment as well as working to improve standards and competence of the workforce. Visit for more information



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MP calls for hospitals to adopt higher animal welfare standards Hospitals should be forced to serve food that meets higher animal welfare standards, a Westcountry MP has told ministers. Neil Parish, Conservative MP for Tiverton and Honiton, said making it mandatory for meals to meet RSPCA guidelines would end a ‘postcode lottery’ that sees standards vary across the country. Government buying standards are mandatory only for Whitehall buying departments, the Ministry of Defence and prisons. He added that producers who farm to higher welfare standards would be rewarded, and hospitals would serve food to a level now expected from supermarkets. Parish cited research published by the RSPCA and the Campaign for Better Hospital Food that found most eggs, chicken and pork bought by hospitals are produced from animals that are given just basic welfare standards and live unhappy lives. The research found that half of eggs bought by hospitals in the South West are from caged hens. Parish, a former farmer in Somerset who is also chairman of the parliamentary group for animal welfare, told MPs: “Our health service does a very good job, but sometimes – dare I say it – patients might like slightly tastier meals when in hospital. It would certainly improve our view of life, even if it does not cure us instantly. It can have a positive effect.” He added the introduction of mandatory school food standards by the Government in 2005 led to a dramatic improvement in the quality of school meals. Parish added: “Hospital food should reflect the ethical concerns of the British taxpayer. The introduction of mandatory RSPCA welfare standards for hospital chicken, pork and cage-free eggs is an affordable way to ensure that chickens, pigs and hens that have been reared for patients’ meals are given a good quality of life.” In response, Health Minister Daniel Poulter rejected making improved welfare

standards mandatory, arguing it would ‘stifle’ good hospitals that are already helping raise standards across the NHS. He said: “The problem with a rigid framework or set of criteria is that it might stifle local innovation that can improve standards, as we have seen elsewhere in the NHS.” Dr Poulter also said the Government was looking to link central government payments to “good, ethical” procurement. Meals served at Derby’s hospitals have also been criticised by campaigners. The city’s hospital trust is among dozens of NHS organisations across the country highlighted by the RSPCA and the national Campaign for Better Hospital Food group. According to its figures, 1 per cent of eggs served at the Royal Derby Hospital and London Road Community Hospital are “cage-free” – either barn, free-range or organic. David Bowles, head of public affairs at the RSPCA, said: “It is strange that, just when they are at your weakest, patients are served food which may not be to their taste and can be from animals kept under intensive conditions. “Even hospitals serving food made from free-range eggs in their coffee shops and cafeterias are still delivering food made with cage eggs to patients. We support the idea of having standards for hospital food.” Alex Jackson, co-ordinator of the Campaign for Better Hospital Food, said: “It’s disgraceful for the taxpayer to pay for hospital food which causes misery to animals. A spokeswoman for Derby’s hospitals told the Derby Telegraph: “We have a contract with ISS Facility Services Healthcare, which purchases all the food used by the catering departments in Derby’s hospitals, in accordance with standard NHS catering service contract requirements. “All the eggs purchased are British Lion branded. Some of the chicken and pork used in our catering is British Red Tractor approved.”

National Nutrition Day set for March 20th



The Hospital Caterers Association has joined forces with the National Care Caterers Association to help raise awareness of the importance of good nutritional care, which includes hydration, in all social and healthcare settings throughout the UK. National Nutrition Day will be held on 20th March 2013, and will focus on providing vital advice and guidance to health and social professionals on the action that can be taken to help prevent undernutrition and dehydration. The benefit of the campaign to professionals and staff within social and healthcare settings will be the preventative role they can play in catalysing a reduction in malnutrition related illnesses that often require complex treatments, prolong recovery periods, delay hospital discharges and increase NHS costs. FURTHER INFORMATION

AVEX joined by FM vending show AVEX, the UK’s largest biennial exhibition for the vending and water industries, will take place from 11th-13th June 2013, Hall 3, NEC, Birmingham. The show has been extended to three days and now incorporates the ‘FM Vending Show’ as part of its draw. The FM Vending Show has been specially created with Facilities Managers in mind, and will comprise an array of educative workshops, seminar sessions run in conjunction with the Facilities Management Association (FMA), and pre‑arranged ‘Meet the Buyer’ sessions. The AVEX Gala Awards Dinner and Vending Industry Awards, run by the Automatic Vending Association (AVA), will take place on the evening of Wednesday 12th June at the Hilton Birmingham Metropole. FURTHER INFORMATION

James Martin: “Every hospital is different” Celebrity chef and star of ‘Operation Hospital Food’ James Martin has blasted central government’s efforts so far to increase the standard of food in hospitals. He told Radio Times: “Over the last 15 years, the government has spent 60 million of taxpayer’s money on trying to make food better and none of it has worked. Well, it’s not going to work unless you actually get off your arse and go into a hospital because each one is different. You’ve got to change each one individually and make them feel proud about what they’re doing and not just keep throwing tomatoes in their face.”



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Hospital Directions, which took place on 27-28 November at Olympia, London, offered senior secondary care managers best practice advice and real world solutions through seminars and workshop sessions, plus a tightly focused exhibition space featuring some of the most innovative suppliers in the sector

The NHS is going through significant change with high expectations for improved efficiency, and is expected to deliver savings of £20bn by 2015. This happened at the same time as the government launched the biggest reform of healthcare services since the inception of the NHS. It has left hospitals desperately trying to manage rising demand against the backdrop of a real-terms cut to funding. The new structures in primary care mean that hospitals are forging fresh relationships with commissioners, who are in turn under pressure to deliver more health services in the community and nearer to people’s homes. In the past, when such funding challenges have arisen, services have been slashed, waiting lists increased and training and quality compromised. But with an ageing population, increasing levels of obesity, and rising expectations, the NHS can’t afford such short sighted solutions. Thousands of hospital doctors, managers and directors gathered at the event to get

The two day conference covered key topics from diabetic emergencies, acute headaches, heart failure, chest x-rays, leadership challenges, innovation in the NHS, business and management advice plus many more. up-to-date with the latest in medical practices and gain up to 11 CPD points – Royal College of Physicians accredited – from the high‑quality, 11-stream education programme. The two day conference covered key topics from diabetic emergencies, acute headaches, heart failure, chest x-rays, leadership challenges, innovation in the NHS, business and management advice plus many more. Delegates rated the speaker programme highly. Six speaker streams ran over two days, jam-packed with CPD accredited seminars, and were supported

by a vibrant exhibition, which brought managers together from across the different disciplines and from all around the country. Hospital Directions offered senior care managers best practice advice across eight key areas: patient services, HR, leadership, estate management, outsourcing, technology, information management and infection control. Hospital Direction’s event executive, Daniel Harding said: “Inside six months we delivered the only event in the country that brings senior managers in house with senior E



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 doctors, with well over 3500 attending I am pleased that Hospital Directions is firmly placed in the medical calendar.” Acute and General Medicine ran alongside Hospital Directions, hosting over 80 talks, which delegates were able to tailor make using their personal online networking planner. AGM’s director of healthcare, Ralph Collet said: “Acute and General Medicine proved itself as a concept to work with enormous success. Delegates and exhibitors alike have expressed how significant AGM and Hospital Directions are for their career development.” BESPOKE PROGRAMMES Clinicians, consultants and physicians from all grades, across all the medical specialties and from all seniority levels were able to create their own bespoke programme and network with key suppliers and colleagues from all over the country. A post show survey revealed 86 per cent delegates rated the quality and range of the seminar programme as excellent or very good. Also available and unique to any other medical conference was the Simulation Lab, offering participants the opportunity to practice real-life hands on emergency procedures. The courses ran by Advanced Life Support Group, throughout the two days delivered the latest skills and training in delivering prompt, accurate assessment of patients with medical emergencies and offered an insight into the practical procedures necessary for their effective management. As well as practical training and advice, the Presentation Arena at AGM provided a networking hub for delegates with an interest in the latest in technology and innovative new products and solutions, which were showcased during the programme breaks. The vibrant exhibition floor placed delegates in the ideal location to source the services and information that will support them in their everyday work and career development. Many exhibitors contributed to the educational development of delegates by holding workshops throughout the two

Also available and unique to any other medical conference was the Simulation Lab, offering participants the opportunity to practice real-life hands on emergency procedures. days, showcasing their innovative ideas and products exclusively to AGM delegates. EXHIBITOR SATISFACTION Exhibitors expressed their satisfaction with the event. Fiona Ritchie, RIS Products said: “We’re thrilled with the amount of relevant contacts we’ve met at AGM. We didn’t expect such a flurry of people at the conference and we’ve had some incredibly good meetings with consultants who might have not necessarily had an interest in the product we supply. There will be no doubt that we will exhibit at next year’s show. AGM as an idea is perfect and we will certainly gain business from our time here.” Katherine Lindsay, teaching and research Fellow from Sherwood Forest Hospital Trust said: “Overall AGM has been very useful,

the range of topics has been excellent. Being able to tailor-make your own bespoke programme flexibly has been great. The variety of educational sessions available has been invaluable and it’s so important to have revalidation addressed at the same time.” Nahla Awad, Consultant Anaesthetist from United Lincoln Hospital said: “The variety of topics on offer has been excellent; I’ll definitely attend next year. The presenters have given delegates the most up-to-date education and it’s been very helpful to have someone explain about revalidation. It’s the biggest scale conference in terms of content I’ve attended in England and also very affordable.” L FURTHER INFORMATION

Free ‘How To’ guides from NHS Improvement NHS Improvement’s strength and expertise lies in practical service improvement. It has over 12 years of experience in clinical patient pathway redesign in cancer, diagnostics, heart, lung and stroke services. The organisation demonstrates some of the most leading edge improvement work in England. It works closely with the Department of Health, Trusts, clinical networks, commissioners, other health sector partners, professional bodies and charities. In the last year it has tested, implemented, sustained and spread quantifiable improvements with over 250 sites across the country as well as providing an improvement tool to over 2,250 GP practices.

Recently NHS Improvement has helped to deliver free practical service improvements across a range of different clinical areas including seven day services, Enhanced Recovery, unscheduled care and focused pieces of work in Diagnostics, COPD and Stroke services.

Working with managers, consultants, nurses and commissioners, it has assisted them in reading the current health landscape to identify its opportunities and challenges. NHS Improvement produces practical ‘how to’ publications and electronic resources that are free to download from the website or via email. NHS Improvement was ranked 50 in the 2012 Sunday Times top 100 not for profit companies to work for. FURTHER INFORMATION Email:



Become a qualified trainer Our BTEC Level 4 Safer People Handling Trainers course develops consistency of care for residents and clients and the psychological wellbeing of people handling carers. By applying skills and methods taught, your organisation will benefit from improved functional mobility of clients as well as more motivated staff. Get qualified today!

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Healthcare staff that handle patients must ensure that they work safely to reduce the risk of injury to both themselves and the person being cared for, as well as respecting the patient’s dignity and comfort. A visit to Moving & Handling People 2013 will give them the tools to do just that This event is designed to help individual practitioners and service providers review work practices to ensure safety and efficiency now and in the future. Anticipating future change is not easy, so only by careful planning can an organisation hope to achieve robust policies, protocols and work practices and ‘future proof’ its services. With this in mind the theme for Moving & Handling People 2013 was developed and the programme constructed to help promote good work practices which are adaptable to change, reduce the risk of injury and minimise insurance costs.

& Moving eople gP Handlinaccredited is a CPDrganised by event oabled Living the Dis dation on Foun ary and 31 Janu ruary 1 Feb In the context of moving and handling people, hospital, care homes, social care and care service providers must comply with legislation and national standards. Compliance assures the public and organisations including the Health & Safety Executive, Care Quality Commission and NHS Litigation Authority that there are effective policies and planning in place to provide effective risk and client assessment, care management and safe working practices for both client and carer delivered in a safe dignified manner. Interpretation of legislation and achieving compliance with standards creates more work for care organisations and practitioners and does sometimes cause confusion. PROMOTING GOOD WORK PRACTICES Moving & Handling People is a CPD-accredited event organised by the Disabled Living

Foundation (DLF) taking place on 31 January and Friday 1 February at the Business Design Centre, Islington, London. The main two-day conference features topical plenary and concurrent sessions, while the comprehensive exhibition features a wide range of equipment and services, including a Professional Resource Centre and New Products Poster Gallery. There is also a series of practical interactive workshops. Speakers and workshop facilitators at Moving & Handling People are selected due to their insight into problems and solutions of people handling and so will consider the practical areas of practice in their sessions. These include health & safety and associated legislation, quality standards as well as the application of ergonomic principles in policies, protocols and practices throughout the conference programme.

STAYING SAFE The principles of safe practice will be discussed and reviewed throughout the programme and considered practically in the interactive workshops through peer reviewed algorithms and use of equipment to reflect the range of environments (acute, primary and in the home) in which health and social care is delivered. Where and how this care is delivered has changed dramatically with many more people being managed in their own home, compared to the past when these cases would have been considered as only manageable in the acute environment. These different environments set challenges for the carer and providers. Information and training for hands-on practitioners must be delivered to ensure that they work safely to reduce the risk of injury to both themselves and the person being cared for, as well as respecting their client’s dignity and comfort. The practical workshops offer delegates the opportunity to discuss with the facilitators and their peers solutions to everday problems in moving and handling. Practical examples and models of good practice to create and maintain a successful service will be discussed to provide delegates with as much useful and up-to-date information as possible to help plan, audit and improve services. REDUCING THE RISK OF INJURY FOR ALL Unfortunately, despite a host of legislation, professional codes of conduct, research and the outcomes from legal cases, serious work related injuries and specifically work-related musculoskeletal disorders continue to be reported in the news. In this context, the injuries to people being cared for have most E




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Swan First Aid Services (UK) takes great pride in being one of the South’s leading first aid providers. The company, based in Hampshire, utilises the extensive up-to-date experience of their nursing and paramedic trainers to deliver professional training throughout all parts of the UK. Swan First Aid has established an excellent reputation for delivering high standard of first aid and health & safety training not just healthcare professionals but all your employees. We will discuss your training needs with you and deliver a combination to meet your legal requirements, such as basic life support/defibrillation and new up-to-date Anaphylaxis treatment and devices. All sessions can be taught at your premises and

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Transcend Group Ltd has been established for over 23 years. In that time we have assisted countless organisations to ‘Excel’ within their sector. We have developed over 20,000 employees to achieve improvement both within themselves and the organisations they work for. We are experts in assisting Organisations with their Strategic intent, Leadership Development and implementing Best Practice. We are specialists at transforming the culture of organisations for change sustainability. Transcend Group Ltd is a Skills Funding Agency provider offering qualifications with the Institute of Healthcare Management, EAL, City and Guilds, RSPH and Institute of Leadership and Management. A selection of our education & development programmes:  ILM Leadership Development Level 2-7 (a number of ILM qualifications now met the requirements of the NHS Leadership Framework)  Strategy Development  Executive Coaching At Transcend Group we can help your organisation with its Leadership, whether it’s at Team Leader or Senior Executive level. We are a fully  Project Management approved ILM Centre offering Level 2 to Level 7 Leadership development in NVQ, Award, Certificate & Diploma qualifications.  Change Management  Behavioural Change Why don’t you Level phone now Diploma Roger G. Edmonds and let’s start discussing your requirements? I would be pleased to visit so we can more fully  B-iT 2 &me 3 NVQ present Company and detail how effectively we work with our customers through our Project Based Learning system. ourTeam Building T: 01386 446100

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HEALTH & SAFETY  notably been attributed to client transfers using incompatible hoists and slings, and/or the failure of organisations to provide adequate training for their safe use, failed systems of assessment, training and education and poor equipment maintenance. The practical workshops will pick up these issues and identify safe systems of work and practice which delegates can take away and apply back at work. Reducing the risk of injury to both client and carer is paramount in any handling situation and while all the practical workshops at the event will have safety as the number one priority, one particular workshop (workshop 4) will be looking in detail at hoists and sling compatibility and their use in a range of handling situations. MARKET AWARENESS It is vitally important for care providers, those recommending equipment through assessments and equipment loan services to know which new products are available to assist with moving and handling people. Take a few moments to consider the following different situations: You are requested to undertake a moving and handling risk assessment by a service manager. There is a protocol to follow in assessing the hazard, risks and control measures generated by the task but ultimately you have to provide solutions which often require the use of equipment. You are facilitating training and someone asks what you can do to assist or move a client in a particular environment. You are part of a project team putting a business case together to purchase equipment for a unit or service. What is common in all three situations is the need to know what is available and where you can source it. Moving & Handling People 2013 will help with sourcing, by bringing a large range of these solutions together in one place. This is the best opportunity to listen to plenary and concurrent sessions speakers with insight into not just the problems but ideas and solutions they have developed and that work. See how some of these ideas have been

incorporated into safe moving and handling in the pre- and main conference workshops. The programme has been developed with real people working in the real world and reflects the challenges facing practitioners and service planners. The 2013 event includes creating a safe environment for people with dementia, managing the manual handling risk, nursing people at home, evacuation of the bariatric client, transfer and transport, moving and handling in emergency situations, and learning from incidents. PRODUCTS Take an active part in a series of practical interactive main conference workshops featuring equipment for adult, paediatric and bariatric clients for use in acute, home and social care environments. These workshops are focused on areas of practice including complex handling situations, such as the day-to-day handling and caring for both immobile clients and people with limited mobility, moving and handling people with dementia and exploring compatibility between hoists and slings. Visiting the comprehensive exhibition to view and try out the very latest equipment is an essential part of the delegate experience. Product types for moving and handling people will including beds, mattresses and pressure relief equipment, chairs and seating including wheelchairs, equipment for bathing/ showering and personal care, transfer boards/aids, slide sheets, small handling aids, hoists and slings, stand aids, trolleys and emergency evacuation equipment. Optional pre-conference New Products Evaluation Workshops and Display will feature products in development, bespoke equipment and over 50 new products. PROFESSIONAL RESOURCE CENTRE If delegates have issues concerning areas of practice not only can these be discussed with the session presenters and workshop facilitators but they can also be discussed with representatives of professional bodies in the Professional Resource Centre on the exhibition floor. A list of the suppliers who will be at

the event as well as these organisations is available on the website. There are many opportunities to add to your CPD portfolio. Use the event to network with peers, colleagues and exhibitors throughout the conference. Delegates are provided with a template to record this and other ‘developments’ they have achieved at the event in their CPD record form. Core to the educational side of the event is to help delegates develop their practical knowledge, so they can maintain an up-to-date and accurate record of personal aims. Attending Moving & Handling People 2013 contributes to this by making them think about what they want to achieve, allowing them to focus their attendance and will contribute to the quality of their practice, service delivery, offering benefits to themselves and service users. Essentially, Moving & Handling People 2013 will provide delegates with new information to update policies, protocols and practices, the opportunity to evaluate the latest new equipment and to find out which products are available and from which suppliers, peer reviewed algorithms from the practical interactive workshops and the chance to network with suppliers and colleagues from around the UK. Delegates attending Moving & Handling People 2013 will receive one year’s free access to an information portal of equipment for moving and handling people following the event.

Patient Handling


ABOUT DLF Moving & Handling People 2013 is organised by the Disabled Living Foundation (DLF). DLF’s mission is to provide every older and disabled person with the expert and impartial advice they need to make choices about their daily lives, and to ensure that all front-line health and social care professionals are well trained and well informed. For help and information about equipment and gadgets to make life easier, visit DLF’s impartial advice website ‘Living made easy’ L FURTHER INFORMATION Register now. Quote ‘Health Business’ for a special rate

Paper archiving made easy with Omnidox Records Manager Box-it, the nationwide document management business, announces an exciting new addition to its award-winning Cloud based Omnidox family. The launch of Omnidox Records Manager provides a secure platform for total control and lifecycle management of all physical records archives across one or multiple sites. Departmental based archives, or those stored across multiple sites, are notoriously prone to inconsistencies, sometimes with little cohesive application of retention rules. Omnidox Records Manager allows for efficient consolidation of archive paper records through implementation of a fully-compliant management system providing a unified view of an organisation’s

records. There are no costly user licenses or software purchases and it delivers rapid ROI. Taxonomy and powerful MI prompting scheduled actions are key features. Simple taxonomy rules can be created for every type of archive required ensuring consistent data input. Drop down menus and input constraints deliver

conformity and compliance to statutory and internal file-plan standards. User levels and access rights can be defined. Users can search, request and retrieve files, boxes or documents either physically or by scan on demand showing current status and a full audit history. Box-it provides a range of records management and document lifecycle solutions for both the public and private sector, including NHS Trusts. FURTHER INFORMATION Tel: 01962 830 200 Email:




Improved systems for capturing, storing and sharing information are helping NHS Trusts save money and work more effectively, explains Roger Lamb, health sector manager at not-for-profit global supply chain standards organisation GS1 UK The cost to taxpayers of inefficient procurement and duplicated processes in the NHS is a topic which is never far from the headlines. In November 2012, a report from Ernst & Young, highlighted unnecessary spending by some NHS hospitals due to significant purchasing discrepancies. Of course, this is an important issue that continues to need addressing, but what this report and others often fail to fully recognise is the significant progress already being achieved by some NHS hospitals to improve efficiency and reduce costs. One of the ways in which Trusts are effecting change is through global standards for bar codes and Radio Frequency Identification (RFID) tags, which help hospitals to identify, capture, and share patient and product information automatically, improving safety and supply chain efficiency. In so doing, they can also make considerable financial savings. SUPPLY CHAIN BENEFITS There are multiple ways in which global standards can improve patient safety. Bar codes and RFID tags can help reduce errors by matching the right patient to the right treatment and can also be used to track medication and ensure that patients receive the right dose at the right time. Patient safety is also protected by preventing counterfeit medication entering the hospital by identifying and tracing them in the supply chain effectively. Patients can also be protected from harmful medication by accurate identification of products, which can improve the efficiency of recalls and withdrawals. Accurate product data can also reduce data errors on patient and inventory records. The knock-on benefits in reducing costs by ensuring a fully efficient supply chain are no less impressive. Paperwork and manual processing can be reduced, enabling staff to spend more time caring for patients – which is always a high priority for Trusts. Knowing exactly what you have and where it is sounds straightforward, but in an organisation the size of an NHS Trust or even a hospital when

using manual systems, it isn’t. By replenishing stocks automatically, the need for manual ordering and counting is removed, while greater data integrity means new assets are only bought when they are needed, delivering cost savings and improving efficiency. These savings can then be reinvested into further improving patient care – the ultimate ambition of every healthcare manager. LEEDS STOCKS UP Many NHS hospitals have already successfully implemented GS1 standards. One of these is Leeds Teaching Hospitals NHS Trust – one of the largest Trusts in the UK and including St James’s University Hospital, the largest teaching hospital in Europe. It employs around 14,000 staff across six main hospital sites, treating over a million patients every year with a budget of around £930 million. The Trust has been at the forefront of

When it comes to ordering and delivery of stock, many NHS Trusts face the same problem – there’s no standard way of identifying delivery locations and costs are often allocated to the wrong department or cost code due to poor-quality data. The problem is magnified as Trusts have hundreds of delivery and stocking points across different departments and hospitals. Yet hospital staff need to be able to communicate accurate product and location information with their suppliers, as well as various departments within their own Trust. This is essential to ensure that the supplier knows where the order needs to be delivered within the hospital and the finance department knows which cost code to allocate to the order purchased. Due to a lack of standards for identifying locations in hospitals, orders are very often delivered to the wrong delivery point or go missing. Poor data quality in the ordering

Written by Roger Lamb, GS1 UK


Healthcare IT


Bar codes and RFID tags can help reduce errors by matching the right patient to the right treatment and can also be used to track medication and ensure that patients receive the right dose at the right time. implementing GS1 bar coding and RFID technology to improve patient safety and efficiency. It has used GS1 standards to develop an automated stock control and forecasting system that employs bar code scanning at point of use to reduce unnecessary stock holding levels by £570,000 in one department over three years. The Trust has also successfully piloted RFID technology to track and trace its orthopaedic loan kits, containing vital hip and knee joints. The pilot showed the system provided better information to staff and suppliers, reduced administration and improved efficiency. Leeds has also adopted GS1 Global Location Numbers (GLNs) to ensure the correct stock is delivered and invoiced to the right location, cutting wasted stock, improving stock visibility and driving efficiency savings.

system also affects the Trust’s finance function which requires an accurate cost code to be matched to each order. Staff at Leeds previously manually charged orders to cost codes which was prone to errors and resulted in the wrong departments being charged for the order. Fixing these errors often involves time-consuming and complex investigative processes which costs the hospital vital resources. GLOBAL LOCATION NUMBERS At Leeds, GS1 Global Location Numbers (GLNs) are used to identify physical locations such as the supplies department reception, theatre store or ward reception. The GLNs are allocated and maintained by the Trust’s supplies department. The full list of GLNs which E




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BARCODING & RFID  includes the unique number, location address and description is sent electronically to distributors together with the corresponding cost codes. Any updates to the list are sent daily via email. Hospital staff can order stock electronically using the Trust’s inventory stock replenishment system which is linked up to suppliers’ systems. Staff can also top up their stock using handheld bar code scanners which are linked to Leeds’ electronic ordering system. This ensures that only scanned products are ordered, avoiding any potential manual keying-in errors. More than 94 per cent of the Trust’s orders are made electronically, with GLNs ensuring the order location and cost code are identified and recorded automatically by the ordering and finance systems. By using the GLN and associated information, suppliers receiving the order electronically now know where to deliver the stock and who to invoice. A printed bar code label containing the GLN is also included on the order’s roll cage, tote or box. The Trust’s supplies team is able to keep an accurate and up-to-date record of all the stock ordered and delivered to each department or ward. Using GLNs which are matched to the hospital’s cost codes has also benefitted the Finance team which can now accurately match suppliers’ invoices to the electronic order. As well as ensuring the right department is charged for the right stock, this has improved the Trust’s data quality and reduced the number of costly invoice disputes and investigations. Receipting invoice disputes with one of the Trust’s main suppliers have been reduced from 20 per cent to less than two per cent since implementing GLNs, generating significant cost savings. TRACKING MEDICAL RECORDS The flow of medical records can be complex as patients move between wards and clinics and several people handle a record. It is compounded by the fact that hospitals may operate multiple permanent storage facilities, on-site and off-site, as well as a large number of temporary storage areas including wards, secretaries’ offices and clinics. Tracking medical records manually creates several opportunities for them to go missing (defined as the physical location no longer matching the system location), which can cause confusion and wastes staff time. This is one application of many where RFID can be effective. RFID uses radio waves to transmit a unique identification number into a product or person for identification and tracking purposes. By using Electronic Product Codes in RFID tags, it is possible to identify anything – from an individual item, to a case of products, to a transportation container. This enables organisations to save money through improved efficiency, effective tracking of assets and reducing the amount of inaccurate data being shared.

RFID ENABLED RECORDS MANAGEMENT The Royal Bolton Hospital is one of the busiest hospitals in north-west England for emergency admissions, and its medical records department manages almost 450,000 records in a main library facility with an off-site location for older records. The Hospital has been investigating how RFID can be used to improve the efficiency of the medical records department and the management of files in order to drive cost and operational benefits. At the request of the

Healthcare IT


which uniquely and accurately corresponds with a record on the Patient Administration System, to each physical medical record. Fixed RFID readers at key locations in the hospital can then be used to automatically track the movement of files. Additionally, hand held readers can be used to “sweep” an office or an aisle in the library in order to exactly pin down and locate a file. By replacing manual processing of returned records with an automated system, the departments could save £22,600 per

RFID also reduces the chances of notes not being available for a patient clinic visit, or not being located in timely fashion for an emergency or unplanned visit. Safety risks attached to consultations without case notes are also reduced. Department of Health, GS1 UK carried out an independent review in order to identify the areas within the current management system that would benefit from RFID technology and determine what these benefits are. In common with other large NHS hospitals, the flow of medical records in the Royal Bolton can be complex as patients move between wards and clinics and several people handle a record. The current manual tracking process creates several opportunities for records to ‘go missing’ (the physical location no longer matches the system location). REVIEW FINDINGS GS1 UK’s review found that: Records are passed between areas and in emergency situations or at times of high pressure on resources, the movement happens without the event being tracked on the system, which creates confusion as to their current location and wastes staff’s time; when files have moved without the event being recorded, knowledge of the workings of the hospital is required to locate files in many cases – a great challenge for new staff; Manual processes create opportunities for files to be placed in the wrong location; With the number of files and their compactness, there is a risk that thin files can be placed in larger files or that they can be missed when looking for the record; Non medical records staff, without the necessary training, have controlled access the files to insert letters etc, which increases the possibility of files being misplaced and not being tracked properly. Finally, when files are outside of the medical records department their management varies considerably – often there is limited or no system for tracking files. By switching to an RFID enabled medical records management system, major efficiencies can be realised. The process is quite simple and involves attaching a small RFID tag, carrying a document identifier

annum and automated location tracking throughout the hospital could save a further £25,000 per annum. Greater visibility of file locations has additional benefits. Clerks can plan their routes around the hospital more efficiently and manual tracking can be removed entirely from certain locations, such as receiving files back into the library. This will save £19,000 per annum. REDUCING CONSULTATION RISK RFID also reduces the chances of notes not being available for a patient clinic visit, or not being located in timely fashion for an emergency or unplanned visit while safety risks attached to consultations without compete case notes are also reduced. The conclusions of the review provide an illustration of the transformative effects that RFID can have. After studying the current process, it is anticipated that switching to an RFID enabled medical records management system will cut time spent looking for misfiles by 80 per cent, saving £38,300 a year. In addition, the average time taken to locate a missing file will be reduced by 92 per cent, saving £20,500 a year. By cutting the time to find misfiles and missing files, lost revenue due to coding time outs will be cut by 64 \ per cent, saving £230,000 every year. CONCLUSION GS1 standards are already at the heart of Department of Health Guidelines for maintaining complete and accurate medical records, as well as many other individual hospital initiatives, and it will continue to work with the Department on its new bar coding system for clinical products and management of goods and assets across the NHS supply chain. FURTHER INFORMATION




Great Ormond Street Hospital for Children saves time and money thanks to Wasp Barcode Technologies Cut costs, not services. The British Medical Association (BMA) insists that services be made more efficient without compromising patient care. Dr Brian Keighley, BMA chairman, recently said: “Our NHS is facing tough times and, as financial pressures mount, tough choices will need to be made about what the NHS can and cannot afford to deliver.” Meanwhile, patients are waiting longer for treatment whilst fears over care rationing have surfaced. And, as more care is provided outside the hospital, all aspects of operations will be accountable. The NHS calls for more innovative and efficient services, and providers must decide which efficiencies will offer them the brightest future. With secondary care on the rise, innovative solutions that track operations from origin to delivery willWhite help Technologies cut costs, reduce waste, and identify inefficiencies. In anticipation of future needs, Wasp is developing solutions to meet these needs. Wasp Solutions can help you manage your operations, and cost very little up front. The return on your investment is more time, more efficient operations, and most importantly, more time for patients.Bee Staff Only turnaround puts pressure on your staff and

and reduce wastage of expired stock, and supply accurate procedure costing to commissioners that pay for GOSH services. With Wasp Inventory Control, conducting year-end audits and determining cost for each procedure completed are now easy, efficient processes. Inventory Control has saved GOSH time and money, while improving their stock accuracy and forecasting. Barcodes provide a slew of standalone solutions that integrate easily into your operations. Because barcode solutions work with any system you have in place – even if you use many different electronic systems or have no system at all – you can easily and quickly puts quality of care delivery at risk. The CQC begin realising benefits of information plans to do more checking services, and management. Whether you need barcoded will “act quickly to stop poor services.” Business Card labels Logofor pharmacy operations and patient With barcode solutions in place, your staff wristbands, or more detailed solutions has more time to focus on what matters: that help you work more plan better and your patients. These solutions can be tailored eliminate waste, the time to embrace to meet the specific needs of providers. these technological efficiencies is now. One Wasp partner, Great Ormond Street Hospital for Children NHS Trust FURTHER INFORMATION (GOSH), has already realised benefits from these efficiencies. GOSH needed a Tel: 0845 430 1971 Regular Logo PMS116 CVC way to computerise stock to identify

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Wasp Healthcare Solutions Improving efficiency and accuracy beyond patient care Accurately track and manage stock Reduce medication administration errors Improve patient safety with patient identification wristbands and specimen labeling


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The wider challenge of protecting the Critical National Infrastructure is a fundamental objective across G4S Technology. It is eradicating the risks faced with a range of security solutions Securing your healthcare facility is a significant long-term investment. You need an efficient supplier, with the expertise to help you to consider the long-term costs of the system, rather than just initial outlay, in order to maximise your budget. You also require a provider you can rely on to be there for the lifetime of the system and guide you when your requirements change. G4S Technology is a leader in providing cost effective building security systems for the public and private healthcare sector. The wider challenge of protecting the Critical National Infrastructure is a fundamental objective across G4S plc and Technology is eradicating the risks faced. We have over 30 years proven experience in securing healthcare locations throughout the UK and by working with estate, facility and security professionals we have seamlessly integrated a range of technologies, including access control and video management to protect your staff, premises and assets. We specialise in migrating existing systems into one centrally managed infrastructure to link unlimited sites, card readers and users to meet your specifications, within budget. Increasingly this migration involves the IT department too, to create a centrally managed security system across the IP network infrastructure. REPUTATION COUNTS Our reputation to deliver value over the life of the system has ensured we continue to grow and that includes providing complex installations within the NHS Blood & Transplant, Yorkshire Ambulance Service NHS Trust and Sheffield Children’s NHS Foundation Trust. G4S Technology’s Symmetry Security Management software provides the platform for access control, video management, biometrics, visitor management, physical / logical integration, offline lock systems, together with a comprehensive list of other security and building management functions. Our service team of over 70 engineers is distributed across the UK to ensure we are never more than 30 minutes away from 95 per cent of the UK population – critical for single or multi site support.

We are the only building security company to be accredited to ISO 27001, the internationally recognised standard for information management security systems – showing that we are serious about managing risk. In addition, we comply with ISO 14001 Standard for Environmental Management Systems, delivering all our goods and services in a socially and environmentally responsible way. STAFF & PATIENT SAFETY The Symmetry Security Management System takes the safety of the staff and patients as priority and using the tightly integrated access control and video management solution, can monitor any situation before an incident occurs to reduce staff and patient injury. Symmetry can provide evidence of violence against staff when cases go to court. SECURE AREA CONTROL Using the Symmetry Security Management System, areas can be assigned different levels of access depending upon the time and date, user type, department and area use. The systems can be administered via an existing HR database and new users can be added in less than a minute. Where access to a particular building, department or ward is limited or controlled, the system can use biometric fingerprint readers which will add an extra layer of security.  VISITOR & CONTRACTOR MONITORING Healthcare facilities often have a weak perimeter, which requires strong and consistent management, administration and monitoring. Symmetry Visitor Management enables staff to enrol visitors, capture their photograph, issue an ID badge, assign to responsible employees and monitor their movements throughout the site. Quick transfer data rates ensure processing the high volumes of patient and visitor movements is exceptionally fast.  PROTECTION OF FACILITIES & SUPPLIES The Alarm Management feature within the Symmetry Security Management Solution enables security staff and other personnel to quickly view, acknowledge

and respond as a result of an alarm within the tightly integrated security system being triggered. We have considerable experience of providing systems to mitigate risk against theft of high value items and drugs by staff, patients and visitors.   TERRORISM The tightly integrated Symmetry Security Management Solution with the Threat Level Management feature enables security staff and other personnel to quickly amend the site security with a single click of a button. The change can determine the card holders who are allowed to gain access, the areas they can access and the operation of security equipment around the building. If required readers can, for example, be switched to card and PIN or fingerprint mode and scheduled or conditional operations that are normally used to relax site security can be suspended. ABOUT G4S TECHNOLOGY As a leading provider of integrated security solutions within the healthcare sector, we are ideally suited to help protect and secure your facility against a variety of threats. Our extensive experience includes the protection of over 50 healthcare sites throughout the UK including Cambridge University Hospital’s NHS Foundation Trust. L All readers of Health Business are entitled to free Symmetry version 7.0.1 software and associated version 7 upgrades on orders placed before 31st March 2013. FURTHER INFORMATION For a risk based assessment contact us today: Tel: 01684 277425 Twitter: @G4S_Technology



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PATIENT INFORMATION AT THE TOUCH OF A BUTTON Aintree University Hospital NHS Foundation Trust receives ‘highly commended’ accolade at the UK IT Industry Awards 2012 for its innovative electronic medical records solution Aintree University Hospital NHS Foundation Trust has been named ‘highly commended’ in the public sector project of the year category at this year’s prestigious BCS and Computing UK IT Industry Awards. The Trust was recognised for its innovative approach implementing an electronic medical records (EMR) system to enable instant access to patient information, guarantee case note availability at the pointof-care, improve efficiency, and reduce the costs, security risks and space associated with paper handling and storage.  The BCS and Computing UK IT Industry Awards provide a platform for the entire profession to celebrate best practice, innovation and excellence. In total, this year’s awards featured 23 categories which covered project, organisation, technology and individual excellence. The categories were open to organisations and individuals involved in IT across the public, not for profit and commercial sectors. ELECTRONIC DOCUMENTS Used by around 3,000 health professionals on a daily basis, the Trust installed an electronic document management system from CCube Solutions, with outsourced scanning services provided by Capita Total Document Solutions powered by Kodak production scanners and imaging software.   The project is grounding breaking for two main reasons. First, Aintree is the first NHS Trust to successfully use forms recognition technology, including OCR, to automate the process of recognising pre-printed forms – which make up 95 per cent of the paper file – when digitising records. This ensures contents are correctly indexed even if forms are incorrectly filed in the physical records. This is in contrast to other Trusts where staff manually go through the paper files prior to scanning to check and order contents. Forms recognition technology allows the system to automatically ‘find’ forms in the scanned patient record rather than clinicians having to ‘search’ for them.   Professor Mike Pearson, consultant physician, said: “Some Trusts have just scanned the whole patient record which is useless as doctors are presented with thousands of PDF pages and accessing information is almost impossible. The innovative indexing developed for our solution means we can find many results as quickly or faster than



using paper, with the system allowing doctors just three or four clicks to information.” Second, Aintree is the first NHS Trust to successfully work with a third party using a scan-on-demand approach to outsource the huge task of scanning its records library. MEDICAL JOURNEY In addition, a cleverly designed portal makes the record easy to use with a ‘timeline’ tool showing a patient’s medical journey over time and the treatment given – key for chronic disease management given patients see more than one speciality.   Around 282,000 patient files will be scanned which equates to 45 million pages. As outpatient case notes are used – on average – two and a half times a year, once a person’s file is scanned, the notes are available digitally for subsequent visits. 

project took 15 months and was completed on budget and to acceptable timescales. Ward Priestman, Aintree’s director of Informatics, said: ”We’re delighted to be commended. This type of project is risky, difficult, and we went out on a limb to do it.  We didn’t just buy off-the shelf software, but created the solution in partnership with our IT suppliers such that we are at the vanguard of using this technology in the NHS. It means we are one of the first Trusts in the country to truly get legacy records management right – forms recognition, timeline view, and quick access to information to deliver a streamlined and modern solution which clinicians accept and like.” INDUSTRY AWARDS David Clarke, MBE, Group Chief Executive Officer of BCS, The Chartered Institute for IT,

While the primary driver behind the project was patient safety and care, operational costs will be substantially reduced with the Trust expecting to save of £1 million annually by closing its traditional paper library, reducing staff and avoiding the transportation costs associated with moving 4,200 patient files every day. In close partnership with CCube Solutions, the project was driven by the Trust’s informatics department, under the leadership of Ward Priestman, informatics director, and Professor Mike Pearson, who led a clinical advisory team. The solution cost £1.5 million.     MAKING SAVINGS While the primary driver behind the project was patient safety and care, operational costs will be substantially reduced with the Trust expecting to save of £1 million annually by closing its traditional paper library, reducing staff and avoiding the transportation costs associated with moving 4,200 patient files every day around the organisation. Aintree has also gained 30 per cent additional space [a whole floor] in a new £45 million building which is now used for clinical activities not paper storage – a £13.5 million estate benefit. The

said: “On behalf of BCS, The Chartered Institute for IT, I would like to congratulate all the winners, those who were highly commended and those who were finalists. Our awards celebrate the professionalism and innovation that exists in the IT profession and demonstrates the extent to which IT is the enabler in so many businesses in the UK today. To qualify as a finalist is tremendous – to win one of our prestigious awards is a fantastic achievement.” This is the third time this year the project has been recognised as being innovative. Aintree University Hospital NHS Trust won ‘Gold project of the year’ at Document Manager (DM) magazine’s annual awards scheme, and was shortlisted in the enterprise project of the year category at the Techworld Awards 2012, run by international publisher, IDG. L   FURTHER INFORMATION



The doors have closed on EHI Live for another year, and despite the current austere climate, the event was busier than ever, with delegate numbers up by more than 10 per cent. The buzz appears to be back, particularly about the role of SMEs in providing creative and useful solutions The delegates at this year’s EHI Live attended with real purpose. Many exhibitors have reported holding interesting conversations with senior IT and clinical staff from the NHS who wanted to discuss specific projects and investigate new technologies. While NHS budgets overall may be shrinking, around half of those who attended said their IT spend was increasing this year, reflecting other research released by EHI Intelligence at the show that revealed that total IT

spend in the acute sector will increase by 4.2 per cent in 2012-2013 and continue to grow in each of the following four years. HEALTH INFORMATICS: THE BUZZ IS BACK This positive outlook was reinforced in the conference programme, particularly in the keynote speech to the conference given by new health minister, Dr Dan Poulter. As well as laying out the key parts

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of the new NHS Information strategy, Dr Poulter suggested the government will announce “…more dedicated funds for clinicians to harness technology” in the coming months. As one exhibitor commented: “The buzz is back in Health Informatics, showing us there’s life after the national programme. EHI Live captured and amplified that very well.” The feeling was shared by other vendors: of the 120 suppliers exhibiting at the show, 75 per cent signed up on the day to exhibit again next year. Small and medium-sized companies (SMEs) also received a boost at the show, with Markus Bolton, founder of SystemC and now director of Shearwater Healthcare Solutions arguing in his conference presentation that procurements for NHS IT systems should not exclude SMEs. As he pointed out: “If you automatically cut out small providers, you are cutting out the agile, smart ideas. The input to your procurement, even if you do not choose them or choose to include them as partners with a larger company, can be massive.” Bolton feels the government is finally taking on board the message that large projects need to be broken down into smaller chunks which will allow SMEs to participate. That perception was borne out by the remarks made by another speaker, deputy government chief information officer Liam Maxwell. He agreed that SMEs are where most innovation comes from and that they are generally much cheaper and more flexible to deal with than large companies, but acknowledged that major cultural change would be needed – culture change the Cabinet Office is looking to promote. CLINICIANS TO PLAY GREATER ROLE EHI Live 2012 also saw a greater emphasis on the role clinicians should play in NHS IT, with this year’s event playing host to the first CCIO Leaders Network Annual Conference. The CCIO Leaders Network was established last year to support the CCIO campaign launched by eHealth Insider in June 2011, which calls for every NHS provider organisation to consider appointing a chief clinical information officer (CCIO). Mike Farrar, chief executive of the NHS Confederation, warned in a keynote speech that lack of senior management interest in information is no longer viable – but that CCIOs, as clinicians with real frontline experience, are in a particularly powerful position to encourage that transformation. E




Save money and streamline your clinical correspondence process Designed for healthcare organisations looking to save money and streamline their clinical correspondence process, BigHand digital dictation systems offers a single, high quality technology platform, uniquely developed and supported entirely in the UK. With over 50 healthcare organisations and 20,000 users currently using the BigHand software in the UK, this platform gives customers choice and flexibility on speech recognition engines, integrations, user hardware, smartphones and outsourcing providers. In November 2012 BigHand released its latest version of its product 4.3, a feature rich, innovative release that will dramatically decrease document turnaround time and costs in a Trust using exciting new speech recognition technology, a dedicated electronic document approval suite, including an iPadbased remote approval solution.


By working smarter, streamlining processes, and extending the range of product, potentially beyond the Trust’s site, BigHand 4.3 incorporates the Trust’s full clinical correspondence system. BigHand for Healthcare 4.3 incorporates Speech Understanding from M*Modal for fast, accurate, and most importantly, structured transcription. Adding Speech Understanding to your BigHand system will help you produce better-quality documents faster and smarter than ever before. FURTHER INFORMATION Tel: 020 7940 5900








Cloud2: Successful SharePoint delivered fast Cloud2 is a company with a vision: successful SharePoint delivered fast. It does this for the NHS, other public sector organisations and the corporate sector, combining a range of sophisticated solutions with related services, frank advice and a determination to be involved and make a difference. Cloud2 has an uncommon approach, focusing on Information Architecture and configuration in preference to development. Most of its solutions are preconfigured, based on years of research, development and testing. Hadron 8020 is the company’s world class Enterprise Intranet solution. Hadron 8020 can be implemented on site or to Office 365. It delivers a robust and successful intranet, encompassing content, collaboration, communication and business process. Hadron 8020 can be ready to go live in as little as eight weeks. It includes policy & document management

and publication, governance, directorate, department & team working, programmes and projects, BI, knowledge centre, extended search and more. Hadron Prime and Hadron are services for defining the strategy, roadmap & ROI and for adoption, training and support respectively. Hadron Migrate aids moving documents off file servers; Hadron UX provides visually and functionally enhanced SharePoint components. Other Cloud2 SharePoint based solutions include eForm and workflow development and extranet and website development. FURTHER INFORMATION 01274 741871


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EHI LIVE  He described CCIOs as “white knights” who can deliver increased awareness of the value of information in connecting with patients and bringing about clinical improvements. “The quality of the messenger is important,” he pointed out. “Clinicians are trusted more than politicians and managers.” Meanwhile, in the main conference programme, Dame Fiona Caldicott called for “information governance” to be renamed “clinical governance” as part of encouraging a cultural shift in the NHS towards more information sharing. Dame Fiona, who is leading an independent review of information governance in the health service, said it has become clear that the NHS is “erring on the side of not sharing” information in ways that are not acting in patients’ best interests. She suggested the name change would help encourage greater understanding and commitment to the need to protect

and implementation, to find out what works and who is behind the success stories. As one visitor commented, the Best Practice Showcase provided “some of the most informative and useful sessions: real-life examples, warts and all, with the chance to meet presenters after sessions to share experiences.” TWITTER TRENDING The buzz didn’t just happen in the conference halls and on the exhibition floor, either. This year, the #ehilive hashtag was ‘trending’ on Twitter in the UK top 10 on both days of the event. Altogether, #ehilive received more than 2.5 million impressions over four days, starting on the eve of the show, with 2,260 tweets made by 455 tweeters. In short, while many eHealth events and conferences have struggled to provide value to either attendees or exhibitors in recent years, EHI Live has once

Small and medium-sized companies (SMEs) also received a boost at the show, with Markus Bolton, founder of SystemC and now director of Shearwater Healthcare Solutions arguing in his conference presentation that procurements for NHS IT systems should not exclude SMEs. patient privacy and confidentiality, while at the same time ensuring that clinicians have the necessary information to treat their patients. AWARD WINNERS It wasn’t just vendors, politicians and policy makers who took centre stage at the event, though. Finalists from the EHI Awards 2012 in association with BT outlined the work that made them finalists, the impact it has had, and the latest developments in their projects. Meanwhile, the Best Practice Showcase was expanded to provide even more space for visitors to meet people from NHS trusts working at the cutting edge of innovation

again proved itself to be the key event in the eHealth calendar. This year’s event brought together everyone involved in healthcare IT – suppliers, healthcare IT professionals and clinicians – for lively and productive discussions and debates about how to use IT to improve the efficiency and quality of health services. And the eHealth world will get a chance to do it all again in a year’s time: organisers are already planning how to make EHI Live 2013, which takes place 5-6 November 2013 at the NEC Birmingham, even bigger and better. L FURTHER INFORMATION

Commerce-Connections offers EDI software and services for healthcare Commerce-Connections was founded in 1999 as a provider of B2B/EDI software and services. The company enables organisations to gain visibility and control over their supply chains by automating inter-company processes with their suppliers, customers and other trading partners across their supply network. The firm’s latest healthcare endeavour was to provide a VAN and EDI translation solution allowing for accurate validation down to line item detail for BMI Healthcare. After reviewing several EDI companies, BMI

selected CommerceConnections for its substantial integration project based on the service broker’s flexibility, realistic pricing and willingness to work on a scaled basis. Currently 40 per cent of BMI Healthcare’s invoice volume goes via EDI for all B2B documents which has drastically reduced the margin for error.

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IT spending set to increase, says report According to the latest EHI Intelligence report, NHS acute trusts in England will be spending around £800m a year on IT in four years time as they respond to the end of the National Programme for IT in the NHS. The latest report from EHI Intelligence, launched in November at the EHI Live event, calculates that total IT spending by NHS acute trusts in England will increase by 4.2 per cent in 2012-13, taking the total for which trusts are directly responsible to £763m. The ‘Market by numbers’ report calculates that spending will continue to grow in each of the following four years, reaching £829m in 2015-16. This is in marked contrast to the squeeze on public sector spending that is expected over the remaining years of the present Parliament. It reflects the need for a significant number of trusts to make big investments in the patient administration and electronic patient record systems that NPfIT failed to deliver. EHI Intelligence calculates that a further £400m will be available to trusts over the period of this report from the remains of the national programme, based on around 40 trusts being funded for systems at a nominal £10m each over the lifetime of their contract. Paul Smith, director of EHI Intelligence said: “It is very easy to assume that every area of public sector spending will be cut as the government implements its austerity plans. But our analysis shows clearly that NHS IT will demonstrate robust growth over the next four years.” FURTHER INFORMATION

In addition to EDI software and services, Commerce-Connections has recently partnered with a monitoring hardware manufacturer to offer a range of practical solutions designed to meet strict regulatory compliance requirements. These can be used for pharmaceutical goods, consumables and other products where temperature and humidity monitoring is essential. Wider international reach is achieved via a network of partner organisations across Europe, US and Asia. FURTHER INFORMATION +44 (0) 845 127 9955




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A look at the 2013 healthcare events calendar


31 January-1 February – Business Design Centre, London Healthcare workers who handle patients need to work safely to reduce the risk of injury to both themselves and the person being moved, as well as respecting their client’s dignity and comfort. Organisations have a responsibility to provide such information and training. The principles of safe practice will be discussed and reviewed at Moving & Handling People through the conference programme and taken practically into the interactive workshops. Delegates will also get to view and try out the very latest equipment at the comprehensive exhibition. Any healthcare worker involved in the assessment, equipment recommendation and moving and handling of people should attend this event.


16-17 April – NEC, Birmingham HC2013, the health informatics event, will bring together healthcare professionals with those who provide the systems that support the delivery of care. HC2013 will enable stakeholders to explore some of the current issues that affect the way we deliver healthcare, the environment in which we deliver it and how modern information systems available at the point of care will transform the patient experience. This year’s conference will address how information and supporting technology can help commissioners to make the best decisions for planning and funding healthcare, and how technology is helping citizens manage their own health. Two commercial theatres will showcase innovative changes in clinical care pathways that have been enabled by technology, improved information flows and examples of the whole system working together.


13-14 March – Excel, London The third Healthcare Innovation Expo 2013 will support the delivery of the NHS Chief Executive’s report Innovation Health and Wealth – Accelerating Adoption and Diffusion in the NHS. Widespread adoption of innovation is a key priority for the NHS. This event will play an important part in spreading new and existing ideas across the NHS, helping to deliver improvements in quality and value and drive economic growth. Healthcare Innovation Expo 2013 will feature over 200 seminars, 200 speakers and 250 exhibitors all featuring high impact innovations that are ready now to improve patient care and productivity.


30 April-2 May – NEC, Birmingham Naidex is the UK’s largest disability, rehabilitation and homecare event with over 300 exhibitors featuring the latest products and services to aid independent living. It offers the latest thinking, strategies and products to support the ageing population and those affected or living with disabilities and limiting health conditions. It’s also open to members of the public who have a need to source products and services to support and assist with independent living. The Naidex National Conference programme is certified for CPD purposes and is completely free to attend.




1-2 May – Olympia, London MEDTEC UK exhibition and Conference 2013 brings together the medical device manufacturing community. The conference aims to understand some of the challenges surrounding R&D, design and regulation. It will be packed full of case studies, innovative start‑ups and industry guru discussion. It will discuss how regulatory and healthcare reforms will effect device development in the future. The event will feature key educational content on leading innovations and new technologies; live demonstrations of next generation technologies, as well as live networking opportunities.


29-30 September - NEC, Birmingham Pharmacists are facing a host of challenges in these tough times, from medicine shortages to declining NHS margins, whilst on the other end of the scale, a variety of opportunities including Medicine User Reviews and the New Medicine Service, which if understood properly, can considerably benefit pharmacy businesses. As the biggest show for the pharmacy industry, created for the industry and now led by the industry, the Pharmacy Show allows delegates to get the very latest information on all of the changes taking place in the sector, as well as advice from leading experts on how they can adapt to take advantage of the opportunities.


30 September-2 October – Excel, London Infection Prevention 2013 is the UK’s largest infection prevention and control event. It brings together the healthcare community to discuss the latest thinking around infection control such as the global threat of infection spread, antimicrobial prescribing and stewardship, behaviour change, cleaning, disinfection and Sterilisation, and outbreak investigation and management. Delegates benefit from an exhibition of the latest products and services to combat infection as well as an informative conference programme with a line up of expert speakers.


8 October – Olympia 2, London The Healthcare Efficiency Through Technology Expo brings together healthcare leaders to discuss how to deliver better patient care and outcomes through technology. As well as being a showcase for innovation, technology and best practice, the Expo also brings together senior executives, clinicians and GPs, patient facing organisations, regulatory bodies and local authorities with senior government officials and healthcare specialists from not-for-profit organisations and private sector businesses.


5-6 November – NEC, Birmingham EHI Live brings together everyone involved in healthcare IT – suppliers, healthcare IT professionals and clinicians – for lively and productive discussions and debates about how to use IT to improve the efficiency and quality of health services. Anyone who has an interest in healthcare IT and the use of information in healthcare systems and clinical practice should attend EHI Live 2013. The show features more than 100 exhibitors showing their newest products and ideas and the programme places an emphasis on the latest technology and software designed to improve the healthcare sector.



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PRINT MANAGEMENT printer stock down to 47 devices. This was just the start. One of the most important benefits of MPS as far as Kehoe is concerned is the constant support and the fact that consumables are now replaced as and when they are needed. “So, there’s no consumable management needed from my side now,” she says. “The majority of machines are networked and we have the option of remote monitoring and management. When the printer detects that a toner is down to, say, 20 per cent, it automatically orders a new one and this is sent out straight away. “All I do now is make sure deliveries go to the correct department, so this has really freed up my time. We have also been able to set up a standing order for payment so all that tracking down of purchase orders and matching up invoices from seven different suppliers is now finished,” she adds.


Aut Even private hospital in Kilkenny has shaved off 23 per cent from its printing costs thanks to OKI Managed Print Services Managing printers is one of those responsibilities that is often tagged on the end of a job description. However, it can be an extremely time-consuming and thankless task. This is what Yvonne Kehoe of Aut Even private hospital in Kilkenny discovered. Her role is as IT manager, but instead of addressing complex IT issues, she was forever ordering new toners and fixing paper jams for the hospital’s 52 printing devices. However, after the hospital decided to invest in OKI’s Managed Print Services, she now has far more time to devote to her main job. And the change is saving the hospital 23 per cent of its previous printing costs. DIFFERENT MAKERS & MODELS Aut Even Hospital, which is accredited with Joint Commission International, has 71 in-patient beds and around 50 consultants, who are leading practitioners across a wide range of medical and surgical services, including general surgery, gynaecology, orthopaedics, cardiology, diabetes care and direct access endoscopy. These specialities are supported by excellent facilities and a dedicated, highly-skilled nursing team. However, according to Kehoe, there was one operational area that wasn’t working as efficiently as it should. The hospital had a variety of printers from seven different manufacturers and no maintenance support agreement from any of them. These devices were used to print all the hospital’s documentation, including patient

labels, wristbands and care plans for new admissions, patient information leaflets and exercise sheets for physiotherapy patients. If something went wrong it was more than just inconvenient. “Take the admissions printer,” says Kehoe. “It’s a very busy area and if the printers ceased to function firstly, the patient’s experience would be affected and secondly we wouldn’t have the information to give to the nursing staff or to the theatre – there could be serious delays. We are talking about people’s lives here, after all.” But one of the most time-consuming aspects of the set up was managing consumables. “I was ordering new stock from so many different places, just trying to manage everything was taking a lot of my time. And then there was the job of chasing invoices and making sure everything was up to date on that side,” she adds. So when Kilkenny-based IT solutions company Business IT Solutions (BITS) suggested to Kehoe that the hospital tried OKI’s Managed Print Services (MPS), it seemed like a lifeline. GETTING STARTED OKI’s first step was to assess the volume of the printing carried out by the hospital over a month. “We’d never investigated this before – we just did what we did so we had no idea what we really needed,” says Kehoe. However, using these figures, OKI managed to consolidate the hospital’s

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REDUCING WASTE There are also some further bonuses – areas of waste that taken individually seem relatively small, but which together add up to a substantial amount over time. For example, Kehoe recalls that with the old printers staff would replace toners before they had actually run out because warning signals were being shown. As a result, toners which would have gone on longer were being thrown away. “Now consumables are monitored more carefully,” she says. “Also, where possible, all printing is double sided which is saving a good deal of paper. Altogether we have shaved almost a quarter of our printing and consumables bill.” There are also other benefits which are not measured in cost, but in peace of mind. “Some devices have a secure print option accessed only by a pin code which means printing confidential material is very simple. “Also recognising how critical some of the printers are, OKI has included spare devices in its service, so if something went wrong with the admissions printer we can replace it immediately, without having to wait for an engineer to arrive. It’s great to know that there won’t be a problem that could have serious repercussions,” says Kehoe. While getting the new MPS up and running, OKI and the hospital met monthly. Now everything is well-established they meet every six months to check that everything is running smoothly and to adapt products and services in line with any changes in the hospital’s business requirements. “OKI is always very responsive whenever I need to talk to them and it’s good to know they are there,” says Kehoe. “I used to spend my working life fire-fighting. There were always paper jams and when anybody else tried to genuinely help, they sometimes made it worse. Now I can go back to being an IT manager,” she concludes. L FOR MORE INFORMATION




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YouTube videos enhance users’ understanding of communication apps In an evolving healthcare environment with diverse nursing practices and high patient expectations, Fusion-IP from Static Systems Group is at the leading edge of healthcare communications. To demonstrate the flexibility and platform independent nature of Fusion-IP, the company has produced a suite of videos outlining the range of applications available for both site-wide and departmental use. Over 20 apps have so far been launched on YouTube including; hand hygiene, roaming patient call, catering call, SIP/VoIP speech, bed exit alarm, staff attack and patient fall monitoring. Each video explains how the ‘app’ works in practice and is an invaluable aid in demonstrating the simplicity of operation and scope of many of the company’s nurse call related services.

Static Systems’ sales and marketing director, Phil Wade said: “However skilfully written a brochure or manual is, there is no more effective way to demonstrate the practicalities of how systems work, than to show them visually. The initial reaction from client teams who have seen the videos has been so positive that we felt we should make the videos more readily accessible.” FURTHER INFORMATION

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Viruses or bacteria have the ability to wreak havoc in any healthcare business. However, prior to any outbreak, there is a proactive regular approach to monitoring microbial levels of activity. This proactive monitoring of patient waiting rooms, surgeries, operating theatres and hospital wards is known as Hygiene Risk Assessment Monitoring. Monitoring equipment measures how much microbial life is present. This information is then tabled and forwarded to your department electronically on a regular basis. With Log6 performing a regular assessment, this will show a pattern for analysis of your hygiene cleaning programme. Bacteria free or free bad press? Hygiene Risk Assessment Monitoring effectively demonstrates that duty-of-care and due diligence are being upheld for both patients and employees. In addition, upon visiting, when measuring

microbial levels of activity, Log6 would report back high levels of activity and immediately put an action plan together to perform the necessary action to kill viruses and bacteria present. Does your health care business carry out Hygiene Risk Assessments and demonstrate effectively that ‘duty-ofcare’ is being monitored at a microbial level? To discuss your requirements call Rob York-Andrews, Log6, Cleaning to sterilisation level, on 01229 465366 nationwide service. FURTHER INFORMATION Tel: 01229 465366


NHS Alliance Conference



Addressing the 15th NHS Alliance Conference, which took place in Bournemouth this November, its chairman, Dr Mike Dixon OBE has cause for optimism as the April 2013 deadline for Clinical Commissioning Groups to be in place approaches Since the early 90s, Dr Mike Dixon OBE has been a leader of the GP/clinical commissioning movement, with the aim of allowing frontline clinicians a far greater role in improving local services and health. He co-founded one of the first Locality Commissioning Groups in Mid Devon in 1993 and served on the National Executive of the National Association of GPs before becoming the first chair of the NHS Alliance, in 1998. As the April deadline for CCGs to be in place approaches, his speech to the conference delegates, summarised below, shared his cautious optimism. “Today our fifteen year struggle to establish clinical commissioning is over. It is now a reality. Does that mean mission accomplished? A chance that we might return home to our neglected families and friends? Perhaps not yet.  LESSONS The lessons of the past, the imperatives of the present and the challenges of the future suggest that the battle may be far from won. First, the lessons. Perhaps my worst moment during the past fifteen years was a phone call late one evening in 2000 - on the eve of publishing our document “Implementing the Vision”.  The Minister wanted his foreword removed from every copy. Why? Because we were the very first to suggest, in a discussion document would you believe, that

the Government should consider creating an arms length body to which it would specify its requirements and then agree the necessary funding. Thus, to match expectation of the NHS with available resources. Twelve years later, last month to be precise, that arms-length body of Government - the National Commissioning Board - went live. Last week, it received the new Secretary of State’s excellent liberating Mandate. Today’s heresy is tomorrow’s orthodoxy.  Lesson one:-  It can take twelve years to happen. ENGAGEMENT Lesson two came with the publication of our later documents Engaging GPs, Engaging Nurses and Engaging Allied and other Primary Care Professionals. No Ministers, noR senior managers attended the launch of these pieces of work.  We were told they were unhelpful. They raised issues that did not exist. Issues that did not need to be discussed. It was an attitude ‘at the top’ so well expressed by Thomas Hardy (and how could I fail to quote him speaking in Dorset today) in his poem In Tenebris. “All’s well with us: ruers have nought to rue! And what the potent say so oft, can it fail to be somewhat true?”  Of course, it can. Powerful vested interests rarely speak the truth. The main reason for the failure of NHS reforms to date has been the effective exclusion of primary care clinicians and patients from NHS policy

and its implementation. Those at the very heart of NHS delivery that the Alliance has always championed and always will.      The third lesson of the past is that a passionate, determined and visionary force can eventually win the argument. That passionate, determined and visionary force of the last fifteen years is, of course, represented by so many of you here today. So to the imperatives of the present. The first is that clinical commissioning should succeed. That it should deliver better health and services for our patients.  That will require great leading clinicians, great managers and great providers working with them. So what of those harbingers of doom, who told us that we would be unable to find those leaders? That they would not want to lead. That they would not be up to leading. How wrong were they? HEROES  211 heroic men and women and very many others are now ready to lead and meet the challenges ahead. NHS heroes in every sense. Those leaders will need the wisdom of Solomon, the courage of Nelson, the determination of Mandela and the humility of Ghandi. That is because the lessons of the past tell us that a centralist, secondary care dominated system run by a managerial hierarchy will not relinquish its grip without a fight. Those Clinical Commissioning Groups and their leaders will also need strong champions to give them headroom. That is why the commissioning arms of NHS Alliance, NAPC and NHS Confederation have come together as ‘NHS Clinical Commissioners’. E



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Patients check in themselves CST’s EasyCall buttons give reassurance to outpatients at The Royal Surrey County Hospital The Royal Surrey County Hospital, near Guildford, offers general hospital services and specialist care including cancer, ear, nose and throat, maxillo-facial and oral surgery. It has a busy outpatients department through which five to six thousand patients pass every week. To reduce queues and increase efficiency, the outpatient departments decided to streamline booking-in procedures. A new self booking-in system uses EasyCall buttons from Call Systems Technology, alongside computer touch screens and has greatly reduced reception queues. When patients arrive at The Royal Surrey County Hospital, they may use the booking-in screen at the main reception area, before proceeding to their department, or go directly to their destination, where there is another ‘reception kiosk’. “Generally our patients are used to self check-in from their doctors’ surgeries,” says Ross Buttery, outpatients services manager. “But now and again someone needs assistance. All they need to do is press the EasyCall button and one of the duty team will be there. “The queues at outpatient receptions have significantly reduced,” says Ross Buttery. “CST’s EasyCall was the best product to ensure we maintained a high standard of patient care while doing away with manned reception desks.”



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NHS ALLIANCE CONFERENCE 2012  With most Clinical Commissioning Groups being now full members, we can provide a strong unified voice for them.   From now on, anyone who wants to mess around with CCGs or their leaders will find themselves looking down the wrong end of the gun. A gun, this time, with three barrels.  Because this time, we will ensure that the ideals, that you fought for, actually happen. This time, there will be no replay of the broken promises of the past. GRAND PROTECTOR   I hope and believe the NHS Commissioning Board will play an important part in this – perhaps as thanks for our role in its creation. It must become the Grand Protector of clinical commissioning and Clinical Commissioning Groups. Just as, in the early days of Locality Commissioning Groups, the chief executive of my local Health Authority told us that she was there to cover our backs and support our difficult decisions.    The current language of the Board is exactly right with phrases such as “assumed liberty” of CCGs. Those words must now translate into action. That is why last week NHS Clinical Commissioners announced that we will be undertaking 360 degree appraisal of the National Commissioning Board.    Each year, we will collect appraisals from each Clinical Commissioning Group of the National Commissioning Board and local office. From these appraisals, we will produce a national report, which we will share with the National Commissioning Board and then we will publish the results with proposals as to how things might be improved.  That is because there can be no “same old” in the relationship between the centre and the new clinical commissioners. No reversion in type from Grand Protector to Grand Inquisitor.   What applies to relationships between CCGs and the Commissioning Board applies equally to every CCG in its relationship with frontline practices and clinicians.   MOTIVATION That was the other missing link of the past. Clinical commissioners, as the second imperative, must now work as hard as possible to ensure their frontline clinicians are motivated, effective and (dare I say it) happy in their new commissioning role.    Those GPs, nurses and other clinicians have legitimate concerns. Some feel that they have got too much on their hands already.  Some think they will be blamed if resources and services are less than expected. Some fear that their relationship with patients will be compromised. Others suspect this is the beginning of widespread NHS privatisation.  We must answer these fears. Explain and show how every clinician now has a real chance to make a real difference for every patient.     It was George Bernard Shaw, who said over a hundred years ago: “Until the medical profession becomes a body

From now on, anyone who wants to mess around with CCGs or their leaders will find themselves looking down the wrong end of the gun... trained and paid by the country to keep the country in health it will remain what it is at present: a conspiracy to exploit popular credibility and human suffering”. Clinical commissioning marks the end of that conspiracy, if there was one. A promise that clinicians will, henceforth, be able and committed to “keep the country in health”.   The third imperative is to ensure that patients and clinicians make as fearsome partnerships as commissioners as they do in the consulting room. Partnerships that will enable local people and clinicians, in Clinical Commissioning Groups and Health & Wellbeing Boards, to shake the floor beneath the trembling feet of any centralist left standing. Because in future, patients and local people must be more than critical friends and co-planners, they must also become an intrinsic part of our system for creating better health and care.

and exploits that rich seam of goodwill and giving that lies behind the very idea of an NHS.   That will mean reigniting the altruism that lies beneath the skin of every clinician, however scarred by life’s events. Reinvigorating the professional ethic that wants to make a difference.  Releasing that pent up altruism that is so endemic in the population at large.  So visible among the Olympic volunteers. So visible every day in my own surgery – from the next door neighbour that brings in the elderly patient to the patient that encourages a sicker patient to go before him or her. The NHS must become more than just a service - a consumer service. From now on, it must also be a partnership   Only if we can do that can we maximise the co-production between clinician, patient and population and de-professionalise and de‑medicalise wherever possible and appropriate. 

REMOVING RED TAPE To enable the frail, elderly and those with long term disease to be looked after within their communities, clinical commissioners must become demolition experts. Removing the obstacles and the red tape that prevent them securing better services and outcomes. Enabling good providers to provide even better care and going elsewhere only when they can’t. We are already beginning to see this transformation – witnessed in our document Clinical Commissioning in Action published earlier this year. Yet, however much we redesign our services, however cost effective we make them, we will eventually hit the buffers of unaffordable cost, deteriorating quality or reduced availability. That means we will need to think ever bigger, wider and more ambitious. Public health will need to get its hands dirty. Every patient and clinician will need to play his or her part in improving personal health. Ensuring that resources are used to best effect. Maximising wellbeing and resilience. Breaking new boundaries. Involving new legions of health trainers, health advisors, community workers and volunteers. Supporting local initiatives from fishing clubs in Newcastle to dementia friendly towns like Crawley. Initiatives that have all too often been ignored in favour of short term targets and cash strapped services.    Even that will not be enough. Patients will still remain over medicalised, over professionalised and over hospitalised.  Then we need to ask ourselves: “Do we really want a fair and equitable health system?” If we do then we will need to re-engineer a totally new relationship between the NHS and the people it serves. A relationship that reflects

THE FUTURE OF NHS ALLIANCE Next March, we will gather together all the words and aspirations of this conference and the conversations that follow from it to produce a piece of work, in partnership with the Nuffield Trust and King’s Fund, that will lead the future. A manifesto for that future.   Standing on the brink of this brave new world has helped us, at NHS Alliance, to clarify our own vision for the future.  I have been proud to have been chosen to lead the NHS Alliance for the past fifteen years but what of the next fifteen? Put simply, you could say we have dealt with commissioning. It is now time to look at provision. Because excellent commissioning relies on excellent provision. These ambitious reforms will only deliver if we can successfully harness the enthusiasm and commitment of frontline clinicians and managers and the wider providers of services within primary care.  In future, as NHS Alliance, we want to represent the people and the organisations, whose services  commissioners will be proud to commission .    In our new role, NHS Alliance will continue with the same values, the same determination and the same passion. An NHS that is fair (as we said in our very first manifesto) to patients and fair to those who care for them. Promoting integrated primary care, tackling inequalities and emancipating our members- so much so that every member, whether individual, practice  or primary care provider, will be free to decide what membership fee to pay depending upon what a member thinks we are worth.” L

NHS Alliance Conference





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• Verification and validation of British Standard NIST outlet points.

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SLKids products will provide an effective distraction to children while they are in a medical environment: whether that be because they are about to undergo a medical procedure themselves or are accompanying someone else receiving medical attention. Children from 18 months to 8 years will enjoy playing with our robust play products. It will help them remain calm, meaning that those sitting with them in that waiting room, can relax too. When you consider what will make your waiting area, consulting room or in-house cafÊ a more pleasant place to work, consider SLKids. The full range of products can be found at or contact us for a free, no obligation consultation.

Health Business Magazine 12.08  

Business information for Healthcare professionals