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GREENING THE UK’S HOSPITALS The Government’s scheme to help the NHS slash its energy bills PATIENT SAFETY


How better reporting of problems can play a vital role in patient care


A FLEXIBLE WORKFORCE How properly managed agency staff can help an NHS under pressure








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The Government’s scheme to help the NHS slash its energy bills PATIENT SAFETY


How better reporting of problems can play a vital role in patient care


A FLEXIBLE WORKFORCE How properly managed agency staff can help an NHS under pressure




OVERHAULING PATIENT SAFETY Over the last few months we have seen a number of initial reports as to how the government would react to the 290 recommendations made in Robert Francis’ report into the failings at Mid Staffordshire NHS Foundation Trust. Now the government has released its final response. Amongst the changes, ‘wilful neglect’ will now be a criminal offence, so that those responsible for the worst failures in care are held accountable. Other measures include the requirement to publish key statistics including staffing levels and better reporting of safety incidents. To that effect, the NHS is transforming the way it reports patient safety incidents, joining together the two existing systems (National Reporting and Learning System and the one run by the Medicines and Healthcare Products Regulatory Agency [MHRA]). This will mean that all incidents go through the same system locally and nationally. NHS England and the MHRA have also drafted two new Patient Safety Alerts documents; one on improving medical device incident reporting and learning, and one doing the same for medication errors. This will help improve the early detection of risks and enable actions to reduce harm to patients. The two organisations are also developing a National Medical Devices Safety Network which will provide a new forum for discussing potential and recognised safety issues, identifying trends and suggesting actions to improve patient safety. Read the full news story on page 7. Further discussion on the topic of the safety of medical devices is on page 37, where John Wilkinson from the MHRA explains how better reporting of problems with medical devices from NHS staff can play a vital role in patient care.

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 Richard Gooding PRODUCTION CONTROL Jacqueline Lawford, Jo Golding WEBSITE PRODUCTION Reiss Malone ADVERTISEMENT SALES AJ Baker, Jeremy Cox, Azad Miah, Steve Nicolaou, Nicola Towers ADMINISTRATION Victoria Leftwich PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Patient safety reporting to be overhauled; almost two million visit A&E due to lack of GP appointments


The MHRA’s John Wilkinson discusses how better reporting of problems with medical devices from NHS staff can play a vital role in patient care


Better supplier engagement is key to get temporary staffing right in a changing NHS


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Patient safety reporting to be overhauled The NHS is developing a new way for patient safety incidents to be reported. The National Reporting and Learning System (NRLS) was previously run by the National Patient Safety Agency and is used to report and analyse patient safety incidents such as falls or surgical errors. However, it has taken a back seat since the closure of the agency in June 2012, when responsibility was transferred to NHS England. There are two national reporting systems for patient safety in the NHS; the NRLS and one run by the Medicines and Healthcare Products Regulatory Agency. This causes inconsistency as some incidents will be reported to both systems, while others will only be reported to one of them. NHS England and the MHRA are working together on the new development, which will join these two systems via an integrated reporting route, meaning all reporting, information and feedback on incidents will go through the same system locally and nationally. The organisations have also drafted two new Patient Safety Alerts documents; one on ‘improving medical device incident reporting and learning’, and one doing the same for medication errors.

“Further integration of local and national systems for reporting and learning about medical device incidents in the NHS, will improve the early detection of risks and enable actions to reduce harm to patients,” says the paper. “Essential reporting information will only need to be entered once at local level and it will then be available to local and national learning systems.” The integration means information on the incidents will need to be gathered and included in local risk management systems and sent immediately to the NRLS. NHS England and the MHRA are also developing enhanced governance systems, improved feedback systems and a National Medical Devices Safety Network. The network will provide a new forum for discussing potential and recognised safety issues, identifying trends and suggesting actions to improve patient safety,” the response says. “The network will also work with new Patient Safety Improvement Collaboratives that will be set READ MORE: up during 2014.”


Almost two million visit A&E due to lack of GP appointments As many as 1.88 million people alone have visited A&E in the past 12 months because they couldn’t get a GP appointment, suggests a new online survey commissioned by Network Locum. Over 2043 British adults, aged 18+, were surveyed online by YouGov on behalf of Network Locum in November. The responses showed that just over one in three (34 per cent) of people who asked for an appointment as soon as possible in the past 12 months had to wait for over 48 hours to be seen. And four per cent admitted going to A&E when they weren’t able to get a GP appointment. With the average A&E visit costing the NHS £88, this behaviour may have cost the NHS as much as £120 million in a single year, says Network Locum, based on population figures, and the difference in average costs between a GP and A&E visit. The survey findings also suggest that the lack of GP appointments might be putting people off visiting their local doctor altogether.  Just over one in six (18%) women respondents delayed booking an appointment because they were worried that they would be wasting their GP’s time. And one in four admitted that they



NEWS IN BRIEF Online map shows quality of dementia care around the UK Find the online dementia map at http:// dementiachallenge.

A new interactive online map has been launched to show members of the public the quality of dementia care and support in their local area. The map shows a regional and local picture, based on a range of data including diagnosis rates, how often anti‑psychotic drugs are prescribed, and referral rates for further investigation. By entering their postcode people will be able to see this data in an accessible format. This will give the public the information they need to hold organisations to account over poor services and it will highlight areas that are performing well. READ MORE:

GP surgery manager prosecuted for snooping on patient records A former manager who oversaw the finances of a GP’s practice in Maidstone has been prosecuted by the Information Commissioner’s Office (ICO) after unlawfully accessing the medical records of approximately 1,940 patients registered with the surgery. The 37-year-old Steven Tennison pleaded guilty to charges of unlawfully obtaining personal data and was fined a total of £996.

Sheep could combat C. diff

had stored up a number of concerns to discuss in one GP visit. Just under one in five respondents (19%) said they would be prepared to pay for a guaranteed appointment on the same day and over half (52%) would be prepared to have an online consultation with a GP. Nearly a quarter (24%) said that they would use an online video call such as Skype to discuss their symptoms and would only go to see a GP if it was READ MORE: absolutely necessary.

C. difficile, a superbug found in the gut of five per cent of humans can be harmful if taking antibiotics. Last year 1,646 people in England and Wales contracted the digestive tract infection and 10 per cent died. Biotech firm MicroPharm, with help from an £800,000 grant from the UK’s innovation agency, may have found a solution. It has found that most sheep have the superbug but do not display symptoms and are now looking to extract antibodies from the animal to fight infections in humans. If successful, clinical trials could start in humans in three years and the product could be on sale in ten. READ MORE:



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Reported assaults against NHS staff rise by six per cent


Care standards in Welsh hospitals need review, says RCS A review of all Welsh hospitals about standards of NHS care has been urged by the Royal College of Surgeons (RCS). It said it was worried about poor performance and called for “urgent assurance” on safety. It also stated that the hospital inspection system should be beefed up with more input from professional medical bodies. But the Welsh government said a review was not needed. In a briefing prepared for assembly members, the college argued more should be done by politicians, NHS managers and clinicians to improve public confidence. It is worried about the high number of patients who die waiting for heart operations in south Wales and about the rise in people waiting too long for hospital treatment. Conservative Shadow Minister for Health Darren Millar welcomed the RCS call. The Conservatives have previously demanded Darren Millar an inquiry into Welsh NHS care standards, similar to an investigation by Sir Bruce Keogh into health trusts with the highest death rates in England. But the Welsh government has ruled that out. Millar said: “It’s not right that the people of Wales have hospitals with higher death rates than elsewhere in the UK. We need to understand the reasons for that and I am pleased the RCS has made this call.” The RCS wants the current inspection regime led by Healthcare Inspectorate Wales (HIW) to be beefed up, and suggested setting up a dedicated “hospital inspectorate” within READ MORE: the watchdog.

The number of reported assaults against NHS staff in England rose six per cent last year, figures from NHS Protect have revealed. The 2012-13 figures for reported physical assaults, against NHS staff in England show that there was a rise of 5.8% in total reported assaults from 59,744 in 2011-12 to 63,199 in 2012-13. The figures add up to an assault rate of 21 per 1,000 staff in the acute sector, 39 per 1,000 in ambulance services, 210 per 1,000 in mental health services. The number of criminal sanctions taken rose from 1257 to 1458 — a rise of 15.9%. NHS Protect urges health bodies to take advantage of the joint working agreement with the Association of Chief Police Officers and the Crown Prosecution Service and use existing guidance to pursue local arrangements building on this national agreement to ensure that criminal assaults do not go unpunished. It says that employers should seek advice from the enhanced network of NHS Protect’s Area Security Management Specialists (ASMSs), which can assess risks of violence, and pursue legal action when assaults do occur. Staff should be adequately trained to use available powers under the Criminal Justice and Immigration Act 2008 to respond decisively to low-level nuisance behaviour before it escalates into violence, it says. “NHS staff should expect to be able to provide care in a safe environment, free from violence and physical assault. NHS Protect urges employers to take firm action in all cases of assault against NHS staff,” commented Richard Hampton, Head of Local Support and Development Services at NHS Protect.

“We urge all NHS staff to report assault and acts of violence against them. Employers must do all they can to support staff in preventing incidents and pursuing offenders,” he said. Christina McAnea, UNISON’s head of health, said: “It is absolutely unacceptable that every day more than 173 NHS workers are physically assaulted and that only one in 40 cases results in a criminal sanction. Sadly, this is only the tip of the iceberg as violence on NHS premises remains an under-reported problem.” “We’re pleased that more people are being prosecuted for assaulting staff but much more still needs to be done to ensure the NHS provides a safe working environment,” she said. NHS Protect has been included in the forthcoming Anti-Social Behaviour, Crime & Policing Bill in order to provide new tools for dealing with persistent anti-social behaviour within the NHS. And it will shortly be issuing new guidance on the prevention and management of challenging behaviour in NHS settings in a bid to help NHS staff de-escalate confrontational incidents and reduce violence in the NHS.



iPads for patient records access in Ipswich

Nearly half of senior health bosses rated poorly by staff

Ipswich Hospital NHS Trust has given clinicians iPads to access patient records at the bedside. The trust, which uses Kainos’ electronic document management system app, Evolve, has rolled out iPads to 80 clinicians. Neil Turnbull, head of programme delivery at Ipswich, told eHealth Insider that the trust planned to roll out a further 40 iPads by the end of the year. “At the moment it’s read only. Even with that, I’ve had clinicians say it’s revolutionary. We’re getting a new version of the EDM app before the end of the year, which will give read and write access and they can load up patient records and put in information as well out in the community.” As well as having access to Kainos, clinicians can also access their trust emails, calendar, pathology READ MORE: results and clinical apps.


One in three managers working in health and social care (38 per cent) are considered ineffective by their staff, according to a new report looking at the state of management and leadership in the sector from CMI (Chartered Management Institute). The research reveals particular problems at senior management levels, where the number of ineffective managers rises to almost half (43 per cent). Lower than average levels of investment in management and leadership development and the promotion of clinicians into management roles without adequate training and support are pointed to as contributing factors. Unlike other sectors, perceived management ability does not improve with job level – junior managers are most positive about their managers, with just a quarter saying their boss isn’t hitting the mark.  Analysis of the top and bottom five line



management traits shows managers are perceived to be stronger in the skills that come from having a clinical background, like understanding the organisation, but are weaker in management areas  such as communicating objectives, setting priorities, and seeking and responding to feedback on performance. While the report, ‘A Management and Leadership Health-Check’, highlights much room for improvement, it does not support the contention that management is significantly worse in the sector generally compared to other UK industries. Employee engagement levels were similar to the overall results – 54 per cent of health and social care respondents are highly engaged compared to 57 per cent across all sectors. There is also strong evidence that where managers and leaders are developed, rewards are reaped. Read more:



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Better supplier engagement is key to get temporary staffing right in a changing NHS, writes Chris Wilford, the Recruitment and Employment Confederation’s Senior Policy & Public Affairs Manager The NHS procurement market for agency staffing services is complex, convoluted and controversial. But in the government’s much anticipated NHS Procurement review, ‘Better Procurement, Better Value, Better Care: A procurement development programme for the NHS’, published over the summer, the opportunity to review the total workforce strategy for the NHS was not taken up. Whilst we welcomed the call for greater transparency and improved opportunities for SMEs, we believe that it needed to be more explicit that better supplier engagement will be essential to improve NHS workforce management going forward in a changing health environment. REORGANISATION Supplier engagement has improved over recent years but increasing it will be essential to build sustainable supply chains that deliver value for the NHS. This is all the more important as we believe that in debates surrounding the future of the health and social care system in England, matters concerning the workforce are all too often ignored. The NHS is currently undergoing a period of large scale reorganisation and social care services

are struggling to cope with increased levels of service demand and limited resources. Andrew Hine, the UK head of healthcare at KPMG, cautioned in October 2012 that very little attention has been paid to staff in this changing health and social care environment, “the very people at the heart of our healthcare system.” With NHS organisations and local authorities striving to reach stringent efficiency targets, more effective workforce management and use of resources (such as flexible staffing) is needed if standards of care are not to be compromised. The recent controversies surrounding standards of care in some of our hospitals, and the fallout from the Francis Report, have served to underline that the quality and management of staff is of the utmost importance in health and social care services under considerable financial strain. If there is to be an important shift, from an acute to a community driven health and social care service that strikes the right balance between national entitlements and local flexibility to plan and deliver services, then the staff will have to feel ownership of the processes that achieve this. In short, whilst patients

More e effectivce r workfo nt with me manage re is needed ca quality organisations if NHS to meet are ciency fi f e t c i str targets

have to be an integral part of care decisions in the health and social care system so that services are geared to their local needs and expectations and that resourcing decisions are taken to reflect these, so do the staff who actually deliver these services on the ground.

Written by Chris Wilford, senior policy & public affairs manager, Recruitment & Employment Confederation (REC)


TURNING AWAY The health and social care workforce in England is currently in crisis. Our members have long reported that they are seeing increasing numbers of doctors and nurses, as well as other categories of staff, choosing to leave NHS and local authority social care services to work in a flexible capacity or leaving England to work overseas. Figures from the Health and Social Care Information Centre issued in 2013 illustrated that the number of district nurses fell by 39 per cent between 2002 and 2012, whilst modelling work from the Centre for Workforce Intelligence predicts that there could be a shortage of 190,000 registered nurses by 2016. We believe that with the current workforce models in place, sustainable and safe nurse staffing levels are fast becoming unobtainable. The Royal College of Nursing’s 2012 UK nursing labour market review entitled ‘Overstretched. Under-resourced,’ highlights an overall staffing decline in the NHS. In the review, it is clear that a relentless focus on cost has contributed to reductions in the numbers of commissioned training and education E



Meeting the Remote Care DES in your practice What is the Remote Care DES? The aim of the DES is to encourage GP practices to prepare for remote monitoring of patients with stable but long term conditions in line with national guidelines

What is Telehealth? Telehealth is a term used to describe remote patient monitoring, and more specifically the technology that enables this monitoring. But to us it means so much more: it means empowerment and delivering tangible outcomes that benefit the health economy and individual patients.

Reductions possible with appropriate application of telehealth intervention • • • • hhh

67% in visits to the GP 85% in GP home visits 75% hospital clinic attendance 88% Medical Assessment Unit (MAU) attendance

*based on 23 COPD patients post 6 months of receiving HomePod service

What Long Term Condition to choose? The CCG will work with you to determine the LTC your DES will cover. This is what our nurse specialists say about COPD and CHF: “COPD is particularly suited to telehealth monitoring due to the early interventions possible with health monitoring over time. Acute exacerbations of COPD often require hospital admission for treatment of respiratory failure; this could be avoided with telehealth interventions” Lawrence Gora, COPD nurse specialist

We have designed a telehealth service focused on the needs of the individual but adaptable to your local care pathways. Our skilled staff engage with patients, carers, clinicians and commissioners to ensure the service is developed to support local health needs and priorities. Our years of experience of working with NHS partners enables us to share best practice with our customers. Telehealth can be a highly cost effective intervention that improves quality of life for patients and reduces impact on services. Our studies show that the key to achieving these benefits, is to build the service around centralised nurse case management, utilising the skills of specialist nurses to manage patients within their own homes. HomePod is designed to enable personalised care. It is very easy for patients to use. In addition to wireless connectivity to a range of peripheral medical devices such as pulse oximetry, patients can respond to questions designed to monitor changes or trends in their health and well-being.

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“Telehealth is viable in Chronic Heart Failure due to the early recognition and intervention possible with daily monitoring. Measuring bodyweight, blood pressure and other parameters on a daily basis, in combination with specific clinical protocols, can significantly improve outcomes for chronic heart failure patients.” Vivat Baah, CHF nurse specialist

AGENCY STAFFING  places, to reductions in staff numbers, pay freezes and reduced training budgets for the nursing workforce. Whilst the lack of data is a big issue in seeking to understand trends in the workforce, the review indicates that shift demand for agency and temporary staff has been increasing steadily in England. The Recruitment and Employment Confederation and KPMG Report on Jobs – published in association with Markit – provides the most comprehensive guide to the UK labour market, drawing on original survey data provided by recruitment consultancies. Recruitment consultants are asked to specify whether the demand for staff from employers has changed on the previous month, thereby providing an indicator of the number of job vacancies. The summary indexes are derived from asking recruitment consultants to report whether availability of permanent and temporary staff has changed on the previous month, leading to the calculation of an overall indicator of staff availability. The nursing/medical/care sector has consistently been one of the top performing sectors. In the September 2013 REC/KPMG Report on Jobs the nursing/medical/care sector was the second strongest performer in terms of temporary employees, having been the strongest the previous month. The respective index posted 67.9 (scores over 50 indicate growth on the previous month) for the August 2013 period, having stood at 68.3 for the July 2013 period. INTERNATIONAL COMPETITION The RCN’s 2012 nursing labour market review also provides a stark warning that in the international competition for clinical talent,



The recent controversies surrounding standards of care in some of our hospitals, and the fallout from the Francis Report, have served to underline that the quality and management of staff is of the utmost importance in health and social care services under considerable financial strain England and the UK as a whole is falling behind: “In the international context, the UK has moved from a situation of net inflow of nurses to a position of net outflow in recent years, meaning that more nurses are moving abroad than are coming to the UK to practice. The main destinations are Australia, Canada, New Zealand and the USA.” The REC would join organisations such as the RCN in calling for a new health and social care system in England to have medical workforce planning and increased flexibility at its heart. Temporary and locum staff are an indispensable element of the NHS workforce, allowing services to meet spikes in demand and cover unexpected absences. How they are managed and used efficiently alongside other staff will remain important and is likely to become more so in an evolving NHS. Increasing competition between procurement providers, critical shortages of important staff such as nurses, and international competition for clinicians, means the NHS has to get its total workforce strategy right if it is to continue to deliver world class care at a time of limited resources and unprecedented structural transformation.

EASING THE PRESSURE Flexible staffing is a major opportunity in an NHS under pressure. With the latest statistics from the Health and Social Care Information Centre highlighting that the average sickness absence rate for the NHS in England has risen, staff are needed to plug the gaps to ensure patients get the care they need. If services are to respond to unexpected circumstances and do more with less as NHS Trusts strive to hit efficiency targets and meet increasing levels of demand, then innovative ways of working and different models of workforce planning will be required. Health Minister Dr Daniel Poulter MP and others in government talk about efficiencies and productivity. In this time of transformation for the NHS following the Francis Report, the debate needs to be about safety, quality and new ways of working. As part of this, properly managed agency staffing must be seen as part of the solution rather than part of the problem and better supplier engagement will be essential. L FURTHER INFORMATION




Healthcare in the UK is underpinned by facilities management, which, as Gareth Tancred, ceo of British Institute of Facilities Management (BIFM) explains, is much more than just sweeping up and general caretaking duties – facilities management is an intrinsic part of its success Healthcare is never far from the media spotlight; fears over A&E capacity, waiting lists, administration issues and lack of funding serves to generate unwelcomed publicity. Regardless of the headlines though, the business of providing critical healthcare services to the people living, working and holidaying in UK continues 24/7. On the front line, rightly taking the glory, are the clinical staff, but look behind them and there is an army of managers, administrators and technicians providing the critical systems maintenance, asset management, logistical and material support necessary that enables effective clinical care to be delivered where it is needed most. Facilities management (or FM) is a core element of the support services. Often part of an estate and property service department, almost always outsourced, the facilities management team cater for anything and everything in and around a hospital from the surrounding landscapes and car parks, the cleaning of the wards, provision of porter service and the physical maintenance of the actual hospital buildings and M&E equipment themselves. IN THE MIDDLE OF IT ALL This puts facilities management right in the middle of what is regarded as a complex environment. As individuals they are the silent heroes. Their role is to be diligent, customer service focussed and unseen. But if they get it wrong then, as an economic sector – the

big outsource organisations – they instantly become a target. Cleaners, maintenance teams and engineers, often the unseen workers within a hospital, are an easy target, highlighting the noise and disruption in hospital wards and the dilapidation of the built fabric. This means there is no room for failure: 99.9 per cent is not good enough, service providers must through their expertise maintain an operational environment that is continuously running at

Written by Gareth Tancred, ceo, British Institute of Facilities Management (BIFM)

Whiston Hospital, Merseyside has FM built into its design

Facilities Management


BUILDING TOGETHER For the project at St Helen’s and Knowsley Teaching Hospitals NHS Trust, the company had a head start, as the FM team were involved from the outset of a scheme to create two new hospitals in 2002. Through PFI funding, the Trust appointed a New Hospitals Consortium; work began in 2004 with VINCI Construction (UK) responsible for the design and build of both hospitals,

On the front line, rightly taking the glory, is the clinical staff, but look behind them and there is an army of managers, administrators and technicians providing the critical systems maintenance, asset management, logistical and material support necessary that enables effective clinical care where it is needed most 100 per cent. It means that FM is at the heart of UK healthcare, at the front line of service accountability and doing a critical job for our society as a whole – there is no place to hide. That is one of the reasons why BIFM highlights the best organisations servicing our healthcare facilities. For example, VINCI Facilities recently won the FM excellence in a major project award for its work at St Helens and Whiston on Merseyside.

whilst VINCI Facilities provided hard FM services for interim and steady periods. The two sister organisations worked together to embed FM into the building design. The brief was to plan, design, project manage and deliver comprehensive maintenance services to two modern hospitals – Whiston, an 80,000m2 acute general hospital, and St Helen’s, a 20,000m2 day treatment centre. There are 956 beds across the two sites. E



Kings College Hospital, gowlain Building group It was extremely important to the Client that there were no delays incurred on this project even though it grew in size considerably from the original tender document.

Montefiore road, Mansells ConstruCtion

We supplied and installed Polyflor Wood FX to communal areas including welded joints and silicone sealant to perimeter edges. All Wet Rooms were installed with Self-Cove. All works were completed out-of-hours in order to cause minimum disruption to other trades and was completed on time and on budget.

Spire Health are the second largest provider of healthcare in the UK and on this particular project in Brighton the interior design of the hospital was influenced by some of the City’s top boutique hotels to give an exceptional visual experience, so we were delighted to be appointed as the flooring contractors on this project. Over 4000sqm of flooring materials were installed including Marmomleum, Altro, Gerflor, Heuga Carpet tiles and Broadloom carpet using the Durafit System. The resilient floor coverings were installed with either self cove or set-in-skirting details to comply with the healthcare provider’s hygiene standards. Our teams of qualified flooring installers worked many shifts, including out of hours and weekends to minimise disruption to other trades and to help bring the project to completion ontime and on budget.

The Flooring Co Ltd is a well established firm of flooring suppliers and contractors, with over 20 years of experience in the commercial field. We are a member of The Contract Flooring Association, registered with CHAS, Constructionline, Altius and ISO 9001 approved. With a wealth of knowledge and experience pertaining to all aspects of flooring, we can supply and install all types such as Altro, Polyflor, Amtico, Gradus, linoleum, vinyls, carpet tiles, natural carpets, solid/engineered wood and many more. In addition to our Altro Safety Flooring we are approved installers of Altro Whiterock and can supply and install various types of hygienic decorative wall cladding systems. Over the years we have maintained The Flooring Co Ltd as an individual firm of professional flooring experts with qualified fitters and an emphasis on attention to detail. We strive for personal customer service and after care whilst maintaining a competitive price. Our working processes ensure that we meet the highest of standards at all times. The Flooring Co Ltd has worked within the Healthcare sector for many years and have completed works in numerous major hospitals. Our of our projects being a £300K installation for Spire Healthcare and a £60K project at Kings College Hospital, London.

FACILITIES MANAGEMENT  The first six-year ‘interim’ stage of the project required the company to develop solutions to 24/7/365 hard FM requirements that conformed to current legislation from the outset, while meeting complex patient, staff and visitor needs. These encompass the building fabric, mechanical and electrical (such as medical gasses, fire systems services), clinical and other waste removal, grounds and pest control. Experience of working on PFI hospital builds at Princess Royal University Hospital, High Wycombe and Amersham Hospitals, helped inform decisions about products best suited to the environment, such as prefabricated bathroom pods and vinyl skirting boards. It also provided the teams with an insight into design elements that would benefit this project, such as incorporating segregated FM routes and zonal FM hubs. ENERGY EFFICIENCY Increasing sustainability was a key consideration, with long-lasting, energy‑efficient and minimal maintenance choices made for ventilation, lighting, heating and air-conditioning. Energy monitoring is achieved through 400 electrical meters feeding data to the VINCI Facilities’ in-house Technology Centre and regularly assessed to develop improvement strategies. In April 2013, further emphasis was placed on energy management with the launch of an innovative ‘emissions gain share’: where losses and gains in consumption are shared. The financial stakes serve to ensure both parties’ fulfil commitment to the goals. A STRONG CULTURE At the heart of successful facilities management in healthcare is a strong culture. Because it is ever present, FM helps to bind together the care provided by hospitals. Almost all of the non‑clinical employees are employed by an FM contractor in the NHS. When it is done well, facilities management in the NHS is not just a critical support service that backs up clinical and administrative staff in hospitals and healthcare centres across the UK – it plays a major role in adding value to the patient experience. It is crucial to make sure that across the FM team there is a strong, robust and consistent system of behaviours and values. Healthcare is comparable to retail, where the customer is king and the experience of the retail consumer is paramount. No matter what their role or task, cleaning, catering, checking and fixing fire extinguishers, portable appliance testing, planned maintenance or critical plant maintenance, FM teams must put the needs of the patient and their relatives above everything else. That means establishing a climate of collaboration and open communication essential to ensure all user-groups at St Helen’s and Whiston – among them 42 Trust staff TUPED over to the VINCI team – could have their input. Focus groups were set-up to facilitate idea sharing, learning and risk management and a core FM group assessed the needs of hospital staff, patients and the community, and developed appropriate solutions. For example, discussions with patients led to the understanding that FM workers should minimise their presence on wards to protect the privacy and dignity of patients. This approach is crucial to long term success and as part of the monitoring and control process VINCI set up to help improve performance, a centralised help desk was introduced. VINCI invested £300,000 developing a bespoke computer-aided facility management (CAFM) system to provide open book monitoring of response and rectification times against targets, with staff able to produce status reports on the move on personal digital assistants. It acts as the central hub of all FM activities and receives an average of 2,800 calls per month along with calls logged via a web based portal. Clinical staff are actively encouraged to log calls via the online helpdesk, which automatically feeds a job request to a pre programmed resource. This approach has been successful, with over 50 per cent of work requests processed via the web. The helpdesk function is exemplary in its resilience to increases in work volumes, with 98 per cent of calls answered within four seconds, and at peak times, within 15 seconds. The scope of the ‘steady state’ 35-year FM contract, which started in January 2013, includes life cycle replacement programmes, ensuring a safe environment, providing logistical access for delivery of all FM

services and asset and property management. And it is going well. Aside from the BIFM award, for the proof the formula is achieving its goals, look no further than the results of the new PLACE (Patient‑led Assessments of the Care Environment) surveys. This put Whiston top in the country in the acute care category, and St Helen’s third.

Facilities Management


PUTTING THE PATIENT FIRST A good facilities management service provider makes every effort to appreciate what is required to run a healthcare facility efficiently and effectively and to put the patient first Nothing is taken for granted. This is critical to how the public judge our hospitals. Many people working within the NHS are not actually directly employed but, work for the various facilities management companies employed to deliver non-clinical and therefore, non-core services. But to the patients and their relatives receiving care and experiencing the non-clinical services it is all a core service. This means it is crucial that no matter how small it might appear, all of the non-clinical issues that arise within a hospital must be dealt with quickly and efficiently – because if they are not, then the end users’ experience of the whole healthcare environment is judged accordingly. BIFM believes that FM service providers are making a positive difference to the healthcare environment. Consequently, FM is having a positive effect upon our society as a whole. But a lot more can be done right across the NHS if healthcare professionals and leading players and consultants in facilities management work even more closely together. If the two sectors work as a team, then the most important person, the patient, the end‑user will have the best possible experience, at a time when they are most vulnerable, during their stay in one of the country’s hospitals. L FURTHER INFORMATION

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Government-funded schemes across the country are taking place to demonstrate how the NHS can power its hospitals more efficiently, save on energy bills, and reduce its carbon emissions The NHS spends approximately £600 million a year on energy. Hospitals run a 24 hours‑a-day, 365 days-a-year service and it takes a huge amount of energy to power lifesaving equipment such as intensive care beds and operating theatres. Recently, Health Minister Dr Dan Poulter announced nearly 70 schemes across the country will receive a slice of a £50 million fund to cut the NHS energy bill, which is expected to reduce the NHS energy bill by up to £13.7 million per year. As well as helping to cut carbon emissions and save the environment, all the money saved in energy bills will be redirected to front line patient care. The expected saving of £13.7 million a year is enough to pay for 18,500 cataract operations or 2,300 hip

replacements. As well as financial savings these schemes will save almost 200 million kilowatts in energy consumption and reduce CO2 emissions up to 5.6 million tonnes a year. GREENER TRAVEL One of the winning schemes is Cornwall Partnership Foundation Trust, which has been given £525,000 to reduce the environmental impact of its travel. The funding will be spent on electric cars, new conferencing equipment and a more efficient appointments system, and is expected to reduce staff travel by 750,000 miles a year. This will save up to £326,069 a year. Based over 1,376 square miles, Cornwall Partnership NHS Trust covers a large geographical area and is aiming to make efficiencies in staff travel. They have introduced a new scheduling system, which will enable staff to plan their workloads in the most efficient way, so patients continue to be seen by

Health Mnister lter Pou Dr Dan nnounced a recentlyschemes will that 70 e a slice of reciv und to cut f a £50m HS energy the N ill b



the right professionals and reducing the time clinical staff spend travelling. In addition they have invested in electric vehicles, reducing CO2 emissions and money spent on fuel. Finally, they have upgraded their video conferencing equipment to reduce staff travel, improving staff efficiency and reduce energy waste. STEAM PIPE UPGRADE Addenbrookes Hospital in Cambridge has been given £58,618 to reduce wasted heat energy and help them to better control temperatures. The hospital will be removing and replacing the insulation for boilers and pipes, which will reduce the heat energy lost through insufficient insulation and enable them to better control temperatures, which are prone to overheating. The scheme is predicted to save £61,163 a year in energy bills, which will be reinvested in to patient care. It is expected this will save over 1,500 tonnes of CO2 a year. Meanwhile, St Helens and Knowsley Teaching Hospitals in Liverpool have been given £22,094 to install a new system to automatically shut down idle and inactive computers that have been left unused for over 15 minutes. The system also included the option to customise computer shut down – such as setting all admin computers to shut down out of working hours. This is expected to save up to £57,000 a year. EFFICIENT ENERGY Northampton General Hospital received £2.76 million for its energy supply strategy which includes a biomass boiler E

St Helens teaching hospital in Liverpool has been given funds to install an automatic shutdown computer system, saving energy





CARBON REDUCTION  and new CHP (combined heat and power) plant. This is expected to reduce the trust’s carbon emissions from buildings by over 3,000 tonnes a year from their current level of just over 14,000 tonnes. The scheme, which will be installed by March 2014, will also deliver significant financial savings in the region of £500k per annum, replace key energy related plant and improve the resilience of its energy infrastructure. Head of estates Stuart Finn said: “The £50 million fund presented a perfect opportunity to help us deliver the step change required to meet the target of a 25 per cent reduction in carbon emissions by 2015. We’re delighted that our bid was successful.”

equivalent to the environmental

benefit of removing 991 As cars from the road. As well as the well as ergy n e environment benefits, n o saving and bills, annual energy costs e t at the Trust are also s l l a i w und w l f expected to be reduced m 0 5 the £ pport loca by more than 400,000 pounds within five years. help su es, boosting Elaine Andrews, s busines cal and UK Head of Environmental Sustainability at UHNS, the lo nomy said: “Installing a Combined eco

HEAT AND POWER ENGINE University Hospital North Staffordshire has received almost £1.5 million pounds for a combined Heat and Power Engine (CHP) to be installed on the hospital’s City General site. Once the engine is fully operational, carbon emissions are expected to reduce by 2,792 tonnes per year - almost eight per cent of the Trust’s current carbon output and



Heat and Power Engine will further reduce our impact on the environment and significantly reduce carbon emissions. There is also a cost implication – in recent years, the cost of energy has been rising between 10 and 20 per cent each year and this trend is likely to continue. “This project will deliver recurring revenue savings in energy costs. As well as helping to cut carbon emissions and save the environment, all the money saved in energy bills will be redirected to front line patient care.” Charlie Cox, energy manager at University Hospital, added: “Being able to generate our own power locally on site means that there will be a lot less energy wasted through transmission and distribution.”

REDUCING RUNNING COSTS Health Minister Dr Dan Poulter said: “This summer I launched the procurement roadmap showing how our NHS could be run more efficiently and how we could reduce the running costs of NHS buildings and estates. These energy efficiency schemes will help our NHS to make £13.7 million of savings each and every year.” Poulter continued: “Winter is fast approaching and we are all looking at ways to reduce our energy bills while keeping our homes warm and well-lit. Our NHS is one of the largest users of energy in the country. And just like the rest of us, hospitals should be doing everything they can to reduce the amount they spend.” “These schemes demonstrate the easy ways our NHS can make improvements to help power hospitals more efficiently, save on energy bills, and reduce their carbon emissions. Money saved will be reinvested directly in to patient care,” Poulter added. As well as saving on energy waste and energy bills, the £50 million will help support local businesses. Hospital Trusts have used local tradespeople – like plumbers and electricians – to do work like replacing old and insufficient heating and lighting systems. This means the money has helped boost local business, as well as the UK economy. L FURTHER INFORMATION

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The Soladapt Touchscreen Overlay is simple and easy to use. The Overlay’s frame needs to be strapped on to the front of any desktop monitor or TV and plugged into a personal computer through a USB connection. The unit is plug and play, so there is no software drivers required. The Overlay comes in a range of sizes, from 17” to 159”, offering two to 40-point multi-touch function. The Touchscreen Overlay allows the user to experience the full functionality of Windows 7, Windows 8, Windows 8.1, Android, Vista and XP on their existing monitors, all from an affordable £99.99. Simply put, Soladapt’s Touchscreen Overlay is a pane of toughened glass you put over the front of your display and plug in via USB, giving you touchscreen capabilities. Using infrared touchscreen technology, small LEDs are built into the frame, which can register multiple touch points. With such a simple design it’s not surprising that it is also extremely strong and will even offer protection to your existing display. COST-EFFECTIVE ALTERNATIVE Richard Plaskow, co-founder Soladapt, says: “With endless applications in the home, office, private and public sectors we are aiming to establish the Touchscreen Overlays as a cost-effective and environmentally friendly alternative to all those who have a non-touchscreen monitor already. “We are delighted to introduce the Touchscreen Overlay to the UK consumers and trade at the Ideal Home Exhibition and Bett Fair. As a business, we are striving to bring unique, high-quality and cost-effective products to our customers and the Touchscreen Overlay hopefully demonstrates our efforts. With endless

applications in the home, office, private and public sectors we are aiming to establish the Touchscreen Overlays as an alternative to those who have a non-touchscreen monitor already.“ Soladapt’s Touchscreen Overlay presents the unique and cost-effective opportunity to experience the full functionality of touch-based systems like Windows 8. Simply put, it’s a pane of toughened glass you place over the front of your display and plug in via USB, giving you touchscreen capabilities.

well as Android products. The overlay fits on top of existing monitors and can be fixed permanently by being strapped on by Velcro. “This solution connects to the computer via USB and is a cost-effective way of providing a touch experience in the office, and also means that if you have or intend to upgrade to Windows 8 – which is all about the ‘touch experience’ – it no longer means that you have to buy new hardware, also. Starting from £100, this really does prevent waste from the disposal of unwanted monitors.” UK EXCLUSIVE Soladapt is pleased to be launching a global exclusive product that will allow the conversion of a Windows 8/8.1 laptop to a touchscreen. This unique and exciting overlay comes in a range of colours and sizes to suit all customers. Launched at the Ideal Home Show this November and at Bett Fair in Jan 2014, visitors can see this innovative piece of hardware in action. Offering 10 touch points via its

Using infrared touchscreen technology, small LEDs are built into the frame, which can register multiple touch points. With such a simple design, it’s not surprising that it’s also extremely strong and will offer protection to your existing display An independent review by Connected World, April 2013: “If you are looking at the new OS from Microsoft Windows 8/8.1, we all know that it is really designed for touch interaction. But what if you don’t have a touchscreen monitor for your PC? What should you do? Go out and buy a new touchscreen for Windows 8? I have the answer for you from the good people at Soladapt, which has designed an overlay for your monitor to turn it into a touchscreen monitor, that works on 17” to 159”. An independent review by Computer Weekly, April 2013: “Soladapt is a company that produces a touchscreen overlay for computer monitors. The start-up company uses a framed screen to provide touch functionality to Windows XP, Vista, 7 or 8 computers, as

capacitive overlay, the product sits in front of your laptop screen with the use of the two gripper stands provided. Simply position to your requirement, plug in to the USB 2.0 or 3.0 ports and your Windows 8 programme will come to life. But not just for the Windows OS, use your overlay to power Office and design software, games and web browsing. This is a unique opportunity to upgrade your laptop for under £100 and have a touchscreen overlay for life. L FURTHER INFORMATION Soladapt is exhibiting at Bett Fair, ExCeL London, 22-25 January 2014 Tel: 020 7748 5203




MAKE THE VISIBLE The Evidence Based Program to Improve Cleaning Performance Delivers a significant improvement in cleaning standards

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You do not need the British Institute of Cleaning Science to tell you that high standards of cleaning are vital in the fight against infection, particularly within the healthcare environment. But despite eminent awareness, we regularly see a multitude of negative news articles appearing in the media, scrutinising the NHS for its cleaning and hygiene standards. They tell stories of unfortunate individuals that have contracted deadly infections like MRSA, C.Diff and other related infections. These not only have had devastating effects on the individuals themselves but also on the families of those involved and the hospital in question. These stories have also led to heightened public concern of NHS standards and therefore an increased pressure on the NHS to focus on improvements. Whilst these regrettable incidents are still occurring, we have to ask ourselves, is there more that can be done? With lack of NHS funding consistently proving to be a problem, it is

important to recognise cost effective methods that are available. If successful procedures are identified and enforced across the NHS, this will in turn ensure that lives can be saved from these relentless, destructive and devastating infections. STANDARDISATION AND PROCEDURE It would however be extremely unfair not to mention that there has been a significant increase in recognising preventable illness and improving standards within the NHS in recent years. Particularly with the introduction of standardised procedures being put in place throughout UK hospitals. For example in 2007 a National Specification for Cleanliness in the NHS was developed. This introduced, not only a set of cleaning standards but also illustrated how to access performance against these standards. Among the standards championed by this document was a national colour coding system that is now used across the NHS facility to help prevent cross infection

Colour coding ducts s pro identifieshould be which ny situation a used in and is useful or area e language wher riers bar exist

BETTER RELATIONSHIPS WITH CLEANING STAFF NEEDED The British Institute of Cleaning Science actively campaigns for protecting and recognising the needs of the cleaning operative. If NHS cleaning operatives needs are understood, then improved working relationships and overall ‘bigger picture’ objectives are much easier to achieve. Communication is key to any relationship. Bearing in mind that most cleaning operatives do not receive the usual communication channels that other staff receive (e.g. Internal email etc.), this can mean that they are not briefed on the overall objectives and activities of the hospital whilst the rest of the team are kept informed. Excluding operatives E

Written by the British Institute of Cleaning Science (BICSc)

Cleaning operatives within the NHS play a crucial role in improving standards of infection prevention and control, writes the British Institute of Cleaning Science (BICSc)

and contamination with cleaning materials. Colour coding identifies to the cleaning operative the particular product (mop, bucket, cloth, etc.) that should be used in any given situation/area. This simple system is easily understood by staff and helps to prevent cross contamination from one cleaning area or surface to another. The designated colours are particularly useful when language or literacy barriers exist (which can often happen within a diverse workforce). As the institute for cleaning science BICSc, actively promote the importance of clear colour coding within educational materials and via its accredited training. Other examples of improvements include campaigns promoting hand hygiene and enforcing stricter hand washing policies within hospitals. There are now signs across entrances, wards and other clinical areas to remind everyone (cleaning operatives, staff, visitors and patients) to clean their hands thoroughly and use alcohol gel solutions from the dispensers provided.





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Protecting your business Employment Law and Health & Safety Solutions

Effectively dealing with employment law and related issues is vital to any health care organisation. At Archon Solicitors, we specialise in providing organisations with a swift and robust employment law service. Our “outstanding”* and “highly competent”* team has extensive experience in the health sector. As specialists, we are happy to be engaged on one-off projects. Call Jill Scott or Rob McCreath on 0207 397 9650 for a free initial assessment of any employment law or related issue your organisation may be facing. *Legal 500 Tel: (+44) (0)20 7397 9650 Fax: (+44) (0)20 7929 6316






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The g Cleanin nal io Professe covers uit Skills S competence, first steps in improving l standards, the next chemicaipment safe step is ensuring that u e q r e d ca n a hospital cleaning y l b assem torage of operatives are educated well enough to actually and s rials understand and practice mate these standards. It’s all well

 from this process can create barriers and leave the operative feeling that they are not seen as part of the overall team. By spending time regularly bringing cleaning operatives into the bigger picture, this will ensure that they feel valued, respected, part of the team, more confident in their work and able to voice their concerns. If they do not feel part of the bigger picture, they will be unlikely to want to provide this information. Voicing concerns about things that make their job difficult, is vital in developing infection control techniques and addressing hygiene issues and barriers around the hospital. This process will also ensure that the operative feels more in control of their work and are able to do their job to the best of their ability. The Royal College of Nursing (RCN) recently produced a report (November 2013) advising best practice for nursing and cleaning professionals to develop better working relationships within the NHS. The article recognises that cleaning and nursing staff are the two main groups of healthcare workers responsible for maintaining a safe and hygienic patient environment and provides recommendations for overcoming cultural and organisational barriers within these roles to improve patient experience. The article defining the relationship between cleaning and nursing staff is available to view on the RCN website. EDUCATION AND ACCREDITED TRAINING FOR CLEANING OPERATIVES Whilst putting standardised procedures in place, improved staff relationships are the

and good standardised procedures being created, but if they are not understood by the person using them, they become meaningless. Unfortunately, this is where things can go very wrong. Another clear solution to reducing this risk is Education and Accredited Training for Cleaning Operatives which ensures the safety of themselves; the safety of the hospital building; and the safety of the other staff, visitors and patients around them. ACCREDITATION It is only through official (and trustworthy) accredited training providers and assessment criteria that the NHS can ensure that staff have not only undertaken training courses, but have thoroughly understood what they have learned and are competent in their abilities. Overall, staff accreditation benefits everyone. The results have shown that accreditation of cleaning operatives reduces health risks within the hospital, improves staff productivity, creates a happier more valued work force, improves the hospitals reputation, and gives staff the tools to meet assessed audit requirements. BICSc accredited operatives abilities can easily be identified by their ‘Licence to practice card’ and certificates proving their qualifications.



ACCREDITED TRAINING ORGANISATIONS Whilst hiring an already accredited cleaning operative is ideal, an increasingly popular choice among hospitals (with a number of cleaning operatives on site) is to become a BICSc Accredited Training Organisation (ATO). NHS ATOs are hospitals that have members of their own staff on-site that have the ability to deliver BICSc training. After being trained by BICSc these individuals then become ‘licenced assessors’ with the ability to certificate other staff within the hospital. This means that staff from the hospital can receive official qualifications without having to attend external training courses each time a new member of staff arrives or they wish to develop their skills further. This ensures that all staff are trained to a high standard within the hospitals establishment. Other benefits of becoming an ATO includes raising standards via education of staff, supporting succession planning; training can take place on locations suitable to business contracts / needs; it fulfils tender requirements for accredited training standards; and provides evidence that your establishment has cleaning operatives that are trained to an Accredited Industry standard throughout the hospital. HAVING THE RIGHT SKILLS Launched in March 2011, the Cleaning Professionals Skills Suite (CPSS) is becoming the most widely used cleaning qualification in the UK and internationally and is a very popular choice for cleaning operatives working in hospital environments. Training can either be delivered at a BICSc Associate training site or delivered within ATOs by the hospitals own trained licenced assessors. The suite consists of three mandatory units, which cover chemical competence, equipment safe assembly and care and storage of equipment and materials. After successful completion of these three mandatory units, there are further 60+ skills modules that can be chosen depending on the requirements of the establishment. For those with little time to gain certificated BICSc Cleaning Qualifications, the institute provides an online jointly badged certificated ‘Infection Control’ E-Learning course with the University of Northampton. If you would like to be sent an information pack please contact with the subject title INFECTION CONTROL INFO PACK. In summary the Institute recommends the following overall formula for improvements to handling infection control in the NHS. Education +Accredited Training + NHS Cleaning Operatives = Infection Prevention and Control. L FURTHER INFORMATION Tel: 01604 678712




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In the fight to prevent infection from spreading, antimicrobial technology incorporated into surfaces is really proving its worth. BioCote’s Dr Andrew Summerfield explains how

THE BIGGER PICTURE Whilst bacterial resistance to antibiotics is somewhat newsworthy and certainly of concern there is considerably more to the world of antimicrobials than this issue. The term antimicrobial also refers to (non-antibiotic) chemicals or other means by which bacteria can be controlled. For members of the public the most commonly encountered antimicrobials are disinfectants, more specifically referred to as biocides or non-agricultural pesticides. Biocides can be conveniently divided into specific categories. In Europe the Biocidal Product Regulation (BPR) is the legal instrument controlling the trade of biocides and categorises biocides into twenty two types. These types are further divided into four groups: disinfectants (on humans, animals or surfaces), preservatives (for wood, plastic etc.), pest control (e.g. rodents) and ‘other’ biocidal products. Disinfectants are usually thought of as being sprayed or wiped onto a surface to remove microbial contamination (in conjunction with cleaning, which removes detritus). However, a surface can be rendered permanently or semi‑permanently antimicrobial by intentionally incorporating a biocide into it. A wide range of biocides, including organics and inorganics, can be used for this type of application. Every biocide has pluses and minuses as a candidate active substance. Nowadays, for

example, environmental issues have gained a prominence when biocides are considered for application. Triclosan has been subject to criticism from environmental and government groups internationally for its potential ecological fate and environmental impact. In addition, there is evidence that triclosan can induce bacterial resistance and is connected to hormone disruption in mammals. However, the Food and Drug Administration in the US are currently maintaining the position that triclosan is safe for human use. Inorganics such as silver and zinc avoid much of the bad press associated with actives like triclosan due to their low toxicity to mammals (humans) and the environment. Also these elements are not considered capable of inducing significant bacterial resistance. Perhaps the most common surface-integrated biocide is the inorganic element silver. Silver has been used for thousands of years for its potent antimicrobial properties. In the 20th century, silver has been used clinically in burn creams as silver sulfadiazine and to treat the bacterium Neisseria gonorrhoeae by dropping silver nitrate into babies’ eyes that have become infected during birth. Since the discovery and widespread use of antibiotics, however, the clinical use of silver has understandably declined. The chemical stability of silver favours its use in materials including plastics, paints, lacquers and coatings to give manufactured products a sustained antimicrobial effect. REGULATION These finished products or ‘treated articles’ (treated with a biocide) are for the first time in Europe facing formal regulation. Up to September 2013 only the biocides themselves were regulated. Now we see legislation being extended to cover product labelling, proof of efficacy and to prevent the use of unregistered biocides being used in the European Union. In practise biocidal regulations are proving complex and the European situation continues to evolve. In the US the regulatory situation is more established because registration requirements and claims language restrictions have been operation for some time. Globally claims for treated articles should be substantiated or at least provable. This can be considered a trading standards issue but may

Written by Dr Andrew Summerfield, BioCote

Microbiology is one of the oldest scientific disciplines. We know micro-organisms are crucial for life on earth because they medicate mineral cycling but they also produce a wide range of undesirable effects such as human disease and material degradation. Opposing these effects has naturally occupied microbiologists who inevitably have had to resort to man-made and naturally-occurring substances that display antimicrobial properties. Antimicrobials are discussed frequently in the modern world, primarily with regard to the continuing emergence of bacterial resistance to antibiotics. Since their discovery in the early 20th century, antibiotics have been utilised in widespread applications with real success. After decades of reliable use, we are now aware of the fact that various medicallyimportant bacteria have acquired resistance to commonly prescribed antibiotics. The concern of antibiotic resistance is starting to be realised as the possibility of no effective treatment for even relatively minor infections.

also fall within the scope of biocidal law. Antimicrobial surface efficacy is routinely determined under laboratory conditions to international standards such as ISO22196:2011 ‘Measurement of antibacterial activity on plastics and other non-porous surfaces’. This straightforward method assesses the numbers of bacteria (Escherichia coli and Staphylococcus aureus) before and after exposure to the biocide treated surface, ideally in comparison to an identical but untreated surface. The results will therefore give an indication as to a surface’s potential to eliminate bacteria contaminating its surface. Antimicrobial technology developer BioCote is aware of the challenges manufacturers of treated products face as they supply into the healthcare market. A main challenge is the potential for antimicrobials deployed in the healthcare to promote poor hygiene standards. An educational approach is the best response to this particular issue. An antimicrobial surface can be thought of as providing a continual antimicrobial effect that works best in combination with routine cleaning. The benefits of antimicrobial technology combine well with hygiene awareness, good hand washing and so on.

Infection Control


ANTIMICROBIAL TECHNOLOGY (AM) An issue occasionally raised by healthcare professionals is that antimicrobial technology needs to be used alongside existing hygiene practises to have the greatest impact. It is true that antimicrobial technology should work in conjunction with cleaning, but it is equally valid to consider the technology provides a level of ‘continuous’ protection above and beyond standard cleaning. A disinfected surface is only clean until re-contaminated, thus the benefit of cleaning only temporary. AM technology works continuously but needs complimenting by regular cleaning to keep the surface clear of debris which antimicrobial technology cannot remove. In general, antimicrobial surface technology should be considered part of, not the complete, solution. BioCote has commissioned a variety of environmental studies to measure the antimicrobial efficacy of its technology deployed in working environments, which will be explored in the next issue of Health Business. L FURTHER INFORMATION




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Written by Mark Hughes, IOSH vice chair Healthcare Group Committee

What is the Core Skills Training Framework for the health sector and how can it improve standards in health and safety? Mark Hughes, vice chair of IOSH’s Healthcare Group Committee reports

Since its introduction in 1948, the National Health Service (NHS) has grown to become the world’s largest publicly funded health service. Responsibility for healthcare in Northern Ireland, Scotland and Wales is devolved to the Northern Ireland Assembly, the Scottish Government and the Welsh Assembly Government respectively. The NHS in England is the biggest part of the system by far, catering to a population of 53 million and employing more than 1.35 million people. There are different strands to the NHS. As a result of the Health and Social Care Act 2012, all Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) were abolished on 31 March 2013 and replaced by Clinical Commissioning Groups (CCG). Even more recently, NHS Property Services was set up. This is a company formed by the Department of Health (DH) to take over the ownership of around 3,600 NHS facilities. When it comes to training in the NHS in England, things can get even more intricate. There has been for a significant period of time no standard approach on what is classed as mandatory and what is graded as statutory training; some of which depends on the commitment and the Trusts’ approach to risk. There has been work to identify core training requirements and to formalise the Statutory and Mandatory (S&M) approach to it. This was originally started in the London region, and is now expanding across England, in the form of the national UK Core Skills and Training Framework. The overarching principle is to standardise the training approach across the NHS and develop a ‘passport’ scheme to streamline training and avoid any duplication.

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CORE SKILLS TRAINING The UK Core Skills and Training Framework sets out a structure for each identified area which offers: Identified core subjects; Proposed learning outcomes; Suggested standards for delivery; Proposed refresher training periods. The aim is to encourage a quality driven and consistent approach. The guidelines set out the minimum standards expected. Many healthcare organisations will already meet, if not exceed these, but the guidelines offered will be helpful in establishing a healthcare-wide minimum standard. This will enable the mechanisms and quality assurance processes to be put in place, which will then support efficiency and also enable potential recognition of training. The core subjects are: Equality, diversity and human rights; Health and safety; Conflict resolution; Fire safety; Infection prevention and control; Moving and handling; Safeguarding adults; Safeguarding children; Resuscitation; and Information governance. The passport initiative is something that has been discussed in different forums for over 10 years now. The idea is that training is the same no matter which Trust you go to. Only familiarisation with Trust E





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The passport initiative is something that has been discussed in different forums for over 10 years now. The idea is that training is the same no matter which Trust you go to. Only familiarisation with Trust equipment would be required, potentially saving time and money  equipment would therefore be required, potentially saving time and money. The core skills take into consideration the requirements of the NHS Litigation Authority (NHSLA), which manages negligence and other claims against the NHS in England. The body aims to share learning about risks and standards in the NHS and improve safety for patients and staff. INTRODUCING STANDARDS The NHSLA has tried, and succeeded to some extent, to introduce standards targeted around safety at different levels. With each level achieved comes savings for the Trust. Part of these standards are based specifically around training and ensuring a suitable needs analysis is carried out, covering each staff group. This would include, for example: Admin and support staff; Doctors; Healthcare assistants; Qualified nursing and midwifery; Consultants and career grade doctors; Clinical support staff; Qualified allied health professionals. For each of these staff groups the Trust would need to identify: requirements for each group; length of training; frequency; updates; who provides training; and method of delivery. So there are many demands for Trusts to meet. The disadvantage with no standard approach is that each one has its own view on what statutory and mandatory training is. The main benefit of introducing the UK Core Skills and Training Framework is that there would be

a structure to work from. Of course, it is vital to adapt training material to different staff groups – for example, clinical and non clinical, consultants, and estates staff. Aside from the generic content to be covered each group will have different requirements, so keeping the material relevant is a must. MAKING IT MEMORABLE Sometimes the mere mention of health and safety is seen by many as not the most dynamic of subjects, so fixed ideas of the session content can be a hurdle for the trainer. Delivering a memorable training session is about knowing the subject, and being able to relate it to practical examples and true-life scenarios. It is about making it interesting and relevant. Naturally, delivery of content will vary. For example, an executive and a board of directors need to know what their roles and responsibilities are, but it is also an opportunity to win their attention by making them aware of the importance of health and safety within their organisation. It is also a chance to remind them of all the good work that has gone on. For the majority of the health and safety training required, the question has to be how much law and how much actual awareness of the hazards and risks are delivered. Effectiveness can be measured by means of a staff survey; from evaluations and feedback of the training and through

incident data and audits of wards and departments. This enables measurement of the content and also the approach. Needless to say, we must not forget there are other necessary forms of health and safety training requirements within an acute setting. These can include display screen equipment; control of substances hazardous to health; risk assessment training; the management of stress; conflict resolution; inoculation injuries – the list goes on. Despite all of this, two key factors remain: the ability and time of the trainer, and the availability of staff to attend. Getting the two to match up is always going to be the challenge. And with demands on the NHS growing, the dichotomy of nurses delivering patient care or being away from the wards receiving training is an ongoing debate. L FURTHER INFORMATION

About IOSH The Institution of Occupational Safety and Health (IOSH) is the chartered body for health and safety professionals. With more than 42,000 members in 100 countries, it is the world’s biggest professional health and safety organisation. It sets standards, and supports, develops and connects its members with resources, guidance, events and training. It is the voice of the profession, and campaign on issues that affect millions of working people. IOSH was founded in 1945 and is a registered charity with international NGO status.



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costs for the early termination of contracts. While this argument is most pertinent to low‑carbon models, it is relevant to EV adoption. Organisations who are serious about a switch to plug-in vehicles should move to whole-life cost calculations as opposed to lease-cost based choice lists, as a more effective means of identifying whether vehicles should be changed and think in three, four or even five year ‘blocks’ rather than focusing on first-year savings. The AFMR 2012 also asked fleet managers what their primary concerns were when considering alternative sources of fuel. The lack of a suitable product was the chief reason (56 per cent), closely followed by a lack of refuelling/recharging options (54 per cent) and anxiety over the range of alternative fuel vehicles (41 per cent). Managers in charge of NHS Trusts, emergency services and medical charities all face the same dilemma when running vehicle fleets; how to reduce costs while supporting their organisation’s ‘green’ values. In fairness, Alphabet’s annual fleet survey, the Alphabet Fleet Management Report (AFMR), highlights that public sector organisations are far more likely to adopt an environmental approach to running their vehicles, compared to their private sector counterparts. Alphabet’s latest AFMR poll confirmed that while 79 per cent of businesses in the private sector had set themselves green targets where vehicles were concerned, this figure rose to 83 per cent for public sector organisations. However, despite the good intentions of many NHS managers to embrace the low-carbon agenda, the issue of cost still gets in the way.

why adoption of low-carbon vehicles has been relatively slow. But this situation may well be about to change. EV ADOPTION GOING UP At present, UK adoption of EVs has been modest, with only 138 units sold in 2010 and 1,082 sold in 2011. Sales rose sharply in 2012 with 2,254 cars registered by the DVLA, while year-on-year sales at August 2013 have shown an increase of more than 70 per cent. With an expanding range of plug-in vehicles on the market, a growth in the number of public charging points (now up to 5,000 in the UK) and further government investment of £37m for infrastructure, Alphabet is confident of strong growth in EV adoption for the next few years. While most managers agree that green fleet policies will deliver cost savings, mainly in fuel

AlphaElectric is designed to help organisations assess the suitability of electric vehicles for their fleets, support the introduction of EVs into a fleet and provide a full in-life support service While the heart wants to run a fleet of purely ‘plug-in’ cars and vans, the head worries about the cost and cost-effectiveness of electric vehicles (EVs). The perceived cost of ‘going green’ is still a major barrier to the more widespread adoption of EVs, with over half of all fleet managers citing budgets as the main reason

and tax for trusts, the road to EV nirvana is not as straightforward as it could be. Around half of fleets see the cost of changing vehicles as the main barrier to attaining these goals. The suggestion is that many would like to bring forward the replacement of existing vehicles with lower CO2 models, but have not done so because of the additional upfront

Written by Clive Buhagiar, head of public sector, Alphabet

Clive Buhagiar, head of public sector at mobility provider Alphabet, believes the health sector can lead the way in the adoption of electric vehicles – and cut costs, too

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s Diabete, meters rs, ke pacemad breast, an inhalersknee implants hip andedical devices are m e controlled that ar der EU un ions regulat

ALL EYES ON REGULATION While the PIP company directors, including PIP founder Jean-Claude Mas, were charged with aggravated fraud and face up to five years jail if convicted, the episode has shone a bright spotlight on the regulation of medical devices. Breast, hip and knee implants, pacemakers, inhalers, diabetes meters and hospital equipment are all examples of medical devices that are regulated under the European medical device regulations. While many people are aware of how medicines are regulated through clinical trials public knowledge of how medical devices are regulated was little until the PIP episode. Very few people understand that if a medical device such as a new hip implant is made by an Italian manufacturer and approved for use by a Norwegian-based Notified Body – an independent company that assesses the safety of a new medical device – then it can be implanted into patients in the UK or any other European country. The lack of public knowledge about the European system of regulation for medical devices was demonstrated when the MHRA was blamed by the media and people affected by the PIP episode ‘for E


Written by John Wilkinson OBE, medical devices director, Medicines and Healthcare products Regulatory Agency (MHRA)

John Wilkinson, from the Medicines and Healthcare products Regulatory Agency (MHRA), discusses how better reporting of problems with medical devices from NHS staff can play a vital role in patient care

Just before Christmas, on the 23rd December 2011, around 40,000 women with breast implants in the UK anxiously watched their television screens as the national news channels broadcast the news that the French government had recommended that 30,000 women in France should have their breast implants removed on a precautionary basis. The implants, made by French company Poly Implant Prothese (PIP), had been banned in March 2010 after they were found to contain a non-medical grade silicone filler that was different to the filler that had been approved under the European system of regulation. Testing of the unauthorised filler by scientists in the UK was quickly commissioned by the MHRA and the UK results, published in September 2010, showed there was no evidence of a cancer risk. This finding was later supported by Australian and French laboratories. Further testing on additional samples of PIP breast implants by scientists in the UK, Europe and Australia has shown that there is no evidence of a long-term risk to human health. This has supported the UK Government’s position that it is not necessary to remove PIP breast implants from women in the UK on a precautionary basis. Instead, women are entitled to a free NHS scan and consultation to discuss any concerns they may have about their implants.

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influence on MHRA’s ability to assess whether a medical device is performing as it should be and whether it should continue to be used. For example, if we aren’t aware that a specific model of defibrillator is unreliable then we can’t alert other users of potential problems and this could have serious consequences for patients. At the same time, even if we receive an adverse incident report about a faulty medical device, we need a good quality report. We need to know the model of the defibrillator, when the problem occurred and in what circumstances. We know that healthcare professionals are extremely busy but adverse incident reporting isn’t time consuming. It can be done quickly and easily on-line via the link on the front page of the MHRA website: The MHRA is also working closely with NHS England to improve levels of reporting of problems with medical devices in NHS trusts through enhanced Medical Device Liaison Officer roles. We will publish more information about how this will work in near future and hopefully this will help to raise awareness about the importance of reporting to the MHRA.

 letting PIP breast implants into the UK’. In reality, all the MHRA could do, like every other national regulator in Europe, was to monitor the safety of PIP breast implants once they were being used and then take action to remove them from the market if the evidence showed they were not safe. The MHRA immediately recommended that the PIP breast implants should no longer be used and the German Notified Body responsible supported this by withdrawing their CE marking so they were no longer used in Europe. GETTING THE RIGHT BALANCE The MHRA believes the current European system of regulation must be strengthened to protect patients from unsafe medical devices but a balance must be found in promoting innovative new medical devices. For example, if medical devices underwent clinical trials like medicines before being used, a new hip implant might need to undergo a clinical trial lasting at least 10 years to demonstrate its long term durability. Such an approach would deprive patients of access to treatment involving new medical devices which could have a significant impact upon their health and wellbeing. Last year the MHRA held a public consultation about strengthening the European regulatory system and 116 responses were received in response. These were broadly supportive of our position that there must be tighter controls on notified

bodies, better post-market surveillance of medical devices and better collaboration between regulators in different countries We have fed these views into the negotiations that are currently taking place in Europe and we are optimistic that an improved European system of regulation for medical devices will emerge. A system based on what’s best for patients. Improvements in Europe will take time but I believe the regulatory system in the UK can be strengthened more quickly and NHS staff can play a major part in this.

Medical Devices


NEW TECHNOLOGY New technology is also being developed by the MHRA to help our surveillance of medical devices. We are working with a number of NHS trusts in piloting a new tracking system for high risk medical devices that will improve the monitoring of medical devices such as breast and hip implants, heart valves and pacemakers. The new tracking system will ultimately incorporate unique device identifiers into hospital patient electronic records and national Hospital Episode Statistics databases. Analysis by the Clinical Practice Research Datalink (CPRD) – a secure e-health research service – will enable the MHRA to better assess the performance of high-risk medical devices and to trace patients in the event of a device recall or safety alert, without

The quality and numbers of reports about problems with medical devices from healthcare professionals have a major influence on MHRA’s ability to assess whether a medical device is performing and whether it should be in use REPORTING PROBLEMS The MHRA needs nurses, doctors, pharmacists and other healthcare professionals to report any problems they encounter with any medical device; whether it is a hospital trolley, a dialysis machine or even an inhaler, the MHRA needs to know about it. The quality and numbers of reports about problems with medical devices from healthcare professionals have a major

the need for multiple device registries. This project is one of 11 projects that the MHRA has established to strengthen the regulation of medical devices. Many of these projects are still in early development but we need the help of surgeons, nurses, doctors, social workers, pharmacists and other healthcare professionals now so the MHRA can ensure that patients are protected from unsafe medical devices. L



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OPTICCLEAR SCREEN PROTECTORS • Crystal clear shields for all iPad screens • Anti-scratch; comes with cleaning cloth


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The modular charge/sync/ security solution. • Charge multiple iPad devices • LEDs indicate charge status for each iPad • Sync your apps, media and more other content through iTunes



Written by Andrew Hartshorn, chair of the Health & Social Care Council, techUK

DIGITISING HEALTH AND CARE: NOW AND NEXT In January 2013, the Health Secretary Jeremy Hunt set out an ambition for the NHS to be ‘paperless’ by 2018. Andrew Hartshorn, Chair of the Health & Social Care Council at techUK – formally Intellect – examines what this means, what has already been achieved, and what hurdles remain in the way In January 2013, the Health Secretary Jeremy Hunt set out an ambition for the NHS to be “paperless” by 2018. In March 2013, Intellect (now known as techUK), the Trade Association for all suppliers of technology and information services across the UK, responded with our paper ‘Digitising the NHS’. Currently, we are refreshing our paper for release early next year, on what progress industry believe has been made and what is yet to do. This editorial reflects some of our early thinking on this issue. MEASURING SUCCESS One of the difficulties in measuring progress towards such a bold ambition is in understanding what lies beneath the ‘paperless’ banner. The NHS will never be truly paperless, nor should it be; there are very good reasons and necessary circumstances where paper is the optimal medium. The ambition cannot be taken literally; we

interpret the ethos behind it to be: “The continuous pursuit of optimal approaches to the ways in which we acquire, store, share and use information across the health and care sector for all citizens, whether they be staff, patients, clients, carers or any other role they may have.” Optimal is about “the best result possible with available conditions.” We think about this as “affordable quality”; the best thing we can do with what we have got and we know, and expect, the ‘bar’ will raise over time as we mature into the Digital Age. A pragmatic measure of overall progress is to determine how optimally any given information in health and care

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is being dealt with. Whether ‘baby steps’ or ‘giant leaps’, it is all progress and should be valued and recognised. All progress must add tangible value, to efficiency, effectiveness, experience, and preferably all of them. This value has to be tangible to the citizen, staff and NHS organisations, with demonstrable benefits to all of them. THE BOUNDARIES OF HEALTH AND CARE This ambition cannot be ‘bounded’ by the NHS; health and care is a diverse and complex environment where public, private and third sector organisations regularly interoperate, with citizens interacting with them all, largely unknowing and uncaring about the various organisational boundaries that exist over time. The ‘paperless’ challenge must consider social care, third sector, private sector and any other sectors where health related care is planned or delivered. These E

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 care boundaries, largely irrelevant to patients and their families, themselves create information inefficiencies. Most importantly, the Paperless NHS challenge must include the citizen, as the ultimate owner of their care, and a huge and increasing consumer of care information. We are still a very long way from this; the vast majority of work towards optimal information is not undertaken across the care boundaries; this will continue to create more duplication and wasted effort. WHERE DO WE NEED TO FOCUS NEXT? Almost a year closer to the date set and we have seen some substantial positives, such as more funding. The Government has already committed over £500m in new funding for NHS organisations to transform healthcare provision through technology and we expect more will follow if this demonstrates value. Another positive is greater ‘executive’ commitment – information solutions and supporting technology are increasingly seen as ‘core’ to the business of health and care, not peripheral. This ‘mind shift’ is vital; the business will not just be receptive to digital transformation, it will demand it. Another positive is the continuing solid infrastructure foundations – the building blocks of information solutions in health and care are well established and ongoing; networks and core information components such as the NHS Number or example, but they need to ‘bridge’ the organisational domains better. The willingness to think differently is also a great change. We are seeing emergent shifts in systems thinking, around ‘open’, platforms, standards and commoditisation for example, particularly in some of the newer strategic systems led by NHS England.

New f o funding m the fro £500mvernment arrive, increasingly you UK Go lready have be on the journey. a s ha d to e t Organisational silos t i m m o e c r n a still dominate digital c e h e t b heal gh thinking m in health and r o f s tran sion throu care, yet the real potential provi hnology of using utility technology, shared information and a tec

THE NEGATIVES Regrettably however there are still some negatives. For example, in procurement approaches. Most procurements are still being run under old approaches and old thinking, with a preference for large scale, long term ‘prime contractor’ deals. “One throat to choke” in procurement terms is no longer the optimal way for the Digital Age. Health and social care organisations are understandably highly risk aware and often quite risk averse. For information and technology solutions, innovation is directly associated with risk – some things work and others will not. Health and social care organisations need to reset their assumption about digital innovation; it is not always possible to sit back and wait for the solution to

portfolio of solutions/ services within and more importantly between organisations will have a profound effect on efficiency and value. This is now beginning in central and local government; health and care is lagging far behind. Currently, we are seeing open source as the principal interest of the NHS. This is one element of ‘open’, and is important, but all elements need to be progressed equally; standards, platforms, data and systems all need to embrace the philosophy of open digital services; too much focus in one area is not enough to make a difference. Regarding information sharing, despite a lot of effort, it still feels we collectively are not much further forward on this critical issue. Health and care services cannot perform optimally without necessary information sharing. While difficult, both legislatively and culturally, this remains one of the biggest obstacles to achieving a digital transformation in health and care. A DIFFERENT WAY OF THINKING From an industry perspective, techUK remain committed and supportive of this ambition. We absolutely believe this is achievable but will require a very different way of thinking and acting,

for users, buyers and suppliers of health and care solutions and services. Why are we so confident? Healthcare is not in the digital ‘dark ages’; there are many examples – throughout primary care, social care and other health care areas – where information and supporting technology is being exploited and healthcare revolutionised as a result over several decades and it is still happening right now. What we still do not have is consistency and spread. However, we think one of the biggest missed opportunities remains in stakeholders knowing what is possible, available and of value to them. techUK absolutely believe technology is not the constraint, nor are information solutions that are enabled by the technology. Our industry only exists through constant and rapid innovation and the UK is an acknowledged world class technology and information services industry. There will always be many ‘right’ ways to get to a ‘paperless NHS’ and that is essential – one size will not fit all. A vibrant supplier market, fuelled by knowledgeable and discerning customers, will keep the innovation engine running, the result of which will be a portfolio of solutions and services, large and small, that together will deliver this optimal approach to acquiring, storing, sharing and using health and care information in the Digital Age. We have a way to go, but it absolutely can be delivered, together between industry and its health and social care customers. Can the health and social care sector afford it? techUK believes it cannot afford not to. L FURTHER INFORMATION



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As the NHS is challenged by the health secretary to become paperless, Milton Keynes Hospital NHS Trust invested over £2m to digitise its entire patient records library and deployed CCube Solutions’ EDRM software to improve the quality and accessibility of outpatient notes for clinicians

Milton Keynes Hospital NHS Foundation Trust invested over £2 million to digitise its entire patient records library totalling 287,000 files, each containing an average of 200 images. It releases space, saves money and puts in place technology to support the hospital in the future, especially important as the NHS is challenged by the health secretary to become paperless. The heavy workload of back-scanning the records library was completed by Hugh Symons Information Management. Milton Keynes Hospital now digitises paperwork, having created its own internal scanning bureau. Kodak production scanners are used in this process given their ability to guarantee image quality and cope with high paper volumes. Since the electronic document and records management (EDRM) project went live in all outpatient clinics three years ago, it has delivered a cumulative £1 million saving against previous levels of spend, and continues to deliver recurrent cost savings, as outlined in its original business case. The Trust has reduced the number of medical records staff by over a third. In addition, it has made other administrative processes far more efficient and repurposed the use of parts of its library building. Employing around 3,000 staff, the hospital has approximately 400 inpatient beds and treats 200,000 outpatient episodes per annum, 20,000 elective patients, and 70,000 A&E visits. SETTING THE SCENE Milton Keynes Hospital was built about 25 years ago and is now short of space. It is



unable to accommodate the number of paper patient files, especially given that some records have to be kept 25 years after a person’s death. Trudi Mynard, Milton Keynes Hospital’s head of patients’ services, says: “There is no more room in the inn. It was affecting processes as there wasn’t space to store the notes.” In addition, a paper-based records system was hindering how staff work, given there is one set of the notes – so only one person at any one time can access them. While the processes for managing paper has been made efficient and lean, there would be several thousand notes out in the Trust every day rather than in the library, which required the employment of ‘runners’ to collect. If notes were not tracked carefully, records staff would have to search for them, extensively, prior to clinics starting. Milton Keynes Hospital wanted to make the notes available 24 hours a day, 365 days a year, and ensure multiple clinicians would be able to access them. Furthermore, by moving to electronic notes, the quality of the record can be improved. This is because paper records degrade, get damaged, ink fades, carbon copies become difficult to read and the contents can fall out of a file. By scanning, a crisp, clear document is created which will last in perpetuity. Mynard says, “The digital records management project will help the Trust meet its key organisational objectives to increase patient safety, improve the patient experience and enhance clinical effectiveness.”

THE SOLUTION CCube Solutions was chosen as Milton Keynes Hospital’s EDRM software supplier given its response to a thorough tender process, feedback from clinicians after they attended a demonstration, and medical records’ staff visits to other hospitals to see its system in practical use elsewhere. Working in partnership with Hugh Symons Information Management, who provided the back file bureau scanning services, the Trust has digitised 287,000 records, each containing on average 200 pages. This totals 57.4 million images. The project went live in August 2010. A scan-on-demand approach was adopted for those coming into outpatient clinics with inactive files cleared at the same time. In other words, Milton Keynes Hospital is currently scanning everything. If the hospital needed a record back urgently while the back-file scanning was in process, it would be sent back via secure FTP. The hospital never had an issue where notes were unavailable because they were being scanned. A ‘big bang’ approach was adopted and all specialities in outpatients went live at the same time. There was some dual operation with both paper and electronic notes as it took nine months for the back scanning to be completed. This approach was taken to avoid processes being disjointed – some departments using paper, others electronic – as it was felt that this might increase clinical risk. THE NEW DIGITAL RECORD REPLICATED PAPER Further to input from clinicians, CCube Solutions created an electronic version of the medical record to mirror the format of the paper notes. All clinical correspondence is stored in the EDRM system along with colour photographs, ECGs, CTGs and reports. The system is intuitive and easy to use, which has enhanced clinical acceptance of it. This helped to significantly reduce training time. The digital record features tabs similar to the paper file, along with sub sections to help navigation. For example, within individual tabs, the subsections enable clinicians to find important information, such as consent forms and operation sheets, quickly and

The EDRM system means Milton Keynes Hospital is paper-light but not completely paperless. Clinicians still complete a paper history sheet, which is scanned and the digital record updated easily – documentation they regularly need to review. The EDRM solution is accessed throughout the hospital in all clinics, wards, offices, operating theatres, on wheeled trolleys and tablets. All authorised staff has access to it once training has been given. OUTSOURCED AND IN-HOUSE SCANNING While Hugh Symons Information Management was responsible for scanning the records library, the EDRM system means that Milton Keynes Hospital is paper-light but not completely paperless. Once a clinic has finished, clinicians still complete a paper history sheet which is scanned and the digital record is updated. Milton Keynes Hospital is now managing the day-to-day scanning process itself, rather than outsourcing. Based on recommendations from its IT partners, the hospital has standardised on Kodak for its whole scanner fleet and a variety of production scanner models have been installed, including the Kodak i730, i750 and the latest i4600 scanner, which is rated at 120 pages per minute and designed to cope with volumes of up to 50,000 pages per day. The EDRM solution runs on a mirrored dual-server environment to ensure resilience and availability, and guarantee business continuity in the event of a hardware failure. Today, paperwork from outpatients, on the wards, loose data and A&E is collected everyday, prepared for scanning and then digitised. It is a two-working day process to get new paperwork into the system alongside existing patient records, ready to be viewed. LOOKING TO THE FUTURE Milton Keynes Hospital is working with CCube Solutions to develop a ‘generic importer’ that will enable patient information from various hospital systems to be integrated into the EDRM without requiring manual input. For example, the first system being looked at is pathology. Results will automatically

appear in the EDM database once published without clinicians having to swap systems. This will also eliminate the need to print and scan results. The hospital will then look at incorporating other IT systems over time. Milton Keynes Hospital continues to realise savings as a result of investing over £2 million to digitise the Trust’s entire patient records library. Since the electronic document and records management project went live in all outpatient clinics, it has delivered a cumulative £1 million saving against previous levels of spend, and continues to deliver recurrent cost savings as outlined in its original business case. The cost savings will be realised as the Trust has reduced its medical records staff by over 35 per cent. In addition, it has made other administrative processes more efficient and repurposed the use of its library building. OPERATIONAL AND CLINICAL BENEFITS As well as financial savings, the EDRM solution has delivered a variety of important operational and clinical benefits for the hospital: Notes are now accessible 24 hours a day, 365 days a year by multidisciplinary clinical teams who often provide care to one patient but are located in different buildings; Clinicians who see their patients across multiple sites have been given remote access to the system so they can access the files of their patients who attend more than one location; Secretarial support has been streamlined and made more efficient. Historically, the location of paper notes would have to be laboriously tracked in the Trust’s Patient Administration System so staff knew who had the files; Producing clinical letters for GPs and patients can now be facilitated within the EDRM system, which automatically populates demographic information into standard letter templates. These letters then go on to be saved into patients’ electronic files without the need for printing and scanning;

Image quality of the paperwork is guaranteed in contrast to paper, which degrades over time, with useful features available within the computerised system; Deployment was successful and very close to budget with the main cost overrun due to VAT increasing from 17.5 per cent to 20 per cent; Information governance has been improved as an audit trail tracks those who have viewed the electronic record. With paper, this was difficult to do; Plus, space devoted to the file storage of medical records has now been repurposed to create a Back Care Department [an internal training facility] as well as enabling the records team to be in one area rather than various places within a building. This has improved joined-up working.

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IMPROVING PATIENT CARE Dr Ijaz Mehdi, associate medical director and member of the EDRM project board, says: “EDRM has made a big difference to us because we can access and review the notes any time, enabling us to improve patient care. For example, we may have a patient arrive at A&E or the Medical Assessment Unit with chest pain. Before EDRM, the previous ECG would not be quickly available for us so we could not compare and confirm if the changes were new or old. Now we can immediately see the difference, correctly diagnose the condition thus enabling us to provide appropriate treatment that could be life-saving.” Trudi Mynard adds: “We’ve also established two new large offices in the old records library to house staff moved from another area of the hospital to allow our new emergency care unit (Ambulatory Emergency Care Unit) to open. In just one month of operation, 96.5 per cent of patients were seen within four hours – up from 77 per cent. Far exceed national targets. It is something the hospital is rightly proud about.” Based on the success of the project, Milton Keynes Hospital has been visited by other NHS organisations who are seeking to grapple with the challenge presented by paper. Vijay Magon, CCube Solutions’ managing director, says: “Moving away from paper is not easy. It is a huge transformation process which radically changes the way NHS organisations work. It’s challenging. “We’ve worked closely with Milton Keynes Hospital to overcome issues as they have arisen to ensure the system delivers exactly what records and clinical staff want so they can move away from well-understood but archaic paper-based systems, which just don’t work in today’s hospital environments.” L




EHI Live 2013


Is the prospect of a paperless NHS by 2018 simply a pipe dream or a genuine possibility? Cloud2 is already known for its super-fast build and flexibility; offering business-critical enterprise SharePoint and business intelligence solutions. Here, Cloud2’s director, Simon Hudson, discusses how the company’s approach is helping to make the vision of a paperless NHS a reality: “Despite the advent of electronic communications and records, paper is still used extensively for communicating and recording information. “However, paper is a flawed medium, presenting limitations on how it can be shared, transferred, updated, governed, protected and managed. “It’s been well-publicised that the NHS should go paperless by 2018, which could lead to billions in savings, as well as improving services and helping meet the challenges of an ageing population. “The health secretary, Jeremy Hunt, said that patients should have compatible digital records so their health information can follow them around the health system. This would mean that in most cases, whatever care a patient requires, the professionals involved in their care could see patient histories ‘at the touch of a button’. “In NHS Trusts, we are already seeing a

desire to introduce and develop more robust internal systems with a view to widening that out to patient solutions in the future. Our ROI calculator indicates savings in the millions, even for non-clinical documents. At EHI Live in 2013, we talked about solutions and methods Cloud2 has developed to help health organisations to finally embrace a paperless system. “We absolutely believe that the 2018 goal is achievable, but it will require users, buyers

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and suppliers to think and act differently. We see this as an opportunity, not a threat. There are solutions, including those we have developed, that can deliver all the foundations necessary for a paperless NHS. To give you an example, we’re working with Norfolk and Suffolk NHS Foundation Trust which introduced an integrated intranet, extranet and internet solution to better engage with staff, professionals and patients. The joined-up solution builds on their Hadron 8020 intranet with public websites, a professionals’ portal and referral form integration. Not to mention the added visibility and efficiency that can be won through better business intelligence solutions we’ve introduced for SharePoint. “The journey towards paperless is as much about culture as technology. The 2018 paperless goal is only going to become reality if the NHS, and its users, wants it to be. It can be achieved, and almost certainly within the timescale the health secretary has set, if there is the will.” FURTHER INFORMATION Tel: 01274 308378




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Organised by E-Health Insider, EHI Live 2013 provided food for thought for business, clinical and technical managers committed to using IT and information to transform healthcare delivery. But, as EHI journalists report, the key messages centred on collaboration to make technology part of the care process

Billed as the place ‘where the e-Health community meets’, EHI Live 2013 provided a showcase for everything from enterprise systems exhibited by global companies to a Build Your Own App booth. Many visitors and exhibitors commented there was a buzz around the show and a sense that things were moving in a positive direction driven by a challenge from health secretary Jeremy Hunt, to move to paperless working by 2018 and two technology funds which, with matched funding, will deliver £1billion to NHS IT over the next three years. There was a familiar caution, however, from several speakers commenting that technology alone cannot deliver results. NHS England’s director of strategic systems and technology, Beverley Bryant, told the conference that the commissioning board is taking the lead on a national technology strategy, due in March, to make sure that “technology does not become a means in itself” and to pull together interests from across health and social care.

While King’s has been building its electronic patient record for 15 years in a best-of-breed approach, Cambridge is going from a ‘homegrown, haphazard, unstructured’ IT base to a full electronic patient record in just 18 months “It’s really important to stress that we as the NHS and care system need to join ourselves up digitally and move to a digital environment,” Bryant told the NEC. “The only way to deliver this revolution is through collaboration with the market and IT professionals.” Bryant revealed that NHS England is starting to broker introductions between industry and NHS trusts that need help to get safe digital record-keeping in place and is holding its “first big matchmaking event on 3 December”. The conference also included some powerful dispatches from the frontline of technology

implementation. King’s College Hospital’s NHS Foundation Trust chief clinical information officer Dr Jack Barker and eHospital programme manager at Cambridge University Hospitals NHS Foundation Trust Carrie Armitage gave engaging and honest presentations about what implementing technology is really like. Dr Barker described how his trust tried to launch e-clerking four times before getting it right, the first three times having to withdraw because the software was not usable. “Clinicians have to want to use this more than grabbing a piece of paper and that’s a E



EHI Live 2013


Streamlining care in South West Hampshire using Map of Medicine to meet quality targets University Hospital Southampton NHS Foundation Trust (UHS) in collaboration with two local primary care trusts, NHS Southampton City and NHS Hampshire, set out to reduce unnecessary demand on secondary care. Specifically, the aim was to deliver safe, affordable, high-quality care efficiently while reducing outpatient readmissions by 10 per cent. There was also a need to develop a set of referral guidelines that could be communicated easily among the health community. In primary care, most best practice information was stored in hard copy by individual GPs. Dr Sonpal, a Hampshire GP, says: “Guidelines and current best practice change frequently and keeping up to date with all is very difficult. The Map of Medicine collates all of these pathways into one easily accessible place. Furthermore, I can work through pathways with patients and methodically manage their issue – often without making a referral.” Map of Medicine was selected to help standardise referrals and provide

a central repository for all local guidance. Commissioners and providers worked together using the Map of Medicine to develop a series of evidence-based, locally relevant pathways. They worked to present local data in an easy-to-use, intuitive and succinct format for GPs. Contributors were able to communicate key messages for pathways and set local referral thresholds and referral routes, and alert GPs to alternative treatment options available in the area. Dr Hunter, a Hampshire GP, comments: “I look at locally developed maps during the consultation most days of the week and share these with patients. This is a really effective way to describe and store the agreements we make with providers on the pathways and services we commission.” Lucie Lleshi, Map of Medicine project

manager, South West Hampshire, says: “Map of Medicine has supported us in making this project a resounding success by helping us garner strong clinical engagement and leadership and facilitate direct communication between primary and secondary care clinicians.” Co-operation between primary and secondary care has been a resounding success of the project, increasing communication across care settings to improve the quality of care for patients. The health community has significantly reduced GP referrals by 15 per cent across gynaecology, haematology, paediatric orthopaedics and endocrinology, leading to notable financial savings and quality, innovation, productivity and prevention (QIPP) achievements. The quality of referrals improved by more than 50 per cent, with the number of referrals rejected from secondary care falling to 112 for orthopaedics and 56 in gynaecology. FURTHER INFORMATION Tel: 020 7492 6300

Having it all: efficient and effective referral management Map Referrals allows GPs to access comprehensive, evidence-based local guidance at the point of care, and helps CCGs achieve their quality and productivity targets.

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EVENT REVIEW  challenge,” Dr Barker said. While King’s has been building its electronic patient record for 15 years, Cambridge is going from a ‘homegrown, haphazard, unstructured’ IT base to a full electronic patient record in 18 months, aiming for a ‘big bang’ implementation of its Epic EPR on 25 October next year.

EHI s Live wa ch n the lauhe EHI t pad for ce Clinical ON TO THE en Intellig aturity Index EPIC WAY M Cambridge is spending Digital artnership £200m on the p in S H eHospital programme N h t i w over 10 years, of which England the majority (70 per cent)

is going towards improving its infrastructure as part of deal with HP. Another £40m is for the implementation and licences for Epic and £20m in trust costs for implementation. Carrie Armitage stressed that the project is not about trying to implement technology: “The most challenging thing we have to do is embed technology into the healthcare process; that means people – that’s the hard bit.” The trust’s business case is “dependent on the technology being at the heart of that care process.” As part of ‘the Epic way’ of doing things, Cambridge has 100 staff working full-time for

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18 months to become accredited Epic analysts, of whom 22 are consultants. Over two months, the trust built more than half of the workflows needed for go-live; and it is now thinking about getting 500 super-users identified. The intensity of Cambridge’s experience is unique in the NHS, but the level of commitment and resource required is not news to those with implementation experience. MEASURING PROGRESS How can NHS managers know how they are doing? EHI Live provided the launch pad for the EHI Intelligence Clinical Digital Maturity Index in partnership with NHS England. This new index benchmarks the administrative and clinical systems in use across all the 160 English NHS acute trusts. Work is underway to extend the index to mental health trusts. Each system is broken down by penetration percentage, age, supplier, etc. Then each system in place is given a score. This scoring system has enabled EHI to develop a ranking system that helps NHS organisations understand what they have compared to their peers. L FURTHER INFORMATION If you have an NHS subscription you will have access to the CDMI report. To register, visit EHI Live 2014 will be back at the NEC Birmingham on 4-5 November.

Olympus professional digital dictation: the best devices on the market

‘Where Digital Dictation Makes Sense’ Follow us on Twitter @BigHandHealth Contact us on: +44 (0)20 7940 5900 or email for more information

With a long-standing history in the medical profession, Olympus understands the varied challenges that healthcare professionals face from day to day. There is no doubt that dictation saves countless hours of valuable time and Olympus’s scalable digital dictation solutions can be tailored to fit perfectly within your individual working environment. They provide complete workflow transparency, better utilisation of resources and optimum cost-savings. With the range of Olympus Professional Voice Recorders being awarded the highest Nuance ‘Dragon Score’, you are guaranteed optimal speech recognition accuracy to assist with faster document turnaround times. It is the first time that an entire range of professional dictation devices – mobile and stationary types – utilising the established industry standard

format, DSS Pro, has received the maximum rating of six Dragons in recognition of impeccable speech recognition accuracy. This underlines the focus Olympus places on remaining at the forefront of innovative, efficiency-boosting solutions for the professional dictation industry. The six Dragons rating, combined with integration of the Olympus Dictation Management System workflow software with Dragon NaturallySpeaking from Nuance, confirms the superiority of Olympus solutions to all professional users wishing to integrate the benefits of speech recognition into classic dictation workflow.






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In England, the NHS spends £110m on emollients per annum.[1] Many of these are branded emollients, which could be substituted for a similar Zeroderma emollient, saving the NHS £12m per annum without compromising on patient care. A new QIPP and emollients toolkit has been developed by medicines management teams and contains everything you need to implement product changes at practice level, plus a cost-savings calculator to calculate how much your particular region could save. Zeroderma products are

similar in formulation to around 40 per cent of currently prescribed emollients and offer cost savings of up to 37 per cent. Many clinical commissioning groups (CCGs) are now using the Zeroderma range and one Northern-based CCG is predicted to make savings of £250,000. Ref: [1] NHS PCA data for England – 2012

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Written by Dave Smith, the British Parking Association


The idea of a healthcare parking benchmarking survey, to better understand current policy on how parking is managed and charged for – and how this varies between locations – was discussed at a recent BPA Healthcare Parking Special Interest Group The British Parking Association (BPA) has a clearly defined role to raise standards across the parking profession and nowhere is this more apparent than in the healthcare environment. Balancing the needs of hospital patients and visitors, staff and healthcare professionals to ensure that access to health care is fair, and cost‑effective, requires courage and determination. Parking managers at healthcare sites across the UK face these challenges every day. Working alone they seek to resolve their problems locally, often challenged by local media and indeed, their own colleagues. In support of this work, the BPA has initiated a Healthcare Parking Special Interest Group, bringing together people in NHS facilities with parking operators and service providers to share knowledge and experience with the BPA’s role to educate and inform people about the best practice that is already out there BENCHMARKING The most recent meeting took place on November 26th at St James’ Hospital, Leeds. Healthcare members have been keen to undertake a benchmarking survey for some time to better understand current policy with regard to how parking is managed, implemented, charged for and how this varies between locations and facilities across the entire parking profession. The content of the survey and questions to be asked were discussed and agreed. The group are seeking to follow in the

footsteps of the higher and further education sector. Earlier this year, 52 higher and further education establishments, representing around 34 per cent of all those in the UK took part in an online benchmarking survey. The data was analysed and a report produced providing an overview of the data collected, together with some of the key findings grouped into specific areas. The report is the first of its kind, examining the size, shape and nature of parking across the higher and further education sector.

CHARTER FOR HEALTHCARE PARKING In 2010, the BPA first published its Charter for Healthcare Parking, aiming to strike the right balance between being fair to patients and others, including staff, and making sure that facilities are managed effectively for the good of everyone. Now nearly three years on, the BPA has revisited the Charter and with the help of those working in both the parking and healthcare sectors, has republished its guidance. Following this success, the BPA has developed a Charter for Higher and Further Education Facilities. This brand new initiative was launched at Parkex 2013, the biggest event for those working in parking and traffic management. Already, a number of Trusts that are also teaching hospitals have added their names to the list including George Eliot Hospital NHS Trust, Lancashire Teaching Hospitals NHS Foundation Trust, University Hospitals of Leicester NHS Trust, and York Teaching Hospital NHS Foundation Trust. A full list can be found at www.britishparking. One of our main aims is to encourage members to raise standards so that they provide a better, fairer service to their clients and to all car park users. Our members recognise the value of maintaining high standards, and membership of the BPA enables them to do this. L

The BPA has a d initiate Parking are Healthcal Interest Speci bringing Group NHS staff r togethe parking and tors opera

THE HEALTHCARE SITUATION It is expected that the first survey in the Healthcare sector will take place in early 2014. The survey will be carried out annually in order to provide a true benchmarking exercise for all participants. Working together through the BPA Health Care Parking Special Interest Group we can collectively share knowledge and best practice, as well as campaign for better recognition of the services provided and the need for them to be properly funded. The health of the nation depends upon the NHS. The NHS depends upon the parking profession to help ensure that access to its facilities is fair and appropriate, properly managed and adequately funded.

FURTHER INFORMATION Tel: 01444 447 300



Moving & Handling




Moving & Handling People 2014 has a focused programme which recognises the significant role that healthcare practitioners play in safeguarding the well-being of patients whilst maintaining their own health and safety when facilitating moving and handling activities The Disabled Living Foundation’s annual CPD accredited Moving & Handling People conference and exhibition is the major event in the moving and handling calendar for healthcare professionals. Taking place on Thursday 30 and Friday 31 January at the Business Design Centre, Islington, London, the focused programme recognises the significant role that healthcare practitioners play in safeguarding the well-being of clients whilst maintaining their own health and safety when facilitating moving and handling activities. Moving & Handling People 2014 is very much aimed at both health and social care professionals who manage services and provide ‘hands-on’ practical care from assessment to safe service delivery. The event is designed to ‘enable’ and ‘support’ moving and handling practitioners, therapists and support staff and expose them to new products and ideas to widen their experience and knowledge in the delivery of safe practice through improved performance and safer handling techniques. This includes the use of equipment, while considering the implications of legislation, professional guidance and outcomes of legal cases. The practical programme will help to empower practitioners, promote health and safety for patients, clients and carers through a range of interactive learning activities.

MH Risk assessment – identifying the best option for moving and handling the client in the health and social care settings to ensure safety for all and good practice in everyday work activities.

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EXPERT SPEAKERS The event team have identified speakers with a wealth of experience to confront and discuss real life issues in their presentations and workshops so delegates can really take away practical and useful information. The two keynote Plenary sessions will consider the legislative implications for moving and handling practice, as well as consent, dignity and safeguarding issues that arise. Speakers include Susan Clayton and Michael Mandelstam. Both speakers will consider issues which practitioners must ensure are reflected in their day to day practice including processes which focus on achieving zero harm; measuring and monitoring safety; protecting



quality standards; and the need for compassion, respect and dignity. Four concurrent sessions will focus on specific areas of practice for discussion & review: Donna Forsyth, Associate Director Patient Safety (Investigation & Training), for NHS England will take a session called ‘Empowerment from experience’, which will look at learning from adverse incidents and how we can empower practitioners to improve practice. Clare Henson, Senior Occupational Health Physiotherapist at Kings College Hospital NHS Trust, will examine assessing and improving work postures by considering how posture can contribute to work related musculoskeletal disorders (WRMSD) and how assessments can be used to reduce these and encourage staff to adopt better postures for their work activities Anita Rush, Clinical Nurse Specialist Berkshire, Community Equipment Services, will examine how option appraisal of moving & handling products is key to ensure effective use of resources whilst also considering the client’s capability and changing needs. This session will consider appraisal of equipment to assist with client moving and handling, selection and key factors to consider. Carole Johnson, Freelance Moving & Handling Advisor, will discuss the use of

WORKSHOPS Four practical workshops will focus on specific areas of practice for discussion and review of solutions and use of equipment. The workshop ‘Single handed care packages’ provides realistic and safe guidance when only one carer is available and answers to the question – what can I do if l am on my own? The workshop, ‘transferring people’ will consider different transfer techniques for a range of client groups and equipment. There will also be a workshop on the use of assessment tools to identify suitable handling techniques and equipment which can be used by practitioners to assess the client’s ability, identify resources and solutions. The workshop facilitators are from Acute and Community settings and will be drawing on their range of practical experiences to help delegates identify suitable tools for their clients. The last workshop will tackle moving and handling interventions with equipment – people and load handling activities. OPEN FORUM Based on feedback from previous events, Moving & Handling People 2014 will feature a new Practical Open Forum to allow for discussion of moving and handling solutions to unusual situations but uniquely, this forum will be structured to allow practice of potential solutions. Exhibitors are encouraged to attend this facilitated session to allow for open discussion and exchange of ideas and solutions. The optional Pre-conference New Products Evaluation Workshops provide small groups of delegates with the opportunity to view, trial and discuss the very latest new products, many of which will be launched at the event, as well as seeing and discussing emerging products in development and bespoke moving and handling equipment. All practitioners have a professional responsibility to provide guidance which incorporates safe practice and often this will include the need for equipment and therefore knowledge of up to date products and suppliers is essential.

About the Disabled Living Foundation These workshops fulfil a key role in providing delegates with information on new products designed to improve the quality and delivery of care for those clients with moving and handling needs. EXHIBITION The extensive exhibition gives delegates the chance to view, discuss and try out a wide range of moving and handling associated equipment, some of which will feature in the practical workshops. Tailored timetables allow delegates to attend the exhibition prior to the workshops in order to identify equipment which they might wish to discuss with facilitators and peers in the session. Exhibitors are often highly knowledgeable and experienced in assessment of client needs and so delegates can also benefit from talking through moving and handling issues with them as well as areas of professional practice with representatives of professional bodies in the Professional Resource Centre. Both the CSP and COT will be involved in the programme through chairmanship of two sessions and again; this allows delegates to pose questions to those at the apex of their profession. The conference programme and exhibition affords delegates the opportunity to attend all the plenary and concurrent sessions, the Open Forum and all four workshops over the course of the main two day conference, in addition

to protected time to attend the exhibition to discuss client needs with suppliers, exhibitors and representatives from organisations associated with health and social care. DETAILS In these days of hard economics DLF recognises the need for efficient use of resources and has maintained the cost of attending the conference at 2010 prices, as well as offering discounts for small group bookings – prices from as little as £187 per person + VAT for the main 2 day conference or from £240 + VAT for the main conference + Pre-conference New Products Evaluation Workshops which provides delegates with over 24 hours of learning! DLF not only organise Moving & Handling People but also wish to support delegates back in their workplace. Following the event, delegates will be given a year’s free access to an information portal of equipment for moving and handling people, including paediatric and bariatric equipment, taken from DLF Data. Post conference, delegates can print off their own certificate of attendance and CPD record in which they can record their aims for attending the event, what they have learnt and how they can apply this as part of their work to update their CPD portfolio. L FURTHER INFORMATION

The Disabled Living Foundation (DFL) is a national charity providing impartial advice, information and training on independent living since 1969. It has a vision that people, of all ages, who face difficulty in daily living should be able to live full, independent lives, shaped by their own choices. To make these choices, people must have full access to information and advice about practical help to sustain independence. DLF is an innovative charity which exists to help people deal with the impact of disability or advancing age and to maintain choice, independence and control over their lives. We do this by giving ready access to expert advice and impartial information that makes a practical difference to daily life. For help and information about equipment and gadgets to make life easier, visit DLF’s impartial advice website ‘Living made easy’:

Reduce staffing costs with the Etac 4 Way System

Sidhil launches its new Innov8 IQ hospital bed

The Etac 4 Way System is an in-bed care system for turning and positioning patients with reduced mobility, pain or pressure issues. It is also ideal for helping provide care to larger patients who remain in bed for long periods. In addition to the benefits for the patient, the high-tech fabrics allow the carer to carry out procedures with the minimum risk to their own wellbeing. The system helps prevent back injury. The Etac 4 Way System has a unique ‘braking’ system that prevents the patient from any unwanted movement or slipping. This means that when it is used on a profiling bed that has cot sides, one carer can carry out the work that previously would have needed two. This is a great cost-saving when providing a care package.

Building on over half a century of expertise in the design and manufacture of high-quality hospital beds, healthcare furniture specialist Sidhil has announced the launch of the latest model in its flagship Independence Innov8 range, the all-new, high-performance ward bed known as the Innov8 IQ. Dubbed ‘the modern ward bed with intelligent thinking’, the Innov8 IQ has been designed around optimising tissue viability, infection control and health and safety in terms of manual handling and falls prevention. This level of design flexibility means the bed is suitable for a wide range of patient groups, resulting in reduced requirements for transfer from bed-to-bed and increased relevance for the entire patient population. One of the key features of the Innov8 IQ is the low

And the advantages don’t end there: studies have shown that there is no significant reduction in the effectiveness of pressure-care mattresses when used with The Etac 4 Way System. This means that it is suitable for even the most critical patient. Contact Etac for more details on this study or to find out more about the product.

FURTHER INFORMATION Tel: 0121 561 2222

Moving & Handling


mattress platform height, reducing the risk of falls. The bed also provides a tilt function with auto regression, achieving a ‘one-touch’ full chair position for optimum patient comfort, facilitating open airways, improved circulation, a good nutritional position and clear vision around the ward to enhance the patient environment. Contact Sidhil’s customer services team for more details. FURTHER INFORMATION Tel: 01422 233 000



Advertisement Feature




How the NHS could benefit from a managed document services strategy As has been widely documented, the NHS remains under intense pressure to meet rigorous efficiency targets. The organisation is aiming for a 10% reduction in carbon emissions by 2015 and is working towards a goal of £20 billion of efficiency savings by 2015. Closely aligned to these targets, we are seeing an ongoing focus on cutting paper usage across the NHS. Originally, Tim Kelsey, National Director for Patients and Information, called for the Health Service to be paperless by 2015. Although Health Minister Jeremy Hunt subsequently revised this to 2018, it remains a key objective. KEY ROLE OF PRINTING At OKI, we believe that buying printers and printing in the right way can help towards all of these targets. NHS departments rarely have a clear view of their expenditure on document output and management and printing is often overlooked when it comes to energy savings, carbon emissions and going paperless. When talking of savings, the focus is usually on lighting and heating. Printers tend to be treated as utilities – people often take them for granted. They are not top of mind. In fact, better management of printing and documents can play a key role in meeting these efficiency goals. Many NHS units and departments don’t even realise how much energy – and money – they are wasting by not considering carefully the printers they buy and having no clear view of their overall print landscape. In our view, a completely paperless environment across the NHS is unlikely to be achievable. Even if patient records and referrals become paper-free – the NHS will not be able to stop people sending letters or wanting hard copies for legal reasons. So while paper reduction is a good goal to pursue, going fully paperless is not likely to be practical straightaway. Indeed, an extensive new survey we carried out this summer, with over 2,000 respondents showed that 92% carry out some kind of printing daily, with 45% printing more than 10 pages each day. This covered businesses – but there is no reason to believe that the situation in the NHS is significantly different. Incidentally, we found that 79% use office equipment to print personal documents, a figure that reveals just how much the concept of printing is ingrained in our workflow, while also illustrating the need to control and manage it efficiently.



WHAT CAN A CONTROLLED APPROACH DO? Some straightforward tweaks to printing policy can be highly effective in driving efficiencies. For example, logically ensuring that double-sided printing is default for everyday work can cut paper consumption by up to 50% at a stroke. Incoming faxes can be forwarded by emailing them directly to designated recipients. And restricting access to specific PCs can limit unnecessary printing. But to deliver far-reaching and lasting changes,

these changes need to be accompanied by a more fundamental change in an organisation’s whole approach to printing. In this context, a managed documents strategy has many benefits. In particular, such an approach can optimise the use of paper and printing by improving workflows and managing resources to ensure departments are using printers and multifunction devices as efficiently as possible. As such, it can effectively aid the move to a paperless – or at least a ‘paper-lite’ process. At the same time, the approach has the potential to save energy by enabling digital communication, archive, retrieval and distribution of information; by ensuring better distribution of records across the organisation and by digitising key administrative process, including the electronic distribution of those records. THE WAY FORWARD So, how can the approach work in practice for NHS units or trusts? The first step of


any project will typically be an all-inclusive analysis of the print environment and document workflow in the form of an audit on existing practices including output volumes and printing types. This brings a number of benefits to any user organisation. First, it provides a transparent view across the print and document management landscape. Second, it enables a healthcare practice to see where budget is spent and ensure costs are transparent. Third, it creates a platform for expert vendor to enhance usage and drive efficiencies, including

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potentially cutting paper usage and driving energy costs down. The results of the audit can then be used to inform and shape a best practice managed document services approach. This will help ensure print devices are used in the most resourceful manner and that where necessary, only the most efficient and technologically advanced devices are deployed, in order to streamline processes, reduce energy consumption and in turn, cut costs. The audit’s findings may even reveal, for example, that the NHS unit needs to work more efficiently by consolidating a number of individual printers, such as slow, high cost inkjet printers with a reduced number

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of high‑quality printers. Similarly, departments may potentially be able to achieve benefits by combining printing, copying, faxing and scanning needs within one multifunction printer instead of having separate devices. With a closer eye on printing, NHS departments can start tracking and controlling print usage, which instantly makes printing more efficient as users become aware of what they are printing.

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ALL UNDER CONTROL A managed document solutions approach drives sustainability by ensuring the right printers are being used for the right job. It can highlight unseen overheads so further savings can be made. Replacing multiple devices with smaller number of MFPs, for example, can help cut energy consumption and cost. Where budgets are tight, healthcare organisations need to maximise use of devices for document output and management. Using MFPs, organisations just need one device, not separate copiers, fax machines and printers. Also, by deploying a managed document solutions approach, healthcare organisations can ensure they work with just one contract for print and document management needs including, purchasing printers; buying supplies and requesting maintenance. All of this makes it easier to monitor ongoing costs, reduce capital investment and control budgets. KEEPING IT SECURE Of course, security is critically important within the NHS. Today, it is possible to deliver secure printing as part of a managed document solutions approach. Secure Print enables the user to store documents prior to printing on the printer’s Hard Disk Drive (HDD) or Secure Data (SD) card. Many MFPs feature scan to email which convert the scanned image to a PDF and send to email recipients. Documents can still fall into the wrong hands, so encrypted scan to PDF may also be required. PUTTING PLANS IN PLACE We have already considered the reasons why the NHS is looking to save energy, drive efficiencies and cut down on paper usage – and we have looked in detail at how they can achieve this. Today, it’s important to encourage greener printing by using LED devices and adopting approaches like making double-sided printing the default option and tracking and controlling print usage. Yet it’s still more critical to adopt a managed document solutions approach that allows you to work with your vendor to audit your entire printing environment; consolidate your printer fleet; consider implement smarter printers with environmentally‑responsible features and ultimately streamline your entire operational workflow. L



Fire Safety



Written by the Fire Industry Association


With people of limited or no mobility, multi-sited buildings, and life-saving surgeries taking place around the clock, an environment like a hospital can pose many challenges for fire safety. The Fire Industry Association covers the main points to consider for effective fire safety provision in healthcare settings As the person responsible for fire safety within a building, it is crucial to ensure that you are using competent subcontractors. Most people outside the fire industry will not have had the appropriate training to enable them to understand what competency and knowledge is required to complete this work. However, in the fire sector there are industry specific certification schemes that can give purchasers confidence in the ability of the companies and individuals that they are employing to do work on their behalf. Whether employing people to carry out installation and servicing work on your fire equipment or to provide a fire risk assessment, there are appropriate certifications for the type of work. The schemes available are written and administered by different bodies (two key scheme providers in the fire industry are BAFE and LPCB) but they all effectively show that an independent audit has taken place to assess technical capability as well as the fire company’s quality management system. A subcontractor will be able to provide evidence of their certificate but it is important to also go to the scheme provider or certification body’s website to authenticate that certificate. The FIA has a white paper on Third Party Certification, available to download from, which explains this subject in an easy to understand way.

the premises they are able to assess. Now two months old, PAS 7 is in effect a performance code for fire safety management and the fire safety industry is looking into making this a certification scheme. A premises owner/operator whose fire safety management was certificated to PAS 7 would obviate the need for fire brigade inspections as a PAS 7 audit would go far deeper than a fire officer’s inspection. The whole fire safety industry is watching these developments with interest. TIME FOR EVACUATION If you get an alarm sounding on your fire detection system what do you do? Evacuate? Whilst in a small retail premises the plan of everyone out is probably right, that won’t work for a complex site like a hospital. Here you will have people of varying levels of mobility and some that can’t be moved at all. If you’re in the middle of surgery do you drop everything the moment the bell rings? Of course not. That’s where the evacuation strategy comes into play. Horizontal, vertical or stay put, you need to have this planned. Remember, when the Fire & Rescue Services (FRS) arrive they are there to fight the fire and not to evacuate the patients; that’s your job. The NHS internal reports show that if you have a well-planned and well-rehearsed plan then everyone gets out alive if you do have a real fire.

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FIRE RISK ASSESSMENTS Still on the subject of Certification, the International Fire Consultants Certification (IFCC) is expected to launch their fire risk assessment certification scheme very soon. Like the existing BAFE SP205 scheme it will be UKAS accredited but this scheme classifies the assessor and the assessor’s company according to the nature of



FALSE ALARMS Note the ‘if’. Fire detection systems are designed to detect ‘fire like phenomena’ so when the alarm goes it may not necessarily be a fire. FRS’ across the country are changing how they respond to automatic fire alarms and in many cases unless there is a confirmation of a ‘real’ fire they will not attend. Many FRS’ recognise that hospitals are the worst offenders in terms of unwanted fire signals so this needs to be factored into your plan.

You need to know what the policy is for your FRS and, if you manage multiple‑site facilities, what the policy for all the facilities is. It will differ from FRS to FRS! Consider an investigation time before the signal is transmitted; look at what detection type you use and modify it to your situation; or modify what you do, for example the simplest way to reduce false alarms in hospitals is to make sure ward toasters are nowhere near a fire detector. Advice on managing false alarms and the FRS response to automatic fire alarms can be found on the FIA website: What else can you do to reduce the chance of a fire or an unwanted fire signal? Well, if any maintenance or building work is carried out on the hospital make sure that any hot work is managed on a permit system and, if necessary, isolate the fire alarm or cover the detectors in that area (remembering to uncover the heads once the work is done). This also applies if the work is liable cause a large amount of dust. Arson can also be a problem so ensure that access to areas with large amount of flammable/explosive liquids, gases or solid is strictly controlled. Don’t just leave waste lying around; bag it and store it securely. MULTI-SITE FACILITIES For those of you that have multiple sites that overlap several Fire & Rescue Services then you might want to consider a Primary Authority Scheme. These are being extended to cover enforcement under the Fire Safety Order. Through such schemes businesses have access to reliable information from one source based on a detailed understanding of their operations. Primary Authority Schemes for fire will be covered by the new Regulators’ Code which is due to come into effect next April and will replace the Compliance Code and Enforcement Concordat that came before. The revised code has been changed to improve regulation in areas such as the Focus on Enforcement review of appeals, the Accountability for Regulator Impact measure and the planned Growth Duty for non-economic regulators. In addition, the new code, based upon a beneficial relationship between regulators and the companies they work with, should reduce burdens and help to boost business growth. For more information on managing your fire safety download a copy of the FIA’s Best Practice Guide to Fire Safety at the web address below. L FURTHER INFORMATION



Powerpoint Fire: supplying Fireserv UK: for all of your all of your fire and health and safety needs emergency requirements Fireserv UK wants to change needed to ensure all disciplines PowerPoint Fire Systems is the one-stop solution for: fire alarm systems, low-voltage emergency lighting systems, PA/ VA alarm systems, extinguishers, gaseous and Vesda system, electronic system design. PowerPoint was formed to meet a need in the marketplace for a technically specialised and dedicated fire alarm company, which now has over 60 years’ experience within the industry. It is a fully approved ISO 9000 and BAFE SP203 company. Within all aspects of the industry, PowerPoint provides a full range of services: from design, manufacturing and installation through to service, support maintenance and commissioning of systems, and it provides a 24 hour/365 days a year service and support. The company endeavours to provide a high-quality,

cost-effective solution in response to a constantly changing market in which its clients operate and specialise in large multi-panel systems, such as hospitals and shopping centres. These generally require a higher level of support than most normal systems. As an example, one of its engineered solutions is for a well-known club in London’s Wimbledon that currently has 17 multi-loop panels and six graphics workstations as a complete integrated solution.

the way fire safety is dealt with by providing you with that all-important personal service at a competitive cost. Being an up-and-coming fire safety company based in the east Midlands, it offers independent appraisals of your requirements. Fireserv UK’s centrally located professional team is here to ensure that you have all of the relevant information you require, along with a comprehensive and bespoke design solution adapted to suit the needs of your business criteria, whatever that may be. Being a full third-party accredited company gives both Fireserv UK (as the service provider) and you (as the client) the knowledge and comfort

Products & Services


of work are carried out to the highest maintained standards. Whether this may be fire specific, alarms or indeed safety/security, intruder, CCTV or door access related, you can be sure that Fireserv UK is on hand to assist and excel in all situations. No service contract maintenance? Contact a Fireserv UK customer representative to find out more on how Fireserv UK can offer tailored and complete service contracts for all your existing systems, including immediate response to system activations. FURTHER INFORMATION Tel: 0116 224 3516




Do not wait until it is too late – call Fraser Fire Alarms now

Domestic & commercial electrical contractors serving the South West

Fraser Fire Alarms is a totally independent family run Fire Alarm Company. The company specialises in fire alarm design, installation, service, commissioning and maintenance of both conventional and addressable systems throughout the UK. In addition, the company can offer installation of gas suppression, emergency lighting access control, air sampling systems, disabled refuge, fire risk assessment, and electrical services. With over 50 years’ experience in the fire industry, Fraser Fire Alarms has worked within many major sites, including hospitals, schools, offices, small/ large business, factories, MOD sites, power stations, etc. Fraser Fire Alarms employs a team of highly motivated and skilled engineers who aspire to

GN Electrical prides itself on not just reliability but also on the highest-quality workmanship, which it achieves by maintaining a staff of experienced, time-served electricians. The company has built a sound professional reputation, within local communities across Devon and Cornwall, for electrical work of all types. Based at the attractive, purpose-built Mount Pleasant Ecological Park at Porthtowan in Cornwall, the company works with its highly qualified and professional electricians and a reliable fleet of vehicles. The premises of GN Electrical has ample storage, where a large permanent stock of electrical accessories are kept. In the event that GN Electrical is called out in an

deliver the highest quality of workmanship for its customers. The company’s project manager will work with the client throughout the installation, commissioning and handover to

ensure that the project complies entirely with BS5839 standards. Fraser Fire Alarms is also a fully accredited company. FURTHER INFORMATION Address: Fraser Fire Alarms 68-74 Queen Elizabeth Avenue Hillington Ind Estate Glasgow G52 4NQ Tel: 0141 880 9080 Tel: 07964 828521

emergency, the company is able to provide most replacement parts from its own stock. This is very handy when the call-out is outside of normal working hours. GN Electrical’s working office is comfortable and manned during working hours, and most enquiries can be sorted out over the telephone by an efficient team of office staff. FURTHER INFORMATION Tel: 01209 890658 Tel: 01209 891663



Products & Services




Face2Face Contact – for when you need the right people in the right places

Dealing with debt collection in an ethical, experienced and professional manner

Face2Face Contact is the expert in the management of a wide range of specialist field-visiting services, including vacant property checks, property assessments and information gathering, account rehabilitation, financial means-testing, commercial site surveys, document exchange and licence checks. Using a combination of the company’s bespoke External Visit Application system, latest handheld technologies and agent management systems, Face2Face Contact provides a secure and reliable end-to-end service over the life cycle of its clients’ accounts. Face2Face Contact works in partnership with all of its clients, integrating and complementing each of their processes with its own while offering complete understanding of, and compliance

UK Debt Recovery is an established debt collection and trace investigation company, managing debt portfolios across a variety of business sectors for private and commercial clients in the UK and Europe. The company delivers bespoke solutions, tailored to client’s individual requirements. The service it offers includes: credit control; debt collection; tracing absconded debtors; status reports; and litigation. UK Debt Recovery’s aim is to maximise recovery and achieve this through a combination of its experienced personnel, comprehensive collection methodologies and use of advanced DCA technology and systems. Given its wealth of experience, UK Debt Recovery is fully aligned to the issues facing its clients and has the necessary skills and expertise

with, any industry regulations. The company provides a solution which safeguards your reputation with a focus on speed, accuracy, security and quality – all resulting in improved performance for its clients. Face2Face Contact can provide full UK coverage on both residential and commercial sites and its highly trained internal staff and field representatives manage high volumes of work on a daily basis, within strict service levels. FURTHER INFORMATION Tel: 01789 413707 (David Houlton, managing director)


to deliver a quality service. In the current economic climate, there is increased pressure to collect overdue debts. Financial and resource constraints mean that parties need to be more proactive when tackling their debt portfolio. UK Debt Recovery is a fully licensed and regulated agency and active member of the Credit Services Association. Strict codes of conduct are adhered to in order to ensure full compliance and set higher standards of best practice and ethical standards. FURTHER INFORMATION Tel: 01494 473325 enquiries@ukdebt


Arcomedical: leading the Rapid legionella DNA way in infusion technology detection (PCR) Medication errors are a recurring issue in modern hospitals around the world. These errors may have serious consequences for the patient and the reputation of the hospital. Professionals in charge of patient safety are constantly looking for solutions that eliminate infusion drug errors. Arcomedical recognises the need to identify various groups of drugs in a straightforward and easy-to-use way. Arcomedical’s new MedMarker™ solution uses a simple and clear colour-coding system, which helps clinicians categorise drugs to minimise the risk of mistakes. It is the first time that colour-coding is available on infusion pumps. The Swiss-made origin and the quality of Arcomedical’s


infusion and syringe pumps are of the highest standards for you and your patients. Being part of Arcomedical’s world offers you access to an innovative, simple and robust Swiss-made product. As a frontrunner in infusion technology, the company offers its customers a full range of infusion devices and consumables. Leading the field in infusion-pump development, Arcomedical’s innovative MedMarker is available on the Chroma infusion pump series – taking patient safety to the next level. FURTHER INFORMATION Tel: 01277 810 432


The ALcontrol Molecular Biology Laboratory offers rapid, sensitive legionella testing based on the DNA detection of species-specific genes. The test detects legionella species and legionella pneumophila with results ready within 24 hours of sample delivery. This technology is ideal for facilities managers or those involved in the management of water systems when time doesn’t permit waiting for the results of samples analysed by conventional methods. This cutting-edge molecular technology is accredited to UKAS 17025 and supported in ALcontrol’s custom-built facility by experienced molecular biologists with backgrounds in water testing who understand that results

can be critical. If you wish to submit a sample, ALcontrol will request that you supply 2x1L: one will be analysed by the conventional culture method as recognised in L8 as well as one by polymerase chain reaction (PCR). Your results will be reported in genomic units (GU) rather than colony-forming units (CFUs) as PCR defines different properties of the cells. If a negative result of your sample is obtained using the PCR method then you will always get a negative result for the culture method. FURTHER INFORMATION Tel: 01709 777309



Providers of fire safety Diamond: integrated fire services throughout the UK and security solutions Top of most wishlists when choosing a fire safety consultant is that it has significant years of experience of working in the healthcare and residential care home sectors, and is one of a handful of independent healthcare specialists in the country. These have involved some of the largest PFI projects in the country as well as existing premises with large refurbishment projects. This has included representing NHS Trusts on projects as well as working direct for the architects, design teams and construction businesses. Giving a service to the development of conceptual hospital designs and/or care facilities through to ongoing fire safety management services in and for NHS Trusts. The design philosophies within the healthcare sector continues

to develop rapidly as new technologies and medical advances occur. By applying innovative holistic design approaches, Thomson Fire Consultancy can enable Trusts to adequately respond to the modern changes whilst maintaining the functional operational requirements of the facilities required. Individual fire safety challenge is addressed to allow the building to function safely whilst meeting the architectural, operational and financial constraints. Thomson Fire Consultancy offers and delivers on a wide range of all fire safety aspects within healthcare premises. How may Thomson Fire Consultancy help you? FURTHER INFORMATION Tel: 01799 514900

Diamond Electronic Systems, established in 1987, provides design, installation, commissioning and maintenance of electronic fire and security systems. Diamond Systems is one of only a handful of NSI Gold approved companies for both fire and security systems in Northern Ireland, and is also BAFE approved. Diamond is a systems house, providing a complete range of services and solutions around your requirements, without being limited to a particular range or supplier. The company’s industry knowledge and experience will ensure your system – irrespective of size or complexity – is an effective, compliant solution. Diamond Systems is a Siemens Cerberus Pro Solution Partner and products comply with applicable European standards and are covered under warranty.

Diamond Systems offers the broadest range of alternatives to offer customers the optimum solution in order to meet budgets and requirements: from audible-only intruder systems to large networked building management systems, analogue to IP cameras, conventional fire systems to intelligent addressable systems, wireless devices to more traditional cabled options – the scope is endless. The services Diamond Systems offers are: intruder detection, access control, CCTV, integrated building solutions, IP-nurse call solutions, fire detection and alarm systems, intelligent extinguishing solutions, and intelligent emergency lighting. FURTHER INFORMATION Tel: 028 9020 7207



Parking enforcement systems from ZatPark

For those in the healthcare sector, Saturn cares about the people who care

ZatPark from Unity Five provides cutting-edge parking notice back office technology and cost-effective on-street solutions. The system offers innovative tools to allow sensitive management of parking resources, with inbuilt appeals handling, automated letter generation and full integration to online payment solutions and on-street cashless payment systems. With optional integration to third-party providers, offering final stage recovery services. ZatPark provides market-leading functionality, this has resulted in over three years’ development work to be able to offer on-street software utilising Apple iOS or Android-based mobile hardware.

This enables customers to benefit from low costs when rolling out on-street devices, which could allow technology to be deployed at a ratio of 3:1 compared to other solutions. The choice of hardware is extensive and includes rugged waterproof devices from leading manufactures, if required. Existing clients include the NHS and ZatPark is experienced in its support of the unique challenges hospital parking presents. Contact ZatPark to discuss how its systems can help you with your own challenges. FURTHER INFORMATION Tel: 033 3344 0834

Founded in 1991, Saturn Sales & Services has specialised in the care, assisted care and healthcare sectors. Its core products include NurseCall, WardenCall, fire systems, staff security, access control, door entry and CCTV, all backed-up by a 24-hr maintenance and service provision. Based in Somerset, Saturn has completed assignments throughout the UK. These include new builds and upgrades for existing establishments, whereby the company provides a full design, supply, installation and commissioning service, or part thereof. In-house CAD design experts will provide detailed drawings, to assist when you adopt the supply and commission route. For your convenience, see Saturn Sales & Services’ website for its online shop.

Products & Services


For fire alarm systems, Saturn is BAFE-registered (SP203-1) and approved providers for the full range of Hochiki detection with advanced electronics fire panels. Adopting an ‘open protocol’ policy ensures the client the optimum maintenance support flexibility. Communication and staff safety are paramount. Saturn is a national distributor for the ‘Guardian’ range, which conveniently interfaces with the ‘InterCall’ NurseCall system. Finally, Saturn encompasses a varied range of access control systems from a simple keypad to fully networked proximity and biometric systems. Door entry and CCTV are also available. FURTHER INFORMATION Tel: 0844 846 8335



Products & Services



Demma’s iNergy software Reliable maintenance can help you control support for your gas essential energy remotely generation system Demma is an independent systems house that offers the design, installation, commissioning and maintenance of building energy management systems from various manufacturers. Based in three regional offices, Demma offers national coverage and its experienced teams of engineers can support many systems, including: Trend, Honeywell, Cylon and Johnsons. The company’s unique software package Integrator and Energy Performance (iNergy) can integrate many systems and, with the built-in performance and energy aspects, is an invaluable feature for large property portfolios, such as local authority schools, libraries and other government properties. This internet-based software enables premise managers the ability to have a simple traffic light indication of the energy performance and HVAC efficiency within their

buildings. It is essential to ‘fine-tune’ your BMS on a regular basis. Demma is committed to energy services work with many clients to help them control their energy use, and has extensive knowledge of large public buildings. Demma works with a number of partners and is able to offer submetering, water and air hygiene services, energy-efficient pumping

solutions, and supply and install variable speed drives and lighting. Contact energy services manager Brian Rollason for further details. FURTHER INFORMATION Tel: 08709 222300/07872 455688

Clarke Energy provides, engineers, installs and maintains combined heat and power (CHP) plants that operate on gas. The company is an authorised distributor and service partner for GE’s Gas Engine Business. Clarke Energy provides added value to the customer by acting as single point of contact from initial sale, project management, engineering, and installation, through to commissioning and long-term, reliable maintenance of your gas engine combined heat and power plant. The company has operations in 12 countries across the globe, and is a specialist in combined heat and power-using gas engines. It has significant experience in a wide range of different renewable and high-efficiency gas-to-power applications, including natural gas, biogas, landfill gas and coal gases.

Clarke Energy has worked on a range of high-profile public sector combined heat and power installations, including Guy’s and St Thomas’ NHS Foundation Trust, Great Ormond Street Hospital, Christie’s, Broad Green University Hospital and Freeman’s Hospital. Cogeneration (CHP) plants are of high interest within the healthcare sector, securing reliable power and heat for hospital facilities. FURTHER INFORMATION Tel: 0151 546 4446



Solar PV giving power to the people

DWJ ColourPrint for presentation folders and conference packs

Paul Bevis, managing director of Rentec, says: “I believe we, the building services sector, are in the enviable position of being able to make changes that really can make a difference – perhaps even the difference.” Despite the economic downturn, demand for renewables is as strong as ever, driven by increasing legislation as well as the need to reduce both energy costs and fossil fuel consumption. “Solar PV is an extremely popular low-carbon option,” says Paul. “We are getting enquiries from businesses, schools and farmers as people realise the massive benefits of renewables and the Feed-in Tariff scheme.” This scheme guarantees a minimum payment for all electricity generated by the system, as well as a separate payment for the electricity exported to the



grid, whilst providing a large reduction in electricity bills. Rentec can offer assistance with finance and a free solar scheme is available (subject to status). Rentec can also offer advice on other renewable options, including solar thermal, ground and air source heat pumps, rainwater harvesting, biomass boilers, wind turbines and low-energy lighting. Rentec’s renewables team is ready to offer professional, honest advice. FURTHER INFORMATION Tel: 01202 717060


Pocket folders are a great way to professionally promote your brand image and communicate your key message statements, while providing flexibility of content for different events. Perfect for exhibitions, conference packs and training resources. DWJ ColourPrint is an established public sector supplier of highquality custom presentation folders and their service is fully ISO and FSC accredited, with all folders printed sustainably using FSC-certified stock. DWJ has invested thousands of pounds to create the UK’s largest range of standard folder cutting dies, in the broadest range of styles, to save you money. These are all available with free downloadable design templates, just visit the website If you are looking for inspiration, simply browse the range of folder styles and images, then request a

free sample pack or call the sales team for advice. DWJ ColourPrint offers free shipping to mainland UK, reduced rate graphic design services and instant credit account facilities, with invoice billing for all public sector clients. Contact DWJ ColourPrint to request a sample pack. Quote the special Health Business magazine readers’ discount code ‘HBM5’ today to receive a five per cent discount on your first order. FURTHER INFORMATION Tel: 01792 704880



Digital solutions: designed, Yescando: delivering developed and delivered information effectively Pixelbuilders is a client-focused, award-winning digital agency. Since early 2008, the company has been helping health-focused organisations to embrace the web in a way they and their audiences love. The company’s client list has grown, and so has the team, but its ambitions remain the same. Pixelbuilders continues to offer a full range of digital services, including website design, bespoke web-systems development, responsive builds, digital marketing and hosting. It prides itself on being proactive, insight-driven and always delivering on time and to budget. Pixelbuilders understands the need to balance the demand for information governance with usability and fundraising-focused objectives. It has delivered web projects for the NHS, Wakefield Hospice, and the charity Brain Tumour Research and Support in Yorkshire. Developing in ASP.NET,

its website projects are secure, accessible and user-focused. If you’re going to invest in Pixelbuilders’ services, it wants customers to feel secure in the knowledge that it’s with you for the long-run. That’s why its solid financial foundations underpin everything it does as a business. With the company’s tried and tested approach of ‘Discover, Design, Develop and Deliver’, you can be comfortable in the knowledge that the solution you want will look great, work perfectly and generate tangible, real-world results. FURTHER INFORMATION Tel: 0113 2473 895

Your customers turn to the internet first to find out more about what they can expect when they visit. Where are you? When can I come? How do I book? These are possibly the most commonly asked questions, but an up-to-date, fully managed website gives you the opportunity to answer questions before they’re asked as well, such as who will I be seeing? Is there a car park? What is your policy on…? Yescando provides a full website service and makes it very easy for you to deliver the information that your clients need. Firstly, the company creates the perfect website for you – it’s not a ‘one-size-fits-all’ approach. Yescando listens to you and suggests the best solution. Then, it maintains and updates the website for you. Yescando

does not expect its customers to learn how to be technical wizards, just send the company an email and the team of Hampshire-based technical consultants take care of the rest. Yescando guarantees to make the changes within two working days, meaning that your website need never be out of date. Over 300 organisations of all types already know that the company’s answer is always ‘Yescando’, so get in touch to find out more. FURTHER INFORMATION Tel: 02392 373235



CIMScan for elegant and affordable continuous monitoring solutions

Care Monitoring 2000: award-winning solutions for the homecare sector

If planning a new continuous monitoring system or an expansion, you should be considering CIMScan as your number one choice. Indeed, CIMScan’s benefits, such as total cost of ownership, redundancy, scalability and ease of management, outperform other available offerings. CIMScan offers highly scalable and cost-effective systems from small to many thousands of monitoring points, using a long list of the latest off-the-shelf wireless sensor technologies and wired sensors. Alerts are sent by email, text, pager, or voice calls on the telephone. Log on using a web browser or smartphone; all monitoring points requiring attention are immediately visible. ‘Trend charts’ show you recent history to help determine how to react to any situation.

CM2000 provides electronic monitoring, scheduling and financial management solutions. The award-winning systems are proven to bring significant cashable savings and efficiencies, as well as increased quality and safeguarding of the working staff and service users. Over the last 12 years, CM2000 has grown with the adult social care market, helping 93 local authorities and primary care trusts all over the UK harness technology to manage challenges facing the sector. Care Monitoring 2000’s patented, electronic monitoring service CallConfirmLive! provides accurate, electronic timesheets with up-tothe minute care visit data via the internet – 24 hours a day, 365 days a year. Its portfolio of innovative technological solutions to deliver cost reductions and business efficiencies include Opticare Inside: a next-generation optimisation

If the CIMScan standard reports don’t meet your needs, use Microsoft Reporting Services to generate custom reports easily within the system. CIMScan’s general architecture is straightforward and easily understood. Physical installation of the hardware and its maintenance is handled by typical hospital maintenance departments or clinical engineering groups, meaning expansion or redistribution of monitoring is no longer a prohibitively expensive exercise. FURTHER INFORMATION Tel: 0844 334 0115

Products & Services


tool for care scheduling. Care Monitoring 2000 has a suite of transformation tools to help its customers meet the challenges of the personalisation agenda. Care Monitoring 2000 is proud to be approved on both PRO5 frameworks (previously known as ESPO) for electronic monitoring and electronic scheduling to ensure quality care. The company can help with homecare monitoring, saving money and enhancing the experience for vulnerable service users and lone workers. FURTHER INFORMATION Tel: 0121 308 3010



Products & Services




Legionella Consultancy Services tackles all issues relating to water hygiene

EcoHydra for germ-killing hand-hygiene solutions

Established in 2009, Legionella Consultancy Services (LCS) specialises in water management specific to legionella in water systems, relating to prevention and control. LCS’s services are classified in business streams: consultancy – risk assessments and independent advice on legal issues relating to legionella; control – water hygiene monitoring programmes and the main distributor of the Electronic Legionella Risk Management; compliance – water system upgrades and associated works; competency – legionella awareness training and site-specific guidance and training; water management – products and services to reduce the consumption of energy and maintenance costs. In recent years, the company’s

work has been more focused on providing advice and services specific to the needs of individual business sectors with a view on tackling the challenges that each company faces relative to this. LCS’s sectors of expertise are care and nursing homes, schools/ colleges/universities/nurseries, hotels and leisure. LCS has a product that replaces water softeners, saving you pounds. The company provides advice for the long-term benefit of its clients by assessing the benefits of preventing legionella altogether rather than just trying to control it, as in valued engineering. FURTHER INFORMATION Tel: 01827 259346


EcoHydra is the home of a new a generation of skincare. The company prides itself on its highly effective alcoholfree formulas which are kind to the skin whilst providing superior germ-killing results. Developed to the highest standards for use in demanding clinical, healthcare and hygienereliant environments in which infection prevention is of the upmost importance, the antimicrobial range of alcohol-free hand sanitiser complemented by Triclosan-free handwash, barrier cream and hand lotion provides a complete solution to hand hygiene, and encourages better hand hygiene compliance. Current alcohol-based hand hygiene products are less efficient in use and typically less costeffective compared to EcoHydra’s range. The inclusion of moisturising agents in EcoHydra’s products encourages regular use by nourishing and moisturising the

skin rather than causing irritation and dryness – a huge benefit for those needing to wash their hands frequently on a daily basis. Without the need for water, the EcoHydra Alcohol-free Foaming Hand Sanitiser kills up to 99.9999 per cent of common bacteria, quickly and safely with no sticky residue, and is effective against viruses including Norovirus. The company’s non-toxic, non-alcohol formulas are safe and suitable for everyone, including children, and are already trusted around the world in hospitals, schools and homes. FURTHER INFORMATION Tel: 0116 2870655/ 07974 964038


Promoting the highest An effective treatment for standards in management depression where traditional and leadership excellence medication has failed The Chartered Management Institute (CMI) is the only Chartered professional body in the UK dedicated to promoting the highest standards of management and leadership excellence. The organisation has over 60 years’ experience championing good management and helping businesses transform their workforces and organisational performance through management and leadership development. As a membership organisation, CMI has been providing practical support and advice to individuals and businesses for decades. It continues to give managers and leaders the tools they need to improve their performance and make an impact. As the only organisation to offer qualifications from Level 2 (GCSE) to Level 8 (PhD), CMI is committed


to equipping individuals with the skills they need to be exceptional managers and leaders. Qualifications and accreditations such as Chartered Manager, combined with products like CMI’s Continuous Professional Development scheme and the online support resource ManagementDirect, support the development of management and leadership excellence across the UK. Through research and policy surveys of its 90,000 individual and 450 corporate members, CMI maintains its position as the premier authority on key management and leadership issues. FURTHER INFORMATION Tel: 01536 207404 employer.engagement@


In many cases, patients suffering from major depression obtain inadequate relief from antidepressant medication. As a result, alternative or adjunctive therapies are needed and, in this context, Repetitive Transcranial Magnetic Stimulation (rTMS) has been shown to be an effective, yet non-invasive treatment for depression. As the pioneer of Transcranial Magnetic Stimulation, Magstim is industry recognised as world leaders in diagnostic, research and therapy solutions. Magstim Rapid Therapy offers patients a new and effective treatment for drugresistant depression, which is revolutionising the field of clinical psychiatry. By producing a complete clinical solution without the systemic adverse effects associated with medications, the Magstim Rapid Therapy treatment has

no adverse cognitive effects. The evidence for the clinical efficacy of TMS in treating major depression spans more than 30 randomised, controlled trials in over 2,000 patients worldwide. As a result of thorough usability research, Magstim has developed a complete TMS package to address the needs

of the clinician and ensure comfort for the patient. As a pioneer in the field of TMS, Magstim systems is able to provide consistent and effective therapy for a variety of protocols. FURTHER INFORMATION Tel: 01994 240798



DHL: logistics services for the healthcare industry

Introducing the ‘Claire’ biological safety cabinet

DHL Supply Chain’s Healthcare Division is committed to supporting healthcare providers and the NHS to get maximum efficiency from their supply chains. Working in partnership with hospitals and health services, DHL has developed a range of customised services that drive increased efficiency and lower cost, achieve greater return on investment and enable improved clinical care and governance. Managed inventory services: DHL manages and tracks all consumables, medical devices, fluids and medicines to enable visibility of stock levels, stock location and stock expiry dates. This helps reduce waste and unlock cost-savings, making sure the right product is available at the right time in the right place. On-site services: DHL Supply Chain receives, checks and replenishes inventories within

Berner International GmbH’s new ‘Claire’ Class II Microbiological Safety Cabinets are intuitive to use, ergonomically friendly and, most importantly, designed with impressive and innovative new safety features. A proud winner at the 2013 Red Dot Design Awards, Claire represents the leading edge of cabinet technology. Prevention of unwanted occurrences is the underlying principle behind safety protection systems; in this regard Claire sets new benchmarks. Berner’s rigorous research and development programme continues to ensure its cabinets are the highest performing brand available, offering the widest airflow safety margins, as shown in performance envelope testing. As leaders in safety cabinet design development, Berner has members or advisors in several relevant standards committees and working groups.

hospital wards to improve efficiencies and creates value by reducing waste, freeing up space, creating better organised stock-keeping areas and releasing clinical staff to focus on patient care. Patient transport: DHL provides non-emergency patient transport services with the highest level of patient care based upon medical need. Our drivers, co-ordinators and managers are recruited to meet the needs of the patients and hospitals, providing an efficient and caring service. For more details on DHL’s specialist healthcare services, contact Richard Dunn.


Claire’s sensor technology offers you the first safety cabinet to be aware of your presence: able to alert users to any potentially unsafe movement past its working area, also to engage standby mode automatically if required. Claire’s LED lighting, high-quality EC fans, choice of four modes of operation and auto on/off functions mean that, compared with rival manufacturers’ models, the overall cost of ownership over its lifetime is significantly reduced. FURTHER INFORMATION Tel: 0844 334 0115



Benefit from geographic information to help improve patient care

Improving efficiency in healthcare through smart document management

Geographic information is a key component to providing integrated, timely, and coordinated health services across the UK. Understanding key questions (such as where your patients are based, what services are available nearby, are there any gaps in service, and what the transport network is like) can all enable evidence-based care decisions to be made. Combined with other statistical information, up-to-date geographic information is a powerful tool in supporting the delivery of improved healthcare services. Snowflake Software’s GO Loader tool enables you to access all this information by loading geographical data into your Oracle, SQL Server or PostGIS database without any costly custom engineering.

The NHS is facing an increasing number of challenges regarding the management of patient files and medical records, including increasing file management costs, requirements to be compliant with guidelines and legislation, the importance of maintaining patient confidentiality, and the desire to move from paper-intensive to paper-light. Cintas Document Management works closely with its healthcare customers to develop partnerships and understand where they are on the journey from paper to paper-light, what challenges they are facing and what solutions it can design to meet customers’ requirements and objectives. Over 60 NHS Trusts trust Cintas to manage their document management requirements, which

With comprehensive support for PSMA and the One Scotland Agreement data products, including OS MasterMap, OS Address Base, OS MasterMap ITN, and OS VectorMap Local, GO Loader helps you model and store geographic data in a manner tailored to your needs. GO Loader can have you loading and using geographic information in just hours rather than weeks or months, enabling you to benefit from your data investment even sooner. FURTHER INFORMATION www.snowflakesoftware. com/health

Products & Services


include: archive and active file storage; scanning, document digitisation and workflow; secure confidential destruction of paper records; and online document and image hosting. Cintas’s services offer cost-effective records management, reduce the risk of patient data loss and improve efficiencies in services.With extensive knowledge in specialist NHS departments, the experience and range of services offered means Cintas can craft a bespoke solution to meet the requirements of your Trust. Cintas has the services to suit your needs and expert consultants to assist you through the process. FURTHER INFORMATION Tel: 0800 328 4242



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Solutions to save you time, money and stress

Significant investment and challenges for the NHS

Essex Marketing has been set up to provide professional marketing assistance to Essex-based business. With extensive online and offline marketing experience, the company focuses on user experience to provide improved conversion for your business. Essex Marketing focuses on utilising the latest technologies when developing websites, providing mobile, tablet and desktop-friendly sites, as well as utilising Web 2.0 technologies for creating rich, interactive experiences for your visitors. By providing a unique Website Management Service devised from the company’s experiences and that of its clients, and customised for each client, Essex Marketing’s Website Management Services ensures you not only get a great website but you also benefit from its marketing knowledge to build an online audience, convert more customers and, most importantly, you know what your website

The NHS has two main objectives: achieve savings of £20bn and improve quality of service to patients. Trusts are focusing on low-cost high-impact solutions. The impact IM&T could have is profound and transformative and will support the efficient management of services resulting in the following projects: information management – provide management information on the Trust’s performance (digital dashboards). Telehealth/telemedicine – the delivery of health-related services and information via telecommunications technologies and mobile devices. The aim is to reduce hospital admissions and realise resulting cost benefits. Electronic patient records (EPR) – NHS Trusts need to have electronic patient records systems in place by April of 2014: (a) e-prescribing – support the medicines use process, enabling medications to be managed electronically; (b) e-ordering; and (c) electronic document management system.

visitors are doing on your site. Essex Marketing keeps you ahead of the competition by providing a service that starts with the planning and development of your website and goes on to provide an understanding of what your website visitors are looking for, how your website is converting and what your competitors are up to. Let Essex Marketing know your vision and it will light the way. FURTHER INFORMATION Tel: 01206 804290

SystmOne – works with EPR by having one integrated record across primary, secondary and social care and with the ability to pull through on-admission medication from the GP record. Improving IT infrastructure – upgrade to a robust infrastructure capable of delivering improved IT services. Microsoft is withdrawing support for Windows XP in 2014 – an estimated 90 per cent of Trusts still rely on XP. Concept Resourcing provides specialists and teams of people to offer support in all projects throughout the NHS. The demand for these people has increased significantly over recent months. FURTHER INFORMATION Tel: 0844 800 6600


The publishers accept no responsibility for errors or omissions in this free service Absolute Property 17 Actaccom 30 Alcontrol Laboratories 56 Alphabet Car Lease 32, 33 Archon Solicitors 24 Arco Medical Infusion 56 Asckey Data Services 40 Aspull Catering Equipment & Services 30 Big Hand 47 C2 IT Commercial Collections 34 Canon 6 Case Monitoring 2000 59 Ccube Solutions 42, 43 Chartered Management 60 Cintas Document Management 61 Clarke Energy 58 Cloud2 44 Co Law 24 Computers Unlimited 38 Concept Resourcing 62 Decorative Panels 26 Defence Systems 48 Demma Services 58 Devon Medical 36 DHL Supply Chain 61 Diamond Electronic Systems 57 DWJ Colour Print 58



Ecohydra Technologies 60 Ecolab 22 ERBE Medical UK 36 ETAC 51 Expand International 26 Face 2 Face Contact 56 FDB 46 Fireserv UK (Midlands) 55 Formica 14 Fraser Fire Alarms 55 GN Electrical 55 Grountel OBC Hologic UK 36 Legionella Consultancy 60 Magstim Co 60 Marmot Resources 20 Medical Gas Services 34 Microtec Cleaning 24 Monodraught 36 Morse Watchmans 10 Multitone Electronics IFC OKI Systems UK 52, 53 Olympus Keymed Group 47 Optical Sciences 61 Parkare 48 Phs Water Logic 26 PHSC 28

Pixel Builders 59 Powerpoint Fire Systems 55 Purity Furniture 4 Ranger Services 24 Rentec 58 Safety Gel 30 Sail Shades Direct 18 Saturn Sales & Services 57 SCC 8 Sidhil 51 Smart Solutions 18 Snowflake Software 61 Soladapt 21 Sovereign Exhibitions & Events IBC Static Systems Group 40 Stephen Provis & Co 62 Telehealth Solutions 12 The Flooring Co (UK) 16 Thomson Fire Consultancy 57 Thornton & Ross 48 UK Debt Recovery 56 Ultima Business Solutions 18 Unity 5 57 WPS 48 Yescando 59 Zilico 34


Groundtel are taking an active role in helping hospitals to improve the external presentation of their sites and working closely to ensure a regular programme of maintenance is matched to available budgets. While achieving the specified service we always aim to minimise disruption caused by site visits and we are particularly conscious of our responsibilities under Health & Safety legislation.

TEL: 01895 832222 e-mail: e-mail: web:

Health Business 13.6  
Health Business 13.6  

The Business Magazine for Health Management