Health Business Volume 9.6 by Public Sector Publishing

Volume 9.6

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Dear Reader, The number of cases of swine flu in England is on the up again, and Britain is the worst hit nation in Europe. The number of deaths of people with swine flu stands at 85 in Britain, with 72 in England, 10 in Scotland, two in Northern Ireland and one in Wales. There is, however, good news about vaccination. The first batches of Pandemrix vaccine are expected to be available this month, and approximately 50 million doses are expected by the end of the year, with more following after that. The European Commission has also approved a Swiss vaccine and the London-based European Medicines Agency has recommended that the European Commission give the green light for the Celvapan vaccine. With the NHS under financial strain as it is, one does wonder how much this mass-vaccination will cost. And as neither the manufacturers of the three vaccines nor the Department of Health are disclosing any figures, your guess is as good as mine! Enjoy the issue.

Sofie Lidefjard, Editor

HEALTH BUSINESS MAGAZINE ONLINE If you would like to receive six issues of Health Business magazine for £45 a year, please contact Public Sector Publishing, 226 High Road, Loughton, Essex IG10 1ET. Tel: 020 8532 0055, Fax: 020 8532 0066, or visit the Health Business website at: P NEWS P FEATURES P PROFILES P CASE STUDIES P EVENTS P AND MORE

8 www.healthbusinessuk.com HEALTH BUSINESS MAGAZINE PUBLISHED BY PUBLIC SECTOR PUBLISHING LTD 226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Editor Sofie Lidefjard Assistant Editor Angela Pisanu Production Editor Karl O’Sullivan Production DESIGN Jacqueline Grist Production CONTROL Julie White

MEMBER OF THE PERIODICAL PUBLISHERS ASSOCIATION

Advertisement Sales David Morgan, Karen Hopps, Marina Grant, Jasmina Zaveri, David Moore Sales Administration Jackie Carnochan, Martine Carnochan Administration Charlotte Casey, Victoria Leftwich Publisher Benita Lester Group Publisher Barry Doyle Reproduction & Print Argent Media

© 2009 Public Sector Publishing Limited. No part of this publication can be reproduced, stored in a retrieval system or transmitted in any form or by any other means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publisher. Whilst every care has been taken to ensure the accuracy of the editorial content the publisher cannot be held responsible for errors or omissions. The views expressed are not necessarily those of the publisher. ISSN 1362 - 2541 The Business Magazine for Health Management

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Health Business | Volume 9.6

Contents HEALTH BUSINESS VOLUME 9.6

5 NEWS 11 HEALTH BUSINESS AWARDS A preview of the third annual Health Business Awards, taking place at Arsenal’s Emirates Stadium

13 PATIENT SAFETY The AfPP reports on the Safer Surgery Checklist and the Patient Safety First campaign Melinda Lyons discusses the risks that occur from human factors

25 SECURITY Control of access should be a concern for all NHS managers, according to the National Association for Healthcare Security

35 FIRE SAFETY The Fire Industry Association discusses how to prevent and manage false alarms in a hospital setting

43 SUSTAINABILITY By acting as Good Corporate Citizens, the NHS can reduce its carbon output as well as achieving a wide range of other benefits

51 CLINICAL WASTE The Environment Agency discusses how clinical waste should be disposed of safely

55 FACILITIES MANAGEMENT The Healthcare Facilities Consortium looks at how we can work towards maintaining clean and effective facilities for healthcare delivery in an environment of reducing budgets

61 SIGNS What’s the best way to implement a clear and consistent wayfinding and signing strategy?

67 SKILLS & TRAINING Skills for Health explains the importance of workforce transformation A look at the London Strategic Health Authority’s Wellness Strategy

77 LEGIONELLA CONTROL The HSE discusses what organisations need to know about legionella prevention

83 CATERING

working to improve patient nutrition Find out how the health and wellbeing of hospital workers across Merseyside and Cheshire has been improved The BDA looks at effective menu planning for minority ethnic patients

89 CALL CENTRES Do procedures get in the way of delivering an excellent call centre experience? The CCA investigates

93 INFORMATION TECHNOLOGY Wireless technology can be used in a variety of ways in healthcare delivery, as described by BCS – The Chartered Institute for IT

97 EMERGENCY SERVICES The challenging and complex nature of today’s emergencies will be highlighted at The Emergency Services Show, 24-25 November

103 CONFERENCES & EVENTS Telford and Shropshire have a range of interesting venues, with many boasting green credentials

This year’s Hospital Caterers Association conference called for greater partnership

Health Business online - www.healthbusinessuk.com

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NEWS

£86,500 government funding for cancer charity

he government has given £86,500 to the charity My New Hair which helps cancer survivors, hairdressers and NHS staff work together during hair re-growth following treatment. Founded by celebrity hairdresser Trevor Sorbie, My New Hair focuses on training for hairdressers to help them understand the needs of cancer survivors and their hair at this difficult time. It also provides advice and information for patients and NHS staff on wig styling, hair loss and re-growth. The £86,500 grant from the Department of

Health will provide advanced nurse-led ‘after care’ skills training for hairdressers focussing on hair re-growth and communicating with patients, and a comprehensive education resource for hair professionals to support the education programme to help them provide precare and aftercare services for cancer patients. There will also be a booklet made for patients and healthcare professionals with information on hair loss, wig services and hair re-growth. It will also deal with the psychological implications and sensitivity issues surrounding wig styling for cancer patients.

NHS SBS wins 17 new NHS contracts since April HS Shared Business Services (NHS SBS) has announced a further eight new contract wins with NHS organisations, totalling 17 new customers since April 2009. NHS SBS now supports nearly 30 per cent of all NHS organisations, enabling NHS Trusts to save money through operational efficiencies and improved service quality. It provides back office services to more than 120 NHS Trusts and aims to increase this further by expanding core services to deliver real added value – improved financial control, management information, better reporting and benchmarking. John Neilson, managing director of NHS SBS,

said: “We have worked very hard this year to make sure all our clients have great service, value for money and better management information. Our overall ambition is to deliver even more savings for NHS Trusts and we are on target to put back around €268 million (£250m) over 10 years, which could pay for more than 12,000 extra nurses.” NHS Shared Business Services is a unique joint venture between the Department of Health and Steria, and leads the way in developing and providing finance & accounting, payroll, e-procurement and family health services to all types of NHS organisations.

Percy the Smokefree Penguin visits Burnley ercy the Smokefree Penguin recently visited Burnley to encourage smokers to quit after it was revealed that three people in the town are killed every week by smoking. On average, 178 people die each year in Burnley as a direct result of smoking. However smokers are far more likely to successfully quit with free NHS support, and last year 2,818 people became smokefree with help from East Lancashire PCT Stop Smoking Service. Percy visited Burnley with staff from Smokefree North West to talk to shoppers and direct smokers to free NHS help so they can quit for good. Percy is touring 25 shopping centres across the region. The roadshow is part of a new television advertising campaign called ‘One Way Street’ which features Percy

the Smokefree Penguin. Smoking costs the NHS in the region an estimated £194 million per year and the North West has some of the highest rates in England for deaths from heart disease, stroke, cancer and smoking related illnesses. It is hoped that hitting the streets to speak to smokers through Percy the Smokefree Penguin and the One Way Street campaign will help drive more people to seek the free NHS support they need to quit smoking. Andrea Crossfield, director of Smokefree Northwest, said: “Through the One Way Street campaign, we are going directly out into town centres with Percy the Penguin to talk to smokers face to face about how they can quit smoking. You are never on your own and it is much easier to quit with professional NHS support.”

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NEWSINBRIEF Workshops provide knowledge on ‘lean’ management issues The Institute of Healthcare Management and Amnis are working together to provide five workshops on key healthcare issues. Beginning with ‘Service Improvement & Lean for Managers and Executives’ (in London, 27 October), the series continues with ‘Developing a Culture of Continuous Improvement’ (Birmingham, 17 November); ‘Problem Solving Tools for Service Improvement & Innovation’ (London, 1 December); ‘Sustaining Lean’ (Birmingham, 19 January 2010), and concludes with ‘Thinking Strategically’ (Birmingham, 9 February). The IHM’s Phil Slinger commented: “Our members abide by the Healthcare Management Code, which requires managers to keep their skills and competences up to date and so we are delighted to be able to add these five workshops to our portfolio of continuous professional development (CPD) resources.”

Student becomes the UK’s first deaf male nurse A student from the University of Salford has become the first deaf male nurse to enter the nursing register using British Sign Language as his first language. Andrew Maxim graduated with a Diploma in Mental Health Nursing, making him only the tenth deaf nursing graduate nationally. He has been offered a role as a staff nurse at the National Centre for Mental Health and Deafness at Prestwich Hospital.

Charity calls for medical professionals to refer more children Make-A-Wish Foundation® UK is looking to increase the number of wishes it grants each year. Throughout 2008, Make-AWish granted a record 961 magical wishes to children and young people fighting life-threatening illnesses and is aiming to grant 1,000 a year by 2010. Anyone can refer a child – a health professional or social worker, the child’s parents or their teacher. A child can even put themselves forward for a wish. Make-A-Wish asks medical and health professionals working with children to encourage referrals by suggesting they may enjoy a special treat. According to figures commissioned by Make-A-Wish, there are some 20,000 children in the UK at any one time with a life-threatening illness. Referral forms are available through the website, www.make-a-wish.org. uk , by calling 01276 40 50 60 or by emailing info@ make-a-wish.org.uk.

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NEWS

Patients at risk from working time limits

ince the introduction of European Working Time Regulation in August, surgeons across the country say the 48-hour limit on the working week has left hospitals overstretched, which ultimately jeopardises patients’ lives. A survey from The Royal College of Surgeons of England suggests patients are at increased risk of dying as a direct result of more shift changeovers and rotas that leave no time available to handover. According to the survey, 62 per cent of surgeons said they were not complying with a 48-hour week and half of consultants said compliance with the

European regulation had been achieved at the expense of patient safety. John Black, President of the Royal College of Surgeons said: “Throughout this affair the call from the Department of Health has been that this legislation is about making patients safer. We now have a clear message from the frontline that patient care is being made significantly less safe through systems that lead to poor continuity of care, the loss of teams and ‘wildcat’ closure of services.” The Department of Health said it had received no evidence that the directive was not working.

Online rating helps patients make correct choices atients can now rate and compare GP practices on a new online comparison service launched by Health Minister Mike O’Brien. The government recently announced that it is opening up more choice for patients as they will soon be able to register with a GP practice of their choice. This new tool will give patients all the information they need to decide which of England’s 8,300 practices is right for them. Similar to the hospital comparison service, the tool will make it easier to find information

in one place, such as opening times and additional facilities. Patients will also be able to read other people’s comments about services, such as how well patients are treated by staff. Health Minister Mike O’Brien said: “This new tool allows every single GP practice in the country to see the patient’s view on what they are doing well and what needs to be improved. It will help drive up quality across the board, and is another step in ensuring we have a modern NHS which reflects the needs of the patient.”

New ERIC data services for NHS in Scotland range of data collection services developed for NHS estates are now available in Scotland. Topscan has opened offices at Lochside, close to Edinburgh airport and is currently looking for pilot projects in the region. If you need accurate floor plans, and could benefit from departmental occupancy and space utilisation data then Topscan is currently offering subsidised terms right now, whilst building reference sites to establish their presence in the Scottish market. Topscan has worked with the NHS and universities throughout England and Wales for the last 15 years, building a reputation as the leading supplier of building based records management services including, site surveys and creation of accurate CAD floor plans together with room and usage data collection. Alisdair Lamplugh, Topscan director said: “We believe that there are real opportunities for businesses prepared to invest in Scotland and build a local

Sean Cooney

team.” As a first step, Topscan has been joined by Sean Cooney as project manager based in Edinburgh. Sean was previously CAD manager for a firm of building consultants, based in Central Scotland, and brings with him a wealth of experience gained over the last decade. To find out more, have a look at www.topscan.co.uk or call Alisdair on 0131 452 2042.

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NEWSINBRIEF PM calls for a change in attitudes to mental illness The Prime Minister has called for a “fresh openness” to mental illness across society, in a message to mark this year’s World Mental Health Day, which took place 10 October. He said: “As a government we are transforming the way in which the NHS sees and treats those with mental health issues with a five year plan to offer everyone who needs it, access to talking therapies and counselling. “However, whilst the NHS can do its part we also need a change in attitudes and a fresh openness to recognise mental health issues across our society. The day when anyone with mental illness can live free of the fear of stigma is coming but it is the responsibility of all of us to bring that day about as quickly as possible.”

Liverpool improves patient entertainment Liverpool Women’s NHS Foundation Trust is deploying a new entertainment solution to systems at patient bedsides that also enables clinicians to access patient information. The trust has already started to roll-out the solution from Exterity, which uses the hospital’s existing IP network to supply TV and radio channels to its Philips CareServant patient information system. The content can also be streamed to TVs in waiting rooms. By using the trust’s IP network, the Exterity solution avoids the need for a separate analogue TV cabling system. It captures the TV and radio channels from an aerial and then transmits them into the hospital network as standard, easily managed MPEG streams.

New two-way wireless nurse call system launched The new Aid Call Touchsafe® Nurse Call bedhead devices use a unique two-way wireless radio technology to ensure that all calls transmitted are successfully received by the central display panels. An acknowledgment that the call has been received is given at the bedside providing reassurance to the caller. The Aid Call Touchsafe® two-way Nurse Call is a professional wireless system, compliant with the EN 300 220 Class1 requirements and designed to provide maximum safety and security. It is the only system to use the dedicated 869MHz alarm frequency. All elements of the device that are likely to be touched or handled are embedded with anti-microbial additives. The display panel has a full alpha-numeric large screen, which can display room/location names, residents’ names so that staff can clearly see who is calling for assistance and can also show the attending nurses identification. It has an on-screen map facility as well and all events are logged to provide audit trail.

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NEWS Leicester selected for pioneering research eicester has been chosen to participate in a groundbreaking international public health research project to address chronic disease. Spearheaded globally by the Oxford Health Alliance (OxHA), Community Interventions for Health (CIH) is being carried out in Leicester by researchers at De Montfort University (DMU). They will be looking at interventions for three risk factors for chronic disease – poor diet, tobacco use and lack of physical activity – and will be collecting data from around 8,000 people to compare with different communities

at other international research sites (Mexico, India, China, and the USA). Overweight and obese individuals cost the NHS approximately £4.2 billion a year to treat, this figure is predicted to more than double by 2050. The NHS Information Centre estimates that smoking accounted for 5.5 per cent of total healthcare expenditure in England in 2005/06. The World Health Organization predicts that in the next 10 years, the UK, India and China will lose $33 billion, $237 billion and $558 billion, respectively, in foregone national income due to heart disease, stroke and diabetes.

Online mental health checker launched n online mental heath checker has been launched by NHS Direct in response to rising numbers of people seeking help for depression and anxiety. NHS Direct’s telephone service has dealt with 37,500 people complaining of stress and mental health problems

in the first six months of the year. This is 5,000 more than the previous 12 months. It works by asking the user a series of questions and depending on the information provided, suggests a number of options, such as to call 999, visit a GP or speak to an NHS Direct nurse.

Financial incentive keeps weight off, study suggests inancial rewards for sustained weight loss could be the key to solving the obesity epidemic, according to the results of a 600 person UK trial. Over six months, the average per person weight loss of all participants who started Weight Wins’ Pounds for Pounds pilot programme was just over a stone, equivalent to 6.5 per cent of the group’s body weight. After 12 months, the average weight loss of all starters rose to 18.2 lbs (8.3 per cent of body weight). Over one in four participants active in the programme after a year achieved an average weight loss of 29 lbs, equal to 13.4 per cent of their start weight. This is more than double the average 5 per cent long term weight loss of members of traditional diet groups. The programme works by

HEALTH INFORMATICS CONGRESS

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The biggest annual combined conference and exhibition of its kind in Europe... HC2010 is an essential diary date for health informaticians, ICT professionals and clinicians. The 27th annual HC Showcase at the ICC Birmingham, will feature new initiatives and opportunities for all those involved in health informatics and social care, to exchange knowledge and expertise: • Exhibition - featuring a host of established exhibitors plus many new companies • Conference - the 2010 theme is ‘Achieving Quality, Innovation and Productivity’, focusing on how informatics supports healthcare • Networking Opportunities - Innovative approach to networking for delegates, suppliers, demonstrators of best practice, international colleagues and strategic leaders of the profession to interact between themselves • High profile speakers - including presentations from clinicians and commercial organisations

participants setting their target weight loss over a chosen period of time. Participants are weighed each month by a health professional at a pharmacy, GP surgery or fitness centre. The health professional signs a form confirming the weight, which is returned to Weight Wins. Participants are rewarded for each pound of weight they lose. Rewards are redeemable as cash or vouchers. Weight Wins believes that incentive programmes such as Pounds for Pounds could save the NHS £1.7 billion in lifetime medical expenses for every one million people taking part.

• Delegates & Visitors - registration opens in January 2010 • Supported by - The Informatics Directorate of the Department for Health, Intellect and ASSIST

Find out how you can get involved in HC2010 at

www.hcshowcase.org For all enquiries contact Citadel Events 01423 526971 H O S T E D B Y:

O R G A N I S E D B Y:

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WorkforCe shorTages gLobaL soLuTIons Hays Healthcare delivers a comprehensive and bespoke recruitment service to solve clients’ skill shortages across global healthcare markets. Building on many years of industry experience, our expert teams deliver an innovative and effective solution, tailored to the strategic demands of your organisation. From the initial advert to response handling, short-listing and recommendation for interview, we provide a complete end-to-end recruitment service, eliminating the administrative burden, which means you keep control of all decision-making. Workforce solutions You will have access to an extensive pool of highly skilled medical professionals to meet emergency, planned day-to-day, short term and longer term cover, including permanent recruitment campaigns for those ‘hard to fill’ roles. We can also harmonise your temporary staffing requirements through a single company, controlling the management, interaction, reporting and invoicing of all your agency suppliers. International recruitment We have created a purpose-built project management methodology – ‘Locate’ – to guide you through the complex international recruitment process, from initial project scoping through to candidate vetting and the arrival and support of new employees.

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Health Business | Volume 9.6

hb awards

The NHS means business December 10th will see NHS organisations from across the country rewarded for their efforts at the third annual Health Business Awards, taking place at Arsenal’s Emirates Stadium Since the establishment of the NHS in 1958, it has become the largest employer in Europe with over 1.3 million staff. It continues to provide a constantly evolving range of services to nearly 60 million people, and represents almost a third of the government’s departmental spending. A year has passed since the publication of Lord Darzi’s review ‘High Quality Care for All’, and already much has changed. Plans are now being examined which will allow clinical teams to manage their own budgets. This aims to promote entrepreneurship, and will help to deliver services that are built around the needs of the patient. Sustained focus Also, a sustained focus on patient safety is delivering results as rates of C. difficile and MRSA have fallen by over a third in the last year. In primary care, GP-led health centres have revolutionised access for patients, providing flexible opening hours that enable people to drop in at lunchtime, after work or even at the weekend. Over 75 per cent of GP practices are now providing extended opening hours, an increase of 25 per cent since September 2008. Plans to abolish practice boundaries will provide further choice for patients. The achievements being made in the NHS are testament to the work of thousands of people. The Health Business Awards is establishing a reputation for showcasing the success stories in the heath sector. The Awards will recognise and celebrate the significant contributions made each year by organisations that work inside and alongside the NHS.

Taking place at Arsenal’s Emirates Stadium on December 10th, the award categories (see panel) incorporate facilities, technology, human resources, hospital management and transport as well as the Outstanding Achievement in Healthcare award, which will be presented to an NHS organisation that has achieved success in their role and brought benefits to the wider NHS through their dedication and expertise. Dr Hilary Jones The Awards are again being presented by Dr Hilary Jones of GMTV, who qualified as medical doctor at the Royal Free Hospital, London in 1976. He then held various positions, including from 1978 the only medical officer on Tristan de Cunha in the South Atlantic. Returning to the UK he became a junior doctor at Basingstoke Hospital, and from 1982 became a full-time Principal General Practitioner in the Basingstoke area. Jones became a GP Trainer in 1987, and still practises part-time. He stated: “When I looked at the achievements of last years winners, I feel more proud then ever of our NHS. Despite being increasingly seen as a TV luvvie, I do still practice as a doctor seeing patients on a one to one basis, and I remain as aware as ever of just what a fantastic job the NHS does for the people of this country.”

FOR MORE INFORMATION For further information on the Health Business Awards, and to enter online, visit www.hbawards.co.uk

Dr Hilary Jones

Awards categories • Hospital Building Award • Hospital Procurement Award • Hospital Cleaning Award • Hospital Security Award • Hospital Catering Award • Air Ambulance Service of the Year • Ambulance Trust of the Year Award • Transport Logistics Award • Healthcare Recruitment Award • Healthcare IT Award • Telehealth Award • NHS Website of the Year • NHS Publicity Campaign Award • Environmental Practice Award • Sustainable Hospital Award • Outstanding Achievement in Healthcare Award

Comprehensive air ambulance services ond is one of the UK’s largest onshore and offshore helicopter operators, providing support to police services, lighthouse services, the oil and gas industry and most recently the renewable energy industry. Central to the onshore activity is the provision of HEMS aircraft. Helicopter air ambulance services commenced in the UK on 1st April 1987. The Cornwall Ambulance Service, in partnership with Bond, flew the first mission, landing on Porthcurnow beach for a student with a spinal injury. Since that day, the UK has seen air ambulances develop in number and capability, now offering comprehensive

coverage for the people of Scotland, England and Wales. Bond alone has flown in excess of 250,000 missions during the 22 years since its first flight, and now operates 17 of the 33 air ambulances across the country.

Since commencing the first air ambulance service using the Eurocopter BO105, Bond has pioneered the introduction of the Eurocopter EC135 T2i aircraft. This helicopter uses the latest technology while still achieving the original principles of speed, dedication and flexibility, carrying two stretchered patients with a team of two clinicians/paramedics flown by an instrumentrated pilot. Bond is pleased to support the Health Business Award for Best Air Ambulance Operation.

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Health Business | Volume 9.6

patient safety

Safety first Patient safety in surgical procedures has rocketed up the healthcare agenda in recent months. The Association for Perioperative Practice (AfPP) reports on the introduction and benefits of the Safer Surgery Checklist and the Patient Safety First (PSF) campaign The World Health Organization (WHO) Safe Surgery Saves Lives initiative began in 2008 and has seen more than 200 national and international medical societies and ministries of health working together to reduce avoidable deaths and complications in surgical care. The National Patient Safety Agency (NPSA) supports the WHO initiative and is working with key organisations representing perioperative professionals – including AfPP – to take forward work in the UK. The scale of the issue is dramatic. 301,368 incidents were reported in England between 1 April and 30 June 2009; representing an increase of 44,626 incidents compared to the previous quarter (256,742 incidents in January to March 2009). 22,180 incidents were reported in Wales between 1 April and 30 June 2009, this is an increase of 8,527 incidents compared to the previous quarter. These incidents vary hugely from incorrect treatment or procedure to misplaced patient notes. Not all of these incidents are serious but some have led to patient harm or death and many could have been prevented. Diane Gilmour, president of the Association for Perioperative Practice, commented: “We want to make surgical safety everyone’s highest priority and include practical suggestions to achieve just that. Our membership represents all those working in operating

theatres and so we particularly welcome the emphasis on encouraging a culture of safety embracing the whole surgical team.” AfPP is strongly supporting the Patient Safety First campaign. This campaign is led by NHS clinicians to help NHS clinicians. Its cause is to ‘make the safety of patients everyone’s highest priority’ aiming for ‘no avoidable death and no avoidable harm’. The campaign has identified a series of ‘interventions’ in healthcare that can improve patient safety. These areas for improvement are: • Leadership for safety • Reducing harm from deterioration • Reducing harm in critical care • Reducing harm in perioperative care • Reducing harm from high-risk medicines The campaign encourages trusts to sign up to its aims by introducing at least two of the above interventions. Surgical Safety Checklist The perioperative ‘intervention’ concentrates on two areas – reducing surgical site infection and the introduction of the WHO Surgical Safety Checklist. The checklist has three main elements – sign in, time out and sign out. Each of these elements contains a simple set of questions for the whole perioperative team that ensures that the whole team knows one another, the patient and the procedure

5 good reasons why practitioners should use the Safer Surgery Checklist

1. The WHO Checklist is a tool to improve perioperative safety for patients. It is expected that by 1 February 2010, as a minimum, the checklist will be used for all surgical interventions in England and Wales. 2. All clinical staff groups report major improvements in the ability to perform their role, the reduction of incidents and improved team working and communication where this has been successfully introduced. 3. Adding briefings before the list starts and de-briefings after the list ends significantly enhances the safety benefits and team performance. 4. The time invested throughout the list on briefing, the WHO checklist elements and de-briefing, should be considered an essential part of professional practice. The universal experience is that more time is saved by improved communication than is spent achieving it. 5. The checklist is not a simple tick box; it is important that teams enter into the ‘spirit’ of the checklist as a tool to achieve cultural change.

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Health Business | Volume 9.6

patient safety

About AfPP The Association for Perioperative Practice (AfPP) is a registered charity working to enhance skills and knowledge within operating departments, associated areas and sterile services departments. It aims to enhance the quality of care in the NHS and the independent sector throughout the UK. AfPP also works to encourage the exchange of professional information between members and co-operation with other professional bodies. These include the Departments of Health in the UK, the Perioperative Care Collaborative, the medical royal colleges, Chief Nursing Officers (CNOs) of all four member countries, Skills for Health and many of the British Safety Institution Committees and other groups set up to discuss specific issues related to perioperative care.

Diane Gilmour, President of te AfPP

that is to be undertaken. The checklist ensures that any complications which might occur are anticipated at the outset. During the sign in part of the checklist the identity of the patient is confirmed as well as the procedure to be undertaken, the body area where the procedure is to be applied and checking that the patient’s consent has been obtained. Other checks are made on areas that might cause a problem such as the patient having airway problems and the potential for blood loss. Before any skin incision, the time out

section of the checklist is used. All the team introduce one another by name and role. The surgeon, the anaesthesia team and the nursing team all report on any critical events they anticipate during the procedure. Finally, before the patient leaves the operating theatre the checklist ensures that all the instruments and swabs have been counted out to ensure they tally with those that were counted in. This reduces the chances of equipment being left in the patient. A review is undertaken of the

equipment and the procedure to ensure that any concerns are logged and action taken. Through the reliable implementation of the Surgical Safety Checklist significant improvements in outcomes for patients as well as a better and more efficient working environment for staff can be realised. All over the world, including in the UK, health care workers are proving that patient safety can be greatly improved and many complications or harm events that were previously considered unavoidable actually are avoidable. They are in fact, redefining what is acceptable in terms of patient safety. The checklist was designed for international use so there may be some items that are already accepted or essential practice in the UK. Therefore local organisations are adapting the checklist to their local context. It is recognised that there may be some rare emergency situations where stopping to use the checklist may not be appropriate. The National Patient Safety Agency (NPSA) has mandated all health trusts in England and Wales to adopt use of the checklist by February 2010.

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FOR MORE INFORMATION infection, no repeat sterilisation costs, reliability and confidence in procedure packs containing all correct items, quick and secure deliveries and

Tel: 0845 3012007 Fax: 0700 606 3377 E-mail: sales@ disposablemedicalinstruments.co.uk Web: www.disposablemedicalintruments.co.uk

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Health Business | Volume 9.6

the importance of natural light Monodraught natural lighting systems deliver real patient benefits for hospitals and healthcare facilities

In the past ten years natural lighting specialist Monodraught has installed its Sunpipes in almost 400 hospitals. In this article managing director Tony Cull examines the health benefits and the equally important cost benefits of natural lighting technologies. The importance of natural light Many scientific studies conducted in the healthcare sector now support the conclusion that natural daylight shortens patient recovery times, improves their mood and generally promotes well being. Results have shown that the health of patients close to windows improves more quickly, and the babies of mothers exposed to higher daylight illumination grow quicker and are released earlier. It is a well known fact that SAD and S-SAD, which are said to affect 20 per cent of the population due to a lack of natural daylight, are known to respond to the hormone serotonin, whose production is triggered by natural daylight. It is accepted that Sunpipes can be a real benefit to the elderly and infirm who suffer most from SAD due to difficulty in getting outside, especially in winter. The ability to pipe in natural light, particularly to areas where it is needed most, will therefore greatly benefit older people. So it’s no surprise that architects involved with hospitals, housing for the elderly and other healthcare buildings are constantly

adjusting and updating their designs to reflect the importance of introducing daylight and, more specifically, natural sunlight. Not only is there increasing evidence of the health benefits, but in this energy conscious time, it is increasingly important to recognise that the increasing use of natural daylight reduces the need for electric lighting, and therefore the energy costs associated with its usage. Innovative solutions Among the most innovative solutions available for the provision of natural lighting is the Monodraught Sunpipe, which is increasingly specified for hospital wards to assist in patient recovery by increasing the awareness of changes in the daylight entering their rooms. Sunpipes achieve a much more effective solution than traditional rooflights because their super reflective tube intensifies and reflects natural daylight to deliver free outdoor light to the wards below. Also, unlike the ‘shaft effect’ experienced with rooflights, the natural daylight from Sunpipes is evenly diffused by a translucent ceiling fixture, usually with less than five per cent light loss from rooftop to diffuser. This compares favourably with a typical rooflight shaft where as much as 50 per cent of the light captured at rooftop level is absorbed by the white painted walls of these shafts, resulting in a relatively narrow

area of natural daylight below ceiling level. Furthermore, the omni-directional Monodraught Sunpipe Diamond domes capture light from all directions, and the resulting diffused light bounces down into the wards or rooms below. To quote an example, a 300mm diameter Sunpipe provides reading-quality diffused light over a three metre distance from the ceiling and to an area of approximately 9 square metres. Besides their proven contribution to patient recovery, Sunpipe natural lighting systems are also a most innovative solution to the problem of our growing energy consumption, since they eliminate the need to use electric lighting during daylight hours. With government committed to reducing energy consumption and CO2 emissions by 20 per cent over the next five years, and the cost of electricity expected to increase by up to 20 per cent, it’s no surprise that natural and sustainable alternatives such as Sunpipes are being specified as an alternative to energy-hungry electric lighting in almost every area of our daily lives. Savings At least 75 per cent of electricity costs used for lighting can be saved during daytime where Sunpipes are used to replace electric lighting during daylight hours. Monodraught estimates that cost savings can result in a 5 to 6 year pay-back period in addition to the considerable health benefits experienced due to the much improved patient environment. As well as the on-going cost savings from their energy-free operation, Sunpipes also require little or no maintenance outside the building, thus saving even more on costs. The unbreakable diamond shaped dome is made of 4mm UV-protected polycarbonate and is designed to ensure that dust and dirt is washed off naturally by rainwater. Internal ceiling diffusers require no maintenance. The Sunpipes’ highly effective sealing system prevents dust, dirt, rain, condensation and heat loss, and the units are guaranteed for 10 years with an expected lifetime of 35 years. The installation and application of Sunpipes is extremely flexible as there is virtually no limit to the length or size of Sunpipe that can be installed. Using a combination of elbows and connections, natural daylight can be reflected horizontally or vertically with an incremental loss of intensity of approximately 3 per cent per metre length. This enables Sunpipes to take light wherever it is required, even into basements. The range of ten different size models is fully supported by the Monodraught design and installation service.

FOR MORE INFORMATION Halifax House, Cressex Business Park High Wycombe, Buckinghamshire HP12 3SE Tel: 01494 897700 Fax: 01494 532465 E-mail: info@monodraught.com Web: www.monodraught.com

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Phoenix – specialised passenger transport

PiedPiper leads the way in pest control

are a long W eestablished, privately

iedPiper Northern Ltd, a respected local company with a proven record in pest control, is a member of the British Pest Control Association and adheres to its strict criteria. Specialist services, using the very latest products are in place to deal quickly, effectively, and humanely with any pest problem, 24 hours a day, seven days a week. PiedPiper’s highly trained technicians know how to avoid the use of toxins in all but the most serious infestations. They are experts in the use of substances only available to a professional company and are familiar with the biology and behavioural habits of rats, mice, fleas, wasps and cockroaches etc. This ensures treatment is applied in an environmentally responsible way. Plus, any legislation associated with particular pests and the criteria to deal with them safely and effectively, will also be fully complied with. A commitment to customer care, full back-up services, and excellent value for money maintains PiedPiper’s

owned, Warwickshire based company providing a caring and professional service. Our aim is to give a careful, understanding, prompt and comfortable service and we have gained a reputation for providing consistently high standards. We do not offer an emergency service. We provide a uniformed and specialised private ambulance service to meet the needs of the private health sector and transport needs of those unable to use other methods. This involves providing vehicles and staff able to transfer stretcher, wheelchair or walking cases. We provide transport for hospital outpatient appointments, moves to and from care, retirement or nursing homes and day outings. Our team pride themselves on achieving the highest standards of passenger care. Our priority at all times is our passengers’ comfort and peace of mind and we aim to give a service that exceeds our clients’ expectations. All posts within Phoenix Private Ambulance

Service are subject to Criminal Records Bureau enhanced checks. Our ambulances are all equipped for non-emergency passenger transfers. They are regularly inspected and maintained to a high standard to comply with the standards for all private hire vehicles.

FOR MORE INFORMATION Tel: 01788 816192 Web: www.phoenix-ambulance.co.uk

position as one of the most trusted pest control providers in the North West. The company also provides a complete range of washroom and hygiene services.

FOR MORE INFORMATION PiedPiper Northern Ltd Tel: 01229 480463 Fax: 01229 480463 E-mail: info@ppnl.co.uk Web: www.ppnl.co.uk

JAAL Consultants Ltd Legionella Management, Control, Audit, Risk Assessment, Training, Development

Providers of Bespoke, Comprehensive Consultancy Services to Owners, Managers Operators and Users of Legionella Susceptible Plant, Services and Equipment. In accordance with: - The Health and Safety at Work Act 1974 - The COSHH Regulations 1999 - The Occupiers Liability Act 1984 - RIDDOR - The Management of Health and Safety at Work Regulations 1999 - The Corporate Manslaughter and Corporate Homicide Act 2007 - The Health and Safety (Offences) Act 2008 And - The Health and Safety Commissions Approved Code of Practice and Guidance, L8 - Department of Health Technical Memorandum 04-01

JAAL Consultants Ltd, 12 Derwent Avenue, Luton, Bedfordshire, LU3 2DX Tel: 01582 707 780 www.jaal.co.uk, info@jaal.co.uk

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Pierson Surgical – Patient preoperative quality surgical products skin preparation ierson Surgical distributes an extensive range of innovative products from major US and European manufacturers, offering a very responsive service to meet the needs of Surgeons and Theatre teams. We have a particular specialisation in Cardiovascular surgery. The products include: Surgical Instruments from Delacroix-Chevalier and Landanger, now available from us through the new nhs supply chain framework agreement – visit www.supplychain. nhs.uk to access the online catalogue. Sutures for every discipline from Péters Surgical, featuring unique material properties for optimal strength, elasticity and suppleness and superior silicon coated needles. Pressure sore prevention – the Rooke® Heel Float System is a triple layer insulating lightweight boot designed to provide optimal insulation and protection to the lower extremities of patients and is excellent for preventing heel pressure ulcers. The world’s only autologous Fibrin

atient’s skin dwelling bacteria are the major source of infections associated with medical and surgical invasive procedures. Normally ‘harmless’, these bacteria live in the top cell layers of the epidermis and can enter the bloodstream whenever the integrity of the skin is breached, for example ‘cannulation’. Whilst hand washing and appropriate environmental cleaning are essential to the prevention of cross-contamination and limiting the spread of the usual suspects – MRSA, C-Diff, and their cousins – the patient and their skin should not be left out of the prevention equation. Blood stream and surgical site infections remain a significant burden to the NHS, patients and their families. The use of all appropriate, evidence based measures to prevent the avoidable infections is paramount. ChloraPrep® is a medicinal product containing a solution of two per cent

Sealant and Platelet Rich Fibrin wound treatment from Vivostat® which uses the patient’s own blood to produce the sealant. A unique Vessel Occlusion Gel , LeGoo™, which forms a gel plug at body temperature and temporarily stents the vessel. Upon completion, LeGoo™ is dissolved by applying ice directly to the vessel. Procedure Packs for Cardiovascular surgery to reduce theatre preparation time and increase costeffectiveness of consumables.

FOR MORE INFORMATION Tel: 01225 766632 Fax: 07092 315510 E-mail: sales@piersonsurgical.com Web: www.piersonsurgical.com

chlorhexidine gluconate (w/v) in 70 per cent isopropyl alcohol (v/v), is a single use, sterile, ‘non-touch’ skin antisepsis system. This allows healthcare practitioners to apply sufficient antiseptic solution with a gentle back and forth motion whilst remaining compliant with ANTT. This use of ChloraPrep has been shown to provide greater skin decontamination, and significant reductions in line related infections than application with a simple swab and weaker antiseptics.

FOR MORE INFORMATION E-mail: jburns@carefusion.com Web: www.chloraprep.co.uk

Davis Associates – user insights for design

Identification wristbands from Brenmoor

ood design requires more than just inspired guesswork; particularly in the health industry where human errors caused by poor design can compromise patient safety. A true understanding of users’ needs, capabilities and limitations is essential. Davis Associates has over 20 years experience in providing ergonomics expertise and eliciting essential user insights to identify opportunities for innovation and inform design decisions. Our evidence-based approach reduces project risk by clearly defining the users’ functional and emotional needs and assessing design concepts against those requirements. To do this, we engage with end users from project conception to implementation and we apply scientific methods, ranging from ethnographic studies to empirical trials. This evidencebased approach saves time and money by clearly defining user requirements, quickly eliminating unsatisfactory design concepts and identifying how others can be further refined. Our team includes qualified ergonomists and designers who

renmoor’s range of hospital wristbands are used in more UK hospitals than any other products. They are the only printable wristbands available from NHS Supply Chain that are made in the UK. The wristbands fully comply with all aspects and requirements of the NPSA safer practice notices concerning patient identification. Brenmoor wristbands are comfortable, durable and economical; printable with barcodes, photo’s and text; available in sizes from newborns to adults; can be fitted with RFID if required; heat sensitive materials and so no need for expensive thermal transfer ribbon; designed

after consultation with hospital staff; resistant to soaps, water, gels, creams and alcohol cleaning fluids. We would be delighted to send out samples, boxes for trial or attend presentation days. Right patient – right care – right choice

FOR MORE INFORMATION Brenmoor Ltd Summit House Riparian Way Cross Hills West Yorkshire BD20 7BW Tel: (+44) 01535 633088 Fax: (+44) 01535 636911

are used to working within multidisciplinary design project teams on projects as diverse as patient service design, medical delivery devices, products and equipment, humancomputer interfaces, information design and interactive systems, wayfinding strategy and workstation design. If you would like to know more about capitalising on user insights to develop effective design solutions, contact us today.

FOR MORE INFORMATION Tel: 01707 663665 E-mail: gary@davis-associates.co.uk Web: www.davis-associates.co.uk

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High quality consultancy Pierson Surgical – services in ergonomics quality surgical products and human factors P ynergy Consultants Ltd specialises in the study of the human performance in complex work situations. This involves the analysis of processes and strategies adopted by highly skilled professional staff when faced with decision-making in fast moving situations. Synergy seeks to ensure that such tasks are designed to exploit human skills whilst taking account of human limitations. Unusual situations, such as equipment breakdowns or unexpected events in highly practised, routine operations, present the most severe challenges to human performance. Coping with such emergencies depends on co-ordinated team activity as well as fluent individual skills. Through their work in dynamic environments where human performance is a paramount factor in ensuring safety and integrity, Synergy has identified three interrelated elements in promoting effective outcomes in the handling of events: Human-machine interfaces must be engineered to

ergonomics standards and should be adaptive to meet action requirements, procedures should be developed from task analyses and designed to reduce any risk of human error, and staff must be effectively trained. Synergy is always keen to exploit the application of their techniques in order to improve the management and application of these crucial work factors in all work places where the safety and wellbeing of the public are an overriding concern.

FOR MORE INFORMATION Tel: 015395 36678 Fax: 015395 36678 E-mail: les.ainsworth@synergy-ergs.com Web: www.synergyergonomics.co.uk

ierson Surgical distributes an extensive range of innovative products from major US and European manufacturers, offering a very responsive service to meet the needs of Surgeons and Theatre teams. We have a particular specialisation in Cardiovascular surgery. The products include: Surgical Instruments from Delacroix-Chevalier and Landanger, now available from us through the new nhs supply chain framework agreement – visit www.supplychain. nhs.uk to access the online catalogue. Sutures for every discipline from Péters Surgical, featuring unique material properties for optimal strength, elasticity and suppleness and superior silicon coated needles. Pressure sore prevention – the Rooke® Heel Float System is a triple layer insulating lightweight boot designed to provide optimal insulation and protection to the lower extremities of patients and is excellent for preventing heel pressure ulcers. The world’s only autologous Fibrin

Optimising the human element

FOR MORE INFORMATION Tel: 01225 766632 Fax: 07092 315510 E-mail: sales@piersonsurgical.com Web: www.piersonsurgical.com

Double your desk space with FlexDesk A combined document holder, writing slope and keyboard store. Clever, neat, simple and highly effective

Desks with curved fronts can often be a nuisance..... A corner desk extender quickly provides a neat, straight working edge, which gives more room for keyboard, screen, paperwork and even When you design user interfaces for some of the most stressful and demanding environments imaginable, your systems have to minimise human error while optimising situational awareness and workload.

a writing slope, if required

BAE Systems Advanced Technology Centre has a wealth of experience in designing user interfaces for the defence and aerospace industry. This experience can be applied to the medical arena in areas such as: -

the design of surgical instruments the ergonomics of operating theatres the assessment of team-working skills and team situational awareness

Back rests For more information, contact Laird Evans: Telephone: +44 (0)117 302 8063 E-mail: laird.evans@baesystems.com

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Health Business | Volume 9.6

patient safety

Human factors in healthcare How can you write a business case for ‘common sense’? asks Melinda Lyons, Lyons Evolution

“A stitch in time saves nine”, “More haste! – less speed!” Many of us will be so familiar with the messages held by such phrases, it would be almost inconceivable to consider a scientific investigation to challenge their validity or measure their impact in a quality improvement exercise. Collectively, they might now be described as ‘common sense’ and worthy of no more attention that a passive acceptance of their usefulness. But by the very fact these phrases arose and have been passed on from generation to generation sends a strong message that they needed to be communicated – that the ‘sense” that they held was not common to all. Safety is a key reason why these messages come back to haunt us. The unexpected incident that could have been prevented through simple rules of thumb will be well known to all of us – whether occurring to us at home in work; or occurring to other people

in the news or even the fictional dramas on television. Such incidents can provide harsh reminders of the ‘uncommonness’ of this sense may motivate many professionals in safety-critical industries towards the application of the scientific models or methods. But where a competing number of patient safety management solutions exist that all appear to be ‘common sense’ – why would the choice be for a solution involving ‘human factors’? THE HUMAN FACTOR ‘Human factors’ is not, as many people perceive, just ‘team-training’ or a sociological exploration of the culture of an organisation. It is not (as may often be associated with human factors’ alternative term ‘ergonomics’) designing comfortable chairs or easy to use pens or mouse-mats. And with this initial misperception of the field’s objectives, the challenges begin. Possibly the title ‘human’ factors signals something familiar and

known, and that every ‘human’ believes they have expertise. But there definition of the scientific discipline is quite specific. HFES 2009 states: “Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data, and other methods to design in order to optimize human well-being and overall system performance.” Human Factors suffers yet another blow when there is the confusion between this and ‘systems thinking’ – to illustrate, I will return yet again to traditional common sense sayings: “For want of a nail the shoe was lost. For want of a shoe the horse was lost. For want of a horse the rider was lost. For want of a rider the battle was lost. For want of a battle the kingdom was lost. And all for the want of a horseshoe nail.” Whilst a common sense reminder of

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Health Business | Volume 9.6

PATIENT SAFETY

the relevance of systemic failures and their impact on the big picture and consequences, it lacks real consideration or insight of the humans in the equation. Were there influences on those supplying the nails that prevented them from delivering a reliable service? Were there influences on those replacing the shoes so that they could not respond by addressing the issue in a timely fashion? Was there a possibility of redesigning the horseshoes to prevent a drastic failure with the loss of one nail? Ultimately, one key question remains: “Why were those planning and managing the battle so heavily reliant on the role of one rider?” Whilst admittedly a tongue-in-cheek illustration, this is not dissimilar from the range of influences that impact upon the people working within and around the healthcare system. HIGH EXPECTATIONS Still, in practice, it is reasonable to question how this analysis of the roles and responsibilities of people would be any different from normal working life – whether clinical, design, management or policy. We may implicitly expect that equipment and workplaces are designed with consideration for human users. We may even expect that the people working in an environment or as part of a professional discipline would have some input into drastic changes impacting on its current or future practice. But these expectations are not significantly different from the same expectations that insist that every patient is treated in a health system that has been designed and managed to reduce the risks of harm to patients and staff – something a patient would expect to be assured. There may a strong belief in the value of these goals and feeling of a moral responsibility to aim for them, but their occurrence in practice may not be as evident throughout the system. From these examples, the obligations to address human factors may be clear - but for chief executives and front-line staff alike, when these obligations compete in priority with all the others; they may easily be lost in a wealth of financial targets, efficiency or more pressing clinical tasks. Without a demonstration of human factors integration within an organisation, it can be difficult for either chief executives or front-line staff to recognise that the extent of the value for all areas can greatly outweigh any initial effort. Few managers would be willing to take this as a leap of fait” without any convincing predictions of a good outcome and so, to jump its first hurdle, the scientific field of human factors must be willing to be scrutinised through the traditional methods of writing a ‘business case’ including specific outcome measures. Part of this effort towards this has fortunately been addressed by the Defence Technology Centres (2006)’s cost-benefit analysis of human factors integration using case studies from a broad range of industries.

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Together with convincing financial information, their report ends with a comment from the Inquiry into the London Ambulance Service, concerning the Computer-Aided Despatch system that “users were not sufficiently involved in the system’s development” – a poignant reminder of the extent of the difference between what may be considered an expensive and time-consuming ‘luxury’ for some and ‘common sense’ for others. SAFETY CONSEQUENCES A business case is not simply about the up-front cost, neither is it purely based on quantitative targets. In many ways, the range of influence of human factors may make them difficult to measure and scientifically demonstrate. Consider the implications of a standardised drugs chart, designed and implemented in accordance with human factors principles. Whilst this may make each visit to the patient for each healthcare professional safer and more efficient; in terms of measurable economic

and safety targets, the time saved would only appear significant when added up for each professional and every patient. And the safety consequences are usually only measured not in terms of profits but in terms of reduced costs. But this would be considering the change implemented only at local level – now consider this concept on a national scale. Firstly, these small time savings and safety improvements would be replicated over a wide area. Secondly, there would be reduced need for induction training. Thirdly, there would be reduced time delays in struggling with “just another new thing” in a new area and reducing the burden on other staff as they stop to point out how their local practice works or correcting the errors on the chart where information has been written wrongly or in the wrong place. Whilst to present a business case for such an idea would be challenging, with benefits such as these, it seems difficult to see any barriers to implementation of such a concept. Yet if design or implementation is done without

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Practical ergonomics advice and training

Human factors support for the health sector

provides practical W orksOut ergonomics advice and training to

uman Engineering is one of the world’s largest human factors consultancies. Established in 1995, we have grown to more than 60 employees, with a global reach as part of the Lloyd’s Register Group of companies. We specialise in bringing the fruits of many years of academic and applied human factors research to address immediate issues, providing practical solutions to problems in an open transparent way. We provide robust reports by using proven and established techniques, with the full participation and co-operation of the end users and our clients. Our staff of professionally qualified psychologists and ergonomists have been at the forefront of integrating human factors in a wide variety of industry sectors, applying techniques such as user-centred design, task analysis, human error assessment, safety culture and organisational integrity. Human Engineering has extensive experience in supporting clients in the healthcare sector. We have recently supported the design of safe, usable

enable the comfortable, efficient and safe design and use of your workplace. We have experience in a wide range of industries, including the NHS; we have helped organisations select suitable equipment, design work areas, undertake risk assessment programmes and reduce risk. Our expertise will help you: • Ensure your staff work comfortably and safely; • Ensure your furniture, equipment and work processes are suitable for your staff; • Reduce any risks of discomfort (backache, RSI etc) through work activities. We can: • Assess work equipment or work areas to identify ergonomics risks and provide appropriate, practical solutions. • Undertake workstation assessments of individuals who experience discomfort

and provide them, and their manager, with practical, prioritised advice. • Assess drivers and their vehicles to help reduce driving discomfort. • Advise on policies and procedures relating to DSE use and other work activities. • Train your staff in ergonomic workplace design, and how to undertake risk assessments (in DSE, manual handling and ergonomics). We run a 5 day Ergonomics Essentials course suitable for health and safety personnel, occupational physiotherapists and manual handling coordinators, enabling them to apply ergonomics in the workplace. WorksOut is an Ergonomics Society Registered Consultancy.

FOR MORE INFORMATION Tel: 0131 343 3144 E-mail: info@worksout.co.uk Web: www.worksout.co.uk

InterAction of Bath for healthcare ergonomics he importance of ergonomics to the health sector is well known. Incorporating ergonomics in the design of medical equipment and systems ensures that they match the abilities and requirements of their users. This includes physical requirements, such as easy handling, and mental ones such as simple, self-evident operation. By systematically analysing the underlying causes, ergonomists can also reduce the frequency and consequences of the human errors that naturally occur during diagnosis, surgery and treatment. InterAction of Bath has an established reputation for delivering clear, practical ergonomics recommendations based on rigorous analysis. We offer consultancy and training across the whole field, including usability analysis, human reliability assessment, manual handling techniques and the new standard ISO60601 on the usability of medical electrical equipment. We can also develop safety cases for new equipment and systems – analysing hazards and

risks as required by Healthcare Failure Modes and Effects Analysis. As well as ergonomics, our knowledge base ranges from physics to industrial psychology. Our commitment to quality underlies our approach. We are certificated to ISO9001:2008 and our quality management system assures the accuracy, clarity and value of our deliverables. We look forward to your call.

FOR MORE INFORMATION Tel: 01225 482 882 E-mail: info@ergonomics.uk.net Web: www.ergonomics.uk.net

medical devices by major suppliers, facilitated the implementation of the WHO checklist in Acute Trusts, and provided strategic advice to national bodies on developing human factors capability in the NHS.

FOR MORE INFORMATION Company Name: Human Engineering Limited Tel: +44 117 962 0888 Fax: +44 117 962 9888 E-mail: info@humaneng.co.uk Web: www.humaneng.co.uk

Human Factors: improving safety performance nvironmental Resources Management (ERM) is a leading global provider of environmental, health & safety, risk and social consulting services. ERM has 137 offices in 39 countries and employs approximately 3,300 staff. ERM has applied its experience in a wide range of industry sectors, such as oil and gas, chemical, transport, construction and mining to bring about performance improvements in the health sector. ERM recently supported the Department of Health to define the process for Root Cause Analysis of health care associated infections and to develop supporting tools for medical staff. Other health experience includes producing guidance for occupational physicians making risk and evidencebased fitness for work decisions; developing a health conditions tool kit for rail industry managers; working with the Institute of Occupational Medicine to standardise the outcomes of medical assessments for rail workers; and health impact assessments for large scale development projects including Stansted Airport second runway and Ebbw Vale regeneration. ERM works with clients to identify where human performance can

impact on safety and to identify risk reduction measures individually tailored to the organisation. Work areas include human error assessments; safety culture improvement programmes; fatigue, shiftwork and workload studies; procedure design; workspace, environment, interface and equipment design support.

FOR MORE INFORMATION Tel: 020 3206 5336 Fax: 020 3206 5440 E-mail: tim.geyer@erm.com Web: www.erm.com

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Health Business | Volume 9.6

PATIENT SAFETY

human factors, even the most beneficial and well-meaning idea can fail. Consider if the chart was designed only with one set of healthcare professionals in mind, or implemented in an area without all the local staff being consulted. Whilst this still appears like common-sense advice to avoid such scenarios, few of us have to resort to reading public inquiries or national news to identify scenarios where this common sense did not emerge. Doubt may still remain in the minds of stakeholders such as chief executives, managers and healthcare providers and these may not prioritise a need for patient safety against financial or efficiency objectives quite as much as a patient would. So if there could be a broad business case for patient safety, patients themselves certainly would be key advocates. But if given a range of solutions, why would patients choose a comprehensive management of ‘human factors’ and not simply the purchase of technology or employing more staff? STAFF ROLES Perhaps because for some well-staffed, high technology industries, it may not be for the want of staff or technology that problems arise, but the way the people’s roles and responsibilities are organised within their systems of work. No one would doubt the level of technology or ‘adequacy’ of the numbers of qualified people working in the banking sector – yet still there have still been

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several undisputed failures within this system. There is often the assumption that technology always enhances human abilities – and it is easy to forget that the human error can pervade even the most complex of systems; through design of technology or management of the human roles that surround it. Put simply, technology can introduce as many new risks as it is perceived it eliminates. Perhaps then the solid rationale for ‘human factors’ is based on knowledge that the occurrence of actual incidents usually results from a catalogue of human errors, and rarely from just one. It is regularly quoted that 80 per cent of incidents are due to human error and it is a common mistake to focus this entirely on the front-line provider. But, when one consider the broader system, it is likely that 100 per cent of these unforeseen events are a result of human error, from throughout an organisation and even beyond it, from the policy-makers, educators, management, procurement, recruitment, IT, designers or manufacturers of devices and more. It may be easy to sometimes forget that each and every one of us is a member of this error-prone human community and pour scorn on the mistakes of others. But should an individual perceive themselves as naturally occurring in some idyllic error-free domain; they would also tragically disassociate themselves from the experiential learning mechanism that provides the solution – the opportunity for

human perception of error occurrence; human actions to avoid past errors occurred and actions towards error recovery. The IT system that does not allow human action to reverse the progress of unintended and negative consequences is the stuff of nightmares (indeed, the basis of several horror movies). In a system that is as heavily reliant on human behaviour as healthcare, there is a key necessity is to ensure recognition of human fallibility and the influences, whether from design, environment, policy or culture, that weaken us to a state where the risk of errors becomes high. No field or discipline, other than human factors, integrates the psychology, physiology and systems thinking with this goal entirely in mind. Whilst it may be all too easy to proclaim that healthcare cannot afford to account for human factors; quite simply, it seems it cannot afford to ignore them. Acknowledgements Thank you to Bruce Warner of the National Patient Safety Agency for his support in producing this paper. References • HFES (2009) Human Factors and Ergonomics Society homepage (accessed 1 Sep 2009 http:// www.hfes.org/web/AboutHFES/about.html) • Defence Technology Centres (2006) Cost Arguments and Evidence for Human Factors Integration. Issue 1. October 2006. HFI DTC.

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Managing the human element of risk...

Human factors and ergonomics consultancy

do people W hy do what they do?

people are W hen motivated and get

Why don’t people learn from mistakes? Why do we keep repeating the same failures? How do we improve the system? Healthcare, whilst not unique, is different from many high-hazard industries in the extent and range of demands it makes upon people. If you want to increase system resilience against predictable human failures, you will need to understand why people do what they do. Greenstreet Berman has many years experience helping organisations solve problems, understand and manage human performance and implement solutions. We have experience of risk assessment, system and equipment design, incident investigation, training, exercises and emergency response, safety culture, attitudes and behaviours, safety management, compliance management and many other areas where human performance affects the efficiency, safety and capability of an organisation. Our healthcare experience ranges from the development of risk assessment methods, through guidance on the

involved, performance increases dramatically. We find ways to grab that extra performance and smooth out the barriers that cause frustration and inefficiency. We specialise in analysing systems and processes to maximise performance. We explore why processes do not deliver what is expected and rectify them. Our services are based on wide industry experience and are established on a firm foundation of quality, value and practical application. Keeping it simple works and we deliver. The results every time increase performance through understanding the problems, reducing the potential for human errors; operational improvements through systems alignment; open communication generating individual effectiveness; operational cost savings

design of hospitals, to root cause analysis and evaluations of programmes and care pathways. Additionally, we have experience and knowledge from nuclear power, rail, utilities and manufacturing industries. Human performance is predictable and manageable – contact us to find out more about our range of services that can help you manage the human element of risk.

FOR MORE INFORMATION Greenstreet Berman Ltd Tel: 0118 938 7703 Fax: 0118 938 7729 E-mail: jonathan.berman@ greenstreet.co.uk Web: www.greenstreet.co.uk

Human Factors – shaping healthcare Barron Consulting

M Ltd (MBCL) is a human factors and business change consultancy. We work with our clients to conceive, design, develop and deliver workplace innovation to maximise human performance, reduce error and preserve health and safety. The healthcare industry is awakening to the benefits and savings that are achieved by addressing human factors issues and improving human performance. With experience in a wide range of safety critical business sectors, MBCL is well placed to help you realise business improvements and cost savings by identifying

and rectifying human performance issues within your organisation. Our specialist consultants can provide support across a number of key areas including usability, lean business process, workload analysis, human error analysis, product ergonomics, workspace design, training analysis and business change. MBCL is an Ergonomics Society Registered Consultancy.

through greater interaction and alignment; increased organisational learning through shared knowledge and experience and compliance with legislation through achieving ‘best practice’. Visit our website and take advantage of our experience.

FOR MORE INFORMATION Tel: 01224 666 304 E-mail: tim@progressthroughpeople.com Web: www.progressthroughpeople.com

Vectra Group – providing risk management expertise worldwide ew facilities like polyclinics or new policies seeking greater efficiency bring new ways of working. However, change is not confined to new developments. Healthcare policies and protocols are being re-examined in the light of incidents to reduce medical error and staff injuries: but, are they effectively re-designed to prevent the incidents that have yet to happen? The Arcadis-Vectra Ergonomics Design Solutions Group has unusually wide ergonomics expertise that can offer the possibility of reduced error for patients, reduced injury for health care workers and increased efficiency. We have extensive experience in predicting human errors and so redesigning policies, protocols, equipment and environments to minimise

error and increase effectiveness in many different sectors. This means we regularly translate the best solutions from one sector to another. Our designers deliver solutions for the built environment, workstations and the design or selection of information technology products. Unusually, for an ergonomics consultancy, we can project manage design, construction and manufacture, with assistance from architectural and other colleagues where required. This includes changes in existing facilities equipment and systems to ensure the minimum of disruption to ongoing service provision.

FOR MORE INFORMATION Tel: 01925 444 648 E-mail: info@vectragroup.co.uk

FOR MORE INFORMATION MBarron Consulting Ltd Tel: 0845 838 6225 E-mail: info@mbarronconsulting.com Web: www.mbarronconsulting.com

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Health Business | Volume 9.6

demand greater access control Securing clinical information and patient record data is critical in all Healthcare practices, we know this beyond question – but it is a challenge to gain acceptance of it in the real clinical world – why? The main reason is user convenience, quite simply the more clinical workstations are locked down by authentication and access control mechanisms, the less convenient they become for clinicians to use. Anything that slows down a clinician’s access to patient data will consume time that would otherwise be spent providing care and so, getting the balance between applying appropriate security measures and clinical convenience right is critical if the security measures are to be accepted and adhered to. This is one of the major reasons why a great number of Trusts across the NHS have deployed, or are looking to deploy, a Single Sign On (SSO) solution in a kind of “deal” with their clinicians – “OK, I’m going to lock down your workstations but in return I will remove the need for you to remember and submit all of those usernames and passwords – is that a deal?” Yet, even with an effective SSO solution in place your clinicians will continue to: • Confuse data from different patients because of the number of systems they have to juggle • Burn away clinical time navigating from one system to the next, while ensuring all systems are looking at the correct patient • Yearn for the ability to see all relevant patient information in one place, on one screen, with a single login. Fusionfx Fusionfx from Carefx eliminates these issues and consequently has a huge impact on the acceptance of intrusive security measures. It works hand in hand with SSO solutions by taking the clinician directly to the patient or record they need to see, in every system, automatically, with no need to search or navigate the application manually. As one system changes “context” to a new patient or record, all the other systems will switch to the same record usually resulting in a 50 per cent or greater reduction in the time clinicians have to spend looking at computer screens rather than patients. We are all familiar with using portals from the likes of Google, Yahoo and MSN, these portals allow you to configure information that is of interest to you and display it on a page configured in line with your interests. These systems do not duplicate the information from the Internet rather they provide a specific “view” of what’s out there and, when you want more information, these portals take you straight to the source of the information. Wouldn’t it be great to do this with clinical information - a summary of all the

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From this...

To this...

information out there in all of your clinical information systems, on a single page? Fusionfx provides the only platform that will seamlessly transition you from a Security Strategy through to this World, and moreover, just like mainstream web portals, Fusionfx will take the clinician straight to the underlying applications automatically, and directly to the correct patient, encounter or record without any manual navigation or login. Greater value Quite simply it will free up clinical time, minimise errors, and reduce support costs whilst allowing you extract much greater value from your existing IT investments. ™ Using open standards, including CCOW, Web Services, Grid and Cloud computing techniques, Fusionfx aggregates data from multiple systems, across multiple facilities, and presents it in a single summary view via a browser page without duplicating, transforming or in any way modifying it. This data is presented dynamically, in real time, so there is no delay introduced due to message synchronisation,

which means that it can be used in direct clinical decision making right at the point of care. All healthcare organisations are faced with the apparently mutually exclusive challenges of improving efficiency, quality andsafety whilst also improving their financial effectiveness. Fusionfx is a platform that integrates, leverages and reuses existing 20th century systems and infrastructure to deliver 21st century capabilities and user experiences in support of achieving these objectives.

FOR MORE INFORMATION Fusionfx is in use by over 600 healthcare facilities around the world, to see what the fuss is about visit: www.carefx.com

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Health Business | Volume 9.6

security

Let the right one in Control of access – a necessity or a nuisance? Nick van der Bijl BEM, National Association for Healthcare Security, gives his views

In 1992, a man was admitted to a hospital for a minor operation, however, he had fallen out with his business partners and while he was waiting to be taken into theatre, an assassin murdered him. The assassin fled the country but was extradited and convicted to a life sentence. The murder was unexpected because for years, hospitals had assumed that they were isolated from the ills of society and access control into parts of the hospital was weak. The assassin knew that the victim would be in the hospital at a particular time and therefore an opportunity was presented. The rhetorical question is why when we carefully lock up our houses, rooms and flats when we go to work, and indeed restrict access to parts of the property when we are at home, do NHS managers at work not apply the same principles? A SERIES OF BARRIERS Control of access can be defined as a series of real, imagined (to the outsider), mutually supporting and interdependent barriers arranged in depth designed to: • Slow down penetration with each barrier a

“

Defence in depth is an ancient concept that we practice every day and is a strategy used to defend against crime and unauthorised access. It can also make a contribution enhancing health and safety and limiting cross infection

risk or obstacle to consider and to be negotiated before moving on. Barriers include perimeters, reception, an alarm system and ID badges. • Buy time to allow a reaction or response to be organised. The reaction might come from security officers. • Highlight weaknesses in the control of access strategy. Defence in depth is an ancient concept that we practice every day and is a strategy used to defend against crime and unauthorised access. It can also make a contribution enhancing health and safety and limiting cross infection. It is sometimes known as the onion peel, in which each skin is pealed until the core in the

”

middle is reached. Take a car, defences include – door keys, ignition locks, window etching, the vehicle registration number, insurance and tax disc as a minimum. The addition of a wheel or gear lock buys more time. While each defence require different lengths of time to negotiate, the accumulated protection and nuisance value of the defences can be significant in deflecting unauthorised access. The more defences the better, however, on rare occasions a few can suffice. The posting of the Smartwater property marking logo on an office window is often sufficiently effective to divert thieves because they know that the Smartwater invisible solution is effective as DNA in proving ownership. On seeing the logo, the thief will ask: “Is it

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Health Business | Volume 9.6

security

a trick or is the property inside marked? Not sure. I’ll move on to an easier target.” LEGISLATIVE PROCEDURES An element of defence in depth is legislation. Had the assassination of the roofer taken place in 2009, the possibility exists that those who had failed to ensure his safety could have been prosecuted under the 2007 Corporate Manslaughter and Corporate Homicide Act. This far-reaching legislation recognises that fatalities consequent to lapses in health and safety procedures and practices are not always accidental and misadventure. Briefly, the Act states that an organisation is guilty of an offence if the methods organised by the senior management lead to a gross breach of duty of care resulting in death. Schedule 1 of the Act lists the Department of Health and, therefore by implication NHS Trusts, as bodies at risk. Some definitions: • ‘Gross’ – breach of the duty of care well below that which what can reasonably be expected of an organisation in the circumstances. • ‘Senior management’ – those in significant decision making roles that affect the management of all or part of the organisation and its activities. • ‘Duty of care’ applies to its employees, other persons performing services for it, such as maintenance staff, building contractors, an occupier of premises – i.e. a patient, and a contracted or voluntary

supplier of goods and services. As with any health and safety practice, the employee has a duty to follow procedures. Allowing someone without the appropriate authority to tailgate through controlled access cannot usually be held against senior management. FOUR PRINCIPLES Irrespective of the size of the area to be protected, for instance a small locket kept in a matchbox or an aircraft hangar the size of two rugby pitches, four fundamental principles govern the control of access in the defence in depth strategy. Access: The fewer control points, the easier the access control to, from and throughout the facility. Controls might include the physical presence of reception staff, the simplicity of keys, electronic access systems, security notices and staff security awareness. Increasing use is being made of biometric security technology. Essentially, biometrics is the application of electronics to measure selected unique

features of an individual, such as fingerprint patterns, variations in structure of hands and eyes and even our gait, to confirm identity. Advantages of such systems are: • dispenses with identity cards, although it is interesting the comfort drawn by staff from an ID badge. • unlike microchips in cards and reliance upon personal identification number, biometrics cannot be stolen, in spite of amputated fingers in films and drama. • cannot be stolen or copied. Fingerprint biometrics can be bypassed with gloves, including surgical gloves. This would be a consideration in parts of the hospital. There are also likely to be data protection issues surrounding the retention of the unique profiles of those on the system. Witness the debate on DNA libraries. Movement: Some general hospitals have almost uncontrolled access into sensitive parts of the hospital and it is still possible to arrive alongside a bed in a ward without going through any doors protecting the

“

The fewer control points, the easier the access control to, from and throughout the facility. Controls might include the physical presence of reception staff, the simplicity of keys, electronic access systems, security notices and staff security awareness

”

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Health Business | Volume 9.6

security

patients. So why do the NHS managers, at all levels, continue to expose patients and staff to risk by not ensuring the security, safety and protection from crime and crossinfection that control of access brings? The perception, surely, is that there is a long held belief that since hospitals sees themselves as caring places, which they are, the perception remains that they are immune from the ills of society. The facts rather prove the opposite. Exclusion: Hospitals are, however, gradually realising that while they are caring institutions, part of the healthcare security philosophy now requires improved target hardening, by exclusion, of some parts, such as theatres, stores, pharmacies, some offices for all except for those with authority to enter. Exclusion prevents theft, unauthorised access and deliberate damage to medical equipment. Containment: Containment promotes the necessity to corrall people into areas where some control over their activity can be exercised. We all experience containment in hotels where guests are confined to public areas and in airports where passengers are contained in departure zones. Typical containment areas in hospitals are waiting rooms and the wards themselves. LOCKDOWN Lockdown is the current ‘buzz word’ being circulated by Department of Health emergency contingency planners. Lockdown is not new to the NHS. Most hospitals have the ability to isolate all or part of its function, particularly relating to infant abduction and paediatric wards. Not quite so well protected are the equally vulnerable elderly patients in general hospitals, who are at far higher risk of going missing than an infant or young person. Only in the mental health sector is prevention exercised using effective controls of access. But few maternity wards exercise an abduction risk, although one South West trust regularly did and could prevent access to and from a hospital within 90 seconds. The Department of Health defines Lockdown as: “The process of controlling the movement and access – both entry and exit – of people (NHS staff, patients and visitors) around a trust site or other specific trust building/area in response to an identified risk, threat or hazard that might impact upon the security of patients, staff and assets or, indeed, the capacity of that facility to continue to operate. A lockdown is achieved through a combination of physical security measures and the deployment of security personnel.” Full lockdown requires full control of access to a hospital, perhaps in response to civil disturbance. It follows that the fewer existing controls of access, the better lockdown. Hospitals with demarcated perimeters eases control of access by pedestrians and vehicles with defined control points and access granted by the presentation of an ID badge for staff or an appointment letter by patients.

“

Hospitals are, however, gradually realising that while they are caring institutions, part of the healthcare security philosophy now requires improved target hardening, by exclusion, of some parts, such as theatres, stores, pharmacies, some offices for all except for those with authority to enter

”

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Digital Dictation and Transcription Outsourcing Part of the UK’s largest digital dictation and transcription service provider, DictateNow Medical division is focused on the specific dictation and transcription requirements of the public and private healthcare sector in the UK. DictateNow delivers:  All UK based, qualified & experienced medical secretaries  Fast document turnaround – Under 2 hours  Documents anonymised, securely encrypted & confidential  Support for periods of high workload or staff absence  Dictation & transcription workflow management software  Continuous transcription coverage  High quality transcription of medical reports, notes and correspondence  Integration with patient administration software For further information or to arrange a free trial please contact DictateNow:

T: 0845 601 7726 E: info@dictatenow.com W: www.dictatenow.com

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Health Business | Volume 9.6

security

Partial lockdown requires control of access to a specific part of a site or a building. Examples are cordons erected around a crime scene so that evidence can be collected and HM Prison Service escorting high-risk prisoners to and from treatment centres. Partial lockdowns can be either static or the equivalent of rolling roadblocks on motorways in which the control of the lockdown moves with the problem. These are sometimes known as ‘portable’ lockdowns. Progressive lockdown is a phased response to an escalating scenario and can lead to full or partial controlled access. Several years ago, a hospital that had isolated part of its grounds during a hostage situation in a clinical setting was then forced to widen the cordon as the situation developed. Such escalation needs to be flexible and systematic so that logjams are easily negotiated. Control of access is disruptive and can be annoying, however, it is a vital element of effective security management. Measures must be effective and counter measures exercised to prevent serious incidents. ‘Secured by Design – Hospitals’, which was written as part of the Secured by Design initiative, gives good advice on developing a safe and secure hospital environment, including lockdown. In the end, security is rarely as expensive as insecurity.

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Visit the website to view the categorised product finder

Never worry about losing keys again hen you lose a key

W you suffer the expense and

inconvenience of replacing locks and keys. With access control, you simply void the lost token from the system – problem solved. Your premises remains secure. Access Security designs, installs and maintains all types of electronic access control from single-door to on-line networked PC-based multidoor installations for large sites. An access control system allows you to restrict access within your site, monitor activities throughout your controlled areas and provide 24 hour protection for your staff, visitors and property. Computer Networked Systems – benefits and features: • Full control from your desk – control who enters, when, where and which areas of the site they have access to  • Central control – all doors can be controlled from one place  • Instant access or denial  • Tokens can be quickly and simply added or voided   • ‘Real time’ reporting – every access gained is recorded   • Instant overview – glance at your

orge enables IT departments at healthcare organisations to protect work in the event of an emergency – such as a flood, electricity outage or human error. If downtime occurs, Forge alerts the IT administrator to send copies of workloads, including data, application and recovery systems, to its hardware within minutes. When the server is up again, or a new server is introduced, the workload is transferred back without disrupting the business. Forge can protect up to 25 standard or virtual servers with one hardware solution using a single web-based management dashboard,

Dictate.it announces three new contract wins he UK’s leading supplier of digital dictation, speech recognition and outsourced transcription services to the medical sector, Dictateit, has announced three new contract wins, bringing the total number of NHS Trusts the company works with to 27, covering over 25,100 beds. Dictate.it’s patient digital dictation platform has been selected by Derby Hospitals NHS Foundation Trust, Barking, Havering and Redbridge University Hospitals NHS Trust and Basildon and Thurrock University Hospital NHS foundation Trust. Dictate.it is the largest provider of medical transcription, digital dictation and speech recognition services to NHS Trusts. The company has won 17 of the last 47 contracts for dictation and transcription services put out to tender by the NHS,

computer and find out who is in  • Identify the last know position of a user  • Check for unauthourised access attempts  • Create time zones for authorised access, i.e. office staff 9-5.30 only  • Issue one-day cards to visitors with specified access zones and times   • Control access on remote sites via modem or LAN/WAN  • ‘SiteGraphics’ provides a visual representation of the site, allowing operators to monitor events around the entire site at a glance, including unauthorised access attempt as and where they occur   • Full integration with your intruder and fire alarm

placing it well ahead of its nearest competitor, which has won seven. Mark Miller, managing director, Dictate.it commented on the contract wins: “This is a significant move from tape-based to digital dictation systems, enabling these Trusts to improve the quality of care they offer patients, through faster, more efficient and more cost-effective data management processes. At the same time they will be reducing data backlogs and be better able to comply with legal requirements for document turnaround times.”

FOR MORE INFORMATION TopLine Communications Tel: 020 7886 0856 E-mail: aakriti@toplinecomms.com Web: www.toplinecomms. com/www.dictate.it

FOR MORE INFORMATION If you’d like to find out more about club management systems, call and speak to our specialist on 01908 613326.

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and is compatible with all server types. Disaster recovery can account for 80 per cent of a healthcare organisation’s IT budget, but Forge costs as little as £1.99 per day and includes hardware, storage and software out-of-the-box. At this price point, the solution is ideally suited for departments within large enterprises and small to medium sized businesses. It gives IT teams the ability to protect more servers for less, reduce risks and recover from outages quickly and safely without loosing data and workloads.

FOR MORE INFORMATION Web: www.novell.com

Do you put up with violence at work? ave you or your staff been abused, threatened or assaulted in circumstances relating to your work? If the answer is yes, according to available statistics you are one of 75,000 healthcare professionals who have suffered violence at work. Should you have to put up with that? Is it part of the job? The answer is no. It’s not part of the job and the Health and Safety Executive is mindful of the effects of violence in the workplace, now reportable under the RIDDOR Regulations. How many of your staff are absent because of a violence issue, either directly or indirectly? We can help you. We have delivered Conflict Management training to many government and private organisations. Our expertise has been gained through first hand operational experience of dealing with conflict. We deliver simple skills and techniques that can help reduce conflict. We don’t guarantee 100 per cent success, we do guarantee tangible results

if the techniques are followed. Do you want to be one of the 75,000 (one member of staff subjected to violence every seven minutes) or do you want the knowledge and skills to avoid conflict? If it’s the latter, don’t delay call SPP Solutions today.

FOR MORE INFORMATION Security and Personal Protection Solutions Tel: 02392 415540 E-mail: info@sppsolutions.com Web: www.sppsolutions.com

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Sound Environments

Rockwool insulation... built-in peace and quiet Rockwool insulation the sound choice for hospitals, where noise pollution can affect patient welfare. By reducing intrusive sounds from machines and other people, Rockwool helps reduce stress and anxiety, thus aiding patient recovery and improve working conditions for hospital staff. Rockwool insulation comes from renewable resources, is recyclable and has outstanding thermal and fire protection properties too, which makes it a healthy, responsible choice. Call: 0871 222 1780 Email: healthcare@rockwool.co.uk rockwool.co.uk/healthcare

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The introduction of the Regulatory Reform Order (RRO) means Fire certificates are no longer issued by the Fire Brigade. Instead, the onus is on the person responsible for a building’s fire safety to reduce its risk from fire by carrying out a risk assessment and acting upon its findings. Failure to do so could result in a fine or litigation. An effective fire alarm system is key to the fire risk management of any site and the best way to prove your fire alarm is fit for purpose is to use a third-party certificated contractor. Enter Solid State - the first company in the North West of England to be awarded the National Security Inspectorate’s Gold medal for the design, installation, commissioning, handover, verification and maintenance of fire detection and alarm systems. For peace of mind, look no further than Solid State.

To find out more call our RRO Action Team now on 01257 463018 or visit www.solidstatesecurity.co.uk

Written by Robert Thilthorpe, technical manager, Fire Industry Association

8 www.healthbusinessuk.com fire safety

A false alarm Evacuating patients for a false alarm is a potentially dangerous and even life-threatening situation A false fire alarm for any organisation is, at best, an irritation. For hospitals and other healthcare organisations it is much more – a potentially dangerous and even life-threatening situation if patients have to be evacuated. When a fire alarm sounds, for most people this stimulates a ‘danger’ mode, triggering an awareness of their surroundings and an almost automatic checklist which assesses the situation – “where is the nearest exit?” “Can I smell smoke?” “I should use the stairs rather than the lift shouldn’t I?“ “Do I have time to grab my bag?” However, the hospital environment is different. For the patient, who may well be immobile – perhaps

a leg in traction or connected to monitoring or drug-dispensing equipment – the ‘flight’ instinct may well be stimulated but the option to take their own actions is effectively removed. They have to place their safety in the hands of the hospital staff, relying on them to move them to a safe area.

Hospitals are mindful of the potential panic a fire alarm can cause in this situation and, in intensive therapy and coronary care units, for example, audible alarms are often replaced by a buzzer and flashing beacon in the nursing station. Nevertheless, should an evacuation be deemed necessary, each of

For the patient, who may well be immobile – “perhaps a leg in traction or connected to monitoring or drug-dispensing equipment – the ‘flight’ instinct may well be stimulated but the option to take their own actions is effectively removed

”

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Health Business | Volume 9.6

8 www.healthbusinessuk.com fire safety

the patients will need to be moved, along with any necessary equipment – estimates suggest it could take up to 10 minutes to move a single patient. If all this is required and the alarm proves to be a false one, then the extensive disruption and potential consequences for patient care have been for nothing. AUTOMATIC DETECTION That is not to argue against automatic fire detection systems – their role in an environment where an early warning is more important than ever means that they are widely employed in hospitals and healthcare premises, the vast majority providing a swift and reliable means of detecting and alerting of fire. In most cases, certainly in hospitals, those fire detection systems are connected to Alarm Receiving Centres (ARCs) or directly to the fire and rescue service to ensure the quickest of responses to an emergency situation. This means that in addition to the problems caused on site for the hospital’s staff and patients, false alarms (or ‘unwanted fire signals’ as they are referred to within the fire protection community) waste fire service resources. Given that a large hospital will involve a risk-based response which requires attendance by a number of fire appliances, it also impacts on the fire cover available for other genuine incidents. Add to that the fact that the credibility of the fire detection system is damaged every time there is a false activation and it is easy to see why reducing false alarms remains a key objective for the fire protection industry.

Alarms stimulate the ‘flight’ instinct in most people

Whatever the reason and irrespective of any “discussion regarding people error versus equipment malfunction, false alarms remain a potentially significant problem in the hospital environment ”

WHAT CAUSES FALSE ALARMS? The cause of false alarms are numerous, from malicious activation through to people operating the alarm in good faith but there is no actual fire. An example of the scale of the problem in some hospitals is shown by the experience of the University Hospital of North Staffs which in 2008 concluded that only six of the 185 fire calls made were real fires. The hospital’s annual fire safety report showed that four of the genuine fires were in electrical equipment with the other two breaking out in waste bins and skips. Of the remaining alarms, 34 were made with good intent (including some triggered by people calling 999 after seeing fumes through windows from people smoking and mistakenly suspecting a fire). Most of the rest were triggered by smoke alarms being set off accidentally. The accidental activation of smoke alarms is undoubtedly one of the major causes of ‘false’ alarms but, in reality many are not false alarms in the strictest sense. Toasters are one of the most common causes, leading to a ban from wards in two major hospitals in north Wales a few years ago which resulted in false fire alarms falling by 75 in the first six months after the toasters were removed. It is important to recognise that in such instances it is not the detection equipment that is at

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Health Business | Volume 9.6

fire safety

fault – it is doing its job correctly, ie detecting the presence of smoke. It is the design of the system or, more commonly, lack of thought or knowledge in the people that are using the toasters that is causing the alarm – although it might appear to be common sense not to use a toaster in the immediate vicinity of a smoke detector, it is surprising how often it occurs. Whatever the reason and irrespective of any discussion regarding people error versus equipment malfunction, false alarms remain a potentially significant problem in the hospital environment. NEW CFOA POLICY The Fire Industry Association (FIA), has been working closely with the fire and rescue services and other partners for a number of years to reduce false alarms. This resulted in the publication in August 2008 of a new document by the Chief Fire Officers Association (CFOA) entitled CFOA Policy for the reduction of false alarms & unwanted fire signals. The policy was implemented on 1 September, 2008 and applies to all premises identified and regulated under the Regulatory Reform (Fire Safety) Order, 2005 (RRFSO) that are, or will be, installed with automatic fire detection and fire alarm systems. The individual Fire & Rescue authorities do make allowances for certain higher life risk premises such as hospitals but, in essence, the document is intended to focus attention on false alarms and how premises that are persistent offenders can address the issue. There are two distinct elements that the policy seeks to address: (a) false alarms which may contribute to fire safety issues; and (b) unwanted fire signals which impact on the fire services’ resources. One of the main objectives of the policy is to provide the brigades with different levels of response, all of which are defined within the document, thereby offering specific procedures to follow when faced with varying degrees of unwanted fire signals. It also includes protocols for Telecare premises and ARCs, which are widely employed by hospitals to provide a swift response to an emergency situation, as well as defining and providing options for call filtering. The Policy encourages a culture change in the building owner/occupier/responsible person, promoting the importance of effective management of fire safety systems in reducing the incidences of false alarms. Martin Harvey, Chairman of the FIA, has been heavily involved in the development of the Policy, along with myself as FIA technical manager. As the FIA we have long recognised the vital importance that third party certification has to play in ensuring quality in design, installation and maintenance of fire alarm systems. Some problems arise because of the particularly difficult challenges of the environment being protected and in

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FIA Chairman, Martin Harvey, at the launch of the new CFOA Policy on False Alarms

Stoke Mandeville Hospital The world renowned National Spinal Injuries Centre at Stoke Mandeville Hospital has been helped by FIA member Kentec Electronics Ltd to tackle their chronic problem of false alarms. Buckinghamshire Fire & Recue Services advised that there was a serious problem for both themselves and the hospital. Following the building of an extension to the hospital in 2006, the number of false alarms rose to 149 from about 90 a year between 2004 and 2006. Every time the alarm system activated, their risk-based response was to send two fire appliances. Invariably, when they arrived they would discover a false alarm. A single smoke detector had been activated, usually by a cooking activity such as toast burning – a relatively innocuous event but one which nevertheless wastes fire service resources and causes disruption to the efficient running of the hospital. A redevelopment was funded by a PFI (Private Finance Initiative) and the installers chose an open protocol system that interfaces with Kentec’s Syncro AS control panels, which allow for more accurate interrogation and interpretation of possible fire events within the hospital. Working with the local NHS Trust and Stoke Mandeville Hospital’s fire safety adviser, a fire safety system was developed that enables the hospital’s specially trained fire wardens to investigate the cause of an alarm signal, on the activation of one smoke detector, which either confirms or cancels the 999 call. This ensures that only 999 calls are made in the event of a real fire. However, should a heat detector, break glass call point or more than one smoke detector be activated, then the Fire & Rescue Service is summoned immediately. One of the main requirements of the new system was clarity of distributed intelligence, with the system required to give a view of the whole system at each control panel, so allowing an alarm or fault on the system to be viewed locally. In addition, with one single comprehensive system throughout the complex, training in fire safety is much simplified as nursing staff understand the system wherever they are located on site. The disruption for staff and patients is now greatly reduced and the burden placed on the fire and rescue services has also been alleviated, with a reduction of some 80 per cent in the number of false alarms. This project illustrates the FIA’s ‘bottom-up’ strategy whereby the Association and their members work with the Fire and Rescue Service, the responsible person/end user to resolve the issues of false alarms and publish the results as case studies. The intention is to help others resolve their false alarm issues by demonstrating what may be achieved. If any hospital needs help to resolve false alarm issues, the FIA is available to provide expert and impartial advice.

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Storage solutions for fire and safety

DKI Services – fire and protection specialists

o Bird is one of the world’s leading manufacturers of high performance storage solutions for fire, safety and lifesaving equipment. These products, which include the Firebird and Toughstore ranges, have been successfully used over long periods in some of the world’s most hostile environments. The Toughstore range of injection moulded ABS/Polycarbonate cabinets are not only very robust but also have a very high standard of finish to complement indoor environments. Within the range are cabinets for fire extinguishers, breathing apparatus, defibrillators, lifejackets, lifebuoys and fire hoses which are widely used in factories, offices, schools, marinas and waterfronts. We have recently introduced a new model for use in hospitals and care homes. The SOS101AM features an anti-microbial additive which kills at least 99.9 per cent of bacteria. This helps to cut down the risk of infection and makes the process of cleaning easier together with protecting the equipment inside. The clear door means it is possible to easily check the state of the equipment

KI Services Limited are a specialist provider of fire alarm solutions. The latest and most efficient technology is used in the equipment which we supply and we offer our customers flexible design options to ensure all operational requirements are met. We will help you select the fire alarm equipment which is most suited to your needs to complete a design in accordance with the British Standard BS5839. DKI Services has an established reputation throughout the UK, providing assistance with fire protection systems for hospitals, nursing homes and commercial premises. We offer a full range of maintenance services to suit your requirements including periodic inspection and servicing, which is essential to ensure the continued reliability of any fire system to protect life. Our servicing and maintenance is carried out by our fully trained engineers, all of whom have a specialist knowledge of fire detection systems. Along with the provision of fire

and it has a quick release handle for rapid access in an emergency. Most of our cabinets also uniquely carry Lloyds Type Test approval.

FOR MORE INFORMATION Please see our website for the full range of products available: www.jobird.co.uk Jo Bird and Company Ltd Tel: 01278 785546 Fax: 01278 780541 E-mail: info@jobird.co.uk

Lawrence Webster Forrest – fire consultants awrence Webster Forrest Ltd is a fire safety engineering consultancy with over 20 years experience in the development of fire engineering technology and the application of fire safety standards. As the UK’s leading independent fire consultants, LWF provides building managers, owners, occupiers, developers and designers with innovative solutions to the problems of establishing an integrated premises fire safety strategy. Such solutions are individually designed to each building considering relevant constraints such as structure, occupancy, use, operation and cost. The company has been providing these service since 1986 and has built up an impressive client list which includes architects, developers, government

departments, project managers, consulting engineers, building owners, facilities / building managers and owners. Services offered include, fire safety training, fire safety management and procedures, fire risk assessments, fire safety audits/surveys, fire alarm and detection system design, fire suppression system design, emergency lighting system design, fire engineering design solutions, fire strategy development, evacuation modelling, fire and smoke modelling, design review and appraisal.

FOR MORE INFORMATION Peter Gyere, marketing manager Tel: 020 8668 8663 Fax: 020 8668 8583 E-mail: fire@lwf.co.uk Web: www.lwf.co.uk

protection systems, we also supply, install and maintain fire extinguishers, emergency lighting, disabled toilet alarms and nurse call systems and related support services such as Fire Risk Assessments, Staff Training and advice regarding DDA requirements. Included in our product range are fire alarm systems, voice alarm systems, emergency lighting, disabled refuge, disable toilet alarms, nurse call systems and fire extinguishers.

FOR MORE INFORMATION Tel: 0845 293 9380 Fax: 01732 849 247 E-mail: admin@dkiservices.co.uk Web: www.dkiservices.co.uk

Hillmoore – the fire protection specialists illmoore Fire Protection is a specialist contractor for the design, supply and installation of all Passive Fire Protection Systems. These include fire stopping, fire and smoke compartmentation cavity barriers, fire walls, fire doors and structural steel fire protection. Being approved installers of all the major products available, Hillmoore is able to offer the correct and most economic solution for each individual site requirement. Designs are underwritten with back to back warrantees with material manufacturers together with Hillmoore’s own professional indemnity insurance. All work carried out is third party accredited by both FIRAS and LPCB with site installations open to regular third party inspection. This provides peace

of mind to their clients that the work is carried out correctly and to specification. A Certificate of Conformity is provided upon completion of a project which is also underwritten by the third party fire authority. Full site inspections can be carried out, normally free of charge, and a full defects report with a required action plan and costing provided to the client. The ethos of Hillmoore Fire Protection is to provide clients with an unrivalled service throughout a project, be it new build, refurbishment, upgrading or change of use of a property.

FOR MORE INFORMATION Tel: 01628 890122 Fax: 01628 478543 E-mail: info@hillmoorefire.co.uk Web: www.hillmoorefire.co.uk

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Health Business | Volume 9.6

fire safety

Automatic fire extinguishing solutions ased in Biggar, central Scotland, APL designs, supplies, installs, commissions and maintains all types of automatic fire suppression and extinguishing systems throughout the UK, Ireland and Europe. The company offers a variety of systems to protect all sizes and risks, from aircraft hangar to comms cabinet. The DetExt F/F system is ideal for the protection of racks and electrical switchgear or indeed any item of potential risk, high value or critical to the existence of any company. As part of APL’s commitment to its customers, the company has recently purchased a Retrotec kit to allow them to carry out Integrity tests for both commissioning and maintaining full flood systems. APL is probably the world leaders in storage machine protection, offering systems that can fully flood with extended inertion to cost effective local application protecting the

Call filtering, providing a risk-based approach and safe working practices are adopted, can be an invaluable help in driving down false alarms

“

It is clear that the ideal place to prevent false alarms from being transmitted to the fire service as unwanted fire signals is on-site. This process is known as on-site call filtering and should be carried out using a risk-based approach and safe working practices. This is where the most accurate information can be gained to ascertain the cause of the alarm activation. It is here where the fire protection companies can play a key role by ensuring that systems are correctly designed and installed and issues relating to false alarms are swiftly corrected

such cases close co-operation between the system owner, the system designer/installer, the fire service and, where applicable, the ARC, can reap real benefits. However, given that our research shows the majority of false and unwanted alarms arise from the ten per cent of so called rogue systems, the strong recommendation that the Policy gives to certification is a vitally important factor in driving down the figures. ON-SITE CALL FILTERING It is clear that the ideal place to prevent false alarms from being transmitted to the fire service as unwanted fire signals is on-site, a point well illustrated by the case study on Stoke Mandeville Hospital. This process is known as on-site call filtering and should be carried out using a risk-based approach and safe working practices. This is where the most accurate information can be gained to ascertain the cause of the alarm activation. It is here where the fire protection companies can play a key role by ensuring that systems are correctly designed and installed and issues relating to false alarms are swiftly corrected. A copy of the Policy can be downloaded from the FIA website: www.fia.uk.com (click on the ‘Information’ button on the home page main menu and then access through ‘Guides & Codes’).

FOR MORE INFORMATION Tel: 020 8549 5855 E-mail: info@fia.uk.com Web: www.fia.uk.com

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”

potentially hazardous parts of the machine e.g. the electrical motors and electronic compartments with or without smoke detection. Aspirating high sensitivity smoke detection is always recommended when protecting areas of vital importance. This air sampling system will give very early indication of smoke and can be utilised to shut off power and indicate to the building alarm. Oxyreduct systems can be installed to prevent fire starting, particularly where there is a requirement for a number of extinguishing gas cylinders. It is impossible to have a fire in an oxyreduct protected area.

FOR MORE INFORMATION Contact: Stuart Harrison APL House, Park Place, Biggar ML12 6BT Tel: 01899 220330 Fax: 01899 221736 E-mail: info@autoproltd.co.uk Web: www.autoproltd.co.uk

Market leaders in the provision of fire safety ire and Risk Management Support Services Limited (FARMSS) is a market leader in the provision of fire safety management support services; customers include fire and rescue services, NHS trusts, universities and government. We have an excellent record of working with NHS Trusts, providing a full range of ‘cost effective’ support services. Our expertise in corporate fire safety management means that customers benefit from Strategic Fire Safety Audits that highlight ‘risk’ areas and that provide both prioritised action plans and schedules. This ensures resources are focused firmly on those areas of highest organisational ‘risk’. Our Premises Asset Management System provides an extremely powerful

electronic system to assist managers to meet the requirements of the Regulatory Reform (Fire Safety) Order 2005 and to manage all aspects of fire safety. Following the fire risk assessment process this integrated system produces management reports, that highlight progress and flags poor performance, and provides a structured prioritised action plan together with costs, thus ensuring effective management control. FARMSS provides a full range of specialist fire safety and health and safety support services.

FOR MORE INFORMATION For more information please visit our website www.farmss.co.uk or e-mail info@farmss.co.uk.

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Eton Fire Ltd – specialists PFC Corofil – protecting in fire protection systems people around the world ton Fire Ltd is an LPCB approved and highly respected fire protection company with a proven track record in new build, alterations and maintenance in all market sectors. Our recent projects and clients include Castleoak Care Partnership (Care Homes and Supported Housing), Kent’s Building Schools for the Future (BSF) Programme, Wembley Stadium, Bluewater Shopping Centre, Marston Aerospace, HSBC and Canary Wharf to name but a few. Established in 2001, we combine experienced personnel with bright new talent to create a fresh and friendly team with a professional

approach to business. The corner stone of our success comes from developing strong relations with our clients from the very beginning and our hands-on approach promotes excellent co-operation ensuring we provide the best solution to meet your specific requirements every time. We are confident in our ability to undertake projects of any size or complexity, and will be delighted to discuss how we can be of assistance to you.

FOR MORE INFORMATION Please visit www.etonfire.com or call 0207 517 6300 for further information.

rading since 1962, PFC Corofil has become a tried and trusted brand for firestopping in the UK Construction Industry. The business has developed over the years from manufacturing bespoke fire rated trapezoidal filler blocks and movement joints, branching out to offering coatings, sealants and intumescent firestopping products for service penetrations in fire compartments. Within occupied buildings, especially hospitals, fire barriers are being damaged daily by the installation of new electrical, data and telecom cabling, through walls and floors. In response to this threat, PFC Corofil has developed a unique range of Cable Firestop management systems (E.g. PFC Corofil Intumescent Conduit) to create cable transit points in the building’s fabric to reduce the risk of fire spread through cable runs. PFC Corofil has been involved

with a number of projects focussing upon upgrading firestopping within hospitals. We aim to support Trusts by delivering a practical and long term fire stopping management strategy, giving reassurance that the systems in place will perform, at the first time of asking.

FOR MORE INFORMATION For further information, please contact us or visit our website: Tel: +44 208 391 0533 Fax: +44 208 391 2723 E-mail: sales@pfc-corofil.com Web: www.pfc-corofil.com

JPro Services Ltd – ‘safe in our hands’ the introduction of W ith the Regulatory Reform (Fire Safety)

At the forefront of the fire protection industry T Fire Protection Ltd is a company at the forefront of the fire protection industry. We offer a range of different services including emergency plans, fire compartment surveys, fire stopping, fire alarm systems, fire extinguishers and signage, fire rated/non fire rated partitions. The company has worked primarily for the NHS and is vastly experienced working in live clinical areas where health and safety and clean working practices are of the upmost importance. We are a third party accredited company providing certification for the protection of the client and to offer assurance that the works are always carried out to a very high standard. Once any works are complete, we provide detailed records through the surveys and drawings we produce in electronic format. This allows quick and easy access to obtain any information on the works carried out. For one trust in particular, we

Order 2005 employers are required to manage the risks from fire within their premises. In order to identify the risks a fire risk assessment is to be conducted by the responsible person, or some other competent person, who is then required to manage, appropriately, the hazards identified in the assessment. Failure to carry out suitable fire safety management leaves the Responsible Person open to prosecution, which can result in unlimited fines and/or imprisonment. JPro Services Ltd can offer a full service from Fire Risk Assessments (carried out by a highly qualified ex-fire safety officer) to design, implementation and ongoing service maintenance and customer care. We can guide you through the

British Standard requirements, such as BS5839, to make sure you meet all your legal duties. We have considerable experience in Care Home Fire Safety and the NHS. Advice is free of charge. By employing an FIA registered company such as JPro Services Ltd to advise and take care of you, you can be sure that you have done everything to secure the safety of your residents and patients and that your business is compliant. Visit our NEW website www.jproservcies.co.uk.

FOR MORE INFORMATION Tel: 01732 356242 Fax: 01732 356242 E-mail: info@jproservices.co.uk Web: www.jproservices.co.uk

have been incorporated onto the design team to ensure that any fire precaution issues are picked up at an early stage avoiding any mid-scheme headaches and delays for the client. If your organisation has any worries regarding fire precautions, GT Fire Protection Ltd are definitely the company for you.

FOR MORE INFORMATION Tel: 07894 261491/07856 030962 E-mail: gtfireprotection@aol.com Web: www.gtfireprotection.com

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A Handheld Computer for Healthcare Applications The Socket Mobile SoMo® 650Rx The Socket Mobile SoMo® 650Rx is a hospital-grade handheld computer made with antimicrobial materials that provide an extra layer of protection against the multiplication and spread of potentially harmful bacteria and microbes. Software drivers and utilities are pre-loaded on to the SoMo® 650Rx making it ready to deploy straight out of the box. The SoMo® 650Rx is easy to customise with an expanding range of Socket Mobile peripherals which also feature anti-microbial protection. ®

SOMO 650RX HANDHELD COMPUTER WITH ANTIMICROBIAL MATERIALS

BLUETOOTH CORDLESS HAND SCANNER SERIES 7RX WITH ANTIMICROBIAL MATERIALS

COMPACTFLASH SCAN CARD 5XRX WITH ANTIMICROBIAL MATERIALS

SOMO 650RX WIRELESS BROADBAND EXPRESSCARD ADAPTER BACK PACK WITH ANTIMICROBIAL MATERIALS

The Socket Mobile SoMo® 650Rx

SOMO 650RX MULTI-BAY CHARGING CRADLE WITH ANTIMICROBIAL MATERIALS

• Case plastics made with an antimicrobial additive • Durable, lightweight, ergonomic handheld design • Expanding range of compatible anti-microbial peripherals • Windows Mobile® 6 operating system • Fast roaming Wi-Fi® 802.11b/g switches seamlessly between access points • Bluetooth® 2.0 + EDR Class 2 wireless connectivity For more information about Socket Mobile products and FREE Case Studies on their implementation into healthcare environments, call the team at Peak Development now.

tel: 01489 796979 e: industrialsales@peak-uk.com www.peak-uk.com RET 04.09 - HB FP

Written by Anna Coote, Health Commissioner, the Sustainable Development Commission

8 www.healthbusinessuk.com sustainability

Good Corporate Citizenship in the NHS

Climate change poses a threat to human health and the NHS has a duty to respond. By acting as Good Corporate Citizens, NHS organisations can reduce their carbon emissions and achieve a wide range of other benefits

Earlier this year, The Lancet and University College London published a report highlighting the potential impacts of climate change on health. It concluded with a wake-up call: “Climate change is potentially the biggest global health threat in the 21st century.” This conclusion has reached many leading health experts and organisations, including the BMJ, who have warned that a failure to act on climate change is likely to result in devastating health impacts that will affect us all. Climate change is a major environmental issue – but it is also a major health issue. In the UK, it is predicted that climate change will produce a wide range of direct health impacts, including increases in heat related health problems, and flooding related illnesses and injuries. And on the global scale, climate change could produce major social problems – such as food and water insecurity, mass migration and conflict. Climate change is one of a wide range of serious problems that we now face as a result of the impact of unsustainable human activity.

Others include loss of habitat and biodiversity (and all the food, medicines and other products they provide), air pollution, land degradation, ocean acidification and water shortages. All of these pose significant potential health risks. A POWERFUL ORGANISATION As the organisation charged with safeguarding the nation’s health, the NHS needs to take these issues seriously and has a responsibility to act and use its influence to reduce these impacts. The NHS has enormous power to do good, or harm, to human health and the natural environment, not just by providing health services, but also by deploying its vast corporate resources. The NHS employs 1.4 million people, and has an annual budget of over £100 billion. It spends £20 billion a year on products and services. Its buildings consume over £410 million worth of energy every year and in 2007-8, the NHS consumed an estimated 38.8 million cubic metres of water. More broadly, the NHS has the largest property portfolio in

Europe, it accounts for five per cent of all road traffic in the UK, and it interacts with over a million patients and their families every day. How the NHS operates – as an employer, purchaser, manager of transport, energy, waste and water, as a landholder and commissioner of building work, and as an influential partner in many communities – can make a huge difference in limiting carbon emissions and other environmental impacts. By making decisions that take into account environmental, social and economic considerations, NHS organisations can meet their business needs and achieve a wide range of additional benefits – saving money, and helping to builder stronger, healthier communities. GOOD CORPORATE CITIZENSHIP This is at the heart of Good Corporate Citizenship – the term used to describe how NHS organisations can contribute to sustainable development and a reduction in health inequalities through their day-today activities. The term Good Corporate

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Light at the end of the tunnel Attend a FREE ESTA event for a comprehensive

Your legal responsibilities on energy use and climate change impose many obligations. These impact on all consumers, business and public sectors. Shed some light on the steps you should be taking, visit a FREE ESTA event this Autumn.

understanding and practical advice on implementing:

• UK Low Carbon Transition plan • Carbon Reduction Commitment • Part L Building Regulations • Wider use of Display Energy Certificates

• New EU Energy Management Standards EN16001

…plus whatever else is coming your way!

www.esta.org.uk

BIRMINGHAM Aston Villa FC, Tues 3 Nov 2009 WAKEFIELD Cedar Court Hotel, Tues 10 Nov 2009 LONDON Britannia International Hotel, Canary Wharf, Thurs 12 Nov 2009 NORTHWEST Mere Golf & Country Club, Tues 17 Nov 2009

Sustainable Futures is taking a new approach in tackling the problems of carbon emissions and climate change. With the combination of Eco Architecture and Renewable Fuel Consultancy we are able to advise our client’s as to the most efficient methods to reduce their carbon footprint. Our clients include national and local government, educational, health and leisure/recreational institutions. Fuel Cell Research Hydrogen Fuelling Station Waste to Energy Hydro-Electric Photo Voltaic

Eco Science Building

University of Birmingham

Whether the requirement is for a new building or the mechanical and or architectural retro-fit of an existing, working with leaders in their field from thermo-technology to building envelopes, we are able to provide solutions that will substantially reduce both carbon emissions and energy expenditure.

www.sustainable-futures.biz info@sustainable-futures.biz 01752 241370 07872 381805

Lydney Harbour Regeneration Environment Agency

Please contact us to see how we can help you to meet your Carbon Reduction Commitment. Garden Tower Concept HDB Singapore

Code 6 Sustainable Home Eco Hotel & Leisure Park Solar & Hydro-Electric Waste to Energy

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Health Business | Volume 9.6

sustainability

Citizenship first appeared in Choosing Health: Making Healthy Choices Easier (2004) as one of five priorities for the following ten years. Good Corporate Citizenship follows the five principles of the UK Sustainable Development Strategy, Securing the Future (2005): • Living within environmental limits • Ensuring a strong, health and just society • Achieving a sustainable economy • Using sound science responsibly • Promoting good governance By acting as good corporate citizens, NHS organisations can not only limit their carbon emissions and other environmental impacts, but can also realise a wide range of co-benefits. For example, by encouraging low carbon active travel (travel by foot or by bicycle), NHS organisations can reduce carbon emissions and air pollution, and also help to tackle lifestyle diseases such as obesity. Over time, integrating this approach in all areas of business can help move the provision of healthcare from treatment to prevention, save money required to treat illness, and reduce demand on the NHS. More immediately, with fuel costs rising and budgets under strain, any reduction in energy costs makes good business sense. SELF-ASSESSMENT In 2006, the Sustainable Development Commission produced the Good Corporate Citizenship Assessment Model (www. corporatecitizen.nhs.uk), funded by the Department of Health. This online tool can be used to help organisations assess their progress on good corporate citizenship in six key areas of business – procurement, travel, workforce, facilities management, community engagement and buildings. Organisations can register with the model, and answer a series of questions in each key area to determine where they are performing well on good corporate citizenship, and where there is room for improvement. The tool allows organisations to compare their performance with others, and monitor progress over time. It also contains information, resources and case studies to provide ideas on how to improve performance, and a forum to allow exchange of ideas. In its first three years, almost 60 per cent of NHS trusts registered with the Good Corporate Citizenship Assessment Model. The model has been revised and updated in 2009, in cooperation with the NHS Sustainable Development Unit, and now has a new, more strategic set of self-assessment questions. It also contains guidance on how to introduce good corporate citizenship effectively within organisations, and guidelines on how organisations should be performing by 2012, 2015 and 2020. INFLUENCING OTHERS The NHS can use the Good Corporate Citizenship Assessment Model to help it reduce and minimise its carbon footprint and other impacts by modifying its decisions about what

it buys, what it builds and how it manages its affairs. By acting as Good Corporate Citizens, NHS organisations can also use their influence to encourage patients, visitors, staff and suppliers to behave in more sustainable ways. For example, through the vast scale of its commissioning and procurement, the NHS can drive innovation and shift markets towards more sustainable modes of operation. This is an approach now being taken by NHS Manchester, which commissions extensive healthcare services and is committed to supporting the UK sustainable development agenda by contributing to environmental improvements, regeneration and reduction in health inequalities. NHS Manchester has developed questions on sustainable development that are now included in all of their tendering documents during the commissioning of services. Short listed providers must show that they have considered sustainable development in their bids – demonstrating that they are developing employment opportunities for local people, minimising energy use and waste production, promoting sustainable travel and opening up procurement contracts to local suppliers. By making sustainable development a requirement in the commissioning process, Manchester PCT is giving a clear signal that sustainable development is a key element of its core business. MEETING GOVERNMENT TARGETS The NHS as a whole has begun to demonstrate its commitment to carbon reduction. In January of this year, the NHS chief executive David Nicholson launched the NHS Carbon Reduction Strategy: Saving Carbon, Improving Health, which sets out how the NHS carbon footprint is made up and how it can be reduced. The NHS is currently responsible for more than 25 per cent of the public sector carbon footprint – equivalent to over three per cent of the UK’s total carbon emissions. The NHS Carbon Reduction Strategy contains

a pledge to become one of Europe’s leading sustainable and low carbon organisations, and to meet the government’s target of an eighty per cent reduction in carbon emissions by 2050. As a start, the NHS has set itself a target of achieving a 10 per cent reduction in its 2007 carbon footprint by 2015. The strategy recommends that NHS organisations use the Good Corporate Citizenship Assessment Model to help reduce carbon emissions and become more sustainable. Many organisations are already doing this – and making great progress on Good Corporate Citizenship. For example, in 2005, Nottingham University Hospitals NHS Trust, in partnership with Nottingham City Council, introduced the Medilink Service, a free bus service that links separate sites, with transportation links into the city centre. Following expansion of the service in 2007, it now carries over one million passengers a year. The service has significantly reduced traffic in Nottingham, taking around 600,000 cars off the inner ring road annually. The scheme has also contributed to a reduction in CO2 emissions and travel expenses. Nottingham University Hospitals NHS Trust supports a number of other initiatives to promote carbon reduction and sustainable development, and as a result has won the 2007 and 2008 Health Service Journal Awards for Corporate Citizenship. The NHS is one of the most loved, respected and trusted organisations in the country, and is in a prime position to demonstrate leadership on carbon reduction and sustainable development. This is not a matter of altruism. It is a matter of dealing with the key threat to health of the 21st century. Now is the time to act.

FOR MORE INFORMATION To register with the Good Corporate Citizenship Assessment Model, go to www.corporatecitizen.nhs.uk

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Pembury Hospital is a new £235m PFI acute hospital currently under construction. It will provide 66.000m2 of clinical treatment space and will be the first of its kind in the UK to provide all in-patient accommodation in single en-suite rooms. It’s just the latest project in a portfolio of outstanding health facilities for which we have provided a wide range of engineering services including structural engineering, vibration analysis, civil and geotechnical engineering, highways and transport planning.

Vibration is a critical issue for operating theatres. Gifford’s engineering analysis team used proprietary programmes and our own specialist software to assess construction methods and floor dynamics to enable a solution far exceeding the tolerance thresholds previously prescribed.

Built into a steeply sloping hillside (heights vary from three to seven storeys) the building comprises a concrete frame on reinforced concrete pad foundations with flat post-tensioned floor slabs and traditional concrete columns and retaining walls braced by concrete shear walls to stair and lift cores.

0343_Health Business ad 178x125_v3.indd 1

Recent healthcare projects using Gifford’s civil, structural or building services engineering expertise; • • • • • • • • • • • •

Burnley Womens’ Hospital Flagg Court Health Centre, South Shields Homerton Hospital, London Lewisham Hospital, London Newham Treatment Centre, London Primary Care Centre, Lytham Hospital Rathbone Mental Health Unit, Liverpool Royal Berkshire Hospital Royal Preston Hospital Maternity Unit Stepping Hill Hospital, Stockport Victoria Hospital, Blackpool Wythenshawe Breast Care Centre, Manchester

11/09/2009 13:08:03 TM

Taking care of your PC so you can focus on your business

IT Management for the future, now

Cut PC energy usage, save money, reduce carbon! Care Taker software can reduce the demand for electrical power across your organisation’s PC network by at least 35% and as much as 68%, without affecting your productivity – saving an average £28 and 141kg of CO2 per computer each year. Care Taker will also have paid for itself well within six months, leaving your organisation not only with a reduced electrical bill but a smaller carbon footprint! To learn more about Care Taker please contact 01224 224 235 or email info@carboncontrolsoftware.com

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Eg-audit looks at the problems surrounding energy suppliers’ billing systems he failure of energy supply companies to bill business customers accurately is well known within the energy industry; but rarely is this reported in its proper context in the media; all too often overcharging is only linked to the unit price. To illustrate the problem suppliers have with their billing systems, here are a number of examples which confirm that not all is well within the industry. A major energy supplier is suing the IT company it says is responsible for the development of its billing system. It accuses the company of costing it millions of pounds in lost revenue; however, there is no mention of the potential overcharges that its customers may have incurred. In 2008 a supplier withdrew a three rate tariff because its billing system could not support a certain type of meter. Any business customer who stayed with this particular supplier is now on a tariff that may be inappropriate to their business needs. The meter operator, that is responsible for the meters, has been installing this type of meter for well over 20 years. Finally, here is one example of how a billing system can overcharge regardless of the unit price. Note a billing system is only as good as the parameters it works to in its validation of the information it receives. In other words, if the information received, such as a meter reading, does not fall within certain guidelines, a billing exception should be created by the system. If, for example, an excessive bill is produced because of inaccurate or misinterpreted data, it should, in theory, cause an exception. In such an event the excessive

bill should be withdrawn until it is manually checked. Some supply companies run automated programs that remove exceptions and produce bills, because they can not deal with the sheer number of exceptions that are being generated. Billing systems are generally designed to retain information such as meter readings and consumption history. Depending upon the billing system, it is possible that estimation routines are using false data. Therefore, estimated bills can be excessive, and overestimated or incorrect readings can be accepted by the billing system validation. Once this happens, an account can be routinely overcharged for a number of

The specialists in biomass solutions t UK Biomass we will design and install biomass solutions up to 5MW steam, whilst also offering low and medium temperature solutions across the range using chip or pellet. With over 20 years experience working with biomass and independent of all manufacturers our engineers will ensure only the correct plant is selection for your project. As the UK’s only designer and installer of Yanmar MicroCHP installations (up to 50kWe) we will design and install systems to meet building loads and maximise revenue from the feed in tariff (FIT). MicroCHP can prove

extremely viable in high load situations such as nursing homes and hospitals; giving low duration paybacks. With outstanding performance and operating at temperatures as low as -20 deg C, air source heat pumps are fast being recognised as a excellent way to reduce energy usage and can be readily installed in existing facilities.

FOR MORE INFORMATION Tel: 0191 265 4400 Fax: 0191 265 5500 E-mail: info@uk-biomass.co.uk Web: www.uk-biomass.co.uk

years without question. To illustrate, the recent audit of a fairly small concern in Aberdeen, lead to the recovery of £45,000 from its electricity supplier for this very reason. Eg audit specialises in the recovery of overcharges for business electricity and gas customers throughout the UK. We can review invoices as far back as six years and sometimes even longer.

FOR MORE INFORMATION Contact eg-audit for a free consultation, if you have been overcharged we will find it. www.eg-audit.com

Steam services for better healthcare S

pirax Sarco has all the products, services and expertise needed to ensure steam services are available 24/7. Over our 60 year history with the health service, we have developed long standing relationships with 100s of hospitals throughout the UK/ Ireland. We help these customers achieve maximum benefits from their steam system, efficiently and safely, while meeting the stringent standards applying to the healthcare environment. Benefits including energy reduction, improved health and safety standards, reduced maintenance costs, and ensuring reliable supplies of hot water, heating and sterilisation services. For instance, our packaged EasiHeat system has gained wide acceptance as the energysaving replacement for calorifiers, saving plant room space, virtually eliminating maintenance downtime and providing hot water on demand. In addition, we have a complete and flexible range of services available to cover any need – from undertaking steam trap surveys, to project managing a new

plant room, and everything in between. Well-trained personnel are essential to achieving the best plant performance. Spirax Sarco can provide the training your maintenance staff requires, either on-site or at the Cheltenham-based training centre, for nationally recognised qualifications including BTEC, City & Guilds and the Boiler Operative Accreditation Scheme (BOAS).

FOR MORE INFORMATION Spirax-Sarco Limited Tel: 01242 521361 Fax: 01242 535277 E-mail: ukenquiries@spiraxsarco.com Web: www.spiraxsarco.com/uk

The Business Magazine for Health Management

8 www.healthbusinessuk.com Visit the website to view the categorised product finder

Earth Wind and Power energy consultancy arth Wind and Power provides an energy consultancy for London and the South East. We provide detailed Energy Audits, Breeam Healthcare Assessments, Energy Performance Certificates and Display Energy Certificates for all Health Service, Commercial, Public and Domestic Buildings. By optimising your usage a large reduction in carbon emissions can be made often with little/no extra cost or extra technology. Highly trained experienced consultants and engineers can prevent building hyper pyrexia using systems that return your building to homeostasis. Simple methods for example: deciding on a team energy policy, can reduce fuel bills and save much needed funds for patient health care.

The specialists in energy and environmental awareness campaigns IFES have been designing and delivering energy/ environmental awareness campaigns for the NHS for 20 years. Currently we are running 12 full scale campaigns for NHS organisations in England and Scotland. A unique tool used by NIFES is an on-line survey which measures the awareness and motivation levels of respondents. The survey also helps to quickly identify staff who are willing to volunteer to Environmental Representatives (ERs). NIFES services include campaign strategy, briefing senior/middle managers, training ERs, conducting environmental walkabouts, writing reports, leading campaign team meetings and writing articles and materials. NIFES also provide a full graphic design/

FOR MORE INFORMATION To help make your Health estate one of the many that are now cutting a minimum of 15 per cent off their carbon footprint please call or e-mail Chris Steer, consultant, Earth Wind and Power Tel: 07773402986 Fax/phone: 01474 334906 E-mail: mail@earthwindpower.co.uk Web: www.earthwindpower.co.uk

print facility for awareness materials and campaign website design. NIFES can also provide in-depth technical training for energy intensive area such as catering, laundry, IT and for staff operating boilers, chillers and other equipment. NIFES also advise on how to monitor savings and maintain momentum and savings over the long term. For NHS campaign studies and papers written by NIFES on staff engagement visit www.nifes.co.uk/energy09

FOR MORE INFORMATION NIFES Consulting Group Tel: +44 (0) 115 984 4944 Fax: +44 (0) 115 984 4933 E-mail: training@nifes.co.uk Web: www.nifes.co.uk

One-day emissions trading seminar truggling to understand the Emissions Trading Scheme? Whilst many companies familiar with commodity trading environments are coming to terms with the ‘cap and trade’ requirements of the Emissions Trading Scheme, those with little experience in this area are finding it difficult to effectively apply its directives. MJMEnergy’s one-day Emissions Trading Seminar provides a vital overview of the carbon market, and gives an informed view of the impact of carbon prices on businesses. The course offers an ideal opportunity to learn about the complexities of the carbon market with experts David Long and Margaret Chadwick and offers time to discuss and ask questions relevant to your involvement. The courses are presented

The Business Magazine for Health Management

in London and Oxford or in-house at the client’s location. Dates and more details may be found on our website. MJMEnergy experts provide a wide portfolio of excellent, costeffective training courses to build your understanding and enable you to operate effectively and confidently in the world’s energy markets. We also present our CPD accredited courses in-house, tailored to our customer’s requirements often dealing with more advanced or specific aspects of the industry.

FOR MORE INFORMATION Find out more at www.mjmenergy.com, phone +44 (0) 845 299 7072 Ext.4 or e-mail: info@mjmenergy.com

Systematic Energy – use less, cost less ystematic energy has been operating for three years. The proprietor has been involved with the operation of buildings for over 25 years. Identifiying waste needs to be the first step of the many ways to reduce energy waste, costs and carbon emissions. Our key aspiration is to help clients use less, without impacting on operations. Use less will result in least costs. Carbon emissions will naturally fall in line with the reductions. Services provided can include: • Energy tracking, identify waste and produce action plans • Advice in making better use of building services. Use less will cost less • Optimising the operation of energy using services. • Fast energy audits with usable feed back • Benchmarking energy usage with comparable buildings and

provide targets for best practice. If the client has half hourly metering, remote data logging services can be provided for no capital cost or alterations. Advice and support can be provided for the provision DEC and EPC certification, keeping clients ahead of emerging legislation that affects energy users and emissions. Documents for projects and tendering can be set up and validating tender offers with a view to meeting best practice in services installation, focused on reducing carbon emissions.

FOR MORE INFORMATION Contact: Mr G J Goldner, Systematic Energy 70 St Clements Road Benfleet, Essex, SS7 5XG. E-mail: goldner@systematicenergy.org.uk Tel: 01268 456162 Mobile: 07908 205023

Visit the website to view the categorised product finder

8 www.healthbusinessuk.com

Time is running out to combat climate change

CRC support services from Swan Energy Ltd

ombating climate change will require rapid action to reduce emissions in buildings, plant and equipment, plus vehicles and transportation systems. Equally important, there will have to be significant behavioural changes from everyone. EIMR is a UK-based energy and environmental consultancy. Since 1989 it has worked with UK and overseas clients in both the public and private sectors. We offer technical assistance and a wide range of solutions. EIMR can identify opportunities to reduce energy consumption and carbon emissions. We provide bespoke client research – including project appraisals, evaluations and market assessment studies – ensuring that we supply the data and information required for accurate decision-making. And if we don’t have the data or expertise in-house, we’ll use our network of contacts to find it fast. EIMR also provides an event

wan Energy Ltd provides professional carbon and energy management consultancy services associated with the responsible use of depleting energy sources and combating global climate change. We provide consultancy services for organisations that need to comply with the EU Emissions Trading Scheme or with the imminent Carbon Reduction Commitment (CRC). The CRC is the mandatory cap and trade system for carbon emissions from large commercial and public sector organisations which is due to be introduced from April 2010. CRC management and support services offered by Swan Energy Ltd include: • Eligibility audit to determine if your organisation will be covered by the scheme • Completion and submission of all forms and other documentation associated with the scheme • Development and implementation of monitoring and reporting procedures to ensure compliance with

management service, producing events and developing the right messages and campaigns on environmental issues for both staff and the wider public. Let us know your requirements – contact us today.

FOR MORE INFORMATION Energy Intelligence & Marketing Research Address: 192 Sandyford Road, Newcastle upon Tyne NE2 1RN. Tel: 0191-261 5274 E-mail: cox.andrew421@ googlemail.com

Barron Evers Ltd – energy engineering and consultancy arron Evers Ltd is a multi-disciplinary engineering consultancy in energy and utilities including renewables, providing both technical and commercial aspects for your projects and at any stage from primary design through to operation and maintenance. Main services include: energy engineering and consultancy, utility engineering, renewable projects technical advice and management, mechanical engineering and design, HV/LV engineering and design, HV/ LV operation and maintenance, power systems and earthing design, owners engineer, legislative and compliance advice, and contract and commercial advice. Well versed in EBPD and Climate

Reduction Commitment. Vast experience with Electrical Private Networks and Grid Connections. Barron Evers Ltd has well qualified staff with registered energy engineers (Energy Institute), energy assessors (EPCs & DECs), Carbon Trust energy advisors and HV authorising engineers. Barron Evers Ltd has ISO9001, ISO14001, and OSHAS 18001 as well as being an equal opportunities employer. Main office in Glasgow and with a presence throughout UK.

FOR MORE INFORMATION Tel: 0141 353 5020 Fax: 0141 332 7005 E-mail: mark.hobbins@ barronevers.com Web: www.barronevers.com

the scheme rules • Complete management of CRC requirements for your organisation on your behalf by Swan Energy Ltd. We also provide carbon footprinting services to assist organisations that choose to report their emissions on a voluntary basis. Swan Energy Ltd offers carbon footprinting assessments leading to accreditation to the prestigious Carbon Trust Standard.

FOR MORE INFORMATION Swan Energy Ltd Tel: 01484 843867 Fax: 01484 840961 E-mail: crc@swanenergy.co.uk Web: www.swanenergy.co.uk

Sustainability, energy management and climate change experts nderstanding and responding to sustainability challenges and opportunities, and demonstrating commitment to minimising impact on climate change, are essential to an organisation’s efficient and responsible operation. DNV is a leading provider of sustainability, energy management and climate change services, combining industry knowledge, technology expertise and innovation to help organisations enhance their performance responsibly and cost-effectively. Through 300 offices in 100 countries, DNV provides advisory, assessment, assurance and training solutions in the public and private sectors. Through our engagement with a wide range of healthcare organisations in the UK and around the world, DNV has gained an in-depth understanding of sector. We have also developed a range of healthcare-specific solutions which deliver tangible and cost-effective improvements in sustainability performance and build stakeholder trust, including: • Sustainability report assurance • Sustainability management advice

• Energy management advice • Climate change advice and assurance • Clean energy advice • Quality, environmental, health and safety advice and certification • Ethical supply chain management assurance • Corporate governance assessment • Training

FOR MORE INFORMATION Find out more at http://www.dnv.com/focus/cr/ or contact us on dnv.uk@dnv.com

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Need help with CLINICAL WASTE ? Grundon provides a Total Waste Management package to hospitals, clinics, laboratories, care homes and PCTs, comprising some or all of the following: Clinical waste from medical, nursing, dental or pharmaceutical applications. Sharps containers, yellow sacks and colour-coded 660 & 770 litre lockable wheeled bins to comply with HTM 07-01 Radioactive waste low level waste from teaching or R&D labs

Hazardous waste 'Haz-Box' for low volume producers; advice and quotations for larger volumes, including batteries and WEEE Confidential waste secure, mobile on-site shredding service

Mixed recyclables all cardboard, paper, plastic bottles, steel cans, aluminium cans, glass bottles & jars into a single container General waste wide range of container types & sizes for residual waste Energy from Waste sustainable disposal option avoiding landfill tax Technical assistance to ensure compliance with pre-acceptance audits

For more information please call our Clinical Operations team on 0870 060 4322 or e-mail them at clinical@grundon.com

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together we can find the right solution... Polkacrest is a leading provider of total waste management solutions for the healthcare industry Professional, Sustainable, Clinical Waste Management Solutions. Responsible

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or visit www.polkacrest.co.uk

Written by Gill Ross-Jones, policy adviser Hazardous Waste, Environment Agency

8 www.healthbusinessuk.com clinical waste

Safe waste disposal Clinical waste is almost always considered hazardous and mishandling it presents a very real risk to human health The correct handling of healthcare waste is an issue that must not be overlooked within the NHS. Although the necessary procedures are not particularly complex or challenging, significant effort is required by management to ensure systems are set up properly and then monitored to ensure they continue to run effectively. ENVIRONMENTAL IMPACT The Environment Agency monitors all types of waste producers and their output with the aim of reducing the impact of that waste on the environment. In the case of clinical waste – almost all of which is classified as hazardous waste and where mishandling presents a very real risk to human health – the emphasis is on ensuring safe as well as efficient treatment or disposal. The Environment Agency seeks to achieve this by working with healthcare establishments to promote and support best practice. Working

in partnership with industry is the preferred option and has been found to be the most effective. However, as the environmental regulator, the Environment Agency also has enforcement powers to discourage infringements of the law, which can be used to impose fines on persistent offenders. Best practice in managing healthcare waste would see employment of a fulltime environment manager who oversees trained staff, ensuring complete waste segregation, keeping accurate records

and employing a fully compliant waste contractor. There are several measures that are comparatively simple to implement that can help trusts move towards this ideal. WASTE SEGREGATION Segregation is the key to effective waste management as mixing hazardous wastes with non-hazardous wastes means it all has to be classified as hazardous. Trusts are reminded that this is not optional and that the law requires waste producers segregate materials through

“

Best practice in managing healthcare waste would see employment of a full-time environment manager who oversees trained staff, ensuring complete waste segregation, keeping accurate records and employing a fully compliant waste contractor

”

The Business Magazine for HEALTH MANAGEMENT

8 www.healthbusinessuk.com

Health Business | Volume 9.6

clinical waste

the Hazardous Waste (England and Wales) Regulations 2005. This prohibits the mixing of a hazardous waste with any other category of hazardous waste, non-hazardous waste or other substances (unless authorised to do so). Guidance on this is available in the government’s Health Technical Memorandum, Safe Management of Healthcare Waste (HTM 07 01). This is available on the Department of Health’s website and explains how to segregate waste in order to meet legal requirements. Implementing waste segregation is not difficult, particularly as most people sort their household waste already. Trusts that have implemented outstanding segregation procedures have done so by ensuring the following measures were in place: • The support of senior management • Trust-wide training and induction of all staff • Careful placement of properly labelled bins

and the waste manager would then advise and coordinate a consistent approach. Internal auditing is a major part of the Health Technical Memorandum and many disposal sites now demand this as a prerequisite for receiving waste from medical practices. WASTE DOCUMENTATION Clinical waste from medical practices, with the exception of the small sub-waste stream of non-hazardous medicines, is always a hazardous waste. This means it must be accompanied by a consignment note when it is removed from a practice. If your waste contractor does not provide a hazardous waste consignment note you should seek advice from the Environment Agency immediately. There are two problem areas surrounding consignment notes that are all too common. Firstly, the waste producer is often unaware

It is the legal responsibility of the waste producer to “provide a detailed written description to the contractor of the composition of each clinical waste stream. Management should be aware that each time waste is collected a legal declaration is signed on behalf of the trust certifying that the description is correct

• Use of internal audits and ward champions to monitor performance • A co-ordinated programme of change. The message behind this is that staff will segregate effectively if you provide the tools, training and support for them to do so. A few posters and e-mails will probably do little to bring about change. Packaging and labelling is another vital aspect of segregation. The segregated waste must be kept in appropriate containers that are clearly labelled, identifying both the waste contents and the source department or unit. This is particularly important for pharmaceutical wastes, anatomical wastes (particularly from pathology laboratories), and chemically contaminated wastes. Furthermore, the packaging must meet the requirements for the carriage of dangerous goods to ensure it can be transported by the waste carrier, or internally, without the risk of leakage. Advice on this should be sought from your dangerous goods safety adviser. AUDIT YOURSELF Segregation is rarely going to be perfect. But what is important is that management systems are in place to prevent serious failures, to monitor performance and identify where improvements can be made. An effective audit system would see each ward, unit or department having its own waste champion who supports local staff and audits performance each month. The trust could form a committee of these champions

The Business Magazine for HEALTH MANAGEMENT

”

that completion of key parts of the note remains solely its legal responsibility. This can lead to the second issue: producers tend to let the waste contractor complete it for them. Although this is acceptable in some circumstances, producers are reminded that the legal responsibility remains with them. It is the legal responsibility of the waste producer to provide a detailed written description to the contractor of the composition of each clinical waste stream. Management should be aware that each time waste is collected a legal declaration is signed on behalf of the trust certifying that the description is correct. Transport is another important issue. Waste producers have a duty to ensure waste is packaged properly for transport. The Carriage Of Dangerous Goods Manual, available on the Health and Safety Executive’s website, forms the basis of standards for this. Primary Care Trusts should be particularly aware that the requirements for the carriage of loose bagged waste (‘in bulk’) can be fundamentally different to the carriage of waste in wheeled carts or other suitable rigid containers. If your contractor is collecting bagged waste ‘in bulk’ the Environment Agency would recommend checking this is packaged and loaded onto the vehicle in accordance with the relevant requirements. FINAL DESTINATION Historically, clinical waste has been sent to incinerators operating at hospitals. These

incinerators were considered suitable for almost all clinical wastes and so poor segregation was not such an issue. In recent years, however, the number of clinical waste incinerators has declined significantly, creating greater demand for the reduced incineration capacity. In the last decade there has also been a rapid expansion in alternative treatments. Often these are based on the well established principles of the laboratory autoclave and the most modern of these devices use state of the art technologies that are very effective at killing bacteria and viruses. They represent a substantial, innovative and forward-looking investment by the clinical waste industry and now form a large and essential part of the treatment and disposal infrastructure. Unfortunately, these alternative treatments have no recognised performance against chemicals and pharmaceuticals, are not used for anatomical waste for ethical reasons, and can be prone to mechanical problems if they are fed large metal implements. They are, therefore, not normally authorised to process certain clinical waste streams. This point highlights further the increasing importance of segregation by the producer, to ensure that optimum use is made of the remaining incineration capacity, and that unsuitable wastes are not sent for alternative treatment. RECORDS AND RETURNS As producers you are legally required to keep a register of hazardous waste records. This must include consignment notes (and related documents) and consignee returns provided by the destination waste management site to confirm the waste arrived and detail what was done with it. If the destination waste site has not provided this confirmation, the Trust’s register is incomplete, something which should be addressed with some urgency. Management should also be aware of how far their Duty of Care extends. Each producer has a Duty of Care that continues after waste has left the premises and been transferred to a waste contractor. To discharge this, Trusts should take reasonable measures, in addition to those mentioned here, to ensure that the company you transfer waste to is appropriately authorised to deal with it. Waste management is not meant to be difficult, however, it does require some resources and management to ensure that there is no risk to the environment or human health. If things goes awry, the producer may have some liability that could result in a substantial fine. The Environment Agency hopes to avoid this through working in partnership with the healthcare industry to ensure waste is properly disposed of. This would benefit the healthcare industry and help improve the broader environment for all of us.

Visit the website to view the categorised product finder

8 www.healthbusinessuk.com

Clinical waste disposal from PHS Group

Solutions for a safe, secure workplace

many years W ith experience in the collection

eton is a leading mail order company providing more than 57,000 health and safety and facilities management solutions to promote a safe, secure workplace. From safety signs and spill kits to first aid kits and fire extinguishers, we are the market leaders in health and safety products and we aim to help businesses comply with health and safety regulations by using our expertise in the most up-to-date legislation. We pride ourselves on our UK contact centre based in Banbury, Oxfordshire. Our customers recognise the difference that local staff can make to their business. They understand customer needs, recognise the solutions and deliver it with a smile. The easy to view online catalogue can be browsed from any PC and is supported by secure online shopping available 24 hours a day, seven days a week. If there is something you can’t find in our catalogue or online then our Quotes and Specials team can help, they can customise almost anything and source

and disposal of healthcare waste, PHS Wastemanagement is the preferred choice for the healthcare sector. We are able to offer a highly reliable and flexible service for all forms of healthcare waste such as infectious clinical, pharmaceutical, offensive and even chemical waste. At PHS we pride ourselves on providing a tailored solution to meet the complex needs of the healthcare community including high street pharmacies, NHS Trusts, care homes and at-home care. Our focus on providing community services means that we are able to collect a wide range of waste streams from small sites as well as high volume collections from hospitals.

Our highly trained staff can offer advice on all areas of waste legislation and will ensure that your waste is stored only in approved containers, transported in strict accordance with legislation and “Best Practice Guidelines” and disposed of in the most appropriate and environmentally conscious manner. All of our disposal routes are fully audited and use Best Available Technology to ensure that your waste is safely disposed of in a way that seeks to limit the environmental impact.

FOR MORE INFORMATION PHS Wastemanagement Tel: 029 2080 9090 Fax: 029 2080 9091 E-mail: wastemanagement@phs.co.uk Web: www.phshealthcarewaste.co.uk

those hard to find items for you. We manufacture in the UK giving you the benefit of custom signs the very next day and custom labels within 48 hours. All in stock orders received before 5pm will be despatched same day – normally for delivery next day.

FOR MORE INFORMATION Seton, PO Box 77, Banbury, OXON, OX16 2LS Freephone: 0800 585501 Fax: 0800 526861 E-mail: sales@seton.co.uk Web: www.seton.co.uk

Complete healthcare waste services from SRCL RCL is the UK’s leading healthcare and specialist waste management company. We work with local and national companies across the public and private sector to improve employee and customer safety, ensure legislative compliance and minimise the environmental impact of waste disposal. With an extensive UK network, we provide healthcare waste collection and disposal, hazardous waste services, waste auditing, waste training and onsite waste management services to NHS trusts, GPs, dentists, pharmaceutical

Seal and identify your clinical waste bags he hospital and medical environment presents many opportunities to make use of tamper evident sealing devices to provide security and identification, from pharmacies to waste disposal areas. JW Products Ltd was established eight years ago to provide health professionals with a single supply source for these types of products. Our products are used extensively in major acute hospitals, small PCTs and research laboratories throughout the UK. Give us a call or drop us an e-mail to discuss your requirements and find out how we can help you find a solution. Some common uses of our products are: • Sequentially numbered and custom printed bag ties ideally suited for sealing and identifying clinical waste bags, providing the mandatory audit trail for waste disposal. • Tamper evident security seals for many and varied applications including

manufacturers, private sector businesses; research companies and many more. Our services deliver unrivalled levels of compliance and, with fully managed, in-house disposal; we provide a direct-to-customer service, missing out third party suppliers.

FOR MORE INFORMATION Call our Customer Service Team on 0845 124 20 20, go online at www.srcl.com or e-mail us at info@srcl.com to find out how SRCL Protects People and Reduces Risk.

key cabinets, fire doors, patients property bags and pharmacy tote boxes to name but a few. • Multi-use zipped security pouches for secure storage or transportation of hospital files, medicines or patients’ property.

FOR MORE INFORMATION JW Products, PO Box 220, Egham, Surrey, TW20 9WH Tel: 01784 471155 Fax: 01784 470170 E-mail: sales@jwproducts.co.uk Web: www.jwproducts.co.uk

The Business Magazine for Health Management

If a hand dryer doesn’t have this logo on it – it’s not certified hygienic. Other hand dryers are unhygienic. They recycle dirty washroom air, blowing it onto your hands. So we developed the Dyson AirbladeTM hand dryer. A HEPA filter removes 99.9% of bacteria from the air it uses. An anti-microbial coating inhibits surface bacteria growth by 99.9%. It’s the only hand dryer certified hygienic by independent public health specialists NSF International.

To find out more or to arrange a demonstration, please call UK: 0800 345 7788 ROI: 01-401-8300 or visit us at www.dysonairblade.com

8 www.healthbusinessuk.com

Health Business | Volume 9.6

facilities management

Economic climate change – the impact on healthcare facilities With prime minister Gordon Brown recently having discovered the c-word (cuts), Keith Sammonds, managing director at the Healthcare Facilities Consortium, takes a look at some of the possible impact on facilities management services within the healthcare environment In the last edition I noted that in a recent television interview NHS chief executive David Nicholson spoke about the challenge of delivering efficiency savings and how facilities management can contribute while adding value to the patient experience. Specifically he outlined 5.5 per cent growth over the next two years but after that several years with very little growth. He noted: “We need to think five years rather than two…over the next two years when we have money to invest we must invest it in things that will improve productivity across the system as a whole and that is where we want to see people focusing their attention.”1 PUBLIC SPENDING CUTS It has been interesting to note the reaction to the David Nicholson interview I quoted in the last edition as I have travelled around the UK meeting healthcare facilities teams. This has been brought into an even tighter perspective by the recent Flourishing FM Conference in Oxford (16-17 September) as the morning news was full of Gordon Brown having mentioned “cuts” in public spending. He specifically noted that there would be no cut in front line services BUT there is no real definition as to what are considered front line services by the politicians. To put this into perspective: In round figures facilities management represents about 30 per cent of the national healthcare spend and employs approximately 25 per cent of healthcare staff. But facilities are often quoted as providing 100 per cent of the patient (and visitor) experience. Some of the items that have been brought up in this context are very enlightening2: • If there is to be no cut in front line services (medical and nursing teams) this means the budget reductions will fall in unequal proportion on the support staff including the facilities team. • We have been struggling to get the funding from our board to properly fund the cleaning regime to maintain the hospital to the National Standards for Cleanliness – how are we now supposed to do this with a cut in budgets? • Having worked very hard towards our environmental targets the reduction in electricity use has moved us down a pricing band, which means our actual bill has gone up. We need to use about two or three per cent more electricity to show a saving on the bills. • We have highlighted the potential loss of staff

“

In round figures facilities management represents about 30 per cent of the national healthcare spend and employs approximately 25 per cent of healthcare staff. But facilities are often quoted as providing 100 per cent of the patient (and visitor) experience

”

The Business Magazine for HEALTH MANAGEMENT

Utility Services Major projects for the installation of ducts and cable for utility providers. We currently provide an extensive contribution to the regeneration programme of the electricity network, for 11kV, 33kV and 132kV ducting and cabling.

Civil Engineering All forms of highway construction works, from demolition, excavation, foundations, trenching, construction and reinstatement. Including improvement works, such as footway, street furniture, crossovers and surfacing. Several projects have engaged our contribution for the proposal of potential solutions, from our experiences.

Street Lighting All forms of work for exterior and highway illuminated and non-illuminated furniture. Services range from consultancy, project management, installation, maintenance, trenching & reinstatement and specialist projects. Extensive knowledge and experience with P.F.I. agreements.

Utility Services, Civil Engineering & Street Lighting contractor Unit 1, Riverside View, Spellbrook Lane East, Bishops Stortford, Herts CM22 7SE Tel: 01279 723020 Website: www.ojsmithltd.co.uk Utility & Civil enquiries please contact oscar.smith@ojsutilities.co.uk Street Lighting enquiries please contact andrew.malins@ojslighting.co.uk

The Genus Locker Range is suitable for high demanding education environments. The lockers are manufactured from solid VITRATHENETM which provides outstanding benefits when compared with any other material. Weary Steel Lockers

Bright VITRATHENE Lockers

■ Generally Poor Appearance

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■ Heavy Duty Locks

■ Damaged Doors

■ High Impact Strength

■ Regular Replacement Required

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■ Durability with all Components Recyclable

Vitrathene Limited, ‘1907’ Rufford Road, Churchtown, Southport, Merseyside PR9 8LA Tel: 01704 509 888 Fax: 01704 509 777 Email: sales@vitrathene.co.uk or Smile@vitrathene.co.uk

8 www.healthbusinessuk.com

Health Business | Volume 9.6

facilities management

within healthcare facilities locally and note that this aligns with the national overview that HFC provided at its conference in September 2008. This prompted us to look at training and staff development within the facilities team but there is already little or no training budget other than for medics and nurses. What hope have we got with cuts coming? • We are being driven to address the single sex accommodation issues but at the same time being asked to explain why our available bed days figure is increasing as we reconfigure the multi-bed bays within wards. These things are not mutually exclusive but they do impact on each other. DEMORALISING EFFECT ON STAFF While I am not one to propagate doom, gloom and despondency it behoves us all, from the chief executive down, to bear in mind the demoralising effect that much of the current media speculation about public sector cuts has on our junior staff. The fact that this is then reflected in the middle and senior managers whose comments I have distilled into the snapshots above just reinforces the point that staff involvement at all levels is really important while there is so much uncertainty. So the first question has to be “What are we doing to ensure that all of our staff are fully appraised

of the current situation and how we envisage it affecting our ability to continue to deliver our services in a clean and safe environment?” After all – is this not part of the primary objective of any healthcare provider organisation? So what can we do about any of this? Firstly; do what you do well and to the very best of your ability. We should always be striving to provide cost effective, efficient and reliable services in support of the healthcare provision that is provided from within the facilities we manage. This means that we should have proper planning in place to ensure that our facilities services properly support healthcare delivery to our local community. From the statutory inspections to the Estates Strategy, from the cleaning schedules to the menus and meal delivery – does what we plan properly support the primary objective? Having planned we should then be monitoring; are we providing the planned service? Do we meet our SLA targets? How do our costs look compared with others? Are we meeting quality standards? All this requires proper monitoring regimes and also willingness to benchmark, whether internally or externally, between NHS teams or with contract teams. If you do not have a target you will never ever hit it. One of the biggest costs to the NHS, after staff and drugs probably, is the cost of the

buildings we use, so it follows that if we are not going to cut services we need to look at how we can save money by better and more efficient use of our buildings. Within the estates discipline we are all too used to surveying our buildings for maintenance, safety and energy issues, so we have tried to look at space utilisation and functional suitability in more recent years but I get the distinct impression that there is much more that could be done in these two areas. Although we can probably assess quite easily the spare capacity in our buildings it is a much more complex matter to see how we can then re-align building use to free up disposable space, especially when our larger hospital sites tend to be relatively self contained. Selling off an old ward block that could be surplus to requirements is not easy (or even possible) when it is in the middle of an active District General Hospital. But this should not discourage us from being pro-active in assessing the actual use of our premises and seeing if some buildings or even floors of buildings could be mothballed to help meet potential budget reductions. AREAS OF SAVING Areas we can look at for possible quick wins are out patients, office and other administrative support areas. For example, how many consultants

World-class medical devices for the UK

ETI introduces the new SuperFast Thermapen™

rom its Berkshire headquarters, Vertec has grown in 30 years to become one of the biggest distributors of world class medical devices in Great Britain. Representing leading brands like Surgery C-Arms and DEXA from Hologic, Extremity MR from ONI Medical, Virtual Colonoscopy from Viatronix, Digital X-Ray from Swissray, Portable CT from Neurologica, Ultrasound systems from Ultrasonix, X-Ray protection with Scanflex and radiotherapy consumables from GAFCHROMIC, Orfit and Beampoint, the company has earned a high reputation for customer focus and support. In a recent expansion, a wholly owned subsidiary, VertecSA, was set up in South Africa. Things have gone very well and the new company has had significant success in the market, due again to Vertec’s unique customer focus. Managing director Bill Hipgrave comments: “Vertec is all about the customer. We bring high quality, proven products into the market

TI introduces the new SuperFast Thermapen thermometer. The thermometer is housed in a robust polycarbonate, water resistant, case that contains a Biomaster additive which inhibits bacteria growth. Simply pull out the foldaway, stainless steel, penetration probe to take rapid temperature measurements in under four seconds. The large digital display gives a precise read-out of temperature over the range of -49.9 to 299.9°C with a 0.1°C or 1°C resolution and a high accuracy of ±0.4°C. The new Thermapen has a long

and our customers know that we are prepared to support everything in our range – totally.” A recent addition to the Vertec range is the Picsara image management system. Developed in Sweden, Picsara enables fast efficient management of digital images, still and moving, from almost every department in the hospital. Compatible with PACS, Picsara takes imaging beyond radiology.

battery life of 1500 hours continuous use. The instrument will automatically turn off when the probe is folded back into the side of the unit or after 10 minutes, if this feature is not required it can easily be disabled. The SuperFast Thermapen is available in a choice of nine colours to help eliminate cross-contamination, and is competitively priced at just £46 excluding VAT and carriage.

FOR MORE INFORMATION For further information contact ETI on 01903 202151 or visit www.etiltd.com to buy online.

FOR MORE INFORMATION Tel: 01189 702100 Mobile: 07825 776853 Fax: 01189 701861 Web: www.vertec.co.uk

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8 www.healthbusinessuk.com Visit the website to view the categorised product finder

Clean ventilation systems Term-time maintenance – never more essential without the disruption ichard Norman, managing director of Indepth Hygiene Services, the UK’s leading provider of specialist cleaning of ventilation systems, explained at a recent seminar why there has never been a previous time when those responsible for the maintenance of ventilation systems had more reason to ensure they are maintained in a clean and safe condition. His company’s experience of working with the NHS has shown that regular cleaning of general ventilation systems is an essential component of any programme to combat the spread of hospital acquired infections, notably MRSA. Organic compounds, including human hair and skin flakes, are invariably found in ventilation ductwork to provide an excellent environment for the growth of micro-organisms. But it is not only general extract and supply systems which warrant special attention. Grease extract systems are legally required to be kept clean of grease deposits to ensure they do not present a fire risk to building occupants.

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LC Group plc is one of the leading property and asset maintenance companies in the UK. We have an experienced, directly employed workforce, across our fifteen branches nationwide, enabling us to provide our clients with a comprehensive service on a local, regional and national scale. We are a multi-trade contractor, offering; cyclical decoration, building refurbishments, electrical installation, responsive maintenance and repairs. Since the company was established in 1969, we have built an enviable reputation as a reliable contractor, who works with

In providing their services to the healthcare industry, Indepth follows the HVCA’s Guide to Good Practice “Internal Cleanliness of Ventilation Systems”, TR19. This sets out clearly the required compliance standards and how effectively ventilation systems should be cleaned.

FOR MORE INFORMATION To assist management to assess risk Indepth provide an Assessment of Risk report for ventilation systems free of charge. Tel: 0208661 7888, E-mail: ductclean@ indepthhygiene.co.uk Web: www.indepthhygiene.co.uk

its customers to provide the best solutions for their maintenance requirements. We pride ourselves in building and maintaining long-standing and mutually beneficial relationships with our customers, by ensuring that quality is at the forefront of our work.

FOR MORE INFORMATION Please visit the CLC website at: www.clcgroup.com. Alternatively, please e-mail: mail@clcgroup.com or call 02380 701111 to arrange a face-to-face meeting or to request more information.

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Health Business | Volume 9.6

facilities management

still have their “own” office that is actually used for only a few hours a day or even a week? In simple terms space costs money and empty space (i.e. space that is not in actual use) is money wasted. For an average Acute Trust in England the cost of occupancy in the 2007/08 year was £226.56/square metre so for every unnecessary filing cabinet or equivalent this is a potential saving. If the average office is 28m2 then the potential saving is £6,343.68 per year. This might appear to be small bier but some figures I saw recently showed that one trust has office accommodation running at about 18 per cent occupancy. There are some simple expedients that can be applied to certain staff groups that can help with our occupancy of space too. Our medical typists provide a really important service in support of our clinicians but do they have to work 9 to 5? Do they really need to be all in the office at the same time? Could they split shifts and so reduce the space requirement by hot desking? Indeed do they actually have to be on hospital premises to do the work they do? Modern communications technology prompted one Trust to look to outsourcing their service to India but they could have simply looked to use a proportion of their team as home workers with VoIP phones and good, secure network access. This could also be used to support some of the

“green” issues as we would be reducing the greenhouse gasses by reducing staff journeys and potentially also reducing the car parking pressures on site and so easing one of the biggest gripes from our visitors and patients. I am not picking on medical typists but citing this as an example of the questions that may be worthwhile asking. Just because space is currently occupied does not mean that has to be the case long term. We may need to think a little laterally to come up with some really innovative and productive solutions that could actually improve our staff working conditions and productivity as well as relieve our reliance on space within the hospital environs. A start point has to be the use of a properly designed and managed space management information system linked with the CAD drawings of our estate. We can then start to analyse the space we use, what it is used for, how suitable for purpose it is and how much it is used. Space is not a free good. At the recent Flourishing FM Conference4 that I noted at the start of this article it was interesting to hear the nurse practitioners talking about the progress they had made with their estates colleagues by implementing a rapid improvement team in response to a “poor” audit visit and report. The result was more effective use of the nursing staff and saved space. The keynote at this conference was delivered by

Paul Kingsmore from Health Facilities Scotland and he spoke about Facilities at the Heart of Healthcare citing five core issues: Quality, Innovation, Safety, Productivity and Sustainability. He noted that although we work under differing political contexts we all work towards the same goal – delivering healthcare! Specifically he said that “we will have to do more with less over the next 10 years – need to be more efficient – individually make a difference”. As we move into an era framed by the profligacy of the banking sector and the governmental response to shoring this up, we all need to ask ourselves “how can I make a difference in my organisation?” Notes: 1. The David Nicholson interview is on Focused FM TV and can be viewed at www. focused-fm.tv from any computer equipped with a browser and media software 2. Comments distilled from various discussions and questions raised at recent conferences, meetings and day events 3. HFC Benchmarking Club information for Acute Trusts 4. The Flourishing FM Conference was held at the Kassam Stadium Oxford on the 16th & 17th September and the presentations from the conference are available on the HFC web site www.hfc.org.uk.

Secure archive and destruction services

Telephone systems for the health sector

larks Archive Storage offers state of the art archive services supported by our storage facility designed to allow maximum flexibility and access to your material. CAS is ISO9001 and ISO27001 certified. Using the latest technology, each archive box is bar-coded and scanned, keeping a secure audit trail of all clients’ transactions. Our retrieval and collection service has been proved and tested over many years. We are able to supply storage boxes designed specifically for the storage of document records and files, made from high quality, strong and durable board. All businesses produce documentation containing confidential and sensitive information which, under ever increasing laws, must be securely destroyed and disposed of to comply with legislation. We offer a reliable destruction service, supplying a secure waste wheelie bins in a variety of sizes for ease of transportation. There is no contract

ootprint supplies telephone systems to medical practices. As they only deal with medical practices they have gained a deep understanding of their requirements and practices all across the UK now look to Footprint for advice, support, products and services. If you are looking to upgrade or change your telephone system you can draw upon the experience they’ve gained. The MediCall telephone system supplied by Footprint comprises of uniquely designed features such as M-Call. M-Call is the facility for staff to immediately notify colleagues when they are in need of assistance. Footprint also supplies a range of specialist call recording solutions. These range from a simple on-demand system (a button on the handset) to a system that captures all inbound and outbound calls. Footprint’s products include: • Telephone systems start at just £3,995 • Call recording systems

to adhere to, only a charge on each collection when required. The bins are transported back to our premises and the documentation is then shredded and destroyed in accordance with the Data Protection Act. We provide a daily service to and from London and a pre-arranged service to the rest of mainland UK.

FOR MORE INFORMATION Clarks Archive Storage Contact: Danny Clark Address: Stour Valley Business Centre, Brundon Lane, Sudbury, Suffolk CO10 7GB Tel: 0845 5050 003 Fax: 0845 5050 004 E-mail: info@archive-storage.com

start at just £1,495. All products are designed to assist medical practices in dealing with high volumes of calls. The MediCall telephone system will integrate directly in to clinical databases. The automated appointment booking system will reduce DNA levels by allowing patients to book, amend and cancel appointments 24 hours a day.

FOR MORE INFORMATION Tel: 01903 531567 E-mail: info@footprint-tele.com Web: www.footprint-tele.com

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Triline shows the way

Europe’s Leading Sign System Now Available in the UK

Combining stylish good looks in a unique anti-vandal, anti-theft design, the comprehensive range of Triline wayfinding systems are now available in the UK. Flat and curved signs can be created from aluminium and plastic components that are available off-the-shelf. They offer an almost unlimited range of combinations in seven different styles, enabling architects, designers and specifiers to create their own designs. Get the full details now.

Triline_HealthBusiness_Sep09(1781 1

10 Lyon Road • South Wimbledon London • SW19 2RL Tel: 020 8545 8880 • Fax: 020 8545 2988 Email: solutions@trilinesigns.co.uk www.trilinesigns.co.uk

26/8/09 11:47:03

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Written by Navigator Signing Solutions

signs

Making buildings legible How can a hospital implement a clear and consistent wayfinding and signing strategy? When you visit A hospital, are you able to find your desired destination or the correct department quickly and easily? No? Feel as though you are being sent round in circles? Lost? Becoming stressed because you are late for that important appointment? This is not an uncommon scenario but one which can be avoided if hospitals and buildings in general are made more ‘legible’ to their users. The simplest way of doing this is by planning and implementing a clear and consistent wayfinding and signing strategy. Signing is an essential element in a building’s effectiveness, getting it right is not something that can be left to chance. Poor signing is consistently mentioned in the ‘top ten’ complaints by building users. SUCCESSFUL SIGNING There are clear issues to address and accepted ‘best practice’ principles and methodologies for successfully signing a building. This begins by taking a holistic view of a building and identifying a ‘family’ of sign types that together, address all of the signing requirements for a building. Each sign in the ‘family’ should work in isolation but they should also work seamlessly together. Signs should work rather like a relay race, in that the building user is passed from sign to sign until they reach their desired destination. To develop a successful signing or ‘wayfinding’ strategy, it is necessary to consider six key questions, these are: 1. What are your communication objectives? 2. Who are the signs for? 3. What is the function of each sign? 4. What are the messages? 5. Where to locate signs? 6. What should signs look like? What are your communication objectives? Information conveyed by signs goes well beyond literal statements of fact. Choice of typeface, colour and style of signing, and the way that signs are integrated into a building will together transmit a message about the way the organisation sees itself. In other words, a signing system can express qualities, such as dynamism or integrity that define corporate image. In setting communication objectives, the full range of dynamic capabilities offered by the signing system should be exploited. WHO ARE THE SIGNS FOR? Signs have different audiences, all of whom require different sorts of information from signs. Staff needs are often underestimated. High

“

Signing is an essential element in a building’s effectiveness, getting it right is not something that can be left to chance. Poor signing is consistently mentioned in the ‘top ten’ complaints by building users

turnover of permanent staff, frequent temporary and freelance manning, and insularity of working location all generate a need for effective messages. The extent of staff needs should be thoroughly researched and allowed for. Maintenance personnel often belong to third party management agencies. They need to find lift control rooms, riser and service ducts, air conditioning systems, alarm systems, telephones and office equipment. Deliveries and internal mail require a referencing system to ensure supplies and post reach their correct destinations. This may be an alpha numeric coding system which ties in with the facilities management system for the building or even an electronic system of referencing spaces. Emergency services like the Fire Service must be able to orientate themselves quickly, both from outside and inside a building, relative to reference access points such as entrances and stairwells.

”

WHAT IS THE FUNCTION OF EACH SIGN? A signing strategy will include a ‘family’ of sign types, each of which will have a specific role to play. Branding Signs: The role of this category of signs is to establish ‘ownership’ of a space. These signs may appear at site entrances, on building elevations, in reception areas and other important locations within a building. These signs are usually significant and play a role in corporate marketing. Directory Signs: Directories give an overview of a building. They offer the main building or floor occupants in the form of a list and may display a map or floor plan. Direction Signs: This category of signs guides a person to a destination. They form the backbone of a signing strategy. Typically they originate at a directory, and then give guidance along a route. If their audience comprises of mostly visitors, then a high frequency of

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Health Business | Volume 9.6

signs

signing is necessary to maintain reassurance. Location Signs: These signs inform the visitor of arrival at a destination. This might be a building, an area within it or a specific room. Each room or area should be unambiguously labelled, perhaps with a building management referencing code. Instruction Signs: These signs tell people how to act in specific circumstances or how to operate equipment or inform of policies or procedures. Safety signs: There are five categories of safety signs; Prohibition, Warning, Mandatory, Safe Condition or Fire Exit, and Fire Fighting Equipment. Such signs are a statutory requirement in a building and are designed to a prescribed format. WHAT ARE THE MESSAGES? Communication in signing is usually made up from text, maps, pictograms and logos. Text: Written language forms the majority of signing messages. Its language and terminology must be familiar to the audience and should not employ in-house jargon or unusual abbreviations. Consistency is very important; destinations must be described identically throughout the range of sign types. Message length should be minimised and punctuation eliminated. Maps: Maps should be simple and orientated in the direction faced by the viewer. Maps should show the main circulation routes and destinations and include en-route reference landmarks like lift cores or trees. Maps are a valuable orientation guide but should not represent the primary source of information. Pictograms: Sometimes called symbols, pictograms are a shorthand expression of a verbal message. Some are universal, like toilet, telephone, wheelchair access and many traffic signs. Pictograms should be used with caution and text used where there is any doubt about comprehension. Logos: Logos are company brands and are symbols; visual images, words or both which have been chosen to suggest the values of an organisation. Care should be taken when using logos in signing as over use can lead to a ‘wallpaper effect’ which will devalue the logo. WHERE TO LOCATE SIGNS? Positioning signs should be carefully considered. In the context of non-retail signing, for example, offices, factories, hospitals, universities etc, there are three types of locations for signs: Wall or door mounted signs: Mounting signs on walls and doors is simple and secure. It works well when directly facing the audience and has few dimensional constraints. Impact can be enhanced by spacing signs off a wall or door. Projecting signs: These signs have a big impact and can be visible from a long distance. Projecting signs can carry messages on both sides. The size of projecting signs should be limited for structural or vulnerability reasons. Suspended signs: Suspended signs have

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similar advantages to projecting signs but can be dimensionally larger. Suspended signs require pre-planning for headroom and ceiling suspension points. Freestanding signs: Signs in this category can be either permanent or moveable. Permanent signs require a robust support structure and are normally used for external directional signs. In interior situations, moveable freestanding signs negate the need for structural the need for structural mounting in the floor. Lighting is important. Signs should be positioned in good light or lighting should be provided. WHAT SHOULD SIGNS LOOK LIKE? There are ‘good practice’ guidelines for how signs should look. This should not inhibit creativity. Size of text: Size of text should be determined by reading distances. Larger than minimum sizes can be used but there should be consistency across sign types. Upper and lowercase letters are more legible than all capital letters. Lines of text that read from left to right are easier to read than lines of text that are ‘centred’ or ranged from the right. Typeface: Choice of typeface is critical as it greatly effects legibility and sets the tone and image for the building. Letters with even character strokes are more easily read; highly decorative fonts are more difficult to read.

Some typefaces are strongly linked to historical eras or to architecture or design movements. Choice of letterforms is often constrained by following an organisations corporate identity manual. Process of reproduction should play a part in choosing typefaces. Colour: Colour in signing makes a corporate statement and contributes to a buildings decor. Colour can enhance the understanding of complex signs and can also be used as a coding device for floors, buildings or wings. It should be noted, however, like all codes it has to be learnt and may not be immediately understood. Care should be taken to ensure that there is enough contrast between the graphics and the background colours to make signs legible. The appearance of colours can change dramatically under different lighting conditions. By considering the information above you will have decided what different type of signs you will require and how they relate to each other, what they say, what they look like and how they are to be made and where they will be located. This should result in the building being legible to its audience who can now find their way around easily, efficiently and effectively.

FOR MORE INFORMATION Navigator Signing Solutions Limited Tel: 0191 2605252 E-mail: navigatorsigns@btconnect.com

Visit the website to view the categorised product finder

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Quality plastics from Abbey Distribution Ltd

Digital Signage Solutions – LCD advertising

stablished in 1998, Abbey Distribution Ltd is a medium sized family business operating from headquarters in High Wycombe, specialising in the manufacture and supply of premium quality sign products to sign makers and direct to market for renowned British retail and national organisations. Abbey guarantees competitive pricing thanks to CNC machining and digital print facilities in the following products: • Easytray® sign boxes • LED • Door signs • Acrylic signs and lettering • Dibond panels • Wall cladding systems • Leaflet/brochure displays Efficiency at Abbey extends beyond simply providing superior product for

llSee Technologies is the innovative manufacturer of cost effective Digital Signage LCD Advertising screens. We tailor make dynamic digital signage products for all budgets and requirements. Our products range from 15” digital photo frames to 82” large screen display for panel or rack-mounting. Recently we introduced a new advertising platform LCD Digital Poster. This freestanding digital player which has been designed to replace traditional posters comes with USB port to allow you to upload digital content and is very easy to use. There is no need for cables, DVDs, computers or software; Just plug in and play. All you need is one electrical socket. You can schedule your picture

less cost. Our environment is primary and all material is selected with the planet’s needs in mind. We operate over 10 recycling categories. Records of products supplied are maintained for up to 10 years so we can not only supply parts throughout that period, we can even recycle your old signage products for you. Our care helps us both to be better, greener and save money.

FOR MORE INFORMATION For more information please contact us at: Abbey House, Lisle Road High Wycombe, Buckinghamshire, HP13 5SH. Tel: 01494 449975 Fax: 01494 449978 E-mail: sales@abbeydistribution.com Web: www.abbeydistribution.com

and sound files using the scheduling programme supplied, there is also an eco-friendly timer so you can have the screen on 9am-5pm Monday-Friday and switched off Saturday and Sunday. This new concept of advertising is 10x more eye-catching than static displays used to promote NHS services. The new digital displays are a great way to offer flexible and dynamic ways to promote your details 24/7 easily.

FOR MORE INFORMATION AllSee Technologies Ltd. Tel: 01224 289 780 Fax: 01224 515 188 E-mail: info@allsee-tech.com Web: www.allsee-tech.com

‘Signs’ of healthy living with DoroTape UK Ltd Slingsby can meet all your workplace needs

over 20 years experience, W ith from humble beginnings supplying application tape alone (hence the name), Doro Tape has since matured into one of the major consumable suppliers in the UK’s sign and graphics industry. Doro provides a vast range of consumables, film and accessories for standard plotter cut signage and display, including whiteboard film, popular for hotel, conference and hospital signage boards, digital printing – everything from poster paper, through to canvas, banner and pop-up film; and the increasingly popular garment decoration flex and transfer paper for work and corporate wear. It’s not just about signs and graphics though. Doro Tape also provide health and safety materials such as non-slip floor laminates, shatterproof window films and, more recently, their Anti Bacterial Laminate with Microban© technology. Along with the great selection Doro Tape can offer, they also pride themselves on the friendly and efficient service

ndustrial and commercial equipment provider Slingsby supplies over 35,000 products through its website and catalogue including a wide range of lockers, changing room equipment and health & safety products. But even with over 35,000 products you may still not find what you’re looking for. No problem, whatever your requirement we can provide bespoke solutions tailored to your needs. With 116 years experience of solving workplace problems our skilled staff can provide advice or guidance and we can manufacture or source solutions especially for you. Our no quibble guarantee and 12 month

provided by their well- trained staff, making their emphasis on ‘Service and Reliability’ second to none. With an extensive stock-holding, Doro Tape can provide next-day service as standard, with the added benefit of free carriage on orders of one hundred pounds or more, and the option of timed deliveries for those last-minute panic orders!

FOR MORE INFORMATION Tel: 01858 431642 Fax: 01858 466992 E-mail: sales@dorotape.co.uk Web: www.dorotape.co.uk www.dorodigital.co.uk

warranty scheme give you complete peace of mind and we can also offer you an instant credit account to make it even easier to place your first order. Nothing is too much trouble, we’ll do all we can to accommodate your needs and we’re confident that our unique combination of product choice, free delivery and no minimum order make us hard to beat. In addition we offer a free next day delivery service for all stocked products.

FOR MORE INFORMATION Call 0800 294 4440 or visit www.slingsby.com today. Quote ref: PH4

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Sign making equipment and materials

Mood Creative nationwide signage

ignscape Systems Ltd provides wayfinding products for exterior and interior, including post and panel, fingerposts, noticeboards and directory units to enable easy navigation of premises and grounds. We supply modular or bespoke systems to suit the need of the client, including our Solar Powered EcoVision range, which negates the need for running costly power to a specific location; this also demonstrates your commitment for being environmentally aware. Working with wayfinding experts we can ensure that your project is well thought out, delivered on time, within budget and that it meets the needs of your “viewing” target audience. All signs and wayfinding solutions

W based company who between

can be colour co-ordinated to meet your corporate needs and improve pedestrian and vehicle traffic navigation The majority of our sign systems for both inside and out are very flexible and can allow for personalisation and simple updating. Our bespoke products can be manufactured from a variety of materials to suit your needs.

FOR MORE INFORMATION To find out more about Signscape Sign Systems and to learn about our comprehensive service, please visit: www.signscape.co.uk Alternatively you can e-mail us at: sales@signscape. co.uk or ring us on: 01934 852888, we’re here to help.

Harveyboard – the printing specialists arveyboard Print & Digital is a specialist Screen Printer and Digital wide format specialist, based in Stockport, south Manchester. We can produce Signs, Labels, Stickers, Promo Items, Clothing, T-shirts, Vinyl Graphics, Vehicle Signage, PVC Banners, Roller Banners for display work also we print stationery duplicate Pads…etc etc. Our website has basic information and images of some of our past work, but please contact us with your requirements and we will do our best to help your or point you in the right direction. We were established in 1980 as

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Harveyboard Screenprint and traded with that name until April 2008 when we decided to amend the name as we had gone digital and went LTD at the same time. We are a family run business and deal with several major companies around the uk, some include NHS, MOD, BROTHER, The National Trust to name a few.

FOR MORE INFORMATION Tel 0161 477 0288 Fax 0161 480 1240 E-mail sales@harveyboard.com Web: www.harveyboard.com

e are a North West

us have been serving the commercial and retail industries over a number of years with the supply and installation of all types of signage from wooden fascias to illuminated panels and flex face signs as well as neon and LED. We offer a full nationwide signage and lighting maintenance, refurbishment and installation service, including rapid response to damaged existing installations. We offer minimum lead times for manufacturing of signage. All our crews are fully experienced and hold all current scaffold tower and access machine certification. Due to the high risk factor of some of

our works, our crews are all experienced in the paperwork required to comply with strict health and safety requirements. Our crews have worked on a wide range of projects, including The Trafford Centre, The Metro Centre, Cheshire Oaks, Salford Quays, Wyre + Fylde Health Board, Stepping Hill Hospital Stockport, Edinburgh Royal Infirmary to name only a selection. I would welcome the opportunity to discuss in more detail what we have to offer.

FOR MORE INFORMATION Tel: 0161 612 0058 Mobile: 07738 825514 Fax: 084441 77320 E-mail: sales@mood-creative.com Web: www.mood-creative.com

Never worry about losing keys again hen you lose a key you suffer the expense and inconvenience of replacing locks and keys. With access control, you simply void the lost token from the system -problem solved. Your premises remains secure. Access Security designs, installs and maintains all types of electronic access control from single-door to on-line networked PC-based multidoor installations for large sites. An access control system allows you to restrict access within your site, monitor activities throughout your controlled areas and provide 24 hour protection for your staff, visitors and property. Computer Networked Systems – benefits and features: • Full control from your desk – control who enters, when, where and which areas of the site they have access to  • Central control – all doors can be controlled from one place  • Instant access or denial  • Tokens can be quickly and simply added or voided   • ‘Real time’ reporting – every access gained is recorded   • Instant overview – glance at your

FOR MORE INFORMATION If you’d like to find out more about club management systems, call and speak to our specialist on 01908 613326.

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A healthy future Premier Life Skills Ltd is dedicated to promoting wellbeing and managing stress. We help managers and employees to respond positively to challenges, building resilience to enable staff to perform effectively and productively. We can help to build and sustain a healthy future for organisations and their employees. We have more than 12 years’ experience of dealing with stress related problems and issues affecting either individuals or organisations. All our trainers are stress management experts from relevant professional backgrounds, including health and education. We run a range of public and in-house programmes designed specifically to tackle issues of stress in the workplace and to support the work of stress professionals working on a one-to-one basis with clients. Bespoke in-house training can be provided for all staff at all levels, along with consultancy, advice and training in healthy living and lifestyles.

thus enabling them to build healthier lifestyles CPCAB – Level 5 Diploma in stress management The diploma gives you a formal qualification to demonstrate your competence in delivering the training programme in stress and wellbeing to groups or on a one-to-one basis with individuals. CPCAB – Level 5 Diploma in stress coaching The diploma gives you a formal qualification to demonstrate your competence to coach clients regarding work or personal stress. Measuring and managing stress – the risk assessment approach This programme enables employers and external consultants to develop and demonstrate competence in risk assessment for stress at an organisational level. Premier Life Skills can also provide other training programmes for manager and employee development.

We are the only stress training company offering the Counselling and Psychotherapy Central Awarding Body (CPCAB) accredited training courses in stress management and stress coaching.

Courses Tackling stress at work for managers An essential workshop for managers – everything managers need to know about preventing and managing stress in the workplace Developing wellbeing and performance at work A workshop for employees to provide individuals with techniques and skills to combat the impact of stress,

Premier Life Skills Ltd 13 Woodlinken Close Verwood Dorset BH31 6BP Tel: +44 (0)7808 215674 +44 (0)1202 821751 info@premierlifeskills.co.uk jane@premierlifeskills.co.uk www.premierlifeskills.co.uk

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Health Business | Volume 9.6

skills & training

workforce transformation Candace Miller, director of Strategic Workforce Transformation at Skills for Health, explains the importance of workforce transformation and shares some of the tools available to help those involved in workforce design, planning, and development Imagine the chaos faced by healthcare providers this winter if a worst case scenario for the swine flu pandemic is realised. With 12 per cent of the workforce absent from work – struck down during the second wave – those remaining will be working in a hugely pressured environment; at the same time struggling to cope with a massive increase in patient demand. Alternatively, consider the UK’s demographic time bomb – not only do we have an ageing population increasing the pressure on healthcare services, but the healthcare workforce itself is ageing. However one looks at it, it’s going to get increasingly difficult to satisfy the requirement for ever-increasing healthcare quality. These are just two scenarios. In addition are the sociological, financial, technological, and policy trends that drive change within the sector on an ongoing basis. For these evershifting service demands to be met, we need a healthcare workforce that is flexible, affordable, sustainable and appropriately trained. Achieving the optimum workforce Whether public, private or voluntary sector – and regardless of location – the optimum healthcare workforce will have the right staff with the right skills in the right place at the right time. Such a workforce doesn’t come about by accident. It requires ongoing investment in workforce design, planning and development. Historically, planning the healthcare workforce concentrated on ensuring that the required number of people were employed and trained within each traditionally defined job role. However, today’s healthcare workforce cannot afford to be so prescriptive. Adaptability is crucial; and so is quality. The sector needs skills that are flexible and portable. An effective way to achieve this is to focus on the job functions people are performing rather than on their job roles. Each function can then be broken down into recognised national workforce competences. These describe what individuals need to do, what they need to know, and the skills they need to demonstrate, in order to carry out a particular activity. Such a measurable approach to workforce design ensures that each activity is carried out to an agreed and recognised standard – no matter who is doing it, or where in the UK they are based. It enables staff to respond quickly to the ongoing changes faced by their organisations, and it also means that, should the need arise,

“

Consider the UK’s demographic time bomb – not only do we have an ageing population increasing the pressure on healthcare services, but the healthcare workforce itself is ageing. However one looks at it, it’s going to get increasingly difficult to satisfy the requirement for ever-increasing healthcare quality

staff members can be redeployed confidently within the region – or even across the UK. Adopting a function and competencebased approach can provide a way to look objectively at workforce design. Skills for Health has developed a comprehensive database of competences, which can be used to define all clinical and non-clinical roles across the entire healthcare workforce. These are freely available for use by employers. Competences in action Competences are essentially building blocks. When used in context, it is the workforce challenges they help to solve that impact directly on service delivery. In some instances, clusters of competences and related activities have already been amalgamated into Nationally Transferable Roles (NTRs). In partnership with employers,

”

service leads and education providers, Skills for Health is developing a suite of NTR templates. The templates are aligned to the Career Framework for Health and define specific job functions – describing what is involved and outlining the core, role-specific and locality-specific competences required to perform each task. NTR templates are currently available for advanced practitioner, assistant practitioner and administration roles. NTRs speed up the definition of specific roles, saving time and resources. Service delivery can be reconfigured more cost-effectively and the skills mix reorganised more readily. Additionally, recruitment for these roles is made simpler and transferability is increased because skills and competences are consistent, applicable and replicable anywhere in the UK. The use of NTRs also has a knockon effect on service outcomes; such as

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Action Centred Leadership Training John Adair Accredited Professor John Adair is the chair of leadership for the United Nations and is recognised as one of the world’s greatest leadership thinkers. His Action Centred Leadership approach to management within organisations is recognised internationally as a benchmark for excellence. Procentus Consulting are associate consultants to John Adair and will be delivering the following two day courses in Gatwick.

Action Centred Leadership – leading your team to success. Gatwick 11th-12th November 2009

Action Centred Leadership in a Primary Care setting Gatwick 25th-26th November 2009 These courses will introduce delegates to the most robust and powerful of leadership models for application in the workplace. Delegates will complete the course with a full understanding of leadership and its application in the work environment The cost of each of these two day courses would be £395 + VAT For further information and course booking, please contact 01403 793880 or email info@procentusconsulting.com

www.procentusconsulting.com

Advancing management performance in the health sector

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Request a demo today Call us on 020 8652 4653 email enquiries@xperthr.co.uk or visit www.xperthr.co.uk

Health Business | Volume 9.6

8 www.healthbusinessuk.com skills & training

patient satisfaction and reduced waiting times. From an employee perspective, the portability of individuals’ qualifications, skills, and learning and development, results in increased opportunities for progression across the career framework – without the need to repeat education and training. In collaboration with other partners, Skills for Health has also developed approaches to Modernising Healthcare Careers and New Ways of Working. More than a dozen projects have already taken place around New Ways of Working to improve working patterns in the NHS. These cover both extended roles – for positions such as Radiographers and Physiotherapists – and the introduction of new roles; including Emergency Care Practitioners, Associate Practitioners, Spinal Pathway Co-ordinators and waiting time Tracker Co-ordinators for example. First things first Prior to adopting a competence-based approach to workforce design, an organisation must firstly be clear about service need and be aware of what skills and talents are present within its existing workforce to address that need. After reviewing current workforce skills, a strategy can then be developed to tackle shortages, fill any gaps, secure the current workforce and put routes in place to attract and develop new recruits. This workforce strategy is the cornerstone of effective workforce planning. Addressing the requirements outlined in the workforce strategy, the workforce plan then examines different ways to make best use of existing and potential talent – whether this involves a team, a department, or the whole organisation. The end goal is optimum service delivery based on service need. The workforce plan considers how best to configure and manage existing skills and talents to achieve this. Without it, optimum service delivery is impossible. Regional Labour Market Intelligence can be downloaded from the Skills for Health website to help organisations understand the forces affecting service change and consider the implications of national and regional policies and other drivers affecting workforce strategy. To assist in workforce design, planning and development, Skills for Health has developed a range of tools – each of which is designed to provide an easy and time effective way of obtaining, filtering and saving information. Through the Healthcare Workforce Portal, support is also available to for organisations looking to develop their workforce planning capability and capacity. Visit www.skillsforhealth.org.uk to find out more. Skills for Health is the Sector Skills Council for the UK healthcare sector, encompassing the National Health Services, independent healthcare providers and voluntary organisations. Its purpose is to help develop solutions that can deliver a skilled and flexible workforce to improve health and healthcare.

THE SIX-STEP ROUTE TO EFFECTIVE WORKFORCE PLANNING Skills for Health has developed a number of tools to assist in workforce planning. These include the Six Steps Methodology to Integrated Workforce Planning tool, which breaks the process down into six clear stages and shows how to map service change, and define, plan and deliver the workforce required. The methodology can either be used as an educational resource or referred to as a guide to best practice when developing workforce plans. Step 1 – defining the plan Be clear why a workforce plan is required and what it will be used for. Determine the scope of the plan: whether it will cover a single service area, a particular patient pathway or a whole health economy. Then be clear who is responsible for ensuring the plan is delivered and who else will need to be involved in the planning process. Step 2 – mapping service change The first of three interrelated steps towards service redesign in response to patient choice, advances in care or financial constraints. Be very clear about current costs and outcomes and catalogue the intended benefits from service change. Identify those forces that support the change or may hamper it. Create a clear statement about whether the preferred model better delivers the desired benefits or is more likely to be achievable, given anticipated constraints. Step 3 – defining the required workforce Map the new service activities, identify the skills needed to undertake them and specify the types and numbers of staff required. This will involve consideration of which types of staff should best carry out particular activities in order to reduce costs and improve the patient experience. On occasions this may lead to the development of new roles and new ways of working. Step 4 – understanding workforce availability Describe the existing workforce in the areas under consideration. Cover existing skills and deployment, and assess any problem areas arising from demographics and staff turnover. It may follow that the ready availability of staff with particular skills – or, alternatively, the shortage of such staff – contributes to service redesign; in which case Steps 2 and 3 will need revisiting. Consideration should be given to the practicalities and cost of any retraining, redeployment and/or recruitment activities that could increase or change workforce supply. Step 5 – developing an action plan Reflect on the previous three steps and determine the most effective way of ensuring the availability of staff to deliver redesigned services – even if this means some further service redesign. Develop a plan for delivering the right staff, with the right skills, in the right place – incorporating milestones and timescales. Incorporate an assessment of anticipated challenges – including clinical engagement – and consider how a momentum for change can be achieved. Step 6 – implementing, monitoring and refreshing Following implementation, the plan will require periodic review and adjustment. Be clear from the outset how success will be measured, at the same time remaining aware of any unintended consequences of any changes so that corrective action can be taken.

The Business Magazine for HEALTH MANAGEMENT

Performance

Health

HOW RESILIENT IS YOUR WORKFORCE?

Confidence

Managing and improving staff/employee well-being is critical to improving organisational health and resilience as much as it is a matter of compliance with health and safety requirements. While the value of better employee health is now recognised and acknowledged, many organisations ‘struggle’ with knowing exactly where to target action and intervention, particularly when resources are limited and value for money is so critically important. ‘Blanket’ approaches such as (yearly) opinion surveys don’t really help with this. They tell us something about how things look from the point of view of employees, e.g. how satisfied staff are and how they see managers, but they don’t really tell us ‘what goes with what’, i.e. which factors in people’s experience of work tend to be instrumental in yielding different outcomes.

HOW committed they are to their organisation, HOW engaged they are in their jobs, HOW likely they are to look for another job elsewhere, etc. we need to know WHAT factors in the job or work environment give rise to these positive - or negative - work experiences. The key to this is not knowing what factors in the workplace generally promote wellness - or conversely lead to harm - but what factors in ‘my’ work organisation are positive or negatively linked to such important measures of individual and organisational performance, effectiveness and resilience as job satisfaction, organisational commitment, symptoms of stress, attitudes towards clients/customers, citizenship behaviour, etc.

Put simply, rather than simply knowing HOW satisfied people are,

ORA is a method and tool developed to deliver precisely this level of knowledge and understanding about organisations.

ORA helping you understand your organisation and your people.

Helping organisations achieve tomorrow’s goals today

ORA is a surveying system that has been created by Zeal Solutions, an organisation specialising in work psychology.

ORA has helped many different organisations to confidently deal with many different challenges.

ORA offers organisations one of the most efficient and accurate ways of understanding individual and organisational health and well-being.

• Sickness Absence – ORA has helped organisations improve attendance. • Staff Engagement – ORA has helped organisations improve levels of employee motivation.

ACCURATE

EFFICIENT

POWERFUL

Discover workplace features that promote or damage employee wellbeing, motivation and performance.

Understand where to invest resources to achieve maximum impact and results.

Informative reports and feedback procedures enabling transformation of individual and organisational behaviour.

• Stress – ORA has helped organisations take appropriate action for tackling stress. • Management Behaviour – ORA has helped organisations identify performance enhancing management behaviours. • Violence – ORA has helped organisations deal with work-related violence. • Change Management – ORA has helped organisations support their staff through times of change.

Some users of ORA Police Forces

Ambulance Services

Healthcare Trusts

New Media Agencies

Retailers

County Councils

Want to know more about ora? It costs nothing to find out more. Please register your interest today and receive a copy of the ORA brochure and a free ORA sample report. Why not take advantage of our 15 minute no obligation consultation service where you can discuss your specific requirements with one of our advisers.

Simply call or email and quote reference: MORE ORA email: enquiry@zeal-ora.co.uk tel: 0207 419 5081 web: www.zeal-ora.co.uk

Helping you understand your organisation and your people. ORA is registered product of Zeal Solutions Ltd.

Banks

Fire Services

Transport

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Health Business | Volume 9.6

skills & training

Bold, innovative and employee led London Strategic Health Authority’s Wellness Strategy and implementation aims to support the delivery of world class people and world class healthcare in London  In the UK we are now seeing a common direction and terminology and a national focus on health and wellbeing, which highlights the need for the wellness of every individual to be a much higher priority. NHS chief executive, David Nicholson said earlier this year: “We have an ambitious agenda to put quality at the heart of everything we do in the NHS. For staff, the quality agenda offers both exciting opportunities and some considerable challenges as we encourage them to work in new and innovative ways. A key part of our ambition is to turn the NHS from a service focused on sickness to one that promotes and supports wellness.”

AN INTERNAL STRATEGIC CHOICE NHS London has a “bold vision (Healthcare for London – A framework for Action) to ensure every Londoner can access healthcare that is genuinely world class … and ‘ High Quality Care for All – NHS Next Stage review final reports demands that we go further. To achieve this vision, we must place staff at the centre of the movement to deliver real improvements.”1 To deliver this vision and in keeping with our values, NHS London has begun the implementation of a bold, innovative and integrated internal Wellness Strategy for all its employees. The development of this strategy has been influenced by other cultures

around the world and examples of best practice within global wellness companies where world class service, performance and productivity have undergone step changes through the recognition that wellness is an untapped and fundamental way of closing the productivity gap and making a step change of 15-20 per cent in customer service levels. This approach recognises the importance of taking traditional management practices and principles around productivity and performance and fusing them with proactive and positive action for all employees around individual health and wellbeing.   WELLNESS REPORTING As part of the implementation programme, NHS London will be looking at the range of reporting options available. These will come from high-level management reports generated from the Personal Wellness Profiles, such as: • Organisational Wellness – measures against 44 different norms that covers all aspects of wellness at work and outside of work • Brand Ambassador – drawing on a

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Health Business | Volume 9.6

skills & training

basket of over 20 different lifestyle measures to provide insights on how staff “walk the talk” of wellness • Performance & Productivity Index – how well personal wellness capabilities will provide a solid foundation for improving and sustaining world class levels of healthcare and how well employer practices foster such levels of healthcare • Job Quality Index – insights into levels of engagement and retention of staff • Active Travel – how well integrated is everyday physical activity of walking and cycling into commuting and barriers to achieving higher levels of physical activity • 100 per cent v Low Attendance Wellness Attributes – what differentiates people in terms of Personal Wellness Management capabilities who have 100 per cent attendance (recognising also presenteeism as well) versus those with relatively high absences due to sub optimal wellness. Also what are the predictors of absence and how these can be minimised to maximise attendance and performance • Wellness Segmentation Profiling – to understand and develop tailored wellness services and resources • RSI Predictor – to provide greater insights into the wellness habits and capabilities which enable some people to be at low risk of RSI and therefore move towards elimination and not just early intervention • Staff Physical Activity levels – utilising Department of Health five levels of exercise segmentation to determine numbers of people within the different bands - linked to Wellness Segmentation Report - targeted and tailored physical activity improvement plans based on World Health activity pyramid • Wellness Investment – optimising investment in wellness development - frequency tables of the different wellness development activities - readiness to change stages - locus of control scores As part of the scorecard and as a resource for leaders in the London NHS Personal Wellness Zone there is a new section being developed, which will give access to Wellness Benefits Evaluators – an output from the Boorman Review; and WellKom’s ROI Calculator for Wellness Management and other such tools. Also to be investigated is the use of the balanced dashboard, including to see how it is possible to overlay this data against staff survey results and other reporting mechanisms to give us high quality and robust management information to inform our future wellbeing initiatives and identify hotspots for action.   behavioural change principles The wellness implementation pilot approach developed is based on an NHS London branded and tailored online Personal Wellness Zone (POWERING UP) which offers every employee

The Business Magazine for HEALTH MANAGEMENT

“

We have an ambitious agenda to put quality at the heart of everything we do in the NHS. For staff, the quality agenda offers both exciting opportunities and some considerable challenges as we encourage them to work in new and innovative ways – David Nicholson,

NHS chief executive an opportunity top open up a Personal Wellness Management Account. The design, ongoing development and implementation of this Zone is based on recognising these principles: 1. Employee led not expert led – so based on summary of employee wellness development activities and other information in the wellness profiling reports 2. Moving away from the traditional single solution wellness advice to integrated and holistic wellness mapping to enable the individual to understand the inter-relationships and interim steps perhaps required to help them achieve their desired wellness goal and the subsequent benefits this will bring to their personal and professional lives.

”

Learning options could include: skill sheets, mini e-learning modules, one-to-one wellness reviews/wellness coaching sessions – phone/ face to face or web – externally or via own internal nationally accredited Personal Wellness Reviewers and Personal Wellness Coaches, pod casts of wellness development activities, group wellness workshops – by internal nationally accredited Wellness Champions or external experts, nationally recognised vocational wellness qualifications. Notes 1. Extracts from Foreword by Ruth Carnall, chief executive NHS London Workforce for London a Strategic Framework.

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AMC Mentoring – supporting all NHS staff

Getting more from understanding people

OS means Support of Staff. AMCsos supports all staff to be healthy and well. AMCsos works with managers to implement the HSE’s Management Standards by developing effective management skills and competencies. Such skills, when used effectively, reduce work related pressure and hence stress. AMCsos works with all staff, to understand how life and work affect them. We can show staff how they can make the most of their inherent strengths and ditch unhelpful thinking styles which can cause stress. AMCsos offers various training days, personal coaching and StressWatching. StressWatching is an innovative 10 session programme based on the book ‘The Stress Gremlins’. It encourages

evelop a simple system of understanding colleagues enhance communication, learning, trust and organisational skills at all levels. Discover why so many organisations fail to be efficient and how to achieve efficiency through improved communication skills. Business behavioural coaching company Babel Consulting, develops and runs refreshingly different experiential workshops that look at organisations as a whole and the way they communicate and should communicate for success. Using such systems as the New Zealand based psychometric instrument, TetraMap®, Babel Consulting demonstrates business behavioural differences and how to achieve improved team performance. Workshops are bespoke, fun and practical

stress watchers to understand themselves better and take responsibility for how they behave and think. The result is reduced or no stress and improved resilience to future challenges. Our StressWatching trainers will run the programme for you or we can train ‘in-house’ champions to run the programme to empower all staff who chose to enhance their lives. Stress is a serious concern, manifesting in both physical and mental ill health resulting in absence, distress and even death. Take action now.

FOR MORE INFORMATION AMC Mentoring Tel: 01788 823361 E-mail: support@amcmentoring.com Web: www.amcmentoring.com

Onsite conflict management training onflict will affect all of us at some stage in our lives. Whether it is in the home, on a night out or in the workplace. Our courses have been specifically written and designed to help individuals, companies and large organisations manage conflict. They represent over 30 years of work, and have been compiled with the help of people who themselves have experienced much conflict. They also contains extracts from courses that have been delivered to hundreds of frontline personnel throughout the UK, working in many different sectors of industry. The aim of these courses is to educate personnel in the essential

skills that can help to manage conflict, as it is knowledge that protects you, not ignorance. Gaining these skills will give individuals and companies alike the confidence to perform better in difficult situations. It can also allay underlining fears that can result in stress related illnesses and absenteeism.

FOR MORE INFORMATION 3 Musketts Court, Birchfield Road, Redditch, Worcestershire, B97 4NA Tel: 07768 744148 Answering service: 01527 540678 E-mail: david.cutler@virgin.net Web: http://business. virgin.net/david.cutler

with lasting results, leaving people empowered and understanding. Workshops are perfect for: • Administrators • Board members • Clinical/non-clinical teams • Directors • Managers/Team Leaders Babel Consulting Limited, established 2004, works with a broad range of clients ranging from the young and disenchanted to boardroom nationals, providing bespoke group and one to one coaching.

FOR MORE INFORMATION Visit their website or telephone 01302 390777 and ask for Andrew Mills.

You could be eligible for free software training Software Training M atrix Ltd is an approved training provider for Gloucester Works. This enables us to offer IT training (funded by the European Social Fund) to local businesses at no cost to the employer. Matrix offers a wide range of tutorled training courses from introduction to advanced levels in all Microsoft Office applications such as Word, Excel, Outlook, PowerPoint etc. We also offer training in specialist applications such as Sage, Adobe, QuarkXPress and Crystal Reports. We specialise in tailoring courses to meet a client’s needs where our experienced trainers can work with you to create bespoke courses to match your exact requirements. Matrix has been established in Gloucester for the last 18 years where we offer a high standard of training to organisations of all sizes within the public and private sector. Our modern premises are conveniently based in Gloucester city centre where

our training is tutor-led in a friendly and relaxed environment which has proved to be the most successful way of training staff. Our courses are supported by comprehensive notes and a 30 day post-training telephone help-line.

FOR MORE INFORMATION To find out if your company is eligible for free computer training or for further information please telephone us on 01452 387002

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JDS Training Ltd – specialist training

Using mediation to restore performance

DS Training Ltd is a training company that has provided down to earth, realistic, enjoyable and affordable training to various NHS trusts, PCT’s, nursing/recruitment agencies, social care companies, registered charities, special schools, security companies, retail and leisure industry plus licensed and food retail establishments for many years. The training team have been delivering specialist sector specific training for over 23 years. As well as conflict management training, JDS Training Ltd can provide training in: • Level 3, (1886) Delivers in Conflict Management • Level 2, (1884) Conflict Management • Basic First Aid, First Aid at Work, Children’s First Aid, AED (Defib), Oxygen Therapy and Airway

MP know mediation can achieve exceptional outcomes and this year the Department of Health agreed. Their booklet ‘Listening, Responding, Improving: A guide to better customer care’ concluded that: “An impartial mediator helps both parties reach conclusion…Mediation is particularly useful when there is a risk of communication breaking down. When emotions are running high, the mediation process can help both parties express their frustration or anger without affecting progress towards an effective solution.” The new NHS Complaints system has meant that many NHS Trusts are re-writing policies; a partnership with CMP will enable you to source the mediation provision that is right for your organisation, and the parties. With over

Management, plus Medical Gases • Moving and Handling of People and Loads • Level 2, Foundation in Food Hygiene • Level 2, in Health & Safety • All care induction training to meet CQC, HSE, NHS and PASA requirements • Level 2, Physical Intervention and Disengagement Techniques, Control and Restraint. (MAYBO, NHS, BILD and Skills for Security Approved) • Bespoke training courses tailored to meet your requirements.

FOR MORE INFORMATION E-mail:- daveash@jdstraining.co.uk or info@jdstraining.co.uk Web: www.jdstraining.co.uk Mobile:- 07788 594110 (Dave Ash) or Lo-Call:- 0845 643 4842

Professional emergency response training mergency Response Training Ltd provides a quality, professional and cost effective training service with a range of courses in first aid, fire safety, moving and handling, train the trainer (fire safety and manual handling) and fire risk assessments. We are a recognised training provider to numerous NHS PCTs for BLS, AED and oxygen therapy courses. We also offer AED supply and training packages. Our training service is provided with the emphasis on customer service and developing our courses with the aim of being flexible in order to meet the needs of our customers by offering a range of bespoke courses to suit you’re working patterns and tailored to your specific needs. The courses and service we provide are always of the highest standard, with a quality assurance that all our courses are undertaken or facilitated by approved trainers who have operational experience, are occupationally competent and hold national recognised

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qualifications. Their expertise is continually developed through regular assessments and the application of quality monitoring procedures. Our first aid at work courses are HSE approved and our paediatric course has NCMA/PLA approval and is Ofsted compliant.

FOR MORE INFORMATION Contact us for more details: Tel: 01302 371166 Fax: 01302 371166 E-mail: mail@ertraining.co.uk Web: www.ertraining.co.uk

20 years experience, our Interactive Mediation™ model was the first model to focus on increasing communication, awareness and understanding to identify needs-based solutions. CMP delivers a holistic range of mediation options from initial employee awareness sessions, training for management and staff for in-house service implementation or providing you with an independent mediator. Any part of our Introducing Mediation™ package can be tailored from the exact point you need to begin from. Contact us to discuss your needs. We can help.

FOR MORE INFORMATION CMP Resolutions Tel: 01763 852225 E-mail: info@cmpresolutions.co.uk Web: www.cmpresolutions.co.uk

Developing knowledge and skills for the future eveloping people has never been more important for employers in the public sector. With demands for greater efficiency and the trend towards more “business-like” ways of working, ensuring that all your people have the knowledge and skills they need to perform effectively is essential. With 20 years experience in learning and development, Understanding People can help in a number of ways. We can design and deliver training courses and workshops in topics such as dealing with stress, managing people, and interpersonal skills. However, to ensure you are offering the right training we can help in designing and implementing processes to identify development needs, such as skills audits and development reviews using the NHS Knowledge and Skills Framework. We also offer coaching to managers so they gain confidence in using these tools. We can support you in developing the policies and procedures to ensure your people get the development they need and you get value for money

from your training budget. Because we understand that long term reliance on external consultants isn’t always best for your organisation, we will also work with you to develop the skills in-house to maintain these activities, for example through coaching, training and mentoring your people.

FOR MORE INFORMATION Tel: 08450 943874 Fax: 01449 710187, e-mail: susan@understanding-people.co.uk Web: www.understanding-people.co.uk

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Bespoke courses for the health sector

Making a difference with motivation

are a National W eCompany delivering high quality

M issue in performance, stress

bespoke courses to the healthcare industry. Our courses are a combination of theoretical knowledge and practical sessions that are designed to develop ability and most importantly provide practical confidence. Drawing upon our vast experience in both training and consultancy, as well as our enviable industry experience, we provide solutions that are both vital and highly cost-effective. We are totally committed to delivering first class training in the fields of, first aid training, health and safety training, health and social care training and personal development training throughout the United Kingdom and Europe. As well as a large training course

directory, we also offer tailored training programmes that are designed and run specifically for a particular client, with an emphasis on a particular topic, company and/or industry. In addition to being leaders in providing training courses, we also offer a comprehensive healthcare consultancy services. See our strategic consultancy section to learn how our flexible, discreet and highly effective consultancy services can help you and your business. To find out how we can help you and your organisation meet your training needs, please contact us and our friendly team will respond to you.

FOR MORE INFORMATION Tel: 0845 4507644 Fax: 020920400165 E-mail: info@gateway-training.co.uk Web: www.gateway-training.co.uk

Discover your leadership strengths with coaching is achieved “S uccess by developing our strengths, not by eliminating our weaknesses” – Marilyn vos Savant It is tempting to focus our energies on remedying our faults and weaknesses; but to truly realise our potential requires us to recognise and claim our strengths. I am an executive coach, specialising in leadership and career transition; supporting leaders to be more reflective, ask themselves the difficult questions, and take action in line with their goals and values. My coaching approach is rooted in the belief that the best leaders are authentic, choose to take positive action, and are willing to make mistakes (but learn from them!) I am a certified coach with the International Coach Federation and on the executive coaching register

for the NHS Institute for Innovation & Improvement. I also work as a leadership development facilitator, delivering workshops and team development events linked to real work issues and change. I previously worked for HayGroup, and have held operational and financial roles within the private sector. I work with my clients to tailor coaching packages to fit individual needs. Coaching can be delivered face-to-face or by telephone.

FOR MORE INFORMATION If you want encouragement, thought-provoking questions, supportive challenge, call now for a free coaching consultation. Contact: Martha Creaser Tel: 07721 977156 E-mail: marthacreaser@yahoo.co.uk Web: www.developingtalent.co.uk

otivation is a key

reduction and staff retention. In short, if you want to make a big difference in making your people effective, you need a strategy for motivation. Such a strategy will describe, measure, monitor and maximise the motivations of each individual, and every team. Further, it will show how to align the motivational profiles for both the benefit of the individuals and, crucially, the organisation. This is a tall order – most motivational work is either ‘Ra-Ra’ (aka let’s walk on fire) or a one size fits all approach. However, there is a new cutting-edge tool called Motivational Maps which provides the science and the art of a real motivational strategy. Maps are – seriously! - unlike anything you will have encountered before. They are currently experiencing phenomenal growth in the education and public sector, as well as the corporate market. But their benefits are

almost unknown in the health sector. If you want to make a real difference with your people, if want to be at the cutting-edge of people development, and if you want to learn new, deep knowledge about people, this solution to motivation is really for you.

FOR MORE INFORMATION Tel: 01202 393660 Fax: 01202 393660 E-mail: info@motivationalmaps.com Web: www.motivationalmaps.com

missions during the 22 years since its first flight, and now operates 17 of the 33 air ambulances across the country. Since commencing the first air ambulance service using the Eurocopter BO105, Bond has pioneered the introduction of the Eurocopter EC135 T2i aircraft. This helicopter uses the latest technology while still achieving the original principles of speed, dedication and flexibility, carrying two stretchered patients with a team of two clinicians/paramedics flown by an instrument-rated pilot. Bond is pleased to support the Health Business Award for Best Air Ambulance Operation.

FOR MORE INFORMATION Web: www.bondairservices.com

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‘Be part of the solution’ The HSE

‘Take responsibility’ A Government directive

Bad Practice is a Ticking Bomb

‘Duty to care’ OHS

The same message!

www.ohs.co.uk

Driving forward best practice in healthcare HS mirror the philosophy of both the HSE and the Department of Health in their determination to drive forward health and safety ‘best practice’ within the healthcare industry. Asbestos, legionella and waste management need constant review and monitoring and OHS has the experience and knowledge to make sure that hospitals, doctor’s surgeries and care and nursing homes are safe places for patients, staff, visitors and suppliers alike. Legislation is perpetually changing with the healthcare industry at the forefront of the battle to improve working practice. Experience, professionalism, care and knowledge are needed to maintain the nation’s wellbeing. These are qualities, associated with OHS, that are also vital behind the scenes in the provision of health and safety management and in the consideration of environmental issues. ‘Duty to Care’ is the OHS mantra, the safety of each individual as they go about their everyday work

and experiences. OHS can help all organisations achieve compliance, it can save on insurance premiums and on legal fees but ultimately it is the care of the workforce, clients and the public that is most gained by using OHS to manage all health, safety and environmental requirements, a fact that should resonate with all decision makers within the healthcare world.

FOR MORE INFORMATION Tel: 0800 834 293 Fax: 01274 392 280 E-mail: info@ohs.co.uk Web: www.ohs.co.uk

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Health Business | Volume 9.6

legionella Control

There’s something in the water The health sector must be familiar with and take action against the risks of legionella, says the Health and Safety Executive Legionnaires’ disease is one of those illnesses that most people will have heard of. But what exactly is it? A potentially fatal type of pneumonia caused by legionella bacteria, people can become infected by breathing in small droplets of water contaminated by the bacteria. Anyone can be infected but some people are at higher risk, particularly those over 45, smokers and heavy drinkers, those suffering from chronic respiratory or kidney disease, and people whose immune system is impaired. It cannot be passed from one person to another. The deadly legionella bacteria are common in rivers and ponds. Prevalent in the natural environment, they may contaminate and grow in other water systems such as cooling towers and hot and cold water services. The bacteria can survive low temperatures and actually thrives at temperatures between 20-45°C if a supply of nutrients such as rust, scale and algae is present. MANAGING LEGIONELLA The most reliable way of killing legionella bacteria is by exposing it to high temperatures. A spokesman for the Health and Safety Executive (HSE) said: “Under general health and safety law, employers must consider the risks from legionella that may affect their staff or members of the public and take suitable precautions. “It is up to employers or those responsible for a workplace – such as a landlord – to identify and assess sources of risk.” Managing legionella involves

The deadly legionella bacteria are common in rivers “and ponds. Prevalent in the natural environment, they may contaminate and grow in other water systems such as cooling towers and hot and cold water services ”

Legionella management and control services ith so many providers of legionella services currently on the market, it can be a difficult task to source and employ a specialist who meets your requirements without costing the earth; and who will give expert trustworthy advice. As an established and experienced company that is registered with the Legionella Control Association Code of Conduct; The Oakleaf Group has a tailored approach to supplying the Care Provider Industry where often difficult financial restraints and limited resources can be a factor in the Management and Control of Legionellosis. We provide individual advice and a service that

information on the requirements for compliance; we do not endorse any products or services (other than those required to comply with ACoP L8). Legionella management and control can be quite simple, given the correct understanding; it does not have to be onerous in either costs or resources.

FOR MORE INFORMATION is both practical and impartial. We aim to assist you in achieving your goals of protecting your staff and service users, whilst conforming to the requirements of the Approved Code of Practice L8. The Oakleaf Group provides unbiased and upfront

For more information contact: The Oakleaf Group Tel: 0845 2937571 E-mail: tim.cooper@theoakleafgroup.co.uk Web: www.theoakleafgroup.co.uk

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8 www.healthbusinessuk.com Visit the website to view the categorised product finder

Versatile experts in water treatment

Helping you with current legionella legislation

qua Engineering Systems Ltd has over 25 years’ experience in the water treatment industry. As experts in the design and installation of Ultraviolet water disinfection equipment for drinking water and chemical dosing systems for swimming and hydrotherapy pools, they also offer their expertise in a range of services for the control of legionella. As registered service providers with the Legionella Control Association, Aqua Engineering can offer legionella water testing via a UKAS accredited laboratory and can carry out risk assessments and reviews of existing arrangements. Full back up and support services are provided and Aqua Engineering can carry out cyclic tests and checks to ensure clients continue to comply with their obligations under the L8 regulations. Tank cleaning and disinfection services are also available, on an

quadition Ltd has specialised in all aspects of commercial and domestic water treatment and bacterial control for over 35 years. We are a second generation family company offering the personal service to help and guide our clients through all aspects of the current legislation and regulations regarding legionella and bacterial control, with the minimum of expense. Aquadition Water Treatment can provide professional consultations and training for you and your company to the control of legionella bacteria in water systems as required by the Approved Code of Practice and Guidance, plus The Management of The Health and Safety at Work Act Regulations 1999.

The Aquadition fully trained engineers are also on hand to complete any water system quality, monitoring or maintenance works that you may require to achieve regulation compliance. When you employ the services of Aquadition Water Treatment you can rest assured that you are dealing with an accredited quality company that are approved contractors to the Royal Property Services at Buckingham Palace, the Ministry of Defence and its contractors, the NHS Primary Care Trusts and Hospitals, Hampshire County Council and many major facilities companies.

FOR MORE INFORMATION Te: +44 (0) 23 9269 1035 E-mail: enquiries@aquadition.co.uk Web: www.aquadition.co.uk

individual or contractual basis.

FOR MORE INFORMATION For further information and advice on how to comply with the HSE regulations, or to arrange a consultation, please contact Aqua Engineering Systems Ltd. On 01524 66512 or e-mail us via info@aquaengineering.co.uk

JAAL Consultants Ltd Legionella Management, Control, Audit, Risk Assessment, Training, Development

Are your patients, staff and visitors at risk? We help hospitals and healthcare facilites comply with HSC ACoP L8 and HTM 04-01 for the control of Legionella bacteria through our portfolio of on-site services:

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In accordance with: - The Health and Safety at Work Act 1974 - The COSHH Regulations 1999 - The Occupiers Liability Act 1984 - RIDDOR - The Management of Health and Safety at Work Regulations 1999 - The Corporate Manslaughter and Corporate Homicide Act 2007 - The Health and Safety (Offences) Act 2008 And - The Health and Safety Commissions Approved Code of Practice and Guidance, L8 - Department of Health Technical Memorandum 04-01

JAAL Consultants Ltd, 12 Derwent Avenue, Luton, Bedfordshire, LU3 2DX Tel: 01582 707 780 www.jaal.co.uk, info@jaal.co.uk

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Health Business | Volume 9.6

legionella Control

creating and implementing a system for dealing with the risks, identifying a responsible manager, keeping records and checking that what has been done is effective. Employers with a cooling tower on site may also have to notify the local authority. • A series of simple questions give a rough indicator of whether more rigorous action is necessary. • Are conditions present which will encourage bacteria to multiply? For example, is the water temperature between 20-45°C? • Is it possible that water droplets will be produced and, if so, could they be dispersed over a wide area? For example, consider showers and aerosols from cooling towers. • Is it likely that anyone particularly susceptible will come into contact with the contaminated water droplets? Cooling towers, evaporative condensers and hot and cold water systems have all been associated with outbreaks. Other potential sources where precautions might be needed include humidifiers and spa baths. If employers decide that the risks are insignificant, no further assessment is necessary although the assessment will need to be reviewed periodically to ensure that it reflects changes in the business. IMPLEMENTING CONTROLS In a business where likely risks have been identified, safety law requires proper controls to be introduced. Risks from legionella in water systems can be controlled but careful planning, a successful management policy, competent staff and attention to proper control strategies are all essential. The main advice to employers is to consider whether you can prevent the risk of legionella in the first place by looking at the type of water system being used. For example, it may be possible to replace a wet cooling tower with a dry air cooled system. A written scheme will be needed that sets out how the risk from legionella will be controlled. It should cover: • the system – an up-to-date plan or schematic diagrams are sufficient • who is responsible for carrying out the assessment and managing its implementation • the safe and correct operation of the system • what control methods and other precautions you will be using • what checks will be carried out on the control scheme and how often The key point is to design, maintain and operate water services under conditions which prevent or control the growth and multiplication of legionella. If employers have a cooling tower or evaporative condenser on site you must, under the Notification of Cooling Towers and Evaporative Condensers Regulations, notify the local authority in writing with details of where it is located – including when/if such devices are no longer in use. AN OUTBREAK Should the worst happen and a case of legionellosis be diagnosed in an employee who has worked on cooling towers or hot water systems that are likely to be contaminated with legionella, this must be notified under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). If there is an outbreak, local authorities have special plans for dealing with major outbreaks of infectious disease including legionellosis. These are usually investigated by an outbreak control team whose purpose is to protect public health and prevent further infection. “Legionella is a serious illness that needs to be taken seriously by employers and others who have responsibilities,” a HSE spokesman said. “It is important that the health sector is familiar with both the risks and the legal requirements on them. It is unacceptable for employees and members of the public to be put at risk of legionella exposure.”

Helping to put an end to legionella outbreaks he form of pneumonia ascribed the media moniker ‘Legionnaires’ disease’, though a relatively low proportion of total cases has always been able to ‘punch well above its weight’. Its ability to grab media attention has continually made clusters of cases and outbreaks of the disease ‘blockbusters’ in terms of the newspaper headlines generated. The legislation and the responsibilities that follow for the statutory duty holder are laid out in ACOP L8 (Legionnaires’ disease: the control of legionella bacteria in water systems). They focus on the four ‘Ms: • Manufacture • Management • Maintenance • Monitoring Water Treatment Technology supports clients in meeting their responsibilities for the key areas of assessing the

risk; preparing and implementing controls to reduce that risk; monitoring the effectiveness of the precautions taken; keeping clear records of all action taken and checks made. In addition Water Treatment Technology provides a full range of water treatment chemicals, chemical analysis (on-site and laboratory), legionella sampling, and water treatment plant (sales and service).

FOR MORE INFORMATION Website: www.h2owtt.com E-mail: mb@h2owtt.com Tel: 01787 313993

Legionella management control with Aqualog® ou are responsible for water quality and have a large property portfolio to manage. You have hundreds of risk assessments in files that need attention. Then the task of prioritising all the remedial works, raising funds and the management of the water treatment contractor arises. The effective management of comprehensive legionella programmes carries enormous costs, hence the reason for so many examples of non-compliance. We can help. Aqualog® is the powerhouse behind many of the leading web based logbook solutions on offer. In its simplest form Aqualog® provides secure electronic logbook solutions for managing the record keeping of multisite operations. Though now, most of our clients take advantage of Aqualog’s asset management capabilities and use the real time workflow

solution that processes remedial actions, monitors programme performance and integrates with contractors monitoring activities, CAFM systems and alike. Aqualog® delivers: • Secure web based legionella record keeping and risk management • Automated asset identification • Data entry by PC, phone or pda. • Multimedia document management • Instant reports, programme and defect status • High level of compliance • Asset condition management • Reduced costs

FOR MORE INFORMATION Call us for a preliminary chat 0845 0568691, e-mail: enquiries@aqualog.co.uk or visit www.aqualog.co.uk

FOR MORE INFORMATION Web: www.hse.gov.uk/legionnaires/index.htm

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Health Business | Volume 9.6

Legionnaires’ and other infectious disease control Helping to keep your shower clear from bacteria, virus, fungi and mould Today there are approximately 500 recorded cases of legionnaires’ disease annually. However, leading epidemiologists at the Health Protection Agency believe that this figure could be as high as 9,000 per annum. Cases are not identified for many reasons including, sub clinical infections, unclassified bacterial pneumonia and unspecified pneumonia organism. Recent research in America lead by Professor Norman Pace has indicated that other harmful bacteria lives in shower roses. The BBC headlined their comment about the research as “Taking showers can make you ill”. The research was done on Mycobacterium avium which causes lung problems. Many of the cases identified are caused by showers and probably the majority of those not identified will be from showers. Showers are the most probable cause because in a well controlled system where the naturally occurring legionella bacteria in the hot water has been killed by the water temperature and it has been too cold for the bacteria to grow in the cold water, the shower mixer valve produces an ideal temperature. If the shower is then not used it allows time for the bacteria to multiply to dangerous levels and the next user finds it easy to breathe in the contaminated water droplets. Possible Solutions There are several ways of reducing this risk. The Approved Code of Practice L8 calls for weekly flushing of little used outlets. Some systems have even been flushed daily to try to keep the bacteria at bay but it is only diluting

the problem and will not totally eradicate it. Self purging showers are an automatic way of flushing. However, they have the disadvantage that if the shower is used regularly they waste a considerable amount of water. Shower head filters can be fitted but they are expensive and require changing regularly at great cost. UV shower head disinfection treats the flowing water through the shower. They require regular maintenance to maintain

“

washers are used at the connections to keep the beads in their respective positions. Silver is a biocide and copper gets rid of biofilm. Together they kill the legionella bacteria and other bad bacteria such as pseudomonas etc. It is so simple to fit it takes just two minutes to fit to a domestic type shower and can be done by any competent person. In fixed copper pipe work the copper beads are not required but additional filter washer

Shower-Safe is a new environmentally friendly, sustainable solution that treats the stagnant water left in the shower after it has been used

their efficacy and it is conceivable that dirty water on the incoming main, from say a fractured pipe, could cause all the outlets to shut down. They are expensive to install, maintain and run on 24/7 electricity usage. Sustainable Solution Shower-Safe is a new environmentally friendly, sustainable solution that treats the stagnant water left in the shower after it has been used. It will not contribute to retrograde contamination. It does not waste water or use electricity. It is very simple to install and will last a very long time. In fact if the shower is not used it will last for ever. Shower-Safe is a very simple retro-fit kit containing silver and copper mesh beads. Half of the beads are put into the shower head and the remainder into the hose. Filter

”

support fittings with compression fittings will be required. The kit also contains a water proof label to be fitted to the shower to indicate that Shower-Safe is fitted. Silver and copper are well know for their beneficial properties indeed as far back as the Romans who kept their drinking water in silver containers to preserve its quality. Silver reputedly kills bacteria, fungi, mould and viruses. Included in some of the bacteria it kills are E.Coli, Salmonella Staphylococcus and legionella pneumophila. Don’t get showered with bacteria! Enjoy a clean, fresh experience..

FOR MORE INFORMATION For further information visit www.shower-safe.co.uk or www.legionnairesdisease.com or phone lo-call 0870 SafeH2O (7233420)

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Written by Kevan Wallace, Chairman, Hospital Caterers Association

8 www.healthbusinessuk.com catering

Making meal-time matter This year’s Hospital Caterers Association conference called for greater partnership working as the way forward for improved patient nutrition

Former HCA Chairman, Neil Watson-Jones (right) welcomes on board the new Chairman, Kevan Wallace

The 2009 Annual National Conference of the Hospital Caterers Association took place at the Scottish Exhibition & Conference Centre and Crowne Plaza Hotel, Glasgow on 23-24 April. Entitled ‘No Borders, No Boundaries’, the conference debated the issues that affect patients’ meal time experiences and tackled the concerns that create a divide between the various professional disciplines in delivering an effective catering service. Many improvements have been made to hospital food over the past few years but headlines have continued to appear about patients being malnourished whilst in hospital. With this in mind, the HCA Conference 2009 focused on how health professionals can work together to recognise and overcome the obstacles that work against food service and delivery on the wards. PARTNERSHIP WORKING All professional disciplines acknowledge that maintaining and protecting patients’ nutritional status is a primary focus and the efficient management of food services is central to patient wellbeing and recovery times. This year’s conference agenda placed the spotlight on the initiatives and measures that are aiming to strengthen partnership working. Dr Liz Jones, head of Patient Environment at the Department of Health, started the conference with a presentation theme of ‘Merging the Boundaries around the Healing Environment.’ Dr Jones also launched the new Department of Health’s ‘Sustainable Food – A Guide for Hospitals’. The quality, nutritional value and sustainability

of food has an increasingly high public profile and will become one of the factors by which patients will exercise choice when selecting their healthcare providers. In response to the sustainable food agenda, the Department of Health has produced a Guide for hospitals that illustrates good practice through case studies and details relevant various food assurance schemes, regulations, reports and publications. The Guide anticipates the public sector Healthier Food Mark which will be launched in 2010 and which will have a significant sustainability component. Aimed primarily at catering and procurement managers, but also of use to facilities directors and commissioners when planning service developments, the Guide describes why the sustainability of food is important, provides guidance on what hospitals can do to improve the sustainability of the food they serve to patients, staff and visitors, and advises on how hospitals can assure the sustainability of their food service provision. The Guide is available from the NHS Purchasing and Supply Agency (PASA) and information is available on the agency’s website. NUTRITIONAL FACT SHEETS Caroline Lecko, nutrition lead at the National Patient Safety Agency (NPSA), launched the final three of ten new Nutritional Fact Sheets. These are designed to assist health care staff to implement the Council of Europe 10 Key Characteristics of Good Nutritional Care. The Fact Sheets are designed to be ‘meaningful from the bedside to the boardroom’. They aim to help with the implementation of

each Characteristic by identifying the actions that need to be taken and the resources that would help ensure the delivery of an effective food and beverage service. A joint initiative from the NPSA and the Royal College of Nursing (RCN), all 10 Fact Sheets are contained together in one folder. Outspoken journalist and food critic, Jay Rayner “challenged caterers to raise the bar” by outlining the findings of his latest research into the quality of food service provision. He also offered his views as to whether changes for the better have occurred since his article published in September 2006 in The Observer Food Monthly entitled ‘Hospital food – It’s enough to make you sick’. Jay highlighted key issues about the need for better communication with patients as well as questioning the investment in drugs versus the provision of real food. Other speakers included : • Using E-Learning to Blur the Boundaries, by June Lancaster, Core Learning Unit, Skills Academy for Health (NHS) • An EU Approach to Making your Catering Services Greener, by Tracy Cook, European policy manager, NHS European Office • It’s All About the Money – The Scottish Route to Branding, by David Bedwell, Health Facilities Scotland • The Premises Code: A Code of Practice for Quality and Safety in Healthcare Premises, by Peter Sellars, Deputy Director of Gateway Reviews and Estates and Facilities • Hungry to be Heard – 1 Year On, by Gordon Lishman, CBE, Chair of The Nutrition Action Plan Delivery Board • RCN ‘Nutrition Now’ Campaign – Enhancing Nutritional Care, by Susan Watt, learning & development co-ordinator (Professional Practice), RCN, Scotland In summary, it is apparent that we must continue to place the emphasis on improving the delivery of food to patients and the whole meal time experience. We also need to explore how we can, particularly in acute hospital environments, overcome the hurdles that often inhibit our ability to achieve higher levels of service for our patients, both to meet their expectations and to safeguard their nutritional status and wellbeing. The key messages that clearly emerged from the 2009 HCA Conference were that there should be no boundaries in providing a better meal service to our patients and that we should all ask the question mentioned in one of the sessions “would you be happy to eat this meal?” It is up to us as hospital caterers to stand up and be counted when it comes to providing nutritional care for our patients.

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Health Business | Volume 9.6

catering

Food for thought The Hospital Food Project, initiated by Heart of Mersey, has successfully boosted the health and well-being of hospital workers across Merseyside and Cheshire The ‘Nourish’ campaign, which ran from September 2008 through to January 2009, aimed to increase awareness about healthy eating options and the importance of a good diet amongst more than 30,000 hospital staff across 10 participating NHS hospital trusts in the region, as well as many hospital visitors. Following an extensive consultation period with more than 1,700 hospital staff across six of the Trusts, which revealed a poor understanding of the term ‘healthy eating’, a series of interventions were developed across each of the Trusts to help promote healthier eating options to staff. As part of the project, each of the 10 hospitals were asked to monitor and evaluate the effectiveness of a wide range of new healthy eating promotions, canteen menu overhauls and health food discounts, as well as the impact of modifying existing recipes to reduce the amount of additives such as fat, salt and sugar in meals. The project also offered practical training

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workshops around nutrition for catering staff and encouraged them to look at how they could influence staff to choose healthy options. Findings from the project’s final Evaluation Report reveal a significant increase in the uptake of healthier meals and snacks amongst the participating Trusts. PROJECT ACHIEVEMENTS Some of the Hospital Food Project’s key achievements over the 12 week ‘Nourish’ awareness campaign included: • A weighing-in club was started up amongst staff at the Liverpool Heart and Chest NHS Trust which successfully saw participants loose a total of 27lbs • The Royal Liverpool & Broadgreen University Hospitals Trust (RLBUHT) was able to involve all the outlets in the campaign and saw an increase in the purchase of healthier options in each facility, between

16-50 per cent on some products • Low salt beans were introduced at the Countess of Chester NHS Foundation Trust and at Broadgreen Hospital, resulting in an approximate reduction of 0.6 grams of salt, and a reduction of three grams of sugar per portion • Wirral University Teaching Hospital NHS Foundation Trust sold an extra 12,000 healthy sandwich options during the project period, and reported a 40 per cent increase in fresh fruit sales after introducing two large branded fruit stands into their staff restaurant • The introduction of an improved salad bar at Liverpool Women’s NHS Foundation Trust saw sales steadily rise throughout the project period, from 300 salads sold in August 2008, to 719 in January 2009 • Fruit sales at Mersey Care NHS Trust increased from 75 pieces per week to 90 a week over the three month campaign

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Health Business | Volume 9.6

catering

• A Grab and Go healthy range – salads, fruit, sandwiches – was introduced at Whiston Hospital, part of St Helens & Knowsley Teaching Hospital NHS Trust, which accounted for up to 16 per cent of all food purchased during the campaign • Aintree University Hospitals NHS

and to facilitate a sharing of best practice with each other during the pilot period, and beyond. Each participating hospital was provided with their own web page where they could supply information on current promotions, recipes and menu options. The ‘Nourish’ campaign also served to

“

Hospitals haven’t always historically had the best reputation for good catering, and even after important improvements to canteen food have been made, there remains a real major challenge in actually encouraging staff to take up new healthier food options

Foundation Trust reduced the saturated fat content of many of their daily meals by four grams per portion, simply by reformulating their cheese sauce recipe • Southport and Ormskirk Hospital NHS Trust has seen an increase in its staff asking for healthier option snacks, and to date has sold 144 boxes of healthier variety snacks and crisps. SHARING BEST PRACTICE ‘Nourish’ also introduced a new website: www.nourish-uk.com, which acted as a mechanism to inform hospital catering teams

”

highlight a number of challenges for the Hospital Trusts to continue to work on, including issues around the close proximity of external fast food outlets and problems with promoting healthy options in the current economic climate which meant that staff were more inclined to choose food based on price not health considerations. Some Trusts were also unable to make dramatic improvements to the range of healthy food options they could offer staff due to existing contractual obligations with external catering companies which

prevented them amending their orders. Robin Ireland, chief executive of Heart of Mersey, commented: “Hospitals haven’t always historically had the best reputation for good catering, and even after important improvements to canteen food have been made, there remains a real major challenge in actually encouraging staff to take up new healthier food options. “The reality is that although most people do understand what a balanced diet looks like, getting people to change their lifestyle doesn’t just happen overnight. There are genuine barriers to healthy eating such as the accessibility and affordability of choosing healthy food options. For me, the success of this project has been in its introduction of lots of small changes and its focus on helping catering staff to understand how to remove some of these barriers, in order to make it easier for people to choose a healthier diet.” Wider audience Over the coming months, each Trust will continue to build upon learning from this project with further menu alterations and healthy food promotions, and will continue to monitor food sales on different healthy food product lines and meals, sharing this learning with a wider audience.

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Health Business | Volume 9.6

catering

Catering for all Providing food that meets the nutritional, cultural, social and religious needs of the population is no easy task, says the British Dietetic Association The importance of meeting patient’s nutritional needs to aid recovery has long been recognised and recently resulted in moves to implement malnutrition screening for all inpatients and improvements in the quality and availability of hospital food for patients (Council of Europe 10 Key Characteristics of Good Nutritional Care 2007). The ‘Standards for Better Health’ form part of the Annual Health Check, which was launched by the Healthcare Commission in April 2005, and is now the responsibility of the Care Quality Commission. This requires all NHS organisations to make a declaration on compliance against 24 core standards which cover areas agreed with patients as basic requirements for healthcare. These include the need to provide evidence of appropriate catering for all groups including those from different ethnic minority groups. MENU PLANNING To meet a patient’s nutritional needs, the food available must be capable of meeting the nutritional, cultural, social and religious needs of the population and also be something that the patient wants and is able to eat! Menu planning for hospital inpatients has always been challenging as there is a diverse range of dietary needs for any hospital population. Large acute hospitals increasingly have to cater for a variety of ages from newborn to elderly, a large number of different cultures with specific religious food needs and also specific therapeutic diets depending on their area of speciality e.g. ‘clean’ diets for transplant patients and complex modified protein diets for patients with metabolic disease. Issues associated with bulk catering for a large number of people over a short meal period and at a controlled cost have resulted in the need to develop menus that attempt to meet all of the patients needs in a limited number of food choices on a daily basis. Menu planning is now extremely challenging and should involve the caterer and dietitian to work to balance all of these needs. If we accept these menu planning principles and recognise the importance of helping patients to eat via providing appropriate food choices then surely it should be simple? However, practically there are issues that need to be considered when agreeing a menu which reveals how complex and challenging this has become. DON’T MAKE ASSUMPTIONS Firstly, it is essential that assumptions concerning food choices are not made. In many hospitals where there is a high percentage of patients from a particular ethnic group a separate ‘ethnic’ menu is made available. This menu may only be

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available to those patients who are considered to be from that particular ethnic group. So how can this be policed? Who decides who should have this particular food choice? Is this inappropriately based on a patients name or how they look and will that person actually be adhering to the requirements of their culture? For many ethnic groups the young are from second and third generation and have developed a more westernised diet which may or may not still adhere to their cultural requirements. Increases in the availability of food from a whole range of cultures within restaurants, takeaways and the local supermarket has increased the variety of food eaten by much of the population and these foods are now seen as part of the British diet and eaten by a wide variety of people from a range of age groups. It is wrong to assume that for example the elderly will not eat lasagne any more than a Muslim patient will only want to eat curry. Personal taste and preference are now a very strong factor in food choice and this can often become more important to patients who are unwell and within an environment in which they do not feel at home. Hospital menus do contain foods from a range of different countries and are enjoyed by a wide range of different cultures. UNDERSTANDING ETHNIC NEEDS Secondly is the challenge of how many different cultures a hospital menu can practically serve and when is it essential that a specific choice be included? This is a complex area and I attempt to explain. For many hospitals serving major city populations there is a large percentage of people from a particular ethnic group but a number of other groups in smaller but still significant numbers. For example within Bradford there are a number of South Asian patients who are either Muslim, Hindu or Sikh and also a smaller number who are African-Caribbean, Chinese or Eastern European. There is also a small Jewish population. So should cultural choices from each of these groups be included on the menus together with those deemed appropriate for the larger white British population? In an ideal world this would be nice but within the confines of the large scale catering systems and cost pressures applied is actually impossible. It can be extremely difficult as cultural groups often apply significant pressure to Hospital Trusts to cater for them individually and this is where it is important that the need for ethnic diets is understood. It is important here to separate cultural food likes from religious food requirements. To clarify, Orthodox Jewish patients cannot consume pork at all and need other meat

to be slain in a particular way and approved as Kosher. These foods cannot be cooked with or served with non-kosher foods and it would cause extreme distress to a patient to be offered food that did not comply with these requirements. To simplify it would be like offering many of us rat stew or serving our ordinary stew with a spoon that had previously served rat! For these groups it is essential that appropriate food is made available as otherwise they would be unable to eat and malnutrition would result. For these groups it is essential that there are systems to provide appropriate food choices however small a minority they are in. Within Bradford there is a very small Jewish population but kosher foods are made available via an a la carte menu and the food is appropriately sourced and stored frozen until needed. Jewish patients are able to choose from both the Kosher and normal menus to improve the level of choice. So where does this leave groups whose food requirements are around

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Health Business | Volume 9.6

catering

preference rather than religion? For many Trusts who have a large percentage of their population from these groups it is possible to provide a menu that includes these foods but for those where these groups are in very small numbers it can become economically and practically difficult and therefore impossible to include them on the main menu. How this issue is resolved will vary by area but needs to be considered when reviewing and setting up catering systems. CULTURALLY DIVERSE BRADFORD Finally here is an example of how catering for different religions and cultural groups have been approached within Bradford. Bradford menus have been designed to include a choice of Halal and vegetarian curry for lunch and supper sourced from an approved local supplier to meet the needs of the traditional orthodox south Asian patients. There is a childrenâ&#x20AC;&#x2122;s menu that offers Halal kids meat choices e.g. chicken nuggets and sausages as well as their non-Halal versions. These are never offered on the same day to prevent confusion. It is important to remember that Sikh patients who do eat meat will not consume that which is Halal and so menus need to be carefully coded. To deal with the issues of cultural food likes we have developed a separate a la carte menu for African-Caribbean clients as these are required in small but regular numbers and this food is sourced frozen and can be stored until needed. Menus ask patients to discuss their dietary requirements with the nurses or catering team and if their needs are not being met appropriate food is sourced and provided via the dietitian in consultation with the diet kitchen e.g. vegan or food allergy. In conclusion, catering for the dietary needs of the wide range of patients from different ethnic groups within hospitals is challenging but is essential in the bid to meet nutritional needs and prevent malnutrition.

Hagesud Bosse â&#x20AC;&#x201C; help for your food budget agesud Bosse (UK) Ltd is an established manufacturer and supplier of spices, herbs, seasoning blends, soups and sauces. The company was established over 30 years ago and is able to offer NHS hospitals a range of soups and sauces that offer the catering departments a convenient and cost efficient product range that is well liked by patients and good for your budgets. The range includes gluten free products that meet specific dietary needs without any loss of flavour or performance. The product range is also good for ward application. The products are produced here

in the UK to BRC Higher Level Accreditation. Packaging is from sachet packs through to bulk packs depending upon site requirements. Our products are backed up by a dedicated sales team covering the whole of the UK. Please contact us to request product samples and further information.

FOR MORE INFORMATION Company Name: Hagesud Bosse (UK) Limited Tel: 01989 565971 Fax: 01989 767684 E-mail: bosse@hagesud.co.uk

20091006 Health Business 86x125mm SOLO.pdf 06/10/2009 12:46:39

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CONTA C T C E N T R E P E R F O R M A N C E AT I T S B EST Are you looking to set up a new contact centre or to improve the performance of your existing operation? Do you want to create a work environment where your agents feel truly supported and know that they make a real difference? Do you gather and take on board the feedback of your customers? With the help of CyberTech UK you can set up and manage your quality and performance cycle more efficiently. Our suite of ASSESS & innovative voice and screen recording, EVALUATE as well as live agent coaching solutions, enable contact centres of any size to ANALYSE & REPORT achieve the highest levels of performance, quality assurance and liability protection.

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Health Business | Volume 9.6

call centres

Improving customer contact Do procedures get in the way of delivering an excellent call centre experience? asks Marcus Hickman, executive research director at the Customer Contact Association ‘Just following procedure’ is often the favourite mantra of those seeking to defend the indefensible. At a time of cutbacks and efficiency drives, customer service staff may increasingly be tempted to utter the well-worn phrase as an excuse for something going wrong. Excuses are never a solution. We need to ask tough questions about the role of procedures in delivering satisfaction and trust to the public. First, we need to be sure that the public are satisfied with the way we do things. Second, we should ask whether our procedures might actually prevent us delivering an excellent experience for the public. On the first point, CCA’s 2009 benchmarking of Industry Council members shows that over 80 per cent of callers are satisfied with the contact centre experience. This

Excuses are never a solution. We need to ask tough “questions about the role of procedures in delivering satisfaction and trust to the public. First, we need to be sure that the public are satisfied with the way we do things. Secondly, we should ask whether our procedures might actually prevent us delivering an excellent experience for the public

compares well to the negative impression given by media coverage of the sector. ROOM FOR IMPROVEMENT However, there is room for improvement. One common complaint from consumers

”

is that agents are JFP – just following the procedure. They get frustrated by systems and processes which get in the way of meeting an individual’s needs. Professor Cary Cooper, Professor of Organisational Psychology and Health at

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Health Business | Volume 9.6

call centres

Lancaster University Management School argues that too many organisations think that, in rule-bound workplaces, employees will still recognise that solving customers’ problems must come first but he says staff are afraid to act. Yet there is a paradox in this view: if compliance doesn’t exist then customers receive variable service which might breach legal constraints – or fairness. In some sectors, managers are applying lean service, demand management and avoidable contact strategies. Driven by efficiency, we can expect more of these initiatives as budget cuts strike. Lean service techniques can and should improve poor process. At a bank’s contact centre, we saw many ideas to improve experience. At a telecoms provider, agents meet every morning to identify problems. At an insurance company, a social networking site enables ‘grass roots’ generation of ideas from Generation Y agents. In some trusts similar techniques are being identified to improve service. But it’s not just about listening to our colleagues. Dr Carsten Sorensen of the LSE and PA Consulting released new research: ‘Listen! Open for innovation with information technology’. The report says customers will increasingly make complaints and suggestions through third party social networking sites rather than directly to the contact centre. As Gareth Turpin of 02 observed, there are comments on Facebook such as “you’d expect someone at X [the brand] would have seen the issue here and got back to us.” But how many brands have even set up an alert on Google for “[your brand] sucks”? CCA CUSTOMER EXPERIENCE COUNCIL In June, we had our first meeting of the CCA Customer Experience Council. The group explored ideas for capturing the public’s feedback and, importantly, the way these ideas are used to improve processes. One manager raised the dilemma: Should I respond to a customer’s query/complaint on Twitter openly or take the issue offline? The manager had concerns about both. Do the former and customer privacy may be an issue. Do the latter, and followers don’t necessarily know that you’ve responded. Through benchmarking, case studies and workshops CCA aims to help organisations solve these issues. No doubt Lean Service and new forms of customer feedback will deliver many ideas to overcome JFP. In fact, CCA analysis shows between 15 per cent and 50 per cent of contacts are avoidable so the business case should be straightforward. But some of the resultant end-to-end process improvements won’t be solved by simple fixes. Co-operation from other parts of the health system will be needed and investment in technology, training and skills.

FOR MORE INFORMATION Web: www.cca.org.uk

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CCA Global Customer Convention We know that you are facing difficult times, most likely tasked with driving costs down yet keeping your workforce engaged to deal with increasingly difficult customer demands. Some would argue an impossible task? Deep down we know there are no quick fixes – it’s all about continual improvement. The good news is that we have 15 years experience and are at the centre of a vast and growing network with more than 1,000 organisations facing the same issues as you – we can help! CCA Convention 2009 is the pinnacle of our learning to date, drawing from unrivalled experience, research, benchmarking and academic input. There is no better investment of your time – not only will you access proven techniques for immediate impact, but also the latest thought-leadership to ensure that you are positioned to drive and influence change in your organisation. There has never been a more pressing time to recognise the efforts of customer contact teams and leaders who have worked tirelessly to provide help, advice and a lifeline for customers during difficutl times. This is your time. We invite you to be part of it – you’re better connected with CCA. The convention takes place on 4-5 November at the Edinburgh International Conference Centre (EICC), Edinburgh. Visit www.cca-global.com to book.

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valuable contact management and support services, designed around the customer experience. Our Customer Relationship and Business Assistance Centres are practical, commercially aware service operations that achieve real business results. We are now taking this extensive experience to the Health Service. To date, we have improved customer satisfaction and retention, created brand ambassadors, saved millions of dollars and redefined the customer experience for some of the world’s most recognised premium brands. We help all of our partners change the way they deliver for their customers. We can do this because we take time to understand where your organisation is heading. We know

your performance indicators, what your customers experience as they use your services and the cultural and financial circumstances in which you work. We can provide advice and show you how things could be done, or partner with you to create and deliver your entire customer programme. To comment on customer experience in public services or to find out how we can help you improve performance against local and national indicators, deliver real value for public investment and ensure service users become advocates of your work, visit us online at www.percepta.com/publicservice

FOR MORE INFORMATION Tel: 0141 571 3400 Fax: 0141 571 3406 E-mail: enquiries.uk@percepta.com Web: www.percepta.com/publicservice

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EWA – contact centre and marketing solutions WA is one of the UK’s foremost providers of outsourced contact centre solutions with over 25 years experience in the marketing and communication industries. Our unique approach delivers a service that adds real value, providing our clients with marketing and contact centre solutions tailored specifically to their needs. EWA has used its experience of working with the Department of Health and Primary Care Trusts to launch a service designed specifically to help NHS trusts reduce their patient ‘Did Not Attend’ rates. The service provides a channel for proactive patient contact at agreed times via telephone, e-mail and SMS and is designed to remind patients about forthcoming appointments. This contact not only offers a gentle reminder

but gives patients the opportunity to ask questions, be directed to other sources of information and if necessary, cancel or change their appointments. As an additional bonus, many patients comment that they welcome the call and provide very positive feedback. EWA’s patient contact service aims to find the most effective channel of communication that offers the best return on investment and has the highest impact on reducing DNA rates – therefore saving money and improving patient relations.

FOR MORE INFORMATION Company Name: EWA Bespoke Communications Tel: 01245 492828 E-mail: contact@ewa.ltd.uk Web: www.ewagroup.com

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PC & User Management Software

Effective Management and Support For Your Most Important Assets Since 1989 NetSupport have been supplying the public and private sectors with market-leading software solutions that help manage and support your IT infrastructure. Desktop Management software can pay big dividends by highlighting the true ongoing costs of your IT Assets as well as enabling you to quickly and efficiently communicate vital information across your user community. NetSupport offers complementary solutions that go a long way to enhancing your organisation’s computing experience. IT Asset Management NetSupport DNA is a complete modular solution that delivers best-of-breed Hardware & Software Inventory and License Management - vital information if purchasing decisions are to be made from an entirely informed position. Add to this Application and Internet Metering, Software Distribution, web-based Helpdesk & Ticket Management, Remote Control and an eco-friendly Energy Monitor component and there’s never been a better time to see how NetSupport DNA can save you money and time.

For more information and to download a free trial please visit www.netsupportdna.com

Desktop Alerting & Notification NetSupport Notify is an instant alerting and notification tool that gets round the immediacy issues surrounding more traditional forms of communication. With the ability to deliver attention-grabbing notifications to Windows, Mac and Linux desktops you can be sure that urgent system and administrative notices aren’t being ignored by your user community.

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01778 382270

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Written by Dr K T Ma, on behalf of BCS – The Chartered Institute for IT

information technology

Improving life for patients and clinicians What are the types of wireless communications used in hospitals and what benefits do they bring to clinicians and patients? capability can provide real time alerts for adverse drug interactions, or potential sideeffects. In a fully integrated environment, real time pharmacy stock control is a by-product of real time prescribing and data entry.

The explosion in wireless technology in recent years has delivered a wealth of new applications in the delivery of ‘anytime, anywhere’ information for all of us as we go about our daily business. A new market analysis report from Frost & Sullivan, ‘Mobile/Wireless Healthcare Technologies in Europe’, has estimated that the total mobile/wireless technologies market in Europe during 2008 was $1,479.2 million and will reach $6,791.7 million by 2015. The report then goes on to say that the wireless technology transforming various areas of business today is yet to be fully explored by the healthcare industry to support quality maintenance and improved efficiency. Against this backdrop, it seems that further exploitation of wireless technology within healthcare will be indisputable, not only to realise savings and increase efficiencies in an increasingly uncertain financial future for the NHS, but also to capitalise on opportunities for delivering improved clinical care. COLLECTING INFORMATION Wireless technology can used in a variety of ways in healthcare delivery, but a key objective is to bring together all patientrelated information in a timely way to give an optimal basis for clinical decision making, given that the information is likely to come from a diverse set of sources and that clinical

staff themselves form a very mobile workforce, who are often difficult to track down. Ways in which this is achieved differs across the different care settings. This article provides a high level overview of some of the more widely adopted uses of wireless technologies across a variety of settings, focusing on benefits derived by patients and staff. As well as identifying opportunities and successes it also reviews the ongoing challenges faced in realising the benefits on offer. In an acute setting, clinical staff reap the rewards of wireless through the use of COWs (Computers on Wheels), or tablets, which can be moved or easily carried from patient to patient, allowing both the viewing of a complete set of electronic patient data and providing the opportunity for real time update. This can be particularly effective when coupled with a ‘Single Sign On’ application, to give consolidated access to the full patient record, including pathology or other results, images and recent vital signs observation. This allows more informed and faster clinical decisionmaking, since the clinician is no longer reliant on paper notes (which may or may not be to hand, and may or may not be complete). Electronic prescribing and medicines management systems can also be brought to the bedside, which reduces clinical risk of missed or duplicate prescribing and when integrated with drug clinical decision support

STAFF COMMUNICATIONS Many hospitals have been using wireless to improve communications between staff through the use of a voice-activated badge worn around the neck. Badge wearers can call other badge wearers or landline users simply by saying the name of the person or team they want to contact. This delivers enormous efficiencies in staff time and improved care across a wide range of areas – including A&E and theatres management. Staff are able to speak to each other instantly, questions can be answered immediately and patients are moved to be in the right place at the right time. A number of wireless applications have been developed in response to the NSPA’s 2007 report ‘Safer Care for the acutely ill patient:learning from serious incidents’, which recommended earlier identification of deterioration through appropriate monitoring of vital signs. Such systems typically make use of wireless technology through the use of PDAs for nurses to input vital signs at the bedside. Once a full set of vital signs has been entered, centralised software calculates the patient’s risk score, automatically alerts any escalation necessary, and indicates when the next observation should be taken, based on the patient’s condition. In many cases, such systems have been extended to directly connect monitors (for example in cardiac patients) to a central decision support and alerting platform. Not only does this lead to a safer environment through the removal of wires and cables, again, it also provides the means for rapid clinical intervention, if necessary. BENEFITS OUTSIDE THE HOSPITAL The benefits of wireless are not just for hospitals. Many peripatetic health workers are able to take advantage of the technology, allowing them to perform their jobs more efficiently and provide better care to patients at home – again through access to timely and relevant information. In a recent trial in Nottingham, communitybased clinicians and therapists used highspeed wireless laptops securely connected to N3 to access and update records

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Health Business | Volume 9.6

information technology

as they moved from patient to patient on their home visits. Patients at home increasingly benefit from wireless technology using applications that can directly transfer data from a sensor to a base station. Miniature sensors capable of being implanted are available that can accurately monitor a variety of physiological functions. Output can either be monitored through wireless transmission of data to a central base station or linked to a longer range external network, allowing opportunities for remote patient monitoring – and, if necessary, rapid action before complications occur. Such applications are often used for monitoring chronic diseases and increasingly provide feedback to the patients themselves, giving them greater visibility and control in self-managing their conditions. RFID is becoming an increasingly popular wireless technology, with the potential to support more robust, efficient and safer healthcare delivery. RFID tags may be applied to people – patients and staff – and to objects, allowing readers on door frames, wards and treatment areas to detect and record interactions. RFID can be used to reduce preventable medical errors, such as occurrences of equipment being left in a patient during surgery, the administration of a mismatching blood products or an incorrect medication. In the UK, many adopters of RFID focus on its potential for reducing delays in treatment by being able to locate the key players needed – the patient, equipment required and staff – capitalising on the data captured for stock control and asset management purposes. FINDING THE RIGHT DEVICE From a wireless perspective, the choice of an appropriate mobile device often causes some contention. COWs, tablets or PDAs (and even notebook PCs, as technology continues to evolve) all have a part to play. A key demand on any device used in a clinical environment is that it must conform to stringent infection control requirements – many newer devices have alerting capability when they need to be cleaned. In general, it has been found that doctors much prefer full-size screens – and will opt for either a COW, or tablet (provided it is sufficiently lightweight and easy to use when walking around) since they need a full screen view on many applications (for example to see trends of test results) and may also wish to switch between different applications to access supplementary data. For vital signs entry, research has demonstrated that PDAs are popular with nursing staff, with a well laid out and simple data entry screen for input. Studies conducted by different vendors have revealed that the simpler the data capture screen the better, since fewer input errors are made. Given the sensitivity around the use of mobile devices (and the ease with which they can be lost) all mobile devices must be configured such that sensitive data is secured and remains on them no longer than absolutely necessary. Sometimes the network itself provides such capability, since the mobile device itself is simply a means to capture and transfer transient data to a secure server. In other cases, if not docked, all data is automatically removed from a device after a preset period of time. SECURE WIRELESS NETWORK There are numerous examples of successful wireless deployments supporting applications described above, but these are not without their challenges. From a technical perspective, the wireless network must be secure, robust and resilient, without loss of coverage or any drop of signal. Both of these can lead to clinical risks, and, importantly will lead to lack of confidence in the technology and low adoption by the clinical staff. For some of the older hospitals in particular, this can present considerable demands (e.g. number of access points for full coverage). Device battery life can be a problem – particularly for those working in the community for extended periods. Cost is often a barrier. Although cheaper to install a wireless network than a wired one, if a wired solution is already in place, the business case for change can be difficult to justify. Problems raised most often are around guaranteed security and the clinical safety of the networks and devices themselves – and an ongoing campaign to assure both of these continues. Ultimately, the adoption (and successful realisation of benefits) for wireless comes through an enthusiasm for staff to take up new working practices and for those with success stories to continue to share them.

A complete management information solution innula operates a fully integrated service suite which opens the door to your information. Our solution transforms enormous amounts of data into the real business environment making it accessible to end users for fast analysis and reporting. Critical features include ease of scalability for drastically reduced installation time with rapid deployment tools, without a high initial cost. This solution is powerful when manipulating dispersed data and integrating from multiple sources. The application suite provides reports, multi dimensional analysis, dashboards and the ability to monitor data thresholds

and send alerts and automated e-mails. Pinnula has the expertise to integrate with your current systems to provide a single simple to use end user interface. Pinnula also offers a varied portfolio of applications which help manage and control your information needs, our expertise in application and information integration has helped many organisations achieve their business needs.

FOR MORE INFORMATION Contact: Jeni Steele Tel: 01709 839933 Web: www.ims-uniplan.co.uk E-mail: info@ims-uniplan.co.uk

Outsourcery – smarter working for everyone utsourcery is the UK’s leading communications and hosted IT company that believes there is a better way. We believe all organisations should be able to enjoy the benefits of the latest technology. That’s why our tailored communications and hosted IT help you work smarter not harder. We’ve invested over £10 million in our data centres. Behind the tough doors of these state-of-the-art facilities are the best servers money can buy. Your information is instantly accessible but the expense, worry and complication of maintaining a server of you own is taken away. We’re always up to date with the latest developments so your technology is always up to date. You can stop worrying about software

upgrades and compatibility issues. We’re also a trusted partner of Microsoft, Vodafone and BlackBerry, giving you the benefit of first class communications and hosted IT to go alongside our high quality service and support. We currently work with public and private sector healthcare organisations across the UK such as the Cheshire & Wirral Partnership and Amber Trust, and provides mobile voice and data solutions to approximately 25,000 customers and over 100,000 business users. Outsourcery is a Microsoft Certified Gold Partner and employs over 250 staff based in 3UK offices.

FOR MORE INFORMATION For more information, please visit www.outsourcery.co.uk

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Health Business | Volume 9.6

emergency services

The Emergency Services Show 2009 Taking place 24 and 25 November, the Emergency Services Show brings together all relevant organisations and equipment suppliers with the ultimate aim of improving public safety The challenging and complex nature of today’s emergencies, from natural disasters and terrorist attacks to the current swine flu pandemic, makes it essential for individual agencies to work together and plan for the unexpected to ensure a more effective response. What if there was a blackout in your facility? What contamination issues would there be if your ambulances brought in victims of a CBRN attack? What if smoke forced closure of operating theatres and wards? If you or your colleagues are involved in any aspect of emergency planning in the health sector, the Emergency Services Show will put you in the picture. Now in its fourth year, The Emergency Services Show is leading the way in encouraging multi-agency co-operation by uniquely bringing together all relevant organisations and equipment suppliers. The Emergency Services Show provides an invaluable insight into the workings of the emergency services and associated

agencies to arm you with the information you need and with no Ambex this year, the Emergency Services Show has an even more important role to play. The Exhibition Over 350 trade exhibitors will form the free exhibition giving unrivalled access to cutting

and rescue services to highlight individual initiatives and working practices, encouraging inter agency co-operation. Exhibitors this year include: the Health Protection Agency, CO Awareness, Casualties Union, St John Ambulance, Medic Alert, the Department of Health, BASICS and RAF Medical Reserves. The fire at the Royal Marsden Hospital in

“

The Emergency Services Show provides an invaluable insight into the workings of the emergency services and associated agencies to arm you with the information you need and with no Ambex this year, the Emergency Services Show has an even more important role to play

edge technology and actively promoting co-responding. The Networking Zone, a focal part of the Exhibition, is made up of the Emergency Response Zone and the Blue Light Zone, an area for police, ambulance and fire

”

London in 2008, and its resulting evacuation, highlighted the importance of the emergency service organisations, public bodies and support agencies working together. The networking opportunities presented by the

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8 www.healthbusinessuk.com emergency services

event are an invaluable way to develop interagency collaborations, initiatives and strategies and the Emergency Services Show provides an ideal environment to gain a better understanding of current emergency response issues and a forum to debate these. The Conference The integral two day conference ‘Planning, Response and Recovery’ provides the sole opportunity to join decision makers from other agencies and features expert speakers to explore current strategic thinking and past, present and future challenges in emergency response. Highlights for healthcare personnel include Russ Mansford, strategic ambulance adviser to the Department of Health giving a progress on the roll out of the Hazardous Area Response Team (HART) Programme. Catherine Philpott, emergency planning officer for Royal Brompton and Harefield Hospital, will be part of a presentation discussing hospital evacuation, clinical experience and evacuation and shelter guidance development, whilst Dr Keith Still from crowd safety based consultancy Crowd Dynamics Ltd, will discuss the psychology of crowd behaviour for mass emergency evacuations. Professor Anthony Kessel, director of Public Health Strategy at the Health Protection Agency, will be looking at the swine flu pandemic and additional topics to be covered include business continuation and the National Resilience Extranet. Details of the speakers and a full conference programme is available at www.theemergencyservicesshow2009.com. The FPHC Scientific Day The Faculty of Pre-Hospital Care (FPHC) will be holding its annual Scientific Day on 24 November as part of The Emergency Services Show 2009. The FPHC Scientific Day is suitable for all practitioners in prehospital care and will provide updates on process, planning and critical care decision making in the pre-hospital environment. Speakers have been selected for their expert knowledge and experience and are drawn from the FPHC and our supporters JRCALC, College of Paramedics, 999 Emergency Research Forum and BASICS. Sponsored by Emergency Services Times, Boundtree and PHYSIO Control, the FPHC Scientific Day will provide an introduction to next year’s inaugural integrated pre-hospital care conference which will take place within the Emergency Services Show in 2010.

FOR MORE INFORMATION For further information and to register for the exhibition, Networking Zone (which are free to attend) and the conference visit www. theemergencyservicesshow2009.com

The networking opportunities presented by the “event are an invaluable way to develop interagency

collaborations, initiatives and strategies and the Emergency Services Show provides an ideal environment to gain a better understanding of current emergency response issues and a forum to debate these

”

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Health Business | Volume 9.6

emergency serivces

Satellite broadband Effective communications anywhere Satellite Broadband is enabling Ambulance Service Trusts, as well as other emergency services, to effectively communicate from any location by providing access to a wide range of voice, data and video applications that allow major incidents to be managed more efficiently and operational outcomes to be enhanced. Excelerate Technology pioneered the initial concept of providing access to high-speed broadband using automatically deployable satellite platforms fitted to new and existing mobile ICUs as well as standalone transportable solutions that deliver reliable and resilient communications across the incident ground. Satellite broadband enables uninterrupted communications to be maintained, even in environments where GSM networks are unavailable, and enables the emergency services to achieve interoperability and share information to meet their responsibilities under the Civil Contingencies Act. Satellite broadband is playing a central role in a new generation of civil contingency vehicles currently being delivered as part of the Department of Health’s HART (Hazardous Area Response Teams) programme. As technology supplier nationally for this important programme, Excelerate has played an important role in helping to ensure that these vehicles are equipped to provide operational commanders with the tools to manage major incidents and make more effective decisions. According to Mark Rainey, CBRN HART co-ordinator for London Ambulance: “These new vehicles are constructed to the highest quality with resilient and reliable technologies that provide high levels of real-time information and communications. They will enable ambulance service personnel on the ground to make more effective decisions and enhance patient care at major incidents in any environment.” Major impact Excelerate Technology has made a major impact on the UK market by investing in research and development as well as providing a one-stopshop approach to managing all the integration, real-time network operation and support issues. This expertise has resulted in the company being awarded contracts to equip some of the UK’s largest and most advanced mobile command and control vehicles. Customers include South Central Ambulance Service NHS Trust (SCAS), West Midlands Ambulance and South Western Ambulance Trust as well as other emergency services including Royal Berkshire Fire and Rescue Service, Fife Fire and Rescue Service, the Garda, Thames Valley Police, Gwent Police and Nottinghamshire Police. James Amos, emergency planning officer at SCAS, added: “Excelerate Technology has provided us with a powerful suite of

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communications technologies that enable us to deliver a more effective response to major incidents. The vehicle will also play an important business continuity role by providing an essential fall back should our central CAD be compromised.” Achieving Connectivity To achieve connectivity, automatically deployable satellite platforms are fitted to new or existing mobile ICUs. They can be fully operational within four minutes of arriving at the scene of an incident enabling a wide range of specialised command support applications to run including STEPS (Strategic Emergency Planning Software), advanced GIS mapping, asset management database information and risk information. It also allows the use of email, instant messaging, video-conferencing and the viewing of live CCTV footage from incident and traffic cameras or television news. As well as displaying data and imagery on touch screen displays mounted inside the main ICU, wireless networks can be deployed, enabling personnel using PDAs, mobile data terminals and laptops to access tactical plans or information from STEPS anywhere within a 100 metre range. This range can be extended almost indefinitely using Excelerate’s self-powered, rapidly deployable mesh wireless nodes. Excelerate Technology has been responsible for developing many innovative solutions that are now routinely fitted to mobile incident response vehicles. An example of this is RapidNet, a Private Mobile Network solution that enables mobile incident response vehicles to carry their own GSM network delivering full telecoms capabilities irrespective of the presence or capability of any incumbent national cellular network. This powerful solution was recognised with the Vehicle Services Innovation Award at the recent Global Telecoms Business Innovation Awards 2009. Another innovation is ECMS, an integrated system that provides satellite and GSMbased VoIP (Voice over IP) PBX switching, enabling VoIP handsets to function as fully featured extensions of any HQ-based PBX. It also enables different voice devices, including UHF and VHF radios, mobile and VoIP phones, to be patched into each other as well as providing real-time voice recording of all voice communication channels. Stand-alone Solutions Excelerate Technology also supplies many innovative stand-alone solutions that can be rapidly deployed in any environment. These include a body worn camera system that delivers high quality, interference-free images regardless of line-of-sight using COFDM Video and UHF Telemetry. This enables high quality

images to be received from personnel operating inside buildings or in tunnels where traditional transmission technologies will not work. Excelerate Technology also provides a comprehensive range of compact portable satellite solutions that are quick and easy for a single person to operate with motorised setup and antenna positioning. They have been successfully trialled in remote areas including the Hebrides to provide secure and confidential outreach healthcare services. Used during patient examinations, satellite broadband enabled video images to be streamed over the internet to consultants based on the mainland to aid the diagnostic process. It also reduced the need to regularly transport bed-

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Health Business | Volume 9.6

emergency services

“

These new vehicles are constructed to the highest quality with resilient and reliable technologies that provide high levels of real-time information and communications

”

– Mark Rainey, CBRN HART co-ordinator for London Ambulance ridden patients from remote locations to the mainland, a process that can often require the use of an air ambulance. This trial showed that innovative use of satellite broadband can deliver significant savings to Health Authorities as well as improving patient care. Satellite broadband has also been deployed by mobile medical screening services to prove the concept of transmitting data files

generated during the screening process back to locations where consultants and radiologists can provide an instant diagnosis. It enables the delivery of a realtime, while-you-wait service that will result in more successful outcomes as well as significantly reducing the cost of handling and responding to digitally created files compared with traditional manual processes.

FOR MORE INFORMATION Excelerate Technology Ltd Willow House Pascal Close St Mellons Cardiff, CF3 0LW Tel: 0845 658 5747 Fax: 08700 516792 E-mail: nicolas@excelerate.info Web: www.excelerate.info

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Coventry Transport Museum

The Driving Force in Conference & Events Why not hold your next event at one of the biggest Transport Museums in the world! If youâ&#x20AC;&#x2122;re looking to book a venue with a variety of modern & dedicated event spaces, look no further. Coventry Transport Museum pride themselves in being versatile, flexible and adaptable in every aspect of your event, with dedicated event spaces

that can cater for small intimate meetings of 10 to larger formal events such as awards dinners of 200, We specialise in exclusive hire events that never fail to make an impact. For special offers and information on booking your Christmas event with us please log onto our website or contact our events office.

We are delighted to be able to offer for a short period only a 15% discount on all bookings made before the 31st October 2009, this discount is based on Room Hire and the DDR with minimum numbers of 20.

Tel: 024 7623 4270 Email: hospitality@transport-museum.com www.transport-museum.com

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Health Business | Volume 9.6

conferenceS & events

Dare to be different As well as being an area of outstanding beauty and the birth place of Charles Darwin, Telford and Shropshire offers a range of interesting venues, many of which boast green credentials Telford and Shropshire is fast building itself as a destination with a reputation for leading innovation and creativity in business tourism. Its attendance at Event UK this year further enhanced this with the unveiling of its new Green Network – a pioneering approach to sustainability in conferencing designed to push the boundaries of green business and promote sustainability. The area attracts in excess of 1.6 million tourists each year with over 5,000 major conferences and events set to take place in this centre of innovation in the next year. Bucking the economic trend, Telford and Shropshire is busier than ever with enquiries from major conference organisers looking to try something new in the heart of the UK. Telford and Shropshire provides creative venues, inspiring locations and out of the box ideas for

powerful events. Added to this is real value for money and a location that is simply the natural place to meet in the heart of the UK. HIGH PROFILE FIGURES A host of high profile anniversaries are propelling the area into the spotlight as a pioneering destination of distinction for the 21st century. Charles Darwin was born in Shrewsbury 200 years ago, his The Origin of Species changed the way we view the world today. Dr William Penny Brookes inspired the Modern Olympic Games as we know them and was born in Much Wenlock at the same time and Abraham Darby’s inspirational idea to change the way iron was made led to the birth of the Industrial Revolution 300 years ago. Alongside the history of these outstanding individuals is a range of outstanding and unique

venues catering for every business need – be that a need for 4 delegates or 4,000. From world-class convention centres, modern hotels, handsome country houses and castles to steam trains, unique museums and themed venues. CREATING A GREEN NETWORK In addition to a range of world-class facilities, Telford and Shropshire is unashamedly beautiful with acres of wide open, breathtaking landscapes, gorges and forests. Ever committed to setting the standard for conferences and events, Telford & Shropshire Conferences has developed a Green Network – a selection of venues that are committed to sustainability and the environment and where environmental and corporate responsibility meet with a can-do attitude with regards to sustainable event policies

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Health Business | Volume 9.6

conferenceS & events

day with Positive Impact to understand the new BSI8901 Sustainable Events standard. The standard provides guidance on reducing carbon emissions and waste, improving the resource efficiency of the entire event supply chain as well as social impacts such as community involvement and fair employment,” comments Sarah.

Coracles on The River Severn

Exhibition at The International Centre

and practices. Details of the Green Network were unveiled at Event UK in September with the Launch of the ‘Green Paper’ on the destinations stand F301. The launch promises to be unique and daringly different. “Event UK provides the perfect platform to launch our network and tell UK event organisers about the world-class, green facilities that can be found in Telford and Shropshire – and our commitment to making business tourism in the region as sustainable as possible,” says Sarah Bird, business tourism manager for Telford & Shropshire Conferences. “Our ‘Green Paper’ will provide a unique insight into the demands of buyers for more sustainable event locations and highlight what delegates and buyers really want – and expect – when it comes to green venues and how we as destinations can really help them meet a changing events market. “This is the start of a five year journey for Telford and Shropshire, a commitment that will see the destination evolve into a top sustainable

events location in the UK. In tandem with the multi million pound developments taking place across the counties visitor facilities, this is exciting not only for us but for our UK customers.” The Green Network will be supporting a number of initiatives in 2009. “We are working closely with our venues, accommodation providers and services to pursue professional accreditations. Telford and Shropshire already has very strong green credentials and over ten of our venues have already achieved accreditation through the Green Business Scheme – the national sustainable tourism certification scheme for the UK and the only certification scheme validated by Visit Britain, through the International Centre for Responsible Tourism (ICRT),” says Sarah. The Convention Bureau team at Telford & Shropshire Conferences have been working with leading sustainable events company Organise, and their not for profit company Positive Impact, to understand how to build the foundations for the destination as a leading sustainable events destination. “We have already held a consultation

THE RIGHT CONNECTIONS According to the Convention Bureau, one of the most popular misconceptions about Telford and Shropshire is that beautiful surroundings must mean inaccessibility. “We’re in the heart of England and getting to us and our venues is actually incredibly easy. We’re only 40 minutes from Birmingham, 2.5 hours from London in the South, Leeds in the North and North Wales in the West, and less than four hours travel from most of the rest of England and right in the heart of the motorway network.” says Sarah. “But we also offer some unique services to our business visitors in terms of travel to help reduce their carbon footprint whilst still travelling in style. For example the new direct rail link from Marylebone to Shropshire provides business users travelling to The International Centre with what can only be described as an outstanding first-class service.” The route runs up to five times a day and in addition to the standard services you would expect from a direct rail link, this service offers unique and bespoke services to business users heading to Telford and Shropshire. Telford and Shropshire is also served by two international airports. Birmingham International Airport is less than 40 minutes drive away while Manchester Airport is less than 1.5 hours away; and Telford and Shrewsbury stations connect to the mainline intercity network that runs throughout the UK. For those that prefer to drive, Telford and Shropshire is at the heart of the UK’s motorway network, connecting seamlessly to the M6, M5 and M1. It also connects quickly and easily to the M6 toll helping drivers avoid congestion around major city conurbations like Birmingham. PICK ‘N’ MIX VENUES As well as offering a range of unique venues designed to inspire the imagination, Telford and Shropshire also has one of the UK’s top 10 convention and exhibition centres. The International Centre’s three exhibition halls offer a blank canvas to create the ultimate conference or gala dinner. The venue has one of the best simultaneous conference, exhibition and banqueting environments in the UK for events for 50 to national and international events for 4,000. An under-one-roof approach ensures the organiser has everything they want in one place including on site and group accommodation, in-house catering, event production and AV, and executive check-in to its 341 hotel rooms. With over 40 venues to choose from there is something for every event in Telford and Shropshire. There are top town centre hotels including Rezidor Telford Park Inn and

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8 www.healthbusinessuk.com Visit the website to view the categorised product finder

Nimlok supplies high impact exhibition stands designed to get your brand noticed imlok Ltd was founded nearly 40 years ago and is part of the P3 Group of companies whose mission is to deliver display, exhibition and event solutions worldwide. The group is made up of ten companies with over 500 people in eight locations with partners in sixty countries. The power of this diverse group of companies offers Nimlok client’s the scale of a partner who can offer competitive prices and services through a group purchasing and delivery resource. Nimlok’s credentials include the first exhibition company to achieve certification in 2008 to the ISO 14001 environmental standard, and certified to ISO 9001:2000 Quality Management Standards since 1995. Nimlok is fully compliant with BS8901 Sustainability Standard. In 2009 Nimlok received the Sunday Times Award for one of the Top 20 Green Companies and also the Excellence Award for the 2009 Display Systems Supplier of the Year from the AEO. Nimlok’sclient list includes: Johnson & Johnson, Lifescan, Finsbury Orthopedics International Limited, Arthritis Research Campaign, NHS Quality Improvement Scotland, Invitrogen and Prostraken. Nimlok has delivered in conjunction with these clients many successful events including local and international exhibitions, conferences and backdrops for internal and external meetings. Nimlok works together with our clients to develop relationships that truly become an association whose goals are focused to delivering the best possible solutions our client’s objectives.

The result of this collaboration has been award winning exhibits that have been distinguished in their unique design and message. Nimlok always keeps in mind the real objectives the client is striving to deliver to their unique audience. Through the use of custom modular systems, Nimlok has been able to utilize our client’s assets to deliver best value at multiple events and configurations whether they are large or small. At Nimlok’s UK centrally located facilty everything ‘lives’ under one roof, from solution centre to design, consultation, construction of stand, production of large format graphics and preview area. Nimlok

works in conjunction with their sister company VU, a creative design agency that can support the integrated marketing campaigns which surround all events. There is really no need to look any further than Nimlok to support any face to face marketing in which a company wishes to participate. Nimlok is uniquely positioned to deliver success to companies that have face to face marketing as part of their marketing strategy.

FOR MORE INFORMATION Tel: 01933 409409 E-mail: info@nimlok.co.uk Web: www.nimlok.co.uk

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106 The Business Magazine for Health Management

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Health Business | Volume 9.6

conferenceS & events

Shrewsbury’s Lion Hotel and country houses that combine modern meeting facilities with championship golf, spas and all the space you need to think. Unique venues that are simply out of the box include the Severn Valley Steam Railway to creative Enginuity, academic venues of scale and profile and historic houses that promise exclusivity and opulence. EDGE OF ADVENTURE With all the natural assets you need for the perfect event during the day as well as after the conference, Telford and Shropshire offers the edge of adventure for your delegate. Whether its team building and outdoor pursuits or rewarding incentives there is a staggering landscape to explore. Experience the 450 acre town park just steps from The International Centre and one of the UK’s largest urban parks. Challenge yourself on the Adventure Rope Courses at Albrighton Hall Hotel, learn Pole Lathing at the Greenwood Centre or play a champions game on one of over 33 golf courses including Patshull Park and Hawkstone Park Hotel. If it’s relaxation you need there are award wining spa resorts to rejuvenate in, miles and miles of breathtaking scenery to explore and breathtaking landscapes that offer the space you need. Telford and Shropshire has certainly put itself

on the map thanks to a major investment programme over the last five years of over £78 million in new facilities and a new campaign driven by its ‘Dare to be Different’ message. The campaign, launched in London in February 2009, dared business users to sample the region’s unique venues and inspiring surroundings and the results have seen a surge in business. There has been an explosion of investment in the region in recent years creating new and exciting venues including the £10 million Q Hotels’ Telford Golf and Spa Hotel, the £12.5 million National Cold War Museum, the iconic £28 million new Theatre Severn and the £10 million expansion of Blists Hill Victorian Town. The World Heritage Site of Ironbridge has also undergone development into a world-class visitor experience. Access to all of these existing venues, and more, is being made ever easier by Telford & Shropshire Conferences and the Convention Bureau for the destination, which offers a range of free services to event organisers. “Having a central, impartial point of contact for a destination can really help take the hassle out of organising an event,” says Sarah. “The Convention Bureau does just that. It provides free advice and support for event organisers to help create the perfect event, whether it is for 10 or 4,000

delegates. We can assist in venue finding and booking, finding accommodation, site inspections and facility visits, social and entertainment programmes and the provision of maps and guides. Basically, we’re here to help make the whole process of event organisation less stressful.” However, Telford & Shropshire Conferences hasn’t stopped there. The organisation has also developed a range of new on-line services to help organisers make the most of the area, 24/7. A new website www.telford-shropshire.com gives access to a range of online tools such as ‘My Event Planner’, an online free event proposal service. There is also an interactive venue search to find the perfect venue in two minutes or less, an Organisers Toolkit and the destinations unique Pick N Mix Cards. The area also runs a series of familiarisation trips for event organisers that the region has dubbed ‘The Big Weekend’, the next one scheduled for March 2010. “Telford and Shropshire is building a national reputation as a major events centre. We’ve been chosen as the location for the G8 Conference Away Day, Pro Retail, Youth Sports Trust and World Snooker events,” says Sarah. “It’s not just our location that makes us popular; it’s the people, the food, our dedication to providing a world-class service and our truly inspirational venues and event experiences. Like we say in Telford and Shropshire, Dare to be Different!”

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Host an event to remember for 50-500 guests in our stunning indoor venue and 1.5 acres of themed rooftop gardens. T: 0207 368 3971 www.roofgardens.virgin.com/eventsoffers

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Health Business | Volume 9.6

Advertisers index The publishers accept no responsibility for errors or omissions in this free service Abbey Distribution

ETI

Outsourcery

Access Security

Eton Fire

Peak Development

IBC

Access2

Evac Chair

Percepta Connect

Aid Call

EWA

PFC Corofil

AIT Partnership Group

Excelerated Technology

Phoenix Private Ambulance Services

AllSee Technologies

FAMSS

PHS Group

AMC Mentoring

Footprint

PiedPiper Northern

Amputees in Action

Fredson Enterprises

Pierson Surgical

Aqua Engineering Systems

Fujitsu

Pinnula

Aquacare

Fyr Fyter UK

Polkacrest

Aquadition

Gateway Training & Consulting

Premier Life Skills

Aqualog

George Boyd

Procentus Consulting

Automatic Protection

Gifford

Progress Through People

Babel Consulting

Green Street Berman

Rockwool

BAE Systems

Greenline Chemical Waste Solutions

Safe & Secure

Barron Evers

Grundon Waste

Security Watchdog

BAXX UK

GT Fire Protection

Sedao

Bond Air Services

Hagesud Bosse UK

Sentinel Water

Brenmoor

Harvey Board Print & Digital

Seton

Building Water Solutions

Hays Specialist Recruitment

Signscape UK

Capital Solutions Group

Slingsby

Carbon Control Software

Hillmoore Fire Protection

Solid State Security

Carefx

Human Engineering

Solo Sea Salt Trader

CitroĂŤn

Indepth Hygiene Services

Spirax-Sarco

HC2010

100

Clarks Archive Storage

InterAction of Bath

SPP Solutions

CLC Group

ISS Mediclean

SRCL

Conflict Management Plus

Jaal Consultants

STI-Europe

Connections (Oxford)

JDS Training

Sustainable Futures

Courtney-Thorne

JPro

Swan Energy

JW Products

Symtrax

94 18

Coventry Transport Museum

102

Cybertech UK

Keyspace Hire

Synergy Consultants

Cygnet - ECM

Lawrence Webster Forrest

Systematic Energy

LED Lighting Supplier

The Belfry

D&A Clinical Coding

48 104

David Cutler

LiftStore

The Bradford University School of Managment

Davis Associates

ESTA

The Emergency Services Show 2009

Developing Talent

Matrix Information Technology

The Priory Rooms

107

Dictate IT

Mbarron Consulting

The Roof Gardens

107

Dictate Now

Medical Rescue International

Triline UK

Disposable Medical Instruments

mjmEnergy

Tudor Tea and Coffee

DKI Services

Monodraught

IFC

UK Biomass

DNV

Mood Creative

Understanding People

Dorotape

Motivational Maps

Vectra Group

Draeger Safety UK Drayton Manor Hospitality

96 104

National Coal Mining Museum for England

104

Vertec Scientific

Nepal Systems

Village Hotel & Leisure Club Walsall

57 102

Dyson

Netsupport

Vitrathene

Earth Wind and Power

NIFES Consulting Group

Water Treatment Technology

EG Audit

Nimlok

106

Worksout

Emergency Response Training

Novell

Xpert HR

Energy Intelligence & Marketing Research

Oakleaf Technical Services

Zeal Solutions

Enturia

OHS

Environmental Resources Management

OJ Smith Lighting

108 The Business Magazine for HEALTH MANAGEMENT

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