VOLUME 14.2 www.healthbusinessuk.net
ERGONOMICS
LANDSCAPING
DESIGN & BUILD
SIGNAGE
FINDING YOUR WAY TO BETTER HEALTH Effective wayfinding is important for patients, staff and visitors alike HEALTHCARE IT
OVERCOMING PAPERLESS HURDLES
What issues might a hospital face when going ‘paperless’ and sharing patient records across Primary and Secondary Care boundaries?
PLUS: HEALTH & SAFETY • ENERGY • FACILITIES MANAGEMENT • FLEET MANAGEMENT
HEALTH BUSINESS MAGAZINE ISSUE 14.2 VOLUME 14.2 www.healthbusinessuk.net
ERGONOMICS
LANDSCAPING
DESIGN & BUILD
SIGNAGE
FINDING YOUR WAY TO BETTER HEALTH Effective wayfinding is important for patients, staff and visitors alike HEALTHCARE IT
OVERCOMING PAPERLESS HURDLES
What issues might a hospital face when going ‘paperless’ and sharing patient records across Primary and Secondary Care boundaries?
PLUS: HEALTH & SAFETY • ENERGY • FACILITIES MANAGEMENT • FLEET MANAGEMENT
Comment
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
THE NHS PAY PREDICAMENT GPs warned that an insufficient funding increase would risk exacerbating the primary care workforce crisis and undermining services. The 0.28 per cent rise in contract payments, recommended by the Doctors and Dentists Review Board and endorsed by the government, is expected to deliver a 1 per cent pay rise for GPs. But staff who receive job progression increases will not get the 1 per cent increase as well, a change which will affect close to 600,000 nurses and other staff working in the NHS. GPC deputy chairman Dr Richard Vautrey said: “The bottom line is that it is nowhere near enough to deliver the 1 per cent rise in GP income being recommended. The result will inevitably be a further pay cut to GPs who will feel their hard work and dedication has been completely undervalued and they will see this award as another kick in the teeth.” In Scotland, health minister Alex Neil announced a total additional £6 million into the Scottish GP contract, which could take total investment beyond the 0.28% DDRB recommendation. Medicine Show The NHS Alliance had drawn attention to difficulties in the medicines supply chain. Stock shortages are becoming common place in community pharmacies, and the issue is further complicated by manufacturer quota control systems. The effect is that pharmacists are having to spend more time looking for supplies of medicines to fulfil patients prescriptions, taking them away from important elements of patient care. Dr Michael Dixon, chair, NHS Alliance commented: “We have to recognise the additional workload in community pharmacies to maintain supplies of medicines to our patients. They are doing a great job in reducing the impact on patients, but we are noticing more occasions where we are having to change prescribed medicines to alternatives. In some situations this is a difficult process and puts the patient to inconvenience and in some cases to additional risk.
Danny Wright
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CONTENTS
07 NEWS
33 DESIGN AND BUILD
Government agrees 1 per cent rise in GP practice funding; new nursing apprenticeships; increase in prescription and dental charges
Susan Francis and James Chapman of the Design Council’s Cabe Team explain how high-quality care environments can be delivered with tight budgets through expertise and leadership
11 ERGONOMICS
NHS ergonomist Liz Leigh writes about the risks involved in moving and handling patients
35 SIGNAGE
Being able to get from one part of the facility to another quickly, efficiently and without worry is crucial in a hospital, writes David Watts
17 HEALTH & SAFETY
RoSPA discusses the importance of a strategic approach to staff safety
11
38 LANDSCAPING
Jonathan Tame from the British Association of Landscape Industries explores the connection between plants and outdoor spaces and quicker patient recovery
21 ENERGY
Richard Pearson from the Carbon and Energy Fund focuses on the benefits of combined heat and power technology to reduce carbon
41 FLEET MANAGEMENT
27 HEALTHCARE IT
Dr Ian Jackson considers some of the issues a hospital might face when going ‘paperless’ and sharing patient records
27
Contents
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
ACFO Chairman Damien James discusses the challenges that today’s fleet managers face
31 FACILITIES MANAGEMENT 43 PRODUCTS Too often FM is the silent resource and & SERVICES only comes into focus when there is an
A look at some of the latest products and services for the healthcare sector
issue that requires attention, writes the BIFM’s James Sutton
38 33 35
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GENERAL PRACTICE
Government agrees 1 per cent rise in GP practice funding The government has accepted some of the Review Body on Doctors’ and Dentists’ Remuneration’s recommendations regarding funding for GP practices. In line with the proposals, GPs will see their income rise by 1 per cent overall from April. Staff costs have fallen by 1.4 per cent, the review body claims, meaning only an additional 0.28 per cent in practice funding from the global sum will be needed to pay for the higher GP salaries. Health Secretary Jeremy Hunt said: “The DDRB’s recommendations for a 1 per cent consolidated rise for all staff, on top of automatic increments, are unaffordable and would risk the quality of patient care. Without a pay rise, incremental pay increases already commit nearly £1billion every year for all NHS employees and add 2 per cent each year to the NHS pay bill for employed doctors and dentists. The DDRB proposals suggest a pay rise that would risk reductions in front line staff that could lead to unsafe patient care. It is not possible to maintain appropriate numbers of front line staff, give a general pay rise of 1 per cent and pay for incremental progression.” Some in the GPC have voiced concerns about how pay adjustments are being administered.
New appointment to HSCIC management role Professor Martin Severs has been appointed as Caldicott Guardian and lead clinician of the Health and Social Care Information Centre (HSCIC). Professor Severs was previously chair of the Information Standards Board for Health and Care in England. In his capacity as Caldicott Guardian, he will be responsible for ensuring the security of patient data. READ MORE:
Study finds low implementation of Safer Sharps directive READ THE REPORT:
tinyurl.com/qj2nwmw
GPC chair Dr Chaand Nagpaul said: ‘It beggars belief to suggest that an 0.28 per cent uplift in the GP contract will translate into a 1 per cent increase in GP pay at a time when expenses are projected to continue to accelerate. This decision fails to recognise the expanding role and workload in general practice that shows no signs of abating.’
New nursing apprenticeships Tracey Cottam, Director of Transformation and Organisational Development of Royal Devon and Exeter NHS Foundation Trust said: “We are delighted to be involved in this important initiative. This underlines our commitment to enabling our healthcare assistants to become registered nurses through a vocational pathway that will be designed to meet professional registration requirements. This will help us to meet current and future demands for READ MORE: high quality tinyurl.com/na7smhh healthcare.”
MENTAL HEALTH
Rise in children on adult mental health wards Recent NHS figures compiled by the Health and Social Care Information Centre show that there has been a rise in the number of children being treated on adult psychiatric wards. During the first eight months of 2013-14 there were 250 admissions, more than in the whole of the previous year. This represents a reversal of a trend in recent years towards fewer child admissions.
NEWS IN BRIEF
tinyurl.com/owbo7n3
HEALTHCARE
The government has announced that healthcare assistants will be able to train directly towards a nursing qualification for the first time. The new initiative is to be aimed at high achieving apprentices who lack the academic qualifications needed to gain a university place. The scheme was drafted in response to recommendations in the Francis Report. As part of the requirement that all new nurses must have a nursing degree, the apprenticeship will closely match the degree curriculum.
News
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Current guidelines state that young people should only be placed on adult psychiatric units in exceptional cases. Lucie Russell of the charity YoungMinds said: “Urgent action must be taken to ensure that the worrying increase in children on adult wards is halted and that both early intervention and crisis READ MORE: services tinyurl.com/na3yqbz improve.”
A number of UK NHS Trusts are failing to implement EU directives concerning the use of sharp instruments, it has been claimed. The independent research body MindMetre found that while most trusts are complying with regulations on using sharps with protective mechanisms where possible, a third are failing to inform their staff of the importance of doing so. The Safer Sharps directive is in place to prevent injury and infection among hospital staff; there are an estimated one million sharps injuries in the EU every year.
READ MORE:
tinyurl.com/og952jh
Christie Hospital to be investigated The healthcare regulator Monitor has announced that an investigation into the Christie Hospital Manchester is underway. It said the process aims to learn whether the Christie NHS Foundation Trust “has breached its license to provide health care services by failing to operate in accordance with the principals of good governance.” There are concerns that the trust’s board is not meeting standards of corporate governance. READ MORE:
tinyurl.com/nwnxx4a
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GENERAL PRACTICE
GP practices to receive two weeks’ notice before inspections
PRESCRIPTION CHARGES
Rise in prescription and dental charges
Chief inspector of primary care Professor Steve Field has announced that GP practices are to have greater notice before CQC inspections, going up from two days to two weeks. Professor Field said that the change is part of a ‘new approach’ which aims to support practices. A CQC statement said: “This week the CQC will be sending out letters to 12 CCG areas chosen to form part of the first wave of new GP inspections, they have been chosen at random for a representative geographical spread. “CCGs are being given at least four weeks advance notice that their area has been selected and GP practices in those areas will have at least two weeks’ notice of an inspection as opposed to the previous 48 hours, CQC reserve the right however to inspect unannounced at any time where a practice is identified as a risk. These inspections will only include practices that have not yet READ MORE: been visited tinyurl.com/nretrzz by the CQC.”
Health Minister Norman Lamb has announced that the cost of NHS prescriptions in England (which currently stands at £7.85) is to go up 20 pence in April, with another 20p rise scheduled for next year. There are exemptions for low earners, children and those over 60. Wales, Scotland and Northern Ireland no longer charge prescription fees. The price of dental treatment will also increase, with band one treatments increasing 50p to £18.50, band two treatments up £1.50 to £50.50 and band three treatments
DRUG TRIALS
FINANCE
Lung cancer trials underway Researchers at Cardiff University are to use the breast cancer drug Olaparib in medical trials to determine its efficacy in treating non-small cell lung cancer (NSCLC). They aim to recruit 100 patients with advanced forms of the disease from hospitals around the UK for second-phase testing. Olaparib is a PARP inhibitor, meaning that it targets cancer cells. It will be given to patients following chemotherapy treatment. It is thought that around half of NSCLC sufferers develop a fault in how their cells repair themselves, and there are hopes that the drug can kill off cancer before it recurs after chemotherapy. This is part of a wider trend towards using medicines designed to treat one type of cancer to target other types. Kate Law, director of clinical research at Cancer Research UK, said: “It’s through research that we’ve seen how this PARP inhibitor could be effective in other cancers that have faults in their DNA repair mechanisms. We’re now taking this knowledge from the lab to see if and how it can help READ MORE: cancer tinyurl.com/nw3m3bu patients.”
News
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READ MORE:
tinyurl.com/n6hj6ot
up £5 to £219. Lamb blamed growing demands on the NHS for the price rise. He said: “This government has made tough decisions to protect the NHS budget and increase it in real terms, but charges for some items remain an important source of revenue to support the delivery of high quality NHS services. “This is particularly important given the increasing demands on the NHS, with spending on medicines alone almost doubling since 2000.”
Hospital closure bill passed MPs have passed a measure allowing the health secretary to close hospitals with 40 days’ notice – even those that are meeting healthcare targets. Clause 119 in the Care Bill gives the health secretary the power to shut down or downgrade any hospital with a neighbouring trust that is in financial difficulties. The move comes after Health Secretary Jeremy Hunt’s plans to scale back Lewisham Hospital’s services were ruled to be unlawful in 2013. 297 MPs voted in favour of Clause 119, and 239 against. Concerns have been voiced that the new clause prioritises financial outcomes over clinical outcomes. Shadow Health Secretary Andy Burnham said: “It subverts the established process in the NHS which requires
that any changes to hospitals should first and foremost be about saving lives, rather than saving money, and it puts management consultants, not medical consultants or GPs, in the READ MORE: driving tinyurl.com/q889vcu seat.”
TREATMENT
Breast cancer care standards not enforced The health charity Breast cancer Campaign has said that insufficient monitoring is carried out to ensure NICE standards for breast cancer care are met. The charity’s report Finding the cures, improving the care found that the breast cancer quality standard (BCQS) is underused. The report found room for improvement
in a number of key care measures. Breast Cancer Campaign chief executive Baroness Delyth Morgan said: “There is an urgent need to ensure that appropriate levers and incentives are in place to deliver these improved READ MORE: standards tinyurl.com/ooll6za of care.”
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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ERGONOMICS
GUIDELINES FOR SAFE HANDLING PRACTICE
Nurses and other healthcare professionals are one of the highest groups for back injuries, causing many to give up their career prematurely. UNISON estimates that 3,600 nurses are forced to retire every year due to back injuries. Patient moving and handling tasks are physically demanding and often performed under difficult conditions. Recruitment and retention of nurses is becoming a serious problem, and nursing shortages have been exacerbated by occupational injuries and related disabilities. Together with rising obesity rates, an ageing workforce and an increase in physical demand more pressure is being put
on clinical staff increasing their risk of injury. Legislation requires staff to avoid hazardous manual handling operations as far as reasonably practicable, and where this cannot be achieved they must take steps to reduce the risk to the lowest possible. The introduction of equipment following assessment can reduce staff injury. A hoist is one of those items of equipment that may be required to move an immobile patient to lower the risk of injury. However, a hoist can be a deadly weapon if used incorrectly as the end result could be injury to patient/ staff or both and in extreme cases the death of a patient.
ion Legislat es requir oid av staff tos manual u hazardo operations g handlin s reasonably as far a able or take practic to reduce steps risk the
HOISTS AND HOIST SLINGS There are various types of hoists to choose from dependent on the patients’ needs. An active hoist is a piece of equipment used which requires the patient to be able to bear some weight through their feet for short periods of time. A passive hoist lifts the entire person’s body weight. Hoists can be categorised into three groups, overhead hoists, mobile hoists and fixed hoists. Fixed hoists are either fixed to the floor or wall mounted and are usually found in a bathroom or swimming pool. A hoist sling and spreader bar must be compatible with the hoist chosen. The sling design is not universal and slings can be attached in various methods. There are clip type slings and loop attachments dependent on the spreader bar. The bar may be a coat hanger style or a wishbone shape. E
Volume 14.2 | HEALTH BUSINESS MAGAZINE
Written by Liz Leigh, Manual Handling Adviser/Clinical Ergonomist, Southend University Hospital NHS Foundation Trust
NHS ergonomist and manual handling adviser Liz Leigh writes about the risks involved in moving and handling patients and advises on how it can be made safe for patients and staff
Patient Handling
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ERGONOMICS INCIDENTS A community nurse won £107,246 compensation from Surrey Primary Care Trust after injuring her back while trying to lift the leg of a 20 stone patient. The gentleman was so overweight he was unable to lift either foot on his own to have dressings applied. The nurse, aged 56, who was 5ft 4 inches and weighed 8 stone, had repeatedly complained to her manager about the difficulties treating this patient but had been ignored. The resulting injuries were so severe she had to give up her job. This could have been avoided if lifting equipment had been introduced. On 24th July 1994 a nurse was awarded £205,000 for a back injury. The nurse and a colleague had been trying to help an elderly patient from a commode to a chair, when the patient’s legs gave way. Due to the lack of space the nurse was forced to twist her back to place the lady in the chair. This resulted in the nurse being forced to give up work as she was often confined to bed and regularly attended a pain clinic. While the risk of injury to healthcare professionals is well known when moving patients. The obesity epidemic has exacerbated the problem. There were 163 incidents in which people were injured while being moved in a hoist reported to the Health and Safety Executive (HSE) between April 2001 and December 2007. PATIENT DEATHS A BUPA care home in Leeds was fined £100,000 in January 2007 and ordered to pay £50,000 costs after the death of an elderly resident following a fall from a hoist while being moved. While the hoist was stationary one carer turned away to pick up the lady’s slippers and the second carer was behind the mast of the hoist. The lady fell forwards to the ground and suffered a head wound, resulting in her death a week later. The investigation found the sling loop fixings attached to the hoist were wrongly adjusted. Had it been correctly fitted this accident could have been avoided. Two nursing home owners in Leicester were each ordered to pay £20,000 costs and fined a further £50,000 after a pensioner died following a fall from a hoist. The investigation found the hoist sling had a two-year lifespan but had been in use for nine years. The Health and Safety Executive (HSE) were told it had been an oversight as an outside contractor completed safety checks regularly but the hoist inspections had inadvertently been missed. The HSE found an unqualified member of staff had been completing maintenance checks at the home. The Health and Safety Executive (HSE) investigate and prosecute establishments for the death of any individual which takes place at work. A number of establishments have been investigated and prosecuted over the years because a patient has died following an incident with a hoist.
Ergonomics and working in partnership can make a difference to a patient’s dignity and reduce the risk of injury to staff ERGONOMIC ASSESSMENT When considering the use of a hoist an assessment should always be carried out to ensure the patient has the correct size sling and the hoist is appropriate for them. Staff using the equipment should be competent to use it. There is also a duty on the employer to ensure that staff who are not expected to regularly be involved in manual handling are made aware of the risks of doing so. It is important the sling is compatible with the hoist selected and is correctly fitted. Manufacturers will provide guidance on assessing the correct size sling for individuals. Sling sizes vary between manufacturers, with no standardisation within the industry. Therefore it is important staff are taught how to measure the sling to ensure it fits correctly to avoid any accidents. The style of sling is also important to ensure the person is given the right amount of support required. The assessment should include factors such as: the task that is to be undertaken; the person’s sitting balance, trunk and head control; degree of leg support required; and skin condition and other vulnerabilities. Other considerations include the chair/bed the person is to be transferred into, the person’s position (recline/sitting) and unpredictable movements (related to restlessness, aggression, spasm, or lack of muscle tone). It is also important to maintain the equipment and have it serviced every six months. This should include hoist slings as well as the hoist. STAFF ATTITUDE Having taught manual handling for over 25 years I have often heard staff tell us they hardly ever use a hoist. They feel this item of equipment should not have to be used by them during their annual updates as it is a waste of time. In response to this staff have been asked if they would get in a car and drive it without first having had a series of lessons. The response to this is usually ‘no’ however, when asked ‘why not’ they say ‘because a car is dangerous and someone could be hurt or killed.’ It could be argued that the same principle applies to using a hoist. The benefit of using equipment to move patients is to maintain their safety. Patients are becoming larger and more immobile and the need to hoist is increasing. As the population is becoming larger hoists are used not only to hoist an individual, but also to hoist limbs during surgical procedures. LEGAL OBLIGATION Legislation is in place to protect staff at work. It is also there to ensure the safety of patients while they are being cared for in
Patient Handling
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either hospitals or care homes. The employer’s duty at common law is to take reasonable care to safeguard all employees against the reasonable foreseeable possibility of harm arising from work-related disorders. Under the ‘Manual Handling Operations Regulations 1992 the employer must take steps to avoid the risk of injury to employees. Suitable and sufficient risk assessments must be carried out. The Management of Health and Safety at Work Act 1974 requires the employer to provide information, instruction, training and supervision. Training staff in the use of equipment as well as how to recognise defects that may affect the stability or safety of lifting equipment is part of a risk assessment (Manual Handling Operations Regulations 1992). The HSE have published a short guide Getting to grips with hoisting people. In it, it says that practical training has an important role to play in ensuring that staff have the skills and confidence to hoist people safely. CONCLUSION Like any weapon competency when using the weapon decides the target. People who are trained to use the hoist correctly and understand the consequences of their actions are no longer a danger to their target. Many Trusts have seen an increase in the number of bariatric patients that are being admitted. This increases the variety of equipment needed to ensure they are able to move them. This is not only for the safety of staff but also the safety, dignity and respect of patients. Ergonomics and working in partnership can make a difference to a patient’s dignity and reduce the risk of injury to staff. As the nation becomes larger more solutions are required to manage situations while maintaining dignity and safe systems of work. It is essential that staff receive training in good risk assessment to enable them to recognise the importance of hoisting safely and competently to prevent injury. RECOMMENDATIONS Despite unnecessary deaths and prosecutions by the HSE it appears that those responsible for providing care to those vulnerable patients requiring hoisting, senior management fail to understand the importance of knowledge, training and competence on the subject. This information should be targeted at Directors and senior managers as they are the people who should ensure their staff are properly equipped and equipment is fully and competently serviced. L FURTHER INFORMATION www.ergonomics.org.uk
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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HEALTH BUSINESS MAGAZINE | Volume 14.2
Date of preparation: February 2014
HEALTH & SAFETY
TRAINING TO PROTECT STAFF FROM DANGER
The Royal Society for the Prevention of Accidents briefs our readers on the importance of a strategic approach to staff safety and advises on how hospitals can formulate a tailored risk plan
Effective health and safety management is not just about acting ethically and complying with the law. There is also a strong business case for investing in health and safety in the workplace, not least because an accident or work-related ill health can disrupt service delivery
and can also be very costly, both financially and in terms of damage to reputation. The care sector comprises of a wide range of establishments including local authorities, and in the NHS, the private and voluntary sectors. Hospitals are about restoring or assuring health but they are also
potentially hazardous workplaces. It is widely known that those employed in the care sector are often putting the needs of their patients/residents ahead of their own – and sometimes to such an extent, that they risk their own health in the process. The Health and Safety at Work etc Act 1974 (HSWA) requires employers to ensure the health and safety of all its employees and anyone who may be affected by their work. The latter is built on by The Management of Health and Safety at Work Regulations 1999, which require suitable and sufficient risk assessments to be carried out in order to ensure the necessary preventive and protective measures are put in place for everyone affected. It is, after all, an employer’s duty to assess, “so far as is reasonably practicable”, the absence of risk to the safety and health of employees and others who are affected by their undertakings, such as patients. Those employed in the care sector can come across a variety of threats to their safety, health and wellbeing E
Staff Protection
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are Healthconals i professng in worki will be ls hospitaed to use requir e equipment iv protecth as gloves suc and eyeon i protect
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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CareFlexibility速
HEALTH AND SAFETY during the course of their daily work – and we are not just talking about slips and trips here. Issues associated with shift work, violence and aggression, cross infection, manual handling, use of chemicals (the list is quite long) can all arise and take their toll on staff. Something else to think about is the fact that care homes, for example, are not only a place of work but also a home. Each resident has different needs, which is why a flexible approach towards the design of facilities and safety is needed. MANAGING THE RISKS In the health and social care sector, the risk of injury varies depending on your occupation. According to the Health and Safety Executive (HSE), care workers and home carers suffered more non-fatal injuries in 2012/13 than any other occupation in the field. A total of 493 care workers and home carers were reported to have suffered non-fatal major injuries, with a further 1,903 suffering other injuries which required them to have at least seven days off work. The latter was exceeded only by nurses and nursing auxiliaries and assistants, who amassed 4,073 injuries between them. UPHOLDING GUIDELINES When it comes to health and safety management in care homes, a set of strict guidelines governing every hazard will not necessarily suit every environment. A balance has to be struck between the person’s needs and the independence of others who may not suffer the same restrictions. These differences, however, should not detract from protecting the needs of the most vulnerable resident, which is laid out under health and safety legislation. The National Health Services and Community Care Act 1990 (Community Care Act) places emphasis on involving some level of risk-taking in acknowledgement of the need to develop and maintain skills associated with “everyday living”. The Act focuses on the promotion of independence and the treatment of residents (with dignity and respect), as well as encouraging residents to live as independently as possible. This is why carrying out a robust risk assessment is a good place to start. Not only will this identify principal hazards, it will also assess the associated risks, and will encourage the recording and investigation of accidents and near-misses. Similarly, in a hospital environment, some staff, such as nurses, may have to adopt and hold awkward postures as part of their job, so it is paramount that any stresses and strains arising as a result are addressed. It is important for all managers to work with employees to minimise risks, and to ensure who is responsible, for example, for clearing up spillages and objects quickly.
JOINED UP THINKING Risk assessment is a responsibility that should be taken seriously. The Royal Society for the Prevention of Accidents (RoSPA) offers training at locations across the UK to ensure businesses comply with the legal requirement to carrying out “suitable and sufficient” risk assessments. The one-day course puts the emphasis on practical exercises and covers legal requirements, hazards, and risks. Incorrect handling of people in the health and social care sector can cause serious injury and so it is important that employees know and understand what they need to do to prevent or minimise the risk of injury to themselves and others. According to the HSE, provisional statistics for 2012/13, show an estimated three million working days were lost due to handling injuries and slips and trips, with the health and social care sector carrying the highest number of reported handling injuries (3,539). Preventing handling injuries remains a major challenge. To help, staff should be trained on how to minimise the risk to their backs and limbs and this is why it is advisable for residential homes
Depending on the level of risk, healthcare professionals working in hospitals, in particular, will be required to use personal protective equipment such as gloves and eye protection, for example, when dealing with harmful substances, such as those found in some ingredients in cleaning products and which can cause skin allergies and asthma. The controls you need will depend on the task, which is why it is advised that employers enrol those who have a responsibility for using, handling, transporting and storing hazardous substances, on a chemical safety training to keep themselves and others safe. The Control of Substances Hazardous to Health (COSHH) Regulations 2002 requires employers to control substances such as chemicals, fumes, dust and harmful micro‑organisms that can harm workers’ health. If the packaging shows any hazard symbols then it is a substance which is likely to present risks to health and the right safety measures should be taken. RoSPA offers two courses for organisations seeking to increase their
Staff Protection
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Those employed in the care sector can come across a variety of threats to their safety, health and wellbeing during the course of their daily work – and not just slips and trips and authorities to purchase appropriate handling aids. Some other ways of helping to minimise risk include encouraging patients to assist in their own transfers and evaluating equipment and furniture before it is purchased. Equally important is a commitment to support and rehabilitate where possible those who have been injured in connection with their work. Above all, there is a need for “joined up thinking” between the various caring agencies, not only in training and selection of equipment but in how the use of handling aids should be negotiated between agencies and clients. It is useful for carers to learn about human movement patterns and how to apply these to assist in transfers, both actively and passively, using a variety of small handling aids as well as hands-on techniques. RoSPA runs safer people handling training courses designed to suit all care sectors as well as one that is focused on the person. These include the new BTEC Safer People Handling Trainers (Level 4) and Safer People Handling Hoist training, among others, which can be held either in-company or at the charity’s own fully‑equipped skills centres, providing delegates with a realistic training environment.
knowledge of COSHH. The first is a one‑day course, also available in-company, and the second is a consultancy service focussing on the importance of identifying hazards – the first step towards completing “suitable and sufficient” risk assessments. A SAFER WORKPLACE In today’s busy and challenging healthcare sector, it pays to work together to ensure the health and safety of staff, patients, contractors and visitors, with staff training remaining of the upmost importance. A systematic approach to health and safety management is to be preferred to a series of disjointed one-off interventions. This is why RoSPA is urging organisations not to turn their backs on health and safety, especially when times are tough, since for the most part, spending in a targeted way to reduce costly accidents and work‑related health damage will not only see the number of working days lost going down, but also a reduction in the associated costs which otherwise put a significant strain on already tight budgets. L FURTHER INFORMATION www.rospa.com
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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Advertisement Feature
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
ENERGY
ENERGY-SAVING LIGHTING SOLUTIONS FOR THE NHS
The NHS is being charged with reducing carbon emissions by up to 80 per cent by 2050, so NHS Trusts up and down the country are looking for innovative technologies to help them achieve this target… Wasted energy in healthcare facilities is higher than in most buildings, due to many areas working on a 24-hour a day basis. European Lamp Group (ELG) provides specialist products, designed and engineered to reduce carbon emissions and save energy. This has the additional benefit of saving money on energy bills. The company’s well-established and long-standing sales team has proven credentials and a great record on delivery and service. As well as continuing to supply general and specialist lamps, the company holds comprehensive stocks of lighting control gear. It has carried out supply and service for lighting upgrade projects from single units to roll-out projects in excess of £1 million. PATIENT AND STAFF EXPERIENCE Quality lighting enhances patients’ experience in every area of a hospital, from the moment of arrival through to departure. The need to maintain a feeling of safety and security is crucial to that experience, especially in areas with easy public access and significant people movement. Hospital employees also need quality lighting to perform their daily duties effectively, especially with the flexibility that different work areas demand. Lighting also influences comfort and stress levels, and improvements contribute to reduced absences and increased productivity. European Lamp Group has been supplying lamps and tubes for over 40 years and employs a very experienced and knowledgeable sales team. Its lighting design service can help to create the best environment for staff and patients. ELG partners all UK major lighting manufacturers as well as reputable factories in the far east who are at the forefront of energy-saving technology. The company has worked closely with health trusts as well as many high-street establishments, such as Asda, Whitbread and M&S, in reducing costs and carbon emissions. LED has exploded on to the market and offers a varied range of energy-saving solutions. ELG has closely monitored the development of this technology for the past five years and has set up its own in-house testing facility. It now only offers products that have been rigorously tested to the highest standards in output, reliability and EMC emissions to the appropriate standards.
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HEALTH BUSINESS MAGAZINE | Volume 14.2
ELG has developed a hi-tech showroom over the past four years at its premises in West Yorkshire, showing the latest energy-saving luminaires and retrofit lamps. On display are working units of floodlights, ranging from 10-500 watts ELG takes out the uncertainty when buying into new technology which many people have experienced. The company also realises that LED is not the only solution and keeps a range of induction and fluorescent options, together with 8,000 lines of lamps and tubes, including specialist types for dental and theatre applications. If you want a lamp, chances are it can be supplied from stock. Supplying lamps and fittings doesn’t end there with ELG as it also offers free energy site surveys with cost of ownership reporting to suit you. Size doesn’t matter as ELG can offer solutions from a small practice to a full hospital trust. In addition to its own delivery vehicles, ELG dispatches daily to all points in the UK, from small packets to pallets. WHAT ELG HAS TO OFFER The company offers: free on-site surveys; energy-saving solutions, up to 90 per cent; cost of ownership reporting; free lighting design and advice; nationwide deliveries; comprehensive stocks; product-testing; and experienced sales team. ELG has developed a hi-tech showroom over the past four years at its premises in West Yorkshire, showing the latest range of energy-saving luminaires and retrofit lamps. On display are working units of floodlights,
ranging from 10-500 watts. Also on display are flexible LED strips, downlights, lighting panels and a full range of induction lighting, which carries a five-year no quibble guarantee. Induction not only offers an impressive energy-saving solution but, on average, will save five lamp changes when compared to traditional forms of discharge lighting. ELG also has a meeting room available for presentations. If your visit is over the lunch period, refreshments can be provided. The company’s stock holding is over £2 million, with over 8,000 lines. Its aim is to supply the right product at the right price when you want it. Contact ELG with any enquiries on the special NHS email address below. L
FURTHER INFORMATION Tel: 01274 473400 health@europeanlampgroup.com www.europeanlampgroup.com
CARBON REDUCTION
Energy
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
COMBINING HEAT AND POWER FOR A GREENER NHS
The conversation about sustainability in the NHS is starting to change, and whilst the goal of carbon reduction is still there, the approach to delivering the message is wider, recognising the impacts of climate change that we are now enduring, and the fact that our health economy as a whole is not sustainable from a financial perspective. Consequently the Sustainable Development strategy paper published in January (Sustainable, Resilient, Healthy People and Places), highlights that “environmental and social sustainability can be addressed alongside economic sustainability challenges.” Interestingly, this vision not only talks about reducing carbon emissions and minimising waste, but also fosters the building of resilience to climate change and nurturing community strengths. At the heart of the strategy’s goals however, remains the need to adhere to the Climate Change Act target of a reduction in emissions of 80 per cent by 2050 against the 1990 baseline. To plot a trajectory to that target, a 34 per cent reduction is required by 2020. This applies to emissions from building energy, travel and procurement. With this in mind, this article looks at the most effective way of reducing emissions from building energy, and the impact that one organisation, the Carbon and Energy Fund, is having on emissions in the NHS. E
Written by Richard Pearson, prokect director, Carbon and Energy Fund
Richard Pearson, project director of the Carbon and Energy Fund writes about the latest developments in efforts to make hospitals more sustainable, focusing on the benefits of Combined Heat and Power (CHP) technology
The nts NHS wae CHP, ot to prom arbon and C and the Fund (CEF) Energy established n has bee it to help with things make en happ
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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PERFECT SPACES.
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CARBON REDUCTION ACHIEVING REDUCTIONS There are many ways of reducing building related energy consumption, but in the writer’s experience, the importance of affordability, practicality and resilience have tended to reduce the list of measures adopted to combined heat and power (CHP), high efficiency lighting, boiler enhancement, insulation and improved controls. All of these produce measurable reductions in terms of CO2 and cost, and are suitable for the application of cost guarantees by performance contracting. Other measures will undoubtedly become more and more viable as their economics improve and as the news of successful case studies spreads. Behavioural change programmes could well be much more comprehensively adopted in the future as a result, for example. COMBINED HEAT AND POWER The technology which is most effective in terms of carbon reduction and at the same time also effective financially, is combined heat and power, or CHP. To the uninitiated, this can be described simply as an engine that generates electricity, with heat from the exhaust gases being recovered and used to supplement a local heating system. This reduces the CO2 footprint, as it reduces the import of electricity from the national grid, a source of power which is far less efficiently produced. It is also cost effective, as although the user will burn a lot more gas with a CHP engine, there are huge cost savings to be made by making electricity at site level, rather than purchasing it from the grid. On top of this is the opportunity to export excess electricity back to the grid, reaping the benefit of the feed-in tariff. Consequently CHP has the potential to make a big impact on NHS finances and its CO2 footprint. This is borne out in practice, and by the research that the Sustainable Development Unit has carried out. It produced a marginal abatement cost (MAC) curve study, presented in their 2010 update, which portrayed the relative merits of 29 CO2 reducing initiatives. SAVINGS The introduction of CHP within NHS England where not installed at that time could save over 232,000 tonnes of CO2 per annum, and nearly £50 million per annum. Putting to one side the figures relating to medical equipment packaging, drug wastage and travel planning, these amounts represent 32 per cent and 50 per cent respectively of the total value of savings for all of the listed measures. POTENTIAL BARRIERS The take up of CHP in the NHS is growing, but there are perceived barriers to it. Cost is one of these, as most installations will cost over £1 million all-in. Past failures of CHP, or at least problems with maintenance and overall performance are another issue.
But the potential benefit is too good to be overlooked, and the import of performance contracting from the more developed USA energy industry is making a difference. The NHS wants to promote CHP, and the Carbon and Energy Fund (CEF) has been established in partnership with it to help make things happen, and has been set ambitious targets. The intention is that the CEF, with a framework approach, will be able to foster a degree of positive uniformity, with a form of contract that guarantees financial savings within a highly competitive bidding structure. This approach will prevent NHS trusts from having to “re-invent the wheel” for each procurement, but at the same time promoting a lot of flexibility and innovation to suit individual site needs. The CEF is partnered with NHS Shared Business Services, overseen by a membership of trustees selected from NHS trusts, the Department of Health and the Carbon Trust. It has created a framework of 17 contractors who are leaders in the field of energy performance contracting, procured through the EU’s OJEU process. The CEF provides support to trusts in
Energy
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THE PROCUREMENT PROCESS First, a trust which is interested in working with the CEF makes contact with them. Assuming both parties are happy to move forward with each other, a no-obligation feasibility study is carried out. If the study points to a viable project, the parties enter into a membership agreement, which describes what the CEF will do, and what is required of the trust, e.g. provide detailed information about the site and the energy infrastructure/consumption. The procurement commences with interviews of interested contractors, who are then shortlisted for the first stage of a mini competition – usually four in number. Over a period of six to eight weeks, the bidders use their knowledge of the site and the data provided by the trust to develop site wide proposals for energy/CO2 reduction. During this time, two sets of meetings between the trust and each contractor individually will take place. These discussions will help each bidder’s proposals adapt and evolve into schemes which will be beneficial and acceptable to the trust. This is followed by a formal tender, in
The annual cost of providing and maintaining the installation will be met and usually exceeded by the guaranteed financial savings on utility bills that the project will generate the form of project management and technical advice, and legal representation alongside the model contract mentioned earlier. It helps arrange funding for all of the projects that it works on, meaning that trusts don’t have to use their own reserves – unless they wish to. A feasibility study is offered, as well as management of the procurement without any financial compensation or cost commitment, right up to board approval of a preferred bid. OVERHAULING THE SYSTEM With CEF procurement, a trust will have new energy infrastructure and a variety of energy saving measures installed, eradicating some of the trust’s backlog maintenance requirements. It will achieve this without capital expenditure, following a competitive tender of the entire installation, which will be innovative and tailored to the trust’s needs. The annual cost of providing and maintaining the installation will be met and usually exceeded by the guaranteed financial savings on utility bills that the project will generate, and the trust’s carbon footprint will be substantially reduced. From feasibility through to installation, the process can be completed in as little as 20 months, and the payments for it don’t commence until the plant has been proved to be working in accordance with the contract specifications. This might seem like a salesman’s dream, but it is a reality and trusts are already realising the benefits of what the CEF offers the NHS.
which the concepts developed in the previous stage are worked up into fully priced bids, setting out the proposals’ annual charges and guaranteed savings. These are evaluated on a best value basis which combines qualitative and financial metrics. At this point a business case is required to approve acceptance of the preferred bidder. This enables the trust and contractor to enter into the contract finalisation period – around four months will be expended in agreeing the documents for signing. Once the contract has reached financial close, the installation period commences, usually taking a year. On satisfactory practical completion the installation becomes operational, and payments to the contractor by the trust will start to flow. LONG TERM GAINS Contracts will normally run for a minimum of 15 years, during which period the CEF will audit performance of the equipment to ensure that the guaranteed cost savings are being realised by the trust. The CEF has been running for less than three years now but already contracts to a total capital value of around £100m have been signed. Its formula is now being extended beyond the NHS to local authority and university application, such are the advantages of what it can do. L FURTHER INFORMATION carbonandenergyfund.net
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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Etac is growing in the UK as a developer of unique products for those with impaired strength and mobility
Etac develops products and services that help enhance the lives of people with disabilities and their carers. With over 40 years’ experience, the company now offers a wide range of solutions, including Molift hoists and slings, Etac manual transfer products, Etac daily living, Etac toileting and bathing as well as Etac manual and powered wheelchairs.
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HEALTH BUSINESS MAGAZINE | Volume 14.2
All of the company’s products are designed to be the best in terms of quality, simplicity, function, reliability and comfort. Every product is designed to ensure the well-being of the user and the care giver. In the last 12 months, since Etac established its UK distribution centre, it has been supporting key industry distributors and promoting the company’s brand and product ranges to occupational therapists, community equipment services and moving and handling specialists. The company now has both an established, dedicated customer service and sales team that are able to provide advice and support on a wide range of products to support the user, whatever their circumstances. In 2013, Etac launched its new website (www.etac.com/etac-uk), a new range of brochures and the company also had a full exhibition programme. Etac is known for a number of market-leading products. The Molift Smart is the benchmark in the industry for its lightweight aluminium folding mobile hoist, which can be folded without the need for tools and is easy to transport. The company also offers hoist servicing and repairs for the Molift hoist range, including
mobile hoists and ceiling track hoists. The Etac Clean shower chair range meets all of the company’s ambitions in terms of function, design and quality. This product range is available in three colours and comes with a five-year warranty. When it comes to in-bed patient care, Etac has the widest range of solutions, including the Etac SatinSheet and 4Way Glide System. These products help reduce pressure care problems for the patient and allow carers to provide personal care with minimal risk of back injury. The Etac Cross 5 Wheelchair combines maximum comfort with optimum functionality. This high-quality wheelchair has an enormous range of variation options to ensure there is a Cross 5 to suit everyone and every need. Etac ‘creates possibilities’, and its vision is that everyone should be able to live a free and independent life and pursue their dreams as well as manage their daily lives, regardless of any physical disabilities. FURTHER INFORMATION Tel: 0121 561 2222 enquiries@etac.uk.r82.com www.etac.com/etac-uk
DIGITAL PATIENT RECORDS
Healthcare IT
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Written by Dr Ian Jackson, chief clinical information officer, York Teaching Hospital NHS Foundation Trust
OVERCOMING PAPERLESS HURDLES
Dr Ian Jackson, chief clinical information officer at York Teaching Hospital NHS Foundation Trust considers some of the issues a hospital might face when going ‘paperless’ and sharing patient records across Primary and Secondary Care boundaries During a speech in January 2013 the Health Secretary Jeremy Hunt issued a challenge to the NHS – that we be paperless by 2018. Official government reports of his speech record that he was proposing a series of developments linked to recording patient data and sharing this across health and social care services. To oversee this process NHS England has created a Strategic Systems and Technology Directorate – their key deliverables are stated on their website. They have already published Safer Hospitals, Safer wards: Achieving an integrated digital care record – which is described as providing a roadmap for us to follow through ‘paper light’ record keeping to a paperless Integrated Digital Care Record (IDCR). So where does this leave us in Secondary Care? No one should doubt that this is a huge challenge – this might be a ‘take two’ of the National Programme for IT, but this time
it comes at a time of severely constrained budgets and limited external funding support. However let us ignore the funding and the available software (both are beyond the scope of this editorial) – instead let us look at experience at the sharp end and consider some of the issues faced.
each ward, each outpatient clinic, in theatres and maternity units and what are they used for? This is a real challenge going forward as I would suggest ready access is vital to success. Mobile technology is an interesting area and really divides IT colleagues opinions across the NHS. There are those who advocate the use of iPads, iPods and similar rival technology whilst others say these are not suitable for the hospital environment. There is no doubt that we need suitable mobile solutions but I continue to see problems with theft, battery life, the need to consistently plug in small charging leads, providing enough electricity sockets and E
NHS Englandd a ate has cre Systems ic Strateg chnology and Te e to create rat Directo erless NHS a pap 2018 by
HARDWARE There is huge variation in the amount of hardware that is on the frontline, i.e. available for easy access and linked to direct patient care. Computers in the offices of consultants, ward sisters, matrons help but I would argue are not available for direct patient care. So how many access points are there in
Volume 14.2 | HEALTH BUSINESS MAGAZINE
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MapReferrals
Having it all: efficient and effective Having it all: efficient and effective r referral management Map Referrals allowsallows GPs to access Map Referrals GPs tocomprehensive, access comprehensiv evidence‑based local guidance at the point of care, and helps at theachieve pointtheir of care, helps CCGs achieve their q CCGs quality and and productivity targets.
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practice information at the point of care please contact richard@mapofmedicine.com or call 0207 492 2. Embeds seamlessly with the GP workflow and provides standardised referral forms that auto‑populate with patient information 3. Is supported through Map of Medicine’s expert deployment team to ensure uptake across a CCG.
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DIGITAL PATIENT RECORDS a lack of ruggedness. Any hospital technology has to be reliable and be suitable for 24/7 use as hospitals do not stop at night. I suggest this includes the ability for the IT department to be able to quickly change batteries when they begin to lose performance. Hospitals have had varying success with Computers on Wheels (COWS) – for the most part these are heavy to move round, are of low performance and have battery issues with 24/7 use. Laptops on trolleys are another option and offer lighter weight and so increased mobility but again depend on people remembering to plug them in when they are finished. However they do offer the advantage of allowing the IT Department to incorporate an planned battery replacement programme.
so these exercises will need repeating on a regular basis. This brings us to manpower.
referral management ve, evidence-based local guidance quality and productivity targets.
MANPOWER It is an interesting fact that many of those people whose involvement is important in the move to an EPR have previously had little or no exposure to IT within their hospital. Think about the registered nurses, health care assistants, physiotherapists, dieticians, specialist nurses and the many others who contribute to patient care. Each currently records valuable information on paper that is needed for the safe care of our patients. My
Healthcare IT
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plans in place for those records to be able to follow individuals, with their consent, to any part of the NHS or social care system. I believe this remains a huge challenge. My own experience of providing access to GP systems from secondary care has been less than successful though progress is being made on access to the Summary Care Record (SCR). This however is hardly the described ‘secure linking’ or the record following the individual. This will remain an issue while what I see as artificial boundaries are placed on our records in Primary and Secondary Care. Sadly we are one NHS but not one organisation – if I were
Providing safe patient care without using the as worked with those on the front-linetraditional of folder of patient notes is within WIRELESS NETWORK Mobile technology – whatever device you aging care to develop a tool that enables reach in quite a number of hospitals. However use depends on the network and I believe this continues to be a challenge. Many ve referral management for both GPsmany and are still not even on the starting blocks, hospitals do not yet have a wireless network ap Referrals: struggling with patient administration systems but even in those that do there can still be problems for ward staff as they move around. and several departmental stand-alone systems Single point in time network surveys might be reassuring but it is only when you have thatbest do not talk to each other s delivery quality byonproviding local staff using mobilecare technology a large
thatpoint you can find your system has ation atscale the of ifcare any blind spots. Wireless networks depend
own experience of rolling out electronic nursing on a large amount of equipment – as we assessments within my hospital has brought move our clinical to beingand reliant provides home the fact that many colleagues working essly with the GPcolleagues workflow on mobile devices then monitoring this and on our wards have had little or no exposure eferral forms that auto-populate patient quickly responding to any issues is vital. with to IT – either inside or outside the hospital. The investment in training and time spent SUPPORT on the wards delivering this has been a large Whatever system is used the entire hospital undertaking for us but I believe this has laid system of will Medicine’s need responsive 24/7expert support deployment an important foundation for us to build on rough IT365 Map days a year. The move to paperless as we remove paper from the system. importantly care without casenotes) uptake(or more across a CCG. using an Electronic Patient Record (EPR) INTERACTION/COMMUNICATION means that any down time will have a severe This is clearly spelt out in the plans from effect on patient care. We talk about the NHS England which states there will be importance of business continuity plans but clear plans in place to enable secure linking I believe we will need to move to the next of these electronic health and care records level – running actual exercises in defined wherever they are held, so there is as high risk areas to ensure these plans are complete a record as possible of the care robust. Staff change, rotate or even forget and someone receives. It also states there are clear
n,
Are mobile devices suitable for a hospital environment?
2 6300
a locum doctor in a GP practice then I would have access to primary care patient records and my GMC registration would be at risk if I looked at any patient record where I did not have a legitimate reason to view it. However if I then moved to a locum post at the local NHS Emergency Department I would not be allowed to view even the patients SCR unless I asked them their permission or declared on the record that it was vital for the safe care of the patient. Personally I would argue that routine access to more than a mere summary without these steps is needed if we truly wish to promote safer care for our patients. SO WHAT IS ACHIEVABLE? Providing safe patient care without using the traditional folder of patient notes is within reach in quite a number of hospitals. However many are still not even on the starting blocks struggling with patient administration systems and several departmental stand alone systems that do not talk to each other. So it is easy to suggest that we will have a number of hospitals who will succeed in being paperless for the patient record or be close to it by 2018 but many others will fail. I believe that the sharing of information/ records across Primary and Secondary Care boundaries will be more difficult and sharing with Social Care even more problematic. I leave you with one thought – if a Foundation Trust were to provide Primary Care Services with the GPs employed by the Trust then would there be a block to running a single patient record for the organisation? Would the boundary which I have suggested is artificial just disappear? L FURTHER INFORMATION www.england.nhs.uk/ourwork/tsd/sst/
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Top 10 Tips for an effective Agile Working Program reducing up to 30% of Real estate costs Real estate is the 2nd largest expense for any organisation; so many NHS Trusts are already adopting Hot Desking initiatives using Asure Software solutions to reduce real estate operational costs alongside meeting room scheduling and wider Agile working initiatives. There are also other benefits that include increasing productivity and job satisfaction, a better work environment, team collaboration, retention of the best talent, reduced stress and less time wasted. All this helps towards providing a better healthcare service and save costs. When developing and implementing a hot deking program, there are several straightforward, yet vital, concepts all the stakeholders should understand. There are our top 10 tips: • Build the Business Case for an Agile Working Program • Assist Mobile Workers with Cultural change adjustment • Guarantee success by planning ahead • Understand how IT, Facilities, HR and other Departments are affected • Align with Current infrastructure • Maintain productivity while maximise efficiency • Reduce and Repurpose Workspace • Manage and measure performance • Record and Analyse Actual vs Planned utilisation of scape • Understand changes in ROI
The Benefits of Agile working In a traditional office, up to 50% of desks, offices and workstations are unused at any given point in a typical workday. An average cost of desk in the UK costs £5746 PA (according to DTZ). Agile Working enables organisations to maximise smaller real estate footprints (especially as corporate lease rates fluctuate). In addition, the trend allows organisations to continue to keep up with technological advances that enable new work habits. With many companies leveraging mobile apps and cloud-based software, employees can have the same access to company documents, applications and records no matter where they’re working. Other internal apps help keep employees productive and connected even when they’re out of the office.
For more information please visit www.asuresoftware.com or contact our UK Sales Team Email: asurespacesales@asuresoftware.com. Tel: +44 020 8328 9460
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HEALTH BUSINESS MAGAZINE | Volume 14.2
HOSPITAL MAINTENANCE
James Sutton of the British Institute of Facilities Management (BIFM) writes about the importance of facilities management in healthcare and how the sector can achieve its due recognition Facilities management is a huge sector, employing thousands and bringing millions of pounds into the UK economy – but how much to do we understand and appreciate its impact and value? Some facilities managers (FMs) feel that they are not given the credit they deserve, and when you begin to assess the impact that they have on the economy and society it is not surprising that they feel aggrieved. At BIFM we are keen to demonstrate that FM touches so much in everyone’s daily lives and therefore has a huge influence on the wider world. It is when you take a step back and assess the environment that we all live our lives in that you realise how far reaching and important our profession is. A BROADER CASE It is fair to say that the healthcare industry is probably one of those where FMs wider impact is most evident. It has the potential to have a positive impact on patients, those visiting their loved ones and the essential staff that are caring for them. In terms of demonstrating FM’s impact on wider society there are very few examples that are more tangible. The danger, however, is that FM is not seen as a vital tool in delivering on objectives; in this case patient care. Too often FM is the silent resource and only comes into focus when there is an issue that requires attention. When it’s considered like this there is a danger that its impact is stunted. Often multiple suppliers will provide a range of services and at times, when these different services need to work together, things fall between two stools. This will have a negative impact on the three groups of people mentioned above. Turn that around, and view FM as a central part of you
achieving your objectives, and you will begin to look at the proactive role that it can play rather than taking the reactive approach which can lead to a disjointed operation ultimately failing to deliver on the experience you want to create. Facilities managers know this; it’s everyone else we need to convince. DEMONSTRATING THE VALUE OF FM So, how do FM practitioners, with our support, make the case internally to the key decision makers? At BIFM we’re looking at a number of ways in which we can demonstrate FM’s value. Our ThinkFM conference this year, ‘The workplace and beyond’, will focus on the impact on business, the economy and society with a range of speakers from a variety of different sectors, professions and expertise discussing key trends driving change in the workplace, managing energy and the convergence of professional disciplines. We will also be launching a number of research projects that will aim to quantify FM’s impact, outline leading edge thinking in the industry and look at the future trends that will take the profession forward. We are also working on a joint project with ITN Productions to create a series of short films on how FM makes a difference. Avoiding the temptation to delve into the technicalities and focusing on the difference it makes through profiling FM’s in a range of organisations and seeing the results of their work. We want to focus on helping practitioners with their internal conversations. It is always too easy to fall into the trap of using the language and terminology that we’re comfortable with but all this does is perpetuate stigmas that may exist around a given profession. What decision makers want to hear is how you can help them achieve their goals. By putting yourself in their shoes, understanding their challenges and aims, assessing how FM can drive them to overcome the challenges and reach their goals and, finally, communicating that back to them in a way which will resonate with them we will see that awareness and recognition grow. L FURTHER INFORMATION www.bifm.org.uk
The role of estates and facilities professionals within a healthcare environment is essential for patient care. Within the National Health Service (NHS) there is a regulatory framework within which estates and facilities professionals work and which healthcare providers are regulated on. The quality and fitness for purpose of the healthcare estate is vital for the delivery of high quality, safe and efficient healthcare. Quality and fitness for purpose are set against a set of legal requirements, standards and best practice guidance. The NHS Constitution pledges to patients that a key priority is that services are provided in a clean and safe environment that is fit for purpose, based on national best practice. There are a number of core standards within the Care Quality Commission (CQC) registration to which Trusts must comply. The CQC is the independent regulator of all health and adult social care services in England. The CQC monitors, inspects and regulates services to make sure they meet fundamental standards of quality and safety and it publishes what it finds, including performance ratings to help people choose care. The registration requirements are set out in the CQC (Registration) Regulations 2009 and include requirements to the safety and suitability of premises, safety, availability and suitability of equipment, cleanliness of the building and environment and measures to prevent infection. These priorities coupled with increasing public concern about healthcare associated infections, means hospitals need to not only be clean and safe but able to demonstrate how and to what standard they are kept clean and safe. This is the challenge for estates and facilities professionals. High standards of quality and safety can only be achieved through clear specifications; proper training of staff; documented lines of accountability; and all staff recognising their responsibilities. Since the publication of the Francis report, the government has introduced a legal duty of candour on organisations to be open and honest about mistakes and the introduction of a criminal offence of wilful neglect to hold NHS staff to account. Estates & Facilities professionals are integral to providing sustainably services by working in partnership with clinical colleagues, patients, the public and communities.
Volume 14.2 | HEALTH BUSINESS MAGAZINE
Written by James Sutton, chief operating officer, BIFM
BETTER FACILITIES FOR A STRONGER HEALTH SECTOR
Opinion: Carolyn Lewis, healthcare specialist, BIFM Expert Panel
Facilties Management
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Design & Build
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positive about the switch (to the Zeroderma range) as it had no negative impact on care.” A new QIPP and emollients toolkit developed by medicines management teams contains everything needed to change to the Zeroderma range. It also includes a cost savings calculator. All Zeroderma products are available on prescription and most are listed on NHS contract.
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HEALTH BUSINESS MAGAZINE | Volume 14.2
Part of the Design Council Cabe Team’s Design Review for the Alder Hay Children’s Clinic in Liverpool included creating an uplifting environment
BUILDING TO MEET HEALTH NEEDS IN THE COMMUNITY
Susan Francis and James Chapman of the Design council’s Cabe Team explain how high-quality care environments can be delivered with tight budgets through expertise and leadership Good design is all about the approach and the process. The focus should be on design quality and its impact on wellbeing. This need not mean extra cost, but does require inspiration and leadership. Capital investment is not simply about making buildings more comfortable or giving them a contemporary make-over. It’s all about committing to a step change – making sure that the physical settings for health are fit to deliver care in the future. We acknowledge the urgent need for high performance environments that are affordable and adaptable whilst sustaining therapeutic design quality for all users. There needs to be a change in content and vision where projects aim to deliver health and social care in a more effective way, as part of a strategic plan. MANAGING ESTATES The Department of Health owns extensive estates that require careful evaluation and management; delivering quality projects in an era of austerity requires very careful thought so that they can lead to improved outcomes. Rather like keyhole surgery, the process demands more precision and up-front preparation to deliver results. Much of the existing estates and buildings are no longer fit for purpose and are tying up capital value and revenue cost. High performance premises in the right location
that are ‘fit for purpose’ are essential for delivering high quality services fit for the 21st century. Doing nothing is no longer a viable option for survival; making any intervention, however small, has to deliver better outcomes, reduced costs, with greater satisfaction for staff: Design is central to this purpose. DESIGN REVIEW An evaluation of the quality of space, environment and buildings should take place with a view to enhancing therapeutic impact. It is important to create strategies that are both robust and sustainable to improve clinical functionality, eliminate backlog maintenance, meet statutory compliance and environmental measures to achieve carbon reduction targets. An example of where Design Review helped develop a masterplan and design strategy for a major hospital is Alder Hey Children’s Clinic in Liverpool. The Cabe team supported the NHS Trust during the bidding process and helped identify the preferred design team. Design Review improves the quality of design of major projects and often speeds up the planning process, leading to the quicker delivery of high quality places. The proposal for Alder Hey promised to provide a new kind of hospital experience and to create an uplifting environment. There were a few elements that needed addressing in order for it to be fit for purpose in the round.
For instance, we suggested simplifying the landscape design of the courtyards to create a fully usable, child-orientated environment that responds to the clear design rationale of the buildings. There was also an accessibility issue on one side of the development which we advised on and some comments on the elevational treatment of the buildings. This resulted in better therapeutic ambience and a hospital that has the potential to become a truly exciting addition to this part of Liverpool. The NHS Academy stresses the importance of leadership. Our experience is that strong leadership is a key element in any successful project. It all starts with well informed clients who are able to develop a clear brief and demand high quality design solutions from experienced design professionals. Getting the brief for a project right is one of the main tasks of a client. It will be an essential guide for the delivery team throughout the project. NEWTON ABBOT The Cabe team provided support in brief development for The Newton Abbot Community Hospital in Devon which is part of the Integrated Care Network. It was developed between Teignbridge Primary Care Trust and the local Acute Trust to deliver coordinated services to local communities. It had a challenging brief to write that combined a number of facilities from Stroke Patient Care to Minor Injuries and a Maternity Unit. We helped them through the procurement process by providing advice early on in order to define a successful brief and select an effective bid team. We also presented to stakeholders and critiqued the bid proposals. There is also guidance available for clients on the best way to assemble teams for healthcare projects, such as Future Health and Creating Excellent Buildings. Cabe helps health professionals unlock the potential of their projects through support, review and training and each process can be tailored to the clients’ needs. A network of 250 Built Environment Experts support the team’s work delivering high-quality designed places and provide the specialist knowledge needed for healthcare projects.
Written by James Chapman & Susan Francis, Design Council
Copyright BDP, Trust, Laing O Rourke
HOSPITAL DESIGN
Design & Build
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A WORTHWHILE CHALLENGE It’s this independent expertise that is invaluable. Planning and procuring buildings and facilities that will meet a community’s long-term health needs is always a challenge. These are just a few examples but the general rule still applies – health estate commissioning is a challenge but injecting good design leadership into the process early on can save money, improve the quality and longevity of the building and have a positive therapeutic impact on patients. L FURTHER INFORMATION www.designcouncil.org.uk/cabe
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WAYFINDING
Hospitals are complex environments, and for patients, staff and visitors the ability to get from one part of the facility to another quickly, efficiently and without worry is an important one. David Watts explores what effective wayfinding should look like My only complaint about the hospital was its design – which resembled one of those mazes that scientists use to induce stress in rats.” So says a recent visitor to one of Sussex’s more modern hospitals. He may not be alone in feeling like this. All hospitals are complex environments, and for patients, staff and visitors the ability to get from one part of the facility to another quickly, efficiently and without worry is an important one. There is no blueprint for the ideal hospital design, and that means facilities vary enormously across the UK – from the latest hospitals such as Central Manchester University Hospitals to Victorian sites such as St Mary’s in Paddington, or Whipps Cross in Epping Forest. This enormous variation highlights the need for good wayfinding design to help people enter, traverse and exit any hospital facility.
IMPROVING THE CUSTOMER EXPERIENCE The requirement for better wayfinding has been crystallised by the drive for improving the ‘customer experience’ across the NHS. This is a term borrowed from the commercial world, which has appreciated for many years the importance of understanding how products and services inter-relate and how this impacts on how customers feel. In the health sector it effectively encapsulates the demand for improving quality of care at all levels in all health facilities. The trend is embodied in initiatives such as the NHS Choices and the Friends and Family test, and the soon to be rolled out Care Connect website – effectively a ‘Tripadvisor’ for hospitals. Even the BBC is running a performance measure for hospitals on its news website. Everyone is watching and demanding better. People are being put at the heart of the healthcare service as never before and lessons are being learned from other industries including hospitality and aviation. Let’s look at how and why wayfinding plays a vital role in making hospitals
ing Wayfinds start ey ree k with th providing es: principlentation, ori giving n o i t c e r di ision and decing mak
Written by David Watts, managing director, CCD Design and Ergonomics
FINDING YOUR WAY THROUGH THE HOSPITAL MAZE
run better for everyone whether staff, patient or visitor. There are many benefits, including financial – a recent American research study showed that the cost of an inefficient system for navigation in a major regional hospital was more than $220 000 per annum or $448 per bed. Beyond finances, there are efficiency gains which come from reducing late appointments and reducing the time taken for people to move around the facility between departments. There are emotional benefits as well with reductions in stress as people are more confident about coming into and moving around the hospital. Even for staff, who know their way around, a poor wayfinding system will have an impact as they have to spend time directing disoriented visitors as well as a more general lowering of morale. Finally wayfinding can address safety issues – ensuring that visitors don’t head to inappropriate areas, and that staff cannot become disorientated in times of high pressure, as well as reducing congestion by managing (people) traffic flows. In addition good wayfinding can lead to increased patient empowerment by improving cognitive skills in spatial understanding, and increased inclusivity with signs tailored to the needs of both older and disabled patients. There is also the question of how good wayfinding contributes to the branding of the hospital as patient and visitor friendly – the brand is significantly undermined if it cannot even deliver on a basic such as wayfinding.
Signage
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MORE THAN JUST SIGNAGE Wayfinding starts with three key principles: providing orientation, direction giving and decision making. There’s more to it than just signage – it is how people respond to a space or environment, and the wayfinding E
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Signage
WAYFINDING strategy must help people make sense of a place and use cues to find destinations and achieve various goals. In other words, it is about people’s experience of the place and how they respond to it. Getting it right is more critical in a hospital because they are stressful environments – visitors coming to see a sick friend or relative, staff needing to provide care in a time critical fashion, or even suppliers who have busy schedules to adhere to. To develop a strategy, the wayfinding designer must understand the operational requirements of the facility, as well as understand the different types of people, their varying needs and how they will interact with the environment. RESEARCH AND AUDITS Research using questionnaires, observations and interviews can be used gain an understanding of peoples’ journeys, their needs, and how they interact with the architecture and spaces in the facility. The research must provide an insight into people’s full experience of the facility – from their first interaction (which may be a telephone call or letter) to the last, including the actual journey to and from the hospital. For new facilities, the research should be done as part of the master planning so that the wayfinding strategy can be integrated into the building design. With existing facilities where there is an intuitive sense that the wayfinding system is not up to standard, or where refurbishment work is planned, the first step is to undertake an audit. Again, the starting point is to understand user needs, but then to measure that against the existing system. This can be
become increasingly difficult to navigate as they have changed or expanded over the decades. The results of an audit will provide the information needed to formulate recommendations. It is rare, if ever, that a new scheme can be implemented in one go because it can be too expensive and too disruptive in terms of operations for a hospital that has to keep working and operating. The strategy should be to create a kit of parts allowing a phased implementation, as well as enabling the scheme to grow as future changes occur and the hospital buildings change, grow and new ones are built. This ensures that a hospital can achieve short term gains at low cost, as well as preparing the ground for a more strategic approach that works to a longer term goal and takes into account future requirements. A JOINED-UP APPROACH An optimal wayfinding strategy will adopt a ‘joined up’ approach. This means knowing where any journey might start, and understanding how every stage is related. So, direction signs from local roads are important, as well as routes to the right car park and walking routes into the hospital itself.
The enormous variation in hospitals – from the latest hospitals such as Central Manchester University Hospitals to Victorian sites such as St Mary’s in Paddington – highlights the need for good wayfinding design to help people enter, traverse and exit any hospital facility very revealing. A recent audit undertaken by CCD revealed in one hospital reception: “A jumbled mess of 15 different brown and white signs hung in an unstructured fashion from the ceiling, overlapping revealing more and more confusion the closer you got.” A large amount of signage which lacks any consistent use of colour is not untypical and often the result of signage being added over time with different strategies and sourced from different manufacturers. Temporary signage, printed by staff, stuck on the wall with blu-tac is usually a good indicator that the signage is not working. Observation is one element of any audit, but just as important is the use of interviews to identify how the system works on a day to day basis. It is probably fair to say that as wayfinding has not been a priority for many years, if ever, there are a large number of hospitals which have
Naturally, not everyone comes from the same direction, or uses the same entrances but too often, signage can often be located assuming everyone comes in the main entrance. Entrances to different departments need to be clearly visible, and once inside a hospital there needs to be a balance struck between how much visitors are guided by signage, and how much they interact with reception staff. From the arrival areas, people need to be clearly guided to their destination point, and given reassurance along corridors – and if they happen to make a mistake, given the opportunity to get ‘back on track’. The strategy also needs to help people find their way out at the end of their visit – all too often this is forgotten. For a hospital visitor the need for a good wayfinding strategy starts long before they arrive at the facility. For an outpatient, they need to
get from home, through reception and to the right department in a timely fashion. This might mean that their appointment letter not only tells them the time of their appointment, and the department but will also provide directions – public transport routes, which car park if they drive, which is the best entrance and how to reach the right destination point. Hospitals should regard wayfinding as just one “touchpoint” in the broader patient care experience. As it is part of the journey it has to be made to join up with all the other elements and fixing isolated parts often falls short of changing the experience. Simplicity is often the key to avoiding information overload – often symbols can be used to break down barriers, and where wording is used, the preference should always be for layman’s language rather than medical terminology. Colour coding of departments can be very effective in providing immediately recognisable and easily understood destination points. This approach will also ensure inclusivity for all users. BREAKING IT DOWN In the same way, breaking down a journey into manageable elements can be highly effective. So, for example, where someone is navigating across the hospital along numerous corridors, which probably all look the same to them, landmarks can be introduced to help people orientate and for people to be given instructions. These need not be signs, but could be refreshment points, changes of wall colouring – anything that is describable and can be included in the directions. Hospitals’ artwork strategy can be integrated into the wayfinding, playing a functional role, as well as being aesthetically pleasing. The commercial world has long understood the benefits of effective wayfinding, and the lessons that have been expensively learnt elsewhere can now more easily be applied in the health sector. Budgets are at a premium, but with the increasing need to provide a better experience for all users, hospitals need to reassess the role of wayfinding in the overall healthcare experience. The benefits are manifold, with relatively small investments providing boosts to efficiency, safety and satisfaction, as well as having a positive impact on the bottom line. Whilst the launch of NHS Choices and the Friends and Family test, doesn’t yet provide an opportunity for giving feedback on the wayfinding at any hospital, health care managers are likely to find that positive responses and satisfaction levels will improve with better wayfinding systems. L FURTHER INFORMATION www.ccd.org.uk
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Landscaping Written by Jonathan Tame, BALI
LANDSCAPE DESIGN
RECOVERING WITH NATURE AT YOUR SIDE
Increasing amounts of research from across the world is supporting an irrefutable connection between plants in buildings and in urban open-spaces and the improved health and wellbeing of those exposed to a ‘green’ environment. Jonathan Tame, technical officer for the British Association of Landscape Industries explores what this means for those recovering in a healthcare setting
Various concepts of quality of life (or life satisfaction) emerged in the realms of medicine, health and social sciences in the 1950s. Early methods for measuring quality of life now seem somewhat primitive, focusing on the mobility of the individual or on other more basic measures generally associated with an individual’s independence. However, a recent model has been created that consists of six major life domains: social wellbeing, physical wellbeing, psychological wellbeing, cognitive wellbeing, spiritual wellbeing and environmental wellbeing. Each of these domains can be divided into several sub-dimensions in order to operationalise the concept of ‘quality of life’ so that a common standard of useful measurement can be used. Each of these life domains can also be directly linked to good quality landscape design and construction, which we will look at in this article. THE BENEFITS OF PLANTS A large amount of research has been undertaken into the benefits that ensue from
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HEALTH BUSINESS MAGAZINE | Volume 14.2
people’s proximity to plants, especially in healthcare and work environments. The results from many studies show that a person’s wellbeing increases across numerous levels when working near plants or in a natural setting. Concentration and memory are shown to improve, often dramatically, and this is often combined with a higher quality of work being produced by working in a more natural environment. The results from studies investigating the effects of indoor plants typically show the same results as being near plants outdoors. Two recent studies both show that the number of indoor plants in proximity to a worker’s desk has a small but statistically reliable correlation with levels of sick leave and productivity. Importantly, a range of studies has shown
that plants accelerate the healing process, with the presence of plants in patient recovery rooms reducing the recovery period. Simply giving patients daily access to flowers and other ornamental plants in landscaped areas outside patient recovery rooms can also significantly speed up recovery time. A number of studies have also shown that the presence of ornamental indoor plants is conducive to generating a positive learning environment and reducing children’s tendency to be distracted. This effect can be amplified in children with specific attention disorders such as ADHD. At the other end of the age spectrum it has been shown in a number of studies that elderly care home residents working with plants showed an increase
The results ies ud from st ellbeing at w show thases across incre levels when us numerong near plants worki a natural or in ing sett
Landscaping
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If hospitals have outside space, whether a small neglected area at an existing site or at a new development, they can benefit from working with a BALI-registered designer or contractor urban areas and for hospital patients and their visitors where a lack of foliage from shrubs and trees in external landscaped areas surrounding hospital buildings increases the risk of this phenomenon. Landscape planting plays an important part in reducing the effects of storm water runoff by absorbing rainwater through the foliage and the roots. This helps to prevent flooding in urban areas and reduces the amount of water that requires treatment. Plants also absorb some of the pollutants in run-off water from roads and car parks. It is well documented that plants help to clean our air by removing potentially harmful gases from the atmosphere and by filtering particulate matter from the air. Particulates are known to exacerbate a range of health problems, including asthma, bronchitis and other lung conditions that relate to premature deaths.
in alertness, interacted more with fellow residents and staff and required less staff care. ENVIRONMENTAL BENEFITS Even without supporting research evidence, most people are able to appreciate the environmental benefits of plants, e.g. cleaner air, reduced soil erosion and reduced flooding/less stress on urban drainage. Other benefits are more relevant to a healthcare setting, such as reduced noise pollution, an offsetting of the urban heat island effect and reduced building energy costs. Modern building design, particularly in high rise city business districts, is increasing the incidence of urban glare. This was demonstrated with dramatic effect in London in the summer of 2013 when the now infamous ‘Walkie Talkie’ building’s design resulted in damage to the paintwork of a parked car at street level from sunlight reflected from the building’s expanse of glass. Urban glare can also be unpleasant for those working in
QUALITY LANDSCAPE DESIGN The research already undertaken confirms what the landscape industry has been saying for many years – that the presence of plants and foliage in the internal and external environment leads to healthier, more productive, more alert and happier people. Plants also enhance the natural and built environment in numerous ways. However, many of these positive aspects can be lost by poor design and construction carried out by unqualified or inexperienced landscape contractors. The British Association of Landscape Industries (BALI) is the UK’s largest trade association for interior and exterior landscapers and designers, grounds maintenance contractors, and companies supplying industry-related products and services. BALI members have designed and built many landscape
schemes at healthcare facilities, many of which have won national awards. Maggie’s Cancer Care Centre in Cheltenham, Gloucestershire, offers practical, emotional and social support to people with cancer and their families and friends. The centre’s garden was skilfully designed by BALI Registered Designer Christine Facer Hoffman and constructed by BALI Registered Contractor Graduate Gardeners, both based in Gloucestershire. The design brief from Maggie’s was clear – to create spaces that encourage a positive mindset. This has been well achieved and the garden creates a calm environment in which patients and visitors feel less stressed. Horatio’s Garden, at the Duke of Cornwall Spinal Centre in Salisbury, Wiltshire, is a garden inspired by Horatio Chapple, who was tragically killed at the age of 17. The garden was constructed by Bournemouth based BALI Registered Contractor Wycliffe Landscapes and went on to win two BALI National Awards in 2013. The garden has been carefully designed and expertly constructed to allow use by patients in their beds and wheelchairs. This is a beautiful garden and a great example of how outside space can be inclusive to all, even those who are bedridden. These are just two examples of a host of beautiful and functional outside spaces that have been designed and built by BALI members specifically for healthcare facilities. If hospitals have outside space, whether a small neglected area at an existing site or at an entirely new healthcare development, they can benefit from working with a BALI registered designer or contractor. This can help maximise the site’s potential by working with approved and inspirational businesses. L FURTHER INFORMATION www.bali.org.uk
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Fleet Management
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
New digital analysis software for all your tacograph requirements Visit TDi on Stand 4E130 at the Commercial Vehicle Show 2014 (29 April-1 May, NEC Birmingham). TDi offers a wide range of solutions, all at very competitive prices. These included: Tachograph Analysis (reports in English, Polish, Russian, Lithuanian and Latvian); Tachograph Analysis Software; Driver CPC Training; Transport Consultancy; Health & Safety Consultancy and Training; First Aid Training; and much more… At the CV Show, the company is launching its brand new digital analysis software, which is set to become the industry leader in tachograph analysis. TDi also has a new vehicle check app. The TDi Vehicle Checks app eliminates the need for paper defect reports, everything is stored and accessed online and can be viewed/actioned as soon as the check or incident has
SEE US ON STAND
The Wiper Specialists! Isla Components specialises in the manufacture of wiper arms & linkages. Isla have a large range of wiper blades. It also offers conventional blades, upgrade blades, commercial blades, rear arms and blades for cars and the new type of flat blades for both car and LCV. This range incorporates a “Multi‑Fit Adapter” system, that covers 86% of the market place. The commercial blades include a range of heavy duty hook blades (9x4 & 12x4 adapters), spray jet blades, with the jet fixed to the blade frame, also a range of saddle fitting blades, from 20” (500mm) to 48” (1200mm).
been submitted by the driver. Working with TDi guarantees you a quality service and rapid turnaround, with no set-up fees and no hidden charges. You can also be assured of all of the back-up and support you might need, from a company that is at the forefront of technological advances. FURTHER INFORMATION Tel: 01246 252375 info@tdi.tc www.tdi.tc
Isla manufacturer a variety of wiper arms for all types of PSV vehicles and CCTV cameras used in different industries & environments. Isla have an extensive range of replacement wiper motor & washer pumps for PSV vehicles. Isla also supplies an extensive range of replacement wiper arms, blades,wiper motors & washer bottles for the Plant & Agricultural sectors. Isla are able to offer “own branding solutions”. Our knowledge is extensive, our range is forever increasing! We are an accredited company to ISO9001.
Tel: 01885 485950 www.islacomponents.co.uk Email: sales@islacomponents.co.uk
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SSI Schaefer Limited 01264 386600 solutions@ssi-schaefer.co.uk www.ssi-schaefer.co.uk
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HEALTH BUSINESS MAGAZINE | Volume 14.2
Unit 12 Seax Court, Southfields Industrial Park, Laindon, Essex SS15 6SL
INTERVIEW
A QUESTION OF FLEET
Fleet Management
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Health Business talks to ACFO chairman Damian James about his role within the Association and the challenges faced by today’s fleet managers WHAT ARE YOUR PRIORITIES AS ACFO CHAIRMAN? Becoming chairman last year is a really exciting opportunity for me and marks the highpoint of my career with ACFO. I joined the ACFO board more than three years ago having been involved with the organisation for over a decade through its South West and Wales Region. Over the years I have found the knowledge and experience of fellow ACFO members tremendously helpful in assisting me in managing a fleet, and through my work as chairman I hope I am able to return that assistance and help other fleet decision-makers. As a result, a key priority for me is to expand ACFO’s membership, particularly among employees who, like me, have part-time fleet management responsibility within a wider job brief. ACFO offers members’ tremendous value for money through its website – www.acfo.org – and an array of benefits including regional meetings, networking opportunities and access to a wide range of knowledge and experience, and seminars and conferences. Consequently, ACFO’s influence will naturally grow and that is another key objective for me as chairman. I want ACFO to grow its influence among all fleet decision‑makers – not just those that focus on fleet 100 per cent of their time, but employees whose main role is perhaps in HR, finance or procurement, for example. Additionally, ACFO already has strong relationships with a range of external agencies. They include Government departments, such as HM Treasury, HM Revenue and Customs, the Department for Transport and the Driver and Vehicle Licensing Agency. Additionally, ACFO works closely with the likes of the British Vehicle Rental and Leasing Association, Freight Transport Association, Institute of Car Fleet Management and the Society of Motor Manufacturers and Traders. I want to further strengthen ACFO’s relationships with these organisations – forge partnerships with other representative groups in the transport and travel arena – and ensure ACFO’s voice is heard loud and clear on a wide range of Government and transport issues.
WHAT ARE THE MAIN CHALLENGES FOR FLEET MANAGERS THESE DAYS? Irrespective of whether we are talking about cars or light commercial vehicles cost management remains the critical issue as it has been for a number of years. However, that broad term covers a multitude of issues and vital to both car and van operations is a corporate focus on vehicle emission reduction. In turn that also brings into play numerous management issues around the so-called ‘grey’ fleet – employees who drive their own cars on business which are typically older than if they were to drive a company, hire or pool car on work-related journeys. The Government’s emission-based company car benefit-in-kind taxation policy is driving manufacturers to produce vehicles with ever-lower CO2 figures. Taken at face value that means that HM Treasury’s tax take from the sector will reduce at a time when its coffers need rapidly replenishing. Therefore, the long-term tax treatment of company cars is a key issue and tied in with that is significant uncertainty around the true fleet operational viability of alternative fuels from a cost perspective – tax, service, maintenance and repair and residual values. Simultaneously, there are major challenges around educating the company car
‘White ’ n van ma e syndromsue. Yet an is remainsority of these the majts operate flee est and n a e l c the ficient most efcles vehi
driver population around the viability of the alternative fuel options available given that when selecting their vehicle they must take into account both their work and private requirements. Turning to LCVs and ‘white van man’ syndrome remains an issue. Too often the public and the media in general – I exclude the specialist fleet press – use the ‘white van man’ as a derogatory term. Yet, the vast majority of these fleets operate the cleanest and most efficient vehicles on the market in accordance with best practice as highlighted by, for example, the Freight Transport Association’s Van Excellence programme. But, there are always exceptions and as a fleet industry we must unite to spread the message that actually operating vans in line with best practice in terms of vehicle choice, maintenance procedures, driver behaviour, and so on, we can ensure that ‘white van man’ really is a myth. WHICH GREENER FUELS DO YOU SEE AS BEING THE MOST SUCCESSFUL? There remains much discussion around the fleet viability of electric vehicles. ACFO’s view has been consistent for many years and it is that such models are not financially or operationally viable except in a handful of niche circumstances. One of the key viability issues for fleets is vehicle range and pure electric vehicles E
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Fleet Management
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
INTERVIEW currently do not meet the majority of corporate needs in that respect. Therefore, ACFO believes the most viable fleet alternatives to a 100 per cent petrol or diesel engined car is either a hybrid, in which a petrol or diesel engine is combined with an electric motor (albeit that zero emission range is restricted to a few miles), or range extender vehicles
WHAT ADVICE WOULD YOU GIVE TO FLEET MANAGERS WHO WOULD LIKE TO REDUCE THEIR CARBON FOOTPRINT? As head of operations at Bracknell Forest Council, I have signed-up to the Government‑backed Plugged-in Fleets Initiative to discover if electric or plug-in hybrid vehicles make sense for the authority.
Fleet managers should be following best practice and operating fit-for-purpose sub-130g/km cars where a small generator, powered by a petrol engine delivers a more ‘reasonable’ range. In the longer term, ACFO would expect hydrogen power to become a force, but there is a long way to go in terms of ensuring operational cost and a suitable refuelling infrastructure meet fleet requirements. WHAT IS STOPPING OTHER GREENER FUELS FROM BEING AS SUCCESSFUL? List price, service, maintenance and repair costs including battery longevity, residual values and a viable recharging infrastructure are key concerns impacting on widespread fleet adoption of electric vehicles in addition to limited battery range. Additionally, there are concerns as to whether the Government’s plug-in car and van grants to support vehicle acquisition will remain in place post the 2015 general election. Given the state of HM Treasury coffers it is difficult to believe that the grants are sustainable. Therefore, manufacturers must cut list prices significantly to encourage demand. Equally, tax breaks may go along way to help stimulate fleet demand for electric vehicles. However, current company car benefit-in‑kind tax policy suggests that rates for zero and ultra low emission cars will increase from 0 per cent to five per cent in 2015/16 and to seven per cent in 2016/17. Such tax rates are not conducive to encouraging demand for technology that is in its infancy. Meanwhile, hydrogen has long been viewed by motor manufacturers as the Holy Grail of future vehicle power sources as there are no harmful emissions with water vapour the only tailpipe emission. The UKH2Mobility project published a report earlier this year that sets out a roadmap to commercialise hydrogen fuel cell electric vehicles and supporting hydrogen refuelling infrastructure in the UK from 2015. However, the same issues that impact on fleet adoption of electric vehicles will potentially effect operation of hydrogen vehicles. Fleets are conservative by nature and need to be certain that business efficiency and costs will not be impacted by the introduction of new technology. Unless fleet decision‑makers can be assured that utilising this new technology will not send budgets soaring and transport operations will not be impeded by breakdowns they are unlikely to become early adopters in any significant numbers.
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HEALTH BUSINESS MAGAZINE | Volume 14.2
As part of the Initiative, which is funded by the Department for Transport and Transport for London, the Energy Saving Trust is undertaking a free bespoke analysis on 100 fleets to help them understand where ultra‑low emission vehicles could work for them. The application process is not onerous – after all, I have done it – and the EST will deliver a detailed report and analysis with recommendations of how plug-in vehicles could work; a whole life cost analysis comparing the fleet’s existing vehicles with suitable plug-in alternatives and infrastructure advice. Armed with that independent report I can then either dismiss such vehicles as not viable for the Council’s fleet or undertake further research and discussion with a view to delivering the case for investment to the authority. I understand that the EST is still recruiting fleets to the programme so my advice would be to visit www.energysavingtrust.org.uk/pifi Aside from that I would suggest that all fleet managers should be following what has become established best practice and operating cars with CO2 emissions of sub-130g/km subject to them being fit for purpose; have in place effective journey and mileage management techniques; and analyse whether ‘grey’ fleet usage should be allowed when clear alternatives are proven to save money, trim corporate carbon footprints and reduce occupational road risk. WHAT CAN THE GOVERNMENT DO TO HELP ORGANISATIONS ‘GREEN’ THEIR FLEETS? Over many years, irrespective of Government party make-up, ACFO has called for measures to be in place that enable fleet decision‑makers to plan for the long-term. Unfortunately, that does not always happen. For example, private, public and voluntary sector fleets buy the majority of new vehicles in the UK and therefore assume the position of early adopters. The Government is keen for ultra low and zero emissions vehicles to take to the roads. To that end, it introduced its Plug-in grant scheme to assist in the purchase of such cars and vans. However, in Budget 2012 Chancellor of the Exchequer George Osborne shocked fleets by announcing that company car benefit-in-kind
tax rates on zero emissions cars would leap from 0 per cent in 2014/15 to 13 per cent in 2015/16 and rates on ultra low emissions models would jump from 5 per cent to 13 per cent. In Budget 2013, he realised the error and performed a partial U-turn saying rates would rise to 5 per cent and 9 per cent respectively. Unfortunately, such moves do not give clear long-term financial incentives for the take up of alternatively-fuelled vehicles that give confidence to fleet managers’ decision making process. Similarly, the Government has said that Plug-in grants will remain in place for the duration of the current Parliament – May 2015 – which is less than 18 months time. Long‑term fleet decisions cannot be based on such short‑term incentives. On some issues it is important that an all-party consensus is reached so fleet managers know what the future holds. WHAT HAS YOUR ROLE AS HEAD OF OPERATIONS AT BRACKNELL FOREST COUNCIL TAUGHT YOU? In short, expect the unexpected. The fleet industry changes on a daily basis and that means keeping up to date on trends, new initiatives and the potential impact of legislation emanating from both Whitehall and Brussels is a full time job in itself. Therefore, it is critical to be surrounded by a great team that is fully focused on ensuring the transport operation functions at optimum efficiency and effectiveness and continually questions the status quo. It is also vital to join ACFO as the membership with its knowledge and experience will support you through best practice guidance and ensure that what can sometime seem a lonely existence is not. L FURTHER INFORMATION www.acfo.org
About ACFO ACFO (formally the Association for Car Fleet Operators) is the UK’s premier representative organisation for fleet decision‑makers in charge of cars and light commercial vehicles. The organisation exists to help fleet decision-makers improve the effectiveness and efficiency of their business travel operation. Established more than 40 years ago, ACFO’s membership includes most of Britain’s major fleets as well as those drawn from the SME sector. Additionally, affiliated organisations include motor manufacturers and a wide range of companies drawn from the supplier network.
ASBESTOS SERVICES
ASBESTOS SERVICES
Kingsley – providing a You can bSure of low-cost safe and efficient package asbestos removal solutions With over 25 years’ combined experience in the asbestos market, the team of supervisors and operatives at Kingsley Asbestos Services are capable of undertaking work on any project, big or small. Its management team has experience of working on asbestos projects in Europe, and specifically: England, Scotland, Wales, Ireland, Netherlands, Belgium, Jersey, France and Portugal. The company has experience of working within the following areas: public sector boroughs, including London boroughs, local authorities and housing associations, NHS and private sector estates and housing associations, construction and demolition companies, retail estates and domestic properties. Kingsley Asbestos Services can provide the full service from surveying to removal and disposal of the asbestos; and it is also fully able to encapsulate
asbestos areas, depending on specific customer requirements. As a member of the Asbestos Removal Contractors Association (ARCA), the company holds a current full asbestos removal licence. All of Kingsley’s sites are regularly checked by the Health and Safety Executive (HSE), and it also makes sure to maintain the latest approved code of practice set out by them. When dealing with such a lethal product, Kingsley believes it is vital to provide a safe and efficient package; it therefore ensures work is carried out to the highest possible standards.
The company bSure believes in independence and innovation that’s why, in 2004, the company took a fresh look at the cost of asbestos removal and decided to implement a self-sampling solution. This innovative approach combines three elements: training and accreditation; supply of self-sampling kits; and independent laboratory testing. The company’s objective is to enable duty managers and the contractors they employ to meet their obligations under the Control of Asbestos Regulations and to do so in a reliable, cost-effective way. The company has trained over 3,000 operatives and sold more than 50,000 kits, across the UK; this has enabled contractors to carry out sampling safely
and to substantially reduce the cost of managing asbestos. The service offered by bSure is wholly independent of removal and is focused on three outcomes: safe sampling; eliminating exposure to asbestos; and providing a cost-effective and proportionate use of removal. So, how does its results compare? Typically, positive results using a survey and removal company average 55-65 per cent. With bSure’s independent testing service, it consistently averages 30-35 per cent. Imagine if your annual spend on asbestos removal was £1m, you’d be able to reduce this by at least one-third.
Products & Services
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
FURTHER INFORMATION Tel: 020 7264 1010 www.bsuretesting.co.uk
FURTHER INFORMATION Tel: 01903 227722 www.kingsleygroup.co.uk/ asbestos_removal_disposal.htm
ASBESTOS TRAINING
ASBESTOS
The company natas:asbestos is a consortium of specialist asbestos businesses: NATAS Training, NATAS Environmental, NATAS eLearning and NATAS Highlands. Formed in 1996, NATAS is the acronym of National Asbestos Training & Accreditation Scheme – the UK’s first dedicated asbestos training company recognised by the Health and Safety Executive. However, the experience of NATAS’ trainers and consultants reaches back to 1983 with the commencement of HSE Asbestos Licensing. Renowned for being cutting-edge, innovative and customer-led, NATAS provides a range of asbestos-related services. These include: asbestos training – asbestos awareness, non-licensed/ licensed work, duty to manage, BOHS P401 (bulk analysis), P402 (surveying), P403 (fibre counting), P404 (clearance testing), P405 (managing asbestos). E-learning – asbestos awareness, duty-to-manage,
Fibre Contract Services provides bespoke asbestos abatement solutions throughout the UK on projects of varying sizes. Fibre’s reputation for delivering on every project – even the most complex of projects – is well-known across the industry. You can trust Fibre’s ability to get the job done by interpreting exactly what its clients require. Having the best people ensures that your projects are dealt with efficiently. The company believes that the calibre of the individuals occupying the key roles is paramount. Essential to Fibre’s success is its dedicated management team, which has over 25 years of industry and on-site experience. The difference is that the people Fibre employs are dedicated to their roles and have the experience to prove it. The company believes in creating lasting
Trust natas:asbestos with Fibre: leading the way your training requirements in asbestos removal
non-licensed work, Legionella, plus other H&S and environmental awareness courses. As well as UKAS-accredited asbestos surveys; sampling; risk-assessment; air monitoring and clearance testing. Plus, re-inspections; and 3D/360 laser surveys. Asbestos consultancy – advisory service on-site, remote, online from a pool of highly experienced (CCP/CoCA) certified consultants. Free initial 30-minute confidential advice via phone or email. FURTHER INFORMATION Tel: 0870 751 1880 info@natas.co.uk www.natas.co.uk
relationships with customers, partners and employees. Fibre, which was founded in 2004, has completed over 8,500 asbestos removal projects, clearing away more than 11,000 tons of hazardous and often harmful materials from our worldwide community. Contact Fibre today to see how it can assist you with your asbestos management needs and to have a trained and experienced asbestos removal operative help you with your asbestos jobs. FURTHER INFORMATION Tel: 0113 387 8660 www.fibreservices.co.uk
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Products & Services
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
WEB DESIGN
ICT
Giving you the confidence A fully managed website to deliver a better service service from Yescando
Zipporah provides online solutions, such as e-bookings, e-commerce, scheduling and queuing systems to local authorities. The company’s solutions allow councils to ‘open’ their services to their customers by providing self-service options. Council services can now be accessed 24/7 with instant confirmations and payment receipts. It supplies to over 70 authorities across the UK; as well as a growing market base in Ireland and Australia. Zipporah’s customers enjoy increased revenue through lower costs per transaction and increased service requests. The ease and speed of using its solutions encourages channel shift across a range of council
services. Implementation of the Zipporah product suite has proven results of streamlining back-office processes and workflows. The company’s integrations to other systems, such as CRMs, payment provider and finance systems, provide truly joined up and efficient business processes for the service areas and their customer base. Zipporah’s products are easy to install and contact centre/ one-stop shop users are up and running quickly as there is little training required. FURTHER INFORMATION Tel: 029 2064 7048 info@zipporah.co.uk www.zipporah.co.uk
HEALTHCARE IT
The Yescando fully managed web design service was created five years ago to address all your website needs. Firstly, the company creates the ideal website. It’s not a ‘one-size-fits-all’ approach; Yescando listens to you and suggests the best solution. Then it maintains and updates it for you. Yescando doesn’t expect its customers to be technical wizards. Send the company an email and its team of Hampshirebased technical consultants will take care of your changes and updates for you. The company guarantees to make the changes within two working days, meaning that your website need never be out of date. These days just ‘having a website’ is not enough. It needs to be well-maintained, be capable of answering your visitors’ most pressing questions and to be completely up to date.
If your website doesn’t do that, as a minimum, people will go elsewhere. Doing this takes a lot of time and skills that many small businesses don’t have. Additionally, in this age of smartphones and tablet computers, your website needs to be easily readable on many different devices. Websites from Yescando tick that box, too – responsive websites are its minimum standard. Yescando focuses on making the whole process very easy for you.
FURTHER INFORMATION Tel: 02392 373235 info@yescando.com www.yescando.com
HEALTHCARE IT
Asthma and chronic Digital signage, video obstructive pulmonary resource management & disease (COPD) intelligence bedside TV from Tripleplay Health Intelligence is an IGSoC compliant organisation committed to delivering solutions and services that will enable change in the management of long-term conditions. The company’s vision for change is to work collectively with the NHS to reduce health inequalities and preventable health decline by enabling integration across the systems. Health Intelligence has worked with national respiratory clinical leads to develop an innovative N3-based asthma and COPD solution. This will enable you to stratify your asthma and COPD population in a meaningful and manageable format, identifying patient cohorts at need of intervention based upon their risk position and gaps in care. This enables health economies to: make informed clinical evaluations across the patient pathway; shift resources based upon evidence from within health
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economy populations; complete key intervention planning at a practice/cluster level; map QoF delivery and identify gaps in care; make secondary care/ pharmacy recommendations at a practice level; carry out virtual patient reviews; make treatment interventions in line with disease status; and track the impact of change management on patient outcomes. Contact Health Intelligence to arrange a meeting with a healthcare development manager.
FURTHER INFORMATION Tel: 01270 765124 enquiries@health-intelligence.com www.health-intelligence.com
HEALTH BUSINESS MAGAZINE | Volume 14.2
Harnessing digital media applications in the medical and healthcare industry is something that can bring benefit to a number of areas. Whether improved internal communications, heightened patient awareness and satisfaction or increased convenience for clinical and medical staff, there is benefit to be derived for all areas of operation. Tripleplay’s digital media services for healthcare includes digital signage, IPTV, video on-demand, mobile streaming and TV entertainment solutions, all delivered via an internal IP network to any screen, TV or IP-enabled device. Digital signage and IPTV are being used within healthcare around the world to aid in wayfinding within a hospital or surgery, whilst its eye-catching nature has meant it has become a vital tool in patient and staff
communications – in particular in the fight to reduce ER admission numbers and patient GP visits; live TV also helps to entertain patients in waiting rooms. Tripleplay’s video streaming solutions are also a modern and accessible way to provide patient after-care assistance, staff induction training and CPD course content, making all accessible via web browser, TV and mobile device. Tripleplay solutions are also suitable for bedside TV provision.
FURTHER INFORMATION Tel: 0845 094 3326 enquiries@tripleplay-services.com www.tripleplay-services.com Twitter: @tripleplayserv
TRAINING
Cost-effective solutions for asbestos training Beaumont (BIACS) provides a down-to-earth, no-nonsense, cost-effective solution to asbestos, training, consultancy, management and surveying, as well as health and safety consultancy throughout the UK and Europe. BIACS is a BOHS-approved training provider, a registered member of the IATP and FSB, as well as being Safecontractor-approved. BIACS understands how the industry works and for this reason it is able to offer practical and affordable advice and solutions and, above all, continued support. The company offers a full range of services relating to asbestos and health & safety, from training to consultancy through to asbestos surveys and asbestos management. BIACS delivers Asbestos Awareness Training, Non-licensed Training, Licensed Personnel Training and a comprehensive range of BOHS courses, on a regular basis. Along with
delivering the BOHS P402, BOHS P405, BOHS P406 and BOHS P407, it offers candidates advice and help on how to complete any required reports to obtain their qualifications. With over 26 years’ experience of dealing with asbestos, managing director Paul Beaumont is in the perfect position to impart his knowledge and expertise to help you and your company in this often confusing and litigious industry.
FURTHER INFORMATION Tel: 0844 372 2826 info@biacs.co.uk www.biacs.co.uk
FIRE SERVICES
EA-RS Group: simplifying your fire protection Fire security can be a complex business, so EA-RS Group’s message is simple: it protects people, property and critical equipment from fire. EA-RS Group provides a complete solution for fire detection, fire suppression and fire extinguishing. With one call, you will get a bespoke solution for fire safety system design, installation and maintenance. The company does not sub-contract any part of the process, which means you can rely on EA-RS Group for your fire alarms, sprinkler systems and maintenance. Your job is made easier in a number of ways through reduced response times and lower operating costs. When you use EA-RS Group for your fire maintenance
contract, you benefit from a guaranteed four-hour response, 24 hours a day, 365 days a year. All your documentation is stored on its website, so you can access drawings and certification at any time. EA-RS Group also provides a complete service for the planning, design and installation of passive fire protection systems throughout the UK. The company has a can-do attitude to fire security and a flexible approach to purchasing. Simple, isn’t it? If you are tired of companies making fire safety complicated, give EA-RS Group a call. FURTHER INFORMATION Tel: 01376 503680 www.ea-rsgroup.com
SECURITY
For those in the healthcare sector, Saturn cares about the people who care Founded in 1991, Saturn Sales & Services has specialised in the care, assisted care and healthcare sectors. Its core products include NurseCall, WardenCall, fire systems, staff security, access control, door entry and CCTV, all backed-up by a 24-hr maintenance and service provision. Based in Somerset, Saturn has completed assignments throughout the UK. These include new builds and upgrades for existing establishments, whereby the company provides a full design, supply, installation and commissioning service, or part thereof. In-house CAD design experts will provide detailed drawings, to assist when you adopt the supply and commission route. For your convenience, see Saturn Sales & Services’ website for its online shop.
Products & Services
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
For fire alarm systems, Saturn is BAFE-registered (SP203-1) and approved providers for the full range of Hochiki detection with advanced electronics fire panels. Adopting an ‘open protocol’ policy ensures the client the optimum maintenance support flexibility. Communication and staff safety are paramount. Saturn is a national distributor for the ‘Guardian’ range, which conveniently interfaces with the ‘InterCall’ NurseCall system. Finally, Saturn encompasses a varied range of access control systems from a simple keypad to fully networked proximity and biometric systems. Door entry and CCTV are also available. FURTHER INFORMATION Tel: 0844 846 8335 mail@saturn-sales.co.uk www.saturn-sales.co.uk
DEBT MANAGEMENT
Dealing with debt collection in an ethical, experienced and professional manner UK Debt Recovery is an established debt collection and trace investigation company, managing debt portfolios across a variety of business sectors for private and commercial clients in the UK and Europe. The company delivers bespoke solutions, tailored to client’s individual requirements. The service it offers includes: credit control; debt collection; tracing absconded debtors; status reports; and litigation. UK Debt Recovery’s aim is to maximise recovery and achieve this through a combination of its experienced personnel, comprehensive collection methodologies and use of advanced DCA technology and systems. Given its wealth of experience, UK Debt Recovery is fully aligned to the issues facing its clients and has the necessary skills and expertise
to deliver a quality service. In the current economic climate, there is increased pressure to collect overdue debts. Financial and resource constraints mean that parties need to be more proactive when tackling their debt portfolio. UK Debt Recovery is a fully licensed and regulated agency and active member of the Credit Services Association. Strict codes of conduct are adhered to in order to ensure full compliance and set higher standards of best practice and ethical standards. FURTHER INFORMATION Tel: 01494 473325 enquiries@ukdebt recoveryltd.co.uk www.ukdebtrecoveryltd.co.uk
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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Top 10 Tips for an effective Agile Working Program reducing up to 30% of Real estate costs Real estate is the 2nd largest expense for any organisation; so many NHS Trusts are already adopting Hot Desking initiatives using Asure Software solutions to reduce real estate operational costs alongside meeting room scheduling and wider Agile working initiatives. There are also other benefits that include increasing productivity and job satisfaction, a better work environment, team collaboration, retention of the best talent, reduced stress and less time wasted. All this helps towards providing a better healthcare service and save costs. When developing and implementing a hot deking program, there are several straightforward, yet vital, concepts all the stakeholders should understand. There are our top 10 tips: • Build the Business Case for an Agile Working Program • Assist Mobile Workers with Cultural change adjustment • Guarantee success by planning ahead • Understand how IT, Facilities, HR and other Departments are affected • Align with Current infrastructure • Maintain productivity while maximise efficiency • Reduce and Repurpose Workspace • Manage and measure performance • Record and Analyse Actual vs Planned utilisation of scape • Understand changes in ROI
The Benefits of Agile working In a traditional office, up to 50% of desks, offices and workstations are unused at any given point in a typical workday. An average cost of desk in the UK costs £5746 PA (according to DTZ). Agile Working enables organisations to maximise smaller real estate footprints (especially as corporate lease rates fluctuate). In addition, the trend allows organisations to continue to keep up with technological advances that enable new work habits. With many companies leveraging mobile apps and cloud-based software, employees can have the same access to company documents, applications and records no matter where they’re working. Other internal apps help keep employees productive and connected even when they’re out of the office.
For more information please visit www.asuresoftware.com or contact our UK Sales Team Email: asurespacesales@asuresoftware.com. Tel: +44 020 8328 9460
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The publishers accept no responsibility for errors or omissions in this free service BAFE 8 Beaumont (Biacs) 45 Bsure Testing 43 Careflex 18 Certuss (UK) 34 Closerstill Media 12 Commulite 40 Crowne Plaza Nottingham 22 EA-RS Group 45 Euro Payment Systems 30 European Lamp Group 20 Fathom IBC FDB 28 Fibre Contract Services 43 Harvest Healthcare 26
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HEALTH BUSINESS MAGAZINE | Volume 14.2
Health Intelligence 44 Human Reliability 16 Isla Components 40 Jayex Technology 34 Kingsley Group Asbestos 43 Meeting Maker 30, 46 Metsa Tissue 36 Multitone Electronics IFC Natas E-Learning 43 OKI Systems 24 OMD UK Citroen UK 14, 15 R82 UK 26 Rebo BV 16 Rehmat Lighting BC Saturn Sales & Services 45
Sonosite 4 Spirit Healthcare 16 SSI Schaefer 40 Stokvis Energy Systems 32 Swisslog (UK) 6 Tenthmatric Information 32 Text Help 30 Thornton & Ross 32 Transport Data Interchange 40 Tripleplay Services 44 UK Debt Recovery 45 Venue Essex 34 Voice Connect 10 Yescando 44 Zipporah 44
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