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FOCUSING ON AIR QUALITY What impact does air quality inside buildings have on health?



Does the Internet of Things hold the key to unlocking digital healthcare?


CELEBRATING SUCCESS A look back at the winners of the 2015 Health Business Awards


Flexible, versatile and the taste of home







Introducing your Healthcare Range Our specially selected Healthcare range helps a busy kitchen create appealing, varied and nutritious menus, while also being cost effective and efficient. All our products taste delicious and create comforting dishes for patients, visitors or staff alike, with minimum waste.






What impact does air quality inside buildings have on health?


Does the Internet of Things hold the key to unlocking digital healthcare?

Playground politics is for the Commons, not hospital wards







CELEBRATING SUCCESS A look back at the winners of the 2015 Health Business Awards


With the current recruitment crisis sweeping through the healthcare sector, it was disappointing to hear of the junior doctors strikes going ahead this month.

Due to commence on 10 February, the strikes represent the ongoing struggle between the government’s refusal to lift its heels from an entrenched position and the British Medical Association’s (BMA) understanding of unsocial hours. In October 2013, the Department of Health granted NHS Employers a mandate to negotiate with the BMA and formal negotiations over improved contracts commenced. Throughout the following 27 months, neither party has managed to agree on the necessary safeguarding measures for doctors’ welfare and patient safety. While the impact is being minimised by the concession of doctors to provide emergency care cover, the impact to patient care remains in jeopardy. Politics, pay and pertinacious stubbornness should not continue to stand in the way of what the NHS stands for – good and free healthcare for all those who need it. The Health Business Awards were a celebration of success in our NHS. With a host organisations from up and down the country competing in a number of categories, there is no doubt that, amid busy schedules and unnecessary pressures, our health service is in need of more recognition for its incredible work. A list of the winning organisations and their successes are listed from page 55. Michael Lyons, acting editor

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

226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: EDITOR Angela Pisanu ASSISTANT EDITOR Michael Lyons PRODUCTION EDITOR Richard Gooding EDITORIAL ASSISTANTS Tommy Newell, Rachel Brooks PRODUCTION DESIGN Jacqueline Lawford, Jo Golding PRODUCTION CONTROL Sofie Owen WEBSITE PRODUCTION Victoria Leftwich ADVERTISEMENT SALES Patrick Dunne, Ben Plummer, Jeremy Cox, Nigel Gladstein, Amanda Frodsham, Paul Nicholas ADMINISTRATION Vickie Hopkins PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

© 2016 Public Sector Information Limited. No part of this publication can be reproduced, stored in a retrieval system or transmitted in any form or by any other means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publisher. Whilst every care has been taken to ensure the accuracy of the editorial content the publisher cannot be held responsible for errors or omissions. The views expressed are not necessarily those of the publisher. ISSN 1362 - 2541






Autism diagnosis time questioned; BMA leader warns of unsafe care; and £7m energy efficiency fund for Salford

Signage in hospitals has far wider advantages than simply getting people from A to B. Mark Hughes investigates the health and safety considerations



The air quality within buildings has a major impact on the health of those inside. Guiseppe Borgese of the Building Engineering Services Association explores






The NHS has been set large efficiency saving targets. Peter Akid of the NHS Shared Business Service argues that, despite this, more savings are possible

Jessi Pervola explains the use and benefits of ‘design thinking’ and why it has the potential to revolutionise the UK health system


What better way to lower your organisation’s carbon footprint than by adopting an electric fleet?


The BPA discusses its new accreditation for healthcare organisations: the Professionalism in Parking Accreditation


Health Business digs into last year’s ‘Breaking down the Barriers’ report and possible improvements to the patients complaint process



The Internet of Things is expanding the reliance on technology in the NHS. Ben Plummer reports on its success


Launched in 2015, Diabetes Professional Care handles the treatment and management of diabetes


With aims for a paperless NHS still firmly in the Department of Health’s eyeline, is the digitisation process likely to reap its rewards in time?



An event not to miss for those involved in facilities management. Health Business looks back at last year’s show


Health Business casts its eye back to December and the NHS organisations that scooped a Health Business Award at the prestigious annual event


The e-health community gathers for the UK’s most vibrant IT healthcare show. Health Business wanders among the event floor to witness the highlights

Solar energy is both financially and environmentally beneficial – so why aren’t more hospitals using it? The Solar Trade Association delves into the answer The topic of staff recruitment is not fading away, and is unlikely to unless we maximise staff collaboration, says the REC’s Vicky O’Brien




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Over 40 per cent of hospitals offering poor end of life care Over 40 per cent of hospitals are providing unsatisfactory end of life care to patients, according to data from the Care Quality Commission. Data shows that, while some hospitals offer excellent care to the dying, too many are performing below expected standards, with 67 hospitals rated as requiring improvement and seven rated as inadequate. The Patients Association has said it is ‘deeply concerned’ by the variation in end of life care highlighted by this data and has called on hospitals to improve palliative care. Katherine Murphy, chief executive of the Patients Association, said: “The Patients


Association believes that end of life care should always be safe and dignified. As our population ages, providing a good standard of palliative care is becoming more important. Good end of life care requires early and careful planning so that patients receive care that focuses on the needs of the individual and their family. “The Patients Association is deeply concerned about the variation in quality of end of life care that this data has highlighted. For patients receiving palliative care, there is only one chance to get treatment right and give patients safe and compassionate end of life care. There must be increased leadership and training to help staff provide humane care for dying patients. “As the need for end of life care increases, The Patients Association calls for palliative care to be as accessible and efficient as possible. It is vital that hospitals have enough specialist staff who are equipped and trained to provide truly patient-centred end of life care.”


NHS England must monitor autism diagnosis waiting times, advises NAS The National Autistic Society (NAS) has called upon the NHS to monitor the amount of time it takes for autism to be diagnosed. The NAS said that delays between being referred to an autism specialist and diagnosis are ‘unacceptably long’ and are putting ‘families into crisis’. A report by Public Health England (PHE) has found that there is a huge disparity in waiting times across England, which showed people in the South West of England were waiting as long as 95 weeks between a referral to an autism specialist and a diagnosis. The medium wait across England was 13 weeks, whilst the national guidelines from NICE direct that the wait between referral and diagnosis should not exceed 12 weeks. The NAS claimed part of the problem was thanks to more awareness of autism, which has led to an increased amount of referrals and thus further delays in the system. However, it says the issues are largely due to a lack of monitoring, adding it would be difficult to solve the issue as the reasons for delays are likely to differ according to each region. Jane Harris, director of external affairs at the NAS, spoke to the Victoria Derbyshire programme about why the situation was a concern. She said: “At the moment people are waiting months – if not years – for a first appointment. If they’re adults that might

mean losing their job, if they’re children they might be excluded from school. It can be really difficult. You can know that there’s something wrong but not what. “At least when you know, there’s then a coping mechanism to deal with it, people know where to get support. The NHS needs to look at autism in the way it looks at other treatments - there’s a waiting time for conditions from depression to hip operations.” An NHS England spokesman said: “Diagnosis of autism spectrum disorders should of course happen as soon as possible, but is often complex and involves many different professionals and agencies. “This is an issue we take very seriously and we have committed to working with local areas to identify and overcome the reasons behind long waiting times. We’ll continue to work with NAS and others to make sure people with autism can get the help they need, when they need it.” A Department of Health spokeswoman said: “The guidelines on autism make it crystal clear that families should wait no more than three months to start diagnosis. Every bit of the NHS should be adhering to these guidelines and NHS England is working with local areas to make sure these waiting times are cut.” READ MORE:



NEWS IN BRIEF Salford Royal NHS Foundation receives £7m energy efficiency fund Salford Royal NHS Foundation has announced it has secured a £7m fund which will be used to upgrade the trust’s combined heat and power plant and switch lighting to LEDs, in a bid to save £2m in annual energy costs. The funding was awarded by investors DLL and The Green Investment Bank (GIB), which is providing £3.4m as part of its £50m NHS energy efficiency funding alliance. The fund will be used to finance the installation of a new 2.5MW combined heat and power system, new energy saving lighting and an upgrade to the trust’s building management system. The project is being run by Vital Energi, which already has a 15 year contract to install and maintain the new technology. Ed Northam, head of investment banking at the UK GIB, claimed upgrading the NHS’ existing technology would increase the resilience of its entire estate. He said: “This programme of energy efficient improvements will save energy, cut costs and reduce greenhouse gas emissions without impinging on patient care.” READ MORE:

Responsibility for devolved services to remain with Health Secretary Amendments to the Cities and Local Government Devolution Act 2016 will ensure that ultimate responsibility for devolved health services will remain with the Health Secretary. The Devolution Act gained Royal assent in January and enables local authorities to take control of local services such as healthcare. The House of Lords made amendments to the Act following concerns that the new law would remove accountability from the state. The amendments were made by Labour peer Lord Warner, with clause 18 of the new act stating that devolution deals must not ‘transfer any of the Health Secretary’s core duties in relation to the health service’. Changes to the Act will also ensure that regulatory functions held by national bodies such as the Care Quality Commission and Monitor will not be transferred. READ MORE



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NEWS IN BRIEF NHS hits carbon reduction targets The NHS hit its carbon reduction targets for 2015, according to a report from the Sustainable Development Unit for NHS England and Public Health England. The Sustainable Development in Health and Care Report found that the NHS reduced carbon emissions by 11 per cent between 2007 and 2015, exceeding its target of 10 per cent. The wider healthcare sector, including public health and social care, saw an even greater improvement with a reduction of 13 per cent. Breaking down where these efficiencies were made, the report found that carbon emissions in relation to procurement were reduced by 16 per cent, with travel emissions dropping by five per cent and energy emissions by four per cent. These improvements have also led to considerable cost savings for the NHS through increased efficiency, with actions such as using combined heat and power systems and staff behaviour change programmes contributing energy savings of £25 million in the last year. The report notes that these reductions are a notable achievement considering that health and care activity has increased by 18 per cent since 2007, but warns more still needs to be done to reach the next target of a 34 per cent reduction by 2020. READ MORE:

Over 100 GP trainees offered £20k to work in areas with shortages A £20,000 ‘golden hello’ will be given to 109 GP trainees working in areas with the lowest GP fill rates between 2013 and 2015. Health Education England has confirmed that trainees who work in under-recruited regions will be awarded a £20,000 bursary at the start of their training placements. The bursary will be available to prospective GPs who are willing to train in Lincolnshire, East Cumbria, West Lakes, South Cumbria, Blackpool, Northern Lincolnshire and the Isle of Wight. According to Health Education England, these areas have ‘an extremely good track record for education’ but face recruitment issues due to their geographical location. READ MORE




GP pressures put care at risk, says BMA leader Dr Chaand Nagpaul, British Medical Association (BMA) GP leader, has declared that increasing pressures on GPs in England and Wales could result in doctors failing patients and potentially providing unsafe care. Nagpaul warned that doctors were having to rush to keep up with patients, which risks their ability to identify cancer or correctly prescribe medicines. Ministers have responded to the concern, promising they would invest in services to address the shortfall. The news comes after the BMA released the results of an online survey of nearly 2,900 practices in England and 145 in Wales. The survey showed that 55 per cent thought the quality of the service their practice offered had deteriorated in the past year, with 68 per cent claiming their workload was unmanageable and 92 per cent reporting demand had increased. Nagpaul said: “It is unsustainable and getting to the point where it is not safe. The ageing population means many of our patients have multiple conditions and are on multiple medicines, but we simply don’t have the time to properly consider how they interact. “On cancer we are having to make rushed decisions. And we are seeing growing numbers of patients with dementia - and yet just have 10 minutes to see them. “It’s not enough. We are being forced to let down patients. We need to see more investment in general practice so we can keep up with demand and have longer 15-minute consultations.” The analysis also found that: there are an estimated 370 million consultations a

year – up 70 million in five years; one in 10 GP trainee places went unfilled last year; a third of GPs say they are planning to retire in the next five years; there are 32,628 full-time GPs – a rise of just over 500 in five years; and that the number of GPs per head of the population has fallen since 2009 to 60.6 per 100,000 people in 2014. The government has promised another 5,000 GPs this Parliament in order to cover the push to provide seven-day opening. It also pledged to increase GP funding by five per cent in order to pay for the recruitment initiative. Minister for Health Alistair Burt, argued: “General practice is at the heart of the improvement we want to see in the NHS. We recognise absolutely that it is under pressure, which is why we are delivering record investment. The Health Secretary will shortly announce further support for GPs, which should assist in meeting the pressures doctors are reporting.”



Wexham Park Hospital hailed for improved services NHS Improvement chief executive Jim Mackey has praised staff at Wexham Park Hospital for making significant improvements to their services. Previously criticised as one of the most troubled hospitals in England, it has turned around its healthcare services and was commended by Mike Richards, independent chief inspector of hospitals, as ‘the most impressive example of improvement’. In an inspection report published by the Care Quality Commission (CQC), the hospital was rated as ‘good’ overall and ‘outstanding’ for critical care and emergency services. During the merge between Wexham Park and Heatherwood, the hospital was put in special measures. Following the rating, Monitor advised it could benefit from the leadership of its neighbouring trust,

the Frimley Health NHS Foundation Trust. Commenting on the hospital’s improvement measures, Mackey said: “This is a great example of hard work by the staff at both trusts and an innovative approach to fixing deep-rooted problems within a very challenged trust. It should serve as an example to other challenged parts of the NHS that, no matter how tough challenges seem, things can be turned around. I congratulate the leadership of the trust who have made real improvements for patients. “In just over a year, the leadership and staff have turned this hospital from one which gave great cause for concern to one which local people can really be proud of.” READ MORE:



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BMA confirms second junior doctors strike will go ahead The British Medial Association (BMA) has confirmed that a second strike starting on 10 February will go ahead, after failing to reach agreement with NHS Employers and the Department of Health on the new junior doctors contract. At the time of writing, the industrial action is scheduled to run from 8am on Wednesday 10 February to 8am on Thursday 11 February, with junior doctors providing only emergency care during this period. This represents a change to original plans for the 48 hour strike to be the first ever full walkout with no care provided. The strikes will mirror the action taken on 12 January and come after a second strike scheduled to take place on Tuesday 26 January was suspended in hopes of reaching an agreement. Johann Malawana, BMA junior doctors committee chair, said: “Over the past few weeks, we have welcomed the involvement of Sir David Dalton in talks about a new junior doctor contract, which recognises the need to protect patient care and doctors’ working lives. “His understanding of the realities of a health service buckling under mounting pressures and commitment to reaching a fair agreement has resulted in good progress on a number of issues. It is, therefore, particularly frustrating that the government is still digging in its heels. “The government’s entrenched position


Over-65 year-olds let down by NHS, report claims

in refusing to recognise Saturday working as unsocial hours, together with its continued threat to impose a contract so fiercely resisted by junior doctors across England, leaves us with no alternative but to continue with industrial action.” READ MORE


First NHS hand transplants set for April The NHS is set to start performing hand transplants in England as early as April 2016, officials have confirmed. NHS England has given the go ahead for Leeds Teaching Hospitals NHS Trust to begin assessing suitable adult candidates, with a view to begin performing the complex procedure from April. Patients will need to be carefully screened for eligibility, due to the special matching required of donor limbs for transplant and the complex nature of the procedure. Candidates will also be assessed for psychological suitability and it is estimated that between two and four patients a year will be listed for the surgery. The centre in Leeds is led by Professor Simon Kay, who successfully performed the UK’s first hand transplant in 2012. Dr Jonathan Fielden, NHS England’s director of specialised commissioning, said: “The NHS is leading the world in offering this cutting edge procedure, which has been



shown to significantly improve the quality of life for patients who meet the strict criteria. “We will be working closely with Professor Kay and his colleagues at Leeds, as well as NHS Blood and Transplant, to ensure that this highly innovative service for the NHS can get up and running as soon as possible.” Professor Simon Kay said: “We are delighted to be confirmed as the provider of this new service. “The extensive multi-professional expert team here at Leeds is keen to now assess new patient referrals and benefit patients and their families in a way they may never have thought possible before. “The Leeds unit has an existing surgical service which can now continue with NHS England support.” READ MORE

A report commissioned by the NHS Confederation claims that a significant number of over-65 year‑olds end up in A&E unnecessarily. The report, ‘Improving Urgent Care for Older People’, claimed that too many older people were ending up in A&E due to a lack of support when they became ill. It calls for new measures to be introduced, such as providing urgent care at home and getting doctors to carry out ‘ward rounds’ in care homes. The report also commented that once admitted to hospital, elderly patients often faced longer stays, decreasing their independence. It added that more support should be provided to help older people navigate the complexities of the health care system. The study proposed that GP’s should identify patients most at risk of hospital admission and work to support them in avoiding visits, citing a team in Hertfordshire, where GPs visited care home residents on a regular basis. Data found that: most hospital beds are occupied by people over the age of 65; health and care spending on over-75 year-olds is 13 times higher than that on younger people; that those over the age of 65 account for 3.7 million A&E visits – about one in six of the total; and that once admitted those aged over 85 stay 11 days on average – twice as long as the average for all ages. Dr Mark Newbold, who chairs the commission, said: “Older people do need to access A&E at times, and the best hospitals tailor their service to meet their needs. But all too often, older people are forced to go to A&E because the alternative services that would help them be cared for at home are not available at the time they need them.” A spokeswoman for the Department of Health said the government was highly supportive of the proposals and referred to the £5.3 billion Better Care Fund, which has been set side to fund schemes largely focused on keeping people out of hospital. READ MORE



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The recent scandal concerning diesel emissions from cars should focus minds on how this affects air quality inside buildings and the impact on the health of their occupants, says Giuseppe Borgese, chairman of the Building Engineering Services Association’s Indoor Air Quality Action Group Poor air quality in urban areas is held responsible for 29,000 premature deaths in the UK every year (360,000 across the EU), which is more than obesity and alcohol combined, according to Public Health England. New studies carried out by Kings College, London have linked nitrogen dioxide (NO2),

from diesel car manufacturers has put this issue into stark context and, although the nature of the problem is now out in the open, it will take many years to remove the effects of these emissions from the air in our cities. In central London the concentration of diesel and nitrogen dioxide (NO2) is about

The recent scandal over falsified test data from diesel car manufacturers has put this issue into stark context and it will take many years to remove the effects of these emissions from the air in our cities which is often caused by petrol and diesel emissions, to higher rates of mortality, lung cancer and heart failure. The World Health Organisation (WHO) has declared diesel particulates as a Class 1 carcinogen. The recent scandal over falsified test data

three times the level recommended by the WHO. This figure was only made public following a challenge from the Campaign for Clean Air. Benchmark estimates from the Harvard Six Cities survey indicate that central London suffers a 20 per cent

increase in mortality rates as a result of mainly traffic particle air pollution. EPIDEMIC The building engineering industry has been pointing out for some time that this growing outdoor air pollution epidemic also has a direct impact on people inside buildings – particularly in schools, hospitals and offices. Many facilities managers and building managers have not taken the necessary steps to protect occupants from the effect of outdoor air pollutants entering their buildings. Poorly maintained ventilation systems; clogged or missing filters; dirty ductwork and ageing air conditioning systems are all contributing to a huge health and well‑being problem. If the government has lost control of the outdoor air; then we must take urgent measures to protect building occupants and make sure our buildings are a haven from the pollution outside. However, this task has been made more difficult over the last two decades by the E

Written by Giuseppe Borgese, Building Engineering Services Association Indoor Air Quality Action Group

Diesel scandal and the health impact on building occupants

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AIR QUALITY  drive to improve the energy efficiency of buildings, which has involved making them more airtight. Sealing up buildings puts greater pressure on ventilation systems to dilute rising levels of CO2 and replenish oxygen while simultaneously trying to

hygiene inspection and remedial cleaning. The new BS EN 15780 standard provides recommended inspection time periods for air systems and the revised Guide to Good Practice for Ventilation System Hygiene (TR/19) from the Building Engineering Services

The Healthvent EU research project reported last year that almost two thirds of the burden of disease traced back to poor indoor air quality (IAQ) was from pollutants coming into the building prevent the rising number of harmful external pollutants from finding their way inside. Many airborne particles are precisely the right size for inhalation into lungs. The human body has no way of removing these invaders so they go on to cause damage and disease to vital organs. The Harvard survey showed how exposure to airborne particles below 10 microns in size posed a serious health risk. Those beneath 2.5 microns (PM2.5) are referred to as ‘fine’ particles and are particularly dangerous because they settle deep in the lungs. The Healthvent EU research project reported last year that almost two thirds of the burden of disease traced back to poor indoor air quality (IAQ) was from pollutants coming into the building. If you live on a busy arterial road in London you are continually exposed to two or three times more harmful inhalable particulates than the WHO warning level. Whether you are inside or outside a building, you are under siege; and let’s not forget that we spend 90 per cent of our time indoors. For good health and productivity the air where you live or work needs to be about 20-24degrees Celcius with a relative humidity (RH) of about 40-60 per cent. The ventilation system needs to dilute CO2 levels and replace oxygen – it’s a very fine balance, especially when most establishments are now heavily focused on reducing energy use. Air tight building envelopes can be a good way of keeping out external pollutants, but they often lead to occupants opening windows, which is not such a good idea unless you know the level of pollutants you are letting in. Ensuring the ventilation system works well is a better solution. Measurements have shown that a well-sealed building envelope and effective filtration of incoming supply air can reduce particle penetration by 78 per cent. There has been a growing interest in airtightness testing to help improve energy efficiency perspective, but that process can also be used to measure IAQ. HYGIENE Every planned maintenance regime should include a check on air handling unit performance as well as a ductwork

Association (the BESA) is adopting this guidance, which can be very helpful to FMs. The Building Services Research and Information Association (BSRIA) has reported a very high success rate for building airtightness tests with 89 per cent of 10,000 tests meeting energy efficiency standards set out in Part L of the Building Regulations. However, it also recorded repeated problems with mechanical ventilation systems charged with ensuring these airtight buildings also

benefit from adequate ventilation rates. It suggested that most of the problems were as a result of installation faults explained by poor training and lack of experience. This is adding to IAQ issues; rising condensation and damp problems; and the consequent impact on the respiratory health of occupants. Air filtration quality efficiency also has to be addressed. Standard G3 filters will not necessarily deliver the level of clean air quality required; the only recommended solution available at the moment that also provides improvements at low energy are F7 filters. In areas with high NO2 levels gas filtration should be considered. However, many good filtration systems are compromised if the filters are inserted in side withdrawal

mounting rails, which means the air can bypass the filter and travel around it. Second stage air filters are designed to remove smaller particles and they must be mounted in properly engineered front withdrawal mountings to ensure they can be fully sealed and air does not bypass them, thus defeating the object of fitting them in the first place. Low energy air purifiers can also be used as a room‑by‑room solution. Many of the remedial measures needed to improve IAQ are not expensive. Cleaning intake grilles, for example, is very straightforward and will payback in a matter of hours because of the immediate running cost and health benefits. Servicing and upgrading ventilation fans will also ensure the system operates more effectively as well as reducing energy costs. However, the first step is to set up a process for measuring indoor pollutants. It is still rare for facilities managers to even consider IAQ as a threat – they tend to be more focused on maintaining comfortable temperatures and adequate lighting levels in response to occupant complaints; or on looking for ways to reduce energy consumption.

Building Facilities


They now face a longer term and increasingly serious IAQ problem that can directly affect the health and productivity of building occupants. Recognising the threat and taking action will become increasingly valuable as the situation outside continues to deteriorate. L

The Building Engineering Services Association is the UK’s leading trade organisation for building engineering services contractors - representing the interests of firms active in the design, installation, commissioning, maintenance, control and management of engineering systems and services in buildings. FURTHER INFORMATION



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The NHS has the potential to save millions if estates managers take a closer look at heating, ventilation and air conditioning systems, says the Building Engineering Services Association The Building Engineering Services Association (the BESA) has identified an area of building efficiency where the NHS could not only save money but reach savings targets. A study by cost consultants EC Harris, identifying £1.5bn worth of savings the NHS could make by improving efficiency across its estate, was unveiled at the recent Healthcare Estates conference in Manchester. The current annual bill for NHS estates management stands at £7.2bn and is rising at almost eight per cent every year despite the austerity measures introduced by the coalition government. Conference delegates responded by urging the Department of Health (DoH) to renew the

publicly funded £50m pilot programme run by several trusts last year to trial energy saving strategies and to bolster the department’s own Encode sustainability design guidance. Trusts that ran the pilot schemes were able to reinvest their savings from reduced energy bills in frontline patient care. However, DoH spokesman Peter Sellars told the conference there was no more ‘capital spend available’ for another round of energy efficiency schemes. Although he did say: “The ministerial team are always asking us to do more about the energy efficiency agenda. The evidence

ENERGY EFFICIENCY Experts who spoke at a session organised by the BESA identified lots of ‘low hanging fruit’ that almost every healthcare facility can find to quickly and cheaply improve its energy efficiency. Estates managers were urged to carry out extensive measuring and monitoring to investigate how well their heating and cooling systems were operating. In many cases, they will find they are working against each other because occupants have been changing the temperature settings, the BESA speakers said. This situation is often made worse by building users opening the windows because they feel hot, rather than turning the heating down. Even relatively new hospitals could benefit from extensive re-commissioning to eradicate this type of problem, delegates heard. Facilities managers (FMs) should make sure there is a temperature ‘dead band’ programmed into the controls by optimising the set points to ensure the heating and cooling systems do not end up running at the same time and wasting huge amounts of energy. E

Written by The Building Englineering Services Association

NHS temperature systems could save millions

shows that the way we currently manage our estates is not sustainable.” Sellars urged trusts to look for alternative sources of funding such as the Green Investment Bank.

Building Facilities


Estates are rs manage arry out oc urged t monitoring ve extensi estigate how to inv r heating and i well theing systems cool rating are ope



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HVAC EFFICIENCY  Darren Jones of specialist consultancy Low Carbon Europe also told the session that ventilation systems were always overlooked as a source of potential savings. He said that optimising the way air was supplied to just one operating theatre could save a hospital £5,000 in annual running costs. That could add up to £10m a year if replicated right across the whole of the NHS and would also avoid 80 tonnes of carbon emissions. He said that any ventilation fan that is over five years old is almost certainly inefficient and a replacement would pay for itself in less than three years. Healthcare FMs could cut running costs by 29 per cent by replacing the fans in their air handling units and the addition of heat recovery to ventilation systems can reduce costs in non-clinical areas by up to 30 per cent. Even more basic measures like having grilles and filters cleaned regularly can save thousands of pounds a year. Mr Jones urged hospital FMs to measure air flow rates to get an idea of how well their systems were working and look for ‘free cooling’ opportunities – where the system will cool the building without the need for the refrigeration circuit to operate. He said: “When we survey NHS buildings, we often find that the chillers have free cooling circuits that are not being used because the building managers are not familiar with the controls. We need to train people to take advantage of this so that refrigerant plant only runs when it is really needed.”

to be able to contend with airborne contaminants and VOCs; as well as cooking and body odours, but it was often not designed with any of those things in mind.” Ruskin is actively involved in the design and refurbishment of healthcare ventilation systems and Mr Fitzpatrick said that a big problem his team encountered was the fact that an area was often designed for one purpose, but was reconfigured and used for something else at a later date. He added: “We are seeing increased demand for a mixed approach to ventilation that combines natural, low energy solutions wherever possible with powered ventilation only where it is essential. This provides the necessary amount of flexibility so the system can adapt to changing uses and conditions, but also keeps the initial capital cost down. Natural ventilation measures are generally fairly easy to install, but the controls are critical to ensure the system works properly.” In fact, 80 per cent of ‘quick wins’ in hospitals are linked to making better use of Building Management Systems (BMS) that are already in place, but are not controlling as many of the building functions as they are capable of, the BESA experts explained.

NHS managers usually say there is no money for energy efficiency measures, but relatively small investments can realise huge savings in such energy intensive buildings Jones pointed out that partial free cooling was possible even when the outside temperature was as high as 18 degrees. He continued to say that variable speed drives are often installed in plant rooms, but have just been left at a constant speed setting, which defeats the object. RECOVERING PATIENTS David Fitzpatrick, sales and marketing director of Ruskin Air Management, told the conference that, because the primary focus tends to be on operating theatres and critical areas, the wellbeing of recovering patients and hospital staff can be forgotten. He said that his company’s research among bed management teams revealed their top priority was to help patients recover more quickly. This means that a high standard of indoor air quality (IAQ) is required in general areas, according to Mr Fitzpatrick. Fitzpatrick said: “Things are already pretty fraught in A&E as it is, so having poor air quality is just going to make everyone feel even worse. The ventilation, therefore, needs

BESA: Guide to Good Practice

– Internal Cleanliness of One Ventilation Systems (TR/19) y s as a good source of very eacut o advice for healthcare t y wa ce a l premises managers p e r o t s i d s e on tackling the t r s v co th lou n threat posed i w s w by poorly maintained windo ngs which ca systems. openi e ventilation Heventilation added: “Many of v impro by 15 per the measures needed rates nt are very low cost, ce such as cleaning intake

Maintaining high levels of air purity in clinical and general healthcare facilities remains a major priority, but the BESA indoor air quality expert Peter Dyment said many FMs were missing the growing threat from increased outside air pollution. The increase in the concentration of diesel particulates, particularly in urban areas, since the government encouraged the adoption of diesel vehicles has led to a worrying rise in respiratory diseases, he said. However, the Health Technical Memoranda (HTM) used to guide NHS managers on a wide range of design issues do not cover contaminants that might enter the building from outside. Dyment told the conference: “HTM guidance concentrates on the transmission of diseases inside hospitals and a lot more needs to be done about the potential health impacts of outdoor pollution. 360,000 premature deaths in the EU are already down to worsening air pollution.” Mr Dyment, who is a consultant for Camfil Farr, cited newly revised guidance from the

Bulding Facilities


grilles, and will payback in hours because of the immediate running cost and health benefits.” Mr Dyment explained that energy saving filters were now a much more significant section of the market ‘growing by 20-30 per cent per year.’ He said: “They will also last two or three times as long as commodity products.”

FIGHTING ON THE FRONTLINE Persuading NHS trust boards to spend money on remedial measures is not easy because they are fully focused on frontline patient care, but Mr Fitzpatrick said it was important to avoid talking about the technical issues and express the possible investment in terms of its direct impact on improving conditions for patients and how energy savings can be reinvested in patient care. One very easy way to cut costs, while also improving ventilation rates, is to replace standard windows with louvred openings. These meet health, safety and security requirements, but can improve ventilation rates by 15 per cent due to their larger ‘free area’, he added. Many conventional windows have to be secured shut for safety reasons. The BESA Eastern Counties regional manager Mike Malina warned delegates against the use of renewables for ‘token’ reasons and said they should only be considered once an ‘energy hierarchy’ had been put in place first i.e. measures to reduce energy demand along with energy efficiency improvements to existing systems. He also said heat pumps could not be deployed as direct replacements for boilers unless other improvements to the building were first carried out such as better insulation and a proper controls strategy. Malina said: “NHS managers usually say there is no money for energy efficiency measures, but relatively small investments can realise huge savings in such energy intensive buildings. There would be no need to raise taxes to pay for more investment in the NHS because energy efficiency improvements pay for themselves and free up more tax payers’ money for frontline patient care.” L FURTHER INFORMATION



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Design Thinking Facilities Management


Written by Jessi Pervola, Director of Design, Smart Design

How design can shape the future of healthcare There are three trends that seem set to transform healthcare in 2016. With the aid of ‘design thinking’, Jessi Pervola looks at each and how design can revolutionise the UK health system The global healthcare industry is in flux, and the UK serves as a clear example of the challenges facing both the public and private sectors. The goals of each are aligned and often seem simple: to help people live full and rich lives; and to mitigate preventable illness and to create a healthier, happier society. But, dramatically rising costs, changing policy and declining quality of care make for a complex reality. Innovation from across the industry is also transforming the dynamic between patients, physicians, hospitals, insurers and pharmaceutical companies. With countless sources of information online, wearables to track our personal stats, apps to diagnose, and new services emerging, patients are becoming increasingly empowered to manage their own health experiences and outcomes. But it isn’t enough to simply focus on the technology that enables them. Technology is the ‘how’ behind the delivery of an idea, but for an idea to make a true impact we have to focus on people first, on the ‘what’ and ‘why’ behind it. What do people need in order to live healthier lives or deliver better care? Why is a company, solution or technology best suited to meet that need above others? Using this type of people-first approach often falls under a methodology referred to as ‘design thinking’.

This is well-summarised by Tim Brown, CEO of the consultancy IDEO who says: “Design thinking can be described as a discipline that uses the designer’s sensibility and methods to match people’s needs with what is technologically feasible and what a viable business strategy can convert into customer value and market opportunity.” High profile businesses like Pepsi and Samsung are increasingly bringing design

how the design of a physical exam space could better facilitate conversation between a patient and their doctor. One idea greatly leverages new technologies while the other is completely offline and analogue, but each has identified and solved for a deep human need. Here in the UK, St. Mary’s Hospital has built an entire design team to drive a similar approach. Called the Helix Centre,

The uncertainty of how to navigate the healthcare system and where to turn for advice can be truly overwhelming. With so much information available, whom should a patient trust? thinking into the boardroom. This approach gives space for employees to nurture new ideas and understand what these ideas mean for customers. Quickly and cheaply prototyping to build the ideas, fail, and build again allows these companies to measure the impact on their customer’s lives, and healthcare is catching on. In the US, the Mayo Clinic’s Center for Innovation prototypes ideas like OB Nest, which examines ways to give prenatal care from a distance. Other ideas, like the ‘Jack and Jill’ rooms simply explore

it is exploring how design can quickly and affordably transform healthcare for both patients and providers. Other organisations, like MacMillan Cancer Support, have a dedicated team helping them embed an innovation process within the organisation. Looking ahead in 2016, what are the biggest opportunities for design to transform healthcare? As designers ourselves, we’ve considered this question carefully, with the hope of providing long-term and effective solutions for the industry. Here we outline three of the key trends, which are set to E



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TRANSFORMATION  transform healthcare – in both private companies and public institutions alike. EMPOWER PATIENTS TO TAKE CONTROL With an overwhelming amount of information available online, an ability to track personal data, and access to basic diagnostic tools, patients are taking control of their own health. They can now understand and plan their own wellness in a way that works for them personally. Of course, this isn’t to say doctors or nurses – the true experts – will become obsolete, or that the patient always knows best. Rather, the relationship with a caregiver will shift from a single ‘get better’ transaction to one

CLARITY ON THE PATIENT PATH TO CARE ‘Patient engagement’ is often described as the next revolution in healthcare. In general, the term is used to describe patients who are actively involved in getting the most benefit out of the healthcare system. Many experts suggest that if healthcare providers can get patients involved in their care then it will cut costs and prevent disease, in a way that no pharmaceutical could match from administering a drug alone. But is the lack of ‘engagement’ today due to patients not caring about their health? Or could it be due to the lack of clarity they encounter when facing an illness?

Jessi Pervola, Director of Design, Smart Design

Design thinking can be described as a discipline that uses the designer’s sensibility and methods to match people’s needs with what is technologically feasible

that spoke to them in their words, addressed their true concerns, and gave them tools to start a conversation with their doctor. This ‘layer’ of information from a reputable third party helped the women feel informed and comfortable in taking an active role in choosing the birth control option that worked best for them personally.

that is longer term and can result in fewer readmissions and more time with the patients. With patients empowered with knowledge of what’s happening to their own mind and body, providers and pharma can help them reach their long-term wellness goals on an individual level rather than categorically by condition or life-stage. An example of this is a platform called Elma, which allows patients to take control and record their wishes for their end-of-life care. This information can be shared with family and physicians whose care they may be under, but with whom they might not have a personal relationship. While this idea leverages new technologies, it ultimately allows the patient to feel secure that their wishes are being carried out in all stages of life.

BETTER JOBS FOR HEALTHCARE WORKERS Patients aren’t the only people in the complex healthcare equation. Those who work within the field – the doctors, nurses, therapists, and aid workers, among others – must be considered as we look towards a better healthcare future. How can we design a healthcare system that considers clinicians and makes their lives easier at work so they can deliver better care to their patients? We expect healthcare providers to put their best foot forward in every interaction with a patient, but we have to take into account that they are faced with a myriad of issues in their work environment that can make this difficult. The NHS is losing an estimated £8.3bn annually from a lack of efficiency. Looking again at the work being done at the Helix Centre, we see that even simple, cost-effective solutions to seemingly small problems – like a new stock and storage system for IV fluids at St. Mary’s – can have a big impact for the staff. This is one small idea, but can imagine big change as it scales out across other hospitals within the UK. An incredible healthcare future sits in front of us, and the possibilities for how our lives could change for the better seem never-ending. With the aid of a design-led approach, it’s a future where experiences are seamless and simple, providing end-to-end support for patients. Where doctors can easily collaborate with patients to spend time on care-giving, rather than on paperwork and a patient backlog. Where technology is used with a defined purpose and devices and ideas that were once science fiction are viable and part of our daily lives. And where we’ll shift from fixing an illness to maintaining our wellness overall. L

The uncertainty of how to navigate the healthcare system and where to turn for advice can be truly overwhelming. With so much information available, whom should a patient trust? In a recent project at Smart Design we partnered with TNC, The National Campaign to Prevent Teen and Unplanned Pregnancy in the US, to build awareness, reduce uncertainty, and bring a new level of clarity to young women around IUD’s and implants. These birth control methods are 20 times more effective than the pill at preventing pregnancy but only six per cent of women were choosing them, mainly due to negative perceptions and incorrect information. Through interviews and work sessions with young women, we designed a campaign

Design Thinking





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EFFECTIVE ENERGY PROCUREMENT IN THE PUBLIC SECTOR NHS budgets are under pressure and finding ways to reduce costs can be a major challenge. The good news is that effective energy procurement offers a real opportunity for savings The energy market and the way energy is purchased have changed radically within the past decade. Gas and electricity are purchased now through a commodity market which trades ‘forward periods’ on a daily basis. This has created wholesale markets for the trading of the ‘commodity’ prices of gas and electricity. Prices are made up of the raw energy cost (ie the traded element), transmission and distribution costs, various industry and environmental charges, and supplier administration fees. Buying energy is different to buying other products and services, so successful energy buying cannot normally be achieved through usual procurement methods. The volatility of the energy market means that all energy contracts contain an element of risk and purchasing decisions involve a choice as to how to best manage that risk. For example, if your energy is bought on a single day and fixed for an annual period, you have a one in 250 chance that you have selected the best day for making the purchase. FLEXIBLE PUBLIC SECTOR PURCHASING Consequently, over the last decade and particularly in the public sector (PS), there has been a growing trend to ‘flexible’ purchasing, which may involve a number of purchasing decisions over a defined period, usually in advance of the contractual period. In the PS this is usually undertaken on a ‘portfolio’ approach and implemented for the majority of PS organisations by Public

Buying Organisations (PBOs). There are a number of PBOs in the UK which have specialist energy procurement teams. They normally have a significant number of organisations within an energy portfolio, the aggregated consumption volume of which allows them to develop a procurement risk strategy which will include the flexibility to make a number of purchase decisions. QUESTIONS YOU MIGHT ASK How can we take advantage of the movement in prices? Total Gas & Power (TGP) offers a variety of gas and electricity flexible products which are designed to allow as much or as little risk as the customer requires, but are based on allowing a number of ‘forward’ purchases for energy in a variety of ways. For example, the most common purchases are for forward purchases of ‘clips’ of months, quarters or seasons. How can we take advantage of price changes and maintain price certainty? Typically, there will be a number of ‘basket’ options available, which primarily focus on the timing of the purchases. So, for the vast majority of PS customers, all of the energy purchases (to an agreed purchase volume) are made before a contract (budget) year commences and the cost of electricity or cost of gas can be calculated and billed. How can we be certain we are not paying extra for ‘risk’? All of the flexible products offered by TGP

are transparent; the element of risk that is built into the cost for any variation for the forecast volume and profile of the customer is visible to the customer and is usually formula based (particularly for electricity) so that it can be understood and verified by the customer. How can you ensure that we are not being overcharged for Industry charges? All of the flexible TGP products have a ‘pass through’ component for the non-energy charges. That means all non-energy charges charged to the supplier by those bodies (whether set by the Industry for distribution, transmission etc or by the government) are passed through to the customer and broken down in as much detail as they require to enable checking against published rates. Being a PS organisation we require our goods and services to be ‘OJEU compliant’. TGP operates a number of OJEU compliant frameworks with major PBOs. If a customer’s energy requirement cost is likely to exceed the OJEU threshold, it can access one of the existing frameworks for its energy needs, as an alternative to running its own procurement exercise. ABOUT TOTAL GAS & POWER TGP is one of the leading energy suppliers to industrial, commercial and business customers within the UK and is part of the Total Group of businesses. Established in 1987, when the gas market deregulated, TGP now supplies over 120,000 sites across industrial, commercial and public sectors. We are the market leader in gas in the highly competitive Industrial and commercial sector, and have been supplying electricity to those sectors since 2001. We have five frameworks in place with PBOs and there is a bespoke public sector team which manages contracts with over 600 PS customers, including some NHS Trusts. L FURTHER INFORMATION Kevin Matthews 0791 2997692




The potential environmental and financial benefits of having more hospital buildings fitted with solar systems is very worthwhile, says Chris Roberts of the Solar Trade Association Hospitals are power-hungry animals. The MRI scanners, dialysis machines, x-ray machines, heart rate monitors all need electricity and, more often than not, need to run 24/7. The lights are on round the clock. Air conditioning units and refrigeration requirements are also very high. Hospitals need a lot of electricity. But hospitals are also blessed with a large amount of empty roof space. And more and more, as solar PV gets cheaper, the roofs above our heads need to be considered as an asset to help bring energy bills down and green our buildings, rather than just empty space. The cost of solar PV has been falling fast in recent years. Prices have dropped 70 per cent over the last five years, due to a maturing supply chain for solar products in the UK and ever more efficient manufacturing of the panels themselves. The main benefit of going solar is that it

is a cheaper way of getting electricity when compared to buying in power from the grid from your usual supplier. If you assume that you are purchasing power at 10p/kWh, at the moment (and this is about to change) a solar system with a Power Purchase Agreement might be able to supply you with electricity at 7p/kWh. That means more money to spend on front-line medical care. In addition to savings on energy bills, solar also currently benefits from a generation tariff under the Feed-in Tariff, where the owner of the solar PV system on a commercial building is paid anywhere between 3p and 10p per unit of power. Additionally, under the Feed-in Tariff system the owner is paid an additional 4p per unit for the electricity that is exported back to the grid and not used on-site. Depending on how

MEETING PLANNING REQUIREMENTS But the financial return for hospitals isn’t the only reason to go solar for existing hospitals - the Carbon Reduction Commitment energy efficiency scheme is also an important consideration and is often a driver for hospitals to put solar on their roofs. And for new build hospitals, or indeed the refurbishment of old building stock, solar can help project managers meet planning requirements and building regulations. The 2013 Building Regulations require hospitals to achieve an additional 14 per cent carbon savings (as opposed to just nine per cent for other types E

Written by Chris Roberts, technical specialist, Solar Trade Association

An ideal way to help power our hospitals

big the solar PV system is, it is either assumed that half of the electricity is exported, or the export is measured through a meter. However, as you may have seen in the news, the government’s subsidy system for solar PV is currently in a state of flux. The Feed-in Tariff system has undergone a complete overhaul and the government has proceeded with some fairly major cuts. However, even with lower or no tariffs investing in solar is still very much worth considering for hospitals, due to the high power demand and the potential to therefore save a huge amount of money on energy bills. Other commercial buildings can only hope to use 50-70 per cent of the power their solar system generates, as their buildings are often dormant during weekends and holidays. Hospitals however are far more likely to achieve what in the solar industry is called ‘100 per cent self-consumption’ – the holy grail of commercial solar installations.



The in one ma solar of benefit is that it power er way of ap is a che electricity getting mpared to o when c ing from buy the grid





SOLAR POWER Power Purchase Agreements Here are some key questions to ask before entering into a Power Purchase Agreement (PPA): What is the PPA rate? What is the price per kWh of electricity offered? How does that compare with what you pay at the moment? How does it inflate each year? Is there a guarantee to ensure that the PPA will not be higher than the prevailing market price for electricity? Does the hospital have to buy all the electricity generated even if not used on site? (This is less likely for a hospital, but some PPAs will require the building to buy 100 per cent of the electricity even when it doesn’t use it all.)  of commercial buildings) when compared to the baseline building standards. In addition to this the NHS requires that all new hospital facilities meet the ‘Excellent’ BREEAM New Construction standard. And within London, the Greater London Authority has required that all new builds demonstrate a 35 per cent improvement over 2013 standards. Solar PV can help with all of this. HOW TO FINANCE YOUR SOLAR SYSTEM There are various business models that can be used to pay for a solar installation. The simplest is to pay for the installation outright and earn your investment back thanks to energy bill savings, the generation tariff and the export tariff. At the time of going to press it typically takes less than 10 years for the system to pay back the initial cost. Second, if the institution doesn’t have funds available to pay for the system outright you can look at borrowing the money. But the most popular option is financed or funded solar. This is where an external investment company pays for the installation and receives the subsidy payments. The hospital pays nothing upfront and buys the electricity generated by the system from the investment company more cheaply than grid electricity through a Power Purchase Agreement (PPA). Maintenance is usually covered for the duration of the term. See ‘Power Purchase Agreements’ panel for more information. KEEPING GOING DURING A BLACKOUT All hospitals with Category 3 patients need Uninterruptible Power Supply to make sure there is no break in power for critical equipment and areas.



As solar PV gets cheaper, the roofs above our heads need to be considered as an asset to help bring energy bills down and green our buildings, rather than just empty space One important misconception about solar PV is that it keeps going during a power cut – unfortunately this is not the case as the ‘inverter’ machines that convert the DC from the solar panels into AC for the building need AC power in order to operate. Systems are designed however to integrate with existing emergency back-up diesel generators but it is not inconceivable that innovative solutions could be found in the near future that combine solar and electricity storage and help to displace some of the diesel generators. And in case you were wondering whether the power will have to be switched off while the solar system is being installed – the answer is usually not. Depending on the electrical systems on site it should be possible to install without any need for a shutdown. Worst case scenario might be a partial shutdown of one area (the one served by the sub-distribution board which you are going to connect the PV system to), but this remains rare. Roofs are not the only place to put solar on a hospital’s estate – although for urban hospitals it’s probably your best bet. A few hospitals around the country are already

considering solar canopies for their car parks, which can supply both the hospital itself as well as any electric vehicle charging points and as a bonus provide shelter for patients getting in and out of cars. Another option for rural hospitals that perhaps own a considerable amount of land around the estate is a ‘mini solar farm’ or ground mount solar array. This can then be used to supply the building with what is called a ‘private wire’ connection. SOLAR THERMAL To date the biggest solar market has been for solar panels that generate electricity – called photovoltaic solar or PV. However there is also the alternative option of solar thermal hot water heating. Hospitals have considerable hot water requirements for showers and catering. Solar thermal hot water installations are typically cheaper than solar PV panels, and subsidised by the Renewable Heat Incentive (RHI) which means that the technology has similar rates of return on investment and similar payback periods as solar PV. (Solar thermal could also in theory be used for space heating



What to ask your solar panel installer CONCLUSION Solar has a lot to offer hospitals – a green and cost effective way of generating at least some of the power they require. But conversely hospitals also have a lot to offer solar, as a fantastic example of big buildings with high electricity demand. As Jonathan Selwyn, managing director of Lark Energy Commercial recently said: “Despite the uncertainty over the government’s support for solar, Lark Energy Commercial is seeing an increasing number of enquiries from Health Trusts, hospitals and health centres looking to solar to reduce both their energy costs and carbon emissions”. The policy framework for solar is changing, so make sure you stay up to date with the latest subsidy offering, but installing solar on the roof of a hospital could well still be a very canny investment for your site.

but it then isn’t eligible for the subsidy.) However as with the Feed-in Tariff for solar PV, the Renewable Heat Incentive is being reviewed by the Department of Energy and Climate Change and is subject to change. If you decide to go ahead with a solar install, it may be worth engaging the services of an experienced independent consultant who can draft a technical specification document. The consultant can also liaise with the installer as well as inspect the finished system prior to handover – this should give you some additional peace of mind. However if you do want to deal direct

CASE STUDY The Heart of England NHS Trust installed solar PV on Heartlands Hospital and Solihull Hospital in 2014. The Trust was spending more than £1million a year on energy before the installations. The arrays are predicted to deliver over £2 million in savings and feed-in tariff payments over the next 20 years, and a 10 per cent saving on energy bills. Pete Sellars, Director of Estates for the NHS England, said that he was delighted that the project did not result in the closure of any wards or disruption to critical services. Seaton Community Hospital installed a solar system in 2012 – the first to go solar out of the 18 hospitals managed by the Northern Devon Healthcare NHS Trust. The installation was funded by the League of Friends of the hospital – a support charity – which raised £27,000 towards the cost of the panels. The Feed-in Tariff payments were then split 50-50 between the hospital trust and the League of Friends. The hospital is still saving almost £2,000 a year on its energy bills. Musgrove Hospital in Taunton installed solar a few years ago, in a move that was part of an ongoing partnership between Taunton and

Ask to see sample risk assessments and method statements from previous similar projects. Ask to see design statements covering things like lightning protection and how fire risks will be minimised and managed. Obtain confirmation that the roof will be assessed and signed off by a qualified structural engineer. Ask to see samples of all structural and structural design assessments undertaken for similar projects and confirmation they will actually be provided for the project in question. Require detailed justification (including energy modelling) of the system as designed including component selection (panels and inverters). If the operatives working on‑site will be directly employed or subcontracted, and if they will be DBS-checked. Confirmation that the contractor will obtain permission to connect to the grid under G59, and ensure that this will be provided before works commence. Confirmation of what kind of system monitoring will be provided to ensure no faults – and consider also using a public display in a waiting area for example, so that your staff and patients are aware that the building is solar‑powered. Check whether the installer is a member of the Microgeneration Certification Scheme (MCS) and the Renewable Energy Consumer Code (RECC).

Roofs are not the only place to put solar on a hospital’s estate. A few UK hospitals are already considering solar canopies for their car parks, which can supply both the hospital itself as well as any electric vehicle charging points with your solar installer or oversee the process the Solar Trade Association has developed a management toolkit called the Commercial Solar Rooftop Confidence Checklist. This is freely available from the STA’s website. In brief, the ‘What to ask your installer’ panel suggests some of the key questions to ask and the full checklist can provide you with more information.

Somerset NHS Foundation Trust and supplier Schneider Electric. The installation saw 90 solar panels fitted to the roof of the hospital, and it is estimated the panels will generate up to 18,960kWh of electricity every year, equating to an energy saving of £5,000. L FURTHER INFORMATION



Providing people that care

We believe in creating a work climate for nurses and carers that nurtures and supports clinical expertise and work hard to recruit and retain staff who demonstrate the highest integrity, passion, competence and qualifications. The needs of our patients and their families guide our care, and through collective communication, we collaborate with our staff, to provide the best possible care for our clients. “I am writing to say a huge “thank you” for the very professional service you give to your clients. From my first phone call to your office, to the review when you visited myself and my disabled sister in her home, you have shown us great kindness and compassion. I will not hesitate to use your company in the future.”

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Collaboration with staffing suppliers is now more critical than ever in ensuring NHS trusts can weather the recruitment storm of the coming months, says the REC’s Vicky O’Brien

The recent caps and controls introduced to reduce agency spend are illogical and counter‑productive in their design, and risk jeopardising patient access to high quality care across the NHS, as well as escalating agency spend in the long term. Over the past six months, NHS Improvement has introduced a variety of caps and controls to reduce NHS trusts’ agency spend, and dis-incentivise healthcare professionals from choosing locum work over bank or substantive roles. For all these highly disruptive interventions, they have still failed to tackle the fundamental driver of agency spend in the NHS: the shortage of staff willing to work to standard substantive

Ensuring our wards are safely staffed is becoming increasingly challenging not only for NHS trusts but also their temporary staffing suppliers. The lack of nursing, medical and care staff available for both perm and temporary placements is consistently flagged in the REC’s ‘Report on Jobs’ survey, the most up-to-date monthly picture available of recruitment, employment, staff availability and employee earnings in the UK jobs market. While we fully support recent efforts to improve booking procedures at trust level, as one acute trust neatly surmised in a recent Kings Fund’s NHS Quarterly Monitoring Report: ‘We need a workforce solution to ensure that we can recruit sufficient nurses and doctors. The increase in temporary staffing is not just down to a lack of controls’. Stakeholders across the NHS are having to concede that government cuts to training places, high attrition rates due to unfavourable substantive pay and working conditions, and barriers to overseas recruitment are really starting to bite. Nearly everyone, it seems, except the Secretary of State for Health. Sadly, the recently introduced caps and controls on NHS agency spend will only exacerbate the escalating recruitment and retention crisis facing the NHS. Since November last year, the healthcare professionals who provide crucial front-line services to NHS patients – often at short notice, during unsociable hours, and having travelled vast distances – are having their pay progressively cut to the point that working for the NHS is no longer affordable for either substantive or agency staff. The REC does not believe that these price caps are sage, sustainable or cost‑effective. In their current form they undermine existing framework agreements, leading to an escalation of rates and off‑framework usage (the stated targets of these reforms). They are also driving many existing agency staff out of the market, further exacerbating staff and skills shortages within the NHS. E

Written by Vicky O’Brien, Senior Policy Advisor, Recruitment and Employment Confederation

Weathering the recruitment storm



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pay and conditions. While REC members continue to supply staff to cover last minute sickness and spikes in demand, they are also increasingly being called upon to cover longer-term vacancies and staffing gaps caused by years of poor workforce stewardship by the government. As many as 82 per cent of agency bookings by 54 NHS trusts in Q2 2015/2016 were to fill substantive vacancies, an increase from 66 per cent of bookings in Q3 2014/15.



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STAFFING SHORTAGES  FILLING IN AT SHORT NOTICE Three quarters of REC members we surveyed in January said that restrictions on NHS spending on agency staff have made it more difficult to find doctors and nurses willing to fill temporary vacancies. While demand continues (a third of recruiters we surveyed say they are receiving on average more than 100 requests for staff per NHS trust, a similar level to the demand recorded in an REC in the summer), eight in ten told us they were only able to fill up to half the requests they receive from NHS trusts, due to a drop in the number of doctors and nurses willing to fill in at short notice on NHS wards. At the time of writing, Monitor is yet to reveal whether or not this shortfall is being picked up by substantive staff, despite having a statutory obligation to ensure patient safety. What we do know is that, only a month into the first November caps, 92 per cent of acute hospitals in England reported that they were unable to find enough nurses to staff their wards. A survey conducted by the Nursing Times found that three quarters of nurses feel they are being forced to leave patients without the care they need at the end of shift due to staff shortages, unsurprising when half feel there are rarely or never enough staff on their wards. NHS agency workers are highly skilled professionals who trade job security and many of the perks enjoyed by substantive staff in return for greater flexibility. Our members tell us that the overwhelming majority of their candidates are formerly long-time, substantive employees of the NHS, or alternatively, or they combine locum work with existing substantive posts to supplement their poor pay or gain experience in different areas. These workers are keeping some of our remote and most challenging health services going. The idea therefore that by cutting what they earn they will clamour to return to the NHS as permanent employees is misguided – especially in light of current negotiations on pay and conditions for substantive staff. Inevitably some agency workers will go to work overseas, others will move into the private healthcare where the caps won’t apply and some will find flexible and better paid employment in another sector all together. TEMPORARY STAFFING Another significant cohort of agency workers are overseas migrants, who come to work in the England for a fixed period (usually 2-3 years) in order to gain experience of working in the NHS and earn a certain amount of money. Many of these candidates have fed back categorically to REC members if the pay caps are introduced, England will no longer be a destination of choice. And for the large share who supplement substantive positions with locum work, they may choose to avoid bank work and evaluate their careers in the NHS completely. The real impact is that we could see the care of

millions of patients who depend on the NHS being put at risk over the coming months. REC members fully recognise that there is an urgent need to make savings, and improve the cost-effectiveness of temporary staffing in the NHS. However, current design and implementation timescales of these caps and controls are unsustainable and potentially dangerous. Many NHS trusts appear to agree – just over half of the chief executives, HR, finance and clinical directors recently surveyed by Health Service Journal felt their Trust was ‘unlikely’ or ‘uncertain’ to meet the capped rates for Band 5 nurses, staff grade doctors and for consultants. To add to this landscape of disruption and uncertainty, various stakeholders are still pressing NHS Improvement for immediate clarity on several outstanding questions including: will the new set of framework agreements due for tender address design flaws that made previous incarnations commercially unsustainable – for both trusts and their staffing suppliers?; and will pay uplifts in critical skill shortage and remote regions be back on the cards as NHS Improvement moves to specifically cap worker pay?



prioritise poor workforce reporting, the REC is happy to facilitate regional and local roundtables for NHS HR managers to feedback suppliers insights on how to better manage and monitor local supply chains. CONSIDER YOUR REGIONAL BRAND With the removal of regional pay enhancements, and diminishing candidate pool, both recruiters and NHS trusts are learning the importance of considering their brand. The REC’s Good Recruitment hub contains a wealth of case studies, research and data on good recruitment practice for employers, and the latest developments in recruiting and resourcing, collated from over 90 business organisations that have signed up to the Charter. The self‑assessment tool enables employees to benchmark their company’s recruitment processes. While trusts’ hands are tied when it comes to long-term pay incentives, Good Recruitment Campaign research such as ‘The Candidate Strikes Back’ shows how getting the initial recruitment process right in a fiercely competitive market, has long-term dividends in terms of retention.

Since November last year, the healthcare professionals who provide crucial front‑line services to NHS patients are having their pay progressively cut to the point that working for the NHS is no longer affordable for either substantive or agency staff GET BACK TO BASICS WITH WORKFORCE REPORTING Unless data collection is radically overhauled, any long-term impact assessment of these caps and controls will be impossible. The Health and Social Care Information Centre lacks the ability to measure how many temp workers there are in the system. Meanwhile, far too many NHS trusts are struggling to adhere to any standardized procedure for measuring and tracking their staffing costs. A recent Monitor audit found that 49 per cent of Foundation Trusts made ‘materially inaccurate’ data submissions, including on staffing costs. Bad practice highlighted included calculating staff costs based on subjective codes, and the use of inaccurate job plans. And even more worrying, the weekly monitoring form used by Monitor to capture the frontline impact of these caps and controls does not allow trusts to describe the impact on patient safety and service quality. Poor workforce reporting was both a symptom and driver of escalating agency spend. With NHS Improvement slow to

DIVERSITY NOT MONOPOLY IS THE KEY TO LONG TERM STABILITY With Monitor and the TDA telling NHS trusts to lever their collective purchasing power, surely it makes sense for them to encourage a diversity not monopoly of suppliers. The majority of REC members that operate off-framework do so not by choice. Rather, many new start-ups or SMEs have faced numerous challenges in gaining access to existing frameworks agreements. If customers choose only framework agreements that are commercially viable for SME healthcare recruiters, they will be in a better position to ensure suppliers buy in. The REC is working hard to seek clarity on these and many other points, champion the vital (and all too often miscast) role healthcare recruiters play at the frontline of the NHS, and steer NHS Improvement away from further disastrous interventions – such as the proposed April cap rates. In the meantime, our members are keen to step up and help their clients navigate the immediate fall-out. We hope you’ll join us. L FURTHER INFORMATION





An established nursing agency that has earned a reputation for providing dedicated service 24/7 As an independent and off Frame Work nursing agency located in Bristol and supplying staff within the South West, Medicat Ltd finds itself facing a very uncertain future with regard to supporting the NHS with the current staffing crisis. Medicat takes great pride in the excellent personal 24/7 service it provides not only to clients but also the professional and dedicated nursing team, whilst remaining very price competitive as an independent. Medicat’s independence enables the agency to provide a level of service that is very much valued by its existing NHS clients. Medicat is very adept in reacting proactively to client’s very specific requirements. It not only fills a shift with the appropriate grade and skills required, but goes further in effectively matching a specific member of the team who will truly and very productively compliment the team to which they are to be allocated, allowing the maintenance of professional continuity. This ensures that the necessary support is

supplied to provide the optimum level of care delivered to patients. This is only achieved by truly knowing, understanding and valuing both its clients and the team of nurses. Medicat has NHS clients who wouldn’t be able to operate safely if at all without its support. Why should this be when they have Frame Work Suppliers? Because demand is too great and unable to provide for a specific clinical skill set. Regulatory controls that presently exist in the utilisation of agency nurses in the NHS have hugely restricted Medicat’s ability to provide the services of

its team of highly experienced Emergency Nurse Practitioners, both a scarce and valuable discipline required by the NHS. The NHS is under huge pressure to maintain the quality of care delivered by both The Department of Health and its patients, whilst having to carry the hugely impeding burden of the existing financial deficit. It is clearly recognised that the NHS has a nursing and other clinical disciplines staffing crisis. The Frame Work suppliers as large and diverse as they may be are not always able to meet all the existing and potential temporary staffing needs of their NHS clients. Is this not the time to recognise both the value and qualities that the Independent nursing agencies can provide to the NHS and to accept that inadequacies do exist with Frame Work Suppliers? FURTHER INFORMATION Tel: 0117 9739900














Recruiting and retaining staff are becoming major issues for the majority of hospitals. To help solve the problem, organisations should be more age aware, says Rachael Armistead of the WLG Currently 47 per cent of the NHS workforce is aged 45 and above, with the average age being 43 and predicted to increase. The ageing workforce is an issue that organisations need to address today to prevent workforce challenges in the future. The normal pension age is now equal to state pension age. This change means that 70 per cent of the NHS workforce will have a pension age of between 65 and 68. The NHS Working Longer Group (WLG) is a partnership group of nationally recognised NHS trade unions, NHS employers and health department representatives from England, Wales, Scotland and Northern Ireland that was established to review the implications of working to a later retirement age. Since the group was established in 2012, it has undertaken a significant amount of work, including an audit of existing research into the impact of working beyond age 60. It has made a national call for evidence to obtain NHS specific information about the impact of a raised retirement age, and has taken into consideration a range of data. Data from these pieces of work were used to inform the preliminary findings and recommendations report, which made 11 recommendations, submitted to the health departments in spring 2014. In October 2014, the group was formally commissioned to deliver a body of work based on these recommendations. DATA MONITORING A number of groups have been established to deliver these pieces of work, which include a range of products for use across the NHS workforce. One of the groups has been undertaking some national research through visits to NHS organisations across the UK to gather intelligence on current practice in a variety of areas relating to working longer. This looked at what data is currently collected and how it’s used; what older workers’ access to learning and development is, how their skills are kept up to date and what policies,

practices and initiatives organisations have in place to support the ageing workforce. The group also looked at how organisations currently use equality and diversity monitoring to support an ageing workforce, how they promote the use of the NHS Pension Scheme flexibilities and how they work in partnership with trade unions to support their staff to work longer. This research was undertaken through qualitative interviews and a number of themes emerged during the visits. The results demonstrated there is a desire to open up conversations about career and retirement plans between line managers and staff and there appears to be large variations in the use of flexibilities, such as retire and return, or step down. It was felt these flexibilities should be utilised more to support staff to work longer. There is also a demand for national data to help organisations benchmark. Data is often collected, but more could be done with it to develop initiatives to support the ageing workforce. There is a perceived difference in the duties carried out by different age groups. The information gathered through this research will inform future work. It was clear from initial findings that further work needs to be done to help members understand the pension scheme and the flexibilities available to them. One of the groups is now developing a training package for HR teams, which will include information on the NHS Pension Scheme and how flexibilities within the scheme can be used to enable staff to work to a raised retirement age. The training package will help HR teams further their understanding so they feel more equipped to support staff.

AGE AWARENESS Another group has recently launched an age awareness toolkit for employers. This was designed to help them work in partnership with trade unions to create organisational awareness of the opportunities and challenges associated with an ageing workforce. During the initial work, it was observed that organisations across the UK are at varying stages of awareness of this important issue. The toolkit includes resources to help employers raise awareness of the issues that working longer presents, including how to assess workforce demographics and organisational readiness for the ageing workforce. It will also support them to embed actions to make sure practices or policies within their organisation reflect workforce demographics of the future. Age awareness is not simply about knowing the age of the workforce, it’s about using an understanding of the age demographics across an organisation to inform effective workforce planning. Raising awareness will help facilitate cultural and behavioural change within organisations and changes to policy and practice that support and enable employees to work longer, safely. Although it is clear that a wealth of information and evidence has already been gathered, there still remains further work to be undertaken. The WLG is continuing to gather evidence to feed in to this work and will continue to produce resources that meet the needs of the NHS. L

Written by Rachael Armistead, NHS Working Longer Group, NHS Employers

The ageing workforce and the NHS

The ageing work is an iss force organis ue that to addr ations need preventess today to w challen orkforce g the futues in re




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A PATIENT SAFETY SYSTEM THAT WORKS EarlySense is a patient safety system that reduces falls, pressure ulcers, critical code blue events and alarm fatigue The NHS has identified areas where there are very high, but potentially preventable, costs: £2.3bn on falls1, £2.1bn on pressure ulcers2, and £30,000 per person on resuscitation3 per year. As a tool to reduce these costs, BES Healthcare has brought to the UK market ‘EarlySense’, a remote patient monitoring system that has proven to reduce falls, pressure ulcers, and critical code blue events in hospitals around the world. EarlySense is a contact-free patient monitoring system which, when placed under a bed mattress, continuously monitors vitals such as heart and respiratory rate, and detects movement. Most critical events (such as cardiac and circulatory arrests) are preceded by warning signs six-eight hours prior to the event4, 5 . By detecting early deterioration of these vitals this system helps nurses respond to these early warning signs, thereby reducing the costs of code blue interventions, and avoiding unexpected deaths6. REDUCE FALLS EarlySense can help hospitals meet their patient safety goals of reducing avoidable injuries caused by falls. Most falls occur shortly after bed exits. EarlySense reduced the incidence of falls by 87.2 per cent7 in a hospital in Florida. A clinician in the hospital also said: “The EarlySense system integrates with the hospital’s current clinical workflows, requiring no additional overhead.”8 REDUCE PRESSURE ULCERS EarlySense was evaluated by a team of clinicians on a 33-bed surgical unit which included patients with general medical, trauma, and surgical needs in a community hospital in California9. The data was collected from 1000 patients



over a period of six months. Within this period EarlySense helped reduce pressure ulcers (Stage II and above) by 74.7 per cent (also, the overall rate of nurse satisfaction with the system was 84.6 per cent). COST SAVINGS IN HOSPITALS When a cost analysis was performed in the same hospital in California, the system had saved them $54,117 per bed per year9. Research has shown that the potential savings by bringing these ‘harms’ under control are: $19,440 per patient per event on falls10, 11, $15,229 per patient on pressure ulcers12, and $1448 per patient per length of stay12. REDUCE ALARM FATIGUE Alarm fatigue is a major concern for patient safety co-ordinators in hospitals because it leads to nurses ignoring alerts before a critical event. The EarlySense system helps reduces the risk of alarm fatigue - on average there are 2.8 alarms per 100 EarlySense monitors in comparison with 200 alarms per 100 monitors seen with typical ICU systems13. BETTER QUALITY OF CARE Along with cost savings, reduction in unexpected injuries, alarm fatigue, and critical events, EarlySense also helps to provide better quality of care. Early warning of patient deterioration means that clinicians can inform families about their relatives’ decline in health allowing them the opportunity to be part of the end of life care. It also assists nurses in dealing with their patients in a timely manner, along with managing their own work load. Elderly patients often do not want to ‘bother’ staff, but EarlySense alerts staff when appropriate intervention is required.

EARLYSENSE IN THE UK EarlySense implemented in the UK North Tees & Hartlepool NHS Foundation Trust has taken up the initiative to meet their patient safety goals of reducing falls by implementing 59 EarlySense systems in their elderly care and surgical wards in the University Hospital of North Tees. Steve Heavisides, ward matron, said: “It has made a real difference to the care we can give to patients, particularly during the night where we have seen real improvements in care.”14 EarlySense can help support the National Early Warning Score (NEWS) system used by nurses to warn them about patient deterioration. National Institute of Care and Excellence (NICE) has also published a review on the EarlySense which can be found on the NICE website. This review has been commissioned by NHS England and produced in support of the NHS ‘Five Year Forward View’, as one of a number of steps which will accelerate innovation in new treatments and diagnostics. L FURTHER INFORMATION To help meet your patient safety goals, there is an opportunity to trial EarlySense in your hospital to see the differences for yourself. Call Tom on 01179 666 761. Visit References 1 National Institute for Health and Care Excellence (2013) Clinical Guideline CG161. 2 Bennett, G et al (2004) Age and Ageing 33, pp230-235 3 Dingwall, R et all (2002) Nursing Times 98, p36 4 Schein, R.M. et al (1990) Chest 98, pp1388-92 5 Franklin C. & Mathew J. (1994) Critical care medicine 22, pp244-247 6 Young, M.P. et al (2003) J Gen Intern Medicine 18, pp77–83 7 Impact of Nursing Safety Initiatives on Patient Outcomes Florida, Tampa (2013) FONE Poster 8 Florida Hospital Tampa is First in the State to Implement EarlySense Proactive Patient Monitoring System (2013). Florida MD 9 Brown, HV & Zimlichman, E (2010) White Paper Patient-safety, 10 Rizzo J.A. et al (1998) Med Care 36, pp1174–1188 11 Haumschild M.J. et al (2003) J Health-Syst Pharm 63,pp1029-32 12 Allman, R.M. et al (1999) Adv Wound Care 12, p22 13 Zimlichman, E Evaluation of EverOn as a Tool to Detect Deteriorations (2009), 14 Patient monitors research trial, North Tees and Hartlepool NHS Foundation Trust, patient-monitors-research-trial/


Patient Safety


Could improving the complaints process improve patient safety? Health Business analyses the Parliamentary and Health Service Ombudsman’s ‘Breaking down the Barriers’ report and examines what improving the complaints process could mean for improving patient safety and care outcomes for older patients People aged 65 and over are some of the most frequent users of NHS and social care services, but a recent report found that the Parliamentary and Health Service Ombudsman received far fewer complaints from this age group than would be proportionally expected. Older patients are some of the most vulnerable in the NHS and a lack of knowledge and confidence to complain could have disastrous impacts on patient safety and outcomes, as it means that many continue to suffer in silence and could lead to missed opportunities to improve services for others in the future. The Parliamentary and Health Service Ombudsman is an independent complaint handling service that is responsible for making final decisions on complaints that have not been resolved by NHS England. The Ombudsman service published the ‘Breaking down the Barriers’ report after witnessing evidence of the particular barriers older people and their carers face when they want to raise concerns about poor care, with the hope of instigating action to help complaints be heard. AGEING POPULATION Caring for older patients is an ever increasing issue as the UK currently faces the prospects of an ageing population. According to the Office of National Statistics, approximately one in 10 people in the UK will be 75 or over by 2030, with the number of people over 85 set to double in the same time frame. As it currently stands, people aged over 65 make up over half of all the time spent in hospital beds, but only account for one sixth of the country’s population. Additionally, people 85 or older account for one in 44 of the population, but account for approximately one sixth of the time spent in hospital beds. Data from a national survey conducted by the Parliamentary and Health Service Ombudsman found that 76 per cent of the UK population aged over 65 had used an NHS service in the past 12 months, of which 14 per cent indicated that they had been unhappy with something when using these services. However, of these older patients who encountered issues, only half went on to complain. With a growing

number of potential older patients who rely on health and care services, ensuring that there is complaints process in place that allows them to have their voice heard and encourages them to speak up could be vital to ensuring good quality of care.

lack awareness of complaints processes as they are directed to communication channels that are unfamiliar and not easily accessible to them. Only 17 per cent of people over the age of 75 found out about complaints services online, compared to an average of 26 per cent across all age groups. A participant at a focus group in Manchester said: “The problem is that when people have a problem they don’t know where to go; they are referred to a computer which they don’t have; they are referred to a library which is too far away to get to and they wouldn’t know what to do anyway.”

A rier key barting preven le from eop older p g with the engagints process is in compla y don’t know that the to make a how SUPPORT int Another factor that influenced compla

KNOWING HOW TO COMPLAIN One of the key barriers that is preventing older people from engaging with the complaints process is that they don’t know how to make a complaint or who they should be complaining to. The Parliamentary and Health Service Ombudsman found that one in 10 people over the age of 65 did not know where to go to complain about a public service such as the NHS, with 15 per cent replying that they would not know where to go if they were unhappy with how an organisation has dealt with a complaint. Furthermore, 18 per cent of over 75s said that they did not know where to go to make a complaint, with 26 per cent saying they would not know what to do if they were unhappy with how a complaint had been handled. A contributing factor to this is that complaints processes are increasingly being transferred to online services. An obvious limiting factor is that many people over the age of 65 are not as computer literate as younger generations, with only a third of over 75 year‑olds having access to internet at home. The survey found that many older people

older patients’ decisions to not complain was a lack of support. Over 3.5 million people over the age of 65 in the UK reportedly live alone, with 49 per cent of those over 75 living alone. Additionally, those over 75 are likely to live a more isolated life, with 11 per cent reporting to have no close friends at all, compared to two per cent of 18-24 year-olds. This absence of a support network can limit patients ability to raise concerns, due to a lack of confidence or a lack of communication skills due to their condition. The report highlights that many older people may require additional support and encouragement to make a complaint, as they are unlikely to take this step without the intervention of a family member, friend or advocacy group. The survey found that among those older people who have complained about the NHS over the past 12 months, only 28 per cent received additional support to make their complaint. Of those who had not complained about an issue they faced, 14 per cent indicated that they would lack confidence to do so. A consistent theme from focus groups was that bureaucratic hurdles deterred many older patients from complaining E



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PATIENT SAFETY AND BOARD GAMES Improving patient safety and staff training are inseparable. The changes needed to improve care delivery can often be relatively simple. But we must help staff to understand, accept and implement these changes PATIENT SAFETY AND BOARD GAMES Improving patient safety and staff training are inseparable. The changes needed to improve care delivery can often be relatively simple. Staff need knowledge, competency and confidence, to make changes and face-to-face discussions are the most effective way of making this happen. But group work can appear difficult or expensive so organisations may avoid it. But they don’t have to, because board games can make face-to-face engagement easy,

resources or to support other methods of training. Games are self-supporting, so no specialist facilitator is needed. SUPPORTING THE CARE CERTIFICATE WITH A BOARD GAME Group work is a key element of the Care Certificate and the CQC requires proof that it is being implemented. Employers and assessors need practical tools to deliver effective face-to-face learning with minimal disruption at a reasonable cost. Focus

and reflection. The board game is easy to play and delivers an interactive learning experience directly mapped to 8 key standards of the Care Certificate. Players discuss and reflect on questions and scenarios, learning from each other and sharing knowledge. The game is also a simple visual competency assessment tool that reflects levels of understanding around each standard. Success in the game is reflected on the board and directly maps levels of knowledge and understanding. Health Education England has reviewed and officially endorsed the game. “Health Education England has been working with external developers to identify the most effective tools to support employers. The Care Certificate Game has been selected as one of the resources that we endorse and that organisations might wish to acquire.” The Training Manager at the Oxfordshire Association of Care Providers commented: “I really like the game, it is simple and effective in a format everyone will understand...very effective as a summative assessment consolidate and observe learning while keeping energy levels up. Excellent.” WHY BOARD GAMES? Introducing people to new ideas and ways of thinking is exactly what the Care Certificate is designed to do. But changing behaviour isn’t easy. We believe that face-to-face collaborative discussions are the most powerful tools for persuading staff to think and work differently. However, this can seem complex, risky and expensive. But it doesn’t have to be. We’ve made face-to-face engagement easy, effective and affordable by using board games to stimulate discussion.

The Care Certificate Game is a practical group learning tool designed to stimulate discussions and reflection effective and affordable. A carefully designed game built around relevant issues can deliver a vast amount of information to between 2 and 14 players in a 45 - 60 minute session. Games can be used as standalone learning



Games Ltd have created a board game to help employers deliver Care Certificate group work easily and effectively. The Care Certificate Game is a practical tool designed to stimulate discussion

ABOUT FOCUS GAMES LTD We’ve been creating bespoke games for engagement, training and education since 2004. We’ve developed over 40 different board games that are being played by hundreds of thousands of people in hospitals, care homes, schools and universities across the world. L FURTHER INFORMATION Find out more at Twitter @FocusGames

COMPLAINTS  without additional help and that access to additional information, such as leaflets, could enable more older patients speak up and better understand the process. IMPACT ON TREATMENT The report also found that many older patients were deterred from complaining due to concerns that it could have an adverse affect on the way they are treated in the future. 56 per cent of patients over 65 who had experienced a problem and not complained cited concerns about the impact it would have on future treatment as a contributing factor. While a proportion feared about the negative impacts of making a complaint, the report also found that a large number felt that complaining would make little difference so would not be worth the hassle. Among those older patients who experienced problems and did not complain, 32 per cent felt that complaining would not make a difference. This was found true for patients even when a problem is having an ongoing impact on their quality of life. One patient speaking at a focus group in Poole spoke of a cataracts operation that went wrong and left her blind in one eye. The woman in question said that this had a big impact on her independence and ability to drive, but didn’t pursue complaining as she thought it would be too much hassle and she wouldn’t ‘get anything from it’.

IMPROVEMENTS The Parliamentary and Health Service Ombudsman concludes that organisations across health and social care are missing key opportunities to learn from what they are doing well and where improvements are needed, recommending that patients need to be proactively encouraged to give feedback and supported to raise concerns or complaints. A key part of improving this process is increased communication, with the report suggesting that every organisation working within the health and care sector should make every service user aware of how to complain and point them to support services that are available to help them make that complaint. Additionally, it recommends that patients must be reassured that their future care will not be compromised if they speak up. Creating a culture where it is OK to open up a dialogue about issues is important, so as not to alienate older people and leave them to suffer in silence. Older people often need additional support in order to complain, and the Ombudsman service recommends that increased targeted support and information for older people and they carers could be incredibly useful. It also directs organisations to use the ‘My expectations’ report on raising concerns and complaints, which offers advice on how to meet people’s expectations, as well as measure how effectively they are doing this and how

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the process of complaint handling could be improved. Commissioners of healthcare services are also directed to use ‘My expectations’ as a framework for determining how well organisations listen and respond to complaints. Moving into the future, the report promises that the Parliamentary and Health Service Ombudsman will continue its work to raise awareness of its service and offer targeting information to enable people to complain. Plans have recently been proposed for the Parliamentary and Health Service Ombudsman to merge with the Local Government Ombudsman, and the report suggests that this would help to reduce the complexity of the complaint system by streamlining the process for patients, especially those with complaints that straddle health and social care boundaries. L

‘Breaking Down Barriers: Older people and complaints about health care’ was originally published by the Parliamentary and Health Service Ombudsman in December 2015. The full report can be found here: ‘My expectations’ was originally published by the Local Government Ombudsman, the Parliamentary and Health Service Ombudsman and Healthwatch in November 2014. The full report can be found here: FURTHER INFORMATION

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The Nasal Alar SpO2 Sensor. Accurate long-term pulse oximetry monitoring with greater patient comfort, lower cost and application beyond the ICU FDA APPROVAL OF THE NASAL ALAR SPO2 SENSOR On 18 March 2015, Xhale Assurance, developer of the patented Assurance Nasal Alar SpO2TM Sensor, announced approval by the US Food and Drug Administration (FDA) and the global launch of its second‑generation pulse oximetry sensor 1,2. The new Xhale Assurance Nasal AlarSpO2TM Sensor is compatible with the majority of pulse oximetry monitors used in many different healthcare settings. Pentland Medical is now marketing this product as the Nasal Alar SpO2 Sensor3. OXYGEN SUPPLEMENTATION IN PATIENT TREATMENT There are acute and chronic medical conditions that are associated with hypoxia and where supplemental oxygen therapy is required. The acute medical conditions include attacks of asthma, pneumonia or respiratory distress syndrome (RDS). In premature babies, oxygen supplementation is given for the condition of bronchopulmonary dysplasia (BPD). The chronic conditions requiring oxygen supplementation include chronic obstructive pulmonary disease (COPD), heart failure and sleep apnoea. In the treatment of these conditions, oxygen is usually administered through a nasal continuous positive airway pressure (NCPAP) machine, a nasal tube or a ventilator. PULSE OXIMETRY IN THE EVALUATION OF BLOOD OXYGENATION It is important to monitor the requirements for and effects of oxygen supplementation as too much oxygen can be as harmful as too little. Pulse oximetry is a non‑invasive method used to measure the oxygen level (or oxygen saturation) in the blood of the peripheral tissues, usually using a sensor attached to the finger. The technology is based on detection of the light absorptive characteristics of oxygenated haemoglobin and the pulsating properties of the blood flow in the peripheral arteries and arterioles. With each heartbeat, there is a small increase in vascular volume, with an associated increase in oxygen-rich haemoglobin. The pulse oximeter consists of a clip-like sensor that houses a light source, a light detector, and a microprocessor. One side of



the sensor contains an infrared and a red light source which are transmitted through the tissues to the light detector on the other side. The oxygen-rich haemoglobin absorbs more of the infrared light; oxygen‑poor hemoglobin absorbs more of the red light. The microprocessor calculates these differences and converts the information to a digital readout of the amount of oxygen being carried in the blood. This information enables the attending physician or nurse to evaluate the need for supplemental oxygen. THE LIMITATIONS OF CURRENT TECHNOLOGY Standard pulse oximeters using sensors on the patient’s finger fail to work in a variety of common clinical conditions that lead to diminished blood flow to the digits, including patient shock (low blood pressure from a variety of causes), patient anxiety, peripheral

vascular disease (a disease of blood vessels outside the heart), the advanced age of the patient (the elderly tend to have less blood circulation), abnormally low patient body temperature (including hypothermia), swelling of the digits and the administration of many drugs that decrease peripheral blood flow. In addition, during surgery a patient’s hands are frequently covered or wrapped, providing limited access to the anesthesiologist. The digit placement of the oximetry sensor also often results in the sensors being dislodged, resulting in loss-of-signal alarms. USE AND ADVANTAGES OF THE NASAL ALAR SPO2 SENSOR The Nasal Alar SpO2 Sensor fits comfortably on the nasal ala that is lateral to the nostril (nares) and does not require any adhesive to keep it secure3. The Nasal Alar SpO2 Sensor can be easily removed and reapplied

There are acute and chronic medical conditions that are associated with hypoxia and where supplemental oxygen therapy is required. The acute medical conditions include attacks of asthma, pneumonia or respiratory distress syndrome (RDS)

References for use during the patient’s hospital stay3. The nasal ala is a highly vascular region that is fed anatomically by both the external and internal carotid arteries. This multi-directional arterial supply provides strong, reliable photoplethysmography signals that respond rapidly to changes in the patient’s arterial oxygen saturation. These signals can be lost when using sensors located on the finger (4). The nasal alar site has the following advantages: This site has no clinically significant sympathetic tone and, therefore, does not lose signal due to the patient being cold, anxious or stressed. This site is less affected when patients experience diminished peripheral perfusion, as in cardiovascular disease, hypovolemia or

smooth skin contacting surfaces. These smooth surfaces provide a high coefficient of friction, allowing the sensor to stay in place with minimal pressure, and without the use of adhesives. The light pressures allow for the use of a very flexible plastic clip with thin cross sections. It is very lightweight to further enhance patient comfort. CLINICAL EVALUATION OF THE NASAL ALAR SPO2 SENSOR Recent studies support the feasibility and accuracy of nasal alar pulse oximetry5. The many unique features of this nasal alar pulse oximetry sensor have encouraged clinical studies to evaluate its role beyond the operating

The nasal alar attachment site is easily accessed by an anaesthetist during surgery; the non-adhesive attachment makes the sensors easy to reposition following medications that cause vascular changes. The nasal alar site is less subject to signal distortion due to sensor interference from ambient light. The strong signal from this location provides consistent accuracy, even at very low oxygen saturations. The nasal alar site location makes the sensor less likely to be dislodged, which reduces alarms. The nasal alar attachment site is easily accessed by an anaesthetist during surgery; the non-adhesive attachment makes the sensors easy to reposition. NASAL CANNULA The Nasal Alar SpO2 Sensor will not interfere with nasal cannula and the oxygen supply will not affect the sensor’s ability to determine a reliable measurement. MASKS The flex cable from the sensor is paper thin and can pass under a mask without affecting the seal. If used with heated humidification through a mask, the sensor should be used for no longer than 24 hours and the site checked frequently. SENSOR WIRE MANAGEMENT The sensor wire is very thin and lightweight and will not pull on the sensor. It can be looped over the patient’s ear (like a nasal cannula) to keep it out of the way. The wire can be secured to the cheek with tape – this is recommended when the sensor wire is looped over the patient’s ear. COMFORT The sensor was designed paying specific attention to the applied pressure. The cushions encapsulating the optical components are molded in a soft, medical grade silicone with

theatre, in patients with acute, chronic or long-term medical conditions. In February 2015, the results of a usability and acceptance study for the use of the Nasal Alar SpO2 Sensor in a non-hospital setting, showed that 50 volunteer subjects were able to wear the sensor for seven days6. All 50 study participants reported that, when compared to wearing a finger pulse oximeter, the Nasal Alar SpO2 Sensor was more comfortable and interfered less with daily living activities6. Although the use of oximeter sensors at sites such as the finger and forehead have been associated with skin pressure complications, there are no reported complications from the use of the Nasal Alar SpO2 Sensor6,7. BENEFITS The benefits of the Nasal Alar SpO2 Sensor include reliable, consistent and accurate oxygen saturation measurement, that is unaffected by reduced peripheral perfusion. Sensitive and rapid detection of changes in oxygen saturation. Ease of access to the alar nasal sensor attachment site, even during surgery. Comfort when wearing the sensor for long periods of time, with no complications. The nasal alar location of the sensor resists monitoring fluctuations or signal distortion due to ambient light or motion. Cost savings, when compared to finger and forehead sensors. COST: NASAL ALAR SPO2 SENSOR The Nasal SpO2 sensor is designed for single patient use for up to 28 days. The sensor is low cost and can offer cost savings in longer term monitoring. Simply, check the sensor every eight hours and change sides every 24 hours.

(1) Xhale website: (Accessed June 18, 2015) (2) Press release: Xhale Assurance Announces FDA Approval of its Second Generation Nasal Alar SpO2 Sensor. March 18, 2015. (Accessed June 18, 2015)

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(3) Pentland Medical. Nasal Alar SpO2 Sensor product information. index.php/products/pulse-oximetrysensor/ (Accessed June 18, 2015) (4) Davis DP, Aguilar S, Sonnleitner C, Cohen M, Jennings M. Latency and loss of pulse oximetry signal with the use of digital probes during pre‑hospital rapid-sequence intubation. Prehosp Emerg Care 2011;15(1): pp18-22. http:// 10.3109/10903127.2010.514091 (Accessed June 18, 2015) (5) Morey TE, Rice MJ, Vasilopoulos T, Dennis DM, Melker RJ. Feasibility and accuracy of nasal alar pulse oximetry. Br J Anaesth 2014;112(6): pp1109-14. content/112/6/1109.long (Accessed June 18, 2015) (6) Melker, RJ, et al. Usability/ Acceptance Study Final Report Xhale Assurance Nasal Alar Sensor. February 2015. Unpublished data. On file, Xhale Assurance. (7) Lee M, Eisenkraft JB, Forehead pulse oximeter-associated pressure injury. A Case Rep. 2014 Jan 15;2(2):13-5. doi: 10.1097/ ACC.0b013e3182a66b29. (8) Pfuntner A, Wier LM, Steiner C. Costs for Hospital Stays in the United States, 2010. HCUP Statistical Brief #146. January 2013. Agency for Healthcare Research and Quality, Rockville, MD. reports/statbriefs/sb146.pdf. (Accessed June 18, 2015) In conclusion, these results indicate that the Nasal Alar SpO2 Sensor can be used comfortably, safely, effectively and at relatively low cost, not only in the operating room during anaesthesia or in intensive care, but also in a variety of situations within and outside the hospital. Alar will work when other sensors do not. L FURTHER INFORMATION



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Leadership at its best is a set of knowledge, skills, behaviour and experiences that can be developed, supported, improved and excelled in. But none of this happens by accident and good leaders know that they need to invest in themselves to do justice to the job they hold The focus of the NHS Leadership Academy is to ensure that leaders in all parts of the health and care system are properly supported and developed with the skills and knowledge to achieve the very best for patients whilst meeting the ambitions of the NHS. Our leadership development principles are simple and well proven - leaders need confidence in their role to be at their most effective. The competence, skills, expertise, experience and support to secure this confidence comes from expert development and training as well as on-the-job learning. Leaders also need the right behaviours to build alliances with a wide range of professionals and across organisational boundaries to serve diverse communities with complex needs. The Academy is committed to a more inclusive workplace and a more representative leadership community and we strive to support every leader to recognise inclusion as a key leadership responsibility and to develop in every leader the skills to deliver it. So the success of the NHS over the next decade or so will heavily rely on the behaviours of healthcare leaders at all levels and their ability to work across all sectors. Leadership is therefore a collective responsibility, with everyone accountable for the part they play in ultimately delivering better services to patients. The NHS needs all leaders, at all levels, united by a common purpose and collective endeavour, moving in the same direction. This is why the NHS Leadership Academy has developed a series of world-leading development programmes for leaders, wherever they are in health and care. TAKE THE NEXT STEP IN HEALTHCARE LEADERSHIP For those in mid-level leadership positions, the transition into a senior role can be a challenge. The Elizabeth Garrett Anderson programme aims to equip new or aspiring senior leaders with the confidence to drive lasting change to improve the patient experience. Anderson has been designed by a consortium of internationally renowned academic, healthcare and business experts, and with



direct input from patients too. It is fully accredited, leading to a Masters in Healthcare Leadership and an NHS Leadership Academy Award in Senior Healthcare Leadership. The focus of the programme is to increase resilience, so our participants

the most about it is the amount of work I could relate back to my practice. “I started my job as a Project Manager at the same time as I started Anderson and a lot of what I learnt related back to managing and leading teams. It taught

The success of the NHS over the next decade or so will heavily rely on the behaviours of healthcare leaders at all levels and their ability to work across all sectors. Leadership is therefore a collective responsibility, with everyone accountable for the part they play can meet the demands of working in high‑pressured healthcare environments. Kerry Fenton-Coopland, Patient Experience Project Manager says: “The Elizabeth Garrett Anderson programme taught me a lot about leadership and gave me the opportunity to develop. The thing that surprised me

me to look at innovative ways to project manage, think outside the box and encouraged me to put all the theories into practice. This programme made me reflect on the small things I could change to make big improvements in the system. “Anderson is very intensive, but you get so

much out of it and there is a lot of learning. You get a lot of links with people from different hospitals – along with enthusiasm support and ideas to move forward. Ultimately Anderson encouraged me to think that the end result of anything I am working on should be improvement to patient care.” Dr Shubhra Singh, Clinical Consultant for Older People, Bradford District Care NHS Foundation Trust, says: “The Elizabeth Garrett Anderson programme was one of the best courses I’ve done. It didn’t feel like a solo enterprise. It felt like a journey that was supported by many others in similar positions. At those times when you have your head in your hands over an issue or a problem, you know you can pick up the phone to someone else. Participants were encouraged to interact and to communicate in so many different ways. The programme made me and my fellow participants believe that together, we can achieve so much more for the NHS. “I am now a more resilient leader who can identify issues, see problems from different viewpoints and offer solutions to my organisation. My starting point is always: what’s right for the patient?” Anderson provides the skills and capabilities for leaders from all backgrounds, clinical and non-clinical, to create a more capable and compassionate healthcare system. It is created to holistically develop the knowledge, skills, expertise, attitudes and behaviours to support each participant in leading teams to create tangible and positive performance improvement at the front line. Applications are now open for the June/July intake. For more information please visit our website. The details of which can be found at the end of this article. EMPOWERING TODAY’S LEADERS FOR TOMORROW’S LEADERSHIP Aimed at developing the best executive leaders, the Nye Bevan programme increases an individual’s progression into executive roles. It helps them perform better at board level, and therefore supports boards to

that differentiate executive performance at board level, holding their peers to account for their impact as leaders, and making pass or fail decisions on each other’s work. Cath Randall, Head of Commissioning/ Deputy Chief Nurse says: “My experience of the Nye Bevan programme and the NHS Leadership Academy has been evolving over a period of time. It has changed my life as a leader. “I was frustrated in my current position because I wanted to do a lot more and learn a lot more. I needed that understanding of where I needed to go as a leader and the Nye Bevan Programme gave me that.

the £100bn spent by the health service. With a background in private sector consultancy, I was beginning to question whether I wanted to continue working in the sector. The programme completely re‑energised and focused me on the privilege and value of working for the NHS. The challenge and support I got from my peers on the programme gave it a value that has lasted well beyond the graduation process. I have a genuine desire, each day to do everything I can to improve patient care.” Shahana Ramsden, Senior Co‑production Lead, NHS England says: “I completed the programme in spring 2015 – a tough

Suddenly I had a voice and I wanted other people to hear my voice. This has had a real impact on the team I lead and the patients within the organisation.” If you are looking at the Nye Bevan Programme, please go for it! It’s one of the best things I’ve ever done. It’s a hard journey; you turn yourself inside out, upside down and then out yourself back together again. You will change as a result of doing Bevan. Within the last eight weeks I have been successful in gaining a position as a Chief Nurse!” Nye Bevan reflects and explores the level of working needed at board level to promote safe, high-performing, and continuously improving organisations. It fosters the leadership skills essential to enabling the kind of radical service

but rewarding experience. Through the programme I developed personal resilience and realised that I can make decisions under pressure. I was reminded that when it comes to leading in the NHS, it’s not about ‘them and us’ or working in silos. “It’s about understanding the whole picture and ensuring equal relationships across the whole system to get the best results. We’ve got to work collaboratively and maintain our focus on patient outcomes. Bevan also gave me a global perspective as we had the opportunity to step back from our own organisations and explore and discuss what was happening in a global context.” Applications are open for Nye Bevan programme, for more information please visit our website. The details of which can be found at the end of this article. The NHS Leadership Academy operates at every level of leadership so that at any point in a leader’s career, there’s an appropriate offer of support and expertise. Up to the end of March this year, over 35,000 colleagues had registered on our programmes. The Academy also offers other tools, models and bespoke support packages to guide and help individuals, teams and organisations to develop leaders, celebrating and sharing where outstanding leadership makes a real difference. L

Nye Bevan reflects and explores the level of working needed at board level to promote safe, high-performing, and continuously improving organisations meet short-term operational challenges while driving long-term change. Designed with national and international experts in health and organisational performance, this unique one-year programme offers support and learning to build personal resilience, confidence and capability. Participants submit evidence to each other, practising the kind of behaviours

redesign our health service needs. Chris Knight, Head of Programme Management Office, NHS England says: “I finished the Nye Bevan programme last year. I was working for Sheffield Teaching Hospitals and by the time I graduated, I was at NHS England in a role with responsibilities for provision and analysis of data that informed commissioning of

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FURTHER INFORMATION For more information and to download our 2016 programme guide please visit:



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DILIGENT BOARDS HAS YOU COVERED WHERE IT MATTERS MOST Security, Efficiency, Engagement, Support: Achieving a Paperless NHS Jeremy Hunt’s challenge to the NHS to be paperless by 2018 has led to a shift in thinking, with internal processes as well as patient records being digitised. Achieving a paperless NHS takes real organisational change. It starts from the top: senior-level internal processes and business structures can be enhanced and improved by a digital approach, moving away from long-held paper-based systems. It just isn’t feasible to deliver public-facing services digitally, and still retain old systems internally. Every NHS trust board meeting requires packs of information to be prepared, distributed and reviewed in advance. Traditionally, this has been a paper-heavy process, both time-consuming and costly, when the NHS is trying to reduce both its budget and its carbon footprint. In line with government digital strategy, innovation has come in the form of board portals: secure technology

healthcare providers. And unlike paper board books, which can easily fall into the wrong hands, the Diligent Boards solution puts your network in control of who sees what and when. And emailing PDFs also has security issues – someone could hack into your email program and get access to your private data. Fortunately, you can rely on Diligent to deliver stringent security at all levels, including data storage on our own secure servers located in Germany, world-class data encryption, two-factor authentication, ISO 27001 Certification, and full security auditing and testing. EXCEPTIONAL EFFICIENCY Digital board and trustee meeting materials take significantly less time to produce and send than paper. That gives your board members and trustees more time to spend with the material, helping

“Our expert support team is committed to providing personalised service to make sure your board’s transition to Diligent Boards is as smooth as possible.” that enables the compilation and distribution of board-level information to NHS trustees, directors and senior management teams. A board portal can help improve governance and all senior-level communications across the organisation. It reduces staff and IT resources needed to prepare previously paper-based board documentation and delivers significant savings in terms of paper, couriers and postage. Diligent Boards is the most widely used of these portals, working with over 100,000 directors, leaders and administrators worldwide, including 40 of the FTSE 100 and over one-third of the Fortune 1000. And although we serve many large enterprise organisations, many notfor-profits and government entities also appreciate our simple functionality, worldclass security and around-the-clock support. AIRTIGHT SECURITY Because of the sensitive nature of medical data, security is of paramount importance to



them make better-informed decisions and be more effective leaders. And the intuitive interface – it’s just like reading a book – makes it simple for your board members and trustees to work with the material right away. PDFs, on the other hand, are difficult to navigate. DEEPER ENGAGEMENT The healthcare industry is under pressure to comply with a multitude of unique regulations and challenges. By giving board members and trustees instant, secure access to the most critical governance materials, the Diligent Boards solution can help them make more informed decisions. ROUND-THE-CLOCK SUPPORT Our expert support team is committed to providing personalised service to make sure your board’s transition to Diligent Boards is as smooth as possible. Whether your board needs to access information at 9am,

9pm or even 3am, they’ll have the peace of mind of knowing our support team will always be available to help them with any issues, wherever they are. Here’s what other healthcare providers are saying about Diligent Boards: “The main drivers for going digital were cost and efficiency. Before using Diligent Boards, we used paper copies for our board packs but this involved a considerable amount of administration. We want to be seen as an organisation that embraces new technology to deliver an efficient service.’’ — Aneurin Bevan University Health Board. “It’s more than a tool. Diligent Boards is part of doing business effectively.” — David McCleskey, chairman of the Board, Gwinnett Medical Center. “We selected Diligent because the product was easy to use and on the iPad looked and functioned much like a paper-produced product, which made member acceptance very easy. When the information is produced in an electronic format, it will enable us to edit our materials and push them to the members much more easily and in a timely fashion. It will also save the administrative staff the time and effort.” — Darryl Duncan, president and CEO, Mon Health Systems. L FUTHER INFORMATION For more information or to request a demo, contact us today: Call: +44 (0) 20 7605 7480 Email: Visit:

Document Management


Is the NHS reaching the peak of its data mountain? Health Business investigates how successful the NHS has been amid the growing volumes of content and the ongoing push for paperless hospital environments The technological age that is raging through healthcare is changing many things, but one thing that remains a constant is that patients depend on correct medical records to get the right treatment and that clinicians rely on them to provide it. Health Secretary Jeremy Hunt has claimed over and over again that a fully paperless NHS would save billions and increase efficiency, setting a target of 2018

they are held, so there is as complete a record as possible of the care someone receives, and for those records to be able to follow individuals, with their consent, to any part of the NHS or social care system, and that by April 2018, digital information to be fully available across NHS and social care services, barring any individual opt outs.

The idea of a ‘paperless’ NHS was first introduced by Health Secretary Jeremy Hunt in a speech at the Policy Exchange in 2013, planning for all patients to have read/write access to their own records by 2018 to have a paperless health system. But, as we settle into 2016, the question remains – are we any nearer to a paperless NHS? The idea of a ‘paperless’ NHS was first introduced by Health Secretary Jeremy Hunt in a speech at the Policy Exchange in 2013, planning for all patients to have read/write access to their own records by 2018. In that speech, he stated that everyone will be able to get online access to their own health records held by their GP by March 2015, the heavy adoption of paperless referrals, clear plans to enable secure linking of these electronic health and care records wherever

GROWING CONFIDENCE While full adoption is still a way off, a belief that it is possible is growing. Last year, the Digital Health Intelligence NHS IT Leadership Survey surveyed members of the Health CIO Network and CCIO Leaders Network and in November printed their results, claiming that 67 per cent of respondents were ‘quite confident’ or ‘extremely confident’ that the NHS could significantly reduce paper and reach paperless targets by 2020. Only 14 per cent said they were ‘not at all confident’ or ‘not very confident’ of achieving the target. Furthermore, 28 per cent said they

were confident that patients would have this read/write access to their records, with 53 per cent saying they were not confident. Since Hunt’s declaration much has been done to integrate digital care records. The ‘Safer Hospitals Safer Wards’ fund, with the key priority of enabling information flow across care settings was created, and was shortly renamed the Integrated Digital Care Fund. DIGITAL ROADMAPS Talking to visitors at the 2015 InterSystems connected-healthcare conference, Inderjit Singh, head of enterprise architecture at NHS England, said: “On one hand we talk about the ability for patients to be able to access the information online, but on the other hand we still have discharges being sent through the post in a significant number of organisations. “We talk about technology as an enabler, but we need to move beyond that and really translate what this means for key clinical pathways and key focus areas the healthcare service is looking at.” One of the reasons why NHS trusts are struggling in the paperless quest, and still having ‘discharges sent through the post’ is the vast number of records that need digitising and the overwhelming cost associated in doing so. Singh suggests that every local area would be required to create an annual digital roadmap outlining how they plan to achieve paper-free status through an open interface which should be underpinned by key standards. E



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PAPERLESS NHS  At the NHS Innovation Expo, a dedicated Digital Zone showcased how new technologies are supporting commissioners and providers in achieving local digital roadmaps and learned about how digital innovations are transforming health and care services for patients. Speaking before the Expo, Tim Kelsey, who views 2020 as the time when paper should be absent from patient records, said: “The NHS in England must end the unnecessary reliance on paper in the treatment of patients. It’s key to making services safer, more effective and more efficient. “As well as saving precious resources, technology can dramatically reduce errors. Urgent action is a moral imperative where paper is the currency of clinical practice.” TOP OF THE MOUNTAIN With 2018 only two years away, Jeremy Hunt’s aims seem more and more ambitious. However, Kelsey’s determination to be document-lite by 2020 seems more likely. The Pharmacy Informatics Forum

highlighted the speed at which electronic prescribing is growing within UK hospitals. Figures shared at the show revealed that 13 per cent of UK hospitals have a fully implemented electronic

“As well as saving precious resources, technology can dramatically reduce errors. Urgent action is a moral imperative where paper is the currency of clinical practice”

Document Management


prescribing and medicines administration (EPMA) system and 50 per cent are in the process of implementation. Implementation is set to grow with the aid of The Integrated Digital Care Fund and with a determination to see savings made, perhaps 2016 will be the year that the paperless dream becomes more realistic. L FURTHER INFORMATION system/uploads/attachment_data/ file/384650/NIB_Report.pdf



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The transformation to digital healthcare in the NHS is well underway. Using technology to improve healthcare delivery and patient care has been a hot topic over the last few years

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Technology is not just making its presence felt in operating theatres and hospital wards – NHS trusts and PCTS are quickly becoming aware that being able to access, store and share patient records is as crucial to improving patient care as the latest breakthroughs in medical science. THE NEED FOR EFFECTIVE INFORMATION MANAGEMENT The need for an efficient and effective information management system manifests itself across all levels of modern healthcare provision. It encompasses everything from consultants and surgeons accessing x-rays and scans from workstations across a hospital complex, ending the need for cumbersome transfer of paper records from site to another, with the incumbent risk of them being misplaced or lost or misused; to administration staff using systems that help automate selected processes, saving time and money. HOW REALISTIC? Add a dose of security and audit, and suddenly, the prospect of a system that mandates governance and eliminates un‑scrutinised misuse, becomes quite real. This has been achieved in some NHS Trusts

to digital healthcare – it is about managing that transformation. Actually, its all to do with very careful application of the available technology, to solve defined problems and then build on that success to tackle other problems, but at your pace.

Paperless healthcare is not a dream – it is real, has been done in the NHS – and, not just once – it does deliver real and measurable benefits. There is plenty of evidence from sites where paperlite, if not paperless healthcare has been achieved over the last five to six years who took the bold step to deliver change some years ago and are now leading the way forward including lessons learnt. THE KEY POINTS Two key points must be emphasised: First, paperless healthcare is not a dream – it is real, has been done in the NHS – and, not just once – it does deliver real and measurable benefits. EVIDENCE OF BEING PAPERLESS HAS BEEN ACHIEVED There is plenty of evidence from sites where paperlite, if not paperless healthcare has been achieved over the last five to six years – there is a good and positive track record for all to see and learn from – in other words, it is eminently do-able, and doing nothing is an expensive option. Second, the focus is not technology, or at least, technology plays a small but important part in meeting the enormous challenges imposed by transformation

THE KEY MESSAGE TO SOLVE PAPER PROBLEMS The key message is that careful application of established technologies is delivering measurable improvements and benefits. These must be applied to address strategic requirements, rather than as a short-term measure to solve paper problems. The technology is not rocket‑science, but has evolved gradually as customer demands, interoperability, and web accessibility have evolved. To ensure successful transformation to digital healthcare, such lessons must be embraced. ABOUT CCUBE SOLUTIONS Designed and built with NHS practitioners using Microsoft’s latest .NET technologies, CCube’s award-winning solutions deliver electronic health records to clinicians, secretaries and administrators in the format they require, when and where they are needed. CCube is already delivering measurable

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benefits to over 25 NHS trusts, helping to deliver paperless healthcare within 20 months. EDRM PRODUCTS CCube’s suite of Electronic Document & Records Management (EDRM) products includes the following modules which can be tailored to suit your needs and expanded from departmental to hospital and trust-wide solutions EDRM: scans, stores and views patient notes. Forms Recognition and indexing: automatically recognises, indexes, and presents the digital health record. Connect: pulls in patient data from third party systems as it is created. eForms: allows clinicians to enter structured data in real-time. Workflow: configured to support standard operational processes. Portal & Web API: allows CCube to be integrated with third party applications. Mobile: access to patient data and data entry using mobile tablet devices. With Workflow and Electronic Forms, the solutions are designed to automate defined processes without any dependency on paper. The Dot-Net technologies supports use of mobile tablet devices for access and for data entry. Solutions are supplied at two levels: Workgroup (departmental level for scanning, storage, management and access of patient records) and Enterprise: (rust-wide paperless healthcare, typically in under two years). Developed with the NHS and utilising an open, client/server architecture, the CCube suite is customisable, fast to deploy, easy to integrate, scalable, standards-based, feature rich and compliant with current legislation and data protection rules. The system supports full security controls, document retention and disposal, and comprehensive auditing. L



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ACHIEVING PAPERLESS HEALTHCARE Health Secretary Jeremy Hunt wants the NHS to be paperless by 2018. He said going paperless would ‘save billions’. In a directive issued in January 2013, Hunt desired patients to have digital records so that their information can follow them. But unlike previous large scale, top-down directives, he wants this driven bottom up and by 2018 any crucial health information should be available to staff at the touch of a button Most NHS sites hold patient related data on a variety of different media, for example, paper, microfilm and digital. It is currently very difficult to identify exactly what information may be held on a given patient. PAPER RECORD PROBLEMS This has resulted in falling standards for maintaining the patient’s acute medical record; increasing risk and leaving patients and clinicians at a disadvantage. Furthermore, there are many well-known issues related to paper-based delivery of care, such as: the physical handling and transport of paper records; lack of audit on who looked at any record; only one person can see a record at any time; cannot

easily share records without copying lost records; and escalating costs associated with handling physical records. Yet, health and IT professionals remain deeply sceptical that the NHS can be paperless by 2018 – a large percentage of healthcare professionals engaged in this work feel that

The electronic medical record cannot sit in a document management system that remains un-connected with other hospital systems and processes – information must be exchangeable and shareable amongst all practioners paperless by 2018 goal is ‘a great ambition, but unrealistic’. A recent survey (The Struggles of Going Paperless, August 2015), completed by 877 people - including healthcare leaders, clinicians and IT professionals – showed that more than 73 per cent identified operational areas that could benefit from going digital. The key concerns expressed included: IT Compatibility – lack of interoperable systems, and cost of replacing legacy systems costs, timescales, technology, and cultural changes, insufficient information about the potential benefits from improved IT systems However, on a more positive note, the majority expressed a need to improve their understanding of the key issues and learn from other organisations who have successfully used IT to achieve paperlite healthcare if not paperless healthcare. A number of Trusts took the bold step towards paperless healthcare some years ago. These Trusts achieved paper lite health care using Electronic Document and Records Management (EDRM) technologies – not by simply installing IT, but by paying great attention to the underlying processes. Cost effective solutions based on established EDRM technologies offer the chance for Trusts to embrace a culture of compliant information management practice to deliver paper lite health care if not paper less! There is no magic bullet solution – just a common sense approach which focuses



the available technologies on specific processes to ensure that the solution delivers what is expected of it. The process is a migratory one which promotes a trust-wide information repository with newly created clinical documents being ‘born’ onto the repository whilst ‘legacy’ information is

scanned and digitised in a staged manner. The core technology has been around for over 35 years, and is in use across many industry sectors. Lessons have been learnt through careful application of EDRM technologies. The returns from investments in EDRM are being realised through careful application of this technology to address the needs of key users who deliver medical care. Key users include clinicians, secretaries, administrators, etc. Each places specific demands on the medical record, and each of these demands must be addressed Systems have become more affordable and are delivering real and measurable benefits. KEY POINTS TO KEEP IN MIND It is vital to understand that simply digitising paper records is not enough – the solution must offer facilities to stop producing new paper through generation, management, and integration of electronic records. This includes catering for specific issues related to ‘living document’ - ie. documents are live and updated over long time spans, such as paediatric growth charts – simply digitising such paper charts is not viable. Interoperability - Patient information resides on many disparate systems within trusts. The electronic medical record cannot sit in a document management system that remains un-connected with other hospital systems and processes – information must

be exchangeable and shareable amongst all practioners. There is substantial legacy information in many institutions which is not automatically interoperable. Something has to be done to it to make it interoperable. Delivery – to be optimally effective the electronic record has to be delivered to key users when and where they need it. A solution which offers a standard interface for all users will provide limited functionality to most users. So, what have the pioneers achieved? Process Efficiencies - savings gained through process efficiencies achieved by minimising dependencies on paper, by delivering the electronic patient record to those who provide care, at the right time, every time, and by guaranteeing the accuracy and quality of information delivered. St Helens and Knowsley NHS Trust already has all of its patient records accessible online for doctors, nurses, GPs, and community services Real Estate - savings gained through realisation of real estate to provide more treatment facilities and better quality of care. The recently launched e-LGs managed service (digitisation of Lloyd George) is a great example of how a very ‘low-tech’ service is helping GP practices to release much needed space in the surgery for clinical activities without breaking the bank. Access and Control - digitising patient records makes it easier to control access and sharing. The Hunt directive of ‘information following the patient’ is both practical and readily manageable. Innovation – one step leads to the next – innovation is within reach instead of being unreachable. Advances in IT and the consumerisation of IT mean that rapid progress towards the wider digital revolution can be made within the NHS IT, to help deliver timely and accurate information. Use of electronic forms, for example, to capture, store, manage, and deliver information electronically. Similarly, the vast amount of information locked in paper records is now being transformed into actionable data – systems that can understand content and deliver it to those who need it, when and where they need it. These are no longer predictions. There is a real track record now, a record that has been established over the last five years, accompanied by real data which is accessible and should be used to learn from. This track record makes the case for going digital compelling. So, the question is: why isn’t everyone doing it? Given the bad press about large scale IT implementations, two valuable lessons must be learnt: not all trusts are ready for the top end solutions – each must accommodate the technology and its implementation gradually to suit a number of local conditions including budgets, IT infrastructure, user training, etc.; a core application cannot be driven top-down without involving the people who will actually use it and

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It is vital to understand that simply digitising paper records is not enough – the solution must offer facilities to stop producing new paper through generation, management, and integration of electronic records who will be held accountable. While it is good to see that the Hunt directive is accompanied by a financial commitment, each trust must make its on case for improvement and demonstrate willingness to change. Each trust has to fight for money for this because there are so many competing demands. Some of the lack of confidence in the NHS to achieve the flagship 2018 target may well

be due to a fear that a large chunk of the technology fund has already been raided to finance support for hospitals struggling with their accident and emergency demand. Simply throwing money at a problem will lead to yet another IT failure. The bottom-up approach means that the digital revolution in the NHS is achievable – gradually and over time rather than committing astronomical sums on large scale IT projects. L



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Milton Keynes Hospital already saves over £1 million by installing CCube Solutions’ EDRM software and digitising its entire patient records library Occupying a 60-hectare site to the south of the city, Milton Keynes Hospital is a medium sized district general hospital that serves Milton Keynes and surrounding areas, providing a range of general medical and surgical services including accident and emergency (A&E). Employing around 3,000 staff, the hospital has approximately 400 inpatient beds and treats 200,000 outpatient episodes per annum, 20,000 elective patients, as well as handling 70,000 A & E visits. Milton Keynes Hospital was built about 25 years ago and is now short of space. It is unable to accommodate the number of paper patient files, especially given that some records have to be kept 25 years after a person’s death. 24 HOURS A DAY The hospital wanted to make the notes available 24 hours a day, 365 days a year and ensure multiple clinicians would be able to access them. This is because care is often provided by multidisciplinary teams, or patients may have appointments close to each other and getting the notes from one place to another in time is difficult. Furthermore, by moving to electronic notes, the quality of the record can be improved. This is because paper records degrade, get damaged, ink fades, carbon copies become difficult to read and the contents can fall out of a file. By scanning, a crisp, clear document is created which will last in perpetuity. Milton Keynes Hospital NHS Foundation Trust has invested over £2 million to digitise its entire patient records library totalling 287,000 files – each containing an average of 200 images. It has deployed CCube Solutions’ electronic document and records management (EDRM) software to improve the quality and accessibility of outpatient notes for clinicians. It also releases space, saves money and puts in place technology to support the hospital in the future which is especially important as the NHS is challenged by the Health Secretary to become paperless. The heavy workload of back scanning the records library was completed by an external contractor. Milton Keynes Hospital now digitises paperwork, having created its own internal scanning bureau. Production scanners are used in this process given their ability to guarantee image quality and cope with high paper volumes. Since the electronic document and records management (EDRM)



project went live in all outpatient clinics four years ago, it has delivered a cumulative £1 million saving against previous levels of spend, and continues to deliver recurrent cost savings as outlined in its original business case. The trust has reduced the number

is stored in the EDRM system along with colour photographs, ECGs, CTGs and reports. The system is intuitive and easy to use which has enhanced clinical acceptance of it. This helped to significantly reduce training time. The digital record features a series of

Since the electronic document and records management (EDRM) project went live in all outpatient clinics four years ago, it has delivered a cumulative £1 million saving against previous levels of spend, and continues to deliver recurrent cost savings of medical records staff by over a third. In addition, it has made other administrative processes far more efficient and repurposed the use of parts of its library building. SCAN ON DEMAND APPROACH A scan-on-demand approach was adopted for people coming into outpatient clinics with inactive files cleared at the same time. In other words, Milton Keynes Hospital is scanning everything. The hospital never had an issue where notes were unavailable because they were being scanned. Further to input from clinicians, CCube Solutions created an electronic version of the medical record to mirror the format of the paper notes. All clinical correspondence

tabs similar to the paper file, along with a variety of sub sections to help navigation. A ‘big bang’ approach was adopted and all specialities in outpatients went live at the same time. There was some dual operation with both paper and electronic notes as it took nine months for the back scanning to be completed. This approach was taken to avoid processes being disjointed - some departments using paper others electronic – as it was felt that this might increase clinical risk. The EDRM solution is accessed throughout the hospital in all clinics, wards, offices, operating theatres, on wheeled trolleys and tablets. All authorised staff have access to it once training has been given. L



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Papworth Hospital NHS Foundation Trust. Back to the future: electronic medical records system caters for new patient pathways not legacy case notes scanning Papworth Hospital is the UK’s largest specialist cardiothoracic hospital and the country’s main heart and lung transplant centre. It treats over 22,800 inpatient and day cases each year along with 65,000 outpatients. A tertiary trust with most referrals coming from other hospitals, Papworth employs 1,628 staff and has 276 beds split across a dozen wards and units. Further to HM Treasury approval in May 2014, Papworth Hospital has been authorised to build a new state-of-the-art £165 million hospital on the Cambridge Bio Medical campus. The campus brings together key NHS hospitals with commercial companies doing innovative medical research and drug development. The new hospital will have 310 single room beds. Construction will start early next year with the project expected to be complete by late 2017. ELECTRONIC MEDICAL RECORD SYSTEMS Papworth Hospital has installed the CCube EDRM, Workflow, and eForms solution to create an electronic medical records system (eMR) focused on improving how current patient referral paperwork and medical notes are indexed, routed and shared among clinicians and clerical staff. This will boost efficiency, reduce costs and ultimately enhance patient care. eMR provides a different approach to enable Papworth to manage patient records at its own pace. The plans for the new hospital do not allow for a paper records library on site hence the need to

improve how patient referral paperwork and medical notes are indexed, shared and information routed to boost efficiency, reduce costs and enhance patient care. The eMR is also the portal access to other hospital applications like the PAS and pathology solution without consultants having to change systems. In other words, there is a single sign on which gives staff access to various data bases including: transplant, pulmonary hyper tension, sleep centre and oncology databases. Papworth has integrated its new digital dictation system (DDS) with eMR replacing an old analogue solution as below: voice files are uploaded into the DDS from various portable digital devices and then into the eMR;

It is a hugely important solution which is improving the speed of the whole letter drafting process, allowing managers to organize their staff workload better, and routing work to people as necessary address how patient notes are managed. In addition, given most referrals come from other hospitals in the form of paper letters, a better system to handle this was required. Unlike many other trusts who have digitized patients records, eMR is not concerned with scanning legacy records. Papworth is concentrating on the patient’s pathway from the moment an individual is referred to the hospital. The eMR will

secretaries can then listen and type letters within the system. It is a hugely important solution which is improving the speed of the whole letter drafting process, allowing managers to organize their staff workload better, and routing work to people as necessary. Papworth is also introducing an eForms solution for nurses to replace their nurse cards which will then be visible in the patient record. Currently nurses duplicate what is in

the patient file by writing their own patient cards. An electronic form will be prepopulated with information with updates then made by nurse themselves directly imported back into the eMR. Papworth has addressed the beginning of the patient’s journey within the hospital. It hasn’t worked back like other trusts and focused on scanning legacy records. ELECTRONIC DATA FIGURES Papworth is hoping that by greatly reducing the amount of paper produced at the outset, it won’t have to do back scanning given the cost and complexity of doing so – this makes a lot of sense as over 70 per cent of new patient information is generated electronically. From a patient’s perspective, Papworth wants to work electronically from the beginning of patient engagements to realise clinical efficiency, enhance productivity, save money and provide faster and joined up services to patients. This is inline with the government’s QIPP agenda and the drive for trusts to be paperless by 2018. To date, 850 staff have been trained and registered to use eMR including around 120 consultants. Training has been based on job role with two super users providing instruction. Consultants have all had one to one guidance. In terms of roll out, eMR went live two years ago in all seven main hospital specialties including: cardiology, respiratory medicine, cardiac surgery, thoracic surgery, transplants, respiratory physiology and oncology. L FURTHER INFORMATION



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WHAT PAPER? Aneurin Bevan University Health Board successfully introduces new electronic growth chart solution to monitor the development of children in South Wales Aneurin Bevan University Health Board provides acute, community, mental and child health services from five sites for 693,000 people in South Wales, approximately 21% of the total Welsh population. In October 2012, it was the first health board in NHS Wales to procure an electronic document and records management system (EDRMS) from CCube Solutions installed and operational by May 2013. Given the wholesale move to electronic patient records, Aneurin Bevin University Health Board required a way of managing children’s growth records within its health economy for two key reasons: They were the last paper documents in use and had to be circulated individually around the organisation – in some sense, negating the value of installing a computer-based medical records system; They are dynamic “active” documents which change constantly and therefore printing out individual graphs, literally adding a dot(s), scanning and then storing the chart again in the EDRMS was not practical given the time and the impact on readability, especially as these sheets have to be kept up until a child is 18 years old. Using a spreadsheet to log height, weight and head measurement data was also considered cumbersome. GROWTH RECORDS AND CHARTS FOR CHILDREN Growth records are absolutely essential in the assessment of every child. Chronic diseases impact growth and therefore deviation from expected norms in effect act as an early warning signal that something is wrong and medical investigation is required. For parents or guardians, growth chart data is also recorded in their child health record which is their personal log

of their child’s health and development, separate from GP or hospital records. Dr. Tom Williams, consultant pediatrician (retired) and clinical lead on the electronic growth records project, says ”I’ve been involved in NHS IT for many years. This is not just about digitizing a process. IT must supplant existing activities but over this improve them which is what we are doing with our electronic growth charts application.” Traditionally, charts for children aged 0 to 2 and 2 to 18 years old have been

Bevan University Health Board are not issued with paper charts anymore. The system is currently used in the context of children presenting to hospital with an illness not all children within the region. Within nine months of ‘go live’, growth data is available for 11,000 children. HOW IT IS DIFFERENT The application is unique for the following reasons: The first end-to-end system allowing a distributed group of users to

Growth records are absolutely essential in the assessment of every child. Chronic diseases impact growth and therefore deviation from expected norms in effect act as an early warning signal that something is wrong and medical investigation is required produced nationally. As part of the project, Aneurin Bevan University Health Board broadened this to add a third chart which documents growth from 0 to 4 years old. This adds more granular detail of development. The display of charts has also been designed such that both height and weight can be displayed on the same screen which contrasts with competitive systems where charts are shown in isolation. Once a child becomes an adult, the growth chart can be output as a locked PDF and stored in the EDRMS, integrated with other records for that patient. A pilot was started in June 2014 with the system now fully implemented and in widespread use. Children visiting Aneurin

record and view children’s growth chart data via the Clinical Work Station portal; The first system to allow data to be easily and openly shared given it is held in a non-proprietary format (Microsoft SQL Server). This means processes can be put in place to make data ‘actionable’ to drive other systems or share it with other databases. This could include GP systems, eRed Book solutions, national growth chart databases, as well as third party best of breed analytical software for reporting. EFFECTIVE MANAGEMENT The effective management of children’s growth charts is an absolute requirement for every NHS organisation introducing electronic medical records systems. The NHS is often much maligned for how IT projects are procured and delivered. In contrast, CCube Solutions and Aneurin Bevan University Health Board have worked hard and interactively to develop and implement a cost effective, easy to use system which has the support and buy-in of clinicians who now use it day to day, such that the introduction of an electronic growth chart has totally replaced paper within the organisation. L FURTHER INFORMATION 01908 677752



Health & business 1 04/12/2015 – 13:28 BUSINESS INFORMATION FORmagazine.pdf HEALTHCARE PROFESSIONALS




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Health Business Awards


Rewarding success in our healthcare A number of hospitals and trusts across the country received an early Christmas present last December: a Health Business Award. With Christmas now a nearly forgotten memory, Health Business looks back at the winners and celebrates their success St Pauls’ Grange Hotel played host to the per year in funding. The 2015 winner was seventh annual Health Business Awards on East Anglian Air Ambulance. Air Ambulance the 3 December 2015. The event, sponsored Services across the country play a vital role and by CCube Solutions, was hosted by Dr work tirelessly every day to save lives in Mark Porter – GP and medical dangerous situations. This year’s The correspondent at The Times, winning service established a s d r doctor on The One Show working group in 2014 that a w HB A ate and presenter of Radio developed a consistent 4’s flagship medical communications strategy celebr cant ifi n series Inside Health. to build awareness g i s e e d th a m NHS Foundation Trusts, of critical care. Those s n tio Clinical Commissioning ontribu isations and commended included the c n Groups, Collaborates, Midlands Air Ambulance by orga iduals that Partnerships, and Air Charity, Cornwall Air indiv side and Ambulance Services Ambulance, and Essex joined together to & Herts Air Ambulance. work in gside celebrate the very alon S best within the NHS. ESTATES AND FACILITIES the NH INNOVATION AWARD AIR AMBULANCE SERVICE AWARD Sponsored by Swallow Evacuation Sponsored by MD Helicopters, this award & Mobility Products, the Estates and recognises the hard work and dedication of the Facilities Innovation Award recognises Air Ambulance sector, which operates as 18 NHS and other healthcare organisations separate charities that raise over £35 million that have developed innovative procedures

for managing and maintaining healthcare facilities. In the Autumn last year, this years winner began accepting suspected Ebola patients. With its private sector partner, the team at Heart of England NHS Foundation Trust developed a plan which, during patient transfer, ensured privacy and dignity was maintained, whilst safeguarding staff, patients and visitors. The two other contenders for 2015 were North Bristol NHS Trust and Royal United Hospitals Bath Foundation Trust. ENVIRONMENTAL PRACTICE AWARD This award will recognise the individual NHS project (smarter use of energy, transport, waste management etc.) that has furthered the progress of environmental practice in the NHS. This years’ winning trust, Guy’s and St Thomas’ NHS Foundation Trust implemented considerable improvements to its waste management services. In the last year, recycling has increased by five per cent, with high temperature disposal reduced by seven per cent, saving over £260,000. E



Heatlh Business Awards



Designing, developing Manufacturing high performance aerosol drug and delivering computer telephony technologies delivery technology Aerogen is the global leader in aerosol drug delivery. Aerogen’s breakthrough palladium vibrating mesh technology has transformed the science of nebulisation. Founded in 1997, Aerogen was first to market with a palladium vibrating mesh aerosol drug delivery system for the acute care setting and has become the gold standard of care. Today its products are sold in over 75 countries worldwide and has benefited over three million patients. Aerogen is the preferred partner of choice for the world’s leading mechanical ventilation companies including Philips Healthcare, GE Healthcare, Covidien, Maquet, Drager, Hamilton and ResMed. Aerogen is a dynamic and evolving company, focusing on innovative products that create new market opportunities. This

innovative approach has seen Aerogen register over 40 US and corresponding international patents and continually develop new products, leading the way in the aerosol drug delivery market. The company also partners with pharmaceutical and biotechnology companies to develop and deliver superior inhaled drug candidates, utilising its proprietary palladium vibrating mesh technology platform in the acute care and home ventilator setting. FURTHER INFORMATION Tel: +353 91 540 400

Voice Connect is a specialist integrator of computer and telephony solutions. Working in partnership with EMIS, INPS, SystmOne, FrontDesk and Microtest, Voice Connect has been providing original cost saving systems to the NHS since 1991. Its products are also deployed in the public, charity and business sectors. Patient Partner, Voice Connect’s 24/7 automated booking system, has become an essential part of any practice’s access strategy, proven to reduce DNAs, extend out of hours options, improve patient access and reduce A&E attendances. It works to support hardworking reception teams, reducing the amount of calls they take, freeing them to help patients at reception. Recent developments such as telephone triage and GP card payment solutions continue to support Voice Connect’s reputation as an innovative,

cost saving solution provider to the healthcare sector. Voice Connect’s product range also includes Medical Messenger, an enhanced email and texting service which automatically sends appointment confirmation and reminders and is perfect for mass campaigns. VC SmartMail (a GP specific letter mailing service), Patient Echo (call recording for practices) ,VC LoneWorker (a staff safety service), Automated 24/7 telephone repeat prescription ordering and a sexual health triaging system, are all part of the Voice Connect range. FURTHER INFORMATION Tel: 0116 232 2622

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It was an honour to have been a sponsor at the Health Business Awards 2015 and presenting the Clinical Commissioning Award to a worthy winner in NHS Southport and Formby Clinical Commissioning Group (CCG). PFU offers a broad portfolio of document scanners for professional personal, desktop, workgroup, high-volume production and networked environments and is one of the world’s leading document scanner companies. PFU has been engaged in the document imaging scanner business for more than 25 years and generates an annual turnover of over $1 billion. Operating in Europe, the Middle East and Africa, PFU (EMEA) Limited is responsible for marketing and sales of Fujitsu document scanners. Scanning solutions for healthcare can help you realise: centralised storage

interfacing services to other systems. Highly scalable and modular by design, the system can grow with your business. With market leading feature content and functionality already in place, fast return on investment and low cost of ownership going forward is guaranteed. All Fathom systems come with a variety of deployment options, whether you require in-house or hosted solutions. Modular pricing together with a range of finance options means there is a Fathom solution for most requirements and budgets. FURTHER INFORMATION Tel 0118 975 0044


with enhanced security for all information, including patient records; business process agility that can lead to productivity gains and cost savings; enhanced compliance throughout all departments with all regulatory guidelines; faster access to patient information, leading to improved patient outcomes and better access to critical information across the care continuum; and notable ROI, with most hospitals reporting a full return on their ECM investment within 18 months of implementation. FURTHER INFORMATION Tel: 0208 5734 444

Health Business Awards

EVENT REVIEW  HEALTHCARE IT AWARD The most competitive category this year was the Healthcare IT Award. With a revolutionary new electronic medical records system which has improved the way referrals are dealt with and medical notes are indexed, routed and shared among clinicians and clerical staff, Papworth Hospital NHS Foundation Trust has boosted efficiency, reduced costs, and ultimately, enhanced patient care. Others commended at the Awards dinner were Pennine Acute Hospitals NHS Trust, NHS Northern, Eastern and Western Devon CCG, and Leicester City CCG. HEALTHCARE RECRUITMENT AWARD Improving patient access and choice depends on the quality and availability of staff in all areas of the hospital practice. Sponsored by de Poel health+care, this award will recognise the NHS organisation that has developed a robust recruitment policy that delivers both safety and continuity to patients. The Education Training and Development department at Guy’s & St. Thomas’ NHS, winners for the second time on the night, is recognised for its inclusive recruitment policies, which includes supporting candidates with autism, mobility needs and deafness. HOSPITAL CATERING AWARD Sponsored by McCain, The Hospital Catering Award is presented to the NHS Trust that has strived to improve the standard of food and its nutritional value for the benefits of both patients and staff. The in-house catering team at Hinchingbrooke Health Care NHS Trust spends 80 per cent of its budget on ingredients from local suppliers, supporting local, independent businesses, aiding economical growth and helping the environment by reducing food miles. Since 2011, patient satisfaction levels regarding its hospital meals have increased from 48 per cent to 96 per cent in 2014-15. Chief executive Lance McCarthy said: “We were delighted to win the hospital catering award at this year’s Health Business Awards. Good nutrition plays a vital role in a patient’s recovery. Our catering team really understand the importance of good nutrition and are committed to providing the best quality produce to help improve patient and staff well-being. In the last year we have seen patient satisfaction levels rise to more than 96 per cent. This is a result of the team’s determination to provide our patients with high-quality, healthy food that meets their nutritional needs.” HOSPITAL CLEANING AWARD Patients expect hospitals to be clean. This award, sponsored by i-Clean Systems, acknowledges the efforts made by NHS organisations in recent years to raise standards in cleanliness and reduce the risk of hospital acquired infections. Housekeepers and supervisors create a

“We were delighted to win the hospital catering award at this year’s Health Business Awards. Our catering team really understand the importance of good nutrition and are committed to providing the best quality produce to help improve patient and staff well-being” Lance McCarthy, chief executive, Hinchingbrooke Health Care Trust hygienic and safe environment for patients at Weston General Hospital. Tailored training programmes have helped the Trust achieve a 98 per cent cleanliness rating in its latest Patient-Led Assessments of the Care Environment, and also helped the hospital bag a Health Business Award.

winter period, Liverpool Community Health NHS Trust delivered a digitally-led internal communications campaign, titled ‘Immunise Your Selfie’, to encourage staff to have the flu vaccination, highlighting the reasons why staff must take responsibility for staying healthy during the winter.

HOSPITAL PROCUREMENT AWARD Dartford and Gravesham NHS Trust and London Procurement Partnership celebrated taking home the Hospital Procurement Award, sponsored by Aerogen. Their project has delivered huge financial benefits, well in excess of the government’s targets for PFI reviews. It focused on developing professional commercial skills and knowledge, and it has resulted in a 12 per cent annual saving on Soft Facilities Management services alone.

OUTSTANDING ACHIEVEMENT IN HEALTHCARE Sponsored by CCube Solutions, this year the ‘Outstanding Achievement in Healthcare Award’ recognised Frimley Health Hospital NHS Foundation Trust, who have a patient-centred culture which is evidence of strong leadership. Staff had been praised for their pre‑natal care and cancer support and biomedical scientists from its pathology department recognised in their efforts to combat the spread of the Ebola Virus. Further to this, under the Care Commission’s new rating system, September last year saw the trust become the first to be recognised as ‘Outstanding’. The trust’s head of midwifery Adrienne Price said: “It was an honour to be at the awards. The Outstanding Achievement Award was the last one to be announced so we were just ecstatic when they named Frimley Health as the winner.”

INNOVATION IN MENTAL HEALTH AWARD Sponsored by Lloyds Pharmacy, this accolade is awarded to NHS organisations who have made strides in improving the experience and overall care of its patients. The winner, NHS Northern, Eastern and Western Devon Clinical Commissioning Group, developed a ‘Street Triage’ pilot last year that sees mental health professionals work with the police, sharing relevant information which helped to avert a person’s attempt to end their own life on nine occasions and was responsible for savings in excess of £130,000. The 2015 commended list in this category included Cheshire & Wirral Partnership NHS Foundation Trust, Bradford District Care NHS Foundation Trust and the University Hospitals Coventry and Warwickshire (UHCW) NHS Trust. NHS PUBLICITY CAMPAIGN AWARD This is awarded to the campaign which can demonstrate success in achieving its objectives. Throughout the 2014/15

PATIENT DATA AWARD The need for timely, effective information in healthcare is key to realising the benefits of the huge investments in NHS staff and buildings. Datasets developed by University Hospitals of Leicester NHS Trust helped to create predictive models that will aid future allocation of resources. The Paediatric Observation Priority Score quickly scores acutely ill children on a combination of risk identifiers,which can enable a hospital’s capacity to be predicted 24 hours in advance. E



Heatlh Business Awards


The number one company Facilities, property and for access, evacuation and energy management for lift breakdowns solutions public sector businesses The company is owned by Greg and Julia Pons who first saw the Evac Trac CD7 evacuation chair in 2006 and realised that this was easier and safer to use than the standard evacuation chairs that people are familiar with. The company understands that people with different disabilities require different solutions and that one design does not fit all. You also must take into consideration the stairs and landings, as these again affect the evacuation chair that can be used. Is the person in a wheelchair? If yes, then should they transfer? What happens when they are outside without their wheelchair? People were looking at fire evacuation in isolation and SwallowEMP realised that access and egress are part of the solution and should be equally considered. If you look at access

and egress (The Equality Act) then fire evacuation should be covered but if you look at fire then access and egress is not covered. Swallow EMP offers a range of portable products that are primarily powered and therefore go both up and down stairs. Products are available for people who are in wheelchairs or people with limited mobility and can operate on Spiral straight and flared stairs. The system can reduce manual handling so people do not have to carry others up and down stairs. and impartial advice. FURTHER INFORMATION Tel: 0121 366 9275

i-Clean Systems - Your sponsor of the Hospital Cleaning Award 2015 i-Clean is the independent best practice benchmarking process for cleaning and waste management that helps continually improve service delivery at in-house and contracted sites, across organisations in all sectors. Helping clients and providers improve standards, reduce costs and ensure best value for money, i-Clean works alongside a number of high profile trusts and providers to balance cost improvements and provide robust infection prevention control, independently evidencing that services are clean, sustainable and comply with the ever-increasing legislative burden. With three fully integrated modules of activity to support the cleaning and waste function in any organisation, i-Clean has a demonstrable track record of reviewing, embedding and certifying cleaning and waste management solutions,


on contracts of all sizes. Having independently reviewed the practices and performance of over 225 individual service providers across more than 5,500 commercial sites, whether your services are delivered inhouse or contracted, on average, i-Clean identifies 27.5 per cent in efficiency improvements. For more information about how i-Clean could help your organisation please visit the i-Clean website. FURTHER INFORMATION Tel: 01684 580 680


Everyone in the UK has a local NHS Trust that they can depend upon when needed. In order to treat these people and to function at its best the NHS works with trusted partners in many fields and one of the most critical is facilities management (FM). Mitie is one of the foremost FM providers within the NHS in England today, embedded in trusts around the country, working in true partnerships to deliver best service and best value. Mitie healthcare specialists work within the NHS dealing with cleanliness, infection control, security, supply chain management, patient catering, linen supplies, and many other areas, freeing up NHS management and clinical staff alike to focus on what they do best. In the past year alone, in different NHS trusts around the country, Mitie has invested

£250,000 in a new retail restaurant, pioneered new smart technology in patient dining options, trained up its employees in lean six sigma for greater efficiency and has recruited and trained hundreds of local people to work in local hospitals. Mitie’s waste and recycling experts help trusts to operate sustainably through innovations and investment, and for this reason Mitie is proud to sponsor the Most Sustainable Hospital Award. FURTHER INFORMATION E: W:

Training for those in the private and public sector Pass Training Consultancy is a leading training company with experience of delivering a broad range of in-house training courses including City & Guilds Courses, SIA Security training, Civil Enforcement Officer, Health & Safety, Customer Service, Conflict Management, Notice Processing training Team leading, Management and e learning courses. The company works in both the private and public sector including local government. As professionals, Pass Training Consultancy engages with its clients to ascertain their real training and development needs and provide bespoke training programs that seamlessly fit your company’s requirements and culture. Within these training programs, it offers the use of a variety of tools to meet different learning styles. These assist in producing self-managed learning resources and facilitate group

learning, with training courses designed to meet your staff and organisations needs. The company provides training consultancy services in the UK and has over 30 year’s experience in providing high quality industry leading training solutions. There are over 34 training courses, awarding body and in house training, run in locations throughout the UK. Pass Training Consultancy trains large numbers of people each year and 99.8 per cent of delegates say that given the opportunity they would like to attend another Pass Training Consultancy training course. FURTHER INFORMATION Tel: 0843 2895581 www.passtraining

EVENT REVIEW on performance targets and with a huge debt, 2012 saw the Bolton NHS Foundation Trust in breach of its authorisation. The Board has driven through a number of changes to ensure robust governance, and its chief executive became the first to successfully bring a Foundation Trust out of financial breach. Under her leadership, it finished the 2014/15 financial year with twenty percent higher than planned cash balance

The winning project in the Hospital Building Award sponsored by Cube Solutions category was from Northumbria Healthcare NHS Trust and Cramlington Hospital. The building is specifically dedicated to emergency care and is the result of 10 years work led by clinical teams  PATIENT SAFETY AWARD Sponsored by Ascom, the Patient Safety Award is presented to the NHS Trust which has made great strides in providing a safe hospital environment for patients, and has taken action to reduce Hospital Acquired infections and mortality rates. The identification and treatment of sepsis is exemplary at Great Western Hospitals NHS Foundation Trust. A set of six internationally recognised clinical interventions are performed within the first hour of diagnosis. These, including early prescription of antibiotics and administering oxygen, have helped to increase survival by up to 30 per cent. SUSTAINABLE HOSPITAL AWARD The Queen Victoria Hospital NHS Foundation Trust set up the first medical PVC recycling project outside Australia, in which three common single use PVC items were picked for their suitability: anaesthetic face masks, oxygen tubing and oxygen masks from elective, non‑infectious patients. The pilot encouraged the Environmental Agency to allow ‘sensible’ recycling of items previously considered clinical waste and helped to open up channels to manufactures to make more single use items recyclable. Compliance with the process was nearly 100 per cent and cross contamination of the recycling bins with other waste was zero, resulting in approximately 200kg of PVC diverted from landfill or incineration to date. This award was sponsored by Mitie.

NHS COLLABORATION AWARD Sponsored by ISS Facility Services Healthcare, this Award is presented to the NHS Trust which has worked with other public/private sector organisations, such as local government, police, fire, charities, schools etc to engage the local community in preventative campaigns. The winning collaborative project between Staffordshire and Stoke on Trent Partnership NHS Trust helped raise awareness of the difficulties faced by those with visual impairments. The Trust worked with the local Fire service, and the results have seen an increase in referrals and helped to maintain their independence and autonomy. HOSPITAL BUILDING AWARD This Award, sponsored by CCube Solutions, will be made to the new hospital building project that raises the standard of the healthcare environment and demonstrates value for money and project management excellence. Touted as the first hospital of its kind in the country, the winning project from Northumbria Healthcare NHS Trust and Cramlington Hospital has already been recognised at a national level by the medical director of NHS England when he described it as a ‘glimpse of the future’. The result of 10 years work led by clinical teams, the building is specifically dedicated to emergency care.

Health Business Awards


CLINICAL COMMISSIONING AWARD Sponsored by Fujitsu, this Award recognises the recently formed CCG sector, and an organisation which has quickly made an impact to reduce hospital admissions through preventative practice. NHS England data ranked NHS Southport and Formby (CCG) as the best in the country in supporting adult diabetics. The CCG focused on prevention- educating sufferers on how to successfully manage the disease in order to reduce the risk of future complications. It also works to ensure that patients at risk of developing Type 2 diabetes have access to lifestyle advice to help them stay healthy. HOSPITAL SECURITY AWARD Sponsored by Pass Training Consultancy Ltd, this award recognises hospitals that have made significant steps towards a safer environment for patients and workers through the implementation of a security policy which incorporates the latest advancements in CCTV, access control and other monitoring technologies. In order to tackle a rise of violence against staff and patients, a pilot project at East Lancashire Hospitals NHS Trust introduced two full‑time police liaison officers, stationed in the A&E Department. They have been specially trained to work with medical staff to identify individuals who display challenging behaviour, signs of alcohol and substance misuse and also those with undiagnosed mental health issues. L FURTHER INFORMATION

NHS FINANCE AWARD NHS Finance Award, sponsored by Fathom, recognises a hospital trust which has developed prudent financial practices which represent good value for the taxpayer. Failing




2018 The business of delivering healthcare is becoming increasingly complex. Providers are being tasked to deliver quality care whilst cutting costs and meeting strict targets yet still ensuring patient safety and improved operations.


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Signalling the best way forward Signage should be a major consideration for hospitals, especially from a health and safety perspective. Mark Hughes, from the Health and Social Care group at the Institution of Occupational Safety and Health, looks at the importance of the correct use of signage in hospitals

Wherever you look in hospitals there are signs. They tell you what you can and cannot do. They inform you of hygiene requirements. They show you which way you need to go to the department you require. Signs come in all different styles and formats, with some printed and some handmade. It cannot be disputed that signs are necessary in a hospital environment. They are a great way to warn the many thousands of people who go through the doors of hospitals every day of some of the risks and specific precautions that need to be taken. However it is important that there are not too many signs as this can lead to ‘sign blindness’. By this, I mean too many signs mean people switch off and walk by, ignoring them and potentially missing important information. When thinking about signs in a hospital one of the most important factors in getting messages across is to have a joined-up approach between departments, including infection control, health and safety, communications, specialist and other departments, charities, volunteer organisations, and so on. All of these departments want to get their message across to the right people. But without a joined-up approach they can tend to use different methods and styles, which can result in a lack of control and standardisation of signs. This in turn leads to ‘sign blindness’. If signs

are not used properly it can cause problems for patients and visitors, which in turn can lead to frustrations being taken out on staff. HEALTH AND SAFETY From a health and safety perspective there are obvious requirements for signs. For example, they can be used to warn of dangers such as nearby X-Ray equipment, or they can be used to warn of potential hazards such as wet and slippery floors. All of these signs are off the shelf and come in either the mandatory or advisory colours. There are, however, many more signs than those which warn of hazards to patients and visitors. Among them are those which inform patients how long they may have to wait to see a medical professional. These can, in turn, be used to protect staff. When people visit a hospital they will expect to queue but if they feel they are waiting too long they may start to get annoyed and agitated, which can lead to aggression towards staff – something which is unacceptable. Hospital staff are there to do a job. As with people in all other industries they should

be covered by a culture of care, something the Institution of Occupational Safety and Health’s (IOSH) Health and Social Care group – and the Institution as a whole – strongly believes in. This includes preventing them being the target of aggression from the public. Signs play an important part in this. If you take accident and emergency departments as an example, signs can be used to warn people how long they may have to wait depending on their injury and how it was sustained. For a sports injury, the wait may be as much as threeand‑a‑half to four hours – essentially the end of the queue as the injury is viewed as self-inflicted. If the patients are warned that they must expect such a long wait this reduces the chances of them getting annoyed. As technology has moved on, we now find in most A&E departments the use of TV screens to keep patients informed of waiting times. This has been shown to reduce the amount of aggressive incidents towards members of staff. As referred to earlier, another group of signs which are relevant from a health and safety point of view are those warning of the dangers of E

If signs ed us are not it can y properl blems for ro cause p and visitors, s patient can lead to which ions being frustratn out on take ff sta




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HEALTH & SAFETY  the different types of waste and wet floors. Positioning is crucial with these. They are there to serve a purpose but if they are left where people only see them at the last minute, there is a risk of a slip or a trip. If used and positioned correctly these signs do serve a purpose. Hospital floors, for infection control purposes, tend to be mainly vinyl. However when wet can they can become slippery, especially with the wrong footwear. So signs need to be displayed to warn patients, visitors and staff and must be displayed well in advance of the area in question. We must also not forget hygiene signs in key locations. This includes those in toilets which have information about good hand-washing techniques and the use of hand gels. They can also include when to stay away from visiting, such as if you have the winter bug, which can create the risk of infecting others, but these signs must be clear and on their own and not swallowed up among many others. DIRECTIONS Good signage is also useful for directional purposes, both inside and outside of the building. For patients, arriving at hospital can be an anxious time. Hospitals can be big and scary places with lots of buildings, departments and people. Once inside a hospital, there must be clear signs to different departments. Generally outpatients areas are split into various specifics like fracture clinics and the common approach for directional signs is to colour code them. This means it is a case of following the red or green lines along the wall or floor to the relevant clinic. Such signs can also be handy for patients who have to make their way to and from different departments, for example if they need to have their bloods taken. It isn’t just patients who signs play an important part for. They are also important for visitors such as patients’ relatives and patient transport like taxis, ambulances and volunteer drivers. Clear signs are needed for drop-off and pick-up points and car parking. The same is the case for the relevant wards and clinics as well as coffee shops and restaurants. The need for signs begins from the moment people arrive at a hospital. Car parking arrangements must be displayed. There should be clear signs taking you to the right car park for the specific department or ward you are visiting, including clear car parking fees and how to get a reimbursement if applicable. If hospitals don’t get these signs right it can cause numerous problems. As with waiting time information, directional signs are important in preventing patients and visitors from becoming frustrated and taking this out on staff. STANDARDISING SIGNAGE Standardisation of signage and ensuring they are controlled is key. A successful way of doing this is nominating someone within each department and Trust wide to be responsible for monitoring the amount of signs and their clarity. Those nominated must ensure that the important messages carried in signs are not lost among too many trivial signs. The use of technology like TVs to generate messages and keep people informed is a move in the right direction, but we must not stick with the same message over and over again; there needs to be a program in place to continually update and remove unwanted and old messages. Even when a sign is temporary it should still be made to a specific standard and it must be removed when it becomes out-of-date. An example of this is in infection control isolation areas. It is crucial that once the problem has been removed so should the sign. The responsibility of those nominated people can also include ensuring hospitals make use of the information that they have, for example which languages they need signs to be in. Hospitals gather huge amounts of information about people’s nationality, so they must use this to work out who use their services. By doing so means that in the most important cases they can have signs printed in the key languages for the demographics of the area. This again can help staff avoid potentially confrontational situations. Having signs printed in relevant languages significantly reduces

It is important to remember that having too many signs can actually have a detrimental effect when it comes to health and safety as people can become oblivious to them the chances of having people getting lost in a hospital because they don’t understand the signs. So, signs are more than useful in hospitals, vital even. But it is important to remember that having too many signs can actually have a detrimental effect when it comes to health and safety as people can become oblivious to them. Signs should be used only when necessary and should be clear and readable. If this is the case, staff in hospitals are able to get on with their job without the risk of coming into contact with agitated patients and visitors. This is one way in which hospitals can meet the culture of care which staff should be covered by. L FURTHER INFORMATION 86 x 125mm NHS Advert

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SOLARWINDS SUPPORTS HIGH LEVELS OF PATIENT CARE IN LINCOLNSHIRE SolarWinds solutions are helping the United Lincolnshire Hospitals NHS Trust to meet the 24/7 challenge of looking after thousands of patients at seven widely dispersed hospitals

Such an onerous responsibility demands an efficient and effective IT infrastructure, orchestrated by an ultra-reliable network, and SolarWinds tools are playing a key role in maintaining high levels of reliability. LOOKING AFTER PATIENTS The United Lincolnshire Hospitals NHS Trust was formed in April 2000 by the merger of the three former acute hospital trusts in Lincolnshire. Through the three main hospitals and the other four sites that provide services, the Trust provides a comprehensive range of hospital-based medical, surgical, paediatric, obstetric, and gynaecological services to the 700,000 people of Lincolnshire. More than 7,500 staff and volunteers deliver a wide range of healthcare services costing more than £390 million a year to provide. In an average year, the Trust treats over 180,000 accident and emergency patients, nearly half a million outpatients and almost 100,000 inpatients. The main hospitals are Pilgrim Hospital, Boston; Grantham and District Hospital; and Lincoln County Hospital. Limited services are available at Louth, Skegness, Gainsborough and Spalding. The Trust has data centres at Pilgrim and Lincoln (40 miles apart) each with a pair of Cisco 6509 switches in the network core, while the Grantham site has a single Cisco 6509. The network has around 300 access switches. All sites connect via 1Gbps point-topoint links, managed by the National Health Service’s N3 national broadband network. Among the 7,500 staff, up to 3,000 users are active at any given time. Main applications are Microsoft Office, McKesson patient



administrative software (PAS) system, and Web V for blood and pathology results. The Network team has relied on SolarWinds solutions for many years, so Senior Network Engineer, Jon Hill and his colleagues have excellent visibility into the network. According to Hill, SolarWinds’ network monitoring has been in place for over seven years. Initially, only two IT professionals looked after an expanding network. Their urgent need was for a clear insight into the network and to receive alerts when problems developed. They wanted to know when nodes went down, response times slipped, or packets were being dropped. Hill’s team evaluated solutions from only two vendors. Today, their primary tool is SolarWinds Network Performance Monitor (NPM), which is viewed from Hill’s laptop. They also use SolarWinds Network Configuration Manager, SolarWinds Server and Application Monitor, SolarWinds VoIP & Network Quality Manager, SolarWinds Engineers Toolset, and most recently, SolarWinds Virtualization Manager. The SolarWinds solutions are supplied and supported by Kenson Network Engineering. According to Hill: “Kenson, and in particular their account manager, have been really good for support and general account management. Although we do not log many support calls, they are really quick at responding to those I make. If required, they call in SolarWinds’ engineers who are always readily available to resolve problems.” Discussing return on investment for the SolarWinds solutions, Hill says the monetary and time savings from having a reliable network are incalculable.

He said: “Just consider what would happen if our critical patient case applications were unavailable. If the system were to fail it would cost the Trust time and money, but more critically patient care would suffer. The big advantage of IT in the NHS is the efficiency derived from having updated information available instantaneously to all relevant staff. For instance, when a patient returns to a clinic after having X-rays, those X-rays are available almost immediately.” Today’s ultra-reliable network results from Hill and his colleagues are having deep levels of visibility into the network, thanks to the SolarWinds solutions. Hill added: “From day one, SolarWinds has given us the visibility we need. Before, we would be waiting for problems to happen, we were reactive—now SolarWinds allows us to resolve issues proactively before we receive complaints. We can fix many network faults even before the user calls to report them. Without SolarWinds, we would struggle daily with issues, and given all the critical medical and administrative applications that rely on the network, I think we would have very serious concerns.” AFFORDABLE SOFTWARE SolarWinds provides powerful and affordable IT management software to government agencies worldwide, including the European Parliament, NATO, Health and Social Care Information Centre, Ministry Of HealthTurkey, and nearly every U.S. civilian agency, DoD branch, and intelligence agency. Present across a broad range of NHS Trusts in the field, in the data centre and in the Trust’s offices, SolarWinds technology offers powerful yet simple-to-use solutions for IT management challenges, including continuous and protective monitoring, cybersecurity, network operations, compliance, data centre operations, and IT consolidation across a range of applications. L FURTHER INFORMATION +353 21 233 0440


The health service is now on target to save £1bn in efficiencies by 2020 by working with NHS Shared Business Services. Much more is possible when the wider public sector takes action, writes Peter Akid, NHS Shared Business Services director of procurement When the Department of Health set up NHS Shared Business Services (NHS SBS), ministers and Whitehall officials realised the enormous potential for saving essential money through

collaboration. Since then NHS SBS, a unique venture, which is half owned by the government, has helped the NHS to identify more than

£350m in efficiency savings, achieving initial targets more than a year ahead of schedule. The health service has continued to identify savings by making effective use of NHS SBS and as a result is now on target to achieve at least £1bn of cost savings by 2020 in areas including IT, finance, employment services and more. At a time when health and care budgets are under immense pressure, and with demand continuing to rise, realising savings like this is an essential activity in protecting vital public-facing services and in helping to ensure the sustainability of the NHS itself.

Procure has bee ment key foc n one which N us area in been ab HS SBS has NHS org le to assist a identify nisations in ing se savings rious

Written by Peter Akid, NHS SBS director of procurement

NHS buying power can save the public sector millions



RESPONDING TO LORD CARTER’S REVIEW Lord Carter’s 2015 review into NHS efficiency highlighted major room for improvement in the way the NHS procures products and services, with significant variation emerging in the amount hospitals pay for standard items. Procurement has been one key focus area in which NHS SBS has been able to assist NHS organisations in identifying serious savings. A key part of this has been the creation of procurement frameworks that allow NHS bodies to cut out the costs, time and complexities of running their own competitions, whilst ensuring they still have access to a comprehensive range of relevant and appropriate suppliers to meet their needs. In some instances, this has involved the creation of specialist frameworks. For example, in 2015 a new framework was created in collaboration with NHS customers to help save money on important and widely used prescribing technology. Medicines management and prescribing decision support systems, which help clinical staff to decide on the most appropriate and most cost effective treatments for patients, have E



26-27 April 2016. Olympia, London. Efficient Productivity Without Compromising Quality Hospital Innovations offers visitors and delegates the chance to hear from, and interact with leading trusts, supporting organisations and sponsors, who focus on improving Governance, Efficiency & Productivity without compromising patient safety and quality of service. With Procurement, Finance, Technology and Facilities at the heart of the event, the programme provides a unique look at the NHS and how it could look in 10 to 15 years’ time. Event Supporters:

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 traditionally proven very costly in the NHS. Now, as a result of the new framework, new competition has been injected into the market, and NHS organisations can immediately select their supplier of choice, benefit from improved negotiated terms and achieve better prices, without having to engage in costly individual procurement exercises. THE OPPORTUNITY FOR THE WIDER PUBLIC SECTOR As much as specialist frameworks like the one that covers medicines management systems have the potential to help the NHS save millions of pounds on software licenses, their specific nature carries little relevance beyond the healthcare marketplace. Yet there are opportunities for pan public sector savings elsewhere. Many procurement frameworks that have been set up by NHS SBS do have enormous potential beyond the NHS, covering everything from IT, to translation services, construction, clothing, security and much more. This has not gone unnoticed. A growing number of public sector organisations across Whitehall, local government and beyond, are starting to recognise the potential of sharing in the buying power that these frameworks offer. NHS SBS has a total of 498 associate members that use its frameworks to save money on procurements. Of these, there are 234 organisations that are outside of the NHS. This includes 89 local authorities, 40 educational establishments, 18 police forces, and 87 other organisations including central government departments, fire and rescue services, charities and housing associations. At a time when integrating services is particularly important, these public bodies are already collaborating at the procurement level. What is more, they are all tapping in to NHS buying power, immediately benefiting from both the prices and terms available to them through the frameworks. They have all been able to avoid the delay of navigating

public finances hit headlines again with the announcement of the Chancellor’s Spending Review. Frameworks used by the NHS have the power to help public authorities mitigate some of the urgent savings required.

For some frameworks, such as interpretation and translation services, savings can be as great as 30 per cent, whilst contracts in other areas, such as estate security, could alone save the public sector more than £50m every year Official Journal of the European Union (OJEU) procurement rules, which can take anything up to nine months, and they have escaped the financial burden of running procurements which can cost anywhere up to £20,000-£30,000 per procurement. Savings being realised here are only the tip of the iceberg. With further adoption across the public sector much more could be achieved. November 2015 saw the reality of

For some frameworks, such as interpretation and translation services, savings can be as great as 30 per cent, whilst contracts in other areas, such as estate security, could alone save the public sector more than £50m every year. KEEPING PUBLIC SERVICES EFFECTIVE Recognising the growing public sector interest and requirement, NHS SBS is now consulting public sector organisations that

are already drawing from its contracts, as well as the NHS, in the creation of some of its new frameworks. For example, at the end of 2015, a new facilities management framework was launched covering everything from grounds management to catering, the first of its kind to offer such a fully comprehensive range of services needed by the NHS, councils, universities, police forces and more, from both national suppliers and small to medium sized enterprises (SMEs). Simply put, frameworks like this are being used to save significant sums for the taxpayer and can save much more. We are proud that the NHS has worked in partnership with us to deliver hundreds of millions of pounds of savings. As we look to increase this figure to £1bn of savings for the NHS, there is no reason why additional efficiencies cannot also be realised across the entire public sector. Every pound that can be saved in procurement can be used to keep public-facing services effective. L FURTHER INFORMATION



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Steve Mellings, of the Asset Disposal & Information Security Alliance, discusses the problems facing data diposal and how it should be managed The incidence of data breaches is on the rise. It seems that public and private sector organisations are left embarrassed because they’ve suffered a ‘cyber-attack’ and there is a predisposition for most readers to assume these issues are as a result of a highly sophisticated attack on our networks. The reality in many cases is very different. Whilst the press and security industry waxes lyrical about the need for increased cyber defences, most government departments and businesses as a whole need to pause for breath and take stock of the situation they currently find themselves in. There are a whole array of very basic vulnerabilities which exist and require very little expertise to exploit that need addressing. One area of continued poor performance is ICT asset disposal. In a Big Brother report, the health sector’s ICT disposal featured as two of the 10 top data breaches. So what is the problem? Why does a seemingly innocent and simple business process go wrong?

INVENTORY MANAGEMENT With inventory list accuracy ranging from 60-80 per cent for equipment on the network it can hardly be surprising that when ICT asset disposal companies come to collect equipment it is often done so after a request such as ‘we have a van full’ or ‘I’ve got a few bits’. Sometimes an inventory list is provided but is virtually a work of fiction and bears no resemblance to the actual assets ready for collection. So why is this important? An inventory list is essential if the releasing company is going to have any hope of showing control over the process. How can the chain of custody be shown to exist through various internal stages and therefore mitigate the likelihood of internal and external theft? For those organisations who comfort themselves with ‘certificates of destruction’, ‘waste transfer notes’ or even ‘audit documents’ I would suggest that this is cold comfort. After all, how can you evidence that all of your items have been processed when you don’t even know what you released?

There le ho are a w very f array o rabilities e ln basic vu e x i s t a n d w h i c h very little require e to exploit s experti at need th ing address

PERCEPTION OF IT DISPOSAL Within the NHS I’ve seen Informatics and IT teams treat retired ICT assets as nothing more than door stops. I’ve personally inspected equipment left in a public corridor all still holding data and in another trust I’ve seen a publicly accessible fire exit stairwell used as a storage area. Furthermore, as the industry looking to win business from this sector we see, on an on-going basis, an enormous indifference to the seriousness of the process. Tenders coming out with little service specification and with the majority of the weighting being on price. We constantly see RFPs being released with only cursory equipment lists and then a request for ‘best bids’. So for any organisation looking to manage risk within ICT Disposal they must first change their perception. Their partners are not IT Dustmen, they perform an essential part of the effort to protect data. Once this process is looked at in a different light it will be seen that, whilst there are risks throughout, they can be neatly categorised into three key areas.

VENDOR MANAGEMENT Most organisations will engage with a third party to perform these services. As such, how this partner is selected and managed is an imperative part of this process. Vendor selection is perhaps the greatest concern in this sector. The industry itself is highly competitive and historically has done very well out of organisations seemingly happy to just give old infrastructure away. However, this has significantly changed in the past few years and with the exception of companies who offer ICT disposal as part of a portfolio of IT services, it is extremely difficult to offer these services for free without absolute guarantee over the volume and quality of equipment. The second user market has become far less buoyant for older technology and commodity pricing has decreased significantly in the past 12 months. This has meant that the recycling value of equipment is about 30 per cent of the level

where it was previously. It makes sense, therefore, that if the resale value is lower, the material value is lower and the type, quality and age of equipment is unknown, then no one can be absolutely assured that they can cover their costs from a collection. Hopefully it can be seen that to base selection just on price in a highly competitive market is a questionable strategy. It’s interesting to note within the ICO’s NHS Surrey (£200,000 fine) penalty notice that they specifically make mention of poor vendor selection and this incident should be used as a case study for others. The most critical area where organisations fail is to not have a contract in place and to not audit their partners.

Written by Steve Mellings, Asset Disposal & Information Security Alliance

Preventing unnecessary data disposal risks

Asset Disposal


TECHNICAL SOLUTION I think we all know that delete doesn’t work but organisations are still taking little responsibility when it comes to dictating what tools should be used on their data carrying media. The technical solution can get even more confusing when there are occasions that a CESG approved software overwriting tool might give a ‘pass but with exceptions’ and generate the report. Those exceptions generally are not easily accessible to a user and require forensic recovery but unless the releasing company dictates the behaviour you are leaving your vendor to make those types of decisions. For any organisation now using Solid State media they need to be aware that there are no government approved software overwriting tools. Furthermore, many destruction tools don’t actually impact on the storage element of the media itself (the NAND cells) so some traditional drilling or punching process may not work. The easiest way of managing risk is to simply engage in this process in a more intellectual way. Have an inventory of equipment which is being released. Release it to a professional company who holds relevant certification, contract with that company and include a detailed service specification, and finally, audit them. The solutions are out there and there are ways of meeting all different types of budget. L FURTHER INFORMATION



“Dario’s ‘Hypo Contact’ feature can remotely inform caregivers of low blood glucose readings via phone message.”

Your Smartphone is now a Smart Meter with Dario... Blood glucose meters were bulky, inconvenient and impractical, until now. The Dario Smart Meter has the power to turn your smart phone into a smart blood glucose meter. The sleek all-in-one design is not only attractive but functional and convenient, fitting easily into pockets or bags. Your lancets, test strips and finger sticking device will always be to hand, whenever you need them. The Dario Smart Meter system uses your smartphone to provide you with not only your blood glucose levels but also a comprehensive selection of other facts, figures and statistics on both Android and IOS.

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For more information on Dario contact: tel: +44 (0)1926 833 273 e-mail: web:

EHI Live 2015

Sponsored by

Digital integration and interoperability EHI Live is the biggest and most vibrant UK IT healthcare show, where the eHealth community comes together to meet, network and discuss current challenges and developments in healthcare IT. Health Business looks back at November’s event EHI Live is the UK’s largest and most popular digital health event. It has become one of the big three must-attend health management shows in the calendar, bringing together the biggest players in digital health, along with some of the most influential people within the NHS, public health and the wider e-health sector. Taking place at the NEC Birmingham, the show has grown so much that over two days in early November, EHI Live 2015 welcomed over 3,900 attendees visiting 159 exhibitors and coming to hear over 90 speakers in 14 conferences. Visitor numbers were up 10 per cent on the previous year, and of the 2,775 IT healthcare professionals participating, 35 per cent represented the NHS. It was an opportunity to tackle the big industry issues such as IT leadership, big data, cloud technology and security, wearables, imaging informatics, open source data standards and governance, and social media. Conference streams included national conferences for CCIOs and for health CIOs organised by Digital Health. INTEGRATION AND INTEROPERABILITY A common theme was integration and interoperability. Besides a dedicated conference on health and social care integration, the issue was raised by a number of key note speakers including Tim Kelsey. He was giving one of his last speeches as NHS England’s National Director for Patients and Information before taking up a new role in Australia. He said that interoperability is a ‘fundamental requirement’ to achieve the 2020 targets set out in the Personalised Health and Care 2020 strategy, which has evolved under the NHS Five Year Forward View. Kelsey called for continued effort to make all parts of the health and care service technologies able to ‘talk’ to each other, so that online patient records can allow patients to transfer seamlessly through the health and care system. The Electronic Patient Record is one such project, and he called on EPR

suppliers to work with clinicians, as well as each other, to make the system fit for purpose. Not only will this benefit patient care it will also help contribute to the necessary cost efficiencies required for the NHS. And he warned that more needs to be done to make sure technology failures do not ruin people lives and delay treatment or care.

systems facilitate this and is supported by an open and vibrant technology market’. Blogging about the event, Grainger summed up her experience: “EHI Live had great energy and it was lovely to see so many people supporting the Digital Primary Care Programme. I am really looking forward to next year to showcase more amazing work ahead!”

Tim Kelsey said that interoperability is a ‘fundamental requirement’ to achieve the 2020 targets set out in the Personalised Health and Care 2020 strategy DIGITAL PRIMARY CARE Tracey Grainger, NHS England’s Head of Digital Primary Care, welcomed the introduction of a dedicated Digital Primary Care Programme conference stream. Sponsored by Elsevier Clinical Solutions and NHS England, the DPC conference’s full two-day agenda was designed so that speakers from NHS England and the wider NHS could update delegates with the progress being made on ‘achieving the fundamental vision set out in the Five Year Forward View and the National Information Board Framework, Personalised Health and Care 2020’. Highlights of the presentations singled out by Grainger included the achievements that have been made already in improving patient access to their GP. She noted that one significant statistic from the ‘Making time in general practice’ study worth noting was that ‘if 30 per cent of patients in a 10,000 patient practice accessed their records twice a year, this would save 4,747 appointments and 8,020 telephone calls with a cost saving of £29 per patient’. She also shared findings from the first independent National Evaluation Report for improving access to general practice. Going digital ‘has the potential to transform primary care, as long as the infrastructure and high quality IT clinical

PAPER-FREE PROGRESS Another key note speaker, Beverley Bryant, who is Director of Digital Technology at NHS England, talked about the progress being made towards an NHS being paper-free at the point of care. Beverley suggested that everyone must think of digital technology as a vital component to healthcare, not a ‘nice to have’ element. She said: “We are mindful of placing administrative burdens on providers – but the goal is not to fill the form in, the goal is to use the technology.” Among the steps being taken to achieve this is the establishment of the Digital Maturity Assessment to establish to what degree healthcare services in England are supported by the effective use of digital technology. All clinical commissioning groups had already started the process by reporting back on which providers were included in the local ‘digital roadmaps’ drawn up by the CCGs in late summer. Similarly, CCGs were also assessing general practices’ digital maturity. Other developments taking place were the upgrade to the NHS e-Referral Service, a replacement for Choose and Book allowing patients to book, cancel or change appointments online. Beverley said that the new service had worked through E





The opportunity for networking was enhanced with a big red London bus converted into a bar and cafe, and exhibitors enjoyed a show party hosted by Informa on the first evening  teething problems and user feedback was indicating it was fit for purpose. Bryant also mentioned that NHS England was considering bringing in a system to accredit or benchmark IT interoperability. LAUNCHES EHI Live was chosen as the setting for the launch of the Code4Health Interoperability Community by Inderjit Singh, NHS England’s Head of Enterprise Architecture. This has the mission to create a common and open set of application programme interfaces (APIs) to support information sharing across health and care. Another item that generated interest was the Health and Social Care Information Centre announcing that the Health and Social Care Network was likely to get Cabinet approval by the end of November, paving the way for it to replace the N3 network from April 2017. Visitors were also intrigued to see a tele-health system operating on a Raspberry Pi device but allowing patients and GPs to communicate via the NHS Spine. Notably, the hardware component parts cost under £100. INNOVATION INTRODUCED BY INFORMA Informa Life Sciences exhibition, the team behind Arab Health, the world’s second largest medical show, purchased EHI Live in November 2014. The organisers were keen to introduce new ideas into the show, and among the innovation for 2015 was the introduction of a 3D digital printing zone. It also expanded the EHI Live Social Media Village which proved popular, bringing together delegates to share ideas about making social media work for the benefit of patients and citizens. Tweeters, bloggers, LinkedIn users and others shared ideas formally and informally about how these platforms can be used to facilitate and improve patient care. Other showcase events were the Handi Health Apps and Pipeline Sessions. In the Handi Health Apps forum, speakers included practising health professionals actively involved in developing in health technology as well as IT industry specialists. Topics ranged included open eco digital systems, app accreditation and app case studies.

Pipeline presentations covered topics such as the activist consumer, healthcare content in context, the development of patient manager systems, and the hybrid cloud for health ICT agility. In the Health and Social Care Integration Conference, Diarmaid Crean, Deputy Director – Digital for Public Health England, warned of the challenges faced in developing a new NHS endorsement model for healthcare apps, rating the odds of success at 50:50. A new system will replace the NHS Apps Library which closed at the end of October, and will take into account aspects including self-assessment by app developers, as well as evaluation by an independent organisation, he said. EXHIBITOR LAUNCHES Among the other launches were two by techUK, the membership body for over 850 IT companies. It launched a paper on Personal Digital Care, looking at the barriers to adopting widespread technology enabled care and offering practical solutions to government and the industry on overcoming these challenges. It also featured a techUK start-up hub - where Ipros Cube, Patient Source, Policy Partners Project and Source Code Control were selected to exhibit. IMMJ Systems launched its new Mediviewer electronic document management solution designed to provide a ‘best of breed’ medical records management solution, specifically designed to meet the needs of the NHS and other health providers. Among its key features are: its ability to recognise and order documents with or without a barcode; smart indexing, enabling clinicians to find patient information and related notes quickly and in their original context; and its presentation of records in a manner similar to the original paper record. POSITIVE FEEDBACK Feedback from attendees was impressive, with 94 per cent saying the show had met or exceeded their expectations, and 88 per cent saying they had learnt something new. And one in two attendees said they found new suppliers they otherwise would not

EHI Live 2015

Sponsored by

Health Business at the show Health Business’ Ben Plummer attended EHI Live 2015 and had this to report: The event began with a bang, with Tim Kelsey, the outgoing National Director for Patients and Information giving his swansong speech. During his time in the role there has been a sustained and considered effort to build a culture of open mindedness towards new, innovative technologies within the NHS, which was very much on display here. The delegates were clearly keen to engage with what was a vast range of IT based solutions on show, which had designs on improving and transforming anything from patient safety at point of care to business analytics, and everything in-between. In the wake of funding initiatives such as the nursing technology fund, the NHS has made great strides in upgrading the technology available to its employees, which has challenged the private sector to keep up, and the exhibitors proved that it was up to the task. There was a healthy blend of organisations on show, as you would expect from one of the biggest ehealth events of the year, with some of the most established companies in the industry being supplemented by SMEs and comparative startups who showed just how broad the scope for evolution in healthcare IT space is at the moment. have considered using. The success of the event is in part down to EHI Live being a forum where tech-savvy clinicians can meet the industry IT directors and senior NHS managers with CCIOs, CIOs, and COOs in abundance. The opportunity for networking was enhanced with a big red London bus converted into a bar and cafe, and exhibitors enjoyed a show party hosted by Informa on the first evening. Bear in mind that 93 per cent of visitors to EHI Live 2015 said they intend to go to EHI Live 2016 which takes place on November 1-2 at NEC Birmingham. Planning for November 2016 is underway to make it the go-to-event for people with real buying power in the UK to search for new solutions in IT healthcare. L FURTHER INFORMATION Volume 16.1 | HEALTH BUSINESS MAGAZINE


Technology to help

transform Nursing Care See how we can help at: The Future of Nursing Technology 03MAR16 Wesley Hotel, London

Healthcare Forum 21/22MAR16 The Grange Hotel, London

Hospital Innovations 26/27APR16 Olympia, London

Healthcare Strategy Forum 17/18MAY16 Heythrop Park, Oxfordshire

HSJ Modernising Healthcare 25/26MAY16 Deansgate Hilton, Manchester

Enhance Safety

Increase Mobility

Improve Productivity



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The show at EHI was a very busy time for Ascom with some key trends emerging from the great work that is clearly going on within the NHS to improve productivity and to enhance safety We learnt that dealing with patients is increasingly affected by major social and technological trends. An ageing population, driven primarily by baby boomers and increasing life expectancy, will almost a double the number of pensioners by 2020. Additionally life-cycle choices are driving the need to treat patients differently too. Increasing consumption of alcohol, coupled with poor diet and lack of exercise, has resulted in ballooning levels of obesity and diabetes. We, as patients, are also expecting more in

both the patient experience and staff morale. It is clear, as the demand for care increases, we need to find smarter ways of working and to make life a little easier for our clinical-staff too. There is technology that can help today; from simply keeping in contact with colleagues wherever they are in the hospital to delivering important time‑critical alerts and information on the go. Ascom provides dependable onsite communications solutions for the healthcare environment bringing increases in staff productivity, mobility and enhancing safety.

Research shows that 85 per cent of clinical alarms do not actually require immediate intervention terms of who, where, when and how we engage with our medical professionals. This has driven a requirement for more information and a faster more consistent response. PRESSURE ON THE NHS AND A&E DEPARTMENTS Ultimately this has resulted in increased pressure on all front line staff and in particular our A&E departments. Add to this an increase in complexity from life-changing technological advances in medicine driving better ways of treating ailments. We also learned also lean that the UK is no different to the wider world where nurses only spend approximately 1/4 of their time with patients – which need to change to improve

FREEING STAFF TO DO WHAT THEY DO BEST One of the most reported benefits of a wireless communications solution is that it helps colleagues to stay in touch wherever they are, as no one is tied to a desk. This saves valuable time for example chasing results on the go, communicating directly to the bed after a patent call or instantaneously finding colleagues throughout the hospital, Less intrusive two-way messaging, very much like texting, also helps staff stay in-touch while in meetings or when dealing with a patient. Research shows that 85 per cent of clinical alarms do not actually require immediate intervention. Ascom can help here by ensuring that the correct alarm, from example patient

monitors, are sent out directly to the relevant clinician (or group) with a confirmed delivery. Alarms can be prioritised, filtered and even escalated then delivered directly to the right wireless handset with seconds. This ensures a consistent and effective response reducing time to administer corrective treatment and improving outcomes. IMPROVING STAFF SAFETY AT WORK Feeling safe at work is always on the mind of senior clinicians especially with a rise of 8.3 per cent of reported assaults on staff in 2014. Solutions that arm each personal handset with a panic button to allow a call for assistance. The alert is then delivered, with exact location information, to security staff within seconds. This helps reduce risk of assault and provides the nurse with increased peace of mind perhaps more so when working alone. AVAILABLE WHENEVER NEEDED The key to a successful implementation is technology that works today and continues to operate. While there are tremendous benefits in using a smartphone or a tablet it is important to ensure that the choice is not based purely on consumer based technology. As part of a complete solution, Ascom handsets can provide smartphone functionality but also have changeable batteries, are less likely to be broken or stolen and are built to operate 24 hours a day including being passed from shift to shift. The solution also uses the hospital’s own missioncritical network and business continuity infrastructure, allowing healthcare staff to be always be in contact with colleagues, no matter what may have happened outside. For example a mobile network or power failure. We continue to learn from the feedback that we receive when we attend a number of key in events in the healthcare calendar. This allows us to implement the new innovations into the solutions that are already helping to improve productivity, mobility and enhance safety. L FURTHER INFORMATION For more information visit: Mike Pawezowski, Ascom UK Tel: +441215028971 Email:



Electric Vehicles



Making NHS blue light fleets green Many NHS hospitals are being set the target of lowering the carbon footprint. While much of the change needs to happen within the hospital walls, electrifying ambulance fleets and becoming greener on the roads is an option worth exploring With the fall out from the Volkswagen emissions scandal having a knock on effect on the rest of the vehicle manufacturing industry, it has been widely assumed that public sector fleets will lead the uptake of green vehicle procurement. It is too soon to say whether ‘dieselgate’ will encourage the popularity of greener vehicles across the board, but greener fleets in the NHS are certainly an area worth exploring. The NHS employs more than 1.7 million people, and 18,687 of those are ambulance staff. It has environmental targets of an 80 per cent carbon reduction by 2050. NORTH EAST AMBULANCE SERVICE The North East Ambulance Service has replaced five of its pool cars will fully electric Nissan Leafs. The decision to introduce electric vehicles to the service’s fleet aims to reduce carbon emissions and fuel costs. North East Ambulance Service covers an area of 3,200 miles across County Durham, Northumberland, and Tyne and Wear, and has worked with Elm EV to build a charging infrastructure. Nine EV charging points have been installed in six locations in the North East to support the new vehicles. These charging points are the first in the UK to be made by Dutch firm ICU, and use smartware technology to help ease the load on the national grid. Clare Swift, Environment and Sustainability

Manager, North East Ambulance Service, said: “The uptake of electric vehicles was vital for the Ambulance Service. We aim to be proactive in promoting a cleaner environment and the use of electric vehicles also enables us to save money on high fuel costs. “Elm EV provided the service with a full EV charging infrastructure report, which included smart and reliable equipment at a competitive price.” Alex Earl, ICU UK, Country Manager said: “Having produced over 15,000 charge points for the mainland European market, ICU is very excited to have made a start now in the UK. Our success has been built on producing high quality, reliable, intelligent charge points so it is crucial for us that we work with partners in the UK who share our values. “Elm EV is certainly one such partner with already great experience in the UK EV market. We are very happy to be working with them and look forward to sharing continued success well into the future.” Additionally, Northumbria Healthcare NHS Foundation Trust has replaced 13 of

its fleet with Nissan e-NV200 electric vans. The vans were deployed after a recent trial and are expected to cut transport costs by 80 per cent, while reducing annual CO2 emissions by 59 tonnes. Michael Taylor, who is responsible for the Trust’s fleet, said: “With increasing financial challenges on the NHS, we needed to make the service more efficient while being more environmentally friendly so decided to look at whether electric vehicles could work for us. “We’ve been very impressed by the performance of the e-NV200 and it’s definitely helped to change perceptions of electric vehicles among our staff. Due to its success we will be looking at how we can expand its use across the trust.”

It oon is too s ether h to say wate’ will ‘dieselg in greener se see a ri , but greener s vehicle fleets are S NH worth y l n i a t r ce g explorin

ELECTRIC VEHICLE SCHEME The North East Ambulance Service is not the only blue light service turning green. Three premises across Northamptonshire Healthcare NHS Foundation Trust – Berrywood Hospital in Duston, Northampton, Campbell House in Northampton and St. Mary’s Hospital North East Ambulance Service has worked with Elm EV to build a charging infrastructure


Electric Vehicles

Renault Twizy all-electric ambulance

in Kettering – are benefitting from an electric vehicle scheme. Each site now hosts two permanently‑based EVs, while electric hook-ups are also available at Isebrook Hospital in Wellington, Willowbrook Health Centre in Corby and Manfield Campus in Northampton. The trust’s fleet consists of a combination of Renault ZOE and Nissan LEAF fully electric hatchbacks, with an average range of 90 miles on a single charge. Chairman of the trust Paul Bertin, said: “I am absolutely delighted that we at Northamptonshire Healthcare have taken this significant step forward and are the first NHS trust in the county to provide such a service for our staff and the public. “As a trust we have made a commitment to reduce our carbon footprint by 28 per cent by 2020 and by encouraging our staff to park up their own vehicle and use an electric vehicle for business travel will help us move towards achieving this target. Looking after the environment is everyone’s responsibility. Providing such a countywide service for our staff and the Northamptonshire public will further raise the profile of sustainability and how we can all do more for our environment.” VEHICLE EVALUATION In the NHS, the role of the fleet manager or fleet director is a well established function. The NHS operates a huge and complex range of vehicles that present considerable challenges to those responsible for managing them. Frontline activities depend on the availability, reliability and safety of a wide range of specialist vehicles including A&E ambulances, doctors’ cars and other complex fast response vehicles (FRV), together with converted vans and patient minibuses. The larger fleets also may have the added complexity of managing HGV vehicles with all of the additional regulation that entails. Before purchase, it is good practice to set clear technical and qualitative evaluation criteria including cost and performance at the outset. Give the manufacturers and the vehicle conversion specialists’ feedback. They need this to develop the product – and hopefully enable them to make a sale next time round. One area where innovative vehicle technology can provide challenges is the service, maintenance and repair infrastructure to support the new vehicles. So any decisions about new vehicle models must include adequate provision for keeping them on the road and reducing downtime. Enlisting the support of drivers is also a critical element of selection and evaluation. NHS vehicles often operate on a shift basis and multiple driver operating styles bring further management challenges including ensuring every driver is familiar with the correct procedure for adjusting the vehicle for their use. While on the road trials are an invaluable opportunity to put vehicles to the test they must be done by employees who understand the evaluation criteria and can make an objective assessment. It should also be remembered that badly driven green vehicles can be more polluting than well driven conventional ones. A critical factor in successful green fleet management is securing drivers’ buy-in to the new vehicles. Even when given the most efficient and clean vehicle available in the market today, an employee who resents having the vehicle will manage to make it perform inefficiently. Therefore, geting the drivers’ early buy-in to environmental policy and the objectives will be much more achievable.

Frontline NHS fleet manager activities depend on the availability, reliability and safety of a wide range of specialist vehicles Ensure that employees are made aware of any financial savings available to them – low CO2-emitting cars will reduce company car tax and private fuel costs. Employees need to be shown the key features of vehicles to understand any special driving characteristics. For example, hybrids require a different driving style to optimise their dual-power systems. L FURTHER INFORMATION

Providing all Transport Solutions Bradshaw Electric Vehicles is Britain's largest manufacturer of industrial electric vehicles, supplying to both the UK and world market since 1975.

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INCIDENT INVESTIGATION AND PROBLEM SOLVING TO THE FOREFRONT Kelvin TOP-SET offers free trial of online root cause analysis course and introduces TOP-SET Live, the world’s first incident investigation app Kelvin TOP-SET, the leading incident investigation specialist is offering a free trial of its e-RCA Root Cause Analysis online course to all readers of Health Business. The company is also pleased to announce the launch of the world’s first incident investigation App – ‘TOP-SET Live’. Root Cause Analysis (RCA) is probably one of the most misunderstood terms in global industry. With over 30 years of practical experience teaching and conducting Incident Investigation and Root Cause Analysis, Kelvin TOP-SET realises that, for many people, getting to the real root causes of incidents poses a serious challenge. With this in mind, Kelvin TOP-SET recently launched its online e-RCA course. The company believes that the Kelvin TOP-SET e-RCA course could help to save lives and reduce injuries in the workplace. The course can be completed online in approximately four hours and requires no prior knowledge of RCA. It is suitable for anyone who may be involved in incident investigation and for those who simply wish to gain a better grasp of the fundamentals of good Root Cause Analysis. STEP BY STEP Users are guided through the course with simple step-by-step instructions and a blended learning approach using videos, case studies with animated incidents, online exercises and interactive tests. Users learn how to conduct effective Root Cause Analysis and have ample opportunity to practise and perfect this vital investigation skill. The e-RCA course is highly interactive and can be easily accessed on multiple devices. PEOPLES OPINIONS A training manager from SapuraKencana Drilling said: “The e-learning course was very well constructed with relevant content - it hits the spot.” A safety officer at Allseas commented: “The course did exactly what it said in the introduction. It was kept simple and the learning pace was adequate for people with no experience whatsoever... a great introduction to Root Cause Analysis.” 2015 has also seen the launch of an innovative investigation App. TOP-SET Live



enables teams to collaborate and solve problems from multiple locations in ‘real time’. Details, images, live sketches, audio and video can be shared ‘live’ from diverse locations. This means that team members can work together simultaneously with the same information and data even though they may be physically separated – for example communicating from an office location direct with a colleague at the incident site. Iain Livingstone, developer of TOP-SET Live, commented: “Unique aspects of this App are that users can see and speak to each other whilst drawing on the screen and incorporating symbols if required. This allows investigators to easily highlight details of complex incidents, equipment failures and problems so that issues can quickly be identified and resolved through speedy collaboration.” David Ramsay, Kelvin TOP-SET Group managing director, said: “We are very excited to be able to offer TOP-SET Live as part of our product portfolio. This application will be of great benefit to businesses in the health sector. It is suitable for use in the investigation of incidents and the solving of problems in areas such as the NHS, the emergency services, local authorities, government agencies, HM Prisons, housing associations and social services. “It is a very powerful communication tool and enables crucial detailed information concerning incidents or problems to be discussed live. This substantially cuts down on time, travel and cost. Images and messages can be worked on in real time and can also be stored for subsequent analysis and discussion. “As long as a 3G or Wi-Fi connection is available, this App can be utilised anywhere in the world including remote locations. The collaborative App was used successfully in a recent transatlantic investigation where several parties were able to simultaneously look at, discuss and draw on photographs of failed equipment. Although it has been designed for investigating incidents, it can be applied to any issue or problem and used as a valuable communication tool between several locations.” Mr Ramsay continued: “Investigation is a vital process for understanding and preventing incidents, and with the current

growing pressures within the health sector to investigate incidents and pinpoint the Root Causes, Kelvin TOP-SET is well placed to assist. With an established reputation for our Incident Investigation courses, e-learning tools and software and the new addition of the TOP-SET Live App to our product portfolio we really can offer practical cost-effective solutions to out clients.” Kelvin TOP-SET has a significant client base in many business sectors including emergency services, health, oil and gas, utilities, ports, marine, rail, airports and civil engineering. L FURTHER INFORMATION To learn more about TOP-SET Live please go to To access your free trial of the e-RCA online Root Cause Analysis course, please go to, click on the yellow register button and register using the following code: GB1115.



A radical new accreditation, the Professionalism in Parking Accreditation, will be of great benefit to healthcare organisations, says Nick Teasdale of the British Parking Association Many organisations offer parking services that are a cut above the average, but how many are truly excellent? The British Parking Association (BPA) plans to find out through a new, audited accreditation: the Professionalism in Parking Accreditation (PiPA). Excellence in parking is a product of organisational professionalism, and this concept lies at the heart of PiPA. We are initially launching PiPA for healthcare providers such as NHS trusts and, in time, we will make this revolution in professional standards available to other parking sectors. What, though, does it mean to be a professional organisation? It means you take seriously every aspect of your parking operation. It means you treat your parking staff as ambitious professionals and provide them with the support, encouragement and recognition they need to develop skills within parking. It means you acknowledge your responsibilities in society and adopt the ethical ethos of an organisation that meets the needs of the wider community. It means you are committed to improving your parking services continuously, in response to car-park user feedback. All of this will help to ensure that your customer service is peerless. Only a professional organisation can achieve that goal. Organisations that hold PiPA can shout from the roof-tops: we are professional, we epitomise excellence. NEW DAWN FOR HEALTHCARE PARKING NHS trusts and other healthcare providers work tirelessly to deliver an optimal level of clinical care. For many healthcare organisations, that effort is reflected in their provision of parking. This dedication is exemplary, and it is high time that it was recognised. PiPA will go one step further than recognition: it will celebrate professionalism in healthcare parking.

We are launching PiPA in healthcare parking precisely because this sector is so important. No one enjoys a visit to a hospital or a doctor’s surgery. If someone does make that visit, it is generally because they are ill. Why, on top of that, should they feel stressed about parking? How does it help anyone if a doctor, nurse or surgeon is also stressed about parking? A professional organisation will take steps to help minimise anxiety in its car parks. Accredited healthcare providers will become nationally-recognised role-models for parking professionalism and excellence. PiPA will help raise levels of customer service for patients,

Written by Nick Teasdale, British Parking Association

Parking professionalism and excellence have steadily raised the bar for standards in private-land parking through our celebrated code of practice. Since 2010, we have also delivered two voluntary charters for parking, with one dedicated to healthcare parking. Our healthcare parking charter has now evolved into the sector-specific sections of the new, audited PiPA standard for healthcare parking. We will build on all the lessons learnt throughout our 45 year history to create a comprehensive accreditation that is sensitive to the needs of the healthcare parking sector. Although PiPA reflects the accumulation of considerable experience at the BPA,

No one enjoys a visit to a hospital or a doctor’s surgery. If someone does make that visit, it is generally because they are ill. Why, on top of that, should they feel stressed about parking? visitors and staff, and it will recognise the high standards that already exist. It will help increase patient, visitor and staff satisfaction and ease their worries about parking. It will improve the reputation of NHS trusts and other healthcare providers, and it will help to counteract adverse publicity in the media. PiPA is a new dawn for healthcare parking. Yet for the BPA, it is the next logical step in our long march towards professionalism in parking. Founded in 1970, the BPA has always strived to increase professionalism: our articles of association declare that we will ‘work for the general advancement of standards.’ In partnership with the Association of Chief Police Officers, we run the Park Mark Safer Parking Scheme, helping to improve safety standards in car parks. We launched our Approved Operator Scheme (AOS) in 2007 and

it also represents the beginning of an exciting new journey. As we embark on this journey, we are keen to take you with us, every step of the way. KNOWLEDGE AND EXPERTISE PiPA is and will continue to be the product of collaboration between BPA members, key stakeholders and staff at the BPA. It is the ultimate synthesis of professional knowledge and expertise. The development of PiPA for the healthcare parking sector offers an object-lesson in collaborative development and consultation. From the very beginning, we were determined to seek the views of our members in healthcare parking, ensuring that the first phase of PiPA truly reflects this sector’s needs. At last year’s BPA Annual Conference, we E



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WHERE DO PATIENTS FIT IN YOUR PRACTICE COMMUNICATIONS? How are you keeping in touch with patients with long term conditions? Are your communications relevant? Do you have an up to date way of collating patients’ communication details and preferences? Ask yourself some of these questions to find out “[It] has saved us time and money… and increased patient awareness of our services and is starting to provide us with valuable information on patient behaviour to help us meet QOF targets by sending a message to those with a mobile number or email address to ask them to come in to be checked out.” Burnham Health Centre ACCESS TO PRACTICE SERVICES Digital channels offer fast and convenient two way communications with patients 24/7, 365 days of the year. Messages sent to and received from patients can be automatically recorded directly to their record. Appointment confirmation messages help to quickly free up unwanted appointments – as patients can conveniently text back to cancel their appointments, dramatically reducing reception time on the telephone, and substantially improving access to practice services for more patients. “We can now reallocate 100% of cancelled appointments, whereas prior to the system being installed we had a DNA rate of 60-70%. To be able to reallocate 150 appointments within the first week was astonishing.” Cripps Health Centre PATIENT ENGAGEMENT Patients opting-in to practice services through their preferred method of communications (SMS, voice or email) respond in greater numbers than through traditional methods of communication - increasing response rates to Annual patient surveys through SMS (links to the survey in the SMS) – generating a 5% response rate using SMS messages against the time and cost of sending surveys via post. Busy lifestyles mean patients want the ability to respond to and access healthcare information when convenient to them – mobiles are cost effective, suit most of the population and are our primary communication device, be it for online shopping or banking. A dedicated practice Text-In number gives patients this easy option – makes contacting



your practice simple and avoids the frustration of trying to get through to reception. GREATER PATIENT REACH People across all ages have embraced mobile technology because it makes their lives simpler and easier – demonstrated by the frequency of usage of new devices (smart phones, tablets) which are now used to access most personal communications. Often, emails are checked first thing in the morning and last thing at night. With smartphone ownership steadily increasing, especially in the 55-64 age range, where 50% now own a smart phone – a figure which has doubled since 2012. For those aged 64 plus the figures have trebled. “Our older population are using both [SMS and email]. One 80 year old patient who came to a Patient Group Meeting said he struggles to get out and he does everything online.” One Medicare Email messaging can deliver much more in‑depth information such as health management advice for Diabetes; directs patients to online health services for detailed information; provides greater patient choice and access – as patients get information ‘on the go’ via apps; and widens reach to those who access their emails at work and at home. Automated Voice messaging delivers Flu Vaccination clinic invites securely to patients; provides results and prescription ready messages; allows practices to conduct health status checks e.g. smoking status; and also simple telephone surveys. IMPROVE DISEASE MANAGEMENT Pre-configured message templates enable practices to automatically send messages to patients for chronic diseases, annual reviews, screenings and vaccination recalls, using selected searches within their clinical system (integrated with all leading PAS). Innovative ways to promote self‑care for patients, reduces avoidable appointments at the practice. Scheduling campaigns for the year in advance isn’t just wishful thinking

- flu invites, vaccinations and annual reviews can all be sent, and repeated, when needed with just a few clicks! It not only frees up administrative staff time but has removed the need for traditional print and postage costs. We were sending out over 3,000 letters a month, so this cost and time saving was seen very quickly.” The Moatfield Practice INCREASED PRACTICE INCOME Practices have used multiple digital channels (SMS and email) to send out annual reviews for Asthma and Diabetes. “…staff simply have to click a button and it’s done, which saves us valuable staff time” One Medicare Digital communications also allow tracking of alcohol consumption or smoking status, as well as offering advice or direction to online resources. This increases patient awareness, but without the limitations of face to face consultations which have staffing implications, resulting in a dramatic cost saving at practice and CCG level. “The advantages and effectiveness were demonstrated in a recent ‘no smoking day’ campaign. 1,500 SMS messages were sent to patients stating they were current smokers reminding them of the Practice’s quitting services and signposting them to online resources.” Clapham Park Group Practice L FURTHER INFORMATION Read more at Email:




consult at every step, capitalising on the unparalleled knowledge and expertise of BPA members and key stakeholders. AN AUDIT YOU CAN TRUST The PiPA audit for healthcare parking is rigorous but fair, and has evolved through the recent tests with two NHS trusts. Following your organisation’s initial application for a PiPA audit, the BPA will send you a special PiPA audit pack, and we will ask you to submit a pre-audit self-assessment form. One of our expert area managers will then review the form and ask you for any additional evidence during a site-visit audit. The audit will focus on the nine key assessment standards for the healthcare parking PiPA: customer service and stakeholder relationships; safer and properly maintained parking facilities; fair pricing and easy-to-use payment services; fair enforcement of parking terms and conditions; impartial and fair appeals service, accessible to all; clear and comprehensive parking information; employee wellbeing, development and recognition; social responsibility and equality of service delivery and continuous improvement. Throughout the audit process, you will have access to a guidance document, which will suggest possible evidence-types that you may like to consider for each PiPA assessment standard. The area manager will then submit your organisation’s audit results to a moderator, who will ensure that standards are met at a consistently high level. Once you have achieved PiPA, your accreditation will last for two years, with an interim self-assessment to maintain standards at the half-way point. This approach to auditing combines high standards with the flexibility needed to meet the needs of a diverse healthcare parking sector. It is an audit you can truly rely on.

This approach to auditing combines high standards with the flexibility needed to meet the needs of a diverse healthcare parking sector. It is an audit you can truly rely on asked our members to determine the general direction for PiPA development. Since then, we have gained valuable insights through meetings of our healthcare special interest group and through a dedicated PiPA development workshop. In collaboration with key partners such as the Healthcare Facilities Consortium, we have consulted NHS trusts through detailed electronic surveys, and a further survey provided us with useful intelligence from motorist and patient groups. In parallel with PiPA development, we helped the Department of Health as it drafted the new Health Technical Memorandum for

parking, and we considered this document and the ‘NHS patient, visitor and staff car parking principles’ while developing PiPA. Most recently, we have worked with two NHS trusts to test the PiPA assessment methodology. We have learnt invaluable lessons during the tests, which strengthened the PiPA standard and paved the way for a robust new accreditation. There can be no doubt that PiPA reflects the deepest and broadest range of contributions from the healthcare parking sector, helping to make this the new benchmark for parking professionalism. As we roll PiPA out to other parking sectors, we will continue to

JOIN THE PIPA REVOLUTION PiPA was the focus of a reception at the House of Commons last year, and the campaign to spread the word about PiPA continues to gain momentum. NHS trusts and other healthcare providers can now seek PiPA accreditation, and interest is sky-high. If your organisation wants to ride the wave of support for enhanced professional standards in healthcare parking, contact us today. PiPA is an accreditation that will make your organisation proud. So why not join us at the start of this revolution and help make professionalism the new norm in healthcare parking? L

Are you a healthcare provider? If so, you can join the PiPA revolution today by emailing membership@britishparking. for more information and to express your interest in becoming accredited. FURTHER INFORMATION



Advertisement Feature By Colin Tankard, Managing Director, Digital Pathways



UNDERSTANDING THE SECURITY ISSUES OF THE INTERNET OF THINGS The Internet of Things (IoT) was first envisaged in the last century. It is a vision whereby potentially billions of ‘things’ such as smart devices and sensors are interconnected using machine-to-machine technology enabled by Internet or other IP-based connectivity A study by the McKinsey Global Institute estimates that the IoT will have a potential economic impact of US$3.9 trillion to US$11.1 trillion per year in 2025 across nine settings: homes, offices, factories, retail environments, worksites, human health, outside environments, cities and vehicles. Estimates vary widely regarding how many IoT devices will be connected but an often quoted statistic is from Cisco which estimates that 50 billion objects and devices will be connected by 2020. SECURITY ISSUES Whilst the IoT holds much promise many security issues have been uncovered. Owing to the wide range of sectors involved, and their impact on everyday life, such security issues can have serious consequences causing damage, disruption to operations or, in some scenarios, even loss of life. In smart buildings where systems such as HVAC, healthcare systems, door access and video surveillance are all interconnected, a security threat that is exploited to disrupt power or lighting could cause loss of life. This can be seen in a hospital, or even a door access control that is hacked could provide an intruder with unauthorised access into the pharmacy or private wards. Issues with IoT devices are far from hypothetical: one example was the Stuxnet worm that disrupted industrial control systems causing extensive damage, loss of production and cancelled operations. A range of security risks have been uncovered in the devices themselves that make up the IoT. Among the reasons for this is that many IoT devices are not developed with security in mind. Many contain embedded software, often proprietary

firmware, which is problematic to patch and upgrade, leading to vulnerability and configuration management issues. SOLVING THE SECURITY CHALLENGES A different stance needs to be taken to solve the security challenges of IoT devices. Security needs to be built into products by design. It cannot be bolted on afterwards. The Open Web Application Security Project (OWASP) has identified the top 10 issues with IoT devices: insecure web interface; insufficient authentication/authorisation; insecure network services; lack of transport encryption; privacy concerns; insecure cloud interface; insecure mobile interface; insufficient security configurability; insecure software/ firmware; and poor physical security. Unfortunately building in security is going to take a long time to happen and even when it does there will still be legacy devices in our networks to exploit. Organisations should look to limit what is allowed in the workplace, considering the risks versus the benefits, as well as looking at how systems are interconnected and, therefore, how risks such as malware infections can be spread. Our experience has shown that it is time to link physical and network security together to enable a total view of incidents, which has lead us to develop our nLiten system to enable organisations to have a manager gathering information from data systems, physical guarding/monitoring or even Care Plan records. This enables management to make decisions regarding the threat posed and how it can be controlled. Where anomalies are uncovered

organisations need to have workflow and escalation procedures in place so that those in charge of security are alerted promptly to any potentially serious threat or incident. This helps greatly in the time taken and, therefore cost, for remediating problems. It is essential that all procedures and processes are documented, completed in a compliant way and an audit trail generated to provide evidence of the effectiveness of actions taken. We feel that such auditing needs to remain stored and tamper resistant as incidents completed might only be investigated sometime, even years later, and so having a searchable database of events ensures good governance and in cases within healthcare we have seen that strong evidence protects organisations against negligence. REMAINING VIGILANT Whilst it could be said that the IoT is still in its infancy, IoT devices, and increased connectivity, are being seen across a wide range of sectors. Many will be familiar with consumer-oriented smart, highly connected devices and these are invading workplaces. Organisations are still grappling with the bring your own device (BYOD) phenomenon creating headaches for many in terms of managing them and controlling what sensitive data can be accessed. Now this is being extended to wearables such as smartwatches and health and fitness monitoring devices. But the industrial IoT holds the greatest promise, and threat, and is being overlooked. The IoT appears to be an unstoppable force. Until security issues are solved organisations need to be vigilant ensuring that they weigh-up the security risks against the benefits to be gained putting appropriate controls and policies in place, and, keeping a constant eye over what is connected to their network and how devices are performing. L FURTHER INFORMATION Colin Tankard, Managing Director T: 0844 586 0040 E: W:





Written by Ben Plummer, Health Business Magazine

Exploring the potential of The Internet of Things With the rapid reliance of technology increasing each year, Health Business’ Ben Plummer delves into the The Internet of Things and what it could mean for the NHS in 2016 The Internet of Things (IoT) is the term used to describe the network of ‘smart’ objects and devices that are connected wirelessly via the internet or bluetooth, with the capability of sharing the data they collect with each other. Although the concept has been around for many years, the advancements in technology in recent times has meant that the potential of the idea has gathered pace rapidly. The UK population is becoming more and more reliant on the internet as a source of information on their health and well-being – according to the ONS, usage of the internet to search for health related information has more than doubled since 2007 – and as smartphones and tablets have become more and more prevalent in hospitals, as well as wearable technologies becoming readily available to consumers and patients, the issue of how to best utilise IoT in order to improve patient care, cut costs and improve efficiency within the NHS, has been brought to the fore. There are certain issues, such as how to best integrate primary and social care, and how to become a totally paperless institution without putting vital and established processes that protect patients at risk, that have dogged the NHS for years without a clear or defined

solution being unearthed. However, there are steps being taken, and evidence to suggest that 2016 could be the year that IoT becomes a vital factor in helping ameliorate such problems.

Apps are crucial to the future of IoT in the NHS. In the Monitor Deloitte report on Digital Health, released by in September last year, the UK app market was forecast to grow 35 per cent by 2018, and in a study of over 1000 people by PushDoctor, 58 per cent of those asked regularly and actively use technology as a means of managing their health. The Monitor Deloitte report notes that the information collected through smart technology can be divided into two categories: low confidentiality data, such as fitness, sleep and activity statistics, and medium to high confidentiality data, which consists of personal health records and clinical illnesses that individuals may be concerned about sharing, but also offer ‘the greatest potential to improve healthcare outcomes’.

The t Interne in s of Thinghas the are healthc to empower al potentints, and give patie voice in the them a vision of pro re their ca

WHAT WORK IS BEING DONE? There is a vast array of different ways that IoT could impact the way the health sector works. Fitness trackers, small watch-like wearables that record exercise routines and sleep patterns via the wrist, give a good indication as to the kind of lifestyle an individual lives, though the possibilities have a much larger scope; last year, King’s College Hospital piloted a trial scheme wherein a small number of their oncology patients were given an Apple Watch to use in conjunction with a specialised chemotherapy app that reminds them when to take their medication, and allows them to record any negative symptoms they experience, which are sent directly to their doctor’s mobile device.

WHAT ARE THE CHALLENGES? In many ways, out of all of the industries E



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BETTER CARE WITH SMART TECHNOLOGY Smarter Communication Technology helps multidisciplinary teams deliver better patient care Recent years have seen a significant growth in group decision working when considering a patient’s care pathway. Prior to multidisciplinary team (MDT) working being the norm, diagnoses were often made and treatments given by clinicians working in isolation, with little collaboration between radiologists, oncologists, surgeons and physicians who understood the specific cancer. This resulted in key factors being regularly missed, and therefore beneficial treatments being overlooked for the patient in question. By establishing a forum where highly specialised individuals are brought together to clarify diagnosis and decide upon patient treatment, there is a strong belief that healthcare decision making has improved, and the likelihood of error reduced, resulting in greatly improved outcomes for patients. However although MDTs have become well established across the UK in the past 20 years, there are still common concerns about the wide variation of facilities at NHS trusts nationwide, alongside challenges with improving efficiency of processes in place. These concerns must be overcome to ensure all patients receive the highest quality care available, wherever they are located, and facilities develop in-line with technological and clinical advances. Suitable meeting facilities and technologies are essential to the efficient functioning of an MDT meeting. Image viewing equipment such as Picture Archiving Communication Systems (PACS), high quality displays for viewing pathology reports and radiology data, appropriate meeting recording solutions and integration with patient record systems

create a suitable environment for meetings to take place, whilst video conferencing tools, data sharing and collaboration technology ensures individuals can see, hear and interact within the MDT, wherever they are located. AGEING TECHNOLOGY Video technology was originally installed in many NHS MDT rooms nationwide to speed up discussions and decision making between professionals from multiple clinical disciplines. However studies have found that much of the video conferencing technology within MDT rooms today is ageing, with complex controls, low quality images and failing connectivity resulting in the efficiencies expected not being recognised. UPGRADING MDT ROOMS: A REAL WORLD EXAMPLE Brighton and Sussex University Hospital (BSUH) NHS Trust has recently upgraded its ageing video conferencing and collaboration technology across MDT rooms after recognising that the overcomplicated technology in place was confusing and costly. BSUH NHS brought on board UK video collaboration and conferencing partner, VideoCentric, to consult, design, deploy and support a modernised collaboration solution. The BSUH aims included: reducing the number of calls into IT; growing confidence and adoption; cutting down travel between sites; and improving the quality of integration of platforms and technologies already in place, such as Microsoft Lync 2010 and 2013. Any technology implemented needed to be intuitive to use so that training would

be minimal, and external medical devices and equipment, such as PACS machines, needed to easily share their outputs at the highest possible quality, with those both within the room and at remote sites. To ensure MDT rooms within the acute medical team, cardiac services, neurology research and radiology departments could meet the trust’s requirements, VideoCentric provided a pilot install within the Radiology department to enable cardiologists and clinicians, along with IT staff, to test and trial the new solution. With built in touch-panel controls, Lifesize Icon endpoints were then installed within each of the meeting rooms, paired with high quality AV equipment so that data and images could be shared and viewed clearly, both for local meetings and those involving remote consultants. The solution provided access to multipoint conferencing and mobile applications via virtualised infrastructure situated within the trust’s own data centre at the Royal Sussex County Hospital. By providing simple and secure access from any mobile device, remote consultants are now able to join an MDT meeting wherever they are located, removing distance barriers and enabling clinical decisions to be made in much shorter timescales. To simplify the MDT rooms further, old complex touch panels were removed, and a single switch programmed to turn on or off all of the systems, screens, projectors and AV equipment in the room. Iain Kelly, senior IT project manager at NHS BSUH, commented: “Our complex video conferencing technology has been replaced by modern, simplified collaboration tools, enabling our teams to gain the benefits of video communications without the inefficiencies we experienced previously. Our partner took the time to understand our needs and provide a solution that is much more cost efficient and simple to use. We continue to be supported with a high quality and personal service from VideoCentric’s technical experts.” In the past 18 months, VideoCentric and Lifesize have worked with a number of forward thinking NHS Trusts to develop and deploy similar solutions that enhance interaction and improve multimedia information sharing within MDT rooms, whilst making sure that high quality technology is accessible and user friendly for all. Improved efficiencies in modern technology means more patients will have the advantage of multi‑disciplinary team discussions for their case, and better collaboration between sites and specialists is expected to have a significant impact on patient outcomes. L FURTHER INFORMATION For more information, visit or call 0118 979 8910.



THE INTERNET OF THINGS  that could potentially benefit from IoT, healthcare is perhaps the most obvious. Arguably, no other division of the public sector requires such sensitive and personal information, in real time, in order to fulfil its duties to the best of its ability. However, one of the greatest challenges the NHS faces in its adoption of IoT is how to protect itself from the threat of a potential cyber attack. A recent freedom of information request by Accellion, a US‑based cloud solutions provider, revealed that the vast majority of NHS trusts that provide their staff with, and acknowledge use of, smartphones and tablets in the workplace have no parameters or protocols in place for dealing with potential e-security breaches. According to the release, patient data is seen to be of more value than financial records to hackers looking to sell the



There are certain issues, such as how to best integrate primary and social care, and how to become a paperless institution without putting established processes that protect patients at risk, that have dogged the NHS for years information on the black market, and there is an alarming absence of a ‘formal and recurring training program’ to prepare hospital workers for these eventualities. Another, more familiar issue preventing full scale IoT functionality within the NHS is lack of funding. Even though in his 2015 budget in March, Chancellor of the Exchequer George Osborne committed £40m towards IoT in general, and promised

another £1bn towards technology solely within the NHS in his spending review last winter, the current IT frameworks in place are too out of date, and too inconsistent between cities and the countryside, to facilitate key parts of IoT systems. A study by the Oxford Internet Institute into the ‘digital divide’ in Britain revealed that 53 per cent of people who live in ‘deep’ rural areas do not have access to a high‑speed broadband connection, which would be an important factor in fully capitalising on the benefits of wearable and remote patient monitoring technologies. It would take a truly nationwide communications infrastructure, with full Wi-Fi capability in order to fully embrace IoT. Despite the obvious difficulties and costs involved in implementing a network so vast and complex, the government has signalled its intent to move in the right direction. Martha Lane Fox – the entrepreneur who co-founded the travel website lastminute. com, and the person commissioned by Health Secretary Jeremy Hunt to help form the country’s vision for digital health – made a four point proposal to the National Information Board for consideration. Her recommendations were made ‘in a bid to increase take-up of internet enable services across health and care’. They include free use of Wi-Fi in all NHS buildings, with the specific goal of enabling patients to self monitor their conditions and expanding the use of electronic health records (EHRs); making sure that those most in need of health and social care (who are often the least likely to be engaged with new age technologies) are prioritised when it comes to the introduction of new digital developments; a commitment to improving digital literacy among the NHS workforce; and, most specifically, to have at least 10 per cent of registered patients in each GP practice using a digital service, such as online appointment booking. While the proposal is ambitious, each recommendation made would, in varying ways help advance the sector towards being able to make better use of IoT. The Internet of Things in healthcare has the potential to empower patients, and give them a voice in the provision of their care, while simultaneously allowing healthcare professionals to improve the quality of care they can offer, as well as improving the administrational aspects of the day to day running of hospitals and GP surgeries. But it will take time, investment, commitment, and patience before we see it become a reality. L



Diabetes Professional Care



Serving the diabetes market in one event

Launched last year, Diabetes Professional Care showcases innovation in the prevention, treatment and management of diabetes. Health Business details the highlights of the 2015 event Diabetes Professional Care is the UK’s only free to attend diabetes conference and exhibition for HCPs, CCGs, CSUs and research professionals. The event is unique in its make-up, having been designed for healthcare professionals, by healthcare professionals.  Launched last year, the inaugural CPD accredited event attracted over 1,579 attendees ranging from diabetes specialist consultants and decision makers in hospital trusts, to commissioning board managers and pharmacists. Over 40 exhibitors showcased the latest innovations and

De Montfort University’s Prof. Joan Taylor, and the role of social media in diabetic care with Dr Partha Kar, Clinical Director of Diabetes at Portsmouth Hospitals NHS Trust and Laura Cleverley, aka @ninjabetic1. Other sessions addressed the issue of commissioning care, patient information, self-care and interventions to tackle the diabetes epidemic in the UK. DEBATES AND WORKSHOPS Conference streams were specially designed to provide sessions for everyone – prevention, commissioning, primary and secondary

Conference streams were specially designed to provide sessions for everyone – prevention, commissioning, primary and secondary care, co-morbidities, research, diagnostics/ new technologies and paediatrics products including MSD, Bayer HealthCare, Abbott Diabetes Care, Cardiff University, Public Health England, JDRF and iHealth. Seven conference streams ran throughout the two-day event featuring keynotes from the likes of Professor Chris Ham, CEO of the Kings Fund; Dr Jim O’Brien, the national programme director for Diabetes Prevention, Public Health England; Tim Kelsey, national director for patients and information at NHS England and Professor Sir Bruce Keogh, medical director at NHS England.  Highlights included insights into developing an implantable artificial pancreas for the treatment of insulin dependent diabetes from


care, co-morbidities, research, diagnostics/ new technologies and paediatrics. An array of workshops ran alongside the CPD accredited conference presenting real-life case studies and practical sessions. Among them was Adam Hoare, managing director at V-Connect, whose workshop focused on ‘The Clinic at Home: Helping Patents to Look After Themselves’. Hoare said: “This technology creates a two-way communication video channel between patients and their care providers using their own televisions, effectively creating remote clinics in homes. It means patients can do their own analysis, with

coaching from the hospital, collapsing pathways, reducing anxiety for the patient and minimising traffic in terms of letters and attendance at hospitals. It transforms the way they feel supported, the education they receive and their long term care.” On day two of the event, there was plenty of show floor ‘theatre’ in the form of a live debate where a panel of experts from Xperio Health, De Montfort University Leicester, X-PERT Health and Public Health England discussed the topic ‘Which single intervention will be most effective at tackling the diabetes epidemic in the UK?’ Chairing the debate was Hon Stephen Dorrell, Former Secretary of State for Health and Chair of House of Commons Health Select Committee, with the conclusion being drawn by Roy Lilley, Health Analyst, who said: “We need to think about diabetes care like the self-checkouts we get at supermarkets. Ten years ago when it was introduced, we were taking the onus off the workers and organisation, putting it onto us, the customer. “This is what we should be encouraging within the health sector. We need to help diabetes sufferers help themselves. If there is a sufferer that is able to manage their own care, we need to provide the opportunity to enable this to happen, and show them how best to do it. There is no silver bullet at the moment, so we need to pull together in order to handle this epidemic.” Jens Birkenheim, Founder of DiabetesCareFinder, an online platform for people with diabetes to find and review local care and support services, remarked: “The live debate was both engaging and entertaining to be part of and, of course,

DIGITAL HEALTH TECHNOLOGY Diabetes Professional Care 2015 also joined forces with Digital Health Kitchen, led by Professor Nicholas S Peters of London’s Imperial College, where six start-up companies showcased their latest digital health technologies to enable greater self-care. Innovators included Smartsensor Telemed, Slow Control and Proteus Digital Health; all demonstrating the benefits emerging technologies can have on health and wellness. Feedback from visitors and exhibitors was extremely positive. Rajiv Dhir, senior prescribing advisor at Wandsworth Clinical Commissioning Group, said: “I came away from the conference reflecting on areas of diabetes care I may not have considered in my professional role but am now already incorporating – this will no doubt improve my care for patients.”

of diabetic services. Fantastic inaugural event, it’s hard to believe it’s the first!” Also commenting on the success of the show was exhibitor Michael Spiers, director at Clinical Professionals: “We have found Diabetes Professional Care 2015 to be a refreshing change from other exhibitions and conferences. The show has attracted a fantastic quality of visitor. Everyone who has come to our stand has been interested and clued up on what they want and how we can help. We have also used the show to meet some of our clients in the pharmaceutical and device sectors, to discuss our staffing solutions and in particular, our Graduate Academy, which helps get the very best university talent into these markets. What a great show!” SO, WHAT’S IN STORE FOR DPC2016? The event team is committed to listening to and working closely with companies and individuals supporting HCPs who carry out important work on the frontline of diabetes care. The 2015 visitor survey revealed that 100 per cent of responders said they would attend in 2016 – indicating a genuine thirst amongst visitors to interact with and speak to companies and organisations who

Diabetes Professional Care 2015 also joined forces with Digital Health Kitchen, where six start-up companies showcased their latest digital health technologies to enable greater self-care Floris Newby-Rush, senior staff nurse at St Andrew’s Hospital, added: “Learning first‑hand about the latest developments in the prevention of diabetes is invaluable, it’s good to see a show like this in London.” Punya Liyanage, health economy liaison manager at Janssen, enthused: “It’s fantastic to have a free-to-attend show with such a great line-up of speakers providing invaluable content. The atmosphere is great, to have this amount of buzz on the first day is really impressive, especially for a launch show.” Exhibitor Caroline McGowan from Flexitol commented: “The events team have worked especially hard to help us, as an exhibitor, to get the maximum from attending their event and we’ve seen high quality, genuinely interested delegates from a wide cross-section

provide products and services in the diabetes arena at Diabetes Professional Care 2016. Now doubled in size, this year’s event brings together more than 100 exhibitors pioneering new services and innovations for diabetes. Some 4,000 visitors are expected at Diabetes Professional Care 2016 and any company with a focus on diabetes or related comorbidities is encouraged to get in contact soon with the organisers soon. The 2015 event revealed it’s an audience with a big budget; 39 per cent of attendees had an annual purchasing budget of more than £1m. Maggie Meer, founder of Diabetes Professional Care, explained: “We are thrilled with the success of the launch and are now focused on delivering another impressive

Diabetes Professional Care

I’m delighted that the patient’s perspective on the vital role of education won the audience vote. The conference as a whole was a huge success and provided a valuable platform in bringing together diabetes professionals, innovators and patients. I look forward to next year’s event.”

event in a bigger and more accessible venue. The overwhelming consensus was that the 2015 show worked brilliantly and has plugged a major hole in the UK diabetes market - addressing the needs of professionals dealing with diabetes type 1 or 2. “We will continue to provide HCPs in the diabetes arena with high quality education in new and innovative treatments, products and services. The event will remain completely free to attend for HCPs ensuring that all those with a professional interest in diabetes have an opportunity to improve the treatment and information that they provide to their patients.” LOOK OUT FOR... The Conference – a two-day, innovative and relevant conference programme delivered by those working at all levels of diabetes care - from HCPs working at the front line, to policy and decision makers (CCG & CSU). Industry Led Workshops – building on Diabetes Professional Care 2015, workshops will be practical, interactive and relevant, including: ‘How to’ sessions, useful advice, real life lessons, and opportunities for mindshare. The Digital Health Kitchen – an exciting feature area returning in 2016 – a dedicated area for a handful of start-up companies working at the knife-edge of innovation and technology in healthcare. An opportunity for visitors, once again, to look at what’s brand new and what’s coming…. The Diabetes Village – a special feature located at the heart of the dedicated networking and lounge area is exclusively for HCP’s working in primary and secondary care. The Diabetes Village provides the opportunity to share experiences and best practice over free refreshments. VIP & Commissioning Zone – in response to feedback from the large number of visiting commissioners and high-level public health decision and policy makers, 2016 will host a brand new meeting and networking area, specially dedicated for this group to interact with industry, in a focused and interactive environment. Innovation and e-health Zone – the show’s Innovation and e-health Zone will help visitors to learn about the latest innovative developments in e-health, life sciences and technology, with experts in this field on hand to discuss issues and explain new developments. Come and see innovation in action! We do things a little differently and we hope that you will be able to join us on the 16-17 November to find out! Diabetes Professional Care 2016 will be bigger and better and we look forward to welcoming you to Diabetes Professional Care 2016. L FURTHER INFORMATION



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We’ve extended our Yeoman Shield Guardian Handrail Range with an innovative new product. The 50mm Dia. PVCu Handrail comes in a range of 10 colours with either matching or contrasting accessories. We also offer a Timber and Stainless Steel Handrail on Cream PVCu underslung brackets with Stainless Steel accessories. The Twin Handrail offers support whilst protecting both the rail and wall surfaces against impact damage.

For a FREE brochure call 0113 279 5854 or email |


Healthcare efficiency through innovation

Healthcare Estates


Health Business looks back at October’s Healthcare Estates show, which attracted a record attendance, and looks ahead to what is in store at this year’s event

Healthcare Estates is the unrivalled platform for estate managers, directors and facilities managers to network with industry colleagues while sourcing and specifying the latest healthcare products and services Healthcare Estates is a unique event that consists of the prestigious IHEEM Annual Conference, Awards Dinner and the UK’s largest trade exhibition for the sector. In healthcare, the built environment is constantly evolving. To help shape and contribute to the discussion, Healthcare Estates provides a networking platform which enables decision makers, service providers and manufacturers to be at the forefront of what the future has in store for this key sector. Healthcare Estates is the unrivalled platform for estate managers, directors and facilities managers to network with industry colleagues while sourcing and specifying the latest healthcare products and services. In 2016, Healthcare Estates will target an audience responsible for engineering, design, construction, maintenance, operation and estate management, providing the

opportunity to explore how to improve the built environment for the benefit of the patients using UK healthcare facilities. The Feature Areas and Theatres will include the Energy & Efficiency Theatre, the Water & Infection Control Theatre, the Specification & BIM Theatre, the Mental Health & Dementia Theatre and the Hospital Engineering Theatre. All are free to attend for both visitors and delegates. LOOKING BACK TO 2015 Taking place on 20-21 October, the overall attendance to Healthcare Estates 2015 increased significantly year on year as visitors and delegates flocked to Manchester Central for the biggest showcase of products and services in the UK healthcare sector. Attendance was up 25 per cent on day one, resulting in a busy day on the exhibition

floor and a packed opening keynote session by Mike Hobbs of Carillion. The keynote presentation was followed by a panel discussion featuring Peter Sellars, Department of Health, Dr Sue O’Connell, Community Health Partnerships, Mike Hobbs, Carillion, Julian Amey, IHEEM and Karen Baker, Isle of Wight NHS Trust, and was chaired by Simon Corben, CAPITA. Official attendance for the conference, exhibition and dinner surpassed 3,600. Visitor attendance was up by 14 per cent with 1,527 visitors compared to 1,451 in 2014. The total number of 3,685 includes visitors, delegates, speakers and exhibitor guests to this year’s Exhibition, Conference and Dinner. Healthcare Estates also saw 364 NHS VIP’s, representing senior estates professionals from many of the UK’s leading hospital trusts in the UK attend the event. The attendance continues the increase seen since the event moved to Manchester, with attendees able to network with more than 200 exhibitors; an increase of 10 per cent on the previous year. Exhibitors in 2015 represented more than 220 suppliers to the healthcare sector. 474 delegates and speakers attended the two day conference, while a record attendance at the IHEEM dinner of 500 enjoyed a fantastic evening at the Mercure Piccadilly in Manchester with guest presenter, Ex England rugby international Gareth Chilcott. Exhibitor numbers also grew, helped in no small part by the addition of a new area for Water Management and Infection Prevention. New theatres, new areas and a significant increase in promotion of the event helped attendance grow significantly resulting in a much busier show and conference. Regional representation across the UK was fairly evenly distributed, London and the North West make up 50 per cent of the audience while the Midlands, East Anglia, Yorkshire and the South West accounted for 32 per cent. Visitors from Wales, Scotland, Ireland and Overseas delivered six per cent of the visitors in 2015. L

Healthcare Estates will next be held on 4-5 October 2016 at Manchester Central. FURTHER INFORMATION




Finding an affordable, quality venue for your conference or meeting in central London isn’t easy, which makes Holiday Inn London Bloomsbury and Regent’s Park such a great discovery. From private functions and team building events to awards evenings and training sessions both these conference venues are excellent choices for you! All our meeting rooms are newly refurbished and now offer additional facilities, exciting break out areas and an award winning Food For Thought menu.

Some Exciting Offers you can benefit from this year include: Day Delegate Rate from £49* Call our dedicated London Meetings & Events team on 0207 341 3400 or email

Subject to availability



The Meetings Industry Association examines the key considerations of planning a conference or event, and why an accredited venue often serves as the best choice for planners With over 1.3 million business events held in the UK each year, with a value of over £39 billion to the economy, meetings and events are big business. Regardless of sector, meetings and events are an effective tool for

organisations to facilitate networking and team-building, run product launches, deliver essential communications and promote innovation. Organising

events is a big responsibility and there are a number of things to consider to ensure you are getting it right.

Wh plannin en g budgetyour TIMING factor i s, Timing is crucial contnge n some across many ncy for aspects of your th that ma y crop uings event planning. Firstly, whilst there p later do wn will be occasions the line when an event needs to be organised on a

Written by The Meetings Industry Association

The pinnacle of conferencing excellence

Conferences & Events


tight timescale, if you can allow plenty of time for planning, research and marketing, your event will benefit as a result. It is also important to consider other industry events or launches taking place, particularly annual events which typically take place at the same time every year. Doing so negates the risk of clashing with established events and therefore affecting your delegate numbers. For the event itself, the schedule for the day should be clearly laid out and allow for networking opportunities and sufficient rest breaks. As a planner, some allowances should be considered for sessions that overrun or and issues that arise on the day. Timely feedback is also important after the event. Whether you choose to ask all delegates or a select few for feedback after an event, do so promptly, whilst the event is fresh in their minds. If you are going to ask for feedback though, be prepared to act on it when it comes to your next event. If problems have been highlighted, work to eliminate them for next time and acknowledge and address them for those who have been affected. BUDGETS Budgets can vary from the generous to the ‘shoestring’. Regardless of where yours sits, you can hold an effective and successful event. Hidden costs often represent the sting in the tail for many organisers. A good venue will have clear terms and conditions and will be transparent regarding their pricing structure. At the point of booking, ask about additional charges rather than be faced with an unwelcome surprise when you receive an invoice. When planning your budgets, factor in some contingency for things that may crop E




B O O K N OW F O R A N U N F O R G E T TA B L E E VE NT w w w.theview

Conferences & Events


 up later down the line. If you are charging delegates to attend your event, think about benchmarking against similar events and allow for ‘early bird’ rates or discounts. VENUES Choosing the right venue is vital. When selecting the best location for your event, there are several things to consider. How accessible is the venue for your delegates? Is it close to transport links, is parking available, is it well signposted? What do the facilities cover? Is there Wi-Fi and AV support available? Think about legal obligations too – if your venue is serving food do they comply with the Allergens Act? Are there up-to-date risk assessments available and compliance with legal acts and requirements? It can seem like an overwhelming task but there are initiatives that can help. For example, Accredited in Meetings (AIM) provides the meetings industry and its buyers with a universally recognised indicator of quality for meetings space and services. AIM was developed by the Meetings Industry Association (mia) with the support and assistance of event professionals from various strategic partners including Visit Britain and the North West Development Agency. Launched in Spring 2007, there are over 500 AIM accredited venues and suppliers in the UK who demonstrate their commitment to quality, service and continuous improvement, all of which benefit the event buyer.

Timely feedback is also important after the event. Whether you choose to ask all delegates or a select few for feedback after an event, do so promptly, whilst the event is fresh in their minds THE BENEFITS OF AIM Essentially, AIM helps event planners to source venues they can instantly trust. But what does it mean for prospective buyers and bookers? It means: doing business with venues that care and have integrity; delegates are well looked after and commitment to service excellence is paramount; the facilities and event spaces are fit for purpose and of high quality standard; accountability through an ethical code of conduct; knowing every element of the venue’s costs in advance; industry-approved contracts and terms and conditions; doing business with credible, legally compliant venues; standardisation of best practice; procurement boxes ticked; stress free venue selection; and total peace of mind. MEETINGS CODE All AIM venues abide by the Meetings CODE which demands: Consistency; Openness; Decency; and Ethics. AIM venues must achieve 50 grading criteria that include: the location and accessibility of the meeting rooms and facilities; the suitability of the lighting and heating in meeting rooms;

the levels of security; how often the rooms are cleaned and decorated; whether the space and furniture are adequate and suitable; the provision of in-room services such as power sockets; what is supplied at no extra charge; and how transparent the published prices are. AIM-accredited venues and suppliers must also comply with a number of legal acts, which complement the criteria, including: Health & Safety at Work and Fire Safety; The Bribery Act; Licensing Laws; Data Protection; and Disability Discrimination. For venues and suppliers, achieving AIM means gaining an industry accreditation and receiving recognition for the management of the business. Internally, the accreditation can help them audit their processes and procedures and ensure they are offering an excellent level of service. The process also highlights any room for improvement so that they can be addressed quickly and appropriately. In obtaining Gold accreditation, Nick Milne, conference manager at Robinson College, said: “The application process was an opportunity for us to assess, review and identify E




Have you discovered Manchester’s

yet? King’s House Conference Centre is one of Manchester’s premier medium-sized versatile conference venues. In these challenging economic times, spend public money wisely and partner with us for your next conference or event. Situated in the south of the city centre, we have excellent public transport links and ample discounted local parking. Our fully equipped Auditorium is perfect for day conferences for up to 350, as well as shorter presentations for up to 600, exhibitions, product launches, exams and much more. We have a large stage, stage lighting, professional PA system, multiple LCD projectors and repeater TV screens. There are seven other conference and meeting rooms, ideal for catering, exhibitions and breakout space from larger events, or as stand-alone rooms for smaller events. Our recently upgraded superfast WiFi system is complimentary for all delegates. We regularly host government departments and other public sector bodies. We would be delighted to work with you in making your event a great success. King’s House Conference Centre, King’s Church, Sidney Street, Manchester. M1 7HB Tel: 0161 276 8194




Choose the right speakers – you can have the best venue, great food and perfect programme, but if the speakers and facilitators aren’t right, your event may suffer  opportunities to improve how we do things. We learnt that much more already happens in the business by way of effective management and customer focus than we realised.  “The process of preparing for AIM put everything in its place and provided an opportunity for us to ‘take stock’.  We knew that our customers were already happy with what we do but by being more formal in recording feedback about specific performance, we have been able to target those areas where we could be even better.  Everyone is focused on improving wherever we can which is a significant and important goal.” FACILITIES GRADING Facilities are subjected to 46 self-assessed criteria, which again the MIA makes available for those who wish to access them. Ensuring all AIM criteria are viewable helps ensure the scheme is open, fair and transparent. The Facilities Grading criteria are verified via spot checks that are unannounced, random or following a complaint, and range from

cleaning routines and provision of guest supplies, to lighting, sound, heating and ventilation systems, to redecoration schedules. Legal compliance is a ten-point code of guidance and self-grading process. For those buyers or other interested parties who wish to see the full code, it’s available from the MIA on request. They include compliance with health and safety, Disability Discrimination Act, Data Protection Act, Trade Descriptions Act and Employers Liability Act. AIM HIGHER The AIM accreditation encourages continuous improvement through AIM Higher. Along with the standard entry-level of AIM, there are two ‘AIM Higher’ levels: AIM Silver and AIM Gold. These demonstrate compliance with a more stringent set of criteria and it is an optional step for venues and suppliers. Venues that have been awarded AIM Higher complete a much more rigorous process, covering 50 pieces of criteria, a ten-section self-assessment, producing

a portfolio of evidence in support of their application and have been visited by an independent assessor who determines whether the venue is worthy of the accreditation and, if so, whether AIM Silver or AIM Gold should be awarded. Therefore, for a venue or supplier to achieve AIM Silver or Gold is significant achievement. Any venue that achieves AIM Silver/Gold must be re-assessed every three years. This is to encourage continuous improvement and is key to the AIM message of maintaining high standards in the MICE industry. Therefore, choosing to do business with an AIM accredited venue means that much of the hard work has been done for you. The reassurance that legal compliance and industry approved terms and conditions have already been checked gives you time and freedom to focus on the other aspects of your event.

Conferences & Events


PEOPLE Finally, though perhaps most importantly, think about the people involved in your event. Choose the right speakers – you can have the best venue, great food and perfect programme, but if the speakers and facilitators aren’t right, your event may suffer. Work from recommendations or try and see the speaker in action first if you can. Always follow up with feedback and thanks. E


The Lensbury is full of surprises, nestled on the banks of the River Thames in Teddington. Set in 25 acres of landscaped grounds it has unrivalled indoor and outdoor leisure facilities including a fully equipped gym and award-winning spa. Our 30 room Conference Centre features state of the art audio visual equipment and can accomodate meetings for 2 to 200 delegates. With 171 unique bedrooms, free WiFi, on-site parking and a team of dedicated professionals The Lensbury is the perfect choice.

Book online or call our reservations team on 020 8614 6400 The Lensbury, Broom Road, Teddington TW11 9NU




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It’s important that everyone who will have contact with your guests, whether on the registration desk on arrival, serving at lunch, on the cloakroom or handing out programmes understands the event and the value of good customer service

NHS providers receive 10% off at our stylish and affordable meeting and events space minutes from London Bridge.

Conferences & Events


Capacity for up to 100 people.

 In terms of delegates, make sure they are well informed. Send out joining instructions, include maps and take note of any dietary or accessibility requirements. If delegates are looked after in the build up to and post-event as well as on the day itself, you’ve ticked one of the most important boxes. In terms of staff, it’s important that everyone who will have contact with your guests, whether on the registration desk on arrival, serving at lunch, on the cloakroom or handing out programmes understands the event and the value of good customer service. People are at the centre of every successful meeting. Build strong relationships and keep people as your focus and you will have a firm foundation for your events. L FURTHER INFORMATION


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Conference, training and event facilities are where Northamptonshire based Whittlebury Hall excels. The award-winning conference, training centre and hotel offers 20 principal management training suites supported by 28 fully serviced syndicate rooms, six spacious meeting rooms, an executive boardroom, three conference and banqueting suites (Brooklands, Grand Prix and Wellington Suites), three secluded private dining rooms and can cater for up to 500 delegates. At Whittlebury Hall, all of the meeting and conference rooms are large, flooded with natural daylight and provide uninterrupted countryside views. They include the latest technology, in addition to coffee stations with unlimited servings of speciality teas, bean to cup coffee machines and tasty treats. When staying overnight, guests have the choice of 254 bedrooms, including five

In several acres of landscaped grounds just off the main road to Otley and the Dales and only 2.5 miles from Leeds City Centre, Hinsley Hall offers a comfortable cost-effective venue for all. The attractive listed building set in the Headingley conservation area underwent a complete internal refurbishment whilst carefully retaining many of the original features. Hinsley Hall has 50 refurbished en-suite bedrooms, 11 well appointed meeting rooms completely equipped with AV services and suitable for groups of various sizes from four to 90. All rooms have large windows giving lots of natural daylight. Hinsley Hall also has a library, bookshop and chapel with free Wi-Fi available throughout the building. With ample free parking facilities, a well stocked bar, comfortable lounges to relax in, good food and true Yorkshire hospitality, Hinsley Hall is the

Passionate about making your event a total success

individually designed suites, providing a restful escape with a host of modern touches and thoughtful extras. In addition to a dedicated team working hard to ensure expectations are exceeded in every way, the famed levels of hospitality are further enhanced with a corporate rewards programme. It’s called ‘Exclusively Yours’ and it means that organisers can enjoy a reward or donate to their nominated charity every time they book with Whittlebury Hall. FURTHER INFORMATION Tel: 0845 400 0003



Situated in the heart of London’s West End, overlooking the tranquil Portman Square gardens lies Hyatt Regency London - The Churchill. It is well-connected and within easy reach of London’s main commercial, financial and leisure districts. As one of London’s most highly rated five-star business hotels, Hyatt Regency London - The Churchill provides the perfect setting for every occasion, with the highest level of service, state-of-the-art technology and outstanding catering. With boardrooms for 10 people, to large banqueting suites for up to 350 guests, the hotel’s 12 meeting and event rooms offer a range of event spaces to suit any event, from top-level meetings to professional conferences. Hyatt Regency London - The Churchill prides itself on the quality, professionalism and flexibility of its dedicated meetings and events team, who will take care of all of your

Event planning is one of the top five most stressful jobs in the UK. At Liverpool Medical Institution (LMI), they understand this. When you book with LMI, you get access to a dedicated events team with over 20 years of industry experience, who will guide you through the process and ensure your event runs smoothly from booking to billing. This magnificent neoclassical venue will wow your delegates and get people talking about your event. The unique building boasts a beautiful Victorian lecture theatre, oak panelled board room and two modern seminar rooms, all accessible and fully equipped with audio-visual equipment, airconditioning and free Wi-Fi. LMI can provide expert audio visual technicians to assist you with your event requirements; say goodbye to tech headaches. Relax in atmospheric dining spaces with impressive glazed

Helping to make the most of being away


A warm welcome awaits at Hinsley Conference Centre

wishes and requirements before and during your event. For those looking for an all-encompassing package, Hyatt Regency London - The Churchill also offers a great value Daily Delegate Package. The above, together with high quality technology, guarantees a stress-free event. Please contact the sales department to book your next event or meeting, or visit the website for more information. FURTHER INFORMATION Tel: 020 7299 2390


perfect choice for your event. Hinsley offers competitive, good value rates for day meetings and residential conferences. Its experienced and friendly staff are here to relieve you of the burden of organising your meeting or conference. Hinsley’s help and expertise will ensure a successful event and an enjoyable stay. For further information please visit the Hinsley Hall website, call or email. FURTHER INFORMATION Tel: 0113 261 8000

One of the oldest medical societies in the world

ceiling domes and enjoy a wide variety of delicious, locally sourced fresh food, made on the day just for you. Choose between the inclusive solution of competitive day delegate packages or mixand-match tailored options, which offer excellent value on a budget. LMI’s convenient city centre location is in the cultural heart of Liverpool, and is easy to reach with great rail, bus and air transport links. FURTHER INFORMATION Tel: 0151 7099125



The Newton Rigg College is situated on a 200-hectare estate, just two miles from the junction 40 off the M6, at the gateway to the Lake District. It has a dedicated conference centre with five rooms ranging in capacity from 150 theatre style to 16. All are equipped with data projectors, screen, flip charts, pens and a water fountain. Wi-Fi access is available in all rooms. The college is just out of Penrith, on the main west coast train route. It is also only ten minutes away from Ullswater and the picturesque scenery of lakes and mountains and is on the coast to coast cycle route. Newton Rigg caters for a full range of conferences and events from a fully catered residential conference to self catering holiday lets. In addition it can hold your training event, day meeting, exhibition, product launch, summer school, away day, lecture, as well as a wedding or christening. It is

Synergy Environmental Solutions, based in the UK, provides first class environmental monitoring and health and safety services. It has an extensive national client base of customers ranging from private home owners, to local authorities to International PLCs. Among its services, Synergy runs environmental monitoring testing and consultancy services. The environmental monitoring services include, UKAS and MCERTS accredited stack emission monitoring, sick building syndrome testing, indoor air quality, ambient air quality testing and contaminated land consultancy services. Synergy’s health and safety testing and consultancy services include workplace air monitoring, LEV testing, noise assessments, COSHH risk

One of the leading land based colleges in the UK

open all year round with late week day opening times to facilitate evening meetings. Other facilities on site include Equine Arena, Sports Hall, and climbing wall. The college has 200 bedrooms available in the Summer from July to September ranging from en-suite to hostel accommodation. The food at Newton Rigg College is prepared on the premises using a range of excellent Cumbrian food producers and suppliers including award winning cheeses and relishes, pies and breads. FURTHER INFORMATION Tel: 01768 893707/09

Environmental monitoring and consultancy solutions



Delegates can now take advantage of Marriott UK’s complete meetings package at Waltham Abbey Marriott Hotel, located on the borders of Hertfordshire and Essex. The initiative allows organisers to create bespoke conferences and events for parties between eight and 25 people at a fixed price, and includes a Meetings Service App, as well as a seamless booking experience. Organisers can use the Meetings Service App to control every aspect of their event, taking care of everything from more coffee to expert technical support or even additional seating. Delegates will enjoy refreshments and varied food menus - including sweet, savoury and healthy options, as well as regionally-inspired lunches - free wi-fi and parking for up to 25 delegates. The hotel has a pioneering partnership with Starbucks

Storofile’s managing director, Jim Sutcliffe, has 25 years of experience in document management for scanning and archive storage. Jim welcomes any enquiry and aims to offer the best solution for any problem, absolutely free of charge. Storofile pioneered the idea of scanning in 1991. It was the first company to use CD’s for digital storage (unheard of then), using PDF format for an open system to save on expensive proprietary systems and licences. Optical Character Recognition (OCR) index’s any word or string of words at no extra cost. Storofile’s clients include hospitals, The Highways Agency (the whole of the M25 scanned), R.A.F, colleges, solicitors, and

Offering a unique setting for business travellers

so that filter coffee is offered as standard to delegates. This follows research conducted by the hotels that suggests great coffee is a meetings must-have. The Waltham Abbey Marriott Hotel offers an ideal location just off junction 26 of the M25 for anyone looking to host a stand-out event in the region. Boasting close proximity to key transport routes and rail links, including the M25, the venues are both easily accessible for guests travelling from Stratford, London or even further afield. FURTHER INFORMATION Tel: 01992 717170 www.walthamabbey

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assessments and respirator air quality testing, all carried out by BOHS qualified technicians. At Synergy Environmental Solutions, the company’s philosophy is always to provide the best quality measurements and the best service at the best possible price. That’s why, on average, Synergy’s customers rate it at 96 per cent for quality, service, reports and turnaround. To find out why Synergy’s customers are so happy with the service ask for an obligation free quote today. FURTHER INFORMATION Tel: 01782 614236

Providing expert service in document management

accountants. It was the first to offer a Scan-on-Demand service (1998), and has over two million medical records stored with an On-Demand Retrieval service that finds information within the hour. Stororfile is a cost effective way to manage budgets. For a full list and details of the services and products Storofile offers, please visit the website. FURTHER INFORMATION Tel: 01202 822855



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As the volume and complexity of health data grows, its safe handling is fast becoming an impossible challenge. Much of the harm that has arisen from the misuse of sensitive personal data can be ascribed to poor or absent staff awareness of the risks. Analysis of past data breaches and data mishandling clearly shows that health businesses are making the same errors over and over again - mistakes that staff could have easily spotted if they were well trained and prepared. iCompli’s training methods come from industries where mistakes cost lives; your staff will learn how the systems they interact with (email, their current state of training and knowledge), and the external factors affecting

D-Tangle is the first product of Laidback Life; a company that aims to design and bring to life commodities that will make every day products more user friendly, easier to handle and at the same time more enjoyable. D-Tangle is an innovative, patented product that prevents earphones from getting tangled in a fun and easy way. It has a unique, internal spring mechanism where users can place their existing set of earphones and automatically unwind them – as simple as that! D-Tangle is compatible with most brands of earphones like the ones of iPhone, Samsung, Senheizer, Nokia, Sony etc. D-Tangle can fit any cable up to 1,200mm in length and 1.25mm in width and also comes with a removable clip feature. D-Tangle comes in five different colours; blue, red, white, yellow and black.

Putting complex data regulations into context

them (pressure to complete a task on time) can all lead to a catastrophic mishandling of data. iCompli’s trainers have expertise in many safety critical businesses including offshore oil and gas and civil aviation, from where it brings some of the most advanced thinking in Threat and Error Management (TEM). iCompli teaches staff to understand how their behaviour and actions can dramatically change the risk profile of your organisation. This is not ‘sheep dip’, ‘tick-the-box’ training. It’s data protection training that achieves results. FURTHER INFORMATION Tel: 020 3291 3415



Actus Performance Management Software is designed to revolutionise the annual appraisal cycle and create year round conversations that are meaningful and engaging. In addition to appraisal it also supports nurse revalidation, one-to-one supervision, talent management and pay progression. Easy to use and highly cost effective, it is securely hosted in the UK Cloud and quickly available via the government’s G-cloud or Digital Market place. The Actus software encourages better quality conversations all year round, not just at appraisal and saves HR valuable time administering staff appraisals and development, freeing them up to focus on developing and retaining talent. Health professionals value the way the system encourages staff to take ownership of documenting performance appraisal and

Embrace-learning is a UK market leader in delivering high quality e-learning courses in the health and social care sector. With 11 years experience, the aim is to further the use of educational technologies in work-related training. A dedicated team of educationalists, designers and software developers work together to write and build e-learning courses that are up-to-date and relevant for todays workforce. As well as a range of over 50 off-the-shelf courses that are updated in accordance with new legislation and government guidelines, Embracelearning also builds bespoke courses and convert existing classroom-based material. Courses include Safeguarding, Mental Capacity Act, The Care

Increasing productivity and profitability


D-Tangle: making earphones user friendly

development actions. This supports a culture with more regular, open discussions about performance and development, removing the need for lengthy annual appraisals that take up time that could be better spent with patients. The software is designed and owned by culture change experts Advance Change who offer full support and training. Advance Change already works with many NHS clients from trusts, to CCG’s and can easily configure the system to fit the individual needs of NHS and other healthcare clients. FURTHER INFORMATION Tel: 01582 793 053


Another important feature is its advertising capabilities. Anyone can customise D-Tangle according to their liking. This could be an individual wanting to place their name on D-Tangle or a big corporate company that wants to place their logo. D-Tangle has an international patent and is ready to take international markets by storm. The company is looking for distributors/retailers that will be ready to accommodate D-Tangle. More information and contact details can be found on the D-Tangle website. FURTHER INFORMATION Tel: +357-22-447300

Furthering the use of educational technologies

Certificate and a range of Disability Awareness courses. Embrace-learning recognises that training in this sector can be difficult to complete due to a dispersed workforce and night working. E-learning courses can be carried out at a time, place and pace to suit each individual learner and is recognised as one of the most powerful tools in any training strategy, especially where a large dispersed workforce is involved. It provides a flexible, consistent and versatile learning system that enables training to be tailored to fit with company specific requirements. FURTHER INFORMATION Tel: 0161 928 9987



Placing a defibrillator into a community is a worthwhile and exciting thing to do. However people forget these are medical devices being used on humans, and as such are required to be treated with respect and full governance. If placing indoors, you will be covered by PUWER, but externally you also need to take into account public liabilities, and also any duty of care requirements, as well adherence to legal obligations such as the disability and discrimination requirements. After all anyone can use an externally placed defibrillator, and you cannot discriminate against non-English speakers, disabled, SEN, or any other requirement. This applies both to the actual model defibrillator as well as the storage. These rules also cover the

Calibre Climate Control has long recognised the importance of a diagnostic approach to clients and their individual situations. Like a good doctor, the company tries hard to put itself in your shoes, and get a detailed understanding of your situation and how it affects you; only then is Calibre Climate Control willing to diagnose the issues and suggest a way forward. The company only ever provides solutions if they genuinely match its client’s needs. Does it work? Calibre Climate Control gets a very healthy amount of business by personal recommendation or from long-term clients, so the answer has to be yes. The company provides airconditioning and ventilation solutions for thousands of healthcare professionals, covering design, installation, maintenance, repair and even end-of-life solutions. Trust Calibre to look after

Managing community defibrillator projects – do it right


storage mechanisms, and these need to be up to scratch, and meet the ShockBox standards. The Community Heartbeat Trust charity will help guide you through this minefield, and help you place the right equipment, the right training, the right support and the right governance to make sure your solution is safe, effective and offers a long term benefit to your community. The Trust also provides long term support, as a defibrillator is not just for Christmas… FURTHER INFORMATION Tel: 0845 86 277 39 www.communityheartbeat.

Specialist town and country planning advice

A medical approach to climate control

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your atmosphere with clinical efficiency, surgical skill and above all, care and understanding, and the company is sure you’ll start to feel better soon, as the treatment takes effect. Contact Calibre Climate Control to receive a comprehensive diagnosis of your needs and discover the specialist solution that the company can bring you. FURTHER INFORMATION Tel: 020 3191 9131


Landscape, and Landscape,planning planning and urban urbandesign design services services

As As a multi-disciplinary a multi-disciplinary consultancy, Sophie consultancy, Sophie Smith is well Smith LtdLtd is well placed help clients placed to to help clients with developing with developing realising andand realising estates strategiestotodeliver deliver estates strategies first class health care facilities first class health care facilities has also become a specialist in maximise disposalofof andand maximise thethedisposal the renewable energy sector. surplus land and buildings. surplus land and buildings. Where a job requires input from Director Sophie O’Hara Smith Director Sophie O’Hara Smith a range of different professionals, has extensive experience hasnegotiating extensive experience the company is able to use its with local negotiating localbring forward extensive network of contacts authoritieswith to help authorities to help bring forward to set up and coordinate the development on complex and development on such complex team environment required sensitive sites as theand sensitive such as the site in to get the task done. Williamsites Julien Courtauld William Julien site in You can get in touch with Braintree andCourtauld Severals Hospital Braintree andfor Severals Hospital the company via the contact Colchester housing. Colchester for housing. details below and speak to At Broomfield Hospital a Graham Carlisle, the director of was produced Atmasterplan Broomfield Hospital a the company, or alternatively as supplementary planning masterplan was produced either Amy, Christian or Michelle as guidance. This ring-fenced supplementary planning will be happy to help. the clinical for essential guidance. Thiscore ring-fenced provided thehospital clinical uses coreand for essential FURTHER INFORMATION a flexible approach to the hospital uses and provided Tel: 01792 830238 balanceapproach of the land, a flexible to preserving the the ancient woodland and balance of the land, preserving defining development zones the ancient woodland and defining development zones

Sophie Smith Ltd

For over 25 years CDN Planning has provided planning and development services to the South Wales area and beyond. Based in Swansea, the company has developed a reputation over the years for giving prompt and helpful advice both to the business sector and to the many private clients who have benefited from the company’s advice. CDN Planning is able to advise on all aspects of the development world, including planning applications, planning appeals, enforcement and lawful use, development plan submissions, urban design and the assessment of development potential. In recent times, CDN Planning

toallow allow for for the the disposal to disposalofof surplus land. land. Work surplus Work also alsoincluded included detailed planning permissions, detailed planning permissions, and aaWoodland Woodland Strategy.. and Strategy.. Barnardo’s Barkingside Barnardo’s Barkingside Regeneration project involves the Regeneration project involves the planning and design strategy for planning and design redevelopment at thestrategy campus for redevelopment at the campus to enable the client to redevelop to enable thefor client to redevelop surplus land residential to surplus landa new for residential to cross fund headquarters. cross a new headquarters. Thisfund included producing included producing aThis development brief as asupplementary development planning brief as supplementary planning guidance, detailed planning permissions and landscape guidance, detailed planning design. The project, now in the permissions and landscape later phases was shortlisted for design. The project, now in the an Inside Housing Award in 2015. later phases was shortlisted for an Inside Housing Award in 2015. FURTHER INFORMATION

Tel: 07771768082 FURTHER INFORMATION Tel: 07771768082



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Synergy Environmental Solutions, based in the UK, provides first class environmental monitoring and health and safety services. It has an extensive national client base of customers ranging from private home owners, to local authorities to International PLCs. Among its services, Synergy runs environmental monitoring testing and consultancy services. The environmental monitoring services include, UKAS and MCERTS accredited stack emission monitoring, sick building syndrome testing, indoor air quality, ambient air quality testing and contaminated land consultancy services. Synergy’s health and safety testing and consultancy services include workplace air monitoring, LEV testing, noise assessments, COSHH risk

Blueline is a UK-based mobile startup aiming to revolutionise the primary healthcare industry by leveraging cutting edge technology to connect patients with healthcare professionals. The team has extensive experience in healthcare provision and medical IT as well as a strong entrepreneurial background, which helps to identify several pain points with primary healthcare services in large metropolitan areas.     Convinced that house-calls can play a significant role in enabling primary healthcare services of a better quality and with a higher time and cost efficiency, the company has created a mobile application to make immediate consultations with doctors as simple as calling a cab from one’s smartphone. Blueline users will be able to choose their preferred doctor or nurse from the service’s pool of healthcare professionals using criteria such as specialty, price

Environmental monitoring Passionate about quality and consultancy solutions healthcare services

assessments and respirator air quality testing, all carried out by BOHS qualified technicians. At Synergy Environmental Solutions, the company’s philosophy is always to provide the best quality measurements and the best service at the best possible price. That’s why, on average, Synergy’s customers rate it at 96 per cent for quality, service, reports and turnaround. To find out why Synergy’s customers are so happy with the service ask for an obligation free quote today. FURTHER INFORMATION Tel: 01782 614236

range, spoken languages or user ratings, and pay the consultation fee directly from within the app. Over a year in the making, Blueline’s service and accompanying applications were showcased to the public for the first time at the Digital Health Forum (London, 8 December), receiving interest from investors and industry stakeholders. A pilot launch of the service, targeting Athens and London, is planned for 2016, with other major European cities (Paris, Istanbul, Moscow) to follow. FURTHER INFORMATION Tel: 020 3289 2902


The publishers accept no responsibility for errors or omissions in this free service Accord Group 98 Advance Change 100 Advanced Therapeutics UK 70 Aerogen 10, 56 AGFA Healthcare UK 72 Alcontrol Laboratories 6 Anglian Archives 45 Ascom UK 74, 75 Atlantis Medical 30 Avensys UK 68 BES Rehab 34 Blueline 102 Bradshaw Electric Vehicles 77 Calibre Climate Control LLP 101 CCube Solutions 46, 47, 48, 49, 50, 51, 52, 53 CDN Planning 101 Community Heartbeat Trust 101 Cordant Group 28 Digital Pathways 82 Diligent 42 DL Biocomposites 16 Eastwood Park Training 32 Embrace E-Learning 100 Evac Chair International 37 FIAT 8 Fairtrade Vending 54



Fathom 56 Focus Games 36 Hardy Signs & Digital 63 Healthcare Publishing and Events 86, 87 Hinsley Hall 98 Holiday Inn London Cluster 90 HYATT Regency London 98 i-Clean Systems 58 iCompli 100 ICS Cool Energy 18 Informa Sciences Exhibitions 71,73 ISS Mediclean 12 Ivory Vaults 94 Kelvin TOP-SET 78 Kings House Conference 94 Laidback Life 100 Langley Waterproofing 22 Lensbury Hotel 95 Liverpool Medical Institution 98 Medicat 32 Mitie 58 MJog 80 Newton Rigg College 99 Nexus Industries 14 NHS Leadership Academy 40, 41 Octopus Healthcare 20

OKI Systems UK 60 Olympus Digital Dictation BC Pass Training Consultancy 58 Pentland Medical 38, 39 PFU 56 Principles Media IFC Radisson Blu London Stansted 97 Sample Answers 62 Sidhil 54 Solar Winds 64 Sophie Smith 101 Step Exhibitions 66 Storofile 44 Swallow Evacuation & Mobility 58 Synergy Environmental 102 Tech Graphix Signs 62 The View from the Shard 92 Total Gas and Power 24 Triangle Public Relations 45 UK Chamber of Shipping 97 Voice Connect 56 Waltham Abbey Marriot Hotel 99 Weetwood Hall 94 Wilo UK IBC Yeoman Shield 88 Zycko 4, 84

Learn more at www.

Innovative technology that goes beyond pumps – the Wilo-Stratos with Q-Limit function The high-efficiency pump for heating, air-conditioning and cooling applications. It sets new standards in needs-based delivery to systems. The new Wilo-Stratos offers not only proven performance, quality and reliability, it also features volume flow restriction for different control modes thanks to the efficient Q-Limit operating mode. Design improvements have optimised its energy efficiency by a further 15 percent and increased its EEI value to ≤ 0.20. Thanks to the IF Module, it can be integrated into standard building management systems. Wilo is going beyond pumps. for further information

Wilo-Stratos, the diverse one ƒ Energy savings thanks to higher system efficiency provided by Q-Limit function (volume flow restriction) ƒ Higher energy efficiency, e.g., starting at EEI ≤ 0.20 for all individual pumps ƒ Display is easier to read ƒ Space-saving installation thanks to compact design and variable-orientation LC display. ƒ Modular design for connection with any standard bus system (e.g., Modbus, BACnet, CAN, LON, PLR) ƒ Proven quality and reliability


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Health Business 16.1  

Business information for healthcare professionals

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