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Patient Centred Care Platform






THE BEFORE, DURING AND AFTER OF SURGERY Tracing the journey of medical instruments to ensure integrity



Expecting transformational change at Healthcare Estates


ADOPTING A STRONG SET OF STANDARDS The role of barcoding in saving the NHS time and money


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HEALTH BUSINESS MAGAZINE ISSUE 16.4 15.6 Patient Centred Care Platform






Savings are key during the spending spree



THE BEFORE, DURING AND AFTER OF SURGERY Tracing the journey of medical instruments to ensure integrity



Expecting transformational change at Healthcare Estates



The BBC has learnt that spending on high-cost overtime has risen by more than a third since 2014, with one consultant at Lancashire Teaching Hospitals NHS Foundation Trust pocketing a hefty £375,000 on top of their salary in overtime payments. With the current shortage of consultants, as well as substantial shortages of other NHS staff, having to pay overtime is slowly emptying the deep pockets of the majority of trusts.

The role of barcoding in saving the NHS time and money


Which raises the recurring question – where can savings be made? On page 27, we detail the success stories of a partnership between Barts Health NHS Trust and Global Action Plan, whose Operation TLC programme supports staff throughout the hospital to adopt simple, energy efficient behaviours that help save a significant sum of money. So far Operation TLC has saved the NHS over half a million on a £17 million energy spend, and this could be just the start. Elsewhere, on the topic of savings, Lord Carter’s review into NHS productivity last year highlighted that the introduction of GS1 standards could allow every NHS hospital in England to save up to £3 million each year, while steadily improving patient care. Glen Hodgson, of GS1 UK, tells us why on page 33. Spending heavily on overtime is not a sustainable approach to good finance, but adopting sustainable approaches can limit the need to spend heavily.

Michael Lyons, 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 Michael Lyons ASSISTANT EDITOR Rachel Brooks PRODUCTION EDITOR Richard Gooding PRODUCTION DESIGN Jacqueline Lawford, Jo Golding PRODUCTION CONTROL Sofie Owen WEBSITE PRODUCTION Victoria Leftwich ADVERTISEMENT SALES Ben Plummer, Jeremy Cox, Amanda Frodsham, Addy Ajibola ADMINISTRATION Vickie Hopkins PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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New scheme to ease A&E pressures; court rules on PrEP HIV drug; and UK cancer patients surviving longer


19 27

58 LEISURE INDUSTRY WEEK Leisure Industry Week is expanding its offering this year, detailing how to boost activity while dropping costs


Paul Briddock, of the HFMA, explains why better alignment between providers and commissioners is necessary for mental funding to gain clarity

‘Transforming the estate through collaboration’ is the theme of this year’s event. Health Business outlines what to expect at Healthcare Estates 2016



The recruitment issues facing the NHS have been widely publicised. Kate Shoesmith, of the REC, delves into the skills shortage and its role in the issue

Gareth Baxendale, of the BCS, outlines the potential for greater application of digital services across UK hospitals

24 FACILITIES MANAGEMENT 76 EHI LIVE The healthcare environment can offer difficulties to estate and facilities management. Paul Lloyd explains why



Caroline Watson describes how two programmes, implemented at Barts Health NHS Trust, are tackling the environmental problems facing the NHS


Michelle Fitzgerald-Shaw, of the NHS Leadership Academy, examines the significance of talent management


With hospitals constantly looking for ways to save money, Glen Hodgson of GS1 UK analyses the current state and role of barcoding in healthcare


Health Business reviews June’s Health+Care show, which provided a great platform for integrated learning


Combining conferencing, exhibition space and a networking forum, the UK Health Show returns on 28 September


The BSIA’s James Kelly analyses the importance of the Data Protection Act’s Seventh Principle in healthcare


Taking place on 7-8 September, the Health and Care Innovation Expo will showcase forward-thinking and transformative healthcare technologies

Health Business

Being held on 1-2 November, EHI Live will demonstrate the technology solutions hoping to alleviate pressure on commissioners and clinicians


Bryony Samuel outlines the latest information on the use of copper surfaces to boost infection control in hospitals

81 PERIOPERATIVE PRACTICE With all instruments needing to be sterilised for surgery, the AfPP’s Mona Guckian Fisher looks at the typical journey of surgical equipment

85 INFECTION PREVENTION The ‘go to’ event for infection control, Infection Prevention 2016 will return this September. Here is the preview


Hospitals and dietitians have a responsibility to tackle the current obesity crisis in the UK. Lucy Turnbull examines how they can change the tide

92 CUSTOMER CONTACT Health Business outlines why self service kiosks are creating a more positive environment for patients


The Emergency Services Show returns on 21-22 September at the NEC. Health Business previews what awaits visitors


The BPA and Keith Fowler discuss the role of the Professionalism in Parking Accreditation within hospitals settings Volume 16.4 | HEALTH BUSINESS MAGAZINE



Overtime pay rises by more than a third A freedom of information request by the BBC has discovered that spending on high-cost overtime has risen by more than a third in the past two years. Responses from 114 NHS trusts and boards showed that spending on high-cost overtime rose by a third to £168 million last year, up from £125 million in 2013-14. UK hospitals are becoming increasingly reliant on premium overtime pay to allow consultants to do the necessary extra work that a staff shortage is creating. Hospitals have individual responsibility to negotiate payments, with the BBC stating that £600 in overtime for a four-hour shift is commonplace, although there are examples of lower rates and indeed higher rates as well. The request only examined overtime pay paid at a higher rate than normal pay. According to the BBC, one unnamed consultant at Lancashire Teaching Hospitals NHS Foundation Trust made an extra £375,000 last year on top of their salary. Additionally, two in three trusts paid at least one consultant more than £50,000 last year, with one in four paying £100,000 or more. The most likely recipients of high rate overtime pay were surgeons, radiologists, urologists, anaesthetists and gastroenterologists. Professor Mark Pugh, medical director of Lancashire Teaching Hospitals NHS Foundation Trust, said: “There is an acute shortage of consultants for some of these specialities and as we have not been able to source the additional staff we need as demand has risen, we have paid overtime to the existing workforce to deliver

extra clinics so that patients can be seen and treated as quickly as possible.” Andrew Foster, chief executive of Wrightington, Wigan and Leigh NHS Foundation Trust, which stopped paying premium overtime rates in 2010, said: “I don’t think it is very defensible to pay a huge premium to one group of staff and not to other groups of staff. No other member of staff gets triple pay for doing extra shifts.” Danny Mortimer, chief executive of NHS Employers, said: “There is a variety of reasons why we are seeing the costs rising – patient demand and supply of doctors are two important factors. Clearly the information obtained challenges NHS organisations and teams about what arrangements they have in place. What it doesn’t show however is that there are a greater number of doctors doing overtime within the terms of their contract and being paid in line with that or not being paid at all. “The BMA and the NHS have accepted that the contract needs to be improved in relation to how we plan and reward work at evenings, nights and weekends. When our negotiations conclude, I am hopeful that this will provide a more standardised basis for new arrangements going forward.”



GP practices with 2-3 GPs have lowest expenses According to data from NHS Digital, non‑dispensing, GMS-contracted practices with two-three GPs have the lowest level of expenses per registered patient. The analysis examined GP income and tax records from 2013-14 practice level, and found that such practices had average expenses of £76.18 per patient. In comparison, the practices with the highest level of expenses were found at single-handed dispensing, PMS-contracted practices, with average costs of £189.71 per patient. The analysis was commissioned by NHS England to inform its ongoing review into the Car-Hill allocations formula, which is used to calculate how much funding

individual practices should receive. The figures also identified a discrepancy in costs of practices located in rural and urban areas. Rural non-dispensing practices had expenses of £91.90 per patient, compared to urban counterparts with just £84.63 per patient. Commenting on the analysis, NHS Digital advised that the figures ‘should be treated with an appropriate degree of caution’ due to ‘uncertainty associated with sample data’ retrieved from GP census information already published. READ MORE:



NEWS IN BRIEF Court rules on PrEP HIV drug A High Court judge has ruled that NHS England can fund a preventative drug that can be used to combat HIV, after health bosses previously argued the responsibility did not lie with the NHS. NHS England had initially decided that local authorities should be responsible for providing the pre‑exposure prophylaxis drug (PrEP). However, the move was opposed by the National Aids Trust (NAT). PrEP has been shown to reduce the risk of HIV infection by more than 90 per cent, and costs £400 per month per person to manufacture. The medication is currently in use in America, Canada, Australia and France to help homosexual men who are most at risk from the virus. According to NHS England, PrEP is preventative and had legal advice claiming that ‘local authorities are the responsible commissioner for HIV prevention services’. In an interview with the BBC, Paul Steinberg, from the London HIV Prevention Programme, argued that while the drug was a significant breakthrough, it was still important for people to wear protection in order to stay safe. He added: “Buying online is what people are being forced to do to get access to this drug, but that’s not a sustainable situation.” Deborah Gold, chief executive of NAT, said: “This is fantastic news. It is vindication for the many people who were let down when NHS England absolved itself of responsibility for PrEP.” Meanwhile a spokesperson for NHS England said: “NHS England has considered the judgement carefully and has taken legal advice. Queen’s Counsel has advised that the court’s ruling interprets the legislation governing NHS England’s role and functions in a way that is inconsistent with Parliament’s intention.”

Jeffrey Beall – Own work, CC BY-SA 3.0, https://commons.wikimedia. org/w/index.php?curid=19631183




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Small increase in uptake of GP training posts

According to official figures published by Health Education England (HEE), around 83 per cent of GP training posts have been filled in England, the first time the number has increased in three years. HEE confirmed that 2,691of its 3,250 places been filled after two rounds of recruitment, a seven per cent increase on the 2,513 places filled at the same stage last year. Nonetheless, HEE is still under its target for achieving 3,250 GP trainees per year by August 2016. However, data has shown there are still 101 vacancies being advertised in Scotland – 31 per cent of the 325 positions in total. A similar situation can be seen in Wales, with 32 per cent of the 136 positions still being advertised. It also suggested areas such as the North East of England were struggling, where 40 per cent of places remained unfilled. The news follows a range of efforts from

the government to boost recruitment, including providing £20,000 bursaries for doctors to train as a GP in under-doctored areas such as Blackpool and Lincolnshire.



Expert seven-day services opinion ‘airbrushed’ out The British Medical Association (BMA) has claimed that the Department of Health ‘airbrushed’ out experts’ concerns on the controversial study which led to calls for a seven-day NHS. Last September, a report in the British Medical Journal suggested that there were 11,000 more deaths in the NHS during the weekend than in the week each year. However, experts, including report author and NHS England medical director Professor Sir Bruce Keogh, have since claimed that the information was ‘misused’. A newly published email, revealed in the Daily Mirror, shows Health Secretary Jeremy Hunt and the Department of Health believed that the report ‘broadly’ supported the government’s plan to roll out more hospital services during the weekends, and consequently ignored expert concerns about that conclusion being drawn.

Mark Porter, BMA council chair, said: “The evidence that the government has repeatedly used misleading figures to undermine doctors and justify its pledge to increase seven-day services in the NHS becomes more irrefutable with each passing week. This email shows the DH airbrushed valid concerns and mitigating factors to spin the line which best suited its argument. “The issue of weekend mortality rates is far more complicated than the government has portrayed, which is why the health secretary was challenged by the editor of the BMJ for his misuse of data, why leading experts raised concerns about his use of out-of-date figures on stroke survival rates, and why MPs called him out for using academically unverified and unpublished data to back up his plans. These concerns are clearly raised in the email and should have been listened to.”



NEWS IN BRIEF NHS England to increase pool of applicants to GP training NHS England has announced it has been working with Health Education England (HEE) to recruit English‑speaking medical students in Europe in a bid to boost the number of successful applicants for GP training in England. It said the recruitment campaign will focus on medical schools that teach in English. According to the board paper, NHS England and HEE had been developing relations with these medical schools and planned to market directly to their students and graduates. It said: “HEE, working with partners including NHS England, wishes to increase the pool of applicants making a positive choice to apply to enter GP specialty training. One approach is to increase applications from medical schools across Europe. “A particular focus will be the medical schools that teach in English. Many of their students are UK citizens. HEE has been developing relations with these medical schools and their students. It is now proposed to market directly to these students and graduates, as an opportunity to increase the pool of good applicants.” In its GP Forward View last year, NHS England said it would attempt to attract 500 overseas GPs to England. READ MORE:

CQC finds inadequate staffing levels at Southend Trust The Care Quality Commission (CQC) inspectors have raised concerns over insufficient levels of staffing at Southend University Hospital NHS Foundation Trust. The CQC said the hospital ‘must have sufficient and appropriate staff available in medical services to provide care and treatment’. It has called upon the trust to take action to ‘ensure sufficient numbers of suitably qualified, competent, skilled and experienced nurses are available at all times on wards caring for palliative and end of life patients’. Professor Sir Mike Richards, the CQC’s chief inspector of Hospitals, explained: “Staffing numbers were not adequate to meet patients’ needs. The identified shortfalls compromised patient safety. However, the trust responded promptly when we identified the concern.” READ MORE:




Case Study


Striving to ensure proper evaluation and prioritisation of patient safety improvement recommendations Recently, Datix wrote about the importance of organisational memory in healthcare; ensuring that when something goes wrong, the organisation undertakes a process to understand the contributory factors and make changes to reduce the chances of the same events occurring again. This means not just writing down recommendations on paper, but embedding changes into policy, procedures, training and everyday practice. Whilst this may sound straight forward, Datix understands that in reality the complexity of health care delivery, constraints on resources and time, together with strong and often knotty cultural influences can result in health care organisations failing to take opportunities to learn and the same mistakes being repeated. Since 2000, there has been a major increase in the use of incident reporting systems across health care organisations internationally. The use of incident reporting systems is widely perceived by health care staff to positively improve patient safety and increased

reporting has been shown to positively correlate with independently defined measures of safety culture. However, incident reporting systems also create challenges that without good systems and processes in place, can limit how effective such systems are in driving tangible improvement. The reality is that most health care organisations operate in a cost/resource limited environment and therefore, as the number of reported events increase, organisations must put in place intelligent processes and systems to ensure that resources are assigned to carry out an appropriate level of investigation or review as necessary to provide an understanding of the underling contributory factors and risks. In addition, it is clear that health care organisations would benefit from having a systematic framework to analyse aggregate

incident reporting data in an intelligent way so that common contributory factors and associated risks across an institution can be identified. Most current incident reporting systems tend to classify incidents at the point at which the event occurred. Allowing for the classification of the underlying contributory factors as well as the event itself has the potential to add significant value to the ability of such systems to identify and prioritise areas for safety improvement. Finally, greater focus needs to be placed on prioritising and evaluating proposed patient safety improvement measures resulting from such processes. This should involve an evaluation of the cost/resources involved with implementing the proposed recommendation along with an evaluation of the benefits and the likely effectiveness in eliminating, reducing or controlling risk. FURTHER INFORMATION Tel: 020 8971 1971

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DTX1000140 - PSI Magazine - Half Page.indd 1


HEALTH BUSINESS MAGAZINE | Volume 16.4 28/04/2016 13:58


Bolton trials scheme to ease A&E pressure NHS Bolton Clinical Commissioning Group (CCG) and Bolton NHS Foundation Trust are piloting a new scheme aimed at redirecting inappropriate accident and emergency attenders to a more appropriate point of care. The initiative will involve issuing patients who visit A&E with minor symptoms such as coughs and colds with information on how to manage their illness themselves. Those who need to be seen by a GP will be helped to access an appointment at their practice. The scheme will also involve putting up new signs on the hospital site warning people that they may be turned away and directed to a more suitable NHS service. Bolton’s Trust and CCG will monitor the success of the pilot and decide whether it should be made permanent.

Tim Almond, senior commissioning manager for urgent care at the CCG, said: “Around a third of all those who go to our A&E department here in Bolton do not need to be there. “This essential service is under significant pressure and the CCG remains committed to doing everything we can to maintain patient safety and the quality of care Andy Ennis, the trust’s chief operating officer, added: “People who seek treatment at A&E when they don’t need to, cause delays for everyone and put additional pressure on staff who are already working very hard. We hope this pilot will reinforce the messages and support patients to find the appropriate place for treatment.” READ MORE:


Fire crews standing in for paramedics Figures obtained by The Times have shown that patients are being put at risk by a shortage of paramedics that has led to firefighters being sent to manage serious injuries, heart attacks and strokes. Fire chiefs have cautioned that the crews were ill-equipped to deal with medical emergencies with firefighters receiving just a few days of medical training. The figures showed that over 4,000 life‑threatening emergencies were attended to by 15 of the 35 fire crews who are working as ambulance co-responders. In some areas the medical emergency callouts were more frequent than fires, with 70 per cent of fire and rescue teams across Britain acting as co-responders for Code Red 1 and 2 emergencies involving cardiac arrests or breathing complications. The firefighter teams are trained to operate a defibrillator and use a standard first-aid kit in order to stabilise the patient in an emergency but must thereafter wait for a paramedic. Fire officers are not authorised to take patients to hospital. John McGhee, national officer of the Fire Brigades Union, said: “We’ve had

a number of incidents where people have thought they were attending someone who has a heart attack only to get there and discover a major trauma. “We’ve not got the medical training to deal with somebody impaled on a fence. If we get to an incident where we are as much use as a car of football fans then it raises serious concerns.” Katherine Murphy, chief executive of the Patients Association, argued: “Firefighters should not be asked to do the job of a paramedic with just first-aid training. It comes as no surprise that as a consequence of underfunding of our health services we are left with this nightmare situation.” Meanwhile, a spokesman for the Department of Health, countered: “It is the responsibility of individual ambulance trusts to decide how best to respond to 999 calls. We strongly support better communication and working between the emergency services, while recognising that it is imperative that people who are unwell or injured receive the care and support they need from a health professional, which is why paramedics will continue to respond to patients in an emergency.”




NEWS IN BRIEF Calls for price offers on healthy foods Consumer group Which? has claimed that supermarkets should start to focus their promotions on healthy food to help tackle the obesity crisis in the UK. The group analysed 77,165 promotion deals across major UK supermarkets – Asda, Morrisons, Ocado, Sainsbury’s, Tesco and Waitrose – and discovered that 53 per cent of them were placed on less healthy products. Confectionery, of which 52 per cent was on special offer, held a stark comparison to fruit and vegetables, with only 34 per cent holding some kind of promotion. Alex Neill, director of campaigns and policy at Which?, said: “Everybody has to play their part in the fight against obesity and people want supermarkets to offer more promotions on healthier foods and yet our research found the opposite. “It is time for supermarkets to shift the balance of products they include in price promotions and for all retailers to get rid of temptation at the till by taking sweets off the checkout.” READ MORE:

Hepatitis C deaths fall, PHE says Public Health England (PHE) has published its annual hepatitis C report for 2016, showing that deaths from the disease in the UK have fallen. The latest figures from the study have suggested that treatment rates increased by around 40 per cent in 2015, up to 8,970 from an average of 6,400 in previous years. PHE has claimed that the improvement is likely to be due to better access to new treatment, which offer improved cure rates, fewer side effects and are easy to administer. Data shows around 160,000 people in England are living with hepatitis C, a disease which causes inflammation of the liver. However, many people are unaware they have the condition since the liver is often still able to operate even when damaged. Dr Helen Harris, hepatitis C expert at PHE, who led the publication of the report, said: “There is genuine hope that we are seeing an impact on the number of deaths from hepatitis C related end‑stage liver disease and liver cancer. However it’s not enough to just treat the liver damage caused by the virus, we also need to prevent infection in the first place, and continue to highlight the importance of prevention and testing.” READ MORE:





NEWS IN BRIEF Poor most likely to suffer ill health, report says A report by the Joseph Rowntree Foundation has found the effects of poverty to have cost the UK an average of £78 billion per year, with the NHS bearing the brunt of the costs. The report found that those in poverty were most likely to suffer ill health, with £29 billion being spent on treating health conditions associated with poverty. The research outlined other costs including: £10 billion on schools providing initiatives such as free school meals and pupil premium for poorer students; £4.6 billion on adult social care; and £4 billion on housing. Professor Donald Hirsch, co-author of the report, said: “The experience of poverty makes it more likely that you’ll suffer ill health. The large amounts we spend on the NHS means that making a section of the population more likely to need them is extremely costly to the Treasury.” READ MORE:


UK cancer patients surviving longer A report by Macmillan Cancer Support has shown that cancer patients are twice as likely to survive for at least a decade after being diagnosed, compared to the 1970s. The study, Cancer Then and Now, shows that more that 170,000 people in the UK who were diagnosed with cancer up to 40 years ago are still alive, and that better treatment and quicker diagnoses are some of the reasons for the diagnosis. However, the report warned that thousands of people are struggling with the physical, emotional and financial effects of a cancer diagnosis and treatment for many years afterwards. Professor Jane Maher, chief medical officer at Macmillan Cancer Support, said: “We now see fewer of the big side-effects, such as an increased risk of heart attack and stroke, we saw after treatment in the 1970s and 80s. “But some of the effects doctors consider ‘small’, such as fatigue and poor bowel control, can have a profound impact on someone’s quality of life. Sadly there is no cancer treatment available at the moment that does not carry a risk of side-effects.” Health Secretary Jeremy Hunt commented: “The fact that more people are surviving cancer is excellent news, due in no small

part to the work of NHS staff who carry out the diagnosis, treatment and care to help patients beat the disease. “To help, we announced last year that by 2020 people diagnosed with cancer in England will benefit from an individually tailored recovery package. “This was originally developed by Macmillan Cancer Support, and I would like to pay tribute to the charity’s enormous effort in this area over many years.”



Report calls for better continuity in maternity care A report published by the Picker Institute Europe has called for more support for staff in the maternity service to deliver ‘person‑centred care’ to women who are giving birth. The charity, which campaigns for high quality health and social care, highlighted that almost half of official safety assessments of maternity services from December 2013 to May 2015 revealed shortcomings. It cited figures which suggested seven per cent of services were rated ‘inadequate’ for safety by the Care Quality Commission while 41 per cent required improvement. Gaps were also found in the support and information offered to women during and after their pregnancy, particularly concerning postnatal care. “This demonstrates the value of having an ongoing relationship with a single practitioner as a means of ensuring continuity of care. “Whilst there will be occasions where people need to see different midwives due to changes in staffing, personal circumstances, or preferences, it is important for as many women as possible to be given the opportunity to

see the same midwife throughout their maternity care if they want to.” It concluded: “Staff need to be supported to deliver person centred care. To enable this, they should have the opportunity to work in high performing teams and organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries.” READ MORE:

NEWS IN BRIEF New BMA deputy pledges to highlight funding crisis David Wrigley, the British Medical Association’s (BMA) newly elected deputy chair of council has assured that he will use his position to hold the government to account over the challenges facing the NHS. Wrigley, a recognised critic of cuts to NHS funding and further attempts at privatisation, said he was delighted by his election and vowed to continue to speak up for doctors and patients by highlighting the challenges facing the NHS. He said: “I am delighted to have been elected to this position, following in the footsteps of Kailash, who was an outstanding deputy chair of council. At a critical juncture for the NHS I want to use this role to continue to highlight the huge funding challenges and pressure on frontline services as well as staff, which many politicians and policy makers appear to be oblivious to and which make it harder to deliver high-quality patient care. READ MORE:



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The Healthcare Financial Management Association’s Paul Briddock discusses doubts over funding promises and why clarity for the necessary investment to reach the right people is needed There has often been disparity between mental and physical health provision in the NHS, which is something that needs to be rectified. To achieve this providers and commissioners need to work collaboratively towards the same goal. According to research earlier this year, the government’s commitment to deliver parity of esteem between mental and physical health services is not being achieved as the planned funding is currently not reaching all frontline NHS trusts. A survey of mental health trusts and clinical commissioning groups (CCGs), published by NHS Providers and the Healthcare Financial Management Association (HFMA), found that only a half of mental health trusts in England received the required real terms increase in their services last year (based on survey responses by 55 per cent of mental health providers). This is despite a directive to increase investment in line with commissioners overall allocation. The research in May 2016 revealed that: only half (52 per cent) of providers reported that they had received a real terms increase in funding of their services in 2015/16; there is a limited confidence that funding

increases will be delivered this year, with only a quarter (25 per cent) of providers saying they were confident that their commissioners were going to increase the value of their contracts for 2016/17; a higher proportion of providers received a real terms increase from CCGs than from NHS England teams in 2015/16; there is a lack of alignment between commissioners and providers over what it means to implement parity of esteem – there is confusion over what services should be covered, and how much investment should be made; and that over 90 per cent of providers and 60 per cent of commissioners were not confident that the £1 billion additional investment recommended by the Mental Health Taskforce and supported by NHS England will be sufficient to meet the challenges faced by mental health services. CREATING ALIGNMENT There are clearly a number of challenges faced as we try to get the balance right. There is a lack of alignment between commissioners and providers over what

CONFLICTING GUIDANCE Feedback from the research highlighted that it is difficult for local organisations to understand how payment rules interact with the planning guidance. The national tariff is the payment system for the secondary care system, covering £70 billion worth of NHS spend. It is set annually by E

Written by Paul Briddock, director of policy, Healthcare Financial Managament Association

Striking the balance for mental health

it means to implement parity of esteem. A number of themes emerged from our joint report in March, highlighting a lack of shared understanding about how parity of esteem can be implemented. Many of these inconsistencies need to be clarified by system leaders at national level so that local mental health services could improve. Feedback from the survey clearly indicated a disjoint between commissioners and providers about whether the requirement in the planning guidance to increase the real terms investment in mental health services was being met. Commissioners highlight that they have invested in mental health services, and frontline providers argue that they have not always seen this investment play out as they expected it to. There is some confusion around what organisations deem as mental health spend. According to respondents, commissioners might be investing in areas not provided by secondary care trusts, such as primary care, drugs, the mental health component of continuing healthcare and out of area services. This means that commissioners might report that they have increased their spend on mental health services, while some providers will have seen no direct evidence of this. Ideally some funding should be aligned at local level, such as through Health and Well-being Boards, and there are a number of positive examples of how providers can be better involved and engaged in their work.



There f o is a lacketween nt b alignmessioners and commi ders over provi eans to m what it ent parity implem steem of e




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 NHS England and NHS Improvement and determines the efficiency requirement and cost adjustments for prices and contracts across the sector. In 2015/16, prices and contracts were reduced by 1.6 per cent – this is intended to be the starting point for discussions between commissioners and providers for locally priced services, such as mental health. A number of respondents to the survey highlighted that their contracts were simply reduced by this amount, making planning guidance requirement to increase investment much more difficult. COMPETING PRIORITIES AND FUNDING PRESSURES In a difficult financial climate, the survey bears out that CCGs continue to face competing service pressures in 2016/17 which will have implications for how much of their resources can be dedicated to mental health services. As in 2015/16, these include the ringing‑fencing of part of CCG allocations for direction into the Better Care Fund; inflationary pressures in relation to primary care contracts; continued pressures in acute services (both emergency and planned activity) and prescribing budgets, as well as increases in continuing healthcare costs. WHAT NEEDS TO HAPPEN NEXT? The additional funding for mental health services, and the on going commitment in the planning guidance for commissioners to increase their real term investment, represent a real opportunity to reset the way mental health services are prioritised. HFMA believes that four things need to happen if we are to better support NHS organisations to meet their parity of esteem commitments over the course of this Parliament. Firstly, clarity from the government and system leaders about how much is being made



A survey of mental health trusts and CCGs found that only a half of mental health trusts in England received the required real terms increase in their services last year available for mental health services, and in which areas. We know that there is £1 billion to implement the recommendations from the Mental Health Taskforce, but it is not clear whether this separate or in addition to the £600 million previously announced in the 2015/16 Autumn Statement and the £1.25 billion for children and young people’s services. It is also unclear whether this is incorporated in to commissioner allocations or will be funded through sustainability and transformation funding. Additionally, explicit alignment is needed about what it means to meet parity of esteem commitments. At both national and local level, organisations are interpreting the requirements in different ways, leading to a patchwork of investment and services for patients. This also creates mistrust between local organisations and frustrates commissioners and providers in their attempts to work more closely together. NHS Improvement and NHS England need to support providers and commissioners respectively to agree an understanding of what parity of esteem means in practice at local level, and key questions need to be clarified. Thirdly, better enforcement and support for local organisations. Our research highlights a great deal of local variation about how the rules are being interpreted and responded to. NHS England needs to work with local organisations to ensure that the rules are consistently and fairly implemented. Where organisations are struggling to invest in line

with the guidance, support will be required to ensure that challenges are addressed. CLARITY AND TRANSPARENCY Finally, greater transparency across the system about how much is being spent on mental health services. The recommendation in the taskforce for commissioners to publish in detail spend on services is helpful, but NHS England will need to support organisations to implement this in a meaningful and simple way. We also need to recognise that this in itself is not enough to achieve parity, and we need to avoid this simply being a measure to create a league table of commissioners. It’s clearly a work in progress and there is no quick way to fix the issues. However, concerted efforts will need to be made at local and national level to ensure that money for mental health services reaches the front line. Key to this will be creating an environment for commissioners and providers to work more closely to determine how and where additional investment is spent. It is not sustainable to have a situation in which commissioners report that they have increased their overall spending, yet individual providers have seen no direct investment, despite their services being under intense pressure. Clarity and transparency will be the most important factors in trying to get this right, alongside working collaboratively and positively together. L FURTHER INFORMATION




Kate Shoesmith, head of policy at the Recruitment and Employment Confederation, analyses the recruitment and skills shortage affecting the NHS We all know the NHS is facing challenges – the budget deficit, growing patient waiting times, serious questions into the quality of care and an ongoing debate about creating a ‘truly’ seven day service. But arguably the most significant of all these issues is the skills and recruitment crisis facing our NHS. Since the start of this year, medical, nursing and care professionals have been among the most in-demand category of worker across all sectors, according to the monthly REC/Markit Report on Jobs. For the last four months in a row, a short supply of nurses to fill permanent roles across the UK has been reported by recruiters. At the same time we’ve seen a sharp rise in demand for temporary and contract staff in the health sector; primarily to deliver

For the lastths n four moa short , in a rowf nurses to o supply anent roles fill permthe UK has across ported by been reruiters rec

short-term access to the strategic skills that health and social care employers cannot find any other way. The same report finds that care workers, nursery nurses, care assistants and home carers are in high demand, but the availability of suitably skilled, qualified and vetted professionals for these roles is in decline. That the supply of staff is in decline should not be entirely surprising. Analysis from the Institute of Employment Studies has found that currently, one in every ten nursing vacancies goes unfilled. This is being exacerbated by an ageing workforce – with 29 per cent of the current

Written by Kate Shoesmith, head of polict, Recruitment and

A short incoming supply of skilled NHS staff

nursing workforce being aged over 50. The problem is not confined to nurses either. Following a Freedom of Information (FoI) request late last year, the BBC showed how there are now 6,207 doctor vacancies – which means the vacancy rate had increased by 60 per cent in the two years from 2013 to 2015. Similarly, the Royal College of Anaesthetists has identified that we will have 3,800 fewer anaesthetists than required by 2033. Further FoI requests from the BBC have revealed the extent to which a shortage of consultants has pushed up trust spending in order to cover rota gaps: a consultant at Lancashire Teaching Hospitals NHS Foundation Trust was paid as much as £375,000 in overtime. Spending on high-cost overtime has risen by more than a third in the past two years – a trend which surely can’t continue. Undoubtedly, demand for NHS services is likely to increase – and of course we must maintain the highest level of care – but it simply isn’t sustainable for the NHS to cover the costs in this way.



A WAY OUT OF THE SKILLS CRISIS? Many noble and intelligent people have set their minds to this task, and nothing I am E



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 about to say is revolutionary – but it seems that going back to the basics of effective organisation management is what we need to focus on right now. First up, train as many people as you are going to need for the jobs that will exist in the future. It seems almost inconceivable that the number of nurses we are training in the UK has been declining, rather than going up. The Royal College of Nursing has long campaigned for more student nursing places. Their research has identified that cuts since 2010 have resulted in a 15 per cent decrease in available places – at a time when demand has only increased. The new government has now confirmed that bursaries for student nurses, midwives and allied health professionals are to be scrapped. Unsurprisingly, given the worker shortage, this plan has been met by anger from representatives across the sector - but it is also understandable on some levels why a cash-strapped NHS and government believes they cannot afford to continue the current level of subsidies. Now that a decision has been made about the bursaries, what we need is a strong, coherent plan about how to engage and encourage young people from all backgrounds to consider health and social care careers. This means a clear careers advice and guidance strategy which reaches out to children while they are still at primary school, and which prioritises contact with students at the times when they make key decisions about their future. Rightly or wrongly, student loans are part and parcel of university education in the UK today, so the health sector should

Spending on high-cost overtime has risen by more than a third in the past two years – a trend which surely can’t continue. It isn’t sustainable for the NHS to cover the costs in this way consider what we have learnt from the rollout of loans, how this has affected student numbers, what we can do to mitigate any impact on enrolments, and the best ways of engaging potential students about the return on investment derived from a university education in healthcare. WORKFORCE PLANNING Hand in hand with delivering quality training and encouraging more people to consider a career as a healthcare professional, the government needs to prioritise workforce planning for the NHS. Back in 2013, the Centre for Workforce Intelligence predicted that there would be 47,500 fewer nurses than we need by 2016. The government has acknowledged that while they have put 10,600 more nurses onto wards since the coalition government came into power in 2010, there is plenty more to do. Now that the Centre for Workforce Intelligence no longer exists and its responsibilities have been transferred to the Department of Health, Public Health England and Health Education England, the government should be leading the way in ensuring that we have robust data to inform decisions around future training and staffing needs in the NHS.

It appears that this is still not a priority as there has not been an update on the relevant page since August 2015. In light of the challenges around supply in our domestic workforce, the question of how to source workers from overseas has come into sharp focus. The result of the EU Referendum and the UK’s decision to leave the EU will bring fresh challenges for the sector. Being able to recruit well-qualified and vetted EU nationals has been a lifeline to the NHS. Some may argue that the impending departure from Europe may make it easier to recruit from outside the EEA if, as part of the Brexit negotiations, it is decided that we no longer have to conform to the rules around free movement of people. But this is a long way off. In the meantime, we need to make it clear to anyone with the skills and capabilities to contribute to the NHS that Britain is open to them. The Migration Advisory Committee’s recommendation to keep nurses on the Shortage Occupation List, making it easier for the NHS to bring them in when they have exhausted all avenues for domestic recruitment, is a step in the right direction and one that must be considered for other NHS professions when the evidence shows there is a need. E





Partnership working to reduce spend and reliance on temporary staff through permanent workforce solutions Healthier Recruitment is a business dedicated to providing the highest quality recruitment services and workforce solutions to both candidates and clients within the Healthcare Sector. Established with the sole purpose of recruiting into permanent positions, Healthier Recruitment assist NHS, private, local government and not-for-profit organisations and services in reducing the reliance and spend on temporary staff and locums. This is achieved by building a consistent and permanent workforce of candidates who share the same visions and values as the organisations they are introduced to. With the Monitor price caps being introduced, it further cements Healthier Recruitments’ purpose and it is working in partnership throughout the UK to support Healthcare organisations and services in dealing with these changes. As a specialist provider of permanent staff Healthier Recruitment has a robust structure in place in order to service the different clinical sectors and professions we work with. It holds the market intelligence

required to respond quickly and efficiently to the demands of the organisations they support, which is complimented by a robust sourcing strategy that allows the company to grow, constantly engage and leverage its network of high quality candidates. Each specialist sector is managed by a professionally trained consultant that operates in conjunction with a business support function. Healthier Recruitment consultants focus solely on attracting and engaging talent with specific skill sets. Career Consultants who work at Healthier Recruitment are immersed in their areas of expertise and as a means of communicating with candidates they regularly attend exhibitions, accredited events and conventions. At Healthier Recruitment, staff strongly

believe the future of patient care relies heavily on having the right people in the right jobs who are not only skilled and qualified but passionate about the role they are in, the organisation they work for, and most importantly the positive effect they are having within Healthcare. The company’s passion to help clients and candidates achieve this promotes a level of quality that makes it more than just another agency. Covering recruitment at all levels for clinical and non-clinical positions, Healthier Recruitment offers cost effective services and solutions which are tailored to its client’s current and future needs. For a personal consultation on how Healthier Recruitment can support your organisation with its permanent recruitment needs, please call, and one of its specialist consultants will be happy to help. FURTHER INFORMATION Tel: 0207 205 2202

Will Brexit possibly break it for the prolonged NHS’ recruitment and retention strategies? The Kings Fund had indicated a recruitment shortfall in 2014 of 5.9 per cent. Is the ensuing; so far non-negotiated divorce from the EU leaving a troubling measure of uncertainty for the health service’s recruitment needs? Currently a staggering 10.38 per cent of the 1.3 million NHS staff have come from other EU countries, will they remain and under what agreements? Domiciliary care recruitment is also under huge pressure, again indicated by the Kings Fund, a staff turnover of 25 per cent, equating to a staggering 300,000 job leavers annually. Jane Cummings, chief nursing officer of NHS England has reiterated the need to deliver safe, consistent and quality care. This presently being achieved with the support of externally employed temporary staff. There is suggestion that this is detrimental to both continuity and team work. However, the existing capping on Frame Work providers has enabled some control of the financial cost of temporary staff. The existing recruitment crisis that the NHS is struggling to manage, does and will require



the continuing support from non framework nursing agencies for the foreseeable future. NHS England has planned strategies both for recruitment and retention, including the development of the Health Care Assistants role, potential training and development to better support the registered nurse and midwives. These initiatives will take time to both plan and implement. Their contributing support to recruitment, retention and effective safe staffing levels being an unknown quantity at present. Brexit will obviously further fuel the need for the NHS to productively and possibly more aggressively strategise recruitment and retention plans. There will be a continued challenge for framework nursing agencies to meet the

extra demands of the NHS to provide safe staffing levels, this will trigger the need to utilise non framework nursing agencies. It is paramount that these non framework agencies are compliant and meet the required standards, however and sadly, non-domiciliary nursing agencies are no longer regulated by the CQC. Medicat & Medicat Specialist nursing agencies have always applied CQC standards to maintain its excellent reputation for the professional and compliant service it provides to both clients and staff. Being an independent agency of its size has allowed it to develop very productive, professional relationships, but with a valued personal touch with its client base including the NHS, allowing for the specific needs of clients to be met with continuity. FURTHER INFORMATION Tel: 0117 968 4474

SHORTAGES  TEMPORARY WORKING Another aspect of supply has also been the attention paid to those individuals who work on a locum or temporary basis in the NHS. Much has been made of the sums of money paid to locum doctors and agency nurses. But our data suggests that the day rates reported in the media are often greatly exaggerated. On average, a Band 5 agency nurse will earn between £20 and £25 per hour. Locum doctors will be in receipt of around £50 to £60 an hour. But more important is the reasons why individuals are choosing to work this way. In a YouGov poll of over 4,000 people for the REC, we found that one third of all working adults work on a temporary, contract or freelance basis at some point in their career. The evidence also points to the fact that it is a growing trend among individuals, rather than something being done to people by business. When we asked why people work this way, particularly in the healthcare sector, they pointed to the fact that it enabled them to get experience of different disciplines and it supported their lifestyle choice. Agency nurses told us that they had turned to a recruitment agency after decades of working on a permanent, substantive basis in the NHS. They found that as an employer, the NHS could not offer them the flexibility they now wanted and needed in order to restore

a work/life balance. Working via an agency meant these individuals could still use their years of experience and put their skills to good use, but in a way that suited them and without putting the care of patients at risk. Rather than scapegoating recruitment agencies for the problems being faced by the NHS and placing ever tighter caps and controls on the workers they supply, a better approach would be to see recruiters as partners in helping to design the NHS of the future. Recruiters often work across multiple trusts so they can see patterns emerging in terms of the skills that are in particularly high demand and low supply. Recruiters also know the reasons behind a candidate’s choice to work or refuse certain shifts in the NHS, and this insight is important to drive improvement. It is worth noting that in the vast majority of cases, individuals are often still working via both routes – direct and through an agency. All in all, recruiters bring intelligence that one NHS trust in isolation may not have the capacity to acquire, especially given the current constraints on their resources. This insight should inform the wider workforce planning strategy that today’s NHS so desperately needs. L FURTHER INFORMATION

Working via an agency meant these individuals could still use their years of experience and put their skills to good use, but in a way that suited them and without putting the care of patients at risk



Looking for talented healthcare professionals? This September, the first integrated Healthcare Recruitment & Training Fair is happening from the 15–17 September in ExCel, London, UK. Organised by Informa Life Sciences Exhibitions, the fair offers the ideal opportunity for the medical industry to come together and get involved. Host to an unrivalled portfolio of health professionals and industry leading companies and organisations, the show will be an unparalleled environment to meet and recruit talented professionals, facilitate face‑to‑face interactions and build long‑term business relationships with the region’s leading consultants, specialists, doctors, nurses, surgeons and many more. Healthcare organisations exhibiting will gain exclusive access to domestic and international candidate’s onsite and accelerate their recruitment needs in a cost-effective way based on set specific criteria, while being able to position themselves as a leading employer in the healthcare market. All healthcare professionals will benefit from attending, as exhibitors will be looking to recruit medical and non-medical professionals. Sales, marketing, HR, and administrative roles have all been highlighted as key positions that desperately need experienced professionals. The show will also run 18 free‑to‑attend clinical and non‑clinical conferences over the three days. These conferences have been tailor-made to encourage dialogue, interactive discussion and best practice sharing in key focus areas for the UK healthcare sector. Sessions are free‑to‑attend and each participant will receive Continuing Professional Development (CPD) points from the CPD Certification Service. Marketing and promotional opportunities such as sponsoring the show will also assure that sponsors get increased exposure to the market through the fully integrated marketing campaign that will take place ahead of the show.



Facilities Management Written by Paul Lloyd, Healthcare Facilities Consortium


Modern challenges facing estates and facilities management There are a vast number of challenges that the healthcare environment poses to estates and facilities management. Paul Lloyd, managing director of the Healthcare Facilities Consortium, examines the role of a facilities manager and their role the in day-to-day running of a hospital When considering the challenges it faces on a day-to-day basis, it’s worth considering where the modern estates and facilities management (E&FM) function came from and why. ‘Support Services’ functions as they were known (and still are to some) were individual departments within hospitals managed by ‘a head of…’ – usually reporting to the hospital manager and accountable for their area only. This presented a number of challenges; the most important being that co-ordination of activates relied more on personalities than procedure. A large number of direct reports across the hospital environment proved complex to manage, as did individual financial arrangements. As each function was managed by a professional head in a silo structure there was very little opportunity for staff to understand other functions, or to grow or develop without moving elsewhere with the inevitable loss of corporate memory about the site and its issues. This is particularly important with an estate and services as complex as those in the NHS. Bringing those functions together attempted to resolve many of the issues set out above. However, it came with its own drawbacks. To succeed in the E&FM environment each



professional head of department had to become more generalised and corporate in their approach. They needed an appreciation of the issues faced by each of the respective functions they managed together with a wide range of financial management skills, including the ability to determine what should be the spending priorities and where it was safe to make cutbacks or to delay or even cancel investment. Without sound knowledge, this presented obvious challenges and risks.

for patients and staff, the E&FM professional has become a well respected and valued member of the hospital management team. However, the role now demands even greater skills in areas such as strategic planning, wide knowledge of the estate’s condition and an almost scientific approach to hospital cleanliness, catering and infection control. Compliance with an ever‑increasing list of regulations places further pressure on the team managing these vital services. Clearly many healthcare services could not be offered without the requisite estate and facilities. It is also important to recognise the financial commitment the modern E&FM department makes to the daily running of the hospital; in pure revenue terms approximately 30 per cent of turnover is vested in E&FM making it the largest cost outside of the payroll bill. The list of guidance and legal requirements

eed To succ &FM in the E nt, each me environ ional head profess rtment had of depa ome more to bec lised and genera te in their corpora roach app

A DEMANDING POSITION Things have moved on considerably over the years both in terms of skills, knowledge and greater integration with top management and clinical priorities. As the estate and facilities have become more complex, and the public and ministerial interest has become greater and greater in the quality of the environment

placed on E&FM teams is extensive, covering everything from hospital parking to legionella. Add to this the list of returns, surveys and inspections expected to be completed, recorded and evidenced such as ERIC, PLACE and fire risk assessments to name just a very few. Newer government initiatives such as Premises Assurance and the recent Carter Report add more pressure by expecting yet more information to be collected and analysed in the name of efficiency. While each has its value in managing the E&FM function they all add to the pressure on the department through the collection, compilation and analysis of information, all of which consumes valuable time and resources and obliges teams to choose reporting over other potential uses of their time. Such information also needs to be monitored and reviewed against defined action plans, extending the resource commitment over a longer period of time. To add to the already significant pressure, there could also be a huge number of inspectors from CQC descending on the site either announced or unannounced to inspect everything from the hospital buildings to the trust’s procedures and records. As one would expect – and rightly so – the safety and quality of the environment is critical. A FACILITIES MANAGEMENT SYSTEM So, with a myriad of legislation, guidance and compliance issues to consider as well as planned and reactive maintenance to manage, what tools are available to help with monitoring, tracking and analysing progress in each of these areas? Besides the trusty and ever-popular spreadsheet, hospital E&FM teams usually purchase a facilities management (FM) system to help keep on top of everything. There are many solutions out there, all doing similar things and spanning a wide price range. The choice of which to use comes down to the best suited for your specific working practices and that means drawing up a specification, going through a lengthy (and costly) tender process and evaluating the options by inviting potential suppliers to deliver detailed software demos. As FM systems become more comprehensive we are seeing single systems with the capability to handle everything required by a modern E&FM department. On the face of it this sounds very attractive and efficient however there are downsides; most systems have been designed for a specific purpose and subsequently adapted to widen their reach. This can lead to sub-optimal performance in certain areas; if the system fails, everything fails and although contingency plans should be in place should such incidents occur, there is a continual risk of business interruption which can have serious consequences both in terms of cost and on service delivery. Larger, all-encompassing systems tend to be corporately driven and local influence is not always effective when changes are

Besides the trusty and ever-popular spreadsheet, hospital E&FM teams usually purchase a facilities management (FM) system to help keep on top of everything requested. So, for many users it is inevitable that additional software will be required to manage and monitor specific issues and this is usually provided by a specialist organisation who understand the need and not just the technology. While this may not be ideal, tools are available to allow for the relatively easy integration of such disparate systems should they share unique identifying data elements such as location codes for example. Such integration allows for the exchange of data and the introduction of some consistency between such systems on a basic level. Key to the success of any FM system is the quality of the data going into it. This extends beyond simply populating the database and relies on the ability of the user fully understanding what the output from the system needs to be and how it is intended to be used. All too often, this isn’t the case and the implementation of the system becomes a struggle and can fail altogether. In contrast, taking the time to build solid, flexible coding structures and adopt working methods to complement the software’s functionality, even if it means adapting or modifying your existing procedures, will result in better output and save time and money in the long-term. FLEXIBILITY AND SPEED The introduction of any computer based system will inevitably involve a great deal of time and effort to build and populate in the early stages but expending that effort and taking the time to properly structure the data will quickly start to pay off. The quality and usefulness of the data coming out of an FM system is only as good as the data put into it. It is for these reasons that getting this right from the start and working in collaboration with reliable and experienced suppliers will pay significant dividends. Ensuring you have a supplier you can trust and who understands the industry you operate in is critical to achieving that best in class performance from the chosen system; peer group pressure on suppliers to ‘get it right’ must not be overlooked. Although it was mentioned above that local variation is an important feature it must be recognised that this is more about the flexibility of the system to adapt to your local needs, at least to some degree, rather than being a ‘one size fits all’ solution from the start. After all, all healthcare E&FM professionals essentially carry out a similar role regardless of their hospital’s location or specialty. Keeping on top of sector changes and making sure all those involved are as knowledgeable as possible is a

Facilities Management


major challenge for E&FM professionals and their teams, especially as they are expected to maintain and improve their performance and standards year on year with increasing pressure on their budgets. The routine collection and analysis of data, either through reporting or via real-time dashboard systems and the like, is essential to the monitoring and improvement of performance and efficiency. Liberating even small savings from this budget makes a significant difference to the clinical funds available. Making these critical decisions requires experience, knowledge and a wide understanding of what is possible within the hospital environment. In this time of increasing pressure on budgets, one of the first targets to make savings is often the training budget. However, this can prove to be a poor decision. E&FM is an area that is always developing, with new regulations to be met, and new case studies or guides to be absorbed and applied to keep getting the most effective use of E&FM. Without a clear understanding of the issues and challenges, including the ability to analyse costs and their implications in terms of possible savings as well as warning signs, then the trust will end up paying out more in the medium to longer term. Keeping all staff as upskilled as possible will without doubt improve performance, grow staff commitment and reduce likely costs on retention and recruitment. A COLLABORATIVE APPROACH It isn’t possible, however, to make these savings in isolation from other parts of the hospital system. Proper collaboration in the use of the assets and utilities is fundamental to achieving even the most modest of improvements. The E&FM director needs help from not only their departmental colleagues but from the external market bringing best in class solutions to bear, and there is definitely no shortage of companies keen to get their products into the healthcare market. The challenge for the director is how to evaluate the range of products and services on offer. Experience and talking to existing product/service users is a common way of doing this. However, it may not be the best way to source the newest or best solutions available because each NHS body’s characteristics and drivers will be different, so E&FM directors and their teams need to invest effort in identifying and evaluating the possible options and making the best value choice. L FURTHER INFORMATION



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What role do staff have in tackling environmental challenges for the NHS and the community that they serve. Caroline Watson shares some success stories from Barts Health NHS Trust programmes on air quality and sustainability

Each year in the UK, the equivalent of 40,000 people per year die due to poor air quality. A recent report on the effects of air pollution, produced by the Royal College of Physicians and Royal College of Paediatrics and Child Health, estimated that this costs the UK health economy around £20 billion a year. Cited in the report as an important example of best practice, Barts Health Cleaner Air for East London showcased the role healthcare providers can play in inspiring staff to improve critical aspects of public health. The programme was developed as a unique cross-collaboration between Barts Health NHS Trust, its four London boroughs, the Greater London Authority and Global Action Plan to tackle poor air quality and help patients and staff breathe cleaner, healthier air. The Barts Health Cleaner Air for East London programme incorporated a ‘Protecting Patients’ initiative to advise vulnerable patients about simple, practical actions they could take to protect themselves from the effects of air pollution. The initiative was designed around the ‘Trusted Messenger’ behaviour change framework (whereby a message is delivered to a target audience from someone they already know and trust) so a ‘train the trainer’ approach was adopted with key Barts Health clinicians and community health staff. Embedding the training so that staff felt

Thomas Avery

confident enough to deliver it themselves, empowered them to share their new-found knowledge with almost 3,000 patients. Ultimately, the project was about patients using this knowledge to change behaviours that would reduce their exposure to harmful air pollution. The results bear this out – with all those interviewed or surveyed reporting at least one behaviour change as a result of the advice given by Barts Health clinicians. The significance of this should not be understated – it is estimated that if the Barts Health Cleaner Air for East London programme was embedded in the care pathway on a national scale, it has the potential to change the behaviour of over two million patients. By reaching out to at-risk groups and informing them about prevention, pressure on the NHS could be eased by working towards a more sustainable, self‑managing health community with fewer emergency admissions. We know that patient well-being is a key motivator for NHS staff, and empowering staff to know that they could make a difference was crucial to the success of this initiative. 85 of the trained clinicians in the Protecting Patients project said they had improved their knowledge of air pollution and felt more equipped to give their patients advice to reduce exposure.

Empow er staff toing know th could mat they ake differen ce was a cr to the s uccess ucial of this init iative

Written by Caroline Watson, senior partner, Global Action PLan

Inspiring staff to encourage change

CLEANER FLEETS, HEALTHIER STREETS The emphasis on patient benefit as a driver for motivation among staff was also evident in another project within the Barts Health Cleaner Air for East London programme. Cleaner Fleets, Healthier Streets worked with Barts Health NHS Trust and their ambulance fleet subcontractor, ERS Medical. Global Action Plan trained the fleet drivers to adopt fuel efficient driving behaviours. Insights gained from driver surveys showed 25 per cent of them and their families suffered from asthma, so tailored messages were created addressing their motivation to improve the health of their families, communities and patients. During bespoke training sessions, drivers pledged to ‘Drive Down Pollution in East London,’ and as they took to the road each day, branded air fresheners hanging from their mirror with this key message reminded them of their promise. Another incentive was the opportunity to be crowned ‘Most Fuel Efficient Driver’ and gain pole-position on an EcoDriving Simulator Leader Board. Telematic software allowed instant visibility of individual driver performance and, in the first month of engagement, drivers showed a 63 per cent improvement in driving behaviours. They were also encouraged to switch off their engines on NHS Sustainability Day. Patient well-being as a driver of staff motivation was also clear from our work with Barts Health NHS Trust on our award-winning sustainability programme, Operation TLC. CREATING HEALING ENVIRONMENTS Operation TLC is a staff engagement programme which helps staff take actions E



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SUSTAINABILITY  to cut energy waste from healthcare buildings, whilst improving patient experience and staff well-being. The name TLC stands for Turn off equipment, Lights out, Close windows and doors, helping aid recall of the actions people are asked to take. Talking with nurses prior to the programme revealed that providing the best quality of care for their patients was their prime motivation. As a result, we explored how the energy saving actions could assist with best patient care – leading to the name Operation TLC and the tagline ‘creating healing environments’. The TLC actions not only cut energy waste, but also make the hospital wards more comfortable and restful, for patients and staff alike. Positive feedback for Operation TLC came from the wards, in some unanticipated ways. For example, the introduction of quiet times was implemented to give patients a chance to rest in a darkened room with no disturbances, but it also gave visitors a break and nurses noticed that the quality of interactions between patients and visitors improved when they returned. Staff reported that quiet times were beneficial for them too as they had time to catch up, reflect and plan for the rest of the day while their patients rested. The programme was pioneered by Barts Health NHS Trust and shows the huge potential available to NHS trusts. A patient survey analysed by the Trust’s Clinical Research Unit and Queen Mary University of London identified that patients experienced up to a third fewer sleep disruptions and 25 per cent fewer privacy intrusions in a small patient sample. Implementing the programme has also successfully enabled the trust to cut energy waste and save £425,000 per year on energy bills. We were delighted when Operation TLC won an HSJ Efficiency Award and a Guardian Sustainable Business Award, as it raised the profile of an initiative which has now been adopted in eight NHS trusts. As highlighted in the Carter Review, the NHS could save £125 million per annum on energy costs, and Operation TLC contributes towards realising this ambition whilst simultaneously benefitting patients and staff.

best quality of care is a huge driver of NHS staff motivation. Seeing benefits to patients, such as longer rest times, helps re-inforce why the action is important. Don’t make assumptions: Just because something has been done a certain way doesn’t mean it’s necessarily the best way. For example, our Operation TLC work has resulted in unused equipment being decommissioned. Don’t underestimate the benefits that behaviour change can bring. Degree of personalisation: Research and then tailor messages to increase the relevance of the action and its impact to the audience. For example, the ERS Medical drivers were inspired to act after linking their driving with the health of their families and communities. Branded reminders: Messaging repeated on merchandise serves as a helpful reminder to encourage the behaviour. Global Action Plan gave the ERS medical drivers branded air fresheners which acted as a daily reminder of their pledge to ‘Drive Down



Pollution in East London’. Operation TLC materials include posters, door stickers, pens, checklists, labels on lights and machines – all of which make remembering the behaviour (turning lights and machines off, closing doors) as easy as possible. Recognising and celebrating success: Operation TLC has won awards from Guardian Sustainable Business and The Ashden Award and that external recognition is very energising. Staff will also respond positively to a public ‘well done.’ When participating wards reach the final phase of Operation TLC, boxes of tea and chocolate are sent to them to thank them for their work. Individual contributions are also applauded through personalised posters that feature a staff photo. These simple actions go a long way to reinforce the positive messaging and inspiring continued behaviour change. L FURTHER INFORMATION

The ‘Cleaner Air for East London’ programme incorporated a ‘Protecting Patients’ initiative to advise vulnerable patients about simple, practical actions they could take to protect themselves from the effects of air pollution

TOP TIPS – FOR MOTIVATING ENVIRONMENTAL ACTION Here, Global Action Plan provide their top tips on maximising staff motivation and environmental action, based on our programme work at Barts Health NHS Trust: Increase confidence through training: As with our Protecting Patients project in the Clean Air programme, clinicians felt more confident once they had received training. Adopting a ‘train the trainer’ approach is a good way to empower staff to own the message and embed the behaviour in workplace culture. Clearly link benefits to patient well‑being: From our Operation TLC research among nurses, we know that delivering the


Leadership Written by Michelle Fitzgerald-Shaw, national programme lead for talent management, NHS Leadership Academy




Keeping tabs on talent management Talent management is the core element to the success of any NHS organisation and is now more important than ever, says Michelle Fitzgerald-Shaw of the NHS Leadership Academy Getting the right talent into the top jobs across the NHS is a challenge in itself but keeping people there is another issue completely. A recent report issued showed that on average, a chief executive of an NHS trust – the top role within trusts across the UK – only last two years. But why, at a time when leadership is so important than ever before, are we losing people in these top jobs? What else do we need to do? And how should we spread the message about the importance of talent management across all levels within an organisation? Talent management is described as a process of finding, developing, managing and evaluating talent. In other words a way of bringing in people who are suited to certain roles and helping them develop to be the best they can be. Simply put, organisations need to give talent management more importance, particularly succession planning. Clearly more work needs to be done to help the most senior leaders understand their role and tackle daily challenges while operating in a consistently pressurised environment. It can often take months or years for NHS talent to pass through the ranks until they get into one of the most senior positions within their organisation. For them to quit 20 months later is absolutely devastating. But we’ve got to look at the full picture. These roles have massive responsibility and to expect one person on their own to shoulder this is both challenging and unrealistic. There needs to be more support for directors and senior managers prior to, and during their time in the role – something which the Academy offers with a whole host of programmes and offers including The Nye Bevan programme. We need to make sure that as leaders, we all take responsibility for managing talent. A culture where leaders care about and actively develop their teams means there’s an increasing chance that the organisation will be able to deliver its

objectives with the core goal of providing good quality care firmly at the centre. PLANNING FOR SUCCESS Succession planning looks at potential future leaders, as well as individuals to fill other business-critical positions, either in the short or the long term. It’s important for the NHS in a broad range of scenarios. There’s a real need to plan for succession into high level leadership and managerial roles; and for critical technical

Simply t en put, tal ent m manageed as a b is desciof finding, processeloping, dev ng and i g a n a m ng evauatit talen


or specialist roles. Only by doing this can organisations truly lead effectively putting patients at the core of their every decision. If the leader at the helm of an organisation decides to leave, there’s proof that this can impact on the workforce by causing instability and lower morale. Therefore, having a good plan which shows what directors and senior managers should do will help an organisation stay calm throughout the storm per se. We plan for everything else – risk planning, care planning, so why not talent planning? The importance of talent management in general was also a talking point following the Lord Smith and Rose reviews published last year. These papers emphasised the benefits it brings to both the organisation and the employee but that more work needs to be done at national level to manage, develop and nurture talent effectively across the health system. As a response to this, my colleagues in the Academy and from across partner organisations have now begun work to create a national strategy. This will address the recommendations raised and will support the NHS to build talent management capability, ensuring we know who the talent is at organisational, regional and national level so that we’ve got the right talent in the right posts and can help keep them there. Talent management is a continuous journey for any employee – people begin in their role and develop further, either in their role or with an aspiration to move on. We, as


health care organisations, need to be able to influence each stage of their journey to ensure we get the best out of people within our organisation to continue delivering high levels of care. If you look at The Francis report which was published in 2012 – you’ll see a whole host of catastrophic errors which led to one of the biggest scandals in healthcare. But break this down and look at it more closely – if those people on the frontline were cared for properly, if their line managers honed in on what their talents were and helped them develop, would the result have been the same? We need to learn from things like Mid Staffs and change things for the better. And talent management needs to be at the core of all organisations. KEEPING DIALOGUE OPEN Within the talent journey, the most important aspect is the talent conversation. This never ends; employees and managers need to keep it open and go back to it as often as they can. For example in one‑two‑ones, informal discussions, opportune moments, being open and transparent in team

meetings where appropriate and in any other ways that demonstrate that the employee is valued by the organisation. This approach means people feel more fulfilled and energised, helping them achieve their goals more effectively and perform better. By keeping this dialogue open, organisations can: be seen as an organisation which is determined to develop its employees, which will help them attract the best people to the roles on offer; improve employee and staff satisfaction to retain talent (a key element of succession planning); and help to keep people in the roles which suit them the best. Of course – there’s also the big debate about who talent management is actually for. We know CEOs in organisations are finding the pressure hard at the top but does that mean they should be the only ones who get

Talent management should be about considering everyone as an individual and the development that is right for them, making them feel rewarded and able to do a good job within the NHS

support? Surely not. Talent management is for everyone, whether that’s someone who needs support to be able to reach their potential or someone exceeding expectations who’s ready for the next step. People at the frontline who account for more than 66 per cent of our workforce and the majority of our workforce who have contact with our patients are bands 1-5, are vital. Excluding them would be more catastrophic than anyone could ever imagine. MAKING EVERYONE COUNT We also shouldn’t forget other people in the organisation who have first-hand patient contact – the porters, health care assistants, cleaners and the list goes on, because they are far more likely to come in contact with patients than senior leaders. We all need to feel that we’re listened to, understood and valued in our roles to achieve our maximum potential. Talent management should be about considering everyone as an individual and the development that is right for them, making them feel rewarded and able to do a good job within the NHS. There are some good examples of inclusive talent management in non-NHS organisations. For example, if you join Tesco, from day one, no matter what role you have in the organisation, you know you’re on a talent journey and this is discussed regularly with all employees. The NHS is however hugely complex, so there’s never going to be a one size fits all approach, but if we consider talent management in the context of everyone, rather than the most senior people, we’ll start to see positive change happen. TALENT MANAGEMENT SUCCESS Here at The Academy we’re working tirelessly to help organisations across the NHS recognise the importance of talent management and support leaders at all levels. We’ve created a talent management hub – a central online resource – with lots of information, guidance and support that managers can take back with them to build that environment where staff are cared for. This, along with, our leadership development programmes, aims to support leaders at all levels to achieve their potential, and help their team achieve theirs. Talent management is the core element to the success of any NHS organisation. It’s time for organisations to realise its importance and ensure they are using it at all levels. If you care for your employees, they’ll care for your organisation in return, but most importantly, they’ll care for our patients. L FURTHER INFORMATION



Advertisement Feature Written by Paul O’Hanlon



ARE YOU READY TO MEET THE REQUIRED GS1 STANDARDS? Omnicell offers a suite of GS1 compliant solutions including barcode scanners, RFID systems and cabinets to meet the differing needs of all hospital departments A pharmacist by profession, Paul is now managing director of Omnicell Ltd. Founded 24 years ago in the U.S., Omnicell is a leading provider of medication and supply management solutions to the global healthcare market. The company specialises in improving the medication and supply distribution process throughout hospitals. PRODUCTIVITY WITHIN THE NHS An interim report into operational productivity within the NHS, published by Lord Carter, made it clear that hospital efficiency needed to be at a consistently high standard in every hospital and that innovation needed embracing to ensure continual improvement. One simple way that hospitals can adapt for the future is by automating their existing medical supplies processes. By using technology in this way, hospitals can access an accurate breakdown of treatment costs at patient level and free up clinicians’ time so it can be redirected back into face to face patient care. Hospitals hold many weeks or even months of supplies and medication stock and a lack of automated systems for managing the distribution of this throughout hospitals contributes to increased costs, inefficiencies and creates an unnecessary risk to patients. In addition, manual processes consume vast amounts of valuable clinicians’ time. We know from experience that the majority of trusts, many of whom are in deficit and are being required to make financial savings, are wasting millions of pounds on supplies they don’t need simply because they don’t know what is being used where, how and by who. This doesn’t just have an impact financially, it also has an impact on patient safety – without an automated process you don’t know what supplies have been used on which patient which could have serious consequences if ever a product needs to be recalled. NEW STANDARDS The new GS1 standards, mandated by the Department of Health in its eProcurment strategy for all acute trusts, will go a long way to resolving these issues but they must be implemented correctly if trusts



are to achieve the maximum benefits. Lord Carter’s review says GS1 standards will allow every NHS hospital in England to save an average of £3 million each year, while improving patient care. These standards need to be in place by 2019/20 and that’s why it is crucial all trusts are in the process of developing a robust plan for GS1 right now that will work for them in the long term. But, as with many aspects of this new digital age, it can often be hard to know where to start. Omnicell has already helped 100 NHS hospitals save a total of £50 million with its range of solutions which are available right now to help you meet the required GS1 standards. With over 20 years’ experience in ensuring the health of patients through reliable inventory management systems, we know one system won’t fit every hospital department. That’s why our ability to create bespoke solutions for our customers is very important. All our solutions, which include open scanning systems, RFID and cabinets, can scan the user location, patient, item and lot number and are designed to drive efficiencies across your organisation. They can all be integrated with existing hospital systems and are available with no up‑front costs so you only pay as you save. Implementing our solutions gives you the ability to make more informed financial decisions as a trust going forward by providing you with a clear picture of everything moving through your hospital supplies system. We know there is too much at stake to guess if you are doing your best, so we

have a number of reporting tools, including web‑based reporting, which enable you to get the most from your systems and maximise your savings and benefits. This coupled with our excellent patient cost tracking, means that you can review cost variances and have clear visibility of any discrepancies. MAXIMUM BENEFIT But automation alone is not enough. To ensure hospitals get the maximum benefit, Omnicell puts in place a dedicated project team from the outset to help you to build your business case for supply inventory management. We are the only GS1 accredited partner to offer the full range of scanning, cabinet and RFID systems with unrivalled NHS experience. We will work with you to design a solution that will fit each scenario and meet the needs of each hospital, department and product range. We work with you to review your workflows and processes and help you to choose the best system for each hospital department. When we say we will save you money or make your business more efficient, we mean it. We put in place ongoing support to ensure you drive savings and ensure your systems continue to evolve and grow to meet the needs of the hospital, patients and staff. We recognise that there is a long-way to go to implement GS1 standards across the NHS but here at Omnicell we look forward to working with more trusts to achieve them. L FURTHER INFORMATION


Time and money are necessities that the NHS can no longer afford to waste. Glen Hodgson, head of Healthcare at GS1 UK, analyses the current state of barcoding in hospitals, and explains how it is saving lives, time and money GS1 standards offer the healthcare industry the same benefits that have been embedded in every stage of the retail supply chain over the past 40 years – improving operations and inventory management, and saving time and money. Applying the same standards in healthcare means that the trusts can save time and money, prevent mistakes, improve patient care, and outcomes and, most importantly, increase patient safety. In 2014, the Department of Health introduced a change for hospitals that – if the experiences of the retail sector are anything to go by – can be transformational. What has now changed, as suggested by the eProcurement strategy, is that GS1 standards have been introduced into all acute trusts in England. Both the eProcurement strategy and the subsequent review into NHS productivity, led by Lord Carter, have emphasised the need for a big change in how our hospitals are run. Their publication represents a fundamental shift to integrated, patient‑centric care, through the better integration of technology – the Carter Review highlighted that this transition has the potential to release £5 billion of efficiency savings over the next three to four years alone.

Carter’s review couldn’t have been any clearer: it states that the introduction of GS1 standards will allow every NHS hospital in England to save, on average, up to £3 million each year, while improving patient care. But what does it really mean in practice to

The introdu of GS1 ction will allo standards hospita w every NHS to save l in England a up to £ n average 3m each ye illion ar

implement GS1 standards in healthcare? In practice, it means having a barcoded wristband on every patient. And having barcodes on all medical supplies, equipment, assets and pharmaceuticals. And it also means using a barcode to identify every physical and operational location. Their adoption and implementation allow hospital managers and clinicians to know at all times who E

Written by Glen Hodgson, head of Healthcare, GS1 UK

The power of standards to transform the NHS

Asset Tracking


GS1 STANDARDS Wasting time and money can no longer be an option. And of course, there are a lot of new challenges that trusts need to deal with through this cultural change, but they shouldn’t be put off by them. Instead, they should use this opportunity to make better use of the technology and data they have available – to offer better and safer care. The trusts need to gain greater control over their supply chain, save money and help eliminate wastage – and the introduction of GS1 standards is a fundamental driver for this. When referring to GS1 standards, Lord



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ENSURING THAT TRACKING AND TRACING IS MADE EASY Welsh company Torchwood Technologies specialises in providing bespoke RFID, NFC and Barcode labels and tags for use in all healthcare environments Torchwood Technologies supply ruggedised products using high impact adhesives and pride ourselves on providing labels where others fail. Our labels are in use for asset management in a wide range of vertical markets and applications with many ‘blue chip’ companies including a number of NHS trusts throughout the UK. In particular we can manufacture antibacterial resin coated virtually indestructible labels to GS1 standards in a variety of sizes bar coded and RFID enabled ideal for identifying medical devices. There are many acronyms in general use these days, and many of them have differing meanings depending on the context in which they are used. One specific example is triple A. This can of course refer to the size of a battery, but we in Torchwood believe that it refers to good management practice which is ‘All About Assets.’ Assets take many forms, and include people, fixed plant, moveable equipment; materials used or consumed; data or information particularly that stored on paper documents, and end products. The relative importance of these assets and their management varies across economic sectors, but there are three fundamental requirements to the management of assets. What are they? Where are they? Are they fit for purpose? Systems must be in place to monitor the management of assets based on collecting the right data in the right place at the right time by the right method and processed in the right way. There are a variety of technologies than can be used, with barcodes, RFID and NFC being the most common. FIXED PLANT AND EQUIPMENT Fixed plant such as back-up generators must have individual identification which can be automatically read. Common technologies include linear bar code, 2D bar code, RFID, or NFC. The choice of identifier depends on the way in which data is integrated to the appropriate database. Many fixed assets have critical functions, for example a back–up generators in hospitals. These must be part of a full Repair Maintenance and Overhaul (RMO) system to ensure that when required they work.



These can be identified with the GS1 Global Individual Asset Identifier to guarantee world wide unique identity. MOVEABLE PLANT AND EQUIPMENT Much of the moveable equipment used in the health service is used in life threatening situations; therefore such equipment also needs to be uniquely identified. The GS1 system of Unique Device Identifier (UDI) provides such a code and is being adopted world wide. The rapid location of such equipment and the need to know that is fit for purpose is critical. Whilst barcode systems may deal with such movements they require human intervention and in time critical situations this presents a problem. Most such equipment is therefore usually tracked by means of RFID. Passive RFID systems are economic to install and rely on reasonably priced RFID tags, and are often adequate when ‘last known location’ is sufficient. Real time location can be achieved but depends on expensive active RFID tags, complex wireless networks and sophisticated architectural information systems. Fitness for purpose must be tracked via an RMO system specific to the individual asset. PEOPLE Whilst this can be a contentious area there are instances when people need to be identified, for instance often it is necessary to check individuals have the correct training to perform certain processes and to record which individual performed which process with which asset and/or drug. This can only be achieved automatically if all three elements are uniquely identified ideally using GS1 codes.

CONSUMABLES Adequate identification is required to ensure that drugs are in date and readily available where required. Such tracking is based on GS1 standards which exist using 2D Matrix symbols for pharmaceuticals and as with UDI these are increasingly becoming mandatory throughout the world. RECORDS Paper records often need to be found in a hurry, a process that can by hugely aided by the attachment of an RFID tag. If documents are filed with RFID tags relating to patient identity then they can be located by scanning for the file required using a reader which emits an intermittent tone which increases in volume and rapidity with its proximity to the tag. CONCLUSION It is our firm belief that none of the above can be successfully achieved unless assets are properly identified with the right coding structure, using the right technology, on labels/tags which can survive in the often harsh conditions in which some assets exist. We have experience in many spheres of providing anything from complete solutions to the supply of labels/tags. Our labels are in use for asset management in a wide range of vertical markets with many ‘blue chip’ companies including a number of NHS trusts. We work closely with customers to ensure any solution in which we are involved is totally fit for purpose. L FURTHER INFORMATION


About GS1 UK GS1 UK is a community of over 30,000 members working in retail, foodservice, healthcare and more. It is one of 112 independent, not-for-profit GS1 organisations operating across 150 countries worldwide.

Lord Carter’s review states that the introduction of GS1 standards will allow every NHS hospital in England to save an average up to £3 million each year, while improving patient care  did what to whom, when, why and where they did it and with which medical device, implant, pharmaceutical drug and dose. The 2014 eProcurement strategy mandated the use of GS1 standards in all acute trusts in England by 2019/20 but much of the positive impact is already being felt across the industry. For example, since the introduction of GS1 standards in April 2014, Derby Teaching Hospitals NHS Trust has saved at least £25,000 per month just in the consumables they’re using in general surgery, imaging and cath labs. That’s an annual saving of £300,000, with more to come when fully rolled out. At Barking, Havering & Redbridge University NHS Trust, they’re implementing GS1 standards through a health records tracking solution and they’ve identified three-year net cumulative savings of £1,444,690. And these are just some examples of how GS1 standards can help. In January this year, Jeremy Hunt, Secretary of State for Health, announced the six GS1 demonstrator sites of excellence, each with a share of a £12 million investment from the Department of Health. Those sites are tasked with demonstrating the benefits, as well as challenges, they encounter from using the standards. The six demonstrator sites are: Derby Teaching Hospitals NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust; North Tees and Hartlepool NHS

Foundation Trust; Plymouth Hospitals NHS Trust; Royal Cornwall Hospitals NHS Trust; and Salisbury NHS Foundation Trust. THREEFOLD BENEFITS As shown by the eProcurement strategy, GS1 standards will be used for three core enablers to drive operational efficiencies, improved patient safety and regulatory compliance: Firstly, every person: identifying patients with a wristband, which includes a GS1 barcode, enables accurate and consistent information to be captured and stored about the patient and the caregiver – a major driver for patient safety. Next, every product: easily accessing accurate and transparent product information for medical supplies, equipment and pharmaceuticals enables precise ordering, improved product availability and lower transaction costs. Thirdly, every place: identifying every physical and operational location within the healthcare system enables information to be collected and stored where each event occurs. These three core enablers will then underpin three primary use cases identified by the Department of Health as areas where GS1 standards will have the biggest and most immediate impact in acute trusts. These are: purchase-to-pay, which enables the acute trusts to manage their procurement

Asset Tracking


GS1 UK helps everyone involved in making, moving and trading goods to automate and standardise their supply chain processes using the common language of GS1 global standards, bringing the same efficiencies to the healthcare supply chain – right through to improved patient safety. GS1 standards have provided a common foundation for business since the first barcode was scanned over 40 years ago. The standards now play their part around the world and around the clock – from scanning supermarket groceries or buying a CD online, to locating equipment in a hospital quickly enough to save a life. In fact, there are over five billion successful scans of a GS1 barcode every single day. Additionally, GS1 UK enables enhanced efficiency, safety and sustainability for a wide range of businesses and their customers. The globally recognised open standards help members to uniquely identify, capture and share information, wherever they operate in the value chain and whatever their size. And as the landscape adapts to changing technology and globalisation, GS1 UK evolves its standards too, so that it can support its members as they develop and grow.

processes more efficiently while providing improved product availability; inventory management, which ensures the acute trusts keep fewer products in stock and reduce wastage, yet ensuring products are readily available where and when needed; and patient safety recall, which makes it easier to identify and remove all recalled products across all acute trusts, or even when with the patients once they’ve been discharged. PUTTING IDEAS INTO PRACTICE The opportunity to have more efficient processes across all these areas isn’t just a great idea in theory, in practice it also offers tangible benefits. In the last few months, all 154 NHS acute trusts in England have become GS1 UK members and many have already written, or are currently writing, their plans for the implementation of GS1 standards. This means that suppliers to these trusts now also need to become GS1 compliant so they can keep trading with them. E



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PEPPOL – Pan European Public Procurement Online – is a term not many people had heard of before 2014. Little over two years on, and it is probably the topic we get asked about most often here at GHX. Many NHS trusts, and even more suppliers to the NHS are asking us what it means, whether we’re an access point and how they can join up

The NHS has been driving towards adoption of PEPPOL since the publication of the NHS eProcurement Strategy in May 2014. The aim of both PEPPOL and the NHS Strategy is to increase the take-up of eProcurement. GHX has been working towards the same goal, focused only on healthcare since 2000, and some of our team have been working towards this goal since well before that. This synergy of objectives, as well as the GHX Community footprint, has further illuminated the leading role that is required of GHX to drive the adoption of PEPPOL and eProcurement practices in the UK and across Europe. In recognition of this, GHX has been working with its established trading community of NHS hospitals and multinational healthcare manufacturers, as well as with other PEPPOL Access Point providers, to take the PEPPOL trading environment from theory into practice. There are three key learnings that have emerged as part of this exercise: PEPPOL IS FOR PROCUREMENT, BUT NOT ALL PROCUREMENT IS THE SAME Firstly, one of the key learnings is that the PEPPOL standard has been architected without consideration to industry specific applications. It is designed to aid the procurement process, specifically the procurement process of publicly administered organisations. The standard adds complexity to electronic procurement systems. For example, PEPPOL requires: structured message formats that are not commonplace in healthcare, particularly in the NHS, and; use of a PEPPOL ‘Yellow



Pages’ by which the sending Access Point can ‘look up’ to find the recipient Access Point. For healthcare, this complexity comes for a supply chain that, relative to other industries, is already quite immature. GHX has an established global network of trading partners that includes, in the UK, over 53 per cent NHS acute care hospitals and around 80 per cent of the medical device market. Each trading pair has been set up over time, often each has its own set of ‘business rules’, which determine the structured format of the business documents the recipient organisation prefers to receive as well as any bespoke requirements. Our experience tells us that these formats vary and that the factor determining which format is required is often the ERP or customer service system dependent. For manufacturers, systems such as these are often provided by the likes of Oracle and SAP. These systems are huge installations and massively disruptive for an organisation to change. This requirement and support for outbound messages to be in multiple structured formats will not change. On top of this, PEPPOL adds additional message format structures and increases the opportunity for errors in an already intricate electronic supply chain. THE HEALTHCARE SUPPLY CHAIN IS LIFE SUSTAINING Secondly, the risks associated with adding complexity into the healthcare supply chain are high. For retail and other industries, the risks associated with non-fulfilment of

an order are generally lost revenue and/or increased cost. For healthcare, the risks can be much greater. Non delivery of a medical device, critical drugs, or consumables required for patient care can delay or impede the provision of quality care to patients. We are all patients at some time in our lives and none of us want to see this uncertainty introduced into the healthcare supply chain. The timeline for suppliers to the NHS stipulates that they must have joined a PEPPOL Access Point by September 2016. That means you have two months to engage with an Access Point provider. We are setting up new services to allow companies of all sizes to connect to GHX as an Access Point. It is important that no one is excluded and the benefits of eProcurement can be felt by everyone across the industry. EXECUTING AGAINST THE WHOLE VISION – ONLY GHX CAN SAY THAT Thirdly, the NHS eProcurement Strategy has led to an unprecedented level of collaboration in the healthcare supply chain. Here at GHX, we have stated from the beginning our backing and support for the implementation of the NHS eProcurement Strategy. We are working with our partners and competitors to execute the vision. This is what is required of us as a community to take the industry forward. As we move towards this brave new world, maintaining the knowledge that resides in the industry will be critical. Experience and healthcare industry-specific expertise will be more valuable than ever. We are able to work with our customers to offer the opportunity to comply not only with PEPPOL, but with the whole eProcurement Strategy. Our track record of storing, managing and transporting quality product data is enabling us now to offer compliance with the data elements of the Strategy. For example, GDSN connectivity, master data management for suppliers, catalogue management for hospitals, and access to an already established trading network of hospitals. We believe that, and only GHX can say that. L FURTHER INFORMATION


Implementing GS1 standards means that more time will be freed up for patients, there will be a better understanding of costs, better comparison of clinical performance and of exposing variations in clinical practice  Over the next four years, we’ll see these efficiencies come into practice and manage to measure the true impact they’ll have across all NHS processes. Just some of the benefits that trusts will have is complete traceability, ability to capture and share information automatically, whether it’s

between departments and care professionals or between hospitals and their suppliers – in other words, true interoperability is achieved between people and systems. But a shift in procurement processes is not just what will occur – implementing GS1 standards means that more time will be

Asset Tracking


freed up for patients, there will be a better understanding of costs, better comparison of clinical performance and of exposing variations in clinical practice. But of course, it’s not just about finance or procurement, this impacts the whole hospital. And everyone must play their part – from executive boards and managers to nurses and clinicians. CLINICAL VALUE Clinical engagement will be fundamental and it was a key focus of our recent healthcare conference, as our keynote speaker – Lord Prior, Parliamentary Under Secretary of State for NHS Productivity – made clear: “If we’re really going to embed GS1 barcoding into hospitals, we have to accept this is a behavioural or cultural issue, not a technological issue. If you have clinicians who can see the real value in GS1, then we’ve got a real chance of getting it established. I think the way forward is to expose unwarranted variation. “And one of the reasons why I believe exposing variation is the most powerful lever for improvement is because it’s the only way we’ll get true clinical engagement. If we can’t engage clinicians, we’ll never get real, sustainable improvement.” If we can engage clinicians, we’ll see lasting change made to the everyday processes and functioning of hospitals across the country, and savings of billions of pounds in the years to come. In a time where there’s increasing pressure to do more for less, this can be transformational. But, more importantly, this isn’t just about money – it’s about making hospitals safer – and by doing that, we’ll save thousands of lives too. L FURTHER INFORMATION

Glen Hodgson, head of Healthcare at GS1 UK Glen joined GS1 UK in late 2014 as head of Healthcare. He is charged with supporting the NHS and the healthcare industry to deliver greater efficiency and a more robust approach to patient safety. Glen is a highly accomplished senior executive, with over 15 years of national and international experience. He has served at board level in a variety of operational and commercial roles within complex organisational structures inside the pharmaceutical/healthcare arena with particular interest in caring for patients outside the hospital setting and rare diseases.



Advertisement Feature Written by Geoff Broome, Apira



ELECTRONIC DOCUMENT MANAGEMENT AND GOING PAPERLESS In recent months there has been much written about the desire to move to paperless operation in the NHS. So what exactly are the benefits for patients and trusts if they embrace this change and how can they get there? The national target for paperless operation been set to 2020, and plans for ‘Digital Roadmaps’ and ‘Sustainability and Transformation Plans’ are being built with varying levels of emphasis on this agenda. Before reviewing the benefits of EDM there is a myth in this field that is very important to address. Many commentators have suggested that there is no need to digitise old records or current paper as very soon the use of modern Electronic Patient Records will naturally make the paper record redundant. Whilst this has elements of truth to it, the reality in most trusts is that paper is still being generated and received from third parties. Standard medical records retention policies mean that any paper generated today must be kept for eight years. Moreover, some doctors and some specialities have a great need to see the full history of a patient before making clinical decisions. And, finally, the earliest possible release from the management of paper produces the greatest quantitative and qualitative benefits. We have to deal with the legacy if we are to go paperless, the fact that we still have mountains of the stuff in 2016 should be testament to that fact. SO WHAT ARE THE BENEFITS? Firstly, trusts desperately need to drive down overhead costs. One huge area of spend is in the management of paper records, which requires people to find and pull records, move them to where they are needed, update them with new content and return them to a physical store. This represents a large financial cost in people. With EDM, a saving of between £1 million – £2 million per annum can be achieved on a recurring basis. Secondly, many trusts find space is at a premium. Typically, over 1,000 sq meters of space is being used for records with well over double this figure in larger trusts. Lord Carter suggested the running cost across the NHS is in the range of £105‑£970 per square metre per annum. Trusts are considered good if their metric is lower than £320. This means that, even on a maintenance



basis alone, disposing of or using this space for an alternate economic purpose would save a trust £320,000 per annum. For large trusts this figure will likely double. Of course there are other smaller savings e.g. relating to printing (2p per page typically), the paper itself and other consumables such as files and folders. However, more fundamental is the impact on the quality of working lives and the ‘time to care’ savings as medical secretaries, ward clerks and junior clinicians spend less time hunting for and updating paper records. SO WHY ISN’T EVERYONE DOING THIS? Two fundamental issues seem to be holding decision makers back. Firstly, the inevitable ‘invest to save’ nature of these projects. Even with the most accommodating of terms from suppliers (many are prepared to spread costs), the upfront investment in the project team, the procurement and then the hardware, software and change management often leave local organisations without an affordable proposition. National support has been largely rhetorical, with promises of funding but little follow through. Secondly, the ‘horror stories’ from some mixed outcomes in other trusts are off-putting. Some had a lack of ambition, working in individual departments rather than trustwide, others a desire to get to perfection before launching. The key to success is to ensure we have buy-in at the top and from clinicians, we configure a capable team able to handle the technical, project and change management aspects of the deployment keeping a sharp eye on the benefits. This is the best way to realise the cash benefits as fast as possible (i.e. releasing people and space). In Surrey, Ashford and St Peter’s NHS Foundation Trust has just taken such an approach and after signing a contracts in March 2015 (with Kainos for EDM and

Hugh Symons for scanning). They are now fully live with their EDM, with all inpatient files being scanned on discharge, legacy and new records that are created are also scanned for 33 per cent of the trust outpatient appointments now with plans to move to the whole trust before the end of 2016. They are on track to achieving recurring savings in the region of £1.5 million per annum during 2017/18 as well as comfortably meeting the 2020 paperless target. The next stage is to use the EDM to digitise all the paper into eForms so it does not get created in the first place. L

Geoff Broome is a director at Apira and leads the company procurement and EDM practices. In the fast five years he has delivered several business cases, conducted procurements and deployed EDM in trusts including at: Ashford and St Peters NHS Foundation Trust; Frimley Healthcare Foundation Trust; Imperial College NHS Trust; London North West Healthcare NHS Trust; Royal Surrey Count NHS Trust; Kingston Hospital NHS Trust; and Surrey and Sussex Healthcare NHS Trust. FURTHER INFORMATION


Putting integration on centre stage

Health+Care 2016


The Health+Care conference returned to London’s ExCeL on 29-30 June, providing a world class teaching and networking for healthcare professionals. Health Business reviews the show Health+Care is the most comprehensive event for health and care professionals and takes visitors from vision to implementation. With a focus on integration, Health+Care 2016 comprised of four events, running in tandem, and included: The Commissioning Show, Technology First, The Residential Care Show and The Home Care Show. This year’s show satisfied the needs of all key health and care system stakeholders and fulfilled all learning needs to disseminate transformation and deliver best practice in a senior peer to peer environment, enabling visitors to meet and network with like‑minded professionals facing similar challenges. In the face of social care funding cuts that are

leaving care business, big, small and council reliant, struggling to keep afloat, Health+Care brought all of the stakeholders together to discuss preventative steps to ensure the situation does not get any worse, providing a dedicated programme with hard-hitting advice to help care businesses cope with the mounting pressure. TRANSFORMATION HUB Across England, local leaders of public services are now facing up to the challenge of meeting the needs of their local populations with significantly less

resources. The government has embarked on the process of devolving decision making powers and control of available resources to local areas, and the pace is set to quicken. For local areas, the challenge of truly transforming how services are delivered is immense. Not only do new service delivery models need designing, but new organisational models that threaten the existence of existing organisations may be needed. The 2016 Health+Care presented the E

Health+ C present are the inau ed gural Transfo r m a t ion a ro u n d the the Hub me: ‘Deliv Transfo ering rm at Scale ation an Pace’ d


Health+Care 2016


 inaugural Transformation Hub around the theme: ‘Delivering Transformation at Scale and Pace’. A powerful, topical, thought‑leading centre-piece for the event’s core ‘integrated care’ theme, the hub created a significant and wide ranging communication platform for all those involved. Transformation programmes ideally would have the best expert advice and practical support built in from the start to ensure success, particularly as many of the familiar rules, relationships and assumptions of the NHS are shifting, meaning that building confidence and certainty across local systems becomes even more important. It creates opportunities to help develop and facilitate that implementation, which in turn creates opportunities for any organisation that can assist. At its centre was the NCM theatre where Vanguards, ‘Fast Followers’ and other initiatives were invited to present their individual programmes and respond to delegates’ questions – speakers focusing on ‘the how’ of moving from vision to practical delivery, the challenges they encountered and the solutions they developed. CONFERENCE STREAMS The 2016 conference streams included a positive mix of keynote sessions and debates, case studies and presentations and Q&As in the main conference lecture theatres and interactive peer-to-peer workshops and round tables in break-out rooms. The ‘NHS providers: delivering safe sustainable



care’ stream presented a rare opportunity for senior figures from NHS provider organisations to step out of their silos, take a strategic view of the future and find out how their peers are tackling challenges similar to their own. This programme enabled the rapid dissemination of ideas and solutions to support NHS trusts and other provider organisations to operate more efficiently and effectively. High on the agenda was the implementation of the Five Year Forward View, the Carter Report and the Dalton Review. There was also discussion and

The ‘Clinical Commissioning Groups-Shaping the Future’ stream, delivered in partnership with NHS Clinical Commissioners, focused on how CCGs need to adapt to survive and continue to add value to the rapidly changing health and care system. CCGs will be under pressure to operate at greater scale, collaborating with each other and other stakeholders across health and social care and this stream will explore what needs to change to allow CCGs greater freedom and flexibilities to innovate and transform care for the local population they serve.

Health+Care 2016 comprised of four events, running in tandem, and included: The Commissioning Show, Technology First, The Residential Care Show and The Home Care Show case studies on how hospital care needs to be remodelled for the future, with a move away from traditional institutions towards hospital chains and networks. As part of the NHS providers stream, Jim Mackey, chief executive of NHS Improvement, analysed what NHS Improvement is doing to support the NHS to get back on its feet and work towards long-term sustainability, as well as the role of NHS Improvement in embedding a learning culture across the NHS. Mackey set out his vision for improving quality outcomes for patients and explained why quality and financial objectives cannot trump one another.

Commissioning leads and providers of mental health services were welcomed to ‘A New Era for Mental Health’. This stream provided a chance for mental health commissioning leads and providers to share best practice and discuss current challenges and opportunities facing mental healthcare in the NHS. Sessions involved case studies illustrating new models of care focussing on crisis and recovery and new population-based approaches to mental health through health and social care devolution and the Vanguard programme. The ‘NHS Right Care – Commissioning for Value’ stream witnessed a keynote

Health+Care 2016

session outlining the overall vision and principles behind commissioning for value and why the decision has been made to embark on a multi‑million pound roll-out of Right Care across all CCGs. There was also a parallel session, run in the CCG Theatre, on commissioning Population Healthcare, variation and value. PRIMARY CARE The transformation of primary care to enable the shift of more activity out of hospitals is fundamental to successful implementation of the Five Year Forward View. The ‘Transforming Primary Care’ stream looked at how general practice and wider primary care is being expanded and fortified through the Vanguards and other new care models. Case studies showcasing innovative new approaches to the delivery of general practice at scale – from super‑practices and partnerships to highly effective and efficient GP federations – were revealed. The focus was on primary care collaborating with community, acute, mental health and social care in new accountable‑are style organisations. One significant example featured at this conference was the Primary Care Home – the radical new community‑based model of integrated health and social care featuring accountable‑care organisations with capitated budgets for

The transformation of primary care to enable the shift of more activity out of hospitals is fundamental to successful implementation of the Five Year Forward View populations of between 30,000 and 50,000. GP practices and federations could also access advice on how to operate efficiently and effectively in an increasingly tough market as part of the ‘Essential Practice Finance’ stream. This half-day conference stream, aimed at practice managers and GP partners, included expert-led, highly interactive sessions designed to give delegates a more in-depth understanding of the growing

complexities of general practice finance as well as the enhanced skills you need to protect and grow your practice or federation. An overview of the financial risks and challenges for practices in 2016/17 and advice on identifying new business opportunities and income streams were also presented. L FURTHER INFORMATION

Maldaba Ltd introduces the My Health Guide app to support and benefit adults with learning difficulties

People with learning disabilities often have difficulty managing complex information that comes their way, including information about their health and the care they receive. My Health Guide is a tablet-based app for Apple and Android that provides a way for people to hold on to and make sense of the information they are given about their health and wellbeing. The app enables users to capture what matters to them in a single, userfriendly place in a format that best suits them: text, images, video and audio. It also enables users to share information with carers and health professionals. Finally users are able to establish better quality relationships with support staff and health professionals. Trish Bailey, clinical care director of Children & Learning Disability Services, Humber NHS

Foundation Trust, said: “My Health Guide has unlimited possibilities. It really will help put people with learning disabilities in control of their own health and wellbeing.” The app lets individuals build up a picture and support profile of what has happened to them, what has worked well and what they need for the future. It empowers patients to make better choices and decisions about their care and to share that information with their family and professionals. My Health Guide benefits users, family carers, providers and commissioners. Users receive better outcomes, and gain greater control and confidence. Family carers are better informed and more involved. Providers are able to deliver more effective front-line delivery, and receive real-time monitoring. Commissioners benefit from improved service efficiencies and outcomes.

My Health Guide is a service that, by improving quality for a person, can help deliver your Forward View ‘Must Do’ Number 8 in 2016/17 and beyond. David Hill, CEO, Humber NHS Foundation Trust, commented: “It’s a bespoke record of the patient. A complete picture of the person, available to them, to their carers, to their family and to health care professionals. It provides a much richer picture of that individual.” My Health Guide is provided by UK software company, Maldaba Ltd. For more information about the My Health Guide app, please visit the website. FURTHER INFORMATION






The UK Health Show brings together senior healthcare professionals and decision makers for one day to help the NHS and the wider sector promote and improve service delivery for better healthcare outcomes across the UK

*The Show is entirely free to attend for those who work in the public sector, charities and the third sector.


A 360-degree experience at the UK Health Show

UK Health Show


On 28 September, the largest healthcare show in the UK will arrive at Olympia London, combining a first class conference, exhibition and networking forum all under one roof The UK Health Show is the leading learning and networking platform, bringing senior healthcare professionals and decision makers together for one day to help the NHS and the wider sector promote and improve service delivery for better healthcare outcomes across the UK. Taking account of current challenges facing the ever-changing healthcare sector, the conference puts local and place-based models of care at its heart. Merging several large events on the healthcare calendar, the UK Health Show brings together the well-established Healthcare Efficiency Through Technology (HETT) show, which has allowed innovative NHS uses of technology to be shared more widely. HETT has been combined with Commissioning in Healthcare, another flagship event in the sector, along with three entirely new streams on procurement, estates and cyber security, to provide a wide-reaching learning opportunity for NHS professionals in a single day. Now, as 2016 sees even greater evolution of an integrated healthcare system and cumulative pressures it faces, the show has sought to give today and tomorrow’s leaders the chance to address national priorities and their own local challenges that, collectively, underpin the future of the NHS. This 360° experience allows you to create your own personalised visitor pathway, with exclusive

access to all five unique healthcare events. In what is set to be one of the largest one-day gatherings of healthcare professionals in the UK, thousands of delegates are due to attend the UK Health Show in September, to engage on issues crucial to the future of the NHS. Complimentary passes are available for public sector healthcare professionals and you need only register once to gain access to all five shows. Places are limited so register shortly to avoid missing out.

The UK Health Show will combine the crucial areas of focus as the NHS continues to face unprecedented pressures, with dwindling resources and financial instability. However, as transformation programmes set in and decision-making power is devolved to local leaders – the opportunity to overcome some of these challenges through integration, collaboration and innovative service delivery models is being pushed from all angles and requires an interactive platform to develop. New care models, as part of the NHS England vanguard programme, are moving from blueprint to reality and act as an inspirational catalyst for greater delivery of the Five Year Forward View’s vision. Population health and place-based models of care, alongside a greater focus on prevention and integration, are at the heart of the new care model vanguards and aim to reduce the demand on services, resources, workforce and funding. Yet the transformation programme faces continuous barriers to implementation, as the sector adjusts to a shift in principles, E

With 2016 th e year of d e livery, the sus t a i n a bility and tra agenda nsformation the NHSis changing l as we kandscape now it

WHY ATTEND? The UK Health Show is the prime opportunity to listen to and directly engage with the UK’s healthcare leaders, alongside gaining real-time experience of how this is actually playing out on the frontline. The conference will feature contributions from NHS England, the Department of Health, the Health and Care Social Information Centre, NICE, NHS Clinical Commissioners, the Care Quality Commission, and Public Health England, and will host presentations from a range of senior leaders across healthcare. With 2016 the year of delivery, the sustainability and transformation agenda is changing the NHS landscape as we know it.



EVENT PREVIEW  with significant impact on practice. What then becomes clear is that the journey to full-scale implementation of the transformation programme is underway, but needs to be consolidated. The UK Health Show will do just that, showing the industry how to move from vision to delivery, counteract challenges on the way by sharing what has been encountered and understand the innovative solutions being developed. Each show is unique in its focus, but together allow for cross-sector collaboration and alignment on common goals. Exhibition and content theatres are shaped around the individual show zones, with the leading solutions on the market taking central stage for each of the five industry areas. This will allow primary and secondary care organisations to identify new business opportunities and income streams, alongside the opportunity to strike deals with budget holders present on the day. As healthcare becomes more integrated, organisations must move outside of their historical silos to tackle common issues together, whilst also retaining their specialist know-how in order to best inform one another. SHOW THEATRES AND STREAMS The UK Health Show realises the challenges outlined and responds to them through its various conference streams that cater for the needs of all senior healthcare stakeholders. Whether you are looking to exchange strategic and policy insights, benchmark your progress by learning through best practice case studies, obtain access to tools with guaranteed time and cost savings, or simply follow personal interests – the show allows you to develop the skills and knowledge that can be instantly applied to your daily role. Not only will the programme feature over 65 hours of cutting-edge content from more than 100 leading speakers, distinct types of theatre open up the chance to take whichever learning pathway is best suited to your personal and organisational requirements. The Conference Theatres bring together senior strategists, policy specialists and innovators setting the direction of travel and leading the way in the digital revolution of the NHS. Keynote addresses and panel discussions will focus on the big strategic initiatives and share the best practice examples that are allowing the NHS to deliver more integrated, effective and sustainable patient care. Leaders including the likes of Dr Phil Moore, Jim Mackey and Paul Rice will be present to share and explain the latest developments in NHS strategy and policy, with the opportunity to engage with them directly. Seminar Theatres will showcase a range of best practice trends and case studies, drilling down into key topic areas within the Commissioning in Healthcare and Healthcare Efficiency Through Technology arenas. These intimate, yet interactive sessions are your opportunity to hear from key stakeholders

The event will show the industry how to move from vision to delivery, counteract challenges on the way by sharing what has been encountered and understand the innovative solutions being developed and leading organisations in a close-knit environment, whilst gaining practical advice for application in the areas that matter most. The seminar programme is designed to allow you to understand and tackle key challenges facing the healthcare sector. From the future of commissioning with clinicians at its heart, to STP and test-bed implementation, whilst spanning the personalisation and patient-centred care agendas – these theatres will give you the chance to pose questions to the full range of stakeholders, in a place where your voice will be heard. Open Seminar Theatres will bring to the table a range of leading initiatives from across the healthcare sector and beyond. These highly interactive half-hour sessions take place within the buzz of the exhibition show floor and are your opportunity to hear from the very best case studies, from advancing a new mental health pathway in Dorset to implementing a sustainability and energy efficiency programme at Guy’s and St Thomas’ Foundation Trust. In discussing how experience can be transferred across to your organisation, this theatre programme is designed to take top-level policy and show how it can be applied to real-world situations, illuminating how opportunities can be capitalised on and challenges overcome. Transcending across all five shows, delegates can pick and choose the specific theatres which benefit their line of work and use these learning approaches to jointly work towards achieving £22 billion worth of efficiency savings for the NHS – now the underlying and most pertinent objective, despite growing concerns over how it can be reached. SURVEY RESULTS A widespread lack of confidence that the NHS can achieve its £22 billion efficiency target by 2020 is among a mix of concerns that have been expressed by hundreds of UK healthcare professionals in a survey of more than 400 senior individuals due to attend the event. The results were stark, revealing anxieties on how NHS services are commissioned and deep

UK Health Show


concerns that the NHS cannot meet national efficiency targets put in place to allow the health service to cope with escalating demand. But the survey also revealed an anticipation that the use of technology in delivering better NHS services is set to improve. In total, 85 per cent of those questioned in the survey said they were either ‘not very confident’ or ‘not at all confident’ that the health service is in a position to deliver the £22 billion savings now expected across England by 2020, despite the state of NHS finances being seen as the single-most-important challenge facing the health service. The key finding follows warnings from the House of Commons Public Accounts Committee, that there is ‘not yet a convincing plan in place for closing the £22 billion efficiency gap and avoiding a ‘black hole’ in the NHS finances’. Many of those surveyed agreed that the overall performance of the NHS was presently good, but the practicality of national plans designed to urgently save the NHS money into the future was questioned. For example, the survey revealed that only one in 10 individuals were at least ‘fairly confident’ that recommendations set out in Lord Carter’s recent review of NHS efficiency would be achieved. More than four in five respondents rated the current performance of the NHS positively. However, over half (56 per cent) of the same group are pessimistic about the future of the NHS. With a third of respondents expressing disagreement that the commissioning of NHS services is currently carried out efficiently and effectively. Over a quarter (27 per cent) expected commissioning to get worse. But 74 per cent believed the way technology is used in the NHS will improve over the next few years, an area that has become central to government and NHS England plans to integrate health and social care services, deliver better outcomes for patients and improve patient safety. Underlying issues highlighted in the survey will be debated in depth at the UK Health Show. L FURTHER INFORMATION


Advertisement Feature Written by Chris Neath, head of new product development, LapCabby



A HEALTHY RELATIONSHIP: STORING THE DIGITAL NHS IT is now an integral part of the healthcare sector. Those within medical organisations are looking to use technology to ease the burden on stretched staff and improve patient experience and service delivery The way in which this technology is implemented in hospitals, clinics and other organisations has wide-reaching and serious implications. Therefore, IT choice and integration needs to be carefully considered. Medical data is of the utmost importance to those in charge of it – making it a target for those on the wrong side of the law. The continuing trend of medically-focused ransomware attacks is testament to the fact that medical organisations would rather pay to regain data that has been taken from them than leave patients vulnerable without it. First-hand accounts from medical centres reveal there is no doubt that lives could be lost in critical care units such as operating theatres, accident and emergency units and ICU’s if data is not instantly accessible. Connected mobile devices already play a major role in the move towards Jeremy Hunt’s ambition of a ‘digital NHS’. Devices are commonplace as the transition from paper-based records continues, allowing clinicians and other staff access to full, connected data sets while on the move. In order for this vision to become a reality, the foundations need to be laid through the storage and charging solutions put in place. After all, if the devices are not secure, run out of charge, or are not regularly synced with up-to-the-minute data, then they are little more than an expensive paperweight. There are a number of key areas for medical organisations to consider when selecting the right option for storing, transporting and syncing mobile devices: SECURITY Security must be of paramount importance. Medical staff must ensure that devices are stored securely, in a solution that cannot be accessed by just anyone. Storing the devices in a safe location and password protecting the device itself will prevent unwanted parties gaining access and is a good starting point. PHYSICAL RISKS Although it sounds simple, the physical risk of technology is often overlooked and it would be ironic if this caused an issue in a medical setting! Hospitals, for example, often store



and charge hundreds of devices. Therefore, these need to be housed away from harm in order to protect both the equipment and people. As well as positioning devices to avoid cables becoming trip hazards, they must be constantly monitored to ensure that all elements are intact. For example, cables should be stored correctly and not be fraying. If they are, then they should be replaced immediately. TEMPERATURE CONTROL As mentioned above, often hundreds of devices need to be stored and charged in one location. In this environment, the high temperatures can pose a serious threat. Therefore, the chosen storage solution should have fire retardant materials housing all electrical components to mitigate the risk of overheating. Organisations should also ensure that their storage solutions have temperature monitoring capabilities and temperature limiters. This way, if devices do begin to overheat, chargers can be shut down until a safe temperature is restored. SAFETY FIRST Medical facilities must also ensure that they are introducing physically safe and fit-for-purpose storage to the environment. The default stamp of approval is generally considered to be the universal marker of the Declaration of Conformity (CE). However, medical organisations have to be more stringent in their safety regulation than the CE, as it does not take into account the environment or the fact devices will be stored and charged together. Therefore, those in healthcare should look instead to independent test houses such as TUV, Intertek and SGS, who take into account how devices will be stored and test them accordingly under much greater scrutiny than the CE. These certificates are not easy to obtain and are a true mark of safety. DIGITAL PROGRESSION The number and type of devices being used will also fluctuate as the move towards a truly paperless NHS becomes a reality. Therefore, organisations need to make sure that they have storage equipment that is

fit for purpose. Can it store the number of devices you need it to? Can it charge a selection of different devices? Does it have a weight limit? And can it scale as more and more devices are introduced? Staff need to ensure they have a solution that reflects their unique and ever changing needs. EDUCATION AND INCLUSION As important as the practical elements of device storage are, they have to be supplemented by a focus on education. Acceptable Usage Policies are a good way to define expectations, aims and rules in order to be certain everyone understands the associated risks and best practices. Coupled with this, medical organisations should invest time in educating everyone in how to use technology correctly, avoid the majority of risks, and gain the maximum benefit from technology. Alongside education comes awareness. After all, digitally-based healthcare is a big step and all stakeholders have to be on board. Communication is vital at the early stages, and if everyone involved feels comfortable in the aims, practices and eventual outcomes, then the implementation of technology will be a much smoother process.

Find out how LapCabby can support your medical device storage and deployment via the link below. L FURTHER INFORMATION



Advertisement Feature


Time is money and, as we speed into the future, we are placing more and more pressure onto efficiency to meet strict deadlines. As technology evolves to meet demand, so too does our customers’ expectations; fast response times are paramount and supporting our staff to achieve this is key Dictation is proven as an efficiency tool and has been utilised for decades. However, it is not as simple as just buying a voice recorder and transcription set. In order for you to achieve maximum benefits it is important to first address the areas of your organisation which need support – for example, this can be the secretaries or typists, customer documentation and records or consultants and directors. There are now complete solutions which can be tailored to meet your needs and Olympus is continuously working with customers to further improve the service and solution package. The possibilities are endless for consultants, with various products and models available for the many working preferences. For field based work one can simply utilise their smartphone and a dedicated App such as Olympus ODDS, this allows flexibility for quick dictations. A consultant can dictate their notes from their appointment as they walk to their car or office so they are up to date before even starting the next meeting. Information is fresh and accurate and time is maximised. Even desk based dictation provides dedicated recorders connected directly via USB, and now, with new developments such as Voisquare, you can find a complete solution. EFFICIENCY BENEFITS The story from the other side of the dictation workflow is less obvious, and there is often a misunderstanding that these product developments have a negative impact on typists and secretaries. In reality, companies like Olympus consider all members of a team to ensure the product offering benefits

everyone; efficiency benefits are only effective when all parties are involved in the process and whilst there are a plethora of recorders, there are also solutions to support typists. For those transcribing the audio files, clarity is important for accuracy of documents and preventing delays in reviewing and approving prior to dispatch. Also the speed of receiving files will support any deadlines allowing the typist to maximise their time, by supporting networks, emailing of files and software to manage all aspects, the entire workflow is faster. Transparency and access is also key whilst protecting critical data. This is all supported via solutions which can be tailored to your individual needs – for example, if one member of the transcription group is away or on holiday, all files can be delegated or accessed by their colleagues, even outsourced for additional support. Finally, there are the gadgets that are available. Concerns such as RSI and ergonomics from w orking in an office environment can be avoided by utilising foot pedal products and headsets. Since Olympus launched the world’s first micro-cassette recorder in 1969, we have consistently evolved technology to meet customer’s needs. Our current products are all digital and include features such as encryption to protect your data and even App based solutions. Olympus is currently offering Health Business readers the opportunity to test the DS-7000 and provide direct feedback, with one member also able to win the DS-7000 to keep. To enter simply email your details to, quoting Health Business in the subject line by 1 August 2016. SPEECH DOCUMENTATION SOLUTIONS Improve efficiency and save money with our speech-to-text solutions and professional dictation devices. Discover the complete portfolio for all business areas including medical, legal, financial and more. SPEECH-TO-TEXT SOLUTIONS VoiSquare is the first wireless voice over intranet solution designed for all clinical needs.

It is also the first highly secure, all‑in‑one digital medical assistant, which is especially designed for professional use. Voice over Intranet solutions – such as professional dictation and VoIP telephonie are run by an android operating system, which makes it adaptable to an unlimited amount of use cases. Turning speech into text has never been easier thanks to the slide switch which is enabling blind operation. Via HL7 interface, this wireless device can have a real time access to the individual Hospital Information System (HIS). TRANSCRIPTION Highly secure solutions for audio transcription and professional dictation workflow management. The high-end professional footswitch RS31H incorporates four buttons to easily control not only Olympus dictation management software (ODMS, DSS Player Standard, Sonority), but also your preferred third party software MOBILE DICTATION Dictation wherever and whenever for highest demands. With its customisable workflow, and the vast array of functions and accessories like USB, a docking station and speech processing software, the DS-7000 can be customised to form an essential part of any professional dictation workflow in any IT environment – comfortably from the palm of your hand. DESKTOP DICTATION USB microphone dictation with superior ergonomics and unrivalled reliability. All RecMic devices are equipped with a low‑noise directional microphone that has been meticulously engineered to deliver the highest possible audio quality for dictation and voice recognition. It reduces undesired background noises with high signal-to-noise ratio, and adopts a windscreen to reduce breath noise and shock absorbers to reduce friction noise during operation – thus guaranteeing ultra-clear dictation recordings. L FURTHER INFORMATION




James Kelly, chief executive of the British Security Industry Association, discusses the importance of secure data destruction for health sector organisations to comply with the Data Protection Act’s Seventh Principle Breaching the Data Protection Act carries severe consequences and can lead to heavy monetary fines or even prosecution. For organisations in the health sector, these consequences can be even further reaching, with a breach of the Data Protection Act posing a huge risk to organisational reputation and further pressure on already strained resources.

Unfortunately, you don’t have to look too far to find examples of where organisations operating in the health sector have fallen short of their obligations under the Data Protection Act. Indeed, a simple search on the Information Commissioner’s Office’s (ICO) website shows that the ICO has had to take action against 11 different healthcare organisations since January 2016 alone. These fines have been handed out for a variety of misconducts that have led to a breach of the Data Protection Act. Under the Data Protection Act 1998, everyone responsible for using data has to follow the data protection principles. These

include ensuring that data is used fairly and lawfully; for limited, specifically stated purposes; used in a way that is adequate, relevant and not excessive; accurate; kept for no longer than is absolutely necessary; handled according to people’s data protection rights; kept safe and secure; and is not transferred outside the European Economic Area without adequate protection. Failing to abide by these principles can put a person’s information at risk which can lead to identity theft and fraudulent activity. Data breaches for healthcare organisations also pose an added risk due to the sensitive nature of the information they hold relating to a patient’s health or treatments. Therefore, it is vitally important that organisations of all sizes – that use data – understand their obligations under the Data Protection Act.

Written by James Kelly, chief executive, British Security Industry Association

Healthy data protection habits

Document Management


THE SEVENTH PRINCIPLE The seventh principle of the Data Protection Act stipulates that an organisation must take appropriate measures against accidental loss, destruction or damage to personal data and against unlawful processing of the data. To fully comply with the Data Protection Act, a handler must have a written contract with a company capable of handling confidential waste, which can provide a guarantee that all aspects of collection and destruction are carried out in a secure and compliant manner. To ensure this, suppliers should comply with European Standard BS EN 15713:2009 for security shredding and also BS 7858 for staff vetting. One such example, where a healthcare organisation breached the Data Protection Act for not taking the appropriate level of care when disposing of data, occurred in 2013. The now disbanded NHS Surrey moved away from its approved information destruction supplier and handed over old computers to a new service provider, without ensuring that the thousands of patient records they contained had been deleted. Subsequently, the computers were sold via an online auction site, causing the ICO to levy a hefty £200,000 fine against the NHS trust in question. At the time, the British Security Industry Association (BSIA) conducted a survey of E

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DATA PROTECTION  healthcare professionals, which identified a number of issues and trends associated with the secure destruction of information, whether held on paper or data processing related media. Interestingly, 27 per cent of those completing the survey were aware of a significant data loss incident in their organisation. Of these, two‑thirds said that the data breach was a direct result of incorrect disposal whilst, worryingly, another third attributed the loss to the action of criminals, such as theft. THE IMPORTANCE OF EN 15713 BS EN 15713:2009 should be a crucial requirement for organisations of all types and sizes, as it provides recommendations for the management and control of collection, transportation and destruction of confidential material and recycling to ensure such material is disposed of securely and safely. The BSIA’s Information Destruction section was a key player in the development of EN 15713 and helped to provide specifications on how the processes should be handled within the secure data destruction industry. Adam Chandler, former chairman of the BSIA’s Information Destruction section, believes that it is important for end-users in the public sector to have an understanding of the various elements of EN 15713 in order to make informed procurement decisions and ensure that they meet the requirements of the seventh principle of the Data Protection Act. Chandler explains: “Essentially, EN 15713 ensures that companies providing data destruction services are doing so in a secure manner which provides maximum security for end-users’ information. The standard covers a number of key aspects of a data destruction service, from premises to personnel and a company providing data destruction services will need to meet these requirements to comply with the standard. “The standard requires that premises used for confidential data destruction must have an administration office where the necessary records and documentation is kept for conducting business, which should be isolated from other business or activities on the same site. An intruder alarm installed to EN 50131-1 and monitored by an Alarm Receiving Centre should be present and the premises should also have a CCTV system with recording facilities monitoring the unloading, storage and processing areas. CCTV images should be retained for a minimum of 31 days unless otherwise agreed with the client. “A written contract covering all transactions should exist between the client and the supplier and any sub-contracted work should only be allocated to other companies compliant with EN 15713. The client should be made aware if any sub-contractors are used. All staff should be screened in accordance with BS 7858 – Security screening of individuals employed in a security environment Code of Practice – and should sign a deed

of confidentiality prior to employment. “Confidential material should remain protected from unauthorised access from the point of collection to complete destruction and should only be collected by uniformed and suitably trained staff carrying photographic identification. The destruction of confidential material should take place within one working day from arrival at the destruction centre, where shredding is taking place away from a customers’ site. “There are also a number of requirements relating to the use of vehicles for the

collection and transportation of confidential material, or the destruction of confidential material on a customer’s site. These include the ability to communicate via radio or telephone to the home base, the ability to be closed and locked or sealed during transit and the ability to be immobilised or alarmed when left unattended.”

Document Management


PROCUREMENT AND GUIDANCE The BSIA’s Information Destruction section has produced a comprehensive, step-by-step guide to help end-users to navigate and E

For organisations in the health sector, consequences can be far reaching, with a breach of the Data Protection Act posing a huge risk to organisational reputation and further pressure on already strained resources



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SECURE DIGITAL SOLUTIONS: VITAL FOR FINANCIAL HEALTH OF NHS Secure data solutions are available that can wean the NHS off its reliance on paper documents and help it to move forward with a digital infrastructure

Safeguarding personal medical information is critical for the NHS, particularly in light of the recent recommendations from MPs that organisations face fines of up to £20 million if they lose customers’ data – with healthcare the biggest culprit for data breaches in the public sector according to the recent Culture, Media and Sport Committee report. The Select Committee’s inquiry, triggered by a series of data breaches at communications company Talk Talk, found that 90 per cent of large organisations had suffered a security breach, and 25 per cent of companies experience a cyber attack every month. However, not all threats to data protection are from external factors – 40 per cent are caused by employees, contractors and third party suppliers. CYBER SECURITY Robust cyber security must go hand in hand with the government’s drive for a paperless NHS by 2020 to help maximise patient care by harnessing new technology. Digitisation of medical records is designed to make the service leaner and more efficient so that it can keep up with the increasing demands being placed on it. Data management companies in the UK, such as PHS Data Solutions, offer secure services that enable organisations like the NHS to capture, process, manage, retrieve, share and destroy when necessary, critical documentsand information digitally across all platforms. PUT SYSTEMS IN PLACE A division of the award-winning PHS Group, PHS Data Solutions has eight specialist document storage facilities across the UK designed to help businesses and organisations



protect their records with the latest fire and security protection. It supplies a secure vault storage system in all sites for high value documents or magnetic media. You know your organisation’s documents and data are in safe hands if systems are in place which meet with ISO 9001, ISO 14001 and ISO 27001standards, while PHS’s data destruction process is accredited to BS EN 15713, providing peace of mind that confidential data is securely destroyed when required. DIGITAL MATURITY The NHS Digital Maturity Index for the 239 trusts, which measures the extent to which healthcare services in England are supported by the effective use of digital technology, paints a varied picture of how far the hospitals are with the digital transformation agenda. Some trusts have implemented digital technology, including Electronic Document Management Systems, and are already seeing the benefits which will help lead to the efficiency savings that the NHS is looking for. On the other hand many trusts are still lagging behind and need to focus on how they are going to achieve the government’s ambition of a paper-free NHS at the point of care. This mixed level of progress could be a headache for those in charge of boosting digital technology adoption across England’s hospitals. A ‘paperless’ NHS will require total data solutions for the billion pieces of critical information from the point of creation through to when it’s destroyed at the end of its life cycle. It is imperative toprotect patient confidentiality, employee and supplier data with robust controls, by using contractors who are suitably experienced and accredited. P HS Data Solutions is currently working with NHS trusts as well as private healthcare

organisations to help enable a step change to full digitisation of the service. As one of the world’s largest organisations, the NHS faces a huge challenge to eliminate paper usage in hospitals, clinics, surgeries and amongst administrators. Delaying the transformation to digital may be due to a variety of factors – the many systems that are required to integrate in order to digitise patient records, a poor change culture or the fact that too many departments are involved in the process, leading to decisions not being made. Karen James, PHS Data Solutions’ managing director for scanning services, said: “There could be a number of reasons why NHS trusts are behind in their digitisation programme, such as management not having experience in this area. We have the resources and digital expertise to safeguard against data breaches and help the NHS meet the government’s ‘paperless’ goal.” OUTSOURCING Outsourcing patient documents and data to accredited contractors offer an additional layer of cyber security against the loss of vital information or data breaches of personnel data, whether intentional or accidental such as disasters like fire or flooding. It can also free up valuable ward space and reduce time spent on administration within hospitals. Jesse Norman MP, chairman of the Select Committee, said: “Companies must have robust strategies and processes in place, backed by adequate resources and clear lines of accountability, to stay one step ahead in a sophisticated and rapidly evolving environment. Failure to protect consumers must draw sanctions serious enough to act as a real incentive and deterrent.” Data breaches could lead to financial penalties that cash-strapped NHS trusts can ill afford. Secure data solutions are available that can wean the NHS off its reliance on paper documents and help it to move forward with a digital infrastructure that, like the health service itself, can be the envy of the world. L FURTHER INFORMATION Tel: 0800 376 4422

Document Managaement

DATA PROTECTION  understand EN 15713, which provides a full list of the requirements which information destruction companies should meet to be compliant with the standard. This guide also offers some additional recommendations on other areas of best practice which aren’t requirements under EN 15713, to help end-users make informed decisions when it comes to procuring or renewing information destruction services. Using the information provided in this guide, along with the range of other publications published by the BSIA’s Information Destruction service – which includes a guide to the Data Protection Act for end-users and a guide to information destruction in the public sector – can help businesses to understand their obligations to good data management. Organisations can also find a range of information to help them comply with the Data Protection Act on the Information Commissioner’s website, including the recently launched SME Self-Assessment Tool. Launched in early February, the tool helps small and medium sized organisations to assess their compliance with the Data Protection Act and was welcomed by the BSIA’s Information Destruction section. Chandler commented: “The self-assessment tool provides SMEs with a fantastic opportunity to ensure that they comply with the Data Protection Act. Compliance will help to reduce reputational risk and ensure that

Data breaches for healthcare organisations also pose an added risk due to the sensitive nature of the information they hold relating to a patient’s health or treatments directors are not faced with fines or prison sentences for non-compliance. Users can take part in a comprehensive assessment covering all areas of the Act, or alternatively, break the assessment down into separate checklists tailored to their particular needs and risks. “If you have concerns about your current confidential information destruction procedures, a good place to start is with some of the freely available information published by the BSIA’s Information Destruction section or to consult one of our members who would be happy to offer you guidance.” The BSIA’s Information Destruction section consists of companies that securely destroy a

range of confidential information, including paper, DVDs, computer hard-drives and other items that could potentially cause problems if they fell into the wrong hands, such as branded products and uniforms. L

All members of the BSIA’s Information Destruction section are compliant with EN 15713 as part of their ISO 9001:2008 inspection and are committed to promoting best practice within the industry. FURTHER INFORMATION information-destruction

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Bringing the future of healthcare to life Taking place on 7-8 September at Manchester Central, the Health and Care Innovation Expo will make delegates think forward and experience transformation in healthcare Innovation is happening in every part of the health and social care sector, but translating big ideas and the right new techniques into an established organisation or team can be a tricky business. That’s why NHS England hosts the annual Health and Care Innovation Expo every September. Expo focuses on the innovations that are available now, and aims to help both commissioners and providers understand how to choose the new pathways, practices and equipment that fit their unique services and communities. Over two days at Manchester Central on 7-8 September, the public, private and voluntary organisations that commission, deliver and support health and care services in England will join together for what has become the NHS’s biggest event of the year to share expertise, and hear national leaders’ plans and priorities for the coming year. NHS chief executive Simon Stevens and Secretary of State for Health Jeremy Hunt will each make keynote addresses, and the wider programme of speakers and events will explore the biggest health and care issues facing our organisations as we continue to implement the NHS Five Year Forward View. The event

comprises two main speaker stages, four feature zones, and over 100 workshops, and most public and voluntary sector staff are eligible for free-of-charge tickets. Speaker schedule highlights this year include comedian and campaigner Ruby Wax leading a discussion on mental health, sportsman, journalist and author Matthew Syed discussing his book Black Box Thinking, and National Data Guardian Dame Fiona Caldicott giving the latest advice and guidance on the ways in which patient data can be used ethically and effectively. DIGITAL TECHNOLOGY AND NEW MODELS OF CARE The speaker line-up also includes digital health expert Prof Bob Wachter MD, who will unveil the results and recommendations of his review into IT usage across the NHS. Prof Wachter’s recommendations are expected to have significant impact for the NHS, and at Expo 2016 you’ll hear instant reaction from the most senior healthcare leaders. Professor Wachter, who is interim chair of the Department of Medicine at the University of California, said: “It’s essential that information technology across the NHS works well and can perform the tasks needed to deliver high-quality, safe and efficient care.” Continued digital development within

Expo 2 will pr 016 detaile ovide and up d insights progre dates on t he ss m the NHade across huge r S in a an projec ge of ts

the NHS is a key element of the wider modernisation ongoing across England. Expo 2016 will provide detailed insights and updates on the progress made across the NHS in a huge range of projects at local, regional and national level, alongside demonstrations of the latest new devices and software, alongside support and advice on specific digital development needs in the Digital Zone – the first of Expo’s four feature exhibition zones. At last year’s Expo, the vanguard areas that are pioneering new care models and systems that can be replicated across other communities were announced, and this time around they will be demonstrating just how much they have achieved over the last 12 months. Samantha Jones, director for New Care Models at NHS England, will lead a main-stage panel discussion about the vanguard sites’ work and take part in talks and activities on the next exhibition zone, which is dedicated to them. She said: “The ambition of the vanguards is absolutely inspirational, and I’m incredibly proud of all that has been achieved towards radically redesigned care models that are fit for the future of healthcare while providing the broad, flexible range of choices that are needed to cater for each local area’s different needs.” Local teams developing the vanguard new care models will lead a series of workshops in a ‘pop-up university’, where they will share insights and information to help others replicate their successes.

Innovation Expo


EXPERT-LED WORKSHOPS The pop-up university is a unique feature of Health and Care Innovation Expo and it will host a wide range of workshops that will provide a chance for delegates to engage with senior professional leaders in the NHS, and its partner organisations, while also gaining first-hand insights from front-line teams pioneering innovative work. Workshops will be led by Jonathan Benger, national clinical director for Acute Care Professor, and Keith Willett, national director for Acute Care Professor, on new standards for integration in urgent and emergency care. Dr Robert Varnam, NHS England’s head of General Practice Development, will lead talks on technology and working practices to revolutionise primary care, and Candace Imison, the Nuffield Trust’s director of policy, will lead a workshop on transformational change through staff engagement. E



EVENT PREVIEW  Jane Dwelly, head of Health and Care Innovation at NHS England, said: “The pop-up university is very much unique to Expo, and really does offer something for everyone. Whatever your area of interest or expertise, you can find visit the pop-up university to discover new ways of working that you can implement at your own organisation. “There will be insights from the most senior clinicians in England about the latest developments in care and treatment, and from the people pioneering new ways of working in the vanguard sites. Hospital teams, voluntary groups and academics from all over England will also demonstrate and explain how their work is making a difference in their own local areas. Make sure you sign up quickly to the workshops that matter most to you – space is limited and the most popular workshops always fill up quickly.” REVOLUTIONISING LOCAL COMMISSIONING NHS Right Care is a commissioning model that will be rolled out to all 211 CCGs in England over the next few months. It is all about improving population health and outcomes, increasing value and helping deliver a sustainable NHS. The third of Expo’s four major feature zones will focus on NHS Right Care, with detailed displays exploring all aspects of the model and the opportunity to meet with a range of different CCG leaders currently implementing the model. Scheduled presentations and discussions within the NHS Right Care zone throughout the two days will feature national and international leaders including the Dartmouth Institute for Health Policy’s managing director for Global Healthcare Delivery Dr Al Mulley, and global healthcare systems expert Professor Sir Muir Gray. Pop-up workshops from the NHS Right Care delivery team will help attendees understand the intricacies of medicines optimisation for both individual patients and for communities as a whole, and the improvements in treatment pathways this work can lead to. It will also explore how clinicians can work with patients to match their perceptions to the realities of treatment options available to them during shared decision-making. Professor Matthew Cripps, national director for NHS Right Care, said: “Expo gives us a great opportunity to engage with delegates from every part of the NHS. It’s a very effective way for them to hook into this work, hear from experts in the field, and talk to practitioners who are already putting the RightCare approach into practice. I’m looking forward to meeting commissioners, providers, public health professionals, local authorities and primary care people – and of course patients – to explain why RightCare is critical in addressing some of the challenges faced by the NHS today, and how we can work together to land the approach successfully at a local level.”

Innovation Expo


Local teams developing the vanguard new care models will lead a series of workshops in a ‘pop-up university’, where they will share insights and information to help others replicate their successes Personalised medicine – the future today Expo 2016’s fourth and final exhibition feature zone will focus on the exciting growth area of personalised medicine. There will be updates and information on the groundbreaking 100,000 Genomes Project that is already changing families’ lives by giving accurate diagnoses for rare genetic conditions for the first time, along with wider discussion and demonstration of the next-generation targeted medicines and tests becoming available to the NHS. Professor Sir Bruce Keogh, national medical director at NHS England, said: “The shift to personalised medicine is already underway – our role as a system leader and commissioning organisation is to consider how this transformation can be accelerated. To ensure we capitalise on the current NHS transformation and the investment made by both NHS England and the NHS, there is a need to locate the genomes initiative within a broader and more expansive strategy for personalised medicine.” HOW TO ATTEND EXPO 2016 Look out too for a huge range of professionally-focused satellite events

in separate rooms around Manchester Central, providing excellent networking as well as further opportunities to learn directly from the most senior clinical and commissioning leaders. Health and Care Innovation Expo has grown in recent years and more than 5,500 people are expected to register this year. It presents a unique opportunity to engage with all sectors involved in health and social care provision in England. Last year, more than 90 per cent of delegates shared their Expo learning with colleagues, and more than 50 per cent made a change in their own organisation as a result of what they learned. Limited numbers of complimentary tickets are available to those working in the public sector. To claim your free-of-charge Expo 2016 place, check your complimentary ticket code with your manager and enter it into our online form to register. You can also e-mail to check whether you are eligible. L FURTHER INFORMATION



Leisure Industry Week



Benefiting the health and leisure industry Leisure Industry Week focuses on boosting physical activity levels and delivering real commercial benefits through attracting new customers and driving down operational costs Leisure Industry Week (LIW) is the UK’s biggest health and leisure trade show and the largest gathering of leisure decision makers, influencers and buyers in Britain, bringing together thousands of like-minded professionals to shape the future and growth of the sector. Fresh off the successful first edition, BodyPower is pleased to introduce the new look LIW, featuring six distinct educational streams, each with a targeted marketing campaign to attract new footfall and reach visitors who had never considered LIW in the past. Featuring seminars on employee engagement, business strategy, social media marketing, and point of use sales, delegates will discover education streams on Health, Fitness, Play, Wet Leisure & Spa, Sport and Facilities Management with a dedicated timetable of industry leading speakers including a host of keynote names mixing celebrity, sport and business. Steve Orton, UK managing director, said: “Our goal is to put on a world class event that provides relevant and worthwhile experience for all roles and positions within the industry. We don’t want people to come for just one seminar, we want visitors to come to LIW and benefit from an entire day of world class education, networking and to see the latest equipment and services on the market. I firmly believe that the new format of LIW will allow us to realise this vision and enable us to put on a comprehensive program that anyone operating in the sector will benefit from immensely.” HEALTH Supported by SPORTA, the national association of leisure and cultural trusts, the Health education stream will focus on the impact of physical activity on the nation’s health and how the leisure industry has a huge role to play in driving change. With the aim of tackling the inactivity epidemic and creating a health conscious mindset throughout the population, the Health education stream will cover a wide range of major topical issues which impact on people’s lives, day in day out. Seminars focus on everything from children through



to the ever expanding ageing population, from the impact of physical activity on mental health and how healthy lifestyles can be promoted through positive stimuli. The seminar programme will also highlight the benefits of integrating physical activity into everyday operations and how the industry can benefit commercially from an increased emphasis on health practices such as physiotherapy, chiropractorcy and rehabilitation. The link between leisure, physical activity, health, medicine and fitness should be closer than ever, and the Health education stream will cover topical issues that ensure a stronger bond between professionals.

of combined experience, the Fitness Business School will enable you to change your career for the better, through high quality advice, round tables and cutting edge information. There are numerous avenues for a fitness professional to advance in, and the Fitness Business School will ensure you have a rounded view of the industry, helping you understand how to drive your business forward, how you can gain more clients on a commercial gym floor through to understanding how social media and digital media have changed a fitness professional’s life. With over £5,000 worth of knowledge and advice shared, the Fitness Business School is an unmissable event for any aspiring fitness professional who wants to make a difference in the fitness industry.

lth The Heaion educat cover will stream range of a wide ical issues op major t impact on which lives, day ’s people day out in,

FITNESS A world class education programme offers fitness professionals the opportunity to advance their knowledge and education over two action packed days. Listen and learn from the industry’s finest educators, coaches and professionals enabling any level of fitness professional to come away from LIW feeling inspired and motivated. The fitness stream consists of three focal areas: The Fitness Business School, offering business acumen for fitness professionals; Practical Coaching, with theoretical and practical application of topical trends and speaking points designed to improve client’s results; and the Gym Operators conference to support the effective running of a fitness centre. FITNESS BUSINESS SCHOOL The Fitness Business School offers fitness professionals the ability to learn from the fitness industry’s most prominent coaches and educators that have developed their own businesses successfully. With over 200 years

TRAINING AND NUTRITION Two days of world class education will ensure fitness professionals come away having taken on board practical and evidence based information that can be applied on a dailybasis in a facility or online with clients. Designed to provide trainers, coaches and industry professionals with workshops, this will provide hands on opportunities and lectures to increase knowledge. With a focus on the latest theoretical developments in the fields of training and nutrition, the theatre will cover a range of topics including training styles for hypertrophy, female training considerations, HIIT training, macronutrient variations based on gender, coaching contest meal preparation and encouraging lifestyle changes for weight loss. INDEPENDENT OPERATORS CONFERENCE Created specifically to support the owners of independent gyms, the Independent Operators Conference will deliver a host of seminars to improve business performance at low cost. Visitors will discover seminars covering free marketing options such as Facebook and Linkedin, the importance of human

interaction in the retention process, optimal staffing to meet core business requirements and the creating a customer culture so your members will never want to leave. PLAY Play is the primary activity for many children and can provide the perfect platform to get people active as an effective alternative to the gym. The Play education stream will tackle the issue of inactivity through the medium of play and will offer practical insight into how play businesses can boost their commercial performance by creating a wider appeal for families. Providing seminars on differentiation, branding, market diversification, safeguarding and training needs, the Play education stream will explain the importance of play to all ages and backgrounds, creating facilities for active and game based play and provide operators with the tools to attract new audiences and boost profitability. The Play education stream is ideally tailored for: hotels; campsites; schools; councils; visitor attractions; country parks; adventure parks; activity centres; and academies. SPORTS The Sports education stream will focus on two main themes – encouraging sporting participation and developing sports facilities.

Delegates will discover workshops with a host of leading brands providing practical tools and tips for raising awareness of your sport and creating interest from new groups and demographics. The Sports education stream will also tackle the often daunting process of facilities development, offering practical advice on planning, material selection and multi-use considerations. This stream is ideal for anyone working in the sports industry or looking to add sports to their business. The seminar programme is designed specifically for: national governing bodies; schools; universities; sports clubs; sports facilities; local councils; gym chains; golf clubs; functional training specialists; strength and conditioning coaches; groundskeepers; and sports coaches. FACILITIES MANAGEMENT Delivered in partnership with Facilities Management Forum and Sport & Leisure Facilities Forum, the education programme will be devoted to all aspects of the design and layout of a leisure facility. Delegates can leave this theatre armed with the knowledge to effectively set up their own facilities to maximise sales and customer experience. Designed to support you in improving customer experience and operational efficiency, the seminar programme will feature

topics and discussion on entry systems, energy efficiency, booking software, lighting, flooring, layout, planning and much more. The Facilities Management education stream is ideal for anyone responsible for the day design and maintenance of a facility. The seminar programme is designed for: facilities managers; procurement teams; architects; interior designers; specifiers; pool maintenance professionals; IT professionals; cleaners; and operations managers.

Leisure Industry Week


SPA & WET LEISURE This stream will focus on increasing swimming participation and improving operational efficiency to increase revenue and drive down costs. In partnership with STA and SPATA, the Spa and Wet Leisure education stream will deliver seminars on effective programming for swimming classes, water treatment, health and safety and filtration, to provide delegates with the tools to save on costs and boost revenue. The Spa and Wet Leisure education stream is targeted at: swimming coaches; water parks; spas; pool designers; swimming pools; gym chains; pool maintenance professionals; engineers; leisure trusts; and councils. L FURTHER INFORMATION

Freedom Leisure lists the reasons why you should trust Physical Company Not-for-profit leisure trust Freedom Leisure enjoys a very positive and proactive relationship with Physical Company which it trusts to deliver on both price and service. As one of Freedom Leisure’s regular suppliers, Physical Company can find itself providing a few pieces of supplementary gym kit right up to helping equip newly refurbished fitness suites. “I find Physical Company very helpful and reliable,” says Richard Merrick, group fitness and wellbeing manager at Freedom Leisure. “I can trust them to have stock and their prices are very competitive. I can rely on them to meet our deadlines and, as a smaller business, I enjoy the fact they retain that personal touch which

makes all the difference to a strong working relationship.” Physical Company offers ‘complete fitness solutions’ supplying some of the best functional kit available in the UK. Its clients range from smaller independent gyms, to larger leisure centres and private gym chains. The business is dynamic and fleet-of-foot, able to react quickly to requests from customers, pay personal attention to an individual site’s needs and deliver on time and on budget. FURTHER INFORMATION Tel: 01494 769 222



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Healthcare Estates


The theme for the annual IHEEM conference, which takes place on the 4-5 October at Healthcare Estates in Manchester, is ‘transforming the estate through collaboration’. Health Business previews the Healthcare Estates show The NHS estate in England has a floor area that would cover the City of London ten times over. The land owned totals 6.9 million hectares, while total floor space of trusts and primary care buildings is around 28.4 million square metres (excluding primary care premises). The NHS operates over 1,200 hospitals plus nearly 3,000 other treatment facilities, many of which operate 24/7 every day of the year. There has been little real attention given to how this huge resource could help to improve efficiency, move more care out of hospitals and exploit new technologies. Models of care are still designed around buildings, but could re-thinking the way that the NHS uses its estate catalyse change? LORD CARTER This year’s Healthcare Estates takes place a year after the Carter review, published in June. Following the review a ‘model hospital’ has been developed which advises NHS trusts on the most efficient allocation of resources and allows hospitals to measure performance against other trusts. The model hospital examples should

save hospitals £5 billion a year by 2020/21 and put an end to the variations the review uncovered across the NHS. As well as reviewing hospitals across England, Lord Carter’s review looked at healthcare systems abroad, including in the US, Germany, Australia, Italy and France where hospitals have a greater focus on efficiency because they have established the clear link it has with patient care. Lord Carter says: “My experience of the NHS and hospitals internationally is that high quality patient care and sound financial management go hand in hand. To improve the quality of care hospitals must grasp resources more effectively, especially staff, which account for more than 60 pence of every pound hospitals spend. “Giving hospitals the tools and support to better manage resources will make it

easier for boards to follow the example of the best trusts and mean every patient can receive the same world class care and taxpayers will also receive a fairer return on their significant investment in the NHS.” He added: “We should celebrate that in England we have some of the best hospitals in the world both in terms of quality, innovation and operational efficiency. The great challenge we face is to lift hospital efficiency to a consistently high standard in every area of every NHS hospital and, where we already perform well, innovate to improve further.” ESTATES MANAGEMENT The IHEEM conference which takes place alongside Healthcare Estates exhibition in Manchester will include case studies from the ‘cohort of 22’ NHS hospitals that worked with the review to develop an ATI (Adjusted Treatment Index). This gives the NHS a consistent approach to measuring E

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“The great challenge we face is to lift hospital efficiency to a consistently high standard in every area of every NHS hospital and, where we already perform well, innovate to improve further”

 efficiency so NHS hospitals can compare themselves with their peers and help identify opportunities for productivity improvement. The big picture is that the cohort of 22 spends £1 billion annually on estates and facilities. With such a diverse estate spread across cities and rural locations, the cost drivers vary widely and include size, age, condition, space utilisation, energy efficiencies, as well as availability of and cost of labour. Early indications from the 22 hospitals show potential annal savings of £150 million in areas such as cleaning, energy, building and engineering, laundry, waste, water and sewage.

Healthcare Estates


THE THREE STREAMS OF THE IHEEM CONFERENCE Three streams devoted to ‘Strategy, Engineering & Facilities Management, Design and Construction’ allow delegates to make the most of their attendance with the ability to attend different streams and take part in all the main presentations. Speakers on day one in the Strategy Stream include Conor Ellis, head of health sector at Citrica, presenting on ‘Optimising Clinical Service and Estates Plans to Meet Future Demands’. This presentation provides an overview of the NHS estate and some of the challenges it faces. Showing the current state of the NHS estate in entirety, the funding aspects and comparisons to European countries in terms of usage, facilities management, land usage, IT and sustainability. The presentation includes a case study from work being done as part of STRIDE with Burton Hospitals Trust. The Strategy stream also sees a presentation on ‘Transforming the Way Integrated Technologies Are Delivered’ by Chris Needham, healthcare solutions lead at Schneider Electric. The marketplace is a buzz with the latest and greatest gadgets and applications each promising to solve a specific, niche problem. In the complex healthcare environment niche solutions are great but the wider challenge is how to integrate these technologies to provide a safe, efficient, and sustainable patient experience across the continuum of care. The presentation looks at the latest technologies available in healthcare estates and facilities and how they can help trusts do more with less through integration and transforming the way they are delivered. ESTATES & FACILITIES STREAM In the Estates & Facilities stream one of the sessions is focussed on ‘Medical Device Management’ by Caroline Finlay, joint managing director of MTS Health Ltd. Equipment, finance, procurement, and management requirements are often driven by competent but disconnected processes. ‘Medical Device Management’ extends way beyond the technical aspect of equipment. As equipment becomes more reliable and software-driven, the E



Healthcare Estates


Overcladding future-proofs the NHS estate d+b facades is a leading design build overcladding specialist focused exclusively on external refurbishment of occupied, ageing buildings. Through highquality overcladding, healthcare buildings from the 1960’s and 70’s are transformed delivering the appearance and performance of a comparable new hospital building for a fraction of the cost. Visit Stand H5 to see the recently completed transformation of Bristol Royal Infirmary, one of the most challenging overcladding projects undertaken within the NHS. The new building envelope comprising aluminium rainscreen and high-performance windows is designed to surpass current building standards and protect the original building’s fabric, future-proofing and extending the life of building for generations to come, exemplifying sustainable regeneration. The internal environment is also transformed, reducing solargain and improving natural ventilation

Creating a Comfortable Environment Designed for the demands of the care and mental health sectors, ECONOMIX offers outstanding performance, the latest trend colours and excellent environmental credentials.

0333 014 3132



and patient comfort levels. Bristol Royal Infirmary is now a landmark building with a striking energy-efficient façade which reflects its reputation for excellence in clinical services. d+b facades provides a turnkey solution taking single point responsibility from design through to completion delivering projects on time, on budget and with minimal disruption to patients, clinical services and other building users. The Business’ proprietary highquality insulated aluminium rainscreen system has a design life in excess of 60 years and proven performance of more than 25 years. FURTHER INFORMATION

Specialist manufacturers of healthcare and commercial carpets Supportive and welcoming environments can have a positive effect on those that live in and visit care homes and hospitals. As a leading manufacturer and supplier of healthcare carpets danfloor offers practical and stylish flooring solutions for all care settings. Creating a domestic and therapeutic surrounding within such environments is essential and carpet plays a key role in this. Carpet not only helps to reduce stress related behaviours but also helps to reduce injuries and falls and should therefore be considered as part of any design specification within a care setting. However, carpets must be engineered so that they are able to perform in these demanding environments. danfloor use the highest quality yarns which are built to last and assist with appearance retention and

cleaning and maintenance regimes. Furthermore, many of the company’s carpets include maedical i-link an antimicrobial yarn treatment with a 4-log reduction against harmful bacteria, including MRSA, and an impervious membrane which stops liquid spills reaching and contaminating the sub floor. danfloor’s Equinox and ECONOMIX collections offer a variety of colours and designs to suit any interior scheme and have outstanding performance characteristics, full BRE certification and guarantees making them ideal for the healthcare market. FURTHER INFORMATION Tel: 0333 014 3132

Healthcare Estates


There has been little real attention given to how this huge resource [the NHS estate] could help to improve efficiency, move more care out of hospitals and exploit new technologies  issue of who actually maintains and repairs equipment is becoming far less important than the equipment management function and achieving best value and assurance. Demands of regulatory requirements, CQC, requirements for better technology, integrated training needs, and the Lord Carter review’s focus on reducing budgets result in the necessity to think more strategically. Taking a strategic quality-driven approach to managing medical devices should be high on the executive agenda. NHS trusts are only just beginning to focus on a more commercial view of managing assets, including medical equipment, realising there are savings to be made in managing their assets more efficiently. It goes without saying that the equipment management structure must have the right set of tools to manage the performance of equipment assets, be patient-focused, and operate in an efficient manner, to drive out service and cost improvements at the same time as meeting all governance and patient safety standards.

MTS will also profile a trust to demonstrate where achievements have been made. WATER & INFECTION CONTROL THEATRE IHEEM, The Water Management Society and Legionella Control Association have pooled their resources to bring together a free programme of accomplished speakers within the dedicated Water & Infection Control Zone of the Exhibition Hall. Each bite-size presentation of 20-30 minutes will cover new innovative ideas and potential solutions to the ever present challenges of water hygiene and engineering. Speakers have been chosen with insight into their specialist topics, such as rapid microbiology, facilities management, existing and emerging water pathogens and the challenges of infection control and engineering. This is a unique opportunity to engage with peers in a less formal setting. The introduction will be led by Colin Shekleton, chairman of the Water Management Society, while the following

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Conor Ellis, head of health sector, Citrica

seminars will include: Opportunistic Waterborne Pathogens in Healthcare Showers; Making Light Work of Hard Water; Compliance and Governance in Water Safety; Preventing Brand New Problems; and How Safe is your Hospital Water?. ENERGY & EFFICIENCY THEATRE Focusing on the ongoing work carried out in the NHS to reduce the carbon footprint of the largest single estate in the UK, this full programme works alongside the Carbon and Energy Fund and BRE. A full two day programme, delivered with partnering associations and exhibitors, will witness: Shamir Ghumra, BRE’s head of Responsible Sourcing, discussing ‘Certifying and assessing sustainable products and E

TEAL showcases fast delivery of hand wash units at Healthcare Estates In support of infection control departments and health estates managers, a unique, fast response service – the TEAL Task Force (TTF) – has been created to help tackle medical and water emergencies immediately with a ‘next day’ delivery of hired, portable, hand wash units. TEAL Patents – the UK’s leading manufacturer of portable hand wash units requiring no access to mains water or drainage – will be showcasing the TTF which launched in September 2014 at Healthcare Estates. The TTF is ideal when units need to be hired at short notice because of an infection outbreak or plumbing issues. The keystone of the TTF is the Stop n’WashTM unit. Designed to educate and encourage the correct hand wash procedure, the Stop n’WashTM unit – created in partnership with infection control departments – includes a

synchronised video display taking users, step-by-step through the seven handwashing actions laid down by NHS guidelines. Suitable for staff, patients and visitors, the hired units are delivered and installed by TTF qualified personnel who ensure it is ready to use. TEAL also trains relevant members of the NHS team, such as hospital estates departments, on how to use and maintain their hired units. TEAL’s safe and fast solution helps contain the spread of infection thereby protecting patients and staff. For further information, please visit stand A17 at Healthcare Estates. FURTHER INFORMATION



Workspace concepts tailored to your needs Complete solutions from a single source Selecting the right partner is crucial when it comes to the smooth implementation of sensitive areas of a building, such as operating rooms, intensive care units or central sterilization departments. Getinge Hospital Solutions understands these needs and meets the technical and economic requirements and expectations of the hospital.

Maquet Ltd. • 14-15 Burford Way, Boldon Business Park • Sunderland, Tyne & Wear, NE35 9PZ • Phone: +44 191 519 6200 •


Healthcare Estates features over 200 leading companies, showcasing the latest technologies, equipment and services designed to improve healthcare environments and patient experience  services to meet NHS environmental impact (BREEAM) requirements’; James Honour, senior technical consultant, BREEAM Existing Buildings Team, showcasing a seminar on ‘BREEAM Refurbishment and Fit-Out in Healthcare Buildings’; and Gareth Sewell, BIM Expert within BRE’s BIM Technical Team, analysing ‘How to deliver client value and business benefits through better BIM product data: a new BRE tool’. DINNER & AWARDS The organisers and IHEEM have announced that this year’s after dinner speaker and presenter of the 2016 awards is NHS doctor, campaigner, health writer, investigative journalist, broadcaster, speaker and comedian Phil Hammond. Phil will be helping present the esteemed awards and presenting a short after dinner speech. This year the dinner is expected to once again be a sell-out with over 500 expected to attend, with the awards sponsored by Wandsworth Group and Sika. Steve Webb, director for organisers Step

Exhibitions, said: “Healthcare Estates is ideally placed to provide the latest information four months on from the European referendum. As a response, registrations are at record levels, already table bookings are going fast for those looking to attend the dinner while record numbers have reserved their delegate places at the annual IHEEM conference.”

Caroline Finlay, joint managing director, MTS Health Ltd

BIGGEST EXHIBITION TO DATE The exhibition provides visitors with an opportunity to find out about the latest changes and implications for you and your teams. For estates and facilities departments, architects, consulting engineers, construction companies, suppliers and others directly involved in managing estates and facilities the exhibition, features and conference is critical to helping you run your organisation. The exhibition brings together suppliers and customers in the largest gathering of the UK healthcare sector. With over 200 exhibitors and key organisations, just one day at the event could help you and

High accuracy ultrasonic clamp-on energy metering systems and surveys Sustainability, energy efficiency, green energy, ISO 15001; today everyone is aware of the need to be better stewards of energy consumption. Poor energy consumption harms our environment and creates significantly higher operating costs. Public sector hospitals, universities and government buildings are under ever increasing budget limitations and need to adopt cost-saving and effective energy efficiency measures. Thermal Energy – the cooling and heating of buildings is one of the primary areas where better energy management, with the twin goals of efficiency and energy reduction, will bring some of the highest returns to the public sector real estate. To effectively begin energy reduction initiatives, accurate and reliable thermal energy metering has to be in place. You can’t manage if you don’t measure.

your work colleagues in many ways. Face-to-face, visitors and suppliers have the opportunity to make practical decisions while considering the feel of the product together with the knowledge of the supplier. With most of the key suppliers and organisations servicing the healthcare sector in the same place, you can compare every aspect of products and service available. The challenges will be for organisations to adapt to new ways of working, often in partnership with other organisations, and to respond quickly to the demand that will be E

Healthcare Estates


Looking for lost Energy?

FLEXIM’s FLUXUS family of permanent (fixed installation) and temporary (portable survey) Thermal Energy Meters are class‑leading in measurement accuracy and repeatability, do not require shutdown for installation and are highly cost-effective to install. FLEXIM Instruments UK Ltd has installed energy metering at sites as diverse as St. George’s Hospital, London, The London Olympic Velodrome and RFU Twickenham Stadium. Call today for advice on achieving your goal of accurate, reliable, and cost‑effective thermal energy metering.

The ideal system for temporary or permanent submetering, energy audits, plant optimisation tasks and the verification of existing meters in the industrial sector!

FURTHER INFORMATION Tel: 01606 781 420 01606 781 420

FLUXUS® Energy is the answer.  Certified traceable accuracy of both flow and temperature measurement  Simply clamped-on to the pipe wall outside – no risk of leaks, no process shut down needed – instantly measurement ready  Extremely high turndown range, ability to measure very low flow rates, no flow cut-off  Even applicable at high temperature water lines above 200 °C



Healthcare Estates


Providing a range of doorsets and hardware for challenging environments CERTIFIED DOORSETS FOR MENTAL HEALTH ENVIRONMENTS High performance doorsets designed specifically for mental health environments. Supplied pre-hung with all components factory fitted ensuring reduced installation time and great results. T: 01959 577 727 E:

The Kingsway Group is a specialist manufacturer of glazed panels, hardware and doorsets for the mental health sector. Within these areas the Kingsway Group cover a wide range of products that have unique features for overcoming the challenges that the mental health sector face in terms of staff and patient safety, privacy and dignity issues and general robustness. In each area the company has developed products and systems that greatly enhance the healing environment whilst making a real difference to level of staff and patient safety. At Healthcare Estates the Kingsway Group will be showing a small selection of products including a full size anti barricade doorset that is fitted with Logica hardware and glazed with a Duralux panel from its Lux family of products.

All the company’s products and systems have been developed as a result of advice and guidance from those working within the mental health sector and many of its initial designs have been tested in early stages by those within these environments for flaws and defects. This has resulted in a range of products that is constantly evolving to keep up with fresh challenges to make mental health environments a better place for staff and service users alike. FURTHER INFORMATION Tel: +44 (0)1959 577 727

Revolutionary Healthcare Lighting Solutions

Visit the Whitecroft Lighting

stand at Healthcare Estates 2016 Improving the patient experience • Visit us for an exclusive live demonstration of how our latest generation Careline SQ ward lighting solution can aid recovery in our purpose built 'Patient Ward'

Reducing energy • Our energy experts will be on hand to explain how our solutions can vastly reduce energy consumption whilst compressing payback throughout the healthcare environment.




Healthcare Estates

EVENT PREVIEW  created for high quality, low cost services. IHEEM will once again be running the VIP scheme, which following the success of the last few years, is sponsored by Wandsworth Group and gives VIP visitors a place to relax, enjoy complimentary refreshments and conduct meetings with suppliers and colleagues. Qualifying visitors from the NHS, Department of Health, private health, hospice, care home, mental health trust, primary care or strategic health authority will be offered a VIP package that will cover the costs of parking and refreshments on site, a dedicated area to network with colleagues and meet with key suppliers exhibiting at the show. If requested, IHEEM will help plan your day, set up meetings with suppliers and can even help find accommodation and places to eat. CATCH UP WITH COLLEAGUES With the whole industry together, Healthcare Estates is also the perfect place to network, where customers and suppliers rub shoulders with their peers, competitors, future suppliers and employers which proves invaluable. Visitors to Healthcare Estates will also benefit from discussions around the hottest topics of the moment and you can learn the latest methods to deal with specific issues you encounter in your job. Lots of companies invest in training on a regular basis, but there is nothing better than learning from E

The exhibition provides visitors with an opportunity to find out about the latest changes and implications for you and your teams

Building maintenance no longer needs to be a major operation


Completely unique, SFG20 is the essential tool to keep hospitals, NHS Trust buildings and healthcare estates working safely, benefiting the environment for patients and staff alike. A significant number of healthcare trusts already benefit from using SFG20 as the dynamic web-based service contains over 500 industry maintenance task schedules covering over 60 equipment chapters helping Healthcare Estates stay compliant saving time, energy and money. HTM Alignment: In collaboration with IHEEM, SFG20 will launch an aligned HTM Functional Set at the Healthcare Estates Conference in October 2016.

To find out more or to request a free online demonstration visit or call 01768 720 090

SFG20 is published by BESA Publications, a BESA Group Company.



Healthcare Estates


One of the largest, most innovative air control solution manufacturers As market leaders in Fire, Smoke and Air Control products, protecting lives is no small challenge. Ruskin Air Management is proud that due to its commitment in testing and quality, the company is seen as the number of the art facilities with one in the market place. It is all too easy to think of HVAC the latest equipment and exceeds the requirements of systems as only being found BSEN12238:2001 (for air terminal in major buildings whether residential, business or industrial. devices aerodynamic testing Most, if not all of these projects, and rating for mixed flow applications). Not only does provide actionair with ample opportunity to demonstrate the every single one of the company’s products meet the significance of its innovative latest European standards and and proven product ranges. regulations, but the depth of Life safety is the ultimate research and testing that goes motivation behind Ruskin Air Management’s ongoing research, into the design and manufacture of dampers and fancoil units development and testing ensures that the majority exceed program. Creating innovative products whose preliminary task the legislative demands. is to protect buildings but whose FURTHER INFORMATION ultimate test is to save lives. The Ruskin Test Centre at Whitstable provides state







DCRS Health Business Qtr Page Advert.indd 1



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 experts and highly experience speakers. Healthcare Estates is open from 8.45am each morning. Manchester is one of the most accessible places from most parts of the UK, and the easiest city to travel around. Booking your train ticket today could save you a lot of money, and, once in Manchester, Healthcare Estates is just a short walk from Piccadilly station and surrounded by hotels and facilities to make your visit worthwhile. The exhibition is attended by many professionals involved in the sector; management from the Department of Health, NHS estates, facilities, sustainability and procurement professionals, managers and buyers for private hospitals, nursing and

Healthcare Estates


With the whole industry together, Healthcare Estates is the perfect place to network, where customers and suppliers rub shoulders with their peers, competitors, and employers care homes. You will also be mixing with visitors and exhibitors from NHS health trusts, primary care, ambulance trusts, mental trusts, care trusts, foundation hospitals, architects, consultants, main contractors, developers and government bodies and agencies. Healthcare Estates features over 200 leading companies, showcasing the latest

technologies, equipment and services specifically designed to improve healthcare environments and the patient experience. So make Healthcare Estates a date in your diary - we look forward to seeing you there. L FURTHER INFORMATION

Bringing over 30 years of experience to hospital engineering teams Supported by over 40 years of experience, Water Solutions Group specialises in water hygiene audit expertise across the healthcare sector, providing that added peace of mind in respect of compliance and governance. Waterborne pathogens such as legionella, pseudomonas and stenotrophomonas within the healthcare sector present as high risk. Through the group’s investigation, remediation and compliance services as authorising engineers (Water Hygiene and Chlorine Dioxide), it work in partnership with clients to minimise and manage the risk. From Water Safety Groups, Policy’s and Plan’s to hands-on water testing via their associate UK accredited laboratory, they provide an in-depth service unsurpassed within the water treatment industry. This provides added reassurance to clients who will be safe in the knowledge that their

current water regime delivers the correct level of protection. Whether you require confirmation of compliance or assistance with resolving a water pathogen issue, Water Solutions Group provides crystal clear guidance, whilst ensuring HTM standards are being attained. Clients enjoy a considerable degree of autonomy, safe in the knowledge that they are there every step of the way to provide the specialist mentoring and guidance required. Water Solutions Group produces conclusive results 24 hours a day 365 days a year. FURTHER INFORMATION Tel: +44 (0) 754 889 9686



Hea;thcare Estates


Providing an accurate measuring and control option for the water sector Kuntze Instruments is a long established manufacturer of Water Monitor and Controllers which when combined with quality sensors provide clear; concise control of your water. Kuntze Instruments is as precious about its reputation as the materials it uses to manufacture the company’s disinfection sensors. The gold used in the sensors is at the heart of its measurement, providing a quick response to changes in concentration and accuracy. Kuntze Instruments’ disinfection instruments use the patented Automatic Sensor Cleaning (ASR®) system. This clever process provides near perfect cleaning of the entire electrode surface. With such an effective method of cleaning the electrode surfaces, it significantly increases accuracy and reliability for the measurement of chlorine, chlorine dioxide, bromine, ozone or hydrogen peroxide. ASR® is

an electromechanical process and is automated and controlled within the Neon software, it can be programmed to take place at a time convenient to your process. The neon instrument range adopts the latest technology to provide critical analytical information to control your process. Reporting can be accessed through its Cloud Connect® remote access software saving you time and money. Kuntze Instruments will be exhibiting at the Healthcare Estates Exhibition & Conference on 4-5 October at Manchester Central. Stop by stand E47 to familiarise yourself with the range. FURTHER INFORMATION

Enhancing fire safety with thermal monitoring of electrical installations



technology transforming fire safety

Thermal monitoring systems to prevent electrical fires. Protection for:

The risk of fire exists with almost everything that has an electrical source of supply - on average, there are 35,000 fires of an electrical origin each year in the UK. Thermarestor is a unique and innovative way of preventing such fires. As a heat detection system for electrical connections and components it offers a preignition solution to the problem. By permanently monitoring such points it can sense the presence of excessive heat and provide early warning to avoid a potential fire. Where the electrical supply is via an RCD it can automatically disconnect the supply and remove the source of ignition. As a fire prevention system, Thermarestor provides


protection against electrical faults and overloads – wherever they may occur within the electrical installation. It can be installed to new and existing installations, allowing thermal monitoring of incoming supplies, distribution boards, switchgear and accessories, such as socket outlets. It can easily be connected to fire alarm and building management systems, providing a means of notifying occupants of any overheat conditions and allowing investigation of the problem well before it turns into an emergency. FURTHER INFORMATION Tel: 01242 509003


Distribution Boards Switch Gear Sockets Appliances Visit us on stand H34

01242 509003

Providing innovative and high standard electric heating and water supplies Heatrae Sadia is a marketleading electric heating and hot water products manufacturer specialising in domestic and commercial water systems, hygiene and drinking water solutions and renewable technology. At Heatrae Sadia, the company always attains valuable insight into the customer’s hot water needs when developing its range of innovative smart technology products. Heatrae Sadia’s extensive research and development ensures products are always energy efficient, durable and reliable. Made to the company’s own demanding standards of safety and quality, its products provide the perfect balance of control and comfort and are backed by its UK based customer support team and a nationwide network of engineers. Leading the water heating market, Megaflo Eco combines high performance with optimum

efficiency for more powerful mains-pressure showers and faster filling baths. For peace of mind, Megaflo is supplied with an unrivalled lifetime warranty including on-site service support. In fact, all Heatrae Sadia’s products meet and exceed the latest European standards for safety, energy efficiency and quality compliance. Customers will also benefit from a 363 daysper-year dedicated after sales service for cylinders and electric boilers from the company’s award-winning customer support team, so you can rest assured you’re in safe hands. FURTHER INFORMATION Tel: 01603 420220

Virtual reality: step into the future of healthcare Wireframe Immersive is a multidisciplined CG studio based in Glasgow’s Lighthouse Building, known for creating stunning photo-realistic visual solutions for a range of clients including architects, developers and interior designers. The company’s work is designed to enhance clients’ bid submissions, marketing and sales presentations. In the relatively short period of time since Wireframe’s inception, its work has attracted commissions from some of the largest bluechip organisations in the UK Construction, Infrastructure, and Oil and Energy sectors. Wireframe’s new game-changing ‘immersive walk-through’ virtual reality platform allows it to create 3D environments and virtual experiences. This gives the end user the ability to ‘enter’ a space before it’s built, fully explore and interact with it at will. Having envisioned the multitude of benefits that this technology can bring to the healthcare industry, Wireframe

has partnered with experts to produce an innovative virtual reality simulation designed to aid architects in making advanced improvements to healthcare homes. The project will pave the way for key design and planning enhancements, and open doors for further research and development. As the company continues to work to push the boundaries of this revolutionary design tool, Wireframe is excited to keep combining virtual reality with healthcare applications to dramatically improve the lives of others.

Contributing towards the continuum of quality and sustainable healthcare Getinge Group is a leading global provider of products and systems that contribute to quality enhancement and cost efficiency within healthcare and life sciences. The company operates under the three brands of ArjoHuntleigh, Getinge and Maquet. Founded in the early 1900s, Getinge has been driven by a passion for life since it first entered into the medical technology field. Getinge’s unique value proposition mirrors the patient pathway and applies to care providers, care givers and care receivers. The company enables hospitals to perform surgeries and assists healthcare professionals in treating acute health conditions. Getinge also help to provide safe care for patients during recovery. The enabling of surgeries brings a combination of infection control, surgical workplaces and advanced

Healthcare Estates


IT tracking systems, which gives Getinge a unique position to optimise flow of sterile equipment and surgical instruments. Also by a combination of cardiac, pulmonary and vascular therapies the company offers a broader selection of solutions for life or limb-threatening health conditions. Along with ICU-related equipment, Getinge can offer a thorough range of products for life support in acute health conditions. Finally by a combination of rest and mobility-related products Getinge offers a complete solution within patient care. FURTHER INFORMATION Tel: 0191 519 6200

Whitecroft Lighting – experts in healthcare lighting innovation For over 20 years Whitecroft Lighting has been pioneering lighting solutions in the healthcare arena. The company is proud to be associated with some of the most prestigious healthcare developments in the UK in recent years. Now with a vast team of new product designers focused on LED innovation and product design, coupled with an onsite 10,000m2 light engine and luminaire manufacturing facility, Whitecroft Lighting has full control over the quality, design and manufacture of its

luminaires and can produce over 600,000 a year. This is further enhanced by a 70 strong nationwide network of sales engineers, project managers and in-house commercial and technical support teams to support all of your project requirements. For more information on how Whitecroft Lighting can assist with your project, please visit FURTHER INFORMATION Tel: (0)870 5087 087

FURTHER INFORMATION Tel: 0141 552 4443



Advertisement Feature



LAB INFORMATION MANAGEMENT SYSTEMS InterSystems discusses why laboratory information management systems are out of step with industry changes and explains how its new laboratory business management system could help

Connected health models are changing clinical practices around the world. Sometimes it seems these changes are occurring only very gradually. But in other areas, the revolution is rapidly gathering pace. InterSystems recently conducted a survey on the clinical laboratory management systems market in the UK and Australia, and it confirmed our view that the laboratory business is changing dramatically. Industry consolidation, advances in automation, genomic testing, and the increased use of point-of-care testing are driving major shifts in where, when and how testing takes place. RISING DEMAND Laboratories are facing pressure to meet the rising demand for laboratory services, while also using fewer resources – to increase efficiency while driving down costs. What’s more, we found that current information systems are not equipped to support the changes clinical laboratories are undergoing. When asked to select the drivers of change in their laboratories, almost nine in ten (88 per cent) of UK and three quarters (75 per cent) of Australian respondents cited ‘cost savings/ efficiencies.’ Over half (52 per cent) of UK and more than three in five (63 per cent) Australian respondents also selected ‘automation’. Before we go any further, you might want to know why and how InterSystems conducted the survey. We believe laboratories require a new generation of informatics solutions to manage the lab as an agile, knowledge-driven business. Existing laboratory information management systems, or LIMS, aren’t up to the task. That is why we are introducing the world’s first laboratory business management system, or LBMS, to help laboratory customers transform from a reactive testing and results service to a proactive healthcare partner.



To validate and inform our approach, InterSystems conducted two surveys in September 2015, one in the UK and one in Australia. In the UK, we surveyed 81 professional staff representing 60 NHS public pathology laboratories, 10 private or independent pathology laboratories, and 11 related organisations including government at the IBMS Biomedical Science Congress in Birmingham, UK. During the same month, at the 53rd Annual Australasian Association of Clinical Biochemists conference in Sydney, Australia, we also surveyed 60 professional staff representing 29 public pathology laboratories, 18 private pathology laboratories, and 13 related organisations including government. The survey results substantiate our view that current laboratory information management systems fall short of what labs need. When asked how their laboratory was changing, 72 per cent of UK survey respondents said it will have to continually assess its costs and the services it provides to optimise its service mix. This is a key requirement under the NHS hub-and-spoke model for laboratory network formation. In Australia, 65 per cent of respondents said the laboratory will operate as part of a multi-site laboratory network, and 60 per cent that the laboratory will continually analyse and improve its processes. However, only 26 per cent of UK respondents and 29 per cent of public lab respondents in Australia agreed that their current laboratory information management system is able to support changes their laboratory is undergoing. Other key findings included 67 per cent of UK and 75 per cent of Australian respondents said complete visibility, control and accountability over the testing process are important to the success of their laboratory

in the future. A further 58 per cent of UK and 62 per cent of Australian respondents said the ability to predict laboratory workloads and pinpoint bottlenecks is also important to their laboratory’s future success. The respondents also identified some draw backs with existing systems with 65 per cent of both UK and Australian respondents saying their existing LIMS cannot provide analysis of which tests are running at a profit and which at a loss. In additional 62 per cent of all UK respondents and 59 per cent of Australian public lab respondents indicated that their current system does not have the ability to predict laboratory workloads and pinpoint bottlenecks. Of course, every clinical laboratory faces its own set of challenges, and there are significant differences between the changes occurring in different countries around the world. Our survey seems to have uncovered some common themes in two advanced markets, the UK and Australia, however. Does what we’ve found strike a chord with your own experience? We’d be interested to hear from you if it does GO BEYOND THE LIMITS OF LIMS The nature of the laboratory business is changing dramatically. Market consolidation, advances in automation, genomic testing, and the increased use of point-of-care testing are driving major shifts in where, when, and how testing takes place. To survive and thrive, laboratories require a new generation of informatics solutions, designed to manage the lab as an agile, knowledge-driven business in an increasingly interconnected world. InterSystems has raised the bar by introducing the world’s first Laboratory Business Management System (LBMS), a fully-unified module with TrakCare, which will help customers transform from a reactive testing and results service to a proactive healthcare partner. L

Authored by Martin Wilkinson. Martin Wilkinson leads the development of InterSystems solutions for the laboratory market. Based in Sydney, Australia, he has more than 25 years’ experience in health information technology. FURTHER INFORMATION


Digitalising care

Late last year Health Secretary Jeremy Hunt appointed Baroness Martha Lane Fox to look at how the take-up of internet services could be made widely available and include the 10 million people who currently have no internet access. Her recommendations, made to the National Information Board chaired by Tim Kelsey, included ‘basic infrastructure’, such as free Wi-Fi access for health and social care settings. Fox wants a digital health service to be inclusive of those who do not have internet access and start with the disadvantaged first. There’s no question that Fox is excited and impassioned about digital change in the NHS. She says that every GP should have at least 10 per cent of its patients using online services by March 2017 and 90 per cent of patients by 2025. She wants to encourage this different way of interaction between doctor and patient by training GPs in digital skills. THE NEXT STEPS Following on from these recommendations, Hunt announced a £4.2 billion investment to bring the NHS into the digital age. Areas of improvement included an ambition to have a paper-free NHS, investment in cyber security and data consent, a new NHS website and apps for patients, development of a new click‑and‑collect service for prescriptions, and, of course, free Wi-Fi in all NHS buildings.   Running in parallel to this ambition are the seven workstreams of the National Information Board. These include objectives such as providing patients and the public with digital access to health and care information and transactions, with a focus on prevention and self-care.   In supporting better decision making on behalf of the patient, workstream 1.2 focuses on providing citizens with access to an endorsed set of NHS and social care apps. The workstream suggests that endorsement can encourage health and care professionals to recommend the use of safe and effective digital applications and give greater confidence to patients and citizens to select and use them. PRACTICAL APPLICATION Returning to Fox’s key recommendations, they do appear quite simple; and perhaps obvious to many, after all you can get free Wi-Fi almost anywhere, and in fact many

GP practices already offer this. We all use online appointment booking systems to book travel, order grocery deliveries and to reserve a table at our favourite restaurant. But the obviousness of these recommendations perhaps suggests that there is a struggle to move things forward. There are numerous siloed successes where forward thinking health professionals and CIOs have taken it upon themselves to deliver digital services. The MyMR (My Medical Record) Personal Health Record initiative, implemented by University Hospital Southampton, allows patients to send secure messages via a portal to contact their clinical support team, as well as access an online journal to track and record patient activity or behaviours based on the condition being treated. Comprehensive guides and advice are provided and tailored for the specific health episode. MyMR also allows the patient to view hospital appointments - both past and future, check medications, weights and test results and a two-way upload of medical documents. As one MyMR patient suggests – ‘self-management is empowering, liberating and informative’.   Linking up with commercial digital solutions will also be essential. For example, Philips has just announced its plans to make it easier for patients to self-monitor their health using Amazon Web Services (AWS), Cloud and Internet of Things (IoT) technologies. Philips believes this is a key way to reduce the burden on the NHS as it will reduce the number of repeat appointments with a health professional simply to collect statistics. GPs and hospitals will need to be in a position to consume such data in real-time if they are to benefit from this approach. CHALLENGES On a very practical level there are challenges involved in delivering digital solutions, such as upskilling health professionals with necessary technical skills and creating patient awareness in order to adopt new services. On the matter of digital exclusion, there will be technical constraints to overcome in rural areas that struggle with poor infrastructure. Numerous factors come into play such as distances from exchanges and even the type of cabling as many struggle with poor broadband speeds over aluminium

(as opposed to copper) wiring. In such cases technology will likely be designed to operate in an offline mode, collecting data and uploading when the patient happens to be in a Wi-Fi area. The alternative could be investment in additional 4G mobile masts in such areas to truly enable digital services.

Written by Gareth Baxendale, BCS

Health Business revisits a piece from Gareth Baxendale, chartered fellow of BCS, the Chartered Institute for IT, who discusses the scope for greater application of digital services across the NHS

Information Technology


DELIVERING AT SCALE Speaking at UK eHealth Week, Beverley Bryant, director of digital technology at NHS England, said: “Our greatest challenge is delivering at scale. We cannot impose top down technology and information services on the NHS. It all needs to be owned locally. It needs to be the day-to-day business of all of the NHS organisations that are delivering care. “We know our care organisations need interconnected systems and services to deliver better outcomes for patients, so we will support them to ensure they are ready with the capabilities and infrastructure needed. For patients, we need to build public awareness of how digital tools and accessing their record can help them if we are to make this work. “The priority is that we join the NHS up to itself and we join the NHS up to social care and we allow information about patients, like discharge summaries to transfer electronically back to primary care for example. Citizens’ information needs to be transferring across care boundaries between the acute and community and back to primary care.” THE FUTURE The future does seem positive and there is a sense of real focus in delivering digital solutions for patient benefit; especially those that perhaps came under the banner of digital exclusion. The focus must, of course, remain on patient’s wishes and needs. To this end, many groups such as BCS Health, will be working closely with the National Information Board and other partners to support and assist in making a digital NHS a reality and working hard to ensure that digital exclusion is a thing of the past. L

Gareth is a Chartered Fellow of BCS, The Chartered Institute for IT, and vice chair of the BCS Health Executive. FURTHER INFORMATION



EHI Live 2016



Seizing the opportunity at EHI Live EHI Live 2016, taking place on 1-2 November, promises to be perfectly pitched to showcase technology solutions that will address the key concerns of commissioners and clinicians It will highlight programmes such as the NHS Innovation Accelerator which will encourage people to think about how they can optimise outcomes and make savings within the constraints of the NHS budget. But it will also address commissioners’ concerns about the implications of the increased use of technology: the impetus for integrated working means increasing data sharing across care settings, so there is a need to ensure the best data security systems are in place. That’s why EHI Live 2016 will have cyber security as one of its six core themes in November. Earlier this year, the Health and Social Care information Centre (HSCIC) – soon to become NHS Digital – introduced the Cyber Security Programme (CSP) with the Care Computer Emergency Response Team (CareCERT) Project. Its main purpose is to ‘offer advice and guidance to support health and social care organisations to respond effectively and safely to cyber security threats’. Such is the size of the threat across all parts of government that the Chancellor made provision for £1.9 billion in the December 2015 Spending Review to protect Britain from cyber attack and to develop its sovereign capabilities in cyberspace. Within healthcare, the increasing level of cyber attack is becoming apparent. Digital Health has reported on a number of incidents that have impacted on patient care including a ransomware attack with a virus locking down internal files, and an XP virus affecting emails which forced a trust to postpone operations. Security is a concern for patients, too. HSCIC data noted that as of June 2016, ‘2.2 per cent of patients in England (around one in 45) have opted out of information that identifies them being shared outside of the HSCIC for purposes beyond direct care’. There were also 1.5 million instances of patients opting out of information sharing, preventing their records from being shared outside the practice for purposes other than direct care.

Visitors to EHI Live will have the opportunity not only to discuss how CareCERT is supporting organisations to prevent and respond to cyber threats, but also how cyber security exists within the healthcare cloud, and its impact on the rest of the IT infrastructure. It will also analyse the costs of safeguarding digital applications. INVESTING IN TECHNOLOGY It all fits within a significant period of change with regards to the approach being taken in the NHS towards investing in technology. Simon Stevens, NHS England’s chief executive, has indicated that despite, or because of, funding pressures, the NHS approach to new technology will be ‘energising and exciting’. Stevens told the NHS Confederation in June that capital is ‘incredibly tight’ and the existing plans to redesign care may face significant financial

The biggest o t changelayout e EHI is thhibition to x of the econnect the better content with leading g solutions leadin viders pro



pressures. Although there is a commitment in the Five Year Forward View to increase funding, ‘a lot of that extra purchasing power is back‑ended towards the 2019, 2020 period’. That said, the groundwork is being laid now and there are already some great opportunities. Back in January, NHS England announced the NHS Innovation Test Beds. Working in partnership with organisations such as Verily (formerly Google Life Sciences), IBM and Philips, the scheme is focusing initially on care for older patients, people with long-term conditions and mental health patients. Frontline health and care workers are being encouraged to ‘pioneer and evaluate the use of novel combinations of interconnected devices such as wearable monitors, data analysis and ways of working which will help patients stay well and monitor their conditions themselves at home’. In May, NHS England published ‘Securing Excellence in GP IT Services: Operating Model 3rd edition (2016-18)’. This latest edition ‘includes expanded core and mandated GP IT requirements – making it clear what

EHI Live 2016

general practice should be able to expect from IT service delivery arrangements, together with driving digital adoption through maturity assurance, providing a new maturity assurance framework to assess progress towards digital adoption – the Digital Primary Care Maturity Assurance model’. Then in June, the NHS Innovation Accelerator (NIA) opened another round of applications, inviting healthcare innovators to address the challenges around prevention, early intervention and LTC management. Stevens wants to see innovations that will make a difference ‘diffused much more quickly, much more widely’. And from April 2017, he announced that ‘a piece will be added to the national tariff system specifically for new med tech innovations that have been shown to be cost-saving or help patients with supported self-management’. This ‘information and technology tariff’ will ‘accelerate uptake of new medtech devices and apps for patients with diabetes, heart conditions, asthma, sleep disorders, and other chronic health conditions, and many other areas such as infertility and pregnancy, obesity reduction and weight management, and common mental health disorders’. There is no reason, therefore, why EHI Live will not be able to capitalise on the opportunities being presented. HOW EHI LIVE IS RESPONDING EHI Live is now in the second year of management by the Informa Life Sciences Exhibitions team, the people behind Arab Health, the world’s second largest medical event. Names already signed up for EHI Live 2016 include: Philips; Dell; EPIC; Intersystems; Imprivata; Cerner; GE; Siemens; SystemC; TPP; and Lexmark. NHS Digital will have a significant presence, in part to help establish itself following its rebranding from HSCIC to clarify its role as

the national information and technology partner for the health and care system. Changes being made to the conference line up mean that the conference streams will be: EHI Keynotes; Big Data; Integration & Interoperability; Open Source; Governance and Data Standards; Cyber Security; Health & Social Care Integration; Mental Health; Annual CCIO Conference (hosted by Digital Health); and Annual CIO Conference (hosted by Digital Health). Like cyber security, the mental health conference is another new conference for 2016. Long a Cinderella subject for the NHS, mental health has been given much greater attention in the recent NHS reforms. Steven’s speech in June gave it due prominence, saying that savings being made in other parts of the NHS will be used to increase the spend on mental health services and community services, and implement the recommendations of the mental health task force. Mental health priorities over the coming year include work to reduce out of area treatments and to connect secondary and tertiary mental health services; to reduce waiting times; and to expand child and adolescent mental health services. In terms of changes to the format, Josué Paulos, EHI Live exhibition manager, said that ‘the biggest and most exciting change to EHI is the layout of the exhibition with purpose‑built theatres on the showfloor to better connect the leading content with leading solutions providers and to allow better networking’. He added: “We are happy to be offering the CIO and CCIO conferences once again which will bring those senior decision makers back to EHI Live. And for the first time, the UK Clinical Research Collaboration will be hosting a closed meeting at EHI live which will bring up to 150 clinicians to EHI.” The UKCRC was established in 2004 ‘with the aim of re-engineering the clinical research environment in the UK’. It brings together the major stakeholders that influence clinical research in the UK – research funding bodies, academia, the NHS, regulatory bodies, and industry covering bioscience, healthcare and pharmaceuticals industries, as well as patients. GETTING GOOD VALUE The changes are being introduced in response to feedback from the 4,000 exhibitors and visitors at the 2015 show. It’s clear that EHI Live is regarded as one of the UK’s big three e-Health must attend events. More than nine out of 10 (91 per cent) exhibitors said EHI Live was successful in meeting their overall objectives, with 86 per cent saying the show generated promising new leads for their business. A similar number

(88 per cent) rated the quality of visitors as very good and 93 per cent said they intended to come to the 2016 show. More than two thirds of visitors said the main reason for attending the event was for networking and industry updates. One of the networking innovations introduced in 2015 will be returning – the Big Red Bus bar, creating an informal but eye-catching networking area. Exhibitors will have a wide range of sponsorship and speaking opportunities. This will include ‘The Pipeline’, 30-minute supplier-led presentation sessions with details publicised on the EHI Live websites, in the show guide and on‑site signage. One of the big themes at last year’s event was the ambition of a paperless NHS by 2018. In April, the results of the digital maturity self-assessment for secondary care providers was published. The data suggests that while the majority of organisations are well over half way in their readiness, most organisations believe their capabilities still have a long way to go. Paul Rice, Head of Technology Strategy in the Digital Health team in NHS England, has said that the results reflect that ‘while it’s necessary to have all the technology available, it is far from sufficient to ensure benefits are being optimised’. It clearly presents a picture of opportunity. DON’T FORGET THE AWARDS A little over a month before EHI Live are the EHI Awards, regarded as the flagship awards event within the UK’s healthcare IT calendar. Celebrating its 10th anniversary, the gala event takes place on September 29 in London. It will bring together more than 700 of the country’s top IT and clinical professionals from the NHS along with supplier companies hosting their customers. The evening provides an excellent opportunity to network with industry peers in sumptuous surroundings on an evening of celebration. One of last year’s winners was Blithe Computer Systems and the Chelsea and Westminster Hospital NHS Foundation Trust. Jordan Arkell, business relationship executive at 6PM Blithe, said winning at the EHI Awards had raised the company’s profile. She said: “We have experienced high volumes of enquiries from the healthcare sector wishing to discuss our involvement in the project. Our experience with the EHI Awards team has been excellent, and the awards have really ensured that the right people are hearing about the innovative work we are doing.” L FURTHER INFORMATION



Infection Control Written by Bryony Samuel, Copper Development Association



Giving patient safety a boost Bryony Samuel of the Copper Development Association, discusses the latest information on the use of copper surfaces to boost infection prevention and control in hospitals The healthcare environment is increasingly recognised as a significant and continuous reservoir of microbes that can cause infections. Whilst regular cleaning and disinfection, good hand hygiene and other existing measures can be effective, they rely on human intervention and – even when fully implemented – can’t eliminate the risk posed by contaminated surfaces. Augmenting hospitals with continuously‑active antimicrobial copper surfaces offers a simple and effective hygiene boost, requiring no change in human behaviour, working alongside a bundle of infection prevention and control measures to improve patient safety. WHAT IS ANTIMICROBIAL COPPER? There are many technologies and materials currently marketed as being antimicrobial, but none are as effective under typical indoor conditions as copper. Copper rapidly destroys microbes that can be picked up, unseen, from frequently-touched surfaces in the environment, potentially spreading infection. These include bacteria (such as E. coli), viruses (such as Influenza and the ‘winter vomiting bug’ norovirus), and resistant organisms such as MRSA and VRE. Fewer microbes on surfaces mean a lower risk of infections spreading by touch. Copper’s antimicrobial efficacy extends to over 500 copper alloys – including brass and bronze – creating a large family of metals collectively called ‘antimicrobial copper’. Evidence shows that upgrading the most frequently-touched surfaces in a healthcare environment to antimicrobial copper can reduce the spread of costly infections and improve patient outcomes. This article presents a summary of the body of research and considers some of the practicalities and economics of upgrading key surfaces to copper.

began to be assessed. Sixteen years on, more than 60 papers report copper’s broad‑spectrum, rapid efficacy against bacteria, viruses and fungi. No pathogen tested has been able to survive on copper. Claims of antimicrobial efficacy made for many antimicrobial products are based on JIS Z 2801 and ISO 22196 tests, conducted at over 90 per cent humidity, 35°C and over 24 hours under a plastic film. These basic tests are described as a proof of principal, and do not indicate how a material will perform in the field. To better represent actual in-use conditions when testing copper, researchers developed new protocols to reflect typical room temperature and humidity, and used representative contaminants. Laboratory research on the antimicrobial efficacy of copper and copper alloys has been carried out and verified at institutions around the world, with results peer-reviewed and published in respected journals. They exhibit efficacy under typical indoor conditions, unlike silver‑containing materials and triclosan, which

nting Augme s with l hospita sly‑active ou continumicrobial anti aces offers surf copper ctive hygiene an effe boost

TYPICAL INDOOR CONDITIONS Copper’s antimicrobial properties have been documented in scientific literature for more than a century, but it was not until 2000 that its efficacy against the pathogens responsible for healthcare-associated infections (HCAIs)



showed no antimicrobial efficacy under these conditions. HOW DOES IT WORK? A leading researcher in this field is Professor Bill Keevil, chair in Environmental Healthcare at the University of Southampton, and his work includes investigation of the mechanisms by which copper exerts its antimicrobial effect. For bacteria, the current consensus among researchers is that there are several interacting mechanisms for so‑called contact killing. The nature of these leads researchers to believe it is unlikely bacteria will develop resistance to copper. Professor Keevil explains: “Copper works in completely different ways to antibiotics or common biocides. It punches a hole in the cell membrane, like a balloon, and the bacteria collapse. It stops them respiring, goes into the cell and destroys their DNA. Mutation happens because you get small changes in DNA in cells. The beauty of copper is it destroys the DNA; there is nothing left. We’ve shown this for bacteria, fungi and viruses. They can’t mutate. They have no time.” The Southampton team has also investigated the contribution antimicrobial copper surfaces can make to combating the rise of antibiotic resistance – a global threat that a joint UK government and Wellcome Trust review recently said could kill 10 million people a year across the world by 2050. The team assessed the ability of two different strains of bacteria to pass genetic material conveying antibiotic resistance between them on copper and stainless steel. While this took place on stainless steel, it did not happen on copper. Copper could therefore contribute to the fight against antibiotic resistance in two ways – by reducing the spread of infections and thus the need for antibiotics, and by preventing the transfer of resistance between bacteria on surfaces.

COST BENEFITS HCAIs are very common and very costly, both financially and in terms of human life. Approximately 20 per cent of ICU patients in European hospitals get HCAIs, and in 2011 they affected 4.1 million patients, necessitating 16 million extra days in hospital. 37,000 deaths were recorded as being caused by HCAIs, plus 110,000 deaths where they were a contributing factor, and they had a direct clinical cost in excess of €7 billion. York Health Economics Consortium (YHEC), a leading global health economists based at the University of York, developed a fully‑referenced cost benefit model for hospital managers to illustrate the economic rationale of an antimicrobial copper installation. Using researched data for cost of infection, industry data for cost of antimicrobial copper and standard components, and a conservative infection rate reduction of 20 per cent (where the US trial reported a 58 per cent reduction), the model considers a planned refurbishment or new build. It predicts the cost of replacing the six key touch surfaces in a 20-bed ICU with antimicrobial copper equivalents will be recouped in less than two months, based on fewer infections and the resulting shorter lengths of stay. It also calculates a positive impact on bed days and quality-adjusted life years offered by antimicrobial copper. Dr Matthew Taylor, YHEC’s director and one of the model’s authors, concludes: “After the initial two months, ongoing cost savings will accrue from the reduction in blocked beds and better-directed staff resources.” HOW TO PRIORITISE SURFACES FOR UPGRADE In the copper clinical trials, multi-disciplinary teams have prioritised high frequency touch surfaces to upgrade to copper. The factors considered include known hotspots (from microbiological testing) and likely hotspots (based on experience and understanding of staff/patient/visitor dynamics). Based on a review of international research, the United States Centers for Disease Control published a checklist of high risk surfaces based upon the likelihood of touch and contamination. These were bed rails, chairs, IV poles, over-bed or tray tables, door and cabinet handles, grab rails, light switches, push plates, sinks, toilet seats and flush handles. From the experience gained by hospitals adopting this technology, it is clear that when considering which components to upgrade in a particular facility, input should be sought from the infection control team and ward staff to ensure that all key touch surfaces are identified. The regular environmental swabbing carried out by infection control teams to assess the state of cleanliness will also indicate contamination.

Infection Control

CHALLENGING CLINICAL CONDITIONS Antimicrobial copper has also been put to the test in real clinical environments. Numerous trials have been conducted in different healthcare systems – such as the UK, US, Germany, Finland, Poland, Chile and Japan – and different clinical environments, including nephrology, geriatric, general medical and ICU wards. They report a continuous and greater than 80 per cent reduction in bacterial contamination on antimicrobial copper surfaces compared to non‑copper surfaces, with trial leaders concluding that antimicrobial copper can provide an additional measure to reduce the spread of HCAIs. It is important to note that these trials have used solid materials since the effective surface will not wear away, or be susceptible to reduced efficacy over time, unlike coatings and composites. A multi‑centre clinical trial in ICUs, funded by the US Department of Defense, explored the effect this reduction in surface bacteria has on HCAI rates. It found that replacing just six key, near-patient touch surfaces reduced the incidence of infections by 58 per cent. Official recognition of copper’s potential to boost infection control is growing as the evidence base and experience of use grows. The evidence-based EPIC 3 guidelines included copper as an emerging technology in 2014 and, last year, the CMJ (Poland’s National Centre for Quality Assessment in Healthcare) recognised copper’s potential to boost infection control in its new hospital accreditation scheme. With this proven efficacy in mind, the next question arising will naturally concern the cost of installing antimicrobial copper touch surfaces.

SPECIFYING ANTIMICROBIAL COPPER Help with identifying products is available in the form of an industry stewardship scheme: the Antimicrobial Copper brand and Cu+ mark are used by leading manufacturers of hospital equipment, furniture and fittings to indicate their products are made from solid, approved antimicrobial copper alloys, and that the organisation adheres to strict usage rules guiding their understanding of the underlying technology and its deployment. Copper alloys offer a wide palette of colours, from the gold of brasses to the rich brown of bronzes, right through to the silver/white shades of copper-nickels. Copper alloys will naturally darken over time, but this does not impact their antimicrobial efficacy. More colour-stable technical alloys, traditionally used in demanding applications, are available. CONCLUSION Antimicrobial copper surfaces are an adjunct to, not a replacement for, existing infection control measures. Alongside good hand hygiene and regular surface cleaning and disinfection, they will continuously reduce surface contamination and consequently the risk of infections being passed between people via these surfaces. Installations have already taken place around the world, in more than 25 countries, including several UK facilities. In these places, the importance of taking a multidisciplinary approach to making the decision of where to deploy antimicrobial copper has been clear. L FURTHER INFORMATION

For product information please call: 01293 851740 BRITISH MADE

ANTIMICROBIAL COPPER SWITCHES & SOCKETS Full range now available from leading British manufacturer

Antimicrobial Copper provides: • Rapid action against bacteria and viruses • Round the clock efficacy, between cleans • Solid protection from the spread of infection • A boost to standard infection control practices Available from all good wholesalers



Case Study


A breakthrough in international healthcare: bringing together hospitals, clinics and healthcare providers MedicaNet actually changed the way healthcare is delivered by building a global network for Hospitals! MedicaNet is the first membership based, global medical network for patients and healthcare providers. MedicaNet is a bridge to globally internationally accredited hospitals and highly qualified doctors and medical clinics to provide you with the highest quality of medical care worldwide. MedicaNet is a valuable medical treatment resource, which will provide you with a free quote for treatment, and assist in arranging travel, accommodation and treatment at your chosen hospital. MedicaNet network of hospitals and clinics are equipped with advanced medical technology to offer you the latest procedures, all at affordable prices. As a medical network, MedicaNet is representing a broad group of hospitals, clinics and doctors, so is able to offer you competitive prices no matter what your treatment. Till now more than 100 hospitals and clinics



joined MedicaNet from India; Turkey; Spain; United Arab Emirates; Cyprus; Thailand; Indonesia; Hungary; Czechoslovakia; Mexico; Dominic Republic; Germany; Malaysia; Malta; Singapore; the UK; and Greece. Working with the top facilities and doctors, MedicaNet offers access to a large range of high quality treatments across different specialties, including: general surgery; obesity treatment; cardiology; organ transplantation;sex reassignment; bone marrow transplantation; cancer treatment; cosmetic surgery; eye surgery; spinal surgery; and dental treatment. Get a free medical quote from MedicaNet by

sending in the necessary medical reports. MedicaNet will match your requirements with their healthcare providers to provide you with treatment plans, including the cost of the treatment. You get to choose at which top facility you would like to undergo treatment in, and after travelling to your treatment destination, the MedicaNet team will happily assist you with any queries. Once your surgeon has completed all the necessary checks, your treatment will begin, after the treatment, you can recover in your hotel where MedicaNet will support you all the way. To relax and unwind, MedicaNet will arrange tours and other activities so you can enjoy also the beautiful and historical sites of your treatment country. When the time comes that you have to return home, MedicaNet will ensure everything is organised for your safe return. MedicaNet believes that a relationship is for life and will support you even after you are back at home. FURTHER INFORMATION Tel: 90(216) 338 72 00


Mona Guckian Fisher, president of the Association for Perioperative Practice, looks at the before, during and after of surgical equipment safety ‘Primum non nocere’ is a latin phrase that means ‘first, do no harm’ and is a mantra that is often heard within healthcare settings. It reminds the health care staff that they must consider the possible harm that any intervention might cause to patients in their care. There is nowhere that this is more appropriately stated than within the environs

INSTRUMENTS OF INTEGRITY The importance of providing surgical instruments and equipment which are of perioperative practice. unimpaired, of a standard quality, Perioperative practice appropriateness and integrity to Deconta covers the period the surgeon to perform his minatio enable before, during and role cannot be overestimated n involve after a patient on any level. There are s c o n s i d e ra b l e a has undergone other additional factors numbe of proc a surgical directly at the point of use r procedure in the which need consideration are sev esses. There eral me such as availability, integrity, achieve thods to cleanliness, functionality, the appropriateness, sterility require d outco and decontamination me status. The science of decontamination is a world apart from most people working within the operating theatre, who have an expectation that instruments will arrive in time for procedures and will be prepared and sterilised to the required standard. Surgical instruments have a medical purpose and are considered as medical devices defined within the terms of the Medical Devices Directive (MDD) 93/42/EEC (MHRA 2014). As far back as 1999 the Department of Health launched the National Decontamination Programme to support the NHS in England in improving and maintaining standards relating to the reprocessing of medical devices. The aim of the programme was to review working practices, to assess the condition of facilities and equipment and to agree local action plans to improve standards where necessary. A snapshot survey in England (NHS Estates 2000) investigated the application of decontamination standards and found instances where decontamination processes fell short of current standards, and in some cases practice was poor. It identified that substantial improvement could be achieved by ensuring effective management of decontamination services and improving staff training and development. At the time, many of the buildings and much of the equipment used in sterile services departments (SSDs) needed refurbishment or replacement. Analysis of the findings of this initial survey highlighted the need for a comprehensive review of decontamination services across the whole of the NHS. As an E


Written by Mona Guckian Fisher, president, Association for Perioperative Practice

The long journey of the surgical instrument

operating theatre. It is well documented that the operating theatre is an area that is fraught with risk, and there is therefore a legal, moral, ethical and professional duty on organisations and individual healthcare workers to minimise risk for each single aspect of the care that is delivered. It is unimaginable to most people who work outside of the operating theatre to visualise the amount of equipment necessary to care for one patient at a time within this specific environment. This is aside from the vast quantities of individual instruments which are the tools of surgical trade and without which the actual procedure could not be undertaken.

Perioperative Practice



Perioperative Practice

SURGERY  outcome of this work a considerable amount of surgical equipment was replaced, and many units upgraded or newly built to provide the service and the required quality standard. As a nurse who can clearly recall this initiative, the changes that have been introduced and embedded in practice throughout the NHS and independent sector hospitals are today extraordinary by comparison, and certainly more in keeping with 21st century healthcare provision. In 2006 the National Institute for Health and Care Excellence (NICE) published the guidance 196: Patient safety and reduction of risk of transmission of Creutzfeldt-Jakob Disease (CJD) via interventional procedures (NICE 2006). Whilst the guidance relates to high risk surgical procedures (intradural operations on the brain and operations on the retina or optic nerve) many of the principles in the guidance are recognised as best practice and multi-professional groups continue to explore how issues such as migration of instruments, instrument tracking systems, and the quality of single use instruments can be adopted in everyday decontamination practice. In February 2007 the chief medical officer (CMO) reiterated that NHS trusts were required to implement the NICE guidance to minimise the risk of vCJD transmission from medical devices during certain procedures (DH 2007). Concerns that vCJD could be transmitted during surgical procedures led to the publication of updated guidance (DH 2015a, b, NICE 2006). The guidance recommended changes in practice which could be achieved and delivered within a short time frame. SAFE STANDARDS As perioperative nurses and practitioners we rely on the decontamination experts to provide a consistent safe standard in the provision and availability of surgical instruments which are in all aspects and at all times fit for purpose. Decontamination involves a considerable number of processes and there are several methods which can be used to achieve the required outcome. The process is determined by factors such as the instrument itself, its integrity and most suitable procedure to provide sterility working in consensus with the experts and the manufacturers guidance. This is a process which all reusable medical devices must undergo before they can be used safely on a patient. The various cycles that form part of this process are defined and validated according to the standards that are set by the industry. The basic principle of decontamination is to remove microorganisms that might harm a patient if introduced into their body. The process for decontamination can be broken down into many elements all of which are important as part of the overall process. Cleaning is obviously the first stage of this process and whilst we each have an understanding of what ‘clean’



All instruments must be handled with care throughout their entire use since any scratches and roughened surfaces will harbour dirt and bacteria means to us as individuals; as part of the decontamination process cleaning of surgical instruments requires to be undertaken by mechanical, thermal or chemical means and there are strict principles to adhere to in relation to each task within the process. The cleaning process itself is monitored during routine production to ensure that each established part can be validated and that the intended outcome has been achieved. It is imperative that the highest standard of care must be taken to ensure that all medical devices and equipment used within the perioperative environment and during surgical procedures are not a source of microbial contamination thereby presenting high risk for the patient. It is accepted that instruments which are used in invasive procedures present significant risks for healthcare associated infection. The Healthy Technical Memorandum HTM 01-01 issued by the Department of Health in 2013 provides guidance about the management and decontamination of reusable surgical instruments and medical devices used in acute care. The Choice Framework for local Policies and Procedures (CFPP) CFPP guidelines (DH 013b) stipulate that in commissioning decontamination services for medical devices used in acute care, organisations should aim to ensure that staff are trained throughout the reusable surgical instrument cycle. Training should be of a standard recognised by the Institute of Decontamination Sciences (IDSc) recommended by the MHRA (2014) and quality controlled by external organisations such as the Care Quality Commission (CQC

2014). The CQC monitors organisations to ensure that they have met the requirements stipulated for the NHS on the prevention of healthcare associated infections (DH2009a). The CQC assesses healthcare organisations on their compliance with the requirements of section 20(5) of the Health and Social Care Act 2008 (DH 2009a)(AfPP 2016). In order to meet the requirements of the directive organisations need to implement a quality management system. This quality system must focus on measuring all aspects of the decontamination work from staff, processes, products and equipment. The code of practice provides details for healthcare organisations on how they can meet the requirements and sets nine compliance criteria (DH 2009a). Some of the criteria states that a provider must designate a lead manager for decontamination of equipment used in treatment. This individual has responsibility for ensuring that a decontamination programme demonstrates that appropriate and dedicated facilities are provided for the decontamination of reusable medical devices, that staff are trained and can show evidence of competencies within their role, that the systems and processes are fit for purpose and there is a system of audit in place to support that the required standard is met. (DH 2009a) (AfPP 2016). AN INTERVENTIONAL ENVIRONMENT There are several individuals involved in the process of providing surgical instruments to the surgeon or interventional professional and numerous checks to undertake prior to

and appropriate regulatory body. This responsibility also extends to the purchasing, deployment, maintenance, repair and disposal of medical devices (MHRA 2006), and providing a safe system for instrument storage and transportation.

handing these instruments to be used on a patient. This is in addition to all the checks and processes already referred to as part of the actual decontamination process. The national perioperative standards (AfPP 2016) are in place to protect patients, staff and others who may be at risk of acquiring a healthcare associated infection (HCAI), and states that healthcare organisations should ensure that there are effective arrangements in place for the appropriate decontamination of reusable invasive medical devices and other equipment. These should be incorporated within appropriate disinfection and decontamination policies (The Health and Social Care Act 2008 criterion 2 DH 2010). Theatre staff inspect instrument sets on receipt to ensure that packaging is undamaged and sterility is not compromised. The ‘scrub’ practitioner who assists the surgeon by providing the instruments directly during the surgical procedure, will check immediately prior to the surgery to ensure that all instruments are sterile and available to use. Only then can the operation be performed. The theatre team take responsibility for tracking the instrument tray details to the patient postoperatively. Theatre staff return sets of instruments to SSD for reprocessing using a method set out and agreed in local policy, ensuring that they are appropriately containerised or packaged and addressed for collection by supplier at the agreed time. All instruments must be handled with care throughout their entire use since any scratches and roughened surfaces will harbour dirt and bacteria. Healthcare professionals who hold responsibilities for decontamination are required to meet the requirements of the core standards (DH 2009a) and personnel working in the perioperative setting understand their legal and ethical requirement with regards to their duty of care, and the principles of professional accountability with respect to their employer

EFFECTIVE DECONTAMINATION Perioperative practitioners working within the operating theatre department have a responsibility to ensure that patients are protected from the risk of cross infection from reusable medical devices. Decontamination of instruments and equipment is of vital process in ensuring this. It is imperative that any decontamination practices which are undertaken within the operating theatre department are carried out by appropriately trained personnel, and that a consistent and reliable service is provided from the central sterilising supply unit to enable the operating theatre efficiency and patient satisfaction. Effective decontamination of reusable medical devices is critical in the management of healthcare acquired infections (HCAI) and patient safety. Local practice is led by a local risk assessment group to ensure that current evidence and best practice determines local processes. There are policies detailing the processing of reusable instrumentation, including decontamination,

tracking and traceability, maintenance and repair that conform to national guidance. Reusable medical devices are decontaminated to national standards and provide a consistent and reliable service to users. Where instruments are on loan from medical device companies or elsewhere there must be a policy which details that they are appropriately sourced, decontaminated and used safely with support, education and guidance from appropriate persons. The hospitals infection prevention and control (DIPC) specialist is responsible for the infection control aspects of decontamination, and is responsible for the departmental risk assessments and provision of support to the theatre team. Part of this process establishes the instrument management of identified high risk patients; and where reusable invasive medical devices have been used in high-risk procedures. The ability to be able to track patients to instruments used is a critical part of the process of protecting individual patients and providing assurance to the public that the long journey from manufacture to the operating table is a well-considered, methodical safe and regulated process; and one that is under scrutiny at all times. L

Perioperative Practice



Decontamination involves a considerable number of processes and there are several methods which are determined by factors such as the instrument itself, its integrity and most suitable procedure to provide sterility


Infection Prevention 2016


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Infection Prevention 2016


Preventing infection by sharing best practice Infection Prevention 2016 will be held at the Harrogate International Centre from the 26–28 September 2016, offering a scientific programme covering all infection control needs Organised by the Infection Prevention Society (IPS), this is the premier infection prevention conference and exhibition of the year. The conference has been awarded 14 Continuing Professional Development (CPD) credits from the Royal College of Pathologists. There will be in excess of 800 delegates in attendance and over 100 exhibitors. The scientific programme will deliver an array of renowned speakers covering all your infection prevention needs. With an exciting programme on offer, this event promises to offer delegates the latest in infection prevention research, education and expertise, with inspiring speakers and informative sessions. This year’s programme features specialist streams on surgical site infection and New to Infection Prevention. We also have four specialist workshops: focusing on writing for publication; mental health; audit and surveillance; and the ambulance service. Outside the dedicated streams and workshops there will be inspirational presentations from national and international speakers. We are once again offering separate one-day conferences on Wednesday 28 September – these include Infection Prevention in Dentistry, and Infection Prevention in Care and at Home. MONDAY HIGHLIGHTS Professor Gary French is delivering the Keynote Address which opens Conference entitled ‘The battle between Gram positives, Gram negatives and humans’. In this session, Professor French will describe and explain the changing picture of Gram positive and Gram negative healthcare associated infections and the implications for present and future treatment and control. Professor A.P.R Wilson, consultant microbiologist at the University College London. Professor Wilson will be discussing ‘Emerging threats and prevention opportunities’. Within this engaging session, delegates will learn to understand the measures and rationale

for infection prevention measures against multi‑resistant gram negative bacteria. We are delighted that Mary Dixon Woods, a fellow of both the Academy of Social Sciences and the Academy of Medical Sciences, will deliver the EM Cottrell Lecture. During this session, Mary will explore how research in patient safety and infection prevention and control can mutually inform each other to the benefit of both. The New to Infection Prevention Stream will also be held on Monday afternoon. This is a new style of workshop run by Michael Neville from the British Pregnancy Advisory Service and Karen Wares from NHS Grampian, for those new to the specialty, to equip them with the basics needed to be an effective infection prevention practitioner. This stream will feature sessions that will provide an overall introduction to the essentials of infection prevention and control. TUESDAY HIGHLIGHTS Tuesday morning starts with a series of ‘Meet the Expert’ sessions on ‘Standard infection control precautions’ with Lisa Ritchie, ‘Current microbiological threats’ with Tim Boswell, and ‘Using the toolkit to build a CPE policy’ with Jon Otter. The Surgical Site Infection Stream will also be held on Tuesday morning. This stream will feature Dr Peter Bischoff who will deliver a session on ‘Introducing the new WHO guidelines for surgical site infection prevention’. Hilary Humphreys will present a session on ‘Laminar air – review of the evidence’ and Professor Judith Tanner will deliver a session entitled ‘Patient warming in the perioperative setting’. In addition to this stream, Tuesday will also feature a workshop focusing on Mental Health with sessions including ‘Outbreak of Campylobacter in a mental health trust’ by Penny Criddle and ‘Self‑harm and wounds’ from Amanda Miskell. Peter Jenks, director of Infection Prevention

The scientifi program c will del me array o iver an speake f renowned r all your s covering in preventfection io needs n

and Control at Plymouth Hospitals NHS Trust is looking at ‘Staphylococcus aureus carriage in patients and staff – what are the implications?’ The objective of this session is to understand the current significance of Staphylococcus aureus carriage in patients and staff. One of the final sessions of the day is a debate on ‘This house believes that contact precautions are essential for the management of patients with MDROs’. Debating cons will be Dr Eli Perencevich, denured professor of Internal Medicine and Epidemiology at the University of Iowa, USA. This debate will ask if contact precautions are essential for the management of patients with MDROs, do they work, or are we trying to find and flog the proverbial dead horse which is no longer in the stable. WEDNESDAY HIGHLIGHTS On Wednesday there are two, one day conferences taking place, including Infection Prevention in Dentistry and Infection Prevention in Care and at Home. Both programmes are featured within the main conference programme and can be accessed as a standalone event which can be booked directly on the conference website. The Infection Prevention in Dentistry One Day Conference will be of interest to dental surgeons, dental nurses, infection control support dental nurses, general dental practitioners, orthodontic group nursing managers, special dentist nurses and those with an interest in infection prevention and control. The programme will feature sessions on: ‘Spreading odontogenic infections and severe oral sepsis’; ‘PHE studies on the transmission of prions and the efficacy of E









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EVENT PREVIEW  washer disinfectors’; ‘Infection prevention and control in dental labs’; ‘Oral sex and HPV – the missing link’; and much more. The Infection Prevention in Care and at Home One Day Conference is relevant for all staff and in particular those senior staff with the accountability for infection prevention within the organisation. Key sessions will be delivered on ‘Laundry – New Insights’, ‘Outbreaks’, ‘Surveillance of healthcare-acquired infection in the homecare service’, ‘Dental health in older people’ and much more. The cost to attend is £50 and includes access to the exhibition. The third and final day of conference will be opened by Dr Eli Perencevich who will be presenting this year’s Ayliffe Lecture on ‘Using science to guide hand hygiene surveillance and improvement’. Following which, Professor Brett Mitchell, associate professor of Nursing and Director of the Lifestyle Research Centre will present a session on ‘Infection prevention and control staffing, what’s the story?’. This session will explore infection prevention and control staffing, outcomes and the role of credentialing. Wednesday morning includes two workshops, the first is an Ambulance Forum Workshop with sessions from Stevie Slade from St Johns Ambulance entitled ‘IPC in a volunteer organisation – a road trip!’ and a session from Kirsty Lee Morgan. The second workshop is focussed on Audit and Surveillance and

features sessions on ‘Enhanced surveillance of carbapenemase-producing Gram-negative bacteria in England’ by Dr Rachel Freeman. This is closely followed by ‘Surgical Site Infection surveillance: behind the scenes’ by Pauline Harrington, Senior Infection Control Nurse from Public Health England. The final session at this year’s conference will be delivered by best-selling author, Andy Cope with a session on ‘The art of brilliance’. Within this session, Andy’s aim is to make you feel positive, motivated and brilliant. The conference will be brought to a close by incoming IPS President Professor Neil Wigglesworth. ORAL PRESENTATIONS AND EXHIBITION A highlight of the annual IPS Conference is always the oral presentations and posters. Infection Prevention 2015 featured over 100 posters and 12 oral presentations which covered a huge range of subjects and provided an invaluable resource during the conference. Infection Prevention 2016 promises to offer a similar array of quality information. The Exhibition at Infection Prevention 2016 will feature products and services from over 100 companies working within infection prevention and control. Some of these companies will be long term supporters of IPS, but the exhibition will also feature some new faces, new products and recent innovations.

Committed to quality and innovation in sluice and dirty utility room design DDC Dolphin is dedicated to excellence and innovation in sluice room and dirty utility room design, equipment manufacture, installation, testing and servicing. The company specialises in the UK and around the world in sluice rooms and dirty utility rooms in hospitals, hospices, care homes and special needs schools. Over twenty years of experience allows the company to provide comprehensive and meaningful advice and support throughout planning, design and specification processes for new or existing facilities, allowing it to tailor solutions to your requirements and enable you to meet modern infection control standards as efficiently as possible. DDC Dolphin focus exclusively on the design of effective and

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THE SOCIAL EVENTS The exceptional educational programme at Infection Prevention 2016 is enhanced by the social events, which allow valuable time for collaborating and building up relationships with fellow infection prevention and control colleagues.

Infection Prevention 2016


CPD Conference provides the ideal opportunity for continual professional development for all healthcare professionals. All delegates will receive a certificate of attendance after the event which will record the sessions that they have attended. In addition, the main programme has been awarded 14 CPD credits for medical staff from the Royal College of Pathologists. In addition, the Infection Prevention in Dentistry one day conference has been awarded 4 CPD credits which can be added to your portfolio. All sessions will be mapped against the IPS competences, this information will also be on the certificates of attendance and full information will be available online. The mapped chart will help delegates decide which sessions they should attend as part of their professional development. L FURTHER INFORMATION

Allowing staff to safely use smart devices in the clinical environment Medical teams are more mobile, and patients are better connected with home, than ever before. The iPad is now the dominant leader in tablet technology; however, it presents challenges in a healthcare environment. Apple stipulates that iPads can only be cleaned with a lint cloth. Healthcare teams need the freedom to use harsh infection control chemicals and up to now there has not been an iPad case that could withstand this level of cleaning. The FlipPad solves this problem. The FlipPad is a medical grade case compatible with the iPad Air 2 and iPad Pro 9.7”, and is cleanable with harsh infection control chemicals. Featuring an antimicrobial, scratch-resistant glass screen and FDA approved materials; the FlipPad can be used by clinicians and patients alike

knowing their device can be easily disinfected. The FlipPad has a drop and water resistant design to allow for the inevitable knocks, falls and spills in a healthcare environment. The FlipPad is a practical solution for busy clinicians on the move. The hypersensitive screen works with any surgical gloves and is easy to hold for long periods. To find out more about sensible and sensitive device protection for healthcare, please visit the website. FURTHER INFORMATION Tel: 0330 124 1999



Case Study


allmanhall draws on its expertise and understanding of supply chains to inspire better food procurement allmanhall’s goal is to inspire improvement for clients’ procurement of food and beverages, cleaning materials and catering equipment. This is broken down into seven clear objectives: lower costs; greater added value; security of supply; reduced supply risk; improved quality; increased process efficiency; and finally, insight and innovation. allmanhall work alongside the existing catering and facilities teams, with a fully integrated procurement solution driven by four areas. The company ensures procurement value with the negotiation skills of experienced buyers, coupled with leveraged purchase volumes, resulting in cost-savings and profit improvement.  For clients, allmanhall undertake: cost negotiation with suppliers on products and logistics; menu development and range management; contract management of nominated suppliers; new product innovations; demand management; and e-auctions. It carries out procurement control, with its industry-leading, end-to-end cost management platform, which delivers efficiencies and control. Clients benefit from being able to track and manage every penny of spend.



Key functionality includes: full EDI integration (e-ordering and invoicing); stock take; recipe and menu management (costing and nutritional); cost centre transfers; bookwork; reporting; and EPoS / cashless integrations. allmanhall also offer a central billing function through outsourced purchase ledger management. Commenting on allmanhall’s usefulness, Hilary Garrison, senior catering manager at Ampleforth Abbey & College, said: “In addition to cost savings, Ampleforth also benefits from allmanhall in a number of ways, such as vetting suppliers and dealing with issues, sourcing new equipment, constant information updates… and allows us to monitor and control costs more effectively.” allmanhall offers procurement support where clients are aided by a dedicated, experienced

and knowledgeable support team. The result? Quick and effective resolution of supply challenges. The company also delivers procurement insight, using expert insight regarding market trends and forecasts, allmanhall make predictions. This helps negotiations and innovations, alike. allmanhall has close working relationships with various third party food and cleaning accreditation standards. It closely monitors any changes in such standards and is well equipped to provide expertise regarding the sourcing of sustainable products. Mark Vernon, general services manager at St Paul’s Girl School, said: “We believe that we are at the forefront of catering services and this is in no small part down to the support we receive from allmanhall.” In addition to this procurement expertise, allmanhall’s consultancy arm ‘avisso’ advise on improvements to catering operations. Why not explore the improvement allmanhall could help inspire for your organisation? FURTHER INFORMATION Tel: 01225 745 520




Obesity – very expensive and expansive

Obesity is a growing problem in most developed countries and is responsible for a significant degree of morbidity and mortality in the Western world. More than 2.1 billion people – nearly 30 per cent of the global population – are overweight or obese. Obesity, is responsible for about five per cent of all deaths worldwide. The McKinsey Global Institute report, Overcoming obesity: An initial economic analysis found the global economic impact from obesity is roughly $2.0 trillion, or 2.8 per cent of global GDP, which is roughly equivalent to the global impact from smoking or armed violence, war, and terrorism. The UK has the highest rates of obesity in Europe. Although this recent increase in the prevalence of obesity has been seen in virtually every country in the world, the rate of increase in England has been particularly high. The prevalence in England has more than doubled in the last twenty five years, with results for 2013 showing that around 62.1 per cent of adults were overweight or obese (67.1 per cent of men and 57.2 per cent of women). The Health Survey for England data also showed that between 1993 and 2013, the prevalence of severe obesity (defined as adults with a body mass index [BMI] of 40kg/m² or more) increased dramatically. The proportion of people with severe obesity in England is predicted to rise further over the next 20 to 30 years. According to the Foresight Report, by 2050 the prevalence of obesity is predicted to affect 60 per cent of adult men, 50 per cent of adult women and

The NHS currently spends about £6 billion a year on the direct medical costs of food has. We’re being conditions related to bombarded every day being overweight by the food industry to consume more and more or obese food. In the UK, there has

25 per cent of children. According to the McKinsey report, obesity currently costs Britain’s economy £47 billion a year. It also estimated that the NHS currently spends about £6 billion a year on the direct medical costs of conditions related to being overweight or obese, five per cent of the entire NHS budget, and a further £10 billion on diabetes. It is forecast that the cost to the NHS will increase to almost £50 billion by 2050, prompting the 2011 Department of Health policy ‘A call to action on obesity in England’.

SOCIETAL FACTORS Conventional wisdom says that weight gain or loss is based on the energy balance model of ‘calories in, calories out’, which is often reduced to the simple refrain, ‘eat less, and exercise more’. However, there are many complex behavioural and societal factors that combine to contribute to the causes of obesity. The foresight report referred to a ‘complex web of societal and biological factors that have, in recent decades, exposed our inherent human vulnerability to weight gain’. They list over 100 variables that directly or indirectly influence energy balance which can be cut into seven cross‑cutting predominant themes. Professor Jimmy Bell, obesity specialist at Imperial College, London, said: “Genetically, human beings haven’t changed, but our environment and our access to cheap

Written by Lucy Turnbull, British Dietetic Association

The obesity crisis facing Britain is a growing concern. Lucy Turnbull, of the British Dietetic Association, examines how hospitals and dietitians can best manage the issue

been a steady spread of fast food chains and cheap unhealthy food.” While unhealthy diets and lack of appropriate physical activity are also considered leading causes, some experts argue that this is not the case. Professor Bell, continues, contrary to popular belief, that the people of the United Kingdom have not become greedier or less active in recent years. One thing that has changed is the type of food that we eat. Western diets rely more on highly processed foods high in fat and sugar and this may be leading to an increase in obesity. AN OBESITY CONDITION There are also a number of genetic, medical and psychological factors that may play a part in the nation’s culture of obesity. Medical conditions such as diabetes, hypothyroidism, polycystic ovary syndrome and various endocrine disorders can be contributing factors to weight gain. Medicines such as anti-psychotics, anti-depressants, corticosteroids and contraceptives are also examples of a long list of medications that can contribute to weight gain. Attention must always be given to psychological causes including binge eating and comfort eating; a complex psychological issue in its own right. The prevalence of E





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OBESITY  obesity appears to be higher where there is deprivation and in individuals with lower levels of educational achievement. There is increasing awareness of an element of genetic influence on obesity. The possibility of determining this opens the potential of effective interventions in the future. It is emerging that obesity is the result of a complex pathophysiological pathway involving many factors that control adipose tissue metabolism. Cytokines, free fatty acids and insulin all play a part and genetic defects are likely to have a significant effect on the fine balance of this process. REVERSING THE PROBLEM So what can we do to slow down or reverse this crisis? Over recent years the UK has taken measures in an attempt to tackle its obesity problem. It ideally involves joined up working between health and social care. Unfortunately, the treatment and care is not consistent across the UK with some areas having these services in place with others having very little obesity care. This can be split into four tiers. Tier 1 involves environmental and population wide services, and includes public health initiatives such as the change4life campaign. The government also used the London 2012 Summer Olympics to help tackle obesity and inspire people into a healthy active lifestyle. A £30 million grant was issued to build cycle paths, playgrounds and encourage children to cut out snacks. There are also public health campaigns by charities such as the British Heart Foundation and the Children’s Food Campaign to remove unhealthy food from supermarket checkouts. These are just a couple of examples of many public health campaigns to help prevent obesity, however, the UK spends less than £638 million a year on obesity prevention programmes, (approximately one per cent of the country’s social cost of obesity). The Tier 2 model involves lifestyle interventions, such as commercial slimming clubs, local activity and nutrition programmes. These should include dietitians or qualified nutrition professionals to ensure the correct evidence based advice is being given. Dietitians are trained to translate nutrition science into understandable, practical information about food, allowing people to make appropriate lifestyle and food choices. Dietitians are governed by the HealthCare Professionals Council (HCPC) to ensure that the advice they give is safe and evidenced based. Tier 3 weight management involves non‑surgical specialist weight management services. This is a multi-disciplinary, intensive service that includes dietetics, psychology, specialist physical activity advisors and medical input. The Tier 3 services are usually offered to those with a BMI >40kg/m² (or BMI >35kg/m² with co-morbidities). In April 2013 the NHS Commissioning

Board published guidelines that stated that all bariatric surgery candidates must in the first instance access a local Tier 3 service for a period of 12 to 24 months. Tier 4 usually refers to bariatric (or weight loss) surgery, such as gastric band, sleeve or bypass. Bariatric surgery is a highly specialised intervention used in appropriate, selected patients with severe and complex obesity that have not responded to all other non-invasive therapies. Patients need to be motivated and adequately prepared for surgery and for the post-surgical treatment and monitoring which is necessary for success. Currently bariatric surgery costs the NHS approximately £6,000 per surgery. RESTRUCTURING CONTEXT No single solution creates sufficient impact to reverse obesity. Education and personal responsibility are critical elements of any program to reduce obesity, but they are not enough on their own – only a comprehensive, systemic programme of multiple interventions is likely to be effective. These include: national and local governments; retailers; consumer-goods companies; restaurants; employers; media organisations; educators; health-care providers; and individuals. Restructuring the context that shapes physical activity and nutritional behaviour is also going to be a vital part of reversing the obesity trend. Thus, public health strategies such as town planning, convenience store planning, school food and exercise programmes and good information campaigns are needed. Other identified examples include reducing portion sizes of packaged foods and fast food, changing marketing practices, and changing physical activity curricula in schools. Such interventions rely less on individual willpower, but make healthy lifestyles easier to achieve. The National Obesity Observatory was set up in an effort to collate the research information and to provide a single point



of contact for wide-ranging authoritative information on data and evidence relating to obesity, overweight, underweight and their causes, in order to support policy makers. A FUTURE ACTION PLAN In 2013 doctors of the United Kingdom united to form what they call a ‘prescription’ for the UK’s obesity epidemic. The report presents an action plan for future campaigning activity, setting out 10 recommendations for healthcare professionals, local and national government, industry and schools which it believes will help tackle the nation’s obesity crisis. Recommendations include: food-based standards to be mandatory in all UK hospitals; a ban on new fast food outlets being located close to schools and colleges; a duty on all sugary soft drinks, increasing the price by at least 20 per cent, to be piloted; traffic light food labelling to include calorie information for children and adolescents – with visible calorie indicators for restaurants, especially fast food outlets; £100 million in each of the next three years to be spent on increasing provision of weight management services across the country; a ban on advertising of foods high in saturated fats, sugar and salt before 9pm; and existing mandatory food – and nutrient-based standards in England to be statutory in free schools and academies. The McKinsey report concludes that additional interventions need to rely less on conscious choices by individuals and individual responsibility, and more on changes to the environment and societal norms. These interventions reset the default and make healthy behaviour easier and more normal. It reports that ‘as many interventions as possible must be delivered to have significant impact. A holistic approach by the public, private, and third sectors is the best way forward’. L FURTHER INFORMATION

‘As many interventions as possible must be delivered to have a significant impact. A holistic approach by the public, private, and third sectors is the best way forward’


Customer Service


Guiding the customer towards a positive patient experience Customer services in hospitals are changing to keep apace with technology advancements. Health Business examines the role of customer contact to enhance the hospital experience for patients and visitors amid the growth of self-service There is quite regularly, and correctly, a push to enhance the patient experience in our hospitals. Much of this is achieved through appropriate patient care, provided in the first instance by the patient’s nurses and doctors, with an aim to put the patient experience at the heart of the NHS. But customer services reach much further than patient experience – it is the platform which links those with knowledge working inside the hospital with those seeking assurance and answers. There is no escaping the fact that caring for patients makes serious physical and emotional demands on hospital staff. Vulnerable and worried patients seek to be more informed, while their conditions and needs become more complex, and an increased workload and schedule can often spiral the situation beyond an easy fix. Staff are not always on hand to offer immediate reassurance, nor can they be expected to dedicate time to assist a patient when they are already overburdened with a heavy workload. Self-service offers a platform on which to provide information without wasting staff time that is better used elsewhere. Contact



details, booking technology, maps and basic information and advice can all be displayed without the need for human interaction. SELF-SERVICE Self-service is everywhere. Supermarkets and most high street shops have a selfservice check-out option alongside a manned till, while buying train tickets or checking in at the airport involves less human interaction than ever. Having become a normal activity for people going about their business on a daily basis, it is no surprise that hospitals are beginning to implement self-service machines more prominently and with more trust. The popularity of self-service – that being speed and convenience – are desirable in a

healthcare setting. Appropriately placed kiosks at hospital receptions and waiting rooms allow patients to quickly and easily check-in for their appointment, meaning queues are cut and staff are able to concentrate their time and assistance elsewhere. Speaking in 2013, Phil Taylor, acting directorate manager at The Royal Manchester Children’s Hospital, commented on the use of self check-in kiosks in their children’s outpatient department: “The big difference for us has been that the patient and family experience has been much improved. We no longer have queues and we are managing the patient flow in a much more efficient manner, which ultimately means that the quality of the visitors’ experience is much better.” Similar to the idea of a hospital reception desk, first impressions carry a lot of weight and can have a large impact on the patient experience and the mood they adopt for

vice Self-serlatform p offers a to provide h on whictient with a pa n without tio informa g staff time wastin etter spent b that is ewhere els

the remainder of their visit. Therefore, any self-service check-in/out kiosk must be welcoming, easy to find, easy to use and instructive. If they are too difficult to use, then a patient may become stressed, enter information wrong, direct themselves towards an incorrect destination or cause queues. Simplicity is often key – a self-service screen should be uncluttered and clear. The location of the self-service machine is also important. When a patient enters the hospital there are many factors that can lead them to walk in the wrong direction or cause obstruction and confusion. The patient may be on their first visit to the hospital, and will therefore be unaware of their surrounding, with children, which may distract them, or in a state of disorientation, due to their illness or nerves. All three situations are likely to lead to a patient walking into the building and heading straight to the reception desk with an employee sitting behind it. Hence, to ensure that the patient sees and chooses to use the kiosk, it needs to be positioned where it can be easily spotted from a main department entrance and accessible without obstruction. CASE STUDY The Walton Centre NHS Foundation Trust operated a ticketing system with a manned reception which led to complications

Having become a normal activity for people going about their business on a daily basis, it is no surprise that hospitals are beginning to implement self-service machines more prominently and with more trust with patients unable to book their next appointment and confusion leaving patients returning to the wrong waiting room. Estimated waiting times were inaccurate and re-scheduling became an impossible task. Benefiting from the Safer Hospitals Safer Wards Fund, the centre installed three selfservice check-in kiosks and large display screens. Patients are now able to check themselves into the clinic using a scanner that reads appointment letters, while the display screens showcase up-to-date waiting times and appointments where consultants are running late. Barcode scanning can enable a patient to skip five screens were information would otherwise need to be entered manually. Barcodes are unique to each appointment, so the correct appointment letter is required. Julie Thompson, assistant divisional general manager at The Walton Centre, said: “In our first year, 88 per cent of outpatients used self check-in kiosks. The waiting

Customer Service


room now has a relaxed environment and reception and nursing staff spend more time dedicated to patient support and care.” Chris Harrop, chief executive, added: “We welcome patients the best way we can and try to minimise the street from hospital appointments. Our self check-in system is quick and easy to use and a dedicated member of staff is always on hand. Patient feedback has been incredibly positive.” THE PROBLEMS OF SELF-SERVICE It was reported in April this year that Hull and East Yorkshire Hospitals were reconsidering their use of self‑service check-in kiosks after patients were faking symptoms to jump the queue. The system, put in place in 2012, was intended to allow the most urgent cases to be seen quickly, and save staff time. However, patients were found to be entering their own symptoms in an attempt to be seen earlier. L

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93 | Hall 5 | NEC | Birmingham | 21-22 September 2016 | | Hall 5 | NEC | Birmingham | 21-22 September 2016 | | Hall

Bringing the Emergency Services together to improve public safety A unique event for everyone who works in the emergency services Visitors from the Fire & Rescue service are invited to • Network with like-minded emergency staff • Source new kit and save money • Meet the market leaders in emergency services products • Get updated on collaboration and multi-agency plans • Learn about #fireasahealthasset at the new Home Safety 2016 event • Gain CPD points from our free College of Paramedics workshops • Learn from past incidents at the free seminars • Get up to speed on UAV technology in the Drone Zone • Watch live water rescue demo's Free entry and free parking - register at today!

ESS - the only show for the entire spectrum of the Emergency Services

Show supporters and sponsors include COLLEGE OF

paramedics leading the development of the paramedic profession


Emergency emphasis on education and innovation

Emergency Services Show


The Emergency Services Show returns to the NEC, Birmingham from 21-22 September 2016. Health Business previews what delegates can expect to see from their visit This year’s event will include a new CPD‑accredited Trauma Care Training & Education Zone, as well as an area dedicated to home safety featuring case studies from fire and rescue services that have expanded their preventative work into health. Around the exhibition there will be numerous opportunities to try out new equipment and network with the emergency services, first responders, voluntary organisations and NGOs. The popular College of Paramedics CPD area has also been expanded to allow for more participants. TRAUMA CARE & EDUCATION ZONE Comprising CPD skills stations and a training suite where teams will compete to perform a primary survey, the interactive Trauma Care & Education Zone is open to anyone involved in pre-hospital care, with any skill level. Elsewhere in the Education Zone, visitors can take advantage of free CPD skills stations to earn CPD certificates. Designed to be completed as a circuit, the four 20-minute skills stations will cover airway management, haemorrhage control, splinting and immobilisation and burns. COLLEGE OF PARAMEDICS CPD AREA The College of Paramedics’ CPD area has been expanded to enable more delegates to participate in the 30-minute, bite-sized workshops covering breech birth, elderly patients, positive mental health, sepsis in obstetrics and seizure management. Speakers include: Aimee Yarrington, education and training officer, West Midlands Ambulance Service; Richard Steggall, clinical supervisor (specialist

paramedic), South West Ambulance Service; Martin Berry, teaching fellow, Oxford Brookes University; and Will Broughton, honorary paramedic, Paediatric Emergency Department, Imperial College Healthcare NHS Trust. No pre‑booking is required and all those attending will be provided with CPD certificates. THE LEARNING ZONE THEATRE New for 2016, The Learning Zone Theatre at the Emergency Services Show features a free two-day seminar programme curated and inspired by JESIP and the National Operational Guidance Programme for the Fire & Rescue Service. Sessions will review the multi‑agency responses to recent incidents, identify the operational challenges and capture positive learning. A number of exhibitors will be available to speak to visitors about collaborative projects. London Fire Brigade, for example, will be showcasing the results of Exercise Unified Response, a large scale and complex, live and command post exercise, which was held earlier this year, based on a significant building collapse, incorporating heavy transport and mass casualties. All of London’s emergency response organisations, including local and national authorities, were involved along with specialised teams from across the UK and from Hungary, Italy and Cyprus.

EXHIBITION: ONE-STOP SHOP Over 450 exhibiting companies and organisations will be showcasing the latest solutions in communications, emergency medical care, protective clothing and uniforms, training and outsourcing. Companies exhibiting vehicles and vehicle equipment for the ambulance sector will include: Baus; O+H; Terberg DTS; Cartwright; Volvo; Allied Fleet; BMW; Mercedes-Benz; and Ferno. New exhibitors include Bariquins which will be exhibiting its bariatric training mannequins for the first time in the UK, and Defib Store which manufactures outdoor defibrillator cabinets and works closely with the ambulance services. Private ambulance company Salop Medical Services will also be exhibiting for the first time.

Lond Fire Bri on gad will be showcae sing the re E x e rc i s s u l t s o f Respon e Unified NETWORKING was he se, which ld earlie Around the show r there will be valuable this yea r opportunities to network

with blue and amber light services, which are increasingly working together in emergency situations. Over 80 secondary responders, voluntary sector partners and NGOs will feature in The Collaboration Zone. Key associations including BASICS, the Independent Ambulance Association, Association of Air Ambulances and Ambulance Services Institute will all be represented. Consensus Day on Crush and Suspension The Faculty of Pre-Hospital Care will be holding a Consensus Day at The Emergency Services Show covering Crush and Suspension Injuries. Open to pre-hospital care providers of any level, the meeting will be held on Wednesday 21 September. L

Getting to the Emergency Services Show The NEC is linked to Birmingham International Station and Birmingham Airport and is directly accessible from the UK motorway network. Parking and entry to the exhibition and seminars at The Emergency Services Show are free. FURTHER INFORMATION






Advertisement Feature


Community services have long been hailed as the knight in shining armour that can transform NHS care In line with widespread Public Health initiatives aimed at shifting emphasis away from emergency care and towards disease prevention, community services can play a significant part in transforming patient/NHS engagement to alleviate the burden on critical NHS resources. In the age of the smartphone, technology is providing a powerful stimulus to enhance communication across the health and social care system. Increasingly, the NHS workforce is being empowered by innovative mobile technologies that are enabling health care professionals (HCPs) to become more responsive, informed and agile in community settings. The effective use of mobile tools is helping trusts to collect more information across a multitude of locations, unlock best practice tariff funding, reduce administrative overheads, improve productivity and increase time spent with patients. Over the last few years, some elements of care for diabetes patients have started to move from traditional hospital based specialist units out to the community. Patients are increasingly being seen at home by community diabetes specialist nurses (DSNs) and GPs with a special interest (GPwSIs). APPROPRIATE CARE Appropriate care in the community offers a significant improvement in the patient experience, and reduces appointments and admissions in the specialist units. It does though, raise a challenge in how

HCPs access and update patient records when away from the hospital network. At present, one approach is for nurses and doctors to manually make paper-based notes on the information they are collating during visits, which is subsequently typed into the diabetes management system when they next have a secure connection. This process not only duplicates effort but also opens up the risk of transcription errors. Moreover, patient records need to be printed and then referred to whilst the HCP is with the patient, which is neither secure nor in line with the drive by the NHS to become paperless.   Alternatively, HCPs may use a combination of a laptop connected to the mobile data network often using potentially fiddly PIN generating devices, which leave the user subject to the vagaries of mobile phone reception and can be frustratingly slow or unreliable.   In response to this situation and based on over 20 years of working with diabetes professionals, Hicom is soon to release its new Community Module. This new innovation will enable DSNs and GPwSis to truly take care out into the community, while still being able to utilise the information stored in Diamond and Twinkle, Hicom’s adult and paediatric diabetes software solutions, and without breaking the security needed when taking data out of the hospital network. The technology to bolster community services that straddle both health and secondary care is now well-established. A proliferation of digital and mobile media has

enabled multi-channel communication across multiple devices and platforms – allowing the mobile workforce instant and reliable access to vital information to support clinical decisions. Hicom strives to remain at the forefront of this innovation by modernising the approach to community-based services for diabetes patients and supporting the NHS in providing more efficient, effective and joined-up services. TECHNOLOGY Technology is playing a valuable role in providing liaison, support and indeed care outside of hospitals and specialist units. No longer will HCPs need to make manual notes when they are with patients and then spend additional time typing these up, as of the all data they collect will be automatically synchronised back into Diamond or Twinkle when a suitable and secure connection is available. STRONG COMMUNITY SERVICES Strong community services are a vital component of an effective model of integrated health and social care and Hicom will be launching its Community Module at this year’s Diabetes Professional Care on 16-17 November at Olympia in London. If you are a diabetes care professional and would like to know more about the module and about working with a diabetes solution provider, Hicom will be at stand G12. L FURTHER INFORMATION



Parking Written by the British Parking Association




Raising standards in parking management The British Parking Association share the experiences of Keith Fowler, head of facilities services at Northern Lincolnshire and Goole NHS Foundation Trust, who were one of the first recipients of the Professionalism in Parking Accreditation for high standard parking in a hospital setting The British Parking Association (BPA) is dedicated to making parking a recognised profession and raising standards in parking management and operations. The Professionalism in Parking Accreditation (PiPA) is an accreditation programme supported by the Department of Health and is now available for organisations to work towards, focusing on 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. The BPA has launched 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, 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, and improve the reputation of NHS trusts and other healthcare providers, helping to counteract adverse publicity in the media. PiPA builds upon the BPA’s voluntary

Healthcare Parking Charter, developed by the BPA in conjunction with other stakeholders, and will enable hospitals to work towards a nationally accredited standard for their parking services. CHARGING FOR PARKING When parking charges were abolished in hospitals in Scotland and Wales, patient accessibility didn’t improve; instead nearly all the spaces were taken up by commuters and staff to the detriment of visitors and patients. And because demand isn’t managed properly it spilled onto yellow lines, grass verges and nearby residential streets. In some cases, bus companies actually refused to offer a service because they couldn’t get through. So it seemed like a good idea, but those that relied on public transport, those very people that MPs champion for, ended up the hardest hit. In reality, there’s no such thing as a free parking place – somebody is paying for it. This is true everywhere: in town centres, at the beach, in the countryside and at the hospital. Like most NHS medical services, some car parks may be free at the point of use but someone, somewhere is paying for their upkeep and maintenance. If they are patrolled to keep them safe someone is paying for that too. Your so-called free parking is always paid for – by someone else. Is that fair? The BPA believes it is wrong that healthcare budgets should be used to provide parking facilities for those who choose to drive to  hospital. Additionally, is free parking fair on those who arrive by public transport and continue to pay? We

strongly believe that healthcare budgets be used to provide healthcare and that car‑borne visitors should pay for this service. We also believe there should be exceptions where long term or vulnerable patients should receive discounted or free parking. PARKING IN A HOSPITAL SETTING The BPA’s Healthcare Parking Special Interest Group allows for the sharing of knowledge and best practice, as well as allowing campaigning for better recognition of the services provided and the need for them to be properly funded. Keith Fowler is chair of the group and head of facilities services at Northern Lincolnshire and Goole NHS Foundation Trust, one of the first recipients of PiPA, and recognises the importance of delivering a high standard of parking in an acute hospital setting. He said: “A year has now passed in my role as chair of the BPA’s Healthcare Parking Special Interest Group (SIG) where I am also elected to serve on the BPA Council of Representatives to ensure that the views and concerns of members from NHS trusts are put forward. “The group was formed almost five years ago to be a focal point for members of the BPA who are involved in managing parking at healthcare sites. The group meets three times per year at different locations around the UK, providing valuable opportunities for learning, sharing good practice and networking. “Managing parking alone can be immensely challenging and at times rather contentious, even more so at hospitals, with space at a premium and sensitivity to the nature of environment bringing some unique issues. The priority for car parking staff is to ensure that access and egress routes are clear enabling emergency access, but to also keep traffic flowing, ensuring it is appropriately directed and managing parking according to the designation of area. Car park staff and the facilities are invariably the first experience patients and visitors have of the organisation, and it is important that initial interaction is positive. My team have experienced a variety of situations, and the unexpected is

NHS trusts r e and othare healthc work rs provide to deliver ly tireless timal level an op linical of c care

often a regular occurrence. The staff must have an exceptional level of site knowledge, access routes to wards and departments with clear understanding of support options to reach an appointment on time. In an age where automation of services is increasing, the day of switchboard staff being the focal point of knowledge is slowing moving to the car parking teams on the ground. “Parking is always at a premium, and initiatives such as park and ride schemes with local authorities and transport providers is often a positive step in allocating visitors to the most appropriate choices, single occupancy journeys create unwanted demand and fore warning visitors is essential for a smooth days parking. Staff parking is often a cause of anxiety with colleagues wishing to park on site and arrive at work, on time. The juggling of priorities is therefore a skill the parking officer must apply to decisions made. Clinical services cannot be delayed, but patients must be ready at stated times for appointments. As important as initiatives such as park and ride are in allowing planned visiting to alleviate site demand, so too must the parking of staff working regular office hours, with minimal clinical input be considered for alternative options to reduce pressure. “These clashes of priority mean that a robust policy for parking must be in place applying an overall approach to

the management of parking facilities, traffic management and enforcement. Organisations and parking managers have a responsibility to ensure what facilities are available, are open to those that require them most to reduce operational pressures of parking with effective management plans, infrastructure and resource. The parking service that allocates sensibly to essential users, provides usable options in partnership frameworks for operational and planned activity will certainly be working towards better parking services, with the parking officer at the coal face enabling the sound plans of parking policy are played out. “As chair, one of my aims is to put the ‘positive into parking’ within healthcare. I’ve found the topic of parking is often met with a fairly dour response within the NHS, but from my own experiences here at Northern Lincolnshire and Goole this doesn’t have to be the case. I firmly believe if you can get your parking policy right then good things follow. See parking as a service rather than a burden, strive for excellence and go the extra mile. Your customers will notice the difference and in turn you may find your attitude and approach to parking management changes.” L FURTHER INFORMATION



Healthcare parking survey “PiPA is just one example of the kind of projects the special interest group get involved in. Plans are also well underway for a comprehensive national benchmarking survey to enable trusts to measure their services and performance way beyond the basic parking information gathered in current ERIC data. “The BPA’s Healthcare Parking Special Interest Group is usually for BPA members only, but I would like to extend an open invitation to all NHS trusts to come along and find out more about our work. There is no charge for attendance at this event. If you would like to attend please e-mail Alison Tooze at the BPA ( If you would just like to know a bit more about the group and my role within the BPA please do get in touch via email on”

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Are you having problems with false fire alarms? At least 50% of all Fire Service call outs are false alarms, resulting in a potential loss of millions of pounds to health organisations, with thousands of hours lost in staff time.

Protect your fire system from malicious and acccidental abuse with the Sigma SMART GUARD The Smart+Guard is a tough polycarbonate hinged protective cover that can easily be installed over a range of emergency switches and other devices to provide protection from vandalism, accidental damage or misuse.



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With increasing demand and yet evermore cuts, the UK health sector is facing unprecedented pressure. tabs® is a multi-award winning, end to end smart recruitment and deployment solution that will slash health sector recruitment budgets, even negate the need to costly agency spend, delivering savings in the millions. tabs® is already on the G-Cloud 7 government portal, highlighting its effectiveness and credibility. tabs® not only delivers savings, but increases agility and response times, helping frontline services respond to demand in real time. It’s entirely customisable to individual and departmental needs, but features such services as: send multiple jobs alerts and push notifications in just a few clicks; geo-location search for real time availability; 24/7 issuing of live job or shift requests and assignments; fully automated booking, rostering,

If you are looking for low energy light solutions then you have come to the right place. Prime LED has a wide range of LED products to help you cut your energy bills down to size. Whether you are looking to replace a few or a complete full LED lighting upgrade they can help. Prime LED specialise in office and clinical lighting for small and large commercial buildings, outdoor lighting and emergency lighting. With great value LED products from reliable quality brands like Energizer, Epistar and Bridgelux that will give you a very long maintenance free service life as well as a three or five year warranty. Their LED products consume up to 90 per cent less energy in comparison to conventional lighting and 60-70 per cent against florescent lighting. Prime LED sell Energizer LED tube lights that can be easily retrofitted into your existing

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acceptance, timesheet sign off and approval; client billing, freelancer invoicing and payroll management; submission, verification and approval of compliance documents; evaluation tools to rate temporary staff or contractors; deploys workforce across multiple sites - locally, regionally and nationally; provides route and travel planners; and social media integration across all channels to encourage candidate registration. Visit the website to find out how tabs® will revolutionise your recruitment and deployment. FURTHER INFORMATION

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Coordinate My Care (CMC) is a clinical NHS service that supports patients in urgent care situations. Together with their clinicians, patients can record their preferences and wishes within an electronic urgent care plan that also includes clinical information and relevant medical history. This care plan can be viewed by all the healthcare professional teams involved in the patient’s care including emergency services, NHS 111 and out of hours providers 24/7, and ensures that the patient is at the heart of their own healthcare. The service is currently commissioned across London and over 28,000 urgent care plans have been created. CMC is the first ‘virtual’ multidisciplinary digital urgent care plan across acute and community settings and connects all clinicians around the patient in real time.

Commissioned by NHS England, a revolutionary new smartphone app - myGP™ - developed by London based health tech specialist iPLATO has launched for GP practices, to help speed up access to care by allowing patients to securely book and/ or cancel appointments remotely on their smartphone. Remote patient registration to myGP takes a few seconds with no effort from the practice team. myGP which works on iPhone and Android devices will improve patient outcomes, by enabling GP practices to automate data collection such as smoking status, streamline call and recall, improve adherence and access to medication and support self care through digital care plans. One of the key benefits of myGP is that it simplifies the registration process to access digital patient services. Patients register remotely using their date of birth and mobile number registered with the GP practice.

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light fittings, saving time, fitting disruption and expense. The vast saving on your electric bills allows more business funds to be spent on the things that really matter to your organisation as well as reducing your carbon foot print. You can purchase directly from the Prime LED website or call for an energy assessment. FURTHER INFORMATION Tel: 0121 7836146

An NHS clinical service that myGP: transforming supports 24/7 patient care patient access to care

The service is also accessible via EMIS Web, the main GP system provider in London. What this means for CMC users is that within EMIS Web, they can create, edit and approve a CMC care plan for patients avoiding double data entry and logging in to two separate systems. Work is also underway for a patient portal where people can start creating their own urgent care plans in the future. For more information please visit the website, or call to speak to an adviser. FURTHER INFORMATION Tel: 020 7811 8513

Following a quick authentication process, they are ‘ready to go’ with functionality including secure ‘WhatsApp-like’ practicepatient messaging, appointment booking and cancellation, medication reminders and self care support tools to monitor weight and blood pressure. Initial response and uptake of myGP has been very positive with patients eager to try out the new service to obtain faster access to care, 24/7 – in some cases adding over 25 per cent of target patients to digital services within a few days of operation.  FURTHER INFORMATION Tel: 020 3178 4675



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NCE Computer Group (Europe) is one of the leading independent providers of supply chain and data centre services with over 30 years of industry experience in field service, technical support, repair and engineering solutions and parts supply services across the globe. NCE provides a full range of Data Destruction Services to meet customers’ requirements and help them to comply with the new regulations. There are a number of options available depending on the type of data and the customers’ personal needs, all of them delivered to the highest standards. The company provides both off-site and secure mobile on-site data wiping and shredding, where all media types can be physically destroyed. Alternatively your data can be removed while leaving the media ready to be used again. NCE is dedicated to tailoring

In healthcare reliable communication tools are vital – two way radio and applications from DCRS can assist, allowing you to manage incidents and emergencies, and prevent security breaches from happening by offering safety for all levels of workers in your establishment. DCRS can also raise the standards of patient care and reduce stress for all teams involved. For added security, solutions and applications can be added to your two way radio systems to allow seamless communication, connecting: Nurse Call Systems; panic buttons; tracking solutions; BMS; alarms; lifts; phone and paging; and email. DCRS will give you both audible and silent communication alerts to ensure maximum efficiency and 100 per cent safety for staff and patients. DCRS offer a full portfolio from various manufacturers such as: Motorola, Hytera, eVerge, Kenwood and Icom. The

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services that meet and exceed customer expectations for both supply chain and data centre services. The company continually adapts to incorporate best-of-breed technology into the solutions and services it architects for its customer base that includes a wide variety of businesses in numerous vertical markets. Selecting from the full range best-in-breed software and hardware products available, NCE has the skills and experience to deliver a solution that is perfectly tuned for the customers’ individual needs and demands. FURTHER INFORMATION Tel: 01249 813666

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company can assist with any new, or existing radios fleets/ systems in place. It offers a full no-obligation test and trial service so you can ensure you only buy once, and make sure that the equipment is suitable for your environment.  As a service provider it has the ability to tailor a solution to meet your exact requirements, giving you options. For more information please visit the website, or call to speak to an adviser. FURTHER INFORMATION Tel: 0800 043 2688


The publishers accept no responsibility for errors or omissions in this free service 2T Security 86 Aerogen 16 AGFA Healthcare 56 Allman Hall 88 Apira 38 Ascom IFC Bariquins 86 Besa Publications 69, 84 Birchwood Price 86 Bodypower 58, 59 Broden Media 94 Brother 14 Carecheck 18 CCube Solutions 48 Citroen 12, 13 Coordinate My Care 101 D + B Facades 60, 64 Danfloor 64 Datix 10 DCRS 70, 102 DDC Dolphin 84, 87 Doyle & Tratt 79 ECA 54 Evac Chair 100 Fairtrade Vending 90



Fitwise Management 85, 87 Flexim Instruments 67 Futurenova 84, 87 Getac 50 GHX Europe 36 Global ilabs 101 GovNet 42, 43, 45 Healthcare Publishing & Events 96 Healthier Recruitment 22 Heatrae Sadia 62, 73 Hicom 97 Hospedia IBC IMAGEholders 93 Informa Sciences Exhibitions 76 Intersystems 74 iPLATO 101 ISS Mediclean 8 Kingsway Group 68 Kuntze Instruments 72 Maldaba 41 Maquet 66, 73 MedicaNet 80 Medicat 22 Metric Group 99 Monarch Acoustics 46

NCE Computer Group 102 Olympus Keymed BC, 47 Omnicell 32 PHS Group 52 Physical Company 59 Prestige Recruitment 20 Prime LED 101 Q-Nomy 44 Ruskin Air Management 70 S&B Herba Foods 90 Sample Answers 53 Seat 4 Sonosite 28 Step Exhibitions 61,63 TEAL Patents 65 The Water Solutions Group 71 Thermarestor 72 Torchwood Technologies 34 University of Strathclyde 90 Whitecroft Lighting 68, 73 Wilo 26 Winkworth Farm 90 Wireframe Immersive 73 Yeoman Shield 6


New Point of Care Solution transforms Vital Signs Capture and Nursing Assessments in Hospitals A new Observation Capture solution, which allows the electronic recording of vital signs, nursing assessments and associated care plans at the point of care, has recently been launched by Hospedia. Using a handheld tablet device, smart phone, COWS or the Hospedia bedside terminal, clinical staff can now easily record patient observations, helping to recognise, escalate and alert medical staff to deteriorating patients in a more effective and timely way, in line with recommendations from National Guidelines. The bi-directional data feeds also means that it updates the ExtraMed Patient Flow System in real time. This new addition to the already proven Clinical Solutions range from Hospedia not only provides greater efficiency, but also improves accuracy in monitoring and recording. The system also caters for the provision of unlimited assessments and associated care plans, delivering greater Patient Flow integration and increased management and oversight.

To find out more about how this could transform your current hospital processes, visit or contact for a without obligation demonstration

HOSPITAL BENEFITS  National Early Warning Scores are calculated automatically reducing the risk of errors and improving patient outcomes  The automated highlighting of deteriorating patients to ward staff, supports early intervention  At a glance prompts and task lists improves compliance with clinical standards  The ability for hospitals to define their own assessments  Flexible and fully future-proof  Full audit trail and charting of results

GUARANTEED PERFORMANCE SOLUTIONS Service provision and capital product options Olympus has developed Guaranteed Performance Solutions, a new service in response to the changing health service landscape, to improve patient outcomes through efficiency gains. Guaranteed Performance Solutions options: • Capital replacement programme

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• Consumable management To investigate potential efficiency gains under an Olympus Guaranteed Performance Solution contact us on 01702 616333 or so that we can begin the process of change within your hospital.


KeyMed House, Stock Road, Southend-on-Sea, Essex SS2 5QH | Tel: +44 (0)1702 616333 |

Health Business 16.4  

Business Information for Healthcare Professionals

Health Business 16.4  

Business Information for Healthcare Professionals