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Patient Centred Care Platform





DIGITAL RECORDS Exploring NHS digitalisation and the progress of achieving paperless plans


HEALTH BUSINESS MAGAZINE ISSUE 16.5 15.6 Patient Centred Care Platform





DIGITAL RECORDS Exploring NHS digitalisation and the progress of achieving paperless plans




Jeremy Hunt: our NHS hero? The Conservative Party Conference was interesting on a number of levels – most notably Theresa May’s end-of-March deadline for triggering Article 50 and commencing our exit for the EU. But perhaps more intriguing was her decision to praise Jeremy Hunt as a ‘passionate advocate for our doctors’. Under the banner of creating a ‘society that works for everyone’, May and Hunt pledged to train more UK doctors and make the NHS ‘self-sufficient’. The announcement of more funding to increase the number of medical school places by 25 per cent from 2018 is welcome, but the plan to end our dependence on foreign doctors is risky, to say the least. Immigration was such a central theme of the EU referendum that it was always likely to dominate the Party speeches. But if it is reasonable to have ‘hard Brexit’ and ‘soft Brexit’ options, would it not also be wise to have ’hard migration’ and ‘soft migration’ alternatives? Staff shortages and recruitment crises regularly preside over the growing list of impending concerns within the NHS, and with over half of our current NHS workforce foreign-born, it seems far more likely that this announcement will inflict more pressure on an NHS outfit already beginning to burst at the seams.

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May and Hunt have declared the Conservative’s as the party of the NHS. But the pair’s latest musings show little intention to stem the blood loss of our most valuable institution, but more worryingly appear to show an attempt to block the wound by taking away the stitches.

Michael Lyons, editor

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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, Addy Ajibola ADMINISTRATION Vickie Hopkins PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Health efficiencies will be harder to find; calls to improve social services; and high spending agency staff threat


A review into the digital future of the NHS has suggested the ‘paperless’ NHS 2020 aim should be pushed back to 2023. Health Business looks at the report and the progress of digital records



EHI Live returns to Birmingham’s NEC on 1-2 November, exploring the latest technology solutions for commissioners and clinicians. Health Business previews the conference agenda and exhibition

29 ENERGY 37 56

Health Business explores the details of the Securing Healthy Returns report, which calculated potential NHS savings of £414 million and carbon emission cuts of one million tonnes by 2020


The NHS Supply Chain outlines the potential of saving while spending when working within a financially‑constrained environment



With the future of the NHS European workforce a major discussion topic, Kate Ling of the NHS Confederation’s European Office looks at the possible post-Brexit NHS. Plus, a review of the Healthcare Recruitment & Training Fair


The size and complexity of hospital buildings makes them more susceptible to fire risk than most environments. Will Lloyd of the Fire Industry Association discusses the best safety steps to take


Visitors flocked to Manchester for the biggest showcase of products and services in the UK health sector. Health Business reviews the event


The well-attended UK Health Show explored the hottest topics of healthcare in the UK – cyber attacks, data handling and digital leaders. Health Business reviews the show

Health Business




Leadership is far more than the figurehead in charge, and in the current NHS climate, it has never been more important. In the first of two articles on the topic John Yates, group director at ILM, discusses leadership at all levels, while Chris Lake, of the NHS Leadership Academy, looks at six reasons hindering investment in leadership development


New guidance is ensuring that health apps that qualify as medical devices comply with safety regulations. Valerie Field, of the MHRA, outlines the importance of the guidance


Returning to the ExCel Centre on the 22-23 November, Patient First is the leading national event for patient safety and infection prevention. Health Business previews the conference


Taking place on 29 November, the annual Health Business Awards return for its eighth edition, celebrating the success stories in our hospitals


An expanded showfloor and exciting seminar programme makes Diabetes Professional Care one of the most anticipated health shows of the year

82 INFECTION PREVENTION Over 800 delegates and 100 exhibitors attended Infection Prevention on the 26-28 September 2016. The Infection Prevention Society review the event


Health Business discusses the requirements that meetings and events for healthcare professionals should have that a normal venue cannot offer

88 LEISURE INDUSTRY WEEK The 28th Leisure Industry Week enjoyed distinct educational streams, engaging content and a positive atmosphere. Health Business looks back at September’s event

91 PRODUCTS & SERVICES A look at the products and services for the health care sector Volume 16.5 | HEALTH BUSINESS MAGAZINE


NHS 111




NHS 111 to refer fewer patients to out-of-hours GP New plans announced by the Department of Health indicate that the NHS 111 will be referring less patients to GP out-of-hours services and A&E. It claims that GPs spent almost 40 per cent of their time advising patients on minor ailments. However starting from December, NHS 111 will send patients requiring urgent repeat prescriptions, or suffering minor issues like ear aches, sore throats or bites, straight to a community pharmacy instead. Additionally, pharmacies will be given direct powers to hand out medicines to patients who have run out, without the approval of a doctor, as long as their surgery has put the prescription on repeat. The Department of Health said NHS 111 currently receives 200,000 calls each year from patients needing urgent prescriptions. The plans suggest that GPs would be kept informed about their patients’ medication via the Summary Care Record, which is in the process of being rolled out to community pharmacies nationally. The pilot has already been trialled in the North East, where the Department of Health said it had been ‘positively received by patients and supported the resilience of the local urgent and emergency care system’. David Mowat, community health and care minister, commented: “Community pharmacists already contribute a huge amount to the NHS, but we are modernising the sector to give patients the best possible quality and care. “This new scheme will make more use of pharmacists’ expertise, as well as freeing up vital time for GPs and reducing visits to A&E for urgent repeat medicines.” Professor Keith Willett, medical director for acute care at NHS England, said: “Directing patients to go to a community pharmacy instead of a GP or A&E for urgent repeat medicines and less serious conditions, could certainly reduce the current pressure on the NHS, and become an important part of pharmacy services in the future. “This pilot will explore a sustainable approach to integrate this into NHS urgent care.”


Health efficiencies will be harder to find The NHS Confederation has said that there will be ‘considerable challenges’ in finding savings in the NHS in Wales. The comment comes in response to a major report by the Health Foundation which looks at the increasing challenges of meeting growing demand. The report, The path to sustainability, examined the immediate challenges facing the NHS until 2020 and also explored what else the health service could be faced with for 10 years following this. It identified that the NHS in Wales must deliver at least £700 million of efficiency savings to close the projected funding gap by 2019/20 – almost 10 per cent of NHS spending. Discussing the report, Anita Charlesworth, director of Research and Economics at the Health Foundation, said: “The next few years will be tough for the NHS in Wales. Immediate and sustained action is needed to protect patient care, but long-term sustainability is possible. “Tackling the urgent funding pressures facing the Welsh NHS requires an unrelenting focus on improving efficiency. Securing its long-term future also requires increased investment and continued reform so the service meets the changing needs of an ageing population. But the health service is not an island – ensuring people can access high quality social care will also be vital to the future of the NHS in Wales.”

The NHS Confederation, the body representing Wales’ seven health boards, said there were reasons for ‘cautious optimism’ in the longer term but it was ‘very tough’ to expect further savings in the short term after £800 million efficiencies had been made over the last five years. Vanessa Young, NHS Confederation director, commented: “The NHS will continue to work hard to drive efficiency but it’s important to recognise that significant savings have been made in the last few years, and this becomes harder and harder to maintain each year. “Our members are also facing considerable recruitment and retention challenges across the NHS and there is a risk that the assumptions around pay may not be deliverable.” Vaughan Gething, Welsh Health Secretary, commented: “If they continue to cut public spending in the way they’ve outlined it could really compromise our ability to have a service which is properly affordable.”



Prioritise funding for social services over NHS, say experts Stephen Dorrell, chairman of the NHS Confederation and a former Conservative Health Secretary, has called on the government to focus more money on improving social services. Dorrell warned that ‘fetishing’ the NHS is damaging the health service because hospitals are used as an expensive way to look after the elderly. He argued that around £5 billion per year is needed to take councils back to the level of a decade ago and that such funding should be prevalent in next month’s Autumn B udget. Research has shown that health spending has increased by 25 per cent over the past decade but social care spending has remained flat. Dorrell said: “Fetishising the NHS budget and imagining it’s the only public service that relates to health is fundamentally to

miss the point. It is not true to say we are supporting the health service by asking it to do social care. We are using the health service as a very expensive social care service and then talking about efficiency. It’s insane economics and very bad social policy. “We would deliver a more efficient NHS and better health if we spent the money on supporting people out of the health service rather than waiting for them to become ill.” A spokeswoman for the Department of Health said: “This government is committed to making sure funding is used effectively right across the health economy. That’s why we are giving local authorities access to up to £3.5 billion extra for adult social care by 2020.” READ MORE:



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Spend on agency midwife staff doubles

Welsh Budget: extra £240m for NHS Finance Secretary Mark Drakeford has pledged an extra £240 million for the NHS in the Welsh budget. While there were cuts to some areas of local government and community projects, total spending rose by 2.7 per cent to £14.95 billion. Drakeford said: “In these uncertain times, we have published a one-year revenue budget, which will provide stability and assurances for our valued public services in the immediate future while we work collectively to plan for the future.” Funding also included £111 million for apprenticeships and traineeships, and £4.5 million towards a pledge to raise the savings limit for people in residential care to £50,000. The news comes as the Health Foundation recently published a report warning that the costs of the health service are likely to rise by an average of 3.2 per cent per year in the long term. This means that, despite the increase in funding, the NHS will continue to need to deliver a significant portion of efficient savings.


The Royal College of Midwives (RCM) has warned that the NHS in England has spent £25 million on agency midwives in 2015, more than double the figure spent in 2013. The RCM compiled the data by submitting a series of Freedom of Information requests to around 123 NHS trusts in England. The data revealed that 46 had used agency midwives last year to fill gaps on hospital rotas. It found the total spending in 2015 on agency midwives, overtime and the NHS’s flexible ‘bank’ midwives was £72.7 million. The report highlighted that agency midwives were paid, on average, around £41 per

hour, half of which went to the agency. Jon Skewes from the RCM, said: “An over‑reliance on temporary staff is clearly more expensive than employing the correct number of permanent staff and needs to be corrected sooner rather than later.” A spokesman for NHS Improvement maintained that trusts had made good progress and saved over £600 million on agency staff since last year. They added: “We are committed to helping the NHS cut the cost of agency midwives and all agency staff, so that patients get the right care, from the right staff, at the right time.”



Pharmacy funding cuts risk closures


Safer pregnancy awareness campaign launched can make or the signs to look out for, they can increase their chances of a healthy pregnancy. “The new campaign is a game-changing moment and will help us halve the rates of stillbirths, neonatal deaths, maternal deaths and brain injuries occurring during or soon after birth by 2030.” Wikipedia/Ted Eytan

The Department of Health has launched the ‘Our Chance’ campaign aimed at maximising women’s chances of having safer pregnancies. The initiative has been developed with Best Beginnings and Sands to give parents the knowledge and confidence to maximise their chances of healthy outcomes for themselves and their babies. The campaign assures that with a timely diagnosis, most conditions can be well‑managed to reduce the risks of stillbirth, neonatal death and maternal death. Through the website and the Best Beginnings Baby Buddy app, women and their families can learn about how to best look after themselves and their baby. Commenting on the launch, Health Secretary Jeremy Hunt said: “The loss of any baby or new mum is a tragedy. We want any NHS hospital to be one of the safest places in the world to have a baby. By making sure women are aware of the small changes they

Health Secretary Jeremy Hunt: “The loss of any baby or new mum is a tragedy.”




Sue Sharpe, chief executive of the Pharmaceutical Services negotiating Committee (PSNC), has warned that the cuts to the sector would throw the health service into chaos, as closing pharmacies will mean more people will turn to GPs instead of pharmacists. In a letter to the Department of Health, Sharpe said: “The proposals were, and remain, founded on ignorance of the value of pharmacies to local communities, to the NHS, and to social care, and will do great damage to all three. We cannot accept them.” The PSNC warned that the new plans indicated that pharmacies would receive £113 million less than expected from December 2016 to March 2017 and £208 million less the following year. The news comes after plans for a £170 million cut this year were delayed after two million people signed a petition opposing the change. Currently 90 per cent of the income that pharmacies receive from the government pays for dispensing prescriptions. A spokesman for the Department for Health said: “We are committed to offering more help to those pharmacies people most depend on.” READ MORE:






Low blood pressure and dizziness in dementia link Research published in Plos Medicine has suggested that people who experience frequent drops in blood pressure or dizziness when suddenly standing may have an increased risk of dementia. The study claimed that less blood reaches the brain during these moments which could lead to brain cell damage over time. It involved tracking 6,000 people for an average of 15 years. The researchers noted that those who suffered repeated periods of low blood pressure on standing were more likely to develop dementia in the years that followed. Dr Arfan Ikram, one of the researchers involved in the project, said: “Even though the effect can be seen as subtle – with an increased risk of about four per cent for people with postural hypotension compared to those without it – so many people suffer from postural hypotension as they get older that it could have a significant impact on the burden of dementia across the world. “If people experience frequent episodes of dizziness on standing, particularly as they get older, they should see their GPs for advice.” Commenting on the findings, Professor Tom Dening, from Nottingham University, said:

“The suggestion is that feeling dizzy, which results from a fall in blood pressure, may interfere with the circulation of blood round the brain and that over time, this causes damage which may contribute to dementia. “This is a plausible hypothesis and has support from other research. It is possible that something else may be going on. A dizzy spell is not a death sentence nor does it mean you are certain to develop dementia. On the other hand, if this problem occurs frequently, then it is worth seeing your doctor as there may be remediable causes, for example if you are taking medication it should be reviewed.”

Dr Laura Phipps, of the charity Alzheimer’s Research UK, said: “While the risks found in this study are reasonably small compared to other known risk factors for dementia, it adds to a growing and complex picture of how blood pressure changes throughout life can impact the brain. “As well as maintaining a healthy blood pressure, the best current evidence suggests that not smoking, only drinking in moderation, staying mentally and physically active, eating a balanced diet, and keeping cholesterol levels in check can all help to keep our brains healthy as we age.”




Over four million children to be offered flu vaccination

70 per cent would pay extra 1p per pound in NHS tax

Public Health England (PHE) has announced that it is extending the flu programme to include children in Year 3. The Stay Well This Winter campaign (SWTW), launched on 12 October 2016, is the biggest ever flu vaccination programme in England for children. This year the programme is being extended to those in school Year 3, offering more than four million children protection against flu – around 600,000 more than last year. The scheme will help reduce the spread of this infection to the most vulnerable in the community, particularly younger children, the elderly and those with long-term conditions. With the school vaccination programme set to get underway, children aged two, three and four can now get the vaccination from their GP. Research shows that children are most likely to spread the flu to others, so targeting them helps protect the wider community too. It is estimated that several million people get the flu each winter, leading to more than 2,000 NHS intensive care admissions across the UK last year.

Professor Dame Sally Davies, chief medical officer at PHE, commented: “Flu can be much more dangerous for children than many parents realise, and when children get flu, they tend to spread it around the whole family. Every year, thousands of children have flu and it is not uncommon for them to be admitted to hospital. “The single best way to help protect your children, and the rest of the family, is to get them vaccinated. For most, it is just a quick, easy and painless nasal spray.”

A poll ran by ITV has indicated that at least 70 per cent of Brits would happily pay an extra 1p in every pound if the money was guaranteed to go directly into the NHS. The survey of 1,002 people was conducted by Survation for a health-focused The Agenda, and showed that almost half of those surveyed confirmed they would even pay an extra 2p per pound to boost NHS funding. Furthermore, 46 per cent of respondents thought the current NHS was performing badly with only 23 per cent saying that it was performing well. The research suggested that while taxpayers were prepared to pay more to support the NHS, patients are not willing to pay on an individual basis for specific treatments. Around 66 per cent of respondents said that they would not pay £5 to visit their GP (27 per cent said they would) while 79 per cent said they would refuse to pay £10 with only 15 per cent saying they would do so.









£20,000 trainee offer for Welsh GPs

Agency spending ‘name and shame’ threat

Funding incentives are to be offered to doctors who train and work as GPs in Wales in a bid to tackle the country’s recruitment problems. Part of a Welsh government campaign to get doctors to train and work in Wales, the offer will see junior doctors offered £20,000, providing they stay for at least one year after completing their training. Additionally, the incentives, which will come in to play in time for the August 2017 intake, will also see those who train as GPs receiving a one-off payment of £2,000 to cover the cost of their final exams. Understood to be the first scheme of its kind in the UK, a new contract will be offered to all trainee doctors in Wales, regardless of their specialism. Specialist training in general practice takes three years to complete. Recent research from the British Medical Association found that over a quarter of GPs in Wales were considering leaving the profession, with concerns over workload and understaffing. READ MORE:

In a bid to crack down on agency spending, NHS bosses are threatening to ‘name and shame’ high spending trusts in England. NHS Improvement believes that the NHS has slipped behind schedule in its efforts to reduce the agency bill, and has warned that it wants more progress. A cap was introduced in October 2015 and has so far saved £600 million, but the regulator wants the £3.6 billion spent on agency staff last year brought down by £1 billion by the end of this financial year. The latest accounts suggested NHS trusts were 10 per cent below where they wanted to be. Hospitals, mental health trusts and ambulance services should not be paying more than 55 per cent above normal shift rates for any staff, reducing the overall cost of agency staff and reducing hospital reliance on them in the process. NHS Improvement has therefore threatened that it would start publishing ‘league tables’ of the best and worst-performing trusts on agency spending later this year, after discovering examples of hospitals being quoted double the rates for doctors.


Jim Mackey, NHS Improvement chief executive, said: “The NHS simply doesn’t have the money to keep forking out for hugely expensive agency staff. There’s much more to be done.”



Council cuts affecting A&E services, CCQ finds

Ambulance patients face long A&E delays

The Care Quality Commission (CQC) has raised safety concerns about two thirds of A&E units in England, claiming the drop in standards is partly due to underfunding of council care services, leading to overcrowding in hospitals. In its review, the CQC outlined that emergency care was one of the poorest‑performing parts of the system, with safety cited as a major weakness. The data showed that 22 of 184 units were rated inadequate and another 95 as requiring improvement. The regulator warned that rationing of council care, including access to home help for daily tasks such as washing and dressing, and care homes was pushing more vulnerable people into hospital. David Behan, CQC chief executive, said that the council care system had reached a ‘tipping point’ and was in the worst state it had been a long time. Behan called on the government to pump more money into the council care system, but did not quantify how much extra funding the care system should get. The review did note that there were many examples of good care among the 20,000

inspections it had carried out. It maintained that despite cuts to council care services, help that was being provided in the home and in care homes was rated as good or outstanding in 72 per cent of cases. 87 per cent of GP practices were ranked as good and outstanding, in addition to 42 per cent of hospital care overall. Katherine Murphy, chief executive of the Patients Association, said: “While there are nuggets of positive examples of trusts successfully swimming against the tide, fundamentally, the tide has turned and the pressures are becoming so great that the health and social care sector is struggling to meet demand whilst delivering excellent quality care.”


Data obtained by the Labour Party has highlighted that thousands of patients who are taken to hospital by ambulance face long delays before being seen by accident and emergency (A&E) staff. The figures showed the number of patients waiting more than an hour has trebled in two years. Ambulances are expected to be able to hand over patients to A&E staff within 15 minutes of arrival. However data for NHS England has shown there were 76,000 waits over an hour in 2015-16, up from 28,000 in 2013-14. The number of waits of more than 30 minutes rose by 60 per cent over the same period, from 258,000 to nearly 413,000. Ambulance crews have explained that delays happened when there were no A&E staff available for the ambulance crews to hand patients over to. The most life threatening cases would be prioritised. The ambulance crews are then forced to wait with their patients, meaning the emergency vehicle is unavailable for 999 calls. READ MORE:





Advertisement Feature


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

Technology is not just making its presence felt in operating theatres and hospital wards – NHS Trusts and PCTS are quickly becoming aware that being able to access, store and share patient records is as crucial to improving patient care as the latest breakthroughs in medical science. The need for an efficient and effective information management system manifests itself across all levels of modern healthcare provision. It encompasses everything from consultants and surgeons accessing x-rays and scans from workstations across a hospital complex, ending the need for cumbersome transfer of paper records from site to another, with the incumbent risk of them being misplaced or lost or misused; to administration staff using systems that help automate selected processes, saving time and money. Add a dose of security and audit, and suddenly, the prospect of a system that mandates governance and eliminates un-scrutinised misuse, becomes quite real. This has been achieved in some NHS Trusts who took the bold step to deliver change some years ago and are now leading the way forward including lessons learnt. TWO KEY POINTS MUST BE EMPHASISED: First, paperless healthcare is not a dream – it is real, has been done in the NHS – and, not just once – it does deliver real and measurable benefits. There is plenty of evidence from sites where paperlite, if not paperless healthcare has been achieved over the last five to six years – there is a good and positive track record for all to see and learn from – in other words, it is eminently do-able, and doing nothing is an expensive option!

Second, the focus is NOT technology, or at least, technology plays a small but important part in meeting the enormous challenges imposed by transformation to digital healthcare – it is about managing that transformation. Actually, it’s all to do with very careful application of the available technology, to solve defined problems and then build on that success to tackle other problems, but at your pace. KEY MESSAGE The key message is that careful application of established technologies is delivering measurable improvements and benefits. These must be applied to address strategic requirements, rather than as a short-term measure to solve paper problems. The technology is not rocket-science, but has evolved gradually as customer demands, interoperability, and web accessibility have evolved. To ensure successful transformation to digital healthcare, such lessons must be embraced. ACHIEVING DIGITAL HEALTHCARE Health Secretary Jeremy Hunt wants the NHS to be paperless by 2018. He said going paperless would ‘save billions.’ In directives, issued in January 2013 and February 2016, Mr Hunt wants patients to have digital records so that their information can follow them. But unlike previous large scale, top-down directives, he wants this driven bottom up and by 2018 any crucial health information should be available to staff at the touch of a button. Most NHS sites hold patient related data on a variety of different media, for example, paper, microfilm and digital. It is currently very difficult to identify exactly what information

may be held on a given patient. This has resulted in falling standards for maintaining the patient’s acute medical record; increasing risk and leaving patients and clinicians at a disadvantage. Furthermore, there are many well-known issues related to paper-based delivery of care, such as: physical handling and transport of paper records; lack of audit on who looked at any record; only one person can see a record at any time; cannot easily share records without copying; lost records; escalating costs associated with handling physical records; etc. Yet, health and IT professionals remain deeply sceptical that the NHS can be paperless by 2018 – a large percentage of healthcare professionals engaged in this work feel that the paperless by 2018 goal is ‘a great ambition, but unrealistic.’ The key concerns expressed included: (a) IT Compatibility – lack of interoperable systems, and cost of replacing legacy systems, (b) costs, timescales, technology, and cultural changes, and (c) insufficient information about the potential benefits from improved IT systems. A number of trusts took the bold step towards paperless healthcare some years ago. These trusts achieved paper lite health care using Electronic Document and Records Management (EDRM) technologies – not by simply installing IT, but by paying great attention to the underlying processes. Cost effective solutions based on established EDRM technologies offer the chance for Trusts to embrace a culture of compliant information management practice to deliver paperlite healthcare if not paperless! There is no magic bullet solution – just a common sense approach which focuses the available technologies on specific processes to ensure that the solution delivers what is expected of it. The process is a migratory one which promotes a trust-wide information repository with newly created clinical documents being ‘born’ into the repository whilst ‘legacy’ information is scanned and digitised in a staged manner. Systems have become more affordable and are delivering real and measurable benefits. L FURTHER INFORMATION



Advertisement Feature



A DUAL APPROACH TO BRIDGING THE DIGITAL DIVIDE Low literacy is mirrored by poor health, whether it’s caused by disability or socio-economic disadvantages. Assistive technology can make access to medical services and data easier for individuals with literacy and language challenges who are the biggest consumers of healthcare resources What is health literacy? A clear linkage between literacy levels and public health was identified as long ago as 1992 ‘Health status of illiterate adults: relation between literacy and health status among persons with low literacy skills’. This original conjecture has since been cited regularly by other observers. In 2013, the WHO repeated the original assertion that “literacy is a stronger predictor of individual’s health status than income, employment status, education level and racial or ethnic group.” Closer to home, it’s a view expressed by Joe Morrisroe of the National Literacy Trust, who argues that low literacy negatively impacts on the health of communities in the UK: “The inability to access and interpret information stemming from a lack of basic skills presents individuals with a fundamental challenge to take control of their own health. As a result, health literacy skills should be considered an integral part of any public health strategy, and it is essential that literacy skills underpin such strategies.” REMOVING OBSTACLES TO BETTER HEALTHCARE Poor literacy can be the result of factors such as educational attainment, often linked with limited financial and social resources. It can also be due to disabilities like dyslexia – a condition that according to the British Dyslexia Association affects 10 per cent of the UK population, four per cent to a ‘severe’ degree. Equally, individuals for whom English isn’t their first language (including ethnic minorities and recent migrants) can struggle to understand basic healthcare advice. While the causal factors vary, the outcomes remain essentially the same. Individuals with poor literacy are less able to access information about beneficial lifestyles and self-regulate existing medical conditions such as asthma and diabetes. They may be unable to read basic nutritional information on food packaging and make less healthy choices as a result. Similarly, they may struggle to read important pharmaceutical information and medical instructions. As Public Health England points out: “People with limited health literacy are less



likely to use preventive services and more likely to use emergency services, are less likely to successfully manage long-term health conditions and as a result incur higher healthcare costs.” (September 2015). The World Health Organiztion (WHO) echoes this, pointing out that individuals with weak health literacy typically make sub-optimal lifestyle choices with a consequent drain on healthcare systems. MAJOR BARRIER With 42 per cent of working-age adults in this country unable to make adequate use of everyday health information (source: Public Health England), literacy is clearly a major barrier to helping individuals understand and manage their own health. But as the NHS shifts towards greater electronic interaction with end-users – from booking GP appointments and requesting repeat prescriptions to providing test results – there’s the danger of a growing divide between the general population and patients who may lack basic digital skills. Of course literacy has another profound impact on the provision of healthcare. Of around 1.6 million NHS staff and community health workers across the UK, 11 per cent are officially recognised as ‘not British’ according to data from the Health and Social Care Information Centre

(HSCIC), now known as NHS Digital. Our health service relies heavily on staff from overseas, with 2014 figures indicating that 73 per cent of UK hospital trusts recruited employees from abroad who make a major contribution in all roles, from doctors and nurses to carers, porters and ancillary staff. And while doctors joining the NHS from overseas are now subjected to stringent language skills tests, not having English as a first language can be a real challenge for many employees coming to the UK from over 200 different countries. Today, assistive technology has a vital, dual role to play in helping healthcare providers deliver a more efficient, cost-effective service. Screen readers can help those with low literacy understand and interact successfully with everything from personal health records to online appointment booking. Similarly, online translation tools can help almost 10 per cent of the population for whom English isn’t their first language – including patients as well as NHS staff recruited from overseas. L

Jason Gordon is health manager at Texthelp, a company producing digital inclusion and assistive software products for adults and students worldwide. FURTHER INFORMATION


Information Technology


Making IT work, or creating a digital divide? Bob Wachter has predicted that the NHS has the potential to be paper-free, but suggested that the aim of a paperless NHS by 2020 is too ambitious. Health Business analyses the reviewed targets in the Making IT Work report, and the journey the NHS has taken to digitise its healths records so far The world around us is changing at an alarming speed. In order for the NHS to continue providing a high level of healthcare at an affordable cost, it needs not only to modernise, but also needs to overtake and transform its current digital offering. The first thing to make note of when analysing Professor Bob Wachter’s Making IT Work report is that he deems the Department of Health’s push for a paperless NHS by 2020 as ‘aggressive’ and ‘unrealistic’. Instead, the report suggests that a target should be set for all trusts to be ‘largely digitalised’ by 2023 rather than 2020. Matthew Honeyman, policy researcher at The Kings Fund charity, summed it up quite nicely by saying that Wachter’s recommendation of a relaxed paperless timetable ‘injected a welcome dose of realism into the debate’. Current pressures on the NHS are piling up at an unsustainable rate, and while funding fails to match expectation, the 2020 paperless push is, and will always be, too optimistic. There is nothing wrong with ambitious intentions – and the aim to digitise the NHS in all of its forms is certainly the direction that the health service should be heading. But most health leaders agree that this has

to be a wholistic movement, a national progressive step that is incorporated across large trusts and local hospitals alike. The end goal should not be a paperless NHS for the sake of having a paperless NHS. A responsive report released by Intellect in March 2013, shortly after Jeremy Hunt’s initial announcement of creating a paperless NHS by 2018, said that a paperless NHS must add ‘tangible value to [the] efficiency, effectiveness and experience’ of the ‘citizen, staff and NHS organisations’. CURRENT POLICY COMPLICATIONS In September of this year, in response to Wachter’s review, Health Secretary Jeremy Hunt outlined that 12 successful NHS organisations were to become global exemplars in pioneering digital service best practice, and help others in the NHS to learn from their success and experience. Described by Hunt as an ‘Ivy League’ for others to aspire to, this has the potential to

instil a hospital centric mindset, rather than one of national integration and improvement. It could also mean that half of all the trusts in the NHS could miss out on central funding ahead of the 2020 ‘paperless’ target. The 12 ‘global digital centres of excellence’ will benefit from approximately £10 million from a £100 million pot, but they will be expected to match that amount locally. Another wave of 20 organisations will follow, forming what Wachter described as a ‘Group B’, each receiving around half that figure. The third group, which would represent half of the UK’s NHS trusts would not receive central funding until after 2020, due to the fact that they were not yet digitally advanced enough to use the money effectively. Wachter said that ‘if you throw money at them [Group C trusts] there is a decent chance you will be wasting it, and you will get it wrong’. Funding would then follow, post-2020, when culture E



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PUSHING FORWARD THE MOBILE REVOLUTION TO IMPROVE NURSING CARE The nurse holds a very important role in our healthcare system – at the heart of patient care, handling the needs of medical professionals, families and of course the patient themselves. It is clear, as the demand for care increases, that we need to find smarter ways of working and to make life a little easier for our nurses too Interestingly Ascom research shows that less than a quarter of a nurse’s time is actually spent interacting with patients. The remainder is providing and chasing information, admin, transportation and calling other colleagues. Just think of the effect on patient care, staffing levels and moral if we could free more time by delivering relevant information to their fingertips and by helping to automate key processes. The really great news is that there is technology that can help today; from simply keeping in contact with colleagues wherever they are in the hospital to improving workflows that help improve patient pathways such as sepsis and AKI. However, just like a chef needs professional tools to ensure speed, quality and consistency of the menus they create, nursing care also needs the right solution to cater for complex and constantly changing clinical needs. Ascom provides dependable onsite solutions for the healthcare environment with its patient systems, unique middleware and a variety of robust handsets. Wireless handsets are specifically designed to be the nurse’s companion matching their needs with close attention to size, weight, and ability to sanitise while allowing information to be delivered directly to one device. SETTING THE NURSE FREE One of simplest benefits of a wireless communications solution is that it helps colleagues to stay in touch wherever they are, as no one is tied to a desk. This saves valuable time for example chasing results on the go, communicating directly to the bed or instantaneously finding colleagues throughout the hospital. Less intrusive two‑way messaging, very much like texting, also helps staff stay in‑touch while in meetings or when dealing with a patient. This smarter way of working can help reduce delays and improve patient care. RIGHT RESPONSE AT THE RIGHT TIME Ascom also found that over 85 per cent of alarms do not actually require immediate clinical intervention. Ascom helps here by ensuring that the correct alarm is



sent out directly to the relevant nurse (or nurse group) with a confirmed delivery. Alarms can be prioritised, filtered and even escalated then delivered directly to the right wireless handset within seconds. This ensures a consistent and effective response. When you add this to a patient pathway workflow then the ability to ensure that resources are alerted and available, especially for time-critical issues such as sepsis, can also help improve outcomes. IMPROVING STAFF SAFETY Feeling safe at work is always on the mind of senior clinicians especially with an 8.3 per cent rise of reported assaults on staff in 2014. Each personal handset can be armed with a panic button to automatically call for assistance. Any alert is then delivered, with exact location information, to security staff within seconds. This helps reduce risk of assault and provides the nurse with increased peace of mind. MAKING LIFE EASIER FOR THE CHARGE NURSE With the integration to existing clinical systems, time-sensitive information such as alarms from medical devices, monitors and even blood fridges can be directly sent to the nurse’s mobile device too. The solution has a built-in patient assignment module so the charge nurse can easily allocate

patients to one, or several nurses and set an auto‑escalation chain of two or three steps for responding to the patients’ alarms. This means that important alarms always get answered even if the primary responder can’t attend for any reason – crucial for patient care. HOW CAN TECHNOLOGY HELP YOUR HOSPITAL? Wireless communication is truly a flexible solution to match the ever changing needs of nursing in striving to continuously improve patient care. It can directly modernise manual workflows within a clinical environment helping to provide: faster decisions; faster time to treatment; faster mobilisation of multidisciplinary teams; increased patient care hours; coordinated care; reduced wasted time and effort; reduced uncertainty of response to bleep call; and analytics to improve clinical work-flows. Call us to arrange an on-site demonstration to show how this technology can help improve, for example, sepsis pathways. Helping to drive improvements by the automated mobilisation of key hospital resources, such as the Outreach team, doctors and nursing staff, directly from a clinician’s handset. L FURTHER INFORMATION Tel: 0121 502 8979

DIGITAL RECORDS  changes have been made and they have their IT houses in order, although whether this will happen is unknown – Hunt avoided the topic of further funds at the Expo. The 12 global exemplar trusts will be: City Hospitals Sunderland NHS Foundation Trust; Royal Liverpool and Broadgreen University Hospitals NHS Trust; Salford Royal Hospitals NHS Trust; Wirral University Teaching Hospital NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust; Luton & Dunstable University Hospital NHS Trust; West Suffolk NHS Foundation Trust; Royal Free London NHS Foundation Trust; Oxford University Hospitals NHS Foundation Trust; Taunton and Somerset NHS Foundation Trust; University Hospitals Bristol NHS Foundation Trust; and University Hospitals Southampton NHS Foundation Trust. FINANCING CHANGE OR CHANGING FINANCE There is no denying that a national, comprehensive drive to digitalise the NHS is costly – it has been already and it will continue to be so. Put blankly, the £4.2 billion that the Treasury made available to promote digitisation this year is not enough to enable

full digital implementation and optimisation at all NHS trusts – a point that Making IT Work acknowledges by highlighting that although funding has been ‘generous’, it is ‘not enough to complete the entire job’. A phased approach has been suggested, with national funding combined with local resources to support implementation in trusts that are prepared to digitise, and to support those that are already digitised and ready to reach even higher levels of digital maturity. This would ideally by completed by 2019, leaving four years for the second phase of funding to take place – and for all remaining trusts to gain digital maturity by 2023. A side note to consider – Aesop’s ‘Tortoise and the Hare’ fable is one of the Greek storyteller’s most well known and explored. The race of unequal partners is often interpreted for its messages on trickery and the dangers of mocking those considered inferior, or in this case, slower than ourselves. For the purpose of this illustration, we will take the ambiguous story as one warning against moving too fast and moving too slow.

Slightly contradictory to the phased funding model proposed, discussed above, Wachter’s review stated that ‘while there is urgency to digitise the NHS, there is also risk in going too quickly’. The theme of this part of the report is that it is better to digitise the healthcare system correctly than to do it quickly. This was enhanced by Jeremy Hunt’s speech at the NHS Innovation Expo last month, where he acknowledged that trusts would move at ‘different speeds’ and should not be force into big IT project they could not handle.

Information Technology


CREATING A NATIONAL DIVIDE Forcing a trust into an IT project beyond that which they can handle would be catastrophic, but equally damaging could be devoting time, money and resources to one trust to digitise while neglecting another, even if it is smaller and more challenging in digital terms. The distance between the hare and the tortoise emphasised the pitfalls of sprinting away from the crowd, yet the Ivy League of NHS exemplars E

Profess Bob Wa or suggest chter current ed that the trusts t target for all o digitise be largely should d by 2020 b e re to 2023 laxed




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.

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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

Information Technology

DIGITAL RECORDS  seems to be the same method. When considered in a regional setting, where one large NHS trust invests, and is invested in, to enhance its digital offering, and a smaller, more local hospital is left with paper records - less reliant on IT and less trained to operate digitally - then the vacuum becomes more visible. A patient that may need to visit both sites for differing treatments may find that their records are not easily transferred between the two. If that patient is elderly, or even lacking the information or confidence to discuss their treatments, they may even end up having unnecessary, or unnecessarily repetitive, tests being done simply because their information has not readily moved from one site to the next. Now is this the fault of the smaller hospital or the larger trust? Is the former to blame for being digitally immature? Or the latter for being more advanced than its neighbour and colleague, who can no longer maintain pace – leaving patents at risk, increasing waiting times etc? Or is it the fault of the system that invests time and money into one, making it an example from which others can learn, while leaving the other abandoned, an example of where improvement is needed? Exemplars create a divide – Hunt himself has stated that trusts could rise or fall to become or lose ‘global exemplar’ status. Yes they can be inspirational and a target for which to aim, but they can also further the distance between the digitally literate and illiterate. Wachter’s review also stated that return on investment from digitisation is unlikely to be just financial. It reads: ‘experience has shown that the short-term ROI is more likely to come in the form of improvements in safety and quality than in raw financial terms’. The statement that ‘the one thing that NHS cannot afford to do is to remain a largely non-digital system’ emphasises the reports opinion that finances shouldn’t be the overwhelming issue – although how trusts feel about that is likely to be different to Wachter’s view. SO WHAT NEXT? The National Programme for IT in the NHS (NPfIT), intended at its creation to be the largest public sector IT project of its kind in the UK, was marked by opposition, delays and implementation issues. Although dismantled by the Conservative‑Liberal Democrat coalition government in 2011, the ill fated programme still lingers in the memory, leading many to believe that the NHS will always struggle to do IT. Nonetheless, where NPfIT failed strongest was the failure to implement national comprehensive electronic patient record (EPR) systems. By the spring of 2007, the programme was due to have delivered 155 systems, but had managed a measly 16 - many of which crashed regularly, malfunctioned and were unable to connect to other hospital systems. The scrapping of

NPfIT almost heralded a new start for ERP systems, so what progress has been made? The future undeniably lies in deploying an EPR system and digitising health records. Taunton and Somerset NHS Foundation Trust, one of Hunt’s exemplar sites, became the first NHS trust to go live with an open source EPR system last year, with the aim of seeing the open source technology pay for itself within three years. Further to this, by 2018, the trust hopes that the system will save the trust £600,000 a year by going paperless. The project allowed eight million records to be migrated into the new system with only seven individual records needing to be manually loaded, resulting in minimal disruption to service delivery. Efficiency and coordination has consequently improved in the admission, transfer and discharge of patients – with real-time bed management and discharge planning now digitally managed. Outpatient workflows were redesigned so that record outcomes and patient waiting lists are added and changed in real time. Clinic outcome letters and discharge summaries are sent electronically to GPs and other care providers, marking real progress towards paperless working. Additionally, all care providers in Somerset are able to access diagnostic information due to the county-wide implementation of order communications, picture archiving and communication system solutions. Progress is currently being made on fully paperless nursing and outpatients, and the trust plans to be completely paperless by 2019, enabling patients to have full access to their records and to interact with the service in a way that meets their needs. Elsewhere, Salisbury District Hospital is expecting to go live with a new EPR system this month, where records will be instantly visible on any computer within the Salisbury NHS Foundation Trust and be ‘easily transferable’ from one provider to another. As chief executive Peter Hill acknowledged as a board meeting earlier this month, the new system ‘ensures staff have faster and easier access to the right level of information to look after their patients’. The first phase of implementation to begin will cover inpatient care, outpatient care, emergency department, some clinical documentation, and pathology and radiology orders/results reporting. Meanwhile a second phase is

due in July 2017 and will cover electronic prescribing, medicines administration, maternity services, and theatres. ESTABLISHING EPR PRIORITIES Torbay and South Devon NHS Foundation Trust is rolling out Intersystem’s HealthShare platform across the region, following a successful pilot programme. Using the system, each patient registered in the region will have a single health record that follows them regardless of which service they need to see, with information integrated across acute, community, social care and GP services. As for other trusts, a Digital Health News survey in September of 17 Local Digital Roadmaps (LDRs) revealed that new EPR systems top the wish lists in many draft roadmaps. In the roadmap for NHS Wakefield Clinical Commissioning Group, the CCG stated that an EPR that ‘interoperates with systems in and beyond Mid Yorkshire Hospitals NHS Trust is critical to its goals’. Moreover, Merseyside said that it has long since adopted a ‘strategic aim to have a common EPR for all adult services, seamlessly linked with children’s acute services, community based services and social care’. Only last month, Royal Liverpool and Broadgreen University Hospitals NHS Trust digitalised tens of thousands of records ahead of announcing a new EPR. This is key for the opening of the New Royal Hospital, scheduled to open September 2017, which will not have the capacity to store any paper records. Work is clearly being done, and the difference is certainly being recognised in the trusts that have been able to pursue the paperless dream. But as the years click slowly towards 2020, the elitist approach to distributing funding on a three tiered level may leave the divide wider than it is at present. The UK’s most digitally‑sophisticated hospitals still trail behind international counterparts, and if the disparity in our own hospitals widens, our healthcare digital future may not be as idealistic as many hope it to be. The time scale has been reset, the necessary shortcomings have been voiced, although not yet answered, but the divide is being encouraged rather than addressed. L FURTHER INFORMATION



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USING TECHNOLOGY TO IMPROVE PATIENT CARE Adoption of technology to improve patient care and reduce costs The challenge for the NHS to do more for less is well recognised. The continued funding squeeze, rising demand and the need to safeguard quality, combine to exert pressure across the entire system, with none of these factors likely to abate. There is now wide consensus that health care needs to change to meet these demands. Technology can help to respond to the pressures and enable change. However despite the potential benefits of technology, it is generally acknowledged that its adoption within the health care sector is slow and disparate. Back in 2004 the Healthcare Industries Task Force described the NHS as ‘a late and slow adopter of technology’. The NHS Next Stage Review interim report in 2007 emphasised the importance of technology in the NHS and highlighted the role that technology can play in improving health outcomes. More recently in October 2014 the NHS five year forward view, by NHS England, stated as well as the gadgets we use, change will be as much about different ways of working and relating to each other, adding that future solutions will involve rethinking how health care is organised and delivered with technology playing its part. PRINCIPLE BARRIERS The principal barriers that influence decisions to adopt technology revolve around several factors including the procurement process and the availability of both financial and organisational resources. The procurement process within the NHS is highly complex, presenting many barriers to the adoption of technology. These include multiple points of sale, extended and complex procurement processes, and a tendency to focus on ‘least cost’ rather than ‘best value’. With the creation of the Crown Commercial Service G-Cloud Digital Marketplace, the procurement process within the public sector has been simplified. The G Cloud Framework can be used by organisations across the UK public sector including central government, local government, health, education, devolved administrations, emergency services, defence and not-for-profit organisations. Organisations such as Kirona are pre-selected as approved suppliers, thus speeding up the procurement process for many organisations. Kirona have enabled social care providers such as North Lanarkshire Council to improve



their quality of health and social care service, whilst also saving in excess of £1.5m. By implementing Kirona’s digital workforce solutions across its Housing Property Services and Home Support Services the council have been delighted with the outcomes. Together with the impressive cost savings the council has also improved the service for patients receiving care at home via the Home Support Team, as well as their social housing tenants. Added to this they also have the full support of their workforce who have experienced improved efficiencies in their day to day roles. Healthcare providers looking to improve their workforce productivity, streamline processes, increase the quality of patient care can achieve these objectives through Kirona’s suite of digital workforce software. Firstly, Dynamic Resource Scheduling (Xmbrace DRS) optimises the working day of each healthcare professional, by enabling home visits to be appointed in the optimum way. Dynamic intra-day scheduling allows for emergencies and exceptions to be taken in your stride. Kirona also enable field-based workers to remain connected through their Job Manager mobile application that provide them with the information they need to deliver patient care. These mobile applications also reduce paperwork by capturing information in the field directly into centralised systems. DIGITAL WORKFORCE SOLUTIONS Kirona’s InfoSuite management information software provides true insight across the entire operation enabling continuous improvement. Added to this Kirona also offer Mobile Device Management software, which enables

your organisation to manage, monitor and secure mobile devices and data within the organisation. So if a healthcare worker has confidential data on a mobile device and that device is lost, it can be locked remotely thus ensuring the data remains secure. By adopting technology such as Kirona’s digital workforce solutions Hospitals, Trusts and NHS Services can drive greater efficiency in the services they deliver, reducing unnecessary travel time, cutting paperwork and delivering a far better patient experience. ABOUT KIRONA Founded in 2003, Kirona has grown to be recognised as the leader in delivering digital workforce solutions. We combine innovative software development with an exceptional service to ensure that our technology delivers significant value to our clients. Kirona works with a wide range of healthcare providers including private organisations, government organisations and local authorities enabling improved productivity, enhanced patience care, real time visibility of workers, and management information data and analytics. By using Kirona’s Dynamic Resource Scheduling (DRS), organisations are able to appoint, schedule and manage work in an optimum way. With Kirona’s Job Manager application, field based workers remain connected and work can be tracked in real-time; and with InfoSuite true insight can be gained across the entire operation enabling continuous improvement. L FURTHER INFORMATION


EHI Live


From implementation to patient outcomes Taking place on 1-2 November, EHI Live 2016, the UK’s largest digital health event, will 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) – now operating under the name of 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 cyber space.

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DIGITAL THREAT 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, now NHS Digital, 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

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 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 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 E



EHI Live

EVENT PREVIEW  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. THE INDUSTRY RESPONSE 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

Such is the size of the threat across all parts of government that the December 2015 Spending Review made provision for £1.9 billion to protect Britain from cyber attack and to develop its sovereign capabilities in cyber space 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. CELEBRATING ACHIEVEMENT Organised by Informa Global Exhibitions, the 10th anniversary of the EHI awards has paid tribute to an extraordinary array of talent in the NHS who are attempting to bolster efficiency and patient care with state-of-the-art IT initiatives. The unique awards provide a snapshot of what is happening nationwide and help drive forward changes in the industry through a healthy dose of competition. The winners were announced in London on 29 September, with Salford Royal NHS Foundation Trust named as this year’s winner for the ‘Digital NHS Trust or Health Board of the Year’ award for it’s Roadmap to a Digital Health Enterprise project. The EHI awards, hosted by comedian Ruby Wax at London’s Lancaster Hotel celebrated the vital, ground-breaking IT work carried out in the UK’s health sector. The awards also acknowledged the efforts being made to ensure NHS England’s target of making the NHS paperless by 2020 is met. A record 210 entries were received this year which the judges had to narrow down to three finalists for each category. A full list of entries and winners is available on the EHI Live website. L FURTHER INFORMATION




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eHI LIVE Booth 1H10 Patient First Booth J30 | © Copyright 2016 iMDsoft ®.iMDsoft ® and MetaVision ® are trademarks of iMDsoft. m-AD-028- Health.Business.UK-(Ver1.0)



Helping you to improve the quality of patient care whilst reducing costs Founded in 2003, Kirona has grown to be recognised as a leader in delivering digital workforce solutions. The company combines innovative software development with an exceptional service to ensure that its technology delivers significant value to clients. Kirona works with a wide range of healthcare providers including private organisations, government organisations and local authorities enabling improved productivity, enhanced patience care, real time visibility of workers, and management information data and analytics.   By using Kirona’s Dynamic Resource Scheduling (DRS), organisations are able to appoint, schedule and manage work in the optimum way. With Kirona’s Job Manager application, field based workers remain connected and work can be tracked in realtime; and with InfoSuite true insight can be gained across

the entire operation enabling continuous improvement. Kirona also offer healthcare providers mobile device management; enabling your organisation to secure, control and manage the use of mobile devices and data across your organisation.   Kirona is a G-Cloud 8 Crown Commercial Service Supplier and is ISO 9001 Quality Management and ISO 20000-1 Information Technology Service Management accredited.  To find out more visit Kirona’s stand at EHI Live on 1-2 November at stand 1F20. FURTHER INFORMATION

Leaders in private cellular solutions in Europe Druid’s dedicated 4G coverage technology is ideal for healthcare environments as a single wireless network to handle all voice, messaging and broadband needs. Compared to Wifi, private 4G offers a better Quality of Service (QoS), it’s more secure and it is specifically designed to deliver mobile services as opposed to wireless services. Druid has already deployed its P4G core in leading edge autonomous vehicle test sites delivering services to vehicles travelling at speeds up to 300Km. By easily integrating the latest nurse call alarm servers and location based technology Druid turn the mobile phone into a pager, location device and reporting tool. The Druid optimised messaging center is essential to the delivery of critical messages and alarms. Providing 100 per cent accurate information for care audit trails and analysis. Druid’s 4G core application comprises a complete Evolved Packet Core (EPC) and IP

Multimedia Subsystem IMS. The IMS enables delivery of IP multimedia services such as voice over LTE (VoLTE) and other LTE advanced services. Druid’s IMS also enables integration with third party IP based enterprise applications allowing for rich value added services to be supported. Druid’s open RESTful interface is the gateway to the core application offering tight integration with such applications. FURTHER INFORMATION Tel: 353 1 201 4752

Homerton NHS integrates image data into its EPR via next generation VNA

Early detection of deteriorating patients: Sepsis, AKI and more

Homerton University Hospital NHS Foundation Trust (Homerton) in east London has extended the use of BridgeHead Software’s Independent Clinical Archive (ICA), HealthStore™, to integrate images into its Electronic Patient Record (EPR) in an effort to realise its digital strategy. Homerton initially deployed BridgeHead’s ICA, HealthStore, as the primary data repository for radiology images due to the ending of its national PACS contract in 2015. Since then, the Trust has extended the ICA’s use to integrate image data into its Cerner Millennium EPR. Clinicians can now view all radiology images, alongside patient notes, in the EPR, rather than logging into the ICA separately, saving them valuable time searching for patient information and providing a prompt and seamless level of patient care.   To continue on its digital transformation path, Homerton

iMDsoft is a global leader in clinical information systems. Hospitals and health networks worldwide, including more than 20 NHS hospitals, use the MetaVision CIS for critical care. The company’s mobile electronic observation system, MetaVision SafeTrack™, offers advanced options for early identification of patients at risk for lethal conditions. The system provides smart alerts for sepsis and AKI, based on NICE guidelines, which prompt clinicians to take action. Tools for screening and assessments make it easier to check for conditions such as venous thromboembolism (VTE) and to calculate scores such as MUST and GCS. Hospitals can create additional alerts or screening forms for any condition they define. In addition, MetaVision

now hopes to expand the use of the ICA to archive all other departmental image data. The next areas under consideration are cardiology, medical photography and endoscopy. Niall Canavan, director of IT and Systems, Homerton University Hospital NHS Foundation Trust, commented: “We have proved how simple it is to use the EPR to call radiology images from the ICA, so we look forward to replicating this with data from other departments.” FURTHER INFORMATION Tel: 01372 221950

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SafeTrack offers all the advantages of a mobile electronic observation solution, ensuring faster intervention for patients in need. It helps nurses document vital signs and observations at the bedside, calculates early warning scores and provides options for immediate escalations to caregivers. Nurses work more effectively and can prioritise care with tools for task management and shift handover. The system processes all of the information that is collected to generate reports that help improve hospital performance. FURTHER INFORMATION Tel: +44 7500 839677



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Written by Rachel Brooks, Health Business


Making savings while saving the environment The Securing Healthy Returns report has calculated potential NHS savings of £414 million and the potential to cut one million tonnes of carbon emissions every year by 2020. Health Business’ Rachel Brooks explores the research cla In a time where the NHS is facing a myriad of challenges, ranging from dwindling numbers of health professionals and a burgeoning financial deficit, it is wise to be conscious of the numerous ways in which the healthcare system can implement strategies to ensure the long term sustainability of the service. With over 1.3 million people working in the NHS alone, the health service is both a significant component of the regional economy and owner of a vast carbon footprint. Data shows that the NHS is the largest public sector contributor to climate change in Europe, emitting 22.8 million tonnes of carbon

with the Healthcare Financial Management Association (HFMA), outlines a number of methods which can be used to mitigate the environmental effects of the NHS, whilst also making impressive financial savings. Securing Healthy Returns draws attention to a series of instances where the health and care system has the potential to improve sustainability through financial and environmental means, to aid decision makers in making the right choices for their healthcare business. In fact, data from the study claims the health sector could save £414 million per year, along with an annual reduction of one million tonnes of CO2e by 2020. The research encourages managers of healthcare organisations to assume a kaleidoscopic approach to implementing sustainability initiatives, to choose financial investments that address social, economic and environmental issues, over those which merely cut the numbers.

Data ims tha t the health s e c t o r save £4 14 milli could year, an o d an an n per reducti nual million on of one to CO2e by nnes of 2020 THE FIVE YEAR

dioxide equivalents (CO2e) each year. The Sustainable Development Unit (SDU) is accountable to NHS England and Public Health England and exists to support the NHS, public health and social care to embed and promote the three elements of sustainable development – environmental, social and financial. The SDU’s Securing Healthy Returns report, compiled in coordination

FORWARD VIEW As voiced by Sandra Easton, chair of the HFMA, we need to ‘exploit the financial opportunities of being socially and environmentally sustainable’, in order E




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SUSTAINABILITY  to meet the £22 billion efficiency savings outlined in the Five Year Forward View. At the end of last year, NHS England shared new guidance directing every health and care system in England to produce a Sustainability and Transformation Plan (STP). The STPs should be designed to set out how local services will evolve to become more sustainable over the next five years. The report advised moving towards more long term principles of improvement, as opposed to short term routes involving quick fixes. It claimed that using this technique in areas ranging from procurement, public health and better models of care can significantly improve the NHS’s financial and environmental forecast. CARBON CUTTING INTERVENTIONS Examples of sustainable measures were included in the SDU’s Carbon and Cost Benefit Curve, which displayed 35 carbon cutting interventions. The graph measured the tonnes of CO2 emissions saved against the cost per tonne of CO2 emissions saved. The resulting data highlighted that the most dramatic savings were made, both financially and environmentally, through measures such as waste prevention, waste reduction, alternative models of care and staff behaviour. The top ten ranked interventions which sustained a top figure of savings and a reduction in CO2 included: theatre kits in hospitals – reducing packaging; sugar

health and well-being, health sector organisations have a responsibility to select financial processes which minimise negative impacts on local public health and social value. It recommended that an integrated approach to sustainability should: support local employment in the supply chain through sustainable procurement; support innovation and participation in efficiency through staff and community engagement; protect local public health through reduced air, water and ground pollution; and use investment in NHS infrastructure to leverage social value. This could be done by connecting a new energy plant to a district heating network to supply low cost heat to people in fuel poverty, for example. The report also highlighted the importance of using Organisational Sustainable Development Management Plans (SDMPs), which are in place in most NHS organisations. The aim of SDMPs is to bring together measures that drive down the use and cost of finite resources, as directed by the NHS Constitution Commitment, Number 6, which states: “The NHS is committed to providing best value for taxpayers’ money – it is committed to providing the most effective, fair and sustainable use of finite resources. Public

Data shows that the NHS is the largest public sector contributor to climate change in Europe, emitting 22.8 million tonnes of carbon dioxide equivalents each year reduction in soft drinks; combined heat and power (CHP); reducing medicine waste; active staff travel; psychiatric liaison; biomass boilers; effective use of long-acting injections; driver training for fuel efficiency and safety; and reducing social isolation in older people. For example, the graph plotted potential savings made from active staff travel, which involves encouraging staff and visitors to walk, cycle or use public transport to get to sites. The benefits from switching to this mode of transport could mean the NHS would generate £2.9 million in savings, thanks to reduced vehicle use and air pollution and added health benefits from exercise. COLLABORATIVE WORKING IS SUCCESSFUL WORKING The report outlined the importance of collaborative working to ensure smooth and effective implementation. The analysis pointed to the importance of considering the wider benefits when contemplating a particular sustainability initiative. Since the financial decision made by health organisations will ultimately impact on local

funds for healthcare will be devoted solely to the benefit of the people that the NHS serves.” Another measure which performed well on the graph included the installation of combined heat and power (CHP) systems which generates usable low cost, low carbon heat and electricity. Rampton Hospital replaced its coal fired heat plant with a CHP unit and a wood chip boiler. Following its implementation, the trust managed to reduce energy costs by 44 per cent, making an annual saving of around £790,000 and cutting 8,614 tonnes of CO2e. COST CUTTING CASE STUDIES A further case study from the SDU documents the savings made by Sussex Community NHS Foundation Trust. Staff across the trust were travelling almost six million business miles per year, representing a collective cost of £3 million and producing a similarly significant quantity of carbon emissions. In order to help alleviate the costs, the trust created a Business Travel Plan with resources to assist staff in reducing their business mileage. The strategy involved encouraging staff to book one of 15 low emission vehicles

for use during work hours, allowing them to travel to work on foot, by bike or on public transport. As a result of the Travel Bureau initiatives, the trust was able to shed 949,500 miles from its business mileage, translating to a saving of £500,000 and 60 tonnes of CO2e, in the first year after launch. Meanwhile, a Worcestershire County Council and local CCGs programme launched a Social Impact Bond, whereby social investors covered the upfront costs for social enterprises and charities to deliver new and exciting programmes to address the needs of vulnerable groups and reduce social isolation for 3,000 older people. The programme will deliver £1.3 million in direct annual savings and 244 Quality Adjusted Life Years (QALYs – worth £15 million in avoided social cost), reducing CO2e by 217 tonnes. MORE PROGRESS NEEDED The report maintained that many organisations have already made progress in aligning financial and environmental sustainability. However, in order to fully reap the financial, social and environmental benefits and potentially save £414 million annually, the report calls for improved collaborative working with finance, sustainability facilities, procurement, commissioning and between all health staff. Michael Brodie, Finance and Commercial director for Public Health England, commented: “In addition to the legal and scientific reasons for taking sustainable development and climate change seriously, there are equally important financial and organisational reasons for action. In PHE, we have already saved millions of pounds and reduced our carbon footprint by rationalising processes and estate, empowering our staff and the public with the latest opportunities in IT. We will continue to work with our partners in health and local government to create the right conditions for a fair, healthy and sustainable future for us all.” L FURTHER INFORMATION



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MANAGING THE ANTICOAGULATION TREATMENT PROCESS Mobile computing solution transforms the management of anticoagulation treatments Buckshaw Village Surgery aims to provide the highest quality of healthcare services to patients in the area. A large proportion of these patients are elderly, many with dementia. The previous pathway for anticoagulation treatment would include unnecessary handling of patients in clinics, delays in analysis and the prescription of medication. This pathway required patients to travel to the nearest acute, phlebotomy or anticoagulation clinic. A venous sample was taken on a first-come-first-served basis, sent to the pathology for analysis and the patient sent home. The patient’s yellow dosing book stayed with the clinic and the INR result entered, before being mailed to the patient or GP. The patient was then called to the GP practice. On collection of the prescription, the yellow book was returned to the patient, providing their daily dosing schedule and warfarin medication was dispensed. This process was repeated as dictated by the patient needs, taking between three and five days. SOLUTION The deployment of a comprehensive mobile computing solution enabled the delivery of a domiciliary, single point of care service. The process time is reduced significantly, and the solution allows for a simple and cost effective pathway. The mobile working solution is based on a Motion C5 Tablet PC, running a full EMIS Web client with Electronic Prescribing enabled, linked with the INRstar decision making software, alongside a mobile diagnostic tool for measuring INR results. Healthcare assistants can now visit patients at home, carrying a mobile diagnostic device and a Motion Tablet PC running INRstar and EMIS Web. The simple thumb prick is taken at the patient’s home, and can be analysed in real time, with the result providing an instant dosing schedule for the patient’s yellow booklet, and an update for the clinical record. The healthcare assistant is able to provide a daily warfarin medication regime, which is authorised remotely by a responsible GP. Medication is electronically requested and prescribed, with clinical records updated in real time. Thanks to the smart capabilities of the Motion Tablet PC, the pharmacy receives the prescription, dispenses it, and delivers it



to the patient. Equipped with a mobile label printer connected wirelessly to the Motion C5 Tablet, the healthcare assistant is able to print off labels with a correct and up-to-date warfarin dosage schedule. This negates the need to handwrite this into the yellow booklet, hence eradicating clinical risks further. WALK-IN SERVICE In early 2016, Buckshaw Village Surgery saw the launch of three new purpose-built surgeries for the delivery of multi-care services to its residents. Since then, patients can visit the ‘drop-in’ clinic for the administration of their anticoagulation treatment, using the same technology as the mobile solution used at the patient’s home. Being able to use the same hardware for both the surgery based drop- in sessions and domiciliary home visits ensures maximum use of the new hardware giving a greater return on investment. BENEFITS In allowing the management of the anticoagulation medication to be delivered either through a ‘drop-in’ clinic, or at the patient’s home, a greater flexibility is given to patients. For vulnerable elderly patients, many suffering from dementia, the ability to deliver treatment in an environment in which they feel comfortable and safe is an important

consideration. In enabling the healthcare assistant to manage the anticoagulation treatment process at the patient’s home means greater convenience for patients, and a much less invasive procedure. Taking treatment and assessments to the patients also results in a much greater quality of care. In delivering a shorter and more effective process, time savings are considerable too. The fact that medication is available within four hours and can be delivered to the patient improves warfarin compliance. The real time decisions and instant prescribing method improves the service patients receive as well as the quality of clinical treatment. Commenting on the solution, Brian Hann, business & operations director, said: “As an organisation, we have seen massive reduction in handling times and associated costs since the introduction of this solution. It has allowed us to reduce clinical risk significantly and compliance to warfarin medication has vastly improved. Service costs have been reduced too, eradicating the previous double handing of patients, and the faster process ultimately means that staff are more productive and patients given a greater quality of care.“ L FURTHER INFORMATION Tel: 0161 776 4009




Maximise your budget – buy more for less Having access to the right medical equipment is critical for the delivery of safe and efficient patient care, with advancements in technology delivering improvements in both productivity and health outcomes. However many NHS trusts have ageing medical equipment which is exacerbated by the current financial position of the NHS. Understanding the pressures facing trusts, NHS Supply Chain’s Capital Solutions team are working to help trusts maximise their budgets to help acquire the latest medical equipment. The extent of the Capital funding challenge facing trusts was highlighted in a report from The Kings Fund, published last July. The report spoke of the ‘growing tendency to redirect capital spending to shore up revenue budgets and support day-to-day running costs with £640 million switched from capital to revenue in 2014/15 and £950 million in 2015/16.’ Jason Lavery, vice president of Capital Solutions at NHS Supply Chain, explains:

“Managing capital expenditure is an ongoing challenge that every Trust faces. The NHS is faced with significant financial challenges. Yet at the same time, more and more medical equipment needs replacing to ensure clinicians can access the latest technological advancements. We understand this and are working across the NHS to help trusts maximise their budget, deliver savings and make the right spending decisions.” By purchasing their capital equipment through NHS Supply Chain, individual trusts can use the combined buying power of the NHS to share in leveraged savings, driving best value for money and deriving maximum benefit for patients and staff. CAPITAL EQUIPMENT FUND Since March 2012, over £61 million in incremental savings have been delivered back to the NHS through the Department of Health’s Capital Equipment Fund. This fund, developed

by the Department of Health (DH), the NHS Business Services Authority (NHSBSA) and NHS Supply Chain, was implemented to allow NHS Supply Chain to buy medical equipment in bulk and make the best possible use of NHS buying power. It is accessible for all NHS Supply Chain Medical Equipment frameworks and has delivered significant incremental savings back to the NHS, particularly on the Radiology and Radiotherapy frameworks where there has been increased focus due to the high cost of purchasing this equipment. Although the benefits of large scale procurement on areas such as Linear Accelerators and MRI scanners are more visible, the importance of lower value medical equipment is also recognised. Following the mantra ‘pennies make pounds’ a specialist team of Capital Planning Coordinators have developed aggregation techniques for lower value equipment categories, utilising the DH Fund as a financing vehicle to E

Written by NHS Supply Chain

Savings are the holy grail for hospital trusts. The NHS Supply Chain discuss best practice for managing medical equipment in a financially constrained environment

Case Study: Leeds Teaching Hospital NHS Trust Leeds Teaching Hospitals NHS Trust recognised the need to meet rapid advances in medical technology across multiple clinical areas in order to future proof their patient services for the long term. They had to overcome budget restraints, and needed to reassess requirements, and prioritise replacement within challenging timescales. Their project sought to replace the obsolete and ageing medical equipment, introduce innovative technologies to future proof patient services for the long term, and optimise savings to ensure best value. The trust worked in partnership with NHS Supply Chain to benefit from their framework agreements, that are compliant with EU Public Procurement regulations, gain access to the Department of Health (DH) Capital Equipment Fund, and extend potential savings by leveraging national demand with multiple trusts (multi-trust aggregation). Leeds Teaching Hospitals NHS Trust consequently achieved £1.3 million in total savings from MTA, the DH Capital Equipment Fund and framework discounts. Utilisation of savings realised

St James’s University Hospital, Leeds

were reinvestment back into clinical areas with budget limitations, to procure additional equipment which would not have otherwise been purchased. Innovative equipment and technologies were also rolled out trust-wide. By adopting a partnership approach with NHS Supply Chain and providing a dedicated working group with the power to make decisions, Leeds Teaching Hospitals NHS Trust, successfully delivered the project with minimal difficulties. Combining their procurement arm, with NHS Supply Chain’s knowledge, insights into routes to market and access to additional savings opportunities, opened

up new possibilities. This provision of information, dialogue across multiple stakeholders and NHS Supply Chain’s engagement enabled maximisation of savings through framework volume discounts, the DH Capital Equipment Fund and MTA; alongside the evaluation and delivery of ‘best fit’ equipment. All of which added value to the Trust, enabling successful project delivery. Through Leeds Teaching Hospitals NHS Trust sharing their equipment plan data, NHS Supply Chain were able to cross check this with other Trusts nationally, and identify trends and requirements that could be aggregated to achieve additional savings. David Brettle, head of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, said: “Providing best in class medical equipment and service to patients demanded we update our asset base as a priority. NHS Supply Chain has the skill and flexibility to deliver savings. They are best placed to flex their muscles and have the skills to negotiate MTA deals.”



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BUDGETS  establish Multi-Trust Aggregation (MTA). MTA is a mechanism which combines the requirements for a particular device from a specific supplier across multiple trusts and aligns procurement activity to allow customers to take advantage of volume discounts. Since the first MTA deal in November 2014, participation has grown to include 135

trust, believes wouldn’t have been possible without the support of NHS Supply Chain. Booth commented: “I am very happy with the service provided and the proactive approach that NHS Supply Chain has adopted for the MTA and DH deals. It has helped us to achieve savings that otherwise would have alluded us.”

By purchasing their capital equipment through NHS Supply Chain, individual trusts can use the combined buying power of the NHS to share in leveraged savings, driving best value for money and deriving maximum benefit for patients and staff trusts and 18 suppliers who have supported the delivery of procurement aggregation across 21 different equipment areas. In total an incremental saving of £1,441,195 has been delivered back to the NHS. East Kent Hospitals NHS Foundation Trust is one of the 135 trusts that have benefitted from MTA. Since June 2015, the trust has achieved £36,735 savings due to participating in eight MTA deals across five equipment areas which Adam Booth, buyer for the

The increasing success of MTA is largely attributed to the introduction of the Regional Collaborative Workshops. Hosted by NHS Supply Chain, these workshops bring together stakeholders from procurement, Electro Bio Medical Engineering (EBME) and finance to discuss purchasing requirements and aggregation opportunities in order to generate savings back to their trust. University Hospitals of Leicester NHS Trust has benefitted from the workshops so much



so that future opportunities are already being considered. Andrew Hawkins, category manager at University Hospitals of Leicester NHS Trust, said: “The workshops have been very informative and have provided insights to equipment modalities where potential savings can be achieved by aggregating demand across the collaborative. To date we have been involved in eight MTA’s, however, this has the potential to increase as we look to the wider collaborative sharing 2016/17 plans.” To further develop the MTA process, an Aggregation Calendar has been produced which combines trust requirements on a larger scale in order to drive further savings. An example of this is the aggregation of neonatal and diathermy equipment where 11 trusts from four different regions aligned requirements and benefitted from a total incremental saving of £17,900. NHS Supply Chain is committed to supporting the NHS to achieve savings across medical equipment categories using various savings levers including MTA. Sharing requirements and working in partnership allows the Capital Solutions team to continue to deliver and improve the savings achieved enabling trusts to fully utilise their Capital expenditure. L FURTHER INFORMATION

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Brexit and the NHS: where are we now? With the NHS featuring heavily in this year’s EU referendum debate, Kate Ling, of the NHS Confederation’s European Office, looks at the NHS European workforce in a post-Brexit world First and foremost – the UK is still a full member of the European Union, so nothing is going to change in the near future for EU staff working in the health service. Negotiations on our ‘exit package’ will not begin until the UK government officially informs the EU that it wishes to withdraw from the EU (under Article 50 of the Lisbon Treaty). For a minimum of two years after this, all current EU legislation, including employment law, will still apply. Domestic legislation deriving from EU law will remain in place unless or until actively repealed. And during this time the residence and employment status of EU nationals will remain unaffected, as will free movement across the EU. BREXIT – WHAT NEXT? The implications of Brexit for EU citizens working in the UK is dependent on the type of exit the UK makes from the European Union.

A ‘soft’ Brexit would largely preserve the status quo, retaining the UK’s access to the single market and freedom of movement for workers across the EU without visa or work permit requirements. Current employment legislation, including the European Working Time Directive, would still apply, as would the current cross-border healthcare rules entitling UK citizens to healthcare in EU countries (and vice-versa). A ‘soft’ Brexit would still require the UK to contribute to the EU budget, in a similar way to Norway. On the contrary, a ‘hard’ Brexit would not require further contributions to the EU budget: the overall economic impact of

such an exit is however unquantifiable, and expert predictions vary. This form of Brexit would leave the UK free to determine its own laws. The UK would be able to amend employment legislation (for example) if we so desired, but domestic contracts would remain in place until re-negotiated. Even if the UK leaves the EU in a ‘hard’ Brexit and migration policies overall become harder, the UK government can, if it so chooses, take steps to protect EU nationals already working in the NHS and to reassure them their future is secure. They can also devise rules, such as shortage occupation exemptions, to ensure a continuing future pipeline for vital sectors such as healthcare. If and when that priority has been guaranteed, then Brexit could present both threats and opportunities for the NHS workforce. An ‘inbetween’ or ‘bespoke’ agreement for Brexit is a possibility, although European leaders have stated there is no access to the single market without free movement. It’s impossible however to predict what compromises or exceptions could emerge during the negotiating process, and whether or not the EU will want to take a hard stance against the UK ‘pour encourager les autres’?

Written by Kate Ling, Senior European Policy Manager, NHS Confederation European Office


The NHS wa the hea s at pre-refert of the debate, rendum remain and it must at t of the Bhe heart negotia rexit tions

THE NHS CONTEXT The NHS is currently facing massive financial and service pressures which E Volume 16.5 | HEALTH BUSINESS MAGAZINE


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BREXIT  pre-date the EU referendum. The challenges posed by the Carter and Willis report, the need for greater health and social care integration and new models of care to cope with an ageing population, the challenge of delivering seven-day services and of developing Sustainability and Transformation plans (STPs) is more than enough, without any added complications from Brexit. There are varying predictions of the likely impact of Brexit on the UK economy. Clearly a ‘soft’ Brexit would have a lesser impact than a ‘hard’ Brexit. And although the UK economy is relatively buoyant compared with the Eurozone, most economists predict that lower economic growth is likely in the short term, which will require difficult decisions about public spending. The implications of this for NHS funding are significant, given that £1 in every £5 of UK taxes is spent on the NHS. THE EUROPEAN WORKFORCE The NHS is an attractive employer for many EU nationals: UK salaries are higher than in several EU countries, especially Eastern member states. Austerity and cuts abroad (Ireland, Greece, Spain, Portugal, Italy) have given rise to a lack of jobs in home countries – a significant ‘push’ factor for healthcare professionals. In addition, the NHS has a high reputation and offers the experience

of working alongside top clinicians and researchers in world class institutions. Consequently, European nationals make up around five per cent of the total NHS workforce, with this proportion much higher in London, the South East and in specialist trusts. This varies by staff group, but includes around 10 per cent of the NHS medical workforce – almost 30,000 doctors. Furthermore four per cent of UK medical students are EU nationals. The evidence that the UK is already underdoctored is indisputable, with multiple rota gaps and failure to fill 42 per cent of consultant physician posts – in some trusts, over 40 per cent of locum consultants are EU-trained. The most important workforce priority, whatever form Brexit takes, is to ensure those EU nationals already in the NHS don’t leave either voluntarily or as a result of changes to migration policy and legislation. As well as ensuring that EU nationals who are already working in the NHS do not leave the UK, there are concerns EU nationals may be put off coming to work in the UK – especially during the two uncertain years of Brexit negotiations. Workforce leaders in the NHS have highlighted their fears that this may exacerbate staff shortages, inflate agency costs and threaten

In the immediate, short-term future NHS employers and trade unions have banded together to ram home the message that the NHS welcomes and values EU workers



planned service delivery, all within a likely context of tightening overall funding. In the immediate, short-term future NHS employers and trade unions have banded together to ram home the message that the NHS welcomes and values EU workers. We must reassure them, provide support and guidance and campaign for their ‘right to remain’. POST-BREXIT IMPERATIVES The newly-formed Cavendish Coalition, an alliance of health and social care organisations including (amongst others) NHS Employers and provider networks, trade unions and professional bodies, is doing just this. The coalition’s members aim to support the NHS workforce pre and post-Brexit by creating training places and jobs locally, while promoting good employment practice to attract and retain both home-grown and international talent. It is advocating to the UK government for the ‘right to remain’ for EU health and social care workers, and for a future migration policy which will support world class services and research. The prospect of Brexit redoubles the urgency of existing initiatives such as the ‘Talent for Care’ drive to expand massively the number of apprenticeships in the NHS both for younger and more mature candidates, offering opportunities for existing local staff as well as new recruits. Proposals to pilot new roles such as ‘nursing associates’ and for new pathways into nursing may offer opportunities for skilled healthcare staff to progress and gain qualifications ‘on the job’ without the disincentive of having to leave work to go back to studying. We welcome the government’s recent announcements of additional domestic training places for healthcare professionals, but this will not be enough on its own. Longer term workforce planning must incorporate not only ‘growing more of our own’ in order to reduce dependence on overseas staff, but must acknowledge that for the foreseeable future the NHS will need to continue to attract and retain a global workforce. THE NHS VOICE IN BREXIT The NHS was at the heart of the pre‑Referendum debate (remember the Battle Bus?): it needs to remain at the heart of the Brexit negotiations. The NHS Confederation and NHS Employers are working to get the best possible deal for the Health Service by minimising the risks and maximising the opportunities that Brexit presents. Other sectors are intensely lobbying for their interest: we must ensure the NHS voice is heard loud and clear above the clamour. L FURTHER INFORMATION nhs-european-office



Healthcare Recruitment


Making recruitment in healthcare easier A new healthcare training and recruitment event has offered health professionals with new, significant continuing professional development opportunities. Health Business reviews the Healthcare Recruitment & Training Fair In 2013, the World Health Organization (WHO) predicted shortages of 12.9 million health-care workers globally by 2035. Failing to immediately solve this issue will have serious health implications for billions of people across the world. This has caused tremors in hospitals and clinics currently facing projected shortages in their workforce. In the UK, HR departments are struggling to meet workforce demands which leaves little time to plan for future staffing issues, let alone the current shortage of qualified staff in the UK, both resulting from an increase in demand for care versus a decrease in the supply of qualified staff. One major factor impacting the increasing demand of the UK healthcare system is attributed to the prevalence of a growing

ageing population and the development of new medicines which have led to people living longer and thus places healthcare systems under more strain to manage capacity. This growth of ageing populations can only expect to further increase demand for health care services in the future. Additionally, the shift in the leading causes of death in the UK from communicable diseases to chronic diseases such as cancer, cardiovascular diseases and neurological conditions such as dementia, also impacts the demand. Moreover, the global migration of ethnic minorities, and more recently migration from war, is increasing the numbers of patients in communities. While immigration into the UK tends to be of younger people and who are more likely to have lower healthcare

are Healthc s are ll shortfa England, : in evident HS vacancies N 62,520 advertised in were ree months just th autumn in the 014 of 2



needs, population growth is demanding is contributing to demand for NHS care. NHS workforce planning must reflect factors such as the high propensity of less health migrants to move into deprived areas where hospitals and general practitioners may be at capacity limits. This increasing demand adds significantly to the current workforce shortages and is only expected to keep on increasing over time. STAFF SHORTFALLS Shortfalls in qualified healthcare staff is also evident by the number of job vacancies advertised for hospital and caregiver roles throughout the UK. In England, 62,520 NHS vacancies were advertised in just three months in the Autumn of 2014. These shortfalls are attributed to high recruitment costs and a decrease in the number of students going into the medical field. Looking deeper into the issues underpinning the shortage of skilled healthcare workers, high staff turnover also plays a big part;

16,000 or 30 per cent of nurses leave their roles each year. On top of this, many are also being recruited from abroad, in 2014 one in four nurses were recruited from the EU with an estimated cost of £2,500 per nurse. The importance of finding permanent staff therefore becomes crucial in the light of the government’s commitment to cut temporary staff costs by €1 billion. Shortages in qualified staff is also stemming from the lack of young people entering medical and healthcare training programs. This drop has been attributed to high education fees and recent cuts in funding for training in healthcare disciplines. Factors such as the lengthy training programmes, antisocial working hours, high stress levels and low remuneration for junior roles also impact choices for medical and healthcare careers. Solutions to meet current and future work force demands including promising long term government initiatives to fill the future UK healthcare deficit are already underway. These include government supported road shows, event days in schools to help generate interest at an early age in addition to fast track career development and apprentice programs in efforts to ensure qualified medical staff for the future. However, it takes time to implement such solutions. Immediate actions are needed to fill in vacancies quickly. THIS YEAR’S SHOW Recruiting good staff is time-consuming and costly for any organisation and as such retaining great employees should be a top priority. Career development opportunities, flexible work schedules, benefits tailored to individual needs and goals are tested ways to retain valued employees. Hospitals are thus encouraged to consider career development programs to retain key workers which will definitely build their existing workforce and meet future demands. Recruitment shows are a popular and effective solution for providing a platform to advertise vacancies, meet and screen potential candidates on site, find top talent and reduce recruitment costs instantly. The Healthcare Recruitment & Training Fair opened its doors on 15-17 September at ExCel, London, to 1,026 attendees to assist healthcare organisations in their recruitment process in the midst of the UK’s healthcare workforce deficit. Organised by Informa Life Sciences Exhibitions, the fair offered the ideal opportunity for the medical industry to come together and get involved. As the UK’s newest recruitment and career development event designed to support the whole healthcare sector, the Healthcare Recruitment & Training Fair hosted 18 free-to-attend conferences across the three days during the event. Twelve of the conferences, which delegates were free to attend, had a clinical focus. The conferences included: Anaesthesia; Cardiology; Dermatology; Diabetes; Emergency Medicine, General Practitioners; Nursing;

Obstetrics and Gynaecology; Orthopaedics; Paediatrics; Radiology; and Surgery. The other conferences were: Leadership; Working Abroad; Best Practice & Trust Showcase; Alternative Careers; Placement & Specialist Selection; and Nursing Workforce Planning & Strategy. On top of this, an extensive and specialist list of 77 speakers were on hand to pass on their knowledge and experience. Outside of the conferences, the Placement and Specialist Selection Workshop presented a session on how to approach the medical specialist application form and prepare the perfect medical CV. Further to this, an all-day conference on leadership and management skills considered techniques and tools, and also looked at developing leadership skills including structuring career pathways, leading organisational change, developing enhanced influencing skills and dealing with underperformance. EXHIBITORS AND THE FAIR Data revealed before the show suggested that NHS England is placing around 26,000

included a number of overseas and international organisations, including representatives from Western Australia, and Gulf Region hospitals in Dubai, Abu Dhabi, Riyadh, and Doha. Among the 55 exhibitors, the main reasons for exhibiting were noted as: to seek candidates to fill immediate or future vacancies; to broaden recruitment programmes; to meet new candidates faceto-face during the event; and to promote companies as a great place to work. Dr Tahira Rashid, head of development at Informa Life Sciences Exhibitions, said: “A key element to the Fair is in the range of CPD-accredited conferences and masterclasses. In line with Informa Life Sciences’ philosophy of ‘Exhibition with Education’, these premier seminars will attract a diverse range of specialists and doctors. “Recruitment shows are a popular and effective way of filling vacancies quickly,” she added. “These one stop solutions have proven to be the ideal way to fill current vacancies in the shortest time while delivering training to enhance the retention of good employees. “The Healthcare Recruitment & Training

Healthcare Recruitment


Career development opportunities, flexible work schedules, benefits tailored to individual needs and goals are tested ways to retain valued employees – and the NHS should be no different full time equivalent job vacancy adverts each month. The data also suggested that each advert attracts an average of 13 applications, with three applicants shortlisted, but with only around one in five vacancies being filled. Running parallel to the conferences is a healthcare recruitment fair with exhibitors representing a range of trusts, clinical commissioning groups, and healthcare service providers from around the UK. Potential employers include University College Hospital London, Kings College Hospital, and Peterborough and Stamford Hospitals NHS Foundation Trust. Exhibitors

Fair will appeal to all professionals working in healthcare who are interested in career opportunities, with exhibitors 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.” L

The Healthcare Recruitment & Training Fair will return in September 2017. FURTHER INFORMATION


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Hospitals can be very large and complex buildings that pose more fire risks than other environments. Will Lloyd, of the Fire Industry Association, analyses the risks and steps to take to ensure safety In a shocking lack of knowledge regarding fire safety, news of four hospitals within the UK reached national press this year. The reason? They all lacked sufficient fire protection. The Sun reported that the hospital in Coventry was hit with £380 million bill after it was revealed that builders had failed to fire-proof it. Of course, this is no fault of the doctors and other medical staff working in the building, but it does highlight the dangers that a fire could do to a building and how important it is to comply with fire regulations. Regardless of the type of building, the fire regulations for England and Wales are all part of a piece of legislation called the Regulatory Reform (Fire Safety) Order 2005. This legislation sets out all the responsibilities of the owner of the building (called the ‘responsible person’ in UK legislation).

In simple terms, the ‘responsible person’ must ensure the safety of all of the people within the building. In a hospital setting, the real crux of the matter is the sheer volume of vulnerable people within the hospital building that must be protected in the case of fire, along with all the staff and visitors to the hospital. As a legal responsibility, the ‘responsible person’ must carry out a fire risk assessment to manage the risk to the vulnerable people.

potential risks involved, called ‘Fire safety measures for health sector buildings (HTM 05-03)’. This guide is essential reading for a responsible person as it outlines some important factors to consider in terms of fire safety, and is both thorough and comprehensive. The guidance outlines almost everything that one should consider in terms of fire safety – from general fire safety, to more specific aspects such as provisions for textiles and furnishings, escape lifts, and fire detection and alarm systems. All of these guides are available to download from, but the Fire Industry Association (FIA) is also available for practical and technical advice and guidance regarding fire risk assessments and fire alarm systems over the phone.

Be practicest that a fi states should re alarm weekly be tested – inform it is vital to s test to taff of the min disrupt imise ion

FIRE GUIDANCE Hospitals can be very large and complex buildings. The main risks for fire in a hospital are the main risks of fire everywhere, but with hospitals there are more risks. There’s the risk of patients with limited mobility as well as all the flammable substances that most buildings do not contain, such as chemicals and oxygen supplies, and all the flammable materials within a pharmacy or an operating theatre. Even if one simply considers the sheer volume of curtains and bedding within a hospital, that presents a risk too, because naturally cloth is flammable. The Department for Health has published a wide range of guidance for hospitals on the

PATIENT SAFETY Of course, a great consideration is the patients themselves and the danger present to them in the event of a fire. Due to limited mobility, a plan should be drawn up for progressive horizontal evacuation, whereby each floor or section of the hospital acts as a different ‘compartment’ for a fire. When the fire approaches a nearby compartment, staff and patients should evacuate that compartment, E

Written by Will Lloyd, technical manager, Fire Industry Association

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RISK MANAGEMENT  rather than evacuating everybody from the whole building at once. This is why passive fire protection – insulation from fire within the walls, doors, and windows is vital – as it blocks fires from travelling from one compartmented area to another. This is the reason that fire doors are such an important part of trying to contain the fire in the room behind the doors.

by the FIA from earlier this year, entitled Investigations into the causes of false fire alarms, highlighted that despite this problem being exceptionally common, it is something that can easily be remedied. The solution is to ask a specialist fire alarm company to install a special plastic cover to go over the call point, which should protect it from getting banged or knocked by busy staff with trolleys.

Due to limited mobility, a plan should be drawn up for progressive horizontal evacuation, whereby each floor or section of the hospital acts as a different ‘compartment’ for a fire Fire doors are designed to help stop the spread of fire beyond the doors; it helps in the event of an evacuation situation to keep the fire contained within the designed ‘compartment’ of the building. However, in a hospital, fire doors are often propped open or bashed into by hospital trolleys. But this can be exceptionally dangerous as it increases the risk of fires spreading through the building. Keeping the doors closed keeps the fire safely behind the door, allowing for a greater escape time. Therefore, it is vital not to prop fire doors open with hospital trolleys or cause damage to them as this reduces their effectiveness. Additionally, hospital trolleys banging into manual call points (the button that activates the fire alarm) is one of the prime causes of false alarms in hospitals. Research sponsored

Not only do false alarms cause time to be lost investigating the cause, they also cause distress to patients who may be worried that there is a real fire on the premises. It is therefore recommended that alarms have a delay before sounding. During this time, a team should investigate the cause of the alarm – and confirm if the fire is real or false. If a fire is confirmed, the evacuation plan including progressive horizontal evacuation should be followed. HAVING A SOUND FIRE PLAN Understanding the evacuation plan and having a robust system for the event of a fire is a necessity. Perhaps even more important is the need to communicate this plan to the staff. Communication is key, particularly in a situation where fire alarms need to

Fire Safety


be tested. Best practice states that a fire alarm should be tested weekly – but it is vital to inform staff of the test to minimise disruption and allow the staff to reassure patients that it is not a real fire alarm. This is why the best advice anyone could give in regards to fire safety is just to remain vigilant; keep the fire risk assessment upto-date and follow its recommendations to the letter. The fire risk assessment forms the entire basis of the fire safety management strategy for the building, and should be reviewed on a regular basis. Talk to staff and make fire safety an integral part of caring for patients. Staff should all be involved. As a minimum, fire safety training should be carried out once a year, but it depends on the needs of the staff and patients as well as the type of training – staff should be made aware not just of the evacuation procedure, but of how to use evacuation equipment such as sleds, chairs, or other equipment designed to evacuate the immobile. Additionally, portable fire extinguisher training is such an important part of the strategy; if staff are trained to know how to use a fire extinguisher, they can combat small fires (no larger than a waste paper basket, for example), which will prevent the fire getting bigger and becoming a problem. Training staff how to use the equipment in a practical sense and letting them use it in a mock-fire situation will help increase their confidence and help them to provide better care for the patients overall. L FURTHER INFORMATION


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Setting a new standard in healthcare Visitors and delegates flocked to Manchester for the biggest showcase of products and services in the UK healthcare sector. Off the back of this, Health Business reviews Healthcare Estates As the built environment of the healthcare sector continues to evolve, Health Business looks back at the Healthcare Estates show, which took place on the 4-5 October at Manchester Central, and is the UK’s largest trade exhibition for the healthcare sector. On the 4-5 October, an assembly of delegates gathered together at Manchester Central, to exchange knowledge and network at the Healthcare Estates show, which included the IHEEM Annual Conference, Awards Dinner and exhibition.  A COLLABORATIVE ESTATE At this year’s show, the conference followed the theme of ‘Transforming the Estate through Collaboration’ and concentrated on

maximising the NHS estates and facilities’ budget through efficiencies in design, build, management and maintenance. Healthcare Estates featured four streams of content, including: Strategy; Design and Construction; Engineering and Facilities Management; and Governance and Assurance. Day one of the show began with a record number of visitors and kicked off with noteworthy keynote presentations from Professor Timothy Evans, consultant in intensive care and thoracic medicine at Royal Brompton & Harefield NHS Foundation Trust; and David Powell, development director at Alder Hey Children’s NHS Foundation Trust. Evans and Powell were then joined by a panel of experts, and quizzed by

question master Simon Corben of Capita Health Partners. Infrastructure panellists included Clive Nattrass, Carbon and Energy Fund; Peter Sellars, Department of Health; and Julian Amey, Institute of Healthcare Estates and Engineering Management. Keynote addresses on the second day included a detailed exploration of the ‘The View of the Estate and the Contribution of the Estates and Facilities Community from the Perspective of the DH Director General with Responsibility for NHS Finance’, by David Williams, director general of Finance at the Department of Health. Following the keynote address, a short break for coffee and a chance to visit to the exhibitions, the streams commenced at around midday. The first day of the conference centred on Strategy, Engineering & Facilities Management and Design and Construction. 

Healthcare Estates


STRATEGY First up on the agenda for Strategy was an introductory discussion on ‘Optimising Clinical Service and Estates Plans to Meet Future Demands’, from Connor Ellis, head of Health Sector at Citrica. The presentation examined the current state of the NHS Estate in its entirety and explored ways we can achieve a long-term health and social care investment plan. Further discussions ranged from ‘Transforming the Way Integrated Technologies are Delivered’ to advice on making a success of private and public sector partnerships. Meanwhile, the second day of the exhibition saw the Strategy stream debate subjects ranging from an update on the Carter Review and the potential for new healthcare models.  ENGINEERING & FACILITIES MANAGEMENT The Engineering & Facilities Management dialogue included an assortment of topics within the healthcare sector. Lynda Cox of assent management company Currie & Brown set the ball rolling with an analysis of ‘The Importance of Independent Review of Facilities Management Contracts’. Later on in the day, Nick Hill of Water Quality London and John Predergast and Sue Holding from Technical Publishing Resources, provided an informative overview of their part in assisting the Department of Health in the production of recent Health Building Notes (HBN) and Health Technical Memoranda (HTM) updates.  The Engineering & Facilities Management’s second day of dialogue included an overview of the importance of monitoring high voltage power equipment, by Geoff Yeomans, associate director at Eta Projects and a presentation on maintaining essential hospital ventilation systems, by Jerry Slain, director of Occupational Hygiene Services.  DESIGN AND CONSTRUCTION  Day one of the Design and Construction stream kicked off with a talk from Martin E





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EVENT REVIEW  Townsend, from the Building Research Establishment (BRE), which centred on the sustainability impact of BREEAM on the NHS estate since it was first launched in 2008. Further discussions for this speciality involved an exploration on creating safe and secure A&E departments and rethinking A&E operations and design to progress the delivery of supportive clinical care for the dementia patient. Concluding the stream, Christopher Shaw, senior director of Medical Architecture, provided advice on implementing a new class of healthcare infrastructure, to support complex and integrated care settings and local networking in hospitals. 

of the West Suffolk NHS Foundation Trust, outlined the trust’s multi-disciplinary approach to implementing the Premises Assurance Model (PAM) in an NHS acute trust and what steps could be taken to improve the process. Next up on the Governance Assurance Agenda was a presentation on CQC preparedness by Robert Nettleton, strategic estates adviser and a concluding speech by Bellas on ‘The Future of ERIC and the Estates and Facilities Dashboard’. 

EM IHEEM AWARDS The IHE inner, WINNERS D s d r Awa d by NHS Meanwhile, the e t n t IHEEM Awards e s i s l e a r p rn u o j Dinner, which d n a took place on doctor Hammond, t s the 4 October, e Phil n the fi d celebrated the finest e t a r celeb healthcare of the healthcare estate sector and was of the e sector t presented by NHS doctor, a t s e

GOVERNANCE ASSURANCE The Governance Assurance conference featured solely on the second day, 6 October, of the Healthcare Estates show, with Michael Bellas, strategy, informatics and assurance lead of the Estates & Facilities Efficiency Team, Carter Improvement Programme, beginning the discussion with an introduction on the developments in the sector.  Following the introduction, Jacqui Grimwood

campaigner, health writer, journalist, broadcaster, speaker and comedian Phil Hammond. Awards and winners included: Estates & Facilities – Yeovil District Hospital NHS Foundation Trust and the Yeovil Estates Partnership; New Build Project of the Year – Alder Hey Children’s Hospital; Patient Experience – Recovery Academy ‘The

Curve’; Product Innovation - Bed Stacker Project, Healthcare Storage Solutions/ Salisbury NHSFT; Refurbishment Project of the Year – Endcliffe, The Longley Centre, Sheffield Health & Social Care NHS FT, P+HS Architects; Client of the Year – The Christie NHS Foundation Trust; and Sustainable Achievement – Carbon and Cost Reductions. EXHIBITION In addition to the enlightening discussions and conference streams which took place, the show included an exhibition with over 200 exhibitors from across the sector. It brought together those who design, build, manage and maintain healthcare facilities and showcased the latest technologies equipment and services designed to improve healthcare environments and patient experience. Specifically aimed at estates and facilities departments, architects, consulting engineers, construction companies, suppliers and others directly involved in managing estates and facilities, the exhibition features and conference provided essential support to both organisation decision makers and professionals. L

Healthcare Estates


The event returns next year to Manchester on the 10-11 October 2017. FURTHER INFORMATION



Andy Williams, chief executive, NHS Digital speaking at HETT as part of the UK Health Show

Unleashing NHS potential at the UK Health Show Rising cyber attacks, public trust in data handling, and the need for new NHS digital leaders, were at the forefront of issues debated at the UK Health Show 2016 More than 4,000 healthcare professionals descended on the conference and exhibition floor of the inaugural UK Health Show, where some of the biggest names from NHS England, NHS Digital, the Department of Health, royal colleges, regulators, providers, commissioners, and industry partners came together to share best practice, to urge for rapid action and to warn of new threats facing the health service. A new event, in the sense that it now brought together five conferences on a single day around technology, cyber security, estates, procurement, and commissioning, the UK Health Show still had familiar footings; incorporating the firmly established Healthcare Efficiency Through Technology (HETT) into its strong programme line-up, from which a rich source of material emerged to help in the better running of the NHS. LARGE CYBER THREATS SUSTAINED AGAINST THE NHS Delegates heard the NHS had become an increasingly tempting target for cyber attackers, a recurrent theme that might have come as little surprise to many. A pre-show

survey revealed widespread concerns from NHS professionals that their organisations faced an increase in attacks in the coming years. But those at the helm of NHS policy told the event they were making a concerted effort to boost preparedness. Rob Shaw, NHS Digital’s chief operating officer, told the event’s Cyber Security in Healthcare Conference that frequent attacks were already taking place, confirming that the organisation is ‘seeing more and more ransomware attacks’. A failed, but nevertheless large and sustained national level attack that took place in September, ‘may or may not have been state sponsored’, he added, warning that in the past attacks like this had not been identified until the moment of the ‘worst outcome’. He told the event that we are now

UK Health Show


‘in detect mode, rather than defence mode’. Speakers from organisations ranging from an ambulance trust, through to Jeremy Hunt’s former ministerial home in the Department for Culture, Media and Sport, all referenced the degree of the cyber threat now facing the NHS. Weaknesses had to be addressed. Andrew Rose of the Information Commissioner’s Office, warned that a lot of successful attacks were being introduced by staff themselves, sometimes due to carelessness, but more often, he said, due to poor training and procedures. The ‘bring your own device’ (BYOD) policy, though less fashionable than it has been in previous years, was nevertheless still a significant security threat to the NHS, insisted Rose. He said: “BYOD, as far as we are concerned, is another potential security disaster waiting to happen. As a data controller you must remain in control of the personal information you are responsible for, regardless of who owns the device. If you allow people to put it on their own devices and take it home, can you retain and keep that control? Probably not.” WHY SPEND SO MUCH ON DIGITISATION? Away from the discussion on the threats of technology, came urgency for its potential in transforming the NHS. Ahead of the UK Health Show, a survey of more than 400 attendees revealed significant concerns over the future sustainability of the NHS – in particular, 86 per cent of professionals questioned cast serious doubts on the NHS’ ability to reach the £22 billion savings outlined in the Five Year Forward View. With finances so stretched, NHS Digital chief executive Andy Williams told the HETT conference just why so much money was being spent on making a digital reality. Referencing findings from the recent Watcher report as his answer, Williams stated that ‘the one thing the NHS can’t afford to do is remain a largely non digital system’. He reflected on trollies of paper seen during a recent personal NHS encounter and the scale of the task still faced. But for Williams, digitising the patient experience had to happen. It was essential for patients facing a lack of co-ordinated care. It was a must for patients like Hugh Huddy, a blind patient who wanted to use digital technologies to avoid unnecessary ‘blind person miles’ in visiting GPs. There were a number of key questions: How can we progressively make sure simple things are available electronically? How can we encourage an apps and wearables revolution? How can we help make the E

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EVENT REVIEW  health and care system digitally accessible? Technology needed to become interoperable, the right leadership was needed, and fundamentally, patient trust was required, said Williams. He told the conference: “NHS Digital, in the last two years, has taken an enormous amount of effort to be much more careful about the way information flows, to us and from us. If we are going to use data and information more effectively we have to do it with the consent of the public. The public has to trust us, and unless we have that trust, we are not going to be able to use that information to manage the system better, to understand patient flows, to develop new methods of care, to allow research, to develop new treatments.” But with that trust, he insisted: “A revolution can start to happen. If we don’t do this, we will never achieve the Five Year Forward View.” CALLING THE ‘DIGITAL DOCTOR’ Professor Bob Wachter, the world renowned ‘digital doctor’ who recently delivered his review of NHS digitisation to Health Secretary Jeremy Hunt, provided his diagnosis to the HETT conference via a Skype call. Interviewed live by NHS Digital’s Sir Nick Partridge, Wachter emphasised the importance of interoperability. With a good number of US technology multinationals exhibiting at the event, he said: “A mistake the US made was to promote wide scale technology adoption, but we didn’t force interoperability from the beginning. 90-95 per cent of our hospitals

He floated the idea of having a technology scaffolding in place and positions like a nurse informaticist, who lives in the same clinical world and who thinks hard about delivering most value for patients, and how this was very exciting for most clinicians. A real risk was the absence of the people needed to form the bridge. Chief clinical information officers still didn’t have the status needed. But the appointment of Dr Keith McNeil as a national CCIO now ‘sets the tone’, added Wachter. He went on to say: “We need more people who have 50-75 per cent of their time available for technology. There aren’t those people in the system today. Trusts need to be pushed to hire these people, with appropriate status. But you also need to train such people. To truly have a robust ecosystem where you are training the right number of people and those people have the right positions in the trust to get the work done, that’s a five to 10-year journey.” DIGITISATION IS ‘NOT A NIKE MOMENT’ Dr Harpreet Sood, senior fellow to the chair and CEO of NHS England, agreed strongly that dedicated clinical infomaticists were needed, and that a structure was required to support them. He said: “I am a clinician with a huge interest in this space, but I have no clear route or training path to combine my clinical training, with informatics training. This will require dedicated resource within organisations which will do this on a full

“Technology adoption is about change, and change is coming to a street near you. It is about culture, which enables us to engage people and unleash innovation, which is what technology is all about” have systems that don’t talk to each other very well or to the GP systems.” Putting the right people in place, with the right skills, would be key. He said: “No clinician or person wants to drive themselves out of a job. Technology transforms in ways that sometimes leads to very different staffing models. In healthcare, I think that idea is very, very far away. That is not what we are talking about for the next 10-20 years. “What we are talking about is doctors and nurses who want to deliver the best possible care for their patients and feel that they are spending their time doing work that doesn’t add value, that is well beneath what they are trained to do, not allowing them to focus their attention where they add most value. Those people are used to seeing technology in the rest of their lives and want their work to be redesigned in a way that makes more sense.”

time-basis. Half a day a week or a day a week is not significant enough to help large scale transformational change.” NHS England’s new CCIO, Dr Keith McNeil, who was referenced by Wachter as the example job function now needed throughout the health service, argued that people held the key. He told the conference: “It would be really nice if it was a Nike moment ‘Just do it’, but it ain’t [sic] that simple. Technology allows us to unleash our potential. But if you look across health, or any industry, potential is really about people. We have got to find a way for technology enabling people to be unleashed. “Technology adoption is about change, and change is coming to a street near you. It is about culture, which enables us to engage people and unleash innovation, which is what technology is all about.”

UK Health Show


Dr Harpreet Sood, Senior Fellow to the chair and CEO, NHS England

HETT Conference at the UK Health Show 2016

The UK Health Show exhibition floor at Olympia London

MORE THAN JUST TECHNOLOGY The UK Health Show was about far more than just technology. Amongst an equally strong speaker line-up that debated everything from devolution to outcomes and clinically led commissioning, the Commissioning in Healthcare conference saw NHS England’s James Sanderson argue strongly for personalisation, with other discussion focussing on achieving 100,000 personal health budgets across England by 2020. The Estates in Healthcare conference saw rich sessions on efficiency and sustainability across the NHS estate. And Procurement in Healthcare pushed the boundaries of just who should lead on NHS procurement. In particular, a convincing address by Janet Davies at the Royal College of Nursing, and Mandie Sunderland, from Nottingham University Hospitals NHS Trust, showed how the hearts and minds of nurses had been captured in reducing waste and variation in procurement when the result was improved patient safety and hundreds of thousands of pounds saved for frontline nursing. At a time when NHS resources are tighter than ever, including the time staff can spend at conferences, the UK Health Show proved a highly valuable resource worth the investment. L

The UK Health Show returns on 27 September 2017 at Olympia, London. FURTHER INFORMATION



Leadership Written by John Yates, group director, ILM



What makes a good leader within the NHS? In a time of constant change and upheaval, leadership has never been more important. John Yates, group director at ILM, discusses leadership at all levels and why support to leaders is critical When it comes to effective leadership, the UK has a skills gap that spans all sectors with UKCES finding that 500,000 new managers are needed by 2020; and 46 per cent of employers struggle to recruit leaders overall. The public healthcare sector is no exception to this shortage either. In his 2015 review of NHS leadership, Lord Stuart Rose raised his concerns about the NHS not having the leadership capability to deal effectively with the changes demanded of the service. Whether it’s changing the way that services are currently contracted, ensuring greater savings and efficiencies, or finding skilled professionals in a complex recruitment landscape – NHS leaders need to be able to work in a constantly shifting environment. More than ever before, we need leaders within the NHS that can face up to the challenge. SINK OR SWIM We frequently hear that those with leadership responsibilities are not given development or support to learn the skills required for such a role. For example, clinicians in the health sector tend to be promoted into leadership positions because of their medical expertise and clinical experience. When promoted, they are expected to pick up leadership skills naturally rather than being taught best practice methods to manage others. This means that clinicians are thrust into leadership positions with the right medical expertise but not necessarily the leadership skills to manage and nurture staff. As highlighted in The King’s Fund report The future of leadership and management in the NHS, many clinicians in leadership positions experience a disconnect between their day job requirements and leadership expectations – not knowing how to strike a suitable balance. This sink or swim approach to leadership, having to learn on the job, is often at the expense of those they are managing. We can all think of bad leaders we’ve had in the past – those who handled a conversation insensitively, or those who we doubted really listened to our concerns before providing an ill-fitting solution. In order for professionals to be effective leaders, training and



development is required to help them hone skills such as active listening and empathy. LEADERSHIP AT ALL LEVELS When we discuss leadership development, it’s all too common to think in terms of training those at the top of an organisation. But actually, leadership skills are needed at all levels of an organisation – so we should be thinking about those starting their careers within the NHS right through to the senior ranks. Leadership requires negotiation, motivation, risk management and problem solving skills (to name a few) and whether entering a first line management role or leading an entire department – these skills will always be needed. Learning doesn’t stop once a training programme is over either; leadership skills need to constantly adapt and develop. We now have an unprecedented four generations working together in the workforce – meaning that different leadership skills need to be utilised to accommodate differing generational expectations. Someone that entered the NHS workforce in the 1970s, for example, will no doubt have seen the significant changes it has gone through over the decades and have had to adapt their practices. So why should leadership skills be any different? Effective leadership styles that worked then are likely to be outdated now and need modernising to meet today’s workplace demands.

responsible for a particular task or service, being passed from pillar to post as individuals cite that it isn’t their responsibility. Therefore each time change occurs, it’s vital that roles and responsibilities are revised within this to ensure they are still fit for purpose and clearly understood. Leaders must communicate this to their direct reports, helping them to understand where they fit and what their responsibilities are. The NHS staff survey also found that only 43 per cent felt able to meet the conflicting demands on their time. Leaders play a key role in supporting employees in managing their time, by understanding what pressures they face and helping them break it down into essential and non-essential activities. What may seem like an urgent activity due to pressure from other stakeholders, may not be a priority in the leader’s eyes – so it’s important to know how employees are managing demands on their time. COACHING One tool leaders frequently use to support employees in their daily working lives and career progression, is coaching. It’s a technique whereby the leader helps the employee to find a solution to their work problem that works well for them – rather than the leader imposing an answer on them. It is an effective way of teaching people how to problem solve and think differently in their approach to work, rather than relying on seeking answers from others. During times of instability and flux coaching techniques are useful, as it helps individuals to work out solutions for themselves rather than simply await further instruction. South Staffordshire and Shropshire Healthcare NHS Foundation Trust (SSSFT) has created a culture of coaching across its hospitals. Through ILM accredited training in coaching, the programme reaches professionals from Shropshire to the Isle of Wight, helping them to build and lead effective teams of clinical and administrative staff. The trust has since seen a positive impact on both new staff joining the Trust and on those transferring as a result of acquisitions. Theresa Shaw, head of learning and development at SSSFT, comments: “As a trust, we wanted to build our teams and equip our leaders with the skills needed to manage transitions in the workplace. We wanted to empower employees to take ownership and responsibility, helping them to

Many clinician experie s n disconn ce a ect bet day jobween their  req and lea uirements d expecta ership tions

CERTAIN UNCERTAINTY The only constant in the NHS is that change is a constant. Leaders need to be able to navigate change themselves, whilst helping others to understand where they fit and their role and responsibilities. A frequent complaint we hear from those working in the NHS is that it’s difficult to find who is

be more resilient in an ever changing trust. The programme has given them confidence in their skills and helped them to develop others too. “We’re really proud of what we’ve achieved to date. In fact we are only one of three mental health trusts in the UK to receive a good rating in the Care Quality Commission’s (CQC) inspection report. Our investment in employee development has really helped to ensure that we have a productive and engaged workforce.” MOTIVATING STAFF Another challenge that cuts across the whole NHS sector is motivation. When taking into account cuts to funding, extended hours for GPs and strikes by junior doctors, it’s understandable that morale has been low in the NHS organisation in recent years. Trusts are having to hit targets for cost improvements with less and less resource, with services being stripped back. When staff are under more pressure than ever before to provide their patients with the quality care under strained resources, personal motivation suffers and there is a conflict with values. Leaders play a crucial role in aiding motivation. Celebrating successes, encouraging staff to take control of their own careers, and helping them to source new opportunities to learn and develop are all ways that can help motivation. Wide geographical spreads often make this more challenging too, as professionals are rarely all together in one place. So it’s important for leaders to think about how to motivate a highly mobile workforce. Sending e-mails is one, often overused, tool – but leaders that make the effort to have face-to-face time can dramatically help to improve morale too. The NHS Staff survey found that 14 per cent of staff hadn’t received an appraisal in 12 months, rising to 34 per cent for ambulance trusts. In order for employees to feel

truly engaged in the workplace, they also need to be assured that they have a career and a future with the organisation. Leaders within the NHS can support this, by holding regular career conversations and formal appraisals. CONCLUSION Leaders at all levels within the NHS face ongoing transformation, which requires regular support to ensure they have the skills needed to navigate such a rapidly changing environment. Not only does teaching individuals’ leadership skills help them to manage their direct reports, but it also has a positive impact on patient care too. Using vital communication tools to manage daily work can be used across multiple stakeholders – helping them to manage work more effectively. We have incredible talent within the NHS; let’s see it flourish. L



About The ILM ILM is passionate about the power of leadership and management to transform people and businesses. ILM believes that good leadership and management creates effective organisations, which builds social and economic prosperity. ILM provides qualifications in leadership and management, coaching and mentoring and specialist areas such as social enterprise and accredits 2,500 training experts to deliver our qualifications globally.

FURTHER INFORMATION Tel: (0)1543 266867



Leadership Written by Chris Lake, head of professional development, NHS Leadership Academy



The barriers to making health leadership development a priority When it comes to investing in leadership development, the health sector is the poor relation. Chris Lake, head of professional development at the NHS Leadership Academy, explores six of the reasons why We spend over £100 billion a year on health, but the proportion of spend on leadership and management development and other organisational development (OD) initiatives as a proportion of this is incredibly low in comparison to many other businesses, even to the rest of the civil service. According to The missing link: effective management and leadership training in the NHS which was published in 2012, annual spending on management and leadership training for NHS provider employees equates to approximately £260 per employee compared to £320 in the private sector.

getting people into senior jobs can be a huge challenge, and keeping them there can be even more difficult. We constantly hear from our programme participants and colleagues about the demanding situations they face day in, day out. Today’s NHS has a difficult culture where staff can find it hard to have a voice, to feel valued, to develop and progress. This isn’t true everywhere; there are islands of appreciative, nurturing, enabling culture, but in the NHS, resilience is definitely a core characteristic. I’m not denigrating resilience as a good thing to have, but the fact that our system requires it in such spadefulls is a bit of an indictment of the culture. Wouldn’t it be better to run organisations where resilience was desirable rather than essential? Organisations fit to house the human spirit. Just as it isn’t acceptable to move into a leadership role with no training, nor should it be acceptable to be unsupported either, especially in your critical first year in post.

We lly don’t fu dge le acknow ct that a the imp ip has on h leaders isational organ nce and a performnt care patie

LACK OF RIGOUR In several sectors there’s a very structured approach to leadership development tied to career progression. The military and the police service both require development and assessment, for example through promotion boards, before leaders are appointed to more senior roles. You do your development first, then you’re promoted. Other organisations also clearly articulate the knowledge, skills, attitudes and behaviours necessary to succeed in leadership roles. They provide structured on-the-job development alongside development programmes, and assessment to say whether or not aspiring leaders are fit to practice at the next level of influence. In the NHS, it’s quite common for people to be promoted first, and development to do the job is almost an afterthought. There should be a minimum expectation of management competence, leadership behaviours, knowledge, attitudes and values running right across the NHS. LACK OF SUPPORT When you do take up a leadership role, you might excel, you might do the job to the required standard, or you might fail. However,



LACK OF STRATEGIC DIRECTION The NHS, with its workforce of 1.4 million and its challenges in filling key leadership roles, has no well-developed strategic framework for leadership development. The Academy is currently working with a consortium of NHS bodies to rectify this. Guided by the National Leadership Development and Improvement Board, several organisations are working together to develop a strategic framework for leadership development and improvement. Lead collaborators in this process include colleagues from NHS Improvement, NHS England, Professor Michael West, senior fellow at The King’s Fund, and more. The framework won’t be a top-down strategy – that’s been tried, and not worked, before. Instead, it will be an enabling framework that

describes what leadership development can be delivered locally, regionally and nationally. More, a strong theme of the framework will be the actions and behaviours of the Arm’s Length Bodies in modelling an enabling environment where leadership flourishes.

LACK OF RESPECT FOR LEADERSHIP DEVELOPMENT We don’t fully acknowledge the impact that leadership and management practices have on organisational performance and patient care. The horrific failures at Mid-Staffs occurred because of a failure of leadership. Michael West’s research has proved that high quality leadership leads to lower patient mortality. When we realised that prescribing too many antibiotics lead to increased antibiotic resistance, superbugs and more deaths, the NHS took it seriously and took action. We need to do the same with leadership, development, team work and organisational culture, or we could end up back in Mid Staffs territory. I’ve heard a few people whisper that there’s another Mid Staffs out there somewhere – we just don’t know where it is. But we don’t want it to emerge in the future. THE DEMONISATION OF LEADERS AND MANAGERS The value of leadership and the worth of managers and management within

healthcare is questioned, and that needs to change. Politics and media combine to see management as bureaucracy and managers as bean-counters – an overhead to be reduced at all times. No other industry I’m aware of demonises management in the same way. We look at high-performing organisations like Apple and we tell inspirational stories about Steve Jobs. Yet senior leaders in our healthcare organisations are too often portrayed as bureaucrats and an expensive resource. Some of our hospital trusts are very large businesses in their own right, with turnovers of half a billion pounds not uncommon. These organisations need managing and leading, but we’ll only reward people for this depth of responsibility somewhat begrudgingly. And beyond the boardroom, managers dedicating their working lives to coordinating care in service of patients and their families see themselves called number-crunchers. Media and politics tend to love the doctors and talk about nurses as angels. I too value hugely the skill and dedication of all clinicians working across our NHS, but I also value



the finance managers who get best value for our tax-pounds, the service managers who develop ever-better systems for patient care and the HR managers who support the human systems at the core of organisations. I’ve listed above six barriers to making leadership development in health a priority. There’s definitely work to be done. I’m not despondent though. I see many examples of good practice in the participants we meet on Academy programmes – and great evidence of the difference leadership development is making. And I visit organisations that are shining examples of leadership practice with a culture of development. We just need to make that the norm. L

The NHS Leadership Academy was launched in April 2012 with the purpose of developing outstanding leadership in health, in order to improve people’s health and their experience of the NHS. FURTHER INFORMATION


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UPWARDLY MOBILE – DIABETES CARE Jon Elburn, product manager for Clinical Information Systems at Hicom, explains how joined-up community services can improve the trajectory of diabetes care October marks the second anniversary of the NHS Five Year Forward View. The publication set out a shared vision for the future of the NHS based on ‘new models of care’, and once again highlighted the importance of breaking down the traditional divide between primary care, community services and hospitals. The drivers for change – broadly the need to reduce the financial and physical strain on the service and to improve patient experience – are particularly resonant in diabetes. It is well-documented that the NHS spends around £8 billion a year treating the complications of diabetes, in addition to the inherent costs of managing the disease itself. It is therefore no surprise that health leaders and policy makers have identified diabetes as a key focus area for more effective community services. EVIDENCE Evidence suggests that the past decade has seen terrific efforts across the NHS to provide diabetes care outside of hospitals. Patients are increasingly being seen in, or near to, their homes by community diabetes specialist nurses (DSNs) and GPs with a Special Interest (GPwSIs). There are great examples of community‑based diabetes services up and down the country that are delivering high-quality care. However, as a recent Care Quality Commission (CQC) report into community diabetes care reveals, there is still great variability at local level. Moreover, although patients’ experiences of community diabetes services are largely good, care is not always responsive to individual needs. BARRIERS One of the major barriers to optimal community diabetes services is a long‑standing Achilles’ heel within the NHS: the common inability for healthcare professionals to access vital patient information across clinical settings. This not only affects continuity of care and disrupts the patient experience, it can also compromise health outcomes. If we are to reach the utopia of joined-up care, healthcare professionals need to be empowered by access to the best information available. In the field of diabetes, where mismanagement can lead to serious complications like heart disease, stroke, blindness and amputation,



that need has never been greater. As community diabetes services grow in number, DSNs and GPwSIs cannot afford to be hamstrung by a lack of access to crucial information that is routinely collected elsewhere along the patient journey. THE SOLUTION We live, however, with the solution every day. As diabetes specialists demand greater connectivity with their teams in the community, mobile communication and smartphone technology can help DSNs and GPwSIs become more informed and responsive in community settings. These new tools, which are accessible via standard mobile devices to deliver a familiar, intuitive user experience, bring much-needed connectivity and agility to diabetes teams. Trusts should be using them to collect and share information across clinical settings and, in the process, can improve the quality of diabetes care in the community. Since the mobile interface typically integrates with the diabetes management system used within the hospital, multidisciplinary teams can also use them to help unlock Best Practice Tariff funding, reduce administrative overheads, improve productivity and increase time with patients. The mobile approach is a quantum leap from traditional methodologies. The most common sees community diabetes teams make paper-based notes during patient consultations and then input them to the diabetes management system when they next have a secure connection. This approach is slow, inefficient and prone to transcription error. Moreover, post-consultation administrative tasks deprive HCPs of valuable time with patients. In many cases, HCPs’ manual notes are often scribbled on patient records

that have been printed off in advance and taken out of the hospital, which is neither secure nor auditable. Mobile technology overcomes all of these challenges. EFFECTIVE MOBILE TOOLS The most effective mobile tools allow community teams to download their patient lists at the start of their day and then lock the records on the central system so that they cannot be updated by anyone else whilst community visits are taking place. Teams are then able to carry out their consultations in the community, add the appropriate notes to patient records in real time, and then synchronise the updates back to the diabetes management system when they next have a secure connection. The application of mobile technology to diabetes community services can drive major productivity and efficiency gains across local health economies. In a health service striving to be more patient-centred, the technology removes the need for patients to explain their entire history to HCPs, simply because the latter have no access to the patient record. This aspect alone can significantly improve the patient experience. Fundamentally, the use of mobile tools in diabetes community services will have its biggest impact where it matters most: patient care. Real-time access to patient information at the point of care not only empowers community-based diabetes professionals, it helps them make the most appropriate treatment decisions that can alleviate avoidable hospital admissions and enhance health outcomes. For truly joined-up care in diabetes, it is time to get upwardly mobile. L FURTHER INFORMATION Tel: +44 (0) 1483 794945

Guidance to regulate medical device apps

The Medicines & Healthcare products Regulatory Agency has produced new guidance to ensure that health apps which qualify as medical devices are being identified and comply with safety regulation. Valerie Field, interim group manager in the MHRA devices division, explores the situation We live in an increasingly digital world. Healthcare professionals, patients and the public are using software and stand-alone applications (apps) to aid diagnosis and monitor health, with many manufacturers, software developers, academics, clinicians, patients and organisations use software apps for both healthcare and social care needs. From counting steps to helping healthcare professionals diagnose burns treatment, healthcare apps and standalone software are a part of everyday life. We are all so familiar with apps that you might not realise depending on an unregulated app to provide a diagnosis or recommend treatment could have life threatening consequences. Some apps, which are used on smart phones and computers, can be considered a medical device in their own right if they have a medical purpose. These can be called stand-alone software or stand-alone medical devices. This doesn’t include software that

is part of an existing medical device such as software that controls a CT scanner as it is seen to be part of the device already and not stand-alone in its own right. THE REGULATIONS Many apps and pieces of standalone software currently on the market are classified as medical devices. These are apps which gather data from the user, such as diet, exercise, or heartbeat and then analyse and interpret the data to make a diagnosis, prescribe a medicine, or recommend treatment. It is important that apps which are medical devices comply with medical device regulation to make sure they are

NEW GUIDANCE The Medicines and Healthcare products Regulatory Agency (MHRA) has issued updated guidance to help identify the health apps which are medical devices and make sure they comply with regulations. This will help to make sure the health apps which meet the classification of medical devices are being identified and comply with regulations for safety and consistency. The guidance is presented as a step‑by‑step interactive PDF and will help software and app developers identify if their product is a medical device. It will also help developers navigate the regulatory system so they are aware what procedures they need to have in place with regard to CE marking and post-market surveillance. It also has information on the need to register as a manufacturer / developer and to self- certify that their app meets the regulatory requirements. This guidance uses examples within flowcharts to show which standalone software and apps meet the definition of a medical device, an in vitro diagnostic device or active implantable medical device and therefore required to be CE marked, and those which do not. For developers of software, including apps, we have also including information on classification, suggestions on how to address the main aspects of the CE marking process and responsibilities for reporting and correcting when things go wrong.

Written by Valerie Field, interim group manager, MHRA


Medical Devices

not providing an incorrect diagnosis which may have severe, potentially life‑threatening consequences for the user. Where apps or stand-alone software make a diagnosis or recommend a treatment, people should check for CE-marking before using their apps and developers should make sure they are complying with the appropriate medical device regulations. As well as medical device apps becoming a growth area in healthcare management in hospital and in the community settings, the role of apps used as part of fitness regimes and for social care situations is also expanding. However, in the UK and throughout Europe, standalone software and apps that meet the definition of a medical device are still required to be CE marked in line with the EU medical device directives in order to ensure they are regulated and acceptably safe to use and also perform in the way the manufacturer/ developer intends them to.

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IS IT THE RIGHT APP FOR ME? For users we offer a few tips on how to decide if the app or software device you are using is a medical device and if so how to ensure it is CE marked E



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CUMBRIA HEALTH ON CALL LAUNCH BOB (BETTER OBSERVATION) Cumbria Health on Call provide out of hours healthcare services to patients, families and communities throughout the county. Better observation (BOB) provides real time activity monitoring over operations

Cumbria Health on Call (CHoC) provide Out of Hours healthcare services to patients, families and communities throughout the county.If you require medical attention when your GP practice is closed, CHoC is ready to help. CHoC has treatment centres in Carlisle, Penrith, Wigton, Whitehaven, Kendal and Barrow, offering out of hours’ support, Monday thru Friday 6.30 to 8.00 am, 24 hours at weekends and Bank holidays.Cumbria Health on call (CHoC) was formed from a merger between CueDoc and Baycall in April 2009 to form a not-for-profit organisation serving patients and visitors to Cumbria covering a population of approximately 500,000 resulting in approximately 150,000 patient presentations. THE NEED TO BE EFFECTIVE In 2014, CHoC identified the need to be more effective at analysing and reporting on their activities, internally to the operations management team and externally to commissioners. In addition, there was a need to be aware of what was happening when it was happening NOT learning of issues after they occur and too late to take remedial action. Up until this point all reporting was developed using spreadsheets running off clinical data being captured within the Adastra system. There were a number of challenges posed by this approach which included; time taken to accurately prepare reports, in particular NQR’s required by themselves and their commissioners; inability to be able to ‘drill down’ easily or at all to original data to analyse in depth any particular issues



incorporating and combining other data sources to provide a more holistic view of operations; and difficulty in fulfilling ad hoc requests in a timely manner for information required by various stakeholders. FLEXIBLE AND DYNAMIC MI View from Total Intelligence Ltd was chosen as the solution most suitable to provide CHoC with a more flexible and dynamic reporting environment for the following reasons. Other similar organisations had successfully managed to move from predominately spreadsheet based reporting to using MI View. MI View was relatively quick to install, implement and be trained to use, so return on investment was attractive. Developing the necessary reports and dashboards was intuitive and very quick. MI View provided CHoC with the opportunity to move to a real time reporting environment. CHoC now produce all their key operational reports through MI View which encompass; reports showing a variety of metrics including capacity versus demand, demand versus forecast, GP attendance rates, case closure types, productivity, walk in rates, referral sources (A & E, Ambulance, 111), referral on rates (A & E, Ambulance, Hospital) and clinical presentations. Quality and performance reports showing performance trends against NQR’s and locally agreed quality measures as well as metrics identified above. A live dashboard showing current and rolling demand (county wide and by location), walk in rates, 111 rates, waiting times and current cases. A live

map showing the location of vehicles and all current outstanding home visits. Current home visits coordinates are taken from Adastra whilst Tom Tom’s feed in the current coordinates every 30 seconds giving the most up-to-date geographical positions. The benefits of implementing MI View have been impressive. Regular Operational meetings have been extended by half an hour as the operational data now available for analysis is so much richer leading to improvements in productivity and utilisation of resources whilst external recipients such as commissioners have been impressed and now have much better visibility over CHoC’s services. THE ENABLING TECHNOLOGY MI View was developed to be a ‘game changer’ in the world of business intelligence solutions. Virtually all presently available solutions in this area were developed decades ago and it shows in their lack of flexibility and the cost, whether to buy or implement or both. Compared to its competitors, MI View is quick to set up and is firmly aimed at the world of self service. Today’s organisations do not have the appetite for needlessly long projects to generate management and operational intelligence, to be able to continuously improve the management of their operations. The process of responding to ad hoc demands for information should take minutes, not days or even weeks, and shouldn’t necessarily require the involvement of expensive IT resources. MI View was developed with this new age in mind, not for the world that existed decades ago when information requirements were rather more ‘analogue than digital’. CHoC QUOTE MI View has enabled CHoC to become much more aware of what has happened, what is happening and what is likely to happen therefore becoming a valued tool in our goal to providing the best possible care to the residents and visitors to Cumbria. L FURTHER INFORMATION

HEALTHCARE APPS  along with how to report problems. You should think about what you will do with the results and the information that the app is giving you. If the app is giving you significant health information then be sure you will understand the result and you know what you need to do when you get the result. THE IMPORTANCE OF A CE MARK When an app developer applies a ‘CE mark’ they are claiming that the app is fit for the purpose it claims and it is acceptably safe to use. The CE mark should be visible on the app

marked. If you see a medical device app that does not have a CE mark, then you can report it to MHRA through our Yellow Card Scheme. Once you are sure the app is right for you and it is CE marked then you should follow the instructions carefully. Be honest with the information you put into the app. If you enter wrong information about yourself, the app may not give you the right result. Ensure that you always update the app to the newest compatible version. Tell MHRA if you have any problems with the app not working as stated through our

Where apps make a diagnosis or recommend a treatment, people should check for CE‑marking before using their apps and developers should make sure they are complying with the appropriate medical device regulations when you are looking at it in the app store or on the further information or ‘landing’ page. This information should also tell you what the app can be used for and how to use it. If you can’t see these details or are unsure we suggest you contact the developer to ask and in the meantime that you don’t use it. Please use only medical device apps that are CE

Yellow Card Scheme. This could be: if the instructions are not clear or the app is difficult to use; if the app isn’t giving you the results you expected; or if you have any concerns over the safety of the app or the information that it provides. You should also contact the developer of the app to tell them. It is important that you have read the small

print to understand what personal data you may have agreed to share with the developer by signing up to the app and how they might store or use your data. This includes information about you such as your name, address, date of birth and information about your health. If you are in any doubt about the information that the app has given you or you are concerned about your health you should consult a healthcare professional such as a doctor or pharmacist. RESPONSIBILITY Manufacturers have a responsibility to implement an effective post-market surveillance system to ensure that any problems or risks associated with the use of their device are identified early, reported to the relevant authorities, and acted upon. L Read the guidance here: government/uploads/system/uploads/ attachment_data/file/549127/ Software_flow_chart_Ed_1-01.pdf

The MHRA, an executive agency, sponsored by the Department of Health, regulates medicines, medical devices and blood components for transfusion in the UK. FURTHER INFORMATION

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The show that puts patient safety first Patient First, the national event for patient safety and infection prevention and control, returns to the ExCeL on 22-23 November. Health Business looks at the various conference streams Patient First, in association with Sign up to Safety and The AHSN Network, is the largest conference and exhibition covering patient safety and infection prevention and control, providing strategic and practical content for doctors, nurses, pharmacists, the management community and other healthcare professionals in the NHS and the independent sector provider and commissioner communities. Returning to the ExCeL for two days, delegates, including medical directors, nursing directors, IPC Leads, pharmacists, patient safety, governance and risk managers and other senior NHS and CCG members from across the UK, will benefit from a programme of unparalleled CPD accredited content delivered by a faculty of world‑class speakers and experts in their field. Lucy Pitt, Patient First marketing director, comments: “Patient safety remains at the heart of healthcare. Structural, cultural and financial pressures play their part in adding to the challenges brought by a growing – and more elderly – population. But in a post-Mid Staffordshire era the momentum on improving the quality and safety of healthcare is greater than ever

and Patient First brings all stakeholders together to embrace a learning culture.” WHAT’S NEW? This year, there are a host of new attractions, theatres and workshops where delegates can enhance their development and understanding of patient safety. There will be a series of round tables including: NAPC new models of care; HFMA cost cutting and patient safety; embedding patient safety into the culture of the organisation with PCAW; and learnings from the VMI programme. There will also be a round table interactive learning session in the Sign up to Safety feature area. This is enhanced by the introduction of three new theatres: the AHSN Best Practice Theatre, the HQIP & NQICAN Quality Improvement Theatre and the Dedicated Safety through Technology Theatre. Co-located with the dedicated Infection Prevention & Control conference, the show will also see a Hospice UK dedicated IPC workshop and hands-on skills training from BBraun & Beckton Dickenson. THE PLENARY THEATRE The Plenary Theatre, covering big topics affecting patient safety, will begin with Jim

Patient First


Mackey, chief executive of NHS Improvement, delivering the opening address. Mackey, who was previously chief executive of Northumbria Healthcare NHS Foundation Trust, has a keen interest in quality of care, especially patient and family experience, and has participated in a number of reviews and national projects, including the Dalton Review in 2014. Samantha Jones, director of New Care Models Programme, within the Five Year Forward View, will then be joined by Malte Gerhold, the Care Quality Commission’s interim executive director of strategy and intelligence, to address ‘New care models and what they mean for safety’. Samantha will be overseeing the launch of 50 vanguards which are taking the lead on the developing new care models which will act as the blueprints for the NHS. ‘Safe care is efficient care: Progress and strategic learning from the VMI programme’ will outlines the progress made by the five trusts mentored by influential US hospital Virginia Mason through its Virginia Mason Institute - Shrewsbury & Telford NHS Trust; University Hospitals Coventry & Warwickshire NHS Trust; Barking, Havering & Redbridge NHS Trust; Surrey & Sussex Healthcare NHS Trust; The Leeds Teaching Hospitals NHS Trust. The programme will help these rusts adopt lean methodologies to improve quality, productivity and efficiency in their work. Matthew Hopkins, chief executive of Barking, Havering & Redbridge NHS Trust will have the aid of Simon Wright, chief executive of Shrewsbury & Telford Hospital NHS Trust, to deliver this informative session. The second day in the Plenary Theatre will hear from Mike Durkin, director of Patient Safety at NHS Improvement as he lays down his thoughts on ‘Evolving national patient safety strategy’. This will be followed be a E



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Patient First

EVENT PREVIEW  seminar entitled ‘Candour, transparency and whistleblowing’, before Helen Hogan, senior lecturer in Public Health at the London School of Hygiene and Tropical Medicine, covers what was learnt from the PRISM studies and what can and cannot be achieved by undertaking mortality reviews. The theatre will close with Donna Forsyth, head of investigation at the Healthcare Safety Investigation Branch, share her session on ‘Learning from fatal claims’, where she will explain claims trends in recent years and how taking steps early on in the process where there is a fatality can ensure that both the family and staff are supported through the processes that follow and that lessons are learned. PATIENT SAFETY THROUGH TECHNOLOGY The Patient Safety Through Technology Theatre will start with Ann Slee, ePrescribing lead of digital technology at NHS England, discussing what the Wachter Review means for patient safety. Joined on stage by Wai Keong Wong, consultant haematologist at University College London Hospitas Foundation Trust, the Wachter Review, published in September, claimed that a ‘digitally mature’ NHS can be achieved by 2023, but not without extra funding. Glen Hodgson, head of healthcare at GS1 UK, will lead a session on the second day of the conference looking at the GS1 standards implementation journey. With the help of Keith Jones, clinical director for Surgery, and Kevin Downs, director of Finance and Performance, both at Derby Teaching Hospitals NHS Foundation Trust, the seminar will look at the rollout at Derby and illustrate how a project that started out as a procurement device, transformed into a much more significant vehicle with benefits for patient safety, clinical effectiveness and financial control. Further success stories will be shared in Paul Rice’s discussion on the Nursing Technology Fund and the Integrated Digital Care technology Fund. Paul is the head of Technology Strategy in the Digital Health team in NHS England, and leads the team that is instrumental in delivering a digitally enabled and ‘paperless’ NHS. The theatre will also hear from: Ian Pocock, director of Service Design at NHS England on the digital behaviour change and ‘Using technology to support prevention and improve management of conditions’; a review of the progress of the Test Bed sites evaluating the real world impact of new technologies for better care and better value; and ‘Innovations for safety: SBRI Healthcare and AHSNs’, led by

There a host o are f new attracti o n s , theatre and wo r k s h ops wh s delegat e re e their des can enhance Karen Livingstone, director of Eastern and und velopment Academic Healthcare erstand Science Network. i n g of patie n INFECTION safety t PREVENTION

The Infection Prevention & Control stream, split into two theatres, has an array of leading experts sharing their knowledge and advice with the audience of the show. Kicking things off in the Infection Prevention & Control Theatre 1, John Watson, deputy chief medical officer at the Department of Health, will discuss ‘Antimicrobial resistance: it’s as bad as they say it is’. This seminar will be followed by Jon Otter, an epidemiologist at Imperial College Healthcare London NHS Trust, analysing the growing dangers around Carbapenemase‑producing Enterobacteriaceae (CPE). CPE are an emerging threat to healthcare facilities worldwide, combining the ‘triple threat’ of high levels of antibiotic resistance, the potential for causing untreatable infections, and the risk of rapid spread. This talk will provide an overview of the challenge we are facing, and how we need to respond. Survival of pathogenic bacteria on environmental surfaces contributes to increasing incidence and spread of antibiotic resistance and infection in hospitals etc. In addition to coughs and sneezes, a major

problem is infrequent washing of hands which then contaminate surfaces. One way to address this could be to use biocidal surfaces in conjunction with improved cleaning regimes. Bill Keevil, professor of environmental healthcare at the University of Southampton, will present ‘The case for Antimicrobial Copper’ in the afternoon of the first day in the Infection Prevention & Control Theatre 1. The second day will witness Tim Briggs, national director for clinical quality and efficiency for the NHS, address ‘Deep wound infections’, before Public Health England’s Diane Ashiru-Oredope, pharmacist lead for the AMR Programme, delves into ‘IPC and antimicrobial stewardship: Training for HCPs, the public and patient engagement to tackle AMR’. SafeHands is a patient safety programme using information from radio-frequency and infra-red hardware locating devices attached to patients, staff and assets to automate patient flows, real time bed management, alerts and alarms, equipment, staff and patient interactions, and can monitor hand hygiene in real-time. ‘Safe hands or big brother? Using real-time locating technology to improve patient safety’ will be presented by Clare Nash, programme manager for SafeHands, and Neil Jarvis, ward manager of respiratory medicine, at The Royal Wolverhampton NHS Trust. ‘Implementing the latest Government ambitions about gram negative bacteria in the whole health economy’ will explore how E



Case Study


Negotiating where the line should be drawn between unacceptable behaviour and blameless unsafe acts In 2014, the PHSO published a report relating to the tragic death of three-year-old Sam Morrish. It found Sam would have survived had he received appropriate care and treatment. However, whilst the 2014 report confirmed that Sam’s death was avoidable, it didn’t provide a satisfactory explanation as to why the local NHS failed to uncover what happened and therefore couldn’t ensure that necessary learning took place. At the request of Sam’s parents, the PHSO undertook a new investigation to look at why. They found that the local investigation process was not fit for purpose, was not sufficiently independent, inquisitive, open or transparent and that the people carrying out the investigation were not adequately trained. It’s a hard hitting, compelling document that builds on the now strong evidence base that tells us there is an urgent need for change in the way the NHS responds and learns from mistakes.  When the report was published, Ombudsman Dame Julie Mellor commented: “We hope

that this case acts as a wake-up call for NHS leaders to support a no-blame culture in which leaders and staff in every NHS organisation feel confident to find out if and why something went wrong and to learn from it.” The sentiment of the message is absolutely right, but as with so many areas of healthcare, language can be very important and the phrase ‘no-blame’ is one which I know can lead to misunderstandings. Although ‘no-blame’ is still frequently mentioned in healthcare as being desirable, it is outdated and has largely been superseded in other industries by the concept of ‘just culture’. In September 2004, a report looking at culture in aviation was published in which renowned safety expert James Reason

wrote the following: “The term ‘no-blame culture’ flourished in the 1990s and still endures today. Compared to the largely punitive cultures that it sought to replace, it was clearly a step in the right direction…But the ‘no-blame’ concept had two serious weaknesses. First, it ignored—or, at least, failed to confront—those individuals who wilfully (and often repeatedly) engaged in dangerous behaviours that most observers would recognise as being likely to increase the risk of a bad outcome. Second, it did not properly address the crucial business of distinguishing between culpable and non-culpable unsafe acts.” “In my view, a safety culture depends critically upon first negotiating where the line should be drawn between unacceptable behaviour and blameless unsafe acts.” FURTHER INFORMATION Tel: 020 8971 1971

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HEALTH BUSINESS MAGAZINE | Volume 16.5 28/04/2016 13:58


 a cohesive whole health economy approach can contribute to reducing Healthcare associated infections (HCAIs) and infections in general. Investment in Infection Prevention and Control as everyone’s business is a public good and a ‘win-win’ situation for all as an individual health and social care provider will be influenced by standards in other providers with whom they share a patient population. The theatre will close with an ‘NHS Clinical Evaluation Team Update’, led by Clare Johnstone, clinical specialist lead, and Liam Horkan, clinical specialist lead, both of the National Clinical Evaluation Team. COVERING CLEANLINESS The second Infection Prevention & Control Theatre will open with a discussion on ‘AMR: Primary care antibiotic prescribing’, held by Cliodna McNulty, head of Primary Care Unit at Public Health England, and Alastair Monk and Deborah Giles of the North of England Commissioning Support. Following this, Tracey Radcliffe of the UK Sepsis Trust and Global Sepsis Alliance, will present on ‘OneTogether to reduce surgical site infection’. This presentation will describe the OneTogether partnership and its program of work from its launch in 2013 to date and the next steps. OneTogether has a sole objective to support clinical staff ensure that the best infection prevention practice is provided to every patient that undergoes surgery. The Sepsis Trust and Global Sepsis Alliance will also be on stage later in the day, as Ron Daniels, CEO, advises on the ‘Effectiveness of antibiotics in treating sepsis: research update’.

Patient First


Clean hospitals are important to patients and the public for a number of reasons – some symbolic and some literal – yet delivering a consistently clean environment is challenging and can be costly The second day in the Infection Prevention & Control Theatre 2 will begin with Andrea Jenkyns, MP and chair of the All Party Parliamentary Group on Patient Safety, reporting on the ‘All Party Parliamentary Group Inquiry into the effectiveness of infection procedures in the NHS: zero tolerance, patient information; mandatory reporting; vascular access devices’. Jenkyns will be assisted by Katherine Murphy, chief executive of the Patient Association. ‘Breaking the chain of infection with antimicrobial copper’ will address the evidence behind and practicalities of installing antimicrobial copper touch surfaces as an additional infection control measure. Mark Tur, of the Copper Development Association, and Delly Dickson, of the East Sussex Healthcare NHS Trust, will address how East Sussex Healthcare Trust has taken the science to the people, reviewing work published by York Health Economics Consortium. Clean hospitals are important to patients and the public for a number of reasons – some symbolic and some literal – yet delivering a consistently clean environment is challenging and can be costly. Liz Jones, head of patient environment at the Department of Health, will explore this with her highly anticipated

session on ‘Acute healthcare environment – cleanliness and flow’. This presentation will examine why a clean hospital is an essential foundation for good infection prevention, and will outline some of the difficult decisions that have to be made when considering how to deliver value for money and quality in tandem. EXEMPLIFYING BEST PRACTICE Sponsored by the ASHN Network, the Best Practice Theatre will provide case studies and examples of best practice to encourage a more efficient and safe NHS. Starting with a session on ‘Implementing self-administration of insulin in hospital – a toolkit for change ‘, Melissa Richards and Vicki Rowse will talk about their journey and the development of a toolkit to support hospitals in introducing and embedding self-administration of Insulin for as many patients as are able to and willing to do this. 40 per cent of patients treated with insulin experience one or more errors while in hospital, with this session arguing that a trust wide approach is necessary for successful implementation. ‘Communities of practice: changing perceptions of change’ will provide a brief overview of the theory behind communities of E




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EVENT PREVIEW  practice as well discuss how the communities of practice (CoP) concept has been used in practice to successful influence change and embed innovation on a local and regional scale. Cheryl Crocker, regional lead EMAHSN PSC, and Katherine Joel, senior project manager at the Health Innovation Network, will provide practical examples of how CoPs have been used across AHSNs in order to drive local and regional improvement. The first day will close with a seminar on ‘Sailing the seventh C’. In this session, Attainability UK’s Trevor Dale will discuss the missing ‘C’ in healthcare – Confidence. Understanding our inevitable fallibility and knowing how to combat it enables confidence and many high performing professionals can be blind to, ignore or misunderstand their own and other’s mistakes, unable to use the learning and move on. The highlight of day two in the Best Practice stream of Patient First will see Dawn Scott, CEO, and Mona Guckian Fisher, president, of the Association for Perioperative Practice, discuss ‘Maintaining momentum: sustaining high performance’. THE EXHIBITION Patient’s First’s unique integrated conference and hall also gives delegates access to get advice and learn from over 100 product and service providers on the busy

exhibition floor. Organisations represented include: GAMA Healthcare; Ascom; B. Braun; Datix; Abloy; CQC; DDC Dolphin; All in one medical; Nervecentre; AOmnicell; Biodose; iMDsoft; Stanley Healthcare; Vanguard; Sage Products; OBS Medical; and RL Solutions. B. Braun will be running a series on hands-on workshops from the Skills Training area covering ‘The future of IV Medication

Patient First


great and is very relevant for me. I’ve also been impressed by the range of technology at the show and seeing what a difference it can make in releasing clinical time.” Emmanuel Idowa, pharmacist, Maidstone & Tunbridge Wells NHS Trust, added: “There’s a lot of content at this show and it’s very interesting to hear the latest thinking from the experts. I work in antibiotics,

Patient First, in association with Sign up to Safety and The AHSN Network, is the largest conference and exhibition covering patient safety and infection prevention and control Safety – The Connected Clinical Environment’, while Sign up to Safety will be hosting a series of interactive workshops from their feature area. Together with a range of round tables sessions hosted by the HFMA, PCAW, NAPC amongst others, delegates have a huge choice of learning styles over the two days. Speaking after last year’s show, Raymond Guirguis, pharmacy manager, Princess Grace Hospital, said: ”This has been really good for seeing new ideas and innovations and for learning from other people’s lessons in patient safety. The talk on Incident report was

so it has been useful to see how other professionals approach patient safety.” Duncan Hall, senior incident investigator, North East London Foundation Trust, concludes: “This is a great show for getting inspiration from what other people are doing. One of the sessions I attended at last year’s show really helped one of my investigations and genuinely made a difference, which is why I’m back for more.” L FURTHER INFORMATION

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The Conference Programme Plenary Theatre Time

Tuesday 22nd November


09:00 09:30

Quality as a driver for change – from seven day services and new models of care, to leadership, culture and efficiency Ben Gummer, Parliamentary Under Secretary of Secretary of State for Health, Department of Health

09:50 10:35

09:55 10:45

Building patient safety capacity at a local level Dr Suzette Woodward, National Campaign Director, Sign up to Safety Dr Rosie Benneyworth, Managing Director, South West AHSN

11:25 11:55

Session delivered by Royal Voluntary Service David McCullough, Chief Executive, Royal Voluntary Service

12:00 12:30

The next step in patient safety? James Titcombe, Patient Safety Specialist, Datix Jonathan Hazan, Director, Datix

13:30 14:10

Session delivered by Jim Mackey, Chief Executive, NHS Improvement

14:20 15:20

New care models: what they mean for safety Samantha Jones, Director, New Care Models programme, Five Year Forward View

15:30 16:15

Safe care is efficient care: Progress and strategic learning from the VMI programme

16:30 17:30

Chief Executives’ panel discussion Dave Evans, Chief Executive, Northumbria Healthcare NHS FT Andrew Foster, Chief Executive, Wrightington, Wigan & Leigh NHS FT


Wednesday 23rd November

09:00 09:45

Evolving national patient safety strategy Dr Mike Durkin, Director of Patient Safety, NHS Improvement

09:55 10:40

CQC inspection: Protecting patients and encouraging improvement Professor Sir Mike Richards, Chief Inspector of Hospitals, CQC

11:20 12:20

Candour, transparency and whistleblowing Helené Donnelly, Ambassador for Cultural Change, Staffordshire and Stoke on Trent Partnership NHS Trust Cathy James, Chief Executive, Public Concern at Work Rob Webster, Chief Executive, South West Yorkshire Partnership NHS FT Dean Royles, Director of Human Resources and Organisational Development, The Leeeds Teaching Hospitals NHS Trust Dr Umesh Prabhu, Medical Director, Wrightington, Wigan & Leigh NHS FT Henrietta Hughes, National Guardian, Freedom to Speak Up, Care Quality Commission

12:30 13:00

Fail to prepare, prepare to fail: Stay ahead of the CQC Paul Ridout, Partner, Ridouts LLP

13:45 14:35

Learning and improving from mortality reviews Kevin Stewart, Clinical Director, Clinical Effectiveness and Evaluation Unit, Royal College of Physicians Michael McCooe, Clinical Leadership Fellow, Yorkshire & Humber AHSN Improvement Academy Dr Helen Hogan, Senior Lecturer in Public Health, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine

15:30 16:30

Learning from incidents Helen Vernon, Chief Executive, NHS Litigation Authority The Chief Investigator, Healthcare Safety Investigation Branch (to be appointed)

Infection Prevention & Control Theatre 1

Best Practice Theatre

11:15 11:55

Tuesday 22nd November Mental health: Failure to return to acute psychiatric wards

Jill Bailey, Head of Patient Safety, Oxford Academic Health Science Network Leadership, Teamwork, Communication: Foundation of Safety Programme

Ronke Akerele, Director of Programmes, Change & Performance Management, Imperial College Health Partners Implementing self-administration of insulin in hospital - a toolkit for change

12:10 12:50

13:50 14:20

14:30 15:10

Tracy Broom, Associate Director - Patient Safety Collaborative, Wessex Academic Health Science Network Vicky Rowse, Programme Manager Medicines Optimisation , Wessex Academic Health Science Network Melissa Rowse, Quality Improvement Consultant, Eli Lilly Communities of practice: changing perceptions of change

Dr Tony Kelly, Director, Patient Safety Collaborative Cheryl Crocker, Regional Lead EMAHSN PSC; Honorary Associate Professor, University Of Nottingham, East Midlands Academic Health Science Network “The deteriorating Patient - What about Bobby?”


Tuesday 22nd November

09:00 09:45

Antimicrobial resistance: it’s as bad as they say it is

09:55 10:40

11:20 11:55

Professor John Watson, Deputy Chief Medical Officer, Department of Health The growing dangers around CPE

Jon Otter, Epidemiologist, Imperial College Healthcare London NHS Trust Surgical site infections: how are we going to reduce them?

Professor Judith Tanner, Professor of Adult Nursing, University of Nottingham

12:05 12:40

13:40 14:20

What makes a good CQUIN

AMR: Antibiotic prescribing in acute settings

Philip Howard, Consultant Pharmacist, Leeds Teaching Hospitals and Chair, Consultant Pharmacists Group, NHS England The case for antimicrobial copper

Kevin Hunter, Programme Manager, Patient Safety Collaborative, West of England AHSN Deborah Evans, Managing Director, West of England AHSN

15:45 16:25

AKI – KSS, the improvement journey so far

16:35 17:30

Integrating the goals for IPC, patient safety and quality: ensuring clarity and alignment


Wednesday 23rd November

15:40 16:20

Ed Kingdon, KSS AKI Clinical Lead, KSS PSC/AHSN Sailing the seventh ‘C’ – Confidence builds and maintains personal resilience, a vital aid to patient safety

16:50 17:20

Trevor Dale, Chief Executive, Atrainability

Professor Bill Keevil, Professor of Environmental Healthcare, University of Southampton

Whole healthcare approach to infection prevention & control


Wednesday 23rd November Session delivered by Kate Hall

09:50 10:30

11:15 11:45

Kate Hall, Director of Capability Development, UCLPartners

Cheryl Crocker, Regional Lead EMAHSN PSC; Honorary Associate Professor, University Of Nottingham, East Midlands Academic Health Science Network

13:40 14:20

14:30 15:10

Harnessing flexible infrastructure to support the Five Year Forward View

Susie Singleton, Senior Specialist Health Protection / Consultant Nurse HCAI & IPC; National lead IPC & HCAI Centre’s & Regions, Public Health England

Deep wound infections 10:00 10:40

Will Lilley, Patient Safety Collaborative Manager, South West Academic Health Science Network Matt Hill, Regional Lead, Patient Safety Collaborative, South West Academic Health Science Network

Carole Clive, Nurse Consultant Infection Prevention and Control, Worcestershire Health and Care NHS Trust

Dr Raheelah Ahmad, Health Management Programme Lead, Faculty of Medicine, Imperial College London

Discharge, transfers and transitions of care: work of the PSC cluster

Culture and score surveys 12:05 12:50

09:00 09:50

13:40 14:15

Professor Tim Briggs, National Director for Clinical Quality and Efficiency for the NHS and Consultant Orthopaedic Surgeon, Royal National Orthopaedic Hospital Safe hands or big brother? Using real-time locating technology to improve patient safety

Clare Nash, SafeHands Programme Manager, The Royal Wolverhampton NHS Trust Neil Jarvis, Ward Manager, Respiratory Medicine, The Royal Wolverhampton NHS Trust

Stuart Lloyd, Director, Lloyds Healthcare Solutions and Consultant Urologist Steven Peak, Sales and Business Development Director, Vanguard Healthcare Solutions Safety in care homes

Cheryl Crocker, Regional Lead EMAHSN PSC; Honorary Associate Professor, University Of Nottingham, East Midlands Academic Health Science Network

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Patient Safety Through Technology Theatre Infection Prevention & Control Theatre 2 Time

Tuesday 22nd November

10:05 10:50

AMR: Primary care antibiotic prescribing Professor Cliodna McNulty, Head, Primary Care Unit, Public Health England Dr Pete Smith, GP, Churchill Medical Centre Deborah Giles, Medicines Optimisation Pharmacist, North of England Commissioning Support Alastair Monk, Medicines Optimisation Pharmacist, North of England Commissioning Support

11:20 11:55 12:05 12:45

14:30 15:05


10:00 10:45

12:05 12:50

13:45 14:25 14:35 15:10 15:45 16:30

09:55 10:35

11:20 11:55

12:00 12:40

Commissioning toolkit best practice

OneTogether to reduce surgical site infection

Tracey Radcliffe, Clinical Governance Lead Nurse, OneTogether Partnership

13:40 14:20

All Party Parliamentary Group inquiry into the effectiveness of infection procedures in the NHS: zero tolerance, patient information; mandatory reporting; vascular access devices

Andrea Jenkyns MP, Chair, All Party Parliamentary Group on Patient Safety and Trustee, MRSA Action UK

Water safety - legionella and pseudomonas

Dr Michael Weinbren, Chesterfield Royal Hospital NHS Foundation Trust Breaking the chain of infection with antimicrobial copper

Multi-resistant gram-negative bacteria - identifying patients and stopping the spread Maintaining momentum: sustaining high performance

Dr Wai Keong Wong, Consultant Haematologist, University College London Hospitals NHS FT

Presentation Theatre:

From reporting to surveillance – patient safety in real time


Peter Askew, VP, UK and EMEA, RL Solutions

10:15 10:45

Session delivered by Ascom

11:00 11:30

Keith Jones, Clinical Director for Surgery, Derby Teaching Hospitals NHS Foundation Trust

Karen Livingstone, National Director SBRI Healthcare, Eastern Academic Healthcare Science Network

15:20 15:50

Session delivered by Imd Soft


Wednesday 23rd November

09:55 10:35

The role of the CIO and CCIO in patient safety

11:10 11:50

12:00 12:40

NHS Five Year Forward View – progress of the Test Bed sites evaluating the real world impact of new technologies for better care and better value

Building capacity and capability in healthcare human factors

MHRA devices update

14:00 14:30

Hot issues in patient safety delivered by Ridouts

Time 10:45 11:15

Ian Pocock, Director of Service Design, Transform UK

Neil Bacon, Founder and CEO, iWantGreatCare Clare Rees, Paediatric Surgeon , Great Ormond Street Hospital for Children NHS Foundation Trust

13:10 13:50

16:10 16:50

Digital behaviour change: using technology to support prevention and improve management of conditions

15:35 16:20

Mr. Myles Murray, Founder & CEO of PMD Solutions

Jeff Goulding, Assistant Director of Human Factors, Aintree Hospital NHS Foundation Trust

15:30 16:00

Dr Paul Rice, Head of Technology Strategy, Strategic Systems and Technology, Patients and Information, NHS England

Session delivered by PMD Solutions

Can single parameter track and trigger systems improve patient safety by #MakingEveryBreathCount ?

11:45 12:15

14:40 15:20

Success stories from the Nursing Technology Fund and the Integrated Digital Care Technology Fund

13:50 14:30

Tuesday 22nd November

How embracing real-time patient feedback boosts morale of clinicians

Glen Hodgson, Head of Healthcare, GS1 UK

14:35 15:10

Acute healthcare environment - cleanliness and flow

Liz Jones, Head of Patient Environment, Department of Health

Ann Slee, ePrescribing Lead, Digital Technology, NHS England

Innovations for safety: SBRI Healthcare and AHSNs

Mark Tur, Technical Consultant, Copper Development Association Delly Dickson, Service Redesign Manager, East Sussex Healthcare NHS Trust

Digital Future of the NHS – What the Wachter review means for patient safety

Kevin Downs, Director of Finance and Performance, Derby Teaching Hospitals NHS Foundation Trust

Dr Ron Daniels, CEO, UK Sepsis Trust and Global Sepsis Alliance an Clinical Adviser, NHS England

Wednesday 23rd November

Tuesday 22nd November

GS1 barcoding standards – delivering enhanced patient safety and financial control through reduced clinical variation and improved clinical productivity

Effectiveness of antibiotics in treating sepsis: research update

Katherine Murphy, Chief Executive, The Patients Association 11:20 11:55


Incident investigations – identifying “hidden” human factors affecting performance

Stephen, Webb FRCA FFICM, Consultant in Anaesthesia and Intensive, Care Papworth NHS Foundation Trust Social media and HCPs: how can its use improve treatment, advise politics and predict crises Daniel Ghinn, CEO and Founder, CREATION National safety standard for invasive procedures – learnings from Barts Health

Wednesday 23rd November Session delivered by University of Nottingham

Disruptive technologies vs patient safety

Dawn Stott, Chief Executive, Association for Perioperative Practice

14:40 15:10

Mo Rahman DipClinPharm MSc(SEng) MGPhC MRPharmS CSO(NHS), Solution Director, Promatica Ltd Dr Zak Rahman MBChB MD FRCS, Managing Director, Promatica Ltd

Quality Improvement Theatre Areas of discussion include:

Confirmed speakers include:

Dynamic use of clinical audit data in practice

Ben Bray, Clinical Fellow, UCL

Can dashboards really drive better care?

How to create real local improvement following NCA

Dr Marc Farr, Director of Information East Kent Hospitals University NHS Foundation Trust

Clinical Outcome Publication: vision for 2016-2

Dr Kieran Mallon, HQIP Clinical Lead for the Clinical Outcome Publication

n! Register before 23rd September


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Patient First


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Theatre kitting with RFID drives improvements at Addenbrooke’s hospital

kits. Centralised stock holding eliminates the need for each theatre area to hold stock of each item which may be required. To reduce waste, kits only include the items that are normally needed during an operation. This avoids clinical staff opening packaging and getting additional just-in-case items ready, which are subsequently wasted. Phil Lapish comments: “The cost per operation is down by between 2.5 and 7.4 per cent in the specialties where the solution was first deployed.” FURTHER INFORMATION

e at us o Pa n tie sta nt nd Fir M st 61

Cambridge University Hospitals NHS Trust (CUH) is believed to be the first Trust in the UK to introduce a theatre kitting service with Radio Frequency Identification (RFID) technology. Using Harland Simon’s RFID Discovery Inventory system to centralise and streamline the management of theatre supplies, CUH has optimised stock holding, minimised waste and enabled theatre nurses to spend more time on patient care. The system tracks items used in operations with passive RFID labels and interfaces with CUH’s inventory database. Phillip Lapish, supply chain manager, explains: “This enables us to accurately capture the cost of each operation and at the same time allows clinical staff to focus on patient care delivery.” The Trust prepares around 100 to 120 patient specific kits per day for elective procedures plus 50 for emergency and contingency


t: 01908 276700

Once downloaded, the content is available offline. MedHand sells individual apps on the various app stores, but also offers special institutional subscription packages via a free download, the MedHand Mobile Libraries app. Institutional subscriptions include downloads to five devices and all new editions published during the subscription period, as well as offering subscribers the option to add their own local documentation (i.e. local guidelines) to the app. MedHand customers include a number of NHS Trusts as well as medical schools and colleges. FURTHER INFORMATION Tel: 07833 451595

MedHand provides mobile resources for healthcare professionals at the point of need.

Increase device utilisation Reduce capital expenditure Improve patient safety Active & passive RFID

MedHand International provides mobile resources that are used by thousands of healthcare professionals, medical trainees and medical students to provide answers at the point of care, sometimes in remote locations. MedHand works with all the leading healthcare publishers (e.g. OUP, Wiley, Elsevier, etc.) and offers hundreds of authoritative medical, nursing and other healthcare titles in mobile app format. MedHand apps are available in iOS and Android formats (Windows to come) and have fantastic functionalities, such as complex search, bookmarking, highlighting and annotation (text and images). They include in-built medical, nursing and dentistry dictionaries, plus more than 30 medical calculators.

available in iOS and Android formats

Track your mobile medicaldevices    

All your medical books in one convenient app

Patient First


Talk to us about GS1assetlabelling

The MedHand Mobile Libraries App provides hundreds of authoritative medical, nursing and other healthcare titles from leading publishers that are available offline after initial download. The App offers fantastic functionalities, including sophisticated search, bookmarking, in-built specialist dictionaries, highlighting and annotation (text and images). Institutional subscribers automatically receive new editions, and can choose a flexible title package that may include local content (e.g. local guidelines). Contact MedHand today to find out more:; 07833 451595



Patient First


Working in partnership to achieve excellence in public and global health research

Early detection of deteriorating patients: Sepsis, AKI and more

The London School of Hygiene & Tropical Medicine is an internationally renowned centre for research and postgraduate education in public and global health, with 4,000 students and more than 1,000 staff working in over 100 countries. The School’s mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. The School is highly ranked in various global university league tables. In 2015, it was ranked third in the world for social sciences and public health in the 2015 US News Best Global Universities Ranking. The School was rated by the 2016 CWTS

iMDsoft is a global leader in clinical information systems. Hospitals and health networks worldwide, including more than 20 NHS hospitals, use the MetaVision CIS for critical care. The company’s mobile electronic observation system, MetaVision SafeTrack™, offers advanced options for early identification of patients at risk for lethal conditions. The system provides smart alerts for sepsis and AKI, based on NICE guidelines, which prompt clinicians to take action. Tools for screening and assessments make it easier to check for conditions such as venous thromboembolism (VTE) and to calculate scores such as MUST and GCS. Hospitals can create additional alerts or screening forms for any condition they define. In addition, MetaVision

Leiden Ranking as Europe’s top university and fifth in the world for research impact. It offers 18 London-based masters; six via distance learning; research degrees and short study courses. The teaching programme has a combination of laboratorybased biological courses and social science courses to cover all areas of public and population health, epidemiology, control of infectious diseases and tropical medicine. It has also launched a series of free online courses. FURTHER INFORMATION

• • • •

Master’s degrees Research degrees Short courses Free online courses

Improving health worldwide



FURTHER INFORMATION Tel: +44 7500 839677

Working in partnership with patients and staff to improve care outcomes


Postgraduate programmes in global health and infectious diseases. Study in London or by distance learning:

SafeTrack offers all the advantages of a mobile electronic observation solution, ensuring faster intervention for patients in need. It helps nurses document vital signs and observations at the bedside, calculates early warning scores and provides options for immediate escalations to caregivers. Nurses work more effectively and can prioritise care with tools for task management and shift handover. The system processes all of the information that is collected to generate reports that help improve hospital performance.

Applications open November 2016:

The Healthcare Quality Improvement Partnership (HQIP) improves healthcare by enabling those who commission, deliver and receive care to measure and improve health services – and in particular increasing the impact clinical audit has on quality improvement. HQIP is directing the QI Theatre – two days of dynamic data case studies, debate and best-practice sharing. HQIP’s work includes commissioning and managing: The National Clinical Audit Programme (30+ national audits covering the following care areas: Acute, Cancer, Cardiac, Children and Women’s Health, Long-term Conditions, Mental Health and Older People); The Clinical Outcome Review Programmes (including Maternal, Newborn and Infant, Medical and Surgical, Mental Health, Child Health, Learning Disability Mortality

Review and the Retrospective Case Record Review); The National Joint Registry or NJR – a mandatory registry which holds 2m+ hip, knee, ankle, elbow and shoulder records and monitors implant, hospital and surgeon performance in England, Wales and Northern Ireland; And quality improvement support, including: evidencebased guidance, practical case studies, patient and public involvement tools, eLearning and webinars. FURTHER INFORMATION Tel: 0207 997 7370

Enabling simple and secure patient data transactions Imprivata® provides healthcare organisations globally with a security and identity platform that delivers authentication management, fast access to patient information, secure communications and positive patient identification. Imprivata enables care providers to securely and efficiently access, communicate and transact patient health information to address critical compliance and security challenges while improving productivity and the patient experience. At PatientFirst, Imprivata will be showcasing its range of healthcare security solutions. OneSign®, the Imprivata Authentication and Access management platform, is recognised as the leading healthcare enterprise single sign-on solution used by the majority of NHS hospitals. It enables care providers to securely access clinical and administrative applications without the need to type different passwords, while

maintaining security best practice. Imprivata PatientSecure, recently introduced to the UK market, uses palm vein biometrics for positive patient identification, linking patients to their full medical record across disparate patient record systems. Imprivata Confirm ID™ is a comprehensive identity and multifactor authentication platform for clinical transactions such as ordering medication, drug disposal, blood administration, and transactions with patient information on medical devices. It replaces passwords with fast, convenient methods such as the tap of a proximity badge or swipe of a fingerprint. Visit Imprivata on Stand K71. FURTHER INFORMATION

A trusted provider of quality medicines that deliver sustainable value Ethypharm is an independent pharmaceutical company with global reach. It is dedicated to developing innovative drugs to treat pain and addiction, two major therapeutic areas with large unmet medical needs. Ethypharm has a unique experience of more than 30 years in developing its own portfolio of drugs based on state-of–theart proprietary technologies in oral formulation. Each year, the company invests a significant share of its turnover in R&D and has a rich pipeline of products at various stages of development. Ethypharm also develops complex generics that contribute towards optimisation of healthcare costs. Ethypharm UK Ltd aims to be chosen by the NHS as a trusted provider of quality, affordable medicines that deliver sustainable value. Ethypharm’s medicines currently provide treatments for pain, depression, schizophrenia,

and Parkinson’s. Significantly as Category C specialists, Ethypharm is dedicated to providing meaningful cost savings to CCG’s/ HB’s without compromising healthcare delivery for patients Its future portfolio continues to build on these complex medicines and potential cost savings, with Ethypharm due to launch treatments in gastroenterology, cardiovascular disease, ADHD and additional Parkinson treatments. If you require further information on Ethypharm UK or any of its medicines please call to speak to an adviser. FURTHER INFORMATION Tel: 01483 726929

Delivering quality legal advice to providers

Human Factors training to boost safety for patients

Ridouts is a niche practice of outstanding health and social care lawyers, who offer clarity and common sense advice when clients need it most. In a field dominated by generalists and big firms, you’ll find it refreshing to deal with lawyers who know your sector as well as you do.   Ridouts provide services tailored to the needs of health and social care providers, across a range of regulatory and operational issues. They do not act for regulators, service users or commissioners. This specialist commercial and legal support, provided in a timely manner, can avoid great loss at a relatively low cost. Ridouts gives you peace of mind - knowing that a team of dedicated, specialist lawyers and consultants can be swiftly brought together to support you through the regulatory and commercial challenges your business may face.   Services include challenging the regulator: challenging

There are many threats to safety at every turn, but the human can be trained to avoid, trap and mitigate them wherever possible. Human factors non-technical skills training has been mandatory in aviation for many years and Atrainability has almost 15 years experience of transferring them to health and social care. Atrainability can increase our understanding of how the human brain functions, how to combat fallibility and avoid conditions that lead to avoidable errors. That way teams caring for patients side by side can learn to work more safely than ever. Ergonomic studies of human factors encompasses the equipment and processes, design and usability of equipment/ layouts, but this doesn’t address human fallibility problems. Human Factors training presents learners with the understanding

inspection reports, cancellation, suspension or variation of conditions, warning notices and fixed penalty notices, regulator prosecutions; application for registration, special measures; dealing with the local authority adult safeguarding and LADO investigations; serious case reviews; contractual and fee disputes; mental capacity and deprivations of liberty safeguards    Ridouts also provides a range of other services including: inquests; professional disciplinary; regulatory due diligence; training; and NHS improvement. FURTHER INFORMATION Tel: +44 (0) 20 7317 0340

Patient First


and tools covering the social skills of leadership, team working, cooperation, management; plus cognitive functions of situation awareness, decision making and more. These are the non-technical human factors we are all subject to. HF non-technical training can help individuals understand their own fallibility and how to combat everyday threats such as: interruptions; distractions; multi-tasking; stress; fatigue; lost time; overload; and incomplete communications. Root cause analysis usually finds these problems after never events have occurred. FURTHER INFORMATION Tel: 01483 272987




Rewarding excellence in healthcare The Health Business Awards return in November 2016 to once again recognise the leading examples of excellence in the NHS 2016 has been yet another year with the NHS firmly in the media spotlight. The standard of the nation’s health has been scrutinised on more levels than ever before, with the ongoing dispute surrounding the junior doctors contracts taking centre stage, the obesity struggle gaining national coverage, and delays in discharge times and regional stumbling to meet targets paintng a bad picture. Moreover, Professor Robert Wachter’s review, Making IT work, claimed that a ‘digitally mature’ NHS can be achieved by 2023, but not without extra funding. In light of this, with financial constraints tighter than ever, the work of our hospitals and their staff is

in need of higher recognition and praise than ever before. The good news coming from the people working tirelessly to care for the nation is cause for celebration. Sponsored by CCube Solutions, the eighth edition of the annual Health Business Awards are once again taking place at the Grange Hotel in London on 29 November. Spread across 20 categories, NHS Foundation Trusts, Clinical Commissioning Groups, Collaborates, Partnerships, and Air Ambulance Services will join together to celebrate the very best within the NHS. The 2016 Awards will be hosted by London-based GP Dr Sarah Jarvis. Jarvis

is the health and medical reporter for The One Show, a regular guest on The Jeremy Vine Show and clinical consultant for health website Patient_UK. The categories in this year’s event include: the Air Ambulance Service Award; the Clinical Commissioning Award; the Environmental Practice Award; the Estates and Facilities Innovation Award; the Healthcare IT Award; the Healthcare Recruitment Award; the Hospital Building Award; the Hospital Catering Award; the Hospital Cleaning Award; the Hospital Procurement Award; the Hospital Security Award; the Innovation in Mental Health Award; the NHS Collaboration Award; the NHS Finance Award; the NHS Publicity Campaign Award; the Outstanding Achievement in Healthcare Award; the Patient Data Award; the Patient Safety Award; the Sustainable Hospital Award; and the Transport & Logistics Award. L FURTHER INFORMATION

Facilities management services for healthcare

Keeping high standards of professionalism in parking

ISS Facility Services has retained its contract for providing healthcare cleaning services at Moorfields Eye Hospital NHS Foundation Trust, the leading provider of eye health services in the UK and a worldclass centre of excellence for ophthalmic research and education. After a competitive tender the new contract has been extended to include the provision of Security Services to the famous London site. ISS has been providing healthcare cleaning to the specialist hospital since 2009. The new contract, which could run for the next seven years, could have a total revenue in excess of £10 million. Dean Gornall, head of Facilities, said: “After a comprehensive tender process for Cleaning and Manned Guarding for Moorfields Eye Hospital at City Road, I am pleased to confirm that ISS has retained this contract for a further five to seven years. The

The British Parking Association (BPA) is the largest, most established and trusted professional association representing parking and traffic management in Europe. The Association is the recognised authority within the parking profession which uses its influence to represent the best interests of the sector. The BPA also provides an extensive range of membership services to support parking professionals and organisations in their day-to-day work. BPA’s diverse membership community of around 700 organisations includes: technology developers and suppliers; equipment manufacturers; learning providers; consultants; structural and refurbishment experts; local authorities and parking on private land operators including retail parks; healthcare facilities; universities; airports;

ISS submission with a strong local leadership presence allowed the tendering panel to conclude that ISS were the right company to manage these services. Moorfields looks forward to continuing a successful and productive partnership.” Chris Ash, ISS Healthcare’s managing director, said: “This award has only been made possible by the continued commitment of our local team to working so closely with the Trust in delivering a shared vision of delivering the best possible patient experience.” FURTHER INFORMATION

Health Business Awards


and railways stations. The BPA has launched a new, audited accreditation for organisations: the Professionalism in Parking Accreditation (PiPA). PiPA recognises and celebrates the highest standards of professionalism in parking. Organisations that hold PiPA are nationally recognised role-models for parking professionalism and excellence. The PiPA accreditation helps to raise levels of customer service for patients, visitors and staff, increasing car-park user satisfaction and improving the reputation of healthcare landowners. This is an accreditation that will make your organisation proud. FURTHER INFORMATION



16th & 17th November 2016 Olympia, London FREE TO ATTEND FOR HCPs


Showcasing Innovation Facilitating Dialogue Connecting You Diabetes Professional Care is a dynamic exhibition and conference where quality information is free, innovation is showcased and connections are made. If you are a provider or practitioner committed to the future of diabetes care you cannot afford to miss out on this refreshingly different event at London’s Olympia in November. Diamond sponsor:

Platinum sponsor:

Gold sponsor:

Silver sponsor:

Silver Silver sponsor: sponsor:

Silver sponsor:

What’s on: • Major Exhibition • 7 Stream CPD accredited Conference • Industry-led Workshops • Innovation Zone • The Diabetes Village • The Commissioning Zone • Live Debates • New for 2016 Obesity in Practice Silver sponsor:

Silver sponsor:

Silver sponsor:

Commissioning Diabetes Zone Village sponsor: sponsor:

Registration Sponsor:

Diabetes Research & Wellness Foundation

To Register for your free pass visit

Catering Area Sponsor:

Gathering pace towards diabetes treatment

Diabetes Professional Care


Diabetes Professional Care 2016 is back with more innovation, an expanded show floor and a hotly anticipated seminar programme. Health Business explore the content and innovation on display London’s biggest diabetes show, held on 16-17 November 2016 at Olympia, offers the perfect forum for discovering and developing the future of diabetes care. Visitors will be able to see the state-of‑the-art technology, hear about the latest thinking and research, whilst also networking with like-minded industry experts. For the first time ever, Jonathan Valabhji, national clinical director for Obesity & Diabetes at NHS England and Dr Partha Kar, associate national clinical director for Diabetes at NHS England will take to the stage together to present the show’s first keynote session. Valabhji will discuss ‘Diabetes and the NHS in England in November 2016’, while Kar will conclude by looking at ‘The art of the possible’. In a major show coup, Beverley Bryant, director of Strategic Systems at NHS England, will be discussing how new technologies are going to change the face of diabetes. Driven by the need to innovate, Bryant has been crucial in the movement towards making the NHS paperless, looking at the transformative powers that technology has to offer. For those who rely on technology or feel more faith should be put into it, this session is not to be missed. Samantha Jones, director of New Models of Care at NHS England will also be presenting on day one, analysing new models of care in diabetes, whilst Pauline Latham MP, chair of the Diabetes Think Tank will feature in the afternoon session on day two.

of the skin, caused by multiple injections. Anyone interested in diabetes and ethnicity will not want to miss Dr Sophie Eastwood, clinical research fellow at the Institute of Cardiovascular Science at University College London, analysing Type 2 diabetes in ethnic minority groups. This presentation will be closely followed by Dr Kesar Sadhra, GP at Manor Park Medical Centre, Slough, who will talk about the practical challenges of diabetes in the Asian population. As part of the diabetes technology and diagnostics stream Dr David Strain, senior clinical lecturer at Exeter University, will examine the role of Ketosis - the condition characterised by raised levels of ketone bodies in the body, associated with abnormal fat metabolism and diabetes mellitus. Technology has become an increasingly popular stream with the visitors, with cutting edge innovation on show as well as the very latest thinking. Dr Partha Kar will take to the stage again to discuss ‘Diabetes & Technology: Overhyped or a necessity?’, while Sue Wales will explore how using innovations and technology can effectively improve diabetes control. Those looking for an update on the first wave of the NHS National Diabetes Prevention Programme need look no further than Dr Jim O’Brien, national programme director for the NHS Diabetes Prevention Programme at Public Health England. Building on this prevention theme, Dr David Haslam, GP and chair of the National Obesity Forum will analyse just how big the diabetes problem is and look at how best to address prevention. Karen Richardson, conference director at Diabetes Professional Care 2016, comments: “After the huge success of last year’s conference programme, we wanted to make sure we kept the momentum going for 2016. We will host a multi-

cus “Our fo– we is clear ncrease i want towerment of o the empts and create patien er patient bett mes” outco

DEDICATED STREAMS Within the Primary and Secondary Care stream, Debbie Hicks, a nurse consultant for Diabetes from Enfield & Haringey Mental Health Trust and chair of FIT UK, will take a look at the learning curves experienced within diabetes care since the seventies. Hicks will also be running an interactive session on lipohypertrophy, which will see patients being treated live in one of the theatres, whilst educating visitors on how to identify this accumulation of fat underneath the surface

stream programme, covering the full diabetes spectrum from technologies, diagnostics and prevention to commissioning, paediatrics and primary and secondary care. “We want our conference to be the forum where new ideas are born, understanding is deepened, solutions are progressed and hot topics like DKA, Monogenic Diabetes and Biosimilars are addressed. Our focus is clear – we want to increase the empowerment of patients and create better patient outcomes.” INNOVATIVE SHOWFLOOR In addition to the seven stream CPD-certified conference programme, Diabetes Professional Care 2016 will play host to major suppliers from across Europe who will use the show to launch their latest developments in medicine, technology, life sciences, healthy living and lifestyle and wound care. For instance, Hicom will debut its Community Module, a new innovation that will enable DSNs and GPwSis to truly take care out into the community, without breaking the security needed when taking data out of the hospital network. Launching a ‘world first’ is Cellnovo, with its mobile diabetes management system, comprised of three parts – an insulin patch pump that is small, discreet and tubeless, a wireless touchscreen handset with an integrated blood glucose meter, and an online platform that automatically syncs data to the cloud, making it available anytime, anywhere. If it is measurement you are after head to the GlucoRx stand. It will be presenting its Nexus meter range, which utilises advanced GDH-FAD enzyme technology for fast, precise and reliable blood glucose results. The GlucoRx HCT meter and smartphone dongle have Haematocrit Correction Technology and measure blood glucose, ketones, haematocrit and haemoglobin. A series of educational visual aids have been launched by X-Pert Health, which will be presented live on the showfloor. This will include its nutrition for health plate model, its fat awareness magnetic labels, its food labeling guide and its revised patient handbook. E



Seeing how everyday activities affect their blood glucose. That’s illuminating.

Diabetes management is about to be seen in a new light. The Contour®Next ONE smart meter seamlessly connects to the Contour® DIABETES App to capture remarkably accurate blood glucose readings.1,2 This new system gives patients the ability to share their results with you to help focus your discussions with them. Meanwhile, they can easily log daily activities to help them understand how these affect their blood glucose and to manage their diabetes, smarter.

References: 1. CONTOUR®NEXT ONE user guide. 2. Christiansen M et al. Accuracy and user performance evaluation of a new blood glucose monitoring system in development for use with CONTOUR™NEXT test strips. Poster presented at the 15th Annual Meeting of the Diabetes Technology Society (DTS); October 22–24, 2015; Bethesda, Maryland, USA. Ascensia Diabetes Care UK Ltd. Ascensia House, Albert Road, Newbury, Berkshire RG14 1DL. Ascensia, the Ascensia Diabetes Care logo, CONTOUR and the CONTOUR Diabetes app are registered trademark of Ascensia Diabetes Care Holdings AG. © 2016 Ascensia Diabetes Care. All rights reserved. Apple and the Apple logo are the trademarks of Apple Inc., registered in the US and other countries. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google Inc.


For further information on the Contour®Next ONE meter contact your local Ascensia Diabetes Care representative on 01635 566331 or visit

EVENT PREVIEW  Ascensia Diabetes Care will be demonstrating the new Contour Next One blood glucose monitoring system, the next exciting development in the evolution of self‑monitoring of blood glucose for people with diabetes. Ascensia Diabetes Care believe that the Contour Next One blood glucose monitoring systems can be a significant advance for people with diabetes. These systems combine the remarkable accuracy of Contour Next meter platforms with the easy-to-use features of the Contour Diabetes App to provide insights that help patients to better manage their condition. These systems enable people with diabetes to learn more about their condition and make the appropriate management decisions. RESOURCES AND INNOVATION Launching live at the show, through interactive workshops, is the Forum for Injection Technique (FIT UK) with its UK Injection Technique Recommendations, focusing on best practice. Every visitor to the workshop will receive their own personal copy of the recommendations, plus they will have access to the many tools and resources developed by FIT UK to ensure that people with diabetes who inject, get the best possible outcome from their injected insulin or GLP-1 receptor agonist by using the correct injection technique. Neuropad will be showcasing its patented 10-minute home and clinic based screening

DPC-Noctura 400-Advert.indd 1

test, for the early detection of diabetic foot syndrome (peripheral neuropathy); a condition which can lead to serious complications such as foot ulceration and even amputation. The test is completely painless and uses sudomotor dysfunction as a proxy for autonomic neuropathy. Free resources and support will be provided for all visitors interested in type 1 diabetes by JDRF, the type 1 diabetes charity, and the world’s leading charitable funder of type 1 research. These resources cover both adults and children with type 1 and cover diagnosis, school, teens, university, pregnancy and more. For those interested in innovation within the support network, Advanced Therapeutics will be introducing its Dario Smart Meter, which turns smart phones into a fully equipped diabetes management tool. This all-in-one meter design is not only attractive, but functional and convenient fitting discreetly into pockets or bags. This complete, cloud-based solution, gives you and your support network real-time tools and actionable information that make it easy to track and better understand your glucose levels, carbohydrate intake, calorie expenditure and insulin dosage via the carb/insulin bolus calculator. METEDA will be showcasing an array of products, including the NeuroTester Air, its renewed system for the guided execution

and automated processing of Cardiac Autonomic Neuropathy tests which comprise the Deep Breathing, the Lying to Standing and the Valsalva Manoeuvre tests. Toby Baker, event director of Diabetes Professional Care, comments: “It is great to see so many leading names getting behind the show, with more on the way. We are delighted that the show has gone from strength to strength, attracting new exhibitors and sponsors from across the diabetes arena, many of whom have chosen DPC2016 as the place to launch their new diabetes solution. I can’t wait for the doors to open, it is going to be electric.” Diabetes Professional Care will also host an array of show features including: The Innovation Zone, which provides the opportunity to get close to the people and technologies shaping the future of diabetes care; The Commissioning Zone, where high-level public health decision and policy makers can converse and interact in their own space; and, returning by popular demand, The Diabetes Village, a dedicated networking and lounge area where Healthcare Professionals working in primary and secondary can share experiences and best practice over a relaxed coffee. L

Diabetes Professional Care



Providing a non-invasive prevention and treatment for diabetic eye disease

The Noctura 400 Sleep Mask, by PolyPhotonix Medical, is a monitored ophthalmic treatment for Diabetic Retinopathy and Diabetic Macular Oedema. The mask can be used at any stage of disease progression and is now available for clinical use. The non-invasive technology involves a soft fabric mask housing a pod that delivers a precise dose of light therapy during a patient’s normal hours of sleep. It works by reducing the oxygen demand of the eye’s retina during the night. This lowers the risk of retinal hypoxia, which has been shown to be a key contributing factor in the development of retinopathy in diabetes patients. This award-winning, innovative device differs entirely from current

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treatments, such as intravitreal injections or retinal laser therapy, which require frequent hospital attendances and are often invasive and uncomfortable. These procedures are expensive for the NHS, inconvenient for the patient, and are generally given only when eye complications have advanced to a late stage. The Noctura 400 sleep mask is easy to use, cost-effective and offers treatment and prevention. It is fully CE marked, based on proven safety and efficacy data, and can be delivered at a fraction of the current treatment cost. To see for yourself visit the Noctura website. FURTHER INFORMATION Tel: 01740 669143



Infection Prevention 2016



Fighting infection on all fronts

Over 800 delegates and 100 exhibitors came together for the infection prevention conference of the year, Infection Prevention 2016 on the 26-28 September 2016 in Harrogate. Here, the Infection Prevention Society look back over the key messages from the show This year’s scientific programme welcomed an array of renowned speakers offering delegates the latest in infection prevention research, education and expertise. With so much to offer throughout the three-day multi-stream programme it was difficult to select only a handful of sessions to review. EMERGING THREATS AND PREVENTION OPPORTUNITIES Professor Heather Loveday welcomed Professor A.P.R Wilson, consultant microbiologist at University College London, to the stage to deliver an overview of current



and emerging threats in the world of infection and described a range of the infection prevention challenges we face. A rapid increase of Multi Drug Resistant (MDR) gram negative organisms combined with a dearth of new antibiotics sees us entering a new phase in healthcare, where infections become increasingly difficult to treat. Professor Wilson described two patients that recently presented with infections that no antibiotics could combat. Although both patients survived, he predicts that not all

patients will be as lucky in the future. Suppression regimes are not available for MDR gram negative organisms and screening programmes to identify gut carriage are viewed as invasive- while eradication is not considered possible. It remains that infection prevention practice is the best defence we have and key to slowing the inevitable crisis in healthcare. Professor Wilson set the scene for this year’s conference and provided a reminder of the importance of learning in a

This cientific s ’s r a e y me programan array ed welcomned speakers w of reno ng delegates i r r offe ght afte u o s r i e th se experti

EM COTTRELL LECTURE Our new president, Dr Neil Wigglesworth welcomed Professor Mary Dixon-Woods, a fellow at the Academy of Social Sciences and the Academy of Medical Sciences, to deliver the prestigious Cottrell Lecture. A light-hearted personal potato (yes potato) and meningitis tale to illustrate the similar challenges we have in infection prevention and control and how we create structures and address the realities of how we behave as humans set the scene for Professor Dixon-Woods lecture. Having set the scene she then described how when you try to map clinical systems they are largely chaotic and many of the basic systems we need to deliver care are not standardised or harmonised. When you observe healthcare professionals do their work they are often spending huge amounts of time dealing with challenges, even something as simple as how you know if this commode is clean? Professor Dixon-Woods suggested we have to get beyond individual versus systems and have to have collective competence. There is a need to get beyond that the belief it is only interventions and we need to go back to our professionalism and what that means. If we are going to improve Improvement in infection prevention and control we are going to need a range of strategies, not just individual. We need to improve operational systems, get better at quality improvement with large scale cooperation and improved scientific rigour. This was a session with ample information that left the audience with a lot of food for thought! THE DEBATE FLOOR On Tuesday 27 September we were presented with an exciting debate on whether contact precautions are essential for the management of patients with MDROs. Dr Eli Perencevich, tenured professor of Internal Medicine and Epidemiology at the University of Iowa, USA argued for the motion, while against the motion stood Dr Fidelma Fitzpatrick, senior lecturer at the Royal College of Surgeons in Ireland and consultant microbiologist at Beaumont Hospital in Dublin. A debate starts with a statement: This house believes… and then arguments for and against. The audience then decides if it agrees with the statement. Eli Perenevich and Fidelma Fitzpatrick presented sound arguments as to why the audience should agree (or disagree) that: contact precautions are essential for the management of patients with MDROs. The result divided the audience almost completely down the middle. The outcome is important as it says that the audience (IPC professionals) are unconvinced of the contents of their policy manuals and evidence-based guidance. The debate found that many do not believe that what we ask people to do is doable and worth doing. Well done

Professor Mary Dixon-Woods delivered the Cottrell Lecture at the Infection Prevention Conference

Eli and Fidelma, thoughtful and thought provoking. And most importantly they left everyone wanting another debate at IP2017. IMPROVING HAND HYGIENE The final day of conference began with a session on ‘Using science to guide hand hygiene surveillance and improvement’ in the Ayliffe Lecture. In this thoroughly interesting session, Dr Eli Perencevich returned to discuss each of the opportunities for hand hygiene observations, and explored the literature surrounding this subject. The importance of the World Health Organization’s five moments for hand hygiene improvement was commended, although it was suggested by Dr Perencevich that, along with each moment, a series of other actions need to be undertaken in order for staff

REFLECTIONS The conference this year saw the use of our very first conference app which allowed live voting throughout the three day programme. On the afternoon of 28 September, Dr Jon Otter, epidemiologist from Imperial College Healthcare NHS Trust, gave the delegates control over his session title and ended up presenting a session on the ‘Use of social media by healthcare professionals – useful or waste of time?’ Dr Jon Otter had the unenviable task of preparing three talks to present, with delegates given the choice via the conference app. The result was announced by Jon on Twitter, of course. Jon starts with presenting the position of many of his peers with regard to social media; ‘Stop wasting time on social media and do some real work’ said a colleague when he was discussing the notion of an infection control journal having an active Twitter feed. Jon then takes the sizeable audience through his argument that social media is an essential learning tool for healthcare professionals and we must be ready to recognise that times are changing. The delegates are given a brief overview of social media and the platforms available and examples of the many benefits it provides. Jon finishes by championing the potential of social media to advancing the infection control agenda, and provides an example of its use at Infection Prevention 2016.

Infection Prevention 2016

common way to minimise the threats to modern day healthcare.

THE ART OF BRILLIANCE The penultimate session at this year’s conference welcomed best-selling author Andy Cope to the stage. Although on this occasion Andy was unable able to present much of the science behind his theories, what he presented

The importance of the WHO’s five moments for hand hygiene improvement was commended, although it was suggested that a series of other actions need to be undertaken in order for staff to actually reach that moment to actually reach that moment, indicating that to enable someone to undertake hand hygiene at the correct opportunity is far more complicated than five steps. Dr Perencevich also discussed whether we could actually get to a sustained 100 per cent compliance for hand hygiene, and posed the question ‘If not, how much is enough?’. Dr Perencevich felt that most automated monitoring systems did not lead to increased compliance, and many can’t be linked to hand hygiene opportunities. He suggested that video technology could be the way forward as the ‘Big Brother’ fear of being watched may increase compliance, such as that which has been seen by the Hawthorn effect of direct observation.

was entertaining, poignant, thoughtful and just side-splitting funny. The key theme was this: happiness can be experienced here, now and every day. Rescheduling happiness for a Friday, or retirement, is a waste of our allotted 4,000 weeks. Andy Cope’s message is simple and obvious: don’t discard the Monday through Thursday. Don’t save your best pants for your ‘nominated’ best days – enjoy it all. We are now looking towards 2017 and are delighted to announce that Infection Prevention 2017 will be held from the 18-20 September at Manchester Central. Registration and abstract submission will open in February 2017. L FURTHER INFORMATION










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An accredited venue often serves as the best choice for conference planners, and it is no different for healthcare meetings. With that in mind, Health Business revisits guidance from the Meetings Industry Association

With over 1.3 million business events held in the UK each year, with a value of over £39 billion to the economy, meetings and events are big business. Regardless of sector, meetings and events are an effective tool for businesses to facilitate networking and teambuilding, run product launches, deliver essential communications and promote innovation. Organising events is a big responsibility and there are a number of things to consider to ensure you are getting it right. TIMING Timing is crucial across many aspects of your event planning. Firstly, whilst there will be occasions when an event needs to be organised on a tight timescale, if you can allow plenty of time for planning, research and marketing, your event will benefit as a result. It is also important to consider other industry events or launches taking place, particularly annual events which typically take place at the same time every year. Doing so negates the risk of clashing with established events and therefore affecting your delegate numbers. For the event itself, the schedule for the day should be clearly laid out and allow for networking opportunities and sufficient rest breaks. As a planner, some allowances should be considered for sessions that overrun and issues that arise on the day. Timely feedback is also important after the event. Whether

you choose to ask all delegates or a select few for feedback after an event, do so promptly, whilst the event is fresh in their minds. If you are going to ask for feedback though, be prepared to act on it when it comes to your next event. If problems have been highlighted, work to eliminate them for next time and acknowledge and address them for those who have been affected.

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

Written by The Meetings Industry Association

Meeting the requirements of event planning

Meeting & Events


When ur g yo plannin factor in s, budgetontingency some c ings that for th up later p may cro the line down

BUDGETS Budgets can vary from the generous to the ‘shoestring’. Regardless of where yours sits, you can hold an effective and successful event. Hidden costs often represent the sting in the tail for many organisers. A good venue will have clear terms and conditions and will be transparent regarding their pricing structure. At the point of booking, ask about additional charges rather than be faced with an unwelcome surprise when you receive an invoice. When planning your budgets, factor in some contingency for things that may crop up later down the line. If you are charging delegates to attend your event, think about benchmarking against similar events and allow for ‘early bird’ rates or discounts.

THE BENEFITS OF AIM Essentially, AIM helps event planners to source venues they can instantly trust. But what does it mean for prospective buyers and bookers? It means: doing business with venues that care and have integrity; delegates are well looked after and commitment to service excellence is paramount; the facilities and event spaces are fit for purpose and of high quality standard; accountability through an ethical code of conduct; knowing every element of the venue’s costs in advance; industry-approved contracts and terms and conditions; doing business with credible, legally compliant venues; standardisation of best practice; procurement boxes ticked; stress free venue selection; and total peace of mind. E




MEETINGS CO N FE R E N C ES At Ripon Racecourse

The perfect venue for your next event - Yorkshire’s garden racecourse With plentiful free parking, a beautiful backdrop and lots of natural lighting, Ripon Racecourse really does offer something unique for your next event. Call: 0113 287 6387 Email: or Visit:

Quirky Unconference Venue in an Industrial Victorian Setting Just a short walk from Birmingham City Centre 7 unique meeting spaces, capacity ranging from 2-200 On-site parking for cars and canal boats Meeting room catering provided by our Canalside Café Contact our friendly team for our latest offers and packages

RIPON RACES Yorkshire’s Garden Racecourse

CONFERENCES & EVENTS Towcester racecourse is perfectly situated for all major commuting networks making our conference centre the perfect choice for your event.

GREYHOUND RACING Experience the thrill of the track like never before with a unique experience of entertainment and quality dining. Towcester Racecourse offers Free, Fast and Furious racing 3 times per week.

HORSE RACING Towcester Racecourse is one of the country’s most scenic National Hunt racecourses, provides a stunning setting in which to enjoy the thrilling spectacle of racing ‘over the sticks’.

telephone: 01327 353414 email:

or visit our website:




Timely feedback is also important after the event. Whether you choose to ask all delegates or a select few for feedback after an event, do so promptly, whilst the event is fresh in their minds  MEETINGS CODE All AIM venues abide by the Meetings CODE which demands: Consistency; Openness; Decency; and Ethics. AIM venues must achieve 50 grading criteria that include: the location and accessibility of the meeting rooms and facilities; the suitability of the lighting and heating in meeting rooms; the levels of security; how often the rooms are cleaned and decorated; whether the space and furniture are adequate and suitable; the provision of in-room services such as power sockets; what is supplied at no extra charge and how transparent the published prices are. AIM-accredited venues and suppliers must also comply with a number of legal acts, which complement the criteria, including: Health & Safety at Work and Fire Safety; The Bribery Act; Licensing Laws; Data Protection and Disability Discrimination. The AIM effect on venues and suppliers For venues and suppliers, achieving AIM means gaining an industry accreditation and receiving recognition for the management of the

business. Internally, the accreditation can help them audit their processes and procedures and ensure they are offering an excellent level of service. The process also highlights any room for improvement so that they can be addressed quickly and appropriately. FACILITIES GRADING Facilities are subjected to 46 self-assessed criteria, which again the MIA makes available for those who wish to access them. Ensuring all AIM criteria are viewable helps ensure the scheme is open, fair and transparent. The Facilities Grading criteria are verified via spot checks that are unannounced, random or following a complaint, and range from cleaning routines and provision of guest supplies, to lighting, sound, heating and ventilation systems, to redecoration schedules. Legal compliance is a ten-point code of legal compliance through a self-grading process. For those buyers or other interested parties who wish to see the full code, it’s available from the MIA on request. They include

compliance with health and safety, Disability Discrimination Act, Data Protection Act, Trade Descriptions Act and Employers Liability Act.

Meeting & Events


PEOPLE Finally, though perhaps most importantly, think about the people involved in your event. Choose the right speakers – you can have the best venue, great food and perfect programme but if the speakers and facilitators aren’t right, your event may suffer. Work from recommendations or try and see the speaker in action first if you can. Always follow up with feedback and thanks. In terms of delegates, make sure they are well informed. Send out joining instructions, include maps and take note of any dietary or accessibility requirements. If delegates are looked after in the build up to and post‑event as well as on the day itself, you’ve ticked one of the most important boxes. In terms of staff, it’s important that everyone who will have contact with your guests, whether on the registration desk on arrival, serving at lunch, on the cloakroom or handing out programmes understands the event and the value of good customer service. People are at the centre of every successful meeting. Build strong relationships and keep people as your focus and you will have a firm foundation for your events. L FURTHER INFORMATION

Discover Lillibrooke…

15th century manor and barns, 21st century tech An inspiring heritage venue for your private use, Lillibrooke offers a Small Barn, Great Barn, character syndicate rooms and 15 acres of grounds – all against the backdrop of a 15th century Manor House.  Included in the DDR is full use of our high-tech AV, high speed secure wi-fi, ample free parking, access to the grounds, a highly experienced events team, and carefully chosen menus prepared by our on-site chefs.  Ideally located just 5 minutes from the M4, 15 minutes from Heathrow, and 20 minutes from Paddington station.   Contact us by phone, email, or via our website- the Lillibrooke team look forward to welcoming you.

T: 01628 90 60 40 E: W:



Leisure Industry Week



Leisure Industry Week 2016 The 28th Leisure Industry Week enjoyed distinct educational streams, engaging content and a positive atmosphere As the dust settles on another LIW (Leisure Industry Week), the thousands of delegates who passed through the doors at the NEC can reflect on a packed two days of world class education, networking and an extensive exhibition. LIW was purchased in mid-2015 by the organisation responsible for producing BodyPower, one of the largest consumer shows in Europe. Despite a short lead time, year one saw an increase in visitor numbers and positive feedback from both delegates and exhibitors. It stands to reason, therefore, that given a full year of marketing and positioning the show, year two was hotly anticipated. Pre-show strategy for LIW was to position the show as a hub for workforce development with education taking priority. Distinct education streams were established in Spa & Wet Leisure, Sport, Play, Facilities Management, Fitness (including Practical Coaching and a Fitness Business School) and Health. BUSINESS-FOCUSSED Whereas 2015 was underpinned by a sprinkling of star dust (where the Keynote Theatre hosted the likes of Stuart Pearce, Ben Cohen, Kellie Maloney and Sally Gunnell), 2016 was far more about business. The draped Operators and Keynote Conference hosted CEO of Think Digital First, Warren Knight, former head of Digital at Microsoft, Allister Frost, and former head of the John Lewis Intelligence Team Andrew McMillan, alongside a host of top names. As Steve Orton, show director, explains: “Given the additional time and resource we had to prepare for LIW this year we’ve taken into account the viewpoint of some extremely influential people within the industry to implement a show that reflects the state of leisure and delivers in areas that need improvement. “Skillset is a word on the tip of every operator’s tongue, and we’ve taken a stellar line-up of successful businesspeople from both inside and outside of the sector to deliver workforce development opportunities that cater for that demand.” On education, LIW certainly delivered. Lift the Bar founder Chris Burgess commented that LIW was the ‘best show I’ve been to’; Emporium Gym owner Warren Dyson



said that he is ‘old enough to remember LIW in its former glory and I can say it’s starting to return to that former glory and more’; while Shredded by Science founder Luke Johnson noted that the show was full of ‘highly motivated trainers looking to improve their knowledge’. HIGHLIGHTS Over the two days there were numerous highlights. The Sport Education Stream shared a space with the Play Education Stream, both delivering a half day conference. Sport saw the likes of Dean Horridge, Fit for Sport CEO, deliver a talk on how to improve participation by ‘engaging with the dis-engaged’ and even looking at why ‘sport is not for everyone’. Horridge was joined on the stage by David Gent and Andrew Soutar of British Weight Lifting and British Judo respectively, looking at the ‘impact of the Olympics on UK sport’ as well as physiologist Colin Thomas covering ‘how to run without injury’. Play was also a popular destination. Speakers included the likes of Jupiter Play’s Kristina Causer covering ‘inclusive play and designing an inclusive strategy’, Dr Lee Smith (a senior lecturer at Anglia Ruskin University) talking about ‘encouraging activity within the family unit’ and principle research associate Dr David Whitebread discussed the ‘value of play for young children’s development’.

We’re ning plan already ar’s event next ye e’ll have and w astic new nt some fa ns to make additio 17 bigger LIW 20 better and

SPA & WET LEISURE Backed by the support of STA and SPATA, Spa & Wet Leisure had a strong presence at the show with exhibitors including the likes of AquaMat, ColdTub, SRS Leisure and many more. The education stream featured the likes of Invictus Games Swimming Champion Mike Goody discussing ‘how to turn your swimming teachers into champions’ as one of many highlights. Speakers including director of IQL Martin Symcox, Devin Consulting managing director Chris Graham and Aquatzi’s Anna Roscoe, whilst STA provided both Robbie Phillips and Kayle Burgham in a stream that covered everything from participation,

safety standards, pool design, programming, UK Aquatics Qualifications and cost-saving. The Facilities Management Education Stream was sponsored by the Sports & Leisure Facilities Forum and Facilities Management Forum (both run by Forum Events). Featuring talks on smart energy strategy, employee engagement, interpersonal communication, recruitment, safety culture and sales the diverse conference was a popular destination throughout the show. Speakers included PlanDay chief marketing officer John Coldicutt, Pure World Energy CEO Simon Wright, DataHub director Alex Burrows, Serco Sales coach Gary Edwards and head of Group Development at Right Directions Gill Twell. GETTING EVERYONE ACTIVE LIW were extremely proud to announce SPORTA as a premier partner early in 2016 and the sight of the Health Education Stream being packed out on Tuesday

Leisure Industry Week

for the SPORTA Health Improvement Conference was a major highlight. Public Health England’s Dr Mike Brannan kicked things off with a discussion on ‘the challenge of getting everyone active’ in an insightful day. Wednesday saw the likes of East of Riding Leisure’s Kevin Hadfield doing a case study on GP referrals, Hayley Jarvis discussing ‘the role of physical activity in tackling mental health issues’ and Dr Dane Vishnubala of Core Fitness looking at how ‘the fitness industry can get more involved in the physical activity agenda’. THE FITNESS STREAM Certainly the busiest and arguably the most talked-about area of the show, however, was the Fitness Stream. Covering three distinct zones, the Fitness Business School, Practical Coaching and Tropicana Wholesale Nutrition Zone, there was a wealth of knowledge and expertise that impressed both speakers and delegates. Standout names included Americans Sol Orwell and Mark Fisher, as well as Ben Coomber, Dr

Gary Mendoza, Phil Learney, Jamie Alderton, Paul Mort, Luke Johnson, Chris Burgess, Martin MacDonald and many, many more. The Fitness Business School offered fitness professionals the ability to learn from the most prominent coaches and educators that have developed their own businesses successfully, whilst Practical Coaching targeted personal trainers, fitness managers and nutritionists to deliver a world class line-up of industry figureheads discussing the practical application of training and nutrition. Other noteworthy areas included the sight of over 300 Pure Gym Personal Trainers converging on the closed Pure Gym Personal Trainer Conference that attracted top name speakers, whilst the likes of Sosa Dance Fitness, BhangraBlaze and Hulafit all provided energetic demonstrations in the Studio to showcase the latest classes. Urban Attack ran an extremely popular assault course over the two days and the Trampoline Park was once again a great place to let off steam. All that education was complimented by a packed show floor that saw over 150

exhibitors get some excellent sales leads with some engaging visual displays. Steve Orton commented: “We were confident that LIW would be a superior event to 2015 with a full run-up of event promotion and that opinion has only been reinforced during a two packed days. Our tailored educational programmes, excellent features, exciting interactive areas, ground breaking product launches and hundreds of exceptional brands made the show a clear success. “We’re already planning next year’s event and we’ll have some fantastic new additions to make LIW 2017 even bigger and better. We’ve seen growth both in the number of visitors and exhibitors and the show will keep being nurtured by our team. I’m proud of the event and I hope it was as enjoyable for everyone who attended as it was for us as organisers.” L

Leisure Industry Week will return to Birmingham’s NEC 12-13 September 2017. FURTHER INFORMATION





Providing cost-effective, tailored parking solutions Originally formed to tackle unauthorised parking on private land, Vehicle Control Services (VCS) now offers client focused parking control to both the public and private sectors. By approaching each contract individually VCS ensures a service tailored to a sites specific needs. Flexibility is at the heart of everything it endeavours. As traffic levels increase the demand for parking intensifies. With a client portfolio that encompasses NHS trusts, university campuses, ports, train stations, multi-acre business parks, airports, high street retailers, retail parks and red routes; VCS has the expertise to ensure that every site, no matter how complex its individual characteristics, receives the service most suited to its needs.

Every parking environment is different: size, traffic flow and location vary wildly, therefore, a ‘one size fits all’ approach simply doesn’t work. Clients receive a no obligation site survey and detailed consultation. All service options are tailored to clients’ specific requirements to ensure the best balance of cost-effective operational rigour. VCS services include, but are not limited to: regular foot patrols; site inspections; mobile CCTV enforcement; ANPR technology; permit management and administration; PCN processing; 24 hour client call-out service; site security; and parking equipment procurement. FURTHER INFORMATION Tel: 0114 261 7373


You can’t be healthy without being clean Next year is Cleanovation’s 30th anniversary in the cleaning business. Cleaning properly is increasingly challenging, long gone are the days of a flick with the feather duster. Cleaning the spaces we all work in these days involves kitchens, washrooms, desks and delicate cabling, vast windows and a myriad of materials each of which needs different treatment; leather, stainless steel, wool upholstery, various woods, lino, rubber, marble and terrazzo. Cleanovation has even had to learn how to deal with kids’ crayons.  The company goes out of its way to avoid harmful chemicals. Detergents, which are made with petrochemicals, do terrible things to your skin. Cleanovation prefer soaps which are just as effective at cleaning, but rarely provoke allergies. Products include those that break down naturally after use - we all have to do our part in thinking about our planet.



Go To Goal Limited is a young but successfully expanding company. Its aim is to provide the highest quality cleaning service in all London areas. It does that by keeping clients satisfied in every aspect related to its business, be it a friendly and cheerful approach from all members of staff, or the excellent quality of work it gladly delivers. Go To Goal’s staff are very carefully selected with their background and experience checked. The company believes, that when you respect each and every member of your staff, you receive the highest quality of work in return. That is why Go To Goal is proud to say that it pays staff a decent salary above the minimum wage and that staff are always motivated to deliver and aim towards higher standards. Finding a great cleaning company which is passionate about its work is not always easy. However,

Jackpad is a Leicesterbased business providing foundations for modular and relocatable buildings. The product is a re-usable foundation system suitable for temporary or permanent modular buildings and in most instances negates the need for excavating the existing surface or pouring concrete. This is especially important if a building is temporary and the surface on which it is placed needs to be returned to its former use afterwards like offices or clinics on a car park.   Jackpads provide an environmentally friendly solution – manufactured from 100 per cent recycled plastic and painted steel, the product includes incremental packers which overcome any fall in the ground, so levelling is simple and foundations structurally sound. Suitable for up to triple storey modular buildings, the Jackpad system has been

Fanatical about cleaning, ensuring every job is completed to perfection

Go To Goal never disappoints and is always aiming to provide the very best customer service. Go To Goal only works with experienced cleaners who are trained to its own best practice and standards There are no hidden fees, it agrees an hourly or fixed rate for your cleaning, with 100 per cent Satisfaction Guarantee. Go To Goal provides superior customer service seven days a week! FURTHER INFORMATION

Products & Services


The company could go on and on singing its virtues – the way it vets staff (no one gets to be a key-holder without years of demonstrating they can be trusted), the way it cleans the windows in reception every day, the way many of its clients have kept using Cleanovation for twenty years or more – but the proof of the pudding would be giving us a try. Call Nick Morley to talk about your needs. FURTHER INFORMATION Tel: 020 7252 5550

Reusable foundations for modular buildings

proven to be invaluable in many healthcare projects including temporary clinics and offices at GP practices and hospitals around the UK.   Kris Cartwright, managing director, said: “Jackpads come into their own when used for otherwise difficult projects. The Jackpad system is fully calculated and is accredited by Building Control. It is simple to install and simple to take away later should the portable building need to be moved.” FURTHER INFORMATION Tel: 0116 286 6966



Products & Services




The Bacou White Labo from Honeywell is a range of white clogs designed specifically for use in hospitals and laboratories, where the demands of the job require the wearer to spend long hours on their feet. With this in mind, Honeywell has designed the Bacou White Labo range with a leather lining and upper, which has been perforated to provide the wearer with aeration to the foot, helping to keep it cool throughout a long shift. In addition the PU wedge sole offers the wearer flexibility of movement and

Humanitas Healthcare Services (HHS) Limited is a clinicallyled Independent Healthcare Organisation committed to supporting and enhancing models of provision and delivery of an expanding range of communitybased local anaesthetic surgical procedures. It was established almost 10 years ago and is based in the West Midlands. HHS’ service users include both NHS choose-and book e-referrals as well as private/self-referrals. The expanding range of procedures HHS performs include minimally invasive Vasectomies; contraceptive implants; Carpal Tunnel Decompression; Trigger finger release; removal of benign lumps, bumps and moles; and musculo-skeletal injections. HHS is CQC registered, AQP accredited, and its medical director is a member of the Independent Doctors Federation, an associate member of the British Society for Surgery of the Hand, and an ASPC

Introducing the Bacou White Labo range

improved slip resistance on many different types of surfaces. The Bacou White Labo range complies with EN ISO 20345:2007 SB EA SRC standard and is available both with and without a 200J steel toe cap. The Bacou White Labo range is available in sizes 2-9 (35-42). More information on the Bacou White Labo range can be found on the Honeywell website. FURTHER INFORMATION Tel: +44 (0) 1256 693200



Medical Models Online is a leading UK supplier of medical training models, manikins and anatomy models, from small phlebotomy and IM Injection training models through to catheterisation models and full body manikins. Medical Models Online supply hospitals, universities, surgeries and training providers in the UK and overseas. NHS purchase orders welcome. To ensure the best available equipment at a competitive price, models are sourced from factories around the world and made available on one site for easy purchase. This ensures a wide choice of equipment with models from major manufacturers at reduced rates and models specifically made for Medical Models Online. The importance of education, training and development in healthcare professionals cannot be underestimated, and

Obviously a situation everyone wants to avoid. So, how do you effectively and safely display information to patients in a medical environment? This is the core question that should be considered when making a sign for display in any busy environment – the last thing anyone wants is to have a hard to see sign fall on their head when all they were looking for was the doctor’s office for a consultation about an ingrowing toenail. The process of buying signs in general can also sometimes be a complicated affair. PJ’s Graphics, based in Ruislip, West London, specialises in making the process simple, yet still guaranteeing a finished product which is both attractive, useful and installed safely. Whether the client has a good grasp of the signs that are needed or not, PJ’s Graphics

Medical training, models and educational manikins


Commited to excellence in community based surgery

with modern equipment it is possible to closely simulate the reality of performing various procedures in a safe, patient free environment. Modern materials and manufacturing also mean the cost of equipment has come down, and so many professionals now buy their own equipment to allow practice at their convenience. Medical Models Online can provide suture, injection, phlebotomy, gynaecological, catheterisation, surgical and many other types of manikin as well as skeletons, charts and anatomical models. FURTHER INFORMATION Tel: 01460 200111


approved vasectomy trainer. HHS’ values are founded on principles and practice of ethics, safety, and evidence-based high quality and its culture embraces respect, dignity, equality, and diversity of all services users. These ensure excellent feedback scores. For the convenience of service users HHS is able to provide seven days availability and its service model mission seeks to ensure treatment closer-to-home to meet the choice of service users. It also provides education and training and is passionate about performance monitoring. FURTHER INFORMATION Tel: 01922 504 991

Man seriously injured after sign falls on head

ensure to keep any technical drawings for approval basic and easy to understand. Successfully completing sign works in the past for many businesses in the corporate sector the company can confidently advise an effective solution to any sign requirements that adhere to all legal requirements. Visit the website to find out how PJ Graphics can help you with your signage needs, or alternatively, call up and speak to an adviser. FURTHER INFORMATION Tel: 07717 337 658



As part of the Craggs Energy Group, recently recognised as ‘one to watch’ in the Times 100 fastest growing businesses in the UK, Craggs Environmental provides public sector and commercial customers UK-wide with a range of fuel management services to minimise the risks and costs associated with using and storing bulk fuel. Fuels such as diesel, gas, oil and kerosene are subject to degradation through exposure to light, heat and particularly the absorption of water from moisture in the atmosphere. Water reacts with naturally occurring bacteria within the fuel forming a black sludge like material which forms the bulk of contamination problems for stored fuel.   Craggs Environmental’s core services include fuel sampling and testing, on site fuel cleaning, tank base cleans, fuel uplift and

recent years and should always be considered for heating and lighting in large scale buildings and refurbishments. ESP energy, renewable energy experts and installers based in Shropshire, is MCS accredited, ensuring that all projects are executed to the highest standards. With over three hundred commercial installations using a range of renewable energy technologies such as: heat pumps, solar panels, underfloor heating, biomass boilers, combined heat & power (CHP) and district heating schemes, ESP Energy is the first choice for expert renewable energy advice. ESP’s recently completed 2.2MW district heating scheme project in the picturesque tourist attraction of ‘Portmeirion’ in North Wales, demonstrates the company’s extensive knowledge and ability. For this project a total of 27 properties were

What would happen if the Installing high quality and renewable energy systems fuel in your emergency Renewable energy has become generator tank failed? mainstream and affordable in

transfer and NDT inspections. The Craggs Energy Group is licensed by HMRC and the Environment Agency as both a Registered Dealer in Controlled Oils and as a Waste Permit Holder. To find out more about how Craggs Environmental can ensure your fuel is fit for purpose please contact the team via the telephone number listed below.   FURTHER INFORMATION Tel: 01422 882500 www.craggs



CMR Consultants is a privately owned energy and water consultancy based in the Midlands, but provides services across the UK and globally. CMR’s energy consultants have over 25 years’ experience working in the NHS and private healthcare sector where the company has carried out a diverse range of services from simple energy surveys and Carbon Trust work through to the provision of complete combined heat and power installations. CMR’s surveys initially focus on low and no cost recommendations with less than three year payback periods which it expects to yield a 10-25 per cent saving on current energy costs. Using protocols such as the IPMVP, CMR can independently verify the energy and water savings claimed by energy services companies. The company’s integrated service of consultancy, monitoring and targeting, and forecasting

With over 130 years experience in the production of printed material, Wotton Printers has earned its reputation for quality, service and innovation throughout the South West. Established in 1885 by Samuel Wotton, the original printing presses were powered by a gas engine with a drive train of overhead shafts and belts. They have come a long way since then, duly embracing each generation of new technology to enhance the range of services they offer, with speed of delivery and commitment to customer care. State-of-the-art four and five colour litho presses are capable of meeting all your print requirements including corporate stationery, full colour brochures, fine art catalogues, books, leaflets, newsletters, booklets, point of sale material and calendars. For business forms and NCR sets such as invoices, statements and order forms, as well as

Providing carbon, energy and water solutions

is developed around your needs and delivered by an experienced team. CMR can help you develop and implement an energy management framework that not only achieves ISO 50001 certification but is also tailored to your specific organisation. Its water consultancy team has many years of experience identifying and implementing water related cost reductions. Please feel free to call for an initial discussion, or send an email. FURTHER INFORMATION Tel: 0844 225 1166

Products & Services


linked together onto one district heating scheme with over 3.5 miles of underground pipework. District heating schemes and combined heat & power units are energy efficient, cost effective and earn the highest revenue when used in large building complexes or villages which demand a vast amount of heat and electricity. For a free, no obligation site survey, or to discuss your projects requirements call ESP Energy to speak to an adviser. FURTHER INFORMATION Tel: 01743 718003

Highly trusted digital and litho printing company

tickets, flyers and envelopes, the spot colour line provides a rapid turnaround for all your dayto-day requirements, including numbering and perforating. For shorter run print requirements Wotton Printers digitally print a variety of work including award winning football programmes and has recently invested in a large format printer now able to produce pull-up banners, canvas banners, advertising boards and complete signage for your individual needs. Please visit the Wotton Printers website for more information. FURTHER INFORMATION Tel: 01626 353698



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A clinical health coaching programme for patients with long term health conditions commissioned by Parker Drive Practice & Manor Medical Centre, Leicester City CCG, has shown dramatic results in clinical improvements in patient care, quality improvements and activity reduction for the NHS. The coaching service designed and delivered by specialists Totally Health, focused on ensuring that patients were better educated about their condition and had a greater insight into the support that was available, with the aim of helping them to become less dependent on NHS services. Coaching was carried out over the telephone, which allowed for flexibility with appointments and meant patients did not have to travel. An evaluation of the scheme found that amongst participants there had been: a 67 per cent reduction in unplanned admissions; a 47 per

Our Mobile Health specialise in health app assessment and digital health consultancy. It provides the ability for service providers to confidently recommend and deploy apps. The company also advises the digital health industry and helps policy makers set industry standards. Our Mobile Health currently sits on the EU mHealth Working Group developing health app assessment guidelines, as well as advising the National Information Board on its health app assessment framework. The company’s input is frequently sought for white papers and academic research; for example for the Royal Academy of Engineering (IET) and the Academy of Medical Sciences. Our Mobile Health has the credentials to help healthcare organisations navigate their way through emerging technologies in this arena and also to create a successful strategy that can

Cut A&E attendance with clinical health coaching

cent reduction in secondary care out-patient appointments; a 39 per cent reduction in contact with all health professionals in local services; a 30 per cent reduction in GP/practice nurse appointments; and a 22 per cent reduction in community healthcare appointments. Dr Durairaj Jawahar, lead GP at Manor Medical Practice, said: “Clinical health coaching enables patients with longterm conditions to be a major partner in managing their condition effectively and helps the NHS to achieve valuable healthcare outcomes.” FURTHER INFORMATION Tel: 020 3866 3337

Curated mHealth apps for better patient care

be confidently adopted and deployed. There are now over 250,000 mHealth apps available and the quality of many of them is unknown. To that end, Our Mobile Health launched the UK’s first curated library of health and medical apps. The curated apps are peer-reviewed by relevant experts in the appropriate fields, developing tailored portfolios of high-quality apps suitable for deployment to staff and patients. This means healthcare organisations can confidently make best use of the latest mobile health services to reduce costs and improve patients’ health outcomes. FURTHER INFORMATION


The publishers accept no responsibility for errors or omissions in this free service AGFA Healthcare 50 Ascensia Diabetes Care 80 Ascom 18 Atrainability 74 Birchwood Price Tools 30 BodyPower 88, 89 Bosse Interspice 84 Bridgehead Software 27 British Parking Association 77 Bryant Plastics 35 Citroen 12, 13 CCE Group 35 CCube Solutions OFC, 14 , 15 , 76 CFH Docmail 10 CGC Events 86 Cleanovation 91 CloserStill Media 70, 71 CMR Group 93 Craggs Energy 93 Craven Energies 30 CV Library 36 Dakota Intergrated Solutions 32 Datix 66 Druid Software 27 ESP Energy 93 Ethypharm 69, 75



Evac Chair International 42 Excel Parking Services 90, 91 FIAT IFC Glasdon 48 GoToGoal 91 Gratnells 38 Harland Simon 73 Health Enterprise East 72, 74 Healthcare Publishing 78, 79 Healthcare Quality 74 Hicom 58 Honeywell Safety Products 92 Hospedia 20 Humanitas Healthcare Services 92 iMDSoft 26, 27 Imprivata 68, 75 ISS Mediclean 8, 77 Keele University 72,74 Kirona Solutions 22, 27 Langley Waterproofing Systems 48 Lillibrooke Manor 87 London School of Hygiene & Tropical Medicine 72, 75 Medhand International 73 Medical Models Online 92 Nicky Stephen Marketing 91

Olympus Keymed OBC Omnicell 34 Our Mobile Health 94 PJ’s Signs & Graphics 92 Polyphotonix 81 Poole Bay Holdings 61 Q-Nomy 26 Ridouts Professional Services 64, 75 Safesmart 44 Safety Technology 44 Static Systems 49 Targett Business Technology 4 Texthelp 16 The Association for Perioperative Practice 62 The Bond Company 86 The Caledonian Hotel 86 The HCI Group 24 The Rack People 30 Total Intelligence 60 TOTALLY HEALTH 94 Towcester Racecourse 86 Vending Solutions IBC Wilo 28 Wotton Printers 93 Wynyard Hall 87 Yeoman Shield 6

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PRECISE AND RELIABLE PERFORMANCE Maximise equipment uptime with Olympus Service. Olympus Service Solutions maximise equipment availability and performance, assisting healthcare providers in their drive for efficiency to meet the increasing demands on their endoscopy services. · · · · ·

Maximised equipment uptime ensures equipment is available for clinical use Guaranteed repair quality in accordance with OEM technical specification All repairs exclusively performed by trained and licensed technicians, using only OEM parts, tools and processes Site level repair analysis and on-site training delivered by Uptime Support Managers Extensive loan inventory, including latest generation instruments performing to OEM standards

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Health Business 16.5  

Business Information for Healthcare Professionals

Health Business 16.5  

Business Information for Healthcare Professionals