Health Business 16.6

Patient Centred Care Platform

VOLUME 16.6 www.healthbusinessuk.net

INFORMATION TECHNOLOGY

MODULAR BUILD

SOLAR ENERGY

HEALTH BUSINESS AWARDS

RECOGNISING EXCELLENCE Once again, the Health Business Awards celebrated the successes and toasted the innovation taking place in our NHS

INFECTION CONTROL

BRINGING HYGIENE BACK TO BASICS

With bacterium advancing at new speeds, basic hygiene practice is the order of the day

PLUS: DOCUMENT MANAGEMENT | NORMAN LAMB INTERVIEW | PROCUREMENT

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HEALTH BUSINESS MAGAZINE ISSUE 16.6 Patient Centred Care Platform

VOLUME 16.6 www.healthbusinessuk.net

INFORMATION TECHNOLOGY

MODULAR BUILD

Comment

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Celebrating 2016 and looking ahead to 2017

SOLAR ENERGY

HEALTH BUSINESS AWARDS

RECOGNISING EXCELLENCE Once again, the Health Business Awards celebrated the successes and toasted the innovation taking place in our NHS

INFECTION CONTROL

BRINGING HYGIENE BACK TO BASICS

With bacterium advancing at new speeds, basic hygiene practice is the order of the day

PLUS: DOCUMENT MANAGEMENT | NORMAN LAMB INTERVIEW | PROCUREMENT

The NHS has once again endured a bumpy ride in 2016.

Financial shortcomings, excessive workloads, junior doctor strikes and staff shortages have all contributed to an image of a care system in disarray and desperation.

Nonetheless, behind those discouraging headlines remains an eager workforce, working tirelessly to ensure that the NHS continues to be the best it can be.

In 2016, budgets have been stretched, junior doctors have striked, waiting times have lengthened and yet we still demand more.

There appears very little time to vocalise the recognition that our health service deserves. But that is exactly what the Health Business Awards aim to do every year – celebrate the hard work, dedication and success stories that drive the sector to new heights.

Turn to page 37 to read our review of last month’s Health Business Awards, detailing the winning hospitals, organisations and initiatives that have exceeded expectations and performed beyond their means this year.

To all of our readers, I wish an enjoyable Christmas and a prosperous New Year.

Follow and interact with us on Twitter: @HealthBusiness_

Enjoy the issue.

Michael Lyons, editor

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

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226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: www.psi-media.co.uk 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 Jeremy Cox, Addy Ajibola, Jake Deadman, Wayne Leacock ADMINISTRATION Vickie Hopkins PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Volume 16.6 | HEALTH BUSINESS MAGAZINE

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Care You Can See â„¢

CONTENTS

07 NEWS

NHS letting down bereaved families; £90m fine issued for drug price hike; and survey suggests obesity becoming normalised

14 HB INTERVIEW

With 2017 fast approaching and the NHS in the midst of another tough winter, Health Business talks to former Health Minister Norman Lamb about his views on funding, mental health and the New Year

17 INFORMATION TECHNOLOGY

09

Following the Nuffield Trust report on the topic last month, Sophie Castle-Clarke looks at how patients are taking care into their own hands through new digital tools

21 EHI LIVE

Health Business reports on the success of ehi Live 2016, with the mental health and cyber security streams catching attention

14 37

23 PROCUREMENT

Using examples of success from the London Procurement Partnership, Laura Quirke discusses how effective procurement strategies can produce significant savings for NHS trusts

26 CYBER SECURITY

Data breaches have returned to the media spotlight this month with cyber attacks causing chaos in a Lincolnshire hospital.

Dan Taylor, head of security at NHS Digital, looks at the relationship between cyber security and patient care

47

31 DOCUMENT MANAGEMENT

With the end of 2016 bringing us closer to the 2020 paperless NHS target, Health Business discusses how better utilisation of data can improve the delivery of care, and how communications are digitalising

37 HB AWARDS REVIEW 62

47 ENERGY

Hospitals up and down the country are seeking better ways to save on their energy bills. Oliver Savory, of the Solar Trade Association, explains why occupying such large buildings means that hospital roofs are the perfect space to install solar panels and save on energy

50 MODULAR BUILDINGS

There is an alternative to traditional construction that can save time, money and ease pressure on the NHS. Jackie Maginnis urges hospitals to consider modular buildings in their building plans

53 ePROCUREMENT

PEPPOL is not a new concept for the UK, but for many it remains a fairly unknown concept. Health Business explores its use in the NHS and what NHS procurement leaders need to be aware of

62 INFECTION CONTROL

Returning to the basics of hygiene is the best attack to take when fighting infection says Derek Butler of MRSA Action UK

65 IP EXPO REVIEW

Europe’s number one IT event, IP EXPO Europe, attracted a record attendance in 2016. Health Business reports on why the show is going from strength to strength

67 PATIENT SAFETY

Expanding upon National Voices’ Realising the Value campaign, Don Redding examines the available concepts of care and their appropriateness to the FYFV

71 PATIENT FIRST REVIEW

Health Business reviews Patient First 2016 – the show that explores, enhances and encourages the importance of patient safety for the NHS to its large audience

74 PARKING

The winners of the 2016 Health Business Awards were announced last month at a ceremony celebrating the success stories from within the NHS. Here, we list the winning organisations and the reasons why they collected their awards

Dave Smith, of the British Parking Association, looks at some of the measures hospitals are taking to raise the standards of their parking facilities

44 CALL CENTRES

More visitors than ever attended this years Diabetes Professional Care conference to hear about the latest technological advances in the care, prevention and treatment of diabetes

Call centres have widened the scope of customer contact within the healthcare sector. Richard Abdy explains how and why

Health Business

Contents

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76 DIABETES PROFESSIONAL CARE

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END OF LIFE CARE

News

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NHS letting down bereaved families The Care Quality Commission (CQC) has said that NHS investigations into patient deaths are inadequate, causing extra suffering to bereaved families.

The CQC report is the culmination of a one-year inquiry on the back of some high-profile cases of neglect, finding that grieving relatives are too often shut out of investigations or left without clear answers.

The CQC’s review looked at NHS trusts in England providing acute, community and mental health services, placing a particular focus on people with mental health conditions and learning disabilities, considering evidence from more than 100 families.

The report concluded that the level of acceptance and sense of inevitability when people with a learning disability or mental illness die early is too common, and that there is a current failure to prioritise learning from deaths so that action can be taken to improve care for future patients and their families. This is in part due to there being no consistent national framework in place to support the NHS to investigate deaths.

Additionally, and most painful for families, is the discovery that many carers and families do not find the NHS to be open or

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transparent, and that families and carers are not routinely told what their rights are when a relative dies, what will happen or how they can access support or advocacy.

Professor Sir Mike Richards, chief inspector of hospitals at the CQC, said: “We found that too often, opportunities are being missed to learn from deaths so that action can be taken to stop the same mistakes happening again.

“While elements of good practice exist, there is not a single NHS trust that is getting it completely right currently.

An agreed framework needs to be established that sets out exactly what the NHS should do when someone dies and ensures that families and carers are fully involved and treated with respect.

“Investigations into problems in care prior to a patient’s death must improve for the benefit of families and importantly, people receiving care in the future. We have made a number of recommendations for action as a result of this review. This is a system-wide problem, which needs to become a national priority.”

END OF LIFE CARE

End of life care should be for the whole family New guidance from the National Institute for Health and Care Excellence (NICE) has argued that end of life care should be available for the whole family, and not just the dying child.

It is reported that approximately 40,000 children and young people are estimated to be terminally ill in England, meaning that parents and sibling often become carers, carrying monumental pressures in the process.

The new guideline looks at a wide range of issues including where the best place to die might be, and how to manage a child’s pain and symptoms.

NICE, who developed the guidance alongside children at the end of their lives in order to reflect what they felt was important from their care, believe that the medical and social care team responsible for a child’s care at the end of life should be aware that

the needs of the family may change as the child’s illness progresses, adapting to the family’s requirements where possible.

Anne Harris, director of care at the Rainbow Trust, an organisation providing emotional and practical support to families who have a child with a life threatening or terminal illness, said: “This guideline sets a high standard for what care and support should be provided to children and their families, and how that care is delivered, wherever they live across England. It recognises both the need for compassionate care for the whole family, and that children have different needs to those of adults at the end of life.

“The next step will be ensuring that the guideline is well understood by all those involved in child palliative care, and that sufficient resources and skilled staff are put in place by local decision-makers to make sure these ambitions are realised for all terminally ill babies, children and young people.”

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CONTRACEPTION

Contraceptive cuts could lead to more abortions The BBC’s Victoria Derbyshire programme has learned that funding cuts have left many GP practices unable to provide some forms of contraception.

Clinicians have warned that cuts to contraceptive services will result in an increase in ‘unplanned pregnancies and abortions’.

The Advisory Group on Contraception (AGC), an advisory group made up of clinicians and advocacy groups, reports that one in three councils have cut, or are considering cutting, the number of GP practices able to provide Long-Acting Reversible Contraception (Larc) methods, such as coils and implants.

This, they argue, is leaving the right of women to access the full range of contraceptive choices at risk.

Further research has suggested that

a quarter of councils have shut or may close some of their contraceptive services.

Approximately 3.9 million women live in an area where contraceptive services are restricted in some way – representing nearly a third of women of reproductive age in England.

A survey of 1,023 GPs by the Family Planning Association (FPA) from across England found that: only two per cent offer the full range of contraceptive methods; 53 per cent do not have enough time in a standard contraceptive appointment to give women all the information they need; and 23 per cent do not offer the contraceptive implant.

Natika Halil, chief executive of the FPA and an AGC member, said: “It’s a false economy to restrict women’s access to

contraception. Every £1 spent on contraception saves £11 in averted health costs.

“Making it harder for women to choose the right contraception for them will mean more unplanned pregnancies and more abortions. Councils need adequate funding to deliver the comprehensive contraceptive services women need and deserve.”

The government maintains that ‘local areas’ can best decide on sexual health provision, despite the 2015 Spending Review saying that there would be a 3.9 per cent year‑on‑year budget cut for five years for public health budgets from April 2016 until April 2021, which totalled at least £600 million.

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FINES

News

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BRAIN ABNORMALITIES

Pfizer and Flynn fined £90m Extra MRI scan can spot baby for drug price hike brain problems The Competition and Markets Authority (CMA) has fined pharmaceutical companies Pfizer and Flynn Pharma nearly £90 million for charging excessive prices to the NHS for an anti-epilepsy drug. Pfizer, fined £84.2 million, and Flynn Pharma, fined £5.2 million, have been found to have broke competition law by charging excessive and unfair prices in the UK for phenytoin sodium capsules, an anti-epilepsy drug, and have since been requested to reduce their price.

The CMA has released details showing that the amount the NHS was charged for 100mg packs of the drug rocketed from £2.83 to £67.50, before reducing to £54.00 from May 2014. Consequently, NHS expenditure on phenytoin sodium capsules increased from about £2 million a year in 2012 to about £50 million in 2013.

Philip Marsden, chairman of the Case Decision Group for the CMA’s investigation, said: “The companies deliberately exploited the opportunity offered by de‑branding to hike up the price for a drug which is relied upon by many thousands of patients. These extraordinary price rises have cost the NHS and the taxpayer tens of millions of pounds.

“Businesses are generally free to set prices as they see fit but those holding a dominant position should not abuse this situation

and set prices that are excessive and unfair.

There is no justification for such rises when phenytoin sodium capsules are a very old drug for which there has been no recent innovation or significant investment.”

Phenytoin sodium capsules are used in the treatment of epilepsy to prevent and control seizures, and are an important drug for an estimated 48,000 patients in the UK. Since the fine for Pfizer and Flynn, Actavis UK has also been found to have overcharged the NHS for its hydrocortisone tablets. The NHS was charged £0.70 for 10mg packs of the drugs in April 2008, but raised the cost to £88.00 per pack by March 2016. The CMA is investigating the company, with an outcome ,a nd likely fine, expected soon.

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PARAMEDIC PAY

New pay deal agreed for paramedics The Department of Health, NHS Employers and ambulance unions have agreed that paramedics pay will be re-banded nationally from band 5 to band 6.

The agreement will see certain paramedics in England move up the pay scale from band 5 to band 6 in recognition of the increasing responsibilities of being a modern paramedic.

Paramedics, whose job description is matched to the new band 6 profile, will move from a pay scale paying from circa £21,000 to £28,000 to circa £26,000 to £35,000. New paramedics appointed after September this year will have a maximum two year consolidation of a learning period at band 5 prior to moving to band 6.

It also means paramedics will be able to earn more as they progress through the Agenda for Change pay scale.

Health Secretary Jeremy Hunt said: “Our dedicated paramedics do a vital job helping patients when they need it most so I’m very pleased that we have agreed a new pay deal with unions.

“In recognition of their increased responsibilities we have agreed to look at re-banding around 12,000 paramedics where their job description matches the requirements of the new band 6 profile, moving them up the pay scale and making sure we are able to better recruit and retain paramedics in the future to ensure patients will continue to get the very best care.”

Paul Wallace, NHS Employers’ director of Employment, Relations and Reward, welcomed the deal: “I would like to extend my thanks to trade union colleagues for working constructively and in partnership with employers to agree a way forward for the ambulance paramedic workforce across the country, which recognises the demanding work they undertake and supports the further development of their contribution to patient care.”

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Researchers have highlighted the benefits of offering some women in pregnancy more detailed MRI scans to help spot brain defects in the developing baby.

Published in the Lancet, the study on 570 women showed that doctors were able to make a much better diagnosis using MRI scans, rather than the common ultrasound scans that already look inside the womb and check that the baby is growing properly.

Pregnant women are offered an ultrasound scan at 20 weeks that can spot abnormalities in the brain, with the method detecting three in every 1,000 pregnancies.

The study analysed the impact of using MRI scans to confirm any diagnoses, showing that combining an ultrasound with an MRI increased a correct diagnosis from 68 per cent to 93 per cent.

Tested across 16 centres in the UK, approximately 95 per cent of mothers‑to-be said the scan was helpful and would have it again if there were concerns on the ultrasound.

A failure in the brain development can result in miscarriage or still birth, with couples generally offered counselling and some choosing to have an abortion.

The study showed that the number of abortions increased from 25 per cent with just the ultrasound to make the decision to 36 per cent with the extra MRI scan.

Although possibly considered controversial, the researchers highlight that the study ‘is really about informing pregnant women and their families to ensure they have the correct information when they’re going through what can be a traumatic time’.

Professor Paul Griffiths, from the University of Sheffield, said: “Based on our findings, we propose that an MRI scan should be given in any pregnancy where the foetus may have a suspect brain abnormality.”

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HEALTH BUSINESS MAGAZINE | Volume 16.6

A great hospital roof isn’t just about materials and labour. It’s about the technical understanding and insight that comes from working extensively in the healthcare sector. It’s about having a wide choice of BBA approved systems and cost neutral renewable solutions. It’s about partnership and comprehensive end-to-end support – from design consultation and bespoke specifications through to live site monitoring which delivers on time and within budget.

All this goes into a Langley roof – with access to approved contractors and installers and after care support – all designed to minimise risk and deliver roofing excellence. In other words, we put everything we have into your roof, so you get more out of the project, and end-users get more out of healthcare.

News

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CANCER SERVICES

NHS England cancer services boost NHS England has announced the first wave of hospitals that will benefit from a major national investment in NHS radiotherapy machines.

Fifteen hospitals, selected in the regions believed to be in the greatest need, have been selected to receive new LINAC linear (accelerator) machines, as part of a £130 million investment in radiotherapy technology upgrades.

The hospitals which will receive new LINACs are: North Cumbria University Hospitals NHS Trust; The Newcastle upon Tyne Hospitals NHS Foundation Trust; Lancashire Teaching Hospitals NHS Foundation Trust; The Clatterbridge Cancer Centre NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust; University Hospitals Coventry and Warwickshire NHS Trust; Maidstone and Tunbridge Wells NHS Trust; University Hospital Southampton NHS Foundation Trust; University Hospitals Bristol NHS Foundation Trust; Torbay and South Devon NHS Foundation Trust; Royal Surrey County Hospital NHS Foundation Trust; University College London Hospitals NHS Foundation Trust; University Hospitals of Leicester NHS Trust; Hull and East Yorkshire Hospitals NHS Trust; and Sheffield Teaching Hospitals NHS Foundation Trust.

Speaking at the Britain Against Cancer conference in London, NHS England chief executive Simon Stevens also announced £200 million of funding over two years to improve local cancer services, particularly through encouraging local areas to find new and innovative ways to diagnose cancer earlier and improve the care of patients.

The £200 million fund has been set up to encourage local areas to find new and innovative ways to diagnose cancer earlier, improve the care for those living with cancer and ensure each cancer patient gets the right care for them.

Cancer alliances are being asked to bid for a share of the fund to use within three priority areas: early diagnosis;

care during and after treatment; and after cancer treatment, including a more personalised approach to follow-up.

Stevens said: “Across the country, the

NHS is now making great strides in upgrading modern cancer radiotherapy equipment and ensuring faster access to the most promising new cancer drugs”.

“Because the quality of NHS cancer care has improved so much over the past year, an extra two thousand families will be able to celebrate the Christmas holiday with a loved one who has successfully survived cancer. It’s an enormous tribute to dedicated nurses, doctors, scientists and patients organisations that we are on track to save 30,000 more lives a year from cancer.”

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CANCER PATIENT FERTILITY

Make women with cancer aware of fertility options Women with cancer in the UK are not being given enough information about the options for safeguarding their chances of having children after treatment, fertility experts have said.

Published in the British Medical Journal (BMJ), Richard Anderson, professor of clinical reproductive science at the University of Edinburgh, and Melanie Davies, a consultant gynaecologist at University College London Hospitals, have raised concerns that patients are often unaware of the fertility options available to young women with cancer.

Infertility is often found to be the leading concern of young people with cancer.

While men’s fertility can be preserved through freezing sperm samples, for women the options are more complex, involving the freezing of eggs, embryos or even tissue from the ovaries.

According to research from the UK charity Breast Cancer Care, 88 per cent of 176 women under the age of 45 who had breast

cancer said they were not referred to a fertility specialist after being diagnosed.

The professors also highlighted that there are huge variations in the availability of the technologies, storage and funding methods around the country, with funding often being granted by commissioners on a case by case basis.

Anderson said: “There is a very sketchy provision – in some places it is quite well organised, in other places it is not. The National Institute for Health and Care Excellence (Nice) recommendation is that women [with cancer] should be aware of this and should be offered oocyte or embryo preservation, including adolescent girls. But the issue is that that doesn’t seem to have been established around the country by any means as yet.”

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HIV TESTING

Millions should be offered routine HIV testing, experts say New guidance from the National Institute for Heath and Care Excellence (NICE) aims to increase testing for people with undiagnosed HIV in England.

Coinciding with World Aids Day, the updated guidance recommends that all patients in areas with high and extremely high rates of HIV be offered a test on admission to hospital, if they have not previously been diagnosed with HIV and are undergoing a blood test for another reason.

This would cover 3.7 million people.

Additionally, hospitals should offer the

tests in extremely high rate areas even if they are not having blood tests as part of their care. GP surgeries in high and extremely high-rate areas should also offer patients an HIV test on registration, which would cover 7.9 million people.

It is estimated that 103,700 people are living with HIV in the UK and 17 per cent of people with the virus are unaware of their infection, so risk unintentionally passing it on to their sexual partners.

There are 20 local authority areas with extremely high prevalence including

Manchester, Brighton and Hove and 18 London boroughs. There are 54 local authority areas where HIV rates are classed as high, including Leeds, Birmingham and Newcastle.

Professor Gillian Leng, deputy chief executive of NICE, said: “It is easier than ever before to access testing for HIV, but with thousands living with undiagnosed HIV we know there is much more to do. We want to normalise HIV testing so it isn’t viewed any differently from any other blood test. There are now highly effective treatments for HIV and it should no longer be seen with fear or stigma.”

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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OBESITY

JUNK FOOD ADVERTISING

Obesity becoming normalised, survey suggests

Children’s online junk food ads banned

NHS Digital’s Health Survey for England 2015 has highlighted how the majority of parents of overweight children do not recognise their child as having an unhealthy weight.

Despite media attention on the topic, the survey, which was based on interviews with 8,034 adults and 5,714 children, showed that child obesity remains stubbornly high, raising concerns that high levels of obesity have normalised unhealthy weights.

With approximately three in 10 children being overweight or obese, the figures show that 48 per cent and 43 per cent of fathers said their obese child was about the right weight.

Gillian Prior, head of health at the National Centre for Social Research, said: “Around three in 10 children are overweight or obese, yet nearly half of mothers think their obese child is about the right weight.

It is possible that consistently high levels of childhood obesity in recent years have normalised an unhealthy weight.

“This should be of concern to parents and public health professionals alike. Obesity is linked to a number of health conditions in later life, such as diabetes and heart disease.

“Parents want to do the best for their children and the difficulty of recognising obesity in their own child could be putting them at risk.”

The obesity figures were also worrying for young adult health, with 27 per cent of men and women measured as obese last year, and a further 41 per cent of men and 31 per cent of women deemed overweight.

In addition to this, 47 per cent of women and 35 per cent of men were found to have a very high waist circumference – defined as a waist circumference greater than 88cm for women and greater than 102cm for men.

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FERTILISATION

Mitochondrial donation in treatment approved

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The UK’s fertility regulator has approved the historic move to allow two women and one man to conceive a baby, despite its controversy.

Doctors in Newcastle, where the advanced form of IVF was first developed, are expected to be the first to offer the procedure and have already appealed for donor eggs.

Originally planned to prevent children being born with deadly genetic diseases, the first such child could be born by the end of 2017.

Some scientists have questioned the ethics of the technique, suggesting that it could open to the door to genetically modified ‘designer’ babies. However, the Human Fertilisation and Embryology Authority (HFEA) has reassured that it must approve every clinic and every patient before the procedure can take place.

Sally Cheshire, chairwoman of the HFEA, said: “It is a decision of historic importance.

This is about cautious go ahead, not

gung-ho go ahead, and there is a long way to go. I’m sure patients will be really pleased by what we’ve decided.”

Prof Mary Herbert, from the Newcastle Fertility Centre, said: “It is enormously gratifying that our many years of research in this area can finally be applied to help families affected by these devastating diseases.

“Now that we are moving forward towards clinical treatments, we will also need donors to donate eggs for use in treatment to prevent affected women transmitting disease to their children.”

However, Dr David King, from the campaign group Human Genetics Alert, contested: “This decision opens the door to the world of genetically-modified designer babies. Already, bioethicists have started to argue that allowing mitochondrial replacement means that there is no logical basis for resisting GM babies, which is exactly how slippery slopes work.”

Clinics can now apply to the HFEA for a licence to conduct three-person IVF. NHS England has agreed to fund the treatment costs of the first trial of three-person IVF for those women who meet the HFEA criteria, as long as they agree to long-term follow up of their children after they are born.

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Following a full public consultation, the Committee on Advertising Practice (CAP) has announced new rules banning the advertising of junk food or drink products in children’s media.

The rules, which will apply in media targeted at under-16s and will come into effect on 1 July 2017, will apply across all non‑broadcast media including print, cinema and, crucially, online and social media.

Bringing the non-broadcast advertising rules in line with the TV rules, the new restrictions will lead to a major reduction in the number of ads for high fat, salt or sugar (HFSS) food and drinks seen by children, also meaning that ads for HFSS products will no longer be allowed to appear around TV-like content online if they are directed at or likely to appeal particularly to children.

James Best, chairman of CAP, said: “Childhood obesity is a serious and complex issue and one that we’re determined to play our part in tackling. These restrictions will significantly reduce the number of ads for high, fat, salt or sugar products seen by children.

Our tough new rules are a clear demonstration that the ad industry is willing and ready to act on its responsibilities and puts the protection of children at the heart of its work.”

Critics say the new rules do not go far enough and may not have any impact, pointing to the thousands of children watching TV shows and videos online not specifically targeted at children, which these rules will not cover.

Malcolm Clark, co-ordinator of the Children’s Food Campaign, said: “Just as many of the TV programmes most watched by children aren’t covered by the rules, so it looks like many of the most popular social media sites won’t be either; neither will billboards near schools, or product packaging itself.”

READ MORE: tinyurl.com/zvu4lla

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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HB Interview

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Q&A

Health Business interview: Norman Lamb

HB talks to Norman Lamb, Liberal Democrat MP for North Norfolk and former Minister of State for Care & Support, about NHS funding, mental health, innovation and hopes for the NHS in 2017 Health Business (HB): Given to encourage closer integration and that funding is so tight, what collaboration has, in too many places, ended opportunities are there to make up being a fig-leaf for cutbacks to services, savings within the current and money that should have been used framework of the NHS? for transforming care models has instead Norman Lamb (NL): Everybody been used to keep a failing show on the agrees that the health and care system road. Mental health services also seem to could be run far more effectively and be very peripheral to the focus of many of efficiently than it currently is. It ultimately these plans, despite the rhetoric of parity boils down to the fact that the system we of esteem. It’s a golden opportunity wasted. have is too reactive and fragmented, which doesn’t work for patients or the taxpayer.

HB: In 2013, as Minister of State The NHS was set up to treat ill health, for Care and Support, you made rather than to think about how we can stop a commitment to achieving people from getting ill in the first place and ‘joined up care’ by 2018. Where keep them out of hospital. That was the case has this fallen short, and what in the 1940s and it’s still the case today. We can be done to aid the process know that prevention is always better than of integrating the two? cure, but this principle has never been the NL: The Better Care Fund, which was a foundation of our healthcare service. brainchild of the Liberal Democrats, Perverse financial incentives in was set up to pool NHS and g n i the NHS, such as incentivising social care budgets locally t s Inve d activity in acute hospitals, to support the integration n a n re d l i h mean that resources of services and more c n i ple’s o e are constantly being p g n st joined-up care. This u you m pumped into acute h t l a hospitals while primary ental hety – ending m care, mental health iori be a pr scandalous and other preventive services lose out. The in the stment e NHS also suffers the v n i s i d by consequences of cuts servicess to social care. Record CCG numbers of people are stuck in hospital beds when many of them shouldn’t be there at all – but there’s often no care available in the community. It’s a ridiculous false economy, and completely unsustainable in the context of an ageing population and a rapidly growing number of people with multiple long-term conditions.

So there’s huge scope for doing things differently so that we’re more focused on prevention, integrated care and supporting people out of hospital. That was the original intention of the much-maligned Sustainability and Transformation Plans (STPs). The idea was to pull the different parts of the system together in each locality – physical health, mental health and community care and social care.

But in reality, the STPs have been developed behind closed doors with an excessive focus on cost savings rather than delivering better patient care. What had the potential

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should have been the mechanism for bringing health and care spending together over the longer-term. I envisaged a process of pooling more and more of NHS and social care funds in the BCF until, by 2018, you ended up with a single, integrated, pooled budget.

But instead, the Better Care Fund has been starved of cash and we’ve seen only incremental increases in funding. Although an extra £1.5 billion has been promised, most of this won’t come through until the back end of the Parliament. In the meantime, with the government chipping away at local government funding, the Better Care Fund is just plugging the gaps in social care provision rather than delivering more integrated care.

It’s a great shame, because pooled budgets and joint, coordinated commissioning would go a long way to solving the problems in the current system. Getting more money into the Better Care Fund is an absolute must.

But given what we are witnessing with the STPs, the prospects for bridging the divide between health and social care is looking increasingly bleak.

HB: Where are the current deficiencies in mental health care, why do they exist, and how in your view can progress be made?

NL: The bottom line is that there is a complete imbalance of rights of access to treatment between physical health and mental health in the NHS. National standards like the four-hour A&E waiting target and the 18-week referral to treatment are politically very potent in affecting where the money goes. But when Labour introduced these standards, mental health was left out completely. It’s a historic discrimination at the heart of our health service. Mental health remains chronically under-funded, so many people don’t get any help when they need it. How can we possibly tolerate that?

In government, Nick Clegg and I introduced the first ever access and waiting time standards in mental health, focusing on psychological therapies and psychosis treatment. As a first step towards redressing the imbalance, it was a critical moment.

But we have to build on this. Theresa May highlighted the lack of mental health support as one of the burning injustices in society she was committed to tackling – if she really intends to deliver on that, she has got to invest in improving access across the board.

Investing in children and young people’s mental health must be a priority, given that mental ill health costs the economy an estimated £105 billion every year and three quarters of mental illness starts before the age of 18. The coalition produced an effective blueprint for modernising these services, with a renewed focus on prevention and early intervention. The government now has to implement that vision, which will mean making sure that the promised extra investment reaches the frontline and ending the scandalous disinvestment in mental health services by CCGs. HB: There are lots of new innovations in technology that have tangible benefits, both financial and clinical, that are becoming more readily available and cost effective, but the NHS struggles to adopt them and take advantage.

How can that be changed?

NL: The NHS has generally been poor at making the most of novel medical technologies and devices which could promote faster diagnosis, earlier intervention and support people to take control of their own healthcare. I think this is partly a cultural reluctance to change old practices and embrace new ways of doing things, but it’s also a symptom of short-term thinking on cost. We often hesitate to pay for new tech, even when doing so has potential to bring dramatic benefits further down the line in terms of patient care, efficiency and overall

HB Interview

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The health and social care system is facing an existential crisis, and there is no doubt that access to treatment and care will be increasingly rationed next year if the government fails to act quickly cost to the taxpayer. We need to break free from that mentality, but it’s very difficult when commissioners and providers are under such intense pressure to make immediate savings. The Department of Health and NHS England have to give local services room to innovate. The Accelerated Access Review has looked at new ways of getting diagnostics and medical technologies to patients more quickly, and what we need to see now is a focus on translating those ideas into reality.

Diabetes care is one area that has benefited from self-care devices and digital apps, and there are exciting opportunities for other conditions. In Norfolk, for example, the community care trust recently launched a new self-monitoring service supporting patients with heart and lung problems to check their vital signs at home. The information gets transmitted directly to the clinician, who can intervene quickly if the readings give any cause for concern and prevent unnecessary admissions to hospital. Proactive approaches like this should be a model for the whole NHS.

HB: What are the main trends in healthcare to look out for next year?

NL: The fact that health and social care didn’t even get a mention in the Autumn Statement was astonishing. The system is facing an existential crisis, and there is no doubt that access to treatment and care will be increasingly rationed next year if the government fails to act quickly.

We can expect to see more vulnerable elderly and disabled people left without publicly-funded social care. The sad reality

is that only those who can afford to pay will be able to expect high-quality care, while many others will be left to fend for themselves, with only the support of families and other unpaid carers.

And the recent sobering assessment of the National Audit Office was clear: the financial problems in the NHS are endemic and unsustainable. Longer waiting times are inevitable, and CCGs will be on the lookout for new ways to restrict treatment.

The public are crying out for an honest assessment of these challenges, and it’s high time that all parties work together to find ways to raise more resources and to make the system more efficient to ensure we have a modern and effective healthcare service. I’ve made repeated calls for the creation of an independent, cross-party commission to examine the challenges facing the NHS and social care, and come up with a new long-term settlement to secure these cherished services for future generations.

The government is confronted with a stark choice. It can agree to these calls, putting partisan politics aside in the interests of the nation; or it can preside over a rapidly disintegrating system which is putting the safety and lives of patients at risk. L

Under the coalition government Norman Lamb served as Minister of State for Care and Support in the Department of Health. In January 2015, Norman was appointed to the Liberal Democrat General Election Cabinet as the party’s health spokesperson. He has been the Member of Parliament for North Norfolk since 2001.

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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DIGITAL NHS

Sophie Castle-Clarke, fellow in Health Policy at the Nuffield Trust, focuses on the digital tools that are starting to have an impact on patients looking after themselves Many have criticised the sluggishness of the NHS in joining the digital revolution.

While as consumers our lives have been transformed by a plethora of online services and information sources, the health service has been comparatively slow off the mark.

But while the NHS is struggling to keep up, patients are becoming increasingly interested in using their Smartphones to manage their health and care. And technology developers are eager to oblige; there are already over 165,000 health apps on the market.

Meanwhile, policy-makers have encouraged patients to go online to book appointments, order prescriptions and access their records.

But while the health app and wearable market seems to be booming, uptake of official online channels remains low.

Our new research looked at the impact of patients engaging with digital tools such as apps and online services and how the NHS can harness the growing enthusiasm for healthcare technology. Here, we focus on the digital tools that are starting to have an impact on patients looking after themselves.

WHAT WORKS? Equipping patients with the confidence to manage their health and care is one of the biggest benefits of patient technology.

Although the majority of apps have not been evaluated, we are already seeing positive impacts on diet monitoring, physical activity and chronic condition management from ones that have.

Some of the reasons for why consumer technologies like apps work well are that they are personal, interactive, customisable and in the patient’s pocket all the time.

This makes behaviour change supported by consumer technology much easier to scale than professional support alone.

Wearable technologies, like Fitbits, have also had some success in improving physical activity and weight loss, although a recent study showed wearable technology was less effective than a website for those looking to lose weight. Sustained engagement with wearable devices and weight regain present significant challenges.

Granting patients access to their medical records online has also had very positive impacts on supporting self-care. Patients

Patie are bec nts o increas ming interest ingly their Sm ed in using manage artphones t o t care, an heir health an developd technology d ers a to obligre keen e

Written by Sophie Castle-Clarke, the Nuffield Trust

Tracking the rise of the digital patient

often gain a better understanding of their health, which can lead to more productive conversations with their GP. Likewise, professionals have found their job is made easier by patients attending appointments with a prepared list of queries and concerns.

Record access can also allow doctors and their patients to decide the best course of action together, incorporating patient preferences.

Finally, online patient networks that allow patients to connect with each other and share tips on how to manage their condition can result in improved behavioural and clinical outcomes and a greater sense of support for patients. One example is Patients Like Me which is open to patients with any condition. Patients complete profiles on the site, including their diagnoses, symptoms and treatments. They are also invited to complete treatment evaluations, noting any side effects, adverse reactions and positive benefits. This information is then aggregated and available to all members of the site so patients can learn about new or potential treatments.

Information Technology

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

SO WHAT’S THE DOWNSIDE? There’s some good work happening, but it is not all positive or straightforward.

Although some apps are starting to return positive results, most of them haven’t been evaluated, and of the ones that have been evaluated many are inaccurate, ineffective or do not protect patient data.

Maintaining long-term engagement with consumer devices is also a significant challenge; many people get bored after the initial novelty wears off. And almost all apps are developed with a single condition in mind.

Many patients who would benefit significantly from support to better manage their health have multiple long-term conditions: at the moment this means they will need several apps (unless they’re using generic medication reminder apps for example), making it even less likely that they’re going to stick with them.

While online access to records can lead to positive results for patients, we do not E

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 properly understand how they impact on demand for services. Some have suggested they can release administrative efficiencies by removing the need for patients to call their practice for test results for example. But in one large study in the United States, online access to records and clinicians via email increased GP appointments, telephone consultations, A&E attendances and hospital admissions.

Patient access to records also raises a number of governance concerns. Some worry that vulnerable patients could be harmed by having access to their record or their data could be exploited. Where full record access is granted – with referral letters and free text entered by clinicians – professionals are also concerned about the extent to which third party data is shared.

Perhaps most importantly, many people struggle to understand health information.

Recent work suggests 60 per cent of working age people in the UK find health information containing both words and numbers that are too complex. Some people also struggle to identify trusted sources of online information.

And millions of people in the UK are still offline or lack basic digital skills. Many of these are the people at most of risk social exclusion such as those aged 65 and over, the unemployed and people with disabilities.

HOW CAN THE NHS HARNESS THE POTENTIAL? Despite the risks and concerns, the NHS can benefit greatly from engaging with patient technology. But to do this it needs a new approach to support patients to look after themselves, regulating new innovations and encouraging uptake.

Where apps have been prescribed, estimates suggest that engagement is 10 per cent higher – and 30 per cent higher for fitness apps. Not only that, apps for behaviour change and monitoring are likely to have impact when professionals draw on the data and encourage on-going use.

This suggests professionals need to actively engage with consumer technology.

But before they can do that they need appropriate support. Firstly, they need assurance that it is accurate and effective.

Plans to evaluate apps and wearables according to their function and risk level are welcome and will play an important role.

Secondly, they need robust guidance about how far they are expected to use patient‑generated data and whether they will be held accountable if patterns in the data are missed or ignored. Data reports that are clear and easy to interpret may go some way towards addressing these concerns. Thirdly, they need support to identify and prescribe appropriate innovations – easy access to consumer technology that has been through any of the four stage evaluation process and a generic framework for prescribing apps may help. It may also be beneficial for policy-makers to consider incentives to

Information Technology

DIGITAL NHS

Sophie Castle-Clarke, Nuffield Trust

Granting patients access to their medical records online has also had very positive impacts on supporting self-care. Patients often gain a better understanding of their health, which can lead to more productive conversations with their GP encourage NHS staff to use patient data where appropriate, at least in the short term.

Patients too need to be on board with this new approach, and should be informed about the benefits of sharing their data alongside their right to opt out. Bespoke technology for patients with multiple conditions would make greater reliance on apps to support self-care more feasible. The innovation and technology tariff, that will reimburse technology suppliers whenever their app is used in the NHS, may incentivise innovators to focus on more complex patients, which they have historically shied away from.

Similarly, professionals need to take a different approach to medical record keeping.

The record should be used to actively support patients to look after themselves, with signposting to appropriate resources and information. This is a significant shift from using the record for professional communication which has been its primary function to date. It will take time and may require additional training.

Most importantly the evidence suggests we need a workforce that can support sustained self-care, encourage digital uptake and improve health literacy – particularly for those at risk of exclusion. This could include greater use of health coaches, public health nurses and volunteers in the community and general practice. There are already a range of self-care initiatives throughout the country and there are good opportunities to build on existing efforts.

Of course digital services should only be offered alongside traditional channels to avoid disadvantaging those who are offline.

All of this suggests investment and concerted effort is needed to make this work successfully and at scale. It is a mistake to think that self‑care through apps or other means will be a magic bullet for reducing deficits. But there is potential for significant improvements in patients’ quality of life, confidence and ability to manage on their own which may lead to savings in the longer term.

By creating an environment for self-care and innovation to flourish, the NHS might be able to finally join the digital revolution. L Read The digital patient: transforming primary care here – http://bit.ly/2ghGmjB

Sophie is a Fellow in Health Policy at the Nuffield Trust. Her current projects at the Trust include analysing the potential of technology to improve service provision and workforce productivity in the healthcare sector and mapping the various approaches to the delivery of acute care across the NH. Prior to joining the Trust, Sophie worked as an Analyst at RAND Europe. Her work there spanned a diverse range of research areas including health innovation and drug discovery, attitudes towards vaccines and strategic health policy. Her clients included the Department of Health, Public Health England, Vaccines Europe and the Structural Genomics Consortium.

Sophie gained her MPhil in 2011 from the University of Cambridge.

FURTHER INFORMATION www.nuffieldtrust.org.uk

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

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EHI LIVE 2016

INTEGRATED CARE SOLUTIONS TO MEET PATIENTS NEEDS

At EHI Live, Agfa HealthCare showcased healthcare management solutions that help providers optimise resources and patient care At the EHI Live 2016 digital health show, held on 1-2 November 2016, Agfa HealthCare showcased its proven and comprehensive range of healthcare IT solutions, including ORBIS, the Engage Suite and Enterprise Imaging.

Based around the theme of ‘Care You Can See’ these solutions demonstrate how Agfa HealthCare, as a value-based healthcare provider, is supporting organisations on their journey to reinvent themselves in order to facilitate patient-centric care.

ORBIS: FOR SUCCESSFUL HEALTHCARE DECISIONS The ORBIS enterprise-wide IT solution enables healthcare facilities to enhance patient care quality, by providing fast and complete availability of patient data and by facilitating medical, diagnostic and care workflows. It supports integrated care and urgent care with functions and tools that meet the needs of today’s caregivers, including decision support, CPOE, observations, medications, mobile functionality, enterprise scheduling, a clinician dashboard, care planning and more.

ENGAGE SUITE: CONNECTING TO CARE In patient-centric programs, collaboration and engagement take on a new importance for creating a continuum of care. With the Engage Suite, healthcare organisations can assure ‘anywhere, anytime’ access to patient care information and data for all involved players: GPs, clinicians, colleagues/peers, and the patient. Information from different sources is available from a single interface, while native mobile functionality enables users to access that information on the go.

With solutions like the Portal, this Suite empowers clinical networks and opens new doors to image sharing, care information exchange and patient engagement, all while enabling cost savings.

ENTERPRISE IMAGING: AN IMAGING ECOSYSTEM Imaging is no longer the concern of a few departments such as radiology, cardiology, etc. Today, it is taking a central role in

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HEALTH BUSINESS MAGAZINE | Volume 16.6

The ORBIS enterprise-wide IT solution enables healthcare facilities to enhance patient care quality, by providing fast and complete availability of patient data and by facilitating medical, diagnostic and care workflows value-based care. Enterprise Imaging offers hospitals a truly enterprise-wide approach to medical imaging. This integrated solution built on a modern IT platform goes far beyond the traditional PACS: it supports multi-specialty collaboration, image exchange, shared working and mobility, as well as patient-focused healthcare.

Grant Witheridge, general manager of Agfa HealthCare UK, comments: “At a time of continued change and increased pressure on efficiency across healthcare, we offer healthcare organisations a range of products that can help them deliver better care and maximise their existing resources and technology investments. Whether

taking a web, cloud or modular approach, we have imaging, clinical and integrated care solutions to support organisations’ needs, for the benefit of the patient.”

ABOUT AGFA HEALTHCARE Agfa HealthCare helps healthcare organisations deliver better care. It does this through a range of eHealth and digital imaging solutions, with over 100 years of healthcare experience and over 35 years as an NHS supplier. L FURTHER INFORMATION paul.jackson@agfa.com www.agfahealthcare.com

EVENT REVIEW

ehi Live 2016

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Sponsored by

Talking technology and prioritising the patient The 2016 ehi Live show witnessed 4,017 attendees pass through the doors at Birmingham’s NEC to hear from the 13 conference streams on offer. Health Business reports on the show’s success, focusing on two of the conference streams – mental health and cyber security For anyone involved in the use of information in healthcare, ehi Live is a golden opportunity to update knowledge, get answers to questions, meet the experts and think about the future. The 2016 edition of the show contained many new developments and changes, including a new knowledge hub to share leading insight on the latest technologies that are changing the industry and a two‑day developer challenge, tasking developers with creating industry changing solutions live on site to help better NHS processes.

ehi he Live is t form at ideal pl ge with to enga ‑makers, decisionnce and influe sers end‑u care h of healt logy techno

MENTAL HEALTH Around one in four people in the UK suffer from some form of mental health issue each year. Not only do a lot of these people not know they are suffering, GPs might not necessarily have the right training to diagnose a mental health problem, access to mental health services can be very limited and there is a severe lack of funding. Digital advancements can help dramatically improve provision of mental health services, from remote diagnosis to problem sharing applications.

With speakers such as Rebecca Cotton, director of mental health policy at NHS Confederation, and Dr. James Reed, chief clinical information officer at Birmingham and Solihull Mental Health NHS Foundation Trust, topics covered in this session included: improving the quality of mental health services; how is technology currently used in mental health? Taking digital further; the role of apps in mental health – meeting patient needs; making technology accessible and understandable for GPs; and creating a digital framework to increase your chances of funding.

CYBER SECURITY As more trusts take advantage of the operational and clinical benefits that digital advancements offer, there will be greater pressures on healthcare information security systems and the data they are protecting.

Utilising Cloud services will enable

healthcare providers to be more flexible with data and information sharing, and, overtime, will dramatically lower costs. However, there are a lot of issues to deal with, namely; preparing for cyber threats, ensuring data protection and how to integrate the latest technology and services in to existing infrastructure.

Topics covered in this session included: is the ‘healthcare Cloud’ still just a myth?; integrating a secure BYOD strategy in your organisation; enhancing your cyber security capabilities; how will Cloud systems effect the rest of the IT infrastructure?; and breaking down the cost of safeguarding your digital applications.

Rob Shaw, chief operating officer at NHS Digital, also led an informative session on how healthcare organisations can defend themselves from cyber attacks. Read NHS Digital’s article on cyber security on page 26, authored by head of security Dan Taylor.

NHS DIGITAL The presence and support of NHS Digital at ehi Live 2016 created a real buzz on the show floor. The Lightning Talks and NHS Digital Theatre provided knowledge to a key audience and encouraged footfall around the exhibition.

NHS Digital will have an even greater presence at the 2017 edition of the show.

The Lightening Talks were a series of engaging and informative tutorials, tech-talks and practical demonstrations,

giving visitors the chance to find out more about NHS Digital’s wide range of resources and support for developers.

These sessions focused on technical capabilities and design considerations and valuable insight into leading expert’s experience of the market place.

Additionally, the Digital Drop In was open throughout the show to answer questions and offer advice about how delegates can work with: GP Connect; Spine Mini Service Platform; Spine; Message Exchange for Social Care and Health (MESH); Open Test; Care Identity Service Authentication; and Digital Services Platform (NHS Mail).

THE EXHIBITION ehi LIVE is the ideal platform for anyone wishing to engage with an audience of decision-makers, influencers and end-users of technology for healthcare. If your company has anything to do with the digitisation of processes surrounding a healthcare setting, you should be exposing your brand alongside your competitors at ehi Live.

The ehi Live 2016 exhibition featured 130 companies showcasing the latest developments in digital technology to support healthcare. The exhibition floor provided prevalent opportunities for client and prospect engagement, featuring networking areas such as the Big Red Bus Bar, the Knowledge Hub and various catering outlets, as well as all conference rooms.

The Post Show Report highlighted that, amongst exhibitors, 98 per cent of overall business objectives were met, with 96 per cent of exhibitors claiming to have met their target audience. As a result of this, 98 per cent of exhibitors in 2016 want to exhibit again in 2017, with 89 per cent having generated new business leads.

Greg Richards, sales and marketing director at Connexica, said: “ehi Live has become one of our key events. It is well managed, filled with innovative and cutting edge technology providers with a key focus on facilitating conversations, meetings and networking opportunities.” L FURTHER INFORMATION www.ehilive.co.uk

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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NHS SAVINGS

With savings expected across the NHS, and budgets tightening, Laura Quirke, of the London Procurement Partnership, outlines examples of how effective procurement and maximising purchasing power can produce significant savings The NHS is under ever increasing pressure to deliver more for less. Trusts are having to make savings every year to enable them to cope with rising demand and escalating costs. Therefore, trusts need to leverage the maximum savings from procurement to support their savings targets.

NHS London Procurement Partnership (LPP) is a member led procurement hub. Established in 2006, we currently save the NHS around £2 million a week because of the support and engagement of our members from London and beyond who want to collaborate to secure the best deals and services for patients. The work of LPP isn’t just about striving for the lowest price, but improving quality and patient outcomes as well. This requires innovation beyond the traditional procurement aims

of best prices for stock items.

LPP has been working to introduce Dynamic Purchasing Systems (DPS) into areas that would benefit from this approach.

The DPS process has been available since 2006 but uptake has been low.

The advantage of the DPS is it can provide a large pool of suppliers, as new suppliers can be added to an agreement once the framework has been let. This encourages small and medium enterprises (SMEs) to be able to join as well as providing trusts with a compliant and cost effective way of using local firms who meet

the quality criteria. LPP’s first Creatin DPS was for Language g a frame Services, which has 30 suppliers, the is only work one par majority of which of a suc t are SMEs. Savings c e ssful procure on this framework me 20 per cent. encoura nt process; are A second DPS for g implem ing its Minor Building Works has more among entation membe than 200 suppliers, r anothe per cent of which r mattes is are88SMEs. Having shown r

Written by Laura Quirke, London Procurement Partnership

Showcasing savings nous and purchasing pedigree

Procurement

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that this approach can be successful, LPP is looking at other areas where it could be effective.

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Volume 16.6 | HEALTH BUSINESS MAGAZINE

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NHS SAVINGS

Although procurement can make savings by simply getting better deals on the same services, to truly realise the savings needed, procurement departments have to be catalysts for change and be willing to co-operate with other trusts  works in areas of non pay spend, LPP has shown that opportunities for significant savings exist in the supply of temporary staff to the NHS. Facilitated by LPP, staff bank managers from London trusts have a history of working together to manage the market for agency workers and our previous London Regional Agency Nursing Framework generated savings of over £25 million as well as ensuring NHS pre-employment check standards.

CLINICAL STAFFING FRAMEWORK A new national Clinical Staffing Framework, developed by LPP in conjunction with the other three NHS procurement hubs working together as NHS Collaborative Procurement Partnership (CPP), was awarded in August 2016. Work on the framework had already commenced before the introduction by Monitor (now NHS Improvement) of their price caps for NHS agency staff.

Prior to the award, LPP undertook an assessment of pay and charge rates for agency workers across London, based on several million lines of information collected from previous LPP Frameworks. This analysis, along with discussion with staff bank managers enabled trusts to be ambitious and require pay and charge rates below the NHS Improvement capped rates. After testing the proposal to ensure workability, trusts could see the benefits in agreeing pan-London rates to remove the incentive for agency workers to move to trusts or agencies willing to pay the most. Suppliers benefit through reduced compliance costs as they are less likely to lose workers to another agency.

Pan-London arrangements were put in place at the end of October 2016 and are expected to generate significant savings for London trusts. Trusts are committed to working together to get the best deal for patients and for the NHS as a whole, and are clear that the best way to ensure a sustainable and affordable service is to share information and a common approach to managing the agency market.

Creating a framework is only one part of a successful procurement process; encouraging its implementation among members is another matter. Trusts can (and often do) generate savings from a new framework by keeping things ‘as is’ – in simple terms, where the same suppliers are on the new framework, providing the same products but at a more competitive price, the trust will see savings. In clinical areas this keeps

the clinicians happy and requires little input – they can continue to use the products they have always used. Two national clinical frameworks, cardiology and orthopaedics, have recently been developed, again via CPP. Previous LPP Orthopaedic Frameworks had saved members £5.6 million between 2012 and 2014. Once the new national, multi lot framework was awarded, an analysis of the ‘as is’ benefits was released to trusts. This showed that far greater savings could be achieved where trusts combined their areas of spend across orthopaedic disciplines. By providing trusts with a variety of scenarios, the savings in the first year were £6.18 million, almost double the ‘as is’ savings.

By November 2016 average savings were 14.5 per cent for 28 LPP member trusts.

Nationally, 80 trusts are using the framework with more in the pipeline. Savings of approximately £22 million were achieved in the first year. This change was only possible by using evidence and risk analysis to reduce product variation, increase standardisation and deliver better financial and clinical outcomes; making clinicians fundamental to the decision-making process which ensured that sound decisions were made on both commercial and qualitative grounds.

In cardiology, a strategic purchasing guide was created, enabling a standardised approach to market for each NHS trust. This allowed for best practice improvement, long term planning, commitment, future changes in the market, process rationalisation, cash releasing savings and value-added mechanisms. The creation of a detailed comprehensive specification removed the requirement for repetitive tender processes.

As with orthopaedics, as many suppliers have products in more than one lot, cross category deals can benefit both the NHS and suppliers.

The annualised cash releasing savings for 16 LPP member trusts were almost £7 million.

The multi lot approach can again encourage SME suppliers to apply for a place on the framework as they do not have to compete with major suppliers across the whole framework.

Procurement

Sponsored by

clinical commissioning groups. An area of innovation is biosimilars, where a copy of a biological medicine is substituted for the original. This is not the same as substituting a generic medicine for a branded one. The use of biosimilars has the potential to hugely reduce expenditure on treatment. One biosimilar, infliximab, costs 40 per cent less than the branded original, which the NHS in London spent £32 million on in 2015/16.

Introducing a new biosimilar into clinical practice incurs a very significant extra workload for clinical staff. It is important that decisions to start using a biosimilar are approved by trust governance mechanisms, the decision to change treatment is discussed with the patient and that they are monitored closely. As most savings on biosimilars benefit the commissioners, whereas the work to make the change is provided by the trusts, for the changes to be successful, trusts need to retain a proportion of the cost saving. Biosimilars will continue offer major savings opportunities to the NHS for the next five years at least.

These are just a few examples of how effective procurement, both internally across trusts and externally through effective market management and maximising purchasing power, can produce significant savings. It requires trusts to be open to new ways of working and being able to involve clinicians in decision making.

Without clinical involvement, the most likely outcome for many frameworks is the status quo which will deliver minimal savings.

Although procurement can make savings by simply getting better deals on the same items or services, to truly realise the savings needed, procurement departments have to be catalysts for change and be willing to co-operate with other trusts, both locally and beyond. Combining volumes releases significant savings, but the big prizes can come from the intelligent use of data and effective market management. L FURTHER INFORMATION www.lpp.nhs.uk Laura Quirke, London Procurement Partnership

BUYINGS MEDICINES One of the major areas of cost pressure in the NHS, but equally an area with significant potential savings, is medicines. Since early 2014, the LPP Medicines Optimisation and Pharmacy Procurement team has played a key role in providing clinical, commercial and financial information to trusts and

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Cyber Security Written by Dan Taylor, head of security, NHS Digital

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NHS DIGITAL

Cyber security and the NHS Following the recent news of Northern Lincolnshire and Goole NHS Foundation Trust having to shut down their computer systems due to a cyber attack, Dan Taylor, head of security at NHS Digital, looks at the relationship between cyber security and patient care Cyber security is a hot topic in the NHS right now, but it seems to invoke one of two reactions in a lot of people – either concern about whether the IT team has everything under control, or a disinterest because the IT will have everything under control. Neither is helping us to ensure that our information is safe and secure, and both could be inadvertently affecting patient care.

‘Patient care?’ I hear you ask, ‘but cyber security is about computers and nerdy computer hackers… it isn’t patient care, it’s technical folk buying expensive software.’

Cyber security can, and is, affecting patient care, and it isn’t just the responsibility of a few experts who know about computer programming, it is the responsibility of every single person working for our NHS. PEOPLE AND CYBER THREATS I head up security at NHS Digital, and one of my jobs is to work with a team of specialists to deliver CareCERT services to health and care – a set of tools and services to help health and care organisations to make the best decisions about cyber security and to support the system to protect their information.

We know that the threat of cyber attacks on the NHS is rising, as it is with every other sector. We also know that often the NHS isn’t a particular target for these attacks, which are simply looking for vulnerabilities in any system across any sector. So my job is both to set up appropriate protections and services nationally, and also to

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So this means supporting staff with the right training and knowledge so that they understand their responsibilities and also working to change the culture in each organisation so that good cyber hygiene becomes as important as good hand hygiene.

Some of these steps are simple – having good, strong passwords and keeping them safe; not clicking on unverified links; not using your work computers for personal use and not using common passwords shared across work and personal networks.

PROTECTION THROUGH CARECERT So, how does CareCERT support the NHS to protect itself? Firstly we work on a national level, monitoring national systems and networks and ensuring that the right security is in place and that vulnerabilities are recognised and remediated. But apart from people, another threat to the health system is our design as a devolved system, meaning that there are thousands of different networks running locally, which NHS organisations have individual responsibility to protect. The rest of our services are designed to support local organisations to make the best decisions about their own cyber security, taking into account that nobody has a blank cheque or an unlimited pot of money, so we have to make sure that where NHS organisations do invest money they do so wisely, getting the best possible return on their investment.

CareCERT began in 2015, but has recently expanded its services to offer a wider range of

Cyber and can securityng patient i is affect it isn’t just d care, ansponsibility the re computer of a fewrts within expe NHS the

help NHS organisations to make the best choices about their own cyber preparedness.

Whilst central expertise can and does support the NHS to keep its information safe, by far the most common shared factor in successful cyber attacks is people. And as the NHS has 1.3 million staff then that is both a big risk and a massive opportunity. Great cyber security does of course involve good technological solutions, but we also need each member of staff to take sensible action to keep information safe.

When you combine strong processes, great technology and engaged and committed staff, we call that defence in depth.

Cyber Security

support. The idea of CareCERT is that it provides the health and care sector with sensible national support and solutions where it is possible to do so, without taking over the responsibility that each individual organisation has for protecting its own information. The main things that we offer or will soon be offering are listed below.

CARECERT BROADCAST CareCERT Broadcast launched in October 2015 and analyses threat intelligence from a variety of sources, before producing and broadcasting relevant, focused advisories to health and care organisations.

The idea of these broadcasts is that they help organisations to be aware of the threats out there, and to be able to take sensible precautions to prevent them from having an impact. We know that organisations acting on these broadcasts have seen dramatic reductions in the number of threats to their systems. To use the analogy of burglaries, Broadcast is about telling people that there are specific criminals in the area, and giving sensible advice about how to strengthen the protections in their home, protecting their belongings by ensuring that sensible security precautions are in place.

Organisations following broadcast advisories are effectively making sure that their doors and windows are locked and their valuables kept out of sight.

CARECERT ASSURE CareCERT Assure is a free service designed to test organisation’s own cyber preparedness. It offers an individual assessment and the result is a report which will outline key vulnerabilities and provide a set of recommendations to reduce these risks to technology and data.

The report will also help organisations to decide where best to focus efforts and investment for the greatest return.

CARECERT REACT CareCERT React is a support service to provide swift, professional guidance and advice in the case of a cyber security incident. It will provide specialist expertise to support organisations to take decisive actions to reduce the impact of any incident, as well as supporting organisations to bring the right expertise in to offer longer term support. CareCERT React has a team of specialist security advisors in place and offers both a helpline and, where required, an on-site service.

CARECERT KNOWLEDGE CareCERT Knowledge is a new e-learning service relating to data/cyber security, information governance and information management. The aim is to inform health and care staff of their personal responsibility for data security and to support them to make sensible day to day decisions that help to protect information. The service

Great cyber security does of course involve good technological solutions, but we also need each member of staff to take sensible action to keep information safe will offer a range of levels of training so that there are modules suitable for staff who have no direct expertise in cyber security, along with modules which will offer advanced training for specialists.

We work on the basis that all of our services should be driven by the needs of health and care organisations, so we are always open to hearing additional ideas about what would offer the most support to health and care organisations.

What we aren’t here for is as a regulatory organisation, or to point the finger at organisations or to lay blame. We want to be a trusted advisor and to support

organisations to protect themselves. Our aim is to provide a responsive and supportive service and I would urge people to get in touch if they have any concerns about cyber security and think we could help or offer advice, regardless of whether we seem to offer a service that fits your exact needs.

We are always happy to offer advice and we are committed to support health and care organisations to protect their systems and services, as a trusted advisor for cyber security issues. L FURTHER INFORMATION https://digital.nhs.uk/

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Advertisement Feature Denise Basow CEO of Clinical Effectiveness, Wolters Kluwer Health

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CLINICAL DECISION SUPPORT SOLUTIONS

ALLEVIATING TIME STRESSORS TO SPEED ACCURATE DIAGNOSIS Physicians today are under increasing pressure to see more patients in less time, a serious stressor that is compounded by rapidly changing medical evidence. Dr Denise Basow explains how Clinical Decision Support Solutions (CDS) can reduce pressure The perfect storm of too little time, too much information, and too few resources creates an environment more open to diagnostic error.

Clinical decision support (CDS) solutions can make a significant impact in these circumstances. In particular, CDS solutions that provide clinical information the physician chooses as relevant – rather than CDS technologies that overwhelm physicians with too many alerts – can be a central component of broader clinical cognitive support initiatives. These initiatives enable physicians to determine both the correct diagnosis and appropriate treatment plan quickly and accurately.

NO TIME TO THINK The double stressors of too little time and too much information are highlighted in a survey of practicing physicians conducted

by Ipsos on behalf of Wolters Kluwer Health.

Spending time with patients (88 per cent), keeping up with the latest research (83 per cent) and managing increasing patient volumes (73 per cent) are among the top 10 challenges identified by participants.

The problem runs deeper than time constraints, however. The sheer volume of new information also comes into play. A physician would need to read 19 journal articles every day just to keep up with the two million scientific articles published annually.

This is one reason it takes an average of 17 years for new medical evidence to be incorporated into clinical practice. Another factor contributing to physician pressure is the lack of corresponding guidance to help physicians determine when new findings are significant enough to change clinical practice.

Left to make such decisions in a silo and with little time available, many clinicians continue to use practices that are no longer current.

The Internet is one way physicians have tried to keep up in recent years. The Wolters Kluwer Heath survey found that while professional journals remain the top resource (84 per cent), physicians also rely heavily on search engines (80 per cent) such as Google and Yahoo for information.

Despite its popularity, using ‘Dr. Google’ can actually compound the problem. Multiple studies have demonstrated that two out of every three clinical encounters generates a question that, if answered, would change five to eight care management decisions each day. Unfortunately, only 40 per cent of those questions are routinely answered—in part because a typical Internet search will return hundreds of relevant and irrelevant results, often from sources that are not immediately evident or credible. No physician with a sick patient waiting in the exam room has time to evaluate and determine which search result, if any, is applicable.

CALMING THE CHAOS The solution to these interrelated problems is broader adoption of CDS resources that quickly answer clinical questions at the point of care. Clinicians have confirmed that using CDS enables them to answer approximately 90 per cent of their questions.

Dozens of studies have demonstrated a link between CDS and clinically substantial changes in diagnosis, management and acquisition of medical knowledge.

CDS, specifically UpToDate, has been directly linked to improved health outcomes,

Multiple studies have demonstrated that two out of every three clinical encounters generates a question that, if answered, would change five to eight care management decisions each day. Unfortunately, only 40 per cent of those questions are routinely answered 28

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including reduced hospital length of stay and mortality. And, by providing actionable, detailed, evidence-based answers to clinical questions at the point of care, CDS has a proven impact on increased quality, safety and efficiency of care.

As such, CDS has become a critical tool in

managing the flood of clinical information and empowering physicians to have confidence in the treatment decisions they make. CDS resources not only assist clinicians in generating a differential diagnosis, but they also address the broader need for cognitive support systems to aid in diagnosis and management-related decisions.

TRUSTWORTHY, RELIABLE DATA To be truly effective, CDS resources must deliver information that is trustworthy, easily accessible and presented in a way that delivers the answers physicians need most.

They must quickly and succinctly answer a clinical question with the most relevant

information. At UpToDate, we believe it is best to provide original content that has been authored and peer-reviewed by clinical domain experts based on their critical evaluation of the latest medical literature. It is also crucial that any new medical evidence be put through the same rigorous evaluation, with a mechanism for highlighting findings that change prevailing clinical practice presented along with graded recommendations doctors can implement with confidence.

How that information is accessed also makes a difference. The Wolters Kluwer Health survey confirmed what many physicians already know—mobile devices are quickly becoming the preferred tools for

Clinicians increasingly want access to essential resources via mobile devices, through clinical or library portals and, of course, embedded in the electronic health record (EHR)

accessing clinical information. Eight out of ten physicians report using smart phones in their daily practice, while six in ten use tablets and more than half use both.

The primary uses of smartphones were identified as accessing drug information (72 per cent), medical research (43 per cent) and evidence-based clinical reference tools at the point of care with patients (42 per cent). Tablet use results were similar: medical research (63 per cent), drug information (55 per cent) and evidencebased clinical reference tools (50 per cent).

Clinicians want CDS that provides rapid access to state-of-the-art, evidencebased guidance on current diagnostic and treatment approaches and delivers relevant information that is trust-worthy, easily accessible and helps them deliver the best possible care. Convenience is another important consideration.

Advertisement Feature

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ACCESSIBLE RESOURCES Clinicians increasingly want access to essential resources via mobile devices, through clinical or library portals and, of course, embedded in the electronic health record (EHR).

Regardless of how they are accessed, CDS resources should be tightly linked to clinical workflows. Thus, the user interfaces of both the CDS resource and the application through which it is accessed are critically important.

To that end, a growing number of hospitals are turning to HL7 as the conduit between the patient record and the medical evidence.

Mercy Health, a Catholic healthcare ministry serving two states in the U.S., saw CDS as an opportunity to deliver on its promise of making lives better and healthcare easier. It deployed UpToDate Anywhere, enabling its clinicians to access the CDS resource on mobile devices, from any terminal in the hospital or clinic, at home or from within the EHR system.

Within the EHR, users can instantly find relevant guidance via a HL7 infobutton.

Integrating HL7 messaging at critical areas of the patient chart (problem list, health maintenance, on order entry and chief complaint) allows Mercy clinicians to access context-specific information within seconds. This, coupled with ease-of-access, has significantly enhanced clinician adoption and use.

Synthesising existing and new medical evidence into easily digestible information delivered at the point of care, coupled with specific, actionable recommendations, makes it possible for physicians to avoid floundering in the seemingly incessant flow of new evidence. Doctors can also make the most of their limited time with patients by ensuring more clinical questions are answered accurately and quickly to support the best care management decisions. L FURTHER INFORMATION uptodate.com

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+ All your different paper types in one printer.

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DATA

HANDLING

What to do with all that data?

With the end of 2016 bringing the NHS a step closer to Health Secretary Jeremy Hunt’s 2020 paperless NHS plan, Health Business discusses how better utilisation of data can improve the delivery of care and support efficiency savings across the NHS If the NHS is going to achieve its target of being a wholly digital institution by 2020, as outlined by the government, it will need to evaluate how it utilises data in order to improve the delivery of care, as well as, in the face of a projected £2 billion deficit by the end of this financial year, create new metrics by which it measures its performance and efficiency.

We live in a time where our lives are inextricably connected to the Internet, and data in its infinite forms can be recorded and transmitted instantly to the Cloud – referred to as ‘big data’. This opens the door for medical professionals to be able to assess statistics and indicators, in huge volumes, from a bird’s eye view like never before.

It’s important to be able to differentiate the various classifications of data in order to make best use of its applications to healthcare, and, broadly speaking, there are

three considerations to take into account that can help extrapolate the potential benefits and pitfalls of data in healthcare.

HOW DATA CAN BE SHARED As the NHS continues its initiative to become paperless, there are new technologies that allow nurses to carry out assessments and calculate early warning scores digitally, through mobile technologies and bedside terminals. This data is recorded and then transmitted to a central system, which is accessible to doctors and nurses across the hospital, who then get notified of any developments in the patient’s condition in real time. Having remote access to this kind of data means that caregivers can not only react more efficiently in clinical terms, but as the data is

available to all hospital staff, it can improve on the often complicated rota system, which promotes better time management.

Outside of the hospital, the sharing of data provides healthcare professionals and patients with a huge scope of possibilities that could lead to a significant portion of care being administered elsewhere.

Mobile apps that are centred around fitness and well-being collect data on how active the user is, often in conjunction with a wearable device, can be useful on a superficial level in helping combat diseases such as obesity and diabetes, but also online therapy apps for mental illnesses which monitor interactions with the user and flag worrying results back to clinicians for assessment that can lead to potentially life-saving interventions.

As technology advances, there is more and more anticipation surrounding projects that promise to be able to provide clinicians with more detailed information about their patients relating to illnesses that can’t be treated by patients themselves. At the turn of the year, The King’s Fund highlighted ‘eight technologies that will change health and care’, one of which noted the potential of ‘portable diagnostics’, such as the AliveCor ECG, which records ECGs and heart rates through an attachment to a smartphone accurately enough for clinical use.

The landscape of innovations that harness health data is constantly shifting and evolving, but one constant factor that remains is skepticism from the public as to whether they trust the NHS to handle some of their most intimate details.

As such, it is important to take into account, and create a specific strategy for handling and using these two separate tiers of data in order to make them clinically and operationally beneficial.

Document Management

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With t en the adv s that stem of IT sy te remote facilita care, the patientf ‘population to concep ’ has grown in health eal over app years HOW DATA CAN BE TREATED recent

Medical records are said to be more valuable to hackers than financial data, and with the penetration of mobile devices into the NHS, the issue of security around the data that’s transferred has come into sharp focus in 2016.

A survey conducted by security firm Sophos in January highlighted a worrying disparity between the beliefs of the IT managers and CIOs who were asked and the reality of the level of encryption; only 34 per cent had data stored in the Cloud encrypted.

This leaves the NHS very much open to a cyber attack, which would jeopardise the safety and privacy of patients.

Data that has been shared with consent by the public also needs to be recognised as one of the biggest concerns, especially given the NHS’ rocky history with data privacy. The care.data programme was designed to help narrow the gap between what doctors E

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Advertisement Feature Written by Geoff Broome, Director at Apira

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

DOCUMENT MANAGEMENT

ELECTRONIC DOCUMENT MANAGEMENT AND GOING PAPERLESS In recent months there has been much written about the desire to move to paperless operations within the NHS. So what exactly are the benefits for patients and trusts if they embrace this change and how can they get there?

The national target for paperless operation been reset to 2020, plans for ‘Digital Roadmaps’ and ‘Sustainability and Transformation Plans’ are being built with varying levels of emphasis on this agenda.

Before reviewing the benefits of electronic document management (EDM) there is a myth in this field that is very important to address.

Many commentators have suggested that there is no need to digitise old records or current paper as very soon the use of modern Electronic Patient Records (EPR) will naturally make the paper record redundant.

Whilst this has elements of truth to it, the reality in most trusts is that paper is still being generated and received from third parties. Standard medical records retention policies mean that any paper generated today must be kept for eight years.

Moreover, some doctors and some specialities have a great need to see the full history of a patient before making clinical decisions. And, finally, the earliest possible release from the management of paper produces the greatest quantitative and qualitative benefits. We have to deal with the legacy if we are to go paperless, the fact that we still have mountains of the stuff in 2016 should be testament to that fact.

WHAT ARE THE BENEFITS FOR NHS TRUSTS? Firstly, trusts desperately need to drive down overhead costs. One huge area of spend is in the management of paper records, which requires people to find and pull records, move them to where they are needed, update them with new content and return them to a physical store.

This represents a large cash cost in people. With EDM a saving of between £1 million - £2 million per annum can be achieved on a recurring basis.

Secondly, many trusts find space is at a premium. Over 1,000 sq meters of space is being used for records with well over double this figure in larger trusts.

Lord Carter suggested that the running cost across the NHS is in the range of £105‑£970 per square metre per annum.

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Trusts are considered good if their metric is lower than £320, meaning that, even on a maintenance basis alone, disposing of or using this space for an alternate economic purpose would save a trust £320,000 per annum, for large trusts double this figure.

Of course there are other smaller savings e.g. relating to printing (2p per page typically), the paper itself and other consumables such as files/ folders etc.

However, more fundamental is the impact on the quality of working lives and the ‘time to care’ savings as medical secretaries, ward clerks and junior clinicians spend less time hunting for and updating paper records.

SO WHY ISN’T EVERYONE DOING THIS? Two fundamental issues seem to be holding decision makers back. Firstly, the inevitable ‘invest to save’ nature of these projects.

Even with the most accommodating of terms from suppliers (many are prepared to spread costs) the upfront investment in the project team, the procurement and then the hardware, software and change management often leave local organisations without an affordable proposition. National support has been largely rhetorical, with promises of funding but little follow through.

Second to holding decision makers back is the ‘horror stories’ from some mixed outcomes in other trusts. Some had a lack of ambition, working in individual departments rather than trust-wide, others a desire to get to perfection before launching.

The key to success is to ensure we have buy-in at the top and from clinicians, we configure a capable team able to handle the technical, project and change management aspects of the deployment keeping a sharp eye on the benefits. This is the best way to realise the cash benefits as fast as possible (i.e. releasing people and space).

In Surrey, Ashford and St Peter’s NHS Foundation Trust has just taken such an approach and after signing contracts in March 2015 (with Kainos for EDM and Hugh Symons for scanning) it is now fully live with its EDM with all inpatient files being scanned on discharge, legacy and new records that

are created are also scanned for 100 per cent of the trust outpatient appointments.

The trust is on track to achieving recurring savings in the region of £1.5 million per annum during 2017/18 as well as comfortably meeting the 2020 paperless target.

The next stage is to use the EDM to digitise all the paper into eForms so it does not get created in the first place. L

Geoff Broome is a director at Apira and leads the company procurement and EDM practices.

In the fast five years he has delivered several business cases, conducted procurements and deployed EDM in trusts including at Ashford and St Peters NHS Foundation Trust; Frimley Healthcare Foundation Trust; Imperial College NHS Trust; London North West Healthcare NHS Trust; Royal Surrey Count NHS Trust; Kingston Hospital NHS Trust; and Surrey and Sussex Healthcare NHS Trust.

FURTHER INFORMATION 0330 124 1966 info@apira.co.uk www.apira.co.uk

Will mail fail?

The scale of the financial and carbon savings facing the NHS has forced a change in the way in which postal communications are handled. In many ways the rise of electronic messaging is a direct result of Jeremy Hunt’s plan to facilitate a paperless NHS by the beginning of the next decade.

From patient reminders and letters to awareness campaigns, the NHS sends out a variety of confidential documents.

Hybrid mail is a communications strategy that is delivered using a combination of electronic and physical delivery – with digital data being transformed into physical letter items at regional distributed print centres.

This helps hospitals ensure quick delivery of its necessary communications, but also reduces postage costs and lowers production – as well as limiting the need to purchase printing equipment at the hospital site.

Over two thirds of organisations within the NHS have a postal communications strategy in place, with hybrid mailing growing in prominence. Maidstone and Tunbridge Wells NHS Trust’s mail output had increased in recent years to the point where the cost of processing patient letters was no longer economical.

Using a UK hybrid mail system called Minkz Mail solution, supplied

by Funasset, the trust saw savings of £224,044 in 1st and 2nd Class mail volume for April 2014 to March 2015, representing a 45 per cent saving on previous costs. On top of this, the hybrid mailing system frees up monuments amounts of staff time that can be redeployed to more fulfilling activities for staff.  and GPs could share with their patients and vice versa. However, it was widely criticised for its perceived insensitivity towards its treatment of the data, and its complicated and underdeveloped opt-out process.

Another example of perceived mishandling of patient data was brought to the fore in September 2015 when researchers from Imperial College London investigated 79 apps from the NHS Health Apps Library and found that 70 of the apps transmitted information to online services and 23 of those sent identifying information over the Internet without encryption, while four apps were found to be ‘sending both identifying and health information without encryption’.

Public perception is absolutely key to capitalising on the benefits of data moving

The landscape of innovations that harness health data is constantly shifting and evolving, but one constant factor that remains is skepticism from the public as to whether they trust the NHS to handle some of their most intimate details forward; regardless of how effectively a countrywide digital information programme has the potential to be, any attempt to implement one is doomed to fail without a national consensus that it is working in the best interests of its patients and their privacy.

When KPMG explored attitudes towards how comfortable UK consumers were with granting access to their personal information, 78 per cent of 1,000 UK adults questioned would be happy to share the data collected by fitness bands and lifestyle apps with their GP, but given that more advanced technologies are yet to be tested on a larger scale, it remains to be seen whether sharing ‘medium to high level confidentiality data’ will be embraced by the public.

HOW DATA CAN BE APPLIED With the advent of IT systems that facilitate remote patient care, the concept of ‘population health’ has grown in appeal over recent years, particularly overseas. However, given the imperative need for an NHS that can more effectively integrate health and social care it has been taken more seriously in Britain.

By definition, population health takes a view of the overarching healthcare needs of a specific geographic catchment area as a whole, in order for the different medical services to work together in improving health outcomes for the population. This is done by using expertise from all areas of NHS services, and collaborating to share and analyse data collected to pinpoint problems that arise more commonly. While it’s early days with population health, it brings the NHS a step closer to towards the objective of easing the burden on hospitals and apportioning care based on where it would be most effective and efficient, which can often be in one’s own home, particularly in managing long term conditions.

Within the hospital, there are digital business intelligence (BI) tools and staff rostering systems that have proven effective in maximising resources, which is absolutely critical to combating the huge funding deficit that the NHS is facing, while maintaining a high standard of care. By using data collected to clarify where and how doctors spend their time, in conjunction with data on which wards or departments are busiest or require most attention, those

Document Management

DATA HANDLING

charged with running the hospital can base their decisions as to where improvements could be made on statistics that are much more reliable and specific than those that have been traditionally used.

Another key issue that data can be used to improve is the huge difference in prices that trusts pay up and down the country for basic, everyday medical instruments, which is costing the NHS an estimated £5 billion.

The latest report conducted by Lord Carter of Coles, released earlier this year, once again shone a spotlight on the inefficiencies of the buying decisions made by NHS trusts.

A theme of Lord Carter’s findings, dating back to his first report last June, has been the lack of collaboration and communication between trusts with regards to the purchases and management choices that they make – a problem he refers to as ‘significant unwanted variation’.

Having based the recommendations on conclusions that have been drawn from studying healthcare systems around the globe, the report believes that there is a discernible correlation between good management and financial practices and quality health and productivity outcomes.

It proposes that a ‘single integrated performance framework’ be introduced, in order to eradicate the inconsistency with which trusts evaluate different datasets.

With such a framework in place, it would allow the NHS as a whole to aggregate the costs of essential equipment, and the most competitively priced services offered by suppliers, which could be the first step in implementing a top-down procurement strategy to help narrow the funding gap.

Data is such an enormous umbrella term that covers so many different areas, it becomes difficult to discern how to handle it and where to apply it. But it is now ubiquitous in our daily lives, and from a healthcare perspective it provides greater clarity and transparency as to how patients can be better treated in and out of the hospital, and how NHS institutions can be managed and work together to improve its services. With the government committed to providing free Wi-Fi in all NHS buildings, huge amounts of health related data will be shared every day, which will quickly become a pillar in how the sector integrates new technologies into the caregiving process. L

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DOCUMENT MANAGEMENT

NHSBSA AND OPEX CORPORATION: HELPING DELIVER A PAPERLESS NHS

Advertisement Feature

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As the NHS in England moves towards an entirely paperless system of storing and sharing records, the scanning of legacy documents has become a key priority Under plans set out by government, NHS England is expected to provide all health professionals with access to real-time, online patient data by 2020. It is a transformation requiring hundreds of millions of paper records to be scanned and their contents stored and managed in digital format. With the target date just four years away, the NHS Business Services Authority (NHSBSA) is striving to take on as much of the scanning work as they can.

Established by government as a Special Health Authority with a remit to deliver a range of critical central services to the NHS, the NHSBSA has huge experience in converting legacy documents to digital.

In addition to successfully delivering digitisation projects for NHS Dental Services and the North East Ambulance Service, the authority currently scans around 40 million prescriptions every month. In keeping with its aim to be the delivery partner of choice to the NHS for business solutions, its goal is to offer a cost-effective and market-leading scanning solution. It has recently added OPEX Falcons to its fleet of scanners.

DOING MORE FOR LESS Similar to health services all over the world, the NHS is under pressure to do more for patients while at the same time working with finite financial resources. As NHSBSA head of Prescription Services, Martin Kelsall recently pointed out that the digitisation programme is expected to channel money to patient care by enhancing collaboration and embedding operational efficiencies. The authority is committed to delivering £1bn to patients.

He said: “By providing scanning solutions for Trusts, clinical commissioning groups and other NHS support providers, we can help them meet their savings targets and the money saved can be used to support frontline services.”

MEETING THE CHALLENGE But digitisation is a mammoth task. The challenge facing NHS managers lies in moving to a paperless age without compromising the integrity of information currently stored within legacy documents. Not only is the scale of the scanning programme itself daunting– with hundreds of millions of documents to

be processed – but it is also a highly complex and potentially difficult undertaking. For instance, old NHS documents are often in poor condition. Simply running them through a scanner without careful preparation and subsequent checks on image quality is not an option. The result could be lost information, much of it crucial for patient care.

So when the NHSBSA was looking to enhance its scanner capacity, it required a solution that was capable of handling high volumes of documents, often in less than optimal physical condition.

THE OPEX FALCON SERIES OF SCANNERS And with these requirements at the fore, the NHSBSA has purchased 15 OPEX Falcon Document Scanning Workstations.

The ability to scan direct from folder or envelope without time consuming and costly pre-preparation of documents was a key consideration. OPEX Falcon comes equipped with a large touchscreen monitor that allows NHSBSA personnel to check the quality of imaging in real time during the scanning process. Equally important, OPEX Falcons use a high capacity hopper, holding up to 700 sheets and offering continuous feeding. Operators can also utilise external devices to capture large format documents or challenging x-rays directly into OPEX’s CertainScan software. These inputs are backed up by a rescan feeder, which enables rapid reinsertion of paper that hasn’t been processed correctly on the first pass.

This combination of features enables the NHSBSA to accurately process a broad range of documents – of varying size and quality – while cutting the time spent on preparation and checking to a minimum.

The result is a major saving on labour costs and significantly increased security and integrity of the documents with the scanner constantly collating key process management information as a background task.

Paul Keefe, UK and Republic of Ireland Sales Manager at OPEX, said: “We are very proud to be involved with this project. The drive towards a paperless NHS is a vital initiative and one that is set to have a real and positive impact on healthcare. By eliminating the time

NHSBSA employees would have to spend prepping documents and monitoring the accuracy of scans, our products are helping to maximise the benefits of this vital programme.

We are very pleased that the authority has chosen OPEX Falcons as the most efficient and secure way to digitise content.”

IMPROVING CARE Digitisation will not only help to create a more efficient NHS in England but also improve care and outcomes for patients.

Once all information is stored in digital form, there will no longer be any need for doctors and other health practitioners to wait for the transfer of physical files – something which may take days or weeks. As a result, health professionals will be empowered to deliver care and make diagnoses with all the available information at their fingertips.

NHS England’s ‘paperless NHS’ programme has recently been awarded a further £4 billion investment ahead of the 2020 target, as announced under the last coalition government. By deploying a state of the art scanning solution, the NHSBSA is ensuring that document digitisation is delivered as efficiently as possible. This in turn plays a key role in maximising the return on a significant investment. L FURTHER INFORMATION www.opex.com

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EVENT REVIEW

Recognising excellence in the provision of NHS facilities

Health Business Awards

Sponsored by

The winners of the 2016 Health Business Awards, sponsored by CCube Solutions, were announced at a ceremony held in central London on 29 November. Health Business supplies a review of the winning organisations in all 21 categories The NHS has once again been portrayed negatively by the media in 2016. Financial shortcomings, excessive workloads, junior doctor strikes, staff shortages and bed blocking have all contributed to an image of a care system in disarray and desperation. But while more money, staff and space are all necessary to tackle these growing issues, little has been done in the media coverage to emphasise, congratulate and celebrate the success stories that have been lost behind the headlines.

Unprecedented turn-arounds, recruitment triumphs, energy savings, new successes with technological advances and the many other strides forward that the NHS has managed, despite its constraints, are the headlines that should be broadcast.

Presented by GP and well-known media doctor Sarah Jarvis, over 80 organisations were represented at the annual Health Business Awards, the event which

attempts to swim against the tide and acknowledge the ongoing, and too often, unrecognised excellence taking place within the NHS. Here, we list are winning organisations and the success stories which led to their well-deserved achievements.

SUSTAINABLE HOSPITALS Sponsored by ISS Healthcare, the Sustainable Hospital Award was presented by Jarvis to West London Mental Health NHS Trust for the Broadmoor Hospital redevelopment project. As well as a new energy centre and combined heat and power boiler that turns wood chips into fuel, the Broadmoor Hospital redevelopment project features ongoing ecology work which sees hundreds of animals

relocated to safer environments in surrounding areas.

Scheduled to open in 2017, much of its demolition material is being processed for recycling, with environmental mitigation measures used on the access road for construction traffic.

Keith Thomas, technical project manager, was at the event to accept the award, and said: “We incorporated a number of environmental elements from the outset to ensure the delivery of greener buildings.

These included an extensive enabling works programme to create safe habitats for displaced wildlife, the recycling of over 4,200 tonnes of concrete from our decommissioned hospital buildings and the installation of a combined heat and power unit to make future energy consumption much more efficient.

“As you can see, sustainability has played an important role in this project, so we’re delighted that our work has been recognised by the judges.”

The commended hospitals in the category were North Bristol NHS Trust, Yeovil Hospital, University Hospitals Bristol Foundation Trust and East Cheshire NHS Trust.

Elsewhere, beating West Suffolk NHS Foundation Trust, NHS Blood and Transplant and NHS Employers to the NHS Publicity Campaign Award, sponsored by Your Socks On, was the UK Renal Registry for their ‘Think Kidneys’ Campaign. Endorsed by the Royal Pharmaceutical Society, ‘Think Kidneys’ comprises a website and series of posters and is displayed by GP surgeries and pharmacies across England. These carry simple messages to explain how kidneys function and tips to keep them working well, such as drinking enough water, as well as signs to look out for which may point to a problem.

The ann u Health al Busine acknowss Awards ongoing ledge the ,a unrecognd often, excellen nised ce place w taking it the NHShin

RECOGNISING FACILITY MANAGEMENT Burton Hospitals NHS Foundation Trust were the recipients of the Estates and Facilities Innovation Award. Sponsored by Swallow E

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Advertisement Feature

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BARCODING

IMPROVE SAFETY, ENHANCE CARE AND SAVE COSTS Assistive Partner has developed a specific hospital inventory management (UNIQUS® HIM) version of its highly successful UNIQUS® cloud based software.

It explains how the system has played an important role in primary care settings

There’s no doubt, if you ask any trust’s finance management, they’re clear that the £22 billion savings mandated between now and 2020 must come from non-pay sources.

The lemon has been well and truly squeezed already. Most savings from staff pay and property have already been banked. Even the prices the NHS pay for ‘stuff’ has been reduced to a point where there is little room for further manoeuvre if suppliers are to remain solvent.

SO WHERE IS THE FAT? If the NHS were a FTSE 100 business or a leading global corporation, what would the board be focussed on to deliver that kind of saving over the next few years?

Well, surprise, surprise – most of them have already been there. In the world of commerce, times have never been more competitive.

Nor more cost conscious. To survive and prosper, the world’s biggest commercial organisations have been forced to look down the barrel of this same gun. Their answer has been to embrace more efficient systems.

Like the NHS, almost all of these behemoths have already become ‘lean’ in terms of their people and property costs. So they have turned to savings in processes and supply chain management. Every business process they have has come under the microscope. And potential savings have been calculated. Then ranked in order of the best return on investment first and so on.

At the top of the UK healthcare tree, the Department of Health has kicked off a similar process. The Carter report, the Wachter Review and the NHS Chief Executive’s Sustainability and Transformation ‘Triple-Aim’ of: improved

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health and well-being; transformed quality of care delivery; and sustainable finances.

So the agenda is set. There are savings to be made that are nothing to do with reduced prices, workforce pay or property costs. In short, there is to be investment in systems – spend to save. Frankly, if supermarket, clothing firms and DIY chains can do it – so can the NHS. ENTER THE SIMPLE BARCODE… In fact, the NHS doesn’t even need to invent new technology. It just needs to take what has been tried and tested in Civvy Street and adapt and adopt. Let’s take barcoding as an example. The DH e-Procurement Strategy has already outlined best practice.

And there are six well-funded demonstrator hospitals charting the areas for instant success and quick wins. There’s a GS1 compliance requirement for all hospitals.

Helping non-clinical staff move from paper based systems and a fire-fighting approach, to a proactive, systems-driven paperless pathway.

Helping clinical staff step away from administration duties which add little value, to more bedside time. Ensuring that records are accurate, electronic and easy to interrogate.

So that there can never be another PIP implant scandal, where thousands of patients are left vulnerable and at-risk because of poor record-keeping procedures (nothing whatsoever to do with clinical incompetence).

The technology exists; whereby a simple scan of the patient wristband and scans of the packs of material is all that is required to: a) record what was consumed during an operation; b) record the whereabouts

of what may need to be recalled; c) create an automated replenishment order based on actual usage; and d) deliver an accurate patient and procedure-level cost analysis.

Assistive Partner’s hospital inventory management software – known as UNIQUS HIM, is simple to use and swift to implement.

The business case for its deployment is easy to create and will show how an investment of less than £60,000 per annum is very likely to deliver savings of well over £400,000 per annum when just deployed in a hospital’s operating theatre environment.

When a hospital integrates finance systems and catalogue systems with UNIQUS HIM the resultant end-to-end (P2P) system goes a long way to delivering a digital future and helps ensure a futureproof operating system across the trust.

SPEND-TO-SAVE Assistive Partner can help trusts develop a ‘spend-to-save’ business case in line with the following objectives (which most trusts have in common): scalable, hospital-wide e-procurement goals; sustainability and Transformation ‘triple-aim’ plans; ‘smarthospital’ digitisation (Wachter guidelines); spend to save business case for safety improvements and cost savings; easy to use and swift to implement systems; GS1 compliance programs; freeing up of clinical time; reduce administration and paper; enhance patient safety; patient level costing; and waste reduction.

Scale these types of proven technology savings (already tried and tested in industry and commerce) across the whole hospital; multiply such savings by the number of hospitals, and extend the use of similar systems-based, mobile workforce, track and trace technology into pathology samples and other hospital and community based areas - and the £22 billion savings start to become true reality and very achievable. If Walmart can do it, so can the NHS. L FURTHER INFORMATION Tel: +44 (0) 844 335 6791 info@assistivepartner.co.uk www.assistivepartner.co.uk/HIM.aspx

EVENT REVIEW  Evacuation & Mobility Products, the Endoscopy Decontamination Services were heralded for improving patient safety and efficiency. The facilities for cleaning endoscopes at the trust are all purpose built for the space and have been designed with the input of staff, and consistently provide clinicians with safe, clean equipment. In recent inspections the trust scored highly for discharging patients, keeping the noise down on wards during the night and communication.

Having won the Innovation Award at the Health Estates and Facilities Management Association (HefmA) Awards in May, Wendy Kirk, decontamination lead, said: “I am over whelmed that we have received another award for the Endoscopy Decontamination facility within Burton Hospitals. There were multiple entries and so it is really lovely our hospital was overall winner.

“It’s fantastic that the team has once again been recognised for the hard work

they have done this year. The facilities we now use are purpose built for our needs and the area is now a much better environment for staff to work from, importantly our staff had input into what would work and what would not. Our main priority remains providing safe, clean equipment in a timely manner for our clinicians to use which, in turn, keeps our patients well. And provision of Endoscope decontamination from within the decontamination unit and therefore allowing clinical staff to concentrate on patients is proving to be the right decision.”

Northumberland Tyne and Wear NHS Foundation Trust and Lancashire Care NHS Foundation Trust were the commended trusts in the Estates and Facilities Innovation category.

The Environmental Practice Award, sponsored by STC, was presented to Barts Health NHS Trust for their Cleaner Air for East London project. Barts Health partnered

Barts Health partnered with the GLA, its four London boroughs and Global Action Plan to create a cross-sector collaboration to take action to improve air quality and reduce exposure for those most at risk

Improve safety, enhance care and save costs

The £22 billion NHS savings mandated between now and 2020 must come from non-pay sources.

So where is the fat? If the NHS were a FTSE 100 business or a leading global corporation, how would they deliver that kind of saving over the next few years?

In the world of commerce, times have never been more competitive. Nor more cost conscious. The world’s biggest commercial organisations have been forced to look down the barrel of this same gun. Assistive Partner’s answer has been to embrace more efficient systems.

The company has turned to savings in processes and supply chain management. Every business process has come under the microscope. Savings have

been calculated. Ranked in order of the best return on investment.

Enter the simple barcode. The NHS doesn’t need to invent new technology. Just adapt and adopt.

Simply scan the patient wristband and scan the packs of material to improve safety, enhance care and cut costs.

Assistive Partner’s hospital inventory management software –UNIQUS HIM, is simple to use and swift to implement.

Discover a ‘spend-to-save’ business case. An investment of less than £60,000 per annum is likely to deliver savings of well over £400,000 per annum.

FURTHER INFORMATION info@assistivepartner.co.uk www.assistivepartner. co.uk/HIM.aspx

with the Greater London Authority (GLA), its four London boroughs and behavioural change charity, Global Action Plan, to create a cross-sector collaboration to take action to improve air quality and reduce exposure for those most at risk. The Cleaner Air for East London programme has delivered seven projects to tackle air pollution over three years. There has been a measured reduction in air pollution evident as a result of the work at St. Bartholomew’s hospital site.

Health Business Awards

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Sponsored by

CHALLENGING RECRUITMENT ISSUES With staff shortages plaguing the majority of NHS trusts throughout 2016, the Healthcare Recruitment Award, sponsored

by Interact Medical, was a hotly contested category, with the success stories of the nominated trusts proving a breath of fresh air in a difficult subject for the sector.

Improved recruitment processes at Guy’s & St Thomas’ were noted as the reasons for the award making its way to the London teaching hospital. The trust continues to use its successful recruitment formula of speed meeting with line managers and candidates, and now includes a personality style assessment day as part of the process. Opportunities for candidates with learning difficulties, dyslexia, dyspraxia, health issues and complex family backgrounds have been promoted. E

Need help putting your socks on? Get your independence back...

Imagine you couldn’t put your socks on because you had broken your back, had just come out of surgery or were simply struggling with mobility in old age.

Socks On was born out of its founder Mike Milligan’s frustration from these common issues and decided to do something about it. SocksOn is a dressing aid which takes the pain and hassle out of putting on both compression socks and regular socks.

After an operation, hospitals spend a lot of time helping patients get their socks on. Wouldn’t it be easier for everybody if patients could do it themselves?

The Compression SocksOn model has been designed with heavy duty use in mind. Ideal for care homes, retirement villages and hospitals, the Compression Socks machine is a lot more robust and is designed to cope with the demands of a hospital

environment, making it sturdier and more resistant to wear. It includes a stronger PVC base which features anti-microbial components and wheels for easy transport. These enhancements ensure the Compression SocksOn model is robust enough to cope with the demanding stresses of continuous use in environments such as hospitals, which the personal in-home model cannot.

Both models exceed the weight threshold for break tests by twice what is required, and have recently been awarded the CE Marking for sale and distribution in the UK and Europe.

FURTHER INFORMATION Tel: (+44) 790 774 8213 info@yoursockson.co.uk www.yoursockson.co.uk

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Health Business Awards

Sponsored by

EVENT REVIEW  Unfortunately missing out on the prize in this category this year were Western Sussex Hospitals NHS Foundation Trust, Hull and East Yorkshire Hospitals NHS Trust, Humber NHS Foundation Trust, and Mid Yorkshire Hospitals Trust.

Sponsored by Assistive Partner, the winner of the NHS Finance Award was Bolton NHS Foundation Trust. As a pilot site for the Carter review of efficiency and productivity, the finance team at Bolton has overhauled its operations and recorded a much improved performance, emerging from financial adversity to record a surplus in just one year.

Despite facing huge pressures the team made drastic improvements to the financial reporting schedule. A successful cash management improvement project exceeded expectations.

IT FOR SEIZURE SAFETY The Healthcare IT Award, sponsored by Fujitsu, was perhaps the most hotly contested category at the 2016 Awards. There are over 600,000 people with epilepsy in the UK, and approximately 42 per cent of epilepsy deaths are preventable. The EpSMon app, collaboratively developed between the Cornwall Partnership NHS Foundation Trust, Plymouth University, Royal Cornwall Hospital Trust, SUDEP Action and UCL Institute of Neurology, was the technology that gained the judge’s attention and won the prize. An evidenced based free app for smartphones and tablets, it works by providing a seizure safety checklist to support people with epilepsy, allowing patients to monitor their risk for free to keep themselves safer. It has already demonstrated improved communication, safety and reduced mortality within patients.

Jane Hanna, CEO of SUDEP Action, said: “To win this across all health initiatives is yet further evidence that our digital tool supporting people with epilepsy manage their risk and access the right service is a solution that is hitting the button right now.”

Continuing the theme of patient safety, Frimley Health NHS Foundation Trust were the recipients of the Patient Safety Award, sponsored by Ascom. Since taking over Wexham Park Hospital in 2014, the trust has brought about a remarkable turnaround, with the Care Quality Commission now recognising a strong patient safety culture at the hospital. Avoidable harm rates have been significantly reduced, a ‘Sign up to Safety’ campaign saw 500 staff make personal pledges to improve safety and formal complaints at Heatherwood and Wexham Park fell by 62 per cent over the last year.

Wendy Jardine, deputy head of patient safety at the trust, commented: “It was an honour for us to accept the award on behalf of the trust and it reflects the huge amount of work that everyone put in to turn around performance at Wexham in particular.

After the CQC results earlier this year this latest award has finished 2016 off nicely.”

The Outpatient Parenteral Antimicrobial

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Therapy programme at Wirral University Teaching Hospital, the PROSPER Programme at Essex County Council, NHS Fife’s Patient Track and the Pennine Acute Hospitals NHS Trust’s electronic prescribing and medicines administration (ePMA) were the commended nominees.

NHS Barnsley CCG and the RightCare Barnsley service were announced as the winning entry for the 2016 Clinical Commissioning Award. Run in alliance with Barnsley CCG by Barnsley Hospital and South West Yorkshire Partnership NHS Foundation Trust, RightCare Barnsley provides a co-ordination service for GPs and other healthcare professionals. Over 1,000 patients have avoided being admitted into hospital over the past 10 months since the service started, which is staffed by both community and hospital nurses.

BUILDING MENTAL HEALTH EXCELLENCE For the Hospital Building Award, sponsored by headline sponsors CCube Solutions, Guys & St Thomas NHS Foundation Trust picked up their second award of the ceremony for their Cancer Treatment Centre. The culmination of more than 10 years of planning, the new 14-storey Cancer Centre brings the majority of hospitals cancer treatment and research under one roof. Six linear accelerators will be the first radiotherapy machines in Europe to treat patients above ground level, which aims to help patients feel more comfortable in natural light and air.

Northern Devon Healthcare NHS Trust’s Seamoor Chemotherapy Unit, University Hospitals Bristol NHS Foundation Trust’s Queen’s Building development, NHS Merton Clinical Commissioning Group’s Nelson Health Centre and East and North Hertfordshire NHS’ New QEII hospital were the commended NHS organisations.

The Innovation in Mental Health Award, sponsored by Celesio, is an award that always contains some of the most innovative technologies and services, attempting to raise mental health awareness and treatment on par with physical health.

The EIP London Programme, run by The Office of London Clinical Commissioning Groups, prepares Early Intervention in Psychosis (EIP) teams and CCGs for the new standard, whcih was introduced on 1 April 2016, ensuring that more than 50 per cent of people across London are commencing NICE‑concordant treatment within two weeks of referral. The success of the programme, recognised through the Office of London Clinical Commissioning Groups winning of the award, requires frontline staff and senior level buy in, meaning EI teams are reporting higher numbers of referrals and investment into EI teams has grown across London.

A CLEAN SWEEP Sussex Community NHS Foundation Trust were the winners of the Hospital Cleaning Award in recognition of the consistently high standards maintained by the cleaning and housekeeping department. This year’s Patient Led Assessment of the Care Environment (PLACE) ‘Cleaning Scores’ achieved 98.93 per cent across the 11 community hospitals inspected – the third consecutive year the cleaning scores have been above the national average.

Peter Prentice, strategic director of estates and facilities, said: “This is fantastic recognition for the hard work and commitment of our facilities staff to provide clean environments for both our patients and staff, and to improve the experience of care.”

The unlucky, but rightfully commended, hospitals for the Cleaning Award were Ashford and St Peter’s Hospitals NHS Foundation Trust, Royal Devon & Exeter NHS Foundation

“To win this Award is yet further evidence that our digital tool supporting people with epilepsy manage their risk and access the right service is a solution that is hitting the button right now.”

Jane Hanna, CEO of SUDEP Action

Trust, North Lincolnshire and Goole NHS Foundation Trust and NHS Forth Valley.

The Transport & Logistics Award, sponsored

by The British Parking Association was awarded to NHS Blood and Transplant for their transport management system. NHS Blood and Transport collects blood from more than 3,000 donation venues, delivers it to 15 holding units and then transports shipments on demand to every NHS trust in England and North Wales. Last year, NHSBT implemented new transport management software to improve the efficiency of its 220-strong fleet.

The winner of the Air Ambulance Service Award was announced to be London Air Ambulance, recognised for its use of a pioneering balloon procedure known as REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta), to prevent a road crash victim bleeding to death. It was only the second time the procedure had been carried out on the roadside and the patient survived.

Wiltshire Air Ambulance, East Anglian Air Ambulance, Midlands Air Ambulance and Great North Air Ambulance were commended within the Air Ambulance Service Award.

CELEBRATING COLLABORATION Yorkshire Ambulance Service NHS Trust, South Yorkshire Fire & Rescue, South Yorkshire Police were awarded the NHS Collaboration Award. The Local Intervention and Falls Episodes (LIFE) team, operating within the organisations, attend lower priority incidents in Sheffield, seeing fire and police staff visit hundreds of homes in the city to reduce fire risk in properties, improve security and help people who have fallen and contribute to reducing the risk of falls. The team operates using two specialist vehicles and four staff – two South Yorkshire Fire & Rescue employees and two South Yorkshire Police community support officers (PCSOs).

Steve Helps, head of prevention and protection at South Yorkshire Fire & Rescue, said: “This award is the best possible example of our commitment to collaborate with our emergency services partners.

It’s also deserved recognition for a brand new team, which proves emergency services are working together locally to help make people safer and healthier.

“We know that there are huge links between the people who need the help of the police and health services, and those who are at risk of fire. So collaborative working such as this undoubtedly benefits our public safety work.”

Dr Steven Dykes, deputy medical director at Yorkshire Ambulance Service NHS Trust, added: “It’s great to see this example of joint working recognised at a national level, particularly as it has benefited many local residents in its first few months by providing them with an integrated approach to their social and medical needs.”

A PRODUCTIVE FOOD FOLDER Musgrove Park has been developing best practice initiatives in areas such as food waste reduction, and making cost savings of £120,000 per year without any loss in food quality. For that reason, Taunton & Somerset NHS Trust were awarded the Hospital Catering Award. Moving to a same day system and working closely with its catering provider, housekeeping team and ward nurses, food waste was reduced from 21 per cent to five per cent through effective monitoring of patients’ needs and bed turnover. A new food folder provides housekeeping staff on each ward with a greater clarity on the meals offered.

Celebrating victory on the day in the Patient Data Award category was Royal Cornwall Hospital Trust. RADAR (RCHT Analysis Data and Reporting) has been in development for the last eighteen months at the trust, producing live reports, such as number of patients in the Emergency Department and number of occupied beds, informing the patient flow team and on-call managers and driving decision making based on the most up to date information. On top of this award, Royal Cornwall Hospital Trust was recently named as one of the top trust’s in the country for completeness of data on the NHS Digital Maturity Index.

PROCURING IN THE RIGHT PLACES Through the joint venture that is South West London Pathology (SWLP), three trusts – Croydon Health Services NHS Trust, Kingston Hospital NHS Foundation Trust, and St George’s University Hospitals NHS Foundation Trust – have delivered a single, integrated, NHS-led pathology service which caters for 3.5 million people. Therefore, the Hospital Procurement Award was presented to South West London Pathology, whose 35-strong procurement team conducted rigorous assessments of potential partners, with each evaluation session taking up to three days to complete. As a result of the time spent developing each partner agreement, the resulting contracts are air‑tight, in turn minimising any risk to SWLP. SECURING A TOP AWARD The East Lancashire Hospitals Trust was announced as the successful nomination in the Hospital Security Award for the secure

Health Business Awards

The Health Business Awards 2016 ceremony was presented by GP and well-known media doctor Sarah Jarvis

storage system developed in partnership with a local company, for patient’s valuables.

The storage drawer has been designed as part of the patient’s bedside cabinet, which can only be locked and unlocked using a Radio Frequency ID wristband, which is programmed on the patient’s arrival.

The programming of the wristbands takes only seconds and they have been designed to be compliant with infection prevention and control requirements. It is anticipated that the system will be rolled out to its other wards and hospitals in order to enhance the security of patient’s property throughout the trust.

Jed Morris, security and governance manager at the trust, said: “We are very pleased to have won this award having worked extremely hard on innovation for our patients using our hospital services. We really wanted to improve the patient experience and environment for patients to ensure they feel confident in the security of their belongings during their stay if they chose to hold their valuables at their bedside. This is a relatively simple system to use for the patients, yet ingenious scheme that so far has reduced loss and generated some really positive feedback from our patients.”

Southend University Hospital NHS Foundation Trust’s recent security improvements and NHS Greater Glasgow and Clyde’s Infra Red Personal Activation Device rollout were also merited within the category.

OUTSTANDING ACHIEVEMENT And finally, the stand out category of the day was rightly left to last and was received well from all of those in attendance. For the 2016 Health Business Awards, the Outstanding Achievement in Healthcare Award, sponsored

by CCube Solutions, was handed to Hinchingbrooke Health Care NHS Trust.

Competing in the category against Royal Free London NHS Foundation Trust, Western Sussex Hospitals NHS Trust, Northumberland, Tyne and Wear NHS Foundation Trust and East London NHS Foundation Trust, after returning to NHS management on 1 April 2015 after a period in private control, Hinchingbrooke Hospital is out of special measures, with the latest CQC report from August this year now rating all of the trusts’ services as Good. As well as several areas of outstanding practice, the latest patient survey reports show improvements in food quality.

A merger with Peterborough and Stamford Hospitals is planned for April 2017. L FURTHER INFORMATION www.hbawards.co.uk

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HB AWARDS REVIEW

WHAT PAPER? – ELECTRONIC GROWTH CHART SOLUTION

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Aneurin Bevan University Health Board successfully introduces new electronic growth chart solution to monitor the development of children in South Wales Aneurin Bevan University Health Board provides acute, community, mental and child health services from five sites for 693,000 people in South Wales, approximately 21 per cent of the total Welsh population.

In October 2012, it was the first health board in NHS Wales to procure an electronic document and records management system (EDRMS) from CCube Solutions installed and operational by May 2013. Given the wholesale move to electronic patient records, Aneurin Bevin University Health Board required a way of managing children’s growth records within its health economy for two key reasons: They were the last paper documents in use and had to be circulated individually around the organisation – in some sense, negating the value of installing a computer-based medical records system.

They are dynamic ‘active’ documents which change constantly and therefore printing out individual graphs, literally adding a dot(s), scanning and then storing the chart again in the EDRMS was not practical given the time and the impact on readability, especially as these sheets have to be kept up until a child is 18 years old. Using a spreadsheet to log height, weight and head measurement data was also considered cumbersome.

GROWTH RECORDS ARE CRUCIAL Growth records are absolutely essential in the assessment of every child. Chronic diseases impact growth and therefore deviation from expected norms in effect act as an early warning signal that something is wrong and medical investigation is required. For parents or guardians, growth chart data is also recorded in their child health record which is their personal log of their child’s health and development, separate from GP or hospital records.

Dr. Tom Williams, retired consultant pediatrician and clinical lead on the electronic growth records project, says: ”I’ve been involved in NHS IT for many years. This is not just about digitising a process. IT must supplant existing activities but over this improve them which is what we are doing with our electronic growth charts application.”

Traditionally, charts for children aged 0-two and two to 18 years old have been produced

nationally. As part of the project, Aneurin Bevan University Health Board broadened this to add a third chart which documents growth from 0-four years old. This adds more granular detail of development.

The display of charts has also been designed such that both height and weight can be displayed on the same screen which contrasts with competitive systems where charts are shown in isolation. Once a child becomes an adult, the growth chart can be output as a locked PDF and stored in the EDRMS, integrated with other records for that patient.

PILOT PHASE A pilot phase began in June 2014. By October it supplanted the use of paper charts for all patients. Every child in ABHB has a viewable chart. Entry of data can be from all primary, secondary and community locations. Within a year of ‘go live’, growth data was available for over 10,000 children (unique records).

Currently, the system holds over 136,000 data points for 18,000 unique patients – it is widely used with an average of 120 accesses per day across clinics, wards, GP practices, school nurse, and dieticians. eGrowth use has become established and user feedback overall been positive, with many examples where clinical practice has been enhanced.

A UNIQUE APPLICATION The first end-to-end system allowing a distributed group of users to record and view children’s growth chart data via the Clinical Work Station portal.

The first system to allow data to be easily and openly shared given it is held in a nonproprietary format (Microsoft SQL Server).

This means processes can be put in place to make data ‘actionable’ to drive other systems or share it with other databases. This could include GP systems, national growth chart databases, as well as third party best of breed analytical software for reporting.

The effective management of children’s growth charts is an absolute requirement for every NHS organisation introducing electronic medical records systems. The NHS is often much maligned for how IT projects are procured and delivered. In contrast, CCube Solutions and Aneurin Bevan University Health Board have worked hard to develop and implement a cost effective, easy to use system which has the support and buy-in of clinicians who now use it day to day, such that the introduction of an electronic growth chart has totally replaced paper within the organisation.

EGROWTH eGrowth is already proving a successful substitute to paper. Future development and design will be directly influenced by user feedback. There is enormous potential in sophisticated use, including on a mobile platform and for adults – it is accessible via a range of all major device platforms including IOS, Android, and Windows Mobile 8.1.

An aspiration is to build a reference set of data which documents child growth in Wales and beyond - this would provide clinicians, health officials, politicians and, of course, the public with broad insight into the health and development of children, especially in terms of obesity. L FURTHER INFORMATION www.ccubesolutions.com

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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Customer Contact Written by Richard Abdy, membership engagement manager, The Forum

44

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CALL CENTRES

The roll of call centres in the current health system Richard Abdy, membership engagement manager at The Forum, discusses how call centres have widened the scope and improved the work of customer contact within the healthcare sector The technical capability to create large‑scale call centres was made available in the 1970s.

However, it wasn’t until the late 1980s and early 1990s that their adoption became widespread. For the health sector this evolution took some time to embrace, but there has always been an element of ‘Control Room’ presence. The modern health sector contact centre operates using the same tried and tested techniques and technologies that the early adopting private companies have used for years.

The healthcare system has always relied on telephony contact and through the increases in patient choice and the need to better manage demand, the important

role that call centres play is becoming paramount. Ambulance services traditionally operated from control rooms, and along with reception facilities within GP surgeries and hospitals, would have been considered the bulk of telephony work undertaken within the sector. However an ageing population along with the ability to better treat many ailments and diseases and a rise in expectations from the public have placed unprecedented demand on the whole healthcare system. This has led to service transformations which have increasingly turned to call/contact centre environments for solutions.

The 14 ambulance services that cover the United Kingdom handled approximately 10 million 999 calls

The 14 e nc ambula t cover tha servicesK handled the U imately approx 999 calls on 10 milli last year alone

alone last year. With the implementation of the 111 service, replacing NHS Direct in England and the number being adopted into existing services elsewhere in the UK, calls into the NHS are at their highest ever volume. The public are being increasingly targeted with advertising campaigns looking to promote the most appropriate healthcare for the needs which inevitably will further grow this volume of contact.

COST EFFECTIVE RESILIENCE Call centres, and more recently contact centres, have proven to be a cost-effective way of dealing with queries from customers. The 1990s witnessed the initial upsurge in the call centre as predominantly private sector companies looked for more cost-effective ways to handle queries from customers.

Banks, insurance companies, travel agents and other retail organisations over the last

Call centres, and more recently contact centres, have proven to be a cost-effective way of dealing with queries from customers. Although slow to react initially, the health sector is now also at the forefront of call centre thinking 30 years have created large‑scale contact centres and closed inefficient branches with low footfall compared to overheads. Although slow to react initially, the health sector is now also at the forefront of call centre thinking.

Technology was the initial enabler to allow work to be centralised with better connectivity allowing multiple calls to be handled in the same location and data to be stored and transferred more effectively. As this technology has matured it has become more cost effective and therefore more widespread and importantly more robust with use and resilient.

It is this cost effectiveness and resilience that has enabled the health sector to join private sector organisations in benefiting from contact centre environments.

Technology also opens the door for further enhancements like video calls that allow healthcare professionals to see as well as speak to patients negating the need to be seen physically.

However, Adrian Hawes, associate planning specialist with The Forum, also makes the valid point that at the same time there has to be an unerring focus on quality of care for the patient. Therefore the balance of how performance metrics are managed is also vital and this mirrors what we have seen happening in other contact centres where the focus has shifted (thankfully) away from hard metrics (e.g. AHT) to more qualitative measures of customer experience and call quality. Speed of service will of course always be a key driver and therefore right sizing and scheduling to meet demand are key drivers.

Adrian comments: “Whilst it is true that learning from the private sector has (and remains) important, I think we are seeing that there are many organisations in the private sector that would now benefit from looking at the approaches in some of the health service contact centres – and the diligence with which they have to plan, resource and manage and the consistency of performance they need to

deliver. There are few industries that are under as much pressure as health.”

These changes have meant that methodologies developed primarily in the private sector have been adapted and embraced within the healthcare system.

Workforce management systems now more accurately plan when staff need to work to match patient demand.

THE 111 SERVICE This is in line with private sector organisations and the Forum, champions of best practice and professional development in customer contact, acknowledged this when presenting Yorkshire Ambulance Service’s NHS 111 Planning Manager Wayne Deakin with a Planning Hero award in October 2016.

Wayne could take skills he learned in a private contact centre career and adapt them to implement a safe yet efficient and effective process for forecasting, planning and scheduling the 111 service.

Calls to the 111 service have increased since its inception to more than the higher acuity 999 service making the primary contact for non-urgent out of hours’ calls combined with 999 calls one of the largest collection of call centres in the UK, handling over 20 million calls per year.

There are a whole host of other services within the health sector that are delivered by telephony. Some are already delivered in a call centre environment like NHS Business Service Authority (NHSBSA), who deal with a variety of calls from European Health Insurance Card enquiries to pensions and prescription certificates. The NHSBSA, along with Yorkshire Ambulance Service, North East Ambulance Service and other private 111 providers, are active members of The Forum and have shared innovations through previous customer Strategy & Planning conference’s as part of sharing best practice with each other and back to other healthcare organisations.

As champions of best practice and professional development in customer contact, we are widely recognised as an innovative, inclusive and independent community of professionals who stimulate collaboration, continual learning and customer focus.

Our team of independent experts offers advice and support, enabling our members to make a tangible impact in their organisation and show how the capability of each support function is fundamental to the business, through specialist accreditation, qualifications and standards benchmarking.

We provide opportunities for improvement, development and recognition in three specific communities of continuous improvement: Professional Planning Forum, Quality & Customer Experience Forum and the Data, Analytics and Insight Forum.

The Customer Contact Innovation Awards and Customer Strategy & Planning conference will be held in Harrogate on 24–25 April 2017.

Customer Contact

About the Forum

HOW IS THE INDUSTRY’S LEADING CUSTOMER CONTACT CONFERENCE LOOKING TO SUPPORT HEALTHCARE ORGANISATIONS THIS YEAR? Whilst acknowledging and working with different sectors, best practice tends to lend itself to any environment. The Forum’s membership base is extremely diverse and it is that diversity that gives it a unique strength in discovering and sharing innovation. Through sharing of best practice at events organisations learn from one another and it is great to see how methodologies conceived in one industry are easily lifted and adopted. Likewise, there is an increasing cross fertilisation of skills as people move between industries.

This ‘full circle’ demonstrates how far healthcare call centres have come and the opportunities for the future are endless and paramount in delivering service in increasingly challenging financial positions and increasing service demand. Several hospitals have already centralised their telephony functions and others are looking at opportunities of multiskilling/sharing resources. Again, this demonstrates the desire to utilise call centres to make further service transformations. L

Richard Abdy is the membership engagement manager at The Forum. Prior to joining the Forum, Richard worked for the NHS for seven years within the ambulance sector and NHS Business Services Authority, following 12 years in private banking and telecommunication organisations.

FURTHER INFORMATION www.theforum.social

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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FACILITIES MANAGEMENT

Hospitals are blessed with large buildings, which means large roof spaces. Oliver Savory, of the Solar Trade Association, suggests that it is time that hospitals started to manipulate this space to save energy. Here, he details how and why The MRI scanners, dialysis machines, x-ray machines and heart rate monitors all need electricity and, more often than not, need to run 24/7. The lights are on round the clock. Air conditioning units and refrigeration requirements are also very high. Hospitals need a lot of electricity.

With budgets tight, and getting increasingly tighter, all that electricity can represent a significant cost. With volatile energy markets, and expected price rises over the coming years, controlling, and bringing down, those costs allows for greater

flexibility in other areas. What hospitals often do have, however, is lots of roof space, and that space needs to be considered an asset rather than just empty space.

SAVE ON YOUR ENERGY BILLS Solar PV keeps getting cheaper. It fell by 70 per cent between 2010-14 and has continued to fall from there, with recent government predictions expecting it to get even cheaper still. This has meant that even as government support has tailed off, solar PV systems can still offer great value for money.

The main benefit of going solar is that it is a cheaper way of getting electricity

Solar a lot to has offer hospita l s – and cos a green way of t effective g at least enerating the powsome of er require they

HOW TO FINANCE YOUR SOLAR SYSTEM There are various business models that can be used to pay for a solar installation.

The simplest is to pay for the installation outright and earn your investment back thanks to energy bill savings, and generation tariffs if you qualified. Secondly, if the institution doesn’t have funds available to pay for the system outright you can look at borrowing the money.

But the most popular option is financed or funded solar. This is where an external investment company pays for the E

Written by Oliver Savory, Communications & Public Affairs Officer, Solar Trade Association

Hospitals need energy – a lot of energy

when compared to buying in power off of the grid from your usual supplier. If you assume that you are purchasing power at around £100 MWh, after grid charges and policy costs, a solar system with a Power Purchase Agreement (PPA) might be able to supply you with electricity at £70-80 MWh. Government schemes, such as the Feed-in Tariff which pays you a set amount per unit of energy created, still exist; however caps on deployment can make them harder to qualify for, and the low rates mean they make up less of the business case for solar. For a hospital this shouldn’t matter, as they are far more likely to achieve the holy-grail of commercial solar installations – 100 per cent self-consumption.

Whereas other commercial buildings may only use 50-70 per cent of the power their system generates, as they are closed on weekends and holidays, hospitals have high power demands seven days a week.

This can make the business case stack up even with zero government support.

Solar Energy

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

New Build Hospital (Image copyright: Eco2Solar)

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

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HEALTH BUSINESS MAGAZINE | Volume 16.6

Project Management We deliver Projects within agreed timescales, on budget to meet specifications and business goals. Services includes: • Building projects • Office refurbishments • Specialist Laboratory Services • Heating and Cooling Plants • Consultancy • Provision of skilled Consultancy and multi-disciplined Personnel • Provision of Single Project Managers • Management Only Service • Leadership, Management and Stakeholder Management • Complete Management Control Service, inclusive of Planning, Process – Concept to Definition – Commissioning, Implementation and Handover.

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Construction Line member as well as CHAS Accredited which is established as the market leader for health and safety pre-qualification in the UK. CHAS is the largest and fastest growing health and safety assessment scheme in the UK.

What to ask your installer

Solar Energy

FACILITIES MANAGEMENT

Ask to see sample risk assessments and method statements from previous similar projects.

Ask to see design statements covering things like lightning protection and how fire risks will be minimised and managed.

Obtain confirmation that the roof will be assessed and signed off by a qualified structural engineer.

Ask to see samples of all structural and structural design assessments undertaken for similar projects and confirmation they will actually be provided for the project in question.

Solar PV keeps getting cheaper. It fell by 70 per cent between 2010-14 and has continued to fall from there, with recent government predictions expecting it to get even cheaper still  installation and sells the power to the hospital. The hospital pays nothing upfront and buys the electricity generated by the system from the investment company more cheaply than grid electricity through a PPA. Maintenance is usually covered for the duration of the term.

Here are some key questions to ask before entering into a PPA: what is the PPA rate? what is the price per kWh of electricity offered? how does that compare with what you pay at the moment? how does it inflate each year? is there a guarantee to ensure that the PPA will not be higher than the prevailing market price for electricity? and does the hospital have to buy all the electricity generated even if not used on site? (This is less likely for a hospital, but some PPAs will require the building to buy 100 per cent of the electricity even when it doesn’t use it all.)

CAR PARKS OR A MINI SOLAR FARM? Roofs may not be the only place to put solar on a hospital’s estate – although for urban hospitals it’s probably your best bet.

Solar canopies can be considered for the car park; they can supply both the hospital itself as well as any electric vehicle charging points and, as a bonus, provide shelter for patients getting in and out of cars.

An option for rural hospitals that perhaps own a considerable amount of land around the estate is a ‘mini solar farm’ or ground mount solar array. This can then be used to supply the building with what is called a ‘private wire’ connection. If considering a ground‑mounted system it is important to think about the area around it, many solar farms are doubling up as areas of high biodiversity through the sowing of wildflowers around the panels.

SOLAR THERMAL To date the biggest solar market has been for solar panels that generate electricity – called photovoltaic solar or PV. However there is also the alternative option of solar thermal hot water heating.

Hospitals have considerable hot water requirements for showers and catering.

Solar thermal hot water installations are typically cheaper than solar PV panels, and are subsidised by the Renewable Heat Incentive (RHI) which means that the technology has similar rates of return on investment and similar payback periods as solar PV. Contrary to misconceptions, solar thermal relies on light, not heat, to heat the water, so can continue to work even with outside temperatures below freezing.

It is worth nothing that the RHI is currently under review, with the results due out by the end of the year. One of the proposals is to take solar thermal out of the RHI. The exact details of all government support for solar systems are changing quickly, so always check what you are eligible for.

HOW TO DO A SOLAR INSTALL If you decide to go ahead with a solar install, it is usually worth engaging the services of an experienced independent consultant who can draft a technical specification document. The consultant can also liaise with the installer as well as inspect the finished system prior to handover – this should give you some additional peace of mind.

However if you do want to deal direct with your solar installer or oversee the process the Solar Trade Association has developed a management toolkit called the Commercial Solar Rooftop Confidence

Require detailed justification (including energy modelling) of the system as designed including component selection (panels and inverters).

If the operatives working on‑site will be directly employed or subcontracted, and if they will be DBS checked.

Confirmation that the contractor will obtain permission to connect to the grid under G59, and ensure that this will be provided before works commence.

Confirmation of what kind of system monitoring will be provided to ensure no faults – and consider also using a public display in e.g. a waiting area so that your staff and patients are aware that the building is solar powered.

Check whether the installer is a member of the Microgeneration Certification Scheme (MCS) and the Renewable Energy Consumer Code (RECC).

Checklist. This is freely available from the Solar Trade Association’s website.

CONCLUSION Solar has a lot to offer hospitals – a green and cost effective way of generating at least some of the power they require. There are substantial savings to be made, and with energy prices looking increasingly volatile the ability to control costs is becoming increasingly attractive to all kinds of organisations. The policy framework for solar is changing, so make sure you stay up to date with the latest subsidy offering, but installing solar on the roof of a hospital could well still be a very canny investment for your site. L FURTHER INFORMATION www.solar-trade.org.uk

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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Modular Build Written by Jackie Maginnis, Modular Portable Building Association

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CONSTRUCTION

Helping hospitals overcome increased demand The Modular and Portable Building Association is urging hospitals to consider an alternative to traditional construction to ensure that they can provide the best possible facilities to ease the pressure on health services. Jackie Maginnis explains why With the ever increasing demand for emergency care units, talk to the industry about requirements now. It may be a completely new building or and add on to and existing building. Whatever the need the skills within companies today can ease the burden to design the correct facility and minimise disruption to the existing facilities.

Given the critical nature of the healthcare industry, the necessity to quickly source low cost, modern and fully functional buildings is imperative. With off-site modular construction companies can work on severely restricted sites, more often than not in half the time taken by traditional construction methods.

Today with the very stringent requirements A building at Hull Royal Infirmary built off-site

by Portakabin

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HEALTH BUSINESS MAGAZINE | Volume 16.6

for quality and NHS standards modular design can fulfil that need and, equally important, can work within the budget restraints that face estate managers.

More importantly, modular can deliver a building on time. And their popularity shows no signs of diminishing as increasing numbers of healthcare managers discover their benefits for themselves.

Temporary or permanent modular buildings are proving to be the healthy choice for hospitals looking to quickly overcome problems relating to peak‑time demand. They are rapidly

becoming a popular solution for hospitals seeking to overcome high patient demand.

The Modular and Portable Building Association (MPBA) believes that the cost‑effectiveness and speed with which modular buildings can be used to both construct new state-of-the-art hospitals from scratch and extend existing structures make them ideally suited for medical purposes.

Jackie Maginnis, chief executive of the MPBA, explained: “Modular buildings provide a perfect solution for hospitals looking to access long-lasting buildings that truly cater for their needs both quickly and painlessly. It’s been well documented that many hospitals will face increasing pressure on their infrastructure over the next few years.

“At the MPBA, we want the health sector to be aware that modular buildings have the potential to be more costeffective than conventionally built projects. Jackie added that modular building companies specialise in providing a ‘complete service’ to the health service from undertaking the initial design and carrying out all necessary groundwork to construction and final fit out.

“They can create standalone structures, single-storey ‘cluster’ departments, two-storey schemes or whole-hospital configurations.

In addition to being fitted-out for wards, theatres they can be fitted out with kitchen and dining purposes, the expertise also exists to design, create and subsequently install more ‘specialist’ accommodation such as, meeting rooms, laboratories to name a few.”

Maginnis also said that healthcare managers greatly appreciate the possibility of sourcing these cutting-edge facilities both quickly and cost-effectively.

She explained: “It’s my impression that hospitals are now starting to realise that you don’t have to employ one of the really big contractors and undertake a conventional build to get the premises they require. Modular buildings can

The of some gs y t u a e b buildin e y r a r o temp they can b is that and reused d remove er parts of in oth ospital that h lex comp

Modular Build

A building at Hull Royal Infirmary built off-site

by Portakabin

be manufactured with ultra-quick lead times and supplied as an extension or an ‘add-on’ to meet peaks in demand.

“Sometimes, healthcare managers aren’t aware that these structures are available as a permanent – as well as a temporary option at a cost to suit their needs. There is also a strong refurbished market along with a large hire industry within their reach. Other major benefits of modular buildings include energy compliance, meeting the latest regulations and the ability to create buildings that are designed to meet the precise specifications of that hospital’s requirements.”

FULLY FUNCTIONAL HOSPITAL BUILDINGS Modular units are planned and designed to suit specific user requirements. Buildings are also created off‑site in a factory, which enables urgent clinical services to be delivered faster, resulting in minimum disruption in a hospital.

Maginnis added that a misconception – in some quarters – is that once a modular building has been installed, it can’t subsequently be moved and used elsewhere.

She continued: “The beauty of some temporary buildings is that they can be removed and reused in other parts of that hospital complex – or elsewhere – as the need arises. Modular buildings can be constructed to the latest healthcare standards fully compliant to all building regulations and encompass ‘Part L’ energy efficiency – which means some modular buildings also have lower carbon emissions than the traditional option.

“Members of the MPBA produce the required Energy Performance Certificates, so a customer can be certain of the energy rating for a building.”

THE HIGHEST POSSIBLE CONSTRUCTION STANDARDS – BUT FASTER Maginnis adds that it’s the ‘flexibility’ of a modular approach that gives healthcare managers the greatest benefits. And this is particularly relevant when it comes to urgent and difficult projects. The length of time it takes to install new modular buildings will vary according to a hospital’s specific requirements and the ease of access to the site is another among many more

The benefits of a quick installation combined with minimal on‑site disruption are not to be overlooked. And they’re also major reasons for the increasing popularity of modular buildings within the healthcare sector considerations. But it will always be quicker than ‘conventional’ construction projects.

Maginnis added: “The benefits of a quick installation combined with minimal on‑site disruption are not to be overlooked. And they’re also major reasons for the increasing popularity of modular buildings within the healthcare sector.

“But those healthcare managers thinking of going down the modular route should talk to industry directly. This will without doubt save money. The MPBA has members who have been fully vetted before joining.

Our members will consistently provide the highest quality structures and meet the needs of any healthcare project.”

SAMPLE CASE STUDIES Royal Liverpool Hospital – The new building work at Royal Liverpool Hospital is no small undertaking. Main contractors Carillion are not only creating a new development for Merseyside’s busiest hospital, but are adding a cutting edge Biocampus to the site of the old hospital building. The site is active 24 hours a day, seven days a week with over 1,000 operatives on site at any time.

Royal Stoke University – A highly complex, 4,200sqm two-storey ward and theatre building at Royal Stoke University Hospital has been constructed by Portakabin Hire in less than four months to help meet the increasing demand for orthopedic services.

The £13.5 million contract is the largest in the 52-year history of the Portakabin Group’s Hire Division and the project is one of its most challenging schemes in terms of programme and site constraints.

The structure for the high quality patient facility was installed in just 18 days which included weekend working to minimise disruption to the hospital’s service provision

as there were fully operational wards immediately adjacent to the new building.

This construction solution allowed the project to be built in the shortest possible time to the benefit of patient care.

If a site is working all hours of the day, then the site welfare needs to deliver.

To cater for such a busy site, Wernick Hire provided a 39 bay welfare complex, complete with canteen, industrial kitchen, drying rooms, toilets and showers.

Princess Royal University Hospital, Kent – Princess Royal University Hospital in Kent recently found themselves with what seemed like an insurmountable problem. Increasing patient numbers were stretching the limits of the hospital’s facilities. A critical decision unit, where patients could be cared for while an assessment is made to decide where in the hospital they should be treated, was needed urgently.

Unfortunately, the speed with which the building was needed was not the only problem. To provide an optimum service, the location of the unit was vital. By far the most effective placement for it was in the existing ambulance bay adjacent to the Accident and Emergency ward.

However, from a construction point of view this area offered several challenges of its own. Hemmed in on three of its four sides, and sitting partly above the entrance to the underground car park, any solution would need to overcome problems of severely limited space and weight distribution.

For more details of the case studies mentioned visit the MPBA website where these plus other case studies are available. Access to all member companies web sites is also available where much more information can be obtained. L FURTHER INFORMATION www.mpba.biz

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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NHS Adoption of PEPPOL – How it Changes Procurement The Pan-European Procurement Online (PEPPOL) network offers significant cost-saving opportunities through increased compliance, visibility, and automation With the adoption of PEPPOL by the NHS, many businesses will now have to connect to PEPPOL in order to conduct business. Although this means many will have to adapt, it is an opportunity for organizations burdened with inefficient invoice and purchasing processes to grow and improve as a result.

Fortunately, PEPPOL paired with eProcurement offers numerous ways to increase the efficiency of the procureto-pay process. This comes in the form of reduced invoice processing costs through e-invoicing, automatic matching, and channeling purchases to approved suppliers and pre-negotiated contracts.

The Helse Vest Regional Health Authority demonstrates the impact of joining PEPPOL. Before utilizing

PEPPOL, the Norwegian health authority struggled with inefficient invoice and purchasing processes, low contract compliance, and a lack of visibility.

To address these issues, the health authority decided to connect to PEPPOL through Capgemini IBX Business Network.

By connecting to PEPPOL through an experienced partner, any business can experience such improvements in efficiency and cost savings.

“PEPPOL has really transformed the way we do procurement. Our number of e-invoices has grown 500% with no-touch orders rising by 10% and cost-per-invoice resulting in 88% savings in process costs”, Pål Røynesdal, Senior Advisor Procurement, Helse Vest RHF.

Contact us: ibx.global@capgemini.com

How Suppliers Can Benefit from PEPPOL Although the majority of conversations about PEPPOL focus on how it changes procurement for buyers, the advantages it offers extend to suppliers as well.

As a result of connecting to PEPPOL, your business can streamline the orderto-cash process and experience quick, dramatic improvements in payment speed and order accuracy. In addition, PEPPOL offers numerous automation options that reduce administrative processes and improve customer responsiveness.

grants access to a large number of suppliers and buyers through a single access point and will only continue to grow.

Ultimately, the greatest benefit of PEPPOL comes in the form of increased efficiency when dealing with trading

“You are no longer forced to enter into multiple agreements with the mandated providers of your customers. Choose one PEPPOL Access Point provider to reach all buyers and suppliers within the PEPPOL network.”

Already, PEPPOL has spread quickly across Europe and is now poised to spread globally. This means that PEPPOL

Brikt Grendar Head of Public Sector Sales Capgemini IBX Business Network

partners located in different countries.

By introducing procedural standardization in Europe, PEPPOL has removed many of the hurdles businesses must clear in order to complete cross-border transactions, resulting in an open and secure network for document exchange and evaluation.

Taking advantage of these benefits is simple: a supplier only has to connect to PEPPOL access point provider, which will then connect them to all other access points and partners.

In many cases, this will mean that an organization can retain their current supplier. However, finding a provider experienced in processing procurement orders through PEPPOL is encouraged.

Suppliers have much to gain from PEPPOL and should begin thinking about how they will join. Finding the right partner to help make this transition will prove essential.

Read more at: capgemini.com/peppol

eProcurement

PEPPOL

Adopting an effective eProcurement strategy The ith NHS, w ntial sta its ‘sub wer’, is the po buying organisation ideal nefit for to be ability in er interop urement proc

The NHS has a challenge to deliver £22 billion in savings by the end of the financial year 2020/2021 including £700 million from improving procurement.

In its quest to increase efficiency and release resources to the front line, the NHS is embracing electronic procurement (eProcurement) as an important part of its procurement efficiency programme.

Previous efforts to improve eProcurement have been met with limited success, with

PEPPOL is not a new concept for the UK, but for many it remains a fairly unknown concept.

Health Business explores its use in the NHS and what NHS procurement leaders need to be aware of

many procurement processes within acute NHS providers remaining fragmented across multiple supply functions.

In May 2014, the Department of Health published the NHS eProcurement Strategy, a policy document supporting the Procurement Development Programme, requiring the adoption of common global standards by NHS providers and their suppliers, throughout their internal and external supply chains.

The key standards required by the strategy for adoption by NHS providers and their suppliers are: GS1 standards for product coding, location coding and data synchronisation; and PEPPOL, for purchase order, despatch advice and invoice messaging.

Pan European Public Procurement Online (PEPPOL), which was made mandatory in Norway in 2012 following nationwide success, enables the NHS and its suppliers to use standardised connection for eOrdering, eInvoicing, electronic credit notes and advance shipping notifications. This, consequently, simplifies contacts and the procurement actions for NHS trusts, E

Volume 16.6 | HEALTH BUSINESS MAGAZINE

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Need to use PEPPOL? We can help you!

Use of PEPPOL (Pan-European Public Procurement Online) for exchanging business documents including purchase orders and invoices will be required for all NHS Trusts and their Suppliers. To comply with the requirements, each actor in the NHS supply network must start using a PEPPOL Access Point to enable sending and receiving these business documents through the PEPPOL network within the defined timelines.

Liaison Technologies is a Certified PEPPOL Access Point provider. As a global integration and data management company we deliver the documents between our customer’s systems and the PEPPOL network while handling any required data transformations and validations to make the process work in a reliable and automated manner.

Want to learn more?

Please contact us via email at sales@liaison.com or call +44 (0) 1425 200620

www.liaison.com

PEPPOL  moving away from individually negotiated contracts towards a single eProcurement link that enables trusts to trade with current future suppliers, of any size, both within the UK and internationally.

By moving towards the adoption of the GS1 standards (for product and location coding and data synchronisation), and PEPPOL messaging standards (for purchase order, despatch advice and invoicing), together with common business processes and business rules, NHS providers and their suppliers can exchange data automatically without changing their existing IT systems. Standardisation will result in significant cost savings, greater efficiency and higher data quality.

PEPPOL is the culmination of a four‑year project, co-funded by the European Commission and 18 government agencies, aiming to harmonise and simplify procurement processes, reducing ‘digital’ barriers of trade across the EU. This delivers straight‑through-processing through a set of standard-based specifications that enable business documents to be exchanged electronically through PEPPOL Access Points.

To ensure the long-term sustainability of the PEPPOL specifications, the international non-profit association OpenPEPPOL AISBL was formed in September 2012, and has over 100 member organisations across 18 European countries, Russia and the USA. André

eProcurement

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PEPPOL enables the NHS and its suppliers to use standardised connection for eOrdering, eInvoicing, electronic Credit Notes and Advance Shipping Notifications Hoddevik, OpenPEPPOL secretary general, says that PEPPOL is the ‘natural choice’ to ensure interoperability in procurement, and the NHS, with its ‘substantial buying power’, is the ideal organisation to benefit from its use.

DEMONSTRATOR SITES Steve Graham, eProcurement lead at the Department of Health, said at the start of the year: “Following the successful completion of the first demonstration of technology, showing how PEPPOL will work in the NHS environment, we are moving ahead in our plan for wide adoption. We are currently working through a selection process to award central funding to six GS1 and PEPPOL demonstrator trusts who will begin implementation of the PEPPOL standards in January 2016.”

In January 2016, following national adoption of GS1 standards across all acute trusts in England and as part of the government’s eProcurement strategy, six acute trusts were selected as demonstrator sites to pilot the use of GS1 and PEPPOL standards.

Derby Teaching Hospitals NHS Foundation Trust, The Leeds Teaching Hospitals NHS Trust, North Tees and Hartlepool NHS Foundation Trust, Plymouth Hospitals NHS Trust, Royal Cornwall Hospitals NHS Trust and Salisbury NHS Foundation Trust each received funding from a £12 million Department of Health pot, to demonstrate significant efficiencies and cost savings, reduce errors and better patient outcomes by adopting GS1 barcoding standards. It is expected that the introduction of these standards will enable every NHS trust to save £3 million on average each year.

Speaking back in January, after the announcement of the demonstrator sites, Ann James, chief executive of Plymouth Hospitals NHS Trust, said: “We are delighted to have been chosen as one of only six sites of excellence to be at the forefront of rolling out these new, national standards. Our selection comes as a result of a lot of hard work and commitment to this partnership from our staff. We look forward to the challenges and improvements this will bring.” E

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eProcurement

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 Leeds Teaching Hospitals Trust has been at the forefront of efforts to cut costs through eProcurement and has a wealth of experience in successfully implementing new technology and practices.

Tony Whitfield, director of finance at The Leeds Teaching Hospitals NHS Trust, said: “We are thrilled at the opportunities provided by being selected as a GS1 demonstrator site of excellence by the Department of Health. The Leeds Teaching Hospitals NHS Trust is fully committed to the implementation of GS1 and PEPPOL standards in order to further drive patient safety and increase efficiency.

“Being selected offers us the chance to harness the potential of GS1 standards for patients and the taxpayer and support the trust in developing best practice for procurement. We look forward to the next stage and to demonstrate the benefits that these standards bring to the healthcare industry.”

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PEPPOL  implementing a ‘four-corner’ model.

NHS trusts and suppliers should select their own preferred PEPPOL Access Point provider to be connected to all organisations in the PEPPOL network and to exchange these business messages. The core underlying principle of the four-corner model is that a supplier or buyer should connect once to trade with any EU public sector buyer or supplier in the network.

By moving towards the adoption of the GS1 standards and PEPPOL messaging standards, together with common business processes and business rules, NHS trusts and their suppliers can exchange data automatically without changing their existing IT systems.

Electronic ordering (eOrdering) begins with the issue of an order by a buyer and ends with the receipt of an order response from the supplier, by electronic means. The process may include an order change or cancellation advice from the buyer and a shipping/dispatch advice from the supplier. Ordering is an important phase of the public procurement process, and has a direct connection with the catalogue and the invoice. There is a strong desire from both contracting authorities (buyers) and economic operators (suppliers) to achieve efficiency across the procurement process through automation. This requires a specific structure, ensuring the flow of information between different parts of the process, and specific models, ensuring data synchronisation.

In its quest to increase efficiency in order to release resources to the front line, the NHS is embracing electronic procurement as an important part of its procurement efficiency programme PEPPOL has made it possible for economic operators to receive orders electronically from any public sector awarding entity in Europe, and to respond to such orders.

The solutions provided by PEPPOL demonstrate that electronic orders can be exchanged and processed without manual intervention across EU borders. This lowers the cost of entering data into systems and it reduces ongoing operating costs.

Electronic invoicing (eInvoicing) is the automated process of issuing, sending, receiving and processing invoice data by

electronic means. Creating efficiency and cost reductions, eInvoicing can also unleash significant resources for further value-added tasks and innovations. eInvoicing links two important value chains, the procurement and the payment process. However, it is governed by different country-specific legislation and may be subject to processes and standards specific to regions or industries, often creating barriers to cross-border trade. L FURTHER INFORMATION www.peppol.eu

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ePROCUREMENT

IMPLEMENTATION OF PEPPOL: CHALLENGES AND CONSIDERATIONS In May 2014, the Department of Health published the NHS eProcurement strategy.

The key standards put forward by the strategy for adoption by NHS providers and their suppliers are GS1 and PEPPOL. Transalis discusses how it can reduce process inefficiencies The implementation of PEPPOL is intended to remove unnecessary process inefficiencies that arise during the transfer of business documents. It is estimated that the current process requires significant manual intervention. It also means that a single supplier wishing to trade with the NHS may have to accept anything up to 150 different formats of purchase orders. The adoption of a common standard allows parties to exchange these business documents through a single ‘Access Point’ (AP). This will reduce complexity and costs in the NHS supply-chain using what is commonly known as a four-corner model.

This also allows the supplier and the provider to select their own AP. It is the APs which will ultimately ensure the delivery of documents.

While NHS providers and suppliers also need to comply with GS1 standards, in the event where GS1 identifiers - GTINs and GLNs - are not yet available, PEPPOL implementations should proceed in the absence of those identifiers, in line with relevant Supplier Compliance Timelines published by the DH and relevant PEPPOL standards.

A key feature of the PEPPOL network is the option for suppliers to engage with an AP provider of their choice, to send and receive electronic documents with any organisation within the PEPPOL network through a single source, eliminating complex technical connections with buyers and their service NHS providers.

There is also a strong international drive for mandatory eProcurement. In the case of the EU, this technological leap is further framed in regulation. And July 2018 is the deadline set for member states to implement e-procurement in their public administrations.

Whilst the UK might be less bound by such regulation going forward, given the current strong momentum and support, having established the necessary infrastructure, put in place framework agreements, facilitated interoperability testing and proclaiming readiness, deadlines are set and the ball now sits firmly in the court of suppliers and NHS providers. All the fundamentals are in place, technology has been tested, confirmed, and framework agreements are in place.

So, how much of the gap is left to close by

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NHS providers and their suppliers? How close are they to adopting eProcurement? Is this straightforward, or maybe challenging, and perhaps even disruptive? What is the state of readiness and how prepared are NHS providers and suppliers?

CONSIDERATIONS Let’s examine this from a number of perspectives, such as the need for adequately established procurement systems and processes. Whilst most organisations will have some kind of system in place the key question is what other manual processes exist?; Are all purchase orders generated automatically?; Is the supplier process capable of getting a message straight into an order management system? Do those systems support UBL as a message standard?; Where would the mapping of internal formats to the required UBL format take place?; What if not all the data is available to create a PEPPOL compliant order or invoice?; How large is the fragmentation of the procurement process within a single trust – ordering might be decentralised, multiple systems might be in place depending on products or services procured. The challenge here is to ensure alignment of internal processes so as to channel purchase orders through a standard way on the NHS provider side and to process those purchase orders on the supplier side.

From a technology point of view a number of factors will need to be examined. For example, are internal systems able to or required to deal with standardised product coding vs. existing coding standards? Both NHS provider and supplier will need to review the adequacy of their inventory management system in light of the new coding standard. Will current eProcurement solutions be replaced, adapted or otherwise need to be evolved to support connectivity to the AP? For some NHS providers this may involve migrating existing collaborative networks to support the new standards in message content and transmission. Not only that, but their suppliers’ move will need to be co-ordinated carefully so as to maintain connectivity during migration.

With regards to advance shipping notes: even after years of traditional EDI in the retail

space advance shipping notes are still often the remaining missing link in supply-chain automation - either not implemented or not supported by internal processes. It may or may not be necessary to ‘flip’ a purchase order into an electronic invoice – in reviewing their internal systems and processes, NHS providers and suppliers will therefore need to consider current IT architectures, timescales, skills and resources. For example, where will all of the details, codes and standard representations of orders, invoices and advance shipping notes reside within existing ERP systems in order to get them into the required PEPPOL standard formats? Changes to internal systems may involve expensive IT projects.

SELECTING AN AP PROVIDER The selection of the AP provider will be critical to both NHS Providers and suppliers.

In selecting an AP provider with additional capabilities it may be possible to significantly reduce the cost, possible complexities and risks of implementing PEPPOL. Certified AP providers, such as Transalis, with a long-standing and deep expertise in the development, rollout, provisioning and operation of collaborative supply-chains are set to greatly increase the adoption success rate of NHS eProcurement. L FURTHER INFORMATION Asabatino@transalis.com

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GETTING CONNECTED WITH ADVANCED

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Those responsible for NHS trust budgets continue to deal with heavy pressures, whilst at the same time striving to improve patient-facing services for a growing and ageing population In order to meet these challenges, it is vital that processes and systems are regularly reviewed to see where time and money can be saved. Being as efficient as possible in back office procedures means resources can be freed up for frontline patient investment.

Innovation is at the heart of success in difficult times, and those organisations that succeed are agile and seamlessly connected both internally and externally.

A modern, integrated infrastructure will ensure efficiency, and provide real-time data enabling the best possible decision making. The benefits of this can be keenly felt in the finance department, where teams are often overwhelmed with paper documents and outdated, inefficient manual processes. The wider public sector efficiency agenda is driving the prompt payment of suppliers, and, as such, the time is ripe to look critically at these processes.

The Accounts Payable (AP) department can spend many hours sorting, filing, scanning, retrieving and manually entering data from paper invoices. This is followed by lengthy approvals processes, and numerous phone calls from suppliers needing updates on payment. A more automated approach can transform the process, and bring in huge cost and time savings.

“By investing in AP Automation your organisation is taking a simple step towards improved productivity and efficiency.” Aberdeen Group, 2015 AP Automation includes electronic invoicing (eInvoicing), and the matching of invoices with POs. KEY BENEFITS The key benefits of this automation method are: elimination of human errors; invoices are integrated into finance systems within minutes of receipt; business rules and policies can be enforced, with controls embedded in the technology; online archive and reporting features ensure the invoices, plus full audit trail history, can be retrieved within a couple of clicks; suppliers have increased visibility and can be paid on time, enabling trusts to take advantage of early settlement discounts; and reduced amount of paper coming into the office, helping the NHS become greener and more sustainable.

AP Automation within the NHS is facilitated by PEPPOL – Pan European

Public Procurement Online. Conceived as a means of creating a cross-border messaging standard to enable suppliers to trade with public sector organisations across Europe, it is now seen as a central pillar of the UK government’s NHS eProcurement strategy.

PEPPOL will change the way the NHS does business, making it simpler, faster and more efficient. The goal is to have all trusts using it by 2020. PEPPOL enables documents such as POs, shipping notes and invoices to be exchanged in a standard way electronically between buyers and sellers, with no manual intervention. A NHS buyer connects to PEPPOL via an Access Point and electronic documents are sent/received to/ from the supplier’s own Access Point.

ABOUT ADVANCED Advanced has a long and rich heritage in providing solutions and services to the NHS, and we are one of the largest providers of eInvoicing services. We have partnered with CloudTrade to provide a gateway into the PEPPOL network with our Access Point known as ACAP. Our NHS customers can take advantage of an established community of over 2,000 suppliers on our network, ensuring the fastest and highest supplier adoption rates in the market. We have a range of methods to suit all organisations, irrespective of their technical maturity.

Suppliers can be PEPPOL-ready without any changes to IT systems, and without incurring additional costs. Supplier on-boarding is simple and takes a matter of minutes, and they can then view their transactions with the trust via a portal, raise queries online and get visibility of approvals and payment status.

NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST One of the largest trusts in the UK – the Newcastle Upon Tyne Hospitals NHS Foundation Trust – has recently been working with us to eliminate their manual invoicing.

Within the first three months of going live, 75 of the trust’s suppliers had moved over to the new system. The Accounts Payable department has been transformed, invoices are now processed on the same day, and 70 man hours a week are being saved. Staff have more time to focus on value added activities, and suppliers are being paid more quickly in line with the NHS Better Payment Practice Code (BPPC). The trust is also saving around 250,000 pieces of paper, helping with cost savings, and supporting the NHS move towards being ‘paperless’.

Iain Bestford, assistant director of Finance at the trust, said: “We are delighted with the success of the project. The efficiencies that we are gaining from this will have a major impact on how the trust operates going forward.”

The digital era provides an opportunity to reimagine the world in which we live, embrace new communication channels, and enhance how we collaborate both internally and externally. By utilising PEPPOL and AP Automation to connect NHS buyers and suppliers across Europe, finance systems are becoming more visible, streamlined and productive. These efficiencies will be helping the NHS to serve the changing demands of the population in the 21st century. L FURTHER INFORMATION 0845 160 5555 www.oneadvanced.com

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Infection Control Written by Derek Butler, chair, MRSA Action UK

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

MRSA

Infection control: getting the basics right Derek Butler, chair of MRSA Action UK, discusses the importance of returning to the basics of hygiene as technology and bacterium speedily evolve

Over the past couple of months there have been reports and headlines about a new government ‘war’ on superbugs to raise the basics of hand hygiene compliance in preventing the spread of bacteria such as MRSA, C-diff, MSSA and E.coli. Other bacteria were mentioned, but it was the rise in patients contracting bacterial infections such as E.coli that has prompted the present Health Secretary to push for better hand hygiene compliance.

The ‘war’ will focus on better infection prevention and control in hospitals, surgeries and care homes to stop the spread of bacteria (mainly E. coli) by improving hand hygiene levels and the way the NHS cares for patients

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to great fanfare. We are all fully aware of the importance of hand hygiene in ourselves to prevent us from contracting infections in our homes and communities, or at least we should be. However, hand hygiene is woefully inadequate in general especially in the community - from my observations of just watching the public, they can be very poor at washing their hands especially after visiting the toilet. We must remember that many of those in the public domain will be healthcare staff and washing hands should be second nature to them. Good hand hygiene compliance by everyone would make a huge reduction in community infections and reduce incidents of the deadly phenomenon knowns as ‘sepsis’.

The Greek philosopher Aristotle once said that ’we are what we repeatedly do, excellence then is not an act, but a habit’ – and he was right. Washing hands should be second nature, whether we are healthcare staff or not. Fighting bacteria such as those above is an ‘all or nothing affair, there can be no half measures’ and it must include everyone, not just those who work in the NHS. TACKLING INEFFECTIVENESS The new government incentive to publish E.coli infection rates on hospital wards is commendable, and in my opinion long overdue. However, there is a perverse incentive here which is to reward hospitals if they reduce E.coli infections by just 10 per cent. Why are we rewarding people to achieve something that we should expect anyway, that is infections as low as possible no matter what the bacteria? This is the equivalent of rewarding airline companies that prevent aircraft crashes - it is immoral and perverse, in my opinion, the 10 per cent reduction is too soft a target, there needs to be a tougher target as there was for both MRSA and C-diff some years ago of 50 per cent and 30 per cent respectively without cash incentives to achieve it.

We all know that there is a serious problem with Antimicrobial Resistance to our present stock of antibiotics, and with current growth rates of resistance to our stock of antibiotics, we could be looking at the widespread ineffectiveness of these antimicrobials within the next 20-25 years. Even developing new antimicrobials will only lead to bacteria eventually building up resistance, and any new drugs, even those currently under development could be at least 10-15 years away from public use.

Before the widespread use of antibiotics, all we had was ‘Hand Hygiene, Hospital Cleanliness and Aseptic Techniques’ yet

Good ne gie hand hynce by complia ould make ew everyone reduction in nd a hug infections a f nity commu ce incidents o redu dly with conditions the deaenon which require phenomsis’ insertion devices. ‘sep People with urinary tract infections, for instance, often require catheters which, if not inserted properly or managed responsibly by clinicians or carers, can result in E. coli infections. As well as being deadly itself, E. coli can also develop into sepsis. E.coli rose by 20 per cent over five years in England, causing more than 5,500 deaths last year.

You may ask why the government is having to raise the profile of hand hygiene compliance, especially 10 years after the ‘Clean your Hands’ campaign was launched

even now with all our knowledge, modern methods and technology we still cannot get the basics right first time every time. Ever since Florence Nightingale proved that hand hygiene was critical to prevent the spread of bacteria, along with hospital cleanliness, we have struggled to ensure that these two issues work in conjunction with each other.

STRONG LEADERSHIP, STRONG HYGIENE On the issue of cleanliness, they say that you never get a second chance to make a good first impression. I believe that cleanliness is a marker for diligence and commitment - it shows without doubt that the staff and management are taking their work seriously.

Keeping a hospital clean does not require much money or expensive equipment.

It requires the will to implement it and someone to exercise authority and to take responsibility on the behalf of the patients.

Florence Nightingale understood this when she cut the fatality rates of wounded soldiers from 40 per cent to five per cent just by imposing hand hygiene and cleanliness.

She did so, however, by imposing the basic standards of hygiene and sanitation, and by organising her nurses on almost military lines with everyone knowing what their duties were and how important it was to ensure the patient came first. Her strong leadership skills are a salutary reminder of what is needed.

Why is it then that these basic standards are missing from the wards of our hospitals?

And why are we having to incentivise people to do what should be natural. The trouble is that, although management numbers may have increased at the top in the NHS, sadly the closer you get to the patient, the less leadership there is.

Governments and managers in many of our hospitals are failing to come to grips with the lack of any strong leadership at the patient level. Nowadays, nobody has the power to give orders in numerous different spheres of hospital activity for one end only – the comfort, safety and well-being of the patient.

In the past, we all remember the real matron who had authority over every one of her patients, nurses, cleaners, porters and even the doctors. Doctors respected, even feared the matron of old. In addition, she disciplined people on the spot, including patients and visitors, ensuring spotless wards.

Today, because our leaders have refused to take on the power of the trade unions and medical associations, it is all but impossible to discipline or dismiss those who fail to do their job.

The emphasis in my opinion has shifted from the well-being, safety and rights of the patient, over to the well-being of staff.

It would seem that modern management in the NHS is there to nurture its employees, and that modern matron’s lack the power to enforce basic standards of hygiene.

Today the modern matron is more likely to be found in a bed crisis meeting than on

Technology that can bring hand hygiene compliance nearer the 100 per cent mark is now readily available, tried and tested – helping to reinforce a far higher level of hand hygiene between patients the wards enforcing hygienic standards.

No one is disciplined for repeatedly not washing his or her hands. No one is disciplined for leaving off the protective gloves that should be worn when dealing with an infected patient. No one is disciplined for leaving a patient lying in his or her own excrement for hours at a time. No one is reprimanded for leaving a ward in a dirty and filthy condition.

Transgressors often do not get a telling off. They have to be spoken to, as one sister complained to me, in ‘a nice soft voice’ and offered some more training. So modern matrons in our hospitals lacked the power to get wards clean. What is the answer then for better hand hygiene compliance and cleaner hospitals? Education and discipline can only play a part to a degree. We need to move away from 19th century methods and bring infection prevention and control in to the 21st century where it belongs.

RECOGNISING INFECTION PREVENTION We first need to move away from self‑regulation of hand hygiene. All too often we see compliance rates at 100 per cent which we know for fact is inaccurate and more likely to be around 60 per cent at best. Technology that can bring hand hygiene compliance nearer the 100 per cent mark is now readily available, tried and tested, and whilst doing so it can regulate the compliance rate whilst highlighting the gaps in compliance, helping to reinforce a far higher level of hand hygiene between patients.

This system would highlight the weaknesses within the system and allow management and staff to ensure no gaps are left in this

Infection Control

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part of infection prevention and control whilst following the World Health Organisation’s (WHO) five moments of hand hygiene.

On hospital cleanliness, we are fully aware that we treat cleaners as the poor relations of hospital staff, yet they play a critical role in ensuring patients are safe from avoidable healthcare infections. They need to be given the training, time and resources to ensure they can keep a hospital clean. We know that environmental contamination and survival favours endemic settlement.

It is now widely accepted that the hospital environment contributes to the high levels of infections in hospitals in the UK and this therefore needs to be eradicated and a system of work put in place to ensure that the environment is kept as clean as possible.

This should include a robust ‘systems thinking’ approach to every interaction with the patient with the cleaners as part of a holistic approach to infection prevention and control.

If the government and the Health Secretary are serious about combating the high rates of infections in our hospitals, we need to ensure that the basics of hygiene are followed and reinforced in our modern medical facilities. The bacterium have evolved to become very resilient to most things we use to counter them and we have to look to what there already is, and has been developed in other fields of expertise. The bacterium will always constantly evolve and change and we need to evolve and change the way we face this problem. L FURTHER INFORMATION http://mrsaactionuk.net

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HEALTH BUSINESS MAGAZINE | Volume 16.6

EVENT REVIEW

IP EXPO Europe 2016 celebrates its most successful year ever

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Record attendance topped 15,000 at Europe’s number one IT event, confirming that IP EXPO Europe’s winning format of quality speakers and exhibitors continues to attract high-profile visitors Europe’s number one enterprise IT event, IP EXPO Europe, returned to London on 18 October 2016, announcing a record attendance of 15,512 visitors. Hosting a raft of inspiring presentations, seminars and panel debates, the event featured some of the industry’s leading technological thinkers, entrepreneurs and media personalities.

CONTINUED GROWTH Now in its 11th year, IP EXPO Europe’s continuing growth is confirmation that the appeal of its winning format is going from strength to strength. With six sub-events under one roof, speakers at this year’s event covered a wide breadth of technology topics, including the latest developments in cyber security, Cloud computing and the intersection of the Internet of Things (IoT), through to robotics and artificial intelligence (AI).

Highlight sessions included keynote talks from author and founding director of Oxford University’s Future of Humanity Institute, Nick Bostrom; the ‘Father of Java’, James Gosling; the creator of the ‘MySpace worm’ and independent security researcher, Samy Kamkar; and independent cyber security consultant, Dr Jessica Barker.

IP EXPO Europe 2016 also saw lively debates on the future of science, technology, engineering and mathematics (STEM) in education, as part of a series of sub events held in collaboration with Hewlett Packard Enterprise (HPE).

IP X E PO ’s Europe rowth ing g continu mation that r is confi ning format its win ing from is go th to streng th key topics currently of streng

HIGH CALIBRE SPEAKERS Bradley Maule-ffinch, IP EXPO Europe’s director of Strategy, commented: “The calibre of speakers at this year’s event was simply second to none, with a hugely impressive line-up of significant industry leaders and computing industry pioneers.

In bringing together many eminent speakers to present, discuss and debate

interest to industry decision makers, IP EXPO Europe has further cemented its reputation as Europe’s number one IT event.

“With an event of this size and significance in such a competitive market, a six per cent year-on-year growth really is a great achievement, and is testament to the passion, hard work, aptitude and tenacity of the entire IP EXPO Europe event team. This year the IP EXPO Event Series, which includes IP EXPO Europe, IP EXPO Manchester and IP EXPO Nordic, has attracted a total of 23,181 attendees to the entire series of European events, a 28 per cent growth in total audience from 2015.

“As we are all aware, it’s not just about the volume of visitors through our doors but also the quality, seniority and engagement of these individuals. We have already received amazing feedback from exhibitors and will continue to analyse our full data sets to understand more about our audience, who they are and how this is changing year on year.”

Next year’s IP EXPO Europe will run from 4-5 October 2017 at ExCeL London. Full details can be found on the website. L FURTHER INFORMATION Tel: 44 0203 841 8531 www.ipexpoeurope.com

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AEROSOL DRUG DELIVERY

REDUCE EMERGENCY ADMISSIONS BY 32 PER CENT WITH AEROGEN Breakthrough data released at the American Association Respiratory Care (AARC) Congress (San Antonio) in October reinforced Aerogen’s credentials as global leader in high performance aerosol drug delivery The study looked at 1,594 patients over two sequential 30-day periods in a busy, urban emergency department. It compared the impact of bronchodilator medication administered with Aerogen® Solo vibrating mesh technology to treatments administered with a traditional small volume nebuliser.

The results show a 32 per cent reduction in the admission of patients to hospital from the emergency department when treated with the vibrating mesh technology.

SOLO VIBRATING MESH TECHNOLOGY The same research also shows that patients treated with Aerogen technology in the same setting required 75 per cent less medication versus those treated with traditional small volume jet nebulisers. Secondary analysis confirmed a significant reduction in median length of stay of 37 minutes.

Commenting on the results, John Power, managing director and CEO of Aerogen said: “This large clinical study demonstrates the impact Aerogen technology can have in the Emergency Department and is further evidence of the outstanding clinical results we’ve seen when Aerogen technology is used in critical care units all over the world.”

“When patients feel better and can go home faster, without an extended hospital stay, it benefits everyone. This is truly great news for patients, clinicians and hospital administrators alike.”

Speaking at the announcement of the results, lead investigator and study author Robert Dunne, MD, Vice Chair of Emergency Medicine at St. John Medical Centre, Detroit said “The study results prove what we saw everyday treating patients in our emergency room: people who needed treatment with a bronchodilator got better faster, with less medicine, and required fewer admissions when using the Aerogen Solo and Ultra than patients receiving treatment with a traditional small volume jet nebuliser.”

REDUCING HOSPITAL ADMISSIONS The introduction of Aerogen’s technology already used in many ICU’s has the potential to significantly impact the number of hospital admissions, as a superior treatment

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option in the emergency department.

Offering superior clinical performance and improving treatment of respiratory patients, is at the forefront of Aerogen’s philosophy.

This commitment has led to four million patients, in over 75 countries benefiting from these innovative technologies by receiving more effective and efficient treatment.

The impact of the technology has not gone unnoticed by the caregivers. Aerogen was selected as one of six recipients of the 2016 Zenith Award from over 400 competing suppliers to the respiratory care field. The win represents the third time Aerogen has received the award in the last four years.

ABOUT AEROGEN Aerogen (www.aerogen.com) is the world’s leading medical device company specialising in the design, manufacture and commercialisation of aerosol drug delivery systems. Aerogen’s patented vibrating mesh technology turns liquid medication into a fine particle mist, gently and effectively delivering drugs to the lungs of critically ill patients of all ages. The technology can be

used for many respiratory therapies, including; MV, HFOV, HFNC, NIV and spontaneous breathing, offering ease of management and care for medical practitioners. As a market leader in aerosol drug delivery, Aerogen’s innovative technology has changed the science and set a new standard of aerosol drug delivery in critical care which is resulting in better care for the most critical patients from pre-term babies to adults.

Selling via local distributors Aerogen’s products are available in over 75 countries worldwide. Aerogen products are also supplied as partnered integrated ventilator products, distributed by major respiratory OEM’s such as Philips, GE Healthcare, Covidien and Maquet. L FURTHER INFORMATION www.aerogen.com

Patient Safety

VALUE

Don Redding, of National Voices, discusses the organisation’s Realising the Value programme and summarises the available concepts of value, and their appropriateness for the Five Year Forward View world Slowly but surely, efforts are under way in the NHS to bring greater focus to questions of ‘value’ rather than just financial efficiency.

But notions of value are not simple, and they can be contested. The Realising the Value programme, funded by NHS England, completed its work in November and has published a series of reports and resources, whose theme is the ‘value’ experienced and created by people and communities acting in pursuit of health and well-being.

This includes a conceptual report, New approaches to value in health and care, that argues for a new, consensus-based set of outcomes, based on what matters most to people (not systems), to be shared across all sectors of health and social care, including the voluntary and community sector.

A NEW RELATIONSHIP Chapter 2 of the Five Year Forward View states that the goals of the whole document will depend on forging a new relationship with people and communities, mobilising their energies and assets for prevention, for better management of health, and to safeguard the sustainability of the healthcare system.

It is an updated version of the Wanless report’s conclusion that only a scenario where people are ‘fully engaged’ in their health will enable demand to be balanced with available resources. It recognises what decades of research have shown (and Realising the Value updated and interrogated this evidence): that where people are more involved in their health and care, we achieve better outcomes and a more appropriate use of healthcare resources.

PEOPLE AND COMMUNITIES A first step towards the Chapter 2 aim is to understand that people and communities themselves create and contribute value.

Individually, we make daily decisions about our health and how to manage it, in the context of our lives and circumstances.

These include decisions about diet, exercise, stress and anxiety, and whether to take part in social and cultural activities; and also

Whe peoplere more in are in their volved care, w health and better o e achieve a more utcomes and use of happropriate ea resourclthcare es

about how to manage existing conditions, whether and how to adhere to treatments and monitoring, and when and where to use health services.

As Wanless concluded: “For every £100 spent on encouraging self-care, around £150 worth of benefits can be delivered in return.”

Individuals also care for others. Over six million people are involved in informal caring, a quarter of them full time, with its value estimated at £132 billion a year – greater than the NHS budget.

They are the biggest ‘workforce’, and arguably the ‘primary care system’.

People volunteer, with a quarter of adults doing so regularly. Its value is calculated by the Office of National Statistics at £24 billion a year.

Collectively, people have created a vibrant and resourceful voluntary and community sector: 163,000 organisations, with assets of over £100 billion, a workforce of 827,000, and a ‘gross value added’ contribution to the economy of over £12 billion a year.

Of course not all that this sector does is related to health and care, but much of its can be related to supporting well‑being.

These forms of value creation are rarely recognised by the value frameworks used in the NHS, whose focus has always been on its own budgets, as if these were somehow the source of health.

COPRODUCTION Nor does the formal sector’s accounting adequately recognise what happens in ‘coproduction’. An individual who actively takes care of his or her own health is ‘producing’ health. Where they interact with the formal health service, making decisions together with professionals, they are ‘co-producing health’.

Likewise, community activity that supports people’s well-being helps to produce health; and where the formal and informal sectors cooperate in this, they are ‘co-producing health’. Historically, however, the NHS has been poorly equipped to make decisions

about investment based on what it can achieve in coproduction.

That might mean, for instance, using Social Return on Investment methods and prioritising the engagement of people and communities over, for example, individual treatments and procedures, or the maintenance of NHS institutions.

It could mean unlocking funds for ‘social innovation’ – the joint production of effective community based schemes for supporting health and well‑being – rather than always thinking innovation is about drugs and technology.

Written by Don Redding, director of policy, National Voices

Realising the value in patient safety

CURRENT NHS RESPONSES As leaders and policy makers in the NHS have begun to shift direction towards population health approaches, and their incipient delivery through vanguards and accountable care organisations, the limitations of traditional financial approaches have been recognised.

The Future Focused Finance (FFF) programme and the Right Care programme both explicitly seek to shift from a focus on cost to a focus on value. FFF’s Best Possible Value work draws heavily on Michael Porter’s work, which argues for an emphasis on whole system outcomes rather than those from specific single episodes of care.

But Porter still assumes that this ‘whole system’ works by completing identifiable ‘cycles of care’. Arguably this is outdated when 70 per cent of NHS resources are being used by people with long term conditions that are not going to be ‘cured’.

Moreover, it is still looking solely at service inputs and outcomes – not at what people are doing in coproduction, or how community approaches might divert or prevent use of the formal system in the first place.

The Right Care programme recognises the value of involving people in two ways: that sharing treatment decisions creates better value; as does that personalised care for a small number of ‘complex’ (ie costly) patients. But the overwhelming focus of its Commissioning for Value work has been in driving out variation in the value E

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Case Study

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Datix introduces a revolutionary software application will show why healthcare mistakes happen Datix Cloud IQ, a newly released software application from Datix, will transform the way healthcare organisations learn when things go wrong by providing enhanced analysis of patient safety events.

Datix, the world’s leading provider of patient safety software, has just released Datix Cloud IQ, an enhanced SaaS based application that enables healthcare organisations to go beyond simple incident data, to actually uncover ‘why’ mistakes happen – allowing healthcare providers to eliminate root cause issues that lead to medical errors, and truly embed change in their organisation.

With Datix Cloud IQ, healthcare providers can reverse the negative and increasing trend of preventable patient harm. This provides the means for organisations to significantly improve institutional learning, resulting in better patient outcomes, enhanced efficiency and reduced cost.

Oliver O’Connor, head of product management at Datix, said: “Mistakes happen in high-risk environments, but by learning from those mistakes, we ensure a safer future for both patients and staff. This is a dramatic leap forward in the ability for organisations to move to a culture

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where learning is key to risk mitigation, rather than seeking to lay blame.”

As well as identifying ‘why’ safety incidents occur through a rigorous investigations module, Datix Cloud IQ allows recommendations to be made for improving processes and assessing the value and outcome of those improvements.

Building on Datix’s reputation for providing comprehensive incident reporting and patient safety solutions, this system provides a fresh view of managing patient safety data. It is the result of academic collaboration, research, user engagement and a continued drive for innovation. Datix Cloud IQ provides five toolkits (capture, evaluate, strategy, implement, and assess) that take organisations through a continuous improvement process. There is also a comprehensive analytics feature, allowing organisations to

look at trends as they occur and even predict where instances may arise in the future.

CEO Seyed Mortazavi said: “Healthcare leaders and academics have acknowledged that we urgently need a more rigorous way to respond to untoward incidents and the failure to learn. Datix Cloud IQ is a direct response to that requirement. At Datix, we are harnessing the latest, easy-to-use, SaaS based technology to enable all manner of healthcare systems to investigate and analyse why things go wrong. This is a pioneering next step to reporting on incidents, and one that will enable healthcare organisations to make a very real difference to patient safety.”

FURTHER INFORMATION Tel: +44 (0) 20 8971 1971 info@datix.co.uk www.datix.co.uk/iq

VALUE  of spend on single disease pathways.

For the full Forward View world, we need to be looking for something wider than these approaches, as we described in this table: www.nesta.org.uk/publications/ new-approaches-value-health-and-care.

A FULL CROSS SYSTEM APPROACH The published frameworks for the PACS and MCP new care models show the direction of travel: to place-based, population focused health services, integrated with other services, and closely engaged with people and communities.

In this future, ‘whole system outcomes’ are those produced by a range of services (public health and social care as well as the NHS) and individuals and communities acting together.

When considering and capturing value, therefore, we need to look at what matters to all stakeholders; and at outcomes in several dimensions – such as social and economic impacts, and well-being, not only ‘health’.

There is some dawning recognition of this. The leaders of all the national system leading bodies have signed a shared commitment to engaging and empowering communities that includes the intention to develop a simpler set of shared outcomes; and stakeholders including the NHS Confederation, NHS Clinical Commissioners and the Academy of Medical Royal Colleges have called for a single outcomes

Value: broadening the focus framework for integrated care systems.

Our paper, New approaches to value… makes concrete recommendations for developing a single, cross system outcomes framework based on what matters most to people and communities. And as a first step, working closely with local partners who are demonstrating successful person centred and community based approaches, we developed a set of value statements that such systems can adopt.

In another publication, the PPL consultancy helped us develop economic modelling for person and community based approaches, such as peer support, education for self management, and health coaching. These provide a new kind of guide for commissioners and providers considering whether to invest in such approaches, and will be used in the MCP and PACS vanguards to create greater focus on community-engaged systems. We would urge everyone involved in developing financial and value-related strategies to take a closer look. L

National Voices is a coalition of national health and social care charities working to bring service user voice into policy making in England.

FURTHER INFORMATION www.nationalvoices.org.uk

Patient Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Not only...

Specific clinical outcomes.

What the system values, e.g. cost and value for money indicators.

Patient experience, i.e. what direct contact with services feels like.

Immediate outcomes of a single service, e.g. success of a treatment.

Individual outcomes for the person.

But also…

Wider health and well-being impacts.

What people and their communities value, i.e. the outcomes most important to them.

Well-being, e.g. quality of life; people feeling supported, in control, socially connected and independent.

Outcomes over time of all the services and support a person or community may draw upon.

Equity in health and well-being, with greatest value achieved by targeting people and groups with greater need, lower health literacy, least access etc.

What is GPTeamNet? GPTeamNet is a web-based sharing and compliance platform for Primary Care.

• For GPs - it provides rapid access to information and eases the collection of appraisal evidence.

• For practices managers - it provides a powerful practice intranet which includes information-sharing, CQC compliance, and personal CPD records.

• For GP federations and practice groups - it provides uniquely powerful tools for information-sharing, collaboration and shared services.

• For CCGs - it facilitates information-sharing, communication and engagement in a way that is unmatched by any other solution.

• For all - it provides an information management system trusted by hundreds of Practices, CCGs, CSUs, Trusts, Local Authorities and NHS England.

In Primary Care we know that you need accurate information from a multitude of different sources. At times you will need to find this quickly and share across the whole practice team. This includes day to day tasks, CQC inspections, and evidence for annual appraisals. Additional features enable scheduling annual leave, significant events, compliments and training.

GPTeamNet provides you with the ability to collate all of this in one easily accessible place.

In addition to the powerful compliance and sharing aspect of GPTeamNet, Clarity Informatics have now integrated GPTeamNet with the Appraisal Toolkit for GPs. This allows easy export of practice related information directly into a GP’s appraisal portfolio with the click of a button, simplifying the whole process of appraisal evidence gathering.

We are confident that you will find the platform useful and that it will become an essential resource for your organisation.

For more information contact James Stephenson on +44 (0) 191 287 5813 or email james.stephenson@clarity.co.uk WEBSITE: HTTP://GPTEAMNET.COM/

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m your

next move Not only are we one of Europe’s largest specialist medical recruitment agencies, we’re also proud to be recognised as a company that inspires Britain as well as leading the Recruiter Hot 100 Awards.

If you are a Doctor, Registered Nurse or looking for a rewarding career within a fast-paced recruitment business, we would love your next move to be with Interact Medical!

For more information and to discuss each of our opportunities further, please call 01908 357998 or email recruitment@interactmedical.co.uk

EVENT REVIEW

Patient First rings the alarm for patient safety More than 3,700 delegates, exhibitors and speakers, all with a passion for patient safety, came together for the 2016 Patient First conference and exhibition, held in London’s ExCel on November 22-23. Health Business reviews the show Representing the whole range of commissioner and provider communities, front line clinicians, support staff, managers and administrators all responded to the conference call for continuous improvement in patient safety and in infection prevention and control.

With eight separate conference programmes delivering a total of 46 hours’ of education, the 2016 Patient First event became the premier forum for thought leadership, best practice sharing, education and networking for everyone involved in patient care.

Key speakers included Dr Suzette Woodward, the national campaign director for Sign up to Safety, who said: “This is one of the leading shows for patient safety and there’s a great buzz here. It really focuses people’s minds on patient safety. It’s a great platform for reaching a broad spectrum of people who are attracted by the wide range

of sessions on offer here as well as the impressive exhibition.”

NEW STREAMS This year, two new education streams joined Patient First’s signature quality conference programme offer: a new dedicated patient safety technology programme, which was opened by NHS England chief information and technology officer Ann Slee, and the new quality improvement theatre, delivered in association with Healthcare Quality Improvement Partnership (HQIP) and the National Quality Improvement and Clinical Audit Network (HQICAN).

Bringing this education stream to a close on day one of the conference was Charlie Davie, managing director of UCL Partners, Academic Health Science Network, with a popular presentation on effectively combining primary and secondary care data for quality improvement.

Amongst a host of new attractions, a series of round tables were hosted

Openi the eveng nt, Health Ministe r Philip D u n n e outlin Departmed the Health’s ent of pr for pati iorities en safety t

Patient First

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Sponsored by

in the 2016 show 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 was also a round table interactive learning session in the Sign up to Safety feature area.

Taking place just one week after the publication by Public Health England of a report showing increased antibiotic resistant infection rates, Patient First 2016 once again provided a timely opportunity to have the antimicrobial resistance strategy conversations that matter.

Delegate Audrey Sothcott, patient safety manager from Central London Community NHS Trust, said: “I’ve had the opportunity to make plenty of contacts to help me improve patient safety. This knowledge will be really useful to me back in the workplace.”

Opening the event, and speaking to Patient First delegates by video, Health Minister Philip Dunne outlined the Department of Health’s priorities for patient safety and infection control. Other luminaries attracting a standing-room only audience included Jim Mackey, chief executive of NHS Improvement, Professor Sir Mike Richards, chief inspector of hospitals for the Care Quality Commission (CQC), and Professor John Watson, deputy chief medical officer at the Department of Health. Also providing important frontline input to the event were trust chief executives including those to receive an ‘Outstanding’ rating from the CQC. THE EXHIBITION As well as the education programme, visitors to Patient First 2016 were able to view the latest product and service innovations from over E

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EVENT REVIEW

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Learning and improving from mortality reviews

Patient First

Sponsored by

On the second day of the conference, three speakers – Kevin Stewart, Royal College of Physicians, Michael McCooe, Yorkshire & Humber AHSN Improvement Academy, and Helen Hogan, London School of Hygiene and Tropical Medicine – provided an update on the National Mortality Case Review Programme, covering what can be learnt and achieved by undertaking mortality reviews.

 85 exhibitors. Must-see innovations included Vanguard Healthcare’s mobile treatment unit solutions, PMD Solutions’ respiratory rate monitors, Ridouts specialist healthcare solicitors, Datix patient safety software solutions, iMDsoft clinical information systems and RL Solutions patient reporting software.

Two stand out exhibition programmes saw B. Braun run a series of hands-on workshops from the Skills Training area covering ‘The future of IV Medication Safety – The Connected Clinical Environment’, while Sign up to Safety hosted a succesful series of interactive workshops from their feature area.

Exhibitors were overwhelmingly positive about Patient First 2016. Laura Beyers, account manager at Datix had this to say: “Our clients expect us to be at this show. We’ve just launched a new suite of products and delegates have been very interested to learn more about them. We’ve had some very beneficial conversations with new and existing clients.”

Ryan Franklin, country manager for Sage Products, commented: “This is a very well‑organised event. Locating the talks in and around the exhibition works well. There’s a wide variety of delegates here who are looking for ways to improve patient safety, so it’s been a good opportunity to raise awareness of our brand and get some good leads.”

Meanwhile, Celine Hathaway, head of Healthcare at Medipal, added: “We’ve had

Since the Patient First conference, the Care Quality Commission (CQC) has said that NHS investigations into patient deaths are inadequate, causing extra suffering to bereaved families.

The CQC report, the culmination of a one-year inquiry on the back of some high-profile cases of neglect, finds that grieving relatives are too often shut out of investigations or left without clear answers.

The CQC’s review looked at NHS trusts in England providing acute, community and mental health services, placing a particular focus on people with mental health conditions and learning disabilities, considering evidence from more than 100 families.

The report concluded that the level of acceptance and sense of inevitability when people with a learning disability or mental illness die early is too common, and that there is a current failure to prioritise learning from deaths so that action can be taken to improve care for future patients and their families. This is, in part, due to there being no consistent national framework in place to support the NHS to investigate deaths.

Additionally, and most painful for families, is that discovery that many carers and families do not find the NHS

to be open or transparent, and that families and carers are not routinely told what their rights are when a relative dies, what will happen or how they can access support or advocacy.

Professor Sir Mike Richards, chief inspector of hospitals at the CQC, said: “We found that too often, opportunities are being missed to learn from deaths so that action can be taken to stop the same mistakes happening again.

“While elements of good practice exist, there is not a single NHS trust that is getting it completely right currently. An agreed framework needs to be established that sets out exactly what the NHS should do when someone dies and ensures that families and carers are fully involved and treated with respect. Investigations into problems in care prior to a patient’s death must improve for the benefit of families and importantly, people receiving care in the future. We have made a number of recommendations for action as a result of this review. This is a system-wide problem, which needs to become a national priority.”

FURTHER INFORMATION http://www.cqc.org.uk/content/ cqc-calls-action-end-missedopportunities-learn-patient-deaths

Taking place just after the publication of a report showing increased antibiotic resistant infection rates, Patient First 2016 once again provided a timely opportunity to have the antimicrobial resistance strategy conversations that matter a good first show. It’s the right audience for us and we’ve had a regular flow of people to the stand with no dead times.”

COLLABORATIVE PATIENT CARE Summarising Patient First’s wonderful reception with speakers, delegates and speakers alike, event director Lucy Pitt said: “Among the key messages to emerge from Patient First is that patient safety is not a quick fix: excellence requires effort sustained over many years and the development of a culture that ensures people regard safety and quality, candour and transparency as the key drivers of service change. Over many years, the Patient First

conference and exhibition has forged a niche as the place where this effort can be inspired and fine-tuned through education, networking and innovation. Already, bookings are being made for next year, as exhibitors and conference speakers recognise the important role that the annual Patient First event plays in bringing together the NHS in the name of patient safety and infection control.” L

Patient First 2017 takes place on 21-22 November 2017 at London’s ExCel. FURTHER INFORMATION www.patientfirstuk.com

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Parking Written by Dave Smith, British Parking Association

SERVICES

A healthy parking solution The NHS has more special requirements than most organisations offering car parking facilities. Talking to CP Plus, Dave Smith, of the British Parking Association, looks at some of the measures in place to raise parking standards in the NHS Managing parking on behalf of NHS trusts is invariably the biggest challenge that any parking operator can undertake.

CP Plus, members of the British Parking Association (BPA), manage parking for some 20 trusts at over 50 sites having started the business in this difficult environment some 25 years ago, and have unrivalled experience of the issues and solutions.

Grahame Rose, CP Plus director, says: “Parking at most hospitals and other healthcare sites is at an absolute premium and it is hard to envisage this situation improving. As smaller hospitals are closed by the government and more services moved to larger sites, more parking spaces will be needed.

“The government also encourages successful hospitals to expand their services, but as a hospital becomes more successful, the more people want to be treated there and trusts are then often faced with the problem of increasingly overcrowded, inefficient car parking for patients, visitors and staff.”

The NHS has more special requirements and considerations than most organisations offering car parking facilities. Besides the obvious emergency services and A & E access, NHS trust managers have the unenviable task of juggling the interests of patients and visitors with the needs of healthcare professionals, who understandably want convenient, secure and affordable parking when they come to work.

Adding to the complexity of parking in the healthcare arena and putting people first, NHS trusts, like other public sector bodies, have a duty to ensure their assets are professionally and cost-effectively managed.

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policy; operators should be a member of an accredited (by the DVLA) trade association; and contracts should not be let on any basis that incentivises additional charges, e.g. ‘income from parking charge notices only’.

Charges should also be reasonable for the area. The BPA strongly believes that healthcare budgets should be used to provide healthcare and those car-borne visitors should pay for this service. Concessions, including free or reduced charges or caps, should be available for the following groups: disabled people; frequent outpatient attenders; visitors with relatives who are gravely ill; visitors to relatives who have an extended stay in hospital; carers of people in the above groups where appropriate; staff working shifts that mean public transport cannot be used; and other concessions, e.g. for volunteers or staff who car-share, should be considered locally.

HEALTH BUSINESS MAGAZINE | Volume 16.6

RAISING STANDARDS IN PARKING MANAGEMENT & OPERATIONS NHS trusts and other healthcare providers work tirelessly to deliver an optimal level of clinical care. For many healthcare organisations, that effort is reflected in their provision of parking.

This dedication is exemplary, and it is high time that it was recognised.

The Professionalism in Parking Accreditation (PiPA) is an accreditation programme supported by the Department of Health and is now available for organisations to work towards, focusing on healthcare parking.

PiPA will go one step further than recognition: it will celebrate professionalism in healthcare parking.

The BPA launched PiPA in healthcare parking precisely because the sector is so important. No one enjoys a visit to a hospital or a doctor’s surgery. If someone does make that visit, it is generally because they are ill.

Why, on top of that, should they feel stressed about parking? How does it help anyone if a doctor, nurse or surgeon is also stressed about parking? A professional organisation will take steps to help minimise anxiety in its car parks.

The aim is for accredited healthcare providers to become nationally-recognised role-models for parking professionalism and excellence. PiPA will help raise levels of customer service for patients, visitors and staff, and recognise the high standards that already exist. It will help increase patient, visitor and staff satisfaction and ease their worries about parking. It will improve the reputation of NHS trusts and other healthcare providers, and it will help to counteract adverse publicity in the media.

PiPA builds upon the voluntary Healthcare Parking Charter, developed by the BPA in

sts, NHS tru public er like oth dies, have o sector b to ensure a duty ssets are their a onally and i profess ffectively cost-e aged man

Grahame adds: “Trusts need well defined, well signposted and well managed spaces in order to keep an efficient throughput of patients and to help alleviate any stress they may be under.

“Emergency services must have clear roadway and building access as do outsourced suppliers such as catering and laundry services.

And no hospital wants health workers to turn up late for clinics or worse, surgeons turning up late for operations because they can’t find a parking space. Parking needs to be made available for priority clinical staff and other workers such as night shift staff.”

Many trusts have put measures in place to help reduce anxiety for all visitors.

Drop-off zones are often made available to those with mobility problems. Many people arriving at a hospital will be in a highly traumatised state and at peak times staff can provide a reception service and be made available to direct drivers to the most appropriate parking area.

When considering their options for parking management, all trusts should be aware of the guidelines published by the Department for Health, which the BPA and its members were consulted on: NHS patient, visitor and staff car parking principles. These set out some principles that the BPA and its members managing parking at NHS sites support, including: pay on exit systems should be adopted; trusts should publish a parking

conjunction with other stakeholders, and will enable hospitals to work towards a nationally accredited standard for their parking services. This is just one example of the kind of projects the BPA and its dedicated Healthcare Parking Special Interest Group are involved in. The BPA is currently running a comprehensive national benchmarking survey to enable trusts to measure their services and performance, way beyond the basic parking information gathered in current ERIC data.

RECOGNISING SUCCESS The BPA were delighted to sponsor the Transport and Logistics Award at this year’s Health Business Awards in November.

Managing and delivering an effective transport and logistics solution, including the provision of parking at healthcare facilities, is always challenging. It requires a professional and strategic approach that considers the needs of patients, visitors and staff and strives to deliver excellence. The BPA shares those aspirations and those of the Health Business Awards. To the parking sector, the advantages of landowners working with a professional management company are obvious.

Asking the right questions to determine the right scheme and equipment is essential if the scheme is to be successful. For example, traffic flows, access and egress, roadway layouts – these amongst others will influence

Parking

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Many people arriving at a hospital will be in a highly traumatised state and at peak times staff can provide a reception service and be made available to direct drivers to the most appropriate parking area the scheme, but perhaps the most important question is how to determine the division of spaces between staff and the public.

Once these and other questions have been answered, the equipment for the scheme should not only be the best on the market in terms of its functionality, flexibility and ease of use, but also take into account reliability and maintenance request responses.

And once the system is in place, there is compliance. Providing parking in a healthcare environment means combining sympathy with strength, compassion with control. In the sensitive area of healthcare parking, it is more appropriate to emphasise the positive, and work through encouragement and prevention, rather than primarily focus on punishment.

Most hospitals would benefit from highly trained staff that can ensure the smooth running of a site and where there is an allied parking and security obligation, professionally‑trained staff in the two

disciplines is going to create advantageous synergies and be more cost effective than two separate teams. With all of the above in mind it is no wonder that so many trusts turn to parking operators for expert advice.

A final thought from CP Plus’s Grahame Rose: “It’s essential to recognise the difference between an operator who will advise on the best scheme and then the best equipment for that scheme, and a manufacturer who is in the business of selling their equipment. Operators have a wealth of knowledge that trusts should tap into.” L

If you would like further details about the work of the BPA’s Healthcare Parking Special Interest Group or how to access the benchmarking survey, please email: dave.s@britishparking.co.uk FURTHER INFORMATION www.britishparking.co.uk

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01895 454 269 uksales@apcoa.com www.apcoa.co.uk

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Diabetes Professional Care

Showcasing diabetes innovation Record-breaking numbers of healthcare professionals, educators and commissioners came together at Diabetes Professional Care 2016 to hear the latest advances in the care, prevention and management of diabetes Diabetes Professional Care, the two-day, CPD accredited conference and exhibition, which took place at London’s Olympia on 16-17 November, offered an expanded show floor featuring leading suppliers, and over 65 hours of educational content from the UK’s major diabetes experts.

Toby Baker, event director at Diabetes Professional Care, commented: “Not only have we been blown away by the success of this year’s show, but the atmosphere has also been fantastic. Visitors have been actively engaging with our exhibitors, creating a real buzz around the latest advances in diabetes care.

“With over four million people estimated to be living with diabetes in the UK, and the rate of diagnosis showing no signs of slowing, it is no wonder that a show like ours is so important. Our content has been designed to educate and inspire healthcare professionals to offer improved care, patient management and treatment.

“Plus, with the full spectrum of healthcare professionals in attendance, from diabetes specialist nurses all the way through to commissioners, we hope that some of the ground-breaking solutions on the show will be rolled out across the UK in the future. Thank you to everyone who supported and attended this year’s show.”

SEVEN CONFERENCE STREAMS The show featured seven CPD accredited conference streams spanning the full diabetes spectrum. The thought-provoking presentations were delivered by an array of high profile figures, all of whom are involved in key initiatives within the healthcare sector.

They included headlining talks from Samantha

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Jones, director of the New Models of Care at NHS England, and Pauline Latham, OBE, MP and chair of the Diabetes Think Tank.

Delivering the show’s first keynote session was Professor Jonathan Valabhji, national clinical director for Obesity & Diabetes at NHS England, and Dr Partha Kar, associate national clinical director for Diabetes at NHS England.

Valabhji began his session with an overview of the NHS’ diabetes prevention programme, highlighting the results of the four key work streams: improving uptake of structured education; improving access to specialist inpatient support; improving access to multi-disciplinary foot teams and improving the achievement of the NICE recommended treatment targets, whilst also driving down variation between CCGs. Kar then took to the stage to explore ‘The Art of the Possible’, concluding his talk by highlighting the innovations that are happening in the field, including the new models of care, digital strategy and raising awareness through new channels, such as social media.

apps, primary care and even comic books. He argued that education should be ‘part of the treatment’ not a ‘bolt on’ or an ‘after thought’.

Patel also encouraged healthcare professionals to find out what educational content is available locally for their patients, so they can give recommendations based on first-hand experience.

Visitor Lis Warren, co-chair of SCLG Patient Experience work stream for NHSE London, commented on the conference sessions she attended: “There have been some brilliant presentations with fantastic speakers who completely capture the audience’s attention. I’ve found it inspiring that there are so many people here on the right wavelength to improve diabetes care.”

Obesity was a eme ing th iven r r u c c o re sg tendee icated t a h t i w o a ded access t ctive forum intera Obesity called ctice in Pra

‘EDUCATION IS PART OF THE TREATMENT’ Dr Mayank Patel, diabetes consultant at the University Hospital Southampton NHS Foundation Trust, discussed education in diabetes, outlining the need for educational opportunities beyond the classroom including

TACKLING OBESITY Obesity was a reoccurring theme at the show. New for 2016, attendees were given access to a dedicated interactive forum called Obesity in Practice. Highlights from this zone included the effects of salt and sugar on the reduction of obesity, the role of the commercial sector in supporting weight management in patients and why the NHS should do more bariatric surgery.

Tam Fry, spokesperson for the National Obesity Forum, expert advisory team member at Action on Sugar and Patron of the Child Growth Foundation, who presented the opening Obesity in Practice session discussed the UK’s obesity crisis.

Over the two-day conference, a series of interactive workshops also took place which closely examined key issues including technology, diet, and patient/HCP relationships She said: “The UK epidemic is suffering from government inaction. The UK has no strategic plan in place to combat either adult or childhood obesity, despite being promised a comprehensive strategy by former Prime Minister David Cameron. I hope that the Obesity in Practice sessions will inform health professionals, whose principal concern is diabetes, of some of the peripheral aspects of obesity of which they were not aware.”

Over the two-day conference, a series of interactive workshops also took place which closely examined key issues including technology, diet, and patient/HCP relationships.

Stephen Clancy, Team Novo Nordisk cyclist, took to the stage for his session where he detailed how active diabetes sufferers can actually be. Clancy commented: “Exercise is the billion-dollar drug that never gets prescribed.”

Diabetes Professional Care also featured a packed exhibition hall with over 60 leading organisations, many of whom were launching new products to the UK market.

Smriti Ranjan, marketing specialist at Nova Biomedical, comments on their exhibiting experience: “It’s been a very interesting show. We released a new product and we’ve received some great feedback so it’s definitely provided the ideal platform for us to speak to people in the industry.”

service in front of so many people and we’ve had some brilliant interaction. The profile of the visitors is perfect because they are so keen to hear the latest advances, which companies like us are providing.” L

Diabetes Professional Care

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Diabetes Professional Care will return on 16-17 November 2017.

FURTHER INFORMATION www.diabetesprofessionalcare.com

THE EDGE The show also demonstrated its commitment to innovation by hosting The Edge – a dedicated space for start-up companies to showcase their new technology-based healthcare solutions. These included Entex Health who presented the Silhouette System, OurPath which shared its digital behavioural change programme, Cook and Count which demonstrated its new health app and AlterAid which exhibited the full extent of its mHealth services.

Jesus Alcober, manager at AlterAid, comments on why his company was so keen to be at the Diabetes Professional Care show: “It is a great opportunity to get our

RISING COSTS REQUIRE COST EFFECTIVE INNOVATION Introducing KEYA® Smart, the first meter that accurately tests glucose and ketones in every strip at no extra cost KEYA® Smart automatically checks for elevated ketones during routine blood glucose testing and provides actionable alerts One Test. One Cost. One Solution.

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

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PSi events are the live version of our magazines and websites. Events range from live challenges, interactive test drive events, awards ceremonies, conferences, seminars and debates. These unique events offer the perfect platform to do business face to face with some of the UK’s biggest spenders.

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HEALTH BUSINESS MAGAZINE | Volume 16.6

MODULAR BUILD

DESIGN AND BUILD

MTX is a leading construction and engineering company in the UK, offering a unique alternative to a traditional construction solution.

Focusing primarily on projects within the healthcare sector, MTX offers bespoke modular buildings constructed offsite, in addition to being involved in the refurbishment and remodelling of existing hospital spaces.

MTX delivers a fast quality service with guaranteed cost and programme certainty.

Applications include, but are not limited to; operating theatres, ward accommodation, plant rooms, mortuaries, clean rooms, outpatients and diagnostics.

The project is completed in an average period of just 18 weeks from date of order, including enabling works and offsite factory construction, to onsite assembly, finishes and commissioning.

The tailored design offers endless flexibility ensuring it meets your exact requirements and can include HTM and HBN

Medite Smartply is the market leading manufacturer of environmentally produced, sustainable timber construction panels. As acknowledged industry pioneers in the fields of MDF and OSB, the award winning brands Medite and Smartply are renowned for delivering the highest quality products, customer led innovation and industry leading customer service.

Medite Smartply products are widely used and specified throughout refurbishment, regeneration and new build projects, due to the company’s sustainable supply chain, innovative, problem solving range and respected technical support. From pre-primed, FSC approved site hoardings to ‘no added formaldehyde’ products ideal for use in museums, galleries, medical and educational facilities, flame retardant OSB and MDF boards for numerous

Innovative construction and engineering services

compliance, a design life of up to 60 years, solid concrete floors and no visible columns allowing for maximum floor usage.

We have completed many successful projects for both the public and private sector, including London North West Healthcare NHS Trust, Central Manchester University Hospital Trust, The Walton Centre NHS Foundation Trust, Betsi Cadwaladr University Health Board and Care UK. To discuss your next modular project please contact MTX via the number listed below.

FURTHER INFORMATION Tel: 0845 130 9639 info@mtx.co.uk www.mtx.co.uk

Sustainable timber construction panels

flooring, roofing and sheathing applications, right through to the world’s only airtight OSB for use in Low Energy construction projects as certified by the Passive House Institute, Medite Smartply has a panel for the most demanding situations.

And just when you thought these applications were pushing the innovation envelope to its limits, how about Medite Tricoya Extreme, a high performance wood panel that offers all the flexibility of MDF, with up to 50 year guarantee when used externally!

FURTHER INFORMATION Tel: 01322 424 900 www.mdfosb.com

MEETINGS & EVENTS

ENERGY & SIGNAGE

Catering for all types of meetings, large or small

UK’s leading commercial sign maintenance service

At the Holiday Inn Leicester, you’re spoiled for choice.

With excellent transport links just a stone’s throw away and state-of-the-art facilities, the hotel boasts a dedicated conference centre that makes the ideal choice for business meetings, training seminars, presentations and more. With nine individual meeting and conference rooms, there is space that’s perfect for individual needs.

Board rooms that are ideal for smaller meetings, along with more expansive spaces allowing you to present to hundreds.

The Leicestershire Suite can comfortably accommodate up to 300 delegates, while many of the other suites can be rearranged to optimise capacity, giving flexible venue solutions for every function. All suites and meeting rooms are equipped with airconditioning and high-speed internet access, along with the latest audio-visual technology to allow for seamless presentations

From signage directing the public around the interior of the premises through to car parking signage, from large scale high level ‘name of premises’ signs right down to nameplates on doors, the medical environment hosts a huge number of signs of every description.

It is a little surprising therefore to discover that it can be difficult to change signage quickly when a need arises; maybe a damaged sign needs replacing, maybe there’s a change of name or a reorganisation of departments, maybe there’s a large requirement for major rebranding.

It is good to know that there is a one stop solution at Cygnia Maintenance Ltd. Cygnia has been providing precisely this service to the retail trade on a national scale throughout the UK since 1995, and for years have supplied an all-embracing

and pitches. The Conference centre has its own private lobby at ground floor level, along with a separate breakout area so there is room for delegates to stretch their legs and disperse between sessions. When using the Holiday Inn Leicester you will get access to premium facilities and the latest technologies and have access to a dedicated hospitality team and Meetings Host to ensure everything goes off without a hitch.

FURTHER INFORMATION Tel: 871 942 9094 www.hileicesterhotel.co.uk

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

signage maintenance and repair service within that demanding environment, where no job is too small, no major refit too big. Taking your lead from that retail world will ensure you tap in to the best service available.

Cygnia is the UK’s largest provider of sign maintenance and repair services, its network of directly employed maintenance teams throughout the country mean that your service is from a local hub regardless of where you are based.

FURTHER INFORMATION Tel: 01843 862944 sales@cygnia maintenance.com www.cygniamaintenance.com

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Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PROCUREMENT

PROCUREMENT

Celtrino has been serving the e-business needs of the healthcare, retail and foodservices sectors for over 27 years and has been involved in PEPPOL since its inception.

PEPPOL is a pan-European initiative designed to make it easier for suppliers to do business electronically with European Public Sector bodies.

Celtrino is one of the founding members of the OpenPEPPOL association, set up in 2012 to promote the PEPPOL standard.

Suppliers and buyers connect via a PEPPOL Access Point provider and Celtrino became the first Irish access point provider in 2012, currently processing over 100,000 e-invoices in the Irish healthcare sector for providers and suppliers.

When PEPPOL is in use across all NHS trusts – as has been mandated – it should provide a powerful example of cost saving

Invinet, an experienced and Certified PEPPOL Access Point provider since 2012 is rollingout its B2BRouter.net eBusiness portal to the UK Market, targeting SMEs which are looking for a simple and affordable solution to become PEPPOL compliant for the NHS procurement program.

With B2BRouter, suppliers can reach all of their NHS buyers through one single PEPPOL Access Point connection, creating and sending PEPPOL invoices easily, by entering invoice details into a simple web-portal template.

The B2BRouter portal sends auto-email notifications when PEPPOL orders are received and provides a facility to flip orders into invoices, ready to send

PEPPOL: the future of NHS A simple and affordable eProcurement is here solution for NHS suppliers

potential to the rest of UK Public sector. Public sector suppliers will also make significant savings as they will only have to support one NHS-wide common format instead of hundreds of file formats as they do currently.

Celtrino’s extensive experience in helping businesses trade electronically combined with an in depth knowledge of, and experience with, PEPPOL will provide a head start to all suppliers adopting this standard.

For more information about Celtrino, visit the website.

FURTHER INFORMATION Tel: +353 1 873 9900 www.celtrino.com

HEALTHCARE IT

ASBESTOS

ReStart Consulting Ltd is a specialist in providing Interoperability and Integration services to the healthcare sector. With over 10 years’ experience and 65 plus NHS customers, ReStart is the market leader for delivering innovative integration solutions for complex healthcare challenges through its comprehensive skills in Trust Integration Engine (TIE) agnostic consultancy, implementation, data migration and 24/7 Support and monitoring for all major TIE environments. The company believes in open standards and has extensive experience with HL7, FHIR and IHE. ReStart has also developed Viper360®, a second-generation interoperability solution for integrating health and social care. Built on open technology, Viper360® is completely

Rilmac Insulation has been a specialist in all insulation services for 60 years.

Originally founded in Lincoln the company also operates from its offices in London, Huddersfield, Northampton, and Bradford.

With six decades of experience Rilmac Insulation is ideally suited to undertake any insulation project. From ductwork insulation, to insulating boiler rooms, to specialist insulation for laboratories, it can provide the solution to any insulation challenge. This has included various projects across several hospitals, each successfully met with enthusiasm and professionalism. Rilmac Insulation is able to provide a full professional commercial and industrial insulation service.

In addition to Rilmac Insulation’s long experience with high quality insulation for heating and ventilation ductwork, it also

Innovative integration for healthcare challenges

80

integration platform-agnostic, enabling organisations to create a building-block approach to achieving true integrated care. By aggregating and providing a realtime view of patient information from underlying source system(s), Viper360® can create a virtual patient record from across a single hospital site or multiple organisations within any care setting(s). Unlike first-generation and traditional portals, Viper360® does not have to rely on data repositories, therefore reducing implementation timelines for a faster, and more cost effective deployment permitting benefits optimisation of agreed budgets and resources whilst ensuring better patient outcomes and treatment at the point of care.

FURTHER INFORMATION www.restartconsulting.com

HEALTH BUSINESS MAGAZINE | Volume 16.6

out at the touch of a button.

All activity can be monitored through the portal and invoices, orders and other documents can be downloaded in PDF or other formats, for internal use.

Clients can expand their use of the portal to include non-NHS buyers or suppliers, as multiple formats are supported - or they can upgrade at any time, if volumes increase, to send or receive electronic files directly to and from their ERP systems supported by Invinet’s excellent team of integration experts.

For more information, please visit the b2brouter website.

FURTHER INFORMATION info@b2brouter.net www.b2brouter.net

Insulation and removal of absbestos services

has a deep working knowledge of acoustic insulation, which makes the company highly suited to working in hospitals, and across the healthcare sector.

One testimonial from Birmingham NHS said: “My thanks for a job well done at West Health - High Standard.”

Wherever insulation is required Rilmac has the experience, know-how and resources to achieve the right results, and within budget. Rilmac Insulation & Asbestos Services is part of the Rilmac Group of Companies, which also offers full scaffolding and steel fabrication services.

FURTHER INFORMATION Tel: 0800 612 9002 enquiries@rilmac.co.uk www.rilmac.co.uk/ rilmac-healthcare-services

ENERGY

ENERGY

Greenwood Utility Management Limited is a multi-utility management consultancy for all sizes, from single domestic dwellings to commercial construction sites. Greenwood Utility Management Limited management service allows clients to take a step back when it comes to arranging their utilities, from new connections to disconnections the company can cater for all of your utility requirements.

Having worked with a number of property developers and construction companies they understand the challenges that arise to ensure all utilities are installed to meet required deadlines. The streamlined process that Greenwood Utility Management offer, allows you to have an untroubled yet relaxed utility experience.

Once you start to use Greenwood Utility Management you will have your own account manager who will take care of you from

Cetronic Power Solutions is an ISO9001 accredited company and provides engineering solutions to electrical power problems. The Cetronic name has been synonymous with solving electrical power problems since 1966 and offers a range of products and services aimed at a variety of industries including: data/telcom; security; process control; automation; commercial; and industrial.

The advantage of using Cetronic is that the company offers a wide range of power quality solutions and services. Therefore, it can assist in selecting the most appropriate and cost effective solution worldwide.

Cetronic prides itself on supplying products, services and support; all designed to give its customers the optimum solution for business continuity, power protection and uninterrupted power. The company’s pro-active ideas and understanding of this competitive market has enabled it

Catering for every kind of utility requirement

quotation to completion. It’s also possible to have on site meetings with your account manager so that everyone involved understands the job in hand.

What the company’s clients have said: “The process works, and this becomes simply achievable.”

It also offers smart metering solutions for efficiency taking care of both gas and electricity.

If you would like to obtain a free quotation, you can contact Greenwood Utility Management using the details below.

FURTHER INFORMATION Tel: 0333 358 3603 www.greenwoodutility management.com

Cetronic – uninterruptible power supply units

SECURITY

SECURITY

Controlling access to hospitals or establishments within the health sector is essential to allow staff to easily move around specific areas including sterile environments such as operating theatres and laboratories.

Nortech offers hands-free access control solutions which are both secure yet user-friendly.

This benefits maintenance staff, porters, ambulance drivers, nurses, doctors and surgeons.

It can restrict access to areas containing dangerous equipment or medicines and grant access to areas where escorting patients in wheelchairs/beds or carrying sterile equipment is important.

Nedap’s uPASS Access UHF readers’ offer hands-free building access opening doors at a distance of up to two metres whereas their uPASS Reach readers offers long-range vehicle identification opening barriers to authorised vehicles at up to four

exactly where blood products are, exactly where they’ve been and exactly who they’ve gone to, so it is critical that staff are equipped with technology that allows them to access this information in a timely manner.

With a view to become asset-free in the next 3-5 years, NHSBT recently underwent a large scale transformational project to move away from their legacy infrastructure and begin transitioning services into the cloud.

To support this, SCC, Europe’s largest independent IT solutions provider, teamed up with HP Inc. to design and execute a solution to refresh their desktop estate and provide futureproof technology to support desktop modernisation.

NHSBT employees can now connect to SCC’s secure cloud network to remotely access their desktop applications

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

to become the supplier of choice.

Cetronic’s product range includes uninterruptible power supplies (UPS Systems), AC/ DC secure power systems, generators, transformers and harmonic solutions, in fact, anything to do with electrical power quality issues.

Offering associated services such as power surveys for monitoring load profile, harmonics or disturbances, other services include battery installation/ replacement, maintenance and repair of systems.

FURTHER INFORMATION Tel: 01920 871077 sales@cetronicpower.com www.cetronicpower.com

Driving digital change with Providers of hands-free security and access control NHS Blood and Transport At any given time, NHSBT to the healthcare sector employees need visibility of

metres without the need for the driver to present a card or badge.

When combined together you create a total hands-free environment, allowing secure but traceable freedom of movement from your staff car park right through to a ward or an operating theatre.

There is no doubt that Nortech’s hands-free access control systems can improve the running of a hospital establishment, call or visit the website for more details.

FURTHER INFORMATION Tel: 01633 485533 www.nortechcontrol.com

from any device. This increased business mobility aims to improve efficiencies across the infrastructure.

The whole project is funded using SCC’s Flex Start finance scheme, simplifying billing and improving cash flow.

Following a successful hardware rollout, SCC provides ongoing managed services, with teams of HP accredited device experts on hand to provide maintenance to all NHSBT sites across the UK and 24x7 support from SCC’s award winning customer service centre.

FURTHER INFORMATION Tel: 0121 766 7000 www.scc.com

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Advertisers Index

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PATIENT SAFETY

MEETINGS & EVENTS

Clarity Informatics’ high reputation is based on: saving patients’ lives; improving clinical quality of care and treatment; excellence in knowledge-based solutions; making doctors lives easier; expert software development; and facilitating sharing and collaboration in Primary Care.

The company has a number of products and services on offer, including: GPTeamNet - a webbased sharing and compliance platform for GP practices and practice groups; The Appraisal Toolkit - the most widely used on-line resource for doctors and nurses in the UK for their license to practice needs; Quality Improvement Service – a comprehensive programme delivering improved clinical quality of hospital care, proven to save lives and save money; Drug Ontology - an unparalleled drug information resource, containing the names, doses, indications, side effects and interactions of

At the Holiday Inn Leicester, you’re spoiled for choice.

With excellent transport links just a stone’s throw away and state-of-the-art facilities, the hotel boasts a dedicated conference centre that makes the ideal choice for business meetings, training seminars, presentations and more. With nine individual meeting and conference rooms, there is space that’s perfect for individual needs.

Board rooms that are ideal for smaller meetings, along with more expansive spaces allowing you to present to hundreds.

The Leicestershire Suite can comfortably accommodate up to 300 delegates, while many of the other suites can be rearranged to optimise capacity, giving flexible venue solutions for every function. All suites and meeting rooms are equipped with airconditioning and high-speed internet access, along with the latest audio-visual technology to allow for seamless presentations

Clarity Informatics: Saving Catering for all types of money and saving lives meetings, large or small

all western medications; and Prodigy - the best and most up-to-date evidence-based information and guidance for healthcare professionals working in primary and first-contact care around the world. Trusted by the UK government for over 20 years.

Clarity Informatics employs 40 highly skilled experts in the following disciplines; medicine, analytics, informatics, software architecture and development.

It works predominantly in the UK and has a widening footprint in the English speaking world.

To learn more, contact Terry Phillips via the details below.

FURTHER INFORMATION Tel: 0191 287 5825 terry.phillips@clarity.co.uk www.clarity.co.uk

and pitches. The Conference centre has its own private lobby at ground floor level, along with a separate breakout area so there is room for delegates to stretch their legs and disperse between sessions. When using the Holiday Inn Leicester you will get access to premium facilities and the latest technologies and have access to a dedicated hospitality team and Meetings Host to ensure everything goes off without a hitch.

FURTHER INFORMATION Tel: 871 942 9094 www.hileicesterhotel.co.uk

ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service

AGFA Healthcare UK 4, 20 APCOA Parking 75 Advanced Computer Software 61 Aerogen 66 Apira 32 Assistive Partner 38, 39 Ballyclare 64 Bandera 48 Bosse Interspice 12 Bradshaw Electric Vehicles 75 Brother 30 CCUBE Solutions 42, 43 CFH Docmail 16 CSP 22 Celtrino 80 Cetronic Power 81 Clarity Informatics 69 Costco 78

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HEALTH BUSINESS MAGAZINE | Volume 16.6

Cygnia Maintenance 79 Datix 68 Evac Chair International 46 Fairtrade Vending 64 Fiat IFC Gratnells 18 Greenwood Utility 81 Holiday Inn 79 Hospedia 24 IBX Group 52 ISS Medicean 8 ITIM 57 Inside Biometrics 77 Interact Medical 70 Invinet Systems 80 Kentec Electronics 48 Kwick Screen Electronics 72 Liaison 54

MTX Contracts 79 MYSUPPLY APS 58 Medite Smartply 79 Netedi 79 Nortech Control 81 OPEX Corporation 38 Procare 48 RILMAC 80 Restart Consulting 80 S.A.T.A Applicazione 59 SCC International 81 SEAT OBC Safety Technology 64 Sterling Safety 64 Transalis 60 Wolters Kluwer 28, 29 Wyatt International 10 Yeoman Shield 6 Your Socks On 39

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