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Patient Centred Care Platform

VOLUME 17.2 www.healthbusinessuk.net

MENTAL HEALTH

HEALTHCARE IT

SUSTAINABILITY

DATA SECURITY

KEEPING PATIENT INFORMATION SECURE

Recent breaches have thrown data security into the spotlight. So how can the NHS keep its records safe?

INFECTION PREVENTION

IMPLEMENTING INFECTION-FREE ENVIRONMENTS All future hospital plans must outline how the environment will maintain cleanliness and keep the NHS infection-free

PLUS: CATERING | FACILITIES MANAGEMENT | HEALTH+CARE | HOSPITAL INNOVATIONS


HEALTH BUSINESS MAGAZINE ISSUE 17.2 Patient Centred Care Platform

VOLUME 17.2 www.healthbusinessuk.net

MENTAL HEALTH

HEALTHCARE IT

Comment

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The timely return of health policy on the campaign trail

SUSTAINABILITY

DATA SECURITY

KEEPING PATIENT INFORMATION SECURE Recent breaches have thrown data security into the spotlight. So how can the NHS keep its records safe?

INFECTION PREVENTION

IMPLEMENTING INFECTION-FREE ENVIRONMENTS All future hospital plans must outline how the environment will maintain cleanliness and keep the NHS ingection-free

Prime Minister Theresa May’s surprising decision to spring a snap election for the 8 June is likely to see future plans for health and the NHS hold much weight in swaying the electorate How each of the UK’s political parties plan to handle leaving the EU will dominate much of the campaigning. However, as an Ipsos/Mori survey in January showed, the UK electorate consider the state of the NHS to be of higher concern than the UK’s departure from the EU, with 49 per cent highlighting it as the biggest issue facing Britain, compared with 41 per cent.

PLUS: CATERING | FACILITIES MANAGEMENT | HEALTH+CARE | HOSPITAL INNOVATIONS

Health has long been a key priority of Labour and the Liberal Democrats on the general election campaign trail. Shadow Health Secretary Jon Ashworth has argued that the recent winter pressures and A&E delays have made public concern over the NHS higher than two years ago, while the Liberal Democrats health spokesperson Norman Lamb has emphasised the merits of a collaborative effort to chart the future of the NHS.

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Jeremy Hunt has long defended his record as Health Secretary, arguing the successes of Conservative health policy on a near weekly basis. Having just pledged money in the Spring Budget for social care, it remains to be seen whether any new policies appear on their agenda, or whether more defensive play will be the tactic of the day. Either way, health policy will maintain its large influence in the campaigning of the next few weeks, and rightly so.

Michael Lyons, editor

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CONTENTS

07 NEWS

NHS England strategy for improved care published; Scotland approves HIV prevention drug; and NHS sustainability under threat

12 HB TOP 10

At the start of the year, Theresa May promised to ‘transform the way we deal with mental health problems right across society’. Health Business documents a Top 10 list of mental health trusts which have been working particularly hard to improve the services they provide to mentally ill patients

19 DATA SECURITY

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In light of recent NHS data breaches, Steve Mellings, founder of the Asset Disposal & Information Security Alliance, looks at the importance of data protection and the EU General Data Protection Regulation

25 SUSTAINABILITY

Jerome Baddley, of the Sustainable Development Unit, writes about the opportunities for sustainable procurement to save money, help the environment and boost local communities and economies

33 51

29 FACILITIES MANAGEMENT

Thousands of premature deaths could be avoided and millions of pounds in running costs saved if ventilation and air conditioning systems were properly maintained. Giuseppe Borgese of the Building Engineering Services Association explains why

33 INFECTION PREVENTION

Ahead of the Infection Prevention conference later this year, Dr Neil Wigglesworth, president of the Infection Prevention Society, outlines the importance of safe infection prevention measures when implementing hospital and healthcare design plans

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39 WORKFORCE INTEGRATION

Skills for Health’s Ian Wheeler maps out the workforce development needed to make integrated care a success, whereby both health and social care services are delivered in a seamless fashion, shaped around the needs of the patient

43 RECRUITMENT 87

Neal Suchak, policy advisor at the Recruitment & Employment Confederation, analyses the workforce problems in the health and social care system, and the vital role that agency staff provide in ensuring patient safety

47 PROCUREMENT

In February, the NHS Supply Chain launched its new surgical instruments framework, outlining the body’s strong commitment to ethical procurement. Health Business has spoken to Stephanie Gibney, ethical and sustainability manager at NHS Supply Chain, about transparent dealing in healthcare

Health Business

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51 HEALTHCARE IT

Health Business revisits a recent article from the Nuffield Trust, which explores the use of digital tools and how they are beginning to have an impact on the ability of patients to look after themselves

56 HOSPITAL INNOVATIONS Taking place at London’s Olympia on the 25-26 April, the conference and exhibition at Hospital Innovations will address the key issues currently facing the NHS. Health Business previews the event

61 HEALTH+CARE

Taking place on 28-29 June 2017, Health+Care represents Europe’s largest integrated health and social care event, building relationships between commissioners, providers and suppliers. Health Business investigates the main talking points leading up to the show, mainly concerning STPs, which feature heavily in the show’s Keynote Theatre

71 UK E-HEALTH WEEK

Returning to London’s Olympia for the third year, UK e-Health Week is devoted to the people and organisations that use the power of IT to transform health and care. Health Business analyses May’s show

75 SECURITY

James Kelly, of the British Security Industry Association, discusses how CCTV systems can provide an effective deterrent to would be criminals and help to protect staff, patients and visitors

80 IFSEC INTERNATIONAL From small businesses to the biggest corporate brands, no one is safe from cyber crime. However, hospitals have become a particularly attractive target for hackers – and ransomware appears to be the weapon of choice. Carina Nobrega investigates the situation

83 SIGNAGE

When analysing health and safety in hospitals, the use and location of signs is of paramount importance, says Mark Hughes of the Health and Social Care group at the Institution of Occupational Safety and Health, who reports on the correct use of signage in hospitals

87 CATERING

For the first time the Campaign for Better Hospital Food has undertaken an in-depth report into the current state of hospital food in NHS England, using London as a test case for the rest of the country. Here, we report on their findings

91 CONFERENCES & EVENTS Using guidance from the Meetings Industry Association, Health Business looks at the benefits of an accredited venue when organising healthcare meetings

www.healthbusinessuk.net Volume 17.2 | HEALTH BUSINESS MAGAZINE

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FIVE YEAR FORWARD VIEW

News

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NHS England publishes strategy for improved care NHS England has published new plans, two-and-a-half years on from the publication of the NHS Five Year Forward View, spelling out what has been achieved and the changes which will take place across the health service. The plan involves measures for: improved cancer care aimed at saving an extra 5,000 lives a year through new one-stop testing centres, screening programmes and state of the art radiotherapy machines; and boosting mental health services by increasing beds for children and young people to cut out of area care, more beds for new mothers and more mental health professionals in the community and hospitals to prevent crisis admissions. The proposed improvements also involve better access to GP services with everyone benefiting from extended opening in the evenings and weekends, newly designated ‘Urgent Treatment Centres’ and an enhanced 111 service to ease pressure on A&Es; better care for older people by bringing together services provided by GPs, hospitals,

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therapists, nurses and care staff, cutting emergency admissions and time spent in hospitals; and driving efficiency and tackling waste to make money invested in the NHS go further in delivering the services and staff that patients want, including the latest treatments and technology. Launching the plan, Simon Stevens , NHS England chief executive, said: “Heading into our 70th year, public support for the NHS is as strong as ever but so too are the pressures on our frontline staff. Today we chart a course for practical care improvements for the next few years. We

do not underestimate the challenges but, get these right, and patients, staff and the tax-paying public will notice the benefits.” “The document outlines significant progress made over the last three years, including record high cancer survival rates, 8,000 extra doctors and nurses, the first ever waiting time standards for mental health treatment being introduced and met, and cutting waste – in particular agency staffing bills. It also, however, frankly sets out where progress has not been as quick, with rising pressure on A&E and acute wards partly caused by delayed transfers of care.”

HIV DRUG

Scotland approves HIV prevention drug Scotland has become the first of the UK nations to approve the provision of PrEP (Pre Exposure Prophylaxis) by the NHS to prevent HIV. The Scottish Medicines Consortium (SMC) has announced that PrEP, the HIV prevention drug, has been deemed a cost-effective treatment to prevent the transmission of HIV and will be made available on the NHS in Scotland. While the anti-retroviral drug is already

licensed for use by people diagnosed with HIV in Scotland, the new ruling means the drug can now by used as a preventative basis by people who do not already have the virus. The drug is consumed once per day and has been found to reduce the risk of HIV infection by 86 per cent. Each prescription costs £450 per month. READ MORE: tinyurl.com/mqbfkkt

NHS SERVICES

Long-term sustainability of NHS under threat The Select Committee on the Long-term Sustainability of the NHS has published a report criticising the ‘short sightedness’ of successive governments for failing to plan effectively for the long-term future of the health service and adult social care. Lord Patel, chairman of the committee, warned that the Department of Health was failing to think beyond the next few years at both a political and official level. The report outlined a lack of long-term strategic planning in the NHS and blamed politicians for implementing short-term fixes as opposed to long-term solutions. Patel recommended the creation of a new body that is ‘independent of government and is able to identify clearly the healthcare

needs of a changing and ageing population and the staffing and funding the NHS will require to meet those needs’. The proposed Office for Health and Care Sustainability should be a trusted, independent voice that will need to look ahead and plan for 15-20 years into the future. Patel said: ”We also need to recognise the NHS will need more money. NHS spending will need to rise at least as fast as GDP for 10 years after 2020. One area where more spending will be required is on pay for lower paid staff. We are in an increasingly competitive international market for health professionals and a decade of pay constraint in the NHS has damaged morale and made it difficult

to train and recruit the staff we need. “We have heard much about the need to integrate health and social care and we think the best way to do that is make the Department of Health responsible for both health and adult social care budgets. We also think it is time to look at the way care is delivered. This may well involve changing the model where GPs are self-employed small businesses. Delivering health care fit for the 21st century requires improvement in primary care to relieve pressure on hospitals. That change should be delivered by GPs.” READ MORE: tinyurl.com/knfoto8

Volume 17.2 | HEALTH BUSINESS MAGAZINE

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News

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A&E SERVICES

STROKE TREATMENT

Number of ambulances turned away from A&E doubles

NHS England approves stroke treatment NHS England has approved a ‘game‑changing’ new stroke treatment, called a mechanical thrombectomy, meaning that 8,000 patients are set to benefit from the revolutionary procedure annually, when it is rolled out to specialist clinics across the country. A mechanical thrombectomy involves inserting small piece of wire mesh into a blood vessel, usually in the groin area, and travels through arteries to the brain, where it is used to dislodge and remove the blockage. Trials of the procedure have shown that if a patient undergoes the procedure within six hours of symptoms beginning to show, survival rates and quality of life are dramatically improved. The treatment will now be introduced at all 24 neurology centres in England, having previously only been available at a limited number of hospitals across the country.

Juliet Bouverie, chief executive at the Stroke Association, said: “Thrombectomy is a real game changer which can save lives and reduce the chances of someone being severely disabled after a stroke. Stroke is the fourth biggest killer in the UK, and a leading cause of disability. Current treatment options are limited and do not always work. “This decision by NHS England could give thousands of critically ill stroke patients an increased chance of making a better recovery. It could mean more stroke survivors living independently in their own homes, returning to work and taking control of their lives again as a result. And this will undoubtedly lower NHS and social care costs for stroke.” READ MORE:

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CANCER RATES

Childhood cancer incidence rises globally by 13 per cent According to a study by the International Agency for Research on Cancer (IARC), published in Lancet Oncology, childhood cancers have risen across the globe by 13 per cent over 20 years. Currently, the rate of cancer in children is comparatively rare. Occurrences of childhood cancer are usually by something in the child’s genetic makeup than by anything to do with lifestyle or the environment. The researchers maintain that part of the reason for the rise is thought likely to be better detection. The IARC said the numbers recorded in cancer registries around the world have gone up since the 1980s. Between 2001-2010, there were 140 children in every million who were diagnosed with cancer under the age of 14,

which represents a 13 per cent increase. IARC cited that there were 185 adolescents in every million diagnosed with cancer, most commonly lymphomas, which are cancers of the white blood cells. Christopher Wild, IARC’s director, explained: “Cancer is a significant cause of death in children and adolescents, in spite of its relatively rare occurrence before the age of 20 years. This extensive new set of information on the pattern and incidence of cancer in young people is vital to raise awareness and to better understand and combat this neglected area of health early in life.” READ MORE:

tinyurl.com/mcgbgr7

The Royal College of Paramedics (RCP) has warned the number of times hospital A&E units in England have had to close their doors to ambulances has almost doubled this winter compared with the previous three. It cited new research from the Nuffield Trust health think-tank which warned that the extra time paramedics are having to spend on the road as a result is a factor in the service’s inability to meet its targets for urgent requests for an ambulance. The report, Winter Insight 3: The Ambulance Service, indicated that in the last five years, the number of category A calls (the most serious) resulting in an ambulance arriving at the scene of an incident has increased by 7.4 per cent year on year (from 2.5 million in 2011/12 to 3.3 million in 2015/16) – whereas over the same period there has been an average annual increase of 2.1 per cent in the number of emergency admissions to hospital, and a 1.6 per cent average annual increase in the number of attendances at A&E. As a result, in a new analysis of ambulance trusts’ performance against targets, the report revealed the three main urgent response time targets have been met in only six out of the last 49 months, and none have been met since May 2015. The most recent figures published, covering January this year, show that just 67 per cent of ‘Red 1’ calls for ambulances (which include those for cardiac arrest patients who are not breathing and do not have a pulse), and only 58 per cent of Red 2 calls (which are serious, but less immediately time-critical), received a response within eight minutes – significantly off the target of 75 per cent. The report sheds new light on the reasons ambulance trusts are finding it so difficult to meet these response times. Although organisations such as the National Audit Office have provided extensive evidence of the long waits ambulances face before being able to hand over their patients at A&E departments, there has been little focus to date on what is often the ultimate outcome of these delays – the decision by a hospital in ‘exceptional circumstances’ to implement a ‘divert’ from its A&E, when ambulance trusts are instructed to take patients to other hospitals instead. The analysis showed that while these diverts were implemented an average of 249 times over the three winters 2013/14, 2014/15 and 2015/16, 478 were instigated over the same period this winter, a virtual doubling.  The data revealed five hospital trusts accounted for over half of all the 478 diverts reported this winter – four in the North of England commissioning region (Pennine Acute Hospitals, Northumbria Healthcare, County Durham and Darlington, South Tyneside), and one in the Midlands (Worcestershire Acute Hospitals). READ MORE:

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News

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MENTAL HEALTH

11,000 mental health patients not receiving follow-ups Figures released by Mind have shown that one in ten people (11,000) discharged from mental health hospitals after being admitted in crisis are not getting a follow-up within a week of leaving. The data was collected via Freedom of Information (FoI) requests, which were sent

to all 56 mental health trusts in England (54 trusts responded) asking for information about how quickly people are followed up after being discharged from hospital. A follow up appointment, which usually involves a face-to-face visit or a phone call, provides continued contact and ensures that the right ongoing support is in place. National Institute for Health and Clinical Excellence (NICE) guidelines currently state that all patients should be followed up within seven days because people are at high risk of post-discharge suicide in the first week. However, there is growing recognition of the urgent need for timelier follow-up as a

key suicide prevention measure, with the National Confidential Inquiry into Suicide and Homicide showing of all patients who died in the first week after discharge, the highest number occurred on day three. The study also included a survey of over 850 people which showed that those who weren’t followed up appropriately were twice as likely to attempt suicide and a third more likely to harm themselves compared to respondents who said they were followed up within seven days of being discharged. READ MORE: tinyurl.com/mvdj9tk

INSPECTIONS

Hospitals placed in special measures Kettering General Hospital NHS Foundation Trust has been placed in special measures after the Care Quality Commission (CQC) found services at the hospital were inadequate and safety ‘not a sufficient priority’. In a statement, Professor Sir Mike Richards, CQC’s chief inspector of hospitals, said: “One of the reasons we rated the trust as Inadequate for being well-led and safe was because risks to patients were not always identified and when they were identified, there was a lack of adequate management

of these. In addition, there was a lack of learning from incidents to prevent patient harm. This was particularly the case in the emergency department, outpatients and services for children and young people.” Additionally, the Isle of Wight NHS Trust is set to be put into special measures after the CQC found a ‘deterioration in safety and quality’, highlighting low staff morale, unsafe mental health wards and ‘out of touch’ management in a leaked document reported by the BBC.

Among the key findings staff were found to have breached regulations with staff failing to report incidents. The draft document also highlighted that patients’ dignity was not protected, with male and female patients having to share the same bathrooms, and it found that in some cases, staff had not sought patients’ consent for treatment or examination. READ MORE: tinyurl.com/mcllj3d

STAFF SAFETY

Two thirds of GPs experience abuse from patients The Primary Concerns report, from Pulse, has highlighted that rising numbers of GPs have experienced some form of verbal, written or physical abuse from patients in the past 12 months. The research involved surveying almost 2,000 primary care workers, including 600 GPs, and found that 66 per cent

have experienced abuse – a rise of seven percentage points from the year before. Figures indicated around four per cent of GPs experienced physical violence from patients in the past 12 months, compared to two per cent the previous year. In the same time period, 61 per cent of GPs reported having experienced verbal abuse – an

increase from 55 per cent the year before. Finally, 24 per cent of GPs received written abuse, up from 17 per cent in 2015. Across all primary care workers, the numbers experiencing abuse were reported as: verbal – 64 per cent (up from 54 per cent); physical – six per cent (unchanged); and written – 24 per cent (up from12 per cent). The report said: “Physical abuse from patients was rated as having no effect on morale, whereas verbal abuse from patients seemingly had a greater impact. While this only had a moderate effect on GPs, it was rated more highly by practice managers – the professional group most likely to receive this form of abuse.” READ MORE: tinyurl.com/mrom637

Volume 17.2 | HEALTH BUSINESS MAGAZINE

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HB Top 10

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MENTAL HEALTH

HB Top 10: measuring mental health successes At the start of the year, Theresa May promised to ‘transform the way we deal with mental health problems right across society’. Ahead of Mental Health Awareness Week, taking place 8-14 May, Health Business looks to document a top 10 list of mental health trusts which have been working particularly hard to improve the services they provide to mentally ill patients

Northumberland, Tyne and Wear NHS Foundation Trust Taking first place is Northumberland, Tyne and Wear NHS Foundation Trust, one of the largest mental health and disability trusts in England, serving a population of approximately 1.4 million. The trust launched ‘Respond’, a training scheme aimed at transforming professional responses to mental health crisis through better collaboration and knowledge. Participants in the training were presented with videos of real-life situations, in a safe environment with constant input and support from a mental health professional, police officer, paramedic, psychiatric doctor, A&E crisis nurse and, most notably, an expert by experience. Viral Kantaria, project manager for NHS England’s urgent & emergency mental health care programme, said: “Respond is clearly an impressive, innovative way that professionals from different sectors – health, social care, policing and more – can come together to better understand one another’s roles, responsibilities and skills. I can see great potential in this approach if it is supported by professional bodies – it appears quite easily replicable if tailored to other local areas.” The trust also piloted Street Triage, whereby a mental health nurse worked alongside a dedicated police officer to provide better care to individuals struggling with mental health issues. Implementation of the specialist team was found to more than halve the number of police detentions under the Mental Health Act, suggesting a potential annual savings of £1 million if the measure was put in place by large trusts.

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CQC rating: Outstanding East London NHS Foundation Trust Following close behind in second place, is East London NHS Foundation Trust (ELFT), with an East London

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population of 750,000. The trust has set in motion a number of initiatives targeted at offering outstanding mental health services. Impressively, ELFT produced a short film with White Boat TV (WBTV) called Teenage Misadventure, aimed at transforming attitudes to self-harm among health professionals and comes as figures show a 68 per cent increase in children and young people being admitted for self-harming. Commenting on the film, Dr Navina Evans, chief executive of ELFT, said: “This film explores some of misconceptions around self-harm that young people face. People who self-harm do so privately and fear of stigma and judgement can deter people from getting the help that they need. We will use this film to provide our staff and local partners with the skills, knowledge and support to ensure that every young person who self‑harms is treated with dignity and respect.” The trust also won the Royal College of Psychiatrists’ Award for Team of the Year for staff involved in the Newham Front Door scheme, a specialist psychiatric team at the Newham Child and Family Consultation Service. The service was credited for successfully co-developed quality improvement ideas with patients, carers and stakeholders including the production of a library of self-help resources and a telephone triage system. Waiting times for clinic based services

reduced from 11 weeks to nine weeks with 45 per cent of referrals seen within five weeks for assessment.

CQC rating: Outstanding Oxford Health NHS Foundation Trust In third place, is Oxford Health NHS Foundation Trust (OHFT), which provides physical, mental health and social care for people of all ages across Oxfordshire, Buckinghamshire, Swindon, Wiltshire, Bath and North East Somerset. The trust’s South Region Early Intervention in Psychosis (EIP) team reaches out to young people having their first episode of psychosis, and works intensively with them and their families, offering therapy and support. According to a study by the University of Oxford, the team’s efforts at sharing best practice and training others have resulted in all 16 mental health trusts across the South of England now meeting national targets for treating patients with a first episode of psychosis within 14 days;

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before the team’s intervention, only eight out of 16 trusts were meeting this target. As of October 2016, 83 per cent of patients across the region are now assessed and treated within 14 days of referral, a result that is the best in the country and which far exceeds the national target of 50 per cent. The South Region EIP team has also provided training for over 180 clinicians in the specialist treatment of early psychosis, and 45 per cent of patients treated by Early Intervention in Psychosis services across the South of England are now in employment or education. The team, which was nominated as ‘Best Mental Health Team of the Year’ by the BMJ awards, was found to have saved the NHS £4,031 per year for each person treated. The research estimated that, if the service was rolled out across the country, the NHS would save a tremendous £33.5 million each year.

CQC rating: Good Worcestershire Health and Care NHS Trust Worcestershire Health and Care NHS Trust has made strides in delivering better care to mental health patients, developing a self-help app in-house to help

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HB Top 10

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Mental health success – First place: Northumberland, Tyne and Wear NHS Foundation Trust – CQC rating: Outstanding. Second place: East London NHS Foundation Trust – CQC rating: Outstanding people maintain a good mental wellbeing. ‘Worcestershire Healthy Minds’ was developed by Worcestershire Health and Care NHS Trust’s Communications Team and its Healthy Minds service. It provides tips and techniques to help people self-manage more common mental health problems such as stress, anxiety and low mood and is accessible to all 560,000 people the trust serves. Simona Stokes, clinical lead for Worcestershire Healthy Minds, explained: “In this age where using mobile applications is a way of life, Worcestershire Healthy Minds has developed an app to enable people to get self-help information at their fingertips about managing common mental health difficulties. The app is especially helpful for raising awareness of signs and symptoms of emotional distress and in giving people some

useful tools to start managing their difficulties. The app is also a way to reach out and to engage people with early help when there may be a reluctance to seek professional support.” The trust has also recently launched Reach4Wellbeing, a team targeted specifically at supporting young people who are experiencing anxiety, low mood and self‑harm. The programmes are open to children and young people aged 5-19 years and those over the age of 13 can refer themselves onto a course. The service aims to reduce the stigma of mental health by promoting positive wellbeing in communities and offering short‑term group programmes that will initially focus on anxiety and eventually progress to offer sessions on low mood and self-harm.

CQC rating: Good E

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HB Top 10

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MENTAL HEALTH  Bradford District Care NHS Foundation Trust Boasting a ‘whole person’ approach to caring for patients with mental health needs, Bradford District Care NHS Foundation Trust launched the First Response service, which offers mental health crisis support 24 hours a day, seven days a week to vulnerable people needing urgent crisis support. Prior to the radical redesign of urgent mental health care, patients in Bradford often had to travel a significant distance to receive mental health care at a time when they were in crisis. Following the redesign of services, patients are getting the help they need within their own communities without having to travel long distances. First Response has made a significant difference to the local management of crisis care, in particular for the emergency services. Intervening early and signposting to the right services has reduced demand on the police, ambulance services and A&E department and achieved a significant reduction in people detained under section 136 – which gives police the power to take someone to a place of safety. Debra Gilderdale, director of Operations and Nursing at Bradford District Care NHS Foundation Trust, said: “Our local A&E departments have reported a reduction in waiting times and West Yorkshire Police have reported a 50 per cent reduction in people sectioned under 136, of the mental health act. Officers receive immediate 24 hour access to health professionals, allowing for informed decisions to be made on how best to support people without being placed in custody and ensuring people in crisis get the help they need.”

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CQC rating: Good North West Boroughs Healthcare NHS Foundation Trust North West Boroughs Healthcare NHS Foundation Trust provides treatment for a wide range of physical and mental ill-health issues and learning disabilities in the boroughs of Halton, Knowsley, St Helens, Warrington and Wigan. It recently partnered with Wigan Council to form the Specialist Health and Resilient Environment (SHARE), which gives children and young people specialist support at a time when they have significant mental health concerns such as self-harming or thoughts about taking their own life. As part of the project a dedicated home, which is registered with Ofsted, has been created with bedrooms that allow young people a place to stay for up to 72 hours with staff on hand 24 hours a day to offer support. It also offers them space to go and get advice and a place to talk to staff when they need it. SHARE works with young people aged from 11 to 17 over a period of at least 12 weeks

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HEALTH BUSINESS MAGAZINE | Volume 17.2

including support for their family and access to psychiatry and psychological services. The service is backed up by a team which includes a registered manager, clinical psychologist, advanced mental health practitioners, social workers, key workers and support workers. Ian Stirton-Cook, North West Boroughs Healthcare NHS Foundation Trust’s head of Urgent Response for Wigan, said: “This is an exciting time in the evolution of mental health care in Wigan. SHARE will provide young people with a safe place to go when they are most in need, as well as access to professional support and advice to help them and their families to understand and manage the symptoms they are experiencing. “As Wigan’s mental health provider, we are committed to working with local people to make sure we get the right support, to the right people, at the right time, and in the right place.”

CQC rating: Good Cheshire and Wirral Partnership NHS Foundation Trust Cheshire and Wirral Partnership NHS Foundation Trust (CWP) serves a population of over one million people, within Liverpool, Sefton, Bolton, Warrington, Halton and Trafford. While it received an overall CQC rating of ‘Good’. It has been rated as ‘Outstanding’ for services for people with learning disabilities or autism during an inspection by the Care Quality Commission (CQC). Further to this, the trust has established a working relationship with the local MAPPA (Multi Agency Public Protection Arrangements) framework to improve processes and care pathways for potentially dangerous offenders. The partnership has proven so successful that the trust is now working with MAPPA to develop national guidance as part of its partnership.

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and develop care and support to help potentially dangerous individuals with their mental health issues. We’ve also made staff more aware of how to cater for each individual’s needs and have developed a more robust liaison service for victims.”

CQC rating: Good 2gether NHS Foundation Trust 2gether NHS Foundation Trust provides specialist mental health and learning disability services to serve a combined population of 761,000 people in Gloucestershire and Herefordshire. Last summer the trust celebrated the official opening of the Fritchie Centre, its Research ²gether centre and Managing Memory base. The new centre will be a dedicated base for research, and also to respond to increased demand from those affected by dementia and other long-term mental and physical health conditions. Genevieve Riley, head of Research and Development, Research ²gether, said: “The development of the new Fritchie Centre is an exciting time for research services in ²gether NHS Foundation Trust. For many years, we have had a skilled, dedicated group of clinicians who work on national research studies, as well as developing their own ideas. The Research Centre will give us a fantastic opportunity to expand our clinical trial portfolio and help us work towards our vision of being a worldclass centre of practice-based research. “We want to provide more opportunities for patients and carers to be informed about research they can participate in locally that could make a difference to their lives and the lives of others, and we will be doing this in partnership with Cobalt Health and our primary care colleagues.”

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Brendan O’Hea, Cheshire MAPPA coordinator, explained: “The work between CWP, MAPPA, Cheshire Police and local prisons has meant that Cheshire is ahead of the game nationally. In recent years we have strengthened relationships, removed barriers to communication and improved information sharing so that we can identify risks earlier and act accordingly. “Through partnership working we have been able to improve public safety

CQC rating: Good Berkshire Healthcare NHS Foundation Trust Specialising in community and mental health, Berkshire Healthcare NHS Foundation Trust provides a wide range of services to people of all ages living in Berkshire. The trust has developed a digital dashboard tool so clinicians could make sure people receive the early help they need and to evaluate performance against each National Institute for Health and Care Excellence (NICE) recommended intervention for early intervention in psychosis (EIP). The standard, which came into force on 1 April, requires more than 50 per cent of people experiencing a first episode of psychosis to begin a NICE-recommended package of care within two weeks of referral. That includes: cognitive behavioural therapy for psychosis; family interventions; prescribing antipsychotics, if clinically indicated; education

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HB Top 10

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

and employment support; physical health assessments; wellbeing support; and carer/ family focused education and support. In June and July 2016 the Berkshire service saw 100 per cent of its referrals within the required timeframe, up from 89 in May and 88 per cent in April. NICE interventions are offered to everyone at the outset and the service is working to ensure these are offered at timely intervals throughout the three-year treatment period because patients vary in their readiness to engage with interventions, such as cognitive behavioural therapy for psychosis and Individual Placement and Support (IPS). The dashboard is refreshed each morning, which means up-to-date information is available to discuss during staff meetings attended by the multidisciplinary team who include a pharmacist, psychologists, IPS workers, social workers, occupational therapists, community psychiatric nurses and other care co-ordinators.

CQC rating: Good South London and Maudsley NHS Foundation Trust South London and Maudsley NHS Foundation Trust serves a local population of 1.3 million people across Lambeth, Southwark, Lewisham and Croydon. As well as being rated the top mental health trust for research, South London and Maudsley has formed CUES-Ed, an innovative project that aims to help children to improve their resilience and emotional well-being. CUES-Ed has been developed as a result of direct feedback, gathered over many years from children across the country who use the Maudsley’s Children Adolescent and Mental Health Services (CAMHS.) CUES-Ed’s ‘Who I Am and What I Can: How to Keep My Brain Amazing’ – a psycho‑education package for children, was designed by Maudsley Clinical Psychologists and CBT therapists, and aims to help each child realise their own potential and maximise their learning. The package, consists of six sessions embedded with evidence based CBT practice, delivered to the whole class. Each session is highly interactive and draws on a range of media sources to ensure the active engagement of all the children. The package helps children recognise how they feel, think and behave and teaches them how to talk about this with others. Staff encourage children to notice the signs (cues) when things aren’t right, such as an increase in worry, a change in appetite or sleep patterns and difficulties with friendship groups. Children are taught simple cognitive behavioural ways to cope with life’s ups and downs.

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CQC rating: Good The top 10 list has been collated through examination of CQC ratings and surveys and media reports. L

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work duplication (such as administering multiple lab tests) with an accurate audit trail; and achieve caregiver confidence, with the surety that they’re with the right patient, and, a full view of that patient’s records, caregivers can work, and prescribe, with confidence. ADVANCED MOBILITY Zebra’s mobile devices and Dakota’s healthcare applications simplify workflows and provide a real-time ‘command center’ for patient care in the palm of the hand. With the option to view EHRs at the bedside, update these easily, and accelerate key tasks (e.g. scanning drugs to auto-update a patient’s EHR), your teams spend less time on admin and more with patients. Our advanced mobility solutions include a number of benefits. Improved staff communications is achieved through mobile devices supporting intuitive, secure and instant communication between your teams using voice or instant messages for simple and immediate collaboration. Workflow efficiency is improved with Zebra’s mobile devices and Dakota’s healthcare applications, which provide all the tools your teams need in a single device to standardise processes through simple forms, collaborate with colleagues, and quickly collect data – for example our superior scan engines capture codes first time, every time. Designed for healthcare, Zebra’s enterprisegrade devices boast unmatched durability, security and interoperability, are certified by all leading EHR and tel-coms systems and are impervious to hospital sanitisers. What’s more, they’re comfortable to use for long periods and have features specifically created to support caregivers. For example, our scanners have a vibrate option to confirm data capture. This ensures that wards are not disturbed at night and allows nurses to stay focused on patients without having to look to see if data has been successfully recorded. ACTIONABLE INTELLIGENCE Maintaining the health of your hospital means keeping a finger on its pulse. We help you do this by transforming the data captured at each touch-point into actionable insights that your teams can use to improve workflow accuracy, efficiency and patient care. As everyone can access the right information

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Overview What does the term ‘Asset Retirement’ mean to you? Are you aware of the obligations that your company has when recycling and disposing of IT equipment? Do you know that your company will Asset Retirement is the process of maximising the value of unused or end-of-life assets through Protection and the Waste Electrical and Electronic Equipment (WEEE) Legislation. There is no doubt that Asset Retirement is an ongoing process that spans across multiple – if not all – departments in an organisation and it is

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GDPR

In light of recent NHS data breaches, Steve Mellings, founder of the Asset Disposal & Information Security Alliance, looks at the importance of data protection and the EU General Data Protection Regulation By the end of May next year, a key EU regulation governing data protection will have become part of UK law. The EU General Data Protection Regulation (GDPR) goes far further than existing legislation and comes in a time when technological and cultural attitudes towards data have changed beyond recognition. With both the Secretary of State, Karen Bradley, and Information Commissioner, Elizabeth Denham, confirming that Brexit will not stop the adoption of GDPR we know that this is one final EU Law which we

cannot ignore. So, why is it so significant? It’s been 20 years since the last EU Data Protection law. In that time we have grown to view data, personally and in the business sense, as a commodity. People now post pictures, tweet secrets and trade insults from a wide variety of devices – and in the process, break down the barriers to privacy our physical environment once provided. This release of

control on a personal level has boosted the appetite from businesses to use data in far more aggressive and advantageous ways. The concept of ‘Big Data’ is largely down to the ability of data analytics to take swathes of unstructured information and analyse and use it in ways which might prove useful for the controller. There is a statistic that suggests 90 per cent of all data generated came about in the past three years, so it follows that data protection is more than a passing fad and we’re at the very beginning of what will be a long, drawn-out battle to maximise data usefulness but not at the detriment of our privacy or rights. The starting point was the passing of EU GDPR. And for once the regulators seem to have done a good job, and in quite difficult circumstances when you E

There be shor will pain in t‑term data pr taking on as reso otection, needed urce will be need to , budget will b and moe allocated tivat found ion

Volume 17.2 | HEALTH BUSINESS MAGAZINE

Written by Steve Mellings, Asset Disposal & Information Security Alliance

Why GDPR doesn’t need to spell disaster for NHS data management

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The NHS should take a pragmatic view and look to finally embark on a programme of improvement which results in what we all want – secure, available and accurate information to help our health system  consider the maturity of data protection in terms of the broad EU membership. But it’s a sensible piece of law. It’s more specific than its predecessors, and whilst it continues to not deal in absolutes, it gives many clear guidelines to give us a starting point. Of course, business will only start to take a real interest when cases are brought and penalty notices are served by the regulator. Or, worse, courts begin making awards for victims of non-compliance. Until then, many will undoubtedly pay lip service in terms of improvements, moving tentatively towards compliance. But inaction is not an option. And, unlike many headline makers, I don’t believe the real concern is the published increase in the maximum fine, nor the proliferation of ‘cyber stories’. These are just a smokescreen. More important are the fundamental changes within the regulations that will force businesses to view data protection, not as a bolt on, but as an entire wrap‑around solution. Mandatory Breach Notification, Privacy Impact Assessments, evidence of permissible use from data subjects and the need to have business operations wrapped up in data protection processes ‘privacy by design’ are key themes. All of which cannot be ignored and which cannot be simply

added-on. They need embedding and implementing across all business operations and expanding outside the limitations of a technology remit. After all, a data breach from a badly disposed-of asset or a lost USB stick is not a cyber attack, but a type of data breach resulting from a varied range of possible sources, including human error. APPROACHING DATA PROTECTION So if those operating in data protection or regulatory compliance look to the industry for help then, sadly, the industry will leave them wanting. The volume of FUD (fear uncertainty and doubt) spread so liberally throughout marketing and social media feeds is enormous. If one is to believe some articles, GDPR will spell the end to operational compliance as we know it – the only solution being to spend on seemingly endless technical solutions. The truth in my opinion is a little different. Yes, I agree that in my experience the way organisations approach data protection today is not sufficient to either current laws let alone GDPR. But this doesn’t mean you need to open the chequebook and wildly start spending. There are too many within the information security – and wider data protection – sector who promote compliance (£250 compliance tool kit anyone?) or sell

solutions proclaiming they ‘help you meet your information security needs’, when all they are promoting is one small part of an operational and technical ecosystem which must be fully understood and controlled from within. So, when faced with the question of helping data protection within the NHS, do we shut down and lock the door to show compliance – or take a pragmatic view and look to finally embark on a programme of improvement which results in what we all want – secure, available and accurate information to help our health system? If so, where do we start? Like all improvement programmes, a solid first step must be an acceptance that problems exist and the motivation from all concerned to move from where they are today, to where they want to be. For data protection, this means understanding your current situation, and for the NHS, that doesn’t mean just asking the information governance manager or senior information risk officer. Data protection has a far more varied range of influencing factors than are generally understood – from supply chain management to information security, HR and training and third party management. There are so many contributing factors that it is unsurprising that many organisations prefer to deal with known issues than look beyond to the root cause. In fact, many legal houses are simple advising clients to prepare for breach and invest in incident management and cyber insurance, seemingly in the belief that the problem is unmanageable. WHAT PRECISELY IS THE PROBLEM? I am fortunate enough to be involved in a project called DPG Pathfinder which looks to break down the ‘where are we now’ E

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GDPR  question into smaller more manageable and explicit areas. I helped into my specialist area of data processors and IT asset disposal, an area which the NHS has suffered historically in the past (over £500,000 in fines). But the project as a whole identifies over 70 core business activities and more than 1,300 areas of potential root cause issues. Capturing intelligence relating to all these and enabling businesses to see the critical areas of concern, helps them progress from that difficult first step – because they know where they need to get to and understand how to get there. During this project, I spoke to many practitioners and found a real feeling of being overwhelmed by the enormity of the project. Even seasoned information security professionals were only looking at problems from their own silo and admitted to feeling neither empowered nor motivated to take on more. Further still, risk-owners or heads of cyber were frustrated that, whilst the buck stopped with them, they didn’t feel they had the scope of resource to take on what they saw as an organisation-wide problem. So when we look specifically at the NHS and GDPR, the question of ‘what precisely is the problem’ is perhaps the most pertinent. Even a cursory look at the penalty notices on the ICO website shows that the NHS has a history of dealing with data badly.

But is that any surprise? In an environment where data is one of the most critical assets and needs to be available to be useful, and where the core purpose is health care, then any spend away from providing those front-line services is wasteful, is it not? So, without getting into a political discussion about budgets and resource allocation, it’s clear to see why information governance and cyber is seemingly not viewed as an imperative requirement within the NHS. A recent Sky News freedom of information request showed that the average annual spend on cyber was £23,040. But with North Lincolnshire and Goole NHS Foundation Trust being forced to cancel operations due to malware, the time has surely come when spending in this area cannot be viewed purely as a cost. It must be viewed as an essential strategic spend. BUT WHERE DO YOU SPEND YOUR MEAGRE BUDGET? As outlined, cyber is just one part of data protection and the wider framework needs to be explored to create a solid foundation from which to grow. A data protection ecosystem is constructed of varied and interlinked operational processes which build together to not only deliver on their operational purpose but to help put key building blocks in place to help the overall objective of data protection. A cyber attack due to malware may be due

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to poorly configured hardware, bad user training, lack of investment in intrusion detection or a failure to respond to alerts. All of these can be viewed as standalone issues to be addressed after an investigation but that wouldn’t stop the same issue arising from a different attack vector. If organisations are to stop having to respond to issues in a knee-jerk and reactive way, the best defence is to look at the root cause of the issues and to evoke change in these areas. If the NHS wants to take on data protection then there will be short-term pain as resource will be needed, budget will need to be allocated and motivation found. I discovered during my work on Pathfinder that, once a business starts to fully understand the scope of the problem, the solutions themselves don’t need to cost the earth. Training, new policies, auditing, and vigilance are typically all in-house solutions which can start to shift the balance of power back into the hands of the controllers. Knowing where to focus and where to spend a limited budget is key if management are to view data protection not as an unsurmountable challenge but as a key business function, worthy of investment, strategic in nature and most importantly of all – everyone’s problem. L FURTHER INFORMATION adisa.global

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PROCUREMENT

Jerome Baddley of the Sustainable Development Unit writes about the opportunities for sustainable procurement to save money, help the environment and boost local communities and economies The health sector is facing major challenges with growing demand for services and increased financial pressure. This calls for new approaches and new ways of thinking that combine financial efficiency with improved delivery of health outcomes. In addition public authorities have a legal duty to operate with regard to their environmental, social and economic impacts and should endeavour to improve their performance on all three. Sustainable procurement is one of the ways that the system can support these objectives. Procurement decisions driven by cost savings can often have unintended, unrecorded and unrewarded environmental benefits, such as the associated air pollution reduction benefits of telecare. The reverse is also true; environmentally preferable options can often result in financial savings, such as energy saving measures aiming to reduce an organisation’s carbon footprint frequently results in a reduction in costs. Financial savings can also come from identifying innovative approaches to social, environmental and local economic challenges; such as a community share issue to pay for NHS energy generating technology. Integrating a wider ‘triple bottom line’ view in procurement can benefit or reveal hidden benefits to public health, patients and local communities – ensuring that the

pressure on NHS finances supports high quality care for all, now and in the future. The importance of procurement to the carbon reduction agenda has been well established since the Sustainable Development Unit (SDU) published the first NHS Carbon Reduction Strategy in 2009. The carbon embedded within the goods and services procured by the NHS and wider sector are estimated to be two thirds of the system’s total carbon emissions. This is the largest contribution to the system’s overall footprint, greater than energy use and travel combined. Measuring and reducing the carbon footprint of procured goods and services is one way to demonstrate a more sustainable procurement approach across the system. Indeed the leadership of the NHS locally and nationally in this area is essential. The NHS is one of the largest procurers in the country, spending over £20 billion per year on goods and services. The SDU recently estimated that the health sector could save over £400 million and cut one million tonnes of carbon emissions every year by 2020 through making changes that also benefit people’s health. The Securing Healthy

Returns report identified 35 areas – including some specifically focused on areas of procurement such as theatre kits in hospitals and furniture reuse – and calculated their financial and environmental benefits. The work clearly showed that there does not have to be a compromise between financial, environmental or social sustainability. Early progress has already been made in decarbonising the NHS and wider sector’s supply chain. The sector exceeded its 10 per cent reduction target by 2015. However given the size of the challenge to further reduce emissions by 80 per cent the opportunity for reduction in procurement emissions provides a huge target to aim at. In parallel to the increasing pressure on health sector spending there has been a rapid growth in the size of the UK’s low carbon and environmental goods or ‘Cleantech’ sector. This has been in part driven by the 2008 Climate Change Act, but also by a push for organisations to manage rising utility and natural resource costs. In 2015 the Department for Business Innovation and Skills calculated this sector to be worth over £26 billion; 2.5 times the size of the pharmaceuticals sector. In the UK we already have world class expertise in our low carbon economy to help us address some of the pressing financial and environmental impacts in the health sector supply chain. In saving money for the NHS could we also support job creation in an innovative low carbon and resource efficient healthcare products and services sector?

Written by Jerome Baddley, the Sustainable Development Unit

Tackling carbon emissions through procurement

Sustainability

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Integr a wider ating bottom ‘triple in procu line’ view reveal h rement can id to publ den benefits patient ic health, sa commu nd local nities IDENTIFYING OPPORTUNITIES

Procuring for Carbon Reduction (P4CR) was a programme initiated to address the commitment to reduce emissions. In addition to the various guides and tools, P4CR introduced the Hierarchy of Interventions which forms the backbone of the SDU’s methodology and solutions in lowering the sector’s carbon footprint. Reducing demand offers the most easily demonstrable cost savings as well as environmental/carbon benefits and is where the system has the biggest influence. The most environmentally sustainable solution is to look for opportunities to reduce the E

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PROCUREMENT  need and demand for goods and services. A sustainable procurement approach constantly questions whether procured products are necessary, supports interventions that reduce demand for products or uses them more efficiently ensuring procured products are not wasted. IN-USE EFFICIENCY The system can exert direct control over its resources and carbon emissions by buying products, equipment or services that consume less and have a lower environmental impact throughout their ‘in use’ life and at their disposal and recycling. Additionally, understanding the environmental and social impact of procured goods in more detail can help identify opportunities to improve sustainability. Where appropriate, alternative products, materials or approaches can be used that have less impact on the global environment and are more sustainable. This offers opportunities to work with the market to create carbon efficient alternatives. Improvements in the performance of suppliers and their supply chain can be achieved by setting clear expectations through procurement process, and working closely with suppliers to find solutions that deliver sustainability benefits. Performance on carbon reduction in procurement is improving. The SDU’s Health Check 2016 showed that carbon emissions in relation to procurement have reduced by 16 per cent since 2007. A large part of this is due to pharmaceuticals’ carbon footprint (through both carbon intensity and spend reductions). Attitudes amongst procurement professionals are also shifting. A survey into the state of sustainable procurement implementation published in 2016, concluded that most procurers (88 per cent or respondents) now take sustainability considerations into account, in varying degrees. It also indicated there is strong demand for greater, more visible and accessible support for sustainable procurement. BEYOND CARBON Whilst carbon is a good indicator, it does not fully capture what sustainability is for the health and care system. The SDU’s interests and remit include wider social and ethical issues, such as, for example, managing labour standards in health supply chains. The health and care system has an ethical duty to protect and promote health and well-being. It is important that suppliers of goods and services operate in a socially responsible way. Buying goods or services from suppliers which damage public health through poor environmental practices or promote social inequality through their employment practices is a breach of that duty. Equally the health co-benefits of buying goods or services from providers that take sustainability, staff health and wellbeing and environmental impact seriously will deliver savings and improve health outcomes through linked environmental, social and financial considerations. The products and materials used in delivering health and care are procured from all over the world. An environmentally and socially responsible procurement approach provides an opportunity to enhance health and wellbeing globally as well as in the UK. The recently reviewed Ethical Procurement for Health Workbook offers a mechanism for extending our wider sustainability principles to global supply chains, with benefits not only for the system but also for workers worldwide NEXT STEPS In January 2018 the SDU will publish its 2018 Health Check including a full carbon footprint of the NHS and wider care sector. At that point the scale of the carbon reduction challenge will be updated and the opportunities presented by sustainable procurement will come into clear focus. We are increasingly seeing how partnerships can deliver benefits to heath and care organisations, the public and businesses. By encouraging collaboration with suppliers organisations can draw in private investment in to solving the sustainability challenge we face in the NHS. The NHS and wider health sector in the UK is well regarded around the world for the care it provides and the steps it has taken to address carbon reduction and climate change. If approached with a wide enough lens, the sustainability challenge is a huge

Sustainability

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

business opportunity and an opportunity to save money for the sector, whilst also delivering health benefits, through social and environmental gains, both at home and internationally. CASE STUDIES Royal Liverpool and Broadgreen University Hospitals worked with their supplier of surgical devices – to optimise the way in which theatre packs were supplied and used. In doing so they improved staff efficiency and patient safety whilst reducing waste and carbon. By moving from individually wrapped items to specially designed preprepared packs containing core items for a given procedure, the trust almost halved the set up time per operation, increased consistency and simplified stock management processes. This has saved valuable staff time and improved efficiency. This initiative has also reduced associated packaging waste by 90 per cent (around 2.6 tonnes) helping the trust to reduce its carbon footprint by five tonnes. NHS Supply Chain has recently let a contract for examination and surgical gloves, products with known and documented labour standards risks, using the Labour Standards Assurance System, a risk management tool that relies on early engagement with the supply base, to articulate their expectations to the market and set a robust framework with clear objectives on labour standards for the successful suppliers to adhere to, as part of their contract. This approach did not lead to an increased price; in fact, an impressive £782,000 (or 1.4 per cent) of savings have already been achieved whilst NHS Supply Chain’s procurement team anticipate further price reductions. This is because ethical and labour issues were not ‘bolted on’ but rather they were considered from the outset, as an integral part of the products required and as an expectation of responsible suppliers. L FURTHER INFORMATION www.sduhealth.org.uk

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VENTILATION

Thousands of premature deaths could be avoided and millions of pounds in running costs saved if ventilation and air conditioning systems were properly maintained, according to Giuseppe Borgese of the Building Engineering Services Association More than 25 per cent of all child deaths globally are attributable to unhealthy environments including indoor and outdoor air pollution, according to the World Health Organisation (WHO). Its latest research shows that 1.7 million children under five years of age die every year as a result of the poor state of their living environment with air pollution a major contributor. Infants and pre-schoolers exposed to indoor and outdoor air pollution have an increased risk of pneumonia in childhood, and a lifelong increased risk of chronic respiratory diseases, such as asthma. Exposure to air pollution may also increase their lifelong risk of heart disease, stroke and cancer. Dr Penny Woods, chief executive of the British Lung Foundation, explains that air pollution is now a full-blown ‘public health crisis’. Urban populations across the planet face growing risks from air contamination, which increases the severity of asthma attacks, instances of heart failure and certain cancers. It reduces lung capacity so upsetting the balance of nutrients and oxygen in the blood. OBLIGATIONS There are few more serious issues out there, but cleaning up the air is proving a seemingly intractable political problem and the government has admitted that the UK will remain in breach of its obligations under EU

clean air regulations until at least 2025. The government has also lost two court cases over its plans to tackle the key pollutant nitrogen dioxide (NO2) and has been ordered by the High Court to publish a draft new clean air plan to tackle NO2 by 31 July this year. Sarah Wollaston, chair of the All Party Parliamentary Health Committee says poor air quality is affecting ‘the health of millions of people across the UK because of the impact of invisible particulates and other pollutants’. Reducing air pollution inside and outside buildings and protecting pregnant women from second-hand tobacco smoke can prevent children’s deaths and diseases, according to the WHO, which also estimates there are 360,000 premature deaths in the EU every year as a result of worsening air pollution – around 40,000 of which are in the UK. It also estimates that between 11-14 per cent of children aged five years and older worldwide display asthma symptoms and an estimated 44 per cent of these are related to environmental exposures including air pollution, second-hand tobacco smoke,

Giuseppe Borgese, Chairman, BESA

and indoor mould and dampness. In central London the concentration of diesel and nitrogen dioxide (NO2) is about three times the level recommended by the WHO with Londoners suffering a 20 per cent increase in mortality rates as a result. Therefore, the more alarming pollution becomes outside, the more desirable and valuable it is for buildings to be turned into ‘safe havens’ that protect their occupants from the worst effects. We do, after all, spend up to 90 per cent of our time inside – and by addressing the ventilation solutions available it is possible to create indoor ‘clean air zones’. We are all familiar with the principle of controlling temperature inside buildings to improve comfort and health. When it is too hot or cold outside, people expect to be able to step into comfortable conditions inside. The same principle should apply to air pollution – with people expecting a similar protection from outside conditions. Unfortunately, in many buildings, the opposite is the case with indoor conditions having a very negative impact on human health. At the Building Engineering Services Association (BESA), we are campaigning hard for any legislation covering air pollution, in general, to take account of the importance of indoor air quality (IAQ) alongside the more high profile issue of transport and industrial emissions. This is timely because, to mark the 60th anniversary of the UK’s first Clean Air Act, a powerful coalition of environmental campaigners, health bodies and industry groups is pressing the UK government to update clean air legislation.

Written by Giuseppe Borgese, chairman, Building Engineering Services Association

Calling for greater focus on indoor air quality

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Th more al e pollutio arming outside n becomes , valuabl the more building e it is for s into ‘sa to be turned that profe havens’ tec occupa t their nts

AIR QUALITY AMBITIONS The group, which includes Greenpeace, Friends of the Earth, the Royal College of Physicians, the British Lung Foundation and environmental lawyers ClientEarth, wants the UK to give the UK the most ambitious air quality legislation in Europe. Paul McLaughlin, BESA chief executive, said: “People spend more than 80 per cent of their time indoors and there is still a lot more we can do to improve IAQ. A series E

Volume 17.2 | HEALTH BUSINESS MAGAZINE

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VENTILATION  of low cost, maintenance measures to ensure ventilation systems work properly and incoming air is filtered and cleaned would make a major difference to the health and well-being of building occupants. “Reducing toxic emissions from vehicles and industrial processes is vital, but will take many years to produce results and involve major long-term investment. Improving building ventilation is a quick and relatively painless process that can be tackled today to help protect people in the meantime. Building owners also have a legal duty of care to protect the health of their tenants and employees.” A well-sealed building envelope combined with effective filtration of the air supply can reduce the amount of harmful particles coming in by 78 per cent. Considerable investment has already been made in improving the airtightness of buildings to reduce heat loss and, therefore, energy consumption and that same process can be used to manage air quality, but it requires a clear focus on the effectiveness of ventilation systems. BESA’s own ‘Guide to Good Practice – Internal Cleanliness of Ventilation Systems’ (TR/19) includes step-by-step guidance and references UK and international standards on maintaining ventilation systems to a level essential for good IAQ. Detailed service and maintenance schedules can also be set up by using the association’s widely adopted SFG20 online tool, which includes targeted tasks related to air quality in specific building types. This approach has been saving businesses money in a wide range of sectors for a number of years by optimising maintenance, avoiding over-spend, ensuring efficient running of plant and maintaining compliance. It now includes a HTM (Health Technical Memorandum) module designed specifically for healthcare buildings. This Healthcare Functional Set, developed in collaboration with healthcare professionals, aligns SFG20 with the requirements of the HTMs for hospitals, NHS trusts, dentists, as well as vets and doctors’ surgeries. The new schedules display how often tasks need to be carried out to avoid over or under maintaining assets and what skill set should be used to perform the tasks. This has been shown to save estates managers as much as 20 per cent on their maintenance budgets as well as ensuring buildings perform better in terms of occupant health and productivity.

to building occupants, but also does it in a way that improves the overall efficiency of the ventilation and so significantly cuts running costs. Optimising the way air is supplied to just one operating theatre could save a hospital £5,000 in annual running costs – or £10 million a year if replicated right across the whole of the NHS and would also avoid 80 tonnes of carbon emissions, according to recent estimates. Any ventilation fan that is over five years old is almost certainly inefficient and a replacement would pay for itself in less than three years. Healthcare facilities managers could cut running costs by 29 per cent by replacing the fans in their air handling units and the addition of heat recovery to ventilation systems can reduce costs in non-clinical areas by up to 30 per cent. Even more basic, low cost measures like having grilles and filters cleaned regularly can save thousands of pounds a year.

DYNAMIC ACCESS SFG20 is a dynamic online tool so makes best practice widely available and easy to access. As well as featuring over 500 core maintenance schedules, covering more than 60 equipment types, SFG20 also gives users the opportunity to customise maintenance schedules, including service times, frequency and criticality ratings. SFG20 is also aligned with rapidly emerging digital working methods and is constantly updated to capture evolving service and maintenance techniques. Planned service and maintenance programmes play an increasingly important role in helping facilities managers maintain comfort levels; identify areas requiring improvement; and meet energy efficiency goals. With the NHS spending £8.3 billion on estate costs in 2015, according to the NHS Estates Review carried out by the consultant Arcadis, focusing on building engineering maintenance issues has the potential to make a significant difference to the bottom line of most NHS operations. Brian Dunne, PPM manager at St George’s Hospitals University NHS Foundation Trust says: “SFG20 saves a lot of time that we previously had to spend making contact with equipment manufacturers regarding routine maintenance. SFG20 has simplified the task of setting specifications for our maintenance contractors at the same time as making sure we’re following all correct procedures. I also like the fact it’s speedy, making essential information readily available.” Maintaining good air purity in clinical and general healthcare facilities remains a major priority, but many facilities managers are missing the growing threat from increased outside air pollution. Current NHS technical design guidance is largely focused on managing the risk posed by the transmission of infections from sources inside a building. However, the building engineering services industry has a wide range of solutions to offer including different levels of filtration, but also other (mainly low cost) improvements, such as upgrading fans; servicing air conditioning and simple maintenance that, not only reduces health risks

Reduce R educe tthe he eenergy nergy coonsum consumption sumpt mpt pttio ion in in your yoouur buildings you buiilding llddin ings

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VULNERABLE PATIENTS Persuading NHS trust boards to spend money on remedial measures is not easy because they are fully focused on frontline patient care. However, most of these changes pay for themselves through energy efficiency improvements, but even more importantly; they represent a worthwhile investment in protecting vulnerable patients from the potential impact of external pollution. The whole principle of a ‘safe haven’ is of particular relevance to healthcare facilities housing people with reduced immunity, who are therefore, more vulnerable to the worst effects of airborne pollutants. While critical care areas already achieve high standards of air cleanliness; NHS managers should also consider the significant benefits of putting in place relatively low cost maintenance regimes that can transform general areas around their buildings into internal clean air zones for the benefit of both patients and staff. L FURTHER INFORMATION www.thebesa.com

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Volume 17.2 | HEALTH BUSINESS MAGAZINE

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Infection Prevention

2017

Manchester Central 18th – 20th September 2017

The UK’s premier infection prevention conference is now open for abstract submission and delegate registration.

Julie Storr

Consultant World Health Organisation Infection Prevention Unit

Highlights include:

• UK’s largest infection prevention exhibition • Specialist streams on new to infection prevention, audit and surveillance, international engagement and mental health • Full social programme • Oral presentations and posters • Annual IPS awards ceremony and gala dinner • Ayliffe Lecture to be presented by Professor Sanjay Saint and E.M Cottrell Lecture by Julie Storr • Opportunities to learn from Scott Drawer, Head of Performance Hub at Team Sky and Dr Ruth May, Director of Nursing and National Lead for Infection Prevention and Control for NHS Improvement

Abstract submissions until: 12th June 2017 Early bird price valid until: 3rd July 2017 @IPS_Infection | #IP2017 | #IPS10 Infection Prevention Society

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Infection Prevention for Estates and Facilities One Day Conference Who should attend?

• Facilities managers • Estates managers • Water engineers • Building services managers • Catering managers

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Head of the Infection Prevention and Control Department Mater Dei Hospital, Malta

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DESIGN

Dr Neil Wigglesworth, president of the Infection Prevention Society, outlines the importance of safe infection prevention measures when implementing hospital and healthcare plans The Infection Prevention Society’s vision is that no person is harmed by a preventable infection, and a key part of this is ensuring that any healthcare facility is designed and maintained in a way to support infection prevention. Healthcare associated infections (including those caused by E. coli, C. difficile and MRSA) can present major risks to patient safety and also incur costs to the NHS of at least £1 billion each year. Providing the right environment in all healthcare settings – including hospitals,

clinics, GPs and specialised care centres – is a vital part of minimising the risk of HCAIs and ensuring that healthcare professionals work in a setting that best supports them. INFECTION PREVENTION IN PLANNING To ensure the best healthcare settings, infection prevention and control requirements need to be considered at the very outset of the planning and design stages, and infection prevention teams must be involved, from the start, as an integral part of the design team. Infection prevention measures are not only vital when building new facilities, but also when refurbishments are taking place. Determining whether the building designs will support infection prevention and control will involve ensuring things such as: enough well placed hand hygiene facilities to meet demand; appropriate

Infecti preventon ion measur es are n onl ot buildingy vital when ne but alsow facilities, refurbis when hm are tak ents ing place

storage space; single‑bed rooms with en‑suite facilities, for patient isolation; the right ventilation and airflow systems, especially in specialised facilities such as operating theatres; and facilities for decontamination of reusable medical equipment. The importance of adequate space and air flow in combatting infection was famously articulated by Florence Nightingale, hailed as the founder of modern nursing. In her 1860 work ‘Notes on Nursing’ she highlighted the need to keep patients’ windows open to allow a breeze in. While hospital settings have of course become ever more sophisticated, these principles have stood the test of time, and remain relevant to 21st century healthcare. When it comes to designing the building, there are several straightforward ways to encourage good practices and behaviour. For example: ensuring there are adequate, separate facilities for clean and dirty procedures; providing facilities for cleaning staff to E

Written by Dr Neil Wigglesworth, Infection Prevention Society

Infection prevention measures crucial to healthcare building plans

Infection Prevention

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DESIGN î † store and dispose of cleaning equipment and supplies as well as adequate waste disposal facilities; ensuring that all the surfaces are cleanable and able to withstand disinfectants such as chlorine; and making sure patient rooms, whether single or multiple occupancy, have doors so that they can be isolated from other areas and can be decontaminated with modern technologies such as Vapourised Hydrogen Peroxide (VHP) or Ultra Violet (UV) technology. Protecting existing patients, particularly the most susceptible to infection, from contamination during improvements and renovations is also crucial. Key measures include: using floor-to-ceiling sealed barriers that encompass the work area; sealing windows; moving debris in sealed containers or bags; increasing cleaning in adjacent areas; and, in some cases, temporary air filtration systems may be required. CATERING FOR YOUR NEEDS Once the building is constructed, good standards of basic hygiene, cleaning and regular maintenance will all help prevent healthcare associated infections. It is however important to highlight that there is no one size fits all approach when implementing hospital and healthcare plans. The type of patients and setting you are catering for must be considered, as the needs and requirements will of course vary significantly from a small GP surgery to a vast suite of intensive care units. As is true with much infection prevention and control work, planning is critical to helping establish what the particular needs are in each situation. Doctors and nurses need to feel confident that their surroundings support them in delivering high quality patient care. By involving infection prevention teams in all planning and design, and adhering to key infection guidance and measures, we can ensure our healthcare settings are best equipped to prevent infection. L

The Infection Prevention Society represents around 2,000 members working in the field of infection prevention and control, and plays a key role in helping to protect the public. Its vision is that no person is harmed by a preventable infection. FURTHER INFORMATION www.ips.uk.net

IPS Annual Conference Infection Prevention 2017 will be taking place on 18-20 September 2017 at Manchester Central. This is a special conference as the Infection Prevention Society becomes 10 years old in June, and will be formally celebrating the occasion at IP2017 by including presentations from the most experienced and influential IPS leaders, its past presidents, who will share insights and intelligence as to where infection prevention priorities will take us next.

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INFECTION PREVENTION

ARE MOBILE DEVICES A SOURCE OF INFECTIOUS ORGANISMS? The worldwide issue of increasing antibiotic resistance is presenting healthcare professionals with significant challenges In less than 100 years the development and use of antibiotics, a massive benefit to human health is creating an array of highly resistant organisms against which we currently have no effective treatment. The impact upon human health may be devastating and the direct financial costs to both healthcare organisations and government are significant. In Europe, healthcare acquired infections (HAI) cause 16 million extra-days of hospital stay, 37,000 attributable deaths, and contribute to an additional 110,000 every year. The world health organisation (WHO) estimates 1:3 surgical patients contract a surgical site infection, 40 per cent of them being methicillin resistant Staph aureus (MRSA), reducing this is critical to the antimicrobial resistance agenda. The annual financial losses are estimated at approximately Euro 7 billion of direct costs. In the United Kingdom every case of hospital acquired MRSA is said to cost the NHS £8,000 and overall the cost of HAIs to the NHS is around £900 million per annum. In 2001 Carbapenem resistant enterobacteriaceae (CRE) were deemed the ‘nightmare bacteria’ an ‘urgent threat’ to human health by the Centre for Disease Control. That year in the United States reports of CRE infection were made to CDC from only 1 US state, in 2016 it was found in 48. Concerns have been raised that CRE may disseminate in foods and eventually contaminate fresh retail meat products and genes that confer resistance to colistin and carbapenem have been found in several farmyard bacteria. Now there have been reports that one in four supermarket bought chickens have been shown to contain highly resistant strains of E coli. It’s not just an issue for healthcare establishments. THE PATIENT ENVIRONMENT One area of concern within the mix of key infection control challenges facing healthcare staff is contamination of surfaces and devices. Organisms such as MRSA, clostridium difficile (CDI) and vancomycin resistant enterococci (VRE) are capable of surviving for many days to months in the patient environment. The use of mobile devices such as phones, personal digital assistants (PDA) and tablet

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HEALTH BUSINESS MAGAZINE | Volume 17.2

PCs is increasing rapidly in healthcare. Several software systems that enable clinical staff to collect vital signs, link with data from pathology or radiology, providing huge benefits to patient safety and clinical efficacy, are driving their uptake. For many years hospitals have embraced use of antibacterial PC keyboards and mice because of potential cross infection risks. Some studies have shown MRSA isolates on keyboards to have the same antibiotic resistance patterns and DNA identity as patients with clinical infections in the same ward. The new keyboards, mobile devices that

are used every day also similarly carry pathogens on their surfaces and in your pocket. Protective cases that are not designed for the task can conceal pathogens and could exacerbate this problem. These devices as well as stethoscopes, pressure cuffs, gloves and keyboards are frequently colonised with bacteria. The common contamination is skin flora such as Staph epidermidis, but significant contamination of MRSA/MSSA, E Coli, Pseudomonas, Klebsiella and other antibiotic resistant strains have been frequently reported on up to 95 per cent of mobile devices tested. Smartphones seem to show greater levels


of contamination than conventional phones. Both the London School of Tropical Medicine & Hygiene and University of Surrey have reported bacterial contamination of smart phones with a variety of skin, environmental and faecal organisms. Up to 82 per cent of disposable gloves have been shown to be contaminated with pathogens, 59 per cent the patient’s infectious organism, 64 per cent were not changed between patients. Reducing unnecessary use of gloves and proper hand hygiene are key programs to help reduce hospital cross-infection being driven by the WHO and infection prevention specialists worldwide. Hand hygiene is not just about touching the patient! An NHS healthcare care assistant recently told me about a isolated and barrier nursed patient with confirmed CRE, she then explained how the same PDA used to record routine patient observations is taken in and out of the side room and normal ward without it being cleaned. Cleaning mobile equipment with iso-propyl alcohol, bleach, hydrogen peroxides and peracetic acid is not recommended by electronic mobile equipment manufacturers and will certainly invalidate equipment warranties. The manufacturer of the world’s leading tablet PC simply recommends using a lightly moist microfibre cloth only.

Decontamination with healthcare approved disinfectant wipes may only be a temporary measure, until next handled and may also damage the equipment, connectors or electronics. Wouldn’t it be better if a permanent ‘always-on’ approach were available as the first line of defence? SILVER Bacteria moulds and fungi have a weakness; silver. Hippocrates first described its antimicrobial properties in 400 BC and it has been used to fight infection for thousands of years. The privileged believed that eating from a silver spoon protected them from harm hence the saying ‘born with a silver spoon in your mouth’. Many patients report the benefits of using colloidal silver to treat recurrent bladder or fungal infections without having to use antibiotics. Dissolved silver ions attack bacterial cells in three main ways: it makes the cell membrane more permeable; it interferes with the cell’s metabolism, leading to the overproduction of toxic oxygen compounds. Silver also interferes with bacterial DNA preventing replication. These mechanisms have the potential to make today’s antibiotics more effective against resistant bacteria. Many antibiotics are thought to kill their targets by producing reactive oxygen compounds, James Collins and his team (Boston USA) showed that when boosted with a small amount of silver these drugs could kill between 10 and 1,000 times as many bacteria. The increase in membrane permeability also allows more antibiotics to enter the bacterial cells. Silver has also been shown to have effects against viruses and fungi; it may destroy norovirus on fabrics and kills aspergillum, candida and other potentially harmful moulds. A WHOLE SYSTEM APPROACH We need a whole system approach to combat microbial contamination that Includes innate forms of control using appropriate agents that are not subject to genetic resistance mechanisms that are rapidly transferred between bacteria. Silver may be used in healthcare to help provide overall microbial contamination in the patient environment, for example in surface coverings, fabrics and equipment. Products specifically designed for and incorporating antimicrobial materials are

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another part of the overall strategy for combating surface contamination and HAI in healthcare. Such products provide a 24/7/365 ‘always-on’ first line of defence to enhance other infection control measures. When incorporated correctly into products designed for the task harmful bacteria on their surfaces are destroyed or inactivated in minutes. Tough-PAC® are cases and docking systems specifically designed for healthcare use for iPad and iPod mobile devices. Tough-PAC® incorporates silver-ion antimicrobial technology shown to actively kill more than 99.9 per cent of MRSA and 99.6 per cent EColi contaminants in the ISO22196 standard, so reducing the risk of device borne cross infection in hospitals when using these mobile computers. CASE STUDY The Walton Centre NHS Trust was no different to any other hospital in the need to use devices with an anti-microbial case in clinical areas, adding to this the importance of durability, safety and security of a product. “Tough-PAC® was the obvious choice, allowing for a much safer, cost-effective and environment friendly transition towards a paperless department”, said Katie Lawrence, lead nurse for POCU. The latest iPod Tough-PAC® product is allowing us to explore further options in the use of smaller hand-held devices and could fit well for our nurses completing regular observations at patient bedside, said Nasser Shaikh, EPR Programme Manager. “We have had no breakages of an iPad casing in three years, which is exemplary as they look like a clinical device.”

About the author: Keith Smith qualified as a Chartered biomedical scientist and Fellow of the Institute of Biomedical Science. He holds Masters degrees in Immunology for Disease Control and in Business Administration. He has worked extensively in clinical pathology, research & development and eHealth for over 38 years. Keith now is Managing Director of Inner-Vision Technology Ltd. L FURTHER INFORMATION innervisiontechnology.com

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ADMISSIONS

REDUCING EMERGENCY ADMISSIONS BY 32 PER CENT Aerogen technology reduces Emergency Department admissions by 32 per cent when compared to a standard jet nebuliser.1 Data recently released reinforced Aerogen’s credentials as global leaders in high performance aerosol drug delivery The results from this study showed a 32 per cent1 reduction in the admission of patients to hospital from the emergency department when treated with their vibrating mesh technology compared to traditional jet nebulisers. The same research also showed 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 also confirmed a significant reduction in median length of stay of 37 minutes.1 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.” Lead investigator and study author Robert Dunne, vice chair of Emergency Medicine at St. John Medical Centre, Detroit, added: “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.”

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STUDY SHOWCASES IMPROVED PATIENT OUTCOMES A new clinical efficacy study by Royal College of Surgeons in Ireland (RCSI) provides further proof that treatment by Aerogen Ultra enhances patient outcomes.2 When comparing a single standard bronchodilator dose delivered by the Aerogen Ultra versus an SVN, there was a significant improvement in FVC and an improved patient symptom score. The Aerogen Ultra improves lung response which has been associated in other studies with enhanced exacerbation recovery.3 ABOUT AEROGEN Aerogen 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.  Aerogen’s innovative products, such as the Aerogen® Solo and Aerogen® Ultra, significantly improve aerosol drug delivery resulting in better patient care throughout the Hospital. Founded in Galway, Ireland in 1997, Aerogen has grown to become the global leader in high performance aerosol drug delivery and has partnered its technology with the leading mechanical ventilation companies.  Aerogen technology is used by millions of patients and caregivers in over 75 countries worldwide and, it has partnered

its technology with world leading companies including Philips Healthcare, GE Healthcare, Covidien, Maquet, Drager, Hamilton and ResMed. Aerogen, which employs over 100 people in Ireland, has reported 30 per cent business growth year on year for the past eight years, surpassing annual growth targets. Having invested over 40 million in creating a breakthrough high performance nebuliser and setting a new standard of aerosol drug delivery in critical care, Aerogen products are now supplied to over 75 countries and have benefitted over four and a half million patients worldwide to date. L Dunne R et al. Aerosol dose matters in the Emergency Department: A comparison of impact of bronchodilator administration with two nebulizer systems. Poster at the American Association for Respiratory Care. 2016 2 Cushen B, Alsaid A, Abdulkareem A and Costello RW. A Pilot Study To Assess Bronchodilator Response During An Acute Exacerbation Of COPD Using A Vibrating Mesh Nebuliser Versus Jet Nebuliser For Bronchodilator Delivery. ITS poster presentation. 2016 3 Cushen B, McCormack N, Hennigan K, Sulaiman I, Costello RW and Deering B. A pilot study to monitor changes in spirometry and lung volume, following an exacerbation of Chronic Obstructive Pulmonary Disease (COPD), as part of a supported discharge program. Respiratory medicine. 2016;119:55-62. 1

FURTHER INFORMATION info@aerogen.com www.aerogen.com


INTEGRATION

Integrated care describes the shift away from traditional top-down, command-and-control healthcare to a future where both health and social care services are delivered in a seamless fashion, shaped around the needs of the patient. Ian Wheeler, from Skills for Health, looks at the workforce development needed to make this fundamental shift a success Policy makers and workforce planners have over the last few decades been rightly imploring the sector to develop their workforces differently to deal with the demands of a diverse and ageing population. This population will present with co-morbidities which will require the combined involvement of a complex mixture of organisation. The health and social care sectors need to make significant changes and work in greater parallel in order to effectively meet the needs of patients, and the workforce who care for them. This shift will turn the traditional model of healthcare provision on its head, reshaping the way health and social services are provided. Sustainable Transformations Programs (STPs) are currently being developed in 44 different areas across England and are a significant next step in the attempt to integrate the health and social care

workforces. Each area will likely have its own individual concerns and as a result, there is not likely to be a ‘one‑size‑fits‑all’ approach. Workforce development solutions will need to be developed within each locality, tailored towards their community’s needs and priorities. Skills for Health has worked with a number of health providers across the UK and internationally, helping them develop their workforces to be prepared for the coming changes. We recently published a working paper, Integration and the Development of the Workforce to provide healthcare organisations with insight and

guidance on how their workforce needs to adapt to support successful integration. This paper is the third in Skills for Health’s series of research papers on the health sector workforce, Our Health Heroes in Focus. Based on this expertise, here are what we believe are the five most important themes for organisations to consider to make integration a success.

Written by Ian Wheeler, Skills for Health

Development and the integrated workforce

Workforce

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

GET YOUR PRINCIPLES RIGHT Three principles underpin successful integration. The first is the centrality of the patient and placing the patient’s individual circumstances and requirements at the centre of care provision. Second is the adoption of a population-centred approach. Different localities need to consider their health needs E

Integra will req tion organis uire go deep ations to e mixes t r into skills might h han they av in the pe done ast

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TECHNOLOGY

EMBRACING THE NEXT GENERATION OF MEDICAL TECHNOLOGY The advancement and implementation of digital technology has led to a profound shift in the delivery and alignment of medical care across the country. ECA looks at the growth of medical IT, their place in the market, and the options soon to be available Forward-thinking clinical leaders along with digitally-driven opportunities are helping to turn an analogue infrastructure into a truly paperless and digitally viable reality. Challenges filter down from the national stage to local communities, with trusts, hospitals and clinics each facing different obstacles in the provision of patient care. Digital technology is key to bringing these elements together, turning the industry’s biggest challenge into one of its biggest opportunities for growth. POWERED BY INNOVATION ECA supports this momentous transformation by leading innovation within the new worlds of healthcare IT, telemedicine, clinical mobility and surgical intelligence; providing the core enabling technologies that help to drive first class patient care and treatment success. They work closely with a network of industry leaders to bring together one of the largest and most technologically diverse portfolios on the market, from point-of-care terminals and medically graded accessories to mobile medical carts and flexible mounting options. From their well-equipped configuration and test centre in the Thames Valley technology corridor and with decades of combined experience in the field, they have the scope to integrate, customise and deploy a range of fully realised solutions that can support a variety of medical specialities. ADVANTECH’S UK PREMIER PARTNER As one of the world’s leading medical technology providers, Advantech offers a comprehensive range of healthcare solutions including infotainment terminals, medical monitors and mobile tablets. With a partnership of almost 15 years, ECA has since grown into Advantech’s largest outlet in the UK, integrating the most up-to-date technologies into bespoke solutions designed to exceed expectations in every regard. Advantech is soon to be launching the latest in their line of point-of-care terminals. These EN60601-1 certified systems run on the latest sixth generation processors and are designed

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with fanless, high-performance profiles, ideal for both cart and arm mountings. HEALTHCARE IT WITH DELL EMC OEM As a Gold Partner for Dell EMC OEM, ECA has had the opportunity to integrate projects with their state-of-the-art medical technology. From labs and clinics to ORs and bedsides, they understand the ever-changing trends within healthcare IT. With hardware powered by Dell EMC OEM, ECA can help turn project requirements into patient focussed applications that are uniquely designed to address the needs of medical professionals. FLEXIBLE CART SOLUTIONS FROM RAFI Easy to use, clean, maintain and assemble; the elegantly designed range of medical carts and platforms from RAFI are a perfect fit for hospital environments. With both free-moving and powered options, these incredible solutions are all medically certified and future-proofed to meet the developing demands of the healthcare sector. The R’Care Light 4, for example, has been closely developed and designed around the very specific needs of medical personnel. Its wide star base and ultralight frame make the Light 4 a stable and safe workstation, whilst its sleek and simple lines ensure it can be cleaned efficiently and with ease. With variable sit-to-stand adjustment, the Light 4 is a strong and versatile platform, perfect for a range of medical tasks and projects.

FIRST CLASS SOLUTIONS FROM AMICO Amico is a truly unique innovator within the medical sector with a range of equipment mounting options. From the Hummingbird workstation and its state‑of‑the-art induction technology to the Falcon mount and its dual adjustable arms, Amico’s mounting options perfectly complement a range of solutions including point-of-care terminals, tablets, equipment trays and storage bins. A DIGITAL FUTURE The Five Year Forward View is helping to establish the vital role that technology can play in the delivery of healthcare. As experienced specialists, ECA has had the opportunity to support this shift with projects for several NHS trusts and private healthcare facilities across the UK. They’re committed to supporting this initiative with bespoke medical solutions that are designed to complement patient care across all areas of healthcare operations. The adoption of medical technology and changes to processes / protocols hasn’t always been easy, however, a truly technologically‑powered health service that can adapt and change to the demands of tomorrow is something that the country truly needs. L FURTHER INFORMATION +44 (0)118 929 4990 sales@ecauk.com www.ecauk.com


INTEGRATION

Workforce

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 of their own unique population, and the institutions available to provide the care required. The third emphasising the wellness agenda: focusing on how people can sustain and improve their physical and mental health, rather than on the treatment of sickness. ENGAGE YOUR WORKFORCE The health sector is often characterised as being ‘risk averse’ and ‘change resistant’. One of the most compelling findings of our research is the need to shift the mindsets of those working in the sector, in order to effect change. The sector may well already have the skills it needs to provide excellent integrated are, but individuals may have to work in substantially different ways to employ them effectively. There are several ways to help change mindsets, including: building relationships beyond traditional boundaries, such as encouraging people to experience work in other institutions; adopting ‘growth’ mindsets, such as helping individuals step out of their comfort zones and engage with the idea of new ways of working; developing knowledge and understanding of other roles and organisations; and achieving parity of esteem between health and social care, as well as ‘registered’ and ‘non –registered’ roles. STIMULATE DEMAND FOR HIGH QUALITY SUPPORT ROLES Our research indicates that the sector’s productivity may have been inhibited by its failure to recognise the contribution of the support workforce, and to develop and utilise high quality support roles. Rather than attempting one off, large-scale changes, organisations must take regular opportunities to think about functions and skills mixes across both front-line and support staff, and look at what they can do to help the whole workforce. Integration will require organisations to go deeper into skills mixes than they might have done in the past. They must identify the services they need to deliver, both now and in the future, and then explore how they can use the skills of their whole workforce to deliver these outcomes. TRAIN AND DEVELOP Successful integration will not happen overnight: development must be ongoing in order to introduce such a fundamental shift smoothly. Areas that will need to be regularly considered and reviewed include: the development of management and leadership; the refocusing of health professionals and general practitioners; the continual development of generic skills; and strategic and technical skills, to exploit technological innovation. PLAN AND PLAN AGAIN The most effective workforce plans are ones that are open to ongoing review

System-wide planning is needed for health and social care providers to come together. The most effective workforce plans are ones that are open to ongoing review and redevelopment and redevelopment. System-wide planning is needed for health and social care providers to come together. It will require structured debate with a wide range of stakeholders, including the professionals working within the sector currently and those that live and work in the community being served. Their views will need to be sought regularly and their feedback absorbed into future plans. Planning must also be undertaken across geographies, organisations, teams and on an individual level. For instance, individual organisations can develop their own organisational plans while referring to overarching regional or national strategies. Individual or team level planning can then refer back to organisational-level plans. There are a range of useful methods that can assist those wishing to develop their workforce plans. The Six Steps methodology is a useful means by which communities can structure their discussions about the workforce development. Scenario application sessions can also help structure conversations about the possible future shape for health and social care systems.

TAKING THE LONG VIEW One of the most common frustrations of the workforce planning cycle is that it does not always fit in with government initiatives and demands. As a result, some are deterred from taking the long view, but when it comes to integration this is precisely what is needed. Looking to and planning for the future, and being willing to revise plans flexibly as required, empowers those working in the sectors: helping make sure they are prepared for the challenges ahead and ready to do the best job that they can. This will no doubt impact upon those the sector cares for; giving them the confidence that the care they need will be there for them, whenever they should need it. Introducing an effective, patient-centred, integrated workforce will have an enormous impact on the future of all of our health. Successful integration is a marathon and not a sprint, and the workforce truly is the most important resource the sector has to take it across the finish line. L FURTHER INFORMATION www.skillsforhealth.org.uk

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Renaissance Personnel Ltd was founded fourteen years ago after careful analysis of the spiralling demands of medical, nursing, health and social care personnel in the UK. We recognised that the demand for suberb quality temporary workers in these sectors often outweighs supply. We saw the opportunity to create fresh perceptions of the “Agency Staff” by attracting, training and retaining competent personnel contrary to the usual negative beliefs. Our consistent, proactive management of the changing needs and dynamics within our Industry has accelerated our steady growth time and time again. That is exactly why we are able to supply the best nurses, doctors and homecare workers to a various clientele. Our helpful Recruitment Consultants are always willing and able to answer any questions you may have about our services. You can reach us on 0844 848 1411 or 0796601992 anytime.

Here are some of our achievements • Sunday Times Best Small Companies to work For List 2011 (in the top 100) • Best Companies’ Three Star Accreditation- an Exceptional Company to work for (2010) • AEAwards 2014 (Small Company of the Year Award)

www.renaissancepersonnel.co.uk


WORKFORCE

Neal Suchak, policy advisor at the Recruitment & Employment Confederation, analyses the workforce problems in the health and social care system, and the vital role that agency staff provide in ensuring patient safety It will not come as a great shock to most people that the NHS is suffering a crisis. Years of underfunding, inefficiency and poor workforce planning have resulted in a system that is no longer able to cope with the demands placed on it. Previous governments failed to predict the health needs of an ageing population and the necessity to build up a social care system that is fit for such a large number of older people. The problem is not going to go away. It is estimated that there will be 51 per cent more people aged 65 and over in England in 2030 compared to 2010, and 101 per cent more people will be aged 85 and over in 2030 compared to 2010. With these huge and increasing demands, it is highly likely that the NHS and the wider social care sector is going to require significantly more staff. And yet, there are currently around 24,000 unfilled nursing jobs in England and it is expected that one in three nurses will retire in the next decade. The current government now has a problem: does it focus on short-term solutions – for instance by throwing money at the problem - or does it take a longer term view, and plan for the next generation? The answer is probably going to have to be both. Indeed,

the Chancellor announced in the Spring Budget that an additional £2 billion of funding will be provided over the next three years for social care. The extra injection of cash has been widely welcomed, but we don’t really know how this money will be spent. There doesn’t appear to be any co‑ordinated plan for how we will deliver health and social care. The heart of the problem lies with poor workforce planning; but just as the Department of Health was starting to get to grips with this, Brexit has thrown a spanner in the works. BREXIT The latest data from the Health and Social Care Information Centre (June 2016) reveals that there are 1.16 million staff employed in the NHS in England, of which 57,608 are from a European Union member state, and 71,510 from non-EU member states, collectively accounting for around 11 per cent of all staff. The NHS relies upon European workers to provide a safe world-class

service, and a similar picture is found in social care. Latest figures indicate that in the NHS, there are 13,307 Irish workers, 7,451 Polish, 7,199 Spanish, 6,325 Portuguese, 5,299 Italian and 2,992 Romanian. Parliament is taking this seriously and the Commons Health Select Committee is currently examining the impact of Brexit on the health and social care workforce. If the health and social care system is to survive, it will be essential that the government gives the green light for EU nationals working in the NHS to remain. Having said that, the problems appear to have already started. Data from the Nursing and Midwifery Council show that the number of new nurses from Europe has dropped to a quarter of previous levels. In each month from September to December in 2015, an average of 797 EU nurses signed up to work in the NHS. This fell to 194 a month over the same period last year. Figures also show E

If th govern e is comm ment deliveri itted to seven-d ng a true it is goi ay NHS, then ng be on t to have to he s agencieide of s

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Written by Neal Suchak, policy advisor, Recruitment & Employment Confederation

Workforce planning: the key to patient safety

Recruitment

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WORKFORCE  that 2,700 EU nurses already working in the UK left the NMC register last year. WORKFORCE PROBLEMS The latest data from our monthly publication Report on Jobs (April 2017) reveals the strongest increases in demand for temporary/ contact workers is in the nursing/medical/care sector. Demand for permanent staff has also been consistently high. Now that government has decided to scrap bursaries for student nurses and midwives, there is no obvious solution to solving the workforce crisis. George Osborne, who was then Chancellor of the Exchequer, said replacing bursaries with loans would free up £800 million a year to create more jobs in the sector by 2020, and that the new arrangement would allow for an extra 10,000 training places. The number of applications to UK nursing degree courses actually fell by 23 per cent this year. We have recently learnt from a HSJ investigation that almost every NHS acute hospital in England is failing to meet its own nurse staffing targets. Despite attempts to recruit and train up more nurses, 96 per cent of NHS trusts failed to meet their own planned level for registered nurses working during the day in October 2016. And the problem is by no means limited to nurses; we are consistently seeing a lack of doctors on wards at all levels. The NHS employs more than 150,000 doctors – a quarter more than it did ten years ago. But even that has not been sufficient, as vacancy rates are running at close to 10 per cent. Despite the fact that currently a quarter of our doctors come from overseas, Health Secretary Jeremy Hunt has said that he plans for the NHS to be ‘self-sufficient in doctors’ and less reliant on overseas recruitment. He has already announced a 25 per cent increase in the number of funded medical student places; which will be made available from September 2018. However, simply replacing overseas doctors with UK-trained ones, won’t increase the total number working in the NHS and help meet the predicted increase in demand. We have also recently heard that Health Education England expects at least 2,000 extra nursing associate trainees to start in 2018. However, it takes many years to train up new doctors and nurses, and we will have to wait and see what the future impact will be on the system. Furthermore, we can’t afford to wait for these new clinicians to be ready – we need the extra staff now.

caps on agency spending last April and July. One of the intentions of the price caps was to encourage staff to return to substantive positions within the NHS, either in permanent employment or via bank shifts. Our latest research in partnership with the National Institute of Economic and Social Research (NIESR) suggests that there has been no noticeable, widespread increase in temp to perm transitions during the last year. Our research reveals that disillusionment with permanent employment in the public sector is the main driver pushing health professionals into agency work. The research found that agency staff have skills on a par with substantive staff, with many years’ experience working in the NHS; and that a better work-life balance, the ability to pick and choose when they worked, and escaping stress, bureaucracy and office politics, are factors in their decision to go into agency work. Workers reported that the flexibility that temporary work allowed them was a much bigger incentive than pay. Current rules around agency spending in the NHS seem to only address the symptoms, not the problem. What they fail to do is tackle the underlining workforce retention issues. Agency doctors and nurses can’t be a scapegoat for the NHS’s workforce problems; they accounted for only 0.8 per cent of the total NHS employment in 2015. Whilst the media picks up on isolated stories of doctors being paid £1,500 for a shift, this is by no means typical – and is in fact rare. Following pressure from the REC and the Royal College of Nursing, NHS Improvement has recently decided to pause the introduction of a new rule that would have prevented substantive staff from taking up additional agency work. The new measures were designed to encourage staff to take up

Recruitment

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additional shifts via banks. However, our research found that substantive NHS staff are deterred from signing up to internal banks due to unreliable communication, old-fashioned payment procedures, poor management, and a lack of professionalism in comparison to specialist agencies. A recent REC survey of 199 healthcare recruitment businesses found that in 48 per cent of agencies, more than half of the temporary nurses, doctors, and allied health professionals on their books are also employed substantively in the NHS. Had this new ‘ban’ been implemented, seventy-seven per cent of healthcare recruiters said they expect the candidates on their books to prioritise finding work in the private sector rather than the NHS, and 56 per cent said some nurses and doctors would stop working additional shifts in the NHS altogether. THE WAY FORWARD If the government is committed to delivering a true seven-day NHS, then it is going to have to be on the side of agencies. Of course, costs must be controlled, and the REC wants to work with NHS Improvement to develop flexible staffing models that work for all parties – and deliver the best outcomes for patients. Health and social care recruitment agencies provide a vital lifeline to the NHS – especially at times of increased pressure on the system – without which patient safety would be in jeopardy. The need for agency staff is not going to go away particularly in light of heightened demand from patients, and so government must work closer with agencies to find solutions to workforce problems. L FURTHER INFORMATION www.rec.uk.com

Data from the Nursing and Midwifery Council shows that in each month from September to December in 2015, an average of 797 EU nurses signed up to work in the NHS. This fell to 194 a month over the same period last year

VITAL ROLE OF AGENCY STAFF The Recruitment & Employment Confederation (REC) has been consistent in its message to government that the caps and controls placed upon trusts use of agency staff will have an impact on safe staffing levels; and now we are starting to see the evidence. The deterioration in staffing levels appears to have been accelerated by the introduction of tougher

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PATIENT CARE

HICOM’S TWINKLE SET TO STANDARDISE SERVICE DELIVERY AND IMPROVE PATIENT CARE The All-Wales Diabetes Implementation Group, acting on behalf of the Welsh Government and in partnership with The Children and Young People’s Wales Diabetes Network (and Brecon Group), has commissioned Hicom’s paediatric diabetes patient management solution Twinkle for all NHS Wales Paediatric Diabetes Units Latest research shows that there are about 31,500 children and young people under the age of 19 in the UK with diabetes. The new national project, being funded by the Welsh Government and the Diabetes Implementation Group, aims to ensure that paediatric diabetes units across Wales are able to collect patient information in a consistent manner. NHS Wales comprises of seven health boards of which six are currently offering paediatric diabetes services. Building on the success of Cardiff and Vale, ABMU and Anuerin Bevan who are already using Hicom’s Twinkle, the remaining three will now have Twinkle implemented resulting in total national coverage across 14 separate sites. All units will be using the fully hosted web-based application, which provides the standardisation of key care processes, data gathering and reporting; this will result in a dramatic reduction in reliance on paper based records. EASIER AND QUICKER In addition, Twinkle will make it easier and quicker for HCPs to measure performance and collate the information required for the National Paediatric Diabetes Audit (NPDA), as Dr Christopher Bidder, consultant paediatrician and clinical lead for the Children & Young People’s Wales Diabetes Network (and Brecon Group) explains: “I am delighted to see Twinkle being rolled out to paediatric units across Wales thanks to the funding agreed by the Welsh Government and the Diabetes Implementation Group.  Our diabetes team in Swansea has been using Hicom’s Twinkle. Net for nearly two years now and it has transformed the day to day working of the team, our ability to understand our clinic data and how we generate our submission for the NPDA.  A universal approach across Wales will undoubtedly aid checking of the Brecon

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register accuracy and in time will enable units to benchmark against each other.” Jon Elburn, product manager for Clinical Information Systems at Hicom comments: “We are delighted to be extending the usage of Twinkle to the whole of Wales. Standardisation across the Principality will ensure that the quality of care is matched by the level of data collection in a uniform manner. Long term this will allow Hicom to aggregate the information at a national level and through the use of analytics tools we will work with clinicians to provide real insight into the patient experience across Wales.” ABOUT HICOM Hicom’s aim is to be the provider of choice for software and consultancy solutions that meet its customers’ demands. Committed to delivering advisory services and integrated software solutions, Hicom combines consultancy with project management, design, development, implementation and support. Hicom’s capabilities extend to projects of any size and complexity, whilst its personalised approach ensures high quality, flexible and scalable solutions that meet

clients’ specific business needs. With expertise in a range of market sectors, including clinical healthcare, healthcare recruitment, risk management, HR, retail and crime prevention, Hicom prides itself on its ability to deliver solutions that directly address specific industry needs. Its software platform provides organisations with a fully-integrated, scalable web-based solution, which can be tailored, helping achieve greater productivity and efficiency. Since it was formed in 1986, Hicom has achieved an extensive track record of successful implementation for clients in a wide array of sectors and locations in the UK and internationally, which include: Health Education England, Asda, Bedford Hospital NHS Trust, North Midlands NHS Trust, St George’s Hospital NHS Trust, University Hospital Wales, Northern Ireland Trust, Sport Surgery Clinic Republic of Ireland and Abu Dhabi’s Imperial College London Diabetes Centre (ICLDC). L FURTHER INFORMATION Tel: 01483 794 945 admin@hicom.co.uk www.hicom.co.uk


TRANSPARENCY

Procurement

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Health Business Interview: Procurement In February, the NHS Supply Chain launched its new surgical instruments framework, outlining the body’s strong commitment to ethical procurement. Health Business has spoken to Stephanie Gibney, ethical and sustainability manager at NHS Supply Chain, about transparent dealing in healthcare Health Business (HB): Can you explain what the Labour Standards Assurance System is? Stephanie Gibney (SB): NHS Supply Chain has a Supplier Code of Conduct which outlines our main principles for suppliers in the area of labour standards and worker welfare. All suppliers are expected to adhere to these principles which address issues such as child labour, forced labour, wages, working hours, as well as health and safety. The Supplier Code of Conduct is a contractual requirement and has been part of all NHS Supply Chain Framework Agreements since 2009. In recent years NHS Supply Chain has taken steps to reinforce the principles in our Supplier Code of Conduct through the introduction of the Labour Standards Assurance System (LSAS). The LSAS is incorporated into the contract conditions for product areas where there are known and documented labour standards risks or high predictors such as surgical instruments, gloves and textiles. Essentially, the LSAS is a toolkit for labour standards management with NHS Supply Chain requiring suppliers to commission an external third party audit to assess how they are managing these issues in their organisation and also, importantly, in their supply chain. The labour standards assurance system forms our ethical procurement approach at NHS Supply Chain, and was developed in conjunction with the Department of Health back in 2012. The LSAS covers the range of policies, processes and procedures that an organisation employs to identify labour standards issues, mitigate risk and drive improvement. It builds on the principles of due diligence extending this to routine consideration of labour standards – particularly important for suppliers doing business in countries where there is evidence of non-compliances and abuses such as forced labour or child labour. The LSAS sets out staged milestones for suppliers to meet during the framework agreement, this emphasises continual improvement but also spreads the burden of implementation for suppliers, many of whom are SMEs. The results of the LSAS audit are shared with NHS Supply Chain enabling us to monitor the policies, processes and

procedures that an organisation has in place to manage labour standards effectively in line with ILO (international labour organisation).

HB: Which frameworks have Labour Standards built into them? (SB): Nine framework agreements have Labour Standards Assurance built in. These include the framework agreements for: surgical instruments; textiles; gloves; procedure packs; IOL (intraocular lenses/ ophthalmology); suction consumables; urology and bowel management; single use theatre clothing; and polymer. We currently have over 200 suppliers committed to labour standards assurance through their contract conditions. We This will increase current when the framework have ov ly er 200 agreement supplie for General r s c to labo ommitted Wound Care u launches in assuran r standards ce 2017 bringing their co through more suppliers n into scope for conditiotract labour standards ns management. We use experienced labour standards The product areas practitioners to help to build capability for LSAS inclusion have in our supply base ensuring that suppliers been determined by conducting are able to grapple with these issues and a risk assessment across NHS Supply have access to guidance and tools to assist. Chain’s contract portfolio and by working In addition gathering feedback from closely with stakeholder groups such as suppliers on LSAS implementation The Medical Fair and Ethical Trade Group has been particularly useful in making at the British Medical Association (BMA), the process more robust but also experts in ethical trade, bodies such as the understanding what support suppliers Ethical Trading Initiative (ETI) and colleagues need in the way of training or guidance. active in public procurement elsewhere in Europe. The product areas above have HB: How does the Surgical known and documented risks or high Instruments Framework predictors of labour standards issues. enhance the work you’re doing NHS Supply Chain will continue to review on ethical procurement? the areas assigned for LSAS inclusion and its (SB): Labour Standards Assurance is about wider portfolio and new areas may be added if continual improvement within a framework risks emerge or abuses are uncovered. Where agreement and from one framework framework agreements have labour standards agreement to the next. The new Surgical contract conditions built in, NHS Supply Chain Instruments Framework has incorporated are committed to assisting suppliers with LSAS for the second time with enhanced training webinars and feedback sessions. contract conditions. New suppliers are E

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TRANSPARENCY  not excluded from being able to compete provided they are committed to adopting effective labour standards management. For the new Surgical Instruments Framework, an entry level of Level 2 LSAS was outlined setting a benchmark for suppliers to trade on the new contract. However we have also outlined increased requirements to meet Level 3 LSAS in the first two years. Level 3 indicates suppliers have a robust system for labour standards management; processes are effective and evidenced as working overtime. However, level 3 LSAS also includes supplier requirements to verify some degree of primary evidence from their supply chains, increase oversight and engage with stakeholders and other parties in their supply chains. This approach is a blueprint for how we take LSAS forward from one framework to the next.

HB: What future plans does NHS Supply Chain have for ethical procurement? (SB): Ethical procurement is a strategic objective and is included in our commitments for 2017-18. With greater transparency being the new norm of business and with greater emphasis on due diligence and oversight of supply chains particularly with the UK Modern Slavery Act, ethical procurement is more important than ever. For NHS Supply Chain, this will be about wider implementation of LSAS across new contract areas and further implementation down the supply chain for areas like Surgical Instruments. Many aspects of the LSAS align to the reporting requirements of the UK Modern Slavery Act. Many of our suppliers have to publish a Slavery and Human Trafficking

Statement as they meet the £36 million threshold for reporting under the Act. Suppliers will find that implementation of LSAS supports the principles of this legislation and particularly that of ‘transparency in supply chains.’

HB: What are the benefits of ethical procurement? (SB): There are many benefits to this approach. The benefits for suppliers is that it shows industry is responsible and committed to improving labour standards as well as fostering transparency. Effective management and monitoring reduces the potential for labour standards abuses and puts a culture of rectification in place for dealing with issues. Suppliers need to develop greater visibility and oversight of labour standards in the supply chain especially with the advent of the UK Modern Slavery Act. The benefit for the NHS is that trusts can purchase from the Framework Agreement with a degree of assurance that these issues are being managed. For NHS Supply Chain, this approach demonstrates a commitment to procure responsibly by embedding a culture of due diligence with regard to labour standards HB: How are your procurement colleagues involved in ethical procurement? (SB): Buyers are aware of our Ethical Procurement Programme and I take every opportunity to raise the profile of this agenda across the business. As it’s a key element of our Sustainable Development Strategy, I provide regular updates to buyers on procurement webinars and using

With greater transparency being the new norm of business and with greater emphasis on due diligence and oversight of supply chains particularly with the UK Modern Slavery Act, ethical procurement is more important than ever

Procurement

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

various other communication tools across the business (company news, website, intranet, internal newspaper Hub). Ethical procurement is also referenced in policy and externally in our Supplier Code of Conduct which outlines our guiding principles on labour standards, the environment and business continuity. I work really closely with buyers and contracting managers to ensure our Framework Agreements consider ethical and sustainability issues throughout the procurement cycle. This starts at the pre-tender stage when we are formulating strategy to the tender exercise itself and through to contract award and contract management. It’s my role to raise awareness of sustainability issues with our internal buying teams and influence them to embed sustainable and ethical procurement elements in their tenders. Crucially, our category management process helps me to do this. Category management helps buyers to understand the risks and impacts of their procurement and I work closely with buyers as part of a wider cross functional group to put forward how we might manage and mitigate these risks. More specifically, if a buyer is working on a product area with known and documented labour standards risks, we will, of course, work more closely together. My role is to support them in incorporating ethical procurement in the tender and to support contract and supplier management once the framework launches. More recently, I have trained many of our buyers in the requirements of the UK Modern Slavery Act in order that they are aware of what implications this legislation has for our business and our suppliers. This training and capability building is delivered through what we call an ‘Experience Exchange’ – an interactive session which focusses on training but also on live examples. This recent piece of legislation has brought ethical procurement into sharper focus as it’s essential we increase oversight of our supply chain and build in mitigation where there are known risks.

HB: What more could be done? (SB): There is always more that can be done. The important thing is to raise awareness of labour standards issues, initiate dialogue with suppliers and embed a culture of rectification and continuous improvement. It’s about working with suppliers to address these issues and supporting them along the way. We are acutely aware that many of our suppliers are SMEs who may not have been used to grappling with labour standards issues before. It is important for all suppliers to be engaged in the process as it’s only by collaboration that we will deliver change. NHS Supply Chain will continue to support suppliers with capability‑building and awareness raising material. L FURTHER INFORMATION www.supplychain.nhs.uk

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DIGITAL NHS

Health Business revisit’s a recent article from Sophie Castle-Clarke, fellow in Health Policy at the Nuffield Trust, which explores the use of digital tools and how they are beginning to have an impact on the ability of patients to look 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.

THE GROWTH OF THE HEALTHCARE APP 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 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 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 E

Written by Sophie Castle-Clarke, the Nuffield Trust

Letting the digital patient manage their care

Healthcare IT

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Equip patient ping the con s with manage fidence to and car their health the big e is one of gest of patiebenefits technol nt ogy

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Agfa HealthCare’s Integrated Care Suite and XERO viewer enable cross-border radiotherapy service, to enhance patient comfort and care. Agfa HealthCare’s health management platform, including the XERO universal image viewer, is supporting the joint Radiotherapy Treatment Project of the Saolta University Health Care Group and Altnagelvin Hospital, part of Western Health and Socal Care Trust. This cross-discipline, cross-border project will enable patients from County Donegal, in the Republic of Ireland, to access radiotherapy services at the nearby Altnagelvin Hospital, located in Derry, Northern Ireland. Enhanced patient care and comfort The Radiotherapy Treatment Project was set up to enhance patient comfort and care, by allowing patients from County Donegal to attend nearby Altnagelvin Hospital (in Derry) for radiotherapy treatment.

Providing radiotherapy treatment closer to the patient’s home would reduce a

patient’s travel time from 7 hours to 40 minutes. ‘Anywhere, anytime’ access to up-to-date images Galway University Hospitals was already using the XERO universal image viewer. This functionality was extended within the Integrated Care Suite, enabling healthcare providers at Altnagelvin Hospital to access and display patient data in real-time, without needing to move or manage it. Meeting increased demand for image sharing “The ability to integrate and interoperate with other systems has always been important to the Galway University Hospitals radiology staff,” comments Gina Naughton, RIS/PACS System Administrator, Galway University Hospitals. “We have witnessed an increasing demand for cross-border and even worldwide data sharing between public/private hospitals. This project, including the Integrated Care Suite, is a prime example of what can be achieved when hospital personnel collaborate with the technology available to them. The project took less than six months from project initiation to Stage 1 go-live.”

“The Integrated Care Suite has given Northern Ireland clinicians real-time access to patients’ most up-to-date images of patients from Donegal,” highlights Dr David Stewart, Lead Clinician in Oncology, Altnagelvin hospital. “It is reassuring for patients to know that the clinician has their scans, even on their first visit to the clinic. The image access is especially important for radical radiotherapy treatment: fusing diagnostic images such as MRI to treatment-planning CT scans on Varian’s Eclipse Treatment Planning System enhances the radiotherapy contouring process, for improved target volume delineation. This access may result in more informed care and reduced toxicities for patients.”



Reduce a patient’s travel time from 7 hours to 40 minutes.



Access and display patient data in real-time, without needing to move or manage it.



An example of what can be achieved when hospital personnel collaborate with the technology available to them.



Took less than six months from project initiation to Stage 1 go-live.

Visit www.agfahealthcare.com for more information


DIGITAL NHS

Smart bandages to be trialled

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  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. INACCURACIES AND DATA PROTECTION 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 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 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 65 and over, the unemployed and people with disabilities. ADOPTING THE RIGHT APPROACH 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 supporting 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 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

Healthcare IT

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Swansea University’s Institute of Life Science is leading research into the trial of bandages which use real-time 5G technology to monitor how a wound is healing and help doctors keep track of patient’s activity levels. The trials form part of the £1.3 billion Swansea Bay City deal which aims to create a 5G test hub for digital innovation. Prof Marc Clement, chairman of the Institute of Life Science (ILS), commented: “5G is an opportunity to produce resilient, robust bandwidth that is always there for the purpose of healthcare. “That intelligent dressing uses nano-technology to sense the state of that wound at any one specific time. It would connect that wound to a 5G infrastructure and that infrastructure through your telephone will also know things about you – where you are, how active you are at any one time. “You combine all of that intelligence so the clinician knows the performance of the specific wound at any specific time and can then tailor the treatment protocol to the individual and wound in question.” Clement added: “Traditional medicine may be where a clinician might see a patient and then prescribe the treatment approach for a month or three months. “What the future holds is a world where there’s the ability to vary the treatment to the individual, the lifestyle and the pattern of life. “Sometimes we revere doctors so much that we tell them all is well but all of the evidence is there before them in this 5G world, so the clinician and patient can work together to address the challenge.” FURTHER INFORMATION tinyurl.com/kk2dz6x 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 encourage NHS staff to use patient data where appropriate, at least in the short term. E

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Advertisement Feature

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

IT

CFH DOCMAIL – SAVING, TRANSFORMING AND IMPROVING HEALTHCARE This month yet another timely reminder in the shape of the CCG ‘Don’t Swallow Up Your NHS’ social media campaign, that small changes in the behaviour of the many, could help to reverse the fortunes of our health service It’s easy to think that looking after the pennies is futile when the gap in the budget is so vast but by chipping away at waste by looking creatively at process we can all make a difference. Encouraging patients to buy own brand over the counter medicines, rather than requesting prescribed equivalents, is a great place to start. CALL AND CANCEL 60,000 patients a day miss their GP appointments, costing the NHS millions of pounds. We know that often by the time the appointment comes round the patient feels better but is reluctant to call and cancel. A simple message on all patient letters and communicated within the practice can reassure that it’s better to call and cancel than to not attend. Conversely during the flu vaccination season, the extra effort put in to increasing uptake will pay dividends for beleaguered A&E departments as we head towards Christmas. SAVINGS At CFH Docmail we’ve witnessed how the vision of GPs, practice and IT managers has resulted in: a simple letter being used to perform as the recall and administration document for a closed loop process with record breaking results; an outpatient department saving £170k on appointment letters in one year and 4,000 GPs moving to a desktop system to print and mail letters which not only saves the practice money but more importantly, hours of hugely valuable time which can be redirected to patients. Shirley Priestnall is head of Information within the Operational Delivery Unit at University Hospitals of Leicester NHS Trust. One of the busiest trusts in the country with over one million outpatient attendances a year resulting in 80,000 appointment confirmations a month. Despite budgets being cut to the bone by taking the step to outsource and use hybrid mail Shirley was able to not only transform the efficiency and professionalism of the process but also save the Leicester NHS Trust £170k a year. Shirley says: “Our admin system meant

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that the letter would be printed at one of a number of printers and we risked picking up the wrong letter or a failure to print. The print was poor,the letter templates were very rigid, single sided and we couldn’t always say exactly what we wanted. The clinic location was so abbreviated that patients often got lost. It became the biggest source of complaints. With 1,000,000 patients attending every year the knock on effect was huge. Window envelopes compromising patient confidentiality or the address could not be viewed properly. Staff were adding hand written details or corrections none of which looks professional and inspires patient confidence. Anecdotal evidence suggested that letters had not been received. TRANSFORMING The move to CFH Docmail has been transforming. Outpatient appointment letters are requested on-demand as appointments are agreed during the working day. They are generated from the trust’s Patient Administration System. Data is collected by the CFH Print Spooler which is located on the Leicester NHS server. Letter templates have been re-developed using a limited number of letter types, with customisation rules to govern the detail of the content. The rules accommodate large print letters where patients have requested these and identify letters requiring Braille translation. We have the facility to tweak any template

immediately. A change in personnel or the footer happens at the touch of a button. The on demand process removes the requirement to hold stock. Data is received seven days per week. CFH process these files twice per day. Each letter is streamed to its despatch method based on the rule within the appointment date. If the appointment is within eight working days, the letter is sent 1st class, same day. Monthly volumes are 65,000 letters. We print dynamically on pre-printed base stock. Pre-printed map stock for the three hospitals means that each patient has a colour map with full directions. Leicester NHS has a bespoke envelope (one DSA and one 1st class). IMPROVEMENT The £170k a year we have saved has been on hard costs like paper, ink and post, the real saving when you take into consideration staff time and the reduction in inefficiencies is much greater. The quality improvement both in terms of presentation and patient support has been considerable. We also have the benefit of an excellent support team at CFH who anticipate and remind us of any decisions that need to be made. L FURTHER INFORMATION www.cfh.com www.docmail.co.uk


DIGITAL NHS  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 feasibility. 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

Healthcare IT

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

To benefit greatly from engaging with patient technology, the NHS needs a new approach to supporting patients to look after themselves, regulating new innovations and encouraging uptake 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

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 NHS. 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. Read The digital patient: transforming primary care here – http://www.nuffieldtrust. org.uk/sites/files/nuffield/publication/ nt_the_digital_patient_web_0.pdf FURTHER INFORMATION www.nuffieldtrust.org.uk

Aid Call Touchsafe Pro offers wireless nurse communication – flexible and efficient 24/7 support In recent years wireless technology has transformed nurse call systems into integrated problem-solving tools designed to enhance patient care through faster and more efficient communication. Aid Call, a business unit of Legrand Assisted Living & Healthcare, has been leading the way in wireless nurse call technology in hospitals for over 40 years. Its Touchsafe Pro system operates over a dynamic self-healing mesh network which is quick and not disruptive to install as there’s no need for cables. It also reflects the company’s ambition to remain at the forefront of new and emerging technologies which meet the rapidly evolving needs of the healthcare sector. Chris Donnelly, Aid Call national sales manager, explains: “We specialise in the research, design and manufacture of technology enabled care solutions for hospitals. Our Touchsafe Pro system is a direct result of our continued investment in R&D based on feedback from our customers at the front line of care delivery. “Going wireless offers many benefits,

not least greater flexibility to provide a more personalised approach to care provision, offering patients greater independence and making them more comfortable in their environment.” The Aid Call Touchsafe Pro is a flexible, cost-efficient system which is designed to be adaptable to changing care environments. Its user-friendly touchscreen technology enables on screen data to be personalised and an automatic triage system means all calls are displayed in order of their priority. The benefits include improved response times whilst its integrated call logging system ensures all information is fully tracked and recorded.

The Aid Call Touchsafe Pro also has the ability to link with other equipment used to monitor patients’ issues 24/7. This responsive technology allows care teams to support individuals who may not have the necessary cognitive ability to utilise a standard nurse call system. Chris Donnelly adds: “The Touchsafe Pro system assists better communication between staff and reassures patients that help is always close at hand. It’s also important to remember that it’s not just patients that need around‑the‑clock support, hospital staff do too. “We aim to provide complete peace of mind for our customers through our professional technical team who are experienced in wireless technology solutions. We also provide a comprehensive maintenance service and progressive technological updates.” FURTHER INFORMATION Tel: 0800 052 3616 sales@aidcall.co.uk www.aidcall.co.uk

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Hospital Innovations

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

EVENT PREVIEW

Exploring efficiency savings and promoting productivity in the NHS Taking place at London’s Olympia on the 25-26 April, the conference and exhibition at Hospital Innovations will address the key issues currently facing the NHS. Health Business previews the event Hospital Innovations has been launched to foster joined up thinking. This is an event that will bring together key decision makers in hospital management teams who are collectively responsible for the delivery of patient services in the UK. Most importantly, we are working with the direction of representatives from over 20 NHS hospitals across the country. It’s no secret that the demands on the NHS are constantly evolving. Life expectancy is increasing and an ageing population puts greater pressure on both NHS and private healthcare services. Resources are stretched and, while the battle to increase NHS funding is fought in the House of Commons, those who manage hospitals across the UK are looking for new ways of increasing efficiency, reducing running costs and improving the delivery of patient services. Innovation is the key. The Hospital Innovations conference and exhibition will feature a whole host of key names from the sector and innovative solutions to help healthcare professionals improve efficiency in hospitals and health

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centres. Key speakers announced to address the Hospital Innovations conference include: Lord Carter of Coles; Simon Corben, head of Estates and Facilities at NHS Improvement; David Loughton, chief executive at The Royal Wolverhampton NHS Trust; Duane Passman, director of 3 Ts, Brighton & Sussex University Hospitals NHS Trust; Chris Davies, energy and environmental officer at Aneurin Bevan University Health Board; and Julian Amey, chief executive at IHEEM. LORD CARTER INNOVATION AWARD Lord Carter spoke last year at the launch of Hospital Innovations and promised to return in 2017 to give delegates and visitors an update on the Carter report one year on and present the Carter Innovation Award. The review of operational efficiency in acute hospitals chaired by Lord Carter published its final report in February 2016, following nearly two years of work with trusts across England. A co-ordinated programme to oversee the NHS-wide response to the recommendations of this review began

in June 2015 and has, since September 2016, become the responsibility of a new operational productivity directorate within NHS Improvement (NHSI). The basis for Lord Carter’s recommendations was the analysis of metrics and benchmarks that identified significant unwarranted variation across organisations. This was quantified as representing a £5 billion efficiency opportunity, or nine per cent of the £55.6 billion spend on acute hospitals in England. Trusts will talk about efficiencies made, while key organisations providing the latest technologies to help deliver greater efficiencies will both exhibit and present key initiatives. We will also look at the Model Hospital with particular reference to digital and technology, how these are being utilised and how they support clinical processes and empower patients. The first ‘Carter Innovation Award’ will be given to the trust or E

Life is ncy expectag and an in increas population ageing ing greater is putt re on both pressu d private NHS an thcare heal es servic


 organisation which best represents the use of innovation to improve healthcare estates and infrastructure. The ten finalists for the award are: Cambridge University Hospitals NHS Foundation Trust; County Durham and Darlington NHS Foundation Trust; East Kent Hospitals University Foundation Trust; Kemper UK & Ireland Ltd; Lancashire Teaching Hospitals NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust; Moorfields Eye Hospital & Stanburys Ltd; ProCure21+/ ProCure22; South West London Pathology; and The Royal Wolverhampton NHS Trust. INNOVATIVE DISCUSSIONS Hospital Innovations Conference and Exhibition addresses issues in the NHS with a cutting edge conference programme and high quality exhibitor list with innovation at the heart of it. The conference will give real solutions and inspiration that you can take back to the office and initiate immediately. Hospital Innovations will, present the latest update on the Carter Review with a Keynote presentation from Lord Carter himself, and also from Simon Corben, new head of Estates and Facilities at NHS Improvements. The conference will showcase current case studies and projects presented by inspiring Healthcare professionals and industry experts from some of the major NHS trusts, procurement managers and pioneering suppliers. The conference will open with the welcome and president’s address, delivered by IHEEM’s Julian Amey and Pete Sellars. This will then be followed by the aforementioned keynote presentation from Lord Carter of Coles, who will then present the first Lord Carter Innovation Award. Bernard Quinn, director of Improvement Programmes at NHS Improvement, will then provide an update on the work of the department and its push to implement the improvements and innovations needed for the NHS. The afternoon will begin with David Loughton’s session on ‘Improving Patient Pathways and Capacity with a Real-Time Centralised Patient Placement Model’. Chief executive of The Royal Wolverhampton NHS Trust, Loughton will explain the trailblazing initiatives that are transitioning the trust from an environment of siloed and disjoined patient pathways to a centralised model that optimises patient throughput, access and quality by providing staff with real-time location and status visibility to all in-patients, beds and equipment across the organisation. Part of the session will involve input from Michael Gallup, president of TeleTracking Technologies, who are partnering the trust on the IT transformation programme. In November 2015, Aneurin Bevan University Health Board commenced a trial with Thermal Compaction Group (TCG) to collect and process polypropylene instrument wrap from HSDU for recycling. This ‘world first’ project reverses the manufacturing process by applying carefully controlled heat to

Hospital Innovations

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

With the ten finalists recently announced, the first ‘Carter Innovation Award’ will be given to the trust or organisation which best represents the use of innovation to improve healthcare estates and infrastructure re‑melt the wrap and converts it into a liquid that will flow into a mould cavity to create a block of material that is dense and sterile. The machine produces one 12kg block of sterilised polypropylene during each cycle with a volumetric reduction of 85 per cent. The trust’s environmental personnel will present the ‘Rubbish Project’ discussion. The day will finish with a session on ‘Efficiency in Workforce Development, hosted by Duane Passman, director of 3 Ts, at Brighton & Sussex University Hospitals NHS Trust. The trust is pursuing a multi-dimensional approach to workforce transformation – creating coherent career development pathways for NHS staff, delivering sustainable pay cost reductions overall, and ensuring improvements in the quality and safety of patient care. This presentation will highlight the approach being taken and how it is being developed and implemented in practice, identifying key learning points and the experiences of developing this programme in a dynamic and

operationally-pressured environment whilst ensuring clinical leadership and engagement. ACCESSIBLE EFFICIENCY GAINS Having developed repeatable rooms that improve outcomes whilst reducing the cost of construction, ProCure22 are now introducing an immersive and accessible virtual reality experience for engagement with clinician, staff and patients before significant investment is made to improve the efficiency of early design consultation. David Kershaw, director of the Efficiency and Productivity Programme, will provide this session on ‘ProCure22 Repeatable Rooms Meet Virtual Reality!’. The 12:15-12:45 conference session, led by Laura Ellis-Philip, associate director of Informatics at Ashford and St Peter’s NHS Foundation Trust, will examine ‘How to Digitise Medical Records and Improve Organisational Sustainability’. This presentation will cover the journey Ashford and St. Peter’s have been on to procure and deploy a document E

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

A picture tells a thousand words …….. EDMS in action !! Becoming Paperless makes real sense Save 0.5% of your turnover Tangible cash-releasing benefits Improved patient safety Limited operational disruption Apira are on the CDIS Framework

Talk to us about your individual requirements. Find us at Stand 204 Contact Geoff Broome - t: 07831 502138 or e: geoff.broome@apira.co.uk

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Completely unique, SFG20 is the essential tool to keep hospitals, NHS Trust buildings and healthcare estates working safely, benefiting the environment for patients and staff alike. A significant number of healthcare trusts already benefit from using SFG20 as the dynamic webbased service contains over 500 industry maintenance task schedules covering over 60 equipment chapters helping healthcare estates stay compliant - saving time, energy and money. SFG20 has created a set of maintenance task schedules specifically for the healthcare sector that is aligned to the Department of Health's HTMs (Health Technical Memorandum). There are over 100 healthcare schedules which include decontamination, medical gases and ventilation. Using SFG20's healthcare functional set will ensure you remain complaint with HTMs and industry standards, and are fully customisable with colour coding to help you project manage more effectively.

To find out more or to request a free online demonstration visit www.sfg20.co.uk or call 01768 720 090

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HEALTH BUSINESS MAGAZINE | Volume 17.2

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


EVENT PREVIEW  management solution over the past few years, having been part of the Department of Health Southern Acute Programme. The benefits accruing from this are being realised now and are expected to reach £1.5 million per annum on a recurring basis by the end of 2017/ 18, comprising mainly of office space for clinical purposes and pay-cost savings in medical records. These will amount to 0.5 per cent of the trust’s income each and every year moving forward – showcasing sustainability in action. To close the second day, Gordon Watt, business development manager at Doosan Babcock, will present on ‘Sustainability of De-Centralised Energy Systems in a Complex Estate Environment’. Decentralised energy is known to reduce transmission losses, lower carbon emissions and increase security of supply whilst delivering economic benefits and is thus seen as a cost effective route to supporting carbon targets. It is no surprise; therefore, that the installation of cogeneration systems has risen dramatically in recent years and is a trend that is set to continue bringing with it an increase in NOx and particulate emissions to inner city areas that may already suffer poorer air quality conditions and are known to have a negative impact on health. When considering such schemes, it is important to consider their integration within a complex

Brighton & Sussex UH NHS Trust is pursuing a multi-dimensional approach to workforce transformation – delivering sustainable pay cost reductions and ensuring improvements in the quality and safety of patient care estate. This presentation identifies the issues with using cogeneration and considers alternatives that facilitate decentralised opportunities whilst also addressing the wider impact of NOx and particulates to deliver a locally provided, sustainable, competitive and smarter energy choice. MENTAL HEALTH CHALLENGES Hospital Innovations will also feature a series of workshops for visitors and delegates. On the first day of the event, The Cumberland Initiative will deliver part of their Workshop Series: Modelling to make your STP work. As the Strategic Transformation Programmes stake shape and move forward, they face the challenge of turning the high-level thinking into robust, repeatable, scalable services. The Cumberland Initiative is running a one day workshop (11am – 4pm) to report the success of simulation, modelling and analytics in meeting these challenges and to provide

Helping you to deploy electronic solutions and go paperless fast Digitising medical records makes sense as it is low risk with certainty of outcome in short timescales – Apira went from an ‘early adopter’ service to enterprise-wide full digitisation at Ashford and St. Peter’s Hospital in seven months. Electronic document management solutions (EDMS) lead to safer care for patients with no more lost notes or (resultant) cancellations, as they are now available 24/7 (for those with access rights). EDMS provides tangible cashreleasing benefits that move the needle on costs, saving 0.5 per cent of turnover in pay, consumables and the reuse of (much needed) space. Apira found there was only limited operational disruption, as clinical staff can still use paper where needed or efficient to do so. For the most part medical records staff savings can be

realised from natural wastage, some use of fixed-term contracts and re-assignment. Outsourcing scanning is recommended, cost effective with fast turnaround times and can be done to BS10008 standards for medico-legal admissibility. Apira’s professional services for an EDMS project can be accessed via Lot 4.3 of the CDIS framework, recently launched by the LPP, for business case, procurement or deployment support. Find Apira at stand 204 at Hospital Innovations 2017. FURTHER INFORMATION Tel: 07831 502138 geoff.broome@apira.co.uk

Hospital Innovations

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

how-to guidance for taking the next steps. As a workshop, there will be space for delegates to present their successes and challenges. Mental health services find themselves in every greater demand, while suffering from severe funding issues. This workshop will explore the challenges from a clinical perspective and show how better design of the services – and, eventually, the funding models – can be used to alleviate the immediate pressures and lead to affordable provision. Speakers include: Dr Tim Ojo, director of Quality at Sussex Partnership NHS Foundation Trust, who will present, ‘Three things that are keeping Mental Health Providers and Commissioners awake at night’; and professor Sally McClean, of Ulster University, who will report on ‘Modelling to help manage dementia’. L FURTHER INFORMATION www.hospital-innovations.com

The definitive standard for planned maintenance SFG20 is the standard maintenance specification for building engineering services. It is recognised as the industry standard and is an essential tool for planned maintenance. It is the benchmark for working standards; providing building owners, managers, contractors, consultants and end users with the tools to keep buildings properly maintained and compliant. SFG20 is a growing library, providing over 500 industry maintenance task schedules covering all principal types of heating, cooling and ventilation, installation and plant, and electrical services complete with technical updates and legislative references. The benefits of SFG20 include: tailored maintenance with customisable schedules: develop bespoke maintenance schedules to suit your needs, amending non statutory tasks as required; cost savings through optimal maintenance of assets: colour

coded criticality ratings identifies tasks which are statutory, mandatory, functional critical or discretionary; peace of mind with up-to-date legislation: frequent technical bulletins are released and schedules updated in line with legislation changes, ensuring you are always working to the latest standard; and accurate and efficient tendering: specify custom maintenance requirements, including timings and produce PDF booklets. SFG20 has created a set of maintenance task schedules specifically for the healthcare sector that is aligned to the DH’s HTMs. There are over 100 healthcare schedules including decontamination, medical gases and ventilation. FURTHER INFORMATION www.sfg20.co.uk

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7 UR SED AT B1 YO IDI NG 17 /H RE BS SI HB .UK CU SU Y U DE O SE LLY S B CO E.C R S FU PA NG CA KI S O PLU BO LTH A HE

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Health+Care returns on 28-29 June 2017 at London ExCel. It’s the only place where CCGs, NHS Trusts, IT, primary and social care professionals can come together and get 1000’s of practical solutions to help with the challenge of turning ambitious transformation plans into action - securing the future of the health and care services for generations to come.

NEW for 2017 Your badge will give you access to the brand new Digital Healthcare event that runs alongside Health+Care. You will learn more here in just a few hours than you could in months from your organisation. SECURE YOUR FULLY SUBSIDISED PASS BY USING BOOKING CODE HB17 AT HEALTHPLUSCARE.CO.UK/HB17

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28–29 June 2017 | ExCeL London Organised by:


EVENT PREVIEW

Joining innovation with inspiration in healthcare

Health+Care 2017

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Taking place on 28-29 June 2017 at ExCeL, London, Health+Care represents Europe’s largest integrated health and social care event, building relationships between commissioners, providers and suppliers. Health Business investigates the main talking points leading up to the show, mainly concerning STPs, which feature heavily in the show’s Keynote Theatre Health+Care, which enables more than 10,149 senior health and social care professionals to forge new partnerships and productive ways of working in challenging times, focuses on the delivery of cultural, service, system and digital transformation that’s essential to securing the future of health and social care systems. The event is a rare opportunity for colleagues from across the NHS, local government, care homes and the voluntary sector to come together on an equal footing to network, collaborate and share learning around

implementing change. The focus will be on how to deliver real, impactful transformation across local health economies, drawing on the best examples, with the most potential for replication. SUSTAINABLE HEALTH AND CARE Dame Ruth Carnall, conference chair and former chief executive of NHS London, will open the conference and welcome delegates to Health+Care 2017 in the Keynote Theatre, before the day’s first plenary debate begins. Jim Mackey, chief executive of NHS

The of Heal focus 2017 w th+Care how to ill be on real, im deliver transfo pactful across l rmation oca economl health ies

Improvement, said that STPs will ‘reboot the NHS’ and ‘help cut enormous overheads’. An esteemed panel of health and social care experts and local system leaders, including David Smith, chief executive of Oxfordshire CCG, Rob Webster, chief executive of South West Yorkshire Partnership NHS Foundation Trust, Sarah Pickup, deputy chief executive of the Local Government Association, and Stephen Dorrell, chair of the NHS Confederation and former Health Secretary, will discuss how local systems are pulling together to build a sustainable health and care sector and the hurdles along the way. STPs also form the main talking point in the first Big Conversation, in which a panel of leading healths experts discuss how best E

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EVENT PREVIEW

 to embed mental health on whole‑style transformation, including progress in implementing the Five Year Forward View for Mental Health and which STPs are leading the way in rethinking the approach to mental health and well-being across local systems. Sharing their thoughts on these topics are Claire Murdoch, national mental health director for NHS England, Joe Rafferty, chief executive of Mersey Care NHS Foundation Trust, Paul Farmer, chief executive of mental health charity Mind, and Professor Tim Kendall, national clinical director for mental health for NHS England, and consultant psychiatrist for the homeless at Sheffield Health and Social Care NHS Foundation Trust. A more focused approach to integration will be presented by Warren Heppolette, of the Greater Manchester Health and Social Care Partnership, who will explain how Greater Manchester succeeded in forming a strategic partnership of 37 NHS, local government and social organisations and how this operates in practice. In the afternoon of the first day, Professor Sir Bruce Keogh, medical director of NHS England, and Professor Matthew Cripps, national director of NHS RightCare, will address how better population healthcare is everyone’s business and what we can expect in terms of things happening differently via NHS RightCare’s work. This will explore positive patient outcomes, the importance of the role of clinicians in reducing unwarranted variation and how NHS RightCare will support a sustainable NHS. The first conference day in the Keynote Theatre will end with an analysis of the more controversial and complex challenges for all STPs – how to deliver large-scale transformation of acute hospitals. Leaders from

In the afternoon of the first day, Professor Sir Bruce Keogh and Professor Matthew Cripps will address better population healthcare and what we can expect in terms of things happening differently via NHS RightCare’s work different STP footprints will share their ongoing experience of reconfiguring acute services and how they are overcoming the hurdles – be they political or practical. This will include input from Andy Hardy, STP lead and chief executive officer for University Hospitals Coventry and Warwickshire NHS Trust and lead for Coventry and Warwickshire, and Andy Williams, lead for the Black Country STP, and accountable officer at Sandwell and West Birmingham CCG. LOCAL LED CARE SYSTEMS The first session on 29 June will feature a cross-party debate on the NHS and social care funding. David Hodge, leader of Surrey County Council, Health Select Committee member and MP Helen Whately, Jonathan Ashworth, Labour Shadow Secretary of State for Health, and Liberal Democrat Health Spokesman Norman Lamb will tackle the issue of whether STPs really do have the power to reverse the crisis in the NHS and how best to sort out the crisis in social care, that led Surrey County Council proposing council tax hikes of 15 per cent to combat deep cuts. Sir David Behan, chief executive of the Care Quality Commission (CQC), will then present his keynote address on leadership, innovation and safe care, outlining the CQC’s strategy towards innovation and improvement. This

will be followed by a panel discussion with system leaders, such as Phil Moore, deputy chair of Kingston CCG and Wendy Thompson, lead for Norfolk and Waveney STP, on the challenges of regulating an increasingly integrated heath and social care system. Angela Pedder, lead CEO of the Wider Devon Sustainability and Transformation Plan, will focus on her leadership journey through the NHS, culminating in becoming the system leader of an STP serving 1.1million people. Her keynote address will also examine what it takes to be a successful leader of a system as opposed to an organisation, as well as the challenges and lessons learned. Samantha Jones, director for NHS England’s New Care Models Programme, will provide an update on the programme and explain how it is supporting implementation of STPs and the Five Year Forward View – improving the quality of care, preventing ill-health and saving money. The Keynote Theatre will finalise its sessions by hearing the closing plenary address, to be presented by Philip Dunne, Minister of State for Health. SUSTAINABILITY THROUGH TRANSFORMATION Speaking in the Sustainability through Transformation Hub, Andy Hardy, chief E

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

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EVENT PREVIEW  executive officer at the University Hospitals Coventry and Warwickshire NHS Trust, will lead three case studies on the immediate impact of STPs, before a finance focused session explores the different approaches that leaders of STPs and their partnership organisations are taking to achieving financial sustainability across local health economies. This will include assessing key dilemmas, including how to balance the need to meet organisational control totals against the imperative of meeting system control totals and how efficiency and productivity programmes such as NHS RightCare and the Carter reforms support the creation of financially sustainable footprints. A session on Key Enablers for Change will monitor Vanguards that are effectively mobilising people to self-care, to take responsibility for their own health and to engage in shared decision making with clinicians. Case studies examined include My Life a Full Life (Isle of Wight) PACS Vanguard, Better Together (Morecambe Bay Health Community) and Public engagement around changes to stroke services at Coventry and Warwickshire STP. There will also be a session on STPs and other transformation programmes that have rationalised estates quickly and made financial gain, followed by discussion and Q&A with an expert panel. NHS PROVIDERS NHS Providers, the trade association for the NHS acute, ambulance, community and mental health services, will be speaking on both days of the show in the specified NHS Providers Theatre. Chief executive Chris Hopson will use his opening address to highlight the myriad challenges facing NHS providers – rising demand, an unprecedented financial squeeze, growing workforce issues – and what is needed now at both a system and individual provider level to tackle the challenges appropriately. Continuing in the same theatre, Russell Emeny, director of Emergency

Chris Hopson will highlight the challenges facing NHS providers – rising demand, an unprecedented financial squeeze, growing workforce issues – and what is needed now to tackle the challenges appropriately

Health+Care 2017

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Care Improvement at NHS Improvement, is due to present an national overview on the progress in implementing the Urgent and Emergency Care Review Learning from the Emergency Care Improvement Programme, before Jacob West, of the New Care Models Programme, looks at two different-styles of acute care collaboration, focusing on the Walton Centre NHS Foundation Trust led Neuro Network, which is set up to improve services for patients with long-term neurology conditions and spinal problems. Representing the CQC, deputy chief inspector of hospitals Ted Baker provides an overview of the department’s strategy for hospitals, exploring the findings from the State of Hospitals report. The final panel session of the first day in the NHS Providers Theatre will bring together chief executives from a range of NHS trusts, including Rob Webster of South West Yorkshire Partnership NHS Foundation Trust, Claire Murdoch of Central and North West London NHS Foundation Trust, Robert Woolley of University Hospitals Bristol NHS Foundation Trust and Tom Cahill of Hertford Partnership University NHS Foundation Trust. The participants will discuss and debate how we move on from firefighting to delivering real transformation across NHS trusts, what E

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Health+Care 2017

EVENT PREVIEW  needs to change to enable this to happen and how STPs are driving this process. OPERATIONAL PRODUCTIVITY Lord Carter of Coles will open the second day in the NHS Providers Theatre by expanding upon his £5 billion operational productivity challenge, explaining how NHS Improvement is supporting trusts to deliver efficiencies and what we have learned so far since the launch of his report. This will be succeeded by a case-based session looking at how health and social care are working together to tackle the system‑wide problem of delayed transfers of care, sharing solutions that are having the greatest impact on reducing the length of hospital stays and readmissions – work that is potentially replicable in other areas. Claire Casarotto, of East Kent Hospitals NHS Foundation Trust, and Lisa Martin, of Kent County Council, are two of the speakers confirmed to present this session.

ENCOURAGING INNOVATION Digital Healthcare 2017 will be colocated alongside Health+Care, presenting the latest healthcare technologies and showcasing their practical application and integration into existing healthcare infrastructure. Playing host to an innovative conference programme, the stream will explore the latest digital technologies shaping healthcare transformation, as well as present interactive case studies to showcase their practical implementation. Stand out sessions in the Digital Healthcare 2017 conference programme include Keith McNeil’s Exemplars Panel, Christopher Greany of the City of London Police looking at cyber and digital crime, test bed site demonstrations from Liverpool Community

Lord Carter of Coles will open the second day in the NHS Providers Theatre by expanding upon his £5 billion operational productivity challenge, explaining how NHS Improvement is supporting trusts to deliver efficiencies

Health NHS Trust and Dudley Metropolitan Borough Council, an analysis of data analytics in the NHS and an exploration of new models of care in a 5G future. THE HEALTHCARE TRANSFORMATION AWARDS Supported by NHS England, NHSCC and NAPC, the Healthcare Transformation Awards celebrate the success and hard work happening across local healthcare systems. The categories for 2017 include: Primary Care Innovation; Improving Cancer Outcomes; Innovation in Diabetes Care; Improving Patient & Community Engagement; Redesign of Care in Mental Health; Innovation in Improving Outcomes and Reducing Variation; Fostering Commissioner & Provider Collaboration; and Utilising Digital Transformation to Manage Population Health. The relaxed and informal awards will be held on Wednesday 28 June, the evening of the first day of Health+Care, at The Crown Plaza London Docklands. L FURTHER INFORMATION www.healthpluscare.co.uk

We believe that value should mean the same to your patients as it does to your budget. That’s why at Ethypharm we’re dedicated to making and supplying high quality medicines, at prices that have the potential to make significant savings for the NHS, without compromising patient care. Visit us at Health+Care Stand T45 to find out how you could benefit across our main therapy areas: Mental Health, Pain and Palliative Care, Parkinson’s

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A leading expert in the process of tender writing

Bill Watson has spent 30 years working in various roles and functions in the health and social care sector. Initially he trained and worked as a registered nurse in hospitals and in the care home sector. He then worked as an academic implementing and researching the impact of large-scale organisational developments across health and social care, for example, measuring the impact and benefits of integrated approaches to services for respiratory disease, diabetes and cancer. After leaving academia, he worked as a training consultant delivering a range of courses such as infection control, dementia awareness and medication administration within the home care and care home sectors. For the last 10 years,

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Bill has worked as a Business Support Consultant to private health and social care providers. With his business partner, he established Insequa Ltd to provide business growth, tender writing and compliance support. He has developed extensive knowledge and expertise in Public Sector Procurement and health care contracting and now uses his practical, first hand and academic understanding of health and social care issues, coupled with his understanding of procurement and contracting processes to help businesses succeed and grow in an increasingly challenging environment. FURTHER INFORMATION www.insequa.co.uk

Horses helping people for mental health and emotional wellbeing Founded in 1999, the Equine Assisted Growth and Learning Association (EAGALA) is the leading international nonprofit association for professionals incorporating horses to address mental health and personal development needs. EAGALA’s vision is that every person worldwide will have access to these therapy services known as EquineAssisted Psychotherapy.  There are now over 700 EAGALA programs, with professionals trained and certified through EAGALA, providing services helping change the lives of people with a diverse range of struggles, including those suffering from addictions, depression and trauma, and improving relationships in families and groups.   EAGALA has over 4,500 members in 50 countries. EAGALA Model Equine-Assisted

Psychotherapy and Personal Development is experiencing rapid growth around the globe. Equine-assisted work often helps clients change and grow more effectively and quickly than traditional clinical and psycho-educational approaches. That’s because people typically learn best by doing. Life lessons take deeper root when individuals both understand them in their heads and experience them in their bodies. Working with horses is engaging, real time and hands-on. The experience is immediate and fully felt. FURTHER INFORMATION www.eagala.org

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QED Scientific Ltd has established itself as a UK market leader in the design and supply of a wide range of warming cabinets such as fluid, blanket, and contrast media cabinets. A natural extension to this range are patient warming systems which include blankets and mattresses – with sizes to cater for premature babies’ right through to adults in the operating theatre. QED Scientific’s warming products are supplied to both NHS and private hospitals across the UK. As part of its commitment and dedication to temperature management, QED developed a CRT ‘controlled room temperature’ cabinet to provide a safe storage solution for 25°C pharmaceuticals. These cabinets are not only a cost-effective alternative to

Healthcare budgets are under greater pressure every year, as people live longer and medicines become more costly, while funding simply cannot keep pace with rising demand. The number of people living with long term conditions keeps growing and every health service has to face the same challenge: how to dispense medications more efficiently while keeping errors to the minimum. In the new digital era, the levels of dispensing automation we see in countries like the Netherlands and Sweden will become the norm in our community and hospital pharmacies. VMI Care has partnered with pharmacists to redesign the Rx assembly, checking and dispensing process in most major European countries. It can help you to manage your

air‑conditioning, but eliminate the need for constant temperature monitoring of the storage room, preventing temperature spikes, and protecting the efficacy of medicines. QED Scientific also supplies equipment for hospital blood transfusion laboratories, such as blood bank refrigerators, platelet incubators and centrifuges. Its UK factory manufactures laboratory ovens, incubators and sterilisers. FURTHER INFORMATION www.qedscientific.com

HEALTH BUSINESS MAGAZINE | Volume 17.2

operating costs and substantially reduce dispensing errors by bringing its digital dispensing expertise to your pharmacy. VMI Care is trusted by pharmacists and carers to deliver safe dispensing services to thousands of patients across Europe. VMI Care partners with innovative pharmacists to deliver proven digital dispensing solutions which give healthcare professionals the confidence they need to optimise repeat dispensing, to improve the quality of care and to reduce the costs of medicine distribution. FURTHER INFORMATION vmi-group.com/care rcroese@vmi-group.com


BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Intelligence for healthcare Methods Analytics provides strategic and operational intelligence focusing on the efficiency, quality and safety of healthcare services. The firm’s highly qualified team of experienced informaticians and analysts are primarily focused on the provision of strategic intelligence around quality and safety of care for the healthcare market in the UK. Methods Analytics works with a wide range of public and private sector clients delivering actionable knowledge on population health provision, activity and outcomes. It empowers key decision makers and healthcare professionals across the NHS to design transformation, using comparable and transparent intelligence; supporting sustainable improvement. Methods Analytics core solutions include; benchmarking intelligence solutions; clinical portal web development; pharmaceutical and life science data analytics; data science and predictive analytics;

bespoke healthcare consultancy; data visualisation and intuitive displays; managed services such as online portals, dashboards and programme management; and data management (warehousing, integration, quality and analysis) It has developed a range of products that are free to the general public, alongside commissioned bespoke analysis and specialised information products that are available on a subscription basis as a managed service. Examples include: Methods Stethoscope™; urgent care case studies; Royal College of Surgeons PET tool and Quality Dashboards; SWORD TM; GP access; NHS England SSQD; and NHS England QSIS. FURTHER INFORMATION methodsanalytics.co.uk

Experts in absorbency and medical materials Anti-slip absorbent floor mats from Enaris are one of a range of innovative products which are being supplied into the NHS by a new name in medical and healthcare. Enaris – the new name for Sirane’s medical division which rebranded in March – has been created to service medical, laboratory, dental, care-home, emergency and veterinary sectors. It has drawn on Sirane’s expertise in areas including absorbency and material science – as well as from listening to the needs of the market – to create a portfolio of products, many of which are available to buy online from the Enaris website. Jeremy Haydn-Davies, Enaris MD, said: “Enaris is also a development company, and from day one we will be happy to talk to customers about developing new products using our knowledge and expertise, and we’ll also be able to offer many products in bespoke versions.

Let us know the products you want to be able to buy.” Products manufactured by Enaris include anti-slip disposable absorbent floor mats, already used in some NHS operating theatres and scrub areas; absorbent disposable tourniquet drapes; and products such as emergency spill pads. Laboratory products include specimen bags, absorbent pads pouches and spillage protection. Enaris will be exhibiting at the Health+Care Show at the ExCeL arena, stand is J66. FURTHER INFORMATION www.enaris.co.uk

Provider of quality, affordable medicines that deliver sustainable value

Enabling the NHS to improve healthcare and reduce costs

Ethypharm is a European specialty pharmaceutical company with global reach and a committed player in the treatment of pain and addiction. Ethypharm also develops and markets complex generics and essential medicines that help reduce healthcare costs, particularly in the field of emergency care and oncology. The company employs 1400 people mainly in Europe, and its drugs are marketed in more than 50 countries. Ethypharm’s ambition is to become the European leader for the treatment of pain and addiction and to help patients

Medefer is a healthcare service provider focused on facilitating consultant-delivered patient care in the community, improving health outcomes and reducing NHS outpatient waiting lists, at a fraction of the cost of the current outpatient services. Medefer enables delivery of reliable rapid and quality specialist consultant advice and management plan to GPs to enable their patients to be managed in the community, whilst capturing data to enable intelligent commissioning of outcome based and integrated services. Medefer delivers this service through an innovative combination of seamless IT platform and national network of NHS specialist consultants supporting local specialist consultants. Medefer’s IT platforms work with all GP systems as well as NHS’ e-referral

around the world gain access to high quality, essential and affordable medicines. Check out the Ethypharm cost savings calculator to work out just how much you could save per annum. Furthermore, click the prescribing information tab on the website to find out everything you need to know about Ethypharm’s medicines, posology, side effects and recommended dosage. Alternatively call to speak to an adviser. FURTHER INFORMATION Tel: 01483 726929 info@ethypharm.co.uk

system. The platform works in the background, enabling appropriate distribution of referrals between consultants, both locally and nationally, whilst capturing additional data that is essential for commissioning, but currently lost and not captured. The average response time from Medefer consultants is only five hours from referral with over 50 per cent of GP initiated referrals sent through Medefer being avoided. Medefer currently supports nine specialities covering a population of 1.7 million patients, generating savings of between 30 and 40 per cent for CCGs in comparison to the traditional referral route. FURTHER INFORMATION www.medefer.com

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PRTG NETWORK MONITOR SAVES LIVES Any delay in accessing patient medical records could be life threatening. A healthy network means downtime never delays treatment.

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SHREWD

SINGLE HEALTH RESILIENCE EARLY WARNING DATABASE

REAL TIME VISIBILITY OF PRESSURE ACROSS HEALTH & SOCIAL CARE Working with 26 CCGs across England, Transforming Systems has developed a simple, real time view of system pressure that can be implemented quickly across any health and social care system SHREWD draws data from all providers across a health and social care system in real time. It presents agreed diverse, mission critical indicators that identify when and where pressure is building. Using high impact, auditable actions, the system pushes real time alerts to front line teams who, using an App, respond with planned actions that have a digital audit trail. The aim is to pro-actively tackle the causes of emerging pressure using real time data and planned escalation action s.

how our systems help: 1. 2. 3. 4. 5.

Show pressure building in real time across the whole health and social care system Minimise escalation calls and enable proactive escalation planning Streamline your escalation, using easy to use technology to achieve faster response Develop a real time strategic dashboard for your health economy, enabling system leaders to make decisions driven by real time data WaitLess empowers patients to choose where to be seen for minor emergencies using real time urgent care waiting times and live traffic information. The App has delivered an academically verified reduction in A&E attendances

For More Information: Call 0203 040 2265 Email: Support@transformingsystems.com Website: www.transformingsystems.co.uk

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DIGITAL NHS

UK e-Health Week

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Using data and IT to transform healthcare Returning to London’s Olympia for the third year, UK e-Health Week is devoted to the people and organisations that use the power of IT to transform health and care. Health Business analyses May’s show Hosted by HIMSS and BCS – the Chartered Institute for IT, the e-Health Week agenda, developed with the support of NHS England and NHS Digital, will guide delegates through inspiring plenary discussions, informative workshops and practical tutorials, maintaining an overall theme of using data, IT and tech to transform health and care. Attendees will understand the implications of the two-year planning cycle linked to agreed Sustainability and Transformation Plans (STPs), supported by the established vanguard sites. This is enhanced by the newly created Global Digital Exemplars Zone, which will showcase the progress made by the 12 NHS trusts announced by the Health Secretary Jeremy Hunt as the most advanced in their use of IT and data. The exemplars are to receive up to £10 million to continue to deliver innovative approaches to digitalisation and to help others in the NHS to learn from their experience, with the extra funding and support hoping to take these trusts from national leaders in health IT to world-class centres of excellence. The interactive zone will operate as a ‘conference within a conference’, shining a

Th Global e Exempl Digital will sho ars Zone progres wcase the 12 NHS s made by the t advanc rusts in their ed us and dat e of IT a

light on the successes, ambitions and plans of the exemplars. The space will be a hub of collaboration and networking, with local innovators at the forefront of health IT delivery and influential leaders from national organisations shaping the digital agenda on hand to talk about their work areas.

KEY THEMES FOR 2017 UK e-Health Week 2017 will tackle all of the current challenges and opportunities in healthcare IT, focusing on the progress towards a fully digital NHS, scrutinising the plans and roadmaps that NHS England and NHS Digital are putting in to place to make the NHS paper free. This includes the aforementioned Global Digital Exemplars Zone, as well as a focus upon cyber security, interoperability, digital maturity and the new Digital Delivery Board. Additionally, conference sessions will examine leadership and culture within the NHS, using the Wachter Review to explore the new challenges facing healthcare IT leaders,

emerging new customer profiles and voices and the new Digital Academy. Key speakers to present sessions at the show include NHS England representatives, such as Matthew Swindells, national director for operations and information, Keith McNeil, NHS chief clinical information officer, Beverley Bryant, director of Digital Transformation, and Jane Cummings, chief nursing officer. On top of this, other speakers include: Andy Kinnear, chair of BCS Health; professor Ross Koppel, University of Pennsylvania; professor Chris Lehmann, Paediatrics and Biomedical Informatics, Vanderbilt University; and Steven Roberts, strategic transformation director and vice chair, Barclays UK. WIDENING THE DIGITAL EXPERIENCE Following the conference welcome, to be presented by Stephen Lieber, president E

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Unified monitoring that keeps track of your infrastructure 24/7 Modern healthcare providers run networks that include classic IT infrastructure as well as fully-electronic patient medical records and medical equipment. Patient reliability on these systems calls for an equally reliable network infrastructure. PRTG helps improve the quality of patient care by ensuring the infrastructure works efficiently at all times. Paessler AG’s award winning PRTG Network Monitor is a powerful, affordable and easy‑to‑use Unified Monitoring solution. It is a highly flexible and generic software for monitoring IT infrastructure, already in use at enterprises and organisations of all sizes and industries. Over 150,000 IT administrators in more than 170 countries rely on PRTG and gain peace of mind, confidence and convenience.

Founded in 1997 and based in Nuremberg, Germany, Paessler AG remains a privately held company that is recognised as both a member of the Cisco Solution Partner Program and a VMware Technology Alliance Partner. For more information about PRTG or to find out how it could support your business, visit the website or call to speak to an adviser. FURTHER INFORMATION Tel: +49 911 93775-400 sales@paessler.com www.paessler.com/lifeline

Transport and Handling Solutions Electric vehicles available to rent or buy from Britain’s largest manufacturer, supplying to the hospital sector since 1975.

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ICT and healthcare technology products XML solutions have been working on national and local IT projects for the NHS for over 10 years now. It is now contributing to many of the national solutions being brought by NHS Digital and Public Health England such as Spine2, Care Connect and GP connect. XML solutions’ integration experience is unrivalled, having developed many of the national interoperability mechanisms.  NHS England, NHS Digital and Public Health England utilise the company’s EA light method, a proven approach to assessing current ICT landscapes. In recent times XML solutions has worked closely with Leeds Teaching Hospital Trust, developing their electronic patient record ppm+ and integrated the company’s clinical digital forms platform forms4health. The trust is now well on track to being truly paperless by 2020. Forms4health was designed to

place control over IT systems back in the hands of clinicians. An online user-friendly form designer removes the need for programmers to develop forms. The forms can be easily integrated into your other IT systems to support your existing workflows across all areas of operations; from recording health observations, calculating vital signs or general clinical management forms. This enables your organisation to instantly create mobile, tablet and PC friendly solutions, tailored specifically to your needs, without relying on an externally managed software development cycle. FURTHER INFORMATION Tel: 07956734721 www.xml-solutions.com


DIGITAL NHS  and CEO of show sponsor HIMSS, Juliet Bauer, director of Digital Experience at NHS England, will host the first keynote address. The first day os sessions will centre upon the aforementioned themes of digital health, leadership and patient centred care. Following a talk by professor’s Ross Koppel and Christof Lehmann on the unintended consequences of digital health, a joint panel will discuss the importance of ensuring that digital transformation benefits patients and not just the system. Those involved in the presentation include Nick Hopkinson, chief information officer at Devon Partnership NHS Trust, Molly Watts, patient advocate for digital and Sue Farringdon, chair of the Patient Information Forum (PIF). Mike Chitty, head of Applied Leadership at the NHS Leadership Academy and Tracey Watson, director for Innovation and Partnerships at NHS Digital will also speak on the morning of the first day to question whether leadership is the most important criteria to accelerate digital transformation. Juliet Bauer will then return to the stage to explore moving from examples of best practice to widespread adoption, alongside Will Warburton, director of Improvement at the Health Foundation. As the first day reaches its close, Professor Jane Cummings, chief nursing officer for England, will host her keynote and launch the Kate Granger Compassionate Care Awards alongside Chris Pointon, husband of the late Dr Kate Granger, a geriatrician, campaigner for better patient care and creator of the ‘#hellomynameis’ campaign, which encouraged healthcare staff to introduce themselves to patients. INTEROPERABILITY AND INTEGRATION Andy Kinnear, chair of BCS Health, Keith McNeil, NHS England’s chief clinical information officer and Will Smart, chief information officer for NHS England, will lead the welcome and opening panel session on day two of UK e-Health Week. This will

be followed by two keynote presentations – the first by Beverley Bryant, director of Digital Transformation and the second by Harpreet Sood, associate chief clinical information officer for NHS England. Will Smart will then return to present a session on making interoperability and integration a reality, before Keith McNeil leads a talk on meeting the challenges of Paperless 2020, alongside Dr Afzal Chaudhry, chief medical information officer for Cambridge University Hospitals Foundation Trust and Anne Cooper, chief nurse at NHS Digital. Professor Martin Severs, Caldicott Guardian and lead clinician at NHS Digital, will lead a session on making place-based commissioning a reality with digital health. Severs will be joined in this session by Dr Geraint Lewis, chief data officer for NHS England, Dr Michael Dixon, chair at the College of Medicine, Andrew Griffiths, director of the NHS Wales Informatics Service, and Dr Saif Abed, EMEA medical director, Imprivata. UNPLUGGING HEALTHCARE EXPERTISE NHS facilities go to great lengths to protect their data from network intrusions, hacking, viruses, and theft. However, many fail to protect against the disastrous consequences of data security breaches from media that they thought was deleted or erased, with various trusts having already been fined by the ICO over the loss of sensitive information and the maximum fine for Data Protection Act breaches is currently £500,000. This session analyses the consequences of data security breaches and garner erasure solutions.

In this session, Paessler AG take a brief look at how PRTG can help save lives by alerting system administrators and network managers to IT related issues before they impact patients. Maintaining uptime in a healthcare scenario is more critical than in most other industries and keeping pace with modern technology is not always easy. Using healthcare‑specific protocols and sensors, PRTG can effectively be that vital extra team member IT managers have always needed. XML Solutions will provide a demonstration of how easy it can be to go paperless using a publishing paradigm to avoid the slow cycle of requirements gathering, designing, coding, highlighting the importance of having a mechanism to put control of technology back into the hands of the business and clinical users.

UK e-Health Week

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

TAP INTO THE SHOW APP Registered UK e-Health Week delegates have access to an exclusive mobile app to help them get the most out of their visit to the show, including planning their visit, networking with other app users and discovering more about show speakers and sponsors. Other features include personalised programme and ‘favourites’ functionality, which lets users save the sessions, speakers and exhibitors they’re interested in for easy access, and the ability to interact with other registered users through instant messaging. L FURTHER INFORMATION www.ukehealthweek.com

Professor Jane Cummings will launch the Kate Granger Compassionate Care Awards alongside Chris Pointon, husband of the late Dr Kate Granger, a campaigner for better patient care and creator of the ‘#hellomynameis’ campaign

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SURVEILLANCE

James Kelly, of the British Security Industry Association, discusses how CCTV systems can provide an effective deterrent to would be criminals and help to protect staff, patients and visitors The protection of staff, patients and visitors is a top priority for those responsible for security in the healthcare sector. Frontline staff across the UK face a number of threats whilst on duty, with figures suggesting that the number of attacks against them is on the rise. Many sites within the healthcare sector will have a large transient population and many are accessible 24 hours a day. This can pose challenges in monitoring and restricting access to the public areas of a site, which brings challenges to ensuring that the site is safe for staff, patients and visitors. Worryingly, the rate of attacks against frontline workers in the healthcare sector has been steadily rising according to a report published by the Greater London Authority Conservatives (GLAC). During the

period covered by the report, the number of recorded attacks against frontline NHS staff rose from 13,436 in 2010/11 to 16,475 in 2012/13. It is therefore becoming increasingly important to not only protect the valuable assets within healthcare sites, but also to ensure the safety of frontline workers. CCTV can be particularly effective in enhancing the security of sites such as hospitals in terms of both crime detection and deterrence. The placement of CCTV technology alongside

The annual NHS Staff Survey has revealed that attacks on staff at Pennine Acute Hospitals Trust increased in 2016, with 16 per cent of staff at the trust reporting that they had experienced physical violence from patients, their relatives or the public in the last 12 months. The trust, which runs Rochdale Infirmary, Fairfield General, Royal Oldham and North Manchester General, also reported how two per cent of staff experienced physical violence, although that figure did not represent an increase on the previous year. Glynis Jones, security management specialist at the trust, said: “As a priority over the next 12 months we are looking at what we can do to reduce the amount of violence staff experience at work from patients and the public, particularly front line staff, to ensure they feel safe and supported at work. “Our security staff are highly trained and our security managers liaise regularly with the neighbourhood police associated with all our hospitals. We work closely with our frontline staff, particularly in our A&E departments and Urgent Care Centre, our security teams and Greater Manchester Police, to look at how we can address and reduce incidents of violence. We are currently in the process of improving the CCTV and lighting at North Manchester General Hospital, which will help to deter and identify the perpetrators of violence.”

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

Helping to keep staff, patients and visitors safe

NHS Staff Survey shows increase in staff attacks

Security

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FURTHER INFORMATION tinyurl.com/l94sxe3 visible signage can deter would be criminals from engaging in criminal activity for fear of evidence being recorded on camera. CCTV cameras are also unrivalled in their ability to gather real time intelligence – facilitating a speedy and informed response from security staff and/or the police. The ability for CCTV control room staff to track offenders using multiple cameras enables them to monitor their whereabouts and deploy on-site hospital security staff quickly and efficiently. E

Crim are mucinals likely toh more guilty w plead by the u hen faced evidenc ndeniable eo caught f being o camera n

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Security

SURVEILLANCE

 In addition, where incidents require the attendance of the police, real-time monitoring of the camera can enable system operators to provide the Police with on-going information as the incident unfolds. Evidence gathered using CCTV cameras is one of the most successful ways of securing convictions in court; criminals are much more likely to plead guilty when faced by the undeniable evidence of being caught on camera. Using CCTV evidence to secure a conviction in court also serves to save money for the public purse. According to Hugh Marriage, former Home Office crime reduction officer for the South-East of England, ‘a court hearing with a guilty verdict saves around £3,000 to £5,000 and CCTV pictures mean there has been an enormous increase in guilty verdicts’. Indeed, in 2010 alone, the Met Police stated that one in six crimes are solved thanks to CCTV solutions. According to the GLAC’s report, neither the Department of Health, nor the NHS Protect holds data on the number of trusts that have CCTV in their A&E departments and Urgent Care Centres. The report did however receive responses from three of the six London hospital trusts with such emergency departments that are mentioned in the report. All three reported that they have CCVT in A&E departments and Urgent Care Centres which record footage of violent incidents against patient-facing staff.

CCTV operators to be notified regarding the offending object, allowing for its removal and the restoration of public order. DRIVING STANDARDS FORWARD In 2012, the Protection of Freedoms Act formalised the government’s intention to drive CCTV best practice forward. The CCTV Code of Practice – made up of twelve guiding principles – aimed to define best practice in a way wherein public protection was paramount. The Code provides guidance on the appropriate and effective use of surveillance camera systems by relevant authorities (as defined under Section 30 of the Protection of Freedoms Act 2012) in England and Wales, who must have regard to the Code when exercising any functions to which the Code relates. Whilst NHS trusts are not currently considered as relevant authorities – and thereby obliged to comply – they are encouraged to do so by the Surveillance Camera Commissioner. Given that NHS trusts are funded by the public and that sites are generally accessible by the public, E

TECHNOLOGY TO COMBAT THE TERRORIST THREAT The threat level for international terrorism in the UK remains at SEVERE as it has done since August 2014. Those responsible for the security of sites in the healthcare sector should also be mindful of the specific threats that their organisation might face. One application of CCTV solutions that can be used to help protect busy sites, such as hospitals, from terror threats is that of video analytics. This impressive technology is rapidly developing and is invaluable in the protection of largely populated areas – such as hospitals- from the risk of terrorist attacks. One particularly useful application of video analytics in terms of public space surveillance is ‘object left/object removed’. ‘Object left’ refers to the identification of an unattended item such as a bag or package – potentially containing an explosive device. Often, making the assumption that an unattended package is malicious can cause panic and lead to a chaotic situation, which could be disruptive to the provision of care. It is therefore crucial for security professionals to make the assertion as to whether there is an innocent explanation or if the item is indeed malicious and requiring an immediate evacuation. ‘Object removed’ allows

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SURVEILLANCE  the Code may be expanded to require NHS organisations to comply with the Code in the future. The purpose of the Code is to ensure that individuals and wider communities have confidence that surveillance cameras are deployed to protect and support them, rather than to spy on them. To achieve this, the Code sets out 12 guiding principles that should apply to all surveillance camera systems in public places. By voluntarily adopting the Code, trusts will be reassuring staff, patients and visitors that the use of surveillance cameras is for a specified purpose in pursuit of a legitimate aim, and that the effects on individuals and their privacy has been carefully considered. CCTV is one of the most important developments in the security landscape of recent years and maintains a pivotal role in the safety and security of healthcare sites. The success of any system requires a diligent approach to planning, design, installation, maintenance and operation, as well as the use of high quality products. Members of the BSIA’s CCTV section are experts in the CCTV arena and are committed to developing and sharing best practice to drive up standards in the industry. L FURTHER INFORMATION www.bsia.co.uk

Security

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

The placement of CCTV technology alongside visible signage can deter would be criminals from engaging in criminal activity for fear of evidence being recorded on camera

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Written by Carina Nobrega, content coordinator, UBM EMEA

IFSEC International

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CYBER SECURITY

Hospital ransomware payout shows high stakes of cyber war From small businesses to the biggest corporate brands, no one is safe from cyber crime it seems. However, hospitals have become a particularly attractive target for hackers – and ransomware appears to be the weapon of choice. Carina Nobrega investigates the situation In early 2015, an LA hospital’s entire internal computer system went down for more than a week after becoming infected with ransomware, which encrypted patient records and set the ransom for unlocking them at 9,000 bitcoins (almost $3.7 million). Unable to access patient’s records, the hospital had to revert to using paper and pen and had to send A&E patients to different hospitals as emergency rooms were unable to function properly. Though medical devices weren’t affected in this instance, Mike Ahmadi, global director of critical systems security for the Synopsys Software Integrity Group, admits that the prospect is certainly possible. He said: “We’ve done tests at some places where we’ve seen you can take down an entire network of infusion pumps by just sending a couple of bad packets to the network.” Ahmadi, a member of the US Department of Homeland Security Industrial Control Systems Joint Working Group and part of the advisory board for the US Secret Service Electronic Crimes Task Force, says one thing is for sure when it comes to cyber security trends, and that is that ‘we’re going to start to see a lot more malicious activity’.

It sy is so ea into k to brea today e a system er of th ne w o p e h a as t is so inss r e t u p com ssword that pa even a aren’t nge challe

ADDITIONAL HACKING OPPORTUNITIES As traditional crime rates continue to fall across the Western World (in contrast, it seems, to the fear of crime), cyber crime seems to be heading in the other direction, while the Internet of Things is multiplying the vectors of possible attack. Ahmadi suggests that: “The continued growth of technology and continued increase of power and computational power is going to create additional opportunities for hackers to break into systems.” So why do the criminals seem to have the upper hand in what used to be called cyber space, even as some traditional crimes, like burglary or armed robbery, are much less practical and worthwhile than they used to be? “One of the main reasons

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it’s so easy to break into a system today is the power of the computer is so insane that passwords aren’t even a challenge.” Nevertheless, growing awareness does not necessarily equate to taking the problem seriously. Ahmad explains: “The software industry are really pushing back on any attempts to regulate them against cyber security issues. If governments don’t start mandating some sort of real responsibility for software companies, where many of the serious issues actually lie, I believe we may be facing a black-swan event. There will be at least one very big event that will be devastating. As much

as I hope this doesn’t happen, all the data seems to be pointing in that direction.” A ‘black-swan event’, a term popularised by randomness scholar Nicholas Nassim Taleb, refers to an event that is low probability, high impact and extremely difficult to predict. INDICATORS OF A BLACK-SWAN EVENT Drawing an analogy with society’s response to environmental crises, Ahmadi says: “We all knew pollution was getting bad, we knew about it for a long time, but by the time we started to do something on a global basis, it had grown to be huge problem. The thing that is interesting about black‑swan events is that they’re usually preceded by a bunch of indicators that something like this is coming – we’ve seen what’s


BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

STARK ASSESSMENT A white paper recently published by the Institute for Critical Infrastructure Technology (ICIT) has concluded that the healthcare sector is the most vulnerable

A white paper recently published by the Institute for Critical Infrastructure Technology has concluded that the healthcare sector is the most vulnerable and least equipped to defend against hackers and least equipped to defend against hackers. The report, titled ‘How to Crush the Health Sector’s Ransomware Pandemic’, is stark in its assessment of the situation facing the healthcare sector, which it says is ‘pummelled by ransomware attacks, insider threats, APT campaigns and other cyber attacks designed to distract, consume resources, profit by compromising the confidentiality, availability, or integrity of critical health systems, or to outright exfiltrate sensitive EHR, PII, IP, and other data’. Exabeam’s Rick Caccia, an ICIT fellow, believes that ‘artificial intelligence and machine learning bring the same value to healthcare security that they bring to other industries: using big data analytics to detect threats and assist in response. Machine learning can be applied to two useful areas in healthcare cyber security’. The healthcare sector is already using cognitive and AI solutions for big data analytics and for clinical applications. The ICIT’s white paper asserts that ‘the industry needs to responsibly protect its patients and their data by adopting algorithmic defence solutions’. PROTECTING AGAINST RANSOMWARE David Balaban of cyber security resource Privacy-PC.com prescribes a four-step process for protecting yourself. BACK UP YOUR DATA “Many people keep files on network shares, unaware that network shares are as exposed as your desktop computer during a ransomware incident. If the backup is achieved offline, and that place is not accessible from the computer that is initially compromised, then you’re alright. “The same principle applies if you carry out your personal PC backups with a secondary physical drive. Those disc drives need only be in touch with your computer when conducting backups and turned off immediately after that. “In the event your backup disc is linked to the computer during the period the ransomware operates, then it might get encrypted too.” CYBER SECURITY AWARENESS TRAINING “Cyber security professionals generally recommend that organisations provide training to their employees on how to recognise phishing emails and scan email attachments for viruses prior to opening them. With clear, correct instructions and regular training it’s possible to drastically reduce the incidence or risk of online breaches.”

IFSEC International

happening with security but the amount of action that people in the government are taking to solve the problem is nowhere near how bad the problems are getting.” Ahmadi believes this is not entirely a technological problem; rather it’s more of a policy and people problem. Unfortunately, it often takes a major incident before decisive action is finally taken. Organisations tend to be reactive rather than proactive. The risk of anything happening in a single instance is so low it breeds complacency, even if the chances of things happening across thousands of instances is actually quite high. Ahmadi recounts: “I was working with a major medical device manufacturer when their insulin pumps were hacked and because they faced such a huge PR issue and backlash about what happened, they put a lot of time, effort and money into fixing their problem and have now got to a point where there systems are really solid. “Because we haven’t had a black swan event yet, people always look at the numbers and risks and it looks like a fairly safe risk for them to take. They look at it and think: ‘what are the odds of it happening?’ If you look at the numbers, the risk can be construed as being small. I understand they’re playing the odds, but if it happens, the consequences could be really huge.”

PATCH/UPDATE YOUR SOFTWARE “Employees should not be regarded as the final defence line. Your users may still periodically click on attachments or visit compromised websites. No security product or service is perfect, so businesses might take additional security steps to stay safe, like: software patching, updating operating systems, keeping third-party plug-ins like Flash and Java updated, whitelisting computer software operating on devices, and segmenting use of valuable data with supplementary servers.” CONTAIN INCIDENTS “When Washington-based healthcare giant MedStar Health was attacked by ransomware in March 2016, their admins instantly turned off most of the organisation’s operations and networks to stop the virus from distributing. Not only should you disconnect and shut down affected devices, but you must also deactivate all Bluetooth and Wi-Fi on the rest of computers to restrict the virus from dispersing to other devices. “Following that, you should identify what strain of ransomware infected you. In case it’s a known type, antivirus firms might have decryptors to assist you in freeing up important data files without spending money. But if you haven’t backed up your data and can’t find a solution to break the encryption, the only way to retrieve your files is to pay hackers the ransom.” FIND THE RIGHT SOLUTION FOR YOU Taking place in London on 20-22 June 2017, IFSEC International gives you exclusive hands-on access to over 10,000 security solutions, live product demonstrations, and networking with over 27,000 security professionals. Covering every aspect of security, from cyber security, access control and video surveillance to smart buildings, border control and so much more, visiting IFSEC International is the perfect way to keep up to date, protect your business and enhance your career in the security industry. This free-to-attend event gives you access to the largest marketplace of security suppliers, including Anixter, Sony, Avigilon, Comelit, Milestone, Pelco, Honeywell, Bosch, Cisco, Q-Net, InnoSenT, A-Data, Quanergy Systems and 650 further exhibitors.L FURTHER INFORMATION www.ifsec.events/international Volume 17.2 | HEALTH BUSINESS MAGAZINE

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HEALTH & SAFETY

When analysing health and safety in hospitals, the use and location of signs is of paramount importance, says Mark Hughes of the Health and Social Care group at the Institution of Occupational Safety and Health, who reports on the correct use of signage in hospitals Wherever you look in hospitals there are signs. They tell you what you can and cannot do. They inform you of hygiene requirements. They show you which way you need to go to the department you require. Signs come in all different styles and formats, with some printed and some handmade. It cannot be disputed that signs are necessary in a hospital environment. They are a great way to warn the many thousands of people who go through the doors of hospitals every day of some of the risks and specific precautions that need to be taken. However it is important that there are not too many signs as this can lead to ‘sign blindness’. By this, I mean too many signs mean people switch off and walk by, ignoring them and potentially missing important information. When thinking about signs in a hospital one of the most important factors in getting messages across is to have a joined-up approach between departments, including infection control, health and safety, communications, specialist and other departments, charities, volunteer organisations, and so on. All of these departments want to get their message across to the right people. But without a joined-up approach they can tend to use different methods and styles, which can result in a lack of control and standardisation of signs. This in turn leads to ‘sign blindness’. If signs are not used properly it can cause problems for patients and visitors, which in turn can lead to frustrations being taken out on staff. A CLEAR CULTURE From a health and safety perspective there are obvious requirements for signs. For example, they can be used to warn of dangers such as nearby X-Ray equipment, or they can be used to warn of potential hazards such as wet and slippery floors. All of these signs are off the shelf and come in either the mandatory or advisory colours. There are, however, many more signs than those which warn of hazards to patients and visitors. Among them are those which inform patients how long they may have to wait to see a medical professional. These can, in turn, be used to protect staff. When people visit a hospital they will expect to queue but if they feel they are waiting too long

they may start to get annoyed and agitated, which can lead to aggression towards staff – something which is unacceptable. Hospital staff are there to do a job. As with people in all other industries they should be covered by a culture of care, something the Institute of Occupational Safety and Health’s (IOSH) Health and Social Care group – and the Institution as a whole – strongly believes in. This includes preventing them being the target of aggression from the public. Signs play an important part in this. If you take accident and emergency departments as an example, signs can be used to warn people how long they may have to wait depending on their injury and how it was sustained. For a sports injury, the wait may be as much as three‑and‑a‑half to four hours – essentially the

end of the queue as the injury is viewed as self-inflicted. If the patients are warned that they must expect such a long wait this reduces the chances of them getting annoyed. As technology has moved on, we now find in most A&E departments the use of TV screens to keep patients informed of waiting times. This has been shown to reduce the amount of aggressive incidents towards members of staff. As referred to earlier, another group of signs which are relevant from a health and safety point of view are those warning of the dangers of the different types of waste and wet floors. Positioning is crucial with these. They are there to serve a purpose but if they are left where people only see them at the last minute, there is a risk of a slip or a trip. If used and positioned correctly these signs do serve a purpose. Hospital floors, for infection control purposes, tend to be mainly vinyl. However when wet can they can become slippery, especially with the wrong footwear. So signs need to be displayed to warn patients, E

If sig are not ns properl used cause p y it can patient roblems for s which cand visitors, frustratan lead to io taken o n being ut o staff n

Written by Mark Hughes, Health and Social Care, Institution of Occupational Safety and Health

The signs of a correctly designed hospital

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We do. And so should you. Take into consideration the wide range of mobility issues that could inhibit a person’s ability to evacuate the school or college building in the event of an emergency. Ask the experts. Ask us. www.escape-mobility.co.uk info@escape-mobility.co.uk 0844 800 1775


Signage

HEALTH & SAFETY

 visitors and staff and must be displayed well in advance of the area in question. We must also not forget hygiene signs in key locations. This includes those in toilets which have information about good hand-washing techniques and the use of hand gels. They can also include when to stay away from visiting, such as if you have the winter bug, which can create the risk of infecting others, but these signs must be clear and on their own and not swallowed up among many others. HELPING VISITORS AND PATIENTS Good signage is also useful for directional purposes, both inside and outside of the building. For patients, arriving at hospital can be an anxious time. Hospitals can be big and scary places with lots of buildings, departments and people. Once inside a hospital, there must be clear signs to different departments. Generally outpatients areas are split into various specifics like fracture clinics and the common approach for directional signs is to colour code them. This means it is a case of following the red or green lines along the wall or floor to the relevant clinic. Such signs can also be handy for patients who have to make their way to and from different departments, for example if they need to have their bloods taken. It isn’t just patients who signs play an important part for. They are also important for visitors such as patients’ relatives and patient

transport like taxis, ambulances and volunteer drivers. Clear signs are needed for drop-off and pick-up points and car parking. The same is the case for the relevant wards and clinics as well as coffee shops and restaurants. The need for signs begins from the moment people arrive at a hospital. Car parking arrangements must be displayed. There should be clear signs taking you to the right car park for the specific department or ward you are visiting, including clear car parking fees and how to get a reimbursement if applicable. If hospitals don’t get these signs right it can cause numerous problems. As with waiting time information, directional signs are important in preventing patients and visitors from becoming frustrated and taking this out on staff. STANDARDISING SIGNAGE Standardisation of signage and ensuring they are controlled is key. A successful way of doing this is nominating someone within each department and trust wide to be responsible for monitoring the amount of signs and their clarity. Those nominated must ensure that the important messages carried in signs are not lost among too many trivial signs. The use of technology like TVs to generate messages and keep people informed is a move in the right direction, but we must not stick with the same message over and over again; there needs to be a program in place to continually update

It is important to remember that having too many signs can actually have a detrimental effect when it comes to health and safety as people can become oblivious to them

and remove unwanted and old messages. Even when a sign is temporary it should still be made to a specific standard and it must be removed when it becomes out-of-date. An example of this is in infection control isolation areas. It is crucial that once the problem has been removed so should the sign. The responsibility of those nominated people can also include ensuring hospitals make use of the information that they have, for example which languages they need signs to be in. Hospitals gather huge amounts of information about people’s nationality, so they must use this to work out who uses their services. By doing so means that in the most important cases they can have signs printed in the key languages for the demographics of the area. This again can help staff avoid potentially confrontational situations. Having signs printed in relevant languages significantly reduces the chances of having people getting lost in a hospital because they don’t understand the signs. So, signs are more than useful in hospitals, vital even. But it is important to remember that having too many signs can actually have a detrimental effect when it comes to health and safety as people can become oblivious to them. Signs should be used only when necessary and should be clear and readable. If this is the case, staff in hospitals are able to get on with their job without the risk of coming into contact with agitated patients and visitors. This is one way in which hospitals can meet the culture of care which staff should be covered by. L FURTHER INFORMATION www.iosh.co.uk

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HEALTHY EATING

For the first time the Campaign for Better Hospital Food has undertaken an in-depth report into the current state of hospital food in NHS England, using London as a test case for the rest of the country Thanks to the Taking the Pulse of Hospital Food report, Sustain’s Campaign for Better Hospital Food has detailed data on the food served up in London’s hospitals that shows half of hospitals are failing to meet basic food standards, and nearly two thirds failing to cook fresh food for their patients. The report results, which were released on NHS Sustainability Day, showed that many hospitals are struggling to serve and sell freshly prepared, healthy and ethically sourced food for patients, staff and hospital visitors. The general quality of food across most London acute hospitals is variable, with most hospitals performing well in some areas and poorly in others. Only half are compliant with all five hospital food standards required in the NHS Standard Contract for hospitals. Whilst 77 per cent of hospitals cook all food fresh on-site for staff, this falls to only 30 per cent for patients. Furthermore, only 40 per cent of hospitals

were offering 24-hour access to healthy food for staff when the survey closed in December 2016. This makes healthy eating for staff challenging given that vending machines and shops in the vast majority of hospitals sell a majority of unhealthy food and 23 per cent of hospitals don’t offer staff fridge space to store food. Additionally, 60 per cent of trusts surveyed reported their NHS Trust had a food and drink strategy (a requirement in the NHS Standard Contracts), but only 25 per cent covered all the required criteria. Healthy and sustainable food procurement, one key criteria in a food and drink strategy, was missing in many trusts. CAN YOU EAT LESS AND BETTER MEAT IN HOSPITALS? In terms of less and better meat, it is promising that a small number of hospitals have adopted a ‘less and

better meat’ policy, three hospitals for staff food and six for patient’s food. Of these, Harefield, Hillingdon and Queen Elizabeth Hospitals had a less and better meat policy for both patient and staff food. This is a very important first step, and a sign of the direction that hospitals need to move in if they are to promote truly healthy and sustainable food. The report verified which hospitals had external accreditations and awards since these can be helpful to encourage, verify and reward progress. Three acute hospitals from Barts Health NHS Trust (Royal London, St Bartholomew’s and Whipps Cross University Hospital) have achieved Gold Food for Life Catering Mark Award for their food. This award promotes meat free days and meat in moderation alongside higher standards of animal welfare and sourcing of some organic meat, eggs and dairy. Four hospitals achieved E

Written by the Campaign fior Better Hospital Food

Assessing the current state of hospital food

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The rep shows t ort whilst 7 hat, of hosp 7 per cent food fre itals cook all sh staff, th on-site for only 30 is falls to p for patier cent ents

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HEALTHY EATING

Ending gluten-free prescriptions could save £25 million

With the Brexit process started, hospitals face real challenges in rising food prices and catering contract costs. Yet, unlike the situation in British schools and prisons, there are no minimum legal protections for hospital food  the Good Egg Award from Compassion in World Farming for using higher welfare eggs in hospital food. Two of those have also achieved the Good Chicken Award. WHAT IS THE CAMPAIGN FOR BETTER HOSPITAL FOOD CALLING FOR? These findings come at a key moment for catering in the NHS. With the Brexit process started, hospitals face real challenges in rising food prices and catering contract costs. Yet, unlike the situation in British schools and prisons, there are no minimum legal protections for hospital food. This means hospital food is uniquely vulnerable to a race to the bottom in terms of food quality, and patient care. This is why the Campaign for Better Hospital Food is calling for hospital food standards to be set down in law, on the same legal basis as school food standards, to ensure hospitals must mandatorily meet minimum standards for the food served to patients, staff and visitors. These standards should be independently monitored and enforced. Jo Ralling, Jamie Oliver Food Foundation campaign manager and supporter of the campaign, said: “The Campaign for Better Hospital Food’s report is a must read for all policy makers in the country. We’ve had legal food standards for schools and prisons for a decade, there’s no reason we can’t extend

these same protections to hospitals. Let’s all work together to get NHS patients and staff the good healthy food they deserve.” Prue Leith, new Bake Off presenter and hospital food champion, who wrote the foreword to the research report, said: “Hospital food has a deservedly poor reputation and NHS patients and staff deserve better. This report shows that at the moment most hospitals are not serving fresh, tasty and wholesome food so we must have legal standards, like those already in place for school food and prison food, to make sure good food is a priority in our hospitals.” Overall, despite glowing performance across the board from some hospitals the general standard of hospital food is inconsistent and compliance with food standards is low. Therefore, the Campaign for Better Hospital Food strongly recommends that tough standards should be written into legislation, and checked with regular inspections, to make sure hospitals uphold these crucial food standards. Katherine Button, coordinator of the Campaign for Better Hospital Food, said: “The government has failed to take seriously the dire state of hospital food for too long and now half of London hospitals are not meeting even basic food standards. Good food plays an essential role in recovery, well‑being and morale, and patients and

Catering

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The Department for Health has launched a consultation on the prescription of gluten-free foods, claiming the move could save the NHS £25 million annually. The consultation follows NHS England’s recent announcement of new guidance on the prescription of low value items such as travel vaccines, painkillers, and gluten-free foods. The consultation will consider ending the prescription of all gluten‑free foods in primary care, with estimates suggesting this could save £25.7 million a year for the health service. An additional £10 million could be saved through patients no longer needing to attend GP appointments in order to get their gluten-free prescriptions. Currently, staple gluten-free foods such as bread, flour and pasta have been available on prescription to patients diagnosed with gluten sensitivity, since the late 1960s when it was less easy to buy them. However, the DH has argued gluten-free foods are now sold in many supermarkets and a wider range of naturally gluten‑free food types is also available. Health minister, Lord O’Shaughnessy said: “The NHS is one of the most efficient health services in the world, but we need to do more to ensure we get the best possible value for taxpayers’ money. Changing the way we prescribe gluten-free food could make an important contribution to saving the NHS millions of pounds a year.” FURTHER INFORMATION tinyurl.com/mhp7dxr

staff in NHS hospitals deserve better. The standard of food in schools and in prisons is protected by legal minimum standards and we demand the same high quality food for patients, staff and visitors eating in hospitals.” Katharine Jenner, CASH campaign director, added: “The Campaign for Better Hospital Food’s landmark report shows exactly how lax hospital food rules lead to low quality ingredients and hospital shops and restaurants chock full of foods high in salt, fat and sugar. This has to change. We must learn from the successful work to turn around school food using tough legal standards, and bring the same approach into hospitals.” L FURTHER INFORMATION www.sustainweb.org/resources/files/ other_docs/HospitalFoodSurvey_2016.pdf

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NETWORKING

Using guidance from the Meetings Industry Association, Health Business looks at the benefits of an accredited venue when organising healthcare meetings With over 1.3 million business events held in the UK each year, with a value of over £39 billion to the economy, meetings and events are big business. Regardless of sector, meetings and events are an effective tool for businesses to facilitate networking and teambuilding, run product launches, deliver essential communications and promote innovation. Organising events is a big responsibility and there are a number of things to consider to ensure you are getting it right. TIMING Timing is crucial across many aspects of your event planning. Firstly, whilst there will be occasions when an event needs to be organised on a tight timescale, if you can allow plenty of time for planning, research and marketing, your event will benefit as a result. It is also important to consider other industry events or launches taking place, particularly annual events which typically take place at the same time every year. Doing so negates the risk of clashing with established events and therefore affecting your delegate numbers. For the event itself, the schedule for the day should be clearly laid out and allow for networking opportunities and sufficient rest breaks. As a planner, some allowances should be considered for sessions that overrun or and issues that arise on the day. Timely feedback is also important after the event. Whether you choose to ask all delegates or a select few for feedback after an event, do so promptly, whilst the event is fresh in their minds. If you are going to ask for feedback though, be prepared to act on it when it comes to your next event. If problems have been highlighted, work to eliminate them for next time and acknowledge and address them for those who have been affected. BUDGETS Budgets can vary from the generous to the ‘shoestring’. Regardless of where yours sits, you can hold an effective and successful event.

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

Written by The Meetings Industry Association

Choosing the right venue to host your event

Conferences & Events

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in the UK who demonstrate their commitment to quality, service and continuous improvement, all of which benefit the event buyer.

With o 1.3 millver busines ion held in s events year, m the UK each ee events tings and are busines big s.

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

THE BENEFITS OF AIM Essentially, AIM helps event planners to source venues they can instantly trust. This means doing business with venues that care and have integrity, ensuring that delegates are well looked after. Commitment to service excellence is paramount and the facilities and event spaces are fit for purpose and of high quality standard. MEETINGS CODE All AIM venues abide by the Meetings CODE which demands: Consistency; Openness; Decency; and Ethics. AIM venues must achieve 50 grading criteria that include: the location and accessibility of the meeting rooms and facilities; the suitability of the lighting and heating in meeting rooms; the levels of security; how often the rooms are cleaned and decorated; whether the space and furniture are adequate and suitable; the provision of in-room services such as power sockets; what is supplied at no extra charge and how transparent the published prices are. For venues and suppliers, achieving AIM means gaining an industry accreditation and receiving recognition for the management of the business. Internally, the accreditation can help them audit their processes and procedures and ensure they are offering an excellent level of service. The process also highlights any room for improvement so that they can be addressed quickly and appropriately. L FURTHER INFORMATION www.mia-uk.org

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Products & Services

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CONFERENCES & EVENTS

CONFERENCES & EVENTS

Set in a semi-rural location with great links from the motorway, Becketts Farm Conference Centre is a relaxed, contemporary and totally flexible venue, ideal for meetings, training and workshop events. Conveniently located just south of Birmingham city centre and just one mile from J3 of the M42 the venue is a great central location to meet. The venue’s six rooms cater for between two to 60 delegates and are fully air conditioned with natural daylight. Room hire includes free-flow tea, coffee, water, Wi-Fi access, projector, screen, flip chart and free parking. With the award winning Becketts Farm Shop and restaurant on-site, the food options are not only fresh and delicious but can be fully tailored to suit your requirements. The Becketts Farm Conference Centre also offers some great team building activities, taking advantage of either the outdoor

Glasgow Science Centre’s iconic buildings are located on the Clyde, where historic Glasgow meets the modern city, providing an unforgettable backdrop for events. Whether your requirement is a conference for up to 370, a dinner for 500 or a drinks reception for 3,000, the Centre’s events team will provide a bespoke package with flexible in-house catering and audiovisual solutions. Glasgow Science Centre believes food should be tasty, fresh and uncomplicated and its menus are designed to meet the requirements for the diverse range of events Glasgow Science Centre attracts, however it can also create bespoke menus and themes designed for your needs as well as budget. In addition to three floors full of interactive exhibits, GSC also

A contemporary and totally flexible venue

farm space or its fantastic Cookery School facilities. From the Centre’s Chocolate Challenge to Local Wine Tasting, there’s an event to suit every team. Becketts Farm Conference Centre pride itself on its personal and friendly service. The Centre’s dedicated conference team will support you from your initial enquiry right through to your event and will be on hand throughout the day to ensure that everything runs smoothly. FURTHER INFORMATION Tel: 01564 823 402 www.beckettsfarm.co.uk

Historic Glasgow fuses with the modern city

AIR CONDITIONING

INFECTION PREVENTION

Specialising in a vast range of filter products, The Filter Company, a division of health and safety engineering, can cater for all product needs throughout the health sector from high efficiency HEPA filters through to self-cleaning fluid filters. The Filter Company’s AutoKlean range has filtered ‘anything that flows’ for almost 100 years and the firm’s background in dust collection means it has a wealth of experience in air filtration of all kinds including a full range of heating, ventilation and air conditioning panel and bag filters. The Filter Company product range includes: a full range of HVAC filters for fume cupboards, cooker hoods, heating, ventilation and air conditioning systems; and a full range of HEPA filters For liquid applications, the company has: Klariflo range of high efficiency water filter cartridges for applications such as drinking water, X-ray cooling and other water process systems; and

DiffX is a powerful nonchlorine disinfection system which eliminates all surface contamination including spores, bacteria, viruses and pathogenic organisms. The patent protected formulation of disinfection represents a new generation of disinfection. It is not deactivated by soiling, it works through the dirt. The powder is contained within a water soluble sachet, which when dissolved in warm water creates a disinfecting agent which outperforms chlorine based disinfectants, especially under the most extreme conditions. DiffX kills MRSA and viruses, C diff spores 100 per cent, TB and Mycobacteria. It is non chlorine based, has a corrosive inhibitor and is pH neutral. DiffX is low risk - COSHH; cleans and disinfects working through dirt; effective against C. diff, MRSA and Norovirus; cleans and disinfects

houses an IMAX cinema and fulldome digital planetarium. Whilst guests enjoy the Centre’s unique venue, you are doing your bit for charity, helping it achieve its charitable mission. Scientists can also be on hand to provide an unforgettable array of demonstrations with liquid nitrogen, fire and more! Call or visit the website for more information. FURTHER INFORMATION Tel: 0141 420 5008 glasgowsciencecentre.org

A wide range of filters Innovative antimicrobials and extraction equipment for the healthcare sector

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Auto-Klean self-cleaning filters are used on a wide variety of liquid applications including heat exchange protection, oil burner protection and fuel filtration. It has also designed and installed a full range of both wet and dry dust collector systems, several currently used in pharmaceutical production. The Filter Company specialises in Donaldson replacement cartridges and can supply AAF and Camfil Farr as well as unbranded replacement cartridges. FURTHER INFORMATION Tel: 0870 4214206 sales@thefiltercompany.co.uk www.thefiltercompany.co.uk

HEALTH BUSINESS MAGAZINE | Volume 17.2

in one at the same time; improves cleaning standards; is patient, staff and visitor friendly; and safe in the environment. DiffX saves money by keeping wards clean, disinfected and infection free. It also maximises the use of materials being non-corrosive saving money on replacement cloths and mops. For further information, call to speak to an adviser, or visit the MTP Innovations website. FURTHER INFORMATION Tel: 01484 505615 www.mtpinnovations.com www.DiffXdoesit.com


CATERING

SECURITY

Marigold Catering Solutions have 30 years of experience within the catering industry and pride themselves on providing the complete catering solution package for busy kitchens that require complete reliability and stability. Marigold is committed to providing the highest quality and competitiveness in sales, services and installation of commercial catering and refrigeration requirements, and work closely with leading catering equipment manufacturers to reduce running costs and increase efficiency within your kitchen. Its services include sales; design; installation; preventative maintenance and service contracts (contract clients entitled to discounted price for any additional breakdowns); repairs and testing; gas safety inspections and gas certificates; and supplying and installing extraction gas

B-Cam works with healthcare clients to provide a visible deterrent to those who may cause harm. It provides a trusted source of evidence should an incident occur, whilst ensuring the privacy and security of service users and colleagues. The presence of an overt camera will often be sufficient to cause a would-be assailant to modify their behaviour, therefore reducing the number of incidents arising in the first instance.  Using a B-Cam device can provide this deterrent factor without compromising privacy.  B-Cam devices only operate when the wearer activates them, with an audio and visual indicator ensuring those being filmed are also aware that recording is taking place.  All B-Cam cameras have a tamperproof design meaning that data cannot be removed from the device, protecting the chain of evidence should an incident have occurred - but also ensuring

Quality catering solutions for busy kitchens

interlock and proving systems, which are required by the current gas regulations. The firm’s engineers are fully qualified to work on all catering equipment, gas, electric and refrigeration. Marigold’s cover all catering appliances from combi ovens, ranges, and fryers to dishwashers, coldrooms and ice machines. All the engineers are Gas Safe Registered and have completed Enhanced DBS Checks. Visit the website for more deails. FURTHER INFORMATION Tel: 01206 870863 www.marigolds.uk.com

Body-worn cameras for the public sector

ENERGY

ENERGY

Ozone Lighting Solutions supply, design, install and maintain all types of low energy lighting and lighting control systems to all industries. Based in Greater Manchester, the firm has extensive experience and provides a reliable, cost effective service throughout the UK. Given that many healthcare environments operate 24/7, there is a huge opportunity to substantially reduce your energy bills. Replacing outdated, inefficient lighting with new low energy lighting will consume lower levels of energy and last much longer, reducing ongoing maintenance costs. Ozone Lighting Solutions has the knowledge and experience to ensure each environment is suitably lit for its use. All its products are manufactured in the UK and come with extensive warranties. Ozone is an accredited supplier of the Carbon Trust’s Green Business Fund and a fully

You don’t need Solar South West (SW) to explain that hospitals, running 24/7, have an extremely high energy demand. Constant consumption puts hospitals in the ideal position to benefit from solar power. Unfortunately, budget restrictions often mean that CAPEX options for renewable energy projects go to the back of the queue. That’s why Solar SW is offering funding via a competitive power purchase agreement to hospitals and the public sector. Solar SW will construct your PV system with no capital investment required. You repay our investment by purchasing generated energy at a sizeable discount to what you currently pay.  Yes… you pay for your own PV system by paying less for your electricity. Benefitting from immediate savings on bills, and obtaining a solar system to reduce long-term operating costs. Once the system is repaid,

Save up to 80 per cent on your lighting costs

accredited member of the NICEIC, SafeContractor, CHAS, ISO9001, ISO14001 and Constructionline. Ozone Lighting Solutions’ installation company, Konect Electrical Services, is an established electrical contractor that has been providing electrical services, installations and technical solutions for commercial and industrial clients throughout the UK for over 20 years. Konect’s specialities include the design, installation and maintenance of all types of electrical lighting, mains and small power systems, cable management solutions and fire and security installations. FURTHER INFORMATION Tel: 0800 035 3234 www.ozonelighting.co.uk

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

that any patient or service user information recorded is secure. B-Cam systems are created with security, integrity and quality, providing vital reassurance and enhanced safety to those who work in this critical sector. To find out how B-Cam can help you please get in contact via the deails listed below or visit the website. FURTHER INFORMATION Tel: 0207 769 6709 info@b-cam.net www.b-cam.net

Solar PPA funding;
 life after FIT

Solar SW can transfer ownership. Alternatively, to avoid increases in business rates, it can retain ownership and provide 100 per cent of the electricity at the nominal cost of annual maintenance. Pricing structures will be arranged to suit you, and Solar SW has a number of payment options; including flat rate payback, and tiered pricing, whereby price/kWh will reduce annually. There is also potential to include energy storage. FURTHER INFORMATION Tel: 01460279575 www.solarsouthwest.co.uk

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Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

SIGNAGE

ENERGY

Founded in 1909 and into its fourth generation of family sign makers, Harrisons is one of the UK’s leading sign manufacturers, providing a full signage consultancy to businesses up and down the country. Whether it’s wayfinding signage, window, wall or floor graphics, internal or external signage or display stands the Harrisons’ team can provide guidance and expertise that will ensure you achieve maximum impact and value for money. Having worked in hospitals such as York, Hull and Harrogate Harrisons understands how important it is for visitors to find their way around as easily as possible and to create a calm environment for patients, staff and visitors. The firm prides itself on the quality and range of its services while being dedicated to perfecting and enhancing

Small Feet Energy provides energy certifications with efficiency support and advice. It works direct with the public, estate agents, social housing, public bodies, academies, facility management companies, SME’s and large organisations. Small Feet Energy are wholly independent assessors providing unbiased compliance surveys such as energy performance certificates (EPCs – domestic and commercial – including new build on-construction), display energy certificates (DECs), TM44 air conditioning inspections (ACI), energy savings opportunity scheme (ESOS) and Scotland Section 63 assessments. It also conducts Legionella Risk Assessments on behalf of landlords to comply with HSE’s ACoP L8 (Approved Code of Practice). Small Feet Energy can support renewable technology/battery storage installations and provide energy management via metering or building

Perfecting your business image through signage

its client’s image through innovation, customer care and craftsmanship which has evolved over a century of trading. For larger projects with multiple signs and locations Harrisons will project manage your job from start to finish ensuring an efficient and coordinated result. The company operates in all areas of the UK so no matter the size or location, its dedicated team will deliver customer satisfaction every time. FURTHER INFORMATION Tel: 01904 699600 www.harrisonsigns.co.uk

ENERGY

ENERGY

Energy costs have increased by 158 per cent over the last 15 years and projections show this trend is set to continue. Yet complicated tariffs and government imposed taxes have made negotiating a competitive energy price a science in itself. Approved Energy Services like to keep things simple and the simplest way to reduce your energy cost is to simply buy less of it. Following a comprehensive survey of your current lighting and heating systems, Approved Energy Services will propose a range of technical solutions which meet your exact requirements, improving your environment, whilst dramatically reducing energy consumption. For example, on average in the UK, lighting accounts for 35 per cent of an organisation’s electrical energy consumption. So reducing this cost by up

Daylight Energy Ltd is a specialist in the renewable energy sector with over 12 years experience and believes every home and business should be able to invest and have access to clean energy with many businesses already waking up to the advantages of self-sufficiency. Legislation is already setting targets for its use in many new developments and switching sooner will give your business a head start in the renewable sector. Whilst improving your environmental credentials and strengthening your business brand, there are many benefits to be made. An extensive range of subsidies are currently available to businesses, including the Feed-in Tariff (FIT), the Renewable Heat Incentive (RHI), the Renewables

Expert implementation of renewable energy and energy efficient systems

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Looking to reduce your energy consumption?

to 90 per cent will have a dramatic effect on your bill. Public sector organisations can attract interest free finance to pay for such measures and even after repayments expect to see a net benefit on their bottom line. The medium-long term benefits can be staggering. The company’s initial survey and consultation is free of charge and will give you all of the information to make an informed decision. FURTHER INFORMATION Tel: 0117 244 3325 www.approved energyservices.co.uk

HEALTH BUSINESS MAGAZINE | Volume 17.2

management systems (BMS). Although, energy efficiency is ensuring your competitiveness over a longer term, a review of your utility costs is just as important for your current revenue, providing energy procurement for your business ensuring competitive prices and working hand in hand with energy efficiency. Much of the simple savings in any building can be via LED lighting. As a supplier of (and installation if required) LED lighting to improve building efficiency, the products can be suitable for typical household, commercial, industrial or specialist lighting projects. FURTHER INFORMATION 0191 495 7600 Turbine way, Turbine Bus. Park, Tyne & Wear, SR5 3NZ www.smallfeetenergy.co.uk

A range of cost cutting, green energy solutions Obligation (RO) and the soon to be launched Contracts for Differences (CfDs). Eligible businesses can therefore benefit greatly from these deals including exemption from paying duty under the Climate Change Levy (CCL) – this duty is a tax on the energy used by businesses. Also renewable energy sources are not subject to the same price rises as fossil fuels. As a market leader, Daylight Energy provides high quality and bespoke green energy solutions including Solar Photovoltaic, Tesla Battery Storage and Air to Water Heat Pumps all of which are designed to help your business combat the rising energy costs, increase the building’s EPC and maximise investment. FURTHER INFORMATION www.daylightenergy.co.uk


SECURITY

SECURITY

PageOne, part of Capita plc, is one the UK’s leading mobile messaging companies providing a range of secure messaging services and applications, enabling organisations to leverage multi-channel messaging and alerting to communicate and engage with staff and customers on the move. PageOne has over 30 years’ experience of working with the public sector, including blue-light services and NHS organisations across the UK. PageOne services include: multi-channel critical and operational messaging; SMS text messaging for staff and customer engagement; incident management and business continuity alerting; paging and alerting services and systems; SMS gateway for integration with third party software systems; 999eye – remote video/photo streaming for emergency and triage; and lone worker solutions –safeguarding

TouchStar access control and CCTV solutions are in use around the UK in healthcare environments such as hospitals and clinics, care homes, doctor and dentist offices, home care, social centres, group housing and more. The firm’s surveillance solutions provide security, access control and resident and staff management. The challenges involved in securing a hospital or other healthcare environment are unlike those in almost any other building. Most healthcare facilities operate 24/7 and have relatively open access because they are required to provide a welcoming environment. It is often necessary to allow for high levels of public access to the hospital or other health service amenity, including the routes linking different departments. However, entry to many back of house areas and most other

Integrated messaging and Optimal management of communication solutions facilities and personnel

vulnerable staff on the move Data security and integrity is assured by PageOne’s ISO27001 accreditation and an approved connection to the N3 network. PageOne is also an approved supplier on the Crown Commercial Service (CSS) Network Services framework agreement RM1045 (Lot 7). To find out how PageOne can help your organisation, get in contact via the details listed below. FURTHER INFORMATION Tel: 0333 200 5033 info@pageone.co.uk www.pageone.co.uk

SECURITY

SECURITY

Lone Worker Solutions (LWS), has developed an award-winning*, system to protect healthcare professionals and social services staff when working alone, or out of eyesight or earshot of colleagues. The company’s proprietary platform, LoneWorker Manager, connects staff via dedicated devices or mobile and desktop applications to a state-of-the-art Alarm Receiving Centre (ARC). With emergency, proactive, reactive and broadcast functions, the system offers support and protection at the press of a button. LoneWorker Manager works on all devices (discreet, wearable, satellite, intrinsically safe and ruggedised). On top of that, LWS offers a user-friendly app for Windows, Android and Apple smartphones, BlackBerrys and standard mobiles; there’s even an app for desktop users. LWS is one of very few service

In today’s healthcare industry there are a number of key challenges that need to be considered such as protecting staff and patients, guaranteeing the safe and secure storage of medication and medical equipment and procuring a solution capable of meeting comprehensive auditing requirements to name but a few. Gallagher’s access control system and Command Centre central management platform, can provide control over access in and out of areas within your healthcare facility. Often access profiles that change on a daily basis, as medical staff often move between different departments on different days, therefore making it a key requirement of any access control

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

facilities needs to be restricted for the protection of patients, doctors, nurses, care staff, administrative personnel, visitors, suppliers and the property itself. How TouchStar systems achieve this depends on many factors including the level of security and convenience required in specific areas such as operating theatres, consulting rooms, pharmacies, laboratories, drug cabinets, surgical wards and so on. Whatever the solution used, it has to be both secure, reliable and flexible so that staff and patient safety is maintained at all times. FURTHER INFORMATION Tel: 0845 337 9155 info@touchstar.co.uk www.touchstar-atc.com

Award winning protection Protect your healthcare for lone healthcare staff facility with Gallagher

providers accredited BS8484 Gold by the NSI. Mitec, the ARC it utilises is accredited to NSI Quality Schedule BS5979 Gold Category II. The company has also achieved the coveted Secured by Design Award, launched by the Association of Chief Police Officers. *Winner: Best Deployment of Lone Worker Technology’ 2016 Security and Fire Excellence Awards. Call today to find out how LWS can help protect your lone workers. FURTHER INFORMATION Tel: +44 161 885 2122 www.loneworkersolutions.com

system to have the ability to be updated simply and efficiently. The safe and secure storage of medication and medical equipment – ranging from syringes and surgical tools, to large expensive machinery – is a requirement of all hospitals. Gallagher’s access control solution forms a part of the security system that can deliver this for your facility. Utilising a single access card system - where permissions can be set to allow different access - ensures the efficient movement of staff, reduces the risks associated with handling keys, and provides a comprehensive audit trail that identifies access movements by employee. FURTHER INFORMATION security.gallagher.com

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Products & Services

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SIGNAGE

SIGNAGE

New Vision is a well-established signage and graphics company with a specialist area of its business dedicated to creating and manufacturing products for the healthcare industry, primarily hospitals and care homes. This range of products includes general and wayfinding signage, wall murals and unique sliding display system, Picture This. The company also offers an innovative range of dementia friendly products including reversible mirrors, memory boxes, retro TVs, reminisce room items and dementia signage. Products such as digital fish tanks, false windows and false fireplaces can be used in dementia and non-dementia environments alike. The company has been recognised for its healthcare products, being part of the dementia ward renovation project

With over 41 years experience Signet Signs has a vast portfolio of exciting signage solutions including one of the most iconic pieces of the London 2012 Olympics ‘The House of Flags’. Signet Signs Ltd has grown over the past four decades to become one of the UK’s leading suppliers of polling and election signs, healthcare directories, general and educational signage including thermoplastic playground markings. By providing the optimum no hassle service, you can get on with your day and relax while Signet Signs Ltd take care of all the necessary details. The company has been approached by several healthcare institutions private, government funded and all things in between requiring bespoke designs to fit their own colour schemes

Understanding the needs of dementia patients

at Bradford Royal Infirmary that won the Building Better Healthcare award for interior design and also the innovation category at the Bradford Means Business awards in 2016. In 2017, the company launched an online shop, selling a number of its ‘off the shelf’ healthcare products though they also work directly with clients to offer bespoke solutions for healthcare projects. Clients include Bradford Royal Infirmary, King’s Mill Hospital, St George’s Hospital London and The Abbeyfield Society. FURTHER INFORMATION Tel: 01274 728831 health@new-vision.co.uk www.new-vision.co.uk/health

SIGNS

TRANSLATION SERVICES

Envirosigns has over 30 year’s industry experience which means that the company has gained a thorough understanding of the significant role signs play in a whole host of public sectors. Combining the perfect blend of professionalism and ingrained knowledge, Envirosigns provides value for money solutions that will ensure that you are able to communicate with the public in a clear, concise and effective manner. No two projects are ever the same. This means that Envirosigns can always approach each and every job with an open mind. This allows Envirosigns to ensure that, when it comes to integrating effective signage solutions into your space, the

Sign Solutions, established in 1998, is the leading provider of services for deaf and hard of hearing people. As an ISO 9001 and 27001 accredited, Crown Commercial Service framework supplier, of non-spoken interpretation and translation, Sign Solutions provides experienced, NRCPD registered, DBS and BPSS checked, interpreters onsite, nationally and internationally. The firm’s innovative InterpretersLive! video relay interpreting service, provides a British Sign Language interpreter, on demand, using a desktop computer or tablet. Deaf employees have instant access to meetings and the ability to have phone calls with hearing customers and colleagues. It helps organisations become accessible to all consumers, via a link to Sign Solutions’ video service, from their website, which increases the accessibility rating of their website. Check out http://

A nationwide sign service for the public sector

96

Signet Signs Ltd growth leads to relocation

company really takes the time to understand your exact needs. Above all, Envirosigns is well informed and equipped to provide solutions which are not only striking, functional and engaging but also represent your organisation in the best possible light. The company is an expert in supplying and installing a wide range of products – Envirosigns services extend to fascia signs, window graphics, signage lighting, internal signs as well as a number of other visual solutions designed to accommodate the needs of public sectors. FURTHER INFORMATION Tel: 01206 845515 www.envirosignsltd.co.uk

HEALTH BUSINESS MAGAZINE | Volume 17.2

and consumer needs. If you already have existing signage or directories that need updating, or you would like more information about a new design and install, visit Signet Sign’s website for a free no hassle quote, or call to speak to an adviser. FURTHER INFORMATION Tel: 01275 463601 mail@signetsigns.co.uk www.signetsigns.co.uk

Supplying innovative communication services

www.interpreterslive.co.uk/ Live!customers/for more info. Sign Solutions’ training centre provides qualifications in BSL and CPD for interpreters. Its deaf awareness training can be delivered onsite or via e-learning. The company’s aim is to assist organisations to become accessible to the deaf community under the Equalities Act 2010 and the NHS can use video interpreting to meet the requirements of the Accessible Information Standard July 2015. FURTHER INFORMATION Tel: 0121 447 9620 office@signsolutions.uk.com www.signsolutions. uk.com/contact


FACILITIES MANAGEMENT

Your partner of choice for facilities management SPIE UK, a subsidiary of SPIE group, the independent European leader in multi‑technical services in the areas of energy and communications, provides energy, safety and environmentally focused solutions across multi-technical and support services from initial design, through installation, testing, commissioning to long term maintenance and facilities management. SPIE UK employs more than 3,000 people from a network of regional offices throughout the UK. SPIE UK is a leading provider of facilities services nationwide – keeping buildings functioning, and maintaining a positive environment for the people working in them. The company’s highly skilled team of engineers bring together all the core elements of facilities management and support services across a broad range of built environments. With proven experience across

single disciplines to total facilities management covering individual buildings to multi-site, multi‑location portfolios, it can offer you a tailor-made solution whatever your challenge. SPIE UK’s commitment to technical innovation and the continuous development of skills and techniques across its teams is a testament to its success, and with a strong focus on forming close and effective working relationships with customers, the company can genuinely understand your building, your business and your day-to-day operations, enabling it to deliver bespoke solutions every time. FURTHER INFORMATION www.spieuk.com

FACILITIES MANAGEMENT

Leaders in energy control for the public sector

CP Electronics is recognised worldwide as a leader in energy saving lighting controls. The company’s systems minimise energy use and cost without affecting user convenience. CP Electronics can work with any light source, in any building and any space, from a sports stadium to a CEO’s boardroom. It works with both private companies and public sector organisations. Its UK-based production team works to BSI/ISO standards, using advanced production techniques. CP Electronics is so confident of its quality and testing regime that it offers a five year warranty across the range. Marcus Martin, managing director of CP Electronics, commented: “When CP

COMMUNICATIONS

LIGHTING

direct-to‑nurse communication for patients and other staff’, commented judges. Ascom’s innovative communication solutions at NHS Royal Free Chase Farm hospital, Queen Elizabeth University Hospital in Glasgow and Benenden Hospital demonstrate Ascom’s unique approach to putting health delivery into the hands of caregivers on the move.   John McGarrity, technical manager, Med. Physics at QEH, Glasgow stated: “It was clear right from the start that we needed this technology.  I feel that staff have embraced it very quickly.  It’s not our system, it belongs to the staff, and that’s how they want it to operate.” The solution integrates Internet Protocol nurse call systems with patient monitors and monitoring alert systems. Messages, calls, alerts and requests are made mobile - going to clinicians’

Simmonsigns’ priority is your safety and saving lives. Whether you are on foot or behind the wheel the business makes sure that your journey is well illuminated, well informed and as safe as possible. From its top of the range LED illuminated directional signs and bollards, high intensity LED Belisha beacons to light your pedestrian crossings, to its brand new range of car park lighting, Simmonsigns can help and support you from initial enquiry right through to after sales care and maintenance. The business’ technical experts can advise and design solutions as well as carrying out surveys and full lighting designs to ensure all current standards are adhered to. With over 30 years’ experience and a UK based manufacturing plant Simmonsigns is ideally

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Electronics was founded in 1970, awareness of climate change was in its infancy. Yet even then it was clear that the age of cheap energy was coming to an end. Our vision - to design and make reliable energy-saving controls - found a receptive market. “The drive for innovation, cutting edge technology and ongoing expertise in the energy controls sector are our tools to help you take control of your energy costs and your carbon footprint. “It’s this drive that made us the perfect fit for Legrand, and in 2016 we became part of the Energy Controls business unit of Legrand UK & Ireland.” FURTHER INFORMATION www.cpelectronics.co.uk

Ascom wins award for best Simmonsigns: quality communications systems traffic management and lighting solutions ‘This is a great concept, providing wireless devices such as the Ascom Myco. The BBH Awards judges were particularly impressed by the solutions’ speech capabilities and their ability to directly link clinicians and patients. With single room environments growing in popularity within the healthcare sector, this enhancement is crucial to improving staff productivity, total communications and patient privacy. Check out the full release at: http://content.y udu.com/web/ fiqy/0A3zyjg/bbhcnov16/flash/ resources/index.htm?dm_ i=8EU,4N9MG,FQ5Y7V,HBG78,1 FURTHER INFORMATION Tel: +41 41 544 78 00 www.ascom.com

placed to meet all of your needs and requirements. For more information, please email Steve Keary, national sales manager or visit the website for further details. FURTHER INFORMATION Tel: 07545 610282 steve.keary@ simmonsigns.co.uk www.simmonsigns.co.uk

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ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service Aerogen 38 Agfa Healthcare UK 52 Apira 58 Approved Energy Services 94 Assistive Partner 48 B-Cam 93 Balanced Agency 95 Beckett’s Farm 92 BESA Publications 59 Birmingham Botanical 90 Blackburn Special Products 82 Body Worn Video Systems 77 Bosse Interspice IBC Bradshaw Electric Vehicles 72 BTR UK 20 Carecheck 44 Centerprise International 18 Central Medical Supplies 34 CFH Docmail IFC CHGIP 34 CloserStill Media 60 Complete Signage 82 CP Electronics 97 Cult Furniture 24 Daikin Applied Service 30 Dakota Intergrated Solutions 16 Daylight Energy 94 DSA Connect 23 EAGALA 64

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HEALTH BUSINESS MAGAZINE | Volume 17.2

Ebm-Papst UK 31 ECA UK 40 Edesix 79 Envirosigns 96 Ethypharm UK 67, 69 FGD UK 22 Firemark 84 First in service 86 Fitwise Management 32 Gallagher Security 95 Garran Lockers 4 Glasgow Science Centre 92 Gratnells 50 Harrions Signs 94 Hicom 46 Hospedia 8 Inner-Vision Technology 37 Insequa 64 Intratest 30 ISS Mediclean 6 Konect Electrical Services 93 Legrand Electric 55 Life enviromental services 28 Lighting motion 27 MacCormack Media 35 Maltin PR 88 Marigold catering solutions 93 Medefer 69, 66 Methods analytics 69

Metric group 84 Moduleco 26 MTP Innovations 92 New vision 96 Paessler Ag 70 Page One communications 95 Pal International 34 Porkka 86 Premier Guarantee 10 PRMax 90 QED Scientific 68 Renaissance Personnel 42 Sign solutions 96 Signet signs 96 Simmonsigns 97 Sirane 69, 65 Skene house hotel suites 90 Small feet energy 94 Solar south west 93 Spie 97 The Filter company 92 Touchstar 95 Transforming Systems 70 UBM Information 80 VM1 Holland BV 68, 62 We are lean and agile BC Webeye 78 XML Solutions 72


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