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INVESTIGATING FRAUD AGAINST THE NHS The NHS Counter Fraud Authority launched on 1 November. HB looks at the authority’s five main objectives


RECOGNISING OUR HIGH STANDARDS OF CARE The Health Business Awards return on 14 December, celebrating the success stories within the NHS


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Extra funding, but bleak winter ahead for NHS




Chancellor Philip Hammond has announced that an extra £2.8 billion will be available for the NHS by 2020, of which £335 million will be used to support services this winter.

The NHS Counter Fraud Authority launched on 1 November. HB looks at the authority’s five main objectives


RECOGNISING OUR HIGH STANDARDS OF CARE The Health Business Awards return on 14 December, celebrating the success stories within the NHS


However, health authorities have been quick to argue that the funding ‘does not begin to take account of the enormous challenges we have to confront over the next few years’. Alongside no extra funding for social care, Hammond also remained noncommittal on a pay rise for nurses and midwives. Saying that nurses ‘deserve our deepest gratitude’, he said that Health Secretary Jeremy Hunt is negotiating changes to NHS pay scales, with any wage increase dependent on wider pay reforms. Our final Top 10 list of the year concerns the progress made in GS1 standards across the NHS. Read our analysis of the trusts leading the way in scanning systems and barcoding technology on page 12.

Follow and interact with us on Twitter: @HealthBusiness_

As always, combatting the bleak NHS outlook is the end-of-the-year Health Business Awards, recognising the often overlooked success stories within our outstanding health service. We hope that you enjoy the award ceremony (for more details see page 19) and beyond that be blessed with a joyful Christmas and a Happy New Year.

Michael Lyons, editor

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

226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: EDITOR Michael Lyons EDITORIAL ASSISTANT Marianna Christostomou PRODUCTION EDITOR Richard Gooding PRODUCTION DESIGN Jo Golding PRODUCTION CONTROL Ella Sawtell WEBSITE PRODUCTION Victoria Casey ADVERTISEMENT SALES Jeremy Cox, Lucy Rowland, Damian Emmins, David Green, Annette Dore, Lucy Maynard ADMINISTRATION Vickie Hopkins, Charlotte Casey PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Budget reveals ‘missed opportunity’ for NHS despite funding boost; waiting times debate; and innovative NHS project funding

12 HB TOP 10

At the start of the year, six NHS trust demonstrator sites were awarded a share of £12 million by the Department of Health to demonstrate the benefits of GS1 and PEPPOL standards, including significant efficiencies and cost savings, reduced errors and improved patient outcomes and patient safety. Following the recent GS1 UK Healthcare Conference, Health Business reports its final Top 10 list of 2017 focusing upon the use of GS1 and PEPPOL standards within the NHS and listing the trusts leading the way in making efficiency savings through the technology



The shortlist for the 2017 Health Business Awards has been released, with NHS organisations recognised for their successes across 22 categories. Ahead of the event, we preview the categories, the shortlisted and the year gone by

26 FRAUD 63

Following its launch on 1 November, Rianne Endeley-Brown introduces the new special health authority responsible for investigating and countering fraud against the NHS


Health professionals have been set a challenge to prevent the 400 ‘never events’ that take place in the NHS every year. Glen Hodgson, head of Healthcare at GS1 UK, explores how these can be prevented and the role GS1 standards have to play


Peter Akid, director of Procurement at NHS Shared Business Services, describes how the newly-launched Hard Facilities Management (FM) framework provides value-for-money and legally-compliant access to a huge range of essential goods and services


NHS England recently warned that confectionery sold in hospitals should be 250 calories and under. Here, Health Business looks at price promotions and advertising of unhealthy foods on hospital premises, and how the vending industry is adapting to these changes


There are many benefits of providing a vegan-friendly service. Dietitian Heather Russell, from the Vegan Society, explains why well-planned vegan diets can support healthy living in people of all ages


Following the devastation of the Grenfell Tower fire, Mark Hughes considers how signage can play a part in the safe evacuation of large numbers of people in the event of a fire in a hospital environment


Managing the risks from asbestos in hospitals is a legal duty, says Sarah Hallam of the Asbestos Removal Contractors Association


The number of obesity-related A&E admissions continues to grow, leading to a nationwide increase in spend on bariatric ambulances






Victoria Cetinkaya, from the Information Commissioner’s Office, looks at the main aims and principles of GDPR, and dispels some of the recent misconceptions




Dr Alex Graham explores the challenges of heightened clinical risks during the deployment of new IT systems; Plus, an examination of the benefits of NHS organisations sharing digital success

Andrew Scott discusses the findings of the recent Cyber Resilience Report and the growing threat to organisations of digital disruption


The government has announced its commitment to offer the NHS a £10 billion investment package in frontline services over the course of this Parliament. Nick Bowles analyses the importance of a healthy, transparent recruitment supply chain and the benefits of cooperation in NHS recruitment

Health Business



High standards of cleaning are vital in the fight against infection in the healthcare environment. HB examines the complex and challenging aspects of sanitising NHS buildings and facilities NHS workforce planning is essential to transforming mental health services, says Leila Reyburn, policy and campaigns manager at mental health charity Mind Think Kidneys, the NHS campaign to improve the care of people with acute kidney injury, won a Health Business Award last November. The UK Renal Registry explain the success of the campaign


A record number of healthcare professionals came together at Diabetes Professional Care 2017 (DPC2017) to share their experiences and hear about the latest advances in the prevention, treatment and management of diabetes Volume 17.6 | HEALTH BUSINESS MAGAZINE


Providing The Human Touch to award winning customer service

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Budget speech reveals boost for NHS Chancellor Philip Hammond used his Budget speech to reveal a £2.8 billion boost for the NHS in England – £1.2 billion less than NHS England chief executive Simon Stevens recommended – with £350 million immediately available to address pressures this winter. Furthermore, £1.6 billion will be available for 2018-19 and the remainder in 2019-20. He also revealed a £10 billion capital investment fund for hospitals. However, NHS organisations, including NHS England and the NHS Confederation, have claimed that the Budget falls short

of measures needed to relieve pressures facing the NHS, representing ‘another missed opportunity to pull health and care services back from the brink’. Niall Dickson, chief executive of the NHS Confederation, said: “Over the years, the NHS has required increases of around four per cent above inflation to deal with demand and maintain services. What the government is promising for next year represents around 1.4 per cent plus whatever is allocated to cover the lift in the pay cap. Of course the extra money announced is welcome, as is the promise of more capital

and some more funds for this year. It was better than we expected but it does not begin to take account of the enormous challenges we have to confront over the next few years.” Furthermore, according to an NHS Confederation poll, just three per cent of healthcare leaders believe the Budget will bring about a big improvement to their organisation’s ability to provide high-quality care. READ MORE:


One in five regularly miss GP appointments New research of more than 500,000 people in Scotland has revealed that one in five patients are regularly missing GP appointments, with 19 per cent of patients missing more than two in a three-year period. The study, published in The Lancet Public Health, found that appointments booked two or three days in advance were more likely to be missed than those made two weeks in advance, whilst younger, male patients aged 16 to 30 were found to be the worst offenders. The Royal College of GPs has reiterated

how frustrating it can be for doctors when patients don’t turn up to their appointments. The organisation warned that with ‘current resource and workforce pressures’, it is becoming more difficult ‘to offer appointments that are timely and convenient for patients’. David Ellis, one of the lead authors of the study from the University of Lancaster, said: “Some of the solutions might include practices learning to better manage patients who are more likely to not attend. So for example that might mean giving more appointments on the

day than say, two to three days in advance. And because we’ve already got a kind of profile of what those patients might look like who are more likely to not attend, that’s where the more targeted interventions could be pushed.” NHS England estimated in 2014 that more than 12 million GP visits are missed each year in the UK, costing the health service in excess of £162 million per year. READ MORE:



NHS England must stick to waiting time limits

18 per cent drop in nursing applications

Health Secretary Jeremy Hunt has rejected service chiefs’ public warning that meeting targets is impossible without increased funding, and has ordered them to stick to waiting time limits. Following the Budget, NHS England told ministers it would not be able to guarantee waiting times and would delay patients new drugs next year because of a lack of funding. However, Hunt has rejected these proposals and signalled the start of months of difficult negotiations over what care the NHS can and cannot afford to provide in 2018-19. NHS England used a recent board meeting to warn that it had to make ‘difficult choices’ next year that would involve limiting what it could provide for patients. It blamed Chancellor Philip Hammond for creating what the Patients Association said was an ‘extraordinary’

situation by giving it only £1.6 billion extra funding for 2018-19 in his Budget, less than half of the £4 billion Simon Stevens called for. NHS England made plans to stop prescribing cough mixture, cold treatments, eye drops and laxatives, which it wants patients to buy over the counter instead, as well as fish oil, herbal remedies and homeopathy, as part of a plan to save up to £190 million from its £9.2 billion bill for prescribed medications. NHS England dismissed the idea that the service could be expected to provide even more care at a time when its annual budget increases of one to two per cent were far smaller than rises in patient demand, running at up to seven per cent a year.

The number of students accepted onto nursing courses in higher education in 2017 was 28,620 – the second highest figure on record – though there was an 18 per cent drop in the number of applications. UCAS’s End of Cycle Report 2017 shows a 13 per cent decline in acceptances to nursing subjects in the 21-25 age group, and a six per cent decline for those aged 26 and above. These decreases have been offset by the increased acceptances of younger applicants. For the first time, the report gives greater analytical context for the subjects studied in higher education. The top five subject groups in 2017 by acceptances, were: business and administration, subjects allied to medicine, biological sciences, social studies, and creative arts and design. Meanwhile, official figures from NHS Digital have shown that GP numbers have fallen by over 1,000 in the last year despite the government’s 2015 pledge to bring in another 5,000 practitioners. There has been a 3.5 per cent drop since September 2016 – from 34,495 full-time equivalent GPs to 33,302 in September this year.






A consultation has been launched by NHS England to simplify and standardise the process for getting research projects up and running in the NHS. Cuts to bureaucracy and faster access to new and innovative treatments are at the heart of 12 actions also agreed by the NHS England board to support research and its application in the NHS. A common obstacle to research is management of excess treatment costs which often arise from conducting research in the NHS. Changes have been proposed to the processes associated with this, including for specialist services and linking the wider process with the effective research networks that exist across England. NHS England is also consulting on ways to further improve commercial clinical research set-up and reporting; seeking to eliminate delays for research studies conducted across multiple sites by standardising processes. Depending

Consultation launched to simplify research arrangements

on the outcome of the consultation the proposals would result in suggested changes to the NHS Standard Contract. Alongside the consultation, the board is supporting the ambitions in the Life Science Industrial Strategy, by prioritising the research needs of the NHS, ensuring there is strengthened local and regional support for research and innovation and simplifying how innovative treatments break through to become routine care. The Department of Health, NHS England, NHS Improvement, the Health Research Authority, the National Institute for Health Research and the Office for Life Sciences are to work together to agree the way forward, taking into account the responses to this consultation. The consultation is to run for nine weeks and is live on the NHS England website. READ MORE:


11 innovative projects receive NHS backing 11 innovative projects are being backed in the last round of NHS England’s programme to develop and spread pioneering ideas, equipment and technology that have the potential to save lives as well as millions of pounds. A wireless sensor that better detects breathing rate in hospital patients, an app to help pregnant women monitor hypertension and another that directs patients with minor injuries to treatment units with the shortest queues are among the innovations. The 15 NHS Academic Health Science Networks (AHSN) will promote their adoption across the NHS. Included in this third round of the NHS Innovation Accelerator (NIA) programme are: RespiraSense, a wireless device that measures breathing through chest and abdomen

movements delivering highly accurate, continuous data; home monitoring of hypertension in pregnancy (HaMpton), allowing pregnant women at risk of pre‑eclampsia to input blood pressure readings and urine test results into an app, then answer a set of questions to help identify the condition; WaitLess, an app that shows patients with minor injuries where they can go to access the quickest treatment; and, providing patients with clinically accurate urine analysis from home in a matter of minutes, helping to identify Chronic Kidney Disease and UTIs as well as pre-eclampsia in pregnant women. E Read about AKI awareness on page 80 READ MORE:




Online GP consultations not a ‘silver bullet’ New research from the University of Bristol has found that online GP consultation systems may not be the silver bullet for reducing GP workload and patient waiting times that government policymakers are hoping for. The study analyses eConsult, an online system, piloted across 36 GP practices in the South West of England, whereby patients submit their symptoms to a GP electronically through their practice website, creating an ‘e-consultation’. Studying website usage data and how patients using the system went on to use other care and patient surveys, the research found that patient use of the system was low, with an average of two e-consultations a month for every 1,000 patients. It concluded that while online consultations ‘offer the potential to revolutionise use of primary care’, the use and effectiveness of the technology is limited. It also found that the majority of patients value the eConsult system, with clinicians reporting that eConsult worked best for simple and routine enquiries that they could respond to without the need for a face‑to‑face or telephone follow up. However, 38 per cent of e-consultations resulted in a face‑to‑face consultation, whilst a further 32 per cent resulted in a telephone call from a GP. READ MORE:


New cyber security service for NHS

NHS Digital has announced a £20 million project to boost its ability to support the NHS with its data security. The Security Operations Centre will provide enhanced monitoring of national services across health and care and will also enable NHS Digital to offer specific advice and guidance to local NHS organisations. The new investment will boost existing services provided by NHS Digital in this space, including: a monitoring service which analyses intelligence from multiple sources and shares guidance, advice, threat intelligence and remediation to relevant contacts in health and care; on-site data security assessments for NHS organisations, to enable them to identify any potential weaknesses and to get the best value from local investment; specialist support for any NHS organisation which believes it may have been affected by a cyber security incident; and ongoing monitoring of NHS Digital national systems and services. READ MORE:



Case Study


Care when it’s needed most at St Oswald’s Hospice made easier with Aid Call’s new Touchsafe Pro St Oswald’s Hospice, situated three miles outside of Newcastle City Centre, cares for over 2,000 patients, visitors and relatives. It provides dignified care and compassionate support for patients living with a terminal illness. The hospice opened in 1986 with only 10 beds and has since grown to include a 15-bed In-Patient unit with additional units Lymphoedema, Children and Young Adults. This is in addition to an array of other services offered in the specialised Day Unit. In 2015, during a particularly heavy storm, a lightning strike unexpectedly hit the Newcastle-upon-Tyne facility, causing unavoidable failure to all of the electrics and the Nurse Call system. Val Forster, In-Patient Unit manager at St Oswald’s Hospice, said: “After lightning strike our system was completely wiped out, which was a blessing in disguise when I think back now because it allowed us to have the new system installed. Our Nurse Call provider Aid Call came to the rescue when the incident first occurred and immediately put temporary measures in place to allow us to continue to support patients.” St Oswald’s Hospice had the new Aid



Call Touchsafe Pro system installed in the Newcastle-upon-Tyne facility in 2016. Forster added: “The main thing I remember about the system that we initially had was that it was very loud and the ward always felt noisy, which could be quite disruptive for patients. It didn’t create the atmosphere that we really wanted for the unit and when patients are very poorly, noise pollution can be a significant issue. “The installation of the new system has made a massive difference; our nurses now use the Bluebell Pagers which are small and very easy to clean. They can also be logged in to by each individual member of staff which is great for identifying where they are on the ward by checking the

system. However the main benefit is that the pagers can be programmed to vibrate or quietly bleep, which the nurses love. It ensures there are no noisy alarms across the unit and makes it easier to identify priority calls. The pagers automatically make noise if an emergency alarm call is activated so that everyone including the doctors and physiotherapists can respond accordingly.” Jane Hamblin, facilities manager at St Oswald’s Hospice, said: “I’ve been with the hospice for just over 17 years now and we’ve grown massively in that time. Aid Call has been a very big part of that journey because they have done such a lot of research and development that’s really brought this new system into the 21st century. “We will now continue to work with Aid Call going forward to integrate the new system that’s currently installed in the In-Patient unit into our Day Services Unit, Lymphoedema and Children and Young Adult Units.” FURTHER INFORMATION Tel: 01670 357 431



£6.6 million energy schemes for Royal Bolton Hospital

Hunt calls for better action on baby deaths

A number of energy schemes are now in place at the Royal Bolton Hospital, bringing savings and sustainability while reducing carbon emissions and air pollution. The projects were officially launched with the opening of the John Horlick Energy Centre. The centre houses a clean gas-fired combined heat and power plant which produces electricity and uses waste heat to provide heating and hot water for the hospital while reducing carbon emissions. It replaces two coal-fired boilers. The hospital site’s engineering infrastructure has been upgraded to provide modern energy efficient heating and hot water plant. The hospital has also started to extract water from a natural source under its Farnworth site. The water is treated on site so that it is suitable

for drinking and will provide 95 per cent of the hospital’s usage. It naturally renews itself. In addition, Bolton NHS Foundation Trust gas agreed to offer the hospital’s standby generator electric supplies when not needed, to provide electricity to the National Grid at times of high demand. The work was carried out by iFM Bolton in collaboration with Breathe Energy Ltd, who were awarded a £6.6 million contract and have guaranteed savings of £887,000 a year for a period of 15 years. In addition, the energy programme will reduce carbon emissions by over 7,000 tonnes a year and improve efficiency and safety.

Health Secretary Jeremy Hunt has said that the NHS must learn from its mistakes to cut the number of baby deaths and injuries in childbirth. Unveiling the new plans, Hunt said that the Healthcare Safety Investigations Branch, set up earlier this year, will be tasked with reviewing cases as he announced aims to halve the overall rate of stillbirths, deaths and brain injuries by 2025 – five years earlier than previously announced. According to statistics, there are an estimated 1,000 cases a year where babies unexpectedly die or are left with severe brain injury. It is currently the responsibility of local hospitals to investigate cases or for parents to bring clinical negligence cases. An average of two claims a week are being settled at the moment, with each case costing millions of pounds in lifetime care for these babies. READ MORE:




NHS stroke care has ‘significantly improved’

Private health company sends price lists to GPs

An independent report has revealed that patients are receiving significantly improved NHS stroke care, with patients now getting much quicker access to the crucial tests and treatment they need when they have a stroke, greatly improving their chances of recovery. The report, commissioned by NHS England, found that on the key indicators for stroke care significant quality improvements have been made including on waiting times and specialist care. Improvements highlighted since the first report four years ago include: an improvement in brain scanning times; four out of five patients being assessed by a stroke specialised consultant physician within 24 hours; almost nine out of 10 eligible patients now receiving a clot-busting drug thrombolysis; and nine out of 10 patients receiving a joint health and social care

plan on discharge in 2016/17, compared to only seven out of 10 in 2013/14. The NHS in England is working closely with the Stroke Association and other key organisations to develop a very clear plan to continue to improve stroke services across the country, which will include joining up ambulance services, hospital services and community services to reduce the death rate, disability rate and increase the number of people that return to independent living. Stroke is estimated to cost the NHS around £3 billion a year, with additional cost to the economy of £4 billion in lost productivity, disability and informal care. Rapid assessment and treatment is known to save lives and improve chances of recovery. READ MORE:



Private health firm Care UK has sent hundreds of letters to GPs setting out a price list of operations they could offer their patients to beat NHS waiting times. The company, which runs nine centres offering treatment on the NHS, said it intended to use spare theatre time to provide ‘self pay’ procedures, claiming it was trialling the scheme at two treatment centres in west England but insisted core work at the sites would remain NHS referrals. The letters have, however, alarmed some GPs and health campaigners who are concerned it is another example of creeping privatisation in the NHS. The procedures are being offered at treatment centres near Bristol and Wiltshire, and prices range from £160 to just under £9,000. READ MORE:


NHS warned against ‘betraying’ mental health patients Mental health groups say that the NHS risks a ‘catastrophic betrayal’ of patients if the £1 billion put aside for psychological therapies and staff is delayed to plug funding gaps left by the Budget. The Royal College of Psychiatrists told The Independent that NHS England ‘must keep the promises’ it made in its Five Year Forward View for Mental Health, which launched last year. This comes as a report by the children’s charity Spurgeons showed the number of young people who were admitted to A&E for self-harm increased by half in the

last five years. It also found that 40 per cent of patients referred to Child and Adolescent Mental Health Services (CAMHS) in 2016/17 were never assessed. Mental health charity YoungMinds said these figures were yet more evidence that existing funding for mental health does not yet reflect the ‘true scale’ of the problem. It would therefore be unacceptable to allow any more funding to be ‘siphoned off’, they said. This comes after the Budget revealed that the NHS would get less than half of the £4 billion it requested to keep services

operating next year. This prompted hospital bosses to warn there would be ‘tough choices’ to make about what services the NHS could continue to fund. The £1 billion earmarked in the Five Year Forward View for Mental Health by 2021 is intended to fund mental health crisis teams in A&E departments, suicide prevention, and reduce the number of people sent away from home for treatment. READ MORE:



HB Top 10



Scanning for safety: barcoding progress within the NHS Following the recent GS1 UK Healthcare Conference, Health Business reports its final Top 10 list of 2017 focusing upon the use of GS1 and PEPPOL standards within the NHS and listing the trusts leading the way in making efficiency savings through the technology At the start of last year, six NHS trust demonstrator sites were awarded a share of £12 million by the Department of Health to demonstrate the benefits of GS1 and PEPPOL standards, including significant efficiencies and cost savings, reduced errors and improved patient outcomes and patient safety. It is believed that the implementation



of electronic procurement systems will help deliver up to £800 million in efficiency savings for the NHS, helping to reduce the estimated £150 million wasted each year on products which have been either oversupplied or perished. According to Scan4Safety, early signs from across the six demonstrator sites

are encouraging, with over £700,000 of savings identified, divided between stock reduction (£233,000), reductions in wastage (£462,000) and non-clinical pay efficiencies (£46,000). Furthermore, the programme estimates that for a typical NHS hospital trust, the benefits could also include time released to patient care – equivalent to 16

HB Top 10 may have been affected by the products, even patients with implants who are now at home. Releasing figures at the start of the year, the trust revealed that it had already benefitted from efficiency savings of nearly £800,000 in 2015/16, with further estimates that they would save another £1.18 million in 2016/17. Approximately 52,000 patient procedures were captured in the last year, resulting in Derby Teaching Hospitals NHS Foundation Trust’s Right First Time at Point of Care project winning the Best System or Initiative Adoption/Roll-Out award at the 2017 ehi Live ceremony. Kevin Downs, director of Finance and Performance at Derby Teaching Hospitals, said: “A lot of hard work has gone into the successful implementation of this innovative project across the trust, so it is fantastic to have seen all of this effort recognised in this way. After recently becoming the first trust to complete all four phases of the programme, this award represents yet another reason for us all to be proud. Ensuring that we provide our patients with the safest care possible is central to everything that we do at Derby Teaching Hospitals. Scan4Safety has undoubtedly allowed us to do just that, whilst it has also made a huge difference to staff working in our operating theatres.” Royal Cornwall Hospitals NHS Trust At the start of December 2017, Royal Cornwall Hospitals NHS Trust launched a radio frequency identification system (RFID) to track high-value implants used during surgery, in order to ensure

2 band 5 nurses per trusts, totalling 2,400 band 5 nurses across the NHS. Additionally, it could mean a reduction of inventory averaging £1.5 million per trust, £216 million across the NHS, and ongoing operational efficiencies of £2.4 million per trust annually, reaching £365 million across the NHS. Speaking on Sky News in January 2017, Health Secretary Jeremy Hunt said: “Scan4Safety is a world first in healthcare – and a vital part of this government’s drive to make the NHS the safest and most transparent healthcare system in the world. Using simple barcodes that major industries rely on every day will help to transform standards of care – before, during and after patients have treatment, at the same time as freeing up resources for care by reducing waste.” Derby Teaching Hospitals NHS Foundation Trust Derby Teaching Hospitals NHS Foundation Trust provides health services to a population of over 600,000 people in and around Southern Derbyshire. Chosen by the Department of Health as one of six demonstrator sites


Early signs from across the six demonstrator sites are encouraging, with over £700,000 of savings identified, divided between stock reduction (£233,000), reductions in wastage (£462,000) and non-clinical pay efficiencies (£46,000) for Scan4Safety towards the end of 2015, the trust was concerned with its manual, paper-based tracing process, and therefore implemented barcoding to collect accurate, timely and comprehensive information for product safety recalls and tracking implants and other products to patients. The use of Scan4Safety makes operations safer and more efficient by using scanners to read every piece of equipment used in a procedure before then linking this to a barcode on each individual patient’s wristband. Using a cloud-based inventory management system, a product catalogue and a barcode scanning solution, the trust can now easily identify all products that are held within the hospital estate, successfully identifying all patients that

that they can be accounted for at all times. As part of the Scan4Safety programme, the trust aims to reduce the incidence of errors, as well as the amount of labour time hospital personnel spend tracking products, including medicines and implants. As one of the six demonstrator sites, the trust says that implementing a digital system using RFID to replace the paper-based system should be much faster and more accurate. In September, a review of current inventory management systems and processes within Royal Cornwall Hospitals Trust highlighted a number of areas for improvement, including: heavily overstocked wards; incomplete periodic stock reviews; and a lack of standardised processes for setting E



HB Top 10



In February 2017, Plymouth Hospitals NHS Trust became one of the first trusts in the country to have applied barcoded labels to every room on the estate, as part of a national Scan4Safety programme  up and stocking wards. Therefore, inventory management improvements using GS1 barcoding standards were needed to enable standards to be effectively implemented. Royal Cornwall Hospitals Trust identified over-stocking in wards to the value of over £1 million, as well as holding stock for over seven weeks, as opposed to the recommended level of two weeks of stock in wards. The design of standardised layouts for all store rooms improved the ability of staff to locate stock easily, no matter where they were in the hospital. Alongside investment in new equipment to create efficiency storage areas, and further staff training, the trust reduced the number of unique items stocked in medical wards by an average of 22 per cent, with the reduction reaching 40 per cent in trauma wards. Furthermore, the trust saw a year-on-year reduction in the ordering of medical consumables by 21 per cent for a medical ward. Royal Cornwall Hospitals Trust also removed 880 obsolete stock items valued at £93,000, including 2,800 out of date products with a value of £61,000. Dawnne Jenkins, a ward sister at the trust, said: “Scan4Safety has enabled us to create a relatives room and a storage area for medical equipment, reducing clutter in the ward. Time has been released to care as all stock is in one location and easy to identify. I am saving money from my budget every month.” Salisbury NHS Foundation Trust Salisbury NHS Foundation Trust is one of six NHS trusts in England to be selected as a Scan4Safety demonstrator site. Following a highly successful rollout in cardiology in October 2016, Salisbury NHS Foundation Trust launched a new inventory management system, Genesis Automation, with point-of-use scanning in orthopaedic theatres in March this year. Through the Scan4Safety programme and the introduction of point-of-use scanning, 93 per cent of the trust’s implantable devices have been accurately tracked to a patient. With 60 members of staff fully trained, this means that in the event of a future product recall, the affected product can now be automatically traced to the patient and appropriate action quickly taken. Additionally, by scanning products at point-of-use, stock is now automatically replenished, releasing time




for clinical staff to care who previously had to complete these stock orders. Like many other trusts, Salisbury NHS Foundation Trust didn’t have visibility of its stock wastage. This has now been identified as around 10-15 per cent of total inventory value. Through point-of-use scanning, the trust has improved visibility of its stock and can better track expiring stock and wastage, including identifying the reasons why items are being discarded. This enables the trust to reduce waste in the future. The trust is now looking to roll the technology out across all areas of the hospital so that 100 per cent of all implantable devices can be tracked by early 2018. It has already saved £121,069 through product range rationalisation in orthopaedic theatres, and, as the data continues to build, the trust believes that more benefits will become apparent. Tim Wells, consultant cardiologist at the trust, said: “Knowledge is power – not only does this provide us with a level of data and insight that can be used to better challenge clinical practice and variation, helping us to reduce inefficiencies and improve patient experience and outcomes – more importantly it ultimately helps to safeguard our patients from avoidable harm. In the event of a product recall, we can now easily and quickly track an affected product to the right patient.” Plymouth Hospitals NHS Trust Back in February 2017, Plymouth Hospitals NHS Trust became one of the first trusts in the country to have applied barcoded labels to every room on the estate, as part of the national Scan4Safety project. With over 6,700 rooms within the hospital estate, the unique numbers enable trust staff to reference any location on its site, helping to improve efficiency. The GLNs are also shared with suppliers who work within the trust so that they too can keep accurate and up-to-date delivery information. Speaking in February, Theresa Gunn, Quality System Manager at Derriford Hospital, said: “I’m very proud of the work my team has done to complete this task one year ahead of the Department of Health’s suggested timescales. Now that we have barcodes available in every room, the trust will be able to use these to accurately and efficiently record locations where activities occur. Staff will be able to quickly and easily scan the GLN barcode to track where products are


delivered or care is administered. This, in turn, will enable the trust to more accurately and efficiently locate products or patients.” This was the second milestone reached by the trust earlier this year, with the Scan4Safety demonstrator site also announcing in February that it was on target to reduce waste and increase efficiency by achieving a transaction information milestone. With support of NHS Shared Business Services and Global Health Exchange (GHX), the trust has streamlined the payment and product identification process for suppliers, reducing waste across the ‘Purchase to pay’ process. Plymouth Hospitals NHS Trust also has plans to use GS1 standards within trauma and orthopaedics, so that theatre teams can track products such as knee and hip implants used by each patient and so support faster product recall, and more efficient inventory management. In October, Lord Carter of Coles visited the trust to analyse the eOutcomes work, as one of the only hospitals in the country using such an electronic system. The trust revealed as part of his visit that out of a total of circa 9,000 clinic attendances, it processed 6,300 outcomes electronically, capturing the outcomes for patients in real time. Leeds Teaching Hospitals NHS Trust In September 2017, Leeds Teaching Hospitals NHS Trust announced plans to link information gathered from barcodes to its electronic patient record and patient administration systems. As the largest of the Scan4Safety demonstrator sites, the move has been heralded as ‘quite revolutionary’ and will allow for the scanning of a wristband to immediately supply information from the patient record. Focusing on stock and inventory management, which the trust first started implementing using GS1 barcoding in 1999, Leeds Teaching Hospitals NHS Trust uses a system known as ‘CHOC Stock’, which enables the live update of stock usage through barcode scanning at point of use and has achieved ongoing revenue benefits by using quality inventory information to reduce unnecessary stock holding levels without the risk of stock outages. The system is implemented throughout the hospital including cardiology, radiology, orthopaedic and trauma, and, to date, has 3,000 barcoded items which can be scanned at 270 stocking points. Leeds Teaching Hospitals NHS Trust has so far saved £812,000 through reducing the amount of stock they hold. Discussing the GS1 demonstrator site programme announcement, Tony Whitfield, director of Finance at the trust, said: “We are delighted to be working on this exciting project, which will enhance patient safety while enabling us to have a much greater


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overview of all the items we use every day to look after 1.5 million patients every year, reducing waste. It will mean that every location, medicine and medical device will be identified using a unique barcode which is also associated with a particular patient, providing additional monitoring for safety purposes. “It will make it easier to track individual patient journeys through our hospitals and ensure we only order the stock we need at the time we need it, delivering significant cost savings. We also see the broader opportunities the adoption of standards bring in, supporting us to deliver year-on-year improvements to the way we design services to best meet the needs of our patients.” North Tees and Hartlepool NHS Foundation Trust North Tees and Hartlepool NHS Foundation Trust was also among the six NHS trusts that were chosen to be at the forefront of rolling out a set of new national standards, receiving part of the £12 million funding to demonstrate significant efficiencies and cost savings through the adoption of GS1 barcoding and PEPPOL standards. Since 2016, all in-patient wristbands used at the trust are 100 per cent GS1 compliant, including Neonates, with location numbering (GLNs) used in all of the trust locations. The trust has also adopted a new catalogue management solution from VirtualStock, called The EDGE, as part of a focused drive to design-out process inefficiencies both within the hospital and its wider supply base and to deliver a radical step-change in system interoperability. As of December last year, North Tees and Hartlepool NHS Foundation Trust reported ‘a significant milestone’ in the Scan4Safety programme, following the ‘smoothest upgrade ever’ of their Electronic Medicines Management solution. Philip Dean, head of pharmacy, North Tees and Hartlepool NHS Foundation Trust, said: “Largely this was down to the planning and preparatory work between staff at the trust and staff at EMIS Health, working together to ensure a seamless upgrade. The changeover of systems was invisible to our pharmacy staff and users - our expectations were excelled on the day. This upgrade means that we can now fully support Scan4Safety, and we can also achieve dm+d compliance, all of which will be a great benefit for the trust and the wider health economy.”

6 Taunton & Somerset NHS Foundation Trust Musgrove Park Hospital, an acute hospital that is part of Taunton and Somerset NHS Foundation Trust, serves a population of over 340,000.


Through the Scan4Safety Programme and the introduction of point-of-use scanning, 93 per cent of Salisbury NHS Foundation Trust’s implantable devices have been accurately tracked to a patient Adopting the measures outlined in the eProcurement Strategy, the trust aimed to use GS1 standards to better inefficient working patterns and processes and began approaching all of its suppliers and solution providers to ensure all products received were uniquely identified, supporting the management of data at every stage of a product being received, stored and used. The trust has seen immediate benefits in improving their processes, including stock adjustments since 2014/15, beginning with £0.5 million the year following GS1 standard introductions. Moreover, the trust now turns more accurate reporting of stock turn figures, which means they not only know what is used, but which items aren’t used. This removes over-ordering and has saved the organisation £20,000 in expired stock that

would have previously been wasted. With a truly accurate view of product data and costing per procedure, Taunton and Somerset NHS Foundation Trust plans to continue the implementation across other areas, firstly in cardiology, day surgery, general and ortho theatres, radiology, ITU and A&E, before implementing it further in oncology, maternity, wards and, eventually, all other areas. Nicola Hall, managing director of Ingenica Solutions, the inventory management solution provider used by the trust, said: “Inventory management is fast emerging as a powerful mode to help the NHS achieve significant savings. We are very pleased to continue to work with Musgrove Park Hospital on this large-scale roll out. The hospital is already an example of how efficient and effective solutions improve E


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SCANNING  outcomes; it is a major implementation, that brings great benefits, hence the high level of importance attached to this project.” Cambridge University Hospitals NHS Foundation Trust Comprising of Addenbrooke’s and the Rosie, Cambridge University Hospitals NHS Foundation Trust is one of only five academic health science centres in the UK and a leading national centre for specialist treatment for rare or complex conditions. According to GS1 UK, the trust was spending unnecessary time manually locating and recording each mobile medical device it was using, detracting from patient care and contributing to the purchasing of unnecessary additional stock. Using Radio Frequency Identification (RFID), the hospital’s clinical engineering team starting seeing the benefits of automating the process of tracking devices, with trolleys fitted with RFID readers able to automatically record the date, time and location of any tagged devices within a range of 11 metres. Data recorded in July 2015 revealed that a total of 7,500 higher-value medical devices had been fitted with RFID tags, with work already underway to fit the remaining 32,500 assets with tags. As a result of using GS1 EPC standard tags, device utilisation levels have increased, reducing the need to purchase additional equipment. Additionally, audits now take just eight minutes, compared to 90 minutes per ward previously, and clinical staff are now more easily able to receive a device when needed. Average times for supplying a device to a ward is down to approximately 12 minutes.

8 Portsmouth Hospitals NHS Trust Also focusing on improving their inventory management system, Portsmouth Hospitals NHS Trust made steps to enhance its methods for knowing what stock is available at all times across the entire trust, reducing waste and saving money in the process.


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Derby Teaching Hospitals revealed at the start of the year that it had already benefitted from efficiency savings of nearly £800,000 in 2015/16, with estimates saying it would save another £1.18 million in 2016/17 In 2012, the trust discovered that 13 different types of barcodes were not identified with a uniform system, with different suppliers, manufacturers and distributors often using the same codes for different products. Additionally, stock levels were often inconsistent, sometimes too low and sometimes too high, with inventory values often declared incorrectly. Therefore, a new inventory management system was planned using GS1 standards to identify all products. Initially, the system was implemented across a 27 theatre complex with 40 supporting locations, cardiology, audiology and six wards. Striving to get 100 per cent of products barcoded, the Portsmouth Hospitals NHS Trust now uses Global Trade Item Numbers (GTINs) to uniquely identify products and can now use products with the shortest life remaining first, meaning less wastage of expired products. With figures likely to have improved since, stock had been reduced by 20 per cent and waste had impressively been reduced to less than one per cent. The estate’s department has started its procurement process for a GS1 compliant facilities management system to enable efficient space management. Alongside Derby Teaching Hospitals NHS Foundation Trust, Portsmouth Hospitals NHS Trust was awarded the ‘GS1 Healthcare Best Provider Implementation Case Study Awards’ at the 2015 Global GS1 Healthcare Conference in Budapest. Alan Hoskins, director of Procurement & Commercial Services, said: “The initial roll-out across our theatres has already delivered a huge return on investment. In the first year we saw 8.5 times saving from the initial investment freeing up finances for re-investment in other areas.”

University Hospitals Coventry and Warwickshire NHS Trust As one of the UK’s largest NHS trusts in the country, caring for over one million people, University Hospitals Coventry and Warwickshire NHS Trust first introduced a blood tracking system in 2006, with an upgrade in 2012 introducing the use of patient wristbands. The hospital is the second largest user of blood in the region and uses Blood Track Tx, a system which ensures patients receive compatible blood by matching barcodes on their wristband and on product labels. The Department of Health’s eProcurement Strategy requires GS1 barcoding on the patient wristband complying with ISB 1077 Patient Identification standard. University Hospitals Coventry and Warwickshire NHS Trust then implemented the use of 2D barcodes on patient wristbands allowing for greater positive patient identification, as well as trialling the Path Collect system, an electronic system of labelling blood sample tubes. Since the implementation of the blood tracking system, blood wastage has been reduced to 4.1 per cent and blood stock management has been enhanced. The implementation of the GS1 DataMatrix wristband ensures positive patient identification throughout the transfusion process, which is essential to the provision of safe and effective care to patients. L

10 E Read more about the 2017 GS1 UK Healthcare Conference on page 29.





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Admirable accomplishments in the NHS The shortlist for the 2017 Health Business Awards has been released, with NHS organisations recognised for their successes across 22 categories. Ahead of the events ceremony, Health Business previews the categories, the shortlisted and the year gone by In November, Chancellor Philip Hammond announced in his Budget that an extra £2.8 billion will be available for the NHS by 2020, of which £335 million will be used to support services this winter. According to an NHS Confederation poll following the annual spending speech, just three per cent of healthcare leaders believe the investment will bring about a big improvement to their organisation’s ability to provide high-quality care. Although 50 per cent of the responding 107 senior healthcare leaders believed that the financial settlement could lead to only a small improvement in care, 47 per cent stated that it would bring about no improvement at all. The Budget, for many working in the health service, once again reflected another missed opportunity for the government to intentionally relieve the growing weight that is dragging the NHS into a consecutive year of amounting pressures this winter. It

is somewhat surprising then that, like the the significant contributions made each years preceding it, 2017 has been one year by organisations and individuals of outstanding achievement for that work inside and alongside our national health service. the NHS. A week before t e Fighting back against the the ceremony, which includes g d The Bu gain financial and operational a champagne drinks obstacles in its path, reception and a three once a nother a the NHS has again course luncheon, we d e t c ty i n refle u proved its resilience look at the categories t r o p and determination issed opernment to and the hospitals m to improve, and the nominated within them. gov for the e the growing Health Business Awards, organised by Health OUTSTANDING reliev sures on Business magazine, ACHIEVEMENT pres S this recognise the high IN HEALTHCARE the NH er standard of care offered Sponsored by CCube t n i w within our hospitals and the Solutions, the main sponsor of cutting-edge innovations that make the Health Business Awards, the it the best health service in the world. Outstanding Achievement in Healthcare Held on 14 December at the Grange Hotel, Award is presented to the NHS organisation London, the Awards recognise and celebrate that has achieved success in its E Volume 17.6 | HEALTH BUSINESS MAGAZINE


Health Business Awards



EVENT PREVIEW  role and brought benefits to the wider NHS through the dedication and expertise of its staff. Widely considered as the top prize of the event, there are seven NHS organisations shortlisted who will be hoping to follow in Hinchingbrooke Health Care NHS Trust’s footsteps and claim the accolade. Those seven organisations are Clatterbridge Cancer Centre NHS Foundation Trust, University Hospitals Bristol NHS Foundation Trust, Kent and Medway NHS and Social Care Partnership Trust, Somerset Partnership NHS Foundation Trust, Birmingham Women’s and Children’s Hospital NHS Foundation Trust, Northumbria Healthcare NHS Foundation Trust and Inclusion (part of South Staffordshire and Shropshire Healthcare NHS Foundation Trust). Presented to the NHS trust which has worked with other public/private sector organisations, such as local government, police, fire, charities and schools, to engage the local community in preventative campaigns, the NHS Collaboration Award has a very competitive shortlist. Hoping to win the award will be: Tees Esk and Wear Valleys NHS Foundation Trust and Durham Constabulary; East Midlands Ambulance Service and Derbyshire Police; Bradford District Care NHS Foundation Trust and West Yorkshire Fire and Rescue Service; South West Yorkshire Partnership NHS Trust and Leeds Community Healthcare NHS Trust; and Salford Royal NHS Foundation Trust and Greater Manchester Casualty Reduction Partnership.


The Clinical Commissioning Award, sponsored by the National Autistic Society, recognises the recently formed clinical commissioning group (CCG) sector, and an organisation which has quickly made an impact to reduce hospital admissions through preventative practice. With NHS Barnsley having won the award in 2016, the CCG is once again up for the award, alongside City and Hackney CCG, Mid Essex CCG, NHS Southwark CCG, NHS Fylde and Wyre CCG and NHS South Gloucestershire CCG. THE NHS ESTATE Four organisations will be competing for the Facilities and Estates Innovation Award, sponsored by ISS Mediclean. This award recognises NHS and other healthcare organisations that have developed innovative procedures for managing and maintaining healthcare facilities, and will be taken home by one of Oxford University Hospitals NHS Foundation Trust, University

Hospitals of North Midlands NHS Trust, Shrewsbury and Telford Hospital NHS Trust or Gateshead Health NHS Foundation Trust. Since 1997, the NHS has seen a huge investment in its fabric – the biggest hospital building programme in its history. The Hospital Building Award will be provided to the new hospital building project that raises the standard of the healthcare environment and demonstrates value for money and project management excellence. NHS Dumfries and Galloway, Northumbria Healthcare NHS Foundation Trust, who won the award in 2015, and Bradford Teaching Hospitals NHS Foundation Trust are the three shortlisted organisations for 2017. Sponsored by Centrica Business Solutions, the Sustainable Hospital Award will be presented to one of Newcastle upon Tyne Hospitals NHS Foundation Trust, Aintree University Hospitals NHS Trust or North Bristol NHS Trust. The accolade recognises the NHS hospital that has made progress towards

The Hospital Building Award will be provided to the new hospital building project that raises the standard of the healthcare environment and demonstrates value for money and project management excellence

sustainability through the smarter use of energy, transport and waste management in order to strive towards a reduced impact of healthcare facilities on the environment. The Environmental Practice Award, sponsored by LASER Energy, also recognises the individual NHS project that has furthered the progress of environmental practice in the NHS. Won in 2016 by Barts Health NHS Trust for the Cleaner Air for East London, there are six NHS trusts in contention for the 2017 award: University Hospitals Bristol NHS Foundation Trust, Manchester University NHS Foundation Trust, North East Ambulance Service NHS Foundation Trust, York Teaching Hospital NHS Foundation Trust, Worcestershire Acute Hospitals NHS Trust and University Hospitals of North Midlands NHS Trust. IMPROVING HEALTHCARE FACILITIES The Hospital Catering Award, won last year by Taunton & Somerset NHS Trust, is presented to the NHS organisation that has strived to improve the standard of food and its nutritional value for the benefits of both patients and staff. Cardiff & Vale University Health Board, North Bristol NHS Trust, Hillingdon Hospitals NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust and Newcastle upon Tyne Hospitals NHS Foundation Trust are the five organisations hoping to win at the 14 December event. Four trusts will also be in the running for

the 2017 Hospital Cleaning Award. This award acknowledges the efforts made by NHS organisations in recent years to raise standards in cleanliness and reduce the risk of hospital acquired infections and will be presented to one of City Hospitals Sunderland NHS Foundation Trust, St George’s University Hospital NHS Foundation Trust, West Suffolk NHS Foundation Trust or St Helens and Knowsley Teaching Hospitals NHS Trust. The critical assets of a hospital – its people, property, information and reputation – must be protected. The Hospital Security Award will recognise hospitals that have made significant steps towards a safer environment for patients and workers through the implementation of a security policy which incorporates the latest advancements in CCTV, access control and other monitoring technologies. Alongside three other shortlisted hospitals, Dartford and Gravesham NHS Trust, University Hospitals Birmingham NHS Foundation Trust and Great Ormond Street Hospital for Children, East Lancashire Hospitals Trust will be hoping to win the award again having won it last year for its secure storage system for patient’s valuables. Sponsored by Assistive Partner and awarded to the NHS trust which has made great strides in providing a safe hospital environment for patients, the Patient Safety Award will be contested by University Hospitals of Morecambe Bay NHS Foundation Trust, West London Mental Health NHS Trust, Sheffield

Teaching Hospitals NHS Foundation Trust, NHS Fylde and Wyre CCG and North East London Foundation Trust/BHR CCG. EXCELLENCE IN IT The need for timely, effective information in healthcare is key to realising the benefits of the huge investments in NHS staff and buildings. The Patient Data Award, which will go to either Cambridge University Hospitals NHS Foundation Trust, NHS Arden & GEM CSU or Kent and Medway NHS and Social Care Partnership Trust, celebrates the most innovative introduction of new technology for secure storage, retrieval and distribution of data throughout the NHS. Sponsored by Awesome Apps, the Telehealth Award, last seen in 2014, will be competed for by five NHS organisations: East London NHS Foundation Trust, Cornwall Partnership NHS Foundation Trust, Clatterbridge Cancer Centre NHS Foundation Trust, NHS South Sefton CCG and Airedale NHS Foundation Trust. Telehealth can provide benefits to patients, healthcare providers, and to community projects, and this award will commend the organisation that demonstrates the most innovative use of technology to deliver health services, expertise and information over distance. Furthermore, the much coveted Healthcare IT Award, sponsored by Fujitsu, will recognise an organisation that is responsible for implementing a ground breaking IT project that demonstrates clear cost benefits to the wider NHS. The wider use of computer technology in the NHS is evident throughout the world, with many countries citing NHS projects as examples of good practice. Leading that pursuit of good practice are North East London NHS Foundation Trust, NHS Arden & GEM CSU, Guy’s and St Thomas’ NHS Foundation Trust, East Lancashire Hospitals NHS Trust, Moorfields Eye Hospital NHS Foundation Trust and University Hospitals of Leicester NHS Trust, all of whom will be hoping to win the award this year.

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CELEBRATING GOOD VALUE Improving patient access and choice depends on the quality and availability of staff in all areas of the hospital practice. The Healthcare Recruitment Award will recognise the NHS organisation that has developed a robust recruitment policy that delivers both safety and continuity to patients. Following the success of Guy’s and St Thomas’ NHS Foundation Trust last year, and their reappearance in the shortlist again this year, four other trusts will hope to take the prize from them on 14 December: London Ambulance Service NHS Trust, NHS North Cumbria Clinical CCG; East Midlands Ambulance Service and South London and Maudsley NHS Foundation Trust. Recognising a hospital trust which has developed prudent financial practices, representing good value for the taxpayer, the NHS Finance Award will be presented to one of North Staffordshire Combined Healthcare, University Hospitals of Morecambe E



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Offering NHS trusts bespoke energy solutions

Helping you solve today’s business challenges

Owned by Kent County Council, LASER manages fully OJEU compliant frameworks that any NHS trust can access without having to go through a tender process. Working with over 20 NHS trusts to date, LASER’s wide range of services are becoming more and more attractive to NHS procurement managers, specifically LASER’s Fully Managed and Bureau Services which provide a virtual energy manager offering strategic data and advice to help inform and shape a trust’s energy strategies. Consolidated invoicing also saves significant resources and back office administration costs, and LASER’s invoice validation process provides peace of mind and assurance around billing. Average savings from energy

Skyrocketing costs, historic regulatory changes, patient demands for instant access to their records, compliance to GDPR, SAR and freedom of information (FOI), bureaucracy and security concerns help define the healthcare industry landscape. Indeed the upcoming GDPR that becomes law on 25th May next year poses several challenges, not least the ability to be compliant with stricter data protection rules but also to be able to prove it in a court of law. By deploying a scanning solution alongside other lineof-business applications and embracing digital transformation, healthcare organisations gain a strategic hub for managing all content that flows through the enterprise. Key benefits include: centralised storage with enhanced security for all information, including patient records; business process agility that can lead to productivity gains and cost savings; enhanced compliance throughout all

procurement alone, reported by LASER across its public sector customer base, ranges from four per cent to 10 per cent, with additional four-to-five per cent savings delivered by LASER’s support services. Furthermore, LASER provides its customers with the flexibility to choose from a variety of procurement options, based on their risk appetite and requirements for budget certainty, and enables customers to pick and choose the services that best suit their energy needs. For more information about how LASER can help your trust, please contact the team by telephone or email. FURTHER INFORMATION Tel: 0800 484 0840

departments with all regulatory guidelines; faster access to patient information, potentially leading to improved patient outcomes, better patient engagement, and better access to critical information across the care continuum; and a notable ROI from the investment. With the benefits and rapid return on the investment, moving from paper to digital processes will allow healthcare organisations to tackle the challenges facing the industry in the coming years. For more information please contact the company. FURTHER INFORMATION

Offering you the complete Awesome App’s 3D printing comes of age locker solution

Garran Lockers is an NHS Supply Chain associated locker manufacturer and along with Craftsman Lockers, ICE Locker Group forms one of the largest locker manufacturing companies in the UK. Both companies offer contemporary design and practical solutions with a wide range of standard and tailored lockers options to fit any requirement you might have. For over 50 years Garran Lockers has provided high quality and reliable locker solutions across a wide selection of public and private sectors including the NHS, private hospitals and education institutions to name a few. The company has introduced


antimicrobial powder coat across its metal locker ranges to address the potential for cross‑contamination in high footfall or hygiene-sensitive areas such as hospitals and leisure centres. The finished locker surface has been independently tested and proven to reduce the growth of bacteria such as E. coli and MRSA by 99.9 per cent for the lifetime of the coating. Get in touch today to discover more about Garran Lockers, Craftsman Lockers or the Ice Locker Group and the products and services they can offer you. FURTHER INFORMATION Tel: 02920 859 600


While 3D printing is becoming more widely used in general engineering, the use of 3D printing in the medical and allied sectors such as dentistry has only just begun. The digital approach has been greatly enhanced by the accuracy and automation of scanners and the sophistication of software to ‘fill in’ the scan areas previously regarded as troublesome. Awesome Apps has been leaders in this kind of software and has now matched these advances with the introduction of the MoonRay series of 3D printers. 3D printing too has moved on from the toxic and brittle materials of the past, using bio-compatible resins solidified by ultra violet light everywhere the digital model dictates. This professional and attractive package produces shapes and components at a very high speed and details down to 20 microns or the equivalent of a quarter

the width of a human hair. With proven dental and implant applications now evolving, Awesome Apps is available to assist and collaborate on medical applications beginning to emerge. A specific version for dentistry and orthodontics now brings same day provisions of bridges, caps, implants and customised medical solutions into reach. For the right combination of software, scanners and 3D printers for your business, call Awesome Apps Ltd. FURTHER INFORMATION Tel: 01242 370453



The Outstanding Achievement in Healthcare Award is presented to the NHS organisation that has achieved success and brought benefits to the wider NHS through the dedication of its staff  Bay NHS Foundation Trust, Bolton NHS Foundation Trust or North Bristol NHS Trust. This award is sponsored by Cube Solutions. Sponsored by Garran Lockers, the Hospital Procurement Award celebrates the NHS trust that has delivered value for money and increased efficiency through smarter procurement practice. The winning trust, which will be selected from Plymouth Hospitals NHS Trust, East and North Hertfordshire NHS Trust, Salisbury District Hospital and Newcastle upon Tyne Hospitals NHS Foundation Trust, will demonstrate the success of partnerships and collaborations to achieve procurement excellence and cost effectiveness. Awarded to the campaign which can demonstrate success in achieving its objectives, the winning entry on the NHS Publicity Campaign Award can be either internal or external and can combine media including press, radio, television and outdoor advertising. The three trusts hoping to win the trophy this year are NHS Arden & GEM CSU, Mid Essex CCG and United Lincolnshire Hospitals NHS Trust.

Awarded to NHS organisations who have made strides to improve to the experience and overall care of its patients, the Innovation in Mental Health Award will be contested by Northumberland Tyne and Wear NHS Foundation Trust, Coventry & Warwickshire Partnership NHS Trust, Lincolnshire Partnership NHS Foundation Trust, Camden and Islington NHS Foundation Trust and South London and Maudsley NHS Foundation Trust. Last year it was won by the Office of London CCGs for the Early Intervention in Psychosis (EIP) London Programme. TRANSPORT AND LOGISTICS IN THE NHS Sponsored by the British Parking Association, the Transport & Logistics Award is awarded to the NHS trust that has seen improvements in operational logistics, including: emergency services transport and coordination; fleet management; green transport; car parking and traffic management; postal services; and the supply of materials and goods. Six trusts are in the running for the 2017 award:

Oxford Health NHS Foundation Trust, York Teaching Hospital NHS Foundation Trust, Shrewsbury and Telford Hospital NHS Trust, Yorkshire Ambulance Service NHS Trust, London Ambulance Service NHS Trust and Northern Lincolnshire & Goole NHS Foundation Trust. Also returning for the first time since 2014, the Ambulance Trust of the Year Award is presented to the ambulance trust that has embraced change and demonstrated a decrease in response times, the ability to provide treatment at the scene of an accident, and the provision of outpatient services. Having won in 2014, West Midlands Ambulance Service is once again nominated, alongside East of England Ambulance Service NHS Trust, Yorkshire Ambulance Service NHS Trust, North East Ambulance Service NHS Foundation Trust (NEAS) and London Ambulance Service NHS Trust. The Air Ambulance Service Award recognises the hard work and dedication of the air ambulance sector, which operates as 18 separate charities that raise over £35 million per year in funding. The NHS organisations in contention for the 2017 award include: Yorkshire Air Ambulance, the Hampshire and Isle of Wight Air Ambulance, Devon Air Ambulance, Midlands Air Ambulance and London Air Ambulance. L FURTHER INFORMATION

Intelligent end-to-end energy solutions

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Centrica Business Solutions understands the power of power. As new energy sources and technologies emerge, and power becomes decentralised, Centrica is helping healthcare providers around the world use the freedom this creates to achieve their objectives. The company provides insights, expertise and solutions to enable them to take control of energy – powering performance, resilience and the future. In a changing energy landscape, Centrica helps its customers unlock the power of power to satisfy their needs. It is already helping more than 1,500 healthcare service providers around the world through three initiatives: Powering Performance, which improves operational efficiency; Powering Resilience, which enables businesses to stay on 24/7; and Powering Growth, which unlocks strategies for sustainable growth. The company builds intelligent, end-to-end energy solutions to

The National Autistic Society is the UK’s leading autism charity. Since the charity began over 50 years ago, it has been pioneering new ways to support people and understand autism. The organisation continues to learn every day from the children and adults it supports in its schools and services. Services include diagnosis, residential homes, supported living, daytime services and support in further and higher education. Based on experience, and with support from its members, donors and volunteers, The National Autistic Society provides lifechanging information and advice to millions of autistic people, their families and friends. It also supports professionals, politicians and the public to understand autism better so that more autistic people of all ages can be understood, supported and

power performance, resilience and the future for its customers through: insight – leveraging ‘big data’ to help customers manage energy performance across all their equipment and devices; optimisation – redesigning how buildings use energy to improve operational efficiency; and solutions – providing power sources and systems to help customers take control of their energy supply and manage demand. FURTHER INFORMATION Tel: 020 7901 1594 centricabusinesssolutions@ www.centricabusiness

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appreciated for who they are. Support for professionals includes regular newsletters, training courses, conferences, consultancy and an Autism Accreditation programme to help professionals working with autistic people gain the knowledge they need. The organisation also offers support for employers to help them to understand how to attract autistic employees into the workplace. FURTHER INFORMATION Tel: 020 7833 2299



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Looking after every stage of your information strategy, from capture and life-cycle management to delivery, CCube Solutions highlights some examples of NHS trusts making substantial efficiency savings by making the move towards paperless documentation IN-HOUSE SCANNING: ST HELENS & KNOWSLEY TEACHING HOSPITALS NHS TRUST St Helens & Knowsley Teaching Hospitals NHS Trust started a project in 2009 to remove paper medical files to guarantee notes availability, improve the quality of patient care and, of course, save money. Its IT resource – called St Helens Health Informatics Service (HIS) – created its own in-house scanning bureau along with CCube Solutions’ EDRMS. The results are impressive: it was the first trust in the UK to stop using paper medical files in clinical practice; £1.4 million annual savings from £1.2 million investment; 500 doctors and 130 secretaries trained after a staged rollout taking 22 months; over 155,000 medical records digitised, stopping 7,000 files per week being hand delivered; and an innovative scan‑on‑demand model was developed, meaning only files needed are actually scanned. OUTSOURCED SCANNING: AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST This project was handled completely differently. At first, Aintree University Hospital considered creating its own scanning bureau but then decided to outsource to specialists, Capita Total Document Solutions. Again, CCube Solutions software was installed. Aintree became the first trust to use forms recognition technology to automate the recognition and classification of pre-printed medical forms which make up 95 per cent of medical files; £1 million annual savings from £1.5 million investment; scan‑on-demand with a third party – 282,000 patient files digitised; 30 per cent space gained in a new £45 million building from removing paper records, marking a £13.5 million estate benefit; and three or four clicks to information. HYBRID MODEL: MILTON KEYNES HOSPITAL NHS FOUNDATION TRUST Milton Keynes Hospital approached the whole transition from paper to digital medical records by both setting up its own in-house scanning bureau and working with a third party outsourcing specialist, to do the back scanning. Milton Keynes went for a ‘big bang’ approach where all departments went live on a specific day. The in-house



bureau is used for day-to-day scanning and, just like the other trusts listed above, returns from the project have been significant. Benfits include: over £1 million cumulative savings since the project went live from a £2 million investment; 35 per cent reduction in records staff headcount; 287,000 patient records scanned equating to around 57.4 million pages; 24/7/365 notes availability for multi‑disciplinary clinical teams; project delivered on time and to budget with the only cost overrun due to VAT increasing from 17.5 per cent to 20 per cent; and auditing and information governance improved as medical records are tracked. AVOIDING SCANNING LEGACY PAPER IN THE FIRST PLACE: PAPWORTH HOSPITAL Tertiary Trust, Papworth Hospital, installed an EDRM, workflow and eForms solution from CCube Solutions to create an electronic medical records system (EMR). Unlike other trusts who have digitised patient records, Papworth’s EMR is not concerned with scanning legacy records which is costly, complex and time consuming. The focus has been to concentrate on the patient’s pathway from the moment an individual is referred to the hospital so that referral paperwork and medical notes are indexed, shared and information automatically routed to boost efficiency, reduce costs and enhance patient care. Return on investment has been significant, with: the whole project including software and project management cost under £160,000 plus an annual software licence fee of £25,000. This contrasts with other trusts who have spent over a £1 million back scanning their libraries; significant reduction in operational

costs by removing physical paper records storage and management which cost £200,000 per annum; assists Papworth meet government targets to see patients within the set timeframe of 18 weeks from GP to final treatment; and the first deployment of a registration and referral system where letters are scanners and then handled electronically within the trust using workflow. MEDICAL RECORDS IN PRIMARY CARE – THE GPS The above examples have focused on records management in hospitals. Turning to GPs, CCube Solutions is involved in a significant primary care initiative called eLGS. Capitalising on its experiences digitising records at its two hospital sites, St Helens and Whiston, St Helens & Knowsley HIS – working with CCube Solutions – took the pioneering step to offer its know-how in primary care. In April 2013, it launched a fully managed service to digitise all the patient records which GPs have to keep in their surgeries – colloquially called Lloyd George notes. Costing just 75p per record per year, the eLGS service includes collection, digitisation, hosting, training, and the software GPs then use to access the information on their desktops. This initiative is about releasing more space in primary care, enhancing GP and practice staff productivity and removing a whole paper shuffling industry in primary care which in itself costs millions and millions. To date, four CCGs have purchased the service with around 140 GP practices now using the system. L FURTHER INFORMATION



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Using technology to improve healthcare delivery and patient care has been a hot topic over the last few years and the transformation to digital healthcare in the NHS is well underway Technology is not just making its presence felt in operating theatres and hospital wards – NHS trusts and PCTS are quickly becoming aware that being able to access, store and share patient records is as crucial to improving patient care as the latest breakthroughs in medical science. The need for an efficient and effective information management system manifests itself across all levels of modern healthcare provision. It encompasses everything from consultants and surgeons accessing x-rays and scans from workstations across a hospital complex, ending the need for cumbersome transfer of paper records from site to another, with the incumbent risk of them being misplaced or lost or misused; to administration staff using systems that help automate selected processes, saving time and money. Add a dose of security and audit, and suddenly, the prospect of a system that mandates governance and eliminates un‑scrutinised misuse, becomes quite real. This has been achieved in some NHS trusts who took the bold step to deliver change some years ago and are now leading the way forward including lessons learnt. Two key points must be emphasised. First, paperless healthcare is not a dream – it is real, has been done in the NHS – and, not just once – it does deliver real and measurable benefits. There is plenty of evidence from sites where paperlite, if not paperless healthcare, has been achieved over the last five to six years, providing a good and positive track record for all to see and learn from. In other words, it is eminently do-able, and doing nothing is an expensive option. Second, the focus is not technology, or at least technology plays a small but important part in meeting the enormous challenges imposed by transformation to digital healthcare. In actual fact, it is about managing that transformation and is all to do with very careful application of the available technology, to solve defined problems and then build on that success to tackle other problems, but at your pace. The key message is that careful application of established technologies

is delivering measurable improvements and benefits. These must be applied to address strategic requirements, rather than as a short-term measure to solve paper problems. The technology is not rocket-science, but has evolved gradually as customer demands, interoperability, and web accessibility have evolved. To ensure successful transformation to digital healthcare, such lessons must be embraced. ACHIEVING DIGITAL HEALTHCARE Health Secretary Jeremy Hunt wants the NHS to be paperless by 2018, saying that going paperless would ‘save billions’. In directives, issued in January 2013 and February 2016, Hunt outlined plans for patients to have digital records so that their information can follow them. But unlike previous large scale, top-down directives, he wants this driven bottom up and by 2018 any crucial health information should be available to staff at the touch of a button. Most NHS sites hold patient related data on a variety of different media, for example, paper, microfilm and digital. It is currently very difficult to identify exactly what information may be held on a given patient. This has resulted in falling standards for maintaining the patient’s acute medical record, increasing risk and leaving patients and clinicians at a disadvantage. Furthermore, there are many well-known issues related to paper-based delivery of care, such as: physical handling and transport of paper records; lack of audit on who looked at any record; only one person can see a record at any time; difficulty sharing records without copying; lost records; and escalating costs

associated with handling physical records. Yet, health and IT professionals remain deeply sceptical that the NHS can be paperless by 2018. A large percentage of healthcare professionals engaged in this work feel that paperless by 2018 goal is ‘a great ambition, but unrealistic’. The key concerns expressed included IT compatibility, costs, timescales, technology, and cultural changes, as well as insufficient information about the potential benefits from improved IT systems. A number of trusts took the bold step towards paperless healthcare some years ago. These organisations achieved paperlite health care using Electronic Document and Records Management (EDRM) technologies – not by simply installing IT, but by paying great attention to the underlying processes. Cost effective solutions based on established EDRM technologies offer the chance for trusts to embrace a culture of compliant information management practice to deliver paperlite health care, if not paperless. There is no magic bullet solution – just a common sense approach which focuses the available technologies on specific processes to ensure that the solution delivers what is expected of it. The process is a migratory one which promotes a trust‑wide information repository with newly created clinical documents being ‘born’ onto the repository whilst ‘legacy’ information is scanned and digitised in a staged manner. Systems have become more affordable and are delivering real and measurable benefits. L FURTHER INFORMATION



Counter Fraud Written by Rianne Endeley-Brown, Media Relations Officer, NHS Counter Fraud Authority




Newly-launched: the NHS Counter Fraud Authority Following its launch on 1 November, Rianne Endeley-Brown introduces the new special health authority responsible for investigating and countering fraud against the NHS The NHS Counter Fraud Authority (NHSCFA) is a new special health authority dealing with fraud, bribery and corruption against the NHS. Its launch on the 1 November 2017 marked a renewed focus on economic crimes carried out against the NHS and the wider health service. With this focus comes a need for our intelligence-led organisation to better

understand fraud risks, as well as the capacity to investigate serious and complex fraud cases. So what is fraud? Essentially, it is the crime of using deception to make a personal gain. It is a crime that many are familiar with, whether they have experienced it first-hand or have seen warnings about it. Fraud against the NHS costs an estimated

£1.25 billion a year (based on 2015-16 data), which is roughly one per cent of the total health budget. By ‘fraud’ in this case we mean a range of economic crimes including fraud, bribery and corruption or any other illegal act that is committed by an individual or group of individuals to obtain a financial or professional gain.

“We created the NHS Counter Fraud Authority so that there is a dedicated NHS organisation to tackle health service fraud and corruption and bring fraudsters to justice” There are many different areas of NHS fraud, with the biggest estimated to be procurement fraud, patient fraud and dental contractor fraud. Simon Hughes, interim chair of the NHSCFA, said that ‘every fraud takes a service away from someone that needs it’. £1.25 billion is enough money to fund 40,000 staff nurses, or 5,000 frontline ambulances. PREVENTATIVE METHODS The NHSCFA has formulated a three-year strategy, with five main objectives: delivering the

Department of Health’s strategy, vision and strategic plan, and lead counter fraud activity in the NHS in England; being the single, expert, intelligence-led organisation providing a centralised investigation capacity for complex economic crime matters in the NHS; leading, guiding and influencing the improvement of standards in counter fraud work; taking the lead and encouraging fraud reporting across the NHS and wider health group; and investing in and developing NHSCFA staff. Going forward, the NHSCFA is putting extra effort into preventative measures. It is important to circulate information to stakeholders so that they are informed of the work the organisation is doing, as well as ensuring that the information is fed down the line to frontline employees and contractors, patients and the public. The NHSCFA will draw on the intelligence gathered to investigate complex and serious fraud cases. In doing so, we will analyse the weaknesses fraudsters are exploiting and work on strengthening those areas. Financial losses in the NHS due to fraud divert precious resources away from patient care. Danny Mortimer, CEO of NHS Employers, says that ‘it is unacceptable that the money lost each year is depriving patients of investment in their services’. Wherever possible, NHSCFA financial investigators will exercise their powers under the Proceeds of Crime Act to recover losses and investigation costs. The NHSCFA is making it as easy and accessible as possible for people to report their suspicions of fraud. Under-reporting leads to limited knowledge and lack of data, and ultimately an incomplete intelligence picture. The organisation aims to ensure that fraud is investigated properly. Simon Hughes claims that ‘simply reporting your concerns is a powerful action to protect healthcare’. Reporting your suspicions or any knowledge you have regarding fraud against the NHS is a huge step in helping to protect the health service’s resources. The NHSCFA will seek to reduce the impact of fraud as well as prevent it from happening in the first place. Preventing fraud

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Frauds against the NHS can come in many different forms and here are examples of just a few of them

Counter Fraud


Timesheet fraud: includes falsifying timesheets and trying to obtain money for hours not actually worked. Procurement fraud: exploiting the purchasing of goods and services by an NHS organisation. An example is bid rigging, when bidders agree between themselves to eliminate competition, denying the organisation a fair price or delivering poor quality goods or services. False claims: This can range from patients claiming for free treatment when they are not entitled to it, to NHS professionals claiming money for services they have not provided. and deterring fraudsters is at the heart of the organisation. To do so, the organisation is developing a range of communications and marketing strategies to raise the profile of the NHSCFA and the awareness of fraud and how to report it properly. We use social media to engage with our audiences (you can find us on Twitter, Facebook and LinkedIn), and you can find more information about us on our new website. The website also shows how to report fraud through the correct channels such as the online reporting tool and the Crimestoppers‑powered telephone reporting line. Also available on the NHSCFA’s website is a fraud awareness ‘toolkit’ that encourages the user to participate in raising awareness of fraud against the NHS. The webpage features downloadable and printable posters that can be displayed in office spaces, as well as online banners that can be used for social media sites. Although fraud is a crime committed by only a minority, it has a significant impact on the NHS and its resources. The NHS Counter Fraud Authority is clear in its message that fraud is a major problem within the NHS, and that it takes away money from people who need care. We will not tolerate this and will do everything within our powers to prevent fraud against the NHS. Health Minister Lord O’Shaughnessy said ‘we created the NHS Counter Fraud Authority so that... there is a dedicated NHS organisation to tackle health service fraud and corruption and bring fraudsters to justice’. And that is exactly what the NHS Counter Fraud Authority will be doing. L FURTHER INFORMATION



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Professor Terence Stephenson, chair of the General Medical Council, welcomed delegates to the UK Healthcare Conference

Written by Glen Hodgson, head of Healthcare, GS1 UK


How do we prevent ‘never events’ in the NHS?

At the 2017 GS1 UK Healthcare Conference, the delegates attending were set a challenge by Professor Terence Stephenson: to prevent the 400 ‘never events’ that take place in the NHS every year. Glen Hodgson, head of Healthcare at GS1 UK, explores what is meant by the term a ‘never event’, how can these be prevented and what role does GS1 standards have to play 2017 has been a significant year for GS1 standards in healthcare. More trusts and healthcare suppliers are GS1 members than ever before and momentum is building behind the next phases of the Scan4Safety programme. The 2017 GS1 UK Healthcare Conference is an important landmark in our calendar and this year’s event – taking place over two days on 21 and 22 November – saw more than 400 attendees, including senior NHS and Department of Health leaders, programme leads, suppliers and technology providers, discuss how GS1 standards could be adopted by even more healthcare suppliers and providers. HOW DO WE PREVENT ‘NEVER EVENTS’ The first day of the conference kicked off with Professor Terence Stephenson, chair of the General Medical Council. We were pleased to welcome back Professor Stephenson, who in 2016 had set the audience the challenge of sourcing real clinical evidence to demonstrate how GS1 standards in healthcare increase

efficiencies, while improving patient safety. Why did he set this challenge last year? While Professor Stephenson was a firm believer in the effectiveness of GS1 standards, he said that securing clinical data rather than concentrating on inventory stock – albeit fundamentally important – was going to secure better buy-in from senior NHS management to unlock funding. Thankfully Professor Stephenson has been able to move on from this challenge as there has been substantial progress in this area. So at this year’s conference, Professor Stephenson turned his attention on the challenge of reducing ‘never events’. To describe exactly what ‘never events’ are, Professor Stephenson began by offering many examples to demonstrate where human

error was affecting the NHS. Many came from cases where he had treated patients himself or major news stories, such as the PIP breast implant scandal. But it was Professor Stephenson’s own back surgery that helped illustrate to the audience the importance of GS1 standards in healthcare. Earlier this year, Professor Stephenson had two screws fixed into his spine. After five hours being unconscious during surgery, he wanted to know that the right screws had been inserted, in the right place and fundamentally, in the right person. Through no fault of any person, medical procedures can be beset by human error and Professor Stephenson said every week there are on average at least two operations where the wrong kit has been left inside the patient. E

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SCAN4SAFETY  He called these instances ‘never events’ and said there were 400 cases in 2016/17. 400 doesn’t sound a lot but for Professor Stephenson he said even one was too many. Having completed a secondment on an oil rig, where health and safety was at the heart of everything Shell did, Professor Stephenson was inspired about how he could apply this safety-focused culture to the NHS. Implementing GS1 standards was vital to achieve this strong safety culture in the NHS and while Chair of the Medicines and Healthcare products Regulatory Authority, Professor Stephenson was instrumental in the adoption of Unique Device Identification (UDI) numbers. This saw everyone’s NHS number associated with a barcode to help identify, track and trace every patient who had interacted with the NHS. He closed the session, with his challenge to the audience to prevent the 400 instances of ‘never events’ every year. And the message was clear: if the audience could demonstrate real success after implementing GS1 standards then these standards would be adopted more universally across the NHS. Ultimately, increasing efficiencies while improving patient safety. SPREADING SUCCESS THROUGHOUT THE NHS Matthew Swindells, national director of Operations and Information at NHS England, has worked in the NHS for 20 years. His first



The GS1 UK Healthcare Conference audience were challenged to demonstrate that projects that had adopted GS1 standards were connected and that they could join up different systems and services role was centralising Bolton Hospital’s store room’s supplies and procurement procedures. He is a firm believer in the importance of delivering an NHS that is safe, with high‑quality services and is cost effective. Speaking on the first day, Swindells assumed the audience was of the same mindset but admitted that generally people struggled to get their heads around the fact that the NHS can simultaneously be safe, efficient and provide value for money. He said that the NHS’s performance needed to be put into context as it is fairing better than the UK services sector in terms of driving productivity. Nonetheless, age and changing lifestyles has put increased pressures on the NHS and Swindells stressed that the tax payer needs to be confident further levels of funding will increase efficiencies rather than paper over the cracks. Swindells also admitted that there are regular achievements in the NHS, but for him, the key to achieving real long-term success

was to spread best practice. While this was being done locally and across individual trusts, Swindells said it was important that all parts of the NHS knew what success looked like. Like Professor Stephenson before him, Swindells challenged the audience to spread their pilot successes with the Scan4Safety programme so that it becomes the norm rather than the exception. But to convince the NHS, which isn’t the easiest customer, the Scan4Safety pioneers had to convince their colleagues in other institutions that GS1 standards are a solid investment at a time when so much is going on. Using lessons learnt from the United States and their approach to electronic medicine during the Obama presidency, Swindells suggested that the audience needed to demonstrate that projects that had adopted GS1 standards were connected, could demonstrate effective implementation between different institutions and that they could join up different systems and services. E

Matthew Swindells, national director of Operations and Information at NHS England challenged the audience to spread their pilot successes with the Scan4Safety programme


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Securing clinical data rather than concentrating on inventory stock was going to secure better buy-in from senior NHS management to unlock funding  Our role at GS1 UK is to help the Scan4Safety demonstrator sites illustrate success, while connecting different trusts and we hope to meet Swindells’ mission to help spread best practice right across the NHS. BRINGING THE INDUSTRY TOGETHER Over the next two days, there was a whole raft of presentations, workshops and Q&A sessions which brought together healthcare providers, suppliers and thought leaders so they could network and make firm connections, while all learning from each other. Bob Alexander, deputy chief executive at NHS Improvement, gave an impassioned account of how the NHS suffers from unprecedented levels of ‘never events’ which could be mitigated by universal adoption of GS1 standards. He stressed there shouldn’t be differences in how GS1 standards are implemented before challenging senior decision-makers to change their thinking from when are they going to adopt GS1 standards to why they aren’t doing this already. Dr Andrew Goddard, a consultant gastroenterologist at Derby Teaching Hospitals NHS Foundation Trust, and registrar for the

Royal College of Physicians, helped bring to life how GS1 standards in clinical procedures brought successful results. At the conference, Dr Goddard presented findings from a landmark bit of research he has been conducting where he demonstrated how barcodes in endoscopy procedures were improving patient safety, patient flow and reduce resource wastage. On both days, delegates were treated to panel sessions which included lively Q&As with several NHS trust chief executives, including Alan Foster, CEO at North Tees and Hartlepool NHS Foundation Trust, Gavin Boyle, CEO at Derby Teaching Hospitals NHS Foundation Trust, and Cara Charles-Barks, CEO at Salisbury NHS Foundation Trust. Each chief executive was able to provide their own experiences of implementing GS1 standards in their hospitals and what they envisaged would be the next steps and challenges when it came to seeing further adoption of barcodes in their trusts and beyond. THE SOLUTION TO ‘NEVER EVENTS’ Most of the audience agreed that GS1 standards have an important role in increasing



efficiencies and improving patient safety but were asking where GS1 UK and the standards we promote are providing that much needed added-value. And the final session of the second day addressed exactly where GS1 UK might be able to help. Currently, NHS trusts are using GS1 standards to capture data after clinical procedures happen. But GS1 standards don’t have to always look back and what healthcare would really benefit from is an intelligent point of care scan to provide healthcare professionals with real-time decision support to avoid causing harm to their patients. And that’s the potential of using GS1 standards as they can provide real-time event data or as Lord Hunt put it ‘better outcomes for patients from big data’. When Professor Stephenson challenged the audience to completely eliminate ‘never events’ he was also challenging GS1 UK to help the healthcare industry do exactly that. EPCIS is just one of the solutions that will help drive a patient-centric and efficient NHS and our challenge over the next year is to use the lessons learnt from the conference to go out to healthcare providers and suppliers and really demonstrate the importance of GS1 standards in healthcare. L FURTHER INFORMATION



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Advertisement Feature Written by Paul O’Hanlon, Managing Director of Omnicell UK & Ireland




OMNICELL LAUNCHES NEW SYSTEM Omnicell launches new automated inventory management system to give trusts a real time view of their product and medication supplies At Omnicell UK & Ireland, we are delighted to introduce a new automated inventory management system to process hospital supplies, Omnicell SupplyX Inventory Management System, which will reinforce our reputation as a world‑leading provider of automated healthcare solutions and medication adherence packaging. The new automated inventory management system will help hospitals easily trace all medical supplies moving through trusts and simplify stock control. BEFORE THE NEW SYSTEM Limited visibility of hospital inventory is costly and disruptive for everyone. Poor management of stock levels or re-order trigger points means significant amounts of out-of-date stock is often thrown away, wasting thousands of pounds that could be used elsewhere. Unforeseen stock‑outs can adversely impact a hospital’s day‑to‑day activities and have a huge impact on patient care, including last minute operation cancellations and theatre delays. Hours of valuable nursing time is wasted searching the hospital – sometimes walking between different wards – for the supplies they need rather than caring for patients. When hospitals are really busy, nurses don’t have time to return unused supplies to the correct ward or replace stock they have used and there is no way of tracking


this, meaning cupboards are left empty and stock isn’t available when it is needed. On the flip side, stock is often ordered unnecessarily to provide comfort from stock-outs, which invariably leads to overstocking and wasteful spending. The Omnicell SupplyX is able to eliminate unforeseen stock outs through re-orders based on current stock levels rather than weekly or monthly orders. It also ensures that stock is rotated to reduce out‑of‑date waste including expiry tracking and automated supplier expiry alerts. A lack of visibility of costs at a patient level is costing trusts thousands of pounds. Individual patient treatment costs can vary hugely across different hospitals, departments and wards. Some hospitals are spending double what another might spend on the same operation. Without tracking these costs, hospitals have no way of working consistently. Using this new software trusts are able to track and cost everything at a patient, procedure and consultant level, giving them an understanding of spend throughout departments so they can identify the most economic care pathways and drive efficiencies. BENEFITS OF OMNICELL SUPPLYX At Omnicell, our GS1 compliant systems have been helping hospitals around the world to implement supplies and medication management plans for more than 20 years.

Patient GS1 compliant wristbands can be scanned by the system in a single action, minimising risk of errors and providing positive patient identification, including name and date of birth, for comparison from the PAS or theatre management system. The GS1 patient identification number can be searched and referenced by the trust in the event of a batch recall against any and all procedures that a patient may have had, saving staff the time of having to look through patient files manually. Omnicell prides itself in supplying customers with everything they need to get started with the software, this includes Omnicell Handheld scanners, custom planning and installation, initial training and ongoing support with technical assistance. As technology develops and progresses we must strive to find new ways to embrace it in order to reap the rewards of increased efficiency and accuracy. In today’s heath service environment this means having accurate information at our fingertips, so managers can use real‑time, easily accessible information and data to make well-informed decisions about stock, costings and efficiencies. L FURTHER INFORMATION For more information, please see or call: 0161 413 5333



Written by Dr Alex Graham, clinical safety officer, Hyland

Clinical IT due diligence must not become a tick-box exercise

As the pace of technology continues to quicken, Dr Alex Graham explores the challenges of heightened clinical risks during the deployment of new IT systems The NHS has been digitising for decades, but the focus is now turning to the area of acute care to match the progress made in primary care. However, as the pace of digitisation quickens, the deployment of new IT systems will require clinical risk management to match the standards set in other areas of the NHS. A recent IT deployment highlights some of the lessons being learned across the health service. With clinical risk, one starts with an assumption that if you change clinical practice by introducing a new IT system, you can

also introduce risks to patients that would otherwise not exist. NHS Digital, the arbiter for information in the NHS, is clear on this, and has, since 2009, been publishing two standards (SCCI0129 and SCCI0160) on clinical risk that IT vendors and healthcare institutions have to abide by. Since 2005, over 1,000 clinical safety incidents have been reported nationally but more can be done to prevent clinical risk. Although the standards are mandatory, there is no financial penalty for non-compliance, either for vendors or healthcare providers. As

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a result, despite their increasing presence in the technology procurement process, the actual deployment of these standards has remained limited, with technical and operational requirements taking precedent. The requirements for clinical risk management are in fact fairly straightforward. Both the IT vendor and the institution deploying the technology must have a clinical risk management process in place, led by a Clinical Safety Officer (CSO) - a registered clinician with clinical risk experience. From here, the processes described by NHS Digital must be followed throughout the lifecycle of the product. A MODEL OF CO-OPERATION A large NHS teaching hospital in England began the deployment of its Enterprise E



RISK MANAGEMENT  Content Management (ECM) system from Hyland Software in September 2017. As the trust covers 1.3 million patients and employs 10,000 staff across multiple sites, the potential for new risks emerging from the technology implementation was significant. It was imperative therefore that risk management processes were followed as closely as possible. Hyland has complied with these standards for some time, culminating with the employment of a CSO at the company in February 2016. As a result, it was in a position to create processes for the deployment that would see it work closely with the hospital to mitigate clinical risk during the installation and early phases of the ECM system. The most critical phase of clinical risk management occurs before any installation even begins. From a vendor standpoint, this involves the appraisal of the current technology and how this can impact on risk. Before even beginning the technology implementation programme at the teaching hospital, Hyland ran several workshops internally, led by the CSO. These sessions had buy-in from all team members, from technical to sales and strategic. This all‑inclusive approach was time-intensive but helped instil an organisational culture where risk management is at the forefront of people’s minds when a technical or strategic change is made. By analysing the technology from an end‑user viewpoint, otherwise unknown clinical risks were identified. By including all team members, over 50 clinical safety risks were identified, with over 100 causes in total. Each of these was assessed to see if they were safe and, if not, action was taken to amend this.

For example, the technology allows clinicians to take clinical photographs through a mobile app which uploads into the patient’s record; a significant workflow benefit. However, with medical photographs, the consent process is essential and can be missed if a clinician is taking photos on a phone and uploading. The risk here is that photos are uploaded to the clinical record, without consent, which can then be seen by others. Because of this, it was agreed that a form would pop up before the camera app could open, where the patient could initial for consent. Only then could the camera be accessed to take a photo and uploaded to the record. The combination of clinical and technical experience allowed for the risk in this situation to be reduced, essentially down to zero. Another risk regarded the creation of electronic forms which can be used for investigations and correspondence. In creating the e-form, demographics were auto‑populated from the appropriate patient but could then be altered manually subsequently, potentially allowing for the wrong patient to receive the investigation or correspondence. Clearly inappropriate, it had gone unnoticed until the specific risk analysis process had been completed. A simple solution, such as locking the form when auto-populated, solved this small but potentially serious problem. TRACKING RISKS IN REAL-TIME Of course, the vendor performing risk analysis alone is meaningless if there is no collaboration with the institution deploying the technology. No two installations are ever the same, due to differing legacy systems,

New staff will arrive, different systems will be introduced and clinical working patterns will change. A well-planned re-audit between vendor and institution is the key to ongoing safety of a system



different clinical workflows and differing ways in which end-users use technologies. The next phase was therefore for the vendor and hospital to come together to compare the safety logs created. This involved technical and clinical safety representatives from both sides with a final meeting to signing off the technology as safe to deploy. However, just because both sides are happy before the ‘go-live’, this doesn’t mean that risk has been removed. The capacity for unexpected risks to occur during installation is significant and an ongoing audit process must be in place. During the Hyland ECM installation, a Safety Incident Management Log was used to provide a real-time tracker of risk during the deployment. As soon as an issue was highlighted by one of the hospital’s deployment team, the clinical risk was assessed by Hyland’s CSO. Along with the technical team, solutions were then found to the issues in question. Thanks to this process, the time spent in a risky scenario was reduced significantly. This ensured optimally safe working environments during ‘go-live’ phase. ENSURE RISK BUY-IN FROM THE OFF A critical step in starting the risk analysis was prioritisation before any technical implementation. Clinical safety was treated with high importance on both sides and included within the project management directives from day one. Both sides made concerted efforts months before the go-live point, which paid dividends in the first weeks of implementation. It would have been easy for the safety report to have been signed off and then left in a drawer. But true clinical safety comes when all stakeholders are involved. All IT, project management and administrative teams on both sides were aware of the safety report and contributed to its development and maintenance. The culture within the hospital as a result is one of proactivity rather than waiting for risks to happen. The capacity for clinical risks to occur in an IT system is a constant one. New staff will arrive, different systems will be introduced and clinical working patterns will change. A well-planned re-audit between vendor and institution is the key to ongoing safety of a system. The inclusion of risk management in more granular detail in hospitals’ pre‑procurement documentation (such as Output Based Specifications) could be a sensible starting point. This would help separate vendors who see risk management as a box-ticking exercise from those that truly understand the nature and the dangers of clinical risk, and have invested in the processes and the people required to comprehensively address these issues. L FURTHER INFORMATION



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BEDFORD HOSPITAL – NEW INTEROPERABILITY PLATFORM VIPER360 ReStart offers integration services and support to over 70 trusts, providing real-time Open Technology solutions. In 2016, ReStart launched a presentation and interactive layer platform – Viper360 The Viper360 open interoperability platform is a proven solution already in use in a wide variety of environments, including in cross‑county multi-organisational care record sharing, A&E departments and by ambulance services. Anywhere care records are held, Viper360 can access and present them in a role specific, user-friendly format. THE PROBLEM Like most NHS acute trusts, Bedford Hospital NHS Trust (Bedford) has a wide range of clinical and administrative systems in use across the organisation which are not integrated. This means that hospital staff need to re-enter the same information in multiple places, creating potential for error and omission. Patients and their carers also had the frustration of having to repeat the same information multiple times to different health professionals throughout their care journey. John Bain, associate director IM&T, said: “Bedford had endured the inefficiencies of multiple separate systems in operation for long enough. In a highly pressured care environment it is important to eliminate sources of patient and staff frustration and to reduce the potential for increased clinical risk.” THE RESTART SOLUTION The Viper360 open interoperability platform was selected following a tender process. It is a highly scalable solution which Bedford has requested be rolled out in several stages. Prompt access to new functionality is assured through a phased delivery approach with training taking place at each stage of the expansion. Viper360 provides

clinicians and administrative teams with access to real-time patient information from multiple systems to obtain an accurate and up-to-date view of their patients. Viper360’s first phase roll-out at Bedford was to its clinical administrative team to give them access to Viper360 to view patient Radiology and Pathology reports, and clinical documents through a user‑friendly interface. The next phase of the project planned for imminent delivery includes Interoperability with PACS and Extramed systems, and visibility of Cancer data and Cardiology reports.  Luton and Dunstable CCIO Sanjeev Tajeda, was quoted in February 2017 stating that the PACS system is the most under-rated digital innovation – eliminating the need for the logistical nightmare of hardcopy image transfer between departments. Viper360 will further extend the CCIO’s view through extended PACS across the organisation. THE NEXT STEPS In September 2017 Bedford Hospital NHS Trust confirmed the successful first phase deployment of the Viper360 open interoperability platform. Viper360 is now in active use by clinicians and administrative staff. Currently, approximately 100 users are accessing multiple systems via the viewing platform on a regular basis. John Bain, Associate Director IM&T said, “With a relatively small investment we chose to adopt Viper360 as the platform to increase our quality of care, operational efficiency, AND improve patient experience at the same time”. Mike Symers, managing director at ReStart, said: “ReStart has developed Viper360 in

response to NHS trust requirements. It is an open interoperability platform built using open technology delivering a data presentation layer that can be deployed quickly. Viper360 is also scalable allowing further functionality to be built in as time, budgets and organisational capacity permit. And, very importantly, it is priced to enable even the most cash‑strapped Trust to achieve their aspirations for organisational digital transformation.” BEDFORD HOSPITAL NHS TRUST The Bedford Hospital NHS Trust serves a population of approximately 270,000 across Bedfordshire and surrounding areas (with a 900,000 catchment for vascular services). Its core local authority populations are Bedford Borough (160,000) and Central Bedfordshire (260,000). The trust has over 2,500 members of staff and is the largest local employer in Bedford. It has a current turnover of approximately £180 million and is the main commissioner is Bedfordshire Clinical Commissioning Group. Bedford has approximately 360 beds and provides a full range of acute services, with beds for care of the elderly, ENT, general medicine, AAU, general surgery, gynaecology, neonatal, obstetrics, oncology, trauma and orthopaedics, paediatrics, vascular surgery, breast surgery and urology. In September 2017 the Bedford Hospital NHS Trust and the Luton and Dunstable University Hospital Trust announced their intention to merge their organisations, keeping their separate services and facilities, creating a combined workforce of approximately 8,000 members. The Luton and Dunstable University Hospital Trust was awarded Exemplar status by NHS England in 2016 and under CCIO, Sanjeev Taneja, is focusing on digital transformation, and specifically on interoperability. Bedford has already started on this journey towards enhanced digital maturity with Viper360 from ReStart Consulting Ltd. L FURTHER INFORMATION






The success story of digital collaboration There are myriad ways that digital technology can enhance care, patient experience and the effectiveness of NHS services. As a number of trusts in the North East sign an agreement to collaborate on digital services, HB examines the benefits of NHS organisations sharing digital success

“It’s that excitingatients p all our enefit and b can nowve a number we ha er digital of oth ns in the solutio line” pipe

At the end of November, a number of NHS trusts across the North East publicised an agreement that highlighted their commitment to collaborate on digital health services for the benefit of their patients. County Durham and Darlington NHS Foundation Trust, which serves a population of roughly 650,000 people across the region, has awarded shares in its Healthcall Solutions Limited company to neighbouring NHS acute trusts in return for active participation and collaboration. The trusts involved in Healthcall are Newcastle Hospitals NHS Foundation Trust, Northumbria Healthcare NHS Foundation Trust, Gateshead Health NHS Foundation Trust, North Tees and Hartlepool Hospitals NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust. Healthcall Solutions Limited is the result of a successful collaboration that saw a number of Inhealthcare Limited’s digital solutions used effectively across the trust. The company identifies itself as ‘a vehicle for redefining best practice, recognising specialities and accessing the diversity of care expertise in the North East’.

DIGITAL SELF-TESTING County Durham and Darlington NHS Foundation Trust first set up trial of a digital

self-testing service for patients using Warfarin in 2013. Traditionally, this treatment involved attending an outpatient clinic, but the use of digital technology enables those patients to take a pin prick blood sample at home and submit the readings using a hand held device. This saves both the hospital and patient time, but, as Ian Dove, director at Healthcall Solutions, explained, all involved were surprised at the ‘sense of empowerment patients have when self-monitoring’. Since its introduction, other NHS organisations have purchased the technology, with it also being used for patients hoping to lose weight or more closely monitor their diet or lifestyle. Dove commented: “The NHS in the North East is very good at collaboration and sharing ideas and services to make sure our patients get the very best care possible. It makes sense to extend this into the digital age so when one trust identifies an opportunity to use technology we’ll all be able to use it. This avoids the risk of wasting time and resources that are potentially duplicating development across organisations. “One of the first shared digital pathways has been developed by Gateshead Health’s smoking cessation service, which supports patients trying to stop smoking by sending supportive messages and contacts with

clinicians if needed. Patients can opt to be contacted via email, text or an app and evidence indicates that this kind of support is effective during the process of stopping smoking. It’s exciting that this collaboration means all our patients can now benefit and we have a number of other digital solutions in the pipeline.” DIGITAL DREAMS FOR RECORDS South Tees Hospital NHS Foundation Trust, one of the organisations to benefit from the new collaboration of digital services, is gradually introducing a new electronic document management system across all of its wards at The James Cook University Hospital and the Friarage Hospital, taking another step towards introducing paperless patient notes and making health records more secure and accessible. The Evolve Clinical Noting system will eventually replace all healthcare records at the trust. Clinicians will still have access to past paper records, but any new information will go onto the electronic system so they can securely access it from any NHS site. Benefits of going paperless include that it is more secure, it’s live, it’s efficient and it improves reporting. As part of the project, 1.5 million case notes have been digitally created and 18 months of historic letters are being migrated into the system. Any paper documentation that is received in future will be scanned onto the system. Ian Whitehead, consultant in anaesthesia and critical care and clinical project lead, said: “Patient records are currently paper based and can be located across numerous places in our hospitals or community health services. This can often mean that the complete picture of a patient’s health and care is not immediately available to a clinician at the point of care. “Evolve will enable colleagues to have access to all the information they need at all times and in all locations, with the digital record available 24 hours a day, seven days a week. It’s a stepping stone toward a complete electronic record.” Lisa Lizzio, clinical noting project manager, said: “It has taken a lot of hard work to ensure we are delivering a system that is safe and fit for purpose but it’s very exciting to be able to roll this out across our hospitals starting with our children’s services. Over time patients will see a more streamlined service with clinicians having improved access to clinical records.” L FURTHER INFORMATION



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Providing innovative patient-centred care A new framework agreement that enables health and social care providers to access cutting-edge technology to support direct patient care has been launched by NHS Shared Business Services NHS Shared Business Services’s (NHS SBS) new Technology Enabled Care Services (TECS) framework is one of the first of its kind for the public sector and helps NHS providers and local authorities deliver round-the-clock personalised care, particularly for patients with long-term conditions and people with complex care needs. Running until 2021, the ready-to-use contracts are free to access for all public sector organisations, including the NHS, local authorities and emergency services. They provide a fast, cost-effective and legally-compliant way of purchasing some of the very latest advancements in patient care. The latest framework was developed by NHS SBS in response to the increasing opportunities to use modern technology to enhance quality of life for people with chronic conditions, or those with ongoing care and support needs. It aims to help providers meet local and national objectives, such as those in the NHS Outcomes Framework and the Adult Social Care Outcomes Framework.

The innovative products and services can be used by public sector organisations to help take pressure of frontline staff and support a seven day service ACCESSIBLE CONTRACTS Following a robust procurement process, a total of 20 suppliers were awarded a place on the TECS framework across four different lots. This covers a range of products and services that are convenient, accessible and cost-effective, such as Electronic Assistive Technologies, which provide environmental control systems plus alternative means of computer access for people with complex disabilities or frailties in Lot 2, and can ensure that people continue to live independently with external support. These products are positioned for people who require external support such as housing services, social care and health services. Also included within the framework is continuous monitoring (telehealth) products and services, covering the exchange of data between a patient at home and their clinicians to assist in diagnosis and monitoring often used to support patients with long term conditions. Furthermore, in Lot 4, scheduled remote or on demand services (including telemedicine and teleconsultations) enable the exchange of data between a patient and their clinician to assist in diagnosis and monitoring of those with long term conditions. The negotiated contracts are OJEU (Official Journal of the European Union) compliant, which means framework users can choose to make direct purchases to reduce time and administration costs, or run mini-tenders to drive additional value and ensure any more complex requirements are met.

Peter Akid, NHS SBS director of Procurement, said: “The Technology Enabled Care Services framework is completely new to our portfolio and shows how technology is playing a much bigger part in healthcare than ever before. “The innovative products and services can be used by public sector organisations to help take pressure off frontline staff and support a seven‑day service. The new technology that is available on the framework also contributes to better integrated health and social care. “Those organisations buying via the framework will benefit from high-quality products and services at the most competitive price. They will also have access to this new technology far more quickly, compared with purchasing directly from suppliers.” L FURTHER INFORMATION

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Datix provides an outline of cloud technology and asks if you’re ready for the cloud To many, the term ‘cloud technology’ means so much, but also so little. It often seems vague and conceptual, so many don’t fully appreciate the benefits of the technology. To start with the fundamentals of cloud technology, what is it? Cloud technology has five characteristics: on‑demand self-service, broad network access, resource pooling, rapidly expandable and measurable service. The cloud is already being used for many clinical and non-clinical systems and tools in the NHS, private and public sector organisations and citizens’ private lives. There has been some hesitancy within the patient safety movement however. This is for very good reason – patient safety is such a sensitive field. But is it ready to receive the benefits of cloud received by other sectors? To answer this question, it is important to understand the benefits of the cloud for healthcare organisations. There are three main benefits. Firstly, it alleviates a lot of the burdens on organisations for managing IT. With hosting and upgrades provided by an external provider, healthcare organisations

do not utilise their own resources for these. At a basic level, this is less workload for an organisation and therefore reduces the resources required. Healthcare providers can then focus resources on their core service provision and improving patient safety. Secondly, the leading functionality is always available to organisations. Instead of finding resources to upgrade systems, the same version of a cloud-based tool is typically used across all of its user-base. This means the latest functionality all the time; it also means that cloud systems are future-proofed. Finally, availability. With cloud software typically updated out of hours, up-time is maximised. Even more importantly, access

outside of an organisation’s network is possible, without compromising security. This means software can be leveraged across an organisation. So why are some organisations hesitant to utilise cloud software? Information governance is of course a clear concern, especially when it comes to patient identifiable information (PID). The Department of Health confirmed that they have no opposition to PID being hosted in the cloud. Conditions were given on this, with statements that there should be comprehensive analysis of risks and evaluation of providers. This matches best practice in other industries, where cloud hosting has revolutionised ways of working. In terms of pure readiness for the cloud, assessing the risks is the priority. All things considered then, it certainly seems like the future of patient safety should be no more than a risk assessment away from coming to fruition. FURTHER INFORMATION Tel: 020 8971 1971 @datixuk

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Victoria Cetinkaya, from the Information Commissioner’s Office, looks at the main aims and principles of GDPR, and dispels some of the recent misconceptions Not everything you read or hear about the new General Data Protection Regulation (GDPR) is true. For the most part, writers, bloggers and expert speakers have their facts straight. And what they say – and sometimes challenge – helps organisations prepare for what’s ahead. But there’s some misinformation out there too. Examples we’ve seen include ‘GDPR will stop dentists ringing patients to remind them about their appointments’ and we’ve even heard people saying that big fines will fund our work. If this sort of misconception goes unchecked, people lose sight of what the new law is about – greater transparency, enhanced rights for citizens and increased accountability. The level of detail you need about the GDPR will depend on your job but the key principles apply

across all sectors and all levels of staff. That means looking after people’s information, being transparent about what you’re doing with it and keeping their privacy rights in mind from the start of any project. Many of the GDPR’s main aims and principles are the same as those in the Data Protection Act. So if you’re complying properly with the current law then most of your approach to compliance will remain valid under the GDPR and can be the starting point to build from. However there are new elements and some significant enhancements, so you will have to do some things for the first time and some things differently. The GDPR will include new obligations for organisations – such as reporting to the ICO data breaches that pose a risk to individuals, and in some cases to the individuals affected. Another key

DPR, Under Grs and e consumwill have citizens rights to be r stronge d about how informeisations use organ personal their ta da

change for organisations is understanding the new rights for the public. Consumers and citizens will have stronger rights to be informed about how organisations use their personal data. They’ll have the right to request that personal data be deleted or removed if there’s no compelling reason for an organisation to carry on processing it, and new rights around data portability and how they give consent. There’s a view from some that the new regime is an onerous imposition of unnecessary and costly red tape. That’s not the case. GDPR is an evolution in data protection, not a revolution.

Written by Victoria Cetinkaya, Information Commissioner’s Office

Setting the record straight on data protection law change

Data Protection


BUSTING MISCONCEPTIONS It’s this kind of myth we at the Information Commissioner’s Office (ICO) are working to bust as we try to help organisations sort GDPR fact from fiction: Myth: The biggest threat to organisations from the GDPR is massive fines. E




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 Fact: This law is not about fines. It’s about putting the consumer and citizen first. We can’t lose sight of that. It’s true we’ll have the power to impose fines much bigger than the £500,000 limit the DPA allows us. It’s also true that companies are fearful of the maximum £17 million or four per cent of turnover allowed under the new law. But it’s scaremongering to suggest that we’ll be making early examples of organisations for minor infringements or that maximum fines will become the norm. The ICO’s commitment to guiding, advising and educating organisations about how to comply with the law will not change under the GDPR. We have always preferred the carrot to the stick. Myth: You must have consent if you want to process personal data. Fact: Headlines about consent often lack context or understanding about all the different lawful bases businesses and organisations will have for processing personal information under the GDPR. Consent is one way to comply with the GDPR, but it’s not the only way. The new law provides five other ways of processing data that will in many cases be more appropriate than consent for public bodies. If you do need to rely on consent for any processing, the GDPR is raising the bar to a higher standard for consent. Consent under the current data protection law has always required a clear, affirmative action – the GDPR clarifies that pre-ticked opt-in boxes are not indications of valid consent. The GDPR is also explicit that you’ve got to make it easy for people to exercise their right to withdraw consent. The requirement for

Data Protection


Many of the GDPR’s main principles are the same as those in the Data Protection Act. So, if you’re complying properly with the current law then most of your approach to compliance will remain valid under the GDPR clear and plain language when explaining consent is now strongly emphasised. And you’ve got to make sure the consent you’ve already got meets the standards of the GDPR. If not, you’ll have to refresh it. Myth: All personal data breaches will need to be reported to the ICO. Fact: It will be mandatory to report a personal data breach under the GDPR if it’s likely to result in a risk to people’s rights and freedoms. So if it’s unlikely that there’s a risk to people’s rights and freedoms from the breach, you don’t need to report. Under the current UK data protection law, most personal data breach reporting is good practice but not compulsory. And although certain organisations are required to report under other laws, like the Privacy and Electronic Communications Regulations (PECR), – mandatory reporting of a personal data breach that results in a risk to people’s rights and freedoms under the GDPR will be a new requirement for many. The threshold to determine whether an incident needs to be reported to the ICO depends on the risk it poses to people involved. Pan-European guidelines will assist organisations in determining thresholds for

reporting, but the best approach will be to start examining the types of incidents your organisation faces and develop a sense of what constitutes a serious incident in the context of your data and your own customers. And organisations need to remember that if there’s the likelihood of a high risk to people’s rights and freedoms, they will also need to report the breach to the individuals who have been affected. We’ve provided some initial guidance in our GDPR overview that high risk situations are likely to include the potential of people suffering significant detrimental effect – for example, discrimination, damage to reputation, financial loss, or any other significant economic or social disadvantage. If organisations aren’t sure about who is affected, the ICO will be able to advise and, in certain cases, order them to contact the people affected if the incident is judged to be high risk. Our main aim is to help organisations get it right when it comes to using personal data – and that includes preparing for GDPR. There’s a wealth of material on our website to help. L FURTHER INFORMATION



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What makes the cyber threat so great? Andrew Scott discusses the findings of the recent Cyber Resilience Report and the growing threat to organisations of digital disruption In any one second it is estimated that over 10 Terabytes of data are being transferred across the internet, but the global IT infrastructure makes this a relatively easy task to handle. Cyber attacks are becoming more frequent with some studies suggesting that half of all organisations are affected by at least one attack every year. Arguably, this increased frequency correlates with the rise of the Internet of Things as more and more devices are coming online, and many of these devices do not have effective security. DDoS attacks can be used as a form of activism; perhaps a smokescreen to hide a more malicious attack or theft of data; sometimes the impact on one organisation is just the collateral damage as part of a wider attack. In the case of the BBC it was reported that it was simply to test whether an attack on such a scale could be mounted. It could. It is ransomware, and the encryption of all your data until a ransom is paid, that is currently gaining the most attention in the headlines however. The WannaCry attack back in May which affected about a quarter of a million computers in about 150 countries was soon followed up by the NotPetya attack which may have been smaller in scale but proved more costly to some organisations. The cost to Maersk as a result of losing its IT systems was reported to be in the region of $100 million. Data is a valuable asset for organisations as they gather as much information on their clients or prospects as possible. As many products and services are now being sold online, this data is becoming easier to collect and organisations are building vast databases containing personal contact details and credit card information. This data is worth a lot of money and there

BUSINESS CONTINUITY PLANNING So how do you prepare your organisation for the various disruptions that it could face? Horizon scanning is a fundamental part of business continuity and while the BCI’s Horizon Scan Report offers an overview of the top level threats, it is important for each organisation to assess the threats that are relevant to them. If you know the threats you face, you will have a better understanding of what the potential impacts could be. If you know what the potential impacts could be then you are in a much better position to put plans in place to manage through them. With digital infrastructure, it doesn’t matter whether it’s a cyber attack or a power failure, if the IT is out of action then you need to have plans in place to manage through this. Can it be replicated elsewhere? There are many data replication solutions available that can migrate all of your data to a secondary system, removing the potential single point of failure that could result in you losing all of your data in the event of an IT disaster. You must always make sure that your data is backed-up. If your data is backed-up and you experience a ransomware attack then you can isolate the ransomware, clean the network of it and then restore the data from your back-up. It’s not necessarily an easy process, but it means you don’t lose all your data and you don’t pay a ransom. Of course you need to ensure that the back-up can’t be encrypted by the ransomware as well. Whatever the crisis, it is essential to respond swiftly as the longer you delay any action then the more disruptive it could become. Communicate to all your stakeholders what is going on and what you are doing to resolve it. People are a lot more understanding when you’re being transparent and they can see you’re making an effort to sort things out. Disruptive events will always occur, whatever form they may take. By having an effective business continuity programme in place, it should mean that, in the event of an incident, a drama doesn’t turn into a crisis. L

Data g in is becomcollect o easier t isations are s an and org vast database l buildingining persona conta act details cont ncial and finaation inform

are plenty of people who would like to get their hands on it. Adobe, Sony, JP Morgan – all big names who no doubt invest heavily in IT security, yet all have suffered a data breach in recent years where information has been stolen. Reputation is another important asset to organisations and when customers see their personal information being lost or stolen then the reputational damage can lead to those customers taking their money elsewhere. The financial costs can also be high as fines or legal action can take their toll – the three organisations above were estimated by some sources to have lost over $1 billion each as a result of these breaches. Don’t assume that data breaches are always the result of sophisticated technology used by hackers - human error is often to blame. A recent study found that the most common passwords used are ‘123456’ and ‘password’, and the remainder of the top 20 was made up of passwords that were equally as guessable. It wouldn’t take a computer genius to hack into those people’s accounts. It is cyber vulnerabilities on the part of the end user that the Business Continuity Institute focused on as part of its latest campaign, highlighting the steps that each and every one of us can take to help improve cyber security. It suggested that organisations and individuals should: use secure passwords including a combination of at least 12 upper and lower case letters, numbers and symbols, rather than 123456 or your pet’s name; keep passwords safe and don’t write them on a

Written by Andrew Scott, the Business Continuity Institute

post-it note that’s left next to your computer; lock your computer when you’re not using it; be cautious when using public Wi-Fi and don’t access sensitive information when using it; don’t plug in untrusted USB devices; and don’t click on untrusted links. The essence of the campaign was that cyber security is everyone’s responsibility and we can all play a part in building a resilient organisation.




Recruitment Written by Nick Bowles, head of Stakeholder Engagement & Strategic Alliances, APSCo




Utilising the existing workforce to manage increasing demand The government has announced its commitment to offer the NHS a £10 billion investment package in front-line services over the course of this Parliament. Nick Bowles analyses the importance of a healthy, transparent recruitment supply chain and the benefits of co-operation in NHS recruitment According to official figures, there are now six per cent more staff across the NHS than there were three years ago. However, this is not reflective of what the recruiters we represent are seeing on the ground. The staffing firms we work with report that trusts are continuing to struggle to recruit the volume and quality of clinical and non-clinical professionals they need to keep abreast of ever increasing demand. Candidate pools, meanwhile, are subsequently shrinking in response to ongoing legislative changes and other external factors – not least Britain’s decision to leave the EU. There is no escaping the fact that the NHS is facing a recruitment crisis, with an estimated shortage of at least 50,000 doctors and nurses across the health service. The latest official data shows that the number of health visitors working in the NHS in England has dropped by 18 per cent since local councils became responsible for commissioning public health services in autumn 2015, while England needs 20,000 extra nursing staff according to the Royal College of Nursing (RCN). We also need more doctors, with around seven to ten per cent of posts currently vacant. Against this backdrop, it is unsurprising that a recent NHS Providers survey of managers at 149 trusts in England found that the majority believe workforce issues are the ‘single biggest risk facing services’. When asked for the biggest challenges to recruitment and retention at their trust, 60 per cent of trust chairmen and chief executives cited work pressure – 59 per cent of NHS staff report working unpaid overtime each week – while 38 per cent cited pay and reward. The authors of the report said that the workforce gap has almost certainly widened since Health Education England recorded a staffing shortfall of 5.9 per cent of clinical staff in 2014. It’s been widely reported that nurses working in substantive roles have effectively

suffered a pay-cut in real terms due to public sector wage freezes coupled with inflation. This perhaps explains why, according to research by the RCN, almost a quarter of nurses have to take on a second job in order to pay bills and everyday living expenses. The same poll of more than 7,700 nurses reveals that 24 per cent plan to leave their job over money fears.

are also placing healthcare professionals on assignments in areas that they are not always experienced in, or comfortable doing, such as putting general nurses in A&E – to the detriment of patient safety. Prioritising cost over patient well-being is unfortunately becoming more common-place. The most effective and ethical recruiters are ensuring that they are able to continue to provide the trusts they work with the talent they need through superior candidate engagement strategies. However, offering professionals support with revalidation, CPD or relocation only goes so far. It’s a zero sum game – overall supply simply doesn’t match demand – and things could be about to get much worse.

SOURCING THE RIGHT SKILLS It is no great surprise, then, that the trusts that our members work with are also finding retaining existing staff to be problematic. Over the summer, the Nursing and Midwifery Council (NMC) published shock data showing its register had shrunk in size for the first time in recent history – from 692,556 in 2016 down to 690,773 LOOKING BEYOND EUROPE in March 2017. The figure dipped again to With Brexit just around the corner, there are 689,738 this September, representing a loss widespread fears that access to talent will of 1,678 registrants in the space of a year. become more difficult once the UK officially As Nick Poturicich, managing director of leaves the EU. Prime Minister Theresa May has Mayday Healthcare, points out: “Healthcare said she wants to ‘see more British doctors professionals don’t feel appreciated. The in the NHS’, but at present a quarter of NHS sad fact is that many nurses think it’s doctors are from overseas – therefore there is not worth their while remaining on the uncertainty over how the UK’s exit may affect register. We’re seeing an increasing number staff recruitment from abroad in the future. of candidates moving abroad or leaving Within nursing, we’re already beginning healthcare all together. This isn’t just one to see the impact of last year’s referendum. or two disillusioned individuals, we’ve seen Recent figures from the NMC show the dozens of skilled professionals walk away number of EU nurses and midwives registered from the NHS over the past 18 months.” to work in the UK has fallen by 2,700 in the Since the introduction of pay caps past year, to just over 36,000. Between for agency workers in the NHS, 2012 and 2016, recruitment from which were introduced Spain – which was the most A recen in 2015, trusts are still popular country for sourcing t survey being forced to go EU staff – resulted in an manage of NHS off-framework, or average of 1,966 nurses r s ‘break glass’, to joining the register f o u nd that the source the skills they each year. But between m a jority believe need. As Poturicich 2016 and 2017 this issues a workforce notes, NHS trusts dropped to 104. Most re the ‘ worryingly, the number si biggest joining the register from risk fac ngle the EU has decreased by services ing 89 per cent, from 10,178 last year to 1,107 this year. Government plans to expand

medical education so that we ‘grow our own talent’ will hopefully help to ease pressures long‑term, but in the meantime, many of the specialist recruiters that we work with are looking beyond Europe to source the clinical professionals the NHS needs to keep the wheels in motion short term. Aside from frontline healthcare professionals, the Association of Professional Staffing Companies (APSCo) members are also reporting difficulties in recruiting non-clinical contractors into the NHS. This is largely due to the fact that public sector organisations are shouldering the costs of recent changes to legislation around ‘Off-Payroll’ working. Since April this year, hirers in the public sector have been responsible for determining the status of an assignment to supply services through a Personal Services Company (PSC). Contractors deemed to be working ‘inside’ IR35 legislation are taxed in the same way as employees, even though professionals operating through this model have no employment protection rights and have no certainty of continuity of work. A recent survey of our members found that 45 per cent have witnessed the costs of resourcing contractors increasing since the new rules were introduced. Of these, 46 per cent reported that rate rises were in excess of 15 per cent. As well as increasing spend, public sector organisations are also having to contend with shrinking talent pools,

with the majority (70 per cent) of respondents reporting that contract numbers in the public sector have decreased since April 2017. The increase in rates which has been noted can be attributed to two factors: the scarcity of resource created by candidates moving into the private sector and the market adjusting by passing on additional tax and NI costs to the public sector client. Reports that non-clinical specialists are abandoning contracts – including a high‑profile multi‑million pound NHS IT project – may not have the immediate impact on patient safety that shortages of clinical staff bring, but they will no doubt impact long-term budgets and operational efficiency. FRONT-LINE SERVICES The independent Office for Budget Responsibility (OBR) has predicted that the NHS will need an extra £88 billion by 2067. Among the challenges the service faces are the ageing population, the growing problem of obesity, and adhering to the legal requirement to value mental health equally with physical health. Something needs to give, and it seems that government is beginning to realise this. Health secretary Jeremy Hunt has gone on record accepting that junior doctors ‘had a point’ when they challenged his commitment to patient safety given the significant staffing



gaps across the NHS. The government has since announced plans to expand medical school places by 25 per cent from 2018 to increase the number of doctors being trained each year from 6,000 to 7,500, while 10,000 additional training places being made available for nurses, midwives and allied health professionals will also be funded. Chancellor Philip Hammond announced in his recent Autumn Budget that the government is committed to offering the NHS a £10 billion investment package in front-line services over the course of this Parliament. He also committed to ‘pay structure modernisation’ for Agenda for Change staff to help aid recruitment and retention, but we are yet to see what this will look like in practice. The number of staff working within the NHS may be up six per cent since 2014, but during the same period, emergency admissions have increased by ten per cent, ambulance calls are up 15 per cent and demand for diagnostic testing has risen by around a fifth. We need to ensure that the health service has access to the skills it needs to manage this increase in demand moving forwards, and that relies on not only solid talent pipelining strategies, but also a commitment to valuing and retaining the valuable skills of the existing workforce. L FURTHER INFORMATION

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News columns have been filled recently with some significant healthcare soft FM contracts being awarded to ISS Healthcare. The company has been around since 1982 and has always had a fine reputation for service delivery and the ability to create strong customer relationships The latest announcement saw the Fulham Road Collaborative (FRC) awarding a new five year contract, worth over £100 million, following an extensive market testing exercise. This was the second contract the Collaborative has presented to ISS, the first one running from January 2012. The collaborative of NHS establishments along the Fulham Road in West London, and their associate hospitals, include the Chelsea & Westminster NHS Foundation Trust, the Royal Marsden NHS Foundation Trust, the Royal Brompton and Harefield NHS Foundation Trust, who together represent some of the world’s leading clinical facilities. The new contract will see ISS extend their presence to include waste management,

whilst still providing a wide range of services including healthcare cleaning, patient catering, portering and logistics, linen and laundry, reception and car parking. With the exception of laundry, all the services are self-delivered by ISS, something that makes them almost unique in the Integrated Facility Services market – most providers seek to sub-contract services that are not core to their own business. Just as this award was announced, South Warwickshire NHS Foundation Trust commenced their new Soft Services contract, worth an estimated £45 million over the initial five years. The award was made through the LPP Framework and will see ISS providing patient catering, cleaning, linen, logistics and security services across four sites, including the

impressive new Stratford Hospital. Both these contracts also separately market tested their retail services for staff, visitors and patients and again it was ISS who came up with the best proposals for the locations included. The South Warwickshire award marks a return of ISS to the trust as they provided services to them up until 2010. This is the second NHS trust who has returned to ISS this year, closely following South London and Maudsley NHS Foundation Trust. So why is it that one of the largest collaborations and two other very different NHS foundation trusts decided independently to return to their former supplier – ISS? One of the main reasons is that ISS works really hard to fully understand the individual customer needs. The company recognises that every healthcare site is different: it has specific needs and serves its own community, be that at a local level or one that provides treatment for specific ailments. Because of this, the service delivery has to be created around that need and every attention given to maintaining the highest level of service at all times. CUSTOMER EXPERIENCE SURVEY For the last seven years, ISS has conducted a global Customer Experience Survey, covering almost 50 countries. The on-line survey invites the customer to comment on a wide range of questions that, when put together, provides a deep insight into the relationship between the customer and the provider. This helps to identify where improvements can be made and, equally importantly, it allows for recognition of where things are also going very well. One of the questions asks: ‘How likely is it that you would recommend ISS to a friend, colleague or customer?’. This is known as the Net Promotor Score (NPS) and is scored from 0 – 10, where 0 means that you are ‘not at all likely’ to recommend, and 10 means that you are ‘extremely likely’ to recommend. When all the responses are put together an overall NPS is calculated, this can range from -100 (where nobody is happy) to +100 (where everyone is completely satisfied). The principle is widely used and accepted



as a strong measure of performance. Any score above +40 is considered to be world class. This year 91 per cent of the customers of ISS Healthcare responded to the survey and together gave an amazing score of +75, up from the previous year’s +50. There was also a very strong endorsement in the management at local level, who are widely recognised as being proactive with the ability to make decisions to improve performance. To bring this back to the day-to-day service delivery, the customer, i.e. the person responsible for the safe and reliable delivery of non-clinical services, needs to be sure that they are working alongside a team that really knows what they are doing and shares the same goal of providing the best possible service, each and every day. When they have ISS onboard, they know that this is just what they have. AN ESSENTIAL PART OF HEALTHCARE It is far too easy to forget the critical role that the support services play in the smooth running of a busy hospital. The current terminology is Soft FM Services but we are really talking about catering, cleaning, logistics, security and associated services like switchboard, receipt and delivery, waste management as well as retail, be that for staff, visitors or even patients. If these essential services were to be withdrawn the hospital would quickly grind to a halt with no clean linen for the beds, no sterile supplies to treat the patients, who will soon become very hungry as no meals would arrive at the ward door. Who would be there to answer the thousands of calls that are made through the switchboards? And what would happen to the mountains of waste that is generated in such a hectic environment? These unsung heroes are there 24 hours a day, 365 days of the year as every patient makes their journey through the hospital. Firstly, they may arrive by car which will be parked in the car park. It may be their first visit to the hospital so they may be unclear of where to go, or even be apprehensive about their appointment. This is where a car park attendant or security officer becomes significantly different to their counterparts on the high street or shopping mall, as we should expect a heightened awareness of individual stress and the need to react swiftly when needed – if somebody is rushing to A&E, the last thing they have on their mind is to remember to park within the designated bays and to display the correct ticket but it is something that should be taken in the stride of somebody trained to handle every eventuality. Once the patient comes through the front door they may be met by a receptionist. They are still apprehensive, so a friendly face with a warm welcome goes a long way to allaying some of their fears. At the Royal Liverpool University Hospital there was a famous gentleman, George Wickham, who

for many years, until his recent retirement, stood just inside the door and instinctively knew who needed assistance, or just a kindly word. His gentle approach was recognised with several awards from the trust and his employers but when it came to the attention of a wider ISS audience, George was crowned at the ISS Employee of the Year – a great honour as ISS employ over 500,000 people across more than 50 countries. Once inside the hospital the patient may be required to be conveyed to X-Ray, theatre or other departments. This is where a hospital porter can help ease the journey, with comforting words and reassurance – the porter will have known that the patient required transportation because a controller received a call from the ward and instigated the instruction, either by radio or increasingly by using modern technology. Because of their global reach, ISS are able to share best practice from anywhere and IT systems that were originally developed in Singapore have now found their way into hospitals up and down the country. Meanwhile, throughout the hospital, probably the second largest workforce behind nursing, the healthcare cleaning team are ensuring that all areas are being kept clear of dust and debris. A modern day healthcare cleaning professional is armed with an array of ergonomically designed equipment, again the result of research and development from across the globe. ISS were the first to introduce microfiber cleaning into the NHS and nowadays it is widely used in all walks of life. For many patients the cleaner and the ward hostess are the frontline staff who they can confide in and perhaps exchange a few words with from time to time. The hostess stands on the ward as a representative of the catering department where another

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large work group ensure that a steady supply of food is provided for patients, staff and visitors alike. The Hospital Caterers Association (HCA) has a slogan that ‘food is the best form of medicine’, and so it is. Good quality food, well produced and transported to the bedside depends on teamwork. The Power of Three campaign, which ISS supports, brings together catering (the HCA), dietetics (the British Dietetic Association) and nursing (the National Nutrition Nurses’ Group) to help improve nutritional outcomes for patients. Together they ensure that nutrition and hydration is recognised as a crucial part of patient’s care plan, and that nutritious food continues to be available. All this activity generates a huge amount of dirty linen and waste materials, all of which needs to be removed from site as efficiently as possible, so again the receipt and delivery team are there to ensure that fresh linen is available, that the provision cupboards are well stocked and all refuse and waste is sent to the correct destination, be that recycling, incineration or other. Reducing the level of landfill is something that everyone in the NHS is working hard to achieve and again companies like ISS are playing their part in developing better ideas. If everything goes well, the patient will be ready to leave one day and their route back home will start with a return to the front door, perhaps by porter or under their own steam. Either way, it is to be hoped that they spare a little thought for all those unsung heroes who have made the whole stay possible. ISS strongly believes that their teams play a vital role in the wellbeing of the patient and are proud to be the market leader in facility services for the NHS. L FURTHER INFORMATION




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The NHS Shared Business Services describes how the newly-launched Hard Facilities Management (FM) framework provides value-for-money and legally-compliant access to a huge range of essential goods and services, plus a look at the organisation’s Soft FM framework

As demand increases and pressure to deliver more for less continues to grow in the NHS and wider public sector, Peter Akid, director of Procurement at NHS Shared Business Services, describes how the newly‑launched Hard Facilities Management (FM) framework provides value-for-money and legally-compliant access to a huge range of essential goods and services. Over the next four years – the length of the framework agreement – around £100 million of public sector spend is expected to go through our new Hard FM framework. And with the organisations that purchase via NHS Shared Business Services (NHS SBS) frameworks expecting to save a minimum of five per cent, compared with buying direct from a supplier, the potential cost saving to the public sector stands at over £5 million. The latest framework agreement adds to

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our comprehensive estates and facilities portfolio, which also includes Modular Buildings, Construction Consultancy Services and Soft Facilities Management. It means that the majority of goods and services within the estates and facilities field, which NHS and other public bodies need to function safely and efficiently, and, in an increasing number of cases, to expand to meet growing demand, are available to buy via these carefully‑negotiated and free to access agreements. SPECIALISED SERVICES The Hard Facilities Management framework was introduced to provide hospitals, GP

practices, schools and local authorities – and any other public body for that matter – with a quick, easy and legally-compliant route to market for Hard FM service lines. It includes 85 different suppliers across 45 different lots, covering everything from building management systems and removal services, to fire safety equipment and training, plus electrical sundries and components to catering equipment maintenance. Within each lot there is also a broad range of specialised services. For instance, if an NHS trust is moving to a new hospital site, suppliers providing ‘removal services’ can offer support around the removal of E



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PROCUREMENT  office furniture and equipment, transporting expensive and unwieldy medical equipment, any storage issues, and the full project management around such a move. The framework also provides the scope for organisations to procure the more every day services they need to operate. High quality providers of roofing and guttering, ventilation and air conditioning, painting and decorating, and flooring and plumbing, are all included within the framework. Like with all of the frameworks managed by NHS SBS, this one was launched following a robust procurement process, which included upfront financial checks and evaluation of quality assurance. Crucially for many of the public sector organisations across the country that will use it, the negotiated contracts

are Official Journal of the European Union (OJEU) compliant. This gives public sector organisations the confidence that they are not only purchasing in a way that saves them time and money, but at the same time guarantees their compliance with complex UK and EU procurement legislation. It also means that framework users have the flexibility to either purchase directly from a listed supplier, or run mini-tenders as per their individual requirements, whilst there is even the option for a fully managed service, where one provider is awarded to perform all services across the scope of the framework agreement. Elsewhere, measured term contracts can also be put in place via the framework for the maintenance of building, electrical, mechanical, and painting and decorating. E

If an NHS trust is moving to a new hospital site, suppliers providing ‘removal services’ can offer support around the removal of furniture and equipment, transporting equipment, any storage issues and the full project management

£14.8 million energy centre saves £200,000 in first month

Facilities Management


The new Energy Centre at the John Radcliffe Hospital has reduced NHS spending on energy bills by more than £200,000 in its first full month of operation. The savings were revealed as Anneliese Dodds, Oxford East MP, carried out the official opening of the centre to mark the culmination of Oxford University Hospitals (OUH) NHS Foundation Trust’s Hospital Energy Project. The trust has received figures on energy usage at the John Radcliffe and Churchill hospitals for October. In October 2016, OUH’s energy bill for the two hospitals was £484,175.03. In October this year, the same bill was £252,832.27. This represents a saving of £231,343.03 in the first month’s full service of the Combined Heat and Power (CHP) system – £7,462 a day. The Hospital Energy Project removed old boilers in the Churchill and John Radcliffe hospitals and replaced them with a CHP engine, new combi boilers, Energy Link between the two hospitals, heat stations, updated and upgraded building management systems, and the replacement of 6,407 light fittings. This new energy and heating infrastructure will cut the trust’s carbon dioxide output by 10,000 tonnes per year. Claire Hennessy, head of operational estates and facilities management for Oxford University Hospitals, said: “This is a new era of sustainable energy provision for the trust. For the first time in decades, we are going into the winter with reliable heat and power, while also cutting our CO2 emissions and saving on our energy bills and backlog maintenance.” Mark Bristow, lead project manager for the Hospital Energy Project at Oxford University Hospitals, said: “It is testament to the skill and commitment of everyone involved in this project that it was completed without interrupting patient care at either hospital. No outpatient appointments or operations were cancelled as a result of the works.” Read more at: y9m9qead











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PROCUREMENT  A good mix of large national providers and regional SMEs on the framework, meanwhile, ensures it is reactive to local needs. In total, NHS SBS manages over 100 framework agreements that cover a huge range of products and services used by the NHS and wider public sector. Like the Hard FM framework, they are available quickly through contracts with NHS terms and conditions, which achieve economies of scale cost savings without compromising on quality. SOFT FM AND EFFICIENCY SAVINGS Alongside the Hard FM framework, NHS SBS also runs the Soft FM framework. Running until the end of August 2021, the framework provides a compliant route to market to access various facilities management services including, but not limited to, cleaning services, lift maintenance, laundry services, security services, gardening and pest control services. A detailed procurement exercise has taken place to ensure that suppliers selected are appropriate in terms of meeting all legislative requirements and therefore no formal tendering is required, saving valuable time and money in the procurement process. The procurement offers a one stop shop solution for certain service areas whereby trusts can directly call off from the agreement. Almost 50 NHS organisations sign up to shared services in 2017, as NHS SBS commits

The new Energy Centre at the John Radcliffe Hospital has reduced NHS spending on energy bills by more than £200,000 in its first full month of operation to future proofing back office systems in drive for digital innovations and further efficiency savings. A £10 million investment by NHS SBS, which is aimed at transforming back office functions across the health service, has led to 48 NHS organisations signing contracts for a range of finance, procurement and employment services. Since the beginning of 2017, a number of leading NHS providers have made the switch to shared services, whilst more than 40 NHS organisations have renewed or extended their relationship with NHS SBS. It means that, in total, NHS SBS now provides at least one business service to well over 100 different NHS providers and arm’s length bodies across the country. In addition, 100 per cent of England’s NHS commissioning organisations (currently around 250) use NHS SBS’s finance and accounting service – via NHS England’s Integrated Single Financial Environment (ISFE) – whilst almost a third of commissioners also benefit from other business services (employment services and/

Facilities Management


or procurement) provided by NHS SBS. The Future Services Programme – the major investment underpinning the rise in the number of NHS organisations relying on NHS SBS to improve their back office – was launched last year after NHS SBS carried out a landmark review of the services it provides to the NHS. It is aimed at reducing NHS reliance on time‑consuming, expensive, inconsistent, and often error-prone, paper processes, by developing new innovative ways of working that befit a modern healthcare system. By investing in best of breed technologies, like robotics and automation, NHS SBS is providing the means for trusts to meet NHS Improvement (NHSI) spending targets and the efficiency savings identified by Lord Carter, whilst supporting the delivery of national policy, such as Sustainability and Transformation Partnerships (STPs). L FURTHER INFORMATION

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Case Study


Wilo pumps help energy efficiency and makes significant savings in Isle of Man’s Noble Hospital Wilo high efficiency pumps are helping a leading building services engineer achieve his ambition of reducing a government’s energy bill by 5 per cent, year on year, through the sharing of the company’s energy solutions expertise. The hospital at Braddan was opened in July 2003. The majority of pumps incorporated in the development are the ones that were in the original construction, and the technology available and energy efficiency potential from pumps in major buildings has improved immensely since the early 2000s. The project to improve the energy efficiency of the hospital has been led by Paul Bevan, building services engineer, Public Estates and Housing for the Department of Infrastructure on the island, who has 46 years of experience in the sector. Looking at the benefits of replacing the original pumps was high on his list of priorities and Wilo was pleased to be asked to take a look at the options available. As a result of the company’s experience in energy solutions activity, it Wilo_GB_Advert_Nov_2017.pdf was able to illustrate significant 1 25/10/2017

savings available across the hospital estate by replacing existing pumps with new energy efficient Wilo alternatives, mostly DL-E products which come complete with integrated inverters for variable speed. Wilo has supplied 32 pumps to the hospital, 14 of which have already been installed. The others will be installed as part of a gradual replacement programme in the coming months, ensuring the overall replacement programme follows a smooth introduction of the new pumps. 15:49:29

The Wilo DL-E models have been installed in the various sub-heat stations around the site. Each sub‑heat station has a pump for constant temperature and one for variable temperature requirements. Already the Pathology department, the theatres, Intensive Care Unit, Accident and Emergency and Fractures clinic and the Estates and Kitchens areas have been switched to new pumps. Paul Cairns has been at the sharp end of Wilo’s project. He said: “It’s been a fascinating project to be involved in and it’s been a delight to be able to utilise our energy solutions expertise alongside Paul Bevan, who is 100 per cent dedicated to making a huge difference to the island’s energy use footprint. So much of what we can offer has been accepted by him and his team – we’ve been pushing at an open door and its brilliant to see the benefits these newly installed pumps are already having on the hospital’s energy use and efficiency.” FURTHER INFORMATION Tel: 01283 523 000

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NHS vending machines: where does the conflict lie? NHS England recently warned that confectionery sold in hospitals should be 250 calories and under. Here, Health Business looks at price promotions and advertising of unhealthy foods on hospital premises, and how the vending industry is adapting to these changes With vending machines in the UK selling over 13 million food and drink items everyday – equating to 93 million a week – NHS England has strongly voiced concerns over the need to fight obesity, diabetes and tooth decay within NHS premises. Simon Stevens, chief executive of NHS England, recently warned that confectionery and sweets in hospitals should be 250 calories, following his earlier announcement in April that leading retailers such as WHSmith and Marks & Spencer had agreed to voluntarily reduce sales of sugary drinks to 10 per cent or less of their total drinks within hospitals over the coming year. Although the National Institute for Health and

Care Excellence (NICE) had recommended in September last year that no more than 20 per cent of vending machine drinks should be sugar-sweetened and that sweetened drinks should be sold in sizes no greater than 330ml, only two of 62 trusts responding to a survey from the Observer have followed these guidelines: Sandwell and West Birmingham Hospitals NHS Trust and Bolton NHS Foundation Trust. Vending machines at Nottingham University Hospitals NHS Trust, on the other hand, offer 19 different varieties of sugary soft drinks or juice drinks, outnumbering the sugar-free alternatives. Tam Fry, from the National Obesity

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Forum, said hospitals were giving out ‘entirely the wrong message’, adding: “They’re stoking up business for themselves; particularly with obesity and diabetes, you don’t want to see more of them [patients]; you want to see fewer. One of the ways to see more is to ply them with sugary drinks.” Freedom of Information requests have shown that many trusts are flouting NICE’s recommendations, while all 76 of The Observer’s respondents said they sold a range of confectionery and salty snacks, yet half were failing to offer plain dried or fresh fruit. For example, Epsom and St Helier University Hospitals, Barts Health and Redbridge University Hospitals NHS Trust are just some of the trusts selling ‘grab bag’ sizes of crisps or packets larger than E



NHS CATERING  30g, which goes against the government’s Buying Standards Good Practice guidelines for all sites in the UK government estate. LOWER SUGAR, LOWER SALT AND LOWER FAT The Automatic Vending Association (AVA), the trade body of the vending industry in the UK, also drafted guidance in the winter of 2016/17 for members of the AVA based on government guidance and on the practical experience of operator members. Vending lower sugar, salt, fat and calorie products provides general guidance to vendors, including that operator companies should carry out a sampling for clients who wish to increase the range of products, and that consumers buy taste not health so it is best to have a wide range of products. The guidance suggests providing lower sugar, lower salt and lower fat options such as baked and vegetable crisps and popcorn, and bagged snacks and bars not covered with chocolate. It recommends including a number of products with no red indicators on the nutrition information label, and using unsalted varieties of nuts. A diagram of a ‘healthier’ vending machine is also provided by the AVA, which suggests alternative drinks and snacks for consumers. These include packs of dried fruit, baked and vegetable crisps, popcorn, lower sugar cereal, seed or fruit bars, confectionery with less than 250 calories, portioned fruit, and sandwiches with lower fat or lower salt options. Drink choices include water and flavoured water, small packs of juice, juice drinks with 50 per cent juice, long life milk drinks, and diet versions of carbonated drinks. The food vendor can also have yoghurt and drinking yoghurt. The AVA’s guidelines also refers to the Good Practice guidelines, including that: savoury snacks should only be available in pack sizes of 30g or less; confectionery and packet sweets snacks should be in the smallest single serve portion size available in the market and should contain no more than 250 calories; all sugar-sweetened drinks should be in packs no bigger than 330ml; and no more than 20 per cent of the drinks purchased by the organisation may be sugar sweetened. Additionally, no less than 80 per cent of the drinks in the machine may be low calorie or no added sugar. The NHS England guidance on Commissioning for Quality and Innovation (CQUIN), included in the AVA guidance, also bans products high in salt, fat and sugar from checkouts, bans price promotions on such products and bans the advertising of these products on site. Since NHS England understands that the quality of food on offer does not just affect patients and visitors, but also hospital staff, and especially those working late shifts when alternative options are not available, another of its requirements is that healthy options are available at any point for people working night shift.

Vending machines at Nottingham University Hospitals NHS Trust offer 19 different varieties of sugary soft drinks or juice drinks, outnumbering the sugar-free alternatives Whilst the AVA points to Scotland’s Healthyliving Award and Healthyliving Award Plus, as well as the Welsh Assembly’s guidance on healthier vending as part of their Change4Life programme, which both attempt to deliver healthier food and drink in hospital vending machines, it notes that neither the Northern Ireland Department of Health nor the Isle of Man Department of Health and Social Care have specific guidelines on vended food, demonstrating that vending machine contents have not been prioritised nationwide. HEALTHIER OPTIONS FOR PATIENTS Similarly, although other measures have been taken by the government to tackle the distribution of unhealthy food and drink in hospital vending machines, such as implementing a sugar tax that comes into effect in April next year and rewarding those who make further efforts with financial incentives, more work needs to be done to ensure vending machines in hospitals are supplying ‘healthier’ options for patients, visitors and staff. Following a two-month pilot of different types of sugar policies at four hospitals that showed positive results recently, Simon Stevens announced a formal consultation proposed to cut obesity and reduce the sales and consumption of sugary drinks sold in hospital. The 10‑week consultation seeks views on levying a fee for any vendor of sugar-sweetened beverages on NHS premises, as well as views on an outright ban on certain products

now being sold in hospitals. The formal consultation, although complementary to the government’s proposed sugar tax, begins sooner, in 2017, and closes on 18 January. Announcing the consultation at the ukactive National Summit this year, Stevens said: “Confronted by rising obesity, type 2 diabetes and child dental decay, it’s time for the NHS to practice what we preach. Nurses, visitors and patients all tell us they increasingly want healthy, tasty and affordable food and drink options. So like a number of other countries we’re now calling time on hospitals as marketing outlets for junk food and fizzy drinks. By ploughing the proceeds of any vendor fees back into staff health and patient charities these proposals are a genuine winwin opportunity to both improve health and cut future illness cost burdens for the NHS.” Although much of the public is in favour of the ban, and make the argument that alcohol and cigarettes, which are damaging to health, are not sold in hospitals so neither should sugary food and drink be, the argument that patients who have diabetes, are at risk of becoming underweight, are undergoing chemotherapy etc. will be disadvantaged as a result of the ban is also a prominent one. What the NHS should and need to realise is that a ‘healthier’ option for one patient may not be healthy for another, and this is where the conflict lies. L FURTHER INFORMATION




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Dietitian Heather Russell, from the Vegan Society, explains why well-planned vegan diets can support healthy living in people of all ages Nutrition is a fundamental part of hospital care. This setting can present a number of challenges for caterers, including limited resources and a wide range of dietary requirements. Today, food sustainability is also recognised as an important issue. From nutritional, environmental and social perspectives, the potential of vegan food should not be underestimated as there are many benefits of providing a vegan-friendly service. Vegans avoid the use of animals as far as

is possible and practicable. It’s important to be aware that veganism is a belief system, not just a diet. Someone who follows a vegan lifestyle will today’s of seek to use products that do not contain growing fastest lif animal ingredients, movem ents, soestyle and have not been d for veg tested on animals. an‑frienemand Freedom of thought, dly product belief and conscience s and

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Written by Heather Russell, the Vegan Society

A fresh look at vegan food in hospital catering

is protected by human rights legislation, and this includes veganism. It is necessary to provide care in a way that respects equality and diversity. In the words of the Care Quality Commission, ‘when a person has specific dietary requirements relating to moral or ethical beliefs... these requirements must be fully considered and met’. A vegan diet excludes all animal products, including meat, fish, milk, eggs and honey. The Vegan Society is working with the British Dietetic Association to promote the message that well-planned vegan diets can support healthy living in people of all ages. It’s recommended that everyone in the UK uses a vitamin D supplement during autumn and winter as a minimum. Vitamin D3 from lichen and vitamin D2 are vegan-friendly. Vegans also need to ensure reliable intakes of vitamin B12, iodine and selenium, and one option is to take a vitamin and mineral supplement Veganis designed for vegans like the m is one Vegan Society’s VEG 1.



HOSPITAL CATERING FOR ALL The Vegan Society’s Hospital Catering for All campaign seeks to promote E






 the benefits of a strong vegan offering, and help improve the standard of care experienced by vegan inpatients. Faced with the logistical challenge of using limited resources to cater for a wide range of dietary requirements, it’s helpful to provide meals that are suitable for most people. Vegan options tick this box because they can be enjoyed by the following groups: vegans, vegetarians and people who eat meat and fish; those trying to limit their consumption of animal products; those who require Kosher food; those who require Halal food (if free from alcohol); and people with allergies to milk and/ or eggs (if free from these allergens). The Vegan Society asks caterers to consider featuring vegan options on main menus, making them available to everyone. It should be highlighted that vegan dishes can enhance a caterer’s overall offering of vegetarian food. In 2016, it was estimated that over half a million people in Britain eat a vegan diet, and nearly half of vegetarians would like to reduce their consumption of animal foods, equating to another half a million people. Vegan options provide greater variety for vegetarians, who may grow tired of cheese and eggs during a prolonged hospital admission. In addition to hot meals, it’s important to ensure that certain vegan staples are readily available. What would a vegan breakfast be without fortified plant milk and dairy-free spread? Potentially, a big disappointment! Soya milk is regarded as the most nutritious alternative to cows’ milk because the protein quantity and quality is similar. SUSTAINABLE CATERING Growing food for human consumption is considered to be an efficient use of land,



Some Quorn products now carry the Vegan Trademark; beans, chickpeas, lentils, soya mince and tofu are easy to chew, and, therefore, valuable easy eating options; vegan-friendly sponges, crumbles and fruit pies can be served with soya custard or dessert, ensuring that nourishing puddings are available to vegans crops and water, and vegan diets have been associated with the lowest emissions of carbon dioxide. The Vegan Society’s Plate Up for the Planet campaign has been raising awareness of the environmental benefits of veganism. The recent Grow Green II report, written by the New Economics Foundation and commissioned by the Vegan Society, calls for an increase in the amount of legumes grown in Britain, and served in public sector canteens. Embracing this approach could help NHS catering to be a flagship of sustainable procurement. Faced with the challenge of tackling climate change and the need for greater sustainability in all aspects of our lives, organisations like Medact and Humane Society International (HSI) are also taking an interest in the role of hospital food. There is certainly more that we can do to live the values of NHS Sustainability Day every day. Medact’s report about hospital food contains good arguments for strengthening vegan food offerings. It encourages a shift towards more sustainable hospital menus, including a reduction in meat and dairy, and an increase in plant foods. The environmental benefits of offering legumes as protein sources are highlighted. Overall,

this approach could help catering services to reduce their greenhouse gas emissions, as part of their hospital’s Sustainable Development Management Plan, and help them to meet the Government Buying Standards for Food and Catering, which incorporate sustainability. HSI are helping the catering industry to incorporate more plant-based menu options. As part of their Forward Food initiative, they are able to offer culinary training to hospital catering teams. VEGAN BUSINESS Veganism is one of today’s fastest growing lifestyle movements, so demand for vegan‑friendly products and services is increasing. Although young people are driving the growth of veganism, in 2016, 14 per cent of vegans were older than 65 years. From a business perspective, the Vegan Society is striving for better labelling of products. For example, we encourage any businesses manufacturing vegan-friendly meals to apply for the Vegan Trademark. This is a beacon for attracting customers seeking to strengthen their vegan food offering. Don’t forget that vegan meals can be economical as well as environmentally-friendly. For

example, beans, chickpeas and lentils are both cheap and sustainable sources of protein. HEALTH-PROMOTING HOSPITAL FOOD Recently, there has been growing interest in the area of workplace well-being, and the NHS is getting on board. For instance, there are now financial incentives for English trusts to look after the health of their employees. Since the NHS is one of the biggest employers in the UK, there is huge potential to improve public health. We should bear in mind that the latest version of the Eatwell Guide encourages increased consumption of plant foods. Making healthy vegan options available to staff, visitors and patients can help them to boost their intakes of fruit, vegetables and fibre, and limit their intake of cholesterol-raising saturated fat. Vegan hospital menus often carry plenty of healthy eating options, but lack nourishing main meals and puddings that can help to meet the needs of people who are nutritionally vulnerable. The Vegan Society is keen to tackle this inequality by raising awareness of the full potential of plant-based nutrition. Here are some tips for caterers and manufacturers: vegan-friendly white sauce, pastry, dumplings, potato



The Vegan Society’s Hospital Catering for All campaign seeks to promote the benefits of a strong vegan offering, and help improve the standard of care experienced by vegan inpatients wedges, roast potatoes, Bombay potatoes and creamy Caribbean, Thai and South Asian curries are great for people with higher nutritional requirements; some hospitals operate peanut-free and nut-free catering systems, but for those that don’t, peanuts and nuts are valuable sources of calories and protein; use of soya products, such as tofu, mince, sausages and meat-free balls, can help to hit higher protein targets for meals; and the quality of soya protein is similar to that of animal products. Also, some Quorn products now carry the Vegan Trademark; beans, chickpeas, lentils, soya mince and tofu are easy to chew, and, therefore, are valuable easy eating options; whilst vegan-friendly sponges, crumbles and fruit pies can be served with soya custard or dessert, ensuring that nourishing puddings are available to vegans. Vegan-friendly fortified jelly and rice pudding are a couple of other examples, and don’t forget about snacks and drinks.

Many calorific biscuits and hot chocolate powders are vegan-friendly, and soya yoghurts or desserts boost protein intakes. SUMMARY Demand for vegan-friendly products and services is increasing. Vegan hospital food is inclusive and sustainable, and can be cost‑effective too – could your service or company benefit from strengthening its offering? Making vegan options available to staff, visitors and patients can help them to boost their intakes of fruit, vegetables and fibre, and limit their intakes of cholesterol‑raising saturated fat. Hospitals need to provide higher calorie and protein vegan options suitable for people who have raised nutritional requirements. L FURTHER INFORMATION



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KINGSPAN – PASSING THE FIRE TEST Fire in any building is a serious matter, but when it comes to hospitals it becomes critical to have a building construction that will perform well, giving vulnerable patients time to escape in the first instance, and ultimately helping to protecting assets, such as valuable equipment and the building itself Consideration must be given to a wide range of factors to ensure the best protection, and insulated panel systems can provide a highly effective building envelope solution. Fire is a complex phenomenon. So much in predicting how a building will perform depends on a combination of the materials used, the quality of the installation, fixings, cavities and the design of the building itself. Regardless of whether the insulation core is considered to be ‘non-combustible or of limited combustibility, it is the interaction of all of these factors that will determine how a specific system will perform in a real fire scenario and whether or not it contributes to fire propagation. When it comes to simply applying the rulebook, it has become apparent that there are several issues with the current system of regulation. The first is the assumption that ‘non-combustible’ materials automatically provide a ‘safe’ construction, yet mineral fibre insulated panels with a non-combustible core use a relatively large quantity of combustible PU adhesive to glue the fibres to the steel sheets, for example. The only reliable way of assessing panel system combustibility therefore is to base a judgement on testing the entire system. TESTS AND STANDARDS The existing Building Regulation tests and the Euroclass Reaction to Fire Tests do not fully assess panel performance and should not be taken in isolation. Because insurers take a different approach, having an interest in property conservation, they recognise the limitations of the small-scale reaction to fire tests used to demonstrate simple Building Regulation life safety compliance, and have developed their own large-scale tests. Of these the two most well known and widely recognised are LPCB (Loss Prevention Certification Board) and FM (Factory Mutual – now known as FM Global). LPCB’s LPS1181 test, sometimes referred to as the ‘garage test’ comprises a 10m long, 4.5m wide, 3m high enclosure clad in the materials under test. The enclosure is open at the front and has a ventilation window at the side. A wooden crib, which generates a 1MW fire load, is ignited in the corner and the fire development



is monitored. Although there are several pass – fail criteria, the key parameter is that there should be no fire propagation beyond a 1.5m zone around the crib. FM has a quite different test standard for assessing reaction to fire to the Building Regulations. The test standard is FMRC 4880 (1994) Approval requirements for Class 1 fire classification. There are various levels of performance with the key level being with no height restriction. Achievement of Class 1 with no height restriction is dependent on performance in a number of tests that include: ASTM E84 Surface Burning Characteristics; ASTM D482 Ignition Residue tests; ASTM E711 Oxygen Bomb tests; UBC 26-3 Room Test; FMRC Room Corner Test (25/50ft test); FM 16ft parallel-panel test. The 50ft wall test is very severe. Two walls 15.24m high with a small ceiling are lined with panels and a large fire source (345kg dry timber) is positioned in the corner. To achieve approval without any height restriction, there has to be no flame spread or fire propagation to the extremities of the panel construction. PIR‑insulated panels have performed well in all these tests, characteristically forming a stable protective char and demonstrating no flash over, flame spread or fire propagation, no panel collapse, relatively small and acceptable smoke levels and high levels of fire resistance. This performance has been borne out by a number of case studies, which have proved the strong correlation between the large-scale

insurer tests such as LPS1181 and the actual performance of panels in a fire scenario. CASE STUDY: WHARFEDALE HOSPITAL In 2003 a fire broke out at Wharfedale Hospital, which was under construction at the time, and was partially clad with LPCB/FM approved PIR core insulated panels. The fire was started via an arson attack, when some adhesive was ignited, resulting in a very high fire load, distorting intumescent coated beams and cracking the adjacent compartment floor. At its peak, there were 10m high flames impinging directly onto PIR core panels. Investigation into potential damage to the steel columns led to the insulated panels being cut into by fire fighters, revealing the PIR core, which appeared to have been virtually unaffected by fire. The independent investigation reported that the insulation cores: did not ignite, and did not promote fire spread within the core or to the eaves. NO COMPROMISE At a time when energy efficiency, ease of construction and durability are all important aspects of investment into healthcare buildings, there must be no compromise on fire safety. LPCB approved PIR core panels tick all of those boxes. L FURTHER INFORMATION +44 (0) 1352 717 251


Following the devastation of the Grenfell Tower fire, Mark Hughes considers how signage can play a part in the safe evacuation of large numbers of people There are many causes of fires but, in places where there are many people, the risks are far greater. The logistics of evacuating large numbers of people, and the possibility of panic spreading among them, add to the difficulties. But the use of clear, well-displayed signage goes a long way to helping with this. The devastating danger posed by fire in large, multi-occupancy buildings was brought into terrifying reality last summer with the disaster of Grenfell Tower. The inquiry continues, and no doubt there will be lessons learned into what health and safety

professionals and others can do to minimise the risk of similar tragedies. While Grenfell hit the headlines because of the huge loss of life, there have been other fires in large buildings, including some in the health service. HOSPITAL SIGNAGE In June 2017, a fire broke out in Royal Stoke Hospital, with many patients having to be evacuated. On this occasion no one was hurt, and the fire was contained. This could in part be due to the hospital’s health and safety programme and a clear, well-communicated evacuation plan. Clear and effective signage plays a part in ensuring safety plans are easier to follow. By ensuring visitors can quickly understand

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Written by Mark Hughes, IOSH Health and Social Care Group

Signposting the importance of fire safety plans

and follow the exit strategy, panic can be minimised, and evacuation carried out in a more efficient and safe manner. However, there are many things to consider relating to signs, to ensure they are effective. We must ask when signs become so overwhelming they lose their efficacy and how many signs are too many. Wherever you look in hospitals there is a sign telling you to do this, not to do that, or wash that in this way - all in different styles and formats; some printed, some handmade. There are so many, we run the risk of ignoring them and walking by without taking much notice. We can refer to this as getting sign blindness. Signs have their use, when used effectively and meaningfully. If we look at it from a health, safety and fire perspective there are obvious requirements for signs. For example, to warn of dangers such as x-ray equipment and areas, or to warn of potential hazards like wet floors. Hazard and warning signs are available off-the-shelf and come in the mandatory or advisory colours and styles. These have been designed to be uniform and therefore easily recognisable. For example, a hazardous substance can be distinguished immediately and dealt with accordingly.

Fire Safety


PATIENT SAFETY When it comes to the safety of patients, signage, especially emergency signs, is important. When arriving at hospital, there is always slight trepidation. The buildings are usually large and unfamiliar with many departments and people. Also, hospitals are different from any other organisation; E









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SIGNAGE  patients may be in the hospital as in‑patients, intensive care patients, new born babies, and they may have special mobility or access requirements. Therefore, the signage needs to be clear to ensure patients and visitors know what to do in the event of an emergency and how to get out. If we don’t get the emergency signage right, including suitable and sufficient emergency lighting, it can have catastrophic effects. So when it comes to emergencies, signage is important and a legal requirement. However, it is only a small element in any emergency planning. We must consider other key elements, including training, to make sure staff know what to do and how to assist and evacuate patients. Other points to consider include the standardisation of signage, ensuring they are controlled and ensuring the signs are limited to essential information to avoid overload. This includes nominating someone responsible within each department and trust wide to monitor the amount of signs and having specific areas on internal walls by outpatient clinics or along the corridor for general signs can help keep with this. Additionally, temporary signs should still be made to a specific standard, such as infection control isolation areas, but once the problem has been removed so should the sign. Clear signs should also be in place

Fire Safety


Wherever you look in hospitals there is a sign telling you to do this, not to do that, or wash that in this way – all in different styles and formats. There are so many, we run the risk of ignoring them and walking by without taking much notice taking you to the right car park for the specific department you are visiting, including clear car parking fees. Signage should also direct visitors to the various departments. Generally, outpatients are split into various specifics, and the common approach is to colour code them. These are often directional signs (in colour) along the wall or floor, so it’s a case of follow the red or green etc lines to the relevant clinic. Directional signs can also be used to help find the way out of a building – which could be crucial in the event of an emergency evacuation, whilst walkways should be clearly illuminated with clear exit signage. Signs are a great way to warn the many thousands of people who come through hospital doors every day of some of the risks and specific precautions that need to be taken, but it is important that significant health and safety mitigations are not compromised by being buried in the plethora of other information. L

Mark Hughes is a chartered member of IOSH, having started his health and safety career working at one of Norfolk’s many food processing factories before joining the NHS. After eight years at the Norfolk and Norwich University Hospital NHS Trust, he moved on to Kingston Hospital to manage health and safety, and is now the head of Risk at the Royal Berkshire NHS Trust. IOSH is the chartered body for health and safety professionals. With over 46,000 members in 130 countries, IOSH is the world’s largest professional health and safety organisation. It sets standards, and supports, develops and connects its members with resources, guidance, events and training. It is the voice of the profession, and campaigns on issues that affect millions of working people. FURTHER INFORMATION Unit 12, Metro Centre Ronsons Way St Albans, Herts AL4 9QT Tel: 01727 860657 Fax: 01727 851669


D2 Fire and Security Ltd have developed a range of Fire Compliance Gap Analysis Programmes that provides business owners with the peace of mind that their Life Safety systems are comprehensively serviced, functioning correctly and that they have robust emergency plans in place. If you would like further information on Compliance Gap Analysis or any aspect of the D2 design, install and commission products please CALL: 01634 713000 or EMAIL: jordan@

T F INSTALLATIONS LTD is a dedicated specialist company in Fire Detection, fire alarm system design and Security Systems, founded in 2012. It has quickly become one of the most respected fire system companies in London and the South East following a series of high profile installations and has developed a founding reputation for providing innovative products and superior services that meet and exceed its clients’ expectations. T F INSTALLATIONS LTD predominantly works directly for end user clients in the commercial sector. We offer a complete range of services to our clients; from sales, fire alarm system design, installation, testing, commissioning through to ongoing maintenance and technical support. This includes identifying client needs, determining options and designing systems at the most competitive cost without compromising quality. In 2012, T F INSTALLATIONS were appointed an Engineered Systems Distributor (ESD) for Notifier Fire Systems, a subsidiary of Pittway Corporation of America, one of the world’s leading fire systems manufacturers. Our partnership with Notifier ensures that we are able to offer the best service possible – having become a specialised company with a strong reputation for the quality and reliability of installations with personal service as a local company backed by a multinational company leading the way in fire prevention technology.




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31/10/2017 14:33


Managing the risks from asbestos in hospitals is a legal duty, says Sarah Hallam of the Asbestos Removal Contractors Association

The risks from asbestos must be taken activities. The Control of Asbestos Regulations seriously because it is a class 1 carcinogen 2012 (CAR 2012), places a legal duty to which is the greatest cause of work-related ‘manage asbestos in non-domestic properties’, deaths in the UK. Current figures show that on those who own, occupy, manage or have approximately 4,500 people die responsibilities for premises that may contain each year in the UK from asbestos. Lastly, the Construction (Design asbestos-related diseases and Management) Regulations It is (predominantly 2015 (CDM 2015) places explicit mesothelioma, responsibilities on clients. For vital th lung cancer and example, if asbestos removal organis at asbestosis). These is required the client needs a t i ons t a ke t h people are not to appoint a competent e r i s k s f ro m asbesto just those who asbestos removal contractor. have worked on deal wi s seriously and To explain the CAR 2012, th construction and Regulation 4 a little more, a contr asbestos in demolition sites, o l but also teachers safe maled and and doctors. nner According to an article in The Guardian from 2000: ‘A plastic surgeon died of an asbestos‑linked lung disease, more than 20 years after he unwittingly inhaled blue asbestos dust in hospital corridors. He was 47 when he died of mesothelioma in August 1995. Under the hospital were underground passages carrying a network of cables and pipes covered with asbestos lagging. The passages were used by staff and students to travel between buildings, especially the main hospital and the medical school.’ The same paper reported last year that a ‘teacher died from cancer after decades of exposure to asbestos. Inquest rules death was a result of industrial disease, after years spent pinning pupils’ work to boards resulting in asbestos dust inhalation.’ It is vital that organisations take the risks from asbestos seriously and deal with asbestos in a controlled and safe manner. When asbestos is managed well, inadvertent exposure can be prevented so that the health and safety of individuals is not put at risk. UK law places responsibilities on property owners to ensure that both employees and non-employees are not exposed to health and safety risks as a result of the presence of unmanaged asbestos. The Health and Safety at Work Act 1974 places a duty on every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all employees and non-employees who may be affected by the employers’

MANAGING ASBESTOS If materials are in good condition and managed so that they cannot be disturbed, E


Written by Sarah Hallam, Asbestos Removal Contractors Association

Asbestos is a hidden killer

it places a legal duty on those who own, occupy, manage or have responsibilities for premises that may contain asbestos. Those who have these responsibilities will either have a legal duty to manage the risk from this material; or a legal duty to cooperate with whoever manages that risk. The CAR 2012 places a legal duty to ‘manage asbestos in non-domestic properties’ by: finding out if there is asbestos in the premises, the amount and what condition it is in; presuming the materials contain asbestos, unless there is strong evidence that they do not; making and keeping an up-todate record of the location and condition of the Asbestos Containing Material’s (ACM) or presumed ACM’s in premises; assessing the risk from the material; preparing a plan that sets out in detail how to manage the risk from this material; taking the steps needed to put this plan into action; reviewing and monitoring the plan and the arrangements made to put it in place; and providing information on the location and condition of the material to anyone who is liable to work on it or disturb it.





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At Pier Contractors Limited we provide asbestos removal and building services country wide. We fully appreciate how any project, regardless of the size or complexity, can affect the normal day to day running of your business. As each project has its own requirements and constraints we simply cannot list all the services we can provide. Visit our website for more information.


rtwise, 17 Prime Parkway, Mansfield Road, Derby DE1 3QB T: 01332 253600 ortwise, 17 Prime Parkway, Mansfield Road, Derby DE1 3QB | T: 01332 253600 | At Pier Contractors Limited we provide asbestos | rtwise, 17 Prime Parkway, Road, Derby DE1 3QB T: 01332 253600 Conditions: Whilst every effort isMansfield made to minimise errors, occasionally they do| occur. The final responsibility isbuilding with youservices - the advertiser, removal and country wide. Conditions: Whilst is made minimise errors, occasionally they do required. occur. TheWe final responsibility is with you - the advertiser, Contractors Limited accept Pier responsibility for any changes ase double-check the every adverteffort carefully andtoinform immediately of any alterations cannot Unit 5with Woodside Industrial Estate, accept responsibility forany changes ease double-check theevery carefully and immediately ofdetails any alterations required. We cannot 0871 200 0900 |shall Conditions: made toinform minimise errors,all occasionally they do occur. The final responsibility isare you -any the advertiser, en processed toWhilst print. If advert you effort fail toisrespond, we assume are correct and proceed to print. Deadlines variable depending We fully appreciate how project, regardless of Thornwood, Epping, CM16 6LJ on een processed to print. If you fail to respond, we shall assume all details are correct and proceed to print. Deadlines are variable depending on normal day The Barn, Oak Farm, Weston Road, Congresbury, BS49 5EB accept responsibility for any changes ase double-check the advert carefully and inform immediately of any alterations required. We cannot the size or complexity, can affect the Tel: 01992 576 404 / , and quality of images / colours displayed may not reflect that of the final print. f, and quality of colours not reflect thatallofdetails the final to day running of your business. en processed to images print. If /you fail todisplayed respond, may we shall assume areprint. correct and proceed to print. Deadlines are variable depending on , and quality of images / colours displayed may not reflect that of the final print. As each project has its own requirements and



HEALTH & SAFETY  a periodic check might be all that is needed. For some premises that see a large number of employees and visits, such as hospitals, maintenance work is inevitable and accidental damage is often possible. Therefore, all premises which were constructed prior to the year 2000, will require an asbestos management plan based on a management survey. The purpose of the management survey is to manage asbestos containing materials (ACMs) during the normal occupation and use of the premises. The duty holder can compile a management survey where the premises are simple and straightforward. Otherwise, an asbestos surveyor is needed. When a premise, or part of it, needs upgrading, refurbishment or demolition,

a refurbishment/demolition survey is required. This survey, normally carried out by an asbestos surveyor, is to locate and identify all ACMs before any structural work begins at a stated location or on stated equipment at the premises. Asbestos removal is a licensed industry, meaning to undertake most asbestos removal projects clients, like the NHS, need to appoint a licensed contractor (licences are granted by the Health and Safety Executive – HSE). Also, under the CDM 2015 regulations they need to appoint suitably competent people, they need to make reasonable enquiries to satisfy themselves that contractors are appropriately resourced and competent for the work. One way is to choose a contractor who

The main difficulties for the NHS arise due to scale. The NHS is responsible for a large number of pre-year 2000 properties and a large number of employees



is a member of a trade association or professional body. Guidance on the CDM 2015 regulation states: ‘When considering the requirements for designers and other construction professionals, due weight should also be given to membership of an established professional institution or body. For example, do these bodies have arrangements in place which provide some reassurance that health and safety is part of the route to membership of their profession?’. However, do clients assume what that membership, that logo, means? Don’t assume what a logo means as they can mean different things. At the Asbestos Removal Contactors Association (ARCA) we believe membership is more than a logo. Members don’t just pay to join ARCA, they have to continually prove that they can meet the standards which the logo represents. For example, ARCA is the only trade association for licensed asbestos removal contractors, which conducts all site audits of members as ‘unannounced’. These audits are a requirement to maintain membership and provide reassurance that health and safety standards, and good practices, are continually demonstrated. THE ASBESTOS ISSUE FOR THE NHS The asbestos problem facing the NHS is essentially no different to the problems faced by any property owner/employer with a large portfolio of premises constructed prior to the year 2000. That is, they are responsible for ensuring that employees and non-employees are not exposed to health or safety risks as a result of the presence of unmanaged asbestos. In the case of the NHS this includes in-house maintenance teams, members of the public visiting the premises and external contractors. The main difficulties for the NHS arise due to scale. The NHS is responsible for a large number of pre-year 2000 properties and a large number of employees. Earlier this year, BBC London reported that 94 per cent of hospitals in the capital contain asbestos, and about 1,000 people have died from mesothelioma since 2011 in London, seven of whom were doctors and nurses. All asbestos projects require good coordination and cooperation between all parties. Clients’ decisions, actions and inaction have an enormous impact on how work can be delivered, causing contractors to fail to meet industry and legal standards, and potentially leaving clients with substantial criminal and civil liabilities, lengthy delays and disruptions to projects. With a well communicated structured approach to asbestos management, the NHS can ensure that they continue to meet the challenge to comply with health and safety regulations across their extensive portfolio. L FURTHER INFORMATION




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11/11/2017 09:36




An increasing pressure: obesity and A&E The number of obesity-related A&E admissions continues to grow, leading to a nationwide increase in spend on bariatric ambulances. Health Business examines the situation and questions if it is likely to worsen According to a BBC South East freedom of information request, the results of which were published in May this year, ambulance services across England have been forced to spend hundreds of thousands of pounds to ensure vehicles can cope with a growing number of obese patients. The figures highlighted how the number of obesity-related A&E admissions increased from 52,000 in 2006 to 520,000 in 2016. Bariatric vehicles are designed to provide a safe and dignified transport solution to those whose weight, or condition, requires specialist transport. In response to a 10-fold spike in hospital visits linked to obesity in the past decade, they have been equipped with wider stretchers, more lifting gear and space to accommodate double-width trolley stretchers. Regionally, the BBC figures show that the north west had the highest number of obesity-related admissions in 2016, with 78,000. The North West Ambulance Service, a merger of ambulance trusts from Greater Manchester, Cheshire and Merseyside, Cumbria and Lancashire, has eight bariatric vehicles in operation and has spent £184,000 on specialist equipment since 2015. The ambulances have reportedly been used 40,000 times in four years. In contrast, South East Coast Ambulance has spent £562,000 on three ambulances reinforced to take heavy loads since 2010, which have been used 1,700 times in the last five years. Additionally, the trust has fitted other vehicles with lifts and large stretchers at a cost of £36,000. The BBC reported in February this year that one ambulance trust – South Central–- has spent more than £1 million in the last three years to upgrade nearly two thirds of its 180-strong fleet. The Department of Health claims to spend more annually on the treatment of obesity-related ill-health, a reported £5.1

It is billion in 2014/15, than becomi ng increasi the government does on ‘the police, fire that the ngly frequen t service and judicial size of p atients system combined’. causes p robl NHS obesity statistics moving them a ems suggest nearly in turn 60 per cent of women increasend that and 70 per cent of s risk of i men are overweight. njury tothe Additionally, a third of staff children aged two to 15 are

also overweight or obese. Jonathan Fox, of the Association of Professional Ambulance Personnel, said: “It is becoming increasingly frequent that the size of patients causes problems moving them and that in turn increases the risk of injury to staff. That is why we need this equipment. We are not just talking about those that are really heavy, even patients who are 16, 17 stone can pose difficulties.” WIDENING AMBULANCES IN WEST MIDLANDS Patients are getting larger and larger and ambulances need to be able to respond immediately to what could be life-threatening situations. All 420 A&E ambulances in the West Midlands are bariatric capable, but it has also bought four specialist bariatric ambulances at a combined cost of more than £300,000. Alongside Yorkshire, the North West and Wales, the West Midlands is on its way to upgrading the rest of its fleet. Nigel Wells, an operations manager at the trust, told the BBC: “It is all about safety for

our patients and safety for our crews. We have got a greater number of patients who are larger in size. A few years ago – probably only 10 years ago – your average patient was 12 to 13 stone, now that’s probably 17 to 18 stone. And we quite regularly see patients around 30 stone in weight and even bigger than that.” NORTH OF THE BORDER In Scotland, it is reported that approximately 30 per cent of people are obese, with health experts predicting the proportion to rise to 40 per cent by 2030. This costs the Scottish economy an estimated £2.37 billion per year. The Scottish Sunday Post revealed last month that overweight patients accounted for more than 21,000 ambulance journeys in 2016/17, compared to the 9,399 journeys in 2010/11. On top of this, specialist bariatric ambulances were also used 76 times to take similar patients to A&E wards in the last year, while firefighters were called out 40 times during the same period to deal with call-outs for obese patients – the highest number since 2010/11. Tam Fry, chair of the National Obesity Forum, said: “These ambulances can take people who weigh up to 70 stone. It’s a tragic sign of the times that we now have people that big. The same is happening with the fire service. It is having to invest in bigger hoists and stretchers to bring these people out of difficult circumstances such as first floor flats. “They are having to break down walls and windows to get these people out of their homes. It’s a huge expense. You can be talking about six-figure sums with the number of personnel required. It’s a tragedy but it’s par for the course and it’s going to get worse.” L




Seeing general rubbish by the side of a road or in a layby, you would generally think that it was some lazy person who has just thrown it out of their car window whilst on the move. However, when you come face to face with a scene of extreme fly tipping as we have seen recently, it does stop you in your tracks and to contemplate why people do it?

In an area of outstanding natural beauty with wildlife and livestock in abundance, it does make you emotional, frustrated and then angry to see tonnes of rubbish ranging from asbestos, gas bottles, construction waste and white goods being abandoned in such beautiful areas of the countryside. “Fly-tipping is on the rise again, with the number of incidents up for the third year in a row, official figures show. Councils across England reported 936,090 cases of fly-tipping in 2015/2016, up 4% on the previous year, the data from the Department of Environment, Food and Rural Affairs (Defra) reveals. Clearing up the fly-tipped rubbish cost councils £49.8m.” The Guardian News So why do people do it? Some would say it is because of the increasing restrictions at local amenity facilities where in many cases the general public now have to pay for waste to be disposed of such as construction waste, plasterboard and asbestos. Having been involved in the waste industry for over 50 years, BKP Waste & Recycling along with other waste management companies have worked hard to source alternative routes for various wastestreams; preventing disposal at landfill and encouraging recycling where possible. So really there is no excuse. But let’s be realistic about this, fly tipping is more commonly attributed by rogue tradesmen who charge unsuspecting clients for so called safe, legal disposal of their waste and once collected, they will find a quiet lane, field or layby to tip the waste at no charge to them! However, manufacturers and suppliers are fighting back by using smart data tagging, barcoding and recording of their products when sold; enabling traceability throughout its lifespan. Common fly tip locations are now being CCTV monitored and when captured, the offenders as well as

the waste producers are being fined heavily and in severe cases, face imprisonment. For those who manage to get away with it, sadly it is left to the local councils to arrange and pay for the removal of these eyesores; running in to hundreds of thousands of pounds per annum which is ultimately paid for by us, the taxpayers. So what happens when BKP are employed to clear up a fly tip case? We offer an in-house total service where trained chemists and operatives can attend site, sample and identify the wastes, package the items for secure transit, document the correct paperwork to enable the items to be collected and transported to a licensed treatment facility or transfer station for safe storage; all in accordance with legislative guidelines. Also, to comply with our company’s Environmental Policy, where possible every item is either treated, reprocessed, or recycled before considering the final disposal route; landfill. Backed by all the necessary licences, permits, Risk Assessments and Method Statements as well as their ISO accreditations, BKP are a knowledgeable and reliable company you can trust to do the job properly first time. Detailed reports are always provided to our clients showing before and after photos of the site along with completed EA documentation confirming that the hazardous waste has been professionally and legally handled correctly for future reference. If you are encountering fly tipped waste within your area and you need assistance on an ad hoc or regular basis, give BKP Waste & Recycling a call and one of their trained staff will be happy to discuss your requirements with you. We can be contacted on 0800 376 5004 or visit our website for further information.




Preventing HCAIs and cleaning excellence High standards of cleaning are vital in the fight against infection, particularly within the healthcare environment. Health Business examines the complex and challenging aspects of sanitising NHS buildings and facilities, and reports on the work of West Suffolk NHS Foundation Trust People visiting or receiving treatment in the hospital environment are already vulnerable to the spread of infection, so making sure that effective cleaning regimes are in place for waiting rooms, corridors, reception areas and wards is integral. The key to reducing the incidence of healthcare associated infections (HCAIs) and cross contamination is to keep caring environments cleaned to a standard as near to ultimate hygiene as possible. HCAIs are infections that do not originate from the patient’s original condition that caused them to be admitted to the healthcare establishment. Most infections that become evident after 48 hours of hospitalisation are considered to be healthcare acquired. The overall cost of HCAIs to the NHS is estimated to be over £1 billion per year. HCAIs are caused by viral, bacterial and fungal disease-causing organisms (pathogens), although not all HCAIs are a result of contact with infected surfaces. HCAIs of the urinary and respiratory tracts shows that many of these originate within the body, and that only a part of the total will have arisen because infection control practices were inadequate. Respiratory infections associated with both surgery and intubations are largely caused by the patient’s own organisms, rather than organisms carried through the air or liquids they have ingested. There is always an element of risk of acquiring HCAIs and given colonisation rates in the general population, it is impossible to eradicate all traces of them, so it is the responsibility of those responsible for all aspects of care, from hand hygiene, surgical hygiene, prescribing practice and cleaning to minimise the risk as much as possible. There are a number of different types of infection that can occur in many places in the body; the most common of which occur in hospitals are urinary (23 per cent), lung (22 per cent), wound (nine per cent) and blood (six per cent). The most high-profile type of HCAI is Methicillin‑Resistant Staphylococcus Aureus, popularly known as the MRSA superbug. MRSA includes several strains or types of staphylococcus aureus that is not killed by B-lactam antibiotics. Around 30 per cent of the UK population carry the SA germ in their nose or on their skin. In healthy people, this does not pose a risk, nor do any adverse symptoms occur. Another prominent HCAI is clostridium difficile (C. diff). Although this is bacteria that is present naturally in the gut of around two‑thirds of children and three per cent of the adult population, in some cases it can prove fatal. Older people are most at risk from infection, and most cases occur in people aged over 65. CLEANING INDUSTRY MANAGEMENT STANDARD At the end of 2016, West Suffolk NHS Foundation Trust’s housekeeping team received the CIMS Award for Commitment to Excellence at the British Institute of Cleaning Science’s annual awards ceremony, recognising the dedication of individuals for their commitment to excellence and the CIMS (Cleaning Industry Management Standard) programme. Cleanliness is a high priority across the trust with a particular focus on infection prevention, and staff work together to lead the fight against infections such as clostridium difficile, norovirus and MRSA. Carlos Alves, housekeeping services manager at the trust, said: “All 150 members of our housekeeping team are highly motivated and fully aware of the importance of their contribution to the safety of our patients, staff and visitors. We take cleanliness and hygiene very seriously and with the support of our senior management team we are encouraged to think outside the box and continuously look for ways to improve how we deliver our services.

This award is proof of that, the team deserve this praise and I thank them for all their hard work. Cleaning is a science, and we want to be at the forefront of research and development in this field. I am pleased to say that we are looking to introduce automated floor washing ‘robots’ that will free up our team to focus on improving standards around the trust, such as deep cleaning programmes, air mattress sanitation, and laundry services.” THE SERCO SITUATION The growing trend towards outsourcing cleaning services, recently in the news with Barts Health NHS Trust, means that the number of contractor opportunities will expand, even if individual contracts may be cut back as a result of budget pressures. Cleaners, domestic staff, porters, and security staff based across four London hospitals in the Barts Health NHS Trust began 48 hours of strike action in July after 99 per cent of Unite members voted in favour of strike action over a proposed pay increase of £0.30 an hour. L FURTHER INFORMATION

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Mental Health Written by Leila Reyburn, Mind



Transforming mental health services NHS workforce planning is essential to transforming mental health services, says Leila Reyburn, policy and campaigns manager at mental health charity Mind Earlier this year Health Secretary Jeremy Hunt announced plans for 21,000 more NHS mental health workers over the next five years. The plan, put together by Health Education England, outlines how it hopes to benefit an extra one million people who need support from mental health services by 2020-21 through the recruitment of additional nurses, therapists and consultants. Mind welcomes this plan, which we believe to be key to the successful delivery of the Five Year Forward View for Mental Health – the NHS’s plan for improving mental health services between now and 2020-21. Mental health services depend heavily on the



capacity and quality of the workforce and we know that the support of a great nurse, doctor, psychologist or social worker can make all the difference to people’s lives. While welcome, this plan comes within a wider context of mental health services that have been under-funded for decades and the NHS faces a significant challenge in overcoming years of decline to bring them up to the same basic

Prevent Mental Health Guidance NHS England has introduced new Prevent Mental Health Guidance and a new e-Learning package for providers of NHS mental health services. The information is designed to support providers and staff to exercise their statutory and professional duties to safeguard vulnerable adults, children and young people at risk of radicalisation. Structured into four key components, the guidance looks at: Prevent responsibilities of mental health providers; Prevent referrals from mental health providers; the role of mental health providers in the Prevent process; and referrals into mental health services from Prevent.

standard as physical health services. Failures in workforce planning in the past have contributed to where we are now, with a huge gap between what’s in place and what’s needed to deliver good quality care. Funding cuts to mental health services in recent years have directly led to posts being lost

Health y r Secretant has Hu Jeremy ced plans announ000 more for 21, tal health n NHS mers over the worke t five nex years

Children’s mental health unit rated ‘outstanding’

Mental Health


A child and adolescent mental health ward at a north London trust has been rated ‘outstanding’ overall by the Care Quality Commission (CQC).

Staff working within NHS mental health services do a hugely important job and can make a real difference to the lives of people accessing mental health services, many of whom can be vulnerable, particularly those who are in hospital after being in crisis and those staff that remain have had their morale weakened and have been left feeling demotivated, frustrated and facing burn-out. TIME TO CHANGE The scale of the challenge is clear and it’s not just about recruiting extra staff. The NHS needs also to attract and retain good staff who are passionate and committed, so it’s good to see this acknowledged in the workforce plan. It’s also positive to see a recognition of the importance of ensuring mental health staffing is multidisciplinary, including areas such as peer support. Staff working within NHS mental health services do a hugely important job and can make a real difference to the lives of people accessing mental health services, many of whom can be vulnerable, particularly those who are in hospital after being in crisis. The mental well-being of the workforce is crucial and only when NHS staff are well-supported can they do their best by those in their care,

which includes having a workforce big enough to cope with the workload. Like any other employer, the NHS needs to make the mental health of its staff a priority. If not, it will affect not just employees but service users too. This plan takes us to 2020/2021. We need already to start thinking about what happens beyond that. As the stigma around mental health starts to fall away, and awareness increases – thanks in large part to movements such as Time to Change, the campaign we run in partnership with Rethink Mental Illness – we will no doubt see more and more people identify, acknowledge and seek help for their own mental health. This is hugely positive as it means fewer people will struggle in silence, but it also means that we expect demand for mental health services to continue to rise. We need a longer-term, comprehensive workforce strategy to carry us beyond that, that will take into account increased demand and look to better integrate mental and physical health services. Such a

North East London NHS Foundation Trust’s Brookside Unit was rated ‘outstanding’ for being caring and well-led. It was rated ‘good’ for being safe, effective and responsive, following the inspection in August 2017. Inspectors found that: strong and inspirational leadership at the trust had transformed the Brookside Unit, and over an 18‑month period the ratings went from ‘inadequate’ to ‘outstanding’; staff were fully committed to ensuring that they provided quality services and continued to improve through innovation; staff treated young people and their families as partners in their care; there was genuine empathy and understanding of individual needs and wishes; and there was a strong, visible person-centre culture. Staff morale was high and had steadily improved since the ward re‑opened in September 2016, and the leadership governance and culture of the service drove improvement and underpinned the delivery of high quality person-centred care. Furthermore, there were high levels of staff satisfaction, managers were prepared for staffing vacancies and ensured there were sufficient staff on duty, and families could stay in a family suite on site if needed. Paul Lelliott, Deputy Chief Inspector (lead for mental health), said: “Young people told us that they received excellent care, that staff were amazing and that they felt safe on the ward. I am very pleased that our inspectors also concluded that unit was providing outstanding care. North East London NHS Foundation Trust’s Brookside Unit has come a long way since the trust closed it after a previous ‘inadequate’ rating.”

strategy needs to include staff working in independent and voluntary sector services, and social care, as well as a commitment to improving understanding of mental health for all frontline NHS staff working in non-mental health services. L FURTHER INFORMATION



PR & Communications Written by the UK Renal Registry

Reducing AKI and creating a world first for the NHS Think Kidneys, the NHS campaign to improve the care of people at risk of or with acute kidney injury, won a Health Business Award last November. The UK Renal Registry, who orchestrated the campaign, explains the success of the campaign Acute kidney injury (AKI) is an emerging global healthcare issue. As health care increases in complexity, the interaction between long-term medical conditions, medication and inter‑current illness are too often complicated by AKI. It is estimated that one in five emergency admissions into hospital are associated with AKI, that up to 100,000 deaths in secondary care are associated with AKI and that a quarter to a third have the potential to be prevented. The resource and economic burden upon the healthcare economy is considerable. It is estimated that the additional cost is between £0.5 and £1 billion per annum with



the potential to save between £100 and £200 million per annum with optimal care. THINK KIDNEYS Think Kidneys aims to raise awareness of AKI and develop fantastic, practical resources for the NHS and social care. Our aim is for a future in which health and care professionals think about kidney status in the same way

that they do now about blood

pressure and heart rates. As AKI is a sudden and y l r a e recent reduction in part of cations, a person’s kidney i n u m e com h function and is most t f o commonly seen in a surveyld us that the context of other o t public r cent of the serious illness, such as pe t sepsis, and in someone only 50 tion know tha whose kidneys are popula idneys make vulnerable. It is not, as might be suggested their k urine by the name, AKI caused by a physical blow to the

Our aim is for a future in which health and care professionals think about kidney status in the same way that they do now about blood pressure and heart rates body. The kidneys do a lot to keep us well, so when they go wrong lots of problems arise so AKI causes suffering, can be life‑changing and costs the NHS a lot. Think Kidneys also aims to raise awareness, reduce avoidable harm and death and improve care for people with AKI in the community or in the hospital. Patients and NHS professionals have developed all the resources for the programme. We’ve taken advantage of their passion, skill and commitment to reduce the risk of AKI, improve outcomes for patients and reduce the financial burden on the NHS. Case studies, blogs and latest news are on our website, where we share how people are working differently and improving awareness, prevention, detection, treatment and care right across the NHS and social care. Recognised as a patient safety issue, Think Kidneys is supported by the UK Renal Registry and the safety team of NHS Improvement. Using existing blood results, a new algorithm was implemented in labs systems to provide an AKI warning stage test result. Not only does this help the care of individual patients

but the data is collected by the UK Registry to help the NHS improve care across the country – this is the first and largest set of information on AKI in the world. Think Kidneys formed a small working group to work together to develop our public campaign. This was not part of the original plan for Think Kidneys, but when, as part of early communications activity, a survey of the public told us that only 50 per cent of the population know that their kidneys make urine, the board felt a responsibility to respond to this challenge. While the original aim was to educate the public about the risk and impact of AKI, a priority was to start with simple messages about the importance of kidneys for health. DISPLAYING ACTION The campaign comprised a set of five thought-provoking posters with very clear messages, which were produced for use across the NHS. Four of the posters were endorsed by the Royal Pharmaceutical Society for display in pharmacies, with 20,000 posters now on display across the NHS. An

PR & Communications

AKI is a sudden reduction in a person’s kidney function and is most seen in the context of other serious illness, such as sepsis, and in someone whose kidneys are vulnerable. It is not, as might be suggested by the name, caused by a physical blow to the body animated infographic was also created for the website and is displayed in GP practices and hospital clinics across the country. A media campaign followed which was kick-started by a 30-minute focus on Radio 2’s Jeremy Vine show, supported by GP Dr Sarah Jarvis. Targeting specific media outlets, the campaign reached around 20 million people and won the Campaign of the Year Award at the Health Business Awards in November 2016. The campaign also included: Sky News all day report on hourly bulletins following the publication of the second alert (viewer numbers are four million per day); a feature article in The Mail on Sunday (nine million readers); BBC Midlands – Graham Torrington Show with Michael Wise, Board Patient Representative (9,000,000); and OK! magazine – 3.1 million readers. The posters can be ordered for free, are on display in many GP surgeries, pharmacies, clinics and care homes. We are very keen to help people who are at risk of AKI understand how they can help themselves. The team were absolutely delighted to have won the NHS Publicity Campaign Award at the Health Business Awards for 2016, despite fearsome competition from the other shortlisted campaigns. Karen Thomas, programmes manager for the UK Renal Registry described how it felt: “I was thrilled to accept the award in London today. The team has worked hard on the campaign. We have such an important message to get across the public about the importance of their kidneys and this award tells us we got it right and reached people. We created the campaign with a small budget and a tight timeframe and our aim was to spread the message as far as possible. It’s great to know that others consider our campaign a success as well as us!” L FURTHER INFORMATION



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WORKFORCE PLANNING AND DATA GOVERNANCE: EXCEL WITHOUT EXCEL Scott Baker, chief operating officer, at Hicom, explains the need for NHS trusts to ditch spreadsheets and how technology is helping the industry address the challenges of data security, the Information Commissioner’s Office ICO fines and the forthcoming GDPR Technical guidance from NHS Improvement and Health Education England has urged healthcare providers to make further use of workforce data to inform planning through to 2018/19. Why? Because this will enable trusts to better measure performance against workforce. DEATH BY SPREADSHEET Effective workforce planning is key to a sustainable NHS. As the challenge of managing growing demand with diminishing resources intensifies, providers know that their workforce plans must maintain the delivery of highquality patient services whilst accommodating the long-term requirements of the NHS of tomorrow. Success hinges on nurturing an efficient, trained and productive workforce. Last year’s technical guidance from NHS Improvement and Health Education England outlined how such data would enable trusts to measure performance against workforce KPIs ranging from absence, staff turnover and appraisals, to new starters, agency staffing and mandatory training completion rates. The logic is compelling: with secure access to real-time information, trusts are better able to plan resource to meet demand, respond to fluctuating staffing levels and ensure training enables continuity of services. There is currently an overwhelming reliance on spreadsheets for key workforce planning activities; employee records, staff levels, training and study leave, and safe staff rotations. Similarly, confidential information to support recruitment decisions – preemployment checks, certificates, career history, disciplinary records and basic personal details – is commonly stored on spreadsheets and accessed across shared networks. Such an approach is inherently unsafe and puts trusts at risk of data breach. The flaws in relying on spreadsheets are well-documented. Widely cited research reveals that almost 88 per cent contain errors. These can emanate from human errors in data input, formatting and calculations – but they’re also symptomatic of spreadsheet behaviour; multiple versions, poor version control, uncontrolled accessibility and free-for-all editing permissions.



THE ENCRYPTION FACTOR The spreadsheet’s partner in crime is email. Every day, countless spreadsheets are routinely shared across (and outside of) NHS trusts via email. There’s a popular misconception that email communication across the NHS is secure simply because it’s done over the N3 network. This is not the case. Every email that’s accessed outside of the network – either via an external partner or an NHS employee working remotely – is unencrypted and therefore vulnerable. Providers have undoubtedly worked hard to meet compliance with Information Governance (IG) requirements to protect patient data. However, few have applied the same scrutiny to processes around workforce data – leaving themselves vulnerable to breaches of the new EU General Data Protection Regulation (GDPR). Last month an investigation was launched after the personal details of over 500 GP trainees in Merseyside were published online. With the new GDPR coming into force from May 2018, it’s anticipated that ICO penalties will increase in both volume and size. Trusts can ill afford the financial and reputational costs. If the threat of an ICO fine represents the ‘stick’, motivating trusts to act, the value of maintaining accurate and accessible data (the ‘carrot’) goes beyond compliance. It can be the key to enhanced workforce planning and fuel better, more sustainable patient services. But how? CENTRALISED SOLUTIONS The key to using information to fuel effective workforce planning is straightforward. Simple yet powerful technology can be

used to integrate all aspects of workforce information into trust-specific, centralised data repositories that support the full life-cycle of planning; recruitment, training, deployment and management. The centralised approach, underpinned by robust access control, eradicates the problem of inconsistent data sets, giving trusts greater control over their data. At a more granular level, centralised data warehousing allows trusts to take a customised, modular approach to business processes – powering solutions that support the challenges most pertinent to their organisation. Similarly, managing and measuring mandatory training is less onerous, enhanced by access to reliable data that supports the entire training and development cycle; from registration and induction through to course management, delivery and certification. Technology can help workforce teams secure greater visibility of study leave. Study leave is often agreed through direct communication between managers and their staff rather than logged on accessible systems. The implications for staffing levels and services can be substantial. Centralised management of this aspect alone can make a huge difference to workforce planning. As the NHS gears up for some high profile challenges, the pressure on workforce planning is likely to intensify. Survival by spreadsheet is not an option. It’s time for trusts to take control. L FURTHER INFORMATION


Assessing the management of diabetes A record number of healthcare professionals came together at Diabetes Professional Care 2017 (DPC2017) to share their experiences and hear about the latest advances in the prevention, treatment and management of diabetes Now in its third year, DPC2017 was held at Olympia, London, on 15-16 November. Attracting well over 3,000 visitors across the two days, and with an expanded conference and exhibition, this year’s event was the biggest yet and was hailed a resounding success by participants. Keith Vaz, MP and chair of the All Party Parliamentary Group for Diabetes, said: “The show was fantastically well attended

with two busy days. I’m in awe of what Maggie Meer, DPC’s founder, has done, in bringing together so many disparate groups under one roof, once a year. This is a truly interactive conference and one that makes a big difference to people’s lives. Vaz, who delivered a keynote on the first day of the show on ‘Creating the diabetes village – prevention is better than cure’, added: “I’ve dreamed about the diabetes village,

A big e th part of k is to or NHS’ w sparent as an be as tr le and that’s possib rtunity this an oppoference con s gives u

talked about the diabetes village and here it is. It’s important this conference is free and all these healthcare professionals can come here. They are the living embodiment of the diabetes village.” Dr Partha Kar, Associate National Clinical Director at NHS England, also applauded DPC’s achievement in bringing healthcare professionals together to learn from each other, saying it provides ‘a forum to talk to people and be accessible; it’s a two-way street’. In their opening keynote, Kar and Professor Jonathan Valabhji, National Clinical Director for Obesity and Diabetes for NHS England, gave an update on what’s happening with the NHS and what’s in the pipeline, focusing on digital transformation and taking questions from the packed theatre’s audience. Kar said: “I think everyone would like to know what the NHS is up to. A big part of our work is to be as transparent as possible and that’s an opportunity this conference gives us.”

Diabetes Professional Care


PRACTICAL LEARNING Across the two days, DPC2017’s nine, ram‑packed theatres hosted an outstanding line-up of top practitioners and thought leaders in diabetes care. The conference and workshop sessions focused strongly on developing real‑world skills and practical E



Diabetes Professional Care



DPC is a great platform for us to let people know about the latest advancements in technology and also the advancements in education that will really help patients beyond just the devices they use  learning, and covered a wide range of topics including childhood obesity, the reversal of type 2 diabetes, diabetes funding and the psychological impact of the condition. In response to feedback from supporters and previous visitors, DPC’s organisers also launched several new special feature areas this year. These included the Hypo Hub, with a series of workshops about hypoglycaemia and a unique, virtual reality Hypo Simulator. The Hypo Simulator was particularly busy, said Steve Maishman of Novo Nordisk, with all levels of HCPs – doctors, nurses, podiatrists – able to experience what a patient goes through when



they have a hypoglycaemic event. Another extremely popular new feature was the DPC Foot & Wound Clinic, dedicated to diabetic foot disease and led by Graham Bowen, podiatry clinical lead and his team at Solent NHS Trust. Bowen said: “It’s fantastic, a wonderful event to be involved in. The clinic attracted professionals from every aspect, including a lot from primary care – we need to get as much information out to as many people as possible.” Visitors to DPC2017 were equally impressed. Jennifer Beynon, a diabetes consultant from University Hospital of South Manchester, said: “There’s so

much to be seen here so it’s very easy to get lots of stuff covered in one day.” While Maria Padfield, Diabetes Specialist Healthcare Professional PDSN, East Surrey Hospital, said: “I want a yearly update about what’s happening in diabetes and I got a lot of information here I can take back to my team.” DPC2017 also featured a major exhibition, with more than 75 product and service providers presenting their diabetes care solutions across a range of areas, including technology, pharmaceuticals, wound care and education. Harry Tomlinson, team leader at BD, commented: “DPC is a great platform for us to let people know about the latest advancements in technology and also the advancements in education that will really help patients beyond just the devices they use. We want to improve outcomes and increase awareness of the complications associated with diabetes, and good education can do this.” Emma Clayton, medical education and events manager, Novo Nordisk, agreed: “We’ve supported DPC from the beginning. It’s all about education to improve diabetes care and how you manage patients. There’s such a buzz here and it attracts professionals at all levels, from big names to those at the coalface – dieticians, GPs, practice nurses, people from NHS England. There’s hope that, if we have education, awareness and empowerment, we can conquer diabetes.” Hope also lies in innovative health tech solutions, such as those that were represented in The Edge innovation zone. Toby Baker, event director, of Diabetes Professional care, said: “This is our area dedicated to the most innovative start up companies in diabetes. We wanted to make sure that, alongside more established companies in diabetes care, there was the opportunity for smaller companies to be here as well. Every year, exhibitors in The Edge move to a full-sized exhibition stand the next year, so it must be working for them. “Our mission from the start has been to help improve the care and outcomes for people with diabetes, by raising awareness of the condition, and providing accessible and inclusive education. So we’re delighted to have grown our audience to more than 3,000 and to have attracted such a diverse range of HCPs. “As well as thanking our visitors for taking the time to attend DPC2017, we’d also like to say a huge thank you to our speakers, sponsors and exhibitors, who have embraced our vision and have been instrumental in making this year’s event such a success. We very much look forward to returning to Olympia next year, with Diabetes Professional Care 2018, which, fittingly will start on World Diabetes Day, November 14th 2018.” L FURTHER INFORMATION



Connect Vending is a grass roots independent regional hot drink, vending and fresh food supplier. Founded in 1996 by Stuart Coutts, Connect Vending has had exponential growth over the last 20 years. The company is recognised as an industry leading innovative operator throughout the traditional vending market. Its operations have national reach through a pre-vetted network of carefully selected AVA member vending businesses. This ensures consistent quality in delivering all its services. Connect Vending’s main operated base stretches from Birmingham through central England, including a significant presence in London. Connect has been recognised as the ‘Best Vending Business’ by the industry itself. Connect Vending is a

Avonlea is a small, professional business specialising in medical transcription. The company has a team of carefully selected transcriptionists available, all with a background in either NHS or private healthcare, encompassing almost every specialty. The benefits of using only experienced medical transcriptionists are proven. Knowing that your work is being transcribed by Avonlea means that substantially less time needs to be spent proof‑reading documents when they are returned to you. Avonlea is very proud of their accuracy rating and will produce documents which look professional; are formatted and punctuated appropriately, are grammatically correct and have the appropriate medical diacritics. The team will return work so that it is indistinguishable from anything that is produced by your in-house staff.

Start your vending machine journey today

progressive business that recognises changing consumer needs and innovates to meet the demands. Offering a number of forward-thinking solutions from cashless payment solutions to modern cafe facilities under the brand Deli Café, Connect can provide a wide range of healthy products 24 hours a day. To understand more about who Connect is and what it can offer please visit the website. FURTHER INFORMATION Tel: 01865 341 011

Cost-effective support from the experienced



Angels & Cookies Ltd is the country’s first ever free from and vegan cookie dough company that was selected as one of the top 10 exhibitors at this year’s Allergy and Free From Show at Olympia, London. Angels & Cookies is all about creating healthier, more sustainable and delicious plant-based treats without the nasties! That’s what the company has done with its alternative cookie dough that is refined sugar-free made with the finest ingredients in small handmade batches, mainly organic and fair trade when possible. It all began when founder, Karen Cappetta, baked a free from birthday cake for the child of a close friend who was diagnosed with autism. She was passionate about baking and set about experimenting to create free from and vegan desserts that are delicious – indiscernible from traditional desserts without sacrificing

Bidfood is the UK’s leading foodservice provider. The company prides itself on being close to its customers, both in terms of location with its depots operating locally throughout the country, and, equally important, by working in partnership with customers across all sectors to drive mutual growth. Bidfood offers its customers a wide choice of food, drinks and catering supplies across its collection of own brands, and through its branded supplier partners and its specialist teams can provide guidance and insight into current trends, industry standards and a forward thinking approach to CSR. Bidfood’s years of experience combined with its strong partnerships with suppliers, customers and industry experts means that the company understands both the challenges and opportunities in catering.

So you can indulge without making sacrifices

one’s health. Her journey began in alternative baking and she has never looked back. People want better choices for their health and, though a young company, the cookie dough has been enjoyed by allergy sufferers around the world. Karen would like to see her allergen-free cookies on aeroplanes and trains, and at hospitals and schools as a healthier option for those who suffer from food allergies and for vegans who are conscious about their food choices. FURTHER INFORMATION

Products & Services


The company offers a confidential, secure, cost-effective service and will return your files promptly. The service is ad-hoc meaning that it can be accessed as needed – perhaps to help during busy periods, to tackle a backlog/special project or to cover absence amongst your own staff, thus avoiding costly temporary staff recruitment fees. For further information on how outsourcing your medical transcription can transform how you work, please contact the team today. Avonlea is an ISO27001 Accredited Business. FURTHER INFORMATION Tel: 01977 624 373

Wholesale food, inspired by you

Bidfood can provide you with information and added value resources to make your decision making process much simpler. It can help through recipes to inspire your team with a wide range of winning dishes, menu ideas and tips, trends insights to help you stay on top of market developments, comprehensive allergen advice for all of our products, as well a range of other channel specific support tools to help your business succeed. FURTHER INFORMATION Tel: 01494 555 900



Products & Services




Service Care Solutions (SCS) has been providing staff within the health and social care sector for over 12 years. Founded in 2005, SCS aims to deliver an outstanding service every time, setting the benchmark as the first choice recruitment consultancy. An approved supplier of staff via the HTE, CCS and CPP Frameworks, SCS works nationally with a large number of NHS trusts and most major private healthcare providers. The company has specialist teams recruiting within various sectors of the healthcare sector including: nursing and general healthcare, mental health, secure and forensic, offender healthcare, allied health professions, social work and non-medical non-clinical roles. SCS is one of the UK’s fastest growing recruitment agencies and in 2016 appeared 84th in the Virgin Fast-Track 100, listing the fastest growing

Head Medical is the UK’s leading specialist in international medical recruitment, assisting healthcare providers worldwide in finding highly skilled medical professionals. From GPs and consultants to SHOs and junior doctors, the company will find the right candidates for any permanent, contract and locum opportunities you need to fill. Head Medical has helped over 800 doctors find new roles, both in the UK and overseas. The company’s wealth of experience has allowed it to build an excellent network of contacts and a large database of doctors, giving it access to a pool of medical talent competitors cannot easily match. Head Medical’s work is founded on high-quality, ethical recruitment and the team prides itself in setting new industry standards. The company believes it is testament to the service it provides that over 50 per cent of candidates

Helping you to find the ideal employee

companies in the UK. The company aims to build long‑term and lasting relationships with all of its stakeholders. SCS proudly holds numerous accreditations including ISO9001, 14001 and 27001, which demonstrate commitment to effective and efficient processes, continuous improvement, environmental practices and data security. It holds REC and APSCO membership. SCS has also been awarded with Investors in People Gold status and Best Companies to Work for accreditation. FURTHER INFORMATION Tel: 01772 208962



Faseha Healthcare Recruitment Ltd’s healthcare staff are thoroughly vetted and dedicated to making a real and lasting difference for everyone it supports through the delivery of high quality, clinically effective and efficient care. The company’s aim is to ensure that the safety, physical, mental and social well‑being of your patients and service users are protected at all times. Working closely with its clients, F-HR develops a full understanding of client needs and look after them with care and attention to detail – guaranteeing measurable results every time. The agency supports public and private sector healthcare organisations by placing nurses, midwives, doctors, allied health professionals, health scientists, social workers and support workers into temporary, permanent or contract roles. It is driven by a high commitment to achieve

Yellowstone Healthcare Ltd aims to provide 24 hours, first rated care to service users in either the comfort of their homes or place of abode, putting service users’ needs first and promoting equality and individuality. Yellowstone Healthcare ensures that the care plan is tailored to meet the needs and preferences of the individual. The agency provides a personal care service, as well as services for: people with learning disabilities or autism spectrum disorder, older people, adults/ young adults, people with mental illnesses, people with dementia/Alzheimer’s, end of life care support, people with Multiple sclerosis, people with Parkinson’s disease and people who have suffered from stroke. It also provides Respite

A bespoke recruitment solution which suits you


The UK’s leading medical recruitment specialist

the highest standards of service by passionately monitoring the quality of its staff and services. F-HR achieves the highest standards of service through attracting and nurturing the best people and fully understanding the client’s unique needs. F-HR’s CQC Registered Home Care services gives individuals with special needs the opportunity to stay in their own home. This could be for people who are getting older, are chronically ill, are recovering from surgery or are disabled. FURTHER INFORMATION Tel: 01233226068


come through referrals. If you’re looking to hire motivated doctors, get in contact and let Head Medical help. The company can promote your jobs to a large and captive audience, significantly increasing the chances of filling your vacancy. Let the team know your needs so you can work together to create an efficient, tailored recruitment strategy for your business. To find out more, contact Head Medical today. FURTHER INFORMATION Tel: 0131 226 2200

Delivering high standards of care in your own home

Care Day Care Independent Living Training. Yellowstone Healthcare ensures quality training for all staff before commencing work. It covers trainings for both Skills for Care/Skills for Health, as well as the Care Certificates. It also covers mandatory training, such as Managing Challenging Behaviour, First Aid, AED & CPR, Mental Capacity Act 2005, Infection Control, Medication Administration, COSSH, End of Life Care, Risk Assessment, Fire Safety, Personalisation and Safeguarding. FURTHER INFORMATION Tel: 020 3876 9258 info@yellowstonehealthcare. www.yellowstonehealthcare.


The agency you trust for your medical staffing

Veritas Personnel is a leading healthcare and nursing recruitment agency providing highly trained healthcare and nursing professionals as temporary and contract throughout London and the South East. The Veritas Personnel team has worked in medical, nursing and care recruitment for over 10 years. It is committed to providing a high quality responsive service based on in-depth knowledge, innovation and professionalism which has earned the company an excellent industry reputation. Veritas Personnel is very efficient at responding to short notice requirements when you need a critical resource immediately. Consultants provide a 24 hour, seven day

a week and 365 day service. No stone will be left unturned. Veritas Personnel will go the extra mile! Its database of 500 medical professionals is vast, all of whom are fully vetted with references, work history, relevant qualifications and most importantly are caring, kind individuals. The in-house training team assist in the development of its staff, ensuring they are up to date with relevant training. The company has clinical expertise with one of the leading voices in midwifery an advisor to our board. FURTHER INFORMATION Tel: 020 7048 0163


Reduce your locum agency spending

Messly is an innovative digital solution which helps NHS Trusts reduce agency spending. Its collaborative digital bank solution enables hospitals to more effectively build their medical bank to quickly and reliably fill locum shifts. Messly helps Trusts to quickly build up their internal bank of doctors by connecting them to the medical community through a mobile app. It also builds engagement with current and former employees and manages the doctor’s compliance process to get them onto the Trust bank as quickly as possible. Doctors can receive alerts, set their availability and book shifts



CareX Medical is a leading national recruitment agency providing a diverse platform of recruitment services for clients and candidates. The company specialises in the placement of healthcare and medical professionals on a permanent, fixed term and temporary basis throughout the UK. CareX Medical was established to portray the founder’s passion, innovation and professionalism within the healthcare sector. It is not a large corporate giant but its structure, its people and its approach is one that is unique. The company’s approach is to always work closely with its clients to fully understand their specific recruitment requirements. The staff’s experience ensures that they do things right with care and integrity. CareX Medical is also looking

H1 Healthcare is a successful recruitment company providing suitably qualified medical and care professionals to both the public and private healthcare sectors throughout the UK. Every week H1 Healthcare supplies thousands of hours of high calibre, temporary staff to clients requiring short term cover for absence or as a long term staffing solution. You too can enjoy a less stressful worklife by outsourcing your staffing worries to H1 Healthcare. The H1 Healthcare philosophy is: “We care deeply about people and quality of life.” These two simple thoughts form the guiding principles behind everything H1 Healthcare does for its staff and for the people it serves, particularly those at difficult life stages or least in control of their lives. H1 Healthcare believes ’it

Taking care of your medical recruitment

for experienced healthcare professionals to join its fast growing team. Its approach has enabled the company to forge long-term relationships with clients from local authority to private organisations, thus giving the company access to thousands of roles; from general to specialist healthcare professionals CareX Medical has a wide range of opportunities for talented professionals. FURTHER INFORMATION Tel: 07891 102 753

Products & Services


instantly from their mobiles enabling them to fill shifts through bank rather than agency. The main benefits Trusts have seen are an increase in internal fill rates by up to 50 per cent and consequent reduction in agency spend; a growth in bank size of up to 5x; better insights into spending through bespoke analytics and reporting; and higher staff satisfaction and engagement levels. To find out more contact the company today. FURTHER INFORMATION Tel: 0207 205 4995

Recruiting exceptional care staff across the UK

takes special people to make others feel special and to help them be at their best’. This is why the company selects and trains its staff beyond accepted sector norms, encourage their personal development, applaud their initiative and reward their spirited determination. It’s these qualities which sets H1 Healthcare people apart and brings sunshine to cloudy days. Find out more about H1 Healthcare by visiting its website or by calling the team. FURTHER INFORMATION Tel: 0845 643 2610 recruitment@



Products & Services




The MoonRay 3D Printer is now in the UK and being used for dental and medical applications, thanks to the new availability of biomedically approved resins. This elegant DLP printer uses the latest ultra violet projector technology to solidify the liquid resin layers. Each layer is just 20 microns (or a quarter the width of a human hair) thick and builds up a very faithful representation of the most complex 3D models. Typical dentistry parts can be built in a little over an hour and the number of parts per build makes no difference to the printing time. Repeatability is assured with this 3D method allowing the dimensional accuracy to remain the same wherever the part is on the build platform. This small desktop package can fit easily into an office or lab environment and comes with built in software,

Hintlesham Hall offers individually designed bedrooms, conference facilities, a luxurious spa and fine dining in its 2 AA Rosette restaurant. There are seven conference rooms of varying sizes that can accommodate meetings, workshops and seminars, each offering excellent facilities for a small meeting or a large conference for up to 90 delegates. With 30 acres of land and gardens the hotel also offer team building in the grounds. Guest can incorporate an activity with a conference or event and the hotel also offers exclusive use of the 32 bedrooms, dining facilities, lounges and grounds. For private dining, the hotel also offers a number of private rooms, from The Justice Room for smaller, more intimate dinners for up to 16 guests or The Parlour, with doors leading to the Terrace and Gardens for up to 45 guests, to The Grand Salon which can seat up to 90

An all-in-one system A beautiful Grade 1 hotel designed for your desktop in the Suffolk countryside

a starter pack and wireless connection. Medical components designed by any CAD software or 3D digitally scanned items can be produced effortlessly and amended for prototype assembly or installation. Distributed for Europe from Bath-based Awesome Apps Ltd, the printer is fully supported with a warranty, spares and consumables. FURTHER INFORMATION Tel: 01242 370453


A unique ‘get-away-fromit-all’ venue in Devon Set on the edge of Dartmoor National Park, Buckfast Abbey Conference Centre offers a unique and peaceful venue in Devon, whilst being just a twominute drive from the A38. There are six recently refurbished, comfortable seminar rooms with beautiful views, up-to-date technology and air-conditioning, an exclusive boardroom and the 150-seat Schiller Hall. With reliable technology and on-site support, visual and audio presentations can be seamlessly incorporated into your conference. Buckfast Abbey Conference Centre is renowned for its locally sourced, homemade cuisine. Head chef, John Hughes, who comes from a background of fine dining and has worked at numerous top restaurants and hotels, says: “Top quality food is priority here at Buckfast Abbey. Just because it is a conference centre and not a traditional restaurant does not mean the food should


be any different” - and food consistently rates ‘excellent’ on delegate feedback forms. If you’re looking to book your next conference, please call, or visit the company’s website. You’ll also benefit from a 10 per cent discount offered to all government organisations, ample free parking and the nearby Northgate House Hotel for any overnight requirements. FURTHER INFORMATION Tel: 01364 645530 www.buckfastconferences.


guests. With all of these rooms the hotel is also able to offer exclusive reception areas whether in the Library or Garden Room, where guests can gather for a drinks reception and canapés. A new purpose built first floor private room, The Grandiflora, is ideal for the smaller conference, meeting or private dining. Accessed by its own private outside door, the room is completely away from the hustle and bustle of the main hotel allowing complete privacy with breakout rooms available to hire if needed. FURTHER INFORMATION Tel: 01473 652 334


The British Racing School – a unique events venue The British Racing School was established in Newmarket in 1983. Since then, the school has developed and flourished to its current position as the Centre of Excellence for training in the racing industry, providing a whole range of different courses and training. The school’s conference and events facilities are suitable for a number of different functions to suit a client’s needs, from meeting rooms and boardrooms to a lecture theatre which can accommodate 12 to 80 delegates. It can also offer a high standard of catering for your event and immaculate on-site accommodation if needed. The facilities are extremely popular with clients, especially those looking for something a little different. As you arrive and travel up the tree lined drive you are likely to pass one of the strings of ex-racehorses being taken out for exercise and the fantastic facilities have a touch

of racing history in every room. Personal guided tours of the racing facilities at The British Racing School are available on request. If you prefer the more traditional conference facility experience, the school is fully equipped to provide this and its dedicated team are on hand to ensure that it meets your every need. For more information please contact Liz Smith,Conference and Events Manager, via the details below. FURTHER INFORMATION Tel: 01638 669040



Specialising in a full range Leaders in energy control of fire protection services for the public sector

Mayday Fire Protection Services has been specialising in fire safety since the company was formed way back in 1999. Day to day operations include servicing fire extinguishers, maintaining and installing fire alarms, and providing emergency lighting and fire risk assessments all to the correct British standards. In the past couple of years Mayday Fire has added the servicing and installation of dry risers, travelling all over the UK. The company’s clients range from hospitals, schools, housing associations and tower blocks to shops and offices on the high street. Since day one Mayday Fire has operated a 24/7 customer call-out

service, meaning clients can relax knowing that an engineer will be on site within a few hours – day or night. Mayday Fire’s engineers build good customer relations with its clients, who know they are getting good service and more importantly the right price. Mayday Fire Protection Services was, as mentioned earlier, formed in the 90s, and since then the company has grown and grown. All its engineers are IFEDA-trained and are always going on courses to keep up with new fire regulations. FURTHER INFORMATION Tel: 01202 475 481

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



Geofire has been accepted onto the preferred suppliers list for University College London Hospitals (UCLH) to supply its Salamander range of fire door holders and closers for healthcare buildings it owns and manages across one of the larger NHS Trusts in London. Geofire’s products were trialled at two of UCLH’s locations to establish its suitability in a healthcare environment. The results proved positive and the radio-controlled group of products were given approval. The acknowledgment and inclusion will see the system installed to legally hold open fire doors in Category ‘A’ healthcare buildings, closing the doors in the event of a fire to protect patients and staff. Andy Collinson, CEO of Geofire, said: “We are thrilled to have our products accepted by this prestigious NHS Foundation Trust. We believe this is a true reflection of how well the

Any school, college or university buildings constructed prior to the year 2000 may contain asbestos. As part of your duty of care it is vital that you understand if asbestos is present in your buildings as well as assessing the extent and condition. Staff, pupils and students can be exposed to the dangerous fibres that are released when asbestos is disturbed – this becomes a real danger when you are carrying out any repairs, maintenance or construction projects. BAAC has over 44 years of experience in the building industry and is a specialist in the management of asbestos. An initial survey will identify the presence of asbestos, assess the state and provide a plan for short

Providing fire door access solutions for the NHS

Salamander system works as a solution for hospitals.” Each Salamander device connects wirelessly to a mains‑powered controller unit, which is connected to the existing fire alarm system. The system is suitable for a BS7273-4 critical actuation (category A) installation to ensure that fire doors will safely close in the event of a fault or fire. Geofire’s Salamander range of radio-controlled products are battery-powered, saving time, installation costs and disruption. FURTHER INFORMATION Tel: 01338 770 360

Products & Services


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

Providing a cost-effective solution for asbestos

and longer-term management. In addition, BAAC is a truly independent company and will guarantee that the advice given is impartial and pragmatic. The company focuses on providing you with the most appropriate solution for your site. Removal of asbestos is very often the last resort. To arrange a survey get in touch today, quoting reference number BME17. FURTHER INFORMATION Tel: 01733 843 353



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While discipline in engineering design and manufacture has its place alongside method and procedure, the freedom of expression needed in artistic design and engineering innovation may often be sacrificed for the organisation. The ability to turn around quick ideas has been helped enormously by the availability of 3D design software and 3D printing. These represent a coming together of decades of evolving technologies that has moved from drafting to wire frame layouts, surface modelling, solid modelling and the modern hybrid design tools with specific add-on applications. However the dental sector, whilst being significantly advantaged by virtue of the small end product size, has been slow to grasp the advantages. 3D printing technologies have moved from the toxic and brittle constructions of the past to the present professional MoonRay

Established in 1985 Welwyn Garden Alarms Limited are a NSI (NACOSS) Gold fire & security installer, our objective throughout years of trading is to provide high quality reliable systems with a dedication to customer service. Driven by our reputation, 95% of our business leads come from recommendations from existing satisfied clients. We are proud of our reputation and continually strive to meet the demands of our clients through an active customer care program with any feedback gratefully received. Our offices are Located on the grounds of Hatfield House, Hatfield, Hertfordshire. Although our humble beginnings and preceding 18 years of trading were born out of two earlier premises in Welwyn Garden City (hence the name). We have a team of engineers

Making apps work the way you want them to

3D printer solutions offered by Awesome Apps Ltd that can retain details down to a 20 micron resolution for a range of new biocompatible materials and in a highly attractive package. A specific version for dentistry and orthodontics now brings same day provisions of bridges, caps, implants and customised medical solutions into reach. For the right combination of software, scanners and 3D printers for your business, call Awesome Apps Ltd. FURTHER INFORMATION Tel: +44 (0)1242 370453

High quality, reliable gold fire & security installer in UK

who install and maintain a number of security systems including Intruder Alarms, CCTV, Access Control, Fire Alarms and Emergency lighting We have a substantial client base, that range from small domestic properties with basic intruder alarms to large commercial sites with multiple security and fire systems. FURTHER INFORMATION 01707 266306

ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service Agfa Healthcare 36 Angels & Cookies 62 Assistive Partner 40 Avonlea Services 85 Awesome Apps 22, 88 Axis Security Services 52 Baac 89 Beaucare Medical 74 BidFood 85 BKP Group 76 Blue Rock Media 49 Bosse Interspice 8 British Engineering Services 56 Buckfast Abbey Conference 88 Carex Medical 87 CCube Solutions 18, 24, 25 CLC Facilities 57 Complete Signage 4 Conference Eastbourne 62 Connect Vending 60 CP Electronics 89 CWE Services 72 D2 Fire and Security 69 Datalogic 33



Datix 42 EM1 72 Faseha Healthcare 86 Franks Portlock 70 Fujitsu 22 Garran Lockers 22 Genesis Automation 30 Geofire 89 Gigasoft Data Protection 46 H1 Healthcare 87 Harland Simon 28 Harrow Green 52 Head Medical 86 Hicom 82 Hintlesham Hall Hotel 88 ICEX 44 ISS Mediclean 6, 50 JLA Limited 54 Kingspan Insulated Panels 66 Langley Waterproofing Systems 70 LASER 22 Legrand Electric 10 M&G Fire Protection 56 Mayday Fire Protection 89

Messly 87 MJog Inside Front Cover Natas Asbestos Training 72 National Autistic Society 74 Newgate Technology 31 Nortek 74 Omnicell Back Cover Pier Contractors 72 ReStart Consulting 38 Saker Controls 56 Service Care 86 Simply Removals 52 Space Facility Services 77 Stanley Healthcare 32 Static Systems Group 44 Step Exhibitions Inside Back Cover TF Installations 69 The British Racing School 88 Triscribe 41 Volante Recruitment Services 49 White Spider Media 23 Wilo UK 58 Wudo Solutions 44 Yellowstone Healthcare 86

Healthcare Estates

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Conference. Exhibition. Dinner. Awards. 9-10 October 2018 Manchester Central

200+ Companies exhibit their latest products & services

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Event in the UK for health estates, engineering, and facilities professionals

See you next year! Healthcare Estates is a unique event that consists of the prestigious IHEEM Annual Conference, Awards Dinner and the UK’s largest trade exhibition for the sector. Build innovative and productive partnerships in asset management, integrate efficient patient-centred environments by collaborating with the right people, find inspiration, and foster aspirational attitudes. Visit

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