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ISSUE 19.2





THE CURRENT STATE OF NHS PARKING Is the current state of hospital car parks up to scratch? Our panel of experts share their view


CLEANER AIR FOR THE NHS Helping to mobilise all UK hospitals to create their own clean air plan



ISSUE 19.2





THE CURRENT STATE OF NHS PARKING Is the current state of hospital car parks up to scratch? Our panel of experts share their view


CLEANER AIR FOR THE NHS Helping to mobilise all UK hospitals to create their own clean air plan


Air pollution and the responsibility of the NHS As we go to print, the UK has joined countries from all over the world in celebrating World Environment Day, shining a spotlight on the work necessary to improve air quality and tackle pollution in all of its forms. Encouraged by the efforts of Sir David Attenborough’s documentaries and the words of Greta Thunberg, the climate emergency has perhaps never been higher on the agenda, and the NHS is not exempt from involvement. Last year the British Lung Foundation revealed that 2,220 GP Practices and 248 hospitals in the UK are in locations with air pollution above World Health Organisation standards. Healthcare bosses need to take a broad look at every aspect of a hospital to find specific areas of improvement, so they can operate with the cleanest air possible. The Clean Air Hospital Framework, developed by Global Action Plan and Great Ormond Street Hospital, offers the opportunity to do just that.

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I would encourage you to turn to their editorial on page 86 to read about how the framework was developed and its plans moving forward. It is believed that if 50 hospitals adopted the framework, 1.6 million patients a year could receive vital advice on health and air pollution. Such knowledge can’t afford to be ignored. Michael Lyons, editor

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226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: EDITOR Michael Lyons PRODUCTION MANAGER Dan Kanolik PRODUCTION DESIGN Sophia Mew PRODUCTION CONTROL Lucy Maynard WEBSITE PRODUCTION Victoria Casey ADVERTISEMENT SALES Jeremy Cox, Charlene Hendy, Tara Oakley, Shelley O’Neill SALES SUPERVISOR Damian Emmins PUBLISHER Karen Hopps ADMINISTRATION Emily Robb REPRODUCTION & PRINT Argent Media

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Contents Health Business 19.2 21

07 News

49 Infection prevention

More staff not enough, says NHS People Plan; more flexible pensions for top NHS doctors; and new tech innovations are being introduced across NHS

Infection Prevention 2019 returns in September to raise awareness and best practice on matters of infection control

17 Facilities management

Should patients using NHS services be charged for parking? It is the topic that refuses to drive away. Read the view of the BPA, as well as the views of our first parking panel of experts

What does lean working mean for facilities managers employed in the healthcare sector? Peter Brogan explores


21 Recruitment With staff shortages and rota gaps having been an issue for the NHS for decades, what challenges will the NHS face post-Brexit in recruiting staff? Neal Suchak examines the issue

25 Catering It is important to continue improving the standards of catering in hospitals. In this article we catch up on what the Hospital Caterers Association is doing to further the agenda

29 Staff safety 55

Within the NHS there is a hidden workforce of lone workers, often unnoticed by regular staff and patients. So, how can their safety be ensured?

33 Signage A sign can act as a beacon within a hospital, guiding a patient to the right location. But it can also convey the wrong message if incorrectly implemented. So, how do you get it right?


37 Technology A key focus of the NHS Long Term plan is to empower patients through the use of digital technology. NHS Digital’s Adam Smith writes about the NHS Apps Library and how it is driving standards in healthcare technology

47 Obesity 89

NHS admissions where obesity was the diagnosis increased by 15 per cent last year. What can be done to lower rates?

Health Business magazine

54 Parking

67 Data centres

Data centres in hospitals need to be designed and built to the highest standard. David Leatt explains why

71 Document management Managing data is key in maintaining the integrity of patient records. Here, we look at the role of shredding in the NHS

73 Integrated theatres

NHS SBS has implemented a framework that allows NHS organisations and other public sector bodies to purchase all of their audio visual requirements under the same framework, including integrated operating theatres

81 Pest control

Legal action has been sought following infections caught at the Queen Elizabeth Hospital in Glasgow

85 Health budgets

Personal Health Budgets are key to meeting the government’s personalisation targets, writes Jon Baker

86 Clean air

The Clean Air Hospital Framework advises hospitals on the steps they can take to minimise air pollution on their estates. Larissa Lockwood explains how

89 Medical technology

Barbara Harpham argues that equal access to medical technology and treatment should not be based on patient post codes Issue 19.2 | HEALTH BUSINESS MAGAZINE




More staff not enough, says NHS people plan The NHS needs to rapidly become a much better place to work, says the new Interim NHS People Plan, which will address the once in a generation workforce challenges the service is currently facing. Developed collaboratively with a broad range of partners from across the NHS, the interim report argues that, in addition to recruiting extra staff, much more needs to be done to improve staff retention and transform ways of working. It acknowledges the scale of the workforce challenge facing the NHS and sets out how the NHS needs to recruit, retain and develop more staff to meet rapidly growing demand for 21st century healthcare. The plan focuses on three key areas – recruiting more staff; making the NHS a great place to work; and equipping the NHS to meet the challenges of 21st century healthcare. This includes plans to immediately increase the number of undergraduates studying nursing with an offer to universities of more than 5,700 extra hospital and community placements for student nurses this year, as well as expand the number of

staff in recently created new roles including increasing the number of nursing associates to 7,500, offering a career route from healthcare support work to registered nursing. The new Interim NHS People Plan also says the NHS will devolve significant responsibilities for workforce planning to the emerging integrated care systems



Mumsnet to help fill nurse vacancies

More flexible pensions for top NHS doctors

As part of a package of measures to fill vacancies in the health service, the NHS in England is set to use Mumsnet to help recruit nurses. One of a number of steps unveiled in the Interim People Plan, NHS leaders see the online parenting chatroom and website as a crucial partner to entice nurses who have left the profession, to rejoin it. The Mumsnet plan is understood to involve promoting the opportunities that exist to go back to nursing, with a national return‑to‑practice scheme, initially set up in 2014, being expanded. It offers catch-up training and a route back for nurses and support staff who have let their professional registrations lapse. While the plan mainly targets nurses, it also acknowledges more doctors and support staff will also be needed. The People Plan report sets the ambition of recruiting an extra 40,000 nurses over the next five years, via: international recruitment by appointing lead agencies to co-ordinate the process; ensuring more nurses enter training; improving retention rates by placing a greater emphasis on career developing; and encouraging nurses back into the NHS with the promise of flexible working opportunities. READ MORE

The Department of Health and Social Care has launched proposals to make pensions more flexible for senior clinicians delivering frontline care. This means that high-earning senior clinicians will be able to support more patients while saving into their NHS pension without facing significant tax charges, with the government detailing how it will consult on proposals to offer senior clinicians a new pensions option. Senior doctors have said that pension tax charges are discouraging them from taking extra work to support patients

and develop new models of multidisciplinary working to support the Long Term Plan’s ambition to integrate primary and secondary care. READ MORE

and causing them to question whether to remain in the NHS Pension Scheme. The change would mean clinicians can freely take on additional shifts to reduce waiting lists, fill rota gaps or take on further supervisory responsibilities. A proposal known as a 50:50 option would also allow clinicians to halve their pension contributions in exchange for halving the rate of pension growth. READ MORE


50,000 people have taken charge of their own care More than 50,000 people have taken charge of their own care after being handed control of how their NHS funding is spent. New figures published by NHS England and Improvement show 54,143 people with long-term health problems, including disabled people and those with long-term physical and mental health conditions, are currently benefiting from Personal Health Budgets. The rollout of the Budgets across the country is being ramped up further as part of the NHS Long Term Plan. They can be used to purchase personalised wheelchairs, assistance dogs and respite care to manage complex health problems, as well as tech devices that can control curtains, lighting, heating and door

intercoms to help people live independent lives. NHS England and Improvement believe that at least 200,000 people will be given the chance to improve their health and well-being by using a Personal Health Budgets within the next five years. A Personal Health Budget is not new money, so does not cost the NHS more money. There is a growing evidence base that people achieve better outcomes with a PHB, they are spent almost exclusively on essential care and they save the NHS money over time. READ MORE





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New tech innovations being introduced across NHS Speaking at the Reform digital health conference, NHS England chief executive Simon Stevens announced that over 400,000 more patients will benefit this year from new tests, procedures and treatments as part of the Long Term Plan. Delivered as part of the NHS’ Innovation and Technology Payment programme, the raft of new treatments and tests includes pregnant women getting a new preeclampsia test, cluster headache sufferers getting access to a handheld gadget which uses low-levels of electric current to

reduce pain, as well as 3D heart modelling to rapidly diagnose coronary disease. The NHS’ Innovation and Technology Payment programme which is fast-tracking the roll‑out of latest technology across the country, building on progress in the past two years. NHS England has also confirmed that funding for 10 other new tests and treatments as part of the programme – including a computer programme that creates a digital 3D model of the heart and avoids the need for invasive procedures – will be extended, allowing more patients to benefit.

Stevens said: “From improving care for pregnant women to using digital modelling to assess heart conditions and new tests to prevent unnecessary hospitalisations for suspected heart attacks, the NHS is taking action to ensure patients have access to the very best modern technologies. It’s heartening to see the NHS grasping with both hands these rapidly advancing medical innovations.” READ MORE



Record numbers of GP surgeries closing

Trusts urged to ban smoking on hospital grounds

New research has revealed that GP surgery closures across the UK have reached an all-time high, negatively impacting more than 500,000 patients last year. Pulse reported that a record 138 GP surgeries shut down last year, at a rate of more than two a week, with the majority of blame for the closures landing on poor recruitment and under-resourcing. Freedom of information requests revealed that smaller surgeries were the worst affected in 2018, accounting for 86 per cent of closures, with many merging with others to ensure

continuation of services. Smaller practices are those serving fewer than 5,000 patients. The Patients Association has since warned that closures are pushing more patients towards A&E – ‘which is under severe pressure itself’. Helen Stokes-Lampard, chair of the Royal College of GPs, said: “These figures are sad but, unfortunately, not surprising. The last thing that GP and our teams want to do is close their premises, and it will only be considered once every other alternative has been ruled out. Further closures must be avoided wherever possible. That’s why we need to see the promises made in the NHS LongTerm Plan delivered as a matter of urgency, to ensure general practice has the people, resources, and investment we desperately need to continue providing world-class patient care, both now and in the future.” READ MORE


Doctors ignore majority of patient feedback Only one in five doctors read comments directly concerning them, as research finds that patient feedback about the performance of doctors is ignored by the vast majority of the profession. Healthcare services use a number of methods to collect information on patient experiences, including surveys and Patient Participation Groups, and policymakers have pushed for greater use of online feedback in addition to traditional sources. Published in the Journal of Health Services Research and Policy, the survey involved 1,001 GPs and hospital doctors across the UK, finding that just 27.7 per cent of doctors were aware of feedback online about an episode of care that they had been involved in, while only 20.5 per cent of doctors were aware of feedback about them as an individual specifically. Those figures rose to 21 per cent and 11.1 per cent for nurses.

Furthermore, the majority of doctors did not encourage patients to leave feedback and only 38 per cent felt that it was useful in improving services. The survey also highlighted that healthcare staff were more wary of feedback on social media, with 65.4 per cent of doctors feeling that feedback on social media is generally negative.


A survey from Public Health England has found that more than two-thirds of NHS acute trusts in England now prohibit smoking on site as part of their journey to becoming smokefree. Part of PHE’s Smokefree NHS campaign, which encourages all hospitals to provide smokefree environments as part of supporting smokers to quit and reducing tobacco-related harms, the survey did warn that 31 per cent of trusts have not yet enforced total smoking bans across hospital premises. The NHS Five Year Forward View included a commitment for all trusts to have fully smokefree sites by spring 2020. At present, 69 per cent have banned smoking on grounds. The Smokefree NHS campaign also calls for all patients who smoke to be offered evidence-based quitting support. Duncan Selbie, chief executive of Public Health England, said: “One in four hospital beds are occupied by a smoker, and most of them want to quit. Many patients or visitors will be going through difficult times, but smoking remains England’s biggest preventable killer and it is time for the NHS to stop smoking within its hospital grounds, everywhere. It cannot be right that it is more acceptable in some hospitals to smoke at the front door than it is outside a pub.” READ MORE Issue 19.2 | HEALTH BUSINESS MAGAZINE




£13 million for new ambulances in Wales

Welsh Health Secretary Vaughan Gething has announced £13 million in funding for the replacement of operational ambulances. Under the investment, 111 new vehicles will replace some of the existing Welsh Ambulance Service fleet, including 71 new emergency operations ambulances,

33 non-emergency patient transport vehicles, and seven specialist emergency vehicles for major incidents. All the new vehicles will be chosen for their ‘cleaner, greener’ credentials and will be deployed across the whole of the NHS. Gething said: “The newer vehicles will be

more reliable and promise better performance and lower running costs, which will ensure value for money for the public purse. They will also be fitted with the most up-to-date communications systems and equipment, to make sure we continue to deliver the best service to the people of Wales. “I’m particularly pleased that all 33 of the new non-emergency patient transport vehicles will be fitted with solar panels to convert available sunlight into electricity. Using solar panels instead of mains chargers negates the need to install multiple charging points, which will reduce our energy consumption, as well as the health and safety risks posed by trailing leads.” READ MORE



Overseas doctors added to shortage occupation list

The health effects of Sure Start recognised

Overseas doctors will no longer have to meet onerous visa fees and financial thresholds to work in the NHS, following changes to migration rules. The Migration Advisory Committee has added doctors from all branches of practice, as well as other medical professionals such as nurses, to the UK’s shortage occupation list. Responding to the decision announcement,

BMA council chair Chaand Nagpaul said that the announcement was a victory in the ongoing battle against ‘chronic workforce shortages’. The BMA called on the MAC to include doctors from specialties such as general practice, psychiatry, emergency medicine and paediatrics on the shortage list as a bare minimum short-term action to help alleviate the health service’s staffing crisis. The complete changes to the shortage occupation list means that it will now cover approximately nine per cent of jobs in the labour market, compared to one per cent under the previous list. READ MORE


Staff shortages affecting end of life care Almost two thirds of nurses say staffing shortages are the main barrier to providing good care to dying patients, according to a new survey. The annual Nursing Standard and Marie Curie survey was answered by 5,346 nurses and other caring staff who revealed the devastating impact too few nurses are having on end of life care across the UK. In 2018 only 38 per cent told the same survey staffing was the biggest barrier in providing care for people approaching the end of life, with that figure jumping to 65 per cent this year. At the same time, the proportion reporting time constraints also showed a big jump this year, with 57 per cent saying it was a major barrier, compared to 25 per cent the previous year.

Additionally, 33 per cent reported not sufficiently supported at work to manage grief and emotional stress. More than half said they found accessing support systems to help them manage feelings of grief and emotional stress either difficult or they were unable to do so. READ MORE

New research from the Institute for Fiscal Studies (IFS) has found that Sure Start centres have reduced the number of children taken to hospital and delivered substantial savings to the NHS. However, despite their success in having a largely positive impact on children’s health, the think tank warns that funding has been cut and 500 sites have closed, with the Local Government Association saying that councils have ‘done all they can within ever tightening budgets’. Examining the effect of Sure Start, an early intervention policy designed to support the well-being of children before they started school, the report finds that the provision of Sure Start centres ‘significantly reduced’ the incidence of children going to hospital up to the age of 11. The study found that for every one Sure Start centre per thousand children there were 5,000 fewer hospital admissions for 11-year-olds each year. It also highlighted its effect in reducing health inequalities, with the report claiming that, ‘since the benefits are biggest in the poorest neighbourhoods, access to Sure Start can help close around half the gap in hospitalisations between rich and poor areas’. Furthermore, direct savings through fewer hospital visits saved the NHS approximately £5 million, or about 0.4 per cent of annual Sure Start spending. When the lifetime health savings of avoiding childhood injuries were factored in, the level of savings reached six per cent of the Sure Start budget. READ MORE Issue 19.2 | HEALTH BUSINESS MAGAZINE


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Weekend effect’ not a reliable measure of care A new study has claimed that the higher mortality rate for weekend hospital admissions should not be used as an indicator of quality of care. Due to the lack of data preceding patient admission and on the severity of their illness, the University of Warwick says that the data, used by former Health Secretary Jeremy Hunt to campaign for longer working hours for NHS staff, as ‘sparse and somewhat conflicting’. Researchers from Warwick Medical School and Birmingham examined 68 studies covering data from over 640 million hospital

admissions across the world and concluded that, contrary to commonly held assumptions, the higher death rates amongst patients admitted to hospital at weekends are unlikely to reflect in-hospital quality of care, and may be attributed to differential criteria for admitting patients and other factors in the community preceding hospital admission. While hospital mortality was found to be 16 per cent higher for weekend admissions compared with weekday admissions on average, they noticed that such a ‘weekend effect’ varied by type of admissions, with the effect being



Sexual health consultations risen seven per cent

Social care funding gap of £4.4bn pending

The number of consultations at sexual health services, both in clinic settings and online, increased by seven per cent between 2017 and 2018, a new report by Public Health England (PHE) has shown. This is down to the rise STI diagnoses, which increased by five per cent in 2018 in compared to 2017. In 2018, gonorrhoea diagnoses rose by 26 per cent from 2017 (from 44,812 in to 56,259). Cases of syphilis also increased and have more than doubled over the past decade (from 2,847 in 2009 to 7,541 in 2018). Chlamydia remained the most commonly diagnosed STI, accounting for almost half of new STI diagnoses (218,095). The report highlights that the HPV vaccination programme has led to a marked decline in genital warts diagnosis, which are caused by some strains of HPV that the vaccine protects against. The rate of genital warts diagnoses among girls aged 15 to 17 years, most of whom would have been offered the quadrivalent HPVvaccine aged 12 to 13 years old, was 92 per cent lower in 2018 compared to 2014. A decline of 82 per cent was seen in same aged heterosexual boys over this time period.


New analysis from the Health Foundation has found that there will be a social care funding gap of £4.4 billion in England in 2023/24 to meet rising demand and address critical staffing shortages in the sector. The charity says that the money available for adult social care will rise at an annual average rate of 1.4 per cent a year, which is much lower than the 3.4 per cent a year the government has committed to the NHS and crucially, far below rising demand of 3.6 per cent a year. The Health Foundation also points to poor pay and conditions in social care as a major threat to the quality of care and future sustainability of the sector, with 110,000 current vacancies in adult social care. Over 40,000 nurses work in adult social care but almost a third are estimated to have left their role within the past 12 months, with adult social care wages deemed a large factor in that exodus. In fact, more than 90 per cent of care workers, including those from the EU, earn below the proposed £30,000 salary threshold that could be required to obtain a visa after Brexit. The analysis also shows that England spends considerably less on publicly funded adult social care per person than Scotland

most pronounced for elective admissions and almost absent for maternity admissions. The researchers found little association between weekend-weekday differences in staffing level and weekend-weekday differences in hospital mortality in the small number of studies that looked into this, and suggest that there are other factors affecting the mortality that should be investigated further. READ MORE

and Wales, and that the gap has widened since 2010/11. In that year, England spent an average of £345 per person compared to £457 in Scotland (32 per cent more) and £445 Wales (29 per cent more). But while adult social care budgets in all three countries have since fallen in real terms, Scotland and Wales have provided more protection for funding. Today, England spends £310 per person compared to £445 in Scotland (43 per cent more) and £414 in Wales (33 per cent more). READ MORE


Amanda Pritchard appointed NHS’ Chief Operating Officer Amanda Pritchard, the current chief executive of Guy’s and St Thomas’ NHS Foundation Trust, has been appointed as the NHS’ Chief Operating Officer (COO). The new NHS chief operating officer post is directly accountable to the NHS chief executive Simon Stevens, and serves as a member of the combined NHS England /NHS Improvement national leadership team. In her role, Pritchard will oversee NHS operational performance and delivery, as well as implementation of the service transformation and patient care improvements set out in the NHS Long Term Plan. The COO is also accountable to the NHSI Board as NHS Improvement’s

designated accountable officer with regulatory responsibility for Monitor. Pritchard said: “It is a huge privilege to be joining NHS England and NHS Improvement at this exciting time and to have the opportunity to influence the NHS agenda and help deliver the Long Term Plan. “In doing so, I know that I will draw upon my experience leading Guy’s and St Thomas’ where our strong values and focus on the needs of our patients and staff is always at the heart of decision making.” READ MORE Issue 19.2 | HEALTH BUSINESS MAGAZINE


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Social value refers to the wider financial and non-financial impacts of projects and programmes including the well-being of individuals and communities, social capital and the environment Source: Cabinet Office 2019

Establishing Social Value in public sector contracts is the right thing to do. This is good news for ISS, as their business model has embodied these strategies through its policies, practises and commitments to the local communities for decades and the benefits are clearly there to see, and its why ISS are fully supportive and engaged with the changes.   The Public Services (Social Value) Act came into force on 31 January 2013. It requires people who commission public services to consider how they can also secure wider social, economic and environmental benefits. Since then the Civil Society Strategy committed the government to use its buying power to drive social change. David Lidington, Chancellor of the Duchy of Lancaster underlined this when he said: “We want to see public services delivered with values at their heart, where the wider social benefits matter and are recognised.” So what kind of things will be considered when looking at facility services in both soft and hard FM? We look at the key issues: Environmental sustainability The evolving challenges brought about by climate change mean that we all need to future-proof our businesses and take steps to reduce our own carbon footprint. Due to changes in the structure of its business ISS achieved their 2022 carbon reduction target well ahead of time and have already set new challenging targets. As the expectation on managing and reducing food waste among their customers becomes ever stronger, ISS has also pioneered a new approach to donating food surplus to local charities. The company is among 87 early adopters who are supporting the UK’s new Food Waste Reduction Roadmap. In 2018, ISS began a partnership with Plan ZHeroes to connect their catering sites with selected charities and set up a process for regular collections of surplus food. A successful trial

across five of their client sites, resulted in 420 Kg of legally safe food being donated. Laura Hopper, CEO of PlanZHeroes commented: “ISS took great care in establishing the processes and procedures to ensure that food surplus could be identified and safely redistributed.” Most companies are now engaged in Green Office Campaigns, where pledges aimed at tackling issues such as single use plastics and global warming all make material impacts. These may include the banning of single use disposable coffee cups, eliminating single‑sided printing and enhancing waste stream segregation. The use of computer assisted communications, such as Skype, also help to reduce unnecessary travel, thus reducing the business’ carbon footprint still further. Diverse and safe supply chains Developing diverse supply chains means that small and medium sized businesses also get a share of the spend. When looking at this in greater detail the larger providers should also ensure that their supply chains are accessible to wider groups including BAMEs and those with disabilities. Social Value has also helped develop a sharper sustainability focus to the good and services companies procure, making public their commitment to sustainable procurement, such as their approach to sustainable and renewable food resources. Safe supply chains also help reduce the risks associated with cyber security by understanding who you are communicating with, and how. Modern Slavery safeguards should also be addressed when developing

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Bringing social value into public procurement successful supply chains. Simply because someone is not directly employed by an organisation, should not preclude the purchaser having a responsibility of knowing how their supplies have been produced. In terms of FM this would include not just food and consumables but items like uniforms and other clothing that has often been produced in less than adequate working conditions. Skills and employment Of course, the best way of providing enhanced social value is to create meaningful and sustainable employment. Companies like ISS have invested heavily in their learning and development schemes, encouraging careers through Apprenticeships@ ISS and graduate placements wherever possible and also providing the full range of workplace related training. Martin Wayman, Corporate Responsibility Manager at ISS UK concludes: “We recognise that to provide the best service to our customers we need to employ diverse teams by recruiting from a broad talent pool, often focusing on groups who might typically struggle to access employment opportunities. We have now trained several employees to share their valuable experience and coaching with Service Leavers through our JointForces@ISS programme. Once in the business we empower our employees to celebrate their rich diversity which creates an inclusive culture where people thrive at work. We marked various notable dates such as International Women’s Day and Pride this year. We were proud to have been recognised by the Employers Network for Equality and Inclusion with two awards: ‘An inclusive workplace’ and ‘Overall private sector employer’.” L FURTHER INFORMATION



Building the future of healthcare The use of offsite construction is on the rise within the public and private healthcare sectors as it brings many benefits. Reduced programmes support health trusts’ drive to address waiting times; as the units are manufactured on a flow line in a factory there is no risk of late delivery due to inclement weather or site restrictions. At Premier Modular’s East Yorkshire manufacturing hub, 20 modules a day can be produced, supplying approximately 2500m2 of healthcare accommodation per week. As much as 75% of a building is manufactured offsite, reducing construction traffic and noise in the sensitive health environment. This means a hospital can maintain its care standards whilst expanding its service offering. Premier Modular’s range of high quality modular building systems is a range of long-life, steel-framed buildings, for either permanent or temporary use in single or multi-storey applications. Ideal for singlestorey GP surgeries, through to complex multi-storey ward accommodation, operating theatres, x-ray rooms and MRI facilities – all of which can incorporate our concrete floor option. The company is a client-focussed solution provider with a strong commitment to research and design, ensuring the most innovative products are available to the market. Our factory engineered buildings provide significant advantages in many areas and offer: • • • • • • • •

Surety of cost and programme Significantly faster build programmes compared to traditional build Minimal site disruption A DDA, HTM & HBN compliant design A durable and resilient building system BIM for more efficient and collaborative ways of working An easily relocated, extended or modified building, available on a temporary or permanent basis Excellent acoustic performance.

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Virginia Mason Medical Center, in the US city of Seattle, started losing money in 1998. Rather than panic, its then CEO, Dr. Gary Kaplan, looked to Toyota for a new management style to get the hospital back on track. Toyota has operated a lean production operation for almost a century – although the term wasn’t coined until the 1990s – but what does ‘lean’ working mean to the facilities manager in the healthcare sector? Lean principles are underpinned by the need to ‘improve flow’, which means getting the right things to the right place at the right time and in the right quantities. At the same time, the manager must strive to ‘eliminate waste’ which, in practice, means minimising waste where possible.

of how patient’s interact with staff and the building. The realisation? Patients were being ferried around the hospital inefficiently, which meant a considerable amount of time was being wasted. After seeing the results of the stream mapping exercise, Virginia Mason’s team could identify where time could be saved. Stream mapping They initially trialled the implementation on When implementing Toyota’s principles, the process of administering chemotherapy Kaplan started with stream mapping. This is treatments, which cut the time it took the process of taking a complex for the patient to be treated by activity and breaking it down 50 per cent. Other processes into steps, so you can L ean were then tackled, and identify where efficiency principl it was so successful can be improved. For e s are not that dozens of other Kaplan, this meant cutting about hospitals throughout tracing the patient’s c faster w osts or the US now evaluate journey on a map of in the same way. a hospital using a they’re orking – about m But it’s not just the US piece of blue wool. efficien ore that’s seeing the benefit Once the patient’s tu of lean principles. The journey had been time anse of Lean Six Sigma method mapped, Kaplan money d is now an international was presented with a phenomenon thanks to its E striking visual depiction


Written by Peter Brogan

What can a car company teach us about facilities management in the healthcare sector? Peter Brogan, head of Research & Insight at the Institute of Workplace and Facilities Management, explores

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The facilities management opportunity: As long as a ball of wool



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 proved success – our own NHS is engaging with the method and encouraging their implementation in hospitals to boost patient experience. Not to mention, there are dozens of books readily available in libraries and online, and even more short courses for professionals in every major city throughout the UK. Putting the customer first So, how can you start to improve how your organisation operates by putting the customer first? Because whether it’s a hospital, surgery or private healthcare provider you manage facilities for, there’s plenty you could be doing. Firstly, consider the stream mapping experience. Break activities down to their steps – focus on a single journey initially, such as a patient visiting for a general check-up. Then, using a piece of wool, map out the typical patient journey so that you and your team can identify where and when patients are being unnecessarily ferried from one place to another. Based on your findings, change up your process and trial it before doing the same for other activities, such as department-specific treatments. Beyond reducing how much time is wasted, you should also think about material waste. For instance, if your organisation is overstocked with one type of medication while others suffer from shortages, consider how you can better manage your ordering process to make it timelier and reduce waste. After all, if hospitals throw away even a

Lean principles are underpinned by the need to ‘improve flow’, which means getting the right things to the right place at the right time and in the right quantities fraction of what patients throw away in unused prescription medicines every year, we could be looking at cost savings in the region of hundreds of millions of pounds. Improved processes Lean even goes beyond the patient journey and waste reduction. It also welcomes a sense of openness for teams. What this means is that it’s your mission to encourage your team to raise concerns and make suggestions when they think a process could be improved. In doing so, you will ensure your processes are always improving.

Be mindful that lean principles are not about cutting costs or faster working – they’re about better working and more efficient use of time and money. They’re about making sure your customer is receiving the best possible experience. And with the NHS satisfaction rate continuing to fall, as healthcare professionals, we must do something. With Toyota’s help, it seems, we can be better facilities managers – for the good of everyone. L FURTHER INFORMATION



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Reduce your time to hire and recruitment costs by up to 50% Flabba has been built hand in hand with the NHS to help them identify, attract and screen Healthcare Professionals from not only the UK but from all over the world, using our state of the art online video interview platform. The results are a more accurate, timely and cost effective recruitment process. Key Features Full Applicant Tracking System (ATS) Marketing Videos added to your adverts to bring to life the job and Healthcare unit Applicants automatically integrated into your ATS Online Video Interview capability. Both Live multi‑participant & One Way interviews. Cross reference all supporting recruitment/application documentation during interview. All Interviews recorded and shared Comment on and rating of interviews feature Built in automated messaging both text and email Full workflow management to keep momentum of process. Document Verification as NHS Standards Ready feature Full storage for audit and review. No software downloads All that is needed to use Flabba is access to the internet and a webcam and microphone (usually already built into desktop, laptop, tablet or phones.

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

Healthcare recruitment post-Brexit Staffing shortages and rota gaps have been an ongoing issue for the NHS for decades. The Recruitment and Employment Confederation’s Neal Suchak analyses the challenges that will face the NHS post-Brexit The NHS is one of the top five largest Staffing shortages and rota gaps have been employers in the world. In England alone it an ongoing issue for the NHS for decades employs around 1.3 million people, with a and workforce management has always been further 300,000 across Scotland, Wales and under the spotlight. With over 4.5 million Northern Ireland, and it is estimated that people having contact with the NHS every around two thirds of the health week – and this being forecast service budget is spent on staff to rise with an ever-ageing salaries. At first glance, these population – we simply 10,000 numbers look healthy, don’t have enough staff. and many would be NHS Improvement has EU staf f h forgiven for thinking reported that over the a v e already that we should be last year, on average, l e f t N the HS sinc in a good position one in 11 NHS posts referen e the Brexit to cope with current in England were dum, a and future demand. vacant, accounting for n dw need to However, the underlying more than 100,000 reverse e workforce challenges staff; in the nursing this tren d facing our health and sector, the vacancy social care system are rates are even higher. huge, complex and now with A survey of recruiters looking Brexit uncertainty, critical. at the next five years, reported

in the REC’s Public Sector 2025 whitepaper, found that 77 per cent of specialist health and social care recruiters expected staffing shortages to increase significantly. Data from global jobs site Indeed found that jobseeker interest in nursing has not kept up with the rise in demand, and interest in social care has declined. If these trends continue, recruiting nurses and care workers may become more difficult in the future – at a time when we need them more than ever. Brexit is coming! As the UK prepares to leave the European Union, it looks as though there is no solution on the table for funding and staffing for the NHS. We all know that the NHS featured prominently in the referendum campaign, with promises of an extra £350 million a week to be spent on the NHS post-Brexit. Although the Prime Minister announced last summer that there would be an extra £20 billion for the NHS – partly as a result of the Brexit ‘dividend’ – others have dismissed this suggestion. The Treasury has said a combination of economic growth and perhaps tax rises may be needed to raise the funds. E Issue 19.2 | HEALTH BUSINESS MAGAZINE


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 There are many issues that the NHS may face post-Brexit. In the event of a nodeal, access to medicines would be high on the agenda, despite efforts to stockpile in preparation. Under a Brexit deal with a managed transition, one of the key issues will continue to be staffing. The NHS has relied on doctors and nurses from overseas for decades, particularly from Europe. The NHS European Office has reported that five per cent of nurses are from the EU, 10 per cent of doctors come from the EU (almost seven per cent of the of the UK medical workforce) and 20 per cent of surgeons trained in other EU countries. Some specialist areas such as obstetrics and gynaecology are particularly reliant on doctors recruited from overseas. The Immigration White Paper, published in December, outlines the government’s proposed post-Brexit immigration policy. It is welcome that the White Paper lifts the cap for Tier 2 visas. However, the potential salary threshold of £30,000 for Tier 2 visas – a figure that will be consulted on – is less welcome. Having a salary threshold at this level would have a huge knock on effect for the NHS, which would be severely restricted from hiring certain staff from the EU post-Brexit. Are we ready? Probably not. The UK simply needs to train more staff of its own, and work harder to retain and re-train the staff that it has. The

Nuffield Trust, King’s Fund and the Health Foundation have estimated that 250,000 additional staff will be needed by 2030 to keep up with demand, and to allow for some additional improvements in patient care. We need to work harder at promoting health and social care careers to young people, and make it easier for people to access pathways into the NHS and social care system from a range of different starting points. Securing an NHS in which all staff are paid appropriately for the work they do, are made to feel valued, and receive the training, flexibility and support they need, will be crucial in producing a workforce that is healthy, happy and able to deliver the best possible outcomes for patients. We particularly need to retain our EU staff too. 10,000 have already left the NHS since the Brexit referendum, and we need to reverse this trend. Creating an environment in which the UK is seen as an attractive option for overseas staff is going to be challenging. The government has promised those currently working here will have the opportunity to obtain ‘settled status’ to allow them to stay in the UK and there will be a new skilled migrants system, similar to the one that operates for workers from the rest of the world. However, it remains to be seen how many more will leave, and whether in the years ahead

The need for agency staff is not going to go away, particularly in light of heightened demand from patients, and so the NHS must ensure that it seeks to create a working environment that is favourable to all staff, regardless of how they work


we will have an immigration system that proves to be attractive to overseas staff. At the start of the year the NHS published its Ten Year Plan, 136 pages of ideas on how to protect the NHS. However one thing was missing: the chapter on workforce. We have to wait until later in the year to see that. Without a workforce to deliver the plans, the plans won’t succeed, and with Brexit imminent they are more important than ever. Brexit means we need agency staff Self-sufficiency from training UK healthcare staff has been estimated to be in the region of 10 or 12 years, so we need to look at immediate, as well as long-term solutions. No matter how good the NHS’s workforce planning is, there will always be gaps in rotas. The REC’s monthly Report on Jobs consistently shows that nursing, medical and care employees are the most in-demand type of short-term staff. Agency staff have provided a vital lifeline to the NHS for decades. They continue to provide the NHS with the extra support that it needs in times of increased demand, and are vital in ensuring patient safety. Agency staff have skills on a par with substantive staff, often with many years’ experience working in the NHS. It is essential that these staff are recognised for their professionalism and contribution, are treated fairly, are valued and are made to feel part of the NHS family. Furthermore, health and social care recruiters are experts in workforce planning, and those working in the health sector see first-hand on a daily basis the shortages that the NHS has to contend with. Recruiters are perfectly placed to identify where problems lie, and are able to offer immediate solutions. They are able to supply staff up and down the country, and often to regions that are less appealing to other workers, as well as offering immediate help in critical situations. The way forward Without an adequate supply of highlyskilled and committed health and social care professionals, the NHS simply couldn’t operate, and certainly won’t be able to operate in the future. It is therefore essential that the NHS invests properly in recruiting the next generation of workers, as well as retaining the staff that they already have. The need for agency staff is not going to go away, particularly in light of heightened demand from patients, and so the NHS must ensure that it seeks to create a working environment that is favourable to all staff, regardless of how they choose to work. Creating a workforce model that uses a joined-up hybrid of substantive, bank and agency staff will be needed in order to ensure that patient safety is maintained, and that we are able to deliver a health service fit for the future. L FURTHER INFORMATION



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Catering Written by Craig Smith

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The HCA was one of the first professional associations to be formed within the NHS and was founded by 25 London hospital catering officers. Whilst our first branches were established in the North and Scotland in the 1950s, we have now grown to 15 branches throughout the UK. Our members represent more than 250 NHS trusts. And our network is the single largest group of healthcare catering/facilities providers within the NHS.

The forefront of patient care As a national organisation, we aim to promote, develop and improve the standards of catering in hospitals and healthcare establishments. Craig Smith, chairman of the Hospital Caterers Association (HCA), To achieve this, we support, educate and train explains why investing in high standards of catering is so important people working in healthcare catering services. Ultimately, improving the professional interests With more than 300 million meals served millions of pounds worth of food, services and and status of healthcare catering practitioners. every year and approximately £500 million equipment to the hospital catering sector. Our mission is to set a clear path to keep spent on food annually by around 300 Although the provision of meals for the HCA at the forefront of patient NHS trusts across approximately 1,200 patients is our principal function, care, whilst addressing the hospitals, the NHS is the UK catering our members are also needs of our other customers Our industry’s largest provider of meals. responsible for providing including staff and visitors. focus is Established in 1948, the Hospital Caterers meals for doctors, nurses We recognise that Association (HCA) is the professional body and ancillary hospital we cannot do this in provide to a representing almost 400 senior healthcare staff. Every day they also isolation, therefore are t r u l p y atient-c managers who provide a wide range of cater to visitors who committed to working service, entred food services for patients, staff and visitors dine in the hospital with the Royal College in NHS hospitals and healthcare facilities restaurants, dining of Nursing (RCN), and the nee meeting d s nationwide. Our network of members is rooms or cafe facilities. allied professional o f e individu v responsible for the jobs of 35,000 people, Through these additional organisations such al patie ery 55 per cent of which are hospital chefs and services, hospital caterers as the British Dietetic nt in our c are kitchen-based catering staff. Amongst our help to generate more Association (BDA) and the associate membership is more than 100 than £150 million worth Royal College of Speech and suppliers who are responsible for supplying of income for the NHS. Language Therapists. E Issue 19.2 | HEALTH BUSINESS MAGAZINE


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publicised across the Media and many voices within the NHS over the increasing costs year on year in treating rising obesity and the concerning levels of diabetes. The government introduced a sugar levy/tax on soft drink manufacturers in April 2018 on soft drinks – highlighting the concerns and effects of high sugar levels in our food and drink.

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 In order to provide our members with the appropriate knowledge, support and assistance in achieving and maintaining the highest standards of catering service, we have implemented a range of specialist services and high-profile initiatives. The Power of 3 The primary campaigns we exercise are ‘Power of 3’, ‘Nutrition and Hydration 24/7 365’ and the ‘Last 9 Yards’. These hugely successful initiatives have helped to shape the provision of good nutrition and hydration within healthcare establishments across all four nations. The ‘Power of 3’ initiative seeks to bring together three complementary disciplines; catering, dietetics and nursing. The collaboration of the three professionals can help to improve the patient experience and increase nutritional outcomes. The Nutrition and Hydration 24/7 365 campaign focuses on the importance of nutritious food and beverages, the risks of malnutrition and what can be done to prevent malnutrition in health and social care environments 24 hours a day, 365 days a year. The initiative builds on our campaign to improve patient screening during hospital admission and identify those most at risk of malnutrition. We firmly believe that by actively promoting the preventative role caterers can play, this can help reduce malnutrition-related illnesses, and caterers can endorse good nutritional practice as a key part of quality care for patients. Our focus is to ensure patients are best supported in their recovery with balanced meals suitable for their needs. By undertaking this role, caterers can prevent malnutrition and the requirement for complex treatment and prolonged recovery periods. Lastly, the ‘Last 9 Yards’ campaign presents the case for food quality and enjoyment at the ward level. Arguing that food must form part of the patient’s recovery plan. We advise that a team approach is critical. We urge caterers to work together with the fellow healthcare professional on the wards to offer an enhanced mealtime experience. ‘Last 9 Yards’ also highlights that if food is not eaten it can do no nutritional good. This resulting in food waste, which means money is wasted. Handing food waste Our members produce millions of meals each week. With this comes a huge challenge of managing waste. Untouched food that has Craig Smith, chairman of the Hospital Caterers Association (HCA)

The Nutrition and Hydration 24/7 365 campaign focuses on the importance of nutritious food and beverages, the risks of malnutrition and what can be done to prevent malnutrition in care environments been delivered to a Ward simply cannot be used elsewhere, and it cannot be sent to animal feed either. Simply because there is a risk of cross-contamination. Natural waste such as vegetable trimmings could be sent for composting but the logistics of this present economic pressures for caterers. We are actively working with other interested groups such as local authorities, equipment suppliers and waste management specialists to look at any opportunity that will help healthcare establishments play their part in reducing unnecessary refuse being sent to landfill. Along with other influential organisations such as The University Caterers Organisation (TUCO) and the National Association for Care Catering (NACC), we are signatories to the Courtauld Commitment 2025. Spearheaded by WRAP (Waste and Resources Action Programme), we are committed to working toward a collective goal to cut the amount of resource needed to provide food and drink by one-fifth in 10 years. The targeted overall outcomes from 2015 to 2025 calculated as a relative reduction per head of population, are a 20 per cent reduction in food and drink waste arisings in the UK, 20 per cent reduction in the GHG (greenhouse gas) intensity of food and drink consumed in the UK and a reduction in impact associated with water use in the supply chain. Trend setting Healthy eating trends continue to evolve. Our focus is to provide a truly patient-centred service, meeting the needs of every individual patient in our care. In 2018, we supported The Vegan Society in their campaign for nutritious vegan meals on public sector catering menus. We recognise that patient dietary requirement

are important, and therefore we will always cater for all patients’ individual needs. We acknowledge that healthcare establishments are now expected to offer ‘high street’ standard retail for staff and visitors. Many NHS trusts and health boards seek to divorce the patient catering from the retail and have been inviting high street brands to fill the space, believing that this will maximise the financial returns. We believe this does not always reflect the real needs of the staff, who keep the hospital running 24 hours a day, seven days a week. Whilst there currently is a lot of amazing work in our hospitals, we are always looking for ways to develop and improve our existing practices. As an organisation which prides itself on learning and development, we will continue to work with all four NHS nations. Expanding our ability to deliver networking opportunities such as our regional meetings, study days, regional conferences, educational visits and our annual Leadership and Development Forum. We encourage caterers to sign up to apprenticeships in the workplace and advocate the professional catering qualification for health and social care catering – Level 2 Award in Professional Cookery in Health and Social Care. This was developed by the HCA, National Association of Care Catering (NACC), and the awarding body of the Institute of Hospitality (IOH). The qualification is designed to complement existing NVQ qualifications in professional cookery and tackles the important subjects of nutrition and hydration, and food modification in healthcare settings. L FURTHER INFORMATION



Whilst the British summertime is quickly approaching, you can guarantee it will not be long before the early evening dim once again seeps in. Often having to think months ahead in terms of operations and workforce rotas, the number of lone workers in the NHS could continue to rise, largely driven by the advances

in wireless communications technology and the staffing issues within the health service. Therefore, there is a clear need for employers to consider the policies and procedures in place to safeguard employees whose role might involve working unsupervised.

Written by Michael Lyons

There are over six million lone workers in the UK, representing approximately 20 per cent of the workforce. Within the NHS, they represent the ‘hidden’ workforce that is under represented in the offices and wards they rarely frequent. Here, we analyse the issue of lone worker protection

Staff safety

Raising the standard of lone worker security

Although there is no common definition of a lone worker across Europe, there does appear to be some commonalities in the definition across the UK. The Health and Safety Executive (HSE) defines lone workers as ‘those who work by themselves without close or direct supervision’, whilst the NHS – the UK’s largest employer – defines a lone worker as ‘staff who work, either regularly or occasionally, on their own, without access to immediate support from work colleagues, managers or others. This could be inside a hospital or similar environment or in a community setting’. Lone working, almost by definition, can be both intimidating and at times dangerous. The protection of lone workers, therefore involves a two-fold approach, not only to provide safeguards, but also to offer reassurances to the people involved. The risks faced by lone workers usually fall within three main groups; physical or verbal violence and aggression; occupational risks such as slips, trips or falls; and personal wellbeing risks such as medical conditions. Whilst these risks aren’t exclusive to lone working, they are greater, and if an incident does occur, the alarm may not be raised until it is too late. These risks may be higher still as winter draws in and the nights become longer. Employers have a legal obligation to keep their lone workers safe under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999. Employers have a duty to assess risks to lone workers and to take steps to avoid or control risks where necessary, however, despite this, many businesses do not know what safety solutions provide adequate protection for their lone workers. Part of the confusion lies in the issue of ownership; who’s responsibility is it? Who within the company should pay for lone worker security solutions? Is it a security expense, or a health and safety one? The private security industry has also struggled with this positioning, finding it hard to know who should be targeted within a company. Technology advances The development of technology and practice in the field of lone worker security has focused on encouraging and enabling lone workers to consider the risks they might face in their roles and subsequently provide them with the means both to summon aid in the event of emergency, but also to collect vital information that can be used as evidence should the situation call for it. Whilst there is a huge selection of lone worker devices available on the market, typically, devices provided by a credible supplier will all offer similar functional capabilities. Some of these functions include two-way audio connection between the Alarm Receiving Centre and the user; GPS tracking; ‘Man down’ alarms which automatically raise the alarm if a sudden impact is detected; and the ability to record evidence for prosecution purposes. Smartphone software applications are also available as an alternative to using a dedicated device, which is a viable option for those that do not want to carry around additional hardware. E Issue 19.2 | HEALTH BUSINESS MAGAZINE


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Below is an updated article showcasing some of our work from the PSI magazine. Wisenet hybrid recording solution A Wisenet hybrid recording solution has been installed at New Cross Hospital, Wolverhampton by JKE Security. Dan Mather, director of Derby based JKE Security Ltd, said: “The medium-term objective is to provide the hospital with a complete end-to-end Wisenet solution incorporating the latest video surveillance technology. However, New Cross Hospital is not alone in having to carefully manage its budgets and with this is mind, the priority has been to install a hybrid recording solution which comprises a combination of HD+ and NVRs.” New Cross Hospital provides 700 beds, employs almost 9,500 staff and is the largest teaching hospital in the Black Country. A total of 21 recording devices have been installed. These include one Wisenet 64 channel PRN recorder with 40tb of hard disk drives, six Wisenet 32 channel XRN -2010 NVRs which each have 21 Terabytes of on-board storage and 13 x Wisenet HD+ 16 channel SRD-1694 DVRs, each with five

Terabytes of storage. Using AHD technology, the Wisenet HD+ DVRs are able to record high definition images transmitted over the hospital’s existing coax cabling. Dan Mather says: “An important aspect of this project is that the Royal Wolverhampton Hospitals NHS Trust wanted a recording solution which would be totally compliant with the new GDPR data protection regulations. Having taken advice from the distribution company which we source our video surveillance products from, and having attended a three-day training course conducted by Hanwha Techwin, we had the confidence to recommend the Wisenet hybrid recording solution to the Trust both in terms of its compliance. “Having successfully completed the first phase of the upgrade, we have successfully installed over 250 IP cameras are looking forward to installing over 200 more Wisenet cameras throughout the hospital in the near future in order to provide security personnel and the hospital’s managers with a powerful tool to maintain a safe and secure environments for doctors, nurses, administration staff and patients.” Paul Smith, security manager at the trust and Local Security Management Specialist, said: “We looked long and hard for a suitable solution of integrating our older systems with newer IP systems on the site. For us the best option came in the form of the Wisenet software and recording units and for the first time in years we are now able to view our entire system on one platform, and a platform that is functional and easy to operate. All of our pre-existing cameras have been synced with the new software with the assistance of JKE Security Ltd. I look forward now to the next stage which will be to replace end of life cameras for the much more technologically advanced kit, which will enable us to use the smarter functions of the Wisenet software.” L FURTHER INFORMATION Tel: 0800 011 9242

The medium-term objective is to provide the hospital with a complete end-to-end Wisenet solution incorporating the latest video surveillance technology


Staff safety

 NHS Employers In February last year, NHS Employers produced guidance to raise standards of workplace health, safety and well-being in healthcare organisations and to promote a safer working environment for all healthcare staff, specifically targeting safety for lone workers. Acknowledging that an increasing number of health and social care staff work alone in community settings, such as patients’ homes or on outreach work, the guidance says that lone workers can be vulnerable and at increased risk of physical or verbal abuse and harassment from patients, clients, their relatives or members of the public, simply because they don’t have the immediate support of colleagues or security staff. It focuses upon two main ways to combat this threat: prevention and risk assessment. NHS employers have a legal duty to carry out risk assessments of any work-related activities that present a risk to your personal safety. This risk assessment should identify who might be harmed, the dangers they face and any measures that can be taken to prevent and reduce the risk of injury. This assessment should take into account the job you are doing, the environment in which you will be working, the patients you will be dealing with (for example do they have a record of violence), and any factors specific to yourself such as training and competencies. Tackling prevention, the guidance says that your employer should firstly look at ways of eliminating the hazard. For example, if the risk is caused or increased

The risks faced by lone workers usually fall within three main groups; physical or verbal violence and aggression; occupational risks such as slips, trips or falls; and personal well-being risks such as medical conditions by you visiting a patient, it may be safer if the patient comes to you and is treated in a safe and secure environment. Alternatively, it may be safer if you are accompanied by a colleague on your visit. Inevitably there may be circumstances when you regularly visit patients on your own. If this is the case, your employer must invest in implementing a safe system of work that deals with the risks to lone workers, including a means of discreetly raising the alarm (known

as a lone worker safety device). However, it is important that this technology is supported by robust reporting systems that include colleagues knowing where you are and points of contact should you get in trouble. L FURTHER INFORMATION Employers/Publications/HSWPG-LoneWorkers-staff-guide-210218-FINAL.pdf

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Possibly, the very first thing many The question is people see of your existence is your how do you get it right? sign. The sign does two things. It acts To find the right answer you will need to as a beacon, guiding the visitor to the consider a number of factors, including: what right location and, more importantly, it are the right type of signs?; What are the delivers a message about your services. design criteria and what content should the Get it wrong and it will not only convey signs have?; Who should make your signs? the wrong message. In turn, it could add What materials should be used to create to the anxiety of someone in an and construct the signs?; Do you environment way outside their need planning permission Creatin comfort zone. Get it right to erect your sign? And, however and signage how do I meet my legal success g ful can be a powerful tool obligations if the sign signage which will help them requires maintenance involve be more relaxed in and inspection s than an more your environment during its lifetime? attracti and contribute to the Creating successful a v rrangem e effective running of the signage involves more ent of logos, p property. The importance than an attractive i c ture of well-designed and arrangement of logos, slogans s and planned signage as part pictures and slogans. It of your overall strategy requires the understanding cannot be overstated. and blending of complex

Letter size – generally, the larger the size, the greater the legibility. Letter shape – some letter styles are more legible than others. In particular, script and extended letter styles are more difficult to read unless they form a well-advertised brand name or logo (e.g. Coca Cola). Letter spacing – letters are more discernible if they are spaced apart at a reasonable distance. Crowding together, particularly of adjacent vertical strokes can make them difficult to read. Brightness – to be legible, a sign has to be bright enough to stand out from its surroundings. Location – signs will be more legible if they are placed in a position without competing or confusing backgrounds. Colour – a sign with a colour that contrasts well with that of its background will be more legible than one where the colours tend to merge. Use of directional indicators – not only is it important to keep these icons legible from a distance, consider ways that will not lead to confusion when displaying more than one direction is indicated. E


Written by David Catanach

David Catanach, director of ISA-UK, formerly the British Sign and Graphics Association, outlines the importance of correct signing and finding the right supplier


Signage: pointing in the right direction

elements such as marketing and demographic and it requires an understanding of ‘visual acuity’. The task is further complicated by the fact that the people will be on the move when they see the sign and it must be possible to read and understand its message in an instant. It’s worth repeating, no matter how good your product or service is, if your sign does not inform, it has failed. Investing in professional sign design is sound advice. Experienced designers understand how to get attention and, more importantly, how to get the right reaction. Let’s start with some of the basics: Sign legibility depends on many factors, but the more important are:



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 The following lists in order of decreasing legibility the top five combinations of letter and background colour. Colour of Letter/ Colour of Background 1. Black/Yellow 2. Black/White 3. Yellow/Black 4. White/Black 5. Blue/White Other factors which can influence the design are letter height, spacing and viewing distance and, just as importantly, your ‘corporate’ colours. Mathematical formulae do exist for calculating the optimum values for many of these things and road traffic signs for example are enshrined in the relevant standards and legislation. However, it’s not simply a matter of dropping a few numbers into a spreadsheet and waiting for it to generate the design. While an experienced sign designer should have an understanding of these fundamental principles, it is far more important that he or she has the creative ability to combine these elements to produce a sign that meets your requirements. It is also vital that the designer has knowledge of the materials, production techniques and standards which apply to or are used in the construction of signs. And then there are the planning requirements. Today many businesses and public agencies are influenced by designers who handle their corporate identity programmes and come up with signage schemes that consider neither the intricacies of planning a system nor the feasibility of bending rigid materials into all sorts of weird and wonderful shapes. Thus, when the signage programme goes out to tender, both designer and client are disgruntled when they discover to learn that what they have requested just isn’t possible or it is cost is prohibitive. This is why it makes sense to consult a reputable Signmaker (such as a member of ISA-UK) at an early stage in the design process. Most signmakers, and especially those who specialise in wayfinding or corporate branding, have a good idea of what the planning authorities will allow and will be able to advise on the suitability of designs and availability of materials. They may also be able to suggest more effective – and very often much cheaper – alternatives to those specified. Nowadays, many signmakers also boast an in-house design capability and will happily help create workable concepts that meet both aesthetic and budgetary considerations. When a project is particularly complex, or involves many different types of sign, the best signmakers will produce prototypes to test feasibility and will also supply material samples so that the client and the designer can see whether the specification they had so fondly envisaged is viable. Although wayfinding is a greatly underrated specialism, it actually takes a great deal of skill to produce an attractive and effective wayfinding

Although wayfinding is a greatly underrated specialism, it actually takes a great deal of skill to produce an attractive and effective wayfinding scheme, which guides visitors smoothly around a complex of buildings or floors and then safely back scheme, which guides visitors smoothly around a complex of buildings or floors and then safely back. Wayfinding signage is vital if any large visitor location with multiple entrances and facilities. A key consideration when designing a wayfinding scheme is the Disability Discrimination Act (DDA). Again this is something where a specialist (ISA-UK) Signmaker or design consultant can help. Information on the requirements of the DDA in relation to signage can be found in the Sign Design Guide (Peter Barker and June Fraser). This is published jointly by the JMU Access Partnership and the Sign Design Society. Copies can be ordered from the Sign Design Society on 020 7091 4273 We have given numerous examples of why it is vital that you chose a reputable Signmaker. So, how do you find a reputable signmaking partner – one that is capable of delivering signs that best meet your needs and at a cost you can afford? It may seem like a daunting task, but the good news is that in the UK there are a large number of superbly equipped, highly skilled and very creative specialist companies capable of providing you with signage of the highest quality. Of course, as in any other business sector, there are also a number who will happily promise the earth, take your money and then fail to deliver. The question is how to avoid these. One way is to check that your Signmaker is a member of ISA-UK. The Approved Signmaker Search facility on our web site (or call us on 0845 338 3016) will help you do this. It includes

profiles of all member companies and links to their web sites, where you can find more information on the services they provide. All members of the ISA-UK are vetted before joining and all have signed up to the Association’s Code of Practice, which is designed to promote the highest standards, design, workmanship, health and safety, and commercial practice within the sign industry. The ISA-UK badge is the sign of a quality Signmaker. It is essentially the Code of Practice that sets members of the ISA-UK apart from many others in the industry. The fact that they are members is a clear indication that they are serious businesses and are serious about the sign industry. Should any member be found to be seriously in breach of the Code, the ISA-UK Council will either suspend membership or expel the member completely through it’s Dispute Resolution Service. Your choice of Signmaker will, to a significant extent, depend on the nature of your sign requirements. If you are looking for single ‘door’ sign for a surgery, then a local sign shop may be the ideal partner. However, if it is part of a major project, you may need to consider one of the larger sign manufacturers. Whatever, the case we recommend that you employ a Signmaker that is a Member of the ISA-UK. Quality of product and service is key to our Members. Choosing a BSGA member for signs has never proved to be a wrong move. L FURTHER INFORMATION



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In order to create a truly digital NHS, patients Since launching in April 2017, it’s gone on are going to have a key role in protecting their to have more than a million visits and is own health, choosing appropriate treatments currently home to 74 health-related apps and managing their long-term conditions. covering a range of topics from mental health NHS Digital is working hard to to pregnancy. Every app and digital transform the way that people tool published on the Apps Library experience the NHS, by has been reviewed by experts There a designing digital health to provide reassurance to re current tools and services users that they are safe and ly around 330,00 that connect them secure and can be used to 0 to the information help improve health and worldw health apps id and services they well-being outcomes. e , som which a need, when they In what is a very crowded re very e of need them. marketplace, we’re trying good, but a lo t of the One of the to help patients choose the m remain ways this is being best app for their condition rather achieved is through by saying that ‘these apps poor the NHS Apps Library, have been assessed to a high which houses a range standard and are OK to use’. of digital tools offering We’re sponsored by NHS England personalised advice, self-care through their Empower the Person and signposts to health services. programme and our aim is to help patients and citizens to take more control over their What is the NHS Apps Library? own care by creating a tailored healthcare The NHS Apps Library brings together all journey, which is a key part of the Secretary the apps and digital tools that have been of State’s tech vision for the future. assessed by the NHS. Its purpose is to help users find quality products from the wide selection available on the market.


Written by Andy Smith

A key focus in the government’s Long Term Plan for the NHS is to empower patients through the use of digital technology, says Andy Smith, programme head at NHS Digital

Assessing the suitability of the apps All apps applying to feature on the NHS Apps Library must be assessed against our Digital Assessment Questionnaire (or the DAQ as we call it). The DAQ was set up as a unique cross-body initiative – with the Department of Health & Social Care, NHS England, Public Health England, NICE and the Medicines and Healthcare products Regulatory Agency all sharing their areas of expertise and feeding into what’s now an extremely comprehensive question set. Throughout the questionnaire we’re looking at risk and evidence of effectiveness, so we’re asking a whole host of questions like: ‘does the app really do what it says on the tin?’ and ‘does it meet our security standards?’ If patients are sharing their personal data, they need to be absolutely certain that their data is secure. If you think of every app assessment as being like a journey, you’ve got lots of different apps with different standards and different risks. We’ve got one called Brush DJ, for example, which is really low risk. You download it to your phone and you give it permission to access your music. It then plays music for two minutes, so a child knows how long to brush their teeth; giving a countdown when there’s 20 seconds left. It doesn’t access any personal data and it doesn’t store any personal information. E


Transforming the way people experience the NHS

Up to now, 374 apps have applied to be featured on the NHS Apps Library and 171 are currently going through the assessment process. The words most searched for are ‘anxiety and stress’. We also have quite a few who are looking for support with diabetes and pregnancy but coping with mental health is certainly the most frequent search request.


Free NHS Wi-Fi is now available in 6,749 GP practices and 212 acute, mental health and community NHS trusts across England, benefitting millions of patients.

Since launching in April 2017, the NHS Apps Library has gone on to have more than a million visits and is currently home to 74 health-related apps covering a range of topics from mental health to pregnancy  At the other end of the spectrum, we’ve got the likes of Evergreen which accesses the current GPSOC system; enabling patients to view their medical records, order repeat prescriptions and book appointments. By its nature, this is obviously far more complex to assess. After all, a pair of shoes is a transport mode and so is a rocket, but you wouldn’t assess them in the same way. It’s about breaking the assessment down into a manageable process and that’s what we’ve come up with through the DAQ. The Digital Assessment Portal We currently work with one external assessing organisation called Orcha, but we’re in the process of launching an approved assessor operating model where third-party assessors will assess apps on behalf of the NHS. So very soon, app developers will be able to access a marketplace where they will be introduced to a list of organisations who can assess their apps against the NHS standard. This assessment portal is also quite unique and we’ve had quite a lot of interest from other public departments, who are interested in how they could use such a system for their own digital needs. We’re also creating an API which allows clinical systems to showcase the apps that are trusted. So in the future, GPs will be able to look at a problem and see instantly whether there is a digital solution. For example, if a patient presents with sleep problems, the GP might point them towards a particular app before they prescribe any medication.

Driving standards There are currently around 330,000 health apps worldwide. Some are very good, but a lot of them are rather poor, so by opening up the market and encouraging organisations to assess against the NHS standard, we are getting closer to being able to mandate that standard across the whole NHS. NHS England’s diabetes programme, for example, will not commission any app which does not appear on the NHS apps library. But driving up standards is not just about raising the bar for user experience. We’re also looking to take out a lot of the legwork for GPs and commissioners, and the feedback so far is that commissioners are breathing a sigh of relief because they don’t need a security expert or a clinical safety expert to assess the apps they’re looking to use. If those apps are on the NHS Apps Library, they can rest easy that they have achieved all the relevant standards. User input We’re currently on version 2.3 of the DAQ and we’re updating it on a quarterly basis, so a lot of lessons learnt are constantly being fed into it. There are a lot of user researchers working on the programme and their role is to interview patients, developers, commissioners and healthcare professionals. It’s one of the most user-centric designs we’ve ever implemented. Absolutely everything we do is tested on the users first.


Millions of patients now have NHS Wi-Fi access

NHS Digital exceeded its target to have 95 per cent coverage in GP practices and NHS trusts by 31 March 2019, with the latest figures indicating that 95 per cent of GP practices and 98 per cent of NHS trusts are already connected with the remaining four trusts and ten CCGs all underway with their own procurements and set to be live this year. As well as allowing better connectivity for messaging for patients and keeping injured children entertained in A&E, NHS Wi-Fi is also empowering patients to monitor and look after their own health better using digital health services. Patients can also access apps that help them communicate with medical staff to understand their health needs better using images, photos and text. Reliable staff access to health information has; reduced frustration and wasted time for practice staff, increased satisfaction for patients and increased health economies for CCGs. Staff are therefore able to work more remotely around offices without having to be tied to a fixed desktop PC, avoid network delays and share notes with colleagues more easily in real-time. Mark Nicholas, clinical lead for the programme at NHS Digital, said: “It’s great to have so many patients already connected to free Wi-Fi, empowering them to take more control over their own health through access to digital services. I’m really pleased that the service is being used for such a wide variety of health reasons.”

Working with app developers Since the launch we’ve worked with 350 developers and we’re working with them all the time to offer the smoothest service possible. Their main priority is to get their app on the library and for it then to be easily commissioned or used within the NHS. One of the ways we’re looking to improve this process is by putting the apps onto buying catalogues. So, if a commissioner has a particular health need that they’re looking to address, they can visit the catalogue to see which trusted tech solutions are out there. Once they’ve found an app or tool that works for them, they can then engage directly with the developer. I think initially the app developers found the due diligence process quite a challenge, E Issue 19.2 | HEALTH BUSINESS MAGAZINE


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Infection control gets smart Chris Wakefield, vice president, European Marketing & Product Development, GOJO IndustriesEurope Ltd discusses how innovative technology can be harnessed to improve infection control and hand hygiene compliance Technology has been transforming the healthcare industry for years. As a key strategy in the government’s 10 year plan for the NHS, this trend is set to continue. Indeed, Matt Hancock, Secretary of State for Health and Social Care, recently said at a Royal Society of Medicine event that ‘we must drive tech innovation and improvement across the NHS’ and that ‘the right tech saves lives and makes life easier for staff.’ Innovation has a major role to play in healthcare, from the research and development of breakthrough new drugs, to artificial intelligence and the roll-out of virtual GP consultations. This is no longer science fiction or the distant future. This is happening now. The truth is technology is now such an important part of our everyday lives, that we cannot imagine the world without it. Our smartphones and tablets have become our alarm clocks, our calculators, ultimately, our source of knowledge. We literally have the world in our hands; a mine of information at our fingertips. Pioneering developments are changing the world of healthcare. They give GPs immediate access to essential prescribing and clinical reference; they offer surgeons new techniques and tools; they allow patients to take life-saving medicines, or to track their own health via apps. Importantly, they also have a major role to play in infection control, specifically when it comes to hand hygiene. The power in our hands Hundreds of studies published over the past 20 years have proved good hand hygiene helps to prevent serious infections from spreading, and to reduce healthcare associated infections by up to 50 per cent. Put simply, it can make a huge difference to health. The simple act of washing or sanitising hands in itself, might not sound highly revolutionary, however technology has played its part in every step of the

user’s journey, from the equipment and formulations, to ensuring compliance. Step one – innovative dispensers According to the WHO, hand hygiene products should be easily accessible and as close as possible – within arm’s reach of where patient care or treatment is taking place. Dispensers can be wall-mounted, free-standing, pushactivated or, thanks to innovative technology, touch-free. In fact, these touch-free systems have become increasingly popular; intuitively sensing the presence of hands, they dispense just the right amount of product every time. The fact that they are touchfree also increases their hygiene rating. Step two – high tech formulations Innovation comes in all shapes and forms, and much research is also spent in developing sophisticated, hygienically advanced formulations. In a healthcare setting, these must be effective against germs (conforming to key hospital norms EN 1500, EN 14476 and EN 12791), yet also gentle to skin. This is especially important when you consider the frequency with which healthcare workers wash their hands. Step three – ensure compliance Despite being simple, low-cost and highly effective, this method of infection prevention relies on compliance to work. Shocking statistics regularly remind us that not enough people wash their hands after using the washroom, or if they do, that they don’t wash long enough for it to be effective. To successfully influence hand hygiene behaviour, healthcare settings should place eye catching signage as visual prompts – for patients, visitors and healthcare workers alike. It is also important that hand hygiene facilities remain well-stocked and maintained at all times. GOJO Industries-Europe Ltd has harnessed revolutionary smart technology to create the GOJO® SMARTLINK™ Electronic

Monitoring Solutions. These two mobile apps are a smarter way to help reduce the maintenance time spent on dispensers, measure hand hygiene performance, and help prevent the spread of germs. The GOJO SMARTLINK Service Alerts System app is a preventative maintenance system that continuously monitors hand hygiene dispensers and provides predictive analytics that can enable improvements. The secure software web portal, which includes data on dispenser usage, estimated refill replacement dates, alarm status and history, allows users to customise alerts and alarms. The dispenser data, combined with washroom activity data provides insights on when and where to service, and how quickly service staff respond to alarms. The GOJO SMARTLINK Observation System app provides feedback and delivers reports immediately for both hand hygiene and PPE compliance, saving valuable time. It helps to improve the efficiency of completing hand hygiene audits and delivers targeted reporting to help improve standards. Technology continues to evolve – but is already making its presence felt in terms of infection control. For a tailored, effective, total solution for your setting, or for more information, please call +44 (0)1908 588444, email or visit L FURTHER INFORMATION Tel: +44 (0)1908 588444 Email: Webiste:




 but we’ve done a lot of work on simplifying this process - without diluting any of the standards. What we have found is the process has forced developers to make key improvements, particularly in the GDPR area. There were lots of cases where developers were looking at our assessment process and thinking: ‘well, my app doesn’t do that’. But the end result is they’ve gone away and improved their app to meet that standard. Patient benefits The benefits for patients are plentiful. Even here in my own team, one of my colleagues has started using an app to monitor his diabetes, which has led to him being able to reduce his diabetic check-ups from once every month to once a quarter. He’s able to submit blood readings through the app, which can be seen by his doctor, and this in turn is freeing up more appointments for others, which is excellent. International impact The impact of the NHS Apps Library is not restricted to the UK however, and has already prompted a lot of interest from overseas. Sweden, Germany, Japan, America, Australia and Finland are just some of the countries who have contacted us for advice, as they work to build their own equivalent. Every one of them has said that the NHS is twothree years in front of where they are. A group of 40 health tech workers from Sweden visited us to find out more about our work and France is keen to only surface 1 Health Business Ads_v1 1.pdf apps that are already on our library. A lot of



Since the launch, NHS Digital has worked with 350 developers and we’re working with them all the time to offer the smoothest service possible these countries don’t have a governmentled health service in the same way that we do, 9:34 but they are all looking to the 4/9/19 AM NHS to set the standard worldwide. L









Digital is changing nearly every aspect of the healthcare industry. Visit to download our FREE guide, giving insight into current healthcare trends and the winning formula for improved patient experiences.



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Medstrom are proud to announce the launch of their unique specialist equipment rental service, Medstrom Now

If a hospital had an average of 10 rental episodes per month, paid a £90 delivery charge and a £90 collection charge, they would save £21,600 per year via Medstrom Now Medstrom prides itself on offering specialist innovations and with the exciting launch of Medstrom Now, the company continues to lead the way in delivering exceptional and bespoke services to provide the very best in positive patient outcomes. New rental service Medstrom Now is a revolutionary new rental service that has been designed to remove all barriers to accessing a specialist equipment rental service. It has been launched to provide a transparent and cost‑effective service which eliminates many of the challenges hospitals currently face with their service providers, including excessive delivery and collection charges, long minimum rental periods, inaccurate invoicing, lack of management information, extended delivery lead-times outside those promised, a lack of product training and little to no clinical support. Medstrom Now supports Medstrom’s vision to improve both patient and financial outcomes for customers. Medstrom Now offers a unique solution that guarantees immediate access to equipment by ensuring that products are always available on-site. Medstrom works with customers to identify the location where specialist equipment can be securely stored. Orders are placed online through a bespoke ordering system and once confirmed, a code will be given to access the equipment. This eliminates delivery lead-time and removes charges for delivery and collection. As provided with

Medstrom’s ad- hoc rental service, 24-hour clinical and technical support is offered along with product training by a member of the RN and RGN-qualified clinical team. In an increasingly cost-conscious market, this unrivalled rental service offers a way to make significant cost savings as well as improve patient outcomes by eliminating waiting time for specialist equipment.

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Delivering UK trusts and health boards freedom from equipment rental challenges

Specialist products A range of specialist products are available through Medstrom Now, including bariatric beds and surfaces, ultra-low beds, the Multicare specialist bed and the unique Dolphin Therapy surface; the latter offering proactive protection for the most complex of patient needs. Cost and time effective Rachel Apsey, sales & marketing director, sees this launch as a real milestone for the healthcare innovator, ensuring that cost and time challenges are reduced to allow for better patient experiences. Rachel comments: “Medstrom Now has been developed to provide our customers with genuine added value and is designed to address all financial and non-financial challenges that may be experiencing with their existing rental service. We believe this new service is a real game changer.” The launch of Medstrom Now is a strong testament to Medstrom’s ongoing commitment to improving clinical outcomes and delivering real value. Their philosophy has always been to offer the very best in care and to lead from the front. Medstrom Now offers an unparalleled service which guarantees clean, function and safety tested specialist equipment that is ready for use whenever patients require it. L FURTHER INFORMATION 0845 371 1717



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Admissions to NHS hospitals where obesity was recorded as either a primary or secondary diagnosis increased by 15 per cent last year. So what can be done to reverse this widening trend? An annual collection of new and previously within hospitals becoming a more difficult published figures on obesity, titled issue to address. While it is widely agreed Statistics on Obesity, Physical Activity that public health budgets need to be and Diet, England, 2019, claims that strengthened, especially at local authority there were 94,000 more admissions to level, for obesity to be prevented rather NHS hospitals as a result of obesity last than treated, it is worrying that findings year, and increase of 15 per cent. within hospitals are equally concerning. According to the statistics, which also At the end of May, Scotland issued a examined other obesity-related figures, restriction on the sale of high-energy such as prescription items, prevalence drinks to under-16s from shops on NHS among adults and children as well as sites. The restriction will apply to drinks physical activity and diet, approximately with an added caffeine content of more two thirds of the admissions where than 150mg/litre and is the latest update obesity was recorded as either a primary to the Healthcare Retail Standard, a set of or secondary diagnosis in 2017/18 were criteria which all retailers operating in NHS for women, and women accounted for 79 sites in Scotland must adhere to. It aims per cent of the 6,627 Finished Consultant to increase the amount of healthier food Episodes for bariatric surgery in 2017/18. and drinks in shops in NHS buildings, with Looking at prevalence, the report tighter rules around what can be promoted. establishes that adult obesity prevalence Scottish Public Health Minister Joe stood at 29 per cent in 2017, an increase FitzPatrick said that the Healthcare Retail from 26 per cent in 2016. Prevalence of child Standard ‘supports healthier eating across obesity in both Reception and Year 6 was the NHS estate’ and recognised that it over twice as high in the most deprived areas was right that Scottish hospitals ‘show than in the least deprived areas; a lead in providing food and drink 13 per cent compared to which is health promoting’. six per cent in Reception The year, and 27 per cent Junk food Univers compared to 12 per Whilst the Healthcare Retail ity of Aber cent in Year 6. Standard ensures that at deen sugges least 50 per cent of food ted tha t caps could li Scottish and 70 per cent of drinks on mit the restrictions sale are healthier options, c a lo fat, sug The figures health psychologists ar and rie, conten salt are doing little at the University of t of in to reverse the Aberdeen have revealed items o dividual trend of obesity that people overwhelmingly n NH

premise S s


UK hospital food still deemed unhealthy

bought unhealthy snacks and drinks on hospital premises. Also published in May, the audit findings have led researchers, both within Scotland and across the UK, to call for radical restrictions on junk food on NHS premises. According to a report by the audit’s authors, three-quarters of the bestselling snacks in hospital catering areas were rated as unhealthy, along with half of the most popular cold drinks. In fact, only five of the 20 top selling snacks were found to be healthy. The University of Aberdeen researchers refrained from proposing an outright ban on junk food, but did suggest that caps could limit the calorie, fat, sugar and salt content of individual items, and that hospitals should use behavioural ‘nudges’ to encourage people to buy healthier foods. This is beyond what the Healthcare Retail Standard is currently encouraging. Local level change At the start of the year, 13 local authorities were promised funding and support to develop innovative plans to reduce childhood obesity that can be shared across the country. With each of the local authorities receiving £10,000 in funding as well as targeted support to develop practical plans, the Department of Health and Social Care said at the time that five successful authorities will be selected to take their plans forward over three years. Part of the government’s Trailblazer programme, in partnership with the Local Government Association, the three-year programme will focus on inequalities and work closely with local authorities to: test the limits of existing powers through innovative and determined action to tackle childhood obesity; share learning and best practice to encourage wider local action; develop solutions to local obstacles; and consider further actions that government can take to support local action and achieve large-scale changes. L FURTHER INFORMATION



Infection prevention

Investigating infection prevention and control Leading experts in their field will present on the latest current and emerging threats and state-of- the-art research to help improve your team, your practice and your patients’ outcomes at Infection Prevention 2019 At the start of the year, the government current antibiotics stay effective by reducing published a 20-year vision and fivethe number of resistant infections and year national action plan for how the supporting clinicians to prescribe appropriately. UK will contribute to containing and The plans include targets such as: cutting the controlling AMR by 2040. number of drug-resistant infections by 10 Antibiotic resistance is predicted per cent (5,000 infections) by 2025; to kill 10 million people reducing the use of antibiotics in every year by 2050 humans by 15 per cent; and “Antim without action. Without preventing at least 15,000 ic robial resistan effective antibiotics, patients from contracting straightforward, infections as a result a dang ce is as big er to hu everyday operations of their healthcare manity as clima like caesarean each year by 2024. t e chang or warf sections or hip New technology will also e are. Tha replacements be used to gather realt w ’s e need why could become time patient data, helping a global r n urgent too dangerous clinicians understand espons to perform. when to use and preserve e.” A major focus of antibiotics in their treatment. the plan is to make sure This could be followed and

adapted all over the world, building the database on antibiotic use and resistance. Cutting antibiotic use Since 2014, the UK has cut the amount of antibiotics it uses by more than seven per cent and sales of antibiotics for use in foodproducing animals have dropped by 40 per cent. But the number of drug-resistant bloodstream infections have increased by 35 per cent from 2013 to 2017. The Department of Health and Social Care also outlined in January how the pharmaceutical industry will be expected to take more responsibility for antibiotic resistance. NICE and NHS England will explore a new payment model that pays pharmaceutical companies based on how valuable their medicines are to the NHS, rather than on the quantity of antibiotics sold. E Issue 19.2 | HEALTH BUSINESS MAGAZINE


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whilst offering the safest choice in terms of environmental impact and workers’ safety. Putting science first, Saniswiss leverages cutting-edge biotechnologies to deliver on its Safe Hygiene Solutions promise for healthcare facilities and workers. The company’s technologies to infection prevention are deliberately disruptive, truly innovative, effective and sustainable. The modern approach to infection prevention translates into a tight-knit community of passionate professionals who always look for improvements and customer satisfaction.


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Globus Group is a leading UK manufacturer of Personal Protective Equipment (PPE). The company’s approach to protecting people in the workplace has delivered enhanced safety, productivity and value to organisations across the spectrum of industries. Globus Group manufactures and supplies leading safety protection brands including; ALPHA SOLWAY® chemical clothing, disposable respirators and hearing protection; RILEY® performance eyewear; ENHA® head & face protection and SKYTEC® hand protection. In addition, Globus Group has a strong collaboration with SHOWA® gloves, partnering across the UK & EMEA regions. With a wealth of knowledge within industry, Globus also helps to bring the same level of worker care and systems into the NHS and wider healthcare sector. This includes helping

Tristel is the only company in the world to combine its proprietary chlorine dioxide technology (ClO2 ) with innovative packaging to deliver high‑performance disinfectants. The TristelTM portfolio comprises chlorine dioxide-based disinfectants for semi-critical medical instruments. The unrivalled Tristel Trio Wipes System decontaminates nasendoscopes, transvaginal and transrectal ultrasound probes, TOE probes, laryngoscopes and manometry catheters.

organisations to fight against Healthcare-Associated Infections, supporting you with PPE and RPE programs and your individual training requirements. Globus Group provides a dedicated solution for the specific needs of your staff; helping to solve a multitude of common issues within the healthcare environment. With its lightweight, comfortable and cost-effective respirators, Globus enables you to meet your duty of care and achieve high percentage face-fit test results. Globus Group can even provide a solution for smaller faces with its specially designed Alpha-S respirator.



The Tristel Sporicidal Wipe is proven effective in a uniform contact time of 30 seconds. CacheTM is Tristel’s global brand for hospital surface disinfection, comprising chlorine dioxide-based sporicidal disinfectants for use on high‑touch surfaces in patient bed spaces. Discover SHOT, DUEL, JET and FUSE on stand 37.

FURTHER INFORMATION Tel: (0)1638 721500

Infection Prevention 2019 Infection Prevention 2019 will bring together infection prevention and control professionals from around the world to share and debate best practice, research and discuss issues within the infection prevention field. This year marks a special occasion, as we will be celebrating 60 years of Infection Control Nursing.

Infection Prevention 2019 includes two supplementary one-day conferences, the first for the Development of Infection Prevention and Control Leaders and the second focusing on Infection Prevention in Paediatrics The three-day conference will present the latest scientific evidence from around the globe and is expected to attract upwards of 600 professionals. The audience is varied and will include; infection prevention control nurses, DIPCs, infection control managers, microbiologists, antibiotic pharmacists, managers as well as other colleagues in associated professions. There are many professional and business benefits to attending Infection Prevention 2019. The conference offers an excellent environment in which to learn, build relationships, exchange ideas, network and socialise with your colleagues and industry partners. You will learn from leading experts in their field who will present on the latest current and emerging threats and state-of-the-art research to help improve your team, your practice and your patients’ / clients’ outcomes. These will be delivered through a combination of comprehensive presentations, meet-theexpert sessions and specialist streams of: leadership, paediatrics, new to infection prevention and international engagement.

Infection prevention

 Health and Social Care Secretary Matt Hancock said at the time: “Imagine a world without antibiotics. Where treatable infections become untreatable, where routine surgery like a hip operation becomes too risky to carry out, and where every wound is potentially life-threatening. What would go through your mind if your child cut their finger and you knew there was no antibiotic left that could treat an infection? This was the human condition until almost a century ago. I don’t want it to be the future for my children – yet it may be unless we act. “As Health Secretary, responsible for one of the most advanced healthcare systems in the world, I could not look my children in the eyes unless I knew I was doing all in my power to solve this great threat. When we have time to act. But the urgency is now. Each and every one of us benefits from antibiotics, but we all too easily take them for granted, and I shudder at the thought of a world in which their power is diminished. Antimicrobial resistance is as big a danger to humanity as climate change or warfare. That’s why we need an urgent global response.”

Preventable infection The programme has been prepared in furtherance of the IPS Mission Statement: No patient is harmed by a preventable infection. Secondly, the programme has direct relevance to your practice; you will have learning opportunities that will motivate and inspire you to consider how your local infection prevention and control programmes could be modified to improve care and reduce infection risks. You are encouraged to participate in conference by submitting an abstract for an oral or poster presentation. Presenting will give you the opportunity to play a key part in conference, whilst also contributing towards your continuous professional development. All abstracts are to be submitted online via the conference website before the closing date on 12 June 2019. You will hear from a wide range of UK based and international speakers including Professor Brett Mitchell, Dr Tim Boswell, Dr Gonzalo Bearman, Professor Claire Rickard, David Green, Professor Jennie Wilson and many others who are acclaimed for E



Conference agenda Infection Prevention 2019 includes two supplementary one-day conferences which can be attended on their own or as part of the main conference registration. The first is a day for the Development of Infection Prevention and Control Leaders taking

At the start of the year, the government published a 20-year vision and five-year national action plan for how the UK will contribute to containing and controlling AMR by 2040 place on 22 September 2019. This oneday conference is designed for infection prevention and control aspiring and experienced leaders to help them approach the challenges ahead by providing expert workshops and presentations on behaviour, challenges and quality improvement. The second is focused on Infection Prevention in Paediatrics taking place on 24 September 2019. This day will address paediatric care across areas such as infection prevention and control, tissue viability and wound care, IV and infectious diseases. The programme has been tailored towards all paediatric healthcare workers. The Society’s social programme is equally acclaimed – especially the Infection Prevention Society Awards Ceremony and Gala Dinner, which will be held at the Rum Warehouse (Titanic Hotel) on Monday 23 September and recognises the talent and commitment that lies within the membership at a branch, team and an individual practitioner level. The annual Fun Night will be taking place at

Infection prevention

 their expertise within the infection prevention and control industry. You will gain access to an exceptional educational programme and be able to attend the largest infection prevention exhibition in the UK offering exclusive access each day to learn about new science, technologies, advances, and products that provide solutions to infection prevention challenges and strengthen infection prevention programmes. Application for Continuing Professional Development accreditation from the Royal College of Pathologists is underway. In addition, all presentations will be mapped against the IPS competences to facilitate personaliseddevelopment and career progression. In addition to the main conference programme, Infection Prevention 2019 will see the return of the greatly received Infection Prevention Show. Dr Phil Hammond - NHS doctor, BBC broadcaster, Private Eye journalist and comedian, will host this exciting event taking place on 23 September 2019. The audience will be able to interact with experts and personalities whilst discussing new ways to combat infections and how to prepare for the future.

Revolución de Cuba offering an opportunity for conference delegates and exhibitors to socialise in an informal setting. With all this taking place over a three-day conference, we hope you and your colleagues are able to join us in Liverpool for this exciting, educational and practice-enhancing conference. Microorganisms and healthcare continue to evolve; Infection Prevention 2019 is your best opportunity to stay up to date. The Infection Prevention Society (IPS) represents 2,000 members working in the field of infection prevention and control, and plays a key role in helping to protect the public. Its vision is that no person is harmed by a preventable infection. Its mission is to inform promote and sustain expert infection prevention policy and practice in the pursuit of patient or service user and staff safety wherever care is delivered. L FURTHER INFORMATION


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Panel of Experts

EXPERT PANEL PARKING In our first Health Business Panel of Experts we are joined by representatives from National Car Parks, Smart Parking, Debt Recovery Plus and WPS Parking to discuss the current state of parking on NHS sites

Fraser Richards, Smart Parking

Stewart Clure, Debt Recovery Plus

Lee Holland, National Car Parks

Simon Jarvis, WPS

Fraser joined Smart Parking in 2014. An exceptional cross-party communicator and strategic thinker, he was promoted to National Accounts and Client Services Director in May of 2018. Prior to joining Smart Parking, Fraser spent over three decades in the Royal Navy, which saw him hone his strategic analytical experience. Possessing two Masters’ Degrees, he is used to working under pressure and supports the necessity for open communication.

Stewart joined Debt Recovery Plus in 2015, having previously spent five years working in the private parking sector. Through his experience of working with clients on retail, commercial, NHS and various other sites, Stewart was able to bring his knowledge of the industry to DRP. Since graduating from Leeds University with a 2:1 in Maths, Stewart worked on the Barclays Graduate Scheme before ending up at Savills.

Lee joined NCP as the Property Director in 2009, taking commercial, technical and strategic responsibility for the Property Portfolio, which includes new site acquisition, property development, construction and maintenance. He joined NCP after 24 years with major UK Utilities where he undertook a number of different senior roles.

Simon Jarvis is the UK Managing Director for WPS, a global leader in parking systems for over 25 years, with a long-held reputation for engineering excellence and providing the industry’s most reliable solutions. It is part of Dynniq, a dynamic, high-tech and innovative company with a comprehensive knowledge of managing mobility, parking and energy using advanced systems engineering.

The government has recently announced a new project, to be led by the British Parking Association (BPA), which will create and deliver new world-leading national parking data standards, set to revolutionise the way drivers find, book and pay for parking. Set to increase parking accessibility to places across the country, notably town centres and the high street, the move has been dubbed as having the potential to transform the way we drive and park, just as the Oyster card transformed the way we travel in London. The ambition is for all parking data released by local councils and companies across the country to use the same language, with the

development of parking apps and smarter connected vehicles on our roads meaning that data could identify available parking spaces, permitted times and price. This could have an important knock-on effect for hospital parking. Good quality, well designed and properly maintained parking provision is vital to the success of Britain’s hospitals and healthcare facilities through the setting and raising of standards. Parking at hospitals and healthcare services is always going to be a soft target for the media to tell a good story about how not to do it. However, the BPA believes that providing, managing and charging

for parking at healthcare facilities needs to be seen in the context of delivering a better and fairer service to users. So given the limited funds and resources of the public sector, what are the arguments for spending tight budgets on parking? Income streams Lee Holland, of NCP, stresses that car parking revenue provides an ever-important income stream, helping to support the main hospital functions as well as giving NHS trusts the ability to develop new facilities. This is becoming increasingly important as hospitals increase their individual specialisms.

Panel of Experts

What’s more, providing the optimum quality and quantity of parking can bring additional benefits. Not only does it provide a better experience for patients, visitors and staff during what may be an already-stressful time, but it also helps reduce late or missed appointments which goes some way in helping to further reduce overall costs to the trust. Debt Recovery Plus’ Stewart Clure agrees, and says that whilst free parking for patients would be welcome in an ‘ideal world’, unfortunately the revenue generated from parking on NHS sites helps to support other NHS services. In terms of spending on budgets, Stewart says that there is a noticeable distinction between those hospitals which have considered the benefits of a technology driven approach to parking as opposed to a site which hasn’t. In fact, where a hospital has considered ANPR, pay by phone and parking sensor technology along with the many other various tech solutions in the market, there is a clear improvement to the site. Traffic flow issues are reduced, spaces are frequently available, revenue has grown and importantly complaints from users have fallen. While acknowledging that parking revenues are extremely important to hospitals to fund parking facilities and ensure that limited funds are not being diverted from other

vital services, Simon Jarvis,

managing director of How g WPS, says that there n i k can pars and are alternatives to e i t fine-based parking, i l i c fa ks n i l most notably payt r o p trans spitals be on-foot systems, that o h mitigate potential d n o t u ed aro g a frustration, such as if n a someone is delayed better me a better because of events provid rience outside of their control, e p x e often the late-running for all? of an appointment.

This is where the NHS can balance the need for returns and support well targeted services. Intelligent pay-on-foot systems that have been properly thought through for the specific site deliver a number of advantages, providing a much fairer system for the patient or visitor, as well as the necessary financial returns to the hospital. Simon says that the challenge is enormous. The Welsh and Scottish governments have both already banned paid-for hospital parking as a result of pressure from those who feel the systems are unfair. If hospitals in the rest of the United Kingdom do not invest wisely in systems that are seen to be fair and do not exploit patients/visitors and indeed staff, there is a very real risk that England and Northern Ireland may follow the Welsh and Scottish example. This would have a significantly negative impact on budgets going forward.

Demand versus supply The other issue that usually crops up when discussing hospital parking, aside from charges, is that of demand outstripping supply. However, there are a number of opportunities that have been implemented which effectively improve the parking experience at hospitals. These include Park & Ride facilities set up for staff to create more parking for patients and visitors, as seen at the Royal Victoria Infirmary in Newcastle, through to working with local authorities to create a travel plan that provides an efficient service to users. The increasing use of technology in the sector is also proving to be hugely beneficial. With users able to pre-book their parking space, for example, there is no longer the stress or frustration of being unable to park when needed and the parking estate has the additional benefit of being able to directly contact customers and promote alternative parking facilities. But how can parking facilities and transport links around hospitals be better managed to provide a better experience for all? Hospital management teams often see issues arising from parking at NHS sites where users are not paying for the correct length of stay, staff are parking without displaying permits and users are parking in restricted areas because there aren’t any available spaces on site. Unfortunately, there will always be a level of parking abuse which will remain regardless of which type of parking management is in place. E Issue 19.2 | HEALTH BUSINESS MAGAZINE


Panel of Experts

 The main type of abuse which can be controlled and reduced is that of the persistent offender and the commuter abuse. Persistent offenders are typically staff, residents, visitors – anybody which feels that they can ‘get away with parking for free’. These offenders fall into a category where some levels of offenders can have 10, 20, sometimes more than 100 offences – with no retribution. In these cases, the persistent offender needs to be issued with litigation papers which will help to stop the persistent abuse at site. Through working closely with the parking operators, NHS teams can identify their level of abuse, look at the category of abuse and work together to plan an effective management parking programme on the site which will help to reduce the number of issues raised from demand outstripping supply at each site. Key to a fair system is information and data. It is possible nowadays to link real-time information on car park usage not only to digital car park signs, but also to hospital websites and apps. If the user is able to see that a car park is extremely busy prior to making their journey this allows them to consider alternative travel arrangements. All of which raises the ongoing issue of improving the patient experience. By and large, there has been positive investment that has improved the state and maintenance of hospital parking. There are however still some hospitals that are opting for low-cost, poor-quality parking solutions which deliver

Whilst free parking for patients would be welcome in an ‘ideal world’, unfortunately the revenue generated from parking on NHS sites helps to support other NHS services an unreliable customer experience, not just for patients and visitors, but also with the staff who are at the front line of the frustrations expressed by car park users. Simon Jarvis says that good procurement practice is essential in this respect and we all too often see tenders which value price significantly above performance and customer experience. The quality of the car parking estate across the NHS varies dramatically from trust to trust. Some have large expanses of surface car parks in various states of repair while others have invested in new, high-quality parking facilities for the benefit of both staff and visitors to the hospital. That being said, there is not one solution for all hospitals. Lee Holland says that the needs, opportunities and challenges vary from one hospital to the next which is why NCP always works closely with its partners to create a solution for their specific requirements. The car park is of course an important part of someone’s experience at a hospital, often

being both the first and last part of someone’s interaction and so there’s value in investing in it. While the extent of this investment can vary, Lee believes that a place where users can easily find a space and feel the tariff provides value for money, as well as a space that is safe, clean and easily accessible is fundamental. DRP has also worked with clients on a mix of NHS sites over the last 10 years, during which Stewart Clure has seen more and more NHS sites work with the automation of enforcement and the addition of an on site ‘team’ to help resolve first-hand problems. As expected with most new technology, this sometimes results in cases where patients cannot understand the new system or are simply unaware of any changes to the old set up. An ‘on-site’ team can help to reduce any conflict and answering any questions which may lead from mis-interpretation of a new parking management programme. Therefore, it is vitally important that when any NHS site is considering introducing new

Going green According to the British Parking Association, approximately two thirds of the half million parking spaces across the NHS in England are used by staff, which means up to 300,000 staff use their car to get to work. So, if drivers were offered alternative modes of transport and encouraged not to use their cars or car share, this could have a significant impact on reducing nitrogen dioxide levels. In particular, it is diesel cars (42 per cent) and vans (33 per cent) that emit the most nitrogen dioxide. Health Business Awards short-lister for the Transport and Logistics Award, Western Sussex Hospitals NHS Foundation Trust were recognised for introducing their comprehensive green staff travel plan. A staff travel survey revealed that 64 per cent of their 7,000 staff across their three hospitals; Worthing, Chichester and Southlands, drive on their own. The challenge was to encourage them to travel differently. The waiting list for parking permits had been closed to new applicants for over five years. Something needed to be done. An over-allocation of staff permits meant that five years ago it was not uncommon to see staff waiting in the car park for a space, as four permits were issued for every-one space. Now only 1.8 permits per space are allocated. The trust took the decision that providing green alternative travel options was a priority, especially with a predicted staff increase and a reduction in parking spaces over the next five years. A full survey identified where staff travelled from (a heat map revealed the popular journeys) and the willingness of staff to switch from their car if alternative modes of transport were on offer. For example, some said they were able to switch but not willing. It was going to be difficult to predict just how staff would change their travel mode until it was actually on offer, and importantly encouraged to give it a go. Three working groups were set up; green initiatives (cycling, motorcycling, walking, public transport), alternate parking (cross site minibus, Park & Ride) and on-site parking (permit usage, car share). The trust did not take the easy route and tackle on-site parking first, they set their sights on improving off-site parking and created not one but two Park & Ride car parks outside of the main hospital sites. They installed secure parking for staff cycles and motorcycles with improvements to changing and even drying facilities and lockers. They even signed up to the discount travel company Easit which gives a 15 per cent discount on public transport to all staff who also join the scheme.

Leading the way As mentioned previously, off-site parking facilities, such as Park & Ride that reduce city centre driving, and car sharing schemes, are key to supporting green initiatives and reducing carbon emissions. Within all car parks, electric vehicle charging points are also becoming increasingly important in facilitating the government’s drive in going electric. At present, the cost of electric charging is covered by the hospital, but this is something that may need to be re-considered when more vehicles require the service. Lee Holland goes on step further by saying that the parking industry is leading the way in green travel, investing resources in research into and implementing new solutions. NCP has been installing electric vehicle charging points for 15 years but Lee knows that the industry needs to continue to look forward and plan future changes in consumer travel patterns. For NHS trusts, therefore, there is a real opportunity to embrace change by working with parking providers and utilising their expertise in the area. Car sharing, Park & Ride schemes and cycle hubs within car parks are examples of how this can be done, but it is equally important to have green travel at the heart of the car park design.

Debt collection for parking Returning again to the topic of technology in parking, reviewing NHS portfolios for debt recovery shows a significant difference in the recovery rates on a site which has implemented an efficient, tech driven model to one that has not developed the site and as such their recovery rates have stagnated. The use of debt collection is, quite rightly, viewed as highly sensitive by both the NHS and providers, such as Debt Recovery Plus. Fraser Richards says that, whilst the use of a specialist debt collection agency offers significant benefits, the management of this facility, especially within the health environment, requires careful management. That said, this facility will, over the course of a protracted period, offer a revenue stream that should not be ignored, especially as it is designed to address offenders that have abused NHS facilities. In order for this facet of the car parking management offering to be successful, it is absolutely necessary that the communications between the respective parties are open, honest and totally transparent. Following this, says Richards, this revenue stream becomes a vital part of keeping monies flowing throughout the process.

Panel of Experts

IT solutions to their site or simply changing the way that visitors need to pay, that they inform the visitors and staff in advance through a structured information marketing campaign around the hospital. Stewart also indicates parking scenarios where some of the money raised from enforcement or perhaps pay by phone revenue is offset to help towards improvements on the structure of the site and towards daily maintenance.

It is important that when any NHS site is considering introducing new IT solutions to their site or simply changing the way that visitors need to pay, that they inform the visitors and staff in advance through a structured information marketing campaign The benefit of working with parking operators is that we do this by nature so, as an example, can advise on reducing the amount of time a customer needs to spend driving around trying to find an available space, or the exit, thus helping to reduce unnecessary emissions. More and more sites are pushing the EV charging bays, with NHS sites starting to consider the positive effective this can have with visitors. We have also seen a rise in the share a space drive to work campaigns for staff. An initiative which started out at one hospital as an effort by a department to help to reduce the impact of their vehicles on the environment when driving to work each day quickly turned into an approach which was rewarded by the hospital itself when it implemented the car share initiative throughout the site. The hospital was able to free up 20 per cent of staff parking and introduce this to pay and display visitor parking which helped to reduce visitor parking issues and generate extra revenue towards the day to day maintenance of the site. Travel plans are a great idea in theory. However, as Stewart Clure stresses, the cost to implement and maintain are a cause for concern and possibly a reason why it hasn’t taken off in the NHS.

Debt Collection within the parking industry is a necessity which helps to ensure that any offenders who don’t pay are accountable. There are various ways to identify and recover on unpaid debts, but it is through close working relationships between the NHS management team and the parking operator which helps to identify cases and decide on appropriate recovery action to take against troublesome offenders. Through the debt recovery of unpaid charges, we can help the NHS sites to increase their parking charge revenue by approximately 20 per cent, which can then be used to maintain and effectively manage the day to aspects of NHS parking. The BPA is dedicated to making parking a recognised profession and raising standards in parking management. The Professionalism in Parking Accreditation (PiPA) is an accreditation programme, supported by the Department of Health, focusing on healthcare parking. This builds upon the existing voluntary hospitals parking charter and will enable hospitals to work towards a nationally accredited standard for their parking services. L




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Smart Parking: leading edge data on car park occupancy and sensor technology Smart Parking manages over 400 ANPR car parks in the UK. This experience as a car park operator makes them an ideal supplier of car park management services, to clients seeking an end‑to‑end solution

As well as being a major UK car park management company, we are the world’s leading manufacturer of bay sensor technology. Thus, both through our ANPR and sensor service offerings, we provide leading edge data on car park occupancy and usage patterns. In a hospital car park, for example, sensors can be installed in ‘defined use’ bays such as ambulance waiting bays or maternity car parks. Challenges of the healthcare setting We recognise that car park management is not a “one size fits all” solution. In a healthcare setting, car parking is a highly emotive subject and operates within a politicised environment. It is important, therefore that car park management is done sensitively, and with due regard to the challenges of the healthcare setting. Put bluntly there is no ‘good news story’ in issuing Parking Charge Notices (PCNs) to patients, visitors or staff. It is our philosophy, therefore, to manage car parks in a specific and differentiated way. Easy payment options Measures we take which reflect this approach are aimed at making the customer journey ‘incidental’ to the experience of visiting a hospital or other healthcare premises. Our solution includes chip & pin and contactless payment options as well as via Pay-by-Phone. The solution enables people to make payment upon exit and to make payment once they have left site via our cashless payment provider. Management fee‑based contracts Unlike most operators we do not have a


heavy-handed approach akin to ‘we will have to issue so many PCNs a week’ to achieve income targets. Our business model emphasises the use of management fee‑based contracts, therefore removing the incentive to issue more PCNs as a means of maximising income. This approach is particularly useful in hospital settings where we show a large degree of flexibility and a customer service ethos, given that patients may on occasions overstay through no fault of their own. Our membership of British Parking Association (BPA) and adherence to Parking on Private Land Appeals service (POPLA) gives further assurance in this regard. Dedicated account management The provision of dedicated account management underpins our tailored approach to the management of car parks for NHS or other health sector clients. The account managers have expertise in managing NHS contracts. They are responsible for the mobilisation phase of the contract and for all ongoing client liaison throughout the duration of the contract. For many sites we offer an informal uniformed presence during an initial ‘honeymoon period’ and at peak times. The honeymoon period allows us to be on site, prior to issuing PCNs. Our staff will be on hand alongside trust staff to explain about the regime and to demonstrate how to make payment. We are aware that disadvantaged and vulnerable drivers will visit NHS sites. We take measures to ensure that such service users are not penalised from a parking perspective.


Disability friendly requirements We fully comply with all legislation, including the Disability Discrimination Act 1995. We are members of and work closely with Disabled Motoring UK. They advise us on ‘disability friendly’ requirements of our solutions. We welcome input in areas such as accessibility of signage, payment machines and usability such as keyboard positioning and size. Permit parking We also offer and manage ‘white lists’ which are compiled to accommodate permit parking for season ticket holders. In a hospital car park this facility will be extended to include service users and patients identified by our client. These may include frequent attenders at outpatients such as dialysis patients, or those receiving palliative care, meaning they do not have to pay for parking or do so at a highly reduced rate. Smart Parking’s status as an approved supplier on the NHS Shared Business Services (SBS) Car Park Management and Infrastructure (CPMI) Framework shows our commitment to working with NHS trusts. We adhere to and fully support ‘Health Technical Memorandum 07-03: NHS car parking management: environment and sustainability’. This is a key reference point for the framework, and indeed our operations. The memorandum states that: ‘Contracts should not be let on any basis that incentivises additional charges e.g. ‘income from parking charge notices only’. The contents of the Memorandum are entirely consistent with our philosophy, approach and business model. We regularly attend sector interest groups, including the BPA Healthcare Special Interest Group. At these forums our senior executives get the discuss trends and policy initiatives, outside of the constraints of contractual relationships. Under the framework any eligible public sector body can appoint Smart Parking directly using our ANPR solution as anchor technology. Smart Parking is a reliable and experienced car park management company. We bring our expertise to the healthcare market, fully conversant with the challenges presented by the sector, and equipped to provide a professional service. L FURTHER INFORMATION Tel: +44 (0)845 230 3081

Debt Recovery Plus (DRP) is the leading provider of debt recovery services to the private parking industry, providing debt recovery and back office solutions to 90 per cent of the industry, handling over 120,000 unpaid parking charges each month

Based in a call centre environment we have a core telephony team who can handle incoming and outgoing calls to motorists to help resolve any issues, answer questions and ultimately settle any unpaid parking charges. We can handle client payments 24/7 via our web/automated services along with our dedicated team of advisers. Debt Recovery Plus have been the chosen provider of debt recovery services to the leading parking operators for over 10 years, helping our clients to grow along the way. By working closely with the operators, we have helped to strengthen the parking industry through educating and challenging each other with new ideas.

Delivering a one stop enforcement solution Recently Debt Recovery Plus became part of the Bristow & Sutor Group, who are one of the largest providers of debt recovery to the public parking sector. Together with B&S our aim is to deliver a one stop enforcement solution to all our clients. With over 40 years of enforcement experience within the group we can offer our clients advice based upon our knowledge of both industries along with tried and tested solutions to help our clients maximise revenue recovery whilst protecting their data. Data reports At DRP we know how important each and everyone of our client’s parking charge notices are, which is why we employ client specific teams to analyse the data and report back on any trends, unfamiliar patterns and unusual cases. This helps our clients and landowners to identify persistent offenders and review their parking management strategy to ensure that they are offering their client a suitable solution.

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Debt recovery services for the private parking industry At DRP we create bespoke recovery strategies for all our clients, which helps them to deliver an educated recovery model designed specifically for the industry which they are working. We can provide recovery for clients on Commercial, Residential, Retail, Rail, Airport and NHS sites. Our aim is to deliver an ethical approach to debt recovery to help our clients capture any unpaid parking charges whilst at the same time allowing the motorist an opportunity to discuss their case. Within our group our priority is our client’s data, when making any decisions on strategy, reporting or collecting on a case Compliance is our first thought. When GDPR was introduced we decided as a group to implement a GDPR team at both of our offices. Our GDPR teams implement compliant processes and practices at each office along with helping our clients with any GDPR questions which they may encounter along the way. L FURTHER INFORMATION



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Torbay puts trust in WPS’ parking solutions The issue of parking within hospitals is constantly in the news and evokes strong emotions from all sides of the debate. Finding the balance between meeting the cost of delivering a service with providing a customer experience that is sensitive to the environment is no easy task. Convincing employees that parking is not a right, but a privilege, is also a challenge

In the vanguard of industry thinking is Joanne Brimblecombe, the Sustainability and Site Services Lead within the Estates and Facilities Management Division of Torbay Hospital, part of the Torbay & South Devon NHS Foundation Trust. And supporting Joanne and her team in delivering their vision is parking technology specialists, WPS. Jo explains: “Parking should be fair for all not free for all, and we support concessionary parking on our trust site.” Complex site The Torbay Hospital site, while not especially large, is still noticeably complex. The diverse nature of the portfolio required a mix of solutions to be delivered: for the larger car parks, and staff car parks, a Pay on Foot solution is preferred, with barrier controls; for the smaller car parks, typically with a capacity of 20 vehicles or less, Jo has opted for Pay and Display. Jo says: “Department of Health guidance recommends that ‘NHS organisations should consider Pay-on-Exit systems’. This is considered best practice and will improve the patient and visitor experience. Our site does not lend itself to only being able to offer one solution due to car park sizes so an option of both Pay on Foot and Pay and Display has been adopted and WPS has been able to offer Pay-on‑Exit and Pay and Display solutions.” Alongside managing a portfolio of approximately 650 visitor parking spaces, it also had to accommodate large volumes (up to 1,100 spaces) of staff parking. It had to achieve all of this while ensuring vital highways (i.e ‘the blue routes’) were kept clear, so that emergency vehicles would not be held up by vehicles queuing on the surrounding roads.

having reliable systems that are easy to use, and easy to configure to manage concessions and other specific requirements.” The staff parking experience is similarly important: “At Torbay, we provide staff parking, and staff have to pay. They can do so either on a monthly basis, or pay as you go, but in both cases they use their NHS smart card that acts as an ID badge, a payment card, and a card to operate the barrier.” In terms of visitor concessions, Torbay has adopted an innovative approach that gives them total discretion and control. Thanks to the full TCP IP architecture of the WPS ParkAdvance systems installed, concessions can be easily accommodated. Jo explains: “We have three scanners at various reception desks connected over our local network and several hand-held USB devices in the wards simply connected to ward PC’s.” Discretion and control This level of control helps to avoid one of the biggest challenges every hospital faces. On the one hand, revenues are important to meet the cost of managing the parking estate; on the other, a recently bereaved visitor or patient just diagnosed with a serious illness does not need the additional stress of a Penalty Charge Notice.

Customer experience Jo explains: “Parking is the first experience our patients and visitors have of our hospital. It needs to be as smooth, hassle-free and as comfortable as possible, and that means



Unauthorised and unwanted parking also has to be managed, and abuses minimised. Torbay Hospital manages to achieve the balance it needs, thanks in no small way to the flexibility of the WPS technology. Jo concedes: “WPS technology was not the cheapest solution but offers the right level of technology, reliability, and ease of use. Its Pay on Foot systems have undoubtedly helped us to maximise our parking revenues.” In selecting a parking solution, and an equipment provider, Jo considered various options and suppliers. Among them was a system based on Automatic Number Plate Recognition (ANPR): “We did consider ANPR and there is a place for ANPR in hospital parking, perhaps in the future. But operators who install systems that rely on enforcement and PCNs for their revenues can sit very uncomfortably in a hospital scenario.” Another option considered, was one centred around chip coins: “We looked at chip coins but they are very expensive to replace and easily lost,” she says. “They also need to be hygienically cleaned to prevent the spread of infections.” Jo is excited by what the future holds. She says: “The principal advantage of the WPS technology is that it is effectively future proof. That enables us to think freely and differently about what we want to achieve to enhance the customer experience, knowing that whatever we do, the WPS technology will enable us to do it.” L FURTHER INFORMATION Tel: 0845 094 1543 wpsparking

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Car parking presents opportunity for NHS Trusts The question facing NHS Trusts is often one of whether the car parking operation should be seen as a cost to be concerned about, particularly as securing funding is becoming increasingly challenging, or if parking should be seen as a potential investment that supports their income and yields a return. NCP believes that it should be viewed as the latter Car parking presents an opportunity for NHS Trusts to make use of existing assets to generate a return that can be invested in supporting patient care to the benefit of the whole community. While this cannot come at the cost of over-charging patients, staff or visitors, we believe a balance can be struck by ensuring that those who use car parking facilities see value in the price they pay. Investment in the experience The challenge for many Trusts is the cost of updating and improving car parking and the ongoing investment required to maintain standards. Many use out-dated equipment and payment methods – often offering only cashupfront or timed payments which can cause a sequence of issues for those who must use them. This is in contrast to the modern retail car parking environment, for example, where the customer experience is about getting them closer to where they want to be. Frustrations include paying in cash only, worrying about over-stays and potentially incurring a penalty, plus the stress of finding a parking space, all while there may be far bigger issues for customers to be concerned with – their health or the health of a loved one or patient. Working with an established, trusted brand which has invested millions of pounds in developing tools to make the car parking experience seamless can assist in overturning these years of under-investment. Adopting pre-book for those who have

planned visits to hospitals or clinical facilities enables customers to be assured that they will have a space when they arrive, as well as lowering the environmental impact of drivers ‘circling’ as they seek a space. Introducing technology-based payment solutions means that visitors have a less fraught experience. Not only does this make payments simple and straightforward as an alternative to cash, these solutions also offer the ability to pay post-event, meaning that when they are in a rush and have others things to worry about, parking takes its rightful place on visitors’ lists of concerns. Furthermore, by making payments simpler – for example by implementing Automatic Number Plate Recognition (ANPR) technology – NHS Trusts can reduce the incidence of non-compliance (which can lead to penalties being issued by over‑zealous operators and hence understandable ill‑will). NCP’s experience is that, as the ease of compliance increases, the incidence of under- or non-payment falls dramatically. Investment in space While these improvements – which an established operator like NCP offer – are one set of solutions available to NHS Trusts, there are more extensive investments that a business like ours can offer. At their simplest, these might include support in the quality of design of car parking – ensuring they are easy to use, secure spaces for visitors that offer safe, well-lit environments for sometimes vulnerable users.

More ambitiously, where space and planning allow, operators can work with the trust to deliver new multi-storey facilities on land previously used for surface parking that not only dramatically increases capacity, but also frees-up land and allows capital to be deployed for clinical facilities. Partnering with established operators offers the opportunity to create a lease product that will attract external investment or use, what are termed ‘income strip deals’. While this relies on working with businesses that have a strong covenant and financial stability, NHS Trusts can realise the value of car parking over a long-term agreement. Under these leases, land is offered to an operator on a long-term (often 35 year) agreement in return for an agreed income. This also removes the exposure to the life‑cycle maintenance costs for the trust. At the end of the lease term the land is ‘sold back’ to the NHS trust for a pre-agreed token sum. This allows an operator to invest in building the car park, installing technology and operations over the long term, whilst an NHS trust benefits from the delivery of new parking facilities at nil capital cost. Through this broad variety of solutions, partnering with an established car parking operator with shared values ensures that customer care is at the core of decisionmaking and operations, and can yield a variety of benefits if NHS Trusts believe that car parking can be an investment rather than a cost. Working with NCP can realise that opportunity. L FURTHER INFORMATION



Designing and manufacturing parking management systems across the UK The Metric brand is synonymous with parking, with over 60,000 parking meters in over 45 countries. Wherever parking control and integrity matter, trust METRIC to deliver the system for success. METRIC’s pay and display systems control more than one million car parking spaces in 1,000 towns and cities around the world. Metric Group Ltd is a leading UK manufacturer and supplier of parking equipment. The company works directly with NHS trusts and private healthcare providers to supply smart Parking Management Systems (PMS). Metric offers both Pay & Display (P&D), Payon-Foot (PoF) and ANPR Parking Management Systems (PMS), allowing it to meet all needs and requirements at healthcare facilities. The organisation can accommodate all payment methods from cash to contactless with a range of unique features from twin printers for double ticket capacity to HD video screens to communicate to your patients or provide additional revenue streams. Metric’s comprehensive software not only provides complete visibility for managing hospital car park facilities but fully integrates our P&D and PoF system back-offices. Additionally, Metric can integrate third-

party management systems as required. Interserve Support Services approached Metric to review the vehicle management of their main car parks at the Infirmary. These were originally operated via a Pay & Display regime, which required intensive third party management to administer it. Interserve had identified this methodology was becoming increasingly unpopular with the enforcement of parking fines creating a negative response in the local community and added additional unwelcome stress on all hospital staff and visitors. In consultation with Interserve, Metric Group conducted a full review and site survey. The company’s specialist’s teams implemented a ‘Turn-key’ plan to upgrade from the old P&D systems to a new state-of-the-art ticketed PoF, including pre-sales design and consultancy, installation (Civils works), commissioning and servicing, all overseen by a dedicated project

Patient Care starts in the Car Park Pay & Display Terminals • All Payment Means accepted including Contactless • Permit / Voucher Scanning for Staff or Patients

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team ensuring on-time delivery and minimal disruption and down-time throughout. Interserve’s faith and investment proved itself worthy from the get-go, not only providing a much higher ‘Customer experience’ for all, but also immediately more than doubling the revenues collected for parking. Steve Pearson, Interserve’s contract director stated: “We are delighted at the performance of the new Metric Amano Pay on Foot System. I must admit I did anticipate some challenges with the project, but I am delighted to report Metric took full control and provided a seamless transition.” FURTHER INFORMATION Tel: 01793 647800


Should NHS budgets be spent on parking? Should patients using NHS services be charged for parking? It is the topic that refuses to drive away. Glenn Dives of the British Parking Association explores the current situation

of money that

the costs of maintenance be paid from? Those maintenance costs in the form of surface repairs, painted lines and grass verges would have to come directly from healthcare budgets, either centrally funded or from the operating budget of the local NHS trust. This is unfortunately the reality of the situation - if those sites are not maintained then they can become dangerous. But funding NHS car parks like this is likely to become a contentious issue and is the first reason why we feel free parking at hospitals doesn’t protect the most vulnerable in our society. This issue is not limited to the existing parking infrastructure of hospitals, it is an ongoing one that could have significant effects on the behaviour of administrators for years to come. This was evidenced when the Bill was proposed in the House of Commons. James Duddridge, Conservative MP for Rockford and Southend East, highlighted his concern that capital expenditure will not be found to provide more parking spaces. He believed that future capital expenditure on car parks would be limited, because there would be no revenues associated from the expenditure. E


Written by British Parking Association

There is always a great deal of comment Is anything free? about parking in hospitals. Parking facilities I’m sure everyone is familiar with the saying at hospitals are usually oversubscribed with ‘there’s no such thing as a free lunch’. demand often outstripping supply, and, for this Everything built or maintained by people reason, parking facilities and transport links has a cost associated with it and that goes need to be effectively managed to provide a for parking. There is no such thing as a free better experience for all, whether they are a parking space – somebody, somewhere is patient, visitor or employee. In some cases, paying for it. This is true everywhere: in town this has led to hospitals charging for parking, centres, at the beach, in the countryside and resulting in political and media attention at the hospital. While some NHS car parks and calling for the abolishing of all charges. Such car parks in general may be free at the point of calls resulted in a new Bill which begun its use the upkeep and maintenance is provided progress through the House of Commons from somewhere else. If it is being patrolled in November 2017, sponsored by Robert to keep users safe, then someone is paying Halfon, the Conservative MP for Harlow. The for that too. These operating costs will not Bill sought to ban the charging for disappear if the charges at point of use parking spaces in England’s NHS are abolished. The question of how hospitals and, while it was and ultimately who is funding well intentioned, it failed to this service remains. Not on address several practical Hospital parking is no of the m e issues concerning the exception to this rule. a n y cries fo provision of parking. If hospital parking r f u rther NHS fu Indeed, it may be was not charged for n a case where the at the point of use, as parkingding desires t proposed cure may be proposed by Halfon’s o b e the recipien worse than the disease. Bill, then where would t



All aspects of parking control and enforcement using the latest technology and software on the market Warden Patrol Ticketing Parking Charge Notices have been widely used throughout the UK for many years by local authorities and now, housing associations, managing agents and private land owners can also benefit from this enforcement system.

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We can supply and install pay and display machines, which take cash or credit card payments. These are battery operated machines with integrated solar panels, therefore no mains power supply is required.

ANPR Ticketing ANPR (Automatic Number Plate Recognition) uses hi-tech CCTV cameras that are monitored using wireless GPRS to automatically issue Parking Charge Notices.

DIY Ticketing This is the enforcement method that puts you in total control and can be tailored to any clients needs, from single to multiple spaces.

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 He went on to ask the question ‘what happens in cases where existing car parks are being built?’. If those plans anticipated a revenue stream following a car park’s construction, the removal of the charges would undermine the budgeting process for the expenditure, possibly leading to the cancelling of the construction of that car park. He also believed if demand for parking increased in the future, that there would be no market mechanism to enable more car parking spaces to be built to cater for it. In the end, he conceded that while the ‘Bill is a popular move—it would be popular with my constituents’, but concluding that it didn’t mean it was the right thing to do. Patient accessibility Beyond the financial and budgetary concerns there is some real-world experience of removing parking charges, which those supporters of the Bill in Parliament, the media and the wider public space, should consider. When parking charges were abolished in hospitals in Scotland and Wales patient accessibility didn’t improve; instead nearly all the spaces were taken up by commuters and staff to the detriment of visitors and patients. And because demand wasn’t managed properly it spilled onto yellow lines, grass verges and nearby residential streets. In some cases, bus companies refused to offer a service because they couldn’t get through, further disadvantaging the most vulnerable from accessing the hospital. Finally, there are cries all the time for more money to support the NHS, but not one of those desires parking to be the

Hospital parking is a complex issue which stirs ups a range of emotions, that is why it should be looked at as dispassionately as possible, weighing up the evidence before deciding recipient of that money. For someone who needs treatment, they would not want the hospitals budget to be spent on parking facilities either. What they would want is to receive their treatment and to access the hospital with as minimal amount of stress as possible. We believe that healthcare budgets are for providing healthcare, not parking spaces and with that in mind we contend that there should be some exemptions for long term or vulnerable patients who would receive discounted or free parking. But how to achieve this? Availability and demand We would advocate that charges must be reasonable and reflect availability and demand. That a concessionary system should be given to the following people if public transport may be impractical for them or if parking charges could become a burden over time: disabled people; patients with a long-term illness or serious condition needing regular or long-term treatment (for example, people having dialysis, radiotherapy or chemotherapy); visitors (such as careers) who need to visit patients regularly; staff working shifts that mean

public transport cannot be used; and other concessions, e.g. for volunteers or staff who car-share, should be considered locally. Where such a system is in operation, NHS trusts and operators should work together to make sure they give the maximum publicity to such concessions and that they are taken up by eligible patients. We have long been interested in this topic, publishing a Charter for Healthcare Parking in 2010 and working with the Department of Health in updating parking guidelines for NHS trusts, which was published in March 2015. The guidelines include case studies of good practice that other NHS trusts are encouraged to emulate. NHS patient, visitor and staff car parking principles - Rules for managing car parking in the NHS is an excellent guide to good practice that we commend to all trusts and parking operators to ensure they strike the right balance between being fair to patients, visitors and staff and ensuring facilities are managed effectively for the good of everyone. No one enjoys a visit to a hospital or a doctor’s surgery. If someone does make that visit, it is generally because they are ill or are visiting a loved one who is ill. Why, on top of that, should they feel stressed about parking? It does not help them if a doctor, nurse or surgeon is also stressed about parking too. A professional organisation should look to manage its car parks and take steps to help minimise anxiety. Hospital parking is a complex issue which stirs ups a range of emotions, that is why it should be looked at as dispassionately as possible, weighing up the evidence before deciding. Finding a resolution to this situation is not difficult and our suggestions above could prove the basis for such a solution. The British Parking Association stands ready to work with any and all organisations involved to find a reasonable solution suitable for all parties involved. L FURTHER INFORMATION



Providing the best fire suppression systems for data centres across the UK

Fireworks Fire Protection Ltd specialises in the design and installation of high-pressure water mist systems for industrial and commercial applications and has gained vast experience from many data centre installations across the UK over the past 25 years. Data centres are at the heart of the IT infrastructure and are essential for day to day business operations. It is therefore crucial that data centres are fully and properly equipped with state of the art fire suppression systems. The high levels of power used and subsequent heat generated in server systems are the principle causes of fire in data centres. With data centres now covering hundreds of thousands of square metres, a small fire caused by a fault in just one piece of equipment or wiring can potentially spread to cause incalculable damage to

the operator’s assets and reputation. Technological advances in fire suppression for data centres over the last twenty years mean that gas and chemical-based solutions developments are becoming obsolete. Amongst their disadvantages are the facts that they usually involve releasing chemicals over a wide area and require ventilation systems to be shut down to remove oxygen. Electrical supply often has to be cut and clean-up operations take time. Staff safety, damage limitation and the amount of downtime are all major disadvantages with these traditional solutions. More and more data centres have therefore been turning to high-pressure water mist solutions. These systems comprise a tailormade network of nozzles, which release micro-fine particles of water exactly at the point of the incident. While the localised fire is quickly extinguished, the remainder of the data centre’s operations and equipment remain unaffected and can be kept up and running. The solution is completely harmless to staff and equipment and, as only minute amounts of water are used, is quick to clean up. The key benefit of high-pressure water mist fire suppression solutions are the

extremely low levels of water used. Using a high-pressure pump, clean water is forced through a specially designed, tested network of stainless steel pipework and nozzles at 100bar. The microfine water droplets emitted have sizes ranging from 50 to 200 µm. They quickly vaporise to cool and extinguish the fire, by displacing the oxygen around the fire zone. With this localised response, only the nozzle at the affected point is triggered and hardly any trace of water remains after activation. The area does not need to be sealed in the same way that a gas suppression system requires and ventilation does not need to be turned off. Energy supply and business operations can continue as usual. Fireworks, began pioneering highpressure water mist solutions for data centres over two decades ago. In partnership with Danfoss, the company has successfully designed and installed systems in several major data centres. FURTHER INFORMATION Tel: 0207 205 5793

The fire fighting system that protects all areas of your data centre Introducing the SEM-SAFE® high-pressure water mist fire fighting system One single system covers all data centre fire fighting applications Provides instant cooling in the fire zone Allows you to keep ventilation running and doors closed Environmentally friendly and harmless to personnel Localized protection Compact pumps with small footprint No expensive refill costs Suitable for new and retrofit data centres FM tested and approved

To find out more about how you can protect your data centre contact our team today: London 0207 205 5793 | Manchester 0161 452 7122 | Glasgow 0141 308 8494 | Fireworks Fire Protection Ltd, Amber House, Station Road, Attleborough NR17 2AT

Fireworks have been designing and installing high-pressure water mist systems throughout the UK for over 25 years and are the UK’s authorised distributor for the Danfoss SEM-SAFE® high-pressure water mist system for fire fighting.



Data centres

Maximising your capacity and preparing for the future Writing for the The Data Centre Alliance, David Leatt talks about the specific data centre needs of hospitals, using Rampton Hospital as a case study Rampton Hospital is one of the UK’s three high security psychiatric units and part of Nottinghamshire Healthcare NHS Foundation Trust. It is a major provider of mental health, intellectual disability and community healthcare services employing around 9,000 staff. The hospital provides integrated and coordinated care and support to not only those using their services but also responsibility for a wide range of roles, including handling around 190,000 patient appointments every year. 2bm, a company specialising in the design, build, refurbishment and upgrade of server rooms and data centres, were challenged with building a reliable and scalable data centre in the heart of a secure location without any disruption to the existing services. The brief wasn’t simply to design and build a data centre to a high standard either - it needed to be best in class. In addition to the extremely high specification, the trust’s facility had to be built for the future, with the flexibility to expand the load of the data at any time – again without creating any disruption to existing services. Thanks to the highly efficient, low carbon and sustainable modular design provided by 2bm, the trust now finds itself once again at the forefront of data centre technology and with the space for future growth and expansion. From conception to completion The hospital’s mission is one of continuing to work with commissioners, patients, carers and staff in leading the development and provision of high quality, cost effective, secure forensic health care. However, to meet these goals, Nottinghamshire Healthcare required the necessary infrastructure to be at Rampton. With an existing comms room elsewhere on the site, the trust made four ground floor offices available for refurbishment; three to be transformed for the data centre and an adjacent room to house the switchgear. The data centre also had to be a highly efficient, scalable

solution built within the current confines of the existing listed building but still requiring a low cost OPEX in terms of energy consumption and future maintenance. The facility, once completed, had to also last for a minimum of 15-20 years. From conception to completion, the project was not without its challenges. First, like many hospitals in the UK, the site was restrictive as the structure was an old Victorian building. Aside from being long and thin in shape, the rooms had limited ceiling heights and no space for the introduction of a raised floor. This meant traditional down flow cooling was unsuitable. Second, as the facility is located in the middle of such a high security area, entry and exit to and from the site was not straightforward. Every item entering and leaving the site was scrutinised with tools audited and checked and all deliveries and waste closely monitored. Similarly, with the restrictive nature of freemovement, items such as mobile phones, laptops and other technological equipment critical for installation work was prohibited. The solution that the 2bm team ultimately delivered was constructed to allow for modularity, low cost OPEX and future expansion with virtually zero disruption to the day-to-day running of the hospital. The room itself provided maximum visibility to both the IT department and the Estates department in terms of the operational components, energy use and fault altering. Other benefits of the 2bm design incorporated rear door cooling and the very latest developments in technology, providing an efficient cooling solution within the restricted space. At the same time, the new modular, highly efficient and highly redundant cooling plant solution allowed the connection of the new IT enclosures to a central system in order to maintain an overall low PUE. By installing completely new electrical systems and switch gear, 2bm significantly minimised future risks whilst still providing a high level of redundancy, using one

room supply for IT equipment and the second for cooling equipment. An existing site-wide generator was also utilised as part of the scheme, with UPS protection introduced via a modular UPS with N+1 power modules to provide reliance. Meanwhile, high density IT racks with 100 per cent expansion were also introduced in order to double the capacity. In addition, anti-static data centre flooring, VESDA and fire suppression system and environmental monitoring solutions were installed. These were followed by simulated load bank testing and failover IST testing and a specialist data centre clinical clean prior to final handover. Design success Commenting on the completed project, Russ James, ICT Facilities Manager at Frampton Hospital, said: “The data centre has been designed and built to the highest standard, allowing Nottinghamshire Healthcare NHS Foundation Trust to showcase as an exemplar in the provision of data centre services and innovation.” Going forward, M&E expansion plant has been incorporated within the design, and this can also be connected in the future without disruption to operational IT services. The project itself received significant industry praise and, ultimately, became shortlisted for a national NHS Sustainability Award in recognition of the trust’s investment in the upgrade from standard DX-only cooling to an Adiabatic chiller – helping reduce the data centre’s energy usage and carbon footprint. Whilst 2bm faced some significant competition from other shortlisted projects, they managed to pick up ‘Highly Commended’ Awards in the categories of ‘Innovation’ and ‘Finance’. L FURTHER INFORMATION




Secure I.T. Environments Ltd are pleased to present the newly designed ModCel containerised data centre it is suitable for most Data Centre, Server and Telco applications, designed and built to specific project requirements. The ModCel is built off site and helps to resolve space, deployment time, build complexity and cost challenges. Delivered as standard with features such as:

Benefits: • • • • • • • • •

Purpose Built Structure 4-hour Fire Protection Thermal and Acoustic Insulation Insulated on all Six Sides Typical ISO Container Footprint Expandable Suitable for Harsh Environments Rapid Deployment Easy to Transport Globally


• Lloyds Insurance Accreditation • Internal & External Deployment • Minimum disruption upon installation • M & E Infrastructure fully fitted and tested • 4 Cabinets to 500 cabinets • Stackable up to 9 metres

For more information on how we can help you plan and implement the most energy efficient data centre solution for your budget contact: Shirley Osborne on or call

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Chris Wellfair, Projects Director at Secure I.T. Environments Ltd, looks at containerised data centres and what they offer

You’ve probably heard the term ‘containerised data centre’ and associate it with huge data centre projects, such as those run by the public cloud vendors with tens of thousands of servers and the need for constant growth. In those instances, they are chosen for speed, cost effectiveness and ease of installation, but those benefits are not only true when working at scale. There are several scenarios where a containerised data centre might be just right for you, even if you are a much smaller business. Containerised solutions, such as our own ModCel and ModCel Edge solutions, can form small data centres, particularly in hospitals and healthcare settings, where they help resolve space, deployment time, build complexity and cost challenges. They are very flexible and depending on the internal configuration can perform very well, even in high density applications. If you are facing a data centre design and build challenge and any of the following resonate with you then you should certainly add a containerised data centre to the possible solution list. Speed is of the essence If you need your data centre built quickly then containerisation can substantially shorten delivery times. Many companies offer them in standard ‘ready to load’ configurations, but you can of course have the interior designed to meet specific requirements, if your partner offers this.

and that implemented with a minimum of fuss or raised eyebrows from the CFO! Construction must be offsite There could be many reasons why you can’t build a data centre on site, for example, if it is a high security area, or the data centre is only needed in a disaster recovery situation such as a flood, so you want to keep it offsite. A containerised solution can be fully designed, fitted out and tested at a separate location. It could even be running in a separate location mirroring servers at the main location, and can then dropped in as a ‘clone’ when needed. Mobile data centre If you need your data centre to be mobile, either because you know the facility will be moving to another site in the future or you want to ship it to another country once built, then containerisation is an excellent solution. Firstly, because units are designed to shipping containing external dimensions, use the same interlock systems and to meet or exceed the same rigidity and load standards, shipping them is a lot easier than sending individual components that must be

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re-assembled at the other end. Secondly, it is possible to get the container insured if it meets the correct international shipping container standards, giving you greater peace of mind. There are a couple of misconceptions about containerised data centres, the first being that they really are just a temporary solution and have a touch of the Heath Robinson’s about them! To a degree this is understandable, after all they do look like an upcycled shipping container, but the technology in them is the same as that which would go into ‘normal’ data centre build, or at least from the same suppliers. If you pick the right partner, then your container will be custom designed and built from the frame up, and will carry enviable Lloyds Register structural warranties to give you peace of mind. You’ll have extended or upgraded the data centre long before those warranties expire. The other reasonable question that any data centre manager worth their salt will ask, is about the ability of a containerised data centre to maintain effective cooling and achieve strong Power Usage Efficiency ratings – the misconception is that they will fall short. Our own experience has shown that they can deliver the same high standards as a modular or traditional data centre builds. As outlined above this is because they use the same equipment, including monitoring systems – they are well suited to high density applications where heat can be an issue precisely because of the way containers are configured. Also, where there are particularly stringent demands it is not uncommon to have a second container which is response for housing switchgear, batteries, UPS and cooling hardware, though can be housed within container ‘rooms’. Containerised data centres are not a replacement for a modular room or bespoke data centre build, they are simply another option. As we have seen above, in certain situations their advantages may make them perfectly suited to the challenges that you are trying to overcome in your own healthcare environment. L FURTHER INFORMATION You can learn more about Secure I.T. Enviroments ModCel and ModCel Edge solutions by visiting :

Site suitability In some locations it is simply impossible to house a new a data centre. This could be due to footprint, budget or even local planning regulations. Often in these situations, a container can be a solution accepted by all



For the NHS and other healthcare providers, managing data is absolutely essential to maintain the integrity of patient records. The United Kingdom Security Shredding Association explains why Organisations involved in healthcare inevitably create mountains of data on electric devices and plenty of paperwork. Clearly, it is vitally important for anybody that holds sensitive data to manage it properly. For the NHS and other healthcare providers, managing data is absolutely essential to maintain the integrity of patient records. In 2014, the Federal Bureau of Investigation warned American hospitals and healthcare companies to ensure their data security was strong. This was because hackers were targeting what was considered easy to access patient data. Often, this data was more valuable to criminals than credit card data, because typically people noticed something wasn’t right and cancelled their credit card details. With medical records, people are often unaware that their data has been stolen. But stolen medical records can be used as a way to create a false identity to obtain NHS medication for an improper purpose such as to sell or send abroad. Potentially, stolen records can be used to bribe people about conditions that they might not wish to reveal for professional or personal purposes. There is also the moral right that people’s personal information should be kept secure. Alternatively, stolen data from NHS operations such as procurement or commissioning can also be used by criminals to issue false invoices or to purchase drugs. According to the NHS Counter Fraud Authority, fraud costs the NHS £1.29 billion a year. That’s enough to pay for over 40,000 staff nurses or to purchase 5,000 frontline ambulances. There is also a duty on NHS and other health and social care providers to meet the provisions of both the Data Protection Act 2018 and the General Data Protection Regulation (GDPR). In some (but not all) cases, patients will also have a right for their data to be erased under GDPR. Simon Ellin, chief executive of the United Kingdom Security Shredding Association

(UKSSA), said: “Since the introduction of GDPR, we have seen how it has become even more important for data to be handled and destroyed securely. Anything from hard drives to paper records may need to be destroyed, and anyone procuring shredding services must ensure that high standards are met. By employing an UKSSA member, you know that you are getting the very highest secure shredding and data destruction possible.” Shredding on site UKSSA members are audited every two years to ensure they meet the association’s code of practice. This means they must consistently provide stringent operational standards in confidential data destruction including compliance with EN15713:2009 – the standard on secure destruction of confidential material. NHS guidelines call for paper-based disposal to meet the government’s Information Assurance Standard. Rather than using a traditional vertical shredding operation, this means paper records be destroyed using a micro cross cut shredder that cuts paper into pieces of no more than 15mm x 4mm. This is in line with the EN15713:2009 standard that UKSSA members must meet and ensures destruction of sensitive information. The NHS guidance also calls for shredding to occur on site prior to disposal or removal. This means mobile shredding units can be driven to a healthcare facility to allow on-site destruction. Alternatively, incineration processes may also be used for paper-based data or other types of printed media. A certificate of destruction from a specialist waste disposal contractor is required on completion. This certificate can be provided by UKSSA members. For electronic devices such as hard drives, old computers or solid state drives, again the EN15713:2009 standard is specified in NHS guidelines. The Waste Electrical and

Document management

Secure shredding services in the NHS

Electronic Equipment (WEEE) regulations also apply on ensuring the devices are disposed of as sustainably as possible. Devices should be wiped on site prior to being taken off site for destruction. UKSSA members can advise on meeting both secure shredding requirements and the most sustainable disposal option, including recycling, as part of the WEEE regulations. Solid state drives such as flash drives and SD cards should be destroyed using disintegration processes. For CDs, DVDs and Blu-Ray discs, these must be shredded to 4mm x 15mm, and ideally recycled where possible. Ellin says: “Secure shredding and destruction of sensitive data is absolutely vital for NHS and other healthcare providers. Many UKSSA members are healthcare destruction specialists, and I would strongly advise that you need to meet the highest data destruction standards. By using an UKSSA member, you can be assured those standards and NHS guidelines will be met.” So, how does a mobile shredding service work? A majority of healthcare providers typically require shredding to occur on-site. The first step of organising a mobile shredding service is determining the materials you need shredded and the quantity of these materials. Once you have established how much you need shredded, shredding companies can provide you with an appropriate quantity of lockable confidential waste bins or cabinets to store your sensitive data prior to collection. This step ensures your data is safe from start to finish. When your data is ready for shredding, staff will arrive in uniform at your premises. The operatives will then transfer your documents and materials onto a secure mobile shredding vehicle. Once behind a caged door, operatives will place the data directly into the shredder located on board. After destruction is complete, a Certificate of Destruction and Waste Transfer Note will be issued, confirming the safe destruction of your data in compliance with European standards. All shredded paper will then be baled offsite and sent to UK mills for recycling. Where possible, other materials are sent for recycling, turned into refuse-derived fuel, or are incinerated under strict controls to generate energy for the National Grid. UKSSA members always try to avoid sending material to landfill. Mobile shredding vehicles house industrial shredders on board which are capable of destroying over 400,000 sheets, 160 boxes, or 800 reams of paper every single hour. There’s also no need for clients to remove staples, paper clips, or even the plastic wallets from documents before their destruction. The shredders can handle all materials, and 100 per cent of paper is recycled at UK mills. But that’s not all. Mobile shredders can destroy many other things in addition to paper. The industrial shredders can also destroy clothing and uniforms, ID cards, X-Rays, photographic prints, digital media such as CCTV tapes and USB sticks, hard drives, and electronics. L FURTHER INFORMATION




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NHS SBS has implemented a framework that allows NHS organisations and other public sector bodies to purchase all of their audio visual requirements under the same framework, including integrated operating theatres It is a well known fact that NHS hospitals for patients, scheduling and planning are having to operate under extremely tight staff workloads, holding more effective budgets. Despite the record sum announced meetings, and, in some instances, using by Prime Minister Theresa May as part of the technology in operating theatres. the government’s present to the NHS on the At the end of 2017 research found that occasion of it’s 70th anniversary, which will NHS hospitals could carry out 280,000 total £20 billion a year by 2023, hospital more non-emergency operations a year bosses are still having to offer higher by organising operating theatre schedules levels of care to an increasing number of better, finding that more than two hours were people without the necessary resources. wasted each day on the average operating In an ongoing attempt to improve patient list. The report, published by regulator NHS care, create space in crowded A&E rooms, Improvement, said it is not a question of reduce waiting times and work with more getting surgeons to work harder, instead, efficiency, NHS England and the Department urging that planning lists more effectively of Health and Social Care are promoting the and reducing late starts and early finishes use of technology across the NHS estate. A lot would have made a big difference. of this digital advancement is taking the shape of patient technology, placing responsibility of Lecture theatres care in the hands of the patient so that they The Royal Lancaster Infirmary, part of the can better monitor their own conditions, University Hospitals of Morecambe Bay whether that be measuring NHS Foundation Trust, uses its blood pressure or diabetes Education Centre venue for a self care. However, within range of healthcare disciplines, Operat i the hospital building such as meetings, seminars, o n al from th the use of audio workshops, national and e of Marc start visual technology regional courses. The is becoming hospital planned to agreem h, the e more prominent, update the technology n t c Integra communicating within the Lecture Theatre ted Op overs erating Theat messages to create a better in-

re p and sol roducts utions

room experience for both the audience and presenter, including enhancing sound and image quality along with straightforward user control. Pure AV, who supplied the technology for the project, explain that the project demanded a solution to enhance the experience within the Education Centre’s Lecture Theatre and connected Seminar Room. The room can be used as one large lecture hall or divided into two separate teaching areas. When divided the larger room has fixed raked seating, while the smaller of the two has flexible seating that can be rearranged to accommodate group working or a formal presentation layout. In both scenarios, the University Hospitals of Morecambe Bay NHS Foundation Trust required clear displays, good quality sound reproduction and easy control. The solution allowed the same projector to be used in the large Lecture Theatre in both room layouts without compromising on image quality with the room user triggering the automatic adjustment of the projector image with a single button press. As a result, the Royal Lancaster Infirmary now enjoy an easy to use system that enhances the experience of both room users and support staff. A similar project was undertaken at the Health Academy, based at Lancashire Teaching Hospitals NHS Foundation Trust. E


73 Time to upgrade your ageing MDT, Audio‑Visual and Videoconference facilities?

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For almost thirty years Internet Videocommunications has partnered with the NHS to deploy cutting edge collaborative AV solutions and has recently been awarded supplier status on the NHS Shared Business Services Framework for Audio Visual Solutions and Integrated Operating Theatres including MDT Systems plus the Countess of Chester National Framework Agreement for Managed Video Conferencing Solutions.   Do you have a need to upgrade your existing MDT solution for review and local diagnostic imaging with unparalleled simplicity? Or maybe you have a video conference estate that needs managing to fully realise your investment? Speak with the experts at Internet Videocommunications.   Our expertise will help: Significantly reduce the need for travel, saving time and money Improve the efficiency of day to day meetings Provide seamless collaboration with easy to use, intuitive solutions



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 Another new use of audio visual technology can be found at the Simulation and Clinical Skills Centre, part of the Royal Oldham Hospital. In response to increasing demand for enhanced clinical training within The Pennine Acute Hospitals NHS Trust, Royal Oldham Hospital constructed a £600,000 Simulation and Clinical Skills Centre. Pure AV was appointed by the trust to design an audiovisual system to record and playback training activity for analysis and debriefing. Viewing medical images The Rotherham NHS Foundation Trust provides a wide range of health services to the local area, with the A&E Department dealing with approximately 75,000 patients each year, as well as an estimated 55,000 inpatient and 250,000 outpatient attendances. In 2016, the trust sought improvements and increased efficiency in the way it provided medical images when relaying patient outcomes. The Involve Healthcare Team were chosen to deliver the improvement project, opting for three key clinical and operation rooms to be equipped with a blend of large HD displays comprising of a 2×2 configured video wall in the Multi-Disciplinary Team room and HD projectors and monitors in the other locations. Cisco video conferencing was deployed across all rooms connecting back to Involve’s N3 hosted service platform with integrated multiparty conferencing capabilities. All systems are controlled by an intuitive control system with simplicity and the users input at its heart, and a range of existing clinical systems were integrated into the design and build enabling two way content sharing of data with any external sites. Benefiting patients More recently, in march this year Leeds Teaching Hospitals Trust (LTHT) began offering outpatient appointments via video, using the Virtual Clinic platform by Involve. The use of such technology will benefit patients in several ways, including mental health patients having appointments over video allowing them to remain at home, and children with

Integrated theatres

Supported by

The use of audio visual technology is becoming more prominent in the NHS, communicating messages for patients, scheduling staff workloads, and holding more effective meetings Cystic Fibrosis having an infection risk using it for interactions and the service will be used to reduce the amount of travelling time for patients. Plus, Virtual Clinic will be used by dispersed services across five sites to link the services, therefore offering collaborative care. One of the biggest acute hospital trusts in England, United Lincolnshire Hospitals NHS Trust (ULH) has state-of-the-art MultiDisciplinary Team rooms across multiple sites. The trust, whose vision is to provide ‘excellence in rural healthcare’, has three hospitals which need to collaborate to provide the best patient-centred care possible for more than 720,000 people. Involve’s Healthcare team consulted the trust’s ICT and Cancer Services department to redesign and upgrade

three key clinical and operation rooms across the three main hospital sites. The trust saw the installation of multiple large format professional 65” HD 1080p displays in the MDT rooms and Cisco videoconferencing was deployed across all rooms, plus a host of other equipment to make a first-class MDT room. Shared Business Services Towards the back end of 2018, NHS Shared Business Services (NHS SBS) implemented a framework that allows NHS organisations and other public sector bodies to purchase all of their audio visual requirements under the same framework, including integrated operating theatres. Operational from the start of March, and running until February 2023, the agreement covers Integrated Operating Theatre products and solutions, audio visual products and solutions, video conferencing, patient entertainment solutions, digital signage and Check-In kiosk solutions. A compliant procurement exercise has been already undertaken to ensure that the framework suppliers meet all key standards and requirements, saving valuable time and resources. The framework boasts of the ability to directly award a contract to approved suppliers on the framework, providing a timely and compliant route to market to meet your requirements, without having to undertake an OJEU process. There is also the opportunity to run a mini-competition to meet the bespoke requirements of each organisation as well as helping to drive further competitive pricing. L FURTHER INFORMATION



Right supplier = Right solution We have a substantial standard of understanding, awareness and expertise of patient well-being, allowing us to design and deliver a successful MDT environment. Our solutions capture and engage all participants within the meeting environment. Our network facilitates secure video communication between clinicians irrespective of their locations or device type, enabling the transformation of care delivery possibilities across the NHS, or private estate. • Simple conferencing set-up process • Capturing and storage of image data during & post meeting • High quality HD display of video and still images • 24/7 - 365 on site Service & Support options

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How digitising health within the NHS can benefit multi‑disiplincary teams Digitising health within the NHS is becoming increasingly important especially for teams and specialists from multi-clinical occupations who collaborate on delivering best patient care Technology was a focus point in the recently published NHS Long Term Plan, and the importance of digital health is regularly emphasised by the tech‑loving Secretary of State for Health and Social Care, Matt Hancock. New and innovative technologies are being thrust into the limelight seemingly every day, but the MDT room remains as one of the most important uses of technology within the NHS. MDT rooms bring together dispersed teams to collaborate on providing the best possible care to patients. Important decisions can be made by the specialists from multiple clinical disciplines in these meetings, so it’s imperative that the technology is effective to allow discussions to be held efficiently. Right supplier = right systems New build MDT suites should not be awarded on price. Why? Because, the biggest cost to any Multi-Disciplinary Team is interruption and downtime, causing a reduced speed and poorer quality of care, as well as increased cost. Therefore, you need your MDT to be delivered, installed and commissioned first time, on time and within budget. Just be sure to align with a partner who understands the importance of your needs. The equipment hardware, software and networks that bring together an MDT suite isn’t the end of the story. It’s just as important to pass on the knowledge of how to operate the system to the users. User training and documentation is absolutely key to making sure that the users feel both confident and competent when it comes to using their MDT system. Experience in this field is everything and your installer should have experience delivering MDT suites, because just audio‑visual and IT training doesn’t cut it in the NHS, right? But, for AV skills, look for the AVIXA CTS qualification, which is always a good sign of quality.

SBS Framework Involve work closely with health organisations to identify the most cost-effective procurement method for the latest technology and is proud to be an approved supplier under NHS SBS Audio Visual Solutions and Integrated Operating Theatres Framework for Lot 2 – Multi-Disciplinary Team Room and Conferencing Facility Room. Being on this Framework shows that Involve has built considerable experience and expertise in creating successful MDT audio visual and health videoconferencing solutions with: an integrated user interface with a single point of control, central matrix source switching and excellent audio and video quality with HD video transmission, clear audio, and full platform interoperability through Involve’s service. In addition, Involve can natively register your MDT Video Conference system to the N3 and HSCN network so whether it’s an N3 – N3 call or N3 – internet, we have it covered. Rotherham NHS Foundation Trust Case Study After consultation between the Trust’s Project Team and the Involve Healthcare Team, 3 key clinical and operation rooms were chosen to be equipped with a blend of large format NEC 58” HD displays comprising of a 2×2 configured video wall in the MDT room and HD projectors and monitors in the other locations. Video conferencing was deployed across all rooms connecting back to Involve’s N3 hosted service platform with integrated multiparty conferencing capabilities. All systems are controlled by an intuitive control system with simplicity and the users input at its heart, and a range of existing clinical systems were integrated into the design and build enabling 2-way content sharing of data with any external sites. Janine Birley, Associate Director of Cancer Services at Rotherham NHS Foundation

Trust explains how the new kit is improving the staff and patient experience at the trust :“Although the equipment is not used to a clinical diagnostic level, clinicians have experienced excellent clarity of information and the user-operability positively supports our clinical practice.” United Lincolnshire Hospitals NHS Trust Case Study As a trusted partner of ULHT, redesigned and upgraded three key clinical and operation rooms (MDTs) across the three main hospital sites. John Minett, Telecoms Engineer at ULHT, said: “We have a long-standing relationship with Involve and have been really pleased solutions they have provided us in the past. The new solution by Involve is much more reliable than the one we had before and the support Involve offers is great so we know if there is a breakdown it will be well-handled. The solution is also much more user-friendly, so we’re happy with the work Involve have done.”, our conferencing platform was designed with security and redundancy in mind. The platform is unique because it’s hosted in secure NHS datacentres and is fully resilient, with the unique design ensuring that data never leaves the secure NHS network (N3 and HSCN) when all participants join a medio conference from within NHS network. John Minett, ULHT: “We have had meetings with the clinicians who use the MDT rooms about when the BT service is switched off this year, and the feedback from them is that they wish to use as the main video conferencing platform as it works well and is a good alternative to BT Engage. We regularly recommend to other trusts.” L FURTHER INFORMATION



Leading vendor-neutral managed services provider Genmed provides vendor independent, flexible, scalable managed services to the NHS which provide both tax and operational efficiencies. As prime contractor in an MSC, Genmed provides its clients with full choice of suppliers, equipment and services. It can carry out mini-competitions which ensure that its clients enjoy best value. Since 2007, Genmed has grown rapidly turning over in excess of £60 million in the last financial year and currently manages over 200 contracts in a variety of clinical disciplines including pathology, surgery, endoscopy and imaging along with IT and facilities. It has a presence in more than 40 NHS trusts and its portfolio is valued at in excess of £550 million. New contract structures are continually under development ensuring that all areas of healthcare delivery can benefit from the financial


and operational efficiencies offered by a Genmed managed service. Genmed is appointed to a number of frameworks for vendor neutral managed service providers which means that the delays and cost associated with OJEU procedures can be avoided.

FURTHER INFORMATION Tel: 0345 450 2204


The most innovative equipment in the world Innova Care Concepts has teamed up with the University of Huddersfield to research and improve the effectiveness of pressure care equipment in healthcare. Extensive pressure mapping and panel discussions have taken place to assess each item. This included Innova’s sales director and pressure care specialist Joe Hulbert laying on mattresses for a long time to measure body weight redistribution. The researchers also carried out a sound test on the pump to make sure it would not disrupt the patient, and they tested the stretchiness and durability of the mattress covers. Joe Hulbert said: “It’s been a real privilege to work with Huddersfield University with their studies. Not only has this given us as equipment suppliers actual evidence that our products are at the cutting-edge of research and technology, but it’s also allowed us to further improve


our mattresses and carry-out continuous product development with expert opinions and input.” The studies have included rigorous testing and product developments to ensure that patients are getting the best care possible. It is estimated that pressure ulcers cost the NHS over £3.8 million every year in the United Kingdom.

FURTHER INFORMATION Tel: 0345 034 1450

Held over a single day, P4H England is set to welcome over 1,400 key decision makers through its doors on 4 July, representing England’s healthcare procurement and supply chain community Officially supported by key buying organisations such as NHS Supply Chain, P4H England 2019 will provide a unique platform for both buyers and suppliers to engage across a range of interactive and educational features, all designed to enhance collaboration in support of driving greater efficiencies and savings across England’s £27 billion NHS procurement marketplace, complimenting key initiatives such as The NHS Long Term Plan and the NHS Supply Chain Operating Model. P4H England 2019 is the must-attend oneday event for the UK’s healthcare procurement community, which is designed to give both buyers and suppliers the opportunity to network and engage across a range of interactive features, including: the Keynote Arena; CPD Certified Skills Development Training Zones; NHS Supply Chain Engagement Zone; NHS Supply Chain Procurement Pavilion; Collaboration and Networking Zones; and the Product Showcase Exhibition. For NHS procurement personnel, the event will host a range of dedicated features, designed specifically to enhance skills and capabilities, in order to maximise the opportunity of delivering services across England efficiently and effectively. The event will offer the opportunity to engage directly with both peers and colleagues from across the marketplace, in order to share best practice and further develop opportunities for collaboration. A range of CPD certified training sessions will be able available that will also count towards the CIPS member charted status. In terms of the private sector, it is more essential than ever that you gain an in-depth understanding of and contribute to the future direction of procurement across the NHS. Participating at P4H England 2019 is your chance to do that and more. For both framework holders and non-framework suppliers, the event will provide a rare opportunity to engage with England’s NHS buying community, across one single day. Suppliers can participate across a range of features, including the P4H Product Showcase, which is designed specifically to connect innovation and the demonstration of goods services, directly to England’s £27 billion NHS procurement marketplace.

Conference The P4H England 2019 Keynote Arena will host a range of influential speakers representative of the NHS, Industry and the wider public sector who are responsible for both setting strategy and delivering on the current key objectives across today’s evolving marketplace. New for 2019, the Keynote will take place across two sessions, both designed to keep delegates up to date on the future strategy of NHS procurement. As well as welcoming motivational speaker Ranulph Fiennes who will deliver a fascinating talk on leadership, other notable speakers include Neil Hind, procurement lead for the Greater Manchester Health and Social Care Partnership; Stephen Foulser, customer engagement director for NHS Supply Chain; and Peeta Bailie, chief procurement officer for NHS Improvement.

P4H England 2019

The premier NHS procurement and supply chain event

Skills Development Training Zones P4H England 2019 will host five distinct Skills Development Training and Engagement Zones. For buyers, these zones are designed specifically to enhance overall procurement knowledge, assist with collaborate and share best practice. With many sessions CPD certified, P4H England training zones will help develop your overall career opportunities. For suppliers, the training zones will provide a unique opportunity to gain an invaluable insight into the latest marketplace developments, in addition to providing training on a range of topics designed specifically to enhance opportunities for business growth and developing partnerships. The redesigned NHS Supply Chain operating model is now in place with seven providers operating 11 category towers delivering medical, capital and non-medical products and services, and two support services for logistics and supporting technology The NHS Engagement Zone at P4H England will comprise of a series of sessions delivered by these seven specialist Category Tower Service Providers. This zone will offer both buyers and suppliers a range of sessions which will focus on the latest changes and developments within NHS procurement, in addition to the commercial opportunities that the NHS Supply Chain operating model may represent for suppliers. P4H England 2019 will host five unique Networking & Collaboration Zones. These are designed to allow visitors to interact and engage with a range of important initiatives, topics and themes, all of which are influencing and shaping today’s evolving NHS procurement marketplace. L FURTHER INFORMATION


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Pest control

Fighting against hospital infestation In some of the latest facilities, pest control appears to have fallen down the gap between the management company and the trust in question. In light of this, Health Business looks at the importance of regular pest control in all parts of the hospital to keep infectious diseases at bay Health bosses are considering legal action approaching £900 million, including hundreds against the contractors who built the £842 of outstanding maintenance jobs at the million Queen Elizabeth Hospital in Glasgow Queen Elizabeth University Hospital alone. where there have been a number Alongside the pigeon droppingof infection-related deaths. related deaths, an investigation into Hospitals are vulnerable the water supply at the Queen Audit to infestation. The Elizabeth University Hospital in Scotlan modern hospital Glasgow found ‘widespread d has clai functions on a contamination’ in taps and the tota med that 24-hour, 365-day drains, after an infection l b a basis, with several outbreak in two cancer c k mainte log of n thousand staff, wards at the neighbouring a n c e acros Scotlan patients and other Royal Hospital for Children s d’s visitors, supported (RHC) last year. In total, is appro hospitals by a wide range of 23 children contracted £900 maching services. As such it bloodstream infections in illion resembles a small city, the cancer wards between creating a very attractive January and September last year. habitat for a range of pests. In England, there are many Much has been made of hospitals that formerly had deeply the events at Glasgow’s Queen Elizabeth entrenched infestations that have now not Hospital, where a series of issues with had a significant infestation for several years. infections where found at a Scottish hospital. There is, however, no room for treading water. Holyrood’s health committee has since set up The issues around infestation and its control an inquiry and has written to Scottish Health do not stand still. We know that infestations Secretary Jeane Freeman noting concerns of cockroaches, bed bugs and other pests about cleaning, maintenance and testing. in hospitals are still all too common. Freeman herself has commissioned a In some of the latest facilities, pest control review into infections in Glasgow and what appears to have fallen down the gap between can be learned across the NHS as a whole, the management company and insisting that ‘robust measures’ are in place the trust in question. Pest across the country to tackle infections. control, Three deaths at the Queen Elizabeth where this has been University Hospital remain under investigation considered at all, has from prosecutors, with 63-year-old Mito sometimes gone Kaur’s death found to be the result of a out to tender fungal infection related to two previous along with deaths at the hospital after patients contracted a separate fungal infection linked to pigeon droppings. A 10-year-old boy and 73-year-old woman had contracted cryptococcus, a fungus linked to pigeon faeces, with the Healthcare Environment Inspectorate (HEI) first asked to examine the cleanliness of the hospital in January. The Scottish Health Secretary has since ordered a full independent investigation into the design, maintenance and construction of the hospital, after the HEI reported that some areas of Scotland’s biggest hospital could not be cleaned properly because they were awaiting repair work. In fact, Audit Scotland has claimed that the total backlog of maintenance across Scotland’s hospitals is

catering, cleaning, security, and car parking, with no consideration of existing arrangements or of the specific requirements of the site. Old buildings can also bring their own problems. On numerous sites, redundant buildings sit empty prior to demolition, and some hospitals have removed these from the pest control contract in order to save costs, which can lead to several problems. Sometimes, significant questions have subsequently come to light about the design of details in new buildings, with the topical issue of pigeon roosting sites located close to air intakes and clinical facilities serving as a prime example. Where can they have come from? Faced with these and other issues, those with responsibility for the management of pest control within trusts and hospitals need to actively maintain a broad professional competence in this area. Upon finding an infestation this is normally the first question to be asked, but often the last to be answered, if at all. We can normally identify which factors are conducive to infestation, but it is often very difficult to look at a particular current infestation, and work out its origin with any degree of certainty. Of course we know that feral pigeons visit the site at intervals, and may become established if they find regular food (particularly if it is deliberately placed out for them), and sheltered roosting sites. Rats, squirrels, foxes, and feral cats are all likely to respond similarly. At the other end of the scale, we presume that most stored food pests such as beetles, moths, mites etc, normally arrive within food products. However some storage insects are also associated with bird’s nests, which may provide an alternative route into a building. Pests such as pharaohs ants, cockroaches and bed bugs do not normally colonise buildings very rapidly under current UK conditions, and the actual infestation routes are often difficult to identify. An infestation that re-appears some months after a treatment programme is much more likely to be based on survivors of the old infestation, rather than on newly arrived pests. Once a hospital is truly free of cockroaches, ants, or other infestations of this type, years can easily pass before a new infestation appears. E



Fordingbridge: offering inspiring canopies, walkway and building solutions to all sectors With the continuous preference towards modular build and architecturally rewarding buildings in healthcare, the need for specifying the correct products while at a planning stage has never been more important. With an emphasis on both patient experience and working conditions for staff now key desirable elements, more attention is given to how a buildings exterior can be enhanced to combine both a valuable aesthetic and user protection. Modular buildings provide a huge benefit for healthcare, with faster delivery and commissioning when compared with traditional building methods, but alone they, by nature, offer little in way of weather protection for patients and staff entering and leaving the premises. Exposure to rain, sleet and UV during warmer months can easily undo the hard work of healthcare professionals within the hospital, as an unpleasant transition can often reduce satisfaction ratings. The same is likewise true of Emergency Wards, where an open ambulance bay creates not only an unpleasant environment for patients, but also a safety risk for paramedics where it is often necessary to work quickly when disembarking

patients and handling mobile apparatus. Canopies and covered walkways can provide a simple and effective solution to the above issues when designed and installed correctly. Pre-fabrication playing a key part in time efficiency, the right product can be added to an existing structure or delivered as part of a new project quickly and cost effectively, to enhance the practical and aesthetic elements of the building. With over 50 years trading, and proud ownership of an ever-increasing portfolio of work within a live hospital environment, Fordingbridge has delivered a great number of successful healthcare projects, from covered walkways connecting Award-Winning new modular discharge suites to a main hospital building, to a multitude of ambulance bays and an A&E Department extension. Broad experience within a modular build environment allows their designers and engineers to have formed common solutions for problems encountered by other operators, meaning they are able to provide the necessary enhancement to time and on budget. In-house design and manufacture facilities allow them to maintain high quality and competitive

costings on these projects nationwide. Working with NHS trusts, main contractors and the country’s leading modular building firms, Fordingbridge’s experience in the sector means that a large element of the clients guesswork is removed, as their knowledge from past projects allows them to design functional, cost effective, and visually appealing structures to complement a healthcare setting. FURTHER INFORMATION Tel: 01243 55 44 55

Competent, independent pest advice: Because it’s hard to know where to find it PestTrain, founded in 2012, was established by two of the pest managements leading specialists and qualified Chartered Biologists. Initially as a trouble shooting and problem-solving service, PestTrain has grown into a complete pest management specification consultancy working with sites, in areas of pest activity identifying risk and designing diligent and proactive pest management strategies to establish and eliminate root cause. Services include a review of existing service provision, where sites are either unhappy with their current contractor’s approach and standards and/or the level of active pest infestation within properties has become out of hand. As pests evolve and adapt to their surroundings and local environment, so does the need to review and adjust how they are prevented and controlled. Pest management must be considered as the sum of the parts, rather than as a whole, primarily as different pests, in different locations present different risks and very often require differing strategies to prevention and control. One size does not fit all. Considering pests as a hazard, the aim is to identify what is the associated risk of


such presence which may result in either operational or structural damage; financial loss of stock or disruption to working days; let alone spread of disease, etc. The company also considers historical or prolonged activity where the opportunity for pests to gain access into a building, where the fabric of the building may be vulnerable or onsite activities may support pest immigration. Integrated Pest Management (IPM) has long been misunderstood by many service providers, who focus on control through the use of pesticides or lethal options. Where pests present a significant risk to a business, building or members of the public – identifying and specifying the correct strategy and control options is the fundamental first step. PestTrain provides support and assistance across all pest types and industry sectors where there is a need to understand, practice or demonstrate due diligence in the prevention and management of public health pests. Training and Awareness course are also available, as well as ongoing independent technical audits. The organisation’s portfolio includes large corporate head offices, major hotel


chains, housing associations, universities, through to food manufacturing and individual high risk and high security sites. Pesttrain is a consultant member of the British Pest Control Association. FURTHER INFORMATION Tel: 01453 300 007

Pest control

î † Do we need to actually eradicate them? The reasons for keeping the hospital free of infestation are many, and reducing the risk of litigation and adverse publicity are clearly important. However within the hospital environment, reducing the risk of infection is likely to be uppermost in most peoples minds and with cases of infection contracted within hospitals believed to be running at a high rate, the co-existence of patients and potential sources of infection cannot be tolerated. Studies of insects such as cockroaches, ants and houseflies have shown that these insects acquire a very wide range of human pathogens from their environment (e.g. refuse areas or drains) and are potentially able to transfer these to other areas. The pathogens are carried externally, or via their faeces or vomit. Nonetheless conclusive evidence of human infection by crawling insects is hard to establish although there are several cases that support this theory. With houseflies, there is now recent research overseas to show a statistically clear link between housefly infestation and gastroenteritis. Although disease transmission by some blood-feeding insects is a major problem globally; fleas, bed bugs and mosquitoes are fortunately no more than a severe nuisance in the UK at present. Research has revealed no evidence to link biting insects with infections such as hepatitis and HIV, for example. However the recent upswing in bed bug infestations

Holyrood’s health committee has set up an inquiry and has written to Scottish Health Secretary Jeane Freeman noting concerns about cleaning, maintenance and testing has created particular problems for those suffering from haemophilia. Rodents are recognised as carriers of a number of diseases and human cases of Weils disease occur regularly in the UK. At-risk groups are seen as those spending time in areas infested with rats, with cases having occurred in construction workers, watersports enthusiasts, sewer workers and others. Birds are also increasingly recognised as capable of transmitting a range of human pathogens. For example outbreaks of Listeria have been shown to be caused by birds pecking milk bottle tops, while E. coli 0157 has been shown to occur in the faeces of gulls that have been feeding on refuse. Although direct effects of infestation on patients and staff are of greatest concern in hospitals, infestations can cause a wide range of other problems. For example, an infestation of food stores is likely to result in quantities of food being discarded and the enforced closure of catering, and damage to electrical cables by rodents is a fire hazard, as well as putting computing and communication systems at risk.

Putting procedures in place Almost all hospitals and trusts will have pest control arrangements already in place. However the process needs to be reviewed at regular intervals, especially prior to re‑tendering for pest control work. Key aspects ensure that each hospital has a nominated officer with responsibility for pest control, and ensure that they have been specifically trained to monitor the NHS pest control contract. Moreover, adopt the NHS model pest control contract, ensure it is tailored to meet your needs, and go through a rigorous competitive tendering process at the next opportunity. Use of this contract has been instrumental in driving down hospital infestation rates in recent years. Finally, select a competent contractor. The British Pest Control Association (BPCA) is the UK trade association representing organisations with a professional interest in pest control. All BPCA members meet our strict membership criteria, hold the relevant pest control insurances, and are fully qualified and trained to deal with your pest problems. L Issue 19.2 | HEALTH BUSINESS MAGAZINE


What is critial to any healthcare facility?




Preventing contamination in healthcare is about attacking the point of exposure. Ensuring pure drinking water is no different. Per liter, approximately 100 million bacteria are floating around in the water lines of most buildings. OASIS’s filtration systems is as critical to safe consumption as the provision of water is to life itself. Provision is nothing without purity.In the hustle and bustle of a healthcare facility, we are the hydration OASIS; eradicating the contaminants that should never get through. From filtration internally and at point of dispense to antimicrobial copper surfaces. OASIS is the safest hydration station for your facility.

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OASIS® is there to combat dehydration in your healthcare facility. When investing in an OASIS unit the payoff is bountiful! For over 100 years, OASIS have been the global leader in the design, manufacture, and distribution of eco-efficient, clean drinking water systems: Bottle watercoolers, Point-of-Use, Filtration systems, Bottle Fillers and Drinking Fountains. We invent. We reimagine. We perfect. And then we do it all over again. We deliver the most hygienic and healthful choices.

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Personalisation is so central to the government’s vision for our healthcare system that it has its own chapter in the recently published NHS Long Term Plan; signalling a clear intention to expand this new model of care it is titled: ‘People will get more control over their own health and more personalised care when they need it’. The plan makes it clear that Personal Health Budgets (PHBs) will be fundamental to the delivery of personalised care. PHBs will be provided to those with long term health conditions, empowering individuals to purchase precisely the type of care they need by allocating a personal budget that they can spend on their agreed health and well-being needs. NHS England reports that there are currently around 40,000 people already managing their care in this way; the NHS Long Term Plan states that by 2023/24 this number will increase to 200,000. This increase undoubtedly presents a challenge to Clinical Commissioning Groups (CCGs) who need to ensure they maintain governance to avoid clinical, reputational, regulatory and financial risks associated with the administration of these care budgets. While there are many individuals who have the right to a PHB, they are often not aware that this is the case; a PHB will not always be the right solution for everyone and some may wish to have their care managed in more established ways, to reduce the administrative burden on themselves with traditional oversight being retained by their CCG. But, in the long term, the direction of travel is clear: the choice must be presented and the opportunity for individuals to administer and manage their own budget, to achieve their agreed health outcomes, must be made a reality. This change will shift the ownership and accountability for arranging care and managing budgets, however, CCGs must develop new

ways of working to manage the potential risks, while maximising the opportunities for improved patient care and outcomes. Improving outcomes And certainly, for CCGs, the potential for better service provision for individuals through the use of PHBs should be a significant motivating factor; evidence has shown that patient-led care has clear clinical benefits. Giving PHB holders direct purchasing power also – through the power of the market – has the potential to drive up the quality of care and service provision at both an individual and systemic level. Individual budget holders – who many would argue are best placed to judge care standards – are free to work with only the best providers. But this decentralisation of care also poses administrative challenges for CCGs, who must walk the tightrope of facilitating this sort of patient-led care, whilst simultaneously managing the administrative requirements and potential risks, and demonstrating value for money for the public purse. Our solution, PHBChoices, is a financial management system, which includes a secure, online marketplace for the administration of PHBs. The platform enables PHB holders, or their carer, to purchase products and services direct from national, regional and local suppliers in line with a care plan agreed with their CCG. The individual benefits from the control afforded by a PHB but without the burden of administration. PHBChoices is cashless (using a virtual wallet) and its functionality allows PHB holders to do everything from manage their personal carers’ timesheet and payroll, to buy specialist equipment such as wheelchairs, or find a respite care provider.

For CCGs, it enables them to achieve their NHS England personalisation targets, while providing better visibility, transparency and control than is possible when using a direct payment bank account. PHBChoices is fully integrated with the NHS Integrated Single Financial Environment (ISFE) – the payment platform used by all of the country’s commissioning organisations – so the CCG can retain cash until the patient spends their budget, whereby funds are transferred direct from the CCG to the supplier. Because all communication is online, all transactions are fully ‘auditable’. There are also clear financial benefits for CCGs who need to provide greater personalisation from using existing budgets; it is clear that there is no ‘new’ money to fund the migration to personalised care. PHBChoices provides CCGs with opportunities to achieve both cash releasing savings and avoid future increases in administrative costs, as well as improving cash flow. With – as ever – the aim being to improve patient care, PHBs have great potential to support the best possible provision for the individual – enabling them to benefit from interventions that will make a tangible difference in their lives and improve outcomes. CCGs must have infrastructure in place that enables PHB holders to easily access what they need, without placing undue administrative burden on them; the CCG needs to fulfil its own obligations with regards financial and auditing requirements in order to demonstrate that public money is being spent in the right way. We believe that for many CCGs, a scalable marketplace style solution like PHBChoices is just the solution. L

Written by Jon Baker

Personal Health Budgets are key to meeting the government’s personalisation targets. Managing them, however, can pose many challenges. Jon Baker, PHBChoices director at NHS Shared Business Services (NHS SBS), believes that scalable marketplace style solutions may just hold the key


PHBs: Improving outcomes and value for money




Clean air

Creating cleaner air for the UK’s most polluted hospitals The Clean Air Hospital Framework is the world’s first step-by-step guide for hospitals to create cleaner air. Larissa Lockwood, head of Health and Air Quality at Global Action Plan, explains

T framewhe created ork was conside with a wellr to wha ed approach and po t is practical ssib hospita le within a l setting

Back in 2018, Great Ormond Street Hospital asked environmental charity Global Action Plan: “What would a Clean Air Hospital look like, and how would it operate?” We discovered that there was no single, comprehensive guide for minimising air pollution inside and around hospitals, so we answered that need by creating one together. Combining Global Action Plan’s expertise from almost a decade’s worth of air quality initiatives with Great Ormond Street Hospital’s expert knowledge of running a world-leading


hospital, the framework was created with a well-considered approach to what is practical and possible within a hospital setting. The resulting Clean Air Hospital Framework is a free, comprehensive guidebook of 215 possible steps – established with extensive staff input – that hospitals can take to minimise air pollution from everyday activities and advise patients about air quality and their health, as well as working in partnership at the local and national level towards broader societal change for cleaner air.


Cleaner air where it matters most Our hospitals should be laces that improve our health. Last year’s report by the British Lung Foundation - Toxic air at the door of the NHS - revealed that 2,220 GP Practices and 248 hospitals in the UK are in locations with air pollution above WHO standards.  The Clean Air Hospital Framework offers a straightforward plan to make it easier for hospitals to act on air quality. It takes a broad look at every aspect of a hospital to find specific areas of improvement, so they can operate with the cleanest air possible.  Unpacking the framework The Clean Air Hospital Framework is a succinct, easy-to-understand compilation of information and actionable suggestions built on the everyday experience of staff delivering on-the-ground services within a busy NHS trust. It includes a presentation that can be used to explain the framework to staff, as well as a guidebook, which focuses on seven key areas to improve hospital air quality: travel; procurement and the supply chain; design and construction; energy generation; local air quality; communication and training; and hospital outreach and leadership. Each area has its own sub-list of actions that can be taken to improve air quality. The list of actions is widely varied - some can be done in the short-term, while some take time and planning, some require funding or wider systemic changes and some are simple changes in everyday care practices. The Clean Air Hospital Framework encourages hospitals to be ambitious, and to set one-, two-, five- and ten-year targets, and to ensure interdepartmental cooperation so the actions taken become a part of overall hospital strategy.   Hospitals can track their progress using scoresheets provided within the framework and calculate their air improvement rating based on the number of actions they take on. This is used to prioritise which air improvement actions to undertake in each hospital’s clean air action plan. The framework was created with the purpose of being replicable and adaptable for each and any hospital. Great Ormond Street Hospital – an acute trust - has been a pioneer in incorporating the framework into their own system, but all hospitals have unique designs, specialisms, operations and locations bringing unique air quality challenges. The framework caters for all eventualities by directing hospitals to review all areas of their hospitals that may be prone to air quality issues, with a range of solutions proposed from which the hospital can choose the solutions that work best for them.  

What next? Since the framework was launched in March 2019, it has had almost 500 downloads and we know that at least six other hospitals are already using the framework to create their own bespoke clean air hospital action plans.

Our projected goal of 50 hospitals adopting the framework could result in 1.6 million patients a year getting vital advice on health and air pollution

Our ambitions for the framework are to mobilise all hospitals within the UK to create their own clean air action plan. The framework is also being shared internationally with the Global Green and Healthy Hospitals Network to encourage its use around the world. Opensourcing our Operation TLC energy efficiency programme for hospitals with this network resulted in over 200 hospitals downloading this advice, and we aim for similar results with the Clean Air Hospital Framework. 

Clean air

Implementing the framework Great Ormond Street Hospital has taken the lead – already achieving over 150 points within the framework and working towards a further 200 points in the short to medium-term. They are progressing from a hospital rated ‘starting out’ ‘to one rated ‘good’ on 540 points. Great Ormond Street Hospital has done this by using the Clean Air Hospital Framework to create a clean air action plan – agreed at senior level - that sets out actions they are delivering and ambitions they are aiming for. They are already delivering: driver, contractor, clinical staff and play service training; artwork with patients and families; indoor and outdoor air monitoring; play street with varied local and wider partners; research projects linking health and air quality; clean air contractual provisions; staff induction and online training; and case studies shared through wider NHS structures. The hospital is also planning for: increased charging infrastructure; electric patient transport; zero tailpipe deliveries; BREEAM ‘excellent/outstanding’ construction; increased onsite renewables; patient clean air advocate development; and innovative clean air strategic and technological partnerships. Hospitals have a fantastic opportunity to reduce air pollution emissions and teach the most vulnerable people how to reduce the health impacts of air pollution. Many measures can be taken at no cost to the hospital, but we appreciate that time is a precious commodity. The Clean Air Hospital Framework saves hospitals time in researching what anti-pollution action to take by listing activities graded by impact. If the health sector can minimise its air pollution with limited resources, it creates a powerful precedent to demand action from more major polluters.

Our projected goal of 50 hospitals adopting the framework could result in 1.6 million patients a year getting vital advice on health and air pollution. Additionally, operational changes in these hospitals defined within the framework could reduce emissions of nitrogen oxides equivalent to replacing 54 million miles of diesel and petrol driving with electric vehicles. The ability for the framework to be implemented quickly, and with a range of actions, means that air quality changes can begin to occur immediately. The Clean Air Hospital Framework has been shortlisted for a Sustainable Cities Award in the Healthier Places category, with the awards ceremony in mid-July, only four months after its launch. For such a young initiative to get such recognition already is surely a sign of exciting things to come. Hospitals can pledge to become clean air hospitals and download the framework for free at For hospitals who would like additional support through the implementation process, Global Action Plan and Great Ormond Street Hospital are available to provide on-site aid through workshops, coaching, staff training, planning sessions, and peer-to-peer discussions. Find out more by calling us on 020 7420 4444. L FURTHER INFORMATION





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‘The most cutting-edge system in the world for Group have quantified the financial impact the use of technology to improve our health, of just some of the available technologies. make our lives easier, and make money go Our Keeping Britain Working report revealed further’. That’s Secretary of State for Health that just eight technologies - including sepsis Matt Hancock’s vision for the NHS, whose diagnosis equipment, coronary angioplasty, ambitions include modernising the way and hip and knee replacements - have the the health service delivers care to patients potential to save the economy almost half a through cutting-edge mobile and IT solutions. billion pounds a year from reduced healthcare Medical technology however - from medical costs and benefit payment savings. devices to in-vitro diagnostics, imaging equipment and ehealth - already plays an The postcode lottery enormous role in serving NHS patients. In fact, - alive and well still around half-a-million different technologies It would make sense for patients to have are available, with the health service equal access to medical technology regardless allocating around £6 billion a year to this area. of where they live. Sadly though, this has long This technology delivers considerable been a challenge for the NHS. The main reason benefit to the NHS. It often increases is the way the health service is structured. efficiency, reducing the need for further Devolution of decision-making to local NHS intervention and long-term treatment, organisations means that the final decisions reduces costs by limiting hospitalisations, on which treatments are offered locally and and improves patients’ quality of life. under what circumstances is governed by It can also deliver wider societal individual Clinical Commissioning benefits, helping people return Groups and hospital trusts. to work and care for family The existing Around members. In fact, studies by organisation - alongside half the Work Foundation and budget constraints million -athe Medical Technology - only serves to d prolong the postcode techno ifferent lo lottery, as local g ie availab le, wit s are health services find

allocatin h the NHS g £6 billio around n a yea r to this area

increasingly more creative ways of controlling spending by restricting access to treatments and technologies. A recent investigation by the Medical Technology Group has revealed that CCGs are failing to comply with national guidelines on which treatments should be made available. What’s more, when a CCG restricts access, there’s very little the local population can do to change policies. Our study, conducted in October 2018, took four common proven treatments: cataract surgery, hernia repair, Continuous Glucose Monitoring, and hip and knee replacement. We then looked at the lists of treatments restricted by CCGs. These ‘Procedures of Limited Clinical Value’ (PoLCV) - which are normally reserved for complementary therapies or cosmetic procedures where there is little or no clinical evidence to prove their cost effectiveness or clinical benefit - are, according to the Royal College of Surgeons, generally not funded by Commissioners. The results were startling. We found that, despite all four treatments being recommended by NICE, CCGs across the country are deliberately restricting access to them or applying high thresholds to limit the number that are carried out.

Written by Barbara Harpham

Barbara Harpham, chair of the Medical Technology Group, argues for equal access to medical technology and says that treatment should be based on their clinical needs, not patient postcode

Medical technology

Base clinical decisions on patients’ needs, not postcodes

Cataract surgery Our research revealed that 104 out of 195 CCGs include cataract surgery on their PoLCV lists. Cataract surgery is the most common operation performed in the UK, and NICE national guidelines clearly reinforce its costeffectiveness, indicating that it has a ‘high success rate in improving visual function, with low morbidity and mortality.’ Under current national guidelines, the extent to which a patient’s eyesight is affected by cataracts should not determine whether or not they receive treatment. Instead the condition’s impact on patients’ quality of life should be the determining factor. Nevertheless, a third of CCGs list a visual acuity threshold as a requirement for receiving treatment. E Issue 19.2 | HEALTH BUSINESS MAGAZINE


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Technology often increases efficiency, reducing the need for further intervention and long-term treatment, reduces costs by limiting hospitalisations, and improves patients’ quality of life  While this is a valuable assessment, playing an important role in evaluating a patient’s condition, visual acuity alone should not determine whether a patient is treated. As well as contravening national guidelines, restriction of cataract surgery can also lead to further patient complications. The Royal College of Ophthalmology states that the ‘presence of cataract causes disability and increases the likelihood that individuals will suffer adverse events’, while the Royal National Institute for Blind People confirms that patients with cataracts are twice as likely to experience a fall. Continuous Glucose Monitoring Continuous glucose monitors have become an important tool for people with Type 1 diabetes, allowing them to constantly track their blood sugar levels, identify high and low trends and sound an alarm at high levels. The devices, worn just under the skin, measure glucose levels in interstitial fluid, providing more information than fingerprint blood tests and enabling the user to make better treatment decisions. NICE guidelines on the management of diabetes in adults include guidance on how to commission CGM, setting out clear criteria for commissioning and the type of user that should be considered. However, we found 12 CCGs who do not commission CGM and a further seven that will only do so following an independent funding request from the patient. In other words, around 10 percent of CCGs are placing some form of barrier to CGM. Hernia surgery Hernia repair is one of the most common surgical procedures in the UK, with around 80,000 performed every year. NICE states that

it should be undertaken in most individuals with an inguinal hernia in order to close the defect, alleviate symptoms of discomfort and/ or prevent serious complications, such as obstruction or strangulation of the hernia. The Royal College of Surgeons’ guidance is clear on the impact of delaying treatment, stating that ‘CCGs should not set criteria for referral and treatment for inguinal hernias’ outside that recommended in its guidance, as this approach ‘produces worse clinical outcomes and has not been shown to be cost effective’. Despite this guidance and proven record of successful outcomes following hernia repair operations, our research found that 95 CCGs – almost half – include hernia repair on their PoLCV or Threshold Policies lists. These thresholds mean that many CCGs take a ‘watchful waiting’ approach, where time is allowed to pass while further tests are carried out. While this might be appropriate for some patients, a more widespread adoption of this policy could mean an increasing number of patients only receive treatment when their condition deteriorates, and they require emergency intervention. Hip and knee replacement Around 200,000 hip and knee replacements take place in England every year, according to the National Joint Registry, which found that 92 per cent of patients report high levels of satisfaction six months after treatment. In addition, the British Hip Society’s guidelines describe Total Hip Replacement (THR) as cost effective, returning 90 per cent of patients to their previous employment, while enabling elderly patients to maintain their independence. Previous widespread restriction on access to treatment has prompted the RCS to speak out, stating that ‘blanket bans do

Medical technology

not best serve patient care’. Yet, despite the supporting evidence and hip and knee replacements being used effectively for decades, we found 78 CCGs that include the surgery on the PoLCV or threshold lists. They often apply a Body Mass Index threshold, contrary to advice from the RCS. Analysis of the National Tariff reveals that THR is cheaper than long term conservative treatment for osteoarthritis of the hip. Clinical value undermined The inclusion of common proven treatments on CCGs’ lists of restricted procedures is resulting in a huge variation in the treatment that patients receive. We found, for example, that access to cataract surgery for patients falling under Basildon and Brentwood CCG is restricted, while nearby Barking and Dagenham CCG offers the treatment. Not only does this create inequality for patients, it also undermines NHS England’s drive to assess treatments of limited clinical value. This work, which is clinically-led and based on the available evidence, sets out 17 treatments that are not clinicallyeffective or are only effective when they are performed in specific circumstances. By taking apparently random and inconsistent decisions on what procedures to restrict, CCGs are rendering this exercise pointless. Ration Watch – calling CCGs to account The Medical Technology Group is extremely concerned by the findings of this research. It has long been our mission to ensure that patients have equal access to medical technology and that treatment should be based on their clinical needs, not their postcode. We have responded by creating Ration Watch, a campaign focused on highlighting variation in local commissioning. Ration Watch is calling on CCGs across the country to follow national clinical guidelines on commissioning, and to ensure patients receive the treatment to which they are entitled. Meanwhile, NHS England needs to set clear guidelines on which procedures should be classed as having limited clinical value and where viable thresholds can be applied. A national body, with the power to intervene when unfair policies are being adopted, should also be created to oversee local commissioning practices. Above all, we want to see CCGs taking a longer-term view that looks beyond the immediate cost of a procedure. Instead, they must consider the longer-term impact on a patient’s quality of life and on wider society while assessing the ongoing cost of treating chronic conditions. Only then will we see a fair NHS that finally kicks the postcode lottery into touch, improves NHS efficiency, and delivers what patients deserve. L FURTHER INFORMATION



Providing safer and long lasting heating solutions to hospitals across the UK Contour is acutely aware of the enormous demands placed upon health care service providers, ranging from the constantly increasing pressure to provide buildings fit for purpose, ever present budget and staffing pressures to the intense on-going media coverage surrounding MRSA and other Healthcare Acquired Infections (HAI). We work closely with all channel participants from general and facilities managers, infection control teams, architects, M&E consultants through to contractors and installers, to ensure the cost-effective and best practice deployment of products and services. Uniquely amongst LST guard manufacturers, Contour incorporates BioCoteÂŽ anti-microbial protection into the paintwork of all our LST radiator guards as standard. This technology provides effective and permanent protection to the surface of the LST radiator guard, preventing the growth of harmful microbes such as bacteria and fungi. BioCoteÂŽ technology protects product surfaces from microbes, helping in the fight against the spread of infection. The DeepClean LST radiator guard

is constructed using a patented, quick release hinged door. This allows the front of the casing to be laid flat to the floor and provides an operative easy access to clean the radiator. The door is so robust that it can be stood upon if necessary without resulting in any structural damage. The hinge design also facilitates complete removal of the door if required. To arrange your free site survey and consultation, please use the contact details below. FURTHER INFORMATION Tel: 01952 290498




Reducing energy consumption and fuel use

Solar forges ahead without the Feed in Tariff

CLS Energy (Consultancy) Ltd is a team of chartered and certified energy management and fleet professionals. The company works with its customers to deliver independent and specialist advice and recommendations on energy efficiency technologies, measures and controls to reduce energy consumption and fuel use. This from heating, building management systems controls, HVAC and building fabric, to motors, compressors, chillers and refrigeration; reducing our clients energy consumption by up to 40 per cent. CLS Energy also provides comprehensive advice on a range of renewable and low carbon technologies (solar, CHP, wind, hydro and heat pumps) and engineering assessments as well as providing autonomous advice on appropriate retrofit solutions and post installation inspections. As independent fleet

Now that solar PV is a real, unsubsidised market, Powersun reports increased interest. For all large organisations, the ability to mitigate ever increasing energy costs with a reliable and known technology is becoming important. For self-investors who are high consumers, payback can be as high as 20 per cent IRR and as short as four years. Add to that fully available funding, giving complete installation with no Capex, and solar is irresistible. Simple Power Purchase agreements usually reduce this part of energy expenditure by at least 30 per cent. Localised renewable energy gives security: part of your energy supply is then outside the control of the BIG 6, and away from yearly above-inflation price hikes. With energy storage and EV’s gaining popularity daily, a perfect

consultants, CLS Energy works with cars, vans, ambulances, lorries, marine and air fleets delivering reductions from aerodynamics, alternative fuels, controls, telematics, tuning, training and drag reduction of up to 47 per cent against organisational fuel and associated costs. For both energy and fleet, the company offers data-led assessments and provide ‘double-locked’ guaranteed savings recommendations.



Pest protection specialising in bird control Apex Bird Control is a specialist bird control business within the pest control industry. The company operates across the south of the UK with clients that include architects, construction firms, local councils and facility managers - meaning it is well placed to handle your bird control requirement. Many property owners are unsure how to effectively target the dangers associated with birds and bird fouling. Managing director Mike Fenton says: “Our attitude toward bird control will always be proactive. The advice we give to clients is about preventing the spread of disease, damage to buildings, mitigating risk of injury and adverse effect on reputation in a cost effective solution.” By preventing birds from occupying specific areas, property managers can ensure their buildings are protected



from the problems they can cause and minimise the associated health risks. Apex Bird Control’s close knit team consists of surveyors, installation contractors, office staff and an approachable director. Its team is knowledgable and highly skilled which gives its clients the confidence to know that every project will be approached with effectiveness, aesthetics and health and safety considered in equal measure.


energy triangle is coming – charge EV’s with cheap solar; charge batteries with cheap nighttime power; use the batteries to allow faster EV charging. With a decentralised electricity grid becoming ever more a reality, organisations large and small are realising the power of solar. A large roof stacked with panels can really make a difference, and Powersun is excited to be involved in changing the world of power.


Pestoclear – Pest Control and bird work specialists Pestoclear C & W Ltd specialises in Pest Control, bird work and fumigation. Covering all aspects of pest control, commercial and domestic, Pestoclear is dedicated to bringing you the highest standard and quality at the lowest possible price, either to inspect a possible infestation or fit bird deterrents. With years of experience in pest control solutions, the company specialises in all elements of pests from ants, moths, wasps, bedbugs, birds and rodent infestations – saving you from any stress or issues. One of the main areas of expertise is bird control from netting, spike and wire deterrents to guano removal and falconry disruption. The most effective way to keep birds off an area is by proofing, for example netting – putting up a physical barrier to stop birds accessing. Wire and spike systems are also effective for roosting sites.


Another effective way of dissuading birds from habituating to an area is via the use of falconry. Falcons and hawks are natural threats to gulls and other birds. The use of these in certain areas that invading birds are using is an effective deterrent and helps stop them returning to site. If you have a problem with any pests from ants to birds, give Pestoclear Ltd a call for a free no obligation quote. The company is a member of the BPCA and Wirra Chamber of Commerce.

FURTHER INFORMATION Tel: 01925 654 720



Mechanical and electrical specialists

Mechanical & Electrical services you can trust

Established in 2005, AAC Group is a mechanical and electrical specialist who has a solid reputation in the supply, installation and maintenance of air conditioning, heat pumps, ventilation, gas services, electrical works, heating and plumbing and associated builders works throughout Kent and the South East. AAC Group specialises in designed and installed environmental control systems to deliver heating, cooling and ventilation solutions in any setting whether industrial, commercial or domestic. The company offers a full package, including contractual service and maintenance options, tailored to your specific requirements whether AAC Group installed the equipment, or it was installed by others. AAC Group is committed to maintaining high quality standards and prides itself in holding

Are you compliant? Are you getting the most out of your building? Will your building services meet its life span? If you are not or have any doubts, then Edge M&E Maintenance is here to help. The company was formed in 2010 to offer planned preventative maintenance services. Priding itself on offering compliant solutions to its clients, Edge M&E ensures buildings Mechanical & Electrical plant life expectancies are met. The organisation understands time is critical for its clients and down time of services can harm an organisation. This is why Edge M&E, within a standard contract, have a four hour reactive response time to provide comfort to our clients knowing that our expert engineers will be on site quickly to minimise disruption. Edge M&E understands each business is different and it tailors

the following accreditations: BESA, CQMS, Gas Safe, FGas Certification – REFCOM, NICEIC and ISO9001:2015. The organisation’s ambition has always been to create an outstanding customer experience, one that delivers a truly seamless technical service for its clients keeping them at the heart of what it does and at the forefront of innovation to fit all budgetary requirements.



its contracts to suit individual client’s needs covering building services such as: air conditioning, refrigeration, chillers, plumbing systems, drainage, emergency lighting, PATs, fixed wire testing, boilers, UPS, generators, lifts, fire and security systems, water treatment, air quality testing and building management systems. To discuss how Edge M&E Maintenance can assist you please contact via the details below.

FURTHER INFORMATION Tel: 0207 904 1033


Reliable, family owned deep cleaning services

A sustainable and successful catering service

Established in 1978, Bright Hygiene is one of the UK’s leading hygiene services providers. The company remains a family owned and run business today which means it focuses on ensuring high levels of training, health and safety, and well-being for its staff. Bright Hygiene’s experience in kitchen and ventilation deep cleaning, high level deep cleans and filter exchange is second to none. With Bright Hygiene you can be certain that you are getting a reliable, consistent, high quality, deep cleaning service that respects the environment and at a fair price. Bright Hygiene, unlike most other companies, does not ask for a signed service agreement. You simply say how often you would like the service which is entered into the company database so that Bright Hygiene can schedule a call to you a few weeks before

FDH has been providing catering management systems to the healthcare sector for over 25 years. The Saffron solution is used by over 100 hospitals to control their catering business. Saffron is a modular system and is deployed with the relevant functionality available in the relevant locations. A large NHS CPU might use full line by line stock management and production planning whereas a small hospital may just use patient ordering functionality to capture and collate orders. Saffron is a 100 per cent web-based application available to any location, with the only IT infrastructure required being an internet connection. Saffron is provided as a managed hosted service inclusive of all backups, fixes and upgrades to the latest version Saffron encompasses the entire catering process from management of purchasing, stock, wastage and consumption

your service is due to arrange a date and time that totally fits in with your kitchen routine. To enable the orgainsation to prepare a deep clean quotation, a Bright Hygiene surveyor will carry out a free survey and prepare a survey report, site specific risk assessments, recommendation charter and quotation that is fully tailor-made to suit your needs and your timing.


calculation, recipe and menu management including, production planning with full CPU controls, and nutritional analysis. Saffron Bedside ordering via tablet PC and iPad is revolutionising healthcare catering with huge cost savings already being enjoyed by NHS and healthcare contract caterers. Saffron is a flexible across sector catering management tool that can also be used in commercial/retail catering areas and readily interfaced to Epos and finance systems.

FURTHER INFORMATION Tel: 0114 281 6060




Lose a patient’s records and you’ve both got a problem

PaperMountains: Keep control of your files

These days we all have to maintain records, whether for patients, customers, employees, legal, commercial, accounting or, even, government purposes. More importantly, we want to know that they’re stored safely but readily available when needed. For a lot of people that’s hassle: for StorGuard it’s a way of life. We are one of the leading independent document management specialists in the country. With our head office at our centre of excellence in North London, StorGuard has invested in new facilities and developed a dedicated IT barcoding system to track and trace a box or a file throughout its archiving life. StorGuard provides a fast, efficient and professional

PaperMountains is a total document management company offering secure, GDPR compliant services in London, Kent, Essex, Sussex, Hertfordshire, Bedfordshire and Buckinghamshire. With a wide range of services, including: regular confidential destruction, one‑off secure shredding (paper, hard drives and media) as well as document archive storage and document scanning, PaperMountains can help you get on top of and manage your document processing, storage and destruction. PaperMountains’ secure confidential destruction and shredding services are to BSEN 15713, GDPR compliant and with a certificate of destruction issued. The company aims for 100 per cent of recovered materials to be recycled. With its regular services, PaperMountains

collection and retrieval service, using its own electric vehicles wherever possible. The company can deliver records back to you daily to meet a just-in-time schedule if required: or you opt for deep storage at cheaper rates for those files that you never want to see again but still have to keep! Plus, Storguard can offer timetabled destruction and certified shredding for end-of-life records. Whether it’s one file or ten thousand boxes, StorGuard can solve your problem. Please use the contact details below.

FURTHER INFORMATION Tel: 0800 731 7177




offers simple, clear plans and can provide consoles, sacks or bins. All collections come with no additional costs such as environmental levy or fuel surcharges and no long-term lock in. The company offers clear pricing and reliable, professional services which can be scaled from small departments through to organisation wide solutions.



Buying and recycling redundant IT hardware

Data Planit: Capturing your world of data

Revive IT is an established and highly accredited data destruction and recycling company since 2008. The organisation operates nationwide and helps its clients ensure compliance with the Waste Electrical Electronic Equipment Regulations 2013 Act (WEEE) as well as the European GDPR directive through end of life compliance. Revive IT offers two primary service offers, the first being a free nation-wide collection intended to return a zero-cost service to allow clients an ethical route to the recycling of their redundant IT and WEEE Equipment. The company’s second service allows companies to release residual value in their redundant equipment and Revive IT can offer direct payment or charity donation on client’s behalf to fulfil

Data Planit is a proactive, innovative and reliable provider of state-of-the-art document management services, providing to the NHS and the health sector as well as many others for over 20 years. Digitising your filing and information systems will have an impressive impact on how you operate as an organisation. You will quickly benefit from efficiencies that are not possible with archaic physical filing systems. Paperwork stored in filing cabinets is quickly becoming a thing of the past with businesses all over the world realising the benefits that comes with the paperless working environment. Data Planit can scan, store and help you manage your electronic files, starting with a simple consultation. Files that may need digitising may include patient records, HR documents or invoices. What ever type of files

Corporate Social Responsibility. Every year IT and WEEE waste is discarded by households and companies in the UK, much of which contains hidden data and information in relation to your business and your customers. Revive IT ensures that risk is eliminated and the compliance and integrity of your data security is completely safe. Data security and destruction is the company’s speciality and it is accredited by UKAS ISO 27001, 9001, 14001 to sanitise your equipment completely.



require scanning, the company has over 20 years’ experience in handling the most sensitive documents, and never breaching data protection regulations. By outsourcing your document management needs to Data Planit, you will save time and money on administrative processes to concentrate on what’s really important. If you are interested in where your information can be accessed anytime, anywhere, anyhow, get in touch with Data Planit today.




Helping you find the career you deserve

Drone photography for businesses and individuals

IMC Locums believes in doing things slightly differently than your typical recruitment agency, hand picking recruitment agents who are truly the best within their specialist industries to give the IMC locum workforce the best 360 degree service available anywhere. IMC’s core business belief is to run like a family, everyone who works with us is helped every step of the way in whatever they want to achieve. IMC provides workforce recruitment solutions as an approved framework supplier to the NHS and the majority of

Quayle Industries Ltd provides aerial photography using drones for businesses and individuals in Nottingham and across the UK. The company is proud to be Civil Aviation Authority approved, meaning it is fully licensed and works to the highest standards. Before Quayle Industries undertakes any project, the company seeks appropriate clearance from the authorities to operate the drone. Quayle Industries Ltd works with clients to plan what is needed and how the footage will be used to give you the result you need. There are many instances where drone photography or filming is the best option. For example, drones are cost‑effective and reduce the need for scaffolding or helicopters. The quality of the photography and videos is also of a very high standard. Drones can be used to access hard to reach areas inside and

the private sector, from Nursing to AHP/HSS professionals, IMC provides high calibre staff on a locum and permanent basis. IMC Locums specialises in the following markets: cardiology; respiratory; neurophysiology; sleep; radiography; occupational therapy; physiotherapy; acute nursing; care home nursing; and primary care.

FURTHER INFORMATION Tel: 0203 473 2430


outside. Lastly, data and images can be relayed to you within 24 hours ready to download. Quayle Industries Ltd provides stunning photography and videos for a wide range of purposes from, property developers wanting to showcase their properties for sale, individuals that need a roof inspection through to companies that want some aerial views as part of their marketing campaigns. ‘Why risk working at height when you can send a drone to do it!’



Innovative healthcare solutions for Europe

Providing the complete signage service

EIT Health is a network of best-in-class health innovators backed by the EU, collaborating to deliver innovative solutions that enable European citizens to live longer, healthier lives. As Europeans tackle the challenges of increasing chronic diseases and multi-morbidity, they seek to realise technology’s potential to move beyond conventional approaches to treatment, prevention and healthy lifestyles. To succeed, Europe needs thought leaders, innovators and efficient ways to bring innovative healthcare solutions to market. EIT Health connects relevant healthcare players across European borders – making sure to include all sides of the ‘knowledge triangle’, so that innovation can happen at the intersection of research, education and business for the benefit of citizens.

The Sign Station Limited is based in Chelmsford Essex. The company offers its services nationwide and has extensive experience of providing signage solutions within the healthcare environment. Clients include HCA (The Harley Street Clinic), The King Edward Vii Hospital in Westminster along with various residential care providers such as Larchwood Care. The organisation also has significant experience of providing signage to the veterinary industry. The Sign Station provides the complete service, from site survey through to design, manufacture and installation, and even after sales maintenance. However, the company is happy to work form its customers’ design briefs and specifications and can accept artwork in most digital formats. It approaches every project with excitement and enthusiasm

EIT Health gives health innovators access to the market, funding and the expertise of its network. The company facilitates innovation through programmes, workshops and initiatives. Collaborating on international projects and disseminate our findings to the public, EIT Health creates new products and services for healthy lives in Europe. And, through citizen engagement activities, innovation programmes and skills training.

FURTHER INFORMATION Tel: +49 89 215 474 820

and is always seeking new ways to excite its clients with new materials and the latest sign making technology. The Sign Station aims to be competitive within the market place and has recently invested in a brand-new flatbed printer which makes it even more competitive in certain areas. The Sign Station can work in most materials including aluminium, stainless steel, brass, acrylic, most plastics and even wood.






Property surveying and consultancy services

Welcoming you to vibrant West London

Pennington Choices has worked with asbestos for over 30 years, helping clients across a host of sectors including: healthcare, transport, local government, blue light services, social housing, construction and retail. The company is an expert in asbestos management not by its own words but by its clients. Asbestos services at Pennington Choices include: surveying, air monitoring and four stage clearance testing, sampling and laboratory analysis, project management and remediation, auditing, procurement, consultancy, asbestos management plans and training. The organisation is accredited to ISO17020 and ISO17025 by UKAS and UKATA accredited for training. Pennington Choices has dedicated UKAS accredited laboratories, provides an emergency out of hour’s asbestos service, which operates

Spacious, versatile, stateof‑the‑art, inclusive, cleverly put... all attributes you can apply to your next event in London with ILEC Conference Centre. Featuring one of London’s top largest and most versatile event hall, the venue is fitted with state of the art equipment and technologies, stunning design and on-site 3*accommodation making it the ideal conference venue. This iconic ballroom, will also light up the scene for a flamboyant evening while our chef mouthwatering menus selection and award winning event team will guarantee a memorable evening. Ibis London Earls court also offers 504 comfortable and spacious guestrooms and with 12 floors, some of the best view of the London skyline. Guest can also relax while enjoying a true British experience in our George and Dragon pub. Both venue and hotel benefit from

24/7, and offers nationwide coverage meaning that, no matter where you are in the UK, its expert teams can help you. Alongside providing a wide range of asbestos services, Pennington Choices’ teams also deliver: fire risk assessment services; electrical and gas auditing; legionella services; stock condition surveys; energy performance certificates (EPCs); strategic consultancy and chartered building surveying services. The company’s full breadth of services makes it unique and provides its clients with a cost and time effective solution.

FURTHER INFORMATION Tel: 0800 883 0334

a brilliant location in the heart of West London, with excellent travel links to major airports, train stations, city landmarks and business districts. The close proximity to the shopper’s paradise of Kensington and Knightsbridge and the stylish cafés and boutiques of Chelsea also makes it a great place to stay.

FURTHER INFORMATION enquiry@ www.ilecconferencecentre.


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94 Ltd


PestTrain 82

Glasdon UK


ARI-Armaturen UK AVR Group Awesome Technology


6 IFC,28 36

Globus Group GoJo Industries-Europe




Pure Audio Visual


Quayle Industries



Record UK



Revive IT

96 12

Hiscox-UK 16

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Castle Water

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IMC Locums Internet Video Communications

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Brainsparker 26 Business Events Bournemouth


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ISS Mediclean


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Data Planit


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Jones AV


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Legrand Electric


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Edge M & E Maintenance


Medstrom Healthcare

Eit Health UK Ireland


Metric Group

Evac & Chair International


44,45 62

Smart Parking

10 68,69 58

Storguard 96 The Sign Station


Thomas Ridley Food Service


Toyota 4

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WPS 60

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Murray Equipment Co

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Scanning solutions for Healthcare

By scanning and deploying a document management solution, healthcare organisations can more efficiently manage all their paper and digitally born material. 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 (GDPR) throughout all departments with all regulatory guidelines. ■Faster access to patient information, leading to improved patient outcomes, better patient engagement, and better

access to critical information across the care continuum. ■ A notable ROI, with most organisations reporting a full return on their ECM investment within 18 months of implementation. Administrative capture in the back office

For archiving and digitizing large volumes

SP-1120 fi-6800

Web based document capture and network scanning

Scan securely in the community

Decentralised capture within the front office


Fujitsu Scanners are available through NHS Supply Chain, contact them at or for further information on the ranges visit


PaperStream IP high quality image enhancment


PaperStream Capture enhanced capture

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Health Business 19.2