Health Business 20.1

ISSUE 20.1 www.healthbusinessuk.net

RECRUITMENT

CYBER SECURITY

GS1 STANDARDS

FIRE SAFETY

PARKING

PROVIDING IMPROVED CARE

FAIR FOR ALL? HOSPITAL PARKING

Analysing the potential of Global Location Numbers to drive transformational change in our hospitals

Our panel of experts assess the latest changes in hospital parking, including free parking for the patients most at need

PLUS: CLOUD TECHNOLOGY | DIGITAL HEALTH | FACILITIES MANAGEMENT

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TRAININGS

EQUIPMENT HISTORY & STATUS

DASHBOARD

Comment

ISSUE 20.1 www.healthbusinessuk.net

RECRUITMENT

CYBER SECURITY

FIRE SAFETY

PARKING

GS1 STANDARDS

PROVIDING IMPROVED CARE

FAIR FOR ALL? HOSPITAL PARKING

Analysing the potential of Global Location Numbers to drive transformational change in our hospitals

Our panel of experts assess the latest changes in hospital parking, including free parking for the patients most at need

Does free parking mean fair parking?

At the start of the year, Health Secretary Matt Hancock announced that thousands of NHS patients and visitors in England will soon be able to access free hospital car parking under a new DHSC approach.

PLUS: CLOUD TECHNOLOGY | DIGITAL HEALTH | FACILITIES MANAGEMENT

From April, all 206 hospital trusts in England will be expected to provide free car parking to disabled people, frequent outpatient attenders, parents of sick children staying overnight and staff working night shifts.

The issue of free parking has been a constant one for decades, with NHS trusts in England responsible for making their own car parking arrangements, including setting any charges. But it is by no means the only issue facing the industry.

Our Expert Panel, comprising of Dave Smith, Stewart Clure, Grahame Rose and Simon Jarvis, discuss the Queen’s Speech announcement and the other problems with hospital parking in our piece on page 24.

Additionally, Kelvin Reynolds writes on page 31 about why fair for all, but not free for all, may be the best solution to hospital parking.

Follow and interact with us on Twitter: @HealthBusiness_

Elsewhere, Cancer Research UK has warned that the 2030 smoke-free target is set to be missed by at least seven years. Surely Hancock must make changes to public health funding before ambitious targets become completely unachievable.

Michael Lyons, editor

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Issue 20.1 | HEALTH BUSINESS MAGAZINE

3

Medical Records.

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Contents

Contents Health Business 20.1 07 News

47 GS1 standards

All adults to be automatically enrolled as organ donors; expensive visa fees could deter NHS staff; and service cuts prompting worries for health visitors

Glen Hodgson, head of Healthcare at GS1 UK, looks at the current state of the eProcurement strategy and asks where the GLN sector is heading over the next few years

15 Facilities management 31 41

On behalf of the Institute of Workplace and Facilities Management (IWFM), Preston Gan asks whether the current state of facilities management in the NHS is ready for the investment of IoT, Big Data and AI

19 Fire safety Dr David Gold and Neil Vincer, from IOSH, discuss how organisations can ensure that a sustainable workplace fire safety culture is incorporated to all staff in a hospital setting

24 Expert panel: Parking

47

In our second Health Business Panel of Experts on parking we are joined by representatives from Debt Recovery Plus, GroupNexus, WPS Parking and the British Parking Association to discuss the ongoing issues relating to hospital parking

31 Parking Kelvin Reynolds, director of Corporate and Public Affairs for the British Parking Association, explains why fair for all, but not free for all, may be the best solution to hospital parking

36 Recruitment 56

Neal Suchak, policy advisor at the Recruitment and Employment Confederation, analyses the importance of a healthy, transparent recruitment supply chain and the benefits of co-operation in NHS recruitment

41 Catering

73

Over the last few years, Food for Life has researched intergenerational activity and support for care settings for the elderly. Here, Florence Todd Fordham shares some of the findings

Health Business magazine

53 Technology Barbara Harpham, chair of the Medical Technology Group, considers the mechanisms designed to promote the adoption of innovation by the NHS, and asks whether - at last - we may be making some progress

56 Cyber security Sascha Giese, Head Geek™ at SolarWinds, discusses the failings of legacy NHS technology and how cyber security is vital for the well-being of the health service

61 Digital Health Rewired

Sponsored by

Digital Health Rewired 2020, 3-4 March at London Olympia, will feature an expanded programme focused on showcasing some of the best startups from across the UK and Europe

67 Medical imaging Health Business is delighted to announce a partnership with the Medical Imaging Convention. Taking place on the 17-18 March at the NEC Birmingham, the free-to-attend show will be visited by thousands of medical imaging professionals, including heads of medical imaging departments, senior radiologists, sonographers, mammographers, and radiographers from around the country

73 Cloud With a brand new framework now in place to help public sector organisations purchase cloud solutions, Phil Davies, Procurement Director at NHS Shared Business Services (NHS SBS), explains how it simplifies the procurement process and provides very best value for money

www.healthbusinessuk.net Issue 20.1 | HEALTH BUSINESS MAGAZINE

5

Have you axed the fax?

As part of his ‘tech vision’ to modernise the health service, and make it easier for NHS organisations to introduce innovative technologies, Health Secretary Matt Hancock banned the purchase of fax machines in January last year.

By 31 March fax machines should be phased out of the NHS entirely, instead Trusts will be required to use modern communication methods. This will improve patient safety and cyber security.

Organisations will be monitored until they have declared themselves ‘fax free’.

This is an important step forward in modernising the NHS’ communications network. Matt Hancock commented: “Because I love the NHS, I want to bring it into the 21st century and use the very best technology available.”

However, it is going to be quite a stepchange. In 2017 the NHS was named the world’s largest purchaser of fax machines.

A Freedom of Information request by the Royal College of Surgeons revealed approximately 8,000 are still being used in hospital Trusts across the country, and many thousands more are still at work in other parts of the health service, such as GP practices.

Fax machines are decreasing efficiency and compromising security and confidentiality within the NHS. There are many horror stories of important documents being sent to the wrong place or sitting on a machine overlooked.

the faxes takes considerably longer than sharing documents in digital formats.

Information sent via fax does not have a visible audit trail, it cannot be easily shared with multiple contacts and is sent on paper, which costs the NHS £100m each year.

With pressures mounting, including an increasingly aging population, and targets that are becoming ever more challenging, such outdated inefficiency has no place in the digital future of the NHS. Richard Kerr, Chair of the Royal College of Surgeons Commission on the Future of Surgery, expressed his frustration: “NHS hospital Trusts remain stubbornly attached to using archaic fax machines for a significant proportion of their communications. This is ludicrous.

As digital technologies begin to play a much bigger role in how we deliver healthcare, it’s absolutely imperative that we invest in better ways of sharing and communicating all of the patient information that is going to be generated.”

Confidential medical histories churn out of fax machines located in the middle of busy wards, and doctors have to leave patients’ bedsides to go and retrieve vital information. Sometimes patients arrive for an appointment with their clinician ahead of their documents.

So what are the modern alternatives?

Email is obviously a step in the right direction. However, even better is a structured messaging platform that enables secure clinical communication between different care settings. Docman Connect is a Cloud-based solution that is a scalable, cost-effective way of electronically transferring documents and data securely to GPs, in line with NHS standards.

Hours are currently spent scanning faxes into electronic filing systems, and sending

Available to all healthcare providers, it is the only service that delivers clinical

correspondence into the GP’s workflow system of choice. It enables healthcare organisations without a N3 or Health & Social Care Network (HSCN) connection to send documents through their web browser.

Connect ensures all clinical documents are encrypted when sent and decrypted when received, to maintain a secure transfer of care process. Any type of clinical document can be sent in a structured format, using intelligent routing to ensure the message is delivered in the practice’s preferred format.The sender can track the document journey, providing peace of mind that the clinical document is being received and processed by the intended recipient.

Connect monitors all collection points to identify any reasons for delay, while managing system rejections and returning them to sender. This software as a service (SaaS) subscription model means no server space is taken up. All this results in greater productivity and better security.

The NHS is already seeing exciting advances in technologies such as artificial intelligence, imaging, wearable tech, genomics, electronic health records and numerous apps. It is essential for patient care that communication channels are not the weak link but a vital part of the digital transformation that is now taking place, creating greater efficiencies and enabling clinicians to focus on delivering superior patient services. If you haven’t already axed your fax, what are you waiting for?

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News

ORGAN DONATION

All adults to be automatically enrolled as organ donors

Under a new law due to come into force in May, all adults in England will be automatically enrolled as organ donors unless they choose to opt-out.

It is estimated that the opt-out method, known as Max and Keira’s law, will contribute to an additional 700 organ transplants each year by 2023 and cut down the list of 5,200 people waiting for life-changing surgery. MPs are set to approve the system

as part of a bid to boost the number of transplants on the NHS. Patients who have previously declared that they do not want to donate some or all of their organs will not have to re-record their decision.

If Parliamentary approval is given, 20 May will mark the point at which all adults in England will be considered to have agreed to donate their own organs when they die – unless they explicitly state otherwise or

are in an excluded group. However, relatives will still be asked for their opinion which can lead to donations being blocked if they object regardless of the wishes of the deceased.

The Department of Health and Social Care has also stated that children under 18 will be excluded from the scheme, along with people who have lived in England for less than a year or have ‘lacked capacity for a significant time’.

Health Secretary Matt Hancock said: “Too many people lose their lives waiting for an organ, and I’ve been determined to do what I can to boost organ donation rates.This is an important step forward in making organ donation easier and more available to those who need it and could help save hundreds of lives every year.”

The law change has been welcomed by charities including the British Heart Foundation and Kidney Care UK. READ MORE https://tinyurl.com/wmp7nu3

CORONAVIRUS

DIABETES

Pilots of home testing for coronavirus started

Two million people at risk of type 2 diabetes

The NHS has started pilots of home testing for coronavirus where NHS staff, including nurses and paramedics, will visit people in their own homes rather than them having to travel.

On 23 February it was publicly confirmed that four patients transferred from the Diamond Princess cruise ship in Japan had tested positive for coronavirus. They have now been transferred to three specialist NHS infection centres.

Approximately 77,000 people in China, where the virus emerged last year, have been infected and nearly 2,600 have died. No vaccine is available so far to prevent the new coronavirus and fears are growing that the coronavirus outbreak could become a pandemic as new cases are reported globally. More than 1,200 cases have been confirmed in 26 other countries, prompting more than 20 deaths.

Professor Keith Willett, NHS strategic incident director for coronavirus said: “We have started to pilot home testing for

coronavirus in London, which will be carried out by NHS staff, like nurses or paramedics, allowing people to stay home rather than having to travel, which is safer for you and your family and limits the spread of infection.

“Anyone who is concerned they have signs and symptoms, should continue to use NHS 111 as their first point of contact – they will tell you what you exactly what you need to do and where necessary, the right place to be tested. People should also play their part by following public health advice – wash your hands, cover your mouth and nose with a tissue or sleeve when you cough or sneeze, and put used tissues in the bin immediately. I would also like to thank the NHS staff who are back in Arrowe Park ready to provide excellent care and support to the British nationals who are returning from the Diamond Princess cruise ship in Japan.”

READ MORE https://tinyurl.com/s3r5g2t

New NHS figures show that approximately two million people in England are at risk of developing type 2 diabetes, the highest on record.

Latest statistics show there are 1,969,610 people registered with a GP who have non-diabetic hyperglycaemia, a condition which puts people at high risk of type 2, which is the highest on record. It is also likely that the problem will become even greater as the growing obesity crisis is exposing millions more to the condition.

Around nine out of 10 people with diabetes have type 2 and there were over a million obesity diagnoses in hospital admissions last year, 884,000 the year before.

NHS action to combat the problem includes the Diabetes Prevention Programme which identifies people at high risk of diabetes and supports them in living a healthier lifestyle. It has had nearly a million referrals and seen patients who have so far finished it lose the combined weight of 43 ambulances. The programme, which lasts between nine and 12 months, is designed to stop or delay the onset of illness through advice and support on healthier eating and physical exercise.

Radical low calorie diets, that have been shown to stamp out recently diagnosed type 2 diabetes, will be rolled out by the NHS to 5,000 people from April.

READ MORE https://tinyurl.com/u5kr4tr

Issue 20.1 | HEALTH BUSINESS MAGAZINE

7

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News

IMMIGRATION

Expensive visa fees could deter NHS staff The Institute for Government has claimed that the UK’s ‘sky-high’ visa fees could deter vital NHS staff and the ‘brightest and best’ scientists.

Nurses, lab technicians, engineers and tech experts who currently migrate to the UK from the EU may not be able to afford to do so if Prime Minister Boris Johnson’s proposed immigration overhaul becomes law. At £1,220 per person, or £900 for those on the shortage occupation list, the fees are among the highest in the world – and this is

before charges for using the NHS and costs for sponsoring employers are taken into account.

The think tank has published comparisons with fee structures in other countries, revealing that a family of five with a five-year work visa for one individual would have to pay £21,299 before they could enter in the country. This includes the annual £400 health surcharge that must also be paid upfront per person.

The £400 is double the fee charged by Australia and about 30 times the amount

charged by Canada, where it costs just over £10,000 for a family for five years.

A single person coming to the UK is likely to be charged up to £3,220 for five years. If they want to move to the UK with a spouse, the cost would rise to £6,500 for a five-year work stint. In Canada, it is £220 for an individual visa for three years, £147 in Germany and £2,075 in France.

READ MORE https://tinyurl.com/touzgur

SMOKING

PHARMACY

2030 smoke-free target likely to be missed

Pharmacy referral service to prevent readmissions

A new report from Cancer Research UK has warned that England will fail to be smoke-free by 2030 if current smoking trends continue.

The charity points to new figures which indicate that England is not expected to reach smoke-free until 2037 – seven years behind the ambitious target set last year by Health Secretary Matt Hancock in the government’s Green Paper on Health Prevention.

Currently, 14 per cent of adults in England smoke cigarettes. The government wants to see this drop to five per cent by the end of this decade, but plans on how to achieve this are yet to be set out. Cancer Research UK, alongside other health charities, stress that investing in stop smoking services and national education campaigns that encourage smokers to quit will be essential, as both have had significant cuts in recent years.

The new projections show around a 20-year gap in smoking rates between the least and most deprived people in England, with the richest expected to

achieve smoke-free in 2025, and the poorest not reaching it until the mid-2040s.

To reach the smoke-free 2030 target, smoking rates need to drop 40 per cent faster than projected. A fixed annual charge on the tobacco industry, which would provide funding to reduce the £11 billion burden smoking related illnesses cost society in England every year, is also seen as key to achieving this.

READ MORE https://tinyurl.com/upajf47

BUILDINGS

Patients at risk in ‘crumbling’ mental health wards New data has revealed that patient safety is at risk in ‘crumbling’ NHS mental health hospitals in desperate need of funding to improve dilapidated buildings.

Hundreds of vulnerable mentally ill patients are still being cared for in 350 old dormitory-style wards, two decades after the NHS was told to provide all patients with en-suite rooms. The research also found that funding shortfalls have meant that too many wards still have ligature points that patients can use to try to harm themselves.

A briefing from NHS Providers, Mental health services: meeting the need for capital investment, sets out findings from a survey of mental health trust leaders and warns that, for 27 per cent of mental health trusts, funding allocated for capital investment would not even meet half of their current need.

Furthermore, two thirds of trusts estimate that they need between £50 million and £150 million of capital investment over the next five to ten years. One trust requires just over half a billion pounds to address maintenance and transform services to meet the needs of patients.

More than one in five trusts have faced enforcement action from Care Quality Commission (CQC) over the condition of facilities and the impact on quality and safety of patient care in the last three years.

However, a number of trusts are not able to access the funding required to make these improvements. Two trusts warned that they are unable to meet over 70 per cent of the costs necessary to address CQC’s safety concerns.

READ MORE https://tinyurl.com/skysqrc

Patients who have recently been discharged from hospital will now receive greater support from local pharmacy teams to manage their medicines. The Department of Health and Social Care has revealed that, from July, hospitals will be able to refer patients who would benefit from extra guidance around new prescribed medicines to their community pharmacy.

The NHS Discharge Medicines Service will help patients get the maximum benefits from new medicines they’ve been prescribed by giving them the opportunity to ask questions to pharmacists and ensuring any concerns are identified as early as possible.

Forming part of the Health Secretary’s ‘Pharmacy First’ approach to ease wider pressures on A&Es and General Practice, it means that patients will be digitally referred to their pharmacy after discharge from hospital.

79 per cent of patients were prescribed at least one new medication after being discharged from hospital. Recent research by the National Institute for Health Research shows that people over 65 are less likely to be readmitted to hospital if they’re given help with their medication after discharge.

Health Secretary Matt Hancock said: “I want all patients to get the right care close to home, and to avoid any unnecessary visits to hospital.

To help do that I’ve begun the Pharmacy First programme, asking pharmacies to do more to support people in the community, as they do in other countries like France. It’s good for patients and great for the NHS because it reduces pressure on GPs and hospitals.

“These new services will help strengthen what community pharmacists can do, helping interrelation with General Practice and hospitals, and help them deliver safer, more efficient patient care right across the NHS. This new contract bolsters the enhanced role highly-skilled pharmacists are playing in preventing ill health and helping us to stay well in our communities.”

READ MORE https://tinyurl.com/umpjhzb

Issue 20.1 | HEALTH BUSINESS MAGAZINE

9

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News

HEALTH VISITORS

Service cuts prompting worries for health visitors The Institute for Health Visiting has warned that public health budget cuts have left health visiting services unable to offer the minimum level of support in many areas.

An annual survey of health visitors in England indicates that many health visitors across England have been robbed of their ability to protect vulnerable families by devastating cuts to public health budgets, leading to calls to ringfence new funding for the profession.

Official figures indicate that around one in five health visitors were lost between 2015 and 2019 – the full-time equivalent of 18 per cent of the workforce – with 48 per cent of health visitors saying they feel so stretched that they fear a tragedy where they work.

The iHV State of Health Visiting survey indicates that those professionals best

placed to help children get the best possible start in life lack the resources to do so.

This is due to public health budget cuts and the failure to protect health visitors’ preventative role by many cashstrapped local authorities, after health visiting commissioning moved from the NHS to local authorities in 2015.

The findings also show that only 21 per cent of health visitors rated the quality of care that they can now offer families as ‘good’ or ‘excellent’, and that 29 per cent of health visitors are now responsible for between 500 and more than 1,000 children.

While in 2015, 65 per cent of health visitors were able to offer continuity of carer to all, or most, families, by 2019 that number had fallen to just 35 per cent. Continuity of carer has been shown to be greatly valued

SURGERY

MENTAL HEALTH

Nurses to become ‘surgical care practitioners’

Fifth of mental health patients don’t feel safe in NHS care

Nurses will attend a two-year course to become ‘surgical care practitioners’, with the ability to perform procedures such as removing hernias, benign cysts and some skin cancers.

According to the Daily Mail, those who qualify will also be able to assist during major surgeries such as heart bypasses and hip and knee replacements in a bid to reduce waiting times for NHS patients in increasingly busy hospitals.

Surgeons currently undergo up to 16 years of training, while a surgical care practitioner is likely to have completed a three-year degree as a nurse before the two-year course. Those qualifying will also own an average of £50,000 a year, roughly twice the average nursing salary of £25,000 a year.

Critics have been quick to label the proposals, which are due to be published in the NHS’s People Plan, unveiled next month, as only a ‘sticking plaster solution’ on the serious staffing crisis within the NHS. There are already 800 surgical care practitioners working in hospitals in the UK, but leading surgeons say there will need to be ‘thousands’ before the difference to waiting times is felt.

An NHS spokesman said: “The NHS is supporting the government to deliver its pledge to deliver 50,000 more nurses.

This will require a combination of training and recruiting nurses, and helping our amazing staff who may otherwise have considered leaving our health service altogether, to retrain, upskill, develop their careers and stay in the NHS.” READ MORE https://tinyurl.com/uyn78qf

A new survey has revealed that one in five people did not feel safe while in the care of the NHS mental health service that treated them.

The Parliamentary and Health Service Ombudsman research shows that more than half of people with mental health problems in England also said they experienced delays to their treatment, while 42 per cent said that they waited too long to be diagnosed.

Despite the concerns raised by patients about their treatment in the survey, including having to wait over six months to be referred to a specialist mental health team, 48 per cent said they would be unlikely to complain if they were unhappy with the service provided. Almost 70 per cent of people said they had not been told how to complain by NHS staff.

Furthermore, 32 per cent said they did not think their complaint would be taken seriously while a quarter were worried

by parents and health visitors, as it allows them to build a trusting relationship and gives parents confidence to ask for help.

The Institute is calling for: new ringfenced cross-government funding for early intervention and the health visiting profession; statutory protection for the health visitor role in leading the delivery of the Healthy Child Programme and for health visiting to be returned to statutory regulation; workforce modelling and a new workforce strategy for health visiting; and a new focus on improving the quality of services which health visitors can offer families, regardless of where they live.

READ MORE https://tinyurl.com/wdye22e

complaining would affect how they were treated. The main reason given was that they would not want ‘to cause trouble’.

Ombudsman Rob Behrens said: “It’s unacceptable that so many patients requiring mental health treatment are left feeling unsafe in the NHS but this survey supports what we see too frequently in our casework.

Patients must be supported to speak up when mistakes happen and not left scared that their treatment will be affected if they do so. While the NHS in England must continue to implement its Five Year Forward View for Mental Health, it should also look now at what more is needed to transform mental health services so the people who need them get the care they deserve.’”

READ MORE https://tinyurl.com/rpsmkpr

Issue 20.1 | HEALTH BUSINESS MAGAZINE

11

News

SAVINGS

NHS saves 20,000 trees by switching copier paper The NHS Supply Chain has revealed that more than 200 NHS trusts have made huge environmental savings by simply switching their copier paper.

The move from A4 virgin fibre copier paper to A4 recycled paper last year saved the equivalent of: watching 85,503 hours of a plasma TV in energy; filling 161 Olympic size swimming pools with water; felling 20,000 trees in wood; and travelling 10 times around the world in an aeroplane in Co2.

The move has also driven financial

savings to the NHS. By channelling national commitment, reducing variety from two lines of paper (70gsm and 80gsm) to one (80gsm) and changing from virgin to recycled paper, £256,000 has been saved in the first year with a cost avoidance to the NHS of £1,410,000.

Martin Toomey, head of Sustainability for the NHS Supply Chain, said: “A simple switch from recycled paper has made a big difference to the environmental footprint of NHS trusts. Procurement

accounts for 58 per cent of the NHS’s total carbon footprint so there’s huge potential to effect change and help the NHS to become a low anchor institution.

We want to use the purchasing power of the NHS more assertively to drive change in supply chains and embed sustainability within the procurement process.”

READ MORE https://tinyurl.com/qpzrnj4

BME

WALES

NHS treatment of minority ethnic staff highlighted

Longest waiting times in Wales hit a new record

The latest workforce race equality data has shown that almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year.

Five years after NHS England launched a drive to improve race equality, the data reflects very poorly on the health organisation, with minority ethnic staff in the NHS reporting a worsening experience as employees across four key areas. It has even raised concerns over whether the health service was ‘institutionally racist’.

The data indicates that 29 per cent of BME staff reported being bullied or abused by other NHS workers, up from 27 per cent in 2016. More BME staff also reported

being discriminated against by their manager, up one per cent to 15.4 per cent since 2016.

The number of BME staff who felt they have equal career progression had also fallen, alongside a rise in staff reporting abuse and bullying from patients and the public.

Across England, 49 NHS trusts have a board that was comprised completely of white directors. However, the total number of BME staff at a very senior manager level has increased by 21, from 122 in 2018 to 143 in 2019.

READ MORE https://tinyurl.com/wdd3upq

WINTER CARE

Action needed now to avoid worst NHS winter yet The Care Quality Commission has stressed that action must be taken now if the NHS is to avoid an even worse winter crisis next year.

Ted Baker, hospitals chief inspector, said that the use of corridors to treat sick patients in A&E was ‘becoming normalised’, with departments struggling with a lack of staff, poor leadership and long delays leading to crowding and safety risks.

The hospitals inspectorate has carried out more than a dozen small one-day inspections of A&E departments since December where it had specific concerns about possible safety risks. It has emphasised that capacity issues traditionally reserved for the winter months were now year-round problems.

July 2019 saw the highest proportion of emergency patients spending more than four hours in A&E than any previous July for at least the last five years.

The CQC also warned that poor cooperation and coordination between hospitals, social care and other local organisations had ‘led to fragmented care’ in some places, something that would not

be solved with a ‘quick fix’. Furthermore, A&E departments were found not to have enough nurses with the skills and qualifications to care for children, while inspectors found long delays in ambulance staff handing over patients to the A&E team were causing crowding and patients waiting in corridors.

Baker said: “Our inspections are showing that this winter is proving as difficult for emergency departments as was predicted. Managing this remains a challenge but if we do not act now, we can predict that next winter will be a greater challenge still. We cannot continue this trajectory. A scenario where each winter is worse than the one before has real consequences for both patients and staff.”

The latest NHS performance data showed record numbers of patients waiting on trolleys in A&E departments, with 2019 seeing the worst cancer performance by the NHS since 2016.

READ MORE https://tinyurl.com/uhk625u

Figures show that the number of patients spending more than 12 hours in A&E in Wales was the highest on record again in January.

As in England, there was an improvement in performance against the four-hour waiting time. However, 6,882 patients faced long waits, 226 more than in December. The target is that no patient should be waiting that long.

Latest official figures for January show that 66 per cent of the most serious ‘red’ calls arriving within eight minutes, meeting the target for the first time since October.

Ambulance response times also improved and hit their target for the first time since October.

In other positive news, 83.5 per cent of patients were waiting less than six months to start hospital treatment - the lowest proportion since December 2015 and lower than the 95 per cent target. Furthermore, the number of patients waiting longer than the target time increased for diagnostic tests but decreased for therapy services in December.

A Welsh Government spokesperson said: “We acknowledge that too many people are spending long periods in emergency departments while waiting for a hospital bed, and expect the extra £40 million we made available this winter to make improvements in this area. Waiting times for scheduled care are being severely affected by doctors reducing hours because of changes to HMRC pension tax rules by the UK government. By the end of December, this had led to about 3,200 sessions lost, affecting nearly 27,000 patients.

The health minister has called on the UK government to resolve this matter urgently.”

READ MORE https://tinyurl.com/r3v5sxg

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Putting the Patient Front and Centre

ISS Healthcare is fully supporting the current NHS Food Review and has recently published its fully updated ‘Great Food & Beverage Services Guide’ designed specifically around the patient, reflecting the current advice on allergens, the new modified texture diet standards and why nutrition and hydration is so important when staying in hospital. When it comes to putting the patient first, you can depend upon ISS. ISS - the First in Innovation

Enquiries@uk.issworld.com

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Facilities management

Facilities management and increasing IoT investment On behalf of the Institute of Workplace and Facilities Management (IWFM), Preston Gan asks whether the current state of facilities management in the NHS is ready for the investment of IoT, Big Data and AI

Whether as a patient or as an individual helping our loved ones, families and friends, most of our real-life experience with the current use of technology and information systems used in health and care is not always as positive. As an example, the lack of information about a person residing in a particular region or area is not available because their records are stored somewhere else in the country. Or a person with multiple complex problems often has to repeat the same information many times to different people, as every organisation and professional works with a different system, and a different record. Or, elsewhere, existing systems having multiple logins often creating frustration for staff to do their jobs, leaving people confused and disappointed. Digital technology should be one of the key enablers, rather than a barrier, to delivering excellent care.

The role of technology today has fundamentally changed the way we live and manage our daily lives. Increased technological advances has provided us with greater choices and more control than ever before; whether from how we communicate with each other, the way we travel, shop

To gain a basic understanding of the three elements, IoT is the idea of connecting any physical devices or objects to the internet and to other connected devices. This could mean an extraordinary number of ‘things’ of all shapes and sizes that allow us to connect, collect critical data, analyse and then react to data based on real-time information to enhance performance and prevent losses - most without any type of human input.

To explain the relationship between IoT, Big Data and AI, these connected devices trigger a massive inflow of the different types of ‘Big Data’. Three classifications of data are normally associated with Big Data. Structured data, often categorised as quantitative data, is what most of us are used to working with, data that fits neatly into fixed fields and columns such as databases, spreadsheets CRM or ERP systems, that is often the easiest to search and organise. A much bigger percentage of all data in our world is unstructured data.

Unstructured data that is Is facilit ies most often categorised as manag e qualitative data, which m e nt in the NH cannot be processed S r e the inve ady for and analysed using conventional such as IoT, Big stment of text, audio, video, photos, D a AI in its ta and social media content, and and pay for things, the curr satellite imagery, which way we bank, how we state? ent is difficult to deconstruct. manage our well-being The third classification of ‘on the move’ to how data beyond structured and healthcare is delivered and unstructured is semi-structured how we access healthcare services. data which is a mix of both that contains There is certainly recognition that digital metadata, making it easier to organise. But technology is critical to transforming health there is still flexibility in the data such as and social care services so that care can email messages or a digital photograph. become more person-centred, creating There is no doubt that it will be immensely a positive impact on patient outcomes difficult to comprehend the vast amount and patients can be more empowered to of unstructured data gathered from the participate more fully in their own care. millions of sensors via IoT devices and the complexity to process on a real time basis.

Relationship between IoT, Big However, once the raw input is cleaned, Data and artificial intelligence structured and integrated well enough to The growth and the convergence of the become useful, artificial intelligence will use ‘Internet of Things’ (IoT) with ‘Big Data’ that processed data to build its intelligence and artificial intelligence has opened with the necessary learning algorithms to up a world of possibilities in medicine produce your desired output. In essence, you that will help healthcare professionals can say that IoT is the senses, Big Data is the realise the anticipated benefits that fuel and artificial intelligence is the brain to enhances the workplace to manage and realise the future of a smart connected world. alleviate the clinical burnout that affects As an example for patients, devices in the a significant proportion of clinicians, form of wearables, like fitness bands and allowing them to focus on the core other wirelessly connected devices like blood tasks, giving them more time to care for pressure and heart rate monitoring cuffs, E patients and improve clinical outcomes.

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Utilising the benefits of technology How do facilities managers working within the healthcare built environment utilise the benefits of IoT to enhance the workplace and support our health professionals in providing the best care possible to our patients?

It needs to be understood that real estate for most organisations represents the second highest expense after human resources. Therefore, facilities managers have a direct impact on the productivity on any organisation’s most important asset, their employees. The acceleration of IoT is certainly creating new possibilities for FM by allowing the evolution of intelligent and integrated buildings. IoT data and analytics allow facilities managers to understand what is happening within every aspect of a building, understand how people are using it and oversee the operations undergoing in an automated building environment which will help facilities managers meet demands and drive efficiencies.

The combination of information technology (IT) and operational technology (OT), such as Building Management Systems (BMS), lighting controls, energy monitoring, security and safety systems, transportation for the built environment will provide a digital health care infrastructure with the required connectivity and intelligence, smart controls with the ability to manage, automate and optimise resources and equipment effectively along with the capability to utilise cloud-based digital services.

Patient experience and satisfaction is paramount within healthcare facilities and will only grow in its importance as patients are offered more choices. For example, by using an app installed on their smartphone via environmental sensors, patients can create their own optimal healing environment through individual control over their room temperature, humidity levels and lighting rather than calling on nurses to perform these basic tasks. In turn, this frees nurses up to spend more time on clinical tasks that will improve patient care.

Patient safety presents another top concern.

Uninterrupted access to power can mean the difference between life and death. Hospitals

need constant, reliable power to feed medical devices. IoT-enabled power management solutions such as electrical panels, connected power meters and power monitoring software can ensure reliable electrical power to critical areas, identify potential issues before a failure occurs, reduce operating theatre downtime and automatically test emergency power supply systems.

IoT across the NHS estate Apart from monitoring patient health, there are many other areas where IoT devices are very useful in hospitals. IoT devices tagged with sensors are used for tracking real time location of medical equipment like wheelchairs, defibrillators, nebulisers, oxygen pumps and other monitoring equipment.

Deployment of medical staff at different locations can also be analysed real time.

As an example, NHS Highland’s Caithness General Hospital in Wick began a trial system to automate the process of bed maintenance through the use of sensors to monitor the status of medical beds and improve access to maintenance data. Keeping tracks of beds which require monthly maintenance checks creates significant administrative burden on staff. The Bluetooth tags and centralised dashboard with real time data make it easy to find the beds and access up-to-date maintenance records, enabling smarter, more informed decisions to be made.

Another example is the transition from Planned Preventative Maintenance (PPM) to Predictive Maintenance where current practices in preventative maintenance seeks to decrease the likelihood of an asset‘s failure through the performance of regular maintenance. Predictive maintenance relies on data to determine an asset’s likelihood of failure before that failure occurs based on condition of the asset and reasonable estimates about how it is used (such as expected operating times). This allow facilities managers to move from a repair to replace model to a predict and fix maintenance model using analysis which relies on data, statistics, machine learning, and AI modelling to make future predictions to improve maintenance and production efficiency.

Moving with the times Is facilities management in the NHS ready for the investment of IoT, Big Data and AI in its current state? And how can we move ahead with the times?

The facts are clear. The majority of the NHS estate has passed its ‘sell-by’ date with ageing infrastructure, facilities and equipment that are no longer compliant with statutory safety standards. The total NHS’s backlog maintenance bill is estimated at around £6.5 billion. In my view, I believe this presents a significant opportunity for facilities managers within healthcare across the country to make a difference.

Within individual NHS organisations, there could be multiple existing systems associated with facilities management to manage.

Perhaps the first initial step is to review and consider which systems or applications are the most essential to retain, which of

these are core that is required across the FM environment or specialist, only across a number of FM functions which tend to be single purpose use. Conduct a mapping exercise and cross examine your systems to identify whether there are opportunities for integration, maintain and optimise or potential elimination of others. Do your systems have open protocol?; are they scalable and flexible enough to incorporate the implementation of IoT without the need for further investment of ‘another’ system? and do we have the right digital infrastructure and governance to support the rollout?

If there is an appetite to consider the investment of IoT, we need to understand what problems we are trying to solve.

Understanding your final goal before you start is perhaps the most critical. Identify the quick wins to get the tangible return on investment; will it save on labour costs, resources, increased energy efficiency which you can trade off with the savings made to implement IoT? Perhaps an initial IoT project that could be as small as a wireless device added to an existing meter to collect data, makes it easier for facilities staff to get used to understanding data and make informed decisions based on that data. Or pilot an office space that has minimal impact and risks to patients and office staff by installing environmental sensors with an aim to improve indoor environmental monitoring to improve employee well-being and productivity. L

Facilities management

 glucometer, healthcare apps etc. give patients access to personalised attention and real time health data. These devices can be tuned to remind calorie count, exercise check, appointments, blood pressure variations and much more providing patients with actionable insights that will eventually improve the quality and health care they experience.

For clinicians, using wearables and other remote home monitoring equipment embedded with IoT, allows them to keep track of patients’ health more effectively, reducing the length of hospital stay and prevents readmissions, monitor patients’ adherence to treatment plans or any need for immediate medical attention. IoT enables healthcare professionals to be more watchful and connect with the patients proactively, thereby increased satisfaction due to enhanced patient experience and engagement.

Preston Gan is head of Business Services and Performance at NHS Grampian. He is charged with driving transformational change through the delivery of strategic and operational facilities management. He develops the ‘Informed Client Function’ to enable FM alignment and meet organisation’s business strategy and performance goals.

With over 11 years of FM experience in healthcare, Preston has won multiple industry awards with the most recent ‘FM Professional of the Year’ by IWFM. FURTHER INFORMATION www.iwfm.org.uk

Preston Gan, Head of Business Services and Performance, NHS Grampian

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature Written by Neil Ashdown CertFDI, FSIDip

Fire resisting doors in healthcare premises: Essential to fire safety but difficult to manage?

The greatest consideration regarding fire safety in healthcare premises is clearly safety of relevant persons.

In the event of a serious fire, progressive evacuation in stages to safe places would be necessary in keeping people away from the effects of fire and smoke. Therefore the building’s fire and smoke compartmentation is relied upon to restrict the spread of fire and smoke from one part of the building to another

It is the walls, floors, ceilings and fire doors that divide the building into a series of compartments to keep the fire in the room or compartment where it started thus maintaining safety for occupants and allowing the fire and rescue service to reach the fire and deal with it.

The difficulty with fire doors is that although, just like the wall, they restrict fire and smoke spreading they also have to function in spite of heavy use and in communal areas, opening and closing possibly hundreds of times each day. Add to that the likelihood of damage and the sheer number of them, it is easy to see how managing maintenance to a standard where older doors can meet the required fire and smoke ratings can be so challenging.

Fire door strategy At any large or complex building it will be necessary to have an efficient inspection and maintenance regime for fire doors.

None more so than in high rise residential buildings. Maintaining fire doors could be seen as something akin to painting the Forth Bridge so first it is necessary examine the fire strategy to see which fire doors are most critical in providing protection to enable safe progressive evacuation.

Maintaining fire doors can be a drain on resources so it is vital that the efficient working order of the fire doors lines up with the building’s fire safety requirements. The

entrance doors to individual flats and those that protect escape routes and protect areas providing refuge are the most critical, the maintenance regime should take account of that. In other words there should be a fire door hierarchy starting with doors critical to the fire strategy all the way down to doors that although marked with the blue signs may not when aligned to the fire strategy be as necessary to safety. Dealing with fire safety is ‘risk-based’ so the fire risk assessment should identify fire doors that are vital.

Fire door maintenance Fire doors should be inspected at suitable intervals and maintained in efficient working order. The majority of fire doors are made from timber therefore repairs and maintenance can be carried out by competent carpenters. However, fire doors are different from ordinary doors especially regarding working tolerances, glazing, seals and ironmongery so maintenance teams should be aware that work must be carried out in accordance with the relevant standards.

BS 8214: 2016 is the code of practice for timber based fire doors so installers and maintenance teams should adhere to such guidance along with other codes of practices and guidance for hardware, seals and glazing.

Housing maintenance departments should therefore ensure that repairs, maintenance and new fire door installation work complies with necessary standards.

Training for fire door installation and maintenance teams Those carrying out installation and maintenance works should have the necessary skills and competence. Dedicated fire door installation and maintenance training can help operatives and their managers to understand the

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

requirements for timber based fire doors so that maintenance work and new installations can be carried out to meet the relevant standards.

Fire Doors Complete Limited provides training courses both at its fire door training centre in Queniborough, near Leicester, and via remote learning courses. We can also provide the training at the clients own premises, so long as suitable facilities are available.

Delegates can benefit by understanding more about the legislative requirements and standards that cover installation and maintenance. They can also find out how to access many useful fire door resources that will help them to select suitable products that can help maintain the service life of fire doors and help to protect doors from damage.

Where a fire door must be replaced due to severe damage or as part of refurbishment works the opportunity arises to ensure new doors will meet the necessary durability requirements as well as the correct fire rating.

There are many types of fire doors, impact protection products and hardware that can extend the life of fire doors, so where doors are likely to be subject to heavy use, the specification should meet the demands of the door’s location. Maintenance teams that have the knowledge and resources to procure the most suitable products will be able to reduce costs in the long run.

In summary Valuable resources can be better targeted by ensuring that maintenance addresses those fire doors most vital to fire safety at the buildings. Update fire risk assessments to take account of changes of use to rooms at the building and to help identify the critical fire door locations. Ensure the fire door maintenance teams or contractors are suitably qualified in terms of skills and training and that specifications for new doors take full account of durability requirements as well as the fire and cold smoke performance.

Neil Ashdown is managing director of Fire Doors Complete Limited, providers of fire door inspection, training and consultancy services. L FURTHER INFORMATION www.firedoorscomplete.com

Fire safety

Building a fire safety culture in health facilities Dr David Gold and Neil Vincer, from IOSH, discuss how organisations can ensure that a sustainable workplace fire safety culture is incorporated to all staff in a hospital setting Health care workers play a vital role in today’s society, especially considering the ageing populations in many countries that need or will need care either in health care facilities or at home. All members of the health care profession should continually work in a safe and healthy environment carrying out practices that do not put them at risk of injury or ill health. A previous article in this journal examined several of the risks health care professionals face and described measure to eliminate or mitigate those risks.

Occupational safety and health promotes the concept of a safety culture. A safety culture exists when workers throughout an organisation not only continually look out for their personal safety and health, but also look out for the safety and health of others including their co-workers. The concept of a safety culture embraces positive values, including attitudes and knowledge.

Professionals working in the health care field, by the nature of their profession and their duty of care, extend the safety

culture to protect their patients, some of whom cannot look after themselves, especially during an emergency situation.

The American Bureau of Shipping (ABS) proposes eight categories of leading indicators of a safety culture. The following are leading indicators, adapted from the ABS publication, that fall under the eight categories: A Communication about fire safety The organisation: develops means of communication including the provision of information sheets, newsletters, and toolbox talks, in local languages regarding incidents and

lessons learned about fire safety; includes adequate fire safety information as part of new employee induction providing; and shares with employees, contractors and visitors policies, goals, directives and standards addressing fire safety.

Empowerment The organisation: involves all workers and contractors in fire s culture afety safety; and develops and exists w promotes for all workers hen worker means to bring fire s n o t only continu safety to their home. a

for their lly look out p and he ersonal safety look ou alth, but also t for th and he e safety alt of othe h rs

Feedback The organisation: documents the presence and use of a fire safety worker feedback mechanism; and ensures that information about fire-related risks, incidents, and near misses are communicated to workers. E

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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î † Mutual trust The organisation establishes a fair system for fire-related incident investigation.

Problem identification The organisation: puts in place and maintains a policy mandating fire safety procedures and instructions with specific information on job-specific fire safety; establishes and maintains a policy and procedures for reporting unsafe fire-related conditions and actions; and ensures that fire safetyrelated checklists are regularly updated.

Promotion of safety The organisation: has fire safety-related safety goals and objectives; has a procedure making all fire-related incident investigation findings available to workers; and requires senior management attend meetings related to fire safety.

Responsiveness The organisation: regularly implements fire training programmes for different category of emergencies; puts in place and maintains an organisational-wide effort to continually promote fire safety awareness; and puts in place and maintains training programmes for assessing risks related to fire.

Safety awareness The organisation provides fire safety awareness training and puts in place procedures to document the training.

Management of health care facilities, whether public or private, has an upstream responsibility, a duty of care, to ensure all aspects of safety, health and fire safety are addressed and reinforced for health care professionals, patients, visitors, contractors and others visiting the facility.

For example, bedding is common in a health care environment, and is a source of fuel. Oxygen is ever present, and may be more concentrated around some patients, but the risk of fire is minimal if there are no sources of heat. Therefore bedding, either laundered or soiled, should always be stored away from sources of heat.

In health care facilities areas, such as laundries, laboratories, pharmacies, heating plants and waste disposal areas may have elevated fire risks as the potential for the combination of fuel and heath may be elevated. Even health care facilities that may be designated smoke free campuses may be at risk from ignition from open flames such as cigarette lighters, matches or discarded cigarettes due to a perceived urgent need to smoke by staff, patients, visitors or contractors who will try to find an area where they can smoke unobserved.

Health care facilities may also have flammable and combustible liquids or gases in different areas of the facility. Laboratories, operating theatres and casualty, maintenance areas, pharmacies as well as supply areas may stock certain products that when exposed to heat may ignite. Also shipping and receiving areas may have combustible waste that needs to be disposed of. The basic philosophy which needs to be vigilantly followed is to keep heat, fuel and oxygen apart.

Fire protection Fire protection in health care facilities includes what is needed to protect the patient, workers, visitors and others from the danger of fire. This includes, but is not limited to: the preparation and keeping upto-date a number of required and essential documents; systems to detect smoke or heat; automatic fire suppression systems such as automatic sprinkler systems; mechanisms to notify the local emergency services that an alarm has been activated; systems to notify staff, patients, visitors and others to evacuate; a system of designated primary and secondary emergency escape routes from all areas of the building; designated external emergency assembly areas; a system to account for evacuated patients, staff, visitors and others; mechanisms to provide continuity of care during an evacuation including agreements with other facilities to provide shelter as necessary; staff training on evacuating patients; regular drills and exercises involving the local emergency services; fire related doors including selfclosing mechanisms to limit the spread of smoke and fire by-products; stairways that are protected from smoke; and a compilation of safety data sheets that is readily available and describes the properties of hazardous substances used in the facility.

Although the 14 above-mentioned points are examples of essential fire protection elements, it would take more than a journal article to provide detailed information on each one. We would, however, like to call your attention to a few.

Fire safety

Management of health care facilities has an upstream responsibility, a duty of care, to ensure all aspects of safety, health and fire safety are addressed and reinforced for health care professionals, patients, visitors, contractors and others visiting the facility

Evacuation It is essential that there are designated emergency escape routes from all areas of the facility to a place of safety. These routes need to be clearly marked, continually unobstructed, well lit, and unlocked. E

Fire prevention What managers need to consider about fire prevention is keeping apart the three elements that when combined in the right proportions can create fire or explosions.

The three elements are heat (also known as source of ignition), fuel (also known as combustible or flammable materials in solid, liquid or gas form) and oxygen (bearing in mind the level of oxygen we need to breathe is the same level that supports fire).

An essential element of fire risk assessment, if properly done by an appropriately trained competent person identifies, assesses and proposes control measures to either eliminate or control the risk and follows up where and when these elements, in combination, may increase the risk of fire.

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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î † In consultation with the local fire service, the emergency action plan may call for a phased evacuation, not evacuating all patients and staff at once. In some facilities there are designated areas of refuge (with specific engineering criteria) where evacuees wait for assistance from the emergency services.

An emergency escape route may be part of a normal passageway. Often times the secondary emergency escape routes may be passageways and doors that are not in constant use. In some locations, during the winter season, the doors leading outside may be obstructed by snow. It is essential that all designated escape routes are regularly inspected by a designated person and are continually unobstructed.

Evacuation in a health care facility includes both ambulatory and non-ambulatory patients, although during a fire emergency, ambulatory patients may become non-ambulatory due to fear or stress. Moving non-ambulatory patients in beds may not be feasible. In a number of facilities an evacuation sheet is used. It is essential, however, that health care facility staff are trained in how to evacuate a patient using a drag sheet or other evacuation mechanisms that the facility uses.

Accountability Patients, staff, visitors and others need to be accounted for once outside of the building.

A means of accounting for who is missing needs to be set up and described in the emergency action plan. There also needs to be a means of rapidly informing the responding emergency service who is not accounted for and where and when they were last seen.

This will greatly influence the search and rescue strategy of the emergency service.

Planning Planning for fires and other emergencies needs to be done in advance. As essential documents are drafted, proposed measures need to be tested and revisited as necessary.

When new procedures are designed and implemented and new equipment, materials and products are brought into the facility, plans need to be re-examined and adjusted as necessary. Desk top exercises and evacuation drills are essential means for determining whether plans are effective.

Key to successful emergency planning is the training and education of all staff including hands-on practical training so that their respective roles in a fire and evacuation become second nature. It is also a good practice to provide all staff, during induction, a thorough briefing on fire safety and regular refresher training.

Visitors, contractors and others should also be provided information about fire safety when they work in or visit the facility.

Essential documents This article suggest three essential documents that should be continually reviewed and updated as necessary. The three documents are the fire risk assessment, the emergency action plan and the fire prevention plan. All documents should be drafted in concert with the local emergency services and should be reviewed with these services before finalised.

The fire risk assessment According to the publication Fire Safety Risk Assessment: Health care premises and the (UK) Health and Safety Executive, there are five steps for carrying out a risk assessment: identify fire hazards; identify people at risk; evaluate, remove, reduce and protect from risk; record, plan, inform, instruct and train; and review.

The Fire Safety Risk Assessment: Health care premises publication goes into further guidance of what needs to be considered on the following topics: fire risks and preventative measures; fire-detection and warning systems; firefighting equipment and facilities; escape routes and strategies; emergency escape lighting; signs and notices; recording, planning, informing; and instructing and training.

Strong consideration should also be given to who is carrying out the risk assessment for the facility. Criteria for the competencies of fire risk assessors can be found in the following document: https://www.london-fire. gov.uk/media/1106/guidance-choosinga-competent-fire-risk-assessor-2.pdf.

The emergency action plan An emergency action plan is based on a risk assessment, carried out by a competent risk assessor. Partially based on a document from

Fire safety

the (US) Occupational Safety and Health Administration (OSHA) an Emergency Action Plan must contain the following elements: a description of types of emergencies that could occur to the facility; means of reporting fires and other emergencies; levels of emergencies and criteria for escalation; evacuation procedures and emergency escape route assignments; procedures for staff who remain in order to assist patients and others or shut down critical functions before they evacuate; procedures for accounting for all patients, employees and visitors after an emergency evacuation has been completed; rescue and medical duties for employees performing them; names or job titles of persons who can be contacted; agreements with emergency services; agreements with other facilities to accept evacuated patients; and timing for the regular review of the emergency action plan.

The Fire Prevention Plan A number of organisations also publish a fire prevention plan. It is based on the fire risk assessment and includes a description of sources of fuel and sources of ignition at the facility that could cause or contribute to the spread of fire. The plan also describes alarm systems and fire extinguishing systems. The plan should also describe protection dealing with the detection, the outbreak and the spread of fire.

Based on HSE guidance the plan should also provide clear instructions on eliminating or controlling sources of heat, diminish the amount of combustible or flammable materials. The plan should describe measures to: avoid or control sources of ignition; eliminate or minimise combustible or flammable materials; separate sources of heat from fuel; detect fires and raise the alarm; minimise the spread of fire, smoke, or bi-products of fire; and take action on discovering a fire or when a fire alarm is activated.

Even in the most up-to-date health care facility with the most modern fire safety equipment, fires can and do occur. It is essential that fires are prevented and that we do everything that is reasonably practicable to protect ourselves, workers, patients, visitors, contractors and others from the dangers of fire. Empowering the health care professional and other staff with information and training on preventing fires and procedures should a fire occur will help build a culture of fire safety in the organisation.

A clearly demonstrated commitment by senior management has also been proven to further strengthen this culture.

Everyone needs to understand the risks of fire and the means to either eliminate the risk or mitigate it to an acceptable level. L

Dr David Gold, CFIOSH, is vice president of the Institution of Occupational Safety and Health (IOSH) and former chair of the IOSH Fire Risk Management Group. Neil Vincer, CMIOSH is the current chair.

FURTHER INFORMATION www.iosh.com

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Panel of Experts

EXPERT PANEL PARKING In our second Health Business Expert Panel on parking we are joined by representatives from Debt Recovery Plus, GroupNexus, WPS Parking and the British Parking Association to discuss the ongoing issues relating to hospital parking

Dave Smith, BPA

Stewart Clure, Debt Recovery Plus

Grahame Rose, GroupNexus

Simon Jarvis, WPS

Dave leads the Public Affairs and Communications Team at the British Parking Association to promote, develop and maintain relationships with politicians, stakeholders and the media. Dave developed the BPA’s current communications strategy, to help raise the profile of the association with all key audiences including members, stakeholders, media and public.

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.

Grahame joined CP Plus in 1995. Coming from a small business background his ‘hands on’, service orientated approach fitted in perfectly with the business outlook. He has been instrumental in the creation of GroupNexus, from a company that managed 28 sites when he joined to its current portfolio of over 1,200.

Grahame is a Board Member of the BPA, regularly speaking at industry events.

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.

At the start of December last year, data from the Press Association revealed that a third of hospitals in England put up car parking charges in the previous 12 months, with total income rising by 10 per cent. Freedom of information data from more than 140 NHS trusts showed that £254 million had been raised during 2018-19, an increase from £232 million the year before, with hourly charges varying between £4 and £1 for an hour.

As well as highlighting fee increases, the Press Association survey also indicated dissatisfaction with hospital parking charges, with the poll of more than 7,800 people finding that 86 per cent

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of respondents felt that parking added to the stress of their hospital visit.

Free hospital parking In the same month, the Queen’s Speech announced that hospital car parking charges would be removed for those in greatest need, benefiting thousands of patients up and down the country. Health Secretary Matt Hancock said that disabled people, frequent outpatient attenders, parents of sick children staying overnight and staff working night shifts will not have to pay for NHS car parking from April 2020. Furthermore, the government will also consider car parking

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capacity across the country, and how improved technology will reduce burdens for hospitals and take away stress for visitors.

It means that all 206 hospital trusts in England will be expected to provide free car parking to groups that may be frequent hospital visitors, or those disproportionately impacted by daily or hourly charges for parking. As before, any profits from remaining car parking charges must be reinvested into frontline care.

The British Parking Association is supporting the government in developing the proposals, reiterating their desire to help them devise and deliver a solution which helps to make

WPS were recently criticised by the Green Party for helping a local authority customer to realise a free parking validation scheme to support local retailers because they believed it would encourage people to drive into town.

Supply versus demand We all know that parking space availability is limited – if parking is free, it is likely that demand will increase which is likely to increase congestion and make finding a space far more difficult. How do we control this if parking becomes free to all or many? Using Scotland as an example, Jarvis claims that free hospital parking is attractive to shoppers and commuters, with cases documented of people leaving their cars in hospital car parks while they fly off on holiday!

On the issue of demand, there is no denying that hospitals are always over-subscribed in terms of their parking capacity, and also worth noting that the NHS has more special requirements and considerations than most organisations offering car parking facilities. However, the problem of abuse by motorists that have no business at a hospital has largely been solved by the introduction of parking systems, whether this is barriers or enforcement via ANPR. Demand will always outweigh supply in terms of spaces, because hospital parking is not an unlimited resource and users are continuing to grow. Stewart Clure says that there are various ways to manage the

The Speech d ’s n e e e Qu nnounc r a y l t n e a rec spital c that ho harges will c parking moved for be re greatest those ineed n

staff usage and control dwell times and through close management and flexibility, issues and errors can be controlled.

Dave Smith highlights the statistic that approximately 64 per cent of all journeys involve a car at some point and an average of 39 million parking acts every day. It is widely considered that promoting sustainable travel will contribute to reducing demand.

Choosing an appropriate management system is important too. Proper and effective parking management is essential in our modern society - without it, we all suffer.

Grahame Rose says that GroupNexus works with clients across the UK to bring innovation to this problem, from intuitive, flexible car sharing apps to offsite parking, with car share or shuttles.

Panel of Experts

hospital parking better for everyone. The association’s Dave Smith says that, whilst he believes it is wrong that healthcare budgets should be used to provide parking facilities for those who choose to drive to hospital, the BPA also thinks there should be exceptions, particularly where there is no alternative and especially where long term or vulnerable patients are concerned.

That is a viewpoint shared by our panellists, with Stewart Clure saying that the move is a ‘much needed boost to hospital visitors’.

However, the age-old argument remains, with the opinion of our experts all leaning towards there being no such thing as free parking. The NHS receives a steady revenue stream from their parking provisions which helps to support other NHS funded services. Without this income, says Clure, other services would inevitably have to be sacrificed.

Grahame Rose agrees, stating that if there were no charges, the costs of car park maintenance, equipment and management would all have to be taken from the healthcare budget.

There are numerous estimates but it’s sometimes quoted at £2 million/annum.

Rose also highlights that, when it comes to free parking, people who use public transport or taxis don’t get their fares paid.

Aside from the cost argument, Simon Jarvis of WPS points to the environmental and demand issues. In all other forms of parking, charging forms part of a green transport plan which discourages people seeing cars as the default mode of transport. Indeed,

Recent parking measures and future plans The Conservative success in December’s General Election means that the country is now likely to face another five years of Tory-rule. Given the Queen’s Speech announcement, the way in which parking has become and emotive issue and the prominence of parking in party manifestos, it is important to question how the parking landscape in hospitals has changed since 2010. We have seen more NHS sites implement parking enforcement during the last 10 years, which is now seen as a necessary evil. Stewart Clure, of Debt Recovery Plus, says that whilst some NHS trusts used to think of enforcement as a dirty word, it is now often one of the most talked about hot topics at any NHS site. The reason for more trusts taking up operator services is simply because the industry has strengthened during the last 10 years, with the introduction of POFA, E

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Debt recovery services for the private parking industry 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.

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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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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 www.debtrecoveryplus.co.uk

When people do not pay Debt Recovery Plus is the leading provider of debt recovery services for the private parking sector in the country, and knows better than most the need to ensure debts are paid and issues resolved as quickly, and with as little disruption to the hospital, as possible.

Through close reporting, management and direct relationships between the company and the NHS, Stewart Clure says they can help to identify any issues that may occur and help to work out new ways to improve services.

In most situations, whether that be a staff member who has a permit issue or a family member who is visiting a sick relative each day who simply can not afford their parking, it is important to ensure an amicable solution is reached - often helping the motorist to

Panel of Experts

 banning of clamping and towingwhich means that the only legal way to protect their land is to introduce a robust parking management system.

In terms of the two largest political parties, the Labour Party has a long standing pledge to remove parking fees altogether in England, following on from the abolishment of parking fees at most NHS hospitals in Scotland and Wales in 2008. The Conservatives meanwhile have more recently launched their car parking pledge to introduce free car parking at hospitals for the two million ‘blue badge’ disabled drivers and passengers, as well as frequent outpatients, gravely ill patients, visitors to relatives in hospital for extended periods, and staff on night shifts who cannot use public transport.

Speaking in terms of policy, the Parking (Code of Practice) Act came onto the statute books in March 2019. It’s an enabling Act that provides for the creation of a single Code of Practice regulating private parking firms, and provides for the creation of a single independent appeals service for challenging parking charges.

Simon Jarvis says that the real change we are seeing is hospitals’ ability to fund the right approaches to parking. This is impacting their ability to invest in parking solutions which: are simple and stress free for all to use; are considered fair; are efficient to operate; effectively control demand and space occupation; offer very easy ways to apply concessions (which is even more important now); and avoid possible punitive fines wherever possible.

This is echoed by Grahame Rose, our representative from CP Plus, who points to the British Parking Association’s Code of Practice, which has been in circulation for many years. Bringing this into legislation – it will be compiled by the British Standards Institute – will change the landscape for parking operators. He says that a single appeals service will also take away any confusion and anomalies that sometimes occur under the current two appeals services (the other is run by the International Parking Community). However, with the free parking for specific groups announcement fresh in the mind, there is no doubt that change over the next ten years may be more dynamic than the ten years just passed.

We all know that parking space availability is limited – if parking is free, it is likely that demand will increase which is likely to increase congestion and make finding a space far more difficult understand the reason for issuing the charge and the consequences of not paying.

Dave Smith says that it is important to consider the outcome hospitals wish to achieve, stressing that a good working relationship between hospital, parking operators and debt recovery companies is crucial to ensure that parking enforcement is undertaken fairly and responsibly.

Furthermore, every effort should be made to reduce the number of parking charges notices that need to be issued, by ensuring the rules are clear, simple to understand, easy to comply with and, above all, fit for purpose.

As Grahame Rose suggests, an appeals decision tree should also be agreed so that appeals are dealt with consistently and fairly.

How to help NHS staff It is clear that staff parking continues to be a difficult task, especially for NHS organisations. So, aside from the fair/unfair argument, how can the issue best be solved?

Inevitably there will be peak demands and conflicting demands between the priorities of administrators, clinicians, consultants, and facilities teams to name a few. Just how do you determine the priorities? Dave Smith says that the overarching consideration for us all is climate change and the NHS has been vocal about the role it wants to play in helping to reduce emissions. He says that staff parking requires the same solutions as patient and visitor parking. For staff this means being part of a sustainable travel plan, establishing priorities when and where space is insufficient to meet demand and incentives to reduce the

need to travel by car. It’s also sensible to consider working arrangements and shift patterns to determine optimum occupancy.

The solution is not necessarily immediately agreeable. Simon Jarvis points to the very innovative work from some of WPS’ healthcare customers in increasing the price of staff parking, making investments in additional capacity and making offsite parking far more practical and financially attractive.

On the other hand, GroupNexus argues that it is not sustainable, nor in many cases environmentally acceptable, to keep building spaces sufficient to satisfy the demand for staff parking. The real solution, as suggested

by Grahame Rose, is to encourage staff to use other forms of transport, car sharing and park and ride. He does concede, however, that encouraging staff to use other ways of commuting needs to be compelling, perhaps including financial incentives, more flexible working practices and better public transport.

Equally, Stewart Clure says that, instead of increasing prices to encourage other modes of transport, NHS staff should receive a discounted rate for parking, often with a designated area for staff only.

Alternatively, some operators can subsidise discounts at local contract parking sites for staff in return for a long term contracts.

Ultimately, the BPA says that the answer lies in a good working relationship with the NHS trust working in partnership to deliver the outcome they would like to see. L FURTHER INFORMATION www.healthbusinessuk.net

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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

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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 www.wpsparking.com

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Complete and effective hospital car park management solutions GroupNexus is committed to providing effective hospital car park management while remaining sensitive to patients and visitor’s needs GroupNexus (formerly CP Plus & Ranger Services) provides complete hospital car park management solutions. With over 25 years’ experience, we have a deep knowledge of the healthcare industry, with an excellent track record in delivering high quality parking services to hospitals across the UK. We provide parking expertise with the sensitive approach that is needed at hospital parking locations, working with over 20 NHS trusts at over 40 hospital sites.

Parking enforcement is needed to help manage the car parks and prevent abuse but not at the distress of patients or relatives. Therefore, we train our staff to encompass a range of skills suitable for working at our NHS hospital car parks, as well as providing security management and tailor-made CCTV and control centre systems. With the implementation of more advanced technology at our NHS sites, we can expect to see further enhanced security and safety for patients and visitors.

We understand the importance of keeping vital roadways clear, so that emergency vehicles have immediate access when on call, and the need to be aware that users of the car parks may have an emergency or be in a distressed state. Our unrivalled experience brings sector wide knowledge that allows us to advise on concessions, staff permit parking, green transport schemes and more.

Our end-to-end services: GroupNexus offers an end-to-end service, from technology that allows you to track, monitor and gather data on car park usage, to setting the standard for the provision of management services.

GroupNexus handles installation of ANPR linked car park management systems, barriers, parking permit applications, paid for parking services including machine, cashless and online, concessions, vehicle alerting, user intelligence and on the ground facilities management, parking assistants,

enforcement, security and maintenance.

NexusInsights: NexusInsights has a complete range of insight services that can benefit your trust.

We get under the skin of each of our client’s sites enabling us to build a bespoke package that provides real and valuable insights into how each facility is being used.

The aim of our parking services is to help hospital car parks function in a more logical manner, with patient and visitor needs taken into consideration, enabling the smooth running of vital services. L FURTHER INFORMATION www.groupnexus.co.uk info@groupnexus.co.uk

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Parking

Changes are afoot in parking across trusts in England Kelvin Reynolds, director of Corporate and Public Affairs for the British Parking Association, explains why fair for all, but not free for all, may be the best solution to hospital parking For years newspapers, politicians and parking in hospitals in England: disabled campaigners have told us that paying people; frequent out-patient attenders; for parking at hospitals is a tax on the parents of sick children staying overnight; sick. There have been many attempts and staff working night shifts. to scrap healthcare parking charges in We welcome this more measured England including campaigns by MP’s, approach by government for England, Private Members Bills, charities and which is so much better than the free-forof course trade unions. We absolutely all that has been created in Scotland and understand why, but is it that simple?

Wales, and we now sit on the Department Parking facilities at hospitals are usually of Health and Social Care Hospital Car oversubscribed and demand often outstrips Parking Programme Board to support supply. Free parking usually increases them in developing the proposals. This demand too. We have always encouraged Manifesto commitment is easy to say hospitals to consider the outcome they but more challenging to achieve, without wish to achieve when many unintended consequences. Our aim planning their parking is simple: to help the government provision to ensure devise and deliver a solution it is managed which helps to make hospital The NH S for the benefit parking better for everyone. has mo r e of everyone, We know when parking s p e r c equirem ial whether they’re charges were abolished in conside ents and a patient, r visitor or staff. most o ations than Additional offeringrganisations hospitals and car par k their parking f a c i lities ing operators must work together to ensure parking is used properly by those it is intended for and not misused. This all costs money.

Where does that come from?

hospitals in Scotland and Wales, patient accessibility didn’t improve; instead spaces were taken by commuters and staff to the detriment of visitors and patients. And where parking isn’t managed properly it spills 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.

The NHS has more special requirements and considerations than most organisations offering car parking facilities. Besides the obvious emergency services and A&E access, hospitals have the unenviable task of juggling the interests of patients and visitors with the needs of healthcare professionals, who understandably want convenient, safe and affordable parking when they come to work.

Keith Fowler, chair of the BPA Healthcare E

Recent exemptions The UK government announced recently that from April 2020 four groups of people will no longer be charged for

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E Q U I P M E N T A N D S O L U T I O N S M A N A G E M E N T, PA R K I N G

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.

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Parking

 Special Interest Group, and head of facilities services at an English NHS trust, said: “Parking is always at a premium. Staff parking is often a cause of anxiety with colleagues wishing to park on site and arrive at work, on time. Clinical services cannot be delayed, and patients must be ready at stated times for appointments.

The juggling of priorities is therefore a skill the team responsible for parking must apply when deciding how best to manage parking at healthcare locations.”.”

Free at the point of use Like most NHS medical services, some car parks may be free at the point of use but someone, somewhere is paying for their upkeep and maintenance. If they are patrolled to keep them safe someone is paying for that too. This so-called free parking is always paid for - by someone else. Additionally, is free parking fair on those who travel to hospital using public transport and continue to pay? Far from being a tax on the sick, it could be argued that free parking is a subsidy for the motorist…

It is imperative the proposal being developed by the government to implement its manifesto commitment of ‘free parking’ is well designed and easy to understand; each of the four key groups, namely, disabled people, parents sick children, frequent outpatients and night-shift staff, need to be well-defined in simple and straightforward

We strongly advise that all hospitals in England who are planning, or about to introduce new ways of controlling parking or new charges, to consider how they manage it for these four groups of people currently language and clearly understood, to minimise confusion and ambiguity. People need to know whether they are included in

the scheme of concessions or not, otherwise complaints and calls for clarity will outweigh any praise precipitating from this policy.

We should be learning from the experience of hospitals where some of these concessions already exit and good local implementation plans need to be devised by hospitals and their parking operators to provide solutions that meet local needs.

And of course, paramount is a clear public awareness communicated at a national level across England and providing information on who qualifies and what the ‘offer’ is.

Additionally, today we strongly advise that all hospitals in England who are planning, or about to introduce new ways of controlling parking or new charges, to consider how they manage it for these four groups of people currently.

In a world focused rightly on climate change we also advocate that this ‘Free Parking’ strategy be considered as part of hospitals’ Sustainable Travel Plan. This will demonstrate a commitment to reducing congestion and pollution near hospitals and promote sustainable travel. The government has also said it will consider hospital car parking capacity across the country and how improved technology will reduce burdens for hospitals. This is a much bigger challenge especially as hospital trusts have been under pressure to release surplus land for much needed housing in recent years. Either way, we remain ready to aid and assist government to achieve an outcome that works for everyone. Fair for all, but not free for all. L FURTHER INFORMATION www.britishparking.co.uk

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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What happened to Axe the Fax in the NHS? The deadline for Axe the Fax has passed. Health secretary, Matt Hancock has officially banned the NHS from buying fax machines and April 2020 is the deadline for the phasing out of all fax machines throughout the NHS. Matt commented that “because I love the NHS, I want to bring it into the 21st century and use the very best technology available. We’ve got to get the basics right, like having computers that work and getting rid of the archaic fax machines still used across the NHS when everywhere else got rid of them years ago.”

Why is the NHS still using the fax machine?

With almost 9,000 fax machines owned by NHS hospital trusts, transitioning away from them is a monumental task. However, it looks like the April deadline will not be met by a large number of NHS Trusts, with research suggesting that just 42% of the fax machines had been removed according to September 2019 figures.

The problem with change is that without a suitable replacement process or transition plan, the easiest thing to do is continue as you were. Fax has become an integral part of the healthcare process for decades now, and the move to digital, needs care, planning and training to make the transition effective, whilst delivering the raft of benefits promised by the new technologies.

The fax machine has been around for many decades and relies on the conversion of a scanned document into an audio tone which can be transmitted by a phoneline, converted back into a document and then printed out. It is slow, inefficient, wasteful, offering no audit trail and making document sharing difficult.

Why is there so much paperwork in the NHS? Healthcare generates many sources of paper-based information, including documents, x-rays, medical notes and records for patients, as well as policies, reports and regulatory documents. Storing and managing all of this paper based information takes a lot of energy and space, not to mention the time taken to archive and retrieve these documents. Data security is also a great concern, with significant penalties for violation or loss of information, which could result in impacted patient care.

How can we transition away from the use of the fax machine?

The implementation of document scanning could help NHS Trusts achieve significant cost savings and improved business processes whilst improving the quality of patient care. Through the scanning and digitisation of documents, paper based information can be converted into a digital system accessed via computers, tablets and even mobile phones. With appropriate document management software, processes can be automated and accelerated, and access to data can be controlled and tracked to ensure the privacy of patient information and to produce more accurate audit trails for compliance. This digital data can be stored off-site in the cloud protected from fire, flood

and theft. Through a document management system, data can be shared and sent instantly saving money and time on faxes, couriers and photocopying whilst reducing the chance of loss and damage.

Key benefits of digitisation include: ■ Centralised storage for documents with enhanced security, access control and instant retrieval.

■ Business process agility leading to productivity gains and cost savings.

■ Enhanced compliance with regulatory guidelines throughout all departments.

■ Faster access to patient information, potentially leading to improved patient outcomes, better patient engagement, and better access to critical information across the care continuum.

How do we digitise paperwork?

Fujitsu have a range of scanners, designed with the healthcare industry in mind to aid the transition to digital.

Highlight models with their range include the numberone selling fi-7160; a best-in-class scanner designed for high quantity batch scanning and reliable performance.

The Fujitsu fi-800R is a perfect desktop solution for GP and hospital reception desks, with a footprint smaller than the size of an A4 sheet of paper and the ability to scan ID and everyday documents. The intuitive ScanSnap iX1500 is an easy to use scanner for improving admin processes and the ScanSnap iX100 ideal for capture in the community.

At the higher end of the range are models such as the fi-7900 capable of scanning and processing thousands of patient records a day.

Use of new technology in the NHS is advocated by the UK Government The UK government are now offering support for modernisation in the NHS. Matt Hancock, has announced a new digital aspirant programme, to encourage the whole of the NHS to make use of the latest technology.

Matt stated that “We’re going to use digital technology to ease the burden on staff, give people the tools and information to manage their own healthcare, and make sure that patient data can be safely accessed wherever and whenever it’s needed across the system.” “It’s quite simple: better tech means better health and social care.”

Next steps To find out more about Fujitsu scanners and document management systems, please visit http://emea.fujitsu. com/scanners or call 020 8573 4444. The money saved through the investment in improved efficiencies and processes may mean the new investment costs are recouped within a much shorter timeframe than you imagine!

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Recruitment

NHS recruitment: joining the dots Neal Suchak, policy advisor at the Recruitment and Employment Confederation, analyses the importance of a healthy, transparent recruitment supply chain and the benefits of co-operation in NHS recruitment The UK has now left the EU – so what does this mean for the future of the NHS workforce? How can the NHS best recruit, train and retain its workforce, and what role does the recruitment industry have to play in supporting the NHS through these unchartered waters?

Although the UK has officially left the EU and become a ‘third country’, we are currently in a transition period in preparation for the 31 December, where on-the-ground changes will be evident, including a new immigration system.

Nevertheless, even From before these changes Septem Where are the numbers? occur more than Latest NHS figures show that 10,000 EU all nurs ber 2020 most staff are British – but nationals have will rec ing students eive a p a sizeable minority are not. left the NHS ayment of at le Around 153,000 out of 1.2 since the Brexit year, w ast £5,000 a million staff report their referendum, ith up t nationality as non-British. This including o £3,00 further is around 13 per cent of all almost 5,000 f u n ding 0 nurses; and availab staff for whom a nationality le for e is known, with around 65,000 on top of that, s tudents ligible (5.5 per cent) being EU nationals; fewer nurses the figures are much higher are arriving. in London and the South East.

Recent figures

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from the Nursing and Midwifery Council show that the number of nurses arriving from the EU dropped by 87 per cent from 6,382 in 2016-17 to 805 in 2017-18.

To address these challenges, the Conservative Party has pledged to add 50,000 nurses to the workforce in England by 2024-25. How realistic is this target, particularly given that nurse numbers have gone up by only about 5,000 since 2010?

Early steps With more than 40,000 nursing vacancies, workforce is the main concern for NHS leaders. The current government have said that 14,000 more nurses will be trained with extra placements funded in the NHS. Another 5,000 more nursing staff will come from apprenticeships - which are designed to allow recruits to be trained in the workplace without the need to pay tuition fees and study at university. However, the Nuffield Trust notes that the nurse apprenticeship scheme is relatively new and by the middle of 2018, only 300 people had started.

The government also wants to see 12,500 more nurses recruited from overseas, arguing that halving the cost of the NHS visas will help attract more staff from outside the UK. Will better retention help?

The government says that 18,500 extra nurses can be found by using policies to ensure fewer leave the NHS. NHS England is already addressing this issue by promoting more flexible working, enhancing continuing professional development and encouraging highly qualified staff who have left in

What do health experts think?

Both inside the NHS and among independent health commentators there is agreement that 50,000 more nurses than now will need to be working in the service in five years’ time. The Health Foundation, Nuffield Trust and King’s Fund think tanks, in a joint report, argued that 5,000 nurses will have to be recruited annually from overseas over four years to avoid staff shortages, even if other initiatives are pursued to boost the workforce. That would mean 20,000 more internationally recruited nurses by 2023, considerably more than the Conservative plan.

The Year of the Nurse and Midwife As we enter the Year of the Nurse and Midwife, the Department of Health and Social Care have at least put measures in place.

From September 2020 all nursing students will receive a payment of at least £5,000 a year which they will not need to pay back, with up to £3,000 further funding available for eligible students, including for: specialist disciplines that struggle to recruit, including mental health; an additional childcare allowance, on top of the £1,000 already on offer; and areas of the country which have seen a decrease in people accepted on some nursing, midwifery and allied health courses over the past year.

The funding will be given to all new and continuing degree-level nursing, midwifery and many allied health students, and it is expected to benefit more than 35,000 students every year.

Given the increased administrative burden for many NHS workers in recent years, it would be better to think of how automation could potentially complement human capacity rather than replace it Taking a joined-up approach 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 crucial in ensuring patient safety. Agency staff have the same skills as substantive staff, often with many years of experience.

It is essential that these staff are recognised for their professionalism and contribution, are treated fairly and are valued.

Furthermore, specialist healthcare recruiters are experts in workforce planning, and see first-hand the shortages that it has to contend with. Recruiters are perfectly placed to identify where problems lie and able to offer immediate solutions. They can supply staff up and down the country, often to regions that are less appealing to other workers, as well as offering immediate help in critical situations.

What about AI? Automation has potential to help fill the skills gaps. However, how far this will go is debatable. It’s difficult to believe that most people will be eager to lose their GP, nurse or care worker to automation.

These are roles where the human skills of

Recruitment

recent years to return. Projections suggest that as many as 20,000 nursing staff who might have otherwise quit could still be working for the NHS in five years’ time.

compassion and empathy are so important.

Looking beyond front-line services, the RSA point out that outsourcing decisionmaking in the public sector to computers is also a risk, as it is important that the decisions taken on the services that people rely on maintain a human element.

Given the increased administrative burden for many NHS workers in recent years, it would be better to think of how automation could potentially complement human capacity rather than replace it. There is huge potential for it to minimise administrative elements of the roles.

Looking forward To attract more people into the NHS, it’s important to think of what new generations of workers will be looking for in their jobs.

‘Purpose’ is often cited as having increasing importance in why people choose their career paths. This is something that the NHS has lots of, and playing on this strength makes sense.

Something else frequently cited as increasing in importance in career choices is having more job flexibility. Workers are increasingly expecting to see flexible working patterns offered as the norm. There are challenges with increasing flexibility for some healthcare jobs, but finding solutions to achieving this is important if the NHS is going to compete with the private sector on modern working practices.

With the decline of ‘jobs for life’ and more people leaving the health sector early in their career, it’s also important to think of ways to attract people from the private sector.

The NHS ‘We Are the NHS, We Are Nurses’ campaign, backed by the Health Secretary, targets teenagers who are about to choose their degrees as well as career switchers considering going into nursing. The measures are part of the NHS People Plan, which will set out work to reduce vacancies across the NHS and secure the staff needed for the future.

Recruit, train and retain Deep problems remain within NHS recruitment and there are no quick fixes, but consistent and determined action from the government and employers can deliver results. Government needs to work hard at retaining its existing workforce, as well as adopting a joined-up approach to workforce planning with specialist recruitment agencies. Patient safety always has to come first, and getting the workforce right is the single biggest factor that policy makers and NHS leaders need to be focussing on to achieve that. L FURTHER INFORMATION www.rec.uk.com

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The NHS is the UK’s biggest employer, with 1.5 million employees, and is one of the largest employers globally, ranking fifth behind McDonalds, Walmart, the People’s Liberation Army China, and the US Department of Defense Even with its 1.5 million strong workforce, the NHS does not have enough staff to meet demand. The majority of NHS staff work in ‘hospital and community services’ (HCHS) as direct employees of NHS trusts; providing ambulance, mental health, and community and hospital services. The NHS workforce is made up of direct and indirect employees.

Direct employees count for 319,740 staff members in support to clinical staff, 306,996 nurses and midwives, 171,282 working in NHS infrastructure support, 139,241 scientific, therapeutic, and technical staff, 111,247 HCHS doctors, 78,684 in GP support and admin roles, 34,534 GPs, 20,951 ambulance staff, 16,276 practice nurses, and 4,752 counting for other staff, as of September 2018. In addition to direct staff, NHS organisations have indirectly employed staff through a paying company to provide services such as laundry, cleaning and catering, corporate function and estate management.

Current hiring demands In NHS hospitals, community, and primary care settings, there are approximately 150,000 doctors and over 320,000 nurses and midwives. These two groups make up just over one third of the total workforce.

Shivan Mehta Divisional Manager

Given the multidisciplinary nature of the NHS, finding staff that meet hiring demands is always going to be tough.

Between July and September 2018, there were almost 94,000 full-time equivalent advertised vacancies in hospital and community services alone, equating to an estimated shortfall of eight per cent.

These shortages were unevenly distributed across the country. The lowest were found in the North East & Yorkshire and Humber areas, at 4.5% and 5.6% respectively. Further South, at 9.9% and 11.5%, Kent, Surrey & Sussex and Thames Valley were the highest in the country.

The lowest staff shortages within hospitals and community health services were healthcare scientists, estates and ancillary staffing groups. In a 3 month period both were around 2,500. This is particularly concerning since the latter group are often responsible for ensuring that hospitals are maintained and fit for purpose.

When it comes to recruitment, the first port of call is usually advertising vacancies through different platforms, or internally within NHS organisations. In the short term, this approach to recruitment is cost effective, and makes sense considering current financial constraints.

A permanent recruitment cycle takes on average 47 days. However, when you factor in time to short list candidates and submit applications this process can be pushed past ten weeks. If unsuccessful the clock resets.

The impact of this challenging recruitment process is that jobs are left vacant, or unqualified staff are taken on.

This is a risky approach to take as a lack of resources often means that there is not enough oversight of under-skilled staff, so problems may often go unnoticed or ignored until they pose a serious risk.

For existing staff, this can result in elevated stress levels and ultimately lead to burnout. Some organisations look at solutions that rely on support from service providers and consultancies to fulfil a client side role.

The cost of these services is often magnitudes higher than it would be for internal staff, creating a false economy, and these service providers do not always necessarily represent the trust’s best interests.

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Hiring to better serve your trust

Meeting hiring demands Apprenticeships are a great tool to add to your succession planning. Any method that helps unskilled workers gain valuable experience within the sector should be paramount for any staffing strategy.

It has been troubling to see that UK trusts are sitting on £200 million of unused funds for apprentices.

These funds collected though the apprenticeship levy, will be clawed back by the government if unused. However, according to a government spokesperson speaking in October 2019, new flexibilities have been introduced, ‘to help employers spend their levy funds. It means employers now have 24 months to spend their levy funds and large employers are able to transfer up to 25 per cent of their funds to other businesses’. Hopefully this initiative will enable employers to use their money to invest properly and ensure that apprenticeships play a role in solving the staffing crisis.

Organisations could do well in identifying weaknesses within their departments, for example, which areas are under-resourced, or failing to recruit? Develop your strategy to address these weaknesses. When it comes to a hiring strategy, organisations need to be flexible and not follow a rigid process.

Be clear with deadliness and interview dates. Applications should be monitored two‑three times a week and not left for a hiring manager to sift through after a closing date. Too often candidates slip through the net because there is already a rigid interview process in place that doesn’t accommodate their needs. In a market with a shortage of candidates, it needs to be a two way street, and organisations need to actively promote themselves throughout the hiring process.

A personal touch makes all the difference, and any contact should be made over the phone as opposed to via email.

It would be of benefit to an organisation to engage with fewer agencies, rather than more. Crown Commercial Service (CCS), for example, enables you to identify specialist agencies for critical posts. More time could be invested in speaking with fewer agencies about where a shortfall might exist within a resourcing team, ultimately resulting in a higher quality of candidate and service.

Specialist agencies tend to have a greater understanding of the market and will take the time to filter suitable candidates rather than bombarding clients with CV’s with the hope that something will stick.

This might mean that some positions will cost more in the short term, but the long-term savings, such as time, overall cost and staff retention will certainly outweigh this initial cost.

Recruiting for the NHS will likely continue to be tough for the foreseeable future and the best solution is one that encourages trusts to diversify their hiring strategy and leverage key relationships internally and externally. L FURTHER INFORMATION oysterpartnership.com

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Advertisement Feature

A healthy approach to building design The rapid growth in smart technology means building engineers can now deliver far more sophisticated HVAC solutions, according to Daikin Applied UK Wireless systems and greater connectivity in buildings means it is now much easier to accurately match system performance to user requirements and optimise energy efficiency.

It also gives engineers a route to tackling the individual pieces of equipment that consume the most energy, such as fans and chillers.

This is an increasingly important consideration for NHS estates procurers, who are under pressure to reduce running costs and increase efficiency, while also maintaining good quality indoor environments. It also means Building Services Designers have more tools available to address one of the biggest challenges of our age - the issue of poor indoor air quality (IAQ). Air pollution is a huge problem and has been labelled a ‘public health emergency’ by World Health Organisation (WHO). The British Lung Foundation identified a particular threat to hospitals and healthcare facilities in its 2018 report entitled Toxic Air at the Door of the NHS. This revealed that more than 2,000 GP surgeries and 248 hospitals in the UK are in locations where air pollution is above WHO recommended contamination limits.

The WHO is also concerned that outdoor air continues to be used as supply air for ventilation systems despite heavy contamination by particulates and other outdoor pollutants. It has called for much more effective use of air filters and room air purifiers, particularly in buildings with vulnerable occupants like care homes and hospitals.

Protection Healthcare facilities pose a unique design challenge for heating, ventilation, and air conditioning system engineers. These systems fulfil a broad range of ventilation requirements and provide protection from

40

airborne hazards, but controlling HVAC systems can be complex, particularly in a highly mixed use environment like a hospital.

However, these challenges can often be overcome if good control logic and optimum system sizing based on closely matching demand to the system’s capacity and performance are used. It is also important to use the technology to continuously monitor critical plant remotely once it is installed and up and running.

This will prove increasingly valuable for the NHS because – with summer temperatures staying higher for longer in the UK – continuous monitoring allows facilities managers to spot early warnings. They can see if the cooling system is not achieving its design capacity or efficiency, which could be due to low refrigerant charge or high operating pressures. This allows potential breakdowns to be avoided and any drop in performance to be addressed before it causes serious problems.

At Daikin Applied (DAPUK), we focus on providing a fully integrated HVAC solution.

We have worked on 311 UK hospitals since 2002, delivering solutions worth more than £43 million. This extensive experience has allowed us to build up a team of highly trained mechanical engineers who understand the particular requirements of a healthcare environment.

Our engineering team focuses on the full lifecycle operation of our solutions, which means we have a good handle on operating costs and will always argue for a long-term focus that will deliver a good return on investment – in terms of both finance and human health.

Dainkin Applied’s HTM compliant service and maintenance packages include continuous remote monitoring of site conditions and

can be tailored precisely for the healthcare facility in question combined with excellent air filter technology produced by our sister company AAF, which provides clean air solutions for patient rooms, medical procedure areas, operating rooms, dentist offices, research centres, morgues, and cafeterias.

When it comes to air filtration, the control of viable and non-viable particles is crucial in many process applications in the life science industry. Protection of people from hazardous or potent compounds is equally important and there is a wide variety of supply, exhaust and recirculated air housings and filter types to address each application.

AAF offers a wide range of solutions including HEPA (High-Efficiency Particulate Air), ULPA (Ultra Low Particulate Air) filters and chemical gas-phase filtration. HEPA and ULPA filters are used in isolation rooms, protective environment rooms, organ transplant areas, and other applications requiring ultra-clean air.

This allows DAPUK to deliver high care/clean room technology solutions with the necessary sterile environment and our full system approach includes delivering solutions to control air pressure, temperature and moisture.

It is an important consideration for any HVAC specialist supplier to understand both the operational parameters of the equipment it supplies and the impact of its designs on indoor operating environments.

The extra bonus we now have, thanks to the growing sophistication of digital systems, is that we can continue to monitor and adjust those systems throughout their operating life on behalf of our clients. L FURTHER INFORMATION www.daikinapplied.co.uk

Catering

Supporting the elderly to eat and enjoy food together care Over the last few years, Food for Life has researched intergenerational activity and support for care settings for the elderly. Here, Florence Todd Fordham shares some of the findings Malnutrition presents a significant health threat to older people and care home residents. In the UK, over one-third of care home residents have been found to be malnourished and require treatment (BAPEN, 2015). This has major impacts on their quality of life, with additional consequences such as social isolation and loneliness. Through the Food for Life Better Care programme we have aimed to positively impact on the lives of older people and care home residents.

What is Food for Life Better Care?

Food for Life Better Care was a two year programme to promote good food for older people and included a focus on care homes and intergenerational work in Edinburgh, Calderdale, Kirklees, Leicester, Leicestershire and Rutland. The team used innovative techniques, based on ethnography and codesign, to identify opportunities for change.

Food for Life Better Care sought to be both comprehensive – with a whole settings approach to multiple aspects of food – and developmental – to test out and reflect on what worked and what might be enhanced.

While each area shared a common overarching framework and approach towards engaging partners, it was anticipated from the outset that the team would adapt the delivery of the intervention to fit local circumstances. The programme has consisted of networking, training, support, development and delivery for a wide range of care homes.

This has included creating opportunities to Here is an independent endorsement, backed partner with nurseries and schools, some of by annual inspections, for food providers which are active in the Food for Life schools who are taking steps to improve the food and Early Years national programmes. Food they serve, for climate, nature and health. for Life Served Here, an accreditation from The aim of the scheme is to encourage and the Soil Association that awards sustainable reward caterers who serve fresh food, source and healthy catering, was used as a platform environmentally sustainable and ethical food, for promoting nutrition, hydration and make healthy eating easy, and champion local sustainability standards in care homes. food producers. Food for Life Served Here Key goals of the Food for Life Better Care accreditation is available for all organisations programme were to prevent malnutrition who serve food. The fixed bronze and loneliness, to enhance the standards apply to all caterers wellbeing of people in later life, while silver and gold to build capacity within the are assessed using a Therap care sector around food, points-based system. e u t i c food ac and to bring communities Points are achieved t together through food. at silver and gold dining ivities, r o for sourcing o m experie FFLSH and environmentally n c e s and nutritio sustainability of friendly and activitie n training food provided ethical food, steps A key aspect of Food taken towards benefic s are greatly ia for Life Better Care making healthy care ho l to residents was supporting better eating easy and , m access to nutritious food. championing local cateringe staff and Through our work in other food producers. teams settings, such as schools and If you see a Food for early years, Food for Life has a Life Served Here logo you wealth of experience in improving know that the majority of food the food provision, procurement of on the menu will be freshly prepared, ingredients and the overall dining experience. it will always be free from undesirable trans To help caterers make good changes, Food for fats, sweeteners and additives, be cooked Life supports food providers to meet Food for by trained chefs, and use ingredients from Life Served Here criteria. Food for Life Served sustainable and ethical sources. E Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Air hugs technology “Everything you never knew you wanted in a hand dryer�. With ffuuss you will save time on washroom upkeep and reduced janitorial and maintenance cost.

Features ffuuss has a patented air heating sistem, Preheat, which eliminates the burdens of conventional electric heating and allows a reduction in energy consumption.

Everyone can enjoy an optimal drying experience with capacitive sensors. Allows lateral activation of dryer.

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Catering

 What did we find?

The evaluation of Food for Life Better Care was led by the University of the West of England, collaborating widely and building on related research to ensure relevance across the UK. Through the evaluation we were ultimately testing a hypothesis: if older people have better access to nutritious food, therapeutic food activities and shared mealtimes across care homes, community care services and hospitals, will they be less susceptible to malnutrition and loneliness and enjoy enhanced health and well-being.

The programme introduced individuals and organisations to the methods and benefits of co-design and whole settings approaches. Greater collaboration helped move beyond the fragmented and isolating working practices that often feature in adult social care. The programme therefore illustrated an approach that holds the prospect of being transferable and scaleable. Overall, the Food for Life Better Care activities were linked to promising evidence of benefits for care home residents in terms of positive social interactions, mood and mental well-being, improved diet and enjoyment of meals and eating.

Case study In November 2017, the Food for Life Better Care team collaborated with staff and residents at Summerfield House Care and Nursing Home, a large privatelyowned care home in Calderdale, to test a whole settings approach to food using a co-design test-and-learn approach.

Over an 18-month period, the Food for Life Better Care team collaborated with staff and residents at Summerfield House Care and Nursing Home to focus on food and foodrelated activities as a social experience and a bridge to the surrounding community. Food for Life Better Care sought a comprehensive approach, in that the programme was informed by a whole settings approach to consider multiple aspects of food. The

Food for Life Better Care was a two year programme to promote good food for older people and included a focus on care homes and intergenerational work in Edinburgh, Calderdale, Kirklees, Leicester, Leicestershire and Rutland team adopted a ‘test and learn’ approach to the programme. This involved consulting with residents, care home staff and others on types of activities to run, testing them out, and reflecting upon the learning.

There were several benefits of the programme to residents, staff, residents’ relatives, schools and the care home itself.

The analysis led by the University of West England showed that residents derived social, affective, nutritional and general wellbeing benefits from the programme.

Staff who engaged in the programme were noted to feel valued, supported and developed a higher sense of morale in the care home. Communication between staff and residents were observed to have improved during the implementation of the programme. There were testimonies from staff about residents’ relatives’ satisfaction of care due to residents’ exposure and engagement in the Food for Life Better Care activities.

The activities had a positive impact on school pupils who visited Summerfield House Care and Nursing Home to undertake intergenerational growing, gardening and other food-related activities with residents.

There were observed and reported increase in empathy for older people; counterstereotypical behaviour towards older people; and development of friendships with residents through the intergenerational work. The quality of food was noted to improve during implementation of the Food for Life Better Care programme in

Summerfield House Care and Nursing Home and management had realised savings on food cost and reduction of plate waste.

The future of Food for Life Better Care Because of the experience of successfully delivering Food for Life Better Care, we have learned that therapeutic food activities, dining room experiences and nutrition training activities are greatly beneficial to residents, care home staff and catering teams. This experience and the expertise we have built around improving the health and well-being of older people through food related activities, means we know how to support care homes to develop an outstanding food culture and service.

We can offer tailored support to you if you’re a local authority, care home company, caterer. We can provide help by delivering consultancy, staff training and activities for nutrition and dining experience, and for our Food for Life Served Here accreditation scheme. L

If you are interested in developing a Food for Life Better Care programme where you work, please get in touch with Florence Todd Fordham on ftoddfordham@soilassociation.org and we would be happy to build a programme that would best support your needs.

FURTHER INFORMATION www.soilassociation.org

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The new name from the laptop experts Change has come. We have evolved. We bring over 30 years of knowledge and expertise with us. With quality, reliability, security and innovation at our core we can now evolve even faster.

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Transforming mobile working in healthcare Nick Offin, head of Sales, Marketing and Operations at dynabook UK, explores the challenges and opportunities presented by mobile working in 2019, and how the latest solutions – from mobile zero clients to wearables – can help healthcare organisations ensure security, productivity and mobility are achieved in equal measure Technology is continually transforming the way people work across a diverse range of industries, with the number of mobile workers predicted to climb from 1.45 billion in 2016 to 1.87 billion by 2022 – accounting for 42.5 per cent of the global workforce.

Healthcare is no exception to this, with the global healthcare mobility solutions market predicted to experience an annual growth rate of 28.3 per cent by 2022.

The majority of organisations today already have a mobility strategy in place given the widespread nature of mobile working, and the numerous advantages it can bring. According to an EY study, over 50 per cent of companies have deployed a strategy whereby mobile working is implemented every day. Yet the fast-paced nature of technological innovation, coupled with rapid data explosion driven by the Internet of Things (IoT), mean that such strategies constantly need to be reviewed and refreshed to meet the latest demands.

Unrelenting threats to security in healthcare Remote working and the ever-multiplying swathes of data which are so integral to operations today create increasing opportunity for cyber criminals to strike.

The average annual cost of such attacks on healthcare organisations is $12.87 million (£9.26 million) – the fifth most expensive of all industries, given the immense value

attached to sensitive patient data. The more data available to mine, and the more entry points there are providing access to the network, the bigger the risk. Proof of this within an increasingly data-centric healthcare sector is the 211 per cent increase in disclosed security incidents in 2017 when compared with the previous year, according to McAfee.

The edge and data proliferation While security may be the most pressing IT and mobility-related concern for healthcare organisations right now, ensuring efficient and productive working while on the move is also becoming increasingly important.

5G is set to instigate a further boom in the IoT, meaning this ongoing data rush of unprecedented levels is certain to continue and healthcare must be primed to take advantage of this. In order to relieve the strain this data will place on cloud services, a growing number of organisations are integrating an edge-focused element to their mobility infrastructure. Organisations can provide an enhanced quality of service by processing data at the edge of the network, thus reducing the likelihood of data overloads while also helping mobile workers such as GPs to meet compliance regulations, for example by recording consultation notes in a timely manner.

Paving the way for wearables As edge computing develops, so too will the solutions used to collect and manage this data. Global wearable device shipments will rise to 154 million in the enterprise by 2021, according to ABI Research, as sectors including healthcare recognise how they can utilise such technology to enhance mobile productivity.

Accenture claims that, by 2020, 91 per cent of healthcare solutions providers will include wearables in their IoT offerings to clients. This includes the adoption of long-mooted solutions such as Assisted Reality (AR) smart glasses, which can for example be used by medical workers in the field to record patient information in real‑time during an examination.

What is clear is that, while most organisations have already embraced mobile working, whether they are executing such a strategy effectively varies from one to the next. Verizon’s Mobile Security Index 2018 found that 35 per cent of healthcare organisations reported data loss or downtime from a mobile device security incident in the past year, while 41 per cent admit to purposefully putting themselves at risk of a security breach for the sake of expediency or business performance.

Building, managing and maintaining a secure and agile IT strategy is more complex now than ever before, from choosing trusted devices to integrating bespoke security solutions at a network level. It is, therefore paramount for CIOs to constantly assess their architecture and integrate the right solutions to ensure security, productivity and mobility in equal measure. L FURTHER INFORMATION www.dynabook.com

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Parallels Remote Application Server

Apps and VDI delivery "IT systems in the NHS are so outdated that some staff need to log into as many as 15 different systems to do their jobs."

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With Single Sign-On (SSO), Touch ID, user session roaming, and leveraging AI for ultrafast logins, NHS staff can reduce their login times by 90%.

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Parallels® Remote Application Server (RAS) is an all-in-one virtual desktop infrastructure (VDI) solution that delivers applications and virtual desktops to any device, anytime, anywhere.

Session roaming allows doctors and nurses to move from one device to another and pick up their sessions where they left off.

They can access different applications at the same time and switch effortlessly between tasks and devices while on the go.

With SSO, Touch ID, and AI, doctors and nurses experience a smooth login process without having to re-enter their credentials multiple times when using different applications, reducing the number of logins and login times.

Parallels RAS enables ultrafast logins by leveraging artificial intelligence (AI), making applications ready-to-use when you need them. For example, if a doctor begins seeing patients promptly at 9 am, the applications needed will launch at 8.55 am - reducing waiting times.

Need more info? Contact us | nhs@parallels.com | 44 (0) 203 327 6420 | parallels.com/ras

GS1 standards

A simple approach to providing improved patient care Glen Hodgson, head of Healthcare at GS1 UK, looks at the current state of the eProcurement strategy and asks where the GLN sector is heading over the next few years Trading beyond borders is often a challenge for suppliers. And that’s not just with reference to supply-chain efficiency and traceability that can also be extended to order processing, invoicing and payment management too.

However, when you compound these seemingly simple tasks with the intricacies of a country’s healthcare framework, an already complicated system becomes even more difficult to navigate.

As a result, the Department of Health and Social Care (DHSC) introduced the NHS eProcurement strategy1 in 2014 – designed to help improve procurement efficiencies across the NHS, and enable organisations to provide better value and better care for patients.

After all, irrespective of being an NHS trust, or a supplier, distributor or manufacturer, the main aim is to make sure the patient has the right product or device, available in the right place and at the right time, every time.

With the eProcurement strategy in place, products can be traced to their point of origin, through to their point of issue/delivery. This enables any defective products to be identified and removed from circulation quickly – a significant patient safety advantage.

This depends on the inputting of accurate product data to the GDSN, which can then be attributed back to any individual organisation on the supplyside using their unique organisation identification number – their legal GLN. For NHS trusts, this information feeds directly into their product catalogues. Once an order is placed, suppliers then send the order directly to the trust’s unique delivery How does this work? location, also identified using a GLN. Delivering the aims of the eProcurement The trust is also identified with a legal strategy relies on two central components GLN, so it’s not mistaken any of the other to support the transition to e-trading 153 acute trusts across England. Adding and e-invoicing. Firstly, the use of GS1 further granularity to the process, the trust standards for the unique identification can also use a separate GLN to ensure of products, using Global Trade Item the delivery goes directly to a designated Numbers (GTINs) and of locations, using point such as a department, ward or even Global Location Numbers (GLNs). This a specific shelf or patient’s bedside. feeds into the efficient synchronisation of All GLNs used across the system are held in data across a central network – the Global one central repository – LocationManager3.

Data Synchronisation Network (GDSN).

So, any time a shipping location is modified, Secondly, the use of PEPPOL messaging billing information is updated, or a delivery standards for the electronic exchange point is changed, the amendments of transaction information are available in real time, so such as purchase orders, suppliers have access to delivery details and the D eliverin everything they need, exchange of invoices. the aim g whenever they need it. s of the ePr Without accurate location information strategy ocurement in place, products are central relies on tw susceptible to being o c o m ponent suppor lost and deliveries are s to t the tra at risk of being E ns t Take the example of the Poly Implant Prostheses (PIP) breast implant scandal of 20102. To this day, there are tens of thousands of women still living with these implants a decade after their surgery. Apply this same methodology to anti-counterfeiting and medicines traceability, and there are some clear translatable benefits here too.

o e-trad ition in e-invoic g and ing

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Introducing the PURELL® ES8 Dispensing System Hand hygiene that’s always ready When you choose new PURELL ES8 hand hygiene dispensers, you’re not only getting trusted hand hygiene products, you’re also getting a revolutionary dispenser design that addresses the two most common service issues – empty dispensers and worn out batteries.

AT-A-GLANCE™ Refill Design We make it easy to monitor product levels with one quick look, saving time and labour, and eliminating complaints about empty dispensers.

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GS1 standards

 missed, resulting in unwarranted delays to vital patient care. Without accurate billing information, trusts and suppliers can easily end up with troublesome invoice queries and delayed payments.

All-in-all, this serves to create an efficient procurement system, which is set in place to streamline business transactions across the NHS, improving the purchaseto-pay process for all stakeholders.

Over the next few years, the value of GLNs and effective location management will have real potential to drive even more transformative change beyond the realms of efficient procurement and supply chains

Where are we now?

Fast-forward to 2020, and the adoption of GLNs continues to play a fundamental role in the current healthcare landscape.

Forming part of key mandates and recommendations, the value of GLNs and effective location management has become paramount, with benefits being realised beyond procurement, having demonstrated advantages within clinical settings as well.

The use of GLNs underpins a significant part of the NHS Framework Agreement for the Supply of Goods into the NHS4, and several suppliers are already on the journey, having barcoded their products, and begun to trade messages via PEPPOL. But more recently though, the Medicines and Healthcare products Regulatory Agency (MHRA) has also recommended the use of GLNs in Field Safety Notifications (FSNs) and Medical Device Alerts (MDAs).

Due to the critical nature of product recalls, it is essential for manufacturers, distributors, suppliers and NHS providers to be able to establish where any remaining inventory is located as quickly as possible, in order to limit potential harm to patients.

Therefore, on both of these counts, the use of the legal GLN will feature as a requirement – which in turn supports one of the core aims of the EU device regulations for medical devices (EU MDR) and in-vitro diagnostic medical devices (IVDR).

This particular regulatory update comes into force from May 2020, and will place greater emphasis on the post-market surveillance of products, including the proactive monitoring of device performance

for recertification, annual safety updates for higher-risk class devices, and rapid reporting of safety incidents. Crucially, these changes will impact trusts and wider healthcare organisations that are integral to the supply of products into the NHS. What next?

Over the next few years, the value of GLNs and effective location management will have real potential to drive even more transformative change beyond the realms of efficient procurement and supply chains. There’s no escaping the ‘digital first’ messaging emanating from government, and the drive to go paperless is still at the heart of the agenda, along with the clear focus on interoperability.

And that’s not to disregard the overarching sentiment – to improve patient safety across the board: these changes are all steps in the right direction towards achieving a much needed seamless healthcare system.

Envisage the bigger picture of being able to track each touchpoint of a patient’s journey from community and primary care through to secondary care anywhere across England – or around the world for that matter. It’s a long road to get to that point, but it’s not as unachievable as it might have appeared to be some decades ago.

In reality, there are already some areas of excellence that exist, and trusts and their suppliers across England are making headway. They are beginning to reap the benefits that effective location management has to offer – enabling them to collectively provide better value and, ultimately, a better patient-care experience. L

For more information on GS1 standards and location management, or to start your GLN adoption journey, contact the GS1 UK healthcare team at healthcare@gs1uk.org.

Glen Hodgson is head of Healthcare at GS1 UK. He is charged with supporting the NHS and the healthcare industry to deliver greater efficiency and a more robust approach to patient safety.

With over 20 years of national and international experience, Glen has served at board level in a variety of operational and commercial roles within complex organisational structures inside the pharmaceutical/healthcare arena.

1.

https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/ attachment_data/file/344574/NHS_ eProcurement_Strategy.pdf

2.

https://www.nhs.uk/conditions/pipimplants/

3.

https://www.gs1uk.org/our-industries/ healthcare/locationmanager

4.

https://assets.publishing.service. gov.uk/government/uploads/system/ uploads/attachment_data/file/681448/ Guidance_on_NHS_Terms_and_ Conditions_for_the_Supply_of_Goods_ and_the_Provision_of_Services__ 2018_.pdf

FURTHER INFORMATION www.gs1.org/industries/healthcare

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

New report looks at how we can optimise the path to innovation in digital health The healthcare industry is an ever-evolving space and there is a need to consistently reassess the pathways for innovation so as not to hinder new and exciting developments from reaching the market. For this reason, in 2019, EIT Health hosted a series of round tables across Europe, attended by key stakeholders, to examine the areas of the innovation pathway where improvements can be made In recent years, there has been rapid growth in the field of medical and health technology.

Not only has the number of players in this sector increased, but the diversity of products and services has evolved exponentially. While there are clear benefits in this change in dynamic, we must consider the impact this has in terms of how adequately innovators (those developing products and services) are able to navigate the path to market in a field that is highly regulated and often complex and slow to evolve in line with new technologies.

This is particularly relevant when we consider that we are seeing more and more solutions being developed by innovators who are not sector specific, and therefore may lack relevant experience and understanding of the specificities of the healthcare market.

The regulatory and reimbursement landscapes are also ever-changing, posing new challenges in terms of development, testing, implementation, usability and adoption of new healthcare solutions. As a result, innovators and other stakeholders can face further hurdles in simply keeping abreast of how to access the healthcare market. In light of this environment, the EIT Health Think Tank selected the topic ‘Optimising Innovation Pathways: Future Proofing for Success’ for consideration and debate in its 2019 Round Table Series.

The UK Round Table focused on the digital health market as the introduction and evolution of mHealth applications has seen this market grow rapidly over the past few years. According to a study from Deloitte, the UK market rose from £2bn to £2.9bn between 2014 and 2018.

This trend shows the long-established structure of the healthcare industry, where

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the pharmaceutical sector has traditionally stood at the forefront, is beginning to shift towards digitalisation – opening the path for new entrants and for giants such as Google, Apple and Amazon to diversify into the healthcare space. In fact, only 32 per cent of mHealth developers come from traditional healthcare stakeholders such as hospitals, health insurers and Pharma companies.

The current situation: a focus on today’s innovation pathway The innovation pathway, or route to market for new products and services, is comparable in the UK to the rest of Europe. It is a continuous and modular pathway whereby all parts are interconnected and reliant on each other.

Regulatory and reimbursement stages of the pathway were historically developed to support the introductions of more traditional treatments such as pharmaceutical medicines or medical devices. This has led to a pathway that may be considered to favour more traditional innovation, and in need of reform in order to address emerging technologies such as digital health in all its many forms.

This is particularly relevant when assessing the regulatory processes, which is struggling to keep pace with the rapid introduction of new technologies. In the current landscape, where new technological discoveries are constantly being made, there is increasing need for a more agile regulatory framework.

Such reform of the regulatory pathway in Europe, and consequently, the UK, has indeed been addressed recently, as evidenced by the European Medicines Agency, with the proposed introduction of new guidance for medical devices and in-vitro diagnostics which are planned to be introduced in

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2020. These new guidelines have been developed in response to the increasing pace of innovation and evolution of the types of products and services requiring assessment.

Regulatory capacity to assess innovations based on the introduction of these guidelines, however, is expected to be challenging.

Currently, regulators have the capacity to evaluate approximately 600 products per year; whereas approximately 6,000 are expected to be impacted by the new MDR. This will create a backlog of solutions both new and already on the market that require review via the new guidance and may interrupt and slow access for patients and citizens.

Pathway optimisation is profoundly important for health innovation, as it will in turn ensure that patients and citizens benefit from access to promising solutions as quickly as possible.

Conclusions and recommendations for optimising the path to market The body of evidence collected during the Round Table Series, demonstrated that there are a number of key stages within the innovation pathway where improvements could be made to aid and speed up the route to market for promising innovative solutions. Participants of the UK Round Table Meeting were asked to agree on a set of recommendations that, if implemented, could help to optimise the pathway for digital health solutions. Where possible, they also identified potential stakeholders who would need to be engaged for further discussion.

Bolstering the ideation stage Ideation marks the beginning of an innovation’s life cycle, and if errors are made

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at this early phase, the future success of the innovation may be severely hampered.

Through the Think Tank activity, it is clear that a number of activities could be optimised to support innovators at this stage with regards to digital health solutions: Develop a systematic process for needs identification and assessment to provide better guidance on the evaluation of solutions Digital health solutions should consider both the ‘clinical need’ and the ‘system need’.

While the underlying need may be similar for the two, the environment and context can be vastly different. Therefore, innovators should be encouraged to place greater emphasis on the broader ‘problem identification and mapping’ and this process should be structured and standardised to offer clarity.

HealthTech Connect, provided by NICE, offers a service that presents a centralised repository of granular needs, and EIT Health should consider consulting and promoting this service to ensure innovators are effectively engaging with this resource. Additionally, the needs of the end user (i.e. patient or citizen) should be fundamental to this process, and a cocreation strategy should be at the forefront throughout the innovation pathway.

Map incubators and accelerators available in the UK and promote engagement amongst innovators Many impactful incubators and accelerators are in existence across the UK, however they are often accessed locally and awareness may be low amongst the wider context of the innovation community. EIT Health should consider conducting a mapping exercise of quality health incubators and accelerators in the countries and regions and promoting this as resource to the EIT Health network.

Further discussions should also take place with Academic Health Science Networks,

the National Institute of Health and Care Excellences’ HealthTech Connect or the NHS innovation accelerator to capitalise on existing resources and add value where necessary.

Improving the development phase Embrace failure as part of the innovation process – be prepared to ‘fail fast’ – and systematise learnings. There is great value in failing within the innovation process – failure allows us to learn and strengthen our ability to innovate. Failing fast also allows for time, cost and resource efficiency. However, culturally, we are still fearful of admitting failure which hampers our ability to learn.

EIT Health can help in changing attitudes to failure and promoting positive sharing of learnings within health innovation. EIT Health should consider sharing results and learnings from funded innovation projects that have failed or not continued.

Clarify the evidence generation requirements for digital health solutions to demonstrate true value and facilitate conversation between innovators and regulatory and reimbursement bodies.

The generation of evidence occurs too late in the pathway; it is needed throughout the process. There should also be clarity around the appropriate body of evidence required for regulatory and reimbursement bodies for digital health solutions as a distinct methodology in contrast to evidential requirements for medicines and medical devices. Innovators should be supported by early access to, and dialogue with, such stakeholders (HTA bodies, commissioners, trust executive teams, etc.) to develop and sustain a strong value proposition.

There are a number of resources in existence in the UK which may help including the NICE MedTech Early Technical Assessment (META). Additionally, open-access databases that can be used for testing, such as from NHS Digital. EIT Health can help to

facilitate such a relationship, connecting innovators with decision making authorities to clarify data collection requirements, as well as signposting innovators within the network to existing resources in the UK. Market entry – navigating the changing regulatory landscape Assess the impact of the new medical device regulation on the access to digital health solutions.

The introduction of the medical device regulation in 2020 is expected to slow access to digital health solutions due to changing guidance as well as regulatory capacity.

While estimations have been calculated, it is not clear what the full impact will be on digital health solutions, and guidance is lacking for innovators in approaching the new regulation.

ORCHA has developed a briefing on this for Digital Health Apps Adoption Promote incentives and a value‑based approach to the provision of new digital health technologies. The current reimbursement system is heavily focussed on cost, which presents a challenge for digital health solutions which aim to improve more long‑term outcomes such as adherence or care quality.

EIT Health should consider assessing the value-based healthcare procurement landscape for digital health solutions in Europe specifically, and discuss potential reform with policy makers and reimbursement bodies. L

Find out more about how EIT Health it is enabling innovation in healthcare throughout Europe and access the full report at www.eithealth.eu/think-tank-topic FURTHER INFORMATION www.eithealth.eu/think-tank-topic

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Digital transformation in NHS trusts

Written by James Adie, Vice President EMEA Sales, Ephesoft

Over the last 20 years, new technology, and the changes this technology has had on general workplace practices, has slowly eroded the paper-based past

We mostly send our invoices in PDF form rather than in the post, and we sign our signatures digitally as opposed to printing out documents and putting pen to paper.

But in the NHS, paperwork is still very much alive. From lab results to surgery notes, no sector encounters more paperwork than healthcare. This is still a consistent hindrance to NHS staff, who are required to carry out extensive admin in order to do their jobs.

Looking to a paperless future The integration of smart document capture technology – and the bypassing of excessive admin – is an important step towards delivering a paper-free health service – an objective that many NHS trusts are hoping to achieve by the end of the decade.

More and more trusts are beginning to use scanning platforms to cut down the reliance on paper, but this doesn’t solve the whole problem. We’ve spoken to trusts who have scanned documents into old systems, only for the system to generate one massive file which then needed to be manually searched to pinpoint the information needed.

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Beyond scanning platforms, the NHS requires intelligent systems – perhaps the product of multiple vendors’ technology – that not only scans a document, but is then able to identify exactly what each document is and store it in a fully-integrated digital platform.

In a fit-for-purpose modern-day health system, access to an intelligent, central patient platform is essential to help alleviate some of the administrative strain – one that removes the need for labour-intensive filing and the organising of physical records.

By using sophisticated data capture technology, hospital staff can collate and access patient records from a wide variety of sources all in one place, giving them greater visibility into patient history and affording them quick and easy retrieval of information.

This technology can change the functionality of the NHS. From the patient’s perspective, clever, integrated digital systems can connect them to care more efficiently and effectively than ever before. And for staff continuously weighed down by administrative tasks, these new technologies will allow them to focus their efforts on the more pressing and personal aspects of care.

Technology in healthcare today At first glance, data capture initiatives may not seem the most glamorous examples of new technology in healthcare today – particularly when compared with robot brain surgeons in Canada, and the developments in 5G and extended reality that are creating new possibilities in simulation training and remote patient treatment.

But the conversion of outdated healthcare systems into modern, streamlined and highly effective ones will underpin the continued success of health services across the world.

In the future, further improvements to machine learning and artificial intelligence technologies will radically improve our ability to identify illnesses and diagnose patients. These technologies feed off massive sets of data, and there is an obvious abundance of this in the NHS. But in order to utilise these developments properly, our health services must first

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organise the way they store, use and access the extensive and ever-increasing patient information that staff encounter every day.

Ephesoft in the NHS In recent years, a number of NHS trusts across the UK have selected Ephesoft’s technology – together with specialised healthcare technology partners – to transform their working processes. This partner ecosystem can offer complete data capture solutions to NHS trusts that organises, processes and extracts data from a wide variety of clinical documents – from referral notes to discharge summaries and everything in between.

By scanning stickers containing a patient’s date of birth, NHS number and case note number, for example, each record can be clearly identified, ensuring that staff can always access the relevant documents.

The technology also has the ability to develop itself over time by learning the layouts of different document types as it comes into contact with them. Given the sheer number of clinical records at play in the NHS, this function ensures that no time is lost when document layouts change – the system learns to recognise the record type and remembers it for next time.

The benefits of an NHS without paper records are numerous and include reduced storage costs; the elimination of lost case notes; eradicating the need for manual entry of patient data; efficient and remote access to extensive patient information all in one place; and digitally secured records protected by rolebased access, safeguarding any sensitive data.

But most importantly, the time saved on filing, preparing, auditing and locating patient records – combined with removing the need to ferry documents across wards – will free up the time of hospital staff that can be better spent in patient-facing care.

To find out more about how Ephesoft can help increase efficiency in your NHS trust, visit the website below.. L FURTHER INFORMATION www.ephesoft.com

Technology

The innovation buck stops with you, Mr Hancock Barbara Harpham, chair of the Medical Technology Group, considers the mechanisms designed to promote the adoption of innovation by the NHS, and asks whether - at last we may be making some progress For over 18 years, successive Secretaries of State have championed the importance of innovation and the adoption of new medical technology by the NHS. In that time there have been over 20 reviews, reports, recommendations and initiatives designed to achieve this goal. But how successful have these steps been in ensuring the NHS takes full advantage of the technology on offer and what needs to be done next to make a significant impact?

Fifteen years of frustration When we first reported on efforts to promote the adoption of innovative medical technology back in 2016, we branded our report Déjà Review. The title reflected the frustration we felt from what we perceived as a distinct lack of progress, despite countless hours of civil servant time being poured in to solve fundamental issues.

That was before the publication of the Accelerated Access Review. Déjà Review set out nine recommendations for the Accelerated Access Collaborative (AAC).

The AAC is providing leadership and guidance for development of innovation across the health service. It also appears to be gaining the prominence and leadership needed to ensure it makes a significant impact on the innovation landscape. Its remit has expanded from identifying specific products that it supports through accelerated regulatory Checking the pulse of approval to addressing the more fundamental innovation in the NHS challenges to the uptake of new technology.

Four years on from the Déjà Review report, It now functions as a ‘single front door’ to the we decided the time was ripe to take innovation ecosystem, horizon scanning for another look at the health of the NHS’s the best new innovations so we know what’s innovation systems. Our latest report: coming down the track, and developing Our NHS: A spotlight on the Innovation a local and national approach to Landscape does just that. Launched demand signalling to send a at a roundtable event in clear message to the market Westminster hosted by Chris about what the NHS needs.

Green MP in January, the The go o Similarly, the AHSNs, report makes for more d work d established in 2013 to positive reading. In o n e by one AH spread innovation at fact, we conclude that always SN is not pace and scale across the NHS system for regions and improve innovation adoption well in replicated anothe health and economic is healthier than r while collabo growth, provide a E it’s ever been. ra These included a long-term commitment to the AAR by government, and a central role for Academic Health Science Networks (AHSNs) in supporting the spread of innovative technologies. I am glad to say that much of this advice was heeded.

tion industr with y

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Technology

 vital vehicle for interactions between industry and the NHS, while connecting the academic organisations and the third sector.

This role as ‘catalysts and connectors’ has been enormously successful, and the 15 AHSNs have together helped introduce over 330 technologies which have benefited over 20 million patients. With their licence and funding renewed until 2023, they are well placed to continue to deliver results and build on their crucial regional links.

The vital signs are good, but there’s room for improvement Of course, there is always more to be done.

The good work done by one AHSN is not always replicated well in another while collaboration with industry, essential to ensure that device manufacturers tailor their innovation to the NHS landscape and source of demand, could be improved.

Meanwhile, the AAC has focussed on a limited number of technologies and, although this has produced impressive results in certain fields, the process is unlikely to solve the fundamental issues that slow down the rapid uptake of technology across the wider healthcare system.

In our view the AAC needs greater prominence within the NHS architecture.

It needs support, as the key organisation focussed on the adoption and use of innovative technology, so that it can continue to assist in the development of NHS practices that are fit for patient demand. Furthermore, it needs a more formal role in all aspects of innovation, most notably NHS Business Services Authority and procurement. With a clear function, it can ensure innovation is the absolute priority when procurement decisions are made.

Our report explores the six steps set out by the Accelerated Access Review, from horizon scanning to uptake support, and makes suggestions for enhancing them. It also examines the role and performance of the NHS Innovation Accelerator, NHSX, and HealthTech Connect, all of which have the potential to contribute to ensuring the right technology gets into NHS clinicians’ hands.

However, we believe there are broader issues to be addressed to reform the system:

Many government initiatives, including Getting It Right First Time, are aimed at reducing the demand on NHS services by removing treatments. This sends the wrong signals to policy makers Five ways to further boost NHS innovation adoption 1. Early Access to Medical Technology The NHS still struggles to support and incentivise early access to medical technology. The Medicines and Healthcare products Regulatory Agency (MHRA) already has an ‘Early Access to Medicines Scheme’, alongside the Cancer Drugs fund as a way of allowing early access to medicines. No such scheme exists for medical devices. NHS England should establish an Early Access to Medical Technology scheme that provides funding and support for NHS organisations to give patients early access to medical technology.

2. Joining up the system The NHS needs to look at the vital elements of the system that impact the use of medical technology and ensure they are joined up. This would require a seamless process that supports all technology through the evaluation, commissioning, reimbursement and procurement challenges.

All evidence, data and information on technology gathered during the evaluation phase should also support the latter elements. Doing this more effectively would allow for a reduction in the amount of duplication.

3. Funding mandate The proposals for a medical technology funding mandate will help support the uptake of proven, cost effective medical

technology. The criteria for technologies achieving mandatory funding is initially very narrow, and focused on in year savings.

We would like to see this extended, with a funding mandate similar in operation to that of the system for pharmaceuticals.

4. Change ‘less is better’ mind-set Many government initiatives are aimed at reducing the demand on NHS services by removing treatments. Both Getting It Right First Time (GIRFT) and the Evidence Based Interventions programme are focused on reducing activity. This sends the wrong signals to policy makers. The drive to reduce demand should aim to get people back to full health as quickly as possible.

The most effective way of achieving this is through access to effective diagnostic and subsequent treatment for all patients.

5. Creating a culture of innovation More needs to be done to create a ‘culture of innovation’. A challenge given the NHS employs 1.5 million people. Nevertheless, this needs to come from the very top and the buck stops with Secretary of State for the Department of Health and Social Care, Matt Hancock. Mr Hancock’s commitment to technology has been welcomed, but he needs to look at how he can go beyond the implementation of exciting initiatives to embed a change of culture within the UK health system. L FURTHER INFORMATION www.mtg.org.uk

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Cyber security

How technology can help ease NHS winter pressures Sascha Giese, Head Geek™ at SolarWinds, discusses the failings of legacy NHS technology and how cyber security is vital for the well-being of the health service Winter brings challenging circumstances for the NHS, with the impact of seasonal bugs and flu, among other cold-weather conditions, and places an increased burden on services and resources. Indeed, as recently reported

by The King’s Fund, back in the winter of 2018/19, nearly all NHS beds were occupied due to 18,000 patients a day arriving as emergency admissions during February 2019.

Peaks in demand such as this will test the resources of any organisation, even one as big as the NHS, and it is perhaps no surprise important stakeholders such as the British Medical Association (BMA) have previously characterised the winter situation as a ‘crisis’.

The reasons behind the challenges faced by the NHS during winter are extremely diverse, but there can be no doubt the reliability, resilience, and security of IT infrastructure is fundamental to the ability of any healthcare organisation to meet major spikes in demand—seasonal or otherwise. At any time of year, a security breach or any serious system downtime can cause huge problems for the delivery and efficiency of healthcare services. Add the extra pressure common

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at this time of year, and an inconvenient IT problem can quickly evolve into a wider crisis.

A current example is the recent arrival of the end of support for Microsoft® Windows® 7 – an operating system widely used across The failings of old technology the NHS. Going forward, Microsoft has It’s inevitable in a public sector organisation now stopped providing security updates with over 70 years of history, the NHS will and support for the product and users always feel the impact of ageing IT. Even have a choice of paying for extended when the technology continues to do the job support, upgrading to the current version it was built for without obvious problems, this of Windows, or sticking with what they’ve ‘legacy’ can bring with it an unwanted got in the hope they remain secure. collection of deeply embedded This is no small problem. problems, from reliability, According to information from the collaboration, and Department of Health, there It’s inev performance issues are still ‘approximately 1.05 in a pu itable to an inability to million NHS computers scale when demand using Windows 7 from a organis blic sector ation w rises. When older 1.37 million’. Aside ith over total 70 year hardware and from the difficulties of the NH s of history, software is in daily, upgrading that number S mission-critical use of computers to Windows feel the will always within organisations 10 in the short term, it impact as large and complex shows the sheer size of of ageing as the NHS, the the task facing the NHS for IT technical and financial any wholesale technology issues associated with change. And the process can replacing it are intimidating. take years –indeed, five years

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Cyber security – Vital to the well-being of the NHS Building a strong cyber security strategy focusing on the key requirements of detection and prevention requires a co-ordinated approach from the top down. At a leadership level, efforts should include improving security best practices. For example, because the NHS employs around 1.7 million people, the risks presented by insider threats, whether unintended or malicious, are considerable. Indeed, the security risks from insiders can often be more numerous and acute than those coming from external criminal hackers or foreign governments.

As a result, end-user security awareness training, network access control, and effective patching are among the best routes

to improving insider threat detection and prevention. In general, organisations investing in best practice often see an improvement in security effectiveness, and processes such as employee background checks can play an important role in controlling the risks presented by malicious insider threats. These should form part of ‘basic security hygiene’ for the NHS and will prove of immense benefit under almost all circumstances.

But this only represents part of the challenge. In their attacks against hospitals, cyber criminals probe a variety of apps, systems, and environments, trying to find critical servers where Personally Identifiable Information (PII) resides. These tactics make multi-layered defences essential to augment hospital network security with intelligent threat monitoring, triggering alerts, and automated incident response software to quickly remediate cyber security issues.

Ultimately, the perennial challenge for the NHS is one of funding. In the case of more advanced and sophisticated security tools, for example, the shopping list can be long.

However, to help mitigate the risks of security problems exacerbating the wider winter pressures, intrusion detection and prevention tools, endpoint and mobile security, web application firewalls and encryption technologies are now ‘must-haves’.

Ultimately, the perennial challenge for the NHS is one of funding. In the case of more advanced and sophisticated security tools, for example, the shopping list can be long

It would be foolish to suggest technology alone can take away the challenges brought to the door of the NHS every winter. But it can certainly play a significant role in helping the organisation deliver infrastructure that is reliable, secure and can flex effectively whenever demand dictates. L

Cyber security

after Windows XP went ‘end of life’, the NHS still has some 2,300 computers using XP. There are always going to be challenges with using legacy technology. Despite this risk, the key to keeping systems going is to make the risk as small as possible, through implementing the necessary technology and training to primarily stop cyber threats in their tracks, but also to reduce the negative impact of a potential failure. Every organisation will face these issues; what’s important is how well they cope with them.

FURTHER INFORMATION www.solarwinds.com

Cyber incidents in last year for two thirds of organisations New research has revealed that 67 per cent of healthcare organisations have experienced a cyber security incident in the past year.

Highlighting the serious threat that data breaches and malicious attacks pose to the UK’s health-related data, the Clearswift analysis also found that 48 per cent of incidents within the health sector occurred as a result of introduction of viruses or malware from third-party devices – including IoT devices and USB sticks.

The survey found that further causes of cyber security incidents within the healthcare sector included employees sharing information with unauthorised recipients (39 per cent), users not following protocol/data protection policies (37 per cent), and malicious links in emails and on social media (28 per cent).

The number of security incidents are in stark contrast with further findings from the survey which revealed that 24 per cent of respondents had an adequate level of budget allocated to cyber security.

Alyn Hockey, VP of Product Management, Clearswift, said: “The healthcare sector holds important patient data, so it is alarming to see such high numbers of security incidents occurring in the industry. The healthcare sector needs to securely share data across departments and organisations in order to facilitate excellent patient care. With the proliferation of third-party devices in this process, it’s more important than ever that the industry bolsters its cyber security efforts to reduce the risk of everything from unwanted data loss to malicious attacks and focusses on keeping patient data safe and secure.” tinyurl.com/vhalzpk

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Records management subject matter experts for Health & Social Care, helping Healthcare Organisations with: • Records management strategies

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Where is your Trust in its journey to a digital health record?

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Trusts yet to implement an Electronic Document Management system

Why implement an EDM? Electronic document management enables NHS Trusts and healthcare organisations to reduce and where possible, remove ongoing operational Health Records Management costs. Some of the many benefits can include: • Operational cost reduction

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Excitement builds for Rewired 2020

Digital Health Rewired

Sponsored by

Digital Health Rewired 2020, 3-4 March at London Olympia, will feature an expanded programme focused on showcasing some of the best start-ups from across the UK and Europe UK health care is replete with innovative digital projects big and small, but the key challenge remains to share knowledge, identify and scale up best practice.

Despite the promise of new disruptive technologies, they often struggle to get on the radar of the NHS IT leaders leading transformational change.

Digital Health Rewired 2020, which takes place on 3-4 March at London Olympia, is to buck that trend and bring the diverse UK digital health community together to discover new possibilities for delivering health and care services through technology.

The Rewired 2020 programme focuses on providing attendees from all parts of health and care with real world actionable lessons and insights from those leading some of the most exciting digital health initiatives from the UK and internationally.

The show opens with the one-day Rewired Leadership Summit for the most senior NHS CCIOs and CIOs, leading into day two with the Rewired Conference and Exhibition, aimed at everyone interested in helping shape the digital future of health and care.

Already confirmed is a mix of compelling speakers, including the NHSX senior management team; Matthew Gould (CEO), Tara Donnelly (CDO), Simon Eccles (CCIO for health and care and deputy CEO), Digital Health Awards winners - Mandy Griffin, (CIO of Calderdale and Huddersfield), Gareth Thomas (CCIO at Salford Royal), Natasha Phillips (CNIO at UCL) and a glittering range of digital disruptors and CEOs of cuttingedge digital health start-ups.

Day one: Leadership Summit for 300 senior health leaders The two-day format that worked so well in 2019 remains. Rewired kicks off with the one-day Rewired Leadership Summit for the most senior NHS CCIOs and CIOs. For 2020, the keynote is a hugely impressive digital leader, diversity and champion and president of techUK, Jacqueline de Rojas CBE, who will open Jacqueline de Rojas, the summit. She CBE, President, will discuss the key techUK

attributes of effective digital leadership to tracks alongside some of the most innovative achieve large-scale digital transformation NHS IT leaders, talking about how they and draw on the vital importance of having have harnessed digital to benefit patients. a diverse range of leaders, reflective of High impact digital health disruptors to wider society outside healthcare. catch at Rewired 2020 include; Carron Other keynote speakers Manning, co-founder of iPrescribe confirmed so far include Exercise, Sina Habibi, founder At noted data privacy of Cognetivity, and Daniel t he hear campaigner Phil Nathrath, co-founder t of the star Booth, co-ordinator of Ada Health. t u at Rew p focus of MedConfidential, iPrescribe Exercise is and former developing a service will be ired 2020 t technology based on personalised h e Re Pitchfes advisor to Simon exercise prescription t, the q wired uick-fire Dragon Stevens and Dr programmes for ’s Den s Ben Marruthappu, citizens combining ty compet CEO of Cera Care.

AI programmes and ition fo le The afternoon Apple Watch sensor r start-up programme will also data. Physiotherapist, s include panel sessions from Carron, co-founded the brilliant Shuri Network iPrescribe Exercise threeand DigitalHealth.London, led years ago, to provide personalised

by Dr Shera Chok and Yinka Makinde. The exercise programmes for all. popular Long View also returns, bringing Cognetivity is reinventing dementia together past and present leaders to candidly detection using a new cognitive testing discuss how to balance the relationship platform. The Integrated Cognitive between centre and local on health IT. Assessment is a five-minute test which uses artificial intelligence (AI) and Day two: a packed programme machine learning techniques to help for the digital health community detect the earliest signs of impairment.

Day two is the Rewired Conference and Ada, meanwhile, is connecting medical Exhibition, aimed at everyone interested in knowledge to intelligent technology to helping shape the digital future of health and help people actively manage their health care. Over 1,800 delegates attended Rewired and medical professionals to deliver 2019 and 2,500 are expected for 2020. effective care. Ada is already the number The conference will feature seven packed one medical app for 130 countries, tracks of top speakers and inspirational with 15 million assessments have been leaders on digital health. Delegates completed since its global launch in 2016. will be provided with practical insights, knowledge and ideas they can take Pitchfest returns home and act on. The seven dedicated And at the heart of the start-up focus conference tracks will cover: Digital at Rewired 2020 will be the Rewired Transformation; Clinical Software; Pitchfest, the quick-fire Dragon’s Den style Interoperability Showcase; competition for start-ups less than three CCIO/CIO National years old, that attracted over 80 entries Conference; AI and in its first year. The 2019 Pitchfest winner Analytics; Cloud and Testcard will be presenting, and sixteen Mobile; and shared care. finalists will battle it out in four live heats for a place in the final, which will be Showcasing held on the main stage and be hosted by cutting edge NHSX’s chief digital officer, Tara Donnelly. digital health The start-up stage, meanwhile, will be a key start-ups feature of the Rewired exhibition, providing Disruptive digital a home for the Pitchfest heats and quick-fire health start-ups will presentations from a range of innovative feature across all the start-ups. The 2020 Pitchfest prize is Rewired conference bigger than ever, thanks to Chelsea and E Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Legacy IT is the patient It is crucial that your data is managed with the very highest levels of security.

Blackthorn is a tried and tested system that enables clients to manage their workload with total security, integrity and accountability The discussion about reimagining healthcare through the adoption of digital technologies continues unabated. Here, the narrative is to use technology to greatly improve the sharing of information between health and care professionals, whilst also giving people better access to the care they need.

In the glare of healthcare’s digital agenda, it is sometimes easy to overlook the fact that the public sector is, and has been, reliant on technology for many years, and some of this technology has now reached – or is fast approaching - the end of its serviceable life. For a lucky few, the digital agenda will supplant the need for direct replacements but for the rest, the legacy system will require palliative care or replacement by newer, serviceable technology.

This is exactly the position that the Department of Health & Social Care (DHSC) found itself in in 2016.

The Road Traffic (NHS Charges) Act 1999 gives the DHSC the legislative power to recover NHS treatment costs from patients involved in road traffic accidents if the patient has personal injury insurance, something often incorporated into motor vehicle insurance policies.

The costs recovered are based on set rates for inpatient and out-patient treatment, and whilst these do not cover the actual cost, they still generate significant revenues for Trust hospitals. The Health and Social Care (Community Health and Standards) Act 2003 extended the scheme to all personal injury claims, not just those resulting from road traffic accidents.

The scheme is administered by the Department of Work and Pensions (DWP) on behalf of the DHSC. Information supplied by motor vehicle insurers to the DWP

following a road traffic accident is verified by the healthcare provider for accuracy, in particular treatment/consultation dates.

New Injury Cost Recovery (ICR) claims are forwarded by the DWP to the appropriate healthcare provider using a Lotus Notes platform (client/ server technology) provided by the DHSC. IBM acquired Lotus Notes in 1995 but murmurs from IBM mid-twenty 10’s about ongoing support for Lotus Notes created uncertainty amongst the client base and many existing customers, including the DHSC, started looking at migrating away from the Domino (Lotus Notes) platform.

The ICR treatment verification service was one of many that needed to find a new home and the DHSC’s approach was to engage with industry in the form of a soft market test – an exploration into the possible, with vendors putting forward solutions against draft requirements. One key requirement was security – any new service would need to afford patient data adequate protection from unauthorised access. This was especially important where migrating into ‘the cloud’.

Enter Blackthorn GRC Limited, an established albeit boutique software and software services provider with the agility and deftness to provide clients with a very flexible and personalised service. High up the DHSC’s list of requirements was a solution that looked and functioned exactly the same as its predecessor.

A system with all the foibles of early 90s forms styling and absent of the context sensitive pop-ups and decluttered screens that define best practice now. This curious requirement was not without merit; the transition from old to new technology together with the aggregation and cleansing of approximately 1.5 million data records, all within the pending shadow of new GDPR

legislations, was likely to take its toll, without having to also worry about the retraining/ familiarisation of over 800 users from around the country. Delivering familiar forms would mostly alleviate the need for training.

A cloud-based solution was required that could facilitate the automatic and secure transfer of sensitive information between the DWP and NHS, support extant NHS processes and return the validated information whilst maintaining appropriate separation of concerns between hospital trust groups. The solution needed to work using standard web browsers with no additional plug-ins, add-ins or controls. It also needed to work with a range of versions of MS-Office and browser technologies.

Blackthorn’s solution was to use its generic GRC (Governance, Risk and Compliance) software as the backbone of the new ICR system, leveraging pre‑existing functionality to meet virtually all of the DHSC’s requirements, and relying on configuration data to deliver the required visualisation and business functionality.

By avoiding excessive coding, Blackthorn, was able to expedite the department’s requirements very quickly, and to check accuracy through fortnightly ‘show and tell’ sessions with the DHSC’s project team.

Hosted with a third-party specialist public cloud service provider, Blackthorn architected the virtualised hosting environment, taking on full responsibility for data security which need to be inherent in the design both to meet the Government’s cloud security principles but also to achieve connection to the HCSN healthcare network.

Importantly, the work programme was delivered ahead of the planned cut-off date for the old Dominos technology, and without any significant disruption to healthcare providers using the ICR treatment verification service.

Blackthorn’s GRC software has many applications but is most commonly used for criminal investigations, fraud investigation, cyber incident response, employment vetting, health and safety and other business processes where a prescribed approach is required to manage activities concerning sensitive data.

Blackthorn’s services are available through the G-Cloud 11 Framework administer

by Crown Commercial Services. L FURTHER INFORMATION www.blackthorn.com

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Dr Ben Goldacre, MBE, Author and Senior Clinical research Fellow, University of Oxford

Matthew Gould, CEO, NHSX

 Westminster Hospital NHS Foundation Trust and their charity, CW+. The Pitchfest champion, for the first time ever, will be offered the opportunity to have their innovation tested and scaled in a real-world NHS setting.

A new dedicated health developer conference New for 2020 is the Digital Health Developer Conference (Health Dev Conf), an exciting one-day dedicated event for all developers working in the health care sector, from the NHS, independents, big suppliers and start-up.

The Health Dev Conf, which will run alongside the Conference and Exhibition, will have a host of practical workshops and educational sessions exploring the tools, platforms and standards available to developers working in health.

Presentations will cover openEHR, UX and UI for health, NHS Identity, open source, blockchain, and the regulation of health apps. In addition a series of interactive workshops will take place to develop delegate’s skills in openEHR standards, NHS Frontend Library, adding NHS Login to apps, My Med Record, FHIR, and GP Connect.

Data Lab: how to harness health data Another new addition to the Rewired 2020 programme is the Digital Health Data Lab. This unique dedicated one-day conference and series of hands-on workshops is focused on

helping delegates gain a better understanding of the latest developments in the use of data and data science tools, platforms and techniques to gain benefit and insight from all types of UK health data, either singularly or through aggregation and combination.

UK healthcare has reached a tipping point in digitisation, where core baseline automation is now the norm in most organisations. The greatest benefits to patients will now come from harnessing available data to gain actionable insight.

The Data Lab programme will cover latest developments and approaches across UK healthcare organisations (NHS and independent), international exemplars, and include contributions from life sciences and health research bodies.

A diverse range of engaging speakers The original programme brings together the most compelling content from Caroline CriadoPerez, journalist and campaigner

agenda-setters, local leaders and pioneers across the UK’s digital health sector.

Matthew Gould, the CEO of NHSX, the new agency driving NHS digitisation, will keynote Rewired Conference and Exhibition.

He will review progress of the organisation which was set up in July 2019 oversee NHS IT, and explore key priority areas in interoperability, standards and evolution of the GDE and LHCRE initiatives.

Gould will take part in a sofa conversation and Q&A session on the main Digital Transformation stage at Rewired with Digital Health editor-in-chief Jon Hoeksma.

He is joined at the conference by Simon Eccles, deputy CEO for NHSX, who will talk about the challenge of getting a CCIO or CIO onto every board and developing future clinical informatics leaders.

The afternoon keynote is writer, journalist and campaigner, Caroline Criado-Perez, who will be examining the unconscious biases that emerge from the gender data gaps in healthcare, technology and society as a whole.

Local leaders will also share key lessons and insights from pioneering digital health projects. One of the must-see sessions will be presented by Berkshire ICS CEO, Cathy Winfield, who will outline the digital challenges of creating integrated care and population health.

The next generation of new and emerging CIOs will share how they are meeting the challenges of digital. Four must-see NHS CIOs speaking at Rewired 2020 have recently been announced. David Walliker, the new role of chief digital and partnership officer at Oxford University Hospitals NHS FT, Lisa Emery, the CIO of cancer specialist hospital, the Royal Marsden NHS FT and chair of the London CIO Council will both talk about the challenges and lessons learnt from high-profile NHS CIO roles.

Paul Jones who took up the role of CDIO at Leeds Teaching Hospitals NHS Trust in September, will offer a unique perspective on the challenge of completing the digitisation of one of the largest trusts in the country, whilst Ross Fullerton is the CIO of London Ambulance will reflect on the step-by-step digital transformation of the service’s use of mobile technology to deliver the information paramedics and ambulance crews needed to better treat patients.

Digital Health Rewired

Sponsored by

Join the digital health revolution Rewired will again bring today’s health IT leaders with the best of digital health startups and those aiming to reinvent health and care through digital. Published by Digital Health, the market-leading publishers of news, research and organisers of the annual CCIO and CIO Summer Schools, we focus on delivering the most compelling speakers and original programmes to ensure Rewired has real buzz and excitement and is a must-attend event of the year. L FURTHER INFORMATION www.digitalhealthrewired.com

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The Tavistock and Portman NHS Trust Eggplant has been working with Tavistock and Portman since Spring 2019. The Tavistock and Portman NHS Trust is a London based specialist mental health trust offering high quality mental health care and training. Like most NHS trusts, it was facing digitisation challenges moving from legacy systems to new technology fit for today’s healthcare The digitisation challenge The NHS has progressed a long way down its digitisation journey over the last five years.

Many Trusts have implemented a variety of either single or multi-vendor electronic patient records - as is the case with Tavistock and Portman as David Wyndham Lewis, director of Transformation and Technology explains: “We have found that those big multi-vendor platforms have actually created complications within the system. And while it’s helped to improve patient journeys and helped us deal with the increasing numbers of patients, it’s also created challenges in terms of burden on clinicians, nursing staff, and administrators.”

Systems tend to be configured, creating a burden in terms of iterative change and testing. They don’t perfectly match the clinical process of each trust because they vary quite considerably.

“Over the last five years we’ve moved to a model where systems are more frequently changed but there is a need for rigorous testing as part of that. We need to be able to move quickly and improve our systems while maintaining that low level of patient risk.”

The testing and RPA solution This is when Tavistock and Portman engaged Eggplant from both a testing and a Robotic Process Automation perspective.

The trust uses Advanced Care Notes - a well-developed highly configured system for mental health settings. Tavistock and Portman has an in-house development team making those iterative changes alongside its clinicians’ needs. However, it means there’s a much tighter testing schedule than previously required, where updates could be as infrequent as quarterly.

“Each change needs testing and Eggplant significantly reduced the burden on our development staff in terms of testing, and also to an extent - to increase the amount of clinician-driven testing that we’re undertaking, rather than testing systems purely from a technologist’s perspective.”

The Eggplant platform allowed the trust to work across multiple systems; a student information management system, a timetabling system, and its electronic patient records, mapping different activity types to plan the best time for activities.

Impact The big differentiator has been the reusability of the platform for different use cases. The trust can now architect the platform to interact with the central patient record and entrap student information once, those interactions are usable for both the robotic processing and the testing.

It also means the Trust has been able to build platforms reusable across multiple use cases and it no longer has to rebuild different interactions for every different use case.

“The way that the Eggplant interfaces are built to has meant that we are no longer reliant on highly specialized development skills for all aspects of the process.

We’re able to use business analysts to build the majority of our flows through a plant with some support from our higher end development team, rather than that being required for all aspects of every build.” L FURTHER INFORMATION www.eggplantsoftware.com

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Explore large image datasets and create powerful insights Zegami combines advanced analysis tools with a unique visualisation interface and allows you to rapidly categorise, label and clean large image datasets, invaluable for many applications including training machine learning models. Leading academics and commercial companies all over the world work with Zegami to gain a competitive edge from their data.

The Plant Accelerator project solves food supply issues in large automated greenhouses in Europe, US and Australia, by giving researchers the ability to view thousands of images all at once on a screen, enabling them to spot patterns or anomalies in physiological and chemical traits.

Cancer Research UK funded project, developing a cancer detection system which identifies

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cancerous lesions in real-time by highlighting them on the video as the patient is being examined.

Siemens is using Zegami for process management and quality control enabling real, actionable insight and informed decision making.

Get a free Zegmami trial and discover how your business could benefit from Zegami.

FURTHER INFORMATION Tel: +441865 306635 info@zegami.com www.zegami.com

The only NHS equivalent reporting solution MEDICA Group is the UK`s largest and most experienced teleradiology provider, delivering first class teleradiology reporting services to over 50 per cent of NHS trusts and independent healthcare providers. With a growing network of over 430 Radiologists, MEDICA offers routine, NightHawk and specialist services including cardiac CT, CT colonography, nuclear medicine, DXA, prostate MR, PET-CT and audit.

The company’s market leading emergency reporting service, NightHawk, has been an area of particular investment over 2019. NightHawk now offers exceptional turnaround times, with stroke reporting having an average turnaround time of less than 15 minutes (January 2020).

The consultants who are part of the team have an average of over 10 years’ experience and provide local hospitals will access to Neurospecialists during core hours. Referrals into the

NightHawk service are governed by best practise pathways which ensure excellent clinical quality.

The service can fit into and support existing rosters, and evidences effective gatekeeping.

MEDICA believes that any outsourced radiology service must be of an equivalent standard and quality as that which a patient would receive from the client’s own service. This is the key to MEDICA’s philosophy and is evident in the quality of the organisation’s reporters and its full access to wider patient information and historical imaging.

FURTHER INFORMATION Tel: 033 33 111 222 www.medicagroup.co.uk

Developing technology for breast cancer screening

Providing diagnostic and healthcare solutions

Half a million women a year die of breast cancer and yet if detected early enough it’s one of the most survivable cancers.

Micrima believes the key is early detection.

This requires a method of imaging that is radiation free and comfortable for women so screening can be carried out frequently, from a young age, that women are willing to attend. Micrima has developed the CE marked MARIA® system which uses radio-waves and involves no breast compression. Today it’s being used as an adjunct to other imaging modalities to reduce the chances of missing a cancer.

In clinical trials it has proven effective at cancer detection particularly in dense tissue, which also occurs most frequently, but not exclusively in younger women. Further development

InHealth is the UK’s largest specialist provider of diagnostic and healthcare solutions. Annually, the company provides a test, scan, treatment or procedure for more than two million people, across services including MRI & CT managed and mobile, Gastroenterology, PET-CT, Radiographer Reporting, Cardiac (Interventional and nonInterventional), Ultrasound as well as a number of large-scale screening programmes. The majority of InHealth’s services are delivered to NHS patients and service users, from over 300 locations and the company’s own mobile fleet of more than 70 units. InHealth provides safe, effective, responsive and caring services that contributes to the healthcare economy and improve patient outcomes.

Ultimately, the InHealth aim is to make healthcare better

of MARIA® is ongoing using the clinical data we have as a result of multiple trials, and machine learning to further improve detection and give an indicator of likelihood of cancer.

This is a significant step forward for breast cancer detection.

Come and see Micrima on Stand 612 at the Medical Imaging Convention to find out more about this technology, how its being used today and the exciting developments the company will be launching later this year.

FURTHER INFORMATION info@micrima.com micrima.com

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

by delivering excellence in everything that it does, through continuously improving across its range of services. The company’s mission is to be the preferred provider of high-quality diagnostics and healthcare solutions in hospitals and in accessible community settings, while applying its flexible and dynamic approach to meet some of healthcare’s most pressing challenges. InHealth is proud to be a great place to work, employing more than 2,500 people across the UK.

FURTHER INFORMATION @InHealthGroup www.inhealthgroup.com

Medical Imaging

Experience the future of medical imaging Health Business is delighted to announce a partnership with the Medical Imaging Convention.

Taking place on the 17-18 March at the NEC Birmingham, the free-to-attend show will be visited by thousands of Medical Imaging professionals, including heads of medical imaging departments, senior radiologists, sonographers, mammographers, and radiographers from around the country The Medical Imaging Convention is dedicated Biomedical Imaging at UCL who will be to providing a comprehensive program on the covering ‘Future imaging technologies: a latest medical imaging content across MRI, look at the next-generation of devices’.

CT, X-Ray, Breast Imaging and Ultrasound.

The event provides the most up-to-date Dedicated focus areas research, data and developments that can Be the first to hear about the latest additions enable better patient outcomes, efficiency, to the 2020 lineup and incredible features and cost-effectiveness in UK medical imaging. by securing your free ticket. This convention Visitors to the convention will discover has dedicated focus areas for MRI, CT, an enormous educational stream - the Ultrasound, Breast Imaging and X-Ray. shows’ highly informative CPD seminar Register now to be the first to hear content schedule will offer visitors the chance to updates so you can plan your day around receive expert guidance and insight, the packed two-day schedule. With hear about groundbreaking a devoted program for each solutions, techniques and area, the enormous schedule research. Experts from offers more medical The eve around the UK are imaging knowledge provide nt attending this dedicated than one person could s t h e most u convention to host ever handle, so we p-to-da te researc inspiring and insightful recommend signing up CPD accredited with your larger team. and de h, data velopm seminars. The show There are still many ents that ca welcomes some of more announcements n the industry’s biggest to come in the weeks better p enable atient influencers from leading leading up to the show, outcom organisations, including with the ever popular es The University of Edinburgh, Rutherford Cancer Centre The Institute of Cancer masterclass registrations Research and The Christie opening this week. Some of last Hospital NHS Foundation Trust. year’s topics for this include ‘Addressing Additionally, The Mid and South Essex current challenges in radiation oncology Hospital Groups’ Dr Qaiser Malik will solutions’ - by Nigel Deshpande, Clinical be discussing ‘Radiology Improvement Scientist and Radiation Oncology Lead’ at and Transformation’ and Professor Mark Philips Healthcare, and ‘Using research to Lythgoe from the Centre for Advanced drive oncology advancement’, led by Dr Ian

Barwick, Chief Scientific Officer at Rutherford Innovations. The masterclasses are interactive, allowing attendees to work closely with the hosts, but space is limited so sign up now and receive priority access to registrations!

New for 2020, the show also features a dedicated theatre run by the National Breast Screening Programme. This will feature a full two-day program of industry-leading, CPD accredited speakers in breast imaging.

Some of the seminars include Geeta Shetty of the NBSP on ‘Chest Wall Perforator Flaps for Partial Breast Reconstruction’ and Sheila Roath of the City, Sandwell & Walsall Breast Screening Service on ‘Developments in Breast Screening Administration’.

The event boasts over 150 marketleading businesses exhibiting at the event including Philips, Bayer PLC, Bracco UK and Spire Healthcare who will all be displaying their latest products and services that are revolutionising the sector. These leading exhibitors are at the event to showcase the latest technology, launch new products, announce new policies and to network with the thousands of senior medical imaging professionals in attendance.

These three shows form part of Mediweek, the UK’s largest healthcare event. Made up of nine groundbreaking free-to-attend events, this event brings together senior healthcare professionals from across the patient pathway.

As part of Mediweek, The Medical Imaging Convention ticket will also grant you E

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Medical Imaging

 unabridged access to the Oncology Convention. This convention is dedicated to advancing clinical oncology and lifesaving research. If your work correlates with oncology, then it is the perfect place to be, with leading seminars from the University of Birmingham, The Royal Marsden, and Prostate Cancer UK. The Oncology Convention has focus areas for lung, breast, colorectal and prostate cancers.

As well as this, 2020 will see the launch of The AI and Machine Learning Convention.

This event is dedicated to showcasing the future of healthcare through Artificial Intelligence Technology. Boasting speakers such as Professor Claudia Pagliari The University of Edinburgh, and Dr Sue Astley of the University of Manchester. If you want to be prepared for the coming decade in healthcare, this event is unmissable.

Norfolk and Norwich University Hospital NHS FT Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH), one of the largest acute trusts in England, has selected Swiss Post Solutions (SPS) to deliver a digital transformation solution across the organisation.

Taking its first step to becoming a digital hospital by digitising their paper health records and making them available electronically, NNUH becomes one of the latest UK trusts to embark on this exciting journey to become paper-lite by 2023.

SPS chose IMMJ Systems to provide the Electronic Document Management (EDM) component of the overall solution, and their implementation expertise to deliver MediViewer, their next generation digital platform enabling clinical EDMS to provide digitised clinical content and full electronic patient records at the point of care.

NNUH is a 1,200 bed teaching hospital, employing 10,000 staff and covering a wide geographic region. It is the largest acute hospital in the Norfolk and Waveney region

New for 2020, the show also features a dedicated theatre run by the National Breast Screening Programme. This will feature a full two-day program of industry-leading, CPD accredited speakers in breast imaging and one of the largest acute trusts in the country. This is one of many significant investments being made in technological change and SPS with IMMJ Systems are proud to support them on their journey.

The deployment of IMMJ Systems MediViewer will transform the way the trust provides patient information to clinicians – making patient records instantly available

to them whenever they are needed, and wherever they are based geographically, providing them with a fully consistent and up-to-date version of patient information which will in turn improve patient care.

MediViewer’s functionality will enable clinical and administrative staff to access key patient information with ease. IMMJ’s SmartIndex™ technology facilitates a number of uniquely powerful search capabilities within MediViewer, including real time dynamic indexing, high speed document searching, and industryleading text filtering functions within the HTML based client app, available on both mobile and desktop platforms.

The trust believes that this solution will also help enable greater collaboration across different sites and improved access to clinical data with an off-line working function being delivered as part of the solution, enabling those remote workers to access critical patient records wherever they may be. This will help to streamline internal processes, as well as ultimately deliver significant cost savings of £2.5 million per annum. L

The best thing is that tickets to attend the Medical Imaging Convention are free! You can register for yours by following the link below.

FURTHER INFORMATION www.imagingconvention.com/index.asp

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Delivering on the promise of digital Britain The UK has taken an early leadership position on 5G, with all four of the countries MNO’s launching their initial services in 2019 The country is also seeing rapid fibre deployment, as it attempts to boost its Fibre To The Home (FTTH) penetration levels.

2020 will be a pivotal year for British telcos and service providers as the country strives to provide ubiquitous, gigabit connectivity to more than 60 million people.

Connected Britain is the B2B event which helps organisations to keep up to date with the latest developments in the connectivity market and is ultimately the best place to understand the regulatory and financial landscape for digital infrastructure investment in the UK. The 2020 series continues to focus on the wider implications of the Digital Strategy and explores how the UK can tackle emerging challenges head on to become a leading player in the digital revolution.

Launched in 2015, Connected Britain has gone from strength to strength, starting as a 200 attendee event, doubling in size each year and now expecting 2,500 attendees in June 2020. Its most recent success saw the event crowned the winner of the PPA’s Independent Publisher Awards’ Event of the Year 2019.

So how did it get here?

Ultimately, it’s down to a great concept carefully executed.

In 2015, Connected Britain was all about building high-capacity telecom networks, but now it is the preeminent digital economy event for the UK. Since then the content has evolved to include tracks on building a connected society, promoting digital literacy, delivering the cities of the future, digitising the UK’s workforce, building digitally connected national infrastructure and more. There will be nine streams in total for 2020 with over 350 speakers and 2,500 participants.

Connected Britain receives only the most senior and influential speakers in the industry, including in 2019 the CEO’s of Three, TalkTalk and Openreach amongst a line-up of 160 speakers – 31 of whom were CxO’s of major UK telcos. However, the real uniqueness of Connected Britain is its many relationships that have been built with the public sector including both national government and local authorities. To quote the Chief Strategy Officer of Community Fibre, Connected Britain is ‘one of those rare conferences where all the players are in one place and engaged in real debate’.

Connected Britain also offers a unique platform for industry startups to engage with potential partners and investors thanks to the dedicated Startup Zone and Stage. Additionally, 2018 saw the launch of the Connected Britain Awards, recognising the best and most

innovative players from across the industry.

Rob Chambers, Total Telecom managing director, said: “Connected Britain just gets stronger and stronger and has become the definitive platform for all the critical discussion points in moving the UK network forward. Every year we have more conference streams, and a total sell-out of tickets and exhibition space. Anyone who has an interest and involvement in our network and its future needs to be here in June 2020!”

With connectivity now central to everyday life and work, we see no sign of Connected Britain’s growth slowing.

Now in its 6th year, Connected Britain will return to the Business Design Centre from 18-19 June.

About Total Telecom Since 1997, Total Telecom has provided the connection between the buyers and sellers in the global telecom market. We do this through high quality editorial content and events to facilitate discussion on industry issues, and recognise innovation and excellence by companies and individuals.

Our community of over 120,000 telecom professionals relies on Total Telecom for daily news and regular in-depth insight, delivered through a number of channels including online, video, social media, and at our series of events. L FURTHER INFORMATION www.totaltele.com/connectedbritain

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Advertisement Feature

Medstrom launches new Interactive Academy Learning Space Clinical innovation, evidenced-based practice and education are at the heart of Medstrom’s philosophy. These three elements are front and centre in its newly unveiled facility - The Medstrom Academy This purpose-built space showcases Medstrom’s range of solutions, that focus on meeting patient and caregiver needs in challenging clinical situations. Working closely with hospitals throughout the UK and Ireland, the healthcare company provides innovative products and specialists services that have been proven to help improve patient outcomes. This has supported the collaboration and education around the challenges posed by pressure area care, immobility, falls prevention, safe mobilisation and plus-sized patients.

Deborah Newcombe, Clinical Director for Medstrom, was heavily involved in the launch of The Medstrom Academy and noted: “Over the last year we have been working hard to create an educational centre that marries clinical challenges with evidence and solutions, to create an unforgettable and immersive experience. It is really exciting to be able to share such a unique space with our colleagues throughout the healthcare sector!”

Clinically led content Medstrom Academy is divided between four different clinical challenges, with each area exploring the financial and physical impacts

felt by the NHS and its patients. These areas include pressure ulcers, immobility, falls and safe mobilisation, and plus-sized patients.

Each area is supported with industry evidence and statistics referenced using credible sources, such as clinical journals and articles.

Deborah Newcombe explains: “Using referenced materials ensures we align as closely as possible to the clinical objectives of our visitors. We encourage people to use the Medstrom Academy as an educational tool.

Coupled with the launch of our CPD accredited courses that we can deliver in the Academy, we hope our new centre will become a helpful part of visitors’ professional development.”

Importantly, in each area there are various interactive elements on display throughout the learning space, including empathy suits. Deborah adds: “We wanted to really immerse people into the individual clinical challenges that confront the NHS every day. Being a very practical learner myself, having the ability to experience a situation or condition from a patient’s perspective, makes learning far more impactful.

“There are two suits available to achieve this, one for visitors to experience frailty

via an age-simulation suit, and the other to experience body morphology via a plus‑sized patient suit. For example, with the help of the age simulation suit, visitors can experience first-hand decreased mobility and diminished physical senses, such as hearing and sight.

“Altogether, it puts into perspective the challenges that older patients face, and the increased risks associated with simple tasks such as mobilising from a bed safely. By putting visitors in the patient’s perspective, we can then educate how to use products correctly, and demonstrate why selecting the right specification of equipment, such as a bedframe, is so important for both the patient and the caregiver.”

Meet your interactive companion When you visit The Medstrom Academy, you’re in control. Thanks to its open layout, you can easily journey through the various focus areas, pausing at what you find the most relevant. This is where your interactive companion introduces herself – Alexa.

Medstrom is among the first healthcare companies to utilise the technology in this way, as Amazon Alexa has been programmed to answer questions that are distributed throughout the various clinical areas. For example, ‘Alexa, where did the name Dolphin Therapy come from?’. This allows visitors to learn independently whilst exploring The Academy at their leisure.

Free to use meeting space Medstrom is also offering the upstairs meeting space within the Medstrom Academy as a free venue for recognised groups such as NBE, TVS, critical care networks, and of course NHS Trusts.

Located close to East Midlands Airport and with local railway links, the centre offers an ideal location for regional study days, or hosting events in its spacious seating area.

Interested in seeing the Medstrom Academy for yourself or perhaps using it for your next event? Simply contact 0845 371 1717 to speak to your local Medstrom representative. L FURTHER INFORMATION www.medstrom.com

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Cloud

Navigating the cloud market within the NHS With a brand new framework now in place to help public sector organisations purchase cloud solutions, Phil Davies, Procurement Director at NHS Shared Business Services (NHS SBS), explains how it simplifies the procurement process and provides very best value for money The ever-increasing popularity of cloud And this chimes exactly with the feedback computing across the public sector in recent we receive at NHS SBS. Buyers from across years has provided a great opportunity, the NHS and wider public sector have one that has helped improve the lives described the process of navigating the cloud of those working to deliver our public market as unmanageable and daunting. services, whilst benefiting the general public who access them day-to-day.

Cloud Solutions Framework Perhaps unsurprisingly, the rapid We therefore set about developing a growth of the sector – and new Cloud Solutions Framework, the growing demand from which involved a rigorous The rap NHS organisations and tender process to ensure id growth other public bodies for legally-compliant access to cloud technologies the very best cloud services compu of cloud t – has led to a at the most competitive i n g a t cross he pub somewhat crowded price. Like all our l led to a ic sector has and complex market. frameworks, access is free somew A space where it of charge to public sector hat crowde is all too easy to bodies and the agreement d a n d c omplex be overwhelmed by is awarded under NHS market the huge breadth of terms and conditions, products and services offering maximum leverage on offer from a seemingly for the entire public sector. endless pool of suppliers.

Crucially, we deliberately

limited the number of suppliers on the framework to the 10 or 20 most outstanding across four separate lots. The result is a specialist pool of 24 leading suppliers, which provide the greatest expertise and best value-for-money to the NHS or any other public sector organisation.

The framework is also structured in a way that includes a full range of cloud support services, which means that regardless of where a public body is on its journey into the cloud – or how straightforward or complex its requirements – purchasing the right support is simple, quick, costeffective and OJEU (Official Journal of the European Union) compliant.

Four different lots Four different lots cover a wide range of cloud services and include both bespoke and off-the-shelf solutions. The provision of tailored support – unique to this framework – is particularly appealing, enabling a level E Issue 20.1 | HEALTH BUSINESS MAGAZINE

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www.healthbusinessuk.net Published by

020 8532 0055 www.psi-media.co.uk

Like all our frameworks, access is free of charge to public sector bodies and the agreement is awarded under NHS terms and conditions, offering maximum leverage for the entire public sector And, to reflect the fast-evolving nature of the sector, the agreement also encourages suppliers to bring forward innovative new products and solutions throughout the life of the framework, which would further benefit the NHS and wider public sector.

The best quality cloud service To help launch the framework and enable knowledge sharing across the public sector, we recently held an event alongside Public Sector Connect. Over 80 delegates from across the NHS and public sector heard from organisations like NHS Digital about how it has navigated its journey to the cloud.

Those attending Cloud Solutions 2020 represented central government departments and some of the country’s largest NHS trusts, local authorities, educational establishments and police forces – highlighting the appetite that exists for the government’s long-standing Cloud First policy.

The aim of the new Cloud Solutions Framework is to provide them with a quick and easy way to procure the best quality cloud services at the best possible price – helping them to invest in new and exciting technologies, which transform the way they work and enhance the services they deliver to future generations. L FURTHER INFORMATION www.sbs.nhs.uk/fas-cloud-solutions

Cloud

 of flexibility that is often critical to success in the public sector.

Lot 1, ‘Solution Design and Consultancy’, focuses on the initial support that is needed ahead of cloud implementation.

This would include things like an analysis of an organisation’s ‘as is’ position, cloud readiness assessments, architecture design and migration planning. It is particularly useful for any organisation considering migration from outdated legacy infrastructure to public or private cloud.

Lot 2, ‘Infrastructure as a service (IaaS), Platform as a service (PaaS) and Software as a service (SaaS)’ – in other words, services to design, build, secure and operate cloud hosting environments. This includes public cloud and/or private (and hybrid) cloud hosting, processing, storage, networks and applications running on cloud infrastructure.

It covers access to implementation support and end-to-end security management. And it includes a wide range of advanced services, such as AI (Artificial Intelligence), Machine Learning, Chatbots, Blockchain and Big Data.

Lot 3, ‘Cloud Support Services’, includes real time support, access to professional expertise, and a range of ongoing or ad-hoc specialist support services. This includes everything from on-site management, to light touch remote support, which enables the retention of in-house management.

Finally, Lot 4, ‘End-to-end Cloud Solutions’, helps match a public sector organisation with a trusted partner – a service provider that can offer complete start-to-finish support for its cloud journey.

The framework itself runs until September 2021 (with an option to extend for a further two years) and enables public sector users to make direct awards or run mini competitions – which provides further scope to drive down price – to best suit their individual needs.

SBS adds cyber function to Edge4Health platform The Edge4Health procurement platform now comes with an integrated cyber security feature, helping to improve the security of the NHS’s supply chain.

The newly-launched Edge4Health is being rolled out to more than 60 NHS organisations and will be used by around 30,000 NHS employees.

The platform now also enables suppliers to the NHS to check and improve their cyber security, thanks to a dial indicating whether their rating is good, average or bad.

By clicking on the dial, suppliers can download a report that provides a detailed explanation of the specific threats and vulnerabilities affecting their individual organisation, with reports showing exactly how suppliers can reduce their vulnerabilities, enabling them to improve their own security and that of the NHS. A recent report published by Orpheus reviewed the current cyber security of a large number of NHS suppliers and found that: 88 per cent have had company emails and passwords leaked due to attacks on third-party databases; 37 per cent of companies have vulnerabilities that look attractive to cyber criminals; 17 per cent of companies appear to run databases that criminals could target; and 95 per cent of companies lack advanced email protection.

Phil Davies, director of Procurement at NHS SBS said: “With £9 billion of annual spend, the NHS has some of the longest and most complex supply chains in the world. Ensuring the security and integrity of these supply chains is a priority for NHS organisations, the government, and suppliers.

Enabling suppliers to swiftly check on their current cyber security status is an important step forward in mitigating the threat posed.” tinyurl.com/rpau3d2

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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FACILITIES MANAGEMENT

The best water solutions for your site

Using offsite construction to update heating

ADEY® manufactures and supplies a range of market leading solutions for heating and chilled water system protection and water treatment across a variety of healthcare environments.

Working with specifiers, contractors and facility managers, ADEY has the expertise and experience to enable healthcare providers to optimise their water management system and get the best performance out of their plant rooms. Whatever the demands, size or complexity, ADEY can advise on the best solutions for your site.

An award-winning manufacturer of MagnaClean® magnetic filtration technology, ADEY has expanded its product portfolio to include a range of commercial filters, premium chemicals, plant room accessories and heating system solutions.

Magnetite is a significant issue in large heating systems - if left

Proper co-ordination of equipment, controls and timely project delivery are the most difficult, and therefore costly, aspects of creating a modern environmental application for healthcare estates. Pre-built packaged plant rooms not only maximise space, especially if sited on a flat rooftop, but provide a proven method to secure new, highly efficient and cost-effective to operate domestic hot water (DHW), heating and low carbon systems.

Healthcare sites can opt for a choice of gas, electric or renewables, such air source heat pumps (ASHP), or these can be combined into a single packaged hybrid system providing a timely answer to meeting new sustainability targets across healthcare estates.

To achieve the best results, the decision-making relating to heating and DHW systems

unprotected, it can build up and cause costly damage. ADEY’s commercial filters are designed to tackle this debris and have been manufactured to suit different needs from heavy to light commercial systems, compact plant rooms, and can be fitted inline or sidestream. Plant room accessories and specialist chemicals ensure that every aspect of plant room performance can be optimised.

ADEY prides itself on continued innovation and designing products which will help contractors and installers do the very best job possible.

FURTHER INFORMATION Tel: 01242 546700 www.adey.com

RECRUITMENT

76

ENERGY

needs to be finalised early on to allow for the increased lead-in times. Adveco’s design engineers guide project teams through this process to ensure a highly resilient system is fully defined for before construction begins, ensuring rapid return on investment and lower ongoing operating costs.

Built within a single weatherproof GRP enclosure, the plant room arrives with all appliances, controls and ancillaries pre-fitted and connected, ready to be sited immediately upon delivery and installed within a matter of days.

FURTHER INFORMATION www.adveco.co

IT

Helping you find the career you deserve

Are you getting the most from your WiFi coverage?

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 the

Founded in 1988, Multithread is a wireless and networking business based in Needham Market, Suffolk. The company specialises in wireless and networking optimisation, WiFi site surveys, network support and RF interference investigation, so that you can get the best out of your WiFi installation.

Multithread helps your business by providing expert advice before you invest in a WiFi installation and if required, by optimising your existing network. Its services range from pre-planning an optimised network through to advising on the correct equipment and locations.

The Multithread team of engineers are multi-vendor certified with in-depth experience of working in 2.4GHz & 5GHz wireless bands.

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; mental health nursing; and primary care.

FURTHER INFORMATION Tel: 0203 473 2430 contact@imc-locums.co.uk www.imc-locums.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Multithread recommends that you invest in pre or post installation WiFi site surveys to ensure you are getting the most from your wireless network.

Pre-installation surveys highlight hidden issues that impact your networks performance.

Post installation surveys are recommended when your business experiences WiFi dead-spots or an underperforming network.

Whether you need better WiFi coverage in your small office or large hospital complex, give the Multithread team a call today.

FURTHER INFORMATION Tel: 01449 724247 team@multithread.co.uk www.multithread.co.uk

ICT

IT

CDW: helping you achieve your IT ambitions

Software and digital transformation services

CDW is a company with an international presence in both private and public sector IT, and through our global supply chain provide products and services in over 150 countries.

Integrating new technologies into your organisation demands a careful balancing act; cost, security and competitive advantage all need to be considered as part of a forward-thinking IT strategy. CDW are recipients of the industry’s highest achievable accreditations, and helps its clients achieve their goals by delivering integrated solutions and services that maximise their technology investment.

CDW’s dedicated healthcare team is a trusted technology partner

Brandon Cross Technologies develops custom software solutions, tailored to your organisation’s specific requirements and objectives, while leveraging maximum value from your existing systems and data.

Services, for GP Practices and NHS providers, are: bespoke and yet competitively priced; scalable, reliable and secure; easy to maintain; GDPR compliant; and capable of evolving with your business.

The Brandon Cross Technologies approach is one of evolution rather than revolution. Major change can bring significant disruption, stress and delay. But a progressive, phased approach significantly reduces risk and disruption.

Brandon Cross solutions can work alongside legacy systems, providing new capabilities

to over 200 healthcare providers across the UK. CDW is committed to delivering technically innovative, support-focused solutions and services to NHS organisations, enabling progress which not only benefits patients but also eases pressure on people and resources.

Building IT solutions that generate results is what the company does. And CDW does it better than anyone else because CDW are the People Who Get IT.

FURTHER INFORMATION uk.cdw.com

IT

and efficiencies, allowing your digital transformation to be more easily managed.

The Brandon Cross team is based in the UK ensuring ease of communication and follow through. Its focus is on delivering the capabilities you need simply, yet to the very highest standard. The company starts by analysing your existing systems, processes, security and new requirements to fully understand your priorities before advising on the most reliable and cost-effective way forward.

FURTHER INFORMATION Tel: 0208 144 2000 www.brandoncross.co.uk

TECHNOLOGY

Helping to make your business better

Reflecting expertise in data intelligence

Fusion Business Support Limited provides IT services and solutions to small, medium and large businesses. The company specialises in creating and maintaining IT environments that make your business a more productive, fun place to work.

Rather than re-invent the wheel, the organisation’s tried and tested solutions incorporate modern cloud, and on-premise solutions from providers such as Microsoft, Lenovo, HP, Dell, Cisco, Ubiquiti and other industry leaders.

Fusion understands that the best results come from playing to its strengths, and it excels at turning reactive, problem-prone IT environments into predictable, reliable assets that increase productivity. Fusion prides itself on being able to tailor our services to the specific requirements of each individual customer.

The organisation is committed to giving you the right guidance

Healthcare technology leader, Omnicell UK, has launched its new brand to mark 25 years of driving innovation in medication and supply automated technology and medication adherence solutions.

The rebrand will reinforce Omnicell’s excellence and credentials in the fields of advanced automation, data intelligence and expert services.

Over the coming months, Omnicell UK&I customers and the wider market will begin to see the pioneering new brand communicated across all documentation, products, software and digital platforms.

Omnicell’s core ethos to improve patient care across all healthcare settings remains very much intact. Customers will continue

in order to make business processes more streamlined while ensuring a secure, robust and easy IT experience, while retaining a personable, flexible and transparent approach. It aims to be completely honest and transparent with its customers, right from day one.

By doing so, Fusion hopes you can put your faith, and trust in them to manage what is arguably the most critical component of your business.

FURTHER INFORMATION info@fbslimited.co.uk Tel: 01452447011 www.fbslimited.co.uk

to receive the most cutting-edge products brought to market with the same levels of service and support. The rebrand makes a bold statement and underlines the company’s objectives and plans for future growth.

Omnicell’s products and services fall into three distinct areas: adherence automation, pharmacy automation and supplies automation. These all underpin a core aim of reducing medication dispensing errors, improving patient safety, driving supplies efficiency, enabling medical professionals to spend more time on face-to-face patient care.

FURTHER INFORMATION www.omnicell.com

Issue 20.1 | HEALTH BUSINESS MAGAZINE

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Offsite manufacturing to ensure projects are delivered safely and to time and budget Engineering and construction contractor Fordingbridge continue to deliver in healthcare. Fordingbridge plc, the West Sussex based firm, are now onsite with McLaughlin & Harvey at John Radcliffe Hospital in Oxford.

The firm were approached by the main contractor to undertake the design and build of the ambulance bay canopy for the newly extended Emergency Department at the Oxford University Hospital Trusts’ premises.

Part of a wider expansion project, six ambulance spaces will be created and a more efficient drop off point set up at the entrance of the new building.

Fordingbridge, the architectural canopy specialist, have been assigned the design, manufacture and build of the new structure to protect patients and paramedics from inclement weather, hence enhancing patient experience and working conditions for staff.

The award follows on from multiple successfully delivered healthcare projects by the firm, including William Harvey Hospital, Hull Royal Infirmary, East Surrey Hospital and St Marys Community Health Campus.

Jon Heywood, healthcare specialist for the firm, said: “We are delighted to be

working with our client, and the trust themselves on this project. Our approach to working in a live hospital environment is driven entirely by safety. This is through both a methodical staged build, to ensure a department receives no restricted access during installation and also, through the overall quality of the finished product.

“Our structures are structurally calculated, before being manufactured inhouse, to ensure we can apply our industry leading guarantees which each installation, therefore delivering optimum value to the trust.”

The 330sq ft canopy has been designed to allow for full pedestrian access, and has a delivery programme of seven days, allowing the finalisation works to be completed prior to the client handover by the main contractor.

Heywood continues: “The benefits of operating solely inhouse, and prefabricating our structures offsite, are especially apparent with our work in hospital environments. We appreciate that with healthcare, disruption to the site is not simply an interrupted lesson or loss of trade, as with our education and retail projects; it can be an overarching risk to public safety.

Manufacturing and prefabricating offsite in our custom facility, means we deliver safely and to time and budget. A great deal of ‘canopy companies’ outsource the manufacture of their products, so cannot deliver the same quality or consistency.

With over 50 years experience in external structures, we are in the fortunate position to back up our claims with solid examples.”

FURTHER INFORMATION www.fordingbridge.co.uk

ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service ADEY Innovation

Gojo Industries

48

Advance 6

Illumino Ignis

10

Adveco (AWP)

IMC Locums

76

Inhealth Group

66

ARI- Armaturen UK

76 76 8

BeaconMedaes IFC

ISS 14

Big Dug

54

Legrand Electric

Blackthorn GRC

62

Medica Group

Brandon Cross Technologies

77

Medstrom Healthcare

22 66,68 72

CDW 77

Micrima 66

Group Nexus

29

Multithread 76

Daikin Applied

40

Murray Equipment Co

DDC Dolphin

16

Office Depot

Debt Recovery Plus

26

Opex Corporation

IBC OBC 4

Dynabook 44,45

Parallels 46

EDM Healthcare Consulting

Parking Ticketing

32

Eggplant 60,64,65

Radar Software

60

EIT Health UK-Ireland

50,51

Safety Technology

20

60

Science Animated

Eland Cables

58,59

68

Ephesoft 52

The Oyster Partnership

Fairford Medical

70

Total Telecoms

71

FFUUSS UK & EIRE

42

Trinity PR

77

Fire Doors Complete

18

Trojan Bins

54

Fordingbridge Plc

78

White Horse Scientific

12

Fujitsu 34,35

WPS United Kingdom

28

Fusion Business Support

Zegami 66

77

38,39

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