Health Business 20.2

ISSUE 20.2 www.healthbusinessuk.net

INFECTION CONTROL

HEALTHCARE IT

MENTAL HEALTH

MODULAR BUILDINGS

HELPING THE NHS INCREASE CAPACITY The approach to coping with coronavirus has seen modern methods of construction used to help increase capacity

PLUS: ERGONOMICS | SUSTAINABLE COMMUNITIES | TECHNOLOGY

Comment

ISSUE 20.2 www.healthbusinessuk.net

INFECTION CONTROL

HEALTHCARE IT

MENTAL HEALTH

MODULAR BUILDINGS

HELPING THE NHS INCREASE CAPACITY The approach to coping with coronavirus has seen modern methods of construction used to help increase capacity

Transparency and honesty needed to eradicate NHS backlog The BMA has said that the government must urgently outline a credible plan for addressing the huge backlog of patients awaiting NHS treatment in the wake of the coronavirus pandemic.

PLUS: ERGONOMICS | SUSTAINABLE COMMUNITIES | TECHNOLOGY

As we go to press, the doctors’ union has urged the government to be honest about the scale of the task ahead, and to bring together health leaders and staff groups to ensure frontline clinicians are leading discussions on how to prioritise the sickest patients left without treatment due to the redeployment of staff and resources to deal with the coronavirus crisis.

A survey of more than 8,000 doctors found that 52 per cent said they were either not very confident or not confident at all in their own department being able to manage patient demand as NHS services are resumed. These numbers are not promising. Of equal concern, more than a quarter of doctors said there had been no engagement with them over how to manage the increase in demand in their place of work.

Follow and interact with us on Twitter: @HealthBusiness_

The BMA believes that the priorities for the government in addressing the NHS backlog must concentrate on four areas: transparency; capacity; workforce; and learning. A lack of transparency has made this situation worse than it ever should have been, so let’s hope that the government can be honest about needing to correct that first. Over the next few months, the rest will follow.

Michael Lyons, editor

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Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Contents

Contents Health Business 20.2 07 News

45 Telecommunications

NHS debt ‘write-off’ could cost hospitals millions; Prostate cancer most commonly diagnosed cancer in the UK; Huge backlog in operations resulting from lack of PPE

15 Infection control 25 29

Veronica Johnson-Roffey and Kate Prevc outline the benefits of healthcare facilities management companies employing their own infection control nurse to ensure their staff working in hospitals are trained in infection control

19 Infection control With much in the news covering the social impact of the coronavirus outbreak, Dr. Stephanie Taylor discusses the need to ensure public buildings, such as schools and hospitals, have a humidity level so that viruses cannot spread

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25 Mental health When this is all over, will it be said that ‘it took a pandemic to put mental health where it should be – at the front and centre of daily considerations about working lives?’ Adrian Wakeling, Senior Policy Advisor at Acas, discusses

29 Healthcare IT A key focus of the Long Term Plan is empowering people to take control of their own health care - creating a safe and secure means of accessing their health information is critical to that, says Melissa Ruscoe, head of the NHS login programme at NHS Digital

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32 Technology

Sponsored by

Colin Abrey explains why uninterrupted 4G coverage in public sector buildings and other pop up facilities cannot wait

37 HETT

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HETT is the leading platform to connect digital, operational and clinical leadership and buyers from across the UK health sector with suppliers of new technology, services and innovations. Here, we look at the four agenda tracks for September’s event

Health Business magazine

We take a look at the Crown Commercial Service’s Network Services 2 framework agreement, as well as the latest news regarding the telecommunications industry and the coronavirus crisis

49 Recruitment

Jack Yates, content writer for the Immigration Advice Service; an organisation of UK and Ireland based immigration lawyers, discusses the shortfalls of the NHS Visa and the new Immigration Bill

53 Non-clinical work

Supporting NHS organisations on the frontline of the battle against COVID-19 has become more important than ever, says NHS SBS

57 Modular buildings

The approach to coping with the coronavirus crisis has been vastly different across the globe. Here, Jackie Maginnis describes how her members are supporting NHS trusts and healthcare providers to increase capacity

61 Ergonomics

Sponsored by

The discipline of human factors and ergonomics is key to improving patient safety and ensuring NHS staff aren’t put at risk when caring for patients.

In this article, Health Business revisits some advise from the Chartered Institute of Ergonomics and Human Factors

67 Parking

In March, Health Secretary Matt Hancock announced that the Department for Health and Social Care would be giving immediate financial backing for all NHS trusts to provide free car parking to NHS staff for the duration of coronavirus

69 Sustainable communities With the NHS about to embark on the largest hospitals building programme for decades, Katja Lacey, of PA Consulting, explains why there exists a unique opportunity for the NHS to help create sustainable communities which promote health and well-being

www.healthbusinessuk.net Issue 20.2 | HEALTH BUSINESS MAGAZINE

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News

NHS DEBT

NHS debt ‘write-off’ could cost hospitals millions Matt Hancock’s pledge in April to ‘write off’ £13.4 billion of debt owed by NHS trusts ahead of the worst of the coronavirus crisis could end up costing hospitals millions in annual payments back to the government.

The Independent has revealed that the way the government converted the billions of pounds owed by effectively insolvent NHS trusts will mean hospitals having to pay an annual charge on their assets back to the government in perpetuity.

Experts also warn that the government failed to fix the underlying shortfall in hospital funding, with many trusts unable to meet the costs of providing services with the income they receive from NHS England. Without reform, this means that some trusts could build up debts again within a few years.

Anita Charlesworth, director of research and economics at the Health Foundation, told The Independent: “What the government has done is convert the debt into an equity share. Writing off this debt is not cost free. This is a better deal for NHS providers, but there will be a charge.

“There is no guarantee of that. It remains the case that even with this, this reset is only really valuable if there’s enough revenue in the system to ensure that on an ongoing

basis trusts have enough income to meet their day-to-day running costs and pay their PDC [public dividend capital]. If there isn’t sufficient funding in the system, for the overwhelming majority of trusts, then we will be back in this position in a few years’ time.”

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APP

BAME

Contact tracing app could exacerbate inequalities

Risk of dying from coronavirus higher for ethnic minorities

The Health Foundation has warned that the government’s delayed contact tracing app has the potential to exacerbate existing health inequalities, leaving some people at greater risk of coronavirus than others.

New polling, carried out by Ipsos MORI, analysed the UK public’s awareness of and attitudes towards the planned smartphone app, which, alongside the telephone-based NHS Test and Trace service, is seeking to reduce the spread of the virus.

However, while 62 per cent of people asked said that they are likely to download the app once it is released, the polling revealed a significant ‘digital divide’ along the lines of occupation, educational level and age.

The Health Foundation says that 73 per cent

of people in managerial, administrative or professional jobs say they are likely to download the app, but among the routine and manual workers, state pensioners and the unemployed, this figure falls to just 50 per cent.

Furthermore, while 71 per cent of those with a degree say they are likely to download the app, this falls to 63 per cent for those with A-levels or equivalent only, 59 per cent for those with GCSEs or equivalent, and 38 per cent among those with no formal qualifications.

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BAME

NHS England launches expert research centre NHS England and NHS Confederation have confirmed the creation of a new centre to investigate the impact of race and ethnicity on people’s health.

The NHS Race and Health Observatory, which will be hosted by the NHS Confederation, will identify and tackle the specific health challenges facing people from BAME backgrounds.

The announcement follows significant concerns about the particular impact of the coronavirus virus on people from black, Asian and ethnic minority (BAME) backgrounds.

The Observatory will involve experts from this country and internationally, and will offer analysis and policy recommendations to improve health outcomes for NHS patients, communities and staff.

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Public Health England has said that people from ethnic minorities are at a higher risk of dying from coronavirus.

A new report from the organisation shows that age remains the biggest risk factor, while being male is another.

However, removing age and sex, the report finds that people of Bangladeshi ethnicity have twice the risk of death than people of white British ethnicity.

The impact of coronavirus is also ‘disproportionate’ for other Asian, Caribbean and black ethnicities, although, at this stage, it remains unclear why.

Health Secretary Matt Hancock conceded that the pandemic has ‘exposed huge disparities in the health of our nation’, with ethnic background being a ‘major risk factor’ for coronavirus.

Marsha de Cordova, the Labour MP for Battersea in London, said the report was ‘notably silent’ on how risks amplified by ‘racial and health inequalities’ could be reduced, adding that the government must act immediately to mitigate the risks ‘so that no more lives are lost’.

The report discovered that people aged 80 or older are 70 times more likely to die than those under 40, whilst workingage men diagnosed with the virus are twice as likely to die as women. Public Health England also says that certain occupations, chiefly security guards, taxi or bus drivers and construction workers and social care staff, are at higher risk.

READ MORE tinyurl.com/y9qaltan

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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FIRE SAFETY

THE ONUS IS ON YOU!

Vital all round defence

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News

CANCER

Prostate cancer most commonly diagnosed cancer in the UK Data analysed by the Prostate Cancer UK charity has shown that the disease is now the most commonly diagnosed cancer in the UK. Prostate cancer has now overtaken breast cancer to be the most commonly diagnosed form of the disease, with 57,192 new cases in 2018 – the most recent figures available. This comes just ahead of 57,153 breast cancer cases, 48,054 cases of lung cancer and 42,879 cases of bowel cancer.

Prostate Cancer UK claims that the announcement is a decade earlier than they imagined it would arrive, but said that this may be because increased awareness that has led to more men getting diagnosed.

This would certainly seem to be the case with data indicating that more prostate cancers are being caught at the locally advanced stage (stage III), when the disease is more treatable than if it has spread. More men are also being diagnosed at early stage I, when the cancer

may never cause harm during their lifetime, and therefore close monitoring rather than aggressive treatment is recommended.

Analysis of the figures suggests new cases of prostate cancer have more than doubled over the last 20 years, while about 400,000 men in the UK are living with the disease or have survived it.

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CANCER

DIGITAL

Over two million’ waiting for cancer care in UK

Millions of patients benefiting from remote consultations

New analysis from Cancer Research UK has revealed that approximately 2.4 million people in the UK are waiting for cancer screening, further tests or cancer treatment.

The coronavirus pandemic has caused enormous disruption to cancer services across the UK, including delays to cancer treatment, screening and diagnosis, and huge decreases in patients being urgently referred to hospital with suspected cancer symptoms. Delays to cancer screening have had the biggest impact on the total number, with a backlog of around 2.1 million people left waiting for breast, bowel or cervical screening.

Cancer Research UK claims that urgent cancer referrals, often known as the two week wait, have been severely impacted with up to 290,000 people missing out on further testing, which would normally catch up to 20,300 cancers in the same time period. At the same time, there will also likely be a backlog of treatment to catch up on, with up to 12,750 fewer patients receiving surgery, 6,000 fewer for

chemotherapy and 2,800 fewer receiving radiotherapy since lockdown began.

The charity has estimated that to test patients ahead of hospital appointments and cancer staff weekly, between 21,000 and 37,000 coronavirus tests must be done each day across the UK. Therefore, it is urging for a ‘clear national plan for testing’ to support the effective recovery and restoration of cancer services.

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DATA

NHS will keep data of those with coronavirus for two decades

A privacy notice posted by Public Health England has shown that the NHS will keep personal data about people with coronavirus for 20 years as part of the test-and-trace programme.

This means that information, including full name and date of birth, as well as phone numbers and home and email addresses, will be collected and stored for people with coronavirus, or symptoms of coronavirus, alongside data about those symptoms.

Furthermore, those who have been identified as contacts of people with coronavirus will have all but their date of birth collected and stored for five years.

However, individuals will be able to ‘request’ that their information be deleted, but PHE warns that ‘this is not an absolute right’.

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Millions of patients have been getting expert support from family doctors from the comfort of their own homes while the NHS responds to coronavirus.

Remote consultations are just one way in which GP practices have changed the way they work to ensure people can get expert care and advice in a safe way throughout the coronavirus pandemic.

Health leaders had already signalled the intention to move towards digital first primary care in the NHS Long Term Plan. Progress towards this has accelerated during the pandemic, with 99 per cent of GP practices now activating remote consultation platforms, and NHS bosses are now examining how this progress can be locked in.

Now, with GPs and their teams standing ready to assist, one of the country’s top GPs has urged people to continue to come forward for care when they need it, as part of the NHS’ ongoing Help Us Help You campaign.

READ MORE tinyurl.com/y85mh65y

VOLUNTEERING

Volunteer Responders reach 250,000 milestone The Duchess of Cornwall has thanked volunteers across the country for the many acts of kindness they provide, as figures show that NHS Volunteer Responders have reached the 250,000 milestone.

A quarter of a million tasks have now been carried out by the NHS Volunteer Responders recruited by Royal Voluntary Service to support the NHS and to help the most vulnerable to coronavirus. To aid people isolating during the pandemic, the volunteers have been providing grocery and prescription deliveries, lifts to medical appointments and ‘check in and chat’ calls.

READ MORE tinyurl.com/ycfmngjl

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Don’t let false fire alarms disrupt your routine False fire alarms have risen by 20% in three years at NHS Trusts across England*

Thousands of staff hours are lost every year due to false fire alarms, affecting service delivery, business continuity and patient care.

Eliminate malicious or accidental activation of manual call points with

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News

SURGERY

Huge backlog in operations resulting from lack of PPE NHS Providers chief executive, Chris Hopson, has said that a lack of vital protective equipment and long waits for coronavirus test results are stopping hospitals from tackling a huge backlog in operations.

Speaking to the Guardian, Hopson discussed the cases of patients whose surgery has been postponed because of the pandemic having to face even longer delays

because hospitals are having to wait for as long as 13 days for the outcome of tests.

He blamed ministers for repeated failures to ensure easy availability of fastturnaround testing for NHS staff, while trusts have warned about the lack of adequate supplies of surgical gowns since the pandemic began. He also warned that ’the gap between the tone and content of

YORKSHIRE

SEACOLE CENTRE

Clinical imaging services at Nightingale Hospital Yorkshire

First Seacole Centre opens doors as rehab centre

The NHS Nightingale Hospital Yorkshire and the Humber will begin offering clinical CT scans to some patients from across the region from 4 June.

NHS Nightingale Hospital Yorkshire and the Humber was set up as part of the region’s coronavirus response. On stand-by since its launch, the hospital is equipped with clinical imaging equipment, which means it can also support the region in its recovery phase.

The Leeds Teaching Hospitals NHS Trust and Harrogate and District NHS Foundation Trust will be the first trusts to use the facility and will provide appointments seven days a week. From 4 June 2020, the hospital will provide outpatient appointments for patients with radiology referrals.

The temporary hospital is fully equipped and able to provide the service for patients who are well and mobile. The service will provide a combination of diagnostic scans and surveillance scans, which are used to monitor patients with a prior diagnosis of a medical condition.

As yet, the NHS Nightingale Hospital has not been needed to care for patients with coronavirus and this will be the first time the hospital has been used to provide patient care.

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The NHS Seacole Centre at Headley Court, Surrey, named in honour of the pioneering nurse Mary Seacole, has received its first patients.

The opening means that thousands of people are set to benefit from enhanced community services to help them recover from the long term effects of coronavirus.

This week, the NHS Seacole Centre will provide specialist rehabilitation care for patients who are recovering from coronavirus in the Surrey region.

NHS England has hailed the efforts of all those involved in getting the

the government’s statements on testing and the difficult reality on the ground is painfully wide and needs to be closed quickly’.

Approximately 4.2 million people in England are waiting to have a non-urgent procedure.

READ MORE tinyurl.com/yb4ol9sv

new service up and running, and unveiled plans for similar services in other parts of the country.

Formerly a disused military hospital, the facility was transformed into The NHS Seacole Centre in just 35 days, thanks to the work of teams across Surrey Heartlands, including Surrey County Council, the military and the NHS – including host trust Epsom and St Helier University Hospitals.

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BEREAVEMENT

Bereavement scheme to NHS support staff extended The bereavement scheme has been extended to the families and dependants of NHS support staff and social care workers who die as a result of contracting coronavirus.

Home Secretary Priti Patel said that the Home Office is extending the offer of indefinite leave to remain, free of charge, to the families and dependants of NHS support staff and social care workers who die as result of contracting coronavirus,

effective immediately and retrospectively.

Initially launched in April for health workers in the NHS and independent health and care sector, following mass criticism, the bereavement scheme will now extend to NHS support staff and social care workers.

READ MORE tinyurl.com/yaj44fft

MENTAL HEALTH

Key contribution made by NHS mental health trusts praised A report by NHS Providers has highlighted the key contribution made by NHS mental health trusts in confronting the coronavirus pandemic.

The report, Spotlight on… the impact of Covid-19 on mental health trusts in the NHS, emphasises the critical role NHS mental health trusts have played in maintaining and adapting mental health services while supporting colleagues in the acute hospital, community, ambulance and primary care sectors.

This includes adapting their wards to look after those recovering from the virus, establishing mental health A&Es

and 24/7 emergency service access lines, as well as developing home treatment models and clinical services online.

NHS Providers also highlights the changes in demand for mental health services during the pandemic, including increased numbers of people needing urgent and emergency care. It points to concerns that many who need help and support are not accessing services until they reach a crisis point, and warns of pent up demand that has built up during the lockdown.

The report says the government and national policy makers must take account

of the pressures mental health services will face in the weeks and months ahead.

In particular it points to the need for: PPE and testing; support to prioritise and plan services effectively; full and prompt funding for frontline services that need to expand to meet the extra need created by the pandemic; and a new workable strategic national plan for the workforce, given that the pandemic has exacerbated existing severe shortages.

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Advertisement Feature

Bioquell helping pharmaceutical companies resume operations post Covid-19 Bioquell Rapid Bio Decontamination Service (RBDS) enables businesses to quickly regain control of clean spaces and ramp up capacity

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Infection control

Purchaser and provider working together for infection prevention Veronica Johnson-Roffey and Kate Prevc outline the benefits of healthcare facilities management companies employing their own infection control nurse to ensure their staff working in hospitals are trained in infection control Many healthcare providers contract out elements or all of their soft facilities services and the providers are expected to help in fulfilling aspects of the Hygiene Code in relation to infection prevention and control. It is widely accepted that good facility management is hugely important in helping to prevent and control healthcare infections. Services contracted out are classed as hard and soft facilities.

Registered healthcare organisations are required to comply with the Health and Social Care Act 2008 - Code of Practice on the prevention and control of infections and related guidance. The Act outlines 10 criteria which organisations must satisfy the CQC they are meeting to provide safe care.

These include having systems to manage and monitor the prevention and control of infections, providing and maintaining a clean environment that facilitates prevention and control of infections, providing suitable information on infections, identifying people who have or are at risk of developing infections in order to treat and reduce risk of spread, systems to ensure that care workers including contractors are aware of and discharge their responsibilities in preventing and controlling infections, have and adhere to appropriate policies and managing occupational health needs of staff in relation to infections, This article discusses some facets of how University Hospitals Coventry and Warwickshire (UHCW) NHS Trust, one of the most modern healthcare facilities in Europe with 1,250 beds, and ISS Mediclean Limited, one of the largest facility services providers in healthcare, collaborated on a project to support the message that, infection prevention and

control (IPC) is everyone’s responsibility.

ISS has been providing the soft services facilities to UHCW since it opened in 2006, and the project which involved ISS employing their own dedicated IPC nurse – the first of its kind in ISS nationally - was the idea of the on-site ISS General Manager in 2017 with full support from the UHCW Director of Nursing and their Lead IPC Nurse.

What are soft services in facilities management?

In healthcare these are the services that make the environment safe, secure, efficient and pleasant for patients, staff and visitors.

These services include portering, cleaning, catering, security, waste management, car parking, post, switchboard, helpdesk, and linen and laundry services – all provided by ISS in the case of UHCW. Soft services differ from hard services which are related to the fabric of the building such as heating, plumbing, ventilation, lightning and building maintenance.

The purpose of the role is: to ensure Infection Prevention and Control (IPC) was addressed in all aspects of healthcare cleaning and reflected throughout all activity related to the ISS healthcare cleaning provision (and other soft service elements); to ensure infection prevention is taken into account in assessing method statements, cleaning schedules and training activities; and to provide a professional and collaborative link between the soft service provider and the trust’s clinical and IPC teams.

The core responsibilities include: being a core member of the trust’s Infection Prevention and Control Committee; developing, in partnership

with the Head of Cleaning and Trust IPC Manager, an annual audit and improvement program which was aligned to the ICNA Audit tool and reflects specific objectives of UHCW Infection Prevention and Control annual program; contributing to the development and implementation of policies, procedures and guidelines; working in partnership with the local Infection Control leads, Matrons and Ward Managers ensuring that the ISS service level inputs are appropriate for the hospital size, activity levels and complexity; ensuring programs of auditing are in place in relation to IPC; ensuring all staff completed mandatory infection prevention and control training and review that training to ensure it was most appropriate and effective; implementing and maintain a continuous hand hygiene surveillance and improvement programme for healthcare cleaning and other soft service elements; supporting Trust IPC team in undertaking Root Cause Analysis (RCA) in cases of infection to identify issues and causes with inclusion of healthcare cleaning staff, especially in relation to changes required in practice as a result of identifying the root cause; providing comment and advice on the purchase/introduction and use of equipment in relation to IPC issues; and promoting effective team working across clinical and soft services staff within the team.

The ISS appointed person being a nurse was clinically accountable to the Trust IPC lead who was instrumental in drawing up the job description and recruiting, but was managed operationally and worked closely with the head of healthcare cleaning, although with regards to regular IPC issues was autonomous. E

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Training If staff are informed they tend to be more compliant and more motivated if they feel their work is important. Training was already high on the agenda of ISS but training was an important part of this project. During the project all newly appointed staff including porters, cleaners, catering, ward hostess, retail, security and support teams had two hour face to face IPC training included in their induction. This was important in reiterating the ISS message to staff that whatever their job in the hospital they had a part to play in preventing infections regardless of whether they were patient facing or not. This was an important message because some staff had never worked in a hospital before and had little knowledge of IPC on any level. Training included the basics of standard precautions and practical session on hand hygiene and use of PPE. If the ISS nurse was not able to undertake a session a member from the Trust IPC team stood in, this was also a good way to reiterate that ISS are following the same policies as the Trust and for staff to get to know members of the Trust’s IPC team.

One to one hand hygiene sessions were also undertaken with staff on the wards so they didn’t have to be away from their area. This was also a way to show Trust staff that ISS staff such as cleaners and ward hostesses working in their area, were getting hand hygiene training the same as the Trust

staff. Audits of hand hygiene practices by the Trust included any ISS staff in the area and any concerns or good practice were fed back to the ISS nurse to follow up on.

The ISS healthcare cleaning manager and supervisors were also updated on their IPC and hand hygiene knowledge so they could be an up to date resource for cascade training in their areas.

Audits In line with the national specifications for cleanliness in the NHS: a framework for setting and measuring performance outcomes (NHS 2007) the healthcare environments should pose minimal risks to patients, staff and visitors. Regular auditing of the healthcare environment helps to ensure that high standards are maintained and give an early warning if standards are failing or where best practice prevails.

The ISS IPC nurse attended environmental cleaning audits with the healthcare cleaning team managers or supervisors and, if appropriate, the matron of the area or Trust IPC nurse. This supported the cleaning team but also gave extra assurance to the matron that we were working together to improve standards but also again point out where maybe practices on the ward could be impacting on effective cleaning.

Historically the trust used two methods of auditing the cleanliness of the environment, the nursing team used the Infection Control Nurses Association (ICNA) Audit Tool for Monitoring Infection Control Standards (2004) and ISS used a Maximiser tool to audit against the contractual specifications for cleanliness requirements. This was at times confusing and staff wanted a single tool that allowed ISS to meet contractual obligations but also include the nursing aspects of environmental infection control management.

Together ISS and the Trust IPC team created a single audit tool that produced a single percentage to reflect the overall cleanliness standard of the environment.

This provided a single measure that all staff understood and for upward assurance the trust board could understand what score indicated a well-managed area. The scores could also be broken down into areas of responsibility: ISS, estates and the nursing team. A one day workshop facilitated by a researcher from Imperial College worked with the teams to develop a tool that met a number of requirements, this initially was delayed due to contractual concerns but as the benefit was realised by using it for those area that had increased incidence of Clostridioides Difficile (CDT) it was brought into increased use. Having an IPC lead for ISS during this work was mutually beneficial as there was a unique insight into the issues that both sides encountered.

Infection Control Committee (ICC) The role required the ISS IPC nurse to be a member of the Trust ICC which was important in supporting the cleaning management who were required to present an environmental cleaning report but also to get updated on

other IPC matters useful for self-development.

It was also a good way to give assurance that IPC matters were firmly on the ISS agenda.

Outbreaks The ISS nurse was alerted to any outbreaks in the hospital so she could support relevant ISS teams such as enhanced cleaning and ward hostessing in any actions they had to take to help in controlling the outbreak. It was also a good opportunity to provide some education to staff about the organism causing the outbreak to allay fears. When necessary the ISS nurse also supported the Trust IPC team with e.g. contact tracing activities.

Infection control

 Facets of the role Cleaning Healthcare cleaning is an integral part of IPC so a major part of the role involved working with the healthcare cleaning team. ‘A Matron’s Charter: An Action Plan for Cleaner Hospitals’ and ‘The matron’s handbook’ make it clear that matrons have ultimate responsibility and accountability for standards of environmental cleaning and IPC in their areas.

Therefore, from the outset it was important to quickly establish a relationship with as many of the 34 Trust matrons.

This was achieved by meeting with as many matrons as possible individually but mostly by attending the monthly matrons’ meeting chaired by the UHCW IPC Lead. This was an ideal opportunity to meet the matrons, discuss cleaning audit reports and get feedback from them on any cleaning concerns to feed back to the head of healthcare cleaning and support in rectifying these.

It was also a good opportunity to feed back to the matrons any concerns from the cleaning teams which impact negatively on effective cleaning such as ward clutter or access to areas and making the healthcare cleaner feel part of the ward team was always encouraged.

The nurse in charge of the shift has direct responsibility for ensuring that cleanliness standards are maintained throughout that shift so if the healthcare cleaner always feels part of the ward team they can be directly approached by the matron, nurse in charge or her staff to rectify any cleaning problems.

Observation Walks The IPC Lead for the trust and the ISS IPC nurse would walk as many wards/areas as possible at least once a week and this visibility was very good again for showing that we were working together and it was useful to highlight any IPC problems that needed attention from ISS or the Trust.

The ISS nurse would also do a daily walk around selected wards or depts. with one of the healthcare cleaning managers or supervisor meeting ISS staff and sometimes using it as an opportunity to do ad hoc hand hygiene inspection or to deal with any problems that may impact on IPC. Sometimes this might just be observing staff like porters who are visiting wards or ward hostesses serving drinks and food and making sure they were observing correct practices like hand hygiene and use of PPE where appropriate.

It was also a good opportunity during flu season to encourage staff to have annual flu vaccination and also organising out of hours clinics with occupational health for ISS staff on later shifts to get their vaccine.

Conclusion We are aware that other similar facilities companies have employed nurses in various roles but to our knowledge none have specifically employed a trained IPC nurse to work with the hospital Trust IPC team in genuine collaboration.

Following the project which lasted 20 months, working part time, ISS, UHCW and the appointed nurse, have agreed it was a success and ISS will look to continuing this at UHCW and replicate in any new larger healthcare contracts. This was a part time post but following feedback from the nurse undertaking the role; it’s recognised that a full time person would be able to expand the role further to add even greater value. The IPC team at UHCW felt the role definitely helped to break down barriers and strengthen IPC links between ISS and UHCW and vice versa.

The ISS staff felt it was useful to have their own IPC nurse they could directly refer to and some, especially the cleaners, said it made them realise that their role was important.

The expertise of the Trust’s IPC team to the service provider can sometimes be constrained by time or clinical priority and therefore an initiative such as this helped to ensure that both organisations were aligned in relation to IPC. L Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

How ventilation keeps your building healthy The way air handling units (AHUs) are designed and managed is playing a big part in the UK’s increasingly urgent campaign to ensure ventilation can maintain healthy conditions inside buildings, according to James Henley, product development manager at Daikin Applied UK The role of ventilation systems in maintaining healthy conditions inside buildings has been under the microscope this year. It quickly became clear during the COVID-19 outbreak that target air change rates in buildings needed to be maintained – even in partially occupied buildings – to minimise the risk of moisture, which could contain the virus, settling and remaining on internal surfaces.

Critical health environments, including operating theatres, depend on accurate control of both air change rates and the direction of airflows so that contaminated air is diluted and taken away from patients and the healthcare professionals looking after them.

Managing systems to deliver very precise temperature and relative humidity (RH) control is made easier today by the availability of sophisticated digital control systems. Facilities managers are also supported by remote monitoring of systems made possible thanks to internet connectivity that can provide important diagnostics for both maintenance purposes and optimised ongoing operation.

Highly efficient filtration systems are also widely deployed in the healthcare sector, but these must be supported by regular maintenance to remain effective. This became an area of particular concern during the COVID-19 emergency because expert analysis showed that the virus laden particles were too small to be captured by even the most sophisticated filters and, therefore, ventilation ductwork and air conditioning systems should be regularly checked and cleaned to reduce the potential for wider transmission.

Facilities managers were also advised to switch air handling units (AHUs) to full fresh air mode and temporarily disable any heat recovery recirculation so that potentially contaminated air would not be returned to the occupied space.

A vital role in human health AHUs will also continue to play a vital role in the ongoing threat posed to human health by air pollution after the current crisis passes.

Polluted outside air is responsible for as many as 36,000 deaths a year in the UK, according to Public Health England (PHE).

This has placed AHUs under increased scrutiny because of their role as interfaces between potentially highly polluted outside air and the indoor environment. Modern AHUs are also relatively complex systems

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containing a series of active components like fans, heating and cooling coils, and air filters as well as sound attenuation technology and humidification.

They are subject to the updated European Ecodesign Directive – specifically ErP 1253, which was first adopted in 2014 and came into force two years later to ensure systems meet exacting energy efficiency standards, but without loss of performance. As a result, most AHUs now incorporate heat recovery in order to reduce the amount of wasted heat. Switching this feature off should only be a temporary and precautionary measure during the COVID-19 outbreak.

AHUs are also subject to ISO, CEN and BSI technical standards to achieve compliance with World Health Organisation (WHO) guidelines for IAQ where people work and have public access to buildings in heavily polluted urban environments.

The design issue faced by specifiers of AHUs is that harmful particulates are getting smaller, which makes them more dangerous when inhaled as they can penetrate further into the human body. New filtration standards are focused on PM1 particulates (the smallest easily measurable), including those from diesel engines, which have been identified as a Group One carcinogen by the WHO and have also been linked in recent studies to early onset Alzheimer’s disease.

This means very high standards of filtration are needed, which has a profound impact on the design of the unit and the system as a whole. F7 filters are becoming a minimum requirement in line with the international standard EN779, although a number of end users are requiring higher filtration standard to F9.

This combination of heat recovery and higher specification filters means an AHU will be subjected to higher pressure drops. This has implications for the size of the unit and its fan power, which, in turn, could lead to the use of larger motors that consume more energy. This flies in the face of current design trends, which have been moving towards smaller units to reduce capital cost and free up valuable lettable space in commercial buildings.

The importance of basic design principles However, it is perfectly possible to design a system that meets the energy efficiency and

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

IAQ criteria without driving up costs to the end user, but it does rigorous application of good, basic engineering principles.

At Daikin Applied, we look to meet the client’s requirements by accurately sizing and using technical innovations like EC fans in order to minimise energy consumption. Fan power is also specifically referenced in the revised ErP legislation so is another design aspect that should not be ignored by specifiers.

It also calls for multiple fan systems to build in redundancy as well as improving efficiency.

The bonus for engineers is that EC fans are more compact than DC equivalents, which means they can help to reduce the size of the system and still meet new energy targets while, at the same time, making sure building occupants are protected from air pollution.

Applying these design principles will also mean that systems can easily be adapted to the changing requirements of a healthcare facility over time without any loss in performance or additional cost penalty to the end user. L FURTHER INFORMATION www.daikinapplied.uk

Infection control

Maintaining indoor humidity levels key to fighting the virus With much in the news covering the social impact of the coronavirus outbreak, Dr. Stephanie Taylor discusses the need to ensure public buildings, such as schools and hospitals, have a humidity level so that viruses cannot spread To manage the spread of Covid-19, we The simple factor of maintaining healthy are all working as a global collective levels of indoor humidity is something to manage our behaviours responsibly, that would benefit our health through such as through meticulous attention reducing the burden of Covid-19 as to hand hygiene and social distancing. well as other seasonal viral illnesses.

As individuals, these are undeniably key

steps for us to protect ourselves and each Dry indoor air other as we fight the current pandemic.

In my practice as a paediatric oncologist, However, individual behaviour is just one I was alarmed by how many of my young factor in our efforts to contain the virus patients came down with infections during and limit subsequent disease. The their hospitalisation despite our environment surrounding us best medical treatments. It plays a lesser-known, yet was at this time that I essential role in the became concerned that Among the degree of viral spread there might be another indoor v and in the severity factor at play; the a r that inc iables of Covid-19 illness. indoor climate r e ase the likeliho Since we spend and the hospital most of our lives building itself. After from haod of infection , n in buildings – such years of work, d h ygiene room c as schools and including obtaining t o l e a astound ning, one workplaces and a master’s degree i our homes – we in architecture, factor sng common could and should be reviewing numerous tands o u doing more to ensure studies of patient dry ind oor air t: the conditions of these infections and the indoor environments are built environment optimal for human health. and undertaking my own

research, my suspicion was confirmed.

Among the indoor variables that increase the likelihood of infection, from hand hygiene to room cleaning, one astounding common factor stands out: dry indoor air.

An abundance of data from research in infection control, microbiology and building science show that maintaining indoor relative humidity between 40-60 per cent improves human health through several mechanisms. This relative humidity zone optimises the ability of our immune system to fight viral infections, decreases the bio-burden of infectious particles in our breathing zone (the air) and actually decreases the infectivity of many viruses and bacteria floating in the air and settled on surfaces. When this optimal range of relative humidity is not maintained, it becomes harder for our immune systems to defend against respiratory viral infections even if we maintain high personal hygiene standards. Public buildings like schools, workplaces and hospitals have undoubtedly been hotspots for the spread of the Covid19 outbreak, not just because of viral cross infection via physical contact, but in large part due to the airborne transmission of E Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Infection control

 infectious droplets, aggravated by low indoor humidity levels.

Despite this, there are currently no regulations on minimum indoor humidity levels in the UK and many other countries.

In fact, regulations focused on reducing energy consumptions in buildings have resulted in the lowering of permitted minimum indoor humidity levels, unfortunately at the expense of occupant health. A lack of humidity standards means that building occupants like the hospital workers who have been on the frontlines of the Covid-19 pandemic and patients with compromised immune systems have limited defence against further respiratory viral infection, despite hand washing and social distancing measures.

It is long-established knowledge that viruses can be spread through short distance droplet splashing. But the transmission pathway we must now take into serious consideration is distant spread of infectious aerosols travelling through the air. When droplets are released into the air by an infected person sneezing, coughing, or simply breathing, dry air causes these droplets to shrink and desiccate to reach a moisture equilibrium. We now know that viruses carried in those tiny desiccated particles can travel through the air into an HVAC system and re-infect people from a distance and despite having had no immediate contact.

Improved humidity standards This transmission route is one of the factors that makes this virus particularly alarming.

The concept of airborne transmission is intimidating, but we can help control it by keeping the relative humidity in our breathing zone or in our buildings in the magic zone of 40-60 per cent. Existing regulations on indoor air quality should be updated to reflect the significant body of scientific evidence that 40-60 per centRH is the ideal indoor humidity for health.

These improved humidity standards would have numerous positive effects on human health and well-being. Not only would it reduce the burden on society of Covid-19 disease and other upcoming seasonal viral illnesses, but research shows that it would also reduce absenteeism and improve productivity in offices and schools.

A recent study of a nursery school found that fewer children missed school when the classroom humidity was maintained above 40 per centRH. (Rieman J, ‘Humidity as a non-pharmaceutical intervention for influenza A’, 2018 ASHRAE abstract). Studies support projected reduction of absenteeism

The concept of airborne transmission is intimidating, but we can help control it by keeping the relative humidity in our breathing zone or in our buildings in the magic zone of 40-60 per cent by at least 20 per cent by simply maintaining healthy humidity levels in buildings.

Governments set indoor air quality standards for temperature, fresh air introduction and pollutants. Setting a minimum indoor humidity level in public buildings is easily achievable, will result in net profit for society through increased productivity and reduced healthcare costs. Most importantly, it will save lives.

We must push for these standards to be set to protect ourselves, our children, the elderly, and the health care professionals who are on the frontline protecting us all in the face of the global pandemic. L

Dr. Stephanie Taylor, a graduate of Harvard Medical School, is the CEO of Taylor Healthcare Commissioning Inc. After working as a physician for many decades, Dr. Taylor obtained a master’s in architecture as well as an infection control certification. Her lifelong commitment to patient care includes focusing on improving the health care physical environment and clinical work processes to help patients heal quickly and save hospitals valuable dollars.

FURTHER INFORMATION www.taylorcx.com

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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RDP was founded in 2000 specifically to design and manufacture its own range of healthcare specific hardware for the UK market. This led to RDP being the first company in the UK to provide powered carts designed specifically for PCs for use in healthcare environments.

RDP prides itself on being truly customer focused, designing products specifically to meet the needs of its customers. All of RDP’s products are designed by clinicians for clinicians. By designing and then manufacturing products that customers tell us they need, the business has grown organically to become the leading manufacturer in the UK of mobile computer carts.

In March we got a call from NHS England in urgent need of medical workstations to help with the Covid 19 crisis. The aim was to equip the new London, Bristol and Manchester Nightingale hospitals with mobile computer carts within a very tight deadline. Their initial requirement was for 50 carts for the next working day in the London hospital, which has been housed at East London’s ExCeL exhibition centre with space for 4000 beds. We set about achieving this target and managed to turn the order around in 2 hours, delivering them the same day.

RDP’s Managing Director, Shyam Sonpal said “NHS England asked us to deliver these carts in less than 24 hours but we were able to ship them out on the same day. I am extremely proud of the efforts from the staff at RDP, many of whom worked extra hours, and also the extremely quick response from suppliers who have helped us with providing essential equipment for the NHS in these unprecedented circumstances.”

www.rdp-group.com

This delivery success led to the discussion of further requirements for each bed at the Nightingale.

For the next batch of carts, the Nightingale then wanted RDP to meet the unique intensive care requirements of coronavirus patients and so we set about manufacturing a bedside cart specifically for this purpose. Usually in hospitals they might have roughly one or two carts per ward but at the Nightingale their primary aim was to ensure that all patients and staff remain safe, healthy and protected – therefore we were asked to provide one cart per bed to help prevent the spread of the virus. The carts are placed by each bedside and houses PCs and screens for doctors and nurses to have easy computer access to patient records, a time-saving device which is invaluable to health professionals.

In order to achieve the volume required for NHS England, we had to convert part of our building from a warehouse to a production facility so that we could adhere to the social distancing guidelines.

Temporary staff were taken on from the local area and we utilised a network of suppliers in order to keep up with the demand. Our long-standing transportation company rearranged their schedule to put us at the top of their priority list so that we could ship the carts to the Nightingale around the clock.

During this time RDP’s commitment to its long-standing customers did not waiver and as hospitals increased their own upscaling of ICU beds, RDP where able to support these additional requirements at the same time.

As the country begins to slowly recover and patients are increasingly being admitted to local hospitals rather than the Nightingale hospitals, RDP will work with NHS England to redeploy this kit into the hospitals that require it and ensure that it gets put to good use. We are also on standby to provide more carts should we have another peak. RDP is proud to stand along with all the contractors, military personnel and clinical staff who have been involved in building this temporary field hospital and in making it a success.

+44 (0)1444 245 123

Advertisement Feature

Baxter ICNET: Supporting COVID-19 Public Health Response The ongoing COVID-19 pandemic has presented even the most developed and efficient healthcare systems with unprecedented challenges. Baxter’s ICNET Clinical Surveillance Platform features two products that can assist in the immediate- and longer-term.

Baxter’s ICNET Clinical Surveillance Platform delivers nearly 20 years of real-world experience offering expertise in epidemic outbreak reporting, investigation and management to help healthcare providers and public health bodies effectively manage an evolving global public health challenge.

The ongoing COVID-19 pandemic has presented even the most developed and efficient healthcare systems with unprecedented challenges as they’ve had to adapt quickly to manage its suppression.

Even as we make headway, public health teams continue to implement strategies that will play an important role for the foreseeable future, such as ongoing contract tracing, surveillance testing, and preparation for a future COVID-19 vaccination program.

The ICNET National Suite features two products that can assist in the immediateand longer-term. Outbreak Manager can help with ongoing management of the pandemic, while Protect can support the vaccination program for COVID-19.

ICNET Outbreak Manager There is evidence suggesting that instituting public health interventions for COVID-19 on time can help to reduce transmission, whereas a late response can delay containment and allow further spread.1 Outbreak Manager can provide information needed to support timely implementation of essential interventions.

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Data are captured quickly and robustly for timely analysis, to help facilitate speed of intervention.

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Outbreaks involve huge amounts of complex data. Outbreak Manager sorts through surveillance data to identify early the clusters of infection that can constitute an outbreak.

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In-built data analysis tools, such as epi curves, again support timely analysis and intervention.

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Drilling down into the data, it has visualisation tools to help highlight the chains of transmission and the timeline of infection clusters (TICL)

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It has a comprehensive dashboard to view the progression of the outbreak; this gives easy access to data needed to inform public health strategy and interventions.

Public health bodies also understand that strategies, such as contact tracing and surveillance testing, will remain the way forward for the foreseeable future.2 Outbreak Manager can continue to support suppression of COVID-19 by offering functionalities that assist these strategies.

ICNET Protect Development of a COVID-19 vaccine remains a top priority of the global pandemic response. When a vaccine becomes available, nations will need to manage its rapid deployment where speed is of the essence.

Public health experts can take steps now to prepare for the coming challenge of delivering vaccinations to many people at one or more locations in a short interval of time.

Protect was developed with the technological capability and capacity to enable public health experts to deliver a well-coordinated program when the time

Its built-in workflow enables health responders to capture the details of an outbreak in near real-time, enabling management throughout its timeline.

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comes. Protect is designed for large-scale vaccination management, including mass vaccinations across whole populations for new vaccine or routine immunisations. It was developed to help manage the largescale, fast-moving scenarios associated with response to pandemic threats.

Protect helps facilitate the entire process from ad-hoc clinic set up, to resource management, to vaccine administration.

It also delivers role-specific information to the various healthcare providers involved in the vaccination program.

Protect is scalable for users’ specific needs – from individual facilities to whole population administration, with configurability to target appropriate members as needed. Other capabilities include support for clinic staffing and rostering for ad-hoc scenarios; tools for management and inventory of vaccine stock supplies; and visual work boards that enable users to coordinate and track progress of the vaccination program from start to finish.L FURTHER INFORMATION www.icnetsoftware.com/covid-response

The ICNET Clinical Surveillance Platform encompasses two differentiated product suites that support integrated disease surveillance to facilitate the goals of their respective users and drive desired outcomes within the populations at risk.

ICNET National Suite supports public health communicable disease professionals at the mass population level, while ICNET Hospital Suite supports infection prevention professionals within the healthcare facility setting.

UKI/MG128/20-0015 05/20 References: 1.

2.

Zhanwei, D et al., 2020. Proactive Social Distancing Mitigates COVID-19 Outbreaks Within A Month Across 58 Mainland China Cities. [online] Medrxiv. org. Available at: https://www.medrxiv.org/ content/10.1101/2020.04.22.20075762v1. full.pdf Devlin, C., 2020. Coronavirus: PM Jacinda Ardern Says There Will Be Contact Tracing for Foreseeable Future. [online] Stuff.

Available at: https://www.stuff.co.nz/ national/health/coronavirus/120836335/ coronavirus-pm-jacinda-ardern-says-therewill-be-contact-tracing-for-foreseeable-future

Mental health

Mental health in the lockdown and beyond When this is all over, will it be said that ‘it took a pandemic to put mental health where it should be – at the front and centre of daily considerations about working lives?’ Adrian Wakeling, Senior Policy Advisor at Acas, discusses Charities and stakeholders have been campaigning for a genuine parity between physical and mental health for decades. We may be social distancing to protect each other’s physical health, the NHS and social care, but what impact is the crisis having on our mental health and what can we do about it?

The new normal is mentally challenging We don’t have to look very far for the causes of increased levels of poor mental health. Early findings form an IES survey of the well-being of employees working from home, paints a vivid picture of anxiety and stress: loss of sleep – 60 per cent are losing sleep due to worry; more drinking (alcohol consumption up 20 per cent) and less exercise (down 60 per cent); unhappiness with work-life balance (50 per cent) and a third frequently feeling isolated; worry about job security (21 per cent) and the health of loved ones (41 per cent); and an increase in musculoskeletal complaints, with

survey respondents reporting new aches Of course, technology allows us to and pains in the neck (58 per cent), shoulder stay connected. But it also allows us to (56 per cent) and back (55 per cent). recreate what we had before and for Although we all face many new many this is hours of Skype meetings challenges, much has also stayed the same. instead of face-to-face meetings.

Surveys of employees, such as those from And there is the addictive nature of the CIPD, regularly show that work-life technology which means that it takes a balance is a perennial top concern. This lot of self-discipline to turn off devices. may be heightened at the moment – with Technology can’t solve the connectivity the line between work and home problem on its own. I have heard being not so much blurred as of colleagues having virtual completely rubbed out for tea breaks to chat, quizzes many of us – but it very after work and there Surveys of much a dilemma of has been a great employ e e modern working life. deal of therapeutic s , such as thos sharing. But a recent e f r om the CIPD, re Technology: a survey by YouGov, that wo gularly show friend and a foe commissioned by rk-life b Many people have Acas, shows that alance is a per wondered what the people are still e n ni current experience of missing ‘social/informal concernal top this pandemic would interaction’ while have been like a few working from home (71 decades ago, without the per cent) and feeling ‘out internet and social media? of the loop’ (51 per cent). E Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

NHS Nightingale – a lesson in working together fast “Amazing”, “astonishing” and “extraordinary” were some of the terms used to describe the opening of the NHS Nightingale Hospital in East London’s Docklands, after a nine-day construction process At the time, Chief Executive NHS England, Sir Simon Stevens, noted that the UK had over 9,000 patients in NHS hospitals being treated for coronavirus, and this number would undoubtedly rise.

He further explained the concept: “Under these exceptionally challenging circumstances the NHS is taking extraordinary steps to fight coronavirus. That’s why NHS clinicians and managers are working with military planners and engineers to create, equip, staff and open the NHS Nightingale London, and we’re very grateful for their support. This will be a model of care never needed or seen before in this country.”

Project Management NHS Nightingale was a project to deliver a temporary hospital of up to 4,000 beds within ExCel London. Designer, James Hepburn of Building Design Partnership recognised the benefits of utilising a building like ExCel, where many of the service provisions were already in place.

To deliver this required collaborative working between a mixed team of NHS clinicians, the British Armed Forces, private contractors and voluntary organisations.

For NHS Nightingale, some 700 military personnel were deployed for construction work and logistical support. When ISS Healthcare, as a trusted strategic supplier, were asked to contribute to this unique project, managing director, Chris Ash, recognising the need, did not hesitate in accepting.

The masterplan required existing building incumbents such as Compass and Mitie to provide services whilst ISS Healthcare provided the overall operational management expertise; providing clinical cleaning, daily cleaning,

portering services, receipt and distribution, waste management and helpdesk facilities.

ISS also engaged colleagues, ISS Restoration who, for the initial three weeks, provided deep cleans and sanitisation of the bed areas prior to patient use and general site cleaning allowing other trades to focus on their works whilst the Restoration team cleaned around and after them. Other key suppliers such as Rentokil, for pest control were engaged, it being recognised the conversion and increased activity would represent an elevated risk in their area of expertise.

Collaborative Working Collaborative working on this type of fast track project requires both decisive leadership and agile working. The command model employed was the Gold/Silver/Bronze team approach used by emergency services. Here policy decisions would be made by the Gold team, passed to the Silver Team and thence Bronze for tactical action. During the Nightingale project, the ISS project director supported by an on-site management team would receive direction as part of the Silver Team each morning. They would then immediately brief the rest of ISS team accordingly. In this way executive decisions could be turned into effective action in the shortest time.

Agile working was required by everyone involved. ISS’ four core values include Entrepreneurship and Quality, these both inspire working together towards a common goal. On the Nightingale project there was a critical need for face fitting testing of FFP3 masks to support staff working in the clinical areas. A major airport client had restricted their services during the pandemic, this allowed ISS managers to be re-deployed,

bringing their expertise and test equipment with them. This also applied to consumables such as hand sanitising fluid, which were in short supply. Vacant buildings within the ISS portfolio were identified allowing consumables to be effectively sourced.

Natural Competitors In normal circumstances some of the organisations within the team would be seen as direct competitors but the overriding goal of ‘Protecting the NHS and saving lives’ meant that natural rivalry was temporarily suspended, and everyone worked together for the greater good. When another commercial company began providing soft services to the Nightingale project at Cardiff Principality Stadium, the ISS London Nightingale team freely shared their organisational knowledge and expertise in real time.

Because of the competitive nature of the FM market, ISS Healthcare, along with other private organisations, are experienced in responding to customers’ needs in fast and flexible ways. This leads to a proven mobilisation process with all the necessary competency and experience in meeting this challenge within the operational team. ISS has vast experience in collaborative working having entered earlier formal arrangements using ISO44001:2017, the international standard for collaborative working.

Opening the new NHS Nightingale London Hospital, HRH Prince Charles recognised the important role of the temporary hospital in meeting the national crisis when he referenced the original Crimean War healthcare pioneer: “Florence Nightingale, the lady with the lamp, brought hope and healing to thousands in their darkest hour. In this dark time, this place will be a shining light.”.

NHS Nightingale inspired a further 7 temporary hospitals in Birmingham, Bristol, Cardiff, Manchester, Harrogate, Belfast and Glasgow.

The Nightingale Hospitals will rightly go down as landmarks in the history of the NHS, and as someone has already commented, “Covid-19 has been this generation’s Dunkirk”, and we have risen to the challenge. L FURTHER INFORMATION www.uk.issworld.com

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Mental health

 Technology cannot automatically create good management; and it is concerning that in the same survey, although: 43 per cent of employers have experienced issues affecting their employees related to stress, anxiety or mental health difficulties in the previous 12 months; and only 22 per cent of employees have spoken to their manager about stress, anxiety or mental health in the last 12 months.

Good line management always in fashion Helping people to cope in the current crisis relies on many good old-fashioned soft management skills – such as getting to know your staff and finding how to best to communicate with them. For example, social catch-ups can be good for teams but some colleagues might dominate the conversation and over-share; so one-to-ones may work better for some. And video meetings may be good for picking up on visual signs of well-being, but the World Economic Forum have warned of what is being dubbed ‘video call fatigue’, caused by people feeling they have to constantly perform for the camera.

There is a course a grey area in all this.

Employment law is still employment law, and although some regulations have been put on hold (such a gender pay gap reporting, which has been postponed for a year), employers still very much have a duty of care over their staff. Indeed, this duty of care has arguably never been so important. But it can be tricky knowing how to interpret legal requirements in the current situation. The rise in musculoskeletal

Many people have wondered what the current experience of this pandemic would have been like a few decades ago, without the internet and social media? problems could perhaps have been foreseen, with ONS figures showing almost half of us now working from home. For many of those, this is a new and unexpected development, and we will all know someone who is perched on a stool or using their bed as a workspace. This raises the issue of how to carry out health and safety assessments.

Another pressing issue is around managing disciplinary and grievance issues.

Unfortunately, conflict has not distanced itself from our working relationships.

Everyone still wants to be treated fairly and equally at work and to be protected in doing so. Acas has just published new guidance on how to manage conflict remotely.

The same storm but different boats Everyone has their own lockdown story about how they are coping and the challenges they face – whether that’s home-educating young children for the first time; shielding a vulnerable relative; or waiting anxiously on furlough to see if there will still be a job for you. Although there has undoubtedly been a feeling of camaraderie amongst employees and people in society more generally, there is

growing evidence that some parts of society are being affected more than others.

The EHRC are concerned about the impact the epidemic is having on disabled people; and the Mental Health Foundation have just issued a report linking financial inequality and mental wellbeing. The Institute for Fiscal Studies has pointed out that ‘groups that are vulnerable to poor health are likely to be hit hardest … and evidence is emerging that the economic repercussions of the crisis are falling disproportionately on young workers, low-income families and women’.

The gist of what many charities are saying is that although we may be in the same storm, we are not in the same boat. This year’s Mental Health Awareness Week focused on the theme of kindness and perhaps the kindest thing we can do currently is to look after the most vulnerable in society. At work this means those who are most insecure, financially or psychologically, and those with pre-existing mental health problems that may have been exacerbated. L FURTHER INFORMATION www.acas.org.uk

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Helping the NHS focus on what matters: how to free up back-office manpower Hospitals across the UK transformed their working practices this spring in order to cope with the massive surge in patient numbers that resulted from the COVID-19 pandemic.

Non-essential surgery was postponed, wards were divided into ‘red’ and ‘green’ zones to avoid cross-contamination, and the new Nightingale field hospitals were constructed to accommodate less serious cases of the virus The UK government relaxed some reporting requirements in an attempt to relieve hospitals of some of their administrative burdens, but with many staff self-isolating or sick, this still left a great deal of paperwork to be managed by smaller teams. Patient records needed to be accessible by both clinical and back-office employees – never more so as an increasing number of hospitals established special teams to handle the queries that flood in from concerned families and friends – while documentation relating to equipment orders, invoices and deliveries became more crucial than ever.

This process has been easier for those organisations who had already begun to implement programmes of digital transformation before the coronavirus outbreak. A number of NHS Trusts had already recognised that at the heart of achieving an efficient, shared online record system lay the ability to capture the right information in the first place.

Not just a scan Although many health organisations had already adopted scanning systems in order to store all paper-based documents electronically, this frequently consisted of simply capturing the image of the document. Without the manual input of contextual data such as patient record number, invoice number or some other identifier, the image would be completely useless. A clinician might scan in an update to a medical record, but further human intervention would be required to link this to a patient, a doctor, a laboratory or an entirely different medical unit. In the meantime, a letter from a GP relating to the same patient might arrive by email, requiring an equal level of manual intervention.

The same problem can apply to other unstructured documents. Invoices, purchase orders or delivery notes also arrive in a variety of different formats and demand time from back-office staff to convert them into meaningful information.

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Make AI do the filing Real efficiency can only be achieved when everything from admission forms to discharge summaries, and from purchase orders to delivery notes, can be categorised automatically. The technology to do this uses Artificial Intelligence within the scanning process. Instead of simply capturing an image, the software can look at the document, compare this against its own knowledge base and draw a conclusion about what type of document this is. In a clinical context, that might encompass anything from anaesthetic notes to referrals and observations.

The next stage is to extract essential information from the document. In the case of medical records, these might range from NHS number or case note number to date of birth or even pharmaceutical reference codes. Using text recognition technology, the software can capture these details and convert them into linkable fields, thereby adding the context that transforms a two-dimensional image into three-dimensional information.

In the words of one NHS Trust IT manager, ‘Now you can tell that X is the same as Y’.

Putting it all in context Artificial Intelligence is not instantaneous; it takes time for the software to build its understanding of different types of documents and to learn the range of identifying codes, text or numbers. As it does so, however, the amount of intervention required decreases

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steadily, until finally, it’s possible to put a record into a scanner and simply press ‘go’. Anything that the software is unable to identify definitively will be flagged and passed to a human for verification.

The result is a bank of electronic information, not simply a folder full of images. Instead of time being spent pulling files off shelves and delivering them to the other side of the hospital, it can be devoted to scanning, validating and reviewing patient records.

Administrative staff can devote themselves to delivering smoother patient journeys, while clinicians can be confident that they have all the information that they need about a patient in one place, instantly. And that means better patient outcomes.

A vision for the future: collaboration across all services Ultimately, we believe that the integration of records across the entire healthcare community will be achieved – between hospitals, GPs, social care, hospices, community services and possibly others. We still have a long way to go, but the COVID-19 crisis has reminded us how much we depend not only upon our NHS but upon our care system – and we owe it to the frontline staff to give everyone the infrastructure they need. L FURTHER INFORMATION www.ephesoft.com

Healthcare IT

Providing secure capability for patients to use health apps A key focus of the Long Term Plan is empowering people to take control of their own health care - creating a safe and secure means of accessing their health information is critical to that, says Melissa Ruscoe, head of the NHS login programme at NHS Digital One of the main barriers to patients making the best use of digital health services available to them is the challenge in accessing them, such as having to prove your identity in person or memorising multiple passwords. NHS login is a single, secure login that enables the public to access health and social care apps and websites wherever they see the NHS login button. It means that people no longer have to remember many different passwords – if their device allows it, they can even use device biometrics (for example fingerprint) to login and see their personal information.

With nearly 600,000 people having already created an NHS login, a figure that is rapidly rising each week, it’s clear it has massive potential to transform the health and social care sector. NHS login will help reduce administrative burden for GP practices - most patients can verify their identity online themselves without

the user that has signed up for them. The concept is very similar to logging in with Google or Facebook but requires the user to prove their identity even more securely because of the often-sensitive nature of the healthcare data or service they wish to access.

Before we created our product we tested and researched the user need with the public, and the message was clear: ‘I trust the NHS and if I have to do this to securely access a healthcare app, I want an NHS solution’. So, we set out to produce an NHS-branded identity solution Proving identity with NHS login that included the key controls of likeness and NHS login enables people to be matched to liveness checks to prevent masquerading. their healthcare records and gives We also needed to incorporate the integrating applications existing patient online capability the confidence that the What is to avoid users having to identify connections they make themselves twice if they’ve to healthcare data exciting so already gone through this stores and services a b out NHS log process at their GP practice. E are definitely for in the need to visit their GP surgery. Once created, it can be used for health and care apps and websites where you see the NHS login button.

What’s more, because NHS login was made by the NHS, people can trust it - they can also trust we will only use necessary data. Using official photo ID such as a passport or driving licence, plus a likeness and liveness check, a patient can easily prove their identity so they can be matched to information personal to them.

it encou is that and sup rages innovatports ion

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Making remote patient consultations the new norm In our Covid-struck world, video solutions have come to the rescue for industries far and wide. The importance of connecting virtually in a time when people are quarantined and isolated is slowly being recognised - and this is true for almost all domains that are in operation. Healthcare is no different. Video solutions that revolutionise healthcare by delivering services right into the patients’ homes are constantly evolving A better and faster patient care, with maximum use of internal resources, is the new norm.

General practitioners are having to change the ways in which they normally operate with one key modification being the increased utilisation of telephonic, audio, or video consultations. Many healthcare providers have stopped face-to-face appointments and even hospitals are exploring the use of video consultations to safely and successfully consult patients and provide care, all the while reducing unnecessary close contact.

These specialised tools developed as an answer to the questions puzzling healthcare, allow doctors to interact with patients over a video link to view and discuss symptoms, diagnose an issue and arrange treatment.

Appointments, prescriptions and many other activities can be taken care of in less than 10 minutes. Hospitals and surgeries can get the most appropriate medical professional involved quickly and easily to deliver timely medical interventions.

Safety of procedures While government advice is still under review, MDDUS has reassured people about the overall safety of using remote consultation procedures in these tough times.

Keeping all safety concerns in mind, it is a sensible approach that allows patients to get medical advice while protecting other patients, staff and clinicians from possible exposure to the virus. It also helps by reaching people who are not able to travel out of their homes or are self-isolating.

Flabba has developed one such specialised solution, known as Remote Patient Consultation, that uses the power of intelligent video tools to bring clinicians and medical professionals closer to their patients than ever before. Colin Rhodes, the founder of Flabba, went from being a trainee lawyer to being a consultant and then a recruiter before finding his calling leveraging video conferencing processes for various industries.

His diverse background, experience working with intelligent video solutions and a natural empathy for the healthcare space has helped him and his team come up with an apt solution in these trying times. It can’t be

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denied that the healthcare industry has never been in more dire need of efficient patient care solutions. With the number of cases on the rise, and the number of doctors being constant for the most part, it is important to ensure to not overwhelm healthcare providers and at the same time not neglect the patients.

Flabba’s solutions simplify booking consultations and make collaboration with other healthcare professionals easier. Flabba are UK Government Security approved.

Benefits of remote consultations The benefits of remote consultations can’t be overstated. In a world that’s under Corona’s influence, it becomes all the more important to go remote and online. Going the virtual consultation route will slow down the transmission of Covid by eliminating the need for patients to rush to hospitals and expose themselves to a possible infection.

Further, it allows doctors to talk to people who are in isolation or have travel constraints but are in need of medical assistance.

These solutions will also relieve healthcare workers of excessive stress and constant motion by allowing them to work remotely and from a safe distance. Remote consultation can also be scaled up, unlike physical consultations, therefore, even as the demand rises, remote consultation will be able to tackle problems better than having doctors physically consult patients.

Remote Patient Consultation makes it possible for healthcare providers to

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assist people who need the most medical guidance by reaching out to them from the comfort of their homes. Managing bookings, sharing important documents and providing consultation - all of it is virtually possible by making use of a solution like Remote Patient Consultation. The solution allows doctors to guide patients as easily as if they were sitting in the same room right by their side. It transforms the legacy and practice of consultation by using intelligent video solutions. Apart from that, it also comes with many additional features to streamline the workflow and simplify the process further.

In this day and age when healthcare is a primary concern for countries around the globe, it is important to take a step in a direction that promotes a safer environment. At the moment, with the fear of corona spreading fast, the safest route to keep both healthcare workers and patients from any possible harm is to set up virtual solutions that are sophisticated enough to replace the existing approach.

While what lies ahead is fairly uncertain, the best we can do is to improve upon what we have today. By staying calm and doing what is needed, we can curb the spread of the disease and pave the way for a much brighter future. And in that regard, Remote Patient Consultation is one sure step closer to it! L FURTHER INFORMATION www.flabba.com

 Balancing security with simplicity We’ve had to navigate a balancing act between security and simplicity as people don’t want to go through a lengthy process of verifying who they are. In the same way people find it a bit onerous to complete a passport application or go through airport security because they just want to get straight to their long-awaited holiday, people just want to swiftly access a new app that they’ve seen or that’s been recommended to them.

People can now create an NHS login in a straightforward intuitive way by going through a short ‘prove your identity’ journey involving a photo of an identity document and an additional ‘liveness’ check that confirms they are a real, live, human and match the identity document, in addition to some basic name and address details. The liveness check, often a video or facial scan, is a key component as it replicates people presenting themselves for identification when they require non-digital access or entry to services such as passport control at an airport and can be used to ensure users are not being coerced or trying to access services with fraudulent documentation.

We cross-check the information and then send an email to let the person know if they have been successful – all very straight-forward as most of the public has easy access to the right details and documents. Whether they use this method, or enter their existing patient online details, it takes in the region of six minutes for the majority to complete the ‘prove your identity’ journey, and on average under 45 minutes for identity checks to be completed and a decision returned.

We are continually working on ways to make creating an NHS login even more accessible for people. We work closely with health and social care organisations to ensure that they know about and can explain the considerable benefits of having one single NHS login to patients. Areas we are working on include other NHS staff and related staff groups (for example pharmacists) being able to vouch for a patient’s identity later in 2020/21.

Healthcare IT

Enabling users to verify their identity at a level that is consistent with the transaction they are undertaking will speed up the transaction process between the user and the digital service Exciting future developments on our roadmap include proxy and delegated access to support family members or carers wishing to set up or access an NHS login for dependents. Multi-tiered identity verification will support the use of NHS login by more integrated services - for example, the NHS App can show users their medical record and so requires the highest level of security, but a service that enables an e-consultation may not need to display a record, so a lower level of identification could be offered. Enabling users to verify their identity at a level that is consistent with the transaction they are undertaking will speed up the transaction process between the user and the digital service.

Providing this secure capability for patients to safely use health and care applications supports a growing need for using technology-led, innovative ways to access our health data and the services the NHS provides.

In the longer term, ‘Continue with NHS login’ has the potential to become recognised as a industry leading example of online ID verification and authentication product, and one we can see being used by millions of people across a wide variety of innovative platforms and services. L FURTHER INFORMATION https://digital.nhs.uk/

Inspiring the sector to deliver new innovations What is so exciting about NHS login is that it encourages and supports innovation. NHS login can be used across a wide range of digital health products, increasing the options for the public to have greater control over their health and care. Seven products are now live and this is set to increase rapidly during 2020. We have worked in collaboration with the first organisations to use NHS login, to create a comprehensive integration toolkit to support developers to work on the requirements to integrate NHS login in their products.

We know that there’s still a lot of work to for us to do. The learning we’ve gained and the feedback we’ve heard will continue to shape our solution. Using a combination of user, supplier and analytics feedback, we’re constantly evolving our product. In the short term, we need to offer a solution for people who are not able to use digital identity methods, but still want to receive the benefits of NHS login.

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Technology

Reliable indoor mobile coverage during lockdown Colin Abrey explains why uninterrupted 4G coverage in public sector buildings and other pop up facilities cannot wait As Covid-19 lingers on relentlessly mobile telecoms and home broadband services are providing society with some semblance of normality. Everyday life involves homeworking on a level the world has never seen, socialising virtually via House Party, Zoom or similar is the new normal, videos are being streamed like they’re going out of fashion and phone conversations are, on average, 35 per cent longer than they were before lockdown.

As such, never has there been a greater need for reliable mobile coverage in any commercial, residential, or mixed-use building. This holds particularly true for the Nightingale hospitals, and other pop-up facilities being constructed to aid national efforts to flatten the curve the pandemic.

Telecommunications declared a critical sector Telecommunications has already been identified as a critical sector and there is an urgent requirement for uninterrupted voice and data coverage inside hospitals and care homes. It’s one of the core technologies underpinning safetycritical communications; it’s essential to first responder communications, to the quick mobilization of in the field teams and it’s continuously used by paramedics and other blue light services. 4G is also poised to replace the

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legacy safety critical communications network, Airwaves, as part a crossparty reform to update our emergency services network (ESN). Uninterrupted mobile coverage will therefore become fundamental to every aspect of safety critical communications inside buildings.

Smartphones and tablets are also playing an important role on the wards right now by enabling patient to keep in contact with their families and loved ones now that visiting has all but stopped.

Ubiquitous mobile coverage is central to the smooth running of both; in large field hospitals voice and data services facilitate swift admissions and a positive patient experience. Video calls are replacing real-world visitors and are helping patents overcome feelings of isolation.

Even more importantly, a good communications network enables effective internal communications, thus permitting hospital doctors, nurses and clinicians to make sure that vital supplies and equipment are where they need to be.

Pop up facilities to support frontline staff In pop-up supermarkets and pharmacies, reliable mobile coverage allows instore The role of mobile in staff to liaise with stockroom and Nightingale hospitals distribution centre teams so that More than ten temporary shelves can be replenished. hospitals have been built A strong 4G signal also across the UK in just supports automated A good ns io a few weeks thanks vending machine t a ic n u to the efforts of replenishments comm les effective ab n construction and cashier-less e , s k r n o io t ica netw n u workers, the army, payments, thus m m co electricians, minimising staff internal mitting hospital s r n e ia plumbers and levels. Most p ic s n u li th and c s e telecoms engineers. importantly s r u n l , a In parallel, a number ubiquitous mobile doctors ke sure that vit t of supermarkets coverage is a to ma nd equipmen a s are setting up pop basic health and e li d supp ey nee h t up stores in their safety requirement e r e h are w immediate vicinity in the warehouses to be to serve NHS staff and and distribution centres other front-line workers. serving these temporary

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facilities, yet many have inadequate coverage because of their sheer magnitude and perceived high costs involved.

Wi-Fi not a viable option in temporary hospitals While many of the buildings being repurposed into Nightingale hospitals already have a preinstalled communications infrastructure, it’s more than likely been designed for very different purpose. Wi-Fi is often seen as the preferred option, but implementation can be complex and does not deliver the performance and quality required for voice calls and current demand for video conferencing. These facilities need voice and data coverage now. The UKs different operators (MNOs) are already working together to meet surges in demand and there’s also provision for additional capacity, should the need arise. However additional capacity does not necessarily equate better coverage inside a large building because mobile phone signals are weaker by default inside any building because materials like metal, glass, iron and reinforced concrete hamper their penetration.

Conventional hospital buildings are prone to having poor to non-existent 4G coverage due to the sheer number of internal corridors, clinics, wards, stairwells and basement areas, all of which are notorious mobile black spots. Many of the warehouse and exhibition halls being converted into hospitals may also have

It is crucial that any facility being converted, repurposed or developed to support key workers in their struggle to bring coronavirus under control have unprecedented access to reliable indoor mobile coverage network, regardless of the provider or location limited mobile coverage because of their enormity and coverage is often limited to offices, canteens or break out areas.

Taking the outside network indoors is not that complicated The only way to overcome the mobile coverage problem is to take the outside signal indoors using supplementary signal boosting equipment. This has not always been plain sailing either because of long implementation times, cost and strict licensing laws about their usage. Fortunately, thanks to a relaxation in the mobile repeater rules by Ofcom, this is no longer the case.

The caveat is that any installed equipment must satisfy the regulator’s mobile repeater licence exemption spec and not many do.

Mobile connectivity has long been a key pillar of modern society, but in recent weeks we’ve seen its value more starkly than ever because of the assurance it offers in these

Technology

Sponsored by

uncertain times. It is crucial, therefore, that any facility being converted/repurposed/ developed to support key workers in their struggle to bring coronavirus under control have unprecedented access to reliable indoor mobile coverage network, regardless of the provider or location. L

Colin Abrey is Vice President, Channel Sales for the EMEA region at Nextivity. He has spent more than 30 years in wireless and international telecoms industries and held senior positions with several leading companies operating in this space. He has deployed many large-scale in-building projects, including airports, convention centres, hospitals, malls, commercial buildings, sports stadia and hotels.

FURTHER INFORMATION www.nextivity.com

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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R

Improving Hospital Efficiency through Excellence in Managed Services

enquiries@genmed.eu

0345 450 2204

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Procurement must become centre stage in the NHS if we’re to cope with the public health demands of the nation Jonathan Wedgbury, Genmed’s chief executive officer, provides advice about how NHS supply chains and procurement strategies need to change following the coronavirus disease pandemic The English lexicon has changed markedly in light of the worldwide coronavirus pandemic with language like social distancing, lockdown, viral load and furloughing all now in common parlance. Perhaps what is surprising is that words like ‘procurement’ and ‘supply chain’ have been heard equally as frequently. The media headlines around the whole issue of personal protective equipment (PPE) for frontline clinical staff have been beamed into homes up and down the country on a nightly basis.

Undeniably there have been issues. Reports of medics finding it harder to access any sort of PPE, manufacturers talking about unanswered emails for equipment orders, hospitals running out of items, planes sent to Turkey to collect emergency supplies, and a failure of demand management, all adds up to a steady stream of headlines that haven’t painted a pretty picture of the profession at times.

Clearly there are mitigating reasons for all this and answers as to why things occurred are never simple. Frankly, we’re living in exceptional and unprecedented times. Most of us could not have imagined a couple of months ago how we would be living today. Furthermore, the NHS is a complicated, fragmented, multi-faceted organisation – a diverse entity with numerous needs and requirements, hampered by a history of financial pressures. Even more diverse and complicated is the social care sector where we have seen equally harrowing headlines.

So, and with the benefit of hindsight, we should take the opportunity to learn from what has happened and use this to see what can be learnt to move us forward positively.

How we can use the current experience to transition and run the NHS for the better and prepare for when Covid-20, 21 or 22 – or some other virulent virus - comes along?

First, this is a great opportunity for procurement to demonstrate the strategic role it has to play in NHS activities. No longer should it be seen as simply as an enabler to get medical supplies ordered, ensure that that the lowest price is paid and that invoices are settled. Procurement has a much more important role to play assessing, for example, what are we buying and why, where we get items from, understanding the power regimes in the marketplace, are alternatives reviewed thoroughly, can IT be used to boost order efficiency and so on. And it should even

include getting into the granular detail of what each NHS department or consultant spends on a per patient basis so that productivity improvements can be identified and targeted.

As part of this, greater strategic sourcing initiatives are required to examine the relevant attributes from sourcing from multiple providers, how inventory is managed over time to ensure stock is rotated properly and is within ‘shelf life’. Further, we should review our reliance on overseas suppliers or whether local sourcing and the development of UK manufacturing should be a bigger part of the product buying mix.

Shining a light on procurement is not new.

Improving procurement processes was the focus of Lord Carter of Coles’ report on operational productivity and performance published back in 2016. The NHS has seen many changes as a consequence, but perhaps in certain areas we haven’t gone far enough to challenge existing practices and check their robustness?

Second, supply chain resilience will become the new topic for discussion. Good practice regularly involves a thorough audit of chains so that there’s a detailed and comprehensive understanding about the source of equipment and consumables and therefore a clearer appreciation about the NHS’ ability to react, cope and maintain services in the event of a health crisis. In-depth risk analysis and due diligence of suppliers has to be carried out to know precisely where products are made, are they fit for purpose, whether they meet legal, medical and ethical standards, the different logistics steps in the delivery chain to get them from site of manufacture to UK hospitals, the risks associated with this, suppliers’ financial stability and capability to truly deliver contractually and so on. It is all about understanding the robustness of the supply chain and how you de-risk and mitigate any issues found so as to avoid scrabbling about to find items in an emergency – or even day-to-day – when demand is at a premium.

Third, the pre-occupation with price needs to be balanced with ‘value’. For example, what is the impact of not being able to buy PPE now? The answer is that we are probably spending between five and 10 times more getting it from elsewhere in the world and air freighting it home. And then, of course, there is the impact on the health, confidence and happiness of clinical staff – let alone the

Jonathan Wedgbury, chief executive officer, Genmed

patients themselves - when it comes to hands-on treatment. A greater awareness, sensitivity and acknowledgment of this must be on the agenda.

Fourth, as we come out of Covid, NHS managers will need to review the whole medical ecosystem to look at how procurement and the organisation of it can be improved for the country. More than likely shared services will play a bigger role with the private sector engaged to assist based on their subject expertise. Inherent in this is that there should better pooling of resources and co-ordination between the Department of Health, NHS Supply Chain and third party organisations probably via a shared services collaborative platform. This should be bolstered with ‘pushing and pulling’ of information across the whole NHS system so that co-ordination of procurement activities is enhanced.

Whilst the recriminations around what was and was not done and the timeliness of these efforts will be with us for a while, as a profession procurement has an opportunity to take some positive lessons from what has been an unprecedented few months for the whole world. It would be remiss of us if we didn’t take this opportunity to adapt and learn from the coronavirus experience and change our approach to procurement in the NHS. We need to adopt best practices regardless of which industry we take it from, create the right industry partnerships and collaborations and hire the right people with the expertise and know-how to drive things forward effectively. Through this we can achieve the performance, efficiency and value for money that the NHS deserves. L FURTHER INFORMATION www.genmed.eu

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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HETT

The UK’s leading digital health event HETT is the leading platform to connect digital, operational and clinical leadership and buyers from across the UK health sector with suppliers of new technology, services and innovations. Here, we look at the four agenda tracks for September’s event

Taking place from 29-30 September 2020, HETT, the UK’s leading healthtech and digital health event, will connect the entire healthtech and digital health ecosystem and be the destination of choice for healthcare organisations looking to adopt and invest in the digital revolution.

Attracting 4,000 attendees and in excess of 140 exhibitors, HETT is the leading platform to connect digital, operational and clinical leadership and buyers from across the UK health sector with suppliers of new technology, services and innovations.

With hundreds of face-to-face meetings onsite, endless networking and learning opportunities and interactive features, HETT is the must-attend UK healthtech event of 2020.

In light of the ongoing coronavirus pandemic, the organisers of the event, GovNet, maintain that they have no plans to postpone or cancel HETT 2020, and will ensure that all sensible steps to make sure HETT 2020 proceeds safely and successfully.

However, extra steps will be taken.

In line with the World Health Organisation’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses, HETT is introducing new measures at the show to increase the safety of all attendees. Hand sanitisers will now be provided at the registration desk at the events, in addition to hand sanitation already installed in all toilets and washrooms.

Extra signage will also be noticeable around the event to promote high hygiene standards.

A digital agenda HETT 2020 contains four main agenda streams, covering: Digitally Empowered Patients;

patient representatives; and online triage, self-triage and prevention models of care.

Speakers within this stream include: Ross O’Brien, Digital Innovation Director at Central and North West London NHS Foundation Trust; and Nicola HaywoodAlexander, Chief Information Officer at Portsmouth Hospitals NHS Trust.

Culture & Implementation; Integration & Interoperability; and Digital Maturity Forum.

Pressures on the NHS are greater than they have ever been, and patients are Culture and Implementation at the centre of every decision made in Building solid infrastructure and taking health and social care. An increasingly incremental approaches to transformation are digital world means there are higher crucial to achieving operational excellence expectations from patients around the in digital transformation at scale. No use of up-to-date technology, online transformation project can succeed without provision of care, and how their data is aligning the vision across an organisation managed by healthcare organisations. and ensuring clinicians are engaged with By creating models of care and treatment digital teams, from both a leadership that empower patients, focus can and front line perspective. be turned to prevention and Explore the tools needed engagement with services to build your digital-ready that support personal The workforce and create health through both evolutio the right organisational illness and wellness. n new m of o culture, developing The Digitally d e l s of care have dr the workforce whilst Empowered for bett iven the need reducing technology Patients track will er infor burden and burnout. cover: IoT, apps mation sharing This track will include: and wearables b etween differen arming the clinical and for remote t IT workforce with the treatment and organiscare settings, right digital skills; digitally patient monitoring, ati geogra ons and literate commissioning, hospital and phies procurement and funding; community; how to NHS Digital Academy taster evaluate digital health sessions; HEE Topol Fellowships products and interventions; and TEL Programme; diversity and Personal Health Records (PHRs) bias, and ethical implications of work; and and improving patient pathways; the view from the frontline – nurses, AHPs, digital inclusivity, digital skills and humanpharmacists and dentists E centric service design; perspectives from Issue 20.2 | HEALTH BUSINESS MAGAZINE

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HETT

 Confirmed speakers in the Culture and Implementation stream include: James Freed, Chief Information Officer at Health Education England, Sara Gorton, head of Healthcare at UNISON; Rizwan Malik, Consultant Radiologist at Royal Bolton NHS Foundation Trust; Rachel Dunscombe, Chief Executive Officer at the NHS Digital Academy; Jennifer Dixon, Chief Executive Officer at the Health Foundation; Paul Jones, Chief Digital and Information Officer at Leeds Teaching Hospitals NHS Trust; Gareth Thomas, Chief Clinical Information Officer at Salford Royal NHS Foundation Trust; and Matthew Gould, the Chief Executive Officer for NHSX. Integration and Interoperability The emergence and evolution of new models of care have driven the need for better information sharing between different care settings, organisations and geographies.

In turn, effective data sharing between healthcare providers and patients, so that they can receive joined-up, integrated care, has never been more important.

This track will provide valuable insights for digital health leaders on how to achieve interoperability at scale, as well as deliver the benefits to patients, including: the pathways from STP to ICS, and the formation and delivery of PCNs; open standards and APIs, technical interoperability, and cloud-based data sharing; standard setting for clinicians and technology users, and benchmarking for integrated care; shared care records, LHCRs,

Building solid infrastructure and taking incremental approaches to transformation are crucial to achieving operational excellence in digital transformation at scale and the potential to develop mature record sharing at a national level; best practice approaches to delivering integration projects, working collaboratively across organisations, and effective cyber security and information governance; and common challenges to EPR rollout and delivering accelerated and maintained progress, plus gaining buy-in from clinicians and eliminating workarounds.

Within this agenda stream, speakers include: Rhidian Hurle, Chief Clincial Information Officer at NHS Wales; Terence Eden, head of Open Technology at NHSX; Glen Hodgson, head of Healthcare at GS1 UK; Dylan Roberts, Chief Digital and Information Officer for Leeds City Council and Leeds CCG; Simon Eccles, Chief Clinical Information Officer at NHS England; and Mark Hutchinson, Chief Digital and Information Officer at Gloucestershire Hospitals NHS Foundation Trust.

Digital Maturity When it comes to digital maturity, a select number of advanced organisations are leading the way. This track asks how the rest of the health system can catch up to the front runners and how advanced

sites are pushing forward with innovation through the latest and emerging tech.

Learn actionable insights from mature sites to establish the basics and create a foundation for future digital development, including: accelerating adoption of AI and machine learning, including regulatory updates; AR and VR use cases; scaling up and spreading success from GDEs and Fast Followers using blueprinting; benchmarking digital maturity in primary, secondary, community and mental health settings; disrupting the status quo and engaging with innovators in industry; and utilising robotics, 5G and future technologies to improve healthcare delivery.

Confirmed speakers include: Piers Ricketts, chair of the AHSN Network; Tom Stocker, policy manager for Innovation in Care at the Care Quality Commission; Ian Newington, head of Special Projects for the Health Innovation Challenge Fund, part of the National Institute for Health Research; and Indra Joshi, director of AI at NHSX. L FURTHER INFORMATION https://hettshow.co.uk/

Experts in informed consent and peace of mind

Efficient multi-device charging stations for healthcare providers

With over 700 hospitals already using EIDO Healthcare’s Inform consent to treatment library, EIDO’s new digital tools are set to change the consent landscape – the patient experience will improve significantly through ‘early learning’ about the procedure at home and no unnecessary time in hospital.

Informed consent will be more rigorous, more robust and more defensible and the frequency of consent related claims and litigation payouts will be set to decrease.

A Consultant Surgeon at a major University Teaching NHS Trust said: “These (EIDO) information sheets have made the whole consent process more robust….continuing with good, clear information sheets should be a no-brainer for the trust - I speak as somebody who is currently involved in a medico-legal case that revolves around the information given at the time of consent!

LocknCharge has solutions ideal for the increased use of mobile devices within the healthcare community. The company has a variety of secure charging solutions that can improve efficiency, protect patient information, improve patient satisfaction, enable communication and much more.

The deployment of mobile devices throughout the healthcare field is quickly expanding. 85 per cent of organisations are currently in the research or pilot phase of a deployment–many of which are implementing mobile devices with the goal of improving communications, reducing costs or increasing revenues.

Would it surprise you learn that 73 per cent of organisations fail to plan how they’ll centrally

“I would therefore urge that the trust now agrees to fund the EIDO information sheets, so that we can continue to provide this essential information for patients.”

Another CDIO of a major London Teaching NHS Trust simply labelled the company’s products as a ‘game changer!’.

To start your consent digital transformation or just for more information, please contact EIDO Healthcare via the details below.

FURTHER INFORMATION Tel: 0115 8781000 info@eidohealthcare.com

charge and secure those devices, prohibiting their program’s ability to achieve intended results?

Statistics show that 10 per cent of devices break or go missing each year of a deployment, which may be avoided if the devices are centrally secured and charged.

This critical oversight can create painful hassles for employees and administrators alike. LocknCharge exists to help organisations rise above the rest and achieve deployment objectives by offering a mobile charging station to streamline device deployment and secure your investments.

FURTHER INFORMATION Tel: 0208 441 4107 www.lockncharge.com

Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Digital healthcare: Why haven’t you got started?

Health Business (HB) talks to Vijay Magon (VM), managing director of CCube Solutions, about the current state of digital transformation within the NHS and how EDRM systems can support greater patient engagement with health records

HB: Paperless healthcare has been somewhat of a ‘buzz phrase’ for the NHS and healthcare services for much of the last decade. Amid the wider digital healthcare push, why is now the right time for health organisation to make the paperless shift?

VM: Using technology to improve healthcare delivery and patient care has been a hot topic over the last several years. Technology is not just making its presence felt in operating theatres and hospital wards - NHS trusts and PCTS are quickly becoming aware that being able to access, store and share patient records is as crucial to improving patient care as the latest breakthroughs in medical science. The need for an efficient and effective information management system manifests itself across all levels of modern healthcare provision. It

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encompasses everything from Most NHS sites still hold patient consultants and surgeons related data on a variety of Given accessing x-rays and scans different media, such as paper, from workstations across microfilm and digital. It the consum a hospital complex, is currently very difficult erisatio ending the need for to identify exactly what n o f IT, syste cumbersome transfer information may be held ms have be of paper records on a given patient. This c o m e more afforda from site to another, has resulted in falling ble and with the incumbent standards for maintaining a d re elive risk of them being the patient’s acute medical and mering real misplaced or lost; to record; increasing risk a su administration staff and leaving patients and benefit rable saving time by using clinicians at a disadvantage. s templates and electronic Furthermore, there are many wellforms pre-populated with a known issues related to paper-based patient’s details when sending out delivery of care, such as: physical handling, appointment letters; and by capturing transport of paper records, and transmission electronic patient information at source, of infection; lack of audit on who looked at make a real impact on the production and any record; only one person can see a record dependency on paper. at any time; cannot easily share records

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

HB: Digital transformation can become a never-ending ambition for organisations, with the potential to make more efficient services always progressing quicker than organisational change. In light of this, how important is managing the transformation?

VM: Lessons have been learnt through careful application of the available technologies.

Given the consumerisation of IT, systems have become more affordable and are delivering real and measurable benefits.

There are three key points to keep in mind: Firstly, it is vital to understand that simply digitising paper records is not enough – the solution must offer facilities to stop producing new paper through generation, management, and integration of ongoing (electronic) records - in order to minimise or eliminate the paper chase.

Secondly, patient information resides on many disparate systems within trusts – information that is relevant to the patient and should be presented along with the digital record, at the point of care. The electronic medical record cannot sit in a document management system that remains un-connected with other hospital systems and processes – information must be exchangeable and shareable. This includes sharing with primary care – access to primary care data by users in acute trusts as well as access to the acute record by GPs Lastly, to be optimally effective the electronic record has to be delivered to key users when and where they need it. A solution which offers a standard interface for all users will provide limited functionality to most users.

NHS trusts must adopt a more holistic approach for content management - to develop and provide integrated solutions that use EDRM as the underlying technology to capture and deliver electronic patient information at the point of care. The returns from investments in EDRM are being realised through careful application of this technology to address the needs of key users who deliver medical care rather than shortterm measures to solve paper problems.

Key users include clinicians, secretaries, administrators, etc. Each places specific demands on the medical record, and each of these demands must be addressed.

HB: For those organisations behind the pack in bringing about digital transformation, what are the key considerations that must be addressed before being digitising records and processes?

VM: Organisations looking to digitise legacy records have to meet a variety of business objectives which may include: cost related to maintaining existing record libraries; pressure on storage space, especially if moving to a new site; operational costs - finding and delivering records, especially across a number of geographically distributed sites; strategic objectives related to operational performance and efficiency gains; and customer services, among others.

Each organisation will assign its own priorities for scanning and build a business case within an agreed cost framework. If this points to digitising a given volume of existing records, a budget will be agreed.

Note that new information does not fall into this category – this includes the increasing proportion of information generated and accessible electronically. The benefits seen from application of document management technologies for new and ongoing information are real, tangible, and beyond debate.

However, it is important to align digitisation of legacy records with specific processes within a trust, rather than simply digitising

Interoperability is also a key consideration.

Once existing paper and electronic repositories are captured and managed, it is important to ensure that systems no longer feed storage sub-folders, ie. new patient information can be captured at source, managed, and delivered without resorting to paper. Integration between multiple IT systems and devices that generate patient information must be mandatory. This include medical devices that record vital signs – a key area of concern as currently, most medical devices work autonomously, ie. data from medical devices is (manually) transcribed and re-keyed into IT systems for reuse, or simply printed and saved on paper, adding to the scanning volumes.

Covering data collection, hospital data systems hold a wealth of patient information, yet data entry is duplicated on a daily basis.

Electronic Forms extend the functionality offered by current paper forms - to design and publish web based forms which contain intelligence in the form filling process. The completed forms are automatically captured and saved in an electronic repository where they can trigger workflows for post-capture processing. Furthermore, and specifically with eForms, data captured within forms is available as electronic and machine-readable data which does not require recognition and which can be re-used multiple times within back-end systems. This offers the potential for huge savings in administration and for automating clinical workflow processes.

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without copying; lack of compliance, especially GDPR; lost records; and escalating costs associated with handling physical records.

The implementation of an electronic system turns around the culture of information. Much like the founding principle of the NHS, the modern information management system provides a ‘cradle to grave’ auditable trail of legacy documents such as patient records and correspondence. Implementing an electronic information management solution delivers the proverbial ‘double whammy’ of improving accessibility, whilst ensuring that healthcare providers like NHS trusts and PCTS are fully compliant with their legal obligation in storing healthcare records.

Most NHS sites still hold patient related data on a variety of different media, such as paper, microfilm and digital. It is currently very difficult to identify exactly what information may be held on a given patient records to alleviate problems related to storing and using paper. For example, the ‘scan-on-demand’ approach applied to the Outpatient process has enabled some trusts to realise very tangible benefits including year-on-year cost savings while delivering ‘paperlite healthcare’ – a good example of process mapping and application of the right IT solution.

Advances in recognition and classification technologies offer a way forward for trusts to keep the cost of digitising legacy case notes to a minimum and provide a more acceptable solution for practitioners, ie. systems that take away paper from users must provide clear advantages and a compelling case for not using paper rather than simply replacing paper with an electronic image.

Key considerations include streamlining and minimising dependency on paper. Electronic solutions cannot replace all paper-based processes. While the exponential rise in apps, mobile and wearable devices, and electronic recorders is making a serious dent on our dependency on paper, these do not offer practical solutions for everything.

HB: Outside of the hospital setting, how does Electronic Document & Records Management Systems help to improve accuracy and efficiency in primary care?

VM: The above examples have focused on records management in hospitals. Turning to GPs, CCube Solutions is involved in a significant primary care initiative called eLGS. Capitalising on its experiences digitising records at several hospital sites, CCube Solutions partnered with one of the trusts to offer its know-how in primary care.

We launched a fully managed service to digitise all the patient records which GPs have to keep in their surgeries - colloquially called Lloyd George notes. The eLG service includes collection, digitisation, hosting, training, and the software GPs use to access the information on their desktops. This initiative is about releasing more space in primary care, enhancing GP and practice staff productivity and removing a whole paper shuffling industry in primary care which in E Issue 20.2 | HEALTH BUSINESS MAGAZINE

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 itself costs millions and millions.

To date, four CCGs have purchased the service with around 120 GP practices now using the system.

HB: much of the push towards paperless records focuses upon efficiency and time savings, but what are the financial advantages for cash-strapped health organisations?

VM: Given the bad press about large scale IT implementations, two valuable lessons must be learnt. Firstly, not all trusts are ready for the top end solutions – each must accommodate the technology and its implementation gradually to suit a number of local conditions including budgets, IT infrastructure, user training, etc.; and, secondly, a core application cannot be driven top-down without involving the people who will actually use it and who will be held accountable.

While it is good to see that government directives are accompanied by a financial commitment, each trust must make its on case for improvement and demonstrate willingness to change. Simply throwing money at a problem will lead to yet another IT failure. The bottom-up approach means that the digital revolution in the NHS is achievable - gradually and over time rather than committing astronomical sums on large scale IT projects.

The NHS has set a target to be paperless – many trusts, Health Boards, and primary care practices working with CCube Solutions have already digitised hundreds of millions of records, saved time, money, and improved patient care, and are now ready for the next exciting wave of digital transformation, which will include: sharing of information using established Open Standards, between systems, professionals, and patients; the use of AI for understanding the huge volume of digital content now available; the use of Electronic Forms for data capture at the point of care; and access to digital records using Smartphone Apps – anywhere, anytime.

The outcomes are impressive – several trusts using the CCube EDRM have shown real savings to the tune of c.£1 million per year per site after Go Live. Collectively amongst such sites we estimate savings of tens of millions of pounds delivered back to the NHS! The invest-to-save strategy is working!

HB: Given that the first target for a paperless NHS is nearly two years missed, how is CCube Solutions helping keep trusts and primary care organisations on the digital road?

VM: Top-down directives for paperless healthcare stretch back to 2015 when Health Secretary Jeremy Hunt issued a timeline for the NHS to be paperless by 2018. Hunt wanted patients to have digital records so that their information can follow them.

But unlike previous large scale, top-down directives, he wanted this driven bottom up and by 2018 any crucial health information should be available to staff at the touch of a button. Well, we’re not there yet although

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good progress has been made so its worth looking at what has been achieved and learn from these leaders, rather than ponder why trusts have not started on the digital road.

A number of trusts took the bold step towards paperless healthcare some years ago. These trusts achieved paper lite health care through careful application of the available technologies paying great attention to the underlying processes.

The results are real and measurable: - Process efficiencies: savings gained through process efficiencies achieved by minimising dependencies on paper, by delivering the electronic patient record to those who provide care, at the right time, every time, and by guaranteeing the accuracy and quality of information delivered. St Helens and Knowsley NHS Trust has all of its patient records accessible online for doctors, nurses, GPs, and community services.

vast amount of information locked in paper records is now being transformed into actionable data using artificial intelligence – that can understand content (language), predict, and deliver that content to those who need it, when and where they need it.

These are no longer predictions. We have access to real data complied over the last few years – data that makes the case for going digital compelling. Working very closely with a number of trusts, we have helped three to achieve ‘paperlight’ healthcare, with development projects under way to remove that last bit of paper in Outpatient Clinics, to deliver paperless healthcare.

EDRMS in the NHS is all about transformation and presenting information contained on paper to clinicians in a much more efficient and effective way. Ease of use is crucial. Doctors have to be able to interact with the system in front of patients without it creating any unnecessary

It is important to align digitisation of legacy records with specific processes within a trust, rather than simply digitising records to alleviate problems related to storing and using paper - Real Estate: savings gained through realisation of real estate to provide more treatment facilities and better quality of care. This is not limited to space realisation within acute trusts – most GP practices hold volumes of paper records which are of little use while delivering patient care; these have to be kept for a variety of legal reasons – the recently launched e-LGs managed service is a great example of how a very ‘low-tech’ service is helping GP practices to release much needed space in the surgery for clinical activities, and offer a better service to patients, without breaking the bank.

delays which could make consultations longer. Usability and effectiveness is very important which is what you get with the CCube EDRM software.

The key message is that careful application of established technologies is delivering measurable improvements and benefits.

These must be applied to address strategic requirements, rather than as a shortterm measure to solve paper problems.

The technology is not rocket-science, but has evolved gradually as customer demands, interoperability, and web accessibility have become ubiquitous.

- Access and Control: digitising patient records makes it easier to control access to information contained within the records and for sharing that information. The Hunt directive of ‘information following the patient’ is both practical and readily manageable.

HB: How can EDRM support greater patient engagement with health records? Can it be used with patient portals, meaning patients can get access to their own records?

- Innovation: one step leads to the next – innovation is within reach instead of being unreachable. Advances in IT and the consumerisation of IT mean that rapid progress towards the wider digital revolution can be made within the NHS IT, to help deliver timely and accurate information, for recording information electronically and completely bypassing paper so that once the paper mountain is tamed, we don’t generate any more.

Use of electronic forms, to capture, store, manage, and deliver information electronically (and in many cases via automated processes) where its needed, when its needed, every time. Similarly, the

VM: This is definitely the next step and its starting to happen. At CCube, we are working on patient-portals that will help improve patients’ access to their own medical history, care, etc. and help patients get involved in their own medical treatments – improved patient engagement means Trusts have to spend less reaching out to patients.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

HB: How are EDRM systems evolving?

VM: EDM started as very basic electronic filing of scanned images, developed into EDM which included support for e-Docs – electronic files such as WORD. Excel. PDF, etc.

Simply throwing money at a problem will lead to yet another IT failure. The bottom-up approach means that the digital revolution in the NHS is achievable - gradually and over time rather than committing astronomical sums on large scale IT projects HB: What further improvements and innovations are likely to be introduced? Where will they sit if we reach a stage where the majority of organisations have a full electronic patient record in place?

VM: EPR systems are designed to deal with structured information – not unstructured content which resides in documents. EDRM systems deal with un-structured content. This leads to a union of the two systems, a happy marriage where EDRM can ‘serve’ unstructured records into EPR systems – we have developed click-through functionality from EPR to EDRM

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along with functionality for creating new documents within EDRM, version control, etc. Records management functionality for managing the document-life-cycle was integrated within EDM to provide Electronic Document & Records Management - EDRM. EDRM provides a robust platform for a compound document repository which includes capture and management of the document life-cycle – retention & disposition.

It includes access & control security, auditing, reporting, etc. and can also provide tools for creating new documents within EDRM. Such a platform will serve little more than passive access to the documents it holds, ie. little operational advantage. EDRM has always needed additional application layers above the baseline platform to deliver business benefits, for example by adding a web portal that supports a clinician’s role in Outpatient clinics, EDRM can deliver real tangible benefits to patient care.

Adding additional functionality like eForms, Workflow, content extraction and content management extends EDRM and provides solutions for defined applications.

So EDRM is moving towards a ‘content services platform’ – underpinning and delivering structured and un-structured content wherever its required.

and from EDRM into other patient repositories, helping to deliver a unified patient record.

EDRM provides all the established services including life-cycle management and compliance with legal guidelines (such as BS10008) – both structured and unstructured content. Its ideal for providing content services, it is rule-based and very flexible. It is also Cloud based offering SaaS capabilities – both Cloud and Hybrid-Cloud - opening up possibilities of sharing records between organisations, care centres, …. ‘Blockchain’! L FURTHER INFORMATION www.ccubesolutions.com

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In case of emergency, flex framework NS2 had been designed to better support public sector organisations in their drive for further technological change. Redcentric was among those new suppliers, winning a place on all nine of the telecommunications and network services lots it applied for

Last summer the £5 billion Network Services 2 (NS2) purchasing framework went live, replacing Network Services 1. It is used by all the UK public sector, associated bodies and agencies, the voluntary sector, charities and private companies acting on behalf of the public sector to deliver public services.

With the onus back then very much on supporting digital transformation, efficiency and innovation, NS2 had been designed to better support public sector organisations in their drive for further technological change: a richer service portfolio and wider choice of approved suppliers would improve flexibility, cost-efficiency and speed of procurement.

Redcentric was among those new suppliers, winning a place on all nine of the telecommunications and network services lots it applied for, and effectively opening up its entire portfolio via NS2. And up until the last week of March 2020, life on the framework was pretty normal. We have had a significant public sector business for over a decade and so frameworks have become very much a standard part of our sales culture. With NS2, we saw the typical framework benefits – the acceleration of the procurement process, the greater confidence of buyers in their shortlisted suppliers and ability just to engage at a deeper level more quickly. That in turn meant projects getting greenlighted in shorter order, but safe in the knowledge that all the safeguards around supplier quality and service

compliance, and all the requisite data, security and operational standards had been validated.

From last summer till late March, we went steadily about our business, gaining contracts across data access, telephony, video conferencing and collaboration services. Then Covid-19 hit and the world changed. But critically, in an age where the public sector is still not known for its agility and adaptability, The Crown Commercial Framework NS2 flexed and opened up a real lifeline to the health and social care sector that had to mobilise on an unprecedented scale and timeframe – no longer measuring procurement and deployment in months and years but in days and weeks.

In short, the Crown Commercial Service and NHS Digital came together with its NS2 approved suppliers to work out a viable way of providing secure remote access a) on an unprecedented scale and b) in a hugely compressed timeframe. With NS2 having a Direct Award option, there was obviously real potential to hurry things up but buyers actually needed a relevant solution to buy!

We were approached to help, to see if we could offer up services that were a specific response to the pandemic-driven mobilisation – something that could be easily, quickly and safely deployed by thousands of end users themselves, without compromising the integrity of the health sector data security standards and access protocols.

NHS Digital and Crown Commercial worked together to assist health partners in locating the pre-approved services, with a Covid-specific catalogue where each service was pre-fixed with ‘Covid XXXXX’ in the title. The two services Redcentric offered up were a Secure Remote Access Service (tokens) and Roaming SIMs, both designed to give users as much safe, reliable, on-demand access to central systems as they needed.

We still had to abide by all NS2 rules, so security and best value were uppermost – buyers needed that reassurance that there’d be no profiteering or lowering of standards. As a result, confidence was there from the outset and within two weeks of launch, we gave 40,000 health and social care workers across hospitals, primary care trusts, CCGs and local authorities the ability to connect and continue working.

The ability to leverage the framework in such an agile way is testimony to all the work that goes into the evaluation of suppliers.

Winning a place on a major framework takes exhaustive efforts and while sometimes suppliers might bemoan red-tape, it’s situations like this that highlight the importance of having pre-approved problem solvers ready to go. By bringing Covid response-specific services into the framework, with that inherent validation of products that comes with a supplier’s inclusion, everyone who needed to act could – immediately. We were seeing customers go live in 48 hours whereas preCovid you were probably looking at project cycles of between three-six months.

Of course, continuity and remote access is nothing new. We’ve had weather events in recent years that have caused some disruption and typically prompted short-lived pushes on relevant solutions. But take up has been far from universal and it needed some nimble thinking and smart collaboration to come up with a way of compensating for the shortfall. The collective ‘rescue’ effort was predicated on NS2, proving its worth 40,000 times over in our eyes. We’re regularly clapping for our carers, but we’d also like to give this framework a pat on the back. L FURTHER INFORMATION www.redcentricplc.com

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Telecommunications

Telecommunications within the healthcare sector In April, the companies agreed to provide confirmed NHS workers with the data, call and text access they need to offer remote consultations at no extra cost. This means that they have and will continue to upgrade the capacity to help change the way NHS workers’ broadband speeds as required government bodies and the wider public to facilitate remote work, sometimes sector communicate with – and for – at no extra cost, as well as improve the public they serve. By working with connectivity in care homes and supply fullcustomers, suppliers and industry bodies scale telecoms access to the emergency throughout its design and construction hospitals being built to combat the virus. we have arrived at an innovative With EE, for example, all that NHS workers solution which will drive successful have to do is register online with a valid transformation across government.”

NHS email address to receive the new offer of unlimited mobile data for Telecommunications all NHS staff for the next six and coronavirus months, including those staff Companies such as BT, Networ already receiving discounts Virgin Media and Sky on their monthly mobile have committed Service k s 2 plans from EE. They’ll to support the h a s t he capa then receive a text NHS with its city to help ch message confirming increased need a n g e the w govern that the unlimited data for connectivity a m is on their account, as many essential the wid ent bodies a y nd er publ until 9 October 2020. services have commu ic secto In response to the E moved online. r n

Last October, the Network Services 2 framework went live, helping public sector bodies get the best deal on their telecommunications The new Crown Commercial Service agreement provides access to mobile, voice, video and data services including security and surveillance. It was designed with help from suppliers and customers across the UK, as well as through workshops hosted in partnership with trade body Innopsis and techUK. There are just shy of 100 suppliers, 58 per cent of whom are small and medium-sized enterprises. It will run for three years, with the option to extend by a further 12 months.

The agreement offers customers a range of primary and ancillary services, including: voice and data provision; internet access; Wi-Fi; radio; security and surveillance; audio and video conferencing; equipment; and maintenance and support services.

Ieuan Trigger, Deputy Director for Technology ate the Crown Commercial Service, said: “Network Services 2 has

and for icate with – – th they se e public rve

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Aid Call Proud To Support Dragon’s Heart Field Hospital In Cardiff, Wales Aid Call were delighted to get the call to support our NHS by supplying and installing safety critical emergency nurse call systems to the new Dragon’s Heart field hospital based at the Principality Stadium in Cardiff, Wales Aid Call were delighted to get the call to support our NHS by supplying and installing safety critical emergency nurse call systems to the new Dragon’s Heart field hospital based at the Principality Stadium in Cardiff, Wales.

For over 40 years Aid Call have been supplying hospitals with rapid response, emergency wireless nurse call packages with full business continuity plans for when their hardwired systems cannot be relied upon.

Covid-19 pandemic But In light of the current Covid-19 pandemic we have seen an increase in demand for our Touchsafe Pro critical emergency systems and are currently supplying large numbers on a quick turnaround to the NHS. As many hospitals are re-purposing areas into new wards or converting existing suitable buildings such as private hospitals, hotels and conference

centres into temporary field hospitals.

Many hospitals have taken advantage of our pre-programmed, straight out of the box, wireless set up, with open protocols, HTM and CQC compliance. To ensure the safety of both patients and staff with easy to use scalable wireless solutions.

This project to supply nurse call to all 11 wards in the Dragon’s Heart field hospital in Cardiff. Required over 400 Call Points and 11 Touchsafe Pro Panels and came with a quick turnaround of only 4 days between the initial enquiry and full onsite commission.

No time to lose As always, all our dedicated teams from our factory based in Blyth, Northumberland rose without question to the challenge and were able to assemble all required equipment the very same day. Enabling the shipment to be driven through the night

to the 11 strong engineering team who were primed to begin installation onsite at the Principality Stadium the next day and would continue over a 3 day period to ensure the installation completed on time.

Quick and efficient Aid Call have already supported many hospitals on a wide range emergency systems projects, as well as the Nightingale field hospital in Liverpool and now with the full site installation at the Dragon’s Heart field hospital Cardiff. This only highlights the exceptional flexibility of our teams at all levels throughout the business and cements our ability to react quickly and efficiently to the needs of our customer base at this very difficult time. L FURTHER INFORMATION www.aidcall.co.uk

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Audit Trail

Health information for free The announcement was the second in as many months by the UK’s largest mobile firms, as Vodafone, EE, O2 and Three confirmed in March that they will give their customers free online access to the latest NHS health information about coronavirus.

The NHS is working with its industry partners to make sure everyone can get NHS information and advice that is verified, up to date and free from misinformation, without using up their data allowance or mobile credit. Therefore, it will now be free to access the following websites: nhs.uk; 111.nhs.uk; wales.nhs.uk; nhsinform.scot; nidirect.gov.uk; and publichealth.hscni.net.

Hancock and telecommunications When Matt Hancock became Health Secretary in July 2018, we wrote the following: ‘While Hancock’s health experience may be lacking in comparison with Hunt [Jeremy Hunt, former Health Secretary 2012-2018), who some believe may still have his eyes set on No. 10, Hancock proved very popular and involved at the Department of Digital, Culture, Media and Sport, where upon becoming Culture Secretary he launched his own smartphone app to better ‘connect’ with his constituents. His digital background and enthusiasm could prove very beneficial in promoting the equal distribution and promotion of technology and innovation in all areas of the health service.’

In his first speech after becoming Health Secretary, Hancock has said that £487 million would be spent on technology for the NHS, giving more patients access to health services at home. Approximately £412 million of that figure was to be spent on improving technology in hospitals.

In his Future of Healthcare report, he promised that ‘outdated and

Health Secretary Matt Hancock said: “In the face of the continued spread of coronavirus, it is vital everybody can access the latest verified public health advice on the NHS website when they need to – so everyone knows exactly what they should be doing to keep themselves and others safe. We have been clear this must be a national effort and so I’m delighted that mobile companies will be offering free data to browse nhs.uk. This will

Telecommunications

 announcement, NHSX chief executive Matthew Gould said: “Covid-19 has made stark the importance of technology in helping people and those who care for them stay connected. Technology has the potential to be a tremendous force for good in helping the country and its citizens through the crisis, and we are grateful to industry colleagues for offering their support to the NHS.” Marc Allera, CEO of BT’s Consumer Division, said: “We hope this gives NHS staff one less thing to worry about. They can keep in touch with friends and family and use the internet without worrying about using up their data. Along with the discount we already provide, this is a thank you from all of us at EE to those in the NHS that are working so hard for us all.”

obstructive NHS IT systems will become a thing of the past’ and that he planned to introduce minimum technical standards that digital services and IT systems in the NHS would have to meet. Having these open standards in place means systems will be able to talk to each other securely and ensure they are upgradable.

ensure everyone can access the guidance they need and avoid dangerous misinformation, without incurring data charges, and is an important contribution to the next stage of our plan to delay the spread of the virus.” L FURTHER INFORMATION www.crowncommercial.gov.uk/news/ network-services-2-awarded

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Recruitment

NHS crisis to worsen from post-Brexit immigration rules Jack Yates, content writer for the Immigration Advice Service; an organisation of UK and Ireland based immigration lawyers, discusses the shortfalls of the NHS Visa and the new Immigration Bill It is an oft-repeated phrase, and one that may sound hyperbolic, but to those paying attention it is abundantly clear that the National Health Service is on the brink of collapse.

Week on week, its groaning infrastructure and resources become stretched ever increasingly; underfunding and overworking has resulted in a dwindling workforce that is unable to renew itself. Those who were once aspiring doctors and nurses are now unsurprisingly reluctant to put themselves into significant debt in a lengthy degree that requires weeks of unpaid labour and which will result in a job where they will likely be underpaid and overworked. The eyewatering tuition fees and scrapping of the Nursing Bursary has not gone unnoticed as Universities note applications have dropped by 30 per cent since this move in 2017.

A nationwise crisis EU staff from abroad are further leaving in huge swathes as Brexit creates an increasingly precarious position for migrants – and even homegrown nurses are lured

limiting access to hiring overseas workers, overseas to nations with competitive wages the Home Office has announced plans to such as Greece, Ireland, Australia and implement an NHS Visa. Yet the outcome Chile where they are paid 1.5 times the is virtually the same as the system already average wage. All-in-all, this has created in place: doctors, nurses, paramedics, a nationwide crisis for the NHS where medical practitioners and radiographers one in 10 doctor posts and a staggering are already featured on the Shortage 44,000 nursing posts remain unfilled with Occupation List (SOL) which grants them no sign of the gap ever closing. The wider a Tier 2 Work Visa discount. The NHS Visa impact that such shortages have include echoes this sentiment, inferring a halved an aggravated situation in A&E where cost of ÂŁ464. The only noticeable difference queues are hitting record highs and cancer is that visa decisions should be granted diagnosis going amiss. There are wellfor migrant NHS staff within two weeks. founded concerns that these shortages However, the replacement of Free mixed with a lack of resources is putting Movement with visas for EU staff and patient safety and care at significant risk. their family members appears prohibitively Yet as of 2021, all migrant nurses, doctors expensive as it is, yet the Home Office and medical professionals will intends on billing migrant NHS be mandated to acquire a workers even higher than those Work Visa if they opt who apply now through for an NHS job.

To call the Tier 2 SOL route. The In a bid to skirt the NH Immigration Health around the edges of S a band Visa Surcharge is a compulsory the harsh pointsfee that all migrants have based immigration a gapin aid on g woun to pay alongside each visa plan that will would d be to o come into effect application, no matter verstate any pos wholesale in 2021, age or nationality. E

itiv it may he impact ave

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Sadly, it is clear that the NHS Visa is little more than a marketing tool, seemingly written up by a spin doctor in a bid to create the illusion that the Home Office is earnestly attempting to patch up the NHS  The government now wants to increase this charge from £400 to £625 per person per year of stay, only NHS Visa applicants can ‘benefit’ from having this sum deducted from their salary each year. Essentially what this means is that while migrant healthcare workers cough up £2,000 to satisfy the health surcharge for a five-year Work Visa, as of 2021 new applicants will be losing out over £3,000 in their salary over time.

Although a new route especially for the NHS sounds promising, this route isn’t exactly encouraging as it increases the overall cost and comes with laborious reams of paperwork. EU staff could just as easily curb the UK entirely by working in a remaining EU state where the only paperwork required is their passport. In addition, a job in the EU ensures that their lifesavings and subsequent earnings stays firmly in their bank account.

Attracting talent While it is unarguably depressing that such a wealthy nation requires migrants

to pay the Immigration Health Surcharge, it is genuinely laughable that those migrants who will be working for the NHS will be forced to pay it too. At the very least there should be a discount if it cannot be scrapped altogether for NHS workers.

This would be a much more effective way in terms of attracting talent and would signal real ambition to bring in medical professionals to combat the chronic understaffing issue. Even the fast-tracking element is relatively underwhelming as this is already something that is available for a fee, posing additional concerns that there may even be hidden charges within the NHS Visa as the small print is ironed out.

Sadly, it is clear that the NHS Visa is little more than a marketing tool, seemingly written up by a spin doctor in a bid to create the illusion that the Home Office is earnestly attempting to patch up the NHS. The reality is that this is simply untrue, and in fact the NHS Visa is, for the most part, a replication of the

Recruitment

NHS fees to be scrapped for overseas health staff Since this article was written, the government finally announced that NHS staff and care workers from overseas will no longer have to pay an extra charge towards the health service.

In a move that Labour leader Sir Keir Starmer has labelled ‘a victory for common decency’, the exemption, which Prime Minister Boris Johnson has asked the Home Office and Department for Health and Social Care to sort out ‘as soon as possible’, will include all NHS workers, including porters and cleaners, as well as independent health workers and social care workers.

The announcement follows both increasing criticism of the government and a defence from ministers as to why an exemption had not been made. Johnson had told MPs in the commons on 20 May that he ‘understood the difficulties faced by our amazing NHS staff’, but said the government ‘must look at the realities’ of funding the NHS. The health immigration surcharge on non-EU migrants is £400 per year and set to rise to £624 in October.

A spokesman for Johnson said: “The Prime Minister has been thinking about this a great deal. He has been a personal beneficiary of carers from abroad and understands the difficulties faced by our amazing NHS staff. The purpose of the NHS surcharge is to benefit the NHS, help to care for the sick and save lives.

NHS and care workers from abroad who are granted visas are doing this already by the fantastic contribution which they make.” current immigration rules for healthcare workers, except it will now leave future applicants from EU member states with thousands-of-pounds worth of debts to pay.

To call the NHS Visa a band aid on a gaping wound would be to overstate any positive impact it may have. If anything, it may even contribute to exacerbate workforce shortages. If the government is genuinely concerned with the NHS, then instead of tinkering around the edges it will need to increase funding - both in to the NHS and in to education - and do away with draconian immigration policies. L FURTHER INFORMATION https://ie.iasservices.org.uk/

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Advertisement Feature

How can a team in Mansfield solve healthcare tech problems around the world?

When the NHS technology supplier-customer dynamic moves on to genuine partnership, all sorts of things can happen, writes Jane Rendall, UK and Ireland managing director at Sectra When the newly formed Barts Health NHS Trust wanted to ease the flow of crucial diagnostic images across its five hospitals back in 2012, it encountered some challenges.

Freshly merged and now operating as a single organisation, the trust wanted to ensure that a complete set of patient imaging could be found by staff regardless of which of the five hospitals they worked in, and regardless of which of the sites a patient had visited to have their imaging captured. This led to a major consolidation project which included multiple IT systems in radiology and IT. A project which Sectra fully understood the impact and benefits of and one where Sectra was keen to be a key player in this service transformation.

But faced with a legacy of different radiology information systems and electronic patient records inherited from three historic trusts, imaging was still being managed in different ways at different sites, using a mix of numbering and identification approaches.

The trust needed to find a way to take the different image numbering and match it.

An NHS problem – an unintended answer for the world At the time, Sectra had been contracted to provide a picture archiving and communication system, or PACS, to sites across Barts Health.

Arguably going beyond the traditional PACS remit, our technical specialists from our team in Mansfield, sat down with the trust to try to solve the challenge.

After grappling with the issue, they worked together to quickly create what was then known as the ‘Barts Broker’. It solved the specific need for the trust.

But more than that, there was an unintended consequence. When the global Sectra team looked into what had been done locally, it quickly became apparent that the efforts put in to help Barts Health had much wider applicability.

Now known as the Sectra Connectivity Hub, it is something used today in many hospital installations we carry out as a company throughout the world. Hospitals in the US, for example, where there are lots of acquisitions and mergers, find it particularly useful.

And it’s by no means the only development of its kind. There has been a lot done from our team in Mansfield – most of which

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has global relevance, and some of which has no obvious initial commercial value to Sectra at all, other than solving the problem at hand for our customer. The real art to this kind of development activity is to uncover the common threads which would be useful globally but still retaining the ability to adapt to very local conditions.

a willingness to be able to solve unique local problems now or in the future.

And that in turn requires a willingness to accept risk. A lot of suppliers wouldn’t change their core product through fear of being exposed to risk. But if we are going to get things done, we need to make those adaptions.

How does this work?

Well, first off, it’s about trying to find real solutions. That doesn’t mean selling the NHS a vanilla piece of IT. It means working with them. And that means getting the right people to work together.

Sometimes suppliers send in their sales reps or account managers who try to get a brief from their customers as to what they want to achieve, and then relay that to developers who put it in a queue of development work.

But by putting the ‘techies’ – the appropriate people who understand the technology – in the room with people from the customer side who can articulate their challenges, a much more effective dialogue can be achieved, and a much faster, more relevant solution created.

This requires trust – trust in your people.

We don’t turn to our head office in Sweden each time we want to achieve something.

Having a team here in the UK that is not even based in our UK head office, but that has the autonomy to create global products which originated from local needs, represents

Stop imposing limitations This article isn’t about the Sectra Connectivity Hub. It is about a concept – an idea that if the NHS as a customer and its suppliers rigidly maintain those traditional identities – then limitations are unnecessarily imposed on creativity and collaboration.

There is a symbiosis to be achieved if we work together in much closer partnership, focus less on contractual intricacies and more on the problems at hand. And from that symbiotic relationship, there are benefits to be had for both parties.

In the case of Barts Health – simply selling them a Secta PACS might have met a contractual obligation, but it wouldn’t have done the job. And by going that extra mile, by happy coincidence we now have an improved product offering that helps us to win bids throughout the world and that allows our products to become more deeply rooted in the hospital workflow. L

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

FURTHER INFORMATION medical.sectra.com

Non-clinical work

Bringing the back office home Supporting NHS organisations on the frontline of the battle against Covid-19 has become more important than ever, says NHS SBS With almost two thirds of the NHS dependent on NHS Shared Business Services (NHS SBS) to pay their employees, manage their finance and IT systems, or help them purchase goods and services, supporting NHS organisations on the frontline of the battle against Covid19 has become more important than ever.

Providing the essential non-clinical services that keep the NHS moving - whilst also enabling home-working for almost every UK employee - is an entirely unique challenge.

The country has undoubtedly been reminded of just how important the NHS is.

As doctors, nurses and other clinicians work tirelessly to provide world-class patient care, an army of NHS employees has also been working behind-the-scenes to support them.

Accountants, payroll clerks, procurement specialists and IT support staff. These are just some of the professionals working hard to keep the wheels turning for NHS providers and commissioners up and down the country.

And the 1,500 employees at NHS SBS are no exception.

While transitioning almost 100 per cent of its UK workforce to home-working within less than two weeks, NHS SBS has continued to process weekly and monthly

payrolls for almost 400,000 NHS employees Working for successful change at 90 different NHS organisations, with By facilitating a major change to NHS minimal interruption to its usual service. funding meanwhile, the team at NHS This included thousands of new and SBS has helped NHS England and NHS returning members of NHS staff from Improvement move a massive £20 billion retirement. In just one week, the NHS SBS around the NHS to where it is needed. team facilitated £1 million of urgent salary In the East of England, NHS SBS experts payments to these additional NHS workers. have worked with two NHS trusts to Working from home, NHS SBS teams, increase their remote working capability, up in one week alone in April, sent out from an average of 400 employees a day 25,000 purchase orders to NHS suppliers, to 1,500 NHS workers supported to work ensuring goods and services continue at home - with this number expected to to be delivered to the NHS rise again in the coming weeks. organisations that need them.

And, after beginning the roll In the same time, almost out of The Edge4Health 88,000 invoices have -a new cloud-based, More been paid, including consumer-style than ev e £642 million reaching marketplace where r i t i ’s m possible organisations that NHS organisations not to be insp are helping the NHS can buy goods and i r work o ed by the to provide services, services - earlier this f NHS s and £250 million has year, NHS SBS has t a hospita been collected and made the platform ls up anff in receipted on behalf immediately d down t h of NHS organisations, available to around country e helping cash flow to 60 additional NHS enable the purchase organisations. of valuable equipment It means that despite and additional staffing. not being able to transact E Issue 20.2 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Access to documents digitally will remain of strategic importance OPEX Corporation is a recognised global technology leader in document imaging, high-speed mailroom automation and warehouse automation. Craig Hartley, UK Business Development Manager for OPEX Business Machines GmbH, explains how their solutions are helping the NHS and wider public sector achieve digital transformation

For nearly a decade, the NHS has seen the road to digitisation grow and become more complex and challenging, through multiple governments, regulatory changes and strategic shifts combined with internal complexities.

In 2020, we all recognise that the NHS has been faced with the biggest challenge in a generation. COVID-19 has placed the UK Healthcare system in previously unseen territory, whereby a global pandemic that threatens life as we known it has placed enormous pressures on an already over-stretched service.

Across the length and breadth of the United Kingdom, we have seen amazing response to these trying times. Like always, the NHS has risen to the challenge brought on by this pandemic. Whilst it isn’t possible to perform many of the amazing life saving tasks done by our NHS staff away from a hospital or surgery environment, large parts of the administrative functions and non-patient facing tasks have been moved off-site.

Technologies such as ‘Teams’ and ‘Zoom’ have now become the boardroom and coffee shop for the majority. Battling with cats on shoulders, kids in the background and the many distractions of home life, workers all over the world are clearing a space on the breakfast bar, keeping calm and carrying on.

The nations great response to ‘staying safe’ whilst working from home has highlighted something the NHS has had a great understanding of for a long time – that he need to ‘Go Digital’ is greater now than ever before.

whilst transforming workflow efficiency and reducing arduous document preparation. By creating a unique solution that’s significantly different to all other hardware manufacturers in this space, we have identified and solved the key issues surrounding this monumental task faced by an already overstretched NHS. OPEX is fast becoming the dominant force in digital conversion of hard copy patient files within the complex arena of scanning NHS medical records, seeing NHS and UK service providers selecting OPEX Falcon as the scanner of choice for capturing patient files and information in a structured format.

We already work directly with dozens of NHS trusts across the UK to enable scanning and transformation of legacy and day-forward hard-copy medical records into digital content, for onward ingestion into EPR systems.

Across the UK and Ireland, OPEX’s scanning equipment is directly responsible for creating an estimated two billion Medical Records images annually created, through both NHS trusts and business process outsource partners.

Furthermore, NHS England’s current procurement exercise requires by 2022/23 all ‘Lloyd George’ notes are digitised to enable patients’ access to their records. Each Lloyd George envelope contains a broad range of detailed personal information, so maintaining the security and accuracy of these legacy records becomes vital. Many of these paper records contained within three dimensional ‘Lloyd George’ wallets are over 70 years old and in a state of fragile deterioration, whilst the information they hold is paramount for safe medical practice. The preservation, security and accuracy of these records is vital – an area Craig Hartley, UK Business Development Manager, OPEX Business Machines GmbH

It becomes a valid question to ask - but in all this current chaos and uncertainty, where does something like the scanning and capture of medical records and patient documents play a crucial part?

OPEX provides state-of-the-art document imaging platforms and technologies. Our innovative ‘one-touch’ scanning approach significantly increases processing speeds

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

that OPEX’s Falcon has proven experience, widely regarded by our customers as the perfect solution and technology platform for combined ‘prep, scan and capture’ of these notoriously challenging Lloyd George notes.

Throughout this pandemic, OPEX has been working shoulder to shoulder (…but still two meters apart) with our NHS customers to ensure they are able to keep operating.

OPEX staff have been on-site, installing and relocating much needed equipment, assisting in the configuration of systems and advising on best working practices. Ultimately this ‘behind the scenes’ service supports and enables our NHS medical records teams to keep operating, digitising records for those NHS staff on the front line or working from home within a controlled and safe working environment where required.

Hopefully, this time next year the world and the NHS will look a lot more like it did six months ago. However, there are a large number of lessons that will be learned from this and we firmly believe in the importance of having access to documents digitally and in a timely manner will remain of strategic importance.

As such, we can be confident that in the near future cost savings and workflow efficiencies will be more vital than ever to both central and local government – and of course the NHS. Once the current UK lockdown has passed, for a personal demonstration of the OPEX Falcon®, OPEX would warmly welcome hosting you at to demonstrate the possibilities we offer. With all OPEX technologies, ‘seeing is believing’ – so please contact Craig Hartley chartley@opex.com to arrange the next step. L FURTHER INFORMATION www.opex.com chartley@opex.com

Payroll and pensions As NHS staff work heroically in the midst of Covid-19 - including thousands of former healthcare professionals returning to the frontline - the Payroll and Pensions Team at NHS Shared Business Services (NHS SBS) has worked remotely in April, processing new starters at a rate of around 500 per cent more than usual and ensuring hundreds of thousands of NHS workers continue to be paid as normal.

Managing the payroll for almost 400,000 employees across 90 different NHS

The Payroll and Pensions Team at NHS SBS has worked remotely in April, processing new starters at a rate of around 500 per cent more than usual and ensuring hundreds of thousands of NHS workers continue to be paid as normal organisations is no small undertaking in normal times. But with Covid-19 forcing the NHS SBS workforce to operate from home, in April - for the first time ever - all 164 weekly and monthly payrolls were processed remotely.

In an additional challenge, problems with the national Electronic Staff Record (ESR) system, which is used across the NHS to process payroll, led to the platform only being available intermittently at the same time payments were due to be processed - putting significant pressure on the NHS SBS team to ensure NHS staff were paid.

As a result, the NHS SBS Payroll and Pensions Team worked out of hours - calling on resource from other teams - to ensure cut off deadlines were met and that NHS colleagues were paid without interruption Whilst working hard to ensure business as usual, the NHS SBS team has also been supporting a national campaign by NHS Professionals to attract more healthcare professionals back into the service.

‘Stand Up, Step Forward, Save Lives’ aims to raise awareness of NHS Professionals’ Covid-19 Rapid Response service, which accelerates the bank registration process and moves qualified nurses, doctors and other healthcare professionals to the frontline as quickly as possible.

Non-clinical work

 via the platform for now, these NHS trusts can use The Edge4Health as a shop window to around 500 suppliers to find available products they desperately need.

David Morris, NHS SBS managing director, said: “Our top priority since the outbreak of Covid-19 has been to safeguard our own workforce, whilst ensuring that NHS employees are paid, orders are processed, NHS suppliers are paid, and that cash continues to move around the NHS. Maintaining the level of support the NHS needs, whilst enabling home-working on such a large scale, has required a monumental effort. By the 1 April, our IT team had ensured that an additional 750 NHS SBS employees were able to work from home safely and securely.

“What has really impressed me is the absolute commitment of our teams to help our NHS colleagues in whatever way we can. We are very much part of the NHS family and it’s clear just how much all of us want to support those working on the frontline. Whilst some of what we have classified as non-urgent activity has been affected, we’ve worked closely with NHS England and NHS Improvement to ensure that business-critical services remain in place - helping minimise disruption for hospitals and other NHS organisations at this critical time.”

This has led to NHS SBS processing more than 4,000 new starters a week on behalf of NHS Professionals, compared with an average of around 600 before the Covid-19 outbreak began - an increase of more than 500 per cent.

Tasy Warn, Director of Employment Services at NHS SBS, said: “Our top priority these past few weeks has been about safeguarding our own employees, whilst implementing plans to ensure NHS workers on the frontline of the battle against Covid19 continue to be paid as normal. Moving our entire payroll and pensions operation to 100 per cent home working was enough of a challenge, but with the unavailability of ESR at a crucial time in the pay cycle and the extra capacity needed to manage new NHS starters - processing all of April’s weekly and monthly payments accurately and on time has required a huge effort.

“More than ever it’s impossible not to be inspired by the work of NHS staff in hospitals up and down the country. The motivation for our team at NHS SBS is around ensuring that pay day is one less thing our NHS colleagues need to worry about.” L FURTHER INFORMATION www.sbs.nhs.uk

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Helping the construction industry achieve social distancing through the introduction of new facilities AVDanzer has more than 30 years experience of designing, manufacturing and installing portable modular buildings for the healthcare market. The company provides a complete turnkey package comprising design, planning and building regulation permissions, groundworks, connection to utilities, delivery and installation.

AVDanzer has successfully installed accommodation on many UK hospital sites, including: Derby City Hospital: BMI The Alexandra Hospital; and Aintree University Hospital. It is therefore familiar with the stringent regulations and demanding nature of the healthcare sector, and provides quality buildings which are finished and equipped to meet Health Technical Memorandum requirements and is fully Disability Discrimination Act compliant.

Internal fittings can include lifts, staircases, climate control, increased insulation and double glazed windows along with IT installation and medical gases. Please do not see this as an exhaustive list, AVDanzer welcomes a challenge, so will be more than happy to research and design anything else you may need. The organisation is mindful that its buildings must be designed to ensure that the social distancing requirements

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due to Covid-19 can be maintained.

Whilst the organisation’s buildings are functional, they are also aesthetically pleasing.

The effects of a welcoming environment on patients and staff should not be underestimated, which is why AVDanzer lets you customise the exterior and interior finishing of your permanent buildings. This can include brick or wood exterior cladding and a range of roof options, which allows your new accommodation to attain uniformity with the appearance of your existing buildings.

AVDanzer’s internal finishes allow high levels of hygiene to be maintained at all times and the company is able to design and install canopies to connect new buildings to existing hospital accommodation.

In the healthcare sector it is vitally important the procurement process and installation of new accommodation is done in a way that has the lowest impact to the existing hospital estate. Modular buildings allow for speedy yet quality construction, meaning that it will only be weeks from order to completion of new accommodation.

Off site construction at AVDanzer’s Nottingham factory means the majority

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

of work is carried out prior to the building arriving on site, ensuring minimum disruption and allowing the efficient running of the hospital to continue.

Whether you require consulting suites, additional wards, laboratories, a mortuary facility or simply secure storage, AVDanzer can help.

FURTHER INFORMATION www.avdanzer.co.uk

Modular buildings

Portable building companies supporting the health sector The approach to coping with the coronavirus crisis has been vastly different across the globe.

China used the might of 7,000 workers and 1,000 construction machines, operating 24 hours a day to build hospitals but the strategy here in the UK is very different. In addition to repurposing existing facilities to create NHS Nightingale Hospitals, modern methods of construction are being used. Here, Jackie Maginnis describes how her members are supporting NHS trusts and healthcare providers to increase capacity MPBA members are rallying to support this unparalleled situation. Both volumetric modular companies and those involved in the manufacture and hire of portable buildings are ramping up to meet demand. Temporary and volumetric modular buildings are now firmly in evidence at hospitals nationally.

Given the critical nature of the healthcare industry, the necessity to quickly source low cost, modern and fully functional buildings is an imperative. Because these structures are manufactured offsite, they can also be installed without causing disruption to daily routines.

In response to the Covid-19 outbreak, many MPBA members are increasing their manufacturing capacity to support healthcare providers planning for increased resilience as a result of the ongoing situation.

More than 1,300 people Given answered an advert

for carpenters, labourers, joiners and fitters to help Darwin Group manufacture emergency hospital units to help combat the virus. From the company’s manufacturing centre, wards for more than 150 new beds are being built using their advanced modular design system.

The manufacturing centre will be working virtually 24 hours a day, seven days a week to get the buildings delivered in the shortest possible time. The buildings will be going to three NHS trusts in the North West, Midlands and Home Counties regions. The volumetric modules will be transported to the three sites, from their Shropshire manufacturing centre, where the installation and site completion teams will commission the wards for use.

Just three weeks after receiving the instruction, the McAvoy Group team pulled out all the stops to configure, deliver and install a Primary Care t Covid-19 Centre at Causeway h e critical Hospital in Coleraine for the n a t ure of this Northern Health and necessi crisis, the Social Care Trust. t y t The new 12 o q source u section building modern ickly and fully fu was installed nctiona in just one day b l

and has created much needed additional facilities and capacity for staff to assess and care for additional patients. The assessment unit provides 14 consulting rooms, office, utility room, separate exits for patients and staff, reception and staff welfare facilities.

Healthcare construction solutions Another company ramping up to meet demand is modular and portable building manufacturer Thurston Group, who was given a brief by Tameside and Glossop Integrated Care NHS Foundation Trust. The project is being managed at the firm’s production facility in West Yorkshire. Construction work started on March 30. Flattened steel has been used to create seven box units, each one around 10 metres long and three metres wide.

They will be hoisted onto a low-loader and driven to the hospital, where a 200tonne crane will lift the units into position so they can be joined E

uildings impera is an tive

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Enabling NHS trusts to operate efficiently and safely in response to the coronavirus pandemic Working through strict social distancing measures, construction work on many healthcare projects has been escalated throughout the crisis, ensuring facilities are delivered ahead of programme. New wards have been delivered, improved patient access has been developed in response to the pandemic and NHS Nightingale and shone as a stellar example of how multiple construction firms, from a variety of professions, have pooled together to ensure tough requirements are delivered safely and promptly.

Fordingbridge plc, the West Sussex based engineering and construction contractor, quickly evolved and responded to the pandemic; ensuring all those able to, worked at full capacity from home and reconfigured their factory to ensure safe social distancing among engineering staff. Specialising in the design and build of canopies and covered walkways, the firm are continuing to assist through the situation and beyond, ensuring that the UK is ready to continue in the ‘new normal’.

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Jon Heywood, Healthcare Specialist at Fordingbridge, explains: “Recently we have continued to work with architects, principal contractors and multiple Trusts to help where possible. Along with our existing programme, we have expedited new works to provide assistance to a variety of modular building specialists, NHS trusts and distribution networks, enabling them to operate efficiently and safely in response to the pandemic.”

With a wide portfolio of healthcare projects including ambulance bay canopies, covered walkways and patient waiting shelters, the company are now focusing their efforts

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

on assisting through providing social distancing measures.

Jon continues: “Fordingbridge have worked on a number of projects in a live healthcare environment, but coronavirus of course bought new challenges to the table.

We are in a fortunate position in that all of our projects, from initial concept design, through to manufacture and installation, are handled entirely in-house. This meant that we did not suffer from significant downtime as a result of any outsourcing.

Subsequently, our construction programme remained unaffected through the works.

Our structures are pre-fabricated in-house, so ensuring the 2m distance between our installation team is quite achievable.”

Recent projects include an ambulance bay covering at John Radcliffe Hospital and patient canopies at Stoke Mandeville and Princess Royal Hospitals.

FURTHER INFORMATION www.fordingbridge.co.uk

Modular buildings

 together like a giant jigsaw. Mechanical and electrical items will be fitted on-site before the hospital’s own facilities management team work to install medical equipment such as gas and air together with ventilators.

MTX, specialists in innovative healthcare construction solutions bring together development, design, construction and funding expertise for fast-track building projects throughout the UK. The company has multiple building projects underway – some contracts were awarded prior to the current Covid-19 crisis but are due for completion in the coming week. From a state of the art laboratory fitout for client at Hall Analytical to a rooftop ward extension at Glenfield Hospital and a three storey modular building creating 72 new beds within three wards at Hereford County Hospital – MTX’s range of ongoing and recently completed projects are vast and diverse.

Many modular building specialists are prioritising work for healthcare providers. Elite Systems is manufacturing a 20-bed isolation ward for Royal Surrey County Hospital within an eight-week timeframe. Royal Surrey County Hospital was looking to increase its capacity and following an enquiry in March, the modular building team is now on-site and has already commenced groundworks with a view to the new unit being in place in June.

In total the consultation period, from initial contact to groundworks commencing, took just seven working days. While groundworks continue at the hospital, Elite Systems’ factory team will construct the 20-bed isolation ward in controlled conditions before delivering the modular building to the hospital and completing the final fix on-site, ready for the ward to become fully operational and start receiving patients. The ward will feature 20 individual patient rooms, each with an en-suite bathroom. The central space on the ward will be occupied by a nurses’ station as well as storage space for cleaning supplies and linen, a series of treatment rooms,

Portable buildings can be manufactured with ultra-quick lead times and supplied as an extension or ‘add-on’ to an existing facility. Healthcare managers may not be aware that these structures are available as permanent or temporary options relatives’ rooms, and additional WCs. As well as increasing capacity, manufacturers such as Elliott - An Algeco Company, are providing buildings for additional services.

Changing rooms and showers, as well as a range of furniture from the firm’s 360° service are being delivered to hospitals across Greater Manchester to help nurses follow social distancing guidelines.

But it is not only the manufacturing and portable building hire companies that are stepping to the fore, our membership includes those involved in the supply chain and there are a multitude of companies involved in the provision of materials, sanitary ware, M&E and logistics together with installation teams that are working around the clock to ensure volumetric modular and portable buildings are delivered in record time.

Permanent or temporary Portable buildings can be manufactured with ultra-quick lead times and supplied as an extension or ‘add-on’ to an existing facility. Healthcare managers may not be aware that these structures are available as permanent or temporary options. When a fast-temporary building solution is required, hiring a portable building can provide the ideal solution for healthcare, testing or isolation facilities. With visitors being presently restricted, valuable carparking space can be commandeered to accommodate these units.

Construction clients such as the NHS trusts, appreciate the cutting-edge building

techniques and the short lead times which are a much-needed benefit. In addition, modular and portable buildings are energy efficient, fully compliant with building regulations and can be tailored to meet the requirements of new healthcare buildings or used to extend existing facilities.

As patient-led demand grows due to the Covid-19 crisis, the healthcare sector does not have the time or resources to commission lengthy construction programmes. The team here at the MPBA can help those in need by putting them in touch with their nearest modular manufacturer or those who have portable buildings in stock and available for hire. We appreciate the excellent work the NHS and healthcare providers are doing, and we are keen to help.

Given the critical nature of this crisis, the necessity to quickly source modern and fully functional buildings is an imperative. The MPBA can help and by putting calls out to our extensive network, saving healthcare providers valuable time and resources. L

Government departments, NHS teams and those involved in social care can gain help to quickly engage with portable building providers or modular manufacturers by calling Jackie Maginnis, chief executive of the MPBA on 01686 430400 or emailing: jackie@mpba.biz FURTHER INFORMATION www.mpba.biz

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Ergonomics

Sponsored by

Improving patient care and staff well-being The discipline of human factors and ergonomics is key to improving patient safety and ensuring NHS staff aren’t put at risk when caring for patients. In this article, Health Business revisits some advise from the Chartered Institute of Ergonomics and Human Factors Ensuring the practice of human factors when the main focus was on staff well-being and ergonomics (HF&E) is factored into a following a high number of musculoskeletal design is the key to success. By focusing injuries. HF&E professionals were brought in on the systems in which people interact to help improve staff well-being, especially for with, in physical, organisational and nurses and midwives to reduce injuries. Some social environments, will give two key of the initiatives included redesigning tasks, outcomes; well-being and performance. equipment and taking systems approaches Professor Sue Hignett, fellow of the Chartered to complex challenges. For example replacing Institute of Ergonomics and Human Factors hydraulic hospital beds with electric beds (CIEHF), the professional membership body for enabled hospitals to both reduce risks for ergonomists and human factors practitioners, nurses and improve patient well-being explains: “HF&E looks at redesigning ‘systems’ with better pressure care mattresses. and ‘objects’ to allow people to succeed, by ensuring certain tasks and systems are designed Creating user-friendly devices to suit human capabilities and limitations. This Further opportunities have arisen for HF&E type of practice is common in industrial sectors professionals to look more closely at many and safety critical industries, but is slightly more of the systems, tasks and equipment in the complicated when it comes to the healthcare sector. Following input healthcare sector at it’s both from HF&E specialists, medical By people-centred and peopledevices are now required to driven. This means even fulfil usability criteria, with focusin g on the more focus is required, specialists being brought but benefits could be in to provide expert which p systems in eople in worth investment.” advice in task analysis teract with, in Input from and interface design. physica organis chartered The importance of l , a ergonomists and the human factors environ tional and so cial ments, Human Factors element within the will giv two ke specialists within design of medical e y outco the healthcare devices is paramount. m w e ell-bei s; sector is often The discipline will help performng and requested following minimise user related ance a major incident or incidents, create user-friendly change in legislation. This devices, and support better was apparent in the 1990s treatment of a patient’s medical

condition, all while reducing human error risks.

Professor Hignett added: “The industry is now taking HF&E into account when designing systems. This is clearly demonstrated in increased interest levels from both healthcare regulators and professional bodies. This means we need to be ready to respond to any enquiries and offer support to ensure that the healthcare industry gets expert advice from qualified Chartered Ergonomists and Human Factors specialists.”

In 2013 a National Quality Board Concordat was signed by 16 healthcare agencies in England, which helps demonstrates a commitment to embedding a recognition and understanding of human factors across the NHS. The agreement shows how the health sector is taking the right steps in improving patient wellbeing and understanding the value and support that human factors can offer in this area.

Health Education England, the commission on ‘Learning to be Safer’, reported its findings in regard to improving safety through education and training with 12 additional recommendations, three of which include human factors: develop and use a common language to describe all elements of quality improvement science and Human Factors with respect to patient safety; the content of mandatory training for patient safety needs to be coherent across the NHS; and the principles of human factors and professionalism must be embedded across education and training. Multi-professional human factors training should form part of the induction process for every new employee.E

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 Commenting on the updated Health Education England findings, Professor Hignett says: “As professionals, we need to engage with this opportunity sooner rather than later. One of the many strengths of Chartered Ergonomists is our ability to bring together knowledge, concepts and experiences within a systems framework. So in my opinion there are three key ways in which we, the CIEHF, can respond.

“Firstly, supporting healthcare workers by providing professional HF&E expertise and making sure that they understand the importance of qualified advice from a Chartered Professional Ergonomist (C.Erg. HF). There is no guarantee of professional competency, knowledge or indemnity insurance from non-qualified individuals who may claim expertise in HF&E. “Secondly, engaging with healthcare regulators and professional bodies such as Royal Colleges and Chartered Societies to include HF&E knowledge in competency frameworks for undergraduate education and ‘Continuing Professional Development’.

“And finally, providing accredited education and training for healthcare workers with an interest in HF&E, for example, Postgraduate Certificates for Human Factors in Patient Safety, and Ergonomics in Health & Community Care as well as within Quality Improvement programmes and initiatives.”

Unrealised potential Although the use of HF&E in healthcare is an established element in improving patient wellbeing, it has been a long and laborious process,

When a chartered ergonomist talks about a systems approach, they could be talking about a small system such as the interactions between a patient, nurse, bed or mattress, or a larger system such as a patient journey from A&E, to x-ray, to a ward or to the operating theatre often met with restrictions by healthcare professionals who proclaim the systems rhetoric without really understanding what a system is, or how to analyse it. This means that the benefits of using HF&E to improve patient safety have yet to be fully realised.

When a chartered ergonomist talks about a systems approach, they could be talking about a small system such as the interactions between a patient, nurse, bed, mattress, bed table or monitoring equipment, or a larger system such as a patient journey from A&E, to x-ray, to a ward, to the operating theatre, or to recovery. This large system will include interactions with technology and equipment such as beds, operating tables, anaesthetic machines, information transfer and communication, and building design for turning space, monitoring sight lines and navigation.

Taking a systems approach to safety will support integration of well-being and safety for both staff and patients. A lack of

Ergonomics

Sponsored by

integration can increase the complexity of organisational systems with, for example, separate risk assessments for falls, pressure ulcers, mobility/safe patient handling, continence and confusion, including dementia.

Professor Hignett concludes: “The way forward is to embed Human Factors and ergonomics across healthcare with a champion at executive board level for each trust or healthcare provider.

This will transform healthcare safety culture from trying to fit the human to the environment to a safety culture which understands human capabilities and limitations. HF&E within the healthcare sector will support the design of efficient systems that are fit for patients and staff. A greater use of HF&E and design will create many opportunities for healthcare to take ‘giant leaps’ in improving safety.” L FURTHER INFORMATION www.ergonomics.org.uk

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Advertisement Feature

HB Interview: Perfect parking with Debt Recovery Plus Health Business (HB) talks to Stewart Clure (SC), managing director of Debt Recovery Plus, the leading provider of debt recovery services for the private parking sector in the country Parking was an area that perhaps unexpectedly made headlines as the coronavirus pandemic took hold over the UK. The government announced that it will cover the costs of providing free car parking to NHS staff working in hospitals in England, with areas such as London and Newcastle leading the way in ensuring that key workers and other hospital staff could park at, or as near to, work as possible without the stress of queueing and paying.

However, like all industries, the return to parking norm is upon us, or at least soon will be. In light of this, we spoke to Stewart Clure, managing director of Debt Recovery Plus, which provides debt recovery and back office solutions to 90 per cent of the industry, handling over 120,000 unpaid parking charges each month, about the current situation and other issues affecting the sector.

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HB: It would be unwise to begin without first addressing coronavirus.

With hospitals more overwhelmed than ever before, what impact has the pandemic had on NHS parking?

services during Covid-19.

We have seen operators across the board Like mo st work alongside things, p landowners to a r k i n charges g make sure that conside are not everyone who r the top ed to be on needs access to parking is catered list whe of everyone’s for during this n it com es to SC: We have all experienced period. We have paying bills unprecedented times during the still seen some last few weeks and we have seen parking abuse in how parking enforcement operators, key areas of NHS sites, the BPA, IPC and NHS trusts have come which can often lead to together to ensure that all NHS sites are devastating consequences if reviewed for free parking in some areas. they are not managed effectively which is why There has of course been a light shone on the some sites have had to maintain some sort of NHS, NHS staff and the general well-being of consistent, robust enforcement to make sure anyone associated with carrying out support that the right people do have sufficient access

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HB: How have parking staff been managed and supported during this time?

SC: There has been great support provided by operators for all their staff, whether it is to front line warden services right the way through to back office support staff. Many operators have had to take advantage of Furlough scheme to ensure that they manage their cash flow resources in line with demand. We have also seen a number of operators provide their staff, vehicles and equipment to support NHS services in any way they can, whether it is making deliveries of PPE equipment, helping to provide financial assistance to purchase PPE or simply by providing marshalling services to sites to help with traffic control.

HB: The move to digital seems to have impacted nearly every industry in the UK, and car parks are no different. But, in light of the increasing use of technology in the sector, what benefits do operators and wardens on site have for NHS parking? ?

SC: Wardens can always provide a hands on service to any site where there is a mix use of operation in use. Sometimes it is a helping hand, someone to give advice and support to the public or simply to act

as a security alert on site. Technology will always play a big part to help data analysis and support growth on NHS sites but wardens and operators can often still lead the way in supporting site performance.

HB: What are the knock on effects of mis-management in NHS parking, particular in terms of revenue streams?

SC: We have seen numerous cases of abuse by the public on sites which are in key areas such as city centres, close proximity to train stations etc. if these sites are not managed effectively then the abuse can take up key spaces which are intended for staff, patients and visitors.

Often reducing capacity and revenue which is often used to support other NHS services.

Debt Recovery Plus understands that you may be suffering from some form of financial hardship due to the ongoing effects of the coronavirus pandemic and wants to help you. Advisors are manning the company’s helpline from 9am to 5pm, Monday to Friday and can give advice and assistance to help you pay your parking charge.

Please contact Debt Recovery Plus on 0208 234 6775 for more assistance. L

Advertisement Feature

to parking. The IPC and BPA have worked with operators to compile a list of sites via a website which offers free or support to parking across the UK on selected NHS sites.

FURTHER INFORMATION www.debtrecoveryplus.co.uk

HB: Taking into account the importance of taking each case on its own merit, as well the need of an ethical approach to management, can you outline the necessary needs of debt recovery to support a successful parking management programme?

SC: Like most things, parking charges are not considered to be on the top of everyone’s list when it comes to paying bills. Debt recovery on NHS sites is a necessary evil to make sure that repeat offenders are not taking up vital space and are followed up on any unpaid charges received. For all the unpaid charges the NHS loses out on millions of £ revenue each year which could be spent wisely on much needed services.

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Advertisement Feature Written by Dave Smith, head of Public Affairs and Communications,British Parking Association

Supporting NHS staff to provide free parking during COVID-19 These are extraordinary times and nowhere more so than in the healthcare sector where hospitals are seeing a huge impact on how they are operating. In terms of managing and providing parking, the large number of volunteers and retired NHS staff coming forward to work on the front line means that some hospitals require additional car parking capacity So, what has the parking sector been doing to support the national effort during the Coronavirus pandemic? And how will it continue to work together to ensure that the NHS is supported, and frontline staff can carry on saving lives? At the start of the crisis many local authorities put in place their own local free parking schemes and many private parking operators also responded to local appeals. Then members of the British Parking Association committed to providing free parking for all NHS staff and to cancel any Penalty and Parking Charge Notices (PCN) issued to NHS staff since the lockdown began.

It was clear there was an urgent need for a coherent, user friendly service that helped NHS workers to find free parking places - both public and private. This led to a new website being launched in April that helps NHS staff, health and social care workers and NHS volunteers (critical care workers) to find free parking locations quickly and easily. Since its launch over ten thousand people have visited the site at www.nhs-freeparking.co.uk which contains more than one million parking spaces at car parks, privately owned spaces and driveways. It is hoped that this will allow them to save time as they focus on supporting the national effort. There are a few simple steps to take to find out where the nearest available free parking is and whether registration or a pass is needed to confirm eligibility.

This is a joint collaboration between the BPA and its members Parkopedia, YourParkingSpace and JustPark and is supported by the wider parking community with new car parks being added daily.

The government’s announcement that it will cover the costs of providing free car parking to NHS staff working in hospitals in England (as parking is already free at almost all hospitals Wales and Scotland) was very much welcomed. It also launched a parking pass scheme for critical workers who are eligible for free parking from local authorities, distributed via employer networks to NHS staff, health and social care workers and NHS volunteers and accompanied by guidance about its use.

Back in December 2019, government had announced that it would make ‘parking free for those in greatest need’ from April 2020 in England. These groups include disabled people; frequent out-patient attenders; parents of sick children staying over night; and NHS staff working night shifts. Our healthcare, parking operator and technology company members continue to work closely with the Department of Health and Social Care and NHS England in the development and deployment of these concessions and our aim is simple: to help deliver a solution that works well for everyone.

Despite the recent focus on ensuring NHS staff should have access to free parking whilst

they work tirelessly to save lives and battle the COVID-19 outbreak, things will eventually return to some type of normality. When they do, we do not believe all hospital car parking should be free. Providing, managing, patrolling and maintaining safe parking for users at NHS trusts costs money and we believe that limited NHS funds should be focused on providing healthcare and patient services.

The priority now and always must be to ensure safe and unimpeded access to hospital and healthcare facilities for everyone who needs it. Our members are doing this right now, by providing free parking at hospitals; protecting spaces allocated to NHS staff; repurposing car parks as distribution hubs for essential deliveries, or for drive through COVID-19 testing centres; monitoring routes to and within hospitals, for food supplies to ensure that they are kept clear and safe. And across the country parking attendants more generally are extending their duties to help marshal traffic and assist managing queues at supermarkets and other essential outlets and parking areas - helping communities by delivering aid to the vulnerable and other support.

Like every other business and organisation in the country, BPA members are adapting and responding as the situation evolves and will keep striving to do more. These are unprecedented times for which there is no pre-written guidance, so it is everyone’s duty to use common sense and do what is right - the parking sector is no different.

If you would like to be part of the conversation and benefit from a range of online resources including: discussion forums, webinars, podcasts and more, with access to people and experts like you working directly in your field, then please email membership@britishparking.co.uk to find out about joining the BPA. L FURTHER INFORMATION www.britishparking.co.uk

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Parking

Free parking for NHS staff and other initiatives The government said that it would cover the costs of providing free car parking to NHS staff working in hospitals during this unprecedented time. Here we look at a few examples of how this has been carried out, alongside some other great work by the public

In March, Health Secretary Matt Hancock announced that the Department for Health and Social Care would be giving immediate financial backing for all NHS trusts to provide free car parking to NHS staff for the duration of coronavirus.

Whether he knew that the pandemic would still be as prominent in June then, only he knows, but since that announcement the government has said that it would cover the costs of providing free car parking to NHS staff working in hospitals during this unprecedented time.

NHS Trusts are responsible for setting car parking charges locally, but Hancock urged all trusts to immediately make use of government funding to abolish parking charges for their staff during the coronavirus pandemic. And that is what the majority did. Prior to Hancock’s public announcement, Newcastle City Council revealed that it wass offering 700 free car parking spaces to NHS staff to help in the fight against coronavirus. Eight car parks across Newcastle, both surface and multistoreys, were handed over to staff at the Royal Victoria Infirmary in the frontline saving lives. It was made clear that all spaces would be used by critical care staff.

Charges were fully suspended for more than seven weeks before, on 18 May, the council reintroduced charges as more members of the public returned to work, albeit with more than 300 free spaces in dedicated car parks for NHS staff.

Healthcare staff were also allowed to park free of charge in pay and display bays.

Speaking last month, Nick Kemp, cabinet member for environment and regulatory services at Newcastle City Council, said: “As one of the first councils to introduce free parking for key workers we have been

proud to support the vital contribution that frontline staff are making to our communities. However, what was initially a three week initiative has now lasted almost two months and cost us around £1 million.

“From the outset we’ve said we would review this temporary measure and, with government lockdown advice beginning to ease, we now feel the time is right to reassess, reintroducing fees for the increasing number of people who may be looking to park, and generating funds to support council services.”

London calling In London, boroughs also set out their intentions to help NHS staff and other critical workers by taking a common sense approach to parking and driving fines. On 24 March, London Councils issued guidance for London boroughs on a pragmatic approach to enforcement of parking and driving offences during the coronavirus pandemic. As such, parking teams began focusing on enforcement of safetycritical controls and assisting key workers helping unwell and vulnerable people.

Although down to individual boroughs, some motions that were pit in place included: relaxing parking restrictions for vital members of staff around hospitals, clinics and emergency services control centres; giving parking permits to key workers allowing them to park more flexibly if there are no parking spaces available; taking into account when drivers demonstrate they are key workers; and making additional parking spaces available to key workers.

Much of this work actually followed initiatives set up by the public and local businesses to help NHS workers

and carers with parking. In mid-March, JustPark launched a nationwide public appeal to ease the burden on travelling NHS staff and patients. JustPark, who run a parking app, urged the public and businesses located close to hospitals to offer their car parking spaces for free. The app enables unused parking spaces to be listed for others to reserve and pay for in advance, but is allowing free parking for healthcare workers and patients by making it possible to list spaces for free.

The appeal was for anyone with a suitable space near an NHS site to list it for free so a healthcare professional or patient can have access to it. JustPark announced that it would not levy any fees for either the space holders or the drivers and is offering this to connect key workers and patients with available spaces. With a network of over 50,000 locations and over 4.5 million registered users, it is hoped that this would provide an invaluable service for an already under-pressure NHS. Other commendable initiatives Beyond parking, other organisations also took a step forward to help key workers during the pandemic. For example, the AA launched a free breakdown service for NHS workers during the coronavirus crisis at the start of April, setting up a dedicated hotline for NHS staff and pledging free recovery to and from work as well as help if they break down at home. The AA also struck a deal with the London Ambulance Service to provide additional support to help keep clinicians on the road during the coronavirus epidemic. The partnership includes 24-hour breakdown and incident management services such as roadside assistance and vehicle recovery for London Ambulance Service vehicles.

From the start of April, NHS staff in Wales began receiving free travel on buses in return for hardship funding from the Welsh Government, covering the next three months.

Aside from travel, HomeServe launched a special offer for NHS and social care workers where they will send an engineer to their home free of charge to fix home emergencies any time until the UK lockdown is over, and has set aside £1 million to cover the cost of these repairs.

In April, EE announced that it would enable unlimited mobile data for all NHS staff for the next six months. L

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Advertisement Feature Written by Jonathan Bradley, Engagement Specialist and Head of Practice Development, Bang the Table (UK)

Not another Zoom Welcome to the new normal of public consultation (other platforms are available)!

So it seems the Covid-19 crisis is here to stay, in some shape or another. And now that many of us are starting to come out of the initial shock and morbid amazement we are starting to think about ‘getting on with it’ and carrying on as best we can. The conversation is switching from lockdown to exit strategy and taking small steps back to normality Public consultation and community engagement is going to be an integral part of this ‘getting back to normal’ daily life, playing its part in planning decisions, housing developments, infrastructure projects, local government statutory consultation and changes to health and social care services.

So as a profession, therefore, now is the time that we too must think about the new normal and what it looks like for us.

Already, some of this is becoming clear and specifically the fast transition by many people from face-to-face participation to online techniques - especially Zoom.

But, first things first! Zoom is not best practice online patient and public involvement just like relying only on doing public meetings has never been the best way to do good public consultation! It is just one method in our toolkit.

Early adopters and seasoned practitioners of online methods of participation already know this and they are in demand. Many others are scrambling to find alternatives to how they used to do things and are just jumping on a video conference as a sticking plaster.

As it happens, a range of things like public exhibitions, planning charrettes, community roadshows, focus groups, stakeholder workshops, public meetings, surveys, discovery interviews, citizens’ assemblies, citizens’ juries, Samoan circles (what? I hear you shout), stakeholder workshops, world cafe events and there’s more can all be done online. So now is the time to get clever when it comes to patient and public participation and online dialogue methods What kinds of things will people want to talk about?

Before diving into how though, we should stop to think about what. The world has just

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gone through an almost literal sci-fi movie experience. People are shocked, worried and uncertain about the future. It is going to be quite difficult to jump right in and expect them to share their views and opinions on changes to local library services, for example.

First of all, local government is going to need to start having conversations about coming out of the Corona Crisis, reflecting on what it has meant for local people and going through a hyperlocal catharsis (most probably online). Some have started doing this already like Chester and Cheshire West Council’s Inspire Now online project and there are many other examples like this from around the world. After this it will need to be back to business as usual, asking people to comment on plans for town centres, changes to local health services, planning applications for new housing, and their views on major infrastructure projects in the pipeline. Now is the time to think about how this will happen?

How will these conversations take place?

Thankfully, before Covid-19 many organisations had already begun to take a digital first approach to public consultation.

So we already have lots of examples and case studies to draw from. What do they tell us? Well they tell us that good online public consultation is much much more than a Zoom meeting (other platforms are available). They tell us that good online public consultation does two things It provides a range of methods to take part, like online discussion forums, storytelling, mapping tools, question and answer tools, graffiti walls, blogs, opinion polls as well as online surveys It offers a suite of information and support,

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

like document libraries, video, podcasts, details of who is listening, key dates, FAQs and lots more. So that people can give proposals intelligent consideration.

As we transition to the new normal best practice and public expectations will dictate that local government offers these types of ‘safe places for online dialogue’ and not just a mediocre replication of a shouty public meeting in the form of an online webinar. We’ve already been campaigning for #NotAnotherSurvey to beat consultation fatigue, well soon we may be talking about #NotAnotherZoom!

Will this last forever?

You’ve probably been talking to friends and relatives about their lockdown experience and I bet many of them have enjoyed some aspects of it. We’ve all learned that we can socialise online and we can have work meetings online. Many people previously reluctant to take these steps are now rich advocates of online working and hanging out online.

Well, public consultation will not be immune to this change in mindset. People will be asking some searching questions of any local authorities who try to go back to the old ways. They will be demanding that more public consultation takes place online, digital first, and they will be their own experts in what works and what doesn’t.

So this will probably last forever to a great extent. Yes, we will meet again, but probably when we really need to and in second place to online consultation techniques.

FURTHER INFORMATION www.bangthetable.com

With the NHS about to embark on the largest hospitals building programme for decades, Katja Lacey, of PA Consulting, explains why there exists a unique opportunity for the NHS to help create sustainable communities which promote health and well-being The health and social care system in this country is huge. It represents over 10 per cent of the country’s economy, nearly 10 per cent of the workforce and around five per cent of all road traffic.

Despite an increase in clinical activity and the challenge of managing significant transformational changes, the NHS has made significant progress. Carbon emissions reduced by 18.5 per cent between 2007 and 2017 and water footprint by 21 per cent between 2010 and 2017.

However, despite these improvements, there remains a significant challenge if we are to deliver the Climate Change Act target of reducing the carbon footprint of health and social care by 34 per cent by the end of this year and 51 per cent by 2025.

The new Hospital Infrastructure Programme, the largest hospital building programme in decades, is our once in a generation opportunity to help achieve these targets.

The largest hospitals building programme in decades Many hospitals across the country are facing huge estates challenges.

Sustainable communities

Making the NHS sustainable for our communities be to achieve energy performance targets of 320 kWh/sqm or less.

This can be realised through various means. For example, the choice of materials for construction, choosing renewable energy sources, using modern methods of construction and using consistent designs across hospitals. Specifically, this means a new hospital should, for example, use high reflectance roofing and paving, site facilities in accordance with solar orientation and prevailing wind and prioritise the health impacts of material The environmentally friendly extraction, transport, use and disposal. alternative hospital build A good example of an environmentally There is an environmentally friendly friendly hospital build can be found alternative to the historical in the US. The Gundersen La approach to hospital builds.

Crosse campus in Wisconsin New approaches are installed geothermal emerging across the Embed d heat pumps under their globe to help achieve i n g health car park. This takes a net zero building a n d healthy advantage of the design. The objective the fab living into moderate temperatures in all buildings ric of w underground and a which emerge from here we live 300-ton heat pump, the new Hospital c a n have strong along with 156 wells Infrastructure returns buried about 400 feet E Programme must fo Building a hospital involves significant resource and, once built, hospitals then require a lot of energy to run. They also produce huge amounts of waste that needs to be carefully disposed of.

There is, quite rightly, a growing pressure on hospital design to become more sustainable and to ensure that both the build process and the running of the hospital are as environmentally friendly as possible.

citizens

r

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Sustainable communities

 underneath the parking lot, provide an efficient heating and cooling source yearround. This results in a savings of 70 to 80 kBTU per square foot annually, by far the largest energy saving component of Gundersen’s new hospital. This is something that every new hospital build in the UK should be emulating. As well as this, the Gundersen La Crosse campus also installed a highly insulated building shell – covering windows, walls, ceilings and so on resulting in large savings and reducing their reliance on fossil fuels. Again, something all new hospital builds should seek to replicate.

The benefits of a well-designed, net zero building not only include a reduced carbon footprint, but also an improved environment for patients and staff, with increased natural light and noise reduction methods resulting in huge benefits in terms of health outcomes.

Building hospitals is not the only opportunity for the NHS Better design of new towns not only improves the health and wellbeing of residents but also helps create sustainable communities. Within the NHS Long Term Plan, it’s recognised that the NHS has a wider role to play in influencing the shape of local communities. It is now well-established that new developments need buildings that help to break down the traditional boundaries between different services to support an integrated approach to health and sustainability.

The benefits of a well-designed, net zero building not only include a reduced carbon footprint, but also an improved environment for patients and staff, with increased natural light and noise reduction methods resulting in huge benefits in terms of health outcomes More widely we can draw on lessons from NHS England’s Heathy New Towns programme, which showed that better planning and designing improves the health and wellbeing of residents but also helps create sustainable communities.

This can create a win-win for housing developments which are so often proposed around new hospitals.

Co-location of NHS services, such as primary care or public health, within these communities, through community hubs and other health and well-being services, can bring wide benefits to the local population.

To be successful, these services should be co-developed, with input from public health professionals, local planners and local people, to adapt this to local needs, including the integration into people’s homes.

As our work on the Heathy New Towns programme for NHS England showed,

embedding health and healthy living into the fabric of where we live can have strong returns for citizens, the NHS, social care and wider government. We found that every £1 of spend on heathy new towns created a £3.2 return across the public purse. These principles must now be applied to our new hospitals and their surrounding developments, where the same benefits can be realised.

The Health Infrastructure Programme represents the one chance to make buildings and social assets which promote sustainability, helping to turn around some of the financial difficulties the NHS is facing. This is an opportunity that we cannot afford to miss. L FURTHER INFORMATION www.mpba.biz

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IT

Virtual IT department offering peace of mind Kamazoy Virtual IT Department can offer piece of mind for you and your business. The company has over 20 years of experience in the IT industry. Over the years, Kamazoy has refined its IT support services to benefit its customers, putting their needs first. Aligning with your goals helps Kamazoy to give you the best service it can. The organisation has become more efficient, implementing systems to improve its customer response time, and its system security. Kamazoy has UK based support service staff and communicates with you regularly to keep you in the loop regarding the status of your project.

IT is an essential part of your business. It’s a vital tool to help you, your employees and your business achieve more. Investing in your IT infrastructure brings results, in increased productivity, overall

efficiency, company morale and ultimately, customer satisfaction.

Kamazoy Virtual IT Department is here to help your business be the best. Whatever your needs contact the company today and have a chat about how it can help you setup or reassess your company’s IT solutions.

Products and services include: IT support; networking; Cloud services; back-up; PCs and servers; IT security; internet; leased lines; VoIP; office moves; procurement; and installation.

FURTHER INFORMATION Tel: 0330 363 2000

RESURFACING

FLOORING

Flooring instillation service specialising in healthcare sector

From the initial survey to the completion of the job, Flooring Matters SW Ltd provides a professional installation service of commercial and contract floor coverings, wall and floor tiling, and hygienic wall coverings.

Specialising in works to the healthcare sector, the company is able to offer the full effective impervious Altro walls and floor package which includes a 20 year system guarantee and delivers a safe, hygienic and fire-compliant solution for the healthcare environment. Being hygienic vinyl products with heat welded seams, Altro Whiterock and Altro vinyl floors have no grout gaps to harbour bacteria, germs and mould - essential for areas of utmost hygienic importance. Altro products are

also available in an extensive range of colours to make a welcoming and aesthetically pleasing environment.

Much of Flooring Matters’ work is repeat business which is testament to its customer satisfaction. Being members of the Contract Flooring Association, the organisation always aims to deliver a professional and high quality service that is on time and within budget. Its professional fitters have a minimum qualification of NVQ2 in resilient and impervious floor coverings and carry a CSCS card. Flooring Matters also separates all of its vinyl waste accordingly so that zero per cent goes to landfill and is recycled using the recoflor scheme.

FURTHER INFORMATION Tel: 07545161821 flooringmatters@hotmail.co.uk www.flooringmatters.org

HEALTHY EATING

Car park surfacing and maintenance specialists

Non-carbonated vegan friendly fruit drinks

NMC is a leading independent surfacing, drainage and civil engineering contractor, providing a 24/7 nationwide car park turnkey solution across the UK for the government, councils and some of the biggest brands in the UK, particularly within the retail and petrochemical sector.

NMC’s commitment to safety, quality, and service culture from its senior management right through to operative level, makes the company the ideal choice for partnering to protect brand equity with its key clients.

As specialists with vast experience in dealing with high priority prestigious projects, NMC plays a key role in its clients stakeholder management while delivering project with minimal financial or operational disruption.

The NMC surveying team is on hand to assist you with often

As a nation, we are becoming more aware of our diet and healthy eating. What we drink is also of great concern, especially the effect that caffeine fuelled high sugar drinks have on the human body, which are devoid of any nutritional benefits. Alternatives are hard to find. The lack of choice at restaurants, takeaways, vending machines and shops are very limited and bland in flavour.

After launching in 2008 with a range of natural skincare products, Natural Origin’s frustration at the lack of tasty still beverages drove it to develop its current range of natural, fruit drinks in 2013.

Natural Origin UK offer noncarbonated vegan friendly fruit drinks free from artificial flavours, colours and preservatives.

Oranges, lemons, lime and hibiscus provide high levels of Vitamin C and antioxidants while ginger is known for its digestive and anti-inflammatory properties.

complementary site condition surveys, with surveyors able to visit your site and analyse its current condition before detailing, with a colour coded report that incorporates its findings, evidence of it’s condition, which can assist clients when controlling a budget, prioritising maintenance works and creating a planned maintenance works for the next five years.

FURTHER INFORMATION nmcsurfacing.co.uk

Sales at outdoor events have proven to be very popular with children and adults of all ages and the company is proud to be winners of two Great Taste Awards. The range includes Hibiscus & Ginger, Lime & Ginger, Jamaican Ginger Beer, Real Lemonade and Citrus Fusion.

Natural Origin is available for events, sports, graduation, parents evening, opening days, private functions (using compostable cups and drink dispensers) and wholesale by the 330ml and 750ml glass bottle.

FURTHER INFORMATION info@naturaloriginuk.com www.naturaloriginuk.com/ juices or call 0208 0996513

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INFORMATION TECHNOLOGY

INFECTION CONTROL

A New Rapid Pandemic Response Scheme Omnicell, a global leader in healthcare automation, has been driving innovation in medication and supply automated technology for 25 years across all healthcare settings. With the NHS under unprecedented pressure, Omnicell is supporting NHS trusts to quickly put in place automation which will support frontline workers to meet the increasing demand for services.

Omnicell has fast-tracked production and deployment of its XT Automated Dispensing Cabinets to where technology and support services are needed the most - whether that’s ICU/ED or new/ repurposed care areas. At St Thomas’s Hospital, Omnicell staff have helped increase the capacity of two wards with

Using product innovation to maximise efficiency

additional automated cabinets - creating a brand new ICU. Furthermore, to help clinical staff ‘onboard’ quickly, Omnicell’s Customer Solutions Team are delivering training online to free up existing Omnicell users at NHS trusts to focus on patient care. Understanding the extreme pressures on point of care staff, Omnicell is also offering support with building incoming new data bases.

In addition, Omnicell’s Pandemic Response Team has established procedures and protocols designed to mitigate the risk of exposure to the virus and potential impact on business operations.

FURTHER INFORMATION www.omnicell.co.uk/home/ omnicell-uki-response-tocoronavirus-covid-19/

Daikin Applied UK is the market leader in energy efficient Air Handling Units, Chillers and Heat Pumps. The comany specialises in large scale bespoke projects from data centres and hospitals to large offices and universities.

Daikin’s aim is to contribute to people’s health and comfort by applying innovative technologies to provide cooling, heating, humidity and overall better air quality.

With full lifecycle service and maintenance packages, Daikin Applied Service offers an after sales service covering ANY HVAC manufacturer.

The company’s products are at the forefront of low energy consumption and it aims to be

CO2 neutral by 2050. Aiming for a circular economy, Daikin has embraced reclaimed, recovered and reused refrigerants across all products and maintenance.

Through product innovation it has maximised efficiency, and through smart technology in its cloud based remote monitoring, Daikin can reduce energy consumption.

The organisation has an extensive manufacturing facility located in Newcastle, where highly skilled engineers manufacture a variety of AHU’s from modular units to fully bespoke solutions.

Daiken’s full supply and installation service is supported by its head office in Rome, which is responsible for the manufacture of chiller products across Europe.

FURTHER INFORMATION www.daikinapplied.uk 0345 565 2700

ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service 70

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14

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36, 39

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31

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74

40-43

28 4 30, 33

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12, 13

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74

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IFC, 54

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22, 23

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10 52 73

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

6 62 8

WW.OGELIT.COM

01438 567551

INFO@OGELIT.COM

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