Health Business 20.3

ISSUE 20.3 www.healthbusinessuk.net

SUPPLY CHAIN

TECHNOLOGY

ESTATES

SUSTAINABILITY

GREEN GOALS FOR THE NHS What role does the NHS have to play in tackling the climate emergency?

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Comment

ISSUE 20.3 www.healthbusinessuk.net

SUPPLY CHAIN

TECHNOLOGY

ESTATES

The coronavirus recovery and what comes next

SUSTAINABILITY

GREEN GOALS FOR THE NHS What role does the NHS have to play in tackling the climate emergency?

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It is difficult to outline where we stand with the coronavirus crisis.

The peak of the virus appears to be behind us, but the task ahead is no less daunting.

Health experts still fear a second wave of coronavirus, which would once again put our hospitals under unprecedented strain, especially as the winter months creep closer. With many returning to work, schools reopening and a slightly late holiday season in full swing, the lockdown restrictions of the Spring seem a distant memory.

In light of this challenge, it is more important than ever that the thought leaders and experts from across the whole healthcare sector have an input into how we get back on track and continue to provide the best possible services to those who need them most. Moving forward, we hope to give them a platform to share ideas and success stories that can help drive innovation and success across a wide range of areas.

In this issue, we tackle some of these challenges, from optimising NHS facilities post-coronavirus (page 27) to placing the climate response at the centre of a wider overall plan (page 31).

Follow and interact with us on Twitter: @HealthBusiness_

We also present a number of Panel of Expert discussions, tackling not only the pandemic recovery (page 20), but also the interoperability of IT systems (page 58) and the impact on hospital parking (page 44).

As always, I hope you enjoy the issue.

Michael Lyons, editor

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Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Contents

Contents Health Business 20.3 06 News

41 Ventilation

13 Coronavirus

44 Expert Panel: Parking

Survey prompts calls for better support for female staff; Surgeons should be given ‘emotional intelligence’ training; and Trusts charged over £15m when hiring overseas specialist staff

13 20

At this highly pressurised time, volunteers provide valuable support to reduce demand on NHS services in England. The Royal Voluntary Service explain the role of the NHS Volunteer Responders scheme in helping the health service during the current crisis

15 Coronavirus

A recent survey from the Royal College of Nursing revealed its members’ experiences of working during the pandemic. Here we look at the impact that the coronavirus crisis has had on the profession

31

20 Expert Panel: Pandemic

Given the current challenges facing the NHS, likely to be heightened as we approach what many predict to be the most difficult winter for the NHS since the Second World War, we have gathered together a Panel of Experts to analyse the NHS response to coronavirus, the next step in improving facilities and future working patterns to improve efficiency

27 Estate Management

Simon Taylor, head of Portfolio Optimisation at NHS Property Services, discusses how the NHS and wider healthcare system will need to optimise its facilities post-coronavirus

51

31 Sustainability

David Powlesland, senior manager at the Carbon Trust, asks what role does the health sector have to play in tackling the climate emergency?

37 Modular Build

65

The government and the wider public sector are the biggest clients of the construction industry. Here, the Modular Portable Building Association discuss the growth and benefits of off-site construction

Health Business magazine

Building managers will have to pay close attention to the cleanliness of their ventilation systems in the wake of the Covid-19 lockdown, according to the Building Engineering Services Association (BESA) Stewart Clure and Grahame Rose collaborate to answer some questions on the current state of NHS parking, providing expert analysis on everything from the short- and long-term impacts of the pandemic on NHS sites to the role of technology in parking management

51 Technology

Covid-19 is the catalyst for change in health provision as patients demonstrate strong appetite for virtual care that’s here to stay, argues Alan Lowe

55 Technology

With digital technology playing an increasingly important role in ensuring a happy and efficient NHS workforce, Sean Hopkins, head of Programmes and Technology for Employment Services at NHS Shared Business Services, describes some of the existing solutions that are already available to NHS organisations

58 Expert Panel: Technology Christine Walters, Ian Brewer, Ian Hazel and Ikenna Emenyonu form our latest ICT Panel of Experts, in which we discuss the interoperability of healthcare systems, the role of the patient in digital transformation and the engagement of clinical staff

65 Supply Chain

NHS Supply Chain write for Health Business about how they’ve been working to deliver products to the NHS, particularly PPE, during the Covid-19 pandemic

71 Medical Technology

Barbara Harpham, chair of the Medical Technology Group, looks at how technology has helped the NHS cope during the current crisis, and how it holds the key to a new, more efficient, post-pandemic healthcare system

77 Digital Records

Following a recent digital pharmacy trial, undertaken by NHS Wales, Sascha Giese discusses how digital health records can help lighten the load on GPs

www.healthbusinessuk.net Issue 20.3 | HEALTH BUSINESS MAGAZINE

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News

STAFF WELL-BEING

Survey prompts calls for better support for female staff The Health and Care Women Leaders Network of the NHS Confederation has warned that stress and exhaustion from the coronavirus crisis threatens to intensify burnout among women working in the NHS. According to the survey, the pandemic had amplified alleged bullying, sexism and racism on the part of managers, while one in four of the women responding to the survey said that they did not feel safe sharing personal concerns with their boss. This was especially true for staff from a minority ethnic background, who also reported feeling traumatised by the disproportionate impact of the virus.

The Health and Care Women Leaders Network also revealed that 72 per cent reported that their job was having a greater negative impact than usual on their emotional wellbeing, with more than half reporting a negative impact on their physical health.

The survey, carried out in June, two months after the national peak in hospital admissions, has caused health leaders to raise concerns about burnout among female staff – who make up more than three-quarters of the NHS workforce.

The Health and Care Women Leaders Network makes 10 recommendations, including calling for managers to support workers who

CORONAVIRUS Labour is calling for payments made to people to be disregarded in the same way as other compensation schemes such as the Windrush Compensation Scheme or those who hold a Victoria or George Cross. The party has previously called for the £16,000 upper capital limit to be removed during coronavirus, as claims for Universal Credit soar to 5.5 million amidst the crisis.

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CORONAVIRUS

One in eight hospital coronavirus cases ‘caught on-site’

A study by King’s College London of 10 hospital sites has found that thousands of patients are likely to have been infected with coronavirus in UK hospitals.

At least one in eight patients who had received hospital treatment for coronavirus had caught it on-site, which researchers are saying is a relatively low rate and shows there is effective infection control in place.

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DISCHARGING

NHS compensation leaving bereaved families without benefits New research from the Labour Party has shown that families who have lost loved ones to coronavirus while they worked on the frontline will be stripped of their social security payments.

Under the NHS and Social Care Coronavirus Life Assurance Scheme, the £60,000 lump sum given to the families of NHS and social care workers who die after contracting coronavirus is being treated as capital in means-tested benefits.

This means that, under current rules, a family entitled to Universal Credit, Housing Benefit or Pension Credit would lose their entitlement.

With at least 540 health and social workers having died from coronavirus, the analysis reveals that only 19 families have benefited from the scheme. There is confusion over how to claim compensation for the loss of a loved one as a result of coronavirus, with the Royal College of Nursing and British Medical Association calling for it to be better advertised.

want to speak up about personal concerns in relation to the pandemic, while being mindful that minority ethnic workers may find it particularly difficult and should be able to go through alternative channels.

It also recommended that staff should be discouraged from working unpaid overtime and encouraged to maintain good work-life boundaries, and that requests to work flexible or reduced hours should always be accommodated unless there are exceptional reasons.

Funding to help people return home from hospital People needing additional follow-on care after being discharged from hospital will now be supported by a £588 million fund.

The £588 million investment will cover adult social care or the immediate costs of care in their own home.

From 1 September, the NHS will be able to access the funding in order to provide up to six weeks of additional support so people can receive ongoing help with their recovery and rehabilitation after they leave hospital.

This could include support in their home or access to services such as physiotherapy.

NHS Continuing Healthcare (NHS CHC) assessments will also restart from September ensuring those with complex health needs can continue to access the care they need for free.

It remains the case that no one should be discharged from hospital directly to a care home without the involvement of the local authority, and that all patients are required to be tested for coronavirus prior to discharge to a care home.

New guidance has also been published to help hospitals safely discharge patients into the appropriate setting to maximise their independence and ensure they can remain in their own homes as much as possible.

The researchers analysed data on 1,500 cases to 28 April, covering the peak in the UK. Only those who tested positive 15 days or more after admission were counted as hospital-acquired infections.

If patients who tested positive after five to 14 days are included, the proportion increases to 23 per cent.

The study only looked at people who were being treated in hospital for coronavirus, so does not include the vast majority of people who caught the disease and either showed no illness or just recovered at home with no need for treatment.

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News

STAFF WELL-BEING

Surgeons should be given ‘emotional intelligence’ training Surgeons should be given regular ‘emotional intelligence’ training as an ‘explicit’ part of their professional development to combat epidemic levels of burnout in the profession.

Emotional intelligence is defined as someone’s ability to understand their own emotions, and those of the individuals they interact with. Training sessions in emotional intelligence are commonly used in the business world to improve mental wellness but aren’t yet being fully utilised in the medical community.

Dr Lorna Bourke, Principal Lecturer in Psychology at Liverpool Hope University,

says that the sessions are urgently needed to protect both surgeons and their patients. She says this type of training could help to reduce the stigma associated with anyone who reaches out for emotional support.

Last year the Royal College of Surgeons (RCS) issued a report highlighting the need for surgeons to be better equipped to recognise the early signs of deteriorating mental health. The RCS said symptoms of burnout include ‘feeling emotionally drained, fatigued and frustrated at work, feeling unable to accomplish much and not enjoying working with patients anymore’.

ABSENCE

TEST AND TRACE

Coronavirus peak prompts record high NHS sickness rate

MPs question ICO’s handling of Test and Trace data

New data from NHS Digital has revealed that more than one in 20 NHS staff days were lost to sickness in England in April.

The April figure of 6.2 per cent, up from 5.4 per cent the month before, is the highest level recorded in data that goes back to April 2009.

In terms of staff numbers, the data shows that approximately 2.3 million full-time equivalent (FTE) days of work were lost out of a total of nearly 36.6 million in April 2020. This compares with 1.4 million FTE days lost out of nearly 35 million in the same month last year.

Unsurprisingly, the worst-hit was London, where the sickness rate increased to 7.2 per cent. This number contrast with a rate of four per cent in January, when the capital had the lowest sickness rate of any English region.

South-west England reported the lowest rate of 4.5 per cent, making it the only region in England not to report their highest sickness rate since April 2009. Ambulance trusts recorded the highest rates of sickness absence, at 7.3 per cent.

According to NHS Employers, which represents hospitals and other providers of care, stress accounted for a third of sickness absence in the NHS, costing the service over £300 million per year.

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More than 20 MPs have questioned the Information Commissioner’s Office role in holding the government to account for its failures in the NHS coronavirus Test and Trace programme.

The 22 MPs from four parties have sent a letter to Elizabeth Denham, the Information Commissioner, demanding that the government change the programme after it admitted failing to conduct a legally required impact assessment of its privacy implications.

The group calls on the ICO to consider fining the government ‘if it fails to adhere to the standards which the ICO is responsible for upholding’.

The letter, which was signed by MPs from the Liberal Democrats, Labour, Green party and Scottish National party, was arranged by the

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Open Rights Group, which successfully forced the government to admit its failure to perform a data protection impact assessment in July.

Daisy Cooper, the Liberal Democrat MP for St Albans, said: “During the coronavirus pandemic the government has seemingly played fast and loose with data protection measures that keep people safe. The public needs a data regulator with teeth: the ICO must stop sitting on its hands and start using its powers – to assess what needs to change and enforce those changes – to ensure that the government is using people’s data safely and legally.”

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DIGITAL

Electronic discharge summaries to save NHS time Hospitals across England will soon be able to send secure and standardised clinical patient discharge summaries and outpatient attendance information electronically to GP systems.

NHS Digital says that during its trial with Dorset County Hospital, the organisation was able to send over 4,000 structured Fast Healthcare Interoperability Resources (FHIR) messages to four volunteer GP practices

locally, including outpatient letters, emergency care and inpatient discharge summaries.

The system saves GP practices time in processing and clarifying the information they receive, so changes can be tracked and necessary actions taken. It also notifies hospitals when messages have been delivered and have been actioned. GPs and hospitals benefit from a reduction in paper use, postal costs and time re-

typing information into their computer system.

Traditionally GPs have had to enter information from patient discharge letters into GP systems, taking up valuable admin time. National transfer of care messages allow for the data to be easily extracted straight into GP computer systems.

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News

RECRUITMENT

Trusts charged over £15m when hiring overseas specialist staff The Labour Party has claimed that NHS trusts have been charged over £15 million when hiring overseas specialist staff since 2017.

A freedom of information request by Labour has found that NHS trusts have had to pay extortionate fees through the immigration skills charge in order to fill vital specialist roles that have been left vacant through domestic skills shortages.

At present, 52 out of the 224 NHS hospital trusts in England have responded to the freedom of information request; asking how much they are paying to government in the immigration skills charge, when forced to recruit overseas specialists.

In total, the 52 trusts have cumulatively paid £15,549,944 through the charge since 2017.

Three trusts have paid over £1 million since 2017. Portsmouth Hospitals NHS Trust has been the worst hit, paying £2,007,000

since 2017, whilst Barts Health NHS Trust has paid £1,287,000 since 2017.

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CANCER CARE

MIDWIFERY

Public encouraged to come forward for cancer checks

Midwifes missing meals to keep services running

The NHS has enlisted the help of a number of celebrities who have cancer to encourage the public to come forward for vital, life-saving checks.

Famous faces backing the move to increase take-up of NHS checks include the Nolan sisters, who have recently opened about their cancer diagnosis, and former BBC Breakfast presenter Bill Turnbull.

Although the NHS treated 85,000 people for cancer during the pandemic, nearly half of the public have said they had concerns seeking help in the midst of the outbreak, and one in 10 reported that they wouldn’t contact their GP even if they had a lump or a new mole.

Hospitals have put extensive measures in place so that patients can get safely tested

and treated, including by rolling out covid protected hubs across the country and introducing treatment swaps that require fewer trips to hospital and have less of an effect on cancer patients’ immune systems.

The call to get checked follows a sharp drop in the number of people coming forward, with 141,643 referred in June compared to almost 200,000 during the same period last year.

England’s top cancer doctor has urged people to come forward for checks, and said that waiting to get help can have serious health consequences now and in the future.

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BAME

GPs call for action to protect ethnic minorities

The Royal College of GPs has called for action to tackle the risks posed by coronavirus to ethnic minorities and to ensure doctors and staff are kept safe this winter.

The head of the college, Professor Martin Marshall, has expressed concern for the thousands of GPs from a black and minority ethnic (BAME) background who will be on the frontline of any resurgence of the virus.

Writing to Equalities Minister Kemi Badenoch, Marshall urged the government to act on recommendations made by

Professor Kevin Fenton in his report for Public Health England which highlighted BAME communities were disproportionately at risk of dying from coronavirus. He said that vital steps, such as occupational risk assessments that were culturally competent, must be developed so GPs can assess the safety of themselves and their staff.

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A new survey from the Royal College of Midwives has highlighted how midwives are missing meals and delaying going to the toilet because they do not have enough time for breaks.

During a typical working week, RCM members revealed: 87 per cent delay going to the toilet because they don’t have enough time; 77 per cent skip meals including over a quarter who do so always or most of the time; 52 per cent feel dehydrated most or all of the time at work because they don’t have enough time to get a drink; and 37 per cent never or rarely take their entitled breaks.

Midwives are also working additional unpaid hours, on top of long shifts, with more than one in five working at least five extra hours each week for no pay.

Alice Sorby, Employment Relations Advisor at the RCM, said: “Midwives are putting their own health and wellbeing on the line to ensure that women and babies get the care they need – but it shouldn’t be either/or. The NHS should be doing all it can to promote staff retention and by support our members health in the workplace so they can deliver the very best care to women and their babies.

“The physical and mental health of midwives, maternity support workers and all NHS staff has never been more important, but sadly what the results of our member survey have revealed is there has been little improvement over the past four years. Covid-19 has undoubtedly increased the pressure on midwives, some of whom have been working additional hours unpaid just to keep maternity services open and running.”

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Issue 20.3 | HEALTH BUSINESS MAGAZINE

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News

FACILITIES MANAGEMENT

£500m FM framework opens for NHS

A new £500 million procurement framework has been launched by NHS SBS to offer high-quality soft facilities management services to the NHS.

The Soft FM, Asset Compliance and Security Services Framework provides simple, cost-effective access to a wide-range ofspecialist services.

With average indicative savings of five per cent compared to buying direct from a supplier at list price, the potential cost saving for the public sector is expected to be up to £25 million.

The framework has 32 different lots that cover everything from asbestos removal, active and passive fire safety, CCTV and lift maintenance; to cleaning and laundry services, pest control, and

grounds and gardens maintenance.

Providing complete flexibility to the NHS, local authorities, educational establishments and any other public body, the agreement includes an option to procure single services, bundled services or a complete managed solution. It will run until summer 2022 with the possibility of an extension to 2024.

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CYBER SECURITY

CORONAVIRUS

New framework to help NHS manage cyber threats

Coronavirus antibodies tests putting ‘public at risk’

A cyber security services framework has been launched for the NHS and public sector, which can be used to procure external support and services to help manage cyber security risks.

Developed in partnership between NHS Digital, NHS Shared Business Services and the National Cyber Security Centre, the agreement will also help the NHS increase resilience and recover in the event of an incident.

It enables organisations to bring in additional resource to do such work as implement solutions, carry out security testing, provide consultancy and recover from incidents.

Dan Jeffery, NHS Digital’s head of Innovation, Delivery and Business Operations, said: “This new framework will give NHS and other public sector organisations confidence that they are buying quality cyber security services from trusted suppliers, and a sustainable route to market for organisations who want to improve their cyber security posture.

“It will provide further options, alongside NHS Digital’s central offering, for organisations to procure support which is bespoke and relevant to them, so that they can continue to keep patient data safe and secure and deliver world class patient care. We will continue to work with partners such as the NCSC to support organisations to safeguard against malicious attacks.”

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TAXES

Two-thirds

support raising taxes to support NHS

A new study has revealed that the majority of taxpayers in the UK would pay more tax to provide a funding boost for the NHS since the outbreak of coronavirus.

According to ThoughtWorks, 63 per cent of people would be happy to pay more tax to fund healthcare in the UK, rising to 71 per cent of people aged over 50.

However, 26 per cent believe technology could offer taxpayers better value for money and a more efficient NHS. Just six per cent would accept cuts in this area in order to keep their tax payment down.

Appreciation for the country’s public services is at an unprecedented high, with 65 per cent of Brits admitting they value their hospitals more now than they did before the start of the pandemic.

The survey also found that 56 per cent would be happy to pay more tax to improve emergency services, 45 per cent to improve social care, and 45 per cent to improve mental health.

Asking respondents to predict what areas of healthcare could become a reality in the next 10 years, 30 per cent believed they would be able to speak with their GP via Skype, 27 per cent believed there will be an online medical passport; 22 per cent believed medicines could be automatically re-prescribed; while seven per cent believe hospitals will see robots replace front line staff.

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The Royal College of Pathologists has warned that poor regulation of coronavirus antibodies tests could be putting the public at risk.

The college has written to Health Secretary Matt Hancock urging for rules to be tightened on kits sold direct to consumers, saying that they can ‘mislead the public and put individuals at risk’.

Although many different types are available, no antibodies test has been officially approved for at-home use in the UK. It is also worth remembering that it is still not known whether having antibodies will protect people from a second infection.

Jo Martin, president of the Royal College of Pathologists, said: “Currently, if you buy a test on the internet or you buy it in certain boutiques or shops, we can’t guarantee that the quality of that is of an appropriate standard. We can’t guarantee that the result will be easy to interpret or that it will be not misleading.”

An analysis of 41 antibodies tests sold to the public in the UK, seen by the BBC’s Newsnight programme, found almost a third provided incomplete and inaccurate information.

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Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Coronavirus

Reinforcing NHS services when patients need them most At this highly pressurised time, volunteers provide valuable support to reduce demand on NHS services in England. The Royal Voluntary Service explain the role of the NHS Volunteer Responders scheme in helping the health service during the current crisis When the UK was hit by the Covid-19 pandemic, the NHS faced many complex challenges. A key concern for the NHS in England was ensuring our services did not become overwhelmed – that patients continued to receive essential care and we protected the well-being and resilience of our workforce.

As the pressure on services began to mount, it was essential that those in need remained able to access support. The implementation of a scheme that could not only support vulnerable patients, but also alleviate demand on staff teams was incredibly important.

The NHS Volunteer Responders scheme was launched in March this year; it was set up by NHS England and Royal Voluntary Service, working in partnership with GoodSAM to develop flexible, app-based volunteering.

The service enables those who need to self-isolate, are housebound, or choose to avoid busy public spaces during the pandemic, to do so without having to worry about getting access to vital supplies. It also provides volunteer drivers to take patients to and from medical appointments where PPE can be provided by the host organisation.

A further service available from the scheme with some of them fitting volunteering to NHS organisations is to deliver goods around their existing employment. between sites, reducing pressure on staff “My advice to other NHS organisations teams and the likely resulting costs of filling would be to look closely at your services essential roles with bank or agency staff. and see where the volunteers could support As well as providing support on a caseyou. The service is straight forward to access by-case basis, a number of NHS trusts have and easy to use - all you need to do is found the service can be utilised to drive NHS complete a simple online form. I was fully efficiencies. For example, at Worcestershire reassured that the arrangements met all Health and Care NHS Trust, Administrator Claire data protection requirements, and that all Thomas was redeployed to support the EBBI volunteers had signed the relevant declaration (Evesham, Bredon, Broadway, Inkberrow) multias part of their sign-up procedure, plus the disciplinary Neighbourhood Team as part of the service is assured by NHS England. Using the Trust’s response to Covid-19. This team includes ‘volunteer goods drivers’ also highlighted a 22 district nurses who work alongside a team way which our Neighbourhood Teams could of health and social care professionals within adapt their way of working in the future.” the town of Evesham and surrounding area.

Usually nurses collect dressings for each Claire Thomas said: “The nurses were really home visit from the dispensing GP or grateful that the NHS Volunteer Responders community pharmacist, which not only adds were able to support them at a time when to nurses’ travelling time, but they may also their team was under extra pressure due to need to travel further to pass them on the coronavirus outbreak. The service to another team member if a was brilliant, and the volunteers visit has to be reallocated. were incredibly helpful. They Claire coordinated all As the were able to support us prescribed items, keeping pressur e while working remotely, a shared spreadsheet o n services so nurses could see to mou began when the dressings had been delivered. essentia nt, it was l t She then booked h a t t in need hose the NHS Volunteer r Responders to make able to emained ac the deliveries as suppor cess required. The scheme t. was trialled with half of the team and just ten weeks after launch, NHS Volunteer Responders had made 300 deliveries, saving an estimated 150 hours of clinical time.

During this period when the demand on nurses and other healthcare workers is often at maximum capacity the support of the volunteers can help trusts to avoid additional costs, or the need to reallocate people from other equally hard-pressed services.

The support of volunteers, through NHS Volunteer Responders, is reinforcing NHS services when our patients need them most.

It is an invaluable resource and I encourage trusts which have not yet used the scheme to consider where it can provide support over the coming months. The scheme will be in place until at least December 2020. L FURTHER INFORMATION www.nhsvolunteerresponders.org.uk

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Coronavirus

Coronavirus and nursing: Passionate but pushed to the limit A recent survey from the Royal College of Nursing revealed its members’ experiences of working during the pandemic. Here we look at the impact that the coronavirus crisis has had on the profession Completed by almost 42,000 members, the independent sectors the percentage thinking second report of findings about the future of of leaving the profession has increased to nursing found that 88 per cent of respondents 36 per cent, from 27 per cent last year. remain passionate about the nursing profession.

For those thinking of leaving, 61 per cent However, the survey reveals how hard highlighted pay as a factor, with others citing members have been working and in what the way nursing staff have been treated circumstances. For example, 38 per cent said during the coronavirus pandemic (44 per staffing levels got worse during the pandemic, cent), low staffing levels (43 per cent), and 62 per cent said the needs of people they care lack of management support (42 per cent). for became more complex and 76 per

Those findings also showed that cent reported an increase in while 74 per cent of respondents had their own stress levels. felt more valued by the general Two On top of this, 33 per public in recent months, months cent said they worked highlighted through the i n to the cris longer hours, but Clap for Carers campaign, more th is, and only 40 per cent only 18 per cent said of those reported they felt more valued nursing an a third of s getting paid for by the government. t a f f r being u eported those hours. to care nder pressu Additionally, the Eight key re for pati RCN also reports priorities e possible n that 34 per cent 100 days after the or confits with c o rmed ronaviru said they worked coronavirus pandemic at a higher level was declared by the adequa s without of responsibility, World Health Organisation, te PPE but, again, 90 per 19 June, the RCN set out cent of those said that eight key priorities vital for they received no extra pay. the safety of health care staff Looking at well-being, more and the general public following than half reported that they’re worried about the initial peak of the pandemic and as a their own physical (58 per cent) and mental wider range of health services resume. health (52 per cent) and 91 per cent claimed Two of the priorities focused on the need that they’re concerned about the well-being for a supportive and considered approach of those in the nursing profession generally. to the mental health of nursing staff and The first report from the RCN’s Building other health care workers. Many health and a Better Future member survey in midsocial care staff have worked, and continue July showed that across the NHS and to work, in particularly stressful, exhausting

and traumatic environments, while the backlog of postponed treatment will place great strain on services and, therefore, staff.

The RCN called for employers to make available and fund timely access to confidential counselling and psychological support for all staff, as well as support the health and well-being of nursing staff.

Other priorities include calling on UK governments, relevant agencies and employers to: commit to full and proper risk assessments; tackle underlying causes that contribute to placing BAME staff at heightened risk; ensure nurse leaders are equipped to futureproof infection control and critical care capabilities; and support nursing students as they resume their studies.

PPE Since the pandemic was declared in March, a few issues have remained at the top of the agenda and news headlines across the UK - one is the disproportionate affect that the pandemic has on the BAME community, especially in health and care staff, and another was the overflow of patients to acre homes without proper procedure or due thought.

However, the issue that may have slightly faded in recent weeks is that of personal protective equipment (PPE). Two months into the crisis, and more than a third of nursing staff reported being under pressure to care for patients with possible or confirmed coronavirus without adequate PPE. Although the situation has since reportedly improved, 23 per cent of respondents to the RCN’s member survey on PPE in May who need gowns said there weren’t E Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Providing covered walkway solutions around live-environment working Canopy and covered walkway specialists Fordingbridge continue to prove they are contractor of choice for live healthcare projects, following various new installations during the pandemic.

The design and build firm have recently completed a 18m long gullwing shelter for the ambulance bay at the newly extended John Radcliffe Hospital, along with multiple canopies for units at Stoke Mandeville Hospital among others.

With a number of projects programmed for completion later this year, Jon Heywood, Technical Sales Manager, explains how the firm’s method of working offers such benefits to both NHS trusts, architects and principal contractors.

He explains: “Our main advantage is that all of our services are completed in-house.

From design, through to manufacture and installation, the whole process is internal. This not only means that we can work directly with trusts and architects to come up with a developed design, but that we are very quickly reactive should the programme change on site. While

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naturally this is avoided, the pandemic did see a number of principal contractors forced to escalate their programme to meet demands, and as our controls are internal, we were able to react to support this.”

The engineering and construction firm have also seen a distinct rise in the number of trusts looking for solutions around live-environment working. Jon says: “We have the benefit of working in a number of sectors, including retail, logistics and education. As with healthcare, these are environments where services can not simply stop until works are completed. There are

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restrictions on operational hours, reduced working space and members of the public who must both access the facility but be protected from site. With every project we undertake a full feasibility survey to address these aspects from the outset. This then allows us to provide a practical programme which works for the trust, and delivers timely results on behalf of the principal contractor.”

With an ever increasing portfolio of products ranging from simple glazed entrance canopies to bespoke ambulance bay shelters, the firm still wear their heart on their sleeve with regards to working within the public sector. Jon concludes: “We are currently engaged with a number of trusts in the development of staff breakout areas. This is allowing us to utilise our expertise in glulam timber, not generally used in healthcare settings, to create peaceful, sheltered environments for healthcare staff to unwind.

Staff well-being is equally important.”

FURTHER INFORMATION www.fordingbridge.co.uk

î † enough to use, despite promised deliveries.

A further 34 per cent said they were concerned about the supply of gowns for their next shift.

Of more concern, more than half of those respondents (58 per cent) said they’d raised concerns about PPE with 27 per cent of those saying their concerns had not been addressed.

A further 44 per cent of respondents were still being asked to reuse single use equipment.

The Royal College of Physicians Alongside the work of the RCN, the Royal College of Physicians has also been publishing regular surveys of its members to determine the state of play in their profession. In the most recent survey, dated at the start of August, it was revealed that doctors are concerned for patients as practice and rotas return to normal.

Coronavirus

100 days after the coronavirus pandemic was declared by the WHO, the RCN set out eight key priorities vital for the safety of health care staff and the general public following the initial peak of the pandemic and as a wider range of health services resume

Looking at risk assessment, testing, reset of services, preparedness for further waves of coronavirus and winter, and remote consultations, the RCP stated that the majority of physicians have now returned to their normal areas of clinical practice, with 74 per cent having seen their rotes return to normal.

However, in the north west of England only 64 per cent had returned to normal rotas.

Of more concern, 60 per cent of respondents report being concerned for patients under their care who might have suffered harm or complications following diagnosis or treatment delays during the pandemic. The overwhelming majority (94 per cent) are concerned about the indirect impacts of the virus on their patients, with delays to diagnosis or treatment cited as the most common concern, cited by 58 per cent.

Regionally, London appears to face greater challenges than the rest of England – 46 per cent reported at the start of July that only a small number of procedures were restarting, compared to 30 per cent in the rest of England.

Meanwhile, 64 per cent of respondents reported that they had not been involved in conversations about preparing for a second wave. Of those who have been involved, 93 per cent said that they are preparing on the assumption that a second wave of coronavirus is likely or extremely likely. L FURTHER INFORMATION www.rcn.org.uk

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Procurement

The role of a CCS Strategic Business Manager Lucy Flint, Strategic Business Manager for the Crown Commercial Service, outlines how Strategic Business Managers can really add value to a procurement agreement within the NHS The role of a CCS Strategic Business Manager (SBM) is primarily about relationship management. It’s my job to work with customers to help ensure there is a proactive approach to their procurement needs.

If I can help CCS better understand a customer’s perspective and work with them to save their organisation time and identify efficiencies, UK citizens benefit from improved experiences, service innovations and public spending reductions.

In my view, the three most important aspects of CCS’s role are that we add value, we’re a free resource and we’re driven to help support the best outcome for the customer.

I have 13 years’ experience of working with the public sector in HR and recruitment roles – eight years of this managing my previous employers NHS business. I have learned procurement can and should be a key driver of organisations’ business transformation, though those involved in procurement can often be undervalued and restricted by the conflicting pressures of different parts of an organisation.

Issues that often create procurement challenges include stakeholder noncompliance to public contract regulations, time constraints which affect the ability to plan, limited resources for contract management and lack of market engagement – again often due to time constraints.

Adding value to procurement This is why SBMs like me can really add value to a procurement. We are a free resource who can provide the time to add value to procurement teams through supporting

training, accessing knowledge about markets that an organisation values. We genuinely offer a fresh perspective which will subsequently make contract management easier.

Recently I’ve found myself bringing a focus to issues such as social value, contract management, collaboration and evaluation of the best routes to market.

We’ve a strong history of working with the NHS, the value of this can be seen most recently through our membership of the Workforce Alliance, through which CCS and NHS Procurement in Partnership are working together to deliver health workforce services.

The collaboration ensures our customers have easy and quick access to a sustainable workforce, and it’s part of a long-term plan to deliver a whole portfolio of health workforce services to the NHS. The strength of this collaboration will be a huge asset to the NHS workforce and associated procurement.

We continually listen to our NHS customers and develop our frameworks in tune with the requests and advice we receive from them. But the only way we can get this insight is through listening and learning.

A network of opportunity Part of my role is to build networks across the health sector and find out from customers what their challenges have been. SBMs at CCS operate on a regional level so we understand not only how customers operate in their part of the UK, but also how they network and collaborate with each other. This helps me and my colleagues understand where CCS can add value.

Recently we worked with the regional Heads of Procurement Group in the North East and Cumbria and identified an opportunity to support in upskilling their workforce.

So we partnered with the NHS Skills Development Network and have embarked on a programme to add value, develop efficiencies and support technical skills development and better use of frameworks.

By working closely across the regions and supporting procurement journeys SBMs effectively can become part of the extended team for procurement departments. The result is providing the region with access to a powerful network opportunity, more time to collaborate regionally on larger projects such as linen and laundry, as well as aggregation opportunities for items such as laptops.

Such work has shown us that customers want procurement processes to be simpler: they want easy routes to market, with clear guidance, available support and minimal intervention from their own procurement teams. We’ve been listening and in response have tried to adopt more effective procurement measures such as simplified contracts and more Digital Purchasing Systems (DPSs).

The coronavirus pandemic has seen the advisory part of my role enhanced. Colleagues and I have supported local networking among procurement teams across the regions, and we have also developed ways of supporting each other with the new challenges we have faced.

F or example, we’ve adjusted our training offer and have taken it entirely online – ensuring we have continued to deliver what our customers require.

We have held five virtual events throughout May, June and July – each with delegate registrations of over 170.

I believe the demands of the last few months have strengthened our customer relationships, and I hope we’ve pleasantly surprised them with the speed and efficiency CCS has met their needs.

But it’s been a balancing act for us, we’ve tried to remain vigilant to the pressures our NHS customers have faced over the last few months and have tried hard to respect those, only offering practical input when appropriate.

NHS customers wanting to take advantage of the kind of support CCS can offer through its national network of SBMs should get in touch by visiting our dedicated web page. L FURTHER INFORMATION www.crowncommercial.gov.uk/ sectors/health

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Panel of Experts

EXPERT PANEL PANDEMIC RECOVERY Given the current challenges facing the NHS, likely to be heightened as we approach what many predict to be the most difficult winter for the NHS since the Second World War, we have gathered together a Panel of Experts to analyse the NHS response to coronavirus, the next step in improving facilities and future working patterns to improve efficiency

Matthew Bradfield, Fairford Medical

Catherine Horne, ISS

Julie Lewis, Radiocoms

Matthew began his career in the sciences and environmental sectors.

After studying Marine Biology and Environmental Engineering, Matthew worked as a researcher in Bermuda and after a move to America he shifted career into Cleantech investment and development.

In 2018 Matthew returned to London to take on the role of Mananging Director of Fairford Medical.

Catherine’s most recent operational position was as the Contract Director and Mobilisation Lead at NHS Nightingale Hospital London but across her 16 years with ISS, she has gained extensive operational experience working as the GM for Chelsea and Westminster Hospital and subsequently as a Divisional Director.

She now leads the healthcare sales team for ISS, where she uses her expertise to provide quality solutions for clients.

Julie Lewis was appointed her position as Business Account Manager at Radiocoms Systems Ltd in 2018.

Within her current role, she oversees the development and implementation of large infrastructure voice, video and data radio solutions for a variety of verticals in the private and public sector.

Her knowledge, experience and passionate resonates by being able to provide focused solutions to resolve their critical communication challenges and supporting their digital transformation journey.

It is clear that the NHS will not be returning to any kind of norm for the foreseeable future, and instead will have to adapt to new ways of working and adopt new partnerships to remain as efficient as possible. This will involve making the best use of existing technologies, processes and resources, as well as using the plethora of products and arrangements on the market to maintain high levels of care, whilst being as productive and efficient as possible.

Since March, there has been myriad examples of this in action, from the seven NHS Nightingale hospitals to the free parking for NHS staff at hospitals across England.

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However, with a second wave of coronavirus expected this winter, and a backlog for treatments and surgeries increasing by the day, working through the pandemic will continue despite the easing of lockdown.

Here, in our first Pandemic Recovery Panel, Health Business gathers the views of three healthcare experts on how the NHS takes the first steps to recovery, what this new way of working may look like, and life beyond coronavirus.

The way forward Many health organisations are trying to figure out what the health and care system should

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look like in the aftermath of the coronavirus pandemic. These are certainly uncertain times, and many believe that the health system will be fighting the coronavirus pandemic for some time to come, while having to manage regular day-to-day healthcare services. Matthew Bradfield, Managing Director of Fairford Medical, says that the health service is having to learn to adapt at a very fast pace and with relatively little information to go on, which he believes could lead to a decentralisation of healthcare services away from the central hospital. As we have seen with the agreement between NHS England, the Department of Health and Social Care and the private

Panel of Experts

sector, Matthew foresees that more and more services will be offered at independent locations as a way to reduce the number of patients required to be at high risk locations.

Catherine Horne, who leads the healthcare sales team for ISS, is in agreement, paying tribute to the way in which the whole system and its supporting functions have had to be flexible, agile, reactive and decisive. But whilst she acknowledges that we must continue to build on what we have done and effect change, for which decentralisation could be argued, Catherine stresses that the environment of continuous improvement, cultivated over the last five months, must remain and momentum must not be lost.

As she highlights, we must create a ‘new normal’ and a new ‘business as usual’.

Julie Lewis is Business Account Manager at Radiocoms Systems Ltd, and brings this part of the conversation towards technology and how the NHS needs to continue adopting innovative, dynamic technologies. The coronavirus pandemic shifted communication technologies to being seen as a central priority, but with a second wave likely in the coming months, she says that there is now a real drive for a comprehensive strategy and preparedness amongst health care facilities. With the ongoing and forecast staff shortages, Julie says that it is critical that NHS organisations ensure they have the right tools in place to connect and strengthen team communications. No different than IT systems, radio communications have evolved into sophisticated, feature-rich

communication devices with both hardware and software components that can support team co-ordination and emergency responses.

Has the patient journey changed?

The most important goal for everyone involved is that healthcare facilities and staff manage to maintain the trust of the wider community, who need to know that if they need to visit the hospital, they will be safe. Healthcare has always expected the highest standards of hygiene and cleanliness and this has never been as important as it is now. However, healthcare operations are now experiencing an epidemic of safety issues, so future development is reliant on a strong foundation.

For Catherine Horne, this means that local healthcare facilities will need to create a solution and response that is flexible, agile and can meet the capacity needs in line with the clinical needs of the organisation.

We must maximise the patient flow and the patient journey in a healthcare facility where we may need to treat both coronavirus and non-coronavirus patients, and organisations like ISS must be equipped to do this and be able to keep its patients and staff safe.

Since before the pandemic, ISS developed the principle of ‘Touchpoints@ISS’ where the organisation tracked the patient’s journey from arriving at the hospital car park to leaving at the end of their stay. This allowed them to identify the areas where their actions would impact on the patient, and where they could make a difference. ISS has now taken this one step further with

Pure Space™, where they increase cleaning frequencies in core areas and appoint hygiene stewards – empowered employees tasked with ensuring hand sanitisation and one-way systems are implemented to keep infection risks low and maintain a visible culture of safety around each hospital.

With such technology in use across the country, the experience of Julie Lewis is telling, as she finds that teams throughout a healthcare setting are often running separate technology platforms, with varying user experiences. When you consider that teams must care for the ill and injured inside their facilities while protecting patients, staff and visitors from outside threats, both hygienic and physical, it is hard to ignore the role of technology in helping find solutions.

When closely connected, technology can drive forward NHS Trusts’ digital transformation, collaboration and empowerment of their healthcare professionals and specialists. Providers must put proper security measures and communication systems in place to handle crisis prevention and crisis management.

When they do, safety is strengthened and you can achieve better outcomes.

Motorola Solutions is at the forefront of developing secure, reliable, resilient technology that transforms healthcare estates.

When, in the past there have been arguments against the use of some technologies that could have been considered inappropriate for ward, critical care or A&E teams when a crisis occurs, Julie highlights that with radio E Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Motorola Solutions WAVE PTX: the right communications solution How can Motorola Solutions WAVE PTX Platform create collaboration across your teams and healthcare estate?

The Motorola Solutions WAVE PTX application extends a radio system(s) reach by connecting two-way radios to anyone with a smartphone or other mobile device, regardless of their location, delivering a real-time flow of information. When a crisis occurs, you will have private, ‘always available’ communications to streamline collaboration and speed up response times.

With multi-layered security and intelligent network monitoring the solution is adept at protecting, preventing, and mitigating threats.

The requirement for instantaneous decisions, a method to call for urgent assistance whilst wearing PPE and efficient collaboration between teams are all pain points that Radiocoms Systems Ltd have addressed over the past few months with our healthcare clients. Working with their technology partner, Motorola Solutions, Radiocoms has supported healthcare teams and associated services with communication technologies that have helped them in the moments that matter.

The operational systems of a hospital, specialised facility, or care home must be well equipped with seamless, always available communications, to help manage staff and run departments smoothly. MOTOTRBO has adapted, becoming a well-recognised technology partner that is trusted to deliver efficient broadcasts and helping to address the need for connection. By creating a safe, encrypted solution that empowers Doctors to make decisions on complex matters, to requesting a porters assistance across your estate or connecting remote workers in today’s unique work environments, Motorola’s communication solutions cover every communication scenario.

Moving forward, there is a real drive for a comprehensive strategy and preparedness amongst health care facilities to withstand a second wave of Covid-19. NHS organisations are retaining their EPRR incident coordination functions given the uncertainty and ongoing need. With the current forecast of staff shortages, it is also critical that facilities ensure they have the right tools in place to connect and strengthen team communications.

Providers must put appropriate security measures and communication systems in place to handle a crisis.

Motorola is at the forefront of developing secure, reliable, and resilient technologies that transform a healthcare setting. Working with their partners such as Radiocoms, they are helping to address the need to connect employees both on and off-site.

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Deployment options - How can WAVE PTX support a healthcare estate?

The right communications solution should fit within your existing workflows, not the other way around. WAVE PTX provides cloud-based and on-premises deployment options to meet your specific communication requirements.

WAVE PTX Hosted on the Microsoft Azure Cloud, WAVE PTX provides a predictable, low-cost per-user subscription fee with no capital expense or long-term commitments. With a cloud-based deployment, you control the costs and know exactly how much you are spending. There are also two WAVE PTX mobile apps available for iOS and Android devices, giving you the

WAVE PTX

speed and simplicity of Push-to-Talk (PTT) communications with the ability to share multimedia information at the touch of a button.

WAVE PTX On Premise Deployed within a secure IT network, you control all updates and maintenance activity for your on-premises WAVE PTX deployment. Moreover, with an on-premises implementation, you can provide interoperable PTT communications with your MOTOTRBO, DIMETRA or ASTRO 25 network.

Through four technology options WAVE PTX can support varying user requirements.

Whether the estate is a single site or encompasses multiple buildings and complex facilities, there is a system to connect every user. Expect clear, continuous communication to the very ends of coverage – across buildings, barriers, and diverse terrain – and the expertise to determine which system is right for you. L About Radiocoms Systems Ltd Radiocoms understand that there isn’t a one size fits all when it comes to radio solutions. Over four decades they have consulted on, designed and deployed radio systems across a wide variety of verticals, meeting the unique needs of their client’s business operations with digital communications technologies.

FURTHER INFORMATION www.radiocoms.co.uk

WAVE PTX SafeGuard

WAVE Dispatch WAVE TLK Hand Portable & Mobile

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Julie Lewis is sure that the key to supporting agile working remains in digital transformation, with the last few months highlighting how up-to-date technology is increasing productivity, encouraging innovation and improving collaboration.

She says that policies and procedures with individual facilities may restrict how and when new technologies are introduced, but built-in additional functionality and flexibility should be taken into consideration when considering digital devices to support agile working protocols.

As the workforce becomes increasingly dispersed, employee collaboration and knowledge sharing get harder. Therefore, it is only by exploiting the full range of digital tools available from companies like Radiocoms that healthcare professionals and their support teams can source and use the right technologies they need to achieve the best possible outcome, helping them to improve patient care, boost health system logistics and share information safely whilst adhering to data security protocols.

Collaborative working This brings us nicely to the use and future of the NHS Nightingale hospitals, which have served as an example of quick and wellcoordinated collaborative working. The first NHS Nightingale hospital opened at London’s ExCeL Centre on 3 April, a month after Health Secretary Matt Hancock and Chief Medical Officer Chris Whitty imposed a stay-at-home order, shutting the majority of schools, businesses, venues and places of worship.

The purpose of the hospitals is to provide large-scale critical care sites for projected increases in patients across the country. As it turned out, most of the expected increased demand for critical care was met by expanding capacity in existing hospitals - in fact, by the end of June only two of the hospitals, in London and Manchester, had treated patients.

Nonetheless, despite the lack of use, they serve as a reminder of the need for agile working in the healthcare sector. There is no doubt that the ability to rapidly expand and deploy new healthcare facilities will be vital in fighting any potential resurgence of the coronavirus. As Matthew Bradfield points out, local infection rates will dictate where and when extra resources are required, but the use of modular, mobile and relocatable medical facilities is likely to become a mainstay of the healthcare providers in this country. These systems also will allow for a more flexible and dynamic response rate to healthcare emergencies in the future.

Discussing the role of agile working in the long-term future of the NHS, Catherine Horne says that, in order to deliver a healthcare service that meets the specific needs of our patients, the whole healthcare sector must work differently and create bespoke solutions. These will need to adapt as circumstances change – services that work for everyone within our healthcare facilities.

By remaining agile, working together and with a common purpose, positive outcomes for patients can be achieved.

Private sector deals Looking at collaborative working, Catherine Horne points to the work of the Nightingale Hospital London. Over eight weeks, NHS personal, the military and healthcare professionals from across the private sector came together to truly collaborate and establish a fully functional ICU hospital ready to receive thousands of critically ill coronavirus patients. Speaking from her experience, ISS were ‘truly seen as partners’, utilising expertise to help advise strategy and implement measures as they saw fit.

As an organisation working alongside hospitals, Radiocoms also witnessed a much more direct approach from teams within the health care industry than generally experienced pre-pandemic, where the company would work alongside an external contractor whether that be in a facilities management or security vertical, for example. Julie Lewis says that the past five months has seen a much more direct, dynamic and fluid approach to purchasing utilising public contract regulations.

Alongside the opening of the Nightingale Hospitals, the NHS has also brokered a number of deals with the private sector to ease capacity issues and lower demand on staff. For Matthew Fairfield, he thinks that one of the main positives to come out of the crisis is showing how the public and private sector can work hand in hand for the best interests for the country. Moving forward, it is his belief that this will facilitate more outsourcing partnerships between the NHS and private healthcare providers, helping to reduce workload pressures on the hospitals while helping patients keep healthy and safe in numbers lower than would be expected from hospital based treatment.

Catherine Horne says the next step is to strengthen the public and private sector partnership, emphasising the importance of challenging each other and the slow-moving chains of command, to accelerate the speed of decision-making and programme delivery,

to reduce cost and improve productivity. It is worth pinpointing the the framework of the recently published Outsourcing Playbook 2, published by the Government Commercial Function, that sets out practical guidance to support the delivery and drive improvements in the letting of outsourced contracts.

The considerable uncertainty of the pandemic continues to unfold and to what extent it could rebound is unknown.

For Julie Lewis, is it imperative that healthcare estates are well prepared and have suppliers that can support their emergency requirements.

Panel of Experts

 communications technologies you have private, ‘always available’ communications to streamline collaboration and offer speed responses to team and patient occurrences. Radiocoms works with health care providers, trusts and estates to understand their challenges, pain points and support their innovation strategies.

Beyond technology, the use of offsite buildings can really help. Matthew Bradfield says that primary intake and treatment will likely have to move from the central hospital to designated coronavirus sites for the foreseeable future, so as to take pressure off of hospitals that are struggling to provide regular care. In the meantime, he says, it is important to make sure that the patients that do have to come to the hospital feel as comfortable as possible.

The use of remote location, relocatable, mobile and temporary facilities will be critical to making sure that patients can remain as socially distanced and safe as possible while receiving the best treatment the hospital can provide.

Tackling infections at source Even after coronavirus cases drop, the issue of healthcare-associated infections is likely to remain prominent. As our conversation draws to its close, we asked our panellists how important it is that organisations working with the NHS strive to create and maintain clean and safe environments, and the response was a resounding ‘very important’. Catherine Horne states that there is now a renewed focus on hygiene measures and enhanced cleaning regimes that puts them firmly in the spotlight going forward.

We need to stay on top of the pandemic and quickly learn the lessons it has taught us in case we have to implement them again.

As FM partners within healthcare, she says that we must continue to innovate and continuously improve our processes and ensure that teams receive the highest level of training and development. At ISS, there is also a responsibility to share best practise with private sector colleagues, within areas such as retail and banking.

The fight against healthcare-associated infections did not disappear because of coronavirus, but, it is thought that the general awareness of the importance of good hygiene may help in a small way to keep things at bay.

Currently a very topical discussion point, Matthew Fairfield says that healthcare facilities and providers must make sure that the adequate protection equipment, both in terms of PPE and built-in safety equipment, such as screens and barriers, are installed to allow the patients to stay as safe as possible and keep the healthcare workers protected. It is vital, given the nature of this virus, to maintain clean and safe healthcare sites at all times with a minimal but safe level of staffing, but protective equipment must not be overlooked.

Neither, says Julie Lewis, should the issue of cross-contamination. Usually, many teams would share digital devices based around their shift patterns, but as a high touch item this has meant deployment of additional two way radios for existing fleets on NHS estates and the individual allocation of accessories such as earpieces and carry cases which would normally be shared between teams. L FURTHER INFORMATION www.fairfordmedical.com www.uk.issworld.com www.radiocoms.co.uk

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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OVER 200 MILLION FACE MASKS SOLD ACROSS THE GLOBE T&K are a leading International Manufacturer and Distributor of Disposable, Medical and Surgical Face Masks.

T&K have sold over 200 MILLION Face Masks across the globe to Hospitals, Medical Centres, Public Sector Organisations and Commercial Businesses.

T&K Face Masks conform to EU standards.

T&K also produce other Disposable PPE Products such as Cotton Swabs and Cotton Balls.

Please watch our short introductory video below:

Advertisement Feature

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Since the Covid-19 public health crisis started, T&K has delivered over 200 million face masks to countries such as the UK, Germany, France, Switzerland and the United States.

In the time of pandemic, T&K understands that time is the key to winning our battle with the virus.

As the pandemic gradually recedes and people start returning to work and school, T&K foresees a great demand for face masks in future everyday life and we are ready to supply high-quality masks that are reasonably priced ensuring a better product experience for end consumers.

In addition to Face Masks, T&K also mass produces other disposable PPE products such as cotton swabs and cotton balls.

Disposable medical face mask This mask meets the requirements of EN14683:2019 Type I. The main product features:

• 98 per cent > Bacterial filtration efficiency (BFE) • Differential pressure < 60 Pa/cm2 • Microbial cleanliness < 30 CFU/g • Splash resistance pressure > 16,0 kPa

•

T&K currently has production capacity for 3.5 million disposable face masks and 3.5 million surgical face masks per day from our main factory in Shantou, China. T&K has also invested in a state-of-the-art warehouse and logistics centre in Oxfordshire to take care of our UK and European operation.

T&K is a strong and financially stable company with a current net worth of $84 million and cash reserves totalling in excess of $17 million.

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Medical surgical face Mmask This mask meets the requirements of EN14683:2019 Type IIR. The main product features:

FURTHER INFORMATION T: 0333 339 9999 sales@tnkeurope.com www.tnkeurope.com

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Estate management

Meeting the ever-changing and urgent demand for space Simon Taylor, head of Portfolio Optimisation at NHS Property Services, discusses how the NHS and wider healthcare system will need to optimise its facilities post-coronavirus From offices to health centres, the empty. It is possible to gather this intel in way we use space is changing. The a variety of ways, and one easy example Covid-19 pandemic has prevented of this is by looking to the people on the many from entering the spaces that we ground. We were able to do this effectively have become accustomed to working through our ‘empty spaces’ campaign, in and, as a result, we have all had encouraging our facilities management to adapt to new ways of working. teams who work across our estate to While offices have been closed for months report to the facilities management - allowing managers time to reimagine helpdesk about how the spaces within how space will be used when the pandemic NHSPS’ properties were being used. inevitably relents - hospitals, clinics and Technology can also help organisations health centres have remained very to gather this kind of intel. For example, much open. Because of this, there are simple solutions they have had to rapidly that can be utilised, such We hav adapt their spaces as installing a sensor e been w to protect other in the main foyer of alongsi orking patients and a building that will d e t NHS staff from capture footfall h e to help NHS Covid-19. At going through the t h e m t he ever m e e NHS Property building, providing t urgent -changing Services a rough estimate a d nd emand (NHSPS), we of the number of for spa a challe have been people accessing c e n ; g e that we will con working a property. By alongside the gathering occupancy beyond tinue to face the Cov NHS to help data, combined them meet the with local knowledge pandem id-19 ic ever-changing and urgent demand for space; a challenge that we will continue to face beyond the Covid-19 pandemic.

and technological inputs, we can then better assess how space is being used; a key step to optimising space.

The next important stage in estate optimisation is understanding the demands of the people and services occupying the space. This can become difficult when one building has multiple stakeholders with different priorities, but by asking customers about their current and future requirements and the challenges they face, it is possible to better understand their actual needs and consider all of the available property options. It is important to clearly set out all requirements and challenges from the start, so that all stakeholders can visualise the best option for everyone involved.

Taking the time to understand our customers’ space requirements enables us to identify creative solutions to build capacity in the space that they already occupy, or nearby. This may provide them with lower cost options and quicker delivery compared to building something new. For example, we were approached by a GP who needed more space, with the initial request being to build a new primary care centre on the grounds of a nearby hospital. By having a detailed discussion with them to understand their specific requirements, E

Empty Spaces When thinking about optimising the NHS estate, one of the main challenges is knowing your estate and who it is allocated to. It is therefore vital that organisations are aware of the parts of their estate that are mostly occupied, partially occupied and

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Estate management

 we were able to help the GP and Commissioner consider how much space was really needed and advise them on a range of alternative options. This resulted in identifying the more straightforward solution of reconfiguring and refurbishing unused hospital space.

Allocating space differently Similarly, following the Covid-19 pandemic, it seems likely that a significant number of healthcare consultations will continue to be digital which may mean that different types of space will be needed. If this is the case, additional reconfiguration projects may be needed in order to save the estate money, but also to adapt to new ways of working.

Allocating space differently, as well as using technology to facilitate the booking of space for temporary use, can also help with the process of estate optimisation. For example, if a health centre has an unused room, a local physiotherapist could book the room for the hours that they need to work, with other essential healthcare providers booking the room at different times throughout the day. This allows patients to have a range a healthcare services available to them in their area – services they may not have had access to in the past. If however, there is vacant space that neither the building occupiers nor other professionals are using, we can then consider how it can be used to support social prescribing opportunities in local communities.

Following the Covid-19 pandemic, it seems likely that a significant number of healthcare consultations will continue to be digital which may mean that different types of space will be needed In addition, it’s also possible to adapt existing buildings to change the space internally, particularly if the building is older and structurally sound but its interior needs reconfiguration or an update. We have been able to use this approach successfully over the past few months, transforming under-utilised clinical space to provide additional bed capacity to support Covid-19 wards at low cost.

It is also important to bear in mind the interior or aesthetic of a property and how this impacts the way the space and the staff within it function.

Through a new initiative called ‘Healthy Places’, we plan to adapt the aesthetics of a space so that it can become more functional and suited to the occupier’s demands, while simultaneously benefitting the welfare of all those who use the space.

This is particularly important for hospitals, clinics and health centres as the interior of these spaces will impact the mental

well-being of patients, in addition to the people that work in the buildings.

Covid-19 has undoubtedly changed the way that both office space and healthcare estate are used. The social distancing guidelines brought about by the pandemic have made the standard metrics of how many employees there are in a space somewhat irrelevant for now, while on the other hand, healthcare centres have had to increase their capacity and space in order to treat and protect additional patients.

In the post Covid-19 world, as we continue to support the delivery of the NHS Long-term Plan, workspaces will continue to have a different purpose than before, and we must endeavour to optimise space according to the ever-evolving demands and requirements of this country’s patients and staff. L FURTHER INFORMATION www.property.nhs.uk

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Sustainability

Meeting the sustainability goals of the NHS Long Term Plan David Powlesland, senior manager at the Carbon Trust, asks what role does the health sector have to play in tackling the climate emergency?

The coronavirus pandemic has caused a global crisis that has already tested the strengths of the world’s healthcare systems, with devastating consequences in some regions. It is a stark warning that our healthcare systems are extremely vulnerable and are increasingly going to be required to respond to the impacts of another great global crisis – climate change.

Left unchecked, the climate emergency will have a catastrophic impact on public health.

More frequent extreme weather events threaten agricultural productivity and will drive climate migration as people flee malnutrition.

Rising sea levels will lead to an increase in water-borne illnesses such as cholera, and changes in vector ecology have already increased the transmission of mosquito-borne diseases. If infrastructure, such as hospitals and water supplies, struggle to adapt to climate change, this will impact our capacity to respond to these public health threats.

According to the World Health Organisation (WHO), the direct cost of climate change to the healthcare industry is predicted to be between US$2-4 billion per year by 2030, with an additional 250,000 deaths per year. It is therefore imperative we act

In 2017, the NHS emitted over 27 million tonnes of CO2 emissions (Scope 1, 2 and 3).

Initiatives have already been put in place in the NHS to limit its contribution to climate Why the NHS matters change. In 2008, NHS England established In June 2019, the House of Commons passed its Sustainable Development Unit (SDU) legislation requiring the UK’s emissions of to help organisations embed and promote greenhouse gases to be cut by 100 per cent sustainable development in order to relative to 1990 levels, by 2050. This reduce emissions, save money ‘net zero’ target will have far and improve the health of reaching consequences people and communities. for every sector of The NH S NHS Wales and NHS the UK’s economy, i s the larg Scotland are also and healthcare is public s est undertaking their no exception. e c t o r emitte of carb own sustainability The NHS is one in the U on emissionsr initiatives by carrying of the largest out comprehensive organisations in the for arou K, responsib carbon footprinting world, it has over l n e d fi ve per c of the U and decarbonisation 1.3 million direct ent K’s tota strategies. staff – and makes l CO2 emissio Since its inception, up a significant part ns the SDU has set out of the UK’s economy roadmaps – such as the and workforce. It is also NHS Green Plan for the NHS’ the largest public sector sustainability agenda – developed emitter of carbon emissions tools and policies to complement in the UK, responsible for around their strategy, and has carried out extensive E five per cent of the UK’s total CO2 emissions. now to protect healthcare systems from the worst impacts of climate change.

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Sustainability

 research to adapt the organisation to climate change. Good progress has already been made since the SDU was set up – for example 85 per cent of NHS waste no longer ends up in landfill and over 23 per cent of this waste was recycled in 2017.

Water consumption in the NHS has also been reduced by over 21 per cent.

The NHS England Long Term Plan, launched in 2019, committed to reducing the NHS carbon footprint by 51 per cent (against a 1990 baseline) by 2025, and reducing it to 80 per cent of 1990 levels by 2050. Other commitments include rolling out the use of low emission vehicles and eliminating heating fuels such as coal and oil, as well as minimising usage of single-use plastics. As of this year, carbon emissions from NHS England have been reduced by 34 per cent (against a 1990 baseline), despite the number of patients treated by the NHS having increased.

These achievements look promising, but it should be noted that much of the progress on mitigating carbon emissions comes as a result of grid decarbonisation, and more renewables coming online, as opposed to being the result of any direct action by NHS England. Nonetheless, the momentum generated must be carried forward.

What’s next?

An NHS Net Zero plan is currently in development within a programme called ‘For a Greener NHS’. This will set out how the will achieve the ambitious sustainability targets in the NHS Long Term Plan, and progress towards Net Zero. The SDU has been working with other healthcare and climate change experts to review over 600 submissions it received

The NHS England Long Term Plan, launched in 2019, committed to reducing the NHS carbon footprint by 51 per cent (against a 1990 baseline) by 2025, and reducing it to 80 per cent of 1990 levels by 2050 through a consultation on how to achieve Net Zero. Ideas range from encouraging plant-based diets and sourcing local food, to clean energy production and increasing use of technology to manage conditions.

A similar NHS Wales Decarbonisation Strategic Delivery Plan is also due to be published in 2020. These strategies should refocus the basis and aims for decarbonising the NHS and ensure the governance arrangements are set to enable rapid progress to be made.

To help with meeting the sustainability goals of the NHS Long Term Plan, the Carbon Trust has been working with organisations within the NHS to prepare ‘green plans’ – live strategy documents designed for NHS organisations to take a coordinated, strategic and actionorientated approach to sustainability.

These plans are valid for up to five years and involve setting out an organisational vision, action plan and monitoring system.

Uptake of green plans across the whole of the NHS will be crucial if it is to meet its decarbonisation ambitions.

Committed leadership, clear direction and strategic influence at the decisionmaking level are essential for effective sustainability governance. A sense of project

ownership throughout the organisation will also be needed to help implement the decarbonisation strategy across the NHS as effectively as possible.

Examples of decarbonisation projects being carried out include: NHS trusts’ procuring services from zero emissions couriers in Newcastle-upon-Tyne, substituting anaesthetic gases of high global warming potentials with more benign alternatives in Bristol, and encouraging healthier travel modes in Manchester. Other promising ideas include maintaining the increase in numbers of virtual consultations that have been occurring during the Covid-19 lockdown.

The ‘For a greener NHS’ programme aims to be collaborative as a Net Zero plan develops.

Although a formal consultation finished earlier in the year, staff are still encouraged to get involved by sharing sustainability ideas and practices on social media with the hashtag #greenernhs. If you want to get more involved, the SDU have set up local networks to engage on the sustainability agenda. To find out more go to england.nhs.uk/greenernhs. L FURTHER INFORMATION www.carbontrust.com

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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.

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

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

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

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EXTRA SPACE THE MODULAR WAY Elite Systems recently completed the handover of its modular 20-bed isolation ward at Royal Surrey County Hospital, with the project being praised in parliament.

The new ward was specified in March as part of the hospital’s COVID-19 pandemic response, and was completed in a timeframe of 14 weeks from initial enquiry to handover.

Gary Mountjoy, associate director for estates facilities, health safety and major capital projects at Royal Surrey County Hospital, commented: “Elite is one of the top contractors we’ve ever worked with. A solution like this

20-bed ward would typically take two years to deliver – completing it within 14 weeks, as Elite have done, is unheard of within our industry, and this was only possible through the company’s support and ability to rise to the challenge.

“I would like to thank the whole team at Elite Systems on behalf of Royal Surrey for their long hours and dedication to making the project happen in such a short timeline.”

From the moment the project was announced, Elite distinguished itself by its agility, responding to the enquiry and conducting its first site visit within 24 hours.

14 WEEKS FROM ENQUIRY TO HAND-OVER

20-BED ISOLATION WARD ROYAL SURREY COUNTY HOSPITAL After collaborating with the hospital on the design phase, Elite commenced groundworks on-site at the same time as the factory team began constructing the 24 modules that would make up the ward building in the company’s factory dramatically reducing, the project timeframe.

The new ward was officially opened on 20th July 2020, less than four months after the first enquiry was made.

A TURNKEY APPROACH TO BESPOKE MODULAR BUILDINGS IF YOU CAN IMAGINE IT, WE CAN CREATE IT

www.elitesystemsgb.co.uk 01274 873 232 info@elitesystemsgb.co.uk

Modular buildings

Offsite progression and the shift towards modular technology The government and the wider public sector are the biggest clients of the construction industry. Here, the Modular Portable Building Association discuss the growth and benefits of off-site construction The government and the wider public sector are the biggest clients of the construction industry, they have an important role in encouraging and facilitating the uptake of offsite technology. Historically, manufacturing operations have been considered extensions to construction processes instead of an integral and important part. This perception is changing as offsite has become an increasingly dominant force that utilises high levels of technology, the lines between manufacturing, engineering and construction have become blurred, creating a need for new skills and redefining existing ones. The more the offsite industry digitalises, the more the industry uses technology in end-to-end processes, attracting a new cohort of skilled operatives and technicians.

Offsite technology offers benefits that have had a huge positive impact on the construction industry, bringing longstanding traditional practices up to date. The first key shift away

DfMA facilitates early design detail and threedimensional design information, while BIM minimises the risk of errors by eliminating the time-consuming process of translating engineers’ information into cutting lists and assembly drawings. BIM also facilitates the optimising and testing of from traditional methods is that designs in virtual and prebuild processes take place in production environments. controlled factory conditions Offsite Technology is ever– requiring a change of techno evolving, and the mind-set and approach. l o gy offe offsite industry is that ha rs benefits now exploring Advanced integrating BIM offsite systems positive ve had a hug e and digital design and digital i m p a ct on th constru specifications with technology: Enterprise Resource DfMA and BIM bringin ction industrye g , Planning (ERP) and At the core of offsite traditio longstanding Material Requirement manufacture, design nal pra Planning (MRP) using for manufacture up to d ctices ‘intelligent graphics’. and assembly (DfMA) ate This technology will permit protocols and building manufacturing simulation information modelling and visualisation, clash detection (BIM) enable optimal and virtual onsite assembly modelling/ configuration of offsite solutions programming, which can be enhanced onsite by engaging with multi-discipline using augmented and virtual reality digital and multi-tier suppliers from the beginning developments. Digital technology is as E of the design development process.

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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FIRE SAFETY

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Modular buildings

î &#x2020; relevant to offsite manufacturing processes as it is to offsite design and architecture.

The optimum technology: modular construction Offsite manufacture encompasses a variety of panelised and volumetric modular methods of construction. At the forefront of offsite techniques, modular building has had a remarkable impact on reducing costs while increasing quality and safety measures. Having gained considerable momentum over the past few years, modular construction makes up 60-70 per cent of offsite manufacture and reduces build times by an impressive 50-60 per cent.

Module selection is influenced by transportation dimensions and shipping distances. A number of other factors are also holistically considered to achieve optimal design efficiency: module connection details and quantities, installation and crane costing rates, specific site logistics, foundation/ transfer deck, volumes of required materials and other service core requirements.

The demand for customisation has led the manufacturing industry to develop methods for adaptation during mass production while meeting individual customer needs.

These methods identify design parameters that can be integrated into architectural CAD applications using Revit structures.

Design parameters include: customer view that controls the modular design according to requirements; engineering view that constrains the module design according to deflection, strength, wind loads, fire, acoustic and building regulations; production view that identifies product dimensions and transportation constraints according to factory regulations and capacity; and site view for assembly constraints on site according to site layout/plans.

Having gained considerable momentum over the past few years, modular construction makes up 60-70 per cent of offsite manufacture and reduces build times by an impressive 50-60 per cent Benefits of modular and volumetric technology Modular and volumetric practices augment the construction industry with a multitude of benefits that span from greener, healthier environments to maximised sustainability, heavily reduced costs and quick build times.

Volumetric technology allows providers to customise any modular building to meet exacting needs and blend in with surroundings. Each individual material can be selected specifically for its performance characteristics, tailoring every inch of a modular build. Eco-friendly materials are often specified, and waste is recycled for future projects wherever possible. Not only this, but components are also available in a range of sizes for expansions whenever necessary.

As units are factory manufactured, stringent quality control processes can be undertaken within these well-managed environments. These in-house conditions also prevent weather from inhibiting the manufacturing process, guaranteeing efficiency. On top of this, modular construction enables site work and building processes to be completed simultaneously, reducing labour costs and build times.

Transportation rarely poses issues, as preconstructed, self-contained units can be transported to virtually any location, ideal

when new premises need to be constructed within limited timeframes. As modules are designed to withstand long-distance transportation and craning onto foundations, they are structurally stronger than most traditionally constructed building materials.

About MPBA As the single recognised voice for promoting and marketing membersâ&#x20AC;&#x2122; products and services, the MPBA plays a key role in the connecting of sectors in the modular and portable building industry. The association collaborates with specialist technical advisors to enhance innovation in the design and manufacture of modular buildings. These can be designed and manufactured from timber, steel or concrete, in any size and shape to meet individual client needs while ensuring full compliance with building regulations.

With the MPBAâ&#x20AC;&#x2122;s assistance, offsite construction companies remain ever competitive in the modular and portable building multi-billion-pound industry. The association is represented on committees for BSI, LPCB-Expert Group D and works with BRE, LABC, CLG, NHS, Cskills-CITB, NHS, LHC, CCS and Carbon Trust to represent the industry. L FURTHER INFORMATION mpba.biz

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Good skin health is vital for hand hygiene compliance Chris Wakefield, Vice President, European Marketing & Product Development, GOJO Industries‑Europe Ltd., breaks down one of the most common barriers to hand hygiene adherence Media coverage during the Covid-19 pandemic has brought to the attention of the masses a fact that is well known within the healthcare community - namely that good hand hygiene is a key component of health and well-being. In fact, practising good hand hygiene has been proven to reduce the spread of healthcare associated infections (HCAIs) by up to 50 per cent, as well as lowering the risk of antimicrobial resistance.

It’s a simple action, but the general lack of compliance among health-care providers is problematic worldwide. There are various challenges when it comes to hand hygiene in healthcare. Self-reported factors for poor adherence range from having insufficient time, to the patient needs taking priority, and, worryingly, a lack of knowledge.

However, according to the World Health Organisation (WHO), the most common barrier to good hand hygiene technique amongst healthcare professionals is skin irritation.

This is perhaps unsurprising, given the number of people who consider themselves to have sensitive skin. One study found that 60–70 per cent of women and 50–60 per cent of men reported having it to some degree. In any case, some workers believe that hospital-grade soaps and sanitisers will cause skin irritation and dryness, whilst others with pre-existing issues such as dermatitis are concerned that frequent handwashing will aggravate their condition further.

Taking skin health seriously Research has shown that healthcare staff clean their hands as many as 42 times per shift and up to 15.2 times per hour.

Whether the risk of developing dermatitis is real or perceived has been hotly debated over the past decade. However, with the frequency that healthcare workers wash or sanitise their hands, skin health must be considered when implementing a hand hygiene programme – and therefore choosing products that will not irritate is crucial.

After all, skin irritation is more than just a discomfort; it can cause cracks in the skin on the hands. Damaged skin is more susceptible to colonisation by transient micro-organisms, which, in turn, increases the risk for transfer of potentially pathogenic micro-organisms to a susceptible patient – the very opposite of what hand hygiene programmes seek to achieve!

As a member of the WHO Private Organizations for Patient Safety group, GOJO is a strong advocate of making hand hygiene

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second nature to everyone in a healthcare setting. There are several strands involved in successfully boosting compliance; and one key part is developing products that are both a pleasure to use and effective against germs.

Minimising the risk of skin irritation Firstly, the correct choice of soap and sanitiser is crucial. Opt for formulations that have been tested and passed in accordance with key hospital norms EN 1500, EN 14476 and EN 12791, to provide assurance that they are not only safe for use in healthcare locations, but are also effective against germs.

Formulations must be also mild and gentle to hardworking hands. Workers should ensure that all soap product is rinsed off and dry their hands thoroughly with paper towels.

After all, water is a potential irritant, which may penetrate relatively easily through the outermost layer of the skin (stratum corneum). Frequent exposure to water causes swelling and shrinking of the stratum corneum, and can lead to hand dermatitis.

With this in mind, the WHO advises healthcare professionals to choose hand sanitiser as an alternative to soap and water, where hands are not visibly soiled.

PURELL Hand Sanitising Gels are trusted

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by the NHS and are clinically proven to maintain skin health. Hygienic hand rubs can also provide another level of protection in addition to washing hands.

In addition to frequent hand hygiene practice, healthcare workers should use moisturisers regularly to rehydrate and replenish oils in the skin. This helps to reduce the risk of skin shedding, which can cause additional irritation. GOJO HAND MEDIC® Professional Skin Conditioner is a water-based product, designed to maintain the skin’s natural protective barrier and help prevent dry, damaged hands. Its silicone-free and unfragranced formula is quickly absorbed into the skin and can vastly improve skin condition.

GOJO is committed to creating products which deliver results that are also kind to the skin. After all, hand hygiene is only an effective infection control measure if everybody in a facility practises it. And ultimately, it’s not just about killing germs; it is about protecting the health of workers, patients, visitors, and our wider community. L FURTHER INFORMATION Tel: +44 (0)1908 588444 infouk@GOJO.com www.GOJO.com

Ventilation

Greater focus on ventilation hygiene now vital Building managers will have to pay close attention to the cleanliness of their ventilation systems in the wake of the Covid-19 lockdown, according to the Building Engineering Services Association (BESA) As buildings start to re-open, the importance of complying with industry standards, keeping comprehensive records and using competent companies to carry out ventilation hygiene work will take on even greater significance due to the problems created by the coronavirus, a group of experts told a recent BESA webinar.

As part of efforts to cut costs in the wake of the disruption, some businesses may look to reduce the frequency of cleaning, but this should only be done in a planned way, they said.

Gary Nicholls, managing director of ductwork and legionella risk specialists Swiftclean, said the hospitality sector had been hit particularly hard, but cutting back on ventilation hygiene could increase the risk of fires being spread by poorly maintained kitchen grease extract systems.

He said: “We need to keep grease build up below 200 microns to minimise risk.

Owners should look at how frequently they were having systems cleaned before the lockdown and compare that with their expected turnover.”

Nicholls said it was vital that any changes were supported by accurate records to satisfy fire risk assessors and insurance companies.

Current guidance from the industry Investigations and healthcare experts is to provide Nicholls continues: “In many fire investigations, maximum levels of outside air and avoid there is a complete lack of adequate recirculation to protect against the virus. post-clean documentation to prove if the He said: “There have been ventilation system had been cleaned properly.” hygiene standards in place for many years; BESA publishes the ventilation hygiene so we are not asking people to do anything industry guide to good practice TR19 – and new. However, it is more important than recently added a specification aimed specifically ever if systems are operating on full fresh at kitchen extract cleaning. ‘TR19 Grease’ air that ductwork is properly clean. Building includes a schedule explaining the link between managers should also consider whether the frequencies of cleaning required and their current ventilation strategy is still fit the average daily build-up of deposits in the for purpose. Many are changing layouts and extract system to help manage fire risks. having new partitions installed to maintain The chair of BESA’s Ventilation Hygiene social distancing, which will have an impact group told the webinar that building on airflows around the occupied spaces.” managers should also take similar care of their He also said it was important to carry out a supply air ventilation systems as occupancy comprehensive survey of the ventilation levels start to rise again. as some places, such as toilet George Friend said there was extracts, were often overlooked. no direct link established World TR19 was revised in 2013 between the spread Health to mirror the international of the coronavirus Organis standard BS EN 15780 and the cleanliness a t officials ion that was published in of ventilation, but 2011 and established that should not ‘eviden said ce was safe levels of ventilation mean systems emergi n hygiene for all types of are not cleaned. g ’ t h at Covi 19 can buildings.

HTM 03-01 d sp also sets parameters the air read through in enclo for hospitals and other healthcare facilities. spaces sed Buildings are separated into low, medium and high risk categories in the standard; and Mr Friend suggested that owners may decide their facility needs to move into a higher risk category as a result of changes brought about by the crisis. This will mean it would be subject to more frequent ventilation cleaning. E

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Advertisement Feature

Alternative solutions for energy efficient process heating and hot water Hospitals all over the UK have been utilising ARI-Armaturen’s impressive range of engineered systems. ENCOsys® plate heat exchangers have been a major solution for companies looking for a proficient heating and hot water system that will ensure a secure and economical future for their site be approximately seven per cent more energy efficient when compared to a basic shell and tube heat exchanger.

One of the most significant savings however, is that unlike shell and tube heat exchangers, ENCOsys® does not need to be stripped down for insurance inspections allowing for further cost savings, reduced downtime and dramatically improved health and safety risks associated with this work.

With so much pressure to reduce spend and improve energy efficiency measures, many organisations have been forced to adopt demanding targets to cut greenhouse gas emissions and are therefore looking for alternative solutions to update energy and heating systems.

Reliable and resourceful systems Offering reliable and resourceful systems with considerable savings in energy and cost (when compared to more traditional systems such as shell and tube calorifiers), ARI-Armaturen’s ENCOsys® is a compact, low maintenance steam-to-water plate heat exchanger.

Suitable for various applications including domestic hot water, low temperature hot water, and process heating, these innovative units are currently in operation in many healthcare sites and hospital plant rooms over the UK. Designed to provide hot water instantaneously whatever the load conditions up to 2100kW, there is no need for a water storage vessel. Having

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no water storage vessel is an added advantage because it also helps to eliminate a potential breeding place for Legionella and other bacteria’s, therefore reducing the requirement for regular inspections.

Sites with ENCOsys® units installed benefit from improvements to operating efficiency with reduced heat loss from equipment, improved temperature control as well as better thermal efficiency, all resulting in vast improvements to operation efficiency and energy savings.

This system is more responsive to changes in the secondary operating conditions resulting in far tighter temperature control.

Generally, the water temperature leaving shell and tube heat exchangers tend to cycle in a pattern similar to a sine wave which means the temperature set point may have to be set higher to ensure the unit meets the required load at all times. By using the ARI-ENCOsys®, temperature control is considerably improved, typically providing an estimated three per cent energy saving.

Based on these factors, ENCOsys® can

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Compact design Another benefit of the ENCOsys® heating systems is that the physical design is extremely compact, with the largest unit occupying around 3m3 and the smallest unit occupying less than 1.5m3 resulting in a smaller footprint than many other alternatives on the market as well as allowing for significant savings in valuable floor space.

Nicholas Davies, ARI-Armaturen UK Ltd sales director, said: “By heating the secondary water and sub-cooling the condensate in the same plate heat exchanger, substantial energy savings can be achieved and the cost of ownership is further reduced because improved energy efficiency means lower fuel bills and low CO2 emissions.”

ARI-Armaturen boast a wealth of knowledge and technical experience in energy management systems so from assessing your initial requirements, through to conduction of surveys to final commissioning, the installation process can be completed in a short timeframe, leaving you rest assured that you have been provided with a quality product and quality service.

This range of well-engineered, packaged solutions from valve specialists ARI-Armaturen UK Ltd come fully assembled to specific requirements and tested ready for connection.

See how ARI-Armaturen can help you cope with rising energy costs – contact the UK sales office on 01684 275 752 or email enquiries@uk.ari-armaturen.com. L FURTHER INFORMATION 01684 275 752 enquiries@uk.ari-armaturen.com

Ventilation

 TR19 provides the methodology for carrying out hygiene work in line with the standards and for keeping comprehensive, accurate records of cleaning. It also links to the Ventilation Hygiene Elite (VHE) scheme, which is operated by BESA’s certification arm BESCA. This is a self-certification system allowing firms to demonstrate compliance and competence and is the only way for firms to prove they are carrying out work in line with TR19.

Duncan Sibbald, head of certification at BESA, commented: “There is now much greater focus on the whole area of competence and compliance in light of the changes coming through the Hackitt Review. Companies will have to provide proper evidence of their competence under the new regulatory regime.

The VHE scheme was developed by the industry for the industry and allows firms to self-certify and provide reassurance to the client that their system has been cleaned to the right standard.”

Golden thread Sibbald added that the scheme was recognised by the RISCAuthority, which is backed by insurance companies. It is also an example of the kind of record keeping required by the Hackitt recommendations for a ‘Golden Thread’ of information to support the safe operation of buildings.

He said: “Ventilation hygiene can often seem like an uphill battle because so many building owners just want a certificate and don’t really care about the levels of competence required, but the greater focus on building safety is changing that now. The levels of risk are better understood and this scheme creates a level playing field where everyone must demonstrate they are working to the same robust level of compliance.”

The World Health Organisation (WHO) has also acknowledged the threat posed by airborne transmission of the coronavirus, which reinforces the need for correct operation of ventilation systems.

Its officials said ‘evidence was emerging’ that Covid-19 can spread through the air in enclosed

Schools are a key area of concern with more children now returning to poorly ventilated classrooms. A survey of 20 UK classrooms carried out by NAQTS revealed very low air change rates that could increase the risk of virus transmission spaces. A number of scientists have, therefore, pointed out that building ventilation systems will be crucial in limiting the chances of ‘super spreader’ events in enclosed environments that could spark a second wave of the pandemic.

Benedetta Allegranzi, the WHO’s technical lead for infection prevention and control, said that evidence emerging of airborne transmission of the coronavirus in ‘crowded, closed, poorly ventilated settings…cannot be ruled out’.

The WHO updated its position after receiving an open letter written by 239 researchers in the fields of virology, aerosol physics and epidemiology from 32 countries. They highlighted evidence that showed tiny particles containing the virus could become suspended in the air.

One signatory, Professor Benjamin Cowling of Hong Kong University, said aerosol transmission meant building managers needed to think about ‘how to prevent super spreading events, larger outbreaks that occur in indoor environments with poor ventilation’.

Schools are a key area of concern with more children now returning to poorly ventilated classrooms. A survey of 20 UK classrooms carried out by National Air Quality Testing Services (NAQTS) revealed very low air change rates that could increase the risk of virus transmission.

Douglas Booker, NAQTS chief executive, said: “Our study showed that some classrooms had air change rates below 0.5 per hour and that even small increases in flow rates could significantly reduce the risk of infection.

Raising airflows from zero to 100 m3/hr cuts the risk by up to 60 per cent. However, there are gradually diminishing rates of return from increasing it beyond that level.”

Good investment Speaking during another webinar hosted by BESA, Booker said it was important to focus on what was ‘reasonably achievable’, particularly in an education setting where budgets are constrained, but that low cost adjustments to ventilation were a good investment.

He commented: “The important thing is having quality information and we are using the level of CO2 to show whether the ventilation is working as intended. This crisis is an opportunity to improve the IAQ performance of buildings for the long-term, but we need to focus on affordability. There is a lot of money going into shiny new academies, but that risks increasing inequality even further by leaving older school buildings behind.”

Booker said the WHO announcement and growing awareness of the risks posed by airborne pathogens inside buildings would spark greater demand for the specialist expertise of the building engineering sector.

He told the BESA webinar: “If a pandemic that forces people to spend almost all of their time indoors does not change attitudes to indoor air quality, then nothing will.” L FURTHER INFORMATION www.theBESA.com

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Panel of Experts

EXPERT PANEL PARKING Stewart Clure and Grahame Rose collaborate to answer some questions on the current state of NHS parking, providing expert analysis on everything from the short- and long-term impacts of the pandemic on NHS sites to the role of technology in parking management

Stewart Clure, Debt Recovery Plus

Grahame Rose, Group Nexus

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

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

2020 has seen the issue of parking at NHS sites reach the front-pages, after the government decision in March to provide immediate financial backing for all NHS trusts to provide free car parking to NHS staff for the duration of coronavirus. Health Secretary Matt Hancock pledged that the government will cover the costs of providing free car parking to NHS staff working in hospitals during this unprecedented time, whilst Local Government Secretary Robert Jenrick also revealed that local councils would offer free car parking to all NHS workers and social care staff during the coronavirus outbreak.

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The coronavirus ‘free parking’ offer also overshadowed new rules that came into play in April, which meant that four groups of people will no longer be charged for parking in hospitals in England: disabled people; frequent out-patient attenders; parents of sick children staying overnight; and staff working night shifts.

But, with much of the country returning to pre-lockdown patterns of working and hospitals dealing with fewer coronavirusrelated admissions, what plans to support the NHS moving forward are in place? Grahame Rose says that GroupNexus has worked with its NHS clients throughout the last six months

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to ensure that adequate parking solutions were in place for their staff, including opening up patient parking areas and offering free staff parking. The company also reached out to clients across its full estate and made an additional offer of free parking for NHS staff across all of its 1,200 national car parks.

Alongside free parking provisions, Stewart Clure, from Debt Recovery Plus, points to the number of operators who have also provided marshalling services and simple, additional provisions, such as personal protective equipment (PPE). On top of this, DRP has also seen many operators look towards other avenues to help in any way they can, making E

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Advertisement Feature

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

Based in a call centre environment we have a core telephony team who can handle incoming and outgoing calls to motorists to help resolve any issues, answer questions and ultimately settle any unpaid parking charges. We can handle client payments 24/7 via our web/automated services along with our dedicated team of advisers.

Debt Recovery Plus have been the chosen provider of debt recovery services to the leading parking operators for over 10 years, helping our clients to grow along the way. By working closely with the operators, we have helped to strengthen the parking industry through educating and challenging each other with new ideas.

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Delivering a one stop enforcement solution Recently Debt Recovery Plus became part of the Bristow & Sutor Group, who are one of the largest providers of debt recovery to the public parking sector. Together with B&S our aim is to deliver a one stop enforcement solution to all our clients. With over 40 years of enforcement experience within the group we can offer our clients advice based upon our knowledge of both industries along with tried and tested solutions to help our clients maximise revenue recovery whilst protecting their data.

Data reports At DRP we know how important each and everyone of our clientâ&#x20AC;&#x2122;s parking charge notices are, which is why we employ client specific teams to analyse the data and report back on any trends, unfamiliar patterns and unusual cases. This helps our clients and landowners to identify persistent offenders and review their parking management strategy to ensure that they are offering their client a suitable solution.

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At DRP we create bespoke recovery strategies for all our clients, which helps them to deliver an educated recovery model designed specifically for the industry which they are working. We can provide recovery for clients on Commercial, Residential, Retail, Rail, Airport and NHS sites.

Our aim is to deliver an ethical approach to debt recovery to help our clients capture any unpaid parking charges whilst at the same time allowing the motorist an opportunity to discuss their case.

Within our group our priority is our clientâ&#x20AC;&#x2122;s data, when making any decisions on strategy, reporting or collecting on a case Compliance is our first thought. When GDPR was introduced we decided as a group to implement a GDPR team at both of our offices. Our GDPR teams implement compliant processes and practices at each office along with helping our clients with any GDPR questions which they may encounter along the way. L FURTHER INFORMATION www.debtrecoveryplus.co.uk

Resumed demand As an operator, GroupNexus will continue to use its parking management and insights platform to monitor the volume of vehicles on site as demand for spaces increases, and adjust the management of each site accordingly. As footfall increases and normal day to day services resume, the management of NHS sites by parking operators will be under the spotlight once again. Expecting that most sites will see a spike in traffic, Clure says that if the increase is not monitored and effectively analysed, it will create more problems than we have previously seen.

Group Nexus has introduced the InCar waiting system, which is a unique way of managing traffic count on site and helps to mitigate any risk and control traffic dwell times around NHS sites. As patients arrive on-site, they receive a message that the department they are visiting has been notified that they are on-site and to wait in the car - then they will receive a message when it’s time for their appointment. This prevents large groups of people waiting inside the hospital waiting room and assists with the current coronavirus-safety practices. It also works for A&E departments, allowing receptionists to ask patients to wait in their car or a different area until they are messaged.

Whilst the cost of parking at NHS sites has always been seen as controversial, the revenue does provide a healthy lifeline to all trusts to ensure other services continue Persistent offenders Here, our conversation turns towards the problem of persistent offenders. Grahame Rose says that, surprisingly, the majority of persistent offenders on NHS sites are staff members who don’t qualify for a permit or continually park in areas that they are not permitted to park. If such offenders are not health with at an early stage, it runs the risk of undermining the entire parking management system, as other staff members quickly find out and copy them.

The systems used by GroupNexus are able to easily highlight persistent offenders, and DRP escalates the recovery process so that persistent offenders are dealt with, preventing such practices becoming endemic.

DRP provides a full end-to-end service with its clients which identifies these motorists, issues a further debt recovery warning and ultimately, where the client permits, provides litigation options where appropriate action is taken. Stewart Clure states that the company always provides the motorist with every opportunity to resolve the issue pre- litigation, through various communication methods to ensure a swift and amicable resolution.

Using technology effectively To assume that the use of technology is restricted to operating theatres and A&E departments is incorrect. The use of ANPR (Automatic Number Plate Recognition) cameras combined with parking management and insights platforms, such as the one mentioned earlier by Grahame Rose, allows company’s like GroupNexus to monitor vehicle movements in near-real-time.

Grahame says that this enables them to understand peak visitor times, average dwell times as well as overall usage and therefore allows operators to better manage sites more efficiently and effectively.

Panel of Experts

 use of their vehicles to provide deliveries to ensure vital services are maintained.

Moving forward, Rose says that GroupNexus already has the technology to help its NHS clients better understand their customers, primarily patients, and is working on techbased solutions the will, solve many of the problems that they face, both pre-coronavirus and those that have arisen since March.

However, while the free parking offer was welcomed across the board, it would be wrong to assume that the impact of coronavirus has only been felt within the hospital building. There has been the obvious effect on income as there was reduced demand from patients and visitors, which freed up the space needed for existing and extra staff that was required during the lockdown period.

Although the state of play, regarding the virus, has changed, visitor and patient numbers are still lagging so many NHS trusts are continuing to experience a reduction in car park income. This has a knock-on effect on other services within the NHS, and has also reignited the debate around hospital parking charges, particularly for staff. For Grahame Rose, it has been interesting to hear that Matt Hancock recognises that generally hospitals do not have enough space and that charging is the only effective mechanism for controlling demand.

This is a point that Stewart Clure picks up on, highlighting that, whilst the cost of parking at NHS sites has always been seen as controversial, the revenue does provide a healthy lifeline to all trusts to ensure other services continue. Whilst the effect of this revenue loss may not be apparent yet, he expects to see services in other areas of the NHS to feel the impact during the next quarter.

He says: “Our platform also allows us to monitor and enforce the parking terms and conditions; this, coupled with the knowledge gained from understanding our data, allows us to ensure that spaces are available for patients and visitors and those staff who are permitted to park.”

So, how can operators ensure that the parking experience is simple and easy to understand for patients, visitors and staff?

Stewart Clure says that the answer is simple.

The most common way to ensure clarity is through signage that is clear, concise, not misleading and frequent. The British Parking Association and IPC have clear guidelines which operators must adhere to, to ensure that motorist entering the site receive plenty of notice of the consequences of not adhering to site rules. Clure strongly believes that GroupNexus are a great example of a client going over and above the expectations required to ensure the motorist has every opportunity to adhere to rules at each site.

Grahame Rose couldn’t agree more.

Understanding that people can feel anxious on entering a hospital, GroupNexus takes special care to ensure that all signage is clear and easy to understand, featuring signage both inside and outside of the hospital in order to ensure visitors are aware of the parking requirements.

Lastly, Rose says that his patented technology streams thumbnail pictures of vehicles that match the registration that a visitor starts to enter on the payment terminals, allowing users to simply touch the picture of their vehicle and the terminal calculates the amount to pay. L FURTHER INFORMATION www.groupnexus.co.uk www.debtrecoveryplus.co.uk

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Technology

Virtual care has come of age during the Covid crisis Covid-19 is the catalyst for change in health provision as patients demonstrate strong appetite for virtual care that’s here to stay, argues Alan Lowe As the UK continues to emerge cautiously coronavirus pandemic, allowing patients from Covid-19 lockdown, it’s important to continue to consult their GPs and to remind ourselves that while the virus specialist hospital doctors while face to may be in abeyance it has by no means face meetings have not been possible. gone away. The reality is that until there There have been other benefits of are a range of effective drug treatments this technology. Online image sharing and new vaccines Covid-19 will continue has enabled clinicians from multiple to be a major threat to health. Near geographies to continue to collaborate or to medium term the virus will carry on work together in Multi-Disciplinary Teams, putting the NHS and healthcare pooling their expertise and advice on some providers around the world of the most difficult patient cases. under considerable

The technology also strain. Startling enables unlimited numbers Health figures produced of attendants at web-based provide by the NHS symposiums and seminars rs have a Confederation that would ordinarily recently be physical events with make a choice to bout w highlighted that limited access, mostly techno hich the NHS waiting on the grounds of the l o g ies and applica list could reach time costs spent away t 10 million from the workplace. becomeions should by the end of In short, recent its 2020 or even events have driven standar brand d higher if there is catalytic change for virtual a second wave. care, taking it from niche to The NHS has of course mainstream in a matter of months. adapted itself remarkably The extent of its impact is apparent quickly to coping with Covid, rapidly in the numbers. In the UK, online medical diverting resources to tackle the disease consultations have risen from two per effectively and up taking virtual care cent before the pandemic was declared in and video consultations in GP surgeries, early March to 80 per cent during April. hospitals and clinics with greater speed Southern Health NHS Foundation Trust, than previously. However, there is still the one of the 27 NHS trusts that Visionable opportunity for decision makers within partners with, reported that there were healthcare to consolidate digital systems 5,192 video appointments in April totalling to drive more efficient outcomes.

169,634 minutes. Visionable saw first-hand The fact of the matter is that video collaboration platforms have been adopted with alacrity during the

this unprecedented demand, increasing video conferencing hours by 1,607 per cent, facilitating 4,200 hours of patient consultations and onboarding 16,00 NHS staff in the use of video streaming technology in the first four weeks after lockdown began in the UK. And this spike in demand is not limited to the UK. According to a McKinsey survey in April, in the US 46 per cent of consumers have used telehealth technologies in 2020 compared to 11 per cent in 2019.

While Covid may have been the catalyst for its rapid increase in usage in the NHS, healthcare technologies already in use also enable experts in specialist fields of medicine, say the treatment of strokes, to diagnose and recommend treatments for patients even before they’ve been admitted to a hospital or stroke centre, rapidly improving patient outcomes in the process.

At the moment, Visionable is trialling out technologies in ambulances in collaboration with O2 in the UK, effectively turning them into mobile A&E facilities with 5G technology, where paramedics can connect instantly to critical care team expertise whilst in the field. This is driving improvements in public safety by ensuring teams have the correct, most efficient technological support available.

The merits of virtual care For budget-conscious NHS managers, another strong point in telehealth’s favour is that it offers potentially significant savings in travel costs and with that the chance to cut carbon emissions, an important goal for governments E

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Advertisement Feature

How cleaning audit software can support the NHS Cleaning audit software does what its name implies, it audits the cleaning process. The software allows you to create, manage and report on cleaning audits more easily than using paper-based checklists

The software allows users to set up different functional areas that represent different usages and degrees of risk, that require different cleaning frequencies and levels of monitoring and auditing. Often the cleaning has to be done in compliance with regulatory, industrial or locally agreed standards. And this is where the software can help.

Such software is primarily used by the NHS to demonstrate compliance with the latest National Standards of Cleanliness as well as the NHS cleaning audit standards.

Within the NHS, all functional areas must be assessed and assigned to a risk category.

Identifying the functional risk category is the crucial first step in applying the standards. The level of cleaning frequency, monitoring, audit frequency and audit target scores are all directly linked to the identified risk factor. Once the functional

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area risk categories have been identified, a ‘cleaning specification’ must be produced.

This specification provides more detailed information on how cleaning will take place.

Cleaning audit software helps to speed up this entire process. In just a few clicks you can report on a function, allocate specific tasks to users and generate audit reports.

Speaking of the software, the Facilities Team at Birmingham and Solihull Mental Health NHS FT said: “The cleanliness auditing process (desktop and mobile app) is simplified. Being able to create and undertake specific audits (within the app) is smooth and easy. As a manager responsible for a cleaning service, the software enables the prompt generation of action plans for multi-disciplinary teams, right through to analysing trends.”

This is where Asckey Data Services Ltd.’s cleaning audit software, fmfirst® Cleaning

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can help. Asckey has been supporting and providing software solutions to the Healthcare sector since 1995. We know that staff do not have the time to be clicking through loads of boxes to get to where they need to go.

Asckey’s fmfirst® Cleaning application is designed to speed up the process of audits. It also includes several useful dashboards with drill-down capability allowing for interrogation of the data.

It’s been purposefully built to have minimum click-through options and be an easy to use application. It’s also designed to automate report emails once audits have been completed with any corrective actions that are required. This method of providing instant fault reporting and the options for rectifying, allows users to take action right away.

Being a cloud-based application, you achieve cost-savings and its intuitive design makes it multiplatform and device compatible.

Easy to use, ability to create audits quickly and saves you money, fmfirst® Cleaning could be the software you didn’t know you needed. L FURTHER INFORMATION www.asckey.com Tel: 01480 469001

The pandemic has proved that people welcome being able to consult an expert medic even if that clinician is based many hundreds of miles away and is accessible via a screen rather than in person the software should allow all users on a video call to access the same highquality imaging and be able to stream it without interruption, even when handling simultaneous data sharing from potentially unlimited numbers of participants. And the rollout of 5G in the UK will be an essential factor in the success of this.

Another prerequisite of the software should be that it is platform agnostic.

Participants should be able to join calls without it depending on the make or model of their devices such as tablets, phones, PCs or laptops. Moreover, the software needs to be certified as safe and secure, so it guarantees the protection of patient privacy and highly confidential hospital or GP information and data.

In the end, perhaps what matters most is that virtual care technologies can continue to relieve pressure on overstretched medical staff, including GPs where there will be an estimated shortfall of 11,500 in a decade’s time.

Technology

 everywhere wishing to be net carbon neutral. We estimate that each NHS trust using our technology can save up to 88 tonnes in CO2 emissions a year.

I believe that going forward, now that the merits of virtual care and patients’ willingness to engage through it are established, health providers have a choice to make about which technologies and applications should become its brand standard.

As a former NHS manager, I know that this is no small process. The NHS will have to decide which systems should be considered, and if adopted, how they can be rolled out organisation-wide and as well as how they can be further developed.

What is essential is when consolidating ageing software applications any decision must involve clinicians at all stages, garnering a wide range of views on the merits of particular technologies, their features, security and privacy, and functionality.

What the NHS will need to consider are universal standards in virtual care so that applications can become familiar to users. Ideally, any application chosen as a brand standard will be intuitive to use and easily mastered, including across its full range of functions and continually developed in partnership with the providers and medic users’ feedback and requests.

In my view, telehealth software solutions vary in terms of imaging quality and usability. To achieve a brand standard

To conclude, the pandemic has proved that people welcome being able to consult an expert medic even if that clinician is based many hundreds of miles away and is accessible via a screen rather than in person. It is essential that technology’s role in creating this transition, expanding the most essential resources in healthcare by saving clinician’s and GP’s time, plugging the skills gap and bridging distances is fully recognised. Now is the time for a full review of the virtual care software systems available, and some decisions will need to be taken by healthcare providers about the future role it will play in a future fit health system, even if social distancing measures are ultimately no longer necessary. L

Alan Lowe is a former NHS manager and co-founder of Visionable.

FURTHER INFORMATION https://visionable.com/

Asset and inventory management’s critical role in healthcare

Heart monitors, beds, medications, face masks, respirators and wheelchairs are only some of the critical medical supplies and devices that healthcare providers need to stay safe while saving lives during the Covid-19 pandemic. With so much at stake, the last thing anyone should have to worry about is an inadequate inventory or asset management system.

However, one of the unfortunate consequences of the pandemic has been the exposure of severe flaws in how many organisations are inadequately equipped to manage critical medical inventory and assets.

The good news is that it doesn’t have to be this way. Wasp Barcode Technologies offers proven cloud-based or on premises solutions for healthcare providers which

can manage these supplies effectively so you can stop worrying about manual processes and focus on patient care.

InventoryCloud can help you maintain accurate stock counts, reduce errors, and avoid manual entry of items, location bins, pick orders, and inventory receiving. Realtime inventory reports enable you to compile and analyse essential data, like transactions by department. Maintain oversight and visibility over your inventory levels thanks to InventoryCloud’s compatibility with iOS, Android, or Wasp mobile computer devices.

InventoryCloud’s web-based solution enables you to manage inventory at multiple hospitals or clinics, without all the locations needing to be on the same network. When lives are on the line, every second counts.

That’s why InventoryCloud allows you to receive instant notifications of events such as low stock levels, expiring items, late orders, checked-out items past due and more by setting custom triggers, so you don’t run out of items needed for critical care again.

AssetCloud can help you quickly find exactly what you need with smart views and a conditional search feature. Stay compliant with regulations by quickly generating reports on all your assets, such as where they are, when they were used last, which have been sterilised, what you’re running low on, and more. Mobile flexibility helps your team stay connected and up-to-date on asset activity wherever you and your assets go. Spend less time on manual processes and tracking and more time focusing on the best care for patients.

Asset and inventory management in healthcare is a complicated issue, but keeping those critical medical assets and supplies safe, accounted for, and properly stocked should never be an issue. The simple adoption of an inventory or asset management software like Wasp’s InventoryCloud or AssetCloud is the solution. L FURTHER INFORMATION www.waspbarcode.co.uk

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Free your staff for whatâ&#x20AC;&#x2122;s important your patients Learn how

Technology

Digital workforce solutions that enable real change With digital technology playing an increasingly important role in ensuring a happy and efficient NHS workforce, Sean Hopkins, head of Programmes and Technology for Employment Services at NHS Shared Business Services, describes some of the existing solutions that are already available to NHS organisations As the NHS has become accustomed to for clinic appointments. For many patients operating differently as a result this has been a welcome and more of Covid-19, one of the convenient arrangement than consequences has been the attending in person. acceleration of digital

Before the pandemic, Before solutions that have the direction of travel t h e pande transformed – almost was already very much directio mic, the overnight – how around empowering clinicians interact patients by enabling was alr n of travel eady ve with patients them to do more ry much around and each other. online. The clear patient empowering The speed at focus on digital s by en which the switch to transformation within abling them to remote consultations the NHS Long Term Plan, d o m occurred, for instance, for example, and the online ore shows just what can formation of NHSX to drive be achieved when the digital priorities, such as impetus is there. Doctors interoperability, user experience and patients have adapted and innovation, are part of an NHS quickly to the need for social distancing commitment that ‘digitally-enabled care by using video conferencing technology will go mainstream across the NHS’.

And, whilst the last few months have hastened the digital transformation of some clinical services, NHS organisations should now also be looking at how technology can deliver greater workforce efficiencies, which can make the lives of NHS workers easier as they get used to a ‘new normal’.

In the NHS Operational Planning and Contacting Guidance for 2020/21, which sets out what NHS organisations should do now to achieve the outcomes the NHS has committed to deliver by 2023/24, NHS England and NHS Improvement say that ‘investment in technology, done in the right way, improves care, increases productivity, reduces the burden on staff freeing up more time to care…’.

The Electronic Staff Record The good news for NHS organisations is that there has already been significant E Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Bringing the hybrid cloud to healthcare Tim Cripps, managing director at Trustco, a silver certified HPE partner, explains how the hybrid cloud is the ‘best of both worlds’ for healthcare The Government’s flagship technology ‘Cloud First’ policy recommended the wider public sector consider and evaluate potential public cloud solutions before other options; as part of its drive to reduce costs and boost efficiencies.

Cloud technology has of course delivered a vast range of benefits from improving patient care and increasing efficiencies to reducing costs and wastage; its scalable impact has seen adoption flourish. As new options now open up, other models offer an ever-greater level of attraction, helping to further drive the NHS digital transformation.

Spanning public cloud, private cloud and on-premise, a move to the hybrid cloud offers further advantages; freeing up healthcare to break away from legacy systems and instead embrace a best of both worlds approach. These advances facilitate a new era of efficiency, meaning healthcare can now get the right mix clouds.

With the ability to meet the unique complexities of healthcare, transition to the hybrid cloud overcomes many of the common issues experienced via the more traditional routes and tackles problems such as inflexible infrastructures, high support costs, and security concerns. In fact, the business case for moving to the hybrid cloud is compelling.

Using a mix of public and private cloud services, the hybrid cloud provides a better way of working for healthcare, allowing systems and applications to be deployed in the most appropriate location. Sensitive applications that contain patient data for instance may remain on-site in the private cloud whilst other data is migrated offsite to the public cloud. Effectively this enables the NHS to select the right type of cloud platform tailored to exact requirements, after all there is no ‘one size fits all’.

The perceived difficulties of moving to the hybrid cloud means some healthcare organisations are yet to take the leap; barriers that Trustco is actively helping healthcare overcome by demonstrating the true scope of benefits of offerings such as Hewlett Packard Enterprise’s (HPE) hybrid cloud solutions.

Significant advancements in solutions and next-generation cloud services provide an opportunity to accelerate transformation in healthcare, quickly and easily. For instance, HPE’s hybrid-cloud solution has excellent credentials in the market and brings a new level of innovation by letting healthcare organisations move freely between clouds.

Aligned closely with the evolving healthcare market, HPE has ensured that running operations in a hybrid environment is a highly cost-effective, flexible option, which provides greater control as it facilitates a

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combination of IT remaining on-premises and migrating others to the cloud.

HPE GreenLake is a consumption-based payment model, which allows healthcare to transform existing infrastructure and applications whilst improving services and patient outcomes. One of the key plus points is that healthcare organisations can take advantage of the cost-effectiveness by only paying for what is consumed, avoiding large capital expense, maximising savings, and provisioning more technology, when it’s needed, instantly. This means greater control over budgets, more agility and flexibility, and has the potential to deliver significant return on investment.

Security of systems and patient data are major concerns across the sector, presenting significant ongoing challenges. This has been amplified during the recent crisis as the sector has adopted a growing number of innovative technologies to support staff and patients, processes have adapted to enable remote working, and cyber threats continue to evolve at pace.

Through enabling greater visibility, and by data not being limited to just one single location, there is less opportunity to exploit systems, and therefore the hybrid cloud is considered a highly trusted and secure option.

Beyond this, HPE’s hybrid cloud sets the standard for scalability, and ease of management. It has never been a more demanding time for the sector, and the changes experienced in recent months has accentuated the need for change, highlighting the necessity to completely

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rethink existing processes, and accelerate the digital transformation in healthcare.

A boost in hybrid cloud adoption is expected as the full impact of becoming cloud ready, and responsiveness to the changing healthcare environment is realised. The next step for healthcare is how to go about it, and Trustco is uniquely positioned to accelerate the sector’s move to the hybrid cloud through our solid expertise in next-generation technology and our team’s strong advisory. L Trustco Plc, Silver Certified HPE partner, Crown Commercial Service Supplier on the TePAS framework, and supplier on the NHS Shared Business Services Digital Work Solutions (formally Link IT Solutions) framework.

Trustco has more than 21 years’ experience in the industry, in fact the team lives and breathes IT! The right partner is imperative to a successful migration and we build strong, long-lasting relationships with our customers, taking the time to explain HPE hybrid cloud options and the valuable benefits for your healthcare organisation.

As independent specialists in hybrid cloud and data centre consolidation, we can help you navigate your options. Contact us on 0344 880 1999, email sales@trustco.co.uk, visit www.trustco.co.uk, or follow us @trustcoplc FURTHER INFORMATION Tel: 0344 880 1999 sales@trustco.co.uk www.trustco.co.uk

Technology

 investment in workforce technologies that address the admin burden on NHS workers.

The most well-known is the Electronic Staff Record (ESR), which was rolled out to NHS organisations across the country in between 2006 and 2008, to drive efficiencies, enhance data security, improve productivity and save money. At the time it was considered to be the biggest programme of its kind in the world.

Before joining NHS SBS, I was part of the team that led this national rollout – helping to train users and migrate huge amounts of data from countless other HR and payroll platforms.

This technology is, therefore, already in place at almost every NHS organisation in the country. But the reality is that it is not being used to anywhere near its full potential. The reason for this is that most NHS employers only use the HR and Payroll modules and ignore other functionality.

Today, my team at NHS SBS works with NHS organisations to help them unlock the additional benefits ESR provides.

Implementing or optimising the use of Self Service modules, for example, provides both managers and employees with a single digital platform for HR-related matters.

Instead of paper forms and multiple systems and processes, NHS organisations can enable their employees and managers to book and approve annual leave, manage personal information, enter sickness details, and complete training and appraisals, quickly and easily, all in one place.

As well as helping the NHS to get the most out of ESR, NHS SBS has invested in new NHS workforce technologies, which are designed using the principles of automation, digitisation and user experience – whilst being entirely interoperable with ESR. Just like with patients, the better use of technology can empower NHS employees and reduce the admin burden that gets in the way of delivering world-class care.

The MySBSPay payroll app, for instance, is designed to provide almost 400,000 NHS employees – at around 90 different organisations that use the NHS SBS payroll service – with round-the-clock access to their payslips and P60s via their phone or tablet. The user-friendly app gives a detailed breakdown of pay and deductions, and enables NHS staff to ask questions about their pay via chatbot technology.

The result is a significant reduction in common queries to the payroll service desk, things like payslip clarifications, tax enquiries, pay day information requests and maternity pay questions. This equates to some 380 NHS workforce hours being saved every month at hospitals up and down the country. Time we know is being redirected into frontline care.

Similarly, ePay is a digital system that interfaces seamlessly with ESR and was developed as a more intuitive and quicker way for employees to submit expense and salary claims, or log absence and HR forms.

Around 40 NHS provider trusts currently use the system to provide a better user

As well as helping the NHS to get the most out of ESR, NHS SBS has invested in new NHS workforce technologies, which are designed using the principles of automation, digitisation and user experience experience for their staff. The technology saves hundreds of thousands of pounds for NHS organisations by improving the accuracy of timesheets and expense claims, whilst eradicating thousands of error-prone paper forms every year.

Greater flexibility Providing NHS employees with greater flexibility is also a key factor when it comes to implementing new digital workforce solutions successfully. With the NHS Operational Planning and Contacting Guidance for 2020/21 also pointing to the need ‘to support NHS providers to reduce their agency staff bills and encourage workers back into substantive and bank roles’, one way this can be achieved is by introducing a weekly payroll.

By offering more regular payments, which is one of the main attractions of working through an agency, NHS trusts can incentivise more doctors, nurses and other healthcare professionals to join their ‘bank’ – on average 20 per cent less expensive than paying for temporary agency staff.

One trust we worked with to implement

a weekly payroll managed to double the number of bank hours worked by its own registered nurses – saving around £10 million on agency fees in just 12 months.

In his technology vision for the NHS, the Health and Social Care Secretary Matt Hancock points to the fact that some NHS staff ‘work in paper-based organisations where mobile working and digital technology could increase efficiency and productivity’, but that others ‘report significant improvement in working practices from the adoption of technology that works for them’.

Two years on, the hope is that more NHS organisations will look to digital workforce solutions that enable real change. The reward, as the Secretary of State said when he set out his vision in 2018, is that ‘digitisation will save health and care providers money and free up staff time – money and time that can be better used to provide great care’. L FURTHER INFORMATION www.sbs.nhs.uk/employment-services

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Panel of Experts

EXPERT PANEL TECHNOLOGY Christine Walters, Ian Brewer, Ian Hazel and Ikenna Emenyonu form our latest ICT Panel of Experts, in which we discuss the interoperability of healthcare systems, the role of the patient in digital transformation and the engagement of clinical staff

Christine Walters

Ian Brewer

Ian Hazel

Ikenna Emenyonu

Christine is Director of Informatics at St Helens and Knowsley Teaching Hospitals NHS. She was appointed to her board-level role in 2015, managing a shared informatics service that provides technology to three hospitals, a mental health trust, community health trust, CCGs, GP practices and local councils.

Her overall responsibility is to lead and develop an effective health informatics service, supporting over 14,500 users across 155 sites.

Ian is Head of Information Technology for UHS Digital at University Hospital Southampton NHS Foundation Trust.

Ian has over 35 years’ experience in IT, and has worked in healthcare IT since 1991. His special tech interests include technical architecture for whole systems design with a focus on systems integration and interoperability. He is passionate about using IT appropriately to improve the delivery of patient care, but not using tech for the sake of the tech.

Seventeen years ago, when Ian joined the NHS as Chesterfield Royal Hospitals’ IS Manager, he brought considerable knowledge with him, thanks to his background as an IT professional in the private sector.

Although heavily involved in all IT projects, his personal speciality and focus is on the use of digital improvements that enhance experiences for both patients and staff.

His goal is to ensure that every project contributes to the concept of ‘patient activation’.

Ikenna works as a Solutions Specialist manager at Netcall.

Ikenna has deep experience in delivering transformation projects within the NHS. He has been pivotal in understanding the goals, agreeing outcomes and working though challenges within many NHS Trusts.

His speciality is developing and implementing costeffective patient experience solutions.

Ikenna has been with Netcall for over 15 years.

Digital transformation has been a ‘buzz’ phrase for the NHS for a number of years, but never has the need for it, nor the opportunity for it, been greater. At the start of 2019, the NHS Long Term Plan detailed plans for improvement across the NHS estate within the next 10 years. The plan is underpinned by and thoroughly dependent on enhancing the current state of digital care and supporting further digital transformation.

This has been stressed by NHSX, created to deliver such a tech vision, who have established five key areas where technology advances will make the hospital experience better for patients and staff: reducing the

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burden on the NHS workforce; giving people the tools to access information and services directly; ensuring information about people’s health and care can be safely accessed; aiding the improvement of safety across health and care systems; and improving health and care productivity with digital technology.

Much of this can only be achieved if the wider NHS organisation, with their digital expertise, works better and communicates more directly with front-line NHS workers and hospital IT departments, who have firsthand experience, knowledge and visions for improvements that will collaboratively bring about better patient care.

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Ikenna Emenyonu, Solutions Specialist Manager at Netcall, summarised the above point very well, when he said that the biggest benefit that front line health care teams bring is their vision for patient care, but often teams can find their ideas for possible solutions only ‘through the boundaries of their technology understanding’. Their role, more importantly, is that they are closer to the patient - physically and emotionally, often daily. As University Hospital Southampton’s Ian Brewer says: ‘It is important to think about what the patient needs from any solution’. A tech-only focus can rob that advantage. It’s important to identify what is relevant and important to the

Panel of Experts

The benefit biggestont line that fr re teams ca health their vision bring is patient for care

patient, and understand that the answer might be different from what’s available to clinicians.

It is also worth stressing that technology is more adaptable than people, who can tend to be ‘set in their ways’, which makes balancing the needs of the consumer with the ease of use delivered through the digital device more important.

Convincing people that what they have always known will be no more, can be difficult.

Ian Hazel points to research which has proven that ‘an activated patient’ has better outcomes, whilst his experience has also highlighted that the more involved in their own care a patient is, the better the results.

Integration and interoperability Our panellists were also tasked with responding to a question on the ways in which teams can plan for the integration and interoperability of systems with different suppliers. The NHS Long Term Plan had a particular focus on people having more control over their own health, but its predecessor, the Personalised Health and Care 2020 Strategy, outlined that interoperability is a ‘fundamental requirement’ to achieve the health service’s 2020 targets. Former National Director for Patients and Information, Tim Kelsey, used one of his last speeches in the role to call for continued efforts to make all

parts of the health and care service technologies able to ‘talk’ to each other.

Ian Hazel, CIO at Chesterfield Royal Hospital NHS Foundation Trust, says that, as an industry-wide challenge, hospitals can deliver integration but can’t force interoperability. Most solution providers have a ‘kind of integration’ solution in place, but interoperability is wider than any single local hospital and instead relies upon the engagement of the wider NHS. Ian says that there needs to be a united approach in working with suppliers to create the momentum for all suppliers to accept that interoperability is essential. And, it will work best as a multi-team approach that includes regulators if we want to get interoperability functioning properly.

Ian’s organisation has a policy in place that affirms that no procurement project will be approved before it has been run through IT, replacing the prior method of departments going through supplier procurement and only then considering the interoperability/integration needs.

This sense of engagement is key at St Helens and Knowlsey Teaching Hospitals as well. Christine Walters says that the best way to plan for the integration of systems with different suppliers is establishing

engagement at the first opportunity. This part can be heavily technical, so ensure the technical teams speak to each other from the outset, and then back this up with a strong testing strategy. Christine advises other organisations to look for lessons learned from previous similar projects, and then to speak to other organisations who have gone through it – sharing the knowledge is vital.

Whilst interoperability may be something you implement in piecemeal fashion, it is something that needs to be considered holistically. Ikenna Emenyonu recommends that teams consider immediate interconnectivity and the next desired step at the start of any project. They should know in advance what is essential for golive and then the vision for the medium term. This will allow the requirement scope to be effectively planned.

In terms of integration and user views, Ian Brewer states the importance that the user front end is integrated, with users seeing a unified view of the data. Is the same version of the truth available on, or from, every interconnected system?

And the most important way of ensuring that this works is to make sure that users are setup for testing early.

Pitching the business case Ikenna Emenyonu says that, when it comes to pitching a business case, the two areas which have proven most useful are the money and E Issue 20.3 | HEALTH BUSINESS MAGAZINE

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Panel of Experts

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 mitigating risks. Firstly, are there any cashable savings that enable immediate payback against the cost of the solution?

And, following this, it’s important to help decision-makers to see how a solution is able to mitigate and assist controlling of a risk. The business case then can quantify the impact of that risk.

The former point is also explained well

by Ian Brewer, who adds that, in health, it can be very hard to quantify the ROI in monetary terms, as so many of the technology projects are about gains in quality, delivery and efficiencies. This, according to Ian Hazel, is often aided by a change in approach from the simple ‘I want that..’ to the more appropriate ‘I need the following requirements with these desired outputs’.

On the topic of money and mitigating risks, Brewer also highlights the benefits of clearly defining the cost of doing nothing so that everyone clearly understands all scenarios and you can mitigate any risks.

Commonly, these risks can include that there is no available budget to action the best solution, and, whether we like it or not, the health system is often still guided by a monetary element. Ian Hazel points to the example of the ‘Derbyshire pound’ as a way of navigating potential financial shortcomings with a wider aim. The Derbyshire pound’ represents every £1 spent within the local healthcare system. Supporting an integrated care system ICS approach for the county does alter some decision criteria from hospital cashable savings to total quality improvements. Ikenna Emenyonu is in agreement, emphasising the importance of investigating current investment goals

There is a general expectation across NHS trusts that the transformation team is responsible for all transformation, but, sadly, this is not aligned to reality and political pressures within the trust at an early stage, as aligning with priority goals and matching the required timing can be positive for any business case.

Implementing digital transformation projects Speaking from his experiences as Head of Information Technology for UHS Digital, Ian Brewer points out that the scale of projects in large teaching hospitals presents a big challenge. The hospital and the university may have competing priorities, so understanding how to work with a project at scale is a really important aspect in a large hospital environment. This, he believes, is one of the main challenges that he has had to support his transformation teams to face. A suggestion is to purposefully build a group of people around the team who can dedicate time to the project work streams, otherwise day-to-day business will take over and deadlines will be missed.

Brewer also highlights how the need for change management is all too frequently underestimated. Firstly, in the NHS, change is to be avoided during winter pressures, and that period seems to grow ever longer each year, perhaps more so in this unprecedented of years, meaning that time windows for major change are limited. Additionally,

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while technical challenges may seem the biggest obstacle, creative people always tend to find a solution. This is not so easy to accomplish with people for whom change can be too big an obstacle to face.

Ian Hazel agrees, stating that change management and cultural change are key when implementing transformation within the NHS. Clinicians and staff are trained to be very certain in the decisions they are making as their decisions affect people’s lives, which means they tend to be very sure-minded in what they put forward.

Not only that, but their many years of training has taught them not to rely on artificial sources to make decisions and care for their patients. Ultimately, Hazel says that the cultural shift has been the hardest thing to deal with. At Chesterfield Royal Hospital NHS Foundation Trust, technical teams work very closely with change managers in the teams whom they are developing apps for.

As an example, his Chief Clinical Innovation Officer, whilst still a senior and practicing clinician, is also a part of the development team, which helps to break down some of the barriers previously had. Christine Walters stresses that clinical advocates who can filter the message through their peers are key in this process, as well.

Top tip on managing the change process You need process owners in operations and a dedicated business change team who understand what you are doing, and importantly the reasons why – what is the ultimate goal – keep coming back to it to ensure you are still heading in the right direction. You also need a robust communications plan to keep everyone’s eye on the goal. And understand your resources to deliver the change - finance in place, people available with the right level of skill, teams ready to accept change.

Coronavirus As with nearly all aspects of day-to-day working in our hospitals, coronavirus has played its part in the way in which digital transformation is considered.

Ian Brewer says that the perception of ‘red tape’ fell away when people were faced with the crisis, and what he found was that projects that might have taken months were achieved in weeks. Essentially, people adopted a ‘get on with it’ mentality, and while all steps were taken and no corners cut, he found that people suddenly saw benefits, and were focused on achieving what was necessary. If that meant testing systems, they got on and did it. An easy to see example of this is telephone appointments and video consultations which are currently widely used, whereas before, many said they were not possible.

On the whole, teams have got much better at predicting the financial and cost side of things and looking at how they can best manage the cost of things moving forward. However, underestimating the amount of resource that deployments are going to take, often because deployments of that scale have never been

attempted before, remains an issue that transformation teams still underestimate.

Furthermore, the resource to talk to stakeholders and staff is easily underestimated. Ikenna Emenyonu says that it is important to be realistic and provide the appropriate amount of resource, and give them the necessary time and space in gaining the buy-in and adoption of the transformation agenda.

Data protection Data protection is often forgotten and underestimated in IT projects. However, as Christine Walters knows, a Data Protection Impact Assessment (DPIA) is essential to help you identify and minimise the data protection risks of a digital project or change in the way data is processed. It is also a mandatory requirement under the General Data Protection Regulation (GDPR) and, as Ian Hazel outlined, is a key part of everything we do.

Christine and Ian both stress that everyone should do a DPIA at the start of a project to make sure they understand the impact of data and security form the off. In this way hurdles and obstacles are immediately visible and processes put in

place. Moreover, while a DPIA must be set out at the start of a task, protecting data also needs to be an on-going goal, not solely a first thought or an afterthought.

Part of the reason it is forgotten is that there remains a belief that data protection applies more to digital then to paper files.

As Ian Brewer highlights, if you were to see a doctor on the train open a briefcase of paper files to read on the way home you wouldn’t necessarily think anything of it. But, reading a patient file on a tablet on the train may be deemed wrong.

Additionally, there is a fine balance that needs to be achieved between usability and data protection. Teams will need to make pragmatic trade-offs between security and providing users and patients ease of access. Hard to use systems have low uptake and setback digital plans. For example, Ikenna Emenyonu says that using encryption makes working with data an exact science, and the downside is that there will be reductions in visibility. L

Panel of Experts

There is a general expectation across NHS trusts that the transformation team is responsible for all transformation, but Ikenna Emenyonu says that, sadly, this is not aligned to reality. In his experience, one of the main challenges is being a coordinator of change not a doer of change. Transformation is an organisation-wide program and cannot be achieved with a single team. Instead, that team should coordinate the activities of the organisation to deliver the transformation, not to expect to, or be expected to, make everything happen. Walters adds that, alongside this change of mindset, there must also be an increased willingness to be flexible.

More often than not, plans change and teams must be prepared for that and adapt.

Whether we like it or not, the change process is organic and involves consultation.

When organisations include or exclude certain people or teams this will affect buy-in and slow the project. From this, you can release the staff to attend the training and finally provide them time to be hands-on with the system. Encouraging this environment of consultation ensures that everyone can better understand how they can play their part in the transformation.

FURTHER INFORMATION www.netcall.com/nhs-transformation

IF YOU COULD GO BACK TO YOUR ‘PRE-DIGITAL SELF’, WHAT WOULD YOU TELL YOUR LESS EXPERIENCED SELF? CHRISTINE WALTERS “Embrace exciting opportunities to transform the way we work and remove less value added tasks. Digital programmes, done well, really make a difference to patient care and patient safety by giving the right information to the right people at the right time to enable clinicians to make informed decisions on individual patients and their treatment and care.”

IAN BREWER “Set your sights on the project’s core functionality, and, just as importantly, keep it there. This will enable you to balance objectives and outcomes and make rational decisions in the face of change.

“The first kind of change is that when you show users the system, they will have personal bias and also focus on bells and whistles. This can distract you. The second is change that needs to be managed, such as any national directives or unexpected events. If you have a strong focus on the core competencies and outputs any adaptations will keep the ‘goal-in-mind’.

You will be able to flexibly deliver without going too far of course.”

IAN HAZEL “I’ve learned that getting clinical staff engaged and involved in your team is essential. It helps project teams to understand the impact of their work, ensures solutions are able to deliver useful cost-effective results and helps with credibility during change management. The results we have had are massive. We are now working with that end-user to jointly deliver solutions as a team. I didn’t used to think like that even ten years ago.”

IKENNA EMENYONU “First, I would remind myself to communicate widely and openly.

Then listen, really listen to the answers through the noise. Projects can stumble when unknown facts are revealed. How often have I heard, ‘If only you had told us, we might have told you…?’.

“Second, I’d remind myself to have a flexible approach. When you approach situations flexibly, you can assess how to turn on the most useful functionality first. I’ve learned that a phased approach can be the best route to manage adoption. And finally, use a step-by-step approach tailored to the team, department and organisation. Using a phased approach is more likely to reduce the risks they perceive and allow you to move ahead.”

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NILCO – Saying No to COVID-19

www.Nilcouk.com

The Nilco brand is manufactured, researched and produced in the UK and products are trusted by professionals with scientific research into cleaning surface technology and skin sanitising giving users confidence to know that not only are surfaces clean, but also free from contaminants and harmful bacteria.

Nilbac High Contact - A dry-touch sanitiser spray that gets to work straight away to remove viruses and bacteria from surfaces such as tables, chairs, light switches, handles, worktops and preparation areas.

Nilbac Max Blast - A dry-touch fine mist effortlessly sanitises entire spaces in a few short bursts. This ‘no wiping just spray’ product will cover two average rooms, approximately 50m area, and will be dry touch within 10 minutes. A perfect solution for sanitising any area at the end of a working day ready for the next.

Nilfog PPE Anti Mist - A product that eliminates condensation that can occur on PPE screens and protective eyewear, such as goggles, visors, glasses and helmets. The strong anti-fog formulation creates a micro thin film, allowing for clear visibility and a streak free finish.

Nilco Antibacterial Car Sanitiser Kit – The powerful antibacterial agents clean and sanitise the whole car including the air conditioning system in under 10 minutes without the use of any specialist equipment leaving the interior clean and purified. Simply turn on www.facebook.com/nilcouk

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the air conditioning, place the atomiser in the footwell or cup holder, activate the trigger and close the door.

Peter Schofield, Tetrosyl Group Chairman, said: “The Nilco range is a perfect fit for any business due to its professional bacterial and virus control. We are proud to be supporting the likes of schools, dentists, barbers, beauty salons, offices, garden centres, bars and restaurants in their pursuit to return to full strength and continue to operate in the safest way possible.”

Businesses are turning to the Nilco range as they feel confident in the knowledge that the products meet and exceed European Standards for bacteria and virus control with approvals on BS1276, BS1327, BS1500, BS13697, BS13704 and BS14476 including BRC consumer product certification.

Nilco has an extensive portfolio of hand and room sanitisers, PPE anti-mist products, car sanitisers, glass, floor and fabric cleaners. For more information and to see our professional products in action visit www.Nilcouk.com or check out Nilco on Facebook, Instagram and Twitter.

www.linkedin.com/company/tetrosyl

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www.twitter.com/nilcocleaning

Supply chain

Supporting the government’s response to Covid-19 NHS Supply Chain write for Health Business about how they’ve been working to deliver products to the NHS, particularly PPE, during the Covid-19 pandemic Since the beginning of the Covid-19 Supporting government outbreak, NHS Supply Chain has been led initiatives working closely with the Department of The urgent demand for PPE at the outbreak Health and Social Care, NHS England, NHS of Covid-19 earlier this year was so Improvement and Public Health England unprecedented that despite increasing to supply and deliver products into the staffing levels and running NHS Supply NHS. It is part of the cross-government Chain’s network 24/7, it became clear more approach to managing the pandemic. capacity was still needed to help ensure The government led response to the that PPE products were delivered to the Covid-19 pandemic has seen over two front line. This led to the Government led billion items of personal protective initiative to establish the dedicated and equipment (PPE) delivered to the frontline, totally separate PPE supply channel – set covering acute, community, mental up by NHS England and NHS Improvement, health and ambulance trusts as NHS Supply Chain, the Ministry of Defence well as to GPs and social (MOD) and Clipper Logistics who care organisations are delivering the service. through the national This PPE dedicated supply The logistics effort. channel was set up in gov This includes: parallel to the usual led respernment over 337 million NHS Supply Chain Type 11R service and was Covid-1 onse to the 9 facemasks; over designed specifically p has see andemic 24 million FFP3 to receive and n over tw billion i facemasks; distribute PPE to NHS o t and over 325 trusts and community protectems of person ive eq al million aprons.

health partners such as GPs and social care organisations.

It has enabled the NHS Supply Chain network, to continue to focus on the supply of all their other medical devices and clinical consumable items in high demand at this critical time for the NHS. NHS Supply Chain has received praise from Matt Hancock, Secretary of State for Health for their efforts in securing PPE. He said: “NHS Supply Chain have done an amazing job. The team have been working incredibly hard … and I pay tribute to them and I think that they deserve our thanks in getting PPE out to everyone.”

In addition, NHS Supply Chain’s buying teams were seconded into the government’s centrally led PPE procurement cell. This cell’s focus is on securing supplies of PPE, whilst ensuring that specifications match clinical need. E

ui (PPE) de livered pment frontlin to the e

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Advertisement Feature

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

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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

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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

Communications Communications are critical during a pandemic. The customer engagement team quickly organised regular webinars to communicate key developments and service updates for both customers and suppliers.

In addition, this enabled customers and suppliers to hear from Lord Paul Deighton, former chief executive of London 2012, appointed to lead the government’s efforts to secure PPE and ensure this gets to where it is needed, as well as representatives from NHS England and NHS Improvement to enhance their understanding of key decisions and updates from the national bodies.

The account management team stepped up their support and provided 24/7 cover to help their customers through this challenging period. This involved switching to video based communications with customers, allowing face to face virtual interaction, and ensuring relationships with our customers continued to develop. By adapting to the customer’s needs and maintaining a collaborative approach, the account management team have built stronger, more agile relationships with customers.

Supporting Covid-19 PPE stock management Royal Papworth has treated over 200 Covid-19 positive patients, and collaborated with NHS Supply Chain on using the eDC Gold application to manage their PPE stock, track it to their wards and produce accurate reports on stock holding and product usage data. eDC is NHS Supply Chain’s order capture system for 10 per cent of NHS England and NHS Improvement’s consumables spend across 140 acute NHS trusts. eDC Gold is the inventory management module of eDC, managing £50 million of trust inventory in 32 acute hospitals, and both applications can be managed using the same handheld device.

The results included: effective inventory control of 500,000 PPE items (continuing post-Covid-19); audit trail of PPE stock movements; reduced need for emergency

Supply chain

 NHS Nightingale hospital supplies NHS Supply Chain have been working alongside the Department of Health and Social Care, NHS England, NHS Improvement, and other organisations to prepare their supply chains for the significant increase in equipment and consumables required to equip the NHS Nightingale hospitals. Ventilators, patient monitors, CT scanners and many other products have been in high demand as part of the operation to build additional capacity for the surge of Covid-19 patients in acute trusts and in the new NHS Nightingale Hospitals.

Working to incredibly tight deadlines, NHS Supply Chain has been instrumental in expanding its operations across the UK to support the set-up of NHS Nightingale Hospitals.

In total, seven NHS Nightingale Hospitals have been stood up across the UK, these include NHS Nightingale London, Birmingham, North West (Manchester), Yorkshire and the Humber (Harrogate), Bristol, Exeter and North East (Washington). These hospitals are ready to provide backup for NHS hospitals should it be needed, to either support the response to Covid-19 or other NHS services.

This PPE dedicated supply channel was set up in parallel to the usual NHS Supply Chain service and was designed specifically to receive and distribute PPE to NHS trusts and community health partners supplies as all stock was visible at all times; and the ability to build a more accurate usage model based on issued stock.

Chris Goodier, head of Procurement, Royal Papworth Hospital NHS Foundation Trust, said: “This project will greatly benefit the trust going forward with regards to management of stock during the Covid-19 pandemic. NHS Supply Chain’s eCommerce Deployment Lead, Jason Fendick, has been amazing with the support he has provided to date.”

Howard Blackith, Chief Information Officer at NHS Supply Chain, added: “This collaborative development with Papworth not only actively manages vital PPE inventory inside the trust, simplifying capture of PPE demand, but also has the capability to provide a vital demand signal that can be used centrally in forecasting models, which are so critical at this time of national crisis.”

Support from our suppliers Throughout recent months NHS Supply Chain has been receiving outstanding offers of support from many different suppliers. Here are some examples from the suppliers of scrubs and food.

Scrubs Demand for scrubs has been unprecedented with five years’ worth of product being ordered in the first three months of the pandemic. NHS Supply Chain has been working with 12 different suppliers who have adapted and increased their scrubs production to meet demand.

Some examples include: Alexandra, a uniform manufacturer, increased their supply of scrub sets over the last two months and sourced millions of extra medical supplies for hospitals and care homes; non-medical suppliers such as Dark Blu and Orn International offered invaluable support in terms of product supply and sourcing for scrubs and other medical products to help NHS Supply Chain manage increased demands across the market; Meltemi

& Alsico UK, who in a single day were able to despatch 100,000 scrubs to NHS Trusts, GP practices and care home groups across the country from their warehouse in Preston.

Food donations NHS Supply Chain: Food has been working with some of our framework suppliers to donate food and drink to front-line NHS workers. So far over 346,350 units of food and drink worth £187,000 have been generously donated to 123 NHS Hospitals across England.

LR Suntory, Gate Gourmet, Britvic, UpBeat, Coca Cola, Unilever, Hippeas and PROPER have got involved in providing free cold bottled drinks, crisps, snacks, and other treats.

Andy Jones, head of Facilities, Birmingham Women’s and Children’s NHS Foundation Trust commended the generosity of these donations: “I have seen clinical staff in tears when we deliver the products to the wards, from a biscuit to an Easter egg to drinks, it is great – keep them coming!”

Our support continues during the pandemic NHS Supply Chain is proud to be supporting the government and national bodies at this unprecedented and challenging time. It has adapted its operating model in an agile way to play a pivotal role alongside national partners in the government led initiatives to managing the response to Covid-19.

Jim Spittle, Chairman, SCCL Board, said: “The extraordinary efforts by our teams in responding to unprecedented volume demand from the NHS has been a testament to the strength and depth of NHS Supply Chain.

Throughout the Covid-19 pandemic it has been a privilege to work alongside such professional and dedicated teams that have worked tirelessly to serve the front line of the NHS, it’s been a great effort by all concerned.” L FURTHER INFORMATION www.supplychain.nhs.uk

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Medical technology

Technology has proven its worth, let’s now give it a chance Barbara Harpham, chair of the Medical Technology Group, looks at how technology has helped the NHS cope during the current crisis, and how it holds the key to a new, more efficient, post-pandemic healthcare system The Covid-19 pandemic has put an opportunity to be seized - that we are on unprecedented strain on the National the brink of change and we have a clear Health Service, requiring a level of response choice. We could restart services and return from our healthcare workers that has to the former NHS, struggling to meet the never been seen before. The reaction has growing demand of an ageing population, been admirable; NHS staff have risen to with seasonal demand far outstripping the challenge, adapted quickly supply as budget deficits increase. to new ways of working, Alternatively, we could embrace and embraced new a new way of working, which Until technological advances. re-evaluates the way that now th This rapid uptake care is delivered and very cu e of new and existing recognises the value that l t the NH ure of technology – both communications from remote and medical technology one of S has been the gre communications can bring to the atest barriers and monitoring service, the benefits uptake to the of patients to it delivers to patients, of the fast-tracked and its wide-ranging techno medical introduction of economic and societal logy advanced, non-invasive benefits in the long term. cancer treatments –

The NHS Confederation has accelerated the pace has dubbed this movement of change within the health ‘NHS Reset’, and has called on service, as barriers to innovation have clinicians, leaders, and public servants not been lifted in response to an acute need. to ‘seek to return to the ways of working and approach we once knew, but to reset A return to old ways, the way we plan, commission, and deliver or a new vision? healthcare’. The Medical Technology Group A growing body of opinion suggests that, wholeheartedly supports this message. despite the scale of the human tragedy and As demand on the health service starts to individual stories of loss, there is now an return to some normality, the value that

medical technology brings to the table must be emphasised. Frontline workers have now experienced the benefits in their everyday practice, and new ways of working will be needed to keep patients away from bricks and mortar healthcare while managing the predicted backlog of elective surgery and other routine care.

Technology has proved itself during the pandemic Technology has touched every aspect of the NHS response to the pandemic. The government’s initial Ventilator Challenge called for a rapid upscaling of medical technology production to ensure that respiratory support was available for patients with acute breathing difficulties.

Meanwhile, diagnostics manufacturers have responded swiftly to the demand for accurate and reliable tests, both for SARS-CoV-2, and for serology assessments to support the detection of antibodies, which will be crucial to avoid the potentially enormous social and economic impact of a second pandemic wave.

Meanwhile, the demand for new communications technology has soared during the pandemic, with remote consultations replacing physical interaction between clinicians and patients. In fact, E

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Advertisement Feature

Leading Digital Change with WellSky EPMA Of all of the digitisation projects currently underway at St Helens and Knowsley Teaching Hospitals (STHK) NHS Trust, electronic prescribing and medicines administration (EPMA) represents the biggest step forward for patient safety, ensuring the right drugs get to the right patient at the right time Reducing prescription errors A recent study by the universities of York, Manchester and Sheffield reported that in NHS England alone some 237 million medication errors occur every year, which, as former Health Secretary Jeremy Hunt estimated, accounts for between four and five deaths a day. Whilst the NHS is committed to reducing these errors by 50%, St Helens & Knowsley with the WellSky EPMA system have challenged themselves to achieve an even higher rate.

In April 2017, Whiston, an in-patient hospital, went live with WellSky’s web-based EPMA. In under a year the Trust saw positive results by digitising medicines management.

The system links with the WellSky Pharmacy stock control module, and together they create an end-to-end integrated medicines management platform that can interface with their System C Patient Administration System for order communications, admissions/discharge and other functionality. This digital environment enables quick and easy data sharing across wards and other Trust sites, providing nurses and doctors with secure access to patient records even while on the road.

Why Wellsky?

In addition to already having its pharmacy stock control system, the Trust wanted an electronic prescribing solution with broad functionality, designed by domain specialists and already with a proven user base. At the time of selection, the Trust didn’t have an EPR so were free to choose the EPMA market leader.

of how users navigate screens – greatly simplified the training process.

In fact, the speed with which the Trust overcame cultural and technology barriers was especially impressive considering the complexity of electronic prescribing. There is a vast array of medicines, protocols and dose bandings to be custom configured into the drug database, along with exception alerts for the drug allergies and the special sensitivities of individual patients. Given that a single error can be life threatening, this explains why medicines management has one of the lowest tolerances to error: It simply must be safe.

Eliminating transcription mistakes “On electronic systems you reduce the amount of hand-written transcription of medications; which significantly reduces the number of prescribing errors.” – Dr Andrew Hill, Clinical Lead for Stroke Services Like all hospitals, the Trust used to have problems with the wrong medicines being delivered to the wards because of the order’s illegible handwriting. And while these were always spotted in time, it posed unnecessary risks. WellSky EPMA eliminates this risk.

Other safety features include decision support tools like best practice medicines and dosage defaults. By prescribing electronically, orders no longer go astray and drug administering schedules can be monitored and flagged up if a round is missed. And in cases when care is time critical, a change in prescription or dosage

One of the main priorities was a modern web-based system that was intuitive to use for mobile clinicians and would be easy to deploy, upgrade and interface with other applications as our digitisation programme evolves. With EPMA’s web version updates are done direct from the IT centre with users accessing the system via URLs. Not only does this save a great deal of time, it ensures everyone is always using the same version.

The digital transformation “The new system is much more efficient and quicker than other versions that I’ve used previously” - Dr Andrew Hill, Clinical Lead for Stroke Services When WellSky EPMA was introduced to clinicians, the web interface – which was designed following in depth study

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can be reviewed and amended remotely in real time. The Trust has noted a marked reduction in medicines incident logged by the Datix incident reporting system.

Saving Clinician time With WellSky EPMA clinicians no longer wade through old kardexes to look up a patient’s medication history. Instead, doctors can see a patient’s complete real time prescription sheet on a single consolidated screen; determine when a particular drug was last administered and find out why it was stopped. Because all medicines data is captured within the database, on readmission to the hospital a patient’s treatment history can be called up instantly.

The Pharmacy/treatment dispense information interface is allows EPMA data to be downloaded to create discharge letters for the patient’s GP. Digitising the Trust’s medicines management environment has also had a positive impact on operational and financial efficiencies. The wealth of data captured by the WellSky EPMA system is not only clinically rich but enables the generation of a wide range of reports and analysis of both clinical and operational outcomes in a way previously not possible.

With future EPMA rollouts planned for St. Helens Hospital, Outpatients and possible outreach into community hospitals, the project is nothing short of transformative. L FURTHER INFORMATION www.wellsky.co.uk

Medical technology

 NHS England reports that 99 per cent of GP practices have activated remote consultation platforms. Our research among clinicians and patients in the last few weeks suggests that these alternative communications technologies have been broadly welcomed, enabling clinical staff to see more patients in the same amount of time, and reassuring patients that they are still being monitored and cared for.

Our investigations also found increasing levels of self-care among patients, who have reached out to their patient groups and other sources for information about their condition. This drive for remote care has led to a surge in innovations in recent months, including a pilot of a tele-dermatology service, using artificial intelligence technology to reduce delays in skin cancer detection and treatment, and an at-home safety monitoring test for chemotherapy patients that tests the levels and potential activity of suppressed neutrophil blood cells.

There are, in fact, now 250,000 mobile health applications available, and over 300 million wearable devices in public use.

Reimagining a technologycentred healthcare system The pandemic has, however, had a significant impact on patient services.

Many patients have been avoiding healthcare settings, with GP appointments and Accident & Emergency Department statistics showing a steep decline.

Meanwhile, McKinsey & Company is projecting a 40 to 50 per cent decline in elective procedures in the third quarter of 2020, with the University of Birmingham estimating that there will be 516,000 cancelled surgeries resulting from the 12 week elective surgery hiatus. It suggests that, if the NHS were to increase surgeries by 20 per cent compared to pre-pandemic activity, the backlog would

This rapid uptake of new and existing technology has accelerated the pace of change within the health service, as barriers to innovation have been lifted in response to an acute need take 11 months to clear. That’s without the possibility of a second pandemic wave.

Clearly, a paradigm shift is needed in our healthcare system if it is going to cope with the enormous pressures that are anticipated.

Telemedicine and remote monitoring will certainly have an important role to play. Patients’ satisfaction and willingness to adopt these technologies should be capitalised upon, so that patient-generated data from devices such blood pressure monitors, step counters, weight scales and single lead electrocardiograms, as well as pacemakers, subcutaneous implantable defibrillators, or blood glucose monitors is used to determine those in greatest need of follow-up care.

Minimally-invasive procedures, such as stereotactic ablative radiotherapy (SABR) for example, which delivers a highlyfocused radiation treatment concentrated on a tumour, while limiting the dose to the surrounding organs, can ensure patients are treated quickly, return to their everyday lives sooner, and have the potential to reduce waiting lists for surgery. NHS England’s decision to accelerate the implementation of SABR technology was an encouraging start.

Many other technologies also have enormous potential benefits, and the Medical Technology Group has long argued for the value of technology in improving patient outcomes, reducing the burden on the NHS, and delivering

wider societal benefits to be more widely recognised. In fact, as far back as 2011, we commissioned a report from The Work Foundation to examine the broad benefits of medical technology. Our follow up study in 2017 found that nearly half a billion pounds in savings could be generated each year in reduced long-term health costs and benefit payments from the use of just eight technologies alone.

Change the culture and focus on long term gains Until now the very culture of the NHS has been one of the greatest barriers to the uptake of medical technology. A ‘less is better’ mindset and a focus on first year savings - rather than long term efficiencies and wider societal benefits - has led to rationing of treatments, rather than the enthusiastic adoption of proven technology.

We have seen the benefits of medical technology in action and it has reaped rewards. As Simon Stevens outlined in his message to NHS leaders in April, now is the time to ‘lock in’ beneficial changes that have been introduced in recent weeks.

I hope that the whole NHS - from frontline clinicians to senior managers - will seize this great opportunity, embed a new culture of innovation, and build a healthcare system that’s world-leading and futureproof. L FURTHER INFORMATION www.mtg.org.uk

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Advertisement Feature

How can we make AI invisible in healthcare diagnostics?

As NHSX guidance around artificial intelligence (AI) is digested in healthcare, Sectra’s Chris Scarisbrick (CS) argues that AI should barely even be noticed by the professionals who use it, and that it needs to be made easy to procure HB: What are the key questions that need to be addressed to make AI work in healthcare?

HB: Let’s expand on that last point. Are you suggesting the AI acquisition process itself needs to be made easier?

SC: AI has become a big focus in healthcare. It even continues to make SC: Absolutely. Though the recent national headlines in the fight against coronavirus, crisis has shown that technology can with reports of researchers looking to be deployed quickly in the NHS when validate AI models that they hope could urgently needed, the traditional way help predict which patients are the NHS procures IT is to go through a most vulnerable to Covidlengthy procurement process, in which 19. organisations evaluate several In the healthcare vendors, shortlist the ones As diagnostic space that look most promising, techno particularly, there go to a best and final, l o gy partner is enormous make a five to 10 year respons s, we have a potential for AI, commitment, and sign a i b i l where it is now contract, all before the i t y to help hospita being looked IT or digital department l s a c quire th best ap to in order to needs to think about e plicatio transform the deploying it. It is a familiar n m s eet the delivery of crucial scene in the diagnostic ir need sto diagnoses for a space, as much as any part whole range of of healthcare technology, illnesses and patient and it can be a complex cohorts. and intensive experience both AI is here for the long term. for trusts and for suppliers.

And with real world application now The NHSX AI Lab released A Buyer’s beginning to take hold at pace, AI design Checklist for AI in Health and Care in May and the manner in which it is procured 2020, as a short reference to assist the and implemented could be big factors decision-making for procuring AI solutions in determining whether algorithms are in the NHS. It is a very comprehensive successful or whether they could actually and well thought through document, become a hinderance. addressing the challenges we see today Whether we are applying it to for accelerating safe AI adoption. specialisms in radiology, pathology, Although the document provides a cardiology, or any other profession good and clear checklist, it is still quite harnessing diagnostic imaging, AI should a burden on both trusts and smaller/ improve accuracy and efficiency for end emerging AI developers to run through a users, and it should speed up the work lengthy procurement process each time. that they do. If it adds any extra steps, or Does a commercial function in an slows down our clinicians in their mission NHS trust really want to repeat the to improve patient care and the patient same process and payment terms with experience, then it is a wasted exercise. potentially dozens of different AI imaging The question is how can we take providers, dozens of different times? advantage of emerging AI and minimise And can AI vendors, who might be disruption both for our professionals and start-up companies or small businesses for the healthcare enterprise? Well, this and who might never have navigated NHS can very much start before hospitals even procurement processes, manage to get acquire AI applications. their solution through the front door?

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HB: How far can health tech providers help to overcome some of this complexity in the AI landscape?

SC: There are opportunities for established suppliers of traditional IT systems to play a role both in following the new buyer’s guide, and in relieving these burdens – making AI acquisition easier. Imaging technology providers, for example, can certainly help.

Sectra is committed to doing so, in particular by supporting the hospitals that use our imaging systems by conducting some of the due diligence process on AI vendors where appropriate. We want to be a partner in the buyers’ journey and create a dynamic marketplace from which hospitals or professionals themselves can choose from a range of AI apps, safe in the knowledge that those apps meet necessary regulatory standards and comply with information governance standards.

And we are in continual dialogue with our customers to understand what is really important in clinical practice – which AI applications will make the most impact on the lives of imaging and diagnostic professionals.

The aim of this is to remove a lot of the complexity from the process, and to overcome barriers like the limitations of contracting resource, the scalability of IT, and the ways applications interact.

HB: What about the way in which AI is applied? Can vendors play a role here too to make it easier for the user?

SC: The manner in which applications interact is particularly important to ensuring they fit within clinical workflows.

By using the imaging technology system provider as the point of coordination for imaging AI acquisition, more thought can be put into standardisation and maintaining user control over how images are displayed on screen for professionals.

Advertisement Feature

Our ethos is to tailor this to a close and ever evolving understanding of workflow on the ground. We can also ensure an AI app is integrated into the picture archiving and communication system (PACS), where radiologists spend 80 per cent of their working lives, before it is even procured.

But in essence, for the most part, AI should be invisible to the user. Whilst AI will not replace our professionals and for the foreseeable future a human will always need to remain in the loop in delivering diagnoses, most of the time our professionals shouldnâ&#x20AC;&#x2122;t even notice it is there. If you are using an AI application that measures lung lesions â&#x20AC;&#x201C; only scans that meet these criteria should be forwarded on to the AI, and should be sent automatically, without the need for human intervention. The AI can then run its analytics in the background and push results back to the PACS to alert

By using the imaging technology system provider as the point of coordination for imaging AI acquisition, more thought can be put into standardisation and maintaining user control over how images are displayed on screen for professionals the professional to urgent cases and to help them prioritise and improve the quality and efficiency of their work.

HB: And how can vendors help their customers adopt new and emerging advances?

SC: The growth in AI continues at pace. We as technology partners have a responsibility

to help hospitals acquire the best applications to meet their needs. This is not about what AI Sectra can develop, for instance. It is about providing a channel in which the fantastic innovation emerging can reach those working hard to support the frontline of healthcare. L FURTHER INFORMATION medical.sectra.com

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EIDO Healthcare experts in informed consent

Established in 2000, EIDO was created in response to the lack of medico-legally valid surgical and medical procedure information, in language easily understandable to patients.

Today EIDO’s library comprises nearly 400 procedures and a customer base of 700+ public and private hospitals across four continents and is widely recognised as the standard for informed consent written information.

The library is endorsed by: • The Royal College of Surgeons of England • The Royal College of Surgeons of Edinburgh • The Association of Surgeons of Great Britain & Ireland • The Canadian Association of General Surgeons • The Australian Patients Association The prestigious Plain English Campaign have awarded Crystal Marks to all EIDO titles (Crystal Marks are awarded for the clarity of the language used).

EIDO has expanded its product base and now supports healthcare professionals around consent more broadly: EIDO Inform – Trusted content for informed consent EIDO Inform is a library of nearly 400 treatmentspecific informed consent patient information leaflets.

EIDO Educate – Medico-legal e-learning resources EIDO Educate provides information for health professionals in the medico-legal principles of informed consent.

EIDO Vault – Reliable digital consent EIDO Vault is a reliable digital solution for obtaining and recording patient consent.

EIDO Inform Digital with Home Consent – Insightfulpatient communication EIDO Inform Digital utilises the Inform Library content and delivers it online along with animations and a draft Home consent form.

Audits A recent audit showed that 100% of patients agreed that the Inform library was “excellent” or “good”, “easy to understand” and contained “all the information that they required”.

Another audit showed that 100% of patients would recommend the EIDO Inform library to a friend or family member undergoing the same procedure and demonstrated a 26% increase in the understanding of a given procedure by patients.

In summary…

With over 700 hospitals already using our 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.

To start you consent digital transformation or just for more information, please contact us: w. www.eidohealthcare.com e. info@eidohealthcare.com t. 0115 8781000

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Digital records

How digital healthcare records can spread the load Following a recent digital pharmacy trial, undertaken by NHS Wales, Sascha Giese discusses how digital health records can help lighten the load on GPs at the time the patient is at the pharmacy and needs the treatment. The records shouldn’t be accessible at any other time.

Digitising health records isn’t a new phenomenon, but it’s starting to gain momentum in new areas to better care for patients. In the UK, NHS Wales recently—and successfully—trialled a new digital scheme in which patients could enable their nominated pharmacist to access their medical records and treat them for a sore throat if required.

Sharing this information with the pharmacist meant patients could be prescribed antibiotics, for example, based on additional health information about each individual.

With a 98 per cent satisfaction rate, this system is being rolled out further across NHS Wales to lighten the load currently on GPs, and it also raises the question of whether this type of technology could be used much more broadly. However, it also introduces some concerns around data privacy and cybersecurity that may not have been previously considered.

Why digital records are a good thing This example from NHS Wales is a strong step in the right direction towards digitising the public healthcare sector. As mentioned, digital health records aren’t new, but the extent to which they can be used outside of a consultation with your GP is currently limited. Let’s take pharmacies as a prime example; if more responsibility can be given to pharmacists and patients can obtain more medicines without having to make a GP appointment, some pressure would be relieved from GP surgeries and additional appointments would be available for people with more urgent concerns. From a patient’s perspective, they would receive the help they need more quickly—either directly from the pharmacist on a drop-in basis or from the increased number of available GP appointments.

Keeping private data private One of the easiest ways to help ensure relevant patient data is only accessed by the right pharmacist at the right time is through multi-factor authentication (MFA).

This can help make sure the pharmacist can only access a patient’s records when the person is there to provide the right details (possibly through an app on their phone), including answers to questions, passwords, For dig and even fingerprints or retina scans. Once a records ital to be patient had shared the However, with any used m ore bro required information, digital venture comes across t adly the pharmacist would increased risk, and this patient he sector, be able to access is where initiatives the relevant data. like this must be certain s need to be Unfortunately, this carefully managed as their da may exclude anyone they’re introduced. protect ta is ed who doesn’t have a smartphone. But a simpler What obstacles two-factor authentication must be overcome?

(2FA) would also be secure and For digital records to be used would just require the patient to have a more broadly across the sector, patients mobile phone capable of receiving and need to be certain their data is protected replying to text messages from the security and only relevant information is made system. Though this wouldn’t help 100 available for pharmacists to access. per cent of patients, most people have In terms of data protection, pharmacies mobile phones (even if they’re just for are unlikely to ever be responsible for emergencies), so this would make it the storing patient data—the records will be most effective way to keep data safe. held by the NHS and organisations such Another way to improve this solution is as Public Health England, which will be access rights management. This technology responsible for storing the information monitors everyone who accesses a file or securely. Regulations around this will document and records when they accessed therefore apply more to those parties. it. Having this measure in place would help However, when pharmacists access the with patient confidence; if there was ever records in their pharmacies, they would any doubt about whether a pharmacist had need to be confident their network is managed to access data without a patient’s secure enough to make any attempted consent, there would be a record of it. cyberattack difficult. It would be a major In today’s digital age, having technology problem if medical records were hacked systems capable of better care for through an insecure pharmacy network, patients is crucial for the development especially as these details are sensitive and of the healthcare sector. And though the could have serious negative consequences trial undertaken by NHS Wales is just if they fell into the wrong hands. one step in this direction, it’s a little bit Second, patients would want to be further along the digital transformation sure their pharmacists could only access journey, and the rest of the industry can the relevant data on their records, such use this progress to take the lead. L as other medications that potentially impact the treatment the pharmacist can Sascha Giese is Head Geek™ at SolarWinds. prescribe. Some other details, however, are more private and wouldn’t be relevant for anyone other than the patient’s FURTHER INFORMATION GP—these must be inaccessible. It’s also www.solarwinds.com crucial for this data to only be accessible

Issue 20.3 | HEALTH BUSINESS MAGAZINE

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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

ENERGY

e-Hot Water System tackles challenges of space, cost and sustainability

Health estates and care homes can now gain a resilient domestic hot water (DHW) system that helps reduce both a building’s energy consumption and operational costs to meet sustainability goals whilst unlocking valuable space within the building.

Perfect for both new build and refurbishment applications with high demands for hot water, the Adveco Packaged e-Hot Water System is a prefabricated allelectric water heating system that addresses project limitations by creating a standardised external plant room containing essential building services. The system comprises an Adveco FPi-9 Air Source Heat Pump (ASHP) mounted on the outside of a weatherproof

GRP housing, and inside, an Adveco 200L GLC indirect preheat tank and Adveco 200L GLE direct electric water heater that provides reliable high-temperature water.

Sized to supply up to 500,000 litres of hot water each year with factored peak hour delivery, the FPi-9 ASHP offsets 70 per cent of the DHW load for a 47 per cent reduction in energy demands and CO² emissions when compared with a similar direct electric-only system.

New specification of the electric immersions helps protect the system from scale build-up in harder water areas, and a back-up immersion provides built-in resilience to ensure the consistent provision of hot water.

FURTHER INFORMATION www.adveco.co

FLOORING

INFECTION CONTROL

Flooring instillation service specialising in healthcare sector

Vortice launches new air purifier reducing viruses in the air

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

Ventilation systems supplier Vortice has launched the DePuro Pro plug and play air purifier specifically developed with double filtration to reduce the number of particles in the air such as bacteria, micro-organisms and viruses. Designed for spaces such as care homes, offices, hotels, universities and the health sector, this is of huge interest as we fight the Covid-19 pandemic.

The DePuro Pro is available in two sizes and comes with HEPA 14 absolute filters, capable of retaining up to 99.995% of microparticles (equivalent

diameter 0.3µm) which require periodic replacement, highlighted by the filter status indicator on the control panel. The DePuro Pro 150 is suitable for rooms up to 50 metres square and the DePuro Pro 300 is suitable for rooms up to 100 metres square.

This new product is highly energy efficient, is easy to handle and has sound absorbing panels making it almost silent to operate.

General Manager Kevin Hippey said: “Scientists have reiterated the importance of good ventilation throughout this pandemic and that, coupled with air filtration and purification, can really help reduce infected particles, making the DePuro Pro of particular interest in the health and care sector.”

FURTHER INFORMATION https://www.vortice.ltd.uk/ shop/commercial-ventilation/ depuro-pro/depuropro300/

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IT

A New Rapid Pandemic Response Scheme

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

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

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/

32

Adveco 79 ARI-Armaturen UK

8,42

Asckey Data Services

52

Big Dug

28

Daikin Applied (UK) DDC Dolphin Debt Recovery Plus

OBC 4 IBC,46

Dekomed 17 Durable UK

14

Eido Healthcare

76

Elite Systems

36

Evac Chair International

28

Fairford Medical

70

Flooring Matters

79

Fordingbridge 16 Genmed 66 Glasdon 26 Gojo Industries

INFECTION CONTROL

Using product innovation to maximise efficiency

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

80

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

40

ISS IFC Legrand Electric

10

Lockncharge 48,49 Netcall 58 Office depot

68,69

Opex Business Machines

34,35

Outbound UK

56

Radiocoms Systems

22

Sectra 74,75 T & K Euro Trading

24,25

T-Impact 54 Tetrosyl Group

64

Tristel Solutions

12

VITD Group

79

Wasp Barcode

50,53

Wellsky International

72

White Horse Scientific

30

Yeoman Shield

38

Vortice 79

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net