Health Business 21.2

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ISSUE 21.2





THE BARRIERS TO NHS TECH IMPLEMENTATION What does the techUK Ten Point Plan for Healthcare say about the direction of travel for health technology beyond Covid-19?


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ISSUE 21.2





THE BARRIERS TO NHS TECH IMPLEMENTATION What does the techUK Ten Point Plan for Healthcare say about the direction of travel for health technology beyond Covid-19?

Making better use of the NHS estate This issue of Health Business contains some really important and varied articles that I hope will be of interest to you.


Firstly, as shown on the cover of this issue, Henry Rex of techUK has written an article for us on the organisation’s Ten Point Plan for Healthcare and why digital technology must be at the forefront of improving patient outcomes. You can read the piece on page 37. On the pages following Henry’s article, we look at some of the new innovations being promoted by NHS England, a new Medical IT framework, as well as plans to improve hospital discharge efficiency from NHS Shared Business Services’ Phil Davies. However, in this issue I would most like to draw your attention to Christopher King’s feature on page 21. As he writes, the flexibility of allowing NHS Property Service’s spaces to be hired on an hourly or daily basis has not only helped to make much more efficient use of the NHS estate over the last 12 months, but has also enabled health and well-being providers to offer much needed services at the heart of local communities.

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The work of the NHS Open Space scheme has been a highlight within a difficult year for the health service. Michael Lyons, editor

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Contents Health Business 21.2 07 News

34 Fleet management

4.7 million waiting for operations; 80 long Covid clinics to open; and report finds that maternity care improvements are held back by poor buildings

The NHS has adopted a multiyear plan to become the world’s first carbon net zero national health system, with interventions in greening the NHS fleet. We look at how that change is happening across NHS trusts up and down the country

13 Covid-19 update 13 21

A survey from the Royal College of Physicians has shown that the majority of doctors say it will take at least 18 months to get the NHS back on an even keel

17 Finance The NHS in England has been allocated extra funding of £6.6 billion for additional costs brought about by coronavirus in the first six months of the new financial year, but it may not be enough

21 NHS property


Christopher King, from NHS Property Services, explores the successes of the expanded NHS Open Space scheme, as well as hopes for the future

25 Hospital buildings Commitment to invest in our hospitals is hugely welcome, and a strong and robust programme is required to ensure the delivery of the planned 40 new hospitals this decade, writes Thomas Carnegie, Katja Lacey and Christian Norris


Henry Rex, Associate Director for Government and Health at techUK, looks at February’s Ten Point Plan for Healthtech and why digital technology should be at the forefront of improving outcomes for patients

43 NHS innovations The NHS Long Term Plan laid out a number of pledges to improve patient care by using new and innovative measures and technologies to advance treatments. Here, we look at some recent treatment introductions

47 G-Cloud Managing a framework requires a very different set of management skills to a more traditional waterfall-based project, writes Romy Hughes

51 Digital transformation

Peter Brogan, head of Research and Insight at the IWFM, discusses some of the findings from
the IWFM Market Outlook Survey, which launched this week

As the government announces almost £600 million for its hospital discharge programme, Phil Davies, Procurement Director at NHS Shared Business Services, says NHS trusts can use it to access extra capacity via the Patient Discharge Services Framework

32 Recruitment

57 Medical equipment

Juliette Cosgrove, Chief Nurse & Head of Clinical Governance at NHS Professionals, argues in this article that a focus on flexible worker resilience is needed to support those who support the NHS

The Medical IT Departmental Software and Hardware Solutions framework gives trusts access to an expanded choice of the latest technology from more than 70 suppliers

29 Facillities management 43

37 Technology

Health Business magazine Issue 21.2 | HEALTH BUSINESS MAGAZINE


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4.7 million waiting for operations across England

Latest NHS England data shows that approximately 4.7 million people were waiting for routine operations and procedures in England in February, the highest figure since 2007. Figures indicate that nearly 388,000 people were waiting more than a year for non-urgent

surgery compared with just 1,600 before the pandemic began. NHS England said two million operations took place despite the winter peak of coronavirus admissions. Approximately 40 per cent of all patients who have received hospital treatment for coronavirus since the pandemic began were admitted in the first two months of the year. Professor Stephen Powis, national medical director for the NHS in England, said treating 400,000 patients with coronavirus over the course of the last year had ‘inevitably had an impact on the NHS’. But, he said ‘the hard work and dedication of



80 long Covid clinics to be opened by NHS

4.6m people missed out on hospital treatment last year

More than 80 new clinics to assess patients suffering with symptoms of long Covid are to be opened by the NHS by the end of this month. Speaking at the Health Service Journal’s leadership congress, NHS England chief executive Simon Stevens said that ‘we will have 83 long Covid clinics in place by the end of this month’, marking. Significant expansion on the ’69 clinics identified last year’. Stevens also revealed that the new clinics will be backed by at least £24 million revenue funding going into this New Year, up from the £10 million announced last year. The Office for National Statistics estimates that more than a million people could be experiencing long Covid beyond four weeks with 674,000 people saying it was affecting their day to day lives. Almost 200,000 people have said their ability to carry out normal activities has been severely limited by the condition. Stevens also told the Congress that it was very important that the health service ‘max out the treatment capacity we have’ and to expand elective activity again to make sure that ‘long waits do not become a permanent part of the NHS’.

staff’ helped to deliver almost two million operations and procedures ‘in the face of the winter wave’. NHS England recently announced that a £1 billion fund would be used to help trusts restore operations and other services to get as many people treated as possible. Surgeons are calling for massive investment in the health service so that vital operations can continue no matter what comes its way in the future. READ MORE

More than 4.5 million people missed out on hospital treatment in England last year due to the disruption to the NHS caused by coronavirus. Health Foundation analysis reveals that the number of patients having planned surgery, such as a joint replacement, dropped from 16.62 million in 2019 to just under 12 million last year – a drop of 4.64 million people. The fall is mainly being attributed to hospitals suspending many of their normal services as they focused on the influx of people severely ill with coronavirus, which resulted in operating theatres being turned into makeshift intensive care units and surgical staff being repurposed to fight the pandemic.

Alongside this, GPs referred six million fewer people to have diagnostic tests and treatment in hospital as a result of the disruption to care, patients’ reluctance go to hospital in case they caught coronavirus and a desire not to add to the pressure on the overstretched NHS. The Health Foundation estimates that this has created millions of ‘missing patients’ who could send the overall NHS waiting list soaring from its already record high 4.6 million people to 9.7 million by 2024 if three-quarters of those people belatedly seek treatment now that the pandemic is easing.

New milestone in NHS vaccination programme reached

So far, more than 27 million people in England have now received their first jab, with more than 6.1 million second jabs also being given. Moderna can be stored for 30 days at normal fridge temperatures, but should it need to be stored for longer it can last for six months at -20C. Along with Pfizer, it will be used by the NHS for some of the appointments rearranged for under 30s who were due to receive the AstraZeneca jab.




NHS England has announced that the first Moderna jabs will be delivered

in England as the NHS vaccination programme reaches another milestone. For those aged 18-29 who are eligible for a jab, the Moderna vaccine provides another alternative to the AstraZeneca vaccine, in line with recently updated MHRA guidance. More than 20 sites, including Reading’s Madejski Stadium and the Sheffield Arena, will initially use the newest vaccine, as the NHS continues to expand the vaccination programme.





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Joint letter on the health and social care workforce

The Nuffield Trust, Health Foundation and King’s Fund have jointly suggested that the

NHS Bill put in place independent projections of how many health and social care staff will be in place in the future. Nigel Edwards, Richard Murray and Anita Charlesworth, the leaders of the three organisations, have written to Health Secretary Matt Hancock and Jeremy Hunt, chair of the Health Select Committee, arguing that long term action is needed to avoid the workforce shortages that bedevilled the pandemic response happening again. They stress that the upcoming NHS Bill could help support this by setting up a system of annual, independent projections of how many

health and social care staff are needed, and how many will actually come forwards. The Nuffield Trust, Health Foundation and King’s Fund say that the Health Secretary should hold responsibility for the publication of annual independently verified projections of the future supply of social care workforce in England, compared with the projected demand in England over a 15-year period, consistent with long-term OBR projections on adult social care spending. READ MORE


Consultation launched on consistent uniform for NHS staff NHS Supply Chain has launched a seven week consultation about the potential introduction of a standardised national healthcare uniform for NHS staff working in clinical roles in England. The organisation is keen to hear the views of healthcare assistants, nurses, midwives and allied health professionals working in hospital and non-hospital settings across the country on whether a culturally sensitive, national approach to uniforms should be taken – and if so, should all NHS trusts adopt it. NHS Supply Chain’s specialist hotel services buying function currently offers a uniform contract which provides a compliant framework from which NHS trusts specify the design, style and colours. This has led to significant variation of uniform between different NHS trusts, with many styles, colours, embroidery and rank identifiers which could potentially be

reduced to one shared style for all staff groups differentiated by 15 to 20 colours. According to the NHS body, benefits could include: improved patient safety, supporting recommendations made in the 2013 Francis Inquiry; greater recognition of staff by patients and the public; improved view of professionalism in appearance by staff; development of a high performing, ethical and sustainable supply chain, with a single NHS brand across the patient care pathway, providing consistency across the whole of the NHS in England; and offers the ability to plan for and react to increased uniform demand such as those experienced during the coronavirus pandemic. An independent survey of patients commissioned by NHS Supply Chain across eight NHS trusts found that 88 per cent of

patients think that the same uniform should be worn nationally, 79 per cent of patients think that a strongly defined uniform helps them to identify key workers, and 55 per cent of patients were unable to easily identify senior members of staff via their uniform. READ MORE


Thousands of healthcare support workers join the NHS

The NHS has boosted support for patients, their families and staff by recruiting 10,000 healthcare support workers (HCSWs) in the first three months of the year.

Deemed the result of the ‘Nightingale effect’, the new staff will support the workforce and assist nurses, midwives and other healthcare professionals to perform

health checks, update patient records, help patients wash, dress and move around, and care for women and families in maternity services. They will also support people with mental health conditions, learning disabilities, and autism. Data shows of the 10,000 new staff, half are completely new to health and social care – clear evidence of the ‘Nightingale effect’ caused by the coronavirus pandemic. They will be joined by a further 5,000 HCSWs who will start work following successful pre-employment checks. There are around 150,000 HCSWs in the health service, and in a drive to reduce vacancies and bolster the workforce, the NHS invested £45 million in recruiting more. A total of 10,611 have begun careers with NHS providers since 1 January. READ MORE




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Maternity care improvements held back by poor buildings

A coalition of health organisations have called for upgrades to England’s NHS maternity service buildings to improve care for women and conditions for staff.

The One Voice coalition of health organisations and the Society of Radiographers stressed that women’s maternity care was significantly impacted during the ongoing coronavirus pandemic, made worse by old, poorly designed buildings. Many women were unable to have their partners with them because the layout of maternity facilities prevented social distancing, and would have put women, their partners and other service users at risk of catching the virus. The coalition is calling for better design and use of space, such as having single rooms and dedicated areas for maternity clinics and scans. A survey by Sands for Baby Loss Awareness Week last year found that among the reasons

why partners were not asked to attend routine appointments and scans was the difficulty of social distancing in scan rooms. One Voice is urging for a wholesale review of NHS estates, particularly maternity services, and upgrading those that fall short of the standard needed. They also say better planning of maternity facilities in new hospitals is needed, such as ensuring sufficient space and dedicated clinical areas and rooms – including bereavement rooms – are incorporated into the design. READ MORE



Children at centre of country’s mental health crisis

Overseas health workers to get free UK visa extension

New analysis by the Royal College of Psychiatrists has found that children and young people are bearing the brunt of the mental health crisis caused by the pandemic. A year on from the first lockdown and after warnings from the mental health sector about the impact of the pandemic on the country’s mental health, analysis of NHS Digital data shows that, while the crisis is affecting people of all ages, it is under-18s who are suffering most. The Royal College of Psychiatrists says that 80,226 more children and young people were referred to CYP mental health services between April and December last year, up by 28 per cent on 2019, to 372,438. Additionally, 600,628 more treatment sessions were given to children and young people, up by a fifth on 2019 to 3.58 million.

The analysis also revealed that 18,269 children and young people needed urgent or emergency crisis care - including assessments to see if someone needs to be sectioned because they or others are at harm - an increase of 18 per cent on 2019, to 18,269. The Royal College of Psychiatrists is calling for the additional £500 million in the government’s mental health recovery plan to urgently reach the frontline so that people can get the support they need. This funding is on top of the existing planned investment in mental health services set out in the NHS Long Term Plan. READ MORE


Managing referrals made easier through NHS App

NHS Digital has announced that the NHS e-Referral Service has been integrated into the NHS App to make managing referrals easier.

The move means that patients can now manage their e-RS referrals through the NHS App more safely and easily, reducing non-attendance of appointments and saving GPs’ time. Equally, GPs are now able to email appointment booking details for the NHS e-Referral Service (e-RS) directly to patients with an NHS login. This functionality, live since October 2020, has demonstrable benefits. Research has shown that when patients book their own appointments, the ‘did not attend’ rate can reduce by up to half, so patients are treated quickly while practices don’t need to refer patients again. READ MORE

The Home Office has said that frontline health workers from overseas will be given a free one-year UK visa extension. Covering doctors, nurses, paramedics and midwives, there are an estimated 14,000 people expected to benefit. The move applies to eligible workers whose visas are due to run out before 1 October 2021, as well as their dependants. The Home Office first granted free automatic visa extensions to health workers in March 2020 as the coronavirus pandemic hit the UK. More than 10,000 had received the extension last year. The offer was initially limited to NHS doctors, nurses and paramedics whose visas ran out between 31 March 2020 and 1 October 2020, but it was later extended to include more professions. A health and care worker visa normally costs £232 per person for up to three years or £464 per person for three to five years. It must be extended after five years, or if the worker changes jobs. The visa is £55 cheaper if the applicant is from one of the eligible European countries. READ MORE



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Covid-19 update

Society reopens, but years to recover for hospitals A survey from the Royal College of Physicians has shown that the majority of doctors say it will take at least 18 months to get the NHS back on an even keel It is an odd time to assess the coronavirus The number of first doses administered each impact on hospitals. On the one hand the day is now averaging around 90,000 - a drop government has begun easing lockdown from an average of about 500,000 in midmeasures and the vaccination programme, March - as the schedule of second doses kicks although slowed, continues to impress. Inside in. It is believed that an average of more than of the NHS, however, there are doubts about 345,000 second doses are now being given how quickly the NHS can bounce back. a day. Shops are now open, hairdressers and other personal care businesses have begun Moderna vaccine operating again and indoor gyms and sports The plan for full vaccination by the end of July facilities are up and running. On top has been complimented by the of this, more than 32 million rollout of a third approved people in the UK have vaccine, made by Moderna, received at least one dose which has joined The pla n of a coronavirus vaccine, the vaccines being f o f r u ll vaccin before vaccine supply distributed in the UK. the end ation by issues stalled the Those aged under 30 been co of July has rollout somewhat. are to be offered the mplime Nonetheless, Moderna or Pfizert n h ted by e rollou first coronavirus BioNTech jabs as an approv t of a third vaccinations are now alternative to the being offered to those made bed vaccine, y Mode aged over 45 as part of rna plans for the government to meet its target of vaccinating the whole country by the end of July. People will be vaccinated in age order until all those over 20 have had a first dose.

Oxford-AstraZeneca vaccine due to evidence linking it to rare blood clots. However, the UK’s medicine regulator - the MHRA - says the benefits of the vaccine still outweigh the risks for the vast majority of people. More than 20 sites, including Reading’s Madejski Stadium and the Sheffield Arena, will initially use the newest vaccine, as the NHS continues to expand the vaccination programme. As of mid-April, a large-scale UK trial looking at whether coronavirus vaccines can be mixed with different types of jabs used for first and second doses is being expanded. It has been argued that combining vaccines might give broader, longer-lasting immunity against the virus and new variants of it, and offer more flexibility to vaccine rollout. It means that adults over 50 who have had a first dose of Pfizer or AstraZeneca can apply to take part in the Com-Cov study. Their second dose could be the same again, or a shot of Moderna or Novavax. E



Reducing the risk of Covid with dedicated staff pooling

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start of the pandemic, the case for staff pooling has inevitably become stronger as organisations work hard to reduce the risk of infections and outbreaks of Covid. This aside, staff pooling also presents several other benefits. Hospitals and care homes can meet long-term demands with regularity of staff as well as avoid the time, expense and hassle of repeat recruitment exercises.

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Covid-19 update

 More than 800 people are already taking part in the research and have received two doses of either Pfizer, AstraZeneca or a mix. The doctor’s viewpoint The Royal College of Physicians’ 10th survey of members found that 59 per cent believe it will take at least a year and a half to get the NHS back on an even keel, although 30 per cent say the huge backlogs in care resulting from the pandemic will take more than two years to clear. Delays in care are particularly acute within certain specialist areas of medicine such as gastroenterology, in which 75 per cent of doctors think backlogs will take over a year to clear, including almost half who think it will take over 18 months. Other specialties where physicians expect it to take over a year to return to ‘normal’ include dermatology (82 per cent), rehabilitation medicine (67 per cent), respiratory (59 per cent), oncology (58 per cent) and cardiology (52 per cent). Backlogs are exacerbated by continuing delays for diagnostic testing. Clinical physiology is the worst affected, with 87 per cent of respondents to the survey experiencing delays for outpatient tests and 73 per cent for inpatients. Access to endoscopy testing is also difficult – delays in outpatient tests were reported by 82 per cent of doctors while the figure was 64 per cent for inpatients. The Royal College of Physicians also reports on staff well-being, with the latest survey finding that 69 per cent feel exhausted and 31 per cent are demoralised. Only 57 per cent of doctors say they are getting enough sleep, while two thirds said there had still been no discussion in their organisation about time off to recuperate.

“The problem is workforce. Vacancies were high going into the pandemic – we simply don’t have enough doctors to meet demand which is why we need to expand the workforce.” When asked what impact the pandemic had on teamwork, a third thought it had a negative impact during the first wave. Two fifths thought it then worsened during the second wave. Andrew Goddard, president of the Royal College of Physicians, said: “Doctors are rightly concerned about the length of time it will take to deal with the enormous backlog of non-Covid care that has built up over the pandemic. We know our patients are waiting for treatment, and in many cases have been waiting for some time already. “The problem is workforce. Vacancies were high going into the pandemic – we simply don’t have enough doctors to meet demand which is why we need to expand the workforce. We need to double the number of medical school places and establish transparent processes to ensure we are training enough people now to meet future demand.” Waiting times Latest NHS England data shows that approximately 4.7 million people were waiting for routine operations and procedures in England in February, the highest figure since 2007. Figures indicate that nearly 388,000 people were waiting more than a year for

non-urgent surgery compared with just 1,600 before the pandemic began. NHS England said two million operations took place despite the winter peak of coronavirus admissions. Approximately 40 per cent of all patients who have received hospital treatment for coronavirus since the pandemic began were admitted in the first two months of the year. The statistics are a timely reminder that, despite falling coronavirus infection rates and the progress of the vaccination campaign, the health service remains in an incredibly precarious state. Dr David Wrigley, BMA council deputy chair, said: “With other recent data suggesting a small rise in hospital admissions for Covid-19 in recent days, now is a critical time for the health service. As restrictions begin to ease, it is crucial that everyone does their part in preventing the spread of what is still an incredibly dangerous virus, and continues to practise physical distancing, wearing masks when required and following public health guidance. The NHS, its staff and patients – already stretched to the limit - cannot afford to be overwhelmed by a new surge in infections.” FURTHER INFORMATION




Covid funding welcome, but may not be enough The NHS in England has been allocated extra funding of £6.6 billion for additional costs brought about by coronavirus in the first six months of the new financial year, but it may not be enough This is according to NHS Providers, who argue that £6.6 billion for extra NHS Covid costs in the first half of 2021/22 is lower than the £8 billion that the NHS’s Covid cost run rate during the past year would imply. In a statement to the House of Commons last month, Health Secretary Matt Hancock said that the government was continuing to ‘back the NHS at every point in this pandemic’, assuring the Commons Health and Social Care Committee that direct operational costs incurred in response to the pandemic would be met by the government. However, NHS Providers had warned that without confirmation of budgets, the service would be forced to plan cuts of £7 billion - £8 billion over the first six months of 2021/22. While trusts will be relieved that the budget for the first half of the year has been finalised, NHS Providers’ chief executive Chris Hopson said that the funding is less than expected and that his organisation will be seeking reassurances as we get towards the second half of 2021/22 that the NHS gets the money it needs to recover services. The £6.6 billion is in addition to the £3 billion committed at the Spending Review last November to help the NHS meet the additional

costs of coronavirus, while critically starting the work on the elective recovery ahead. The Spending Review split the aforementioned £3 billion into £1 billion to begin tackling the backlog of planned care, £500m to improve access to mental health services and £1.5 billion to ease existing financial pressures. Hopson insisted that additional coronavirus costs and the cost of the elective recovery should not be conflated.

government to explain to the public what can and can’t be achieved within the resources that are available.

Discharge funding As well as the £6.6 billion, the government is also putting £594 million towards safe hospital discharge and is extending enhanced discharge arrangements for mental health patients, getting patients safely from hospital into healthy community settings, providing better care and freeing up thousands of beds. Longer term consequences Andrew Ridley, chair of the Community Danny Mortimer, chief executive of the Network, which is hosted by the NHS NHS Confederation, which represents Confederation and NHS Providers, said: organisations across the healthcare sector, “We welcome the announcement of £594m also said that health leaders would broadly funding for discharge to assess and welcome the ‘pragmatic, if overdue’ the certainty it provides for funding announcement. But the first half of 2021/22. he also stressed the need The £6. Throughout the pandemic, for the government to 6 billion is both the additional address the longer in addition funding and the new term consequences ways in which patients of the pandemic on billion c to the £3 o m have been discharged the health of the m it t ted at he Spen safely from hospital population and the last Nov ding Review into the community demands on the ember have been hugely NHS. Part of this, he t o help the NH helpful. E said, would be for the S me

et t addition al costs he of coronav irus



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How to prove compliance standards are being met As we come to the end of this financial year, we’ve seen several strategies and white papers released outlining the themes health organisations will be focusing on in the coming years. As expected, the themes surround sustainability and health and safety, but one other recurring theme is compliance As the world moves into a new way of working, organisations in every sector are rethinking how they can create and maintain a safe, hygienic workplace. Whilst for most organisations this won’t mean the extensive levels of deep cleaning being employed by our wonderful NHS and care sectors, it does raise the issue of whether health and safety standards for the cleaning sector need to go beyond using the appropriate cleaning materials and chemicals. Can your organisation prove they’re meeting regulatory, industrial or in-house cleaning standards? Can your organisation provide evidence that the workplace meets those compliance standards? Cleaning audit software One way to prove compliance is by using cleaning audit software, such as Asckey’s fmfirst® Cleaning. The software allows you to create, manage and report on cleaning audits more easily than using paper-based checklists. It allows you to set up different functional areas that represent different usages and degrees of risk. These areas 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.


Within the NHS all functional areas must be assessed and assigned to a risk category. The level of cleaning frequency, monitoring, audit frequency and audit target scores are all directly linked to the identified risk factor. Once the functional 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 can streamline this entire process and provide reports where users can identify trends in the data. Speaking of using the software, the Performance Manager at University Hospitals Bristol and Weston NHS Foundation Trust, says: “The improvement from paper auditing to electronic includes better reporting and consistent auditing.” Making cleaning audits digital Cleaning audit software isn’t just for the NHS, other healthcare environments can benefit from what the software has to offer. However, it can be too complex for some workplaces and this is where survey software can step up. It’s about digitally collecting data that prove compliance standards are being met, as well as identifying trends or areas of improvement. Consistency, compliance and quality are what Asckey strive for in the development of our software solutions. To support other working environments/industries where


cleaning audit software may be too in-depth, there is fmfirst® Survey. This is a more tailored auditing/survey software that can be used for the quick and accurate collection of data that enables users to prove compliance and identify possible risk areas. The software can replace paper-based cleaning audit forms and checklists, providing a digital record and audit trail of what has been completed. With Asckey’s survey software, we can develop templates that match existing paper forms to allow for a smooth transition and ease-of-use for staff. The software also comes with the option of developing your own templates which can include complex conditional question sets. By making your audits digital, time and resources can be allocated elsewhere. You also have a digital record and audit trail of the surveys/audits taken, making it easier to identify when annual reviews are needed. These records also provide evidence that compliance standards are being met. Going digital supports sustainability goals by moving away from paper-based evidence or filling in spreadsheets, and it also saves you some filing cabinet space! L FURTHER INFORMATION Tel: 01480 469001 |

Salaries and pay cuts Although always a contentious issue, the problem of pay rises for health and care staff has taken on added importance over the last 12 months, and many feel that the government’s offer of a one per cent pay rise is not reflective of the appreciation that should be shown to the NHS. More than 60 per cent of the public believes the country’s doctors should get a pay rise in recognition of the risks they have faced during the coronavirus pandemic, with nearly three-quarters believing such a rise should be three per cent or more. NHS England’s chief executive told the Commons Health Select Committee last month that staff deserve a 2.1 per cent pay rise next year, rather than the proposed one per cent. His input followed research by the House of Commons Library showing that nurses, physiotherapists, occupational therapists and other clinicians are set to be hundreds of pounds worse off in real terms every month if the government’s recommendations of a one per cent pay increase are implemented. The figures, highlighted by the Labour Party, show that, under the proposed pay increase,

The government is also putting £594 million towards safe hospital discharge and is extending enhanced discharge arrangements for mental health patients, getting patients safely from hospital into healthy community settings, providing better care and freeing up thousands of beds the basic starting salary of a Band 5 nurse is £174 a year less in real terms. For a band 6 nurse with five years experience in the role, the one per cent pay rise equates to a cut of £236 a year in real terms. Labour also suggests that, under the proposed increase: basic salary of a highly specialist occupational therapist, physio or health visitor, with seven years experience, will be £312 less in real terms; for doctors, a new NHS consultant will be £572 worse off every year once inflation is taken into account; and for the most experienced consultants with over a decade of experience, the real terms impact of this pay increase will be over £680 a month less. This was complemented by research conducted by London Economics, who analysed the Agenda for Change (AfC) framework and ound that, when adjusted for inflation, salaries in all NHS pay grades have fallen in real terms. In one pay grade, this meant a pay cut of 32 per cent. The analysis stresses that, while nursing staff have seen their salary increase in cash terms, in reality this buys them far less than it did 10 years ago. Part of the reason for the dismay is that better pay rises have been offered elsewhere. For example, the Scottish Government has offered


 “Discharge to assess has been a vital policy during the Covid-19 crisis, and has helped local health and care services to increase the numbers of people being discharged, as well reducing delays and, crucially, the length of stay in hospital. The move to continue this funding for the first six months of the next financial year also reflects the direction of travel in the recent NHS white paper, which set out proposals to include these policies in primary legislation “Leaders across both health and social care now want to be able to embed these changes permanently and see recurrent funding included in the next spending review so they can continue to provide these new services going forward.”

a substantial pay rise for NHS Scotland Agenda for Change staff, representing a four per cent pay rise compared to 2020/21 for staff on the pay bands 1 to 7. If accepted by staff, this deal will be most generous NHS pay uplift anywhere in the UK, and would represent the biggest single year increase in pay for NHS staff since devolution. The pay rises will benefit 154,000 NHS Agenda for Change employees - including nurses, paramedics, allied health professionals, as well as domestic, healthcare support staff, porters and other front line health workers. The proposal would mean that staff who earned less than £25,000 in 2020/21 getting a guaranteed minimum increase of over £1,000 in 2021/22. This means that staff on the lowest Agenda for Change pay point would get a 5.4 per cent increase. Those on the highest pay points will receive uplifts of £800. Furthermore, while pay increases are usually effective from 1 April, the 2021/22 pay settlement is set to be backdated to 1 December 2020 in recognition of an exceptional year of significant pressure for staff. L FURTHER INFORMATION



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Inivos launches Health Spaces The leading infection prevention and control company has launched Health Spaces,  a specialist provider for construction and development of healthcare projects and cycle time planning for room cleaning and infection control. All of these elements alongside the actual practical design need to be in place to provide a best-in-class solution that results in excellent patient experience and safety, ultimately releasing time to care, reducing the number of Hospital Acquired Infections and lowering the cost of care.

The ongoing pandemic has illustrated the need for better planning around healthcare infrastructure, making buildings and sites easier to navigate and implement vital cleaning protocols, alongside rapid deployment of specialised spaces to meet urgent demand. Health Spaces has been developed to offer clinical accommodation and treatment spaces which meet the exacting requirements of infection control and patient/staff flow. Health Spaces understands that today’s solutions need to include planning for patient flow, staff safe routes, care pathways

The benefits of Health Spaces Inivos has been at the forefront of infection control measures for over 10 years and today works with over 40 per cent of all hospital trusts in the UK. With a long history working in almost every clinical setting, Inivos have seen some of the best and equally some of the most challenging accommodation designs. Their experience and seeing first-hand what the actual clinical users require, underpins the Health Spaces unique approach to every project. Utilising Inivos’ experience in infection prevention and control, Health Spaces considers all project builds from a true everyday-use perspective, walking in the shoes of doctors and nurses, those who will use the facility, and using their processes to influence the development in ensuring the finished build delivers a practical space that suits all requirements. Health Spaces has heard feedback from doctors and nurses on what would make their everyday jobs easier by improving the nurse-to-patient ratio. They consider this and use design elements and materials that will enable this, enhancing planned care and patient safety. Health Spaces innovatively combines some of the best minds across three

industries – healthcare, architecture and interior design – to result in fully-designed, truly patient-ready spaces. The cliniciandriven, peer-reviewed designs stemming from Health Spaces consider every specialist element of building, installation and occupancy, right from construction specifications and requirements, long-lasting hygiene needs and infection control, to the external and internal aesthetics. The custom-built and modular buildings deployed by Health Spaces can positively impact on patient wait times and waiting lists by improving patient turnover and increasing patient capacity, enabling the hospital to work in a more efficient way. It will also bring together a clinical review panel of senior healthcare professionals that will share best practice, and review and offer guidance on innovative products and processes to enhance patient safety and their healthcare experience. The Health Spaces offering includes pre-designed and custom-built Patient Equipment Cleaning Centre (PECCs) which can be integrated into existing buildings or built modularly within the facility grounds. These PECCs can deliver increased bed space, enhanced standards of cleanliness, improved patient experience and more nursing time released to care. The Health on the High Street initiative aims to engage with landlords and trusts to encourage conversations around utilising empty high street stores for outpatient services. This scheme will see life breathed back onto the dying high streets, using buildings that may otherwise remain empty while taking advantage of the pre-existing infrastructure needed for patients to reach appointments. Why use Health Spaces The Health Spaces team will get into the detail of what your facility requires by building relationships with both stakeholders and those who will use the facilities daily. Health Spaces knows the patient journey and the operational pressures that healthcare staff are facing. They factor in this knowledge when designing your facility to efficiently aid and improve hospital performance. With a dedicated team they offer a fast turnaround on your build that results in an improved patient experience, a lower risk of infection, improved patient flow and throughput, reduced patient waiting times, and ultimately a reduced cost of patient care. L FURTHER INFORMATION Tel: 0845 270 6690



NHS property

The pay-as-you-go rental service for NHS spaces Christopher King, Principal Strategic Asset Manager at NHS Property Services, explores the NHS Open Space scheme’s successes and hopes for the future NHS Open Space was launched by NHS only does this make better use of the NHS Property Services (NHSPS) in April 2019 estate and mean communities can access following a two-year pilot to make the most more services from one local hub, but all of unused space across the NHS. We profits are also reinvested directly saw that some of our spaces back into the NHS. This has were not consistently been particularly important If space occupied and wanted to in the past year when is ensure that services funding has never not bei n g were able to use the been so essential for u s to full c ed space as efficiently the health service. a p a e city by xisting as possible to The idea was N we sho HS occupie support the simple, but building optimisation of a new platform and readily uld make it m rs, availab o the NHS estate. supporting existing r e le for o NHS bo Our solution was users through the t h simple… if space transition would health dies and wide er and r is not being used take some time. services wellbeing to full capacity by We gathered the to rent existing NHS occupiers, details of our first 20 we should make it more facilities and created readily available for other an online booking system, NHS bodies and wider health working closely with existing and wellbeing services to rent. Not users throughout a two-year pilot

to create something user-focused and intuitive. The platform allows customers to view detailed information about sites and rooms, check availability, and then book, pay, and manage their reservations. The spaces available range from clinical space and activity rooms, to meeting rooms and offices. The spaces can be hired on an hourly, sessional or daily basis, providing flexibility and choice for users, and once on site they can be sure of clean, safe and ready-to-go rooms every time, with trained staff available to help. The online booking platform gives NHSPS, services and NHS commissioners clearer data on how our spaces are being used, which helps us to proactively manage the NHS estate and make more efficient use of it. What’s great is that you don’t need to be a healthcare professional to use the spaces on offer. Anyone from a local business, personal trainer or physiotherapist can rent out spaces that they would find useful. E Issue 21.2 | HEALTH BUSINESS MAGAZINE


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NHS property

 Spaces as a lifeline As we all know, the past year has been exceptionally hard on most industries. Many of us have been working from home and restricted to remaining within our local area due to government guidelines. We also knew that many healthcare providers and businesses were looking for alternative property options in the wake of the pandemic. The flexibility of allowing our spaces to be hired on an hourly or daily basis has not only helped to make much more efficient use of the estate but has also enabled health and well-being providers to offer much needed services at the heart of local communities. These spaces have been a lifeline for some of our customers over the past year. Throughout the pandemic, we are delighted to have been able to remain open, allowing providers to safely continue offering support to patients. We have also supported the NHS in providing free spaces for Covid-19 services, including supporting the vaccination programme. We’ve seen almost 3,000 bookings relating to Covid-19 services come through our systems since December 2020. After seeing huge success over the past two years, it is amazing to see how our scheme has developed, and I feel privileged to have been a part of this journey. What started with 20 sites in 2019 now has over 700 clinical and nonclinical rooms in 100 facilities nationwide. So far, over 1,800 users have made more than 141,000 bookings, accounting for more than 745,000 hours of patient service delivery. Our on-site teams are also proud to be a part of this scheme. Norma Lawrence, Receptionist at Birmingham

The flexibility of allowing our spaces to be hired on an hourly or daily basis has not only helped to make much more efficient use of the estate but has also enabled health and well-being providers to offer much needed services at the heart of local communities Soho Surgery, has worked for the NHS for 15 years. She was one of the early adopters of our programme, supporting customers to book rooms in this new way. She said: “Before NHS Open Space came along, I used to use Outlook calendar for booking rooms. There are a lot of customers who book the space months, even years in advance. Since we’ve offered NHS Open Space, I have noticed we get bookings from new customers too, allowing our surgery to provide more services to the local community. We have services using the spaces including flu jab, well-baby clinics, family planning, speech therapy, nutrition, district nurse, diabetic clinic, ultrasounds, phlebotomy and many more. I take great pride in my workplace and the amount of space we have available to nurses and doctors means they can effectively do their jobs and help the wider community.” Staff like Norma are the reason our scheme has progressed so positively. Not only can our customers rent our spaces out exactly when they need it, knowing they are helping to support the NHS, they can also count on us to ensure that sites are

cleaned and maintained to the highest of safety standards. As an NHS body, safety and cleanliness is of absolute priority to us. Customers can trust our teams to keep their employees and customers safe during these challenging times and always. We are excited to continue expanding our scheme to include more sites across the nation. We are constantly exploring how we can improve our system and increase the number of sites available to customers. As the nation begins to get back to some sense of normality, we know that many healthcare providers and businesses will be looking for new working spaces that they can trust, and we want to help support as many of these providers as possible. If we all work together, we can get back on our feet, in trusted spaces, all while supporting the NHS. To find out more about the scheme, or to book a space near you, head to: L FURTHER INFORMATION



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Hospital buildings

There is a significant need for new hospitals Commitment to invest in our hospitals is hugely welcome, and a strong and robust programme is required to ensure the delivery of the planned 40 new hospitals this decade, writes Thomas Carnegie, Katja Lacey and Christian Norris The need for new hospitals within the NHS The NHS Covid-19 response has emphasised is widely accepted by both the public and the need for a modern estate. During the government. Many of our hospitals were not pandemic, hospitals have needed to deliver designed to last as long as they have. Given care differently – increasing critical care the number of hospital trusts in England capacity, adapting their estate to place (c.223), and their typical useful lives of c.60 greater emphasis on infection control, and years, you would need to re-build around enabling a hot and cold split of hospital four hospitals per year. This has not happened services. Doing so has presented big for a long time. In 2018 (the most recent challenges for hospitals, with planned available year), capital investment in health operations cancelled, and hospitals struggling was around 20 per cent lower than it was in to adapt their estates. New hospitals will 2009, and in general, the UK spends less than need to make their estates fit for purpose, the EU average on capital within healthcare. flexible to patient needs and prevent the Addressing this deficit presents big electrical, ventilation and oxygen challenges opportunities to enhance health outcomes, that we have seen during the pandemic. meet growing demand The government has committed to effectively and significant investments in new hospitals. sustainably, deliver This commitment demonstrates its new models of care, support to transform the NHS The and address the estate. The Prime Minister’s New Ho aging estate that announcement in September s p ital Program is presenting 2019 of plans to build me mu now se growing risks 40 new hospitals in the s t to services next 10 years was very coherent out a clear a nd t ratio and patients. welcome to providers

nale fo compre r spendinhensive capita a l g progr amme at a na tional le vel

who have been patching up their estate for many years. However, the Autumn Spending Review offered funding to 2025 of £3.7 billion – likely to be only enough for four to eight new hospitals. This means the majority of the 40 hospitals identified will need to be delivered in the second half of the plan. This will require both significantly more capital, and an ambitious and robust programme to accelerate the build of new hospitals within the second half of the plan. We need to deliver an effective and ambitious programme to address the various estate requirements of the NHS and deliver on the Prime Minister’s plan to build 40 new hospitals in the next 10 years. Delivering on the current Spending Review commitment of £3.7 billion for new hospital infrastructure will be a significant achievement. However, delivering the further investment to build all 40 hospitals makes a coordinated and systematic approach to understanding the scale of the challenge, and how to address it, essential. The successful delivery of this commitment will rely on: E



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Hospital buildings

A dedicated programme, with long term funding, will ensure we continue to improve our health service, that the estate is not left behind, and that we have the future health infrastructure that we need  A strong central programme The New Hospital Programme (NHP) has been established to deliver this commitment. It must now set out a clear and coherent rationale for a comprehensive capital spending programme at a national level, and also set out the investment required to deliver this programme to underpin the next Spending Review commitment. The programme should consider what lessons can be learned from international builds, particularly looking at Europe, Australia and New Zealand, who have all successfully built many new hospitals in the past decade. The NHP must also provide clarity on the role of the providers, and the NHP team, to ensure there is effective learning across schemes that helps optimise value for money, while giving Trusts flexibility to address their main challenges in the most appropriate ways. Maximising the benefits of this investment Hospital investments will be competing with other areas of government investment, such as in transport and defence. It is therefore crucial to maximise the benefits of each of these schemes and demonstrate a strong return on investment, including the wider benefits to society and the UK. There are significant opportunities to improve health outcomes, prevent serious illness and disease, and treat patients more effectively and efficiently. PA analysis of a number of NHP schemes, for example, suggests typically a new hospital build could improve efficiency by between 6 and 11 per cent. Additionally, there will be benefits of the investment in infrastructure itself, with

the NHP having the potential to generate 14,000 – 17,000 new jobs, and support the government’s ‘levelling up’ agenda, with 36 of the new hospitals being outside of London and the South East. To measure and deliver these benefits effectively requires schemes to explore all the opportunities available to them through the use of new digital technologies, and partnerships with the life sciences sector and universities to explore new clinical models and achieve much greater sustainability from the NHS estate. The programme needs a clear framework for each of the schemes to identify and measure the benefits of their investments, providing consistency in approach and avoiding duplication across schemes. Accelerating the delivery of schemes To deliver the plan, all schemes will have to go faster than previous builds. A typical hospital build takes three to four years. To deliver the first wave of hospitals, this Spending Review will require them to be breaking ground in 2022. For the hospitals later in the plan, there will be a need to stagger build start dates from 2024 to 2027 to deliver all 40 hospitals by 2030. The programme must seek and explore opportunities to accelerate these timelines. Modern methods of construction is one opportunity to do so, as well as having the potential to drive down cost. Standardised designs will also support a more rapid build process. We’ve seen during this pandemic how quickly services can be transformed, and new facilities established. While this approach is not

always appropriate for hospitals, more modern approaches to building can be utilised to accelerate the programme. Alongside this, the planning, business case and approvals process, that currently takes two to three years, must also be accelerated where possible. Standard requirements and approaches for the business case will give schemes clarity and focus their energy on the decisions they need to make. A concrete pipeline The programme must set out a clear pipeline for the 10-year period and beyond. This will provide a structure for each Trust to work within, and incentives to accelerate planning and preparation for when the investment is available. Providing greater long-term certainty will help hospitals to plan for the future, avoid wasted investment, time and energy, and most crucially will improve outcomes for patients and deliver a more sustainable health service. It will also provide industry with greater clarity on what is required, and when, to enable the supply side to mobilise appropriately. Our analysis suggests we will see a peak in hospital infrastructure in around 2025-27 on the current profile, so it’s essential there is construction capacity to deliver this. There will always be new pressures on the NHS, and new clinical models and ways of working. However, these cannot delay investment into the estate. A dedicated programme, with long term funding, will ensure we continue to improve our health service, that the estate is not left behind, and that we have the future health infrastructure that we need. L

Article by Thomas Carnegie, economics expert, Katja Lacey, healthcare expert, and Christian Norris, Head Economist at PA Consulting. FURTHER INFORMATION industries/healthcare



Advertisement Feature The Report of the Independent Review of NHS Hospital Food (HFR) was published in October, asking every NHS Trust in England to look critically at their catering services. ISS supported the review and welcomed the recommendations. Lauren Bowen RD, Head of Patient Catering Services at ISS Healthcare represented the British Dietetic Association on the senior review panel and gives her insight into what hospital foodservices look like on a day-to-day basis and what ISS are doing to implement the HFR recommendations. Being part of the HFR was an opportunity to influence the direction of healthcare catering over the next few years and I was grateful to be able to share my operational knowledge and experience. Some of the recommendations will be easy to implement, others will take time. Some will cost money and I urge Trust’s to value nutrition and reflect that in their budgets.

that other people make such as myself and I am always mindful of this, putting the interests of patients first. ISS serves 45,000 patient meals a day, our ward host(ess) role has the potential to interact with a patient 28 times in one day, often more than the clinical team so we know how important each patient is and what their individual needs are. As a company, ISS focuses on the elements we can control such as driving improvements around food quality and innovation in service delivery. I lead a team of foodservice dietitians solely responsible for introducing safe policies and procedures that our catering teams then follow. We provide support, ensuring that our menus are safe and nutritious and are the link between our catering teams and our customers. We use electronic meal ordering as standard and are currently working on innovative ways to drive action in relation to environmental sustainability.

A complex business Providing food and beverages for people in hospital is complex and can be a difficult task. Nutritional safety is paramount and dietary needs are diverse. A significant number of patients (30%) are at risk of malnutrition. Patients will not eat food that is unappealing or unfamiliar to them especially when they are feeling unwell. They are left heavily dependent on the decisions

Collaborative working As a partner to the NHS, we support all our customers in a collaborative relationship, I am excited about the food review in that it puts hospital food services firmly back on the agenda. The value of food and drink is being more widely recognised for its importance as part of a patient’s nutritional care and the value it brings to making the NHS more efficient. |

Facilities management

A post-pandemic workplace opportunity Peter Brogan, head of Research and Insight at the IWFM, provides a preview to the findings of the IWFM Market Outlook Survey, ahead of the launch of the full findings in the coming weeks From the Covid-19 pandemic to the precarious from the insights we gained from the 2021 Brexit negotiations, 2020 was a year of Market Outlook Survey, which I will preview unprecedented challenges, converging for you here ahead of the launch of the full pressures and tremendous uncertainty. findings in the coming weeks. Now as we enter the second quarter of Like previous years, the 2021 Survey 2021, uncertainty has lost little of its vigour, sought the views of our members to although it has taken on different guises. help us build a comprehensive picture Brexit has been delivered, replete with pain of how the UK workplace and facilities points and the promise of more to come, such management market has performed over as potential skills shortages and forecasts of the last year; how it may perform over the weaker economic growth. Covid-19 remains, next 12 months; and the factors that are of course; the road to recovery and the form affecting it. that normality takes for the foreseeable future We used data from our unpublished once industry and society reopens remains 2020 Market Outlook Survey as a baseline shrouded in ifs and buts. against which to analyse our 2021 data; One thing we can be certain of, however, this provided us with a unique opportunity is that the impacts of the past to explore how the events of year will change how many last year impacted on the The live and work in 2021 and workplace and facilities 2021 Su beyond. It is therefore management market and key critical for our the sentiment amongst helps us rvey profession to learn our membership. buil

d a com picture prehensive workpla of how the UK managece and facilities has per ment market form the last ed over year

Engagement was excellent for both years, with the 2021 iteration attracting more respondents than ever before; however, it’s the quality of the responses that have provided the real value. In both surveys, the majority of responses came from senior and middle managers (85 per cent in 2020 and 83 per cent in 2021). This was the ideal outcome because people in these roles are arguably best placed to comment on the health of their organisations and the market more generally. Those in client-side roles, in both the public and private sectors, also made up the majority of respondents (60 per cent in 2020 and 63 per cent in 2021), whilst around a quarter came from individuals in FM service provider organisations. Again, this was an excellent outcome because it has garnered a broad range of perspectives from all corners of our profession. E



Advertisement Feature

A radio? Yes, but so much more! Are you aware that radios can provide solutions to aid health and safety, operational efficiencies and security? All whilst providing instant communication? button. Whilst mobile phones are designed for a one-to-one conversation. Imagine having to alert colleagues to a fire. Radios provide the simplicity to press a button and shout fire, reaching all other radio users at once. To contact the same amount of people via a mobile phone would mean calling each person individually - taking far longer and being much less effective.

Behind the scenes It’s easy to forget that it’s not just the people we meet; there are just as many people behind the scenes keeping the day-to-day operations ticking over. When attending a hospital appointment, a receptionist may greet you, then you speak with a doctor or nurse and be on your way. What you may not always spot is the Security guard on patrol, the cleaning person making their way down the corridor, the porter transporting a patient in the lift or the car park attendant weaving their way through the cars. For the hundreds of people coming in and out of the hospital doors, there are teams of people keeping those doors open. For doors to stay open whilst operating efficiently and effectively, teams will need to communicate. This communication needs to be quick, easy and effective, allowing routine jobs to take place, ad hoc projects to run smoothly, and importantly, people to be aware of emergencies as quickly as possible. So why radio when we have mobile phones? Radios are designed to speak from one person to-many by the simple push of a

Get the coverage you need A radio network can be engineered to provide the coverage that you need. Sites can connect and operate as if they are working from the same location, no matter the geographical distance. For many organisations, getting the required cellular coverage within their building(s) can be problematic, expensive and may still leave them with coverage blackspots. The evolving technology of radio As with all technologies, things evolve and move on, and radios are no exception. A radio’s primary function is to provide instant communication. But with the development of technology, key features relating to health and safety/duty of care, business efficiency and security now enhance the benefits of radio further. Features such as; lone worker; man down; emergency button; GPS tracking; text messaging; and instant communication. Connecting your radio to software applications Radio integration with software applications, such as Gen2™, provides an abundance of functionality, all from the radio you hold in your hand. From receiving information, alerts and alarms from your fire alarm panel, BMS, access control, disabled alarms, security alarms and job management application - it truly helps provide seamless and efficient communications. So, the device you thought you could just talk on has become an

integral tool for your teams and your entire operation. Receive fire alarm alerts to your radio – by using Gen2, you can connect your onsite fire alarm panel to your radio system and be alerted immediately when an alarm is activated. Building Management System (BMS) - Connect your BMS to Gen2 in the same way as a fire alarm alert. Receive text notifications of temperature changes, if a machine has stopped running, or if a door, or window, has been left open. Security alarms, lift alarms, disabled alarms, pool alarms - alarms, alarms, alarms - all delivered to your radio. Access control – open your gate or barrier remotely by using your radio. Perfect if your security personnel are on patrol - never miss a delivery or hold up a drop off again. Job management...? No problem! Send and receive jobs directly to a user’s radio. Manage the job from start to finish via the radio system - with alerts if tasks/jobs aren’t allocated or taking too long. Your radio is suddenly acting like a PDA... but you can talk, have the facility of an emergency button and access GPS tracking (plus much more) - all in one device. The integration with your on-site applications helps people deal with situations as they arise, quickly and effectively. Keeping key team members informed and aiding to manage issues before they escalate. Duty of care Radios provide a vital connection to colleagues when undertaking their duties. For many, team members working alone, remotely, have the added risk of experiencing potential confrontations. But with a radio, they can then raise an alarm and alert colleagues - providing the radio user peace of mind that help is on its way. Providing a solution that works for you Call Systems Technology (CST) has been providing radio communication solutions for over 20 years. The knowledge and experience built up over this time prove invaluable to customers, as they trust CST will provide a solution that works for them. CST prides itself on helping clients improve safety, productivity, and customer experience through effective communication solutions.L FURTHER INFORMATION Tel: 020 8381 1338



Facilities management

 Likewise, although respondents from larger organisations were more prevalent in both surveys, we also received responses from FM professionals working in small and mediumsized organisations, providing a further layer of rich diversity to our insights. But what have these insights told us? A great many things, but what I will focus on here is the evident and exciting opportunity for the workplace and facilities management profession to guide and enable organisations to do things differently, starting with the imminent future of work and its consequences. Workplace and facilities management’s opportunity There have been a number of challenges due to the huge changes that Covid-19 brought to how many of us live and work; however, these changes have also created a paradigm shift that we expect – and hope - will change people’s lives for the better, forever. If, as IWFM and many others argue, this manifests as hybrid working or a similarly agile model that allows work to be carried out in multiple settings, untethered from corporate office buildings, it will improve the quality of life for office workers and benefit organisations’ bottom lines. What is key now, as we look ahead to loosening social distancing restrictions and a return to a sense of normality - afforded, we hope, by the continuing successful roll-out of vaccines - is that we do not cling to old ways and instead embrace the opportunity to do better. ‘But work is changing too… The future proof workplace has to be designed for this new work; one which fosters skills for collaboration, interaction, learning, engaging – human work. The key is changing our profession’s mindset from one that sees technology as helping to do a job (managing the building) to redefining the job as one which helps everyone else do theirs (enabling communities). It is a shift that underpins our repositioning [from BIFM] to IWFM.’ Those words, written by IWFM Chairman Martin G Bell FIWFM, appear in our 2020 technology report ‘Bridging facilities management’s digital divide: the power of digital partnerships’, and they have proven to be highly pertinent. The promise of everaccelerating technological advancements and their transformative powers for industry and society have long been discussed and promoted, of course; however, when we were developing the report in partnership with Microsoft, we had not consulted our crystal balls to foresee that the tide of change was rushing in quite so rapidly for workplaces around the globe. But will the changes stay or recede? The beginning of lockdown in March 2020 saw millions of desk-based workers moved –successfully and swiftly - to remote working. Our YouGov-powered research into office workers’ experiences of and attitudes towards working from home during the pandemic showed that 70 per cent had not worked from home before, which is

What is key now, as we look ahead to loosening social distancing restrictions and a return to a sense of normality, is that we do not cling to old ways and instead embrace the opportunity to do better unsurprising given how old ways of thinking have tended towards presenteeism: placing staff in the same building where they can be seen and monitored. Given how alien working from home has been for most people, one might expect that most were dying to escape, but when we updated the research in March this year (having originally commissioned it in April and June last year), we found that the majority of UK office workers want to work from home more often in future. Before anyone cries ‘this is the death of the office’, most UK office workers are also looking forward to returning to offices, a figure which has grown considerably since June 2020 when only a third were eager to get back to their old desks – influenced, no doubt, by concerns over contracting Covid-19. The message is clear: the majority of UK office workers want agile working options where they spend some time at home and some time in the office. Organisations ignore this at their peril because, as the saying goes, a happy worker is a productive worker and other findings in our home-working research – also due to be released in early April – show that many enjoy a number of the benefits associated with working from home. Despite this, some politicians and prominent organisations have been using the media to urge people back to offices completely. However, vocal opponents aside, the 2021 Market Outlook Survey findings show that most organisations have already taken steps to prepare for a shift to a hybrid working model or at least fewer workers returning to offices full time. As a direct result of the pandemic, 84 per cent of

organisations changed their flexible working strategy and 58 per cent are reducing their occupied space. At the same time, 50 per cent of workplace and facilities management professionals say that the pandemic has improved their team’s position within their organisation, which should lead to a greater influence on decision-making and therefore better, less impulsive outcomes. Time to rethink As tech guru and best-selling author Dave Coplin said when he appeared on our IWFM ‘Navigating turbulent times’ webinar series last year: ‘We still work like we’re Victorians, it’s just we use twenty-first century technology to make it quicker and cheaper. That’s not the gift [of technology].’ The relevance here is that, in grasping this opportunity to do better, we must avoid rehashing old ideas and instead use the lessons of the past year to rethink how we do things altogether, with technology serving as the enabler. In 2016, the Stoddart Review revealed that an effective workplace can improve business productivity, but a workplace is not merely a corporate office: it is wherever work takes place. It is therefore crucial for organisations and the economy that, at a time when finances across the board are under enormous strain, they tap into the benefits of creating agile workforces who work in a variety of settings according to their, and their employer’s, needs. Failure to do so will harm the recovery and risk losing employees to more forward-thinking employers. L FURTHER INFORMATION



NHS workforce

Developing systemic resilience for our flexible workforce Juliette Cosgrove, Chief Nurse & Head of Clinical Governance at NHS Professionals, argues that a focus on flexible worker resilience is needed to support those who support the NHS Resilience as a concept has taken on a new importance and meaning since the beginning of the pandemic, as healthcare workers cope with a rapid rise in physical and emotional demands from the pressures of Covid-19. Change has been fast. As a leader of the UK’s Ventilator Challenge team put it: “We had to deliver 2.5 years’ work in six weeks.” Add to this the extra physical demands from continual wearing of PPE and the need to provide emotional care for patients and their families, especially when visiting and contact is restricted. Flexible working in itself comes with additional challenges, including working with a different team in often new surroundings and sometimes carrying out new or unfamiliar duties. It is vital we remember that no person is an island. While we might often talk of boosting individual resilience, it is potentially short-lived if the support is not focussed on the whole team, the healthcare setting and the larger community. To continue


the capabilities of resilient people. These include: the ability to manage feelings and behaviour in times of stress, rather than exaggerating problems; viewing any mistakes as learning opportunities, rather than becoming despondent or taking things to heart; and Building resilience being flexible and trying When it comes to the individual, Even th e different strategies. building resilience is important most re silient o In building and for mental health. Research i n dividua f reinforcing these carried out last year derailed ls can be capabilities, highlighted that nearly different tactics 60 per cent of frontline But heaby stress. work for different health and social care l t h c a re work sh people, but there workers met the criteria for are techniques either anxiety, depression never b ould ea that we can all or PTSD. Yet, while everyone survivin bout utilise to increase can respond differently to a g our capacity to cope situation and find things hard at with stress. These include: times, there is action we can take to ensuring you take a break increase our capacity to cope with stress. or time away from your duties; talking to In his book, Emotional Intelligence at a friend or colleague about a problem – Work, psychologist Dr Jo Maddocks outlines responding and adapting to both ongoing change and unexpected disruptions, a robust organisational and systemic resilience needs to be in place – one that can keep improving and supporting resilience.


The pandemic has emphasised the importance that, with stress affecting people in such different ways, healthcare organisations can deploy a range of tactics to support the resilience of flexible and substantive workers alike

Systemic resilience When we’re better prepared, and situations or processes are planned, then people feel more confident in their abilities at work, which in turn influences their resilience and wellbeing. It is clear there is a need to address the systemic sources of stress that contribute to workplace adversity to ensure that improving resilience is not the sole responsibility of the individual and is actively supported by the NHS. Organisational resilience isn’t just a challenge for the NHS. Research conducted by Cranfield School of Management reveals that only just under one third (29 per cent) of business leaders trust that their organisations have fully embedded resilience practices, even though 88 per cent think that resilience is a priority for their organisation, and indispensable for long-term growth (80 per cent). A research article within International Journal of Health Policy and Management describes organisational resilience as ‘an emergent property that develops in complex systems as a precursor and response to stressors and risks. Understanding system resilience is a central part of organisational development and design practice, and a key strategic activity

undertaken by leaders across the people profession’. The three key factors of system resilience that leaders might want to consider when developing organisational resilience include: leadership capability, organisational culture and human capital. Of course, effective leadership is key to ensuring all the factors listed above are in place. In order to support individual resilience, organisation and team leaders also need to be able to develop their own resilience and the way they support others. Initiatives like the NHS Leadership Academy has been specifically designed to develop senior leaders, and those looking to progress into a leadership role. This programme offers support and learning to build personal resilience, confidence and the leadership capabilities needed within the NHS. Another key factor at play is culture and the need to ensure every team member feels valued and supported. Having the basics in place is a critical element of this, and a relatively simple one to achieve for flexible and substantive workers alike. Proper inductions, a welcome to a new trust, and signposting of known sources for additional support, as well as a simple thank you for a job well done, are all important to support resilience.

NHS workforce

often, this can make all the difference; standing up for yourself, although sometimes a challenge, to build self-confidence; and expressing your opinions clearly and directly. Growing individual resilience is vital in our current times – but all the more critical is ensuring the whole system surrounding the individual supports this. Resilient individuals can take on additional stress only as long as tools, resources and strong team support exist for them to do the job.

Taking time to recognise a colleague’s achievement is another good way to boost morale and can improve team resilience. In addition, it is important that career development opportunities are clear and accessible – ensuring flexible workers, as well as their substantive colleagues can continue to learn new skills and progress their career. We’re working hard at NHS Professionals to develop career pathways for our Bank Members. For example, a project to develop the specialist nature of the flexible nurse role, and support for Healthcare Assistants to progress into nursing. As Chief Nurse at NHS Professionals, I work closely with NHS trusts, alongside the NHSP team. We look at ways to increase workforce capacity so that there are more people available at critical times. We assess how we can use the skills, experience and knowledge of Bank Members in the right places to further build resilience across the NHS, to attract more people to join us, and encourage those who have already stepped forward to stay. Workforce capacity Even the most resilient of individuals can be derailed by stress. But healthcare work should never be about surviving. Our approach to resilience needs to be focussed on helping healthcare professionals thrive in work, as well as in life as a whole. The pandemic has highlighted the importance of a workforce that is able to flex up and down with demand. It has also emphasised the importance that, with stress affecting people in such different ways, healthcare organisations can deploy a range of tactics to support the resilience of flexible and substantive workers alike. Not only during current challenges, but also for the future. We’re now in a position to assess the transformation that has already taken place as a result of the pandemic and make further improvements. What is vital is that we work together, on every level, to build a more resilient workforce for the future, for flexible workers, our Bank Members and all those who work across the NHS. L

For advice on managing stress and building resilience, visit the health and wellbeing section of the NHS Professionals website: www.nhsprofessionals. FURTHER INFORMATION



Fleet management

Driving greener on the road to Net Zero The NHS has adopted a multiyear plan to become the world’s first carbon net zero national health system, with interventions in greening the NHS fleet. We look at how that change is happening across NHS trusts up and down the country The world’s first carbon net zero national health system commitment comes amid growing evidence of the health impacts of climate change and air pollution, and aims to save thousands of lives and hospitalisations across the country. Air pollution is linked to killer conditions like heart disease, stroke and lung cancer, and academics have linked high pollution days with hundreds of extra out-of-hospital cardiac arrests and hospital admissions for stroke and asthma. Sir Simon Stevens, NHS England chief executive, has said that it is not enough for the NHS to treat the problems caused by air pollution and climate change, but that hospitals should be playing their part in ‘tackling them at source’. A big part of this effort is in greening the NHS fleet, including working towards road-testing a zero-emissions emergency ambulance by 2022. West Midlands West Midlands Ambulance Service is continuing its commitment to reducing its impact on the environment by taking delivery of two fully electric operational manager response cars. Following the launch of the UK’s first 100 per cent electric ambulance by the trust in October


create the most hi-tech and lightest vehicles 2020, West Midlands Ambulance Service has in the country. This has continually reduced worked with its partner, conversion specialist our impact on the environment by lowering VCS of Bradford, to launch two all-electric zero our CO2 levels and ensured that patients emissions Jaguar I-Pace ambulance response receive the highest standards of safety and cars which will be going into operation comfort. With an all-electric ambulance in Birmingham in the coming weeks. already in our fleet, which was launched VCS has used its expert capabilities to develop last year, it’s hugely exciting to now the all-electric Jaguar I-Pace into a have two fully electric response fully capable response vehicle cars to add to our operational – in tandem the Trust has The NH vehicles in Birmingham.” also invested in rapid has ado S charge infrastructure First 100 per to facilitate fully multiye pted a a cent electric charging of these r p lan to become emergency vehicles in less t h e world first car ambulance than hour. ’s On 1 October, West Anthony Marsh, nationa bon net zero l health Midlands Ambulance WMAS chief system, with in Service announced plans executive, said: t e to develop ambulance “West Midlands in greenrventions technology alongside Ambulance Service ing the NHS fle VCS of Bradford through has been at the et the company’s unique forefront of developing construction method to ensure ambulance technology the ambulances are the lightest and operating a modern fleet and most technologically advanced in for the last ten years. Working service anywhere in the world. The next step with industry specialists like VCS, we have of that development is the introduction of the used aircraft style technology and design to


Fleet management

first zero emissions e-ambulance to be used on UK roads. Its development by VCS reflects emergency services operators’ desire to bring the sector in-line with the global demand for widespread zero emission transport. VCS has used the expert capabilities available within parent company, Woodall Nicholson Group, to develop the zero emissions powertrain technology which sees the vehicle powered by lithium-ion batteries sited in the underside of the ambulance floor pan in a specifically designed and compliant enclosure. The design has a low centre of gravity and is powered by a 96kW battery pack which provides a top speed of 75 mph and can achieve a range of 105-110 miles with a current recharge time of four hours. Further developments to the vehicle will be introduced to increase its capability including two hour charge time. Designed within the Lord Carter Report national specification, the e-Ambulance includes a number of design elements and features that ensure it is as versatile and usable as possible. Tony Page, General Manager for Fleet and Facilities Management at WMAS, said: “The aerospace-type technology on board provides enhanced crash structures, which will improve safety while also enhancing the design of the saloon, which will benefit operational staff and patients alike. This vehicle will allow us to develop this technology rapidly so that we can develop a zero emissions fleet over the coming years.” East of England The East of England Ambulance Trust has invested nearly £50 million in 440 new ambulances which have been specially designed to make transfers more comfortable for patients while improving safety for crews and the care which they are able to provide. The fleet replacement programme began in 2019/20 when 214 bespoke vehicles took the

West Midlands Ambulance Service has worked with its partner, VCS of Bradford, to launch two all-electric zero emissions Jaguar I-Pace ambulance response cars which will be going into operation in Birmingham in the coming weeks roads. A further 226 are being replaced this financial year, and will be responding to patients by April. The final 50 ambulances in EEAST’s existing fleet will be replaced from 2021/22. In addition to this, the trust is also delivering 32 specially-designed Volkswagen vans in the coming weeks for its ambulance officers, which have more space than the vehicles they are replacing. As well as allowing staff to carry a wider range of life-saving equipment, the vans also have a bespoke incident command area to improve the response they are able to provide. Chris Wiltshire, head of fleet with EEAST, said: “We are delighted that our ambulance replacement programme is nearing completion with the roll out of these fantastic new vehicles. The ambulances have been designed to make transfers smoother and more comfortable for patients, and to create a safer working environment for crews as they provide the care to patients. The vehicles are also significantly lighter than our existing fleet, making them more efficient and environmentally-friendly as CO2 emissions, fuel costs and maintenance will be reduced. This will save more than £3 million annually when all of the vehicles have been replaced later this year. “The new specialist vehicles for our ambulance officers have much more space, in turn allowing them to carry more lifesaving equipment and manage incidents

on scene more effectively. At the same time, another mental health response car has now gone live in Cambridgeshire, to supplement a joint mental health response scheme in Bedfordshire. These initiatives are ensuring that patients with mental health issues can receive the support they need in the community wherever possible, in turn improving their experience of receiving care. We are looking forward to rolling out this model more widely across our patch over the coming months as more of our specialist vehicles start to hit the roads.” Welsh Ambulance Service The efforts of the Welsh Ambulance Service to create a greener fleet did not go unnoticed last year, with the organisation the recipient of the Health Business Award for Transport and Logistics. The trust has commissioned new and improved emergency and non-emergency ambulances, as well as a fleet maintenance vehicle to help with the upkeep of its new haul. Of equal importance, 46 new Toyota Rav4 Hybrid rapid response cars are now on the road across Wales, replacing some of the Trust’s older diesel-powered vehicles. The mile-per-gallon of the new rapid response car will increase from around 22mpg to 31mpg, which equates to a reduction of around 125 tonnes of CO2 emitted per year. L Issue 21.2 | HEALTH BUSINESS MAGAZINE


Advertisement Feature

UK medical records success CCube’s award-winning solutions deliver electronic health records to clinicians, secretaries and administrators in the format they require, when and where they are needed. Here, Dr Vijay Magon, managing director of CCube Solutions, demonstrates how their proven track record of project successes working with the NHS over 20 years is providing cost-effective and scalable solutions

CCube Solutions specialises in providing electronic document and content management and workflow solutions, based on the CCube software suite which holds and manages some 450 million documents containing over two billion pages for 32 million patients across 30 NHS organisations around the UK. In-house scanning: St Helens & Knowsley Teaching Hospitals NHS Trust St Helens & Knowsley Teaching Hospitals NHS Trust started a project in early 2009 to digitise and deliver electronic patient records files to guarantee notes availability, improve the quality of patient care and - of course - save money. Its IT resource - Health Informatics Service - created its own in-house scanning bureau along with CCube Solutions EDRMS. The results are impressive. St Helens & Knowsley is the first trust in the UK to stop using paper records in clinical practice, and has made £1.4 million annual savings from £1.2 million investment. Additionally, 500 doctors and 130 secretaries have been trained after a staged rollout taking 22 months, and over 175,000 medical records have been digitised, stopping 7,000 files per week being hand delivered. Outsourced scanning: Aintree University Hospital NHS Foundation Trust Aintree University Hospital decided to outsource to an external scanning services provider. Again, CCube Solutions EDRM software was installed and used to deliver the digital records at the point-of-use. Aintree University Hospital is the first trust to use forms recognition technology to automate the recognition and classification of pre-printed medical forms which make up 95 per cent of medical files. It has made £1 million annual savings from £1.5 million investment. To date, 290,000 patient files have been digitised, helping to create 30 per cent more space gained in a new £45 million building from removing paper records a £13.5 million estate benefit. Hybrid model: North Bristol NHS Trust North Bristol NHS Trust approached the whole transition from paper to digital medical


records by both setting up its own in-house scanning bureau and working with a thirdparty outsourcing specialist, to do the back scanning. The in-house bureau is used for day-to-day scanning. Returns from the project have been significant. The trust says that a scan-ondemand model to digitise patient medical records will save over £1.3 million within four years. EDRMS is an ‘invest to save’ initiative with the system paying for itself based on a reduction in operating costs. The move has seen the outsourced digitisation of over 295,000 active patient records, amounting to c.55 million pages. Avoiding scanning legacy paper in the first place – the Papworth Hospital model Tertiary Trust, Papworth Hospital, installed EDRM, workflow and eForms from CCube Solutions to create an electronic medical records system (EMR). Papworth’s EMR is not concerned with scanning legacy records. The focus has been to concentrate on the patient’s pathway from the moment an individual is referred to the hospital so that referral paperwork and medical notes are indexed, shared and information automatically routed to boost efficiency, reduce costs and enhance patient care. Return on investment has been significant. The whole project, including software and project management, cost under £250,000. The project has seen a significant reduction in operational costs by removing physical paper records storage and management (cost over £200,000pa.). Furthermore, the programme assists meeting government targets to see patients


within the set timeframe of 18 weeks from GP to final treatment. The first deployment of a registration and referral system where letters are scanned and then handled electronically using workflow Medical records in primary care - the GPs Turning to GPs, we launched our eLG solution – a secure and hosted platform for electronic Lloyd George (LG) records. A typical practice with 11,000 patients is likely to have around 13,000 wallets given some patients will have more than one. And, on average, each wallet will contain around 80 pages. This means over 1M sheets of paper per practice - in larger surgeries, the numbers will be considerably higher. Following on from an initial launch of eLG (within the NHS), currently holding some 2.5 million records comprising of 90 million pages, for 620,000 patients, accessed by 100 GP practices, CCube Solutions has deployed a secure and hosted platform for the storage, access and lifecycle management of electronic LG records. The upload process of LG files is free, fully automated, and meets agreed SLAs. Access to this information is via a standard Internet browser using any device, no need to install any software in the practice! Contact CCube to discuss how we can look after every stage of your information strategy, from capture and life-cycle management to delivery L FURTHER INFORMATION


Delivering on techUK’s Ten Point Plan: A Guide for Implementation Henry Rex, Associate Director for Government and Health at techUK, looks at February’s Ten Point Plan for Healthtech and why digital technology should be at the forefront of improving outcomes for patients In early February 2021 techUK published The Past our Ten Point Plan for Healthtech, where Covering empowering the public, after careful and extensive engagement embedding standards, digitising social care, with our members and external supporting the workforce and reforming stakeholders we came to ten essential procurement; our report closely recommendations for the health reflects what techUK members and social care sector. believe to be the pertinent These recommendations issues du jour. Initially O ur seco are not exhaustive conceived in 2019, and nd recomm and do not cover following on from the e n dation called f all the challenges successful launch continu or NHSX to that suppliers and of our previous e t the service face, paper in 2018, o w supplie though they do a Manifesto for rs to en ork with the Dig sure tha fundamentally Matt, the paper it address what we began to take Assessmal Technology t believe to be the shape during the e (DTAC) nt Criteria priority areas. summer of 2020 as is fi Now, we look to lockdown eased and purpos t for provide further context we all took a collective e to the barriers discussed deep breath. After initially in the report and, crucially, conducting one on one additional thought on the interviews with our elected Health direction of travel for health technology and Social Care Council, we expanded the above and beyond the response to Covid-19. engagement out in a series of thematic

roundtables that allowed stakeholders wand members to input in a group session. Over the subsequent months as we put virtual pen to paper, the council worked through the final ten recommendations and helped us to distil what was an enormous amount of information into something readable and useful. The Present Once the paper had been published, our priority was how to take it forward and ensure that it becomes something of a living document rather than a historical artefact. To this end, we are currently working closely with the teams at NHS Digital, NHSX and NHS England and Improvement to help deliver the recommendations and fulfil the industry compact that we committed to in our Ten Point Plan. Whilst many of the recommendations place the call to action on local NHS organisations, or more often, the Arm’s Length Bodies, it is equally critical that techUK and our members play their part where necessary and needed. E Issue 21.2 | HEALTH BUSINESS MAGAZINE


Scanning solutions for Healthcare

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■ Enhanced compliance (GDPR) throughout all departments with all regulatory guidelines. ■ Faster access to patient information, leading to improved patient outcomes, better patient engagement, and better

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Recommendation Nine “Enshrining the role of the Integrated Care System into law in line with the Long Term Plan’s recommendation to establish Integrated Care Systems (ICSs) nationally by April 2021, techUK calls on the Secretary of State for Health and Social Care to implement plans to establish the role of the ICS in law. This will help to simplify and codify the provider landscape, making it easier for suppliers to engage with the health and care system.” With the added benefit of the publication of the Bill, it will be important for the Department of Health and Social Care to engage with industry to ensure the wider legislative proposals are both understood and

agreed upon with the healthcare IT supplier community, which will ultimately have to navigate and access the new look system in England. As we recognised in the paper, simply making the legal change to ICSs is not the end of story and much work will remain on establishing a positive and inclusive culture or collaboration among these new organisations who will be expected to work across new boundaries and populations. Our second recommendation called for NHSX to continue to work with suppliers to ensure that the Digital Technology Assessment Criteria (DTAC) is fit for purpose. The team at NHSX have continued to diligently engage with industry pre and post launch of DTAC, and we are optimistic that the success of the programme will go from strength to strength.

Recommendation Two “NHSX should continue to work with industry to ensure the Digital Technology Assessment Criteria (DTAC) is fit for purpose; raise awareness and support commissioners to understand and utilise the DTAC; work with third-party assessors to maintain a pipeline of innovation; and engage with the relevant stakeholders to realise a functional reimbursement model for citizen-facing digital health technology.” Recommendations four and five looked more specifically at standards and interoperability, the collective bête noire of the healthtech industry. Both the teams at NHS Digital and NHSX have been open and receptive to working with suppliers, as evidenced by their participation in our Digital Health and E


 Since publication the pace of change brought on by the response to Covid-19 has meant that some of these recommendations have either already happened or are likely to be happen in the not-too-distant future. First and foremost is recommendation nine, the call for Integrated Care Systems (ICS) to be made legal entities, which through the Health and Care Bill will become a reality de jure later on this year. Although it will take some time for all Sustainability and Transformation Partnerships (STPs) to go through the metamorphosis, the end result of 42 cocoon fresh ICSs will play an important role in reforming the provider landscape.

It will be important for the Department of Health and Social Care to engage with industry to ensure the wider legislative proposals are both understood and agreed upon with the healthcare IT supplier community, which will ultimately have to navigate and access the new look system



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 Interoperability Showcase and more behind the scenes participation in roundtables and user research opportunities. techUK also understands that NHSX are moving forward with the interoperability standards registry, which is currently under development. Recommendation Five “The Department of Health and Social Care should centrally mandate, assess and enforce the use of interoperability standards through NHSX and NHS Digital. Standards should be locally implemented and co-developed with both industry and the service itself. These should then be collated into a single, searchable interoperability standards registry. This standards registry should be transparent and accessible by end users so they understand what they should adhere to.” Work on commercial and procurement activity has been ongoing since before publication and the teams at NHSX and

NHS Digital, including the Chief Commercial Officers David Howie and Nic Fox, have shared their Category Strategy for Digital and Procurement Target Operating Model (PTOM) with our Health and Care Council. Recommendation ten identifies a number of key changes that the centre could make to ensure a more efficient system and to promote excellence in procurement. Recommendation Ten As part of a comprehensive plan to reform procurement, the health and care sector should pivot towards outcomes as the primary success factor for digital transformation; signpost suppliers to existing frameworks; provide an accurate estimate for their total value; offer specialist training for procurement staff who are buying technology; and prioritise the streamlining of existing and future frameworks by committing to reducing their proliferation.

The future As we look ahead to the future, and as alluded to in the paper, one of the key components of successful digital transformation is establishing an answer to the perennial question of: what does good look like? Seeking an answer to this question is Sonia Patel, Chief Information Officer at NHSX, who is developing a programme of work in this area, with one of the potential answers being the establishment of a reliable digital maturity model that measures outcomes rather than inputs. techUK is working with SOCITM, BCS and others to help establish a practical and useful system to address this question. “Measuring digital maturity in healthcare is a challenging but necessary task that aims to demonstrate the real-world impact of information systems that enable process transformations and to identify gaps and investment priorities. Digital maturity comprises multiple dimensions, incorporating infrastructure, application capabilities, workforce capabilities and patient/service user outcomes.” Overall, the recommendations of the Ten Point Plan will form the basis for the work of our Health and Social Care programme for the next few years, with two immediate outcomes likely to be the establishment of more formal Interoperability and Commercial & Procurement working groups. If any stakeholders, members or other suppliers would like to be more involved then we would be more than happy to have a conversation about how we can work together to move some of these recommendations forward. L FURTHER INFORMATION




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NHS innovation

Innovative methods to improve care during the pandemic The NHS Long Term Plan laid out a number of pledges to improve patient care by using new and innovative measures and technologies to advance treatments. Here we look at some recent treatment introductions The NHS has strongly attempted to prioritise has already started using the innovative cancer care during the coronavirus pandemic, diagnostic tool. Clinical lead Ed Seward said: with recent figures in March showing that “Colon capsule is a new innovation that hospitals carried out more than two cancer has recently become available and involves treatments for every patient they treated for swallowing a camera pill that takes pictures coronavirus. In December 2020 alone, more of the bowel as it passes through. These than 25,000 patients were treated for cancer pictures are beamed to a recording device and more than 200,000 people came forward that the patient wears at their waist. for checks – 13,000 more than the same “Not only does colon capsule increase month the previous year. our diagnostic capacity, because it doesn’t Only last month, NHS England chief require the resources of a dedicated hospital executive Sir Simon Stevens said that, as we space to do the examination, it also allows come out of a peak of coronavirus infections us to do the examination in the patient’s and the resulting disruption to hospitals up home, so patients who may be shielding and down the country, the NHS would be or cautious about going to a hospital, can ‘now pushing ahead with genuine innovation perform the procedure in the comfort of to expand services for many other their own homes.” conditions’. One of the services To further support he discussed was ‘ingenious cancer services, capsule cameras’ to allow £150 million has NHS more people to undergo been invested England cancer investigations in diagnostic a nnounc this mo quickly and safely. equipment such e d nth tha Traditional as endoscopy cancer t b reast patients endoscopies mean underg chemot patients need to attend o h e r a p y will be ing offered hospital and have a a ne tube inserted whereas treatme w combined the new technology nt calle means that people can d P H E S GO go about their normal day. However, under an NHS England trial, an initial group of 11,000 NHS patients in England will receive capsule cameras, in more than 40 parts of the country, which they can swallow to get checked for cancer. The imaging technology, in a capsule no bigger than a pill, can provide a diagnosis within hours. Known as a colon capsule endoscopy, the cameras are the latest NHS innovation to help patients access cancer checks at home. The cameras will help to speed up the checks, catching more cancers early when they are easier to treat. For the last 12 months, necessary infection control measures required to make endoscopies Covid-secure has meant that they take much longer to do, which has reduced the number of people who can undergo the life-saving checks. The endoscopy team at University College London Hospitals NHS Foundation Trust

equipment and new MRI and CT scanners. Hospitals are using the funding to restructure their buildings with the funds to allow social distancing and help prevent the spread of the virus while continuing to deliver care. Breast cancer This month NHS England also announced that breast cancer patients undergoing chemotherapy will be offered a new combined treatment called PHESGO, which is injected and takes as little as five minutes to prepare and administer, compared with two infusions that can take up to two and a half hours. Seeking to cut the amount of time breast cancer patients spend in hospital from two and a half hours to as little as five minutes, NHS England says that more than 3,600 new patients each year will benefit from the treatment, as well as others who will switch from the treatment they are on to the single injection, following an NHS deal with the manufacturer. E



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Eliminating headaches Cluster headaches begin quickly and are often described as a sharp, burning or piercing sensation on one side of the head with attacks lasting between 15 minutes and three hours and occurring up to eight times a day. While rare, the debilitating condition is more common in men and tend to start when they are in their 30s or 40s. A small, portable device that can zap away excruciating headaches is now available to anyone who needs it on the NHS, after NHS

NHS innovationd

 The five-minute jab significantly cuts the coronavirus infection risk for cancer patients by reducing the amount of time spent in hospital and frees up time for clinicians in chemotherapy units, with the injection set to be offered to eligible people with HER2positive breast cancer, which accounts for 15 per cent of all breast cancers, and can be given alongside chemotherapy or on its own. Care providers were told they could begin offering the treatment in February and the agreement between the health service, NICE and the manufacturer means it comes at no extra cost to the NHS. Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “Approval of Phesgo being used on the NHS in England is fantastic news as thousands of women with HER2 positive breast cancer will now benefit from a quicker and kinder treatment method. Reducing the time patients need to spend in hospital, this more efficient treatment method also promises to free up precious time for healthcare professionals when the NHS is already under unprecedented strain due to Covid-19. “The announcement reflects the latest of continued advances in breast cancer treatment, and now we hope to see Roche and NHS decision-makers working together to ensure Phesgo is rapidly made available across all of the UK so that even more patients and healthcare professionals alike can reap its benefits.”

“Despite the pandemic, we remain committed to delivering on the ambitious commitments set out in the Long Term Plan to support the latest innovations and allow patients to utilise them across the country, as quickly as possible.” England announced plans to expand the use of gammaCore after successful trials held over the last two years. The gadget is held against the neck and delivers a low-level electric current to block pain signals, relieving pain from people suffering from ‘cluster’ headaches. Approximately 11,000 people are set to benefit from the device when they have the debilitating headaches. Patients can use the device regularly to prevent cluster headaches or when they feel one starting to come on. Matthew Whitty, director of innovation and life sciences for NHS England, said: “Despite

the pandemic, we remain committed to delivering on the ambitious commitments set out in the Long Term Plan to support the latest innovations and allow patients to utilise them across the country, as quickly as possible. The GammaCore device will provide life-changing benefits for thousands of people and it is just one of a number of technologies that are being mandated by the NHS.” L FURTHER INFORMATION



It is Time to Look at IT in a New Way

Helping Healthcare to Drive Transformation and Adopt a Cloud First Approach. We help Healthcare adopt the Governments' (OGCS) Cloud Strategy and discover how cloud solutions can empower performance and results. We can help you adapt and migrate relevant solutions to Public, Private and Hybrid cloud environments. You can trust in over 23 years of experience in helping the Public Sector and Enterprise deliver the right outcomes.



The contract management skills every project manager needs Managing a framework requires a very different set of management skills to a more traditional waterfall-based project, writes Romy Hughes Managing the delivery of ‘as-a-Service’ contracts requires a very different set of skills than managing a traditional waterfall projects. Unfortunately, these skills are rarely prioritised in the public sector, leaving many project managers out of their depth, projects going over budget, deadlines being missed, and projects deviating from their original objectives. How exactly has the role of project management changed in light of the more agile, post-waterfall approach to project delivery, and which skillsets are required for project managers going forward?

course of the contract, while the procurement The new management approach manager would move on to another project. Prior to the introduction of the framework The public sector has now largely shifted agreements, the public sector relied on away from this up-front capex approach to the expertise of procurement specialists to a more operational, opex model (e.g. protect its interests when buying traditional IT has moved to cloud products or services. Once the services which are often, but procurement manager was not exclusively, procured happy with the terms, There through frameworks). Since a project manager n eeds to the frameworks have done would take over to be a recogn most of the up-front ensure the successful i t ion tha success contractual work already, delivery of those t fully de less procurement E terms over the agil liv

ering e pro a changjects requires e manag in project em approa ent ch



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In-life management of a contract vs. waterfall The skillsets required for the ‘in life’ management of a multi-year contract vs procuring it in the first place are generally not the same as each other, yet the staffing of these projects has not changed to reflect this. All too often, project managers, whose skills, training and careers have evolved around traditional waterfall project delivery, must now combine their existing project management role with ongoing contract management too. What do project managers need to do to keep their projects on track? Work more strategically with suppliers – The shift away from a capex funding model which is laser focused on delivering one, very specific outcome is a world away from delivering a framework, which typically involves the delivery of continually evolving business outcomes. This more agile, opex approach requires a very different relationship with your suppliers. You need to work more strategically. You can’t be transactional anymore.

Get out of your silo and manage your stakeholders – It is not uncommon to have more than 100 stakeholders involved in a

project who need continual, not occasional, engagement. As the de facto contract manager you must now go out and build the necessary relationships with suppliers and internal stakeholders. Working this way will also help to move your organisations away from waterfall project delivery and towards a more service management approach.

Work closely with commercial – since you are no longer facing big contractual changes every few years, but ongoing little tweaks, commercial and project management must work together throughout the delivery of the project. Agility is key – Rigid procurement rules in the public sector often prevent projects from being as agile as they should be. For example, if an existing software vendor launches new features which could greatly benefit the public sector, the public sector cannot simply raise a PO for these new features due to the way procurement is still largely about fixed outcomes. Instead, they are encouraged towards a full tender process just to add these features to their service which is a waste of the organisation’s and its supplier’s time. Hire dedicated contract managers – As the above points have hopefully demonstrated, contract management alone is a full-time job. It is therefore unfair to expect project managers to take this on by themselves. This is because project managers are focused

on delivery, while contract managers are focused on outcomes. A contract manager will understand the scope and legalities of the framework, leaving the project manager free to focus on technicalities of delivery. Since the focus of each roles are a little different but complementary, it is important that they work in tandem to achieve a successful outcome. Project managers need a the full-time support of a contract manager, although it is worth recognising that a good contract manager may be able to resource several projects or programmes simultaneously.


 expertise is required at the start of a project. Instead, the focus has shifted to the continuous management of the contract to ensure the best continual result.

The shift to service management Beyond the employment of dedicated contract managers, there needs to be a recognition that successfully delivering agile projects requires a change in project management approach. It is about more than simply distinguishing between the project and contract management roles, but about adopting a service management approach in order to deliver the outcomes your organisation needs. Yes, you need to have the right roles in place with the appropriate skillsets, but you also need the right governance in place. You need to define an operational model that delivers service management at its core. L

Romy Hughes is director at Brightman. FURTHER INFORMATION



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The NHS AI iceberg: below the surface Designing the future of healthcare could become everyone’s responsibility. Making that happen will require a new education focus around artificial intelligence for healthcare professionals and patients, write Jane Rendall and Rachel Dunscombe

A crisis point could be on the horizon for NHS imaging disciplines. Rising demand and pervasive recruitment challenges mean there will be too few experts to go around based on current ways of working. We certainly don’t want to reach that point, and to achieve that the health service will need to adopt artificial intelligence in new ways as an important mechanism in redesigning services. For this to happen radiologists, pathologists and other ‘ologists’ must master how AI works and how it could be used to achieve maximum impact. These professionals, together with organisational and process experts, need to be given the headspace to work out how their profession will evolve in coming years, having taken the potential of this technology into account. They need to understand what part of their profession requires or can be strengthened by human judgement and engagement. And they need to be able to establish when decisions could be made quickly and automatically by AI. What can be safely automated, should be automated, or have the option of being automated. More than an efficiency drive, this is a necessity to be able to deliver healthcare expected by citizens, and to facilitate early engagement and prevention. The iceberg There is a big education piece that needs to be undertaken in order for this complex redesign to happen effectively, and for AI to be used in more sophisticated ways than narrower diagnostic support uses often seen today. Clinical professions are changing and will become more data driven. This will require a new skillset currently absent from learning,

like understanding the technology and mathematical concepts behind algorithms. There are four key areas where people need education and orientation, and the technology is just the tip of the iceberg.

That’s why this needs to be part of continuous professional development and education for anyone in healthcare using AI. People need to understand what problems they are trying to solve, and ways in which that can be done safely.

1. Around the tech – the tip of the iceberg. Clinicians need to have an understanding of how to read and interpret results from AI applications, and a vision of what exists, what AI can do, what is emerging and what it could do in the future. There is then a huge amount underneath the surface. Principally, the remaining three areas.

Educating patients When talking pathway redesign our radiologists, pathologists and others will need to understand how this AI is communicated to citizens. That includes the explanations that patients see, the outcomes and measures patients see, and informing choices presented to the patient, potentially via their patient portal. Many patients already get choices around how they receive information; this could extend to their diagnostic choices. A potential future option to have a preliminary diagnosis in 30 seconds by choosing to use an algorithm to look at your image, rather than 15 days for a human counterpart to examine it, could be a valid option in many cases. And if we can gather evidence over time of the efficacy of those choices, we can show that to patients. We can move from prescribing a set of pathways to citizens to giving them more choice, to informing how they interact with an algorithm. Conversely some patients might have a complex history and prefer an analogue approach. Patients might be advised to rely on a radiologist for complex cases. But for a relatively simple bone break, you might choose an algorithm. Humans add most value where there is complexity. Some of this is about choice, some will be about advice. And part of this equation is about determining where choice is appropriate.

2. Governance and quality assurance – how quality works in an AI environment and the development of continuous quality assurance in institutions. It is important to understand how an algorithm performs on a certain patient population within an institution and how that evolves over time. Being in control and understanding how algorithms behave will be key for institutions. 3. Workflow redesign – changing how clinicians work and augment themselves as professionals. 4. At the system and patient level – pathway redesign to leverage all of the above. This might be around patients going to an MRI scanner that is nearer. Or they might get an automatic text message with results, or access to preliminary findings before they leave hospital. Pathway redesign is essential to un-constrain healthcare for the patient. Unless we tackle this iceberg whole, we won’t achieve impact at scale and pace – instead we risk creating orphaned silos of technology that don’t fit into the healthcare system.

Digitally ready workforce This is transformation – it is about how we are going to practice medicine or radiology in the future – not orphaning tech along the way. It is about empowering a digital and AI ready workforce to reimagine their own careers, their workplace and workflow. The potential crisis point creates a sense of urgency, but this is also an opportunity to make service redesign everyone’s job – so they are not just part of the service, they are part of the future. L Rachel Dunscombe is a director for Tektology and is CEO of the NHS Digital Academy Jane Rendall is UK managing director for Sectra FURTHER INFORMATION



Hospital discharge

Freeing up thousands of extra NHS beds As the government announces almost £600 million for its hospital discharge programme, Phil Davies, Procurement Director at NHS Shared Business Services (NHS SBS), says NHS trusts can use it to access extra capacity via the Patient Discharge Services Framework One of the inevitable consequences of The recent news of £594 million set the pandemic has been the huge aside for safe hospital discharge will, pressure on hospital beds therefore, have been welcomed across the country. In by NHS trusts up and down January this year, the country. Part of a wider The rec amidst more than £6.6 billion package to e n t news o 100,000 Covidsupport the next phase f £594 million 19 hospital of the NHS pandemic admissions, media response over the safe ho set aside for spital d reports suggested next six months, will hav ischarge that more than the Department of welcom e been a fifth of all Health and Social e d general and acute Care (DHSC) said the b y trusts u beds in England ring-fenced hospital p and dNHS own were occupied by discharge funding the cou ntry patients staying two would provide NHS weeks or more – with staff with ‘the resources this rising to almost one needed to enable patients in three in some regions. to leave hospital as quickly

and as safely as possible, with the right community or at-home support’. Announcing the new funding in Parliament, the Secretary of State, Matt Hancock, stated that – in the last 12 months – the NHS hospital discharge programme had ‘freed up over 6,000 beds – and with it the valuable time of 11,000 NHS staff’. This also coincides with a more than tenfold increase in the use of our Patient Discharge Services Framework, as NHS hospitals secured additional capacity last year from independent providers of ‘hospital at home’ and rehab services. Reducing bed occupancy With the national hospital discharge programme now extended – and new funding available for extra resources – we expect E Issue 21.2 | HEALTH BUSINESS MAGAZINE


Advertisement Feature As case loads increase, digital dentistry shows a way forward to streamline the dental workflow and provide fast and efficient in-house solutions to the most complex of problems. At its heart, Awesome Technology Ltd provides the ability to provide ‘same and next day’ production of accurate dental appliances. This often-vaunted dream is now a reality in many dental clinic situations both inside and outside the laboratory environment. By substituting the traditional plaster cast shapes with digital models produced by an intraoral scanner, the dentist is able to speedily produce a highly accurate dental model around which items like crowns, bridges, retainers, aligners and retainers can be made. Using readily available software for treatment planning and design the final appliance can be produced in-house, thanks to a range of modern 3D printers. This has been made possible by the evolution of biocompatible resins that are not only acceptable to modern day demands but also speedy in being cured from the liquid form to a durable solid in short rapid time. The 3D printers use a range of ultraviolet technologies to cure the resin layer by layer that finally forms the intricate and complex shapes required in dentistry.

The 3D Printing process now has specialisations in orthodontics, dentures, implants and temporary teeth production as well as their design an fitting. In addition items such as bleaching trays, surgical guides, temporary restorations, indirect bonding trays, splints and guards can also be made quickly available. Largely dependant on the resins used, we can advise and supply for any solution. We distribute world famous SprintRay, Shining 3D, Exocad software and other digital dentistry solutions around Europe, through our Feniqx subsidiary and qualified resellers. In all cases we stock parts and accessories for all the products in both the UK and Italy. Awesome Technology supplies, warrants and repair their devices carrying both spares and consumables such as resins and tools needed to wash and cure the resultant appliances. We make our own tests on machines, materials and software to bring fist hand experiences to end users as well as trialing new solutions. The drawback to rapid changes in technology and processes can be that their full comprehension, the advantages of one type over another and the range of materials seen as a little daunting. Awesome Technology are very used to the typical (and sometimes abnormal) multiple questions for which answers are normally needed to progress.

Hospital discharge

 many more healthcare providers will now look to the framework to commission support quickly and easily. This will reduce hospital bed occupancy and relieve pressure on inpatient services, helping NHS trusts tackle the backlog of elective procedures that has grown significantly as a result of Covid-19. Indeed, earlier this year and ahead of the new DHSC funding announcement, NHS England and NHS Improvement (NHSEI) had already encouraged NHS systems to use the framework as a way of helping discharge patients who no longer need to be in hospital. The Patient Discharge Services Framework itself was developed so that patients deemed medically fit for discharge can do so in a safe and timely manner. It helps NHS and other public sector organisations to access supplementary services to support this transition and prevent readmissions to hospital. Approved framework suppliers have the experience and capabilities to ensure that patients continue to receive highquality care from appropriately trained professionals, such as registered nurses, after being discharged from hospital. One NHS provider that has used the framework to excellent effect is James Paget University Hospitals NHS Foundation Trust in East Anglia, which has worked with one framework supplier to establish the ‘Paget @ Home’ service, accessing what it describes as ‘professional, flexible and quality patient care within the home setting’. Despite the challenges of developing new patient pathways across various agencies, the trust found that Homelink Healthcare ‘helped to simplify the process – providing project management support and governance

NHS England and NHS Improvement (NHSEI) had already encouraged NHS systems to use the framework as a way of helping discharge patients who no longer need to be in hospital guidelines, as well as expertise across finance, contracting and strategic development’. Norfolk and Norwich University Hospitals NHS Foundation Trust, meanwhile, has worked with the same framework supplier to co-create ‘NNUH at Home’ – providing clinical care in the home to release inpatient bed capacity and improve patient choice. Since the service began in 2019, over 9,000 bed days have been saved – with 80 per cent of patients discharged on or before their expected discharge date. Different Lots In total, the framework – which runs until March 2023 – has 16 approved suppliers across three different Lots. The first is ‘Discharge to Assess’, which covers people that do not need a hospital bed but may still require care services and lower level support. These patients are provided with short term support so they can be discharged to their own home or another community setting. Lot 2 is ‘Third Party Brokerage’ and is designed to reduce delayed transfers of care. These providers work with patients and their families outside of traditional care hours, supporting people to move to a care home, step-down care or back into their own home.

The final Lot is ‘Medical Care at Home’ – also known as Secondary Care at Home or a Virtual Ward. Here a medical professional provides care in the patient’s home and is responsible for medical procedures, safety and recovery. Services here are for patients who are at risk of hospitalisation, which can be avoided by a more coordinated and collaborative case management approach by their GP, district nurse, social services, specialist nurses or third sector organisation. With the new DHSC funding intended to ‘free up thousands of extra beds and staff time to help the NHS recover services’, the extra capacity available via the Patient Discharge Services Framework can benefit NHS systems up and down the country. The ready-made agreement will be an increasingly important route for NHS providers to procure any additional support they need to reduce the length of stay for patients in hospital. L

To find out more contact the NHS SBS Procurement team on 0161 212 3940 or email FURTHER INFORMATION



ASAP Innovations UK Ltd

Certified PPE provider launches in the UK

ASAP Innovations represents the medical PPE provider of choice – credible, reliable and most importantly, certified ASAP Innovations, a leading manufacturer of medical Personal Protective Equipment (PPE) for the healthcare, veterinary, automotive, industrial, hygiene, agricultural, food and beverages industries has officially launched in the UK. Based in Ireland and Malaysia, with over 30 years’ experience manufacturing


disposable products in over 80 countries worldwide and a commitment to hygiene control and quality assurance, ASAP Innovations’ 150 certified product lines of masks and gloves are now available to UK organisations. ASAP Innovations’ products include medical face masks for both adults and notably, children – a product line that isn’t currently widely available. It also includes nitrile gloves, latex gloves, vinyl gloves, cleanroom gloves and surgical gloves. All of its products on offer are highly regulated and certified to EU standards, unlike a lot of the PPE on the market at present – all ASAP Innovations products are registered with the European Medical Device Directive (MDD). Proper hygiene standard is practiced throughout the development of all ASAP Innovations products, from raw materials handling, processing, production, inspection, to the finished product. ASAP Innovations ensures that each design meets current trends and abides by all regulatory requirements, with all its masks and gloves tested and certified by authorised notified bodies to EN standards. Its masks


comply with EN 14683 and EN149 standards and its gloves comply with EN 455 and EN 374 standards. PPE has been a lifeline for the healthcare industry over the past year, enabling it to continue providing the best quality care to patients. However, the result of this is a worldwide shortage of gloves, which ASAP International HQ estimated was at 20­-25 billion gloves per month at the height of the pandemic. This demand has presented opportunities for fraudulent activities and it has therefore never been more crucial that PPE products are selected based on the fact they are tested and certified by authorised bodies to EN standards and that buyers have complete confidence in the products they’re purchasing. If you are looking for certified protection for your functional and practical needs, choose ASAP Innovations, where transparency and legitimacy are the priority. ASAP – quality you can trust with certified products. L FURTHER INFORMATION

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Aerogen, global leader in aerosol drug delivery Aerogen’s closed-circuit nebuliser technology is being used in hospitals across both the UK and the rest of the world to deliver aerosolised medication to critically-ill ventilated Covid-19 patients 5. Reminiac F, Vecellio L, Bodet-Contentin L, Gissot V, Le Pennec D, Salmon Gandonniere C et al. Nasal high-flow bronchodilator nebulization: a randomized cross-over study. Ann Intensive Care 2018; 8: 128. 6. Dunne RB, Shortt S. Comparison of bronchodilator administration with vibrating mesh nebulizer and standard jet nebulizer in the emergency department. Am J Emerg Med 2018; 4:641–646. 7. Moody GB, Luckett PM, Shockley CM, Huang R, Ari A. Clinical Efficacy of Vibrating Mesh and Jet Nebulizers With Different Interfaces in Pediatric Subjects With Asthma. Respir Care 2020; : respcare.07538. 8. Chweich H, Idrees N, Rice L, Rideout J, Barnewolt B, Kamlarz S et al. Effectiveness of a Vibrating Mesh Aerosolizer Compared to a Jet Nebulizer for the Delivery of Bronchodilator Therapy to Acute Adult Asthmatics in the Emergency Department a Randomized Controlled Trial. American Thoracic Society, 2019, pp A2209–A2209. 9. Aerogen Internal data on file, Aug 2020

Aerogen is the world’s leading medical device company specialising in the design, manufacture, and commercialisation of aerosol drug delivery systems. Aerogen’s patented vibrating mesh technology turns liquid medication into a fine particle mist, gently and effectively delivering drugs to patients lungs.1,2,3 Aerogen’s innovative products, the Aerogen® Solo and Aerogen® Ultra, significantly improve aerosol drug delivery resulting in better patient care throughout the hospital and across all ages.4-8 Founded in Galway, Ireland in 1997, Aerogen has grown to become the global leader in high performance aerosol drug delivery and has partnered its technology with leading mechanical ventilation companies including Philips Healthcare, GE Healthcare, Medtronic, Getinge, Dräger, Hamilton, ResMed and IMT Medical.9 Aerogen technology is used by millions of patients and caregivers in the UK and in over 74 countries worldwide9. Designed for the safety of both the patient and the caregiver, Aerogen is the only closed circuit aerosol drug delivery system for mechanically ventilated patients that mitigates the transmission of patient generated infectious aerosol10-16 and delivers effective aerosol treatment1,11,17. Aerogen’s closed-circuit nebuliser technology, which addresses key concerns around safety and improves patient outcomes,4–8 is being used in hospitals across both the UK and the rest of the world to deliver aerosolised medication to critically-ill ventilated Covid-19 patients.9 Multiple countries, including the UK, have recognised the benefit that Aerogen can bring to their patients. Aerogen technology is now featured in guidance documents and peer-reviewed publications on the treatment of Covid-19 patients from across the globe.11,15,16,18,19 The National Institute for Health and Care Excellence (NICE)20 and Public Health England

(PHE)21 have recommended the continued use of nebulised treatment when applicable. Appropriate nebulised aerosol delivery can play a vital role in both treatment of Covid-19 patients via respiratory support such as mechanical ventilation11-14 and other therapies like high-flow nasal cannula and non-invasive ventilation15. Aerogen was quick to anticipate the critical role that development of new inhaled drugs will ultimately play in the Covid-19 response and formed a Covid Unit to support projects researching potential treatments and vaccines. This unit is now working with pharmaceutical companies worldwide to ensure safe delivery of inhaled therapies for both the current and possible future pandemics. For more information on Aerogen’s products or if you would like to have an Aerogen representative contact you, please visit us below. L

10. Aerogen Solo System Instruction Manual. Aerogen Ltd. 11. Ari, A. (2020). Practical strategies for a safe and effective delivery of aerosolized medications to patients with COVID-19. In Respiratory Medicine (Vol. 167). W.B. Saunders Ltd. 12. Miller A, Epstein D. Safe bronchodilator treatment in mechanically ventilated COVID-19 patients: A single center experience. J. Crit. Care. 2020; 58: 56–57 13. Respiratory care committee of Chinese Thoracic Society. [Expert consensus on preventing nosocomial transmission during respiratory care critically ill patients infected by 2019 novel coronavirus pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi 2020; 17: E020. 14. Fink JB, Ehrmann S, Li J, Dailey P, McKiernan P, Darquenne C et al. Reducing AerosolRelated Risk of Transmission in the Era of COVID-19: An Interim Guidance Endorsed by the International Society of Aerosols in Medicine. J Aerosol Med Pulm Drug Deliv 2020; jamp.2020.1615. 15. Gómez C, Peñuelas Rodríguez Ó, Luján Torné M, Egea Santaolalla C, Masa Jiménez JF, García Fernández J et al. Clinical consensus recommendations regarding non-invasive respiratory support in the adult patient with acute respiratory failure secondary to SARS-CoV-2 infection. Med Intensiva 2020. doi:10.1016/j. medin.2020.03.005 16. Halpin DMG et al. Global Initiative for the Diagnosis,


Management, and Prevention of Chronic Obstructive Lung Disease: The 2020 GOLD Science Committee Report on COVID-19 & COPD. Am J Respir Crit Care Med. 2020 Nov 4. doi: 10.1164/ rccm.202009-3533SO. Epub ahead of print. PMID: 33146552


17. MacIntyre NR, Silver RM, Miller CW, Schuler F, Coleman RE. Aerosol

1. Dugernier J, Reychler G, Wittebole X, Roeseler J, Depoortere V, Sottiaux

delivery in intubated, mechanically ventilated patients. Crit Care Med

T et al. Aerosol delivery with two ventilation modes during mechanical

[Internet]. 1985/02/01. 1985 Feb [cited 2019 Apr 17];13(2):81–4.

ventilation: a randomized study. Ann Intensive Care 2016; 6: 73.

18. Chaudhry D, Govil D, Samavedam S, Kar A, Kulkarni AP, Zirpe

2. Dugernier J, Hesse M, Vanbever R, Depoortere V, Roeseler J,

KG et al. Airway Management and Related Procedures in Critically

Michotte JB et al. SPECT-CT Comparison of Lung Deposition using

Ill COVID-19 Patients: Position Statement of the Indian Society of

a System combining a Vibrating-mesh Nebulizer with a Valved Holding

Critical Care Medicine. Indian J Crit Care Med 2020; 24: 630–642.

Chamber and a Conventional Jet Nebulizer: a Randomized

19. Swarnakar R, Gupta N, Halder I, Khilnani G. ICS guidance for

Cross-over Study. Pharm Res 2017; 34: 290–300.

nebulization during the COVID-19 pandemic. Lung India 2020; 0: 0.

3.Dugernier J, Hesse M, Jumetz T, Bialais E, Roeseler J, Depoortere V

20. Overview | COVID-19 rapid guideline: community-

et al. Aerosol Delivery with Two Nebulizers Through High-Flow Nasal

based care of patients with chronic obstructive

Cannula: A Randomized Cross-Over Single-Photon Emission Computed

pulmonary disease (COPD) | Guidance | NICE.

Tomography-Computed Tomography Study. J Aerosol Med Pulm Drug

21. COVID-19 infection prevention and control guidance: aerosol

Deliv 2017; 30: 349–358.

generating procedures - GOV.UK.

4. Avdeev S, Nuraieva G, Soe AK, Fink JB. Comparison of response to


aerosol drug delivery with mesh and jet nebulizers during non-invasive


ventilation (NIV) in acute exacerbation of COPD Poster ERS 2017;

generating-procedures (accessed 10 Nov2020).

50: PA1894.




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Medical IT: Supporting the digital transformation of the NHS The Medical IT Departmental Software and Hardware Solutions framework gives trusts access to an expanded choice of the latest technology from more than 70 suppliers In February, NHS Supply Chain began to further assist hospital trusts across England adopt innovative new digital solutions, such as artificial intelligence (AI) and business analytics, along with the use of data management and cloud-based software and various department-specific solutions. Through the updated Medical IT Departmental Software and Hardware Solutions framework, which launched on 1 February 2021, trusts can gain access to an expanded choice of the latest technology from more than 70 suppliers, with increased product availability and a wide range of services and flexible IT software products designed to modernise NHS systems and increase efficiency. Running for two years, with the option of an additional two, the framework enables NHS organisations to specify and create

years to support trusts. These have been bespoke clinical solutions across single developed with the input of trusts and or multiple departments, sites and trusts. suppliers to ensure they are robust It consists of two Lots: Medical IT and efficient for all users. Software Solutions; and The organisations lists Medical IT Complimentary among the benefits of the Hardware. Lot 1 covers Throug new framework: more anything classed as h the upd than 350 Medical IT medical software, framew ated contracts procured via whereas Lot 2 o rk trust can gai our Framework since covers the IT s n 2012, ranging from hardware to expand access to an short term tactical support the e d choice the late extensions to ten year deployment of o f s t fully managed services; medical software. from m technology o close governance of NHS Supply 70 suppre than an open book contract Chain’s Medical IT liers for transparency; capped team has extensive earnings – all surplus savings procurement expertise returned to the NHS; bespoke with processes that have template contracts, terms and E been developed over four Issue 21.2 | HEALTH BUSINESS MAGAZINE




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Robotic surgical equipment The launch of the new Medical IT Departmental Software and Hardware Solutions framework follows the December 2020 introduction of the Robotic Medical Equipment, Associated Accessories and Consumables framework. The agreement provides a compliant purchasing route for a wide range of robotic surgical equipment for NHS hospital trusts across England in two surgical settings: minimally invasive surgery; and spinal and neurological surgery.

The robotic systems within the minimally invasive surgical setting can be used to perform prostate removal, hysterectomies, thyroid cancer removal, gastric bypass and a variety of other surgical procedures. Benefits for using robotics in surgery include reduced reported postoperative pain, faster recovery time, reduced risk of infection, adhesion formation and postoperative hernias and better cosmetic results for patients, and for customers more effective use of NHS resources and savings for hospitals due to shorter stays. It also provides a safer working position for the surgeon, who controls the movements of multiple robotic arms from a console. The framework also runs for two years with the option to extend for up to a further two years. It is designed to save the NHS time and resource and increase product availability in an innovative and fast-growing market. It includes seven specialist UK, US and Germany-based suppliers which manufacture bespoke robots, with four suppliers producing robots for minimally invasive surgery and another three companies supplying robots for use in spinal and neurological surgery.

Chris Holmes, Director of Supply Chain said: “This is a first for NHS Supply Chain. The framework is an exciting new development as it encourages the innovative use of technology in surgery in the NHS which has benefits for both patients and hospitals. It also gives trusts more choice of suppliers in a growing market.” The Newcastle Upon Tyne Hospitals NHS Foundation Trust has regularly used robotics in surgery, with the clinical team led by Professor Naeem Soomro, Consultant Urologist, Head of Robotic Surgery working in partnership with their procurement team. Owen O’Reilly, their Procurement Manager said: “Robotics in surgery has enabled our trust to adopt robotic surgery widely across no less than eight surgical specialities including colorectal surgery, urology, gynaecology, thoracic, head and neck, hepatobiliary, upper gastrointestinal and knee arthroplasty. “The use of robots has meant more patients receiving minimal invasive surgery, resulting in patients getting the best surgical care with reduced lengths of stay in hospital, cutting complications and the number of readmissions. It has also led to overall E

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 conditions and example specifications developed for and by NHS Supply Chain specifically for this Framework; and fully auditable CRM solution for central storage of all communications issued throughout the process. Phil Scott, NHS Supply Chain’s Trading Manager – Maintenance and Services, said: “Medical IT systems are essential to the NHS digital transformation as every hospital requires a way to store, manage and share vital patient data across each site, region and even nation. “Our updated and improved Medical IT framework aligns to the national NHS Digital strategy. It enables us to provide individually tailored support to acute trusts in procuring a range of cross department digital solutions and supporting hardware from a range of leading technology suppliers, in a rapidly evolving landscape. Our framework solutions are cutting edge and centralise data within trusts, making internal processes more efficient – saving time and duplication of efforts.”

Medical IT systems are essential to the NHS digital transformation as every hospital requires a way to store, manage and share vital patient data across each site, region and even nation.



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 cost savings. Another benefit is it encourages our trust to focus on training future surgical workforce teams who are competent and confident in delivery of robotic surgery across multiple specialities.” Case study: South Tyneside and Sunderland NHS Foundation Trust NHS Supply Chain has worked in partnership with South Tyneside and Sunderland NHS Foundation Trust to help them save more than £450,000 annually after a change of supplier for hip and knee products for orthopaedic surgery. Having merged in 2019, City Hospitals Sunderland NHS Foundation Trust and South Tyneside NHS Foundation Trust decided to undertake the orthopaedic project together with support from NHS Supply Chain category manager and clinical engagement and implementation manager. This enabled them to move to one orthopaedic provider for their hips and knees as soon as they had merged to achieve the best value for the products across both sites. Orthopaedic clinicians led the decision on the new hip and knee providers. As a result, South Tyneside and Sunderland NHS Foundation Trust saved £458,060 against a previous annual spend of £1,509,396 – a saving of 30 per cent. They achieved the savings by going from seven different suppliers to one and rationalising the product range for surgeons. Emmi Mitrunen, a Category Manager specialising in orthopaedics at NHS

Supply Chain, said: “It was very important that the product alternatives were clinically acceptable across both hospital sites. We offered access to a breadth of products and the ability to continue close working relationships with suppliers whilst remaining compliant.” NHS Supply Chain NHS Supply Chain manages the sourcing, delivery and supply of healthcare products, services and food for NHS trusts and healthcare organisations across England and Wales. Managing more than 4.5 million

orders per year, across 94,000 order points and 15,000 locations, NHS Supply Chain systems consolidate orders from over 800 suppliers, saving trusts time and money and removing duplication of overlapping contracts. Its aim is to leverage the buying power of the NHS to negotiate the best deals from suppliers and deliver savings of £2.4 billion back into NHS frontline services by the end of the financial year 2022/23. L FURTHER INFORMATION

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