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ISSUE 21.4 www.healthbusinessuk.net

TECHNOLOGY

CLEANING

ICSs

CYBER SECURITY

CYBER FRAUD & THE NHS What are the key cyber threats that NHS organisations should be wary of?

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Comment

ISSUE 21.4 www.healthbusinessuk.net

TECHNOLOGY

CLEANING

ICSs

CYBER SECURITY

CYBER FRAUD & THE NHS What are the key cyber threats that NHS organisations should be wary of?

WE SCAN THE MOST DIFFICULT MEDICAL RECORDS, LET US SHOW YOU visit www.digitiseyourdocuments.co.uk

PLUS: FACILITIES MANAGEMENT | PROPERTY SERVICES | STAFF WELL-BEING

Welcome news on NHS England chief executive At the end of last month, Amanda Pritchard was appointed as the new chief executive officer of NHS England, becoming the first woman in the health service’s history to hold the post. She was, without doubt, the strongest and most appropriate candidate for the job but has big shoes to fill. Sir Simon Stevens held the role for just over seven years, steering the health service through the heights of its 70th anniversary and securing record funding, as well as the challenges of Brexit and the coronavirus pandemic. Upon his knighthood last year, the citation recognised how administrations across the political field ‘have all turned to him to fundamentally shape the health service’s strategic direction for the better’. As a former Chief Operating Officer of NHS England and chief executive of NHS Improvement, Pritchard is well placed to continue the momentum of Steven’s successes. Much of the success is dependent upon how well the health service starts to tackle the backlogs that have built up in the face of rising coronavirus infections, especially if this winter makes that job more difficult than first envisioned.

Follow and interact with us on Twitter: @HealthBusiness_

All at Health Business thank Sir Simon for this work and wish Amanda all the best moving forward. Michael Lyons, editor

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www.healthbusinessuk.net PUBLISHED BY PUBLIC SECTOR INFORMATION LIMITED

226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Web: www.psi-media.co.uk EDITOR Michael Lyons PRODUCTION MANAGER/DESIGNER Dan Kanolik PRODUCTION CONTROL Lucy Maynard WEBSITE PRODUCTION & ADMINISTRATION Victoria Casey SALES SUPERVISOR Damian Emmins ADVERTISEMENT SALES Azad Miah, Maziar Movassagh PUBLISHER Karen Hopps

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Advertisement Feature

Paraid launches their first powered transfer chair Paraid understands that acute care environments are highly complex and can require an individually tailored transportation solution

Paraid has launched a new 24V, LithiumIon battery operated, motorised transfer chair, to further complement its wide range of products. The IBEX Power is designed for one-person operation, its Powered Belt Track System reduces manual handling and facilitates a smooth, safe and quick method of upward or downward patient transfer. One full battery charge provides enough power to last for 150 flights of stairs, providing plenty of operational time. The IBEX Power has an easy-to-use control pad enabling the user to control the speed and direction (whether that be upward or downward) of the transfer. The head support, arm and foot rests provide additional support and comfort to the patient and with a payload capacity of 160kg (25 stone); the IBEX Power can accommodate a wide range of patients with ease. Quick, compact and easy to operate, it is designed to safely and effortlessly move patients up and down stairs in hospitals, care homes and ambulances.

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With over 35 years of UK design and manufacturing experience, Paraid is the recognised global leader of innovative neonatal, paediatric and adult critical care transportation equipment. Paraid understands that many transfer situations are extremely challenging and aim to deliver solutions that protect both patients and clinicians, during this critical stage of patient care. The Paraid product range includes the highly-acclaimed ACR (Ambulance Child Restraint) - the widest age and weight range paediatric harness in the world, the NeoRestraint which helps reduce movement of a neonate during transfer and a range of critical care trolleys. Paraid offers a bespoke design service enabling medical teams to work directly with their R&D specialists, to design products that meet their precise requirements. The team will take a brief and then applying their skills, experience and knowledge, will design a solution that meets the medical team’s exact needs. Using the latest 3D CAD design software and rapid-prototyping technologies, a prototype will be produced which can be tested and signed off ahead of production, ensuring that the final product provides the optimum transfer solution. Operating to the highest standards, all Paraid products are subject to a wide range of quality checks throughout the entire manufacturing process, which includes a comprehensive quality management system to control all procedures and processes; ISO 9001 for Quality Management standards and ISO 13485 for Medical Device Quality Management. Adhering to these standards provides complete peace of mind, that every product is manufactured using the highest quality components and processes and will meet the demands of any medical environment. In 2020 the company moved to a new state of the art head office in the heart of the UK. The 38,223 sq. ft purpose-built site has allowed the manufacturer to continue to grow and develop its world-leading products.

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Paraid provides nationwide UK coverage for training, maintenance and servicing providing customers with the reassurance, that their IBEX Power will be fully supported throughout its lifetime. It is recommended that all operators carry out training to ensure they are competent and confident in deploying and using the chair. Paraid offers two training courses; the Operator Training Course and the Key Trainer Masterclass. The Operator Training Course provides practical training on how to correctly use and deploy an IBEX Power. The Key Trainer Masterclass, known as ‘Train the Trainer’ provides knowledge for key members of a team to train others. On completion of both courses, all delegates that meet the training standards are certified and deemed competent. As outlined in the PUWER Regulation – Provision and Use of Work Equipment Regulations 1988, it is recommended that an IBEX Power should be regularly serviced and maintained to ensure its safe operation. To assist in meeting this legal requirement, Paraid offer 12-month, three- and five-year maintenance contracts. Power your patient transfers with the Paraid IBEX Power. L To book your FREE product demonstration or to find out more, please contact Paraid FURTHER INFORMATION Tel: +44 (0) 121 700 7455 www.paraid.com info@paraid.com


Contents

Contents Health Business 21.4 07 News

41 Property services

Patients are waiting more than three months for tests; NHScampaign to highlight importance of cancer checks; and new proposals to strengthen medical devices regulation

Kate Richardson, head of National Office Programme at NHS Property Services, discusses the organisation’s smarter working policy which allows staff more flexibility to choose where they wish to work

13 Technology 21 41

Given the pace of change in the technology sector, Dr Philip Scott discusses how technology is radically changing the way the NHS provides services

17 Technology Lorna Green describes the role of the Innovation Agency and the AHSN Network across England and how health innovation is increasingly becoming integral to resolving the long-term challenges faced by the NHS

21 Cyber security

60

57

Delia Cannings looks at how the profile of hygiene importance has been raised to a new level that must be maintained moving beyond Covid-19

51 Infection Prevention There’s not long to go until the Infection Prevention Society’s annual conference, Infection Prevention 2021, which is taking place on the 27–29 September at the ACC in Liverpool and online

57 Infection prevention

The NHS Counter Fraud Authority look at the cyber fraud awareness resource, launched at the end of March, as well as the key cyber threats NHS organisations should be wary of

A novel microwave sterilisation method that could revolutionise the way ambulances 
and hospitals are disinfected has been created by a number of Scottish universities

30 Staff well-being

Rethinking waste as a valuable by-product is vital to meeting sustainability targets across healthcare systems, writes David Rakowski, a sustainability expert at PA Consulting

Danny Mortimer, chief executive of NHS Employers and deputy chief executive of the NHS Confederation, looks at well-being support options for hospital staff, who continue to fight Covid-19 on the frontline

32 Expert Panel: facilities management Following an 18 months unlike any other, Health Business talks to Donna Brown about hygiene standards, sustainable healthcare, hospital food and fully integrated multi-service provision

38 Decision-making

63

47 Cleaning

The experts at PA Consulting look at how placing elected local government representatives at the heart of NHS integrated care systems could unlock their full potential

Health Business magazine

60 Waste

63 Design & build The Royal College of Physicians has published a report outlining how new hospitals should be designed and planned to improve patient pathways and staff well-being

67 Building compliance The Building Safety & Compliance Framework is worth up to £880 million over a four-year period. Here we look at the agreement in further detail as well as the latest news affecting the building safety sector

76 G-Cloud Romy Hughes, director at Brightman, outlines some of the reasons why the public sector still shuns the G-Cloud and other frameworks

www.healthbusinessuk.net Issue 21.4 | HEALTH BUSINESS MAGAZINE

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News

WAITING TIMES

Patients are waiting more than three months for tests

NHS patients are waiting more than three months for tests, with overall waiting lists doubling in some parts of England. The overall waiting list for tests in June was 1.4 million patients, an increase of 28 per cent compared with June 2019.

The data suggests that the number of people waiting more than three months for tests was 22 times that in 2019 as the health system continues to tackle the pandemic backlog. Almost 124,000 people were kept waiting more than three months in 2021, compared with 5,675 in 2019. NHS England’s constitution states that people referred to hospital for tests are supposed to be treated within six weeks. However, more than 306,000 people were waiting more than six weeks for a range of diagnostic tests. This is 7.6 times the equivalent figure in the same month in 2019, but lower than in June 2020

SAFETY

WAITING LISTS

Warning over potential roof collapses at hospitals NHS England hospitals have sounded the alarm over materials used in roofs that reached the end of their lifespan more than a decade ago. Several hospitals are warning of the potential for roof collapses due to structural weaknesses in the reinforced concrete planks used in their construction between the 1960s and 1980s, which have a 30-year lifespan. According to reports, North West Anglia NHS foundation trust wrote in its annual plan that the poor condition of the main theatres in Hinchingbrooke hospital in Huntingdon, Cambridgeshire, posed a significant risk to elective care. Published in June, the plan said that the hospital had been forced to restrict the use of some theatres to patients weighing less than 120kg. Since the report, more structural surveys have been undertaken and the hospital is able to use just one of its seven operating theatres for patients weighing more than 120kg. The hospital said it had received £13m this year to cover the costs of surveys and repairs. Leaked reports to the BBC show that West Suffolk hospital, which has a similar design to Hinchingbrooke, had hired a law firm to investigate the potential for corporate manslaughter charges in the event of a fatal roof collapse, while hospital trusts in eastern England had produced an emergency plan outlining what would happen in the event of ‘significant hospital structural failure’. An initial risk assessment that warned of an ‘almost certain’ plank collapse, which would have ‘catastrophic’ consequences. The risk level has since been downgraded to ‘likely’ in response to West Suffolk launching a multimillion-pound safety works programme, though it is understood this will not be completed until spring 2023. READ MORE

when 539,433 people were waiting six weeks or more. More than half of all patients waiting more than six weeks across England require one of three tests: non-pregnancy related ultrasounds, ‘echo’ scans – used to detect potential heart failure and congenital heart disease – or MRIs. A total of 10 acute trusts reported that their diagnostic waiting lists had more than doubled when compared with the same month in 2019, with some waiting lists rising far more dramatically. READ MORE

Waiting lists will continue to grow without investment

The Royal College of Surgeons of England has warned a ‘volatile mix’ of pressures is affecting the recovery of surgery, with further government investment needed. Latest figures show the NHS waiting list has now hit 5.45 million, the highest number since records began, and commentators warn this could double in a year, if action is not taken. The figures show that 5,727 patients have been waiting more than two years for treatment, a 46 per cent increase on the previous month. The longest waits are patients waiting for hip and knee replacements, gallbladder removals and hernia operations. Some may be unable to work, or carry out day-to-day tasks while they wait for their operation. Neil Mortensen, President of the Royal College of Surgeons of England said: “The summer is traditionally a quieter time for

the NHS, so surgeons had hoped we could catch up on the huge backlog of operations postponed because of Covid-19. However, this summer, the pressure on emergency departments hasn’t let up. A volatile mix of pressures is hindering the surgical recovery. “With more than 5,000 people in hospital with Covid-19, there is still too much pressure on hospital beds, because these patients must be kept separate and distanced from others. Along with staff shortages caused by the app pinging people, it’s been incredibly difficult for some places to get back to pre-pandemic levels of operating. Areas with surgical hubs have fared better, so we need more investment in this model, and in the staff to support it”. READ MORE

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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A part of

The UK's most widely used medicines management solution Medications form a part of almost every care setting, making an integrated Medicines Management platform a vital tool. The CareFlow Medicines Management (formerly WellSky International) system is a closed loop platform, covering Electronic Prescribing, Pharmacy and medicines Administration, that works across a wide range of care settings

including acute, mental health and community - providing an ‘ICS ready’ solution. Our intuitive system includes functionality such as simple and complex infusions, chemotherapy and controlled drugs across a variety of settings including critical care. Read about CareFlow Medicines Management and our solutions here: www.careflowmm.com

CareFlowMM.com • contact@careflowmm.com • +44 (0) 1268 416348


News

CANCER

New campaign to highlight importance of cancer checks

NHS England chief executive Amanda Pritchard has encouraged people with potential cancer symptoms to come forward for lifesaving checks. Research shows that 60 per cent of people are concerned about burdening the NHS, with 49 per cent saying they would delay seeking medical advice compared to before the pandemic. Launching on 16 August, the next phase of the ‘Help Us, Help You’ campaign from NHS

England, with support from Public Health England, will use TV and digital adverts, posters and social media to raise awareness of symptoms of cancers in the abdominal area, urological cancers, and lung cancer. The ads will feature people with a range of symptoms, such as prolonged discomfort in the tummy area or a persistent cough, and aim to persuade people experiencing these to contact their GP. Around a quarter of a million people were checked for cancer in June, the second highest number on record, and treatment numbers have been back at usual levels since March. More than 27,000 people started treatment for cancer in June, a 42 per cent increase on the same time last year. Pritchard stressed that there could be tens of thousands more people who are not coming forward, either because they’re unaware of common cancer symptoms, or because they feel they would burden the NHS.

Despite abdominal and urological cancers accounting for nearly half (44 per cent) of all cancer diagnoses and two in five (41 per cent) cancer deaths in England, new figures from the NHS show that many people are unaware of common warning signs – which could prevent them seeking help. Three in five people said they didn’t recognise discomfort in the abdominal area for three weeks or more as an indication of cancer. Alongside abdominal and urological cancers, the campaign will also highlight common signs of lung cancer – after research has found that two in five people don’t recognise that a persistent cough for more than three weeks as a sign of the disease. There is also concern the symptom could easily be confused with Covid-19. READ MORE

EATING DISORDERS

Treatment for eating disorders reaches new heights A record number of children and young people with a potentially life-threatening eating disorder are waiting for treatment. The Royal College of Psychiatrists has analysed NHS data and reported that while the number of those waiting for urgent and routine treatment has reached record levels during the pandemic, more children and young people are being treated than ever before. The analysis found that there were 207 patients waiting for urgent treatment at the end of the first quarter of 2021, up from 56 at the same time last year. A further 1,832 patients were waiting for routine treatment, up from 441 at the same time last year. And

852 patients received urgent treatment, compared to 328 in the first quarter of 2020/21. An estimated 1.25 million people have an eating disorder in the UK and they can be complex and life-threatening mental illnesses. Disordered eating behaviours include limiting food consumption, eating large amounts of food, purging, fasting or excessive exercise in response to eating, or a combination of these. Agnes Ayton, chair of the Faculty of Eating Disorders Psychiatry, at the Royal College of Psychiatrists, said that the pandemic has disrupted children’s lives and many young people have been unable to seek help for an

eating disorder early enough, meaning their condition deteriorated. READ MORE

DIABETES

1,600 children now living with type 2 diabetes A new NHS Digital report has revealed that nearly 16,00 children and young people in England are now living with type 2 diabetes. The Young People with Type 2 Diabetes Report, published today by NHS digital, reveals that 1,560 children and young people (18 and under) in England have been diagnosed with type 2 diabetes. Though other factors such as ethnicity play an important role, obesity and overweight is thought to be behind the rising number of children with the condition. Labelled ‘an alarming wakeup call’ by Diabetes UK, the research also indicated that only 30 per cent of children who live with the condition are receiving the care they need to live well with diabetes. When people

don’t get the care they need, it can lead to serious complications. Getting the right care is vital for everyone who lives with diabetes, but it’s particularly important for those diagnosed under 18.

Diabetes UK says that the NHS, NICE (National Institute for Health and Care Excellence) and the government all have a role to play in tackling the crisis and is calling for: the NHS to prioritise developing specialist services designed to support children and young people living with type 2 diabetes; NICE to review and reinforce their guidelines and make sure they explain clearly that children living with type 2 diabetes must receive the same level of specialist care that children with type 1 receive; and for the government to work harder to tackle childhood obesity. READ MORE

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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HEALTHCARE COMMUNICATIONS SOLUTIONS Austco’s Tacera is an IP-based nurse call system and advanced communications platform that can be tailored to meet the needs of any healthcare facility.

SOPHISTICATED NURSE CALL SYSTEM WITH, ENTERPRISE REPORTING AND BUILT-IN RTLS Automatic Staff Presence

Automated Workflow

With dual-technology RTLS, the badges and call points interact wirelessly to record a presence event in a location.

Many processes can be initiated with auto-presence and auto-cancel.

Reporting

Automatic Call Cancellation

Location and button press data is stored for reporting, including room visits, response times, and time spent in rooms.

If there is an active call in a given location, Tacera can automatically cancel it when staff are detected there.

Staff, Resident, and Patient Visibility

Mobile Duress Austco badges are enabled with programmable buttons, and users can call for help, wherever they are.

Tacera lights dome light in rooms where staff are present - other staff know, at a glance where care team members are located.

For a demonstration at our facility or remotely, please call 01527877778 or email sales.uk@austco.com www.austco.com


News

MEDICAL DEVICES

New proposals to strengthen medical devices regulation

A new report sets out how the UK could strengthen the regulation of medical devices, learning lessons from the response to the coronavirus pandemic. The Regulatory Horizons Council, who published the report, is an independent expert

committee which identifies the regulation needed to foster technological innovation and provides government with impartial, expert advice on the regulatory reform required to support its rapid and safe introduction. Their new proposals set out how medical devices such as pacemakers or implantable defibrillators should be regulated to ensure we can tackle healthcare challenges effectively, now and in the future. The report identifies the UK’s departure from the European Union as an opportunity to build a UK-specific regulatory system that puts patients at the heart of decisionmaking processes, highlighting the opportunities now available to the UK,

not only to respond more quickly to new advances in technology, but to work with like-minded countries in shaping international regulation. The RHC also calls for lessons to be learnt from the UK’s pandemic response, including addressing delays in medical device approval so that equipment can be authorised effectively and at speed. It also recommends that pandemic preparedness should include fast-track evaluation of new in vitro diagnostics and that reporting of diagnostic tests be transparent and standardised. READ MORE

CLIMATE EMERGENCY

AMBULANCES

UCLH declares a climate and health emergency

Urgent support needed for ambulance service

University College London Hospitals is making a commitment to reduce its impact on the environment with a 10-point plan to reach net zero carbon dioxide emissions in 10 years. Declaring a climate and health emergency, the commitment builds on progress made since UCLH’s Green Plan was put in place in 2020. The plan has seen investment of more than £2.5 million in a programme to: install low energy LED lights; switch to sustainable electricity and recycled paper; reduce patient journeys by 50 per cent; reduce the use of the most harmful anaesthetic gas by 90 per cent; and engage staff to take part in climate action schemes. With support from Global Action Plan and Camden Council, UCLH is also working to improve air quality by holding workshops with staff to promote green travel, such as using public transport and walking or cycling rather than driving. More recent initiatives include a pedometer challenge and a bike user group to promote cycling. The 10-point plan commits UCLH to cutting energy emissions by 80 per cent by 2025. UCLH will achieve this by only using renewable electricity, having switched energy provider to sustainable company Haven Power. The

hospital is installing solar panels throughout it’s buildings, and has installed LED lights at five sites with more sites to follow in the coming months. The new lighting uses 70 per cent less energy than the current lights, meaning the organisation is already saving more than 1,200 tonnes of CO2 every year. Additionally, UCLH is cutting down the amount of plastics in use at the hospital, including encouraging patients and staff to stop using polystyrene cups and instead bring in reusable ones. Procurement will be focused on buying green, with all procurement to include a 10 per cent weighting to sustainability. UCLH’s service partner Mitie is supporting the vision to improve recycling by installing new equipment, changing their waste management contractor, increasing communication about correct waste streams and organising joint waste road shows. This has caused better recycling rates, with a dramatic increase of mixed recycling from 38 per cent to 49 per cent in three months last year. The organisation is on course to hit its current recycling target of 80 per cent by 2025. READ MORE

Shadow Health Minister Justin Madders has written to the Health Secretary calling for urgent help for the ambulance service, including drawing on support from the armed services if necessary. New figures published show that July 2021 was the first month where the Ambulance Services in England answered over a million calls. Response times hit their longest ever for all except the most urgent of calls. Labour’s Justin Madders highlighted examples from MPs across the country who had received emails from distressed constituents about their experiences. Over recent weeks MPs have received numerous emails about long waits for their calls to be answered, long waits for ambulances to arrive or concerns from staff themselves that the service is under pressure. Madders said: “NHS services are stretched to breaking point in the worst summer crisis on record leaving people waiting longer for help in pain and distress. Demand will only rise as we head towards Winter and the current pressures on the NHS are unsustainable. “I am asking you to urgently put in place additional support for ambulance services in England, including drawing on support from the armed services if necessary, to ensure they can give patients the very best care.”

READ MORE

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature Written by Keith Stagner, CEO & Chief Transformation Officer, T-Impact

High tech doesn’t mean high risk! Procuring existing solutions on proven technologies will deliver immediate benefits with minimal cost and low risk

Local councils are facing a tsunami of demand across all services, increasing pressure on already overstretched teams. Old service models won’t work, and agile innovation is required. Councils are identifying new ways to meet challenges, but implementation is fraught with obstacles. Getting the information to understand and define solutions is complicated by data quality issues and duplication, caused by manual data entry - resulting in poor services. Councils need practical solutions to close service capability gaps and Intelligent Automation is a key component. Chatbots, Robots and AI are already helping to improve customer experience and service quality, eliminate errors and improve data quality, free capacity and save money. It can help you too, read on and see some practical, affordable ways it can applied, along with a real-life case study from Durham County Council. Automating services We are working with numerous local authorities, delivering solutions for revenue & benefits, housing, customer care, parking, social care, HR, and finance. T-Impact’s solutions make best use of Chatbots, Robots & AI. Our sample Case Studies can be downloaded here. Examples of our projects include social care, debt recovery, rent increases, private

sector licence applications, gas certificate verification, asbestos reporting, accessible housing data, environmental protection, streamlining payment processing, cash allocation (debt collection via enforcement agencies), legal – managing customer documents and signatures, housing benefit claim and exchange and housing change of address. These solutions are low risk, delivering immediate value and providing the building blocks for significant service transformation. How much disruption will it cause? Not as much as you might think! These are practical, tried, and tested solutions which are usually designed and deployed within foureight weeks. Less time than you would need to recruit, train and performance manage temp staff. Our approach ensures minimal disruption for your operational and IT resources, usually only a few days of their time. We work with you to define the business case to secure stakeholder sponsorship and avoid costly mistakes. They don’t require any changes to your existing IT systems, adding new capabilities that often eliminate the need to replace them. Our solutions can help you overcome challenges and deliver results faster, with minimal risk and expense. Rent increase Automation Case study: Year-end is a challenging time for all Revenues and Benefits Services. To enable them to accurately update Housing Benefit accounts and issue notification letters with Council Tax Bills; accounts must reflect annual rent increases. Durham County Council’s Revenue and Benefits service receive

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

thousands of rent increases from their social landlords. The rent increases must be applied to their Housing Benefit records so that they can be factored into the annual billing process. The council wanted to improve the customer focus, ensuring a ‘right first time approach’, avoiding additional customer contact and subsequent notification letters once the accounts had been updated. The previous manual process was resource intensive, requiring a significant amount of manual intervention and quality control overhead. T-Impact worked with Durham’s team to implement a price increase solution using RPA (Robotic Process Automation), which automated the existing team’s work, which: monitors a dedicated e-mail account, extracting pricing increase spreadsheets; searches for passwords in other emails and if not provided, requests the password; validates the rental and services increase, improving consistency and accuracy; and updates the approved rates in the council’s finance systems. As a final step the robot generates personalised notifications to confirm outcomes. Based on the communication preferences defined in the council’s systems, letters are sent as email attachments or printed for posting. For an investment of approximately £30,000, the council was able to process each of the 10,000 housing increases within a few days of receipt, update rent amounts quickly, enabling recalculation at year end, produce accurate accounts and financial reports enabling year end reporting and forecasting, reduce operating costs, eliminated both agency staff and staff overtime and manage resources more effectively, creating capacity where needed. The solution has been successfully operational for several years and deployed by other councils, such as the London Borough of Hackney. T-Impact solutions We also provide solutions for healthcare, ERT and private sector clients (legal, banking, logistics, manufacturing). L FURTHER INFORMATION www.t-impact.com sales@t-impact.com


Technology

Radical change in health and care Given the pace of change in the technology sector, Dr Philip Scott discusses how technology is radically changing the way the NHS provides services The NHS is a beloved institution and its staff Supporting the triple aim always feature as the most trusted professions The high-level goal of quality improvement in – so why does it need radical change? Since health and care services is often characterised its inception in 1948, the NHS has faced everas the ‘triple aim’: (1) improving population increasing demand. Innovations in healthcare health, (2) reducing per capita costs and (3) mean that previously untreatable conditions improving the patient experience of care. can now be cured or prevented and now Digital technology has the potential to help in we are experiencing the ‘demographic timeeach of these. bomb’ of an ageing and unfit population. Reducing costs is one of the goals of largeThe NHS Long Term Plan calls out urgent scale pathology and radiology networks public health issues that add to the drain on – achieving economies of scale by centralising resources: obesity, alcohol abuse, smoking, services and sharing diagnostic test workload. antimicrobial resistance and air pollution. Likewise, the increased use of 111 (online or On top of all this, we have changes phone) to divert people away from in the workforce with declining unnecessary GP or emergency numbers of experienced department visits should general practitioners, have financial benefit Digital challenges in recruiting (though that is not yet techno and retaining staff, proven). Electronic health already logy has increasing numbers records have been used d o for hea ne much of people with by OpenSAFELY to l t hcare a has the multiple long-term achieve rapid low-cost n d potenti health conditions clinical research in the a f a l to do pandemic. r more. and no sustainable SMS text we are However, financial model for reminders are widely right social care. And then used to reduce healthcare cautiou to be we have a pandemic appointments being wasted s and the gigantic project by non-attendance. to get routine services back Improving population health to normal! How can digital is the aim of online guidance on technology support radical change nhs.uk and personal health apps for longfor the better? term conditions like diabetes or dementia.

Other apps exist to help people with repeat medications keep to their prescriptions, and innovative clinical decision support helps doctors to reduce overuse of antibiotics. Better patient experience is the purpose of the NHS App. It enables patients to access their primary care record, book appointments, request repeat prescriptions and give proof of their Covid vaccination status. An innovative technology that was very helpful in the pandemic was Oximetry@home, which enabled ‘virtual wards’ of people to be supported by hospital clinical teams while remaining in their own home. Innovation with artificial intelligence There are high expectations, not always realistic, of what artificial intelligence (AI) can do for healthcare. Numerous AI innovations have come to nothing, but in fairness that is inevitable for ground-breaking new technology. One aspect of the problem is that there is no single definition or taxonomy of ‘artificial intelligence’ that is universally accepted. Broadly speaking, AI includes rule-based systems, where human knowledge and expertise is hard-coded into software; natural language processing (NLP), where software extracts meaning from or generates text or speech; machine learning, where analytic techniques determine patterns of association in source data; and intelligent E Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Let’s do this

At GE Healthcare, our insights come from you. First we listen. Then we act. We value our place in your team and are committed to working together so that we can respond to your needs, now and in the future. Our unique digital solutions are transforming healthcare giving you the data you need – anytime and from anywhere – to make the best decisions for your teams and for your patients. Let’s keep talking because together we can achieve amazing things.

#collaboratedigitisetransform

Collaborate. Digitise. Transform


Professional leadership and citizen co-design The Topol review addressed the overall workforce need for appropriate skills in the digital delivery of healthcare and the new NHSX data strategy highlights the need for greater capacity in analytics and data science. BCS is working with partner bodies in the Federation for Informatics Professionals to lead professionalization across the whole

The high-level goal of quality improvement in health and care services is often characterised as the ‘triple aim’: (1) improving population health, (2) reducing per capita costs and (3) improving the patient experience of care informatics workforce, and across government departments to support the emergent Digital, Data and Technology Profession (DDAT). Patient and public involvement is crucial. Patients often still have poor experience of healthcare communication, but there are outstanding exemplars such as the Connected Health Cities programme that demonstrated what can be done in extensive patient and public involvement to build trust in data and technology. Citizen co-design is vital for two intertwined reasons. Firstly, general health outcomes are largely determined by social factors. Secondly, there is a ‘digital divide’ in the population that is also related to literacy, housing insecurity, cultural factors, economic status generally and broadband cost specifically. A recent BBC report demonstrated the impact of this in the UK pandemic response. If social determinants are not sufficiently addressed, the digital divide will worsen and the population that most needs improved health will miss out on the benefits of modern technology. Conclusions Digital technology has already done much for healthcare and has the potential to do far more. However, we are right to be cautious.

Technology

 automation, where software or devices act autonomously to trigger or stop some action(s) based on some kind of monitoring or input data. Examples of rule-based AI in healthcare are risk calculators, drug interaction alerts and symptom checkers in patient-facing apps. NLP is put into practice in applications such as voice recognition from digital dictation, chatbots and voice-activated searches like finding the patient’s latest diagnostic reports. Machine learning has been used to build predictive models, such as identifying deteriorating patients from vital signs observations. Another application is diagnostic image analysis, for instance aiming to provide early detection of cancer. In the future, machine learning may support adaptive clinical decision support, where standard treatment guidelines are tailored for the individual patient based on their specific history and medications. Intelligent automation is implemented in so-called ‘robotic process automation’ (RPA), which is often automated transcription from one software application to another to obviate human re-keying of data (when proper data interfacing is not an option). Other forms of automation are smart infusion pumps, predicting demand (for staff, supplies or beds) and waiting list prioritisation.

Technology is not magic. Startup costs are often high and the evidence of effectiveness is usually weak. By all means let us innovate, but we must also evaluate. It is often difficult to know whether a healthcare quality improvement initiative is working or not. Electronic health records are helping to make it practicable to conduct rapid A/B testing and stop ineffective programmes early, as demonstrated by New York University Langone Health. The NHS and social care still have a long way to go in laying solid technology foundations like adequate infrastructure and universally adopted data standards. Health and care are the poor relations in comparison to the level of investment in IT infrastructure in other sectors. Until we get these basics right, we will struggle to realise the possibilities of more advanced capabilities and achieve the radical system change that we need. L

Dr Philip Scott is chair of BCS Health & Care and Reader in Health Informatics at the University of Portsmouth’s School of Computing. FURTHER INFORMATION http://www.bcs.org/health

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Trust saves £500,000 not buying new desktops Pennine Acute Hospitals NHS Trust invests £5 million to upgrade IT infrastructure, refreshing its EUC estate using IGEL

Pennine Acute Hospitals NHS Trust has updated its end-user computing (EUC) environment, implementing IGEL OS and UD3 endpoints throughout the organisation. This is part of a £5 million investment the trust is making to replace and refresh its entire IT infrastructure including compute, storage, WAN/LAN network and thin client platforms. This significant upgrade project is putting in place modern, class-leading technology to support the Trust, provide high quality clinical care and services for around 820,000 local residents. Located in the Northeast of Manchester, Pennine Acute Hospitals employs 10,000 staff and operates four hospitals: Fairfield General Hospital, North Manchester General Hospital, Royal Oldham Hospital and Rochdale Infirmary. As part of the overall project, the necessity to change the EUC platform was pressing. Pennine Acute Hospital’s existing thin client solution was already a decade old, over 2,000 hardware devices were end-oflife and no longer supported; and it had a requirement to expand the use of virtual desktop infrastructure (VDI) and thin clients across the organisation. To complicate matters, the devices couldn’t be centrally or easily controlled because the server-based management software was not up-to-date. Jav Yaqub, the trust’s head of infrastructure, explains: “The upshot was we were consuming a huge amount of time trying to maintain and run our thin client desktops, with major platform mismatches hindering our ability to roll out new operating systems like Windows 10 or deploy Office 365, which was crucial as NHS Digital has mandated that Windows 7 be removed from all desktops. ”

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After a successful trial, IGEL was selected for the new EUC solution. In tandem, the Trust updated its entire compute systems in its datacentre installing a Dell EMC VxRail hyperconverged infrastructure platform as well as Dell EMC network attached Isilon, Data Domain and ECS storage. The new VxRail compute platform is also used to host VMware Horizon – the Trust’s VDI solution – with 3,000 IGEL OS licenses and 500 new IGEL UD3 endpoints purchased, along with IGEL’s management software, the Universal Management Suite (UMS). IGEL Cloud Gateway was acquired to centrally manage endpoints not on the corporate network. Furthermore, NVIDIA virtual GPU technology is being trailed within the VxRail environment to share graphics power and capability across the VDI estate. The move to IGEL OS and UD3 thin client endpoints is already delivering substantial benefits: Budget saved £500,000 has been saved as the trust has avoided buying 2,000 new thin client devices for the organisation. Despite being told they were end-of-life, many of the old endpoints from the previous incumbent supplier have been recycled - converted using the IGEL OS into centrally controlled devices. Reliability improved Most thin client devices at the trust are used at workstations in hospital wards and on 100 laptop trollies which nurses and other health professionals use in various clinical settings. IGEL OS has improved the reliability and performance of these trolly machines given that IGEL OS is much ‘lighter’ - at 1GB – rather than the Windows OS which is typically 16 GB. Implementation simple Roll out was easy and fast with the trust supported by third-party consultants who helped install IGEL OS and convert devices – a re-flashing process which took just minutes. Management straightforward Using IGEL’s UMS makes the day-today management of the whole estate

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

of 2,000 thin clients located across four geographically dispersed hospital sites really straightforward. Just one person now handles this for the whole organisation as part of their overall job role. The local care ecosystem joined up The trust has also connected five local community care providers to its VDI environment. They use an IGEL-OS powered endpoint to view its electronic patient records system. Partners access the EPR via VMware Horizon – with IGEL Cloud Gateway used to manage remote devices - so that patient care is available anywhere across the local community. Remote work capability The trust has ramped up remote access capability to empower staff to work from home during the Coronavirus pandemic. Prior to Covid-19, 600-700 staff did so but this was increased to 3,000 in just three weeks. Staff login to their VDI session via a browser which takes them to their trustbranded Windows 10 desktop. Yaqub says: “The infrastructure update project has been hard work. We’ve done about four years work in just two with staff now commenting that they’ve seen big improvements in system performance, speed, flexibility and the IT teams’ ability to deliver. This makes all the graft worthwhile and rewarding, and IGEL has played an important part in enabling this.” Moving forward, Pennine Acute Trust will use IGEL OS to convert more desktop devices in other departments like estates and finance into locked down, centrally controlled and secure endpoints. Simon Townsend, IGEL’s chief marketing officer said: “Ultimately technology in the health service is all about delivering better patient care. As an IT provider, we have our part to play in this so that clinicians and other health professionals have high performance, reliable desktop solutions offering them the very best user experience. That’s what the IGEL OS running on any endpoint hardware is designed to do.” L FURTHER INFORMATION www.igel.com


Technology

Making health tech adoption a little easier Lorna Green describes the role of the Innovation Agency and the AHSN Network across England and how health innovation is increasingly becoming integral to resolving the longterm challenges faced by the NHS The squeeze on healthcare systems had that combine to offer industry and the third been evident long before the Covid-19 crisis sector a route into the NHS and social care. emerged. Driven by long term demographic The NHS is a complicated organisation, where trends, such as increased lifespans, health regional needs and national specialist services systems around the world have been challenged combine. Despite the NHS being the largest to address the most effective way to manage employer in Europe and being responsible for well-being in an increasingly ageing population. the wellbeing of more than 60 million people, Maintaining the status quo was never a viable there are no centralised budgets and it is not option. With an increasing proportion of a top down organisation. For this reason, the the population living longer into retirement, AHSN Network was established in 2013 to help innovation is critical to the development of a business and academia more quickly access the healthcare system fit for the challenges of the right people to showcase innovation to.” 21st Century. However, innovation in medical Lorna cites the collaboration between AHSNs systems is difficult. Health systems rely on in their different regions as a key value of the tried and trusted treatments, often developed network. She comments: “A critical part of over decades, to ensure no harm comes from what we do is knowing how other parts of the medical intervention. Changing established network are innovating. While it makes sense practices takes persistence and patience. for regional businesses first to engage with the Recognising this, the NHS has taken steps AHSN in their region, it is entirely possible that to make it simpler for health innovation to we will be able to connect you with another part be adopted. A central element is the creation of the network that is focussed on the particular of 15 Academic Health Science skillset a company might be able to Networks (AHSNs). As the bring to healthcare. This can help primary network of regional speed up the process of national Health bodies that connect adoption of innovation.” systems NHS and academic organisations, local A longer journey tried an rely on d authorities, the third Traditionally businesses t r u s t t reatme ed sector and industry, might consider clinical n ts, develop the AHSN Network approval from regulatory ed over often is a catalyst to create body NICE as the decade to ensu s r , e the right conditions critical milestone on n o c harm omes fr for change across the adoption journey. om the entire health and However, as Lorna points interven medical social care economies, out, this is often just one tion with a clear focus on moment in time. “Critical improving outcomes for though it is, NICE adoption does patients. Although the AHSNs not mean instant mass adoption are small organisations they are across the NHS. The process is more tasked with leading large regional networks that nuanced than this and involves NICE approval deliver impact to bring people, resources and as a first step along a route to wider adoption organisations together quickly, delivering benefits across the country. But there are still further that could not be achieved alone. issues to consider.” Even where something seems relatively straight A critical role in innovation forward – for example replacing one treatment Lorna Green is Director of Enterprise and Growth option with another like for like, it is rarely simple. for the Innovation Agency, the AHSN in the North West Coast of England. Following a successful clinical career in the NHS, Lorna worked in a variety of medtech businesses and a seed fund before joining the Innovation Agency shortly after it was launched in 2013. She is a champion of the transformational impact of innovation on healthcare systems and facilitates bringing the right parties together to deliver health innovation that drives positive patient outcomes. Describing her role, Lorna emphasises the importance of acting as a conduit for innovation adoption: “The AHSNs are regional organisations

Innovators need to consider proving not only a clinical case but an economic and practical one; training busy staff in new procedures – including shifts across a 24 hour working period – and being patient in terms of adoption timescales, which can often take several years. Innovation adoption: Examples of good practice Despite the need for this longer-term approach, Lorna is quick to demonstrate examples where innovation has been fast tracked by the AHSN Network. One example from her own region is Inovus Medical - a multi award winning designer and manufacturer of surgical training technologies, based in St Helens. The company was founded by two students in 2012 who realised that there was a more affordable way to produce technology that could help medical students train for surgery before operating on patients. The company has a clear purpose, to improve surgical care through connected training and the AHSN Network helped the company move to wider adoption across the NHS, supporting the company to secure funding, and providing access to the right connections for showcasing the company’s innovation within the wider NHS. Another example of innovation adoption is early detection of pressure induced ulcers. Bruin Biometric is using a Sub Epidermal Moisture portable hand-held scanning device, called Provizio® SEM Scanner, to detect changes under the skin that suggest the early onset of pressure damage that could later lead to ulcers. This is a particularly important early warning system because most pressure sores do not heal easily and require regular treatment in a patient’s home via nursing staff. This, in turn, is an expensive way to maintain someone’s health in comparison to being able to take preventative measures at the outset of the problem. Lorna pointed out the importance of championing innovation that can help shift health practice from maintenance to prevention via early intervention. “So much of what the NHS does has historically been fixing people who are unwell, but if we are able to identify early warning health signals, the NHS can avoid some of the expensive process of maintaining well-being. This is better for the health service and for the individual.” One of the recent MedTech success stories is Sky Medical Technology’s geko™ device. This wearable, watch-sized, medical technology device attaches to the leg, using electricity to stimulate nerves and in-turn muscle contraction, creating blood flow equal to 60 per cent of walking without the wearer having to move. It is painless to wear and has been proven to reduce the E Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Best practice in driving adoption Lorna is increasingly aware of what she describes as ‘grown up conversations’ happening to facilitate risk and cost share between private corporations and health services. She comments: “This can be difficult to implement but there is certainly movement in this direction. As more venture capital is attracted to life sciences, so new business models are beginning to emerge. I am encouraged by the patience that VC money demonstrates in many cases. Whereas

From early intervention and diagnosis to managing data to deliver best practice universally, I believe AI will transform healthcare systems traditional technology entrepreneurs tend to look for a fast exit, life sciences specialists understand that the route to adoption may take longer but can also be more rewarding.” Overall her advice to businesses looking to drive wider adoption within healthcare services is to be patient but persistent. “Historically the NHS sometimes found it difficult to articulate its requirements but this is much better now. Innovation is being supported not only by the AHSN Network, but also with programmes the network supports such as the NHS Innovation Accelerator (that supports uptake and spread of promising, impactful innovations); the NHS Accelerated Access Collaborative, which brings together industry, government, regulators, patients and the NHS to remove barriers and accelerate the introduction of ground-breaking new treatments and diagnostics that can transform care; and the Small Business Research Initiative (SBRI) - which enables the NHS to access innovations that solve unmet needs.” “Businesses need to access as much support as they can – starting first with the local AHSN contact, and then listen, learn and adapt to reflect feedback. Fortunately, there is an increasing number of businesses that have

Technology

 incidence of blood clots for patients undergoing medical procedures in hospital. Lorna has worked with Sky Medical to help extend the reach of the company beyond the hospital. Lorna says: “The interesting thing about Sky Medical is that it is one device that can apply to multiple significant medical issues. Electrical stimulation of the leg to generate additional blood flow can not only help with reducing the risk of blood clots developing in a hospital environment but also help reduce swelling in pre and post-operative patients. “Outside of the hospital environment it could also help heal difficult conditions such as wounds or leg ulcers, again potentially reducing the cost of treatment while at the same time delivering better outcomes for patients. This kind of innovation can be transformative to health systems since it reduces cost as well as improving patient well-being and is exactly the kind of innovation the AHSN Network can help to champion widely once the benefits are evidenced.”

broken through and are typically willing and able to help others do the same.” A future powered by AI Asked about innovation that most excites her, Lorna cites the potentially transformative impact of Artificial Intelligence (AI). She said: “From early intervention and diagnosis to managing data to deliver best practice universally I believe AI will transform healthcare systems. Recently NHSx (the UK unit with responsibility for setting national policy and developing best practice for technology, digital and data) launched The Artificial Intelligence in Health and Care Award which is extremely exciting and provides funding and support for promising AI technologies. Bringing this innovation through the system will make a material difference to the future of healthcare for decades.” L

Lorna Green is Director of Enterprise and Growth at Innovation Agency - part of the AHSN Network. FURTHER INFORMATION www.innovationagencynwc.nhs.uk

Digital healthcare designed with latest technologies Designed and built with NHS practitioners using Microsoft’s latest technologies, 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. With a proven track record of project success and expertise working with the NHS over 20 years, providing cost effective and scalable solutions, tailored to meet individual requirements, its software suite is used in some 30 NHS organisations around the UK – delivering measurable benefits, helping to deliver paperless healthcare within 20 months. Tailored to suit your needs CCube’s suite of Electronic Document & Records Management (EDRM) products includes the following modules which can be tailored to suit your needs and expanded from departmental to hospital and trust-wide solutions: EDRM: scans, stores and views patient notes; Forms Recognition and indexing: automatically recognises, classifies, indexes, and presents the digital health record; Connect: pulls in patient data from third party systems as it is created; eForms: allows clinicians

to enter structured data in real-time; Workflow: configured to support standard operational processes; Portal & Web API: allows CCube to be integrated with third party applications; and Mobile: access to patient data and data entry using mobile tablet devices. Digitising records CCube Solutions help trusts and Health Boards alike digitise legacy patient medical records and make this information available to clinicians and other health professionals at the point of care. It supports the government’s drive that the NHS should be using technology to improve productivity, reduce costs and ultimately enhance patient care. Savings The CCube software suite currently holds and manages some 450 million documents containing over 52 billion pages for 32 million patients across 30 NHS organisations around the UK. Some of our NHS sites have been using the solution for over 18 years. Data on realisable benefits, from just three key sites, shows a collective saving of c.£35 million over 10 years.

Fast and Easy With Workflow and Electronic Forms, the solutions are designed to automate defined processes, including data entry, without any dependency on paper. The Microsoft technologies support use of mobile tablet devices for access and for data entry. Developed with the NHS and utilising an open, client/server architecture, the CCube suite is customisable, fast to deploy, easy to integrate, scalable, standards-based, feature rich and compliant with current legislation and data protection rules. The system supports full security controls, document retention & disposal, and comprehensive auditing. L FURTHER INFORMATION

info@ccubesolutions.com www.ccubesolutions.com

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Serving more sustainably in healthcare For medical institutions that need to update their equipment, MMD, the brand license partner for Philips monitors, offers the perfect displays to achieve more eco-friendly workstations

The health sector serves the UK – by protecting and improving the nation’s health and well-being. This mission includes providing the best possible healthcare for individuals – but these days, health professionals need to think further and include planetary health as well. Sustainability and greener tech have become more sought after across all industries and more and more public and private healthcare institutions are pulling the plug on their dated, energy wasting electronics in favour of more eco-friendly solutions. Ditching the energy hogs Sped up by the challenges of the pandemic, public and private institutions such as hospitals, health clinics and general practitioners are levelling up their digital infrastructure – which is the perfect opportunity to consider eco-friendly tech for the switch. Factors to keep an eye on are energy consumption of the products, production chains that focus on recyclable materials and packaging, and a longer lifespan of products to limit and reduce e-waste as much as possible. The greenest displays by Philips monitors For medical institutions that need to update their equipment, MMD, the brand license partner for Philips monitors, offers the perfect displays to achieve more eco-friendly workstations: the ‘greenest’ monitors from the Philips monitors portfolio, the 24” 242B1G and the 27” 272B1G. Both the 242B1G and 272B1G monitors employ a new backlight technology that

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consumes significantly less energy (8.6 W in according to the ambient light, delivering a ECO mode), while still maintaining constant comfortable and eye-friendly user experience brightness and vivid colours, certified with for the medical crew. The PVC/BFR free the new Energy Label Class C. Furthermore, housing and mercury free production also all plastic body parts, metal chassis parts suit a hospital installation perfectly. Thanks and packing materials are made from 100 to these features and more, both models are per cent recyclable materials, and up to 85 certified with EnergyStar 8.0 and EPEAT. per cent post-consumer recycled plastics are To further underline this green approach, used in the production. Philips monitors plants trees in Tanzania Especially in dual/triple monitor setups, in collaboration with ForestNation, a which improve users’ productivity and foundation that encourages natural and become more and more common in any sustainable reforestation. More than workplace, the total energy consumption 50.000 trees are to be planted in Tanzania’s of regular monitors might quickly add up. Usambara region, which experienced And when installed in institutions such as heavy deforestation in the past 15 years. hospitals with hundreds of workstations, By creating jobs in tree nurseries, planting the benefits in terms of carbon footprint sites and involving the local students in as well as energy costs can quickly the planting process, the campaign has a become significant. positive impact not only on the environment The greenest 24” 242B1G and the 27” but it is for the benefit of the local 272B1G are equipped with IPS panels to communities as well. deliver rich, accurate colours and wide The best time to make more sustainable viewing angles of 178°/178° to ensure decisions was yesterday – but the second best readability. Their 75 Hz refresh rate best time is now. For health institutions that also improves the visibility of moving are ready to take the green leap, Philips images. Thanks to their rich connectivity monitors offers the ideal technology for with VGA, DVI-D, DisplayPort and HDMI sustainably productivity. L Shield_RGB_2013 ports, the models can be used with both legacy PCs as well as modern PCs, laptops FURTHER INFORMATION etc. Additionally, a four-port USB 3.2 hub simplifies connecting other medical www.philips.co.uk equipment, USB sticks, printers, keyboards, mice or mobile phones (thanks to the fast charging USB port) instead of forcing users to reach for the PC case. The EasyRead mode, LowBlue mode, and the Flickerfree technology reduce doctors’ and nurses’ concerns in terms of eye-care, which is proven by TÜV Rheinland’s EyeComfort certification. Both models are also equipped with other energy-saving features. The built-in PowerSensor detects the user’s presence using infrared signals and reduces screen brightness for energy savings up to 80 per cent when the user is away. At a hospital, doctors and nurses can comfortably use their workstations knowing that the energy saving features are automatically reducing the monitor’s brightness as soon as they get up to care for their patients. Another feature, the LightSensor, automatically adjusts the brightness

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Cyber security

Protecting the NHS from cyber enabled fraud The NHS Counter Fraud Authority look at the cyber fraud awareness resource, launched at the end of March, as well as the key cyber threats NHS organisations should be wary of The NHS has been under great strain for the Cyber Fraud resource last 18 months, dealing with the pandemic The NHSCFA launched its cyber fraud and all the challenges it presented to NHS awareness resource in July 2021, a staff and patients alike. Here at the NHS comprehensive extension of the NHS Fraud Counter Fraud Authority (NHSCFA), our work Reference Guide that categorises different has never been more important in ensuring aspects of cyber crime, such as cyber NHS funds are not misappropriated so that threats and cyber security. The resource was they are used for its intended purpose- patient developed by the NHSCFA’s Fraud Prevention care. During the Covid-19 pandemic, Unit (FPU) in response to the crossthe NHSCFA saw new fraud government effort to better risks appear that posed a understand the risks of cyber threat to the NHS. One fraud. It is a detailed guide Collabo of them being cyber for NHS organisations, NHS rative workin fraud. staff and the public on g in coun is essential Over the past cyber crime, providing tering f 18 months, there advice on how to raud, and it w has been a wave protect themselves ill be no differen of cybercrime against the threats and t affecting the public how to stay safe online. the risk in mitigating s assoc and the public The layout of the ia with cy sector. Criminals resource has been ber crimted saw opportunities designed for easy e to take advantage of use, splitting into six the pandemic, preying different areas: on patients and the NHS by • An introduction: explaining stealing money from them through what cyber crime is and the differences falsified means. between the cyber offences to help users

understand the difference between cyber dependant crime and cyber enabled crime. • A glossary: common cyber crime terms and associated definitions to enable users to understand the terms used within the content. • Key cyber threats: setting out five sections that relate to Social Engineering, Passwords, Malicious Websites, Payment Diversion Fraud and Malware. • Cyber Security information: includes security tips on keeping devices and data secure. • Cyber Quiz: designed and produced to complement the cyber fraud to test people’s knowledge of cyber fraud. • Reporting: includes how to make NHS related and non-NHS cyber fraud and cybercrime reports. Mandate fraud (payment diversion fraud) Mandate fraud (NHS) is a type of third party payment diversion fraud, where someone outside of the NHS attempts or succeeds in extracting payments from within the NHS by asking for bank details to be changed under the guise of an NHS supplier. E Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Cyber security

 Social engineering is a significant part of the payment diversion fraud process, with fraudsters posing as trusted and recognised patrons that give them a sense of authority that they use to manipulate individuals and employees into making a bank transfer or providing confidential information. A case study of mandate fraud would be an NHS body that was a victim of a sophisticated mandate fraud which resulted in a loss of just under one million pounds. Working in partnership with a variety of law enforcement agencies, the NHSCFA investigation revealed that a sophisticated money laundering network was used to disguise and dissipate the stolen funds. Responding to payment diversion fraud: • If you believe you might have revealed sensitive information about your organisation, report it to the appropriate people within the organisation, including network administrators. They can be alert for any suspicious or unusual activity. • If you believe your financial accounts may be compromised, contact your financial institution immediately and liaise to secure any accounts that may have been compromised. Watch for any unexplainable charges to your account. • Immediately change any passwords you might have revealed. If you used the same password for multiple resources, make sure to change it for each account, and do not use that password in the future. The NHSCFA has guidance on invoice and mandate fraud to help NHS organisations mitigate the risks. Action Fraud have further information on mandate fraud where you might be the victim.

Mandate fraud (NHS) is a type of third party payment diversion fraud, where someone outside of the NHS attempts or succeeds in extracting payments from within the NHS healthcare systems Working together The resource has come at a time where the new Government Cybercrime Strategy should be coming out soon that will set out a plan for how to protect the UK in cyber space. Cyber crime has continued to rise in scale and complexity through the years, with criminals using new and advanced technology and methods via the internet to commit their crimes. The NHSCFA worked with external stakeholders on the development of the project, adopting some of the methods used by other organisations such as the National Cyber Security Centre, Police Digital Security Centre and NHS Digital who are doing similar counter fraud and cyber crime work. Additionally, the NHSCFA’s FPU collaborated with internal colleagues from different business units, such as Intelligence, Digital and Organisational Development, ensuring that the project is all encompassing and comprehensive. Collaborative working is essential in countering fraud, and it will be no different in mitigating the risks associated with cyber crime. The cyber fraud awareness resource is the first step the NHSCFA have taken in joining in that fight. It has been designed around the overarching themes of ‘Prevent, Protect and Prepare’, keeping the target audience in mind (NHS Staff, Local Counter Fraud Specialists

(LCFS) and members of the general public). It helps them understand how to prevent instances of cybercrime, how to protect themselves, and by providing details of the various threats and risks, prepares them by helping them understand the subject area. Reporting If you have information concerning fraud against the NHS, please report it to us either via our online report at https://cfa.nhs.uk/ reportfraud or by calling our fraud and corruption reporting line on 0800 028 4060. If you have been a victim of fraud or cyber crime, please report it to Action Fraud. Next steps The NHSCFA is currently working on a video to complement the project involving the local NHS counter fraud community and counter fraud colleagues such as Crimestoppers, National Cyber Security Centre and Police Digital Security Centre. The aim of the video is to raise awareness of cybercrime and provide clarity on remits for reporting. The video will be published on our website in the next couple of weeks so keep your eyes peeled. L FURTHER INFORMATION www.cfa.nhs.uk

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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As staff shortages and demands of an evolving work environment have brought on ever-increasing challenges to the NHS, OPEX® continues to bolster its solution to help overcome these pressures

As we readjust and revaluate best business practices instigated by the coronavirus pandemic and other changes in the workplace landscape, it has never been more crucial to address the digitisation of healthcare records. Staff shortages, social distancing and a new way of working have brought on additional challenges to the NHS - and OPEX has the solution to help minimise these pressures. As a results-driven, solutions-based organisation, OPEX has already helped over 30 NHS trusts across the UK streamline inhouse medical records digitisation by making the process as seamless as possible. With an innovative and ever improving approach, OPEX is best placed to supply a variety of unique, automated solutions with proven experience in the healthcare industry. Key benefits of digitisation for both providers and patients include creating additional physical space and increased work-flow efficiency. Digitalisation not only saves time, reduces the margin for human error, eliminates missing or misplaced files but also provides roundthe-clock access to healthcare records. In the end, digitisation leads to overall improved healthcare. Digitisation can significantly help hospitals with regulatory compliance and the elimination of warehouses full of records, creating a substantial cost saving on operating expenses. Eradicating physical paper will free up valuable space needed for patient care and will allow doctors to instantly view records and files directly from their computers. While digitisation can feel like a daunting task, having the right equipment and business partner makes the entire process a lot easier than anticipated and will have a tremendous impact on patient care and internal efficiencies. By working with industry experts who understand digital transformation challenges and who have successfully delivered both onsite projects within hospital premises and offsite projects, many of the unexpected or unplanned for scenarios experienced by other implementation teams are planned for and mitigated before they arise. OPEX uses next generation technology and stateof-the-art equipment on both the hardware and software front that can easily handle the most challenging of tasks. While some hospitals have completely transitioned to electronic medical records, many

others are overwhelmed by the formidable task of digitising warehouses full of patient records. However, the sheer costs, risks and inefficiencies of using a paper-based system are not sustainable, and many government and public sector bodies are mandating the use of digital medical records. It was for those precise reasons that North Bristol Hospital NHS Trust (NBT), one of the largest hospitals in the UK with 1,300 outpatient and 200 inpatient attendances, decided to embark on the journey to digitisation. Over the past five years, successive government Ministers for Health have been driving a digital agenda, initially setting an NHS goal of going paperless by 2020. The current long-term plan encourages all NHS organisations, from large hospital trusts to small practices, to reduce and ultimately eliminate the trail of paper that follows every patient’s journey through the healthcare system. Before they embarked on their digitisation strategy, NBT stored a total of 400,000 medical records in two warehouses, as well as 800,000 additional records at off-site storage facilities. The hospital received daily deliveries of approximately 850 paper files to prepare for upcoming appointments. On occasion, patient records were not delivered or found in time, which meant that the clinicians were unable to access historical information during the appointment. To address the excess costs and barriers to effective patient care, NBT introduced an Electronic Document Management System (EDMS), which would provide instant access to patient medical records for the hospital’s 6,000

Advertisement Feature

How OPEX is providing superior digitisation solutions for the NHS clinicians, nursing and administrative staff. The NHS Business Services Authority (NHSBSA), an organisation that provides back-end support to the NHS, determined that OPEX Falcon scanners were the best available product in the market for the complex, challenging task at hand. The scale of the digitisation process was enormous and many of the legacy documents were in poor condition, ripped, torn or worn with age and in an unstructured format. Such difficultto-scan documents could not quickly and easily be captured by a typical scanner - however the OPEX Falcon scanning solution handled the entire process efficiently and with ease. Vinny Butler, head of Scanning Services, NHS Business Authority, said: “We recognised that OPEX’s Falcon is the go-to product for scanning medical records and patient files, due to the significant labour savings, increased security and document integrity, combined with a powerful chain of custody associated with all records.” Digitisation will help to create a more efficient NHS, which in turn will improve care and outcomes for patients. OPEX currently deals directly with 30 NHS customers across the UK, and many more BPOs. Each captures and transforms a vast array of unstructured paper workflows into structured digital output for onward ingestion into back-end systems, with hundreds of OPEX’s machines already installed across the UK and Ireland, creating billions of images annually. L OPEX offers live virtual or in person demonstrations of medical record scanning. To book a demo or chat more on how OPEX can help with your digitisation, please contact us below. FURTHER INFORMATION www.digitiseyourdocuments.co.uk DMA_EMEA@opex.com

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Cyber security

Improving Cyber Security in Healthcare Cyber resilience in healthcare is now a high priority, following the WannaCry attack in 2017 and the vulnerabilities exposed by the pandemic. Cyber Security in Healthcare 2021 will shed light on some of the current cyber issues facing the NHS and how best to solve them

The NHS is made up of more than 8,000 healthcare organisations with scams and organisations, with many more across the phishing emails over the past 15 months. The wider health and care sector. The sheer size and impact of lockdowns forcing healthcare staff scale of the sector makes maintaining robust to work from home demonstrated that many cyber security a challenge, which is only further organisations were not adequately prepared exacerbated once you consider the complexities for the enforcement of this digital revolution. and sensitivity of the data involved. This meant they were, and some continue to There has been a surge of new digital be, vulnerable to a wide range of cyber threats. technologies being used in Since the outbreak began, a variety of healthcare in the last few complex and coordinated cyber years and ever-larger attacks have targeted healthcare quantities of data are providers across the world. O rganisa being generated. t ions are being e This provides Cyber Security in n c o u raged t t ake a p opportunities to Healthcare 2021 improve health Cyber resilience in than re roactive rath o active a er healthcare is now a high and care services, to secu pproac but it also presents priority and organisations rin h are enormous risks being encouraged to devices g networks, in protecting data take a proactive rather than and da ta and maintaining reactive approach to securing safety, privacy, and networks, devices and data. trust of patients. The Institute of Government & In 2017 the WannaCry Public Policy will be hosting the Cyber global cyber attack affected Security in Healthcare 2021 virtual conference over 200,000 computers in 150 countries. on 23 September. This timely event will bring While not specifically targeted at the UK, together heads, directors, senior managers and the attack compromised IT across the NHS chiefs of information security, technology, cyber and demonstrated its vulnerability to this security, data protection, digital and security type of threat. It brought hospitals and strategy from private healthcare, medical device GP surgeries across England and Scotland manufacturers, NHS, and the voluntary sector to to a standstill for several days, costing discuss pertinent issues facing the sector today. the UK an estimated £92 million. This event will provide valuable insight into what The Covid-19 pandemic has caused a steps organisations across the healthcare supply significant increase in cyber criminals targeting chain are taking to improve cyber security.

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

It will detail the latest resources and support that is available from government and NHS agencies to support their initiatives and help to mitigate the risks of increased data and technology use in the NHS. Best practice examples of innovative cyber security projects will be also detailed through case study presentations. The event will be chaired by Dr Ameer Al-Nemrat, Senior Lecturer & Programme Leader, Information Security & Computer Forensics, University of East London. Delegates will learn from senior representatives from across the NHS and wider healthcare sector, who will share their own insights, learning, resources, and guidance. Stuart Hosking-Durn, Head of Resilience and Patient Flow at University Hospitals of Morecambe Bay NHS Foundation Trust, will speak at the event. Stuart will present a case study on lessons learned from the WannaCry cyber-attack, and how the Morecambe Bay NHS Foundation Trust prepared to respond. Dr Saira Ghafur, Lead for Digital Health, Institute of Global Health Innovation, Imperial College London, will deliver a keynote address on Improving cyber security in the NHS to maintain the privacy, safety and trust of patients. Adam Nickerson, ICT Digital Lead, NHS Shared Business Services, will present a case study entitled Launching A Cyber


Security Framework To Help the NHS Manage Cyber Risks And Recover In The Event Of A Cyber Security Incident. Networking and learning Through the learning opportunities and sharing of best practice, attendees will be able to implement improvements in the workplace. We will identify and assess the key factors that make the health and care sector particularly vulnerable to being targeted by hackers. Attendees will also find out how to effectively increase cyber security awareness and embed cyber security into quality systems and organisational culture. Cyber Security in Healthcare 2021 will provide an opportunity for delegates to network and engage in question and answer sessions with

Cyber security

The sheer size and scale of the healthcare sector makes maintaining robust cyber security a challenge, which is only further exacerbated once you consider the complexities and sensitivity of the data involved speakers throughout the day. The virtual coffee lounge is a great way to connect with other attendees and continue the discussion between the live sessions. Sponsors of the event include Bitdefender, Osirium, Synopsys, One Identity by Quest, SOC.OS, Cybereason, Threatlocker, Securonix, and Zoho Corp. The virtual conference exhibition will provide an opportunity to connect with representatives from the event partners, understanding what they can offer and how they are supporting the NHS and wider healthcare industry to tackle cyber security challenges. Meet other like-minded professionals beneficial to your network, and form part of the conversation and debate that will impact the wider agenda for future planning. L

Find out more about the event and secure your place with a Health Business member discount using the code HBCYBER20 at the checkout. FURTHER INFORMATION www.igpp.org.uk/hbcyber

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GS1 UK

Two crucial elements required to drive traceability in a clinical setting The use of standardised data that can be captured at the point of care, can make a significant difference in healthcare, writes Glen Hodgson, head of Healthcare at GS1 UK

A year on following the publication of in events like product recalls or field-safety the Independent Medicines and Medical notifications, and there are greater measures Devices Safety Review (IMMDSR), and the in place to reduce the risk of harm to patients. recommendations outlined in the IMMDSR are coming to fruition. A two-pronged approach One recommendation There are two main components – for the creation of a required to deliver traceability Withou national perioperative in a clinical setting – accurate t t he accu patient-identifiable unique-device identification rate an unique database – is (UDI) and the subsequent d i d of devic entification already evolving, real-time capture of as NHS Digital standardised data. Both challen es in place, th continue to develop points are evidenced in ge of d e traceab eliverin what is now known the Scan4Safety report, g i as the Medical also published just under a and saflity, efficiency ety ben Device Information year ago, which centred on System (MDIS). the findings from the twowill rem efits ain Established following year Scan4Safety programme a Direction from the established by the Department secretary of state for health of Health and Social Care in 2016. and social care, the national For University Hospitals of Derby database is being formed to collate vital and Burton NHS Foundation Trust, being information pertaining to surgical interventions able to combine these two components where high-risk medical and surgical devices has ensured a safer environment for their are used. Its purpose is to match key product patients. Gavin Boyle, the trust’s chief information about these devices which are executive, explains how implementing the classified as high-risk, directly to the patient Scan4Safety principles of identifying every and will cover all ‘NHS, private providers in person, every product, and every place, using England and across the devolved nations’ GS1 standards has made this possible. and so, will be applicable across the UK. “Since Scan4Safety involves scanning a This will enable better post-market product to a patient – or into stock until it’s surveillance of devices based on procedural used – complete traceability is available at information that will help to monitor the click of a mouse. This means not only performance based on patient outcomes. Add significant patient-safety improvement, but also to the mix the ostensible traceability benefits that, in the event of a recall, staff spend much

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

less time identifying products and patients. “We know exactly what implants we have used on which patients, and we can tell you pretty quickly. If you take the surgical-mesh issue, we can tell you exactly which women have had which mesh implanted and which batch number, as we demonstrated when Baroness Cumberlege came to see our Scan4Safety traceability methodology in action. Most hospitals would be pulling all the paper notes of hundreds of patients and would sit somebody in an office to go through them and see if we can find it out – and that literally can take weeks.” This also extends to the clinical teams, as highlighted by Lorna Wilkinson, former director of nursing and midwifery at Salisbury NHS Foundation NHS Trust: “Imagine the frustration of going to your implant and it’s out of date, so you need to find another implant which might be out of date too. Or, the worst happens, and that out-of-date implant gets through to the patient,” she argues that this also has a knock-on impact for staff satisfaction and that the resultant stress could further affect safety. A tangible difference for NHS personnel The efficiencies the Scan4Safety approach provides for staff makes a genuine difference. At Leeds Teaching Hospitals NHS Trust, staff deal with around 500 product recalls a year. Since the introduction of Scan4Safety, the average time taken to recall a product has fallen from 8.33 days to less than 35 minutes. Without the accurate and unique


There are two main components required to deliver traceability in a clinical setting – accurate unique-device identification (UDI) and the subsequent real-time capture of standardised data Glen Hodgson is Head of Healthcare at GS1 UK. He is charged with supporting the NHS and the healthcare industry to deliver greater efficiency and a more robust approach to patient safety. With over 20 years of national and international experience, Glen has served

GS1 UK

identification of devices in place, the challenge of delivering traceability, efficiency and safety benefits will remain. Healthcare manufacturers and suppliers have already made strides in doing so, and several are already using UDI to make these benefits possible, but there is still more to be done to deliver these advantages on a larger scale. The use of standardised data that can be captured at the point of care, can make a significant difference in healthcare. Irrespective of which data standards are used, or how the data is captured, the capacity to do so will allow for vital information to be identified, captured, and shared seamlessly between systems and organisations. It is this interoperability of data that has the power to drive traceability in a clinical setting and change the way healthcare works for the better. L

at board level in a variety of operational and commercial roles within complex organisational structures inside the pharmaceutical/healthcare arena. FURTHER INFORMATION www.gs1uk.org/healthcare

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Staff well-being

Working to support NHS staff well-being Danny Mortimer, chief executive of NHS Employers and deputy chief executive of the NHS Confederation, looks at well-being support options for hospital staff, who continue to fight Covid-19 on the frontline The UK is now beginning to look towards a future that somehow works around Covid – and of course, that includes health and care staff. They have faced challenges over the course of the crisis the like of which they have never seen in their careers, and they, perhaps more than anyone, will be looking forward to going back to normal, whatever that now may look like. But the toll the pandemic has taken on their well-being, both mentally and physically, is likely to persist for months and even years to come. NHS teams in every setting have faced unprecedented pressure and demands over the course of the pandemic, with remarkable commitment, compassion and selflessness. But they, too, are human and it is vitally important that we continue to support and listen to them so they can be at their best and continue to work in the NHS. NHS organisations are of course fully aware of this, and employers will continue to do all

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guidance and share good practice to improve both staff experience and patient care. At the beginning of the pandemic, we increased our network conversations with health and well-being leads, and we continue to hold fortnightly Staff conversations where they well-be can come together virtually Holding important with their peers to raise conversations hubs ha ing v challenges, share ideas NHS leaders know e a ls o been se and collectively work it is vital that their t up provide together to support people remain at the rapid a to ccess to staff and improve heart of decisionassessm staff experience. making. To support evidenc ent and local e-based In partnership them, NHS Employers, mental health with our network, which is part of the service we also recently NHS Confederation, suppor s and published information works closely with health t on supporting staff to and well-being leaders recover after long Covid, at provider organisations, including supporting staff at helping them to network, develop they can to take care of the well-being of their staff. Line managers are the vital component in this endeavour, as well as ensuring staff have access to good local mental well-being support, including space to reflect, process their experiences, and reset.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net


work and those who are absent because of the condition. In June, we held a webinar to help NHS organisations to understand how best they can support colleagues, with expert advice on areas including returning to work and also legal implications. We actively encourage NHS organisations to continue to use our free ‘How are you feeling NHS?’ toolkit, which aims to help bridge gaps in understanding and enable teams to talk openly and regularly about emotional health. It also provides support with assessing the impact emotional well-being has on staff and patients, enabling organisations plan actions to enable more good days than bad – now more important than ever. Across the NHS, organisations have also been working hard to support staff often using the support offered by their local NHS charities and the tremendous donations given the public, particularly through NHS Charities Together. For example, at Sheffield Teaching Hospitals NHS Foundation Trust, ‘CALM rooms’ are available to staff, offering staff a quiet space to take time out, reflect, recharge and refuel with refreshments. The trust has 49 CALM rooms across its sites, as well as three ‘breathing spaces’ in chapels. The rooms include a range of well-being materials and information, signposting staff to further services. Meanwhile, NHS Wolverhampton Clinical Commissioning Group has worked alongside Public Health Wolverhampton and The Royal Wolverhampton NHS Trust to develop a districtwide risk assessment tool that has helped to support employers to better understand

what the grades of risk are for their staff, with closer attention to age, gender and ethnicity. The unique nature of considering an employee’s risk factor in relation to the risk factor of their workplace allowed for mitigation based on individual circumstances. Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust have also brought together a group of well-being champions throughout the organisation, to give staff members support and guidance with their health and well-being. There are now more than 150 well-being champions in the trust, each of whom completes online learning around having supportive conversations, as well as mental health responder training, and has the opportunity to take part in longer ‘defusing difficult situations’ training. The well-being champions provide a friendly ear to colleagues, and they take part in regular ‘walkabouts’ on site to make themselves available. National support Our work complements the important national leadership and extensive support offered through the pandemic by the People Directorate at NHS England. At the start of the pandemic, NHS staff were given free access to various well-being apps, and some of these have extended free access in recent weeks. NHS staff have generally reported a positive experience of using the apps, via social media and to NHSEI teams, and the body is

Staff well-being

We actively encourage NHS organisations to continue to use our free ‘How are you feeling NHS?’ toolkit, which aims to help bridge gaps in understanding and enable teams to talk openly and regularly about emotional health

now also looking at non-identifiable data to determine how actively staff are using their accounts, and whether there are any trends it can use to tailor future support offers. Staff mental health and well-being hubs have also been set up by NHS England to provide rapid access to assessment and local evidencebased mental health services and support. The hub offer is confidential and free for all health and social care staff, from all services and settings, regardless of whether they are dealing directly with Covid-19 patients. They have also introduced a confidential staff support line, operated by the Samaritans and free to access from 7am to 11pm, seven days a week. However, a key issue putting more pressure on our teams has been the chronic workforce shortages plaguing the health service, stretching teams ever thinner and increasing workload to an untenable degree. We welcome the national call for more people to join the NHS, but equally, it is vital that the investment is there to grow and sustain the workforce after a decade of shortages and poor investment in education. The Prime Minister and Chancellor must this autumn provide hope to a tired and depleted workforce that they will invest in educating and training future workers for the longer term. L FURTHER INFORMATION www.nhsemployers.org

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Panel of Experts

EXPERT PANEL FACILITIES MANAGEMENT Following an 18 months unlike any other, Health Business talks to Donna Brown about hygiene standards, sustainable healthcare, hospital food and fully integrated multi-service provision pandemic. I am immensely proud of the contribution everyone has made; the rest of the healthcare team have seen just how important the healthcare cleaners are in keeping patients safe and the environment clean. I believe we are not just seen as support services anymore, but as a critical part of a hospital’s infrastructure standing shoulder-to-shoulder with the clinical teams. As an organisation we were there to support the NHS, not just with our Placemakers but with the technical excellence only a global business such as ISS can provide. As members of the National Standards of Healthcare Cleanliness 2021 team we had already been working closely with NHS England and NHS Improvement. We had developed our own AssureClean model that suited the rise in demands just perfectly. As other parts of the business saw a reduction in demand we were able to re-train many of our colleagues from other sectors in the special demands of healthcare. Many of these have since chosen to remain with healthcare as they recognise what a rewarding career this can be. Food: What is ISS doing to implement the recommendations from the recent Independent Review of NHS Hospital Food?

Donna Brown, Managing Director, ISS Healthcare

The best healthcare facilities provide worldclass services to patients, visitors and staff. Whether it be through the security of the building, the food on the menu or how best to incorporate intelligent solutions, ISS prides itself on creating environments where people want to work and deliver great care. We have posed a number of questions, looking specifically at some of these areas, to Donna Brown, managing director at ISS Healthcare, and share her responses below.

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Cleaning: In what ways have the last 18 months changed the way in which hospital decision makers view cleaning and hygiene? And how, as a company, has ISS changed to meet growing demand? Our Placemakers have been the bedrock of the front line throughout this

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Two members of our team were honoured to be asked to sit on the Senior Review Panel, so their thoughts were reflected in the overall recommendations. This meant that when the report was finally published, we were quickly looking at how we could work with our client NHS trusts in implementing the eight core recommendations and the subsequent checklist for catering managers and chief executives. This planning is continuing, and we would like to see some of our sites be included on the ‘Exemplar’ listings, helping others raise the standards for every patient. We agree with the need for investment in training to support catering staff as well as infrastructure such as improved facilities and technology. Wherever possible we have invested in our ISS Training Academies, which can provide much of


People: As lockdown ends in July, people will be returning to a degree of normality by going out more and seeing more people face to face. In a hospital setting, with heightened busyness and stress, how valuable are support services in creating an enjoyable hospital experience for patients and visitors? We have a saying in our business, People make Places and our purpose in healthcare is to provide Places that Care. The support teams are vital to making any hospital safe and welcoming, be that by offering a courteous welcome when you enter; by offering nutritious food and plenty of hydration whilst on the ward or assisting on your visits for treatment and removing the waste that is generated throughout

the day. Facilities management team organisations take business members are there for you at every sustainability to the next level? touchpoint throughout the day. Throughout the pandemic hospitals have Healthcare offers great opportunities for the not been encouraging visitors for obvious development of technology, from enhanced reasons but when anyone has had a need communication with the Portering team, to enter the buildings our teams have been through to electronic meal ordering for there to ensure everyone’s safety. I patients. We offer bespoke packages think that the wearing of PPE, to meet every customer’s needs, especially the face masks all designed to reduce our y t for visitors, will continue carbon footprint and e f a S for the foreseeable reduce on waste. n i l a is vit future and you can As a global business, thcare l be sure that we will we can also tap a e h l l a om still be working hard into research and ents; fr nts m n o r i to keep the place development from v e i t en a p g n i t clean and safe. around the world and r s o r transp itoring visito are keen to introduce n l o a t m i Technical: new ideas as soon p d s n o a ing h d r Perhaps one as we see their worth. a u g to s positive to come An obvious current ground from the global development would be pandemic has been the introduction of robotic an increased awareness cleaning, allowing cleaning of sustainability. How can methods to be applied that guarantee intelligent solutions help NHS significant reductions in potential infections. E

Issue 21.4 | HEALTH BUSINESS MAGAZINE

Panel of Experts

the necessary training, but I would urge everyone to consider investing in the future of all the facilities management teams.

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Advertisement Feature

ISS to take a scientific and behavioural approach to healthcare cleaning March 2021 saw ISS launch their healthcare cleaning strategy and focus for 2021/2022. ISS Healthcare has now taken its approach one stage further by commissioning a groundbreaking project that will take a scientific and behavioural approach to healthcare cleaning. ISS’ strategic ambition centres on a groundbreaking project, a scientific approach to cleaning Collette Sweeney, Head of Healthcare Cleaning at ISS, explains: “the application of cleaning science and the impact of behaviour is intrinsically linked to environmental infection control. The purpose of the project is to use science to determine the efficacy and appropriateness of the healthcare cleaning process to deliver evidence-based safe systems of cleaning.” Collette and her team, who worked closely with NHS England and NHS Improvement in the development of the recently published National Standards of Healthcare Cleanliness 2021, believe that by using science to validate the cleaning process it will build confidence throughout the NHS, support shorter patient stays, and ultimately

provide a safe clinical environment to help save lives, not just during the COVID pandemic but beyond. Collaborative approach The successful delivery of this project centres on a collaborative approach with the NHS, and in particular the hospital the ISS research and development team are working with. Heather Cracknell, ISS Healthcare Cleaning SME stated that: “There has never been a better time to demonstrate not just being visibly clean, but clinically clean.” Donna Brown, Managing Director concludes: “This new project is not only ground-breaking but will lead to a positive step forward in healthcare cleaning for everyone, we would be delighted for other collaborators to come on board.” ISS has been at the forefront of healthcare cleaning for over 30 years now and has a long track record of delivering innovative solutions – they were the first company to offer scientific evidence that introducing microfibre into the NHS was a possible improvement. This new project is not only groundbreaking but will lead to a positive step forward in healthcare cleaning standards for everyone.

www.uk.issworld.com | enquires@uk.issworld.com


Panel of Experts

 Technology and sustainability form two of the eight recommendations in the Hospital Food Review, so clearly there is a focus there, but we are also excited to see the development of the Green NHS Team, and the focus that is being given to these topics from the top down. It is only if we all pull together on these issues that we will see any significant progress. Security: Patients and staff alike require the security of knowing that they are safe in the hospital building. Therefore, how important is it for an NHS organisation to have a clear overview of risks to security? Safety is vital in all healthcare environments; from transporting patients and monitoring visitors to guarding hospital grounds. Every trust that we work with takes this very seriously and have detailed risk profiles that cover every conceivable possibility. Major incident planning also helps recognise and mitigate many of those risks and we are there to play our part. Our dynamic security services help create a comfortable setting – no matter the environment – so patients, visitors and healthcare professionals feel safe and secure. This may be simply to provide a helping hand as a visitor has become confused and lost their way or walking a nurse to their car in the early hours of the morning to providing a reassuring presence in a busy A&E unit on a Saturday night. The

At ISS we believe in a fully integrated multiservice provision, it offers a single point of contact for the customer; a single line of management and the ethos of all pulling together as a single team security team play an essential and often underestimated role in a hospital’s daily life. Integrated care: What are the benefits of a hospital having just one outsourcing partner? At ISS we believe in a fully integrated multi-service provision, it offers a single point of contact for the customer; a single line of management and the ethos of all pulling together as a single team. One team offers a flexibility that disjointed services cannot,and allows for integrated training and development opportunities for all our Placemakers. How does this relate to the healthcare environment? Well ISS Healthcare is made up of experts at supporting the patient journey. We share our customers’ purpose in becoming healthcare providers of choice and creating healthcare environments where people want to work and deliver great care. One outsourcing provider allows for investment to be considered across the whole service provision and, of course, our

Placemakers make the difference each and every day. By bringing in other providers who may not share that vision and those values would disrupt the core purpose of what the support services should be there for. L FURTHER INFORMATION www.uk.issworld.com

Donna Brown, Managing Director, ISS Healthcare Donna has over 36-years’ experience of working in healthcare. She sat on the companies CERO group throughout the pandemic and, from the outset, played an active part in the development of new National Standards of Healthcare Cleanliness 2021. She continues to be part of the NHS Improvement team and a standards guardian.

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Financing for patients and providers Huw Phillips, Head of Sales at the consumer finance ecosystem Deko, on how consumer finance can improve choices for both practices and patients when it comes to their healthcare needs. Not just for retailers People have utilised credit in healthcare for several years. Whether it be dentistry, cosmetic surgery or a variety of other private procedures, patients have turned to credit providers to ensure they are able to secure the service that they need. However, the consumer industry has evolved, with products like Buy-Now-Pay-Later now used daily whilst more traditional forms of credit have seen a dip in popularity. What is now key is how healthcare providers are able to capitalise on these new methods of payment. Recent surveys show that 4 in 10 Brits have used a Buy-Now-Pay-Later service when making a purchase. While many people would assume that these services are exclusively for retailers, this could not be further from the truth. These forms of financing can be implemented by all manner of businesses including healthcare providers, ensuring that customers, patients and businesses aren’t restricted due to a lack of payment options. At Deko we have seen a noticeable rise in how consumer finance has been used across the

healthcare sector, having recently reported an increase in demand for consumer credit in this area. This was particularly of note in applications for dental procedures which now make up more than a fifth (21 per cent) of our business, with an average basket value of £7,226. As consumer finance services continue to grow – and are expected to double by 2023 – non-invasive healthcare service providers should not be exempt from this boom. Utilising a multi-lender approach A multi-lender retail finance platform increases the acceptance rate and price range that can be covered in a purchase. Deko filters lender options to ensure that the right lender is found to fit the individual customer, and this multi-lender approach can help users and providers feel more confident that they will secure a payment. This is what we at Deko have identified to be the key driver behind increased sales and successful business growth. Higher acceptance rates are beneficial to all users but especially those with larger than average


Advertisement Feature prices – making it the perfect solution for expensive dentistry or cosmetic service providers, for example. Many of the users that have employed such a tactic have benefited from up to a 30 percent increase in business after integrating a multi-lender platform into their payment process. Challenges facing the provider and the user The past 18 months have been some of the most uncertain and difficult for all businesses and consumers in the UK. Restrictions have prevented all non-essential procedures and as a result patients and providers are now keen to capitalise on the potential new wave of business. We understand that consumer finance will be a key facilitator of this recovery, so a greater range of acceptance as well as a seamless payment experience will be critical. Most importantly, both practice partners and their patients have responded well to our service, and consistently rate us as excellent. Every business is unique and requires its own bespoke service. Consumer finance can undoubtedly improve businesses revenues, but it needs to be responsive enough to the different needs of healthcare providers and consumers alike so as to benefit the greatest number of people - especially when it comes to more specialist services. Buy-Now-Pay-Later solutions are perfect for the retail landscape but also provide an application in the healthcare space. At Deko, our platform is built on delivering choice. We have a wide range of products

that offer payment flexibility, including a new-era digital credit account service, which requires one application and then can be used multiple times. These offerings would be particularly well suited to businesses where patients require regular visits and appointments, such as dentistry practices. Combining these products with more well-known buy-now-pay-later payment offerings and traditional bigger loan facilities, Deko has created a flexible consumer finance service that is applicable across a multitude of sectors. This is crucial for partners in specialised sectors like healthcare, that require options for larger payments. The key for all businesses is partnering with a multilender and multi-product provider who can invest more time in understanding the best match between a practice and their needs, and who can deliver this in an effective integrated experience. The relationship between users and retail finance partners requires trust, as well as a partner that understands your business. This is what Deko strives to deliver for our partners – a seamless, flexible, payment ecosystem. Deko is a multi-product, multi-lender retail finance ecosystem focused on expanding access to consumer finance for lenders, providers and users. Deko partners with multiple lenders to ensure a perfect match for all parties. By providing access to a range of lenders, we can confidently say “yes” to more transactions and help patients access the services they need. To find out more visit - dekopay.com


Decision-making

Put elected members at the heart of ICS decision-making The experts at PA Consulting look at how placing elected local government representatives at the heart of NHS integrated care systems could unlock their full potential The development of Integrated Care Systems (ICSs) in England continues apace – including preparation for taking on a wide range of statutory responsibilities from April 2022 (subject to legislation). One of the key arguments underpinning ICSs – at both national policy level and in how they are being built locally – is that joining-up decision making between the NHS and local authorities as well as other community partners, will provide a basis for drawing on a much wider range of perspectives and resources for creating long-term, sustainable improvements to citizens’ health and well-being. However, the maturity of relationships between NHS and local government organisations across the country remains variable. While relationships between NHS leaders and local government chief executives and directors of social care tend to be well developed, elected members (local politicians) are less likely to be meaningfully involved in integration discussions, and relationships with non-executive leaders are less well-established. The ICS Design Framework’s expectation is that place-based partnerships ‘listen consistently to, and collectively act on, the experience and aspirations of local people and communities’. To meet these requirements, health, care and local government organisations must build closer relationships that include citizens as a part of the decision-making process.

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scope of integrated care to encompass the Why elected members are broader services for which local authorities crucial to integrated care are responsible – those which can enable Placing elected members and NHS leaders some of the greatest gains in health at the heart of Integrated Care Systems outcomes to be made in the and place-based decisionlonger-term. The wider making has the potential to determinants of health, such significantly improve both E f fective as housing, environment the quality of decisionjoint de and economic inclusion, making and the speed c i s i onmaking all have a critical at which subsequent clinical combines bearing on health improvements can take and po and wellbeing - in place. This is because litical perspec many cases a greater elected members t i amplify ves, influence than NHS are necessarily very ing the services. Despite this close to populations. l e g i t i m being well-known, They engage regularly acy of decision they have hitherto with the citizens s remained peripheral they represent and are to most health and care accountable to them at debates and decisions. election time. Their links to Take housing, for example. communities and direct accountability According to The Health Foundation, 32 per give elected members a unique perspective cent of households (or 7.6 million) in England on local people and services, and how they had at least one major problem relating can best be designed to meet local needs. In to overcrowding, affordability or quality of addition, creating structures where elected housing at the start of the pandemic. Poor members are included as joint partners quality homes can lead to (or exacerbate) in decision-making processes as early as physical health problems, whilst affordability, possible will reduce the risk of dispute and fuel poverty or insecure housing can create challenge which may follow the tough or exacerbate mental health issues. decisions involved in re-shaping services. Actively involving local political leaders in Early and active engagement with elected ICS decision making from the outset can act members is also crucial to expanding the

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as an accelerant for deepening collaboration. It provides a visible sign of joint partnership, and can help local authority teams feel like they have a clear and unambiguous mandate to think and work differently with health partners. This can provide the impetus for collaboration that goes beyond local authorities’ remit for public health and social care, into those areas that have a profound impact on quality of life and health demand and which will need to be part of long term prevention strategies. How to bring elected members into integrated care decisions Effective and sustainable involvement of elected members requires genuine joint decisionmaking between local authorities and the NHS. That means moving past consultation, which can be superficial, however well-intentioned. It means investing time into developing relationships and a joint understanding of their places and translating that into a shared vision and narrative for place, underpinned by joint responsibility and accountability. Doing so will require developing genuine joint priorities for the well-being of the population, and a single plan to address them.

Only with such a shared vision can leaders work through issues and decisions together. So, local authorities and NHS organisations should agree the common priorities and plan in writing and express them in terms of population outcomes as precisely as possible. Having agreed a vision, systems will then be in a position to establish joint decision-making structures to work towards it. These should ensure: • Balanced membership of boards (and other decision-making groups) to support honest, open dialogue and genuine joint decisionmaking. For example, there should be either equal representation of the NHS and local authority, or else a mechanism to ensure that substantive decisions require the consent of both NHS and local authority leaders, with any exceptions minimised and clearly defined in advance. This will ensure that decisions combine clinical and democratic legitimacy, giving them a powerful basis for acceptance across the system and swift implementation. Consideration should also be given to ensuring an appropriate executive and non-executive split – which may include more non-executive (i.e. elected) representation from local authorities. • Clear governance links to statutory boards for the NHS and local authority council or cabinet. This includes carving out the widest possible remit for joint decision-making arrangements, within statutory requirements, to

Decision-making

Placing elected members and NHS leaders at the heart of Integrated Care Systems and place-based decision-making has the potential to significantly improve both the quality of decision-making and the speed at which subsequent improvements can take place create effective and comprehensive joined-up services that system partners jointly own. The creation of ICS Statutory Bodies from April 2022 provides a significant opportunity in this area. Provided that systems can work through and jointly agree how local authorities’ involvement can be maximised in a way which does not infringe NHS-specific accountabilities. • Design arrangements appropriate for a decision-making function, rather than scrutiny or advice. For example, the appropriate management and secretariat support to ensure that decisions are timely, evidencebased, and suitably recorded to be acted upon by the system as swiftly as possible. This will ensure that structures reinforce the shift in working relationship from one of elected members scrutinising NHS decisions to open joint decision-making. Finally, it’s important to note that joint decision-making structures and processes also have a cultural underpinning. NHS leaders, especially clinical leaders and elected members, bring not only complementary perspectives but also complementary legitimacy to decisions about health and care services. Direct democratic accountability has no equivalent in the local NHS. Effective joint decision-making combines clinical and political perspectives, amplifying the legitimacy of decisions in a way that neither organisation could achieve alone but is essential to designing and implementing services built around the needs of local citizens. Elected members can unlock the potential of Integrated Care Systems To unlock their full potential to improve population health and reduce inequalities in well-being outcomes, Integrated Care Systems must skilfully navigate significant challenges and opportunities as they continue to develop. Ensuring elected members are at the heart of decision-making from the outset will provide critical perspectives, insights and links into local communities that will be vital to maximising their effectiveness. L

Written by Michael West, James Tyler and Luke Muir, healthcare experts at PA Consulting. FURTHER INFORMATION www.paconsulting.com

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Property services

NHSPS: Smarter ways of working Kate Richardson, head of National Office Programme at NHS Property Services, discusses the organisation’s smarter working policy which allows staff more flexibility to choose where they wish to work The Covid-19 pandemic has forced changes Transitioning to smarter working within all our lives. For many of us, this has Over the past year, our expertise in estates been the transition to a more virtual working and facilities management has put us in good environment. Last year, traditional patterns stead for our transition to smarter working. of working based around the physical office Our specialised National Office Programme became unmanageable overnight, leading to team already has rich experience of optimising uncertain business continuity for some. While and designing the NHS office estate to this way of working was unforeseen, it has encourage more agile ways of working. proven that employees can work effectively We are providing our employees with more from outside the office walls. flexibility, allowing them to choose where they Organisations are learning that embracing wish to work and, at the same time, ensuring flexible working can improve efficiency, and that they feel trusted, empowered and safe in more importantly, employee well-being. the knowledge that they will be measured on Offices make up a significant proportion of the their outputs, not time spent NHS estate, with NHS Property Services in the office. While we (NHSPS) portfolio alone covering are still learning, approximately 400 office holdings, initial changes O rganisa spanning 400,000 sqm and have already t ions are lear serving multiple NHS bodies. resulted in n i embrac ng that Our experiences since the a positive beginning of the pandemic cultural shift workin ing flexible g can im have led to the conclusion that within our efficien prove we, as employers, would like organisation. c y , and mo importa to implement a more flexible One of the re ntly, em working environment. We call benefits we p loyee well-be this our ‘smarter working’ policy. have seen ing This change is allowing us to which would continue supporting staff members have previously in whichever way, or location, that been hindered due to they wish to work in. travel restrictions, is the

ability to attract an array of talent to multiple jobs. Due to our work hubs which are set up across the country for any employee to use, they are more likely to have easier access to one of our workspaces. Cutting down commuting time widens the search pool of applicants, as travel time from home to work is more realistic and promotes the work life balance everyone wishes for and deserves to have. Flexible working also allows people with more responsibilities, such as parents or carers, to be present with their children or family members and reduces the mental and physical burnouts many people will face. Smarter working became particularly important to me personally when my daughter arrived. I’m lucky that I enjoy my role, so I was desperate to continue with it and find a balance with work and becoming a mum. By acknowledging the potential stress points for our employees, we reduce the risk of burnout to our workforce. We have witnessed that through showing we really do care, our colleagues ‘give back’ in a positive and productive way, solidifying growth and transparency within our business. Open conversations At NHSPS we are continuing to learn and grow our smart working policy. Learning and adapting will only make us stronger E

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Property services

 and it’s important to regularly check in with employees to make sure their needs are being met. Surveys are an easy way to make sure new policies are fulfilling their purpose and should be distributed at least once a year to ensure this. The results of an internal survey at the beginning of our transition to smarter working found that 59 per cent of employees agreed that working from home positively affected their work productivity. While 95 per cent of people feel that they are still ‘connected’ with the wider company and felt informed about what was happening within the company. These figures show that most people are capable of carrying out work tasks at home to the same level of productivity and still feel supported and connected to their colleagues and company. The survey also exposed the fact that some prefer and work better in an office environment, and this is why NHSPS will always have office space for people to work in. This space continues to support a face-to-face interaction with colleagues whilst having the flexibility to work from home on their chosen days. In addition to surveys, there must be open conversations about the needs of employees between the employer and its staff. As such, we made sure that inclusivity and transparency are at the heart of our new policies. At the start of the pandemic, we opted to provide our

We are providing our employees with more flexibility, allowing them to choose where they wish to work and, at the same time, ensuring that they feel trusted, empowered and safe in the knowledge that they will be measured on their outputs, not time spent in the office teams with all the necessary equipment they needed to carry out their work from home, making their workspace as comfortable as possible for them. In return, we asked that they set up a suitable ‘home office’ where they can continue to thrive in a ‘new’ workplace. We also wanted to reassure the teams that extensive training and continued learning would be available from home so everyone could continue to grow as a team. We are now looking ahead to the new horizon of smarter working, and are working hard to prepare the estate, technological and cultural changes needed. We are beginning to implement our new Smarter Working Policy and reimagining our office spaces to support

new ways of working. We’ve still got some way to go, and we’re learning all the time, but I’m proud to be part of these efforts as I believe they will make a significant longterm impact on employee well-being and productivity. It’s exciting to see flexibility become a reality and ‘norm’ for my colleagues, and wider networks. Whilst we’re certainly not yet experiencing true smarter working during ongoing restrictions, I’m looking forward to supporting our teams with a new hybrid way of working should they chose it. L FURTHER INFORMATION www.property.nhs.uk

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WE GET TECHNOLOGY AT THE POINT OF CARE. STOCKPORT NHS FOUNDATION TRUST REDUCES DATA CENTRE COSTS BY £100,000 PER YEAR. CDW data protection solution enables Stockport NHS Foundation Trust to overcome backup and disaster recovery concerns. Stockport NHS Trust Foundation Trust depends heavily on its IT estate to provide vital healthcare services to more than 500,000 patients per year. However, the combination of ageing infrastructure and an overstretched IT team comprising 25 people to cover 6,000 employees was causing a number of operarational challenges. With a commitment to providing the highest levels of support to healthcare teams delivering critical patient care, the Trust recognised that it had to embrace new technologies to improve results. Stockport NHS Foundation Trust’s existing ageing technology could only provide the most basic functionality, and it was taking the IT team an enormous amount of time to restore systems when they failed. The Trust identified a need to invest in a modern solution that would provide both security and compliance, while also being future-proofed to meet a requirement for ease of scalability and adaptibility to the cloud. CDW worked with the Trust to design and implement a data protection solution that would fully address backup and disaster recovery requirements.Taking an agnostic approach to technology partner selection, CDW identified Cisco and Cohesity as the standout solution that would provide the Trust with the opportunity to unify its end-to-end data protection infrastructure. Since the solution has been implemented, Stockport NHS Foundation Trust has recognised numerous benefits including excellent backup and recovery capabilities ‘out of the box’ helping its IT team become far more agile and flexible. The Trust also has the confidence to perform upgrade procedures that previously would have required external vendor support, safe in the knowledge that data is protected which has already helped it save a considerable amount of money Additionally, by bringing the technologies in-house and standardising IT operations, the Trust has been able to reduce its support and licensing costs by nearly £100,000 a year. Find out more at www.uk.cdw.com/about/case-studies/stockport-nhs-foundation-trust.

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Cleaning

Cleaning and hygiene will be top of the agenda for years Delia Cannings looks at how the profile of hygiene importance has been raised to a new level that must be maintained moving beyond Covid-19 The awful experience of the Covid-19 pandemic has transformed the public’s attitude towards cleanliness and the work of cleaning and hygiene staff. Those of us in the cleaning and hygiene sector knew how essential our work was but this was not always appreciated before Covid-19 struck. The importance of the work of cleaning teams was best understood in the healthcare sector, as it is essential to stop infections spreading and so plays a vital role in protecting the lives of patients who are often already sick and vulnerable. But the industry’s health and safety role also extends to other sectors, such as the chemical industry, where it can be a matter of life and death. In the hotels and hospitality sector, customers have always expected good standards of cleanliness and, if workplaces were unhygienic and untidy, I’m sure clients and staff would soon vote with their feet. But despite this, cleanliness and hygiene was often not a top priority outside the home. At times, cleaning specifications were reduced and the frequency of cleaning and schedules lessened to reduce costs.

example, in the healthcare sector, my ahcp Our industry employs 1.47 million people colleagues are directly involved in managing and is one of the ten biggest in the country, and delivering cleaning and hygiene services but our workforce was often invisible before in most NHS and independent hospitals. the Covid-19 pandemic struck, partly due to Members also hold key roles in many primary workplace cleaning often happening out of care and GP clinics and surgeries, nursing and hours and contract cleaning operatives being care homes and other residential care separate from the main workforce. settings provided by the public, The terrible tragedy of Covid charitable and private sectors. 19 has now put cleaning Healthcare cleaning and hygiene right at the Nobody operatives have never top of the agenda. The is going relented in dedication bravery of the many this aw to forget f and commitment during operatives who have u l p an and the this period. Many worked to protect the vital im demic p health and safety of o r t ance have worked longer of clean hours, taken on extra others, often at risk to in g and hyg responsibilities and themselves, throughout ien adopted new standards the pandemic, has been anytime e and practices to prevent readily apparent. soon Covid-19 contamination. While many members of Colleagues also played a the public have been able vital role setting up and staffing to work from home in a safer Nightingale Hospitals. Cleaning environment, cleaning and hygiene teams showed huge camaraderie, supporting operatives have gone to work on the frontline each other, holding each other up and, sadly, in the fight against Coronavirus. falling in a pile together when the exhaustion During the pandemic, cleaning staff have kicked in. E consistently gone above and beyond. For Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Leading the way in aerosol drug delivery systems 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

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 Aerogen has partnered it’s technology with leading mechanical ventilation companies including Philips Healthcare, GE Healthcare, Medtronic, Getinge, Dräger, Hamilton, ResMed and IMT Medical.9 It’s vibrating mesh technology has been used to treat over 13 million patients both within the UK and worldwide and is now being used in over 75 countries in all areas of the world.9 Aerogen is also the partner of choice for multiple pharmaceutical companies developing Covid-19 treatments. Aerogen is the only closed-circuit aerosol drug delivery system for mechanically ventilated patients that mitigates the transmission of patient generated infectious aerosol1,10,16 and delivers effective aerosol treatment.1,11,17 Aerogen’s closed-circuit nebuliser technology, which addresses key concerns around safety and improves patient outcomes4-8, is being used in hospitals across both the UK and the rest of the world to deliver aerosolised medication to critically-ill ventilated 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. 11,12,15-24

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The GOLD Science Committee Report on Covid-19 and COPD states ‘nebulisers may be needed in critically ill patients with Covid-19 receiving ventilatory support. In this case, it is vital to keep the circuit intact and prevent the transmission of the virus. Using a mesh nebuliser in ventilated patients allows adding medication without requiring the circuit to be broken for aerosol drug delivery’.16 The National Institute for Health and Care Excellence (NICE)25 and Public Health England (PHE)26 have also recommended the

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continued use of nebulised treatment when applicable. Aerogen is the only device that can deliver aerosol therapy efficiently inline during high flow nasal cannula (HFNC). 3,27, 28 For patients requiring non-invasive respiratory support, a Spanish clinical consensus recommendation stated the following: “If aerosol therapy is used, vibrating mesh nebulisers with adaptation to the elbow of the interface is the option of choice. As a second option we can use a vibrating mesh nebuliser with a T-piece fitted to the NIMV (non-invasive mechanical ventilation which includes NIV + HFNC) circuit. Since this is a ‘closed system’, there is no dispersion into the environment provided leakage at the mask periphery is well controlled.”15 L References available from Aerogen upon request FURTHER INFORMATION education@aerogen.com www.aerogen.com


Other sectors Our cleaning and hygiene colleagues throughout the industry have helped keep other key sectors such as social care, education, key public services, local and national government, supermarkets and the food supply chain and the transport network going. Without cleaning and hygiene staff keeping workplaces free of coronavirus, people would get sick and these essential industries would grind to a halt. And let’s not forget the staff working in the manufacture and supply of products such as masks and hand sanitiser, which have been in huge demand by the public, and the disinfectants, sanitisers, cleaning products, equipment and machinery which staff rely on. So it was wonderful to see this incredible contribution by cleaning and hygiene colleagues recognised last year by both Boris Johnson and Jeremy Corbyn in Parliament. The Prime Minister and the former leader of the Labour Party were taking part in

The importance of the work of cleaning teams was best understood in the healthcare sector, as it is essential to stop infections spreading and so plays a vital role in protecting the lives of patients who are often already sick and vulnerable Prime Minister’s Questions when Mr Corbyn praised the ‘unsung heroes’ of the public sector who ‘keep us safe’ during the outbreak. He went on to add: “I’d like to pay special mention to one group that are hugely ignored, forgotten and decried as unskilled workers – cleaners. All around the country and in this building, (they) are doing their best to keep our places hygienic and safe. “ The Prime Minister agreed, saying they were doing an ‘extraordinary job’. Yet despite all this, the government has never explicitly named cleaning and hygiene staff as key and essential workers, which is nothing short of infuriating. The role of cleaning The British Cleaning Council has been campaigning throughout the pandemic for this

Cleaning

 But as the pandemic wore on, it took its toll with cleaning teams very stretched in some parts of the country. Pure fatigue affected many colleagues and many also had to self-isolate at some point. We’ve seen drinking, smoking and substance abuse issues, mental health issues, anxiety and depression, self-harm and suicide rates all on the rise.

recognition and it is hard to believe that a year and half after the virus reached our shores, we are still having to fight for key and essential worker status for all our colleagues. As we move forward and the UK looks to recover from the pandemic, it is clear that the role of the cleaning and hygiene sector and its staff in maintaining clean, sanitised and safe premises and environments will continue to be vital. High hygiene standards of cleanliness and hygiene are essential if we are to protect the health and well-being of people and reassure them as they return to workplaces and public spaces. A number of recent surveys have made it clear what the public thinks on this issue. For example, last year, one survey found that 80 per cent of consumers are now more aware of hygiene practices when outside the home and the vast majority would not enter a public space if it wasn’t Covid secure. A more recent poll about the hospitality industry found that over half of people reported hygiene to be the most important quality they look for from hospitality businesses, well ahead of any other consideration. And, in a third example, independent research involving 1,000 people showed that the mere sight of disinfection happening in public spaces could go a long way to creating the confidence people need to feel safe and return to the site.   It is clear that the public now demands to see highly visible, professional cleaning to a high standard in our public spaces. Since the start of the pandemic many premises and particularly education, retail, healthcare establishments and care homes have introduced improved and expanded sanitisation regimes. I expect to see a larger investment in cleaning programmes throughout the UK with enhanced specifications and more frequent schedules for years to come.Nobody is going to forget this awful pandemic and the vital importance of cleaning and hygiene anytime soon. L

Delia Cannings is Deputy Chair of the British Cleaning Council and National Education and Training Lead, Association of Healthcare Cleaning Professionals (ahcp). FURTHER INFORMATION www.britishcleaningcouncil.org

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Advertisement Feature

Working to protect NHS workers with high performance FFP3 respirators As the UK continues to fight the destructive effects of Covid-19, Globus Group has stepped up to innovate and help support the NHS throughout the ongoing pandemic frontline. It is essential that those operating on the frontline of the pandemic are properly protected and that their safety concerns are listened to and acted on.” At the start of the pandemic, Globus Group took the responsible approach of prioritising long-term investment and quickly cemented viable domestic supply chains by investing in two new UK manufacturing facilities. This allowed the company to guarantee the reliability of supply and performance of its products and provided the freedom to ensure a better fit and higher levels of respiratory protection. Globus is now producing over one billion medical masks and 300 million FFP respirators per annum for healthcare workers.

In launching a range of innovative FFP3 respirators specifically for the healthcare sector, Globus Group, the biggest British-based PPE manufacturer, worked alongside the NHS to ensure all frontline workers were protected. Recent findings from Cambridge University Hospitals NHS Foundation Trust research highlighted that wearing an FFP3 mask can provide up to 100% protection against infection from patients with Covid-19. By contrast, there is a far greater chance of staff wearing standard issue surgical masks catching the virus. The call for FFP3 masks to be issued more widely is in line with a long-standing demand by the British Medical Association, the Royal College of Nursing (RCN) and many other professional bodies who have repeatedly appealed for higher standards to protect the protectors against the spread of the disease. The Importance of Face Fit Testing In the importance of fit-for-purpose PPE protective equipment for healthcare workers has come to light, demonstrating the serious risk that poorly fitting respirators pose to an individual’s safety. Within the NHS, the standard issue face masks have previously been made to fit the ‘average person’ and, by default, can prove to be a poor fit for those with smaller face shapes, such as females. In the healthcare sector, this affects a large number of workers, with women accounting for 90% of nurses and 77% of all NHS staff.

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Therefore, not all respirators provide a tight seal against the face when worn by those with a smaller face shape, making them uncomfortable during long shifts and compromising the protection they offer, ultimately potentially causing a significant health and safety risk. With a heritage of more than 25 years, Globus Group worked hard to ensure that its products are meeting the needs of the NHS workforce and designed an innovative new range of face masks, HX-Series FFP3, specifically for the healthcare sector that offered a closer fit and higher levels of protection, helping to safeguard every worker. The business’s innovative new range has produced market-leading results, with a high ‘Face Fit Test’ pass rate for those with smaller face shapes. The testing was undertaken over a four-week period between November and December last year by expert technicians at an NHS Trust. Sally Young, a Clinical Leader at Royal Lancaster Infirmary commented: “Wearing a mask can give me soreness on my face, which is not ideal especially in stressful situations. However, the UK made FFP3 HX-3 is a comfortable fit and does not give the soreness other masks do.” Steven Binnie, Managing Director of Alpha Solway, added: “It is simply not acceptable that the majority of the NHS workforce, who happen to be women, should have to contend with PPE which does not properly protect them and ultimately their patients when they are on the coronavirus

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

How Sustainability can Help the Healthcare Agenda Following on from the recent Nursing Times Clinical Practice discussion on sustainability, it highlights that “If healthcare were a country, it would be the fifth-largest emitter of greenhouse gases on the planet.” Also, “The greatest opportunity to reduce NHS carbon emissions is decarbonising the supply chain”. Caps, gowns, masks and overshoes are listed as one of the top 20 clinical products that emit the most greenhouse gases. By buying UK-made the carbon footprint will be significantly less. Globus Group’s strategy is to produce 75% of products in the UK from locally sourced materials. For further information on the HX-Series FFP3 respirators and to hear more about face fit testing from a member of Globus’s dedicated healthcare team, visit: https:// nhshub.globusgroup.com This resource hub highlights a user guide for healthcare workers, complete with donning and doffing guidelines featuring an informative video on fit testing procedure for the Alpha Solway HX-3 respirator. L FURTHER INFORMATION https://nhshub.globusgroup.com


Infection Prevention

The world leading conference on infection prevention There’s not long to go until the Infection Prevention Society’s annual conference, Infection Prevention 2021, which is taking place on the 27–29 September at the ACC in Liverpool and online Microorganisms and healthcare continually The conference programme evolve, and IP2021 is your best opportunity Professor Heather Loveday will be providing to stay up to date. The three-day conference the opening session for the E.M Cottrell will present the latest scientific evidence Lecture. Amongst her positions, Loveday is from around the globe to enable attendees to Professor of Evidence-based Healthcare and recognise, understand and address current and Director of Research at the Richard Wells emerging risks. Research Centre, the University of West To make the most of Infection Prevention London, as well as director of the Joanna 2021, IPS recommends joining the event in Briggs Centre of Excellence for EvidenceLiverpool in September. By doing so, you will based Healthcare at University of West have access to: a world class programme London. She is a national and international including the legacy and learning from a leader in the field of infection prevention pandemic, featuring renowned national and control and patient safety having been and international speakers; the largest UK at the forefront of translational research, the infection prevention exhibition; extensive development of the Epic national evidenceposters and oral presentations on the based guidelines for the prevention of most current and critical IPC themes; and healthcare associated infections in England, networking and social opportunities. and the evaluation of implementation There will be safety measures in place. strategies for the past 20 years. However, if you are unable to travel Professor Jennie Wilson, IPS you have the option access the President, will also be presentations only as a virtual presenting, providing both On the delegate. Additionally, the welcome and close if future coronavirus to the conference. day Dr final restrictions result in the Wilson has worked in Mardel Simon w event moving fully online, the field of infection i l l analyse the pan any physical delegates prevention and d what w emic and can switch to an online control for over 30 registration (with a refund years, both as an from ot e could learn her cou in cost difference) or infection control ntries receive a refund. nurse specialist in and

viruses

London teaching hospitals and as a consultant epidemiologist at the Health Protection Agency. Her current research interests include the use of clinical gloves and hydration of the frail elderly. Other speakers include Dr Tim Boswell, Consultant Medical Microbiologist at the Nottingham University Hospitals NHS Trust, and Peter Hoffman, Consultant Clinical Scientist at Public Health England. Presentations will look at the need for a new handbook on IPC in outbreaks, the challenge of the Chief Nurse and DIPC in the coronavirus pandemic, presented by Dr Maggie Davies, Chief Nurse at University Hospitals Sussex, and the danger for measles reemergence in healthcare. On top of this, sessions will also look at the burden of device related infections, as well as the use of a collaborative approach for improvement, and rapid pathogen genome sequencing in helping infection prevention and control. And this is only on the first day. On 28 September, sessions will cover why guidelines let us down, strategies to prevent SARS-CoV-2 transmission to healthcare personnel, and importantly how we re-engage the public to play their vital role in preventing spread of infection, delivered by Professor Sally Bloomfield, from the London School of Hygiene and Tropical Medicine. E

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Advertisement Feature

Innovative sluice room and waste management solutions Regular service and maintenance for your sluice room machinery is key, writes DDC Dolphin

The overall goals of all healthcare environments are the same: you want to provide the highest quality of care, ensure a comfortable and supportive environment, and enable timely recovery for those who are unwell. Keeping patients safe from preventable HCAIs is therefore an absolute priority to ensure safety, well-being and rehabilitation. In order to ensure that neither patients nor clinicians are exposed to potentially life-threatening HCAIs, it’s essential to ensure sluice room technology is always working efficiently, as well as fixing any maintenance issues with urgency. Any length of downtime could result in negative consequences to both infection control and the institution at large, with loss of reputation, poor patient experience, clinician stress and unnecessary expense all part and parcel of an HCAI outbreak. Almost every hospital in the UK relies on macerators and washer disinfectors to underpin an effective infection control strategy. Uptime of this machinery is, therefore, an absolute priority. A fully operational sluice / dirty utility room is integral to controlling infection so you will want to do everything in your power to keep it up and running. To achieve this, you need reliable sluice room solutions and machinery – which can only be guaranteed with regular servicing and maintenance.

The true costs of breakdowns The life expectancy of a bedpan washer or medical pulp macerator is 10 years with consistent servicing. Without regular maintenance they may last less than seven years, even as little as five years. All machines can fail, but without proper maintenance your sluice room solution will experience mechanical failure on an average of three times a year. It may seem easier and more cost effective to simply deal with the breakdowns as and when they occur, but the reality is quite different. The industry average cost of a breakdown will include a call out charge plus labour and parts, a major expense on its own, but if you add to that the cost of reduced productivity of your nursing staff with the extra number of trips to the sluice room and time spent navigating the problem, you are into thousands of pounds wasted on something that could have been avoided. The average cost of a service contract is minimal compared to the cost of unplanned call-outs and the additional benefits of a service contract far outweighs the alternative, not only avoiding the stress, upheaval and staff downtime but also ensuring you stay compliant by having your machines regularly tested and serviced. 360° servicing for all makes and models Few facilities can afford heaps of maintenance contracts across different manufacturers; and in regard to estates management, this is also needlessly complex. DDC Dolphin are the only company able to

offer maintenance and servicing on all makes and models of bedpan washers and medical pulp macerators, using their own directemployed engineers. We know that all hospitals and care home requirements are different which is why we offer three levels of service, you can choose the package that best suits your needs from Lite, Essential and Ultimate packages. With one of these packages you can ensure that your sluice machinery stays in top condition and is maintained to the highest possible standards. But that’s not all you get. When you take out a 360° service and maintenance contract you benefit from direct access to highly trained engineers who are located all over the country; this allows for strategic dispatch to your facility, ensuring the quickest possible response to urgent requests, regardless of make or model. In addition, we have the biggest Field Service Team of any sluice room technology manufacturer, allowing us to look after even the largest estates in the care home and hospital sector. As part of our servicing and maintenance provision, we offer validation testing of your macerators and bedpan washers to NHS periodic testing guidelines. We can also provide you with detailed machine reporting, to help you interpret test results, plan your asset requirements and better budget for CAPEX expenditure. We can supply a comprehensive breakdown showing machine location, latest condition rating, scheduled service visits against actual completed visits and total call outs per machine per month. We can also supply financial overviews between reporting periods, showing individual invoice costs per site which can be broken down into Capital Sales (Assets), Service and Consumables. In 2020 even with the added pressure of COVID restrictions DDC Dolphin engineers covered an average of 26,000 miles each, made over 25,000 scheduled service visits with 93 per cent attended on the same or next day and 97 per cent completed within the service level agreement (SLA). As the only UK manufacturer to focus exclusively on sluice room solutions and with 30 years of experience you can rely on DDC Dolphin for all your service needs. L FURTHER INFORMATION www.ddcdolphin.com

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Infection Prevention

 Professor Michael Borg will discuss other infections during the coronavirus pandemic, Dr Jon Otter will look at why we need broader and better SSI surveillance, before Martin Kiernan will look at the unintended consequences of PPE. The final day On 29 September, a number of sessions will look at care homes and the protection of the elderly. Firstly the Royal College of Nursing’s Dawne Garrett will examine the risks, rights and ramifications for older people living with dementia in care homes, whilst Fiona Branton will look at whether behaviour in the home will need to change in a post-pandemic world. Lisa Hodgkinson will look at the impact of infection on people with frailty, before Dr Simon Mardel will analyse the pandemic and what we could learn from other countries and viruses. Exhibition All attendees will have access to the largest UK infection prevention exhibition, offering the latest in IPC technology. The IPS exhibition hall is dedicated to infection prevention, showcasing innovative

Presentations will look at the need for a new handbook on IPC in outbreaks, the challenge of the Chief Nurse and DIPC in the coronavirus pandemic and the danger for measles reemergence in healthcare products and services from about 70 companies. Attendees enjoy exclusive exhibition hours each day to learn about new science, technologies, advances, and products that provide solutions to infection prevention challenges and strengthen infection prevention programs. Gala dinner and Awards In addition to providing a platform to share extensive scientific knowledge and expertise, the IPS Annual Conference has an enjoyable social scene in which industry partners and delegates are given the opportunity to network and interact. The evening will begin with a wine reception, followed by a 3 course meal. Before

the dancing begins The Annual IPS Awards will be presented to acknowledge the contributions fellow professionals have made to infection prevention. Awards will also be presented for the Best Exhibition Stands (voted for via the IP2021 mobile app). The evening will include a disco to enable you to dance the night away. To acknowledge the key role that masks have played over the past 18 months, this year’s gala dinner and awards ceremony will take the form of a Masquerade Ball. Delegates are encouraged to wear decorative masks. L FURTHER INFORMATION www.ips.uk.net/conference

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How rethinking water delivery solutions can ensure the NHS is future ready With the demand on health systems only set to increase in the coming years, innovative and sustainable water delivery solutions should be at the forefront of the future of hospital design by 2025 and reduce both financial and workforce pressures across hospital estates.

With the New Hospital Building Programme underway, and fresh leadership in the NHS and Department of Health and Social Care, we need to look at how innovation can help tackle the greatest challenges the health service faces. There is also a welcome renewed focus on sustainability and driving efficiencies across hospital estates, meaning there has never been a better time to consider what the future of water delivery should look like in the NHS. Water delivery sits at the heart of safe, effective and sustainable healthcare. The introduction of digital solutions can transform water management and deliver improved outcomes for patients, healthcare professionals and the health service. Rada’s digital solutions have been on the frontline of infection prevention in the NHS throughout the Covid-19 pandemic, reducing the risk of healthcare-associated infections, cross-contamination and promoting good hand hygiene. Prioritising innovation for water delivery solutions brings many advantages for the NHS. It can help prevent infection, support the NHS to reach its sustainability target

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Prioritising safety and infection prevention Decision-makers within the NHS have challenging roles with competing priorities. They must demonstrate value for money while also ensuring that estates are safe environments for patients, healthcare professionals and staff. By investing in high-quality, innovative washroom control solutions, decision makers can prioritise patient safety and enhance outcomes whilst also managing resources efficiently. Healthcare associated infections are a considerable concern across healthcare settings, with six per cent of patients treated in NHS hospitals acquiring a healthcare associated infection (HCAI). Infection control procedures and policies are incredibly important for reducing these wholly unavoidable deaths, but the current approach is time and resource intensive. Covid-19 has placed ever greater demands on staff and facilities, meaning healthcare professionals need every tool available to them to prevent outbreaks of water and airborne diseases within hospitals. Solenoid valves have been identified as being one of the main sources of microbial growth across water systems in healthcare settings. Intelligent Care’s design and engineering mean that the risk of Legionella and other water-borne viruses is minimised. The water contact areas are also 95 per cent brass or copper, which strengthens resistance to microbial growth and cross infection. The monitoring functions within the Intelligent Care system allow abnormalities to be immediately identified and remedial action taken quickly and safely, minimising the risk of infection. By removing touchpoints from the handwashing process, Rada Intelligent Care contactless taps are a more hygienic alternative that reduce the spread of viruses that can cause health problems. By collecting key data on usage patterns, smart solutions provide infection control leads and facilities and estates managers with insights that make water management

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more efficient and provide better costcertainty. Research found that hospitals with automated hand-hygiene monitoring systems were found to have an advantage during the pandemic. They were also able to gather robust hand hygiene data with minimal investment of personnel time. Intelligent Care solutions also prevent scalding, which is listed as a ‘Never Event’ - a serious incident that is wholly preventable, as the water is delivered at a safe temperature removing the risk of ‘hotshots’. Ensuring temperature is also pre-set at the correct temperature for handwashing meets NICE recommendations. By driving the same innovation seen in other areas of clinical practice to water management, we can come together to reduce infections and keep patients, healthcare professionals and staff safe. The pandemic has highlighted just how important this is. Driving efficiency and sustainability Rada solutions are crucial for NHS hospitals looking to take a coordinated and actionorientated approach to sustainability. We support our partners in the NHS to deliver on sustainability targets and ensure the delivery of year-on-year reductions in water consumption. The NHS is one of the largest organisations in the world, with over 1.3 million direct staff. It is also one of the UK’s largest consumers of water, using approximately 50 billion cubic litres of water a year, at an annual cost of £60 million. With hospital staff using ten times more water than a typical office worker, sustainable use of water in the NHS has a vital role to play in meeting the UK’s climate change targets. The Greener NHS plan rightly identified significant opportunities for emission reductions in primary and secondary estates through better management of water use. NHS stakeholders that we engage with have also told us how much they are prioritising sustainability in response to these plans. Intelligent Care has specific tools in place that support greater monitoring of water


Designing the Future Hospital With new investment being channelled into NHS hospitals through the New Hospital Building Programme, we need to ensure that these new buildings are fit for the future and deliver the best value for money. Health Minister, Edward Argar MP recently wrote that ‘investment in our NHS buildings will transform health services for millions of people for decades to come, by putting world-class patient care, staff wellbeing and sustainability first’ - Rada helps make that a reality. The NHS has acknowledged that ‘technology will play a central role in realising the Long-Term Plan (LTP)’. Therefore, as the Government looks to invest in new hospitals and retrofit existing hospitals to promote patient, economic and environmental outcomes, decision-makers should use every tool available to them to meet the LTP’s ambitions. Rada has worked with hospitals across the country to upgrade and future-proof facilities against the spread of Covid-19 and other infections, installing our new Intelligent Care range of taps, which minimise the risk of infection through nontouch controls, thermal disinfection and automated duty flushing. Intelligent Care solutions use digital technology to solve real world problems. For example, they make compliance easier for facilities managers by removing the need for manual duty flushing, recording and logging – which are time and resource intensive. By automating duty flushing processes, greater efficiencies are achieved, and the risk of human error removed. This also generates

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usage and minimise water wastage. We are proud to partner with stakeholders in the NHS to help them learn, innovate and embed sustainable developments in their approach to water delivery. It was also acknowledged in the plan for digital transformation in the NHS that ‘digitising the estate and smart hospitals, will ensure the NHS meets its targets for delivering a net-zero NHS’. Rada’s solutions support this as the automation of data logging and compliance make it easier for stakeholders to complete Annual Sustainability Reporting. This helps to ensure operational efficiencies can be achieved, as duty-flushing is also automated, meaning staff time can be spent on driving resource efficiency elsewhere. There is also a huge environmental gain with pre-programming temperature and run-times to optimum length, minimising water wastage through over-use. Significant water savings can also be realised as the taps only run when hands are placed underneath. Rada’s water delivery controls are at the forefront of the future of sustainable hospital design, directly supporting the digitisation of NHS facilities and estates. Rada applies the same innovative spirit seen across patient care to water delivery, solving real world problems and driving efficiencies and boosting sustainability.

sustainability efficiencies as the taps can be networked to ensure that only taps that have not been used as flushed, reducing water wastage and supporting hospital trusts to meet the NHS’s ambitions for sustainably delivered healthcare. The intuitive no-touch control of water flow and temperature also encourages users to comply with hand hygiene procedures, supporting the health and well-being of patients through smart design. Making forward-thinking decisions on facilities within the health service will make life better for patients, visitors and staff, save time and money, and reduce the impact on the environment to the benefit of us all. Why Rada? Our greatest strength is our passionate, knowledgeable and experienced team who are always ready to go the extra mile to drive safe and sustainable water use in the NHS. Our team take pride in understanding the needs of the customers and can provide full life cycle support for all of our products. Unlike other manufacturers, we ensure that spares are available for 10 years after a product is discontinued – meaning spare components can be easily sourced and rapidly dispatched, reducing the need to refit new systems and reducing the financial burden of products, and increasing return on investment. Rada has supported critical facilities across the country in the fight against Covid-19, specifying and installing our industry-leading Rada Safetherm, a thermostatic clinical tap that improves bacterial control and user safety. Rada Safetherm, was selected, specified and installed for use in the NHS Nightingale Hospitals. The taps were chosen both

for their performance and Rada’s ability to respond to deadlines and deliver components to site in response to the NHS’s need to help guard against the spread of Covid-19. We are proud to adapt and evolve with our customers, ensuring our products meet the latest industry standards and guidance, ready for installation in any setting. We stand ready to help the NHS build hospitals that are future proof, meeting its ambitions to have a greener NHS. With the demand on health systems only set to increase in the coming years, innovative and sustainable water delivery solutions should be at the forefront of the future of hospital design and our collective approach to the delivery of healthcare in the years ahead. L FURTHER INFORMATION www.radacontrols.com Written by: Stuart Skinner, Marketing Manager, Rada

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Infection control in healthcare: vital steps for contractors In this article, Chris Murphy, Head of Operations for leading national maintenance and construction contractor Novus Property Solutions, talks through the essential matter of infection control within the healthcare sector. With both the client and end-user in mind, he outlines the key considerations when it comes to carrying out work in live environments to ensure compliance in infection prevention

The healthcare sector presents contractors with a unique set of challenges and considerations when it comes to planning works. Carrying out build or maintenance works within healthcare settings usually comes with high client expectations, tight timescales, and more contractor visibility. It’s important to always remember that healthcare buildings such as hospitals are most likely to be used by vulnerable people. It is vital that steps are taken to control the spread of infection across all sectors, particularly in the age of Covid-19, however emphasis on infection control should be top of contractors’ agendas when it comes to carrying out work in the healthcare sector. Carrying out build and maintenance works in healthcare settings means contractors are working in a live environment, which presents its own unique considerations. With most hospitals operating on a 24hour, 365-day schedule, any works being carried out within these spaces will impact the day-to-day running of departments and wards. It’s therefore crucial for contractors like Novus to minimise this impact through extensive planning, and by carrying out works with both flexibility and compassion. Infection control in healthcare settings There are several steps that contractors can take to minimise the risk of infection:

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Minimising dust: Regular housekeeping is imperative in preventing excess dust which can become airborne, and particularly in preventing this from spreading outside the immediate construction area – especially into adjacent patient care areas. There are several control measures contractors can implement to minimise dust and prevent infection outside of the construction zone. A simple way to do this is to restrict access to spaces where dust is being produced to essential staff only, as well as redirecting construction traffic away from patient areas where possible. Other physical prevention measures are also available, and contractors must consider the use of airtight plastic and dry wall barriers, negative-pressure ventilation in the construction area, dust suppression through the use of water, and covering all air intake and exhaust vents in the construction zone to prevent contaminated air from entering the hospital’s heating and air conditioning systems. Waste disposal: Dust and other debris caused by construction works must be disposed of frequently and safely as a way of preventing the spread of infection. It’s important that contractors do not allow any waste materials to build up – not just for safety reasons such as the prevention of physical hazards on site, but also as a way of reducing the chances of infection spreading. Safely disposing of construction waste should involve regularly removing debris from work zones in sealed containers, or as a minimum covering it with a damp cloth to stop it becoming airborne. As healthcare settings are round-theclock environments, contractors may need to arrange specific waste management schedules, as well as other logistics such as delivery of materials, with the client to ensure this is done with minimal risk to service users, in accordance with infection control measures. This may involve carrying

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out the removal of waste materials outof-hours in order to avoid regular hospital traffic, for example.

Maintaining distance: Since the outbreak of Covid-19, social distancing has become a part of our daily lives – and it’s even more important to maintain distance when carrying out work in healthcare settings, both for construction workers and patients. Not only is social distancing a vital step in infection control to protect hospital service users but also to protect construction workers. By maintaining as much distance as possible, on-site construction teams are more likely to prevent the spread of infection to their families and each other, which could otherwise cause delays to the works. The value of communication To implement the appropriate infection control measures, flexibility and communication with the client are key. Healthcare settings require a greater level of communication between client and contractor due to the live nature of hospital environments. Any construction works within these environments have the potential to affect hundreds, if not thousands, of people – so maintaining excellent levels of communication is vital for a contract’s success, both generally and specifically in infection control. Construction teams must work directly with the client from the planning phase and throughout the contract period in order to establish a tailored infection control system that is appropriate for the environment.

For more information about Novus Property Solutions and their healthcare expertise, visit the website below. L FURTHER INFORMATION www.novussolutions.co.uk


Infection prevention

Revolutionising the disinfection of ambulances A novel microwave sterilisation method that could revolutionise the way ambulances and hospitals are disinfected has been created by a number of Scottish universities The University of Edinburgh, Heriot-Watt University and the University of Strathclyde have published research exploring the possibility of a new technique which could drastically reduce the time it takes to get an ambulance safely back on the road to save lives. At present, sterilisation of an ambulance is done manually with conventional techniques that use chemicals, which usually takes around 30 to 40 minutes to disinfect a single ambulance. During this time, the ambulance is out of action, putting increasing pressure on emergency services during busy times. In recent years, several other techniques have been proposed for disinfecting and sterilising surfaces, ranging from hydrogen peroxide aerosols to UV irradiation and infrared radiation. Last April, the Defence and Security Accelerator tested 12 methods to speed-up the sanitising of ambulances – in some cases reducing cleaning time from an hour to around 10 minutes so more lives can be saved. However, according to the three universities, these techniques have been shown to degrade surfaces over time, or to be harmful to humans if they are in close proximity. This has, so far, limited their long-term application. In contrast, the new method works using electromagnetic waves, antennas, sensor beacons, and a liquid layer to heat-up and sterilise surfaces rapidly. The automation

known to denature at 60 degrees centigrade. By looking at the solution turning white, we were able to show that the right temperature was reached to enable virus deactivation. This would be extremely helpful for an operator of the The research proposed system.” Strathclyde researchers played a role in The collaborative team funded the initial demonstrating whether microwave beams research themselves, using existing lab were effectively hitting the surfaces equipment and their goodwill. They and could heat them at the are now seeking funding to right temperature. The S terilisat manufacture a device that can study used microwave io n of an a be installed in ambulances beams emanating from m b u lance is done as a proof-of-concept antennae, like those conven manually wit demonstrator. found in mobile smart Marc Desmulliez, phones and domestic that us tional techniq h e chem ues from Heriot-Watt Wi-Fi systems. The icals usually University, said: “The antennae allow the takes a , which beauty of this new microwave radiation r o u nd 30 to 4 technique is that the to be directed and 0 surfaces sterilised are not focused on locations minute s being degraded which was where it is most needed. one of the key challenges found A microwave powered, with using UV light or aerosol open-ended oven was shown techniques. The resulting microwave to enable the deactivation of live device can also be portable, and this means coronavirus (strain 229E) at a relatively low it can be applied in multiple other temperature of 60 degrees centigrade in applications beyond ambulances and 30 seconds. operating theatres. It could be used to Nico Bruns, a polymer specialist in sterilise dinner tables in restaurants or clean Strathclyde’s Department of Pure and Applied train or airplane tables and seats prior to Chemistry, was a partner in the study. He said: welcoming new customers.” E “My group used hen egg white proteins that are means a person can easily operate the system from a safe distance, rather than touching contaminated surfaces directly during cleaning.

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Helping NHS trusts see the value in reducing surgical site infections By lowering the risk of surgical site infections1, Ethicon’s Plus Sutures may be able to help the National Health Service at a time of unprecedented pressure

On 28 June 2021, the National Institute for Health and Care Excellence (NICE) issued new medical technologies guidance (MTG) recommending the use of Ethicon Plus Sutures in all surgeries when absorbable sutures are an appropriate option within the National Health Service (NHS)1. By lowering the risk of SSIs1, Plus Sutures may help the NHS to manage its hospital bed capacity and cope with the significant backlog of elective surgeries postponed during the Covid-19 pandemic which has served to disrupt routine hospital services globally2. Surgical site infections (SSIs), which account for 37 per cent of all hospital-acquired infections in surgical patients3,4, cause significant clinical and economic burden2. While SSIs can lead to an additional 10 days in hospital5, reducing the risk of SSIs can release beds, save costs1 and allow for extra procedures to be performed. Data shows that 40-60 per cent of SSIs may be preventable3,4 and clinical data, comprising of 31 randomised controlled trials, as well as the NICE MTG meta-analyses, showed that Plus Sutures is associated with a nearly 30 per cent reduction in the risk of surgical site infection1. Dimitri Pournaras, Upper Gastrointestinal, Bariatric and Metabolic Surgeon, North Bristol NHS Trust , said: “Reducing SSIs is crucial for our patients, the multidisciplinary team looking after them, hospitals, and healthcare systems. In the provision of surgical care each procedure needs to be as efficient as possible. Using the resources and technology available to reduce SSIs, we can improve patient

outcomes and reduce the burden of SSI to the NHS, society and our environment.” The use of triclosan-coated sutures in wound closure as part of SSI-prevention is recommended by a growing number of health authorities around the world6-10 with NICE stating that Plus Sutures is cost saving compared with non-triclosan absorbable sutures by an average of £13.62 per patient1. NICE also acknowledged the use of Plus Sutures can result in environmental benefits by preventing SSIs1. Environmental savings were based on the NHS England Sustainable Care Pathways Guidance and included greenhouse gas emissions, freshwater use, and waste generation1. L Plus Sutures is the first and only suture with antibacterial protection recommended by NICE for all appropriate surgery types1.

4. 5.

6.

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8.

9.

FURTHER INFORMATION www.jnjmedicaldevices.com References: 1. NICE 2021. Medical Technology Guidance: Plus Sutures for Preventing Surgical Site Infection. Available from: https://www.nice.org.uk/guidance/mtg59 Accessed August 2021. 2. COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. June 2020. 107:11:1440-1449. 3. World Health Organization. Safe surgery saves lifes. WHO Guidelines for Safe Surgery 2009. (162120201208)

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10.

Odom-Forren, Preventing Surgical Site Infections. Nursing 2009; 36: 58-63. (162120-201208) Jenks PJ, Laurent M, McQuarry S, Watkins R et al. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. J Hosp Infec 2014; 86: 24-33. Berrios-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152(8):784-791. (156562-201021) Ban KA, Minei JP, Laronga C, et al. American college of surgeons and surgical infection society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017; 224(1):59-74. (156562-201021) NICE Guideline Updates Team (UK). Surgical site infection: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/ Recommendations#closuremethods Accessed Nov 16, 2020. (156562-201021) World Health Organization. Global guidelines for the prevention of surgical site infection. https://apps.who.int/iris/bitstream/han dle/10665/250680/9789241549882-eng. pdf?sequence=8. Published November 2016. Accessed Nov 16, 2020. (156562-201021) Prevention of postoperative wound infections. Recommendation of the Committee for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. Bundesgesundheitsbl. 2018;61(4):448-473. (156562-201021)


Infection prevention

The study used microwave beams emanating from antennae, like those found in mobile smart phones and domestic Wi-Fi systems. The antennae allow the microwave radiation to be directed and focused on locations where it is most needed  Dr Symon Podilchak, professional engineer and a senior lecturer of radio frequency technology from the University of Edinburgh, said: “I got the idea over a year ago when sterilising baby bottles for my newborn son using a microwave oven. It was when the Covid-19 pandemic was just starting in the UK in early 2020. “I realised that if bottles could be sterilised in just a few minutes and were safe for a newborn child then it was possible to scale the technique for infected surfaces. However, significant research was required to determine the relative distance between the surface and the antenna whilst ensuring safe power levels. I also figured out that it would be better to target and focus the microwave beam to the areas most likely to be affected. To do this, I reused a technique that I originally developed for charging mobile phones wirelessly.” Welsh Ambulance Service In May, it was announced that a rapid call had trialled and installed a new method which cuts costs and cleaning times across the Welsh Ambulance Service. As mentioned previously, the Welsh Government approached the Defence and Security Accelerator in March 2020 for help in finding innovative solutions to speed up the cleaning of ambulances. Shortly afterwards, a call was launched, receiving over 200 responses within seven days. Hygiene Pro Clean was one of just 12 suppliers selected for testing and their product is now being adopted by the Welsh Ambulance Service NHS Trust (WAST). Hygiene Pro Clean have designed an ultrasonic atomisation delivery system which disperses a highly effective decontamination solution (Decon Pro Clean) in a soft plume-shaped spray; this ensures uniform distribution of the liquid to minimise overspray and waste. The system,

combined with HPC’s training and protocols, provides an effective decontamination of any void or space. Adopting this technology has brought about many savings for WAST, including reducing the time it takes to clean an ambulance as well as achieving significant staffing efficiencies – enabling crew to undertake other duties while the ambulance is being cleaned. L FURTHER INFORMATION www.strath.ac.uk

Over 25 years leading the way in PPE Globus Group is dedicated to developing innovative, high-performing, resilient and reliable PPE solutions for workers in healthcare settings. For more than 25 years, Globus Group has been protecting people at work from injury and infection, empowering them to do their jobs safely and efficiently. The business is one of the world’s most pioneering manufacturers of global worker safety solutions for respiratory, hand, eye, head and hearing protection, as well as protective clothing. A diverse range of marketleading brands, products and support services sit under the Globus Group umbrella. Headquartered in Manchester, Globus is the biggest Britishbased PPE manufacturer and amongst the sector’s largest employers with sites across the UK, Europe and Asia. The Group

has three UK manufacturing facilities in South West Scotland and North West England with a further two sites scheduled for early 2022, with an expanding presence and international footprint. The company takes pride in the safety, reliability and wearability of its product offering, and is equally passionate about protecting our planet. Globus’ strategy is to manufacture a minimum 75 per cent of products in the UK, significantly reducing carbon footprint. L FURTHER INFORMATION www.globusgroup.com

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Waste management

Viewing health by-products as resources rather than waste Rethinking waste as a valuable by-product is vital to meeting sustainability targets across healthcare systems, writes David Rakowski, a sustainability expert at PA Consulting The entire healthcare industry should be The clock is ticking thinking about the sustainability of its As the buyers of the products passing through plastic waste footprint. With the global hospitals, organisations like the NHS have taken focus on Net Zero, and the impact that the lead in setting out robust sustainability waste has on greenhouse gas emissions, and Net Zero targets aimed at driving healthcare leaders need to rethink their transformation throughout the value chain. approach. That includes exploring the In the current legislation, emissions caused increasing commercial opportunities which by waste disposal are a key part of Scope 3 are making waste a valuable by-product. emissions, which cover indirect emissions in the The NHS alone generated an estimated value chain such as products, packaging, 590,000 tonnes of clinical waste and disposal. As more public sector every year (pre Covid-19), with organisations move to Net Zero 25 percent of the overall policies, medical manufacturers The NH waste generated by a will need to have robust S a hospital being plastic. strategies in place by 2030 l o n e genera Much of this is incinerated to continue supplying to t e d estimat a due to the potential the NHS. Rethinking the ed 590 n ,000 tonnes for contamination, use of plastic waste at a o f producing CO₂ emissions system level will need to be c l i n waste e ic and potentially other a core part of this activity. very ye al a pre-Co noxious fumes. Future legislation also vid-19 r, So, if there’s a huge looks likely to place the environmental impact onus on the manufacturers and potentially a commercial to implement an ‘end of life transformation opportunity, why solution’ to plastic packaging waste. isn’t there more happening today and how There are several challenges to can the industry unlock the opportunity? overcome, which include:

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Data insights - While data surrounding what is being procured and disposed of is available, the next layer of detail about the types of material that flows through a hospital is not. Filling this data gap has the potential to provide insights to help hospitals reuse or recycle even more waste. Waste infrastructure – Hospitals have not been designed to collect multiple waste streams, and many do not have the space for the separate collection of plastics for recycling. Contamination – the clinical environment produces a range of hazardous and nonhazardous waste that needs to be handled appropriately. However, there is also a perception of contamination that can result in sometimes overzealous management of waste and waste being incinerated that might not otherwise need to be. A fragmented approach – Design for materials end of life is typically not a focus for medical products, meaning they have not been optimised for material recovery after use.


Waste management

However, through ingenuity and aligning to the shared purpose of a sustainable future, it is possible to overcome challenges like these above and create tailored, actionable roadmaps which stop thinking about plastic waste as a problem, but rather as a useful resource that has value. There are three main themes for leaders across the health system to think about: adapting waste policies, adopting disruptive technologies, and rethinking product and business model design. Adapting waste policies Individual hospitals can achieve a lot at the local level by, for example, looking at local ‘binfrastructure’ to promote a responsible recycling culture and make it easy for people to do the right thing. Leaders must ask, are users aware of hospital recycling policies, are they being misinterpreted or over applied, and are they appropriate for the situation? Great Ormond Street Hospital ran a staff awareness campaign on inappropriate glove usage. The project was a success, reducing glove usage by over four million gloves in a year, saving just over £100,000 and 21 tonnes of plastic that would have otherwise been incinerated or landfilled. While leaders at the local level often have more flexibility to make changes and face fewer barriers in revisiting guidelines, this doesn’t mean we should shy away from developing systemic policies. The emerging UK Extended Producer Responsibility (EPR) scheme states that ‘household-like, commercial and industrial packaging waste that arises in public sector premises’ will all be in scope, which for the first time, implies healthcare will not be excluded. This will create a further incentive on the industry to transform the packaging of healthcare products. Adopting disruptive technologies to better manage waste While recycling efforts are increasing across the industry, there is also an opportunity to make more of the products that are currently going into recycle bins, and later being sorted into waste. What if we could get high-grade polymers that have passed through a hospital and might otherwise be incinerated, in the right place and in the right form, that they can be sold into the recycled polymer market place? The good news is that emerging and existing technologies can be brought together to do this. Sorting is often a challenge, but innovators are using new technologies, like robotic sorting with AI to unlock the value in waste. If we could shrink a waste sorting facility and put it in a container that every hospital could have on site, that could transform the way we manage and unlock the value of waste. Combine this with even better marking of products for recycling, that facilitate more automated sorting, and a whole range of new possibilities are opened up. Rethinking product and business model design Products can often evolve organically to meet the needs of the systems they serve, becoming more complex than necessary. When the system goes through a transformation, like the sustainable one in healthcare, there’s a

As the buyers of the products passing through hospitals, organisations like the NHS have taken the lead in setting out robust sustainability and Net Zero targets aimed at driving transformation throughout the value chain chance to fundamentally rethink those products, which can reveal a lot of easy wins. That can be unnecessary plastic, opportunities to reuse or recycle products by slightly redesigning them and creating incentives for the return of products to extract value from the waste. This can be less straightforward in healthcare, as there are often very long product development cycles with high regulatory burdens that can further slow innovation. So, it is essential to anticipate the future sustainability requirements of both customers and legislators to ensure products will be fit for purpose when they come to market. In the short-term, our experience has shown manufacturers can do a lot without recertification. They could use a different material with similar properties but increase end of life options or implement a takeback scheme, for example Novo Nordisk’s insulin pen return scheme. This scheme not only achieved great success with not only increasing their recycled products but has also reduced the plastic waste from their global production process. Cost reduction through sustainability incentives Doing the right thing is also a way to unlock new revenue streams within financially stretched healthcare systems. Used polymers can be sold to be recycled by other industries, and polymers used in medical products are of the highest grade making the materials even more appealing for second life applications.

The purchase price that some are willing to pay for polymers has risen recently with high grade recycled post-consumer PP trading at upwards of £800 per tonne, while the average cost currently being paid to dispose of it through incineration is greater than £200 per tonne depending on the waste stream. Recovering and recycling Just a tenth of the plastic waste (14,750 tonne per year) could be worth up to £14.7 million to the NHS alone, demonstrating just one example of the potential opportunities. As 95 per cent of the value of a product is lost when you get to the point of recycling, it is clear that closed loop systems where products are not downcycled or even better are reused or remanufactured offer ways to avoid that loss of value. This would need new business and commercial models but using approaches that are increasingly commonplace in other sectors. An end-to-end approach to the sustainable health industry There are many ideas and innovations driving us towards a healthcare system that sees byproducts as resources rather than a burdensome waste stream. However, it’s the ability to redesign, adopt and scale that presents the real challenge. To achieve this will require a systemic approach, with players coming together to set common goals, and look in new places for cutting edge solutions. L FURTHER INFORMATION www.paconsulting.com

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Why Actiform? One of the largest privatelyowned manufacturers of offsite engineered buildings in the UK. A Yorkshire based family business with a national reach. Experts in the design, manufacture, and construction of offsite engineered buildings. On site with multiple trusts nationwide delivering turnkey projects, including stand alone module, refurbishmenst, extenstions and multi storey projects.

Why Modular? Typically, MMC solutions can be up to 50% quicker to construct. Modular construction is far more energy efficient, creating less waste. Find out more: https://actiform.co.uk/ Get in Contact shellie@actiform.co.uk 01924 498557


Design & build

How to plan new hospitals to improve patient pathways The Royal College of Physicians has published a report outlining how new hospitals should be designed and planned to improve patient pathways and staff well-being Hospitals are powerful ‘anchor institutions’ in their communities that the Health Foundation says ‘can positively influence the social, economic and environmental factors that help create good health in the first place’. In the executive summary to the RCP new hospital design report, the authors write that hospitals do not exist in isolation from either the communities they are based in or the wider health and social care system they are part of. The RCP believes that the most important consideration when designing and planning new hospitals is how can we improve the experience and outcomes for patients. The paper explores three themes: how to design hospital services around the needs of patients rather than the ‘system’; how to ensure that patients receive better, quicker services from hospitals; and how to improve staff well-being in hospitals to enable better workforce retention and delivery of services. The report focuses primarily on how better patient pathways should be built into the functioning of new hospitals, including a shift in mindset to design services around the needs of patients rather than the ‘system’. The widespread shift to remote appointments brought about by the pandemic, although not without challenges, has, the report argues, undoubtedly made accessing healthcare simpler for most patients and shows the way forward. Following this, improving patient pathways also means learning the lessons from the quality improvement work that takes place in hospitals, in order to implement very practical changes that we know lead to better patient care. An example of this is co-locating acute admission units and delivering more effective ward rounds.

The third aspect of ensuring that new hospitals function effectively is improving staff wellbeing to enable better workforce retention and delivery of services. We need to think here about both the macro and micro levels – from tackling workforce shortages so that staff feel less stressed, to ensuring there is somewhere for them to hang their coat up. Here, we look at the first of these points: how better patient pathways should be built into the functioning of new hospitals.

also help to break down the divisions in care delivery. Designing in ‘one-stop visits’ to the functioning of new hospitals will also help to improve the patient experience, where multiple tests and scans are done on the same day to reduce the number of hospital visits needed. The report states that the move towards having statutory ICSs responsible for designing and delivering services is a ‘fantastic opportunity’s ensure that services are better designed around the need of patients. However, it is vital that ICSs learn the lessons from good practice in other areas and are able to share information easily.

The needs of the patients The RCP says that person-centred care os the ‘holy grail’ of healthcare delivery. The RCP’s Future Hospital Programme Engineering better worked with eight development service design sites to deliver models of The wa y The report Engineering person-centred care. that he a better care by the Amongst the lessons lt h care services Royal Academy of learnt were: the need a r e delivere can oft Engineering, the RCP for patients to have an d organis en reflect the and the Academy active and valued voice ational of Medical Sciences in decision making and st within is instructive in the need to create the the hea ructures lthcare system, outlining what a mechanisms for patient/ rath systems approach to clinical dialogue. patient er than designing services and The way that healthcare need continuous improvement services are delivered can should entail. The application often reflect the organisational of this systems approach will structures within the healthcare enable services to be better designed system, rather than patient need – around the needs of patients, staff especially the barriers between primary, and communities. secondary and social care and between The report explains that the design of specialties in hospitals. healthcare services can benefit from the rigour The RCP argues that making greater use of the engineering approach to systems. of integrated health and social care teams Its four key findings in relation to how is one answer, as patients the receive faster to implement a systems approach to access to services, with the report also healthcare design and improvement are: suggesting that virtual integrated clinics can systems being centred on people; iteration before implementation; design as an exploratory process; and risk management as a proactive process, which tackles the identification of possible opportunities for and threats to a system before they arise is more likely to lead to the delivery of robust and adaptable systems. Reforming outpatients Achieving significant change that helps patients can often be slow due to little more than inertia. The sluggish progress to reform outpatients is highlighted as a prime example. The RCP’s 2018 report Outpatients: the future highlighted how the system did not work well for patients, with one in five appointments in England, and one in four E Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Design & build

 in Wales, cancelled or reported as DNA (did not attend) – the majority of cancellations by hospitals. Members of the RCP’s Patient and Carer Network had expressed frustration with ‘the heavy reliance on traditional face-to-face consultations, which are often rushed with little opportunity for questions or discussion’, and the fact that reaching a diagnosis and treatment plan required ‘several hospital visits, over several weeks ... prolonging uncertainty and wasting time’. This changed almost overnight when the UK faced coronavirus, with outpatient appointments replaced by remote appointments – most by telephone and some by video. And although this has presented access problems for some patients, and some appointments will always need to be done face to face, the shift was overall a positive one for patients. A report by National Voices found that ‘for many people, remote consultations can offer a convenient option for speaking to their healthcare professional. They appreciate quicker and more efficient access, not having to travel, less time taken out of their day and an ability to fit the appointment in around their lives. Most people felt they received adequate care and more people than not said they would be happy with consultations being held remotely in future’. Another development is patient-initiated follow-up (PIFU), which is relevant to several of the recommendations from our outpatients report. Patients should be involved in selecting

The report focuses primarily on how better patient pathways should be built into the functioning of new hospitals, including a shift in mindset to design services around the needs of patients rather than the ‘system’ appointment times, outpatient appointments should be flexible and minimise disruption to patients’ lives, and individuals should be supported to be co-owners of their health. PIFU is part of the NHS outpatients transformation requirements. It should, where

possible, replace routine appointments, with benefits to both patients and clinicians. L FURTHER INFORMATION www.rcplondon.ac.uk

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WWW.BiGDUG.CO.UK 0800 141 3380 Issue 21.4 | HEALTH BUSINESS MAGAZINE

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Working in partnership with it’s clients The Testing Lab PLC continues to ensure water and asbestos compliance throughout its portfolio from small one off dental practices to complete hospitals. From the simplest to the most complicated L8 risk assessments through to installation of chlorine dioxide units to eradicate high level counts and where necessary installing copper/silver ionisation units to attack and eradicate the biofilm that harbour these dangerous bacteria.

dedicated admin team based within the National Control Centre in Doncaster which is where all the C.A.D. drawings and reports are completed. Daily, weekly and monthly updates for all disciplines are made in real time to the client’s specific secure portal which allows continual support in superfast time.

Depending on the building and its occupants TTL assessors/engineers are highly trained in all elements of L8, HTMO4-01,COSHH, HSG274, Drinking Water Inspectorate and many more whilst also adhering to HSE legislation and taking into account their actions and the way those actions may affect others.

Asbestos surveyors all work from home and are allocated work on the company hand held which is uploaded to the company server and then undergoes data and UKAS checking whilst the samples are tested within the TTL internal, UKAS accredited Laboratory. Working to all HSE guidance surveys are carried out to HSG264, CAR2012, UKAS 17020 and 17025. TTL actually boasts one of the quickest turn arounds in the UK and if needed a report in draft format can be issued before the surveyor even leaves the building.

Fully employed on PAYE TTL’s Engineers are strategically placed throughout the UK with a

Call for a chat and see how TTL can save your organisation some of your budget!

www.thetestinglab.eu info@thetestinglab.eu

0800 177 7264


Building compliance

The National Building Safety & Compliance Framework The Building Safety & Compliance Framework is worth up to £880 million over a four-year period. Here we look at the agreement in further detail as well as the latest news affecting the building safety sector A few months ago, procurement organisation Fusion21 has announced the suppliers successfully appointed to its national Building Safety & Compliance Framework – worth up to £880 million over a four-year period. The framework is open for public sector organisations to use including those in housing, local authorities, blue light, central government, education and health. The updated framework has been designed and positioned to meet emerging requirements particularly in relation to fire safety and the building a safer future agenda. As of April, 175 prequalified, accredited suppliers, both SMEs and multinational organisations, have been assessed for their skills, knowledge, experience and behaviours (SKEB) and have secured a place on the framework, which has been designed and positioned to meet emerging requirements

coverage of England, Scotland, Wales and particularly in relation to fire safety and the Northern Ireland. building safety agenda. The scope of the framework Framework benefits include: covers surveys, planned and flexible pricing options responsive maintenance, available allowing call off The upd ated installation and upgrades, of a comprehensive range framew and complements of works and services designe ork has been d and p Fusion21’s existing to enable smooth ositione to mee Heating and running of any facility d t requirem emerging Renewables and small or large; flexible Lifts frameworks approaches to call in relatioents particular ly n to fire to cover the big six off without reopening sa and the compliance areas. competition – Direct building fety Fusion 21 has Award (with or without a safer fu ture introduced three Negotiation), Single agenda completely new lots, Stage and Two Stage Mini including; Lot 5 – Fire Competitions; procured Safety Surveying, Engineering & in line with Public Contracts Consultancy (Multi- Disciplinary), which Regulations 2015 and Public specifically focuses on complex buildings; E Contracts Regulations (Scotland) 2015; and Issue 21.4 | HEALTH BUSINESS MAGAZINE

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At JM Passive Fire Protection, we have been providing second to none fire protection services since our establishment in 2016. We are a Merseyside-based company, now branching out into most regions across the UK. We pride ourselves on having a friendly team with immense worth ethic as well as our expertise, efficience and combined experience in all sections across the trade.

www.jmpfp.co.uk • 0151 329 3230 JM Passive Fire Protection, 32 Charnock Point, Charnock Road L9 7ET


Building compliance

 Lot 7 Fire Safety Inspections; and Lot 14 – Local Exhaust Ventilation. The full, new 14 lot structure includes: Lot 1 – Asbestos Surveying & Consultancy; Lot 2 – Asbestos Abatement & Removal; Lot 3 – Legionella & Water Hygiene Consultancy; Lot 4 – Legionella Monitoring & Control; Lot 5 - Fire Safety Surveying, Engineering & Consultancy (Multi- Disciplinary); Lot 6 – Fire Risk Assessments; Lot 7 – Fire Safety Inspections; Lot 8 - Passive Fire Protection - Fire Doors; Lot 9 - Passive Fire Protection - Fire Stopping; Lot 10 – Active Fire Safety; Lot 11 – Electrical Testing & Electrical Works; Lot 12 – Electronic Security; Lot 13 – Warden Call & Tele-health; and Lot 14 – Local Exhaust Ventilation. Peter Francis, director of Operations at Fusion21, said: “This framework has been developed to help our members meet the emerging fire safety requirements of the Building Safety Agenda, offering fire safety, surveying, engineering, consultancy and inspections. “As with all of Fusion21’s frameworks, the Building Safety & Compliance Framework enables our members to deliver social value to their communities, and has been set up in a way that gives organisations the flexibility to align their use of the framework to their organisational priorities.” Heating and Renewables Worth up to £500 million over a four-year period, a total of 82 highly skilled firms secured a place on the Heating ad Renewables framework which was designed by Fusion 21 to provide both domestic and commercial solutions to public sector organisations including housing associations; NHS trusts and education providers. Offering 10 lots and a range of services from consultancy to design, servicing, maintenance and installation, the framework incorporates a selection of renewable technology applications from air and ground source heat pumps to solar thermal, electric heating and hot water systems. The commercial element of this framework can be utilised for a range of installations which includes district heating systems and the installation / servicing of Heat Interface Units. For the first time, the framework also features an education specific lot in partnership with the Department for Education, developed to E

The Building Safety & Compliance Framework enables members to deliver social value to their communities, and has been set up in a way that gives organisations the flexibility to align their use of the framework to their organisational priorities

High quality and reliable Fire Protection products from Dorma, Lorient, Mann McGowan, Norseal and Exitex for commercial, public and industrial customers as well as SMEs, landlords and homeowners. Quality Products • Competitive Pricing • Excellent Support LFS Fire Shop is the online retailer of LFS, a UK market leader and specialist in Passive Fire Protection, who from their base in South East London manufacture bespoke Fire & Enhanced Security Doors and provide a range of fire stopping services.

www.lfsfireshop.co.uk Freephone – 0800 035 6827

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Here at Woodnut Construction we provide a caring personalised service to cover a wide range of building and construction services to help keep hospitals evolving, compliant and up to date. Our Trained staff can deliver all of the following services: • • • • • • • • • • • • • • • • ED RD ER A I AW PPL U S 2016

NHS London Procurement Partnership

MINOR BUILDING WORKS DYNAMIC PURCHASING SYSTEM

Fire Compliance Passive Fire Protection Fire Door Installs Response Maintenance Planned Maintenance Hospital Ward Construction Full M & E Installations and Upgrades 25 Year Guaranteed Roofing Installations and Renewals Emergency Response Maintenance Out of Hours emergency Works Shower/Bathroom/DDA Compliant installations Clinical and Lab Upgrade Works Flooring Renewal Air Conditioning Hospital Redecorations and Refresh Works Office Desk Benching Installations

Our personalised service will provide you with a dedicated team to work with from planning and estimating, through to production, construction and final handover.

info@woodnutconstruction.co.uk Call: 0203 981 0296 Company No: 08091775

Fuel Tank, Unit A112, 8 - 12 Creekside, London Se8 3DX


Building compliance

 support schools, colleges, academies and further/higher education establishments with their heating requirements. Providing regional coverage, the framework will facilitate local delivery and is structured to open doors to SMEs, enabling suppliers to bid for works suited to their experience and expertise. Of the 82 firms on the agreement, 75 per cent are SMEs. Lifts The Lifts framework is designed to deliver lift related work and services to estates across the public sector and will support a variety of design, installation, refurbishment and the servicing/maintenance of passenger/ goods lifts and domestic lifts (including stair lifts, step lifts, platform lifts and hoists). Like all frameworks from Fusion21, the Lifts framework is run by technical specialists and only features pre-qualified, accredited supply partners. Worth up to £80 million over a four-year period, the agreement is also designed to meet the needs of housing providers, local authorities, NHS trusts, bluelight organisations, education providers and central government. The framework will deliver lift related work and services to estates across the public sector. The framework will offer options for fully comprehensive or basic maintenance, in addition to specific lots for lift consultancy services and carrying out thorough examinations required by LOLER (Lift Operations and Lifting Equipment Regulations 1998).

The Building Safety Bill will set out a clear pathway for the future on how residential buildings should be constructed and maintained. The government says that the Building Safety Bill, published in July, will create lasting generational change Structured to open doors and collaborate with SMEs, the framework enables suppliers to bid for works suited to their capability, experience and expertise. A total of 32 highly skilled firms – including 84 per cent SMEs – have secured a place on the framework. Building Safety Bill The Building Safety Bill will set out a clear pathway for the future on how residential buildings should be constructed and maintained. The government says that the Building Safety Bill, published in July, will create lasting generational change. As part of the new legislation, a Building Safety Regulator will oversee the new regime and will be responsible for ensuring that any building safety risks in new and existing high rise residential buildings of 18m and above are effectively managed and resolved, taking cost into account. This will include implementing specific gateway points at design, construction and completion phases

to ensure that safety is considered at each and every stage of a building’s construction, and safety risks are considered at the earliest stage of the planning process. These changes will simplify the existing system to ensure high standards are continuously met, with a ‘golden thread’ of information created, stored and updated throughout the building’s lifecycle, establishing clear obligations on owners and enabling swift action to be taken by the regulator, wherever necessary. The reforms build upon Dame Judith Hackitt’s review of Building Regulations and Fire Safety, which highlighted a need for significant cultural and regulatory change. Under the proposals, the government is more than doubling the amount of time that residents can seek compensation for substandard construction work, from six to 15 years. This means that residents of a building completed in 2010 would be able to bring proceedings against the developer until 2025. E Issue 21.4 | HEALTH BUSINESS MAGAZINE

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DELIVERING POWERFUL SOLUTIONS WELCOME TO CABLESHEER – OUR FAMILY RUN BUSINESS WITH OVER 40 YEARS OF SUCCESS, DELIVERING ENVIRONMENTAL & CONSTRUCTION SERVICES NATIONWIDE. With our directly employed multiskilled trades, we invest heavily in our staff providing our clients with the highest quality workforce and added value. By integrating all our divisions; Asbestos Removal, Fire Stopping, Fire Doors, Roofing and Construction, we can drastically improve on timelines whilst also providing a streamlined service. A lot of clients feel the strain when dealing with multiple contractors; managing, liaising & coordinating, only for one party to fail risking the entire programme.

CABLESHEER HAVE EXCLUSIVITY UNDER THE FUSION 21 FRAMEWORK AS THE ONLY UK CONTRACTOR THAT CAN BE ‘DIRECT AWARDED’ ACROSS ALL THREE OF OUR SUCCESSFULLY PLACED LOTS: LOT 2 – ASBESTOS REMOVAL LOT 8 – FIRE DOORS LOT 9 – FIRE STOPPING ASBESTOS REMOVAL

We strive to eliminate this, giving the client back their time whilst keeping their priorities at the forefront of our minds.

Licensed Asbestos Removal Contractors, with nationwide coverage, we have a diverse range of clients, giving us a knowledgeable overview of the industry. Our asbestos teams are often integrated within our construction teams allowing us to offer a same day reinstatement service.

MEET OUR DIRECTORS

FIRE STOPPING & DOORS

RICHARD CARTER COMMERCIAL DIRECTOR

DAVID BROWN DIRECTOR | ASBESTOS

Via our BM Trada Accreditation, we are able to offer Fire Door installation, Fire Door Maintenance and a variety of Fire Stopping Solutions. Our Fire and Asbestos Divisions can also be combined as the two often go hand in hand. For example, we can remove Asbestos containing materials and replace the same day with a compliant solution – closing the window of having zero fire protection from weeks and days to a matter of minutes.

GET IN TOUCH TO FIND OUT MORE

3 FITZROY BUSINESS PARK, SANDY LANE, SIDCUP, KENT DA14 5NL | T:03300 249040 | E:INFO@CABLESHEERGROUP.CO.UK | WWW.CABLESHEERGROUP.CO.UK


Consultation on building safety The public consultation process for PAS 8673, a new specification which provides a framework for the competence of Building Safety Managers, is now open until 15 September. As the UK National Standards Body, BSI is seeking consultation from people in the housing, construction, fire, and safety industries. The standard is a part of the Built Environment Competence Programme, which supports the Building Safety Bill to raise competence requirements for three newly regulated roles which are those of Principal

The Building Safety Bill will include powers to strengthen the regulatory framework for construction products, underpinned by a market surveillance and enforcement regime led nationally by the Office for Product Safety and Standards Designer, Principal Contractor and Building Safety Manager. A Building Safety Manager is an individual or entity appointed to take responsibility for managing building safety. PAS 8673 specifies requirements for building safety competence relevant to the role, functions, activities and tasks of the managers based on the recommendations and core competence criteria set out in BSI Flex 8670. It covers the competence and commitment of Building Safety Managers in regard to: building structures and building systems; interaction of systems and components; operational practices necessary to maintain buildings safe for occupants; risk management; managing change, including the consequences of human behaviour; leadership, communication and planning skills; and personal commitment to ethical behaviour and professional standards. It describes different levels of competence for classifying Building Safety Managers, depending on the Building Safety

Bailey Partnership established in 1971 are a multi disciplinary practice operating across the Country providing fire safety and cladding expertise.

Building compliance

 The Bill will include powers to strengthen the regulatory framework for construction products, underpinned by a market surveillance and enforcement regime led nationally by the Office for Product Safety and Standards (OPSS). The national regulator will be able to remove products from the market that present safety risks and prosecute or use civil penalties against any business that breaks the rules and compromises public safety. Dame Judith Hackitt said: “I am delighted that we have reached this important milestone for the Building Safety Bill. It is vital that we focus on getting the system right for the future and set new standards for building safety. Residents and other stakeholders need to have their confidence in high rise buildings restored and those who undertake such projects must be held to account for delivering safe buildings.”

Manager’s skills, knowledge, experience and responsibility, and indicates the pathways between the levels. It shows how these levels relate to the competence necessary to manage buildings of different complexity and safety risks. The standard is intended for use by both individual Building Safety Managers and nominated individuals working within organisation Building Safety Managers. It is also expected to be of use to: organisations that will assess the competence and commitment of Building Safety Managers, including professional bodies, trade bodies and those that regulate by statute or facilitate voluntary self-regulation; national accreditation authorities; government agencies; employers; and insurers. Following consultation, the standard is due to be published in early 2022. L FURTHER INFORMATION www.fusion21.co.uk

External Wall Surveys (EWS1) / Cladding survey investigations

Compartmentation surveys

Fire Engineering services

Facade Engineering services

Large design and project management team able to lead on cladding/facade remedial projects Bailey Partnership are on a number of open frameworks accessible to Health/NHS Clients including the Fusion 21 Framework and various Dynamic Purchasing Systems’ (DPS).

Should you wish to discuss the services are we able to offer please call 01752 229259 or email ews1@baileyp.co.uk

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Security Event set to reunite the sector The Security Event is set to be the first major exhibition to take place in the sector when it opens its doors on 7-9 September 2021 at the NEC in Birmingham and for the first time it will also encompass the National Cyber Security Show The event last ran in 2019 and has been delayed due to the COVID-19 pandemic. But it is set to be the first major event in the security sector to welcome visitors since the government outlined its roadmap out of lockdown. The Security Event is the leading UK exhibition that targets the commercial and residential security market, this free-to-attend event will bring together a world-class education programme, market leaders and industry experts back at the home of UK security. The Security Event will play host to four theatres offering CPD content to all visitors. Dedicated to the needs of the fire and security installers and integrators, the Installer Theatre will provide important industry updates and guidance for practitioners and business owners. In the Security in Practice Theatre, leading expert speakers will uncover the emerging technologies, latest trends and best practice case studies for security professionals. With a specially curated agenda, attendees will come away with plenty of inspiring ideas and actionable strategies that can be applied to their respective business and profession. The Security Innovation Theatre will give visitors the opportunity to discover the breakthrough technologies shaping the security sector. Learn how these innovations will impact how you specify, integrate and install your solutions, and find out how you can stay ahead of the curve. While, The Tavcom Training Theatre will offer practical training tips and guidance for security installers and integrators. Returning for this year’s event is the popular Designing Out Crime Zone, which is being organised in association with Secured by Design, Police Digital Security Centre (PDSC), Alarms and Police Crime Police Academy (PCPA). This exciting feature will showcase the latest police techniques to reduce crime and keep local communities safe. It is a unique opportunity to discover best practice and learn about this important national Police Crime Prevention Initiative (PCPI).

PCPI is a police-owned organisation that works on behalf of the Police Service throughout the UK to deliver a wide range of crime prevention and police demand reduction initiatives. It acts as a catalyst to bring organisations together to reduce crime and the fear of crime, and create safer communities. National Cyber Security Show New for 2021 is the National Cyber Security Show, which will be co-located with The Security Event. The event’s tagline is uniting the UK approach to tackle cyber threats and protect our digital world. There has never been a more important time to put cyber security high on every SMEs agenda. National Cyber Security Show will help SMEs gain a better understanding of the current mitigating threats, increase SME cyber resilience and showcase the products and solutions that will better protect your business. The National Cyber Security Show will offer a one-stop-shop for visitors to unite from across the country and is expected to welcome 2,500+ visitors all looking to improve their cyber security. The National Cyber Security Show will showcase more than 50 leading brands as exhibitors and has been created in partnership with its own set of Founding Partners who are an alliance of key cyber security brands, who recognise the need for a UK cyber security exhibition focused on SMEs. Visiting The National Cyber Security Show is the perfect way to view and interact with the latest cyber security products from some of the top suppliers and SMEs in the industry. Visitors can meet experts face-to-face and get hands-on product demonstrations, letting you find the solution that best suits your business needs. Cyber seminars With one small business in the UK successfully hacked every 19 seconds, according to Hiscox, and new ‘cyber’ certification standards coming into play for

both physical access control systems and intruder alarm installations in 2021, there has never been a more important time to put cyber security high on every SMEs agenda. The National Cyber Security Show will help SMEs gain a better understanding of the current mitigating threats. The event will feature its own Cyber Security Conference, which will offer free CPD-accredited seminars that are aimed at SME business owners who are now needing to become educated about ‘Cyber Essentials’ due to increased threats to their business. The conference will also cater for the thousands of installers who will be affected by the new standards around cyber vulnerabilities in physical security installations, with dedicated sessions that will offer practical training and advise around the changes to their working practices. The content in the conference will centre around four key areas: managing cyber security, securing your networks and connections, securing your IT equipment, protection and recovery. The seminars will offer practical and easy easily-digestible advice for UK businesses and UK business owners to really get under the skin of what good cyber security looks like and help protect their businesses. One pass six events Both the Security Event and The National Cyber Security Show are uniquely co-located with The Health and Safety Event, The Fire Safety Event, The Facilities Event, and The Emergency Services Show. This means that delegates only have to register once to have access to all six events, which form part of Nineteen Group’s Safety and Security Series, giving them access to six major events in one unmissable opportunity. L FURTHER INFORMATION www.thesecurityevent.co.uk www.nationalcybersecurityshow.com

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G-Cloud

Why doesn’t the public sector embrace G-Cloud? Romy Hughes, director at Brightman, outlines some of the reasons why the public sector still shuns the G-Cloud and other frameworks The G-Cloud, along with the many other framework agreements, were initially developed to keep procurement and suppliers at arm’s length. The aim was to create a level playing field which would stop government projects being awarded to the same large suppliers, again-and-again, irrespective of their performance. In turn, this removal of ‘cosy’ relationships would allow public/private sector business to be conducted on purely objective terms, delivering better value and a better quality of service to the taxpayer. But the G-Cloud framework, among many others, continues to see much lower adoption than they should, with many major procurements still bypassing the framework agreements altogether. But why is this? Below are the five most common reasons we hear from our public sector clients when they have chosen not to use a framework. 1. ‘It wasn’t built here’ Ultimately, the public sector likes to work with its own systems and people. In some sectors

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an entirely objective basis. That is fair enough, there is still a general mistrust of private but it ignores how people actually do business. companies, or the ideological feeling that Ultimately, people want to do business with profit should never touch the public sector. people, not frameworks. It also presupposes There is no room for ideology in procurement. that business relationships built on years of Achieving the outcome in the most effective shared experiences have no value in way should be the only ideology to work a business transaction, when in by. In most instances the private reality it is very important. Trust sector has proven itself to In some is an important factor in be the most efficient, sectors choosing a supplier which cheapest and effective ther still a g cannot be determined way to deliver services. eneral me is in a framework. of priva is trust t e 2. ‘We have c o m o r the id p 3. ‘No one strategic eologic anies, a l feeling likes change’ suppliers that pro fi As reliably as the sun will already’ never t t should rise and set each day, you The framework ouch th e will find that most people agreements are seen as public s ector will avoid change if they artificial barriers to doing can. Change is uncomfortable, business, because that is risky, unpredictable. But change exactly what they were designed is also necessary and inevitable. While to be. They were put in place to remove most people naturally resist change, they will existing relationships from the procurement accept it if they understand why it is necessary. process so that contracts would be awarded on

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4. ‘Each framework is costly to review’ Given the complexity of each framework agreement, no public sector organisation would risk signing up to one without their lawyers reading it first. G-Cloud’s Framework agreement spans 62 pages, while the basic calloff contract is 77 pages long – and this is before any contract-specific terms have been added. Multiply this by each framework that the public sector buyer is expected to use and it is not hard to see why many would simply choose to write their own terms. Why would you invest in legal advice for each and every framework when you can simply pay the same lawyer just once to write terms which address your specific needs? 5. ‘How do we know if its genuinely the right approach?’ Building on the last point, each framework must be individually assessed to determine if it offers good value. This is a timeconsuming process which many organisations simply don’t want to do, so they leave the frameworks on the shelf. Given the number of frameworks and the government’s propensity to continually introduce new ones or renew existing agreements (why the need to renew G-Cloud each year?) it

The G-Cloud, along with the many other framework agreements, were initially developed to keep procurement and suppliers at arm’s length. The aim was to create a level playing field which would stop government projects being awarded to the same large suppliers becomes very difficult for organisations to know if they deliver good value or not. These five points address the most common reasons why many in the public sector remain reluctant to even consider using a framework agreement in the first place. Yet this article has not addressed the elephant in the room – the poor experience that many buyers have when they actually attempt to use one. The G-Cloud in particular is often criticised for being unwieldy and difficult to navigate, and largely ineffective at matching public sector requests with the most relevant suppliers. Given the 5,224 suppliers on G-Cloud 12 alone, there is a pressing need for the matchmaking capabilities of the platform to be overhauled. Even if we could address the five points raised in this article and convince the public sector to use it, we may find that their poor experience will be another reason to stay away.

G-Cloud

The G-Cloud and other frameworks were not introduced to make life more difficult, but that is often how they are perceived by those in procurement. The government needs to make the case that the change introduced by the frameworks is worth it.

We do not disagree with the sentiments of our public sector customers here who have shared their experiences with us, however, these issues are not insurmountable, and the goals of the frameworks remain something to strive for. Ultimately, the frameworks need to be better at efficiently and objectively matching government buyers with appropriate suppliers. We believe this can be better achieved by reducing the overall number of frameworks to simplify the market for buyers, overhauling the online marketplaces (with a particular focus on their matchmaking capabilities) and introducing a sustained communications campaign to educate the public sector on how to get the best out of them. By doing this I believe the frameworks can have a much more positive future. L FURTHER INFORMATION www.brightman.uk.com

Are You Prepared? ISDN / PSTN Switch-Off 2025 Have you considered what exposure or risks the ISDN / PSTN Switch-Off 2025 poses to your organisation? Your telecoms network will have been built historically on these technologies. However, what you are using and where it is located may be an enigma. Voice calls, security, well-being and any equipment reliant on these services will be affected. The longer action is delayed, the more problematic the situation may become. From a completely independent viewpoint, Segmentation Group, with our depth of knowledge in legacy services, can help you gain clarity and remain in control.

Call us on 03300 240480 for a free consultation or email us at info@segmentationgroup.com www.segmentationgroup.com/isdn-/-pstn-switch-off-2025

Issue 21.4 | HEALTH BUSINESS MAGAZINE

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INFORMATION TECHNOLOGY

4C Strategies – Independent ICT Consultants

ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service 4c Strategies

4C Strategies is an independent ICT consultancy specialising in technology and infrastructure projects. The company covers all aspects of technology and infrastructure in the enterprise environment, with consultants showing demonstrable experience in helping clients to procure new technologies to meet their business requirements, providing endto-end support on ICT projects by delivering a portfolio of consultancy services to meet client requirements, from audit and strategy through to procurement, implementation and resourcing. 4C Strategies has been assisting organisations in the healthcare industry for over 20 years. Expertise covers

all aspects of IT technology and infrastructure, including: digital strategy, IT and technology strategy, data centres, servers and storage, patient data security, desktop telephony, Microsoft Teams and wide area networks. Trevor Nelms, Director from West London Mental Health Trust, said: “4C Strategies has assisted in a range of complex ICT projects, from inception through to deployment, and demonstrated a rare ability to bring together technical expertise with business acumen and tight project management skills.” Contact one of 4C Strategies’ qualified healthcare technology consultants today. L FURTHER INFORMATION Tel: 01858 438938 nhs@4c.co.uk www.4c.co.uk

Actacomm 62 Aerogen 48 Asckey Data Services

Bailey Partnership

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73

BeaconMedaes 22 Big Dug

65

Cablesheer Asbestsos

72

Cube Solutions

19

DDC Dolphin

52

Deko 26-37 Evac Chair International

4

Fidelity Energy

18

GE Healthcare

14

Globus Group

50,59 46

IGEL 16

Improved safety for people, assets and infrastructure

For the first time ever, the science of ultrasonics can now reduce airborne contagion spread, and maintain critical sterilisation, in hospitals and pharmaceuticals, via the Portascanner® COVID19. Coltraco Ultrasonics applied 30 years of expertise to design a solution to help the NHS fight COVID-19 having won a UK Government grant. A December 2020 study showed that 56% of air samples taken from hospital hallways contain high levels of coronavirus (JAMA Network). Existing methods for achieving

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Austco 10

Gojo Industries

SECURITY

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pressurisation are disruptive, costly, ineffective – user cannot identify specific areas of leakage, leaving remedial action to inaccurate speculation. The Portascanner® COVID19 improves air quality and protects staff and patients against the spread of airborne diseases, such as SARS-CoV-2 and beyond. This is a hand-held, non-invasive, easy to use instrument, allowing

the user to locate and quantify leaks as small as 0.5mm in diameter. The air flow rate can then be calculated, generating an air permeability value for an entire cleanroom or hospital ward. The healthcare sector can now go above and beyond standards, with the ability to photograph, record, and export test reports, all in the tap of a finger. L FURTHER INFORMATION sales@coltraco.co.uk www.coltraco.co.uk

ISS 32-34 JM Passive Fire Protection

68

Johnson & Johnson Medical

58

Kohler 54-55 LFS Fire

69

MGPS Services

IFC

Novus Property Solutions

56

Opex Business Machines

24-25

Philips 20 Segmentation Group

77

Seven Stones Information

22

T-Impact 12 The Testing Lab

66

Volvina 6 Wellsky International

8

Woodnut Construction

70

Yeoman Shield

42

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