Health Business 22.1

ISSUE 22.1 www.healthbusinessuk.net

INTEGRATION

ESTATES

ELECTIVE RECOVERY PLAN

ADDRESSING THE COVID BACKLOG More community diagnostic centres and surgical hubs.

But are efforts to tackle the increasing backlog for care likely to work?

PLUS: DIGITAL HEALTH REWIRED | FACILITIES MANAGEMENT | TECHNOLOGY

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Comment

ISSUE 22.1 www.healthbusinessuk.net

INTEGRATION

ESTATES

ELECTIVE RECOVERY PLAN

ADDRESSING THE COVID BACKLOG More community diagnostic centres and surgical hubs.

But are efforts to tackle the increasing backlog for care likely to work?

PLUS: DIGITAL HEALTH REWIRED | FACILITIES MANAGEMENT | TECHNOLOGY

Is free access to Covid-19 tests about to stop?

Nearly eight in 10 NHS leaders want the public to continue to have free access to Covid-19 tests, with nine in 10 wanting free access for key workers to continue.

This is according to a new poll from the NHS Confederation, which is calling on the government to take a cautious and evidence-based approach to exiting the pandemic so that the NHS can continue to meet the full healthcare needs of the population.

The government’s ‘Living with Covid-19’ strategy is expected to bring an end to free lateral flow tests for millions of people, as well as an end to mandatory selfisolation for anyone with a positive result from as early as next month. This is as both hospital admissions and deaths linked to the virus continue to fall nationally, thanks in large part to the success of the vaccine roll out.

However, nearly eight in ten of the more than 300 senior NHS leaders responding to the poll strongly disagreed or disagreed with the plan to stop free access to Covid-19 tests for the public, with 94 per cent feeling the same about NHS staff and other key workers.

Follow and interact with us on Twitter: @HealthBusiness_

There is no doubt that returning to normality must continue to be assessed and progressed, but concerns from within our NHS system should be heard before rash decisions are made.

Michael Lyons, editor

P ONLINE P IN PRINT P MOBILE P FACE-TO-FACE If you would like to receive all issues of Health Business magazine for £100 a year, please contact Public Sector Information Limited, 226 High Road, Loughton, Essex IG10 1ET. Tel: 020 8532 0055, or visit the Health Business website at:

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 ADMINISTRATION Amy Hinds WEBSITE PRODUCTION Victoria Casey SALES SUPERVISOR Damian Emmins ADVERTISEMENT SALES Azad Miah, Maziar Movassagh PUBLISHER Karen Hopps

© 2022 Public Sector Information Limited. No part of this publication can be reproduced, stored in a retrieval system or transmitted in any form or by any other means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publisher. Whilst every care has been taken to ensure the accuracy of the editorial content the publisher cannot be held responsible for errors or omissions. The views expressed are not necessarily those of the publisher.ISSN 1478-7687

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We abide by the Editors’ Code of Practice and are committed to upholding the highest standards of journalism. If you think that we have not met those standards and want to make a complaint please contact Michael Lyons or Angela Pisanu on 0208 532 0055. If we are unable to resolve your complaint, or if you would like more information about IPSO or the Editors’ Code, contact IPSO on 0300 123 2220 or visit www.ipso.co.uk

Issue 22.1 | HEALTH BUSINESS MAGAZINE

3

INTRODUCING

NEW reduced-ligature safety curtain track Keeping staff and service users safe from harm in high-risk mental health environments

Curtain separates from gliders at 20kg load

Easy to re-attach the curtain

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Contents

Contents Health Business 22.1 07 News

‘Missed opportunity’ to tackle NHS staff shortages; new network launched for the primary care sector; and guidelines to support disabled children to be more active

13 Elective Recovery Plan 13 25

The NHS and government have recently published a blueprint to address backlogs built up during the pandemic and tackle long waits for care with a massive expansion in capacity for tests, checks and treatments

17 Integration

The Integration White Paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff

21 Digital Health Rewired

Digital Health Rewired 2022 returns 15-16 March in London, with a festival designed to help you achieve your digital future. Rewired 2022 has been reimagined as the UK event to reconnect the diverse digital health community

41

25 Technology

Sascha Giese, Head Geek™ at SolarWinds, identifies the technologies that the NHS should be focusing on, given the £2.1 billion budget announced in the Autumn budget

45

27 Technology

Tom Whicher argues that PIFU, incorporated as part of a digital pathway, gives NHS trusts the ability to tailor the messaging, length of service, number of booking requests and provision of additional monitoring requirements

35 Cyber security

With increased digitisation impacting all aspects of life, cyber attacks will become increasingly ubiquitous and may impact all our activities across the most missioncritical industries, writes David Stroud

45 Facilities management

Chris Yates, chief executive at Federation of Environmental Trade Associations, explores the issue of indoor air quality and the need for better ventilation in public buildings, as well as the effect that heating requirements can have on the environment

50 Fire safety

We revisit an article from Dr David Gold and Neil Vincer, from IOSH, in which they discuss how organisations can ensure that a sustainable workplace fire safety culture is incorporated to all staff in a hospital setting

53 Estates management

Martin Steele, CEO of NHS Property Services, explains the lessons learnt that will help NHSPS improve the health estate and ensure it continues to be fit for patients now and into the future

57 Medical equipment

James Feindt, Marck Aghnatios and Alistair Fleming look at the benefits and opportunities of migrating care from hospital to the home environment, as well as the MedTech challenges it creates

61 Medical equipment

Delivering a Net Zero NHS is a key ambition to tackle within the healthcare system. SBRI Healthcare has awarded £1 million to pioneering innovations to support the delivery of a Net Zero NHS

66 Expert panel: Medical equipment Health Business talks to Benedict Wallner about Medical Device Regulation, the requirements when developing new products and preOx.RS GmbH products

57

41 Cyber security

53

In January, the government approved Cyber Essentials scheme received the biggest overhaul to date. The significant changes to the technical requirements in the scheme reflect the security challenges in today’s digital world

Health Business magazine

www.healthbusinessuk.net Issue 22.1 | HEALTH BUSINESS MAGAZINE

5

PEOPLE MAKE PLACES

Connecting people and places to make the world work better

News

STAFF SHORTAGES

‘Missed opportunity’ to tackle NHS staff shortages

Former Health Secretary Jeremy Hunt has said the government has missed an opportunity to alleviate the workforce crisis in the NHS and social care by rejecting the Health and Social care Committee’s recommendation to overhaul workforce planning.

The government has published its response to the committee’s June 2021 report, in

which MPs warned that workforce burnout across NHS and care systems had reached emergency level and was risking the future functioning of services. The inquiry heard that NHS workforce planning was at best opaque and at worst was responsible for unacceptable pressure on staff.

The report concluded that available funding was the driver behind planning, rather than the level of demand and staffing capacity needed to service it. It further cited the absence of any ‘accurate, public projection’ of workforce requirements in specialisms over the next five to ten years.

Hunt, chair of the committee, said: “Whilst we are pleased that some of our recommendations to improve workplace culture were well received, this longawaited response is a missed opportunity to properly address the single biggest

HEART ATTACKS

RACIAL INEQUALITY

New campaign launched to tackle heart attack myths

Radical action needed to tackle racial health inequality in NHS

NHS England has launched a new lifesaving campaign to encourage people to dial 999 when they are having early signs of a heart attack.

The new polling also showed that fewer than half of people said they would dial 999 if they or a loved one experienced lesser known symptoms of heart attacks.

New NHS research also shows that whilst 70 per cent of those surveyed understood that pain in the chest is a symptom of a heart attack, just 41 per cent knew sweating was a symptom and only 27 per cent understood feeling weak, lightheaded or a feeling of general unease were also symptoms.

The NHS advert will show a person experiencing some of the common early symptoms of a heart attack – sweating, uneasiness and chest tightness – and reminds viewers to dial 999 if they experience the symptoms of a heart attack. The campaign seeks to tackle a number of common heart attack myths, after research identified that three in four people thought a heart attack was the same as a cardiac arrest.

There are more than 80,000 hospital heart attack admissions in England every year. The overall survival rate for people experiencing a heart attack is seven in 10 and this increases to nine in 10 for those who come forward for early hospital treatment.

The campaign, which will run from 14 February to 31 March 2022, is the first of the NHS ‘Help Us Help You’ campaigns specific to heart attacks.

READ MORE

Racism, racial discrimination, barriers to accessing healthcare and woeful ethnicity data collection have ‘negatively impacted’ the health of black, Asian and minority ethnic people in England for years.

According to the review, commissioned by the NHS Race and Health Observatory and seen by the Guardian, radical action is needed urgently to tackle ‘overwhelming’ minority ethnic health inequalities in the NHS. From mental health to maternity care, the sweeping review led by the University of Manchester paints a devastating picture of a healthcare system still failing minority ethnic patients despite concerns previously raised about the harm being caused.

The report says that the pandemic has taken a disproportionate toll on ethnic minorities, prompting fresh questions about inequalities that permeate the practice of medicine. It concludes that inequalities in access to, experiences of, and outcomes of healthcare in the NHS ‘are rooted in experiences of structural, institutional and interpersonal racism’. It adds that, for too many years the health of minority

driver of workforce burnout, staff shortages.

“It is disappointing the government has again rejected our call for transparent and independent projections of the number of doctors and nurses we need to meet future demand. Unless we have future proof workforce planning, it will not be possible to address the NHS backlog and the cycle of crises putting dangerous pressure on staff will continue.

“We hope the government will be persuaded by the case for independent workforce planning as the Health and Care Bill progresses through Parliament. Without it we see little hope that the workforce crisis will be alleviated.”

READ MORE

ethnic people in England has been ‘negatively impacted’ by a lack of appropriate treatment, poor quality or discriminatory treatment by NHS staff, missing ethnicity data from NHS systems, and delays in seeking help for health issues ‘due to fear of racist treatment from NHS healthcare professionals’.

With regards to mental health, it found that minority ethnic groups were less likely to be referred to IAPT by GPs than white people, and that minority ethnic patients who do get a referral are less likely than white British patients to receive an assessment. Minority ethnic people with psychosis are also less likely to be referred for cognitive behavioural therapy (CBT).

Maternity services were also found lacking, with the review finding evidence of negative interactions, stereotyping, disrespect, discrimination and cultural insensitivity, leading to some minority ethnic women feeling ‘othered’, unwelcome, and poorly cared for.

READ MORE

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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News

PRIMARY CARE

New network launched for the primary care sector

The NHS Confederation is launching a new network for the primary care sector, empowering primary care leaders to maximise the impact they have on patient care and shape the future.

The new national network officially will start in April and will focus on ensuring primary care, as the keystone of the NHS, is valued, supported, well-resourced and empowered to improve the health of local communities. It will bring together primary care leaders to shape the future of primary care within integrated care systems.

This means that the NHS Confederation’s two current primary care networks – the PCN Network and Primary Care Federation Network – will unite, resulting in a new stronger voice for primary care.

Lord Victor Adebowale, chair of the NHS Confederation, said: “I am full of admiration

for the vital role primary care plays in the health and care system and the extraordinary lengths it has gone to during the pandemic to protect our communities. As the NHS focuses on a sustainable recovery and there’s renewed impetus to integrate health and care services, this new stronger network will provide the support, voice and recognition for teams across the sector to continue to deliver high quality care, increase capacity and be at the forefront of transformation with system partners.”

READ MORE

ELECTRIC VEHICLES

EEAST to undertake electric vehicle trial Three Rapid Response Vehicles will be trialled

by East of England Ambulance Service NHS Trust as part of a wider NHS move towards zero emissions vehicles.

EEAST has successfully bid for £250,000 from NHS England which will fund two electric Skoda all-wheel drive cars, an electric Vauxhall van, their conversion to medically equipped response vehicles and the necessary charging infrastructure for each of the vehicles.

One of the Skodas will be used as a ‘standard’ Rapid Response Vehicle, used to get a paramedic response to patients quickly. The second will be used in a similar role in conjunction with our other blue-light partners (RAF, Fire and Police), initially in Bedfordshire, but later in Cambridgeshire, Norfolk and Essex, as different programmes and infrastructure configurations are tested.

Tom Abell, chief executive of EEAST, said:

“The NHS has committed to being net-zero of carbon emissions by 2045 – five years ahead of the UK’s nationally set target. It is vital that we understand how this modern technology can help to improve our response times to patients and deliver cost savings over the longer term. We are therefore very pleased to take part in this pilot, which will not only help us trial the latest electric vehicles, but

also enable us to start installing the electrical infrastructure that will enable us to be ready for the future.”

The funding is part of a new NHS England pilot to support ambulance trusts to trial a range of new zero emission response vehicles.

READ MORE

BACKLOG

Backlog in community services will exacerbate inequalities The NHS Confederation has stressed that patients are facing significant delays for key health services delivered in the community due to a mounting backlog of care.

Alongside NHS Providers, the NHS Confederation has expressed concerns that waiting lists for a range of community health services are increasing significantly, with community providers reporting significant impact on children and young people.

At the end of 2021, the backlog in community services was estimated at around one million and is likely to have grown as a result of efforts to tackle the Omicron variant.

The highest numbers and largest volumes of long waits are for community paediatric

diagnoses, audiology and speech and language therapy. One community provider said it has seen a 300 per cent increase in referrals to consultant-led child development services over the last five years, and this has been exacerbated by the pandemic.

Leaders from community providers fear that inevitable delays will exacerbate health inequalities and risk having an enduring impact on those children left waiting. Although long waits for adults remain a concern, long waits can impact outcomes for children much more severely.

Community leaders would like support and cover to make addressing health inequalities a priority feature in how they tackle waiting lists

going forwards, building on recent initiatives to cut elective waiting time data in a similar fashion.

READ MORE

Issue 22.1 | HEALTH BUSINESS MAGAZINE

9

NOW’S THE TIME TO INVEST IN AIR PURIFICATION

3 KEY QUESTIONS WHEN INTRODUCING AN AIR PURIFICATION SYSTEM Has the system been proven to remove Covid-19?

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News

DISABILITY

Guidelines to support disabled children to be more active

The UK Chief Medical Officers have published new guidelines stating that disabled children and young people will be supported to be more physically active.

The guidance, which recommends daily levels of physical activity, will support disabled children and young people to improve their physical and mental health throughout their lives.

The evidence found physical activity can be equally beneficial for disabled children and young people as non-disabled children, tackling misinformation about the risk.

The document recommends that disabled children and young people undertake 120 to 180 minutes of aerobic physical activity per week at a moderate-to-vigorous intensity,

as well as complete challenging, but manageable, strength and balance activities three times per week which are particularly beneficial for muscle strength and motor skills.

In a joint statement, the UK Chief Medical Officers said: “We are delighted to present this report and infographic which are an important step forward in addressing the gap in physical activity guidelines for disabled children and disabled young people. We encourage schools, parents, carers and healthcare professionals to communicate and promote these guidelines across their wider professional networks to enable appropriate physical activity opportunities for disabled children and disabled young people in their communities.”

READ MORE

CERVICAL CANCER

MENTAL HEALTH

New national cervical screening campaign launches

Call for six new mental health hospitals in England

A new national campaign is calling on those eligible not to ignore their invite for cervical screening, as data reveals nearly one in three don’t take up the offer.

The Department of Health and Social Care’s new Help Us Help You – Cervical Screening Saves Lives campaign urges women and those who may be eligible not to ignore their cervical screening invite, and if they missed their last one, to book an appointment with their GP practice or sexual health clinic now.

Around 2,700 women are diagnosed with cervical cancer in England each year and approximately 690 women die from the disease. Previous estimates suggest screening prevents 70 per cent of cervical cancer deaths, but 83 per cent of deaths could be prevented if everyone attended regularly.

As part of the campaign, a new survey of 3,000 women and people with a cervix commissioned by DHSC today reveals a number of concerns which prevent cervical screening. This includes embarrassment, as well as fears about pain.

Maria Caulfield, Minister for Patient Safety and Primary Care, said: “Around two women die every day from cervical cancer, but screening takes just a few minutes and can stop the disease before it starts. Through our new campaign we’re calling on all women and people with a cervix to get screened to help save hundreds of lives. Even if you’re feeling embarrassed or nervous, please don’t ignore your invitation.”

READ MORE

The President of the Royal College of Psychiatrists has warned that thousands of mental health patients in England are being treated in buildings that are ‘dangerous’ and unfit for purpose.

Given crumbling NHS buildings, leaky roofs and increasingly faulty equipment, Dr Adrian James has urged the government to fund six new mental health hospitals as part of its promise to build 48 new hospitals by 2030. He said that existing issues are leaving the most seriously mentally ill people in the country at risk of harm and hindering their chances of recovery.

The government has pledged billions in funding to build 48 hospitals by 2030. Of the first 40 hospital projects announced, only two were for mental health, according to the Royal College of Psychiatrists. The final eight projects are yet to be named but James said at least six of these should be for mental health patients, in order ‘to address the imbalance of the programme’.

He said: “Thousands of people with a mental illness in England are being treated in mental health hospitals that are dangerously old and not fit for purpose. Up and down the country psychiatrists are having to assess and treat patients in buildings that are falling apart and crumbling away. People with a mental illness will be let down unless we have buildings that are fit for purpose. The government can no longer afford to pay lip-service to parity of esteem and treat mental health as an after-thought. We need a firm commitment from government that at least six of the new hospitals will be for mental health.”

READ MORE

Issue 22.1 | HEALTH BUSINESS MAGAZINE

11

Advertisement Feature

Accommodating the new normal in health care The current pandemic has impacted the health sector more than any other. Nearing three years of battling the pandemic, new and more transmissible variants of the virus are still causing havoc in the health system. Staff shortages due to sick leaves, as well as logistical problems partly exacerbated by Brexit, still continues to hinder the efficiency of hospitals, indicating that the pandemic is still not over From the very start of the pandemic, one point became clear very quickly for almost every sector: technology can help overcome the difficulties caused by social distancing, quarantines and lockdowns. Some of the routine meetings between medical doctors and associates can be swiftly done via video conferences. Medical doctors can utilise video meetings for their regular consultations of patients as well, depending on the specialty. Furthermore, health professionals started to employ flexible, remote-working practices too, such as using a work laptop to access and work on patients’ sensitive files, whenever possible.

All these new developments required a serious update of the IT infrastructure to get in sync with today’s technology.

Philips monitors has been successfully supplying displays into the UK healthcare market for years and their innovative line-up offers just the perfect solution for the shortcomings unearthed by the pandemic.

In their extensive business monitor line-up, Philips monitors offers displays with built-in webcams, screens with built-in USB-C docking stations for more flexibility, as well as 10-point touchscreen displays, making them ideal tools for health professionals to employ in their workflows.

Alongside equipping their monitors with innovative features, Philips monitors have invested considerably in delivering sustainable, green monitors which ensure energy and cost savings in the long term, while the production and development of these displays increasingly use more sustainable practices, proven by the monitors receiving the latest, TCO Certified, generation 9 certification.

Say hello to security Philips 242B1H, a 23.8” display with a colour-accurate IPS panel, is equipped with a built-in, pop-up webcam, which supports 2 MP, Full HD resolution and supports Windows Hello integration. Especially useful in the health sector, this enables doctors and medical staff to login to a Windows PC using facial recognition instead of entering a password, increasing the security of the sensitive patient records. To ensure patients’ privacy, the webcam can be pushed down and behind the panel, so it becomes physically impossible for the webcam to

12

record anything unintentionally or even if the security of the hospital network is compromised. If the Full HD resolution on the 23.8” display of the 242B1H would not be enough, Philips 275B1H offers the same functionality, with a 27” display and QHD resolution (2560x1440). Both meeting the TÜV Rheinland Eye Comfort standard, these models offer an ideal viewing experience, thanks to FlickerFree and LowBlue light technologies and delivering an ergonomic stand and wide viewing angles. Furthermore, these models employ PowerSensor to reduce brightness when the user is away, reducing energy costs up to 70 per cent.

Philips 243B1JH (Full HD, 23.8”) or the Philips 276B1JH (QHD, 27”), on the other hand, feature the same functionalities as the above, while adding a fully-fledged USB-C docking station on top. With the inclusion of a four-port USB hub and Gigabit Ethernet port, connecting a laptop via USB-C opens up many opportunities. Via a single USB-C connection, the monitor can charge the laptop (up to 100 W), transfer the video signal (via USB DisplayPort alternate mode), provide connection to the devices connected via the USB hub, and connect it to the network (by routing Ethernet via USB-C).

These monitors can even be used to connect further monitors to create a multimonitor setup, thanks to the DisplayPort output on the monitor. To enable legacy devices without USB-C to take advantage of

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

this talented monitor, these ‘hybrid’ models offer DisplayLink technology and a hybrid USB-C/USB-A cable to extend the display via USB-A, too.

A touch closer to better health Philips monitors’ extensive portfolio offers 10-point multi-touch displays as well, thanks to their Projected Capacitive (P-Cap) touch technology, SmoothTouch. Responsive to interaction with a stylus, fingers or with different kind of glove materials – Nitrile (0.15 mm), Cotton (0.31 mm), CPE (0.03 mm), PVC (0.12 mm) – the touchscreen functionality enables medical professionals to use these monitors without interrupting their hygiene protocols. The robust, water and dust resistant (IP65 certified – front only) touch displays from the B9T display family offers touchscreen monitors from 15” up to 23.8” size, using this technology.

Currently, Philips touchscreen displays (such as the Philips 172B9T, 222B9T) are ready to be employed on medical carts and other mobile workstations, to make the daily life of medical staff a tad easier.

For health institutions that need to take the next step in their IT infrastructure, sustainable Philips monitors offers the ideal technology for productivity. L FURTHER INFORMATION www.philips.com/monitors

Elective Recovery Plan

Elective recovery plan to boost capacity and give power to patients The NHS and government have recently published a blueprint to address backlogs built up during the pandemic and tackle long waits for care with a massive expansion in capacity for tests, checks and treatments The most recent NHS data has shown that the number of people in England waiting to start routine hospital treatment has risen to a record high. As of the end of December 2021, as many as 6.1 million people were waiting to start treatment – the highest number since records began in August 2007.

The number of people having to wait more than 52 weeks to start treatment stood at 310,813 in December 2021, up from 306,996 in the previous month and 39 per cent higher than the number in December 2020. The figures also highlight how, despite Omricon pressures, NHS staff delivered 120,000 more diagnostic tests and checks in December, compared to the same month last year. At the same time as delivering over 14 million Covid vaccinations in December, an extra 107,000 people also started consultant-led treatment compared to the same period last year.

Professor Stephen Powis, NHS national medical director, said of the data: “While seasonal pressures are ongoing, we are now beginning to see the full picture of the Omicron winter on the NHS, and despite skyhigh staff absences, hardworking NHS staff continued to make inroads on the backlog that has inevitably built up and delivered 120,000

prepared for ministers and NHS bosses, more tests and checks in December compared indicate that even under a best case scenario to the same time last year. the waiting list could reach 9.2 million. The “Hardworking staff also responded to the downside scenario shows the list peaking at government’s call to protect the nation from 10.7 million and easing to just 10.3 million in the new Omicron variant, delivering over 13 2025. million lifesaving booster jabs in December alone – providing lifesaving protection to The backlog of elective care millions of people at speed.

On 8 February, NHS England chief executive “While pressures remain for our staff Amanda Pritchard and Health and Social Care with the highest number of life-threatening Secretary Sajid Javid jointly announced that ambulance call outs and 111 calls for the the health service will build dozens more month of January, NHS staff are committed community diagnostic centres as part of the to bringing down the backlog and the clear new elective care recovery plan. plan published this week will help increase More than 100 diagnostic centres will the number of checks, tests and treatment be rolled out, with the increase in capacity provided for patients. As ever, if you have a coming on the back of the NHS accelerating health problem, please come forward for care the rollout of these ‘one stop shops’ over – the NHS is here for you.” the last year, with 66 set to be in Leaked projections have use across England by the end revealed that the number of March – 26 more than of people in England Patient previously planned. E waiting for planned waiting s hospital care could for elective hit 10.7 million by s u r g March 2024. Seen eries will by the Spectator increas benefit from magazine, the and inf ed transparen projections, orm cy

atio followi ng the n sharing the new launch of PlannedNHS ‘My C platformare’

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Expanding capacity and staff numbers Expansion in diagnostic capacity will mean 95 per cent of patients receive a test within six weeks of referral. The increase in capacity will help the NHS towards achieving its target, set out in NHS annual planning guidance in December 2021, of returning the number of people waiting more than two months for cancer care to pre-pandemic levels.

NHS England is determined to get maximum patient benefit out of the extra investment and is expanding capacity and investing in additional space locally as part of a £700 million scheme, to speed up the recovery of elective services. The money will go to more than 180 NHS trusts, split between 870 different schemes including installing modular operating theatres and expanding mobile diagnostic centres for cancer.

Among the schemes to receive the funding is a number of surgical hubs in Cheshire and Merseyside, four operating theatres in Hull and repurposing of outpatient sites in Bedford, to increase capacity.

The plan also recognises that further work is needed to train, recruit and retain

Elective Recovery Plan

 New surgical hubs will also be added to the network of 122 already operating across the country, helping ensure that unless people chose to postpone, the longest time patients could wait will reduce so that by March 2025 patients aren’t waiting longer than a year for surgery. The hubs focus on high-volume routine surgery so more patients can get seen more quickly, making efficient use of taxpayer resources, and creating extra capacity so emergency cases do not disrupt operations and cause cancellations or delays.

As a result of the community diagnostic centres, NHS England will deploy teams of specialists to help patients prepare for their op, and groups of clinicians and teams will be able to get instant access to test results, offering patients faster clinical advice. This, alongside a cavity increase pledge to deliver more procedures and scans in each of the next three years, will mean that patients will be offered around 17 million more diagnostic tests – an increase in capacity of a quarter compared with the three years prior to the pandemic.

On announcing the plan, Pritchard said: “As we move out of the Omicron wave the NHS is applying the same determination and ‘can do’ spirit we have displayed throughout the pandemic, to address backlogs in routine care that have inevitably built up, and reduce long waits.

“That cannot happen overnight but we are determined to make the best possible use of the additional investment and take the best from our pandemic response, including smarter use of digital care and flexible working between teams and trusts, while building this additional diagnostic capacity that will help to accelerate progress. As we have always said throughout the pandemic, it is vitally important that anybody who has health needs continues to come forward, so that staff can help you with the best options for your care.”

The increase in capacity will help the NHS towards achieving its target, set out in NHS annual planning guidance in December 2021, of returning the number of people waiting more than two months for cancer care to pre-pandemic levels staff – and that delivering elective recovery will require not just more new staff, but more opportunities for current staff and those returning to practice to work flexibly and remotely, and to develop new skills to progress in their careers. This is a point picked up on by the Royal College of Physicians.

Andrew Goddard, president of the RCP, said of the publication: “The focus this plan gives us for the next three years is welcome, as is its recognition that staff are central to successful elective recovery.

But we must remember that the pressure the service is currently under has become the norm. The plan will only be successful if it is implemented alongside recovery of urgent and emergency care, as the two are intimately entwined both with respect to workforce and estate.

“We will also need to build on it with a full plan for recruiting enough new staff to meet patient demand and the steps we’ll take to retain existing staff, including flexible and remote working for those returning to practice. Targets help patients to understand what they can expect from the health service – but they cannot be met without a supply of clinicians that is sufficient to meet the demand for care.”

‘My Planned Care’ platform Patients waiting for elective surgeries will benefit from increased transparency and information sharing following the launch of the new NHS ‘My Planned Care’ platform.

The Department of Health and Social Care said that patients and their carers will be

able to access tailored information ahead of planned surgeries, including information on waiting times for their provider. This is in a addition to being able to better understand their expected wait.

Appropriate personalised support could include advice on prevention services, such as stop smoking or diet and exercise plans, to make sure they are fighting fit for surgery to reduce cancellations, prevent deterioration and help patients recover as quickly as possible.

A third of on-the-day cancellations are due to people not being clinically ready for treatment, such as having a long-term condition including diabetes or high blood pressure which has not been diagnosed or properly managed.

Health and Social Care Secretary Sajid Javid said: “At the height of the pandemic the NHS rightly focused on treating Covid-19 patients, but sadly it has meant waiting lists have risen - and the Covid backlog is going to keep rising. This platform, combined with our record funding to tackle the backlog and invest in innovative diagnosis and treatment will help us ensure access to life changing care and support for people no matter who they are or where they live.”

The platform will initially be accessible via NHS.UK, allowing patients, family members, carers and clinicians to all access information at any point of their care pathway. L FURTHER INFORMATION www.england.nhs.uk

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Legrand: We are stronger together Legrand launches Legrand Care, its new global brand specialising in the assisted living, health, and social care sectors

Legrand, global specialists in electrical and digital infrastructures launches its new consolidated brand for the Assisted Living and healthcare market called Legrand Care. This new powerful brand allows the company to be stronger in the international market of connected care, taking advantage of synergies and improving the value of products and services for the care sector.

Legrand Care was born from the integration of the brands that make up the Assisted Living and Healthcare (AL&HC) business unit of Legrand: Intervox, Tynetec, Aid Call, Jontek and Neat.

Chris Dodd, CEO of Legrand Care, states: “The coming together of five highly regarded, customer centric, long established assisted living and healthcare brands into Legrand Care is a significant milestone in our journey.”

Likewise, Arturo Pérez Kramer, who has assumed his new role as Deputy CEO of Legrand Care formerly CEO of Neat, explains that ‘this relevant union of forces responds to the objective that Legrand established in 2020: To improve people’s lives’. This great challenge ‘is the essence of our commitment and our consolidated strategy in the new brand, Legrand Care’ Pérez adds.

Caroline Mouminoux, Sales Director of Legrand Care and Silver Economy manager in France, formerly Silver Economy representative for Legrand France and Director of Intervox, declares that they are

‘very proud of this announcement’ and that, with the launch of this new brand, ‘Legrand confirms once again that assisted living and healthcare is a strategic market for the Legrand group, and we see this as a great opportunity to address some of the social and economic challenges this sector faces’.

This alliance reinforces Legrand’s strong commitment to ‘the connected care market and the silver economy and opens the doors to accelerate developments and innovation’, Íñigo Ruiz Cossío, Director of Product and Marketing of Legrand Care says. Thanks to the creation of Legrand Care, more than 40 years of knowledge and experience of the members of this division are put into joint value ‘under a common strategic vision, with a coherent image in the market, the five brands will cease to operate as segmented entities and will concentrate their strengths to position Legrand as the leader in connected care worldwide’, Ruiz highlights.

In this sense, Mouminoux affirms: “This new Legrand Care division is excellent news for all our customers, partners and stakeholders in the health and social care sector and will give us even more capacity for innovation, to anticipate technological challenges and will allow us to confirm that we are a key player in this market.”

All the members of this division feel very motivated by this alliance and share the deep conviction that our shared resources,

solutions, interests, and vocation will make them stronger and will allow them to work together in the development of ‘proactive and preventative agendas, always placing people at the heart of our services. We will be more innovative because we will concentrate our efforts into achieving our shared objectives’, Ruiz remarks.

Dodd assures that all members of this new brand firmly believe that ‘this strategic union will facilitate the fulfilment of the mission and vision of this entity’.

Mission: A tireless commitment to truly understand customer needs, enabling innovative digitally connected care solutions to be delivered. To be the technological partner of clients, offering comprehensive and fully managed solutions that allow them to efficiently deploy improved care services.

Vision: To empower and help people live the healthiest and most fulfilling lives they want in the place of their choice.

Dodd concludes: “Together we will be better able to channel our combined resources into new product development and will continue to remain nimble and be proactive to the changing needs of our customers with the strength, resources and quality controls of Legrand, the global specialist in electrical and digital infrastructures in support.” L Legrand is the global specialist in electrical and digital infrastructures, offering high-valueadded products and solutions that improve lives by transforming the spaces where people live, work, and meet. Operating worldwide, Legrand works to enhance electrical and digital infrastructures, embracing the shift to digital technologies while contributing to reduced carbon footprints. Legrand solutions are used in residential and nonresidential buildings, care facilities, as well as in datacentres, industrial spaces, and infrastructure.

Its new brand Legrand Care specialises in the innovative development of connected solutions for the health and social care sector.

The Group’s technological expertise, its leading positions, the scope of its offering, its international presence and the power of its brands combine to make Legrand a global leader. With a presence in close to 90 countries and a workforce of over 36,700 Legrand generated total sales of €6.1 billion in 2020.

FURTHER INFORMATION www.legrandcare.com

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Integration

Integration White Paper: NHS and social care systems link up The Integration White Paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff Following NHS England’s release of the Elective Recovery Plan, the Department of Health and Social Care shared details of the government’s new Integration White Paper, which it promised will bring the NHS and local government closer together to improve care for all and value for money.

Acknowledging that the current systems too often means that patients are left having to navigate complex and disjointed systems, sometimes resulting in those with multiple conditions having to repeatedly explain their needs to multiple people in different organisations, the white paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff.

Drawing on the resources and skills across the NHS and local government to better meet the needs of communities, the integration plans will both seek to tackle the increasing waiting lists plaguing the NHS and level up healthcare across the UK, as set out in the government’s wider Levelling Up agenda.

only will this save time, it will help ensure a In amongst the detail, the white paper states patient does not have to repeat themselves that better transparency and choice will so many times, and professionals will have be unearthed, meaning that in situations the information they need to make care plans where local authorities and the NHS share that work for the patient. data and are more transparent about their This will lead to more personalised care. performance, the local population will be By linking GPs with wider forms able to see how their areas’ health of community support, such and care services are performing as social prescribing, the and make decisions about measures could allow care their own care.

There is to be more personalised Key to this is clearer an opp o which would help communication. r t u nity through reduce the need for Integration will mean in t e gration to tailor people to have more patients having a expensive, invasive single digital care specific services to the n e medical treatment. record so they can e d s of the commu There is also an book appointments, n it y to ensu the righ opportunity through order prescriptions, t service re integration to tailor and communicate with s available are services to the specific their care providers on needs of the community to one platform while those ensure the right services are involved in delivering health available. and care services can access For example this could mean more E the patient’s latest information – not Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Integration

 diabetes clinics in areas with higher obesity, or additional support for people to stop smoking in communities where there are higher numbers of smokers.

Another way to limit the need for people to have more expensive, invasive medical treatment is through earlier intervention.

Integration will help people to access the right services at the right time, including specialist services, which could mean earlier intervention that could prevent diseases from progressing and reduce the need for invasive and expensive interventions late in the day.

Currently local authorities cannot access all NHS data to make decisions about access to social care services. An integrated system would allow the NHS to notify a local authority straight away if a person requires social care support, meaning that managing diseases in the community is made easier through better joined up between primary, community and hospital services, meaning better treatment for patients.

The Local Government Association, which argues that a long-term funding solution is urgently needed in order to ensure a sustainable, high quality and sufficient care and health workforce to meet needs now and going forward, says that integrated care systems should develop their place-based arrangements on existing local authority boundaries since many of the components of joined up working already exist at this level.

The government also says that the plans laid out in the white paper will create more flexible services, ensure better value for money, and, through more coordinated services, reduce the burden on people to have to coordinate between different hospital

Drawing on the resources and skills across the NHS and local government to better meet the needs of communities, the integration plans will both seek to tackle the increasing waiting lists plaguing the NHS and level up healthcare across the UK specialists, GPs, social care and local authority services themselves.

Change is underway Integrated approaches are already being pioneered in many areas. Through their contact with people in the community, pharmacies in Sutton recognised a growing problem of loneliness and isolation, so worked with colleagues across the health and care system in that area to identify those most in need and link them up with services that were best placed to support them.

In Portsmouth, local authorities, health trusts and voluntary organisations combined their knowledge and expertise to improve support for vulnerable people in the community across a range of different services including health visiting, school nursing and learning disability support.

And in Tameside and Glossop, an electronic staff record system has enabled data to be fed into Covid-19 situation reports, so that staffing levels can be managed more effectively based on live data.

Matthew Taylor, chief executive of the NHS Confederation, said: “The pandemic has

shown just how interlinked health and care services are and need to be, and it’s vital that we continue to speed up integrated ways of working. The proposals in the white paper to break down barriers between NHS providers and local authorities, including through better data sharing, will be a big step forward.

However, it bears repeating that integration across health and care is not new, it’s already happening on the ground and has been for many years.

“As these proposals are developed further, it is important that we recognise the differences that exist in local areas including in local relationships. They will need to evolve in their own way if we are to crack this agenda.

“Finally, for integration to work there needs to be joined up thinking across government as well as at local level.

Ensuring this will allow local leaders the freedom to work with their communities to identify what will provide the best outcomes for the public.”L FURTHER INFORMATION www.england.nhs.uk

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Digital Health Rewired

Reconnecting the digital health community Digital Health Rewired 2022 returns on 15-16 March in London, with a festival designed to help you achieve your digital future. Rewired 2022 has been reimagined as the UK event to reconnect the diverse digital health community Two years into the pandemic, Rewired conference sessions, exhibition and meetings, 2022 will explore how the NHS is continuing all focused on sharing best to harness digital and data to respond practice and innovation. to unprecedented challenges, while Rewire moving to integrated care and New for 2022 smart health.

New stages for 2022 a d lso More than any other event, 2022 include: provide s Rewired brings together NHS National Policy, a unique opportu national and local leaders Integrated n i from so ty to hear and their teams, future Care, Digital me of t leaders, plus many other Nursing, Digital he most d health professionals who are Innovation, Smart ig interested in how digital can Healthcare and NHS tru ital s help them better care Data and Analytics.

CEOs t for patients.

Eight stages of Taking place at the Business educational content will Design Centre in London, the event will be CPD-accredited. provide a unique opportunity for health and The conference programme for care professionals to network, collaborate and Digital Health Rewired 2022 has recently been learn in-person across two days of educational published, with an exciting and diverse range

of speakers who will explore the future of digital health and care.

Jon Hoeksma, CEO at Digital Health, said: “It’s great to be back in-person with some a fantastic and varied programme, reflecting the huge breadth and diversity of work underway across the sector.

“We know just how hard everyone has worked over the past couple of exhausting years and hope that Rewired 2022 will provide many with an opportunity to take a breath, reflect, catch-up with colleagues and look ahead to what comes next.”

Hoeksma added: “The biggest new part of the programme is our focus on digital nursing and as well as the terrific community of CNIOs, we encourage all nurses, midwives and AHPs with an interest in how digital and data are reshaping nursing to come along and take part.” E Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Learn from NHS CEOs and local digital pioneers Rewired 2022 also provides a unique opportunity to hear from some of the most digital NHS trust CEOs, including: Professor David Rosser, CEO University Hospitals Birmingham NHS Foundation Trust; Dr Ian Abbs, CEO, Guy’s and St Thomas’ NHS Foundation Trust; and Dr Clive Kay, CEO King’s College Hospital NHS Foundation Trust.

Speakers on the Integrated Care Stage speakers include, Guy Lucchi, digital innovation director at Health Innovation Manchester and Sukhmeet Panesar, deputy director, strategy and development, data and analytics at NHS England and Improvement.

Dr Nicola Byrne, the National Data Guardian for health and adult social care in England will be the keynote on the AI and Data Stage, speaking alongside Ayub Bhayat, director of

The event will provide a unique opportunity for health and care professionals to network, collaborate and learn in-person across two days of educational conference sessions, exhibition and meetings, all focused on sharing best practice and innovation insight and data platform at NHS England and Improvement.

The Smart Health stage, meanwhile, will explore the smart networks and Internet of Things revolution now underway in health.

Speakers include Samantha Robinson, associate director of live services at NHS Digital and Andy Callow, CDIO University Hospitals of Northamptonshire.

Focus on digital nursing The Digital Nursing Summit will focus on the fantastic range of work underway to ensure nurses and AHPs at all levels take the lead in ensuring digital tools and services benefit all patients. The programme will showcase digital nursing leaders, teams and initiatives from across the NHS. Nursing leaders confirmed to speak include Natasha Phillips, CNIO, NHSX, Jo Dickson, chief nurse, NHS Digital, and 2021 CNIO of the Year, Emily Wells of Norfolk and Norwich University Hospitals NHS Foundation Trust.

Using technology to reduce costs and enhance patient care

Designed and built with NHS practitioners using Microsoft’s latest technologies, CCube’s awardwinning 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 including Aintree, Blackpool Teaching Hospitals, Aneurin Bevan Health Board, North Bristol Trust, NHS Grampian, NHS Forth Valley, Papworth, St Helens & Knowsley, and

NHS England & Improvement delivering measurable benefits, helping to deliver paperless healthcare within 20 months.

CCube’s suite of EDRM products includes modules covering: EDRM; Forms Recognition; Connect; eForms; Workflow; Portal & Web API; Mobile; and eShare.

CCube Solutions help NHS 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. L FURTHER INFORMATION www.ccubesolutions.com

Digital Health Rewired

 Hear from national policy keynotes Over on the National Policy and Keynotes Stage, keynotes include: Dr Tim Ferris, director of transformation at NHS England and Improvement; Simon Bolton, interim CEO at NHS Digital; Helen Thomas, CEO, Digital Health and Care Wales; Matthew Taylor, CEO of NHS Confederation; and Tom Loosemore, director Public Digital.

While on the Digital Transformation Stage, attendees can catch Saffron Cordrey, deputy chief executive at NHS Provider,s and Professor Jonathan Benger, chief medical officer at NHS Digital.

Pitchfest returns for start-ups Also taking place is the Rewired Pitchfest competition, which returns for its fourth year. The competition will see another 16 digital health start-ups battle it out to the live final to win an NHS test bed site for their idea or solution.

Last year’s winners, Peppy Health went on to close a series A funding round and expand into new services. Co-founder Mridula Pore will return to Rewired to share the story of what happened next for the fast-growing start-up.

Join the digital health community at Rewired Rewired is designed for the whole digital health community and is free to attend for NHS, public sector, non-for-profit and third sector providers, charitable sectors, academics and researchers. L FURTHER INFORMATION digitalhealth.net

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The software connects all sites, integrates with current systems and provides up-to-date insights of performance, risks and information while providing accessible and actionable data that otherwise would be unknown, hidden or unreachable.

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assurance frameworks, preparing for CQC inspections, clinical audits and incident management; to improving communication, managing complaints, or running patient satisfaction and staff surveys. Dashboard and reports offer real-time oversight of an entire system or drilling down to a place, neighbourhood, or an individual organisation. This works alongside an unrivalled analytics engine which enables unparalleled insight and informed decision making. Examples of excellence, best practice and lessons learned can also be found within this data and shared at all levels; helping healthcare organisations to take a more proactive approach to delivering patient care. L FURTHER INFORMATION www.radarhealthcare.com/ book-demo-main/ enquiries@radarhealthcare.com 0330 223 2740

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Advertisement Feature

Improve patient engagement through cloud-based digital solutions

Written by Darrin Chadwick, NHS & Ambulance Account Manager – Avaya UK

What should a healthcare provider look for in a modern cloud communications and customer engagement solution?

What does an ‘Engaged Patient’ look like? As a result of accessibility, regular communications, and of course personal discipline, engaged patients are more likely to come in for their annual exams, or regularly take their prescribed medications if they have a chronic disease. By comparison, less engaged patients are slower to contact their GP with health concerns or aren’t in the habit of taking their prescribed medicine. In fact, non-adherence to prescription medicine is estimated to cost the NHS almost £300 million per annum. Accessibility and regular communications, play a significant role in engaging patients, which can improve their health outcomes, as well as their healthcare experience. But this is not so easily done.

Healthcare organisations were forced to rapidly adopt digital solutions in the early days of the pandemic, such as video GP consultations and SMS alerts. Many were put into place hastily due to the sudden change in circumstances, often relying on outdated technology. They were shortterm fixes with no long-term sustainable value.

Healthcare teams are now more aware of what could be possible if all the currently siloed pieces of technology worked together in an integrated and holistic way.

Treat your patients like a customer when it comes to health communications Communications technology has been considered necessary in every vertical service for some time now, but in many healthcare practices, its implementation is still being planned or in the early stages of deployment. Depending on a traditional calling-centric communication model

is holding healthcare organisations back from the abundant benefits of digital communication services. These solutions can help increase patient engagement levels, directly contributing to improving their health.

The key is to think of patients the way a business thinks of its customers. Healthcare consumers want to be able to engage with their service providers in the same way that they connect with businesses, services and people in their personal lives – in whichever way they want to in that moment.

Other verticals deliver this level of customer-centric engagement and accessibility through digital communication services – such as CCaaS (contact centre-as-a-service) solutions. CCaaS solutions bring together voice, video, chat, email, SMS, collaboration, social media and even elements such as IoT and wearables, to form a unified and, most importantly, integrated contact centre environment. This allows healthcare organisations to design and deliver unique and effective patient experience and engagement strategies.

Benefits for patients, staff, and society CCaaS solutions come with many benefits that help with efficiently running a healthcare organisation. Things like patient self-service, automation of processes and patient enablement can all be helped by integrating IT systems and cloud communications. All these improvements can reduce the number of time-demanding administrative tasks associated with patient records, schedules, prescriptions, referrals, etc, freeing time for more important and urgent matters. What’s more, personalised outreach makes patients feel valued, improving the chances of effective engagement. Digital solutions can provide personalisation at scale, which overburdened healthcare staff don’t have the time to create.

So, what should a healthcare provider look for in a modern cloud communications and customer engagement solution? Here are four vital components to consider as a starting point:

A unified communications platform A unified communications and patient engagement platform in the cloud provides seamless connections across multiple devices and modes of communication, meaning patients can use their preferred communication channel on their device of choice. Tools like appointment scheduling, reminders, and automated confirmations will make it easier for patients to engage.

Real time communications and team collaboration Patient care requires constant access to clinical information, usually by more than one staff member. Staff must often communicate this information as well as updates on treatment across dispersed teams with no margin for error. Secure, real-time collaboration across all communications channels will help patients and staff receive the right support at all times.

Follow-up on patient engagement Automated patient notifications, following up on patient queries, requests, or satisfaction surveys are all on offer with cloud-based communications solutions, freeing critical staff to focus on in-hospital patients and higher priority skill-based services.

A secure and flexible platform To avoid the increased burden and operational complexity of carrying multiple devices, healthcare staff need a ‘one-device, multiple numbers’ experience that enables them to use one device for both personal and on-call extensions. A communications solution should be able to seamlessly integrate with the most common digital systems used by healthcare professionals today, including Electronic Healthcare Record systems, creating an all-in-one intuitive experience of communications.

Communication and collaboration can become integrated into one solution that works across any device, at any time and in any place with cloud services. The flexibility of cloud communications when it comes to open platforms means providers can add new capabilities in minutes, and have immediate access to the latest innovations.

If you want to learn more about the benefits of integrating healthcare IT systems with digital unified communications from a solutions provider that has extensive experience of working with electronic health record (EHR) vendors, visit Avaya’s website. L FURTHER INFORMATION www.avaya.com

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Technology

Prioritising future technology investments in the NHS Sascha Giese, Head Geek™ at SolarWinds, identifies the technologies that the NHS should be focusing on, given the £2.1 billion budget announced in the Autumn budget The 2021 Autumn Budget and Spending Review set out a wide range of public finance priorities and plans, among which was a commitment to spend ‘£2.1 billion over the next three years to support innovative use of digital technology’ across the NHS. This is a significant level of technology investment and gives a valuable boost for an organisation whose IT infrastructure is under constant pressure.

The challenge for NHS technology leaders is prioritising where to allocate the money it is given. Clearly, there’s a core emphasis on digital transformation, using technology to improve efficiency for NHS professionals, and to provide better, more accessible services for the public. Given the rate of digital-led change going on across society, it’s essential for key public sector organisations to keep pace with the speed of change.

But there are also some vital areas of core infrastructure requiring significant ongoing investment and modernisation if the Health Service is not only going to meet its longterm digital goals but also keep systems operating daily.

Focus on cyber security prevention, protection, and recovery In common with other healthcare systems around the world, the NHS is a major target for cyber criminals and nation-state attackers. The alarming situation seen in Ireland earlier this year underlines the severe impact successful ransomware can have on the delivery of vital public services.

In the immediate aftermath of the incident, the number of appointments in some areas of the system fell by 80 per cent, and health workers were forced to switch to using paper records to keep services available.

With the NHS already under severe pressure after nearly two years of dealing with Covid-19, additional technologies and processes to improve cyber security are essential to ensure its IT infrastructure remains protected.

It’s unrealistic, however, to expect the NHS systems to remain totally secure from the sophisticated tactics of cyber criminals.

Although the WannaCry ransomware attack took place several years ago, it illustrates the potential for serious disruption and the importance of recovery. NHS backup and recovery systems must be capable of delivering resilience when future attacks occur.

Replace legacy infrastructure and address technical debt Legacy IT is a recurrent issue in any organisation relying on old and obsolete systems, and the NHS remains particularly at risk. Even if these systems still fulfil an important role, as they get older, they become considerably more prone to issues only modernisation can solve. In the most serious circumstances, legacy tech can be the root cause of catastrophic cyber security breaches and service interruptions, and in the process, remediation incurs considerable costs.

For instance, the Government Technology Innovation Strategy paper highlights the issues that come with continuing to utilise old operating systems. Microsoft Windows 7, for example, is still used in the NHS even though it reached its official ‘end of life’ in January of last year and no longer receives security updates.

It’s a similar situation across the issue of technical debt whereby organisations such as the NHS focus on urgent and remedial software development priorities, where instead a more strategic and long-term approach would deliver better results and overall value for money.

Indeed, commenting on the Autumn Budget, the British Medical Association (BMA), directly addressed the challenges associated with the high levels of technical debt across the NHS. It said: “Without full mapping of the technical debt, it will be difficult to allocate this funding in order to both maximise impact and ensure parity between providers, and therefore patients, in terms of digital maturity.”

Invest in digital innovation In common with a wide range of digital services, the pandemic massively increased the use of NHS apps. While the core app, the most downloaded free iPhone app in the U.K., already offers a wide range of information and services, such as ordering repeat prescriptions, booking appointments, and viewing the user’s own health record, there is scope to develop its capabilities further.

For instance, the wider integration of APIs could allow the app to draw on real medical data or enable users to link to digital health and fitness devices such as their smartwatch. Clearly, a lot of thought and preparation should go into this kind of innovation to protect privacy, but there is scope to make NHS apps and services more accessible and relevant to groups of people across society.

Allocated wisely, government money allocated to improving digital infrastructure and services across the NHS has the potential to deliver significant benefits to all its stakeholders. In doing so, however, it remains vital to balance innovation with everyday operational efficiency and excellence. L FURTHER INFORMATION www.solarwinds.com

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Technology

Why PIFU could be set to radically transform outpatient care Tom Whicher argues that PIFU, incorporated as part of a digital pathway, gives NHS trusts the ability to tailor the messaging, length of service, number of booking requests and provision of additional monitoring requirements Delivering patient-initiated follow-up (PIFU) is a major new change to outpatient services laid out in NHS England’s Operational Planning Guidance and is almost certainly going to be a major component of the Elective Recovery Plan.

With two thirds of all hospital appointments taken up with often unnecessary follow-up reviews, patients can find these appointments inconvenient in terms of travel, financial costs and time out of work. These unnecessary appointments also place an exceptional burden on clinical and administrative staff.

PIFU aims to reduce this by empowering patients to be partners in the decision about when to have their next follow-up appointment.

The target in December, which the majority of NHS trusts missed, was to have 1.5 per cent of all outpatient attendances on a PIFU pathway with the service to be trialled in at least five major outpatient specialties.

Against a backdrop of winter pressures, and a burnt out workforce, is it even possible for the NHS to deliver on what are almost certainly going to be tougher targets in the Elective Recovery Plan?

P Simplifying PIFU through digital While getting any version of PIFU in place is a starting

point, to achieve maximum benefit we need to review entire pathways and integrate PIFU at the most optimum point alongside things like digital assessments. PIFU is sometimes viewed as a project in isolation and digital projects are not viewed as part of a wider transformation of the pathway.

There is also inconsistency around whether PIFU is really digital or not. Many trusts believe they already have a digital form of PIFU in place because they are using spreadsheets or non-integrated lists to manage the pathway. But this doesn’t solve the issue of being able to automate the service and reduce the time spent on admin.

As a result, opportunities to maximise the number of patients suitable for PIFU are missed and the benefits to staff are overlooked.

PIFU, incorporated as part of a digital pathway, gives trusts the ability to tailor the messaging, length of service, number of booking requests and provision of additional monitoring requirements. Forward thinking trusts are already scaling PIFU digitally. One is about to rollout digital PIFU in 30 specialities by tailoring solutions IFU is to specific pathway som requirements. This has viewed etimes enabled those trusts a s a proj in isola to make a dramatic e c t t impact on the way projects ion and digit al are no they deliver care and

t viewe as part d transfo of a wider rm the pat ation of hway

communicate with their patients, giving a better experience of care overall.

The current challenges we face in scaling PIFU One of the barriers to delivering PIFU at scale is the present lack of evidence of just how effective it can be, therefore providing an incentive to implement it. This is in part because there is large variation across NHS trusts about the definition of what PIFU actually is.

A clear, consistent definition of PIFU is essential to determine how many people are suitable for it and to understand and measure the real benefits. PIFU is categorised into four groups, ordered from lowest risk to highest risk: • Open Access Booking • See On Symptom (SoS) • See On Need (SoN) o SoN Patient initiated chronic care management o Clinically initiated – remote follow up management • Remote monitoring For example, while some trusts are seeing a 35 per cent reduction in their follow-up waiting lists, in reality they are only using it right at the end of the pathway to ‘discharge to SoS PIFU’.

This limits the benefits that patients could have by attending fewer appointments earlier on in their treatment and giving time back to both patients and staff.

The right patients for PIFU One of the key areas where PIFU can be most effective is with long-term health conditions or pain management. In this instance patients are assigned to a pathway, complete periodic digital assessments and given control to book their own appointment. They receive real time information about their condition, and depending on the result, can request an appointment. Clinicians can still initiate appointments based on their review of the digital assessments through clinician-initiated follow-ups (CIFU).

The other option is to integrate a digital See on Symptom PIFU list where patients are assigned to a pathway and given control to book appointments should their symptoms worsen. This solution helps negate concerns providers may have about patients no longer being monitored or managed when discharged. E Issue 22.1 | HEALTH BUSINESS MAGAZINE

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 PIFU should exist as part of the pathway – helping to optimise it and give patients the opportunity to take control of their wellbeing in a streamlined way. By consistently using PIFU in the management of long-term conditions, in conjunction with other digital tools such as remote monitoring and longitudinal studies, large cohorts of patients can be easily identified and placed on the pathway.

Mitigating risk to patients What about the risk to patients when they are no longer seen for their usual outpatient appointments at six, nine or 12 months?

We need to have effective communication about the changes to all patients so that they understand they are being given a choice.

One idea currently being examined is whether patients could be automatically scheduled in for a six month follow-up and then given the ability to choose, if they feel it’s necessary,

whether they have a three, nine or 12-month review. For the 15 million people living with a long-term health condition, this could be a game changer.

If this approach can be applied consistently, and if patients understand this is the case, it will free up consultants to see the next person on the waiting list. It would also mitigate any risk by providing a way to monitor patients so that they don’t fall through the gaps.

Looking at PIFU as one part of the digital pathway puzzle also misses the opportunity to actually deliver personalised appointments and prevent wasted time for both patient and clinician.

This is where the true value lies – in being able to personalise what people need and ensuring PIFU is not a one size fits all.

Ultimately, we need to ensure the people who are put on a PIFU pathway are most suited to it.

Technology

Delivering patient-initiated follow-up (PIFU) is a major new change to outpatient services laid out in NHS England’s Operational Planning Guidance and is almost certainly going to be a major component of the Elective Recovery Plan

Personalised outpatients and unlocking growing waiting lists Using digital to optimise pathways allows for far greater impact than introducing PIFU alone. If we start to view healthcare through the lens of the patient and redesign it in a way that works for them, we can improve our outpatient follow-up offer.

Digital delivery of PIFU gives the opportunity for trusts to deliver healthcare in a way that empowers patients, reduces waste and frees up time. This inevitably reduces the backlog and improves the overall experience for patients and clinicians. Whether that’s through patients requesting a blood test slot instead of just turning up, by supporting discharge or through virtual wards, where patients have the control to book their own appointments should their symptoms flare up.

With PIFU targets looming we need to consider how to improve the patient experience and help trusts think differently about the way they meet these targets. If PIFU isn’t working then let’s start talking about personalised follow ups instead. L FURTHER INFORMATION www.drdoctor.co.uk

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Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Cutting through the complexity of technology investment Todays health sector faces many unprecedented challenges. Services are stretched, waiting lists grow, staff absenteeism and shortages continue. To help address these challenges, David Willie, from integration specialist Visavvi, examines how audio visual and collaboration technology can be implemented to reduce professional workload, help staff well-being, and streamline service delivery whilst improving the overall patient experience As an NHS Shared Business Services and a Crown Commercial Service RM6225 framework supplier, Visavvi helps NHS organisations cut through the complexity of digital transformation. They deliver enhanced agility, smarter operations, and substantial efficiencies by harnessing audio visual, communication, and collaboration technologies that digitally transform workflows to innovate new modes of patient and service delivery.

As the government commits to investing £2.1 billion into health care technology, organisations have important decisions to make to ensure maximum benefit is gained.

Carefully specified, correctly installed, and effectively supported, technology can play a vital role not only in helping health service organisations and agencies overcome the current challenges, but can also provide a platform for positive long-term change and help transform operational efficiency and improve patient outcomes.

Wayfinding and public information From the outset, patients who are often worried and stressed need a seamless and rapid journey to access their health care professional. Digital signage, way-finding, and occupancy management/monitoring solutions within hospitals can help reduce patient stress and worry about getting to the right place at the right time. Not only

do these solutions improve the patient experience, but they also help ensure clinic schedules don’t overrun, hugely increasing clinician effectiveness.

Connected, monitored, and managed via an IT network, these solutions are easy and quick to update meaning the most upto-date information is always provided to patients. Being digital of course, allows the displays to be used for multiple applications, for example displaying directions, clinic information, public health care messaging, emergency evacuation notifications, and point of sale advertising such as coffee shop opening hours. The content can be dynamically changed or scheduled to deliver seasonal and traffic-driven targeted content.

Video conferencing/ collaboration As hospital estates expand, often over large sites and with multiple locations, the time pressure imposed through moving between locations for internal meetings, consultations, and appointments increases.

Videoconferencing and Microsoft Teams environments have the potential to save substantial amounts of time, reduce stress, and allow already busy medical professionals to be more productive.

There is a diverse range of facilities, systems, and services available so professionals can securely access video calls from anywhere, including smartphones,

tablets, laptops, dedicated video booths, meeting rooms, training facilities, and even in operating theatres. Videoconferencing has been widely adopted within many healthcare organisations for internal meetings, and training, but some of the real benefits have yet to be fully embraced.

Deploying videoconferencing in MDT rooms saves substantial amounts of time for busy consultants and specialists through remote attendance. Resources such as patient records and diagnostic scan results can easily be shared securely and viewed in very high definition enabling critical healthcare decisions to be made promptly.

Numerous health trusts are investigating the use of videoconferencing solutions to expedite patient discharge. It’s proven that patient recovery improves more quickly when they are in familiar surroundings such as their own homes. For the healthcare provider this, in turn, frees up vital onsite resources such as hospital beds, however, it can cause pressures elsewhere in the service.

Visiting patients at home creates additional workload, cost, and lost time with care professionals spending substantial amounts of time traveling and not delivering care services. Using videoconferencing, clinicians can see and hear their patients in high definition from their own homes, helping to provide additional information that can’t be achieved via a simple telephone call alone. Multiple patients can be seen in quick succession at the touch of a button in minutes, vastly more efficient than traveling between them. As far as the patient is concerned no additional specialist hardware or software is required. Not only does this improve patient outcomes and the patient experience, but it also maximises vital NHS resources and drives down costs within the service delivery.

These are just two examples of how audio visual and communication and collaboration technology can help transform the healthcare sector and there are many more yet to be adopted. L FURTHER INFORMATION Tel: 0370 606 1100 info@visavvi.com www.visavvi.com/nhs

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Scan here to get your tickets gs1uk.org/healthcare

GS1 UK

What next for Scan4Safety in the UK? The highly anticipated GS1 UK Healthcare Conference will be live at London’s QEII Centre on 17–18 March. With more than 70 speakers and over 12 hours of CPD content in store, the upcoming event will bring the Scan4Safety case studies to life Scanning technologies and programmes like Scan4Safety, that use barcodes to track data and devices, have reduced device and patient identification errors.”

Similar references to the importance of the Scan4Safety programme, can also be found in high profile reviews, such as Baroness Cumberlege’s Independent Medicines and Medical Devices Safety (IMMDS) Review, and safety-based investigative reports from the Healthcare Safety Investigation Branch (HSIB).

Unique identification is vital for healthcare.

Traceability enhancing Take the ability to accurately identify a patient patient safety to ensure the right patient is given the right For the first time since the publication of the treatment, or the capacity to unambiguously Scan4Safety evidence, the highly anticipated identify a product so it can be traced GS1 UK Healthcare Conference will be live at throughout the supply chain for example – London’s QEII Centre on 17–18 March. With both align to improve patient safety. more than 70 speakers and over 12 hours It is well known that failures in unique of CPD content in store, the identification can have, and have had, grave upcoming event will repercussions for patients. From 1 April 2021 bring the Scan4Safety to 31 December 2021, NHS England and Using G case studies to Improvement reported a total of 314 S Identific 1 life, together Never Events. This number includes ation Keys, it with keynotes surgeries that were intended for is p o addresses from other patients, retained foreign s s ib correctly le to healthcare objects post procedure, and wrong id e n tify and capture policy implant or prothesis. in directorates However, with data standards in directly formation at t from the UK and place, such instances of unwarranted of care he point overseas. error could be drastically reduced. or use Centred on the Using GS1 Identification Keys (GS1 overarching theme of standards), it is possible to correctly powering traceability in a identify and capture information directly at clinical setting, Baroness Julia the point of care or use, removing ambiguity Cumberlege CBE DL will present the opening and preventing the risk of error. keynote to set the precedence for the event.

Used to identify every person, product, As part of the address focused on medical and place within a healthcare setting or device traceability and patient safety, the supply chain, GS1 standards improve patient session will examine key recommendations safety by enabling interoperability to deliver around standards and transparency traceability. Harnessing the power of these highlighted in the report. standards empowers staff by providing timely One recommendation has since led to access to the information they need at the the early development of the UK-wide touch of a button or scan of a barcode.

Medical Device Information System (MDIS).

Programme lead for MDIS, NHS Digital’s Driving traceability Emma Summers, will also join the speaker through standards faculty to highlight how GS1 standards are The Department of Health and Social Care’s being used to support MDIS data capture Scan4Safety evidence highlights how valuable requirements – for healthcare providers as GS1 standards has been to both clinical and well as medical device manufacturers and non-clinical staff, and their patients. Headline suppliers. results report the release of more than Content also expands to cover the 140,000 hours of clinical staff time, £5 million traceability benefits of using GS1 standards, in recurrent inventory savings and £9 million with an insightful look at the systems in non-recurrent inventory savings. implemented to track and trace Covid-19 More importantly, this real time accurate vaccines as a global supply chain initiative. data capture imposed by Scan4Safety, has The agenda will also address the national resulted in tangible patient safety benefits. policy landscape, with discussions led by Clearly noted by central NHS organisations senior industry representatives including such as NHSX, the 2021 Digital Clinical Safety Richard Murray, chief executive of The King’s Strategy states: “Evidence demonstrates Fund, Melinda Johnson, commercial director the power of digital to support safety.

of the Department of Health and Social Care (DHSC), and Keith Conradi, chief investigator at the Healthcare Safety Investigation Branch (HSIB).

Each day of the programme concludes with deep-dive sessions, panel discussions and practical implementations of GS1 standards adoption across the UK. NHS trusts, such as Hull University Teaching Hospitals, Leeds Teaching Hospitals and East Lancashire Hospitals, share their key learnings, best practice insights, and the challenges and successes from their own Scan4Safety implementation journeys. Plus, hear from representatives from NHS Wales and Scotland as the two nations embark on nationwide Scan4Safety adoption programmes to meet MDIS data requirements.

In between the learning, there will also be plenty of time to re-connect with colleagues and absorb the day’s learnings at the QEII networking reception on the evening of day one. This will then be followed by a special evening reception at the House of Lords hosted by GS1 UK president, Lord Philip Hunt of Kings Heath, exclusively for NHS staff. L

As supporters of this year’s GS1 UK Healthcare Conference, Health Business magazine readers will also have the chance to purchase tickets at a 25 per cent discounted rate using the code HC22_HBM. It is set to be an unmissable event so be sure to register for your passes.

Find out more about the GS1 UK Healthcare Conference and view this year’s agenda and speakers on the conference web page.

FURTHER INFORMATION https://healthcare.gs1uk.org/scan4safety

Glen Hodgson, Head of Healthcare, GS1 UK

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Cyber security

2022 cyber security outlook: be aware, be prepared With increased digitisation impacting all aspects of life, cyber attacks will become increasingly ubiquitous and may impact all our activities across the most mission-critical industries, writes David Stroud Another year of landmark cyber attacks on critical infrastructure, gruelling supply chain challenges, and wiser-than-ever cyber criminals has passed, but certainly not without profound impact. Across industries, cyber security experts watched as bad actors grew more intelligent and learned to circumnavigate organisations’ existing protective measures. This sight was perhaps most arresting for mission critical solutions providers in the government, defence, utility, and industrial sectors.

As government and business leaders question how to defend their devices, data, and networks against mounting attacks, it’s important to consider the magnitude and scope of attacks will likely only evolve in 2022 – creating a more catastrophic impact from attacks than ever. World Economic Forum’s 2021 Global Risks Report forecasted that 39 per cent of industry leaders fear future cyber security failures will present critical threats to business and society.

It is clear connected devices in vitally important industries are vulnerable to attack.

It is essential to be prepared for when – not

if – they are compromised. With the alarm sounded in 2021, what should decision makers look out for specifically in 2022? Here are some predictions for the new year in cyber security, along with advice on how to address the ominous threats.

never been greater. Organisations must be proactive in changing their defensive priority from attack detection to outcome prevention.

Scale up or pay up: massive ransom loss for unprotected data As RaaS gangs learn victims are willing to pay staggering sums to maintain operations Attack origins will diversify (and their reputations), ransomware projects Attacks in 2022 will vary in origin – from to cause unparalleled financial losses in insider sources compromised maliciously 2022. Unprotected data shared across the or simply through negligence to supply cloud to both edge devices and networks is chain sources, to shadowy outsider groups ripe for the ransoming. An increased attack funded either privately or by a nation-state surface with more connected devices than looking to maintain plausible deniability for ever has made this valuable data even easier aggressive behaviour. to get, too, especially if hackers can insert In addition to a diversification in attack themselves into such devices somewhere origin, strikes will rise in severity too as along the supply chain. hackers gain a greater understanding of their Reflecting on last year’s destructive leverage and their targets’ vulnerabilities.

SolarWinds and Kaseya VSA hacks, As all criminals refine their attack more ransomware groups strategies – from private are expected to exploit ransomware-as-a-service It is clea vulnerabilities in supply (RaaS) outfits to seriously r connec chains. It is crucial that moneyed state-sponsored t across industries, groups – the urgency to in vitall ed devices y impo connected devices E act before they do have ind

rtant ustrie to attac s are vulnera ble k. be prep It is essential to are – not if d for when –t compro hey are mised

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The Cyber Prism Platform reduces the resources required to re-establish safety and security for Operational Technology such as medical scanners. Incorporating OT – compatible network visibility, alerting, incident response, and protection of devices and systems; it is low-risk, employing tried and tested technology, and compatible with any manufacturer’s equipment. Human experience and judgement are key: our solutions are tailored to the clients and backed by our proven expertise, born of decades spent protecting Critical National Infrastructure. We reduce the scale of the task and allow people to do what they do best: take control.

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Patching will be punished by relentless AI-assisted attacks Cyber criminals are always developing new tools to exploit new vulnerabilities, and while defenders attempt to stop them by using patches and network defences, it’s often not enough. Remembering the progression of attacks, it’s understandable that actors in 2022 are advanced enough to circumnavigating preventative measures that business leaders have historically placed their confidence in.

The degree of intelligent behaviour from all attackers – internal, external, supply, chain, state-level, and beyond – is increasing to an unprecedented level. Attackers are tricking sensors and honey pots, leveraging selflearning AI and machine learning to analyse data, find new entry points, and constantly adapt to defeat insecure protection measures.

As more complex attacks emerge, continuous improvement to security measures and testing is essential to ensure that you’re always one step ahead of the attacker, and

As more complex attacks emerge, continuous improvement to security measures and testing is essential to ensure that you’re always one step ahead of the attacker, and not the other way around not the other way around. For the known vulnerabilities, performing penetration tests using the known attack vector can help you patch systems on a regular basis. For unknown risks, prioritising preventive security rather than detection solutions is equally important. Basic blocking and tackling and cyber hygiene practices like patching, net segmentation, regular scanning for shadow IT and vulnerabilities remain essential as well.

From a leadership standpoint, using several security methods in different hardware and software levels to cover all bases. After all, effective cyber security strategy should be an adaptive, building-block approach, not a onesize-fits-all solution.

With increased digitisation impacting all aspects of life, cyber attacks will become

Cyber security

 are protected throughout the entire product lifecycle. This starts from the production line and carries throughout supply chain field operations and involves embedding cyber resiliency on OT and endto-end from to IT infrastructure and cloud environments.

increasingly ubiquitous and may impact all our activities across the most mission-critical industries. The threats facing critical industries will continue to expand as their networks do in the new year. Decision-makers must act immediately to evaluate and upgrade security approaches with an eye towards proactive outcome prevention rather than solely relying on reactive ‘hack and patch’ fixes. In 2022, organisational success and survival depends on it. L

Written by David Stroud, head of Europe & APAC at NanoLock Security.

FURTHER INFORMATION www.nanolocksecurity.com

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature Written by Kristina Holland, vice president sales, UK & Ireland, RevBits

38

RevBits® adopts a pragmatic and holistic approach to thwart cyber security threats within the healthcare sector Within Health Business issue 21.6, the lucrative nature of the health sector as a target was touched upon, to include the perceived value to cyber criminals and the various attack methodologies used.

To drill down further, here we consider business critical information assets (BCIAs); vulnerabilities; the ‘risk’ of cyber threats and how to mitigate and remediate these

RevBits is a cyber security solutions provider covering the broadest available range of core cyber security areas from one stack. Next Gen patented solutions have been expertly designed ‘from the trenches,’ to mitigate and help remediate an organisation’s cyber security challenges by considering these against a holistic view of people, process, culture, and information technology. Information assurance and the interplay between an organisation’s BCIAs, vulnerabilities and risk, are baked into the RevBits portfolio of products and services.

These embrace: Email Security (endpoint based); Endpoint Security/EDR; Privileged Access Management (PAM); Deception Technology; Zero Trust Networking and RevBits Cyber Intelligence Platform CIP/XDR. Imminent product launches include Email Security SEG (cloud based) and RevBits Phishing Simulation Awareness Training. Products both onprem and cloud SAAS.

What is RevBits approach?

RevBits approach is very much to understand the ‘pain points’ and the ‘risk of threat’ within the client base and to develop solutions to help mitigate and remediate these.

The market is flooded with well-intended suppliers offering everything from awareness training, health-checks and a million different ground-breaking technologies to address the various identified vulnerabilities.

What tends to be lacking is an affordable means for organisations to identify the ‘most likely risks’ and to translate this into a finite number of information governance (IG) and technology control measures.

While no single organisation can have all the answers, we believe that with the integration of RevBits Next Gen technology; a pragmatic logical business approach; alignment to complimentary organisations and an understanding of the attackers ‘goal,’ it is possible to significantly reduce risk and improve an organisation’s cyber security posture.

A useful equation to capture the cyber threat: BCIA + Vulnerability (V) = Risk of Threat (RoT) The correlation between BCIAs, vulnerabilities and risks are indisputable. To understand

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

what information is at risk of threat, an organisation needs to first identify their critical information assets and subsequently look for any/all potential weaknesses or vulnerabilities around these. A threat will exploit these ‘vulnerabilities’ to obtain, destroy or damage assets. Reduce the vulnerabilities – reduce the risk of this taking place. Understanding this simple premise enables the organisation to create and implement a protection strategy which will reduce the overall exposure of BCIAs to the risk of cyber threat.

Suggested steps to simplify cyber security and reduce the RoT: 1) Identify your key BCIAs It is important organisations understand what and where their BCIAs are before determining how best to protect them. BCIAs are those assets deemed central to your organisation’s success, competitive advantage, and continuing operation. In the context of the health sector, they would include for example patient records, pharmacological data, and research IP. The impact on a company’s reputation, financial stability or very existence could be considerable if sensitive internal or customer information were to fall into the wrong hands.

all assets and accounts. Pursuant real time actionable intelligence vastly improves visibility and SecOps productivity whilst reducing latency and mitigating the risk of threat. RevBits helps protect and secure an organisations BCIAs which in turn significantly reduces the RoT and improves the cyber security posture.

3) Identify the ‘Threats’ to these BCIAs IT-based threats target anything from the individual to the Critical National Infrastructure.

The cyber criminals will exploit any vulnerabilities in the network, people, and processes (attack surface), to gain access to these BCIAs. Phishing has been the most predominant form of attack, often precursive to credential harvesting and ransomware.

This typically: via ‘People,’ exploiting their lack of cyber awareness and the prevalent intentional/unintentional ‘human error’ ; via ‘VPN,’ attaining privileged access via a third-party link, e.g., ‘supply chain’ or more recently remote/ hybrid workers. Supply Chain ransomware attacks hitting the news recently include Kaseya ransomware attack, the Colonial Pipeline breach and SolarWinds; exploiting the Covid catalysed ‘digital transformation’ programmes and comparative lack of security measures, policy, and process in place for remote/hybrid workers.

RevBits Email Security. There is an acceptance in the market that leading SEGs have an email ‘miss rate’ of over 24 per cent - little wonder perhaps that the vast quantity of support issues revolves around phishing.

To combat this, RevBits Email security solution uses patented endpoint algorithmic analysis to detect and block those sophisticated complex phishing and page impersonation attacks which typically bypass the incumbent SEG gateway solutions. Additionally, email authentication automates workflows and reliably deploys standard email protocols that authenticate out-bound emails. DKIM, DMARC and SPF policy settings are automated to prevent email and domain spoofing, removing the complexity and difficulty of enabling such capability. RevBits Email Security offers a highly effective second layer of defence.

T&A. To address the other half of the phishing issue – human error –Users are directed to leading NCSC certified computerbased cyber-awareness training. In addition, RevBits will imminently launch a complete and comprehensive phish simulator awareness training solution ‘SAT,’ which will mimic likely attack paths and techniques and provide advanced reporting capability.

4) Identify appropriate IT and IG controls to mitigate and remediate the ‘risk of threat’ against identified BCIA vulnerabilities.

Cyber security capabilities of identification, detection and response place any organisation in a perpetual state of ‘Disaster/ Recovery’ (D/R). This is an inevitability in a world where it is universally accepted that a cyber attack is not a matter of ‘if’ but ‘when.’ It is important that the balance between IT and IG should continue to be manifest throughout the recovery phase to help ongoing and predictive protection through for example lessons learned, raised staff awareness, simulation exercises and an appropriate governance framework.

Visibility is King. Increasingly, organisations are trying to leverage unified security platforms to help rationalise their heterogeneous environment of multi-vendor solutions and distributed users. Improved visibility and BCIA identification are precursive to securing your estate.

RevBits CIP/XDR provides a 360-degree view, proactively protecting business assets through the automation and integration of RevBits security modules. These detect, lure, alert, respond and intelligently analyse multi-layered security data across the security stack. CIP/XDR is integrated into all major SIEM products and has the capability to scan an organisation’s environment (on-prem and cloud) to identify

Special offer In order to help improve visibility and asset identification….RevBits will provide CIP/XDR with the purchase of any RevBits solution or combination of solutions, at no additional charge. The health sector would immediately benefit from the following: To combat sophisticated Phishing, Spearphishing, Page Impersonations and address cyber security awareness:

To combat ransomware, unknown malware, SQL injection, zero-day exploits, man-inthe-middle, fileless and other attacks: RevBits Endpoint Security/EDR conducts a threephased analysis on new executables and includes the most comprehensive robust EDR solution on the market. RevBits behavioural analysis integrates with the ‘MITRE Attack Framework’ within our intelligence engine. Patented technology includes unique anti-rootkit threat detection, prevention, and removal capabilities to enable visibility and operation at the kernel level, blocking all unauthorised signed or unsigned drivers.

Independent ICSA results reveal 99.8% detection rate and ZERO false positives T&A. Users are directed to online NCSC certified cyber-awareness training.

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2) Identify the ‘Vulnerabilities’ of these BCIAs A vulnerability as described by NIST: … a weakness in an information system, system security procedures, internal controls, or implementation that can be exploited or triggered by a threat source …

Weaknesses or Gaps to these BCIAs need to be identified in order that the appropriate IG and IT controls may be employed to mitigate and remediate these. Good cyber security measures should ensure that the right people, have access to the right information at the right time – conversely preventing the wrong people from accessing such information anytime!

BCIA vulnerabilities may include anything from unauthorised access, denial of service, unpatched systems through to poor cyber awareness of staff and a vendor crowded environment being rendered invisible through its complexity.

RevBits extensive range of capability, greater visibility and actionable intelligence means that RevBits solutions are directly aligned to the specific threat to help ensure BCIAs are secured, protected and RoT-free. L RevBits officially launched last year. Since, many awards have been attained for innovation and efficacy, including recognition as the Top Cybersecurity Solution Provider in 2021 by CIO Applications; multiple best in class awards across the product range from the Cyber Defence Magazine (CDM) and named Winner of the Coveted Global InfoSec Awards during RSA Conference 2021.

RevBits are members of Forbes Technical Council and techUK. Recent articles featured in Cyber Exchange Spotlight and CRN channel web’s Q&A article, articulate the whys and the wherefores of RevBits approach to the UK and Ireland. RevBits is ISO27001 and Cyber Essentials certified. For further information please contact Kristina Holland, Vice President Sales for UK & Ireland kristina. holland@revbits.com or visit RevBits Homepage.

To combat third party access vulnerabilities e.g., supply chain and remote worker plus address ‘Training’ requirements: RevBits ZTN enables granular access to specific BCIAs and applications, identifying, isolating, and monitoring remote network connections in real-time. Moving the network perimeter to the endpoint RevBits Zero Trust Network (ZTN) helps isolate and protect your internal BCIAs without the necessity of implementing complicated network segmentation. RevBits ZTN focuses on protecting resources by ‘trusting no one’ by default, whether inside or outside the network. The ease of implementing a zero-trust architecture has never been so simple.

T&A. Users are directed to online NCSC certified training which may include a range of courses from Information Asset Owner; Procurement; Hybrid Awareness Training through to CISO and Board Room training.

Kristina Holland, vice president sales, UK & Ireland, RevBits

FURTHER INFORMATION kristina.holland@revbits.com www.linkedin.com/company/revbits-inc www.revbits.com

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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HOLISTIC CYBER SECURITY SERVICES AND SOLUTIONS

About Us

Thank you for the great Clinical workshop, lots of great thought-provoking content and insights on why cyber is so important for our clinical teams.

Templar Execu�ves is an award winning, interna�onal Cyber Security company. We work with organisa�ons across the health sector including NHS Trusts, CCGs, NHS Digital, ALBs, Primary and Social healthcare and other NHS agencies. In an increasingly connected, evolving and digitalised NHS integrated care system, we are commi�ed to providing Cyber Security solu�ons that improve the pa�ent journey and outcomes.

I am sure as a Trust we would not be in such a good position as we are now in terms of our cyber posture and compliance with the DS&P Toolkit without all your hard work and commitment to us.

Working within Healthcare

Templar Cyber Academy Enhanced understanding of Cyber Security and roles to be played throughout the Trust from Board, IAO, Clinicians and staff e-Learning training.

Cyber Strategy and Communica�ons

Develop strategies, plans and interven�ons to deliver a Cyber secure culture and business resilience, including Incident Response.

Board Briefings Best prac�ce Leadership and Governance to enable organisa�onal compliance, assurance and risk mi�ga�on.

CORS Programme Helping organisa�ons achieve opera�onal resilience and DSPT and Cyber Essen�als Plus compliance encompassing, people, policy & process and ICT.

SIRO Training and Mentoring; SIRO Portal

Tailored one-to-one personal development training and mentoring with expert facilitators. Exclusive access to the SIRO community portal and webinars.

Cyber Risk Assessments & IT Reviews Cyber maturity gap analysis and IT Health Check to deliver priori�sed ac�ons and roadmap to address vulnerabili�es and mi�gate risks.

Contact us for a free consulta�on or to find out more about our products and services.

Contact Us +44 (0) 203 542 9075 enquiries@templarexecs.com www.templarexecs.com © 2021 Templar Execu�ves Ltd.

@templarexecs

Cyber security

Cyber Essentials, a minimum baseline for all businesses In January, the government approved Cyber Essentials scheme receives the biggest overhaul to date. The significant changes to the technical requirements in the scheme reflect the security challenges in today’s digital world The government approved scheme includes five technical controls that help protect organisations of all sizes from the majority of commodity cyber attacks. A team of experts review the scheme at regular intervals to ensure it stays effective in the ever-evolving threat landscape. The evolution of Cyber Essentials allows UK businesses to continue raising the bar for their cyber security, it is now widely considered the minimum level of cyber security for all businesses.

Cyber Essentials works in the format of a verified self-assessment questionnaire.

Organisations log onto a secure portal to answer a series of questions that address the scope of the assessment, their employees, devices and work location. They will also answer questions that address the five core controls, which include user access control, secure configuration, security update management, firewalls and routers, and malware protection.

A senior member of the board will sign a document to verify that all the answers are true and then a qualified external assessor will mark the answers.

The preparation and process of getting certified to Cyber Essentials will give an organisation a clear picture of their cyber security and an opportunity to improve.

For organisations that require a higher level of assurance, Cyber Essentials Plus starts with the Cyber Essentials questionnaire but the technical controls are then physically audited to verify that they are in place. SMEs based in the UK with a turnover of less than £20 million who certify their whole organisation to Cyber Essentials are awarded free cyber security insurance.

The Cyber Essentials certification badge signals to customers, investors and those in the supply chain that an organisation has put the Government approved minimum level of cyber security in place and can be trusted with their data and business. Many contracts stipulate Cyber Essentials as a pre-requisite.

The scheme was introduced by the UK Government in 2014, as a way to help make the UK the safest place to do business. The environment that the scheme operates in has changed dramatically in the last seven years and, to reflect these changes, some of the technical control requirements were updated in January 2022 in line with recommended security updates.

The pricing of Cyber Essentials has also changed and will adopt a new tiered structure based on organisation size.

While micro-organisations will continue to pay the current £300 assessment charge, small, medium and large organisations will pay a little more, on a sliding scale that aims to better

reflect the complexity involved in assessing larger organisations.

The main technical changes In recent years, business cyber security has been further challenged by the wide adoption of cloud services and remote working, the move to home working and use of privately owned devices. Many of the Cyber Essentials technical requirement changes reflect this new environment.

Home working devices are in scope, but most home routers are not.

Anyone working from home for any amount of time is classified as a ‘home worker’. The devices that home workers use to access organisational data and services, whether they are owned by the organisation or the user, are in scope for Cyber Essentials.

Home routers that are provided by Internet Service Providers or by the home worker are now out of scope for the assessment while Cyber Essentials firewall controls apply to the home worker’s device (computer, laptop, tablet and/or phone). However, a router supplied by the applicant company is in scope for the assessment and must have the Cyber Essentials controls applied to it.

Why the change?

Home working or hybrid working (coming into the office for only some of the working week) is now normal practice for most businesses and is unlikely to change back in the short term. It is difficult to impose rules onto multiple employee’s private home routers unless it is provided by the organisation.

All cloud services are in scope Cloud services are to be fully integrated into the scheme. If an organisation’s data or services are hosted on cloud services, then the organisation is responsible for ensuring that all the Cyber Essentials controls are implemented on that service. Definitions of cloud services have been added for Infrastructure as a Service, Platform as a Service and Software as a Service. Whether the cloud service provider or the user actually implement the control depends on the type of cloud service but the user has a responsibility to check that the controls are put in place.

Why the change?

People commonly assume that cloud services are secure out of the box, but this is not the case. It is necessary for users to take responsibility for the services they use and spend time reading up and checking

their cloud services and applying the Cyber Essentials controls where possible. Previously, Platform as a Service (PaaS) and Software as a Service (SaaS) were not in scope for Cyber Essentials, but the new requirements now insist that organisations take responsibility for user access control and the secure configuration of their services which would include securely managing access to the different administration accounts and blocking accounts that they do not need.

Where the cloud service is in charge of implementing one or more of the controls (eg security update management or antimalware), the applicant organisation has the responsibility to seek evidence that this is done to the required standard.

Multi factor authentication must be used for access to cloud services As well as providing extra protection for passwords that are not protected by other technical controls, multi factor authentication should always be used to provide additional protection to administrator accounts and user accounts when connecting to cloud services.

No matter how an attacker acquires a password, if multi factor authentication is enabled on the account, it will act as a safeguard on the account.

The password element of the multi-factor authentication approach must have a password length of at least eight characters with no maximum length restrictions.

Why the change?

There has been an increasing number of attacks on cloud services, using techniques to steal or brute force a user’s passwords to access their accounts. Thin clients are a type of very simple computer holding only a base operating system which are often used to connect to virtual desktops. These are confirmed as being in scope when they connect to organisational data or services.

Password-based and multi-factor authentication requirements When using passwords, one of the following protections should be used to protect against brute-force password guessing: • Using multi-factor authentication • Throttling the rate of unsuccessful or guessed attempts.

• Locking accounts after no more than 10 unsuccessful attempts.

Technical controls are used to manage the E Issue 22.1 | HEALTH BUSINESS MAGAZINE

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AT A GLANCE • Access to SEP2 Leeds ISO27001 SOC • 24x7x365 support for priority 1 issues • 8am to 6pm business days as standard • Direct escalation into Vendor Support • Health Monitoring & Configuration Backup • Quarterly Backup and Restoration Testing • Patch & Major Version Upgrade Service • Change Management and Implementation • Reporting and Service Reviews

SEP2 Wingman Service Wingman Noun 1. A pilot whose plane is flying behind and to the side of a plane that is leading a group of planes flying together The traditional military definition of a “Wingman” refers to the pattern in which fighter jets fly. There is always a lead aircraft and another which flies off the right wing of and behind the lead. This second pilot is called the “Wingman” because he or she primarily protects the lead by “watching his back.”

With the complexity of environments growing, your in-house engineers require a vast range of knowledge, from switching to routing, firewalls to SIEM. This combined with the growing Cybersecurity industry, puts more and more pressure on organisations to hire and retain quality engineers to run the day-to-day operations. When it comes to larger pieces of work or troubleshooting complex issues, this can sometimes go beyond what your own engineers are experienced or comfortable in performing.

Our engineers will work alongside your own internal resources to provide backups, support, monitoring, change implementation and incident investigation to your organisation. As we work as part of your internal resources, this gives your own engineers the confidence to perform challenging work knowing they have the backup of some of the industries best engineers.

If required, we can perform work and tasks on devices entirely on your behalf, freeing up internal resource to work on other tasks at the same time, increasing the efficiency of your cybersecurity security teams.

Who are SEP2?

SEP2 are an award-winning cyber-security specialist.

We align ourselves with world-class cyber-security vendors, whose solutions cannot be bettered. However, only by supporting our customers with the very best engineers, analysis and consultants can we get the best out of these solutions.

This is why we say: SEP2 offer a tech-driven service powered by passionate and honest people.

51A St Paul’s Street Leeds LS1 2TE 0330 043 7372 www.sep2.co.uk info@sep2.co.uk

We are here to beat the bad guys. We’re here for good.

CONTACT US

VISIT OUR SITE

People must be supported to choose unique passwords for their work accounts. New guidance has been created on how to form passwords. It is now recommended that three random words are used to create a password that is long, difficult to guess and unique. There must be an established process to change passwords promptly if the applicant knows or suspects the password or account has been compromised.

What is a brute force attack?

Brute force attacks use trial and error to guess passwords and encryption keys.

Powerful computers are used to target a login page where they try many different combinations of characters until the correct combination is found to crack the password or encryption key. Depending on the length and complexity of the password and the power of the computer used, cracking the password can take anywhere from a few seconds to many

years. Modern computers have advanced in power and capability to the point where an eight-character alphanumeric password can be cracked in just over two hours.

All high and critical updates must be applied within 14 days and remove unsupported software.

All software on in scope devices must be: • Licensed and supported • Removed from devices when it becomes un-supported or removed from scope by using a defined ‘sub-set’ that prevents all traffic to/ from the internet.

• Have automatic updates enabled where possible • Updated, including applying any manual configuration changes required to make the update effective, within 14 days of an update being released, where: the update fixes vulnerabilities described by the vendor as ‘critical’ or ‘high risk’; the update addresses vulnerabilities with a CVSS v3 score of 7 or above; or there are no details of the level of vulnerabilities the update fixes provide by the vendor.

Why the change?

Previously, there was a set criteria that the vulnerabilities which had to be applied had to meet, which were laid out in the requirements. These criteria have now been dropped and organisations need to apply all high and critical updates on all their systems.

This is raising the bar because organisations can no longer be selective about which

patches they apply and leave themselves weak and vulnerable. The reason for these changes can be illustrated by a high-profile example this year. A vulnerability in the Microsoft Exchange System came out very publicly and was reported by numerous news outlets.

That attack went from being a complex state actor attack to a commodity attack within seven days. It was commoditised into a ransomware attack only 12 hours later. This proves that a high complexity attack can be commoditised in hours and for this reason, all high and critical updates, need to be applied within 14 days for Cyber Essentials.

Cyber security

 quality of passwords. This will include one of the following: • Using multi-factor authentication in conjunction with a password of at least eight characters, with no maximum length restrictions.

• A minimum password length of at least 12 characters, with no maximum length restrictions.

• A minimum password length of at least eight characters, with no maximum length restrictions and use automatic blocking of common passwords using a deny list

Guidance on backing up Backing up your data is not a technical requirement of Cyber Essentials because the scheme focuses on measures to prevent an attack as opposed to aspects to allow recovery after an attack. However, with the recognition of the vital importance of backup, there is now guidance on backing up important data and implementing an appropriate backup solution is highly recommended.

How the changes will work There will be a grace period of one year to allow organisations to make the changes for the following requirements: MFA for cloud services, thin clients and security update management. L FURTHER INFORMATION iasme.co.uk/cyber-essentials

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 22.1 | HEALTH BUSINESS MAGAZINE

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WCS Group.

Specialist water safety solutions for healthcare providers.

WCS Group deliver bespoke, ‘best in class’ water safety solutions and secondary disinfection systems, supporting over 80 NHS Trusts and healthcare providers across the UK to adhere to HTM04.

We are specialists in: • Water Safety Plan Attendance and Consulting • Legionella and Pseudomonas Testing • Waterborne Bacteria and Infection Control Training • Water Purification to Healthcare Standards • Primary and Secondary Water Disinfection • PPM and Reactive Works (Nationally) • Remote Closed System Monitoring and Corrosion Fault Finding • Water Treatment, including Steam Boilers • Hydrotherapy Pool Maintenance and Plant PPM, Refurbishment and Replacement

a

Contact alex.winter@wcs-group.co.uk or visit www.wcs-group.co.uk For a full list of our accreditations please visit: www.wcs-group.co.uk/accreditations-respository

Facilities management

Climate change and the air inside public buildings Chris Yates, chief executive at Federation of Environmental Trade Associations, explores the issue of indoor air quality and the need for better ventilation in public buildings, as well as the effect that heating requirements can have on the environment Arguably the UK did a good job at COP 26. covering buildings to ensure that we have For the first time ever, reduction in fossil fuels safe environments for people to visit and was included in the text, which I think for work, particularly in public buildings. Different many of us was a surprise as it had not been challenges are going to be present depending included before. However, that is often one of on the use of the building. The impact of the the challenges of bringing countries together, pandemic has meant many of the buildings coming from different perspectives, and it have not been utilised fully and will need to sometimes takes a long time to get people on to be assessed to ensure ventilation systems are the same page. working correctly.

Although I am sure we have all wanted to see more progress being made in terms of how Employee welfare we deal with climate change, I for one am very We also have to assess the impact of hybrid encouraged by the fact that these discussions working which is likely to be a permanent are going to take place again next year and feature of the workplace going forward. That will look at how the targets can be reduced could mean that office spaces have a lower and improved further. It is essential to get these utilisation rate, effectively moving the IAQ targets properly defined and measurable, so problem to another building i.e., the employee’s we hit them, but not miss the point on climate home. We need to recognise this in our change. assumptions about the workplace going forward In parallel with a drive towards the net zero that it is equally important to ensure good IAQ target we know that as the planet starts to at both the office and the home if we are to heat up, this is going to increase the chances properly consider the welfare of our employees. of poor indoor air quality (IAQ) which we will CO2 emissions not only harm our need to address through ventilation, cooling planet, but us too as it impacts and air conditioning. Indoor air quality on our productivity. The will need to be addressed through landscape has shifted Being able to summits such as COP 26 and to one where we measur through our own regulations have a wider the e

CO a build 2 levels in importaing is very know t nt as we h on the is impacts performcognitive a individunce of als

building footprint that is not the obvious bricks and mortar that we had before the pandemic and due consideration needs to be given.

For buildings that we see returning to, hopefully, normal occupancy as we come out of the pandemic, risk assessing existing buildings by a commissioning engineer is crucial to ensure that the existing ventilation operates correctly, but also that it is capable of managing the risks of Covid in buildings where there is likely to be a very high footfall. This should already be part of the procedures that the building operates to, but it is well worth reviewing given the impact of Covid and likely changes in working practices that could impact the building as well.

There is also an opportunity to educate when considering how to improve the IAQ of buildings.

Visitors and employees are likely to see public buildings as an exemplar when it comes to how the building is managed. Reassurance that the air quality is being monitored and managed by the facilities management team gives an opportunity to engage with users in a positive manner to show what we are doing to protect them. Given the high profile of the term ‘net zero’ this can be used to hang many messages off the back of as consumers are seeing the term on a regular basis through the media, particularly as a result of COP 26. Looking at research over the last 18 months, produced by BEIS, awareness has been on the rise. E

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Overheating As part of the impact of climate change, what many public buildings are going to have to deal with going forward is the issue of overheating. This is currently being considered as part of the building regulations review for England.

The Zero Carbon Hub’s working definition of Overheating is: “The phenomenon of a person experiencing excessive or prolonged high temperatures within their home/ building, resulting from internal and/or external heat gains, which leads to adverse effects on their comfort, health or productivity.”

There are a number of factors that can affect overheating: • Location: The climate tends to be hottest in South East England, dense urban neighbourhoods are at higher risk.

• Fabric characteristics: Highly insulated buildings, darkly coloured external walls, sky lights or large areas of unshaded south, east, or west facing glazing.

Linking net zero, IAQ and climate change together gives an opportunity for the education of employees, visitors, and users in terms of how all three pillars fit together and also the plan to go forward • Occupancy/behaviour: In the building all day can be at high risk, temperatures higher in the early afternoon.

• Sun can be a risk.

• Type of property: Top floor of buildings can absorb a lot of heat through the roof and can be more exposed to direct solar radiation.

To mitigate this, ventilation is the main method of removing heat from dwellings in the UK. Providing the outside air is cooler than inside, ventilating a dwelling with fresh air will help to lower the internal temperature. Air movement over the skin also has a perceived cooling effect.

Overheating issues may increase as existing buildings are better insulated to enable them to achieve net zero.

Fabric First I would strongly advocate ‘Fabric First’ for any work being done on a building to reduce the input of energy required. With good planning of the design of the building and services, the effects of overheating can be minimised, but ventilation alone will not eliminate overheating.

Facilities management

 Linking net zero, IAQ and climate change together gives an opportunity for the education of employees, visitors, and users in terms of how all three pillars fit together and also the plan to go forward. Many companies have a sustainability statement so why not have a plan for buildings that is publicly available, particularly when the costs can be shown against the savings both in monetary and well-being measures that can justify the investment.

Being able to measure the CO2 levels in a building is very important as we know this impacts on the cognitive performance of individuals. This is true for schools, offices and public access buildings and assessments need to be made to determine the optimal CO2 management strategy as well as how to deal with other pollutants that should be covered under the risk assessment.

And finally, government has put together a new campaign demonstrating the importance of simple ventilation techniques to reduce the risks of catching Covid-19 this winter. The campaign comes as new research reveals two-thirds (64 per cent) of the public did not know that ventilation was an effective way to reduce the spread of Covid-19 at home. Only around a third of people (29 per cent) are currently ventilating their home when they have visitors. Only three per cent of those surveyed continued to ventilate their homes for a period after their guests left. We can apply this thinking equally to buildings to mitigate the risks. L FURTHER INFORMATION www.feta.co.uk

STORAGE PROBLEMS? We’ve heard it all. Better yet, we’ve solved it all.

Get in touch with our Business Services team today to book your FREE consultation.

WWW.BiGDUG.CO.UK 0800 141 3380 Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Advertisement Feature

Fire Doors in the Health Sector Managing the Risks What ever your needs regarding timber-based or composite construction fire doors and escape doors, Fire Doors Complete Ltd is here to help

Without doubt the single most influential event regarding the building of fire safety in to new and refurbished buildings has been the Grenfell Tower Fire. The effects of that tragedy will be felt for many years and the construction industry will feel them more keenly than most other industries.

Since that event there has been much greater focus on the importance of fire resisting doors and escape doors in both new and existing buildings. Building operators have a legal responsibility to maintain fire doors and escape doors in efficient working order and good repair.

At Fire Doors Complete Ltd, we specialise in helping our clients meet the requirements of the applicable legal requirements, regulations and standards. We can do that for existing buildings, new buildings and for refurbishment works.

There are three key areas where we can help: fire door training for installation and maintenance operatives; fire door surveys and inspection; and fire door consultancy.

Fire door training for installation and maintenance operatives During the course of their life fire doors will require routine maintenance and repairs.

We provide training for installation and maintenance operatives so that they can understand the standards and requirements for the doors at your building to meet compliance requirements. We specialise in fire door installation and fire door maintenance training at your premises anywhere in the UK and at our training centre in Queniborough near Leicester. We can accommodate the needs of your personnel so that they are able to install fire doors and maintain them to prolong the service life of the doors.

Approved training courses Our complete portfolio of fire door training has been approved by FireQual and we are very pleased to have received excellent feedback from NHS estates and facilities managers: Rae Jarvis at NHS Lothian, after training for his maintenance team, said: “The consensus from the group is that the course went really well, everyone came out with a good understanding of what’s required and how we can move on. They thought the course was presented really well and having the textbooks and memory stick was a good way of doing the course.”

Jon Freeman at Doncaster & Bassetlaw said: “I have found the course easy to navigate and very informative as to what can and cannot be carried out when installing fire doors. The learning module with the textbook and video work well, I found the course interesting.“ How can fire door improvements be delivered?

Estates departments are now seeking dedicated training so that they better understand the particular requirements necessary for fire doors over normal doors. Trained operatives having a better understanding of the requirements can then achieve higher compliance levels.

Furthermore, in-house operatives are invested in the fire door works they carry out because they are employed at the building full time whereas an outside contractor will leave the building once their work is complete. So, it’s worth investing in some training for inhouse teams as the pay-back has potential to be several-fold.

In providing training services that can improve standards of installation and maintenance of fire doors we can help to make buildings safer. That matters now and it will matter again in future.

Fire door surveys and inspections Fire doors should be inspected periodically for compliance in existing buildings and it is advisable to inspect new fire doors during and post installation works. We provide these services across many sectors including healthcare, housing, education and commercial and industrial properties.

With regard to existing doors at healthcare buildings it is important to identify the fire doors that are key to the safety of the people that use the buildings, we can help you identify the most critical fire doors and set-up an inspection and

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

maintenance program to meet your obligations and help to keep the fire doors in efficient working order and good repair.

Our inspection reports are easy to understand and will clearly identify which doors are compliant and which are not. We will not bombard you with unnecessary jargon but where doors are found to be non-compliant our reports will be clear about describing the necessary work required in order to make them compliant.

The period of time between inspections should reflect the importance of the particular doors in terms of how critical they are to safety of the people at the building and the type of wear and tear they are subject to. By helping you to plan inspection intervals and by providing clear and concise inspection reports we can help you target resources to where they are needed and help you to avoid unnecessary expense.

Where healthcare providers engage contractors to carry out refurbishments and to install new doors we can help to ensure the works are carried out correctly so that the doors meet compliance requirements and that the contractor delivers in accordance with the specification. Very often, new fire doors are not installed correctly and the building owner or operator is left with unsatisfactory fire doors and has to meet the cost of the necessary remedial works.

Our fire door inspection services will help you to stay legal, to stay safe and avoid unnecessary expense.

Many building owners now engage inspectors to undertake post-works inspections so that contractors may be held accountable and brought back to rectify non-compliances. Building operators are consulting Inspectors to assist with specifications so that compliant installation can be better achieved.

What is a competent fire door inspector?

The ‘Fire Safety Order’ became law in England & Wales in 2006 and the fire and rescue authority ceased to provide fire certificates.

Any certificate previously issued under the Fire Precautions Act 1971 is no longer valid.

This means building owners, occupiers and managers carry legal responsibility for fire safety at their buildings. Once the completed building is handed over the person or entity that controls the building must by law take reasonable precautions to ensure people are adequately protected, in a fire.

So, where fire doors have been incorrectly installed at construction stage it’s the building owner, occupier or manager that is potentially liable where issues come to light. This may be due to a fire at the building or because of a visit from the local fire authorities. Any search of media stories covering prosecutions under fire safety law will reveal that such breaches are severely punished and more common than you might think. Especially where there’s sleeping accommodation such as in the housing, healthcare and leisure sectors.

Our professional fire door inspectors services are in demand to help building owners, occupiers and managers to improve standards. Their inspection reports carefully and comprehensively detail any installation faults, non-compliances and maintenance issues. Inspector’s findings are that the most common faults with fire doors stem from poor quality installation. These faults are often as basic as doors failing to self-close or having ineffective cold-smoke seals. So, the Inspector is the Competent Person under fire safety law that has brought these important issues to light.

Why do professional fire door inspectors findings matter?

Inspectors’ reports show that often installation faults are so basic that fire doors fail to self-close correctly and that the smoke seals, although installed in the door frame or door leaf, would fail to correctly restrict spread of cold smoke.

Where such faults exist, the building would be unsafe in a fire and a threat to life could exist.

Thick black smoke could spread and have a huge effect on safety of people trying to escape. If the fire door fails to self-close its not just the smoke that may spread and cause death or injury, the fire itself would be allowed to spread and may render the escape route unusable. Where stayput or staged evacuation strategies exist people seeking safety would be placed at risk because the spread of thick smoke is allowed to reach socalled places of refuge.

An inspection of newly installed fire doors at a high-rise block of flats revealed that the contractor performed so badly that they had to be brought back for a large program of remedial works. The fire door inspectors report revealed that: door and frame misaligned; door to frame gaps too large; doors failed to self-close because closing-devices were installed incorrectly; door leaves unsuitable to meet the severity of use in common areas; glazing

Fire door consultancy Of course, the best way to achieve compliance is to ensure the fire doors are specified and installed correctly from day one.

Our consultancy service provides you with an efficient way to help ensure that the doors will meet the requirements of the building users and be compliant with the necessary standards and regulations. Not only that but because we have complete understanding and experience of the many different types of door construction available, we can help to ensure the doors will be durable enough to meet the demands of the building users.

Too often, the specification is not sufficiently detailed and unsuitable fire doors are supplied and installed. Again, the end result is often that the building owner or operator is left with unsatisfactory fire doors and has to meet the cost of the necessary remedial works.

We have a complete knowledge of the available fire door related products and our consultancy services will help to ensure new or replacement fire doors are suitable for the type of use to which they will be put.

Advertisement Feature

not securely held in place; and no fire stopping to large gaps behind door frames.

Here problems stemmed from a combination of incorrect specification, incorrect product selection and poor installation. The same issues as highlighted by the Hackitt Review.

Our credentials Of paramount importance to us as a company is that our clients are always satisfied with the service we provide. We always work hard to do our best for our clients and help them to avoid the pitfalls of non-compliance with legal requirements, regulations and standards.

We are able to do that every time for every client because we have many, many years of experience and because we possess the necessary qualifications.

All inspectors are individually certificated and as a company we are certificated to a UKAS accredited third party certification scheme for fire door inspections and with regard to our training services we are approved by FireQual for our fire door training portfolio.

Whatever your needs regarding timber-based or composite construction fire doors and escape doors, we are here to help. Contact us today to discuss your requirements and find out how we can help. L FURTHER INFORMATION Tel: 07970 201231 neil@firedoorscomplete.com www.firedoorscomplete.com

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Fire safety

Building a fire safety culture in health facilities We revisit an article from Dr David Gold and Neil Vincer, from IOSH, in which they discuss how organisations can ensure that a sustainable workplace fire safety culture is incorporated to all staff in a hospital setting Health care workers play a vital role in The American Bureau of Shipping today’s society, especially considering the (ABS) proposes eight categories of ageing populations in many countries that leading indicators of a safety culture. need or will need care either in health care The following are leading indicators, facilities or at home. All members of the adapted from the ABS publication, health care profession should continually that fall under the eight categories: work in a safe and healthy environment carrying out practices that do not put Communication about fire safety them at risk of injury or ill health.

The organisation: develops A previous article in this journal means of communication A safet examined several of the risks including the provision y culture health care professionals of information sheets, when w exists face and described newsletters, and measure to eliminate or toolbox talks, in only co orkers not n mitigate those risks. local languages t i n u ally loo out for Occupational safety regarding incidents k safety a their persona and health promotes and lessons l n d the concept of a learned about fire h e alt also loo safety culture. A safety safety; includes k out foh, but safety a r culture exists when adequate fire nd hea the workers throughout an safety information l t h of othe organisation not only as part of new rs continually look out for their employee induction personal safety and health, but providing; and shares also look out for the safety and with employees, contractors health of others including their co-workers. and visitors policies, goals, directives The concept of a safety culture embraces and standards addressing fire safety. positive values, including attitudes and knowledge. Professionals working in the Empowerment health care field, by the nature of their The organisation: involves all workers and profession and their duty of care, extend contractors in fire safety; and develops the safety culture to protect their patients, and promotes for all workers means some of whom cannot look after themselves, to bring fire safety to their home. especially during an emergency situation.

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

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

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

Promotion of safety The organisation: has fire safety-related safety goals and objectives; has a

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procedure making all fire-related incident investigation findings available to workers; and requires senior management attend meetings related to fire safety.

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

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

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

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

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

An essential element of fire risk assessment, if properly done by an appropriately trained competent person identifies, assesses and proposes control measures to either eliminate or control the risk and follows up where and when these elements, in combination, may increase the risk of fire. For example, bedding is common in a health care environment, and is a source of fuel. Oxygen is ever present, and may be more concentrated around some patients, but the risk of fire is minimal if there are no sources of heat. Therefore bedding, either laundered or soiled, should always be stored away from sources of heat.

In health care facilities areas, such as laundries, laboratories, pharmacies, heating plants and waste disposal areas may have elevated fire risks as the potential for the combination of fuel and heath may be elevated. Even health care facilities that

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

Evacuation It is essential that there are designated emergency escape routes from all areas of the facility to a place of safety. These routes need to be clearly marked, continually unobstructed, well lit, and unlocked. In consultation with the local fire service, the emergency action plan may call for a phased evacuation, not evacuating all patients and staff at once. In some facilities there are designated areas of refuge (with specific engineering criteria) where evacuees wait for assistance from the emergency services.

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

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

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

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

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

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

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

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

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

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

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

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

Strong consideration should also be given to who is carrying out the risk assessment for the facility. Criteria for the competencies of fire risk assessors can be found in the following document.

The emergency action plan An Emergency Action Plan must contain the following elements: a description of types

Fire safety

may be designated smoke free campuses may be at risk from ignition from open flames such as cigarette lighters, matches or discarded cigarettes due to a perceived urgent need to smoke by staff, patients, visitors or contractors who will try to find an area where they can smoke unobserved.

of emergencies that could occur to the facility; means of reporting fires and other emergencies; levels of emergencies and criteria for escalation; evacuation procedures and emergency escape route assignments; procedures for staff who remain in order to assist patients and others or shut down critical functions before they evacuate; procedures for accounting for all patients, employees and visitors after an emergency evacuation has been completed; rescue and medical duties for employees performing them; names or job titles of persons who can be contacted; agreements with emergency services; agreements with other facilities to accept evacuated patients; and timing for the regular review of the emergency action plan.

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

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

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

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

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Advertisement Feature

Energy crisis could send NHS bill soaring past £1 billion Research conducted by Zenergi’s Energy Management division in 2019 estimated the energy costs of the UK’s NHS Trusts to be around £500m Energy efficiency in action Heating decentralisation cuts carbon emissions by more than 30%.

Taking hospitals in England into consideration alone, that figure is now estimated to have more than doubled when today’s sky-high energy prices are applied to the last set of figures published by NHS Digital.

The NHS Estates Return Information Collection (ERIC) 2020/21 reveals the true extent of hospital operating costs, with energy accounting for a large percentage of the overall spend.

In the period from 1 April 2020 to 31 March 2021, over £630 million was spent on gas and electricity. Since the end of March 2021, wholesale gas prices have more than doubled (240%) and electricity has gone up by an equally staggering 184%.

Those soaring energy costs will only add to the pressure the NHS is under in the current COVID-19 pandemic but, unfortunately, there is still no end in sight to the rising prices.

Assuming energy consumption has remained consistent since April, based on today’s prices overall energy costs could rocket to £1.2 billion when the next ERIC report is published.

Since many hospitals are based on different sites, there may be multiple energy supplier contracts involved with different start and end dates, making the task of keeping track of energy costs problematic as a result.

Compounding the issue, the NHS estate is made up of a mix of state-of-the-art modern facilities and Victorian hospitals that are no longer fit for purpose. When these old buildings were originally constructed, energy efficiency was not a major consideration. The legacy of antiquated buildings and infrastructure is significantly impacting energy efficiency, limiting opportunities for energy saving.

Despite this, the challenges can be overcome, the key is developing a plan that works for each individual organisation.

For many facilities, development of comprehensive Green Plans that incorporate emissions from buildings (fossil fuels, electricity) and transport, as well as capturing other environmental impacts, including waste, procurement, medical gases, patient and staff travel and biodiversity, is going to be critical to keeping on track with the NHS’s ambitious 2040 Net Zero targets.

But where do you start to transform your estate?

An energy audit will identify where buildings are using the most energy and identify low-cost and no-cost energy saving measures that can be incorporated into a strategic roadmap.

Quick win opportunities that can offer significant returns on investment can include upgrading to LED lighting; and work on building management systems for heating, ventilation and air conditioning systems.

But maximising opportunities to fund energy and carbon saving initiatives through funding streams, such as the Public Sector Decarbonisation Scheme, will accelerate progress. Facilities will need to ensure their Green Plans include comprehensive Heat Decarbonisation Plans to enable them to act quickly when funding is released.

Developing the Green Plan The NHS’s Greener NHS National Programme identified that climate change will disrupt care, with poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer unless urgent action to reduce carbon emissions is taken.

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

A technical feasibility study and financial appraisal assessed the practical options and energy saving potential from decentralising the outdated steam boilerplant, distribution and condense return systems at Brighton General Hospital.

The programme involved replacing a large, inefficient central steam boiler plant and distribution systems with high efficiency independent local condensing boilers, and a fully automated building management control system to provide centralised heating control across the site. The domestic hot water calorifier systems were also replaced by a mix of high efficiency plate heat exchangers and point of use water heaters, significantly reducing secondary circulation losses.

The project delivered: Annual cost savings of approximately £130,000. Annual CO2 savings of approximately 1,000tCO2e.

Award-winning purpose-built medical facility minimises long-term carbon emissions and operational costs.

Developed for the NHS in Leicester, Victoria Park Medical Centre is a purpose-built medical facility that provides a diverse range of specialist accommodation for staff and patients. Development included many low carbon technologies, including low energy lighting, air source heat pumps serving low energy underfloor heating, natural ventilation, advanced BMS controls and a sedum roof.

The development successfully combines modern high quality, flexible specialist medical facilities including treatment rooms, consulting rooms, clean/dirty utility rooms, pharmacy, canteen and shower facilities, with high-tech building services design that minimises longterm carbon emissions and operational costs.

The project achieved a BREEAM Excellent rating through the integration of many costeffective, practical low carbon technologies.

The result is a flexible building that has minimised long-term energy consumption and carbon emissions, while ensuring low running costs throughout its lifetime. L FURTHER INFORMATION www.zenergi.co.uk

Estates management

The importance of a fit-for-purpose health estate now and in the future Martin Steele, CEO of NHS Property Services, explains the lessons learnt that will help NHSPS improve the health estate and ensure it continues to be fit for patients now and into the future As 2022 begins, it is important not only to look to the future, but also to reflect on the past year. Last year brought with it many challenges, including for the health service.

The continued demands of the Covid-19 pandemic combined with the ever-increasing patient backlog put immense pressure on the NHS. For our team at NHS Property Services (NHSPS), this meant drastically changing our ways of working and the way space is used in our buildings across the health estate. From adapting our spaces to support the vaccine rollout, to exploring how community-based health and well-being initiatives can be delivered locally, we have learnt lessons that will help us to improve our health estate and ensure it continues to be fit for patients now and into the future.

Optimising the NHS estate Essential to the running of the health service are our 5,000 strong team of non-clinical frontline workers, who played a key role in the NHS’ Covid-19 response. Over the course of the year, they carried out over 7,000 Covid-19 deep cleans in hospitals, health centres, GP surgeries and clinics across the country to stop the spread of infection and protect patients and NHS colleagues, in addition to delivering their normal cleaning

For example, at a community hospital in services. Throughout the pandemic, I have Devon, we were charged with identifying seen first-hand the important role our and opening additional space to support the estates professionals play, alongside our NHS vaccination roll-out in under two weeks. This colleagues, to ensure patients receive the meant rapidly assembling our project team as best possible care. well as a network of external contractors By collaborating with partners more to repurpose former ward space broadly across the NHS, we for use as a vaccination clinic have also ensured that our for three local GP surgeries. existing assets have been Wit Working with the local adapted in a way that shift to h the in primary care network, best utilises the available t e grated care, en the NHSE Primary Care space. Our expertise in s u r in g patien can eas Estates team and property and facilities ts ily clinical commissioning management allowed services access health group, our Covid-19 us to create additional in their commu local reaction taskforce and clinical capacity, n ity is mo facilities management increase testing importa r team installed LED nt than e capability and promote lighting upgrades, replaced better infection control in ever carpets with vinyl flooring the sites that we own and in clinical areas, completed manage. This could not have multiple deep cleans, and even been done without collaboration put up a marquee to shelter patients between all those involved in the awaiting vaccination. regional estate delivery system. Our skills It is vital that urgent demands for space such have enabled us to support local systems, as these are met swiftly. By having a sound who are relying on us to understand the data knowledge of our buildings and collaborating available from our sites, the demand on our with the NHS, local health systems and the estate, its availability for use and NHSE Primary Care Estates team to share the resources and capabilities we have as knowledge and pool skills, we can continue to an organisation, so they can best serve their make the most effective use of space. E communities.

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Estates management

 The importance of localised healthcare With the shift to integrated care, ensuring patients can easily access health services in their local community is more important than ever. These are considerations that hospital managers, and property developers alike should keep front of mind and is something that we at NHSPS have been investing in.

So far, we have overseen a 20 per cent increase in capital investment, which has resulted in improvements to NHS sites such as GP surgeries and hospitals across England.

For example, this included the development of a community hub at Guisborough Primary Care Hospital, which now provides muchneeded services to the local population. The project completely refurbished and upgraded the space to deliver a modern and fit-forpurpose community health centre and has resulted in savings of £9.6 million for the NHS, since existing space was adapted to meet patient demand instead of a new site being developed.

Our Healthy Places programme – now in its second year – aims to do just that.

The projects under this scheme range from refurbishments and new builds, to accommodating social prescribing initiatives.

Delivering more than 100 projects already, it is helping to solve local healthcare needs and improve outcomes for patients and clinicians alike. At Rotherham Health Centre, for example, we completed a large-scale refurbishment, transforming vacant space into 26 new consultation and treatment

Whether reconfiguring, optimising or building new spaces, we are helping to futureproof the health estate for the benefit of patients and the NHS rooms for an ophthalmology service. The new rooms mean that the ophthalmology service could move out of an acute hospital setting and be closer to the community it serves.

Moving forward, as the grip of the pandemic eases, patient needs will inevitably change. At NHSPS, we are ready to help the health service adapt to this, optimising our estate to meet future requirements in

a sustainable and efficient way. Whether reconfiguring, optimising or building new spaces, we are helping to futureproof the health estate for the benefit of patients and the NHS. L FURTHER INFORMATION www.property.nhs.uk

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preOx.RS GmbH

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Medical equipment

MedTech leaders and the shift from hospital to home James Feindt, Marck Aghnatios and Alistair Fleming look at the benefits and opportunities of migrating care from hospital to the home environment, as well as the Medtech challenges it creates Traditional healthcare is increasingly taking place in patients’ homes, as it offers the potential to reduce costs, deliver more flexible care, and provide better access for patients.

Pre-pandemic, significant indicators like the length of stay and inpatient visits per capita had been declining, while the number of outpatient visits were rising. Better treatment options have diminished the volume of invasive procedures and consequently the length of recovery time. Medical technology innovations have paved the way to continue this shift post-pandemic through connected devices which allow patients to be treated and monitored outside a hospital setting.

This shift in the point of care brings about complex challenges, including adapting solutions to a home setting, the absence of inperson clinical support, and increased reliance on the patient as a user and increasingly as a direct consumer. MedTech companies that can navigate these changes have an opportunity to be at the forefront of an emerging health care industry.

pandemic has accelerated care into virtual and hybrid models. Remote care involves different health professionals and new ways of interacting, with more choice for patients who can now interact directly with product providers. Patient engagement and market access models are likely to continue to change as medical device companies develop new technologies that enable quality care to be delivered in a home setting.

For device developers, the opportunity exists for their products or services to be sold directly to the patient rather than providers.

Patients are becoming increasingly savvy and educated on their care options, and a shift to patient-centric care is placing patient needs and wishes centre stage. MedTech will need to radically rethink existing business models to find ways to engage directly. This may involve approaches such as partnering with community clinics, providing leasing models, enriching solution provision with interaction and advice, and building more disease-centric offerings that entrain and retain loyalty.

Rethink engagement to deliver The opportunity is for radical, not directly to the new buyers incremental change The hospital setting offers Covid-19 was a catalyst for advantages for patients a marked step forward in For dev including continuous remote health provision. develop ice monitoring and immediate It has been stated that opportu ers, the access to health telehealth uptake has nity ex professionals, but the been accelerated by fo

around three-five years due to the pandemic.

Before this, solutions were emerging around connected devices and digital support tools.

Many of these represent small but significant steps, while some sit at the more disruptive end of the scale such as the implementation of data aggregation to predict hypoglycaemic events with Medtronic’s IBM collaboration project SugarIQ. There are signs of dramatic shifts in the capabilities of communications, power and processing technologies that open a realm of new possibilities. Wider trends are also evident – a future home healthcare landscape may be hyperconnected, prevention-focused, precision targeted and holistically informed.

We have also witnessed the pace of innovation increase significantly in the past 18 months.

As we look to the future, we believe that the opportunity exists for more fundamental change. By utilising future-sight strategic tools such as business wargaming or scenario planning, MedTech companies can place themselves in worlds five or ten years into the future, and explore how evolving technologies, markets and attitudes could shape their ability to meet the needs of tomorrow. E

ists r their p r o d ucts or ser sold dirvices to be patient ectly to the rath provideer than rs

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Combating Healthcare-associated Infections (HAI) Healthcare-associated infections are often linked to environmental reservoirs like colonized sink traps.

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Medical equipment

 Value-based care and data sharing opportunities are promoting greater collaboration The emphasis from governments and Insurers on optimising care provision through outcomes-based reimbursement is driving strategies focused on disease and patient rather than symptom and product.

This mindset promotes preventive solutions, increased diagnostics and monitoring and better connectivity. In the context of transitioning point of care, MedTech can help to bridge the physical gaps between care settings by seeking deeper patient engagement across the care-pathway.

This might be achieved through the expansion of complementary services, acquisitions or partnerships to gain access to a more comprehensive coverage of disease stages. Improved visibility and influence over the patient journey should lead to better decisions, more effectively targeted interventions and more efficient allocation of resource.

It is equally important to consider the impact of vertical integration. We have seen an explosion in patient data generation in recent years, but our healthcare systems and regulations are still evolving to accommodate best use of the opportunities this offers. Such limitations are emphasised as care provision becomes more physically spread. Whereas historically, one provider may have been the originator and custodian of requisite patient data, in today’s world, this could be spread between primary and secondary care, local clinic, home care providers, patients and consumer health companies.

For MedTech companies, it can be a bewildering landscape to navigate. Data regulation is far from harmonised, and while there is a growing sector offering data translation between the electronic medical records and hospital information systems providers, challenges remain albeit with success stories. Once again, the pandemic has

Covid-19 was a catalyst for a marked step forward in remote health provision. It has been stated that telehealth uptake has been accelerated by around three-five years due to the pandemic shown how a common purpose can unlock powerful collaborative networks such as the COVID-19 Clinical Research Coalition.

Looking forward Technological innovation has opened a path forward to evolve our healthcare system and make significant improvements to patient care by transitioning from hospital to home.

This transition will be increasingly complex as more care moves to a patient’s home, but it will also be the solution to improve healthcare coverage with increasing demand. The pandemic has forced regulatory, medical device, healthcare and pharma into action and these industries stand to

benefit if they can meet the call to offer value in the new model for care. L

Jointly authored by James Feindt, healthcare expert, and Marck Aghnatios and Alistair Fleming, MedTech experts at PA Consulting FURTHER INFORMATION www.paconsulting.com/ industries/healthcare/

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Lonscher Waagen GmbH Your partner for medical weighing technology

We have been weighing people, objects and food on scales from Germany and Europe since 1965. Our partners are, for example, the company Soehnle Professional which today belongs to the internationally operating RIVA Holding. Our company works with the Soehnle Professional brand with one of the leading manufacturers in the fields of professionally used measuring and weighing technology in medicine. The products developed, manufactured and quality-tested in Germany are used worldwide - for example in hospitals, retirement homes, old people's homes and residential groups; wherever precise measurement results are required.

Chair scales

Of course, we also offer our medical personal scales in a conformity-assessed version.

Stand scales Our chair scales optimally meet these factors with the foldable armrests and footrests, the ergonomically shaped seat and the hold and taring function.

Wheelchair scales Our multifunctional scales are true all-rounders and designed for a wide variety of applications.

Whether used as obesity or wheelchair scales with a high level of accuracy and reliability, user-friendliness and easy reading of the weight value determined, they meet the most important factors for weighing people in hospitals, retirement homes or nursing homes.

Weighing people in wheelchairs in particular is often a major challenge. With two integrated ramps, our multifunctional wheelchair scales offer an optimal solution for this. The scales can easily be driven on with the wheelchair and the weight of the wheelchair can be deducted using the taring function.

Due to the generously dimensioned platform, the multifunctional scale is also ideally suited as an obesity scale. This can also be supplemented with suitable railings for a secure hold.

In addition to the calibration according to Calibration class III and approval according to MPG are high accuracy, reliability and User-friendliness and easy reading the most important factors for weighing in Doctors' offices, hospitals and medical facilities.

These tripod scales offer an extra-large step surface, a brightly shining display and a surface that is easy to clean. When stepping on the scales, the display is activated automatically and the weight is shown with digits backlit in red.

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Medical equipment

Pioneering innovations to support the delivery of a Net Zero NHS Delivering a Net Zero NHS is a key ambition to tackle within the healthcare system.

SBRI Healthcare has awarded £1 million to pioneering innovations to support the delivery of a net zero NHS SBRI Healthcare has awarded a total of in the world to make such a commitment. £1 million to ten pioneering MedTech and Innovations across all NHS operations will Digital innovations to support the delivery play a critical role in helping to achieve of a Net Zero NHS. The new projects are this goal, whilst maintaining and improving funded through a nationwide call by SBRI standards of care.

Healthcare, in partnership with the Greener Competition 18 ‘Delivering a Net Zero NHS Programme, and which attracted NHS’ was launched as a development 46 applications from a range funding competition to help of organisations, including respond to this challenge.

The small businesses, Specifically, innovations newly f technology start-ups were called to address the and NHS trusts. following challenges: projects unded a Climate change has reducing emissions from i m bring b to been identified as a care miles; reducing e n e fits to patient major, and growing, emissions from surgical threat to global pathways; reducing service s and care users, w health, impacting on nitrous oxide emissions; reducin hilst both the provision and tools to support lowg c a r b o of services and the carbon decision making. n emissio resilience of healthcare The competition asked ns systems. In the UK, air for innovations which could pollution accounts for 1 in demonstrate their impact on 20 deaths with harmful emissions carbon emissions whilst considering causing increased cases of asthma, cancer the systematic complexity, supply chain and heart disease. In October 2020 the and product lifecycles involved in their Greener NHS Programme set the target implementation. These solutions also needed of achieving net zero carbon emissions to demonstrate how they will maintain and by 2040, in response to this reality, improve the overall delivery of healthcare making the NHS the first health service and health outcomes within the NHS.

The newly funded projects aim to bring benefits to patients and care service users, whilst reducing carbon emissions.

Innovations include: tools to engage with patients and clinicians, supporting clinical decision making; managing the delivery or capture of anaesthetic gases in clinical environments; providing digital solutions and telehealth, supporting patients at home and improving clinical pathways; reducing care miles through the use of drones; considering the circular economy for surgical textiles.

The projects will run up to six months, with the aim to demonstrate whether innovations are technically feasible and have an impact on carbon reductions.

Innovations that can prove their impact and potential will be available to seek further funding for prototype development and evaluation. The long-term aim is for successful technologies to be adopted for use in the NHS where they can provide benefits for patients, the NHS and the overall community, whilst enabling the NHS to reach its Net Zero ambition.

Dr Glenn Wells, former Director of Strategy & Planning at UKRI Medical Research Council, now Chief Partnerships Officer E Issue 22.1 | HEALTH BUSINESS MAGAZINE

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SAVING LIVES THROUGH RELIABLE AND INNOVATIVE TECHNOLOGY

Safe, Reliable, and Efficient Medical Cold Chain Solutions

DIN 58345

DIN 58375

ÖNORM K 2040

ADR RID IMDG (2008/68/CE) (2002/84/CE)

ICAO-TI IATA-DGR

Reliable storage and transport solutions for safe vaccinations around the world

L ICA DE

E VIC

DIN 13221

State-of-the-art storage, cooling, & transport solutions for blood and blood components

VACCINE COLD CHAIN

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Medical grade storage & transport solutions for your pharmaceuticals and biomedical samples

BLOOD MANAGEMENT SOLUTIONS

MED

MEDICAL REFRIGERATION

(E

U ) C e r t i f i ed 7 2 017 /

B Medical Systems is a global manufacturer of medical grade refrigeration and transport solutions with over 40 years of experience. www.bmedicalsystems.com B Medical Systems S.à r.l. | 17, op der Hei, L - 9809 Hosingen, Luxembourg | Tel.: (+352) 92 07 31-1 | Fax: (+352) 92 07 31-300 | info@bmedicalsystems.com

Winning projects

Elegant Design and Solutions Ltd – Envirolieve® – awarded £99,703.

Anaesthetic gases alone are responsible for over two per cent of all NHS emissions.

Entonox, more commonly known as gas and air, is a cheap, highly effective painkiller used by 80 per cent of women in labour and millions of patients worldwide but is 300 times more environmentally damaging than carbon-dioxide.

Envirolieve® is a portable, breathing system, which significantly reduces Entonox consumption at the point of use, reducing risks to the environment and healthcare staff.

Rutherford Research Ltd – Revolution-ZERO – awarded £ 99,689.

Revolution-ZERO will develop highly effective and sustainable solutions to replace the disposable PPE, drapes and

other textiles that are currently used during the approximately 11,500,000 surgical procedures across the UK. Revolution-Zero will provide specialist re-usable textiles, manufactured and processed to target zero waste and zero carbon emissions.

Green Rewards Limited – Jump – awarded £99,076.

The Jump project is a green rewards scheme, using engaging interfaces, to motivate staff to make low carbon decisions both lifestyle and work-related.

patient care flow charts, in line with national guidelines and local needs for musculoskeletal problems. This supports rapid and optimal decisions that are essential to reduce unnecessary follow-up and investigations, reduce re-presentations to primary and secondary care, reduce length of stay in emergency departments, and improve patient outcomes.

Open Medical – ‘Pathpoint SurgiCare’ – awarded £99,556.

Primum Digital Limited – CrossCover – awarded £99,546.

SurgiCare features a set of patient communication tools with the ability to share information pre and post op, thus reducing the need for the patient to come into the hospital, as a lot of the assessments can be done remotely, whether it’s the digital POA, digital consent or anaesthetic prep. This will contribute to cutting the carbon emissions from travel in the NHS, which account for the 10th of all NHS carbon output. Further, the software will calculate the carbon measurements of treatment, showing users the environmental impact of their treatment choices, and offering less harmful alternatives.

CrossCover OrthoPathway enables patientfacing clinical staff to build fully interactive

YewMaker – MCF Classifier – awarded £83,370.E

Jump is already in working with eleven NHS trusts to encourage individuals to make sustainable lifestyle choices. To date, the platform has recorded 223,190 sustainable actions and saved 410,362 KG of CO2e (carbon dioxide equivalent), which is approximately equal to 2,372 operations.

This project will extend the current platform to include work-related decisionmaking specific for health care.

Medical equipment

 at the MHRA and chair of the SBRI Panel, said: “Delivering a Net Zero NHS is a key ambition to tackle within the Healthcare system and it was great to see so many diverse innovations applying to the SBRI Healthcare programme to make an impact on the carbon emissions and align themselves to the NHS ambitions and more generally, commit to sustainable changes.

“We’ve seen some innovative digital tools that will ultimately drive reduction in care miles or that can be used as educational materials to enable greener decision making. We look forward to seeing how the SBRI Healthcare funding can support the Net Zero targets and enable the development and assessment of promising solutions.”

The new projects are funded through a nationwide call by SBRI Healthcare, in partnership with the Greener NHS Programme, and which attracted 46 applications from a range of organisations

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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Apian Limited – Project Angel – awarded £99,967.

Project Angel will use on-demand, fullyelectric drones to deliver greener, faster and smarter healthcare to patients in the Northumbria Healthcare NHS Foundation Trust. The project is anticipated to influence the supply chain, including new models of collaboration, predictive delivery and carbon footprint reduction.

TCC-CASEMIX Limited – PredictOR Carbon Analytics – awarded £97,364.

PredictOR Carbon Analytics will create a Carbon Registry to provide clinicians, patients, procurement teams and surgical services managers with access to actionable

The competition asked for innovations which could demonstrate their impact on carbon emissions whilst considering the systematic complexity, supply chain and product lifecycles involved in their implementation information on the carbon, energy and waste impact of surgical pathways.

Clinicians and patients will be empowered to make informed, shared decisions on treatment options, with a clear view of the carbon impact of each alternative. This is achieved by overcoming issues with current datasets which have not been collected in consistent, standardised and systematic ways.

Ufonia – Dora – awarded £98,796.

Dora is an autonomous clinical assistant that can telephone patients as an alternative to hospital visits, where clinically appropriate. This sustainably increases the capacity of clinical services and frees clinicians so patients can be treated sooner. In this project, Dora will be

Medical equipment

 Medicines account for 25 per cent of all NHS emissions. YewMaker will create MCF Classifier – a user-friendly tool that provides information on the carbon footprint of medicines to support lowcarbon decision-making in medicines procurement and prescription. The tool will adapt ‘green by design’ metrics (validated by the pharmaceutical sector) integrated with a practical, decision-making framework. It is hoped the solution will drive transparency and yield opportunities to incentivise greener production and empower carbon-informed medicine choices.

used to call people referred to Head & Neck cancer services, one of the highest demand pathways in the NHS.

Concentric Health – awarded £99,175.

A novel exploration and implementation of using carbon data to support patientclinician conversations.

Concentric is a digital consent application, supporting patients and clinicians to make informed and shared decisions about care. This project explores the feasibility of introducing carbon impact into shared decision-making conversations between patient and clinician. L FURTHER INFORMATION www.sbrihealthcare.co.uk

Safe and precise liquid handling /// PETTE fix and vario

BUY 1 PIPETTE & GET 2 FREE with promo code 3FOR1 on www.ika.com

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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IPS-CATH

preOx

RS

technology

for health

Your supplier has discontinued its range of double lumen Thoracic Trocar Catheters? Don‘t worry, we got you covered! preOx IPS-CATH • double lumen 26CH Thoracic catheter without trocar • 2 mm flushing channel • Luer Lock injection valve • 50 cm long • used for pleural lavage e.g after thoracic surgerery.

preOx.RS GmbH Obertiefenbacher Straße 16 D-65614 Beselich

Tel. +49 (0) 6431-21579-0 Fax +49 (0) 6431-21579-10 E-Mail sales@preox.de www.preox.de

Panel of Experts

EXPERT PANEL MEDICAL EQUIPMENT Health Business talks to Benedict Wallner about Medical Device Regulation, the requirements when developing new products and the preOx.RS GmbH range

Benedict Wallner, preOx.RS GmbH preOx.RS GmbH has said that, since the new Medical Device Regulation, now is the time for small medical device manufacturers to come to the forefront of the European market.

Can you explain what you mean by this?

advantage is the image small companies will get because they will be recognised as a problem saver for patients needs.

Many of the big medical device manufacturers cancel products because of small volume compared to regulatory effort. Due to MDR these companies review all product lines and take the opportunity and excuse to streamline their product range and only high margin products with interesting volume will remain.

Small companies who do not need such big volumes could take those products and bring them to market. These products are often niche products but they will add enough value to small companies. The second

MDR is requesting to assess patient benefit, commercial benefit and novelty of new products. If you do not comply with those requirements it will be difficult to pass a conformity assessment with a notified body.

Important is the balance between patient comfort and usability to create a high level of acceptance. Otherwise there is no benefit to buy and use our product and small companies will get no attention on the market.

How important is it to balance patient comfort and usability when developing new, innovative products?

What preOx.RS GmbH products are currently being used in the UK?

A special syringe for the ‘loss of resistance technique’ in epidural anaesthesia is used in UK, supplied in treatment kits of Pajunk Medical and Teleflex Medical. L FURTHER INFORMATION en.preox.de

Benedict Wallner Benedict Wallner has studied in both medicine and medical technology and worked for various medical device companies since 1987.

In 1998 he co-founded preOx.RS GmbH and has been general manager since 2015. He is involved in the development of all preOx products.

Issue 22.1 | HEALTH BUSINESS MAGAZINE

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INFORMATION TECHNOLOGY

4C Strategies – Independent ICT Consultants 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

DESIGN & BUILD

Yewdale launches new anti-ligature curtain track

Leading shading and privacy manufacturer Yewdale has introduced the new K2500 safety curtain track to its YewdaleKestrel® anti-ligature range to help keep staff and service users safe from harm in high-risk mental health settings.

Designed with safety in mind, the new track fits flush to the wall eliminating the risk of its use as a weapon. Unlike similar tracks, the curtains are attached to the anti-ligature gliders so when put under an excess load of 20kg or more the curtains will fall away from the gliders leaving them surely in place on the track. The curtain is then easy for staff to re-install to the gliders.

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Wipe clean and simple to install the track requires no maintenance apart from regular damage inspection. The K2500 is ideal for high-risk mental health settings, care homes, and detention centres where there is a risk of violence.

Yewdale has extensive experience and expertise in manufacturing fail-safe antiligature products including blinds, curtain tracks, shower tracks, en-suite safedoors and room/ en-suite accessories such as towel rails, shelves, coats hook etc.

For more information on this new reduced-ligature track or to receive a demonstration, contact Grant below. L FURTHER INFORMATION Tel: 01268 570900 enquiries@yewdale.co.uk www.yewdale.co.uk

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

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Awesome Technology

14

Axicom UK

24

B Medical Systems Sarl

62

Big Dug

47

CCube Solutions Cyberprism Fairford Medical Fellowes Fire Doors Complete

22,23 36 IBC 10 48-49

Focus Games

26

Fordingbridge

55

Honeywell Commercial

IFC

IKA-Werke GmbH & Co

65

ISS Mediclean

6

Legrand Electric

16

Lonscher Waagen GmbH

60

MoveoMed GmbH

58

Murray Equipment Co

46

Nene Cyber Security

54

Pentesec

34

Philips Monitors MMD

12

Pivotal Solutions

29

preOx.RS GmbH

OBC,56,66

QIAGEN GmbH Radar Healthcare Randstad Solutions

64 20,23 8

Revbits

38,39

Saville Group

30-31

Schneider Electric

28

Segmentation Group

43

Sep 2

42

Swedish Posture

64

Templar Executives

40

Twice2much

18

WCS Group

44

Zenergi

52

Yewdale Corporation

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

4,68

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IAP-Adatper-Set

preOx

RS

technology

for health

New treatment kit for measurement of Intra Abdominal Pressure (IAP) during Abdominal Compartment Syndrome (ACS).

• • • •

easy & quick handling effective measurement reliable & replicable results Step by steps video instruction Product page

IAP-Adapter-Set includes IAP-Adapter, 3-way valve, double check valve, syringe, spike and tubes. preOx.RS GmbH Obertiefenbacher Straße 16 D-65614 Beselich

Tel. +49 (0) 6431-21579-0 Fax +49 (0) 6431-21579-10 E-Mail sales@preox.de www.preox.de