Health Business 24.3

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TECHNOLOGY ENERGY FRAMEWORKS | RECRUITMENT Why the iconic blue and white is so effective THE NHS BRAND SIGNAGE ISSUE 24.3 Together we go further Drive real progress in your patient’s care, reduce financial losses, and enhance your operational e ciency by leveraging data-driven insights, innovative technology and personalised strategies.

Health and Care Worker visa

The healthcare requirements in the UK are becoming increasingly complex each year, necessitating the recruitment of additional healthcare professionals to ensure smooth operations in specific areas of the healthcare system.

If you are a qualified doctor, nurse, health professional, or adult social care professional, you may meet the eligibility criteria to apply for the Health and Care Worker Visa.


Holmes & Partners provides a full end-to-end visa application service to companies, educational institutions and individuals. We are based in Leeds, UK and is here to support applicants with the increasingly complex visa application process.

What we offer

Fixed price fee

Full end-to-end visa application assistance and advice

Contact you directly with clear instructions through every step of the visa application process

Check all documents to ensure UKVI documentary compliance

Complete the visa application on your behalf

Confirm successful visa outcome

Act on your behalf with UKVI decision makers

Answer any follow up questions

+44113 524 6995 or +44772 667 1774 PHONE EMAIL
Contents Health Business 24.3 Contents Health Business magazine ENERGY VENTILATION TECHNOLOGY FRAMEWORK FRAMEWORK FLOORING 13 17 21 27 33 37 46 HR SIGNAGE 56 51 TECHNOLOGY 42 RECRUITMENT 5 Issue 24.3 | HEALTH BUSINESS MAGAZINE

Cyber attack impacts London hospitals

A cyber attack hit major hospitals in London, leading to operations being cancelled and emergency patients being diverted elsewhere.

The incident affected hospitals partnered with Synnovis - an IT provider of pathology services.

King’s College Hospital, Guy’s and St Thomas’ and primary care services were among those affected.

The incident had a major impact on the delivery of services, especially blood transfusions and test results. Transplant operations were also cancelled.

Some procedures were cancelled or redirected to other NHS providers as the hospitals tried to establish what work can be carried out safely.

Synnovis serves patients across six London boroughs, supplying services including swabs and blood tests.

Scotland’s Health and Care Experience Survey results published

Scotland’s chief statistician has released the main findings of the 2023/24 Health and Care Experience survey.

The Scottish Health and Care Experience Survey is a postal survey, which was sent to a random sample of people who were registered with a General Practice in Scotland, lived in Scotland, and were aged 17 and over on 25 September 2023. The survey received 107,000 responses. The survey has been run every two years since 2009.

The results show that 69 per cent of people rated their overall experience of their General Practice as good or excellent. This marks a slight increase since the last survey in 2021/22 (67 per cent), but it is lower than the survey prior to that in 2019/20 (79 per cent).

84 per cent of people who needed to see or speak to a doctor/nurse quite urgently were seen within two working days. This is slightly lower than in 2021/22 (85 per cent) and in 2019/20 (86 per cent).

73 per cent of people rated their overall experience of Out of Hours healthcare as good or excellent. This is higher than in 2021/22 (67 per cent), but it is lower than in 2019/20 (79 per cent).


Enabling healthier communities


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Plans to make medicines dispensing more efficient

The government has announced changes to medicine dispensaries in an effort to make the process of getting medication easier for patients.

Currently, larger pharmacy chains can take advantage of the efficiencies and cost-savings that come with centralising the dispensing of medicines at a larger ‘hub’.

But smaller independent pharmacies are unable to operate the same model due to legal restrictions on dispensing for pharmacies under different ownership, meaning they can face additional costs and workload.

The changes will move closer to making the ‘hub and spoke’ model universally available, allowing pharmacies belonging to different legal entities to use hubs belonging to other companies.

They said this will enable pharmacists to dispense medicines more efficiently and spend more time dealing face to face with patients.

Primary care minister, Andrea Leadsom said: “These proposals will level the playing field and enable our hard-working community pharmacies to benefit from centralised dispensing.

“It will also free up highly skilled pharmacists from back-office duties to deliver patientfacing services, including Pharmacy First and contraception consultations, supply medicines and provide advice.”

The government ran a consultation on its plans for a wider ‘hub and spoke’ model rollout in 2022 and received an overwhelmingly positive response.

Now, subject to Parliamentary approval, all pharmacies will have an option of two hub and spoke models from 2025.


Tech tool to tackle NHS waiting lists in Scotland

Software to reduce hospital waiting times and enhance operating theatre efficiency will be rolled out in NHS boards across Scotland over the next year.

Developed by clinician-led tech company Infix, the national theatre scheduling tool improved operating room efficiency by up to 25 per cent without the need for extra medical staff or additional theatres during successful pilots across three health boards.

It also enabled the completion of additional operations for patients.

The platform will now support all NHS Boards to increase productivity, remove paper processes, and reduce the overall administrative burden in the creation and approval of theatre lists, which can delay patient treatment.

Health secretary Neil Gray said: “Better use of data and digital technology is critical to how we drive improvements in healthcare and is a key part of our plans to reform services.

“This technology is backed by more than five years’ worth of NHS operating times data and is just one of the initiatives that will help enable us to schedule 1.5 million procedures per year – while improving data quality to help safely increase productivity. This will help maximise capacity, build greater resilience and reduce waiting lists.

“Reducing the administrative burden on staff will give them more time to spend on patient care. This is a shining example of how we are embracing cutting edge tools to tackle the challenges facing health and social care.”


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NHS announces 143 hospitals to roll out Martha’s Rule

The NHS has announced which 143 hospitals will test and roll out Martha’s Rule in its first year. Martha’s Rule will allow patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to.

The scheme is named after Martha Mills, who died from sepsis aged 13 in 2021. Her family’s concerns about her deteriorating condition were not responded to and she was not escalated to intensive care.

NHS England is working with Martha’s parents to develop materials to advertise and explain the initiative in hospitals.

Initially the target was to enrol at least 100 sites, but due to significant interest from frontline clinicians this was expanded.

The first phase of the programme will be in place at 143 locations across the country by March 2025. An evaluation of these sites will inform proposals for Martha’s Rule to be expanded further across all acute hospitals, subject to future government funding.

Martha’s Rule will be made up of three components - firstly an escalation process will be available 24/7 at all the 143 sites, advertised throughout the hospitals on posters and leaflets, enabling patients and families to contact a critical care outreach team that can swiftly assess a case and escalate care if necessary. NHS staff will also have access to this same process if they have concerns about a patient’s condition...

Goverment launches five-year plan to fight antimicrobial resistance: READ MORE

Pat Cullen leaves RCN to stand for Sinn Féin in general election: READ MORE

RCN declares national emergency over corridor care: READ MORE

NHS appoints director for mental health and neurodiversity: READ MORE

Concerns over efficiency targets revealed in survey: READ MORE


NHS launches Dentist Recruitment Scheme

The NHS has launched a new recruitment incentive scheme and is encouraging dental practices with the highest demand to make use of it.

Around 240 dentists will be offered bonus payments of up to £20,000 to work in underserved areas for up to three years.

Practices have been issued NHS guidance to encourage them to advertise the “golden hello” scheme.

The initiative is part of the NHS and Government’s dental recovery plan which has the goal of ensuring easier and quicker access to NHS dental care.

It is hoped that an extra 1.5 million NHS dental treatments will be delivered in the first 12 months.

Chief dental officer, Dr Jason Wong MBE said: “Thanks to our dental recovery plan to improve access to vital dental services, many practices are now taking on new patients and we will continue to work with the profession to encourage them to take advantage of our new incentive scheme.

“We are working to ensure that one and a half million additional dental treatments will be offered to patients over the next year with payments made to dental practices for taking on new patients and incentives for dentists to work in underserved areas”...

CONTINUE READING More top news stories from

Ensuring safety for building occupants

Cornerstone have significant independent expert experience dealing with root-cause investigations of reported damp, condensation and mould. Consequently, our knowledge and guidance has been used for cost-effective, long-term solutions and we wanted to introduce an opportunity to make our knowledge readily available for all those concerned with living, working and learning in affected buildings

We are all aware the Housing Ombudsman is issuing maladministration warnings to a number of social housing landlords. However, is that due to genuine administrative matters or, a misunderstanding of root causes for reported issues? This misunderstanding can and does lead to unfortunate undertakings not delivering the expected outcomes to housing. What about the places we attend to work, teach, learn and receive healthcare?

Cornerstone are conscious of the need for a uniform approach that will serve to deliver credible diagnosis alongside specific guidance for building occupants and structural owners/landlords, with a particular emphasis on the safety of those who occupy the buildings for periods of time.

A unique ‘Property Health App’ has been developed to enable those witnessing damp, condensation and mould issues to seek immediate advice and guidance for its likely development and, how simple aspects can be utilised to determine it has indeed been resolved. This proactive approach will align with timely guidance and existing policies and procedures by enhancing awareness of what mould needs to develop and, how the cycles can be broken to reduce the potential. In addition, SMART guidance embraces a ‘did you know’ approach in place of a ‘blame’ approach.

We divulge what root causes there are and how they can be rectified for the long term with this strategy, enabling landlords to enhance their tenant relationships and property owners working closely with everyday occupants alongside an advanced awareness of structural and atmospheric behaviour. Where complex issues persist, Cornerstone are here to help – as and when you need it. Long-term expert support embraces a system designed to manage structural health with a defined delivery of trend data for better decision making. L


Passivhaus: the future of health facilities?

A deep dive into the ultra-low energy buildings and how they are already being used to improve efficiency across the world

It is estimated that the NHS is responsible for almost 5 per cent of the UK’s carbon emissions. This is due to the fact that healthcare buildings like hospitals provide 24/7 care for patients, and a lot of life-saving treatment relies on the hospitals’ energy input.

Lighting, hot water generation, a ventilation system and heating and cooling are among the highest consumers of energy in hospitals.

Even providing meals for patients, guests, and staff takes up a lot of the nation’s energy.

As the climate crisis looms larger every day, healthcare professionals are starting to become more aware of how much energy these centres actually use.

The NHS said in their Carbon Footprint Plan they aim to reach net zero by 2045 for the emissions they can control, with an ambition to reach an 80 per cent reduction by 2036 to 2039.

In 2020, the Department for Energy Security and Net Zero announced the Public Sector Decarbonisation Scheme which provides grants for public sector bodies with funding for heat decarbonisation and energy efficiency measures.

Their aim is to invest in low-carbon heating and energy innovations like heat pumps, LED lighting, building fabric improvements, and renewable energy sources.

The challenge the NHS now faces is how to reduce their carbon footprint while also providing suitable care for all patients.


Enter Passivhaus, a methodology for low-energy building. Developed in Germany in the 1990s, it can be used to create buildings which use around 90 per cent less energy than standard practice for UK newbuilds according to 21 Degrees.

Passivhaus, also known as Passive Houses, are defined as buildings which have an extremely small heating energy demand and therefore don’t need an active heating system.

The buildings can be kept warm solely by using the existing internal heat sources and the solar energy entering through the windows.

Their ultimate goal is to remove the need for space heating and cooling, and is based on the principle that reducing heating loss to a E

13 Energy

1) Understand

Take the first step by understanding your carbon footprint with NFU Energy’s carbon accounting expertise. From assisting with choosing the most appropriate calculator, to a bespoke full calculation project, we’ve got you covered.

3) Identify

Discover what the best renewable energy solution is for your business, and if your proposed renewables projects are worth it, with NFU Energy’s feasibility and electrification studies.

2) Assess

Use less energy and save money with an NFU Energy on-site energy efficiency audit. Helping you assess where, when and how you use energy. From the efficiency of equipment and processes to how well buildings, stores and specialist structures, are built, maintained and used, we help you uncover hidden energy saving opportunities.

4) Optimise

Generate your own with NFU Energy’s Renewable Energy Solutions service. Giving you one-stop-shop access to accredited installers of renewable technology and electric vehicle solutions, finance, and insurance, as well as support at every stage of your journey.

NFU Energy is one of the UK’s leading and trusted providers of sustainable energy solutions, dedicated to meeting the evolving needs of agricultural enterprises, as well as public and private sector organisations.

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The design maximises natural light to save wasted electricity

F minimum is the most cost-effective and most robust way of achieving a low carbon building. This method of energy conservation can be used for a variety of different buildings, from social housing to schools.


In terms of using the method in hospitals, there are an increasing number of architects and builders across the world of this pioneering method. For example, Frankfurt Hospital turned their building into an eight-storey Passivhaus building in 2022 with almost 700 beds, eleven operating rooms and a helipad with direct connections to emergency services. It was the first Passivhaus hospital to be built.

The UK is also leading the way for Passivhaus hospitals. 2021 marked the completion of the nation’s first Passivhaus in Coventry, and it opened for patients in August that year. Foleshill Health Centre cost £3.3 million to build and was completed in partnership with Community Health Partnerships (CHP) and NHS Coventry and Warwickshire.

It was designed to achieve energy consumption figures of about a quarter of a typical health centre of the same size.

The design maximises natural light to save wasted electricity. There is a small heating system using air source heat recovery pumps connected to small radiators.

Solar panels on the roof provide electricity and all the lighting is provided by energy efficient LED lamps. There are no fossil fuels used on site and each sink has its own instant water heater which operates when the hot tap is turned on. This is best practice for the control of Legionella and other water-borne pathogens. In order to further reduce carbon emissions, the site is easily accessible by public transport. It

also has an electric car charging point and bike storage.

Through cost modelling, the design is predicted to save the NHS approximately £450,000 in operating costs over 25 years following construction.

Passivhaus is well-suited to hospitals as they require 24-hour use and higher temperatures in patient rooms. The method of making the most of natural light is also a big plus for both patients and staff. Community Health Partnerships said that natural light has a “therapeutic effect on the occupants” in a healthcare setting.

“Where natural light is not readily available, a lighting strategy should be developed that effectively uses artificial lighting to enhance the environment,” they added.

However, there has been some criticism regarding the suitability of Passivhaus in the UK. For example, there is a limited number of builders or architects who are skilled in creating these buildings in the UK so the process of creating these sustainable hospitals may take longer than necessary. The reason for this is that it is still a new building method that is not widely used anywhere in the world, let alone the UK, so many people have not received the necessary training.

There is also no fresh air ventilation which some say make the building stuffy and stale.

Foleshill is the only British Passivhaus healthcare building, so it is still early days. More public buildings are starting to get on board with the methodology, such as Riverside Primary School in Scotland which became the country’s first accredited Passivhaus school. If the NHS is to reach its net zero target, they may have to start widening their stance to increase the amount of Passivhaus healthcare settings across the country. L


CFA contractor members are part of a supply chain that has a wealth of experience, knowledge and products to fulfil specification with a sustainability criteria.

The CFA supply chain of vetted members includes specialist contract flooring contractors, manufacturers and distributors, all of whom promote the highest standards and expertise.

See the Downloads section at and download our FREE “Why Choose a CFA Member” leaflet TODAY

for sustainability support and advice on your flooring projects
Courtesy of Amtico International Courtesy of Forbo Flooring UK Ltd Courtesy of Loughton Contracts plc
Tel: 0115 941 1126 Email:

It’s all about the flooring…

The Contract Flooring Association is the leading independent professional voice of the contract flooring industry and this year is celebrating its 50th anniversary

Members of the Association include specialist flooring contractors, manufacturers, distributors and consultants — both large and small, operating from locations throughout the UK. The CFA’s membership now accounts for a significant proportion of the UK’s commercial fl ooring market.

Most of the UK’s largest and most well-known companies from throughout the flooring sector supply chain are CFA members. With such a high level of commitment from so many companies and individuals, the CFA has a wealth of resources at its fingertips. It is this breadth and depth of information that makes it so much more than just a trade association.

The objectives of the CFA are to promote the highest standards of professionalism, safety and training while at the same time, providing essential services and expert information to ensure the quality and productivity of our members’ businesses.

The CFA produces the following industryleading publications together with the Contract Flooring Journal, which is the official journal of

the CFA, to ensure that the flooring industry has up-to-date information to hand:

CFA Guide to Contract Flooring – this unique reference guide is updated every five years and gives the latest information and best practice for the installation of common floor covering types. Latest edition is 2022.

CFA Members’ Handbook – is a directory of CFA member companies and gives confidence that you are selecting professionals throughout the contract flooring supply chain (published annually in October). An online directory is available to search for CFA members by location or by flooring type at

CFA Training Guide – offers the latest information and guidance about flooring training in the UK (published annually in March).

CFA Guide to Sustainability – is the definitive source of the latest information about sustainability within the flooring industry (published annually in June).

In addition to providing up-to-date information for the industry through publications, all of E

kindly supplied by Gerflor Flooring UK Ltd 17

Advance Range

The Advance Range is a multifunctional range of seating, providing a solution for most needs within theatres and other clinical areas.

New Saddle

Saddle seats help to maintain an upright posture when seated. Feet are placed flat on the floor at a greater width than possible with conventional seating. The weight of the legs is taken through the feet, the upper body is stabilised accordingly. The pelvis is held securely in a neutral position.

Gemini Range

The Gemini Range features models with a swing around back, ideal for an operative who needs a moveable arm without having to leave the stool.

The SGEM-GT is our entry level of chair, offering a synchronised tilt facility for the seat pad and backrest. Ideal for Aneasthetists, Surgeons, Dentists and Ophthalmologists.

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F which are available to view and download in our downloads website page, the CFA also has various committees such as the Manufacturing Committee working on a national basis for the benefit of the industry as a whole.

Success or a flooring failure

Flooring is a major element in most contracts and, with more products to choose from than ever before, obtaining the right installer has never been so important. Flooring is diverse and technically demanding: each product type has its own challenges and options in terms of installation specification. A quality contractor will know the correct adhesive for the flooring product, or the right primer for the subfloor and so will help maximise your investment and minimise flooring failures.

Architects, specifiers and main contractors require the quality of service, installation and support that CFA members can provide. Consequently, many public and private organisations and an increasing number of local authorities are now specifying that CFA members must be used.

All our contractor members have passed the CFA membership vetting process and are annually audited to ensure that they continue to meet our membership criteria. They are all established quality companies offering high standards of installation. Through the CFA they all have access to up-to-date technical, environmental and quality standards and all adhere to the Contractors’ Code of Conduct.

The CFA provides members with a wealth of knowledge to assist with both flooring

Flooring is diverse and technically demanding

installation and running a business, including: British Standard Institute (BSi) Codes of Practice; employment law; health and safety; technical support and advice including the CFA Guide to Contact Flooring; training; dispute resolution; and the Winter Warning Toolkit – to ensure that correct heat conditions are available on site for the installation of flooring projects.

There is also our newest support document ‘Beyond Installation-Guidance on Underfloor Heating’. This document is designed to provide advice and guidance within this changing context and addresses the impact of proposed new standards which are likely to dramatically change the landscape for UFH and therefore the installation of the main types of floor coverings included within this guidance: textile, resilient and timber-based floor coverings.

Specifying a CFA member for your next flooring project could mean the difference between success or a flooring failure. Being a CFA member is a mark of quality. It will provide you with peace of mind and reassurance that you are dealing with a quality company. M


The CFA is a leading trade association representing the Contract Flooring Industry. If you would like further information please contact the CFA offices on 0115 941 1126, email or view our website at

Image kindly supplied by Polyflor Ltd 19






Brand Identity
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NHS: journey to the perfect logo

From its lettering to its colour scheme, the NHS brand is widely recognised across the world. Robyn Quick investigates what makes it so iconic, and whether it will ever change

When someone enters an NHS healthcare space, one of the first things they will be greeted with are white and blue. These are, after all, the instantly recognisable colours of the national health service. They can be seen in every building under the NHS’ care, from neonatal wards to hospices.

In a survey conducted by the NHS Identity Team in 2016, they found that virtually all (98 per cent) of respondents recognised the logo. Nearly two-thirds of those in the survey said when they saw the NHS logo on information, it created a more favourable impression of the services offered.

This is indicative that the NHS branding is deeply ingrained in the public consciousness. For many, it embodies trust, quality and accessibility in healthcare.

But those iconic colours have not always been associated with the health service. We dig into how the NHS branding came to be, as well as exploring the world of signage in healthcare today.

In the beginning

When the NHS was founded in 1948 by Nye Bevan, there was actually no official branding for the health service. Not even the acronym ‘NHS’ was in regular use until later on. There

were a variety of different colours and logos used before the NHS identity was firmly associated with the brand we know today.

The old iconography for the health service is rather tricky to come across, but there were reports that at one point the NHS was using a red cross to symbolise the brand. However, due to the simplicity of its design, the NHS said any type of red cross could easily be mistaken for the protected red cross emblem so it was discontinued as a logo.

The lack of branding early into the health service’s existence may well be down to the fact that the NHS was not considered a uniform brand, but that all changed just before the dawn of the millennium.

The re-brand

In 1999, the NHS Identity Team was created to bring 600 brands and sub-brands together to create one corporate identity.

The NHS Identity guidelines are based on six overarching principles which provide the strategic direction for the use of the NHS Identity and create a framework to ensure all current and future decisions about the NHS Identity are consistent.

These are: compassion, respect and dignity, improving lives, commitment to quality of E


F care, working together with patients and caring for everyone.

This identity change came as the Labour Party aimed to move away from a healthcare model that aimed to treat people on an illnessby-illness basis and towards a system that can handle complex needs that require crossdepartmental organisation.

It replaced the internal market with 481 Primary Care Groups, which were to operate under a unified NHS Identity.

This is when the signature background blue (Pantone 300 for all the colour nerds out there) rectangle and white logo with the Frutiger font came into the public sphere. The logo is also known as the blue-and-white ‘lozenge’ and is used across the NHS to this day.

The lozenge was used as early as the 1990s, but it was made official a few years later to ensure the entirety of the health service appears organised and uniform.

The NHS refers to it as a “visual representation of the values and purpose of the NHS – a national service, accessible and free to all.”

NHS Scotland has a different logo, in which a blue symbol somewhat similar to a seagull is placed below the acronym. In Wales, a more complicated logo is used featuring an intricate emblem and a gold-and-navy colour palette.


Today, there are specific rules on the specifications of how NHS signs can be designed and branded.

Signage should be as clear and simple as possible, making sure to make it as accessible as possible

For example, the NHS blue and white must be used as the predominant colours for exterior signage because patients and the public strongly associate them with the NHS. If a number of NHS organisations are equally using the same premises, a single NHS logo should be used. Signage should be as clear and simple as possible, making sure to make it as accessible as possible for people with a disability, impairment or sensory loss.

Why so blue?

We all associate blue with safety and trust, but often without even realising it. This is partly why


when the NHS announced 27 new scrub colours for clinical staff at the end of 2023, most of those colours were just variations on blue with the odd inclusion of green and grey.

Other colours are allowed to be used in NHS signage and branding, but they are to be used sparingly. Let’s use red as an example. It is generally confined to emergency healthcare, such as A&E departments or ambulance services.

Instead of the apparent calmness that the colour blue creates, red can represent an urgency necessary for an emergency setting.

But why are blue and white the principal colours used in all of the NHS branding? Dr Helen Thompson-Whiteside, associate professor in marketing and society at the University of Portsmouth, said the brand’s “incredibly simple” style is why it is so successful.

She said: “Blue is a calming colour that represents things like the sky and the sea; these are universal to everybody.”

Dr Thompson-Whiteside went on to say that the white represents purity, hygiene, and cleanliness.

She added: “The lettering is incredibly simple and easy to read, drawing on those colour associations.

“It hasn’t been mucked about with, it has a consistency that a good brand should have which makes it trusted and recognised.”


The iconography of the NHS has been relatively untouched by controversy, but there have been some incidents throughout the years.

The white represents purity, hygiene, and cleanliness

For example, in early 2017, every hospital in England was asked to rework all their publicity materials to change the position of the NHS logo so that it sat above the name of each hospital instead of beside it.

This prompted fury from patients and NHS staff, as it would have required an uphauling of all of the signs for what could be argued as very little pay-off.

The future

Despite a few bumps along the way, the general consensus regarding the logo is a positive one.

Dr Thompson-Whiteside added: We are living in a post-Covid world, where healthcare and vaccines were at the centre of everyone’s lives for such a long time.”

She said that this difficult period “renewed our trust” in the brand.

“It could change in the future, but this brand is a point of reference for a nation of people.”

Dr Thompson-Whiteside said if it were to change at all in the future, it would most likely be small tweaks over time that most of us do not notice.

It would be more than just changing some lettering, she said.

“People would ask themselves questions like: ‘Can I trust this service?’ ‘Does it hold the same values?’”

It looks like the NHS brand is here to stay as a global symbol of our identity. L


Why clean ventilation is essential

Ventilation professionals have a critical healthcare role and could help to save thousands of lives over the coming years by ensuring building occupants are protected from a range of dangerous pollutants, according to Graeme Fox, technical director of the Building Engineering Services Association (BESA)

Cleaning ventilation ductwork has often been considered one of those ‘out of sight out of mind’ tasks that can be postponed or avoided entirely to reduce cost, but the Covid-19 pandemic proved just how risky that strategy can be.

Poorly maintained, dirty air ducts cannot provide the level of air quality needed to safeguard human health and well-being in buildings.

Accumulated debris obstructs airflow, forcing fans to work harder to maintain the desired temperature and air change rates – so there is also an energy efficiency aspect to this.

Indoor Air Quality (IAQ) is affected by a cocktail of contaminants including carbon monoxide from cooking and heating, spores from mould and condensation, particulate matter, and smoking.

Also, more volatile organic compounds (VOCs) are emitted from indoor sources, like aerosols, paint, and furnishings, than transport.

Growing numbers of healthcare experts now recognise that investment in building and facilities management can, therefore, have a dramatic impact on a range of chronic illnesses. And, in response, the industry is investing considerable time, expertise and money in updating its technical guidance and training.


The latest example is a new specification for ventilation hygiene which has been widely hailed as “a big step towards revolutionising air quality in buildings”.

BESA’s TR19® Air ‘Specification for internal cleanliness and hygiene management of ventilation systems’ was designed to address E


F an urgent need for better cleaning and maintenance of ventilation ducting, which was highlighted by healthcare professionals as crucial to reducing building occupants’ exposure to harmful airborne particulates and pollutants.

To support the new specification, the Association’s training Academy has also updated two of its air hygiene training courses. These are designed so contractors can help their clients meet health & safety obligations and comply with increasingly stringent legislation.

Ventilation management is also at the heart of the challenge to reduce energy consumption and prolong system life in line with wider carbon reduction goals.

Cleaning will allow the system to operate more efficiently and reduce wear and tear. This will also be an increasingly important consideration when retrofitting buildings to achieve net zero.

The new TR19® specification covers all relevant legislation and professional guidance, including BSEN15780 ‘Cleanliness of Ventilation Systems’, which has been the British and European Standard since 2011.

It also reflects the aspirations of the first British Standard for Health and Well-being in Buildings British Standard 40102 (Part One), which is being launched this year and provides recommendations for measuring, monitoring, and reporting indoor environmental quality (IEQ) in non-domestic buildings.

It is the first standard of its type in the world and was unveiled at the recent COP28 climate conference in Dubai. It will be formally

Cleaning will allow the system to operate more efficiently and reduce wear and tear

launched in the UK later this year, and provides recommendations for measuring, monitoring, and reporting indoor environmental quality (IEQ) in all types of non-domestic buildings. It includes an evaluation and rating system for air quality, lighting, thermal comfort, and acoustics.

It champions tighter exposure limits based on the UK government’s own Daily Air Quality Index, World Health Organisation (WHO) guidelines which were updated in 2021, and existing measures in Approved Document F, as well as other industry standards including BS EN 16798-1. This makes it another important tool in the armoury of ventilation and air quality contractors.

Healthcare specialist Dr Philip Webb, chief executive of Respiratory Innovation Wales (RIW) , helped to develop the new standard which he said was a response to a growing “indoor environmental quality (IEQ) crisis”. He believes the standard could play a big part in driving greater investment in building and facilities management and so help reduce excess deaths related to respiratory, cardiovascular, and mental health conditions. He called for a fundamental reassessment of the way public money and resources were allocated to tackling air quality, which he says is

Passive cooling measures, such as green roofs and solar shading, can mitigate some of the problem

responsible for higher numbers of excess deaths than the Covid-19 pandemic, cancer, heart disease and mental health combined.


According to data from Public Health Wales, Covid-19 was responsible for 38 deaths per 100,000 of the global population, smoking annually accounts for 180, and cancer 278, but air quality is responsible for up to 1,400 excess deaths per 100,000 every year. However, it receives a tiny fraction of the public money and resources allocated to health and wellbeing services.

Webb also pointed out that there were 3,000 new occupational asthma cases reported in the UK every year linked to the air quality in workplaces.

“We are suffering from a legacy of poor building design dating back to the 1960s and 70s,” he said. “If properly supported, facilities and building management systems could have a bigger impact on health and wellbeing than the whole of the global health and social care system,” said Webb.

Another threat to the health of building occupants is the growing problem of overheating. The UK building stock is not well equipped to cope with our increasingly hot summers and milder winters.

The Environmental Audit Committee (EAC), which advises the government, warned that the country was poorly prepared to deal with this “silent killer” with vulnerable groups, including the elderly and the socially disadvantaged, at greatest risk.

Its recent report: ‘ Heat resilience and sustainable cooling’ says that both physical and mental health are affected by rising temperatures with suicide risk believed to be twice as high when the temperature reaches 32°C compared with 22°C.

The committee of MPs also said high temperatures cost the UK economy £60bn a year due to work-related accidents and lack of sleep. It said more than 4.6 million homes in England experience summertime overheating – underlining the huge scale of the potential retrofit challenge.

This puts a whole new complexion on the debate between retrofit and rebuild on the road to net zero. With the need to retrofit both residential and commercial buildings to improve energy efficiency already established as part of the UK’s net zero ambitions, addressing overheating must now be built into any comprehensive national retrofit programme.

Passive cooling measures, such as green roofs and solar shading, can mitigate some of the problem and would require no additional energy input, but similarly efforts to decarbonise heat and improve ventilation for health and well-being must be addressed simultaneously.

For example, improving building airtightness should not lead to additional overheating problems so long as the ventilation and cooling measures are designed alongside. In fact, the opposite is true as better building fabric with intelligent ventilation solutions makes it easier to control indoor temperatures and reduce other problems such as condensation and mould.

TR19® Air costs £75 for BESA members and £150 for non-members and can be downloaded from the BESA website . Anyone booking onto one of the BESA Academy training courses will also receive a free copy. Details can be found here . M


Infection Prevention returns for 2024

The Infection Prevention Society’s Annual Conference, Infection Prevention 2024 is taking place at the ICC, Birmingham from 23rd to 25th September

This world-leading event features an innovative scientific programme led by international and national experts in infection prevention.

Lisa Butcher, IPS president says “As always, the annual IPS conference promises to be a landmark occasion, uniting professionals, experts, and thought leaders dedicated to advancing the science and practice of infection prevention. This conference provides a unique platform for collaboration, knowledge exchange, and the exploration of innovative solutions to current challenges in infection control.

IP2024 will offer delegates the opportunity to explore the latest research advancements, and will feature an impressive line-up of keynote speakers and experts, giving you the chance to learn from and interact with pioneers in the field, gaining valuable insights into the latest developments and best practices.”

Conference highlights

Highlights this year include: an inspiring scientific programme covering infection prevention in all aspects of care from national & international expert speakers; the largest

UK infection prevention exhibition; a call for abstracts, posters and oral presentations; networking opportunities; flexible registration packages; and an engaging social programme.

Make sure you keep a note of these key conference deadlines. Abstract submissions close at midnight on 20th June 2024 and early bird registrations close at midnight on 5th August 2024.

Full details are available on the conference website here

The programme

IP2024 features a three-day inspiring scientific programme covering infection prevention in all aspects of care. National & international expert speakers will discuss the following key topics: leadership, water, fundamentals of IPC, surgical site, estates & decontamination, antimicrobial resistance and sustainability.

The keynote speakers at IP2024 are Professor Jack Gilbert who will open the conference with this year’s Ayliffe Lecture “Precision Microbiome Medicine”. Dr Mark Garvey will deliver the Tina Bradley Lecture and Tracey Cooper will deliver the Cottrell Lecture “Bouncing backresilience in infection prevention and control”.


Their specialised expertise and insights promise to make our sessions informative for all attendees. View the full programme here

Abstract submission

The deadline to submit an abstract for IP2024 is Thursday 20th June 2024 at midnight. This deadline will not be extended.

Submitting an abstract at the conference is an excellent way to communicate the outcomes of your research project with fellow practitioners, researchers and educators. Presenting will also support your personal development, showcase your skills and help grow your CV.

Each year there are over 100 posters and 12 oral papers presented at the conference from submissions covering the breadth of infection prevention topics.

Selected abstracts may be presented as a poster, an oral presentation or as a poster talk.

Poster: if your poster submission is accepted, you will be invited to bring your poster to Birmingham for all the delegates to view during the conference.

Oral Presentation: if your abstract is accepted as an oral presentation, you will be invited to present a short 13-minute talk in front of an audience of your peers.

Poster Talk: if your abstract is accepted as a poster, you may be selected to take part in a poster talk. Each presenter will give a short five-minute presentation with their poster displayed behind them for reference.

More information and resources can be found here .

The social events

Networking Night: This year’s conference Networking Night is taking place on Monday 23rd September at the BOX Brindley place, which is only a three-minute walk from the ICC.

The evening provides an opportunity to socialise with fellow conference attendees in a relaxed setting. With exclusive access to the venue, the rooms will be set up with a range of activities to cater for everyone’s preferences. Tickets are free for all conference attendees, and the evening includes a welcome drink from 7.00pm followed by bandeoke, shuffle boards and quiz until late.

Please select your ticket when you register for the conference. Please note that these are limited and available on a first come, first served basis. More information can be found here.

Conference Dinner and Awards Ceremony:

This year’s Conference Dinner and Awards Ceremony will be held on Tuesday 24th September at the BCEC located in the heart of Birmingham’s city centre, a 15-minute walk from the Conference Centre.

The evening provides an opportunity for the conference attendees to enjoy quality food and entertainment, while networking with likeminded professionals and industry partners.

Tickets are £50 per person, and the evening includes a welcome reception at 7.00pm followed by a three-course dinner and DJ. The dress code is “Black tie”, but if you don’t have a tux or a long dress any smart outfit is perfectly acceptable. M

About the Infection Prevention Society

The Infection Prevention Society (IPS) represents 2,300 members working in the field of infection prevention and control, and plays a key role in helping to protect the public. Its vision is to be a leading influence on IPC practice at a local, national and international level by 2024. For more information visit:


A framework for soft facilities management

The RM6331 framework for soft facilities management from Crown Commercial Service started on 20 February 2024 and ends on 19 February 2027

All public sector and central government bodies can use this agreement but it is specifically designed to meet the needs of health care providers such as NHS acute trusts, community health trusts, mental health trusts, ambulance services and GPs.

It reflects all the latest NHS standards such as the National Standards of Healthcare Cleanliness 2021 and the HTM 07-01: Safe and sustainable management of healthcare waste. Buyers can purchase single services from an individual lot or purchase multiple services in a bundled option.

What can I buy?

There are a variety of services trusts and GPs can buy. These include linen and laundry including the collection, wash and return of laundry and specialist laundry services, waste services including the collection, storage and removal of general, recycled, classified, clinical and medical waste.

As well as this, they can buy security including guarding services such as alarm response, access control, passes and perimeter guarding.

Visitor support services such as reception duties and telephony service and grounds maintenance (including soft landscaping, tree surgery, snow and ice clearance and planting) are also available.

Porterage services are purchasable, which includes transporting patients, stores, and equipment.

Trusts and GPs can also buy catering such as patient feeding, meeting hospitality, event catering, full restaurant services and vending services.

Finally, cleaning such as routine and reactive cleaning services, including pest control and ambulance vehicle decontamination is available.

What are the benefits?

The CCS said this framework has been designed around the needs of the NHS and the latest NHS standards.

One of the main pros of the framework is that it provides a simplified customer journey which allows buyers to purchase several services from one agreement.


CLEANWISE LIMITED have been awarded p preferred supplier status on C Crown Commercial Service’s (CCS), that supports the public sector to achieve maximum commercial value when procuring common goods and services.

We are proud to have been awarded a Framework Contract for RM6331 H Healthcare Soft Facilities Management Services agreement RM6331 Lot 2a - C Cleaning and Pest Control services! Cleanwise is on top of this list for those who wish to experience “Outstanding Quality” offering a better overall service to teams and patients and “Operations Improvement” counting on our experienced professionals for a smooth hassle-free day-to-day service delivery whilst ensuring the best possible commercial value

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It also offers an increase in opportunities for small and medium-sized enterprises (SMEs) to bid

Buyers can also call-off for single services or they can buy a bundle of services together to ensure all their needs are met.

It also offers an increase in opportunities for small and medium-sized enterprises (SMEs) to bid. The CCS added that the framework supports the NHS in reaching its Net Zero target.

If you need a refresher on what the health service has promised, the NHS aims to reach net zero by 2040, with an ambition to reach an 80 per cent reduction by 2028 to 2032.

All the suppliers for this agreement have committed to comply with the Procurement Policy Note 06/21: ‘Taking account of Carbon Reduction Plan s in the procurement of major government contracts’ as required.

What are the lots?

You can find a full list of all the lots included in the framework, but here is a selection of some of the most notable ones.

Firstly, Lot 3f is focussed on Feminine Hygiene Waste and involves buying waste management services. This includes collection, transportation, recycling or recovery and disposal.

Another lot of note is Lot 2b which looks at ambulance and vehicle deep clean. By buying from this lot, they receive specialist ambulance and vehicle deep cleaning services including internal and external vehicle cleaning, vehicle decontamination and a make ready service.

Also, the Non-Hazardous Clinical Waste lot (Lot 3a) involves buying waste management services for non-hazardous clinical waste.

This includes collection, transportation, recycling or recovery/treatment and disposal. Other lots include Patient Catering, Total Waste Management, and Specialist Cleanroom Laundry Services.

How do I buy?

Before you can buy through this framework you will need to complete the Customer User Agreement (CUA) form.

Return the completed CUA form by email to quoting ‘RM6331 CUA’ in the subject line of the email.

Once your CUA form has been processed, you will receive a unique reference number which will give you access to use the framework. Your unique reference number should be used on all communication between you, CCS and the supplier. Your unique reference number will help to identify you quickly and track your details. M




On the CCS Framework, Derventio UK can offer recruitment services specialising in vacancies under Lot 6:







We pride ourselves on being an equal opportunities recruitment consultancy A diverse and inclusive workforce is not just a benefit to a business – it’s a necessity in the modern age. A diverse and inclusive workforce extends beyond ambitions to create a thriving company culture!

Roles we have filled for CCS 2023-2024:

We have already successfully filled various roles for the NHS on the framework, on a temp placement such as:

Make Ready Drivers Make Ready Operatives Cooks Cleaners

M 6 2 7 7 C C S
N H E L P W I T H . . . D I V E R S I T Y A N D I N C L U S I O N :
C O N T A C T U S F O R A L L Y O U R A N C I L L A R Y S T A F F I N G N E E D S ! 0 1 3 3 2 3 4 7 9 9 6 a d m i n @ d e r v e n t i o u k . c o m w w w . d e r v e n t i o u k . c o m

A framework on non-clinical staffing

The Non Clinical Staffing framework from Crown Commercial Service offers organisations the opportunity to hire non-clinical workers

The framework, which is part of the NHS Workforce Alliance, runs from 25th April 2023 to 24th April 2027 and is available for all public and third sector organisations.

These include NHS contracting authorities, central and local government, universities, charities and emergency services.

Organisations can hire a variety of quality nonclinical workers through a range of engagement types including fixed-term, temporary positions and contractors across the UK.

The roles include, but are not limited to administration and secretarial, finance, accounts and audit, IT technicians, analysts and technical engineer specialists, digital workers and lawyers. Environmental and scientific roles, caterers, drivers and security, estates and maintenance roles are also included.

Organisations have the option to hire the roles they need directly from a supplier as and when they need to or they can set up a managed service.

If they set up a managed service (MS), the MS provider will manage all workforce needs by either filling roles directly or through their supply chain. You can also arrange for suppliers to manage projects on your behalf, and take responsibility for providing your desired outcomes through output-based delivery.


The framework offers several benefits. Firstly, it uses an NHS England approved route to market for non-clinical temporary staffing.

A wide range of experienced suppliers are included in the framework, such as Small Medium Enterprises (SMEs), specialist niche suppliers and managed solution options.

Maximum agreement rates are also fixed and are also limited in line with the NHS England agency price caps.

Additionally, you can achieve larger savings using the built-in discounts (you can access discounts for length of placement, by E


nominating a worker, or by hiring large volumes of workers at the same time).

There are also transparent rates and costs for both pay-as-you-earn systems and limited company temporary workers, including fixed-

The CCS said they carry out quality assurance audits to make sure worker pre-employment NHS Employers Skills for Health policy.

Non-NHS contracting authorities can specify what pre-employment checks they need: for example, Baseline Personnel Security Standard

Direct award is available and supported by the NHS Workforce Alliance to enable quick access to workers when needed, as well as a range of tools to help you select suppliers including rate

The framework is also free to use, so organisations don’t need a membership and framework fees are collected straight from

Additionally, suppliers under Lot 7 of this agreement have agreed to comply with the entitled ‘Taking account of Carbon Reduction Plans in the procurement of major government contracts’. The policy sets out how to take account of Carbon Reduction Plans in the procurement of major central government contracts.

If a supplier has published a carbon reduction plan, you can find it on their individual supplier

All 208 suppliers have agreed to follow this

Use the lot descriptions and the Rate Card and Award Support Tool to identify suitable suppliers

Organisations can procure the services on the framework through a variety of avenues.

For those hiring single or small groups of workers, you should direct award if it is clear from the contract documents that there is one supplier who can meet your needs and provide you with the best value for money.

Direct award contracts occur when a contract is awarded to a contractor without a competition, or where there is a material change to an existing contract.

Requirements need to be fully covered by the framework specification.

Use the lot descriptions and the Rate Card and Award Support Tool to identify suitable suppliers.

The CCS’s tool will help match the types of staff needed to the suppliers offering them. Organisations can then rank the suppliers according to their offers and value for money.

If you would like to use their tool, email the CCS for a copy.

Another way to buy is to use further competition.

This is a procurement process in which suppliers on a framework produce a tender that outlines how they can meet the customer’s needs.

The CCS said they do not recommend this route for single or small groups of workers. Suppliers may choose to not take part in competitions for smaller requirements.

The NHS Workforce Alliance can help customers to work out their requirements and best route to market.

To run a further competition you will need to identify which suppliers can meet your needs, invite all capable suppliers to bid and send E


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The NHS in England currently employs around 1.4 million people

F further competition documents to all capable suppliers.

When completing the latter step, organisations must leave enough time for suppliers to return their tenders.

Once this is complete, you can then evaluate the returned tenders against the award criteria, and adjust their evaluation plan and weightings within the range limits.

You can then award to the supplier who can provide the best value for money (the supplier with the highest score).

If the supplier is unable to meet the organisation’s needs, you should award the supplier with the next highest score, and so on, until your needs are met.

The final way to buy the services on the framework is a rate card. There are two versions of the rate card for customers. One is for NHS customers and includes the NHS England price caps, and the other is for the rest of the public sector to use.

Organisations can enter the worker pay rate and the rate card will calculate the full charge for whichever supplier is selected. It will also include all costs for hiring a temporary worker using this agreement.

The rate cards will also provide information on costs for hiring a fixed term worker and costs for transfer fees where applicable.

The CCS has included an award support tool which will help find suppliers who can provide different roles in different regions.

NHS staffing

This framework comes during calls for urgent action to improve staffing levels across the NHS.

According to The King’s Fund, the NHS in England currently employs around 1.4 million people (on a headcount basis, counting each individual member of staff) and 1.3 million on a full-time equivalent (FTE) basis.

These figures include staff in ambulance, community, mental health and hospital services, as well as those in commissioning roles and central bodies like NHS England, making it the largest employer in England.

Vacancies remain a big concern, with an estimated 112,000 posts currently unfilled substantively. Although the NHS workforce has been growing, demand for NHS services has been growing faster, and the health service hasn’t been able to recruit and retain enough staff to keep up. Although some substantive posts are filled temporarily by bank and agency staff, this can be costly to the NHS. M



How criminal record checks work in the NHS

Criminal record checks are one of the most important steps to take before employing someone in healthcare, but what do you need to do?

A medical setting should be a place of trust, professionalism and safety for both staff and patients. But there have been incidences where staff have violated this trust, and put the wellbeing of their patients at risk.

For example, in November last year, a former NHS secretary was found guilty of illegally accessing the medical records of over 150 people. The perpetrator was required to access clinical and personal information of patients within the ophthalmology department. However, the individuals whose records were accessed had no medical conditions relating to that area and she viewed the medical records of people who lived near her.

The possibility of this happening to patients is frightening, especially with criminal record

checks in place that are supposed to protect all individuals.

So what criminal record checks are needed to ensure the wrong people are prevented from entering the workforce and gaining access to often vulnerable individuals?

We look at best practice for these checks, and the importance of carrying them out correctly.

The basics

In 2002, the Department of Health and Social Care issued a mandate outlining the primary checks which all NHS organisations within England must undertake when appointing individuals into NHS positions.

There are different levels and different kinds of checks that must be conducted by the NHS


before someone can start work. Their purpose is to help employers seek the necessary assurance that individuals are of good character and have the appropriate experience, qualifications, skills and competency to do the job properly.

There is a lot to be said for making sure these screening checks are carried out by one department to make sure they are carried out fairly.

The first of these is checking identification documents. Employees will be asked to provide proof that they have the right to work in the UK. This means they will need to produce either

These checks are crucial to workplace and patient safety

a document or a combination of documents. For example, a passport, a visa or immigration documents if they are non-national.

If the role requires a particular professional registration, the employer must carry out a check with the appropriate regulatory body and secure confirmation of the appropriate registration. Where a check has been made, employers will not be required to verify their professional qualifications separately.

Where a licence is a requirement, confirmation will be sought from the relevant regulatory body as well.

What are criminal record checks?

Criminal background checks are arguably the most crucial aspect of the NHS’ employment checks.

To put it simply, it is a process used by employers to screen potential employees for criminal records, past convictions and any other relevant information that could affect their suitability.

These checks are crucial to workplace and patient safety because they prevent unsuitable people from entering healthcare settings.

In most cases, a check will include criminal convictions, cautions and other similar offences, such as traffic offences for speeding and drinkdriving. E


F They can be accessed through the Disclosure and Barring Service (DBS) in England and Wales, but this differs for Scotland and Northern Ireland.

Types of criminal record check

There are six types of criminal record checks that can be completed by the NHS before someone is employed.

Firstly, there are the basic checks which provide information only on unspent convictions (when someone is in their rehabilitation period following conviction).

Once the rehabilitation period has passed and if the individual has not been reconvicted at any time during this period, they will not be required to declare these offences, nor are employers permitted to consider this type of information in their assessment of suitability for the role.

The next step up is the standard check which must be completed for positions which are listed as exempt under the Rehabilitation of Offenders Act 1974. It details information on spent and unspent convictions and cautions. To meet eligibility for a standard check, the role must require the individual in that role to be involved in the provision of a health service which would also give them access to persons in receipt of health services as part of their normal duties.

There are six types of criminal record checks that can be completed by the NHS before someone is employed

Enhanced checks without barred list information are the third type of criminal record check, and are usually used for positions where the employee will work with adults and/ or children. The enhanced check will provide the same information as a standard check. In addition, it will include any other relevant information that may be held on local police databases which the chief officer reasonably believes should be disclosed and considered by an employer. Including cautions or convictions that may be protected by the DBS filtering rules.

Next are enhanced checks with barred list information, which is carried out for positions involving a regulated activity as stipulated within the Safeguarding Vulnerable Groups Act 2006 (amended by Protection of Freedoms Act in 2012). Additionally, using the DBS Adult First Service enables employers to obtain a fast-track check against the adults barred list. This check does not remove the need to obtain a full enhanced disclosure, but it can help to mitigate risk where any delay to recruitment would have a significant impact on the provision of services and/or patient safety. For example, this might be during the winter period when there is an increased pressure on NHS services. If the check confirms that the individual is not barred from working with adults, and all other

Subscription to the service allows for standard or enhanced certificates to be updated

recruitment criteria have been met, employers can allow them to start work under supervision while waiting for the outcome of the full enhanced disclosure.

The final step you can complete for a criminal record check is the DBS update service, which is available for potential and current employees to subscribe to when an application for a DBS check is made.

Subscription to the service allows for standard or enhanced certificates to be updated and allows employers to mitigate risk by carrying out a quick check online instead of requiring individuals to have a new DBS check each time they change roles and where the new role does not alter the type or level of check required.

Of course, these checks do not completely ensure that an employee is not unsuitable. But putting these systems in place can significantly reduce the chances of this kind of person being employed by the NHS. L


Improving the staff experience

Amanda Heaton, head of Human Resources at Warrington and Halton Teaching Hospitals NHS Foundation Trust explains how the Trust implemented a new way of handling grievances

Like all NHS employees, the experience of staff at Warrington and Halton Teaching Hospitals NHS Foundation Trust was affected by the extreme pressures and disruption caused by the Covid-19 pandemic.

There had been sharp increases in Employee Relations case work around grievances and complaints at the Trust, which employs more than 4,000 staff across three hospitals.

It was a situation not helped by the nationwide pause on Employment Tribunals (except when it came to those cases where there was obviously going to be a detriment to individuals from a delay).

In this way, minor disagreements — mostly the result of a general state of tiredness, frayed nerves and impatience — were being bottled-up and relationships could deteriorate over time. When the tribunal service resumed, more employees were thinking in terms of making use of formal processes.

The issue for the Trust was how to deal with conflict in more informal ways the normal approach: de-escalating situations without need to make use of HR and management time or resorting to a tribunal.

Creating a compassionate culture was one pillar of the Trust’s new overarching people strategy. As part of this, the HR team started to think about what could be done differently to help people facing problems with relationships, with disagreements and grievances, at the earliest stage possible. How could staff be encouraged to make more use of open communications and systems of earlier resolutions, and in ways that would help everyone working for the Trust?


It was important to ensure that the workplace culture was inclusive — making sure everyone had a voice, including those employees who might not be in a Trade Union.

At the same time that means people being able to appreciate different perspectives. Do I really

know what younger recruits, the school-leavers, think about their role and experiences? The Trust wanted to help support people so they had influence and control over their working lives, through upskilling and empowerment.

Workplace relationships specialist CMP was chosen as a partner for the ER initiative, as the organisation that had worked with NHS Lothian on culture change, a Trust which has since become recognised as high-performing in the area.

Process not programme

Warrington and Halton also had its own ideas on how the culture change could best be delivered: not through one particular programme but a full package and process. This included a mix of both pre-existing accredited courses and a bespoke programme designed around the Trust’s objectives, the tried and tested along with the tailored.

HR 46

A cohort of 16 staff have been trained through the ILM-accredited Professional Workplace Investigator programme, a comprehensive six-day course providing trainees with all the information and skills needed for any internal investigation (such as understanding investigations policy and procedures; communication skills and impartiality; information gathering and management and analysis). Another 16 have been trained as Professional Workplace Mediators (also ILM accredited), helping them to both develop a theoretical understanding needed to run mediations, as well as practice core skills.

Employees were selected to take part from across the range of functions, both clinical staff (nurses and physiotherapists for example), and non-clinical (from estates, finance, IT, operations management and HR), and given personalised coaching, mentoring and feedback throughout their training.

The Trust wanted accredited courses to make sure there was a strong foundation of trust and confidence, both among the staff trained and the people who’d make use of their skills. They needed to know they could bring about positive change, raise standards, and be comfortable in dealing with difficult situations, ask the difficult questions and help employees feel able to open up and share personal thoughts and experiences. The numbers involved were chosen carefully. The Trust needed to have enough of a pool

Employees were selected to take part from across the range of functions

of mediators and investigators that there wouldn’t be any bottlenecks, and no problems with juggling workloads. At the same time, it also needed to ensure there would be enough work, so the trained people could keep skills up without needing refreshers, the role would stay familiar.

Bespoke management training around informal conflict resolution and handling difficult conversations has been designed between the Trust and CMP. This element has been focused on empowering line managers to intervene and deal with conflict at low levels; giving them the skills to have constructive conversations and share perspectives. In other words, helping them to walk in another person’s shoes.

Pilots were run in February/March 2024 with plans to roll the programme out to between 100 and 125 managers in the first year. The training will now be made available to all managers, as well as HR and Organisational Development staff and employees acting as ‘Freedom to Speak Up’ champions.


One of the most obvious initial successes has been the motivation and enthusiasm E

The training will now be made available to all managers, as well as HR and Organisational Development staff and employees acting as ‘Freedom to Speak Up’ champions

F among mediators. The trained group meet up regularly to discuss how the service and process is working in general, sharing lessons and experiences as a form of peer learning. The mediators have initiated and driven the setting up of a mediation portal on the staff Intranet: a bundle of content around mediation — including a Q&A, case studies and introductions to the people involved — that helps to make mediation more understood, informal and approachable as a service for everyone. They have also set up a series of informal events and drop-in sessions, giving staff the chance to chat about what mediation is like, and give some initial advice on dealing with minor conflicts. The informal sessions mean access to a less formal route than talking to HR about problems, which in itself can feel like a major escalation of a situation. The Trust makes sure the mediators have their own separate identity from their day job, so even if they’re in HR they have a different staff badge; they have a separate email address and phone number.

Staff have given very positive feedback on the trainers and the consultants we’ve worked with. The mediators in particular have talked about how important and transferable the skills they’ve developed are, so useful for communications in general, in terms of listening skills and empathy. The conversation skills learnt, being self-aware, curious, conscious of body language and not just having an instant response to the words, is useful for every situation, for team meetings and project management — especially with more staff working remotely. Good conversations are critical for the workplace culture and the workforce experience as a whole.

Where to now?

The Trust is monitoring the impact of introducing an informal resolutions culture in a number of ways. This includes metrics around the volume of ER cases, the stages they started at and then progressed to; how many employees are using mediation; and the feedback from those involved


in mediation; as well as the implications for absence, attendance and retention. The issue will be a focus in the next staff feedback survey.

Now we’re thinking about making all the positive changes sustainable. That might include looking at the use of group mediation,

such as Neutral Assessment. We’re always thinking about employee needs, what they want, rather than pushing through an HR agenda. So we’ll be looking at more engagement with employees and letting them drive next steps in partnership. L

The Trust is monitoring the impact of introducing an informal resolutions culture in a number of ways

Digital gateway to make life easier for clinicians and improve efficiency of service for patients

Clinicians are being encouraged to move away from paper and email to shorten lead times for patients receiving home medication deliveries by moving across to a secure online clinician gateway

The Clinicians’ Gateway, developed by clinical homecare specialist HealthNet Homecare, allows clinicians to manage their patients’ homecare more easily. The company has around 150,000 homecare patients assigned to their service by hospital clinicians, who can now review and send invoices and prescriptions, register patients for homecare, create prescriptions, check delivery status and run reports using the Gateway.

“At the present time, those not using a digital platform like the Clinician Gateway have to email or send paper copies of registration forms; have to call up to get information on their patients or request information via email,” explains Sam Cockayne, sales director, HealthNet Homecare.

“That can be very time-consuming. The Gateway can speed up the process by giving them direct access to their patients’ information from the computer in front of them.”

Recent updates to the system include easyto-view patient notes, an administration page so you can manage all staff involved, an

improved search function and the ability to send prescriptions electronically using an E-Sign facility, which is particularly useful.

“It’s quicker because you can get prescriptions approved electronically. And because it’s not a paper copy, you don’t have to rely on people being in the same place to sign it,” continues Sam.

“With the Gateway, you can register a patient without any paper copies. There’s no sitting on a call or waiting on an email, all of which can be time-consuming. To register a patient now, with the patient in front of you, you could go on to the Gateway and do so in five minutes.”

“The key point is that it’s simple, userfriendly. We have never come away from a demonstration with somebody saying it is complicated. It’s built for them to be as straightforward as possible, so we want to encourage as many clinicians as possible to arrange a demonstration because we are confident that they will find it transformative.”

The Clinicians’ Gateway, though, is also useful for hospital administration teams, to see invoices, and statements, but also for prescribers, nurses, anybody who needs to view or edit patient information to see their delivery and prescription information. M

How technology is shifting healthcare demand

In this article, Stacey Hayes-Allen, director of corporate partnerships at Arden University, looks at how the drive for digitisation and technological developments – such as AI and automation – are impacting the healthcare sector and shifting the skills in demand

In a report published in 2020, the NHSE&I outlined its expectations for the NHS to reach a core level of digitisation by 2024. But, with 2024 now well underway, insights from GlobalData suggest the number one obstacle facing healthcare professionals on the journey to digital transformation is a shortage of specialist skills (43 per cent).

How tech is changing the health and care sector

Recent developments in artificial intelligence (AI) and automation have sparked fears around job security in many industries, including health and care. Yet some remain optimistic, with the NHS Long Term Workplace Plan, for instance, maintaining a positive outlook of integrating technology into the health and care system.

There are many different elements where technology and digitisation will inject themselves into the health and care sector. From being able to see patients quicker, streamlining administration and potentially being able to harness chatbots to save time, all the way to more technical capabilities, such as writing genomes, using AI for diagnostics and utilising robotics for assistance in surgery.

The benefits are rife. Digital transformation could potentially allow those in the industry to see more patients while still prioritising patient care, and those in need of medical support should hopefully be diagnosed quicker and on the road to recovery sooner.

Even though a lot of the groundbreaking technology advancements, such as robotics, could fundamentally transform healthcare – there E



Support: Comprehensive guidance and technical expertise to help you navigate the complexities of digital transformation. We connect, manage and secure the Internet of Things

Reliability: Uninterrupted and robust connectivity for real-time patient monitoring and telecare services.

Security: Encrypted data transmission to protect sensitive patient information and ensure compliance with regulatory standards.

Future-Readiness: Smooth transition from analogue to digital systems, supporting the latest healthcare innovations.

E ciency: Cost-effective solutions that reduce operational costs and improve service delivery.

F remain huge gains to be made with digitisation on a somewhat simpler level. For example, some studies have shown that over 70 per cent of a clinician’s working time is spent on administrative tasks, and 44 per cent of all administrative work in general practice can be mostly or fully automated. Digitisation has the potential to save time and ensure patients get the care they need.

The demand for highly trained managers in health and social care will most certainly increase

There is a need to raise awareness of the importance of digital literacy among the health and social care workforce, however. To succeed in today’s digital age, workers must develop the necessary skills, attitudes and behaviours to become digitally competent and confident. In fact, according to the Topol Review, within 20 years, 90 per cent of all jobs in the NHS will require some element of digital skills, stating that “staff will need to be able to navigate a data-rich healthcare environment” and will need “digital and genomics literacy”. Access to training and support to nurture the skills that will enable patients to improve their health and well-being through technology is also becoming increasingly important. This shift will create new career opportunities for some workers in the health and care sector.

The skills in demand

The initial advantages of AI and robotics will include: automating tedious, repetitive tasks that don’t require much human cognitive power, better robot-assisted surgery and optimising logistics. However, its main power is how it will streamline patient care and touchpoints throughout their diagnosis and treatment, so it’s essential for staff to have a complete understanding of data validity and accuracy. E


F Analysis by the Office for National Statistics (ONS) in 2019 found that medical practitioners were one of the three occupations at the lowest risk of automation, mostly due to the fact that many tasks in healthcare are difficult to automate. This is because they require traits or competencies that AI and other technologies currently struggle to replicate. Critical thinking, communication skills and emotional intelligence are central to many health and care roles. Staff, management and even administrative workers must weigh up the benefits and risks of different possibilities, approaches and solutions and tap into their emotional intelligence to make the patient’s journey as easy as possible. Often, experience in the industry helps hone these skills, which is why upskilling staff on digitisation is important – they already have the skills that AI cannot replace but need new knowledge and expertise to be able to integrate technology efficiently, legally and effectively.

It’s important to note that the full benefits of digital medicine, such as earlier diagnosis, personalised care and treatment, can only be realised for the sector if health and care records are fully digitised and integrated. With the introduction of integrated care systems, the

The demand for highly trained managers in health and social care will most certainly increase
Stacey Hayes-Allen, director of corporate partnerships, Arden University

demand for highly trained managers in health and social care will most certainly increase.

A diverse range of job opportunities are linked to progression from this unique offering, including roles in leadership and management across the health and care sectors in both public, private and third-party sectors. Workforce development is necessary to understand the best ways to deploy datadriven technologies to support and improve working practices – this will require a different ‘business-minded’ skillset for health and care organisations, as well as digital know-how. This will make it easier to improve ease of access and decrease non-attendance rates, as well as reduce unplanned admissions.

Patient safety will also be the centre of the integration of new technologies, so health organisations must work with regulators, cyber security and data privacy professionals to ensure transparent, resilient, robust and legally enforceable practices. This means training will need to involve specialists from other industries to improve regulation and assessment of digital technologies.


Equipping the workforce

The health and care sector encounters exceptional challenges when it comes to finding appropriate upskilling opportunities. It’s important to design programmes that facilitate a cultural shift, enhance leadership capabilities and maximise system efficiency. However, achieving this is a daunting task. So, how can it be accomplished?

As listed in the Topol Review, collaboration between academia and industry, and attracting global technical talent through new degree apprenticeships and Masters schemes is a key part of bridging the skills gap. On top of this, research has shown that health and care employees are best prepared to perform their jobs well if they have comprehensive information, clear learning opportunities, feedback along the way to build their confidence, support to innovate and develop new and improved ways of providing patient care and trust in their supervisors and leaders. Utilising apprenticeship degrees not only act as a huge step in widening access to senior positions and closing the skills gap, but it also helps attract and retain talent – an aspect that

It is essential to identify potential leaders at the onset of any new technological advancement

is important in the industry at the moment as digitisation is at bay.

It is essential to identify potential leaders at the onset of any new technological advancement. Creating networks to facilitate collaborative learning is also crucial.

Providing accredited continuous professional development (CPD) and flexible ongoing training, along with career opportunities, such as portfolio careers in academia or industry, will play a crucial role in driving change.

When it comes to closing the skills gap, working with those already in the industry will play a big role for the health and care sector. There will be a bigger demand for businesslevel management to help navigate digitisation, but a strong knowledge of the health and care industry is fundamentally needed. The industry has its own requirements: it’s not about meeting the bottom line to gain more profit, it’s about streamlining processes to help practitioners help patients. This is why upskilling those already within your healthcare organisation with the digital and management capabilities needed is vital – they could help narrow the gap. L


The past of the NHS’ technology and what it means for the future

As a funding boost has been promised for the NHS to improve their technology, we take a look at how far the service has come since its creation

The NHS has recently promised a host of new technology to boost the nation’s health service.

As part of the Budget back in March, Chancellor Jeremy Hunt announced £3.4 billion of funding for NHS technology and transformation.

As part of this funding, NHS England announced they would roll artificial intelligence (AI) to reduce the number of missed appointments and free up staff time to help bring down the waiting list for elective care.

Hunt said in the Budget announcement that the funding boost will be provided over a threeyear period, starting from April 2025. A lot of this funding is being put forward in an attempt to improve the productivity of the current IT system. After all, the British Journal of General Practice found that eight per cent of GP time is lost to IT issues.

While the proposed technology and generous budget is exciting for many, there has been criticism regarding the lack of funding for technology in social care. For example, health charity The King’s Fund said that the digital “part of the system will lag behind, with likely inefficiencies and a negative impact on staff and the people who draw on services.”

Looking back to the past can be an invaluable window into what the future could look like. The NHS has come a long way since its creation back in 1948, so we have taken a look at how much the technology has changed in over 75 years.

1962 - First full hip replacement

Sir John Charnley performed the first total hip replacement at Wrightington Hospital in Wigan. His method of orthopedic surgery was pioneering for the time, as his recovery plan

Technology 56

involved a good balance of painkillers and physiotherapy. This approach to hip surgery is largely unchanged and still used today.

1968 - UK’s first heart transplant

The first heart transplant in the UK was the tenth in the world and was performed in London. The recipient of the heart, Fred West, survived for 45 days. It was only in 1979 that the first successful heart transplant was performed on Keith Castle.

1971 - UK’s first CT scan

Computer tomography scans (known as CT scans) were first used in the 70s, and changed the game for diagnosing brain tumours and

The first CT scan was performed in Wimbledon at Atkinson Morley Hospital, now part of St George’s Hospital

muscle issues. The first CT scan was performed in Wimbledon at Atkinson Morley Hospital, now part of St George’s Hospital. The first brain CT scan took several minutes to complete, but now it takes just a matter of seconds.

1978 - World’s first test tube baby born Louise Brown was born in Northwest England, and is now 45 years old. While some were in E

NHS Direct was the health service’s attempt at health advice and information service remotely

F awe of the technological advancements, there were others who called the milestone a “moral abomination.”

1984 - MRI machine first used MRI machines were the big next step in imaging since the CT scan more than ten years earlier. MRI scans don’t use X-rays, instead they use magnetic fields and pulses of radio frequency to produce detailed pictures of organs, soft tissues, bone and other internal body structures. Even today, the NHS is developing new ways to upgrade this technology. For example, in 2022, Addenbrooke’s became the first hospital to have an advanced MRI scanner which used AI to improve image quality.

1998 - NHS Direct introduced NHS Direct was the health service’s attempt at health advice and information service remotely. The service was led by NHS nurses and provided residents of England with health advice and reliable information. In 2014, it was discontinued and replaced with the 111 service.

2012 - First person in the UK to have hand transplant

The UK does not hold a world-first record for this one, as the first ever successful hand

Technology 58

transplant was performed in Lyon, France in 1998. A former pub landlord, Mark Cahill, from West Yorkshire was the first person in the UK to have the operation after his own hand was amputated due to severe gout. Twelve years on, Cahill is living a normal life with his new hand.

2021 - Highest number of NHS calls responded to in one month

In October 2021, NHS 999 services had their busiest ever month as staff answered a record 1,012,143 calls. The emergency 999 call has existed before the NHS, and was first introduced in 1937 after a fire in London in November 1935 killed five people. It initially only covered a small section of London, but now includes the whole of the UK.

2024 - First artificial pancreas rolled out

In more recent news, the NHS has been trialing a new initiative since April for those with type 1 diabetes to receive an ‘artificial pancreas’. The device continually monitors a person’s blood glucose, then automatically adjusts the amount of insulin given to them through a pump. The technology will mean some people with type 1 diabetes will no longer need to inject themselves with insulin but rely on technology to receive this life saving medication.

The NHS has been trialing a new initiative since April for those with type 1 diabetes to receive an ‘artificial pancreas’

One aspect of the NHS’ technology that is only just beginning is the use of AI. NHS England says it has “the potential to give health and social care practitioners back “time to care” by removing time consuming repetitive tasks that could easily be automated.”

It is being piloted in areas of the NHS such as getting a faster and more accurate diagnosis, reducing errors caused by human fatigue, assisting with repetitive tasks, and decreasing costs.

You can have a look at this guide to see where AI is already being used across the health service. There are issues that the NHS still needs to overcome to fully reap the effects of this new tech such as deciding who will control the data used in AI systems, a lack of standards for using AI for patient care and liability and privacy issues. It will be intriguing to see what the next big milestone will be for the NHS timeline. L

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