Global Opportunity | Healthcare 2015 by Global Opportunity

Global Opportunity Healthcare 2015

Editor Sarah Cartledge 020 8492 5876 sarah@tpggroup.co.uk

Welcome to Global Opportunity Healthcare 2015

Art Editor Nadia Nelson nadia@tpggroup.co.uk Designer Oscar Bowring oscar@tpggroup.co.uk Sales Director Karen Frieze 020 8492 5885 karen@tpggroup.co.uk Advertising Executive Rory Mulkerrins 020 8492 5883 rory@tpggroup.co.uk Publisher Steve Gardner 020 8492 5888 steve@tpggroup.co.uk

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Features Editor Judith Baker judith@tpggroup.co.uk Features Writer Greg Baker greg@tpggroup.co.uk

| Editorial

Welcome to Global Opportunity Healthcare, a wide-ranging publication showcasing the breadth of Britain’s expertise in the field. From 1948 when the NHS was formed the UK has been at the forefront of healthcare innovation. Since then the NHS has grown to become the world’s largest publicly-funded health service, as well as one of the most efficient and comprehensive. Good healthcare should be available to all and this fundamental belief lies at the core of the NHS. More than 62 million people use the NHS; access to its services is based on clinical need and it is free with the exception of some prescriptions and services. More than 1 million people work for the NHS, many of them coming from overseas, either as new British citizens or via training networks, and it has some of the best clinicians in the world. As a result, countries that are looking to expand their healthcare systems are reaching out to Britain for guidance. From clinical services to postgraduate education training, infrastructure, design and services, private care, life sciences, pharma and digital innovation, British expertise is in demand. As one of Britain’s top surgeons observes, learning is a two way process and it is this premise that lies behind the creation of Global Opportunity Healthcare. Already British medical teams visit countries around the world to help them deal with vital issues, and there is a wealth of knowledge and guidance that has yet to be distributed. Within these pages you will find major hospitals, consulting firms, training organisations and suppliers along with thought leadership articles on integration, regulation, overseas partnerships and life sciences strategies. Many of Britain’s major hospitals are included: The Royal Marsden, Chelsea and Westminster, Moorfields and Leeds Teaching

Hospitals, all keen to share their expertise and help overseas partners achieve their own healthcare goals. I am delighted that we are launching Global Opportunity Healthcare at Arab Health 2015, the world’s most comprehensive medical tradeshow. Many of the companies within these pages are exhibiting at the show so they are available to give more information about their services and products to the show’s visitors. So do search out British companies at the exhibition and see what they have to offer it may well be just the right prescription for you.

Sarah Cartledge Editor, Global Opportunity Healthcare

More than 1 million people work for the NHS, many of them coming from overseas, either as new British citizens or via training networks.’

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| Global Opportunity Healthcare 2015

Contents

034 An introduction to The Royal Marsden

Martin Gore, Medical Director at The Royal Marsden, on what the world-leading cancer hospital is offering overseas patients

040 Moorfields Eye Hospital Dubai: Second sight Understanding local needs is as vital as exporting expertise for a successful overseas hospital, says Mariano Gonzalez, Managing Director of Moorfields Hospital Dubai

042 Moorfields Private - your vision, our focus Moorfields Private is the private division of the world-renowned Moorfields Eye Hospital NHS Foundation Trust, with a reputation as a centre of excellence for providing ophthalmic care to private patients from the UK and across the world

044 Chelsea and Westminster Hospital: Bringing hope to childless couples worldwide

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After years of enabling fertility for couples in the UK, Chelsea and Westminster’s Assisted Conception Unit (ACU) is hoping to bring the miracle of life to many more couples around the globe

003 Editor’s Letter Welcome to Global Opportunity Healthcare 2015

050 The Chelsea Children’s Hospital 011 George Freeman, Minister for Life Sciences The NHS as a global resource of healthcare expertise

Simon Eccles, Associate Medical Director at Chelsea & Westminster Hospital talks to Sarah Cartledge about his vision for integrated paediatric care

012 W hy the NHS? Howard Lyons, Managing Director of Healthcare UK, explains how the NHS can assist global healthcare development

16 Bringing the best of British to a global audience UKTI’s High Value Opportunities programme helps British businesses win contracts from the world’s largest and most complex programmes say Andrew Snook of UKTI and Chris Dabrowski of EY

020 Leading the way in modern healthcare The NHS is at the forefront of service development and keen to share its expertise, says Professor Rory Shaw, Medical Director Healthcare UK

022 Developing global healthcare systems Innovation is about sharing ideas says Professor the Lord Darzi of Denham

024 EY: Ensuring quality in health and care The UK’s health system is underpinned by world-class regulatory and supporting bodies, which ensure that quality, efficiency and equity are at the heart of every provider

052 Facing The World: Charitable face of the NHS The NHS assists charities such as Facing the World which provides life-changing craniofacial surgery to some of the world’s most disadvantaged and vulnerable children

054 St Mary’s Hospital Paddington: Ground breaking paediatric haematology Dr Josu de la Fuente, clinical lead for haematology at St Mary’s Hospital, Paddington, tells Sarah Cartledge about the haematology transplant innovations giving children better lives

058 Chelsea and Westminster Hospital: Acute care to after care - the complete burns service Chelsea and Westminster Burns Unit offers a state-ofthe-art burns service with capabilities across the whole patient journey

062 Camden & Islington NHS FT: Delivering a modern mental health service Achieving the same level of outcomes for mental as well as physical healthcare is a key objective for a well-developed health and social care system, says Wendy Wallace, Chief Executive, Camden and Islington NHS Foundation Trust

030 Pinsent Masons: Exporting the NHS Demand for better healthcare services overseas means there is more opportunity for the NHS and private sector organisations to export their expertise abroad. But setting the legal foundations is crucial for success, says Carly Caton, Legal Director at international law firm Pinsent Masons

066 Marie Stopes International: Delivering a new era of reproductive health services Universal health coverage will have a profound impact on how the service delivery sector does business, a shift that is firmly embraced by Marie Stopes International says Caitlin Mazzilli, Head of Health Financing

032 Pinsent Masons: Building and operating a hospital Operating a hospital requires a wide range of skills from different organisations with their own risks and delivery profiles. It’s important to analyse each one in order to work out how best to procure and offer these services, says Barry Francis, Partner at Pinsent Masons

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068 The Children’s Trust: Helping children live better lives The Children’s Trust is proud to be the UK’s leading specialist centre for children with brain injury and complex neurological disabilities, says Professor Gareth Morgan, Medical Director of The Children’s Trust

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London hospitals lead the way in independent healthcare, says Fiona Booth, CEO of AIHO, but eastward trends means expertise and treatment are going global

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Global Opportunity Healthcare 2015 5 || Global Opportunity Healthcare 2015 5

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086 AIHO: The UK as a global centre of healthcare excellence

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084 Aspen Healthcare: Leading light in private healthcare

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Contents

Global Opportunity Healthcare 2015 108 NHSBT Filton: What happens to donated blood? The process through which donated blood is tested and processed into different products is fascinating, and it all happens at NHSBT Filton near Bristol, says Judith Baker

112 NHS England looks towards a digital future Beverley Bryant, Director of Strategic Systems and Technology for NHS England on how technology is revolutionising the UK healthcare system

116 F TI Consulting: Rx for Integration The goal of every healthcare provider and underlying system is to improve the health status of patients in a cost-effective/ sustainable way, says Jeff Benton, Senior Managing Director FTI Consulting

120 SmartMed: Mobile phones empower patients to self-manage chronic conditions Mobile technology has the potential to bring better health outcomes for everyone, says Simon Eyre, joint founder of Appdragon SmartMed

Contents

128 XML Solutions: The digital future of healthcare forms Electronic healthcare forms will save time and make it easier for patients and professionals to share information, says XML Solutions

130 NICIC: Digital Health is vital to China’s healthcare reforms A recent project between Nine Health Community Interest Company and the Lantone Technology Company has allowed the British company to access the thriving Asian digital healthcare market.

132 eIntegrity: E-learning: the next level of healthcare training E-learning for clinicians provides quality-assured online training programmes that can be accessed anytime, anywhere says Graham Shaw, Executive Director of eIntegrity

135 nGage: Digital solutions to health improvement It’s time for technology to transform the way we deliver our healthcare says Dr Peter Mills of nGage Health, who has spent 15 years creating digital health solutions

122 11 Health: Helping patients manage their ostomy A device that started life as a direct result of the personal experience of its inventor is changing the lives of stoma users. Patient-turned-innovator Michael Seres is now introducing his product to the rest of the world

124 GreyMatters: A new internet savvy generation Despite its British roots, the real opportunities for digital healthcare lie overseas, says David Ward of GreyMatters

126 TPP: Using technology to drive down the cost of referring abroad ‘Medical tourism’ is a multi-million dollar industry, but the cost of referring patients is also spiralling. TPP looks at how this can be improved

136 Digital Company Profiles 138 Digital Company Directory 140 Leeds Teaching Hospitals: Sharing expertise on the global stage International collaboration is Leeds Teaching Hospital’s long term goal says David Berridge, Medical Director (Operations)

144 FutureLearn: Interactive medical education online Upskilling the medical workforce, effectively for free, is now possible, says Mark Lester, Global Head of Education Partnerships at FutureLearn

146 Yorkshire and Humber AHSN: Overseas partnerships creating pathways to better healthcare Yorkshire and Humber AHSN is leading the way in collaboration with overseas health providers, sharing innovation and business opportunities says Andrew Riley, Managing Director of the Yorkshire & Humber Academic Health Science Network

148 PU PSMD: A flexible solution to healthcare education Whether you’re looking for faculty development, a new career direction, want to improve your promotion prospects or extend your academic knowledge and skills, Plymouth University Peninsula Schools of Medicine and Dentistry (PU PSMD) Masters degree programmes will enhance your medical skills, says Professor Alison Carr, Director of Postgraduate Education

150 QHA Trent: Maintaining standards Independent accreditation can help ensure healthcare providers are genuinely fit for purpose and standards are maintained at home and around the world, says QHA Trent’s Professor Stephen Green

152 Barts: History in the making

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The historic St. Bartholomew’s Hospital in London is undergoing a state-of-the-art regeneration project

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Contents

Global Opportunity Healthcare 2015 157 Carillion: Barts Health Facilities management services supporting the patient experience

158 Carillion: The right way to build a hospital The complexity involved in building a new hospital is huge, which is why an effective Programme Management approach is vital

160 Vanguard: Flexible healthcare with a global reach The ability to quickly provide additional sophisticated operating theatre capacity is enabling providers across the globe to flex their healthcare delivery, says Mary Smallbone, Managing Director Europe at Vanguard Healthcare

162 Elior: Eat well in hospital As awareness of healthy eating increases, food served to visitors and staff at hospitals should be as nutritious and healthy as that prepared for patients

164 F TI Consulting: An integrated approach to healthcare and life sciences The Strategy for UK Life Sciences and personalised health has the power to transform healthcare and the NHS, says Mariyam Rawat, Senior Director at FTI Consulting

166 Life Sciences Organisation: The Importance of Integration in Life Sciences An integrated approach in life sciences can only benefit the patient, says Dr Mark Treherne, Chief Executive Life Sciences Organisation

Contents

175 Heythorp Healthcare: Helping China to meet the challenges of elderly care Elderly Care specialists Heythorp Healthcare are working to raise the standard of elderly and community care in China

177 Caflon: Pharmacies making profit from piercing Ear piercing can be a refreshing and profitable addition to pharmacy services when it’s provided with the right information and support, says Ron Maguire, Sales Manager of Caflon

178 Vernacare System reduces infection risk The world renowned ‘Vernacare System’ of hygienic patient toileting and washing improves standards of patient safety and care. It is proven to reduce infection risk, save money and nurses’ time, while improving environmental performance

180 TECcare: Benefiting from a new approach to infection prevention It is essential to create the cleanest possible healthcare environments to prevent the spread of infection, says Paul Hoff, International Sales Manager, TECcare®

182 Inditherm: The future of patient warming Changing from forced air patient warming to Inditherm Alpha saved money and time for Pennine Acute NHS Trust

184 Versapak: Security seal of approval Strong, durable medical transport bags are essential for security and hygiene says Julie Goddard, Sales and Marketing Manager, Versapak

169 NHS Employers: Investing in staff wellbeing Helping improve staff experience and patient care in the UK and overseas

172 Olympus: Improving the lives of older men The NHS could save millions of pounds while providing better care for prostate patients with the use of the Olympus TURis system.

187 Odelle: Breaking into the UK health market Bringing health products to the UK market need not be problematic for foreign companies, says Steven Haken of Odelle Technology

188 Globus: Hand in glove Effective hand protection increases safety and productivity in healthcare, says Michael Easton, Sales and Marketing Director at Globus

191 ABHI: The shape of healthcare to come Technology is providing answers to healthcare challenges in both developed and emerging countries, says Peter Ellingworth of the ABHI

192 ABPI: Delivering the medicines of tomorrow Medicine development represents major opportunities for UK pharmaceutical companies, says Stephen Whitehead of the ABPI

195 PharmaConsult: Global Health Training Training and guidance is vital for pharmaceutical firms especially those who are hoping to trade overseas

199 Great UK products and services 202 FCm Travel Solutions: Less travel stress, more travel smarts

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The hidden costs of stressed-out travellers on businesses can be huge, says FCm Travel Solutions

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Foreword

| George Freeman

The NHS as a global resource of healthcare expertise The British NHS is already respected around the world as a world-class leader in healthcare. With expert capabilities gained through 66 years of experience the NHS is a fantastic resource of healthcare knowledge and technological advancements. This expertise means the NHS can take a leading role in a broader global push to create more efficient and successful healthcare models. My central mission is to define a world in which governments can view healthcare as not just a cost to the Exchequer but also as a major economic asset. With ever rising healthcare demands, we need to spend every healthcare pound in a way that delivers more care and creates new markets for innovation that attracts international investment to the UK. We need to move away from thinking of healthcare as something ‘done to us’ by government, but something 21st century “healthcare citizens” have more power over ourselves. Prevention, patient empowerment and precision medicines are the watchwords of 21st century healthcare. Over the last year UK health organisations have won contracts worth £550m, £200m ahead of target, highlighting the huge global potential of the NHS. With £10.8bn worth of overseas opportunities identified there is confidence that the UK can continue to improve the quality of healthcare delivery to our valued international partners. Life sciences are about manufacturing as well as research. The production of modern medicines is one of the UK’s leading manufacturing sectors, with exports worth over £22 billion ($35.86 billion). The Medicines Manufacturing Industry Partnership is helping ensure we remain at the forefront of this highly competitive sector, building on the impressive work they have already led in areas like detailed innovation mapping and modern skills investment. Last year I launched a wide-ranging review of the way new drugs and medical devices are developed and adopted in the UK. The aim is to accelerate patient access to innovation while lowering costs for industry and the NHS. I believe new measures outlined in The Innovative Medicines and Medical Technologies Review could shave years off the time

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it takes to bring a drug to market and make the NHS more of a partner in innovation. Key to the strategy will be in aligning the interests of the pharma, biotech and medical technologies sectors with the publicly-funded National Health Service to improve treatment for patients and boost the economy at the same time. NHS leadership in health research is attracting new investment into our life sciences research sector, generating the health and wealth we need to be a modern economy. A Minister for Life Sciences is every bit as much about data, diagnostics and devices; and with the advances in genomics, finding cures for diseases will increasingly come from clinicians working much closer with patient data. We will see more personalised drugs, more devices using diagnostics and informatics, transforming the way 21st century healthcare is delivered. I want to ensure that patients up and down Britain can get access to important medical innovations as soon as possible. By revolutionising the way in which we look at getting medicines and devices into the NHS we will make sure that the UK is the best place in the world for 21st century medical innovation, research, testing and adoption.

George Freeman MP Minister for Life Sciences

The production of modern medicines is one of the UK’s leading manufacturing sectors, with exports worth over £22 billion ($35.86 billion).’

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Howard Lyons

Why the NHS? Howard Lyons, Managing Director of Heathcare UK, explains how the NHS can assist global healthcare development

he National Health Service spends well over a hundred billion pounds a year delivering high quality healthcare to the citizens of the UK. In the process of doing so, it encounters and overcomes many healthcare challenges similar to those faced by other countries across the world. In the 67 years since it was formed, the NHS has not only been at the forefront of many internationallyadopted innovations, such as the CT scanner, ultrasound, MRI, and in embryology and genomics where we are world leading, but it has also developed different models of care which have been emulated around the world. As a result, we feel the UK has a lot to offer, in particular to the emerging high-growth countries that are seeking to improve both the quality of healthcare and as well as access to healthcare. The World Health Organisation has adopted universal health coverage as the preferred model for the delivery of

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Introduction healthcare and nations like China, India, Brazil and many in the Middle East are looking to double their expenditure on healthcare over the next 5-10 years. At Healthcare UK, we think there is a great opportunity to engage with those countries, government to government, to show them not only what the UK can do but to develop relationships where they can access the knowledge and capability of the NHS to enhance their healthcare system There has always been strong international interest in the NHS but it was the Olympic Games in 2012, where the NHS was highlighted and Great Ormond Street Hospital showcased at the opening ceremony, which reinforced that it was accessible for training, education and the sharing of information. Healthcare UK was set up to help UK public and private sector organisations to respond to the growing interest in the way we deliver healthcare in Britain. We launched in the Middle East at Arab Health in January 2013 and subsequently in China, India and Brazil. In every country we visit, Ministers of Health are looking to the UK for an exchange of expertise. We have signed MOUs with the governments of Brazil, Kuwait, Saudi Arabia, China, as well as large provinces in China, and Mexico has recently asked for a renewal of one originally signed in 2002. China, in particular, thinks the way in which we run our public health system, employ our doctors, train our staff, apply performance indicators, our transparency and the degree to which the public is engaged in the delivery of healthcare are aspects they wish to learn from. We recognise that we have evolved our healthcare system to meet the particular needs of the British citizen and our unique cultural values. Of course, its impossible to simply transpose complex systems from one country to another â&#x20AC;&#x201C; they need to be adapted. Every country is different and each culture

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Howard Lyons

HOWARD LYONS Howard has over 30 yearsâ&#x20AC;&#x2122; experience of public and private sector healthcare throughout the UK and in more than 65 countries worldwide, advising on health services management and strategic health sector reform. He spent the first ten years of his career working in the NHS as a senior manager in London Teaching Hospitals. Since leaving the NHS to work in international healthcare with major British companies, he has managed large hospitals in the Middle East and undertaken a wide range of consulting assignments for public and private sector clients as well as for some of the leading development agencies such as the World Bank, Department for International Development, InterAmerican Development Bank and the United Nations.

has a significant impact on the way healthcare is organised. For example, like the UK, a typical Chinese hospital has a pharmacy with all the necessary western drugs but, unlike the UK, they will also have a traditional Chinese medicine (TCM) pharmacy which is more like a small supermarket and is about 5 times the size of a typical pharmacy in the UK. China thinks TCM is a valid complement to allopathic medicine. It claims in support of that notion that the use of quinine in malaria treatment in China dates from the 4th century, long before its effectiveness was recognised by the west. The Chinese private sector has said it wants to validate traditional Chinese medicine in the UK and has asked for our advice. This is an example of where two countries can share knowledge and learn from each other. In our key markets, Healthcare UK is offering British expertise in clinical services, education and training, infrastructure (PPPs), digital health and health system development. We originally used primary care as a focus because we knew that India, China and the Middle East rate our system of family medicine and community care very highly for its quality and value for money. Saudi Arabia is keen to run their primary care system drawing on UK expertise and we have helped to put together a consortium of about 25 different organisations to deliver a major project. In India, we conducted a project in Tamil Nadu to demonstrate what a Britishstyle primary health care system would look like. Now we are expanding the primary care offering to cover clinical services such as oncology, radiotherapy, paediatrics and other specialities. Globally there is a shortage of healthcare professionals. China requires a further half a million doctors to fulfill the OECD and WHO criteria for doctors per head of population. India is looking to train over 6m allied health professionals to build up their capacity. We also have a shortage in the UK but many people come from the EU to train because of our education excellence. They also come from China and India and we are a real magnet for most of the world from a training perspective. We work as closely as we can with British

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Howard Lyons

Introduction universities and with Health Education England to identify places for those who are able to come from overseas to obtain post-graduate training. The Royal College of Surgeons already examines in over 140 countries and soon nearly all the Royal Colleges will be running courses and examinations overseas. Ten years ago, Nottingham University went further and set up a campus at Ningbo in China, Manchester Business School now has a campus in Shanghai and many UK institutions are looking to establish faculties in different parts of the world. There is a process of continuing professional development in the UK; British doctors continue to be reappraised by the General Medical Council and the Royal Colleges to ensure their skills area up to date. But we can use these methodologies abroad or advise other countries on their development to enable them to achieve the sense of security that high clinical standards will be properly regulated and maintained. The UK excels in developing human capital – but we’re good when it comes to physical infrastructure too. The introduction of Public-Private Partnerships in the 1990s to finance the construction and operation of healthcare facilities instigated an unprecedented number of new developments, and British companies involved have learned a great deal in the process. When it comes to planning, designing, building or operating and maintaining a new healthcare facility, or redeveloping an existing one, British companies have a track record of delivering to the highest standards. But of course, the lessons that British organisations have learned through working in the UK need to be sensitively adapted to local conditions in order to work. Moorfields in Dubai is a relevant example. In their planning, they had to factor in the reality that while in Britain the conversion rate from an outpatient

‘The UK excels in developing human capital – but we’re good when it comes to physical infrastructure too’.

Howard Lyons

attendance to undergoing a surgical procedure is around 2:1, in the Middle East the prevailing culture is to shop around to get second and third opinions so the conversion rate is closer to 10:1. This difference affects facility planning and staffing as well as financial feasibility. A mayor in China recently approached Healthcare UK to help him devise a healthcare system for a city three times the size of Birmingham. He has been tasked by central government to increase the size of his city from 1million to 5 million and he needed a proper healthcare infrastructure to deal with this rapid increase. He was planning to build several large hospitals on the basis that the average length of stay in hospital in China is 9 days; here in the UK it is more like 3 days because we undertake a lot more day surgery. So if we can help the Chinese develop facilities to undertake more day cases then they won’t have to build so many hospital beds. And with a well-organised primary healthcare system, many patients will not need to come into hospital at all. So they are currently looking at building a 1000 bed public hospital at the apex of their healthcare system but with UK-style family doctors acting as the gatekeepers. Governments want to develop their own high quality facilities as it is easier and less expensive than flying patients to London. However medical information is asymmetric. You don’t know what you don’t know about your own condition and rely on the doctor’s knowledge for advice on the best course of treatment. International patients come to London - often paid for by their government - because they trust the integrity of British doctors; they feel they will not only get a correct and unbiased opinion but they will get treatment that is appropriate to their condition not something that lines the pockets of the doctor or his hospital. The integrity of the UK and our healthcare system is really important to overseas patients and governments. Hence the significance of the reputation of world-leading institutions like Great Ormond Street and Guy’s and St Thomas’s Hospitals. Digital healthcare is another area where the world is on the cusp of a major revolution in healthcare delivery. Here British companies are at the forefront of innovation and software development, creating apps and devices that relay information to doctors who can respond immediately without necessarily needing to see the patient. As this continues apace, the UK will be able to share its knowledge with other healthcare providers to provide a targeted and personalised patient experience aimed at prevention and early intervention. So here in the UK we have a wealth of knowledge available to share, along with the experts and equipment necessary to achieve any outcome. What we have to offer is unique in terms of both its quality and breadth. So do let us know how we can assist you – our aim is to find the right solution for your needs.

Further information www.gov.uk/healthcareuk

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HVO Programme

UKTI’s High Value Opportunities programme helps British businesses win contracts from the world’s largest and most complex programmes say Andrew Snook of UKTI and Christopher Dabrowski of EY

The High Value Opportunities Programme –

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Bringing the best of British to a global audience

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Introduction

HVO Programme

stablished in 2011, UK Trade & Investment’s (UKTI) High Value Opportunities (HVO) Programme targets around 100 major projects globally, covering a wide range of markets and sectors. Using expertise from across its international network, together with other Government departments and the private sector, it provides UK companies with in-depth advice as well as access to the full range of financial and political support. Since the Programme started, it has supported UK companies at all levels of the supply chain to access more than £19 billion of contracts.

Accessing high-growth markets High-growth markets such as Brazil, China and India all expect significant import growth between 2015 and 2020. This growth is in part due to the rise of the global middle class. The OECD forecasts that this will double to almost five billion by 2030, representing a great opportunity for UK firms to export the types of products and services at which we excel. Characterised by an increasingly urban population these countries are looking to British businesses to provide the infrastructure, education and healthcare systems that are necessary for their burgeoning middle class. Opportunities exist throughout the supply chain for British companies with the necessary expertise. Rich in natural resources, many of these highgrowth markets are pushing extractive industries into progressively more remote locations, which in turn require increasingly sophisticated technology to exploit the opportunities. The UK’s strong track record in how to manage risk and drive efficiencies in the exploitation of this natural mineral wealth make British companies a partner of choice. Investment decisions increasingly have to balance wider national economic benefits with bidders’ technical and commercial propositions. Successful bidders have harnessed these local content and joint venture partnering requirements to win in-market, as well as bringing innovative financing solutions that lessen the impact of capital expenditure on government budgets. The HVO programme provides UK businesses with support from a wealth of resources, including ministerial visits; expert sector knowledge; access

WORKING WITH UK BUSINESSES IN OVER 40 MARKETS The HVO Programme was established in 2011 as the cross-Government focal point for supporting business’ access to major capital programmes. Its vision is to support UK industry to win work on projects overseas with a value of over £500m in size. These range in size from £500m to £30b, and sit across sectors as varied as Experience Economy to Rail and Nuclear. These are the world’s most complex programmes, with UK firms competing for contracts spanning design and engineering to delivery of major global events and operation of transport systems to aircraft components.

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HVO Programme

to ambassadors; and relationships with overseas governments. And while the UK’s established engineering businesses in oil & gas, aerospace and rail are a key part of the programme, sectors in which UK intellectual property is world-leading, such as sustainable urbanisation, the experience economy and airports, are increasingly prominent. Most recently, in Mexico, UKTI supported Foster & Partners and Arup on the master planning and design bids for the New Mexico City airport project. Fosters winning design was announced in September 2014. This will help the UK supply chain when the project progresses through various phases over the next 5 years. UKTI also facilitates in-country partnership development. In Kazakhstan, UKTI has been instrumental in the formation of partnerships between UK and Kazakhstan. Working in partnership with key UK Oil & Gas majors these partnerships have developed to represent a sustainable route to UK-Kazakhstan trade that brings supply chain growth in the UK and enables new sources of employment in Kazakhstan. The UK’s skill in delivering services in highly regulated environments such as sports, aviation and urban light rail are highly prized by governments looking to provide their citizens with leading-edge services. Nowhere is this more apparent than in the healthcare sector.

Bringing UK healthcare expertise to the global market Through Healthcare UK, UKTI works in partnership with the Department of Health, NHS England and the UK supplier base to bring leading clinical expertise and hospital management experience to the world’s largest healthcare reform programmes. The NHS model is viewed as a shining example by governments throughout the world and by using this brand recognition we are able to introduce UK businesses to contacts at the most senior levels across all healthcare HVOs. Global healthcare opportunities exist for the UK’s small and medium-sized businesses as well as larger firms. These opportunities encompass all sectors of activity including design and planning; education and training; clinical services; regulation and best practice; professional services; medical technology; and hospital management. Our successes reflect this diversity – we have provided support to businesses as varied as a large international hospital management company to a West Midlands-based seating manufacturer.

Connecting British medical technology with local buyers Because many healthcare procurement decisions are made at a local level, building relationships with a large number of geographically dispersed buyers can prove a challenge for many UK businesses. UKTI’s HVO programme is designed to break down these barriers and put British businesses in touch with decision makers. In Brazil for example, we have been working with a major UK medical technology

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‘Using existing connections between UKTI, Healthcare UK and Brazilian state leaders, we have been able to introduce the supplier to key Brazilian decision makers in each targeted state’. supplier to develop a strategy for market entry and development across 26 Brazilian states. Using existing connections between UKTI, Healthcare UK and Brazilian state leaders, we have been able to introduce the supplier to key Brazilian decision makers in each targeted state. Our support enabled introductions for the company at levels of seniority they would otherwise have been unable to achieve in similar timescales. Working with the Embassy and International Trade Advisers, UKTI has provided on-going advice and support to the supplier for over 12 months.

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Introduction

HVO Programme

CHRISTOPHER DABROWSKI Christopher is the HVO Programme Manager for EY. Having joined EY’s London office in 2007, he has over ten years’ experience advising multinationals on international growth in highly regulated sectors. Working with UKTI, he leads the global team of Business Specialists and Project Managers who work with UK companies to win business overseas. Christopher was lead author of the “ADS Group International Defence Market Strategy” in 2012 and 2013. He has been published in numerous periodicals and professional journals.

ANDREW SNOOK Andrew is the Assistant Director for the High Value Opportunity Programme at UK Trade and Investment (UKTI) in London. He joined UKTI in 2011 from the Foreign and Commonwealth Office with over 20 years’ experience in a variety of roles both in the UK and overseas.

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Delivering UK healthcare management expertise to the world UKTI and Healthcare UK worked with a number of UK organisations to support an organisational review for the Kuwaiti ministry of health. The introductions we arranged in London have since led to a medium-sized UK consultancy winning a contract to undertake a study and produce recommendations. UKTI and Healthcare UK are also supporting a small IT provider to introduce a patient referral system specifically for Kuwaiti patients travelling to Europe for treatment; and an NHS Trust to provide management services for a newly constructed mega-hospital. These both required high level, longterm influencing and representation in Kuwait with government and ministry officials. Similarly, in Saudi Arabia, the Healthcare UK team has played a key role in supporting UK consortium wins in the medical training market. This will put UK education and training expertise at the heart of the Kingdom’s next generation of clinical practitioners. Sharing experience and expertise in healthcare reform and infrastructure investment The Turkish Government’s hospital development

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programme is the world’s largest PPP programme. In order to implement it, the Turkish Government has actively sought international support and expertise. UKTI worked with UK suppliers to bring valuable experience gained in the UK and elsewhere, to the Turkish healthcare sector and incorporate it into local thinking. We are now supporting businesses involved in the strategy formation, monitoring and regulatory development. Key to this has been an awareness raising programme for the Ministry of Health and key local players. UKTI and Healthcare UK welcomed several senior Turkish ministry officials and buyers to the UK in 2014 for an intensive programme of education and guidance which has created a highly positive impression of the UK’s capabilities in financing and project delivery that will continue to benefit UK suppliers in Turkey. Once again, the opportunities for UK businesses are present throughout the supply chain and encompass companies both large and small. So far these have included a UK legal firm, a health planning company and a specialist laboratory consultancy firm.

Government’s focal point for export promotion As the global recovery gains steam, the High Value Opportunities Programme will continue to be at the centre of efforts to bring the best of British to bear globally on the world’s most complex programmes.

Further information To find out more about UKTI and how its HVO programme can help your business, visit: www.ukti.gov.uk

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Professor Rory Shaw

| Leading the way in modern healthcare The NHS is at the forefront of service development and keen to share its expertise, says Professor Rory Shaw, Medical Director Healthcare UK

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documented in their 2014 report that the UK healthcare system was the best overall, in particular for quality, access and efficiency. The English healthcare system has four component parts. The government provides the funds from the taxpayer and through the Department of Health sets overall policy. NHS England and a number of commissioning organisations then plan and commission services at a National, regional and local level. A broad range of providers, predominantly from within the NHS, deliver full range of services including primary care, secondary care, tertiary care, as well as community and mental health. The final components of the service are those organisations that set standards, monitor and regulate. These organisations provide assurance to the commissioners, the Government and the general public that the quality and the outcomes of

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aving worked the majority of my career in the NHS, I continue to be impressed by the scope of the ambition. The NHS aims to offer all best modern treatment, to all citizens, in all places, at all times. It offers a number of world-class institutions and a number of major medical breakthroughs each year, and it does all this for less than ÂŁ8 per person per day. The NHS is a system for providing healthcare rather than a number of institutions. The system is characterised by three features. It is universal and offers care to all; it is organised with comprehensive planning and oversight; and it is integrated so that individuals can access multiple services from the system in a seamless manner. The independent organisation the Commonwealth Fund based in New York compared healthcare systems in eleven developed countries, and

Introduction care meet the highest standards. These regulating organisations place the outcome of their work in the public domain so that there is complete transparency over the quality of care provided by the NHS. The clinical pathway for patients in the NHS has at its heart the general practitioner (GP) or family doctor. All citizens in the UK have a personal general practitioner who they visit when they have a medical problem, and 95 percent of all medical problems are resolved by a visit to the GP. This doctor can order tests and, if necessary, arrange for a consultation with a specialist in hospital. After the consultation, an admission or any procedures, the patient returns to the care of the GP who can monitor them and offer follow-up care. The GP is at the centre of a primary care team which includes nurses, pharmacists and social workers etc. This team is able to ensure that, for example, children have all the necessary inoculations, adults are screened for illnesses and given necessary lifestyle advice, and those with long-term conditions and the elderly are managed effectively to prevent medical crisis and admissions to hospital. GPs are also supported by a range of organisations providing direct care to patients, which is delivered outside the hospitals via a number of community healthcare provider organisations. Many countries are interested in developing a similar system for primary care. The Royal College of General Practitioners is actively engaged in many countries in programmes of training examination and accreditationÂ for doctors in this specialty. Some of the community providers are also delivering services internationally. Preventing illness is far preferable than relying on treatment once a disease is established. Public Health England is a large organisation charged with monitoring the health of the population and bringing in measures to prevent disease. On a daily basis they collect data from every area of the country on common illnesses such as flu and infectious diarrhoea. Public Health England run national screening programmes for common conditions such as cancer. They have particular programmes to prevent illnesses when large numbers of people gathered together, for example at the Olympics. They also offer a rapid response for international crisis such as the current Ebola epidemic in West Africa.

Emergency response A rapid efficient response when an individual person has a crisis is vital. London Ambulance Service ensures that ambulance crew equipped to offer resuscitation, defibrillation and ventilation will arrive in central London within four-and-a-half minutes of the emergency call. Patients with specific problems such as a heart attack, stroke or major trauma are taken to one of the designated centres where there is all the expertise required to achieve the best possible outcome. UK hospitals work within networks. This ensures that all the expertise required for every type of clinical problem is available in one of the hospitals within the network. Many of the specialist hospitals

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Professor Rory Shaw

PROFESSOR RORY SHAW Professor Shaw has been a medical director in the NHS for over 15 years, latterly at North West London Hospitals Trust, and previously at Royal Berkshire Foundation Trust and Hammersmith Hospitals Trust. He has also held national roles as non-executive of the NHS Litigation Authority and previously as the first Chairman of the National Patient Safety Agency. He is a consultant respiratory physician.

within the different networks are internationally recognised. Hospitals such as the Royal Marsden, the Christie, the Brompton, Great Ormond Street, Moorfields, as well as the large teaching hospitals - Guys, Kings, Leeds and Birmingham - are all well known. In mental health, the Maudsley and Broadmoor are recognised names and sit within larger Mental Health Trusts. An important aspect of these large well-recognised organisations is their contribution to both research and development, as well as to postgraduate training. There is an intimate link between the major hospitals and universities. The UK has some of the best universities in the world including Oxford, Cambridge, Imperial College, University College London and Kingâ&#x20AC;&#x2122;s College etc. This close relationship with the NHS allows rapid development of scientific advances and an exciting intellectual environment in which to receive training. An example of the benefit of this relationship is the development in England of a national programme for genomic and personalised medicine. This is based on the British developments in science, starting with the discovery of the structure of DNA by Watson and Crick in Cambridge, and more recently the work on the decoding of the human genome at the Sanger Centre. The understanding of the genetic code and the ability to type the whole genome of individual people offers the opportunity to identify those at high risk of disease and to initiate prevention, as well as to ensure that specific therapies are given to those who are genetically predisposed to benefit, and not to those who will have side effects. The NHS is creating a network of Genomic Medicine Centres to ensure that the benefits of these discoveries are available to over 50 million people. The needs of individuals and populations of patients are constantly evolving in the face of changing demography, social and lifestyle factors, as well as changes in pathogens and new emerging technologies. Healthcare systems have to be able to respond and change to meet these developments. The NHS is always at the forefront of service development, and is keen to share ideas and partner with other countries who are facing similar challenges.

Further information www.gov.uk/healthcareuk

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Professor the Lord Darzi of Denham

Innovation is about sharing ideas, says Professor the Lord Darzi of Denham

Developing global healthcare systems

ord Darzi is Director of the Institute of Global Health Innovation at Imperial College London and is leading the charge for international health reform. Here he discusses innovation, investment and the role the NHS continues to play. You have been very involved in helping to develop healthcare around the world, particularly in the Gulf region. What are the major challenges? We hold a global summit in Doha, attended by policy makers, academics and industry leaders from across the globe to share radical innovations that have made a significant impact on healthcare. We held our first meeting there in December 2013 and the next is on the 17th and 18th of February this year. We expect one thousand leaders in healthcare reform to attend including delegates from the Gulf region but also from America, Europe and Asia. Every year we choose a number of important themes for discussion, including this year how to deliver affordable cancer care, programmes for tackling the global epidemics of diabetes and dementia and measures to promote childhood mental well being in schools and at home. Qatar stands at the leading edge of innovation making impressive investments in science, technology and medicine to develop a robust healthcare system that meets its own local needs. I have been very impressed with the speed at which reforms are being implemented there, as well as in the rest of the Gulf region. Most importantly, Qatar is working to avoid the mistakes made in Europe and the US by developing its own systems to match its own needs. What role can the NHS play in the development of these foreign systems? The NHS has been around since 1948 and it has transformed itself many times over the years. If you look at the cost of the NHS per head of population

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it provides excellent value for money. The NHS has many unique characteristics which have provided a valuable touchstone for countries developing their own healthcare systems, such as the emphasis on primary care, which is the rock on which the NHS rests. Many countries are keen to develop their own primary healthcare systems and the NHS has a very long history of supporting such services. Do you think this collaboration can be equally beneficial for the NHS? Absolutely, there is a lot to learn from elsewhere. Innovation is happening globally, including in the emerging economies. It is all about co-learning and the co-sharing of ideas. Co-production is also important, and the NHS is in active partnership with many systems across the world. I personally think that for the NHS to be involved in this exchange of ideas is very exciting. The NHS is of course a government system. How much do you think governments should be involved in healthcare systems around the world? Most healthcare systems are in one way or another government based. Some are insurance based but even the United States, which probably has the largest private health system in the world, still relies on government for pricing and regulation so you cannot dissociate the governmentâ&#x20AC;&#x2122;s role. Do you think the opportunities for inward investment from overseas can be beneficial to the NHS? It depends on what the opportunity involves. Most healthcare systems are struggling in terms of finding new ways of funding health and health care needs because of escalating costs. So while there are of course financial benefits, I believe the opportunity is still there to adopt innovations which improve quality and reduce cost rather than depending on overseas investment.

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Introduction

Professor the Lord Darzi of Denham LORD DARZI Ara Darzi, Baron Darzi of Denham, is one of the world’s leading surgeons at Imperial College London. Professor Darzi holds the Paul Hamlyn Chair of Surgery at Imperial College, the Royal Marsden Hospital and the Institute of Cancer Research. He is Director of the Institute of Global Health Innovation at Imperial College London and he is an Honorary Consultant Surgeon at Imperial College Hospital NHS Trust. In 1991 he was appointed as a consultant surgeon at Central Middlesex Hospital at the age of 31 and then moved to St. Mary’s Hospital in 1994. In 2002 he was awarded a knighthood for his services to medicine and surgery and subsequently elevated to the peerage in 2007. He was appointed to Her Majesty’s Most Honourable Privy Council in June 2009.

You have suggested some pioneering health measures in your report for health in London. Did you take a new approach to this report? Better Health for London was a radical plan. It had 68 different recommendations some of which tackled major public health challenges such obesity and smoking and some of which were designed to improve health care delivery . London’s population was segmented based on disease, age and needs which allowed us for the first time to recommend new ways of delivering healthcare to meet the expectations of the population of London. Moving forward, what health innovations are you most excited about in the coming years? One of the most exciting areas we are looking at is the concept of frugal innovation. These are lowcost, high-impact innovations which are having a significant impact in the developing world. Process innovation is an area which does not need huge financial investment. It could be very cheap but have a big impact. The most common one I use is the surgical checklist which is used to checks basic details before and after an operation. It takes only

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3-4 minutes to do, costs less than 50p and has reduced deaths and complications. When you were working as a government adviser did you find it beneficial to continue as a practicing surgeon? The main thing it did was keep me grounded. I was dealing directly with patients, which was good as I think the most important component is to listen to the users of the service. I have had the privilege of being both a practicing clinician and involved in government, which was key to understanding the dynamics of the front line as well as understanding the relationship between the patients and their provider. So yes the combination was extremely useful, definitely. And as a final point, are you optimistic that the NHS will survive and continue to be the dynamic institution that it is today? The NHS has survived many changes and been through many governments over the years. It is part of our social fabric and we care for it. It will always be there for those who need it.

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Regulations

The UKâ&#x20AC;&#x2122;s health system is underpinned by world-class regulatory and supporting bodies, which ensure that quality, efficiency and equity are at the heart of every provider

Ensuring quality in health and care

n June 2014, the UK was ranked first out of eleven of the worldâ&#x20AC;&#x2122;s best healthcare systems in a report by The Commonwealth Fund (a USbased research organisation). This reinforces the respect the international community has for the 66 year old National Health Service. It also provides evidence that UK patients have access to the best quality healthcare system on earth, accessible and delivered in a timely and efficient manner. The UKâ&#x20AC;&#x2122;s health system is underpinned by worldclass regulatory and supporting bodies, which ensure quality, efficiency and equity. Over the last few decades, the NHS has developed strong standards and governance for its integrated health system, giving sixty million UK citizens assurance. It is the assurance that their local provider will deliver safe, effective and equitable care, which demonstrates value for money for the taxpayer and delivers quality outcomes for patients. The UK is therefore well placed to advise and support other countries in the strategic development of their health systems. Healthcare in the UK is a rich ecosystem of public and private sector bodies operating within a strong regulatory and support framework. Both provider organisations and the professionals working within them are subject to assessment against national standards to ensure that they continue to deliver high quality care and ultimately achieve the best outcomes for patients. Provider organisations are supported in achieving the best possible services for patients by national support services and information systems, which in turn provide expertise which can be leveraged to develop strategic planning and guidance for the whole system.

The CQC makes sure that all healthcare services provide people with safe, effective, compassionate and high-quality care; and requires providers to improve where they fail to meet these standards. Every healthcare provider, public and private, is registered with the CQC, which monitors, inspects and regulates services to ensure they meet fundamental standards. Without CQC registration, an organisation cannot provide healthcare services

Regulation of organisations Regulation of healthcare providers in England comprises two main elements: regulation of the quality and safety of care, and regulation of the market in health care services. The Care Quality Commission (CQC) performs the former, whilst Monitor performs the latter. Each of these organisations is independent of the organisations they regulate, allowing them to challenge practices and take action where failings occur.

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Introduction in the UK. All reports and results of inspections are publicly available, which empowers patients to choose between providers. The application and enforcement of universal standards ensures that each and every patient is able to access the best standard of care, as close to home as possible. Monitor’s primary duty is to support and protect patients’ interests by promoting the provision of healthcare services that is economic, efficient and effective, and maintains or improves their quality. Their regulation responsibilities cover the provision, pricing and procurement of health services, working closely with other regulators and national bodies to ensure a joined up approach. Monitor ensures that healthcare providers are well-led and are able to deliver quality care on a sustainable basis. They do this by setting the governance and operational standards that all healthcare providers must meet to be eligible for the provider licence that they issue. This approach supports a sustainable, well managed health system in the UK, allowing for action to be taken at the earliest opportunity to protect, maintain and improve patient services. The function of these organisations is vital to ensure that those organisations responsible for the provision of healthcare keep service-users at

Regulations

the centre of their care, and to create a culture of openness and a goal of high performance.

Professional regulation and standards Another key function is carried out by the professional regulators, who are in turn overseen by the Professional Standards Authority (PSA). The PSA uses ‘right-touch regulation’ to provide a strong, independent voice for service users and the public in the regulation of health and care professionals throughout the UK. The PSA monitors policy developments in the UK and internationally and provides advice on issues relating to professional standards in health and social care. There are nine professional regulators overseen by the PSA, of which the two best-known are the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC). The GMC helps to protect patients and improve medical education and practice in the UK by setting standards for students and doctors. The NMC offers similar value to the professions of nursing and midwifery. The UK has some of the most highly skilled and empowered nurses in the world; and the midwifery profession is a distinct specialism in the UK. Both organisations support professionals in achieving and exceeding national standards, and

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Introduction

Public Health England (PHE) was established in 2013, formed from a multitude of different public health bodies in the UK. PHE was set up to support the public in, and lead the debate on, protecting and improving their own health. It also prepares the UK for public health emergencies, building on the excellent work that the country had developed under previous auspices (such as containing the flu pandemic). PHE then conducts research and collects data and shares that information with all the relevant local bodies so that all can work together to address health challenges. PHE is the gold standard for a national public health provider, demonstrating to the world the benefits of placing public health at the heart of government for the purpose of health protection,

‘Healthcare in the UK is a rich ecosystem of public and private sector bodies operating within a strong regulatory and support framework.’

surveillance, immunisations, health promotion and emergency preparedness. PHE has recently been active in responding to large-scale global public health emergencies such as the Philippines typhoon in 2013 and Ebola in West Africa in 2014, as well as contributing to international public health activities such as the International Health Regulations.

Support services There are also public bodies which provide coordinated support services to the National Health Service, ensuring that all providers have access to a consistent support function, whilst capitalising on economies of scale and the strategic oversight of a national body. For instance, NHS Blood and Transplant (NHSBT) not only carries out the processing and distribution of blood products and organs but also conducts a significant amount of research on the data it collects, driving developments in transfusion and transplantation. Furthermore, NHSBT already works in countries abroad to develop others’ blood donation services, particularly Malawi and Uganda. NHS Supply Chain provides a one-stop healthcare products and supply chain services to the NHS, procuring and delivering anything from gloves to implants and MRI scanners to NHS hospitals. This end-to-end supply chain ensures that the right

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products get to the right place at the right time at the lowest possible cost to individual organisations and the taxpayer. Since its inception in 2006, NHS Supply Chain has delivered over £700 million worth of savings to the NHS, freeing up funds to be directed at providing improvements in patient care and ensuring the financial sustainability of providers.

Information systems In 2012 the Department of Health published the new information strategy, called ‘The Power of Information’. The UK has extensive knowledge and experience in the development, maintenance and improvement of Health Information Systems, which has now been consolidated within the Health and Social Care Information Centre (HSCIC). HSCIC brings together knowledge and implementation skills for data, information and IT systems across the span of the health sector. Not only does HSCIC cover health and social care, but it understands how to take disparate data from the entire health space in order to produce reliable indicators and products which allow key decisions to be made. HSCIC is well-versed in working on the global stage to help develop meaningful standards in health information. This knowledge is crucial for the interoperability of data and systems, without which it becomes very hard for providers to share information in order to improve the safety, quality and efficiency of care. Recently HSCIC secured international status for the UK as an expert centre for global health classifications. It is committed to improve health through ongoing development, maintenance and promotion of an integrated suite of health classifications that provide information of value and utility across the world.

Standards and guidance There are highly respected organisations within the UK health system which provide standards and guidance, including the National Institute for Health and Care Excellence (NICE), the Human Fertilisation and Embryology Authority (HFEA), and the Human Tissue Authority (HTA). Since 1999, the National Institute for Health and Care Excellence (NICE) has provided the UK health system with an increasing range of advice on effective and affordable healthcare interventions, and has gained an international reputation for rigour, independence and objectivity. NICE does this by providing guidelines in four broad areas: the use of health technologies within the NHS; clinical practice; guidance for public sector workers on health promotion and ill-health avoidance; and for social care services and users. NICE guidelines can be used by the NHS, local authorities, employers, voluntary groups and anyone else involved in delivering care or promoting wellbeing. However, NICE International was established by NICE in 2008 in order to assist other governments to interpret and apply evidence to their policy, as well as providing more technical support. They have since collaborated with over 60 countries

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Public health: protection, prevention and improvement of the nation’s health

Regulations Regulations

take action when standards are not met. These two organisations ensure that, for example, every doctor and nurse in every GP surgery in the country follows standard practices.

Regulations

Introduction as well as contributing to the international process for assessing guidelines. The Human Fertilisation and Embryology Authority (HFEA) regulates and inspects services that conduct in vitro fertilisation, artificial insemination and the storage of human eggs, sperm or embryos. At its inception, the HFEA was the first organisation of its type in the world, and led global thought in its approach to the complex ethical considerations surrounding the work it sought to regulate. The HFEA has been ground-breaking in its policy decisions compared with other similar organisations around the world, for example, work on stem cell research and the creation of the HFEA Horizon Scanning Expert Panel, drawn from international experts. The Human Tissue Authority (HTA) regulates organisations that remove, store and use human tissue for research, medical treatment, post-mortem examination, education and training, and display in public. They also give approval for organ and bone marrow donations from living people. The regulation of human tissue by the HTA gives patients and their families more confidence that their wishes will be respected, that organs and tissue used in treatment will be safe and high quality; and that tissue used for research or other purposes will be put to the best possible use.

‘Over the last few decades the NHS has developed strong standards and governance within its integrated health system.’ By fostering this trust, the HTA hopes more people will be willing to donate their tissue for scientific and medical research, their organs for transplants, and their bodies for medical education and training. It is in this way that the HTA can help healthcare to flourish.

Strategic planning and oversight Over fifty countries are experiencing an acute shortage of healthcare workers. The UK’s response to long-term workforce planning was to set up Health Education England (HEE), which, in addition to guaranteeing the future supply of health professionals to avoid any shortfalls, also works to bring consistency to the skills of carers, and to improve the education of health workers and make that education more responsive to emerging needs. The driving principle for reform of the education and training system is to improve care and outcomes for patients and HEE exists for one reason alone – to help ensure delivery of the highest quality healthcare to England’s population. If a country wants to achieve this, it needs to show clear leadership when planning and developing its workforce, in a way that

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Regulations

is responsive to the changing needs of patients and communities and with resourcing decisions that are transparent, fair and efficient. Of course, it needs to ensure that the supply of professionally qualified clinical workforce is secure and safe to patients, but it also needs to consider how best to spread innovation across its health systems in order to improve quality of care.

The future: harnessing UK expertise to improve health systems and standards Over the last few decades the NHS has developed strong standards and governance within its integrated health system, giving sixty million citizens the assurance that their local provider will deliver safe, effective and equitable care, which demonstrates value for money for the taxpayer. The organisations described above, though not exhaustive, serve to demonstrate how regulatory and supporting organisations ensure that each individual provider and professional is held to worldclass standards of delivery, putting the patient at the centre of everything, whilst ensuring that quality, efficiency and equity are at the heart of the system. From the Care Quality Commission’s focus on current quality, to Health Education England’s strategic management of the future healthcare workforce, UK healthcare providers are held to the highest standards of delivery and supported to develop successful and sustainable healthcare into the future. The NHS is built upon the principle that every citizen deserves equal access to the best possible standards of healthcare; and the UK is therefore well placed to advise and support other countries in the strategic development of their health systems. Although not all of the organisations outlined above are able to offer services in the immediate term, there exists a plethora of public and private organisations within the UK that have co-developed and learnt from these approaches and are able to assist international partners in establishing highquality and accessible healthcare for their citizens. Healthcare UK’s key role is in helping international partners access this expertise, having been established as a focal point for the formation of healthcare partnerships between UK organisations and healthcare providers around the world. As a joint initiative between the Department of Health UK Trade and Investment and NHS England, Healthcare UK has in-depth knowledge of the expertise available in the UK in both the NHS and the commercial sector. This means that it is also strategically placed to bring together consortia of UK organisations to deliver comprehensive solutions to healthcare requirements, however complex. Drawing on UK Trade and Investment’s network of professional advisors in over 100 countries, Healthcare UK works with governments and healthcare providers around the globe to co-develop healthcare solutions.

Further information www.gov.uk/healthcareuk

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Pinsent Masons

Exporting the NHS Demand for better healthcare services overseas means there is more opportunity for the NHS and private sector organisations to export their expertise abroad. But setting the legal foundations is crucial for success, says Carly Caton, Legal Director at international law firm Pinsent Masons

ritain has been leading the way in healthcare innovation since 1948, with the formation of the NHS. Over 60 years later the UK is still at the forefront of global health provision. Many aspects of healthcare are becoming increasingly global, assisted by technology and driven by the changing economic fortunes of many countries. As a result of this, countries are looking to Britain for best practice guidance in healthcare provision and in setting up healthcare units and hospitals. US-based research organisation The Commonwealth Fund published a report in June 2014 ranking the UK number one against eleven of the worldâ&#x20AC;&#x2122;s best healthcare systems. The results signal that the global healthcare market can learn a lot from the UK. Given the current demand for better healthcare services internationally, Pinsent Masons is

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working with NHS organisations and private sector organisations who deliver healthcare services in the UK to export their expertise abroad. We are also working with Healthcare UK and UK Trade and Investment (UKTI) in relation to an international hospital management initiative.

International experience When setting up a project across borders, experience of the local market and legal requirements is vital. Many opportunities, including most of the larger ones, will require collaborative working between providers and possibly a mix of NHS and private sector providers. We help structure arrangements between the collaborators to align their interests in service delivery. There can also be significant cultural differences between providers or between provider and customer which can affect negotiations and the successful delivery of the contract. Our long-held expertise in cross border transactions and public/ private partnering can alleviate the impact of these issues. Some of our NHS clients have not formed contractual relationships outside of England before and therefore we can help to guide them through the

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Legal process, from the memorandum of understanding stage where the parties capture their intentions to work together, through to a signed agreement to work together. Some NHS Trusts are at the start of their international journeys and others are already well established in international working. English healthcare providers can work with organisations outside the UK in a broad range of ways. This could range from an organisation providing services such as training, support and shared learning, to an organisation providing services and clinical care, right up to taking over the management of a whole hospital. Many NHS organisations are not at the stage where they could, on their own, take over and run a whole hospital outside England yet for various reasons, the main ones being lack of resource, time, no capital to invest and concerns around protecting brand and reputation. However our experience means we can help at any stage.

Project structure We have experience of working with Trusts on new and innovative areas, and on creating contractual structures and arrangements to suit whatever is trying to be achieved. We work on public/private and public/public contractual arrangements of all kinds, and can help our public sector clients address the twin and often competing imperatives of delivering cost savings as well as income generation. Our work includes financing and building of hospitals; large outsourcings, including clinical and near clinical services in the UK, Sub-Saharan Africa and the Gulf; and new and innovative partnering

Pinsent Masons

CARLY CATON Carly is Legal Director at the international law firm Pinsent Masons. She has worked in the healthcare sector for over 10 years and is currently leading Pinsent Masons’ initiative in exporting the NHS and the globalisation of healthcare. She is advising several NHS organisations in relation to entering into contracts with international hospitals in places such as The Gulf, India and Sub-Saharan Africa, and is working on various international healthcare opportunities.

arrangements, including joint ventures, local asset backed vehicles (LABVs) and mutualisation. We have just been awarded the Istanbul Ikitelli Health Campus PPP Project, our first healthcare PPP Project in Turkey, and have also worked on healthcare PPP projects in places such as Kuwait, Saudi, Dubai, Abu Dhabi, The Gambia and Uzbekistan. We have helped Trusts explore entering into contractual arrangements with hospitals in Europe, India, the Gulf and Sub-Saharan Africa; and as the demand for better healthcare increases internationally we have the expertise to help players continue to develop opportunities in unfamiliar landscapes.

Further information www.pinsentmasons.com

CASE STUDY: HORIZONS CLINIC, THE GAMBIA Description of project: The client requires us to facilitate the development of a private hospital in The Gambia, the revenues from which will be used to fund the hospital’s charitable activities in maternal care. We co-ordinate and deliver all legal aspects of the project, including corporate, project finance, procurement, operations and engineering, procurement and construction (EPC) in the context of the expectations of the international community and Gambian law and practice. The client requires us specifically to: l Incorporate both UK and Gambian-based companies (including all ancillary documentation) to facilitate the raising of equity in UK, Gulf and Gambia l Produce all finance documents (including intercompany loan, common terms and facility agreements and security and agency documentation) l Produce consultancy agreements for both construction/EPC advisors and project managers l Produce both the EPC and the operating contracts (and the associated suite of documents), and assist with the operator and contractor selection. When choosing a law firm, the client required a firm with international expertise, who would be aware of the country-specific issues which could arise in The Gambia. We have over 35 years’ experience of operating

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internationally, and have built up a broad network of contacts with key legal practitioners, accountancy firms, government and public sector bodies, and specialist practices and organisations upon whom we can call to assist our clients in getting the job done. The client also requires advice on the best corporate structure for the project, taking into account funding requirements, taxation and local laws. Our brief included negotiating with funders. Knowledge of Shari’ah law and Islamic finance is key, as well as avoiding the need to liaise with one team on Islamic finance and another for facilities. Our global team has worked with a huge variety of financing structures, acted for many of the multilaterals and export credit agencies (ECAs) and advised procuring entities on some of the world’s largest projects. Significant input on the EPC and operating processes, including advice on appropriate risk allocation, interface between the two and drafting the respective contracts is necessary for the project. We were selected because of our previous health sector experience and our widely-acknowledged reputation for providing sound construction and projects advice. We are able to draw on our previous experience and gain valuable new experience through this project.

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Pinsent Masons

Building and operating a hospital Operating a hospital requires a wide range of skills from different organisations with their own risks and delivery profiles. It’s important to analyse each one in order to work out how best to procure and offer these services, says Barry Francis, Partner at Pinsent Masons

oth across borders and within borders, people are looking for new ideas in delivering healthcare services and bringing global best practice to the benefit of patients and other user groups. The operation of hospitals draws together a wide range of skills, often in different organisations and with their own risks and delivery profiles. In working out how best to procure and offer those services, it is important to analyse each one. This includes looking at what needs to be done by whom; who should be taking what risk on what basis, and who should integrate what risks so as to provide a more complete service to the customer or procurer. In a simple risk integration model, a government or municipality may take full responsibility, and provide everything needed for a hospital itself, or take responsibility of bringing together the necessary goods and services needed to provide a hospital service. It could commission the building, pay for it out of the government treasury, take responsibility for design, and oversee the installation of medical equipment and maintain it. If, for example, it outsourced the catering services, it could take responsibility for making sure the kitchens were equipped and suitably located and directly manage the contract. The range of interconnecting responsibilities is huge.

However, we are increasingly seeing that the government and other procurers such as charities, do not wish to or do not have the resources to integrate all the risks and directly manage the services. In doing so, they turn to other organisations to provide services and act as a risk integrator. Whatever the solution, risks and

Global Opportunity Healthcare 2015

Range of services Looking at the large circle, we have set out at a high level the range of services which may go into delivering healthcare at a hospital or clinic. The outer bands break down the services into groups which help describe which services will be grouped together for risk integration purposes. The core is divided into segments. Not all may be provided. There may be a specialist day centre which has no concern with general medical services, for example. Our model is designed to support any organisation embarking on procuring hospital operational services. Organisations should look at all the

BARRY FRANCIS

Risk integrators

responsibilities will only be properly managed if they are properly understood and allocated. The chart (right) helps us to ‘segmentise’ the responsibilities and see how they can best be integrated and by whom. We see five circles, each segmented to identify key areas of responsibility. It would not be an unusual model for an authority to commission the design and build of a hospital, finance the construction and then let out responsibility for all or some of the operation. It need not be like that, some public-private partnership (PPP) models will leave a private partner to design, build and finance the hospital.

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Barry Francis leads Pinsent Masons Structured Health Solutions business, having spent over 20 years advising and delivering on major commercial and financial projects in healthcare, including 10 hospital PFI deals. Barry’s current and recent experience includes structuring private hospital transactions in England, advising on new delivery vehicles for NHS health provision, financing and building a hospital in The Gambia and various joint ventures in the Gulf.

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Legal

Pinsent Masons

segments in turn, and refine or exclude as many as appropriate for their project. For example there could be an operational, political or legal need to provide all or some of the clinical services. Organisations should also consider which segments to manage directly (if any), and consider whether the market can respond in a cost effective manner to taking risk in the provision of particular services or in wrapping such risks. For example, a healthcare provider may be comfortable providing specialist day care services but not general accident and emergency, and a builder or facilities management provider might be unwilling to underwrite lifecycling costs at a price which is acceptable.

Supply chain Likewise, those planning to supply hospital operating services should consider similar issues. Including whether they have the skills and the balance sheet to manage and absorb responsibility; whether they can manage reputational risk, and could they respond more positively if the payment mechanism was structured so that the owner retained more risk. By working through the issues segment by segment, it is possible to construct a responsibility and risk allocation which meets the optimum or near-optimum allocation to secure value for money and effective provision. This process is not just relevant for hospitals; similar issues and approaches are relevant in primary and community care and in the commissioning of healthcare.

Further information www.pinsentmasons.com

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| Global Opportunity Healthcare 2015

The Royal Marsden

| An introduction to The Royal Marsden Professor Martin Gore, Medical Director at The Royal Marsden, on what the world-leading cancer hospital is offering overseas patients

s Medical Director of The Royal Marsden, I am very pleased to see that the Hospital is increasingly becoming a popular choice for overseas patients. The Royal Marsden is located across two sites in Chelsea, London and Sutton in Surrey. We are a comprehensive cancer centre offering the very best in private patient and NHS care across all tumour types, diagnostic techniques and treatment modalities. We are particularly proud of our patient-focused approach to care and have been providing cancer care since 1851, which makes us the oldest specialist cancer hospital in the world. London is one of the great multi-cultural capitals of the world and an international centre of clinical and academic excellence. The Royal Marsden is at the very centre of this academic activity. We are the

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countryâ&#x20AC;&#x2122;s only National Institute for Health Research and Biomedical Research Centre (BRC) solely dedicated to cancer. We are one of the top three cancer centres in the world and are recognised by similar institutions in the US, Europe and Asia for the excellence of our research and contribution to the very latest advances in cancer diagnosis and treatment. We offer our patients access to world-leading diagnostic techniques, treatments and individualised care plans, delivered by internationally renowned doctors and highly skilled nurses.

Global opinion leaders Our professors, clinicians and nurse consultants, are global opinion leaders and speak regularly at international conferences such as those organised

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Clinical Services

by the American Society of Clinical Oncology (ASCO) and the European Cancer Organisation (ECO). They also contribute to medical journals and academic papers and many are heavily involved in the UK’s response to cancer research and treatment as heads of professional bodies. Overseas patients will often seek out our doctors because of their academic reputations in the specific tumour types they work in. For example, clinicians in The Royal Marsden’s Breast Unit are making breakthroughs in research and improvements in care all the time. Professor Stephen Johnston, Consultant Medical Oncologist in the Breast Unit, is a member of several scientific committees and advisory board, and is Deputy Editor of the international journal Breast Cancer Research. Dr Alistair Ring, who also works in our Breast Unit, has been published widely in peer-

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The Royal Marsden is one of the top three cancer centres in the world

The Royal Marsden

reviewed journals and is regularly invited as a speaker at national and international meetings. Another rising star from our world-renowned breast unit is Dr Nicholas Turner, who is breast theme lead for NIHR trials, and has been identifying some new targeted therapies for women with early stage breast cancer who are at risk of relapse. A leading breast surgeon who works alongside Dr Turner is Mr Gerald Gui, who is on the steering committees of a number of national training courses and is on the trial management committees of national and international studies in screening moderate and high-risk women. Both are known in their field for excellence and innovation and our patients come from far and wide to be treated by them. Another area where we are excelling at The Royal Marsden is within Gastrointestinal (GI)

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The Royal Marsden

cancer treatment and research. Professor David Cunningham is the head of the GI and Lymphoma Unit and Director of The Royal Marsden/ICR NIHR Biomedical Research Centre, which he represents at national meetings. He has published over 500 peerreviewed publications, 45 in the last year alone. Mr Bill Allum is also part of the GI Unit and is the chair of the Oesophago-Gastric Clinical Reference Group, (NHS England Specialist Commissioning), the European Society of Surgical Oncology (European Oesophago Gastric Cancer Audit) and he is also a council member of the International Gastric Cancer Association. And Dr Naureen Starling, a new medical oncologist and researcher published in the field, is helping to develop the GI Unit’s National and International research portfolio and was recently appointed Research Lead for Upper GI Cancers, South London Clinical Research Network. I am also proud to highlight that The Royal Marsden is leading the way in skin cancer treatment and trials, a notoriously difficult cancer to treat. Consultant Medical Oncologist James Larkin, who specialises in skin and kidney cancer, is a member of the National Cancer Research Institute (NCRI) Melanoma Clinical Studies Group and Chair of the NCRI Renal Cancer Clinical Studies Group. Prostate cancer research is also an area of growth for us at The Royal Marsden, and with the addition of equipment such as the da Vinci surgical system, our prostate cancer patients’ prognosis is getting better and better. We are also leading the way in clinical

‘We offer our patients access to world-leading diagnostic techniques, treatments and individualised care plans delivered by internationally renowned doctors and highly skilled nurses.’ Professor Martin Gore, Medical Director

trials. For example, Professor Johann de Bono has led on the development of multiple important new drugs for prostate cancer, including abiraterone, cabazitaxel, enzalutamide and now PARP inhibitors. He received the prestigious ESMO Award in 2012, has also received an award from the Royal Society of Chemistry for his team’s work in developing the drug abiraterone, and leads the Movember London Prostate Cancer Centre of Excellence. He is also the International Lead for the Stand Up To Cancer Prostate Cancer Dream Team. Dr Chris Parker led the randomised international Phase III trial of Radium 223, also known as alpharadin, in the ALSYMPCA trial for advanced prostate cancer, which has also helped change patient standard of care.

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Clinical Services Each patient is assigned a Clinical Specialist Nurse, allowing them oneon-one support

The Royal Marsden

Dr Shelley Dolan joined The Royal Marsden in 1994 as a Clinical Nurse Specialist and in 2000 became the first Nurse Consultant in Cancer: Critical Care in the UK. As Chief Nurse, she has successfully argued for nurses to lead research studies as primary researchers, and there are now 12 PhDqualified nurses working in the hospitalâ&#x20AC;&#x2122;s health services research unit. Dr Dolan is also Clinical Director for the London Cancer Alliance (LCA). The above are just some examples of the leading cancer specialists we employ here at The Royal Marsden. We really are making a significant impact on the global effort to making cancer a disease of the past.

Individual nursing support The Royal Marsden is also unique in how we approach nursing. Each of our patients is assigned a Clinical Specialist Nurse, meaning that throughout their journey, they have one-on-one support available whenever they should need it. We have always been at the forefront of quality and research in nursing to ensure patients receive the best care. We know that the treatment pathway for our patients can be lengthy and complex, from public education and awareness to diagnosis, acute treatment and living with and beyond cancer. So we pride ourselves on training nurses to the highest standards so that they can nurture patients through every step of their treatment. We are also leading the way in the nursing community by engaging closely with our charity partners. For example we have become the first hospital in the UK to employ an Anthony Nolan Clinical Specialist Nurse, specifically caring for leukaemia patients who have just had bone marrow transplants. This is yet another excellent example of how we are always honing our nurses training and expertise in specialist cancer treatment and care and an example of what overseas patients can expect when they arrive at The Royal Marsden.

Unique approach The reputation of the NHS in quality and outcome is also a key reason why we are continuing to see a rapid growth in overseas patients coming to be treated privately at The Royal Marsden, an NHS Foundation Trust. The Royal Marsden is not only a world leading cancer hospital but is also leading the way in both research and development. The hospital is also unique in its approach to treatment and diagnosis. Every patient treated is discussed in a Multidisciplinary Team Meeting and this approach is continued throughout a patientâ&#x20AC;&#x2122;s time with The Royal Marsden, meaning that experts from across the hospital are all involved in deciding the best course of treatment for the individual. We are one of the only hospitals to offer such unique treatment of our patients. The hospital is recognised around the world for its expertise in treating all cancer types as well as its research and clinical trials into cancer genetics and targeted therapy. All this expertise is available to overseas patients opting for private treatment with us.

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| Global Opportunity Healthcare 2015

The Royal Marsden

Both the Sutton and Chelsea sites offer unrivalled facilities, cutting-edge technology, a comfortable and modern environment, state-of-the-art surgical theatres and countless private rooms.

Pioneering treatment and technology Our private patients have access to pioneering treatment and leading edge technology. Examples include CyberKnife, an advanced radiotherapy machine which uses image guidance to deliver radiotherapy with pin point accuracy to affected areas; Neo-adjuvant chemotherapy is given to patients before surgery who have been identified as likely to benefit from this through genetic testing, and the minimally invasive da Vinci S robotic surgery system significantly reduces the amount of time it takes patients to recover from operations. Another such example of this state-of-the-art technology which will be available to patients of The Royal Marsden is the MR Linac system. The Royal Marsden and The Institute of Cancer Research will become the first institutions in the UK to own one of world’s most advanced radiotherapy machines, thanks to a £9.6 million grant. The MR Linac system combines an MRI scanner and a linear accelerator. Once fully developed for the clinic, it will enable more accurate targeting of tumours immediately before and during treatment, particularly of those that move such as prostate, lung and breast cancers. In addition to the above, the Sutton site houses the internationally-acclaimed centre of excellence for paediatric care, which includes the multi– million pound Oak Centre for Children and Young People. And in Chelsea the Rapid Diagnostic and Assessment Centre (RDAC) is located, which is a one-stop-shop for quick and accurate diagnosis and testing, significantly reducing waiting times for patients. We have also recently invested in the brand new Reuben Imaging Centre, which is equipped with the latest technologically advanced MRI scanners and CT scanners, thanks to £6.9 million raised by The Royal Marsden Cancer Charity. MRI scans enable us to look at a tumour in fine detail. They are particularly important for soft-tissue cancers, such as brain, spinal cord, bowel, gynaecological and prostate cancers, as the magnetic resonance uses the properties of the soft tissue to create the detail in the image. And CT scanners use X-rays to produce cross-sectional images of the body. When the images are reassembled by computer, the result is a detailed 3D view of the body’s interior. CT scans can be used to help make a cancer diagnosis or assess the effects of cancer treatment.

‘Researchers ensure that information flows between the laboratory and the clinic to rapidly translate findings into benefits for patients.’ to offer our patients a personalised treatment plan within innovative clinical trials. Researchers ensure that information flows between the laboratory and the clinic to rapidly translate findings into benefits for patients. They also work closely with many of the other themes as part of an integrated approach, usually in collaboration with other BRCs and cancer centres nationally.

Overseas patients services At the hospital we attract many patients from the Middle East and have seen a rise in Arab patients opting to come to us for private care, as well as patients from Russia, Greece and Malta. We employ multi-national hospital staff, with many able to speak and understand Arabic and other languages. The hospital also provides a dedicated Arabic Advocate Service to support those choosing to come to The Royal Marsden for treatment or

Research and drug development We work very closely with The Institute of Cancer Research (ICR) and together have the status of biomedical Research Centre (BRC) – the only one in the UK dedicated to cancer. With Professor David Cunningham, Director of Clinical Research, as Theme Lead, the BRC Clinical Studies Theme harnesses the latest knowledge in molecular pathology, cancer imaging and drug development

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The hospital is equipped with advanced MRI and CT scanners

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Clinical Services

The Royal Marsden

diagnosis. We can also put patients in touch with a translation service if required. All staff at The Royal Marsden take part in cultural awareness training on a yearly basis to better understand the range of diverse needs patients from all ethnic backgrounds may have. Multi-faith rooms are available at both the Chelsea and Sutton sites. Our staff can also arrange for local religious representatives to come and visit patients in their rooms or on their wards. Our private care website is also translated into Arabic so that potential patients can research the hospital before admitting themselves, and a Halal menu is available for in-patients. In addition, we also organise taxis between the two hospital sites at no extra cost for our private patients if they need to travel between Chelsea and Sutton for treatment or consultations. And we have great contacts with local hotels and serviced apartments in Sloane Square and the surrounding area where private patients can get preferential rates. The Royal Marsden is also currently in the very early planning stages of developing an International Patient Centre at The Royal Marsden which will further enhance the facilities and services available to overseas patients.

Further information International referral and information line: +44(0)2078082063 International referral e-mail: int@rmh.nhs.uk The Royal Marsden, Fulham Road, London SW3 6JJ

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| Global Opportunity Healthcare 2015

Moorfields Eye Hospital

Second sight Understanding local needs is as vital as exporting expertise for a successful overseas hospital, says Mariano Gonzalez, Managing Director of Moorfields Hospital Dubai

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Clinical Services

he world-famous Moorfields Eye Hospital in London opened a hospital in Dubai in 2006, the first overseas venture of its kind for any NHS Trust. Managing Director Mariano Gonzalez explains that it was the vision of the management eight years ago to increase the development of private services to Dubai, mainly because a large number of patients from Dubai and the Middle East were travelling to Moorfields in London for treatment. “We thought if the patients are coming to us in London why don’t we just go there and treat them,” says Gonzales. “A huge effort was made, and eight years later the hospital has become a successful business model for others.” The Moorfields management in London took their initial idea to the authorities in Dubai and were met with a very positive response. ‘We had a warm welcome from Dubai Healthcare City”, says Gonzalez, describing the healthcarefree zone that was established in Dubai eight years ago to promote the city as a hub of healthcare by attracting big international names - Moorfields being one of the first. The reputation of the Moorfield’s name and brand was crucial in the decision, and the process of synergising the work between London and Dubai was carefully managed.

Best patient experience ‘We work as if we were in London; our clinical practice is exactly the same. The qualifications and experience and training of consultants is the same, and we follow the same clinical pathways,” says Gonzalez. “The journey and experience a patient goes though in Dubai is exactly the same as the one in London. So from the clinical perspective it is the same, and we aim to give the patient the best experience possible. “Our consultants are full time consultants here; our medical director in London comes every quarter and we share clinical pathways in the same way they do there. Other levels connected to health and safety, clinical standards and financial procedures are the same as in London.” Crucially, the key factor in the hospital’s success is the importance it attributes to listening to the local population and adapting to their needs. “Basically the link is 100 percent in each department; we follow the same rules and procedures but we localise the way we deal with patient, “ says Gonzalez. “The key is the way we deal with local population and what they need. We didn’t copy and paste, we brought the expertise here but we understood what was required. “To give a specific example, Middle Eastern eyes are darker than European eyes and take longer to dilate, meaning that routine appointments to apply eye drops can take up to three times longer than in the UK.”

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Opposite: Dr Andea Sciscio, Consultant Opthalmic Surgeon at MEHD, examines a candidate for eye rejuvenation Below: More than 23,000 patents were seen at the hospital last year

Moorfields Eye Hospital

Staff were initially brought in from the UK. “From a clinical perspective we started with a small number of consultants in years one and two from Moorfields,” explains Gonzalez. “The number of consultants is now growing year on year to provide answers to local healthcare needs. We recruit internationally, selecting in London using the same procedures, and we then deploy them here. The criteria and process is the same as in Moorfileds London.” More than 23,000 patients were seen last year at the Dubai hospital, a large percentage from the UAE. The second largest group were UK expatriates followed by a mixture of nationalities with 12 percent from abroad, introducing an element of medical tourism to Dubai as Healthcare City itself looks to attract international business. Moorfields was recently awarded the title of Hospital of the Year, which recognises the respect the operation has won locally. “For us, it is very important that in a place like Dubai we know that we have that reputation.” The success of the project means even more Moorfields hospitals will open overseas in the future. “In May 2015 we will open our second overseas hospital in Abu Dhabi,” says Gonzalez. “Although smaller than Dubai, as it will not include all the

‘The reputation of the Moorfield’s name and brand was crucial in the decision and the process of synergising the work between London and Dubai was carefully managed.’ administration services, from a clinical perspective it will be the same. As there is no equivalent Healthcare City there, back up is different, with local partners working together. It will be Moorfields branded, following the same clinical perspective and 100 percent the same as London and Dubai.” The most important lesson that Moorfields Dubai can pass on to others, according to Gonzalez, is the crucial need to ask first what is required locally, and act on that understanding. “The key is to understand the needs, it is not enough to bring the expertise.” Although the Moorfields brand was important, the UK and the NHS names have also been influential. “The NHS and the UK as a brand is a big thing in healthcare and is considered to have a good reputation. The way it is perceived as a name and brand is very important, and will support any venture in the region. It is a good business card.”

Further information Tel: (+971) 4 429 7888 Email: aqf@moorfields.ae www.moorfields.ae

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Moorfields Private

Clinical Services Moorfields Private

Moorfields Private is the private division of the world-renowned Moorfields Eye Hospital NHS Foundation Trust, with a reputation as a centre of excellence for providing ophthalmic care to private patients from the UK and across the world

Moorfields Private your vision, our focus

eing part of the Moorfields heritage offers the reassurance that you will be treated by world class consultant eye specialists who provide treatment and care for private patients with a wide range of eye problems from common complaints to the most complex eye health conditions that often require treatment not available anywhere else in the world. This, together with access to our leading centre offering the latest treatments for eyesight correction and consultants specialising in cosmetic eye treatment, enables private patients to access the most comprehensive range of ophthalmic services available in the UK. We specialise in the following procedures for both adults and children l Cataracts l Glaucoma l Medical retina lA ge-related macular degeneration (AMD) l Retinal conditions l Diabetic eye conditions l Squints

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l Blepharitis l Eyelid

lumps, bumps and cysts

l Conjunctivitis l Cancer l Uveitis

and many more. Our teams are located at convenient, central London locations in City Road and Upper Wimpole Street as well as in Bedford with easy access to London and surrounding Home Counties

Further information For further information or to arrange an appointment please call our New Patient Enquiries line on Tel: 080 0328 3421, Email: enquiries@moorfields-private. co.uk www.moorfields-private.co.uk All laser enquiries Tel: 020 7566 2299 Email: laser@moorfields-private.co.uk

“I had been wearing glasses for 49 years so having this surgery was a major life event for me. My surgeon’s waiting room was full of smiling happy people and my results are fantastic - I came out of the surgery and was able to sit in the waiting room and do the crossword without glasses. I was treated by the best surgeon with the most up to date equipment.” Danny

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Chelsea and Westminster Hospital

Bringing hope to childless couples worldwide

helsea and Westminsterâ&#x20AC;&#x2122;s Assisted Conception Unit (ACU) is one of the largest and most successful fertility clinics within the UK. Offering a range of services such as ovulation induction and In Vitro Fertilisation (IVF), the site also holds capabilities for unique specialities including enabling a safe pregnancy in ageing or infected patients. As it celebrates its 20th birthday, the ACU remains passionate about offering bespoke patient care and the best clinical outcomes. It provides a six day a week service and is located within the private outpatient and inpatient wards on the 4th floor of Chelsea and Westminster Hospital in London. The unit treats NHS and private patients offering private medicine standards with the science-based approach and high ethical standards of an excellent NHS and university-affiliated unit. According to Sir Andrew Dillon, Chief Executive of NICE (National Institute for Health and Care Excellence), one in seven couples in Britain are affected by infertility. At Chelsea and Westminster, new patients are seen within a week of referral, and the size and structure of the unit allows a truly individualised approach. The lead consultants, Mr Dimitrios Nikolaou, Mr Julian Norman-Taylor, Mr Jonathan Ramsay and Ms Paula Almeida, are personally involved in all decisions and treatments. The pregnancy success rate at the unit is currently 55 per cent, where the national average is only 36 per cent. In 2012-13 118 babies were conceived from 349 couples, and 40.3per cent conceived on their first IVF cycle.

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After years of enabling fertility for couples in the UK, Chelsea and Westminsterâ&#x20AC;&#x2122;s Assisted Conception Unit (ACU) is hoping to bring the miracle of life to many more couples around the globe

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Clinical Services

Chelsea and Westminster Hospital

IMAGE: BAGGIO STUDIOS

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Chelsea and Westminster Hospital

DR PAULA ALMEIDA BSC PHD DIPRCPATH Paula is the Laboratory Director and has been a Consultant Embryologist at Assisted Conception Unit since 2000. She has been working in the field of infertility for over 20 years. She has a PhD in Cytogenetic studies in human eggs and embryos from King’s College Hospital London, and has published widely in this field. She is a Diplomate of the Royal College of Pathologists, and a National Assessor for the UK Association of Clinical Embryologist (ACE) Training Committee. She is also the ACU’s Quality Manager From 2012 she became the Lead Healthcare Scientist for Chelsea and Westminster Hospital for London Scientific and Diagnostic network.

MR JULIAN NORMAN-TAYLOR MBCHB MRCOG Mr Julian Norman-Taylor is a Consultant Gynaecologist and a Specialist in Reproductive Medicine. Mr Norman-Taylor is also a lead clinician in the management of fibroids with Myomectomy, Laparoscopic Myomectomy, Transcervical Resection of Fibroids and Fibroid Embolisation. Mr Norman-Taylor graduated from Leicester University with a degree in Medicine and he is a Fellow of the Royal College of Obstetrics and Gynecology. He has held posts at Hammersmith Hospital and later the Royal London Hospital in which he performed East London’s first successful ovum donation pregnancy. He has taken sabbaticals in both Paris and Hong Kong and Mr Norman-Taylor’s interests outside medicine include Modern and Oriental Art and a passion for Fulham Football Club.

The unit offers the whole spectrum of fertility treatments from the simple to the most complex, including ICSI (intracyctoplasmic sperm injection) which is used when sperm quantity or quality is too poor for conventional IVF, and IMSI (intracytoplasmic morphologically selected sperm injection) or optimum sperm selection. Much of the focus is on embryo quality, and the successful management of embryos is at the heart of the unit’s service. The ACU’s laboratories are purpose built and are run by five embryologists who provide assurance that a highly qualified and experienced scientist is making decisions about the patients’ gametes and embryos. Embryo freezing is a key component of the treatment where there are spare embryos. Unlike egg freezing which is a difficult process with few resulting live births worldwide, embryo freezing is more successful and, while not all embryos survive the freeze, it allows the embryo to be implanted during a fresh ovulation cycle. This is desirable as it protects the woman from ovarian hyperstimulation and allows the embryo to implant under the best possible environment. The unit also has particular expertise in the management of older women seeking fertility treatment, as well as young women with early ovarian ageing. Dr. Dimitrios Nikolaou is a specialist in this area. “We have a tradition of managing reproductive ageing. Women are born with eggs but not all women are born with the same number of eggs. Various factors can affect this, the main one being genetics, but women can also lose eggs after sudden weight loss or psychological trauma.” For gynaecologists looking to become fertility experts the ACU has one of the longest and most successful programmes for sub-specialty training

MR DIMITRIOS NIKOLAOU MD MRCOG DFFP CERT ADVANCED ENDOSCOPIC SURGERY Mr Dimitrios Nikolaou is a Consultant Gynaecologist and Specialist in Reproductive Medicine. He is the director of the sub-specialty training programme in reproductive medicine and leads the ovarian ageing and fertility programme as well as the infectious disease programme. Mr Nikolaou is a recognised authority in the areas of infertility in the late 30s and in the 40s, as well as the assessment of the ovarian reserve and management of the early onset of infertility in younger women (early ovarian ageing).He was part of the working group of the Royal College of Obstetricians and Gynaecologists on reproductive ageing and he co-edited the relevant RCOG book, as well as the current for clinical practice and research.

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Chelsea and Westminster Hospital

â&#x20AC;&#x2DC;The pregnancy success rate at the unit is currently 55 per cent, where the national average is only 36 per cent. In 2012-13 118 babies were conceived from 349 couples, and 40.3 per cent conceived on their first IVF cycle.â&#x20AC;&#x2122;

IMAGE: BAGGIO STUDIOS

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Chelsea and Westminster Hospital

Clinical Services

Chelsea and Westminster Hospital

REDUCING THE RISK OF HIV TRANSMISSION One of the unit’s specialities is dealing with patients who wish to conceive where one or two of the partners have a viral infection such as HIV. When there is a HIV positive male a technique called Sperm Washing is used. The infection is carried in the fluid around the sperm and not the sperm itself, which means the fluid can be washed free of infection before being inserted at the appropriate stage. Dr Dimitrios Nikolaou is enthusiastic about the benefits of the technique. “It significantly reduces the risk of transmission. We warn patients that there is a 1% procedural risk of transmission but in reality in the years we have been running the programme I have never witnessed a transmission.” This is very much a unique service, as it is the only facility in the UK to offer this capability. While only 5% of patients currently come from abroad, the significant number of HIV cases around the world means this is an ever-present issue, and Dr. Julian Norman-Taylor is keen for Chelsea and Westminster to assist on a global scale. “HIV conception can sometimes be a sensitive subject, but we have a solution to help,” he explains. “Most of our international patients tend to be African, but the Chinese have an issue with hepatitis at the moment and we would be very happy to form relationships and provide support to anyone. We are very used to welcoming people from outside our own population. We receive referrals from all around the world and are well organised to deal with that.” A joint campaign with a centre in Uganda, a country with a high HIV rate, has also been established. International patients can be scanned locally and then treated at the UK site. “We train local nurses and set up the pathway so the patient only has to come into the UK specifically for the treatment. They can be scanned in their home nation, but to establish the expensive infrastructure for only a small population in other countries is often not feasible.”

for surgery in the UK. This also facilitates innovation and the unit is currently working on a research programme, alongside Imperial College, on the immunology of early implantations. Mr. Julian Norman-Taylor explains: ‘Initial studies are looking into why the embryo is not essentially attacked by the immune system, how is it protected and what is involved in that biochemical process.’ There are of course a number of stand-alone fertility clinics across the country but the Chelsea and Westminster Unit holds a number of advantages over these sites, including their ability to offer the whole pathway to the patient from conception through to aftercare. “On a technical front we treat infection cases with specialised equipment which most other infection centres do not have access to,” says Mr Norman-Taylor. Other reasons for the success of the unit include the quality management of the centre. “It is not that we only take easy cases, we treat everybody. Our success rates are consistently high because every

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decision is reviewed by our consultants and we have an active forum for discussion when a patient does not respond as we thought they would.” Due to these robust processes, 95per cent of the couples that have undertaken fertility treatment at the Assisted Conception Unit would recommend it to another couple. With fertility problems affecting so many couples, Chelsea and Westminster’s ACU has the best possible facilities to ensure that every couple has the greatest chance of a successful and healthy birth.

Further information Assisted Conception Unit, The Westminster Wing, Chelsea and Westminster Hospital 369 Fulham Road. London SW10 9NH Tel: 020 3315 8585 Fax: 020 3315 8921 Email: acu@chelwest.nhs.uk www.chelwest.nhs.uk

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The Chelsea Children’s Hospital

| The Chelsea Children’s Hospital Simon Eccles, Associate Medical Director at Chelsea and Westminster Hospital talks to Sarah Cartledge about his vision for integrated paediatric care

ocated in the heart of London Chelsea and Westminster Hospital is one of London’s largest providers of children’s services, caring for more than 75,000 children a year. It has been designated as the lead centre for specialist paediatric and neonatal surgery in North West London, carrying out complex surgery on babies and children. In March 2013 the different paediatric services including burns and craniofacial surgery, dentistry, ENT, general surgery, ophthalmology, plastic surgery and urology were brought together as The Chelsea Children’s Hospital. “We are the biggest paediatric unit in North West London and our desire is to grow into the third biggest children’s hospital in London,” says Simon Eccles, the Associate Medical Director. Mr Eccles is a craniofacial consultant surgeon who was formerly Clinical Lead for Paediatric Services. He is a firm believer in reducing fragmentation and providing integrated care for children and young people, many of whom are

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Above: TRH The Prince of Wales and the Duchess of Cornwall opened the new Chelsea Children’s Hospital in March 2014

referred from different parts of the UK. The new Children’s Hospital represents a move to integrate care and develop paediatric services for the future. A major £40m redevelopment has seen four new state-of-the-art children’s operating theatres, improved children’s wards, high dependency unit and burns unit. A new children’s emergency unit is under construction, and the next phase will see a new adolescent ward and an acute assessment ward. The first phase has been completed and by the end of the project all paediatric services will be located on the hospital’s first floor. Creative studio Thomas.Matthews has designed the look and feel of the new wards with an overarching Outer Space theme, where illustrated characters interact with the visitors and give them comfort, reassurance and advice. The Children’s Hospital has a large neonatal unit that covers complex neonatology. It also has a new children’s burns unit with a large outpatients department that has what Mr Eccles describes as ‘a wonderful environment.” It is the only burns unit

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Clinical Services

The Chelsea Children’s Hospital SIMON ECCLES Simon Eccles is a Consultant in Craniofacial Surgery at the Chelsea and Westminster Hospital. He graduated as a Doctor from Charing Cross and the Westminster Medical School in 1992 and as a dentist from the Royal London Hospital in 1985.Following a four year training programme in General Surgery, he became a member of the Royal College of Surgeons of England (FRCS) in 1996. At this time he began his training in Plastic Surgery which lasted for a period of 8 years. During this time he was awarded the McGregor Medal at the Royal College of Surgeons in the Specialist Fellowship FRCS (FRCS Plast). He is a past president of the plastic surgery section of the Royal Society of Medicine, and represents London on the National Commissioning Group for Childrens Specialist Surgery.

IMAGE: WWW.SHUTTERSTOCK.COM

in London for children that require care in a high dependency setting. There is also a designated children’s accident and emergency department that provides emergency care for 33,000 children each year. “One of my first tasks when I took over my new role was to secure specialist children’s surgical services here for the whole of North West London,” says Mr Eccles. “We went through a complex bidding process which we won. This process is extremely important as it reduces fragmentation and patients and other clinicians know their referral pathways.” “Often these children have complex facial problems; they have heart problems, gastrointestinal and neurology problems so you need the expertise of lots of clinicians to help you,” he says. “We have multi-professional teams made up of doctors, nurses and other allied health professionals, so the pathway is no longer sequential, which can cause long delays.” In his own area of expertise he attends a monthly

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craniofacial planning meeting with a wide range of specialists to create an optimum treatment plan for patients. “It includes craniofacial surgeons, neurosurgeons, ENT surgeons, oculoplastic surgeons, plastic surgeons, dental and orthodontic surgeons, sometimes radiologists and and most importantly the patient and their parents,” he says. “So rather than going from hospital to hospital to see different consultants the patient should go home with a treatment plan, having had the opportunity to ask questions to a whole range of professionals,” he continues. “As a clinician it gives you fantastic exposure to other people’s abilities. It also reduces the number of procedures as we will often have whole teams working on different areas at the same time.” Chelsea and Westminster is in the process of a proposed acquisition of West Middlesex University Hospital and there are plans to develop a Women and Children’s Institute that will offer teaching, training and research. Research at the maternal level is led by Professor Mark Johnson and investigates the different factors that prevent babies being born prematurely and that encourage maturation. In addition a paediatric da Vinci robot has been acquired to carry out laparoscopic surgery on tiny babies, theoretically giving better results with less healing issues and thus minimising their time in hospital. It is the only such robot in the UK dedicated to babies and children and the £1m machine was acquired through a major fundraising initiative. “Chelsea and Westminster has a caring focus and people recognise our innovation and understand that we are trying to do something different,” says Mr Eccles. “We have a state-of-the-art facility dedicated to providing high-quality healthcare for children and young people in a safe and child-friendly environment.”

Further information www.chelwest.nhs.uk

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Facing The World

Clinical Services

Facing The World

The NHS assists charities such as Facing the World which provides life-changing craniofacial surgery to some of the world’s most disadvantaged and vulnerable children

Charitable face of the NHS

n top of their hard work caring for UK patients, nurses and doctors in the NHS often give their time free of charge to help charities that are involved in important healthcare projects. Simon Eccles, a Consultant in Craniofacial Surgery at the Chelsea and Westminster Hospital in London, is also a trustee of Facing the World. The charity’s medical team offer facial reconstructive surgery in the UK for children from the developing world with severe facial disfigurements who cannot be treated in their home countries. The children come to the UK from all over the world including Vietnam, Afghanistan and Iraq. Some are treated at Chelsea and Westminster Hospital where the NHS assists by providing theatres for operations which the charity pays for from its fundraising activities. Nurses and doctors give their time free of charge to carry out the surgery. The charity is also able to draw on the skills of experts in a wide range of specialties at the hospital and, as a result, the children are given a life-changing opportunity. Their young patients have included a boy from Iraq who was born with a facial cleft that meant that parts of his face were not joined together. Niall Kirkpatrick, Chair of Facing The World’s trustees, operated on him at Chelsea & Westminster and he will return soon for further surgery. Trang, a young girl from Vietnam diagnosed with a fibroblastoma, was brought to London for surgery. On her return she wrote to the surgical team to say: “I have a new face - a fantastic present. I want to express my gratitude to everybody who gave me the energy to overcome adversity.” Trang went on to be placed at the top of her university class and is leading a normal life. The children are selected on the basis that the surgery will be life-changing. Simon Eccles was part of the team

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Right: Simon Eccles in clinic at the Danang Hospital during Facing the World’s programme Below: Viet, a Facing the World patient, with his mother

that operated on conjoined twins Rital and Ritag from the Sudan. “Only one set of twins with this variant had been separated successfully,” says Mr Eccles. “We were fortunate that a sponsor hired a plane for us to bring them to the UK. Then we spent a few months planning the operation using complex computer techniques at the leading edge of technology. Although their heads were joined their brains were separate, but some of their blood vessels were entwined so we had to work out how to separate them without either killing or giving one of them a stroke.” The successful operations were carried out at Great Ormond Street Hospital and funded by Facing The World. They made headline news around the world and now the twins are home in Sudan where they are thriving. During their time in Britain the children

attend the hospital school. On their return they are given iPads so they can keep in contact via Skype and email. They also continue their education remotely with their teachers in London. Facing The World is also involved in sharing knowledge with surgeons in developing countries, principally Vietnam. Every year the team visits Danang in the centre of Vietnam where they teach the local doctors and nurses to care for patients with craniofacial anomalies that are prevalent, and thought to be as a result of the Agent Orange that remains in the soil following the Vietnam war in the 1970s. “Last year we had our first craniofacial conference in Danang which allowed us to share what we know,” Simon Eccles says. “Local plastic surgeons and international speakers joined us and it was a way of demonstrating what we have all learned, as learning is a two way process. They are a very dedicated group of individuals as they want to look after the healthcare of their nation.” While the volunteer medical teams give their time for free, Facing the World must still meet the hospital, travel, food and accommodation costs for the children and their parents or guardians. But for the teams involved in helping these youngsters, the reward is seeing them live happy and fulfilling lives.

Further information www.facingtheworld.net

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Imperial College Healthcare NHS Trust

Groundbreaking paediatric haematology Dr Josu de la Fuente, clinical lead for haematology at St Maryâ&#x20AC;&#x2122;s Hospital, Paddington, tells Sarah Cartledge about the haematology transplant innovations giving children better lives. 54

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Clinical Services

p on the sixth floor at St Mary’s Paddington the paediatric day unit is a cheerful place. Bright and airy, decorated with children’s artwork, it is a reassuring environment for youngsters suffering from non-malignant blood disorders such as aplastic anaemia, inherited bone marrow failure syndromes, sickle cell disease and thalassemia. In charge of the unit is Dr Josu de la Fuente, leading a team of consultants, junior doctors, senior clinical nurse specialists, psychologists, pharmacists, a dietician and Arabic liaison staff. The team has achieved some of the world’s best outcomes in managing blood disorders, pioneering new bone marrow transplant techniques that are less toxic. “We undertake transplants for children who either cannot make blood or cannot make the right type of blood,” says Dr de la Fuente. “This is either because they have thalassemia where they cannot make haemoglobin or because they have sickle cell disease, the wrong type of haemoglobin. Some patients have been born with a condition that prevents them from making blood.”

Imperial College Healthcare NHS Trust

DR JOSU DE LA FUENTE Dr Josu de la Fuente trained in haematology at Imperial College and Great Ormond Street Hospital achieving membership of the Royal College of Pathologists. He was appointed in 2006 to lead the paediatric Blood and Marrow Transplant Programme at St. Mary’s Hospital, which specialises in transplantation for haemoglobinopathies and bone marrow failure, and has been innovative in the use of alternative donors. He has also developed a unique clinical and research programme for Diamond Blackfan anaemia patients. He is member of the Scientific Committee UK Thalassaemia Society and is currently the clinical lead for paediatric specialities at Imperial College Healthcare NHS Trust. He is a member and haematology lead in the Paediatric Medicine Clinical Reference Group of NHS England developing national standards of care.

Specialised treatment There is a high incidence of thalassemia and sickle cell disease in people from African, Mediterranean and South Asian backgrounds. Two thirds of the transplants Dr de la Fuente performs are for these conditions, and while they are very common in the UK his patients come from the Middle East and Asia as well, where specialised treatment is not always available. In particular there is a specific form of bone marrow failure called Diamond Blackfan anaemia, a rare condition where the bone marrow fails to produce red blood cells. These cells are vital because they carry oxygen around the body. Patients are usually diagnosed before the age of one and require ongoing treatment even if transplants are carried out. Dr de la Fuente’s clinic has the largest cohort of patients in the world for this condition. “We often have to wait until the child is two years old to understand the severity of the disease and to judge whether the transplant is warranted,” he says.

Worldwide donors When bone marrow transplantation was in its infancy the bone marrow was taken from a relative, but one of his innovations was the introduction of bone marrow from volunteer worldwide donors, leading to a greater number of children who could be cured. However the majority of donors tend to be from Western countries and North America, while a number of patients are from ethnic minorities who do not traditionally act as donors. “To get over the fact that most people don’t have a donor we started to use transplants from only one of the parents,” he says. “We now have the technology to do a successful transplant with only a 50 percent match.” With thalassemia Dr de la Fuente can predict early in the condition how severe it is going to be, and

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children who require treatment will often come to his Day Unit, though many will also be treated in their own local hospitals. “For sickle cell lysis (the breaking down of cell membranes) there is a surveillance programme to protect those who are going to have the most severe consequences, and there is a series of criteria that determine how severe the symptoms are. That consultation is for the patients who have bone marrow failure syndrome and cannot make blood. Then we have to wait till the point when the bone marrow cannot sustain the blood production. On average that is around seven years of age but it could be early or later.”

Transplant risk Transplantation has its own risks, so each patient is carefully evaluated to make sure it is the right course of action. Once the decision to transplant is taken, an evaluation period of three months takes place in the Day Unit to check whether the child can cope with the transplant. “We are particularly interested in the collection of ions by transfusions and the harm that that may have caused to the liver or the heart. We also have

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Imperial College Healthcare NHS Trust

Clinical Services

to provide a period of time prior to the transplant in which we prepare the patient for the transplant so the new bone marrow doesn’t get rejected. We have to stop the normal blood production to minimise the chances of the new bone marrow being rejected.” The unit has a transplant cubicle to prepare children for their transplants, with a special filtration system that does not allow any viruses or infections into the room. It also has a specialised machine that is used to change the patient’s blood. The unit was the first to use it in the UK and it allows all the red blood cells to be exchanged so the operation and transplant can be done safely and effectively. Following the transplant, the child stays in the unit for a further two months for medication and observation while the bone marrow creates new blood. The patient needs to be in isolation and undergo chemotherapy in specialised wards where a parent can stay with them.

Follow-up care After they return home the patients are followed up on a weekly basis for six months, and supplied with drugs to prevent the new bone marrow being rejected or attacking their own body. After this the medications are withdrawn and the patient is cured. Many of the transplants are done to prevent serious damage in later life, and also to ensure good quality of life. “Most of these transplants do not need to be done on an urgent basis, because the child is still going to survive if the transplant is not done immediately. So we analyse the patients particularly carefully so that when the transplant arises it is done in a safe manner and we can achieve the best outcomes.” The team has a 95 percent success rate for patients with a related donor and a 90 percent outcome for a non family donor. The European Bone Marrow Transplant Group (EBMT) has analysed worldwide transplant rates and the UK has come out at the top. Most of these have been transplanted at St Mary’s Hospital, so Dr de la Fuente is justifiably proud of this achievement. “It was obvious to me that these types of blood disorders required people to work on them and bring transplantation to the same level that it was for other conditions,” he says. “When I took over from Professor Ivan Roberts we were only doing five transplants a year. Now we do up to 40 a year and our protocols have been vastly improved to make them considerably safer. “Any child that requires a transplant for any nonmalignant condition can have a transplant, because we have expanded the possibility of having different forms of donors.”

Further information www.imperial.nhs.uk

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Chelsea and Westminster Hospital

helsea and Westminster Hospital is the only hospital providing inpatient burn care as part of the national burns network in London and, together with burns services at East Grinstead and Chelmsford, forms the London and South East England Burns Network, which serves a population of 20 million people. The service has a strong regional, national and international reputation for expert clinical treatment, compassionate care and research. Each year the burns service at Chelsea and Westminster treats over 600 new inpatients and 3,000 new outpatients for burns. Each patient requires specialist followup care, often including further surgery, extensive dressing care and on-going therapy support. The burns service has been established since 2001 when it transferred from Queen Maryâ&#x20AC;&#x2122;s Hospital in Roehampton, one of the founding units for burns care. It has a long established history on which they have built the state-of-the-art department in which patients are cared for today. The success of the service is based on strong working relationships within their multidisciplinary team. The burns multidisciplinary team includes dedicated burns consultants, intensive care specialists, anaesthetists, specialist nurses, occupational and physical therapists, psychologists, pharmacist, dietitians and a social support team. The team also call upon the acute services within the Trust, such as pain, acute medicine, surgery and elderly medicine, when needed. In addition there is a burns outreach service for dressings and therapies, and a burn care advisor to co-ordinate education and support for other hospitals in the network. This dedicated burns team aims to meet all of the physical and psychological needs of patients with burns. The adult burns unit reopened in 2014 after extensive refurbishment, following on from the opening of a separate dedicated paediatric ward, with increased space made available to ensure all burns care is co-located and meets the national burn care standards. In the new adult unit there are

Acute care to after care - the complete burns service Chelsea and Westminster Burns Unit offers a state-of-the-art burns service with capabilities across the whole patient journey

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Clinical Services

Chelsea and Westminster Hospital

Left: Burns Medical Equipment Above: Burns Reception

two intensive care beds, two high dependency beds, nine ward beds and three day care beds. All surgery, dressings and therapies take place within the unit at Chelsea and Westminster Hospital.

What the new unit has meant for the burns service What the investment has meant for the service: l Third more space for the unit l Two purpose built, dedicated intensive care rooms l Theatre size increased by 30% l New bay of beds dedicated to surgery patients, closer to theatres l Special rooms built for ventilated patients l Gym on the unit for rehabilitation

The patient journey Admission As the specialist regional centre for burns in London and the South East of England, patients are admitted

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following referral from their GP, local A&E or directly via the trauma services. Surgery Surgery is required when the burns are deeper and do not have the capacity to heal well from the undamaged skin underlying the burned area. The majority of our inpatients require surgery for their burns, as far as possible we manage all burns dressings either in the dressing clinic or as a daycase admission to the ward if the area affected is more extensive and painful. Intensive care If the patient has suffered an inhalation injury from smoke at the time of the fire, or if the area of the burn is extensive intensive care support is required with ventilator support and invasive monitoring. This is also the case for patients with less severe burns but significant co-morbidities. Occupational and physiotherapy The therapists aims to reduce the long term disability from a burn injury, and the need for further reconstructive plastic surgery, ensuring they maximise the physical and functional recovery for the individual. This team provides intervention to patients with a wide variety of burns and plastic surgery conditions and often continue rehabilitation for years after a burn injury is sustained. The therapy team works closely with nursing and medical staff and are actively involved right from presentation to the service with early intervention and rehabilitation of patients, ensuring that impairments are reduced whilst physical and functional outcomes are optimised. An extensive range of treatment techniques are

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used by the team including splinting and positioning, exercises, stretches, massage, restoring the ability to undertake activities of daily living, respiratory physiotherapy, hydrotherapy, pressure garments, scar management, education and advice. Two pressure garment technicians work closely with therapists to make, alter and adjust pressure garments for all adult and paediatric patients who require them as part of their ongoing scar management. The team provides services to all adult and paediatric patients under the burns consultants. The patients are seen on the burns intensive care unit, burns wards, general wards, day surgery and even in their homes following discharge through the outreach service.

Chelsea and Westminster Hospital

Clinical Services

Psychological therapy Chelsea and Westminster Hospital is able to provide all inpatients with burns psychological screening to ensure all patients with severe burns receive psychological rehabilitation if required - something that was not previously available. This is thanks to unique funding by the hospital charity CW+. The charity raised the initial ÂŁ100,000 needed to fund

Interview with Isabel Jones, Clinical Lead for Burns and Surgeon specialising in plastics and burns What makes the burns service at Chelsea and Westminster special? The staff and the new unit together make Chelsea and Westminster a very special service. We now have a purpose built department which meets the national standards and is co-located with everything we need in one place, including the paediatrics burns service, our own burns theatres and dressing clinic. We also have a very dedicated team who are extremely committed to the service. They are all extremely dynamic with a vision for the future of burns care and are continually moving forward. They are a great team with a great ethos of hard work and they always go the extra mile. The team are always striving to improve outcomes. We are committed to research and are very well supported by Imperial College and The Magill Department of Anaesthesia, Intensive Care & Pain Management. We are producing a lot of original work and have recently had a clinical fellow awarded to us. We

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Chelsea and Westminster Hospital a clinical psychologist for two years, a service which is now supported by the Trust full-time. Through the screening programme we identify potential psychological issues, address them early and help patients with their emotional as well as physical recovery. In addition any outpatients who have adverse psychological outcomes following their burns are also seen by the psychologists. The service also provides psychosocial assessments for all parents of children admitted with burns. After support All patients with scarring following their burns are seen in the consultant outpatient clinic to ensure their therapy needs are met , and are offered ongoing reconstructive surgery.

Further information If you would like to know more about the service offered by our burns team please contact the general manager for burns on 020 3315 8851. www.chelwest.nhs.uk/burns

are able to improve services for burns patients through our research work. What specialist skills does your team have? Within the team we have a specialist team of surgeons, intensivists, anaesthetists, nurses and multidisciplinary staff all dedicated to burns, plus a wider hospital team to support us. The burns specialists are not only on the ward, there are outreach nurses and burns care advisors. The nurses on the paediatric and adult unit, therapists and psychologists are all specifically trained for burns care. We also benefit from pharmacists and dieticians dedicated to burns patients as well. We rely on the pain team a lot and are supported by medical and surgical teams within the Trust. What does the new unit mean for patient care? From the patient perspective , coming into a dedicated area that is clean, light and modern really helps to create a positive experience at what can be an extremely difficult time. Patients receive a holistic approach to care with everything in the same place with the same staff. The setup is compact but it has also enabled us to install measures to help with infection control. The new unit also means that we now have day care co-located, which is essential for the way burns care has evolved, to care for short term patients.

A dedicated burns high dependency unit makes a huge difference for patients. We also have a space for families and a confidential room for psychology care. How did you design the new burns unit? We had a look at the previous unit and the national standards and then worked within space available in the hospital. There was a diverse project team, led by estates, with representatives from all areas of the burns team, who came up with a design that did not miss any aspects of care. There had been many previous designs over the years using various architects. The principles from the different designs were distilled down over many years and applied to create the unit we have today. The final design stage took just three months and the build took eight months. What have you learnt from opening a new unit? The biggest challenge was infection control for such a vulnerable group of patients. Keeping the builders to their timeline was also a challenge! I have also learnt to never underestimate the attention to detail you need to apply during the design and build phase as I was surprised by how many small issues came up once we moved in. However, it is all worth it as we have an amazing unit that I am very proud of.

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Camden & Islington NHS FT

Achieving the same level of outcomes for mental as well as physical healthcare is a key objective for a well-developed health and social care system, says Wendy Wallace, Chief Executive, Camden and Islington NHS Foundation Trust

Delivering a modern mental health service

ost health systems have a disparity between mental and physical healthcare. Any disparity can be a major cause for a reduction in quality of life and life expectancy, and mental health is often hampered by inadequate investment and outmoded models of service delivery. This does not need to be the case and by investing in research, education and community based models of care, London based Camden and Islington NHS Foundation Trust (C&I) is delivering forward looking and innovative mental health services which put the recovery of patients at its heart.

Respect and dignity in a safe environment For many people, the concept of recovery is about staying in control of their life despite experiencing a mental health problem. It is a way of living a satisfying, hopeful and contributing life even with the limitations caused by illness. Modern health services aim to help people with mental health problems look beyond mere survival and existence. They are encouraged to move forward, set new goals and develop relationships that give their life meaning and purpose. Mental illness and social attitudes to mental illness often impose limits on people experiencing ill health. Health professionals, friends and families can be overly protective or pessimistic about what someone with a mental health problem will be able to achieve. Services should emphasise that, while people may not have full control over their symptoms, they can have full control over their lives. Success is not about hiding problems, but supporting those with mental health illness to establish themselves in the community as independent people with abilities, interests and dreams.

C&I successfully works with organisations to implement new models of care which embed the principles of recovery into services. This supports people and gives their life more meaning.

Building a multi-disciplinary approach to care When the UK moved patients from institutional based treatment to a recovery-oriented model in the community, staff saw patients in the context of their family, their work, their leisure pursuits and as members of the wider community. It became essential to work with the patient and their families to understand what was important to them. Experience in the early years of community based delivery made it clear that both the psychological concerns and the social environment of the patient needed to be addressed. This required a wider range of skills than psychiatrists and nurses could provide, increasing the need for collaboration with a wider range of professionals, including occupational therapists, psychologists and social workers, as well as a range of highly skilled non-professionally qualified staff. Eventually, this led to the creation of multidisciplinary teams forming a central feature of virtually all forms of modern mental health care. The effectiveness of these teams in delivering improvements in care and patient experience is strongly influenced by the quality and extent of education, training and supervision. As staff skills increase, responsibility for determining patient care can be shared across all professions in the team leading to more flexible forms of service delivery, patient experience and increased productivity.

Delivering recovery in the community C&I predominantly delivers mental health services within the Central London districts of Camden and Islington. The local population contains a wide range of social groups including wealthy celebrities, politicians and overseas visitors at one extreme and areas of poverty and social housing at the other. There is a large and diverse immigrant population

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Clinical Services Camden & Islington NHS FT

speaking over 290 languages, and a large transient population of young adults. The area has some of the highest needs for mental health services within the United Kingdom, with a high prevalence of psychotic and non-psychotic mental health problems. We meet this need by delivering evidence based services, based upon our own innovations and research. We are one of the few healthcare providers within the United Kingdom that was established as an integrated health and social care organisation,

WENDY WALLACE Wendy was appointed Chief Executive of Camden & Islington Foundation Trust in 2005, having previously worked in the Trust as an Operations Director. Camden & Islington NHS Foundation Trust is a joint health and social care organisation providing mental health and substance misuse services. She led the Trust to Foundation Trust status in 2008. The Trust has a strong track record in innovation and research enhanced through its links with UCLPartners, an academic health science partnership. Prior to moving into management she practiced as a clinical psychologist working primarily in adult mental health and substance misuse.

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A Somali children’s choir at C&I’s open day. The Trust builds strong relationships in the community to break down the stigma around mental health

allowing us to maximise the benefits of multidisciplinary teams. Over 40% of our consultants hold joint academic posts and are engaged in research across a wide range of mental health areas. We are a lead provider for educational placements in north London and work in partnership with local universities to deliver both education and research projects as well as creating together the workforce of the future. This provides a stimulating environment for our staff to innovate and deliver projects which transform care for patients.

Case study: Crisis houses improve patient satisfaction The Daleham Gardens Recovery Centre provides a short-term residential alternative to hospital admission. The recovery centre includes three services under one roof – a six bedroom Crisis house, crisis team and an acute day recovery programme. Typical users of the service are schizophrenic patients, of which over 70% have previously been inpatients. Patients can refer themselves, or be referred by a GP or carer, and can then be put in touch with other mental health services. The advantage of the crisis house is a significant reduction in length of stay. An average

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Camden & Islington NHS FT

Clinical Services Camden & Islington NHS FT nature of gangs makes it a risky environment for staff and patients. C&I has developed a multi-agency approach designed to tackle gang activity. The approach engages with young people in the context of their antisocial peer group in an authentically youth-led way, while also working with the services and authorities around them that impact their likelihood to change. The project is multi-agency, with police, local authority, employment and local mental health services. Feedback from local stakeholders is very positive, and police say there has been a reduction in gang-related crime in the area.

length of stay is three to four days, compared with significantly longer in an inpatient setting. Patients respond well to the crisis house, commenting on the warm friendly environment and speed with which they are able to recover from a crisis and return home. The Daleham Gardens Recovery Centre is also home to one of C&I’s crisis teams. We created the second crisis team in the UK in 1999, and have led service evaluation research into the model of crisis and home treatment teams. Our innovation has led to a reduction in inpatient admissions, and has enabled us to treat 97% of our patients in the community. Our service users find it a safe alternative to hospital and find it a more homely environment which they prefer.

Evidence based services Providing an evidence base for services is a fundamental part of C&I’s approach to service development. We have a strategic alliance with the division of psychiatry in University College London and support clinical academics, drawn from medical, nursing and social care backgrounds, who are leading mental health research both nationally and internationally. During 2014 we hosted 48 studies and our staff published 116 articles in peer reviewed journals. We are also among the first mental health trusts in England to develop nursing research capacity successfully with a joint deputy director of nursing post in research and development. This staff member leads programme grants as well as recruiting nurses to take part in a range of programmes to build their skills, while at the same time growing C&I’s research and innovation capacity.

Case Study: High needs accommodation Finding accommodation for patients when they leave hospital can be difficult, especially for patients with high needs such as those with a forensic history and challenging behaviours. Private sector housing providers are often unwilling to take these patients as the risk associated with them is too high for them to manage safely. C&I and One Housing Group, a leading social housing provider in London, partnered to develop 15 units of high needs supported housing within the Kings Cross development in Central London. This collaboration brings together the housing and support capabilities of One Housing Group and the specialist clinical skills of C&I to deliver a high quality and cost effective service. The service has been very successful in providing a supportive environment close to patient’s families, with patients reducing their need for medication, increasing participation in the community and moving to more independent living more quickly.

Case Study: Multi-agency approach to tackling gangs Young people with behavioural issues who enter into gang culture are challenging to engage. The violent

Working with international partners to develop mental health services Patients and staff celebrating the opening of the Rivers Crisis House, C&I’s third crisis house

Over the last 20 years C&I has been actively involved in the development of mental health services. Our research provides the evidence base for many services which have been rolled out nationally within the UK. This includes research into community based psychotic and non-psychotic services including crisis teams, early intervention services, assertive outreach, and, more recently, developments in primary care mental health, traumatic stress and services for ageing populations. Our subject matter experts are actively engaged in research and developing new mental health services and our focus is on working with providers in other markets to perform healthcare systems audits, develop and pilot new services, conduct joint research projects, and deliver education and training.

Further information Karl Heidel Head of Communications & Engagement Tel: 0203 317 7083 communications@candi.nhs.uk David Plummer Associate Director of Business Development david.plummer@candi.nhs.uk Tel: 0203 317 7139

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Marie Stopes International

| Delivering a new era of reproductive health services Universal health coverage will have a profound impact on how the service delivery sector does business, a shift that is firmly embraced by Marie Stopes International says Caitlin Mazzilli, Head of Health Financing

nly governments can ensure that universal health coverage (UHC) is achieved so that everyone can access the health services they need without suffering financial hardship. But this doesn’t mean that the rest of us should leave governments to their own devices while we wait for UHC reforms to roll out. UHC will – and should – have a profound impact on how our service delivery sector does business. At Marie Stopes International, that’s exactly the shift we are embracing. Marie Stopes International has always had the long-term vision that we will integrate with domestic financing as health systems develop. In the UK, where we opened our first ever clinic, we work on

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over 70 NHS contracts. This represents 84 percent of Marie Stopes UK’s income, which means we can serve the vast majority of our clients free of charge. We know we can emulate this model in the rest of the world when the time is ripe, and this time is drawing nearer, driven largely by the UHC movement.

Domestic financing The UHC goal is that everyone has access to the health services they need without suffering financial hardship. Pursuing this goal very quickly leads governments to see the need for dramatic health financing reforms. In particular, UHC is giving rise to national insurance initiatives that allow health budgets to be spent on strategic purchasing of health services, rather than on keeping the doors open at public facilities alone. In many of the countries where Marie Stopes International works, between 40 to 70 percent of all health spending comes directly from people’s pockets and a large share of it is spent at private facilities. Tackling

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Clinical Services this problem in mixed health systems like India, Nigeria and Kenya requires replacing out-of-pocket expenditure with public financing in both public and private sectors. We are entering an era where domestic financing, and particularly the public share of that financing, is on the cusp of a considerable scale up. Global service delivery organisations must be ready for this transition to remain relevant. To date, Marie Stopes International’s contraception and other reproductive health programmes are already partially financed by public funds in ten countries, including Vietnam, South Africa, Papua New Guinea, India, Nepal, Ghana, China, Bolivia, Kenya, Australia and the UK. We prioritise our ability to adapt to financing changes in the market so that we can ensure continuity of care to our clients. Aside from gearing up for domestic financing, how else can a global service delivery organisation participate in UHC reforms? As it turns out, more countries are still in planning and piloting phases for UHC. These countries have expressed a desire for service delivery’s experience and skill set at the table. So in these years of transition, Marie Stopes International is focusing on a few key areas where we see we can make a distinct contribution.

Focusing on a cost-effective service package The first is to support and influence benefits package decision-making, to help ensure the best value for money and greatest health impact for UHC reforms. Few services are as cost-effective to both health and economic development as contraception, and as such must be prioritised for universal access. In some cases, there is a trend towards more curative than preventative care. This means coverage for family planning might be omitted. Marie Stopes International is playing our part in countries like Ghana and Kenya, but also globally, to move contraception and reproductive health back up the UHC agenda on behalf of our clients.

Making UHC work for the low-level private sector Next, Marie Stopes International is not only a private sector provider. We also have franchise relationships with 3,600 social franchisees in 17 countries, largely consisting of privately owned and operated, lower-level outpatient clinics. As we enter the UHC era, we are making sure that these lower-level private facilities, which are a frequent lifeline to their communities, are not forgotten in public financing reforms. In the Philippines, we have assisted nearly 200 midwives through the arduous accreditation process into the national health insurance scheme, operated by PhilHealth. Once accredited, these small maternity homes are able to serve their communities free of change with maternal health and family planning services and receive PhilHealth reimbursements. Most of these midwives report not having adequate knowledge or capital to get through the accreditation process alone, making Marie Stopes International’s franchising quality assurance

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Marie Stopes International

CAITLIN MAZZILLI Caitlin Mazzilli has provided technical leadership on Marie Stopes International’s health financing activities, including contracting, insurance and voucher programmes since 2012. She brings eight years of experience in managing health financing activities in low- and middleincome countries, as well as developing strategies for better engaging the private health sector. Previously, Caitlin worked as a consultant across Africa for organisations such as Population Services International, UNICEF, and Family Health International.

and support role the bridge to private sector inclusion in UHC. Meanwhile in countries like Ghana we see another role for private sector support and advocacy related to UHC roll-out. The shift to public financing can mean slow and low payments that can cripple a clinic’s cash flow. Under the African Health Market for Equity project, we are seeking to link private providers’ cash flow and other financial product solutions to ease the teething pains of working with public financed national insurance schemes.

Advocating for financing by doing Finally, in countries that are not yet taking great strides in UHC, Marie Stopes International can still contribute to progress through proof-of-concept interim financing projects that feed the right dialogue. In Uganda, Pakistan and Madagascar, we operate large-scale voucher programmes that demonstrate the power of removing client financial barriers, while simultaneously reimbursing all types of health providers such as faith-based, for-profit, or public, for the quality assured services they offer. We can show that the market takes off and significant results are achieved with this financing strategy, serving as testimony for the potential power of UHC reforms. In all of this, we laud many of our donors who are helping governments but also helping service delivery organisations like ours to do our part towards UHC objectives. The UK’s Department of International Development (DFID), the United States Agency for International Development (USAID) and the Gates Foundation have all helped us move into the next level of family planning/reproductive health programming complexity by frequently including a health financing and health system integration focus. In summary, we are in a new era for global service delivery organisations. Working with emerging domestic financing systems can be messy, but we all need to roll our sleeves up and get busy. Marie Stopes International has never seen so much opportunity to fulfil our mission and serve our clients both sustainably and equitably.

Further information www.mariestopes.org.uk

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The Children’s Trust

Helping children live better lives The Children’s Trust is proud to be the UK’s leading specialist centre for children with brain injury and complex neurological disabilities, says Professor Gareth Morgan, Medical Director of The Children’s Trust

or more than three decades The Children’s Trust has provided specialist services including rehabilitation, assessment, therapy and care for children from birth to 18 years, to help them reach their full potential. Located in beautiful 24-acre grounds in Tadworth, Surrey, The Children’s Trust has its own iconic 17th century mansion building that now houses the organisation’s administrative offices. As the former country branch of Great Ormond Street Hospital, and with easy access to London, The Children’s Trust has a proven track record in delivering high quality services. It continues to

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have strong links with the main London children’s hospitals and research projects with institutions across the UK. Despite its country heritage, these collaborations and its own expertise enables The Children’s Trust to work with some of the most medically complex children. “We aim to ensure all children with neurological conditions have the opportunity to live the best life possible,” explains Dalton Leong, the organisation’s Chief Executive. “We are making significant strides in supporting as many children as possible through clinical excellence and evidence-based practice.”

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Clinical Services Multi-disciplinary approach The children and families are at the heart its multiprofessional approach. The organisation has an experienced and extensive team of doctors, nurses, allied health professionals and interpreters, working closely together to help each child reach their goals. A consultant-led service ensures that all placements are managed safely and effectively. “Our clinical outcomes and research are of paramount importance to us,” explains Professor Gareth Morgan. As The Children’s Trust’s Medical Director and an experienced consultant paediatrician, Professor Morgan coordinates the medical care working alongside Maggie Clancy, Director of Clinical Services, who oversees the nursing care and allied health professionals that comprise the onsite clinical team. Expertise in one place is key. On the medical side its team includes specialists in paediatric neurodisability and neurorehabilitation; consultant paediatricians and specialist registrars; experienced paediatric nurses and brain injury specialist nurses. This complements the expertise of clinical specialist physiotherapists, speech and language therapists,

The Children’s Trust

PROFESSOR GARETH MORGAN Gareth is Medical Director at The Children’s Trust, the UK’s leading centre for children with acquired brain injury and complex neurological disabilities. As a fellow of the Royal College of Paediatrics and Child Health, The Royal College of Physicians and the Royal College of Pathologists, Gareth has a wide and varied experience of medical management. He was previously a clinical director at Great Ormond Street Hospital and head of a Medical Research Council field station in Gambia.

occupational therapists, play therapist, music therapists and clinical psychologists, who deliver the individually designed neurorehabilitation and neurodisability programmes. An on-site X-ray facility staffed by trained radiographers is also available. Education also plays a key role in the children’s treatment, and The Children’s Trust has an onsite school where teachers work alongside medical, nursing and therapy staff.

Individualised care The multi-disciplinary team works with children who have a variety of complex neurological conditions and health needs. Children admitted are medically stable and, because of the complexity of their medical needs, require a range of specialist services which few organisations can provide. “We’re not a hospital and provide a more homely environment for children and their families, while still providing a very high level of medical care,” explains Professor Morgan. These conditions include acquired brain injury, tracheostomy/long-term ventilation, spinal injury,

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The Children’s Trust

Clinical Services global development delay, neurogenetic disorders and stroke. Each child is reviewed on an individual basis and receives specialist medical and clinical assessments and therapy interventions tailored to their needs. Hundreds of children across the spectrum of neurological conditions are treated and supported by The Children’s Trust every year. The organisation is also a partner to the NHS in England, and is the only paediatric rehabilitation centre to receive National Specialised Commissioning status for children with highly complex needs following a brain injury.

Facilities and technology Within the organisation’s unique environment are a range of high-quality purpose-built facilities and accommodation, including an on-site multisensory hydrotherapy pool. Therapy and learning activities take place in a modern on-site therapy centre that houses a fully-equipped gymnasium, multisensory room, soft play area, therapy rooms and classrooms. All children have access to state of the art technology as part of their individualised programme, from iPads to eye gaze, and there are a wide range of outings and fun activities for children both on and off-site. To enable children to be independent, all of The Children’s Trust’s facilities, including spacious residential accommodation, is fully wheelchair accessible and feature hoists throughout.

Treatments An extensive range of treatments are available to the children to augment the specialist assessments and interventions. These include hydrotherapy, splinting, alternative augmentative communication aids, botulinum toxin injections and multisensory augmented therapy. Neurology, psychiatry, epilepsy and orthopaedic clinics are also available. Virtual rehabilitation with video games and a guided vehicle mobility system to be used with wheelchairs, enabling children to explore the environment, are also popular.

Supporting families Dalton Leong believes that “parents are the best advocates for their child,” and family accommodation is available on site, enabling families to be close to their child during their stay. A range of support is provided such as regular meetings with clinical staff to review their child’s treatment and progress, and involvement in the goal setting process for their child. Parents are also given training on brain injury, any equipment their child requires, and treatment strategies for their child.

Overseas service “The Children’s Trust is increasingly becoming a popular choice for children and families from overseas as well as the UK,” explains Dalton Leong. “We are helping a growing number of children from the Middle East as well as from India, Malaysia and Russia.” The organisation’s multi-disciplinary team are experienced in working with overseas professionals,

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The Children’s Trust

CASE STUDY: PRECIOUS STEPS Three year old Rhea was given a one per cent survival rate following a car accident. She came to The Children’s Trust five months post injury from hospital. Rhea’s mum Sotanis explains, “Neurologists told us Rhea would have some sort of life but that she would be permanently disabled because of her brain injury. But despite not knowing what the future might hold, we stayed positive. I didn’t let this deter my hope. I knew she would achieve the ability to do some of these things again.” Rhea received specialist medical and clinical assessments and therapy interventions tailored to her needs. One of the most significant improvements she made was being able to sit up in her wheelchair, beginning to use her right arm to reach out, and starting to take supported steps. As well as physiotherapy and hydrotherapy to improve her strength, Rhea received speech and language therapy to help her say some words and helping her to swallow. “All of a sudden I didn’t have to worry about doing everything on my own,” explains Sotanis. “I had a support network, people to help me wash, dress and feed my little girl who relied on help for everything. The staff also taught me techniques, to make doing these things at home easier.” Rhea was discharged home after 12 weeks. “The community therapists were very pleased with the extensive report from all the team at The Children’s Trust and are continuing to refer to it and follow on from their guidance to aid Rhea in her road to recovery.”

sharing their knowledge and expertise to facilitate the transfer of children, supported by a dedicated team of interpreters. For international families, modern on-site accommodation in a range of houses and apartments is available. All accommodation is equipped with ensuite kitchens and bathrooms. A range of additional support is also offered including access to an interpreter, halal food in its on-site restaurant, an on-site multi-faith room, and links with local faith leaders and religious centres. All families have the support of an International Manager who liaises with The Children’s Trust staff on their behalf, putting children and families at the centre of the placement. For families wanting to keep close links with London and the surrounding areas, The Children’s Trust provides the opportunity for families to borrow a vehicle, or can arrange private cars. “Both across the UK and internationally our services are making a huge difference to the lives of hundreds of children, and we will continue to reach many more children than ever before,” says Dalton Leong.

Further information Please visit www.thechildrenstrust.org.uk and www.thechildrenstrust.org.uk/international

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The Lindo Wing

Many people are familiar with the images of proud royal parents on the Lindo Wing steps at St Mary’s Hospital in Paddington. However it is not just a maternity unit, but a private wing of one of the most famous hospitals in the UK says Sarah Cartledge

World-class healthcare fit for kings

ituated opposite the main entrance to St Mary’s Paddington, just down road from Paddington Station, the Lindo Wing is a Victorian building with a strikingly modern interior. It has 11 post-natal beds, six delivery suites, 18 general beds and five day-care beds. It also has two elective operating theatres and one for maternity emergency cases. “The Lindo Wing has a very large maternity practice but it also undertakes general surgery, ENT, gastrointestinal and bariatric surgery, as well as respiratory cases, because the main hospital specialises in this area,” says Kerensa Heffron, Director of Imperial Private Healthcare at Imperial College Healthcare NHS Trust. The unit has access to more than 350 consultants, who are part of the wider Imperial College NHS Trust, covering every medical, diagnostic and surgical specialty. Imperial Private Healthcare consultants have enviable reputations across many disciplines including cancer, renal services, haematology, neurology,

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cardiovascular services and plastic surgery. “Our focus is on cutting-edge research and highquality training is one of the reasons our consultants are internationally recognised as leaders in their field,” says Jonathan Ramsay, Chief of Service for Imperial Private Healthcare. “Our broad expertise allows us to support patients through their entire treatment. This continuity of care, not to mention the reassurance it brings, is vital to recovery.” The theatres can deal with 10 small or intermediate cases each day or two major cases, depending on the situation. There is no anaesthetic room prior to procedures, so patients are able to walk into the theatre where they can meet the staff and be reassured they are in good hands, and there is also a three-bed dedicated recovery area.

Exceptional maternity services Princes William and Harry were both born in the Lindo Wing, as were Prince William’s children Prince George and Princess Charlotte. All prospective

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Private Healthcare

The Lindo Wing

mothers receive care and advice from their chosen consultant and dedicated midwives. The team creates a safe care plan for each birth, while also offering discretion, space, security and privacy at every stage. The Lindo Wing offers private ensuite rooms, with deluxe rooms or suites for those who prefer more space. The state of the art facilities include a secure, supervised nursery, antenatal classes and postnatal care packages. A dedicated hotel services team is on hand to provide extensive and nutritious menus, catering for all cultural and religious requirements including vegetarian, kosher and halal meals. “Many families, including VIPs, come to have their babies at the Lindo Wing, but our aim is to ensure we treat all our patients as VIPs,” says Kerensa. The Lindo Wing is well-equipped to deal with both straightforward and complex pregnancies with the added reassurance that, should any specialist care be deemed necessary, the unit has access to the critical care and neonatal units within the main hospital.

Reassuring backup As a specialist NHS service on site, the neonatal unit provides reassuring back up for all babies born privately within the Trust. The team treats women who have had complications during their previous or current pregnancies and newborns requiring specialist medical support. The unit is one of the UK’s largest and is based across Queen Charlotte’s & Chelsea Hospital – a unit caring for babies born as early as 23 weeks gestation – and St Mary’s Hospital. The unit has in-house scanning capabilities that cannot be found in most other hospitals. It pioneered the world’s first dedicated neonatal MRI scanner. Only a few hospitals worldwide have this sophisticated technology and the proficiency to carry out non-invasive scans of newborns’ hearts, brains and other organs, and identify conditions and causes. “Many patients are referred through word of mouth, perhaps through friends or family members who recommend us,” says Kerensa. “It is very gratifying to meet a new patient who has heard so much about our services and it spurs us on to deliver the best healthcare possible.” The Lindo Wing is within walking distance of some of the best Middle Eastern restaurants in London, so familiarity is often key. Arabic is a familiar language on the nearby streets, and the hospital is close to key attractions and the best shopping. “We try and treat everybody exactly how we would want to be treated if we were in a five star hotel having healthcare,” says Kerensa. “We want all patients to have the very best experience they could possibly have.”

Further information http://imperialprivatehealthcare.co.uk

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BUPA Cromwell Hospital

First choice for international patient care

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Private Healthcare

BUPA Cromwell Hospital

Bupa Cromwell Hospital in West London is a popular choice for foreign visitors due to its location and clinical services, General Manager Philippa Fieldhouse says

he UK and particularly London has a global reputation as a centre of healthcare ex cellence. Patients travel from around the world to experience the quality of care that the UK can offer, and also to receive treatments and medicines that may not be available in their own country. London’s diverse population can make it an attractive destination, but it is the standard and reputation of the private sector in the UK that really helps it stand out above other world locations. Bupa Cromwell Hospital in South Kensington is one of the most internationally diverse hospitals in the capital. The site itself is owned by the UAE royal family and it has been run by Bupa since 2008. The hospital attracts patients from all over the globe, with 144 different nationalities visiting last year. Such extreme diversity can create some unique challenges but the site has the capabilities to deal with these issues.

Advanced treatment technologies The hospital was purpose built and opened in 1981 as a state-of-the-art private facility for complex procedures and excellence in patient care - a tradition that continues to this day. We have established a reputation for innovation and are continually investing in the world’s most advanced diagnostic and treatment technologies. The majority of our consultants are drawn from London’s top teaching hospitals, and many are leaders in their fields. Our orthopaedics service is

PHILIPPA FIELDHOUSE Philippa Fieldhouse joined the Executive Team at Bupa Cromwell Hospital in April 2010. After a very successful 4 years as Operations Director, Philippa was promoted to General Manager (CEO) in January 2014. Prior to joining Bupa Cromwell Hospital Philippa had 10 years of management experience within the NHS, in services including Paediatrics, Maternity, A&E and Cardiology. Her last position before joining Bupa Cromwell Hospital was as Deputy Director of Operations at Epsom & St Helier University Hospitals NHS Trust, with responsibility for Emergency Care.

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BUPA Cromwell Hospital

Private Healthcare

one of the most comprehensive in the UK private hospital sector. The hospital specialises in areas including prostate, liver, lung, heart and breast cancer. We also perform kidney and liver transplants, complex heart surgery (almost 150 cardiac cases were carried out last year), and run a busy dialysis unit that has just been refurbished to the highest standards. The Gamma Knife Centre was the first in London and uses the latest technology; the Leksell Gamma Knife Perfexion. Gamma Knife targets brain tumours with pinpoint accuracy, and over 1,500 patients have been successfully treated. We also recently performed our first neurosurgery where the patient was awake during the whole operation.

Consistency of care The reason the hospital is able to offer such varied services is that it has the advantage of holding all these specialities on one site. This is quite rare in a busy city such as London, but makes processes much smoother for the patient. We have everything from on-site GPs (who offer walk-in appointments and immediate referral into the hospital if required), to diagnostics all the way through to surgery, chemotherapy, radiotherapy, and physiotherapy. We have adult and paediatric intensive care units for patients with critical conditions, and even make our own cancer medications on site, tailored to each patient to reduce side effects. This consistency prevents patients from being

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‘The majority of Bupa Cromwell Hospital’s consultants are drawn from London’s top teaching hospitals, and some are leaders in their fields.’

shuttled from one hospital to another, but also has the added advantage of making the hospital a real centre of medical knowledge. There is such a variety of consultants and GPs here that they really learn from each other. They are quite happy to pick up the phone and ask questions of each other, because many of them come from different teaching hospitals. On top of this we have set up multidisciplinary teams that are based around a particular body site. So for example if there was a complex lung case the respiratory consultants, surgeons and specialist radiologists would all come together to analyse the case and choose the best course of action as a team. For overseas visitors the hospital has its own International Patient Centre that can offer across the board assistance, from helping patients understand their care through to organising hotels for family

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BUPA Cromwell Hospital

Private Healthcare

members. Language and communication is key, with free interpreters on hand 24/7 and staff using airline style badges to make clear which languages they are able to speak. This familiarity can really benefit the patients. When someone is not from Britain it can be difficult because they might not understand how the system works in this country. We can help guide them through the whole treatment journey. We also have a unique relationship with the embassies, who liaise closely with the International Patient Centre to ensure that everything runs smoothly. The staff play an essential part in ensuring the patientâ&#x20AC;&#x2122;s emotional wellbeing in an unfamiliar environment. Our Nurse Navigator for example is an incredible woman who helps patients through their chemotherapy and radiotherapy journeys. We have

â&#x20AC;&#x2DC;The hospital attracts patients from all over the globe, with 144 different nationalities coming through the hospital last year.â&#x20AC;&#x2122;

people of over 50 nationalities working here and always say to them you have to come in with a smile as it can make a huge difference. Unusually the hospital has very large Royal and Presidential Suites with hotel class facilities such as separate areas for security staff, and even bullet proof glass. These are unique in London healthcare, and both domestic and international patients use them. The majority of international patients used to be Arabic, but they are now from right across the globe. Despite this diversity the hospital still maintains its family feel, which makes it such an attractive destination for both patients and staff. With a maximum of one nurse to every four patients, the hospital is small enough for everyone to know each other. This sense of community at Bupa Cromwell Hospital demonstrates the potential of the health care systems in the U.K. and contributes to the wellbeing of patients, no matter which country they come from.

Further information www.bupacromwellhospital.com

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Kingâ&#x20AC;&#x2122;s College Hospital Clinic Abu Dhabi

Shining a light

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Private Healthcare

King’s College Hospital Clinic Abu Dhabi

Opening a brand new hospital clinic in Abu Dhabi is a challenge, but with the world-class reputation, knowledge and experience of King’s College London behind the project, it can be a growing success says Eileen Lock, Clinic Director at King’s College Hospital Clinic Abu Dhabi

ing’s College London NHS Foundation Trust is one of the UK’s largest and busiest teaching hospitals, with a unique profile and an international reputation across a range of disciplines. In October 2014, King’s decided to utilise this reputation by opening a health clinic in Abu Dhabi in the United Arab Emirates, its first site outside of the UK. The site aims to provide high quality and cutting edge healthcare, and specialises in gynaecology, foetal medicine, paediatric, gastroenterology, as well as family and internal medicines. Starting a brand new health clinic anywhere in the world does not come without its challenges, but these challenges are especially acute when the new site is so far from the original. “King’s College Hospital’s reputation has been crucial,” says Eileen Lock, the Abu Dhabi clinic director. “I think a lot of people use our clinic because they know and trust the brand of King’s in London. The local patients might not have any understanding of the setup of the NHS, but they know the healthcare in England is high quality, cutting edge and can be trusted.”

Local collaboration There is still, of course, a degree of local collaboration because in the UAE you cannot start a business without a local sponsor. King’s has three local partners that have assisted with setting up the clinic and establishing itself in the UAE. Eileen Lock was in the advanced party that came to the UAE a year ago to begin organising the project, and she highlights just how far the clinic has developed in such a short time. “When I first arrived here there were problems with construction, so there was no office space. We had to have our initial meetings in coffee shops until we were able to get office space from one of our sponsors, and use their meeting rooms twice a week to brief the handful of staff we initially had.”

EILEEN LOCK Eileen trained as a nurse in London. She has held a number of nursing posts in hospitals across London up to Director of Nursing. She has Secondary care background in surgery and ambulatory care. Eileen undertook a degree in Healthcare management working in management posts both in the NHS and the private sector, and was previously a Director of Harmoni, the largest out of hour urgent Primary care provider in the UK. Harmon was bought by Care Uk in 2012 .

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Issue 01

| Global Opportunity Healthcare 2015

King’s College Hospital Clinic Abu Dhabi

Private Healthcare

Patient treatment Shining Towers is an impressive structure of two tall silver towers - one commercial and one residential. The King’s College Hospital Clinic covers a space of 2,500 square metres and occupies most of Podium 2. It is a striking clinic: a vast space with various treatment and waiting rooms for both male and female patients, a children’s play area, eight treatment rooms, scanning facilities and a stateof-the-art Pathology service with access to the comprehensive test repertoire of King’s Health Partners. “The clinic is modelled on the values, policies and procedures of Kings’ College London. There is no difference at all between how we treat the patients here to how they would be treated in the UK,” says Eileen. This consistency is maintained by the 14 doctors and 13 nurses at the site, all from England and recruited specifically for the task by King’s College Hospital consultants. Adapting to cultural differences may have caused other issues in the creation of the site, but in fact Eileen explains that this was not as much a concern as originally perceived. “I was quite surprised at how forward thinking it is here. Working in London prepares you for ethnic diversity so coming to Abu Dhabi was not a culture shock. Of course there are differences, but in some respects it is ahead of the UK. For example particularly on the banking side, as every time you use your credit card you get a text immediately to say it has been used. Everything is done by email or telephone as well, so all your bills are dealt with by text message.”

Reducing travel The UAE was chosen specifically because King’s has had a long association with the region dating back to when the then President of the UAE, Sheikh Zayed, donated money to set up King’s College Hospital’s first liver unit back in 1979. Indeed about 60 percent of King’s private sector patients come from this part of the world, and the clinic will allow patients to undergo pre-operation and follow up treatments within their own country to reduce the

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‘The local patients might not have any understanding of the setup of the NHS, but they know the healthcare in England is high quality, cutting edge and can be trusted.’ need for travel. It also provides a seamless pathway to King’s College Hospital in London should the need arise. “One of the local Emirati doctors here did some training at Birmingham Children’s Hospital and has always had an association with the UK. At one of the international conferences he made contact with the King’s College Hospital paediatric gastroenterologist and came up with the idea of having a King’s College Hospital out here in Abu Dhabi,” explains Eileen. While it is still early days, the clinic has been an initial success and the numbers of patients continue to grow. In the Middle East word of mouth is often the most effective marketing tool, which means a new venture such as this may take time to develop to its peak effectiveness. “Most patients come on the recommendation of another patient or friend. We expect to hit our target of full capacity of patients within about a year. That is about 250 patients a day,” says Eileen. These numbers demonstrate the challenges in creating a new clinic are being overcome, and King’s College Hospital has hopes of expanding the services that the clinic offers beyond the restrictions of the day surgery facility procedures. In the longer term there is potential to develop the facility into a full time hospital, as well as to replicate the clinic across the rest of the UAE.

Further information www.kchclinics.com

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Aspen Healthcare

| Aspen Healthcare has a portfolio of top London private hospitals and an impressive record in patient treatment and care, says Michelle Martin, Development Director

Leading light in private healthcare

edical tourism is defined as the practice of travelling abroad to seek medical treatment, and is one of the fastest growing facets of the global healthcare industry. A large percentage of individuals seeking treatment overseas choose to come to the UK, and in particular London, for their treatment. This is due in part to the UK’s long-standing reputation for world-class private hospitals and clinics. With endless options for entertainment and some of the best restaurants and hotels in the world, it’s no wonder that London is a destination for tourists, both medical and otherwise, from all over the globe. Aspen Healthcare’s London portfolio of private hospitals include Parkside Hospital and the dedicated oncology clinic, Cancer Centre London, both in Wimbledon; Highgate Private Hospital in north London; and Holly House Private Hospital in Buckhurst Hill. At Aspen Healthcare, we partner with over 650 highly-regarded consultants who hold senior positions in world-renowned NHS teaching hospitals. This is one of the key reasons why our Parkside Hospital in Wimbledon has been deemed a Centre of Excellence for various specialties. While Aspen Healthcare hospitals in London offer a wide range of services to international patients, from orthopaedic and general surgery, bariatric and

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cosmetic surgery, dermatology to neurology, general and respiratory medicine to name a few; one of the largest areas of medical treatment sought by patients travelling from abroad is for cancer. Aspen Healthcare’s Cancer Centre London is a major destination for patients seeking treatment for a wide variety of cancer treatments, with skilled consultants conducting surgery at the nearby Parkside Hospital, and chemotherapy, radiotherapy and a variety of other treatments and support services provided at the Cancer Centre itself, by some of the leading consultants in the country. Cancer Centre London is also staffed by several professors who have dedicated their lives to research and treatment into the developed world’s most deadly disease. These include two professors recently presented with Lifetime Achievement Awards by the British Prime Minister during the 2013 Pride of Britain Awards for their 50-year careers in medicine and their work on myeloma and breast cancer care respectively. A major consideration for patients seeking healthcare abroad is that treatment is administered with the highest regard for quality of care and

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Private Care

effective outcomes, under stringent guidelines of clinical safety. Aspen Healthcare operates within a robust quality governance framework, and Patient Reported Outcomes (PROMS) include Aspen Healthcare facilities in the Top 25 Hospitals nationally across the UK (including NHS facilities) when it comes to ‘health gain scores’ in relation to hip and knee replacements. For many patients, a stay in hospital might also raise concerns about risks of contracting an additional condition, but in 2013 Aspen Healthcare reported a grand total of zero hospital acquired infections. Patient concierge service While the concepts of quality and comprehensive healthcare are undoubtedly vital to any patient, the importance of good service for medical tourists cannot be underestimated. As well as world-class medical facilities, Aspen Healthcare private hospitals also

Aspen Healthcare

offer unique patient services. These include a concierge service provided by International Patient Coordinators, who may assist the prospective patient with anything from arranging travel to and from the hospital, to navigating the healthcare services they require. These dedicated Patient Coordinators not only speak the relevant language, or have access to interpreting services, but are also familiar with the system, the consultants and nurses and any cultural considerations that may need to be taken to ensure a smooth and stress-free stay. International patients are offered the option of a return trip for a follow-up consultation, or of having their UK-based consultant liaise and communicate with their medical team in their home country, ensuring consistent and continuous care regardless of location. Another important factor for patients choosing to go abroad for care also inevitably involves cost. Patients from abroad seeking treatment in London, or the rest of the UK, have the choice of using international medical insurance to fund their stay, or to pay for it themselves. Despite a recent investment of over £40 million into cutting edge technology and facilities, Aspen Healthcare balances the patient expectations of receiving high quality care with that of affordable cost. Another factor drawing medical tourists to London is the prevalence of groundbreaking techniques and the number of consultants pioneering new technology. The commitment of the British medical community to further progress and innovation in all fields is one of the reasons why the UK is so attractive. In 2014 Cancer Centre London became the first private hospital in London to provide targeted radiotherapy with the Elekta Versa HD linear accelerator system. This system is the latest advancement in radiotherapy technology, and is used in managing a range of cancers in the head and neck, lung, gastro-intestinal system, breast and prostate. It has the ability to continually reshape the radiation beam to the fine contours of the tumour so an extremely precise, higher dose of radiation can be delivered, reducing treatment times and preserving healthy tissue. This machine has been described by Aspen Healthcare CEO, Des Shiels, as “the cutting edge of the most recent technology in the provision of radiotherapy.” In the Aspen Healthcare Patient Satisfaction Survey independently administered in 2013, 99.6 percent of those asked reported a high level of satisfaction with their consultants, and 98 percent reported the same level of satisfaction with the standards of nursing. Overall, 98 percent of patients would recommend Aspen Healthcare facilities to family or friends.

Further information Tel: +44(0) 208 971 8013 Email: michelle.martin@aspen-healthcare.co.uk – Development Director, Aspen Healthcare Email: amit.sharma@parkside-hospital.co.uk – International Business Manager, Parkside Hospital.. www.aspen-healthcare.co.uk

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Issue 01

| Global Opportunity Healthcare 2015

AIHO

Private Care

AIHO

The UK as a global centre of healthcare excellence London hospitals lead the way in independent healthcare, says Fiona Booth, CEO of AIHO, but eastward trends means expertise and treatment are going global

e are at an exciting juncture in international healthcare. Technological advances have given us the tools to diagnose and treat some of the most complex and virulent medical problems out there, and globalisation has enabled tens of thousands to travel, sometimes long distances, to receive this treatment. These two trends have given rise to international centres of healthcare excellence, of which the UK is one. That is why I am delighted to contribute to this publication. As the CEO of the Association of Independent Healthcare Organisations (AIHO), I represent acute hospitals run separately from the NHS, the public healthcare system in the UK. AIHO members are found across the entire country, and patients travel in large numbers every year to be treated in them. Of course, we are all aware of a shift in geopolitical emphasis eastwards, a shift that will accelerate and grow in the coming years. But I hope that London will retain its international reputation, and that AIHO members can help pave the way as we look to an eastern future. To do that, we have to ask how London acquired its reputation as an international centre of healthcare excellence. I believe it is because the quality of care in our hospitals has enabled this enviable international reputation. Patients are treated with dignity, respect and their wishes are paramount in their clinicians’ minds. Some may receive simple outpatient care, whereas others may require more complex types of surgery, requiring a longer stay. The King Edward VII Hospital in

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London provides a good example of the flexible care on offer. On the one hand, the hospital offers a range of occupational and rehabilitative supporting therapies. Some of these are aimed at those recovering from sporting injuries, while others support patients who have had orthopaedic surgery or suffer from arthritis. King Edward VII also offers advanced surgical and critical care, which can require multi-night stays, intensive staffing and follow-up care.

International choices So there is a real diversity of provision here. Some people come to London for extremely specialised cancer treatment; others for more routine

no industry untouched. Healthcare is no different, and we expect to see a growing internationalisation of expertise and treatment. Indeed, some AIHO members belong to international chains of hospitals. We believe that these institutions can assist and develop the internationalisation of healthcare, exporting our reputation for first-rate care around the world. Despite recent medical advances, there remain significant medical challenges in the 21st century. Some are well established, such as the fight against cancer and smoking. Others are relatively new, such as obesity. In a global environment, it is clearly a bonus that more people can travel for diagnosis

‘Some people come to London for extremely specialised cancer treatment; others for more routine surgery unavailable in their country.’ Fiona Booth

surgery unavailable in their country. As a consequence, we have an admirable mix of specialised clinics, general hospitals and consultants’ practices. Moreover, as an international city, patients can be made comfortable by receiving treatment from clinicians who speak their mother tongue, or benefit from readily-available, highly-qualified medical interpreters. So we believe that London will continue to be a global centre of healthcare excellence for the foreseeable future. Nonetheless, we would be foolish to ignore the shift in emphasis and investment to the East, a movement which we believe will leave

and treatment, or can elect to be treated in their home countries. We hope that a growing number will choose to be treated in institutions operated as satellite operations of UK-based hospitals. There are no easy answers to these challenges, but AIHO members and hospitals are very optimistic about helping to find those answers.

Further information London Office: 020 3713 1740 Email: info@aiho.org.uk www.aiho.org.uk

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Spire Healthcare

Inspirational healthcare Increased investment by Spire Healthcare has created specialist centres and improved treatments for patients

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or foreign visitors looking for private healthcare options in the UK the process can often be confusing and daunting. Spire Healthcare makes this process simple, offering clear advice and an easy process for overseas patients to access their hospitals. Welcoming patients from all over the world Spire HealthcareÂ works closely with medical referrers or sponsors including country embassies, country health offices and military offices, sports teams, private companies, companies specialising in repatriation to the UK, and consultancy companies handling international medical care. With 39 hospitals and 13 clinics across England, Wales and Scotland, treating insured, self-pay and NHS patients, Spire offers a range of procedures including in-patient/day-case procedures in areas

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Private Healthcare Spire Healthcare

Main image: Bristol (Aztec West) and reception (below)

including orthopaedics, gynaecology, cardiology, neurology, oncology and general surgery and also diagnostic services including imaging and pathology. The Group also offers outpatient services, such as consulting, minor procedures, treatments, health checks and physiotherapy. In 2014 Spire delivered tailored, personalised care to more than 260,000 in-patients and daycase patients, and is the leading private provider by volume of knee and hip operations in the United Kingdom. As well as leading medical care, Spire places a high emphasis on looking after people rather than just treating patients. In 2014, 92% of patients rated the care and attention from nurses as either excellent or very good and 98% of consultants would recommend Spire to a friend or family member. More than £654 million has been invested in Spire hospitals since 2007. This huge investment has created facilities accredited as specialist centres for a range of medical and surgical specialties. Included within this investment is a commitment to develop a UK wide range of specialist cancer services. Spire currently has four radiotherapy centres in partnership with Cancer Partners UK but its £13m Bristol radiotherapy centre (The Specialist Care Centre) is the first of a planned nationwide network of specialist centres. The centres will offer diagnostics, chemotherapy, radiotherapy, cancer surgery and ongoing care for cancer patients and survivors. The Specialist Care Centre in Bristol hosts an allimportant state-of-the-art linear accelerator (LinAc), enabling Intensity Modulated and Image Guided Radiotherapy treatment. For Dr Amit Bahl, Consultant Clinical Oncologist, the Centre shows the way forward in cancer treatments. “The Spire Specialist Centre in Bristol offers state of the art radiotherapy with precision planning and

SPIRE HEALTHCARE FACT FILE l Out-patients: 260,000 in-patient and day-case appointments were carried out at Spire in 2014 l Infection control: 0.00 rate of MRSA per 10,000 bed days l Satisfaction: 92% of patients rated the care and attention from nurses as ‘excellent’ or ‘very good’ l Recommendation: 98% of consultants would recommend Spire to a friend or family member l Investment: £654m+ capital investment has been made into Spire hospitals since 2007 l Spire Healthcare - voted Private Hospital Group of the year 2014 by Health Investor Magazine

delivery of treatment,” he says. “The feedback from patients treated has been overwhelmingly positive and they have all praised the individualised care and support provided through their cancer treatment pathway,” Bristol is one of few sites outside London offering this service and allows Spire to deliver the entire cancer treatment pathway. Its success shows that private provision can play a key role in the future of cancer treatment. “Flexibility around treatment times with the option of having radiotherapy treatment during the evenings or over the weekends has enabled patients to continue their normal working lives whilst undergoing their treatment schedule,” says Dr Bahl. In December 2014 Spire announced plans for a second cancer centre next to Baddow Hospital in Chelmsford, Essex. This centre will comprise a radiotherapy facility, housing two state-of-theart linear accelerators, a wide-bore CT scanner, consultant rooms and an eight bay chemotherapy suite. This centre supports Spire’s commitment to providing quality cancer care across the country. As they look to strengthen their position as a leading UK private hospital group, Spire has also had approved planning applications for two new hospitals in Manchester and Nottingham to extend the range of services offered and grow its network of consultants, hospitals and clinics. “Spire continues to invest heavily to provide our referring clinicians with the most up to date facilities and equipment, while all the time widening the range of specialities and conditions we treat”, says Neil McCullough, Business Development Director. “Since 2007 we have increased our number of operating theatres from 103 to 122, with many more either under construction or planned. We are now looking forward to the next exciting phase of our growth story, which begins with two new state-of-theart hospitals and a network of specialist care centres across the UK.”

Further information For further information about Spire Healthcare visit www.spirehealthcare.com or call 0808 223 0039

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Issue 01

| Global Opportunity Healthcare 2015

King’s College Hospital

A centre of clinical excellence King’s College Hospital NHS Foundation Trust has a proud history of medical excellence, and patients from the UK and overseas can benefit from its world-class treatment services

ing’s College Hospital NHS Foundation Trust is one of London’s largest and busiest teaching hospitals with a unique set of specialist services. Established in 1840, King’s has been at the forefront of medical innovation for over 175 years. Today the hospital has 1,500 beds, 40 state-of-the-art theatres and over 10,500 committed members of staff across a wide range of clinical specialties, delivering in excess of one million patient contacts each year. King’s Private is a dedicated service for patients wishing to pay for their own treatment either by self-financing, by insurance or by other sponsoring bodies. King’s Private services are based in a beautiful art deco building, called the Guthrie Wing. However on some occasions, patients requiring very specialised services may be accommodated elsewhere within the hospital. For example all children are looked after in specialist children’s wards.

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International patients are provided with additional dedicated services such as Arabic, Greek and Mandarin patient liaison staff, who look after patients during their stay and also act as translators. The hospital provides prayer rooms, tempting meals, television and newspapers in the patients’ own language and also looks after relatives. The doctors at King’s have won many awards, both nationally and internationally, and continue the hospital’s proud legacy of medical excellence.

Liver transplants The Liver Unit at King’s has transformed the lives of thousands of men, women and children from all over the world. Opened in 1840, the Liver Unit has been at the forefront of liver research, innovation and the implementation of new patient treatments for over 175 years. King’s College Hospital has performed more adult

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NHS Foundation Trust

King’s College Hospital

and paediatric liver transplants than any other centre in the United Kingdom. In 2014 the transplant team performed 228 transplants. A pioneer in liver transplantation since 1966, the Liver Transplant Centre uses state of the art technology and leading medical and surgical interventions to provide individualised, ongoing care for adult and paediatric patients with liver disease. Our Liver Transplant Programme provides complete treatment, transplant and management options for patients with acute or chronic liver disease as well as patients with liver cancer. Patients at King’s receive integrated, comprehensive care beginning with a careful assessment and evaluation to ensure that transplantation is the patient’s best treatment option. For international patients, King’s offers a ‘living donor’ liver transplantation programme and the donors and recipients are carefully assessed to ensure the best outcomes for both the patient and the donor.

Antiviral treatments The King’s viral hepatitis service is one of the largest specialist treatment centres for the condition in the UK. We offer high quality, state-of-art treatment for viral hepatitis B and C patients as well as those also infected (co-infected) with hepatitis D (HDV) and the human immunodeficiency virus (HIV). King’s is involved in several on-going studies evaluating the safety and efficacy of various antiviral treatment regimens for chronic Hepatitis B and C, and has already introduced new drug treatments.

Neurosciences The neurologists, together with their neurosurgical colleagues, provide a complete service for patients with a number of neurological conditions. Every year, we see over 20,000 patients with diseases of the brain, spinal cord, nerves and muscles. These include epilepsy, Parkinson’s and multiple sclerosis, as well as rarer conditions like Huntingdon’s. Neurosurgeons at King’s have continued to push the boundaries and challenge established ways of doing things. In January 2009 King’s Consultant Neurosurgeon, Mr Richard Selway, teamed up with neurological experts at Guy’s and St Thomas’ to perform deep brain stimulation surgery on a five-yearold boy weighing just 12.6 kilogrammes. The patient was fitted with a rechargeable state-of-the-art implant to stimulate his brain – something never done before in the UK – that helped him deal with symptoms associated with dystonia, a movement disorder.

Blood cancers King’s is one of the world’s leading centres for the treatment of leukaemia and is the only centre in Europe to have clinical and research expertise in all the main disease areas, including myelodysplastic syndromes (MDS), acute myleoid leukaemia (AML), aplastic anaemia (AA) and paroxysmal nocturnal haemoglobinuria (PNH). King’s also runs the UK’s largest bone marrow transplant service with over 150 transplants taking place last year.

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Issue 01

| Global Opportunity Healthcare 2015

King’s College Hospital

NHS Foundation Trust

King’s College Hospital

INNOVATION AT KING’S COLLEGE HOSPITAL 2014 King’s appointed the world’s first Professor of Metabolic Surgery. Professor Francesco Rubino is an internationally renowned leader in bariatric and metabolic surgery. 2014 The liver team at King’s performed 228 transplants in one year, a record in the history of the hospital. 2013 King’s undertook the world’s first ‘warm liver’ transplant using an organ that was ‘kept alive’ at body temperature. 2012 The team at King’s, led by eye surgeon Mr Tim Jackson, successfully carried out retinal implant (microchip) surgery for patients with retinitis pigmentosa, a degenerative eye condition. 2011 The world’s first injection of donor liver cells was undertaken at King’s. 2009 King’s Health Partners was formed bringing together a world-leading university (King’s College London) and three successful hospitals including King’s College Hospital. 2008 King’s haematology department celebrated 1,000 bone marrow transplants. 2006 King’s consultants repaired the acute rupture of the inner wall of the heart using a device instead of conventional surgery. 2000 A King’s consultant made the Guinness World Records for successfully transplanting a liver into the youngest child ever, at five days old. 1998 King’s started a successful

programme of split liver transplantation. 1996 The first bone marrow transplant was carried out by Professor Ghulam Mufti and his team. King’s is now one of the leading institutions in the world on mini-transplants for myeloid leukaemias. 1995 Professor Nigel Leigh established the UK’s first specialist Motor Neurone Disease Care & Research Centre. 1990 King’s appointed the first Professor of Paediatric Hepatology in the UK. Professor Alex Mowat established the liver transplantation programme in children.

1988 Sir James Whyte Black, Professor of Analytical Pharmacology, won the Nobel Prize for Medicine. 1970 The world’s first specialist liver intensive care ward was opened at King’s. 1966 Miss World 1966, Reita Faria, was the only Miss World who qualified as a doctor during her reign. She went on to continue her studies at King’s College Hospital. 1966 Professor Roger Williams, along with Professor Roy Calne, performed the first liver transplants in the UK. 1923 The Dental School was established at King’s College Hospital. 1877 The pioneer of aseptic surgery, Joseph Lister, performed the world’s first major elective surgery under strict antiseptic conditions. 1860 Florence Nightingale founded the world’s first professional school of nursing. 1840 Sir William Fergusson was appointed Professor of Surgery and introduced practice of conservative amputation. In 1867 he was appointed as sergeant-surgeon to HM The Queen. 1840 Professor of Medicine, George Budd, was appointed. His name is perpetuated in the Budd-Chiari syndrome, a disease of progressive liver failure caused by obstruction to the hepatic vein. 1840 King’s College Hospital was established.

Twenty years ago, there was no service for patients with leukaemia at King’s. The hospital began by conducting autologous transplants (where a patient is treated with their own cells) and now runs the UK’s largest programme of complex transplants, including non-related adult and parent-to-child bone marrow transplants and cord blood cell transplants. The hospital has a large unit with experts in every disease type which is internationally recognised. The outlook for leukaemia patients aged over 50 is often very poor, as traditional chemotherapy treatments are not well tolerated by older people. King’s introduced the concept of non-related bone marrow transplants for patients over 50, using minimal chemotherapy to suppress the patient’s immunity and replace it with a new immune system which then kills the leukaemia cells. This technique is now widely used, especially for myeloid leukaemia, where King’s is an international centre of excellence.

implanting an artificial heart valve through the apex of the patient’s heart via a small incision in the chest wall or groin. In 2009 King’s achieved a UK first in this field by implanting a new artificial heart valve into a patient to replace an old artificial valve fitted during open heart surgery. The procedure has the potential to help hundreds of people with artificial heart valves deemed too high risk for repeat open heart surgery. King’s is also a centre of excellence for primary angioplasty, an innovative procedure helping to save the lives of people suffering heart attacks. Primary angioplasty for myocardial infarction (known as PAMI) uses a ‘stent’ (small metal tube) to open up blocked arteries that have narrowed or become blocked by a blood clot. This is done using a keyhole procedure via an artery up to the heart.

King’s Cardiac Unit

Further information

Over the last year King’s has expanded its keyhole aortic valve replacement programme for patients with narrowing of the aortic valve. The procedure is the preferred choice for many elderly patients and replaces the need for open heart surgery. It involves cardiac surgeons and cardiologists

More information about the services available at King’s Private can be found at www.kingsprivate.com. If you would like to discuss the services offered at King’s or book an appointment with a doctor, please contact the Patient Liaison Manager on +44(0)20 3299 3192, or email kch-tr.PrivateEnquiries@nhs.net.

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Imperial College Healthcare NHS Trust

Overseas patients seeking private healthcare in the UK can benefit from the outstanding healthcare facilities of five major London hospitals, as part of the Imperial College Healthcare NHS Trust, says Dr Kerensa Heffron, Director of Private Healthcare

Continuity of care at top London hospitals

ospitals within the Imperial College Healthcare NHS Trust include St Mary’s Hospital in Paddington, Hammersmith Hospital in East Acton, Charing Cross Hospital in Hammersmith, Queen Charlotte’s & Chelsea Hospital also in East Acton, and the Western Eye Hospital in Marylebone. Each hospital has a private wing offering unparalleled access to some of the best consultants, surgeons and clinicians in the capital, along with exceptional facilities and support in a world-class environment. Imperial College Healthcare NHS Trust was created on 1 October 2007 by merging St Mary’s NHS Trust and Hammersmith Hospitals NHS Trust, and integrating with the faculty of medicine at Imperial College London. Now one of the largest NHS trusts in the country, it joined the College to establish one of the UK’s first Academic Health Science Centres (AHSC), one of only six in the UK. This partnership combines ground-breaking clinical trials and academic research, translating innovative findings into clinical practice so that patients receive the most up-to-date treatment. There has been a hospital at St Marys in Paddington since the 1850s. In 1928 Dr Alexander Fleming discovered penicillin at the hospital, and in 1957 the world’s first heart-lung machines was used during surgery at Hammersmith Hospital. In 2013, robotic surgery was used in a world first to remove fibroids, and this constant innovation is a key feature of the work undertaken at the Trust.

The Lindo Wing The Lindo Wing at St Mary’s is well-known as the place where both Princes William and Harry were born, as well as Prince William’s son, Prince

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Imperial College Healthcare NHS Trust

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Imperial College Healthcare NHS Trust

| Above: Hammersmith Hospital; Below: Charing Cross Hospital

George. It provides world-class maternity care, with neonatal and critical care facilities, and its private paediatric service includes an internationally recognised paediatric haematology service. The Lindo Wing also specialises in a range of other surgeries, including complex and robotic surgeries such as trauma, weight loss, vascular, gynaecology, urology, ear nose and throat, and general surgery. “The practice in the Lindo Wing reflects the work

done in the Trust because we only have Imperialemployed consultants working here,” says Kerensa Heffron, Imperial Private Healthcare’s Director. “We have our own theatres on site, two elective and an emergency theatre just for maternity. There is a Da Vinci robot on the St Mary’s site, so if patients need to be taken across the road for surgery they come back to the Lindo Wing for their post-surgical care.”

The Thames View, Charing Cross Hospital Situated on Fulham Palace Road in Hammersmith, the Thames View is a dedicated private facility on the 15th floor of Charing Cross Hospital. Patients are offered single ensuite rooms with additional access to specialist areas if necessary, and there are day case rooms for a short stay. The hospital is a leading centre for neurosciences, neurorehabilitation, complex surgery, elective orthopaedics and cancer care. There is also a private outpatient department and a dedicated chemotherapy day unit.

The Robert and Lisa Sainsbury Wing, Hammersmith Hospital Situated in West London, the Robert and Lisa Sainsbury Wing specialises in cardiology, cardiothoracic surgery, cancer care, renal and hepatobiliary conditions, as well as offering general clinical services. It is a dedicated private facility within Hammersmith Hospital offering modern, private ensuite rooms for inpatient and day care. It also offers outpatient facilities.

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NHS Foundation Trust

Imperial College Healthcare NHS Trust

DR. KERENSA HEFFRON Kerensa is responsible for the overall management of Imperial Private Healthcare. As well as being accountable for the operational and business management of the dedicated private units, she is also responsible for the ongoing development of the portfolio of services and the quality of care on offer. After spending two years as a management consultant in the city, Kerensa moved into NHS management where she has worked for 11 years. Most recently she spent five years as the director of private practice at the Royal Marsden before moving to Imperial in 2014.

Sir Stanley Clayton Ward, Queen Charlotte’s & Chelsea Hospital The Sir Stanley Clayton Ward is a dedicated private ward at Queen Charlotte’s & Chelsea. The worldrenowned maternity hospital can be found on the same site in East Acton, and offers an excellent level of care for women and their babies through specialist obstetricians, paediatricians and midwives. The hospital is a tertiary referral maternity unit with a nationally celebrated centre for fetal care. It is the largest neonatal intensive care unit in the

Top: Queen Charlotte’s & Chelsea Hospital Left: St Mary’s Hospital

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| Global Opportunity Healthcare 2015

Imperial College Healthcare NHS Trust

NHS Foundation Trust

country and its labour ward has two fully equipped operating theatres with adjacent high-dependency care facilities. The hospital is fully equipped for high-risk cases and, as a result, cares for many women with complicated pregnancies. The hospital also has a midwife-led birth centre for women with uncomplicated pregnancies who would like a natural childbirth experience. Queen Charlotte’s & Chelsea Hospital is also home to the West London Gynaecological Cancer Centre.

Western Eye Hospital The Western Eye Hospital is a renowned stand-alone ophthalmic hospital, established in 1856. Facilities include outpatients, inpatients, day-case and inpatient surgery, and a 24-hour eye accident and emergency service. The Hospital uses state-of-the-art equipment, including the latest optical coherence scanner that provides high-quality images of the retina, giving the very best diagnostic options. New patients are seen in rapid access clinics before being referred on to sub-specialist clinics as required. Opthalmic technicians are on hand to give patients all the guidance to manage their condition once diagnosed.

International patients Leaving home comforts and customs to receive medical treatment overseas can be stressful, but at Imperial Private Healthcare cultural distinctions are a natural part of patients’ care plans. “We believe

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that getting adequate rest in familiar surroundings, however far from home you are, is vital to recovery,” says Tracey Howson, Head of Operations. Multi-faith worship rooms are provided on the three main sites of Hammersmith Hospital, St Mary’s Hospital and Charing Cross Hospitals. Prayer mats and compasses are provided if patients wish to worship in their own rooms. High quality halal meals are provided on-site, and major Arabic TV and radio channels are available in all rooms. Many patients bring family members to the UK with them and visitor policies allow families to spend as much time together as possible. Hospital staff are on hand to assist families to settle in, and female nurses are provided for patients who feel more comfortable with them. Two Arabic advocates have recently been recruited to support Arabic patients with translation services and liaising with their embassies. Furthering knowledge of international patients’ needs is central to Imperial Private Healthcare’s patient services. “We are interested in facilitating collaborative e-learning with overseas health institutions,” says Jonathan Ramsay, Chief of Service for Imperial Private Healthcare. “Our broad expertise allows us to support patients through their entire treatment. This continuity of care, not to mention the reassurance, is vital to recovery.”

Further information www.imperial.nhs.uk

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Royal Brompton and Harefield Hospitals Specialist Care provide expert diagnosis and pioneering treatment to patients with heart and lung disease, and have the capabilities to care for patients from around the world, says David Shrimpton, Managing Director

Royal Brompton & Harefield Specialist Care

New horizons for heart and lung care

he Royal Brompton & Harefield NHS Foundation Trust consists of two sites, the Royal Brompton Hospital in Chelsea and Harefield Hospital (RB&HH) near Uxbridge. As specialist hospitals, they only provide treatment for patients with heart and lung disease. This focus means our doctors and nurses are experts in their field, and indeed we are the largest heart and lung centre in the UK as well as among the largest in Europe. This expertise means the Trust has developed a worldwide reputation and attracts patients from across the globe.

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The concentrated approach allows for the development of expertise, high standards of care and pioneering research. As a consequence, our consultants have been responsible for several major medical breakthroughs, including performing the first heart and lung transplant in Britain, founding the largest centre for the treatment of cystic fibrosis, and discovering the genetic mutation responsible for dilated cardiomyopathy. We work hard to ensure both sites are accessible for foreign visitors, providing personalised care to ensure a comfortable stay. Our dedicated concierge

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NHS Foundation Trust

Royal Brompton & Harefield Specialist Care DAVID SHRIMPTON David Shrimpton has been the Managing Director of the Royal Brompton & Harefield Specialist Care team since 2008, joining from Citigroup where he was the sales and distribution director at the UK retail bank. David spent 17 years at Citigroup holding various positions within the wealth management business working in a number of European and Middle East locations. He has also worked for HSBC and ABN AMRO during the course of his career.

benefit from our heart and lung expertise. Therefore our team of consultants and senior management executives regularly undertake visits to the Middle East, Europe and Asia to establish relationships with local hospitals, government agencies and independent healthcare agents. They attend conferences and deliver lectures on their area of speciality. The RB&HH Visiting Doctor Programme sees our consultants travel to overseas hospitals to work alongside local consultants, sharing expertise and training local teams. RB&HH also offer a remote second opinion service to overseas patients perhaps not able to travel to the UK. Our experts will review the patient’s medical reports and diagnostic tests, and provide their medical recommendation that can be shared with the patient’s doctor. We even offer a chance to set up a remote video consultation in order to provide the patient with even more access to our consultants. RB&HH Specialist Care offers observership and clinical fellowship programmes within our hospitals, enabling doctors to develop their expertise in heart and lung care. We have links with Zhejiang Health Bureau which provides clinical placements for around 40 doctors in their individual specialities per year. Six of our consultants have signed up to oversee these placements at Royal Brompton and Harefield Hospitals. Being able to attract the best medical staff from around the world has been central to our success.

Clinical Expertise

services provide practical support to patients and their families, paying particular attention to their cultural, religious and language needs. In particular, our overseas patients benefit from multi-faith facilities, interpretation services, diverse menu options and assistance with arranging transport, accommodation and medical appointments.

International partners As well as welcoming people to our UK sites, we work closely with international partners and hospitals abroad. We want as many people as possible to

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Above: Dr David Gareth Jones

Our specialities manifest themselves in expert care. Our consultant surgeons offer the full range of surgical procedures and have particular expertise in complex cardiac surgery. Valve repair and replacement: With over 40 years’ experience in valvular surgery, our cardiac surgeons perform hundreds of valve replacements and repairs each year with excellent success rates. Our surgeons use the latest techniques including minimally invasive approaches and non-open heart surgery using devices such as Transcatheter Aortic Valve Implantation (TAVI) and MitraClip. Heart failure: In addition to Harefield’s renowned transplant work, consultants have recently pioneered the use of artificial hearts (left ventricular assist

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Royal Brompton & Harefield Specialist Care

NHS Foundation Trust devices) to support failing hearts. Harefield Hospital has the largest number of LVAD patients in the UK, many of whom are demonstrating the highest rate of myocardial recovery in the world. Heart disease: Consultants at RB&HH use the full range of revasculation procedures to restore blood to the heart, including coronary heart bypass grafts (CABG), robotically-assisted keyhole surgery (EndoAcab) and a hybrid approach using EndoAcab and Stenting. In 2013, we started using dissolvable heart stents to treat heart disease and have since treated over 100 patients with excellent clinical outcomes. Congenital heart disease: Royal Brompton Hospital’s congenital heart unit is one of the largest in the UK, offering foetal, paediatric and adult services. The adult congenital heart disease unit, home to groundbreaking research, attracts a large number of clinical fellows from around the world. The Heart Attack Centre at Harefield has one of the fastest arrival-to-treatment times in the UK (23 minutes compared to a national average of 56), a crucial factor in a patients’ survival. Our hospitals also run the busiest occupational and environmental lung disease in Europe, dealing with occupational asthma, asbestos-related disease, extrinsic allergic alveolitis and pneumoconiosis. Respiratory disease: We diagnose and treat patients with around 50 different groups of respiratory diseases each year. Our areas of expertise include asthma, fibrosing lung disease, occupational and environmental lung disease,

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Royal Brompton & Harefield Specialist Care

Above: Dr Rakesh Sharma and Dr Simon Davies, consultant cardiologists Below: Reggie Wilson Ward, Royal Brompton Hospital

chronic lung infection, acute respiratory failure, cystic fibrosis, domiciliary ventilation and sleep disorders. Occupational lung disease: Our hospitals run the busiest occupational and environmental lung disease in Europe, dealing with occupational asthma, asbestos-related disease, extrinsic allergic alveolitis and pneumoconiosis. Paediatric care: We have the capabilities to treat patients of all ages, as our foetal cardiologists can perform scans at just 12 weeks, when a baby’s heart valve is just over a millimetre in size, and our clinical teams regularly treat patients well into

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Royal Brompton & Harefield Specialist Care

NHS Foundation Trust

their 90s. Babies and children are cared for in our specialist paediatric unit. This offers play and schoolrooms and is specially designed to minimise the unease children – and their parents – might feel when staying in a hospital. Complex thoracic surgery: Royal Brompton and Harefield Hospitals are leading providers of complex

Royal Brompton Private Inpatients Reception

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Above: Professor Carlo Di Mario, cardiologist

thoracic surgery, treating more thoracic sarcomas, mediastinal tumours and primary chest metastases than any other centre in the UK. For patients deemed to have ‘inoperable’ tumours, our specialists have pioneered ‘cyrosurgery’ where tumours are frozen and single port surgery for better pain control and shorter hospital stay. We are also the largest surgical centre in the UK for the management of COPD, performing lung volume reduction and bullectomy with a zero percent mortality rate over the past 100 cases. Our academic partners are the National Heart and Lung Institute in the Faculty of Medicine, Imperial College London and the Harefield Heart Science Centre. We are also part of Imperial College Health Partners, an organisation bringing together the academic and health science communities across North West London. Research is essential to maintaining standards, and we are Europe’s topranked respiratory research centre and our cardiac, cardiovascular and critical care teams are rated in the top three most highly cited health research teams in England. Working closely with Imperial College London, our research teams have gained a five star rating for their contribution in finding new ways to treat heart and lung disease.

Further information www.rbhh-specialistcare.co.uk

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Royal College of Physicians

| Medical skills training for overseas doctors The Royal College of Physicians believes overseas education and consultation are key to achieving its goal of the ‘best possible health and healthcare for everyone’

he UK’s medical royal colleges and faculties play an essential role in improving care for patients by maintaining high standards of medical education and training. They are also professional membership bodies that represent and support their members, and provide advice on health matters to the government, media and the public. The medical royal colleges and faculties have varied remits, though most are central to shaping training, setting exams, and facilitating ongoing professional development. In 1974, the Academy of Medical Royal Colleges was established to promote, and where appropriate, coordinate the work of its 21 member colleges and faculties.

including the membership exam MRCP(UK), which is designed to test the skills, knowledge and behaviour of doctors in training, and is taken in centres across the world. The RCP delivers a range of training courses, workshops, and conferences in the UK and internationally, and provides a range of accreditation services aimed at improving the quality, safety and outcomes of healthcare. In partnership with other royal colleges, the RCP houses the National Clinical Guidelines Centre (NCGC) which is commissioned by the National Institute for Health and Care Excellence (NICE) to write evidence-based clinical practice guidelines.

Globally recognised membership

In addition to delivering exams at centres across the world, the medical colleges use their expertise in education and clinical standards to deliver development and training projects, and provide consultancy services in high, middle and low income countries. Fifteen of the UK medical colleges participate in the Medical Training Initiative (MTI) - a scheme established in 2009 to give international medical graduates the opportunity to train in the UK for up to

Established in 1518, the Royal College of Physicians London (RCP) has represented physicians for almost 500 years and has over 30,000 members and fellows across the globe. The RCP supports its fellows and members to improve patient care throughout their careers, from medical school through to retirement. The RCP works with the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow to maintain and improve the high standards of education and training of UK physicians, by developing curricula for 29 specialties and monitoring trainees’ progress. Together, the colleges develop and deliver globally recognised membership and specialty examinations,

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Improving medical standards

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Royal Colleges two years before returning to their home countries. The RCP’s scheme is the biggest of all the UK colleges programmes with nearly 250 junior doctors currently training in the UK.

Royal College of Physicians

MAIRI MCCONNOCHIE Mairi McConnochie is the Head of International Affairs at the Royal College of Physicians, responsible for developing strategy in collaboration with the international director and identifying avenues for international

International reach Twenty percent of members and fellows currently live outside the UK, and work to improve medical standards touches every corner of the globe. Much of the RCP’s international work is guided by international director Professor David Warrell and a team of seven associate international directors, including Professor Ali Jawad (Middle East and North Africa) and Dr Fraz Mir (South Asia). Each one is responsible for a different region of the world, and leading on developing strategy and implementing projects in that region. Supporting the associate international directors is a network of 60 international advisers in 39 countries. International advisers are local representatives who act as a point of contact between local members and fellows and the RCP. They are tasked with establishing local links for RCP projects, nominating doctors in their country for fellowship, and advising on a range of professional and educational issues.

collaboration. To discuss opportunities for your organisation to partner with the RCP, or for more information on the RCP’s international projects, please email international@rcplondon.ac.uk

Current international projects The RCP is a world leader in postgraduate education solutions, delivering a range of medical education workshops with partners around the world. Recent partnerships include a series of faculty development workshops in Oman, Nigeria, Ghana and the US. These include one and two-day ‘doctors as educators’ courses, aimed at developing the skills necessary for the effective training and supervision of trainees. These intensive courses are suitable for doctors of all grades and specialties, and consist of a series of interactive workshops and problem based activities.

New initiatives Over the last two years, the RCP has been working in Oman on an innovative and novel initiative to

Opposite: International medical graduate symposium, Royal College of Physicians, London Below: Inaugural meeting of the College of Physicians of East, Central and Southern Africa foundation group in Nairobi, Kenya

take recently published evidence-based guidelines (covering a global evidence base) and adapt them to suit the local culture and context. The Oman Ministry of Health funded the initiative and has been instrumental at a policy level in supporting the project from inception through to publication and implementation. An RCP team has been working alongside a team of Omani clinical colleagues, enabling them to understand international evidence-led healthcare systems, develop country specific guidelines and initiate ‘change in action’. The policy value of this approach is that modest global investment generates national guideline programmes, reducing variation in care and optimising healthcare delivery costs. The team is currently examining ways in which they can extend this successful model into other countries.

Medical training in West Africa M-PACT (MDG 6 Partnership for African Clinical Training) is a three-year project in collaboration with the West African College of Physicians (WACP), funded by the Ecobank Foundation. Started in July 2014, the project aims to support the focus of UN Millennium Development Goal 6 – to ‘combat HIV/ AIDS, malaria and other diseases’, by increasing access to high-quality clinical training on managing and treating these diseases for doctors from across the region. The two colleges are working together to develop three MDG 6 training centres in Ghana, Nigeria and Senegal and deliver 18 training courses reaching more than 500 West African physicians.

Supporting a new college in East Africa The RCP is supporting the establishment of a college of physicians of East, Central and Southern Africa. Through providing mentorship, technical support, and access to a range of experts on curriculum development and fundraising, the RCP is helping senior doctors from across the region to establish the institution. The new college’s mission is ‘to improve standards of healthcare throughout the region by providing specialist training for physicians committed to lifelong learning’. It aims to increase access to standardised, high quality postgraduate training and to address urban/rural discrepancies.

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NHSBT Filton

PHOTO: SWNS GROUP

What happens to donated blood?

The process through which donated blood is tested and processed into different products is fascinating, and it all happens at NHSBT Filton near Bristol, says Judith Baker 108

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Special Health Authority

NHSBT Filton

he immediate impression of the NHS Blood and Transplant (NHSBT) centre in Filton, Bristol is of a high-grade pharmaceutical facility. The wearing of hairnets, blue coats and overshoes, the flexible or “lean” production areas, and the specialist centrifuge machines spinning and processing blood into its constituent parts reflect the requirement to maintain high standards in a clean working environment. The separate testing area ensures the clinical safety and high quality of the final product. Finally, the logistics areas allow blood products to be packaged and dispatched to hospitals and stock holding units around the country. The whole process is a complex exercise in supply chain management – and NHSBT’s ambition is to be the best organisation of its type in the world. Once blood has been collected from donors at sites across England and North Wales, it is transported to one of NHSBT’s five manufacturing centres. Filton is the largest of these centres, and it is here that life-saving donations of whole blood are split into red blood cells, white blood cells, plasma and platelets. These products are placed into packs for customer hospitals to order online. The hospitals use NHSBT developed software called Online Blood Ordering System (OBOS), which allows them at the touch of a button to order different blood products and types for delivery.

The Filton Blood Centre and its products NHSBT Filton is situated on an industrial estate with ease of access to major transport networks. It is a £58 million facility constructed by Laing O’Rourke, originally intended to produce over 2,000 blood donations a day. By 2014 it was manufacturing over 3,000 units per day following the implementation of a lean performance improvement programme designed to continuously improve the manufacturing process. It is reputed to be the largest blood manufacturing centre in the world. NHSBT Filton’s Centre Manager, John Kirkwood, has a background in haematology. He studied to become a biomedical scientist only to find himself, in his own words, “managing a factory.” With its meticulous process flow through the manufacturing and testing departments, one can see why that comparison has been drawn. The centre runs along the principles of good and efficient manufacturing, and delegations from companies such as Jaguar and Land Rover have visited to learn from the professionals at NHSBT Filton. The testing process begins at 5am each day when the first team starts work on sample vials that are filled during donation, to ensure the blood is virus and disease free. They are tested for a number of major infectious agents, including Hepatitis B and C, HIV, syphilis and human T-lymphotrophic virus.

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Whole blood donations that enter the production line as full blood bags are hung and allowed to filter to remove the white blood cells. The blood is then separated into plasma and red blood cells, and platelets are removed and stored separately. These product packs are labelled with a unique barcode. Red blood cells can be used to treat severe anaemia or bleeding, while platelets can be used to support the treatment of patients with cancer; platelets allow blood to clot and need to be agitated or moved constantly to stop them aggregating. NHSBT Filton has its own logistics department, with a fleet of temperature-controlled vans that move the products to eight warehouses across England. In the same way that trays of platelet product are “agitated” in the Filton centre, the platelets are kept moving constantly by the motion of the van. Some of the most valuable, life-saving products created by NHSBT Filton include blood from umbilical cords, which contain the stem cells from which life itself begins. Cord blood can be used to treat more than 80 diseases, including blood cancers like leukaemia and lymphoma. NHSBT’s Cord Blood Bank was established in 1996 and currently holds around 20,000 donations. A public facility, it is the fourth largest internationally accredited cord blood bank in the world with the second highest percentage of rare tissue types. October 2014 saw NHSBT achieve a landmark, the issue of its 500th Cord Blood Donation, and the introduction of a new typing system that will allow patients in need of a stem cell transplant to find a match more easily. The NHSBT Cord Blood Bank was the first in the world to embark on this exciting new system. The sheer size of NHSBT’s Filton facility and the scale of what they achieve there is incredible to witness - over 40% of the blood products used by hospitals in England and North Wales are issued from this centre. NHSBT Filton has tangible expertise in the management of the blood supply chain – the way in which these life-saving products are processed in vast batches to ensure the needs of one of the world’s largest publicly-funded health services, the NHS, are met. From donor to manufacturing centre and testing,

and then on to the hospitals where lives are saved the blood makes a truly remarkable journey, starting with the donors who visit NHSBT’s fixed and mobile blood donation units.

Marketing the need for donors

PHOTO: SWNS GROUP

NHSBT is one of four UK blood services and all of them are largely self-sufficient in blood products, although plasma for fractionation has been imported into the UK since 1998 to minimise any risk of variant CJD transmission. Further safety developments over the next few years might mean that surplus plasma, if tested rigorously to the quality standards required, could be exported to global plasma fractionators.

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Special Health Authority

The striking success of the NHSBT system is the way it markets, through local community groups, the need for the population of England and North Wales to give blood. At a national level, NHSBT is able to gain an insight into which specific blood products and blood groups are needed; they can then be collected and manufactured to order. Regular donors are vital to the NHSBT process and appeals can be made to ensure that people with a particular blood type come forward to donate their blood should there be a requirement to increase stocks. An example is the need for more Black and Ethnic Minority (BAME) donors. The new donor portal, introduced in November 2013, has already allowed over 550,000 donors to book their

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NHSBT Filton

appointments online. Donors can now register and donate the same day if required. NHSBT has worked with blood establishments and Ministries of Health from countries around the world, including Turkey, who want to drive up the quality of their blood products to conform to British standards. NHSBT is keen to work with other countries that may not yet operate to the standards seen in the UK, and to share its knowledge and experience in collecting, manufacturing, testing and delivering blood products.

Further information www.nhsbt.nhs.uk

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NHS England

Beverley Bryant, Director of Strategic Systems and Technology for NHS England on how technology is revolutionising the UK healthcare system

NHS England looks towards a digital future faster and take advantage of the opportunities that new and connected technology has to offer.

BEVERLEY BRYANT Beverley is the Director of Strategic Systems and Technology for NHS England. Her role is to set the national direction for NHS technology and informatics and stimulate technology leadership and innovation across the NHS in England. She is the SRO for a number of NHS England commitments including Integrated Digital Care Records, NHS E-referrals, Patient Online and Electronic Prescriptions. Prior to joining NHS England she was Managing Director of Health at Capita. She has undertaken various operational roles in bigfive consulting companies, Department of Health and the NHS and her most notable achievement was the creation of NHS Choices in 2007. Her background includes over 12 years of IT-enabled change in roles that include business and systems analysis and technical design authority.

What is your remit within NHS England? I’m the Director of Strategic Systems and Technology within the Patient and Information Directorate. It’s my job to create the technology vision and strategy for the NHS. It’s not all about technology of course, but it is the enabler to help deliver improved outcomes for individuals and allow greater access to health and care services. It’s an exciting time to be part of the NHS right now, with such progress in technology ready to deploy in the delivery of healthcare. How has the NHS reacted to the changing needs of global healthcare and the development of new connected technologies? We all know that the global population is living longer yet has more complex health issues, particularly for adults. As a nation we remain committed to a high quality healthcare system for all our citizens. We have recognised the need to adapt

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How important are new technologies to the future of the NHS? With more technology available than ever before, the NHS must make smart choices. Nationally, we are focusing on IT systems to provide the ‘electronic glue’ to enable different parts of our healthcare service to work together. Locally, commissioners will look for systems that solve their problems. But it is vital that all these technologies meet with the nationally specified security, interoperability and data standards. Having a digitally enabled workforce and getting off paper will allow our clinicians to have constant access to meaningful information such as medications, allergies, and the medical history of a patient that’s available immediately across all care settings. While the NHS is a world-leader in primary care computing, progress on hospital systems has been slow and the NHS is not yet exploiting its advantage as a population-focused national service. Bringing together patient data and transparent performance data will help patients make informed choices and help the NHS commission better quality care. Where do you look for innovation? The creativity, drive and commitment of the diverse supplier community in healthcare IT is hugely impressive. The UK is fortunate to have a large, growing pool of SMEs who have found ways of applying technology to healthcare. We recognise this is not always easy, particularly for new entrants, however through incentives such as funding initiatives, proof of concepts and pilot demonstrators,

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Digital Health

we have seen many come to life and improve services and care within the NHS. How are new connected technologies helping the NHS deliver care? NHS Choices gets over 40 million visits a month and the NHS Spine handles 200 million interactions a month. Much of this is based on connected technologies which have been harnessed and delivered throughout the NHS to make a difference to health and care. NHS Choices is evolving to ensure we reach beyond our current user profile and enhance the experience for those who already use it.

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Check-in screens save patient waiting times at GP practices

NHS England

How are you enabling improved access to care? Incentives such as the Prime Ministerâ&#x20AC;&#x2122;s Challenge Fund is helping improve access to general practice, and stimulate innovative ways of providing primary care services. One example is to enable GPs visiting patients at home, care homes, or other settings, to have access to systems they would have if they were in their own practice building, such as providing the ability to prescribe medicines electronically and either text/email a confirmation to initiate a dispensing instruction to the pharmacy of the patientâ&#x20AC;&#x2122;s choice.

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Digital Health Do you see any barriers to technological innovation in the NHS? Although unintentional, we come across barriers in the NHS due to the very size, scale and federated nature of our organisation, and its breadth of stakeholders. Change can be the biggest barrier – healthcare staff are busier than ever before so getting their engagement is crucial. Senior leadership championing innovation and its benefits can help drive this change. The recently established National Information Board (NIB) will for the first time bring together organisations from across the NHS, public health, clinical science, social care, local government and public representatives. The NIB has clear plans to publish a set of ‘road maps’ laying out who will do what to transform digital care. Is getting people to take control of their own health the end goal? Of course it’s vital that we all take some responsibility for our own health and wellbeing. One in five adults still smoke. A third of us drink too much alcohol, and just under two thirds of us are overweight or obese, so over the next five years the NHS is committed to supporting national action on obesity, smoking, alcohol and other major health risks. Within five years, all citizens will be able to access their medical and care records (including in social care contexts) and share them with carers or others they choose. Patient Online is a great example of realising patient empowerment. Of all general practices, 99 percent have the capability to allow patients to book or cancel appointments, or to view or order repeat prescriptions online. Will a cultural shift need to take place in the way the NHS operates to fully embrace the opportunities presented by new technologies? I don’t see it so much as a cultural shift. The NHS is not one monolithic organisation, it is made of thousands of caring, clever and committed individuals, many with insatiable appetites for new technology. Some care settings and providers are embracing new technology quicker and better than others. We are here to help share, improve and learn from our experiences, both in the NHS and from health economies across the world, to improve the way we use innovation to improve patient care. What will NHS care look like in 10 years time? The NHS will still be the NHS we know and love, but it will be modernised and more accessible to cater for our diverse population. Patient and public participation is key to a modern health and care service so we are listening to patients and designing services from their perspective. People will access care services in a variety of ways; email, instant messaging, webcam, phone, face to face - this will suit their individual needs and their way of life.

Further information

NHS England

CASE STUDY: MEDOPAD Ensuring doctors have accurate and up-to-date patient information is vital to all aspects of healthcare, and increasingly wearable technology is being embraced as the way to do this. Medopad Ltd is one UK company that is leading the way with mobile health solutions that securely connect healthcare professionals with patient information via mobile devices. The company has a suite of CE certified iPad applications that integrate health data securely from existing databases and puts them in the palm of a doctor’s hand. As a result doctors can use the simple Medopad mobile app to access patient records, lab results, vitals, images and more to help reduce errors and improve efficiencies. Medopad is regulatory approved as a medical device, it has been developed with the largest UK private hospital group, and counts the NHS as its customer as well. Most people these days are familiar with using apps on their mobile telephones and other media, so wearable devices are accepted by all ages as an obvious part of their healthcare. Aside from integrating patient data, Medopad can be integrated with patient wearables and telehealth devices to provide a single point of access of care information for healthcare professionals. It boasts the first enterprise solution to be integrated with Google Glass and has integrated with Apple HealthKit. As well as ease of use, mHealth technology seeks to deliver better clinical outcomes in terms of more evidence-led and patient-centred diagnosis and treatment at the point of care, optimised clinical workflows and staff time, more integrated digital records, and reduced costs in the long term.

CASE STUDY: PML Better clinical decision making and a quicker patient journey was the impetus behind Physiologcal Measurements Ltd iPMC platform. Two years ago, PML decided to integrate a telehealth platform into the iPMC platform to allow reports and imaging data, as well as telehealth data, to be viewed from a single software application. This allows identification and quantification of disease, the development of a treatment plan and monitoring of the patient in a community setting. Disease parameters include hypertension, heart failure, diabetes, arrhythmia and O2 saturation. PML have also developed an app for the iPad so clinicians can access data almost anywhere, meaning patients can receive responsive care based on real time data. PML has been delivering a Community Cardiology service for NHS Bexley CCG for five years.

The movement of all non-invasive cardiology into the community was facilitated by the PML service re-design team working with the cardiology project team. Referrals are received at the patient management centre, triaged, and then added to the iPMC software. After the patients diagnostic test, and consultation with the cardiologist or heart failure nurse, all information is uploaded to the patient’s file on the iPMC. It can then be shared with other colleagues to facilitate faster treatment time. For example, consultants in clinic can discuss images and reports with their surgeon colleagues in a hospital. This speeds up the pathway for the patient to receive treatment. The new system of working has reduced pressure on local hospitals and as a consequence of this, advanced imaging or interventional procedures now have a much shorter waiting time.

www.england.nhs.uk

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FTI Consulting

Rx for Integration The goal of every healthcare provider and underlying system is to improve the health status of patients in a cost-effective/sustainable way, says Jeff Benton, Senior Managing Director FTI Consulting

he dictionary defines integration as â&#x20AC;&#x153;combining (one thing) with another so that they become a wholeâ&#x20AC;?. Therefore using that definition, every health care provider in the world thinks the care provided to its population is integrated and every patient in the world sees it quite the opposite. How can the two opinions come closer together? In practically every country around the world, factors such as aging populations, coupled with a rise in income levels and ups and downs of countriesâ&#x20AC;&#x2122; per-capita GDP, among other things are driving increases in healthcare costs. For example, increases in Asian healthcare costs are being driven by many factors, including rising household incomes that correlate with the higher life expectancies that create a larger population of older, sicker patients which consume a greater portion of healthcare resources. Rising incomes also are associated with the increased incidence in Asia of

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the chronic, non-communicable diseases, as well as common diseases associated with developed economies: diabetes, hypertension, and cancer, among others. (India and China now have the largest diabetic populations in the world and experts expect diabetes rates to rise rapidly throughout Asia.) These conditions have a profound and longterm impact on healthcare costs, even as they point the way toward the new healthcare models required to address them. With this understanding on the trends and results, new strategies are emerging world-wide for a change in delivery of healthcare options that include trying new approaches by introducing and implementing new digital technologies that reduce cost and expand the reach of healthcare services and a strong movement toward integration. The challenges of such a transformation are universal, as is the goal of improving outcomes at

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Digital Health

FTI Consulting

lower cost, whether that be in a mixed government and private system of the United States or in the predominantly government sponsored systems in the remainder of the world. The prescription for a balanced approach to this transformation is developing and implementing a clear, overarching strategy that will achieve three critical aims: l Improve the efficiency of current operations l Embrace new and innovative approaches to care to improve patient experience and drive better value from services l Create agile (regulatory and operating) structures and processes that will allow the organisation to do both simultaneously Despite the difference in delivering care around the globe, the goal of every healthcare provider and underlying system seems to be the same: to improve health status of patients and do so in a cost-effective/sustainable way.

JEFF D. BENTON, CTP, CPA, CVA

Improve the efficiency of current operations

improvement must be to improve patient experience while simultaneously achieving both greater efficiency and value from health delivery systems. Therefore one must combine thoughtful performance improvement tactics based on the principles outlined below with changes to how funding is acquired, all with an eye on how the surrounding health economy is affected. Performance Improvement is best achieved by; l Reducing costs as a by-product of improved safety, quality and outcomes l Empowering and engaging patients l Taking a long-term view - CPI is an ongoing, iterative process that is continuous. It is not a shortterm, quick fix cost-cutting programme.

A move to new funding arrangements that link directly to performance is not only desirable but inevitable. In economically disadvantaged areas there is a global shortage of doctors and critical facilities/ supplies/drugs while wealthier nations struggle with finding the optimal resource allocation and division of responsibility between public and private sector payers, providers and the patient. Predictions are that in the very near future there will be less money in the US healthcare system available to hospitals and physicians so dramatic changes are still needed. Indeed, value-based reimbursement programmes that pay for outcomes, not services, driven in large part by the 2010 Affordable Care Act are now taking effect. To survive, every US healthcare provider will need to develop new strategies, capabilities and tactics to remain competitive by lowering costs while simultaneously improving their current resources, clinical expertise and financial discipline. In the UK there is a movement toward Outcomes Based Commissioning strategies designed to achieve similar objectives. But these “top down” funding reconfigurations are only part of the equation. Focusing on continuous “grass roots” performance improvement (CPI) is the tried and true first line of defence but NOT to the exclusion of all else; to understand the risks of this, one only needs to look at the well-reported case of Mid Staffordshire NHS Foundation Trust (MidStaffs) from the UK, where, according to an independent investigation, patients were “failed by a system which ignored the warning signs and put corporate selfinterest and cost control ahead of patients and their safety” The triple aim of effective performance

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Jeff Benton is a Senior Managing Director in FTI Consulting’s Healthcare practice and leads the London office. Jeff has over 30 years’ of experience in healthcare finance, accounting and real estate with an emphasis on mergers and acquisitions, turnaround, restructuring and workout projects for both stable and financially challenged clients. Additionally, Jeff has held non-executive director seats on a Medicaid HMO, a state-wide integrated delivery system and a captive reinsurance company. He has provided healthcare consulting services for more than 13 years having worked in the healthcare industry for 15 years prior. In industry he has held a variety of senior finance positions, including Chief Financial Officer for an HMO and various Business Development positions.

Embrace new and innovative approaches Adopting new digital technology such as electronic health records is advancing rapidly. These tools can lower costs and expand the reach of healthcare providers through wireless access and mobile devices, helping to deliver care to previously underserved patient populations. Just as importantly, they can enhance the integration of clinical resources which has been demonstrated to improve care while driving down costs. For example, new glucose monitoring systems are being developed with technology that will remotely measure a diabetes patient’s glucose levels every few minutes, allowing accurate and specific alerts to be sent to both the user and the physician about impending hyperglycaemia or hypoglycaemia. The cost and outcomes benefit to this technology are self-evident. In many ways new technologies helps emerging healthcare systems avoid the growing pains that come with learning from innovation. The key to benefiting from the implementation of new technologies is accurate, actionable data. Governments, healthcare institutions, and both public and private organisations should be mobilised to amass a broad and deep pool of patient information that can then be queried by analytic tools to assess current gaps in capabilities and outcomes and

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FTI Consulting

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provide a roadmap for improving treatment while also increasing patient engagement, the prerequisite of improved health management. The Cleveland Clinic, a non-profit hospital system, specialising in cardiac surgery, publishes a wide range of outcome statistics; it now has one of Americaâ&#x20AC;&#x2122;s lowest mortality rates for cardiac patients.

Create agile structures Healthcare integration is critical to the management of chronic diseases, and their costs, and must reach beyond the four walls of the hospital or clinic. This is especially important in Asia, where healthcare outside urban areas is most often fragmented and difficult to access. But while goals of integrated, technology-assisted healthcare are universally understood and accepted, current payer models do not reward physicians and institutions for the investments needed to reach into communities with preventative programmes, wellness initiatives and treatment follow-up networks to manage the health of patient populations outside the clinical environment. To do so requires the development of new delivery and clinical governance models that emphasise the importance of scale and take a new approach to risk. And both demand organisational agility. For payers this could mean engaging consumers/ patients differently by emphasising cost awareness and preventative care. It could mean negotiating contracts with providers that include pay-forperformance (outcomes) models. In the US, some payers have even entered the provider space, creating integrated healthcare systems where they have direct control over the cost and quality of care,

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and a greater ability to reap economies of scale, showing movement toward the more universal government sponsorship model. Whatever model is adopted will mean developing a strong partnership between clinicians, administration and staff, making sure that the collective strategy is clear and broadly communicated to all stakeholders and clearly evaluating the costs and benefits to ensure return on investment and a clear understanding of the value to the payer and the patient.

Conclusion The downside of the much of the worldâ&#x20AC;&#x2122;s rising standard of living is the increased prevalence of the chronic, lifestyle-related diseases formerly associated with the West. At the same time, many parts of the world are experiencing challenges unique to their geographies or culture, such as disparate urban-rural splits in healthcare availability and sophistication, characteristic of every health economy around the globe. Each country has to confront a highly-complex, often unique path to its own healthcare transformation. Pushing for integration too quickly when a national health care system is ill-prepared can be detrimental Advice about what works, what doesnâ&#x20AC;&#x2122;t can be gained from the challenges that the US and to a lesser extent the UK healthcare systems have confronted and may provide ideas for other countries to follow, learn from or avoid.

Further information Tel: +44 (0) 20 3727 1000 www.fticonsulting.co.uk

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SmartMed

Mobile phones empower patients to self-manage chronic conditions Mobile technology has the potential to bring better health outcomes for everyone, says Simon Eyre, joint founder of Appdragon SmartMed

ealthcare providers around the world face a major challenge in addressing the growth of chronic diseases. Providers such as the UKâ&#x20AC;&#x2122;s National Health Service (NHS) face spiraling costs as resources are stretched to address the burgeoning cases of diabetes, coronary artery disease, respiratory conditions and obesity. At the same time the patients, spurred on by proactive patient groups, are becoming more savvy and demanding better service from their local clinic or hospital. One way of addressing this imbalance would be to empower the patient to manage their own condition, in the comfort of their own home. The outcomes for the patient are clear: less time spent travelling to and from clinics, fewer hours spent sitting in waiting rooms and greater control of their own conditions and, therefore, their own outcomes. For the healthcare provider the potential cost savings are just one advantage. Proactive, selfsufficient patients can mean quicker recovery times when treatment is required, and patients being better equipped to understand the affects of diet, exercise and medication on their condition.

Benefits of telehealth Telehealth services, such as SmartMedTM can deliver a range of benefits for patients, the healthcare provider and the healthcare practitioner. Patients can enjoy better outcomes as access to specialists and other interventions is more timely. When clinic or hospital-based treatments or additional home visits are required, the healthcare professional can be equipped with a complete history of the patientâ&#x20AC;&#x2122;s vital signs and health assessment data, allowing them to focus more on treatments than triage and diagnosis. That said, if unnecessary admissions and readmissions can be avoided in the first place, the

Smartphone technology In most countries around the world, be they developed or developing, the mobile phone is ubiquitous. In the UK alone there are some 65m active mobile phones, used by a population of 60m. Increasingly the vast majority of these phones are smartphones with the ability to provide the processing power and screen resolution for almost any application. In this way, telehealth - the delivery of health-related services and information via telecommunications - has the potential to really make a difference to how we live our lives. The smartphone is an intelligent communications device that can be used anywhere the patient goes. This could be in their home, at work or even on holiday. Health workers can also use mobile devices such as smartphones or tablets, enabling them to effectively take the clinic to the patients, with access to patient records and a wealth of assessment and monitoring tools literally at their fingertips.

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Digital Health

SmartMed

outcomes for both the provider and the patient can be significantly improved. If patients are able to monitor themselves, backed up by experts who are able to see their health data remotely then they will be less anxious about their condition. Empowering the patient in this way makes them more proactive in taking control and understanding their illness and its symptoms. A relaxed and confident patient may experience enhanced health outcomes and better overall wellbeing.

Patient self-monitoring If patients require fewer visits to clinics or hospitals, this allows the health care provider to focus precious resources on those patients who are most in need. SmartMed was used by a private hospital in India who wanted to discharge patients more quickly after minor heart operations, thereby freeing up bed space. The patient self monitored their vital signs while still on the ward and was then able to confidently continue this from the comfort of their own home. This approach resulted in fewer re-admissions and quicker recovery times. SmartMedTM provides easy to-use-smartphone apps for patients and health workers, and also their relatives. It enables patients to capture vital signs information on their smartphone or tablet using a range of wirelessly connected medical devices. For example, diabetics can record their blood sugar levels using the SmartMedTM Glucose Meter, heart patients can record their pulse rate, blood pressure, cholesterol levels and blood oxygen content. Patient

questionnaires that run on the phone and guide the patient through a series of relevant questions about their wellbeing and symptoms, provide qualitative information that, together with the vital signs, can help a qualified clinician make an assessment of the patientâ&#x20AC;&#x2122;s condition and how they are managing it. All of this data is beamed back to the clinic via the Internet where it can be viewed in graphical or tabular form, providing the clinicians with a clear view of current and historical data. A series of red, amber and green alerts based on pre-configured, individualised thresholds help spot danger signs so that timely interventions can be made. This could include calling the patient on the phone, messaging them via the app or perhaps, in some cases, sending a community nurse to visit the patient or call the patient into the clinic for further investigation. The key is that the patient not only becomes involved in montoring their own condition, vital signs and symptoms, they are doing so safe in the knowledge that the experts are also monitoring their results. This increases confidence and reduces stress, which can only benefit patient wellbeing.

Further information For more information on SmartMed and how Telehealth can help you as a service provider (or as a patient) manage the challenge of chronic illness, visit our web site www.mhealthcaresolutions.co.uk, call us on +44 (0) 845 057 3860 or email us at info@iappdragon.com For healthcare providers based in the Middle East or North Africa, please contact our agents Harrington Consultants on +44 (0)20 7969 2827 or email info@harringtonconsultantsltd.com.

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11 Health

Helping patients manage their ostomy A device that started life as a direct result of the personal experience of its inventor is changing the lives of stoma users. Patient-turned-innovator Michael Seres is now introducing his product to the rest of the world

stomi -i Alert Sensor is a product that was conceived in a hospital when its inventor, Michael Seres, was recovering from a bowel transplant. After 20 operations for the incurable condition Crohn’s disease, he had became the 11th person in the UK to receive a small bowel transplant. Looking for a solution for managing his stoma bag following the transplant, Seres spent two months developing a hand-built prototype product using parts he had obtained on eBay. It took nine months to take this crude prototype hand built model to fully working product. Along that journey he received the backing of his now business partner Adam Bloom and together they worked with electronics experts to commercialise the product. The results have been life changing. The product clips on to the outside of a stoma bag and sends Bluetooth alerts to a free app on the user’s mobile

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phone. This enables patients to set multiple alarms alerting them as to when the bag is filling. In addition the sensor automatically captures the output data sending it direct to carer, nurse or clinician to provide the first ever real time monitoring of stomas. The device costs about £50 and is purchased direct from the company’s website. From its inception in 2012, 11 Health is now working with hospitals all over the world. Ostomi-i Alert Sensor is available in the USA on prescription, and many leading US hospitals including Massachusetts General Hospital , Mt Sinai and Stanford are undertaking user testing of the device on patients. Michael Seres says that the company is hoping to get the same support from the NHS in the UK. As part of the product development, Michael Seres talked through online social media to around 20,000 patients to get their views and the company continues to talk to patient groups in the UK and USA. As a result they have a good understanding of the issues which, says Seres, are the same the world over.

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Digital Health 11 Health

At the moment the device has 220 paid customers in the UK. In the USA, Ostomi-i Alert Sensor has just received full FDA 510k approval, which represents a major breakthrough in getting it accepted in the American market. The process took a lengthy six months and involved the FDA examining every aspect of the product from looking at the original drawings, safety, user testing and clinical testing. Now the product is attracting attention from a number of different areas. The company continues to work through social media with groups including the Stoma Nurse community and is educating users and carers in its use which dramatically simplifies the management of the stoma bag. The alternative to using the discreet device, explains Seres, is to measure output by emptying it into a jug and measuring it manually. The device calculates output for the user without having to go through this process. Feedback has been positive, with 98 per cent of users saying they are happy with the device and 8 UK hospital sites beginning clinical trials this year.

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11 Health is now moving from its research and development phase to a strengthened sales and marketing drive. More staff are being recruited and the business is growing. The goal, says Michael Seres, has been to ‘clear regulatory hurdles’ . Now it is to get the device embedded in stoma care worldwide. Interest has already been identified in Israel, South East Asia, Indonesia and China. The product continues to be refined and developed with phase 2 and 3 in the pipeline. Phase 2 should be available later this year along with software updates for the app. ‘A solution that was developed by patients for patients’ is how Michael Seres describes a product that already received numerous accolades, including 11 Health being named a Nominet Top 100 company in 2014.

Further information www.11Health.com

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A new internet savvy generation

GreyMatters

Digital Health GreyMatters

Despite its British roots, the real opportunities for digital healthcare lie overseas, says David Ward of GreyMatters

ncouraging older people to embrace technology will enable them to stay longer in their own homes and improve their quality of life. The largest growing market for smart phones is the 65-plus age range, and the people who will be in this age bracket in 10-15 years are already internet savvy now. The use of technology is helping older people manage their conditions and improve communications, meaning less time in hospital. GreyMatters was originally set up to help people suffering from dementia. It makes certificated, easy-to-use webbased technology that helps older people part-manage conditions such as dementia, high blood pressure, diabetes and chronic obstructive pulmonary disease (COPD). It’s a particular type of telehealth. Many companies are involved in telecare, for example supplying personal alarm pendants and wristbands that enable the user to call emergency help when they need it – in other words reactionary care. In contrast GreyMatters provides

anticipatory care, using encryption and high security hosting services provided by NHS-accredited data centres. Sharing information with clinicians, carers, family and friends helps people cut down on travelling, keeps them out of hospital and reduces calls to the emergency services. Generally, older people who have been presented with technology enjoy using it. The technology created by GreyMatters will help avoid the scenario where someone who is frail or unsteady on their feet needs to travel to see a specialist. In order for this to be really effective, healthcare needs to integrate with social care, GPs and hospitals. This is possible with a central portal that connects to different databases, although that is another challenge as each hospital can have its own software system.

Overseas Opportunities In China there is a big focus on the elderly and infirm. The new ‘Elderly Rights Law’ passed in 2014, says adults should visit their parents and care about their spiritual needs. The Chinese upper and middle classes are becoming more and more affluent, and their traditional family culture means that children and grandchildren are willing to spend their own earnings on caring for older relatives. And the country is growing at an extraordinary rate. According to Chinese government statistics, more than 178 million people in China were 60 years or older in 2010, and by 2030, that figure will double. With 16 million people a year moving from rural to urban areas in order to earn more money, older people are increasingly being left behind in the countryside, often a huge distance away. This causes a disconnection which goes against many traditional Chinese family values. Put together, these factors create a huge potential market for healthcare technology in the most populated country in the world. One of GreyMatter’s products is the Carer Portal, which helps connect families remotely. This could be an ideal solution for Chinese families living far apart, as it allows them to stay in touch with their older relatives living in care facilities via Skype, email or text. It also helps care facilities promote the level of care they are able to provide to families. Keeping families connected by technology will be a huge growing market in China, and with the right kind of Grey Matter technology, it could be worth as much as £100 million. GreyMatters is already establishing a joint venture with a well-established large corporate software company in China, and expects to be trading by spring 2015. After that, the company is setting its sights on Australia, New Zealand, Malaysia, Singapore and the USA. GreyMatters also found interest in Brazil. It is looking at creating smaller subsidiaries around the world to roll out products that will keep older people connected to their families, and in control of their own healthcare.

Further information Tel: +44 (0) 191 208 1182 info@greymattershc.co.uk www.greymattershc.co.uk

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TPP

Digital Health

Using technology to drive down the cost of referring abroad ‘Medical tourism’ is a multi-million dollar industry, but the cost of referring patients is also spiralling. TPP looks at how this can be improved

ealthcare delivery across national borders is big business, for all parties involved. The process of sending a patient for treatment abroad can mean an economic boost for the hospitals accepting the patient, and it can also create a boost in local tourism. According to UK newspaper The Guardian1, ‘medical tourists’ visiting the UK spent an estimated £219m on hotels, restaurants, shopping and transport in one year. On top of that, 18 top UK hospitals who accept overseas private patients reported an income of £42m for providing specialist care to overseas patients. But what about the cost to the governments and companies who foot the bill when citizens they are responsible

for need treatment in hospitals abroad? In the Middle East, where nearly all healthcare is paid for by the government, the cost of sending patients for specialist treatment overseas can be phenomenal. In 2010, countries including the UAE and Kuwait were sending as many as 3,000 patients to the UK for treatment every year2. Both countries also send patients to other world-class treatment centres in Germany, France and the USA. Whilst some Middle East countries are actively developing their own tertiary referral hospitals, in the meantime, the cost of sending patients abroad (often with family members in tow), is beginning to spiral out of control.

Fragmentation of care So why is the cost so high? Our analysis has identified that once a patient is transferred to an overseas facility, the referring team has inadequate visibility of the progress and outcome of their care. Often, patients and their chaperones,

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TPP

enjoying generous per diem allowances, find reasons to extend their stay or to increase the scope of the care they receive at the overseas health facility. On top of this, the dependence on lastcentury communication methods often leads to fragmentation of care between services in the country of residence and the overseas provider. So how can this multi-million dollar industry be improved? The whole of the patient pathway should be underpinned by a shared electronic record to eliminate hand-offs and achieve integration between diverse carers. Modern electronic health record systems, in use all over the world, allow for data to be shared in a timely and reliable manner, and for administration tasks to be streamlined. Why can’t we use the same system across international boundaries? If each team involved in the process of managing treatment overseas had access to the same view of the electronic health record, and were able to communicate instantly with other, the entire process would be significantly more efficient.

Increased transparency Changes to the management plan will be readily apparent to the referrals abroad office, who will maintain control of all decisions. When these patients return from abroad, the full details of the treatment they have received will be available to ensure continuity of care. As Qatar’s National Health Strategy outlines4, the goal for a Treatment Abroad service is to be more efficient and effective. This will include a smoother service for patients, increased transparency, better clinical outcomes and more follow-up care closer to home. All of these goals can be achieved quickly through the implementation of an integrated electronic international referrals system.

http://www.theguardian.com/society/2013/oct/24/ medical-tourism-generates-millions-nhs-health 2 http://journals.plos.org/plosone/article?id=10.1371/ journal.pone.0070406 3 http://www.arabtimesonline.com/NewsDetails/ tabid/96/smid/414/ArticleID/209171/reftab/96/ Default.aspx 4 http://www.nhsq.info/strategy-goals-and-projects/affordable-services/management-of-treatment-abroad/ project-overview 1

Further information To find out more about the service being offered by TPP across the Middle East, contact internationalenquiries@tpp-uk.com

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XML Solutions

Digital Health XML Solutions

The digital future of healthcare forms Electronic healthcare forms will save time and make it easier for patients and professionals to share information, says XML Solutions

ML Solutions is a specialist healthcare IT consultancy. We provide strategic and technical services that include enterprise and solution architecture, interoperability and healthcare standards, open source and agile development best practice advice. XML Solutions also provide application development services, and have several open source products. Our clients include major central healthcare bodies such as Ministry of Health Holdings Singapore, NHS England and the NHS Health and Social Care Information Centre. We provide such clients with national healthcare strategies and enterprise architecture consultancy. We also have a proven track record providing systems and advice at the healthcare coalface for hospitals and healthcare charities in the UK. At this level we provide strategic advice, integration and development services, and our flexible healthcare forms product, Forms4health.

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Forms4health Forms4health is an open source application that has been developed in collaboration with Leeds Teaching Hospitals trust in the UK. It is a highly modular electronic forms component that has been integrated with Leedsâ&#x20AC;&#x2122; Electronic Patient Record (EPR), providing the core platform for clinical data entry. Electronic forms are increasingly required to support a more automated healthcare environment. Some approaches to electronic records such as paper scanning are useful for historical records, however they do not support the key goal of digital capture at the point of care. With ever-evolving clinical processes, and central collection and reporting requirements, healthcare institutions require flexible electronic forms solutions that allow forms to be rapidly designed and deployed with little or no technical intervention. For this reason, Forms4health has been designed to function and feel more like a publishing tool than a cumbersome IT system. At the same time, to support analysis and decision support, any solution must have the power to capture structured and coded clinical data that is retained in

the EPR. Clearly there are many benefits to having electronic patient records, however the challenge of replacing paper should not be underestimated: paper is a cheap, fast, flexible and portable medium that is hard to dislodge. In particular, paper readily supports the key activity of collecting information at the point of care. Electronic forms solutions for replacing paper must therefore minimise the burden on the form filler, and be available on portable devices such as iPhones/iPads and Android phones and tablets, providing a user-friendly and intuitive experience. Furthermore, forms should be prepopulated with data from the EPR when that information is known, and should only ask relevant questions appropriate to the context and previous answers provided. Forms4health provides all these powerful features and more. Furthermore forms4health provides a separate patient facing platform. Forms4patients provides the entry of data online, and by patients at home, which supports features like pre-operative assessment and patient feedback. Responses are either integrated into hospital systems or easily emailed to nominated clinicians or inboxes. Our forms are defined using international open standards and can communicate in HL7 and OpenEHR, allowing form definitions to be shared both between the patient and clinician facing platforms, between different institutions and also different applications. Smart electronic forms for patients: l forms completed by patients l completed a patientâ&#x20AC;&#x2122;s convenience l works on mobile devices l no patient identifiable information l completed forms are sent as PDFs (for humans) and XML (for systems) Smart electronic forms for health workers: l minimises time completing forms l pre-populated form data l calculated values, eg Body Mass Index (BMI) l conditional behaviour depending on patient data, eg age, gender, clinical information l re-usable form sections which reduce costs, risk, training and increasing harmonisation between different teams structure and coded clinical data l mobile and tablet friendly

Further information www.xml-solutions.com

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NHCIC

A recent project between Nine Health Community Interest Company and the Lantone Technology Company has allowed the British company to access the thriving Asian digital healthcare market

Digital Health is vital to Chinaâ&#x20AC;&#x2122;s healthcare reforms

HCIC recently signed a Co-operation Agreement with Lantone from the Zhejiang Province, representing an important link between healthcare in the UK and the international community. Lantone are an SME technology company working in health, and they had been seeking a big data specialist company for over three years. The project will automate clinical information support and intelligence processing using Chinese National Guidelines for both Western and Chinese medicine. NHCIC is a community interest company (CIC) a type of company introduced by the UK government in 2005 under the Companies (Audit, Investigations and Community Enterprise) Act 2004, designed for social enterprises that want to use their profits and assets for the public good. Nine Health CIC itself was born out of the need for an organisation to bridge the gap between clinical practice and technology development and implementation in a practical way. NHCIC was created with three distinct divisions focused on technology, development and implementation covering clinical research,development and commercialisation of technology products (e.g. sensors /mobile devices) and services and big data processing and analytics. By forming collaborations and partnerships with other companies, universities and organisations, NHCIC is driving the rapid development and delivery of innovative products and services. After successfully working in the EU on a Framework 7 ICT project with 20 partners across eight countries, NHCIC had decided to expand its international interests into the Asian market and then the Middle East. When UKTI representative Madkhur

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Bose visited the NHCIC stand at EHI Live in the UK in March 2014, NHCIC decided to join the 12 month UKTI National UK Demonstrator visiting locations in China. Early preparations for the trip involved learning about Chinese business culture as well as developing links with the Confucius Centre in Leeds and attending China British Business Council events in London. NHCIC now continues to work with Chinese academics in both the UK and China who provide vital support to the business. These links were strengthened by the fact that NHCIC visited traditional Chinese Medicine Centres and that CEO Elaine Taylor-Whilde (a clinical research fellow) holds a postgraduate qualification in Acupuncture (SHU 1989) and has used traditional Chinese methods in clinical practice within the NHS. The Chinese British Business Council OMIS programme was invaluable in the initial arrangements and detailed negotiations. The process of developing the business in China began with an initial meeting at the UKTI Best of British Demonstrator in Ningbo Hospital No2 on June 2014, where the NHCIC were plunged into a whirlwind of meetings and discussions, including those with Lantone Technology Company. NHCIC had already been working alongside Dorsey and Whitney LLP, a highly skilled team of International and Chinese specialist lawyers who both assisted with the stands at the Demonstrator and helped achieve the cooperation agreement with Lantone. NHCIC immediately followed up contacts from the first demonstrator once back in the UK, setting in motion negotiations for the next trip to visit potential clients. The second visit occurred in August 2014 and included a hectic schedule of three meetings a day of about three hours in duration, as well as lunch and dinner which in China are essential parts of the business process. Chinese colleagues, as well as representatives from Dorsey and CBBC, attended many of these meetings. Professor Yonghong Peng of the University of Bradford set up academic sessions with clinical and technology colleagues from China, including

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Digital Health NHCIC IMAGE: WWW.SHUTTERSTOCK.COM

presentations by NHCIC and GreyMatters Healthcare Ltd. (a NH client), Chinese Hospitals and Senior Clinicians. This led to the creation of a permanent discussion network “Sino-UK chat” on the “We Chat” forum to further strengthen communications between the two companies. At the end of this second visit agreements were made in principal with Lantone and others. After many webinars and phone calls involving UKTI, CBBC, Dorsey and Chinese colleagues, a study visit to the U.K for Lantone representatives was arranged. In October 2014 Lantone were hosted by NHCIC in London at the Royal Society of Medicine and at the Universities of Sheffield, Leeds and other NHS sites. At these meetings detailed tools and systems were explored, such as the Virtual Physiological Human annotation tool. This device automatically attaches machine code to clinical data, thus enabling petabytes of data to be mined using semantic ontologies and Gate, a natural language processing tool developed by Sheffield University able to find clinical terms in text format. On this visit Lantone also worked with Local Health Bureaus and

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made arrangements for formal meetings to take place. UKTI facilitated and attended some of the joint presentations, as well as the final meetings where the collaboration was approved. Since then the development of an Intelligent Community Clinic information system using mobile technology at sites in Zhejiang province has begun. The first NHCIC China team members will include two clinically qualified information systems experts with national and international design expertise, a system architect and an experienced developer of both Chinese and NHS systems. The mobile technology component will include the The Mitac Corporation which is a manufacturer of ruggedized clinical tablets in Shanghai with global outlets. Mitac are exhibiting at Arab Health and will be on the NHCIC stands at the Beijing and Guangzhou Demonstrators.

Further information www.ninecic.org.uk

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eIntegrity

E-learning: the next level of healthcare training E-learning for clinicians provides quality-assured online training programmes that can be accessed anytime, anywhere says Graham Shaw, Executive Director of eIntegrity

Integrity has been established to enable individuals and organisations worldwide to license access to e-learning programmes developed by e-Learning for Healthcare (e-LfH). This is part of Health Education England, on behalf of the UK National Health Service (NHS). These programmes have been created in conjunction with medical Royal Colleges and other leading professional bodies in the UK. The e-learning programmes cover a wide range of subjects relevant to the training of clinicians and other health professionals and their continuous professional development. There are 28 individual programmes which can be licensed, covering acute medicine, advanced radiography, anaesthesia, audiology, dentistry, dermatology, ophthalmology, radiography, radiology, renal medicine, surgery and ultrasound. In addition to clinical subjects, there are e-learning programmes which cover important parts of a clinicianâ&#x20AC;&#x2122;s training, including end of life care, safeguarding children, laser safety, healthy child programmes and sexual and reproductive health.

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The e-learning programmes are delivered via a dedicated Learning Management System (LMS), managed by e-LfH, which supports tens of thousands of subscribers and is available globally via the Internet. Once users have registered on the LMS, they are able to access e-learning content of the highest quality and make excellent use of multimedia resources, including videos and animations. Where relevant, real-life case studies are presented to the user to compare

â&#x20AC;&#x2DC;Institutions can set up reporting groups which include all their individual users and monitor the progress of their staff through the programmes.â&#x20AC;&#x2122;

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Digital Health

eIntegrity

e-Learning for Anaesthesia (e-LA) e-Learning Anaesthesia (e-LA) supports specialty training in all aspects of anaesthesia. It is an invaluable educational resource for trainers and teaching staff, and also supports the professional development of specialists seeking to refresh their knowledge. e-LA features: lo ver 1,000 interactive and engaging e-learning sessions, with images, videos and animations la n extensive e-library of journal articles and selft-assessment exercises le -MCQ assessments that match the standard of the UK postgraduate anaesthesia examinations e-LA has been written and peer-reviewed by leading clinical experts and developed by The Royal College of Anaesthetists in conjunction with Health Education England. e-LA can be used as a self-paced, selfdirected training package or integrated with other methods, such as lectures and practical sessions. With many thousands of users in the UK, e-LA has won numerous international training awards.

Radiology (R-ITI) The Radiology – Integrated Training Initiative (R-ITI) supports and enhances the learning of radiologists. It has been developed with the UK Royal College of Radiologists. R-ITI features more than 750 interactive sessions that cover the breadth of the UK radiology curriculum. The training offers ideal preparation for FRCR* and equivalent examinations. It is also suitable for

their decisions with those of experts. At each stage of the programmes, users can carry out selfassessments, print or save certificates of completion and, where formative assessments are included, produce final certificates of successful course completion. Institutions can set up reporting groups which include all their individual users and monitor the progress of their staff through the programmes. Where particular needs apply, it is possible to develop specific learning paths for users to follow the e-learning programmes in accordance with the requirements of local teaching curricula. eIntegrity e-learning programmes are accredited by the medical Royal Colleges and professional bodies responsible for the creation of the clinical

qualified staff wishing to refresh their core knowledge. Practitioners learn through case studies and practical exercises. The use of a variety of images, including X-rays, ultrasound video clips and 3D diagrams, creates greater spatial awareness and realism than textbook learning. Self-assessment exercises enable learners to check their understanding on key topics. R-ITI enables busy practitioners to study at their own pace, in their own time. In recent years, R-ITI has won several UK training awards and it has established a gold standard for e-learning in healthcare. *Fellow of the Royal College of Radiologists

Acute Medicine (ACUMEN) ACUMEN explores all aspects of acute medicine. It is aimed at physician trainees involved in core medical training (CMT) and acute care common stem (ACCS) but it also provides an ‘aide memoire’ for more advanced trainees. The programme has been developed with the Federation of Royal Colleges of Physicians. ACUMEN features scenario-based exercises involving patients with a range of symptoms from cardio-respiratory arrest through to breathlessness and chest pain. Learners can take a medical history, perform a virtual examination, create a management plan and review the patient outcomes. This novel approach consolidates the development of practical skills in the workplace. These exercises are supported by more than 200 knowledge sessions, which have been written and peer-reviewed by practising clinicians from across the UK.

content. Content is updated regularly through a strict process of peer review. The programmes are suitable both for specialist subject training and for continuing professional development. The e-learning is also widely used as part of blended training programmes, combining classroom and distance training. eIntegrity has licensed its e-learning programmes in over 30 countries worldwide to both individuals and to major training and user institutions. These countries include Australia, New Zealand, Europe, Middle East, India, Africa, South-East Asia, USA, Canada and South America. The availability of e-learning via the Web makes it particularly suitable to the training of health professionals where geography and distances make traditional training impracticable.

Further information Email: graham.shaw@eintegrity.org Tel: 07799 664371 www.eintegrity.org

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IMAGE: WWW.SHUTTERSTOCK.COM

EXAMPLES OF MAJOR E-LEARNING PROGRAMMES

After success in the US market, nGage has set its sights on the UK and abroad

Digital Health nGage

“H

ealth is the last unmodernised industry in the world,” says Dr Peter Mills. “Technology has transformed everything else from banking to shopping, but we still do things the same way with our health: we go to the doctor, get our medication and then go away. After that, unless we go back there is no communication, no way of telling the doctor how we are feeling or what is happening, no way they can ask anything of the patient. Every other industry wants to keep their customers close, but it doesn’t happen in health.”

User-friendly patient solutions Mills’ UK-based company nGage Health has developed the nGage Health Patient Relationship Management platform, which has already proved highly successful in the USA. Online solutions allow physicians to capture self-reported data from patients that would otherwise go unseen, combine them with existing health record data and, using a visually-rich user interface, analyse and highlight health risk issues across their entire populations.

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Value-based healthcare nGage also provides user-friendly patient solutions such as health assessment tools, smart apps and visually-engaging views of their recorded health data as well as customised, actionable next steps and recommendations from their providers. In practice, a doctor suggests the digital solution to a patient during a check-up - or Annual Wellness visit as it is called in the USA - and after an online assessment, a care plan is drawn up. The patients can enter information about their health on their mobile phone or computer and as the data flows into the system the doctor views it on dashboards. They can break the data down into specific groups, such as patients suffering from asthma or diabetes, and even send messages to them. ‘My vision is for a physician to get up in the morning and check the information that has come through to see what has changed, in the same way someone might look at their stocks and shares in a newspaper to see what has gone up and what down,” says Peter Mills. Despite a little resistance to the scheme, the platform has gone down very well with patients, particularly the new wearable devices. “Most people who use technology in their day-to-day lives in other ways are happy augmenting face-to-face relationships with this technology,” he claims.

Formed in 2012, nGage saw how healthcare delivery is changing in the USA, to one where care providers are now being tasked with working within a certain budget and achieving certain predefined outcomes with patients. nGage’s success in the USA does not mean it has turned its back on the UK, but the situation here is different. “The NHS is a single provider with one payer, although the increasing emphasis on value-based healthcare will enable us to do more work here,” says Mills. “There are lots of opportunities in the USA, especially in healthcare,” he says, adding that being from the UK is an advantage to doing business there as many Americans have a positive attitude to the British. In the future the company is also keen to work with developing healthcare systems in countries such as India and China, as well as the Middle East. “We want to bring technology solutions to the healthcare economies in these countries, understand what their needs are and hopefully avoid some of the pitfalls the established healthcare systems have encountered.”

Further information Tel: 07958 215431 info@ngagehealth.com www ngagehealth.com

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It’s time for technology to transform the way we deliver our healthcare says Dr Peter Mills of nGage Health, who has spent 15 years creating digital health solutions

nGage

Digital solutions to health improvement

The information can be transferred to existing electronic health records, already a key issue in the UK as Health Secretary Jeremy Hunt announced that, by 2016, 80 percent of patients will be able to access their health records electronically. A practising physician, Peter Mills gave up full-time medicine in 2000. Unlike many of his peers who saw technology as a threat, he became fascinated with it and its potential to change the face of healthcare. “Fast forward 15 years I think we are almost there,” he says. “I was one of the founding members of a company called Vielife in 2000, combining health and technology into a solution focused on the needs of employers. Although the company had some success in the UK, it became obvious that the bigger market was in the USA, and we built up a business that was acquired by Cigna in 2007.” It was after this, while working for a small startup in Minneapolis, that Mills identified opportunities in the healthcare provider marketplace that lead to the birth of nGage.

Digital Company Profiles

Digital Health

Digital Company Profiles

Keldale Business Services Ltd

Sirius Partners Ltd

“A benefit is a result that someone believes is worthwhile.” Sadly, most programmes don’t deliver the benefits that they should. Often that’s because they don’t understand what those benefits ought to be.

At Sirius we just want to make things simple.

Keldale House Beal Lane, Beal DN14 0SQ 07780 533876

Benefits Management is all about recognising good benefits at the start, then taking the decisions and actions to choose and deliver the right benefits to the right people. Keldale’s practical, tailored approach brings the expertise, experience and enthusiasm you need to: l Develop sound strategy l Add value in all you do l Build successful relationships l Deliver successful business change l Really understand your benefits

36 Middleway Taunton Somerset TA1 3QJ +44 (0)7806 664 603 info@siriuspartners.co.uk www.siriuspartners.co.uk

Between us we have spent 50 years sitting where you are now. We know better than most that the NHS is full of hard working people who feel under such pressure that they cannot see the wood for the trees.

Call Keldale and get the benefit.

We know what that feels like and want to make a difference. So we have developed a whole new approach and confidently make a radical promise: Sirius will create the space so you can focus on doing your job.

SmartMedTM

swiftQueue Technologies Ltd

Europe & Rest of World Appdragon Ltd Unit 4, 17 Plumbers Row London E1 1EQ +44 (0) 845 057 3860 info@iappdragon.com

Middle East & North Africa Harrington Consultants Ltd 43-45 Portman Square London W1H 6HN +44 (0)20 7969 2827 info@harringtonconsultantsltd.com

Healthcare providers everywhere face the enormous challenge of providing quality health outcomes for the millions of patients suffering with chronic illness. Escalating pressures on medical resources mean hospitals, clinics and GPs are looking for alternative ways of dealing with the problem, without significant capital investment. SmartMedTM is an innovative tele-health solution that uses the latest smartphone technology to address the challenge head on. By empowering and engaging patients to self-manage their conditions from home, hospitals, clinics and GPs can address the issues of long-term illness whilst managing costs and enhancing patient outcomes. To find out how SmartMedTM and tele-health can work for you, your healthcare professionals and, most importantly, your patients, visit our web-site today. www.mhealthcaresolutions.co.uk

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London: + 44 (0)20 70975145 Dublin: +353 (0)1 442 8968 Email: global@swiftqueue.com www.swiftqueue.com

“swiftQueue provide self service healthcare appointments online, for patients anytime & anywhere” swiftQueue have revolutionised hospital appointments by working with NHS and HSE hospitals and clinics to enable a more efficient patient centered process. swiftQueue enables hospitals & clinics to empower patients through self service functionality delivering on growing patient expectations to provide more efficient healthcare appointments and visits. If you would like to be part of our solution to: l create new healthcare solutions l address the needs of changing demographics, and l exceed patient expectations Contact us for your swiftQueue project today

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Digital Health Contact: Enda Madden Unit 2.7, Design Tower, Pearse Street, Dublin 2 info@acehealth.co Tel: +353 86 8269647 www.acehealth.co Twitter: @acehealthco Client engagement platform proven to work in mental/behavioural health, child and adolescent mental health services (CAMHS) and chronic disease management. Contact: Adrian Allen 142 South Avenue, Abingdon, Oxfordshire OX14 1QY adrian.allen@akriga.com Tel: 01235 521909 www.akriga.com Twitter: @AkrigaLtd We build secure,innovative and flexible websites, databases and mobile applications. Open source experts with previous healthcare experience.

Aridhia

Contact: Chris Roche, Chief Commercial Officer Hobart House, 80 Hanover Street, Edinburgh EH2 1EL chris.roche@aridhia.com Tel: 0141 229 7580 www.aridhia.com Twitter: @aridhia A world-leading health informatics and analytics company developing technology and capability to support the management of chronic diseases, personalised medicine and biomedical research.

Assesspatients

Contact: Richie Bowden Edinburgh, Scotland rbowden@assesspatients.com Tel: 0131 618 6475 www.assesspatients.com Twitter: @assesspatients Our solution enables older people & their multidisciplinary care teams to collaborate in assessing needs, setting outcomes and managing care plans

Badger Software Limited

Contact: John Langley, Sales and Marketing Director Delta House, 70 South View Avenue, Caversham, Reading RG4 5BB john.langley@badger.co.uk Tel: 0118 946 4488 www.badger.co.uk Twitter: @CLIO_Badger CLIO web based incident event and project management software system is already used by many public sector organisations including health

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Digital Life Sciences

Contact: Melissa Nurcombe Waterloo House, 20 Waterloo Street, Birmingham B2 5TB melissa.nurcombe@digitallifesciences. co.uk Tel: 0121 663 0300 www.digitallifesciences.co.uk Twitter: @digilifesci Working with partners across the NHS and private sector, Digital Life Sciences delivers truly transformational digital models of healthcare.

DrEd Online Doctor

Contact: Amit Khutti DrEd, Prince Consort House, 109-111 Farringdon Road, London EC1R 3BW amit@dred.com Tel: 0203 588 0290 www.dred.com One of Europe’s leading online doctor services, specialising in remote medical consultations, testing and the issuing of prescription treatments.

Deontics Ltd

Contact: Guy Wood Gush, CEO Unit 220, Screenworks, 22 Highbury Grove, London N5 2EF guy.wood-gush@deontics.com Tel: +44 (0) 203 567 1123 www.deontics.com Deontics provides innovative decisionsupport and executable pathway solutions for clinicians and patients to improve healthcare outcomes.

EMIS

Contact: Steve Butcher Rawdon House, Green Lane, Yeadon, Leeds LS19 7BY steve.butcher@e-mis.com Tel: 0114 215 7003 emis-online.com Twitter: @newsfromemis UK leader in clinical IT systems for joinedup patient care. Our systems are used by over 5,000 healthcare organisations from GP practices to community trusts.

FJ McManus Ltd

Contact: Filipe McManus Ross Building, Adastral Park, Martlesham Heath, IP5 3RE Contact Email: filipe@fjmcmanus.co.uk Tel: 07985 143916 www.fjmcmanus.co.uk/dimensions Weekly updated Database of 1700+ tables of reference data, including GPs, Postcodes, Data Elements, Disease Codes, etc.

GROUNDVISION

Contact: Nick Whiteley GROUNDVISION, Hampden House. Hitchin Road. Arlesey. Bedfordshire SG15 6RT nick.whiteley@ground-vision.co.uk Tel: 07710 547 037 www.ground-vision.co.uk Twitter: @groundvisionuk GROUNDVISION Provide solutions for

monitoring patient vital signs, calculation of Early Warning Scores, patient acuity/ dependency, workload measurement and workforce planning.

Health Intelligence Ltd

Contact: Antony Keay (Sales & Commercial Director) Saxon House, Moston Road, Sandbach, Cheshire CW11 3HL enquiries@health-intelligence.com Tel: 01270 765124 www.health-intelligence.com Twitter: @healthintellig Leading software provider of Diabetic Eye Screening services and Long Term Condition population data analysis for UK NHS organisations.

Healthlogistics

Contact: Peter Elwin, Director 68 Akeman Street,Tring, Herts HP23 6AF info@healthlogistics.co.uk Tel: 01442381758 www.healthlogistics.co.uk Healthlogistics deliver integrated eProcurement solutions to NHS hospitals, using validated master product data to enable cost savings within non-pay spend.

IMSMAXIMS

Contact: Dawn Rees Saxon Court Offices, 502 Avebury Boulevard, Central Milton Keynes, MK9 3GD dawn.rees@imsmaxims.com Tel: +44 (0) 203 66 86 999 Website: www.imsmaxims.com Twitter: https://Twitter:.com/IMSMAXIMS IMS MAXIMS Deliver high quality clinical PAS / EPR solutions. Our key drivers are saving lives, improving the patients experience and outcomes.

InferMed Ltd

Contact: Duane Lawrence 25 Bedford Square, London WC1B 3HW, UK enquiries@infermed.com Tel: +44 20 7291 7410 www.infermed.com Twitter: @InferMed InferMed solutions help healthcare users comply with best practice pathways and protocols to get healthcare right, first time, every time.

IPROS CUBE

Contact: Rob Anderson/Julian Moore Surrey Technology Centre, Occam Road, Guildford, Surrey GU2 7YG info@iproscube.com Tel: +44 (0)1483 688 000 www.iproscube.com Twitter: @IPROSCUBE Assured Compliance software enables healthcare services to report across quality requirements, delivering accountable and evidenced measurement of quality and safety.

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Akriga Ltd

Digital Company Directory Digital Company Directory

ACE Health

Digital Company Directory

Digital Health Mayden House Ltd

Contact: Chris May 1 Widcombe Crescent, Bath BA2 6AH Contact Email: info@mayden.co.uk Tel: 01249 701100 Website: www.mayden.co.uk Twitter: @MaydenTweets, @IaptusTweets, @bacpacTweets, @MaydenAnalytic Mayden provides end-to-end managed web applications and bespoke system development for healthcare, specialising in innovative, flexible, cloud-based software solutions

Medipex Ltd

Contact: Richard Clark Medipex Ltd, Pure Offices (Icon), 4100 Park Approach, Thorpe Park, Leeds LS15 8GB Richard.clark@medipex.co.uk Tel: 01133970831 www.medipex.co.uk Twitter: @medipex Medipex is a specialist innovation company working exclusively with NHS and industry to identify and develop cost effective technology solutions.

Norbeck LTD

Contact: James Galloway 8 Sandown Centre Jgalloway@norbeck.co.uk Tel: Office 01225 785126 Mobile 07809 399334 www.Norbeck.co.uk Established for over 25 years Norbeck design and install data networks, CAT5e, 6, 7, Fibre, Wi-Fi and audio visual equipment.

Patient.co.uk

Contact: Stella Bolam Office 2, The Sheffield Bioincubator, 40 LeavyGreave Road, Sheffield S3 7RD Stella.Bolam@patient.co.uk Tel: 0114 215 7003 http://www.patient.co.uk Twitter: @patientuk Empowering patients to take control of their health - leading health information and patient services platform, used & trusted by millions worldwide every month

PatientSource Limited

Contact: Dr Michael Brooks Unit 40 Cobholm Place, Cambridge CB4 2UN solutions@patientsource.co.uk Tel: 01223 851273 www.patientsource.co.uk Twitter:m@patientsrc A tablet-ready electronic patient record system designed by doctors. It covers casenotes, vitals, ePrescribing, appointments, test ordering, and bed management.

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Digital Company Directory

Portable Medical Technology Ltd.

66 Pairc Chuimin, Kilcummin, Killarney, Co. Kerry info@portablemedicaltechnology.com Tel: +353217319541 portablemedicaltechnology.com Twitter: @PortMedTech Portable Medical Technology develops high quality medical apps. We specialise in the development of CE/FDA approved apps. Previous work includes ONCOassist and the CERT app.

QOREX Ltd

Contact: Phil Trickey 10 Mount Close, Fetcham, Leatherhead, Surrey, KT22 9EF Contact Email: phil.trickey@qorex.co.uk Tel: 07834 800416 Website: www.qorex.co.uk Twitter: @PhilipTrickey The QOREX Business Management System is a Software-as-a-Service web-based solution and business methodology that transforms the performance of any organisation.

Toothpick

Contact: Sandeep Senghera/Jozef Wallis 4-5 Bonhill Street, London EC2A 4BX info@toothpick.com www.toothpick.com Twitter: @toothpick UK’s leading online booking platform for dental appointments, offering patients access to NHS dentists, private and cosmetic dentists, and dental hygienists.

Virtualware UK

Contact: David Fried 69 Wilson Street, London EC2A 2BB dfried@virtualwaregroup.com Tel: (0) 7900 043 184 www.virtualrehab.info Twitter: @Virtualrehab_en VirtualRehab is a clinically validated and CE Certified cloud-based videogame platform that uses Motion Capture Technology to complement Physical Rehabilitation therapies.

VTSL Ltd.

Contact: Rob Walton 5 Nickols Walk rwalton@vtsl.net Tel: 0207 078 3206 www.vtsl.net Twitter: @vtslltd VTSL provides state-of-the-art IP telephone systems for medical practices looking to improve patient access and efficiency.

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NON-DIGITAL CTG Health Solutions UK

Contact: Ben Payne CTG UK Ltd, 1 Manor Park, Manor Farm Road, Reading, Berkshire RG2 0NA ben.payne@ctg.com Tel: 07467 912679 www.ctg.com/europe Twitter: @CTGEurope Delivering transformational change & service redesign. Strategic operational planning & business support services. Healthcare Procurement & provider management with business intelligence.

HEALTHTRONICS Ltd

Contact: Adesina Iluyemi 11 Cherry Tree Close, London E9 7SS adesina@healthtronics.co.uk Tel: 07956026010 www.healthtronics.co.uk Twitter: @HEALTHVONICS HEALTHRONICS advices on and researches into business and organisational strategies for hospitals, universities, governments, start-ups and companies.

Highland Marketing

Contact: Mark Venables - CEO Tulloch, Balquhidder, Perthshire, FK19 8PQ markv@highland-marketing.com Tel: +44 (0) 1877 339922 www.highland-marketing.com Twitter Handle: @HighlandMarktng A full service marketing, communications and PR agency focussing solely on healthcare supporting companies and organisations on an international basis.

Neil Stevens Consulting Ltd

Contact: Neil Stevens 36 Middleway, Taunton, Somerset TA1 3QJ neil@neilstevensconsulting.com Tel: 01823 429180/07806 664603 www.neilstevensconsulting.com Twitter: @NeilStevensCons Providing high quality benefits-driven consulting and business change services supported by partnerships with a range of innovative technology solution providers.

Spoonful of Sugar

Contact Name: Andrew Martello, MD 45 King William Street, London EC4R 9AN solutions@sos-adherence.co.uk Tel: +44 (0)20 3714 5630 www.sos-adherence.com/ Twitter: @SoSAdherence A behavioural change consultancy, working with healthcare providers and pharmaceutical companies to improve adherence to medicines through leading edge research.

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Leeds Teaching Hospitals

| International collaboration is Leeds Teaching Hospitalâ&#x20AC;&#x2122;s long term goal says David Berridge, Medical Director (Operations)

Sharing expertise on the global stage

LTHT provides a full range of medical treatments and services

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Training & Education

Leeds Teaching Hospitals

eeds Teaching Hospitals NHS Trust (LTHT) is one of the largest teaching hospitals in Europe, employing nearly 15,000 staff, including 2,000 doctors and dentists and over 4,000 nurses. Operating seven hospitals across five sites, the Trust has an annual budget of over £1bn and delivers local and regional specialist services for more than 1.5m patients annually. LTHT provides the full range of medical treatments and services supported by strong academic and research experience, which ensures we are recognised both nationally and internationally as a centre of excellence. However the Trust faces a continual challenge to ensure the best possible level of patient care within a demanding financial environment. It has recognised that, in order to be successful, it needs not only to be efficient and innovative in the UK, but also develop solutions to attract additional income from abroad. The global reputation of Leeds Teaching Hospitals means that the very broad range of skills and expertise we have in the Trust are valuable assets. Working with hospitals the size and complexity of LTHT can enable our international partners to make a step change in the quality and efficiency of their own services. With strong support from the Board and Executive team, Leeds has identified the development of international commercial opportunities as a key strategic aim, and has already achieved early success.

International partnerships Following an initial enquiry by United Kingdom Trade & Investment (UKTI) in 2012, a delegation from LTHT visited the King Hussein Cancer Center (KHCC) in Jordan to explore the possible development of an international partnership. This preliminary visit was followed by a detailed visit to LTHT by a senior medical delegation from KHCC. Led by the Chair of Leeds Teaching Hospitals, the basis for a memorandum of understanding (MOU) between the two organisations was agreed, culminating in the official signing of that MOU at the World Islamic Economic Conference in London in October, 2013 facilitated by HealthcareUK. The collaboration between our two organisations has continued to flourish, with training fellowships already in progress at LTHT. More recently, we were honoured to receive a Royal visit to LTHT by HRH Princess Ghida Talal in her capacity as Chair of the King Hussein Cancer Foundation, together with the senior team from the KHCC including Dr Asem Mansour, Chief Executive Officer. This opportunity allowed LTHT a further opportunity to showcase its world class oncology facilities in the Leeds Cancer Centre’s new £250 million Bexley Wing on our St James’s University Hospital campus, and also that of paediatric oncology within our Leeds Children’s Hospital, one of the largest in the UK. We continue to explore other possible areas of collaboration. Longer term, the strategic ambition of KHCC to grow their services in the Middle East may

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Leeds Teaching Hospitals

provide Leeds with additional opportunities. Another example of success on the international stage for Leeds Teaching Hospitals comes from a series of commercial deals it has won with Malta. In 2004 Malta joined the European Union, triggering an investment programme in the country’s infrastructure, including healthcare. Part of that investment has seen the building of a new oncology hospital for the island to replace older facilities, which is due to open in 2015.

LTHT shares its experience and integrated team approach with overseas hospitals

Training programmes In April 2013 the Government of Malta placed an invitation to tender in the Official Journal of the European Union (OJEU), seeking bids from organisations to train their student medical physicists who are vital to the success of the new oncology hospital. The Leeds Cancer Centre has 12 linear accelerators (LINACS) - the highest concentration of these complex and expensive machines in Europe - and LTHT has built a highly experienced team of medical physicists, radiotherapists and scientists to support these facilities. A successful bid was submitted, and in July 2013 six medical physicists from Malta commenced a 22-month training programme at LTHT. This initial contract enabled LTHT to develop a relationship with a number of key personnel in Malta, In February 2014, David Berridge, Medical Director (Operations) led a small team to Malta to meet senior health and government officials. The purpose of the visit was to promote the capability of Leeds Teaching Hospitals, and our ambition to provide any further training and other services. Not only did it strengthen our position for the next training contract, we were also able to identify a number of other needs that Malta had for which we may be able to provide solutions. In May 2014, an OJEU tender was issued for the training of a second tranche of medical physicist students. LTHT successfully won the contract, which is now in place, and a further nine students commenced a 22-month programme at LTHT in July 2014. This means that for a 12-month period, LTHT is hosting 15 medical physicist’s from Malta. The professional links that have developed between Malta and Leeds will exist long after the training programme have come to an end, and augurs well for future potential collaboration.

‘The global reputation of Leeds Teaching Hospitals means that the very broad range of skills and expertise we have in the Trust are valuable assets.’

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During our visit in February we discussed a further challenge being faced by our colleagues in Malta. The new oncology hospital will contain three LINACS - two new ones were on order and the third needed to be transferred from an existing facility. Our advice to them was that the commissioning process needed a detailed piece of work to ensure that this would be fully integrated with other systems, to ensure the best level of patient care. Key personnel from Malta visited Leeds Cancer Centre to view first-hand the integrated and multidisciplinary team approach that we have pioneered. As a result, LTHT was invited to submit a proposal to commission the three LINACS. Over subsequent months we undertook detailed operational, financial and commercial due diligence, culminating in a contract being signed between

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Training & Education

Leeds Teaching Hospitals

DAVID BERRIDGE FRCS(EDIN), FRCS(ENG),DM, FEBVS Medical Director (Operations) and Medical Director (International Partnerships), Leeds Teaching Hospitals NHS Trust. David has been a Consultant Vascular Surgeon at Leeds Teaching Hospitals for over 20 years, having worked previously at Queens’s Medical Centre, Nottingham, the Freeman Hospital, Newcastle upon Tyne and St Mary’s Hospital, London. As a member of Trust board committees with responsibility for finance and investment, quality and risk management, David works closely with senior medical and executive colleagues from across the organisation. He also represents the Trust on a number of national NHS and NICE programmes, and is a respected member of a number of professional bodies. In addition to his responsibilities for the efficiency of medical services at the Trust, David is also the executive lead in the development of international partnerships. David has been a key driver in the Memorandum of Understanding signed with the King Hussein Cancer Center in Jordan. He also led a delegation from Leeds Teaching Hospitals in a successful mission to win new business with Malta. Other initiatives include developing relationships with Egypt and Kuwait.

Further information For more information about Leeds Teaching Hospitals NHS Trust please contact: David.Berridge@nhs.net: Medical Director (Operations); Roy.Charlton@nhs.net: Commercial Manager, Communications.LTH@nhs.net Communications Department www.leedsth.nhs.uk/home/ Leeds Teaching Hospitals and Malta’s Ministry for Energy and Health in October 2014. Over the next nine months various scientists and technicians from LTHT will bring the three LINACS up to clinical readiness. It is a major initiative for the Trust and one which we will seek to replicate elsewhere in the future. We continue to explore other areas of commercial opportunity, including a training programme for their oncology nurses which was delivered in Malta in November. International collaboration is key to the long-term strategy of Leeds Teaching Hospitals, and we are actively seeking new partners and projects, building on our existing oncology experience while at the same time looking to capitalise on our broader expertise working with HealthcareUK.

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FutureLearn

Upskilling the medical workforce, effectively for free, is now possible, says Mark Lester, Global Head of Education Partnerships at FutureLearn

Interactive Medical Education Online

revolutionary new learning method has taken hold in the Higher Education sector, led by The Open University (OU) in conjunction with major UK and international universities. FutureLearn delivers massive open online courses (or MOOCs as they are commonly called) bringing together the world’s leading educators with anyone with an internet connection, in a highly interactive learning experience. FutureLearn was set up by The OU to deliver these MOOCs which allow an unlimited number of participants from all over the world to enrol on each course. The OU has always been at the forefront of distance education, but this new system pioneers ’social learning‘, whereby people from all over the world learn by having conversations around the course content formulated by more than 40 leading universities from around the world. FutureLearn offers courses across a range of

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subjects but it is in Healthcare that Mark Lester sees enormous potential to revolutionise workplace learning. “FutureLearn is going to deliver probably the best of British medical education to practitioners across every level of care, and to patients,” he says. “We believe that people learn best when they learn together. Having conversations around the course steps gives people a unique learning experience, where they not only get to engage with world class content but with others around the world with shared learning objectives in a way that’s not been possible before.” Creating a delightful user experience is a major preoccupation for FutureLearn so the company recruited extensively from the consumer technology and media backgrounds to enable the team to bring academic material to life and create engaging content for a wide variety of audiences. The

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Training & Education FutureLearn platform incorporates aspects of social media such as ‘likes’ and ‘following’ along with peer reviews and comment analysis. The contact with the lead academic on the course is evident and this gives a much more personal feel to the course delivery. “What we have done is bring together the best of The Open University’s distance learning expertise and pedagogy and blend that with the best elements of the social web. We’ve used the expertise of the people who built the BBC iPlayer to create a delightful user experience, with the result being a pedagogically robust platform that also makes learning really enjoyable,” says Lester. A search of the list of health-related titles currently on FutureLearn’s website reveals topics like the anatomy of the human abdomen, Parkinson’s Disease, how to manage patients with swallowing difficulties, caring for vulnerable children and understanding drugs and addition, all of which, Lester says, bring together learners from all points of the healthcare spectrum. “Last year we introduced a course called ‘Inside Cancer’ from the University of Bath and were overwhelmed, and quite humbled, to see patients, carers and family members interacting with doctors, nurses and researchers throughout. Those shared experiences and perspectives brought an immediacy to the issues being discussed which is difficult, if not impossible, to replicate off the platform.” Lester goes on explain how closely his team works with its academic partners – like King’s College London, and the Universities of Birmingham, Reading, Leeds and Newcastle, to name a few – to cover practical subjects with universal resonance for medical professionals, while also addressing topical issues in a timely fashion. “In response to the Ebola outbreak, for instance, two of our partners – the London School of Hygiene and Tropical Medicine (LSHTM) and Lancaster University produced two courses on the humanitarian crisis. “The first, featuring LSHTM Director Professor Peter Piot, whose early work helped to identify the Ebola virus, targeted practitioners with expert information about its transmission, and practical accounts advice on how to control the spread of the disease. Lancaster’s course had a very different but equally important function – going behind the headlines to

MARK LESTER Mark Lester is Global Head of Education Partnerships at FutureLearn, the UK-based massive social learning platform, and a member of its Executive team. Prior to joining FutureLearn, Mark headed strategy development at the British Open University, has held senior management positions in the financial services sector and central Government, and was has been a senior advisor to multinational organisations and governments on innovation strategy, industry competitiveness, business strategy and healthcare policy. Mark holds a Masters of Science degree and a Bachelor of Science degree from the LSE and trained as a teacher at the Institute of Education, London. He is married with two children.

FutureLearn

inform the wider public about the symptoms, history and origins of the outbreak.” Each FutureLearn course is broken up into weeks running Monday to Sunday, which each of those weeks broken down further into self-contained steps. A typical course lasts 6-8 weeks but the team is finding that 2-3 week courses can also be useful. Lester stresses the importance of building storytelling elements into each course, giving each one a clear beginning, middle and end to navigate learners through the process and keep them engaged. “The great thing about our courses is that they are designed in bite-sized chunks that you can access anywhere on a mobile device. You could download a 5 minute video to watch on the go if you wanted to. Learners wouldn’t have to sit and watch an hour long lecture; instead they would be watching a short video during a bus journey and engaging in conversation with thousands of people.” All the universities’ courses are free, but a printed Statement of Participation which can be presented as evidence of Continuing Professional Development (CPD) costs £29. Additional validation of learning can be obtained by taking a physical exam at the end of the course, with successful students earning themselves a certificate branded by the University and FutureLearn. It is also possible for its university partners to create pathways from MOOCs into formal qualifications. Lester runs through the range of motivations for employees opting to take FutureLearn courses for CPD purposes, chief among them being the global reputations and brands of the universities delivering them. “The pedigree of the content is high and we apply rigorous quality control to everything we present, he explains. “Employers can enrol their staff on a course created by King’s College London, for instance, and the participants could then write on their CVs that they received training developed by that institution.” FutureLearn is now also offering invitation only courses – created for a fee – for organisations and health systems looking to shake up their training programmes. The value for employers, Lester says, is that FutureLearn’s social learning platform, unlike existing e-learning systems, can help replicate face-to-face dialogue and instruction in a digital environment. And crucially, it’s a much more affordable way of delivering education and training. “Courses on FutureLearn provide powerful ways of recruiting people into professions in Healthcare, complementing teaching from medical schools and other formal instruction, and offering tasters for specialised medical disciplines”, he adds. “FutureLearn is a social learning experience which is absolutely tailored to today’s way of living,” says Lester. “By helping practitioners engage with each other in a neutral environment it can only bring a positive benefit. And if it’s not costing healthcare providers to help train their staff, it’s a no brainer, isn’t it?”

Further information partner.enquiries@futurelearn.com.

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Yorkshire and Humber AHSN

Overseas partnerships creating pathways to better healthcare Yorkshire and Humber AHSN is leading the way in collaboration with overseas health providers, sharing innovation and business opportunities says Andrew Riley, Managing Director of the Yorkshire & Humber Academic Health Science Network

he National Health Service (NHS) has been at the heart of the UK’s globally renowned healthcare system for sixty-six years, leading the way in healthcare delivery, research and training. In 2013, the NHS in England set up 15 Academic Health Science Networks (AHSNs) to create strong partnerships with hospitals, industry and academia, and to bridge the gap between best practice and current practice in healthcare provision. Our goals are to improve patient and population health outcomes, drive service improvement, economic growth and wealth creation, and deliver a step change in the way healthcare providers identify, develop and adopt new changes. We have the potential to transform health and healthcare by putting innovation at the heart of the NHS, which will improve patient outcomes and contribute to economic growth. AHSNs present a unique opportunity to pull together innovation in clinical research and trials, informatics, education, and healthcare delivery. We are developing new solutions to healthcare challenges, and spreading existing solutions faster by building strong relationships with our regional scientific, academic and industry communities.

Practical solutions Each of the 15 AHSNs have specific clinical interests and success stories, and we work as a network, ensuring knowledge and opportunities are spread quickly across the whole of England. AHSN’s are delivering practical solutions for academic progress and business innovation, to be adopted by the NHS as routine practice. Yorkshire and Humber AHSN (YHAHSN) represents one of the largest geographical areas

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within the national network. Within this region are several of the most successful and prestigious academic and healthcare institutions in the country, including two of the largest hospital trusts in England: Sheffield Teaching Hospital NHS Foundation Trust and Leeds Teaching Hospital Trust. Universities in Sheffield, York, Leeds and Huddersfield are just some of the academic powerhouses that we partner with and benefit from. Our work is beginning to get national recognition. In partnership with Sheffield Hallam University, we have developed a cutting-edge staff health and wellbeing programme that is returning a threefold return on investment for employers. We are also delivering excellent improvement services with a focus on patient safety through our unique Improvement Academy. However the main area where we have developed a reputation for leadership is through international activity. YHAHSN is quickly establishing itself as the lead AHSN for overseas opportunities. We are working with a number of foreign government and commercial partners to identify partnership programmes that support our objectives of identifying and spreading innovation. YHAHSN has very strong links with Healthcare UK, UKTI and other

ANDREW RILEY Andrew Riley gained clinical and commercial experience, working at Board level for a number of years, with 15 years’ experience at acute hospital CEO level. As the former managing director for the UK National Institute for Health Research, Clinical Research Networks, Andrew worked closely with bio and medical technology companies in the North of England and leading international bio-pharmaceutical companies. He has led SME teams on International trade missions and has been the key note speaker at a number of international conferences in Canada and China.

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Training & Education

UK-based agencies with international remits, that strengthen our ability to offer advice and support on an international level.

Business collaborations Our most recent success has been the delivery of a UK/China Open Innovation Programme, in partnership with the University of Bradford and Guangzhou Development District. This programme brought together academics, clinicians, and businesses from the UK and China to co-develop new digital health innovations aimed at tackling the challenges of aging. David Wright, CEO/Founder of ViVO Smart Medical Devices, attended. He says: “The event provided a unique opportunity to form new international business collaborations within the healthcare technology sector. A week of intensive brainstorming, networking and project planning, managed by a professional team with lots of hand holding and guidance by YHAHSN. The result of this was that ViVO Smart Medical Devices [left the event] with a Memorandum of Understanding from a Chinese partner and with a clear pathway of progression to securing a business opportunity.” Plans for our 2015 international programme will see us repeat our successful Open Innovation workshop approach with partners in China, as well

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Yorkshire and Humber ASHN

‘We are working with a number of foreign government and commercial partners to identify partnership programmes that support our objectives of identifying and spreading innovation.’

as roll the methodology out to other countries such as Canada, India and Mexico. The YHAHSN will continue to have a strong international presence in 2015. Our work with key international partners across Europe, North America, Asia and the Middle East is supported by our relationships with Healthcare UK and UKTI, and will see us create prosperous and innvative partnerships between the UK NHS and several international health systems.

Further information www.yhahsn.org.uk

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PU PSMD

| A flexible solution to healthcare education Whether you’re looking for faculty development, a new career direction, want to improve your promotion prospects or extend your academic knowledge and skills, Plymouth University Peninsula Schools of Medicine and Dentistry (PU PSMD) Masters degree programmes will enhance your medical skills, says Professor Alison Carr, Director of Postgraduate Education

or health professionals, education is a daily fact of life. New medical innovations and technological advances require constantly updated skills and knowledge in order to be used effectively and safely. The UK is regarded as a global centre of healthcare expertise, and as such an educational hub where new medical advances are developed and learnt to ensure each field provides the very best in healthcare provision. Plymouth University Peninsula Schools of Medicine and Dentistry were established in 2012 following the disaggregation of the Peninsula College of Medicine and Dentistry (PCMD). The University of Exeter and Plymouth University, who had established and grown PCMD as a joint venture, outlined their plans to expand and grow upon the strong Peninsula foundations separately. Since then

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PU PSMD has thrived, maintaining its reputation as a nationally recognised health education provider and expanded the range of postgraduate programmes offered. PU PSMD offers a range of courses with an inter-professional nature, allowing healthcare practitioners to learn and work alongside people of similar backgrounds to create a challenging and engaging learning environment. “Our Clinical Education programme is an accredited programme that equips doctors, dentists and other healthcare professionals to teach in UK universities and is the mainstay of the faculty development in clinical education in our medical and dental schools,” says Professor Alison Carr. The course is available for universities, for example in the Middle East, to buy in, providing 12 days of content plus assignments. The course

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Training & Education provides all foundations necessary to teach medical students and give them the right knowledge and skills sets required. The faculty is even open to the opportunity of designing bespoke courses, tailored around an organisation or team’s individual needs. Sharing and cooperation is often what drives innovation in the sectors of both healthcare and education, and PU PSMD is actively seeking international collaboration so skills developed at the university can be shared globally. Courses can be delivered remotely, either through blended learning or an e-learning programme.

International students However many students prefer to study in Plymouth, a waterfront city on the south coast of England. It’s a vibrant, attractive area in which to live and study, with a population of around 250,000, including 30,000 students. Local culture is built around shipbuilding and seafaring, with a long tradition of adventure and discovery since the Pilgrim Father’s left England from Plymouth to set up an English colony in the New World – now the USA – in 1620. Today, South West England is known for its exceptional quality of healthcare. Derriford Hospital, the home of Plymouth Hospitals NHS Trust, and Torbay Hospital, site of the South Devon Healthcare NHS Foundation Trust, are the principal hospital partners of PU PSMD.

PU PSMD

EXAMPLES OF MASTERS COURSES AT PU PSMD l Healthcare Management, Leadership & Innovation: This new course is designed to be a flexible entry into management and leadership in healthcare services, whether your interests lie in leadership, quality improvement, organisation development, patient safety, or in education. l Clinical Education: This programme is an accredited programme that equips doctors, dentists and other healthcare professionals to teach in UK universities. l Simulation and Patient Safety Programme: This course is for all those who are involved in training healthcare providers or developing systems to improve patient safety at an organisational level.

The quality of education and expertise offered by PU PSMD is available to international students who travel to the UK to study, as well as those who are unable to do so, through a flexible approach to course delivery. For example the master’s degree course is three years part-time, however the dissertation can be produced remotely and digital delivery is also expanding at the diploma stage. ‘Simulation and Patient Safety’ is another area where PU PSMD excels, and the Masters programme we offer is the first of its kind in the UK. It teaches how to use complex simulation as part of medical training, including surgical simulation, and includes teaching the skills required to debrief and interplay with the team,” says Dr Tom Gale, Programme Lead.

Global perspective

WWW.SHUTTERSTOCK.COM

In some cases the university and Acute Hospitals can even send a team over to another country, and this is currently happening in Sierra Leone where they have a team working on the Ebola outbreak. Alison adds, “Leadership is particularly important in these circumstances where people are working in difficult and challenging situations.” The students themselves are also encouraged to develop a global perspective, with Alison noting about half the students are interested in remote or global health. Again this cooperation and worldwide scope encourages and challenges the students, and the diversity of experience it brings ensures a broader area of knowledge in the sector. Another exciting programme that PU PSMD is participating in, ‘Remote and Global Healthcare’, is taken by a number of doctors and dentists working for the British Antarctic Survey (BAS). Alison explains, “They spend one week at the university commencing the Masters degree, then they go to the Antarctic as BAS staff while completing the degree with the help of memory sticks and technology.” Itself a fantastic illustration of just how flexible and far-reaching PU PSMD’s knowledge, expertise and experience are.

Further information Tel: 01752 437333 www.plymouth.ac.uk/peninsula

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QHA Trent

Training & Education QHA Trent

Sheffield, the home of QHA Trent

Independent accreditation can help ensure healthcare providers are genuinely fit for purpose and standards are maintained at home and around the world, says QHA Trent’s Professor Stephen Green

Maintaining standards H ealthcare has a long history of international collaboration and assistance. It is in everyone’s interests for health standards to be maintained across the globe and while international patients can come to the UK to receive top quality health care, this is not financially viable for all. It is therefore important that the standards of medical and ethical practice in local facilities around the world are kept at an appropriate level. Independent accreditation can help ensure that a “UK standard of care” is brought to the people around the world and enable people to be confident that the healthcare provider they are using is genuinely capable of dealing with their requirements. In the USA the system of healthcare accreditation is currently much more recognisable than it is in the UK. With the majority of health providers working privately, patients and purchasers of healthcare services (e.g. insurance companies) in the USA require a stamp of approval from a genuinely independent accreditation organisation to confirm that their care will be of a high and recognisable standard. QHA Trent is a UK based organisation that delivers this type of accreditation service to international health providers. It uses British-based standards and medical expertise to assist and engage with organisations worldwide that are seeking approval as a mark of standard and as a way of improving their

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own service. It aspires to be a completely independent and impartial company that seeks to establish whether healthcare provider establishments are genuinely safe and fit for purpose. In the UK, a somewhat similar service to accreditation is provided by a regulatory quango, the Care Quality Commission or CQC, which like the NHS is run by departments of the British Government. So there also exists room for independent healthcare accreditation companies to exist in the UK, providing another level of reassurance to international patients and third party payers (e.g. insurance companies) who are used to checking for such accreditation. “If, for example, you were working for a British embassy or an oil exploration company in West Africa and were having a baby, would your wife or partner have to fly back to the UK to best ensure a safe birth? Or could you do it safely there and if so, how would you know where you could do it safely?” explains Professor Green. “It can be extremely difficult for a person or organisation to assess objectively whether a healthcare provider is truly fit for purpose without some sort of yardstick , so in doing what we do we are trying to help raise standards of healthcare provision around the world. Once accredited, this is an indicator that a hospital or clinic is of a suitable level.” QHA Trent currently has a

roster of around 50 volunteer surveyors who receive training and are sent abroad, most often during their own annual or study leave (or after retirement), to hospitals and clinics that have requested validation. The company has a policy of charging relatively nominal fees to cover costs, aiming to provide assistance for the many hospitals and clinics that do not have large budgets. “Medicine is one big universal family and we really do favour a collaborative approach between us and hospitals and clinics,” Professor Green says. “The surveyors benefit from new horizons as much as the hospitals and clinics do. We want to encourage the latter to be more adaptable and receptive to change, and to function ethically. We take a very hands-on approach, first looking at what they seek to do then offering advice. It is all about hospitals and clinics trying to be safer, ethical and more self-aware of what is going on in their organisation and beyond.” The ISQua-approved standards hospitals and clinics are referenced against multiple reputable British sources such as publications produced by the Royal Colleges, the UK’s Departments of Health and the Care Quality Commission, as well as universities, professional societies and scientific literature.

Further information www.qha-trent.co.uk

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Barts

History in the Making The historic St. Bartholomewâ&#x20AC;&#x2122;s Hospital in London is undergoing a state-ofthe-art regeneration project 152

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Barts

t. Bartholomew’s Hospital in London has a worldwide reputation not only for its healthcare, but also its standing as one of the oldest hospitals in Europe. Positioned in the heart of the City of London, the hospital is developing a new project with Skanska that hopes to merge history and modernity by increasing the hospital’s capability to keep up with 21st century healthcare, all the while maintaining the site’s historic nature. The redevelopment aims to preserve the charming and characterful area of West Smithfield by sanctioning new constructions as well as the refurbishment of the historic buildings. Due to be completed in 2016, the NHS has ensured that the hospital will maintain its service throughout the refurbishment process. The major development in the project is the construction of a new concrete-framed clinical facility. This aims to consolidate the existing, widely spread hospital operations into a single purpose built unit and maintain the Cardiac and Cancer Centre’s of Excellence. The commencement of this new hospital construction begins in Phase One of the project, which also sees one of the older buildings converted into new catering facilities for the whole hospital. This phase is typical of the venture, as it ensures that new state-of-the-art

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facilities are available to patients while also utilising the older historic aspects of the hospital. Phases Two and Three continue this theme, as an older building is merged into the newly constructed hospital and then the existing Staff Quarters are refurbished and extended. Finally, a brand new energy centre for the whole hospital will be completed. Bart’s also runs research and teaching schemes, and so as well as maintaining the history of the hospital the project also hopes to provide for the future by ensuring students have the best possible facilities available to them. While certainly a complex scheme, all parties are confident of a successful outcome and that the project will improve health services in the area. The project also hopes to demonstrate that new healthcare centres do not need to have to be created on original sites, but can grow organically by developing existing sites no matter how old those sites may be. It is a challenging and exciting venture that will maintain London’s position at the very top of world healthcare.

Further information www.bartshealth.nhs.uk

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Infrastructure

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Barts

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Infrastructure

he brand of healthcare organisations is very important and this is certainly the case at Barts Health. This NHS Trust is a leading, internationally renowned teaching hospital based in East London serving a population of 2.5 million, a turnover of £1.25 billion and a workforce of 15,000. Protecting the brand of Barts Health extends beyond its clinical teams. Facilities management services also have a significant impact on influencing how patients rate their hospital experience. Patients use reference points from their daily lives to judge the quality of their hospital experience, since the vast majority of people do not have a reference point against which to judge the quality of clinical interventions. In the absence of everyday benchmarks of the quality of clinical interventions peoples rating of their experience is influenced by factors that they are familiar with: how helpful was the receptionist? Was the hospital clean? How was the food? Shortcomings in any one of these areas will ultimately impact on a patient’s

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perception of clinical care. Carillion is privileged to be working with Barts Health to provide Facilities Management Services to five out of the six hospitals managed by the Trust. At three of the hospitals: Royal London; St Bartholomew’s and London Chest, the facilities management services are provided as a subcontract under a wider Private Finance Initiative agreement that included the UK’s largest new hospital development. A comprehensive range of hotel services are provided by over 1,000 staff, reflecting the diverse ethnic mix of east London. Service delivery has been designed around clinical zones and neighbourhoods ensuring a swift response and efficient service delivery throughout the hospital – and for less money than it cost in the old hospitals. This service design has been possible through working closely with design teams from the very early stages of the new hospitals. For those requiring facilities management support a single helpdesk number provides a single point of

contact to all of the hotel services. This helpdesk is the nerve centre of the operation and is enabled by a modern Computer Aided Facilities Management system (CAFM) linked to a number of other systems that allow the efficient delivery of specific service lines. The CAFM keeps track of every task, planned or reactive, and allows services to be managed against Key Performance Indicators (KPIs) that are calibrated to allow the contract to be managed using a performance management system (PMS) based on delivering the outputs required to support patient care. Failure to perform results in financial penalties and service failure points which can ultimately lead to termination of the contract. Throughout the construction of the new hospitals, which in total spans 10 years, the existing hospitals have been fully operational and Carillion staff have played an important role in supporting the delivery of clinical care during the construction phase, which commenced in July 2006. At the centre of the approach that we have taken is a passion for the safety of patients, our customer’s staff and our own people. Acute hospitals demand that we use all of our experience of working in critical environments. It is this focus that enables us to play our part in maintaining and enhancing the brand and reputation of Barts Health.

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Facilities management services supporting the patient experience

Carillion Carillion

Barts Health

Carillion

The right way to build a hospital The complexity involved in building a new hospital is huge, which is why an effective Programme Management approach is vital

or many people, new hospitals inspire thoughts of complex construction, the opportunity for a landmark architectural design, and the complexity of project managing all of the disciplines that are required for a new hospital to be ready to accept its first patients. This is the tip of an iceberg, invariably there have been years of planning before construction can start, and without doubt there will be many more years

of operation. Whatever the source of funding, the aim surely must be to have facilities that maximise the number of patients that can safely receive care, while achieving the best whole life value. The Public Private Partnership (PPP) programme in the United Kingdom requires all of the interested parties to focus on achieving the best whole life cost for a safe and available patient care environment. At an early stage in the development of a new hospital, this brings together the competing requirements of a wide range of stakeholders, including hospital operators, architects, patients, contractors, funders, facilities managers and many more. Many claim to have the programme and project management skills to achieve this. The reality is that there are a wide range of experts that make valuable contributions, but very few that have the experience and capabilities to successfully bring a new hospital into operation. Over the last 20 years, the UK has delivered over 100 new PPP hospitals. This has developed the expertise to procure these complex projects and, equally importantly, the capabilities to agree long-term contracts that meet the requirements of stakeholders. This new breed of programme managers have to be capable of successfully bringing together the work of design teams, construction contractors, support services providers, financial modellers, investors, lenders, forward maintenance planners, workforce planners, healthcare planners, hospital operators and patient groups. The complexity of new hospital developments frequently results in protracted planning phases, delayed procurements, changed orders during

Southmead Hospital, Bristol

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Infrastructure

Carillion

investors brings an additional rigor. A key aspect of this approach is gaining an understanding of key financial drivers of long-term value. This includes balancing initial capital costs with replacement cycles; balancing maintenance costs with extending asset replacement cycles; recognising that managing the total area to be constructed and managed has an order of magnitude benefit over striving to reduce construction rates by a few percentage points; recognising that faster construction programmes not only allow the hospital to open sooner, but also has significant financial benefits. Having established the infrastructure financial plan, the new facility needs to be designed and constructed, and the impact of the built environment on the patient experience needs to be a central theme. However all too often this is not the case. The design of a new hospital needs to consider: l How the construction is achieved in a manner that is safe for the workforce, both during construction and for the teams that will maintain the facility l Control of infection needs to be considered from separation of flows of patients and visitors, through to construction methods that protect from the introduction of infection hazards l The delivery of hotel services needs careful consideration, as it is these services that have a significant impact on patientsâ&#x20AC;&#x2122; perception of their hospital experience l The impact on clinical staff efficiency of adjacencies of clinical departments l The flexibility to accommodate fast-evolving clinical equipment and technologies l Recognising the impact that routine fixtures and fittings can have on different patient groups Each element of a new hospital has experts who can provide advice and best practice. Success is when all of these work in harmony, and achieving this requires complex programme management skills.

Southmead Hospital, Bristol

Further information www.carillionplc.com

construction, difficult handovers from construction to occupation, higher than predicted operational costs and insufficient budgets for maintaining and servicing the new facility. Reducing these risks requires dedicated executive level, broad programme management skills, from inception of a new hospital project, through to the steady state operational phase.

Financial planning At the heart of a successful new hospital is a long-term business plan, including the strategic case for the new hospital within the health system, and the implications for providing a clinical workforce to provide care in the new facility. From an infrastructure perspective, the business plan manifests itself in a long-term infrastructure financial model. Testing of this model by lenders and

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Southmead Hospital, Bristol

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Vanguard

Flexible healthcare with a global reach The ability to quickly provide additional sophisticated operating theatre capacity is enabling providers across the globe to flex their healthcare delivery, says Mary Smallbone, Managing Director Europe at Vanguard Healthcare

unique brand of flexible healthcare delivery has arrived for the first time in the Dutch Caribbean island of Bonaire. This innovative UK technology was quickly integrated into the local healthcare system with the emergency delivery of a baby boy within its first moments of use on the island. The baby was born on a state-of-the-art mobile operating theatre, part of the world’s largest fleet of mobile clinical facilities operated by Vanguard Healthcare. The unit had only been on the island for a few days after completing its trans-Atlantic crossing from Rotterdam, and had already been commissioned, validated and was ready to use in unfamiliar climates at the Hospital San Francisco (HSF). At 2am on the morning that the mobile was due to begin its first surgery list, the local clinical team opened the theatre earlier than anticipated to perform an emergency Caesarian section. “It was a lovely, if unexpected start to our service on the island,” said Mary Smallbone, Managing Director Europe. “But the real significance was that later that day we hosted five planned surgical procedures and another five the next day. We were in full swing from day one.”

Ultra-clean environment Vanguard’s ability to quickly provide additional sophisticated operating theatre capacity is enabling providers across the globe to flex their healthcare

delivery by maintaining patient flow during theatre refurbishment; creating additional capacity during busy periods, and providing emergency capacity, for example after a hospital fire. The laminar-flow theatre unit in Bonaire provides 600 changes of air each hour, creating an ultraclean surgical environment so that orthopaedic and even more complex procedures can be undertaken with confidence. This was important because HSF, the only acute hospital on the island, was having essential upgrading works carried out to its single operating theatre. Bonaire is in a relatively remote location off the north coast of Venezuela and patient transfers can be lengthy and problematic.

Expanding capacity Vanguard units have already enabled hospitals to deliver more than 200,000 safe surgical procedures in the UK and carry out a growing number of procedures in Italy, Belgium, the Netherlands and Sweden. Now the company, which is headquartered in Gloucester, England, is expanding its presence in

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Infrastructure

Vanguard

MARY SMALLBONE Mary Smallbone is a qualified theatre nurse, but has spent the majority of her career working in sales, including a period with Smith and Nephew. Mary joined Vanguard in 2003 as Sales Director. In 2007, she took on the role of Marketing and Operations Director, responsible for clinical and corporate governance and the day-to-day running of Vanguard’s staff. In 2015 Mary was appointed the Managing Director for Europe. She is currently responsible for overseeing Vanguard’s growth in the European health market; drawing on her wealth of experience in sales, marketing and operations for the company.

Europe and knocking on the doors of hospitals in Germany and elsewhere. “The challenge for us is not logistical,” said Mary. “We have spent months in Australia providing access to surgery for patients in rural locations there. If we can organise and set up on an island off the eastern seaboard of South America, then we can go just about anywhere. “Our mission in Europe is to show that hospitals can flex and temporarily extend their operating theatre capacity at will, to meet changing circumstances and demand, without permanently changing the estate. Surgeons and their clinical teams like working in our theatres - they offer sophisticated clinical environments complete with their own prep and recovery areas. They are ready to receive patients within a week of arriving on site. “We are proud of the British healthcare and engineering expertise that enabled us to create these unique clinical environments.”

Further information www.vanguardhealthcare.co.uk

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Elior

Infrastructure Elior

coffee has been upgraded to offer a fully branded Costa Coffee that sits alongside a daily selection of freshly made sandwiches and day part-baked goods. Additional behind-the-counter equipment, including a ‘hot fridge’ to offer warm day part-baked goods, such as warm pastries and pots of freshly made porridge in the morning,s has brought even more customers to the café. Lunchtime soups and Panini grills are proving very popular.

Eat well in hospital As awareness of healthy eating increases, food served to visitors and staff at hospitals should be as nutritious and healthy as that prepared for patients

n line with high profile initiatives to improve food in hospitals, backed by the likes of Jamie Oliver, catering in hospital cafes is also set to improve thanks to Elior’s eatwell concept . As awareness of healthy eating increases, food and drink served to visitors and staff at hospitals should become as nutritious and healthy as that prepared for patients . Contract caterer Elior has taken this task to heart with its ‘eatwell’ initiative which is committed to improving standards in hospital catering. Using the best ingredients and healthy cooking methods, menus have been adapted to suit different requirements and ethnic preferences. Reduction of use of sugar, saturated fat and salt is applied by chefs throughout the hospitals and the project is also promoting awareness of nutrition among customers. Elior are proud partners of Carillion throughout the Barts Health NHS Trust hospital estate operating their visitor and staff feeding outlets. Carillion set Elior clear targets to introduce a food and beverage offer that captured the growth in demand within the NHS of serving food that is authentic, healthy and wholesome for hospital visitors and staff. Elior used its own philosophy on health and nutrition called You & Life to underpin a new concept called ‘eatwell’ designed exclusively for the hospital environment. You & Life helps Elior educate its

colleagues and customers about health and wellbeing. Through You & Life colleagues and customers understand the benefits of eating well and how they can make healthier choices in a variety of ways, including the provision of nutritional information (GDA) on or by products and nudging people towards making choices to support a healthy lifestyle.

Barts Staff Restaurant and Visitor Cafe Eatwell was originally introduced at St Bartholomew’s Hospital in London (universally known as Barts) and the Royal London hospitals. The outlets include a very busy staff and visitor restaurant within The Royal London and a visitor cafe at the front of the building near the main entrance. Within St Bartholomew’s Hospital ‘eatwell’ features within the staff restaurant and grab and go cafe which is popular with visitors and NHS staff alike. Since the introduction of the eatwell concept more and more customers are using the outlets, proving that healthy food is something that many people are looking for when they are in hospitals. The ‘eatwell’ brand is tailored to each outlet and specific hospital location. The next locations to benefit from eatwell were The Whipps Cross University Hospital and Mile End Hospital, both in London’s East End.

Whipps Cross Hospital Café A change in service style in the café has made better use of this space for those wishing to purchase a hot drink or lighter meal. The previous self-service

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Whipps Cross Restaurant Moving away from being purely a ‘functional space’ the restaurant at Whipps Cross has now been given a more defined personality and brand identity. Staples such as the full English breakfast and classic comfort dishes at lunchtime are still available, but these now sit alongside a broader range of appealing healthy items displayed in a manner more reflective of the high street. There is a strong focus on healthy alternatives. The Elior team members now speak knowledgeably about the food and provenance of products and encourage customers to try daily specials and meal deals. ‘Theatre cooking’ has been introduced to the counters with a daily chefs’ theatre dish that is prepared and finished in front of the customer. Each day Elior offer a ‘choose your own’ selection of compound and composite salads with a changing range of protein add-ons, toppings and dressings. Customers with special dietary requirements are well-catered for during breakfast, lunch and dinner with daily vegetarian, dairy, wheat and gluten free dishes as well as Halal certified meats. In addition Elior have invested in a coffee pod that serves to bolster the existing Whipps Cross offer by providing an additional site where staff and customers can purchase hot and cold drinks and a range of both healthy and indulgent snacks.

Mile End Hospital - Coffee Pod Elior have given this outlet a more clearly defined brand identity with new signage and labelling – using the eatwell brand marketing collateral. Elior’s central marketing team have trained the onsite team on how to layout the counter so that it looks, modern and appealing and remains this way every day.

Further information www.elior.co.uk

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FTI Consulting

| The Strategy for UK Life Sciences and personalised health has the power to transform healthcare and the NHS, says Mariyam Rawat, Senior Director at FTI Consulting

An integrated approach to healthcare and life sciences

y facilitating collaboration between the NHS, the life sciences industry and academic research organisations, the Strategy for UK Life Sciences has paved the way for a new partnership model. The NHS has an opportunity to take a leading role in a global push to create models for developing and evaluating drugs. For the healthcare practitioner, understanding the impact this has on the lives of their patients from a quality of life perspective is immense, as is the impact on costs. Enhanced value for money to the NHS will improve the drive to support wealth creation, while patients will benefit from fast access to cost-effective and innovative medicines, devices and diagnostics.

An evolving landscape Today, the healthcare and life sciences sectors face an unprecedented and profound number of complex structural, commercial and regulatory challenges. These include the challenge to establish new therapeutic classes such as biosimilars, manage the pressures associated with R&D productivity, and deliver meaningful transformation in healthcare systems. The changing landscape is occurring against a backdrop of austerity and tightened healthcare budgets within the EU and US markets, while the developing and emerging markets face the increased demands of a younger population. The needs of other economies can no longer be ignored

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and must to be taken in to consideration. These markets have large populations and fastmoving Healthcare economies. They want their own innovative pharmaceutical economies, demanding access to existing innovations at a lower cost to support the healthcare needs of their growing populations. In the UK, the NHS spends about ÂŁ13bn a year on medicines, equal to about a tenth of total health spending. In a world of tight budgets this figure is perceived as unsustainable, and critics often accuse pharmaceutical companies of charging too much for products that often only provide incremental health improvements, while the industry complains about the difficulty of selling new products to a cashstrapped health service, and regulatory red tape, resulting in a lengthy 10-15 years for developing a new drug at an average cost of ÂŁ1bn. Recognising that the UK life sciences and pharmaceutical industries are facing such profound issues, exacerbated by socioeconomic factors such as an ageing population, crisis of productivity of the NHS combined with a structural deficit of the NHS, the government launched its Strategy

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Life Sciences IMAGE: WWW.SHUTTERSTOCK.COM

for UK Life Sciences in December 2011. The Strategy recognises the centrality of the NHS to a high-performing UK health and life sciences ecosystem. It is a bold ambition to accelerate the UK’s leadership of 21st century medicine and healthcare technology, and ensure the UK is the best place in the world for foreign companies to invest in the life sciences industry. By lowering development costs through an accelerated path to market, the government can encourage investment in medical science, while also producing affordable treatments for the NHS. This will further improve the nation’s healthcare by speeding up NHS adoption of state-ofthe-art medical advances. Such is the impetus on the sector in July 2014 Prime Minister David Cameron appointed the first UK Minister for Life Sciences. This role is underpinned by the new joint Office for Life Sciences which leads the government’s efforts to harness the UK’s science base and unique NHS, to improve healthcare and contribute to economic growth. This fresh approach could significantly reduce the time it takes to develop new medicines, devices and diagnostics, by taking an ‘end to end’ view of medicine, from discovery through to patient use. It is a step change to the previous model, taking all the components of the lengthy drug production line and making them work simultaneously. Ground-breaking developments in genomics and digital technology mean personalised health could play a significant role in the future of healthcare, helping to prevent and treat diseases now and in the future. The commitment to leadership of 21st century healthcare extends beyond the realms of academic and clinical research, and strives to find innovative ways to use digital tools, data and technology to transform patients’ lives. The adoption of telemedicine and telehealth brings new sectors such as telecommunications and technology providers into the conversation. Comprehensive ongoing monitoring provides more data, which helps physicians develop the best treatment plan. The increased data availability may also give

MARIYAM RAWAT Mariyam is a Senior Director within Healthcare Strategic Communications for FTI Consulting. She has also worked with organisations incluidng multinationals, top FTSE, SMEs and not-for-profit, such as The Boots Company, Pfizer, Reckitt Benckiser and the NHS. Mariyam holds a BSc Honours degree and a MBA specialising in post-merger integration. With more than 15 years’ experience working in healthcare and life sciences communications, Mariyam was recently seconded to the World Economic Forum to manage the transition of a wellness project. The initiative involved the engagement and management of more than 150 stakeholders, transcending several geographies and sectors.

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FTI Consulting

patients greater knowledge of their own health, and assess what the best treatment is for them. With access to quality information about the cost and available treatments, patients are able to influence healthcare systems, prompting companies and payers to review their policies and approach to market access. If industry, academia and the health service are to truly collaborate for the benefit of patient population, a mechanism to interface at a national and local level is required. This will help local NHS services find the research and informatics, services, education and training they need to be innovative. As a result 15 have been created across the UK to develop a systematic approach and ensure innovation. They will also facilitate participation by global partners, including academia, industry and healthcare practitioners.

Conclusion It is clear that the global healthcare and life sciences landscape will continue to evolve over time. In the UK pressures on the NHS, combined with the loss of its life sciences R&D leadership and subsequent effect on GDP, resulted in the government launching an integrated and ambitious strategy. It aims to accelerate the UK’s leadership in 21st century medicine by addressing healthcare needs, while driving innovation, and acknowledging that you cannot build a sustainable life sciences industry on research alone. A fresh, evolutionary approach is needed if the UK is to provide affordable solutions to the NHS and effectively compete in the global market of the future. The healthcare and life sciences sectors also need to evolve. A more holistic approach will support clients as the traditional boundaries continue to shift. Affordable, effective, timely and equitable healthcare is not unique to any one institution, organisation or country. While landscapes, philosophy and infrastructure may differ between the UK’s NHS and GCC nations, there are significant similarities in the challenges faced by healthcare systems. The experts at FTI provide solutions for clients so that they can optimise their performance in the short term and prepare for the inevitable challenges of the future. The FTI Consulting professionals take a strategic approach to engaging stakeholders, including internal audiences, investors, partners, patients, payers, policymakers, providers, and those at the board level. Whether the challenge is to develop a new health economic model, manage the pressures associated with R&D productivity, succeed in the face of global pricing pressures or deliver meaningful, sustained and embedded transformation in healthcare systems at a local and national level, FTI’s healthcare and life sciences professionals have the knowledge and expertise to guide you.

Further information Tel: +44 (0) 20 3727 1000 www.fticonsulting.co.uk

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Life Sciences Organisation

| The Importance of Integration in Life Sciences An integrated approach in life sciences can only benefit the patient, says Dr Mark Treherne, Chief Executive Life Sciences Organisation

he UK is home to the world’s largest integrated healthcare system – the National Health Service (NHS) - and renowned as having one of the strongest and most productive life sciences industries in the world. The industry is as high-tech as it gets, hugely innovative deeply collaborative with world class expertise and proven track records across all parts of the life science and healthcare spectrum. It is recognised however that the life science industry faces increasing challenges, from the rising costs and increasing complexity of research and development to marketplaces that are evolving in response to ageing populations, the prevalence of

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chronic diseases, and escalating healthcare costs. UK Trade & Investment’s Life Sciences Organisation (LSO) was set up in 2012 to support the Government’s Industrial Strategy to help meet these challenges and to signal the importance of the life science sector to the UK economy. The aims of the Government’s ten-year Life Science Strategy are to make the UK the global hub for the sector, ensure that the UK is the location of choice for investment and trade, and sustain the UK’s position as one of the global leaders in life sciences. Implementation of the Strategy means that businesses operate in a streamlined regulatory

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Life Sciences environment, enabling quick entry to market for innovations and access to anonymised patient data and patients for clinical trials. Investors have the opportunity to invest in world-leading research with access to new fiscal measures to reduce costs and support risk taking. Researchers can access cutting-edge facilities, real life data and an integrated system for bio medicine. Clinicians play an active role in innovation and research, and are better able to improve patient outcomes. Patients, meanwhile, are empowered with more choice and as a result have better access to more effective treatments. In the LSO we support overseas investment into the UK from the earliest R&D collaborations through to clinical trials, commercial operations and partnerships. We support and promote trade opportunities alongside that of investment and recognise the need to support every component of the pathway. From bench to bedside, we are making it easier to discover, develop and deliver healthcare innovation in the UK. Businesses benefit from the opportunity to use the UK as a launch pad to other international markets, whether in Europe or beyond. The UK’s excellent reputation in research, clinical development, health regulation, and health economics combined with UKTI’s own global connectivity mean that the UK can help businesses maximise their export and investment potential. Over my 25 years in the discovery of novel treatments for diseases of the nervous system I have seen many changes and the UK now operates in an extremely competitive global environment. We can no longer take for granted that the UK is considered the world leader in cutting-edge clinical trials, we need to keep proving that point.

DR MARK TREHERNE Chief Executive, UKTI Life Sciences Organisation (LSO) August 2012 - Present Mark is a research scientist with a PhD in Pharmacology from Cambridge University and has over 25 years’ industrial experience in the discovery of novel treatments for diseases of the nervous system. Formerly at Pfizer in Sandwich, UK, and responsible for research into neurodegenerative diseases before leaving Pfizer in 1997 to set up Cambridge Drug Discovery (CDD) as Chief Executive, which was sold to BioFocus in 2001. Mark has helped to raise funds for various early-stage biotechnology companies and has now served on the Boards of over 15 private and public biopharmaceutical companies around the world. Mark is Chief Executive of the LSO and leads a team of senior civil servants and sector specialists working together to support the Government’s Industrial Strategy and support overseas investment into the UK from the earliest R&D collaborations through to clinical trials, commercial operations and partnerships. The LSO team also offer trade support to exporting companies and companies seeking to export from the UK.

Life Sciences Organisation

In the UK, partners work together to support a research and innovation culture that spans sectors and geographies, and supports the creation of a fully integrated life science and healthcare ecosystem that places the patient at the heart of the system. Globally, there is a growing demand for stratified medicines and companion diagnostics. With first class research and expertise, world leading data & translational infrastructure and an established value chain, the UK has a great deal to offer in this space. The UK’s focus on improving the efficiency of the translation of scientific discoveries into innovative products and services is showcased by the work of the National Institute for Health Research (NIHR). NIHR funding for providers of NHS services undertaking clinical trials now achieves a benchmark of 70 days or less from receipt of a valid research application to recruitment of the first participant. The NIHR Clinical Research Networks are embedded in the NHS supporting the delivery of multi-centre clinical studies. 630,000 patients were recruited in 2013 into clinical research studies. This has trebled since 2010. The NIHR Office for Clinical Research Infrastructure (NOCRI) helps businesses access world-class facilities, and well-characterised and diverse patient cohorts drawn from the 60 million people who use the NHS in the UK. These are just a few illustrations of how the UK provides an unrivalled ecosystem that brings together businesses, researchers, clinicians and patients to translate discovery into clinical use. The Francis Crick Institute, due to open in 2015, is testament to our world class standing. Housing over 1,250 scientists with a mission to understand why disease develops and find new ways to treat, diagnose and prevent illnesses such as cancer, heart disease and stroke, infections, and neurodegenerative diseases it will be one of the most significant developments in UK biomedical science for a generation. A partnership between the MRC, Cancer Research UK, the Wellcome Trust, University College London, King’s College London and Imperial College London, the Institute will not only help to improve people’s lives but will also keep the UK at the forefront of innovation in medical research and importantly foster meaningful collaborations with other centres of excellence. The ecosystem is further supported by the UK Government’s introduction of fiscal measures to stimulate innovation and growth for companies: for example the Patent Box offers a lower corporation tax of 10% on qualifying profits, and R&D tax credits for small and medium sized enterprises gives up to 33% back on spending - one of the most generous in the world - and importantly we have corporation tax falling further to 20% by 2015. It’s these types of key points and comparative strengths of the UK life science sector that we need to keep re-affirming to deliver the UK’s long-term commitment to life sciences on a global stage.

Further information www.lifesciences.ukti.gov.uk

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Industry Practices NHS Employers NHS Employers

NHS Employers: Helping improve staff experience and patient care in the UK and overseas

ow healthcare staff feel when they are at work is key to the successful delivery of high quality patient care. Having engaged, healthy staff leads to increased productivity and better patient outcomes and this is as true overseas as it is in the UK. NHS Employers is the authoritative voice of workforce leaders in the National Health Service (NHS) in England, an organisation with 1.3 million staff. It also offers its expertise to organisations across the world. The NHS Employers team is made up of experts in workforce and employment

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Investing in Staff Wellbeing

issues.Â They have successfully worked across the NHS for 10 years to support, encourage and promote best practice in workforce related issues, with a real impact on staff experience, including reducing sickness absence and increasing engagement.

A tailored consultancy offer NHS Employers offers tailored and specific consultancy to healthcare providers in the UK and overseas about workforce and human resources issues. They use a wealth of expertise and

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NHS Employers

Industry Practices NHS Employers experience to support organisations to recruit, develop, value and retain staff. This helps to improve staff’s experience in the workplace, and enables them to provide better patient care. NHS Employers’ approach is collaborative. Consultancy will be tailored according to need, but could include assessment of current policy and practice, advice about the application of tried and tested products, help to gain senior manager commitment, and support to develop and evaluate improvement plans with milestones and timescales to work to.

‘In England, stress is believed to account for over 30 per cent of sickness absence in the NHS, costing the service £300-400 million per year and this trend can also be seen elsewhere in the world.’

Our products NHS Employers excels in designing, developing and implementing tailored and specific tools and services to both UK and international healthcare service providers. The products below have helped many organisations to improve the experience of their staff, and get the most out of them..

organisations have reduced their sickness absence, how health and wellbeing programmes are having an impact, and how they are being measured. The lessons learned from these studies can be applied both at home and abroad.

Staff engagement toolkit

Seven steps to effective management

Talking and listening to staff results in positive outcomes for organisations, their staff and their patients. NHS Employers has developed a toolkit, based on extensive work with the NHS. It offers the information and tools needed to help improve staff engagement in organisations, helping them to get better results.

NHS Employers’ seven step guide has been designed to help managers to be more effective. Supporting and empowering individual employees will strengthen the whole team - and therefore the business as a whole. The guide suggests simple ways to manage teams more effectively.

Health work and wellbeing - Developing and implementing a strategy A healthy healthcare workforce is a more productive workforce. Adopting a strategic approach to the physical and mental health and wellbeing of staff has been shown to be an important factor in achieving sustained business benefits. Effective health and wellbeing strategies are about much more than reducing sickness absence. NHS Employers offers advice, guidance and case studies to help organisations recognise the importance of investing in staff health and wellbeing, and support to develop a long term strategy. This will have a positive effect on many things including performance, retention of skills, and most importantly, patient care.

Leading the way – Practical examples of improving staff health and wellbeing NHS organisations across the UK are doing innovative things to improve the health and wellbeing of their staff. Many case studies show how

‘NHS Employers offers advice, guidance and case studies to help organisations recognise the importance of investing in staff health and wellbeing,’

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Managers’ guides to health work and wellbeing A range of information and guidance has been produced for managers of healthcare services and staff. Managers cannot directly influence all the factors which have an impact on the health of their staff, but creating a positive environment in which employees feel able to discuss some of these issues has been shown to help. In England, stress is believed to account for over 30 per cent of sickness absence in the NHS, costing the service £300-400 million per year and this trend can also be seen elsewhere in the world. Guidance on prevention and management of stress at work aims to help managers reduce stress in the workplace and better support staff who experience it. Musculoskeletal disorders (MSDs) account for around 40 per cent of sickness absence in the NHS. We offer information and support for line managers of staff with MSDs.

Sickness absence guide and calculator How sickness and absence is managed can affect its length , and future absences, which of course, affects the business and patients. NHS Employers has designed an interactive online guide to help managers who, at some point, need to deal with staff sickness. The sickness absence calculator is a very useful tool that helps managers to identify how much sickness is costing their organisation.

Further information www.nhsemployers.org/arabhealth consultancy@nhsemployers.org

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Olympus

TURis Long_ Resectoscope

The NHS could save millions of pounds while providing better care for prostate patients with the use of the Olympus TURis system.

Improving the lives of older men

ith an ageing population both in the U.K and around the world, concerns related to old age will increasingly put pressure on health services. One of the most common issues is enlarged prostate glands in elderly men. While not connected to prostate cancer, the frequency that this occurs makes it a concern and thus developments in the field can make a great difference to many peoples lives. A novel surgical system for reducing the size of enlarged prostate glands in men is supported by new NICE guidance. The TURis system by Olympus provides benefits for patients and for the NHS without the need for radical changes in care pathways. Benign prostate enlargement (BPE) is the most common cause of lower urinary tract symptoms (LUTS) in men. With an ageing world population, the issue is becoming increasingly pronounced as around 60% of men aged 60 or over have

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some degree of prostate enlargement. This figure increases to 80-90 % in those over 90. While the cause is unknown, most doctors agree it is linked to hormonal changes that occur during old age. In fact between the ages of 31 and 50 the prostate doubles in size every 4.5 years, but this rate does reduce subsequently. The condition is not usually a serious threat to health but can have a major impact on the patientâ&#x20AC;&#x2122;s quality of life. Surgery is only normally recommended to those in severe cases who have not responded to medicine or lifestyle changes. Transurethral resection of the prostate (TURP) is a surgical procedure where the excess prostrate tissue is removed. Transurethral Resection (TUR) Syndrome is a rare but potentially life-threatening complication of a transurethral resection of the prostate procedure. It occurs as a consequence of the absorption of the fluids used to irrigate the bladder during the operation. NICE, which provides national guidance to improve health care, has now recommended Olympusâ&#x20AC;&#x2122; Transurethral Resection in Saline (TURis) system as the new gold standard for this operation because it reduces the risk of transurethral resection syndrome. Transurethral Resection in saline (TURis) is

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Industry Practices unique to Olympus. The new technology has numerous advantages, the first and most important of which being providing better care for the patient. Other advantages include a reduction in the need for blood transfusions and the need for extended hospital stays. The system can perform virtually bloodless procedures. The device can also save the NHS about £285-£375 per patient, and with approximately 15,000 TURP procedures carried out each year, this culminates in huge savings. The device itself was launched in 2009 and is a bipolar electrosurgical system. The new procedure is bipolar rather than monopolar and utilises saline solution as opposed to glycine. Through utilising the knowledge that impedance is lower in saline than in body tissue, the TURis bipolar current flows to the saline irrigation fluid, meaning only a very small fraction of the current passes through the tissue. Air bubbles are then created around the TURis electrode by the heat generated from the current flow. High frequency current is used to create a plasma corona around the electrode. After plasma ignition, cutting or vaporisation can be performed. The surgical system has already been a success, with 1 million successful clinical cases already performed. As a worldwide leading manufacturer of optical and digital precision technology, Olympus provides innovative solutions for state-of-the-art medical systems, digital cameras as well as scientific solutions in the fields of microscopy and industrial inspection. The company’s award winning products are instrumental in detecting, preventing and healing illness as well as driving scientific research.

Olympus

Top: Large Loop Resection Above: Transurethral Enucleation Below: PlasmaButton Bottom: TURis Keyvisual

Further information www.olympus.co.uk

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Industry Practices Heythorp Healthcare Heythorp Healthcare

Helping China to meet the challenges of elderly care

ising living standards and improved healthcare across the globe have helped people live longer, healthier and happier lives. But our rapidly aging populations will also increase pressure on our often creaky, health and care systems – forcing us to find more efficient and costeffective solutions to meet the challenge of caring for our families in old age. The demographic change seen in China in recent years has made the challenge even greater. With smaller families increasingly unable to provide the standards or quality of care that a frail, sick or dependent elderly relative may need and acute hospitals that look to provide only critical medical support when necessary, the role of elderly and intermediate healthcare services is set to grow significantly to fill the gap between family-provided care at home and the acute care provided at hospital. Heythorp is a British-based company that focuses specifically on this rapidlygrowing intermediate healthcare sector. Heythorp’s Managing Director Dai Dyfed Evans has been active in China for over 20 years and is keen for Heythorp to help China meet the challenge: “We have seen incredible demand for our intermediate healthcare services over the last two years as China continues to grows in wealth and looks to bring its health and elderly care systems closer to that of many developed countries. They have so far lagged behind, but this is beginning to change and Heythorp can help in this.” The company will open its first healthcare facility in China in joint venture with a large local group in April 2015 and plans to open further health and care centres across the country over the coming years.

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Heythorp focuses on providing elderly and intermediate care services that include long and short–term frail elderly care and nursing services, rehabilitation and re-ablement services for those coming out of hospital, care of those with long-term health conditions such as heart or respiratory disease, diabetes or dementia, primary care services for the whole family and a range of other health and wellness services delivered at one of its modern facilities or at the patients’ own homes. Heythorp also provides the extensive yet essential training that health and care professionals need to do their job and to create the conditions for these professionals and newcomers to join and thrive in this important sector. Heythorp recognises the need to adapt its approach as much as possible to meet the local traditions, language, culture and unique needs of such a large and diverse market as China. “With a more traditional family-based approach to care and a greater focus on traditional medicines and therapies such as acupuncture, there is much that we can learn so it would be hopeless simply to impose the UK’s elderly and intermediate care model on China,” says Evans. “The foundation of designing and delivering quality health and care services is universal. It starts by employing, training and

Elderly Care specialists Heythorp Healthcare are working to raise the standard of elderly and community care in China motivating the best, highest quality staff. Although many of our staff in China will initially come from the UK, most of our staff will be local people – trained to the exact same UK standards as our UK staff and encouraged to grow and develop their career with us. This will not only help to bridge any cultural gaps but also ensure that the highest quality standards are maintained in the short and longer term at the point of delivery. It is also critical to introduce tried and tested operating systems, clinical governance protocols and the latest digital and telehealth technologies, all of which provide the essential framework in which our staff can work effectively and efficiently”. The British health and care system is seen by many as the best in the world and Heythorp is keen to promote those same standards of elderly and intermediate care services to overseas markets. While demand for Heythorp’s elderly and intermediate care services comes from a number of rapidly emerging markets and Heythorp has looked at projects in regions as diverse as Africa to India, the focus at the moment is very much on China. “China is obviously a massive market with a great many challenges and opportunities for us to deal with over the coming years,” Evans says. “And while Heythorp will not, on its own, be able to provide services and solutions to more than a small part, we do hope that by setting a high bench-mark for the quality of our own elderly and intermediate healthcare services we can help, in a small way, to show our partners, customers and patients in China what good quality health and care can look like, and in so doing help meet the challenge of raising healthcare standards overall”.

Further information 29 Harley Street, London W1G 9QR Tel: 020 7016 2685 Email: info@heythorphealthcare.com www.heythorphealthcare.com

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Industry Practices

ody modification has been practised for 30,000 years, from South American cultures like the Mayans and Aztecs who ritually pierced themselves, through to the late 1970s and early 80s when the British punk subculture used piercing to shock the social order of the time. Throughout all of this, ear piercing has remained the most popular form of piercing. Despite certain health and safety regulations placed on the operation of ear piercing, it can be a fresh and

inexpensive addition to pharmacy services, and retailing can also be incorporated, with a wide range of eyecatching styles to display. Hygiene and safety is of paramount importance when piercing, so naturally clients will expect the pharmacy to be using a piercing system they can trust. Here in the UK we have several worldleading manufacturers of ear piercing systems that combine skilled British engineering and exceptional value.

Surgical quality Caflon manufactures one of the most affordable, surgical quality ear piercing systems on the UK and international market, and work closely with environmental health authorities in the UK and abroad to ensure that all products conform to international standards.

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At Caflon, our British engineering heritage is reflected in the quality of every ear piercing component we make, including precision instruments and piercing studs. We have a team of experienced ear piercing technicians that can inform new customers on how best to use and promote a safe and sterile piercing experience. Equal emphasis is placed on educating customers about the correct procedures to follow before and after the piercing, as well as demonstrating an accurate piercing technique. Training sessions are available throughout the year, and training videos can also be viewed online. Products for piercing vary according to specific regions, but all comply with correct safety standards. All new customers need to be informed about licensing and insurance, and they will be given a certificate by their ear piercing trainer which they can use to obtain these. They are also advised to contact their local Environmental Health Office (or equivalent), and obtain a copy of local ear piercing by-laws. Another important requirement is that all piercings are formally registered. Piercing clients are asked to complete a form giving information such as their age and medical condition, and state that they understand the procedures and responsibilities for their aftercare. Customers should then use this recorded information to decide whether the client is able to proceed with a piercing.

Aftercare support It is important to pay careful attention to looking after newly-pierced ears. As problems occurring later on is often a result of poor aftercare. Caflon also makes accessories such as lotion and wipes which are vital to the piercing procedure. Dealing with a top ear piercing manufacturer such as Caflon ensures that any pharmacy wishing to invest in ear piercing services will be supplied with the correct information to set themselves up, provided with surgical quality, affordable ear piercing syestems, and backed up with reliable and accurate support to ensure their service is run effectively, hygenically and safely.

Further information Tel.: +44 (0)1296 434158 Email: sales@caflon.com www.caflon.com

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Ear piercing can be a refreshing and profitable addition to pharmacy services when itâ&#x20AC;&#x2122;s provided with the right information and support, says Ron Maguire, Sales Manager of Caflon

Caflon Caflon

Pharmacies making profit from piercing

Vernacare

Vernacare System reduces infection risk The world renowned ‘Vernacare System’ of hygienic patient toileting and washing improves standards of patient safety and care. It is proven to reduce infection risk, save money and nurses’ time, while improving environmental performance

ealthcare providers across nearly 50 countries, including 96% of NHS hospitals in the UK, are using the innovative singleuse method of human waste management pioneered by Vernacare more than 50 years ago.

What is the ‘Vernacare System’? The ‘Vernacare System’ replaces traditional reusable waste management products, such as urinals, bedpans and wash bowls, with hygienic containers – made from renewable natural fibre. These containers disintegrate after use when placed in Vernacare’s environmentally friendly Vortex disposal machines, which break down the waste into miniscule particles using a fast and energy efficient cold water process. The resulting fine slurry flows freely through the drains. This method prevents cross-infection risk and avoids the expense and inconvenience of using clinical waste or chemical disinfection processes. Vernacare is the only company to manufacture a complete single-use human waste disposal system – producing 140 million disposable products last year. Vernacare uses stringent Quality Assurance systems to create robust, reliable products – guaranteed to hold water for a minimum of four hours, without leaking. Adhering to the highest international quality control standards, all of Vernacare’s products are BSI Kitemarked.

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Vortex disposal unit

Global best practice Vernacare’s single-use system of human waste management is accepted as best practice globally and Vernacare products are used by healthcare professionals across every continent. Specialist teams provide the highest standards of educational information, technical assistance, service delivery and customer care to support the Vernacare system. Vernacare’s most recent market entry projects are in European and Asia Pacific countries, where healthcare providers are increasingly moving to the single-use system of patient toileting and washing to prevent infection, reduce environmental impact, and save time and money. UKTI’s support is central to Vernacare’s international strategy, helping us to conduct preliminary research into new markets and identify new healthcare partners.

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Industry Practices

Vernacare

Reduce costs

Reduce Environmental Impact

When all costs are considered, the Vernacare system is 39.4% less expensive 1 to maintain than alternative systems of human waste management. The single-use process utilises significantly less energy and water than alternative re-usable methods. Further financial benefits are provided through the savings in nursing time, the cost of treating Healthcare Acquired Infections (HCAIs) and reduced maintenance costs. In addition, the Vortex disposal unit can often be significantly less costly to purchase than many washer disinfectors.

The Vernacare system uses 60% less water 3 than some alternative systems and less energy because the integral Vortex disposal machines use a cold water process and operate a fast, energy efficient cycle.

Improve productivity The Vernacare single-use system saves nurses more than 27 hours per year 4 – compared to alternative reusable systems. It improves working conditions by eliminating the time spent washing reusable plastic products by hand or processing them though a washer disinfector.

Prevent infection to increase safety By providing a clean product every time, the Vernacare system helps to reduce infection risk from Clostridium difficile, MRSA, E. Coli and Norovirus, as well as also other highly infectious diseases, such as the Middle East respiratory syndrome coronavirus (MERS-CoV). Vernacare’s products have been shown to contribute to a reduction in Clostridium difficile infections of 56% 2. In contrast, studies have shown safety risks from re-using plastic and stainless steel products following thermal disinfection. There is evidence that washer disinfectors may not provide adequate conditions for killing Clostridium difficile spores.

Increase patient dignity and standards of care Patients find the products far more dignified and comfortable, and are reassured when they receive a new clean product each time. The new VernaFem increases patient safety, patient dignity and comfort

VERNACARE’S REVOLUTIONARY SINGLE USE SYSTEM

Assisting the fight against Ebola Vernacare’s products are being used in hospitals in Sierra Leone to help stem the spread of Ebola. As Ebola is spread via bodily fluids, the singleuse system offers protection to both patients and healthcare workers.

Innovation Vernacare is continually innovating in partnership with global healthcare professionals. Vernacare won the Queen’s Award for Innovation for developing the world’s first detergent-proof, disposable wash bowl. Recently, Vernacare launched the VernaFem single-use female urinal, which preserves patient dignity and empowers patients to toilet themselves with little or no assistance from healthcare staff. The launch of the new VernaChair commode provides users of the single-use system with a product with a robust, easy-clean design to further help reduce infection risk, particularly from vancomycin-resistant enterococci (VRE) transmission. VernaChair can be steam cleaned and withstands the thermal disinfection conditions used to clean commodes – aligning with current cleaning practices for commode chairs across all of global markets Durability has been designed into the product and it needs fewer spare parts over its lifespan, ultimately meaning less cost for Vernacare customers. Vernacare Data on file. Vernacare 2001 Reducing Clostridium Difficile infection in acute care by using an improvement collaborative. Power M, Wigglesworth N et al, Salford Royal NHS Foundation Trust, UK, BMJ 2010; 341: c3359. 3 Power and Water Consumption Comparison Test. Bernard G Poulton Pty Ltd. Consultant Engineers, Australia, July 2001. 4 The Evaluation of time factors in the use of the Vernacare Disposal unit. Sally Garratt, Associate Professor and Judith Coles RN, Caulfield General Medical Centre, 2002. 1 2

Further information To find out more about Vernacare’s single-use system please contact us at info@vernacare.com Twitter @VernacareOffice www.vernacare.com

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TECcare

CONTROL range (2014)

Benefiting from a new approach to infection prevention It is essential to create the cleanest possible healthcare environments to prevent the spread of infection, says Paul Hoff, International Sales Manager, TECcare®

ealthcare associated infection (HCAI) is a global problem. In 2012 the European Centre for Disease Control (ECDC) surveyed just under 20,000 patients across Europe and reported a 7.1% prevalence of HCAI in acute care facilities. Each year the ECDC estimate over 4 million people are affected by HCAI’s which result in the loss of 16 million bed days and are a direct cause of 37,000 deaths, contributing to a further 110,000 patient deaths. In financial terms the direct costs alone in Europe account for annual losses of over €7 billion. Similar figures are reported for the USA where in 2002 the estimated HCAI incidence was 4.5%, affecting 1.7 million patients and resulting in approximately 99,000 deaths. In 2004 the annual economic impact of HCAI in

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the US was estimated at $6.5 billion. Increasing evidence links the transmission of bacteria, bacterial spores, viruses and fungi, with environmental surfaces. Enhanced cleanliness of the clinical environment reduces the incidence of Clostridium difficile infection, MRSA and VRE acquisition by patients. The cleaner the clinical environment the lower the risk of an infection. Since patient care takes place in non-sterile settings the clinical environment will always pose a risk to patients, clinicians, carers, visitors etc.

The aim for healthcare providers is to minimise the risk posed by the clinical environment and this is achieved by creating the cleanest possible clinical environment and sustaining this level of cleanliness in order to underpin all other infection prevention processes. Minimising the risk we face from microbes in the clinical environment requires the following; Creating and maintaining the cleanest environment with the fewest possible microbes offers dual benefits in terms of risk management; i. C lean environments have low levels of dirt and organic matter which are often used as a bacterial food source. Removing this food source severely limits microbial survival and growth. ii. M inimisin g the number of microbes present (microbial bioburden) reduces

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Industry Practices the risk of microbial contact and subsequent infection, contamination, or transmission throughout the environment. Interrupting key routes of transmission (transmission pathways). Stopping the movement of microbes from one area to another is a highly effective way to reduce the risks associated with microbial contact. When looking to control the spread of microbes key transmission pathways are the air, water, surfaces and the hands/skin. TECcare® manufacture three world class antimicrobial technology platforms (TECcare® PROTECT, TECcare® CONTROL and TECcare® ULTRA) which are specifically designed to control the growth and dispersal of microbes throughout all clinical environments. TECcare® use very safe, highly effective antimicrobial technologies to create the cleanest possible environments whilst simultaneously targeting the transmission pathways that are key to the spread of microbes throughout the clinical environment. Uncontrolled microbial growth and dispersal can cause significant problems such as infection outbreaks, ward and hospital closures etc. These can be catastrophic for patients and healthcare providers. Targeted use of the appropriate technology platforms and products can create a TECcare® ENVIRONMENT™. These are the safest possible environments, where the microbial risk to individuals (patients and staff) and providers are reduced to their lowest practical levels. A TECcare® ENVIRONMENT™ results from using the correct combination of TECcare® products (see Figure 1) in

order to reduce the number of microbes within the environment to its lowest possible level whilst simultaneously interrupting key microbial transmission pathways. The outcome from this dual approach is to reduce the risk of infection, cross contamination / cross infection etc. The result is improved safety and productivity at both an individual and organisational level. A TECcare® ENVIRONMENT™ is the cleanest, safest, most productive and efficient environment that can be practically achieved. Depending upon your specific needs, the various TECcare® Antimicrobial Technology platforms and products can be tailored to help create your very own TECcare® ENVIRONMENT™, thereby reducing the microbial risks faced by you, your facility, your staff or your patients. TECcare® have extensive experience of operating in the healthcare environment where our customers now recognise the benefits a TECcare® ENVIRONMENT™ can offer them. These benefits include the following:Improved outcomes ‘….the introduction of TECcare® CONTROL, a proven sporicidal disinfectant, which improved the cleanliness of surfaces and patient care equipment, streamlined the cleaning / disinfection process and was well liked by staff, made an important contribution to the impressive year on year reduction of Clostridium difficile infection figures’ (Lowe S. Infection Control Nurse, Manchester, UK) Improved efficiency ‘[The adoption of TECcare® CONTROL] has improved departmental efficiency by

TECcare

over 50%, reduced waste associated with product cleaning and resulted in cleaner equipment whilst simultaneously offering a clear cost benefit to medical device library management.’ (Embleton G. Head of Medical Device Library, Preston, UK)

Increased user acceptance/ concordance/ease of use ‘TECcare® CONTROL products evaluated very well in terms of ‘user acceptance’. Over 90% of staff rated the products easier to use compared with chlorine dioxide with a clear preference shown for TECcare® in all other assessment criteria.‘ (Keward J, Lead Infection Control Nurse, Alder Hey, Liverpool, UK) ‘72% of staff stated they were ‘more likely/much more likely’ to comply with the five moments for hand hygiene when using TECcare PROTECT in place of alcohol based hand rubs’ (Keward J, Lead Infection Control Nurse, Alder Hey, Liverpool, UK)

Cost benefit ‘TECcare® CONTROL solution offered an 84% saving over the existing chlorine dioxide product.’ (Keward J, Lead Infection Control Nurse, Alder Hey, Liverpool, UK) ‘compared to standard laundry which relies on heat-based disinfection the TECcare CONTROL Laundry System resulted in a process cost saving of 43% (equivalent to saving £8.40 per wash)’ (Lees K. Microbiologist, Manchester, UK) Disinfectant technology is constantly evolving. TECcare manufacture a range of advanced antimicrobial technology platforms and products which can be combined to create a TECcare ENVIRONMENT, where the risks posed by microbes are reduced to their lowest practical levels. Extensive use of the TECcare products in healthcare is now proven to offer healthcare providers significant advantages over the more traditional disinfectants. Please contact TECcare to discuss how our technologies and products can help improve your outcomes, efficiency, and user acceptance/concordance whilst simultaneously reducing your costs.

Further information

ULTRA range (2014)

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Contact: Contact: Paul Hoff, TECcare Antimicrobial Technologies Tel: 01794 503 518 Email: phoff@TECcare.com www.teccare.com

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Industry Practices Inditherm

Inditherm

5 year maintenance and extended warranty was £129,000. The project plan therefore represented an estimated saving of over £61,000 using very conservative assumptions, with the annual savings rising to a level of over £57,000 per year.

Clinical Implementation

Changing from forced air patient warming to Inditherm Alpha saved money and time for Pennine Acute NHS Trust

The future of patient warming

he Pennine Acute NHS Trust had used forced air patient warming in their operating theatres and recovery rooms for many years. All four hospitals in the Trust have now changed to using Inditherm Alpha patient warming mattresses and blankets after carrying out a clinical evaluation and gaining approval for a business case based on outright purchase of the Inditherm system. The initial driving factor for change was to improve clinical care by making it more practical to warm all patients effectively. It was identified during the evaluation process that the change could also deliver significant cost savings and this strengthened the business case. The NICE guidance relating to the Inditherm system (MTG7) provided strong evidence that gave the Trust confidence in its own evaluation and expectations. A review carried out 8 months after implementation of the change of warming technology has shown that the Trust has already exceeded the cost savings planned for the first two

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years, amounting to over £56,000. Pennine Acute Trust comprises four separate hospitals and is the largest non-teaching hospital trust in the UK. The Trust had been spending just over £107,000 per year on forced air warming disposable blankets, following the issue of NICE Clinical Guidance on perioperative hypothermia, issued in 2008, before implementation of the Inditherm system. With a total of around 23,600 surgical cases per year this represented warming of approximately 50% of patients having general or regional anaesthesia. A product evaluation was undertaken with three selected products, all reusable patient warming technologies. Each product was trialled for a period of 4 weeks in the main operating theatre suite at the Royal Oldham Hospital and was audited for clinical performance, particularly patient temperature outcomes, along with feedback from the staff on suitability of the device for use with the procedures carried out at the hospital. The Inditherm Alpha system was selected as the product of choice as it met the clinical criteria in maintaining patient temperature and was well received by the staff in the department. The cost of purchase, along with

It was decided that the Trust would equip 31 of the 43 operating theatres and 11 recovery beds to match the case loads and needs of the different hospitals. A mix of different mattress sizes was purchased to allow for different procedure types and operating tables. During the period after full implementation of the Inditherm system ongoing costs of air warming have been monitored and compared on a monthly basis to the same period in the previous year. Eight months after introduction of the Inditherm systems these cost savings were analysed as follows: There is a clear pattern of sustained savings from month to month, and good confidence that the forward projections will be achieved if not exceeded. From a clinical perspective there is a significant advantage as all patients in the theatres equipped with Inditherm systems can be warmed at no incremental cost. The percentage of patients warmed is now very much higher than was the case when using forced air warming, helping to ensure compliance with the recommendations of NICE for the prevention of unplanned perioperative hypothermia (CG65). It is clear from results actually delivered in practice in a complex, multi-site group of hospitals that substantial cost savings can be made. In this Trust the business case has been significantly exceeded and a payback on capital expenditure will be returned in the first year, with some savings achieved. The five year financial return will run to nearly £300,000 for an installation with warming for 31 operating theatres and 11 recovery beds. References Inditherm patient warming mattress for the prevention of inadvertent hypothermia. NICE medical technology guidance 7. Issued August 2011. www.nice.org.uk/mtg7 Inadvertent perioperative hypothermia. The management of inadvertent perioperative hypothermia in adults. NICE clinical guideline 65. Issued April 2008

Further information www.inditherm.co.uk

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Versapak

Industry Practices

Security seal of approval Strong, durable medical transport bags are essential for security and hygiene says Julie Goddard, Sales and Marketing Manager, Versapak

ecurity may not be a word most often associated with healthcare, but in fact unauthorised access to medical records or medical samples could have serious consequences. The moment when these sensitive items are most at risk is during transportation from one location to another, and so reliable and secure transport bags are essential for all health providers. Versapak is a British organisation that has been manufacturing specialist medical transport bags for the healthcare industry for almost 40 years. They supply the NHS and private hospitals in the UK and abroad with bags that are used to transport blood, vaccines, pathology specimens and drugs, as well as confidential patient records and delicate instruments. These bags are more than just a form of transportation;

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they all come fitted with a unique locking chamber for use with genuine Versapak security seals. This provides an indication of tampering, and acts as a deterrent against unauthorised access to ensure the safety of the valuable contents.

Temperature control Medical bags come with a variety of distinctive requirements. As well as being strong and durable to the extent that they can be reused over 2,000 times, they can maintain the temperature inside the bag for up to six hours. This can be crucial when transporting blood or vaccines. Versapak produce a variety of bags, and can adapt their product to the specific needs of different situations. The company has its own manufacturing facility in Europe and as such can respond quickly and effectively to new regulations concerning the movement of medical specimens. An example of the adaptability of the product is when Versapak helped The Cheshire & North Wales Human

Milk Bank deliver human breast milk safely and legally. The challenge was delivering donated pasteurised breast milk to other hospitals across the nation. After liaising with the Human Milk Bank regarding their specific requirements, Versapak designed and produced a five-litre insulated bag in the specified colour complete with tamper evident seal housing and the charityâ&#x20AC;&#x2122;s logo. They were designed at just the right size to fit onto the back of a motorbike and tagged to satisfy the recipient that the bag remained unopened since leaving the Milk Bank. For the last twenty years, Versapak has supplied tamper evident bags and security seals to Windsor Castle, St Jamesâ&#x20AC;&#x2122; Palace, Buckingham Palace and the Palace of Holyroodhouse. The standard of product on offer is so high that in January 2014 Versapak was awarded a Royal Warrant of Appointment to Her Majesty the Queen in acknowledgement of the high standard and quality of provisions supplied to the Royal Households.

Further information Tel: +44 (0)20 8333 5300 www.versapak.co.uk

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Bringing health products to the UK market need not be problematic for foreign companies, says Steven Haken of Odelle Technology

ealthcare products are restricted by the rules and regulations of the industry, which protect patients and ensures competences. However this can seem daunting to companies attempting to bring products to market, especially foreign organisations that may not be aware of the U.K’s processes. Odelle Technology is a British company that guides organisations through the regulatory red tape surrounding medical devices in both the private and public sectors. As experts in the UK Healthcare system they optimise distribution to ensure the best products are brought to market and patients receive the finest possible care. Odelle is experienced in the ways that the NHS deals with new products and technologies and has

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successfully worked with Boots, GSK and King’s College, among others. Odelle has placed overseas developed technologies into UK medtech and life science manufacturers that have enabled efficiencies and new generation products. For the past 11 years Odelle has brought companies into the NHS from countries including Norway, New Zealand, Australia, Scandinavia, Germany, France and USA. Steven Haken of Odelle Technology explained how the organisation facilitates innovation. “We can help products develop here by introducing foreign companies to the right people. Putting products into NICE (National Institute for Clinical Excellence), the NHS schedules and through clinical trials can take a lot of effort but it is a huge step for increasing distribution. It can take between 6 months and 2 years and we can do this for a fixed price, no matter the time scale.” The NHS Reimbursement Listings programme allows the most innovative products to reach the audience they

Odelle Technology

deserve. When a NHS hospital performs an operation it is reimbursed by the Department of Health. In order to receive the reimbursement a clinical procedural code is created, and once the operation is complete the codes are sent to DofH and the hospital is provided with the necessary money. In terms of technology, if a device is used in the operation then it becomes part of the procedure. This is where Odelle Technology can offer assistance. “A hospital can be reimbursed for using certain devices,” says Steven Haken. “Once products have passed certain criteria we will enable new technologies to enter the scheme and a hospital may receive extra funding to use them. This means the new device will be purchased by many hospitals and encourages the NHS to invest in innovation. This can dramatically increase distribution for new-to-market technologies.” As well as products the distribution of ideas can be facilitated, although these can take longer to commercialise. “We are able to take intellectual property to market. This is taken from Universities including Sheffield, Sheffield Hallam or East Anglia. We can also assist in selling IT solutions, of which there are lots of options in the United Kingdom.” Odelle provides a series of on-theground services, including working directly with NHS Chief Executive Officers, Chief Financial Officers and Clinical Directors, to introduce cost saving technology into the NHS. These include listing companies with dermatological and nutritional products with the Advisory Committee on Borderline Substances (ACBS) in the Department of Health, distributing technology through multiple non-exclusive distributors who then specialise in diverse fields including Primary Care, Tertiary Care, Retail Pharmacy, Wholesale Pharmacy, Clinical Research, Veterinary, and Homecare. The company also sells Healthcare IT solutions into the UK. Through service improvement techniques and partnering, clients’ systems have been installed into a variety of National Healthcare Services programmes within the United Kingdom. Odelle works with IT Service Directors and CEOs across the NHS, taking a client’s platform and fitting it into the standards, frameworks and governance process within the NHS Health Informatics industry.

Further information http://odelletechnology.com

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Breaking into the UK health market

Odelle Technology

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Industry Practices

HAIKA

Industry Practices

Hand in glove Effective hand protection increases safety and productivity in healthcare, says Michael Easton, Sales and Marketing Director at Globus

he Union Jack has become a significant asset on the global stage with the red, white and blue synonymous with quality and professionalism. At Globus, an example of British success, we have been flying the flag for Britain for over two decades and, during that time, have become a significant force in the hand protection industry. We have delivered numerous innovations and introduced new levels of ‘wearability’ that have had a positive impact on safety and productivity across a number of industries. Now a multi-million pound international business consistently achieving double digit turnover growth, we have spent considerable time developing a product focused on the healthcare market. The result is the launch of the HAIKA™

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brand that encompasses a range of high performance sterile surgical and nonsterile examination gloves. A lot of research and development has preceded the launch and we are confident that we have come to market with a truly differentiated offering and one that can make a positive difference to healthcare organisations at many different levels. At Globus we take great pride in the positive impact our hand protection solutions have on the lives of many people every day. Globus’ products are used every day by industry professionals across the world, enabling them to create amazing achievements and protect themselves from life-changing injuries. Even Britain’s Olympic athletes have achieved greatness and set world records with the help of a Globus solution. Some people might think we are mad launching into a market and selling a product when the purchase

HAIKA

of hospital consumables has had so much bad publicity recently. However, we believe with the right amount of support the healthcare industry as a whole, both public and private, will be able to better understand the benefits of hand protection, reduce the risk to wearers whilst reducing the cost of hand protection generally. We also offer a combined consultancy and advice package, working with stakeholders to conduct feasibility and usage assessments and make recommendations based on the organisation’s needs. Our rationale for HAIKA’s consultancy-driven approach is that a better understanding of hand protection needs and effective implementation will drive cost savings, rather than simply rationalisation or switching to cheaper, and possibly inferior, products. Our assessment methodology also often uncovers opportunities for cost saving and can highlight ways in which staff can be better protected. Hand protection policies can often be somewhat ambiguous leaving the individual unsure as to what they are meant to do, or wear. We have applied our expertise and this approach across a spectrum of industries, meeting and exceeding a diverse range of hand protection requirements, from the rigours of heavy construction to the complexities of clean room and aerospace manufacturing. Regardless of the industry one thing is clear: Globus sells hand protection, not just gloves. We are passionate about hand protection. From experience we know that the proper use of the right glove can make a dramatic difference both personally and business wide. There are so many stakeholders involved with hand protection and, as such, many benefits to be found and challenges to be overcome. Better patient protection, better staff protection and enhanced wearer performance resulting in cost savings: a win-win situation if managed properly. Hands do the most incredible things every day and we help protect those hands. Over the past twenty years our gloves have witnessed some pretty incredible things, and we are very proud of that.

Further information Tel: +44 (0)161 877 4747 www.haikagloves.com

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Clear Surgical, a new medical device company from the National Health Service in Scotland brings innovative surgical technologies to the market. Designed by surgeons, products include the Oplight, a single-use self-retaining illuminated retractor for improving light in surgical cavities, it provides retraction while using LEDs to illuminate the area of interest. In addition the Cannulated Reduction Forceps are a universal guidance system for reducing fractures in orthopaedic procedures. They facilitate the placement of equipment and implants such as surgical screws, suture systems and K-wires with accuracy and ease.

Bright ideas. Safe hands.

Clear Surgical Ltd 20 - 23 Woodside Place Glasgow, G3 7QF United Kingdom +44 (0) 141 582 1200 info@clearsurgical.com www.clearsurgical.com

Industry Practices ABHI

Technology is providing answers to healthcare challenges in both developed and emerging countries, says Peter Ellingworth of the ABHI Can you explain the range of medical technologies that the ABHI aims to champion?

ABHI members include some of the world’s largest medical technology companies as well as a broad array of SMEs. Medical technologies span a large cross section of products and services from single-use medical consumables to implantable devices, and increasingly digital health solutions. The medical technology sector has a fantastic story to tell. It holds the key to addressing many of the challenges facing health systems around the world, making healthcare more affordable and easier to access, while significantly improving patient outcomes and making healthcare more productive and efficient. Developments in digital technology and the advent of big data provide huge opportunities to re-shape the way healthcare is delivered, improve outcomes and challenge existing models of care. What are the most common aspects of British medical technology that are demanded from abroad?

The healthcare needs of emerging and developed markets are diverse and present opportunities for all segments of the UK Medical Technology sector. We have great strengths in many traditional areas of medtech as well as leading the way in areas such as woundcare, imaging and diagnostics.

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Is the UK’s medical technology already held in high regard around the world because of the reputation of the NHS, or do you have to work hard to get international markets to invest in British products?

In the work that we do to support our members trade across the world, it is always pleasing to hear how well the UK is thought of. That is testimony to Britain’s industrial strengths and also the NHS’s standing. It is that combination of expertise and quality that holds the key to ensuring continued success. Part of ABHI’s role over the coming years will be to build on that unique heritage so that more UK medtech companies expand their activity overseas – exports are vital to the growth of our sector and are the lifeblood of many SMEs. Can you explain more about your relationship with UKTI and how you work alongside them?

UKTI plays an important role in supporting industry to export. The network of commercial staff around the world based in the embassies and consulates develop vital relationships and provide local engagement and intelligence, which our members need when entering and developing business in key markets. ABHI works closely with UKTI to help develop strategy and provide opportunities for industry to meet with potential partners overseas through a

The shape of healthcare to come

ABHI

variety of methods including, among others, trade shows, missions and events. Where are the major markets abroad for UK medical technology? How are these identified?

In identifying critical overseas markets, we are led by our members and their focus and priority. Within ABHI this leadership is provided by our International Policy Group and several supporting geographic working groups constituted by our members. Through the work of our member networks, we establish strategy, tackle market access issues, shape and influence trade policy and assess overseas opportunities. These groups also conduct several industry surveys throughout the year and through these methods we prioritise key markets and focus our activity.Beyond Western Europe, (which remains the UK’s main trading partner,) the USA, Middle East and Asia remain key markets. Throughout the course of the next year we will be extending the support and increasing our activities in these key geographies. What are some of the nations and emerging markets that you hope to target in the future?

We are active in many emerging markets. In the next twelve to eighteen months we will be focussing heavily on Asia. China particularly presents a significant opportunity. Its rate of growth and scale are staggering but it is a challenging market and we will need to ensure we are comprehensively supporting our members if we are to make the most of the potential it has to offer. The Middle East is another key region for UK companies. Our work in the region has included us taking the largest UK healthcare delegation to the Arab Health exhibition. Over 150 companies attended the show in Dubai at the end of January 2015. With help from our partners and members ABHI was able to showcase the best of the industry in a simulated operating theatre environment in the ABHI UK Pavilion. UK Providers, clinicians and technology companies simulated surgical procedures throughout the show to visitors from across the Gulf. The trade show was a huge success and we will be looking to build on this for the future.

Further information www.abhi.org.uk

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ABPI

Delivering the medicines of tomorrow Medicine development represents major opportunities for UK pharmaceutical companies, says Stephen Whitehead of the ABPI

he Association of the British Pharmaceutical Industry (ABPI) represents innovative research-based biopharmaceutical companies, large, medium and small, leading a new era of biosciences in the UK. ABPI members supply 90 per cent of all medicines used by the NHS, and are researching and developing over two-thirds of the current medicines pipeline. How does the ABPI work to develop the medicines of tomorrow? On average, it takes over 12 years and costs over £1 billion to develop new medicines. Medicine development is changing: medicines are becoming more complex; they are being developed for more specific patient populations and we are also targeting rarer diseases. To deliver the medicines of tomorrow, it is crucial that everyone involved in medicine development – patients, academics, the National Health Service, regulators and industry – work together to make it more efficient. The ABPI works with partners across a number of different areas to improve the efficiency of medicine development. Ultimately, the aim of the ABPI is to ensure patients have access to new medicines when they need them. The ABPI believes that a focus

STEPHEN WHITEHEAD Stephen Whitehead was appointed to the role of Chief Executive of the Association of the British Pharmaceutical Industry (ABPI) in June 2011. He is the chief advocate for the research-based industry in the UK. Stephen sits on the ABPI Board of Management and is responsible for all aspects of the ABPI’s work. Most recently Stephen played a core role in successful pricing negotiations with the Department of Health which delivered a transformational deal for industry and patients. His expertise is in policy, public affairs, communications, pricing and reimbursement, social policy issues and reputation management.

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on stratified medicine development, as part of an integrated stakeholder healthcare strategy in the service of patients, continues to represent a major opportunity for the UK to demonstrate world-class leadership. How important is this work globally and in the UK? Stratified medicine has real potential to change the way we think about, identify and manage problems with our health. The ABPI believes that the UK has an exceptional opportunity to realise the benefit of stratified medicine for all stakeholders, not least patients. A stratified approach to medicine has already proven beneficial in the treatment of a number of cancers, and researchers are identifying more and more biomarkers that could be used to refine treatments in the future. What is less acknowledged is the rising number of non-cancer stratified applications in development and – just as importantly – those which are already in use in the NHS, helping to deliver the right medicine, to the right patient, right now. Progress in stratified medicine has been made possible through a strong alliance between industry, the NHS, funders of biomedical science and the regulator. It is this partnership that will continue to provide the springboard for further success, ensuring full engagement of all parties dedicated towards a single goal: improving health outcomes for patients. How does the ABPI work with the government to implement new strategies for development? We engage with key governmental bodies on a wide range of regulatory, research and commercial areas through regular meetings and briefings. For example, we work with the Department of Health, NIHR and others to drive forward clinical research in the UK. We also coordinate industry responses to relevant consultations. What is the key to underpinning investment in the UK? It is very important that a favourable environment is

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Pharma

cultivated to encourage pharmaceutical companies to invest in the UK. The pharmaceutical industry is the jewel in the UKâ&#x20AC;&#x2122;s scientific and industrial crown and a major manufacturer of medicines. The UK Life Sciences strategy showed that there have been successes, but we also need to be realistic in our appraisal and acknowledge that a lot more needs to be done to ensure that UK patients truly benefit from the innovation that exists in the life sciences sector. How important is the work done by the ABPI to represent both large and small biopharmaceutical companies? The ABPI represents innovative research-based biopharmaceutical companies, large, medium and

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ABPI

small, leading an exciting new era of biosciences in the UK. The ABPI is the only full service trade association in the UK working on all policy areas relevant to all sizes and types of company. It is very important for the Association that all members are represented equally irrespective of size and there are a number of representatives of smaller companies on the ABPI Board of Management, a Smaller Companies Forum and an Inward Investor Group that includes a number of smaller and mdeium-sized companies.

Further information www.abpi.co.uk

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Pharma

PharmaConsult Global

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PharmaConsult Global

Guiding light in pharmaceuticals Training and guidance is vital for pharmaceutical firms, especially those who are hoping to trade overseas

onsultants are vital to healthcare companies looking to operate globally, especially in the areas of distribution, training and product development. PharmaConsult is an international consultancy and bespoke training provider that offers solutions to problems though consultation and development to improve staffing skills and competencies. PharmaConsult works across the full spectrum of healthcare services in Europe, the USA, Middle East and Asia. Clients include blue-chip multinational

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pharmaceutical companies (GSK and Novartis), biotech start-ups (Julphar UEA), generic companies (Activas), Regulatory Authorities (SFDA), and local health ministries, such as the UAE Ministry of Health.

PharmaConsult offers a consultancy service to companies operating in all pharmaceutical markets, helping to develop their portfolio of products and to achieve high performance and best cost effective practice from their operating systems. Services range from advice on product registration, specialist product development, regulatory compliance auditing, quality management systems for medicines supply chains and pharmacovigilance.Â This year the company will provide national conference briefings in Delhi, Istanbul, Riyadh, Dubai, Brazil and The Netherlands.

Personalised service PharmaConsult differs from other companies in that it provides a personalised consultancy service tailor-

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PharmaConsult Global

Pharma made to needs and appropriate to the markets in which clients operate. This can be compliance audit services to survive a regulatory GxP inspection, or a turnkey solution to commissioning a new factory or laboratory site. For companies looking to operate overseas, it provides the opportunities to register products through the National Regulatory Authority provided by its associate organisations in India, the Gulf States and Latin America, providing a unique global networking opportunity. Firms might be given advice on the development of their medical products (either large or small molecule) or medical devices to meet the latest international regulatory requirements by its various affiliates. Leading local agents can be proposed to distribute products through local representation provided by PharmaConsult’s associate organisations in these regions, creating unique global networking opportunity. Clients are provided with the opportunity to develop their skills and competencies of their staff though comprehensive training services, including online training or onsite training solutions that comprise more than 40 online eLearning and 25 workshop courses. PharmaConsult is the only training provider that can translate courses into the language appropriate to the region, so that all employers are able to access training, encouraging a lifelong approach to learning and career development. In addition, the company will populate automated quality management software to ensure the product and process training will be provided as appropriate, and ensuring it will be documented in accordance with GxP regulatory requirements.

Training services PharmaConsult is an international training provider of high quality courses based on the latest published technical and regulatory requirements. Method of training delivery is by:

PharmaConsult Global

‘Services range from advice on product registration, specialist product development, regulatory compliance auditing, quality management systems for medicines supply chains and pharmacovigilance.’ Online training: There are 40 eLearning and webinars on eight specialist topics. These include: Pharmaceutical Product Development, Clinical Research, Pharmaceutical Product Registration, Pharmaceutical Quality Management Systems, Pharmaceutical Manufacture, Pharmacovigilance, Pharmacoeconomics and Pharmacy Practice containing current issues (only new regulatory and technical requirements), Presentation (including video/graphics with minimum PowerPoint slides) and including course notes (copy of slides, reading material and case studies), candidate assessment questionnaire, and CPD Accredited Proficiency certificate. Professional training courses: These are provided over six to twelve-month periods consisting of a combination King’s College London is in discussion with PharmaConsult Global to create a new Certificate course in Biopharmaceutics which will comprise five modules on: l Clinical Pharmacology l Clinical Assessment l Product Discovery l Product Development l Manufacturing. The course will be available from Summer 2015. Further details of this important new concept in continuing professional development (CPD) will be available on www.pharmaconsultglobal.com or contact john.jolley@ pharmaconsultglobal.com to register your interest in the course.

‘PharmaConsult is the only training provider that can translate courses in to the language appropriate to the region, so that all employers will be able to access training, which encourages a lifelong approach to learning and career development.’

of two to four-day workshops held at regional centres, and online eLearning, conferences and webinars. Certificate/ diploma qualification courses for membership of the professional group available are: Product development: The major focus of the programme is to develop the knowledge and understanding for teams to devise a good regulatory strategy for continuous project assessment to promote regulatory and pharmacoeconomic acceptance of the developed product. Chartered Quality Institute Certificate in Quality Management: Course Leader is Professor Luigi Martini from Kings College University London. This certificated course establishes the principals of quality management systems allowing use of well-known quality tools and risk assessment techniques. It provides an ideal basis for any person employed in healthcare, wishing to take the exams for a Certificate in Quality Management Practices (QMP), providing the first step to qualifying for entry on the CQI Diploma Couse and becoming a CQI Chartered Quality Professional. Medicines procurement and supply chain management: This introductory course establishes the wide range of causes for medicine supply shortages, dealt with by government agencies, medicines’ regulatory authorities and manufacturing organisations. It provides strategies for managing changes in procurement practices, preventing falsified medicines and defective medicines entering the supply chain. Workshops: A range of 25 specialist subjects relevant to the region and/or company for a basis for presentation, which can vary in duration from half a day up to five days. Public seminars are usually two to four days, and always in small groups to allow for detailed discussion on the topic in question.

Further information www.pharmaconsultglobal.com

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Life-On Healthcare Ltd is an innovative dietary supplements company based in London. Our unique formulations & Superior quality supplements bring wellbeing and health benefits to your family. Manufactured in the UK. Available in two designs and packs size. For Trade & Distribution enquires, contact us on: info@lifeon.co.uk

Unit C, Arlington Building, Bow Quarter, Fairfield Road, London E3 2UB, United Kingdom. UK Freephone: 0808 168 6730 International: +44 208 981 1199

UK Suppliers

Global Opportunity Healthcare showcases some of the great products and services UK companies have to offer Durbin

Haigh Engineering Ltd

intsales@durbin.co.uk Tel: +44 (0) 208 869 6500 www.durbin.co.uk

info@haigh.co.uk Tel: +44 (0) 1989 760 235 www.haigh.co.uk

Established for over 50 years, Durbin is a leading specialist medical supplier that sources and distributes pharmaceuticals, medical equipment and consumable supplies to healthcare professionals in over 180 countries.

Haigh Engineering Ltd is an established name in the provision of pulp disposal technology, with over 50 years of experience in the healthcare sector and is proud of its reputation for continuous improvement, innovation and quality. Haigh invest heavily in R&D in order to continually meet the needs of their customers, resulting in ongoing product innovations and enhancements.

Durbin’s main divisions encompass everything from international sales, sales to NGO’s and charities, clinical trials supply, managed access programmes and imported unlicensed medicines to sexual health supplies, and the storage and distribution of medical products and devices for third parties. From offices and warehouse facilities located close to London’s Heathrow Airport, Durbin can supply everything from a single cold chain item to large scale humanitarian projects.

Accutronics Ltd Unit 20, Loomer Road Newcastle-under-Lyme Staffordshire ST5 7LB, UK +44 (0)1782 566622 sales@accutronics.co.uk www.accutronics.com Accutronics is an industry leader in design, development & manufacture of portable power solutions for medical applications where failure is not an option. OEMs worldwide depend on us to be a valued partner delivering both custom and pre-engineered solutions which are differentiated by innovation, time to market, performance, reliability & safety – from design to manufacture & everything in-between. Our ACCUPRO custom design & manufacturing service integrates seamlessly into device development programmes whilst our ENTELLION products are smart, innovative portable power products that bridge the gap between custom & standard products.

Infection control, sustainability or cost management – whatever your need the Haigh range of high performance, cost efficient waste disposal units provide the optimum solution to many of the major disposal issues affecting the healthcare sector today. Their products include the highly successful Haigh range featuring the Quattro, Classic+ and Incomaster (all pictured below) – each product boasting features and benefits for particular applications. From single pulp disposal solutions to multiple product macerators, each has the patented antimicrobial Bugban technology built in, offering an increased level of protection and greater control in the fight against infection. Handling up to four items per cycle and with cycle times of less than two minutes, the Haigh range ensures that you’re nursing and care staff can dedicate as much time as possible to the needs of their patients. Cost efficiencies are also achieved through a number of product features including reduced up-front costs and exemption from periodic testing requirements.

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UK Suppliers

Great UK products and services

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UK Suppliers

Dycem

Clear Surgical Ltd

GOH@dycem.com Tel: + 44 (0) 117 244 5367 www.dycem-cc.com

20 - 23 Woodside Place Glasgow, G3 7QF United Kingdom info@clearsurgical.com Tel: +44 (0) 141 582 1200 www.clearsurgical.com

Dycem has been manufacturing Contamination Control Zones since 1966. Today, thousands of clean rooms, critical areas and controlled environments are protected by Dycem polymeric contamination control mats and flooring, enabling all organisations to reduce particle counts by up to 99.9%. Dycemâ&#x20AC;&#x2122;s Contamination Control experts manufacturer a technically sound and proven contamination control solution, from their UK Headquarters. Impregnated with Biomaster Anti Microbial and manufactured to an optically smooth finish, Dycemâ&#x20AC;&#x2122;s polymeric flooring solution can capture and retain up to 99.9% of both foot and wheel borne contamination and up to 75% of airborne contamination. In addition to this the anti microbial element to the product helps inhibit the growth of over 20 organisms on contact, including E.Coli, Salmonella, Listeria, plus many more. With a comprehensive sales, service and distribution network covering more than 50 countries, your facility is never too far away for us to visit and provide a free consultation and site survey. Our product range is being continually improved to ensure it meets the changing needs of our customers; this is matched by our excellent sales and after care service.

JJX Logistics

DDC Dolphin

Cooper Street Wolverhampton, WV2 2JL info@jjxlogistics.co.uk Tel: +44 (0) 138 422 1642 www.jjxlogistics.co.uk

sales@ddcdolphin.co.uk Tel: +44 (0) 120 273 1555 www.ddcdolphin.co.uk

JJX Logistics specialise in the transportation of pharmaceutical products. We work directly with some of the biggest names in the pharmaceutical industry. We also work with third party distributors and logistics providers helping them with their supply chain management services for inbound, outbound and aftermarket logistics. We specialise in Ambient and Temperature controlled distribution of high value pharmaceutical products for the Pharmaceutical, Clinical Trial, Biotech and Veterinary Medicine Companies, All vans are capable of moving anything from -25 to +25 degrees, so you can be rest assured your perishable items will stay at the perfect temperature for the whole of the journey. We cover all of the UK and Europe with our Same Day Express Service with our Euro 6 Mercedes Benz vans all under 2yrs old with 24/7 Mercedes road side assistance cover and the same with the refrigerator units supplied by Thermo King with a fantastic breakdown coverage.

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With exclusive totally touch-free maceration and washer disinfector technology, DDC Dolphin leads through innovation in providing total sluice room solutions, reducing the risk of Healthcare Associated Infections (HCAIs), while raising the standard in efficiency, usability and reliability. DDC Dolphin is dedicated to excellence and innovation in sluice room and dirty utility room design, technology, equipment manufacture, installation, consumables and servicing. We provide a range of products and services to care and nursing homes, hospitals, hospices and special needs schools.

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UK Suppliers

1 Newbridge Close Bristol BS4 4AX United Kingdom www.p3medical.com

Premier Way, Abbey Park Industrial Estate Romsey, Hampshire SO51 9DQ United Kingdom phoff@talleygroup.com Tel: +44 (0) 179 450 3518 www.talleygroup.com

P3 Medical Limited is a fast growing UK based company that specialises in the design, manufacture and marketing of innovative medical devices for use in the Operating Theatre and Anaesthesia.

TALLEY

UK Suppliers

P3 Medical

Our range comprises Equipment Drapes, Anaesthesia and Airway Management Devices as well as Surgical Accessories with a number of unique, patented solutions. The company also offers a range of contract manufacturing services in its class 8 cleanrooms including plastic extrusion, injection moulding and product assembly.

TALLEY is a UK manufacturer of medical devices with over 60 years of experience. Operating from its UK headquarters in the South of England, Talley boasts a fully vertically integrated manufacturing site with all aspects of design and manufacture under one roof, meaning a focused approach to delivering high quality and innovation as standard. Product lines include a comprehensive range of pressure relieving mattress systems, compression therapy pumps and garments covering both DVT prevention and lymphoedema and a clinically proven and cost effective range of Negative Pressure Wound Therapy pumps and consumables.

Medopad

Eschmann Equipment

contact@medopad.com. www.medopad.com

Peter Road Lancing West Sussex BN15 8TJ Tel: +44 (0) 1903 753322 export@eschmann.co.uk www.eschmann.co.uk

Medopad Ltd is the UKâ&#x20AC;&#x2122;s leading enterprise mobile health solution provider that securely connects healthcare professionals with patient information via mobile devices. Medopad offers a suite of CE certified iPad applications that integrate health data securely from existing databases and put them in the palm of a doctorâ&#x20AC;&#x2122;s hand. As a result doctors can use the simple Medopad mobile app to access patient records, lab results, vitals, images and more to help reduce errors and improve efficiencies. Medopad is regulatory approved as a medical device and has been developed with the largest UK private hospital group and counts the NHS as its customer as well. Aside from integrating patient data, Medopad can be integrated with patient wearables and Telehealth devices to provide a single point of access to all point of care information for healthcare professionals. It boasts to be the first enterprise solution to be integrated with Google Glass and has integrated with Apple HealthKit. Our mHealth technology seeks to deliver better clinical outcomes in terms of more evidence-led and patient-centred diagnosis and treatment at the point of care, optimised clinical workflows and staff time, more integrated digital records, and reduced costs in the long term.

Eschmann - Supporting global healthcare for over 180 years Eschmann is the UK leader in operating theatre and infection prevention technologies. Established in 1830 Eschmann designs and manufactures innovative medical equipment for use by healthcare professionals across the globe. First class research and development facilities combined with partnerships with clinicians ensures Eschmann continues to design and produce market leading operating tables, surgical suction units, electrosurgery products and autoclaves.

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FCm Travel Solutions

Wellbeing

Less travel stress, more travel smarts The hidden costs of stressed-out travellers on businesses can be huge, says FCm Travel Solutions

he popular misconception about corporate travel is one of relaxed passengers sipping expensive wines in business or first class seats, before being driven to plush hotel rooms withensuite spa baths. However the reality is more likely to feature delayed flights, limited wi-fi and room facilities, leading to tired, frustrated and stressed-out travellers. While companies continue to prioritise travel cost efficiency, the focus is shifting to their travelling employees, and how well they work on the move.

Travel stress triggers A recent study by the Global Business Travel Association questioned corporate travellers across 10 European Countries. Their findings revealed that security, safelty and health are the prime concerns of business travellers. For example 76 percent of those questioned said it was

important to feel their employers took their safety and security seriously; 65 percent felt maintaining a healthy diet while travelling was a key concern; and 85 percent of respondents said they enjoyed business travel, but stress levels rose when their trips were fraught with problems including delays, long layovers and travel outside regular business hours. When business travellers arrive at their destination, they view their hotel room as a place where they can refresh, revitalise and regroup. However accommodation can create its own types of frustration. FCm Travel Solutions has identified that common sources of accommodation stress include highcost internet connection, noisy rooms, limited room facilities, late checkout policies, dining costs and car and valet parking. All of this, combined with airport queues and hotel booking mistakes, can lead to a productivity ‘downtime’ that adds a hidden cost to business travel.

Reducing travel stress Obviously it is impossible to eliminate travel stress completely, as every

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corporate journey can be affected by elements outside the traveller’s control. However businesses can reduce the impact on productivity by making work trips more comfortable for their employees. FCm believes the solution is to focus on traveller needs and comfort as much as cost-saving policies. Employees don’t necessarily need to travel less – they can often travel smarter. In 2013, FCm launched its innovative global SmartSTAY programme to give business travellers value-added extras in their accommodation, at no additional cost. This growing programme is currently available at more than 280 participating hotel properties worldwide. Every SmartSTAY property offers guests a minimum of three complimentary value-added services, one of which is available exclusively to FCm clients. Ranging from free room upgrades to wi-fi, breakfast, car parking and late checkout, the services are available year-round and benefit guests with greater comfort and convenience. SmartSTAY delivers multi-level benefits by giving travellers more in their hotel stay without impacting employers’ travel budgets. It not only helps reduce costs by relieving traveller stress and supporting productivity, but also provides savings for companies. SmartSTAY helps companies optimise their travellers’ well-being while staying focused on their travel policy and savings. It helps take the stress out of business travel for employees, and gives employers peace of mind that their people are travelling comfortably and productively. FCm Travel Solutions is the global, sophisticated corporate travel management division of the Flight Centre Travel Group. With over 30 years’ experience and a presence in 90 countries, FCm delivers the benefits of a global company with the intimacy of a local business. FCm has been named the World’s Leading travel management company for the past four years and was awarded Account Management team of the Year in the UK in 2014. In addition, FCm was shortlisted as a finalist for the Customer Focus Award at the UK National Business Awards

Further information www.uk.fcm.travel

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