Global Opportunity | Healthcare 2017 by Global Opportunity

GLOBAL OPPORTUNITY HEALTHCARE 2017

EDITORIAL

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Welcome to Global Opportunity Healthcare 2017 Senior Features Writer Jack Ball jb@strategyinternational.co.uk Art Editor Nadia Nelson nn@strategyinternational.co.uk Creative Director Oscar Bowring ob@strategyinternational.co.uk Head of Development Joint Managing Director Karen Frieze kf@strategyinternational.co.uk Accounts Nicola McKelvey accounts@strategyinternational.co.uk

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Editor-in-Chief Joint Managing Director Sarah Cartledge sc@strategyinternational.co.uk

Welcome to the third edition of Global Opportunity Healthcare. Over the past three years we have proudly been at the forefront of Healthcare UK’s promotion of the UK healthcare sector globally. From world leading research and clinical innovations to the latest medical advancements promising the best treatment pathways, we remain at the cutting edge of international clinical best practice. As the world’s largest single funded healthcare system, the NHS is a leading light in the global healthcare market – highlighted most famously at the opening ceremony of the 2012 Olympics Games in London. Five years on the UK healthcare sector is making international strides and Global Opportunity Healthcare 2017 continues to bring together various leading players in the UK’s healthcare sector. Housing many of the country’s internationally renowned consultants and support staff, some leading NHS Trusts are also uniquely positioned to drive forward their private patient offerings – separate facilities set apart from NHS provisioned beds but supported and maintained by world-class clinicians. For example leading Trusts such as Guy’s and St Thomas’ and the Royal Brompton and Harefield both enjoy international recognition for their pioneering heart and lung care. Both can be found on pages 38 and 80 respectively. In terms of medical education the UK also has much to boast about, housing some of the world’s most recognised medical education and training institutions – providing undergraduate training though to Continuing Professional Development. Demand for better quality care is set to be a universal trend for the foreseeable future, bringing with it significant opportunities for the UK to hone its efforts accordingly. Central to the UK’s established

presence within the sector sits Healthcare UK. Their work in promoting all the UK has to offer in healthcare is evidenced in the on-going enthusiasm of UK Government to open up the UK to overseas opportunities, driving up standards of care across the world – in many ways a moral commitment as much as commercial imperative. As the UK continues to realign its trading relationships across the world, we can be confident our strengths in healthcare remain as strong as always. Building upon the success of both our 2015 and 2016 editions, this current Arab Health edition highlights all that the UK has to offer in healthcare. If you have any great stories of success that you would like to include in our future editions, do let us know. We look forward to hearing from you.

Sarah Cartledge Editor-in-Chief Global Opportunity Healthcare 2017

‘From world leading research and clinical innovations to the latest medical advancements promising the best treatment pathways, we remain at the cutting edge of international clinical best practice.’

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CONTENTS

in association with

003 Editorial Welcome to Global Opportunity Healthcare 2017

011 Foreword Rt Hon Professor Lord Kakkar

012 Supporting UK healthcare companies in a global market Managing Director Deborah Kobewka outlines how Healthcare UK can help maximise overseas export opportunities

016 Working with clients to give their businesses the freedom to succeed Legal expertise in today’s healthcare environment aims to make life easy for clients in all respects says Kate Orviss, Partner and Head of Global Healthcare Projects Team at Pinsent Masons

020 The Harley Street Medical Area The Harley Street Medical Area is a carefully created conclave of leading specialists at the cutting edge of their profession, says Simon Baynham, Property Director

026 Complex surgery BMI Healthcare is the UK’s largest private hospital group with 59 hospitals and treatment centres. For the last six years it has provided a welcome alternative within the international patient market, with a unique mix that has been a game changer in the London market and beyond, says International Director Scott Feldman

028 Cardiac care Excellence and flexibility at BMI The London Independent Hospital deliver high standards of care, care, as Consultant Interventional Cardiologist Professor Charles Knight tells Sarah Cartledge

030 Reducing the trauma The burden of trauma remains one of the biggest worldwide health issues, Mr Ali Noorani, Consultant Trauma & Orthopaedic Surgeon at BMI The London Independent Hospital, tells Sarah Cartledge

032 Mother of all operations Cytoreductive surgery is a radical treatment for rare cancers of the abdominal cavity, but it has a good success rate says Mr Tom Cecil, Consultant Colorectal Surgeon at BMI The Hampshire Clinic

034 Intensive care At BMI The London Independent Hospital ITU we are able to manage patients with complex medical and surgical problems, says neuroanaesthetist Dr Javid Khan

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038 The collaborative approach The United Kingdom International Healthcare Management Association (UKIHMA) was created a year ago to provide a single front door for overseas organisations to access the very best of UK Healthcare from the NHS and Private Sectors. As a strategic partner to Healthcare UK, UKIHMA delivers a fast track approach as UKIHMA Co-Chairs Ralph Dando and Victoria Cheston explain

046 The full package Offering world class consultant-led care, Bupa Cromwell Hospital has aligned its focus increasingly towards complex treatment in one of the UK’s most luxurious private patient healthcare facilities, as Commercial Director Ahmed El Barkouki tells Jack Ball

050 C linical excellence and worldclass patient care Guy’s and St Thomas’ NHS Foundation Trust offers its partners access to a unique combination of clinical, educational and academic excellence, says Victoria Cheston, Commercial Director

054 An education in cutting-edge tech The ECMO service at Guy’s and St Thomas’ NHS Foundation Trust is one of the largest and most successful in the world, and international partnerships help patients access this life saving treatment, says Dr Nick Barrett, Critical Care Consultant at GSST

058 Breath of fresh air The Lane Fox Respiratory Service based at Guys & St. Thomas’ Hospital in London treats the most complex patients with chronic respiratory failure says Professor Nicholas Hart, Clinical Director

062 Delivering a vision from start to finish MJ Medical’s approach to healthcare planning ensures the aspirations communities and care providers have for their new hospitals are delivered, says Danny Gibson, Technical Director

066 Back to the future The Royal Bucks’ reputation as a pioneering rehabilitation hospital is in great part due to its technical innovations,says Chris Campbell, Business Development Director at Royal Buckinghamshire Hospital

072 The Ebola Crisis – a matter of life and death Dr Seshadri Vasan, Professor of Public Health and Public Health England’s Senior Business Development Manager, discusses Ebola, emergency response models and how to promote international collaboration

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CONTENTS

in association with

076 Data protection in Qatar New data privacy law can enhance patient safety, data privacy and boost digital health in Qatar, say Anthony Fielding, Senior Associate/Counsel and Donna Mayers Senior Associate of Pinsent Masons

078 Healthy outlook With the value of the healthcare market in the Gulf states projected at around US$144bn by 2020, the future for the healthcare sector in the region remains positive, says Alison Hubbard, Partner Pinsent Masons

080 Innovating in the Life Sciences sector Bringing a product to market in the life sciences sector can be challenging, whether a small molecule pharmaceutical, a biotechnology therapy or a medical device, say Adrian Murray, Partner (Patent Attorney, Patent Attorney Litigator) and Clare Tunstall Global Head of Life Sciences Partners at Pinsent Masons

082 Accessible cancer expertise An unparalleled combination of clinical and technical experts, along with pioneering research, makes The Christie a leader in cancer care, says Professor Chris Harrison, National Clinical Director for Cancer and Medical Director at The Christie

090 Building healthcare for the future Modern hospital buildings should be part of the of the solution, rather than the problem, says Richard Cantlay, Global Head for Healthcare Buildings at Mott MacDonald

096 Heartfelt care Innovation and research are the cornerstones of the Royal Brompton and Harefield NHS Foundation Trust’s expertise, says David Shrimpton, Managing Director Private Patients

100 Adapting to new healthcare challenges IHG’s integrated and collaborative approach to healthcare in China addresses the issues of 21st century lifestyles, says Ralph Dando, Development Director of International Hospitals Group

104 Health partners Recent trends suggest that operator led PPP models are becoming more favoured in the healthcare sector in Australia, particularly in New South Wales, say Simela Karasavidis and Margaret Cole, Partners at Pinsent Masons

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106 Nurses fit for the 21st Century UWS’ leading work in nursing and community care has spawned EU funded projects designed to better equip nurses to tackle today’s modern healthcare challenges, both in the UK and overseas, as Dr Tim Duffy, Assistant Dean (International) at UWS, tells Jack Ball

110 The Power of Collaboration Wessex Academic Health Science Network’s collaborative approach between health services, industry and academia has proved critical in the assessment and validation of overseas healthcare opportunities for its members, says Andy Burroughs, Director of Wealth and Enterprise at Wessex AHSN

112 Sweet opportunity Membership of Wessex Academic Health Science Network (AHSN) is helping the diabetes department at Portsmouth Hospitals NHS Trust access international opportunities and export its unique model of diabetes care, as Dr Partha Kar, Consultant at Portsmouth Hospitals NHS Trust, explains

114 Averting healthcare crisis at source Collaborative working between different agencies can deliver impressive results in healthcare when focusing on the person and not the structures says Karen Baker, Chief Executive of the Isle of Wight NHS Trust

116 Creating the future Innovation is the key to success, says Mel Rankine, Commercial Director at University Hospital Southampton

118 Active workplace Health initiatives at Southampton Solent University are promoting well-being for both staff and students, says Martin Skivington Head of Health & Exercise Sciences

120 An internationalised education Bournemouth University’s overseas programmes are based on research, education and practice, says Dr Malcolm McIver, Associate Dean Global Engagement

122 United we stand, divided we fall Professor Michael Owen, Director of MRC Centre for Neuropsychiatric Genetics and Genomics and Professor of Psychological Medicine (Psychiatry) at Cardiff University’s School of Medicine, discusses barriers to providing mental health treatments and prevention

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CONTENTS

124 Real world training Coventry University’s approach to learning immerses students in real life situations to develop crucial clinical skills, says Professor Guy Daly, Pro Vice-Chancellor and Executive Dean at the Faculty of Health and Life Sciences

128 A redefinition of renal nursing De Montfort University’s (DMU) unique three-way partnership in Abu Dhabi is changing the face of renal nursing provision within the UAE, as Professor Marie Richards, Director of Education, Training and Development at SEHA Dialysis Services tells Jack Ball

131 Equipping the next generation DMU’s offerings include specialist programmes in health and science, such as their MBA in Health Management, says Carol Greenway, Head of International, Faculty of Health and Life Sciences

132 Bringing training to life Eastwood Park in Gloucestershire was set up by the NHS nearly 50 years ago as a training centre for specialist healthcare services. Now independent, the centre offers world-class trainers and a wide spectrum of courses that can be adapted to fit international standards says John Thatcher, Chief Executive Officer

136 Stamp of excellence Independent accreditation can help healthcare providers in the UK and across the world maintain universal standards of safe and effective care, says QHA Trent’s Professor Stephen Green

140 Stayng ahead of the game Continuing Professional Development (CPD) is critical, not least of all in healthcare as Simon Monkman, Director at Premier IT tells Jack Ball

144 Accessing UK private healthcare solutions Healix Health Services’ bespoke medical case management solutions are helping overseas insurers and employers access, manage and oversee their medical claims and overall healthcare provision in the UK at preferential rates, says Richard Saunders, Sales Director at Healix Health Services

148 Recipe for success Elior’s refreshing catering alternative is being embraced by many NHS Trusts, says Robin Givens, National Sales Director

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150 Bringing hospitals to life Serco’s strength stems from its global presence, scale and expertise in managing a variety of non-clinical services involved in safe operation of world class healthcare facilities, as Joe Boyle, Serco Middle East’s Managing Director of Health and Integrated Services tells Jack Ball

155 An introduction to Imperial Private Healthcare: Academic health With more than 9,000 patients treated every year, Imperial Private Healthcare, part of Imperial College Healthcare NHS Trust, is one of the largest private healthcare facilities in London

156 Tradition of excellence The Lindo Wing at St Mary’s Hospital in London provides high quality care for complex cases, as well as unrivalled maternity services, says Sarah Cartledge

158 Major trauma Military injuries are complex and challenging, but they offer the opportunity to innovate, Mr Shehan Hettiaratchy, a Lead Surgeon at Imperial Private Healthcare tells Sarah Cartledge

160 Determined to raise the bar With its history of clinical innovation and research spanning over 80 years, the Haematology Department at Imperial College Healthcare NHS Trust’s Hammersmith Hospital is unique in its innovative approach to specialist expert care, says Dr Jiri Pavlu, Consultant Haematologist at Hammersmith Hospital and Honorary Clinical Senior Lecturer at Imperial College London

166 Advanced gynaecological surgery Consultant gynaecological oncologist at Queen Charlotte’s and Chelsea Hospital London, Professor Christina Fotopoulou talks about combining surgical expertise with pioneering research into highly specialised cancer treatment

168 A world-class team for complex problems Luxury bespoke care from world-class consultants in one of the UK’s top teaching hospitals makes Imperial College Healthcare NHS Trust’s private facility ‘The Thames View’ at Charing Cross Hospital truly unique, as Matt Williams, Consultant Clinical Oncologist, tells Jack Ball

172 Leading the charge Kevin O’Neill, Head of Neurosurgery at Imperial College Healthcare NHS Trust, talks exclusively to Jack Ball about the Trust’s pioneering research into developing and integrating the very latest in advanced surgical technologies

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FOREWORD

Building partnerships to access healthcare opportunities overseas It is my pleasure to welcome you to Global Opportunity Healthcare – the third edition of its kind launched at Arab Health over the past three years. Two years after its initial launch in January 2015, Global Opportunity Healthcare 2017 comes in the wake of a somewhat tumultuous year. The UK’s vote to leave the European Union will serve to shape the UK’s trading relationships for the foreseeable future. As we recalibrate our efforts in light of Brexit and as the country responds to shifting demands and perspectives, our strength in healthcare remains as pertinent as ever. Global Opportunity Healthcare, in partnership with Healthcare UK, serves to do just that – to communicate the strength of the UK as a global leader in healthcare, supporting the improvement of standards of care across the world. The UK has long enjoyed a reputation as a beacon of healthcare excellence, helped in no small part by the historical presence of the NHS as one of the world’s most well-respected healthcare brands. We are home to world-class research institutions delivering an unrivalled depth of medical training; bringing breakthroughs from the laboratory directly into the classroom or clinical setting. We can also proudly boast our position as a global leader in health policy – defining our role as a leading figure in the field of international development. With this in mind the UK has a unique opportunity to build on our historical healthcare reputation. Some NHS Trusts have already firmly established themselves as leaders in their class, acknowledging the huge opportunities at hand from engaging internationally and attracting globally renowned consultants. It is the unique ecosystem of the NHS, universities and industry, together with all the other disciplines such as design and engineering, that creates the unique UK offering. Overseas the size and scope of the opportunities for the UK’s healthcare sector has also seen substantial growth. With successes totalling over £5bn since its launch, Healthcare UK has become pivotal to our continued success on the international stage, building partnerships and demonstrating the leading role the UK can

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play in the development of world class health systems and services. Bringing together NHS and industry, both in the UK and overseas, has led to many notable successes over recent years. Healthcare UK’s continued partnership with China is emblematic of the UK’s efforts. Recent Chinese healthcare reforms have sought to develop ‘safe, effective, convenient and affordable’ healthcare for all by 2020. And in 2015 during the state visit of Xi Jinping, the President of The People’s Republic of China, more than £2bn of healthcare and life sciences trade deals and collaborations were subsequently signed between both countries. International partnerships like this abound, indicating the UK’s continued strength in the healthcare sector. Global Opportunity Healthcare seeks to build and strengthen on these developments, highlighting the huge amount we can offer to all our partners across the globe. Indeed there has never been a better time to choose the UK as your key partner. So do use Global Opportunity Healthcare 2017 as a first stepping stone in what I hope will be many more international partnerships to come.

Rt Hon Professor Lord Kakkar

‘The UK has long enjoyed a reputation as a beacon of healthcare excellence, helped in no small part by the historical presence of the NHS as one of the world’s most well-respected healthcare brands.’

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Managing Director Deborah Kobewka outlines how Healthcare UK works to develop productive international partnerships

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INTRODUCTION

HEALTHCARE UK Without doubt, the UK is at the leading edge of healthcare provision amongst developed nations. We challenge ourselves to hold to very high standards of clinical quality, governance and transparency. Our system has many strengths; the integration between primary, secondary and tertiary care to deliver the best care in the most appropriate setting; increasing collaboration between health and social care providers; and developing a highly trained workforce through a world class education and training system.

The role of Healthcare UK The demand from overseas governments and healthcare providers to work with British organisations has grown considerably in the last few years. As a joint initiative between the Department for International Trade (DIT), the Department of Health and NHS England, Healthcare UK is ideally placed within government to bring together UK suppliers to respond to the needs of healthcare providers around the world. Our position within DIT means we have staff in embassies and consulates who are wellconnected with the healthcare providers in their countries, understand their needs and identify tangible opportunities available to UK suppliers. Many of these opportunities require a range of skills and expertise best provided through collaboration between suppliers, both NHS organisations and private enterprises. Being able to introduce both public and private sector organisations to overseas buyers gives the UK DEBORAH KOBEWKA

ere in the UK the NHS has provided universal healthcare, free at the point of delivery, for nearly 70 years. As the worldâ&#x20AC;&#x2122;s largest integrated health system, the UK is renowned for its high quality care and its operational efficiency. Its reputation is founded on the longstanding partnership between the NHS, innovative commercial healthcare companies and our academic sector. This partnership creates a unique breadth and depth of expertise which, through Healthcare UK, is becoming more and more accessible to assist other healthcare systems in their development.

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Deborah Kobewka was appointed as Managing Director of Healthcare UK in March 2016. Deborah has over 30 yearsâ&#x20AC;&#x2122; experience in healthcare, beginning her career in the pharmaceutical industry with Schering Healthcare. Moving to IMS Health she held management positions in client services, sales and marketing, including leadership of the IMS publications business before being appointed to lead the market research business in Europe, then consumer health globally. In 2008 she was appointed President Asia Pacific, based in Singapore, where she led all aspects of the IMS business across this diverse region. Since then Deborah has run her own management consulting company DKK Associates, serving clients in healthcare business intelligence and informatics and worked for GBI Health, a dynamic China based healthcare business intelligence provider where she was responsible for all commercial activities, driving business expansion in China and Brazil. Deborah is a non-Executive Director at Bedford NHS Hospital Trust. Deborah holds a Biochemistry degree from the University Of Sussex and is an alumna of the London Business School.

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a valuable advantage, increasing the chances of winning significant international contracts and contributing to the UK’s goal of increasing exports. At the same time, our overseas partners are able to access the expertise embedded deep within the NHS. In fact, one project we are actively involved with at the moment is focused on bringing NHS capabilities to India. While the commercial healthcare sector is well-versed in exporting their expertise, it is a relatively new endeavour for some parts of the public sector. We have a dedicated team working with the NHS (and other public sector bodies). We work with them to define how their capabilities can contribute to overseas projects, identify the countries and projects with the best fit for their expertise and build their capacity to deliver international projects. A key objective of this support is to ensure that exporting activity does not detract from the provision of services to their domestic patient population. Our role has even more importance in the post-Brexit world, supporting the Government’s vision of the UK as a global trading nation. Healthcare UK has always had a focus on emerging markets. We can use our government relationships to make sure that our potential partners are aware of the UK’s capabilities in healthcare and enable them to achieve their healthcare objectives by introducing them to our innovative, world-renowned suppliers.

Overseas Success Over the last four years, more overseas partners have been choosing to work with UK suppliers. UK organisations have signed contracts overseas with a value of over £5bn. The starting point for this success is facilitating relationships between buyers and suppliers and nurturing these for mutual benefit. For example, in December Healthcare UK ran a highly successful mission to China focused on integrated and elderly care, both of which are high on the agenda of Chinese healthcare providers. Visiting five cities in a week including

‘As we continue to evolve our healthcare provision within its current budget we have to leverage the enablers. We have many opportunities to grow in digital technology and telehealth, and we have to look at how we can use them to improve the offer.’

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Hong Kong, the 31 participating organisations covering private companies, NHS institutions and several universities, took part in business matching sessions and formal seminars. Our embassy staff in China ensured that the party was able to interact with a wide range of Chinese project owners. The mission was timed to coincide with the UK and Chinese Governments’ People to People Health Dialogue, held in Shanghai. The Secretary of State for Health, the Rt. Hon. Jeremy Hunt MP led the UK delegation to the Dialogue. We took the opportunity to hold a high-level business breakfast hosted by Mr Hunt. He presided over the signing of £70m of business deals finalised during the mission, as well as celebrating the £250m of contracts signed within the last 12 months. This level of business with China is a fantastic result for the UK. China is one of our priority markets and we would anticipate taking two or three missions to China over a year. Depending on the requirements of the Chinese buyers, we would look to focus these on specific provinces or around individual areas of interest, such as elderly care or digital health. We also welcome many inward missions every

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INTRODUCTION

HEALTHCARE UK

‘In a post-Brexit world, we need to think more about how we market both the private as well as the public healthcare offering, making sure we reinforce our capability and that countries are aware of it.’

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year from China and other countries, where delegates come to the UK to see the capabilities of NHS institutions and private companies first hand. Something which stands out about meeting with overseas partners – either here in the UK or in their country - is that the learning takes place both ways. Our organisations find exploring how other countries operate invaluable, both for bringing new ideas to the UK and understanding how to meet the needs of their overseas customers more effectively.

Areas of growth Integrated care is a great opportunity – many countries are exploring models of integrated care to tackle the challenges of ageing populations. The cornerstone of integrated care is a good primary care model, an area where the UK excels. Many countries look to the UK to help develop a primary care system. China is a prime example, where the primary care model is part of their current five year plan. We know that here in the UK we create innovative and cost effective approaches to providing high-quality healthcare, especially in the face of increasing demand. Other countries

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face similar challenges and therefore the UK is in an excellent position to implement innovative technological solutions for overseas partners. Digital health, telehealth, genomics and personalised medicine are all areas where the UK has leading-edge expertise. I’m sure that the UK’s Academic Health Science Networks (AHSN) will be of great interest to overseas partners keen to adopt innovative solutions. The AHSNs bring together the NHS, universities, private companies and charities to identify and spread health innovation at pace and scale, driving the adoption and spread of innovative ideas and technologies across large populations. Education and training is also an area of increasing importance as the foundation for delivering high-quality healthcare. We work with universities (both directly and through the AHSNs) and the many private companies involved in training and education to make the connections which assist countries to expand their healthcare workforce. I have found very fertile ground overseas for UK training and education. A number of universities joined the December mission to China and several successful conversations came out of the mission. Over the last 20 years, the innovative approach of Public Private Partnership (PPP) has been instrumental in transforming the healthcare infrastructure across the UK. It’s clear that many countries, for example in Latin America, are very interested in the PPP model to finance developments in their own infrastructure.

Future goals Healthcare UK has set itself a very stretching goal for the value of exports achieved over the next 5 years, which is only right given the demand for UK expertise we see in the markets we prioritise, including India, China, Latin America and the Middle East. To achieve this, the UK must continue to demonstrate it can meet the needs of our overseas customers. We have a superb advantage when we offer consortia involving both commercial healthcare companies and NHS organisations. It’s one of my personal goals to ensure that Healthcare UK is able to support the NHS in the development of its export capabilities, so there is a broad pool of expertise ready and able to respond to the exciting opportunities coming through. There is a great win-wivn here. By leveraging its know-how to enable partners to develop their healthcare services and improve the outcome for their citizens, the NHS will bring revenues back to invest in its own frontline services.

FURTHER INFORMATION

www.gov.uk/healthcareuk

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CONSULTANCY

PINSENT MASONS

KATE ORVISS Kate leads our Global Healthcare Projects Team which advises both public and private sector participants on major healthcare projects, joint ventures and partnership arrangements around the world. We are independently recognised as market leaders in this area and our team has experience in the UK, Turkey, the Middle East, Africa, China and Australia. Kate also interfaces closely with our wider healthcare team which includes experts in health sector related corporate finance and M&A, investment and real estate, life sciences and pharmacy, digital and e-healthcare, data privacy, protection and commercialisation, research, regulation and intellectual property advice.

Legal expertise in todayâ&#x20AC;&#x2122;s healthcare environment aims to make life easy for clients in all respects says Kate Orviss, Partner and Head of Global Healthcare Projects Team at Pinsent Masons globalopportunityhealthcare.com

he business of healthcare is global. At Pinsent Masons we support our clients across our global office network (and also in jurisdictions where we do not have an office but work closely alongside local counsel) to support them accessing and delivering new opportunities wherever they may arise. Our legal expertise encompasses all forms of structuring, partnership and joint venture models, development, financing and operation of major and minor healthcare facilities, crossborder employment matters, life sciences, intellectual property, data privacy, protection and commercialisation, digital and e-health, research and education, genomics, medical equipment and IT. We aim to make life easier for our clients by bringing all of the many legal strands of healthcare together in one place, so they donâ&#x20AC;&#x2122;t have to go to the time and trouble of trying to do it all themselves. Within this publication there are articles from a range of our experts - considering the healthcare markets in Australia and the Middle East, our work in the Life Sciences arena, the importance and relevance of our work on data privacy and its interface in digital health in Qatar, and finally digitalisation within the NHS. But in this piece I want to concentrate on an issue close to my heart, one that I consider will become critical in the coming months and years - the creation of international consortia.

Collaborative approach At Pinsent Masons we pride ourselves on our collaborative approach. Our values are Approachable, Bold and Connected and we live by them. We have a global network of 22 offices. We act for clients across the world and we identify and track opportunities for major healthcare projects by jurisdiction. And we are willing to share our network and knowledge with our clients.

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Without question there is a huge demand for healthcare assets across the world - but those healthcare assets address different needs in different jurisdictions. And the cultural, legal and political drivers are different depending on where you are considering operating. We can help you understand and navigate those nuances. Our clients have different skills and expertise to contribute to any opportunity. Some of our clients are truly global organisations with operations in many different jurisdictions; others are entities headquartered in one jurisdiction but actively involved in many others. We have clients that are counted among the world’s top 250 international construction contractors. We work with many NHS Trusts that are internationally recognised experts in their fields. And we act for many of the world’s leading IT players on their digital, e and m-health initiatives. And of course we are extremely well-connected in the world of finance working with all forms of financial institutions and investors in a wide range of jurisdictions. Imagine if you could work with a law firm that could look after your legal needs wherever they

‘UKIHMA is a compelling concept – a means of bringing the best of British expertise in the healthcare sector together in one place.’

Pinsent Masons Offices

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CONSULTANCY

PINSENT MASONS

‘We aim to make life easier for our clients by bringing all of the many legal strands of healthcare together in one place, so they don’t have to go to the time and trouble of trying to do it all themselves.‘

arose, managing local counsel so you don’t have to worry about it, and helping you meet the people who might be the ones who can help you unlock a new opportunity. In 2017, more than ever, working collaboratively is going to be essential. And working with proactive, commercial and innovative lawyers who don’t just write your contracts in isolation and point out problems but help you structure your project, solve your challenges and help you succeed should be an integral part of your team.

Bringing partners together It is this collaborative, connected approach that led Pinsent Masons to be a founding member of UKIHMA. Whilst our headquarters are in the UK and we act for many UK companies, Pinsent Masons is an international law firm, acting for clients across the world. In the specific world of major projects we have experience of many different forms of project structures, from the Public Private Partnership models involving complex project finance arrangements to more of an asset backed partnership structure, structures involving “not for profit” concepts, arrangements which are Sharia law compliant and structures

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which work in civil and common law jurisdictions. We know that one size does not fit all and that what has happened in one country does not necessarily work in another. But the breadth of our experience means that you can tap in to our knowledge rather than have to start everything from scratch. Perhaps more important than our knowledge of legal structures is our experience of bringing partners together, who will most probably have very different ideas in relation to risk, to explain clearly complex concepts and to project manage deals to completion. Rather than being seen as a necessary evil that should be kept at arms length for as long as possible, we know that our clients highly value our contribution and our early involvement in setting strategy and structure can be the difference between a project succeeding and languishing. UKIHMA is a compelling concept – a means of bringing the best of British expertise in the healthcare sector together in one place and to bring the benefit of that expertise to projects around the world. Pinsent Masons is able to provide support to the UKIHMA members through its global office network, through our experience of helping clients at all stages of their international journey, in a way that mitigates their risk (and often just understanding what those risks are is a very important first step - we know what questions to ask) and through facilitating introductions where we can see connections that may not be obvious to individuals. My personal view is that the natural next step will be to connect UKIHMA members to other international players - whether they are construction contractors, financiers in local markets or equity investors. It is going to be an exciting 2017.

FURTHER INFORMATION

www.pinsentmasons.com bit.ly/freedomtosucceed

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The Harley Street Medical Area The Harley Street Medical Area is a carefully curated enclave of leading specialists at the cutting edge of their profession, says Simon Baynham, Property Director

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PRIVATE HEALTHCARE

HARLEY STREET MEDICAL AREA

SIMON BAYNHAM Simon Baynham heads up a large team at the Estate responsible for all property matters relating to the Estate’s large and varied portfolio of office, medical, residential and retail premises, including implementing strategy, leading new acquisitions and developments and overseeing lettings and property management across the 92 acre estate. Simon joined the Estate in 1995 and has played a significant role in the hugely successful revitalisation of Marylebone High Street and the on-going expansion and redevelopment of the Harley Street Medical Area, including the provision of new key facilities.

The Harley Street Clinic

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or a long time, the Harley Street Medical Area was defined by its past. Doctors began settling there in significant numbers in the late-19th century, drawn by its convenient location and large stock of attractive Georgian townhouses. Harley Street became home to some of the great pioneers of modern medicine—it was a place where monarchs and heads of state sought treatment; a place that became firmly embedded in the public consciousness as a source of discrete, expert, but rather old fashioned private medicine. A strong sense of heritage still exudes from Harley Street’s elegant period buildings, but this historic reputation no longer does justice to what has become a rapidly evolving centre of medical excellence. Today, the most interesting aspect of the Harley Street Medical Area is not what happened in the past, but what will happen in the future. The vast majority of the medical properties on and around Harley Street are owned by the area’s historic landowner, the Howard de Walden Estate. In recent decades, the Estate has become known for the highly strategic, long term approach it has taken to shaping its retail, residential and commercial offerings. The same is now very much true of its relationship with the Medical Area. “As the custodians of the Harley Street Medical Area, we are committing a significant amount of time and money to ensure that the medical community here has everything it needs to evolve as the 21st century progresses,” says Simon Baynham, Property Director of the Howard de Walden Estate. “Medicine is moving very quickly, both in terms of the technological and clinical advances being made, and the questions that are being raised by an ageing population and increasingly stretched resources. What role will private medicine play in the UK in decades to come? What new treatments and specialisms will be required that the Harley Street Medical Area can help to provide? It is vitally important that we are tuned in to the changing face of healthcare

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and that we are constantly laying foundations for the future.” In recent years, the Estate has been increasingly active in shaping the area’s clinical offering. “Rather than take a laissez faire approach to letting out our medical properties, we have been carefully identifying those specialisms that could really add something to the mix, seeking out the top players in those areas, and then working with them to provide world class facilities, tailored to their needs.” In recent years, this has seen the arrival in the Harley Street Medical Area of specialists at the very forefront of their fields: Royal Brompton &

‘Over the coming decade, the Estate is going to be working closely with its existing tenants, as well as seeking out new ones, to ensure that the treatments they can offer here are not just of the highest quality, but are also distinctive and pioneering.’

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Harefield Hospitals, the London Claremont Clinic, Isokinetic, Optegra. The Estate is also attuned to the future needs of its long established and highly regarded hospitals, including The London Clinic, King Edward VII’s Hospital and several HCA institutions, so works closely with them to ensure they can grow and adapt as the demands on them change. So, what of the future? The Estate will continue with its strategic, hands-on approach, but with an increased emphasis on the provision of treatments that represent the leading edge of medicine. Work has already begun on Advanced Oncotherapy’s proton beam therapy unit on Harley Street—the UK’s first centre for this highly innovative form of cancer treatment—and this cutting edge facility will set the template for future arrivals. “Over the coming decade, the Estate is going to be working closely with its existing tenants, as well as seeking out new ones, to ensure that the treatments they can offer here are not just of the highest quality, but are also distinctive and pioneering,” says Simon. There is also likely to be a marked increase in the number of patients accessing the Harley Street Medical Area from overseas. Currently, the UK’s private healthcare sector accounts for less than one per cent of the global medical tourism market, trailing far behind countries as diverse as the United States, Thailand, Singapore, Germany, South Korea and Spain. And yet this meagre market share stands in stark contrast to the stellar quality of the medical services

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HARLEY STREET MEDICAL AREA have attended—the Harley Street Medical Area delegation included representatives from more than 20 world class medical institutions, the impact of which is extremely strong.” Collective marketing efforts such as this are likely to intensify, while many of the individual hospitals and clinics will also continue to build closer ties with the rest of the world. Already, Harley Street Medical Area institutions are offering training to international partners, and in some instances are building overseas facilities that allow them to offer ‘care in country’ as part of their wider offering.

International facilities

available. The Medical Tourism Index, compiled by the International Healthcare Research Centre, an American non-profit organisation, rates the world’s top destinations for medical tourists using a formula that takes into account both the standard of treatments available and the broader environment. The UK is currently ranked second, just behind Canada. It is clear from these numbers that the UK’s relative underperformance in the global healthcare market has nothing to do with the quality of its offering and is instead a product of its outlook historically being somewhat insular. As the country’s largest and most advanced centre of private medical excellence, the Harley Street Medical Area could and probably should enjoy a far greater profile internationally, and the coming decade will see steps being taken to address that disparity. “Over the past few years, we’ve started to become far more global in our outlook,” says Simon. “We’ve been travelling far more widely, making connections, telling our story. Our hospitals and clinics are playing a very active part, which is vitally important: for this year’s Arab Health conference—the second that we

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Left: The London Clinic Top: Isokenetic Above: The Phoenix Hospital Group

Over the next decade, the Harley Street Medical Area’s international outlook will be bolstered by the evolution of a more coordinated offering, better suited to the international market and more actively and coherently promoted. Unlike many of its peers around the world, the Harley Street Medical Area does not exist within a purpose-built out-of-town campus. Nor has it ever had any form of centralised administration. Instead, it is made up of a disparate collection of institutions, located right in the centre of one of Europe’s biggest cities—a situation that creates both challenges and opportunities. Harley Street’s location offers some significant benefits to international patients and their families: easy accessibility from almost anywhere in the world; the presence of high quality hotels, restaurants, parks and cultural venues. But for visitors to be able to make the necessary plans for treatments, travel, accommodation and leisure, greater coordination is required. The Estate has recently launched a Harley Street Medical Area website, providing a comprehensive directory, and publishes a printed periodical—Prognosis—which offers more in-depth information. The creation of a full concierge service for patients is being actively explored, and it would not be a surprise if future developments included a hotel designed specifically for visitors undergoing treatments. “It has been said in the past that the Harley Street Medical Area is like a vast hospital, with fantastic facilities and top doctors, but no reception area or signposts. Here at the Estate, providing those basic services that make accessing treatment easier has become a major focus,” says Simon. Harley Street’s rich history will remain a source of great pride and inspiration both for the Estate and for the clinicians who practice there. But this is an area that intends to be even more relevant to the medicine of the 21st century than it was to the medicine of the 19th and 20th.

FURTHER INFORMATION

www.harleystreetmedicalarea.com www.hdwe.co.uk

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With access to more than 5,000 practitioners, small clinics, full scale hospitals and support services

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Hand Surgery Head and Neck Surgery Hepatobiliary Hepatopancreatobiliary Surgery High Altitude Specialists Histopathology Hypertension Hypnotherapy Immunology Infectious and Tropical Diseases Interventional Cardiology IVF

Key The Howard de Walden Estate Boundary 2016 Harley Street Medical Area Hospitals

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London Underground Crossrail (2018)

Accident and Emergency Medicine Acupuncture Allergy and Environmental Medicine Anaethesia Andrology Audiology Audiovestibular Medicine Back Orthopaedics Bariatric Surgery Bone Densitometry Bone Tumours Breast Surgery Cancer of Head and Neck Cardiology Cardiac Radiology Cardiac Rehabilitation Cardiac Surgery Cardiothoracic Anaethesia and Surgery Cardiovascular Sciences Cervical Screening Chest Pain Clinics Child Protection Childrenâ&#x20AC;&#x2122;s Orthopaedics Child Psychiatry Chiropody Cognitive Behavioural Therapy Colorectal Surgery Conservation Dentistry Clinical Biochemistry Clinical Neurology Clinical Oncology

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Gastric Surgery Gastroenterology and Endoscopy General Dentistry General Practice Genetic Oncology Genitourinary and HIV Medicine Geriatrics Groin and Hernia Surgery Gynaecology

Obesity Specialists Obstetrics Oncology Ophthalmic Surgery Ophthalmology Oral and Maxillofacial Oral Surgery Orthodontics Orthopaedic Surgery Osteopathy Otology Otolaryngology

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Paediatric Intensive Care Pain Management Pancreatic and Endocrine Surgery Parasitology Parathyroid Surgery Pathology Pathology Services Performance and Exercise Medicine Perinatal Psychiatry Periodontics Phlebotomy Physiotherapy Plain Film X-Ray Podiatry Prosthodontics Psychiatry Psychology Psychotherapy Radiology Reconstructive Surgery Renal Transplantation Reproductive Medicine Respirology Respiratory Medicine Restorative Dentistry Rheumatology Sclerotherapy Surgery Sexual Health Sleep Medicine Speech and Language Therapy Spinal Surgery Sports Medicine Practice Stop Smoking and Addiction Services Stroke Medicine Travel Medicine Transplant Surgery Trauma Surgery Ultrasound Urodynamics Urological Surgery Vascular Medicine Vascular Studies Vascular Surgery Weight Loss Clinics Womenâ&#x20AC;&#x2122;s Health

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Complex surgery BMI Healthcare is the UK’s largest private hospital group with 59 hospitals and treatment centres. For the last six years it has provided a welcome alternative within the international patient market, with a unique mix that has been a game changer in the London market and beyond, says International Director Scott Feldman

ith more than 7,000 specialist surgeons and physicians, BMI Healthcare treats over one million patients every year and performs more complex surgery than any other private provider in the country. In London alone BMI boasts 12 hospitals and treatment centres, including specialist units for cardiac, oncology, neurosciences, orthopaedics and spinal surgery. The majority of consultants in London and major regional hubs come from the UK’s leading NHS teaching hospitals, bringing with them worldclass expertise.

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Unlike many private providers, BMI Healthcare has a widespread group of hospitals around the UK, rather than focusing on London alone. This allows the group to offer a greater range of locations for visiting international patients, as well as more competitive rates for treatments and services. “We have relationships with various hospitals in the Middle East and we linkup our consultants with key clinicians across certain specialties, especially in Kuwait and the UAE, where they may go out and help develop their surgical programmes, train their

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teams and operate on complex patients,” says Scott Feldman, International Director for BMI Healthcare. “We deliver an exceptionally good service and many consultants say we have one of the best teams in London,” he adds. “We also offer a wealth of added value services, such as complimentary companion stays, tailored menus and private car transfers, but it’s our core surgical specialities in spinal, orthopaedics, cardiac, renal transplant and colorectal that cement our reputation.”

Speciality services The Alexandra Hospital in Manchester is the largest private critical care hospital in the north and is one of the group’s flagships. However the hospitals with the largest number of international patients are The London Independent Hospital, a comprehensive, acute private hospital located close to the City of London and Canary Wharf, and The Clementine Churchill Hospital in Harrow, north London. With its close proximity to the Royal National Orthopaedic Hospital, the Clementine Churchill shares many of its consultants and Sean Molloy, one of the UK’s leading spinal surgeons, is based there. A key focus for BMI The Clementine Churchill Hospital is the provision of neurological rehabilitation services and spinal services, both surgical and medical. The hospital is one of the three UK providers to have an O-arm® offering real time multi-plane 2D and 3D images, improving vision for surgeons during complex procedures. This allows for a minimally invasive approach, reduced radiation, quicker recovery times and shorter hospital stays. Complex procedures are supported by the six-bedded level 3 Critical Care Facility, offering one-to-one patient care with multi-disciplinary specialist input. “The London Independent is located close to Barts Heart Centre [NHS], one of the largest cardiac centres in Europe, and its consultants have practised with us privately for many years” says Scott. “This is now our main cardiac centre and, again, we have a huge array of subspecialist expertise there. “In addition, we undertake living donor kidney transplants which is a particular speciality, as is complex medical. We receive a substantial number of acute admissions for patients that have a catalogue of issues. We see many from countries such as Kuwait, where they have spent months in ITU. We also see patients from Russia, Qatar, UAE, Bahrain and Egypt, among others.” BMI Healthcare’s flagship hospitals in London and Manchester regularly receive urgent referrals for critically ill patients at the highest levels of complexity, including international emergency medical evacuations and transfers from hospitals around the world. As an experienced provider of acute direct admission services, the BMI team is able to mobilise multiple specialist consultants and hospital critical care teams at short notice

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SCOTT FELDMAN Scott Feldman has been BMI’s International Director for the past four years. During this time the group has more than trebled its international revenues. Prior to that he worked in a senior marketing and business development role at the group for three years. Previously he held a number of senior marketing positions within various organisations, both multinationals and SMEs. He was head of marketing at HCL Healthcare, the biggest healthcare recruitment agency in Europe at the time.

and respond to the demands associated with this type of referral. They work closely with all major air ambulance providers and ground services to ensure a streamlined journey into its Critical Care Units. The level 3 Critical Care Facilities are equipped with isolation pods to safely accommodate patients with potential infection risk and the units are run by a 24/7 team of specialist intensive care consultants.

Dedicated International Patient Centre Navigating the UK healthcare system can be challenging, so BMI Healthcare provides first class support from the start through its International Patient Centre which responds to all enquiries, whether for overseas self pay, or government or corporate referrals. A dedicated team of highly trained, multilingual international patient liaison staff, based in BMI’s flagship hospitals facilitates the journey from initial contact right through to discharge. The experienced team manages the entire patient journey and provides complimentary interpreter support across a number of languages, including Arabic, Greek, Russian, Mandarin and Cantonese. They provide cost estimates for treatment, organise opinions on medical reports, liaise with consultants and deliver a variety of concierge services including booking appointments at all the hospitals. They also provide bespoke case management for complex high acuity admissions via a dedicated case manager. “We came into the market a few years ago and we have really built our relationships and the brand,” says Scott. “It’s a tribute to us that our staff are loyal and we don’t have regular turnover. This benefits everyone and means we can offer exceptional service to all our patients.”

FURTHER INFORMATION

www.bmihealthcare.co.uk/international Tel: +44 (0)20 7780 2525

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Cardiac care

Excellence and flexibility at BMI The London Independent Hospital deliver high standards of care, as Consultant Interventional Cardiologist Professor Charles Knight tells Sarah Cartledge

ablation, and helped develop a rapid access chest pain service. He also helped the hospital become one of the first private hospitals in the UK to implement transcatheter aortic valve implantation. This treatment is for high risk patients with severe aortic stenosis. Professor Knight is also one of the principal UK authorities on septal ablation for treating patients with obstructive hypertrophic cardiomyopathy, and performs the procedure more regularly than any other UK cardiologist. “The main reason I practice at BMI The London Independent is the catheter laboratory staff in the dedicated Cardiac Catheterisation Suite who are very experienced,” says Professor Knight. “They

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MI The London Independent Hospital offers excellent service. With a number of specialist cardiac centres located across the country, BMI hospitals are home to some of the UK’s most esteemed consultant cardiologists and cardio-thoracic surgeons. Professor Charles Knight, who is Managing Director of St Bartholomew’s Hospital and Executive Director of the Barts Heart Centre sees private UK and international patients and performs angioplasties and procedures at BMI The London Independent Hospital in East London. Since he began practising at the hospital Professor Knight has assisted in the introduction of CT coronary angiograms, cardiac MRI and EP

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are a great team; they know exactly what they are doing and are very supportive of the consultant doing the procedure. They are also incredibly flexible and hard working.” International patients who fly in from abroad generally hope to be seen immediately, and the London Independent is very flexible, allowing working late and around the consultant and patient timing. “There is a very good ITU service with a dedicated anaesthetist on the unit and a dedicated consultant, and that provides a lot of reassurance, particularly for overseas patients,” Professor Knight says. For consultants, a full ITU assessment is very useful, especially when the patient has been transferred from an overseas intensive care unit. “Patients from Kuwait tend to fall into this category and have more complex conditions, but often we see people who would like a second opinion before embarking on a course of treatment,” he explains. “We often receive an angiogram with an email enquiry and we can respond to such requests as well.” The hospital offers services including rapid access and comprehensive screening and diagnostics, managing conditions such as angina and heart attacks, heart rhythm problems, coronary artery disease, valve disease, heart failure and hyptertension, as well as structural defects and hypertrophic cardiomyopathy. The dedicated teams adopt a multi-disciplinary approach across the full range of sub-specialities. The cardiology and cardiothoracic surgeries include coronary angiogram, angioplasty with the latest drug-eluting stent technology, cryoablation, alcohol septal ablation, catheter ablation, transeophoageal echocardiogram, PFO closures and AD closures, TAVI, heart bypass surgery, and aortic and mitral valve replacement surgery. “I am constantly looking at new services we can bring to the hospital in order to help improve the care and treatment of patients,” he says. “Heart disease is the UK’s biggest killer, but patients of

“Heart disease is the UK’s biggest killer, but patients of Asian or Middle East background are more prone to get coronary artery disease and we see higher rates of heart disease and heart attack at younger ages than in Caucasian patients. It is a genetic and lifestyle issue, both in men and women.”

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PROFESSOR CHARLES KNIGHT Professor Knight trained at Cambridge and Oxford Universities and is a Consultant Interventional Cardiologist , Managing Director of St Bartholomew’s Hospital and Executive Director of the Barts Heart Centre. From 2008 to 2011 he was Honorary Secretary of the British Cardiovascular Society. He is a member of the Royal College of Physicians Cardiology Speciality Advisory Comittee, and has served as Associate editor of ‘Heart’ journal, the UK’s leading Cardiovascular journal, a specialist advisor to the NICE interventional procedures programme and Chair of the London Cardiology Specialty Training Committee. He assisted Professor Ulrich Sigwart at the world’s first septal ablation procedure at the Royal Brompton in June 1994. Since then he has helped pioneer this nonsurgical treatment for patients with heart muscle disease and attracts referrals from the UK and abroad. He performs septal ablation for obstructive hypertrophic cardiomyopathy more frequently than any other UK cardiologist.

Asian or Middle East background are more prone to get coronary artery disease and we see higher rates of heart disease and heart attack at younger ages than in Caucasian patients. It is a genetic and lifestyle issue, both in men and women. “Statistically women are less likely to have heart disease until the menopause, but there is a catch up after that, and there is still a lack of awareness among women and even general doctors who don’t consider heart issues for women.” Professor Knight is Executive Director of the Barts Heart Centre, based in the new multimillion pound extension of the historic St Bartholomew’s hospital. Opened in May 2015, it is one of the largest cardiac centres in Europe with one of the most comprehensive imaging departments in the world, along with ten theatres and ten catheter laboratories. So patients at the London Independent Hospital are fortunate to benefit from the expertise he brings from a global cardiac centre. “BMI The London Independent Hospital offers excellent service to patients with simple but important aspects like overnight stays before operations and complimentary car transfers to the hospitals,” says Professor Knight. “These are important to patients and relatives who are travelling across the world when they are ill and anxious. Yet the hospital still manages to keep its costs highly competitive and maintain excellence of clinical care.” FURTHER INFORMATION

www.bmihealthcare.co.uk/international Tel: +44 (0)20 7780 2525

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Reducing the trauma The burden of trauma remains one of the biggest worldwide health issues, Mr Ali Noorani, Consultant Trauma & Orthopaedic Surgeon at BMI The London Independent Hospital, tells Sarah Cartledge

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lthough globally the overall burden is declining, some age groups and some regions of the world are not experiencing the same improvement. The global population is predominantly young, with car accidents and injuries being more common in this group,” says Mr Noorani who is one of the top orthopaedic surgeons in the UK. As a result, there are young people worldwide with serious injuries who, in many cases, don’t have access to the medical expertise and resources that are available in this country.” Mr Noorani’s clinical interests include shoulder and elbow instability, sports injuries and fractures with a special interest in treatment of shoulder and elbow sports injuries, rotator cuff and frozen shoulder, arthroscopy and arthroplasty (replacement) of the shoulder and elbow. He also specialises in management of early onset arthritis, joint preservation procedures including stem cell therapy. He is big advocate of rehabilitation and is on the education committee for the European Society of Shoulder and Elbow Rehabilitation (EUSSER). For international patients, particularly those

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from the Middle East coming to Trauma SOS, he use his expertise as a Level 1 Trauma Centre trained surgeon to treat acute trauma as well as delayed reconstruction of injuries of all of the upper limb. “I undertake a significant proportion of my private work at the London Independent Hospital because the team is fantastic,” says Mr Noorani. “I also have consulting rooms in the Harley Street Medical Area. I like taking my patients to the Independent for their surgery. It is so well run with regards to pathways and turnaround time, and it is incredibly safe and efficient. The team at the Independent has engaged with us to implement these pathways. On one hand I always liken it to Formula One, where each person’s role is vital for the success of the whole team. One the other hand it is like the airline industry where meticulous attention is paid to safety.”

Specialist Fellowship Training In fact, it was Mr Noorani who used the LEAN methodology to streamline the patient journey in the upper limb service as well as the trauma service. He used his experience form his training at a Level 1 Trauma Centre as well as

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his Fellowships. He was awarded the coveted British Shoulder and Elbow Society Fellowship in 2010 which is competitively awarded to one candidate. He was also awarded the equally impressive British Orthopaedic Association Fellowship in 2011. He used these fellowships to gain further valuable training in Upper Limb and Trauma Surgery in the US, at Harvard University, the Mayo Clinic, Columbia University, and the Rothman Institute. He was also awarded an AO trauma fellowship to Salzburg. Mr Noorani strongly believes that his primary role is to offer an accurate assessment and a precise diagnosis. Shoulder, elbow, hand and wrist symptoms are common and many patients and therapists often need reassurance and explanations for the problems they are experiencing. He considers a multidisciplinary approach to treatment of these problems is vital, as very few people actual require surgery. Patients need to know that they are seeing someone who they trust and who understands and specialises in their problem. He has used the LEAN methodology to streamline the patient journey in the upper limb service. He has introduced several innovative pathways, including a one-stop clinic where patient assessment, radiological investigations, pre-admission, and scheduling can all be done within 24 hours. Under his leadership, the upper limb service has acquired state of the art surgical equipment to provide patients with the optimal treatment. He has also introduced a therapy clinic, along with rehabilitation protocols, and patient information sheets for upper limb procedures to ensure patients receive timely and effective postoperative physiotherapy. Mr Ali Noorani also looks after upper limb injuries for several London professional sports team and has been the UK team orthopaedic doctor for the NFL, NBA and the Rugby World Cup in 2015.

Accessing expert trauma help To assist overseas patients find their way through the complex UK healthcare system Mr Noorani has established a concierge service, Trauma SOS, with fellow consultant Nima Heidari. The team of specialists at Trauma SOS includes more than 30 of the UK’s leading consultants in many fields including orthopaedics, plastic and reconstructive surgery, spinal and neurosurgery, and intensive care. “Together, we can treat even the most complex of cases in the knowledge that we have the back-up of top nursing and theatre specialists, along with access to the state-ofthe-art diagnostic and critical care facilities,” explains Mr Noorani. They already take a number of referrals from the Middle East who may be either acutely injured patients, airlifted directly to the hospital, or ‘cold trauma’ patients where a previous injury hasn’t healed well, leaving deformities, infection or pain. International patients with more minor

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MR ALI NOORANI Mr Noorani qualified from the Imperial College School of Medicine (London) and completed his Orthopaedic and Trauma training on the prestigious Royal London Hospital rotation and has further specialised in Upper Limb Surgery including Trauma & Sports injuries. He undertook further Specialist Fellowship training in Shoulder, Elbow and Upper Limb Surgery at the worldrenowned Upper Limb fellowship programme at The Royal Liverpool Hospital. He was awarded the coveted Annual British Shoulder and Elbow Society Fellowship in 2010, and the equally impressive British Orthopaedic Association Fellowship in 2011. He used these fellowships to gain further valuable training in Upper Limb and Trauma Surgery in the USA, at Harvard University, the Mayo Clinic, Columbia University, and the Rothman Institute. He was also awarded an AO trauma fellowship to Salzburg.

injuries, including sports injuries, are also able to reach out to the team. Mr Noorani explains that they recently treated an artist from Kuwait, who fell from a ladder while decorating a ceiling. “He had a fracture dislocation of his elbow after falling onto dirty ground,” he explains. “They cleaned it up a bit and carried out a reasonably good fixation. However, unfortunately it became infected. By the time we saw the patient six months later, he was seriously ill with osteomyelitis (infection of the bone). Having assessed him, we operated with a team of plastics, bone infection and upper limb surgeons. We drilled out the infection and re-fixed the fracture, as well as taking samples from which we grew bacteria. The patient stayed in hospital for a month on IV antibiotics, before being able to return home with normal function in his arm. In this case, the fees for our services were covered by the patient’s embassy.” From a patient’s perspective, Trauma SOS is a one-stop concierge service that ensures they receive the best clinical service from some of the finest orthopaedic surgeons in the world. “Patients undergoing trauma, and their families and embassies, who are not covered by the NHS, want to know that they are nonetheless receiving the absolute best care that they can source. Trauma SOS is ideally placed – both professionally and geographically – to deal with this,” says Mr Noorani. “Our unique international service means that, for the first time, patients anywhere in the world can gain fast 24/7 access to the UK’s best trauma and orthopaedics expertise and all at the touch of a few buttons.” FURTHER INFORMATION www.traumasos.co.uk

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Mother of all operations

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Cytoreductive surgery is a radical treatment for rare cancers of the abdominal cavity, but it has a good success rate says Mr Tom Cecil, Consultant Colorectal Surgeon at BMI The Hampshire Clinic

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MI offers many several speciality services, such as the colorectal service at Basingstoke Hospital where Mr Tom Cecil is based. As a consultant colorectal surgeon, he has been Clinical Director of the Peritoneal Malignancy Institute, one of the largest centres in the world in the treatment of peritoneal cancers. His area of expertise is a rare cancer known as Pseudomyxoma Peritonei or PMP, which is a cancer of the peritoneum, the lining of the abdominal cavity. It affects a tiny a proportion of people, around 2-3 in a million, but can be widespread and requires radical surgery. It is also known as jelly belly because of the way the tumour and mucus form in the abdomen, and when Mr Cecil sees a patient it has usually been diagnosed through a previous abdominal operation or found on a scan. “The symptoms include a distended abdomen, discomfort, difficulties eating and pain. By the time we see them they have often had an operation because they may have presented with an ovarian mass. Increasingly with CT scans the condition is being picked earlier, but often in the overseas patients it would have been diagnosed in an operation,” says Mr Cecil who uses the Sugarbaker operating technique. Developed by Dr Paul Sugarbaker in the United States, it is known as the Mother of all Operations as it can take around 10 hours and involves 2-3 surgeons. The peritoneum is a membrane that lines the abdominal cavity and covers the abdominal MR TOM CECIL Tom Cecil started as a Consultant Colorectal Surgeon in Basingstoke in 2002. He specialises in laparoscopic colorectal surgery and peritoneal malignancy surgery. He is the Clinical Director of the Peritoneal Malignancy Institute in Basingstoke. In 2003 he set up the Peripherique laparoscopic training courses with laboratory skills courses, clinical workshops and hands on clinical immersion courses. He ran one of the Lapco training centres for laparoscopic colorectal surgery. He has been on the faculty of National MDT/TME training programme, the Danish MDT laparoscopic training programme and the European laparoscopic masterclass. He was Chair of the CSCCN Colorectal Network Site specific group and Lead Clinician for the International Colorectal Cancer Improvement programme and now Chairs the SCN Wessex colorectal Capacity programme. Since 2011 he has been Clinical Director of the Peritoneal Malignancy Institute in Basingstoke, one of the largest centres in the world in the treatment of peritoneal cancers. He has lectured extensively nationally and internationally on laparoscopic colorectal surgery and peritoneal malignancy and presents and publishes on both subjects. He is on the Medical Advisory Board of Bowel Cancer UK.

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‘The UK Pseudomyxoma Peritonei National Centre at Basingstoke, led by Mr Cecil, is the largest in the world and one of only two in the UK.’ organs, acting as a lubricating structure to allow the small and large bowel to function. Rarely, the peritoneum can develop a primary malignancy, such as a peritoneal mesothelioma, but most commonly peritoneal tumours are secondaries from any abdominal organ, particularly ovarian, appendix and bowel cancers. Whilst this is very serious and often a lethal event, a novel radical approach, combining aggressive removal of the peritoneal tumour by extensive surgery (termed Cytoreductive Surgery (CRS)) combined with intra operative Hyperthermic Intra Peritoneal Chemotherapy (HIPEC), results in prolonged survival and potential for cure. Effectively this is a 30 to 90 minute warm chemotherapy bath designed to eliminate tiny tumours and tumours too small to see. The operation involves removing the complete tumour, stripping the lining of the abdomen and operating on the small intestine, colon, rectum, liver, gall bladder, spleen omentum, and in women, the ovaries and uterus.The abdomen is then washed out with hot chemotherapy liquid for one hour, applying the treatment to the precise area and thus reducing the side effects of chemotherapy and allowing for a quicker recovery. The UK Pseudomyxoma Peritonei National Centre at Basingstoke, led by Mr Cecil, is the largest in the world and one of only two in the UK. It has treated more than 1000 patients with a high rate of successful outcomes. PMP has a 60-70 per cent survival rate for 10 years, higher than for colon cancer, and patients recover very well within three to four months. “The average inpatient stay is three weeks but most go home in less time. Those who stay have complications, which there is a risk of in this surgery. It’s major surgery but we achieve it with quite a low mortality. It’s unusual that people don’t survive, but it is a big operation. Then they have a good quality of life,” says Mr Cecil. “Sometimes they stay in the UK for a few months until they are successfully recovered and they can come back if they are worried. A lot of the follow up is done through CT scans and we can follow up remotely with the local teams.” FURTHER INFORMATION

www.bmihealthcare.co.uk/international Tel: +44 (0)20 7780 2525

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At BMI The London Independent Hospital ITU we are able to manage patients with complex medical and surgical problems, says neuroanaesthetist Dr Javid Khan

Intensive care

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any international patients are admitted to BMI The London Independent Hospital with complex health problems, often coming from intensive care units in their own countries for specialised care. The team consists of six consultants who have expertise in managing patients with neurological, cardiac and tracheostomy issues, and weaning from ventilators is a major offering at this particular unit. “At the London Independent we have an excellent team of physicians and surgeons who support the work I do with my team at the intensive care unit,” says Dr Khan. “So we have found over the last few years we have been able to manage patients with very complex medical and surgical problems, using the multidisciplinary team or MDT approach.

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“Our group of six consultants covers the ITU around the clock and, because the hospital is smaller than other London hospitals, the relationships between specialists and also with patients is much closer and we know who to call if there are any issues.”

Dedicated facilities and care The hospital’s critical care facilities provide dedicated and specialised care for critically ill and post-trauma patients, patients requiring advanced care following major and complex surgical procedures, patients with a variety of medical conditions who require complex multiorgan support, high risk patients undergoing minor/intermediate procedures, acutely ill inpatients or patients admitted through the urgent direct admissions service and patients

requiring weaning from mechanical ventilation. There are six beds for ventilated patients and six Level-three intensive care patients where the team can provide for organ support with one to one nursing. All patients are seen by a consultant every day and regular MDT meetings take place to evaluate their progress. The team covers a wide range of subspecialities within critical care (cardiac anaesthesia and critical care, neurocritical care, general intensive care, complex medical patients and high risk surgical patients). They are experts in weaning patients from mechanical ventilation, tracheostomies, removal of artificial airways and early rehabilitation to facilitate a full and prompt recovery of patients admitted to critical care. The motivated MDT team includes consultant intensivists, critical care resident medical officers, critical care nurses, pharmacists, physiotherapists and dieticians.

Mechanical ventilation weaning Some patients in ITU require long term support and can still be dependent on a mechanical ventilator for a significant period of time. “There is much comorbidity in these patients, and those who have a tracheostomy are usually too weak to breathe by themselves as a result of the critical illness they had previously,” says Dr Khan. “They may have had a stroke in the past, or they might be on dialysis and have experienced previous cardiac arrests, so they are not usually in a very good constitution to cope with more stress. It’s at this point they are referred to us. Our task is to get them off the ventilator to optimise the rest of their medical state, and get them to the condition where they can be discharged to the ward and further rehabilitation.” DR JAVID KHAN Dr Javid Khan is a specialist in neuroanaesthesia and neurocritical care. He is a Consultant at The National Hospital for Neurology and Neurosurgery, Queen Square, London. He graduated from St. Bartholomew’s and The Royal London School of Medicine, University of London. Subsequent specialist training was undertaken in London hospitals including at University College Hospital, Royal Free Hospital, Moorfield’s Eye Hospital, and at Queen Square. He then successfully completed a one year Clinical Fellowship in Neuroanaesthesia at The University of Western Ontario in Canada. This is a leading Neurosciences Centre with particular expertise in complex neurovascular and functional neurosurgery. He has an interest in postgraduate medical education and training, and has previously been Deputy Regional Adviser for Intensive Care Medicine in the North-East Thames Region.

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PRIVATE HEALTHCARE

BMI HEALTHCARE

Renal transplants

Neuro Intensive Care

The dedicated Renal Transplant Facility at BMI The London Independent Hospital offers a surgical service for patients with kidney failure. Here, the specialist clinical teams offer expertise in all aspects of kidney disease from diagnosis of chronic kidney failure and vascular access creation for dialysis, through to renal transplantation. All services are led and delivered by leading consultants in this highly specialised field, including Roberto Cacciola who has been appointed as the National Clinical Lead for Organ Retrieval in England. The dialysis service at the hospital was set up by renal physician Dr Ajith James, who also practices general medicine and thus has considerable input in the ITU where many patients are admitted under his care. “We have undertaken a number of living donor renal transplants, which have been a big success. These have required teamwork, infrastructure and guidelines, along with support for patients and their families as well,” says Dr Khan. “Patients who are in renal failure are usually on dialysis before coming over to London to be assessed for suitability for transplant,” he continues. “We have to decide whether they are fit for surgery and carry out other tests around immunology. We have done some very difficult cases where patients who have undergone surgery require very close monitoring in ITU along with special drugs to prevent rejection of the new organ. Some of these patients are quite high risk generally but all have done really well.

The team manages patients with brain injury, including those who do not wake up after cardiac arrest, patients with stroke and brain haemorrhage and others with ongoing issues such as breathing, heart problems, infection. “We can support patients who have surgery on the central nervous system, brain surgery, spine surgery – some of these patients come to intensive care with specific needs.” As a specialist centre for spinal patients, a team of neurophysiology technicians in the operating theatre monitors the spinal cord during surgery. This is to detect any damage to the spinal cord function and to administer particular anaesthetics as well as monitoring positioning, blood pressure and post operative care. “We deliver top quality patient care within a modern, fully equipped critical care unit,” says Dr Khan. Following their stay in the ITU some patients are discharged to the ward under the care of their admitting consultant. Others who are not well enough to be discharged to the ward may return to their own country where they will continue their recovery. “We may take the view we cannot improve their care significantly in their best interests,” Dr Khan says. “Our work is usually complete at that point.”

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FURTHER INFORMATION

www.bmihealthcare.co.uk/international Tel: +44 (0)20 7780 2525

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Bringing service to life 7500

Number of Healthcare staff employed by Serco

RECEPTION Trust

Care

Pride

5.1m

Number of Switchboard/Helpdesk calls per annum

2.2m Number of patient moves undertaken per annum

Serco in Healthcare Sercoâ&#x20AC;&#x2122;s healthcare business is the specialist healthcare arm of Serco Group plc, a FTSE 250 international service delivery company. We offer care-coordination, integrated facilities management, business process outsourcing and support to clinical services.

For general enquiries contact: T: +44 (0)1256 745 900 F: +44 (0)1256 744 111 E: health@serco.com

www.serco.com

The United Kingdom International Healthcare Management Association (UKIHMA) was created a year ago to provide a single front door for overseas organisations to access the very best of UK Healthcare from the NHS and Private Sectors. A strategic partner to Healthcare UK, UKIHMA delivers a fast track approach, as UKIHMA Co-Chairs Ralph Dando and Victoria Cheston explain

The collaborative approach

KIHMA combines the unique skills and international reputation of the NHS with the knowledge and experience of the private sector to offer bespoke solutions from exceptional suppliers to the overseas healthcare market. Healthcare, by its very nature is a growth sector. As populations continue to grow, people live longer and their healthcare needs become increasingly complex. Many overseas governments and organisations are seeking solutions to enable them to meet this growing demand, and improve their healthcare services and delivery facilities. According to the Commonwealth Fund, the UK has the number one healthcare system in the world. Yet it is facing the same issues as other countries and so is well placed to develop and deliver healthcare solutions on the world stage. Many organisations in the UK are involved in developing and delivering solutions for international customers. UKIHMA has been set

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INTRODUCTION

UKIHMA

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Alder Hey Childrenâ&#x20AC;&#x2122;s Hospital, Liverpool

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INTRODUCTION

UKIHMA

up to make access to the full capabilities of the NHS and private healthcare sectors as easy as possible. Utilising a single front door, UKIHMA provides detailed screening of opportunities to its members and then facilitates the bespoke solutions via consortia that bring together the unique skills and reputation of the NHS with the knowledge and experience of the private sector.

The role of the UK in international health The UK faces many of the same healthcare problems as the rest of the world and is at the forefront of developing innovative solutions to ensure healthcare delivery continues to improve. Clinical services, education and research alongside the design, build and operation of modern healthcare facilities are at the forefront of ensuring that the UK is able to meet the demands of its own population. Increasingly

RALPH DANDO Private Sector Co-Chair UKIHMA As Development Director at International Hospitals Group (IHG), Ralph is responsible for all development projects prior to the operational delivery.

VICTORIA CHESTON NHS Co-Chair UKIHMA As Commercial Director at Guy’s and St Thomas’ Hospital in London, Victoria is responsible for all the commercial activities of one of the largest teaching hospitals in the UK.

the growing international need means that overseas clients and governments are, quite rightly, looking to the UK for help in developing their healthcare systems and facilities. The UK government created Healthcare UK as a joint venture between UK Trade and Investment (now the Department for International Trade), the Department of Health and the NHS. This new organisation’s mission was to promote the UK as a provider of the skills, knowledge and experience required overseas to design, build and manage hospitals and healthcare facilities, share knowledge in terms of best practice, skills and training and to provide system support and help to manage healthcare facilities around the world. Healthcare UK very quickly found itself with opportunities and requests from governments and private sector organisations across the globe, and a need to find UK organisations and skills that could fulfil this function. UKIHMA was formed to respond to this need. UKIHMA undertakes detailed screening of opportunities that are fast tracked directly by Healthcare UK, and responds to these opportunities by facilitating easy access to the public and private providers of healthcare solutions. To raise the profile of the UK healthcare sector internationally, UKIHMA supports Healthcare UK and participates in many highlevel events, missions and meetings around the world, where our members are actively targeting collaboration. Most activities are aimed at the UK’s priority markets, but we also respond to opportunities in other markets on a case-by-case basis. UKIHMA raises the awareness among international partners about the capabilities of the UK healthcare sector through Healthcare UK’s staff in country, and acts as a single gateway to our members to offer the broad capabilities across the Healthcare spectrum.

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INTRODUCTION

UKIHMA

What is UKIHMA? UKIHMA is a company that brings together NHS and private sector providers of healthcare from across the United Kingdom. At its core, UKIHMA collates the expertise of its membership who, between them, can provide all the skills and expertise to deliver major overseas projects in healthcare. UKIHMA includes high calibre NHS organisations - acute, specialist and mental health hospitals - alongside private sector healthcare organisations ranging from smaller equipment and technology companies to those able to design, build and operate hospitals. The NHS is not a single organisation but is made up of many different healthcare providers - many of whom belong to UKIHMA. In establishing UKIHMA, the company specifically set out to ensure that its membership encompassed all the skills and capabilities needed for the development and delivery of comprehensive healthcare solutions across the spectrum of physical and mental health and well being. This is reflected in the chairmanship of the company – which is a co-chair model – one NHS and one private sector. UKIHMA recognised that no single organisation could do everything, from education and training to design and build, to facilities and operational management, and so it created a mechanism by which all of these could be delivered to clients – via a single front door – and with bespoke solutions developed via consortia made up from the most appropriate members required to deliver to the needs of the client.

A single point of contact – the consortium approach One of the great attractions of the UK as a partner in major healthcare projects is our unrivalled ability to provide all the skills required to deliver these comprehensive projects to an extremely high quality. However, there are many organisations involved in delivering these and it is often difficult for overseas organisations and governments to navigate this landscape to source the very partners they need to provide the best solutions. This is where UKIHMA comes in. A single point of contact for an overseas

‘Healthcare, by its very nature will always be a growth sector - as populations continue to grow and people live longer their healthcare needs will keep rising exponentially.’

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partner, UKIHMA is the interface that gives direct access to comprehensive solution delivery via a single front door. A client request comes to UKIHMA, is screened and sent to its members. Consortia are then developed to meet the needs of the client without them having to navigate this complex landscape themselves. For the overseas client we believe that a full solution makes better sense, both clinically and commercially. This is preferable to contracting piece-by-piece where all the individual elements may not fit together to provide an ideal solution and the client has to deal with a range of individual organisations. The uniqueness of UKIHMA is to bring those skills together into a single consortium tailored specifically to the needs of an individual project. By individually

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validating and understanding the needs of each opportunity as it comes up, we are able to form from our membership a consortium that provides the particular skills and expertise to deliver each element of the project, and therefore deliver a complete solution via a single point of contact for the client. This provides a much simpler and easier approach to delivery for the client.

The capability wheel and our members The capabilities of the UKIHMA members are set out in the capability wheel (see above) comprising six broad ability categories: Clinical, Facility, Education, Financial, Equipment and Technology.

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INTRODUCTION

UKIHMA

The key to these capabilities is the way in which they come together. UKIHMA focuses on complex multi-specialism opportunities that require a consortium approach. This provides our clients and governments with a full turnkey solution encompassing, needs-based consultancy and feasibility studies, through design and build, equipping, commissioning,

training, recruitment and ongoing hospital management, including state of the art hospital management systems and ongoing, education, CPD, facilities management services.

Working with clients UKIHMA offers a one-stop shop for overseas clients looking to develop their healthcare services and facilities. We provide a single point of contact and the facilitation of consortia for any overseas client looking to access the skills and expertise of the UK health sector. We want to work with clients and governments across the globe to help them to assess and understand their needs and create solutions that will provide best value and best outcomes for patients across the world.

FURTHER INFORMATION

For more details contact enquiries@ukihma. co.uk at 1 Royal Exchange, London EC3V 3DG on +44(0)203 1463443 or please visit our website at www.ukihma.co.uk

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The full package Offering world class consultant-led care, Bupa Cromwell Hospital has aligned its focus increasingly towards complex treatment in one of the UK’s most luxurious private patient healthcare facilities, as Commercial Director Ahmed El Barkouki tells Jack Ball

uilt in 1981 and acquired by Bupa in 2008, the Cromwell sits in the leafy residential area of South Kensington, West London, and has become synonymous with the very best in private healthcare. The hospital’s formula is simple – internationally renowned consultants delivering a comprehensive and holistic approach to complex care in a world class facility. Their new luxury suites even rival those in London’s famous hotels – many of which are nearby. Many patients are drawn to the Capital’s cosmopolitan nature, its diverse population and a reputation for clinical excellence. “London has so much to offer generally,” says Commercial Director Ahmed El Barkouki; “It’s a very welcoming city and caters for many different international communities. Combining this with the clinical expertise of our consultants, the great reputation that British medics have overseas, and the strong research and development focus in UK healthcare creates a winning formula. “Bupa Cromwell Hospital has always had a reputation as being a truly international hospital, and we offer more than 500 consultants who cover over 70 specialties,” he continues. “We take a holistic approach, and consider every aspect of the patient journey to ensure their experience is as positive and stress-free as possible. It’s not enough to view a patient as someone just seeking physical treatment – there are a lot of emotional factors to consider as well, so we have always catered for the various different requirements of our international patients, from catering to cultural needs.”

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UKIHMA

BUPA CROMWELL HOSPITAL

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AHMED EL BARKOUKI Ahmed El Barkouki’s career spans 16 years in the hospitality and healthcare industries. Before joining Bupa Cromwell Hospital as Commercial Director in 2014 he held senior sales and marketing roles in luxury hotels, including Four Seasons Hotel and Resorts, and the Maybourne Hotel Group (Claridge’s, The Berkeley and The Connaught). He joined The Savoy hotel as Director of International Sales for its reopening, before setting up his own global consulting company to advise businesses on attracting high net worth clients from the Middle East, East Europe and South America. Ahmed’s move to the Cromwell came from a desire to bring exceptional service quality to the healthcare industry. He is passionate about culture change to deliver the best customer outcomes, and is committed with excellence in customer service.

Complex surgery Since 2008 the hospital’s primary proposition has developed around complex surgery in a variety of specialities such as cardiology, oncology, orthopaedics, lung, liver, neurological and gastrointestinal care. It is impossible to lead in every speciality however, so the next three years will see the hospital focusing its efforts increasingly around the oncology, cardiology and orthopaedic offerings, where it really excels. With a concerted move towards more complex surgery, engagement with consultants on the direction of the hospital remains critically important. “We have established a Medical Advisory Board for all our clinical areas, which supports us in making clinical and strategic decisions on a daily basis,” Ahmed El Barkouki explains. “We have also established multidisciplinary teams [MDTs] to support our complex care provision, where patient cases are discussed by a group of pathologists, radiologists, surgeons and other clinicians. This collaborative environment ensures a decision is not made by one person but a group of

peers whose diverse expertise ensures the best possible treatment option.” MDT meetings take place at the hospital once a month, and the number of complex cases requiring discussion has risen significantly in recent years, meaning that some take place even more often. The lung MDT now meets every two weeks for example – a testament to the high volumes of complex patients successfully being treated at Bupa Cromwell Hospital.

Holistic patient journey With more than 50 per cent of all patients at Bupa Cromwell coming from more than 144 countries, the hospital is inherently international in its feel. But this unique cultural mix throws up new challenges in terms of comprehensive patient care. “All the hospitals in Central London are doing their best to meet patients’ needs,” explains Ahmed. “It’s not enough just to treat and discharge people anymore - patient expectations are higher than that when ‘going private.’ “On average an individual is normally hospitalised once every seven years, and attends A&E every three to four,” he continues. “Many patients have no point of reference when it comes to hospital services. Their complete hospital experience is now benchmarked against other customer experiences, like hotels or restaurants, so it’s increasingly important for hospitals to try and match or even exceed the service that people experience in other industries. You must look at the entire consumer experience and all the touch points in the hospital – even prior to a patient arriving.” The International Patient Centre caters for any supplementary aspect of non-medical care for a patient or their family. This is vitally important for an overseas patient – particularly if they aren’t familiar with the UK healthcare system. “It is critical that a patient speaks with someone who understands their cultural needs or emotional complexities at the time,” explains Ahmed. “The International Patient Centre offers free interpretation services, for any language,

‘Before a patient arrives they may want a second opinion via video conference, and we are able to arrange this from our end. We can also arrange to submit their case to an MDT for discussion if they so wish, prior to their arrival.’

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BUPA CROMWELL HOSPITAL

to all patients who do not speak English. We receive frequent requests for Arabic, Greek, Russian and Chinese interpreters, and some have been with us for over 15 years, so they are very experienced –patients and consultants alike value them greatly.” In many ways the International Patient Centre is a logistical hub, coordinating patients’ needs, organising a second opinion prior to their arrival, assisting with any issues that might arise during their stay, and facilitating their eventual discharge. “Once a patient is treated and is fit to be discharged, there is no reason for them to stay at the hospital,” explains Ahmed. “It is better from a mental and spiritual standpoint to be treated as an outpatient. So we have arrangements with some of London’s most luxurious hotels, as well as furnished apartments in the local area, to provide suitable accommodation nearby to facilitate this. “We offer ongoing services from a clinician to clinician perspective. Before a patient arrives they may want a second opinion via video conference, and we are able to arrange this from our end. We can also arrange to submit their case to an MDT for discussion if they so wish, prior to their arrival.” When an international patient returns to their home country, the Cromwell team can liaise with local doctors, giving advice as required.

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Clinical luxury When inpatient care is an absolute necessity, the hospital has set an industry benchmark with the recent redevelopment of its superior suites – the Royal, Presidential, Ambassador and Executive. Patients using this highly luxurious accommodation range from international business leaders to Heads of State – all of whom enjoy bespoke services that are tailored to each guest. “The patient is assigned a team of VIP Coordinators, similar to personal assistants, for the duration of their stay, as well as one-to-one nursing,” Ahmed explains. “A limousine service to pick up the patient from the airport can also be provided, along with medical evacuation from anywhere in the world – subject to an additional charge.” Uniting these aspects of non-medical care with the hospital’s unique multidisciplinary approach positions Bupa Cromwell Hospital at the fore within London’s diverse and vibrant private healthcare market – offering a complete range of treatments for diagnosis, treatment and discharge all under one roof, and a seamless care pathway for all patients. FURTHER INFORMATION

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Clinical excellence and world-class patient care

Guy’s and St Thomas’ NHS Foundation Trust offers its partners access to a unique combination of clinical, educational and academic excellence, says Victoria Cheston, Commercial Director

uy’s and St Thomas’ NHS Foundation Trust is a world-class organisation with a proud history stretching back more than 900 years. We are a centre of excellence for clinical services, education and research. Our clinical services are delivered from two of London’s best known teaching hospitals, Guy’s Hospital and St Thomas’ Hospital. Evelina London Children’s Hospital on the St Thomas’ site is a centre of excellence for paediatrics. As one of the largest, most clinically comprehensive and high quality hospital trusts in the United Kingdom, we constantly strive to push the boundaries of our clinical care in a safe and high quality environment which offers an outstanding patient experience. Few, if any, medical organisations in the world can match

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Guy’s and St Thomas’ in terms of both the breadth of clinical services we can provide or the depth of expertise we have within each specialty. In recognition of our commitment to providing a high level of care for patients, Guy’s and St Thomas’ won the Quality of Care Award at the 2016 CHKS Top Hospitals Awards. Excellence in education and training for healthcare professionals, students and support staff is at the heart of our organisation. With two teaching hospitals of international renown, we are committed to developing a healthcare workforce of the highest quality. This is vital to ensuring that our workforce remains skilled and equipped to deliver improvements in healthcare, and also for training and educating the next generation of clinicians and academics.

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UKIHMA

GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST Guy’s and St Thomas’ is also nationally and internationally recognised for clinical research. We see research as an opportunity to use our expertise and knowledge as an enabler of innovation, leading to continuous improvement in care for patients. For three years running, Guy’s and St Thomas’ has been amongst the top three trusts for NHS research in the National Institute for Health Research’s annual league tables and we are the highest recruiting trust in England for recruiting patients into non-commercial clinical studies. We are part of King’s Health Partners, one of only eight academic health sciences centres in the UK and 66 worldwide. King’s Health Partners brings together world-class research, clinicians with international reputations, education and clinical practice for the benefit of patients. This ensures that lessons from research are used

swiftly, efficiently and systematically to improve patient care and that we continue to educate the future workforce.

Our international offer Guy’s and St Thomas’ has a history of collaboration and partnership. We work with partners within the UK and internationally across all spheres of our work: clinical, educational and research. We work with governments, international healthcare organisations, the military and industry and provide solutions that are tailor-made to the client’s requirements, drawing on the expertise of our leading clinicians and operational managers. This includes: l providing expert advice and support for the strategic development and enhancement of services – from planning and design to implementation l advising on clinical pathways and implementation of best practice including full pathway redesign and achieving international quality standards l advising on clinical and corporate governance to enhance patient safety and experience, clinical outcomes and efficiency l training and education partnerships, ranging from observerships and fellowships at Guy’s and St Thomas to bespoke training programmes delivered in-country l providing guidance on clinical workforce development and ongoing professional development of staff to enhance long-term capability l clinically led planning of estates and medical technology to create a world class and financially sustainable environment for care l bespoke clinical, educational and research partnerships that are tailor-made to our clients’ requirements. All of our partnerships aim to deliver longterm and sustainable improvements in clinical services and enhanced capability in the workforce required to deliver them. Guy’s and St Thomas’ world class expertise is built upon clinical, teaching and research excellence in a variety of settings and across every major medical speciality. This expertise and the partnership experience we have outlined makes us the ideal partner for any healthcare organisation looking to adopt global best practice. If you wish to work with an organisation of international credibility and repute, contact us to find out how we can assist you.

Quality Accreditation for British military healthcare in Germany IMAGES: SHUTTERSTOCK.COM

For the past 20 years, Guy’s and St Thomas’ NHS Foundation Trust has worked with the UK Ministry of Defence to provide hospital care for the British Forces community in Germany. Most of this care is delivered by German hospitals. To assess and enhance the clinical quality of care provided in these hospitals, Guy’s

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GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST

‘As part of a broader programme of clinical governance, this helps to ensure that patients are receiving first class, patient orientated and safe care in accordance with agreed standards, enables recommendations to be made to improve the quality of care and highlights examples of excellence.

and St Thomas’ has developed a successful Peer Review Assurance Model with an ethos of two-way learning, mutual respect and collaboration. As part of a broader programme of clinical governance, this helps to ensure that patients are receiving first class, patient orientated and safe care in accordance with agreed standards, enables recommendations to be made to improve the quality of care and highlights examples of excellence. The process is based upon NHS assurance principles, but with the necessary adjustments to ensure consistency with the German approach to quality management. A joint assurance protocol underpins the whole process and clearly defines roles, responsibilities and timescales at individual and organisational level. At the beginning of the process, Guy’s and St Thomas’ conducts a review of the assurance documentation, using a comprehensive assessment model based upon Care Quality Commission standards, NHS risk management standards and German quality standards. This incorporates data from a wide variety of sources, including clinical indicators, activity data, patient and referrer feedback, incident data and investigations results.

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The assurance visits themselves are led by experienced Guy’s and St Thomas’ senior consultants, in tandem with the head of the clinical department being assured. Following assurance visits, the British and German teams agree on assurance reports with commendations and recommendations to improve services. To promote a culture of continuous improvement, recommendations are routinely made even where unreserved approval is given. Recommendations which have led to improvements to patient care have included changes to clinical pathways, changes to clinical procedures, and the introduction of innovative technologies. The assurance process demonstrates a joint commitment to quality, openness and a willingness to work in partnership to ensure high quality care and where needed implement improvements. It has resulted in longstanding, strong relationships between the clinical teams, leading to improvements in the quality and safety of clinical care. The partnership has also had wider benefits - it has been a significant factor in promoting the development of quality assurance programmes in the contracted German hospitals, with the appointment of dedicated quality assurance managers and more formal clinical review, significant event analysis and patient questionnaires.

FURTHER INFORMATION

For further information on how Guy’s and St Thomas’ can help you achieve your healthcare ambitions, please contact us at commercial.services@gstt.nhs. uk or call +44 (0) 20 7188 9801 www.gsttcommercialservices.co.uk

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An education in cutting-edge tech The ECMO service at Guy’s and St Thomas’ NHS Foundation Trust is one of the largest and most successful in the world, and international partnerships help patients access this life saving treatment, says Dr Nick Barrett, Critical Care Consultant at GSST

xtracorporeal membrane oxygenation (ECMO) is a supportive therapy based on cardiac bypass technology that allows patients with severe heart or lung failure to be kept alive whilst they recover. It is used to treat patients with severe but reversible heart or lung disorders who have not responded to mechanical ventilation using a ventilator, medicines or additional oxygen. Acute respiratory failure from any cause, including influenza, pneumonia and trauma can also benefit from treatment using ECMO.

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Every year Guy’s and St Thomas’ NHS Foundation Trust manages more than 100 patients on ECMO for respiratory failure, boasting one of the most established and highest quality ECMO services in world. The average survival rate six months after admission for ECMO treatment stands at approximately 70 to 75 per cent – a remarkably high survival rate for patients with the most severe forms of respiratory failure. “ECMO has its origins in the 1970s,” explains Dr Barrett, consultant in critical care at St

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UKIHMA

GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST Thomas’ Hospital in central London. “However the last ten years has seen its benefits far outweigh potential complications and its associated risk. With better and more easily transportable equipment we began to see an increase in survival rates. Simultaneously we saw other approaches to respiratory failure falling out of favour because the evidence indicated that they were actually causing more harm to patients. At this point ECMO appeared to be safer and easier, but only if expertly administered by highly trained clinicians adopting a multidisciplinary approach.” As testament to the level of expertise needed to safely administer ECMO, only five severe respiratory failure centres in the UK are commissioned by the NHS to provide ECMO care – one of which is Guy’s and St Thomas’ NHS Foundation Trust. By its very nature the procedure requires a structured approach with care administered by a team of specialist nurses, perfusionists, intensive care consultant doctors, physiotherapists and dieticians. Developed and refined over time, ECMO at Guy’s and St Thomas’ is provided by the team 24 hours a day in a tertiary ICU. They are able to safely manage up to 10 patients on ECMO simultaneously. “We look after five per cent of the world’s ECMO cases and roughly a third of all UK patients,” says Dr Barrett. “We are one of the largest respiratory ECMO centres in the world in terms of patient volumes, so our experience in ECMO is substantial. With ECMO, like most specialist areas, there is a strong relationship between higher volumes of cases and improved patient survival. Some hospitals that claim to provide ECMO are only performing one or two cases a year, but at Guy’s and St Thomas’ we have a wealth of experience that comes from our significant case loads.” Central to the Trust’s strength in ECMO is high quality patient care that stems from DR NICK BARRETT Dr Nick Barrett is a consultant in critical care medicine at Guy’s and St Thomas’ NHS Foundation Trust who originally trained in both anaesthesia and intensive care medicine in Australia. He leads the severe respiratory failure programme at Guy’s and St Thomas’, with particular interests in extracorporeal membrane oxygenation (ECMO) and extracorporeal CO2 removal (ECCO2R). He is a specialist adviser to the National Institute for Health and Care Excellence (NICE) on ECMO, a founder member of Euro ELSO and a member of the ECMO advisery group to the NHS England intensive care clinical reference group (ICU CRG).

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CASE STUDY

Supporting the development of outstanding clinical services: Extracorporeal Membrane Oxygenation (ECMO) in Qatar In 2013 the intensive care units of Hamad Medical Corporation formed a partnership with Guy’s and St Thomas’ to develop an ECMO service in the general ICU at Hamad General Hospital (HGH). The creation of a severe respiratory failure centre with the ability to provide ECMO was a significant undertaking within Qatar, requiring investment in equipment as well as staff training and exposure to clinical cases. Although there was an immediate need for an ECMO service, it was recognised that it would take time to implement the highly complex multidisciplinary care required. The solution was to provide a clinical support service on the ground in Qatar with members of the Guy’s and St Thomas’ ECMO team flying in to provide direct support tailored on a caseby-case basis to the specific requirements of each particular patient. This approach meant that Hamad General Hospital was able to offer an ECMO service with immediate effect while a longer term and sustainable service model was implemented. Following a joint needs assessment, an intensive

educational programme involving theory, simulation and team development, supported by certification of competency, was delivered at Guy’s and St Thomas’ and on-side in Doha. This happened in parallel with the logistical preparation for unit space arrangements, equipment selection and purchase. GSTT also developed standards of governance and protocols of care in accordance with international best practice alongside clinical case exposure. The partnership culminated in the first patient with severe respiratory failure being commenced on ECMO in Qatar by the Hamad Medical Corporation clinical team in mid-2014, with GSTT continuing to provide 24-hour advice to HMC for the management of patients, second opinions on diagnostic investigations and input on key management decisions. This approach to partnership has enabled HMC to develop a self-sustaining service, which has recently been rated as ‘excellent’ by ELSO, the Extra-Corporeal Life Support Organisation.

excellent training, protocolisation of care pathways, structured governance and a multidisciplinary approach. “In the UK we have created more of a collaborative approach,” adds Dr Barrett. “Rather than having an ECMO unit in every small hospital, we recognise that highly specialised care ought to be located in large hospitals. This approach is not necessarily the same in other parts of the world and the model of care we provide can be adapted to other health care settings.”

ECMO in Qatar As one of the most prominent teaching hospitals in the world, Guy’s and St Thomas’ has a significant international reputation. Their ECMO service is no exception, and this has seen the Trust engage in international partnerships with those who share its values and commitment to delivering the highest quality care Dr Barrett speaks from his personal

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GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST diagnostic investigations.” This collaborative approach meant that HGH was able to offer an ECMO service with immediate effect while a longer term and sustainable service model was implemented. Following a joint needs assessment, an intensive educational programme was also established to ensure optimal patient outcomes, incorporating standards of governance and protocols of care, set in accordance with agreed international best practice.

Investing in training

experience in exporting ECMO. “In 2013 we treated an extremely sick Qatari national which then led to a personal contact with one of the leading intensive care doctors in Qatar. At the same time we both began to recognise that MERS [Middle East Respiratory Syndrome coronavirus] – a particularly nasty virus – was on the horizon.” This concern led to a recognition that Qatar needed its own ECMO programme and in 2013 Guy’s and St Thomas’ formed a partnership with the intensive care units of Hamad Medical Corporation (HMC) to develop an ECMO service in the general ICU at Hamad General Hospital (HGH), Qatar. However, establishing a severe respiratory failure centre with the ability to provide ECMO was a significant undertaking in the Emirate – investment in equipment as well as staff training and exposure to clinical cases were all required. “We worked together with the team at HMC to develop a holistic programme of training. The programme involved theory, laboratory based practical sessions, simulation, onsite practical experience in London and team development all delivered in parallel with the logistical preparation for unit space arrangements, equipment selection and purchase. It was based around everything that we do well as a Trust. This includes good governance, education, practical sessions as well as onsite training. We also visited them for their first ECMO case and helped their clinicians, advising them on each case,” says Dr Barrett. “We then provided 24 hour advice to HMC for the management of patients as well as second opinions on key management decisions and

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Guy’s and St Thomas’ places great emphasis on the educational aspect of its partnerships, particularly in terms of developing specialist care requiring the highest levels of multidisciplinary education and training such as ECMO. “It’s easy to buy the very latest in equipment, but you’ve got to be prepared to invest in the education and training,” says Barrett. “We are always looking to improve the quality of care, so the potential for us to export our education and training as an offering is very high.” “As an ECMO service is embedded within an ICU there are also other substantial side effects when investing in an ECMO service,” Barrett continues. “It is not simply a standalone service. You must ensure that all of the ICU as a unit is maintained at the highest standards in terms of education, governance, training and clinical care delivery. Some hospital managers feel comfortable investing in doctors. But we believe it is critically important that the entire team – including doctors, nurses, perfusionists and physiotherapists – are all trained to the highest possible level to benefit the patient.” Following ECMO treatment on the first patient with severe respiratory failure in Qatar in mid2014 by the Hamad Medical Corporation (HMC) clinical team, continuous 24 hr advice from ECMO clinicians from Guy’s and St Thomas’ has enabled HMC to develop a self-sustaining service – recently rated as ‘excellent’ by ELSO, the Extra-Corporeal Life Support Organisation. HMC is now the first hospital system outside the USA to achieve Joint Commission International Academic Medical Centre accreditation for all its hospitals simultaneously and – with a collaborative partnership with Guy’s and St Thomas’ – is one of the few healthcare systems in the Middle East that can safely offer ECMO.

FURTHER INFORMATION

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Breath of fresh air

The Lane Fox Respiratory Service based at Guys & St. Thomasâ&#x20AC;&#x2122; Hospital in London treats the most complex patients with chronic respiratory failure says Professor Nicholas Hart, Clinical Director

he Lane Fox Respiratory Service is one of the oldest respiratory services in the UK. Based at St Thomasâ&#x20AC;&#x2122; Hospital, the service incorporates both the Clinical Unit as well as the Clinical Respiratory Physiology Research Centre. The purpose-built clinical service has a 34 inpatient weaning and home mechanical ventilation (HMV) capacity and currently has 1,700 patients on the HMV programme. Professor Hart and his team treat the most complex respiratory cases in the UK and their expertise is sought after throughout the world. The service investigates chronic respiratory failure resulting from a variety of causes including chronic obstructive pulmonary disease, neuromuscular disease, chest wall disease, spinal cord injury, brain injury and obesity. There is a successful weaning programme to liberate patients from invasive ventilation following

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GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST

critical illness. “Our main drive is to get people home, rather than keeping them in the hospital,” says Professor Hart.

Outreach programme The Lane Fox Respiratory Service was established in 1989 when the Lane Fox Respiratory Unit Patients Association (LFRUPA) raised £1m to develop and build the unit at St Thomas’ Hospital. Baroness Felicity Lane Fox, great aunt of Baroness Martha Lane Fox, and Ted Gates MBE with Dr Geoffrey Spencer OBE ensured that such a unit was built to support complex respiratory patients. Dr Spencer’s work laid the foundations of the Lane Fox Respiratory Service’s successful outreach programme, consisting of a home assessment clinic, critical care weaning, nursing home outreach network and paediatric to adult transitional care.

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PROFESSOR NICHOLAS HART Professor Hart was appointed in April 2012 as the Clinical Director of the Lane Fox Respiratory Service, which is an internationally recognised weaning, rehabilitation and home mechanical ventilation service. Since taking over as Head of Service, Professor Hart has increased the activity by the introduction of 7-day working, opening of the Lane Fox-REMEO Centre, re-structuring the outpatient clinics and increasing the acuity of the inpatient service, supported by the installation of a comprehensive electronic patient record and central monitoring system. The Lane Fox Respiratory Service is the largest ventilation, weaning and rehabilitation service in the UK with over 1700 patients on the home ventilation programme.

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The outreach team liaises closely with ICUs in other hospitals across the UK. Professor Hart is recognised as an expert in the field and regularly provides opinion when other units need independent advice on very complex cases. The Outreach Programme also supports an increasing number of tracheostomy-ventilated patients. Tracheostomy is where an artificial airway is created in the patient’s throat, bypassing the usual route through the mouth and vocal cords, and passing into the airways to ventilate the lungs. “We have more than 100 tracheostomyventilated patients in the community. Over half are very frail and cannot come to the hospital to have their tracheostomy changed, so we actually go into their homes to change the tracheostomy tube,” says Professor Hart. “The aim is to wean patients off the tracheostomy ventilator. Keeping a patient on a tracheostomy ventilator costs the NHS up to £1,400 per day, so by weaning them off within a few weeks not only significantly improves the patient’s health related quality of life, but also reduces the cost of their care. It is truly cost effective care.”

Technical support The service is well supported with six consultants and 52 nurses, as well as three paediatric neurology consultants, one

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cardiologist and two gastroenterology consultants, a urologist, a neurologist, a spinal surgeon, two anaesthetists, five physiotherapists, two occupational therapists, a dietician, a speech and language therapist and a rehabilitation consultant. There is also a substantial technical team, with six in-house technicians working around the clock on the equipment. “We have embedded research into the clinical service, as well as a PhD programme, so we have a high quality team,” says Professor Hart. “We provide 24-hour clinical and technical support, which is really important for this group of patients – the importance of this can’t be underestimated.” The unit also supports the hospital’s paediatric services with the Paediatric Home Mechanical Ventilation programme. “A lot of our early life patients have inherited genetic disorders or acquired brain injuries that require long-term tracheostomy ventilation,” says Professor Hart.

East Surrey Hospital in Redhill The Lane Fox REMEO Respiratory Centre is a new centre based on the East Surrey Hospital site. The result of a partnership between the Guy’s and St Thomas’s Trust and the Linde Group resulted in the development of the Lane Fox REMEO Respiratory Centre in Redhill, Surrey. This is a 20-bed weaning unit that

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GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST LANE FOX RESEARCH PROGRAMME The research vision, through the development of cost-effective treatments, is to enhance the long-term outcome of patients with chronic respiratory disease and post critical illness. Professor Hart has built the Lane Fox Clinical Respiratory Physiology Research Centre, which hosts a programme of translational physiological research: l Advanced physiological monitoring in acute illness programme to prevent inpatient deterioration and readmission l Clinical trials programme to improve outcome in chronic respiratory failure and sleep l Molecular mechanisms of skeletal muscle wasting in non-neuromuscular conditions programme l Rehabilitation programme to define and enhance long term outcome for patients post critical illness Professor Hart was appointed as Editor-in-Chief of Thorax in 2015 and he was awarded Kings College London

Professorial status in 2016. Thorax is the 3rd highest-ranking respiratory journal in the world with an impact

factor of 8.29. He is also the Director of Research Delivery for Guy’s & St Thomas’ NHS Foundation Trust.

opened in 2014. This public-private partnership directly benefits complex respiratory patients and their families by providing world-class respiratory care closer to home in a specifically designed environment. “It’s a new nursing-led medically supported model suitable for patients with low clinical acuity but high dependency,” says Professor Hart. “The consultants do ward rounds twice a week and the consultant will also consult via video conferencing with the senior registrar on site.”

patients with complex issues who wish to fly. Patients can be assessed and given specific advice with respect to any planned air travel. “More people are flying with complex conditions,” says Professor Hart. “So we see patients before they get on the aeroplane and we can make sure that the patient is optimised in terms of their respiratory function prior to departure. This could be anything from oxygen provision, suggesting seating position on the plane and any other issues that need to be addressed.”

Overseas partnerships

Post-polio syndrome programme

The Lane Fox Respiratory Service has been working with the Hamad Medical Corporation in Qatar, with the goal of developing a national model of care for weaning, rehabilitation, long term tracheostomy ventilation and HMV. “Our consultancy offers expert development of pathways and effective working practices whilst providing the tools for educating staff and also the carers who look after the most complex patients,” says Professor Hart. “We will share the protocols and guidelines we have developed to highlight how to wean patients from mechanical ventilation. This would be facilitated by using our state of the art video conferencing facilities”

Another innovation is the post-polio syndrome rehabilitation programme, which is the only one of its kind in the UK. Running three times a year, it provides a comprehensive service for patients suffering from the effects of poliomyelitis as well as post polio syndrome. Delivered with a strong educational focus, the programme aims to advise on the management of post-polio syndrome. It helps improve quality of life and offers coping strategies, establishing a bespoke exercise programme for each patient, and helps participants understand their symptoms, reducing the impact on day to day life.

Aeromedical clinics

FURTHER INFORMATION

The Lane Fox Respiratory Service has developed a monthly Aeromedical Clinic run by Professor David Gradwell who is also responsible for the postgraduate training in aviation medicine at King’s College London. Students are able to gain clinical training with

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Delivering a vision from start to finish

MJ Medical’s approach to healthcare planning ensures the aspirations communities and care providers have for their new hospitals are delivered, says Danny Gibson, Technical Director

stablished over 30 years ago, MJ Medical is a health planning consultancy like no other, working with public and private healthcare providers, investors, engineers, contractors and world-leading architects. Boasting extensive experience with more than 250 completed projects across 75 countries, the company possesses a unique ability to identify areas of strength or weakness within any healthcare development. It establishes efficient world-class services and facilities, adaptable to local healthcare needs over the course of a facility’s operational lifetime. “We can really help at any stage of a project, whether supporting our clients develop a design brief in the early phases or being pulled in towards the end to help commission the building and ensure it is fit to open,” says Danny Gibson, Technical Director at MJ Medical. “No matter the stage or level when we are engaged by a client, our immediate priority is to understand the overall

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vision for the project, so we are always seeing the bigger picture and delivering outputs that support the achievement of that vision”. Using a holistic analysis to determine the most appropriate type and size of space required – often a premium in any healthcare facility – is central to MJ Medical’s offering. “The health planner’s key task is to help the healthcare provider develop and realise the vision for their project. We do this by engaging with the provider, clinicians and local community to determine the services the hospital will provide and how it will deliver those services, and then developing a brief that translates those requirements into a hospital design. “This requires an approach that takes into account the demography and epidemiology of the local population, how the healthcare system currently delivers care and how that may change in the future, what changes in demand for healthcare are expected, and, following these,

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MJ MEDICAL

DANNY GIBSON With more than 20 years’ consultancy experience, Danny has advised on a wide range of healthcare projects across the UK, the Middle East and Africa. He helps clients navigate the often complex journey of developing a considered model of care to determining the most appropriate design. He has a keen passion for futureproofing healthcare systems and buildings, and enables them to respond to emerging trends in clinical best practice and medical technologies. Danny’s areas of expertise include facility master planning, activity analysis and modelling, design brief and business case development, operational policies and medical technology future scoping. Danny seeks to achieve design excellence, cost certainty and predictability of project delivery throughout the project lifecycle.

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Above left and right: Hampshire - Critical Treatment Hospital

what kind and size of healthcare facilities may be needed. We then act as champions of the brief through the design development process, ensuring that the building delivered at the end achieves the vision captured at the beginning.” MJ Medical’s service offering is split into three component parts – health service planning, health facility planning and equipment procurement. “We work extremely hard at integrating our systems and sharing knowledge across our teams,” says Danny. “This means that, even when we are engaged to deliver one discreet aspect of our service offering, our client benefits from our team’s knowledge of the other aspects. When developing initial design briefs, we are able to consider the inside knowledge gained from our procurement works of horizon technologies that have implications for future infrastructure requirements. When undertaking equipment planning and procurement, we naturally sense

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check clinical layouts and functional relationships. These additional inputs are not ‘priced-in’. They are a natural outcome of the expertise in our team, and a company culture and identity that is focused above all else on realising the highest possible quality outcome for the projects we work on”.

Aiding market entry MJ Medical has recently seen an upsurge in healthcare providers exploring and expanding into new markets in other parts of the world. This is a product of the continued growth in demand for all types of healthcare services, and an increasing desire for people in fast developing countries to be able to access high quality and complex services without the need to travel. “Many of our recent projects have involved helping a healthcare provider enter a market which is completely new to them,” says Danny. “This represents a unique set of challenges, not least in coordinating a client, design team, and project location across several different continents. The provider is attempting to introduce their brand and way of doing things into a new market. However, they also need to take into account local cultural factors and really understand patient’s expectations when developing their model of care. To complicate matters further, clinical staff may be recruited globally and have a completely different approach to delivering care. The healthcare provider will most likely be looking for internationally recognised accreditation - that again will have its own, and potentially conflicting, operational requirements”. “We have found that our experience of designing healthcare facilities around the world make us very capable at finding the points of compromise between these potentially conflicting approaches. We have a really good understanding of different models of care, and the varying design codes that are in use. We use this knowledge and experience to help our clients determine which combination of approaches will deliver the optimum solution”.

Below: Papworth Cardiothoracic Hospital Opposite: Midland Metropolitan Hospital, Birmingham

need to make it efficient and adaptable to future needs”. While lifetime costs may not be an immediate consideration compared to the initial capital expense, appropriate and effective planning at the early stages can help organisations avoid potentially costly mistakes. “In many ways adaptability as well as effective design boils down to one central theme when planning a safe and effective healthcare space – efficiency. “When making decisions about how a building is configured and what it contains, we encourage clients to consider the whole-life cost implications, rather than just the immediate capital cost. It is often the case that spending a little more capital initially generates significantly greater benefits in terms of running costs in the longer term”.

Digitalisation & hospital design The building design and construction industry has been transformed in recent years by the digitalisation of the design and construction management approach. Early recognition and incorporation of this trend has been key to MJ Medical’s success, as Danny, who started working for the company about 22 years ago, explains. “At the beginning MJ Medical was planning hospitals in GCC countries and Sub-Saharan Africa using more manual than electronic methods. I brought in a very different perspective. I knew we could, and we did, develop a healthcare planning system that could understand the cost and location of the component elements of the hospital at the earliest stages.”

Ensuring a useful and efficient lifespan From project inception to the doors opening, the process of designing and building a major healthcare facility can take 10 years or more. It then has a lifespan of at least 30 years. The pace of change in medical technology and clinical best practice means that, unless the right decisions are taken early on, you can end up very quickly with an obsolete building delivering care in an outdated way. “We invest a lot in research and development, working hard to stay at the forefront of how care is changing and what medical technologies are on the horizon,” says Danny. “We want a building to be delivering the same level of care in year 30 than it is in year one. In order to do that you

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MJ MEDICAL early briefing to detailed design stages is very powerful”, he says. “At the more detailed end, our BIM capability enables us to sit with clinicians and show them a three dimensional digital model, allowing them to view a room from different angles so they can help determine how it should be configured. We are even able to make live changes to the model to test different options, and these changes automatically update the data content of the other areas of the system”.

A shared vision

Danny began to create a healthcare planning system through the development of bespoke data management software. The resulting system has continued to evolve over time, accumulating innovative design data from each project MJ Medical works on. The system is able to analyse and report on size, content, and cost data on a ‘live’ basis at any point during the iterative design process. It has also responded to fundamental changes in the industry’s approach, becoming BIM compliant in the last few years. “Healthcare buildings are expensive to build and operate. Having a tool that gives us the ability to run accurate cost models from the

“Developing a shared vision at the outset across all stakeholders as to what is important for a new healthcare building is paramount for a successful project”, says Danny. “This might sound simplistic, but when you’re dealing with a wide perspective of stakeholders – the provider, clinicians, architects, patients – objectives and priorities differ and, at times, are competing. Everyone’s voice needs to be heard when you are establishing the project vision”. Developing a shared vision has been central to King’s College Hospital’s latest healthcare development project in Dubai – a new state-ofthe-art 100 bed hospital. Partnered with one of the UK’s oldest and most respected medical institutions, King’s College Hospital Dubai will see a significant proportion of its clinical staff – including all heads of department and 30 per cent of physicians – coming from King’s College Hospital London and its partner hospitals in the UK. MJ Medical is the lead health planner for the hospital, having advised one of the investment partners, Ashmore Group, from the start of the development process. Engagement with stakeholders – including all members of the workforce – is central to the project’s development. “While doctors and nurses as clinicians are vitally important, so too are those members of the workforce who are critical to the success of the hospital but remain largely behind the scenes. Making their experience part of the vision as well can add significant value to the outcome. “Furthermore, it’s important to get the community involved, by taking time to understand their needs and expectations and ensuring they stay informed. At the end of the day, a good hospital should not just be a transactional environment where people go to receive a service. It should play a central role in the community by supporting families through happy and difficult times, and providing security that someone will be there to help when you need it most. That, more than anything, makes ensuring they are as good as possible worthwhile.” FURTHER INFORMATION

Tel: +44187 222 6770 enquiries@mjmedical.com mjmedical.com

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THE ROYAL BUCKINGHAMSHIRE HOSPITAL

CHRIS CAMPBELL Chris has been the Director of Business Development for the Buckinghamshire Group since 2015. His responsibilities include business development for a wide range of group services from The Royal Buckinghamshire Hospital, Affinity Care Management and Affinity Training. This covers a wide array of areas from sales and lead generation, marketing and communications and oversight of all new business development projects. Chris has also led on many innovative international projects including a rehabilitation hospital development in Cairo Egypt and Care training programmes in the UAE.

Back to the future

The Royal Bucks’ reputation as a pioneering rehabilitation hospital is in great part due to its technical innovations, says Chris Campbell, Business Development Director at The Royal Buckinghamshire Hospital

he Royal Buckinghamshire Hospital is an independent rehabilitation centre with an international reputation for treating patients with spinal cord injury, acquired brain injury, stroke and other neurological conditions. Built in 1832, the hospital has a rich medical pedigree as the first civilian hospital in the UK and was designed by Florence Nightingale, the founder of modern nursing. Fast forward nearly three hundred years and The Royal Buckinghamshire Hospital now pioneers some of the most cutting edge rehabilitation technology in the world – sometimes before it is available on the market – and works with the NHS, private insurers, legal firms and private referrals. The hospital’s success as a pioneering rehabilitation centre depends on staying ahead of the game, both in discovering and trialling new products. “Our therapists actively seek out new methods and technology to create better ways to help improve rehabilitation therapies,

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such that companies now come to us with new products because they know we lead the field,” says Chris Campbell, Business Development Director. “When I find a product with potential for our patients, we work closely with the consultants, trialling it in different ways to see how our findings affect patient outcomes.” Patients at the Aylesbury site have access to three rehabilitation gymnasiums, a large hydrotherapy pool and 20 treatment and therapy rooms. Accommodation includes private bedrooms or self-catering apartments in the grounds that suit semi-independent living or allow the patients’ families to stay nearby. The hospital also has living rooms and gardens where patients can exercise, socialise and relax. As well as beneficial surroundings, Chris acknowledges how important it is for the patients to have a positive attitude. “Patients who benefit most are those who understand the innovative spirit of the hospital and are motivated to use all its technological

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THE ROYAL BUCKINGHAMSHIRE HOSPITAL support, returning quickly to their own homes whenever possible,” he says. “They need to feel they are continuously moving forwards, no matter how little those steps are. We do many things to help with this, including creating a video gallery of their journey - it’s easy for patients to feel disheartened when they do the same thing over and over again, and consequently they forget how far they have come.” Staff at The Royal Buckinghamshire Hospital are already gaining a reputation for challenging the equipment parameters and discovering unexpected results. They are currently working with MindMotionPRO, an immersive virtual reality rehabilitation solution designed for hospital use, and the Indigo exoskeleton, a powered lower

limb exoskeleton that allows people with spinal cord injuries to walk and participate in gait training. “We left the MindMotionPRO with our therapists for two months and they began to devise innovative ways to use it,” says Chris. “When the product’s developers were shown the therapists’ extraordinary results they were impressed, because they had spent two years studying the product and had not seen the same outcomes. So now they are bringing their intellectual knowledge with the technology, looking for a different perspective to achieve even better results. As a consequence, the Royal Bucks is now the exclusive development partner for this particular piece of equipment, and our outcomes and clinicians’ evidence supports and EXOSKELETON “Exoskeletons were originally developed for American soldiers so they could carry more and run further without getting too tired to fight. Eventually someone realised this was a negative use of the technology, so it began to be used for rehabilitation. The patient wears the Exo and uses it with assistance from the therapist. The exoskeleton is semi-intelligent so it notices when someone is becoming stronger than when they last used it. If so, it reduces the input it gives so that the weaker part of the body becomes stronger with less support. The latest version is called Indigo and is specifically designed so the patient drives it himself. It’s used for patients who have spinal injuries, strokes etc. If someone has enough core strength to shift or tilt their bodyweight they can effectively give the signals to drive the suit. When a stroke patient leans forward, the suit vibrates to let them know their movement has been registered. They lean forward again and the suit walks forward; they lean back, it stops. It can help the patient walk around corners, down slopes, up the stairs and it’s light enough to go in normal gym kit bags. So a paraplegic person in an aircraft can put it in the shelf above, pull it out, put it on themselves and get off the plane. It’s extraordinarily clever. What amazes me is how much progress has been made in a very short space of time. Moving forward two or three years, a paraplegic person will get up in the morning and think, ‘Right, what will I do today? Do I want to go on the wheelchair or do I want to put my legs on?’”

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THE ROYAL BUCKINGHAMSHIRE HOSPITAL helps to develop the product going forward.” The drive to find new ways to speed up the rehabilitation process is ingrained in The Royal Bucks. Directors and staff alike are clearly focused on improving patient outcomes, helping them deal with the emotional as well as the physical aspect of their situation. “Assisted technology is based on two things: patient benefit, both anecdotally and mentally, and turning it into proven measured outcomes,” says Campbell. “When a paraplegic person in a wheelchair wears an exoskeleton, it is not necessarily just about being able to stand up. Once upright, gravity takes effect which can improve bladder and bowel functions. They may also feel more confident because they can look other people in the eye, rather than being at a different height.” And it is not just about physical assistance. “One of the latest pieces of technology on the market is the Impulse 7, a magnetic room that is shielded from all the electromagnetic fields in lights, vacuum cleaners, televisions and many other products. Inside the room there is a huge electromagnet which effectively realigns all the electrical energy in the body. This has been found to help relieve the patient’s stress and anxiety, which can in turn speed up their ability to learn new skills.” Chris’s vision for the future is to create self-sufficient rehabilitation hubs, a onestop-shop facility with the hospital as its figurehead. Patients would be given ‘transitional rehabilitation’ using the latest groundbreaking MINDMOTIONPRO “MindMotionPRO from MindMaze is mainly used for people who have had strokes, but it can be used for all kinds of upper limb rehabilitation. When human beings develop there are certain things we do instinctively. For example, we don’t think about reaching for something and opening our hand; it’s just something we do. It’s all part of our central nervous system’s built-in DNA. When you try to rehabilitate somebody you aim to re-engage with these natural instincts, but it requires many repetitions. “Say you have had a stroke on the left side of your brain, meaning the right side of your body does not work. The MindMotionPRO puts a picture on the screen of your left hand working. Although this is what the patient sees, he is actually moving his right arm. The subconscious brain does not know the difference between fact and fiction, so it tries to get the right side of the body to work as it sees what is happening and it expects a reaction, but nothing happens. So then it finds other ways - like a satnav rerouting - to make the same part of the brain function again. “People get engaged with the MindMotionPRO because it’s like a computer game – they do not get fed up after 50 repetitions. They do it more often and can do it for longer, meaning it’s more effective.”

technology with no financially-constrained time limit, until potentially they could return to some form of independent living. In his view, this therapy would be more effective and the patients would be less likely to return to expensive acute care. “With a more flexible approach to rehabilitation, patients will find it easier to get better faster. Clearly this would improve their lives and also massively reduce the ongoing cost of care,” he says. “In addition you would have all the benefits of patients who are feeling better about themselves, who can reintegrate into the community and return to work. But no such mechanism exists at the moment, so my job is to bring the stakeholders together to create the environment for it to happen. “It’s unbelievable what we achieve here,” he continues. “What drives me is that I know we can actually deliver better services and better outcomes because we have been so successful. The NHS doesn’t always have the infrastructure and facilities to deliver what we do.”

FURTHER INFORMATION www.royalbucks.co.uk

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Dr Seshadri Vasan, Professor of Public Health and Public Health Englandâ&#x20AC;&#x2122;s Senior Business Development Manager, discusses Ebola, emergency response models and how to promote international collaboration

The Ebola Crisis a matter of life and death 72

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PUBLIC HEALTH ENGLAND IMAGE: SHUTTERSTOCK.COM

DR SESHADRI VASAN Dr Vasan is PHE’s Senior Business Development Manager and Honorary Visiting Professor at the University of York. A former McKinsey consultant, he previously worked as the Head of Public Health for Oxford University’s spin-out company Oxitec Limited. He is PHE’s business lead for Ebola-related activities, global health, innovation and international consultancy. Dr Vasan also represents PHE’s overseas commercial engagement in the UK InterLab Forum and is a member of the Filovirus Task Group of the Medical Counter-Measures Consortium. He is a Steering Committee member of BSL4ZNet and co-chairs its International Response Working Group. He obtained his doctorate from Trinity College, Oxford, and is a Fellow of the Royal Society of Medicine, Royal Entomological Society and Royal Society for Public Health.

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What was Public Health England’s role in the Ebola outbreak? Public Health England (PHE) has a domestic remit but a global role. The agency helped mobilise and train frontline staff, establish laboratories and strengthen safe working practices in the affected countries. Many of my colleagues won the Ebola Medal for their bravery and knowledge transfer to West Africa to combat the outbreak. However, PHE’s role should be seen in the larger context of the UK working with the UN, WHO and the wider international community to combat Ebola at the source in the affected African countries. Significant funds to provide direct support to help contain, control, treat and ultimately defeat Ebola have helped early recovery in these countries. The RCUK-PraxisUnico Impact Awards recognise the role of knowledge exchange and commercialisation (KEC) professionals in maximising research impact. We are honoured to have been chosen as the winner under ‘contribution to society’ from a list of equally deserving projects, in recognition of our KEC stewardship during the Ebola response. This involved phenomenal work for our team under intense pressure to develop systems, build new business relationships, write proposals, negotiate contracts, and troubleshoot issues. We were also featured as a cover story by the Science in Parliament magazine. Looking back at how Ebola was handled, what are the biggest lessons learnt? Ebola and other infectious diseases like it are global health challenges that require sustained, long-term investment and collaboration to strengthen emergency preparedness and response (EPR) in identified areas. The ideal response would be from enabled local experts who are able to stop it at the source. KEC professionals can greatly enhance the effectiveness of response by ensuring a robust, prompt and fair way to exchange knowledge between academia, industry and public bodies. Failure to achieve quick consensus is not an option during public health emergencies. Finally, we have limited Bio-Safety Level 4 (BSL4) capacity in the world therefore such laboratories should share information in near real-time to ensure an effective response. Can you elaborate on how BSL4 laboratories could collaborate better? We are trying to achieve this domestically through the UK InterLab Forum, and with our counterparts in Australia, Canada and USA through the Medical Counter-Measures Consortium and the recently-formed BSL4ZNet. For instance, current UK regulations on biosafety make us better suited to perform rapid downselection of pharmaceuticals, so that promising leads could be evaluated further elsewhere. When PHE down-selected pharmaceuticals

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PUBLIC HEALTH ENGLAND

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‘Ebola and other infectious diseases like it are global health challenges that require sustained, longterm investment and collaboration to strengthen emergency preparedness and response (EPR) in identified areas.’

PARTS OF THIS INTERVIEW WAS FIRST PUBLISHED BY RHODES SCHOLAR MAGAZINE © RHODES TRUST 2016

against Ebola with support from the Wellcome Trust, we successfully convinced developers, many of them private companies, to let us publish negative results because time is of the essence and we do not want another BSL4 laboratory to evaluate something that we know is unlikely to work against this pathogen. We have shared these clauses with our international partners and developed a fast track model agreement which is now available on the UK Intellectual Property Office website. Such templates can save time, and more importantly, lives. You mentioned enabling local experts to stop Ebola at the source. How is PHE working towards this long-term goal? The UK played a major role in Sierra Leone during the outbreak, including contributing regular cargo flights carrying UK aid. When the epidemic was no longer out of control, DFID funded PHE over £6 million to strengthen Sierra Leone’s laboratory diagnostic capacity and EPR capability, including training and skills transfer to local staff to maintain Resilient Zero for Ebola. I am also involved with another DFID grant to help strengthen EPR in Bengaluru and Chennai metropolitan regions of India. We hope this pilot can be converted into self-sustaining training opportunities for global cities and airport hubs in partnership with the BMJ. Has the Ebola experience influenced the way the Zika outbreak is being handled? In some ways. For instance, the WHO made its fourth declaration of ‘public health emergency of international concern’ promptly, even before the link between microcephaly and Zika virus was conclusive. In PHE, we have been reusing Ebola contract templates and the fast track model agreement so collaborative work can start within days. Ebola also set a good precedent where people and organisations, including the private sector, were willing to set aside their interests and come together for an effective global response.

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But the two are also different – Ebola needs BSL4 facilities but Zika work can now be performed under BSL2. Zika is Aedes mosquitoborne, therefore integrated vector control and entomological factors are more important, as is the now proven link to microcephaly. How did you get into public health? I have always been interested in public service and health, but I took my own path and time to get into public health service. After working for McKinsey, I returned to Oxford as visiting fellow and head of public health for its spin-out company Oxitec. In 2011, I joined the British government’s Health Protection Agency which became Public Health England through a merger with 128 other public bodies in 2013. Isn’t Oxitec in the news for Zika? What were you focused on when you worked there? Indeed – Oxitec’s genetically sterile mosquitoes are being considered in the Americas as part of integrated control of Aedes aegypti – one of the two mosquito species transmitting Chikungunya, Dengue, Yellow Fever and Zika. I was Oxitec’s head of public health from 2005 to 2011, and led the world’s first semi-field (and subsequently open-field) trials involving these mosquitoes, and the commercial foundations for translating this technology from laboratory to field. Besides Ebola and Zika, what are some of the other diseases we should be prepared for? Innovate UK’s latest priority list includes Ebola and Zika, as well as Chikungunya, CrimeanCongo Haemorrhagic Fever, Dengue, Hantavirus, Lassa, Marburg, Middle East Respiratory Syndrome, Nipah, Plague, Q Fever and Rift Valley Fever.

FURTHER INFORMATION www.gov.uk/phe www.bit.do/vasan

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Data protection in Qatar New data privacy law can enhance patient safety, data privacy and boost digital health in Qatar, say Anthony Fielding, Senior Associate/ Counsel and Donna Mayers, Senior Associate at Pinsent Masons

ata protection laws recently finalised in Qatar could serve to further strengthen patient safety and improve public and private healthcare service delivery. The legal changes will enable the growth of digital health products and services in the country. The Personal Data Privacy Protection Law published in the state’s legal gazette shortly and is expected to take effect six months after publication, with a period allowed for implementation of the requirements. By setting rules on how personal data can be collected, used and shared, Qatar has become a leading jurisdiction in the GCC in the area of data protection. The new law also represents a further step towards the implementation of Qatar’s 2030 Vision. Outside the Qatar Financial Centre, Qatar does not currently have a specific data protection law and has no specific laws or regulations relating to the protection, processing and sharing of health data. This new law will provide, for the first time, a comprehensive set of safeguards that defines the rights of individuals to decide what can be done with, and who may access, their data that has been collected. The new law will be vital to the implementation of Qatar’s National E-Health and Data Management Strategy – issued and approved last year following work done by the Supreme Council of Health, now the Ministry of Public Health (MOPH). The strategy includes a recommended legislative and regulatory framework for laws, policies and regulations in e-health and was prepared in anticipation of the new Personal Data Privacy Protection Law.

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There will need to be alignment between the new law and MOPH’s proposed framework for e-health and planned implementing policies, standards and requirements for protecting the rights of individuals in respect of their health data. This will include compliance with the Ministry’s requirements to secure informed patient consent to the use of data in areas including medical research and observance with the Patient’s Bill of Rights. As medical devices and e-health technologies and apps become more connected to one another and enable the collection and monitoring of health conditions, biometric data, results and mental health information, data privacy issues must be addressed. The provisions should therefore help address what is arguably a significant barrier to the adoption of digital health apps and services in the Middle East and beyond – a lack of consumer trust. Within the legislation, specific reference is

‘Processing health data without a permit could lead to a fine of up to QR5 million ($1.37m).’

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CONSULTANCY

PINSENT MASONS DONNA MAYERS Donna is an English Qualified Solicitor specialising in telecoms and technology matters. She has experience in advising clients in a broad range of sectors, including highly regulated industries such as financial services, telecommunications and healthcare. Prior to joining Pinsent Masons, Donna spent time working as an in-house legal advisor to a telecommunications company in Qatar and a specialist software development company in the UK. Donna is based in Pinsent Masons’ Doha office and has worked in Qatar for over four years.

ANTHONY FIELDING

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given to personal data of a special nature, which includes data relating to someone’s physical or mental health. To comply with the new law, organisations will need to obtain a permit from an administrative unit within the Ministry of Transport and Communications to process health data. The law provides for the Qatari minister for transport and communications to outline the “measures and rules” to define the permit process. Processing health data without a permit could lead to a fine of up to QR5 million (US$1.37m). In addition, the law also provides for the Qatari minister for transport and communications to “impose further safeguards in relation to the protection of personal data of a special nature” in a future resolution. We can therefore expect future subsidiary legislation to outline more defined parameters on the handling and processing of health data. Absent such additional rules, the handling of health data will be governed by the broad rules within the new legislation that apply to all types of personal data. Obligations include keeping the information secure, explaining to consumers what they intend to do with their data, enabling data subjects’ access to their data, and correcting inaccuracies. Breaching the data security obligations when handling health data could trigger a fine of up to QR5m (US$1.37m).

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Tony is a specialist TMT lawyer with over 15 years’ experience of working with telecommunications, technology and media clients in Asia Pacific. His commercial expertise covers IT and outsourcing transactions, network applications and services, emerging technologies and their related licensing; reseller and other distribution arrangements and complex negotiations with international suppliers and buyers of hardware, software and integrated technology platforms. Tony also advises on regulatory issues relevant to his clients including, most recently, data protection & privacy, big data, cloud services, gambling and M2M platforms.

Organisations must also carry out privacy reviews before commencing new data processing activities, and establish complaintshandling procedures and processes for managing data breaches. In addition, to process personal data in line with the new law, organisations will generally require individuals’ consent, unless such processing is necessary to achieve a legitimate purpose for the data controller or a third party to whom the data is sent. It is not clear from the legislation what intended uses for health data would be considered a ‘legitimate purpose’, overriding the requirements for consent. Breaches of the consent requirements or other rules relevant to health data processing could result in fines of up to QR1m (US$275,000). Specifically protecting sensitive information together with significant penalties for a breach will facilitate trust, confidence, investment, collaboration and development in the healthcare sector and ultimately do what is needed: protect the personal information and privacy of individuals like never before in Qatar.

FURTHER INFORMATION

www.pinsentmasons.com bit.ly/freedomtosucceed

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With the value of the healthcare market in the Gulf states projected at around US$144bn by 2020, the future for the healthcare sector in the region remains positive, says Alison Hubbard, Partner at Pinsent Masons

Healthy outlook

egional governments in the GCC are continuing to prioritise healthcare spending as a major component of their social contracts. Changes in demographics and life expectancy have led to increased utilisation of health services for age-related illnesses. In addition, the prevalence of chronic lifestyle diseases in the GCC is forcing regional governments to focus on health prevention, chronic disease management and early stage intervention. Currently government spending accounts for 65-80 per cent of total healthcare expenditure. However greater private sector involvement is required to manage the funding gap resulting from previous falling oil prices and increasing costs. Another trend is the priority GCC governments are giving to the implementation of international standards, which supports the drive by regional governments to promote medical tourism. Meanwhile mandatory health insurance regimes have been introduced to shift some of the burden of healthcare spending on to the private sector; most GCC counties will have mandatory health insurance by 2020.

Opportunities Alternative models of primary care are needed to provide patient-centred care and to serve as a gatekeeper of the healthcare delivery system. This could potentially include retail care solutions; integrated networks combining treatment with technology to manage health and

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wellness on a large scale; integration of primary and secondary healthcare through telehealth services; establishment of patients communities and forums, early detection devices and innovative preventative services. In addition, Specialist Centres of Excellence will improve the quality of care, reduce health spending, attract medical tourism and attract and retain specialist healthcare practitioners. Home healthcare services are being increased as a more cost effective, convenient care model,

â&#x20AC;&#x2DC;As elsewhere in the world, shortage of beds is a core issue, particularly in long term care, post acute care and rehabilitation facilities.â&#x20AC;&#x2122;

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CONSULTANCY

PINSENT MASONS

ALISON HUBBARD Alison is a Partner in the Corporate Group based in Pinsent Masons Dubai Office. Alison has been working in the Middle East region since 2006, focusing predominantly on cross border M&A, joint ventures and structuring for international clients, including many of those listed on the world’s key bourses. A member of Pinsent Masons’ Global Healthcare Team and a Middle East Healthcare Leader, Alison regularly advises clients operating in the healthcare sector in the region.

Pinsent Masons Global Healthcare Team are experts in healthcare projects including: Structuring Development and operation of healthcare facilities l All forms of partnering, collaboration and joint ventures l Investment and route-to-market l Life sciences l Intellectual property l Data privacy l Protection and commercialisation l Digital and e-health l l

healthcare practitioners results in an overreliance on expatriates which the regional governments are seeking to address.

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and useful for those living in remote areas with limited access to quality care. As elsewhere in the world, shortage of beds is a core issue, particularly in long term care, post acute care and rehabilitation facilities. The current practice of providing long term care and post acute care in acute treatment environments has resulted in a shortage of beds for genuine acute cases, and increased costs as a result of treatment of non-acute cases in an acute hospital setting. Other opportunities include biotechonologybased pharmaceutical products – various GCC countries provide biotech platforms and incubator programmes, such as DuBiotech in Dubai. Given the synergies with the petrochemical industries, lower manufacturing costs and government regulations mandating that international standards are met by manufacturers, there are various opportunities around medical disposables. Similarly, healthcare education and training is a growing area as the lack of local skilled

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With the pressure increasing on government budgets, investors and market participants are in turn under pressure to come up with innovative funding solutions. Ensuring robust legal frameworks are in place around the funding model will be crucial. While many regional governments have taken steps to streamline market entry, barriers to market remain, including local participation rules, complex licensing regimes, cost and timescales. The less developed R&D environments of the GCC are not necessarily conducive to the innovative thinking required for solution-driven healthcare models. The protection of knowhow and IP in an environment with limited legislation and a less responsive means of enforcement needs careful planning, both legally and practically. The business of healthcare is global and less developed regulatory frameworks can create uncertainty around operational and product liability. With a global network of offices Pinsent Masons can help maximise the opportunities and meet the challenges wherever they arise. FURTHER INFORMATION

www.pinsentmasons.com bit.ly/freedomtosucceed

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Innovating in the Life Sciences sector Bringing a product to market in the life sciences sector can be challenging, whether a small molecule pharmaceutical, a biotechnology therapy or a medical device, say Adrian Murray, Partner (Patent Attorney, Patent Attorney Litigator) and Clare Tunstall Global Head of Life Sciences Partners at Pinsent Masons

he future of healthcare globally lies in the adaptation of technology to facilitate diagnosis and ongoing care. Many of the applications making their way into the sector are coming from the private sector, often via patients or doctors who have developed unique and simple methods to transmit information. For many of these innovators, legal advice is key to ensuring that their patent is protected and the development of their product is protected. In the commercial sector, large companies require specific and complex legal advice in the development and distribution of a new product globally. Competition law is one area that is important to consider in this field, as are research and development and collaboration agreements.

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At the inception of any project, an IP strategy will be required to both ensure that robust protection is secured to maximise return on investment and also ensure that competitorsâ&#x20AC;&#x2122; IP rights are successfully navigated. Additionally, collaborations will likely need to be formalised, for example with technical collaborators, contract research organisations, investors and product suppliers. Once the project is up and running, in many cases, a regulatory strategy must be developed to ensure that commercialisation of the product is not held up due to delays in obtaining the necessary approvals to bring the product to market. Additionally, in many cases, clinical trials will be required and there are significant regulatory and compliance issues associated with these.

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CONSULTANCY

PINSENT MASONS

ADRIAN MURRAY Adrian is a highly regarded UK and European Patent Attorney who specialises in assisting clients develop and implement litigation strategy across Europe. He has considerable experience in handling opposition work before the European Patent Office; a contentious procedure with many similarities to the UPC system. As a precursor to such actions, Adrian also routinely provides freedom to operate advice to companies, predominantly in the life sciences sector.

CLARE TUNSTALL Clare is a patent and life sciences specialist, with almost 20 years’ experience of acting for Life Sciences clients on multi-jurisdictional patent actions. Many of Clare’s cases have been precedent-setting, reflecting her approach of challenging legal boundaries where necessary to achieve clients’ commercial goals. Clare is recognised across the industry for having exceptional experience of opening up markets for pharmaceutical products by successfully challenging patent barriers.

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As a product nears approval, its developer may wish to partner with another entity to facilitate commercialisation of the technology, and it is critical to ensure that the effort of the developer of the product is fairly rewarded in any such transaction or collaboration. Additionally, IP rights that could potentially block launch of the product may be identified which may be dealt with via a licensing arrangement, or failing that through a patent challenge against the right, to ‘clear the way’ for the product launch. Regardless of the hurdles faced in the development of a product, Pinsent Masons’ international team of over 70 specialist life sciences lawyers (including many with technically relevant backgrounds) will be well placed to assist through all stages of the product

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lifecycle - from investment for early stage R&D and technology transfer through to market entry and beyond. Examples of the work we have done in the field include: 1A dvising a major pharmaceutical company on its pan-EU litigation strategy for first and alone market access for a highly valuable, respiratory product. In addition to successfully handling the UK litigation, the team supported local counsel across 16 jurisdictions, achieving a 100 success rate in all countries in which the case has been heard to date. 2 Assisting a multinational medical devices company in negotiating a number of research and development and collaboration agreements with a range of commercial and academic research institutions. 3 Regularly advising a multinational life sciences company on competition law issues such as the intersection between IP and competition law, distribution arrangements and the competition issues arising in managing the supply and distribution chain, as well as merger control. Many of the projects will bring life-changing solutions to populations globally, and once the legal requirements are in place this will assist products to reach markets across the world more quickly. FURTHER INFORMATION

www.pinsentmasons.com bit.ly/freedomtosucceed

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Accessible cancer expertise 82

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UKIHMA

THE CHRISTIE

An unparalleled combination of clinical and technical experts, along with pioneering research makes The Christie a leader in cancer care, says Professor Chris Harrison National Clinical Director for Cancer and Medical Director at The Christie The Christie International offers a range of specialist cancer consultancy in the following areas: l Strategic consultancy l Radiotherapy and chemotherapy service design l Education and training l Second opinion consultancy service l Quality review

rom its establishment in the early 1890s to the present day, The Christie is renowned as a world pioneer in cancer care, treatment, research and education. Based in Manchester in the North West of England, we are Europeâ&#x20AC;&#x2122;s largest single site cancer centre and the first UK centre to be officially accredited by the Organisation of European Cancer Institutes as a Comprehensive Cancer Centre. The national health watchdog The Care Quality Commission (CQC) has rated The Christie as Outstanding, the highest accolade possible, meaning that the treatment and care we provide is among the very best in the country. We have also been named as the worldâ&#x20AC;&#x2122;s most technologically advanced cancer centre outside North America due to our advances in radiotherapy, proton beam therapy, brachytherapy, chemotherapy, robotic surgery, advanced imaging techniques, and our integrated clinical trials unit. We are passionate about the ways in which cancer care can be advanced, leading to real improvements in clinical outcomes and patient experience; this is evidenced by our leadership in the creation of the National Cancer Strategy for England. Our vision is to be the partner of choice for specialist cancer advice to health sectors across the world, adding value by delivering innovative solutions, both for large scale planning and for operational service delivery. Utilising the expert knowledge and

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experience of our specialists we can ensure that our clients deliver excellence in cancer care to their patients. Here at The Christie, we are extremely proud of our heritage in leading the way in cancer care. Our outcomes evidence the impact we have had, not only in clinical care but also in patient experience and it is this unique expertise that we offer through our consultancy.

We continue to remain at the forefront of improvements and developments in cancer care. We are part of the recently formed National Cancer Vanguard which is an NHS England established partnership. The Vanguard will review the entire cancer pathway and aims to improve clinical outcomes and patient experience from health promotion and diagnosis, right through to end of life care. As part of the National Health Service (NHS) The Christie is one of only two dedicated cancer centres in the UK. We are proud to provide treatment at one of the largest radiotherapy services internationally with the full range of specialist technology. We run the UK’s largest chemotherapy unit at our main hospital site and also deliver care at seven other hospitals as well as through our mobile chemotherapy unit and in patients’ homes. We are also a national leader in the provision of highly specialist surgery for complex and rare cancers.

Why choose The Christie?

We care, we discover, we teach

The Christie provides an unparalleled combination of clinical and technical experts with a wealth of experience in their fields and extensive analytical tools, specialist capability, and award winning knowledge. We offer specialist cancer consultancy ranging from undertaking a complete assessment of our clients service requirements, through to provision of specific advice on service developments, implementation and quality control. Our portfolio of services is diverse and tailored to our clients’ specific needs. What makes The Christie stand out from other consultancy providers is the difference we make to clinical outcomes and patient experience.

The Christie not only provides excellent clinical services but we are internationally renowned for our innovations in clinical research. Our research portfolio includes a wide range of treatment trials across all phases and non-treatment trials. We undertake leading edge research with over 630 clinical trials being undertaken each year. In partnership with The University of Manchester we have also had a number of developments: The National Institute for Health Research announced a £28.5m investment in Manchester under its Biomedical Research Centre (BRC) scheme, Cancer Research UK announced an investment of around £39m over the next five

PROFESSOR CHRIS HARRISON Professor Chris Harrison is the medical director at The Christie. With a prestigious career spanning a number of decades he has been involved in numerous national and international committees relating to cancer care, quality of care and standards of clinical practice.

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THE CHRISTIE

years for the Cancer Research UK Manchester Centre to support â&#x20AC;&#x2DC;major centreâ&#x20AC;&#x2122; research in partnership with The Christie and The University of Manchester. The grant will fund groundbreaking work in personalised medicine, advanced radiotherapy, and early detection as part of the development of a unique chain of cutting-edge research hubs around the UK focusing on translational research. The Christie has the only dedicated School of Oncology in the UK, established to promote specialist training and education. We provide internationally accredited courses and skills based training, enabling clinical staff to practice to the highest standard. We are passionate about providing the highest quality of care for patients, and it is this dedication and commitment to cancer care that makes us the consultancy provider of choice for our clients.

The Christie consultancy The Christie is renowned not only for providing excellence in clinical care, but also for being leaders in developing new cancer services. Drawing on over a century of leadership in planning, establishing and reviewing cancer

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THE CHRISTIE

‘What makes The Christie stand out from other consultancy providers is the difference we make to clinical outcomes and patient experience.‘

care provision, we have extensive experience of developing innovative operational solutions, producing national and regional cancer strategies, advising the UK Government on all aspects of radiotherapy provision and developing quality mark accreditation to ensure services are being delivered safely and effectively. It is with this expertise that we guide our clients on how to transform services in order to improve efficiency and patient outcomes, as well as attract more patients. Using scientific methods and analytical tools, our consultancy team assists our clients to understand their population and service needs whilst identifying gaps in services and assessing the key issues. The services The Christie International offers are:

Strategic consultancy Based on a well-established methodology, The Christie provides solutions aimed at assessing, delivering and reviewing the clients’ requirements. Accessing any part of this provision places our clients in the strongest position to deliver

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world class cancer services for their patients, significantly improving the patient and customer experience. Initially the team will assess the services that are required and if needed will carry out a gap analysis and capacity and demand review. This will be followed by strategy and policy development which will ensure the client has a clear direction.

Radiotherapy As a world leader in radiotherapy services, The Christie specialists provide a comprehensive assessment of requirements including capacity and demand, design and build of facilities, procurement and commissioning of equipment, training and education of staff and effective use of existing technology. We also provide detailed advice in more specialist aspects of radiotherapy including proton beam therapy for the treatment of certain types of tumour, and brachytherapy which is highly effective for patients with gynaecological, prostate, skin and intraluminal cancers.

Chemotherapy Success in cancer care diagnosis means that many more people are being identified and are commencing lifesaving chemotherapy treatment than ever before. As national leaders in developing innovations in medicines optimisation, The Christie team has a wealth of experience in designing and delivering innovative ways of providing this care. To meet this increasing demand for cancer drug therapies, The Christie’s pharmacy team can support in delivering the most clinically optimal and cost effective drug regimes for their clients’ patients.

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THE CHRISTIE

Education and training The Christie has the only dedicated School of Oncology in the UK. We are therefore uniquely placed to address our clientsâ&#x20AC;&#x2122; need for high quality and effective education and training. The School of Oncology provides a highly successful international programme of learning modules and has access to a complete range of professionals, with the knowledge and skills necessary to develop and deliver world class cancer services. These include medical, nursing, radiography and radiotherapy staff, medical physics and biological scientists, specialist pharmacists, physio and occupational therapists, as well as the complete range of service and performance managers essential to commission, develop and deliver effective and efficient services.

Second opinion consultancy service The Christie consultant team use their skills and expertise to provide support to international partners to help confirm a diagnosis and treatment plan, or recommend additional treatment options. This service is an excellent option for clinicians who want to offer their patients all possible options for care.

Regular audits to ensure quality of service provision Once the client is satisfied that the new developments have been successfully delivered and are embedded into business as usual, the

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team is able to offer assurance that those high standards which have been implemented are maintained through a comprehensive audit and review process. The Christie has developed a highly respected approach to quality assurance known as The Christie Quality Mark. The core elements of success in providing quality assurance have been identified and can be used by client organisations to establish consistent and auditable processes. The aim of the Quality Mark is to ensure that patients are fully assured that the standards and quality of care they receive are consistent irrespective of where their care is delivered. The Christie has a number of key strategic partnerships with academia and industry and is a founder member of the United Kingdom International Healthcare Management Association (UKIHMA) which is a strategic partner of Healthcare UK.

FURTHER INFORMATION

If you would like any further information on any of The Christie Internationalâ&#x20AC;&#x2122;s consultancy packages, please contact our International Business Development team at: International@christie.nhs.uk and we will respond to your request. www.christie.nhs.uk/international

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Modern hospital buildings should be part of the of the solution rather than the problem, says Richard Cantlay, Global Head for Healthcare Buildings at Mott MacDonald

Building healthcare for the future R ight across the globe, healthcare provision and the challenges associated with it sit high on the political agenda. Many factors contribute to failure or success in the prevention, treatment and management of illness, disease, infirmity and disability. But having the right infrastructure and buildings is most certainly a big factor. Whether it is improving access to healthcare in developing countries, or reacting to new clinical practice and technology in developed countries, the effects are felt in the healthcare estate, which can either hinder or help the change. As a proportion of global healthcare spend, investment needed in healthcare buildings is small. But in the context of the construction market, the level of investment is enormous. The investment absolutely has to deliver good value for money. The best measure: faster, better clinical outcomes.

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The construction industryâ&#x20AC;&#x2122;s role is to create environments where doctors and nurses can achieve uncompromised clinical excellence, and where the most important people in this process â&#x20AC;&#x201C; individuals, families and communities â&#x20AC;&#x201C; get healthier, quicker. Looking ahead, the healthcare sector faces some fundamental questions that will need the combined attention of many different problem solvers. For example, how does society build hospitals today that will keep pace with the rapid rate of change in medicine, society and technology? How can estates change the fabric and layout of facilities to make patients feel more comfortable, and so aid their recovery? How can government departments target better use of technology and primary care to meet the growing needs of an aging population? How do economies pay for the necessary improvements, against a climate of financial uncertainty?

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UKIHMA

MOTT MACDONALD

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RICHARD CANTLAY Richard is Mott MacDonald’s Global Head of Healthcare Buildings. He has spent the past 16 years delivering healthcare projects including primary care, mental health, elderly care and acute services. This experience has involved various forms of procurement and contracting including traditional, design & build and PPP. Much of Richard’s experience has been on revenue funded projects (PFI/PPP) as Technical Adviser to the procuring body –leading large teams comprising PPP procurement specialists, healthcare planners, architects, engineers, cost consultants, FM advisers and related specialists. He is experienced in all stages of healthcare projects from early OBC stage through to the operational period.

Addressing these challenges is vital for the future of healthcare in developed and developing countries alike. Converting our solutions into adaptive facilities, connected systems, more accessible care, properly supported clinicians and healthier lives is how we can all make a difference. They are challenges we all relish and are working to resolve.

Trends in emerging countries There is a real effort to match care with health needs, dependent on the burden of disease. Buildings are part of the solution. There is an emphasis on creating buildings that aid day cases – getting patients in and out quickly. Technology is key for this evolution. We are seeing an increase in mobile health clinics. The wide prevalence of smartphones in Africa is also

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encouraging people to take control of their own health. Apps for fitness tracking and antenatal care, as well as smart messaging are already making a big difference. Many hospitals are now able to show patients how to hold their records on their phone and in the cloud, rather than a central database in the hospital itself. In South Africa, they struggle with huge problems of overcrowding. Often, people start queuing at 4am for repeat prescriptions of HIV or diabetes pills. Now they can directly text the manufacturers, who are creating depots in townships where patients simply present a barcode. Another example is in Sri Lanka, where subscribers are now able to measure their blood pressure and heart rate so doctors can diagnose problems digitally and remotely. Certain clinics are linked to Harvard University, so patients are able to get a consultation in the States via video link-up. Mott MacDonald is going to be working

Healthcare by numbers

95,000

Beds by 2023

£9.5bn

Private investment

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UKIHMA

MOTT MACDONALD CASE STUDY HEALTHCARE INFRASTRUCTURE Project: Health PPP Location: Turkey Client: International lenders and development banks Expertise: Lenders’ Technical Advisory (LTA), providing due diligence

Opportunity The Turkish Ministry of Health is building some of the world’s largest hospitals to meet increasing healthcare demands as a result of a fast-growing population. The programme will renovate healthcare infrastructure throughout Turkey, bring together smaller hospitals under 38 integrated health campuses, and increase the quality and efficiency of the health service. The key challenge of these projects was liaising with the Ministry of Health and sponsors in a country new to PPP projects, to arrive at a contractual agreement (in particular, the service specifications and payment mechanism) that was in line with international PPP best practice for risk allocation, and therefore bankable for the international lenders. Solution Our infrastructure finance, investment transaction and health specialists from the UK collaborated closely with

our team on the ground in Istanbul and really went the extra mile to meet every client’s expectations for faceto-face support. We worked with the Ministry, sponsors and their advisors to develop a commercial solution where the risk profile would be acceptable to the lending community. We advised sponsors on their environmental and social due diligence, which was essential to meet the standards, public disclosure and consultation requirements of lenders such as the International Finance Corporation, the European Bank for Reconstruction & Development and the Overseas Private Investment Corporation.

Outcome We have been instrumental in assisting sponsors and the Ministry of Health to

move forward towards a commercial solution that will meet the expectations of international and Turkish lenders alike. To date, six of our 12 projects have successfully reached financial close. In 2015, building began on the Bilkent Integrated Healthcare Campus, the world’s largest greenfield healthcare scheme covering over 1.2M sq m, providing 3804 beds and parking for 7209 vehicles. It will include over 100 operating theatres and is expected to treat around 35,000 patients per day and employ approximately 8000 staff. Early in 2016, the Etlik Integrated Healthcare Campus, also one of the world’s largest hospitals with 3577 beds across more than 1M sq m, received the green light for construction to start.

on the Fleming Fund, an initiative by the UK Department of Health to help tackle the global problem of antimicrobial resistance in low- and middle-income countries. The threat of bugs developing resistances to drugs is well known, but not enough is yet being done. Drug resistant infections could kill an extra 10 milllion people across the world every year by 2050 if they are not tackled. We’re already seeing resistance to strains of tuberculosis and malaria. Sadly, there has been misuse for a long time, bringing real difficulties to overcome. Of course, it’s not just in human medicine, but also veterinary, with farmers throwing sack loads of antibiotics into fish farms or injecting all their cows, whether sick or not. We’ll be helping to plan laboratories and upgrade data, working with medical and veterinary staff in the UK and abroad to promote a holistic approach and provide appropriate training, lab work and epidemiology.

Healthy buildings In recent years, we have seen a growing realisation among healthcare providers that although a building won’t cure you, it could

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contribute to the healing process. Or, at least, the building should not hinder the healing process. If weâ&#x20AC;&#x2122;re being honest, then thatâ&#x20AC;&#x2122;s where weâ&#x20AC;&#x2122;re starting from: buildings should not get in the way of recovery. Healthcare trusts are understandably keen to improve their environments, whether it is air quality, access to daylight or setting temperatures and artificial lighting that suits both patients and clinicians. But they also have other factors to consider, most notably energy

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efficiency. 40 per cent of energy production in the European Union is directed to the building sector. It is little wonder that energy efficiency is therefore the primary focus of regulators and voluntary schemes in healthcare facilities. The upshot of concentrating on energy efficiency is increased air tightness: eliminating leakiness reduces heat loss and improves energy efficiency, which again is a good thing. However, it also means that any air pollutants coming into the building or generated inside the building have less chance of escaping. With attention so fixed on vehicle pollution it may surprise you that in hospitals the most likely source of pollutants is the chemicals that occur throughout surgery rooms, operating theatres, and laboratories. In this indoor environment, even everyday disinfectants such as rubbing alcohol can react with other chemicals inside the building to produce gases such as ozone, a common component in smog. Tests find the same compounds inside the building as you would in an outdoor traffic environment. Indeed, recent studies have shown that healthcare workers reported more indoor-related symptoms than people working in office buildings. The fabric of buildings themselves, and their fittings and furnishings, are another major source of compounds that can make us ill. Designing and specifying healthier buildings is still a niche skill, and more prevalent in the office sector than healthcare, at the moment. There is an increasing number of office owners who are determined to protect the wellbeing (and productivity) of their staff by minimising the use

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UKIHMA

MOTT MACDONALD

CASE STUDY INTEGRATED DESIGN Project: Eastern Oncology Medical Centre Location: Hong Kong Client: Hong Kong Sanatorium & Hospital Expertise: MEP Design service Opportunity The Hong Kong Sanatorium & Hospital Group is the flagship private hospital operator in Hong Kong. Their main healthcare campus is situated at Happy Valley where the existing site is insufficient for expansion of their cancer treatment facilities. The key requirement is to design and construct a new 18 storey hospital at a new site on the eastern side of Hong Kong

incorporating the “State of Art” Proton Therapy System in Hong Kong. Solution We are working closely with the equipment vendor to understand the facility requirements for this new emerging medical equipment which has resulted in the design of a 4 level basement, due to the constraints of

CASE STUDY HEALTH FINANCING

Outcome We continue to work seamlessly with other members of the international design team, the vendor and customer to deliver the first Proton Therapy facility in Hong Kong.

of construction materials that contain potentially harmful chemicals. The challenge for designers is finding healthier materials, and then verifying these new products have been used in construction, with no substitutions made. It asks for a totally new tactical approach, backed by education of suppliers. But the more projects that ask these questions, the less they become a novelty and the quicker the markets will emerge. If you buy a bottle of shampoo in the EU, all the ingredients are listed on it. But not so in construction materials. Like a parent of an asthmatic child, who will be acutely aware of finishes and textiles, designers will need to act like ‘mom’ for their clients in the building process. In a recent office fit-out project, we developed a list of more than 300 products, with an assured ingredients list for each.

Project: Scottish NPD Model and investment programme Location: UK Client: Scottish Futures Trust and various NHS Boards Expertise: Technical Advisory; Procurement; PPP Models The Scottish Government wished to design a new Public Private Partnership (PPP) model to develop a pipeline of hospitals, schools and other facilities across Scotland. Our role was to assist them in developing a model which addressed the perceived weaknesses in the previous PPP models used and provide a more efficient and effective model for their investment pipeline. We worked collaboratively alongside the Scottish Futures Trust and their legal and financial advisers to develop the new NPD (Non Profit Distributing) model. Our focus on the technical and technical commercial issues involved developing the areas of the Project Agreement and the supporting technical schedules (output specifications, payment mechanism and energy provisions) to provide the overall commercial risk balance agreed at the outset. We have been appointed as technical advisers to the NHS

the site and the building footprint. A key issue will be avoiding radioactive leakage through MEP duct penetrations on the shielding wall of the proton radiotherapy facility. We are adopting BIM for coordination of MEP services duct routing and penetrations such that no radioactive leakage path will exist. To achieve Gold rating in energy certification, we are designing energy efficient features including a chilled ceiling system, heat wheel/ heat pipe for energy reclaim, photovoltaic panels, and a high efficiency lighting system.

No perfect solutions Boards on the first four Scottish healthcare projects that adopted this model with projects ranging in size from £50m to £200m. These projects are currently either nearing the end of construction or in operational stage. This new NPD model has been used to finance and deliver a large pipeline of public infrastructure, including 7 hospitals that have been delivered faster and on an improved value for money basis. Across the UK and worldwide, there is growing interest in the model of healthcare finance.

Designing with human-friendly materials and avoiding volatile compounds as far as practical in facilities management and clinical treatments helps solve the dichotomy of opposing outcomes for energy efficiency and air quality. This is a complex area, and demonstrating quantitative metrics is hard. But when you consider the office environment, there’s an obvious business case for proactively safeguarding employee health: greater alertness, improved wellbeing, less absenteeism. In the life or death situations of healthcare, a positive indoor environment that affects productivity and improves performance also makes a lot of sense. FURTHER INFORMATION www.mottmac.com

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Heartfelt care Innovation and research are the cornerstones of the Royal Brompton and Harefield NHS Foundation Trustâ&#x20AC;&#x2122;s expertise, says David Shrimpton, Managing Director Private Patients

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UKIHMA

RB&HH SPECIALIST CARE

DAVID SHRIMPTON David Shrimpton has been leading RB&HH Specialist Care for the Trust since May 2008. In his eight years of tenure, David has grown the Specialist Care department into a truly international offering, which now cares for patients from the Middle East, Russia, China and further abroad. In this time the revenue generated by the division has more than doubled, delivering important funding for the Trust, whilst providing international patients access to world leading heart and lung care.

oyal Brompton & Harefield NHS Foundation Trust is the largest specialist heart and lung centre in the UK and among the largest in Europe. The Trust is a partnership of two specialist hospitals – Royal Brompton in Chelsea, West London, and Harefield, near Uxbridge – which are known throughout the world for their expertise, standard of care and research success. Additionally, in 2016, the Trust also opened its first dedicated private outpatient and diagnostic facility at 77 Wimpole Street, in the Harley Street Medical Area, making it the first NHS specialist trust to open a facility here. As a specialist trust, we provide treatment for people with heart and lung disease. This means our doctors, nurses and other healthcare staff are experts in their chosen field and can develop their skills even further. We carry out some of the most complicated surgery and offer some of the most sophisticated treatment that is available anywhere in the world. We treat patients from all over the UK and other countries. 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 their 90s. Over the years our experts have been responsible for several major medical breakthroughs – performing the first successful heart and lung transplant in Britain, implanting the first coronary stent, founding the largest centre for cystic fibrosis in the UK, and pioneering intricate heart surgery for newborn infants. We are the leading UK provider of respiratory care and are national leaders in the specialist areas of paediatric cardiorespiratory care, congenital heart disease and cystic fibrosis. Our patients are supported by adult intensive care units at both hospitals and a dedicated paediatric intensive care unit at Royal Brompton.

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International partners

Lung Institute at Imperial College, London, and we run additional research projects with other hospitals and universities in the UK and abroad.

In addition to welcoming patients to our UK sites, we work closely with international partners and hospitals abroad. We want as many people as possible to 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. Our consultants regularly travel to overseas hospitals to work alongside local consultants, sharing expertise and training local teams. We work hard to ensure all our sites are accessible for foreign visitors, providing personalised care to ensure a comfortable stay. Our dedicated concierge 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.

In 2015/16 our Trust l Cared for more than 190,000 patients in our outpatient clinics l Cared for more than 40,000 patients on our wards l Recruited more than 4,400 patients into our research studies l Opened a state-of-the-art hybrid theatre, which enables doctors to carry out different procedures for patients in the same session l Was named as one of the best places to work by the Health Service Journal and Nursing Times l Received 10,000 patient comments, 90 per cent of which were positive l Performed 2,276 coronary angioplasties l Produced more highly cited research publications (HCPs) than any other NHS trust in England

Our specialist services: Heart disease

Our research Research programmes play a vital role at both our hospitals. Our clinicians work on numerous research projects that bring benefits to patients in the form of new, more effective and efficient treatments for heart and lung disease. Many medical advances made at the Trust have been taken up across the NHS and beyond. Each year between 500 and 600 papers by researchers associated with the Trust are published in peerreviewed scientific journals such as The Lancet and New England Journal of Medicine. Our main partner is the National Heart and 77 Wimpole Street, London

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Experts at Royal Brompton and Harefield hospitals care for patients with a wide range of complex cardiac conditions, both congenital (present at birth), inherited and acquired later in life Our specialists treat patients from the UK and overseas who have a variety of heart conditions including congenital heart disease, arrhythmias (irregular heart rhythms), heart failure, pulmonary hypertension, coronary artery disease, and structural heart disease. The adult congenital heart disease (ACHD) unit at Royal Brompton is one of the largest specialist centres in the world. Our experts see more than 8,000 patients each year. The Trust is the worldâ&#x20AC;&#x2122;s leading centre for congenital heart disease research and a national and international training centre for cardiologists, cardiothoracic surgeons and other clinicians. The inherited cardiovascular conditions (ICC) team is expanding its service following the appointment of consultant cardiologist Dr Antonis Pantazis, who joined the Trust in January 2016. Dr Pantazis has an international reputation as an expert in cardiomyopathy (disease of the heart muscle) and will use his experience to lead and develop this area of the ICC service at both sites. Our transcatheter aortic valve implantation (TAVI) service enjoys an international reputation. TAVI is a non-surgical alternative to open-heart surgery for patients with a narrowed aortic valve and is carried out in the Trustâ&#x20AC;&#x2122;s new hybrid theatre. Our clinical teams performed 200 of these procedures last year, making ours the largest TAVI service in the UK. Our pulmonary hypertension service is one of only seven designated in the country that form

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RB&HH SPECIALIST CARE

the National Pulmonary Hypertension Service (NPHS) for England. It is one of the most rapidly expanding services and it is also one of the few combining pulmonary hypertension (high blood pressure in the lungs), adult congenital heart disease (ACHD) and lung disease expertise in a single centre. Our Trust has one of the largest pacing and complex device services in the UK. Last year, our experts implanted or renewed 878 pacemakers and 645 implantable cardioverter defibrillators (ICDs).

Lung disease Royal Brompton and Harefield hospitals are world leaders in the diagnosis, management and treatment of lung disease. Our expert teams treat patients from the UK and overseas who have respiratory disorders including severe asthma, chronic obstructive pulmonary disorder (COPD), interstitial lung disease (ILD), allergies, occupational lung disease, cystic fibrosis (CF), sleep disorders and lung cancer. They run the largest ILD clinic in the UK, the largest asthma clinic in London and the south east, and the largest occupational lung disease service in the UK. Our COPD clinic for patients with bronchitis and emphysema treats patients from all over the UK. The Trust is home to the

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largest adult cystic fibrosis centre in the UK, and the largest centre for the surgical treatment of lung cancer.

Genetics and Genomics The Clinical Genetics and Genomics Laboratory is a joint venture between our Trust and the National Heart and Lung Institute, Imperial College London. Based at Royal Brompton Hospital, the laboratory offers diagnostic genetic testing for families and individuals at risk of inherited disease. We currently offer next-generation sequencing (NGS) to improve the diagnosis of inherited cardiac conditions (ICC) for both UK and international referrers, while testing for inherited respiratory conditions (IRC) is under development.

FURTHER INFORMATION

Our dedicated international and private patient team can assist with patient referrals, partnerships and opportunities for shared learning and development. To get in touch please emai: privatepatients@rbht.nhs.uk or phone 0044 (0) 2031 315 520. www.rbhh-specialistcare.co.uk

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Adapting to new healthcare challenges

IHG’s integrated and collaborative approach to healthcare in China addresses the issues of 21st century lifestyles, says Ralph Dando, Development Director of International Hospitals Group

nternational Hospitals Group (IHG) is one of the most experienced healthcare companies in the world – having completing over 480 projects across the world since its inception in 1978. During its early years IHG worked primarily in the public sector and more than 22 governments, the IMF, the World Bank, and the Ministry of Defence have employed IHG to build their respective healthcare capacities. Since starting work in China in 2012, IHG currently has six major health and wellness projects under development. Including two under its joint venture company formed in 2014 with a division of China National Railway Company

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(CREC), for Sun Valley International Hospital to develop 200,000 sqm of residential development focused on the over 65 age-group market. IHG is the only overseas company to be invited to join Samhic (Strategic Alliance of Medical and Health in China) which was established in Beijing in 2013. IHG is also a Founder Member of UK International Healthcare Management Association, where its Development Director, Ralph Dando is now Co-Chairman. In 2015, IHG signed a long-term partnership with Wanda Corporation, China’s largest commercial property company. The first two projects are

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IHG

well underway; the first building will be a 200 bed hospital, as part of Wanda’s innovative 3.5m sqm Movie Metropolis project in Qingdao. The second is to be a 500 bed hospital in the New Tainfu District that is being created 10Km south of Chengdu City Centre.

China is clearly the place to create such an exemplar project. With a 4000 year history of holistic approaches to health, allied to an ambition to maximise fusion for eastern and western traditions, the potential to develop a model which is not only widely applicable to China, but which has lessons globally, is immense. Today, healthcare organisations are facing a torrent of pressures – cost, quality, uneven access to care, epidemics of chronic disease and infectious disease outbreaks. Healthcare leaders and policy makers are redefining the role and responsibility of healthcare providers, beyond healthcare delivery to overall population health. In so doing, they are becoming increasingly aware of the vitally important connection between the quality of healthcare delivered and the physical environments in which that care takes place and the people live, work and play. In addition, they are beginning to recognise the powerful connection between healthcare organisations and the environment and the very planet itself. The world of healthcare and the world of green buildings share a common mission – to protect and promote health. To face this future, healthcare providers and environment creators (developers and their public sector partners) and leaders must understand and build on the connection between healthcare delivery, the buildings that support it, and the health of individuals, communities and the planet. The global healthcare industry is in a pivotal position to lead the 21st century integration of social, economic, environmental, health and resourcebalanced practices in service of restoration and healing. We believe that CREC and IHG have the unique opportunity to align their vision for a community by harnessing the ingredients of success that are available and to create the exemplar health eco-system for the future and to design truly healing environments. Last August, the Chinese Government, The World Bank and WHO published a joint

Overview The impact on health services of an ageing population is profound. This is being experienced on a daily basis by communities and governments around the globe. As life expectancy expands, the range of potential clinical interventions increases, and the expectations of individuals and their families grows. This is often coupled with more elderly people not being able to rely on wider family networks, creating a genuine global challenge. The problem with an illness service model with an aging population is that the demands upon it are potentially infinite, particularly with the tendency to pathologise, for example; mood, lifestyle, food or weight. We know that people who eat well, exercise regularly, and are well educated, socialised and networked, keep their brains active generally develop age-related illnesses considerably later. So how do you deliver these wider health outcomes? Paradoxically it is achieved by focusing less on a bio-medical model, and embracing a wider model that sees health within a community setting. For example, the Intuit in the Arctic traditionally paid their healer only when they were well. If they fell ill, the healer had failed in their primary task - a model that maybe has lessons for us all.

IHG in China In China, IHG have been working with our Partners, China Railway (CREC) on a vision for a Smart City, embracing healthcare and the elderly challenges that China has. It will be a nationwide exemplar project for healthcare, the elderly and family living in general, which will have to address the need for increased personalisation in healthcare; where each individual has their own health plan specific to their DNA and lifestyle history. However, it also needs to build a community, and to maximise the opportunity for members of that community to be empowered to take responsibility and ownership for maintaining their own health, rather than outsourcing it to health professionals. A successful Smart City will be the result of the creation of an integrated community that addresses the issues of primary care, secondary care and social care in parallel and interlinked with those of housing, education, in a joined-up cohesive manner. This involves designing integrated communities as high quality sustainable built environments, but it also involves developing new models of health economics which keep people healthy as much as health interventions when they fall ill.

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RALPH DANDO Ralph is Private Sector Co-Chairman of UK International Healthcare Management Association (UKIHMA) and the Development Director at International Hospitals Group A Chartered Civil Engineer, lawyer and Mediator by training, he has over 25 years’ experience in Development, Project and Construction Management of complex projects, including major mixed-use regeneration schemes, retail and commercial property developments and a wide variety of healthcare schemes from major university teaching hospitalsn Europe, Middle & Far East and China to smaller clinics in Africa. He is responsible for all pre-construction activity on IHG’s hospital projects and is currently Project Director for the Qingdao and Chengdu International Hospitals being developed with Wanda in China. Other live projects include new hospitals in Tanzania,Tunisia, Caribbean, Nigeria, Ghana, Oman, Kazakhstan, UAE, Kuwait and Bahrain.

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paper on deepening healthcare reform in China, encompassing the necessity to embrace primary care with its parallels with the UK Healthcare system. CREC and IHG are working to achieve just this.

Deepening health reform in China China is starting to face many of the same challenges and pressures that high-income countries face. Chinese over the age of 65 now number 140 million, and that cohort is expected to grow to 230 million by 2030. High-risk behaviours like smoking, sedentary lifestyles and alcohol consumption, as well as environmental factors such as air pollution, take a huge toll on health, with non-communicable diseases accounting for more than 80 per cent of 10.3 million deaths every year. At the same time, with higher economic growth, increased personal incomes, and fast changes in consumption patterns, people are demanding more and better healthcare. As a result of all these factors, expenditures on healthcare have been increasing continuously. China is facing greater challenges as the high growth rates of health expenditure over the past years may be difficult to sustain under the economic slow down. The Chinese government fully recognises the need to make strategic shifts in the health sector to adapt to these new challenges. President Xi Jinping and Premier Li Keqiang have placed great importance on healthcare reform. As President Xi Jinping pointed out, it would not be possible to build a well-off society without universal health. IHG and its partners on this strategic project are aiming to create a smart community development. It will have at its healthcare system level, a peoplecentred high quality care model founded on a robust primary healthcare model, like that in the UK – with an acute hospital at its heart, but integrated with and extending to the primary care for the elderly and needy through care in the communities, extending into the homes and very fabric society that it seeks to bind together.

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The IHG team comprises HLM Group and Llewelyn Davies, Buro Happold and Gleeds, University of Salford, Andrew Mawson Partnership, WGP Global and Yecco, working with Living PlanIT and their many Smart Technology, ICT and digital providers, IHG’s Strategic Healthcare NHS Partners, such as The Christie NHS FT, Alderhey NHS FT, Royal Free NHS FT, South Tees NHS FT and Northumbria NHS FT, whose integrated collaborative model of care (see above) fully captures the CREC IHG approach.

Choosing wisely Healthy living involves creating and maintaining health: a state of complete physical, mental and social well-being – not merely the absence of disease or infirmity. The roots of healthy living are multi-layered, influenced by social and environmental determinants as well as specific risky behaviours – especially tobacco use, unhealthy diets, harmful use of alcohol and physical inactivity. The lack of access to basic prevention, treatment and care further inhibits healthy living. All these factors are interconnected and influence everyday decisions. Given this complexity and interdependency, it is clear that enabling healthy living is not just a health agenda, but an imperative for all of society. To have a sustained impact, everyone should work together to build environments in which healthy choices are the easiest choices. The IHG – CREC Smart Community development has the ability to enable these key elements to be put in place to empower its citizens to embrace this vital agenda and take personal responsibility for their own health; achieving better outcomes and experiencing a much better quality of life, having equitable access to healthcare resources as necessary. FURTHER INFORMATION www.ihg.co.uk www.ihg.cn.com

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IMAGE: SHUTTERSTOCK.COM

Health partners Recent trends suggest that operator led PPP models are becoming more favoured in the healthcare sector in Australia, particularly in New South Wales, say Simela Karasavidis and Margaret Cole, Partners at Pinsent Masons

s Australiaâ&#x20AC;&#x2122;s population continues to grow and more health infrastructure needs to be both built and redeveloped, other state governments may turn to this kind of model. The traditional PPP model focuses on the design, construction, financing, operation and maintenance of an asset by the private sector, with operational risks of providing relevant public services (after completion of construction), e.g. custodial services in the case of a prison PPP and clinical services in the case of a healthcare PPP, retained largely by the State. The operator led model differs from this traditional approach. Under the operator led

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model, the private sector operator partner is consortium lead and is responsible for the delivery of relevant public services over the concession period. This is also known as an outcomes-based approach to PPPs, whereby a large part of the operation risk is transferred to the private sector operator partner. Operational performance is then judged against agreed key performance indicators and other specified criteria. Under this model, private sector operatorsâ&#x20AC;&#x2122; work closely with government and other partners to establish performance models from an early stage, and there is a focus on outcomes based solutions.

Benefits of an operator led approach There are a number of reasons for a government to move towards an operator led PPP procurement model. In Australia, private sector consortia bidding on PPP projects have traditionally been led by equity investors, many of whom have no long term interest in the ownership of often significant public assets, and others who are more interested in securing the long term revenue streams investment in these types of assets brings rather than being focused on the provision of important public services.

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CONSULTANCY

PINSENT MASONS In the healthcare sector, private sector operators, Ramsay and Healthscope dominate the healthcare PPP landscape. Moving toward an outcomes-based approach appeals to a broader array of service providers who have the skills needed to deliver clinical services and innovative care models. In particular, credible operators in the not-for-profit sector who may not have the balance sheet to be considered competitive under traditional PPP models are likely to be better placed where significant weight is placed on the ability to provide clinical services over the concession period. The transfer of risk to the private sector is also thought to generate better value for money outcomes, and encourage operational innovation, driving significant social and economic benefits. Private sector operators have greater flexibility to determine how they meet their performance targets, which allows for the optimisation of outcomes. Key to the success of this model is structuring of the contractual terms such that this flexibility is preserved. In addition, having the project’s private sector operator partner involved long term means that its interests are directly tied to the success of the project, with the resulting incentive to make longterm investments in the facility to meet evolving operational standards and care models. SIMELA KARASAVIDIS Simela has 22 years’ experience in the infrastructure and PPP sectors and 10 years in the energy sector in both international and domestic markets. Simela has worked on projects in Australia, the United Kingdom, Europe, the Middle East and Africa and has been recommended for Projects and Infrastructure in the Legal 500 Asia Pacific 2015 and 2014. She has also been recognised for her work in the UK by Legal 500 in 2010, 2011 and 2012 where they said Karasavidis is ‘very well informed in all aspects of energy, infrastructure and project finance’.

MARGARET COLE Margaret specialises in advising lenders and investors on complex international finance transactions. For more than 30 years, she has assisted clients in navigating a range of intricately structured, cross-border transactions, such as limited recourse project finance, as well as securitisations and private placements. Recognised for her leadership role, Margaret has counselled clients and co-ordinated strategic advice across multiple jurisdictions, with a focus on emerging and developing countries ranging from the Middle East, Russia, Central Asia and Africa, to Latin America and Asia.

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‘Due to intense regional public opposition the NSW Government has since scrapped plans to redevelop and operate Goulburn hospital as a PPP.’ Using the operator led model Most recently, the NSW Government entered into a PPP agreement with Healthscope, a private hospital operator, for the new Northern Beaches Hospital. Under the agreement, Healthscope will operate the hospital providing both public and private clinical and non-clinical services for an initial period of 20 years. After the initial period, it may hand back the public portion of the hospital at no cost to the NSW Government. Healthscope will continue to provide private services in the hospital for another 20 year period, before handing back the rest of the facility to the State. In 2016 the NSW Government committed $5 billion to health infrastructure. It announced that it intended to utilise the PPP model of “Health Partnerships” in the redevelopment and operation of five public hospitals across the State, estimating a saving of $1.5 billion over the life of the contracts. The Health Partnerships are expected to be similar to the Northern Beaches Hospital model. The hospitals selected for “Health Partnerships” originally were: Bowral (the hospital to be upgraded, and then handed to a private operator); Goulburn; Shellharbour; Maitland; Wyong. Due to intense regional public opposition the NSW Government has since scrapped plans to redevelop and operate Goulburn hospital as a PPP. The other four projects are still listed on the NSW Health Infrastructure website as PPPs, though there has also been some public opposition to these projects. EOIs for those hospitals were due in October 2016. Interested parties have been advised to focus on the development of care models. The Australian healthcare industry is very aware that NSW Health is speaking to a number of operator led consortia that submitted EOIs, including a number of not-for-profits. It will be interesting to see if the NSW Government can get around real issues such as lack of balance sheet strength and serious capacity constraint, to successfully deliver these projects with different private sector operators, who are all focused on outcomes based solutions. FURTHER INFORMATION

www.pinsentmasons.com bit.ly/freedomtosucceed

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UWS’ leading work in nursing and community care has spawned EU funded projects designed to better equip nurses to tackle today’s modern healthcare challenges, both in the UK and overseas, as Dr Tim Duffy, Assistant Dean (International) at UWS, tells Jack Ball globalopportunityhealthcare.com

UKIHMA

UNIVERSITY OF THE WEST OF SCOTLAND setting. The WHO identified FHNs as a significant asset in areas where there was a perceived lack of access to underserved and poorer communities within the European region. Its various elements boil down to two central tenets of care based on family and community; to strengthen and develop family-focused care as a vehicle for strengthening and developing community-orientated health services. Within this recommendation ‘the home’ is defined as a setting in which family members can jointly address their health problems and create ‘a healthy family concept.’ Testament to their leading work in the field of nursing and community health, 2011 saw UWS receive funding from the European Union Lifelong Learning Project to develop the Family Health Nursing Project (FamNrsE), with UWS chosen to lead its development and implementation. Other European partners across Europe included Armenia, Austria, Germany, Italy, Poland, Portugal, Romania, Slovenia, and Spain. Its objectives were to develop shared academic and practice-based programmes to prepare FHNs in Europe; based on a conceptualisation of FHN including scope of practice, essential knowledge base, and clinical competence across partner countries. “In terms of how the project came about, my colleague Professor Paul Martin was Chief Nursing Officer and Director for Health Workforce for Scotland before joining UWS in 2009 as Executive Dean of Education, Health & Social Sciences,” says Dr Tim Duffy, Assistant Dean (International), UWS. “He implemented a pilot project for family health nursing in Scotland and in doing so, followed the Health21 recommendation put forward by the WHO. So when he joined UWS, he was DR TIM DUFFY

hifting demographics and evolving patterns of diseases are challenging WHO Europe member states to review the ways in which they deliver nursing care. The rise of non-communicable diseases (NCDs) such as heart disease, cancers and diabetes, alongside increasingly ageing populations and declining birth rates have helped redefine the health maps of many countries. Health risks that are major contributors to NCDs include high blood pressure, tobacco use, physical inactivity, obesity and raised cholesterol. A direct response from the WHO, the Health21 health policy framework outlined the role of a Family Health Nurse (FHN) – a concept defined with existing roles of several nursing disciplines within the primary care

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Dr Tim Duffy, Assistant Dean (International), School of Health, Nursing & Midwifery, University of the West of Scotland (CQSW B.A., PhD). Dr Duffy has 25 years of academic experience in the development, delivery and assessment of undergraduate and postgraduate courses. As a strong advocate of new teaching methodologies, he has fully embraced distance and e-learning techniques. As Director of Distance Learning he has managed nursing programmes for students in over 30 countries. As an active researcher with over 50 academic outputs he has particular interests in student motivation and in health related behavioural change and motivation. His current focus is on increasing international student recruitment; distance learning; transnational education; student and staff mobility and internationalising the curriculum.

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extremely keen to progress this project and the discussions, using this already established connection with the WHO.”

The Family Health Nursing Project The FamNrsE was designed to facilitate a consistency of approach in the development of family health nursing, its required core competencies and capabilities as well as consequent education and training and to upskill family nursing capabilities across Europe. Central to its success the project was intended to raise and maintain high quality standards, while also recognising and encouraging local and national variations to ascertain similarities and differences to better identify facets of family nursing that need the greatest attention. “As part of the application we had to identify issues in family nursing that we felt important,” explains Tim. “So we assembled a range of what are called’ work packages’, as they are known within the Erasmus system. These work packages would look into the management of the project and the literature regarding a topic area to ensure partners are aware of the current literature. In terms of service delivery we would then look at who is doing what, identify where the skills gaps lie, and the current teaching programmes available for people to become family health nurses.” “The primary aim is to identify gaps in education and training,” he continues. “We researched the different skills and knowledge required for good family health nurses across our different partner countries. Once these gaps were identified we put forward service models that could be developed across them.” Research also formed a central part of the project, with work packages identifying best practice and core competencies that are

‘We researched the different skills and knowledge required for good family health nurses across our different partner countries. Once these gaps were identified we put forward service models that could be developed across them.’

required to be a successful FHN. Tim explains; “One specific work package involved some pilot research projects. We use the ICN’s [International Council of Nurses] specification list of nursing competencies; a list of about 40 also approved by the WHO.” “We asked participating countries to state which of those 40 roles their nurses typically undertake. Their answers helped us identify the similarities and differences across countries. We noticed strong similarities between the role of nurses across Europe with many involved in health education, health promotion; working closely with both young and older people in terms of mental health.”

MSc Health Studies (Family Health) Following the final project conference of the FamNrsE in September 2013, the team at UWS – in light of the project’s findings – were now able to share their experience, success and understanding of the role of the FHNs. All agreed that it remains critical to equip community nursing staff with the appropriate knowledge and skills to achieve the most optimal outcomes for each population they serve. The International

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Masters programme in Health Studies (Family Health) at UWS was thus born, preparing practitioners to become advanced generalists so they may better meet the diversifying and unique health demands of their different communities. Delivered part time and online, the programme is designed to examine the global health challenges, as well as the increasing complexity in the management and treatment of noncommunicable diseases, all of which are on the rise in the foreseeable future. “The programme gives students an opportunity to examine health policy at local, national and international level,” says Tim. “It presents opportunities for students to explore current and alternate ways of working within family health, to build on existing knowledge and expertise through the development of strategic critical thinking.” The programme consists of a menu of course modules – a mixture of core, optional and independent study modules. All reflect contemporary health issues relevant to health and social care professionals. “Our MSc in Family Health integrates some of the modules that came about as result of the Family Health Nursing Project,” notes Tim. “We have also included some of them in both our undergraduate nursing programmes and other postgraduate programmes.”

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With funding for FamNrsE coming from the EU, material for the four core module units has also been translated from English into European languages such as German, Italian, Romanian, Polish and Portuguese. “Some partners have taken the project further than others, but the overall response has been very encouraging,” Tim concludes. “Germany has tried to take it forward and integrate it at undergraduate level. Italy has also invited myself and others to meet with politicians and senior members of the healthcare industry to stimulate the academic and political will to take this forward.” “We have demonstrated that we are very good at setting up, managing and delivering work packages within a very tight timeframe – we selected key partners and again we delivered everything on time. These projects are exciting and enjoyable, creating wonderful and highly flexible materials that can be used across Europe. Indeed my colleagues and I have already begun progressing with other European funding applications, and responses from potential partners are already saying; ‘Yes!’”

FURTHER INFORMATION www.uws.ac.uk

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The Power of Collaboration Wessex Academic Health Science Network’s collaborative approach between health services, industry and academia has proved critical in the assessment and validation of overseas healthcare opportunities for its members, says Andy Burroughs, Director of Wealth and Enterprise at Wessex AHSN

he NHS is the world’s largest publicly funded healthcare system and the fifth largest employer worldwide. This knowledge base is not only clinical in nature, but operational and managerial – crucial skillsets made increasingly valuable given the strategic and financial pressures that many NHS trusts continue to face. With this in mind, a collaborative approach to the development of innovative solutions to the world’s healthcare challenges remains ever more critical. Nowhere has this been more evident than with the creation of Academic Health Science Networks (AHSNs) in 2013. Spread across England, the 15 networks aim to bring together health services, academia and industry to promote and support innovative approaches, bringing fresh energy to old problems, inspire new and more effective patient outcomes and generate much-needed economic benefits to its members and the local economy “Wessex AHSN covers Dorset, Hampshire, South Wiltshire and the Isle of Wight,” says Andy Burroughs, Director of Wealth and Enterprise at Wessex AHSN. “As a memberbased organisation our network includes NHS providers, hospitals, mental health and community care providers, universities and commissioners of healthcare whose interests we represent.” Bridging academia, the NHS and industry, Wessex AHSN’s strength lies in its ability to work across organisational boundaries to deliver tangible opportunities within its membership.

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“We have a good knowledge of our local partners,” says Burroughs. “Within our region the spirit of enterprise and collaboration is already present. And in terms of an international presence, many of our members already have overseas interests.” Wessex AHSN and the Wessex International Healthcare Consortia (WIHC) are indicative of

‘Within our region the spirit of enterprise and collaboration is already present. And in terms of an international presence, many of our members already have overseas interests.’

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ANDY BURROUGHS Andy joined Wessex AHSN in April 2014 as Director of Wealth and Enterprise. He has nearly 30-years experience in a variety of commercial roles operating across the public and private sector, and most recently was Director of Business Development at Plymouth Science Park. Before that he was Director of Business Development at Ipswich Hospital NHS Trust, ran his own business and management consultancy business for 5-years during which time he was a Non-Executive Director at Peterborough & Stamford Hospital NHS Foundation Trust, and spent 10 years at Microsoft in a variety of strategic and commercial roles in the UK and Europe, Middle East and Africa.

the collaborative approach to the expansive international healthcare market. Burroughs explains; “Three years ago, UK healthcare organisations were mainly undertaking their own individual work, either in the UK or overseas. But as we began to realise the scale of the opportunity that exists, we also took a look at the strengths that exist within our member organisations and assessed international opportunities accordingly.”

Benefits of membership Many of the strongest opportunities presented to the Wessex AHSN come from organisations that share similar demographic characteristics. “We have experience in managing various kinds of population issues, long term conditions or ageing populations,” says Burroughs “Thus many of the most promising opportunities presented to the Wessex AHSN share these population dynamics.” However, the ability to take advantage of such prospects is only as good as the existing organisational infrastructure already in place.

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“We have to make sure that we respond to those qualified opportunities in a timely way with sufficient resources,” he says. “We know from conversations with our partners – particularly healthcare providers – that, although they have significant interest in international opportunities, they don’t have the structure and the means to deliver effectively, if at all.” This is where Wessex AHSN provides real value to its members – an organisation offering a framework to assess, validate and build on tangible opportunities valuable to its membership. “The degree of interest from Wessex AHSN is aligned with our members’ interests,” he says. “However, given the fact that resources are stretched, we are also playing a key role in terms of filtering those opportunities to make sure that we respond to those that resonate strongly with our members – those where we can do the best possible job.”

Spreading the word Strengthening Wessex AHSN’s collaborative approach to international opportunities is Burroughs’ central priority moving forward. Confident in past successes, he believes the adopted model of association in Wessex is easily scalable to other AHSNs across the country. “We’re emphasising our collaborative approach,” he says. “Typically if you’re a frontline clinician, you tend not to think about some of the international opportunities. But when you take a step back, it is easier to assess the skills and expertise that you have as a clinician, or as an organisation. Our methodology is bringing those interests together. And working across these organisational boundaries means Wessex AHSN certainly has much to offer.” FURTHER INFORMATION www.wessexahsn.org.uk www.wihc.co.uk

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Membership of Wessex Academic Health Science Network (AHSN) is helping the diabetes department at Portsmouth Hospitals NHS Trust access international opportunities and export its unique model of diabetes care, as Dr Partha Kar, Consultant at Portsmouth Hospitals NHS Trust, explains

Sweet opportunity

he rise of diabetes, not only in the UK but across the world, is a public health crisis. Fuelled by changes in nutrition, rapid urbanisation and increasingly sedentary lifestyles, obesity is now a large contributor to the development of the disease. Research and expertise in the treatment and effective management of the condition will only prove more useful as its global prevalence increases, particularly in developing areas where diabetes care may be insufficient.

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Such global health problems require expert solutions, adaptable to local pressures and needs. Portsmouth Hospitals NHS Trust is leading the charge with their diabetes care offering, working with the Wessex AHSN to access and build upon international opportunities, and innovating fresh approaches to a health epidemic that features centrally in many of the worldâ&#x20AC;&#x2122;s healthcare organisations. â&#x20AC;&#x153;If current trends continue, the UK will see one in ten of the population having some type of

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‘Rather than assuming somebody else would manage this care provision outside the hospital, we instead saw ourselves as educators and a critical support tool. That’s very different from what many other leading centres offer.”

diabetes,” says Dr Kar. “This is a huge number. If you look at areas such as the Middle East, they’re already way above that figure. Estimates suggest almost one third of the population in this region have type two diabetes. Whatever country you look at, diabetes rates are going up.”

Super Six model of care Joining the Diabetes and Endocrinology department in 2008 before becoming the Clinical Director of Diabetes at the Trust in 2009, Dr Kar and his team have developed a unique model of diabetes care, based on education and support within the primary care setting from a range of clinical avenues. “This model has been part of the history of the diabetes centre in itself,” he says. “We’ve evolved from a specialist diabetes centre to taking responsibility for the whole community.” “We realised that trained consultants see patients inside the hospital in specific clinical areas,” Dr Kar explains. “However, the majority of care actually takes place outside the hospital setting.” The approach is simple, labelled as the Super Six Model. It clearly defines with local GPs, commissioners and specialists which services DR PARTHA KAR Dr Partha Kar has been the Clinical Director of Diabetes since 2009 at Portsmouth Hospitals NHS Trust. One of his main areas is in helping to redesign diabetes care in an attempt to integrate chronic disease management across primary and secondary care. He is the pioneer of the Super Six Model, which won the Care Integration Awards 2012 and Quality in Care in Diabetes Award 2012. He also leads the Type 1 Diabetes service, focusing on adolescent diabetes using technology and social media. He is also a core member of the National Diabetes Audit group. He is also Clinical Service Director for community services in South East Hampshire.

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must be administered within the confines of an acute Trust, owing to the higher expertise involved or the need for a multidisciplinary approach to more complicated conditions. “Rather than assuming somebody else would manage this care provision outside the hospital, we instead saw ourselves as educators and a critical support tool,” says Dr Kar. “That’s very different from what many other leading centres offer.” Embracing the movement of digital technology into the healthcare space, the department has also adopted the latest technologies and download devices – all designed to move care closer to the patient and away from the traditional model of in-hospital care. These developments are critical in freeing up clinicians to focus their attention on delivering care within the hospital setting.

International opportunities and Wessex AHSN As a network connecting academics, industry and health care providers, Wessex AHSN helps pinpoint areas of best practice, and offers the opportunity for collaboration with other leading regional healthcare organisations as they respond to potentially lucrative opportunities overseas. For example, as part of a consortium involved in the construction of a hospital, the diabetes team at Portsmouth Hospitals NHS Trust can help establish a full diabetes facility, from prevention to pharmacy services. “When building a hospital from scratch, most require a diabetes department,” Dr Kar explains. “Another specialist partner would offer respiratory services or care for long-term conditions. It’s great to be part of a collaborative organisation instead of trying to do everything on your own. This is where Wessex AHSN’s strength lies.” The UK healthcare offering remains extremely well respected, continuing to represent some of the best innovators and entrepreneurs in the health sector. “Although some gaps certainly exist, people do look at the way the UK works. If there is something we can adapt, we will definitely do so to build on those results.” Testament to its success, the Trust’s local model of primary care has now been exported to other areas of the country, such as Leicester, Gateshead and Croydon. “This expansion shows that our model is adaptable to other countries too,” Dr Kar concludes. “In countries such as India or those in the Middle East, if you can get the organisation or support systems right and encourage a focus on the specialist side of their work, you can definitely improve care.” FURTHER INFORMATION www.wessexahsn.org.uk www.wihc.co.uk

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Collaborative working between different agencies can deliver impressive results in healthcare when focusing on the person and not the structures says Karen Baker, Chief Executive of the Isle of Wight NHS Trust

Averting healthcare crisis at source

he Isle of Wight was selected by NHS England as one of 50 vanguard sites to lead the development of new care models to act as blueprints for the NHS and inspire the rest of the health and care system. As well as extra funding, the vanguard sites receive tailored national support, and the Isle of Wight has engaged with the Wessex Academic Health Science Network (AHSN) to achieve this through joint working and shared learning.

how the programme works. Highly co-ordinated crisis response teams deliver person-centred care and support in the community, working with GPs, other healthcare agencies and voluntary / community groups to triarge, reduce complexity, increase awareness of care and support, and maximise outcomes for the person involved. “For example our Care Navigators, employed by Age UK IW, are a range of people and they

Early challenges The Isle of Wight’s vanguard programme is called My Life a Full Life, promoting health and wellbeing by developing integrated care while focusing on the needs of the person. With so many partners involved in the programme, including the Isle of Wight NHS Trust (a unique provider of ambulance, community, hospital, learning disability and mental health services), and voluntary and public sector organisations, the Wessex AHSN’s collaborative approach is crucial to success. Karen Baker, Chief Executive Officer of the Isle of Wight NHS Trust, explains some of the early challenges the programme partners faced. “We brought together the leaders from the Clinical Commissioning Group, the NHS trust and the council and we went away for two days to decide how services should look in the future. That was quite difficult because in any organisation there is a structure, but when you start talking across organisations there aren’t any rules. So it’s really important at the beginning to talk about values and behaviours because these bind you together. We didn’t design structures; we didn’t talk about organisational form; we talked about what is really important to us as system leaders and our island residents, for the future.”

Crisis response Collaboration is not only important to the management and implementation of the My Life a Full Life care model; it’s also fundamental to

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WESSEX AHSN receive referrals from amongst others GPs, private care nurses and social care,” explains Karen. “Recently a Care Navigator, visiting a man found his house was in an awful state; he was clearly not coping. But he wasn’t accessing formal healthcare services. So the care navigator worked with him; she put him in touch with relatives he hadn’t spoken to for years; she started to get him more integrated into the neighbourhood, and after six visits she said the change was remarkable. His house was clean, they had got rid of the rats, and they had helped him with things he didn’t believe he could sort out on his own. This simple intervention from the care navigator meant that he was put in touch with people and community groups that supported him in his own home.” Karen says this kind of co-ordinated response is already delivering impressive results. “Across the Isle of Wight we’ve really bucked the trend. Our A&E attendances are down by nearly five per cent; all other healthcare systems have seen increases in their A&E attendance. We’ve stopped those people in crisis from having to come to hospital. You have to do that first because that’s the thing that’s driving everything else. You stop the crisis to begin with.”

KAREN BAKER Karen Baker has been Chief Executive of the Isle of Wight NHS Trust since July 2012. Her career has spanned a wide number of roles which have included professional lead and general management, mainly within the acute sector. She has also worked at regional and national level influencing the development of strategy and clinical networks. She began her career as a nurse and midwife for 17 years. Her main interest is enabling integration across disparate services focusing on meeting the specific needs of the population.

Organising services The Isle of Wight is an offshore island only accessible by sea and air, with a population of 140,000 and thousands of visitors every year who all may need access to healthcare. “The Isle of Wight is slightly different to the rest of the NHS, in that we already have in one organisation for ambulance, mental health, community and acute care. So we’re ahead of the pack really, and if you were redesigning the health service you’d do it like that. You wouldn’t have separate organisations providing separate elements, because we’re all people. I could have mental health issues and I could need acute care; we don’t come in neat little packages. You start by putting those services together and concentrate on the person and what we need to do for them.” Moving forward, Karen is looking at how a collaborative care plan can be implemented further afield. “We’re also now looking at the Wessex region and how we can bring out the best of each region, each local area to make sure they’re achieving the aims that we set out to do. It’s called a sustainability and transformation plan which Wessex AHSN are helping us with, which is all about the best way for us to organise services so we drive up outcomes. “We’ve got an integrated care hub on the Isle of Wight which brings together health and social care professionals and voluntary organisations. We’ve been showing other areas how this works and there has been a lot of interest. We can encourage other areas to make a start and help them out using our experience so their service can run much quicker and smoother. “You always learn something from collaborative working - you always get something back and you will learn from that.” FURTHER INFORMATION www.wessexahsn.org.uk www.wihc.co.uk www.mylifeafulllife.com

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Innovation is the key to success, says Mel Rankine, Commercial Director at University Hospital Southampton

Creating the future

niversity Hospital Southampton (UHS) is a major teaching hospital, with an annual turnover well in excess of £700m and employs 11,000 people. The NHS trust provides services to a population of 1.9million people living in south Hampshire, as well as specialist services such as neurosciences, cardiac services and children’s intensive care to more than 3.7 million people in central southern England and the Channel Islands. The Trust is also a major centre for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust. My job as Commercial Director is to develop a surplus income for the Trust for the benefit of NHS patients. I’m interested in working with innovative companies to develop ideas and products that have commercial potential both in the UK and abroad for the benefit of both parties. We’re particularly keen to help SMEs to find a way of entry into the NHS which many organisations, particularly international companies, find very challenging. We want to show them an easier way to access the NHS by meeting us and telling us about their product or innovation and, where needed, assist with further research and development to proof of concept stage. There are already very well established guidelines for companies wishing to sell existing products directly to the NHS. Our vision goes beyond this – looking for the ideas and products that will shape the healthcare of tomorrow, not today.

‘There are already very well established guidelines for companies wishing to sell existing products directly to the NHS. Our vision goes beyond this – looking for the ideas and products that will shape the healthcare of tomorrow, not today.’

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MEL RANKINE Mel Rankine is University Hospital Southampton’s Commercial Director. He has responsibility for developing business opportunities both nationally and internationally that will benefit the hospital Trust and its patients through mutually beneficial partnerships with other NHS Trusts and the private sector. He joined in April 2013 and has previously been involved in a number of ground breaking commercial developments. He has wide ranging commercial experience in the private sector and the NHS which includes being head of enterprise development at a major London teaching hospital.

Supporting innovation A hospital is much more than a medical establishment; it’s actually a small town. Everything that a small town needs to function, such as providing power, waste collection and maintenance is just as relevant in a hospital as it is in any other environment. We’re always looking to find ways to improve those facilities. For example, we’re currently working with a local company that has produced an anaerobic digester to process all the hospital waste, saving hundreds of thousands of pounds in energy costs. At the other extreme, we’ve partnered with a number of companies to look at digital technology, from developing algorithms and ideas for monitoring patients’ vital signs, to a novel medical device that helps people with acid reflux. We’re open to any ideas that will help us to improve productivity and patient care. If someone has an idea or product that may benefit the NHS they can contact me, and we will quickly assess whether we think it has any potential, and how we might jointly develop the concept. It could mean taking it to an experimental stage where we carry out joint research to make sure there’s a proof of concept; or it might be trialling the product, depending on what it is. Once there is proof that a product works in an organisation, it creates a huge opportunity to expand. Within the NHS it can be difficult, as every hospital operates independently, but we work with enabling organisations such as Academic Health Science Networks to facilitate and spread health innovation across boundaries.

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WESSEX AHSN New phase The NHS is moving into a new phase with STPs – Sustainable Transformation Plans – for the next five years. As a result, many organisations have started talking to each other, creating not only international consortia such as the Academic Health Science Network here in Wessex but also at a local level. As a result we’re able to exchange information in a far more effective way than we’ve been able to do in the past. Joining Wessex AHSN is one of the best moves we’ve made for some time. The NHS is struggling and always will do in terms of resources, and to be able to attract the right people internationally is always going to be a challenge for us as an individual hospital. By creating a consortium we can capitalise on the strengths that all the trusts have to sell business abroad and to attract inward investment into the UK. Being able to pool our resources, particularly for large international markets, represents a fantastic opportunity for all parties. It’s also an opportunity to bring other partners

CASE STUDY ANAEROBIC DIGESTION The Trust has been working in partnership with a local company to develop an anaerobic digester, which will convert all our food and garden waste into energy. This will save us several hundred thousand pounds a year in terms of energy costs, which means that the return on the investment is particularly attractive. Both parties will benefit from the future sale of these digesters, both in UK hospitals and abroad. We have already been approached by a very large public facilities management company that is considering installing the system into other hospitals as they gain contracts. We are supporting our partner by allowing potential clients to view the facility and by talking about it at conferences. These units are potentially mobile; they’re fitted into shipping containers and are easily transportable to any part of the world where they can generate their own power. Robotics is another area that is very exciting, and not just robots that can undertake operations. We have very limited robotics, but there is huge potential to improve productivity in a hospital if you can develop robotic delivery of catering, or removing waste and linen. These services are really in their infancy, and not many hospitals, unless they are a new build, are able to develop them.

with us. One of the companies that we’re working with at the moment is already, off the back of the work they’ve been doing with us, selling some of their products internationally in Europe and indeed in the States and China. As an NHS Foundation Trust we have certain freedoms to develop in international markets where an ordinary NHS facility might find it more challenging. We have the ability to look at products, and set up companies and joint ventures.

Transferring knowledge Within the consortium there is a huge amount of expertise, both clinical and non-clinical, that can help develop hospitals throughout the world. Equally, we have a great deal to learn from other countries and we are keen to share expertise and knowledge for mutual benefit. We want to innovate as much as we possibly can to benefit NHS patients through lower costs and better productivity. We’re concentrating on accessing new ideas and new concepts, and aligning people who can bring them into the NHS. It’s a very exciting time for us – the opportunities are real and bring tangible benefits.

FURTHER INFORMATION www.wessexahsn.org.uk www.wihc.co.uk

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Health initiatives at Southampton Solent University are promoting well-being for both staff and students, says Martin Skivington Head of Health & Exercise Sciences

Active workplace

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ands on exercise and physical training is a key focus for Southampton Solent University, improving the wellbeing of staff and students while giving much needed training opportunities for health & fitness course participants. There is a high probability that many of us have avoided going to the gym at some point in our lives. Some may even be fearful of the whole concept of attending the gym, ignorant as to how they could begin to access its benefits. Health, exercise and physical activity course students at Southampton Solent University are helping university staff benefit from personalised training, giving them the confidence to train and boost their wellbeing, while giving degree course students the hands-on training they need to succeed in their future careers. “The most unique aspect of our programmes is their applied nature,” says Martin Skivington, Head of Health and Exercise Sciences at Southampton Solent University. “We bring work placements into the classroom rather than sending students off campus so they have lots of real opportunities to work with real clients.” Symptomatic of the University’s commitment to increasing student and staff wellbeing the Health, Nutrition and Exercise Science course at the University is specifically designed to encourage people to become more active. “We have now introduced a new initiative called Solent Personal Training (Solent PT). As part of this initiative free personal training is now offered to all members of university staff,” says Martin. “We’re trying to encourage those people who would never normally use or are fearful of going into a gym setting – to give them the confidence to work with a qualified personal trainer, encourage them to be more active and take away that fear factor from going to the gym.”

The structure of the initiative is designed to make accessibility as easy as possible. After signing up, participants can train with a qualified personal trainer whenever is most convenient.

Tangible benefits Solent Health – the health promotion team at the university created in 2009 – has rolled out a number of programmes to promote health and wellbeing for staff and students. In addition to Solent PT, initiatives are designed to build and develop a sustainable, accessible and valued health promotion programme. They include those focused on mindfulness, health screening, blood pressure and cholesterol, as well schemes to reduce the sedentary nature of the modern work environment. “Since rolling out our programmes, what we’ve found is that absenteeism over the past five years has almost halved. While we cannot directly attribute this reduction wholly to the initiatives, it is fairly likely that it has had a significant part to play.”

International focus While some of Solent Health’s initiatives remain in their infancy, they have already begun to make a wider impression nationally. 2016 saw Solent Health win one of the most coveted awards in the health and fitness sector – the ukactive & Matrix Flame award for ‘Active Workplace’ – for the third year in a row. Building on this success, Martin hopes to see their offering develop overseas within the coming years. “We already have a large number of international students on our courses every year because they gain transferable skills as well as subject specific skills,” he explains. “We enable them to take those skills, develop them and return to their home countries where they can help develop their own healthcare systems.” As Southampton Solent University becomes ever more internationally focused, professional collaboration through Wessex AHSN will prove critical. “We know that we have a product that is very marketable,” Martin concludes. “I think it’s just a matter of time before we sell into the wider market.” FURTHER INFORMATION www.wessexahsn.org.uk www.wihc.co.uk

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Bournemouth University’s overseas programmes are based on research, education and practice, says Dr Malcolm McIver, Associate Dean Global Engagement

An internationalised education What does Bournemouth offer in terms of health education? At Bournemouth University’s Faculty of Health and Social Sciences, we share a vision with the rest of the university of ‘fusion’. It’s a philosophy that brings together education and research with professional practice, and explores how we can unify the three to achieve excellence. Based on that ideology, the faculty has a number of programmes rooted in education and based on research practice, that also give students the opportunity to develop new standards within professional areas. These programmes include nursing, physiotherapy, social work, paramedic science, social sciences, criminology, anthropology and sociology. As well as being one of the country’s leading health faculties for programme delivery, we also have a number of research institutes

and centres. The Bournemouth University Orthopaedic Research Institute (BUORI) is one of the leading and best-equipped institutes for orthopaedic research in the country. We also have the Bournemouth University Dementia Institute (BUDI) and the National Centre for PostQualifying Social Work, which is the UK’s only centre of excellence in this field, along with the Centre of Postgraduate Medical Research and Education. How do you compare as a provider of health education? Bournemouth University has recently been ranked 62nd in The Times Good University Guide, but globally we are ranked in the top 300, and for universities under the age of 50 we are in the top 200 in the world. The faculty generates some of the leading research in nutrition, and we are one of the top orthopaedic research institutes. What kind of international engagement have you developed? As a university we only received our charter in 1992, and as a faculty we’re relative novices in terms of international engagement. That’s part of the reason for my appointment to the post in 2015; before then, global engagement didn’t exist within the faculty. We’ve recently signed an agreement with a leading Chinese medical university along with another Chinese university, and we have a partnership with the Universiti Sains Malaysia (USM), the second highest in the country’s rankings.

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In terms of how you engage abroad, do you favour the partnership model or going overseas and teaching? There’s a third way. The Times Higher Education Award shortlisted us in the International Strategy of the Year category. Our strategy is based upon professional groups of practice - developing hubs of practice around the world with strategic, academic partners. We form partnerships with other universities, but then from those hubs we work to engage with industry, governments,

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WESSEX AHSN professional practice providers and regulatory bodies. Our focus is very much on research, education, and practice. We see ourselves more as enablers, allowing our partners to develop those programmes, rather than going overseas to deliver the programme ourselves. How long does it take to go from initial meetings to creating these programmes? If you’re talking about a commercial return on time and effort invested, it can be anything up to two years. But not everything we do is based upon a commercial return. We were approached by a charity in Africa that is developing midwifery services in Uganda. From the initial approach to sending staff overseas to support the delivery of midwifery training was about eight weeks. But this was a commitment from the university to help the development of midwifery training, rather than a commercial venture. Do you think universities have a role to play in putting international projects together? British universities have been working overseas for many years. Service providers in this country have only recently started to engage with the international market. There is a wealth of expertise within the universities which we can share, as well as the networking aspect, the gut feeling and the intuition whether something is viable or not. Should we extend the relationships between the NHS and educational institutions? Absolutely. Within Wessex International Healthcare Consortium, there is a wealth of experience from academia as we already have experience of working and negotiating partnerships overseas. As a consortium, not only can we work with overseas partners but we can also offer consultancy to other consortia and healthcare service providers across the UK who wish to work abroad. What role do you see for universities in such large consortia such as UKHIMA? British universities should be involved at the very beginning in terms of recruitment, staff development and the training of healthcare providers; not just nurses but physiotherapists, occupational therapists and even medical staff. There’s a tendency to go fishing with a big net and scoop up hundreds of overseas healthcare workers who don’t necessarily meet the needs of the patients or the organisation. If universities were involved at the very beginning, we could specifically identify the levels of expertise required and, in the event of a shortfall, we could assist in ringing up that expertise. What do NHS organisations need to learn? Mainly that they are not dealing with other NHS partners and that they’re not operating in the

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MALCOLM MCIVER Malcolm McIver is the Associate Dean for Global Engagement at Bournemouth University. Prior to this he was the University of Hertfordshire’s Director of Studies to the INTI Education Group for the South East Asia region and managed 42 programmes across 12 partners with 5,500 students. In 2000, he received the highest rating from the Economic & Social Research Council (ESRC) for his PhD proposal to research School Effectiveness, which he undertook at the University of Cambridge. As Project Lead for International Developments in 2006 at the University of Hertfordshire, Malcolm developed and managed a range of programmes for delivery across Asia and SE Asia; a role that enabled him to pursue his joint passions of education and internationalisation which he is continuing at Bournemouth University.

UK. The way we do business overseas is very different to the way in which we do business in the UK. The standards overseas are varied; working practices are very different and so are legal practices. One of the biggest challenges we have with contracts is that British companies, and in particular the NHS, want British law to be used in contracts. However, many countries overseas want to engage somebody closer to home who is more familiar with their legal systems. Similarly, not everyone wants an NHS model; they want their own specific healthcare model that meets their needs, and those needs could be very different from those of the average NHS patient. How do you think the organisation can reach its goals? We comprise some of the leading healthcare and education providers within the region. We have a wide range of experience and expertise and an enormous network of contacts overseas. We can certainly help partners to develop their research capacity for diabetes, dementia care and elderly care, management structures, orthopaedic care and research, as well as service provision or staff development. One of the reasons why Bournemouth has joined the consortia is the power of the unified body - you go from being individually good to becoming great. There are things that perhaps as a university we can’t do for our partners but as a consortium we can.

FURTHER INFORMATION www.wessexahsn.org.uk www.wihc.co.uk

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ental health is never far from the headlines these days and this is as it should be. One in four of us will suffer from some form of mental ill health in any given year. Mental illness affects people across the lifespan from children to the elderly, and the burden imposed on individuals and society is immense. It is widely acknowledged that we need more investment in care provision and research into the causes and prevention of mental ill health, and into the development of new treatment approaches. It is also clear that current investment is miniscule in proportion to the magnitude of the problem and the burdens mental ill health imposes. The scale of the challenge is evident from the reports of the Schizophrenia Commission in 2012 and the Mental Health Taskforce to the NHS in England earlier this year. We need new thinking about care and treatment, causes and prevention. We also need to hear from a wide constituency including those with direct or indirect personal experience of mental illness (virtually all of us), health care professionals and academics. I am an academic psychiatrist and have spent my professional life caring for patients with severe mental illnesses such as schizophrenia and bipolar disorder, and researching the causes of psychiatric disorders and dementia. Also, like most of you, I have encountered mental illness and dementia in my personal life. Many of you will know that mental illness can be a controversial area. Stories in the media often give the impression that there are widely held fundamental disagreements about whether mental illnesses are disorders of the brain or mind, caused by nature or nurture, and whether they should be treated by drugs or psychological approaches. These polarisations may make good copy but I sincerely hope that we can move away from them. First, they are profoundly misleading. They assume, implausibly, that mind and brain

are separate independent entities rather than different aspects of the same thing. They also fly in the face of a large body of evidence indicating the importance of genes and altered brain states in contributing to disorders of mental health, and equally compelling lines of

Professor Michael Owen, Director of MRC Centre for Neuropsychiatric Genetics and Genomics and Professor of Psychological Medicine (Psychiatry) at Cardiff Universityâ&#x20AC;&#x2122;s School of Medicine, discusses barriers to providing mental health treatments and prevention

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EDUCATION & TRAINING

CARDIFF UNIVERSITY

PROFESSOR MICHAEL OWEN Michael Owen is Professor of Psychological Medicne (Psychiatry) in the School of Medicine at Cardiff University. He is Head of the Division of Psychological Medicine and Clinical Neuroscience and Director of the MRC Centre for Neuropsychaitric Genetics and Genomics. He is also Emeritus Director of the Neuroscience and Mental Health Research Institute. He has worked on the genetics of psychiatric and neurodegenerative disorders for more than 20 years and brings to the Research Institute extensive research expertise in the genetic aspects of schizophrenia, bipolar disorder, Alzheimerâ&#x20AC;&#x2122;s disease, Attention Deficit Hyperactivity Disorder (ADHD), and Dyslexia. He also continues to work as a consultant in General Adult Psychiatry. In 2014 he was Knighted for services to Neuroscience and Mental Health.

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evidence that psychological and social adversity impact on mental health. There is also strong evidence that drugs, psychological therapies and social interventions can be effective and often work better in combination than when given separately.

Sharing ideas While it might not be apparent from the extreme views frequently expressed in the mass media, most mental health workers, researchers, and those with personal experience of mental illness recognise that mental health disorders reflect a complex interplay of social, psychological and biological factors, and that the relative balance of these varies from person to person. Providing treatment consists in working out for each individual the optimal combination of social care, psychological therapy and drugs as well as management of any concurrent physical illness, and is delivered by a multidisciplinary team of nurses, psychologists, social workers, occupational therapists and doctors (both psychiatrists and GPs). The second reason I hope we can move

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away from these polarisations is that, not only do they misrepresent the evidence and the views of the majority, but also they misleadingly suggest that there is widespread disagreement among mental health workers about how mental illness should be treated and researched. How can we expect the government to support and pay for better services, or funders to support much needed research, or those with mental health problems to participate in research, if the mental health professions appear to be so divided? How can we expect to recruit the brightest and best to work in this area when sometimes we appear to be at war with ourselves? Surely, if we wish to bring much needed resources and innovation into mental health, we need to present a coherent and unified case for greater investment and a positive image of the many exciting possibilities for progress whether in genomics, neuroscience, social sciences, psychological treatments, early intervention, public health measures and so on. Most of us are trying to do this, but we risk the message getting drowned out by the noises offstage. While understanding mental illness and developing better approaches to treatment and prevention represents one of the greatest challenges we face, there are grounds for optimism. Many voices are calling for change; the need to integrate social, psychological and biological approaches to both treatment and research is widely acknowledged; and new research approaches are making this increasingly tractable. What we need to do now is share ideas and work together to make this happen. FURTHER INFORMATION www.cardiff.ac.uk

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Real world training Coventry University’s approach to learning immerses students in real life situations to develop crucial clinical skills, says Professor Guy Daly, Pro Vice-Chancellor and Executive Dean at the Faculty of Health and Life Sciences

he Faculty of Health and Life Sciences at Coventry University is one of the largest providers of professional health and social care courses in the UK. More than 6000 students are currently enrolled within the Faculty, taking advantage of their unique and innovative learning approaches that expertly equip students for successful careers as worldclass clinicians. As testament to the Faculty’s dedication to the very latest advancements in teaching and training, early 2017 will see the completion of a new Science and Health Building as part of the university’s £60m investment plan. Housing a biosciences super-lab and an unparalleled range of life sciences research facilities, this newest addition will also provide state-of-the-art facilities in the field of clinical skills training and hospital simulation, as well as rehabilitation and applied

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biological exercise science research. “We are ensuring that our facilities cater specifically to our particular teaching and learning methods,” says Professor Guy Daly, Pro-Vice Chancellor and Executive Dean at the Faculty Health and Life Sciences at Coventry University. “Our pedagogical approach is student-focused, problem-based, and designed to develop all the skills that a student will need in the future. We have always tried to steer clear of the dry didactic approach that is sometimes the case. The fact that we teach so many health and social care professions means we can effectively mimic and simulate an entire patient or service user journey.”

A unique offering The Faculty’s health offer spans most of the health and social care professions, including

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EDUCATION & TRAINING

COVENTRY UNIVERSITY

PROFESSOR GUY DALY Professor Guy Daly is Pro ViceChancellor and Executive Dean of the Faculty of Health and Life Sciences at Coventry University. He comes from a health and social care background professionally and is a social policy academic. His own research concerns social care (personalisation, choice, adult social care), housing policy, local government, and the governance of public services generally. He is an active member of the Social Policy Association and the Social Services Research Group. He is currently Joint Editor of the journal Research Policy and Planning.

nursing, midwifery, physiotherapy, occupational therapy, paramedic science and operating department practice. They also enjoy a number of strategic partnerships with local NHS Trusts, ensuring the Faculty’s educational offerings remain up to date and relevant to the requirements of today’s clinical workforce. “We work across the whole of the West Midlands,” says Professor Daly. “In our locality in particular we have some great partnerships with four NHS Trusts located in Coventry and Warwickshire. We have also opened a campus in Scarborough in North Yorkshire and, as part of our partnership with Warwick University, we have been able to develop our leading doctorate in clinical psychology.” With over ten health and social care professional courses delivered at Coventry, it has become increasingly important for students to be

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immersed in real life situations to develop crucial clinical skills, dependent upon a specific role. “We prepare and augment students’ skills so they can develop them in practice,” he explains. “Students spend up to 50 per cent of their time working in NHS Trusts and elsewhere to prepare them for delivery as a health professional, once they are qualified and registered.” Much of this is underpinned by a particular pedagogical approach, incorporating world-class research into real life situations. “We always say that all our teaching should be research informed,” Professor Daly continues. “We expect and ensure that our academic colleagues are research engaged and we have a number of research centres, including three in the Faculty – one researches health technologies, another embraces psychology and behaviour and the third biological and exercise sciences.”

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All research is of an applied nature, designed to shape practice and progress clinical developments. This has created a tangible synergy between research and teaching activities. “All research from the centres was submitted to the research excellence framework,” notes Daly. “This happens every five or so years in the UK to measure the quality of research in UK universities. Of the two units we submitted, our heath submission scored highest within the University and scored in the top third more widely in the UK.”

Continual professional development In terms of the development of a healthcare professional, the first part of the journey is to study as an undergraduate, gaining a qualification that leads of professional registration. However, this simply represents the start of their education and training. “There is both an expectation and an aspiration for professionals to continue to meet developing professional requirements,” explains Professor Daly. “So we continue to work with them as an individual and their NHS trust organisation to deliver continued professional development programmes.

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“Some are bespoke to a particular organisation while others are more general. For example, non-medical prescribing is a course that many health professions are now undertaking to allow them the rights to prescribe. Many of our NHS and other health partners are also undergoing their own organisational development and they look to us to support and provide them with an academic framework and academic accreditation.”

Investment for the future Many healthcare professionals have also begun to extend their professional capacities – some nurses for example are now beginning to take on roles and tasks that medics would have traditionally undertaken. In response the Faculty has widened its offering to cater more effectively to the requirements of the modern clinical practitioner. Significant investment in state of the art facilities is symptomatic of this realignment. “We want to ensure that the facilities are second to none in the 21st century,” Professor Daly explains. “This is exemplified by the Science and Health Building. With this new facility we will be able to recreate the total treatment pathway using real life situations. For example,

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EDUCATION & TRAINING

COVENTRY UNIVERSITY we can mimic a road traffic accident outside the building, simulating an acute emergency episode. Our paramedics can then enter our new model emergency department. Training can then move to our operating theatres, an ITU, a high dependency ward and then a more general ward – all contained in the new building.” Building on the Faculty’s leading reputation for life science research, the new building will also include a biosciences super-lab – probably the biggest facility of its type in a university in the UK. “Our new laboratory on the top floor of the building will accommodate 250 students on a particular activity. Alternatively, we can divide the space to allow a number of different activities. The entire floor below is also set aside entirely for applied research.” This next generation of facilities means students can simulate nearly every possible scenario they may encounter in the real world. “We are extremely pleased that the University has chosen to use its resources in this way,” he continues. “Our teaching and learning stems

‘We want to ensure that the facilities are second to none in the 21st century – this is exemplified by the Science and Health Building and with this new facility we will be able to recreate the total treatment pathway using real life situations.’

from the real world and all our research is applied in its nature. As a result our graduate employability rates are absolutely fantastic. Our health students are able to take up jobs both in the NHS and elsewhere as soon as they are qualified.”

International engagement A critical component of Coventry University’s unique offerings stems from a strategic and internationalised approach to all education and training – ‘The Coventry Way.’ David Pilsbury, Deputy Vice Chancellor International, explains this unique approach; “We focus on what our students and stakeholders need and not what we want. The Coventry Way refers to the vitality that international students bring to our university so we make real efforts in the classroom and on the campus to get definitive value out of the fact that we have those different international perspectives.” This commitment to global engagement pervades all teaching and research undertaken by the Faculty of Health and Life Sciences. “We see ourselves as being globally engaged,” says Professor Daly. “As our strategic priority all our students – irrespective of their programme – have an international component to their curriculum. Some students are able to study virtually with international students. Others may go further, choosing to take advantage of the opportunities to undertake long or short placements abroad.” On-going international partnerships exemplifies this commitment, increasing opportunities to widen students’ international learning experience. For example, in terms of mental health nurse training, the Faculty has a close partnership with Hong Kong Polytechnic University. “Both staff and students exchange between the two organisations,” Professor Daly explains. “And for those who can’t travel due to time or resource restraints, we foster mutual learning between organisations using our virtual learning environment.” National Student Satisfaction survey results in part reflect the success of the University’s realignment towards an internationally-focused educational offering. “We very much recognise that the world is global,” he concludes. “We are committed to preparing our students for that world. As an individual Faculty we have scored a 92 per cent overall satisfaction rate in the last three years, and our School of Health this current year fared even better with a 97 per cent overall satisfaction rate.”

FURTHER INFORMATION www.coventry.ac.uk

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A redefinition of renal nursing De Montfort Universityâ&#x20AC;&#x2122;s unique three-way partnership in Abu Dhabi is changing the face of renal nursing provision within the UAE, as Professor Marie Richards, Director of Education, Training and Development at SEHA Dialysis Services tells Jack Ball 128

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hronic Kidney Disease (CKD) has been described as an epidemic of global concern. The prevalence of CKD within Abu Dhabi is around 20 per cent. Although high, this figure is representative of the region and represents a continuing challenge for healthcare providers going forward. Responding to a critical need for quality renal nursing provision within the region, De Montfort University (DMU) has joined forces with SEHA Dialysis Service (SDS) and Fatima College of Health Sciences (FCHS) to develop an MSc in Renal Nursing â&#x20AC;&#x201C; a postgraduate qualification focused solely on providing care for renal failure patients. This part time course delivered over 18 months gives nurses the opportunity to see

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EDUCATION & TRAINING

DE MONTFORT UNIVERSITY IMAGE: SHUTTERSTOCK.COM

PROFESSOR MARIE RICHARDS Marie Richards is currently working as Director of Nursing Education, Training and Development at SEHA Dialysis Services (SDS) in Abu Dhabi. Marie has over 30 years’ experience in the UK, Australia and the UAE working in nursing roles such as Clinical Nurse Specialist, Nurse Lecturer Practitioner and Chief Nursing Officer. She has led clinical programmes in faculties of Nursing, Nephrology Nursing, Public Health and Clinical Genetics. She has been in the UAE since 2012 and in 2014 launched the Masters in Renal Nursing Programme at SDS in collaboration with De Montfort University (UK) and Fatima College, Abu Dhabi. The programme is the first of if its kind in the region and is highly sought after with applicants from across the entire Middle East.

learn in college directly into the clinical space and it was DMU that understood this critical requirement. So we developed our MSc in renal nursing – the first of its kind within the GCC.”

Quality renal nursing

their skills recognised at a Master’s level. The partnership marks a concerted approach to improve the clinical management of CKD and its associated complications, with the added benefit of raising the profile of nursing more generally in the region as well as encouraging Emirati nationals to take up the profession. “What I wanted was a very practicallyfocused programme, based upon expert clinical practice,” explains Professor Marie Richards, Director of Education, Training and Development at SEHA Dialysis Services – an organisation that brings together all dialysis activities within Abu Dhabi. “It was De Montfort University that really understood what I wanted. We ensure students apply everything that they

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In England Chronic Kidney Disease costs more to treat than breast, lung, colon and skin cancer combined, according to a recent NHS Kidney Care report. Abu Dhabi has the one of the highest incidences of diabetes in the world – a major predisposing factor in the development of CKD. By January 2016 more than 1000 patients were undergoing dialysis in the UAE – a figure set to rise between 8 and 10 per cent annually. “When I arrived in Abu Dhabi five years ago we had 400 dialysis patients,” says Professor Richards. “Our dialysis population has now more than doubled to around 1200 patients. And whilst there were world class dialysis facilities in place when I arrived, there remained a noticeable underprovision of specialist renal nursing care. “I assessed many of the nurses at SEHA dialysis services when I arrived to identify their level of proficiency, skills and knowledge. While many of them were technically very competent using the latest in advanced renal equipment, their underpinning knowledge was actually quite lacking. They were extremely bright, but had no opportunities for further education in renal nursing which is an extremely specialised area of care. This is why we developed the MSc in Renal Nursing.”

Nurse led care The management of CKD can be particularly responsive to a highly skilled nurse-led care provision. However this is only made possible through a professionally accredited higher education programme. “In many parts of the world a significant

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CASE STUDY MANAL AL HAMOUDEH MSC GRADUATE IN RENAL NURSING I have been a Pediatric Renal Nurse for ten years which, as a profession, I find diverse, challenging and very worthwhile. Renal Nursing is a very specialised area which requires highly developed knowledge, skills and experience. Chronic Kidney Disease is a long term condition requiring a variety of clinical management and care interventions. To deliver the highest standard of care in this group of patient requires advanced levels of knowledge and skills. This is particularly true in caring for children who have the disease. My role as the Senior Charge Nurse is to ensure that all the children and their families get the best possible clinical and psychological care. As a senior member of the clinical team with extensive responsibility for ensuring best standards of care, as well as taking a lead role in strategic and operational management, I realised that being an experienced pediatric hemodialysis nurse is not enough. I identified that in order to lead this service I needed to develop advanced knowledge and skills in this specialty. The Masters (MSc) in Renal Nursing was the ideal programme for me to develop my knowledge, to challenge existing practice and to develop essential skills in all aspects of renal nursing including community early detection,

‘Taking up and completing a Masters in Renal Nursing gave me valuable insights into higher and advanced learning and has enhanced my standing as an expert professional in this field.’ 130

critical care, peritoneal dialysis, transplantation, vascular access, hemodialysis and of course pediatrics. In addition to this I learned advanced assessment and leadership skills to enable me to be proactive in the future development of our services. I was fortunate to be one of the first cohort of students commencing in 2014 in Abu Dhabi. I completed my studies in January 2016 and alongside my colleagues graduated at De Montfort University in Leicester in July 2016. My dissertation comprised an evaluation of how we could improve vascular access for children in Abu Dhabi and I proposed a service improvement to implement this in practice for which I was awarded a distinction. I have presented this work at the 5th SEHA international Nursing, Midwifery and Allied health conference (SINMAC, 2016) and in an international conference (45th EDTNA/ERCA International Conference) in Valencia, Spain, 2016. Since completing my study I am better placed to ensure that all the nurses on my team will have the opportunity to learn, develop and be up to-date on the current innovations in patient care. Taking up and completing a Masters in Renal Nursing gave me valuable insights into higher and advanced learning and has enhanced my standing as an expert professional in this field. This has opened the door for me to consider new research and evidence-based practice, while the leadership element of the programme has improved my critical thinking and decision-making skills. The MSc in Renal Nursing was a challenging journey for me. Studying at this level turned my existing knowledge and experience on its head, not to mention the considerable challenge of working full time during the programme, but it was worth the pain in order to gain. I would encourage all of my colleagues and any renal nurses within UAE to consider applying for this programme which is the specialist nursing master’s programme in the GCC. It is a huge opportunity and adventure.

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amount of renal services are nurse-led,” notes Professor Richards. “Yet in the UAE medicine has led the way solely because nurses didn’t have the skills or knowledge to take on caseloads of patients.” “Much of the current research demonstrates that nurses are better placed to manage long term conditions such as CKD. Patients undertaking dialysis are coming in three times a week, four hours at a time. There is no one better placed than nurses to deliver their required care.” CKD is categorised into five stages, one being very mild and five indicating total kidney failure. Even at stage five people may not be symptomatic of the disease or require hospital admission; however there is vital work to be undertaken by skilled renal nurses at these stages. “We have now been able to now set up community programmes – going out into the field and working in primary care and identifying patients who are at risk,” notes Professor Richards. “And through our diabetic and high blood pressure screenings, we found that the prevalence of stage two to five CKD is over 20 per cent in the UAE – double that of the USA.”

The programme “The Faculty of Health and Life Sciences at DMU has an extremely good reputation with a very good research profile,” she continues. “It ensures our teaching remains at a high standard within an academic framework.” The programme is also accredited by The European Dialysis and Transplant Nurses Association (EDTNA) – the largest multidisciplinary professional body with more than 3000 members in 74 countries. They have accredited it as ‘highly commended’ – their highest category of award. While the programme has only welcomed two cohorts of students since it began in 2014, its implications are already being felt, not only by the nurses themselves but by clinical colleagues too. “Outcome data has been extremely positive in terms of the way nurses have changed their practice and the way they work,” Professor Richards concludes. “Both managers and doctors say nurses are beginning to lead their own work and move things forward. “They lead in a very different way from before, underpinned with proper knowledge so they can challenge decisions and influence best practices. This is of course extremely beneficial for patient outcomes.” FURTHER INFORMATION

Contact the Academic Partnership Unit apu@dmu.ac.uk Quote GOH 2017

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EDUCATION & TRAINING

DE MONTFORT UNIVERSITY

DMU’s offerings include specialist programmes in health and science, such as their MBA in Health Management, says Carol Greenway, Head of International, Faculty of Health and Life Sciences

Equipping the next generation

y its very nature, the healthcare sector is one that continues to evolve. Incorporating the most up-to-date best practices to ensure smarter care delivery set to the highest possible standards is an imperative for any healthcare training provider. DMU recognises the importance of equipping its students with the required knowledge and skills that ensure successful careers as world-class clinicians. Indicative of this commitment, DMU’s MBA (Health Management) programme aims to equip health managers and administrators with knowledge, insight of international practices and industry-relevant management skills to be leaders in healthcare organisations. Part time and delivered in-country over 24 months, the programme has three core competencies – healthcare management, industry-relevant Left: Leicester Castle Business School A new business school at a dynamic, modern university in England Contact MBA Health Management team enquiry@lcbs.ac.uk

management skills, and healthcare management best practices and their implementation. Its unique curriculum has been jointly developed by two of DMU’s renowned faculties, the Faculty of Business and Law and the Faculty of Health and Life Sciences. Those who benefit most from the programmes include healthcare practitioners and business managers in the field of medical operations, nursing, allied and ancillary support services; senior, middle or executive management staff aspiring to advance their knowledge and skills in healthcare management and administration; those with job scopes that require management of people, projects, budgets, analytics of operations and department work plans in the health sector or related areas. “We are very much open to new and innovative partnerships that provide opportunities for students to have substantive global experiences, including study abroad, joint courses, training and summer schools,” says Carol. “Our core mission is to think beyond conventional experiences and create new and unique opportunities for students.” FURTHER INFORMATION Contact Carol Greenway; cgreenway@dmu.ac.uk

THE DESIGN UNIT A key aspect of the University’s Innovation Centre, the Design Unit at DMU was formed in 1992 to improve the alignment of research and development to the demands of industry, supporting a number of companies, both large and small, to make better use of their product development strategies. The unit has undertaken a significant amount of product development work in the healthcare sector, helping to develop the next generation of commercially viable healthcare products to benefit both patient and clinician alike. The unit’s strength lies in its unique ability to blend the practical and theoretical ends of the design development spectrum, operating in a consultative capacity to bring research into design; to create design principles

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unique to each individual client. The unit enjoys a particular focus in the development of healthcare products for both high and low volume manufacture, identifying cost effective methods for manufacturing product in either context, both in production and prototyping terms. “Customers who approach the unit have certain design challenges,” says Gary Trappitt, Business Development Manager, Faculty of Health and Life Sciences. “So we employ designers to help them understand and tackle them. They enable businesses to realise their development challenges with both the educational and consultancy aspect of the unit’s offering at DMU. Today the unit enjoys a success rate of 80 per cent.”

FURTHER INFORMATION

Contact Professor Peter Ford: pbford@dmu.ac.uk

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EDUCATION & TRAINING

EASTWOOD PARK

JOHN THATCHER John Thatcher has been CEO and Director of Training since 2003. In the early 1990s John joined Eastwood Park as Head of Training Support for what was then the UK National Health Service Training Authority. He has guided the organisation through significant change. Following a management buyout, John now heads the successful, independent and expanding international training business. Combining his engineering and educationalist knowledge, John has developed compliant service strategies for healthcare organisations worldwide. His close involvement with professional and awarding bodies has helped him raise the profile of effective competencies and structured career pathways for healthcare engineering support services.

astwood Park is a specialist training provider offering training to non-clinical staff working mainly in hospitals. The staff are involved in looking after hospital buildings, equipment and services with a particular focus on technical support services, hospital engineering, healthcare estates and facilities management.

Simulated hospitals

Eastwood Park in Gloucestershire was set up by the NHS nearly 50 years ago as a training centre for specialist healthcare services. Now independent, the centre offers world-class training and a wide spectrum of courses that can be adapted to fit international standards says John Thatcher, Chief Executive Officer

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Practical training is really important to develop the skills needed to work in todayâ&#x20AC;&#x2122;s hospitals in order to improve patient care and ensure patient safety. Our unique training facilities at Eastwood Park simulate hospital departments, including an operating theatre, medical gas systems and a sterile services laboratory. This ensures we train in simulated but realistic working environments, allowing our learners to make mistakes in a safe learning environment without endangering themselves or patients. It also makes the learning more transferable to the workplace. Our clients come from all over the world to be trained in our facilities and in turn we deliver training in many other countries. We have centres in Dubai and Malaysia as well as partners elsewhere in the world. We also train in hospitals with trainers travelling globally to do so.

Scheduled courses Eastwood Park offers more than 100 scheduled courses. These include on-site training and work-based learning programmes in hospitals, totally bespoke training to meet individual customer needs, and consultancy and audit services utilising the expertise of our technical training consultants. Our trainers are all highly respected and qualified practising specialists in their fields, with many combining training at Eastwood Park with their work within hospitals. Our portfolio is wide-ranging, not only in

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the subject matter we teach but also in the levels and nature of our courses. For example, we deliver a spectrum of training from initial training for new staff through to continuous professional development (CPD) for experienced staff. These staff also require updating, and in many cases multiskilling, as well as career development programmes, all of which we offer. We also deliver everything from short courses for apprentices through to a three-year honours degree programme for more experienced and senior staff.

Compliance standards Most of the training Eastwood Park delivers is designed to ensure hospitals are compliant with national legislation, codes of practice, or other standards the hospital has to follow. These are usually based on local laws, regulations and guidance but also include contract requirements and internal policies and procedures. For example, we have trained many subcontract staff from private companies in Malaysia to meet the requirements of their support services concession contracts in government hospitals, and to avoid the financial penalties associated with non-compliance. In the UK we have Health Building Notes (HBNs) and Health Technical Memorandums (HTMs) and various other approved codes of practice that we have to follow. HBNs give guidance on the design and layout for specific parts of the building, such as operating theatres. HTMs give guidance on the management, maintenance, servicing and testing of hospital plant and services. All of these standards provide the basis for what we do, whether designing our training, planning audits or the competencies required by staff. They influence our curriculum, hospital staff work roles and need for refresher training.

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Overseas training Hospitals in a number of countries around the world have adopted or adapted our HTMs for their own use, and as a consequence have turned to Eastwood Park to support their implementation as we are uniquely placed to deliver this training and support. We have trained hundreds of hospital workers within the Hamad hospitals in Qatar to perform the roles specified within the HTMs they have adopted. With Hamad we are helping them implement UK practices in Qatar. In a Public Private Partnership in Malaysia we are helping to create something new for the country. We are working with the Malaysian Ministry of Health to implement its Medical Device Act that ensures everybody who maintains, services, tests and calibrates medical devices is competent to do so.

â&#x20AC;&#x2DC;We have trained many subcontract staff from private companies in Malaysia to meet the requirements of their support services concession contracts in government hospitals, and to avoid the financial penalties associated with non-compliance.â&#x20AC;&#x2122;

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EDUCATION & TRAINING

EASTWOOD PARK

International accreditation In both of these cases and in 99 per cent of its curriculum, Eastwood Park provides internationally recognised accreditation by working with recognised awarding organisations and sector specific professional bodies. In addition, Eastwood Park has also helped many hospitals with their own organisational

accreditation, such as the Joint Commission, Accreditation Canada, and in the UK, the Care Quality Commission. This is for the whole hospital and includes all of their support services. Hospitals work with Eastwood Park because of our 47 years’ experience as well as our expertise. We’re good at it, as many graduates and successful developmental projects will testify to. Our trainers have real depth of hospital technical experience and cultural experience derived from numerous international projects. Since the establishment of the NHS Eastwood Park has been its national training centre for specialist healthcare services, and we utilise the leading experts in their fields as our trainers. Finally, Eastwood Park is independent of any single manufacturer or service provider, and we work with a wide range of equipment supplied from all over the world. What this all means to our ultimate customers – our patients – is that they can rely not only on the professionalism of the clinical staff looking after them, but also the building in which they are hospitalised, the safety of the equipment being used and the technical support services that facilitates their recovery. FURTHER INFORMATION

www.eastwoodparktraining.co.uk

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TRAINING AND EDUCATION

QHA TRENT

PROFESSOR STEPHEN GREEN Professor Steve Green has had a long hands-on career at the frontline of the UK’s NHS. He has been a Consultant Physician (with lead managerial responsibilities) in Infectious Diseases and Tropical Medicine in a leading UK teaching hospital, has been heavily engaged in the teaching and training of medical students and postgraduate doctors, and is an active MRCP (UK) examiner. His enthusiasm for promoting and improving the quality and safety of care in hospitals and clinics using UK-based principles and methodologies has manifested itself through his work with QHA Trent Accreditation.

Stamp of excellence Independent accreditation can help healthcare providers in the UK and across the world maintain universal standards of safe and effective care, says QHA Trent’s Professor Stephen Green

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igh standards of healthcare are a global imperative. We are all human beings, suffering the same sorts of illnesses, and benefitting from the same effective treatments. In fact the healthcare industry has a long and proud history of encouraging and supporting international collaboration, and coming together to raise healthcare standards globally. Independent clinical accreditation is critical in this regard, helping to ensure codes of medical and ethical practice are developed and maintained internationally – giving peace of mind to those needing safe and effective treatment overseas. QHA Trent is a UK based organisation that delivers such accreditation, adopting Britishbased standards and medical expertise to assist overseas healthcare organisations in improving their service standards as they seek a universally recognised ‘stamp’ of clinical best practice. “People in the UK take it for granted that the standards are so good,” says Professor Stephen Green, Managing Director at QHA Trent Accreditation. “As a result the NHS and the organisations that have arisen over the years to support the NHS in its mission have together assembled a huge body of data, information, analysis, recommendations, procedures and policies – indeed everything needed to develop and manage an excellent healthcare system.” Indeed, for many the high quality of the vast majority of the NHS’s work remains ‘under the radar.’ But with some of the highest standards of care to be found across the world, many overseas healthcare organisations are looking towards UK based independent accreditation as an internationally recognised stamp of excellence.

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Medical tourism Latin American countries such as Brazil, Middle Eastern states including Jordan, Turkey and the UAE, as well as Asian countries like Taiwan, Thailand and India may offer access to quicker and cheaper healthcare. This has increased the number of people travelling internationally specifically for the purpose of accessing healthcare – a phenomenon known as Medical Tourism. As this trend continues the market for independent professional accreditation – a marker of clinical excellence and high standards of governance and ethics – will only strengthen. “There are over seven billion people on the planet,” says Professor Green. “They all have healthcare needs so there’s definitely space for QHA as a British organisation that can work outside the UK and Europe. Clients require accreditation that is expert-led and based on

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As the world’s largest single health payer system, patients generally expect NHS standards to be excellent. “We have professional bodies in the UK, separate from the NHS, that ensure standards are kept high,” explains Professor Green. “They include the Care Quality Commission, the Human Fertility and Embryology Authority and the Royal Colleges. “These public sector and non-governmental bodies are charged with the duty of maintaining standards in healthcare,” he continues. “And having a healthcare system so effectively organised from the centre is really fairly unique to the UK.” While some overseas healthcare facilities may measure up to the best in the world, some may fall far short of what it should be. With this in mind most people around the world accept that they will either have to pay for optimal care – either on their own or through their insurance company – or rely on their employer to look after their needs. UK people are not so used to this, and when they come to seek healthcare overseas, the challenge of identifying which healthcare facilities meet UK standards or similar is critical. “We can help UK citizens and insurance companies decide where is safest for treatment,” says Professor Green. “If someone is sent overseas professionally and they get sick, or their partner is pregnant and needs to give birth, they need to know where standards of care will be as good as those adhered to in the UK.” Some hospitals themselves exercise free choice and want to achieve standards as high as those expected of UK providers. “An independent accreditation scheme offers hospitals, clinics and other healthcare providers an opportunity to achieve that ambition,” he continues. “We proudly base our system on a British type of model – a distillation that brings together all things that are good about the NHS and QHA.”

‘If someone is sent overseas professionally and they get sick, or their partner is pregnant and needs to give birth, they need to know where standards of care will be as good as those adhered to in the UK.’

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TRAINING AND EDUCATION

QHA TRENT

standards of governance are good, and if their modus operandi is good enough to deliver safe and effective healthcare services. “Even if we are focused on a particular area, such as a cancer treatment ward, we still have to be interested in the feeder parts within the hospital that are vital to ensure the work is being done safely and appropriately, such as pharmacy, blood transfusion, and the catering services. All parts of a hospital or clinic have to work together in a co-ordinated way.”

Raising standards internationally

evidence. The standards QHA work to are themselves independently assessed, accredited and recognised by ISQua [the International Society for Quality in Healthcare].”

The QHA way The main premise of an accreditation scheme is to assist hospitals and clinics in raising their standards so as to maximise quality, minimise risk, and prioritise patients and staff safety. However, it is not enough simply to flag areas of weakness within an organisation. Instead QHA adopts a unique approach to assessment, creating a culture that values quality and promotes ownership of the improvement process – enabling managers and staff to solve problems and think autonomously. “We don’t want caregivers having to look in a manual if someone on their wards has a cardiac arrest,” says Professor Green. “You need to have people who know what they are doing, who do it regularly and are regularly trained and drilled. You need to look at the whole team and assess whether they work well together, if their

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QHA’s international work has one central remit – to keep patients, British or otherwise, safe around the world. “Recreating top-class healthcare delivery systems around the world is heavily dependent on whether standards can be developed, maintained and improved upon. We try and help hospitals and clinics to grow in stature and confidence through the use of British standards,” says Green. “When you travel around the world you can, even in less wealthy countries, come across standards, individuals, and systems that are the equal of what you would encounter in wealthier countries. You don’t need to be a rich country to provide medicine to a high standard, but it undoubtedly will need hard work and diligence.” Indeed, some of the wealthiest countries house some of the poorest standards of healthcare, muddying the water and making it more difficult to identify areas for safe treatment. Smart décor does not create a good hospital. Furthermore, bringing a patient back to the UK for treatment can also turn into an extremely expensive proposition, costing between £100,000 and £250,000. As such, promoting and raising standards locally is not only a moral obligation. It represents sound business sense and offers a significant opportunity to reduce costs, particularly for healthcare insurers responsible for providing care for UK nationals overseas. “In some ways there is both an ‘individuality’ and a ‘collectivity’ to healthcare,” Professor Green concludes. “If the containment of Ebola fails in West Africa the disease can spread rapidly. If infection control fails in Southeast Asia there is the possibility of drug resistant organisms spreading across the world. So it’s in all in our interests to get things right.” Internationally recognised standards of care and independent accreditation are one critical aspect to this equation. Expert-led and evidencebased, accreditation from QHA Trent should be the ‘gold standard’ for healthcare providers around the world looking to replicate all that is great about the UK’s internationally recognised standards of healthcare excellence.

FURTHER INFORMATION www.qha-trent.co.uk

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Staying ahead of the game Continuing Professional Development (CPD) is critical, not least of all in healthcare as Simon Monkman, Director at Premier IT tells Jack Ball

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DIGITAL

PREMIER IT

edical research and development is constantly providing newer and more effective methods of care for all members of the healthcare industry. Continuing Professional Development (CPD) allows healthcare professionals to build on their expertise and skills on a rolling basis, so that every patient under their supervision can be assured they are receiving the highest standards of benchmarked care. A key player in the healthcare industry’s CPD programme, Premier IT has come to expand their remit into appraisal, revalidation, and education services. The company now boasts over 200 healthcare clients across the primary care, secondary care and independent healthcare landscape as partners in appraisal and revalidation services for the nation’s doctors, nurses and care support workers. They include leading UK NHS Trusts, independent hospital groups, clinical commissioning groups (CCGs), area teams, medical staffing agencies and Medical Royal Colleges. “Premier IT started about ten years ago, working with some of the Medical Royal Colleges. They were looking to develop e-portfolios around CPD to enable and capture more effective learning. Revalidation was then developed on a platform of learning, training and development needs with an online system that is tangible and can be captured,” Simon explains. “We were probably the pioneers of the very first comprehensive and absolutely validated online system that enabled doctors and specialist career-grade doctors to revalidate, a process that proved they were fit to practice safely.” In short, the revalidation system allows doctors and other healthcare professionals to engage in a series of submissions, on a rolling basis, as well as patient and colleague feedback to ensure that they are trained to the highest possible level to an agreed benchmarked standard of excellence. “Revalidation is a five year cycle for doctors,” explains Simon. “On a regular basis, within that five years, doctors would be expected to collect evidence through a multi-source feedback tool, SIMON MONKMAN Simon Monkman is the Managing Director at Premier IT – the Westminster-based software house that lead the UK market on all things relating to the appraisal, education and revalidation of healthcare staff. Simon has a career spanning leisure and retail operations for a number of blue-chip companies and the Ministry of Defence, but has found the last ten years working alongside the NHS as his most rewarding. As he puts it, “Providing effective software solutions to healthcare professionals that desperately need and prefer to be patient-facing gives huge satisfaction and wonderful motivation.”

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DIGITAL

PREMIER IT Raising standards internationally

which is driven through our portal. They can collect ratings from up to 20 patients and up to 15 and 20 colleagues, giving them excellent objective as well as granular feedback on their performance. Although some of them don’t like the process, it’s absolutely spot on and their appraiser will use that evidence to have a truly informed conversation about what they might be able to do to improve their working practice.”

E-learning Although this system began as a simple appraisal and revalidation tool, it soon expanded to integrate with other e-learning platforms to create a holistic view of workforce performance within one portal. “Along the journey of appraisal and feedback, doctors, nurses and allied health professionals are able to identify where there are gaps in knowledge,” says Simon. “We can then integrate this with various e-learning tools to blend all the required e-learning together. They can then learn and be educated online within the same portal. Any subsequent submission for appraisal will show not only that there was there a skills gap, but that there was the online education to respond to it.”

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With some overseas developing healthcare systems still struggling to pinpoint areas of weakness or improvement, the company is now looking to further market its software internationally. “It’s often the case that organisations actually don’t know what their training needs are,” says Simon. “So we have to start with a self audit to understand exactly where the bar is in terms of staff performance and what they need to do to raise standards to meet this agreed level of care.” It is at this point where Premier IT can make a tangible difference by providing a truly configurable solution, particularly if they are advising a brand new facility on their staffing and training needs. “We can help such organisations conduct those audits and show where that initial benchmark sits. If there are no previous systems in place then we can provide the tools to enable their professionals to improve their performance, and enable managers in their organisation to report on how those performances can grow and develop over time.” This process of self-appraisal to formulate organisational benchmarks of care, where one can evaluate individual performance, is also supported by universally applicable questions within the company’s appraisal software. “It’s important to note that everything we do is validated by panels of advisors and experts,” says Simon. “So we’ve got some really strong guidelines about the questions that can be asked and, as you can expect, the rules and regulations are quite stringent. However, these questions allow the user to understand very quickly how they’re doing, and more importantly, how their colleagues and patients think they’re doing.” “Their answers come back in the form of a report, and we join up various elements and actions. We also suggest an online plan to help them improve upon their skills. Should e-learning and training be required, then a system of blended learning is already on hand to help plug any knowledge gaps.” With overseas healthcare organisations looking to UK organisations and the NHS in particular, Simon is confident of Premier IT’s future role in helping to internationalise the universal standards of excellence expected from both the NHS and the UK more generally. “Over time, Premier IT systems will help overseas organisations reach UK standards and levels,” says Simon. “Our systems are suitably configurable so users can switch on and off elements to make it their own system, unique to them. They are also sufficiently broad enough that you can narrow them down, enabling us to tune in to the real needs of an organisation.” FURTHER INFORMATION

revalidation.premierit.com

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Accessing UK private healthcare solutions Healix Health Servicesâ&#x20AC;&#x2122; bespoke medical case management solutions are helping overseas insurers and employers access, manage and oversee their medical claims and overall healthcare provision in the UK at preferential rates, says Richard Saunders, Sales Director at Healix Health Services 144

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ith millions of people travelling across the world, whether for work or for leisure, finding the correct solutions to ensure they receive appropriate medical care whilst away from their home country can be challenging. Founded in 1992 by two leading experts in international healthcare delivery, Dr Peter Mason and Dr Paul Bevan, the Healix Group of Companies provides bespoke healthcare and risk management solutions to clients across the globe. Headquartered just outside London, the group boasts a medical team of more than 90 fully qualified doctors and nurses in the UK alone.

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HEALTHCARE SUPPLIERS

HEALIX HEALTH SERVICES

RICHARD SAUNDERS Richard Saunders has worked in general insurance for over 30 years, with the last 17 spent in the healthcare sector, in roles encompassing business development, consultancy and sales. He joined Healix in 2006 as Business Development Director, responsible for developing the corporate healthcare and third-party medical claims markets for Healix Health Services, as well as exploiting opportunities for the rest of the Group. His achievements have included establishing Healix Health Services in the UK as the leading provider of self-funded corporate Healthcare Trust schemes and the only credible, independent medical claims Third-Party Administrator (TPA).

“Healix Health Services is part of the Healix Group and acts as a specialist third-party medical claims administrator for domestic and international insurers, providing independent access to the UK private healthcare system and expert management of medical claims,” says Richard Saunders, Sales Director at Healix Health Services. “We are now the largest, independent medical Third Party Administrator (TPA) in the UK, also acting as medical administrator for approximately 20 per cent of all UK self-insured corporate healthcare trusts.” Healix Health Services offers distinct propositions to two different markets: overseas

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and domestic insurance companies looking for access to Healix’s provider network and management of their UK medical claims; and overseas and domestic employers (and some foreign governments) seeking a company to manage the medical treatment of their staff (people) whilst in the UK. With access to over 22,000 specialists across the UK, Healix can advise, authorise and provide access to medical treatment within the private sector, including NHS Trusts private services if this is where the specialist need is required. The company spends circa £100m annually on behalf of its clients, and has direct billing relationships with all hospitals and specially negotiated tariffs with private hospital groups and other providers. “We have a large portfolio of clients who enjoy favourable hospital procurement costs and access to our Chief Medical Officer and second opinion services,” says Richard. “Where detailed case management is required, our nurse case managers can provide a full micromanagement service, ensuring that the appropriate medical care pathway is taken, without any delays in authorisation and without any hospital restrictions if required. We can also develop bespoke provider networks to make optimal use of our clients’ procurement spend. “We have the flexibility to provide a bespoke service according to each client’s requirements - from providing access to our UK hospital network through to full case management and everything in-between. We also have our own in-house systems and technology, which means we have the ability to accommodate varying requests specific to clients’ requirements.”

Facilitating UK healthcare International insurers find the service from Healix Health Services highly effective in managing claims for medical treatment in the UK on their behalf. It is also of value to international employers who have expatriate employees

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working and living in the UK with their families. Some international governments, such as those in the Middle East, also find the service attractive where they are unable to provide an extensive health service within their own countries. “Some employers don’t have healthcare schemes of their own, instead opting to approach insurance companies to cover their employees’ healthcare needs. An insured member will have treatment whilst in the UK under the terms of their insurance with the bill funded by the insurer. Healix will provide the medical claims administration, ensuring the patient is looked after and receives appropriate treatment and that costs are controlled.” says Richard. “Expatriate employees based in the UK requiring medical treatment, or with specialist healthcare needs, don’t have access to the NHS in the same way as UK residents so Healix will administer their medical needs on behalf of their

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‘An insured member will have treatment whilst in the UK under the terms of their insurance with the bill funded by the insurer.’

employer. We can cover the full range of medical needs which a patient may have, from a simple cough or GP services to a hip replacement for example, as well as some complex heart and cancer conditions requiring treatment in the UK.” Some international companies may decide to self-fund treatment for their employees in the UK. “We would provide a medical helpline to those members and they would call us if there was any medical treatment required. We would then take them through a medically-based assessment so they can get access to the best medical treatment.” Generally, most patients are already in the UK as expatriates or travellers, but Healix can also manage cases on behalf of clients for patients travelling to the UK specifically for treatment that may not be available in their home country. In these cases Healix can provide additional medical support for medical escorts to accompany the patient travelling to the UK and home again if required. Healix can also supply additional supportive services such as aftercare nursing, cashless pharmacy services and 24 hour medical helplines. “Whilst some companies do medically assess their employees before transferring them abroad, there may be issues of pre-existing medical conditions that mean that some are at a higher risk of needing unplanned hospital treatment whilst abroad. To make allowances for this risk, we can assist with pre-medical screening and arrange that on behalf of employers and insurers.

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HEALTHCARE SUPPLIERS

HEALIX HEALTH SERVICES

HEALIX CASE MANAGEMENT In summary, our case management team will: lM anage a medical claim from first appointment to discharge l Gain appropriate and relevant medical information relating to the claimant’s treatment so that their claim can be pre-authorised l Assist and advise on available treatments and care pathways l Make appointments and referrals as required l Discuss treatment plans with the treating medical and multi-disciplinary team and monitor all planned and delivered care to ensure that this remains routine and customary and in line with the patient’s insurance policy/scheme benefits l Answer queries from the patient and provide an explanation for treatment plans and drug therapies proposed l Organise/source a second opinion if required

Bespoke case management Requiring serious medical treatment is a challenging experience for any patient. It can become more demanding when living or working outside your home country and struggling with potential language barriers or general concerns about receiving care in a foreign environment. “We can provide full medical case management for any treatment,” says Richard. “Advising a patient on where they are going for treatment, holding their hand throughout, and providing a fully-managed care pathway for the entirety of their care. If a patient requires physiotherapy treatment, for example, we can prearrange that so they know that care is already waiting for them.” And with the highest ratio of medically qualified to administrative staff in the UK managed health services industry, every client can be assured of a superior quality of service in the medical case management they receive. “Many of our staff managing cases are qualified nurses who act as named case managers they liaise with the patient and provide crucial reassurance and advice throughout the entirety of treatment.” It is the bespoke nature of care that has

‘We have the flexibility to provide a bespoke service according to each client’s requirements - from providing access to our UK hospital network through to full case management and everything in-between.’

proved critical to Healix’s success, particularly when conventional health insurance companies are often only able to offer a ‘one size fits all’ care package. Healix ensures that no aspect of care is overlooked with their ‘end to end‘ case management solution ensuring the highest standards of comprehensive care, from first appointment to discharge. Saunders explains; “Healix case managers handle all cases, from taking that first initial call from a patient to settlement of the final invoice. They check that treatment is covered; arrange and manage treatment with appropriate hospitals, specialists and other providers; authorise bills for payment and settle them in sterling on behalf of our clients.” “Our favourable tariffs are also passed onto our clients, meaning they’re getting a big saving as opposed to going direct. For example, clients may get a 30 per cent reduction in their medical bills as a result of using the Healix network. Although a portion of this will be used to pay for Healix’s services, clients still achieve a significant saving straight to the bottom line.” And with many specialist treatment centres based in the UK, international buyers often look to the UK when complex treatments are required. Healix’s bespoke service combined with their extensive expertise in the field of medical and risk management allows them to deliver cost-efficient solutions to such clients, without compromising on continuous high quality. So it comes as no surprise that Healix Health Services has won the ‘Best Healthcare Trust Provider Award’ in the prestigious annual Health Insurance Awards five times over the last six years, as well as accreditation from both the International Organisation for Standardisation and ‘Best Companies’. FURTHER INFORMATION www.healix.com

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Elior’s refreshing catering alternative is being embraced by many NHS Trusts, says Robin Givens, National Sales Director

Recipe for success

lior is expanding its presence further within the NHS, providing a food and drink strategy that addresses the nutritional and hydrational needs of the whole hospital community with a focus on healthier eating and sustainable procurement. Being a specialist caterer we understand that diet significantly affects the health of our customers. Our service solutions within the NHS are designed to enhance the food experience, encouraging the need to eat for good health. The range of services comprises retail restaurants and food courts, branded coffee shops, retail shops, hospitality and vending. Significant retail contracts are now held at

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Nottingham University Hospitals, Manor Hospital, Broomfield Hospital, Singleton Hospital and Bart’s Health NHS Trust where Elior recently achieved the Soil Association ‘Food for Life’ Gold catering mark. In December 2015, Elior agreed a 15-year deal worth £43m with Northern Lincolnshire and Goole NHS Foundation Trust to transform the Trust’s eight catering and retail outlets at three hospitals, creating approximately 30 jobs. The new catering provision is currently being mobilised across the outlets on a phased basis. Elior has introduced its ‘Eatwell’ healthy living branding to the main restaurant at Diana, Princess of Wales Hospital in Grimsby and also,

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HEALTHCARE SUPPLIERS

ELIOR

as part of an Eatwell express offer, combined with a Costa Coffee outlet, serves a healthy selection of ‘grab and go’ offerings. Another Eatwell restaurant, Fontanella Café and two kiosks serving Costa Coffee will be introduced at Scunthorpe General Hospital, as well as a coffee outlet at Goole Hospital. New vending suites are to be launched at Diana, Princess of Wales Hospital, Scunthorpe General Hospital, and Goole and District Hospital. The redevelopment will provide a wide selection of food and drink options to suit a range of budgets and tastes, from traditional British fare to global street food. An integral part of the offering is to introduce modern menus at all the Scunthorpe and Grimsby hospital restaurants, enabling hospital employees and visitors to enjoy a range of healthy, high street quality on-trend dishes.

ROBIN GIVENS Robin joined Elior in 2008, bringing extensive UK and International business development experience gained in senior positons within the catering industry. Initially responsible for new business in the city of London, Robin has since developed winning value propositions within the Defence and Healthcare markets. Having aligned the B&I and Defence retail operational solutions, he has been instrumental in taking retail services into new markets. Robin was appointed to the UK leadership team as National Sales Director in 2014, with the responsibility of overseeing strategic growth across all Elior’s business sectors.

Transforming nutrition Elior is focused on promoting healthy eating in hospitals and has introduced some immediate changes to the offer North Lincolnshire and Goole NHS Trust since taking over the catering in October 2016. l Bronze standard CQUIN compliance has been achieved and all recipes are CQUIN compliant in line with the government initiative and are low in fat, sugar and salt l Soil Association Bronze Status has been achieved and we use organic meat, organic milk and provide food, as well as catering for all ethnic and dietary requirements l Chocolate has been removed from the retail counters l Low fat alternatives to full fat products have been introduced l Sugary drinks on offer have been reduced l Gluten free sandwiches have been introduced meeting CQUIN standards l Trolley service has been introduced within wards removing sugary products Additional support is also given to our clients as part of the wider relationship and this year Elior sponsored the NHS Trusts awards. The Elior team are also supporters of wider NHS forums to encourage healthy eating. Lincolnshire is endeavouring to achieve bronze soil accreditation across the entire county and they are part of the project team to help achieve this objective. Elior’s refreshing alternative is being embraced by many UK NHS trusts and hospitals as they look for a specialist caterer that can not only focus upon nutrition and excellent food, but also transform the retail areas into the same stimulating environment experienced on the high street. FURTHER INFORMATION www.elior.co.uk

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Bringing hospitals to life Sercoâ&#x20AC;&#x2122;s strength stems from its global presence, scale and expertise in managing a variety of non-clinical services involved in safe operation of world class healthcare facilities, as Joe Boyle, Serco Middle Eastâ&#x20AC;&#x2122;s Managing Director of Health and Integrated Services tells Jack Ball

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HEALTHCARE SUPPLIERS

SERCO

erco has been operating in the Middle East since 1947, delivering essential services to customers of behalf of governments, semi-governmental bodies and large private corporations. Its Middle East division now employs more than 4,500 people across five countries, including Bahrain, Iraq, the Kingdom of Saudi Arabia, Qatar, and the United Arab Emirates. Globally, the group employs more than 50,000 people in over 20 countries, delivering a wide range of services across a number of public sectors including Health, Justice, Defence, Transport and Citizen Services. In Health, their global scale, expertise and diversity, helps clients through the provision of innovative models of service delivery, strong people management and robust processes. Today Serco provides essential non-clinical services to nearly 30 hospitals and some 9,500 beds worldwide. “For many of our healthcare services, there are parallels that can be drawn from other sectors and there is an ability to bring best practice from

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JOE BOYLE Joe Boyle is the Managing Director for the Health and FM services sector, based in Dubai. He is responsible for operational delivery as well as the expansion of Serco services to new markets across the Middle East.

other areas of our business,” explains Joe Boyle, Managing Director of Serco Middle East’s Health and Facilities Management Sector. “As a provider of public sector services, we have robust management systems, documentation, and rigour in our business that allows us to mobilise and adapt more quickly than other organisations. Such high levels of standards and operating procedures do not come overnight – they have come from our extensive history in international service delivery.”

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This global experience is ever more critical when operating in the Middle East – a region where a comprehensive understanding of the modus operandi is integral to success. “We have been active in the region since 1947 so we understand the nuances,” Joe continues. “There are many challenges with opening new healthcare facilities and we try to bring our international experience to bear and bridge the gap between construction and commissioning, leading in to operational service delivery. Our local supply chains and the support of local companies are both key strengths for the company.” No better is this exemplified than at the Cleveland Clinic in Abu Dhabi (CCAD) - a world-class multispecialty hospital where Serco delivers a wide a range of services, predominantly technical and engineering in nature. The Serco team at CCAD were given approximately six weeks to mobilise a FM team and accept handover of the building for service commencement, with Serco employing, training and familiarising itself with the CCAD building and associated assets. “As ever, there are always challenges in bringing a complex facility to life,” he explains. “But having Serco as that friendly face with local knowledge and experience was invaluable – particularly for an organisation that may be unfamiliar with a new operating environment. In recognition of our support, Serco was actually awarded the ‘Cleveland Clinic Caregiver Award’ in 2015 – the first external organisation to receive this highest accolade.”

Unique Contracting Models Hard FM based contracts traditionally involve technical and engineering services while soft FM contracts cover cleaning, portering, house keeping, catering, reception services, help desk services, IT, transportation of patients. An

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integrated model is the preferred type of contract Serco engages in, providing services that span both hard and soft FM services. “In the Middle East there has traditionally been a history of facilities contracting out various facilities services to many different companies through individual ‘siloed’ contracts – this remains the norm,” Joe continues. “But at Serco we work with clients to showcase the benefit and value provided by the integrated contracting model. Not only does it increase the service provider’s accountability, benefit patient safety and patient experience, but cost efficiencies are more easily identifiable, resulting in high quality healthcare environments – achieved with better value for money.” Contract performance management also differs in the region, with a focus on payment for contract inputs – i.e. per member of staff or per item of equipment provided – colloquially known as ‘input based’. Serco promotes a wholly different approach, encouraging output based performance measurements in all of its contracts. In this case, Serco - as the service provider - will establish a service performance level with any client. They are then able to use their knowledge, garnered from their broader experience operating internationally, to establish what technological and human resources are required, then design systems and processes to achieve these targeted levels of operational performance. This fully integrated service model has been brought to life at the Fiona Stanley Hospital (FSH) in Australia – one of the most advanced digital hospitals, located on a 32 acre Greenfield site just South of Perth. “FSH is one of the largest infrastructure projects in the Southern Hemisphere, where Serco was responsible for planning, designing

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HEALTHCARE SUPPLIERS

SERCO

and delivering all non clinical services; some 25 different service lines,” explains Joe, the site’s Project Director at the time. “We worked shoulder to shoulder with clinicians and industry partners to identify, tender and procure all of the equipment required by the hospital – designed, procured and installed the hospital’s high specification ICT infrastructure and the recruit and induct of the hospital’s almost 1000 strong non-clinical workforce.” “This bundling of relevant services to create truly integrated delivery is pivotal to our service design. It simplifies and streamlines the accountability of service delivery - the more services delivered by one service provider, the more accountability is achieved. Clients and patients can truly benefit from this delivery model.”

Outcome-based performance The output-based contract at FSH is also a highly measured environment, managed by more than 470 key performance indicators that positively enforce a culture of innovation and improvement. “We are committed to taking accountability for delivery and ownership of those agreed deliverables,” says Joe. “We will risk our fee – or part of our fee – to guarantee the delivery of those services to the very highest of standards.” Outcome based performance is also integral to all of Serco’s contracts with the NHS, delivering various services for Acute Trusts and Clinical Commissioning Groups through to Community Service Trusts and Mental Health Trusts since 1995. Ian Mullen, former Chairman of NHS Forth Valley where Serco is contracted to provide engineering, cleaning, catering and portering services; “Serco has delivered a very high quality of service, introduced innovation and we’re really very happy with the quality of the services. They have ticked all of the boxes that patients, visitors and staff require. This ranges from the excellent quality and choice of patient meals in the hospital restaurant to the high level of general cleanliness – our facility has seen a significant improvement in infection control, meaning patients are happy, staff are happy and visitors are happy.” Joe is keen to see more output based and integrated care service contracts in the Middle East. ‘A recent client transitioned from using their previously based input service model to our output based one,” Joe concludes. “However, while we are beginning to see this, there is slow movement towards output based contracting, the trend remains prominently within the private sector – for the time being. This remains a large challenge for us moving forward.”

CASE STUDY CLEVELAND CLINIC ABU DHABI Located on Al Maryah Island, Cleveland Clinic Abu Dhabi (CCAD) is a world-class multispecialty hospital – opened in 2015 with the key aim of addressing a range of complex and critical care requirements unique to the Abu Dhabi population. One of many hospitals worldwide where Serco delivers Facilities Management and enabling services, Cleveland Clinic Abu Dhabi is a stateof-the-art medical campus comprising of 252 patient rooms, 72 intensive care units (ICUs), 36 VIP suites and four royal quarters – all spread across a huge net floor area of 409,000 sq. metres. The facility specialises in more than 30 medical and surgical specialties and currently operates five Centres of Excellence in Heart and Vascular, Neurological, Digestive Disease, Eye and Respiratory & Critical Care. Serco currently delivers a wide range of non-clinical services at CCAD – this allows the hospital to focus on the core delivery of unique and unparalleled world-class clinical services. These include: • Helpdesk, Mechanical, Electrical and Plumbing (MEP) • Heating, Ventilation and Air Conditioning (HVAC) • Fire Fighting and Detection Systems

• Grounds and Garden Maintenance • Development of Integrated CAFM (Computer Aided Facilities Management) •Asset Management Bringing both their global and regionally specific expertise to the fore, the Serco Transition Team at CCAD was given approximately six weeks to mobilise an FM team and accept handover of the building for service commencement. This period saw Serco employ, train and familiarise itself with CCAD and its associated MEP assets. Furthermore Serco had to develop and write a full set of Standard Operating Procedures (SOPs) and risk assessments, procure, mobilise, induct and train 18 specialised subcontractors to maintain various services lines, such as medical gas, boiler servicing, grounds and gardens. In 2015, in recognition of their efforts, Serco was awarded a Caregiver Award by Cleveland Clinic ‘for sincere work and valuable contribution in demonstrating the core values of CCAD.’ Serco were the first external company to receive this highest of accolades – testament to the highest standards of service delivered by the company in a safety critical environment such as CCAD.

FURTHER INFORMATION www.serco.com

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IMPERIAL PRIVATE HEALTHCARE Clockwise, from right: Hammersmith Hospital; Queen Charlotte’s and Chelsea Hospital; Charing Cross; St Mary’s Paddington

Academic health With more than 9,000 patients treated every year, Imperial Private Healthcare, part of Imperial College Healthcare NHS Trust, is one of the largest private healthcare facilities in London. Located within five major teaching hospitals across north west London, and within easy reach of London’s Heathrow Airport, it has unparalleled access to London’s top consultants across all specialities. With its academic partner, Imperial College London, it is one of the UK’s seven academic health science centres, working to ensure the rapid translation of research for better patient care and excellence in education. Its hospitals are world-famous – St Mary’s Paddington with the private Lindo Wing, Hammersmith Hospital with the Robert and Lisa Sainsbury Wing, Charing Cross Hospital and The Thames View, The Western Eye Hospital and Queen Charlotte’s and Chelsea Hospital. globalopportunityhealthcare.com

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t Mary’s Hospital, part of Imperial College Healthcare NHS Trust, is the major acute hospital for northwest London as well as a maternity centre with consultant and midwife-led services. The hospital provides care across a wide range of specialties and runs one of four major trauma centres in London in addition to its 24/7 A&E department. The private facility, the Lindo Wing, is well known for obstetrics and gynaecology and many international patients follow the example of Britain’s royal family and choose to have their babies born there. Also, more than 50 per cent of the services in the Wing are general, providing the highest quality of care for surgical, medical and obstetric patients. The unit specialises in a range of complex and robotic surgeries including trauma, weight loss, vascular, gynaecology, urology, ear, nose and throat, and general surgery. For maternity patients there is also the extra reassurance of the neonatal unit. The team treats women who have had complications during their previous or current pregnancies, and newborns requiring specialist medical support. It can care for babies born as early as 23 weeks and has inhouse 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 carry this sophisticated technology with the proficiency to carry out noninvasive scans of newborns’ hearts, brains and other organs, to identify conditions and causes.

Tradition of excellence The Lindo Wing at St Mary’s Hospital in London provides high quality care for complex cases, as well as unrivalled maternity services, says Sarah Cartledge

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IMPERIAL PRIVATE HEALTHCARE is also a three-bed dedicated recovery area. Many patients, particularly maternity patients, come back to the Lindo Wing as a result of the impressive service and familiar surroundings. “It is always nice to welcome people back,” says lead nurse Paul Highton, a former matron and Darzi Fellow at Imperial College. “Many of the staff have been here for years and this provides a sense of continuity which is reassuring for the patients.” Having the consultants on site is also an additional benefit. Consultants operate across the NHS, also working privately in the hospital. If a consultant chooses to undertake their private practice at one of the private facilities, such as the Lindo Wing, they are on site and available for their private patients, instead of being based remotely. “Being able to offer our consultants the ability to do their private practice on site is a huge bonus,” says Jane Boyle, Head of Business Development at Imperial Private Healthcare. “It means they continue to have access to their wider expert team for both their NHS and private work. Ultimately it benefits both parties in a way that’s more than the sum of its parts.”

Long-standing traditions St Mary’s has a long history of innovation and research — penicillin was discovered there in 1928 — and the first robotic surgery to remove fibroids was performed on site in 2013. It’s for this reason that international work comprises at least a quarter of the hospital’s overall work, an estimated £10m business. Many people come from the Middle East, as well as China, Russia, the Far East, Europe and North America.

Excellent services The Wing originally opened in 1937 and has since been updated to offer the most comprehensive modern facilities on site, including private outpatient facilities, dedicated operating theatres, modern, private en suite rooms and day case rooms.

Unrivalled expertise The Lindo Wing has access to more than 350 consultants who are part of the wider Imperial College Healthcare 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, cardiovascular services and plastic surgery. The theatres can take 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

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Hotel services are provided by a dedicated hotel services team. An extensive and nutritious menu caters for special dietary, cultural and religious requirements (including vegetarian, kosher and halal meals), all prepared in the Lindo Wing’s private kitchens. “As a patient with Imperial Private Healthcare, you’ll experience the best of both worlds – world-class consultants providing care in modern, private facilities, all within some of London’s most trusted NHS hospitals,” says Jane. “From diagnosis until discharge, every patient at Imperial Private Healthcare can be assured of the highest levels of discretion and care. Each of our hospitals offer the comfort and convenience of private en suite rooms, where our world-class consultants, working alongside our nursing and hotel services team, will be on hand to support patients throughout their recovery.”

FURTHER INFORMATION

www.imperialprivatehealthcare.co.uk

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Military injuries are complex and challenging, but they offer the opportunity to innovate, Mr Shehan Hettiaratchy, a Lead Surgeon at Imperial Private Healthcare tells Sarah Cartledge

Major trauma

s one of the major UK trauma centres, specialities at St Mary’s Hospital include treatment for those patients with severe limb injuries. With expertise from orthopaedic surgeons and plastic surgeons who are used to dealing with people with limbthreatening injuries, Imperial Private Healthcare’s reconstructive surgery team cares for patients with life-changing injuries from war and crime. These typically include wounds from gunshots, blasts and land mines from conflict-torn countries such as Libya and Egypt. Imperial Private Healthcare’s reconstructive surgery team is led by Mr Shehan Hettiaratchy, who has experience of dealing with battle wounds in countries such as Afghanistan, Chechnya, Kosovo, Georgia, the Balkans and Haiti for both charities and the military. An Oxford graduate who also trained in London, Birmingham and Australia, he spent six months working with the British army and understands the physical and psychological side to such grave injuries. “These are really difficult injuries and very challenging for the patients, but we have a big organisation that can deal with all the issues,” says Mr Hettiaratchy. “The trigger for our involvement in such issues was the case of a 16 year old boy who had been blown up in the Libyan conflict in 2011. The Libyan government asked the NHS to care for 50 patients and they were flown to the UK for treatment.” Abdul Malek El Hamdi was injured when a grenade he and a friend found at their school exploded. His friend died and Abdul had serious fragmentation injuries. “Abdul wasn’t able to be cared for properly in Libya. He arrived one night with a potentially life-threatening infection to his leg, so we took him straight to the operating theatre.” At the moment the hospital has many patients from the Egyptian police force who have blast injuries. Countries such as Libya have a formalised path for evacuating injured citizens to the UK and do so because they do not have enough resources or the right expertise to deal with them in-country.

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Unrivalled expertise Imperial Private Healthcare has a number of British military consultants working within the organisation who are able to evaluate whether Mr Hettiaratchy and his team can help someone. In the case of Egypt, the team will receive an initial referral from the Egyptian Military Office about a patient, but there can often be a delay in obtaining a visa for entry into the UK. “Obviously the first 24 hours of any injury is the most critical time, but sometimes this visa process can take up to two weeks,” Mr Hettiaratchy says. “Although these delays change the clinical picture, we have a unit that includes plastic surgeons – two with military backgrounds – orthopaedic surgeons, microbiologists, prosthetic technicians and a psychologist, supported by related health professionals. “We plan as a team. These injuries require joined-up decision-making between surgical, medical and psychological specialties. To be able to offer the best treatment for complex surgeries, you need those elements – plastic, skin and soft tissue surgical expertise, considerable experience with bones, and skin infection knowledge. Our patients have multi healthcare needs and we

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SHEHAN HETTIARATCHY, MA(OXON), BM BCH, DM, FRCS(ENG), FRCS(PLAST) Shehan Hettiaratchy graduated as a doctor from Oxford University in 1994 with prizes in both medicine and surgery and a blue in boxing. He underwent basic surgical training in London teaching hospitals and obtained FRCS (Eng) in 1998. Shehan carried out a 3 year research fellowship in hand transplantation at Massachusetts General Hospital, Harvard Medical School, for which he was awarded a Doctorate of Medicine by Oxford University, a Hunterian Professorship by the Royal College of Surgeons of England and the Pulvertaft Prize by the British Society of Surgery of the Hand. He has authored over 70 papers, 2 textbooks and numerous book chapters and is lead for trauma research at Imperial. Shehan’s main clinical focus is on hand and wrist surgery and extremity reconstruction. He has particular expertise in hand injuries, reconstruction of complex upper and lower extremity injuries, nerve injuries, infective complications and elective hand surgery. He believes in putting his patients at the centre of all that he does and only accepting the best. He is experienced in the needs of high profile individuals, including professional sportsmen and women.

manage and integrate them all. Some patients, especially those requiring artificial limbs, spend many months in rehabilitation with us.”

Continuing care and research Reconstruction and rehabilitation is another main focus for Mr Hettiaratchy and his team to enable patients to have an optimum quality of life. One of the advantages of the Trust’s partnership with Imperial College London is that the team is able to research new treatments on site. Their tissue engineering studies could dramatically improve outcomes for patients who require prosthetic bones or surgery on skin cartilage, and researchers are also examining different ways of growing bone and artificial skin. Throughout the world there are a limited number of places where surgeons have genuine expertise in these kinds of injuries, and the team is continually building its understanding of conflict injuries to improve outcomes for all its patients. The hospital has an on site limb fitting service and prosthetic service so patients with limb loss can be admitted and treated. Additionally there are multi-lingual surgeons

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among the team so patients can be treated in their own language or one they can understand, to help them understand their treatment and care. Within the organisation there are surgeons from all the Middle East countries and there is experience of all the cultural sensitivities. Currently there is a Middle Eastern patient in the hospital who fell from a London balcony while visiting the UK, and he was fortunate enough to be admitted and treated by the team. The Lindo Wing has its own operating theatres so patients can be seen immediately, improving the chances of a better outcome and helping them deal immediately with a traumatic situation. “One of the reasons the Trust embraced military-related surgery is that our innovative treatment of these patients will benefit other private and NHS patients needing limb reconstruction,” says Mr Hettiaratchy. “These are complex cases that require forward-thinking solutions, and as a result we are able to deal with the most complex of surgeries.” FURTHER INFORMATION

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With its history of clinical innovation and research spanning over 80 years, the Haematology Department at Imperial College Healthcare NHS Trust’s Hammersmith Hospital is unique in its innovative approach to specialist expert care, says Dr Jiri Pavlu, Consultant Haematologist at Hammersmith Hospital and Honorary Clinical Senior Lecturer at Imperial College London

Determined to raise the bar

mperial College Healthcare NHS Trust’s private facility at Hammersmith Hospital, The Robert and Lisa Sainsbury Wing, offers world class specialist care in one of the capital’s leading NHS teaching hospitals. The unit’s adult clinical haematology service, of which I am a member, enjoys an international reputation as a world leading centre for blood disorders, blood cancers, red blood cell diseases, as well as serious bleeding and clotting disorders. Our partnership between Imperial College Healthcare NHS Trust and Imperial College London means that many of our world renowned consultants are leaders in their field. Our best scientists and academic clinicians work together wherever possible, taking advantage of the unique concentration of clinical and academic expertise at Hammersmith Hospital. Research is the lifeblood of what we do in the unit – to improve upon and develop our world-leading treatments to create invaluable opportunities for our patients to access the very latest in clinical trials, research and ground breaking treatments. In much the same way we are able to attract the very best in consultant talent, with every patient assured that their care remains consistently excellent throughout the entirety of their stay with us.

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History of innovation and research Not long after its inception in 1934, the Department of Haematology and the Royal Postgraduate Medical School at the hospital had soon became a leading clinical and research centre in its own right – not only in Britain but across the British Commonwealth at that time. By 1977, following the tenure of worldrenowned British haematologist John Dacie at its helm, the department as quoted in the British Journal of Haematology; ‘had become a model

‘The Haematology Department has now made substantial contributions to the understanding of the biochemical, immunological and molecular basis of many different types of blood cancers through a continued commitment to groundbreaking research and clinical trials.’

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for the training of haematologists internationally, combining laboratory and clinical aspects of the discipline and establishing specialised sections within the field.’ This model remains as pertinent today as ever before, with the unit attracting leading haematologists from around the world, with the standards and traditions of research at Hammersmith continuing to be a primary factor in people seeking treatment at the unit over other leading private facilities in the capital. The Haematology Department has now made substantial contributions to the understanding of the biochemical, immunological and molecular basis of many different types of blood cancers through a continued commitment to groundbreaking research and clinical trials. Indeed a significant proportion of clinicians, including myself, who work in the department are nearly all employees or academics of Imperial College London – a leading global university ranked eighth in the world for its superlative standards of medical teaching and clinical research. The inextricable link between research and ground-breaking treatment in the unit brings a host of benefits to patients, setting the hospital apart from other leading private healthcare facilities in the capital – some of which may not be equipped to offer the high levels of specialist care afforded by the unit’s multidisciplinary team. Today there are very few centres in the UK who would be able to safely perform the amount of transplants that we can do at Hammersmith Hospital.

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Planning the future in healthcare MJ Medical is a health planning consultancy. We work in partnership with healthcare providers, investors, architects, engineers and contractors to deliver innovative, effective and adaptable services and facilities that respond to the changing needs of the community. Established for 30 years, MJ Medical’s diverse and extensive experience spans more than 250 projects across 75 countries totalling approximately US$80 billion in capital value. We have worked on the development of leading tertiary hospitals such as the UK’s new Papworth Hospital specialising in cardiothoracic care; dedicated paediatric centres such as the Al Jalila Children’s Speciality Hospital in Dubai; and cutting edge models of clinical care such as the Hampshire Critical Treatment Hospital in the UK.

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IMPERIAL PRIVATE HEALTHCARE Expert care around the clock Consultants are usually not risk averse in their clinical decision-making – in order to be a researcher you have to go down many different avenues before you achieve a breakthrough. But they are risk averse when it comes to making sure members of the surrounding clinical infrastructure are at the top of their game. If a patient requires a kidney support for example, a private facility may often not have that crucial renal infrastructure. And if the consultant is only there for half of the week, the risks to the patient are too great given the lack of specific supportive clinical infrastructure. This is why our centre at Hammersmith is unique. Although other private hospitals or private patient units across the UK house some exceptionally talented clinicians, the medical infrastructure is just not currently at the level that we need (and have come to expect at Imperial) to treat our patients - many of whom are often suffering from very serious medical conditions. Standard cover from a normal RMO (Resident Medical Officer) may often not be adequate following complex treatments or procedures. Our patients may require round the clock care from our expert specialists. For example, should the unit perform a stomach biopsy on a Friday, the relevant consultant will expect over the following weekend to have a senior doctor available on call. With our large medical unit on site, we are able to roster a senior clinician to be on call, as well as a team of specialist nurses and support staff.

Access to the latest treatments

Our unique concentration of specialists on site opens the possibility for those patients, who may have been previously deemed unfit for certain treatments, to access care from the hospital’s leading consultants.

DR JIRI PAVLU Dr Jiri Pavlu is a consultant haematologist at Hammersmith Hospital and honorary clinical senior lecturer at Imperial College, London. He has worked at Imperial College Healthcare NHS Trust for over a decade and is a specialist in haematopoietic cell transplantation and acute leukaemias. He graduated from the first faculty of medicine of Charles University in Prague in 1998. He carried out his research in molecular haematology at St George’s Hospital Medical School in London and completed his specialist haematology training in London on the Royal Free and Hammersmith rotation. He is a member of the Royal College of Physicians and a fellow of the Royal College of Pathologists. Dr Pavlu is a principal investigator and subinvestigator of various clinical trials and an active member of the British Society of Blood and Marrow Transplantation (BSBMT) and European Group for Blood and Marrow Transplantation (EBMT).

A notable example from our haematology department involved a private patient from Germany who was presented to the Hospital for treatment of relapsed acute myeloid leukaemia. Before he approached us, the patient had been turned down for treatment at another centre for being too old and frail to survive treatment. But under our expert care he performed very well during and after treatment, living for many years after the publication of his case. This is one of many positive outcomes that we continue to be extremely proud of. The unit’s skillset in diagnosis and therapy for many other rare blood disorders, including thalassaemia major, is also very relevant for those patients coming to us from the Middle East – due to consanguinity (genetic links through kinship). Recent examples include two families from Turkey and the UAE who were referred to one of the unit’s leading consultant haematologists, Dr Mark Layton. Working in partnership with his colleagues, he was able to describe a completely new disease, with a newer and more effective treatment plan initiated upon the results of the team’s work. Extremely successful outcomes such as this are largely unique to a leading NHS teaching hospital like Hammersmith – the support, concentration of expertise and a continuous commitment to advancing the most effective treatments for a variety of rare diseases remains pivotal to the unit’s continued success as a world leader in specialist care.

FURTHER INFORMATION

www.imperialprivatehealthcare.co.uk

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IMAGE: SHUTTERSTOCK.COM

Advanced gynaecological surgery

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Consultant gynaecological oncologist at Queen Charlotte’s and Chelsea Hospital London, Professor Christina Fotopoulou talks about combining surgical expertise with pioneering research into highly specialised cancer treatment

t Hammersmith Hospital we treat people from all over the world including Europe and the USA, and I have referrals from the private sector as well as NHS patients. My main area of expertise is in advanced forms of gynecological cancer. Ovarian cancer, the main cause of death from gynaecological cancer, is often diagnosed late, but it is rarely too late for something to be done. Up to 70-80 per cent of patients with ovarian cancer will present symptoms at a late stage three or four. But in spite of such, ovarian cancer is one of the few cancers that can still be operated on even if the disease has spread. The problem of late diagnosis lies in the fact that symptoms are rather not specific, and include abdominal bloating, pain and bowel problems that may be diagnosed by a GP as IBS. An average GP will usually see one ovarian cancer case every five years, and the art is to identify that patient. With surgery a patient’s chance of survival can be increased signifcantly, and a patient who has undergone radical surgery that resulted in complete tumour clearance will have a better survival rate than someone who has not had surgery or had residual postoperative disease. There are even some patients– about 17 per cent across all types of patients in stages IIb to IV who can be cured. I am still contacted by people I operated on in Germany some years ago who get in touch to tell me they are doing well, or ask me to go back and operate again due to a late relapse. The average age of a patient who develops ovarian cancer is around 65 years but in a centre like ours we see also much younger patients.

The importance of research

We are conducting important research here at Hammersmith, which we carry out alongside the surgery. We have a large research facility on site as well as a big tissue collection database. At Imperial the Healthcare NHS Trust and the University work in close partnership, so this arrangement is ideal for patients with complex conditions who require pioneering surgery and treatment. Our research projects include the better understanding of the profile of the tumour and the correlation of the tumour biology to clinical and surgical characteristics. Furthermore, we strive to implement novel and pioneering technology such

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PROFESSOR CHRISTINA FOTOPOULOU Professor Christina Fotopoulou is a consultant gynaecological oncologist at Queen Charlotte’s and Chelsea Hospital in Imperial College London. She was trained in obstetrics and gynaecology at the Charité University Hospital of Berlin in Germany with a sub-specialisation in gynaecological oncology. Professor Fotopoulou was the leading consultant and Vice Director of the Department for Gynecology at the Charité in Berlin, one of the largest accredited centres for gynaecological cancer in Europe. She has also been the principal coordinator of the European Competence Centre for Ovarian Cancer, which was created in 2007 in Berlin. Her principal area of expertise relates to radical and exenterative surgery for primary and relapsed ovarian cancer but also any forms of advanced gynaecological cancer. She is also trained in reconstructive techniques after cancer surgery. Among her research projects she has investigated the implementation of targeted therapies in advanced gynaecological cancers and the implications of novel technology and bioengineering on surgical practice. She has broad experience in national and international clinical and surgical trials in gynaecological cancers and is involved in the German, British and European committees for guidelines development in ovarian cancer and in various national and international consortia. She has been the author and editor of numerous book chapters and articles about gynaecological cancer.

as bioengineering into clinical practice for the maximum benefit of the patients. Every patient with ovarian cancer is unique and for that reason our aim is to treat every woman in an individual way according to her needs and preferences, but also to the profile that her tumour presents. I have had many patients come to me because they have read my research, which they have said is a significant marker of excellence.

Expertise I am a specialist in radical surgery for advanced forms of gynecological cancer and strive always for the best for my patients. However, the whole team contributes to the wellbeing of the patient to achieve optimal outcomes. I only operate in Hammersmith Hospital because every part of the team – every scrub nurse knows what I need and what the patients need. The whole philosophy of fitting the operating theatre to the needs of each specific patient is clearly understood. We are all one team undertaking this difficult surgery to ensure the best possible outcomes. FURTHER INFORMATION

www.imperialprivatehealthcare.co.uk

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Luxury bespoke care from world-class consultants in one of the UK’s top teaching hospitals makes Imperial College Healthcare NHS Trust’s private facility ‘The Thames View’ at Charing Cross Hospital truly unique, as Matt Williams, Consultant Clinical Oncologist, tells Jack Ball

A world- class team for complex problems

s part of Imperial College Healthcare NHS Trust, Charing Cross Hospital located in Hammersmith, West London is universally regarded as a leading centre for neurosciences, neuro-rehabilitation, complex surgery, elective orthopaedics and cancer care. With spectacular views over London that rival some of the capital’s most luxurious hotels, and located less than 15 minutes from central London by train, the Trust’s private patients facility ‘The Thames View’ at Charing Cross Hospital is a home away from home like no other. Located at the very top of the hospital on the 15th floor, the newly refurbished unit offers unrivalled access to the Trust’s internationally renowned consultants in one of London’s most trusted teaching hospitals – using the latest approaches to tackle a range of complex clinical problems. “If you’ve got something that’s difficult and complicated, Imperial Private Healthcare offers a service that’s difficult for other people to replicate,” says Matt Williams, consultant clinical oncologist based at Charing Cross Hospital. “This is simply because we have so many high level resources on hand.” And with the Trust’s partnership with Imperial College London, many consultants are involved in the most cutting-edge clinical research, allowing the most up to date treatment for all Thames View patients.

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World leading neuro-oncology team The facility’s multidisciplinary team (MDT) approach is continuing to set the standard nationally, as the Trust brings together its wealth of clinical expertise and medical technology to ensure the highest levels of comprehensive and holistic care. Their world-class neuro-oncology team, of which Matt is a member, exemplifies how an MDT approach to complex issues can achieve the best possible clinical outcomes. But only if they are done properly. “We have weekly MDT meetings where we discuss all of the NHS and private brain tumour patients. You have to remember that Imperial is a big hospital where many leading clinicians work.” “The advantage of the multidisciplinary approach at Charing Cross is that all of the neurosurgery and all of the oncology are all in the same physical location - in the same hospital. I can very easily go onto the ward or speak to a colleague of a different specialism if need be. So it is very easy to provide that very detailed input with continuous interaction between the specialties.” Although Matt doesn’t go into theatre, he works extremely closely with other specialists. For example, once a specific consultant surgeon has identified an issue during surgery, the whole team is then able to make decisions in an MDT meeting over the best course of treatment – this bespoke treatment plan is offered to all patients. “We expect to discuss all private patients being treated here - this allows input from oncologists, surgeons and researchers and so on.” With the Trust’s specialties spread over the five different sites, expertise is actively shared among all clinicians - this is particularly important for those patients experiencing a multitude of complex problems. “We are all part of the same Trust,” explains Matt. “And one of the crucial benefits of Imperial is that we have access to an extremely wide range of specialists across several different clinical domains. We can bring doctors over from other sites if patients require treatment for more than one issue. For example, Hammersmith Hospital specialises in expert liver treatment. So when I was treating a woman with a brain tumour and various liver problems here at Charing Cross hospital, we were able to bring in specialist liver doctors from Hammersmith during her stay with us - this actually happens reasonably often. “Our clinical notes are also electronically stored on the same computer systems, so it’s incredibly easy to talk to another member of the team on a different site straight away.” And Imperial’s unique multidisciplinary approach to clinical care is also having implications far wider than its immediate catchment area of West London. Matt’s leading work as part of the Trust’s specialist Brain Tumour Service is testament to their pioneering

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Above: ‘The Thames View’ at Charing Cross Hospital, located at the very top of the hospital on the 15th floor Right: Maggie’s Cancer Caring Centre located at the Charing Cross Hospital

work in successfully treating those with complex and life-threatening brain tumours. “The service serves a population of just over two million people. But we attract significant numbers of referrals from other parts of the UK people come and see us from all over the country for second and third opinions.”

Unrivalled luxury

Complementing the exceptional levels of clinical care on hand is the luxury accommodation offered at The Thames View. Similar to any top private hospital in the UK, amenities on hand include daily newspapers, complimentary toiletries and free wifi. Overseas patients can also expect additional services such as translators, foreign-language newspapers and a multi-faith worship room. This year also saw an extensive refurbishment of all accommodation facilities with all rooms fitted with contemporary hotel-style en-suite bathrooms compete with new walk-in showers. Bedrooms have been fully refurbished with improved airconditioning so patients can enjoy the most optimal temperatures all year round. Head of Programmes, Louise McCarthy says; “We have successfully scheduled this upgrade to ensure minimal disruption to patients and clinical staff. And we are absolutely delighted with the results.”

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DR MATT WILLIAMS Dr Matt Williams is a Consultant Oncologist specialising in the treatment of brain and spinal tumours. He undertook his oncology training across London, and was awarded his PhD from University College London in 2009. He spends approximately a third of his time engaged in research, and leads the Computational Oncology research group at Imperial College. Dr Williams completed his undergraduate studies in Birmingham, before moving to London where he worked as a senior house officer at Hammersmith Hospital. He then ran an A&E department in The Gambia for a year, in the capital’s main hospital. Upon returning to the UK he completed his clinical oncology training in London, followed by a PhD with the Advanced Computation Lab at CRUK/UCL. He specialises in brain and central nervous system tumours, skin cancer and palliative radiotherapy. He was appointed as a consultant and honorary senior lecturer at Imperial College Healthcare NHS Trust in February 2012.

Academic partnership Currently ranked eighth in the world1, Imperial College London enjoys a unique partnership with the Trust. The Charing Cross campus, as part of the University’s Faculty of Medicine, is a hub for medical teaching and research. “I teach some undergraduates and run the computational oncology lab at Imperial,” Matt explains. “I’m in the process of developing an

online system where we can get patients to record their quality of life, gathering data for cancer patients. “I have also set up and run the country’s first neuro-oncology Skype clinic – this means that patients do not have to physically come and see our consultants.” In terms of follow up care for overseas patients at Imperial, the Skype Clinic is proving particularly useful. “Although people may need scans which can’t be done via Skype, we can still assess how they are and give them the scans later – a hybrid model.” An unparalleled level of comfort offered at Thames View and the Trust’s multidisciplinary approach from the hospital’s leading consultants in their field means every patient can be assured of the highest levels of individually tailored care. In short, Imperial’s private offering in the form of Thames View brings three unique benefits medical technology and specialist facilities on site 24 hours a day delivered by Imperial College Healthcare NHS Trust’s internationally renowned consultants, in one of the capital’s most luxurious clinical environments. “We give access to an enormous range of specialties,” says Williams. “We offer lots of different treatments for lots of different diseases. It’s rare - there aren’t many places that can do that.” 2016 QS World Rankings – www.topuniversities.com/universities/imperial-college-london 1

FURTHER INFORMATION

www.imperialprivatehealthcare.co.uk

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Leading the charge Kevin O’Neill, Head of Neurosurgery at Imperial College Healthcare NHS Trust, talks exclusively to Jack Ball about the Trust’s pioneering research into developing and integrating the very latest in advanced surgical technologies 172

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ith the Thames View located in one of the UK’s top NHS teaching hospitals, the clinical expertise, research and world-class medical technology on offer at Imperial Private Healthcare at Charing Cross Hospital is unparalleled in its breadth. The facility’s partnership with Imperial College London means leading consultants at The Thames View have access to the very latest in clinical trials, academic and multidisciplinary research. The resulting innovative approaches can be translated directly into the clinical setting – giving hope to thousands of patients living with complex brain tumours looking to Imperial Private Healthcare for the very best in private care. “I want to be actively involved in making things

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IMPERIAL PRIVATE HEALTHCARE

DR KEVIN O’NEILL Kevin is a consultant neurosurgeon and Head of Neurosurgery at Charing Cross Hospital. Having gained his neurosurgical training at Atkinson Morley’s Hospital, Great Ormond Street Hospital and the National Hospital for Neurology and Neurosurgery in Queen Square. During this time he was Chairman of the British Neurosurgical Trainees Association. He is now practicing general neurosurgery at Charing Cross, although most of his elective practice consists of spinal and peripheral nerve surgery. He is also the designated neurovascular surgeon dealing with all subarachnoid haemorrhage patients and complex brain and spinal vascular conditions. His research interests include Brain Tumour Invasion and he is heavily involved in research into novel treatments.

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better for all our patients through research,” says Kevin O’Neill, consultant neurosurgeon at the Thames View and Head of Neurosurgery at Charing Cross Hospital. “At Imperial Private Healthcare we get access to the complete range of NHS support systems already in place, including our intensive care services and all of the sub-specialities which are always available for input when needed. All treatments on offer are kept as up to date as possible through this unique NHS framework with a solid commitment to clinical progress and research.”

Research and development Partnership between the Trust and Imperial College London, one of the world’s leading medical research universities, means treatments

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for all brain tumour patients at the Thames View have the full support of the University’s worldclass academic community. Kevin is keen to stress the inextricable link between the clinical research undertaken at Imperial College London and the latest treatments offered from Imperial’s multidisciplinary neuro-oncological teams. One recent avenue of research for Kevin involves the computational analysis of tumour growth to determine the most effective course of treatment. “When a genetic code goes wrong, tissues become tumours,” he explains. “This code is similar to that of a computer. So we can actually undertake computational analysis of a malignancy to work out where the code differs from those found in normal tissues. We can then use this information to see which drugs already on the market will be most effective in redressing these potentially dangerous genetic imbalances.” Kevin currently works within Imperial College’s large molecular lab, alongside many different collaborators within the Trust who are committed to further understanding the ‘molecular makeup’ of malignant tumours – to establish what goes wrong, when and where, and to use such information to find easy paths to newer and more effective treatments. Only an advanced healthcare facility like Charing Cross Hospital, with its enviable status as a leading London NHS teaching hospital, makes such innovative research viable within the clinical setting. “We have to make sure that we understand and coordinate the correct direction of resources. This requires proper management of all the expertise to hand,” says Kevin. “So I try to develop a process – to look at every single step that a patient follows and gather information from all our different expert specialities.” This interdisciplinary approach between specialities ensures every patient treated at

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‘We strive to make what we already do as good as possible through a continuous process of translation and research – the key is to choose a facility like Imperial at Charing Cross that has those unique levels of energy and drive from a multitude of specialities.’

the Thames View has immediate access to the most up-to-date treatments using the very latest innovations in the field of clinical technology. “It’s about building a platform that gives every patient the opportunity to access the best possible treatment,” explains Kevin. “We can potentially introduce patients into a new trial or a study that they may want to participate in, as well giving access to the latest surgical approaches.”

Continuous clinical innovation Biopsies are crucial during surgery and are critical during neurosurgery, with cancerous tissue looking and behaving similarly to that of healthy brain matter. As such, accurate assessment of which tissues need to be removed can often be a difficult and painstaking process, even for the most advanced surgeon. Developed by Professor Takats of Imperial College London, the iKnife offers immediate biopsy testing during surgery. Kevin explains its technology; “This device cauterises tissue during surgery to produce smoke which is then analysed using a mass spectrometer – the charged particles in the smoke are able to give a molecular fingerprint of the tissue being operated on.” Not only can Kevin and his team use this ‘molecular footprint’ to remove malignant tissue in real time, but they can also establish the most effective treatment options in the fastest possible time.

Fibre optic technology By its very nature, neurosurgery is an extremely delicate undertaking – optimal efficiency and clinical safety remains paramount so as not to damage or remove surrounding healthy tissues that may be critical for normal cognitive function. Part-funded by the charity Brain Tumour Research Campaign, an Imperial trial in 2015 opened the door for the next generation of infrared technology to be used in neurosurgery

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to identify malignant tissue, without the need to cauterise tissue. First developed in Canada for use in skin-cancer surgery, ‘the core’ uses a near-infrared probe to shine a beam of light onto the exposed brain. As the healthy and unhealthy tissues scatter light differently, surgeons can immediately identify malignant tissue without cauterising any potentially healthy tissue. As quoted by the BBC, following its pioneering use in brain surgery at Charing Cross Hospital in August 2015, colleague and fellow neurosurgeon Babar Vaqas said; “Optical technologies are the future. They are fast and don’t destroy any tissue and could be used during many types of cancer surgery or when dealing with infection like a brain abscess.” Kevin and his team are also working on a similar type of technology using a single spot of blood to gather a molecular fingerprint. “This technique can help establish whether a patient has a tumour, the nature of a malignancy and how the patient is responding to treatment.” This next generation of technology spearheaded for use by consultants at Imperial Private Healthcare is only made possible by the extensive research programmes available through the NHS. “A major advantage of Imperial Private Healthcare at Charing Cross is our thorough commitment to progressive medicine, combined with the personalised and individualised attention of the private sector,” explains O’Neill. “We strive to make what we already do as good as possible through a continuous process of translation and research – the key is to choose a facility like Imperial Private Healthcare at Charing Cross that has those unique levels of energy and drive from a multitude of specialities.” FURTHER INFORMATION

www.imperialprivatehealthcare.co.uk

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