HealthInvestor May 2020

HealthInvestor UK May 2020 vol 17 • no 4

essential reading for the healthcare business

Riding the storm Investment strategies for troubled times

Lost property?

Improving vulnerable lives

Protect and survive

Real estate and Covid-19

We talk to Helen Costa of Cornerstone

Providers’ PPE obligations

primary care • secondary care • social care • IT • infrastructure • markets • policy ISSN 1742-884X

AWARD ENTRIES NOW OPEN THURSDAY 12TH NOVEMBER BOURNEMOUTH Note to entrants: We have tried to keep many of the awards categories as open as possible so that a variety of people, organisations and collaborations involved in the dementia care community are eligible to apply. This includes, but is not limited to, day care and community settings, home care providers, third sector organisations, hospitals, businesses, social enterprises, housing and extra care organisations. If you have a question, don’t hesitate to contact us.

Outstanding Dementia Care Resource This award will be made to an outstanding resource which can be shown to have transformed the lives of those living with dementia and/or their carers.

Outstanding Dementia Care Innovation This award recognises the vital role of new and stimulating innovations in developing high quality services for people living with dementia.

Best Dementia Carer This award recognises the vital role of the care assistant in providing quality care. Evidence of dedication, sensitive handling of matters of importance to residents, and career progress through training will all be taken into account.

Best Activities Co-ordinator for People Living with Dementia This award will be made to a person within a care home or community setting with more than 50% of people living with dementia who has made an exceptional contribution to the quality of life, health and happiness of all the people they work with through the activities they facilitate.

Best Dementia Care Practitioner • NEW FOR 2020 This award will be made to an outstanding dementia care practitioner (eg nurse, dementia lead or allied professional) who has demonstrated an expert level of skill, knowledge, management and leadership. They will have supported their colleagues in delivering high quality dementia care either in an acute, residential or community setting, facilitating staff training, developing person-centred care pathways and delivering improvements in dementia care practice.

Best Dementia Care Manager This award will be made to an outstanding dementia manager (or deputy) in a dementia focused environment.

They will be expected to show exceptional leadership, caring, training and management skills for the benefit of people with dementia and staff.

Best Dementia Garden This award will be made to a dementia focused garden in any setting which has outstanding features that significantly enhance the quality of life of people with dementia and staff.

Best Dementia Training Initiative This award recognises the vital role of effective training in dementia care. It will be made to an individual, organisation or collaboration that can demonstrate the value and impact of a training initiative which they have successfully implemented.

Dementia Care Champion This award will go to an exceptional person, whether they are a member of staff, a relative, person with dementia or a volunteer who has gone above and beyond and made a real difference. It could be a charitable achievement or making life better for people with dementia and relatives, or simply someone who has done great things but may not have had the recognition they deserve.

AWARD ENTRIES NOW OPEN #DementiaCareAwards

Outstanding Arts and Creativity in Dementia Care This award will be made to an organisation, collaboration or person that has developed and delivered an outstanding creative arts project, in any setting, to improve the quality of lives of people living with dementia.

Best Dementia Team This award will be made to a dementia-focused team which has developed and maintained an excellent standard of care within any care setting.

Exceptional Contribution by an Informal/Family Carer • NEW FOR 2020 To recognise the valuable contribution of family or informal carers, this award is made by the Journal of Dementia Care to a person, or group of people, to acknowledge the difference they have made. This could be to a person with dementia, to a community or nationally. This award does not require an entry from individuals, however if you would like to nominate someone for the panel to consider please do so along with 500 words to support your nomination.

Best Dementia Friendly Hospital This award will be made to an acute or community hospital which can demonstrate that it has developed outstanding and innovative services for people living with dementia admitted for treatment of medical/surgical conditions.

Dementia Friendly Employer • NEW FOR 2020 This award will be made to an employer that can demonstrate they have developed an open and supportive working culture that values everyone and who flexibly support and enable staff affected by dementia.

Exceptional Contribution by a Person/People Living with Dementia This award is made by the Journal of Dementia Care to a person, or group of people, living with dementia who live and work with incredible passion and commitment to improve the lives and wellbeing of others living with dementia, and who inspire so many within the dementia community. This award does not require an entry from individuals, however if you would like to nominate someone for the panel to consider please do so along with 500 words to support your nomination.

Best Dementia Care Home This award will be made to a care home with more than 50% of residents living with dementia which provides an outstanding environment with exceptional standards of care and support for people with dementia as well as relatives and staff, and is a well-respected place in the local community.

Deadline for entries: Friday 17th July 2020

careinfo.org/awards

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CONTENTS

news In memoriam

6

Business

6

Technology PPE

7-12 12

Social care

13-17

NHS

18-19

Deals and investment

20-21

Testing

22-23

Policy and politics

24-25

Research

25-26

Mental health

26-27

Private hospitals

27-28

Recruitment

28

opinion Space to breathe 33 The alternative real estate sector has a major role to play in easing pressure on the NHS says Julian Evans, partner and head of healthcare at Knight Frank

cover story Bouncing back 34 The Covid-19 virus has put the fragility of the global economic system under the microscope. But Jenna Lomax finds out why some leading industry figures believe the healthcare sector will be able to quickly bounce back from the economic freeze

4

Entry form

29

features Lost property 38 The Covid-19 outbreak has had a significant impact on the UK healthcare real estate investment market. Kathy Oxtoby reviews the landscape Keeping it personal 42 With the technologies now available to us, there is no reason government initiatives to track and control the spread of Covid-19 must come at the expense of personal data privacy, writes R3’s Isabelle Corbett

PPE 48

Obliged to protect 48 Helen Nugent, a barrister in the clinical negligence team at Temple Garden Chambers, outlines what operators need to know about the provision and use of PPE at a time of crisis Standing on the Corner 52 Helen Costa is the founder of Cornerstone, a social enterprise focused on improving the lives of children and families touched by the care system. She talks to Jenna Lomax about challenging the consultancy industry and how virtual reality can improve vulnerable lives Life goes on 56 We could be forgiven for failing to remember that Brexit happened just four short months ago but the implications for the sector are still very much here to stay. Marie Manley and Will Holmes, of Sidley Austin investigate the future for life sciences

Finalists 44

finance Deals The month’s latest transactions

60

executive moves Executive moves

63

HealthInvestor UK • May 2020

UP FRONT

MANAGING DIRECTOR Vernon Baxter – +44 (0) 20 7104 2001 vernon.baxter@investorpublishing.co.uk EDITOR Rob Munro – +44 (0) 33 0052 6193 rob.munro@investorpublishing.co.uk SENIOR REPORTER Jenna Lomax – +44 (0) 20 3762 2557 jenna.lomax@investorpublishing.co.uk REPORTER AND SUBEDITOR Charles Wheeldon – +44 (0) 20 3762 2556 charles.wheeldon@investorpublishing.co.uk HEAD OF SALES Michael Dee – +44 (0) 20 7104 2006 michael.dee@investorpublishing.co.uk SALES MANAGER Grace Mackintosh – +44 (0) 20 7451 7067 grace.mackintosh@investorpublishing.co.uk DELEGATE SALES & ADVERTISING EXECUTIVE Sohail Iqbal – +44 (0) 33 0052 6190 sohail.iqbal@investorpublishing.co.uk DELEGATE SALES & ADVERTISING EXECUTIVE Shakil Ahmed – +44 (0) 20 7104 2005 shakil.ahmed@investorpublishing.co.uk SENIOR EVENTS MANAGER Nicola Jones – +44 (0) 20 3746 2613 nicola.jones@investorpublishing.co.uk PRODUCTION MANAGER Jeremy Harvey – +44 (0) 20 7451 7053 jeremy.harvey@investorpublishing.co.uk DESIGN & PRODUCTION EXECUTIVE Craig Williams – +44 (0) 20 3762 2254 craig.williams@investorpublishing.co.uk PUBLISHER Harry Hyman FOLLOW US ON TWITTER @HealthInvestor

HealthInvestor is published 10 times a year by Investor Publishing Limited, Greener House, 66-68 Haymarket, London, SW1Y 4RF. The content of HealthInvestor is for your general information and use and is not intended to address your particular requirements. In particular the content does not constitute, nor does it purport or intend to constitute any form of advice, recommendation, representation, endorsement, promotion or arrangement by HealthInvestor Ltd and is not intended to be relied upon by readers in making (or refraining from making) any specific investment or other decisions. Appropriate independent advice should be obtained before making any such decision. Any agreement made between you and any third party named or otherwise referred to in the HealthInvestor publication is at your sole risk and responsibility. Any information published in HealthInvestor may have ceased to be current by the time you read it. Those responsible for the publication of HealthInvestor and/or the authors of articles contained therein may on occasion have an interest in the shares or options, futures or contracts for differences relating to shares in companies referred to in the publication. Such interests are disclosed on an issue by issue basis to the extent required under the Financial Services and Markets Act 2000 (Financial Promotions) Order 2001.HealthInvestor is a trademark of Investor Publishing Limited © Investor Publishing Limited 2019

ISSN 1742-884X

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HealthInvestor UK • May 2020

The universal tragedy of Covid-19

A

pril was indeed the cruellest month, to paraphrase T.S.Eliot. The tragedy of so many lives lost will resonate for decades and we will long remember the bitter chill from the sinister shadow of Covid-19.

And now, as we enter summer, the prospects for the UK’s economy are bleak. The lockdown in response to the pandemic has taken a wrecking ball to the vast majority of businesses with a staggering 25% of the workforce now effectively public sector employees, the taxpayer paying 80% of their wages under the government’s job protection scheme.

The private sector has taken a huge hit with only 20% of businesses able to maintain prelockdown levels of activity. Tim Moore of IHS Markit which publishes the widely respected PMI survey warns: “The downturn in the UK economy during the second quarter of 2020 will be far deeper and more widespread than anything seen in living memory”.

Moore says the April survey result is consistent with the economy declining at a quarterly rate of approximately 7%, but he suspects the actual decline in GDP could be even greater, given that the analysis excludes the self-employed and retail sectors.

While the chancellor’s move to subsidise jobs was bold and necessary, it can’t go on forever. HMRC puts the cost of the furlough scheme to the public purse at £8 billion at start of May. The Office for Budget Responsibility has estimated that the scheme could cost £42 billion over three months and the Resolution Foundation say the government will need to find £12 billion for each additional month. That’s roughly equal to the cost of running the whole of NHS England.

The scheme will have to be wound down if the country is to avoid ruinous levels of debt which raises the spectre of mass redundancies as firms struggle to survive with decimated revenue streams.

And anyone who thinks ending the lockdown will result in consumer activity and spending returning in force any time soon is deluding themselves. A poll by IPSOS Mori reveals a frankly terrified public reluctant to leave their homes even if the government tells them it’s OK to do so. The engine of economic activity in the new normal looks like it might be decidedly sluggish if not completely stalled.

It is tempting to see investment in the health sector as a safe haven but a double whammy of reduced public confidence and inevitable constraints on discretionary spend due to financial insecurity, real or perceived, could be a very real threat.

Already care homes are seeing occupancy rates fall as relatives seek to remove their loved ones for fear of them contracting Covid-19 and confidence in the industry as a whole declines amid soaring death rates despite heroic efforts on the part of operators.

Markets such as dentistry, dermatology and veterinary care which have seen significant growth in lifestyle spend will struggle as purse strings tighten and businesses which rely on public sector revenues such as real estate and specialist care may well experience turbulence as the austerity chickens return to roost, as they surely will, albeit in different plumage.

Some have argued that the great lockdown was a kneejerk reaction to media hysteria and mounting public anxiety that had little scientific validity. They point to Sweden which adopted a collaborative approach that didn’t necessitate pulling the economic off switch but merely encouraged reasonable precautions among its citizens. The fact that Sweden’s outbreak is certainly no worse and may even be better than countries that went full lockdown begs many questions.

Of course we are all blessed with infinite wisdom in hindsight and no doubt the acrimony and arguments over who did and didn’t do this, that and the other will be poisoning our political discourse for many years to come. A bitter war of attrition is already raging on social media over Johnson’s government’s handling of the crisis. Attempts to chart a course out of the crisis by urging us to ‘stay alert’ have only confused people. Alert to what exactly?

Covid-19 and the lockdown combine to be that rarest of things: an ill wind which truly blows for all. The irony, if there is one, is that the greatest threat to the UK economy in 2020 was not a disaster of our own making but a vicious assault from mankind’s oldest and greatest foe, the humble virus. n

Rob Munro, Editor, HealthInvestor UK

5

NEWS

In memoriam

David Sanger dies after contracting Covid-19 David Sanger, director in the Colliers International Healthcare team in London, passed away on 25 April after contracting Covid-19 in March and spending several weeks in intensive care Prior to joining Colliers International, David’s healthcare experience included investment director and head of asset

management at Octopus Healthcare, property director at Primary Health Properties, partner of healthcare, valuation and investment at Cluttons and special projects valuer (Healthcare, London Team) at the Valuation Office Agency. His work spanned the healthcare markets in the UK and the Republic of Ireland, Europe and Middle East.

Adam Lenton, head of healthcare at Colliers, said David “was one of a kind and will be sorely missed by all that knew him”.

“David was a very highly regarded healthcare specialist and had worked in the industry for around 20 years, most recently for Colliers since July 2018. He was a valued member of the Healthcare team and made a

significant contribution to the business making many friends along the way. In his spare time David had a real love for sailing and was in the process of purchasing a new home in France,” said Adam.

“Our thoughts and condolences go to David’s family and friends.

He leaves a much-loved daughter Isabelle and son Tom.”

Business

Most UK companies acted to protect workers ahead of lockdown order The majority of UK businesses reacted proactively to the growing Covid-19 threat before the government announced a lockdown, a new report reveals.

The research, conducted by global health benefits provider Aetna International, shows that by 11 March when the World Health Organisation (WHO) officially declared COVID-19 a pandemic, 83% of businesses had already taken some form of action to support employees.

In the UK, prior to the government’s advice to work from home on 16 March, over a third (36%) of businesses had already offered this to employees, whilst over half (56%) had issued health tips to minimise risk and advice for self-quarantine.

A quarter of UK businesses had already banned all travel and 50% had issued a policy on how they were dealing with it, according to employees.

The research amongst office workers across four markets (UK, USA, UAE and Singapore) was part of Aetna International’s ongoing insights programme into issues affecting businesses, including the provision of mental and physical health support.

In the markets the research covered, this date was two to

6

three weeks before local lockdown policies were put in place, and a third (31%) of businesses had already given employees the option to work remotely, and 44% had issued health tips to employees.

Richard di Benedetto, president at Aetna International, said: “The spread of COVID-19 across the globe has been rapid, and its impact

on all our lives – both personally and professionally – has been significant. Despite the economic challenges facing many businesses, it is testament to the resolve of business leaders that they reacted so quickly to support their employees’ health and well-being.

“Whether through simple messages and tips, or bringing

in remote working early, clearly they were doing what they could in unbelievably challenging times.

As this complex situation continues to evolve, we will continue to assess how companies are adapting during this period of uncertainty, to ensure we are doing all we can to help them safeguard the mental and physical health and well-being of their employees.”

Percentages of UK companies taking action prior to lockdown on March 16th: • 58% had issued a message of concern to all workers • 50% had issued a policy on how they were dealing with it according to their employees • 56% had offered health tips for minimizing the risk and advice for self-quarantine • 36% had offered the opportunity to work remotely to all those concerned • 9% had provided access to private medical health checks to all employees • 25% had banned all travel • 23% had begun to implement reduced working times • 35% had suspended work-related events for large groups • 34% had asked those that have travelled to high risk areas to work remotely for 14 days

HealthInvestor UK • May 2020

NEWS

Technology

Social distancing app developed for use in healthcare settings A tech company has adapted its system designed to monitor retail footfall for use in healthcare settings to assist in maintaining adequate social distancing.

The Social Distancing Live Occupancy Counter from Ipsos Retail Performance, is an updated version of the Shopper Count tool, which reports on customer numbers moving through entrances and exits in any given location, building a factual picture of the flow of store traffic hourly, daily, weekly and year on year.

The technology works on a traffic light system, whereby ‘red’ is too busy and ‘green’ is acceptable capacity managed at a local site-specific level. This information is then shared on the Ipsos Traffic Count App in realtime, with alarms set up to staff letting them know any change of status at any threshold points.

Updated to show the live count of visitors at any given time, the tool’s new capability allows decision-makers in hospitals,

care centres and pharmacies to understand accurate building capacity in real-time.

This reduces the risk of any environments being overpopulated when the doors are open, and maintains social distancing guidelines.

Peter Luff, Ipsos Retail Performance president said: “COVID-19 has had a dramatic impact on where, when and how we are able to interact with our world. For the healthcare sector in particular, the new social distancing guidelines have made store traffic an even more crucial data metric.

“We know that decision-makers in healthcare are working hard to care for patients to keep our society functioning, while making sure their staff are safe.

“This new solution is our way to try and help social distancing work as effectively as possible, to stop the spread of the COVID-19 virus, keeping both employees and patients safe.”

HealthUnlocked creates new online community for self-isolators HealthUnlocked, a social network for health, has created a new online health community to provide peer support to people who will be selfisolating in the next few months, due to the Covid-19 outbreak.

The Positive Wellbeing During Self-Isolation community will be a space for more vulnerable senior members of society who require protection from Covid-19. The community will allow individuals to share their tips, advice and experiences on how to keep healthy.

HealthInvestor UK • May 2020

The community already has more than 1,000 new members, many of whom are over 65 years old.

Jorge Armanet, chief executive and founder at HealthUnlocked, said: “At HealthUnlocked we are not only in a unique position to help the healthcare system in these challenging times, but it is also our duty and great privilege to do so.

Our focus will remain on what we know best, helping people to tackle social isolation so we can relieve the healthcare system support burden.”

Tunstall launches tech solutions in bid to address Covid-19 home care pressures

Tunstall Healthcare says it has developed three tech solutions to respond to the current COVID-19 emergency and support contingency plans for similar scenarios in the future.

Tunstall Response, Tunstall Connect and Tunstall Integrated Care Platform will either support individuals in the care system directly, or provide solutions for NHS, Local Authorities and Housing Associations.

Gavin Bashar, MD of Tunstall Healthcare, said: “The Tunstall Response proactive call service utilises our existing community alarm service, which enables older and vulnerable people throughout the UK to easily get help in an emergency, using a home unit and worn pendant which connects them to a 24 hour response centre.

“Through regular outbound calls, operators can check in, offer advice and appropriately escalate any deterioration in wellbeing to other service providers, particularly where people are in self-isolation or at high risk from COVID-19. We’re also introducing a smart device app, Tunstall Connect, that can enable Tunstall Response to keep in touch with vulnerable people who are self-isolating, without the need for a traditional community alarm system.”

The Tunstall Integrated Care Platform enables remote health monitoring. Patients download an app which allows them to record vital signs readings and answer health questionnaires at home.

Clinicians can then remotely review the data via an online portal, using a colour coded dashboard to identify the patients most in need of intervention. This solution is proven to support management of chronic illness, and can provide support for patients recently discharged from hospital. Tunstall has also recently introduced specific COVID-19 and self-isolation questionnaires to support clinicians during the current crisis.

“We’re also introducing advanced services to assist Local Authorities to run their standard community alarm services, that may be experiencing challenges due to COVID-19, such as limited staff due to self-isolation, or limited provisions for staff to work from home or due to staff contracting the virus itself, resulting in decreased capacity at a time of high demand,” says Bashar.

The news comes as Tunstall Healthcare has reportedly secured further borrowing as part of a recapitalisation and debt restructure to finance its move to a software company.

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NEWS

Technology

Diagnostic tech from Medicspot installed at surgeries Healthcare technology provider Medicspot is rolling out a health diagnosis system across the UK that allows GPs to assess patients’ vital signs remotely.

Medicspot allows GPs to carry out tests including temperature, oxygen levels and heart and lung checks without the need for personal protective equipment.

The system guides the patient on performing an examination on themselves whilst the doctor is there to ensure that the patient is doing it correctly.

Five GP surgeries have already installed the new system, including The Goldborne Medical Centre in Kensington; South Downs Health and Care in Eastbourne; Willows Health Centre in Leicester; and St Andrews Health Centre in Tower

Hamlets. Many more are waiting to be installed in practices from Greenwich to Warrington.

Dr Zubair Ahmed, GP and Medicspot CEO, said: “This innovative technology could prove to be life-saving amid the current coronavirus outbreak. With retired GPs returning to work to support the NHS at this time, and a reported quarter of healthcare professionals in self-isolation[1], the ability to remotely diagnose patients removes the associated risk to GPs and patients of contracting the virus. It also lessens the current pressure around PPE provision, which has been in short supply.

“In addition, this system will give GPs the ability to restart their scheduled chronic disease services.

Patients with conditions such as

high blood pressure, COPD or asthma are not being monitored due to the present situation and it is imperative that we do as much as we can to help restart this review process when the time is right.

“Only 6% of patients need to be referred for a face to face consultation after using the Medicspot system which really improves the efficiency that can be achieved through telehealth to combat healthcare shortages. The easy to use system can be used by most patient groups with patients ranging in age from five to ninety years of age. Demand for this technology has been significant with NHS organisations calling for Medicspot to be installed in hundreds of surgeries nationwide.”

Dr Yasmin Razak, GP Principal

at Golborne Medical in Ladbroke Grove, West London, said: “We installed Medicspot last week as a solution to assess patients without danger of COVID-19 transmission and also to be able to treat patients that were suffering from different illnesses.

“We can fully assess the ENT, cardiovascular and respiratory systems and more all without risk of infection to either doctor or patient. The value of the remote oxygen monitoring is unmeasurable. It is the nearest we can get to a face-to-face consultation at the moment and in all likelihood, for months to come. It is an amazing tool and there is no other solution like it available – it is 10 times better than the next technology.”

NHS staff to get free digital health apps for anxiety and insomnia All NHS staff will be provided with free access to mental health apps as part of a nationwide effort to support the mental health of the NHS workforce during the Covid-19 pandemic.

The aim is to support staff to maintain healthy and restorative sleep, reduce anxiety and worry, and to help them learn evidencebased techniques to address mental health issues when they arise.

Big Health’s programmes Sleepio and Daylight are two of four apps that will be made immediately available to all NHS staff.

Sleepio is a digital sleep improvement programme featuring cognitive behavioural therapy (CBT) techniques which aims to reduce symptoms of poor sleep, as well as helping those with anxiety and depression move to recovery.

Daylight is an app for worry and anxiety, developed with anxiety experts and designers from Pixar, NPR: RadioLab and Google. Like

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Sleepio, Daylight uses evidencebased CBT techniques delivered through voice and animation.

Sleepio and Daylight will be available to everyone working in the NHS during the Covid-19 pandemic, NHS England said.

Colin Espie, professor of sleep medicine at the University of Oxford and co-founder of Big Health, said: “I’m honoured that Big Health is able to support our colleagues in the NHS to help safeguard their mental health during these most challenging of times. NHS staff are working under enormous pressure whilst also experiencing significant changes to their lives at home as a result of Covid-19.”

He added: “We built Sleepio and Daylight to help people effectively manage their mental health whether the challenges occur during the night, or day, round the clock. The NHS is facing an unprecedented crisis with the Covid-19 pandemic, and the staff

fighting on the front line urgently need our support. It is imperative, now more than ever before, that we look after the mental as well as the physical health of our most vital workforce.”

Chris Adams, GP and managing director of HFP Medical, commented: “Covid-19 has placed

a great strain on the mental health of our staff and patients. Digital solutions like Sleepio and Daylight allow us to provide instant support for those working either on the NHS frontline or from home and for those self-isolating, helping to keep people healthy during this difficult time.”

HealthInvestor UK • May 2020

NEWS

Technology

Vodafone and Imperial College London partner for new Covid-19 research The Vodafone Foundation and scientists at Imperial College London have partnered to support the Corona-AI project, in an effort to speed up research into effective treatments for Covid-19.

Once the research is complete, it will be made available to the medical profession to facilitate clinical trials.

The project uses artificial intelligence (AI) to trawl through data and identify existing drugs and food molecules that could benefit those with the infectious disease.

As part of the project, the Vodafone Foundation is asking smartphone users across the UK to utilise the DreamLab; an app developed by the Vodafone Foundation and launched in 2017 to facilitate cancer research.

Smartphone users can download the DreamLab app and activate it every night while they sleep and charge their phones. This collective processing enables millions of calculations. The more people that plug in, the quicker possible treatments will be found.

The Corona-AI project is split into two phases; Phase 1 will identify existing drugs and foodbased molecules with anti-viral properties that may benefit those with Covid-19.

Phase 2 will optimise combinations of these drugs and food molecules to provide potential drug treatments and nutritional advice for those with Covid-19.

In addition, any food-related findings will be translated into dietary advice that can be

Babylon launches Covid-19 Care Assistant Babylon, the digital healthcare provider, has launched a new service in response to the Covid-19 outbreak.

The new service, covid-19 Care Assistant, delivers appropriate information and remote care for patients who are concerned they may have the virus.

Patients can use the service 24/7 to check their symptoms; track their illness, cope with self-isolation, access information, chat with trained staff, and consult doctors who can carry out virtual consultations and referrals.

Access to the technology will help lower-risk patients with their needs, while freeing up clinicians to focus on the people who need help most.

Babylon already owns and runs the GP at Hand service, an app that can help patients book a video appointment with a healthcare professional at any time of day or night.

HealthInvestor UK • May 2020

Ali Parsa, chief and founder of Babylon, said: “Covid-19 is the biggest public health threat to our communities for nearly a century and Babylon has a huge obligation to help. We know how hard governments and healthcare systems are working to battle this pandemic and fully support their tireless work.”

He added: “We were founded to help tackle the challenges of accessibility and affordability of healthcare for every person on earth by using technology to increase the reach and impact of healthcare professionals. The combination of our technology and clinical service allows our doctors and nurses to use their time for the most suited tasks, while amplifying their expertise for the benefit of all our patients. We stand ready to help our communities in any way we can and in any manner they need.”

implemented by the medical community for patients recovering from Covid-19.

Scientists from Imperial College London have said if 100,000 DreamLab users power the app for six hours every night for three months they can complete vital research that would take Imperial’s supercomputers a year to process.

Kirill Veselkov from the Department of Surgery and Cancer at Imperial College London, who is leading the research, said: “We urgently need new treatments to tackle Covid-19. There are existing drugs out there that might work to treat it; and the great thing about repurposing existing drugs is that we already know they are safe and therefore could get them to patients quickly. However, we have to do

difficult and complicated analyses using artificial intelligence and all of this takes a huge amount of computing power. DreamLab creates a supercomputer that enables us to do this important work in a relatively short time frame.”

Helen Lamprell, trustee and board member of the Vodafone UK Foundation and general counsel and external affairs director at Vodafone UK, commented: “We’re working hard to keep the UK connected during this challenging time. We ask everyone to come together and harness the collective power of their smartphones by connecting to DreamLab. If everyone in the UK connects, we have the potential to really make a difference in the fight against Covid-19.”

Covid-19 misinformation spreading across social media The vast majority of Covid-19 information shared across social media comes from fake news sites, according to Newsguard, a service that rates the credibility and transparency of web news content.

The service found that official sources like the US Centers for Disease Control (CDC) and the World Health Organization (WHO) are receiving only a tiny fraction of the social interaction concerning Covid-19.

Over the last 90 days, posts from the websites of the US CDC and the WHO have received only 364,483 likes, shares, and comments on social media.

In comparison, Newsguard found that across that same period of time, 76 sites had published Covid-19 misinformation

which has received a combined 52,053,542 likes; shared and comments to date.

This is more than 142 times the engagement of the two major public health institutions providing information about the outbreak.

Gabby Deutch, NewsGuard’s Washington correspondent, said: “We see a remarkable degree of consistency. Sites that are already notorious for publishing misinformation about a wide range of topics are now also jumping on the coronavirus bandwagon.”

She added: “Misinformation and disinformation related to healthcare pose the greatest immediate threat to those who read if it is not flagged for what it is – which is what we do.”

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NEWS

Technology

Hospitals given free Patientrack Covid-19 assessment tool An early warning technology used in dozens of NHS hospitals will now help nurses to carry out crucial assessments designed to help identify potential cases of Covid-19.

Patientrack, which is used by hospitals to detect deadly conditions like sepsis and acute kidney injury, will now be used by nurses to record key information for all respiratory patients, which will then immediately inform professionals if the patient needs to be tested for Covid-19.

The digital assessment tool has been designed by Alcidion, the company which provides the Patientrack system, to make it easy for nurses to assess every patient presenting to hospital with a respiratory illness.

Staff on the ward will follow a series of questions covering symptoms, the patient’s circumstances, and their physiological measurements, and will enter information directly into Patientrack, the system used to track observations, via a computer or mobile device.

Specific questions will be tailored to the hospital’s own Covid-19 assessment criteria and can be configured by the hospital to keep up with the evolving situation.

Depending on the hospital’s requirements, the system can then place a flag on the patient’s record

or automatically alert appropriate professionals like respiratory doctors and infection control teams, if answers indicate signs of Covid-19.

It will also remove the need to record this information on paper, and will make it easier for hospitals to provide more complete information to NHS England on the number of people screened, the number who test positive, and the number of people who have died.

Clinical leads will also be able to use the information internally

to see at a glance affected patients and their status across the hospital.

The Covid-19 assessment tool is already live and in use in the NHS and is available to all hospitals using the Patientrack system.

David Proctor, the implementation consultant at Alcidion who built the initial Covid-19 assessment tool, said: “This is very much about supporting early intervention and early treatment. Nurses have always used Patientrack to help identify deterioration, and to allow a swift clinical response.This new

development is designed to help them detect coronavirus early, so that hospitals can deliver treatment sooner, move patients to intensive care faster, and get them the care they need more quickly.”

Patientrack is traditionally used by staff to capture vital signs and early warning scores and to record digitally bedside observations and patient risk assessments. The system alerts staff to intervene when patients show signs of risk or deterioration.

Across the NHS many hospitals have recorded significant gains in patient safety by using the system, which has given staff visibility of their sickest patients. Measured impact has included significant reductions in cardiac arrests, mortality, lengths of stay, and admissions to intensive care.

Lynette Ousby, general manager at Alcidion, said: “We are committed to helping our NHS partners tackle coronavirus in any way we can. We are working with hospitals that use Patientrack to test and implement the coronavirus assessment tool quickly, which we will be providing free of charge for as long as they need it. Discussions are ongoing as to how we can also adapt our wider range of technologies to respond quickly to the needs of front line staff at this difficult time.”

Eleven suppliers to provide video consultations to help NHS Eleven suppliers have been selected to provide video consultations for primary care to help the NHS cope with rising patient demand during the Covid-19 outbreak.

The suppliers include Doctorlink, eConsult, EMIS, Engage Consult, PreGP, Q Doctor, Lincus, Ask NHS, FootFall and Visiba Care.

They were selected from a group of 33 trusted suppliers that were sent a confidential 48-hour tender for the immediate provision of online primary care consultation

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by NHS England at the end of March.

Tina Marshall, UK country manager of Visiba Care, said: “We are ready to help the NHS to roll out digital solutions to provide the public with access to remote online consultations and welcome this news which green lights 39 clinical commissioning groups across the country to use Visiba Care to get up and running safely, quickly and efficiently with the digital tools they need to tackle this pandemic head on.”

She added: “This contract will mean that Visiba Care can help, to a much greater extent, in meeting the rising demand of primary care consultations, safely, efficiently and responsibly and we have the capacity and technology to support the NHS through the Covid-19 outbreak in the UK.” Graham Kendall, director of the Digital Healthcare Council, said: “Undoubtedly there is huge demand for online consultations at

scale and the rapid tender process shows how quickly it’s possible to move when there’s a coordinated and determined effort.”

He added: “There are some excellent providers on the list and there are many more providers that offer services that go beyond the scope of the tender. We need to embrace all of that capability to deliver a sustainable increase in online capability both in primary care and across the wider range of care services.”

HealthInvestor UK • May 2020

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Technology

Sirma gives diabetics free access to app amid Covid-19 outbreak Sirma is opening up all of its Diabetes:M’s ‘Premium’ functionality for free until 16 June in response to the Covid-19 outbreak.

The app, which is usually only accessible to Premium subscribers, will help doctors monitor their patients with diabetes remotely and prevent them from unnecessary exposure to potential threats when going out for regular checks. It allows doctors, clinicians, carers and other medical experts to have their patient’s information ready and available in real-time.

This means medics can monitor all their diabetic patients remotely in one place in this time of crisis and keep track of their health in great detail.

It also provides an extensive range of statistical information, recurring problems, and other analytical tools.

To access the patients’ data, the medical specialists have to register on the system.

After registration, doctors will receive an email with a clinician’s code and additional instructions, which they can send to their patients. If the patients are already

HealthInvestor UK • May 2020

using the app, the doctor can send them a request to share their data directly from the interface.

To activate it, the users have to enter a special code STAYHOME in the web version of the app.

Sirma has set up a pandemic response page to help people activate this free usage, which also provides other useful information: diabetes-m.com/diabetes-m-covid19-response/.

This period of free access to all diabetics may be extended, depending on the development of the pandemic, Sirma said.

Ivan Yordanov, product lead at Sirma, said: “The Covid-19 pandemic is wreaking havoc in our lives, with millions under quarantine or in isolation across the world. For medical teams monitoring patients with diabetes, they are particularly impacted, as regular doctor’s appointments and hospital visits are cancelled for safety reasons.”

He added: “Our solution enables daily monitoring of the diabetic patients remotely in one place in this time of crisis, and to keep track of how they are doing in great detail.”

LIVI launches new web platform for video consultations LIVI the UK arm of European digital healthcare provider KRY, has launched LIVI Connect, a new web-based platform that enables any healthcare professional to hold video consultations with their patients amid the Covid-19 pandemic.

The platform – available for free to any practising doctor or healthcare professional across Europe – has been designed as a secure method for patients to maintain access to mobile healthcare while the pandemic escalates across the continent.

Healthcare professionals can enter their details and sign-in using an email address, once verified. They can then enter their patient’s mobile phone number to send them a one-time SMS link to begin a video consultation.

The clinician’s email will never be shared with the patient.

Currently available in 10 languages – English, French, German, Italian, Spanish, Swedish, Norwegian, Danish, Dutch and Polish – KRY has plans to roll out the platform worldwide.

LIVI Connect is one of several products being developed by KRY to help tackle Covid-19. The company has also launched a free symptom checker – available via the LIVI app – which encourages patients to input viral symptoms before signposting them to relevant medical advice or support.

Johannes Schildt, KRY’s cofounder and chief executive, said: “We’ve launched LIVI Connect in response to the growing demand from doctors across Europe for a digital solution to the Covid-19 pandemic. For doctors that need to continue to see their patients, this gives a simple and secure option for the delivery of video appointments, at no extra cost.

The fully encrypted video meeting platform will allow any clinician to conduct a secure video consultation with their patients – at the touch of a button.”

He added: “LIVI is the digital solution for Europe’s biggest public health crisis: we’ve delivered double our normal appointments in the past fortnight across our core markets of Germany, Norway, Sweden, France and the UK. Beyond our core offer, we are working round the clock to adapt our offer and find new solutions to help monitor and care for affected patients, as well as developing new products to ensure patients with other health issues can still get the medical help they need.”

Juliet Bauer, UK managing director of LIVI, commented: “Covid-19 is having an unprecedented effect on healthcare systems across the globe. At KRY, which operates as LIVI in the UK, we are working in partnership with the NHS to ensure the health system can manage the surge in demand from patients. As more people selfisolate, LIVI Connect will help to ensure patients can still see GPs and other health professionals face-to-face via video – across the whole of the UK and Europe, and at no cost. This is paramount for people who have tested positive for Covid-19 or for those who rely on regular appointments for chronic illnesses.”

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Technology

Hospitals launch app to help tackle Covid-19 Researchers at King’s College London and Guy’s and St Thomas’ hospitals, in collaboration with the health data science company ZOE, have launched an app to help track the spread of Covid-19.

The app looks at who is most at risk from the virus in an effort better to understand the nature of the pandemic.

The free Covid Symptom Tracker app asks users for personal data such as their age, sex and postcode, as well as other questions on existing medical conditions, such as heart disease, asthma and diabetes. It also asks whether users take drugs such as immunosuppressants or ibuprofen.

If users tell the app they do not

feel healthy, the app asks them questions on their symptoms, such as coughs, fever, fatigue and diarrhoea.

The researchers said they hope it will provide real-time information on how the disease is spreading in the UK, including hotspots, such as London.

Tim Spector, a professor of genetic epidemiology at King’s College London, said: “The concept is an early warning radar device.

We are asking about non-classical symptoms as well, because many people are reporting non-persistent cough, or feeling unwell or a strange feeling of a lack of taste, or chest tightness that aren’t in the classical list, but if we see it across the country in clusters, we know they are probably real symptoms of Covid-19.”

He added: “Speaking to clinicians in the hospital, especially in the elderly, you get very different symptoms to the young, so this idea there are only two types of symptoms – fever and long-term

cough – is wrong. It can occur in many different ways.”

In addition, researchers from the University of Oxford have launched a new clinical trial to test the effects of potential drug treatments for patients admitted to hospital with Covid-19. The Randomised Evaluation of Covid-19 Therapy Recovery Trial will provide doctors and the health service with information they need to determine which treatments should be used.

And in Italy, ArchiMed portfolio company Diesse, based in Italy, is developing a blood test for Covid-19 detection – which will be one of the first in the world capable of accurately mapping the spread of the virus.

PPE

Clipper Logistics to BlueKit Medical boosts supply of PPE to NHS staff manage a new supply chain of PPE for NHS

BlueKit Medical is increasing its supplies of personal protection equipment (PPE) to the NHS with support from a Lloyds Bank funding package.

The funding package will allow BlueKit Medical to increase the demand for equipment including face masks, gowns and gloves.

The funding is also being used to ensure that the equipment can be delivered faster.

The products, which are normally shipped, are being flown in to speed up their availability to frontline staff.

Based in Croydon, BlueKit Medical was founded in 2012 to provide medical equipment to public and private healthcare operators and has been a Lloyds Bank customer since then.

Rebecca Porter, managing director at BlueKit Medical, said: “With demand for medical supplies available to the NHS at record levels, it followed that we’d have

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to increase the quantity of products we’re shipping from abroad. The flexibility and advice offered to us from Lloyds Bank, as well as the speed and efficiency across their teams to increase our funding at short notice, means that we’re able to support frontline NHS staff when it’s most needed.”

Mark Burgess-Clements, business banking manager at Lloyds Bank, commented: “These are unprecedented times and support is needed for businesses and organisations across public and private sectors.

He added: “When BlueKit Medical got in touch to ask for support to help fund extra supplies for use by frontline NHS staff, we knew time was of the essence.

We’d spoken to the customer and agreed to provide it with the capability to place a large order within two hours – testament to our commitment to being by the side of businesses at this time.”

Clipper Logistics is to manage a new supply chain to deliver personal protective equipment (PPE) to NHS trusts and community healthcare organisations, the Health Service Journal, has reported.

The supply channel began delivering pallets to trusts on 31st March, according to an NHS document seen by the publication.

Clipper is a major and longstanding retail logistics and supply chain firm, which serves retailers selling fashion, tobacco and alcohol, among other goods. The news comes after the NHS reported a severe shortage of equipment for front line staff in various trusts across the UK. Meanwhile, Labour MP James Murray, a member of the Commons health and social care select committee, has written to the health secretary Matt Hancock to ask him to review the government’s strategy

for supplying PPE to care homes urgently.

Murray’s response comes amid reports from care home industry leaders that orders of supplies of PPE intended to protect staff and residents in social care settings are being requisitioned by the NHS for use in hospitals.

At a meeting of the committee last Thursday, Martin Green, chief executive of Care England, told MPs that wholesalers were prioritising supplying the NHS over care homes.

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Social care

Care England calls for local authority support Care England has called on the government to instruct local authorities to use funds allocated to them as part of the Covid-19 pandemic measures to help struggling care homes.

The representative body says that prior to the outbreak, the adult social care sector was underfunded, “whilst the current context has merely compounded such difficulties.

It adds that delays in funding making its way to the frontline will only make financial sustainability issues even more acute.

Chief executive Professor Martin Green said: “The pandemic presents social care providers with unbearable human costs, but also has severe financial implications.

As an immediate priority we implore Central Government to instruct Local Authority Commissioners to use the funds allocated to them for the frontline”.

The organisation is calling for three objectives to be met:

• Central government direct business support.

Meanwhile, Care England has also encouraged all its members to engage with their local authorities regarding increased financial pressures as a result of Covid-19.

Martin Green, chief executive of Care England, said: “We have developed a template letter informed by engagement with Care England members over

many weeks cataloguing the sorts of financial issues that they are facing. We hope that it will empower members in their engagements with local commissioners and also help to inform clinical commissioning groups and local authorities of the kinds of challenges that care providers are facing currently”.

Care England said it is “vitally important for care providers to be supported in their response to

Covid-19. The health and social care systems are fundamentally intertwined and any response to Covid-19 on a national basis is reliant upon the support of a strong care system which is in turn dependent upon a well informed discussion at local level.”

It added: “Providers may be facing increased costs from issues such as the National Living Wage, agency fees and a range of operational pressures.”

• £3.2 billion given to local authorities needs to get through to independent adult social care services • More funding for local government and CCGS to give providers the necessary funds to cover COVID-19 related costs

Call for ‘ring of steel’ as care home deaths doubled in a week Covid-19 related in care homes across the UK doubled in one week, according to new research.

Data collected by the National Care Forum, the leading representative body for the notfor-profit adult social care sector, showed 2,500 deaths within care homes within seven days.

Forty-seven of NCF care provider members contributing to the audit, representing 1169 care services that collectively support 30,217 people across the UK – 7.4% of the overall residential care sector population.

HealthInvestor UK • May 2020

The report compares baseline data from providers at the earliest stages of the pandemic, from 6th March to 7th April (a full month), with results from 7th April to 13th April (one week only). It demonstrates a significant increase in Coronavirus related deaths within care homes, which when scaled up suggest that more than 2500 care home residents may have died in the homes of suspected or confirmed COVID-19 during last week alone, representing a 193% increase.

Vic Rayner, Executive Director

of the National Care Forum, said: “The figure of more than 4000 people passing away of COVID-19 within care homes in little more than one month is devastating.

Every death is a loss and a tragedy.

It is even more worrying to see a virtual doubling of deaths within homes in just one week, clearly indicating that whilst all attention has been on managing the peak in hospitals, the virus has attacked our most vulnerable communities. Care providers need to be given every ounce of support from government

to protect the vulnerable people they care for and the health of their workforce, but to date this has not been forthcoming.

“By highlighting the scale of the tragedy, we are giving the government an opportunity to respond with equal effort. It must act immediately and build a ‘ring of steel’ around care homes. They need the right PPE equipment, medical monitoring devices, rapid and comprehensive testing, proper funding and intensive research to safeguard the people they care for.”

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Social care

RVG offers vacant facilities to NHS staff Retirement Villages Group (RVG) has offered its vacant facilities to NHS staff to support them during the Covid-19 pandemic.

The offer seeks to help house NHS staff who require temporary accommodation to free up critical beds and support medical staff to self-isolate during the crisis.

The facilities that are vacant include RVG’s 81 apartments and cottages at Debden Grange, its newest village near Saffron Walden, Essex, and a further ten recently

completed cottages at Lime Tree Village in Warwickshire.

RVG has also created Community Connect – a virtual community group for its residents and the community to remain connected, keeping in line with the government’s social distancing ruling.

Will Bax (pictured), chief executive at RVG, said: “These are unprecedented times. We are focused on doing what we can to support our communities and enable the NHS and its amazing people to save lives.”

He added: “Retirement villages exist to help older people to live better lives. We have been forced to pivot our services in the past few weeks to ensure we can keep our residents as safe and supported as possible. Never has this work been more important than it is now. However, we’re also looking for the silver lining and how we can ensure that communities come through the crisis stronger and more united than ever.”

Care workers at breaking point over access to PPE Care workers in the UK are at “breaking point” because of the lack of personal protective equipment (PPE) available to them during the Covid-19 outbreak, according to Unison assistant general secretary, Christina McAnea.

McAnea made the comment in response to the news that some care home managers are still not providing basic equipment such as face masks and hand sanitiser to staff as they support the vulnerable and elderly during the crisis.

In some cases, the union found care workers are being given just plastic aprons and gloves to protect against Covid-19 which has triggered widespread anxiety among staff that they may spread the virus among their own families and the people they care for.

The union has also received reports of some employees being asked to work even if they have

underlying health issues, and to bring their children in if they cannot get childcare. In one case, a care home worker was told he and colleagues would have to nurse residents who become sick, despite not being issued with proper PPE. Another major concern among care staff is that advice from managers differs from the official government guidance on PPE. Other issues include families still being allowed by managers to make daily visits to residents, despite government restrictions limiting movement and social interaction.

Unison said these issues show that “this fragmented, understaffed and underfunded sector is struggling to cope with the coronavirus crisis.”

McAnea said: “Care workers are being treated as though their safety and that of their loved ones doesn’t matter. They feel they’ve been forgotten about and are at the

bottom of the pile despite doing a vital job. Many are being denied access to vital protective kits that helps prevent the spread of the virus to them, their families and the people they look after.”

Labour MP James Murray, a member of the Commons health and social care select committee, has written to the health secretary Matt Hancock to ask him to review the government’s strategy for supplying PPE to care homes urgently.

Murray’s response comes amid reports from care home industry leaders that orders of supplies of PPE intended to protect staff and residents in social care settings are being requisitioned by the NHS for use in hospitals.

At a meeting of the committee last Thursday, Martin Green, chief executive of Care England, told MPs that wholesalers were prioritising supplying the NHS over care homes.

At the meeting Green told MPs: “Some of my members are having things they had ordered, sometimes before this crisis, ‘taken at the borders’ for the NHS. So, we have got a situation where the normal areas of supply are not getting through.”

Similarly, Nadra Ahmed, executive chair of the National Care Association, which represents smaller and medium-sized care homes, said she had also been contacted by members saying their supplies had been diverted to the NHS. McAnea has called for “a more coordinated approach” which is “needed desperately, with managers all following official guidance.”

She added: “Every care worker who needs masks and other safety gear must be supplied with it as a matter of urgency.”

Care England releases advice for learning disability providers amid Covid-19 Care England, the representative body for independent providers of adult social care, has released new advice for its learning disability (LD) carers to use during the Covid-19 pandemic.

The document addresses five key

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issues pertinent to the LD sector: care and support of people supported with Covid-19, staffing, interface with health services, equipment, and legal and regulatory frameworks.

Prepared by learning disability

care providers, members of Care England, and consultants who work collaboratively with Care England, the document does not provide formal guidance, rather it is aimed at providing helpful information for

providers on how best to deal with the implications of the Covid-19 outbreak.

Members can access the document at: careengland.org.uk/members/ covid-19

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Social care

Adult social care services Calls for furloughed to receive millions of PPE workers to join care teams products Adult social care services are to receive millions of personal protective equipment (PPE) products following a national audit of PPE, according to HSJ. The government said it will deliver more than 30 million items to local resilience forums for distribution among social care and other front-line services.

Major PPE shortages have been reported across social care services in recent weeks, with Unison reporting that many of its members who work in the sector are at “breaking point” because of the lack of personal protective equipment available to them.

In addition, care homes have increasingly been asking for widespread coronavirus testing in their facilities, but current government policy limits a care home to just five tests, only if there is an outbreak.

This is despite government guidance outlining that “more comprehensive testing” to the sector will be available when “capacity increases”.

But some big care chains, that have already had care recipients die from the virus, have said they still have not had a single test, with staff simply being advised to isolate suspected cases at the home.

According to the Daily Mail, there have been at least 40 virusrelated deaths in UK care homes, but the lack of testing means experts can’t know the true scale of the crisis or how many residents and workers already have the illness.

The publication found that Four Seasons Healthcare (FSHC), which runs more than 200 homes, has had no tests for residents or staff, despite 13 residents dying from a suspected outbreak in just one week at the company’s Burlington House in Glasgow. Half of FSHC’s 13,000 staff are self-isolating, and two have tested positive in hospital.

The UK’s largest care home group, HC-One, said none of the staff at its 320 homes had been tested. And similarly, Bupa Care Homes, which operates more than 120 sites, said no staff had had access to testing.

An independent group representing the UK’s social care providers has written to the Prime Minister Boris Johnson outlining the urgent need for more staff to cover the increased demand on social care services during the Covid-19 crisis.

The group comprising Care England, Scottish Care, Fforwm Gofal Cymru (Care Forum Wales) and the Independent Health and Care Providers has requested clarification in legislation that anyone wishing to work in for the NHS or any form of social care will be permitted to take up paid employment, even if currently furloughed in other industries and receiving 80% of their wages from the government.

The group also asked that furloughed workers receive their 80% payment and get paid for their social care work with no penalty – allowing the NHS and social care providers to employ such people during the pandemic.

Simon Parker, founding partner of SP&P a management consultancy for the care home sector, said: “After speaking with care business leaders around the country, it became very clear that there is a fast-

approaching workforce crisis that if left unsupported, could have huge implications for the people receiving care and also the service providers ability to support the people that they are caring for.”

He added: “We are calling upon the government to support the social care sector by making an amendment that would allow the NHS and social care providers, in homes or in community, to provide paid employment to staff furloughed from other industries.

“People in social care do an incredible job every day, but in today’s unprecedented times they are doing so under increasing pressure and increasing risk to themselves. As a nation we need to do everything that we can to support them.”

Care England calls on former social care workers to return Care England, the largest representative body for independent providers of adult social care, has called on former social care workers to come back to work to help the sector tackle the Covid-19 outbreak.

Martin Green (pictured), chief executive of Care England said in an open letter that, like the NHS, “the adult social care sector will require the support of the nation in the coming months if it is to continue to support some of society’s most vulnerable at these most worrying of times. We encourage those who are willing, and able to do so, to join the adult social care workforce.”

HealthInvestor UK • May 2020

Care England is mainly calling upon retired staff with experience in the adult social care sector to take part in this national effort, but

has also welcomed those who are not currently working, particularly those who usually work in catering, hospitality or air travel to become part of the social care sector’s efforts to tackle the virus.

Green said: “If you have previously worked in the social care sector, there has never been a more important time for your skills and knowledge to be reclaimed.

Many providers have noted that they already see rising levels of Covid-19-related absences.”

He added: “This combined with the already extremely high levels of vacancy rates in the adult social

care sector has the potential to create a perfect storm for the sector. However, with your help we can act to avert such a reality and the negative implications it would have upon some of society’s most vulnerable individuals.”

Green’s request for help comes a day after health secretary Matt Hancock urged 250,000 “healthy” Britons to join the newly-created NHS Volunteer Responders scheme which aims to help the NHS with shopping and the delivery of medicines as well as supporting those self-isolating for the next 12 weeks inside their homes.

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Social care

Dozens of MPs back £1m fundraiser for care workers Sixty MPs from the More United Network and across the House of Commons have backed a fundraiser aiming to raise £1 million for grants to support care workers who are forced to self-isolate because of Covid-19.

The fundraiser has a target of £1 million, and has already raised £100,000 since its launch and aims to provide those workers with financial support if they need it.

There are around two million carers in the UK, and many of them will be forced out of work and find themselves struggling if they have to self-isolate. The Care

Workers’ Charity issues grants to care workers in financial difficulty, but the Covid-19 pandemic has seen a huge increase in demand, and driven a need for more funds.

The 60 MPs involved have all signed an open letter congratulating the charity and the public who have donated, and several of the MPs have donated themselves.

Tabitha Morton, chief executive of More United, stated: “These are challenging times for everyone, but the way that people have come together in a time of crisis is amazing.

We saw as a nation how we value the incredible work carers deliver

every day with #ClapforCarers, and this new fund allows people to show that they #Care4Carers and make sure that if a care worker needs financial support then they will get it. The wide support it has got from MPs shows how important this cause is and how valued our social care workers are.”

Karolina Gerlich, executive director at The Care Workers’ Charity, said: “Covid-19 is one of the biggest crises our generation will see in its lifetime. Care workers are at the frontline of this, caring for the people in our society who are most susceptible to the virus. If

a care worker needs to self-isolate they will fall into desperate need.

For this reason, we need more funds for extra emergency grants. I am very grateful to all MPs that have signed the letter of support for our campaign.”

Stephen Hammond Conservative MP, said: “Care workers are at the front line of this crisis, and we need to make sure that those who spend their lives caring for others get the support they need. The grants that The Care Workers Charity provide are a vital lifeline, but the increased need means they need our support more than ever.”

Care home providers criticised for blanket closures Some care home providers, as well as community nurses, have come under criticism for complete blanket restrictions they have placed on visits by relatives and friends, in an effort to protect residents or care recipients from the Covid-19 outbreak.

Judy Downey, the chair of the Relatives and Residents Association, said that there needs to be a “more sensible and properly differentiated approach” to social contact with elderly people, amid the crisis.

Speaking to HealthInvestor UK, Downey commented: “Though I understand many visits will need to be stopped amid this crisis, a relative or friend’s daily visit to an elderly person in their home, or at a care home, is often an essential part of their routine care.”

She added: “In some cases, relatives or friends provide the elderly with an essential source of social contact; they may feed or bathe them and supply other crucial support. Indeed, in some care homes relatives become a virtual part of the care team.”

Downey also said that those living with dementia should have access to family and friend visits wherever practicable, where all parties are free of infection, on the basis of full risk assessments.

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Many dementia care recipients “heavily rely on face-to-face visits for their emotional stability and mental wellbeing and their distress will need careful support and management”, she said.

“Where an outbreak is suspected or in place, relatives and friends need to be informed urgently and ways of maintaining relationships discussed with them, including the use of technology where appropriate”, she added.

“Most care homes and community nurses are acting with a common sense approach”, Downey continued.

“I want it to be known I am in no way attacking care homes or their overstretched staff whose health and wellbeing also need protection. I know this is a crisis. I am not taking this lightly. But in some cases, these blanket closures and restrictions I am hearing about are not being explained and are causing more distress for care recipients and their families, especially in end of life cases. A more nuanced approach is much needed.”

Downey further indicated that specialist care providers housing younger people with specialist needs should also be taking the same sort of common-sense approach to visits, and added that better guidance from

the Department of Social Care and the government is now paramount.

Many operators have decided to place restrictions on visits to residents after the number of people infected with the virus rose sharply across the UK in March.

The first case detected at a care home was reported on 12th March at Oakridge House Care Home in Basingstoke, Hampshire. Since then, new outbreaks have been reported at HC-One’s Highgate Care Home in North Lanarkshire; The Meadowside and St Francis Care Centre in Plymouth, and at Woodcroft Care Home in Trowbridge, Cardiff.

Though care homes are not yet required by law to shut their doors, Bupa and luxury care home operator Dormy Care Communities are among the latest to announce visitor restrictions.

Barchester Healthcare, which runs more than 200 UK homes, has asked visitors only to turn up if it is essential.

Barchester Healthcare stated: “We have not taken this decision lightly, and appreciate that this may cause some discomfort, but feel that this is a necessary step to take.”

In addition, the Care Quality Commission (CQC) is to stop routine inspections in response to the covid-19 pandemic.

The commission said its primary objective will be to support providers to keep people safe during a period of “unprecedented pressure on the health and care system.”

Commenting on care homes’s decisions to close their doors, Nadra Ahmed, chair of the National Care Association, said: “Providers are taking these steps to protect the residents and staff. They are taking steps to increase communication options via telephones etc. The advice remains for relatives who do visit to ensure that they are free of the virus and to comply with precautionary processes.”

She added: “Care providers are working hard to mitigate the risks to the vulnerable people they care for and their workforce, but know that they cannot completely eradicate the risk as there will be circumstances under which families and friends will be enabled to visit.”

Martin Green, chief executive of Care England, said: “Some care providers have introduced [these blanket restrictions] as a precaution, but we need very clear guidance from the Department of Health and Social Care and NHS England as to what the position is. We have been asking for this repeatedly.”

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Social care

Domiciliary care providers in financial crisis Covid-19 has left companies which support older and disabled people in their own homes struggling to cope, says their professional association.

The UK Home Care Association (UKHCA) told the BBC the firms need more funding; more protective equipment for staff, and clearer guidance on protecting clients amid the Covid-19 outbreak.

The virus has put care companies which were already financially vulnerable under additional pressure, the association said.

A £350 billion package to support businesses “small and large” was pledged by Chancellor Rishi Sunak in March.

However, during the statement, the chancellor did not make any comment about social care funding in the crisis, nor did he mention any plans for social care in the government’s budget.

Though the budget included a promise to extend sick pay for UK workers and business rate relief for firms in England amid the virus outbreak, Sunak did not address the chronic underfunding of adult social care, despite Prime Minister Boris Johnson pledging to do so when he took office last year.

The extra demands placed on care at home by the Covid-19 outbreak have thrown the

Ideal Carehomes offers paid work for those financially affected by Covid-19 outbreak The scheme is designed to offer additional income for local people, such as those working in hospitality or retail, who have suffered a loss in income because of the covid-19 outbreak.

Workers will be paid £9 an hour to help perform key tasks, including: kitchen work, cleaning, laundry, serving meals, and everyday tasks such as making a cup of tea.

Ideal Carehomes has affirmed new workers will not be required to perform any personal care or assist residents without the supervision of the trained care staff.

It will also be mandatory for new workers to complete essential DBS and health checks prior to their first shift.

The flexible workers will be given access to e-learning portals via Ideal Carehomes’s Ideal Academy programme which provides essential training for dementia awareness; person-centred care, safeguarding and first aid.

HealthInvestor UK • May 2020

Sarah Colling, head of development and engagement at Ideal Carehomes, said: “As communities throughout the UK continue to suffer the effects of the coronavirus, it is important that we are continuing the daily running of our care homes as normal and maintaining residents current lives with as little disruption to them as possible.”

She added: “In the event that some of our current staff teams are unwell and unable to work, these key members of the community can utilise their cooking, cleaning and domestic skills to enable our dedicated care staff to continue what they do best – caring for our residents.”

Stacey Linn, director at Ideal Carehomes, commented: “We hope our contingencies in place are able to bring peace of mind to both local people, who may have reduced income, and to our residents and their relatives. It is very heartwarming to see communities joining together and working as a team.”

underlying social care crisis into sharp relief, UKHCA said.

The BBC found home care companies are likely to have more people needing care and will need to train extra staff as some will not be able to work if they become ill.

Tuesday’s announcement

by NHS England that hospitals should free up some 15,000 beds by discharging long-term patients who are medically fit into the community is expected to pile even more pressure onto the social care sector in the coming weeks, the association added.

Though, Simon Stevens, chief executive of the NHS has written

to the chief executive of all NHS trusts, foundation trusts, clinical commissioning groups, GPs and providers of community health services clarifying future arrangements between the NHS and independent sector, mainly to free up private beds.

Stevens said: “Nationally we are now in the process of block-buying capacity in independent hospitals. This should be completed within a fortnight.

Their staff and facilities will then be flexibly available to you for urgent surgery, as well as for repurposing their beds, operating theatres and recovery facilities to provide respiratory support for covid-19 patients.”

Care homes’ supplier costs increase since start of Covid-19 outbreak Over half of care home operators’ supplier costs have increased since the start of the Covid-19 pandemic in the UK, while 15% have experienced dramatic increases, according to property consultancy Carterwood.

The finding was reported in a survey conducted by Carterwood in which they asked social care developers, investors and operators their thoughts on the impact Covid-19 will have on the UK social care market.

The concern in supply costs comes as some care homes for the elderly have appealed to the government to prioritise their access to food deliveries after many supermarkets reported shortages due to stockpiling.

In addition, the survey found 44% of respondents stated that they have had to change their 2020 investment plans.

Carterwood said this comes as the Covid-19 pandemic continues to escalate and the economic situation becomes more precarious, leading

the sector to view investment with more caution.

However, on a more positive note, Carterwood also found Covid-19 has had a very limited effect on care home occupancy, with 88% seeing no reduction at all so far.

Although more than half of operators still expect a reduction in occupancy over the next three months, the proportion forecasting no reduction at all is significantly larger now (43%) than it was on 11 March (22%), when Carterwood’s first survey of this kind was released.

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NEWS

NHS

NHS to scale back Covid-19 response as nearly half of acute beds stand empty The NHS in England is to scale back its capacity to treat patients with Covid-19 as demand drops amid concerns that the public believe the NHS is closed for all but coronavirus cases.

Widespread fears over the consequences of cancelling elective surgery and a huge reduction in patients attending emergency departments meant that health service bosses will now free up beds set aside as part of the pandemic “surge” response.

In addition, a public information campaign will kick off this weekend to reinforce the message that the

NHS is still open for business and that patients should access services in the normal way if they are unwell.

Senior NHS managers have told Health Service Journal that NHS England is to issue a plan for “releasing and redeploying some of the treatment capacity”.

Confronted by the prospect of overwhelming numbers, NHSE in March told trust managers to release 30,000 beds, by cancelling routine care and rapidly discharging patients, and also bought up nearly 10,000 beds in the private acute sector.

HSJ reports that 42% of acute

beds in England are now empty, far more than is normal for this time of year.

An NHSE spokesman told HSJ: “A public information campaign beginning this weekend will remind people that the NHS remains open for business, and it is important that non-covid19 patients can also still safely access the appropriate care and treatment they need.”

Health and social care secretary Matt Hancock told the Commons the government wanted to “reopen the NHS” to patients with noncoronavirus conditions “as soon as it is safe to do so”.

NHS patient satisfaction improves during outbreak Satisfaction with NHS services has jumped to more than 90% positive this April despite the additional pressure on hospitals amid the COVID-19 outbreak, The findings by the tech company Patient Experience Platform (PEP) reveal that 90.4% of NHS Acute Trusts patients (in and out-patient) reported a positive experience in the month to 14 April 2020, compared to 84% in March and 76.1% in February.

Patient experience feedback was significantly poorer in 2019, with 75% feeding back positively in April, 75.2% in March and 73.4% in February. This indicates patients are more appreciative of the care and treatment they are receiving, despite healthcare pressure points brought by the COVID-19 outbreak, including staff and PPE shortages.

PEP, a recently selected member of the NHS Innovation Accelerator 2020, collates publicly available real-

time, real-world patient feedback from multiple online platforms to provide comprehensive insights into the standards offered by NHS and private hospitals. Its custom algorithms categorise and score the feedback providing a proven, accurate and unbiased summary of what patients really think, which highlights areas that need focus and improvement. This is particularly important as the current pandemic evolves.

Dr Mark Lomax, chief executive of PEP, said: “The insights gained are particularly useful in the current climate, as feedback will help us support the operational response to COVID-19 through improving services and patient safety, as well as providing learnings on how to more effectively communicate with the public. It also highlights public support for the NHS, which is invaluable for morale.”

Government issues rebuttal to negative Nightingale hospital stories The government took the unusual step of issuing a rebuttal to claims that the NHS Nightingale hospital in London’s docklands is an unnecessary and a ‘white elephant’.

Several news outlets have claimed that the emergency facility built in record time with the help of the army cannot accept patients due to a shortage of critical care nurses and that the 4,000 bed facility has treated just 41 patients.

The Department of Health and

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Social Care refuted the allegations, claiming: “There is no shortage of nurses and all coronavirus patients who need treatment are being treated in existing London hospitals.”

Ministers say the hospital was “set up to treat patients if the NHS was overwhelmed, but thanks to the great work of selfless NHS staff, there is spare capacity in existing London hospitals.

The DHSC adds: “NHS

Nightingale’s staffing model was always designed to be flexible based on demand across London.

“Critical care nurses working across the city have received additional training and are ready to be deployed to NHS Nightingale to treat coronavirus patients should capacity be reached in existing London hospitals.”

NHS England has now taken the decision to mothball all Nightingale hospitals due to lack of demand.

HealthInvestor UK • May 2020

NEWS

NHS

Spire takes over NHS chemotherapy service Private hospital provider Spire Healthcare has taken over chemotherapy services in Norwich from the NHS in a bid to ease the pressure of treating patients with Covid-19.

A partnership between Spire and Norwich and Norfolk University Hospitals NHS Foundation Trust (NNUH) have reached an agreement that will see NHS patients with cancer being treated at Spire’s Norwich hospital, allowing Norwich and Norfolk University Hospital to focus on caring for people with COVID-19.

Spire Norwich did not provide a chemotherapy service prior to the outbreak of COVID-19, but since the end of March, it has worked with staff from the Norfolk and Norwich University Hospital to transfer its entire chemotherapy service to Spire. Approximately 300 patients use the service each week.

Spire Norwich will also provide care for NHS cardiology and spinal surgery patients. A midwifery clinic is planned to begin in the next few weeks.

Since the partnership began three weeks ago, Spire Norwich has seen 500 NHS patients, and is carrying out

35-40 urgent operations per week.

The partnership between Spire Healthcare and the Trust been made possible under a national agreement, which Spire, alongside the whole of the independent sector, has signed to make its staff, equipment and facilities available

to the NHS to help alleviate the pressure caused by the pandemic.

Nayab Haider, Hospital Director at Spire Healthcare, said: “We are very proud to be supporting the NHS during the worst public health crisis seen in decades. Even though tackling the coronavirus is the number one priority, it is so important that people with other urgent health conditions continue to access the treatment they require. We are very pleased that we’re able to play our part in meeting this need.”

Sam Higginson, Chief Executive at NNUH, said: “Our mission is to care for our patients, whether they have Covid-19 or other urgent care needs which are unrelated to the pandemic.

The support we have received from Spire has been tremendous and we are delighted to be working in partnership to benefit the local community at this difficult time.”

Hilton Nursing Partners set up ‘care hotel’ to free up NHS beds A patient discharge and home recovery company, Hilton Nursing Partners, in partnership with West Kent Clinical Commissioning Group, Kent County Council, and Salomons Estate Hotel, has set up a ‘care hotel’ to free-up NHS beds for those affected by the Covid-19 pandemic.

Salomons Hotel, a Victorian mansion in Tunbridge Wells, will be managed and staffed by Hilton

nursing staff to minimise patient infection and maximise recovery during the outbreak.

The hotel closed its normal operations on 22 March due to the Covid-19 outbreak.

Hilton Nursing Partners approached its partners in midMarch in an effort to maintain focus on the recovery of the frail and vulnerable away from high-risk environments.

Ann Taylor, chief executive of Hilton Nursing Partners, said: “We’re delighted that the NHS and Kent County Council have agreed to our care hotel proposal so quickly.

The ethos of Hilton is about getting patients home as soon as possible and supporting their recovery. We recognised that continuing with this model during the current crisis would result in a bottleneck, and risked rationing of care.”

She added: “These are exceptional times requiring exceptional measures, and the care hotel will enable us to maximise the support that we provide, while maintaining patients in a safe environment.

While visiting is not possible in the current circumstances, we will use technology to ensure our patients are kept in-touch with family and friends.”

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HealthInvestor UK • May 2020

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NEWS

Deals and investment

IW Capital backs digital health provider GPDQ

IW Capital has completed a £2 million investment in primary health solutions provider GPDQ. GPDQ delivers a multi-channel doctor-on-demand service, using its technology platform to connect its network of clinicians with both NHS and private patients through home visits, in-clinic or via video.

The investment from private equity specialists IW Capital will be used to secure a leading position in the market working with the NHS, employers and insurers by bolstering sales and account management, generating leads through increased marketing activity and the evolution of the technology platform.

GPDQ has recently set up dedicated Covid-19 visiting services in partnership with GP federations and clinical commissioning groups to support the most vulnerable patients at home. GPDQ’s remote services can also be accessed by 6,500 NHS GP practices via the iPLATO platform, enabling portfolio GPs and doctors in self-isolation to continue to see patients on the front line.

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Luke Davis, IW Capital chief executive, said: “The investment also shows the importance of private investors in growing businesses that can have an impact on national and global issues such as COVID-19. As investment providers we have a duty to offer these opportunities to investors but also to make sure that innovative SMEs get the funding required to grow.”

Paul Roberts, CEO of GPDQ, said: “This £2m Series A investment will bolster GPDQ’s ability to deliver at scale as it supports the NHS, employers and insurers in getting the UK safely back to normality in the wake of Covid-19.

“Remobilising the workforce following lockdown will be an enormous challenge for all employers, and our market leading solution provides the necessary clinical guidance and support for them to do that. Meanwhile our community visiting services will ensure that those most at risk, including those in care homes are not left behind and forgotten.”

Triple Point Investment Management increases its financial support for the NHS Triple Point Investment Management has increased the financial support it provides to the NHS, to help the service accelerate the procurement of vital equipment it needs amid the Covid-19 pandemic.

As part of its broader strategy to relieve funding pressures in the public and private sectors, Triple Point Investment has already financed and supplied medical equipment used in 103 NHS trusts nationwide.

Medical assets financed for the NHS by Triple Point Investment, currently worth more than £118 million, includes more than 2,000 hospital beds, sterilising equipment, more than 800 infusion pumps and one modular hospital building.

In addition, Triple Point Investment has helped finance eight ventilators for the intensive trauma unit at a regional county hospital.

Triple Point Investment also manages one of the largest fleets of

ambulances in the UK, with almost 400 of its accident and emergency vehicles in near constant use by its NHS lessees.

A similar number of specialist patient transport vehicles are now being re-purposed by Triple Point Investment to provide critical frontline services; these vehicles are all fitted with on-board patient ventilators.

Caroline Davis, senior account manager at Triple Point Investment, commented: “It’s an honour to be able to step up our support to the NHS at such a critical time. Our finance can hasten procurements forward, reduce capex strain and enable our amazing front-line health professionals to provide the care needed now more than ever.”

She added: “We will strive to make sure that our world class health service has the necessary resources to operate to the best of its ability, so it can carry on saving lives.”

HealthInvestor UK • May 2020

NEWS

Deals and investment

Recession ‘of a scale not seen in modern history’ likely as Covid-19 ravages UK economy The Covid-19 pandemic is causing the UK economy to shrink at a rate unseen for at least 20 years, according to new economic data.

Research published by financial analysts IHS Markit shows that business activity across services and manufacturing has plummeted as the Covid-19 deals the UK economy “a more severe blow than at any time since comparable figures were first available over 20 years ago”.

Markit says that output has crashed with new orders disappearing at their fastest rate since the financial crisis of 2008, and the outlook for business is grim.

The firm’s benchmark survey of UK purchasing managers (PMI) fell to just 37.1 in March, down from 53.0 in February, representing a precipitous drop in economic activity.

This is the biggest fall since the survey began in 1998 and experts now believe a deep recession is inevitable this year as further government restrictions on business look set to make the situation worse.

Chris Williamson, chief business economist at IHS Markit said: “With additional measures to contain the spread of the virus set to further

HealthInvestor UK • May 2020

paralyse large parts of the economy in coming months, such as business closures and potential lockdowns, a recession of a scale we have not seen in modern history is looking increasingly likely.

“Historical comparisons indicate that the March survey reading is consistent with GDP falling at a quarterly rate of 1.5 to 2%, a decline which is sufficiently large to push the economy into a contraction in the first quarter. However, this decline will likely be the tip of the iceberg and dwarfed by what we will see in the second quarter as further virus containment measures take their toll and the downturn escalates.”

He added what economic growth there was in areas such as healthcare was overshadowed by collapse in demand across large swathes of the economy.

“Any growth was confined to small pockets of the economy such as food manufacturing, pharmaceuticals and healthcare.

Demand elsewhere has collapsed, both for goods and services, as increasing numbers of households and businesses at home and abroad close their doors.”

Slowdown in private equity transactions extremely likely amid Covid-19 outbreak

The global financial market will undoubtedly see a slowdown in private equity transaction volume following the expected economic contraction, according to PitchBook, the data provider for the private and public equity markets.

In its report part, PitchBook says: “As we enter into the most significant market drawdown and economic shock we’ve seen since the financial crisis, private equity is equipped to help alleviate pressures, but it will also certainly be challenged.”

It added: “As we look across our client base that is primarily composed of private equity and venture capital investors, we typically see lags between public market valuation moves and markto-market/model adjustment for private market funds.”

“A drop-off in the stock prices may or may not have a ripple effect on private equity depending on the underlying driver of that move, but a decline in the earnings profiles of those companies certainly poses risk to private equity as portfolio companies aren’t immune to the negative economic pressures that public companies face.”

With tighter lending, private equity firms will be forced to enter transactions with more conservative capital structures that include a larger equity proportion, it outlined.

Discussing the wider market, Alastair George, analyst at Edison, the equity research platform, said: “There will be significant economic disruption and earlier fears, initially dismissed in some quarters as fake news, have become a fact of life.

However, in our view, now is not the time to panic. Equity portfolios and investors should focus on the likely evolution of this healthcare crisis over the next 18 months.”

Though he added: “The decline in global equity markets has been severe, and especially so in continental Europe and the UK. Major indices have fallen by well over 30% year to date and mid-cap UK equities have recorded declines of 40%. This means forward price/ book multiples have fallen to levels not seen since the 2008 crisis.

Where liquidity was poor prior to the coronavirus epidemic, price moves in specific stocks have often been more extreme.”

“Our observation is that in a distressed market all assets become correlated and rather than offering a separate signal, credit markets show that risk premia across financial markets are broadly elevated, as investors indiscriminately try to raise cash. We believe a reduction in uncertainty will occur as investors become better able to outline the shape of the downturn and the consequent recovery.”

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NEWS

Testing

Home testing kits for care workforce piloted The Care Quality Commission (CQC) is piloting a scheme for adult social care workers to order Covid-19 home testing kits.

The regulator says that, since 10 April, 24,590 locations have been contacted and 12,422 appointments have been booked for care staff at a national testing centre but that an home testing scheme will be rolled out next week.

The CQC will also be coordinating testing appointments for staff from other sectors who are not already covered by an existing NHS or local authority scheme, including GPs and practice teams.

Ian Trenholm, Chief Executive of CQC, said it was important that care staff feel supported and able to freely express concerns over standards.

“It is especially important - at a time when staff may be looking after more patients than usual, working outside their normal competencies or in new environments – to highlight the value of safety culture.

Ensuring an open and transparent culture where people can speak up when they have concerns about safety is crucial,” he said “Staff must feel confident that

they will be listened to - without any fear of blame or reprisal – when raising concerns and reporting incidents. In these exceptionally challenging times, identifying and reporting risk so that action can be taken to ensure that safe care is maintained will be more important than ever. CQC will be listening, and we want to help you to keep people safe.”

BillionToOne develops novel Covid-19 test The precision diagnostics company BillionToOne has developed a novel Covid-19 test that has the capacity to perform more than one million tests per day in the US alone.

According to BillionToOne, test reagents will be available in the US soon, pending the manufacture of the kits and FDA approval.

The BillionToOne Covid-19 test does not use the same instruments and chemicals as the existing Covid-19 tests but instead looks at the virus’s genome, which makes the tests extremely sensitive and specific.

Additionally, the test is easily

adoptable at any labs with sanger sequencers, with minimal training.

Sanger sequencing is used to study a small subset of genes linked to a defined phenotype. The phenotype is used in genetics for the composite observable characteristics or traits of an organism.

Oguzhan Atay, chief executive of BillionToOne, said: “We’ve all seen the impact this pandemic has had on every aspect of our daily lives. From the loss of lives and the damage to the economy to the strain on the healthcare system, this coronavirus has delivered a crippling blow to the country. We’re

honoured to be on the front line of this fight against the pandemic, and we’re certain that this unique technology will help save lives and stop the spread of the virus.”

He added: “I’m extremely grateful for the hard work and the dedication of the BillionToOne team in getting this vital resource developed so quickly. Our mission here at BillionToOne is to remove the fear of the unknown by making powerful molecular diagnostics available to all. We believe our Covid-19 test can contribute greatly in removing the unknowns from the Covid-19 crisis response.”

The news from BillionToOne in the US comes as the UK’s Health Secretary Matt Hancock has said that the government is aiming to conduct 100,000 Covid-19 tests daily by the end of April. Currently, the UK only has the capacity to conduct around 10,000 tests a day.

However, Dave Prentis, general secretary of Unison, said: “The government must be realistic about what’s possible and not overpromise. Delivering over the coming weeks will be crucial to how both front line staff and the wider public view the government’s ability to manage the crisis.”

Medbelle to provide cost price Covid-19 in-home tests London and Berlin-based startup Medbelle is offering private Covod-19 test kits at cost price – with the option for to ‘sponsor’ additional tests for key workers and people in need.

The digital hospital’s test uses a method of analysis approved and recommended by the World Health Organization known as RTPCR. This involves taking a swab from inside the mouth and nose and sending it off to a lab to test for signs of the virus. This testing process is the same as used in the NHS, and the lab is United Kingdom Accreditation Service-certified. The lab has additionally already applied for specific Covid-19 certification

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with UKAS and Public Health England.

Medbelle is selling the tests for £225 – the price involved in the manufacture and distribution of the kits, and lab testing – and is limiting

purchases to two tests per person.

Purchasers can additionally choose to ‘sponsor’ up to 10 tests, which will be distributed to key workers and people in need.

Tests will be posted via Royal

Mail, or can be couriered in London for an additional fee.

The company has provided free tests to surgeons redeployed to the NHS. Medbelle founder Leander de Laporte said: “We have seen that even our doctors have a hard time accessing Covid-19 tests, despite fighting on the front line. To fight Covid-19 effectively, we need more tests to understand how the disease spreads and which measures we need to take. We are not doing this to make a profit; we want to do our best to support the NHS in these difficult times; to expand testing capacity and thereby add critical resources where they are needed.”

HealthInvestor UK • May 2020

NEWS

Testing

Private health firms accused of profiting from Covid-19 Private health firms have come under severe criticism for profiting from the Covid-19 pandemic by selling thousands of home testing kits for up to £375 each – while frontline NHS workers are experiencing a shortage.

One London Harley Street clinic is offering next day delivery of the test for £375. And, according to The Guardian, a chain of private clinics in the Midlands has increased the cost of its home delivery Covid-19 testing kit from £149 to £249 in just a matter of days.

It is also understood by the Daily Mirror that more than 2,000 celebrities, as well as members of the nobility and Britain’s business elite have bought the home kits, from Harley Street or elsewhere, to check if they have disease.

It comes amid growing concern that NHS workers are not getting access to tests, with some forced into isolation for up to 14 days if someone in their household is showing symptoms – meaning they will not be able to work and treat patients.

According to the BBC’s health correspondent Nick Triggle, the UK has the capacity to test around 5,000 people a day, compared to South Korea who have the capacity to test 40,000 a day.

Hilary Jones, Good Morning Britain’s resident doctor said on air that firms selling private kits for hundreds of pounds “disgusts” him.

He added: “First of all, we don’t know if [the test] is accurate. If it is accurate, then why should some people be able to buy it while we’ve got frontline healthcare staff not

being able to get it?”

In addition, the NHS is also not getting the equipment it desperately needs to protect its frontline staff from the virus.

Commenting on this, Jonathan Ashworth, shadow secretary of health, tweeted: “Our NHS staff are battling to protect us, the government must protect them. From goggles, gowns, gloves, masks and thermometers we need adequate personal protective equipment for all staff across secondary & primary care. Testing must be scaled up urgently for staff.”

Diesse developing blood test for Covid-19 detection ArchiMed portfolio company Diesse, based in Italy, is developing a blood test for Covid-19 detection – which will be one of the first in the world capable of accurately mapping the spread of the virus.

Diesse Diagnostica Senese indicates whether someone has ever had Covid-19 or is a carrier without symptoms.

The Diesse test will help determine the prevention measures applied to asymptomatic, active Covid-19 carriers and will permit more accurate analysis of how

the infection spreads through populations.

Diesse’s novel blood tests will complement the molecular swab tests now most commonly used for diagnosis.

Following a precise evaluation of its performance by the Lazzaro Spallanzani National Institute for Infectious Diseases in Rome, the Diesse Diagnostica Senese is scheduled for distribution in late April.

Diesse’s first production batches will be used for screening the doctors, nurses and workers

employed by the public and private healthcare sectors in Tuscany.

Diesse plans to distribute the test throughout Italy and globally following approval.

Diesse was purchased last May by Duomodiag Sarl, a holding company wholly backed by European private equity healthcare specialist, ArchiMed. Massimiliano Boggetti, chief executive of Diesse, said: “Blood serum tests like ours are key to getting Covid-19 under control.

Partnering with a sophisticated

industry specialist like ArchiMed has provided Diesse with the financing and freedom to effectively battle against major healthcare dangers like Covid-19 and to stay at the cutting edge.”

Loic Kubitza, partner at ArchiMed, commented: “Aiding bold groups like Diesse is one of the highlights of our job. We want to see partner companies profitably grow over the long term by providing them with the finance, counsel and industry connections needed to successfully address challenges like Covid-19.”

Zava to offer Covid-19 direct-to-consumer testing service Zava, the digital doctor service, is set to start offering a Covid-19 testing service direct to consumers.

The kits will be distributed to patients via the company’s website with results processed and reported back within two to three days.

Medical advice and referral if required is included in the purchase price.

The tech company will start shipping the tests within the next few days at a price of £135 with a 40% discount for health and care staff.

Anyone wanting to acquire a home testing kit will have to

HealthInvestor UK • May 2020

complete a questionnaire on Zava’s website which will be reviewed by medical experts to ensure they meet the correct criteria.

“We want to avoid any stockpiling of tests,” Tom Barltrop, Zava’s head of UK and Ireland, told HealthInvestor UK, adding that the company had gone to considerable lengths to ensure that rolling out the B2C offering would not negatively impact the ability of the NHS and other providers to conduct testing.

Zava is also working with the nursing and care homes sector to enable them to test workers and

residents on a regular basis to limit the spread of the virus Previously The Private Harley Street Clinic in London had defended its decision to sell Covid-19 testing kits for £375 saying, the price reflected “the costs of these logistic and clinical services that we provide”.

The news comes amid growing concern that NHS workers are not getting access to tests, with some forced into isolation for up to 14 days if someone in their household is showing symptoms – meaning they will not be able to work and treat patients.

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Policy and politics

Government’s guidance for care homes on Covid-19 ‘a disgrace’ says Wellburn chairman The Covid-19 guidance from government and regulators “has been a disgrace”, according to Rachel Beckett, chairman of Wellburn Care Homes, which runs 14 homes in the Northeast of England.

Beckett’s comments come amid the news that Britain’s biggest care providers have been denied widespread Covid-19 tests, even as the disease has killed some of its residents. Beckett added that the government’s policy, which currently limits a care home to five tests, only if there is an outbreak, is “ludicrous.”

Government guidance published at the end of March said it would “aim to offer more comprehensive testing” to the sector when “capacity increases”. In addition, Jenny Harries, the deputy chief medical officer for England, insisted that testing during outbreaks at care homes was “happening now”.

But some big care chains have said they still have not had a single test, with staff simply being advised to isolate suspected cases at the home.

According to the Daily Mail, there have been at least 40 virus-related

deaths in UK care homes, but the lack of testing means experts can’t know the true scale of the crisis or how many residents and workers already have the illness.

The publication found that Four Seasons Healthcare (FSHC), which runs more than 200 homes, has had no tests for residents or staff, despite 13 residents dying from a suspected outbreak in just one week at the company’s Burlington House in Glasgow. Half of FSHC’s 13,000 staff are self-isolating, and two have tested positive in hospital.

The UK’s largest care home group, HC-One, said none of the staff at its 320 homes had been tested. And similarly, Bupa Care Homes, which operates more than 120 sites, said no staff had had access to testing.

One care worker, who works in a home for dementia sufferers, said: “None of us has been tested and we have very little access to protective equipment. We are like cannon fodder. We are being made to risk our lives and the lives of our loved-ones for £8.37 an hour.”

CQC halts routine inspections amid Covid-19 outbreak The Care Quality Commission (CQC) will be stopping routine inspections in response to the covid-19 pandemic.

The commission said its primary objective will be to support providers to keep people safe during a period of “unprecedented pressure on the health and care system.”

Other support that CQC is offering the healthcare system includes the return of clinically qualified CQC special advisors

to the frontline to help with the wider national response, as well as secondments of staff to The Department of Health and Social Care, Public Health England and NHS England.

The CQC’s customer contact centre expects to start taking nonclinical COVID-19 calls from next week, in support of the NHS’s 111 service.

The commission said its staff “stand ready to help any other part of the national effort whether that

be in the public or private sector.”

Commenting on the CQC’s decision, Ian Trenholm, chief executive of CQC, said: “During this period, our priority will be to support those who deliver health and social care to keep people safe during this global health emergency. We will therefore be stopping routine inspections. It may still be necessary to use our inspection powers in a very small number of cases when there is clear evidence of harm, such as

allegations of abuse.”

He added: “In adult social care, our inspectors will also be acting as a support for registered managers, providing advice and guidance throughout this period in the absence of a single national body equivalent to NHS England. We are talking to social care providers about how to most effectively collect information from them to ensure that the government has a clear picture of the impact that covid-19 is having on the sector.”

Student nurses need proper support Many student nurses want to make their skills available during the Covid-19 pandemic, but they will need the proper support, according to Sara Gorton, head of health at Unison.

Gorton made the comments in response to the publication of the government’s Covid-19 Bill draft, which allows nursing students to help the NHS cope with the Covid-19 pandemic.

Gorton said: “Never before has the NHS faced a challenge on this scale. Combating the Covid-19 requires unprecedented measures.

Many student nurses want to make

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their skills available at this time of exceptional need. But in a way that’s as safe as possible for them and patients.”

Gorton commented that once the Covid-19 pandemic is over, student nurses “must be able to return to learning and complete more supported clinical placements, if needed. The long-term future of the NHS must also be protected. That means not rushing anyone into becoming a fully qualified registered nurse.”

In addition, Unison general secretary, Dave Prentis has also said that the Coronavirus Bill must not

force healthcare staff to the front line. He said: “For the legislation to be truly effective, it must enshrine the principle that student and retired health workers are volunteers and not conscripts to fight against the virus.

They should not be forced to the front line and must be protected – and paid properly – if they do volunteer.”

He concluded: “The government must work with unions, and professional bodies representing student healthcare staff and doctors, to ensure the interests of these groups are written into the bill.”

HealthInvestor UK • May 2020

NEWS

Policy and politics

Covid-19 bill ‘not enough’ in battle against pandemic The Coronavirus Bill is “not enough” to battle against the Covid-19 pandemic, according to Niall Dickson,, chief executive of the NHS Confederation.

Dickson made the comments in response to the Bill which received its first debate in the House of Commons 23rd March. It is expected to become law by the end of the month.

The emergency Bill allows regulators to register suitable people as regulated healthcare professionals in cases of emergency, including recently retired medical professionals and students near the end of their training.

The Act will also provide an indemnity for clinical negligence liabilities arising from NHS activities in response to the covid-19 pandemic,

and could also give NHS providers the power to delay the assessment process for NHS continuing healthcare, for individuals being discharged from hospital, until after the emergency period.

However, Dickson has said though the “Coronavirus Bill reflects the need for drastic and immediate action, front line services will need the extra investment committed to by the chancellor to fuel a very different set of services, which is being built in real time.”

He added that the supply issues for personal protective equipment and ventilators should be “resolved as promised” and that “another major task is to ramp up testing for staff as it is vital for them and a key weapon in the wider battle to contain the virus”.

The Bill states that concerning mental health legislation, powers to detain and treat patients could be implemented using just one doctor’s opinion, as opposed to two, and the time limits contained in mental health legislation could temporarily be extended or removed.

Though Dickson said the NHS Confederation “supports the emergency powers proposed around the Mental Health Act, they need to be monitored closely, with clear guidance for doctors, nurses and social workers on how they should be used”.

He added: “It is likely that some patients will be detained for longer, and we all want to see a return to the current safeguards as soon as we can.”

Dickson concluded: “The NHS is stepping up to this enormous challenge and the government and medical experts have given strong direction, but all of us have to play our part through social distancing and following other public health advice.

He added: “No one can escape the impact of this – every family and every individual will be feeling it, and for some, especially the most vulnerable and those with caring responsibilities of any kind, these are the most challenging of times. If we are to stand a chance of equipping the NHS to fight this battle, we all need to act, and where we can, support each other and those with greatest needs.”

Research

World’s largest clinical trial for Covid-19 treatments begins in UK The world’s largest randomised clinical trial of potential Covid-19 treatments has started in the UK. The trial, named the Randomised Evaluation of Covid19 Therapy (Recovery), is testing a number of medicines recommended by an expert panel advising the chief medical officer for England.

They include Lopinavir-Ritonavir, commonly used to treat HIV, dexamethasone, a type of steroid use in a range of conditions

HealthInvestor UK • May 2020

to reduce inflammation, and hydroxychloroquine, a treatment for malaria.

The trial is being coordinated by researchers at the University of Oxford, led by Peter Horby, professor of emerging infectious diseases and global health in the Nuffield Department of Medicine and Martin Landray, professor of medicine and epidemiology at the Nuffield Department of Population Health.

The study has received £2.1 million from UK Research and Innovation and the Department of Health and Social Care. It is part of a wider £20 million rapid research response investment by the UK government.

It follows action by the UK’s medicines regulator to fast-track clinical trials for potential Covid-19 treatments, meaning NHS patients could have faster access if medicines are proven to be effective.

The Medicines and Healthcare products Regulatory Agency has put in place procedures to support manufacturers and researchers developing these treatments and approve clinical trial applications in days, rather than weeks.

Almost 1,000 have been recruited in just 15 days and thousands more are expected to join the trial in the coming weeks.

Health secretary Matt Hancock said: “The coronavirus outbreak

is the biggest public health emergency in a generation and we are doing everything we can to fight it on all fronts through our evidence-based action plan. The UK is leading the way on research in the race to find treatments and we have now launched the largest trial in the world, pooling resources with our world-leading life science sector.”

He added: “As one of three major trials funded by the government, this marks a major milestone in our battle against coronavirus and offers renewed hope that together we can beat this.”

Chief medical officer, Chris Whitty commented: “The UK has world-leading life sciences and research sectors and, because of our joined-up healthcare and health research system, we have been able to get hundreds of patients involved in this clinical trial in just two weeks.”

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NEWS

Research

First patients enrolled in new Covid-19 clinical trial Researchers from the University of Oxford have launched a new clinical trial to test the effects of potential drug treatments for patients admitted to hospital with Covid-19.

The Randomised Evaluation of Covid-19 Therapy Recovery Trial will provide doctors and the health service with information they need to determine which treatments should be used.

There are currently no specific treatments for Covid-19, however it is possible that some existing drugs usually used for other conditions may have some benefits.

The treatments initially included in the study have been recommended by a panel that

advises the chief medical officer in England. The treatments are lopinavir-ritonavir, normally used to treat HIV, and the steroid dexamethasone, which is used in a wide range of conditions to reduce inflammation.

The chance to join the trial will be offered to adult inpatients who have tested positive for Covid-19 in NHS hospitals, and who have not been excluded for medical reasons.

Patients joining the trial will be allocated at random to receive one of the two drugs being studied or no additional medication. This will enable researchers to see whether any of the possible new treatments are more or less effective than

those currently used for patients with Covid-19.

Peter Horby, professor of emerging infectious diseases and global health in the Nuffield Department of Medicine, University of Oxford, and chief investigator for the trial, said: “There is an urgent need for reliable evidence on the best care for patients with Covid-19.

Providing possible new treatments through a well-designed clinical trial is the best way to get that evidence.

Adults admitted to hospital with Covid-19 should be offered the opportunity to participate in this trial and contribute to improving care for everyone. All patients will receive the standard full medical

care, regardless of which treatment group they are placed in.”

Martin Landray, professor of medicine and epidemiology at the Nuffield Department of Population Health, University of Oxford, and deputy chief investigator for the trial, commented: “The streamlined design of this clinical trial allows consenting patients to be enrolled in large numbers easily and without compromising patient safety or adding significantly to the workload of busy hospitals and their staff.

In this way we can rapidly assess the value of potential treatments for Covid-19 and provide reliable information on the best ways to treat patients with this disease.”

Mental health

Oxford survey to study mental health of children amid Covid-19 outbreak A new research survey, launched at the University of Oxford, is to track children and young people’s mental health throughout the Covid-19 pandemic to identify what advice, support and help can protect their mental health.

This survey, called Covid-19 Supporting Parents, Adolescents, and Children in Epidemics (CoSPACE) will help researchers identify what protects children and young people from deteriorating mental health, over time, and at particular stress points, and how

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this may vary according to child and family characteristics.

It also aims to identify what advice, support and help parents would find most useful.

Parents and carers will be invited to complete an online longitudinal weekly questionnaire for a month, then fortnightly for a month, and then monthly until schools reopen.

The first survey will ask parents and carers questions about family life and relationships, overall health and wellbeing, parenting,

psychological symptoms and how they and their children are coping during the Covid-19 pandemic.

Regular summaries of key findings will be made available via the UK Research and Innovation emergingminds.org.uk research network website throughout the study and will be shared directly with partner organisations in health and education services and the community and voluntary sector, to inform the development of effective support for children, young people and families.

This research is supported by the National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre, the Oxford and Thames Valley NIHR Applied Research Consortium, and the UKRI Emerging Minds Network Plus.

Cathy Creswell, professor of psychiatry and experimental psychology at the University of Oxford, said: “Research has provided valuable information about how parents and carers can support their children’s mental health in general. However, at this point, we know very little about what might be most effective in the current context of Covid-19.”

She added: “We hope to have more than 10,000 parents and carers across the UK complete the new online survey. Their responses will help us really understand how families are coping and what support could make all the difference to children, young people and their families at this time.”

HealthInvestor UK • May 2020

NEWS

Mental health

Headspace provides free subscriptions to NHS workers Headspace is to provide free subscriptions to all NHS workers in response to the Covid-19 pandemic.

Through its meditation and mindfulness app, Headspace aims to reduce stress, increase resilience, and reduce burnout.

All subscribers will get free access to 1,200 hours of meditation and mindfulness content until 31 December 2020.

The programme coincides with the roll-out of NHS chief people officer, Prerana Issar’s, People Plan, which is a long-term initiative designed to support those in the NHS, signaling mental health as a significant area of focus.

Headspace has also unlocked a free ‘Weathering the storm’ collection in-app, a free selection of meditation, sleep and other

experiences designed to support users during the Covid-19 outbreak.

NHS employees can get their free subscription to Headspace Plus by visiting headspace.com/nhs and enrol using their NHS email.

Rich Pierson, co-founder and chief executive of Headspace, commented: “This is an extraordinary moment in time as we face an unprecedented global

health crisis. Covid-19 has put our health professionals at the NHS under enormous pressure and they are undoubtedly experiencing mounting stress and anxiety as the situation rapidly evolves. As a Brit myself, I know first-hand the incredible work our NHS does, which is why the Headspace team is working to do all we can to support those on the front lines.”

Private hospitals

Bupa pledges to refund customers in response to Covid-19 Bupa has promised to give rebates to customers who have had to make payments to the company amid the Covid-19 outbreak.

Most treatments which are deferred will be delivered and funded as soon as possible later on. However, Bupa said it expects there will be an overall reduction.

Urgent care, such as cancer treatment, will continue, but non-urgent hospital procedures are being postponed.

Meanwhile, Bupa has expanded its range of health support services and resources that customers can access from home to support them through the Covid-19 crisis.

These include telephone and video consultations with nurses, GPs and consultants, as well as specialist help for physiotherapy and mental health, through to chemotherapy at home for cancer patients.

The digital GP service that Bupa provides in partnership with Babylon is being made available to

HealthInvestor UK • May 2020

all insurance customers with a new Covid-19 care assistant feature.

An online hub has also been developed to provide regular updates and health advice to help customers manage both their physical and emotional wellbeing.

The company is to commission a third-party review to ensure that what it does is fair and reasonable across its different customer groups.

Alex Perry, chief executive of Bupa UK Insurance, said: “As an organisation without any shareholders our customers come first. At this point, no one can predict the full impact of this national crisis and we do not have all the answers yet. But we want to reassure our customers that we will do the right thing for them, and that any exceptional financial benefit ultimately arising from Covid-19 will be passed back to our health insurance customers.

This will be by rebate or other appropriate means.”

Spire Healthcare’s lenders agree to waive scheduled covenant testing

Spire Healthcare’s lenders have agreed to waive the covenant testing required under the company’s senior facility agreement for its two scheduled test periods on 30 June and 31 December this year.

The private healthcare provider said this waiver will provide it with further flexibility through, and in the period after, its partnership with the NHS. The agreement signed with NHS England on 21 March will provide Spire with sufficient liquidity and financial stability during the Covid-19 outbreak.

In addition, the company has an undrawn revolving credit facility

of £100 million that remains available.

The Spire Healthcare board has also decided that, due to current uncertainties, it will suspend dividend payments until the current crisis is over. The company will not be putting forward the previously announced 2019 final dividend payment of 2.5p per share.

Spire’s chief financial officer Jitesh Sodha said: “We have had constructive and helpful discussions with our group of lenders, reflecting our solid relationship with them, and would like to thank them for their support while we assist NHS England in combating Covid-19.”

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NEWS

Private hospitals

Check4Cancer launches new clinic for younger patients Check4Cancer’s chief medical officer, Gordon Wishart, has launched the OneStop Breast Clinic, a private clinic for younger patients who will no longer be seen in NHS breast clinics due to the Covid-19 pandemic.

The clinic, in Harley Street, London, will allow women aged under 35 and men under 50 access to all appropriate investigations at the first consultation, including clinical breast examination by

a consultant breast surgeon, breast ultrasound scan and cyst aspiration, or targeted needle biopsy, if required.

The London OneStop Breast Clinic accepts referrals from selffunding patients, and the initial consultation fee is £270.

Wishart’s research has previously shown that the use of triple assessment (breast examination, breast imaging and biopsy) will make the correct

diagnosis in 99.6% of all breast patients.

Due to the outbreak, NHS outpatient capacity has been drastically reduced and some referrals are now being prioritised over others. Many NHS trusts have moved to a position where some patients will no longer be eligible for the urgent two-week wait pathway for breast cancer diagnosis and their appointments may be cancelled.

In response to this, Wishart said: “We appreciate that these measures are mandatory given the current NHS resources, but recognise that this may cause considerable distress and anxiety for these patients.

I still firmly believe that having access to all investigations on the same day is better for the patient, and more likely to provide the most accurate diagnosis.”

Recruitment

NHS Professionals launches rapid response service NHS Professionals, which supplies temporary staff to the NHS, has launched Covid-19 Rapid Response, a protocol to enable qualified nurses and other healthcare professionals to move quickly and safely to the NHS’s front line, amid the Covid-19 pandemic.

The new protocol is designed to allow qualified health professionals

to register with the programme within 24 hours and be available to deliver shifts to the NHS almost immediately.

NHS Professionals runs the largest staff bank in England, providing a simple, central entry point into the service.

NHS Professionals’ chief nurse and director of clinical governance, Juliette Cosgrove, is to join the

bank and has urged health professionals from across the UK healthcare sector to do the same.

Cosgrove said: “Our message is simple. If you are a qualified health professional who wants to work in the NHS to help reduce pressures, one of the simplest and most straightforward routes is through the NHS Professionals staff bank. The country is facing

unprecedented challenges and NHS Professionals is committed to playing a key role in underpinning the current drive to boost front line services. Our priority is to ensure qualified health professionals are in the right place at the right time.

We welcome professionals from any part of the health system, whether NHS or private, whether recently retired or students.”

Locum’s Nest gives NHS free access to its app Locum’s Nest, an online medical staffing company, is to give the NHS free access to its app in response to the Covid-19 outbreak.

The platform, which directly connects clinicians to temporary work, will offer free use of its shiftmatching software to support efforts to recruit NHS clinicians, as part of the NHS’ Covid-19 response.

The technology allows healthcare organisations to immediately reach out to 25,000 clinicians to help fill short term vacancies, currently being listed by the thousands each day, as staffing issues grow across the NHS. The move has been announced to help the healthcare system cope with the anticipated staffing shortages and financial pressures caused by the outbreak.

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Highly qualified, skilled, local and available clinicians who may otherwise have to manually submit forms and qualifications, will now be able to access all shifts listed on the app and get to work within hours.

Locum’s Nest has confirmed that healthcare organisations who are already using its service will not see any excess charges applied during an increased time of usage.

It also said software deployment may need to be prioritised depending on the most urgent needs across the country, this will be assessed on a case by case, day by day basis.

Nick Andreou, co-founder of Locum’s Nest and former NHS junior doctor, said; “Now is the

time to wholeheartedly intensify our efforts in order to support the national fight against the infection.”

He added: “We have to remember that NHS staff are also human beings with relatives who also need as much support as possible.

Our aim is to help healthcare organisations minimise the impact of covid-19 by allowing them to rapidly and remotely deploy the software within just ten days, giving them full access to staff, free of charge.”

Stephen Kelly, board director for Locum’s Nest, commented, “The NHS is run by amazing, committed, kind, selfless people at every level, but extraordinary events like this put our incredible health professionals under enormous pressure. Locum’s

Nest can help to make sure vacant shifts are filled quickly, easily and efficiently with our leading platform – we are humbled to help our NHS manage this very human and economic crisis.”

Saffron Cordery, deputy chief executive of NHS Providers, said: “There is unprecedented pressure on the NHS and wherever possible we need to make sure there are the right staff and resources in place to do that. Teams are working flat out to provide high quality care, but the challenges are huge. It is fantastic that Locum’s Nest is providing its product free of charge to trusts so that temporary staff can fill shifts where they are most urgently needed and those who have left the NHS can be helped to come back to work.”

HealthInvestor UK • May 2020

ed iv ce re uly e 7J tb 1 us y m rida es F tri by En

#CareAwards

ENTRY FORM 27 November 2020 London category sponsors

drinks reception sponsor

photobooth sponsor

dinner programme sponsor

THE 22ND NATIONAL CARE AWARDS| ENTRY FORM Carer

Care Home Manager

This award recognises the vital role of the care assistant in providing quality care. Evidence of dedication, sensitive handling of matters of importance to residents, and career progress through training will all be taken into account.

This award will be made to an exceptional care home manager (or deputy). They will be expected to demonstrate a high level of expertise in managing the services of the home to the benefit of residents, staff and their local community.

Criteria • Give a full description of the nominee’s role and responsibilities (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within their workplace since being in their role (up to 250 words) • Provide examples of how the individual has provided high quality support to the residents, including any relevant information about activities, going beyond standard duties, dedication and commitment to understanding what is important to residents and families (up to 250 words) • 30 word biography of nominee

Criteria • Give a full description of the individual’s role and day to day management (up to 250 words) • Provide examples of where the individual has demonstrated (up to 500 words) • leadership skills and the ability to support, develop and motivate staff • confidence working with relatives and residents • creating a caring, stimulating and person-centred environment that is home-like and with good connections to the local community • Explain what positive effect the individual has had on their residents, staff and local community within the home since being in their role (up to 250 words) • 30 word biography of nominee

Supporting evidence • Provide 1-5 testimonials from staff, relatives or residents • Provide details of training, qualifications or accreditations the individual has received (if applicable)

Care Registered Nurse This award will be made to a registered nurse who has made long term care their area of professional specialisation. In addition to maintaining training and demonstrating outstanding clinical and managerial qualities, the winner will have demonstrated a high level of dedication to, and advocacy for, the people they support.

Criteria • Give a full description of the nominee’s role and responsibilities (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within their workplace since being in their role (up to 250 words) • Provide examples of how the individual has provided outstanding dedication to, and advocacy for, the people they support (up to 250 words) • 30 word biography of nominee Supporting evidence • Provide 1-5 testimonials from staff, relatives or residents • Provide details of training, qualification or accreditations the individual has received

Care Team This award will be made to a staff team who have developed and maintained an outstanding standard of care and team ethos within any care setting.

Criteria • Give a full description of the service the team is based within (up to 500 words) • Explain why this team is a worthy winner of the award, including the development of any innovative projects to improve the quality of life for the residents or users of the service (up to 250 words) • Explain how the team has the skills, knowledge and enthusiasm to empower and enable residents to either regain or maintain a level of independence and meaningful lives (up to 250 words) • 30 word profile of the team Supporting evidence • Include the most recent inspection report from the home/service where the team is based • Provide 1-5 testimonials from management, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)

Entries must be received by Friday 17 July

Supporting evidence • Include the most recent inspection report for the home the individual manages • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received

Dementia Care Manager This award will be made to an outstanding manager (or deputy) of a care service where more than 50 per cent of the residents live with dementia. They will be expected to demonstrate a high level of expertise in managing the service to the benefit of residents with dementia as well as staff.

Criteria • Give a full description of the individual’s role and responsibilities and why you consider them to be outstanding in their role (up to 500 words) • Provide examples of where the individual has demonstrated (up to 250 words) • leadership skills and the ability to support, develop and motivate staff • confidence working with relatives and promoting positive inclusive relationships with residents • creating a person-centred, supportive and stimulating environment with good connections to the community • Explain what positive effect the individual has had on the service and staff since being in their role (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most recent inspection report for the service the individual manages • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received

FOR ALL ENTRIES Please submit ALL the requested criteria and supporting evidence (any entries which do not submit the requirements will be disregarded)

Care Operations / Area Manager The winner of this award will have demonstrated exceptional vision, leadership and be at the forefront of new management techniques. They will have inspired their colleagues to provide exceptional care throughout the homes for which they are responsible.

Criteria • Give a full description of the individual’s role and day to day leadership (up to 500 words) • Provide examples of where the individual has promoted the highest standards of quality care and service (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within the setting since being in their role (up to 250 words) • 30 word biography of the nominee Supporting evidence • Include a recent summary of the most recent inspection reports for all settings (e.g. 5 Outstanding, 4 Good) • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received

Care Activities Co-ordinator/Facilitator This award will be made to a person within a care home or day care service who has made an exceptional contribution to the quality of life, health and happiness of all the people they support through the activities they provide.

Criteria • Give a full description of the activities or lifestyle opportunities the individual has implemented, developed or maintained since being in their role (up to 500 words) • Explain how the individual works in a person-centred way, including how they inspire and encourage participation, motivation and understanding in residents (up to 250 words) • Demonstrate what positive effect the individual has had on the service since being in their role and why they should win this award (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most recent inspection report for the home or service • Supply 1-5 photographs of activities • Provide 1-5 testimonials from staff, residents/attendees and relatives • Provide details of training, qualification or accreditations the individual has received (if applicable)

Care Housekeeper Running the housekeeping services of a care home is vital for the well-being of residents and staff.

This award will be made to an outstanding housekeeper who can demonstrate the passion and commitment needed to make a real difference.

Criteria • Give a full description of the individual’s role and day to day duties and why they should win this award (up to 500 words) • Explain how the individual demonstrates a high level of dedication and innovation alongside a person-centred approach to provide the highest quality of service and environment for residents and staff (up to 250 words) • Provide examples showing where the individual has been a proactive and helpful member of the team, contributing ideas and making the home an enjoyable place to be (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most inspection report for the home or homes the individual is responsible for • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received (if applicable)

• Care Chef

This award will be made to a chef in a long term care setting who shows exceptional ability in providing well-balanced, nutritious and delicious food.

Criteria • Outline the reasons why the nominee shows exceptional ability in providing well-balanced, nutritious and delicious food that takes into account individual needs of the residents (up to 500 words) • 30 biography of the nominee Supporting evidence • Provide a copy of a monthly menu served within the last 3 months • Provide a copy of the three-course menu (taken from the monthly menu) that the nominee will cook at the ‘Cook Off’ if chosen to be a finalist • Provide the cost per resident of the ‘Cook Off’ menu

Entries must be received by Friday 17 July Care Home of the Year This award will be made to a care home with 15 or more residents which can demonstrate exceptional quality care across all the services it offers.

Criteria • Give a full description of the care home including how residents and staff live and work together successfully and how the home is part of the local community (up to 500 words) • Give a brief description of the sort of activities the residents take part in and how they are designed to promote well-being and social interaction (up to 250 words) • Explain how the care home is homelike for the residents and how the residents actively participate in this (up to 250 words) • Describe how the care home provides exceptional care and support to people enabling them to live fulfilled and meaningful lives with a focus on maintaining skills and independence and contact with the local community (up to 250 words) • 30 word profile of care home Supporting evidence • Include the most recent inspection report • Supply 1-5 photographs • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)

The Dignity & Respect Care Home of the Year This award will be made to an exceptional care home which can convincingly demonstrate that it has put dignity and respect for its residents and staff at the very heart of all it does, and that this emphasis has resulted in tangible benefits for residents, relatives and staff alike.

Criteria • Give a full description of how the care home provides an environment for residents where they are treated with dignity and respect (up to 500 words) • Explain how you support the people who live in your home to make choices about the way they live and the support they receive (for example: independence, lifestyle opportunities, cultural and religious beliefs, privacy, eating and nutritional care, pain management, personal hygiene) (up to 250 words) • 30 word profile of the home being nominated Supporting evidence • Include the most recent inspection report • Supply 1-5 photographs • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)

Care Newcomer NEW AWARD FOR 2020 This award will be made to a person working in care, who is new to the sector over the past 18 months, and who is already delivering the very best standard of care. The judges will be looking for an individual who excels in their personal and team roles, and exhibits enthusiasm, professionalism, confidence and a shining commitment to their on-going career development.

Criteria • Give a full description of the nominee’s role and responsibilities (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within their workplace since being in their role (up to 250 words) • 30 word biography of the nominee Supporting evidence • Provide 1- 5 testimonials from residents, relatives of residents and colleagues • Provide details of training, qualification or accreditations the individual has received

Care Champion This award will go to an exceptional person, whether they are a member of staff, a relative, resident or a volunteer who has gone above and beyond and made a real difference. It could be a charitable achievement or making life better for residents and relatives, or simply someone who has done great things but may not have had the recognition they deserve.

Criteria • Please explain why this person is so important, and why they are a worthy winner of this award (up to 500 words) • 30 word biography of nominee Supporting evidence • Provide 1-5 testimonials from staff, relatives or residents

Outstanding Care in a Crisis NEW AWARD FOR 2020 This award will be made to a care home that has demonstrated an outstanding level of care and compassion to their residents during the Covid-19 pandemic.

Criteria • Give a full description of how the care home responded to Covid-19 pandemic, including (up to 500 words); • how exceptional care and support was given to residents, relatives and staff • how the home continued to promote well-being and social interaction in unprecedented circumstances • 30 word profile of care home Supporting evidence • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)

THE 22ND NATIONAL CARE AWARDS| ENTRY FORM Care Leadership This award will be made to an outstanding individual, in any care setting, small or large, whose leadership has resulted in an exceptional outcome for clients, team members and the organisation they work for.

Criteria • Give a full description of the individual’s role and responsibilities and why they should win this award (up to 500 words) • Show examples of where the individual has demonstrated (up to 250 words) • leadership skills and the ability to support, develop and motivate staff • confidence working with relatives and promoting positive inclusive relationships • promoting well-being by monitoring the re-evaluation of care needs in partnership with the resident, their key-workers and relatives • Explain what positive effect the individual has had on people using their service and staff members (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most recent inspection report for the service for which the individual is a care leader • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received

Care Home Group This award will go to an outstanding care group with more than three care homes which is able to evidence exceptional client care combined with excellent staff development and impressive financial results.

Criteria • Give a full description of the care home group including the settings, residents and members of staff (up to 250 words) • Describe how the care home group provides exceptional care and support to residents enabling them to live fulfilled and meaningful lives with a focus on maintaining skills and independence (up to 250 words) • Describe the corporate identity, values and focus, the group’s strengths/ USP, training systems and approaches as well as the group’s success in delivering high quality care and plans for the future (up to 250 words) • Summarise the group’s financial performance over the last five years (up to 100 words) Supporting evidence • Include a recent summary of the most recent inspection reports for all settings (e.g. 5 Outstanding, 4 Good) • Supply 1-5 photographs showing some of the Groups settings • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)

FOR ALL ENTRIES Please submit ALL the requested criteria and supporting evidence (any entries which do not submit the requirements will be disregarded)

Lifetime Achievement in Care This award will be made to an exceptional person who has committed a significant portion of their life to working in a care home, or in social care, in the community or in sheltered housing, and has made a substantial difference to the quality of life of the people they have worked with.

Criteria • Describe and provide evidence of how the individual’s dedication and commitment throughout their care career has impacted the people they have supported (up to 500 words) • Evidence how the individual has influenced or inspired those they have worked with (up to 250 words) • 30 word biography of nominee Supporting evidence • Provide 1-5 testimonials from residents, relatives of residents and colleagues • Provide details of training, qualification or accreditations the individual has received

Care Personality

#CareAwards

An independent panel will select 5 finalists who they feel have made a big contribution to the care home sector within the past 12 months. The people chosen will be contacted before the awards ceremony and notified of the finalist position. This award does not require an entry from individuals, however if you would like to nominate someone for the panel to consider please do so along with 500 words to support your nomination.

27 November 2020 London

#CareAwards HOW TO ENTER

CATEGORY (please tick)

• Choose the category you wish to enter • If you choose more than one category, a separate entry form must be completed for each separate entry • Read the judging criteria provided carefully • Complete and supply ALL of the required information, criteria and supporting evidence • Enter online at careinfo.org/awards • Alternatively, complete this form and email to: events@investorpublishing.co.uk, remembering to attach all your supporting documents • Please make sure that the name of the nominee and the award category is included on all separate attachments and supporting information • If you wish to enter by post please contact the events team on events@investorpublishing.co.uk for the postal address.

RULES • The competition is open to all staff working in long-term care and hospital settings • Entries are treated in the strictest confidence • Finalists will be required to attend the Judging Day in London in October 2020 – date TBC • The Care Chef Judging will take place separately in October 2020 – date TBC • Entries will not be returned • One copy of the submission is required • Use one entry form per entry, photocopies are acceptable • Employees of the Caring Times and their families are not entitled to enter • Entries will be judged by a panel of eminent and impartial adjudicators appointed by Caring Times • The winners will be announced at the National Care Awards Gala Night on 27 November 2020 • There will be four or five finalists in each category • Award winners and finalists may state in advertising or other promotional material that they are or have been winners or finalists. The year that the Award was won must be included in the same typeface and size as the statement of the Award

CHECKLIST (please tick)

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OPINION

Space to breathe The alternative real estate sector has a major role to play in easing pressure on the NHS says Julian Evans, partner and head of healthcare at Knight Frank

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s we all know, the current crisis surrounding coronavirus is extreme.

At a household level, it calls for extreme sacrifices in the way we work, the way we shop and the way we behave towards our friends, families, and colleagues. Above all else, the situation calls for new levels of teamwork and collaboration between people in a time of adversity.

The exact same can be said of business, commerce and government. Up and down the country, organisational leaders are devising ways to protect their businesses, protect workforces and play their part in what will be a monumental collaborative effort between government, the public sector and private sector.

One partnership which has the potential to make a huge difference in the outcome of this virus is that between ‘alternative’ real estate assets such as hotels, care homes and student accommodation and the healthcare sector. This collaboration is already very much in process in the UK and Germany, but there is much more that could be done to capitalise on the unique fundamentals of the sectors to introduce measures to combat the crisis.

Newspaper reports confirm that major hotel chains are already in discussions with the government with the intention to provide the NHS with emergency bed provision and staff accommodation. Best Western, Hilton, Holiday Inn, Travelodge and Premier Inn are among the operators involved in the discussions and the first hotel dedicated to NHS support is set to open within the week.

Hotels, which provide circa 680,000 beds nationally, are set to lose weeks and months of revenue as tourism dwindles whilst student accommodation blocks, which encompass 647,000 beds in the UK, are largely left empty as universities have been closed down owing to the coronavirus. There are also a number of vacant and underperforming care home assets that could be better utilised, with our estimates showing that there are around 75,000 care beds that are currently empty. So, it is clear

HealthInvestor UK • May 2020

Julian Evans, Knight Frank

that at the moment there is actually good bed availability, it’s more about communicating that these spare beds could be used to support the NHS and its needs.

At the same time, both hospitals and elderly care homes will need vital support as they look to accommodate a mixture of essential healthcare workers, recovering virus patients and elderly people. It therefore seems a discernible step for the impacted alternative asset classes to provide support for the healthcare sector to ensure those assets are being used in a positive way whilst helping to solve this global pandemic.

In the current crisis, it’s very easy to forget that in any normal period of time thousands of elderly people become unable to care for themselves and need to enter hospital or fulltime residential care, with approximately 8,0009,000 elderly people needing to go into full-time

care annually creating new bed demand. With hospitals nearing capacity and care homes on lockdown, we are seeing hotels and student accommodation blocks reposition to care for the elderly but also to isolate carers with the virus, especially hotels that are located close to hospitals.

Hotels, vacant care homes and student accommodation providers in close proximity to the NHS could introduce numerous measures that would have a palpable impact on the crisis such as accommodating NHS workers who need somewhere to stay, providing an overspill unit for those individuals in isolation, offering respite for those inpatients who have recently been discharged and offering accommodation for hospital staff who have been diagnosed with the virus.

At Knight Frank, we have been contacted by a leading UK hotel owner, with a national portfolio of circa 2,500 rooms, and a student accommodation provider with assets in various UK cities, expressing a clear interest to offer support to the NHS at all levels and all geographies where necessary. Given we work with leading names across the alternative asset classes, Knight Frank is perfectly positioned to act as a one-stop shop for these parties to collaborate on potential solutions to the current crisis and help facilitate these partnerships.

We expect to see more hotel owners and operators, student accommodation providers and care homes offering their assets and services as they seek to play a crucial role in combatting the epidemic. With 2.9 million people or just under 10% of the UK labour force working for the NHS or adult social care sector, facilitating these types of collaborations could not only be vital in propping up hoteliers and student housing providers but will give the NHS and elderly care sector the vital support needed to save as many lives as possible. n On 21 April, HealthInvestor UK interviewed Julian Evans as part of our Covid-19 Webinar Series. View the recording at ipevents.net/webinars

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HealthInvestor UK • May 2020

INVESTMENT AMID COVID-19

Bouncing back The Covid-19 virus has put the fragility of the global economic system under the microscope. But Jenna Lomax finds out why some leading industry figures believe the healthcare sector will be able to quickly bounce back from the economic freeze

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he Covid-19 outbreak has had a shocking and unprecedented impact upon all our lives. On New Year’s Eve, as most of us celebrated the dawn of a new decade, the World Health Organisation was first informed of cases of pneumonia of unknown cause in Wuhan City, China. And not many of us could have imagined how this news would come to affect our daily lives.

The Guardian journalist Owen Jones summed up this feeling when he tweeted: “Imagine popping back three months in time and explaining all of this to yourself.” It would be hard to believe, wouldn’t it?

As we know, the virus spread through China first. Though in recent weeks the number of infections reported in Asia have for the most part, subsided, Europe and the US are at time of writing, the epicentres of the virus.

Hardest hit initially were Italy and Spain, who are now seeing a decline in virus transmission.

The US now has the most deaths. This is a concerning statistic in any country, but even more worrying in a country where 87 million citizens are uninsured or underinsured and could, unlike their counterparts across the pond, be turned away at the emergency department doors.

Perhaps we will see drastic economic and social change when this tragic episode is over, as it has highlighted just how fragile our global economic system is.

It has shone a spotlight on the millions in the UK who are just one pay packet away from financial crisis as well as the self-employed and gig economy workers that lack security and basic rights.

At time of writing, 950,000 people from a wide range of different sectors have already applied for welfare through Universal Credit because they are unable to work during the pandemic.

Not since Clement Atlee’s post-war Britain has the UK government injected such radical measures into its policies over such a short period of time.

HealthInvestor UK • May 2020

Others who are fortunate enough to still have a job and full pay packet, are working remotely from their homes, while key workers, many of whom are at the forefront of the health and social care sectors, are soldiering on.

HealthInvestor UK first reported the economic impact of the virus on 9th March, when UK markets were in freefall that morning as investors dumped shares amid concerns over the widening Covid-19 outbreak.

This was followed by news that the FTSE 100 index of leading UK shares has slumped to an “unthinkable” low as investors continued to abandon companies amid the uncertainty.

Throughout the rest of March, the stories picked up pace and the full extent of the seriousness of the virus on the world, and indeed on the economic market, quickly became one of the main topics of our newsroom.

to price the risk”, says Justin Crowther, head of UK healthcare at Alantra.

He adds: “From an M&A and healthcare investment perspective, it’s entirely understandable to see only the negatives in the current circumstances, especially in the shortterm.”

Garret Turley, partner at August Equity, says: “At the moment it is difficult to see how many transactions can complete. Social distancing measures mean it is impossible to properly meet and assess new management teams, to visit facilities and to complete full due diligence on many companies.”

But looking to the future, Turley indicates that “the healthcare sector, while dealing with enormous short-term challenges, is better placed than other sectors to bounce back quickly once the uncertainty is lifted.”

Why healthcare investment will bounce back

The healthcare sector is better placed than other sectors to bounce back quickly once the uncertainty is lifted

But what will Covid-19 do to the UK health and social care sectors, specifically its investment and investors? Can the sector and its investors survive this shockwave? Will investment easily “bounce back” like the Prime Minister Boris Johnson has previously claimed the UK economy will?

Justin Crowther, head of UK healthcare at Alantra, comments: “M&A processes across the board and in the healthcare sector have slowed down or have been paused as there is simply too much ‘fog and uncertainty’ to understand and

“History tells us that markets and investors typically adapt and bounce back after serious health and economic shocks” says Crowther, “whether it was after the Spanish Flu pandemic in the early 1900s, or more recently with the 2008 global financial crisis.”

He adds that “while it is very difficult to predict the speed and scale of the recovery”, the healthcare sector is in a strong position and the reasons are threefold.

“Healthcare has now shot up to the top of the global agenda”, affirms Crowther, which should, he says: “result in governments and individuals allocating greater financial and human resources to healthcare and social care, which in turn, should see healthcare growing quicker than other sectors.”

Secondly, there is also a “significant amount of committed capital seeking a home from a wide variety of institutions from venture funds, through to more traditional private equity funds, infrastructure funds, real estate investment trusts, family offices and large corporates.”

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INVESTMENT AMID COVID-19

that private equity firms will continue to pursue the large opportunity presented by an aging population.”

Investment goes on

Justin Crowther, Alantra

▶

Crowther adds that more money is likely to be allocated to the healthcare sector as it becomes “more important, better funded, and investors see the advantages of deploying capital into this counter cyclical asset class.”

Thirdly, Crowther indicates that “new business models are likely to emerge and existing businesses may now be able to scale faster.”

What about social care?

Before the virus really took hold, and went into lockdown, Chancellor Rishi Sunak delivered his first Budget in the House of Commons, and pledged £30 billion to combat the coronavirus, but nothing for social care.

Though the budget included a promise to extend sick pay for UK workers and business rate relief for firms in England amid the virus outbreak, Sunak did not address the chronic underfunding of adult social care, despite Prime Minister Boris Johnson pledging to do so when he took office last year. The sector has also waited three years now for a greenpaper that is yet to be published.

The lack of any mention of funding for social care in the Budget was deemed “an out and out betrayal” for investors in the middle of making deals, said Robert Kilgour of Renaissance Care at the time. He also added front line social

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care would be “hit severely” because of “the government’s inaction”.

Carterwood analytics reflected Kilgour’s opinions in regard to M&As, as it revealed at the end of March that 44% of UK investors stated that they had to change their 2020 investment plans within social care.

The finding was reported in a survey conducted

by Carterwood in which they asked social care developers, investors and operators their thoughts on the impact Covid-19 will have on the UK social care market.

Of course, the main concern for care home companies and their staff is currently to consider the welfare of the occupants and dealing with this crisis, very much on a day to day basis.

But when it is appropriate to do so, naturally, investors will want to look at the opportunities available once the crisis is over.

Kaia Colban, emerging technology analyst at PitchBook, says: “Most nursing homes are run for profit, and private equity activity in the industry has jumped in recent years. The pandemic has given light to the negative aspects associated with private equity-backed nursing homes including cost-cutting and declining quality of care.”

She adds: “Increased regulatory oversight in response to these issues may create headwinds for future investment. In the long-term we expect

Despite the outbreak, there are still opportunities to be had and deals to be done. In the last few weeks, Quit Genius has raised $11 million in a funding round led by Octopus Ventures, with participation from Y Combinator, Startup Health and Triple Point Ventures.

The $11 million investment will support the company’s plans to expand its therapeutic programmes beyond cigarette and vaping addiction to include alcohol and substance abuse, as well as to increase its presence in the US, which is currently experiencing an opioid “epidemic”.

Elsewhere, Gilde Healthcare has raised $450 million in a venture and growth capital fund that targets growth opportunities in the healthcare sector including digital health, medtech and therapeutics in Europe and North America.

One aspect of healthcare that is undoubtedly to change throughout the UK and the rest of the world, during and after the Covid-19 crisis, is the uptake of more medtech and telemedicine.

For what the First World War did for the early development of aviation, and for what the second did for elevating women into the workplace, perhaps, this world event will catapult telemedicine into the spotlight – giving the sector more investment and prominence, especially in the UK’s health system and indeed, the wider world.

“The speed at which previously reluctant commissioners/clinicians have embraced digital transformation after years of resistance has been striking and it is likely that barriers to acceptance have been permanently removed, or at least lowered”, says Garret Turley, partner at August Equity.

And as Crowther comments: “Now is probably the tipping point for all things digital, whether that be remote consultation platforms, telemedicine, mental health apps and a much wider digital ecosystem.”

Perhaps this will be as good a time as any for more government investment in to telemedicine, in particular and not just investment, but a filtering of technology – essentially to keep what’s useful, and throw aside the technology that doesn’t deliver the outcomes that the health and social care sectors are looking for.

As Colban comments: “We expect Covid-19 to have major implications on healthcare technology, spurring rapid adoption of robotics and telehealth by healthcare providers.”

HealthInvestor UK • May 2020

INVESTMENT AMID COVID-19

Meeting again At time of writing, the Queen’s speech on Covid-19, has just been broadcast. In the speech the Queen aptly made reference to the war time song “We’ll Meet Again”, a sentiment that offered hope to many on the front lines during World War Two. Just like in war time, meetings, both with friends and colleagues, have been cancelled in recent weeks, day to day life has paused, and business, in its traditional sense, has been postponed.

“We have paused a number of transactions, both bolt-ons and platforms but have maintained good communications with vendors so that, come the day restrictions are relaxed, we can reboot the processes”, says Turley.

When the UK starts to reboot business as usual, restarting the healthcare investment process to its usual capacity may be easier and quicker for health and social care because, unlike other sectors “healthcare will be a new societal priority”, adds Turley.

He outlines: “Private equity can play a part to ensure we can create the new business models and infrastructure that will be required. Although we must be very careful not to be thought of as taking advantage of the national social and economic tragedy that is playing out around us.”

“The NHS will need support, both insourcing and outsourcing over the coming years and there will be opportunities there for investment; and there may even be some hope that the government will finally recognise the need to properly look after social care.” n On 28 April, HealthInvestor UK interviewed Garret Turley as part of our Covid-19 Webinar Series. View the recording at ipevents.net/webinars

Garret Turley, August Equity

HealthInvestor UK • May 2020

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Lost property The Covid-19 outbreak has had a significant impact on the UK healthcare real estate investment market. Kathy Oxtoby reviews the landscape

P

rofessor Martin Green, chief executive of Care England, sums up the mood of investing in the sector when he told HealthInvestor UK: “Nothing is happening at the moment. Everything is being suspended in effect in terms of real estate transactions - and that’s true of everywhere in the economy,” he says.

Up until the recent outbreak of the coronavirus, market appetite for care homes in Great Britain, both trading and fixed income investments, “had generally remained strong”, says a spokesperson from global real estate services provider Savills.

“Despite the backdrop of Brexit, going concern sales continued to attract a good level of purchaser interest and sentiment remains that those markets that provide a higher proportion of self-funding residents have the highest appeal to operators.

“This has been the case for both prime and secondary assets where operators of the latter are still able to achieve higher fee rates than they would in Local Authority dependent areas, albeit their fee rates are below the levels being commanded by tier one stock,” Savills says.

The big picture for real estate investment in healthcare was fairly positive. And even in the light of the coronavirus, Green says care homes are “maintaining the status quo”. “We’re not seeing any changes at the moment”.

“This is a temporary situation – and what we will see hopefully as we come out of this is that things will restart.

“But currently the coronavirus means the whole of the system that would surround an investment isn’t working. So, say, if you’re making an investment in a company and want to talk to the senior management team, interrogate accounts where their position is regarding staffing issues, public relations, the whole raft of due diligence - none of that can take place at the moment,” says Green.

Nick Hood, business risk adviser at Opus Restructuring, says general talk about the shock to the world economy from Coronavirus being the worst since the Great Depression “understates the gravity of the situation, principally because terrible as the 1930s were all round the globe, the damage happened quite gradually”.

“Coronavirus has for all practical purposes stopped the world economy instantly, like the proverbial ‘train hitting the buffers’.”

He says there is also a fundamental difference driven by modern communications. “The 1930s disaster unfolded gradually in terms of public consciousness and there was much management of public expectations by governments through the media; this time people are living every detail of it in real time.

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“The over arching impact of all of this is to create the most massive uncertainty for investors that I have known, which is always bad news for markets,” he says.

In terms of the healthcare market, Hood says different sectors of it are being affected in different ways. Care homes are facing significant disruption in operational and financial terms. Labour costs will be higher, because of the extra cost of emergency arrangements to cover staff absences and the need to provide higher skilled nursing care in homes that were previously purely residential.

And hygiene spending must have risen sharply, with extra sanitation, PPE equipment, and repeated deep cleans.

While “there are no figures yet”, he estimates, “voids will have risen where unfortunately there have been deaths or where relatives have taken elderly residents out of homes to avoid infection risks, so revenues will have fallen”.

Retirement living is essentially a highly specialised residential real estate market and all housing activity has been ‘frozen’ both by government ‘decree’ and by practical considerations, such as removal firms stopping trading.

Primary care is being “hit in some genuinely unexpected ways”, Hood says. The UK private hospital market had been buoyant, with big investor interest such as the £1.5bn deal last year when Medical Property Trust bought 30 private hospitals. There were four separate deals in 2019 where US REITs invested a total of £1.95bn in UK hospitals (Savills).

“This is basically a classic US-into-UK investment phenomenon, based on demographics and the gradual backdoor privatisation of the NHS. “Unfortunately, clouds had already begun to mask this sunny scenario before coronavirus, after a number of very public scandals about rogue private consultants and unnecessary surgery/procedures highlighted the fragility of the private hospital market.

“The think tank, the Centre for Health and the Public Interest (CHPI) has been extremely vocal about how poor NHS procurement and its underfunding has been propping up the business models of private hospitals.

Now we have coronavirus and the NHS has effectively commandeered private hospitals and their resources, resulting in the suspension of virtually all elective surgery/treatment in them.”

The change to the revenue flows of private hospitals has been “both significant and instant and NHS reimbursement of costs won’t bridge this profitability gap”, says Hood.

HealthInvestor UK • May 2020

INVESTMENT

“The comparison is with restaurants chains that went into home delivery via Uber Eats and Just Eats to maintain volume, only to discover that losing the over-priced drinks element of diner spend has savaged their profit margins.”

There have been reports that US hospitals are laying off doctors or cutting their pay because of the parallel situation there with the ending of elective procedures. “This will happen here in the UK too,” Hood believes.

Acquisitions/new deals hampered Covid-19 has hampered acquisitions and new deals. Julian Evans, head of healthcare at Knight Frank says: “Transactions and advisory mandates that are over c.£50M, are generally on pause. This is the same in the UK and Europe as investors wait to see how well operators manage CV-19.

“That said, due diligence is still continuing on some mandates, albeit at a slower pace. Sub £50M transactions and refinance, appear to be continuing, and taking advantage of historic low debt terms.”

In March it was reported that Aviva Investors had suspended its UK Property fund as well as two feeder funds over “material uncertainty” of the valuation of its holdings.

The move came after two other property funds, the £2bn Janus Henderson UK Property, and Kames Property Income fund, suspended dealing in March for the same reason.

An Aviva spokesperson said: ‘Due to the challenging market circumstances, which are impacting the wider investment markets including real estate, the independent valuer [Knight Frank] of the Aviva Investors UK Property fund has expressed material uncertainty over their valuation of scheme property.’

In a statement published on its website the firm said Covid-19 has impacted the UK property market and made it difficult to value of holdings with the same degree of certainty as would otherwise be the case.

The announcement on 4 April that Welltower had pulled out of its £2.5bn deal to acquire the care home operator, Barchester because of coronavirus uncertainty, “confirms how seriously

HealthInvestor UK • May 2020

the already fragile state of investor interest in social care has deteriorated sharply since the virus struck”, says Hood.

The disturbance to primary care will also “inevitably make investors pause until it becomes clear how long the crisis will last and how deeply it will affect healthcare profitability in general, and in particular the future integrity of the private hospital business model.

“The uncertainty for investors right across the healthcare spectrum is so intense that deal flow this year and into 2021 will inevitably be depressed,” he says.

Tom Morgan, executive director, healthcare transactions, for commercial real estate services and investment firm CBRE is more optimistic. He stresses that it is “really important to be very clear about the market reaction to date”.

“Most investors are telling us that they see the Covid-19 crisis as having a short-term impact, as opposed to a systemic or structural one. That, together with the timeframe required to close a deal, be it real estate or mergers and acquisitions (M&A), means that even though we have been in the grips of Covid-19 for a number of weeks, we are seeing transactions which were in legals now beginning to complete on principally the same terms as were agreed before the pandemic.

“We are also hearing anecdotally that parties are agreeing sensible short-term pauses with the express agreement that deals can be picked up and concluded on pre-Covid terms within specified long stop dates,” he says.

The reaction to the Covid-19 pandemic has not been uniform across the healthcare sector though. Morgan says there has been focus on larger corporate transactions, which were already in the public eye, which by and large have been placed on hold. In part this is because management teams have refocused on the primary business at hand, but also because of the ability to conduct a typical process in atypical times from both a diligence and a financing perspective.

“We have seen the pace of several M&A transactions which were in the market slow down but investors are continuing to work on them so that when the time is right to re-start, they are in as good a position as possible.

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“Real estate transactions which were in train have largely The Group’s tenants have “a strong level of rent cover, with an average of 1.8 times rent cover across Impact’s portfolio continued to close, particularly where the buyer is funding via all-equity. While there is clearly greater uncertainty across the in the year to 31 December 2019,”. In addition to the detailed board, the long income real estate market has so far remained monthly operating and financial data the investment strong, with transactions closing, pricing holding relatively manager receives from all tenants at the end of each firm and investors continuing to bid on new deals,” he says. quarter, the Group has asked its tenants to provide weekly Within healthcare, Morgan says banks have indicated occupancy data for the duration of the pandemic, along with “a continuing support for their existing clients, including a situation report on how the pandemic is affecting their closing on deals previously agreed. But with acquisition operations. So far this year the number of occupied beds in opportunities largely drying up and most operators focussed the Company’s portfolio has been stable, with 3,848 beds on their operations rather than expanding, banks will have occupied on 3 January 2020, and 3,886 beds occupied on limited appetite to write new business in the short term until 20 March 2020.

A number of the Group’s tenants are in discussions with the outlook is clearer.”

According to Morgan, anecdotal evidence suggests debtthe NHS about making beds available in order to relieve funded transactions are at greater risk of being paused, while pressure on hospitals. A principal concern of tenants is to banks focus on existing relationships meaning lower levels ensure they have adequate staff available to provide care. of liquidity and rising cost of finance is having an impact However, some are reporting a higher than normal number on the amount of equity investors need to commit to make of job applications. a deal happen.

Are landlords making provisions for Morgan says the relative value of sterling and the positive reduced rental income? dynamics of the UK health and social care market are attracting new overseas investors Evans, at Knight Frank, says the issue of to the market, “and we already seeing new reduced rental income is “highly nuanced overseas debt investors underwriting deals”. and includes consideration towards Care home “At the same time, and perhaps looking a operator, covenant, registration type, profitability was little bit forward of where we are currently, construction and location. Certainly some marginal at best there are increasing numbers of investors landlords are modelling for potential seeking high quality management teams rental impact, but it appears at the before this crisis and assets which require gap financing, current time of writing there will likely and has been willing and able to deploy capital quickly be a spike in occupancy.” damaged by it albeit at higher returns than was maybe Rent levels in the residential care sector true a month ago. The potential for asset have been “under pressure for a while”, backed businesses to capitalise on the lowersays Hood, “and certainly since the rent return, higher liquidity real estate market strike by Four Seasons last September”.

“Care home profitability was marginal at best before may provide a safety valve for a number of businesses over this crisis and has been damaged by it, as now has the the course of 2020,” he says. viability of many private hospitals. Rent reductions Tenants play critical role in providing care are inevitable, both as short term emergency support Real estate investment trust company Impact Healthcare REIT and then as longer term arrangements. The extent of these adjustments will depend on the funding models of plc recognises that its tenants provide “an essential service to the landlords. the communities in which they operate and will play a critical role in helping to provide care to vulnerable elderly people “Those with significant third party funding are between during the COVID-19 pandemic”. the rock of impoverished tenants and the hard place of their Its “top priority remains the health, welfare and safety of the banking covenants. It will remain to be seen how much Group’s tenants, care home residents, healthcare professionals the banks are prepared to share the pain with landlords and wider stakeholders”. and tenants,” Hood says.

Morgan says there is “no evidence of rent being withheld Impact Healthcare REIT says all the Group’s tenants have business continuity procedures and protocols in place to manage for the March Quarter Date as yet, and most landlords virus pandemics. During March this year, the company’s and operators are speaking regularly to share market investment manager met with each tenant to review the intelligence. additional steps they have been putting in place to prepare “Anecdotally, there is evidence of slight upward for COVID-19. These measures are focussed on three main movement in revenue driven by rising demand for beds areas: ensuring home managers have clear guidance on how and higher acuity cases at higher cost of care.

But he warns the greatest challenges are around staffing to implement the most recent advice from the relevant public availability in light of self-isolation and it is this point health authorities, in particular on closing homes to visitors and how to implement self-isolation, increasing stocks of “which is causing some investors to question whether the critical supplies, and putting in place measures to ensure current status quo will endure into Q2 and Q3 this year if adequate staffing. care homes see a squeeze on cash flow”.

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HealthInvestor UK • May 2020

INVESTMENT

Long term outlook for developments The impact of the corona virus is yet to be known, but “market sentiment is that investors will remain acquisitive in the medium to long term if quality and opportunities align with their return requirements”, Savills suggests.

Development is critical within healthcare and Knight Frank suggests it will remain robust for the long term. But in the short term, and subject to recession and supply chains, “it remains to be seen what the true cost of raw materials and labour will be. However, institutional and overseas funds will likely become a player in the shape of finance for prelets”, Knight Frank says.

For Green, the long term outlook of the care sector is predicated on demographics and the need for services. “So arguably this coronavirus pandemic has forced the need for residential care services and in a way could mean stronger investment in the long term.”

“What care homes have shown is how they can manage and support people with high level needs, which is a cheaper option than people being in an acute hospital environment.

This should strengthen the long term viability of care homes as an investment,” he says.

The needs driven nature of health and social care has been re-emphasised in the last month and “the macro-position remains unaltered” says Morgan. “What Covid-19 has done is to identify and emphasise where the gaps in the system are, particularly around how and where elderly and vulnerable people are able to live independently,” he says.

A number of new forward funding opportunities have been brought to market recently. “We are not yet seeing a pricing reaction or a material reduction in liquidity, but most parties are factoring in a time lag to recruit new staff and fill the home post lockdown with associated impact on cash flow calculations,” says Morgan.

He points out that more immediate concerns relate to the delays in construction programs resulting from social distancing rules and supply chain disruption with knock-on

HealthInvestor UK • May 2020

impacts on practical completion dates, project risks and cost overruns and increased financing costs. For developments in the planning process the picture is mixed, with some local authorities able to process decisions via delegated powers, while others lack the constitution to be able to do so.

Longer term, the current isolation of adult children from elderly relatives in need “could accelerate decisions to move into a safe environment leading to higher demand for retirement living (and care homes),” Morgan suggests.

“But for now, retirement living is likely to experience a stop on new sales and resales whilst movement restrictions are in place. Ironically, the ability to support self-isolation is considered better in retirement living than that in the wider community,” he says.

Opportunities to access sites for development that would otherwise have been bought by other sectors, such as the redevelopment of hotels and urban centres may be brought forward, particularly as the well funded institutionally owned platforms focus on growth as their longer terms strategies remain unaffected. “This could lead to more joint ventures and partnerships with institutional groups looking to redevelop sites and locations that have brought forward development plans. If housing sales slow in the short term, we may see an acceleration of the mixed tenure and rental models,” says Morgan.

He adds that primary care “for the time being at least, should be least affected as it is largely reimbursed rent from the NHS and investment opportunities remain competitive”.

Looking ahead, Hood believes this crisis “will finally force the government to address the shortcomings in its funding and management of healthcare, leading eventually to much higher future investment. Quite how the cake will be divided between direct government spend and private sector investment is pure speculation at this stage.”

But, he warns: “The psychological impact will be profound and may fundamentally change behaviours - both consumer and business -in the medium and long terms.” n

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TECHNOLOGY

Keeping it personal With the technologies now available to us, there is no reason government initiatives to track and control the spread of Covid-19 must come at the expense of personal data privacy, writes R3’s Isabelle Corbett

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HealthInvestor UK • May 2020

TECHNOLOGY

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global health crisis such requires quick and decisive action from our governments. Most countries have found themselves on the back foot, playing catch-up with a virus that had already spread beyond control before measures were put in place to prevent it.

Thankfully, we know that this unprecedented time in our lives will pass and we are beginning to see glimmers of hope of that already, but the decisions made by our governments today will linger on in perpetuity. Around the world, public health agencies and technology firms are working on apps and other solutions that track the health of their country’s citizens and trace who they have come into contact with, often in real-time.

Tech companies gearing up Despite many countries still being in a relatively early stage of the pandemic, we have already seen solutions made live.

In Singapore, the TraceTogether app was rolled out in March to track potential exposure to the virus. Apple and Google are working on a template for an app that can be leveraged by public health agencies in the US and beyond, and in the UK the NHS has contracted a group of tech companies to build a Covid-19 datastore containing health data of UK residents.

All of these projects have huge implications for the way in which sensitive personal data about our health and location is shared with governments and private technology companies. While the key consideration for a government must of course be protecting the health of its citizens, there is no reason why, if the appropriate technology is used, we must lose control of our personal data.

A dangerous precedent If we open the floodgates now, we may be setting a dangerous precedent for a new level of surveillance of our lives for years to come. And if this data becomes commoditised, there is a very real risk it may eventually be leveraged by advertisers, politicians on the campaign trail and many others with a motive that falls far outside the spectrum of protecting our health and wellbeing.

Blockchain is a viable alternative to these centralised digital databases, and the technology exists today to be used by governments, health agencies and tech firms building Covid-19 response solutions. If developed appropriately, a blockchain-based app can enable individuals to exercise control over their digital footprint in an ethical and sustainable way. Users can control which elements of their identity, location and health credentials are shared, and the user can store their data, such as medical records, as they see fit.

While traditional public blockchain models such as bitcoin and Ethereum share all data with all nodes on the network, a purpose-built enterprise blockchain platform can tackle this privacy challenge by using sophisticated encryption techniques, only revealing the data to those who have a need to know.

Taking this concept one step further, it is possible that the user’s data does not even need to be stored on the blockchain.

Using decentralised identifiers, a blockchain network can

HealthInvestor UK • May 2020

verify that the data was issued by a trusted individual or organisation without actually having to store that data.

For example, an individual’s data – such as their immunity status to Covid-19 or the network of people they have been in contact with during the last 14 days – might need to be used by various different parties in the healthcare ecosystem.

Uploading this data to a centralised digital database is to essentially relinquish control of it forever and introduces all manner of data security risks.

However, decentralised identifiers can separate the data from direct identifiers so that linkage to a specific individual is not possible without additional information that is held separately. The correlation can only be made by those parties to which the user provides full access, while still allowing anonymised data to be used as necessary, for example in tracking the total number of Covid-19 infections in a country or town.

Data privacy implications Decentralised identifiers are just one example of a whole host of exciting new technologies in the field of identity and data management in the blockchain space. And these technologies are not hypothetical, they exist today, and in many cases have already been deployed in multiple different industries by institutions across the globe. There is no reason why they can’t also be deployed in the fight against Covid-19.

Allowing corporations and governments to harvest our medical and location data on an unprecedented scale may seem like an appropriate solution to an unprecedented crisis, but when the dust settles in the months and years to come, the implications of this on data privacy will be vast.

Protecting our health must always come first, but our governments also have a responsibility to protect our rights as citizens – and in an increasingly digital world, data privacy is an essential human right. n On 14 April, HealthInvestor UK discussed the topic ‘Covid-19: Can technology help us win?’ as part of our Covid-19 Webinar Series. View the recording at ipevents.net/webinars

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NEW DATE: 22 September 2020

JW Marriott Grosvenor House, London

Finalists

Silver partner

Event partners

Advisory & Finance Bank or lender of the year AIB GB Barclays Clydesdale & Yorkshire Bank Fortwell Capital HSBC UK NatWest OakNorth Bank Shawbrook Bank

• • • • • • • •

Consultants of the year – strategic

• Candesic • Carterwood Consulting • Connell • EY-Parthenon Group • Marwood • PLMR • PwC Advisory • Rushport • ZPB Associates

Consultants of the year – transactional

• Candesic Management Consultants • CIL Consulting • Connell EY-Parthenon • PwC • Corporate financier of the year

International • Clearwater • Deloitte UK • KPMG Lincoln International • Orbis Partners •

ipevents.net/healthinvestorawards

Legal advisors of the year – private Bevan Brittan Browne Jacobson Bryan Cave Leighton Paisner Capsticks Solicitors CMS DAC Beachcroft Freeths Gowling WLG McDermott Will & Emery UK Pinsent Masons Shoosmiths Stephenson Harwood

• • • • • • • • • • • •

Legal advisors of the year – public Bevan Brittan CMS DAC Beachcroft Hill Dickinson Mills & Reeve Pinsent Masons RadcliffesLeBrasseur Weightmans

• • • • • • • •

Legal advisors of the year – transactional

Law • Acuity Brittan • Bevan Salmon • Burges • CMS Dickinson • Hill Aldridge • Lester & Reeve • Mills Masons • Pinsent Harwood • Stephenson Trowers & Hamlins •

22 September 2020 | JW Marriott Grosvenor House, London

RECOGNISING AND CELEBRATING ACHIEVEMENT IN THE BUSINESS OF HEALTH AND SOCIAL CARE

Technology Technology provider of the year Civica Healthcode Ltd London Ambulance Service Oxehealth Perfect Ward Person Centred Software uMedeor

• • • • • • •

Clinical services Diagnostics provider of the year Alliance Medical UK London Ambulance Service Re:Cognition Health

• • •

Primary care provider of the year

• Ascenti 2019 • Fieldbay • Inotec Care Solutions • Premium Health • Re:Cognition • The Dermatology Partnership

IT innovator of the year

Investment Private equity investor of the year Apposite Capital Downing Graphite Capital Intrinsic Equity (Orbis Partners)

• • • •

Private hospital group of the year

Healthcare • Aspen Health • Bramley Healthcare UK • HCA Healthcare Group • Kingsbridge Nuffield Health • Ramsay Health Care UK • Schoen Clinic UK • Spire Healthcare •

Recruiter of the year Appoint Recruitment Solutions (Appoint Group) Blackwood Group Care UK CareTech Community Services Gilbert Meher Hunter Healthcare Jane Lewis Healthcare Nurseplus UK The Finegreen Group

• • • • • • • • •

For more information about the event and sponsorship opportunities, contact our events team on +44(0)20 7104 2000, email events@ investorpublishing.co.uk or visit our website.

Tickets and tables available now: ipevents.net/healthinvestorawards

• Ascenti Ltd • Healthcode • HowDidWeDo? Healthcare • Liva my Care • Log Ambulance Service • London My Clinical Outcomes • The Good Care Group • Zava •

NEW DATE: 22 September 2020

JW Marriott Grosvenor House, London

Finalists

Silver partner

Event partners

Property Property consultants of the year – capital markets Avison Young BNP Paribas Real Estate Christie & Co Cushman & Wakefield Gardiner & Theobald Knight Frank

• • • • • •

Property consultants of the year – property services AECOM Aitchison Raffety Carterwood HealthCare Law Knight Frank MESH Construction Consultancy

• • • • • •

ipevents.net/healthinvestorawards

Property developer of the year Barchester Healthcare Care UK Frontier Estates Hamberley Development Medical Centre Developments Prime Renaissance Care Group

• • • • • • •

Property investor of the year

Healthcare • Barchester UK • Care Investment Management • Civitas Elevation Advisors • Inspired Villages • Medical Properties Trust • Octopus Real Estate • Patron Capital Advisers •

22 September 2020 | JW Marriott Grosvenor House, London

RECOGNISING AND CELEBRATING ACHIEVEMENT IN THE BUSINESS OF HEALTH AND SOCIAL CARE

Public private partnership of the year Group • Keys Well, Taking Control • Living UK • Mckesson Park Healthcare • Regent’s Acute Data Alignment • The Programme (ADAPt)

Social care Community support provider of the year Eden Futures Gaudium Neural Pathways (UK) – part of the Active Care Group Venture People

• • • •

Complex care provider of the year Active Care Group Christchurch Group Complete Care Holdings Cornerstone Healthcare Group Inspire Neurocare Loveday & Co Phoenix Therapy and Care Premium Care Solutions The Oakleaf Group Total Community Care

• • • • • • • • • •

Domiciliary care provider of the year Careline Rochdale edyn.care Eidyn Care Gaudium Home Care Preferred MiHomecare Promedica24 The Good Care Group

• • • • • • • •

Residential care provider of the year

Care Homes • Athena Healthcare Group • Avery Healthcare • Barchester Healthcare • Canford UK • Care Court • Country Care Homes • Hamberley • HC-One Homes • Runwood Strong Life Care •

Tickets and tables available now: ipevents.net/healthinvestorawards

Specialist care provider of the year Accomplish Group Active Care Group Cornerstone Healthcare Group Eden Futures Horizon Care & Education Keys Group Loveday & Co Salutem Healthcare The Good Care Group Voyage Care

• • • • • • • • • •

#HIAwards2020

LEGAL UPDATE

Obliged to protect Helen Nugent, a barrister in the clinical negligence team at Temple Garden Chambers, outlines what operators need to know about the provision and use of PPE at a time of crisis

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HealthInvestor UK • May 2020

LEGAL UPDATE

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or some weeks now the Government has been under fire over the distribution of personal protective equipment (PPE). The shortages of PPE have been reported widely.

For some, the guidance in its various forms arguably fails to provide the real clarity that is needed better to understand what items of equipment should be utilised and when. From a practical perspective, these issues raise a number of important questions regarding the extent to which healthcare nurses and their colleagues are exposed to occupational risks, notwithstanding health and safety protocols and procedures being in place. Within a legal framework, occupational risk is of obvious relevance to the duties and responsibilities of any employer.

In the context of acute shortages of PPE, the most recent guidance was published by Public Health England (PHE) on 17th April 2020. In summary, it recommended the sessional use and reuse of PPE for healthcare workers. The BMA was reported as describing the new guidance to be an admission of a “dire situation”.

In response to the shortages, a consignment of some 84 tonnes of PPE, including around 500,000 gowns, was due to arrive in the UK on 19th April 2020 for national distribution.

The shipment was delayed. Niall Dickson, Chief Executive of the NHS Confederation described it as very serious. It had made a difficult situation worse.

Employer obilgations As COVID-19 raises unique clinical challenges for those working in the healthcare industry, so too does the current crisis raise new challenges for the NHS and employers of hospital and other healthcare workers. But what are the obligations of employers to provide PPE? And are those obligations presently being met?

As a starting point, statutory and common law duties are placed on employers to safeguard the health and safety of their employees in the workplace. The Health and Safety at Work Act 1974 (“the Act”) is the primary piece of legislation addressing health and safety in a statutory context. The provisions of Section 1 of the Act place employers under a general duty to ensure, so far as reasonably practicable, the health, safety and welfare at work of all its employees. It is not an absolute duty, but a qualified one. In practical terms this means that where there is a risk of harm which cannot be prevented or avoided (as is the case here), an employer is expected to take appropriate steps to control, minimise or otherwise reduce the risk. The provision of PPE should be a last resort, to be deployed where methods or organisation of work systems cannot otherwise be effective in managing the risk. PPE is therefore an essential weapon in the battle against COVID-19.

The standard of health and safety in the workplace is set by a series of six regulations, commonly referred to as the “Six Pack Regulations”: derived from European directives and intended to harmonise health and safety law across Europe. Germane to the coronavirus pandemic are the Control of Substances Hazardous to Health Regulations 2002 (as amended) (COSHH), applying to infectious micro-organisms and biological agents. The Provision of Personal Protective Equipment Regulations 1992 (as amended) (PPE Regulations) are also plainly of relevance in the context of work equipment more widely.

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HealthInvestor UK • May 2020

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LEGAL UPDATE

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The principle statutory duty on employers under COSHH is to take preventative action against the exposure of employees to a substance which is hazardous to health; and where this is not reasonably practicable, they should ensure that it is adequately controlled. Adequacy is narrowly defined by reference to the nature of the substance and the nature and degree of exposure generally. PPE is specifically identified as a control measure under the Regulations which, if deployed, is required to be suitable for the purpose it is used and compliant with any relevant provisions of the PPE Regulations.

Under

must be effective. The extent to which an item of equipment is suitable is an assessment to be made by reference to the time when the PPE is provided. Beyond provision, the duty extends to the maintenance of suitable equipment, keeping it in good repair/working order and replacing it. Employees should also be given information, instructing and training on the use of PPE. Against that background, the latest guidance from PHE demonstrates a significant shift. Full PPE previously recommended for those working in high risk areas is now extended to the PPE include alternative options in the event Regulations, Suitability of equipment of non-availability. As an illustration, the suitability of Under the PPE Regulations, the suitability recommended PPE for healthcare workers equipment has a of equipment has a broad definition. PPE in acute hospital in-patient and emergency broad definition must be appropriate for the risks involved departments performing a single aerosol and the conditions at the workplace generating procedure (AGP) on a patient where exposure to the risk may occur; with possible or confirmed coronavirus it must take account of the ergonomic (outside of a higher risk acute area) requirements of the health and safety of previously included a single use disposable fluid resistant coverall/gown, single use FFP3 respirator the employee using it and the nature of their workstation.

It must fit correctly and, so far as reasonably practicable, be and single use eye/face protection. Only one week on, the effective to prevent or adequately control the risk without alternative options to a single use gown for AGPs now adding to the overall risks. In Threlfall v Kingston upon Hull include any reserve supply; and if a reserve fluid resistant City Council [2010] EWCA Civ 1147, albeit by reference to gown is not available, a disposable, non-fluid repellent gown/ coverall or reusable (washable) surgical gown together with the provision of protective gloves in the context of waste a disposable plastic apron. disposal, Smith LJ observed that for PPE to be suitable, it

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HealthInvestor UK • May 2020

LEGAL UPDATE

In its current form, the guidance distinguishes between levels of risk by healthcare context, with AGPs of the respiratory tract being identified as posing the highest risk of transmission. No distinction is made between possible and confirmed cases of infection, or between different areas of discipline. In some ways, it places an unenviable burden on healthcare trusts who will need to agree action plans to implement the guidance and consider how to put systems in place for identifying equipment which cannot be reused; and to implement or review already existing integrity checks and decontamination processes. The onus generally is on the employer to ensure that employees understand and safely put into practice suitable PPE. That there have been various revisions to the recommendations published over the period to date poses the risk not only of there being real confusion on the part of those to whom they apply; but of there being a lack of continuity and consistency across national practice. The doubling up of equipment as an alternative to what would otherwise be a standard provision may well bring about its own challenges, where items are left in short supply for those working elsewhere.

HealthInvestor UK • May 2020

Striking a balance There is a difficult balance to be struck between the use of suitable equipment and PPE availability. The nature of the occupational risk faced by healthcare nurses has not changed, but issues associated with and arising from supply and demand now appear to be key factors in assessing what may constitute suitable PPE. Where there are failures, the NHS may well face occupational illness claims on the basis the risk has not adequately be controlled. Breaches of the duties, whilst relevant in assessing the extent to which an employer has fulfilled its duty, will not in themselves automatically give rise to a civil liability (Section 69 of the Enterprise and Regulatory Reform Act 2013). A claim would need to be brought in negligence. It is obviously difficult balancing personal safety against patient safety and if an employer does not provide adequate PPE (and fails as a consequence to provide a safe working environment) individual healthcare professionals may decide to refuse to treat patients.

It remains to be seen how this will all play out in any private law personal injury claims: the Government priority and focus is clearly on dealing with the state of emergency, as opposed to protecting employers from potential claims. n

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SOCIAL CARE

Standing on the Corner Helen Costa is the founder of Cornerstone, a social enterprise focused on improving the lives of children and families touched by the care system. She talks to Jenna Lomax about challenging the consultancy industry and how virtual reality can improve vulnerable lives How has your previous work experience and being the mother of two adopted children, helped you in your work at Cornerstone?

You have just begun working with Antser Group who are offering a “tech trio” of VR, human centred communication systems and predictive analytics that will provide a personalised service to local authorities. Can you explain how the tech trio works and what the company is expecting to achieve through utilising it?

I have two adopted children and they were my motivation to set up Cornerstone in the first place. They are my inspiration for setting up the partnership which stemmed from my own experiences of adopting children and feeling daunted through When you think about the way in which the individual the whole process. cases of children are managed, local authorities are often Being on an NHS Trust gives you a keen understanding of using old and out-of-date back-office systems that will the pressures the health system is under, its priorities and the provide a very basic functionality with little intelligence challenges it faces. There’s all sorts of things you learn from to them, and will certainly have no involvement or twothat. I have a lot of experience in pharmaceuticals too. way communication with the end user.

All these experiences helped me when I We have technology that does have was setting up Cornerstone. I understood an artificial intelligence (AI) element to how to set out a business plan and how to take Cornerstone to market. At Cornerstone it, but it also has a really useful phone We have a very I learned how you can use innovation and based application so the end user can ‘live’, interactive technology-led innovation to transform effectively be part of their own case notes. way in which we health and social care.

They themselves can communicate back My previous experience has given me a to the service, engaging in a much more manage each lot of insight and confidence about how we 21st Century way. That in turn gives the case and the can really add value to children’s services, as service the intelligence that it needs to people involved opposed to a lot of businesses who say that tweak and amend its offerings, solutions they offer value, without really having the and advice to the user. understanding and the working knowledge.

If you imagine an adolescent that is If you take the big consultancy firms for in social care, for example, we want to example, they can charge a lot of money to consult and advise. be able to help that adolescent and their carers via the But what I think is needed and is obvious at Cornerstone – app to send through pre-crisis advice or solutions, before and what we’re all about– is trying to provide really tangible a major crisis happens. solutions that have a big technology element to them. We are We want users, both a foster carer and the adolescent or child, to be able to use the app in pre-crisis. Depending not going to get to where we really need to be in health and on the issue, a foster carer can make use of the app to social care without the help of technology.

Cornerstone is very much about authenticity – really find training courses that could possibly help a carer understanding what’s going to make a difference on the ground, before said issue crops up again. We have a very “live”, so the public sector spends its money wisely, with people like interactive way in which we manage each case and the us who can really present proper outcomes. people involved.

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HealthInvestor UK • May 2020

SOCIAL CARE

HealthInvestor UK • May 2020

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SOCIAL CARE

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In addition, local authorities might want to find out how many of its foster carers are struggling with the amount of social media their foster children are being exposed to. We can conduct a survey through the app and we can start to provide advice and guidance on that. We can do all of that very easily with the tools that we have created.

Just like people use Facebook, Twitter and Instagram to consume information, advice, support and engage, this app provides advice, support and engagement for social care. Our app provides both a back-office system as well as a front office system that connects the whole thing together with the artificial intelligence embedded within it, so that we are learning from the app all the time. Social carers need more advice and support and that is exactly what we’re offering.

This preemptive, supportive technology is something that we are constantly channelling and updating through our app. We are able to often preempt an issue because of the AI telling us exactly what is going on with the individual child.

For example, if you have a child that is struggling because they are constantly online looking at violent images or footage, we will know from our AI and analytics that they probably need help.

Also, children can often do really badly when they have to keep moving placements. If the Antser Group, alongside social services, can avoid that by providing consistent, quality care while the individual child is going through personal problems, the child is more likely to be able to stay in the same place.

If we can preempt and anticipate problems, the care home or parent has a much better chance of holding on to the child, which in turn gives the child a much better chance of a future as a result.

Another really exciting thing is that we have the technology to be able to connect a foster carer with a teacher, tutor and a youth worker so they can provide what is known as a “team around the child”.

It doesn’t matter who is engaging with that child – whether it’s a health worker, the police, or a youth worker – they are all able to be connected to a central system which enables them to understand what has happened to that child at any point in time.

Rather than one particular incident happening, perhaps at school, and the social worker knowing nothing about it, or the foster carer knowing nothing about it, instead, there’s a mechanism available that can share the right information among the right people.

There is a security in this system, a lock down on who can have access which protects data in line with GDPR rulings.

It’s not a consumer model, it’s very much case management through the model.

How are you using VR to accelerate positive behaviour change? What did you create at Cornerstone?

We have a tool that puts you into the shoes of a child through a virtual reality (VR) headset; you can be the child in that virtual reality. It puts you on the receiving end of an abusive, neglectful situation. It goes without saying that it

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is very unpleasant, because it feels so real, VR allows you that experience in the first person.

But what people really get out of that is a deep and genuine understanding of the child. They have an emotional response to what they’ve experienced which is as close to childhood trauma as you can get. And it has a profound effect. That’s the point – instead of just teaching somebody something, we’ve been able to shift beliefs and outlooks on child behaviour, to the point where it’s been able to change a child’s behaviour.

When you’re dealing with behaviour training, it is about making sure that teachers and other professionals who are around a child are able to understand the child’s experience and to be able to empathise and understand that what happens to them in their early years is what’s driving their behaviour now.

If you’re a child who has been neglected, left on your own and left to fend for yourself, perhaps from as early as nine months old, that could result in a child at aged six or seven stealing or hoarding food or appearing to be greedy. Without knowing the background, sometimes adult’s responses to a situation like this can be punitive.

If you’re the teacher who has that child in the classroom, or if you’re the foster carer of that child, who doesn’t really understand that child’s background, and you don’t understand it in a genuinely empathetic way at that moment, the punishment could be unnecessary and counterintuitive.

But if you can get them to that point of being genuinely empathetic toward that child, then you can really change a child’s behaviour, as well as their relationship with their teacher or foster carer. Then that child has a better chance of thriving in later life. That’s the goal. But that’s really hard to do with traditional methods and training courses.

What led you to look at VR technology as the catalyst for change at Cornerstone?

When we first set up Cornerstone, we were effectively doing an analogue version of what we are now doing with the VR. Though we used to run a really good training course that helped participants to really understand what was going on in the adoption process, and help support them through it, I felt that we needed the introduction of technology to really provide a step change and a real leap ahead.

After research I found VR being used by Alzheimer’s patients and that was a real light bulb moment; I thought about how that could translate to children’s services and social care. Alzheimer’s is a difficult disease; sometimes it can be difficult to care for people with it. Sometimes carers can lose the capacity to care because it can be so frustrating.

I saw this film which showed how to feel real empathy for a patient with Alzheimer’s and it was brilliant. I thought that is what we’re going to do at Cornerstone. I realised it could apply to children’s behavioural issues. We reached out to the people who made the film and the guy who made the film happened to have two adopted children and he worked with us for free. That is the moment when it all came together for us.

HealthInvestor UK • May 2020

SOCIAL CARE

What are the immediate plans for Antser Group, what is in the pipeline for 2020?

Photo: Adobe Stock

utilise technology to improve outcomes for children. We can use predictive analytics to work out where the issues are, as We are combining the VR tool with AI to look at issues such well as using VR and our other tools to address the problems. as youth crime. We’re looking at using the AI capabilities We have a comprehensive and very practical offer to to see the geographical link in terms of the hotspots of local authorities who have famously got to do more with youth crime. less money.

It’s not good enough that local We will look at what types of families authorities are often made to spend money the children or teenagers committing the crimes come from and areas that would be on consultancies that deliver expensive considered high risk. Then the VR will be IT products that are just “one size fits all” We are combining introduced here to create an intervention approaches for children’s services. the VR tool with for those children or teenagers and their Local authorities want an intelligent AI to look at partner to work with. We very much families living in these high risk areas – issues such as to try and prevent things from escalating. hope that we are the ones that are able youth crime We are already working with local to create and provide a very different service, compared to what has been authorities in East London, though Covid-19 may halt our mission for a while. offered before.

But when things start getting back to We offer both the diagnostics and normal, it will be great to bring all the the practical implementations, not just technology together for a really difficult social issue. leaving local authorities high and dry once they’ve spent We are also packaging all the tools that we have developed all their money. We start with what the problem is, where and putting them into one transformation offer to local the challenges are, question what the data tells us, and authorities. We invite any local authority to work with us to what can we then do to address it. n

HealthInvestor UK • May 2020

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BREXIT

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HealthInvestor UK • May 2020

BREXIT

Life goes on We could be forgiven for failing to remember that Brexit happened just four short months ago but the implications for the sector are still very much here to stay. Marie Manley and Will Holmes, of Sidley Austin investigate the future for life sciences

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rexit has now happened. After years of notice period Medical Devices Regulation will come with delays for the and further delay, the United Kingdom left the EU UK, too.

The UK and EU are releasing new guidance and proposals on January 31, 2020, triggering a transition period currently projected to extend to December 31, 2020. During all the time. Below we consider some of the proposals and the transition period, the status quo is mostly preserved measures with regard to the life sciences industry that insofar as EU law relating to the life sciences sector continues have been taken so far, in preparation for the end of the to apply in the UK, even though the UK is no longer a part transition period. of EU political institutions (i.e., there are no UK members of the European Parliament, and no UK ministers attend Medicines and Medical Devices Bill European Council meetings).

The UK has introduced an early legislative bill to tackle the This means that life sciences companies continue to benefit challenges presented to the UK life sciences industry after from the EU legal framework until the end of the transition Brexit. While EU law that exists at the end of the transition period will be preserved in the UK, the UK relies on the period. However, starting in January 2021, companies will have to have established an entity in both the UK and European Communities Act 1972 (ECA) to amend regulations the EU to continue to operate in both in line with industry changes. The ECA will markets. The future of the life sciences no longer be available for this function industry in the UK and the EU will be after the transition period. The Medicines It is also unclear determined by legislation passed by, and and Medical Devices Bill (The Bill), which agreements reached between, the two the Government introduced to Parliament what effect the during the transition period. While the at the end of 2019, seeks to address pandemic will UK’s European Union (Withdrawal) Act this by introducing regulation-making, have on the 2018 converts EU legislation as of the delegated powers covering the fields of implementation last day of the transition period into UK human medicines, veterinary medicines of legislation and medical devices. The Bill creates domestic law, if no further legislation is passed and no agreements reached, the life targeted delegated powers, to keep the already agreed sciences industry will face something akin existing regulatory frameworks updated, to a “no-deal” Brexit scenario. while consolidating the enforcement regime for medical devices. Further, the While it is possible that the UK and EU Bill will allow the Secretary of State the ability to impose could agree to an extension of the transition period for up civil sanctions for breaches of the medical device regime. to two further years, the UK Government has made it clear As currently drafted, the Bill is in four parts: that it does not intend to trigger such an extension, even Part 1 creates a power to amend or supplement human including wording within the EU (Withdrawal Agreement) Act 2020, which legislates against any attempt by the UK to medicines law by virtue of amending the Human Medicines apply for such an extension. This legislative provision can Regulations 2012, the Medicines for Human Use (Clinical Trials) Regulations 2004, the Medicines (Products for Human only be overturned by the passing of further legislation by Use) Regulations 2016 and some parts of the Medicines Act the UK Parliament. It is not clear whether the exceptional 1968. The amendments would allow for updates relating to situation presented by the COVID-19 pandemic will trigger an extension of this transitory period, given that negotiations the manufacture, marketing and supply of human medicines; have not been able to be pursued as initially planned. It falsified medicines; clinical trials; the charging of fees in is also unclear what effect the pandemic will have on the relation to human medicines provision; creating an offence implementation of legislation already agreed – for example, of failing to comply with human medicine regulations; and the proposed delay to the implementation of the new EU supply of human medicines in an emergency.

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BREXIT

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Part 2 allows for the amendment or supplementation of the Veterinary Medicines Regulations 2013, specifically as it relates to the manufacture, marketing, supply and field trials of veterinary medicines; the charging of fees in relation to veterinary medicines provision; creating an offence of failing to comply with veterinary medicine regulations; and the powers of a Veterinary Medicines Directorate Inspector.

Part 3 allows for the updating of the UK Medical Devices Regulations (MDRs) 2002 in relation to the manufacture, marketing and supply of medical devices; the charging of fees in relation to medical devices (e.g., to register a device); recording information about the safety of devices; creating offences of breaching the provisions in the MDR; and the supply of medical devices in emergencies.

Part 4 creates a duty to consult before changes are made under the Bill and provides that the statutory instruments made under these clauses will be subject to the affirmative resolution procedure.

The Bill still has a number of stages to go before it is a legally binding Act. However, it can be envisaged that the provisions set out in the Bill as it stands could allow for a number of changes to the UK life sciences legislative environment. For example, the Bill would allow the Government to amend the process for applying for or holding a marketing authorisation and to bring UK legislation into line with the new EU Clinical Trial Regulations. For medical devices, the Bill would put in place a new system of civil sanctions for breaches of the appropriate legislation, and could allow the Government to introduce requirements like a quality management system relating to medical devices not yet on the market.

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Ultimately, while the Bill is not finalised and may change somewhat before it is, its introduction demonstrates a commitment to ensuring that the UK life sciences industry remains world-leading after the end of the Brexit transition period.

Free movement – goods and people Following the transition period, the UK will no longer be a part of the EU’s rules on free movement of goods and people.

During the transition period, the UK and the EU will engage in trade talks, to agree to the terms on which trade will be conducted after the end of the transition period. This will have a clear and significant impact on the life sciences industry. So far, little is known about what outcome the trade talks will have. Michel Barnier, the EU’s chief Brexit negotiator, has rejected the UK’s call for a “Canada-style” trade deal freeing the UK from EU rules, noting that Prime Minister Boris Johnson had agreed to keep to the EU’s state aid rules, as well as its environmental and social regulations, after the transition period.

In a press release in February 2020, the UK announced that EU goods imported to the UK after the Brexit transition period will be subject to full customs checks. The Government has launched a consultation, asking for views from industry as to the formation of a bespoke UK tariff.

The UK’s shift away from being part of the EU’s regime for the free movement of people means that the UK will make its own rules relating to the movement of people into the country. On February 19, the UK announced the

HealthInvestor UK • May 2020

BREXIT

introduction of a new points-based immigration system to take effect after the transition period. Points will be awarded for different skills, salaries and qualifications.

EU and non-EU citizens will be treated equally. While it is unclear exactly what effect this will have on the UK life sciences industry, and its interaction with European talent, what is clear is that the new rules will significantly change the makeup of personnel working for the life sciences industry in London and the rest of the country.

Office for Life Sciences The UK has been getting ready to seize the opportunities that may arise from leaving the EU by putting in place legal solutions to provide for some flexibility and offer a more attractive platform for innovation and investments in life sciences. Some sources provide further insight into where the UK expects its life sciences industry to go in the years after Brexit. In January 2020, the UK’s Office for Life Sciences (OLS) released its Life Sciences Industrial Strategy Update. The foreword to this update states that the OLS aims to “ensure our regulatory and ethical environment remains world-leading post-Brexit, and take the opportunity to create maximum flexibility for innovative and responsive approaches to regulation, using health data to underpin rapid progress in the field.”

Plans to secure the dominance of the UK life sciences industry set out in the update include these: • A proposed £500 million Innovative Medicines Fund will allow patients quicker access to new medicines.

• Through the British Business Bank, the OLS has

HealthInvestor UK • May 2020

committed to deliver a dedicated life sciences scaleup investment programme worth around £600 million.

• A number of targeted initiatives have been established to further increase public and private funding for innovative life sciences companies.

• In July 2019, the UK launched a renewed Life Sciences Opportunity Zone offer to promote and support science parks and other regional innovation “clusters” to attract investment and enhance local research and development (R&D) and innovation collaborations.

• Investment in health research and development saw US$3 billion invested in 2017, around double that of Germany, Japan, Canada and other competitors and behind only the USA globally. The UK has committed to boost spending on R&D to 2.4 percent of GDP by 2027, and an additional US$4 billion has been invested in R&D since 2017.

• The UK is establishing five patient recruitment centres dedicated to late-phase commercial research.

• Further provision for increasing the capacity of the UK’s clinical trials infrastructure include the introduction of mechanisms to ensure that all patients can be offered the opportunity to participate, measures making it easier to set up a study in the NHS, and the improvement of approval timelines with the MHRA. • The UK has launched a number of initiatives to support the development and deployment of technologies such as artificial intelligence and emerging areas like genomic medicines and advanced therapies.

• The UK is aiming to grow its existing skills base, investing to ensure that the UK has the skills it needs to support emerging industries. n

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FINANCE: DEALS

deals Alphagreen Group secure £500k in funding round COMPANY: Alphagreen Group TRANSACTION: Fundraising CONSIDERATION: £500,000 Alphagreen Group which produces the cannabidiol product, Alphagreen.io, has secured funding in its first equity funding round. Several tech investors took part in the funding round including Sedish investment comany Enexis, which has also backed other cannabis industry businesses including NOBL, Dragonfly Biosciences and Emmac Life Sciences.

Gilde Healthcare raises $450m venture and growth capital fund COMPANY: Gilde Healthcare TRANSACTION: New fund CONSIDERATION: $450 million Gilde Healthcare has closed its Gilde Healthcare V fund, a $450 million venture and growth capital fund, which was oversubscribed and targets growth opportunities in the healthcare sector including digital health, medtech and therapeutics in Europe and North America. Gilde Healthcare V was raised in a single close and is backed by international investors including banks, pension funds, fund-of-funds, sovereign funds, endowments, family offices, entrepreneurs and Gilde partners. Disclosed investors include Royal Philips and Rabo Corporate Investments from The Netherlands, HANIEL and KfW Capital from Germany, BNP Paribas Fortis Private Equity and Belgian Growth Fund, Danish Growth Fund and the European Investment Fund from Luxembourg.

Healthcare Homes acquires two Norfolk nursing homes COMPANY: Healthcare Homes Group TARGET: Saxlingham Hall Nursing Home = and Walcot Hall Nursing Home TRANSACTION: Acquistion CONSIDERATION: Undisclosed Healthcare Homes Group has completed the purchase of Saxlingham Hall Nursing Home in south Norwich and Walcot Hall Nursing Home in Walcot Green, near Diss. The group has acquired the homes from Saxlingham Hall Nursing Home Limited, which was founded by Alan and Jane Bird.

LSP closes $600 million fund COMPANY: Life Sciences Partners TRANSACTION: New fund CONSIDERATION: $600 million Life Sciences Partners, an Amstadam-based life sciences investor, has closed a $600 million fund after reaching its hard cap. The fund, LSP 6, is the largest fund ever raised in Europe focused on life sciences ventures. LSP 6 is aiming to invest in 15 to18 predominantly European private companies developing new medications or medical technologies.

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HealthInvestor UK • May 2020

FINANCE: DEALS

Marlowe acquires Managed Occupational Health COMPANY: Marlowe TARGET: Managed Occupational Health TRANSACTION: Acquisition CONSIDERATION: ÂŁ3 million London-based safety and regulatory compliance company Marlowe has acquired Managed Occupational Health in Norwich, a national provider of occupational health services.

Quit Genius raises $11 million in funding round COMPANY: Quit Genius TRANSACTION: Fundraising CONSIDERATION: $11 million Quit Genius has raised further funding in a Series A funding round, led by Octopus Ventures, with participation from Y Combinator, Startup Health and Triple Point Ventures. Quit Genius replaces telephonic cessation support with a personalised digital programme that includes cognitive behavioural therapy, expert coaching, a connected breath sensor and easy to access medication.

TLC Group acquires Vision Mental Healthcare and New Directions COMPANY: TLC Group TARGET: Vision Mental Healthcare and New Directions.

TRANSACTION: Acquisition CONSIDERATION: Undisclosed The developer, operator and private equity company, TLC Group has acquired Vision Mental Healthcare and New Directions. Vision Mental Healthcare was formed in 2005 as a privately funded venture, and provides care for people with long-standing mental health problems. New Directions is an adult social care company which offers adult service users residential, short stay, home and respite support, as well as dementia care and other services. Connell Consulting provided commercial due diligence for the TLC Group on both acquisitions.

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EXECUTIVE MOVES

executive moves Arix Bioscience

Care Innovation Hub

Arix Bioscience has appointed Naseem Amin as chairman, replacing Joe Anderson, co-founder and chief executive, who is leaving the company.

Amin joined the Arix board in December 2019 as non-executive director. He has life sciences experience in the US and Europe, having held senior positions in healthcare businesses in R&D, business development, marketing, and in venture capital.

Amin has held various roles including venture partner at Advent Life Sciences and chief scientific officer of Smith and Nephew.

He also led business development at Biogen and at Genzyme Therapeutics, where for both companies he initiated and executed a number of acquisitions and partnerships.

Amin started his career at Baxter Healthcare where he worked in marketing, product development and clinical research.

Navin Mayani is to step down as chief executive of the Care Innovation Hub as it pauses all its operations for the foreseeable future, in response to the coronavirus outbreak. The suspension of its operations is likely to last at least six months.

Commenting on the decision, Mayani said: “Care Innovation Hub’s mission is to enable and develop new entrepreneurs, start-ups and leaders who will create positive change in the care sector.

Once the country returns to business as usual, we plan to start up operations again. At that time the sector will need innovative ideas more than ever and we hope to be at the forefront of this alongside yourselves. Myself and the board are extremely grateful for the ongoing enthusiasm and support. I look forward to staying in touch with my peers in the sector and continuing to work alongside all those who work tirelessly to support vulnerable people receiving care services in the UK.”

HealthInvestor UK • May 2020

▶

Navin Mayani, Care Innovation Hub

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EXECUTIVE MOVES

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Dr Arokia Antonysamy, Cygnet Health Care

Dr Erica de Lange, Cygnet Health Care

Richard Jones, Medica Group

Martin Steele, NHS Property Services

HealthInvestor UK • May 2020

EXECUTIVE MOVES

▶ Cygnet Health Care Cygnet Health Care has appointed Dr Arokia Antonysamy as interim regional medical director for the South.

Antonysamy trained in adult psychiatry and addiction, and has experience working as a senior medical manager within the NHS and the independent sector. She has also been mental health clinical lead for the NHS Benchmarking Network since 2013.

Cygnet Health Care also appointed Dr Erica de Lange as regional director of psychology for London and the South.

Lange joins Cygnet from St Andrews, where she spent nearly six years in senior roles, including lead consultant clinical psychologist and lead of the psychology team for Essex. She has worked in psychiatric intensive care units, personality disorder services and secure forensic environments.

Medica Group Medica Group has appointed Richard Jones as chief financial officer and a director of the board.

Medica provides teleradiology services, including outsourced interpretation and reporting on MRI, CT and x-ray. It offers three primary services to hospital radiology departments: NightHawk, an out-of-hours service, routine cross-sectional reporting on MRI and CT scans, and routine plain film reporting on x-ray images.

Jones will succeed Tony Lee, who’s stepping down as finance director after 10 years at the company. Jones has 20 years’ experience of healthcare businesses and is currently chief financial officer at Mereo BioPharma Group and was previously chief financial officer at Shield Therapeutics. He is also a non-executive director and chair of the audit committee at Alliance Pharma.

A chartered accountant, Jones started his career with PwC and moved into investment banking where he specialised in the healthcare services sector, initially as a research analyst, and then into corporate finance as head of healthcare at Investec.

Following a transition period, Jones will join Medica later this year.

Medica Group has also appointed Robert Lavis to the newly created role of clinical director, effective 1 June, reporting to Stephen Davies, the company’s medical director.

Lavis joins Medica from Gloucestershire Hospitals NHS Foundation Trust where he is currently a consultant radiologist and former clinical director. He has extensive experience of clinical practice starting his career as a surgeon before entering radiology with a specialist focus on oncology.

HealthInvestor UK • May 2020

NHS Property Services NHS Property Services (NHSPS) has appointed Martin Steele as its acting chief executive officer.

In his new role, Steele will be responsible for overseeing the management and operations of NHSPS’s portfolio, which comprises more than 3,500 properties with 7,000 tenants across England.

Steele was previously chief operating officer at NHSPS where he recently organised the NHSPS’s strategic and operational response to the coronavirus pandemic. His other responsibilities included the organisation of a 5,000 strong front line workforce, including cleaning, maintenance, catering, security, waste management and laundry services staff.

Prior to joining NHSPS, Steele held senior positions at leading companies such as BT, Andersens, Northern Foods and Debenhams.

Owlstone Medical Cambridge-based Owlstone Medical, which provides disease breathalysers, has appointed Neil Tween as chief financial officer.

Tween was previously vice-president and group financial controller at GW Pharmaceuticals, which grew from a medium-sized UK-listed partnerfunded R&D company to a 900-headcount global commercial organisation and where he was involved in more than $1 billion of public markets fundraising.

Prior to that he was financial Controller at Jagex, and spent six years with Deloitte, advising a range of listed and private biotech and pharmaceutical clients. Tween is a chartered accountant.

Neil Tween, Owlstone Medical

Visionable Visionable has appointed Rachel Dunscombe as chief technology officer to lead the company’s strategy on the development of its video collaboration platform.

Dunscombe was chief information officer at Bolton NHS Foundation Trust before moving to Salford Royal as chief information officer and then becoming director of digital. She left the trust to become the first chief executive of the NHS Digital Academy.

Visionable uses technology to support clinical collaboration and to improve access to services for patients. The company has developed a collaboration platform specifically for healthcare that enables multiple users to share real-time audio and video feeds from any device. It is already being used to connect ambulances with A&E units, to deliver consultant-led stroke care to patients out of hours, to facilitate multi-disciplinary team meetings, and to run virtual outpatient clinics and remote consultations. n

Rachel Dunscombe, Visionable

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November/December 2019 Volume 18 Number 6

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