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FACILITIES MANAGEMENT Always in the news PLUS Preview of HefmA Conference 2010

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HB Spring and election are in the air

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As you probably all know, a date has been set for the General Election and party leaders are falling over themselves trying to promote their party as the one to best lead the country.

Promises on how to ‘save’ and improve the NHS have sprung from the parties, much like cherry blossom at this time of year. Every hospital to become a foundation trust, more choice for patients, reducing waste and bureaucracy whilst making no cuts in frontline services – the options are many but funds are few.

These are exciting times – for the country, for the healthcare sector and for us as individuals – let’s see what 6 May brings!

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FACILITIES MANAGEMENT Always in the news PLUS Preview of HefmA Conference 2010

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Enjoy the issue.

Sofie Lidefjard, Editor editorial@psigroupltd.co.uk

­HEALTH BUSINESS MAGAZINE ONLINE If you would like to receive six issues of Health Business magazine for £45 a year, please contact Public Sector Information Limited, 226 High Road, Loughton, Essex IG10 1ET. Tel: 020 8532 0055, Fax: 020 8532 0066, or visit the Health Business website at: P NEWS P FEATURES P PROFILES P CASE STUDIES P EVENTS P AND MORE

8 www.healthbusinessuk.com PUBLISHED BY PUBLIC SECTOR INFORMATION LIMITED 226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 EDITOR Sofie Lidefjard ASSISTANT EDITOR Angela Pisanu PRODUCTION EDITOR Karl O’Sullivan PRODUCTION DESIGN Jacqueline Grist PRODUCTION CONTROL Julie White

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Health Business | Volume 10.2

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CONTENTS HEALTH BUSINESS VOLUME 10.2

7 NEWS 15 INFORMATION TECHNOLOGY Professor Matthew Swindells, Chair of the Health Informatics Forum at BCS, takes a look at informatics and the NHS’s coming challenges Learning by doing is generally more effective than learning by listening or reading, and e-learning can help with this We discuss pioneering achievements that have been achieved in line with the NHS productivity agenda

29 FINANCE The Finance and Leasing Association looks at different investment options for the public sector

31 FACILITIES MANAGEMENT With the NHS and healthcare related topics seemingly always in the news, the Healthcare Facilities Consortium finds facilities management looks at some recent stories and their relevance to facilities teams Hosted by the Northern and Yorkshire branch, the 2010 HefmA Conference takes place 26-28 May

41 HOSPITAL CLEANING We preview AHCP – Association of Healthcare Cleaning Professionals Annual Conference, 8-10 June Poor and insufficient cleaning in hospitals has been linked to high fatality rates. The British Cleaning Council discusses what could be done to prevent this

47 INFECTION CONTROL A new specification for cleanliness in healthcare facilities is due to be published in May

55 AIR-CONDITIONING & REFRIGERATION F-Gas Support looks at your obligations when it comes to refrigeration and airconditioning

57 ENERGY The Carbon Trust works with NHS Trusts to help cut energy costs and carbon emissions

65 HOSPITAL GROUNDS The Institute of Groundsmanship writes about the role of contractors in maintaining NHS open spaces

69 PARKING The British Parking Association has launched a Charter for Hospital Parking With more that 2,200 attendees over the two days of Parkex, it was the busiest in the show’s history as a stand alone parking event

79 FLEET MANAGEMENT Taking action to prevent ‘at work’ vehicle accidents is of major importance, says the Royal Society for the Prevention of Accidents

85 FRAUD PREVENTION The NHS Counter Fraud Service explains how healthcare providers can help design out fraud using four key principles

89 RECRUITMENT The Recruitment and Employment Confederation discusses key challenges

95 WORKPLACE STRESS Stress costs the NHS millions in absenteeism. NHS Employers writes about how to reduce this problem

101 CONFLICT MANAGEMENT The NHS Security Management Service explains the revisions to the sixth edition of the Code for Crown Prosecutors on treating assaults on health workers more seriously, and what this change means

103 ERGONOMICS What is ergonomics and how does it affect the health service?

107 OBESITY MANAGEMENT More needs to be done to address those who are already obese if we are to lessen the financial strain on the NHS, writes Dr David Haslam, the National Obesity Forum

111 CATERING Providing food that meets the nutritional, cultural, social and religious needs of the population is no easy task, says the British Dietetic Association

115 TRANSLATION & INTERPRETING To accommodate today’s multi-cultural Britain, the NHS must have access to quality translation services

119 CONFERENCES & EVENTS Discover East Midlands and its many conference and events venues

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Patients in driving seat for transport ew proposals to improve nonemergency patient transport services and make them more patientcentred have been announced by Welsh Health Minister Edwina Hart.

A review undertaken by Win Griffiths, Chairman of Abertawe Bro Morgannwg Health Board, said that the current system is fragmented, could be better managed and does not offer a patient-led service.

The review proposes that four pilot projects roadtest the best ways of delivering improvements, including better use of voluntary organisations to provide more services; cementing stronger management arrangements to ensure more coordinated

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provision between public service providers and voluntary organisations; using other vehicles instead of minibuses for more comfortable modes of travel; and offering bespoke services catering for the specialist needs of vulnerable patients.

Non-emergency patient transport enables people to access outpatient, day treatment and other services at NHS hospitals. Around 1.4 million such journeys are undertaken every year. Users of the service are often seriously ill, such as those needing dialysis or chemotherapy. They are usually vulnerable, with physical or other disabilities, and are dependent on such transport, as they often live in rural locations.

Helping healthcare professionals reduce harm from alcohol Ps and nurses can do more to increase delivery of Alcohol Identification and Brief Advice (IBA). This was the finding of research commissioned as part of the Alcohol Effects campaign that indicates some healthcare professionals may underestimate its potential impact.

A survey of healthcare professionals revealed that some GPs and nurses saw IBA solely as a diagnostic tool when in fact evidence shows that it serves as an intervention in its own right – reducing consumption to lower risk levels for one in eight higher risk drinkers. Some healthcare professionals also viewed the tool principally as a way to identify dependent drinkers, rather than it being aimed at all drinkers who are regularly drinking more than the NHS advises.

Professor Ian Gilmore, President, Royal College of Physicians, said: “IBAs really work, and are up there with some of the most effective interventions that are available to us in healthcare. Many healthcare workers don’t realise that IBAs for harmful drinkers are even more effective than current interventions for smoking.”

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The IBA involves using quick and simple tools to not only accurately identify patients’ levels of risk in relation to their drinking, but also help those drinking at increasing and higher risk levels to recognise the potential risk and cut down.

It prompts drinkers to reconsider their behaviour and encourages them to reduce their consumption to lower risk levels.

A range of materials is available via the Alcohol Learning Centre to assist with the delivery of IBA. This includes a GP factsheet, z-cards, leaflets on how to structure advice with patients, AUDIT questionnaires and an updated version of the ‘Your drinking and You’ booklet. An e-learning module has also been developed, which has been endorsed by the Royal College of Nursing and Royal College of Physicians. It has received accreditation by the RCN Accreditation Unit, which means that nurses can count completion of the module towards their reflective learning requirements, and the Royal College of General Practitioners requires the module as preparation for its own Post-graduate certification course on alcohol management.

NEWSINBRIEF Internet diagnosis often unreliable, finds research People who look for information about their child’s medical condition on the internet could be receiving incorrect data, according to research from Nottingham University Hospitals NHS Trust.

The team used Google to look for information about five conditions: HIV breastfeeding, mastitis breastfeeding, baby sleeping position, green vomit and MMR autism.

The researchers discovered that 50 per cent of the results returned by the search engine failed to answer the original query.

They found that 39 per cent of the results gave correct answers, while 11 per cent of the 500 results returned incorrect information.

The highest number of incorrect results were returned about MMR and autism, followed by HIV and breastfeeding.

£1m boost for rural healthcare in Wales A £1 million Rural Health Innovation Fund has been launched to give rural areas in Wales better access to healthcare.

Health Boards are invited to submit bids for funding to develop innovative solutions to improving and integrating services to deliver care in rural communities, by the deadline of 7 May. Health Minister Edwina Hart said: “Our aim is to deliver safe services as locally as possible to people’s homes. People understand that for access to highly specialised services, they may have to travel, but for more routine services, they should be able to go to their local hospital or GPs surgery.

“The plan recognises that through additional training for staff or by using telecare, patients can get more services locally, including pre and post-operative care.”

NHS trusts increase use of private firms NHS trusts are planning to use more private companies in a bid to save money and increase competition, according to data published.

Government plans to move services into the community and away from hospitals could be behind the drive, analysis by Pulse magazine showed. It contacted primary care trusts (PCTs) using the Freedom of Information Act and received 64 responses. Of those, 65 per cent said they planned to increase use of the private sector while 60 per cent had begun transferring services to private companies working in the community.

NHS Hounslow said it had identified a “plethora of independent providers” as part of plans to reduce hospital spend and move services to GP polyclinics. NHS Bristol said it planned to “transfer a broad range of care currently provided in secondary care to alternative providers”, including end-of-life care services, outpatient elective care and care for people with long-term conditions.

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SANYO VIRUS WASHERS

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More hospital food failure, says report rofessor Tim Lang, a leading expert in food policy and prominent government adviser, has joined campaigners to call for legally binding standards to improve hospital food. This follows the publication of a report that shows the government has ignored five warnings since 2006 that voluntary attempts to improve hospital food were failing, at a cost to the taxpayer of more than £54 million in the last ten years.

Professor Lang said: “Improving hospital food would bring great benefits to many millions of patients, but it would also inspire consumers to choose healthier food when out of hospital care and support British farmers to go even further to improve their produce. By doing this, it would support a shift towards a more sustainable diet in the country at large, which we urgently need to achieve. Having worked with government

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to improve hospital food for more than ten years I have come to the conclusion that, to change hospital meals, the government must introduce clear food standards which are given strong legal backing”.

The publication of the ‘Yet more hospital food failure: The bill rises to £54 million, and still counting…’ report reveals that Ministers were last warned only weeks ago by the Government’s Council of Food Policy Advisors that voluntary attempts to improve hospital food had failed.

The report also found that in the last two years alone the government has spent over three quarters of a million pounds on the early stages of developing a Healthier Food Mark – the 17th voluntary initiative to improve hospital food since 2000. The report was published by the Good Food for Our Money campaign, supported by a coalition of health and environmental charities.

£30 million boost for sick children’s care hildren with life-limiting or lifethreatening conditions will benefit from an extra £30 million of funding, Health Secretary Andy Burnham has announced.

Half will go to children’s hospices and half to the NHS for children’s palliative care services.

The money will help hospices extend the range of their services to include more outreach. It will help the NHS continue to move their palliative care services out of hospitals and into children’s own homes.

Both of these will give children and their families more choice over their care.

The extra £15 million for children’s hospices adds to existing investment of £47 million over five years in children’s hospices, with £10 million this year alone to support 40 hospices around the country.

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“For too long, services have been organised to fit the convenience of the system. A great NHS will put the convenience of the patient first, and move services towards them where it is safe to do so. But care in the home can also achieve better results and save money,” said Health Secretary Andy Burnham.

The announcement follows a commitment made by the Health Secretary earlier this year to have a more patient-centred care across the NHS including delivering many more services in patients’ homes. It includes a commitment to help children and young people who have acute or long-term conditions, or disability or palliative care needs to spend less time in hospital and receive care at home or the community instead.

NEWSINBRIEF First national uniform in Wales Health Minister Edwina Hart recently joined nurses and midwives at West Wales General Hospital, Carmarthen as they became the first to wear the new national uniform. The new-style uniforms have been designed to make it easier for patients to see who is in charge of hospital wards.

In addition, nurses and midwives will be provided with more uniforms and hospitals are working to make on-site laundry and changing facilities available to staff. This should help prevent and control healthcare associated infections.

The new uniforms are: navy blue for hospital ward sisters/charge nurses and their deputies; royal blue for clinical nurse specialist; hospital blue for staff nurse; postman blue for staff midwives; green for healthcare support workers; and aqua green for nursery nurses.

Edwina Hart, said: “These new-style uniforms are a simple yet effective way to help patients identify who is in charge on a ward as soon as they enter our hospitals. Having a consistent design will also make it more cost effective as it allows uniforms to be bulk-purchased.”

Wales is the first country in the UK to introduce a national uniform.

Scottish practices trial online patient portal A new online Patient Portal where patients can access and update their own health records online is to be trialled in two Scottish practices.

The Patient Portal will run at two practices in NHS Ayrshire and Arran over the next six months to enable patients to view test results and update their records from anywhere with an internet connection.

Registered patients will be able to log in to undertake a number of tasks, including request appointments online, request repeat prescriptions, access test results, record, track and monitor their blood pressure, set targets for weight and other goals, and record and track blood sugar levels.

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Written by Urban Fröderberg, Business Area Manager – Healthcare, Anoto AB

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INFORMATION TECHNOLOGY

RAISING THE EFFECTIVENESS OF IT IN HEALTHCARE Anoto Group, the company behind Digital Pen & Paper, looks at how the health sector can benefit from new technologies

TO MEET EVER-INCREASING DEMANDS, while continuously streamlining expenditure, healthcare authorities look to technology as a way of delivering more for less and responding more quickly to changing circumstances. However, there are capital and operational costs associated with introducing new technology, as well as the issues of effectiveness and usability. A study last year by industry analyst firm Quocirca suggests that technology is often thrown at problems in the healthcare sector without the proper consideration being given to the underlying processes or the needs of clinicians and carers1.

Given that healthcare is one of the top IT growth markets globally, second only to utilities’ IT spending, this is a worrying trend.

DIGITAL PEN & PAPER In an environment where paper is still the key medium for capturing information, Digital Pen & Paper (DP&P) technology is winning over many healthcare trusts and local authorities in the UK by putting usability and simplicity over IT wizardry.

DP&P automatically captures handwritten information in medical or care forms and digitises it, eliminating the need to type up notes electronically. The digital pen looks like a ballpoint pen, but with a tiny infrared camera at its tip that tracks its movements relative to a pattern of barely visible dots printed on the form, recording and storing what is being written. Stored data is then synchronised with back-end systems by docking the pen in a USB cradle or connecting via Bluetooth and a mobile phone.

While the Quocirca study shows that laptops, PDAs and smartphones have a high penetration in the healthcare sector, it also

shows that these devices can be tricky to write on, difficult to clean, easily damaged and prone to theft and loss – all of which hinders their effective use and drives up costs.

In contrast, a German pilot study comparing the usability of current electronic data capture (EDC) methods revealed DP&P to be significantly more user-friendly, quicker and more accurate compared with using a keyboard, tablet PC or PDA to capture data2.

Evidence from the field also suggests that DP&P users require less training, can be up and running more quickly, and generally find digital pens easy to use. In addition, DP&P systems have been shown to be more cost-effective compared with other mobile technologies.

DATA QUALITY One in four of us will experience mental health problems at some time in our lives, and organisations like Derbyshire Mental Health Services NHS Trust are critical in helping to improve mental health and wellbeing.

The Trust provides a wide range of services to a local population of nearly a million people. The quality of these services is assessed by the Quality Commission as excellent. The challenge, however, lies in being able to collect clinical activity data in a timely, comprehensive and accurate way.

The Trust previously had issues with data collection, which led to serious problems in accurately reporting activity to commissioners.

It became apparent that a very different approach was needed – one that would enable clinicians to enter activity data with less hindrance, less effort and maximum reliability.

The breakthrough came when a small group from the Trust were invited to a meeting where

a number of technologies were showcased under the banner of ‘agile working’. This was the first time the Trust saw DP&P based on Anoto technology in action. The team saw for themselves how staff could use the pens out in the field for sending clinical activity data straight to the information systems.

The Trust carried out a three-month pilot with 90 staff across three Community Mental Health Teams, and the results were both impressive and revealing. Based on the trial, the DP&P system was rolled out to a further 350 staff in 21 teams in a further 12-week period.

With clinicians no longer needing to return to base to enter their data, they save significant amounts of time, ensure better quality of service, reduce travel time and improve patient care. As well as improving timeliness, it means more accurate and meaningful reporting, and supports the demonstration of target attainment and capacity planning.

A HOLISTIC APPROACH When introducing technology to critical healthcare and social services, the first consideration should be the needs of the endusers and the processes they work towards.

Often a relatively simple solution such as DP&P can yield better results more quickly and at a lower cost than an ‘all-singing, all-dancing’ solution that users find hard to get along with.

That said, whichever technology an NHS Trust or council opts for, it is critical to take a holistic approach: only when the front-end technology can be tightly integrated with records databases and other systems can it deliver the greatest benefits.

Notes: 1. Quocirca Ltd., “Light touch, firm impression. Switch from paper systems to IT but keep to the business process script”, April 2009 (http://bit.ly/3At73x) 2. Boldt R, Raasch J, “Analysis of current technologies and devices for mobile data capture. A qualitative usability study for comparison of data capture via keyboard, tablet PC, personal digital assistant, and digital pen and paper”, University of Applied Sciences, Hamburg, 2008

FOR MORE INFORMATION Web: www.anoto.com

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Improve productivity efficiency with secure wireless infrastructure

Congrego: to congregate, share, unite and collaborate

NCREASING THE mobility of your staff, inside and outside your workplace can greatly improve productivity, but it is reliant on wireless technology, which was previously expensive and insecure. Now, the latest wireless technologies, based on the advanced 802.11n standards have changed all that.

LAN2LAN has the experience and expertise to bring you fully secure wireless networks that are easily managed remotely, and deliver a rapid return on investment. A highly resilient, robust wireless platform can securely support the services and high-bandwidth applications that greatly enhance the mobility and productivity of your staff.

Today’s services such as voice and video can now be delivered reliably over WiFi with significant operational benefits being gained by mobilising staff through support for a myriad of scenarios and business applications.

Whether it’s laptop-trolleys, hotdesking, Voice-over-WiFi, guest/ public internet access, RealTime-Location-Services, bar-code scanning, or wireless bridges, there

AN2LAN HAS introduced Congrego, a new solution that takes a social networking approach to community care and disaster recovery. Congrego represents an industry first in terms of applying the principles of wellknown social networking media such as Facebook, My Space™ and Twitter™ to highly specialised community service areas in a totally secure environment.

It is designed for us by government agencies and support organisations as a way of helping people to communicate and collaborate with one another as they cope with the affects of a traumatic experience – anything from flooding, a terrorist incident, military combat, a compulsive disease or a serious long-term illness.

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are now very few organisations that would not benefit from a strategic WiFi deployment.

LAN2LAN’s N3 accreditation, the component of the National Programme for IT (NPfIT), enables us to design, supply and maintain wireless infrastructures for government agencies and departments, connecting remotely via the Public Sector Broadband Access (PSBA) infrastructure to provide remote support services.

Our specialist team at LAN2LAN has developed a well-tested methodology, which will take you effortlessly from initial planning through to final delivery. LAN2LAN has formed a strong partnership with the Aneurin Health Board by helping with the delivery of wireless and innovative services into their infrastructure estate.

NTELLIGENT SECURITY keeps your business productive without locking down your network. Simply managed, from a central point, next-generation security makes your network stronger and business easier.

The conventional view is that security is a necessary cost that eats into profitability. The reality is that a secure network allows you to deploy more productive and cost-saving applications and services, which drives competitive strength and profitability. The importance of an easy to manage secure network environment is heightened by the requirement to deliver Connecting for Health and e-government initiatives.

The ISO27001 standard adds another dimension of opportunity to a security deployment, ensuring that the

Based on secure IBM Collaborative Software, Congrego is very easy to use and can be rolled out rapidly and securely.

A number of county councils are currently participating in pilot programmes of this new solution.

FOR MORE INFORMATION For more information about Congrego visit our website www.LAN2LAN.com/congrego For more information about LAN2LAN Contact: Tony Morreale LAN2LAN Limited 5 Genesis Business Park Woking, Surrey, GU21 5RW Tel: 0870 787 4001 E-mail: tony.morreale @LAN2LAN.com

FOR MORE INFORMATION Find out how we can help you introduce wireless securely into your infrastructure by enhancing existing services, systems and applications, visit www.LAN2LAN.com/wireless

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LAN2LAN has been helping organisations achieve and maintain the ISO27001 certified standard since it was introduced. We know the language, the process, the pitfalls and the rewards.

It can also contribute to your disaster recovery and business continuity planning, taking into account BS25999, the British Standard for DR and BC. Talk to us about how it is achieved, quickly and with expert management and control.

FOR MORE INFORMATION For more information about intelligence security visit www.LAN2LAN.com/security

Mobility – improved working with secure business applications HE PACE OF MOBILE technology innovation is accelerating and the industry is moving beyond using smartphones just to deliver baseline access to email, voicemail and text messaging. Spurred by the demand for ubiquitous connectivity, businesses are eagerly embracing a Unified Communications (UC) model that melds mobility with a new class of collaborative applications, enabling remote, travelling and telecommuting workers to have their desktops at their fingertips – literally.

The success of your organisation depends on your people having access to the information they need whenever they want and wherever they are. To maximise the productivity of your mobile workers it’s essential that they have access to everyday critical business applications. While push services can keep them in touch with their messages there will still be times when they need to pull information from

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INFORMATION TECHNOLOGY

DOING WHAT WE DO, BETTER The NHS has reached a fork in the road that could determine its future as a publicly funded, comprehensive service, says Professor Matthew Swindells, Chair of the Health Informatics Forum at BCS THE NEXT GOVERNMENT WILL INHERIT challenges in the public sector, the likes of which haven’t been seen for a generation. The Institute for Fiscal Studies forecasts that public sector net borrowing will be 11 per cent in 09/10, 12 per cent in 10/11 and 10 per cent in 11/12, meaning that the national debt will have grown from around 40 per cent of national income in 2005 to around 80 per cent in 2015.

The consequence of this is a real reduction in public spending of around £35bn over the next three years projected in the Pre-Budget Report – just over three per cent per annum on average. Yet, despite these constraints, the PBR announced protection for health, with a guarantee to maintain the level of real spending, as well as Overseas Development, schools and Sure Start. Ring fencing these budgets will mean that the annual real cut in everyone else’s budgets – particularly defence, higher education, transport and housing – will be nearer to 6.5 per cent per annum.

The implications of this for the NHS are obvious. As health is the largest spending delivery department in Whitehall, the impact of a real increase in health service funding would be catastrophic for other departments, and therefore very unlikely. An extra one per cent for the Department of Health would equate to a 10 per cent cut in the budget of the Home Office or the Ministry of Justice.

However, maintaining the real level of funding in health is not the triumph it may seem to other government departments. The King’s Fund in their report, “How cold will it be?”, has shown that the NHS has the expectation of real growth hard-wired into its DNA. The NHS has seen average real growth of three per cent per annum since 1948 and seven per cent per annum since 2000. Zero real growth will feel like a cut, and even after the recently announced constraints on pay rises.

The NHS will need to achieve 15-20 per cent productivity improvement over the next five years if it is to meet the growth in demand for its services and maintain public confidence.

THE POLITICAL CHALLENGE As a result of this financial context, the next government will be caught in the cleft stick of having told the public that it will protect the NHS, whilst the NHS itself will be behaving as if it was being cut. Many observers of health and education would argue that the rapid increases in funding have resulted in improved services, but not proportionate to the increase in level of funding. Not unreasonably, they conclude that if public services could

make the step change in productivity that has been seen in successful private sector organisations, they could protect, or even improve, the quality of their services, even during a period of tight financial constraint.

Furthermore, the public know that the NHS budget has doubled in real terms since 1999-00 and will not expect the NHS to start dismantling services the moment the going gets rough. If the learning of the past ten years is that the NHS can only succeed when its mouth is being stuffed with gold,

and annual basis. Dr Foster exposes unsafe hospitals, even when CQC doesn’t, with the help of the national media. Patients are invited to seek out information about their GP or hospital and make choices.

In facing up to the future financial pressures, none of the traditional levers are available.

Pleading for more money will be beyond even a sympathetic government’s ability to deliver, but slipping back in standards will be immediately visible to the public: cutting quality will be exposed by Dr Foster and the CQC,

The public know that the NHS budget has doubled in real terms in since 1999-00 and will not expect the NHS to start dismantling services the moment the going gets rough. If the learning of the past ten years is that the NHS can only succeed when its mouth is being stuffed with gold, we could find ourselves back in the position we were in 2000, with the fundamental concept of the NHS being challenged again we could find ourselves back in the position we were in 2000, with the fundamental concept of the NHS being challenged again.

So the challenge for politicians and the NHS is how to create an acceptance of the need for change in the minds of the public and staff, where there is a general distrust that change equates to cuts, and be seen to be delivering improvement in difficult time, without drawing the anger of the public and professions by being the ones to deliver bad news.

REFORM IN AN INFORMATION AGE The key contribution of informatics to this challenge, so far, has been to make the “sleight of hand” approach to health service management more difficult. When the NHS was last under serious financial pressure, in the 1990s, it was not subjected to real scrutiny.

Hospitals would close wards in the winter to save money. Waiting times weren’t published, no one knew about hospital acquired infection and in-hospital mortality rates were only studied by academics. Public opinion was that the NHS couldn’t be any better; only the patients themselves knew that they’d spent 12 hours on a trolley waiting for a bed.

This is not the case now. The government publishes a waiting time, quality and satisfaction data on a monthly, quarterly

lengthening waits will be exposed by Minister’s own transparency. The choice is now stark, transform productivity or be seen to fail.

WHAT MUST INFORMATICS OFFER? Informatics has two crucial roles to play in transforming the NHS – firstly to help create the conditions for radical change and secondly to make a real contribution to making NHS better and cheaper.

Creating the conditions for change through information: Many of the changes that the NHS needs to go through have the potential to provoke public outcry. Consolidating services, closing inpatient facilities and changing the model of care all create resistance in local communities. Transparency of information has the potential to inspire the public to make demands for radical changes that by-pass traditional vested interests. This is a crucial role for informaticians within and outside the NHS. Think of the power that public opinion could have on health, if campaigning organisations and the local media were able to discover the fact that your chances of dying in hospital after being admitted with a heart attack are three times greater in one NHS hospital than in similar hospitals in the same city and that these two hospitals have very similar costs. This information could challenge the

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INFORMATION TECHNOLOGY

public perception that services can only be improved with more money or that every penny is being well spend. They might move from demanding that their A&E Department be protected at all costs, to demanding to know why the NHS has been so complacent in allowing such variation to occur.

The challenge for informaticians looking in on the NHS is to unleash the challenge that transparency brings and help liberate a force for change which may be the catalyst needed to create a better, cheaper NHS. Enabling the transformation of services: Unleashing a force for change is of no help if the NHS doesn’t know what to do in response.

The challenge for CIOs is to be at the heart of the design and delivery of that solution. If an organisation needs to reduce costs by 25 per cent over the next five years, as many will, then non-critical but ‘nice’ upgrades to systems and business as usual will not be acceptable.

Hospitals and PCTs will be attempting to deliver a set of operational, tactical and strategic changes, all of which need informatics to support them if they are to be successful.

MEETING THE OPERATIONAL CHALLENGES In hospitals, the heart of the changes will be clinical operational performance. Hospital managers need real-time operational information on the flow of patients into, through and out of the hospital so that they can see where the problems are arising, as they happen – not when it seizes up from excess patients. And, crucially, they need timely data on quality fluctuations so that they can see quickly if the changes they are making are putting patients at risk, not three months down the line.

PCTs need to be able to track referral patterns as well as how their money is being spent, both by GPs and provider arms: there is a multitude of productivity opportunities in community hospitals and district nursing services. Hardly any hospital has the information that it ought to have to run a £200m business and even fewer PCTs are really applying the information that they should to spend upwards of £1/2bn of taxpayer’s money.

MEETING THE TACTICAL CHALLENGES Driving productivity and reducing waste are crucial to the future of any hospital or PCT, but they are not enough. Gathering data must support improvement as well as demonstrating failure.

A crucial step is creating real ownership and leadership from hospital doctors and GPs for the changes that are needed. It will be up to informatics and finance staff to provide these clinician-managers with timely, accurate information on finance (service line or practice budgets and spend), activity and quality if they are to take on the burden that their chief executive asks of them.

The hypothesis that too many patients are in

ABOUT THE AUTHOR – PROFESSOR MATTHEW SWINDELLS Matthew joined Tribal as managing director of Health in June 2008 from the Department of Health. During his three years at the Department of Health he worked firstly as the senior policy advisor to the Secretary of State and then joined the NHS Management Board as the NHS’s first chief information officer.

Prior to his period at the Department of Health, Matthew has 18 years experience in the NHS: in procurement; as head of Information Technology at a large teaching hospital; in general management; and, ultimately, as chief executive of a large acute hospital, where he lead the turn-around of one of the worst performing hospitals in England to becoming one of the best.

Matthew is a visiting Professor of Management at the University of Surrey, a Fellow of the British Computer Society and Chair of the Charitable Trustees at Imperial College Academic Health Sciences Centre.

hospital will need to be turned into a change in practice in every PCT and hospital. If this is to be safely and effectively done, informatics will need to provide an evidence based utilisation tool to support the assessment of whether a patient needs to be in hospital or could be cared for in a lower intensity and lower cost environment.

Increases in community based care and reduced hospital admissions will inevitably result both in clinical services being consolidated onto a fewer number of sites and in patient care being shared between multiple locations and providers. PCTs and hospitals should be investing in electronic document management systems, recognising that, outside of the GP surgery, paper will be the primary form of clinical data capture for many years to come and that the inability to move this around electronically is a blockage to change and puts patients at risk.

MEETING THE STRATEGIC CHALLENGES Hospitals and PCTs need to realign whole health economies to ensure that money is spent to maximise health gain rather than simply fund the services that were delivered last year, the year before that and so on.

Firstly, basic core data needs to be accurate: good quality clinical coding, to a depth that is clinically meaningful, with complete use of the NHS number. Information must be shared between organisations; no patient benefits from NHS institutions squabbling over data.

Beyond this, it requires the NHS to focus on keeping people well and to view an admission to hospital by a patient with a long term condition as a service failure. This will require tools to undertake population segmentation, risk stratification and pro-active targeting of the patients to help them manage their illness better. It will almost certainly require the

provision of composite primary and secondary data to allow nurse led call centres to coach patients remotely; and it will involve the integration of home based assistive technologies to be linked to NHS information systems.

And, of course, real transformation of the health system only comes when we recognise that information needs to be clustered around the patient, not the institution. The involvement of multiple institutions in the care of an individual (eg hospital, GP, polyclinic, private provider, social services etc) will increase in the future; informatics will need to decide whether it wants to continue to be a drag on progress or become part of the solution.

CONCLUSION The NHS is about to go through one of the biggest upheavals in its history. This time, it won’t be driven by political decisions but by hard economics. The NHS has two potential responses. One is to declare a financial crisis, start cutting services and reduce the quality and quantity of what it offers to the public.

The other is to declare an efficiency crisis and focus on achieving a step change in the effectiveness with which it buys services and productivity of those services. The former needs very little data. The latter is an information led response, which will require the informatics profession to be at the heart of transformation.

If your organisations don’t sit with data in front of it to make key decisions and doesn’t require the CIO to be part of the decision making process, then informatics hasn’t made itself crucial to the improvement of the organisation and the services probably faces cuts not improvement.

That is the challenge to the informatics profession for 2010. Be relevant, be essential and be right!

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England’s central source for health and social care information INCE IT CAME INTO being in 2005 as a Special Health Authority, The NHS Information Centre (The NHS IC) has continued to establish itself as England’s central, authoritative source of health and social care information, acting as a hub for high quality, national, comparative data.

The NHS IC delivers national information to support government initiatives such as 18 weeks and practice based commissioning, which helps local decision makers within the NHS and social care communities, improve the quality and efficiency of frontline care.

The organisation delivers a substantial portfolio of information resources which include: • National statistics, information resources and analytical tools to underpin health policy, planning, benchmarking and improvements right across the healthcare system • Statistical publications on subjects ranging from lifestyle issues such as alcohol

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Our mission is to revolutionise the use of information to; • Improve decision making • Deliver better care • Realise increased productivity

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Health Informatics: an emerging discipline, an emerging profession H

EALTH INFORMATICS IS A new discipline concerning how ICTs are used within healthcare (Bath, 2008).

Several definitions of health informatics have been proposed, including the “knowledge, skills and tools which enable information to be collected, managed, used and shared safely to support the delivery of healthcare and promote health” (UK CHIP, 2010) and the “the use of information and information and communication technologies (ICTs) to improve the quality of care and health and well-being of patients, their families and carers, and the general public” (Bath 2008, p. 505). These definitions indicate the vital role of health informatics in healthcare.

Interest in health informatics within the NHS increased following the publication of ‘Information for Health’ (Burns, 1998); since 2002, the National Programme for IT (NPfIT) has invested over £12 billion in developing new systems to improve patient care, including the NHS Care Records Service and the Choose and Book Service.

Most health professions are involved in, or are affected by, developments in health informatics, as systems are developed and implemented through NPfIT. Health informatics is an emerging multi-disciplinary profession, including those from IT and information specialties, healthcare professionals and managers. The educational and

training needs of these groups can be met by postgraduate courses. For example, the MSc in Health Informatics at the University of Sheffield attracts students from a wide range of professions including hospital doctors and GPs, nurses, pharmacists, public health specialists, librarians and IT specialists (Bacigalupo et al., 2002; Booth et al., 2003). This multi-disciplinary course emphasises the need for collaboration within health informatics.

Health informatics education must cover not only technical aspects, such as information system design and electronic record development, but also the human and management aspects of developing and implementing ICT solutions within healthcare, e.g., leadership and the management of change. Ensuring that the health informatics training and development needs of these professions are met will be important in the success of health informatics initiatives within the NHS in the 21st century.

Department of Information Studies

FOR MORE INFORMATION Web: www.shef.ac.uk/i References: Bacigalupo R, Bath PA, Booth A et al. (2002) Studying Health Informatics from a distance: issues, problems and experiences. Health Informatics Journal. 7.3/7.4:138-145. Bath PA (2008) Health informatics: current issues and challenges. Journal of Information Science, 34 (4): 501–518. Booth A, Levy P, Bath PA et al. (2005). Studying health information from a distance: refining an e-learning case study in the crucible of student evaluation.

Health Information and Libraries Journal 22 Suppl 2:8-19. Burns F (1998) Information for health: an information strategy for the modern NHS 19982005. A national strategy for local implementation, NHS Executive, Leeds). UK CHIP (2010) Professionalism in Health Informatics. Available at: http://www.ukchip.org/?q=page/ProfessionalismHealth-Informatics (Accessed March 2010).

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E-learning.

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Hospitals, Fire & Rescue and Police services are just some of the organisations benefiting from training entire teams without missing a single day of work.

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A NEW APPROACH TO E-LEARNING E-learning works best when the training relates to real life. A new e-learning environment developed by Airwave is soon to be used on the clinical wards of NHS Trusts in the East of England to ensure that acute care patients get the best treatment possible LEARNING BY DOING IS GENERALLY more effective than learning by listening or reading. When learning is by doing, people are more likely to remember what they have learned. More importantly they are more likely to digest or process the information they are receiving, and reflect on how they learned – especially if they’re able to see the relevance of what they are learning, so that the information is seen in context and is connected1.

A new programme putting this very approach into practice is being rolled out over the next few months. The bespoke, web-based software training being produced by Airwave for the Norfolk, Suffolk and Cambridgeshire Critical Care Network, is set to revolutionise the care of acutely ill patients in general hospital wards throughout the region.

Aimed at general ward nurses, student nurses, healthcare assistants, or anyone in a clinical setting who plays a role in the care of acutely ill patients, the e-learning software helps to minimise the risk of unsafe care by raising the skills levels of nursing staff.

Lorna Garner, director of the Norfolk, Suffolk and Cambridgeshire Critical Care Network, says: “The new system enhances traditional learning. Its format delivers quality assured training and matches content to the individual learning needs of ward-based staff.”

This flexibility means it can accommodate differing learning requirements, and reduces the amount of time staff spend away from the workplace on training.

“The difficulty about training NHS clinical, particularly ward-based staff, is that they’ve all got very hectic work rotas, so time is unbelievably precious,” says Garner.

Training benefits are felt immediately because staff can access content in short bursts when they’re working, or at home, and at a pace which suits the individual learner.

In fact, they can use the system anywhere where there’s a broadband connection.

DUTY OF CARE REQUIREMENTS Trusts can also meet their duty-of-care requirements for providing adequate training and guidelines for staff. Nurses are required to keep their skills up to date, so each learner on the system has their own email address and is contacted regularly about new training materials.

“Because the programme’s structure interrogates and validates staff learning, we can demonstrate our focus on achieving

standards of excellence in the way we care for our acutely ill patients,” adds Garner.

E-learning is more than knowledge transfer.

Rather than deliver information in a static image or textbook-style, the Airwave environment includes elements of rich media, video, audio samples and narration. Its simulation software focuses on seven streams of content, which mirror established clinical ‘ABCDE’ procedures (Airway, Breathing, Circulation, Disability and Exposure), nursing observations and overall assessment of the acutely-ill patient.

These content streams are packaged into a series of short multimedia modules, which last between 5-10 minutes each, and follow NICE Clinical Guideline 50 (CG50) Acutely Ill Patients in Hospital.

Unit. Patients are also able to leave hospital sooner than they might otherwise have done.

Helping staff improve their professional development in such a manageable way, and knowing there will be less chance of them delivering inadequate care, the programme increases staff morale.

DELIVERING ADDED VALUE “Large amounts of learning content stored in libraries do not get used in organisations.

This new system that Airwave has developed is about driving learners to access content by creating a rich learning experience where they need it. The use of real life scenarios make content more realistic and relevant to the learner,” says Andrew King of Airwave.

The new system enhances traditional learning. Its format delivers quality assured training and matches content to the individual learning needs of ward-based staff The programme creates individual learner profiles based on an individual’s needs, interests and job role. Says Airwave’s e-learning specialist, Andrew King: “Working with our customers, we define the sets of competencies that are required, and then prepare assessments that demonstrate competency has been achieved.”

This makes the programme engaging, relevant and, of course, measurable. The management information component of the solution reports on staff performance so that managers can monitor and measure staff skills.

KEEPING COSTS UNDER CONTROL Being delivered as a fully managed and hosted service means there are also no additional technology infrastructure or management costs for the Trust to worry about.

“In this way, the training budget is maximised and operational costs reduced. It’s also a much more cost-effective option compared with conventional classroom training, which takes staff away from the workplace at the very time they’re needed most,” adds King. “It’s also scalable – quick and easy to implement – and there are no long-term costs involved.”

Fewer patients are also likely to be transferred or re-admitted to High Dependency Units (HDU) as a result of improved care on the wards. This relieves the pressure on beds in Critical Care Units and the associated cost this involves – a few hundreds of pounds in a General Ward, compared with thousands in a Critical Care

Experienced in delivering programmes to public safety organisations, Airwave worked closely with clinical experts across the Norfolk, Suffolk and Cambridgeshire Critical Care Network to create the e-learning system. Having worked through a tender process, Critical Care Director Lorna Garner identified a number of companies, which were capable of delivering a content delivery system to the Network’s specifications.

“Then we looked at added value. Airwave was the only company that came up with a very broad range of added-value and an innovative delivery programme. And it was on this basis that we selected the company,” recalls Garner. “More importantly, Airwave has provided us with a training solution we can use again and again.”

Notes 1. School of Biochemistry & Molecular Biology, and Learning and Teaching Support Network – LTSN – for Bioscience, University of Leeds: ‘Exploiting Knowledge of how People Learn to Promote Effective Learning’, BEE-j Volume 3: May 2004

FOR MORE INFORMATION To find out more about how e-learning can help you, please get in touch: Tel: 08000 11 33 99 E-mail: airwave.sales@airwavesolutions.co.uk Web: www.airwavesolutions.co.uk

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UNLOCK PRODUCTIVITY FOR PERFORMANCE GAINS 50 per cent more patients can now be examined by the cardiac MRI system at The Royal Bournemouth Hospital due to a new technology upgrade THE NUMBER OF PATIENTS THAT hospitals expect to see over the coming years for cardiac MRI is increasing. Incidents of Coronary Heart Disease, the UK’s biggest killer, continue to rise fuelled by soaring obesity rates and other lifestyle influences. The need for fast and accurate cardiac scanning facilities is high, to identify conditions early and minimise the impact on the long-term health economy.

The efficient utilisation of equipment such as MRI and CT scanners is the first step in ensuring that you are receiving a solid return on capital investment. But once the service is at full capacity, what more can be gained?

The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust took an inquisitive approach towards addressing this question in partnership with Siemens Healthcare. Although its MRI scanner was working at maximum capacity, which ticked the box on utilisation, it recognised that there was the scope to make image gathering more efficient in order to cope with increasing patient numbers. A day optimising throughput (Dot) software engine was added to the existing system to accelerate the power and increase productivity.

INCREASING CAPACITY “The increased scanning speed has raised patient throughput by 50 per cent allowing six patients to be scanned in a four hour session rather than only four before. Now we can scan over 1,000 cardiac patients a year using only 10 per cent of our total scanning capacity,” states Dr. Russell Bull, consultant radiologist MRCP, FRCR. Siemens’ Dot optimises the patient examination strategy, automating the steps needed to get a high quality scan and adapting to the patient’s condition. It guides radiology staff through each step required, even in the most complicated examinations. This speeds up standard scans with fewer errors or the need for repeats, plus it intelligently advises in more complicated cases.

“Our patient population is almost exclusively adult and Cardiac Magnetic Resonance (CMR) is carried out frequently to provide structural and functional information, particularly for planning revascularisation strategies in patients with known coronary artery disease.

This information is then used for planning ways to restore blood flow. The complexity of procedures and the lack of familiarity with cardiac anatomy presented major issues in staff resource allocation and training,” states Dr. Bull.

Using the Dot software the most difficult MR examination has become much more straightforward and even relatively inexperienced staff members are now able to scan cardiac patients quickly and efficiently

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“Using the Dot software the most difficult MR examination has become much more straightforward and even relatively inexperienced staff members are now able to scan cardiac patients quickly and efficiently. Today, all 16 of our scanning staff perform cardiac examinations compared with just three people before.”

This ensures better utilisation of every member of staff in the department to perform at the same standard. It also means that historically difficult cardiac examinations can be incorporated into the general workload of a busy general hospital rather than having to have dedicated slots when the necessary skilled staff members are available. Traditionally this approach slowed down the number of patients that could be seen and the resulting diagnosis and treatment planning.

BETTER QUALITY ASSURANCE “The automation of the imaging process by the Dot workflow engine makes it easier to obtain high quality scans and streamlines the diagnostic process from patient preparation to viewing the acquired images. Results are now much more robust and the quality is consistently high,” continues Dr. Bull.

“Furthermore, with scan images at a better level of quality, consultants have quick and accurate information to make diagnostic decisions and prescribe the course of treatment.”

The intelligent software engine also offers an intuitive and built in training tool to reduce the need for external training sessions. This

delivers greater cost returns as no future outlay is required and provides an ongoing resource for all members of staff to engage in or refresh on functionality on a frequent basis. This keeps departmental knowledge high at all times and ensures that new staff can learn quickly.

THE PATIENT’S CHOICE Departmental objectives of keeping the number of patients seen each day at an optimum level must also be driven in line with the experience received. Dr. Bull states: “Although our throughput is now much swifter, the patient also gains a more positive experience spending less time in the scanner undergoing an examination. MRI scanning can be a claustrophobic experience for some so a reduced amount of time to achieve results removes associated anxiety. This could become an added advantage if hospital income linked to patient satisfaction comes to life later this year.”

He continues: “The number of referrals from cardiologists to the hospital has also increased due to the speed at which we can scan patients. Patients given the choice would rather be in and out the door in half an hour than a more lengthy procedure at alternative facilities. This is a positive reflection on the Trust’s reputation and positions the hospital’s imaging service as highly competitive.”

Whilst the decision to automate and simplify the cardiac MRI was via clinical leadership, the benefits are also delivered to satisfy Trust objectives and the wider NHS agenda.

THE ROYAL BOURNEMOUTH HOSPITAL The Royal Bournemouth Hospital is part of The Royal Bournemouth & Christchurch Hospitals Foundation Trust, which provides healthcare for over 550,000 residents of Bournemouth, Christchurch, East Dorset and parts of the New Forest.

It offers a comprehensive range of outpatient and inpatient healthcare services, including a large regional cardiac unit, the Dorset Heart Centre, which performs over 2,500 procedures per year.

An increase in CMR capacity delivered by a cost effective technology upgrade to the existing scanner means that more patients can be seen during the working day. This exciting technology has the potential to be a source of additional revenue for the Trust.

Staff resources are also better utilised by the automation of clinical procedures guaranteeing a better result first time. This leads to improved efficiency and financial performance. Finally, and at the heart of clinical decision making, the patient experience is enhanced with shorter scanning times and a better result first time.

Notes: MAGNETOM® Avanto 1.5 Tesla MRI system from Siemens Healthcare was upgraded with ‘day optimising throughput’ (Dot) software engine.

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HE DEPARTMENT OF Health’s recent publication, ‘Commercial Skills for the NHS’ identified capital equipment management as an area in need of transformation if trusts are to maximise savings potential in the future. We’ve invested heavily in our capital equipment offer to set this transformation in motion.

In 2008, the NHS saved around £16 million across medical imaging, devices and equipment maintenance spend through using the capital services from NHS Supply Chain.

“As part of the next stage of our capital equipment offer, we’ll be moving into new areas that offer additional value to trusts, such as capital planning management, leasing and equipment disposal,” says Andy Brown, managing director of Diagnostics at NHS Supply Chain. “By transforming the way that equipment is bought and managed by the NHS, our capital planning team will be able to construct bulk buy and commitment deals with suppliers to bring more value to the NHS.” With public sector budgets coming under greater scrutiny in the coming years, the opportunity for trusts to access innovation and achieve better value without compromising on quality is a major advantage, particularly if the NHS is to meet government targets on key healthcare initiatives.

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buying teams to reflect the needs of the NHS,” continues Andy. “Examples of this are the Women’s Health portfolio to support the government’s £100 million digital mammography programme. We’re working with national and regional breast screening organisations to identify the specification and procurement of equipment to achieve best value. We also have a specialist Decontamination Buying team to

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INFORMATION TECHNOLOGY

TECHNOLOGY IN TRAINING NEC Display Solutions is able to offer the widest range of medical displays, desktop displays, large format displays and projectors A VITAL COMPONENT OF TODAY’S modern health care is the Picture Archiving and Communication System (PACS), which is integrated throughout a facility to provide access to medical images and data. Medical facilities nationwide, if they have not already adopted a digital format, are currently looking at a facility-wide implementation of the latest technology to support the use of PACS. It is therefore incongruous that still today, medical training establishments have not followed suit.

Radiology students are trained using a film format to study and interpret x-rays. There is an enormous disparity between the use of digital imaging techniques compared to that of film format. Digital imaging produces a more flexible image with exceptionally high resolution and wide gray-scale, leaving film images in the dark ages in comparison. Consider too the tools available such as zoom, window level and colour options allowing the radiologist incredible control to examine the smallest detail.

You would not see a consultant in a clinical environment today, using a magnifying glass!

INNOVATIVE MEDICAL DISPLAYS As the leading manufacturer of innovative medical displays, NEC Display Solutions is well positioned to deal with the challenges of hospital wide digitalisation processes. NEC Display Solutions is able to offer the widest range of medical displays, desktop displays, large format displays and projectors to meet the demands of any medical application ensuring the highest standards of crossdepartmental integration to a common standard (DICOM Part 14). It is this level of quality and functionality that is in common use in the clinical environment so it is time for medical training facilities to keep on track, gain a competitive advantage and attract the cream of today’s savvy medical students.

The educational environment is gaining pace in recognising the benefits of technology and embracing the latest techniques to enhance the learning experience. Students today are bombarded with interactive technology and moving images and in order to gain mind share it is necessary to harness this potential for education. To this end, educators must look to increase student interaction and participation to aid the absorption of information to generate knowledge.

One interactive tool in increasingly common usage is the Interactive White Board. NEC’s collaborative visual learning solution combines the latest NEC NP610S short-throw projector and one of three projector-mounting options with aSMART Board™ interactive whiteboard and SMART Notebook™ collaborative learning software. Together these products

offer a powerful and affordable interactive display solution for the education market.

Another interactive tool is the touch screen.

By integrating a touch overlay, an NEC large format LCD becomes a powerful collaborative learning tool enabling student to annotate information and become a participant in the learning experience. Touch screens are increasingly being used in the clinical environment such as A&E departments to track the movement of patients and store data.

Recognising the importance of cleanliness within hospitals, NEC’s Solutions Partner, U-Touch has developed an infection control hood which encapsulates the display enabling deep cleanse processes without effecting performance.

MAXIMISING POTENTIAL Understanding the benefits of interaction, we can maximise its potential by linking a number of displays across a facility or even across multiple locations. NEC can provide a network solution, linking students with lecturers and consultants at different locations to enable remote training. For example, using video conferencing techniques it is possible to perform a live video feed over internal networks to enable students to observe surgical procedures in real time. There are enormous benefits to be gained within healthcare through use of video conferencing, primarily savings in time and travel costs for specialist consultants who are able to impart their expertise without leaving their own setting.

The use of 3D technology has gained much popularity in the field of entertainment recently but there is enormous potential for its use within education as we continue to look for ways to enthuse our students. Within the medical field, 3D has obvious advantages in enabling students to view body parts and explore the human anatomy in new and exciting ways with limitless possibilities.

The new NP216 from NEC brings 3D visualisation within reach of smaller budgets in the form of a mobile projector although still requiring the use of 3D glasses. 3D without the use of glasses is also possible by utilising a 3D overlay integrated on a large format LCD such as the NEC Multeos. 3D visualisation enables greater productivity and efficiency in surgical planning, training and exploration by facilitating applications such as visual endoscopy.

The advancement of PACS has necessitated investment in technology across medical facilities. To ensure that tomorrow’s healthcare workers are equipped to provide their patients with the best care possible it is imperative that today’s training facilities reflect this level of investment and provide the quality of technology in everyday use in the clinical environment.

FOR MORE INFORMATION For further information contact NEC Display Solutions on 08701 201160 or visit www.nec-display-solutions.co.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Put Your Trust in Capable Hands Leasing helps you make the most of your budget.

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*Global Finance, October 2009

Health Business | Volume 10.2

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FINANCE

FINDING THE RIGHT FUNDING Be sure to investigate all your funding choices before investing, says the Finance and Leasing Association WHEN THE GOVERNMENT NEEDS TO invest in new equipment or other assets, it tends to go for one of two extremes. It either enters into a deep, long-term relationship with the private sector through the Private Finance Initiative (PFI) or a Public Private Partnership (PPP), or it tends to go it alone.

There really isn’t any need for this dichotomy of approaches. Through leasing the government can work with the private sector when investing in most types of assets. So why does the government often choose to work with the private sector on some of its largest investments, but less often on smaller ones?

PROVIDING PUBLIC SERVICES PFI/PPPs can help the public sector when making large-scale investments in providing public services. In a PFI arrangement assets are built, owned and maintained by the private sector operator. The operator also uses the assets to provide a service to the public sector or general public. In a PPP the public sector owns part of the assets and may have more involvement in how the assets are used to provide services. Over 500 PFI/PPP projects are in operation, with another 200 in the pipeline.

Forming working relationships with the private sector through PPP/PFI doesn’t guarantee success. The key question, according to the National Audit Office (NAO), is whether the PPP/PFI can deliver something better than could have been obtained through a different procurement route. Despite some failures, which tend to attract a lot of publicity, the NAO has found many examples of successes.

LEASING AS AN ALTERNATIVE Most investments by the government are on a scale too limited to make it attractive as a PFI/PPP arrangement. However, while a deep, long-term relationship with the private sector might not be appropriate, leasing can offer a more suitable alternative. The public sector rents the equipment from a leasing company, typically for up to five years. It then either returns the equipment at the end of the rental period, or extends the period of the rental.

Leasing is already used in the public sector, particularly for vehicles and medical equipment.

The Office of Government Commerce agreement operates a pan-government framework for the lease of cars and carderived vans, which it estimates is worth up to £270 million over a three-year period.

The NHS Purchasing and Supply Agency has a national framework for operating leases, which is intended to help NHS bodies to procure leases more cost efficiently and effectively.

The NHS spends in the region of £500 million a year on operating leases, covering a diverse range of medical and support equipment.

WHY LEASE? Private sector leasing companies may be able to buy equipment for less than a local authority or central government department. The leasing company will often offer asset service and repair, which takes the headache away from those delivering public services. Leased assets can simply be handed back at the end of the agreed period, allowing new equipment to be leased. Finally, at the end of the lease, private sector leasing companies are also experts in selling equipment into second hand markets.

Taken together, these benefits mean that by working with the private sector through leasing the public sector might be able to reduce the cost and increase the quality of public services.

Despite these potential benefits, however, most local and central government equipment is bought outright rather than leased. Of course, for some equipment, purchasing may deliver better value than leasing. But too often, leasing is given scant consideration by decision-makers.

Consequently the best-value deals are missed.

COMPARING COSTS In most cases it can be argued that the cost of the government’s borrowing is less than that of leasing companies. However, it doesn’t necessarily follow that cheaper funds automatically makes purchasing more attractive than leasing. Only by comparing the total costs of equipment purchase, operation, and disposal can a proper comparison be made.

The situation has changed in recent months with the blurring of boundaries between the government and the major banks, which are also many of the largest leasing companies.

Any type of partnership between the public and private sector requires a degree of trust between both parties. In leasing, an important way of achieving that trust is to use a leasing provider that is signed up to the Finance and Leasing Association’s (FLA) Business Finance Code of practice.

FLA members will ensure that customers are well informed before they enter into a new agreement, so that the full costs are clear. They will ensure that agreements are appropriate for the type of assets being financed. This means, for example, that they won’t offer a seven year lease on equipment that is unlikely to be useful for more than five years.

FLA members are required to have effective procedures for handling complaints. The FLA also operates conciliation and mediation schemes for business finance agreements, although these are very rarely needed.

Just as in PPP/PFI, the key question for leasing is whether it can deliver something better than could have been obtained through a different procurement route.

In many cases, the answer is that it can.

When it comes to investment in equipment, whether in the largest deals or smaller ones, it’s not always necessary to go it alone.

FOR MORE INFORMATION Tel: 020 7836 6511 E-mail: info@fla.org.uk Web: www.fla.org.uk

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Professional Role Players Acting-Out is based in Derbyshire at the heart of the country. Acting-Out provides Professional Actors for Role Play in Training situations. All Actors are professional, trained and highly skilled and experienced in both Physical and Mental Health Patient Simulation Scenarios.

Working with you we make certain that your objectives are fully realised. Our in-house training ensures that all our Actors are equipped with the skills and knowledge to portray what you require.

Acting-Out has provided actors to NHS Trusts and Teaching Establishments for the Training of Doctors, Nurses and Students. We also work in exam and exam preparation situations. Testimonials and References are available.

When you use our skilled professional Actors you allow your trainees to experience and experiment with their learning in a safe, controlled and realistic environment which is as near to their ‘real life’ experience as can be created.

Our actors are experienced in giving empathetic and constructive feedback.

Acting-Out is operated by experienced professional role play actors who understand what you require from your role-play scenario. We hold a large data-base of professional trained actors based through-out the country, this enables us to select the most appropriate actor(s) for your needs, getting it right first time, every time.

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FACILITIES MANAGEMENT

ALWAYS IN THE NEWS With the NHS and healthcare related topics seemingly always in the news Keith Sammonds, managing director of the Healthcare Facilities Consortium, takes a look at some of the March 2010 news items and their relevance to facilities teams AS I WRITE THIS1 WE ARE AWAITING the announcement of the date for the General Election (almost certainly 6th May and if not then I for one want to know how Gordon Brown can justify the waste of our money by forcing a second set of election expense when the local council elections are already taking place in the correct time frame). Much of what we are currently looking at in healthcare facilities management will be affected to some degree or other by the outcome of that election. But it does look as if it is only the degree that will be affected and not the overall direction; that seems to have been determined by the government’s reaction to the banking crisis and the recession.

REALLOCATION, REALLOCATION Already this week, and it is only Tuesday lunchtime, we have heard that in order to save money, the battalions based in Germany, due

to relocate to Staffordshire and Shropshire, will now not be doing so. Their repatriation is on hold as the funds to do so are needed elsewhere. Politicians on our local radio are asking how it is less expensive to keep troops abroad than at home. I don’t know but without facts I find it hard to fault their logic. It must be better for Britain to have British Troops and their

families spending Sterling in British towns than in Germany. Or is this too simplistic a view?

And how is this relevant to healthcare facilities? An influx of several thousand MOD staff with their families will create a demand on local healthcare provision and this needs to be planned for. The PCTs in the areas concerned will already have been looking

An influx of several thousand MOD staff with their families will create a demand on local healthcare provision and this needs to be planned for. The PCTs in the areas concerned will already have been looking at the increase in demand on GP and other Primary Care services, and the facilities that support these need to be in place or at the very least planned for

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

31

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FACILITIES MANAGEMENT

at the increase in demand on GP and other Primary Care services, and the facilities that support these need to be in place or at the very least planned for. Additionally such an influx of healthy and active young men and women will reasonably increase demands on the local A&E and Maternity Services at the very least. Is there current capacity or is an expansion required? All this will have had to be looked at and now with the troop movement postponed any planning or actual construction will need to be put on ice too.

At the same time the TV news was also reporting on the battle one man had after spending £100,000 of his own money in America for Proton Treatment for a spinal tumour.2 The outcome of his battle was a win for patients who are now being shipped abroad for this treatment on the NHS and, the report says, we may have a facility for this kind of treatment in the UK in 2015. How can this be cost effective and timely management of our health service provision? Surely as the technology is proven and available for use in other countries we should have been planning for its implementation alongside some of the developments that are just coming on line?

The third news item that caught my eye was a local newspaper report on NHS car parking3 and highlighted three hospitals that made a £2M surplus on their car parking provision. Again, without the facts (and all the newspaper reported was this headline figure as the rounded up sum of the surpluses from the three hospitals) it is difficult to comment. Important information would be: • the number of charged for spaces • average charge levied • percentage occupancy of spaces at peak periods • number of supported or complimentary tickets • cost of car park maintenance

• cost of security and attendants • number of thefts of or from vehicles • if the surplus went to the NHS or commercial contractor But of course all of this gets in the way of a “good story”.

BEST PRACTICE IN PARKING As a regular user of car parks at hospitals all over the country I am only too conscious of the need to control and regulate use and so I was thrilled a while back when we were invited to support the launch of a new Car Parking Charter for Hospital Car Parks. Just last month the British Parking Association (BPA) launched its Charter for Hospital Parking. In this, supported by both the NHS Confederation and the Healthcare Facilities Consortium, as the organisations representing the NHS and Healthcare Facilities Management Teams, the BPA lays out a set of protocols to strike the right balance between being fair to patients, visitors and staff and making sure that parking facilities are managed effectively for the good of everyone.

Parking charges are a pain but why should hospitals near city and town centres provide free car parking for commuters funded

by NHS money that should be providing healthcare? In Scotland, where parking on all but three hospital sites is free, the Fire Service recently had to be called in to remove illegally parked cars from the helipad area so an Air Ambulance could land. Clearly this sort of situation cannot be allowed to put lives in danger.

Within the HFC we have long supported and propagated the use of Best Practice and we are pleased to add our support to this Charter as a Good Practice Guide. Although written with the English NHS Trusts in mind, because of the no charge situation in Scotland and

Wales, we see the Charter as being applicable to all healthcare premises throughout the UK. The important thing is that this is a positive step towards raising standards and we encourage all healthcare provider organisations and their parking contractors to sign up.

BPA had obviously consulted amongst their members and service users and on 23 February the English Department of Health closed its own public consultation on hospital parking. At the time of writing no response to the consultation had been posted but we have received acknowledgment of the response we submitted on behalf of our members and look forward to seeing the outcome provide of course that it does not disappear in the cloud of election fever.

CLIMATE CHANGE Looking at other issues it was very interesting to hear David Pancheon talking at a recent NHS Confederation forum on Climate Change.

He noted that it was time to move from aspirational objectives to promoting actual case studies and Trevor Payne, director of Estates at UCLH, cited their “tube map” of delivery routes as such an example.

By working collaboratively they have been able to significantly reduce the number of large lorry deliveries to hospital premises in Central London. Being able to highlight real success stories that prove environmental sustainability whilst showing real world cost and process savings has to be a meaningful step forward.

Now let’s wait till May and see which colour of political flag is waved over it!

Notes: 1. Article written on Tuesday 16 March 2010 2. BBC Midlands Today Monday 15 March 2010 3. Express & Star Wolverhampton City Edition Monday 15 March

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nurse call syst o i d a r s s e l em Wire

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FACILITIES MANAGEMENT

SURVIVE, STRIVE AND THRIVE While the government is busy planning the next general election, the Northern and Yorkshire branch are also busy organising the 2010 HefmA National Conference. Health Business takes a sneak peek into the plans WITH OVER 60 COMPANIES EXHIBITING and the introduction of visitors as well as conference delegates, the 2010 HefmA National Conference – taking place 26-28 May – is shaping up to be bigger and better than ever before. Set in the historic backdrop of Harrogate in North Yorkshire, the forthcoming conference aims to give estates and facilities managers the arena to discuss and debate how the NHS can survive, strive and thrive, not only the economic downturn, but the bleak financial outlook for public spending over the next few years.

As the Northern and Yorkshire branch explains: “We know now that over the next three years there will be a reduction in real terms regarding the monies available for healthcare, which will have a direct impact on the services we provide. We have brought together a range of experts from the field to share their vast knowledge of driving change and service improvement in a demanding and ever changing environment.”

Chairing the conference will be Nigel Grinstead, chief executive of the About Health Group, which specialises in working with groups of clinicians who want to provide high quality services under contract to the NHS. Organisers say they have chosen Nigel because he “has a comprehensive understanding of the services we provide to our patients and customers”. He has more than 20 years experience working in the UK health and care sector, particularly with GPs, secondary care clinicians and commissioners.

Nigel also has excellent links into national policy making. He has contributed to workshops and policy sessions for the Department of Health, the Welsh Assembly Government and the Cabinet Office. He was also involved in setting up the national Clinical Governance Support Unit and has vast experience in facilitating high profile events and conferences.

SPEAKER LINE UP The line up of speakers is proving to be equally as impressive: Rob Smith, director of Gateway Reviews and Estates and Facilities Management, will outline how our professional leaders at the DH are establishing a framework for delivery of the quality and efficiency programmes.

Andy Nicholson, chief executive BT Global, will share with delegates the work that has

We have brought together a range of experts from the field to share their vast knowledge of driving change and service improvement in a demanding and ever changing environment been undertaken in a business environment to maintain their business with a competitive edge.

Stephen Eames, chief executive of County Durham and Darlington NHS Foundation Trust, will enlighten delegates on the work programme he initiated called ‘Seizing the Future’, which is aimed at providing efficient and effective services across a challenging and competitive health economy.

Alan Maynard, Professor of Health Economics, University of York will look to explore healthcare reform and evidence based policy and how this will impact on the future provision of healthcare.

Keynote speaker Baroness May Blood MBE was born in Belfast and for the last 30 years has lived in the Springmartin area of West Belfast. For 39 years she worked in a mill as a cutter, during which time she became an active trade unionist. In 1996

she became the first woman in Northern Ireland to be given life peerage. The Baroness will share her hard-gained experiences through life and work against a background of extreme adversity as a passionate advocate for those living with the effects of poverty, particularly in relation to housing, unemployment and early year’s education.

Darryn Kerr, director of Facilities from Leeds Teaching Hospitals NHS Trust, will share his experiences from delivering frontline services in the largest Trust in England.

There will also be a number of workshop sessions covering workforce, the development of the BSI Cleaning Standard and innovation within the NHS. CELEBRATING SUCCESS Of course, the HefmA Annual Awards will be back to recognise and celebrate

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Floors holdgers hidden dan costs and hidden

ays develop left alone alw ed floors will, ag ke. These m ali da es or ye s ce plo Uneven surfa mers and em sto cu r ing costly fo ak s m rd n ofte haza into potential oblematic very pr ly nance te ine ut ain ro m are and types of floors giene control rs usekeeping, hy rface slowly get worse. Floo ll ho on ds an dem ets or vinyl su slip, trip and fa rp of ca e ce th ur so as a s budget velop into n routinely de in this conditio costly claims. to d lea n ca ide floor risks that rated nationw s a fully integ ide r the fo ov pr ice g rv rin se Bonus Floo y floor repair and and emergenc avoid the cost to g kin loo maintenance er ag liers. an pp m su s l ra itie ve cil se professional fa and managing r with the ing ide nis ov ga pr or ice of serv quality pit-falls urce flooring so vers all co gle at sin th a ills sk g is management Bonus Floorin ct oje pr d an bility see. in-house capa e bits you don’t lines, even th ntrol flooring discip l Tota quality co e supplier 3 on ll; ca s e ice rv On Benefits: 3 clusive floor se ective 3 All-in 3 Quick & eff hone advice lep te ee Fr t 3 3 Cost efficien NUS FLOOR es TRY A BO ch da ea 0 861666 H g For floorin Ltd. Tel: 01430 861600 Fax: 0143 g rin oo Fl s nu k Bo co.u bonusflooring.

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FACILITIES MANAGEMENT

those working in estates and facilities who make a difference and go above and beyond their call of duty. The Annual Awards will also be presented at the Gala Dinner for the following categories: Facilities Manager of the Year will be made to the person who demonstrates outstanding personal performance and career development in delivering estate and facilities services that are highly regarded by service users.

The judges will be looking for an innovative approach to facilities management within the NHS and will make their decision based on how the person has applied their skills to solving major issues; initiated change which has ultimately led to improving the patient experience; and how they have contributed to facilities management as a whole.

Project Manager of the Year will be awarded to the individual who best demonstrates the most effective project management competence, no matter the scale or type of project. Project managers should be able to:

• Create an environment for success • Provide the drive and impetus to innovate and achieve • Have balanced technical and management skills • A high degree of communication and interpersonal skills • Remain focused to ensure the objectives of the project are met Facilities Team of the Year will go to a team of people who can demonstrate that they have consistently delivered excellent services to their customers including patients, staff, and visitors. The team may be as few as three or many more. The judges will be looking for evidence of: • What service improvements have been delivered to improve their customers’ experience • Improved patient experience • Improved patient satisfaction scores • Genuine team spirit Training Initiative of the Year recognises a

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team or individual working in the NHS who has met one of more of the following criteria: • Developed an innovative training initiative that adds value to estates and facilities functions • Introduced a training initiative that has improved services for greater efficiency • Managed their training in such a way that demonstrates creative technical innovation • Enabled all tiers of the workforce to access training, learning and development The Northern and Yorkshire branch says: “The Awards are an opportunity for our industry to recognise and pay tribute to individuals and teams across the country that are making an outstanding contribution with NHS estates and facilities services, which play an integral part in improving the patient environment an experience.”

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Specialists in stainless steel medical furniture and equipment EKNOMEK LTD is the UK’s leading manufacturer of stainless steel hygiene equipment and furniture.

With over 20 years expertise servicing the furniture and equipment needs to all sterile industries where hygiene standards are the highest priority, Teknomek is known for providing high quality and cost-effective stainless steel solutions. This has led it to develop a state-of-the-art manufacturing and design facility in the UK that offers the following benefits: Quality – reliable and hygienic in the harshest of manufacturing environments. Its products are therefore built to last, manufactured to its exacting standards from 304-quality stainless steel by its highly experienced engineers.

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may be looking for a customised version of one of Teknomek’s catalogue products. As these are Teknomek’s own designs they already know how to make them to the highest possible quality standards providing customers with a cost-effective custom-made solution.

Bespoke design – Teknomek’s in-house design team and manufacturing facilities means it can take customer’s sketches and turn them into reality.

FOR MORE INFORMATION Order direct from our online catalogue on www.teknomek. co.uk, e-mail us at mail@ teknomek.co.uk or call today on +44(0)1603 788833.

Alternatively, fax us your design on +44(0)1603 895052.

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Take one to relieve backache, neck pain and headaches Introducing headsets from Plantronics – taking the pain out of using the phone If you constantly have your ear glued to your phone at work, you’d be far better off with a headset. Using a wired or cordless headset means that you can work without crunching up your shoulder and tilting your head, improving your posture and your health. Tests have shown that they can reduce back pain, headaches and neck pain by as much as 31%*.

At Plantronics, we’ve spent over 40 years designing and refining headsets.

With the combination of stunning design, perfect sound quality, comfort and durability, it’s no wonder that more and more people worldwide feel happier talking with our headsets.

And right now, you can try one for free.

Call us on 0800 0855 655 and quote ‘health business’ or visit www.myofficeheadset.com before 30.04.2010 for your free trial. *Research from the University of Surrey.

©2010 Plantronics Inc. All rights reserved.

Written By Paul Clark, Director for the UK and Ireland, Plantronics

www.healthbusinessuk.com

HEADSET HEALTH CHECK By introducing wireless headsets, companies can reduce the occurrence of many posture related ailments while enhancing workers’ experience A HEALTHY WORKFORCE IS CRUCIAL to a successful business. Issues such as repetitive strain injury and chronic back and neck pain, as a result of poor posture, are among the highest causes of long term absenteeism in the UK. According to statistics from the National Back Pain Association, back pain affects 17.3 million people in the UK and is a key contributor to the £13.2 billion lost by UK business a year as a result of illness.

When looking at ways of enhancing employee health in the workplace, many companies often resort to replacing furniture and training staff – all at a relatively high cost. Yet by simply introducing wireless headsets, companies can reduce the occurrence of many posture related ailments while enhancing workers’ experience.

WORKPLACE ENVIRONMENTS The type of workplace environment is significant when determining the impact a wireless headset can have on health. Research by the Health and Safety Executive found that front line call handlers experience significantly higher stress levels than people in other occupations. NHS call centre agents for example, are a high risk group. Working in fast-paced environments where the flow of work can contribute a great deal to work-related stress and dissatisfaction.

However, call centre agents are not the only ones at risk. The average office worker, in any environment, can spend from 25 to 40 hours a week in a static position in front of a computer or on the phone. In these cases there is great potential to damage posture. This is compounded further by poor lifestyle habits involving long journeys to and from work, and topped off with a TV dinner on the couch instead of exercising.

COMBATING BACK & NECK PAIN According to the Chartered Institute of Personnel and Development, back pain is the second largest cause of long-term absence in the UK – yet it can be easily prevented by ensuring that working environments are back friendly.

Poor use of telephone handsets is the most significant cause of work related disorders of the neck and back, as the simple act of routinely squeezing the handset against the shoulder can cause not only discomfort but potentially structural tissue damage.

According to research, headsets reduce neck pain, upper back pain, and shoulder tension by as much as 41 per cent. And, not only is there a health incentive, but studies have shown that using a headset instead of holding the phone frees up a hand and can improve productivity by up to 43 per cent. When considering the stressful environment experienced by call

The health benefits of wireless technology are not constrained to combating back pain and RSIs. Wireless environments also allow a degree of freedom for employees; reducing the time they spend ‘tethered to their desks’ centre operatives, this can be a significant advantage when faced with the high-stress, fast-paced environment in which they operate.

Repetitive Strain Injury (RSI) from poor posture when using telephone and computers is another symptom of a poor working environment.

Although frequently overlooked it is equally addressable through use of wireless headsets and properly adjusted, ergonomic workstations.

BEYOND BACK PAIN The health benefits of wireless technology are not constrained to combating back pain and RSIs. Wireless environments also allow a degree of freedom for employees; reducing the time they spend ‘tethered to their desks’. From a psychological standpoint, the ability to walk around the office and stretch their back and legs while on a call can help make them feel more active and refreshed both mentally and physically, which in turn can enhance productivity.

At a more advanced level, wireless technology can also be used to support employees when working from home.

Although not directly health related, 2009 saw significant strain put on industry as a result of swine flu. Here, wireless technology and headsets supported employees in their

efforts to work from home, minimising potential exposure to sick colleagues and safeguarding the overall health of employees.

CONCLUSION The use of wireless headsets benefit businesses by improving employee health and reducing absenteeism. With the freedom a headset provides, awkward and prolonged static postures of the head and neck are avoided; and by reducing absenteeism in this way, businesses also benefit from increased productivity in the workplace. Ultimately, wireless headsets are a cost effective solution for business owners and facilities managers to improve the working environment and improve working conditions in the workplace.

FOR MORE INFORMATION Call us on 0800 0855 655 and quote ‘Health Business’ or visit www.myofficeheadset.com before 30.04.2010 for your free trial.

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This professional platform will encourage inclusive discussion and development to promote clear benefits for.…

Our Patients, Our Colleagues and Ourselves.

The 2010 event will offer: • • • • •

An exciting new format which includes interactive sessions Increased networking opportunities with like-minded professionals A dedicated, professional environment within our recognised friendly atmosphere Acquire practical skills in surgeries with leading practitioners In-depth examination of our working partnerships, the challenges we face and a means to identify how we improve our patient experience • Shared learning through exposure to industry experts and specialists • Access to key customers and decision makers

All this - and much more - will be available to YOU As a Delegate;As an Exhibitor;As a Professional Colleague Don’t miss out - Put the dates in your Diary now!

Join us to advance our Patient Experience.

Health Business | Volume 10.2

www.healthbusinessuk.com

HOSPITAL CLEANING

THE NEED FOR STANDARDS IN HEALTHCARE CLEANING Carina Bale, National Chair of the Association of Healthcare Cleaning Professionals, discusses the need for standards in healthcare cleaning ABOUT THE AUTHOR Carina Bale has been working in the healthcare cleaning sector for over 20 years. Her past experience includes working within the leisure industry and the private mental health sector.

Having been recently elected as National Chair for the Association of Healthcare Cleaning Professionals, she is delighted to lead the association which provides access through a professional avenue to national cleaning excellence and best practice.

CLEANING IS ONE OF THE DEFINING issues in healthcare today. According to the Department of Health it is the biggest single factor in successfully reducing the indirect transmission of healthcare acquired infections (HCAIs) such as MRSA and C-difficile.

The Association of Healthcare Cleaning Professionals (AHCP) is the principal organisation which defines the standards and represents the interests of the healthcare cleaning sector throughout the UK. Having grown out of the primarily hospital based Association of Domestic Managers, the AHCP now encompasses all areas of healthcare cleaning including NHS and private hospitals, Primary Care Trusts, care and nursing homes, dental and GP clinics and surgeries as well as the mental health field.

To say that the AHCP is the most influential force in healthcare cleaning in the UK today is not an overstatement. AHCP members are present in every healthcare trust in England, Scotland and Wales and in a growing number of hospitals and clinics in both Northern Ireland

and the Republic. Individual membership is steadily growing as is the network of regional branches. Expertise is shared and best practice encouraged through local branch and national study days, workshops and conferences.

EXPERTISE There is very little the AHCP does not know about healthcare cleaning and the government recognises the AHCP’s expertise, knowledge and experience. The current Revised Healthcare Cleaning Manual, commissioned by the Department of Health, was researched and written by the AHCP’s members. It sets out the best practices and processes which are followed throughout the NHS. The Association is now working on a new BSI standard for healthcare cleaning, due to be published later this year. This involves an evaluation of current cleaning regimes and systems, focussing in particular on risk within each healthcare facility. It will result in a new set of procedures and standards for cleaning, and aligns to the Revised Healthcare Cleaning

Manual, providing working schedules and procedures which will become the standard for all healthcare establishments to follow.

A clearly defined set of common standards is essential if we are to make further progress in improving healthcare cleaning and reducing indirect transmission of HCAIs. Organisations have sometimes been left to define their own standards and best practices and there has been insufficient research into what actually works in different environments.

CORRECT PROCESSES The need for standards is particularly critical when you consider that one of the biggest challenges in healthcare cleaning is that implementation of correct processes can often be difficult to achieve. Practice can at times appear to be very remote from policy.

There are a number of reasons for this.

Cleaning processes are commonly delivered by cleaners who are employed on short term contracts and paid close to the minimum wage. Some may not even have a good command of the English language and are unable to understand written directions.

Centralisation of services and increased use of outsourcing in some regions has lead to an impression of a lack of clear lines of accountability.

In the case of outsourcing, there is the widely held view that this has lead to a fall in standards. There is in fact no evidence to support this view. Contract cleaning companies are employed on rigid contracts incorporating clearly defined standards.

They are subject to internal and external independent checks with stringent financial penalties if standards are not met.

Other factors affecting implementation of healthcare cleaning processes include poorly designed and outdated hospitals, increased numbers of beds on wards, increased occupancy rates, the use of temporary staff,

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HOSPITAL CLEANING

absence of isolation or decant facilities as patient lounges are changed into bed bays, and extended visitor access.

More controversially, internal pressures resulting from clinical needs and the need to meet performance targets of, for example, bed turn around time when beds are in high demand can also have a significant impact on implementation.

healthcare cleaning, which is in sharp contrast to the very high level of importance given by patients and the government to the need for cleaner clinics and hospitals.

Nobody working in the sector would disagree with the need to introduce greater accountability, and clearly defined and realistic standards are essential to achieve this.

In healthcare cleaning we all remember

A clearly defined set of common standards is essential if we are to make further progress in improving healthcare cleaning and reducing indirect transmission of HCAIs. Organisations have sometimes been left to define their own standards and best practices and there has been insufficient research into what actually works in different environments Too often in the past cleaners have taken the brunt of comments apportioning blame for things over which they have little or no control. This may be partly as a result of the previously low status accorded to

improve healthcare cleaning and environment standards and patient and public confidence.

Proper research to define what actually works in different environments and establishing a clear set of standards and procedures is the cornerstone of improving healthcare cleaning and reducing HCAIs in the future.

Ever increasing pressures, patient activity and on going infections highlight this as the most opportune time for everyone involved in healthcare cleaning to stand tall and drive forward the level of expertise and introduce new ways of working to improve the patient experience. The AHCP is committed to improving standards and working as a powerful voice to achieve cleaning excellence and leading the way in healthcare cleaning.

that the patient is our ultimate customer.

Patient surveys apparently regularly show a mistrust of cleaning standards in healthcare.

The AHCP is working hard with the cleaning industry manufacturers and technologists to

The 35th annual AHCP conference takes place at the Bristol Marriott Hotel City Centre, 8-10 June LEANLINESS AND INFECTION prevention are now closely aligned.

Both are high on the national agenda and public awareness of cleaning’s importance to healthcare has never been greater. But in an economic climate where we also face growing pressure to improve our costs, what must we do to ensure that service delivery is not compromised?

This year’s conference and exhibition will provide an opportunity to explore new technologies, processes and practices that can help us deliver the best patient environment within the practical constraints that we all face.

Key features for AHCP 2010 include: • New two-day format – more cost and time effective • Professional development – in-depth surgeries to acquire practical skills • Comprehensive exhibition – latest products and technologies on display • Focused networking with your professional community • Challenging and interactive conference – shared learning with industry specialists and colleagues from across the healthcare service.

The conference programme will take a holistic and multi-disciplinary approach to the key issues of the day, including: Cleanliness priorities across the health system:

C

Image courtesy of the Healthcare Facilities Consortium’

what are the issues for GPs, primary, mental health as well as the secondary acute setting?

Plenary conference sessions and special breakout ‘surgeries’ will provide a chance to assess cleaning needs in diverse health environments.

Creating a circle of care: how can we work more effectively with our professional colleagues? Can we foster a more ‘joinedup’ approach to our relations around the patient? Hear from colleagues in nursing, catering, laundry, infection prevention and other key services about the issues they face and discuss the options for more multi-disciplinary co-operation.

Connecting with the patient: How well are we doing? The 2010 conference will

provide a chance to check in on the patient experience and review our performance.

Nurturing our wellbeing: In a very demanding workplace, what new approaches and practices can help ensure the wellbeing of our people and ourselves?

The conference includes presentations from the Patients Association, the Care Quality Commission, and Dr Stephanie Dancer, consultant microbiologist at NHS Lanarkshire. There will also be updates on the HCAI Technology Programme and the NHS Supply Chain’s Annual framework.

Breakout ‘surgeries’ on patient privacy and dignity, and discussion on key issues such as staff engagement means this conference promises the usual lively debate and opportunity to learn with like-minded colleagues. It is not to be missed.

Alongside the conference is a sellout exhibition with key suppliers to the healthcare cleaning sector keen to showcase their latest products and technologies.

There has been strong support from AHCP Sponsor Members and other companies alike and there will be ample opportunity for delegates to visit all the exhibitors.

FOR MORE INFORMATION Web: www.ahcp.co.uk

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Health Business | Volume 10.2

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HOSPITAL CLEANING

HOW CLEAN IS YOUR WARD? Peter Carroll from the British Cleaning Council talks about the importance of cleaning, whether done in house or through a contracted company, and discusses the need for higher cleaning budgets AT THE END OF FEBRUARY 2010 THE Care Quality Commission (CQC) published findings from its enquiry into the standard of care provided by the Mid Staffordshire NHS Foundation Trust between 2005 and 2008. Their investigation was launched after abnormally high fatality rates were recorded at their Staffordshire hospitals over this period, with at least 400 extra fatalities amongst patients identified in comparison to hospitals with a similar case mix.

Although the CQC, the independent regulator of health and social care in England, could not state how many of the deaths were directly attributable to the poor quality of care, it concluded that the hospitals routine cut-backs on cleaning were likely to have been a factor.

It linked the poor hygiene standards on the wards where patients contracted C. difficile infection, to an ingrained culture where patients were routinely supplied with insufficient care.

The origins of the situation were traced to 2006 when the trust set itself a target of saving £10m, roughly equivalent to eight per cent of its overall turnover. To achieve this over 150 posts were lost, including cleaners, despite the hospital already having comparatively low levels of staff. When the commission analysed the trust’s board meetings from April 2005 to 2008, it found discussions were “dominated by finance, targets and achieving foundation trust status”. The commission’s report also identified a culture of concealment: when the infection rate of Clostridium difficile nearly doubled in the early months of 2006, the information was not released to the board or the public.

The controversy surrounding the enquiries findings provoked several days of media debate about whether the early warning system, which is supposed to detect underperformance at trust level, is working effectively across the whole of the NHS. The hospital in Stafford, which employed its cleaners directly between 2005 and 2008, also became a focus of a discussion around the comparative merits of outsourced or in-house ward cleaning.

ACHIEVEING THE BEST RESULTS Is it really fair to use an isolated case of inadequate care to shape the wider argument of how to achieve the safest and most efficient results within hospital cleaning? There are certain health authorities that are dogmatically against the outsourcing of cleaning services by the NHS. But NHS Scotland, which has a near complete ban on contract cleaning services, consistently scores worse on MRSA blood infection rates when compared with the health authorities amongst England (which has a mixture of contract and in-house cleaning).

Although hospital acquired infections (HAIs) fell by a third in the UK in 2008 in the wake of the government-ordered ‘deep clean’, they are almost impossible to eliminate completely, with facilities specialising in vulnerable patients and invasive care posing a greater risk to patients. And even though the stringent guidance issued by NHS Estates to manage the risk of HAIs applies to private contractors and in-house cleaners alike, the case specific nature of the issue means that we will always witness disparate results.

For every trust that has been deemed to be underperforming, there are many examples of excellent performance over a sustained period; NHS trusts in Royal Marsden and Poole have both seen their cleaning contractors rated excellently in independent appraisals.

Susan Anderson, director of Public Services at the CBI, said: “Independent polling consistently shows that a clear majority of the public do not mind who provides NHS services as long as they are high quality. We need competition between providers of all sectors – the public, private and voluntary – now because they are the best tools the NHS has to improve the value and quality of our health service.”

Ironically, the Mid Staffordshire enquiry concluded that the trust had provided substandard levels in order to hit government targets in order to achieve foundation status, which would allow it greater autonomy from the Department of Health. The major legacy of the failings outlined by the CQC will be greater monitoring across all NHS trusts. The Care Quality Commission said Mid Staffs was now safe to provide hospital services, but confirmed that it intended to place conditions on its registrations to ensure standards were met.

Steve Wright, Chairman of the British Cleaning

Council, commented on the CQC’s report: “This example has uncovered a fundamental failure by the hospital to ensure patients received the standard of cleanliness and hygiene they need. While this was ultimately a local failure, it is vital that steps are taken to ensure that it is not allowed to happen again. Although the events were unacceptable, they do not reflect the efforts of the thousands of cleaners who work in the healthcare sector and serve with dedication and professionalism as they strive to reduce hospital acquired infections.”

UNDERINVESTMENT Whatever their motivation, the real problem is underinvestment in cleaning, and the consequences of constant pressure on health authorities and NHS Trusts to achieve better efficiencies. Although the major political parties have recently offered reassuring commitments that they will protect frontline services in the NHS if they are elected, there is never much mention of ancillary staff. If, as expected, trust managers are forced to reduce their expenditure after the 2010 budget, the Mid Staffs example indicates that the consequences of this could be very serious indeed.

NHS hospitals should be equipped so that they can take every available measure to ensure that the threat of MRSA is contained.

This means making the resources available to tackle the problem effectively, alongside stringent safeguards to ensure that they are implemented and maintained. The British Cleaning Council, which represents the interests of the cleaning industry, strongly recommends that cleaning in hospitals is protected by both budgets and political action, to ensure that the seemingly avoidable loss of life in Staffordshire is never repeated again.

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In a recent study Bodyguards SafeDon dispensed gloves had 92.5% less bacterial contamination than traditionally dispensed gloves*

A NEW INNOVATION IN GLOVE DISPENSING Hand hygiene is a key practice used for preventing the spread of infection and is the cornerstone of good infection control. The Bodyguards SafeDon™ system provides an effective infection control solution within a medical environment.

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NEW CUFF 1ST DISPENSING SYSTEM Hygienic system for dispensing and donning gloves. Each glove is dispensed individually and can be donned hygienically “Cuff 1st” without touching the fingers and palm areas of the glove, this helps to reduce the potential risk of cross contamination within medical environments.

TIME EFFICIENT Fast, easy dispensing saves time and patients waiting.

COST EFFECTIVE Minimise glove wastage as gloves are dispensed individually and disused gloves cannot be put back into the box which helps further reduce cross contamination.

ERGONOMICALLY DESIGNED DISPENSER

The Bodyguards SafeDon™ acrylic wall mounted dispenser keeps gloves away from contaminated surfaces and can be wiped down to maintain hygiene. The acrylic dispenser features an anti-microbial additive and has been designed without joins to avoid harbouring bacteria and trapping moisture.

FLEXIBLE GLOVE OPTIONS Each compact cardboard dispensing box contains 100 nitrile, latex or synthetic gloves (X/large glove boxes contain 90 gloves except for vinyl). When the box of gloves is finished, simply remove the empty box and replace with a new box.

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*“Following a 6 week trial at various end user sites independent results showed that gloves dispensed from a Bodyguards SafeDon unit harboured on average 92.5% less bacterial contamination than those gloves dispensed from a traditional glove box over the same period of time.”

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Call today for your free copy

Health Business | Volume 10.2

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INFECTION CONTROL

CLEANING UP OUR ACT A new specification for cleanliness in healthcare facilities is in development by the Department of Health, National Patient Safety Agency and BSI THE NEW SPECIFICATION, EXPECTED to be published after the general election, will assist in the provision of cleanliness in support of infection prevention and improved patient, public and staff confidence. PAS 5748 (Publicly Available Specification) will specify requirements for the provision of cleanliness in acute, community and mental health hospitals. The aim is that it will include requirements for the: • definition and assignation of cleanliness responsibilities and accountabilities • risk assessment and categorisation of functional areas and elements within hospitals • identification and implementation of cleaning tasks needed to achieve a specified definition of clean for different elements within hospitals

• the measurement, reporting and improvement of cleanliness.

PAS 5748 is intended to be endorsed at board level, and implemented by those employed to maintain cleanliness in hospitals including dedicated cleaning staff, nursing and departmental staff and facilities management staff.

It is initially intended to be used within acute, community and mental health hospitals across the NHS in England though it will be developed, through open consultation, in such a way as to permit wider application in future editions. Any decision to further develop the PAS into a British Standard will require input from public and independent healthcare providers across the UK.

DRIVING PROGRESS Health Minister, Ann Keen said: “The delivery of clean, safe, care is a priority for this government.

The NHS has made great strides in improving cleanliness in hospitals, which is important for both patients and staff. This specification will drive further progress in this area and so we are delighted to be working with our partners and stakeholders in developing it”.

Dr Kevin Cleary, medical director at the National Patient Safety Agency, said: “We are very pleased to be working on the development of a new standard in cleanliness which is applicable to providers of NHS care in England to ensure that patient safety is right at the heart of hospital care. The standard provides a framework for a risk-based and continual

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INFECTION CONTROL

improvement approach to cleanliness, within which providers of NHS care will make localised decisions to ensure exemplary patient safety.”

Mike Low, director, Standards, BSI, said: “BSI is delighted to be able to bring its experience of developing standards in the field of healthcare and risk management to bear on this important new standard for healthcare cleanliness. BSI’s robust and well-established standards-making process, the assembled expert Steering Group and public consultation period will ensure the development of a consensus driven document which those responsible for healthcare cleanliness can implement on the ward.”

ACCOUNTABILITY The Cleaning & Support Services Association, also taking part in the development of the standard, made several critiques on the largely unscientific criteria the PAS 5748 proposes for the assessment of cleaning as well as the disproportionate amount of control given to local NHS trusts. Andrew Large, CSSA chief executive, commented: “In order to move towards an effective healthcare cleaning regime there has to be greater emphasis placed on strengthening central governmental accountability by having them enforce minimum

cleaning frequencies within Trusts and for there to be a more verifiable and scientifically sound assessment system rather than focusing on who provides the cleaning service.”

The development of PAS 5748 included a six-week open consultation, from December last year. Comments will be reviewed by the PAS 5748 Steering Group before updating the standard for publication in May 2010. There will be an opportunity to further comment on the published standard after publication. More details will be made available nearer the time.

PAS 5748 Steering Group members include Association of Healthcare Cleaning Professionals; British Institute of Cleaning Science; Department of Health – Patient Environment; Department of Health – Improvement Team for Infection Prevention and Control; Infection Prevention Society; Health Estates and Facilities Management Association; NHS National Patient Safety Agency; and Oxfordshire and Buckinghamshire Mental Health Foundation Trust.

A Publicly Available Specification (PAS) is a sponsored fast-track standard driven by the needs of the client organisation/s and developed according to guidelines set out by BSI. Key stakeholders are brought together

to collaboratively produce a BSI-endorsed PAS that has all the functionality of a British Standard for the purposes of creating management systems, product benchmarks and codes of practice. After two years the PAS is reviewed and a decision is made as to whether it should be taken forward to become a formal British Standard.

FOR MORE INFORMATION Association of Healthcare Cleaning Professionals: www.ahcp.co.uk British Institute of Cleaning Science: www.bics.org.uk Department of Health – Patient Environment: www.dh.gov.uk Department of Health – Improvement Team for Infection Prevention and Control Infection Prevention Society: www.ips.uk.net Health Estates and Facilities Management Association: www.hefma.org.uk NHS National Patient Safety Agency: www.npsa.nhs.uk Oxfordshire and Buckinghamshire Mental Health Foundation Trust: www.obmh.nhs.uk

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INFECTION CONTROL

FIGHTING INFECTION Meeting the stringent requirements of sterility, durability and easy cleaning, the Formica Group offers a range of surfaces ideally suited for use in healthcare environments THE SPECIFICATION OF THE RIGHT materials is important in any design and build project. Meeting the stringent requirements of sterility, durability and easy cleaning, the Formica Group offers a range of surfaces ideally suited for use in healthcare environments, including consulting and waiting rooms, wards, washrooms, surgeries and clinics, care homes and even corridors and stairwells.

However, not only do Formica® surfacing materials satisfy this demand for high performance products, they also offer a wide selection of contemporary and stylish designs and colours in a wide choice of materials. These coordinating and complementary products provide architects, interior designers and furniture fabricators with many possibilities, allowing them to create coordinated, attractive and high performance interiors.

High standards of cleanliness help reduce cross-infection. Alongside good cleaning practices, high-quality design in building fixtures and fittings is important in allowing efficient cleaning to take place easily and minimising areas where dirt and bacteria can build up.

Today’s extensive use of Formica products throughout healthcare environments is testimony to its success in helping to fight infection.

COMFORTABLE PATIENTS The creation of sterile, antiseptic surroundings conflicts with the need for warm and comforting atmospheres required to aid the healing process. The comprehensive product offering from Formica Group helps designers to act on their knowledge that the quality of care and speed of recovery are influenced by visitors’, staff and patients’ perceptions of their surroundings. Formica products enable architects, interior designers and fabricators to create harmonious healthcare environments that help calm patients and reduce stress.

FORMICA® HIGH PRESSURE LAMINATE The decorative and durable nature of Formica® High Pressure Laminate (HPL) lends itself to a wide range of interior surface applications from wall cladding to desking, worktops and door coverings.

It is the hygienic properties of laminate that allow it to really excel in healthcare environments. Whether in the super-clean context of the operating theatre or pathology lab, in toilets and washrooms, along corridors or stairwells, on wards or in treatment rooms, Formica laminate meets the stringent requirements of sterility, durability and easy cleaning. Its non-porous, wipe-clean surface is inherently hygienic and can be steam cleaned

or disinfected with no adverse effects. The superior quality of Formica laminate ensures long-lasting high-performance is achieved. It is also fire rated as B-s1,d0 as per EN13501-1 and as described in the British Building Regulations.

Formica laminate can be used flat on many surfaces such as counter fascias or tops, as wall panelling or even door coverings. It can also be postformed to hold a curve allowing it to be used as a column casing, and to minimise the number of joins which are particularly vulnerable to trapping bacteria.

CHOOSING THE RIGHT MATERIALS Formica laminate is available in a range of different grades, providing specialist options where required. Formica® Compact™ is a versatile high performance material. It has a stylish black core and faced both sides with a decorative finish, specially designed for applications such as washroom environments, cubicle doors and partitions that require strength and humidity resistance.

Formica® Compact Top is a range of high performance, damage-resistant solid core laminate for horizontal and vertical applications, where the upmost performance is required. It offers a practical and robust design application, ideal for use in many different healthcare environments, laboratory and industrial services, where patient health and staff cleanliness is paramount.

With a 16mm thickness Compact Top has inherent structural solidity and dimensional stability making it ideal for horizontal and vertical surface applications, including benches, tables, splashbacks, screens, fume cupboards, cabinets and shelving, furniture and wall panels.

Compact Top offers a range of nine designs, it has a decorative face on both sides of the sheet, providing the perfect choice for partitions, screens and shelving etc. It can be cut, shaped and routered to produce contemporary and practical interior solutions, and its black core acts as a striking edging design feature which can be cut square or bevelled and highly polished. Compact Top meets the requirements of EN 438 (test method 15), ISO 4586 and produces the highest performance levels specified in BS 4965, providing an easily maintained, hygienic surface.

Chemtop2™ by Formica Group offers an enhanced chemically resistant surface ideal for high stress environments where relatively harsh acids, alkalis, corrosive salts and other destructive or staining substances are used.

The range uniquely includes both standard postforming and structural compact grade High Pressure Laminate ensuring that it offers options for all applications including

Courtesy of Corporate centre for La Salle, Ramón Llull University, Barcelona

worksurfaces, splashbacks, and use in the construction of cabinets and fume cupboards.

For those looking to incorporate customised images and graphics into their designs, the Formica® Bespoke laminate service can produce a unique design in HPL using digital or screen printing techniques. Long-lasting signage that is so important in hospitals can be created, as can customised images and graphics in vivid and exciting colours for use in children’s wards for example.

Sterile, durable and easy to clean, Formica laminate continues to meet the strict requirements of healthcare environments. Its non porous, wipe clean surface is inherently hygienic and offers many possibilities for harmonised, attractive and homely effects, whatever the healthcare context.

FOR MORE INFORMATION Web: www.formica.co.uk

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Leaving Antimicrobial Protection to chance could be Costly!

On the surface BioCote® helps combat bacteria.

Behind the scenes it could help save hospitals £Millions

Providing clean and hygienic surfaces in Health Care environments is vital.

BioCote® silver ion technology is the essential ingredient to give any product constant built-in antimicrobial protection from time of manufacture.

BioCote® is proven to inhibit the growth of a broad spectrum of microbes including bacteria, mould and fungi by up to 99.99% and is tried, tested and trusted in real life environments.

Reduce the spread of disease. Reduce the risk of compensation claims –

Specify BioCote®

Proven Protection Against Bacteria

For a FREE information pack visit: www.biocote.com or call +44 (0) 1902 824450

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INFECTION CONTROL

REDUCING BACTERIAL RISKS Dr Richard Hastings, a microbiologist for antimicrobial specialists BioCote, discusses the persistent dangers of bacteria in the healthcare industry and outlines why silver ion technology can help minimise the risk of bacterial contamination, consequently reducing the risk of patients being infected with superbugs like MRSA and E.coli THERE’S NO DOUBT THAT CLEANLINESS and hygiene are critically important in the healthcare industry. Unfortunately though, even with the strictest hygiene control measures in place, the fact that hospitals have a high volume of human traffic and are regularly populated by people with weak immune systems, means patients are at a greater risk of contracting infections.

MRSA is obviously at the top of the news agenda and making the headlines at the moment, but there are also a host of other harmful microbes like E.coli, Salmonella, Listeria and Legionella that can be spread through cross contamination which the healthcare industry needs to combat.

It is clear then that any interventions that risk assessors in a healthcare environment can introduce to reduce these potentially deadly bacteria being transmitted to patients can only be good news.

IMPACT Looking at the bigger picture, the impact of a patient contracting MRSA in your hospital could be devastating, not only for your reputation if and when it gets out in the wider public domain, but also financially if the patient takes you to court and compensation is awarded.

The fact is that whilst cleaning is effective and necessary to combat bacteria, it is impossible to clean a surface every minute of the day. Even with the strictest hygiene practices in place, well-trained staff and the most effective disinfectants on the market, once cleaning stops, bacteria can rapidly multiply to former levels. As these bacteria grow, so does the risk of cross contamination, infection and illness.

So what else can be done to combat bacterial contamination? One particularly technology that is growing in popularity in the healthcare industry is BioCote’s antimicrobial silver ion technology. Independent laboratory testing consistently shows that BioCote technology is highly effective against a wide range of disease causing bacteria and fungi, dramatically reducing levels of bacteria by up to 99.99 per cent compared to untreated products.

At BioCote, we work with manufacturers of products associated with the healthcare industry to incorporate silver ion technology at the production stage. It can be adopted into a wide range of products, from paint to furniture, sanitaryware, hospital equipment and light switches to name a few. This

RESEARCH WITH HEART OF ENGLAND NHS FOUNDATION TRUST BioCote conducted the first ever environmental trial to investigate the effectiveness of silver ion protected products in association with the Heart of England NHS Foundation Trust.

Two hospital wards were included, one refurbished with BioCote protected furniture and equipment and the other refurbished in a comparable way without the protection.

The aim of the trial was to compare the levels of bacteria on the protected products, which included blinds, tiles, door handles and light switches, with standard untreated items. The wards were used for their normal clinical practices for 12 months before environmental sampling commenced.

Almost 1,500 samples were collected built-in antimicrobial protection lasts for the lifetime of the product, making it ideal for establishments where hygiene is essential.

STRATEGY I am not saying that silver ion technology is the complete solution to the problem, but it should certainly be seen as one part of your overall hygiene strategy.

For any healthcare manager or risk assessor, my advice is whether you are replacing existing equipment or buying new, insisting your products feature silver technology and working with manufacturers that use this will reduce the risk of cross contamination.

from the wards over a period of six months and sent to an independent microbiology laboratory for analysis.

Results showed that the BioCote protected products were 95.8 per cent less contaminated with bacteria than the equivalent untreated products in the control environment.

In addition, untreated surfaces in the BioCote protected ward were shown to be significantly less contaminated than equivalent surfaces in the control environment. An explanation of this observation is BioCote protected surfaces reduce levels of cross contamination within a treated environment.

These results were also reproduced in a subsequent environmental trial in a UK nursing home.

FOR MORE INFORMATION For more information, including which manufacturers in the healthcare industry work in partnership with BioCote to incorporate its technology, plus how you can become a partner, visit www.biocote.com or call 01902 824 450.

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www.healthbusinessuk.com

Visit the website to view the categorised product finder

Notile™ is the hygienic alternative to tiles

Identification wristbands from Brenmoor

OTILE™ IS A GLASS fibre reinforced polyester (GRP) imitation tile panel incorporating the anti-microbial Biocote® within the surface.

Available in large sheets, 2,600mm x 1,800mm, yet easy to cut to size. Fit with a grab adhesive; large sheets can be applied in one instalment.

Available in three tile sizes and manufactured in any standard RAL colour.

The panels are effective against MRSA, E. coli, and salmonella amongst many other bacteria, including Aspergillus Niger (black mould), for the lifetime of the product.

To increase its effectiveness against bacteria, the smooth high gloss surface is easy to clean with soap and water, plus the product does not degrade with use.

RENMOOR’S RANGE of hospital wristbands are used in more UK hospitals than any other products.

They are the only printable wristbands available from NHS Supply Chain that are made in the UK. The wristbands fully comply with all aspects and requirements of the NPSA safer practice notices concerning patient identification.

Brenmoor wristbands are comfortable, durable and economical; printable with barcodes, photo’s and text; available in sizes from newborns to adults; can be fitted with RFID if required; heat sensitive materials and so no need for

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It is easy to cut and fit, and will not fade or discolour, even in direct sunlight. NoTile™ has already been used in hospitals, bathrooms, swimming pools, kitchens, prison cells, mental health units and many public areas where hygiene and cleanliness are paramount.

FOR MORE INFORMATION Composite Fibreglass Mouldings Ltd Tel: 01325 246066/07834 187429 Fax: 01325 246067 E-mail: emma@ compositesfm.co.uk Web: www.compositesfm.co.uk

expensive thermal transfer ribbon; designed after consultation with hospital staff; resistant to soaps, water, gels, creams and alcohol cleaning fluids.

We would be delighted to send out samples, boxes for trial or attend presentation days. Right patient – right care – right choice.

FOR MORE INFORMATION Brenmoor Ltd Summit House Riparian Way Cross Hills West Yorkshire BD20 7BW Tel: +44 (0) 1535 633088 Fax: +44 (0) 1535 636911

Hygienic and durable hospital floors ATUM INDUSTRIAL Flooring Limited is a specialist synthetic resin and pump screed installation contractor, specifying a tried and tested range of products, and the company has extensive knowledge and experience in producing hygienic and durable floor finishes for industry at large.

Datum Industrial Flooring Limited has a unique concept in terms of the products and services available. Our in house expertise enables us with the capabilities to provide the solutions to most flooring requirements, allowing clients to rely on one company for a greater scope of works. We offer a total package to supply and install the following systems giving us overall dependability: • Pumped cementious screeds • Polyurethane, Epoxy and Polymer seamless resin systems

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• Epoxy and Polyurethane coatings • Chemically resistant screeds • Supply and installation of stainless steel drainage components • Anti Static systems in Polyurethane and Epoxy Datum Industrial Flooring Limited carries out a comprehensive site survey, analysis and report findings, advice and recommendations, specification and programming and detailed quotations. Our ‘concept to completion’ ensures that the client’s requirements are monitored from start to finish by owner managers.

FOR MORE INFORMATION Tel: 0845 9000 342 Fax: 01342 893 165 E-mail: info@datum-flooring.co.uk Web: www.datum-flooring.co.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

Pierson Surgical – quality surgical products IERSON SURGICAL distributes an extensive range of innovative products from major US and European manufacturers, offering a very responsive service to meet the needs of Surgeons and Theatre teams.

We have a particular specialisation in Cardiovascular surgery. The products include: Surgical Instruments from Delacroix-Chevalier and Landanger, now available from us through the new nhs supply chain framework agreement – visit www.supplychain.nhs.uk to access the online catalogue.

Sutures for every discipline from Péters Surgical, featuring unique material properties for optimal strength, elasticity and suppleness and superior silicon coated needles.

Pressure sore prevention – the Rooke® Heel Float System is a triple layer insulating lightweight boot designed to provide optimal insulation and protection to the lower extremities of patients and is excellent for preventing heel pressure ulcers.

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The world’s only autologous Fibrin Sealant and Platelet Rich Fibrin wound treatment from Vivostat® which uses the patient’s own blood to produce the sealant.

A unique Vessel Occlusion Gel, LeGoo™, which forms a gel plug at body temperature and temporarily stents the vessel. Upon completion, LeGoo™ is dissolved by applying ice directly to the vessel.

Procedure Packs for Cardiovascular surgery to reduce theatre preparation time and increase costeffectiveness of consumables.

FOR MORE INFORMATION Tel: 01225 766632 Fax: 07092 315510 E-mail: sales@ piersonsurgical.com Web: www.piersonsurgical.com

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Visit the website to view the categorised product finder

BioCote protected Priorclave combats tableware from Harfield surface microbial growth ARFIELD, one of Europe’s leading manufacturers and distributors of polycarbonate tableware, have nearly 50 years experience of supplying their products to the most demanding consumers.

Their polycarbonate products offer the following unique benefits: • Virtually unbreakable • Will not chip, splinter or shatter • Highly stain resistant • 100 per cent recyclable • Market tested for nearly 50 years • Now with the added protection of the BioCote® antimicrobial additive.

As a family run and owned business, Harfield pride themselves on superb customer service: • Large stock holding to ensure 100 per cent order fulfilment • Same day despatch available • No minimum order • No small order charge • Free carriage on orders over £210 • Order by phone, fax, e-mail or on their website • Order to your established account or by credit

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or purchasing card • Harfield also offer the widest range of colours in the market and even offer bespoke colours to your specification.

Harfield’s range of BioCote® protected tableware is suitable for hospitals, schools, nurseries, care homes – indeed anywhere where there is a need for a safe, reliable and robust product.

FOR MORE INFORMATION For details on Harfield’s full range, please visit their website www.harfieldtableware.co.uk or contact their sales office on 0161 477 5678 or info@harfieldtableware.co.uk for further information.

Infection control – all wrapped up NFECTION CONTROL IS one of the most important issues facing the health delivery services at present. To help in this battle, Sefton Transmail, in partnership with BioCote® silver ion technology, produces antimicrobial products that reduce the numbers of MRSA, E.coli and other dangerous micro-organisms.

Sefton Transmail is a UK manufacturer of polythene products and can supply many formats of patient record holders, baby bottle bags, disposal bags, sample bags and others, all made from polythene that incorporates the protective anti-microbial action supplied by a BioCote® additive.

This anti-microbial action is crucial where items or information are being passed from department to department or ward to theatre within your organisation.

The product remains antimicrobial for its life-time; it cannot wear off or be washed off as it is integral to the fabric of the material rather than surface coated. The items can

N THE FIGHT AGAINST surface microbial growth Priorclave remains the leading autoclave manufacturer whose entire range of autoclaves helps the hospital, biochemical, food and pharmaceutical laboratory environments to reduce their risk of cross contamination.

The surface coatings of the cabinets contain silver-based, BioCote® technology, dramatically reducing microbial growth.

BioCote® technology aids the fight against infection by inhibiting the growth of a wide range of micro-organisms, including E.coli, Pseudomonas and MRSA on the exterior surfaces of the equipment.

BioCote® has been proven to work many times through environmental studies across many disciplines, the most recent of which have been undertaken within the nursing home sector.

A refurbished care home in Leicester was kitted out with a bedroom and ensuite containing BioCote® protected products and compared to similar untreated products in another refitted

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bedroom and ensuite. The combined average reduction in microbe levels was an astonishing 94.6 per cent fewer on the BioCote® treated surfaces, similar to that seen at the trial conducted at the outpatients clinics within the Heart of England NHS Foundation Trust, where BioCote® treated surfaces demonstrated an overall average of 95.8 per cent.

Both of these studies have been published in the Journal of Infection Prevention and the British Journal of Community Nursing, respectively.

These trials conclude that silver can complement cleaning and hygiene practices, working in-between cleaning, to reduce levels of bacteria on BioCote® protected equipment.

FOR MORE INFORMATION For further information contact Mr Tony Collins, managing director, Priorclave Ltd: Tel: +44 (0) 20 8316 6620 Fax: +44 (0) 20 8855 0616 E-mail: sales@priorclave.co.uk Web: www.priorclave.co.uk

Docugard® papers combine safety with style

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OCUGARD® PAPERS, produced by James Cropper, incorporate the Biocote® antimicrobial additive proven to be safe and effective against the growth of microorganisms including MRSA. The technology utilises silver, well known for its ability to inhibit bacterial growth. The silver additive does not break down or leach out of the product, thus guaranteeing its effectiveness over many years.

Docugard® papers provide a very high degree of infection control by inhibiting microbial growth and helping to minimise the risk of cross-contamination by peoples’ hands.

Docugard® Manilla is ideal for medical files, folders and indices. Ask your filemaker for Docugard®.

The new Ambassador range of

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all be individually specified and bespoke manufactured to your requirements. The products can also be made from coloured or 100 per cent recycled polythene (with no effect on the anti-microbial action) or printed in up to eight colours.

FOR MORE INFORMATION Tel: 01603 404217 E-mail: sales@ seftontransmail.co.uk Web: www. seftontransmail.co.uk

papers is part of the Docugard® collection. Stocked in a selection of contemporary whites and creams Ambassador is ideal for a vast number of different applications including business stationery, corporate literature and promotional print.

FOR MORE INFORMATION Tel: 01539 722002 E-mail: jcsp@cropper.com Web: www.docugard.co.uk

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Written by F-Gas Support

AIRCONDITIONING & REFRIGERATION

DON’T BE LEFT OUT IN THE COLD Managing refrigeration, air-conditioning or heat pump equipment?

Make sure you use engineers with the right qualifications IT MIGHT SEEM LIKE A LONG TIME, but by July 2011 all engineers or technicians working on stationary refrigeration, airconditioning or heat pump equipment that contains or is designed to contain F gases need to hold one of the new F gas (stationery equipment) qualifications.

Fluorinated gases (F gases) are a family of man-made chemicals that are very powerful greenhouse gases; emission of even a small quantity of an F gas to the atmosphere is harmful to the environment. Most F gases are between 1,000 and 20,000 more powerful than CO2 in terms of ‘global warming potential’. The F gases are part of the Kyoto Protocol-basket of greenhouse gases. In the EU the use and emissions of F gases is regulated by EC Regulation 842/2006.

The F gases that may be found in refrigeration, air-conditioning or heat-pump equipment are: • HFCs (Hydrofluorocarbons): common uses include refrigerants in refrigeration, air conditioning and heat pumps used in many applications such as industry, offices, retail, hospitality and cars. Other uses: aerosols, insulating foam, solvents and fire protection.

Examples of HFCs (usually a blend of a number of HFCs) commonly found in refrigeration, air-conditioning and heat pump equipment are R134a, R404A, R410A, R407A, R407C etc.

• PFCs (Perfluorocarbons): found in some unusual refrigerant blends.

QUALIFIED ENGINEER The engineer who comes and installs, services or maintains refrigeration, air-conditioning or heat pump equipment that contains F gases needs to hold a qualification. At the moment an engineer can hold either an interim or a full F gas qualification. However,

by July 2011 all engineers working in this sector need to hold a full F gas qualification.

There is strong concern in the sector that not enough people are currently getting trained and are putting off this training so there could be a bottleneck next year.

Our research shows that less than 10 per cent of engineers hold the new full F gas qualification. The 93 per cent who still need to attain the new qualification represents in excess of 12,000 engineers.

There are plenty of training providers across the country though they tend to be booked up several months in advance. A course can take up to five days depending on the level of skills and knowledge engineers have. Preassessments are possible and will indicate the level of ability of a candidate and give a guide as to the length of course that they should take.

It is also worth noting that as well as a full F gas qualification the companies that employ

Level

Requirements

City & Guilds Ref.

CITB Ref.

Category I

Certificate holders may carry out all refrigerant handling activities for any size of RAC systems containing HFC refrigerants. This includes leakage checking, refrigerant recovery, installation, maintenance and servicing.

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Category II

Certificate holders may carry out refrigerant recovery, installation, maintenance and servicing, in relation to RAC systems containing less than 3 kg of fluorinated greenhouse gases (or less than 6 kg for systems that are hermetically sealed). Category II certificate holders may also carry out leak checks on any plant provided that it does not entail breaking into the refrigeration circuit containing fluorinated greenhouse gases.

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Category III

Certificate holders may carry out refrigerant recovery in relation to RAC systems containing less than 3 kg of fluorinated greenhouse gases (or less than 6 kg for systems that are hermetically sealed).

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Category IV

Certificate holders may carry out leak checks on any plant provided that it does not entail breaking into the refrigeration circuit containing fluorinated greenhouse gases.

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these engineers need to hold a full Company Certificate by July 2011 and their engineers must all hold the new qualification before they can apply for the full Company Certificate.

Company Certification affects businesses that handle F gases for the purpose of installation, maintenance or servicing of refrigeration, air conditioning or heat pump equipment. Defra has designated three Company Certification bodies – Bureau Veritas, Quidos and Refcom.

QUALIFICATIONS NEEDED There are a number of options; firstly you need to choose your trainer from the two training boards, either City and Guilds or Construction Skills (CITB). Both offer the same level of qualification that is backed up by a quality assurance programme. Whichever course you choose the training provider/ assessment centre will work to the same high standards in assessor qualification, practical test equipment, and knowledge test conditions.

Then you need to choose the right category of qualification. There are in fact four levels of qualification. Each is intended for a different candidate. It depends on what work an engineer does and the type of equipment he works on as to which is the right Category of qualification.

The table above describes the activities for each Category and lists the training board reference.

The courses are not intended for the beginner, but for those with a significant amount of knowledge and experience. The course will cover the ground rules, but also more complex aspects of working with refrigeration, air-

conditioning and heat-City & Guilds Reference pump equipment such as commissioning, efficiency, component design and installation.

The new stationary F gas qualification is Europe-wide. That means an engineer that holds one of these qualifications can work in other EU Member States as long as they hold a copy of the certificate translated in the local language. The European Commission will hold a list of all the courses that are recognised across the EU Member States.

As an employer or a client, will the new F gas qualification make a difference? In a word, yes. For some in the industry it has been a long time since their knowledge was tested.

The new F gas qualification is more involved and demanding than previous qualifications with many engineers coming out of the qualification and feeling more confident.

So the new courses provides the customer and the employers with the reassurance that engineers’ skills are up to the required standard and confirms that they understand why they are doing what they are doing.

One of the main reasons the EC F gas Regulation was introduced was to improve the containment of F gases. The new qualification should test skills resulting in an improvement in reliable, efficient and leak free systems.

FOR MORE INFORMATION Help Line: 0161 874 3663 E-mail: fgas-support@enviros.com Web: www.defra.gov.uk/fgas

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SAVE TIME & MONEY ✔ ✔

Reduce Carbon Emissions Kill harmful bacteria, spores and viruses that lead to MRSA, C. Diff and Swine Flue George Boyd, part of Saint-Gobain Building Distribution, Europe’s largest distributor of building products, is launching a revolutionary new product which has been proven to significantly reduce the pollution around us, simply, cheaply and without environmental side effects.

Ecopurer paint transforms surfaces into active air purifying mechanisms which also have self cleaning, antibacterial and de-odourising properties. The products make an active contribution to improving the quality of air, our health and therefore our lives.

Contact George Boyd now on 0845 601 3547 for more information or test results.

Alternatively visit our website www.george-boyd.co.uk to see other products available including sister product Touch Clean, an amazing antibacterial coating for use on organic materials that effectively protects against MRSA, C-Diff and Swine Flu.

Health Business | Volume 10.2

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ENERGY

LOW CARBON, LOW COST Tim Pryce, public sector manager at the Carbon Trust, explores how healthcare organisations can tackle spending pressure by improving their environmental performance LAST YEAR’S MCKINSEY REPORT revealed that the NHS may be forced to slash its workforce by over 130,000 if it is to achieve planned savings of £20 billion by 2014. The release of the report underlines the extent of spending constraints in the sector and the need to make existing funds go further.

Although the idea of making cost savings through energy efficiency is being explored by many in the NHS, the potential financial savings on offer by reducing carbon emissions are not yet being fully realised by some Trusts. If cost cutting targets set out by the government are to be met without substantial workforce cuts, it is vital that healthcare boards place energy efficiency near the top of their agenda. This will help to reduce costs in a way that doesn’t affect frontline services.

SIMPLE MEASURES The good news is that implementing a few straightforward, practical measures can help reduce the amount of energy consumed by Trusts and in doing so release funding for use elsewhere. For example, costs can be significantly reduced by setting appropriate temperatures, and ensuring heating equipment and controls are operated and managed correctly. In fact, it is possible to save up to 30 per cent on heating costs through the implementation of simple ‘low cost, or no cost’ energy saving measures. Other more far reaching investments, such as boiler upgrades and building refurbishments tackling heat loss can save considerably more than this.

Lighting is also important as it can account for over 20 per cent of the total energy use in a typical hospital. An effective lighting system can both reduce costs and improve the quality of lighting for staff and patients.

Reducing energy consumption will also help NHS Trusts meet the legally binding UK carbon reduction target of a 34 per cent cut over 1990 levels by 2020. Already, new strategies and legislation are targeting carbon emissions in the NHS. The NHS Sustainable Development Unit has developed a carbon reduction strategy to help Trusts reduce their carbon emissions.

Using guidance from the strategy, the NHS has set itself a target of achieving a 10 per cent reduction on its 2007 carbon footprint by 2015.

Whilst this may seem like a daunting prospect to many NHS Trusts, by taking action to reduce their carbon emissions now, healthcare organisations can not only benefit from energy efficiency cost savings but also get ahead of the game in terms of the government’s Carbon Reduction Commitment (CRC).

The CRC is a mandatory scheme that targets

The good news is that implementing a few straightforward, practical measures can help reduce the amount of energy consumed by Trusts and in doing so release funding for use elsewhere

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Health Business | Volume 10.2

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ENERGY

carbon dioxide emissions from large public and private sector organisations, which use more than 6,000MWh of electricity per year. The CRC has significant financial and reputational implications for organisations so it is vital they understand how it will impact them and how they can profit from early action to reduce the cost of compliance and minimise risk. Until 2013, organisations that are part of the scheme must buy carbon allowances to cover their emissions at a cost of £12/tCO2, after this the price will float, and trading will begin in earnest. This money will be paid back to businesses in October of each year, but how much is dependent on how highly they are ranked in the CRC league table. In 2011 the league table is determined solely on the basis of whether the organisation has taken ‘early action’ in advance of the CRC. With healthcare organisations set to make a significant financial loss or gain dependent on their performance in the scheme, carbon reduction will be high on the agenda of every healthcare board across the UK. HELP AT HAND The Carbon Trust’s NHS Carbon Management programme is designed specifically for the NHS – providing support for staff to produce a board approved carbon management strategy, with a roadmap to achieving real cost and carbon savings. What’s more, the Carbon Trust’s advice includes analysis tools, training and workshops, and expert one-on-one support, all free of charge. Past participants have identified average annual cost savings of over £490,000 per Trust per year, with carbon savings of 4,400 tonnes per Trust annually. Since May 2008, the Carbon Trust has helped 82 NHS trusts, like Wrightington, Wigan & Leigh, produce effective carbon management plans.

Wrightington, Wigan & Leigh employs around 4,200 staff, serving patients across Wigan and Leigh. In 2004/05, the Trust spent approximately £1 million on energy, emitting more than 17,000 tonnes of carbon dioxide.

By 2007/08, this figure had risen to more than £1.5 million and it was anticipated that it would double to £3.2 million by 2008/09.

Eager to slow the snowballing energy costs, the Trust joined the Carbon Trust’s NHS Carbon Management programme.

By working with the Carbon Trust, Wrightington. Wigan and Leigh has mitigated the effects of rising energy prices and limited the increase in its energy costs, as well as cutting carbon emissions. The Trust is already saving over £500,000 per year on its energy bill, and has cut carbon dioxide emissions by over 6,000 tonnes per year. Through one project alone – the replacement of a coal fired boiler house with a modern low-pressure hot water system – the Trust has been able to cost effectively save 3,000 tonnes of carbon per year.

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

COMMITMENT FROM THE TOP To implement long term carbon reduction there is a need for board level and senior management support. Achieving energy and carbon savings in hospitals requires strong leadership, ideally from the chief executive.

By demonstrating a commitment to the organisation’s energy policy at the top, staff lower down the chain will be empowered to take action on energy saving initiatives. To be accepted onto the scheme, NHS Trusts need to show this top level commitment, and to nominate a team committed to driving the programme forward. All members of the team need to work across organisational boundaries to promote and implement carbon reduction projects.

Epsom & St. Helier NHS Trust in Surrey was also able to improve its energy efficiency through the use of Carbon Trust surveys.

These free walk-round surveys provide on-site assistance to help NHS Trusts to identify energy saving opportunities.

The Trust employs more than 4,000 people across four sites: St. Helier Hospital, a 600 bed general hospital; Epsom General Hospital, with 400 beds; and Sutton and Nelson Hospitals, both outpatient and day surgery units. Due to its substantial utilities bills totalling £1.5m per year, the Trust became aware of the need to become more energy efficient as a means to drive down costs.

A Carbon Trust survey was undertaken

on each of the Trust’s four sites and made the following recommendations: • Replacing current boilers with condensing boilers • Upgrading the lighting (lamps and fittings) • Introducing additional heating zone controls • Encouraging ‘ownership’ of the hospitals’ building management systems • Carrying out general good housekeeping measures • Raising staff awareness The Carbon Trust predicted that, by following these recommendations, Epsom & St Helier Hospitals could save over £65,000 a year. A CHP (Combined Heat & Power) scoping study was also proposed in the report. Early indications are that CHP could reduce energy bills by £150,000 a year and cut carbon emissions by 300 tonnes, giving total potential savings of £215,000 per year alongside the other survey recommendations.

Considering the potential immediate and long term cost savings that can be made by taking carbon reduction seriously, the case for a more energy efficient NHS becomes clear.

Not only will these savings have an impact on tough cost cutting targets, but they will also pave the way towards a greener health service.

FOR MORE INFORMATION NHS Trusts can find more information about the Carbon Trust by calling 0800 085 2005 or visiting www.carbontrust.co.uk/nhs

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Still curious? Find out how you can lower both your costs and also your Carbon Footprint by contacting ADAS.

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Health Business | Volume 10.2

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ENERGY

HAS AMR MADE YOU CRC RED? Many companies have been investing in AMR and smart meters as a result of the benefits that it can bring to organisations seeking to control their energy consumption or the reduction in estimated energy bills AMR IS NOW A TOPIC THAT HAS reached even the furthest corners of the UK plc. The main driver of recent months has been the Carbon Reduction Commitment Energy Efficiency Scheme (CRCees as it is now to be known), but have you unwittingly found yourself affected by the CRCees?

Many companies have been investing in AMR and smart meters as a result of the benefits that it can bring to organisations seeking to control their energy consumption or the reduction in estimated energy bills (but not eliminated!) etc.

These companies, if not originally qualifying for the CRCees, may have found themselves qualifying for the CRCees scheme after all.

The CRC Energy Efficiency Scheme’s impact on your business (should it qualify) will in 2011 entirely depend upon what are called the Early Action Metrics, whereby a league table is drawn up and your companies relative performance to others is gauged by these metrics. In the first year, a successful installation of AMR across 90 per cent of your portfolio should see you avoid the associated financial penalties as AMR accounts for 50 per cent of these metrics in the first year. The other metric is to achieve the Carbon Trust Standard or other similar scheme.

Originally the qualification for CRCees was based upon your electricity consumption from “00” profile half hourly meters only. If you consumed more than 6 GWh per annum from half hourly metered supplies, then you qualified (unless you were already part of the EUETS).

AMR consumption was not included within the qualifying consumption from mandated “00” profile half hourly meter until February this year when the entry criteria was clarified as follows: QUALIFICATION Qualification for the scheme is based on half-hourly metered electricity usage. Your organisation will qualify if during the 2008 calendar year it: 1. had at least one half-hourly electricity meter (HHM) settled on the half-hourly market across the whole organisation 2. had a total half-hourly electricity consumption over 6,000 megawatt-hours (MWh) once electricity used for transport and domestic accommodation has been excluded Your electricity supplier will be able to confirm if you have any half-hourly meters settled on the half-hourly market. In the scheme, half-hourly meters include any: • mandatory half-hourly meters • voluntary half-hourly meters • half-hourly light meters • pseudo half-hourly meters (commonly used to measure electricity consumption of street furniture – e.g. street lights, traffic lights, etc)

• Remotely read Automatic Meter Reading (AMR) meters that produce half-hourly data.

These are not necessarily settled on the halfhourly market and therefore do not count towards the first qualification criterion All organisations that meet the first criterion but consume less than 6,000MWh of halfhourly electricity will not qualify. They will however still need to submit information to the administrator at the beginning of the scheme.

So, even if you have just one “00” profile half hourly meter, and consume a total of 6 GWh across all your AMR meters and your “00” profile HH meters, then you’re in!

This is a problem for these companies primarily because: a) They have not made an allowance of an additional 10 per cent of their energy budget for this year to prepare for the cash flow of CRCees b) Lack of information about the scheme means that they will struggle to meet the reporting criteria c) Failure to recognise that they are to be part of the scheme means that they may be fined.

However, just a couple of months ago the Environment Agency had a climb down on the requirement to buy two years carbon allowances in July 2011, essentially halving the cash flow impact of the CRC energy efficiency scheme on qualifying businesses, at the same time doubling the benefit in the second and third years of the scheme of installing AMR. In the second and third year of the CRCees the impact of AMR has doubled now delivering 20 per cent in the second year and 10 per cent in the third year. This now gives higher emphasis to Early Action changes and reducing more slowly to better recognise your investment in

AMR. Of course your company’s ability to reduce its consumption weighs heaviest after the first year, with the difficulties of doing this from estimated invoices; AMR is the best way to prove exactly what you have used. It is also worth noting that if your consumption submission for CRCees is based upon estimated readings then they will be increased by 10 per cent, offering further incentive for the installation of AMR.

GETTING AMR RIGHT Jonathan Akers, head of Technical Energy Services BIU, says:” The incentives for getting AMR right are being created by both the government and suppliers. The penalties from the board room for getting it wrong are also due to changing legislation and lack of transparency. It is important that your AMR solution is independently verified, financial and consumption benefits clearly detailed, and that the same company will support you in a year or two’s time when you are asked to prove the results.”

FOR MORE INFORMATION Tel: 01253 789 816 Fax: 01253 714 131 E-mail: info@biu.com Web: www.biu.com

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ENERGY

HEALTHY LIVING WITH BIOMASS Biomass offers a very effective heating solution for hospitals and other healthcare facilities, but it’s important to address the key practical issues that go with it. Ian Dagley of Hoval explains IN STRIVING TO MEET ITS CARBON emissions targets the health sector has been quick to take advantage of the benefits of biomass because of the large heat outputs that can be obtained very cost-effectively.

Consequently, Hoval has considerable experience of hospital biomass projects, with the capabilities to offer a full turnkey service from design through to ongoing maintenance.

With biomass, we have also found that it’s important to go beyond the engineering considerations and take account of all the practical aspects. These include the potential for integration with other heating technologies, such as solar thermal, heat pumps and condensing boilers – all of which are included in our product portfolio – as well as issues such as fuel choice, storage and delivery.

CONTROL Clearly the first stage is to understand the range of heat loads through the year, the potential benefits of a suitably sized buffer vessel and whether other heat sources – conventional or renewable – should be included. Where solar thermal and heat pumps are used, there needs to be back-up as their heat output varies through the year.

This can be from biomass boilers or, perhaps, gas condensing boilers. Here, control is an important element to optimise the use of each technology and we offer specialised controls for integrated different heat sources.

Additional issues include the overall suitability of the site in relation to fuel storage and deliveries; both of which also impact on the choice of wood fuel to be used. Wood chips, for instance, show greater variation in combustion efficiency and physical size and have a lower calorific value than pellets, so for a given heating capacity they will require either higher storage volumes or more frequent deliveries. Ideally, the storage volume will allow a full lorry-load to be ordered each time as this reduces cost and carbon footprint.

Because of the volumes involved, chips are normally delivered by tipper lorry and this will determine the dimensions for access routes and turning circles. Below-ground storage will also be required to receive fuel from the tipper, along with a mechanism (e.g. push/pull floor) for moving the chips from the store to the fuel transport system.

A ceiling mounted fuel dispenser can be used to spread the chips throughout the store or multiple fuel delivery hatches will be required to use the full capacity of the store.

The irregular shape and size of chips means they need more robust handling equipment

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with larger augers and motors, compared to pellets. In addition, the distance from storage to boiler should be as short as possible to minimise the number of augers required, the chances of fuel blockages and the cost.

On the plus side, chips cost less than pellets so this may enter the overall equation, though it’s worth noting that the cheapest chips will usually produce higher volumes of ash, which has implications for everyday maintenance.

Pellets are usually delivered by a smaller ‘blower’ vehicle with less demanding access requirements and the best results are achieved by using a vertical storage silo as this maximises fuel recovery. The silo may be manufactured from GRP (glass reinforced polyester) for outdoor use, or a fabric silo can be assembled in-situ indoors. Because of their height, outdoor silos may require planning permission.

It is also vital to involve the people who will use the boilers on a day-today basis. They need to understand how they differ from more familiar gas or oil, particularly any maintenance aspects.

FUEL AND EMISSIONS All biomass fuels produce particulate emissions and the volume and nature of these will vary with fuel quality, as well as combustion efficiency. Using boilers that comply with EN 303-5 Class 3, in conjunction with high quality fuel, is the first step in minimising particulate emissions

but some filtration will also be necessary.

Until recently cyclones and multi-cyclones have been the only viable option but their operation depends on particle size and they are only able to remove about 50 per cent of the particles down to a diameter of 10 microns (PM10). However, EC Directive 2008/50/EC (Ambient Air Quality and Cleaner Air for Europe), which comes into force in June 2010, will require control of particles down to 2.5 microns (PM2.5).

CAUSE FOR CONCERN Clearly this is a cause of concern for many health authorities but Hoval’s new ceramic filter is capable of removing up to 96 per cent of PM2.5 and PM10 particles and can be retrofitted to existing biomass boilers.

When considering biomass, therefore, it makes a lot of sense to team up with a specialist company such as Hoval that has the expertise and experience to provide sound advice, anticipate issues and resolve them before the project begins.

FOR MORE INFORMATION Further information can be found at www.hoval.co.uk

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Complete engineered system solutions

BRE delivers low carbon outcomes

RMSTRONG IS A leading designer and manufacturer of HVAC equipment, packaged systems and integrated plant rooms for the hospital and healthcare sector. It also leads the market in low and zero carbon solutions with expertise in the integration of any combination of biomass, heat pumps, solar thermal and condensing boiler technology.

The range of projects undertaken

by Armstrong encompasses the supply of HVAC equipment or integrated plant rooms for new builds, as well as refurbishment of existing equipment to make it more energy efficient and to reduce carbon footprint. For example, for the cardiac unit of Blackpool Victoria Hospital, Armstrong supplied pumps with extremely low maintenance requirements, which make it possible to carry out routine maintenance in minutes instead of hours, maintaining the environmental conditions for patients.

RE IS THE UK’S leading independent sustainability advisor for buildings, communities and businesses. Owned by a charitable trust which champions best practice across the built environment, we offer evidence based solutions which enable NHS clients procure and manage buildings which perform better by having minimal environmental impacts, carbon emissions and whole life costs.

We evaluate and certify products and system performance creating cutting edge knowledge from our research, provide training to building professionals and develop tools such as BREEAM Healthcare to assist organisations deliver better building outcomes.

We help public and private organisations develop and implement practical sustainable development strategies and actions across the whole construction supply chain.

We wrote HTM 07-02 Encode making energy work in healthcare and assisted the SDU to develop the NHS Carbon Reduction Strategy for

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At Chorley and Ribble Hospital, the replacement pumps supplied

by Armstrong immediately resulted in a cooler and quieter boiler house, and brought long-term cost savings and lower carbon footprint from improved energy efficiency.

When the Lewisham Children and Young People’s Centre was built, Armstrong constructed the plant room at its factory in Halesowen and delivered it to site requiring only final connections.

This reduced site traffic at this busy London location, and assisted in reducing levels of on-site health and safety risk during the build. It also cut significantly the installation time for the plant room and ensured low energy costs for the future.

FOR MORE INFORMATION Tel: 0161 223 2223 Fax: 0161 220 9660 E-mail: salesuk@armlink.com Web: www. armstrongintegrated.com

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England and can help you by: • Advising on the implementation of the NHS CO2 reduction targets, BREEAM and the Carbon Reduction Commitment.

• Providing leading edge technical consultancy to procurement and estates teams • Developing realistic trust and project specific carbon targets, strategies and delivery specifications • Evaluating design performance at key project stages to reduce project environmental and whole life cost risk.

FOR MORE INFORMATION Tel: 01923 664200 Fax: 01923 664010 E-mail: enquiries@bre.co.uk Web: www.bre.co.uk

Systematic Energy – use less, cost less

Power Efficient Systems: saving energy for others

YSTEMATIC ENERGY has been operating for three years. The proprietor has been involved with the operation of buildings for over 25 years.

Identifiying waste needs to be the first step of the many ways to reduce energy waste, costs and carbon emissions. Our key aspiration is to help clients use less, without impacting on operations.

Using less will result in lesser costs.

Carbon emissions will naturally fall in line with the reductions.

Services provided can include: • Energy tracking, identify waste and produce action plans • Advice in making better use of building services. Use less will cost less • Optimising the operation of energy using services.

• Fast energy audits with usable feed back • Benchmarking energy usage with comparable buildings and

OWER EFFICIENT Systems Ltd (PES), is one of the leading manufacturers and suppliers of energy saving systems for industrial and commercial clients within the UK. Our approach to energy reduction at a plant’s main supply using a number of proven technologies combined is quite unique within the UK and is proving to be a solid and cost effective route to reduce energy costs and carbon emissions in an ever increasing energy conscious environment.

With the main emphasis on Power Factor Correction and the EnergyAce Power Reduction System, we are continuing to deliver impressive results on energy reduction for many of our new and existing clients within all industrial and commercial sectors in the UK and overseas.

Our products and services in

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provide targets for best practice.

If the client has half hourly metering, remote data logging services can be provided for no capital cost or alterations. Advice and support can be provided for the provision DEC and EPC certification, keeping clients ahead of emerging legislation that affects energy users and emissions.

Documents for projects and tendering can be set up and validating tender offers with a view to meeting best practice in services installation, focused on reducing carbon emissions.

FOR MORE INFORMATION Contact: Mr G J Goldner, Systematic Energy Address: 70 St Clements Road Benfleet, Essex, SS7 5XG. E-mail: goldner@ systematic-energy.org.uk Tel: 01268 456162 Mobile: 07908 205023

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association with the Carbon Trust, Envirolink, Regional Energy Forums and many other energy saving organisations are designed to reduce energy costs, improve utilisation of switchgear and reduce carbon emissions in line with the latest CRC legislations (Carbon Reduction Commitment).

FOR MORE INFORMATION To benefit from our energy saving products and services, visit www.pesgroupltd.co.uk, contact us on 01695 559785 or e-mail post@pesgroupltd.co.uk

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Health Business | Volume 10.2

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HOSPITAL GROUNDS

GROUNDS MAINTENANCE – A PRESCRIPTION FOR SUCCESS The Institute of Groundsmanship writes about the role of contractors in maintaining NHS open spaces ACCORDING TO THE CRITICS, MUCH of the country’s public spaces – and that includes the myriad of open areas within and around hospital grounds – are being maintained by unskilled, casual labour that are directed by financiallydriven, corporate contracting companies.

This is, however, not always the case, as contractors are increasingly (and in many cases, continually) upskilling their labour forces.

ESSENTIAL SKILLS The maintenance of hospital grounds can present a number of challenges that invariably require an unusually wide-ranging multitasking skill set to, for example, accommodate the requirements of not only grassed areas but also shrubs, trees, hedges, flower beds, footpaths and car parks, for instance.

Skilled horticulturalists and grounds staff are essential if these are to be maintained to the required high standards, and it is encouraging that certain contractors are taking the initiative and investing heavily in staff training. Indeed, with clients’ standards/demands ever-rising, such investment will become a necessary requirement for many future contracts and contractors that don’t invest in their staff will undoubtedly fall by the wayside.

Hospital Trusts should bear a number of factors in mind when selecting a contractor.

Firstly, identify the key performance indicators of each grounds management/maintenance contract – and the resulting shortlist may include aspects such as resources, skills and minimum qualifications. Another key factor is ‘organisation’; as a minimum, contractors should be accredited to/working towards a standard such as ISO 9001 and ISO 14001 supported by, for example, management programmes and an august approach to day-to-day management and supervision.

Ideally, too, contractors and clients should both be working to a real-time audit trail – at the end of the day, everyone wants the same thing – and such audits will eliminate the folly of lack of checks and show everyone a clear picture of what is, or what is not, happening. Likewise, if there are any problems, the client should be able to pick up the phone and talk directly to the contractor. Specialist tasks like planting schemes may be left to the experts – nurseries, for example – but the end result will be the same.

THE RIGHT STAFF While grounds maintenance has to be part labour of love, contractors that believe in

Selecting the right contracting company, at the right price and one that has the right approach to staff development will mean that skilled and dedicated operators will maintain your open spaces THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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HOSPITAL GROUNDS

training and staff development attract the right calibre of person, and they retain them.

One of the country’s largest privately-owned landscape maintenance service providers, John O’Conner (Grounds Maintenance), is partway through a strategy of having more than 300 employees nationwide trained to NVQ Level 2 via the IOG, and NVQ delivery body.

With a turnover of around £13 million, the company is one of the UK’s largest privatelyowned independent grounds maintenance operations, and according to Jane Wilson, who is coordinating the IOG/NVQ accreditation process from the company’s Welwyn (Herts) head office, the company employs a policy of continuous improvement in all activities – including employee training and improvement. This substantial move towards NVQ accreditation is as much driven by in-house dictates as it is by customer demand, she says.

“We’re working closely with the Institute of Groundsmanship in terms of delivery mechanism and assessments,” she adds. “The fact that the training can be imparted on-site makes the training so much easier for everyone involved.”

Indeed, the company’s efforts recently earned it a prestigious award at the Hertfordshire Business Awards Ceremony, which recognise individuals and companies that have made a significant impact on business in the past 12 months. The company was presented with a special accolade for Training and Development, and the award recognised and celebrated training excellence in both individual and team development and the resulting positive impact on staff and, importantly, customers.

Commenting, managing director Matt O’Conner, said: “We fully recognise that the success of our business is based on the success of our staff, and training is seen as an investment in our most valuable assets.

“We have been able to deliver our training programmes through forming partnerships with our training providers, which include the Institute of Groundsmanship, Lantra, NPTC and working closely with our suppliers.

Together we have been able to develop training programmes that match the needs of our staff, our business and our customers.”

IOG TRAINING Ever since its establishment in 1934, the IOG has been working to develop training and educational opportunities for grounds staff, and today offers a wide range of professional short courses as well as internationally recognised qualifications in most areas of grounds maintenance and management.

The IOG works closely with all relevant organisations in the UK and Ireland to promote these opportunities – including working in partnership with colleges and awarding bodies – to ensure there are adequate and appropriate educational qualifications for all employment levels within the industry.

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Image courtesy of Little Oak Tree Care

The Institute of Groundsmanship (IOG) is the leading membership organisation representing grounds managers, groundsmen, grounds maintenance managers, greenkeepers and all others involved in the management of sports pitches, landscape and amenity facilities in the UK. As well as maintaining the IOG Performance Quality Standards and providing a consultancy service for sports grounds, lawn maintenance and amenity horticulture, the IOG’s extensive Training and Education programme includes cricket, football, tennis, horseracing, bowls, artificial surfaces, turf science and many other specialist subjects.

It also stages the annual IOG SCOTSTURF

and IOG SALTEX exhibition, Europe’s leading show for the open space profession.

At the end of the day, the key is to work closely and cleverly with the contractor which, if it has the skills and knows the business then the agreement will succeed.

Selecting the right contracting company, at the right price and one that has the right approach to staff development will mean that skilled and dedicated operators will maintain your open spaces.

FOR MORE INFORMATION Web: www.iog.org

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The commercial landscaping experts

Grounds maintenance from Your Grounds Care

ALDWIN LANDSCAPING has been providing commercial landscaping services for leading private and public sector organisations for over 45 years. We are a family run business and have developed an enviable reputation for providing a proactive and personal service to all of our clients. We pride ourselves on the quality of our work, our health and safety focus and our prompt reaction to each customer requirement.

Our experience extends from construction of landscaping schemes to annual landscape management and cleansing contracts. We offer a full range of hard and soft landscaping services, including all tree work, newt mitigation fencing, plus play area installation and maintenance services.

Our coverage of working area is the majority of the North West and we are pleased to be members of BALI, Constructionline,

AVE TEN PER CENT OFF your grounds maintenance contract with Your Grounds Care. We provide complete grounds maintenance, internal plant displays, landscaping and winter gritting solutions for the healthcare industry across the UK. With years of experience Your Grounds Care is widely acknowledged as having a reputation for being honest, reliable and offering a high quality service at great value which consistently meets, and surpasses the high standards of its customers.

No matter what the size of your grounds we are committed to providing the highest levels of care and service in all that we do. We tailor make the service specification to meet with your requirements and budgets and working with us you will improve

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Achilles, and CHAS. Examples of our work can be viewed on our newly updated web page.

FOR MORE INFORMATION Direct your enquiries to the following number for a quick and competitive quote.

Tel: 01606 783885 Fax: 01606 76634 E-mail: markwhite@ baldwinlandscaping.co.uk Web: www. baldwinlandscaping.co.uk

the all-important first impression your organisation makes on every employee and visitor.

During the winter we continue to help maintain your grounds by providing winter gritting and snow clearance services.

We are accredited with Safe Contractor, Construction Line, CHAS and Contractor Plus. We promise to beat your current supplier’s contract price by ten per cent on a like-for-like quotation.

Please quote HEALTHBUSINESSYGC to qualify for this offer, and we’ll arrange a meeting to discuss your requirements. We look forward to hearing from you.

FOR MORE INFORMATION Tel: 0845 643 5081 E-mail: info@ yourgroundscare.co.uk Web: www. yourgroundscare.co.uk

Town and Country grounds maintenance services for health OWN AND COUNTRY Grounds Maintenance is the sole commercial provider of grounds maintenance and landscaping services for the whole of the Midlands regions.

Established five years ago our plan was to serve the commercial and public sectors such as schools, hospitals and housing associations. Once established we drew our attention to investment programmes in staff, equipment, training and quality of service levels.

We are now accredited by ConstructionLine, CHAS and Safe Contractor, council approved and carry high levels of insurance required by our customers. All staff take health and safety matters very seriously and adhere to our tailored health and safety policy. Image is as important to

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us as it is to our customers so all vehicles are prominently liveried, staff uniforms are distinctive and all staff wear high visibility jackets with our company logo on.

We carry out annual CRB checks on all staff to ensure our commitment to customers. We are registered with the Environment Agency for waste carrying and disposal and have staff with PA1 weed spraying licences.

All contracts large and small are assigned a contracts manager as a main point of contact to liaise with throughout the duration of the contract.

FOR MORE INFORMATION Look at www.tacg.co.uk for a full list of our services or call us on 08450 170899 to discuss your requirements.

Well known brands at competitive prices T P&G PROFESSIONAL we believe outstanding cleaning, hygiene and the perception of cleanliness play a vital role in the smooth running of hospitals. Having well trained domestic staff using branded cleaning and laundry products that are known and trusted by hospital staff, patients and visitors alike can really make a difference.

That’s why we supply professional formats of brands such as Flash, Fairy, Ariel and Bold at competitive prices through NHS Supply Chain.

The P&G Professional range includes both disinfection and non-disinfection cleaning chemicals to support your needs – whether that’s everyday cleaning or deep cleans. Our products also give the added benefit of increasing the perception of cleanliness through the use of

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fragrance – for example our Flash All Purpose Cleaner is available through NHS Supply Chain in four great fragrances. These products give both outstanding cleaning and leave a long lasting fresh scent around the hospital.

Our products are simple, effective and easy to use and are supported with free of charge usage aids, training materials and engineering support all of which can be obtained via our Freephone Helpline on 0800 716 854.

FOR MORE INFORMATION Web: www.pgprof.com

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17:35 Work’s finished at last 17:40 On the road in my beautiful car!

WPS ParkID

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For many people, the worst part of driving isn’t the traffic jams. It isn’t inconsiderate drivers. It’s parking. Especially in the city. Endless queues at the multi-storey.

Frustrated customers trying to find their way in or out. For them it means lost minutes or late meetings, for you it means lost profits and a damaged reputation.

With the new WPS ParkID, your customers get going faster. A user-friendly, intuitive interface means they can get their ticket instantly on the way in and pay easily on the way out. And you can see an instant overview of all aspects of the day’s profits in real time. Which means everyone’s happier.

www.wpsparkingsolutions.com Visit our website to find a system to match your car park

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Health Business | Volume 10.2

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PARKING

FAIR PARKING FOR ALL Patrick Troy, chief executive, British Parking Association, explains the Charter for Hospital Parking, recently launched to ensure better standards MANY PEOPLE WHO ATTEND NHS hospitals, either as patients or visitors, expect car parking to be free. However, given the limits on space, the costs involved and the demand for spaces, car parking needs to be managed properly. Often the most effective way to do this is by charging for parking. This recognises the value of a car parking space; the needs of other users of the hospital; the environmental impact of driving; and the need to maintain and improve car parks by reinvesting income.

To strike the right balance between being fair to patients and others, including staff, and making sure that facilities are managed effectively for the good of everyone, the British Parking Association (BPA), backed by the NHS Confederation and the Healthcare Facilities Consortium, has published a Hospital Parking Charter, which is aimed at both NHS Trusts and car park operators.

HELP WITH MANAGEMENT The Charter, following a period of consultation in 2009 canvassing views and opinions of all involved and affected by hospital parking – from NHS Trusts to patient groups – has been refined to create a robust document which will help guide hospital parking management in the future.

The resulting document strives to raise standards in the parking sector and deliver a more professional service to the public.

The guidelines will help the health sector with parking management issues. There has been much debate about parking at hospitals and we hope our Charter will provide some much needed direction for this particular sector, and therefore the BPA is encouraging all NHS Trusts to sign up.

Providing, managing and paying for hospital car parking needs to be seen in the context of delivering a better and fairer service to users. Both NHS Trusts and car park operators recognise the importance of car parking policy, both in terms of the wider transport strategy and the need to manage traffic and parking in line with demand and environmental needs. They also recognise the importance of professionalism in delivering their services and providing a high standard of customer care. In particular, it is essential to provide safe car parking for hospital users.

The Charter is designed to help and encourage NHS Trusts to provide parking management systems that are fair for all. The issue of parking management at hospitals is a hot topic, regularly debated, and in response to this the BPA has produced guidelines to

THE BRITISH PARKING ASSOCIATION APPROVED OPERATOR SCHEME (AOS) The AOS was set up by the BPA in 2007 as a response to concerns about the management of private car parking and parking on private land, and because there is no government regulation of the sector.

Members of the scheme must comply with the BPA’s Code of Practice, which sets out requirements for signs in car parks, the levels of charges and what customers can do if they feel they have been treated unfairly. The Code can be viewed on the BPA website www.britishparking.co.uk The BPA is an Accredited Trade Association of the DVLA (Driver

& Vehicle Licensing Agency). The DVLA will only release ‘registered keeper’ information to members of the Approved Operator Scheme. The government is intending to legislate to license clamping companies so that they must also agree to comply with a Code of Practice. The government has also said that an independent appeals service should be introduced as a further option for members of the public who are unhappy about the enforcement action taken against them. The BPA wholly supports that proposal.

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Health Business | Volume 10.2

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PARKING

help Trusts and car park operators deliver effective and efficient parking for users – many of whom have particular needs.

Bringing together the interests of hospital car park users (staff, visitors and patients), government, local authorities and commercial organisations, the Charter will be circulated to all NHS Trusts across the UK. Some NHS Trusts, including Blackpool, have already indicated their support for the Charter, are expected to be amongst the first to sign up, and many parking operators have already added their name to the Charter.

CHARTER RECOMMENDATIONS The recommendations made in the charter will commit NHS Trusts, and their parking contractors, to: • Do their best to provide a high standard of management and customer service in their car parks • Provide good lighting; high standards of maintenance for structures and surfaces; payment systems and equipment that are easy to use and understand; signs that are clear and easy to understand;

THE HEALTHCARE TRAVEL COSTS SCHEME The Healthcare Travel Costs Scheme entitles patients who are getting certain benefits, or who are on a low income, to reclaim travel expenses when receiving medical treatment. To see the full guidance please go to www.dh.gov.uk NHS Trusts and their car parking contractors should define what they mean by ‘regular or long term

and clearly marked parking bays • Do their best to ensure that car parks offer a safe environment for all users and aim to meet the Park Mark® standard • Ensure that parking tariffs and tariff structures are reasonable, reflecting supply and demand, and the cost of maintaining the facility and providing the service. Tariff structures should be set to reflect local conditions, local tariffs and the needs of all hospital users. They should take account of the hospital’s environmental policy. Also, systems need to be in place to protect the legitimate use of hospital car parks. Tariffs should also

treatment’ in consultation with patients, to reflect local demand. It might cover, for example, more than five outpatient visits during a single course of treatment or more than five nights in-patient stay. The concessions might take the form of a cap on payments; for example, free parking or reduced charges after a set number of visits.

take into account what the impact on local residents would be if the level of charges drove motorists to park in local streets • Consider the best practice advice available from organisations such as the BPA, Parking Forum, NHS Confederation and the Department of Health. In particular, information about costs and any income associated with running car parks should be clear, straightforward and published • Tell patients who are eligible about the Healthcare Travel Costs Scheme, and encourage them to claim back their charges • Provide concessionary parking to the following

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Health Business | Volume 10.2

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PARKING

people if public transport may be impractical for them or if parking charges could become a burden over time: patients with a long-term illness or serious condition needing regular or long-term treatment (for example, people having dialysis, radiotherapy or chemotherapy), and people who need to visit patients regularly.

• Work together to make sure that maximum publicity is given to such concessions and that they are taken up by eligible patients • Consider the needs of disabled users for whom other types of transport may be impractical. Trusts and operators should make sure that there are enough disabled parking spaces and, if payment is required, that payment systems are adapted to make them easy to use • Design systems used by car park operators to recognise the unavoidable, unplanned and unpredictable nature of visits to hospitals.

Enforcement action should be designed not to penalise people whose contravention of the parking rules could not have been foreseen by them. There should always be an appeals procedure. Policies should cater for the needs of patients and visitors separately from those of staff, where different circumstances may apply • Ensure that any enforcement is to be proportionate, with a focus on encouraging compliance. Operators should all be members of the BPA Approved Operator Scheme, and read the Charter alongside the AOS Code of Practice, particularly what it says about signs, the levels of charges and what customers can do if they feel they have been treated unfairly.

Parking charges can help to pay for maintenance and management services, and prevent these from becoming a drain on healthcare budgets. Therefore, we encourage NHS Trusts and car park operators who manage hospital car parks to sign up to this Charter and to abide by its letter and spirit.

WHAT IS THE PARK MARK®?

To raise the standard of safety in car parks, the BPA manages the Safer Parking Scheme (SPS) on behalf of the Association of Chief Police Officers. Its aim is to reduce the fear and perception of crime in parking areas. Police-accredited assessors carry out a risk assessment for each site, and look at how the site is managed and maintained. The parking operator must put into place measures appropriate to the surroundings that help to deter criminal activity and anti-social behaviour, in this way doing everything they can to prevent crime and reduce the fear of crime in their parking area.

Park Mark® is the brand of the Safer Parking Scheme, designed to set the standard for parking areas across

the UK, both for the public and their vehicles. National statistics show that around 22 per cent of vehicle crimes happen in car parks. Many parking facilities with the award have seen a dramatic drop in crime. Or, if they had not suffered from vehicle-related crime, they have been able to create a safe and non-threatening environment that encourages customers to keep coming back. Car parks with the award can use signs showing the distinctive Park Mark® tick, so drivers know exactly where to go for safer parking. There are almost 4,000 Park Mark® car parks in the UK. The public can search for them and get directions to them from a dedicated website www.parkmark.co.uk

Health is none of our business – but car park tickets are INCE OUR FOUNDATION in 1911, we have become the number one manufacturers of parking tickets in Europe, and we export to over sixty countries worldwide.

Our tickets are made to rigorous standards in co-operation with all the major ticket machine manufacturers to ensure top quality products that will keep your car parks operating effectively.

It is easy to think of tickets as a minor issue, yet if they run out, or cause machine failures, your valuable revenue stream stops. That’s why it is so important to ensure you buy quality

S

tickets from an approved manufacturer.

We can even manage your supplies for you with scheduled deliveries.

Car parks at hospitals from Southampton to Dundee, from Folkestone to Plymouth, are running smoothly on our tickets. Yours could be too.

FOR MORE INFORMATION To find out what we could do for you just call Bev Hill on 07917 035 666 (for the western side of the UK) or Jim Willamson on 07917 861 000 (for the eastern side) or e-mail us on sales@nagels.co.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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In an ever more demanding world, Variable Message Signs Limited combines innovation, experience and technology in strategic and urban driver information. Our road traffic product range covers applications in the strategic , urban, and traffic management equipment sectors.

We offer a full range of services to suit individual client requirements from design, manufacture, supply, installation and commissioning of LED driver information systems, including fully UTMC compliant systems and all for clients, which include the Highways Agency, Transport for London, Local Authorities, Local Health Authorities, Hospitals and others.

We have supplied and installed a number of hospital sites which use our Safewatch range of vehicle activated signs for road & patients safety, by advising and reinforcing the speed limits and other hazards, such as pedestrian crossings, side roads and car park entrances and exits, etc;

Our range of car park guidance and information signs advise drivers where the car parks are on site and the number of spaces left within each, providing information and choice for drivers entering the site, and via our TRAMS car park management software package, the hospital / customer has control over all the listed car parks, the number of displayed / available spaces as well as providing various management reports and helps reduce emissions by keeping traffic moving and avoiding queuing.

Variable Message Signs Limited now introduce for the very first time, Pegasus our new range of urban dual colour full matrix signs. The sign’s attractive and slim design is especially suited to today’s urban streetscape, where it will deliver driver and pedestrian information.

The sign is offered in three sizes, with high resolution matrix areas suitable for the display of four lines of text with character heights of 160mm, 100mm, and 50mm. All variants are capable of displaying combined text and pictogram information and employ a dual-coloured, amber and red, matrix.

A special feature of the new sign system is the ability to mount it in a landscape or portrait format, with five mounting options for landscape fixing and three for portrait fixing.

VMSL The sign of the times; There’s no substitute for quality:

Variable Message Signs Limited Unit 1, Monkton Business Park North, Mill Lane, Hebburn, Tyne & Wear NE31 2JZ T 0191 423 7070 F 0191 423 7071 E ghutton@vmslimited.co.uk W www.vmslimited.co.uk

Health Business | Volume 10.2

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PARKING

PARKEX CLOSES A SUCCESS Parkex 2010, Europe’s largest dedicated parking exhibition, organised on behalf of the British Parking Association, took place from 2-3 March at London’s Earls Court WITH MORE THAN 2,200 ATTENDEES over the two days, this year’s Parkex was the busiest in the show’s history as a dedicated stand-alone parking event. Going against the grain, Parkex challenged the notions of cutbacks and recession, showcasing an industry that was actively looking to improve and invest in future parking projects. Visitors were notably focused, with clear spending priorities and objectives.

Don Turner, business development executive from SEA, commented: “This year’s Parkex has been busier for us than ever before. The intent of the visitors has been much more serious.”

Ian Whitmore from WPS also commented on the mindset of the visitors, saying “there was a good quality of visitor with genuine intention to buy”, and Craig Alewood from Phillips emphasised the sense of surprise within

the industry: “Given the current climate our expectations were low, but this year’s Parkex has been our best event in the last ten years.”

HOT TOPICS During the show many hot topics were debated in the seminar theatres including two exclusive announcements from the British Parking Association. Following an interview by chief executive Patrick Troy on BBC Breakfast News, Keith Banbury OBE, Chair of the AOS Board, launched the scheme of sanctions for the Approved Operator Scheme and explained how the updates of legislation will affect the private off-street parking sector. Richard Hein, BPA President also announced the BPA’s Charter for Hospital Parking, designed to help and encourage NHS Trusts to provide parking

management systems that are fair to all.

“I am delighted that Parkex 2010 broke all previous records for attendance. It demonstrates the parking sector’s journey to a parking profession and beyond. It was also the crosssection of attendees that was important – people representing the motorist and the consumer were there too proving that the profession is continuing to place the consumers’ needs at its heart,” commented Richard Hein.

Parkex 2010 had the support of four event partners: Bemrose Booth, Civica, Equita and NSL Services Group, representing leaders in the parking industry spectrum from ticketing and enforcement to consultancy and urban management solutions. The attendance exceeded the organisers’ expectations who are now looking ahead to another successful and

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Professional Parking .

Solutions make parking. .

PASS Training is a leading training company with experience of delivering a broad range of in-house training courses including Civil Enforcement Officer, Health & Safety and Notice Processing training and many more. We work in both the private and public sector including Local Government, the Parking Industry and Security.

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Our CIPD training consultants engage with our clients to ascertain their real training and development needs and provide bespoke training programme’s that seamlessly fit your company’s requirements and culture. Within these training programme’s we offer the use of a variety of tools including Psychometric testing. These assist in producing self-managed learning resources and facilitate group learning, with training courses designed to meet your staff and organisations needs. We provide training consultancy services in the UK and have within our team over 30 years experience in providing high quality industry leading training solutions.

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Health Business | Volume 10.2

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PARKING

ABOUT THE BPA The British Parking Association (BPA) ise the largest professional association in Europe representing organisations in the parking and traffic management industry. These organisations are many and varied, and include manufacturers, car park operators, local authorities, health authorities, airports, railways, shopping centres, theme parks, consultants. Currently there are circa 650 members, equally split between the public and private sectors. even larger event at the co-located Parkex, Traffex and Street Design exhibition from 29-31 March 2011 at the NEC Birmingham.

INFORMATIVE SEMINARS The extended free-to-attend Parkex seminar programme is now well regarded as the forum for the parking industry, where leading parking experts covered both on and off-street parking topics focusing on relevant, topical issues that are affecting the parking professional.

Each day the seminars were split into two themes: ‘Driving Issues’ and ‘Raising Standards’ which underpin the work of the BPA. Patrick Troy, Chairman of the BPA, opened the programme on Tuesday 2 March and the sessions that followed included spokespeople from leading parking organisations.

With numerous sessions each day, this year’s programme provided an in-depth look at a diverse range of topical issues, including: • Environmental solutions for ticketing • Pay by phone • Hospital Parking • Blue Badge Fraud • Car Park Management from disrepair to distinction • Baliff and enforcement challenges CAREER POINT The Parkex ‘Career Point’ offered expert advice on training and career opportunities from the industry’s leading recruitment specialists. The Institute of Parking Professionals (IPP) was available to give advice on maintaining the high standards of professional skill, ability and integrity among individuals working in the UK parking and parking related industry.

NEW PRODUCTS LAUNCHED Over 120 exhibitors from the UK and overseas showed the very latest in parking management, parking equipment, parking software and innovations in parking enforcement, access control and car park services. Leading parking brands from the UK and around the world used Parkex as the launch-pad for their latest products and services.

Another Level Car Parks returned to Parkex to showcase its demountable modular deck Car Parking System, for hire or sale. The fully galvanized steel decks simply span existing

car parks without central supports and normally there is no need for foundations, making this system incredibly quick to install. The car park is 100 per cent reusable, once removed there will be no evidence that such a structure had been in place.

Alpha Parking exhibitited the latest in its parking solutions for local authorities and the private sector. Visitors to their stand could benefit from a 5-minute free consultancy session where Alpha Parking answered any parking related questions regarding Civil Parking Enforcement, Traffic Orders, using ParkMap, optimising your car parks, training, Control Parking Zones, and signs and lines.

Buchanan Computing launched TraffWeb; an intuitive but powerful system for mapbased internet and intranet access to orders and parking places for authority staff and public access. Buchanan Computing is the provider of ParkMap, the UK’s most widely used system for making traffic orders and managing on-street parking controls and moving vehicle restrictions, such as speed limits.

Designa, established supplier of ‘Pay on Foot’ barrier systems, featured its full PM ABACUS System, complete with fully integrated ANPR system and a SLIMPARK system. They also demonstrated its ‘MID software’ – a management information dashboard that enables the viewing of all important statistical data on one easy to read screen.

The latest ‘QED’ luminaire de-population battens were previewed by Energy Converservation Solutions. These battens exploit the higher light output of Triphosphor tube use made possible by ‘Save It Easy’ retro fit converters to reduce the number of

fluorescent tubes in multi-tube luminaires – further increasing energy economy.

The Group Fast Park, provider of a unique patent pending parking deck that can afford to be permanent in a “turnkey” complete package, demonstrated its latest parking facilities installed in UK and throughout Europe.

The original and innovative system is distributed at international airports, hospitals, local authorities, shopping malls and railways stations and can offer many different benefits including fast construction and minimum disruption to an ongoing parking operation and to users.

Liberty Services exhibited its full range of parking products and services including PCNs, carriers, permits and notebooks. To compliment its full back office processing system it will be launching a new document scanning and payment processing service in partnership with Documetric aimed at providing the most efficient and technologically advanced mail out, in service in the UK. Parkex also saw the launch of its P600 and P1000 pay and display machines supplied by Island, one of best available on the market with a comprehensive maintenance and repair service.

Metric Group Ltd showcased the latest developments in pay & display equipment with the Aura and Accent machines, new developments with the powerful WebASLAN back office software will be on show. Hardware solutions of note were be the wave & pay credit/debit card machine, ANPR integration and bank note acceptance. The technical team and sales staff from Metric were on hand to provide full demonstrations of all their equipment and back office solutions.

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Rugged computers for tough environments NAUTIZ X5

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Health Business | Volume 10.2

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FLEET MANAGEMENT

MANAGING ROAD RISK Kevin Clinton, head of road safety at the Royal Society for the Prevention of Accidents, discusses a proactive risk management approach to reducing the risks connected with ‘at work’ vehicle use DRIVING IS OFTEN THE MOST dangerous activity that most of us do in the course of our working lives. It has been estimated that up to a third of the accidents that happen on Britain’s roads involve somebody who is at work at the time. This means that every week, around 200 road deaths and serious injuries involve someone driving, riding or otherwise using the road for work purposes.

Some of the pressures faced by “at-work” drivers are vastly different to those they experience when they are at the wheel in their own time. Perhaps they are required, like pharmaceutical reps or ambulance drivers, to drive thousands of business miles a year, often at peak times and in unfamiliar vehicles, to new locations, against deadlines, while under pressure to answer work-related phone calls, and while dividing their attention between the task of driving and reaching a meeting or an incident.

It appears that such pressures are impacting negatively on safety. For example, research has found that business drivers have collision rates which are 30-40 per cent higher than those of private drivers.

It is clear, therefore, that work-related road risk is both a major road safety and occupational safety issue affecting not only vocational drivers – people whose job is driving – but also the vast range of workers who cannot do their job without travelling on the road at some

point. The Royal Society for the Prevention of Accidents (RoSPA) has campaigned for more than a decade to ensure that employers and regulators address work-related road risk as a mainstream health and safety issue.

Since the inception of the managing occupational road risk (MORR) campaign in 1996, the safety charity has developed links with a wide range of businesses and organisations. In fact, there are now more than 100 organisations in the Occupational Road Safety Alliance (see www.orsa.org. uk). In Scotland, a website for the Scottish Occupational Road Safety Alliance (www.scorsa. org.uk) was launched in September 2009.

WHY MANAGE ROAD RISK? It is impossible to deny the ethical reasons for taking work-related road risk seriously.

The potential for pain and suffering caused by at-work road accidents is substantial, with effects for the employee, his or her family and wider society. Changing the attitude and behaviour of road users is an important step towards reducing the number of accidents and this can be achieved through educational programmes such as refresher driver training.

There is tremendous potential for employers in the health sector to get involved in this. Due to so-called “time poverty” experienced by people outside of work, they are more likely to take part in safety programmes delivered within the

workplace than those offered in the community.

So, besides helping to reduce risks to employees while they are at work on the road, employers are also well placed to make a valuable input towards reducing the tragic toll on our roads through the attention they give to road safety.

There is also a growing focus on environmental concerns, and there are clear overlaps between driving technique, safety and fuel consumption. Indeed, some drivertraining providers now offer “eco driving” courses, which explicitly highlight these overlaps. Using less fuel typically means spending less money, and herein lies a clue to the next key reason for taking work-related road risk seriously – the business case.

FINANCIAL SAVINGS Research by the Health and Safety Executive (HSE) into workplace accidents suggests that for every £1 recovered through insurance, between £8 and £36 may be lost through uninsured costs. Occupational road accidents are likely to cost firms in terms of lost business, administrative and legal fees and rising insurance premiums. Particularly when they involve liveried vehicles, they can also adversely affect corporate reputation and this, in turn, brings further financial implications.

Addressing road safety therefore makes good business sense. Indeed, the business case for preventing accidents is stronger

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Health Business | Volume 10.2

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FLEET MANAGEMENT

during a recession. If sales or funding reduce, cutting the costs associated with easilyavoidable accidents becomes an increasingly crucial way to defend the bottom line.

In addition to the ethical and business cases, there are also significant legal prompts. Guidance issued by the HSE and Department for Transport (DfT) in Driving at Work: Managing Occupational Road Safety (INDG382, published in 2003), clearly states that health and safety law applies to on-theroad work activities as to all work activities.

Employers must therefore manage risks on the road within the framework they should already have in place for dealing with other aspects of health and safety. The general duties laid out by the Health and Safety at Work Act mean they must assess the risks involved in the use of the road for work and put in place all “reasonably practicable” measures to manage those risks. There are no specific health and safety regulations covering this issue, but ignoring occupational road risk is not an option.

The police look at work-related factors when road crashes are investigated and action has been taken against employers. For example, we have previously seen company directors successfully prosecuted for manslaughter

after crashes which could be linked back to working practices, including where drivers had spent excessively long hours at the wheel.

There are also specific regulations, such as drivers’ hours rules, plus general road traffic laws with which employers need to comply. An individual, for example, could be prosecuted for aiding and abetting the use of a hand-held mobile phone while an employee is driving.

There has also been a great deal of speculation about the potential use of the Corporate Manslaughter and Corporate Homicide Act

in relation to work-related road deaths.

Work-related road injuries are currently not within the scope of RIDDOR (the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations), although many organisations, including RoSPA, have called for them to be included as a way of confirming that road use should be managed in the same way as other occupational activities. But, as we have seen, even without this, there are many reasons why work-related road safety is something that cannot be ignored.

It is clear that work-related road risk is both a major road safety and occupational safety issue affecting not only vocational drivers but also the vast range of workers who cannot do their job without travelling on the road at some point. The Royal Society for the Prevention of Accidents (RoSPA) has campaigned for more than a decade to ensure that employers and regulators address work-related road risk as a mainstream health and safety issue

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Running a fleet can be a real hassle.

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Health Business | Volume 10.2

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FLEET MANAGEMENT

ACTING ON MORR Essentially, employers must conduct suitable risk assessments and put in place all “reasonably practicable” measures to ensure that: work-related journeys are safe • staff are fit and competent to drive safely • vehicles used are fit-for-purpose and in a safe condition.

In controlling the risk of work-related road accidents, organisations can put in place a range of practical and cost-effective control measures such as: exploring safer alternatives to road travel, for example, taking the train or video-conferencing; specifying safest routes; insisting on compliance with speed limits; setting standards for safe schedules, journey times and distance limits; specifying the use of vehicles with additional safety features; ensuring safe maintenance; and, ensuring drivers are fit to do the task, which includes driver selection procedures, assessment, training and continual development.

But MORR is not about one-off, detached interventions. Instead, it is focused on developing a system (policies, people and procedures) to deliver sustainable and

measurable benefits. It must be led from the top by senior managers and involve effective workforce participation and consultation with employee representatives. Line managers too have a key role to play in ensuring that staff are not put at risk and that they drive safely.

The good news is that plenty of help and information on developing such a system for the health sector is available from organisations such as RoSPA, ORSA, ScORSA, the HSE and the DfT. At first glance, managing occupational road risk might seem like a daunting task. But many organisations are successfully addressing the issue without it being over-burdensome, and service providers are generally happy to help meet the specific requirements of individual firms.

During its 93-year history, RoSPA has led the way in speaking out on road safety and in building an unrivalled reputation as an innovative provider of risk management and fleet safety solutions. Its extensive training portfolio, designed to suit organisations of all sizes and types, includes a Driver Theory Workshop, E-Learning package, Driver Development Course and Advanced Driver

and Rider training. There are also many more specialist courses for drivers and fleet managers, including the Emergency Driving Course. Road accidents caused by vehicles being driven at high speed for emergency purposes has resulted in the introduction of Section 19 of the Road Safety Act 2006, stating that any driver using the speed limit exemption must undergo compulsory training.

RoSPA also offers risk assessment solutions, MORR consultancy and driver training awards.

FOR MORE INFORMATION Details of RoSPA’s Driver & Fleet Solutions can be found at www.rospa.com/driverandfleet E-mail fleetsolutions@rospa.com or call 0121 248 2233 (Birmingham) or 0131 449 9378 (Edinburgh) for more information.

Useful links: www.rospa.com/roadsafety/resources/ www.orsa.org.uk www.dft.gov.uk/drivingforwork/ www.scorsa.org.uk

Fleetmasters – driving your business forward

Reduce accident rates with fleet driver training

LEETMASTERS IS A dedicated driver training and risk assessment company specialising in on-road driver development.

All of our trainers are highly qualified and are constantly monitored to meet stringent quality assurances. We require all of our trainers to be DSA fleet registered to a minimum standard of grade five or six and to be DIAmond Special test holders.

Our aim is to reduce work related road deaths and serious injuries, to protect your company from litigation with regards to the new corporate manslaughter legislation, to make your fleet more fuel efficient, therefore reducing your carbon footprint, and, through coaching better driving techniques, reduce your servicing costs.

We are one of the few training

W fleet driver training? Statistics

F

companies that will carry out risk assessments while the driver completes their normal duties.

This keeps costs low and causes minimum disruption to your operation. It also allows us to ‘target’ any training requirements.

Again, this is a highly cost effective method of risk assessment management and has been the preferred method of all our NHS customers over the last three years.

For an appointment or an informal discussion with regards to your training requirements or for any further information, please phone Wayne Harris, or visit our website.

FOR MORE INFORMATION Tel: 07884 450071 E-mail: info@fleetmasters. org.uk or wayne.harris@ fleetmasters.org.uk Web: www.fleetmasters.org.uk

HY SHOULD YOU consider

tell us that company fleet drivers have accident rates up to 50 per cent higher than other drivers. But safety on the road is not just the responsibility of the driver. New health and safety legislation means that the local manager, fleet manager, and senior management. all have a responsibility to ensure that their driving staff are safe and competent on the road.

So all levels are responsible.

Do you monitor how many accidents, both minor and serious, your driving staff have had in the last 12 months?

How much off road time and inconvenience has this caused?

What are the ongoing costs of this and insurance premiums?

Do you feel that your company image could suffer because of lack of driver training? Insurance research has shown that accident claims can be reduced by as

much as 40 per cent where fleets have invested in a fleet safety programme using consultants who are experienced and trained to deliver this programme.

Driver attitude, and safe techniques behind the wheel, will ensure that a safe and fuel efficient standard is reached and maintained. Training includes precourse information, administrative support, advice on more effective fleet management and continuous support afterwards.

Whether you use ad-hoc drivers, or clock thousands of miles per year, Fleetsafe Ltd will have a programme that will suit your requirements.

FOR MORE INFORMATION Tel: 01925 763928/571024 Fax: 01925 763928 E-mail: enquiries@ fleetdrivertraining.org.uk Web: www. fleetdrivertraining.org.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Health Business | Volume 10.2

www.healthbusinessuk.com

FRAUD PREVENTION

HOW TO CUT COSTS AND IMPROVE FRAUD DETECTION George Mckillop, managing director of Haymarket Management Services, the specialists in the detection of major and complex corporate fraud, looks at ways you can cut costs whilst protecting your organisation from fraud IN THE EARLY 1990s, I SAT ON THE Audit Commission’s External Advisory Group examining probity in the NHS. Shortly after the Audit Commission had finalised its report, my company was retained to carry out a proactive fraud detection review of a UK health trust. Within three weeks we produced an interim report of preliminary findings and appended documentary evidence of contract and procurement fraud, together with a strategy plan including recommendations for a full-scale covert investigation. Within two days of delivering the report, we were thanked for our work and asked to submit our invoice.

Shortly afterwards, the CEO of the Trust quietly resigned and moved on. We heard nothing more from the Trust, which clearly felt it better to maintain a public façade of integrity, whilst masking a rotten core, than to proactively deal with its problems and risk public exposure.

To a degree, things have moved on and senior management of major organisations, such as the NHS, have a more realistic attitude to fraud generally. Gone are the days when the fear of public perception of fraud made it preferable to allow the perpetrators to quietly resign, to sweep the whole issue under the carpet and to utter not a word in public. Nowadays, there is a more pragmatic acceptance that fraud, in major organisations, is not just possible, it is sadly inevitable, and it is more to be commended than condemned when an organisation which suffers a fraud, is prepared to say “we identified a problem, we have dealt with it and we are prosecuting the perpetrators”.

Such a statement is a massive defence against future fraud in itself. Within Health Trusts, the question is how far does one go to defend against it or to attack it when it is discovered?

UNCOVERING FRAUD The more realistic acceptance of the inevitability of fraud in the NHS has seen the establishing of fraud hotlines, local fraud liaison teams and proactive endeavours to uncover ongoing fraud.

However, no matter how much the improved controls and procedures undoubtedly help, the NHS is still a massive target for organised crime gangs who are constantly developing innovative ways to circumvent controls and siphon off what they can through corporate crime. The massive annual NHS budget is a highly attractive target. Added to that, there is a plethora of opportunist fraud perpetrated by internal staff and contractors, often working in collusion.

The fight against professional fraudsters has become almost a game of cat and mouse, but

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it is essential that the mouse, in this case the NHS, does all that it can to stay ahead of the game.

Paradoxically, because of the recession, there will be cuts in the cost of controls, so unless they are carefully considered, then the longterm effect could be a far higher cost and the fraudsters will win the day. The good news is that significant cuts in control costs can be achieved without sacrificing effectiveness!

CUTTING THE COST OF PREVENTION In Haymarket Management Services we conduct reviews, which are aimed at cutting the cost of prevention whilst simultaneously improving the effectiveness of prevention and detection, which in itself should always be seen as an integral part of prevention. Such reviews have to be wide-ranging but it is in key areas that savings can be made whilst effectiveness can be massively improved.

Whilst considering the benefits of proactive detection vs. audit, it is important to remember that fraud is mostly either off record or disguised within records and that as such, normal audit techniques will rarely detect it. For that reason alone, pro-active detection should always win the day. For example, using dedicated state of the art analytical software, combined with other non-audit detection tests, which will almost inevitably detect fraud, actually costs far less than a normal audit programme, which will rarely detect any fraud. This is not to say that audit should be sacrificed – far from it. It is an essential tool. It is simply to say that the audit budget can often be slashed and part

of it allocated to pro-active fraud detection.

Always bearing in mind that forensic facilities and prevention technology are constantly improving, the cut-cost-and-improve-quality philosophy can be applied in many other areas of prevention as well. So, yes, cuts in the costs of prevention can be achieved but the effectiveness of prevention and detection does not have to be, and should never be, sacrificed!

Finally, remember it is people who commit fraud. Employ a crook and you can expect to be defrauded. Employ decent, honest people and your risks are massively reduced.

Effective pre-employment screening costs little and is essential. It should apply to temps and contractors as well as staff – in effect anyone who has internal access to your organisation.

Wherever else the axe may fall, sacrificing screening to save cost should never be an option.

FOR MORE INFORMATION Haymarket Management Services Limited 6-7 Queen Street London EC4N 1SP Tel: +44 (0)20 7801 2400 Fax: +44 (0)20 7248 3852 E-mail: gwm@haymarketco.com Web: www.haymarketco.com

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FRAUD PREVENTION

PREVENTING FRAUD AGAINST THE NHS Martin Wiles of the NHS Counter Fraud Service explains how health bodies can help design out fraud using four key principles THE NHS COUNTER FRAUD SERVICE (NHS CFS) investigates any suspicions of fraud, resulting in convictions that attract public attention. Work to prevent fraud may have a lower profile but is the preferred option. It protects the public purse and prevents the diversion of valuable NHS resources from patient care.

The NHS CFS works closely with the Department of Health and other stakeholders to recommend, develop, implement and evaluate NHS policy and procedures.

There are four key elements that should be built into all policies and systems to minimise the risks of fraud. We recommend having clear rules and evidence-based

procedures, ensuring accountability, proper monitoring and appropriate sanctions.

CLEAR RULES Some policies and systems are straightforward, such as timesheet recording, while others are inherently complex, with caveats and exemptions that require interpretation and judgement – for example, procurement and contracting. Clear rules or guidance to underpin each policy, be it the simplest or most complex, is the first step to reduce ambiguity and minimise mistakes. This will also make it more difficult for a reasonable excuse to be provided by someone who is defrauding the NHS. Wherever a claim or an exemption is made,

systems should be designed to require original evidence to support the claim – for example, receipts for expense claims or a counter signature on a timesheet for agency staff.

Such evidence helps validate any payment and makes monitoring more effective.

Systems should be simple and usable, while opportunities to defraud should be identified and reduced wherever possible. This all helps to make it clear what a person may and may not do.

ACCOUNTABILITY The second step should be a requirement for everyone responsible to be held to account for their actions. This could mean signing a proper declaration on an overtime claim, NHS Bursary application or a contractor’s statement of performance. A good declaration will help deter those tempted to defraud, it will assist in the event of an investigation, and it will ensure any legal issues regarding monitoring arrangements are dealt with properly.

An effective declaration will: confirm that details provided are correct; confirm that the signatory is aware of the consequences,

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FRAUD PREVENTION

including any sanctions, if they have provided false information; and permit the sharing of relevant details in the claim or application to enable effective monitoring to take place.

Of course, some systems and processes will not easily lend themselves to declarations on forms for each transaction, so consideration needs to be given to contractual terms for individuals or companies and to retaining a proper audit trail of instructions, and acknowledgements of those instructions.

This all helps to define who is accountable.

MONITORING Any system involving payment of money, claims or granting of exemptions from charges is at risk from fraud or error, so effective monitoring is necessary to identify any such potential problems.

Checks should validate the claim or payment against original documents and evidence to support the transaction. A good monitoring system will have predefined parameters and be supported by guidance to ensure those operating it follow a clear and consistent methodology.

An appropriate percentage of checks are needed, either taken from a random sample or targeted at the highest risks. The system should have a process to refer any suspicions of fraud to the Local Counter Fraud Specialist/s in the NHS body concerned, or to the NHS CFS via the NHS Fraud and Corruption Reporting Line: 0800 028 40 60.

Evidence gathered as part of a fraud investigation must comply with the Police and Criminal Evidence Act, so it is important that as soon as a suspicion is identified, the person routinely monitoring takes no further action until a trained counter fraud specialist is involved. The outcome of any anomalies found by the monitoring should inform revisions to the policy or procedure and any guidance, as discussed above. This all helps to see if a person committed fraud or not.

SANCTIONS Lastly, while a great many cases of fraud can be prevented, it is unlikely that every person minded to exploit the system for their own gain will be stopped before they offend.

Where fraud is not prevented or deterred and the monitoring identifies a case of fraud, appropriate sanctions will need to be considered. These may include criminal, disciplinary or civil proceedings to recover any losses, following investigation by the specialists. When developing a policy or system, consideration may also be given to including a sanction specifically for that process – for example, a fixed financial penalty or removal from the scheme. This will help prevent fraud happening again.

Martin Wiles is Head of Policy and Research at the NHS Counter Fraud Service.

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Martin Wiles

While a great many cases of fraud can be prevented, it is unlikely that every person minded to exploit the system for their own gain will be stopped before they offend

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Credential management and strong authentication CTIVIDENTITY™ Corporation (NASDAQ: ACTI) is a global leader in strong authentication and credential management, providing solutions to confidently establish a person’s identity when interacting digitally.

For more than two decades, the company’s experience has been leveraged by security-minded organisations in large-scale deployments such as the U.S. Department of Defense, Nissan, and Saudi Aramco. The company’s customers have issued more than 100 million credentials, securing the holder’s digital identity.

Governments constantly seek ways to improve how they serve citizens, ensure national security, and protect each citizen’s identity against falsification or fraudulent uses. To address these challenges, they are increasingly choosing to issue chip-based breeder documents. These documents store a citizen’s information in a digital format and can be accessed only by the citizen or authorised personnel.

Identity cards, passports, border crossing cards, healthcare cards, driver’s licenses, student cards,

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Working in partnership with our clients providing a cost-effective solution to your needs: • • • • • •

For more information on our products and solutions visit www.actividentity. com, or alternatively contact ActivIdentity on +44 (0) 20 7960 0220 or e-mail at info@actividentity.com

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will typically save ten per cent of total hours worked per month; these administrative hours would otherwise have been spent on tracking holidays, overtime, flexitime, billing, project management and other human resource issues.

Timesheet Xpress can also enhance employee time awareness, validate service costs, and enable tracking for financial statements.

Timesheet Xpress is a vital aid for scheduling and forecasting outputs.

When it comes to fraud, there’s no time to waste! Call now, or download our free trial version.

FOR MORE INFORMATION Tel: +44 (0)870 225 1790 Fax: +44 (0)870 225 1791 E-mail: Sales@TimesheetXpress.com Web: www.TimesheetXpress.com

Consultancy Counter Fraud Solutions Security Management solutions Internal Audit provision Computer Audit provision Governance solutions

Contact Kaye Millard - kaye.millard@scaudit.org Paul Montgomery - paul.montgomery@scaudit.org

FOR MORE INFORMATION

Timesheet Xpress combats fraud imesheet Xpress, a global leader in time management software, can be used to combat NHS timesheet and expenses fraud. Its robust time recording structure clearly illustrates personnel and budget allocation. Using Timesheet Xpress, healthcare trusts and departments can monitor individual and team performance. Our clients confirm improved productivity and budgetary control quickly result from using Timesheet Xpress.

“Timesheet Xpress is feature rich and excellent value. It has enabled the City of Peoria to recover over $1m dollars annually of operating budget,” said Edward Striffler, manager, City of Peoria, Arizona.

Improved time recording is made simple with Timesheet Xpress. Reduced budgetary errors flow from a greater transparency of cost centres; while management reporting and alerts are also built in.

Using Timesheet Xpress, a team

Providing a first class Internal Audit, Counter Fraud and Security Management Service to NHS & Public Sector clients across the South of England since 1983

public transport access, and e-wallets all adopt this mechanism.

Although the data on a healthcare card, for example, improves access to medical aid, it also poses a potential threat to privacy. As a result, chip-based solutions must provide advanced encryption and biometric identification techniques to reduce identity fraud.

ActivIdentity Governmentto-Citizen (G2C) solutions help systems integrators (SIs) address the challenges of G2C deployments by offering a credential management solution, as well as complementary components that SI clients can leverage to securely upload data onto chipbased authentication cards.

www.scaudit.nhs.uk Tel: 01424 776750

The specialists in nationwide investigation and surveillance T FOXGLOVE we specialise in investigation and surveillance for insurance, corporate and private sectors.

With a growing reputation for professionalism and dedication we pride ourselves in the knowledge that all investigations are carried out to the highest standards. This enables our clients to work on other matters in the knowledge that all investigation work is being conducted to a full and final conclusion with all data protection and privacy legislation in mind.

We specialise in HR matters in relation to problematic employees and also handle personal injury, fraud investigation and child protection cases, including any aspect of surveillance that may be required.

Our teams of investigators

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and surveillance operatives cover the UK, allowing us to operate efficiently at short notice. All staff are experienced in all aspects of investigations allowing us to provide all the evidence required in individual cases as necessary to facilitate disciplinary, civil or in some cases, criminal proceedings.

FOR MORE INFORMATION A full resume of our services can be found at www.foxgloveservices.com

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RECRUITMENT

MAKING THE RIGHT CHOICES Tom Hadley, director of external relations, Recruitment and Employment Confederation, advises on healthcare staffing AS ANNOUNCED IN THE GOVERNMENT’S recent Budget, public expenditure cuts are inevitable. However, with up to £20 billion of savings to be made by 2014, the National Health Service (NHS) is possibly under more strain than any other government sector.

The temptation will be to make short-term cuts through the supply chain and to drive down recruitment costs. The reality is that the debate will need to focus on the broader resourcing agenda and on more deep-rooted reform of how services are delivered.

HIGH DEMAND The Recruitment and Employment Confederation’s (REC) latest Report on Jobs shows that demand for staff in the healthcare sector remains high. At the same time, the recent NHS Staff Survey from the Care Quality Commission underlined major resourcing challenges, with 45 per cent of those healthcare professionals surveyed believing that there were not enough staff for them to do their jobs properly.

NHS workers are clearly concerned over current staffing levels. This underlines the need for any recruitment freezes in health services to be properly thought through. Unmanageable workloads create a downward spiral of increased stress and absence rates, which only

serves to add to the resourcing challenge.

NHS trusts will need to review staffing levels and resourcing mechanisms. One of the aims of the REC’s current public sector resourcing campaign is to highlight the benefits of flexible staffing arrangements within this context.

However, a key challenge that currently needs to be overcome is the perception that one of the main sources of this kind of flexibility – namely agency workers – is one of the primary areas that needs to be cut.

AGENCY WORKERS Agency work is a vital component of any large organisation’s resourcing strategy and must be seen as part of the solution for costeffective workforce management within the NHS, rather than as part of the problem.

The ability to call on extra resource from agency and locum staff to fill gaps where necessary is crucial to front line delivery of services. The contribution of agency workers is recognised across most sectors of the UK economy, but discussions within the healthcare sector too often depict agency work as an unnecessary drain on resources.

Priority must be given to unpicking pre-conceptions over the perceived cost of using agencies.

As the recent Common Health Select Committee’s report on the use of overseas doctors in providing out-of-hours services

ABOUT THE REC The Recruitment and Employment Confederation (REC) is the representative body for the UK’s £22.5 billion private recruitment and staffing industry. With over 3,500 members, the REC is the voice of the recruitment industry. All members must abide by a Code of Professional Practice. Visit www.rec.uk.com. highlighted, there is an ongoing need to ensure that the right recruitment checks and selection procedures are in place at a trust level. As the overall recruitment process is often complex and time-consuming, when weighing up the benefits of using intermediaries such as specialised healthcare recruitment agencies in comparison to internal recruitment services, it is necessary to factor in the resource required to advertise vacancies, sift through applications, undertake the right checks, take up references and assess each candidate’s suitability.

Specialist healthcare recruitment agencies can make the whole recruitment process far more streamlined and efficient for an organisation.

RESOURCING MODELS If a recruitment agency is not used for the sourcing of flexible staff, it will be necessary for

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A Partnership Approach for best value resourcing Having spent many years working for large healthcare recruitment agencies, the founding directors of Red Professional Locums strongly believe in the need for a personalised, partnership approach to healthcare recruitment which is professional, reliable and cost effective. Red Professional locums ultimately centre its company ethos around the relationship between agency, client and locum. For this partnership to be successful it must always be professional, open and realistic. Red believe our ability to listen and then provide tailor made solutions for all your recruitment needs will establish a successful long term working relationship with both our clients and candidates.

Red is built with highly experienced individuals who have worked in the healthcare market for many years. Our team are fully able to effectively manage all levels of volume business such as SLA’s, specific recruitment drives as well as ad hoc requirements and want to inspire you to have complete confidence in our ability to provide you with Locum cover as and when you need it.

At Red we strongly believe that one size does not fit all and that both clients and candidates are unique, each having their own specific reasons for using a locum agency. Our aim is simple; to identify yours and help you achieve your objectives.

CONTACT OUR RECRUITMENT TEAM | 0845 5390077 Tel: 0845 5390077 Fax: 08455390117 Email: info@redprofessionallocums.com

www.redprofessionallocums.com

Health Business | Volume 10.2

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RECRUITMENT

Tom Hadley

ABOUT THE AUTHOR Tom’s role within the REC focuses in taking forward the views of the recruitment industry to key government and EU officials. He also responsible for promoting professional standards initiatives such as the Diversity Pledge. Before joining the REC, Tom worked for the CBI (Confederation of British Industry), for the London-based recruitment consultancy MBA Training Research & Development, the European Commission and the French multi-national Vivendi. Tom has a Masters degree in International and European Law from Assas University in Paris and a BA Law Degree from Sussex University.

this activity to be taken on internally. Part of the REC’s current campaign is to compare different resourcing models so that the relative merits of different options can be evaluated. For example, it is often argued that an in-house bank of temporary staff is more cost-effective than using private agencies. However, a number of public bodies who have thoroughly compared like with like and objectively evaluated performance have come to a different conclusion.

There are real benefits to using intermediaries

and as such, it is no wonder that research from the Chartered Institute of Personnel Development showed that 78 per cent of employers use agencies to manage the recruitment process. However, the recent NHS Staff Survey also showed that only 44 per cent of staff felt that their trust was committed to helping its staff balance their work and home life. As such, it is important to bear in mind that as well as benefiting employers, flexible working arrangements are also of benefit to

individual workers in the NHS. Many choose to work through agencies so that they have the opportunity to pick and choose their own hours.

Workforce optimisation and flexible working practices have a central role to play in helping the health service cut its expenditure by £20 billion. We must avoid knee-jerk job cuts that could cost more in the long-term and we must challenge easy pre-conceptions. Where managed well, agency staff contribute to the efficient and effective delivery of public services.

Working together to deliver excellence, on 8 June ESOURCING THE PUBLIC SECTOR is one of the major modern challenges that anyone involved in the hiring process will face. After years of escalating UK debt the economic impacts are now clear, and yet the imperative to modernise local and central government resourcing strategies to include a more flexible and nimble cost and resource base is clear.

Meeting this challenge and securing a position that celebrates and elevates best value recruitment services within it is vital. This is a key element in ensuring the resourcing solutions of the future are robust enough to stand the rigours of the skills challenges, demographics, and the attractive private sector market-place.

On 8 June, the REC is delighted to be hosting the UK’s Public Sector Resourcing Summit, bringing together the latest thinking, knowledge, plans, strategies, solutions and challenges direct from government, public sector employers and recruiters.

With an audience of over 250 of the UK’s best, ranging from local authorities, NHS, cabinet office, LGA, DWP to CBI, and the wider UK recruitment industry leaders, the summit will energise and stimulate the planning and engagement required to ensure the decisions that underpin the next ten years of public sector

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resourcing are built with the combined efforts of the key partners in this vital equation.

If you want to know how to compete, need to understand what the latest agenda is, or if you want your voice to be heard and become part of the changes ahead, then this is your must-attend event of the summer.

The full event programme is now available for download from www.rec.uk.com.

Date: 8 June 2010 Time: 9.00am - 4.45pm Place: Congress Centre, 28 Great

Russell Street, London WC1B 3LS REC and IRP member price: £149+VAT Non-member price: £299+VAT We would like to encourage members to bring their public sector clients to this event, so they can engage on this subject together.

We will be happy to extend the member rate to these clients, and offer a 20 per cent on the first client booking with a 40 per cent discount on a second. Book online or call the Account Management team for more information on 020 7009 2188.

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Locum Link – the leader in servicing medical professional staffing requirements

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OCUM LINK WAS ESTABLISHED in 1994 as the first agency to specialise in the provisions of locum doctors and over the last 16 years has worked tirelessly to establish strong working relationships with all the medical trusts throughout Northern Ireland.

Based in Lurgan, Co. Armagh, Locum Link’s central offices provide an easily accessible location for both doctors and trusts throughout Northern Ireland.

Since its establishment, Locum Link has been owner managed on a daily basis allowing every member of staff from managing director level downwards to have a full understanding of all the day to day workings of the company.

Specialising solely in the provision of locum doctors since 1994 Locum Link has built up an extensive and comprehensive database of doctors varying in a wide range of specialities.

With over 700 registered doctors, 450 of which are active, Locum Link prides itself in it’s ability to provide locums that have already been vetted and checked in line with the current NHS guidelines both quickly and efficiently. Our extensive database of doctors specialising in various fields allows Locum Link to provide a quick and efficient service that can often locate and recruit locums when and where required within minutes.

Continually striving to improve our service,

Locum Link has invested in corporate membership of the Recruitment and Employment Confederation (REC) and are firmly committed to adhering to its Code of Good Recruitment Practice.

Locum Link is certified to ISO 9001:2008 standard and this ensures, through independent audits, that the business has the relevant quality management procedures in place to deliver the best possible service to the client. The continual review and monitoring of these processes to ensure that quality management systems are delivered allows Locum Link to provide the highest possible standard of service time and time again.

Our continual commitment to high standards

FOR MORE INFORMATION Address: 28 Market Street, Lurgan, Co. Armagh N Ireland BT66 6AQ Tel: 028 383 29990 Fax: 028 383 29991 E-mail: info@locumlink.com Web: www.locumlink.com

The caring face of healthcare recruitment

Sonographers Medical – recruitment specialists

ROHEALTH RECRUITMENT is a values-driven and distinctive provider of healthcare staffing solutions and extremely proud to be a Care Quality Commission registered provider and preferred supplier to the NHS. We are committed to offering a truly ethical service in the recruitment and supply of temporary, interim and permanent staff spanning the entire healthcare spectrum in the South of England, including NHS and private hospital nurse specialties, nursing and residential homes, and supported living establishments.

Prohealth is owned and managed by a unique combination of healthcare, business and recruitment specialists. Together we possess over 45 years experience within our sector. That knowledge means we understand the people required within our industry, the pace and urgency in which they are needed and the recruitment processes involved in

ONOGRAPHERS MEDICAL has been providing locum healthcare professionals to the NHS for 15 years.

Short or long term placements, full or part time, across the full spectrum of Allied Health Professional and Health Science Staff arenas; we can provide the qualified and experienced staff you need.

Sonographers Medical has built its reputation on the quality of the locums it supplies.

Whether you are looking for a Sonographer, Radiographer, Physiotherapist, Occupational Therapist, Dietitian, Speech & language Therapist, Podiatrist, Biomedical Scientist, Pharmacist or Doctor; we are your answer.

Sonographers Medical is a member of the Buying Solutions (formally NHS PaSA) framework for AHP and HSS locum Medical Staff, ensuring the quality of our service and the price we charge.

In short, at Sonographers Medical we provide quality

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of service are reflected in our opening hours and back up service. Locum Link are contactable 24 hours a day, seven days a week and 365 days a year, thus providing a service second to none that allows all clients the satisfaction of knowing that whatever their problem at whatever time of day or night, someone from Locum Link will be more than willing to assist in any way possible.

delivering a service that not only meets our own high standards, but the exacting legislative requirements of the Nursing Agencies Regulations 2002, the NMC Code of Professional Conduct and the standards of the Care Quality Commission.

Prohealth was created with a firm belief that we can meet the demand for healthcare professionals and are making a difference in our supply through our dedication to our staff, applicants and clients.

FOR MORE INFORMATION Tel: 01202 736455 Fax: 08448 112727 Email: care@ prohealthrecruitment.com Web: www. prohealthrecruitment.com

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staff at an exceptional price.

Additionally, we have now launched a sister company ‘Beehive Solutions’ to provide healthcare consumables and disposable instruments at discounted prices, along with Managed Service Solutions, to help reduce waiting lists and improve hospital services.

Sonographers Medical – putting healthcare before profits.

FOR MORE INFORMATION Tel: 020 8551 1299 Fax: 020 8551 5911 E-mail: enquiries@ sonographersmedical.co.uk Web: www. sonographersmedical.com

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Healthcare Recruitment PJ Locums Ltd is a highly respected healthcare recruitment agency placing temporary workers from overseas and the UK into both the NHS and private sector. Formed in 2002, the company has offices in London (UK) and Melbourne (Australia).

PJ Locums specialise in Dietitians, Physiotherapists, Occupational Therapists, Podiatrists, Radiographers, Speech and Language Therapists and more recently Nurses.

We successfully gained NHS Buying Solutions (formally PaSA) accreditation for the second term and we have negotiated regional contracts and numerous preferred supplier agreements in both allied health and nursing. Our service level agreements are designed to ensure maximum success.

We are able to offer variety with the many organisations we currently supply across the

United Kingdom. Locums are encouraged to experience different parts of the UK and diverse departments.

Having fun at work has always been a part of our company’s values. However, we are very serious about quality and service. Quality is also created by a consistent focus on customer needs, including how we perform services, how we provide access to information, and simply how we treat people.

Consistently providing high quality services requires a tremendous commitment from our organisation - and is therefore assigned a very high priority by our management.

Our role is to provide a solution to a problem not be the problem.

Compliance is now a much more important part of the registration process therefore when asked:

What is required of me to work in the UK? We ensure that all applicants understand the importance of getting registration right first time, which then makes this part of the process bearable. Our representative in Australia was based in the head office in London for 3 years and has first hand experience of what our Locums will face which reassures them before they make the decision to come to work in the UK Two questions we ask ourselves daily: “Did we do what we said we were going to do?”

“Was it what the customer and the candidate wanted?”

We endeavour to give all our candidates a unique and memorable experience both before they get here and when they arrive, which translates into word of mouth recommendations which we value highly.

Take the next step and call us on; Free phone 0800 032 0454 or email info@pjlocums.co.uk

Britannic Medical – first for psychiatry RITANNIC MEDICAL is the only NHS approved specialist psychiatry agency in the UK. We have been supplying psychiatrists to trusts since January 2001, and enjoy a long and rewarding relationship with medical staffing personnel across the UK and psychiatrists who have been with us since our inception, many of which were SHOs and are now full time consultants in the NHS. It is our aim to provide our locum doctors with an enjoyable, instructive and lucrative locum post, and also to provide the trust with a reliable, experienced team player that is able to slot as seamlessly as possible into the team requiring the locum placement.

All of our doctors are compliant as required by the NHS Framework Agreement, and all pre placement checks are made as a matter of course.

Britannic Medical is registered with all pertinent organisations and registered bodies pertaining

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to safe medical recruitment.

We are independently audited annually, and also audited by the NHS. We also supply private hospitals and, from time to time, we assist fellow agencies with their need to supply a psychiatrist to a trust.

FOR MORE INFORMATION Tel: 0788 768 7668 or 07766 100 229 Fax: 0870 4908 508 E-mail: psych@ britannicmedical.com

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A healthy future Premier Life Skills Ltd is dedicated to promoting wellbeing and managing stress. We help managers and employees to respond positively to challenges, building resilience to enable staff to perform effectively and productively. We can help to build and sustain a healthy future for organisations and their employees.

We have more than 12 years’ experience of dealing with stress related problems and issues affecting either individuals or organisations. All our trainers are stress management experts from relevant professional backgrounds, including health and education.

We run a range of public and in-house programmes designed specifically to tackle issues of stress in the workplace and to support the work of stress professionals working on a one-to-one basis with clients.

Bespoke in-house training can be provided for all staff at all levels, along with consultancy, advice and training in healthy living and lifestyles.

thus enabling them to build healthier lifestyles CPCAB – Level 5 Diploma in stress management The diploma gives you a formal qualification to demonstrate your competence in delivering the training programme in stress and wellbeing to groups or on a one-to-one basis with individuals.

CPCAB – Level 5 Diploma in stress coaching The diploma gives you a formal qualification to demonstrate your competence to coach clients regarding work or personal stress.

Measuring and managing stress – the risk assessment approach This programme enables employers and external consultants to develop and demonstrate competence in risk assessment for stress at an organisational level.

Premier Life Skills can also provide other training programmes for manager and employee development.

We are the only stress training company offering the Counselling and Psychotherapy Central Awarding Body (CPCAB) accredited training courses in stress management and stress coaching.

Courses Tackling stress at work for managers An essential workshop for managers – everything managers need to know about preventing and managing stress in the workplace Developing wellbeing and performance at work A workshop for employees to provide individuals with techniques and skills to combat the impact of stress,

Premier Life Skills Ltd 13 Woodlinken Close Verwood Dorset BH31 6BP Tel: +44 (0)7808 215674 +44 (0)1202 821751 info@premierlifeskills.co.uk jane@premierlifeskills.co.uk www.premierlifeskills.co.uk

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WORKPLACE STRESS

STRESS IN THE NHS Stress costs the NHS millions in absenteeism. Julian Topping, programme lead – health work and wellbeing at NHS Employers, discusses how to reduce this problem IN HIS REPORT TO THE DEPARTMENT of Health on the health of the NHS workforce Dr Steve Boorman noted that while musculoskeletal problems accounted for 45 per cent of all staff absence the second highest cause was stress, depression and anxiety at 25 per cent.

The national Labour Force Survey shows over 35 per cent of NHS staff reporting stress as “illnesses caused or made worse by work.” These percentages are higher than in other sectors and, in a workforce of 1.4 million, indicate a huge problem for both employers and staff.

Sickness absence in the NHS is estimated to cost the service some £1.7billion each year of which a quarter is likely to be attributable to stress related sickness.

And it is not just a question of cost. Time lost to sickness absence amounts to 10.3 million working days or the equivalent of having 45,000 whole time equivalent staff not at work – of these, a quarter are likely to be due to stress related sickness.

WHAT IS STRESS? To start looking at the issue it is important to be honest. It has to be recognised that a major barrier to the implementation of good stress management, not only in the NHS but across the whole of the public and private sectors, is the fact that stress is a very individual thing.

Not only may staff be “stressed” by different things but their reactions may differ from day to day or week to week. An action that might cause stress and anxiety today may not even be noticed if it is repeated in a week’s time. Much of the impact is mitigated by the individual’s own personal state of mind at any given time.

It is very difficult to develop a policy framework for dealing with something which is so personal to each member of your staff. However all employers owe a duty to their staff to ensure that they do not arrange work and behave in such a way as to bring added stress to their staff which may cause them pain and distress.

And let us not forget that stress is not an illness itself – a common misconception held by both staff and employers – although it can lead to a wide variety of illnesses, some of which could be very serious, if it is not addressed. But it is not in itself an illness.

The Boorman report says that although stress is widespread in the NHS the reasons for it are not always work related; they include sleep deprivation, financial concerns, and caring responsibilities. However, there are work related factors apart from the general stress that comes from working in a busy and often demanding job. Staff who have been working in the NHS

for a long time report higher levels of stress than colleagues who have joined more recently as do staff in managerial roles. Understandably those who cannot cope with their roles report being more stressed than those who can – twice as much in the research carried out by Boorman.

CAUSE OF STRESS The main cause of stress in staff in any organisation, public sector or private, is a feeling of lack of control. The Health and Safety Executive (HSE) in developing their Management Standards approach to stress recognised that the causes of stress could be defined as:

• Demands which includes issues such as workload, work patterns and the work environment.

• Control which is about how much say the person has in the way they do their work.

• Support which includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues.

• Relationships which is about promoting positive working to avoid conflict and dealing with unacceptable behaviour.

• Role which is about whether people understand their role within the organisation and whether the organisation ensures

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Stress Awareness training so easy to deliver, it’s child’s play About 1 in 5 people say they find their work very or extremely stressful. In fact, over 500,000 people believe work related stress has made them ill.

The ‘Stress Awareness for Managers’ and ‘Stress Awareness for Employees’ eLearning courses, cover general awareness about stress. In the Managers version the latest HSE and CIPD guidance is covered along with case studies that build managers capability to manage stress successfully.

Easily accessible and affordable, the courses will help your organisation manage wellbeing by setting a good baseline of knowledge that can be used to support your stress and wellbeing strategy.

To prove you’re meeting your health, safety and environment obligations, eLearning modules are supported by our learning management system (eSP). Alternatively our training can be integrated into your organisation’s learning management system.

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• Significant cost savings • Accessible training and assessment records • Training delivered at the trainees convenience • Optimal training time • Reduced environmental impact

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personal action plan which can be revisited and progress monitored.

Our clients include private and public sector organisations – here’s what they say: first direct –“Beating Stress Interactive™ is a very personal and private way for people to assess their stress. We would definitely recommend StressCHECK to any organisation looking to combat stress in the workplace.”

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WORKPLACE STRESS

Julian Topping

that they do not have conflicting roles.

• Change which relates to how organisational change (large or small) is managed and communicated in the organisation In the NHS we were already a long way down the path of meeting some of these standards through development of flexible working, childcare provision, self-rostering and the improved staff engagement which flowed from the Improving Working Lives initiative that was rolled out between 2001 and 2006 and for which a revised Framework document can be found on the NHS Employers website.

Other areas identified by the HSE are not as easily addressed in a dynamic and fast-moving service like the NHS and need a more determined approach by employers and staff working together.

Clinical Excellence, that covers the role of line managers, the organisation of work, managing the risks to employees mental well-being and identifying and implementing opportunities for improving staff mental well being. This would address the issues that cannot be covered by the actions already taken by most trusts.

NICE in its work on stress has identified a major influence on the incidence of stress in the NHS which is the role played by line managers.

This is the group that can have a major impact on the way in which staff are affected – or not – by stress. They are also, ironically, the group that that has been identified in reports since the late 1990’s, including Boorman, as being major victims of stress and mental ill health.

However, with their assistance we can reduce current levels of reported stress including theirs.

IDENTIFYING STRESS Staff that work in the NHS need to recognise that life itself is not stress free and that no amount of hard work will ever totally eradicate workplace stress. They also need to recognise that very often they bring their stress into the workplace with them, as indicated in the Boorman research, reflecting problems with home, children, finance or mortgage problems – and that this means they need to develop coping strategies to help them to deal with them.

Boorman recommends that employers should give priority to implementing a policy, promoted by the National Institute for Health and

ADVICE AVAILABLE NHS Employers has published advice for managers and staff on its website and has run a campaign aimed at identifying what part managers and staff could take in addressing this issue. Advice includes coping strategies for staff and tips for managers on identifying potential problem areas. Work carried out in Blackpool, Fylde and Wyre Hospitals NHS Trust has shown that a concerted effort by senior managers to address stress and its causes, which in this case meant looking at bullying and violence issues as well, can have good results.

Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust is a large General Hospital

with 4,500 staff which in March 2007 had a sickness absence rate of 5.34 per cent with 55 per cent of sickness due to staff off for longer than 28 days, and with 40 per cent of staff seen in occupational health reporting mental health problems due to work. There was anecdotal evidence of high stress levels due to excessive working hours, restructuring and bullying.

The impact on individual staff was such that they were demotivated, disengaged and in the worst cases, absent. This left colleagues, frustrated, antipathetic to the trust and with an increased workload and the associated pressure that brought. For the organisation this meant increased grievances, high absence rates, inconsistent patient care and a resulting negative public image. This in turn led to reduced efficiency and performance, a workforce lacking in skills and competency and an adverse impact on service delivery to patients.

The Trust board made a decision to take an organisational development approach to transforming the performance culture through deep employee engagement with four key strands of work based around communication, management style, recognition, and continuous improvement. Key stakeholders in taking this forward were identified as being the chief executive, chairman, directors, staff-side representatives and the whole workforce. After focus groups, consultation and engagement with the workforce the causes of stress were identified and a senior manager was designated to lead a project, with robust timescales, to manage change.

A great deal of work was done by staff and management, and the results so far, on what is a continuing project, are that sickness absence is down, numbers presenting to occupational health with stress related problems are down by 40 per cent and the long hours culture that led to increased stress is now being tackled. (Further information on the Blackpool, Fylde and Wyre project can be found on the NHS Employers website under “Stress”).

Stress is a long way from being eradicated in the NHS workplace, and we should recognise that it probably never will disappear completely – which many would argue is a good thing.

There is evidence from research that shows everyone needs some stress in their working lives in order to drive their work forward.

However, as more organisations take on the sort of project that has been developed in Blackpool the situation is bound to improve.

It may never be as stress free being a nurse or doctor in a busy accident and emergency unit as it is working in some other places but we can and will continue to work towards making that level of stress one which is more acceptable and towards eradicating it where it is not necessary.

FOR MORE INFORMATION Web: www.nhsemployers.org

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Conflict Resolution Challenging Absenteeism The average employee misses 10 days’ work each year – a major drain on resources. Many managers feel powerless when it comes to dealing with absenteeism. This DVD is designed to help them gain confidence in dealing with absence. It consists of 7 real-life scenarios of different problems that managers face.

Each scenario is shown in two parts – how NOT to deal with the problem, followed by ‘The challenge met’ – a more effective way of dealing with the problem that results in progress towards a resolution.

nteeism • Effective measures to reduce abse in dealing • Help managers develop their skills nce abse with tly consisten agers will be • Uses everyday problems that man familiar with

• Define the terms of a dispute, establishing aims and ground rules • Determine boundaries to establish how much negotiating room you have • Make realistic compromises – and discuss what is agreed, not what is in dispute • Decide on common outcomes and points of agreement

Conflict is often perceived as negative and undesirable. Many people go to great lengths to avoid conflict or deny it even exists. However, conflict is a natural part of our lives – we all have different values, needs and feelings that differ from each other.

This Conflict Resolution DVD and training package shows how when handled properly, conflict can highlight problems that need to be addressed, lead to new ideas and behaviours, and help to enhance communication.

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How much is iceberg stress costing your organisation?

CEBERG STRESS can exist in any business. Quite often, it can be the most damaging part of the entire workplace stress problem. Trying to identify the large piece underneath the surface that you may not know about can be a daunting exercise. If you are unable to identify these unseen stress related issues, your business will suffer as a result. That’s where Mind Strengths can help.

With our wealth of experience, we can help identify cases of iceberg stress thereby saving you time, money and sometimes a lot of unnecessary pressure. Underpinned by our efficient corporate, team and individual assessment programmes, we will quickly find out the root causes of stress and then recommend an appropriate action plan to drive your business forward.

With one in six people suffering

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with stress at work and those same people underperforming by over 30 per cent, stress could be costing your business thousands of pounds a year.

Mind Strengths can offer you preventative, pro-active solutions for beating stress at work. Everything from detailed assessments through to interactive workshops, one-to-one coaching and support programmes for all levels of staff. We can help you to reduce absenteeism, improve productivity, increase employee wellbeing and save money.

Contact us today to learn more.

FOR MORE INFORMATION Contact: Ian Barratt MASC (Corp.)

Director Tel: +44 (0)1634 314090 E-mail: info@mindstrengths.co.uk Web: www.mindstrengths.co.uk

Ensuring results for people and teams HENEVER PEOPLE meet, especially in a demanding work environment, there is the potential that stress will cause a decrease in performance. MRD gives a language to help them understand what is happening and then build strategies for lasting change. We work with our clients to produce sustainable results.

At M R Dynamics Ltd we provide a range of professional development services where understanding what makes you and other people tick is key. We give organisations of all sizes the know-how to improve business performance, productivity and profitability through its people.

Our key areas of expertise are leadership, team work, sales training and stress reduction. We also work with clients supporting recruitment processes.

Developing leaders and high performing teams leads to lower stress and greater productivity.

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This can be achieved through MRD managed events and programmes or ILM based courses leading to recognised qualification. The unique MRD blend of UK and international based experience in adult learning and our personality based approach ensure learning is memorable and is then applied.

If nothing changes little is learnt.

FOR MORE INFORMATION Contact: Richard Hoyle Address: 21 Crofters, Sawbridgeworth, CM21 0DE Tel: 01279 722637 Fax: 01423 331504 E-mail: richard@mrdynamics.com Web: www.mrdynamics.com

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The X-Factor in wellbeing and performance F YOU FEEL WELL YOU perform better than when you feel ill’ – the link between wellbeing and performance is obvious, yet there is a long way to go to embed this idea into the management of organisations.

Most recent reviews of health and wellbeing at work focus on how to support people who feel unwell by improving occupational health services and engaging employee assistance programmes.

Our focus is to prevent people from feeling unwell in the first place, in particular preventing people feeling unwell due to psychological distress.

The X-Factor in wellbeing and performance is the context in which managers and staff are expected to work. Managers are a principal cause of psychological distress, and it is their behaviour and actions that make the difference between highly successful and failing organisations.

However, managers behave according to the expectations placed on them by the context in which they manage. The cultural foundations of their organisation will

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be played out by the way managers behave towards their staff.

We specialise in building and sustaining a positive work culture that promotes wellbeing and performance as the key to building trust, commitment and engagement between managers and staff. This is known to achieve highly successful organisations with much lower costs of sickness absence, staff turnover and presenteeism, and much higher levels of quality, innovation, value for money and engagement with patients, clients and customers.

Our programmes for building and sustaining resilience at work have been described as ‘brilliant’.

FOR MORE INFORMATION Tel: 0845 833 1597 Fax: 01242 603 226 E-mail: info@orghealth.co.uk Web: www.orghealth.co.uk

Reducing stress increases wellbeing SICKNESS W ITH absence at record levels, workplace stress is an increasing problem for health organisations. With ten years experience of supporting stressed employees within the health service Judy Reeves knows the impact a ‘sick’ workplace can have on morale, wellbeing and staff turnover.

Judy Reeves Stress Consultants can help you find the right balance between the demands and pressures in your workplace and the coping strategies and strengths of the individuals within it.

The potential benefits will be retention of key personnel and improved relationships in the workplace; improved wellbeing and morale of your staff; reduced sickness absence, staff turnover and risk of grievance and litigation.

With backgrounds in health, stress management and counselling Judy Reeves and colleagues can support both staff and management and find ways to improve morale,

creating a happier healthier workplace. We aim to be flexible and accommodate your needs.

We offer: specialised and focussed one-to-one support; training to build resilience and improve coping strategies; training for managers in how to recognise stress and support staff; training in risk assessment for stress; and how to reduce the risk of litigation.

Contact us for an informal chat and find out how we can help.

FOR MORE INFORMATION Tel: 01692 651195 E-mail: enquiries@ stressconsultants.co.uk Web: www. stressconsultants.co.uk

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Enhancing skills for working with conflict

Preventing and managing challenging behaviour

ANDLING CONFLICT is one thing at which almost everyone wishes they were more skilled. Whether it is dealing with aggressive behaviour from a member of the public, improving performance in a dysfunctional team, handling a sensitive negotiation, dealing with a difficult member of staff, or managing a personality clash between two people that has a negative effect on the general work environment, conflict management skills are certainly an essential part of the tool-kit of anyone who wishes to be more effective at work.

Chris Rose, a psychologist and former psychiatric nurse, has specialised for the past 15 years in helping people who work in the public sector to develop their ‘people skills’.

He is an accredited mediator with CEDR, Europe’s leading conflict resolution body, and an NLP Master Practitioner and Trainer. He has a wealth of experience in helping people

ECURICARE HAS been at the forefront of training in the prevention and management of challenging, aggressive and violent behaviours since the early 1990s.

The training is accredited and can be externally certificated.

SecuriCare is an Institute of Conflict Management Quality Award Centre ICMQAC. The training covers the following core learning objectives and meets the requirements of the NHS National Conflict Resolution Training Programme: Describe the common causes of conflict; Describe different forms of communication; Give examples of communication breakdown; Explain three examples of communication models that can assist in conflict resolution; Describe patterns of behaviour they may encounter during different interactions; Explain the different warning and danger signs; Give examples of impact factors; Describe the use of distance when dealing

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working with conflict situations.

Not surprisingly, then, Chris is much in demand both as a trainer and as a coach. If you are interested in exploring how he might help you to provide your staff with the best support you can offer, he will be delighted to hear from you.

FOR MORE INFORMATION Tel: 07918 679772 E-mail: mulberrydt@ btinternet.com Web: www.mulberrydt.com

FOR MORE INFORMATION For more information please visit our website at: www.securicare.com Tel: +44 (0)1904492442 E-mail: trainers@securicare.com

The experts in project management training

Controlling corporate manslaughter risk

O YOUR PROJECT teams refuse to talk to each other? Do they always end up arguing or just ignoring the project manager? What are you going to do? Particularly now that your funds have to be used ever more efficiently and effectively?

For project managers working in central government organisations, the UK Government recommends professional membership of the Association for Project Management (APM). Their qualifications cover those aspects of project management considered fundamental to the professional management of projects.

The Management Skills Centre is an Accredited Training Provider for the APM. It provides open and in-house courses for both the Introductory Certificate (2-day) and APMP (5-day) qualifications.

These courses complement the Prince2 methodology by emphasising those aspects excluded or only partially covered by Prince2.

“For leadership positions emotional intelligence

OLLOWING THE recent drastic increase in the consequences for firms contravening health and safety legislation, Tom Morton, CEO of Argyll, the UK’s largest lone worker solutions provider, advises how to mitigate corporate risks associated with lone working.

In addition to the existing threat of civil actions and the costs of defending this, the Sentencing Guidelines Council has now recommended a fine for any corporate manslaughter prosecution of at least £500,000 or greater. In addition to this unprecedented fine, organisations may also be burdened with a remedial order requiring them to address any specific health and safety failures and, potentially the most damaging element, a publicity order. The reputational damage caused by this could end up costing far more than any financial penalty the court can issue.

Technical solutions are both affordable and widely adopted.

The Internet is awash with devices, software and response

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with conflict; Explain the use of ‘reasonable force’ as it applies to conflict resolution; Describe different methods of dealing with possible conflict situations.

The training also includes Disengagement skills; and physical intervention/restraint skills where necessary and is part of the organisations policy and staff guidelines. Train the Trainer Packages are available for in-house training personnel and can including NVQ Level 3 Direct Training & Support (QTLS).

competencies account for up to 85 per cent of what sets outstanding managers apart from the average.”

So in addition, the MSC provides in-house courses on Team-building, Negotiation and Conflict Management, Motivation and Leadership. A simple fourdimensional tool of proven worth may be used to analyse team and individual performance.

Workshops and coaching can be provided where necessary.

FOR MORE INFORMATION Tel: 01892 506872 E-mail: andrew@mscsoutheast.com Web: www. managementskillscentre.com

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services and all offering apparently ‘similar’ products, whoever is charged with overseeing health and safety within the organisation should seek professional advice to ensure compliance with the tightening legislation.

The British Security Industry Association has recently published a guide to BS8484, a new lone worker devices and services standard, that will assist employers manage their exposure to risk.

BS8484 is already adopted by quality lone worker solutions and the Association of Chief Police Officers (ACPO) has amended its policy to only permit police response to compliant solutions.

FOR MORE INFORMATION Tel: 0870 750 1475 E-mail: loneworker@ argyll.uk.com Web: www.argyllloneworker.co.uk/support

Health Business | Volume 10.2

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CONFLICT MANAGEMENT

PROTECTING HEALTHCARE WORKERS Revisions to the sixth edition of the Code for Crown Prosecutors means that assaults against anyone providing NHS services will be taken more seriously.

The NHS Security Management Services discusses what these changes mean THE NHS SECURITY MANAGEMENT Service (NHS SMS) is responsible for all policy and operational guidance concerning security management throughout the NHS in England.

It promotes the right of all NHS staff to feel safe in their working environment, despite often being at greater risk of violence and verbal abuse than many other professionals.

Figures released last November showed that during 2008-09 there were 54,758 reported assaults against NHS staff working in all care sectors. A key part of the NHS SMS’s work is ensuring that appropriate action is taken against offenders. In this capacity, it made a number of suggestions in response to the public consultation on the draft sixth edition of the Code for Crown Prosecutors.

CODE FOR CROWN PROSECUTORS The Code gives guidance on the general principles to be applied when making decisions about prosecutions. Crown Prosecutors’ responsibilities include determining the charge in all but minor cases and reviewing cases submitted by the police for prosecution.

When deciding whether charges should be brought, prosecutors consider whether there is sufficient evidence for a realistic prospect of conviction and, if so, whether the public interest requires a prosecution.

Offences committed against those ‘working in the public sector or providing a service to the public’ are classed as public interest factors in favour of prosecution. Taking into account the responses from the consultation in October 2009, some of these factors have been amended in the new sixth (2010) edition.

For example, previous editions gave examples of public sector workers and service providers – citing a police officer, a prison officer and a nurse. The NHS SMS suggested that these factors should be clarified or expanded to ensure that offences against anyone providing NHS services are taken more seriously.

The new Code, issued in February 2010, incorporates various clarifications, as well as changes in law and practice. There are clearer explanations of the public interest factors both for and against prosecution and of how the public interest stage of the Full Code Test is applied. Specifically, the ‘nurse’ example has been expanded to include members of the emergency services and health or social welfare professionals. This places the emphasis on the nature of the service provided, rather than on particular occupations, prompting prosecutors in England to consider a wider definition of NHS staff and view offences against them more seriously. The NHS SMS hopes this will lead to more prosecutions for offences committed

against NHS staff, resulting in more convictions.

The 2010 Code will also increase the work of the NHS SMS’s Legal Protection Unit, which works closely with the police and Crown Prosecution Service to increase the number of prosecutions brought against those who assault NHS staff.

It does, however, also acknowledge the balance that must be struck between the factors in favour of prosecution – including the need to safeguard the public – with the public interest in diverting a defendant with a significant mental illness from the criminal justice system. This is particularly significant in the context of the NHS SMS’s figures for assaults against staff: the highest number, by a substantial margin, is within the mental health sector: 196 assaults per 1,000 staff. A prosecution is usually considered less likely if the suspect is, or was at the time of the offence, suffering from mental or physical ill health, unless the offence is serious or there is a real possibility that it may be repeated.

Those most at risk from offences committed by people with mental ill-health are those who provide care services to them. The revised Code therefore gives equal regard to safeguarding staff providing care services to such individuals.

A key theme in the consultation document was consistency in approach and decisionmaking. Therefore, the NHS SMS also recommended that reference to Home Office guidance dealing with mentally disordered offenders should be reinstated within the new Code. This guidance not only details existing powers, but also encourages interagency cooperation to make the most of resources and deal with mentally disordered offenders appropriately and consistently.

HELP FROM THE NHS SMS The NHS SMS’s priority is tackling incidents of violence against staff that are reported to Local Security Management Specialists (LSMSs). In 90 per cent of trusts, these staff are trained and accredited by the NHS SMS to ensure that the highest standards are applied locally.

It is important for all NHS staff to identify their LSMS and, if subject to any incident of violence, to report it to the police and LSMS. On 1 April 2010, the requirement to report physical assaults to the NHS SMS was extended to capture data on all security incidents. The Security Incident Reporting System (SIRS) is a new security management tool for the NHS, introduced to coincide with this change in reporting requirements.

SIRS will provide a more accurate picture of the nature and scale of security incidents across the NHS in England and enable trends to be identified.

This will inform policy development, further contributing to staff safety. By regularly receiving and collating data from trusts, SIRS allows local

findings to inform prevention and deterrence work nationally. At a local level, it enables trusts to monitor security incidents, spot trends and compare their performance against the national picture.

Working pre-emptively, the NHS SMS has developed guidance for staff treating patients with a history of violence and in need of longterm care. This includes a nine-point plan for nurses to use in care planning to identify potentially violent patients. It advises them to check patient records and engage with the family to establish the patient’s history.

In primary care, there is also support in the form of the violent patient scheme (VPS). This enables practices to report violent patients to the police and could result in the removal of patients from doctors’ lists. GPs should engage with their primary care trust about their local VPS, which may be used when an act of physical violence, verbal abuse or intimidating behaviour is committed against any member of the practice, other patients or anyone who has reasonable fear for their safety or that of others.

Reporting patients in this way could result in their removal from the practice’s list, usually for 12 months. These patients may then be treated under the VPS by the primary care trust.

CONFLICT RESOLUTION TRAINING Clearly, it is essential that there are mechanisms in place for dealing with security incidents.

However, it is equally important that the underlying culture is addressed. In response to this need, the NHS SMS launched a national syllabus for conflict resolution training for all frontline NHS staff in April 2004. This gives staff the skills to recognise and defuse potentially violent situations. Similar programmes specifically tailored for mental health settings and ambulance staff run in parallel.

Specific consideration is also given to lone workers in the NHS. Due to the nature of their work, lone workers need additional organisational support, management, training and instruction to deal with the increased risks to their security and safety, as well as being enabled and empowered to take a greater degree of responsibility for these concerns. To this end, the NHS SMS launched its Not Alone guidance in conjunction with the Department of Health providing 30,000 subsidised lone worker alarm systems to these vulnerable staff.

Whether it is by giving lone workers a means of summoning assistance, GPs the option to remove violent patients or prosecutors the tools to treat abuse of all NHS staff more seriously, the work of the NHS SMS is giving everyone in the health service – staff and patients – a better chance of the safety and security to which they are entitled.

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Health Business | Volume 10.2

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ERGONOMICS

ERGONOMICS AND OBESITY What is ergonomics and how does it affect the health service?

Liz Leigh, manual handling adviser/clinical ergonomist, Southend University Hospital NHS Foundation Trust, gives her view getting heavier and this has caused a number of difficulties for many hospitals and the staff managing the situation. One area of difficulty is managing a very obese deceased patient. This can not only be problematic in a hospital but causes all kinds of problems to other agencies.

Transporting a very obese patient (occasionally deceased) into hospital with dignity has been difficult when there were no reinforced vehicles or appropriate equipment to deal with them.

ERGONOMICS IS A RELATIVELY NEW science in comparison to other sciences which have been in existence for centuries. The Ergonomic Society was set up in the UK and is about to celebrate 60 years of practice. If you were to ask staff in the health service ‘what is ergonomics?’ most would not know as not everyone understands what ergonomics is, what it does, or how it affects people. Staff would, however, recognise the term ‘manual handling’ as they are taught to move and handle inanimate and animate loads as part of their training; however manual handling is a small section of what an ergonomics service provides.

This article will explain ergonomics and what benefits it has within the health service for both patients and staff. It will give examples of changes in ‘best practice’ as a result of ergonomics and working in partnership with other agencies. These examples include work to improve the transportation of bariatric patients in a dignified manner.

For the purposes of this paper a Bariatric person is defined as someone whose weight is over 19 stone – 120 Kg or has a Body Mass Index of greater than 30.

WHAT IS ERGONOMICS? Ergonomics derives from two Greek words; ergon, meaning work, and nomoi, meaning natural laws, to create a word that means the science of work and a person’s relationship to that work. Pheasant (1991) defines ergonomics as “the application of scientific information concerning human beings to the design of objects, systems and environments for human use. The role of ergonomics, as it pertains to health and safety at work, overlaps with that of a number of

other professional disciplines: occupational medicine, occupational hygiene, occupational psychology, production of engineering, production management and so on.”

An Ergonomist in the health service will assess the fit between the person and their work and give consideration not only to the physical aspects but also the psychological aspects. The physical aspects include body size, and shape, fitness and strength, posture, senses and the stresses and strains on muscles, joints and nerves. The psychological aspects include mental abilities, personality, knowledge and experience.

This information allows the ergonomist to assess the aspects of the staff and patients, the working environment as well as the interaction between them to design safe, effective and productive systems of work. Within the health service this includes dealing with issues that affect the patient as well as staff.

OBESITY In the UK, the National Audit Office reported (2001) the prevalence of obesity in England had tripled over the last 20 years and continues to rise. Most adults in England are overweight, and one in five is obese. It was estimated that obesity accounted for 18 million days of sickness absence and 30,000 premature deaths in 1998. Treating obesity costs the NHS at least half a billion pounds per year.

Managing bariatric patients safely is a growing problem and is well documented by researchers; Rush (2005) said that the number of obese patients had more than doubled in the last decade, and Palmer (2004) suggests that handling patients can be more complex when the person is obese.

It is a known fact that the population is

EXAMPLE OF BENEFITS TO STAFF The mortuary is thought of as a place of sadness, grief or repulsion and no-one really wants to have to visit it if at all possible. The families that have lost a loved one may have to visit and this can be a traumatic experience. Mortuary staff attempt to make the experience as pleasant, calm and dignified as possible. In some hospitals the mortuary may have existed for as long as the hospital, which for some can be over a century and can be very small. The refrigerated mortuary shelving system used in most hospitals are of a floor to ceiling design. This requires mortuary staff to use equipment to assist them when handling the deceased person to reduce injuries to staff and maintain dignity for the deceased.

There is evidence that handling bariatric patients is high risk and this was confirmed in a study

by Randall et al (2009). This research showed that when bariatric patients with a body mass index (BMI>35kg/m2) were <10 per cent of the workload, handling accidents had accounted for almost 30 per cent of the recorded staff injuries.

An article in an Australian newspaper (Pepper 2010) informed the public that The director of Forensic Science SA, Dr Ross Vining, had said that racks used to store bodies need to be widened and reinforced, and heavy duty lifting gear needs to be installed to cope with bodies heavier than 300kg. The report went on to say that in 2007 a post mortem had to be performed on the floor of a mortuary in Adelaide because the deceased weighed 315 kilogram’s and was too heavy to lift. Dr Vining said an upgrade of the morgue would take place in the coming years, although no date has been set and costs have not been determined.

In the UK there have been a number of articles in the press about obesity contributing to an early demise. In reality obesity has created real problems for many hospital workers whose role is to look after this group of people. The most sensitive area is the mortuary and the staff working in this area has the task of looking after the deceased until the body is released for burial. In some instances a post mortem is necessary and staff are required to move a body from the

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Addressing human factors/ergonomics in the workplace OR OVER 40 YEARS, the Institute of Occupational Medicine has been at the forefront of knowledge in the health effects of work and work practices.

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Musculoskeletal disorders are a major cause of ill-health and sickness absence in the NHS, as in many other industries and occupations. IOM ergonomists have extensive, relevant experience of offering practical advice to employers – securely underpinned by scientific knowledge. Such work has included manual handling (patients, supplies, laundry, records, equipment, etc); poor workplace postures (surgery, microscope work, glove boxes), and office ergonomics.

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ERGONOMICS

fridges to a mortuary table and return to the fridge on completion. Some Trusts have carried out extensive changes to the mortuary and invested where possible in lifting equipment that is fixed to the ceiling which reduces the risks of injuries to staff involved in performing these tasks.

The type and quantity of equipment in a mortuary varies, in some cases this can be due to the age of the building. In an old building there are limitations to the installation of some equipment as the building is just too small to accommodate it. Ceiling tracking is not an option in some old buildings because the ceiling will not support the extra weight. Free standing gantry hoisting is available but once erected reduces the space the technician has to work in because of the area the equipment requires.

Some of the more recent ergonomic changes that have taken place at the hospital as a result of working with a manufacturer have been to help a hoist company develop lifting equipment which is suitable for the small mortuary as well as those fortunate enough to have been purpose built for the obese person. The work has taken approximately two years to complete but the finished product has received interest from mortuaries all over the UK. The hoist was originally manufactured for moving a patient in a seated position. The hoist moves with a motorised base which allows the operator to manoeuvrer it with a remote control and it can be taken very close to an object. Unlike the conventional hoists that require the operator to push and pull the machine to operate it and usually requires staff to manoeuvre the hoist legs under furniture. The hoist can be manoeuvred in a very small space, which is also advantageous.

The manufacturing company originally did not manufacture slings.

After discussion recommendations were made to the manufacturer to consider using the hoist in the mortuary, which would result in a number of alterations being made. The alterations would be to the spreader bar and type of sling to allow a person to lifted in a supine position. The picture displaying the supine position is showing it being used with a very large sling and a slim person and does not show the benefits when hoisting a bariatric load.

The project resulted in a number of meetings, discussions and trialling of various spreader bars and slings before the team were fully happy with the results. Various methods of putting the sling in position were tried and tested to ensure it was quick and easy to use as staff needs to be confident it works well and is not perceived as time consuming. The latest model is now being put through its paces to confirm it works efficiently and effectively. The finished product will benefit not only mortuaries in the health service but also the private sector because it can be used in more confined spaces than most conventional mobile hoists currently on the market.

EXAMPLE OF BENEFITS TO PATIENTS Based on current trends 50-60 per cent of adults and 25 per cent of children will be obese by 2012 (DOH Healthy Weight, Healthy Lives A cross-government strategy for England). As the population gets heavier, there is a need for hospitals and emergency services to establish plans to work together to cope with obese patients, while maintaining their dignity and privacy. There was a need to establish a safe solution to the difficulties arising from the moving and handling of bariatric individuals from community to acute care in the event of a hospital appointment or emergency admission, and back to community care on discharge.

Within the Acute care setting systems were in place for looking after these patients, however, as a member of the local National Back Exchange Essex group discussions identified the difficulties were transporting these people. Some patients had been brought into the hospital in the past on the floor of an ambulance because they were over the safe working load for the equipment the ambulance service had on board.

This was very distressing for the patient who was already in crisis and was now being subjected to an undignified transfer. Discharging patients was also problematic when attempting to send them home with dignity and ensuring they had an adequate package of care.

Part two of this feature, discussing how to address the problem, will appear in the next issue of Health Business.

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Managing the human element of risk DO PEOPLE DO W HY WHAT they do? Why don’t we learn from mistakes?

Why do we keep repeating the same failures? How do we improve the system?

To increase resilience against predictable human failures, you need to understand why people behave the way they do. What makes checklists work? When is training sufficient? Are you communicating effectively? When do people comply with rules?

Greenstreet Berman is a risk and ergonomics consultancy with many years successful experience helping healthcare and other organisations to understand and manage human performance. We are an Institute of Ergonomics and Human Factors Registered Consultancy, with experience in all aspects of ergonomics, including: risk and human error assessment; system, procedure and equipment design; incident investigation and root cause analysis; training; emergency management; safety

culture and safety management; and compliance management.

Our healthcare experience ranges from the development and application of risk assessment methods, through guidance on the design of hospitals, to root cause analysis and evaluations of programmes and care pathways.

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Human performance is both predictable and manageable – contact us to find out more about how you can use ergonomics to help you manage the human element of risk.

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Written by Professor David Haslam, GP & Chair, National Obesity Forum

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OBESITY MANAGEMENT

A HUGE BURDEN While current obesity campaigns focus mainly on prevention, if we are to lessen the financial strain of obesity on the NHS, more needs to be done to target those who are already obese ONE IN FOUR ADULTS IN THE UK IS obese, and each will lose an average of almost a decade of life, a cumulative loss of 100,000,000 years for the current adult population. Fat people outnumber normal weight individuals by almost 2:1. Because of its link with diabetes, heart disease and other serious chronic conditions obesity costs the economy around £4 billion per year, a sum growing rapidly enough to bankrupt the NHS imminently. Yet the government is content with a policy of obesity prevention.

Obesity prevention strategies have always been with us, since the Law of Moses – the Biblical diet and public health manual – which was God’s word presented to the Hebrews with a promise of disease prevention if obeyed.

Across ancient religious texts, the problems associated with eating too much are also starkly illustrated. Proverbs advised potential sinners: “Do not join those who drink too much wine or gorge themselves on meat, for drunkards and gluttons become poor, and drowsiness clothes them in rags.” Hindus were warned of ‘numberless diseases’ in store for the “thoughtless glutton who gorges himself beyond his digestive fire’s limits”. Followers of Islam were taught: “The food for two persons is sufficient for three, and the food of three persons is sufficient for four.”

Medics and scholars concurred with the religious viewpoints. Over 3,000 years ago Hippocrates noted that “men who are constitutionally very fat are more likely to die quickly than those who are thin” and 1,000 years ago Avicenna, the great Persian physician, wrote that “most illnesses arise solely from long-continued errors of diet and regimen”. Both devised methods of health maintenance, and risk reduction.

MODERN DAY HEALTH INITIATIVE A sequel to the Law of Moses, another diet and public health initiative is now with us – once again conveyed to the population from a powerful unseen force: in this instance, not God but the Department of Health. However, in some respects this modern interference has changed very little since the Law of Moses: less emphasis on circumcision, cloven hoofs and the abomination of eating bats, and more on Bogeyman soup, and strawberry and banana smoothie (recipes from Change 4 Life). The difference is that Moses, Hippocrates and Co were preaching maintenance of health to a lean population, whereas we now exist in the middle of an obesity epidemic, and the advice hasn’t been updated to reflect the fact.

Change 4 Life is a first rate piece of social marketing, and is proving popular with mothers

and families. Saatchi have developed an entertaining user-friendly concept using instantly recognisable bright colours and logos, combined with witty and effective material to produce a highly engaging product which will be important in preventing obesity for the next generation.

However, they have deliberately avoided graphics which might have a negative impact or appear unpalatable, nagging or nannying to the target audience. Thus Change 4 Life portrays a Utopian world in which no inhabitant carries a single extra ounce while they happily dance and leap around and bounce balls on their head. It is like a children’s story without any villains which might upset the delicate flowers. Couch potatoes and computer game addicts are saved from obesity by a vision of an arteriosclerotic future before the bump begins to show. Even the written advice embraces only prevention: “Middle age comes to everyone – ‘middle aged spread’ doesn’t have to.”

Change 4 Life is unique, sophisticated and

brilliant at what it does, and prevention is a crucial part of the battle against obesity, but preventative measures in the absence of tactics to actually deal with the current obesity epidemic is like someone standing in a blazing housefire and calling Health and Safety to check the plugs, when what is really needed is the fire brigade.

TARGETING THE ALREADY OBESE The only reason a government could possibly have for wishing to prevent obesity in people they will never meet, is to prevent the expensive health consequences: diabetes, heart disease, stroke, cancer and other conditions. So an obesity prevention strategy is actually an illness prevention strategy, but one done on the cheap because it ignores those people who are at the highest risk of illness – the currently obese. It is the equivalent of an HIV prevention strategy which ignores prostitutes,

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OBESITY MANAGEMENT

intravenous drug users and homosexuals, and instead targets monogamous couples.

Obesity is not only a significant health hazard to an individual, it is also a massive expensive to the NHS and to the Nation. The National Audit Office compiled figures in 2001: 30,000 deaths a year and 18 million sick days attributed to obesity. The Foresight Report published in 2007 gazed into the future, estimating that increasing levels of BMI will add £7.7 billion to annual costs to the NHS by 2050, and if the ratio of the total wider costs of overweight and obesity to solely NHS costs remains similar, a total cost to the Nation per annum of £49.9 billion attributable to increasing BMI will ensue (assuming the value of money remains the same). However, in 2001 a paltry £9.5 million was spent on obesity treatments per annum.

Clearly the cost of overweight and obesity is huge, but paradoxically the financial resources required to treat obesity are relatively small, and also offset by the savings made in reduced healthcare, and prescribing costs.

The Counterweight programme of weight management for obesity in primary care has been shown to induce multiple health and quality-of-life benefits, is widely available in Scotland, and being commissioned in

growing numbers in England. It demonstrates that weight management can be highly cost-effective even taking into account only the reduction in costs of three out of the many clinical consequences of obesity: type 2 diabetes, coronary heart disease, and colon cancer. The findings of the cost-economic data within Counterweight demonstrate that using the programme is cost-dominant, therefore providing in effect a free intervention for obesity management.

Results generated by the Counterweight analyses were all well within accepted NICE thresholds for cost-effectiveness of £20-30,000/ QALY, interventions with lower ICERs being judged to be a good use of healthcare resources.

Counterweight also analysed the increasing prescription costs of the top ten most expensive drugs from the formulary, including pariet, lipitor, efexor and others, with each increment rise in BMI, inducing a dramatic escalation of costs with increasing levels of obesity.

COST SAVINGS The most emphatic example of cost savings with obesity management is with bariatric surgery.

Operations such as the laparoscopic adjustable gastric band, and the Roux-en-Y gastric bypass

Scalesexpress – expert advice on scales for obese patients CALESEXPRESS IS the UK’s leading online retailer of scales, with an extensive range of body fat analysers, health and activity monitors, bed scales and hoist weighers, from manufacturers including Tanita, Salter, Seca, Salter Brecknell and Marsden.

The website offers a carefully selected range of body composition analysers that are NAWI Class III approved and are suitable for healthcare professionals when dealing with obesity, such as the Tanita SC240 MA. The large platform scale is light and highly portable and instantly calculates body fat, body water and BMI with clinically proved accuracy.

Calibrated up to 300,000 uses, the monitor can monitor ages 5-99 with a 200kg weight capacity and has a USB port to allow data to be easily transferred to a computer.

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The Marsden MPHW 200 lightweight patient hoist weigher with BMI is also NAWI Class III approved and can fit most types of hoists that have the ‘coathanger’ style sling support.

Scalesexpress offers easy, convenient shopping and is focused on giving customers the best advice, the best choice and the best price. You can get tailored advice on a wide range of products from our team of expert customer service advisors.

Scalesexpress can also provide full account terms for hospitals and local health organisations, health authorities, emergency services and councils.

cost around £7,000 and £12,000 respectively, but pay for themselves within 3.5 years of surgery being undertaken. With the insertion of a gastric band, up to 73 per cent of cases of newly diagnosed type 2 diabetes have been shown to achieve remission, and around 80 per cent of all cases of type 2 diabetes with gastric bypass. An Australian paper demonstrated that surgical intervention for diabetes saved AUD2,400 after ten years compared to conventional treatment, not in itself a huge amount of money, but representing considerably higher savings if other obesity related conditions such as CVD were taken into account.

Yet PCTs are routinely contravening NICE guidelines by turning down patients deemed appropriate for surgery by NICE, using their own, arbitrary, non-evidence-based thresholds.

Some patients are therefore denied life-saving treatment, others are even being forced to deliberately gain weight in order to meet strict Specialist Commissioning Group criteria.

The choice is a simple one. The government must prioritise the management of obesity alongside its prevention, or witness epidemics of diabetes, stroke and heart disease as a consequence of the obesity epidemic, and ultimately a bankrupt NHS.

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Our 2010 catalogue contains over 12,000 lines, with over 500 new products. Within this catalogue you will find a 24 page section dedicated to Bariatric products for the bathroom, in the bedroom, around the home and going

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At Homecraft, we also have a dedicated nationwide sales team with a great knowledge of the Bariatric market, available for product demonstrations, advice and the latest offers on any product within our portfolio.

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FOR MORE INFORMATION Contact: Dan Brough, sales advisor Tel: 01204 590231 E-mail: dan@wardworth.com

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CATERING

CATERING FOR ALL Providing food that meets the nutritional, cultural, social and religious needs of the population is no easy task, says the British Dietetic Association THE IMPORTANCE OF MEETING patients’ nutritional needs to aid recovery has long been recognised and has resulted in moves to implement malnutrition screening for all inpatients and improvements in the quality and availability of hospital food for patients (Council of Europe 10 key characteristics of good nutritional care 2007).

The ‘Standards for Better Health’ form part of the Annual Health Check, which was launched by the Healthcare Commission in April 2005 and is now the responsibility of the Care Quality Commission. This requires all NHS organisations to make a declaration on compliance against 24 core standards which cover areas agreed with patients as basic requirements for healthcare.

These include the need to provide evidence of appropriate catering for all groups including those from different ethnic minority groups.

MENU PLANNING To meet a patient’s nutritional needs, the food available must be capable of meeting the nutritional, cultural, social and religious needs of the population and also be something that the patient wants and is able to eat! Menu planning for hospital inpatients has always been challenging as there is a diverse range of dietary needs for any hospital population.

Large acute hospitals increasingly have to cater for a variety of ages from newborn to elderly, a large number of different cultures with specific religious food needs and also specific therapeutic diets depending on their area of speciality e.g. ‘clean’ diets for transplant patients and complex modified protein diets for patients with metabolic disease.

Issues associated with bulk catering for a large number of people over a short meal period and at a controlled cost have resulted in the need to develop menus that attempt to meet all of the patients needs in a limited number of food choices on a daily basis.

Menu planning is now extremely challenging and should involve the caterer and dietitian to work to balance all of these needs.

If we accept these menu planning principles and recognise the importance of helping patients to eat via providing appropriate food choices then surely it should be simple? However practically there are issues that need to be considered when agreeing a menu which reveals how complex and challenging this has become.

DON’T MAKE ASSUMPTIONS Firstly, it is essential that assumptions concerning food choices are not made. In many

hospitals where there is a high percentage of patients from a particular ethnic group a separate ‘ethnic’ menu is made available.

This menu may only be available to those patients who are considered to be from that particular ethnic group. So how can this be policed? Who decides who should have this particular food choice? Is this inappropriately based on a patients name or how they look and will that person actually be adhering to the requirements of their culture? For many ethnic groups the young are from second and third generation and have developed a more westernised diet which may or may not still adhere to their cultural requirements.

Increases in the availability of food from a whole range of cultures within restaurants, takeaways and the local supermarket has increased the variety of food eaten by much of the population and these foods are now seen as part of the “British” diet and eaten by a wide variety of people from a range of age groups. It is wrong to assume that for example the elderly will not eat lasagne any more than a Muslim patient will only want to eat curry. Personal taste and preference are now a very strong factor in food choice and this can often become more important to patients who are unwell and within an environment in which they do not feel at home. Hospital menus do contain foods from a range of different countries and are enjoyed by a wide range of different cultures.

UNDERSTANDING ETHNIC NEEDS Secondly, is the challenge of how many different cultures a hospital menu can practically serve and when is it essential that a specific choice be included? This is a complex area and I attempt to explain. For many hospitals serving major city populations there is a large percentage of people from a particular ethnic group but a number of other groups in smaller but still significant numbers. For example within Bradford there are a number of South Asian patients who are either Muslim, Hindu or Sikh and also a smaller number who are African-Caribbean, Chinese or Eastern European. There is also a small Jewish population. So should cultural choices from each of these groups be included on the menus together with those deemed appropriate for the larger white British population?

In an ideal world this would be nice but within the confines of the large scale catering systems and cost pressures applied is actually impossible. It can be extremely difficult as cultural groups often apply significant pressure to Hospital Trusts to cater for them individually and this is where it is important that the need for ethnic diets is understood.

It is important here to separate cultural food likes from religious food requirements. To clarify, Orthodox Jewish patients cannot consume pork at all and need other meat to be slain in a particular way and approved as Kosher. These foods cannot be cooked with or served with

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Understanding

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Our manufacturing expertise means we can safely provide foods which are often excluded in the diets of people with dysphagia, such as peas, sweetcorn, pineapple, raspberries and fish. With the Findus Care Cuisine range of products, it is possible to provide a safe, varied and above all tasty diet. We like to see empty plates and a satisfied customer.

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Clinical Expertise | Understanding Nutrition | The Joy of Food | Simple & Safe

Health Business | Volume 10.2

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CATERING

So where does this leave groups whose food requirements are around preference rather than religion? For many Trusts who have a large percentage of their population from these groups it is possible to provide a menu that includes these foods but for those where these groups are in very small numbers it can become economically and practically difficult and therefore impossible to include them on the main menu. How this issue is resolved will vary by area but needs to be considered when reviewing and setting up catering systems.

To meet a patient’s nutritional needs, the food available must be capable of meeting the nutritional, cultural, social and religious needs of the population and also be something that the patient wants and is able to eat CULTURALLY DIVERSE BRADFORD Finally, here is an example of how catering for different religions and cultural groups have been approached within Bradford.

Bradford menus have been designed to include a choice of Halal and vegetarian

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is a very small Jewish population but kosher foods are made available via an a la carte menu and the food is appropriately sourced and stored frozen until needed. Jewish patients are able to choose from both the Kosher and normal menus to improve the level of choice.

curry for lunch and supper sourced from an approved local supplier to meet the needs of the traditional orthodox south Asian patients. There is a children’s menu which offers Halal kids meat choices e.g. chicken nuggets and sausages as well as their nonHalal versions. These are never offered on the same day to prevent confusion. It is important to remember that Sikh patients who do eat meat will not consume that which is Halal and so menus need to be carefully coded.

To deal with the issues of cultural food likes Bradford has developed a separate a la carte menu for African-Caribbean clients as these are required in small but regular numbers and this food is sourced frozen and can be stored until needed.

Menus ask patients to discuss their dietary requirements with the nurses or catering team and if their needs are not being met appropriate food is sourced and provided via the dietitian in consultation with the diet kitchen e.g. vegan or food allergy.

In conclusion, catering for the dietary needs of the wide range of patients from different ethnic groups within hospitals is challenging but is essential in the bid to meet nutritional needs and prevent malnutrition.

TW

non-kosher foods and it would cause extreme distress to a patient to be offered food that did not comply with these requirements. To simplify it would be like offering many of us rat stew or serving our ordinary stew with a spoon that had previously served rat. For these groups it is essential that appropriate food is made available as otherwise they would be unable to eat and malnutrition would result. For these groups it is essential that there are systems to provide appropriate food choices however small a minority they are in. Within Bradford there

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Written by Angela Pisanu

TRANSLATION & INTERPRETING

BREAKING THE LANGUAGE BARRIER Accurate communication is crucial in situations concerning health. It is therefore extremely important that the NHS has access to quality translation services to accommodate today’s multi-cultural Britain HIGHLIGHTED IN ITS CORE principles, the NHS sets out to be “responsive to the needs of different groups and individuals within society”.

To this end, there will always be a need for some form of translation and interpreting services in the NHS to accommodate today’s multi-cultural society. But the issue does not just end there; the quality of the translation is also vital. Any inaccuracies caused by a poor translation in the health sector could, quite literally, result in life or death.

RISKY BUSINESS Health professionals need to hear an account of their patients’ illness and medical history in order to make a decision about treatment. If this is not obtained, it could result in failure to identify conditions and failure to take the necessary action.

By having no or a poor quality interpretation service, health professionals may be forced to compromise or lower their standards by treating patients without explanation or discussion. In addition, it is stressful having to perform examinations or treatments on a patient that is distressed because he or she does not understand the situation.

WHICH TRANSLATION SERVICE? There are various different types of translation and interpreting services available to the sector, but how do you know which is the most appropriate for the situation?

The decision about whether to use a faceto-face interpreter should be judged on a case-by-case basis. As a basic rule, the more complex the communication, the more likely the need for face-to-face interpreting. Likewise, if the interview is going to be long, if the patient is vulnerable or if sensitive information or bad news is going to be disclosed.

An alternative service is telephone interpreting where the interpreter is at the other end of the line. The call is connected like a conference call between the patient, health professional and interpreter. This should be utilised when short but important pieces of information need to be communicated immediately. The charges are usually based on the time spent on the call.

Written text that needs communicating to the patient, such as a patient record, leaflet, brochure, website content, e-mail, letter or form, will need text-to-text translation in the required language.

Alternatively, some suppliers offer text-tospeech translation. This is where a document is communicated to the health professional or patient orally or by audio in the relevant language. It can be a good option for the

visually impaired or illiterate. One method is to send the document to the translation agency with the language required and the relevant telephone number. An interpreter will then call the patient to read the content of the document into the required language. Alternatively, the supplier may be able to supply the text as audio.

CULTURAL UNDERSTANDING Another service which is useful in today’s multi-cultural environment is ‘cultural understanding’. This is where minority groups

give feedback on the cultural sensitivity of a document and highlight any issues that might arise due to cultural differences.

In addition to those affected by language or cultural barriers, the deaf community should also have access to an interpretation service. British Sign Language interpreting and lipspeaking allows medical professionals to communicate with members of the public who are deaf or hard-of-hearing.

Sign Language interpreters take spoken words and convert them into hand and body

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LTC provides the very best translation and localisation services at afforda

Global Lingo offers high-quality, cost-effective and reliable language and communications services to Public Sector Organisations, leaving you more time to focus on your job.

We specialise in the following areas: transcription, professional minute taking, translation, localisation and interpreting services.

With ever-more diverse cultures and nationalities living and working in the UK, the need has never been greater for the Public Sector as a whole to provide quality services in a language communities will understand. Whatever LTC APPLIES THE MOST INNOVATIVE LANGUAGE your language and communication needs, you can be assured Global Lingo TECHNOLOGIES will deliver the right solution for you.TO PROVIDE THE VERY BEST TRANSLATION AND LOCALISATION SERVICES AT AFFORDABLE PRICES. Global Lingo LtdCALL US NOW ON +44 (0)20 8549 2359 OR VISIT OUR WEBSITE International House AT WWW.LANGTECH.CO.UK 1-6 Yarmouth Place London W1J 7BU Tel: 020 7870 7100 Fax: 020 7870 7101 Email: info@global-lingo.com

The UK’s leading provider of language support services for the Healthcare Sector – Helping health professionals nationwide The Highest Quality Support

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Call us on 0800 169 2879 and we will introduce you to our Health Sector team.

Or visit www.languageline.co.uk for more information.

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movements. Lipspeakers on the other hand are trained to transfer the spoken word into lip movements that deaf people can understand.

Whichever translation service you use, it is extremely important to make sure that the supplier can offer quality translation and interpreting services for the specific needs of the health sector. Knowing a foreign language alone is simply not enough in the medical profession. The meaning of a text or speech must be understood before it can be translated and if the text or speech is full of medical terms and jargon, then it is unlikely that a

translator without medical knowledge and experience will be able to do a sufficient job.

Suppliers that are members of professional bodies such as the Institute of Translation and Interpreting (ITI) have to adhere to a strict code of professional conduct and can be a good place to start your search.

THE COST OF TRANSLATION It was reported earlier this year in the Sun newspaper that health chiefs are spending £22 million a year on translators, with the cost of interpreters pushing the total

NHS translation bill to an estimated £55 million a year. Polish, Turkish, Farsi, Kurdish, Mandarin, Somali, Arabic and Bengali are the most commonly demanded languages.

When you think how much extra frontline staff you could hire with such money, it is understandable that translation in the NHS is a contentious issue. In fact, some argue that by providing translation services so readily to foreigners, it works as a disincentive for them to learn English.

However, the opposing view is that translation allows immigrants to gain access to services while they learn English and helps ease them into British society. It is unlikely that an immigrant will learn English immediately upon arrival and even more unlikely that they will learn it before they arrive in the UK as the majority will not have access to language learning resources. With this in mind, the translation of certain services will help the non-English speaking communities with the transition into British society.

The debate also overlooks the fact that not using qualified translators can be far more damaging in terms of errors and can actually end up costing far more in terms of money, time caused by diagnostic delays and problems.

There will always be new arrivals to this country with varying levels of English.

There will also always be tourists. So even if all permanent residents learnt English, there will always be a need translation and interpreting in the health sector.

Given that accurate communication is crucial to situations concerning health, it is extremely important that the translation and interpreting services available are of the best quality and tailored to the precise needs of the medical profession.

Network Languages – the translation experts STABLISHED IN 1996, Network Languages offers a translation service in over 1,000 languages and in-house typesetting/DTP in over 2,000 languages. Our translator database exceeds 10,000 professionally qualified mothertongue translators, listed according to their specialist knowledge and experience.

In addition, our team of language experts, highly experienced in all these languages, will not only ensure that all our in-house typesetting is accurate and of the highest quality but will also offer an independent proofreading and language consultancy service. We have extensive experience within medical fields covering medical devices (ICU), pharmaceuticals, white papers and assistance to

E

professionals within worldwide disaster zones.

We are a dedicated team focusing on the pursuit of quality and excellence. Our goal is to perform with pride, ownership and responsibility. Developing relationships based on trust, reliability and commitment, we provide a professional service to achieve total client satisfaction. Network

Languages Ltd is full member of the Association of Translation Companies.

FOR MORE INFORMATION Tel: 01344 870700 Fax: 01344 870710 E-mail: enquiries@netlang.net Web: www.netlang.net

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ENJOY EAST MIDLANDS In the East Midlands you’ll discover a very special part of the country FROM MAGNIFICENT CASTLES AND stately homes that provide a unique glimpse into the past; inspiring countryside with sweeping green hills and dramatic rocky outcrops; cosmopolitan cities combining shopping with night life; historic market towns; majestic gardens and locations that have inspired movie makers – welcome to the East Midlands.

A FRESH LOOK AT DERBYSHIRE Conferencing in Derbyshire is changing – and it’s well worth taking a fresh look at what the county can offer. Nestling between the M1 and M6, at the crossroads of the major rail networks and within easy reach of Manchester and East Midlands Airports, it’s centrally located and couldn’t be more convenient – just two hours away from 80 per cent of the UK’s population.

Derbyshire is home to many international organisations such as Bison, JCB and Toyota, as well as being a centre of manufacturing expertise, housing such businesses as Bombardier and Rolls-Royce. Boasting one of the world’s most visited National Parks, the Peak

District, as well as the dynamic city of Derby and several bustling market towns, the county’s profile as a popular setting for films such as ‘Pride & Prejudice’ and ‘The Duchess’ make it a sought-after location to live, work and stay.

With Derby only 93 minutes from London by train, a host of new hotels have changed the landscape of the city. New arrivals include the boutique-style Cathedral Quarter and Hallmark Derby, new developments such as Ramada Encore and Jurys Inn in 2009, and Hampton by Hilton, due to open its doors in 2010. The city is a very exciting and vibrant place to be, with regeneration projects such as the Derby College Roundhouse and the prestigious Westfield shopping development.

More established venues are also being refurbished such as the ever-popular Derby Conference Centre and Pride Park Stadium.

Derbyshire’s towns combine character and convenience, with unique venues such as The Devonshire Dome, The Barceló Buxton Palace and The Old Hall in Buxton, home of the famous mineral water, with its direct rail link

into Manchester Piccadilly. Bakewell, home of the famous Pudding, is home to The Rutland Arms, while Chesterfield has a brand new fourstar hotel, Casa, opening this year, as well as a brand new stadium, b2net, for Chesterfield Football Club. The jewel in Derbyshire’s crown is undoubtedly the Peak District, home to iconic venues such as Alton Towers Resort and Chatsworth, which has recently broadened its brief to accommodate corporate events.

The area offers many hidden gems ideal for focusing on business amid relaxing surroundings - from the award-winning East Lodge Country House Hotel at Rowsley and spectacular Thornbridge Hall at Ashford in the Water to the oldest Marriott in the world, Breadsall Priory, near Derby, which also boasts two 18-hole golf courses. For people with a sense of adventure, Peak Pursuits has a base at Tittesworth Reservoir, where it specialises in water-based activities, while for those with a head for heights, high ropes courses at Go Ape and at Hargate Hall offer the opportunity to enjoy some high-adrenaline team-building.

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ICONIC NEW VENUE

M E E T I N G S • S E M I N A R S • E X H I B I T I O N S • C O N F E R E N C E S • R E C E P T I O N S • T R A D E S H OW S • C O R P O R AT E E V E N T S

Open for bookings, for further information please email: f l o ra l c o n f e r e n c e s @ w i r ra l . g o v. u k M a r i n e P r o m e n a d e , N e w B r i g h t o n , Wi r ra l C H 4 5 2 J S | w w w.f l o ra l p av i l i o n . c o m

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CONFERENCE DERBYSHIRE We’re here to help you book your conference, meeting or event in our stunning location, right at the heart of the UK, by: • Coordinating an efficient and effective sales enquiry service for anyone looking to stage an event in the area • Offering a responsive, tailor made venue-finding service – saving clients time, hassle and money • Targeting new markets to promote the many advantages of staging an event in one of a wide range of prime locations, right at the heart of the UK • Encouraging local businesses to ‘buy local’ and book meetings using its services • Encouraging buyers and the media to visit the area to discover its potential • Spreading the word further afield to highlight what the city and county has to offer.

Conference Derbyshire shares offices with Visit Peak District & Derbyshire, the area’s official tourist board, at Crescent View, Hall Bank, Buxton, Derbyshire SK17 6EN. For further information, log on to www.conference-derbyshire.co.uk, call 0845 833 0970 extension 4850 or e-mail rachel.guest@visitpeakdistrict.com.

A DESTINATION FULL OF CONTRADICTIONS Breath-taking architecture, contemporary culture, historical houses and boutique style make Leicester and Leicestershire an inspirational destination for your conference or event. Leicester and Leicestershire is home to some of the most inspirational conferencing and event venues in the country – from stateof-the-art and purpose built conference centres, through to traditional conference venues and stately homes combining yesterday’s architecture with today’s hi-tech facilities.

Leicester offers a mix of world cultures with contemporary city style. The changing face of the conference venues mirrors the transformation of the city centre, from purpose built conference centres to converted art-deco cinemas all located in the heart of the city.

Leicester’s style revolution is apparent when you visit Curve theatre, designed by worldrenowned architect Rafael Vinoly. Not only does the dramatic design offer a perfect venue to experience world-class theatre performances, but will also provide an inspirational

backdrop to your conference or event.

As a landmark building situated within the cultural quarter of Leicester city centre, Athena combines original art deco features with state of the art technology, to provide an ideal venue for banquets, conferences, exhibitions and AGMs. Leicester Marriott Hotel forms a stunning gateway to the vibrant region. The hotel offers an outstanding choice of 21 meeting and conference rooms, designed to accommodate every kind of event, from important conferences to private board-level meetings.

How about doing business in space?

The National Space Centre is a top visitor attraction in Leicester but also makes for a unique venue for events and conferences.

This is a flexible venue for conferences and seminars catering for 10-500 guests.

Leicester Conferences is the dedicated conference and accommodation team within the University of Leicester. At the University of Leicester you will have conference facilities for 10-2,000 delegates, with venues set in central locations and within grounds of botanical gardens.

A BREATH OF FRESH AIR Just a few minutes away from the city lies a very different world. Beautiful rolling countryside, winding waterways, ancient woodland, historic market towns and picturesque villages provide the ultimate rural retreat. Leicestershire’s landscape makes for stunning conference venue locations. Take your conference back to nature and bring the event outside. From the National Forest to ancient castles, these all make for ideal settings to hold your conference, event and team building activities.

Belvoir Castle and surrounding parklands are available for a range of events from an intimate dinner in the State Dining Room to a conference or marquee event in the park. In recent times the castle and park have played host to a broad range of diverse events and activities; from product launches and auctions to filming and prom concerts.

For centuries Rockingham Castle has entertained royalty and private guests within its ancient walls. Walker’s House, within the original curtain wall of the castle, has recently been refurbished to provide full conference facilities with meeting and conference rooms and full catering facilities.

Set amidst the 410 acres of Loughborough University grounds, the multi award-winning imago offers an array of facilities for meetings, seminars, conferences, exhibitions and events spread across three state-of-the-art venues.

A picturesque Edwardian country mansion set in the rolling countryside of Leicestershire, Scalford Hall provides an excellent management training centre and its extensive grounds provide a colourful backdrop for events. It was recently awarded The Condé Nast Award for Most Excellent Dedicated Venue 2010 and the event team are gearing up for a busy year.

Hotel manager Mark Watts said: “2009 was a challenging year for most businesses, however, 2010 looks promising and on the top of the agenda, sitting alongside training and development, is re-building teams.

“Scalford Hall Management Training Centre and Hotel has extensive facilities for both indoor and outdoor teambuilding events. Teambuilding does not have to be about expensive events but they are vital in rebuilding trust and removing barriers as well as motivating employees.”

The Centre is recognised for the development of management and leadership skills, alongside a range of external teambuilding equipment, exercises and tasks that provide powerful learning media in support of your training objectives. The activities have all been developed to call upon a participant’s cognitive, creative and organisational skills.

LOCATION, LOCATION, LOCATION Located in the heart of the East Midlands, Leicester and Leicestershire offer a strong transport infrastructure combining excellent road, rail and air links to provide access to the major business centres in the UK and Europe.

• Four national motorways connect with Leicestershire including the M1 • Home to East Midlands Airport, with passenger flights to 16 European capital cities, and with two other international airports within one hour’s drive • The East Midlands Parkway is one of the greenest train stations ever built, and will be served by over 100 East Midlands Trains services per day, with trains to and from London every 15-20 minutes at peak times. The journey time to London will be around 1 hour and 30 minutes. It will serve as a park and ride station for Leicester, Derby

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CONFERENCES & EVENTS

and Nottingham, reducing car use into the major cities and taking traffic off the M1 • Leicester to Paris takes under four hours via the Eurostar link.

Conferences@GoLeicestershire offers a free, easy to use, online guide to the venues large and small, conventional and unique within Leicester and Leicestershire. The site includes a ‘virtual’ conference desk where organisers can view conference-specific venue listings categorised by residential, non-residential and corporate hospitality. However, if you want something a little different and need suggestions of quirky venues, itineraries or social activities – tailored to your needs – contact conferences@goleicestershire. com or call Helen on 0116 299 6666.

VENUE LINCOLNSHIRE Whatever your event plans may be – a getaway to inspire the team or a conference to inform your customers – Lincolnshire has a venue to suit every occasion.

Many may not know but Lincoln Castle situated in the heart of Lincoln City’s historic Cathedral quarter can be booked for full or half day conferences. Built in 1068 it offers an inspirational backdrop to meeting and conference exhibitions.

Refreshments, buffet lunches are available onsite. In addition guided tours and wall walks can also be booked – adding a little something extra to the usual conference experience.

The most recent edition to the county’s conference centre is one of the greenest buildings in the UK; the Lincolnshire Events Centre on the Lincolnshire Showground, known more widely as the EPIC Centre. This award winning ecobuilding offers the opportunity to experience the best in corporate and social functions against a backdrop of total environmental sensitivity. It is the UK’s first purpose build green conference centre and was recently voted the top eco building in the UK. The venue is highly flexible and can accommodate events for 10 to 1,500 people. It is fully serviced, with catering, décor, audio visual and entertainment solutions in place. Located just 10 minutes out of the city centre, or 40 miles from the M180 it is among the top choice of venues in the county.

If you want to blow away those corporate cobwebs head off to Butlins, Skegness on the Lincolnshire coast. Their conference facilities aren’t what you’d usually expect to see at a seaside holiday resort. From product launches to themes gala dinners, conferences to parties, Butlins offers onsite space, parking, entertainment and accommodation parties of three to 3,000.

If delicious food and drink is towards the top of your wish list for a venue then don’t miss Uncle Henry’s newly renovated barn conversion. Located alongside their popular farm shop in the countryside north of the City, just off the A15, it is the perfect place to hold your event. Their cosy function room offers theatre-style seating for up to 50 people

Breath-taking architecture, contemporary culture, historical houses and boutique style make Leicester and Leicestershire an inspirational destination for your conference or event and boardroom-style layout for up to 30.

There is also a lounge for welcoming guests as they arrive and offering breaks during long meetings. What makes this venue stand out from the crowd are the full catering facilities provided by their farm shop kitchen. Don’t miss the chance to refuel on juicy Lincolnshire sausages, plum bread, cakes, scones and refreshments. Uncle Henry’s is the ideal place to hold a meeting in a relaxed rural setting.

If leisure facilities are as important to your party as conference facilities, Forrest Pines in northern Lincolnshire is the place for you. The 4-star hotel is five minutes off the M180 and nestled in 190 acres of countryside. The nationally recognised 18-hole golf course offers an ideal opportunity for delegates to relax before and after corporate events. Inside, the nine conferencing suites are ideal for board meetings, video conference and training days with maximum capacity reaching 370 delegates.

Remaining in the south of the county off the A1 is The George Hotels Business Centre. Set in the Georgian stone built town of Stamford offering a glimpse into a bygone age. Cherry picked by film directors the stunning town inspires all who visit. The George Hotel, one of the oldest coaching inns in the UK is superbly equipped and provides an ideal environment in which to conduct all types of meetings and conferences within the elegant surroundings.

For more information please see www. lincolnshiretourism.com/venue-lincolnshire.

DIVERSITY IN NORTHAMPTONSHIRE Whatever type of event you are organising you can experience the diversity only Northamptonshire can offer. Home to three of the country’s most famous racing circuits, the home of British Motorsport can help you deliver an exciting high-octane event or why

not allow your delegates to experience our fascinating history, heritage and exceptional beauty of our countryside in one of our many historic country house – including a Castle built on the instruction of William the Conqueror.

What better combination could you find than the thrill of a world class racing circuit and a fabulous 4-star conference hotel with leisure facilities? Silverstone Racing Circuit, with its action packed race calendar and, of course, the British Formula One Grand Prix, sits right next door to Whittlebury Hall, which offers a purpose-built, professional learning environment, a personalised and flexible service and the widest range of business and leisure facilities – all centrally located in the heart of the country within minutes of the M1 and M40.

The training and meeting facilities at Whittlebury Hall consist of 14 principal management training suites, 32 fully serviced syndicate rooms, six meeting rooms and an executive boardroom. There are two large conference suites, Grand Prix and Brooklands, hosting up to 500 delegates.

“2010 is an important year to focus on our core market – training, management development and leadership,” said Michael Stott, director of sales and marketing.

“There has never been a better or more cost-effective time to use professional facilities to add value through improved skills and enhanced business techniques.”

Wittlebury Hall also offers award-winning leisure facilities to provide a welcome contrast to your day. Even before you get down to business, the Ice Breaker sessions feature a therapist joining you for a 15-minute session of massage and meditation – this will allow delegates to benefit from a deeper understanding of basic stress and

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EVENTS AND CONFERENCES

20% discount on dELEGAtE RAtEs At thE nAtionAL sPoRts cEntREs* Book now & quotE hEALth Bus 2010 Stoke Mandeville Stadium www.stokemandevillestadium.co.uk 01296 484848 Bisham Abbey National Sports Centre www.bishamabbeynsc.co.uk 01628 476911 Lilleshall National Sports Centre www.lilleshallnsc.co.uk 01952 603003 *terms and conditions apply – offer available throughout 2010

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CONFERENCES & EVENTS

tension-relieving techniques. Furthermore, the Day Spa delivers a range of stimulating experiences for body and soul, including the Heat and Ice Experience, Turkish bath, and invigorating treatments. The leisure club features a fully equipped gym, 19-metre pool plus whirpool spa, sauna and steam room.

The experienced event management team at Whittlebury Hall will work with you to ensure the services you receive match your requirements in every way. To discuss their unique, passionate and innovative approach to meetings and events, call 0845 400 0003.

If you are looking for a corporate day that will keep your employees and customers talking, Rockingham Circuit is the perfect choice. Try one of their superb driving day packages, or combine some serious driving fun with a conference or seminar, helping to break down barriers between staff members whilst enhancing those all important business relationships. Alternatively, a bespoke conference can be booked in conjunction with tailor-made corporate driving activities especially to suit individual specifications.

If you want to slow the pace, delight your delegates with the elegance and tranquility of one of Northamptonshire’s country house venues such as Highgate House, a striking country mansion in the picturesque village of Creaton, near Northampton. It has evolved over the years into a superb venue for all kinds of events. A multiple awardwinning conference centre, it is one of the finest meeting venues in the Midlands.

Or try the historic Holdenby House. Set in beautiful rolling countryside just a few miles from Northampton, Holdenby House was the prison of Charles I and is the surviving wing of what was once the largest private house in England. So many venues seem cast from the same mould, but Holdenby – with its unique history and atmosphere – offers a refreshingly different experience.

Make it a truly historic event in the

magnificent setting of Rushton Hall, a Grade I listed Elizabethan country house hotel and restaurant surrounded by some of the most beautiful, tranquil countryside, with a wide range of activities, attractions and country pursuits on the doorstep.

Last but not least, set in 12 acres of forest and formal gardens, on a hill overlooking five counties, sits Rockingham Castle. Built on the order of William the Conqueror, this was a royal residence for 450 years. For centuries Rockingham Castle has entertained royalty and private guests within its ancient walls and the history and tradition still continue. This is a truly magnificent setting for an unforgettable event.

Explore Northamptonshire is the destination management agency formed in 2004 to promote Northamptonshire as a first choice destination for visitors. Its main objective is to coordinate and deliver the marketing activity of the county, promoting Northamptonshire to UK and overseas leisure and business tourism markets. For more information on how they can help arrange your event visit the website at www.explorenorthamptonshire.co.uk.

POPULAR NOTTINGHAM Fast becoming one of the UK’s premier destinations for conferences, meetings and events, Nottingham is now one of the top six UK cities for conferences. The city has become a popular choice for thousands of domestic visitors, trade associations, professional bodies, societies and organisations from across the UK, helping to generate an economic benefit of £1.86 million. The Nottinghamshire Convention Bureau, Experience Nottinghamshire’s business tourism arm, is confident that the city can become even more popular in coming months as its reputation for rich heritage, cosmopolitan shopping, nightlife and thriving centres of business continue to grow.

With an extensive range of venues, from a 10,000-seat arena to unique heritage sites, Nottingham is well positioned as an

ideal host for everything from small business meetings to full scale AGMs. The past few years have seen Nottingham host a number of high profile events, including party political forums and a visit from the Dalai Lama.

Nottingham is home to a number of purposebuilt conferencing venues, including The East Midlands Conference Centre. Situated on The University of Nottingham’s University Park Campus, it is considered to be one of the region’s most popular venues, catering for anything between 20 to 588 delegates.

In the heart of the city, the Nottingham Arena is the city’s largest venue, with a capacity of 10,000. The Arena can cater for a variety of events, offering flexible conferencing space with a wide choice of conferencing rooms.

For events with a difference, Nottingham Castle allows event organisers to entertain their delegates in the Victorian gallery lined with artwork from the museum collection.

Alternatively, the spacious Long Gallery is a popular room for formal receptions and dinners and will provide a memorable experience.

ACCESS ALL AREAS Nottinghamshire is easily accessible from all areas of the country. The M1 runs directly alongside the county and sits just six miles from the city centre, whilst excellent rail links are available from most major cities, including a direct service to the new Eurostar terminal at London St Pancras. For visitors travelling by air, East Midlands Airport and Robin Hood Airport are just a short drive away.

FOR MORE INFORMATION For more information about bringing an event to Nottinghamshire, visit www.venuenottinghamshire.com.

Alternatively, contact the Nottinghamshire Convention Bureau directly by calling 0115 962 8313 or e-mailing conferences@ experiencenottinghamshire.com.

The simple solution for all your events V

ENUE-SELECT® provides a free, independent venue finding service in the UK and overseas. Taking time to listen to clients’ needs and by understanding the objectives and aspirations of your event, we provide the most appropriate solution. Whether you need to deliver an important message, motivate your staff or run specialist training courses, we can save you hours of research, providing venue choices that closely match your criteria.

More than just a venue finder, Venue-Select® offers creatively tailored solutions for your event, from conception and budget planning,

through total event management to de-brief.

Our experience shows that it is attention to detail and professionalism that turns an event into an exceptional experience. We can offer you a full range of support, including event marketing communication, logistics, production, entertainment and themeing. Our

online event and delegate registration provides a streamlined, environmentally friendly solution to managing events and accommodation management.

For team build solutions our dedicated TeamSelect facilitators offer a range of ideas that help your business meet their CSR objectives, benefit the local community as well as providing challenging team activities.

FOR MORE INFORMATION Tel: +44 (0) 8703 502577 Fax: +44 (0) 1295 678167 E-mail: karen@venue-select.co.uk Web: www.venue-select.co.uk

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ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service Acksen

87

Formica

49

Newbury Data Recording

72

Acting Out

30

Foxglove Surveillance & Intelligence Services

87

NHS Supply Chain

26

Actividentity (UK)

87

Friends House (London) Hospitality

Onezerosix

37

ADAS UK

59

George Boyd

Organisational Health Psychologists

99

AHCP

40

Static Systems

Parking Control Services

70

Airwave Solutions

20

GMC Landscapes

64

Pass Training Consultancy

76

Anoto Group

11

Goodwin Best

76

Patterson Medical

Argyll and Islands Telecom

Green Street Berman

56 9

109

105

PES Group

63

Armstrong

63

Gully Howard Technical

32

PJ Locums

93

Austin Hughes Europe

18

Haigh

48

Praxis42

96

Handheld Europe

78

Premier Life Skills

94

53

Priorclave

53

84

Autobar Group

110

Baldwin Landscaping

67

Harfield Components

BIFM

30

Haymarket Management Services

Prohealth Recruitment

92

Biocote

50

High & Mighty Office Seating

104

P&G Professional

42

Horticultural Halls & Conference Centre

122

Red Professional Locums

90

Bisham Abbey Sports Centre Bonus Flooring

124 36

Hoval

Britannic Medical

93

Ing Car Lease

British Independent Utilities

IBC

IOM Consulting

Britplas

32

IP UserGroup

44

Sefton Transmail

Building Research Establishment

63

Isla Components

80

Sempermed

James Cropper

53

Sheffield University

19

Judy Reeves Stress Consultants

99

Sonographers Medical

92

South Coast Audit

87

Business Furniture Online Capita Total Document Solutions

104 22

62

Rosetta Translation

82

Ross Brand

112

SecuriCare International

100

104

53 2

104

Kensington Conference & Events Centre

Chris Rose Associates

100

Kodak

14

Stress Check

96

Composite Fibre Glass Mouldings

52

Labcold

54

Systematic Energy

63

Cordtape Environmental Services

33

Lan2Lan

13

Teknomek Industries

37

Courtney-Thorne

34

Language Line Services

116

Tersus Consultancy

36

CSAM

18

Launch X431

78

The Best Organisation

96

Lavazza

10

The Legacy Oaklands Country House Hotel

De Lage Landen Leasing

28

Locum Link

92

TMS Consultancy

82

Easibathe

32

LRQA Training

12

Town & Country Grounds Maintenance

67

Education Essentials

36

Malmaison

124

TTC Automotive

82

60

Management Skills Centre

100

Variable Message Signs

Elcomponent

113

122, 124

BC, 114

Chellgrove

Cummins-Allison

Electrolux

113

Medi Placements

Ergosum

102

Medical Rescue International

88

124

74

Venue Select

125

106

Verd OS

105 18

ESTA

60

Medisavers

46

Verizon

Excel Parking Services

76

Mind Strenghts

99

Village Hotels

118

Eye Drive Systems

80

Monodraught

6

Wardworth

109

First Standard

93

MRDynamics

99

Fleet Masters

83

M端ller Dairy UK

83

Nagels UK

120

NEC (UK)

Fleetsafe Driving Solutions Floral Pavilion Theatre & Conference Centre Forbes Rental

126

100

122

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

36

Network Languages

4

Water Efficiency Solutions

8

Wessex Test Equipment

32

73

WPS UK

68

27

Your Grounds Care

67

Zeag UK

76

117

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2.

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