Health Business Volume 10.5

VOLUME 10.5

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FIRE SAFETY

HOSPITAL GROUNDS

ASBESTOS MANAGEMENT

PARKING Striking a balance between effective management and fair parking for all

HEALTHCARE IT – The benefits of mobile health applications PLUS MORE INSIDE

Phoenix Private Ambulance Service Ltd

Specialised Passenger Transport We are a long established, privately owned, Warwickshire based company providing a caring and professional service. Our aim is to give a careful, understanding, prompt and comfortable service and we have gained a reputation for providing consistently high standards.

We do not offer an emergency service. We provide a uniformed and specialised private ambulance service to meet the needs of the private health sector and transport needs of those unable to use other methods. This involves providing vehicles and staff able to transfer stretcher, wheelchair or walking cases. We are available for a variety of purposes, for example:

• Transfers to and from hospital outpatient appointments • Transfers to or discharges from hospitals • Local and long distance disabled and patient transport nationwide Our team pride themselves on achieving the highest standards of passenger care. Our priority at all times is our passengers’ comfort and peace of mind and we aim to give a service that exceeds our clients’ expectations. Our crews have first aid training and are trained to administer oxygen if necessary. All posts within Phoenix Private Ambulance Service are subject to Criminal Records Bureau enhanced checks.

Our vehicles are regularly inspected and maintained to a high standard to comply with the standards set for all private hire vehicles. Our stretcher vehicles are equipped with up to date stretchers and lock systems tested to meet BS EN 1789:2000 standards. Wheelchair restraints conform to the dynamic test requirements of ISO 10542-1. Our fleet is based in Leamington Spa and although most of our work is centred around the Midlands we are able to provide transport anywhere in the UK.

For more information go to www.phoenix-ambulance.co.uk or call: 01788 816192

HB Dear Reader

VOLUME 10.5

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There is still time to comment on the NHS White Paper, Equity and excellence: Liberating the NHS. This sets out the government’s long-term vision for the future of the health service, how to improve patient matters and liberating clinicians to focus on better care. The Department of Health is consulting on elements of these proposals, and if you want to be part of the future of the NHS you can e-mail your suggestions to nhswhitepaper@dh.gsi.gov.uk There is also still time to enter the 2010 Health Business Awards. This event recognises and celebrates the significant contributions made each year by organisations that work inside and alongside the NHS. For more information about the event and how to enter please turn to page 11 or visit www.hbawards.co.uk

FIRE SAFETY

HOSPITAL GROUNDS

ASBESTOS MANAGEMENT

PARKING Striking a balance between effective management and fair parking for all

HEALTHCARE IT – The benefits of mobile health applications PLUS MORE INSIDE

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: ! NEWS ! FEATURES ! PROFILES ! CASE STUDIES ! EVENTS ! AND MORE

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 10.5

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CONTENTS HEALTH BUSINESS VOLUME 10.5

07 NEWS 11 HB AWARDS We preview the Health Business Awards, the event that recognises excellence in healthcare

15 FLEET MANAGEMENT John Webb from the Institute of Car Fleet Management discusses how to introduce low emission vehicles into the NHS fleet

19 PARKING The British Parking Association explains its hospital parking charter, which aims to make parking fair for all

31 DESIGN & BUILD Jackie Maginnis, chief executive of the Modular & Portable Building Association, highlights the benefits of modular construction over traditional building methods

45 FACILITIES MANAGEMENT The Healthcare Facilities Consortium discusses asset management and what it means to a healthcare environment

51 ASBESTOS MANAGEMENT The Institution of Occupational Safety and Health looks at how you can minimise the risks associated with asbestos The Asbestos Removal Contractors Association talks us through the legal responsibilities of managing asbestos

59 AIR CONDITIONING & REFRIGERATION F-Gas Support discusses the latest qualifications for those working on refrigeration and air-conditioning equipment

61 ENERGY The Energy Services and Technology Association looks at opportunities to reduce energy consumption while meeting regulatory compliance targets An increasing number of NHS organisations are taking part in 10:10, a national campaign to reduce greenhouse gas emissions by 10 per cent a year

67 FIRE SAFETY The Fire Industry Association urges us to raise the standards for fire protection in healthcare buildings

71 HOSPITAL GROUNDS British Association of Landscape Industries explains the benefits of having plants in healthcare settings

72 CLINICAL WASTE The Scottish Environment Protection Agency discusses requirements when it comes to handling clinical waste

75 INFECTION CONTROL Patients and the public need to be placed first and foremost in the fight against hospital infections, says the Patients Association

83 PATIENT SAFETY NHS Wales has launched 1000 lives Plus, a five year programme to improve patient safety and reduce avoidable harm across the country

89 BACKGROUND CHECKING Shirley Wright, partner at law firm Eversheds, gives an update on the vetting and barring scheme

95 FRAUD PREVENTION The NHS Counter Fraud Service looks at fraud among staff in the healthcare sector and how this should be handled

99 LEADERSHIP MANAGEMENT The Institute of Leadership & Management’s David Pardey discusses how being a good leader affects staff performance and wellbeing positively

111 STRESS MANAGEMENT Ann McCracken, Chair of the International Stress Management Association, explores how to keep staff pressure to a manageable and motivational level

115 CATERING Grosvenor Continental discusses the pressures you face in running a successful catering operation, particularly during these financially challenging times

121 HEALTHCARE IT Nick Hunn from the Mobile Data Association reveals how mHealth can help healthcare staff work more efficiently The increased use of technology has the opportunity to transform many aspects of the NHS, says the NHS Technology Adoption Centre

131 DATA DESTRUCTION The British Security Industry Association’s Information Destruction Section reports on the risks and the solutions associated with data handling

139 EMERGENCY SERVICES We preview the Emergency Services Show – an important event for all involved in Emergency Planning, Response and Recovery

143 CONFERENCES & EVENTS What do Bath, Bristol and Bournemouth offer the conference organiser?

In Kent you will find a selection of remarkable conference venues in both new and traditional settings

104 TRAINING What is the future of good patient handling?

107 STAFF INCENTIVES & MOTIVATION How can hospitals enhance employee relations and performance during such austere times, asks the UK Gift Card & Voucher Association

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Major initiative to reduce wasted medicines new campaign to reduce the amount of wasted medicines has been launched by the Welsh Assembly Government.

Health Minister Edwina Hart said: “If we all adhere to the clear and simple guidelines in this campaign and patients only order what they need, and GPs prescribe effectively, the safety and benefits of such medicine management will be felt directly by all in Wales. This will ensure that the NHS is able to spend its money in the most effective way.”

The campaign includes radio adverts and leaflets distributed by GPs surgeries and pharmacies. Patients receiving prescription medicines will be handed advice such as ensuring they order the right amounts of medicines and do not stockpile drugs.

More than 250 tons of out of date,

A

surplus and redundant medicines are returned each year to pharmacies and dispensing GP surgeries across Wales at an estimated cost of £50 million to the NHS. This is in addition to medicines that are probably disposed of incorrectly through household waste. Unwanted medicines cannot be reused or recycled and all have to be destroyed in an incinerator.

Campaign to alert people to early signs of cancer new campaign that will alert people to the early signs of cancer and encourage them to get checked out will be launched in January next year, Care Services Minister Paul Burstow has announced.

The campaign will consist of 59 local campaigns focusing on the three big killers – breast, bowel and lung cancer.

Local areas have been given a share of £9 million for their campaigns.

At the same time as running these local projects, the Department of Health will be trialling, in two regions, centrally-led

A

campaign activity to raise awareness of bowel cancer symptoms and to encourage early presentation. Subject to evaluation, the campaign will be introduced nationally.

Examples of local activity include NHS Leeds which aims to reduce mortality from lung cancer in people aged over 50 through social marketing and community engagement. For example, they plan to advertise on bus routes in key areas and provide community health professionals with branded items directing people to new services, such as chest X-ray.

Fathers allowed to sleepover after new birth pilot scheme offering partners an overnight stay after the birth of their baby at the Royal United Hospital in Bath has been so successful that Wiltshire Maternity Services have decided to make it permanent.

Wiltshire’s maternity services said the Partners Staying Overnight project had been a “huge success”.

The scheme, which began in June, allows partners, or another adult family member, to sleep over in new reclining chairs after a birth.

The National Childbirth Trust said it was an important step in supporting the beginning of a family.

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NEWSINBRIEF New phone service saves hospitals £45,000 An initiative at Epsom and St Helier University Hospitals saved the trust over £45,000 in its first month.

In July, the Trust launched a new service to remind patients about their appointments and to help reduce the number of people who fail to turn up. Patients are now called approximately a week before their appointment is due.

Early data shows that the scheme is a success, with the number of missed appointments dropping from 8 per cent to 6.6 per cent in July, saving £45,809 in one month alone.

The service is free of charge to patients.

Patients who wish to opt out can do so by calling the Trust’s appointments centre.

Printed wristbands increase safety in Cheshire Inpatients at hospitals across Mid Cheshire are likely to see a difference in their identification wristbands as new printing technology is introduced at Leighton Hospital.

Joanne Falkland, patient safety lead for Mid Cheshire Hospitals NHS Foundation Trust, said: “Prior to the use of the new printed wristbands, each patient had to have their details written onto their wristband by hand. Handwriting such details was time consuming and posed a risk to patient safety as errors, although uncommon, could be made in transcribing the information.

Jane Palin, associate director of Integrated Governance, added: “The wristbands also now contain a barcode which can be used when nursing staff test a patient’s blood sugar, for example. When the barcode is scanned, the sample is electronically linked to the patient, eliminating the risk of any misidentification. We anticipate that the barcode will be rolled out to additional patient uses in the future”.

New access road to open in Addenbrooke A new access road that links the Addenbrooke hospital campus to Trumpington is due to open this month. Known as Addenbrooke’s Road, it will help to improve access to the hospital campus and reduce traffic congestion in and around the area.

Carin Charlton, associate director of estates and facilities at Addenbrooke’s, said: “We’re delighted that Addenbrooke’s Road will be opening . It’s very good news for patients, staff and visitors”.

The road has been constructed by Cambridgeshire County Council and paid for by grants and loans from central governments and from developers.

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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UK public wants webcam GP appointments, finds study poll has discovered that the UK public expects technology to transform the way it accesses vital healthcare services by 2020.

The ‘Healthcare of the Future’ study of 2,172 people conducted online

by YouGov and Virgin Media Business revealed that 29 per cent of the population believe they’ll be able to access their GP via webcam in ten years time. It also found that 11 per cent of adults are expecting to be able to interact with a doctor by simply pushing the interactive red button on their TV. The overriding message from the study

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was that 77 per cent of the general public would like to be able to book an appointment with their healthcare provider via multiple communications channels. And whilst 43 per cent of respondents would most like to call for remote healthcare services, 34 per cent of the UK adults surveyed said they would prefer the ability to do this online.

When asked to compare the standard of communication channels offered by the NHS to those provided by their bank, supermarket or utility company, 39 per cent of respondents preferred those on offer from the private sector.

Better health for children, young people and their families he government has set out a new vision for the health of children and young people in a new document, ‘Achieving Equity and Excellence for Children’. This forms a detailed supplement to the ongoing consultation for the White Paper Equity and Excellence: Liberating the NHS. Health Secretary Andrew Lansley launched the engagement document, seeking the views of professionals and the community on how the new system should work, alongside a thorough review of children’s services in the NHS by Professor Sir Ian Kennedy.

Mr Lansley said: “Sir Ian Kennedy’s review has revealed the scale of the issues facing the health service. It tells us important things about the lack of effective, integrated and responsive services we have inherited. Sir Ian reminds us just how important the start

NEWSINBRIEF New management arrangements for Cornwall Managers at Cornwall and the Isles of Scilly PCT have approved plans for its staff to be managed by a private organisation.

A community interest company (CIC) will be set up by the trust outside the NHS to manage 2,400 staff.

The move will affect 14 community hospitals, district and school nurses and speech and language therapists.

Celebrations mark opening of new hospital school Students and teachers at the Chelsea Community Hospital School have celebrated the official opening on the brand new school.

It’s one of the first purpose-built hospital schools in the country and provides education for children and young people staying in one of the hospital’s inpatient wards at Chelsea and Westminster, as well as the day-case ward and Burns Unit.

Telehealth comparison website launched

T

of life is for children and young people’s future physical and mental development.

“We need to act urgently to protect our most vulnerable, not just look after those who know their way around the system.

That’s why we are publishing an unique engagement document, which will ensure children’s needs are firmly embedded in the mainstream of service provision.”

A telehealth product comparison website has been launched to help trusts and local authorities choose the best quality and best value telehealth products for their organisation.

Assisted living specialists Alvolution, together with NHS West Midlands and the Joint Improvement Partnership, has built an independent comparison website that reviews a wide range of the UK telehealth products in one database.

The site provides health professionals with access to impartial reviews of technology, to see what is available, what functionality it provides, how it compares and whether it is recommended. It also provides search functionality that allows users to search by condition, scenario or technology.

The technology on the site is divided into several categories including communication aids, environmental control, physical aids telehealth and telecare.

we listen, we discuss, we design, we deliver

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Health Business | Volume 10.5

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HB AWARDS

RECOGNISING EXCELLENCE IN PROVISION OF NHS FACILITIES There is still time to enter the Health Business Awards, an event that celebrates outstanding examples of best practice in healthcare organisations HELD IN DECEMBER, The Health Business Awards is establishing a reputation for showcasing the success stories in the health sector. The event recognises and celebrates the significant contributions made each year by organisations that work inside and alongside the NHS. With the national media all too quick to focus on the perceived failings in the NHS, the Health Business Awards focuses on the many examples of innovation, dedication and teamwork that are evident since the NHS transformation began in 1997. The award categories incorporate facilities, technology, human resources, hospital management and transport as well as the Outstanding Achievement in Healthcare award, which is presented to an NHS organisation that has achieved success in their role and brought benefits to the wider NHS through their dedication and expertise.

HOW TO ENTER Entry is simple and free for any NHS organisation or public sector body.

Entrants must submit a 500-word entry statement online before 29 October.

Shortlisted projects receive two free tickets to the 2010 Awards ceremony at Arsenal’s Emirates Stadium on 9 December, where a drinks reception will be followed by a three-course lunch, after which it’s time for the winners to be announced.

The 2010 Awards will be presented by

Bill Turnbull of BBC News fame. He joined the BBC as a reporter for BBC Radio 4’s Today programme in 1986, and was a regular presenter on BBC News 24 and BBC Radio 5 Live, before joining the Breakfast presenting team full-time. In 2005, he was a contestant in the third series of dancing competition Strictly Come Dancing.

AWARDS CATEGORIES Air Ambulance Service Award: This award recognises the hard work and dedication of the Air Ambulance sector, which operates as 18 separate charities that raise over £35 million per year in funding. 2009 winner: Wales Air Ambulance Service.

Ambulance Trust of the Year Over the past five years the number of ambulance 999 calls has gone up by a third, placing more pressure on ambulances and control room operations. This award is presented to the Ambulance Trust that has embraced change and demonstrated

an increase in response times, the ability to provide treatment at the scene of an accident, and the provision of outpatient services.

2009 winner: London Ambulance Service.

Estates and Facilities Innovation Award, sponsored by Focused FM New for 2010, the Facilities and Estates Innovation Award recognises NHS and other healthcare organisations that have developed innovative procedures for managing and maintaining healthcare facilities. With the threat of budget reductions looming large we are looking to encourage and propagate the best of innovative practice in the healthcare facilities arena.

Healthcare IT Award The National Programme for IT, and the wider use of computer technology in the NHS is becoming the envy of the world, with many countries citing NHS projects as examples of good practice. This award will recognise an organisation that is responsible for implementing a groundbreaking IT project that demonstrates clear cost benefits to the wider NHS. 2009 winner: Alder Hey Children’s NHS Trust – National Paediatric Toolkit (NPT).

Healthcare Recruitment Award, sponsored by Hays Recruitment Improving patient access and choice depends on the quality and availability of staff in all areas of the hospital practice. This award will recognise the NHS

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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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

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HB AWARDS

and cost effectiveness. 2009 winner: Healthcare Purchasing Consortium.

Hospital Security Award The critical assets of a hospital – its people, property, information and reputation – must be protected. This award will recognise hospitals that have made significant steps towards a safer environment for patients and workers through the implementation of a security policy that incorporates the latest advancements in CCTV, access control and other monitoring technologies.

2009 winner: Mersey Care NHS Trust.

IT Innovation Award The need for timely, effective information in healthcare is key to realising the benefits of the huge investments in NHS staff and buildings.

This award will recognise the most innovative introduction of new technology for storing, retrieving and distributing data throughout the NHS. 2009 winner: East Kent Hospitals University Foundation NHS Trust – Speech recognition software implementation.

NHS Publicity Campaign Award Awarded to the advertising campaign judged to have recorded a demonstrable success in achieving its objectives. The winning campaign can be either internal or external and can combine media including press, radio, television and outdoor advertising. 2009 winner: Act F.A.S.T. Stroke Awareness Campaign.

Outstanding Achievement in Healthcare Awarded to an NHS organisation that has achieved success in its role and brought benefits to the wider NHS through the dedication and expertise of its staff. 2009 Winner: Guys & St. Thomas NHS Foundation Trust.

organisation that has developed a robust recruitment policy that delivers both safety and continuity to patients. 2009 winner: Heart of England NHS Foundation Trust.

Hospital Building Award Since 1997, the NHS has seen a huge investment in its fabric – the biggest hospital building programme in its history. This award will be made to the new hospital building project that raises the standard of the healthcare environment and demonstrates value for money and project management excellence. 2009 winner: Queen Alexandra Hospital, Portsmouth.

Hospital Catering Award This is presented to the NHS Trust that has strived to improve the standard of food and its nutritional value for the benefits of both patients and staff. 2009 winner: County

Durham and Darlington Foundation NHS Trust – Darlington Memorial Catering Department.

Hospital Cleaning Award Patients expect hospitals to be clean, and there is clear evidence of tremendous improvement in cleanliness and infection control standards.

This award acknowledges the efforts made

by NHS organisations in recent years to raise standards in cleanliness and reduce the risk of hospital acquired infections. 2009 winner: Barnsley Hospitals NHS Foundation Trust.

Hospital Procurement Award Recognising the NHS Trust that has delivered value for money and increased efficiency through smarter procurement practice.

The winning trust will demonstrate the success of partnerships and collaborations to achieve procurement excellence

Sustainable Hospital Award The environment in which people live and work, has a key influence on their health. This award recognises the NHS hospital that has made progress towards sustainability through the smarter use of energy, transport, waste management etc. in order to strive towards a reduced impact of healthcare facilities on the environment. 2009 winner: United Lincolnshire Hospitals NHS Trust.

Telehealth Award Telehealth can provide benefits to patients, healthcare providers, and to community projects.

This award will recognise the organisation that demonstrates the most innovative use of use of information and communication technology (ICT) to deliver health services, expertise and information over distance. 2009 Winner: Orchard Medical Centre/South Gloucestershire Primary Care Trust.

FOR MORE INFORMATION To enter visit www.hbawards.co.uk or call 020 85320055 for more information.

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FLEET MANAGEMENT

GREENING THE NHS FLEET The NHS should follow proven fleet management principles if it wants to introduce low emission vehicles into its huge and complex fleet and achieve sustainable change, says John Webb, council member of the Institute of Car Fleet Management WHILE IT WAS ASSUMED that public sector fleets would be at the forefront of the uptake of green vehicle procurement, meeting reduced emission targets, it is now clear that prudence with public sector fleet expenditure will be the main priority. This means professional fleet management is definitely the order of the day.

This article will be of interest to all stakeholders involved in vehicle operations within the NHS and also to those who formulate policy on the environment and health and safety.

RETURN ON INVESTMENT The importance of stakeholder buy-in to the business case for a greener fleet cannot be under-estimated. This is the reference point against which all fleet investment decisions must be made. Fleet is usually one of the highest costs for an organisation alongside salaries, estates and IT. Vehicles are costly assets that must support core complex NHS activities and objectives.

Consideration needs to be given to if the vehicle fleet supports operational targets and if company cars are perceived as a valued recruitment and retention tool. An overly restrictive car policy that reduces choice can also push company car drivers into a cash option which can prove to be more expensive, less safe and less environmentally friendly, as older, higher emitting cars are often chosen by employees.

In the public sector, the Office of Government Commerce (OGC) estimates that nearly 57 per cent of at work mileage is covered by employees in privately-owned vehicles. That equates to around 1.4 billion miles a year covered by vehicles that do not necessarily comply with current law or are fit for the purpose. And, in the public sector, the average age of a privatelyowned vehicle used on public sector business is 6.7 years old, compared to the average age of a company car of around two years.

Considerable savings can therefore be achieved through reduction of grey fleet numbers and usage alone. Since 2007/08, organisations engaged with OGC have reduced their grey fleet mileage by 22m miles generating over £8m of savings as well as lowered carbon emissions by over 5,300 tonnes. In the 2009/10 financial year, the OGC forecast is for grey fleet mileage to be reduced by 40m miles, generating over £15m of savings.

There is no one size fits all green solution for fleet operators within the NHS. Starting the process with a fixed view of the technology

In the public sector, the Office of Government Commerce (OGC) estimates that nearly 57 per cent of at work mileage is covered by employees in privatelyowned vehicles. That equates to around 1.4 billion miles a year covered by vehicles that do not necessarily comply with current law or are fit for the purpose to be chosen is often the source of problems further down the line. While a bold step change to introduce the latest low emission vehicles can offer the potential for a significant drop in emissions, this may be at the cost of driver dissatisfaction, reduced operational performance and increased costs. Therefore, the needs of the complex range of business stakeholders must be taken onboard if the end users are to buy in to the change.

The key to successful green fleet management within the NHS is to identify the needs of the organisation and ensure the fleet matches those needs efficiently and effectively. The best approach is therefore to adopt a technologically neutral approach that aims to provide the lowest CO2 emitting vehicle which is right for the job – fit for purpose. This means that a mix

of petrol, diesel, dual-fuel, hybrid and electric may exist successfully within the same fleet.

Selecting the right low CO2 emitting vehicles in this way will result in significant cost savings and will not require policy to be revisited every time new vehicle technologies arrive on the market.

Effective green fleet management should focus on the careful management of all the key elements of business travel and optimising these to minimise non-productive mileage, inefficient vehicles and inefficient driving practices.

VEHICLE EVALUATION In the NHS, the role of the fleet manager or fleet director is a well established function. The NHS operates a huge and complex range of vehicles that present considerable challenges to those responsible

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FLEET MANAGEMENT

Effective green fleet management should focus on the careful management of all the key elements of business travel and optimising these to minimise nonproductive mileage, inefficient vehicles and inefficient driving practices for managing them. Frontline activities depend on the availability, reliability and safety of a wide range of specialist vehicles including A&E ambulances, doctors’ cars and other complex fast response vehicles (FRV), together with converted vans and patient minibuses.

The larger fleets also may have the added complexity of managing HGV vehicles with all of the additional regulation that that entails.

Before purchase, it is good practice to set clear technical and qualitative evaluation criteria including cost and performance. Give the manufacturers and the vehicle conversion specialists’ feedback. They need this to develop the product – and hopefully enable them to make a sale next time round.

One area where innovative vehicle technology can provide challenges is the service, maintenance and repair infrastructure to support the new vehicles. So any decisions about new vehicle models must include adequate provision for keeping them on the road and reducing downtime.

Enlisting the support of drivers is also a critical element of selection and evaluation, particularly for job need vehicles. NHS vehicles often operate on a shift basis and multiple driver operating styles bring further management challenges including ensuring every driver is familiar with the correct procedure for adjusting the vehicle for their use. While on the road trials are an invaluable opportunity to put vehicles to the test they must be done by employees who understand the evaluation criteria and can make an objective assessment. It should also be remembered that badly driven green vehicles can be more polluting than well driven conventional ones.

A critical factor in successful green fleet management is securing drivers’ buy-in to the new vehicles. Even when given the most efficient and clean vehicle available in the market today, an employee who resents having the vehicle will manage to make it perform inefficiently.

Therefore, get the drivers’ early buy-in to environmental policy and the objectives will be much more achievable. Ensure that employees are made aware of any financial savings available to them – low CO2 emitting cars will reduce company car tax and private fuel costs.

Employees need to be shown the key features of vehicles to understand any special driving characteristics. For example, hybrids require a different driving style to optimise their dual-power systems.

wheels. ESC has been shown to reduce fatalities by 25 per cent.

Within the NHS fleet, special consideration has to be given to the impact of the fitment of specialist equipment on vehicle handling and the safe distribution of loads. The over-riding message is that safety must not be compromised for CO2 reduction.

COST COMPARISONS At a recent Institute of Car Fleet Management Conference workshop, the majority of members advised they managed fleet on the basis of Whole Life Costs (WLC). The total cost of ownership over the life of a vehicle is a proven, robust method of cost comparison that works on many levels as WLC modelling involves calculations on lease rate, blocked VAT, National Insurance Class 1, fuel and taxation based on a vehicle’s CO2 emissions. This will future proof policies and ensure that the effects of the tax changes are reflected in the formation of policy and therefore the choices which drivers make. WLC is also a proven method of influencing the vehicle choice of perk company car drivers where the imposition of a CO2 cap restricting choice below say 160g/km may go against rewards and benefits objectives.

The final element of the process is monitoring costs throughout the life of the vehicle and ensuring that the objectives of the original business case have been met.

In conclusion, following a structured planned approach to green fleet acquisition within the complex NHS fleet may require additional effort but the benefits will be enjoyed for many years to come.

FOR MORE INFORMATION Web: www.icfm.com

SAFETY FIRST Any successful vehicle selection policies must have safety at the core. Therefore any vehicle evaluation must include factors such as Euro NCAP (European New Car Assessment Programme) rating.

In terms of choosing safety, start by deciding on the size and kind of vehicle needed, then look for the best performers in that group.

Some buyers may be interested in a particular aspect of a car’s performance and, under the rating scheme, a car’s score is given for each part of the assessment, as well as the overall star rating.

Most fleet selection policies will include front and side airbags and, of course, seatbelts which are a legal requirement.

However, most manufacturers are developing innovative safety features which also need to be considered if available.

Anti-lock Braking System (ABS) helps maintain steering control under emergency braking. Electronic Brake Assist senses how firmly the brake pedal is depressed and keeps applying the brake to help the ABS work.

Electronic Stability Control (ESC) detects when a driver is about to lose control and automatically and selectively applies the brakes to individual

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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PARKING PROBLEMS? PEACE OF MIND PARKING SOLUTIONS & PRODUCTS Car Park Management ANPR Car Park Products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

Car Park Wardens Pay & Display Wheel clamping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

Parking Control Services can also provide the necessary resources to help fund such projects. Why not contact our commercial team at info@parkingcontolservices.co.uk or call us on 0800 970 5109. www.parkingcontrolservices.co.uk

Health Business | Volume 10.5

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PARKING

FAIR HOSPITAL PARKING FOR ALL To strike the right balance between being fair to patients, visitors and staff while ensuring that parking facilities are managed effectively, the BPA has published a hospital parking charter aimed at both NHS Trusts and car park operators HOSPITAL PARKING IS A TOPICAL debate in the parking industry and beyond.

It can often be judged by motorists as being an unscrupulous way to make money and an additional burden for visitors and patients, but this need not be the case. All decisions regarding parking enforcement and management at hospitals are the responsibility of hospital Trusts,

hospitals is operated solely to create revenue at the expense of those using the facility, and is often carried out by rogue operators – let’s look at it from a different angle.

PARKING ENFORCEMENT Parking enforcement is, in fact, a positive step for the healthcare sector. Without the correct management and maintenance, hospital

Due to the high profile debate on this subject there are misconceptions amongst the general public that parking enforcement at hospitals is operated solely to create revenue at the expense of those using the facility, and is often carried out by rogue operators – this need not be the case who manage their own parking facilities.

The British Parking Association (BPA) wishes to work closely with them, to ensure they pick the right solution for their facility.

Due to the high profile debate on this subject there are misconceptions amongst the general public that parking enforcement at

car parks can easily become unregulated park and rides, inconveniencing both staff and patients. Hospitals and Trusts need to strike a balance between ensuring spaces are available for the people that need them without inconveniencing people who use them.

Above all, enforcement revenue in hospital

parking facilities is not particularly profitable when administrative costs are considered.

Regulated parking can allow each facility to provide an adequate balance. All charges can be set by the hospital or Trust themselves – not by the procurators, therefore allowing the complete control and use of local knowledge to deliver a fair system, making enforcement a positive step for every user.

The majority of parking tariffs are subject to local pricing, availability and demand, along with additional facility overheads. The majority of healthcare facilities should be solidly supported by their parking operators, who provide concessionary tariffs for long-term visitors and also subsidise staff charges by using revenue from visitors parking at the facility.

There are many things to consider when developing appropriate parking enforcement for hospitals across the UK and we will provide the necessary help and guidance.

CHARTER FOR HOSPITAL PARKING To strike the right balance between being fair to patients during often difficult times and others including staff, while ensuring that facilities are managed effectively for the good of all, the BPA has published a hospital parking charter aimed at both NHS Trusts and car park operators.

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Land Rover S1

Urgentys

Pass Training Consultancy Ltd – Delivering Professional Training to the Private and Public Sector Industries Business Review is delighted to present Pass Training Consultancy Ltd with the highly accredited Company of the Month Award.The company has received this accolade due to its dedication to educating our society and providing high quality courses.

Pass Training Consultancy Ltd offers a variety of course packages such as: • Conflict Avoidance Training, • Welcome Host Customer Service Training, • Welcome Line Telephone Customers, • Welcome All Disability Awareness, • Customer Care Training, • Telephone Customer Service Training, • Notice Processing Training, • Civil Enforcement Officer Training, • Appraisal Training, • Fire Safety Training, • Manual Handling Training, • Supervisory Training, Health and Safety Training, • Vehicle Immobilisation Training, • Parking Shop Training

• Car Park Officer Training • Basic Deaf Awareness • Basic British Sign Language • First Aid at Work 3 Days (FAW) • 1 Day Emergency First Aid at Work (EFAW) • 1/2 Day AED Defibrillator & Emergency Oxygen • Care for Children (First Aid) courses • In Case of Emergency (‘ICE’)

Mark Cox from Pass Training Consultancy can now supply lone worker devices.

There are many things to consider when doing this and one of the most important is communication.

For lone workers it is important to ensure that they have the necessary means of communication to get assistance when they need it and to ensure that you can contact them throughout the shift as a means of welfare checks. Mobile communication devices such as the Urgentys, GEM-Shield and Land Rover S1 Phone are now available for less than the price of a mobile phone. They are lightweight, durable and designed to operate in all outdoor environments.

CALL US NOW ON

0843 2895581 info@passtraining.co.uk

Health Business | Volume 10.5

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PARKING

The BPA is dedicated to promoting and representing knowledge and standards in every type of parking facility, both on-street and offstreet, and to bringing together the interests of users, government, local authorities and commercial organisations, providing a forum for the exchange of information and ideas concerning parking The BPA believes in raising standards in the parking sector and delivering a more professional service to the public. 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 in terms of the wider transport strategy and the need to manage traffic and parking in accordance with demand and environmental needs. They also recognise the importance of professionalism in carrying out their services and the delivery of customer care. In particular, the delivery of safe car parking for hospital users is paramount.

We encourage all operators of hospital car

parks to sign up to the charter and to abide by its letter and spirit. A number of Trusts and car park operators have already signed the Charter and these will be published shortly on the BPA website (see below for details). The nine points of the Charter are outlined here: HOSPITAL PARKING CHARTER • NHS Hospitals and Trusts and their car parking contractors will strive to provide a high standard of management and customer service in their car parks.

• We aim to provide good lighting, high standards of maintenance for structures and surfaces, simple to use and understand payment systems and equipment, clear and

easy to understand signage and clearly marked parking bays. Operators should strive to ensure that car parks offer a safe environment for all users and aspire to the ParkMark® standard.

• Tariffs and tariff structures will be reasonable and will reflect 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 needs of all hospital users and should take account of the hospital’s environmental policy. Additionally, systems need to be in place to protect the legitimate use of hospital car parks. They should also take into account the impact on local residents should tariffs displace parking into local streets.

• Consideration should be given to best practice advice available from organisations such as the BPA, Parking Forum, NHS Confederation and the Department for Health. In particular, costs and any income associated with running car parks should be transparent and published.

• Patients who are eligible should be made aware of the Healthcare Travel Costs Scheme and encouraged to claim back their charges.

Concessionary parking should be given to patients with a long term illness or serious condition requiring regular and/or long term treatment (e.g. oncology, dialysis) along with those that need to visit patients regularly

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 10.5

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PARKING

BPA SPECIAL INTEREST GROUP The British Parking Association (BPA) is looking to engage further with those involved in parking at hospital sites and, to this end, is looking to set up a Special Interest Group focused on this particular area later this year.

The group will be complemented by the introduction of specialist member resources for those who manage healthcare parking facilities. The BPA already has a number of successful Special Interest Groups which enable members in specific sectors to meet regularly, concentrate on the key issues and take action to bring about change and develop best practice models.

We believe there is currently no other forum which specifically addresses the important issue of parking management for hospitals and we believe the BPA has the necessary breadth of knowledge to fill this gap and provide a wider view by engaging with other sectors within our existing membership.

(e.g. parents of babies/children held overnight), for whom public transport may be impractical and cumulative parking charges could become a burden. Trusts and operators should work together to ensure maximum publicity is given to such concessions and that they are taken up by eligible patients.

• Consideration should be given to the needs of disabled users for whom alternative means of transport may be impractical, ensuring that adequate provision is made and that if payment is required that payment systems are adapted to ensure ease of use.

• Methods of car park operations should

be designed to recognise the unavoidable, unplanned and unpredictable nature of visits to hospitals. Enforcement action should be designed not to penalise unpredictable contraventions, for example allowing users to pay overstay charges rather than fines. An Appeals procedure should always be in place.

Policies should address the needs of patients and visitors separately from those of staff, where different circumstances may apply.

• Any enforcement is to be proportionate with a focus on encouraging compliance.

Such enforcement activities should adhere to the Approved Operators Scheme Code of Practice. Operators should be members

of the Approved Operators Scheme in order to manage hospital car parks • This Charter should be read in conjunction with the Approved Operators Scheme Code of Practice, particularly in respect of signage, customer redress and levels of charges.

ABOUT THE BPA The British Parking Association (BPA), founded in 1968, is the largest independent professional association in Europe, representing around 650 member organisations in the parking and traffic management industry. Members range from technology manufacturers and car park operators to local authorities and NHS Trusts.

Zero cost parking managment schemes APITAL 2 COAST SECURITY was set up in October 2008.

Our aim is to offer a full range of individually tailored parking management schemes to various clients within the commercial, retail and private property management sector. A professional car parking management service, we are an Approved Operator for The British Parking Association to ensure we adhere to a strict code of conduct.

Our services range from vehicle immobilisation to the issuing of parking tickets for unauthorised vehicles to the total installation, management and

at the location required.

There is zero cost to our clients for our standard permit patrol service, which includes permits, generic company signage and regular patrols by our operatives.

C

FOR MORE INFORMATION

operating of pay and display car parks.

We can issue car parking permits for tenants, residents, staff and visitors as needed and also supply and erect any signage

For more information on our services or if you are having problems with unauthorised vehicles at your location and would like to discuss our parking management services please call matt at Capital 2 Coast on 0700 3400351 or e-mail info@capital2coast.co.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Health Business | Volume 10.5

www.healthbusinessuk.com

PARKING

The BPA is dedicated to promoting and representing knowledge and standards in every type of parking facility, both on-street and off-street, and to bringing together the interests of users, government, local authorities and commercial organisations, providing a forum for the exchange of information and ideas concerning parking.

One of the BPA’s primary aims is to encourage its members to raise standards so that they provide a better, fairer service to their clients and to all car park users.

Our members recognise the value of maintaining high standards and membership of the BPA enables them to achieve this.

Many of our members operate car parks accredited with the Safer Parking Scheme award – a Park Mark® – or are a member of our Approved Operator Scheme, having signed up to our Code of Practice.

BPA ANNUAL CONFERENCE The Association held its Annual Conference on 6 October in London. Keeping in line with current government thinking, this year’s conference aimed to examine how effective and efficient parking services may be delivered through collaboration and strategic local partnerships. The Master Class sessions –

including one specifically on hospital parking – gave practical tips to delegates on how to deliver more with less and give a better understanding of parking management across all sectors. In tough times it is crucial to pull together, share resources and exchange ideas, a theme that was echoed throughout the day.

HIGH PROFILE SPEAKERS The day was opened by Norman Baker, Parliamentary Under Secretary of State for Transport, followed by a keynote address from Councillor Daniel Moylan, Deputy Chairman of Transport for London and Deputy Leader and Cabinet Member for Planning Policy, at the Royal Borough of Kensington. He looked at parking as part of the wider transport strategy, and the impact can have on congestion, road safety and sustainable forms of transport as well as how it can stimulate economic activity, particularly in town centres.

Delegates also heard from expert speakers on how efficiency is the key to sustaining services. Collaborative procurement and sharing services were also explored, as well as ways to transform services in the back office and the front line to reduce running costs whilst improving services for customers.

After coffee and networking with colleagues

and suppliers from across the country, delegates split into four streams for the Master Class enabling us to focus in on different areas of interest. Delegates were able to choose from Public Sector Partnerships, Efficient Management and Procurement for Public Services, Parking & the Green Agenda, University Parking and Hospital Parking. Each Master Class allowed delegates to explore areas that may be new to them. Sessions were interactive, enabling delegates to ask the questions they want answered, based on case studies and experience.

FOR MORE INFORMATION To request a copy of the Charter in full and for further information on how to add your name to the list of signatories, please contact Dave Smith, communications & events coordinator.

Tel: 01444 447316 E-mail: dave.s@britishparking.co.uk To see a list of those who have signed up visit our website www.britishparking.co.uk

Security and parking enforcement services

Alligator teeth in hospital car parks

ARKING IS AN EMOTIVE ISSUE. Drivers demand fairness until they themselves flout the rules and get caught. Then fairness becomes unfair as it is not in their favour. Even though acting fairly, establishments and businesses still risk press frenzies unless we give special treatment that makes a mockery of any scheme in place.

We at 14 Services are dedicated to the adherence of site rules and to real equality. Caving in to pressure by the press gives succour to such methods, sets dangerous legal precendents and is appalingly unfair to those that are too private, too ill or too busy to use the publicity route to “get their own way”.

There is need for extra sensitivity in some car parks. We believe this

N INCREASING number of NHS hospitals car parks are installing Alligator Teeth Systems made

by Entry Parking Posts to enforce mandatory traffic direction control at car park exits and entrances.

Alligator Teeth, which are bolted into steel trough in the roadway, are lowered by vehicle tyres moving in the approved direction. This allows continuous movement of vehicles without the need for power supply and maintenance contracts associated with raising arm barriers.

Alligator Teeth are 115mm above road level but can be made at 100mm and also fitted with shock absorbers for faster speed of 25mph at entrances from the highway. The Trough and Drainage system allows for easy cleaning and greasing.

The surface fixed Alligator

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must be in line with fairness for all drivers and with consistency.

Parking control is necessary nowadays. 14 Services operates on private land and offers a free service to landowners/ managing agents 24 hours a day, 365 days a year. We issue Parking Charge Notices in accordance with site rules.

We also offer mobile patrols, dog training, key holding, security dog patrols, alarm response, lone worker support, staff searches and much more.

If you wish to discuss any of these services or anything else we look forward to hearing from you.

FOR MORE INFORMATION Tel: 01452 546984 E-mail: info@14services.com Web: www.14services.com

A

Ramp System is an alternative to the road level Alligator Teeth or Jaws and can be bolted to roads to save site work.

A new Alligator Teeth Silent Action unit will be available November 2010 from the Entry Parking Costs range. Job references are available on request.

FOR MORE INFORMATION Contact: Anthony Prosser Tel/Fax: 01564 773188 E-mail entryparkingpost@aol.com Web: www.alligatorteeth.net

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Visit the website to view the categorised product finder

Looking for a safe place to park?

Park at Camden Council car parks at Bloomsbury Square or Brunswick Centre.

Safe | Clean | Secure | CCTV | Staffed 24 hours a day.

Bloomsbury Square, WC1A 2RJ s s s s

contract parking rates from £3.04 per day for hospital staff (annual permit) business parking rates from £9.56 per day (annual permit) all day parking from £2.16 per hour (9-hour rate) discounts for hotel guests and theatre goers

Brunswick Centre, WC1N 1AE s contract parking from £2.60 per day for hospital staff (annual permit) s business parking for £2.76 per day (annual permit)

To find out more call 020 7405 7412 or go to camden.gov.uk/carparks

TPS – the number one for UK parking solutions ITH OVER

W 30 YEARS’ At TPS we understand the unique demands associated with each sector and provide clients with bespoke parking solutions

Established market leader as a professional car park management operator

Our customer focused approach has resulted in an outstanding level of growth

Key sectors include NHS, Local Authorities, Retail and Leisure facilities

TPS operates efficiently throughout the whole of the UK

Controlled limited stay periods Pay and Display Pay on Foot Pay on Entry/Exit Barrier Controlled Systems ANPR (Automatic Number Plate Recognition) CCTV and Security Personnel Park and Ride Marshalling and Special Events

Total Parking Solutions Ltd, SATRA Innovation Park, Rockingham Rd, Kettering, Northants NN16 9JH Telephone: 0845 257 3540 Fax: 0845 257 3541 info@totalparking.co.uk www.totalparking.co.uk

26

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

combined experience at Total Parking Solutions, managing is not simply about fulfilling a contract – it is constructed around a thorough understanding of our business and the goals of our clients.

Meeting those goals means harnessing some of the most advanced technical products and systems, experience, knowledge and resources that are available to us.

A major player in UK parking, TPS can offer our extensive knowledge and experience to provide an economically efficient operation and high quality service to its customers.

What distinguishes TPS is our genuine commitment to the continuous improvement of our services and the range of services being offered to our clients.

Our operations comply with the British Parking Association Code of Practice and quality

management structure focused around the BSI ISO 9001 standard. TPS team members understand the company’s quality policy and objectives to ensure consistency and competency.

Adopting this philosophy has enabled us to provide effective parking services to the NHS sector to a variety of applications, from Pay on Foot systems, Pay & Display, restricted and permit parking areas including enforcement control.

As a professional operator we understand the environment and are committed to strike a balance between efficiency and sensitivity. Our aim is not only to meet with, but to exceed customer expectations.

FOR MORE INFORMATION Office: 0845 2573540 DDI: 0845 2573542 Mobile: 0778 7165525 Fax: 0845 2573541 E-mail: tito@totalparking.co.uk Web: www.totalparking.co.uk

Visit the website to view the categorised product finder

An alternative solution to wheel clamping E ARE A LEADING

W national car park

management company, specialising in a revolutionary new concept pioneered over recent years as an alternative solution to wheel clamping, which is soon to be outlawed. The system we operate is based on the issuing of parking charge notices and is very diverse and flexible. It can be applied to any size car park from 1 bay to 10,000 bays, from permit schemes to total no parking enforcement.

This system has proved highly successful in achieving very quick results in solving parking issues.

We are members of the British Parking Association and are proud to be one of few who have achieved ‘Approved Operator Status’ that allows us to obtain DVLA keeper details.

Our customers range from large organisations such as

The one-stop-shop for all your parking needs LPHA PARKING is a specialist parking consultancy that offers the expertise required to help you manage your parking asset costeffectively and efficiently. Parking at NHS hospitals was recently criticised by consumer watchdog Which?, with their research citing problems with finding a space, the cost of parking and confusing payment systems.

The British Parking Association (BPA), backed by the NHS Confederation and the Healthcare Facilities Consortium, recently introduced a charter for hospital parking, designed to encourage NHS trusts to develop parking management systems that are fair to everyone.

At Alpha, we understand the pressures that hospitals are under when faced with the problems caused by various parking constraints such as space management. We have the expertise and experience necessary to help you manage these problems effectively and offer a one stop shop

A

Newcastle Airport and Wembley City Estates to national retail chains such as B&Q as well as medical centres, hotels, offices and residents associations. All have found that our solution has been successful in deterring and eradicating unlawful parking on their land in a non-confrontational, ethical and legal manner.

FOR MORE INFORMATION Tel: 08707 203807 Fax: 08707 203808 E-mail: info@parkingpatrol.co.uk Web: www.parkingpatrol.co.uk

New SnowEx trailed spreader for 2010/11 ROADWOOD INTERNATIONAL, UK distributor of the market-leading SnowEx spreader range, has announced the arrival of the new SnowEx Tow-Pro SP-7000 spreader. The Tow-Pro is mounted on an integrated trailer chassis and powered by its own 12v supply, meaning that any vehicle with a ball hitch can simply connect to the Tow-Pro, switch on the spreader’s onboard power system and get spreading.

“Previously the only non vehicle-specific salt spreader has been a ground-wheel-driven spreader,” says Roy Wolfenden at Broadwood. “With the new TowPro end-users can use multiple vehicles with one spreader, and as with all trailed SnowEx spreaders the new SP7000 overcomes the traditional issue of skidding – where in cold weather the ground is too slippery for the wheels to grip and subsequently drive to the spreader is lost.”

As the Tow-Pro is based on the well-known Vee-Pro spreader range all usual SnowEx features

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service in this specialist area.

We have recently assisted a Healthcare Foundation Trust in the south west of England where we conducted a three phase project to survey the car park utilisation and make recommendations for feasible solutions to their car parking problem.

Contact us now for advice and support in space maximisation, traffic counts and occupancy surveys, user management, signage, payment solutions and pricing strategies.

FOR MORE INFORMATION Tel: 020 72422567 Fax: 020 72421366 E-mail: parkingenquiries@ aparking.co.uk Web: www.aparking.co.uk

Cost neutral parking solutions for hospitals NFORCING PARKING regulations at hospitals can be a sensitive issue. To strike the right balance demands professionalism and expertise.

At UK Parking Control (UKPC) our uniformed wardens are trained in conflict management and conduct themselves with tact and diplomacy whilst maintaining and protecting the client’s image, brand and reputation.

We know how important it is to keep access ways clear for ambulances, make sure disabled bays are only occupied by genuine badge holders and that parking areas fulfil health and safety requirements.

Operating Nationwide, we are one of the most experienced and reputable companies within the parking management sector. We are already in partnership with NHS clients including Nuffield Orthopaedic Hospital, Barts, The

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such as patented v-baffles, lowmaintenance 12v motor, vibrator agitator, feed auger and adjustable spinner are incorporated as standard, meaning that the TowPro is able to handle virtually any grade of salt with ease, without risk of jamming or overspreading.

Designed for use in off-road applications the Tow-Pro is set to be a huge hit with transport and distribution yards, airports, large farms, private estates and car park maintenance contractors.

FOR MORE INFORMATION Tel: 01420 478111 Fax: 01420 483000 E-mail: info@broadwodintl.co.uk Web: www.broadwoodintl.co.uk

Royal London and The London Chest Hospital along with major retailers, local authorities, educational establishments and commercial premises.

We provide a comprehensive range of services which, in most cases, are cost neutral and we operate to the highest industry standards and are approved by the British Parking Association, DVLA and the Police.

FOR MORE INFORMATION For more information about our intelligent and commercially driven services and solutions please call Marc Browne on 0844 800 8710 or visit our website at www.ukparkingcontrol.com

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Visit the website to view the categorised product finder

Parking and forecourt management solutions tailored to your individual requirements

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CS IS A LEADING supplier of Transport Revenue Systems worldwide. The transport revenue division is a core business serving customers and end users in parking systems, ticketing and transport toll management. Affiliated Computer Services (ACS) is now a Xerox Company with over 130,000 employees, supporting client business critical operations in 160 countries.

ACS provides unmatched business process and document management solutions worldwide to world-class commercial and government clients.

In February 2010 Xerox acquired ACS and we now offer a deeper and broader set of products and services all over the world.

ACS has more than 35 years of experience in comprehensive parking solutions, with some 1,000 sites equipped all over the world. ACS holds a world leader position for large airport car park systems from Sydney to New York. The North America industry leader for major airport parking solutions, ACS has installations at over 40 per cent of the North Americaâ&#x20AC;&#x2122;s busiest airports.

The best off-street parking solutions are seamless and convenient for both the individual and the entity managing the

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

operations. Our customers need robust and reliable products, competent project management, as well as comprehensive service and support. For over 35 years the ACS staff of professionals has delivered just that to the worldâ&#x20AC;&#x2122;s busiest car parks.

The car park is the first and last experience the customer will have in any retail or hospital environment. Knowing this, ACS has designed the new Light & Reflex range of equipment to not only look good but be easy for customers to use, easy to install and have the flexibility

to meet the demands of a modern 21st century parking operation.

Each application is designed to meet the unique requirements of that particular location. Reliable, comprehensive parking solutions can start as early as the highway with Parking Guidance Systems/ Variable Message Signs directing customers to open facilities.

With a multitude of access and payment options, the entry and exit process is quick and efficient.

Revenue shrinkage is averted with auditing tools such as automatic License Plate Recognition (LPR). Reporting and facility management is easy and accurate with robust and comprehensive back office management solutions. ACS has a proven track record of implementing and supporting thousands of off-street parking installations, offering value and flexibility to customers around the world.

FOR MORE INFORMATION Tel: +44 (0)1276 807100 Fax: +44 (0)1276 807101 E-mail: paul.gillespie@acs-inc.com Web: www.acs-gts.com

Visit the website to view the categorised product finder

Modular parking solutions for hospitals NOTHER LEVEL CAR PARKS provides a rapid assembly demountable modular deck car parking system, for hire or sale.

The fully galvanised steel decks simply span existing car parks without central supports.

Normally there is no need for foundations, making this system incredibly quick to install with minimal inconvenience caused to the client. A typical 100 space car park can be installed in under three days.

The car park can be temporary or permanent and is 100 per cent reusable. Once removed there will be no evidence that such a structure has been in place.

The system is engineered and manufactured completely by Another Level Car Parks in the UK, making the structures adaptable to many different applications from car parking to cabin storage to mezzanine flooring.

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Control and create a revenue from your car parking spaces T CPM SOLUTIONS, we offer a car park management service in order to regain control of your car parks and to stop unauthorised parking by visitors whom are not using your premises.

We work flexible to suit our clients and their needs, and we manage car parks for various industries.

• Customer parking, this method we can put a maximum time limit on your car park for example, Parking limits of 1 hour/2 hours, no return within 24 hours, etc, and we cater for your needs and will provide a level of service that you require.

• Staff parking, permits are issued to all persons authorised to park.

• Pay for parking service, where your spaces are rented out in the car park for a daily/weekly charge.

CPM Solutions will patrol the

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The picture shown is of Warrington Hospital. The two completely separate car parks give a combined amount of approximately 156 spaces on the upper level.

The car parks were completed over two long weekends causing minimal disruption to the normal day to day running of the hospital. This in turn greatly reduced the shortage of car park spaces for the public and staff.

FOR MORE INFORMATION Tel: 0845 3453835 Fax: 0845 3453836 Web: www.another levelcarparks.co.uk

Innovative parking management solutions ORTHERN PARKING SERVICES tailor make your parking management needs.

As a professional parking management provider, we offer our services to both the public and private sector throughout the UK. These are only a few of the services and benefits that we can provide your parking facilities: • Self-enforcement services, using the latest mobile device and communication technology • Full administration and processing of parking charges including free enforcement • Parking control officers who have been trained in accordance to the latest legislation • Signage that fulfil all legal requirements • We compliment your existing systems, all ready in place at your facilities • Our unique systems put you in control • Eliminate unauthorised parking on all roads and car parks • Protects the parking for

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those with special needs.

• Minimise the incidences of accidents involving traffic and pedestrians • We comply with the British Parking Association Code of Practice and are BPA accredited Approved Operators Through our robust structures, systems and processes we can improve and make your parking environment more efficient, for staff, visitors, deliveries and emergency services.

car park for free to ensure that only authorised Vehicles Park on your car park.

We will provide all the signs, a free warden patrol of your car parks as and when required. We also deal with all the clients and administration in relation to your car parks.

We have been trading successfully in car park management for six years.

FOR MORE INFORMATION Tel: 0870 6092453 Fax: 0870 6092453 E-mail: admin@carpark management.uk.com Web: www.carpark management.uk.com

Make parking solutions simpler with Gemini T GPS WE BELIEVE in making life simpler. Parking your car at the local supermarket, hospital or at home should be stress free. However, we know illegal parking can cause unnecessary aggravation and that’s where our unique parking control systems can help.

We believe that parking enforcement is a positive step for the healthcare sector. Without the correct management, hospital car parks could become freefor-all spaces, inconveniencing staff, visitors and patients. At GPS, we pride ourselves on our tailor-made parking control systems that can significantly benefit the health sector.

Each system is set up to fulfill your unique requirements, aims to eliminate illegal parking while

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striving to appease visitors who may view parking enforcement in the health sector negatively.

With a large client base that spans both the private and commercial sectors throughout the UK, our parking enforcement methods vary and are well practiced.

With years of experience we are constantly accredited for our professionalism and effectiveness in dealing with the public and in turn eradicating illegal parking.

Our team of excellent staff and our commitment to providing a friendly service see us stand out from existing companies.

FOR MORE INFORMATION To discuss how our unique parking solutions could benefit you please call us on 0871 2002143.

FOR MORE INFORMATION Get a free consultation, request our professional services or for more information call us on 0870 8921 170 E-mail: sales@ northernparkingservices.co.uk Web: northernparkingservices.co.uk

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DESIGN & BUILD

MODULAR CONSTRUCTION MEETS HEALTH SECTOR NEEDS Less disruption, faster, cleaner – modular construction has many benefits that are not associated with traditional building techniques, writes Jackie Maginnis, chief executive of the Modular & Portable Building Association I’M DELIGHTED TO SEE THAT THE modular building industry continues to fulfil the requirements to supply hospitals, medical centres and many other facilities in the health sector.

FLEXIBILITY When I started in the industry back in 1985, I was asked what you can use these types of buildings for. In my ignorance and to hide the fact I didn’t have any ideas about the product, I responded: “You let us know what you want built and we will build it.”

Turns out I was right; modular building manufacturers – an industry in excess of billions of pounds – has given opportunities to build anything that clients want. With the methods of construction that are used in

the factories today, the industry will, where possible, build to the customers’ requirements.

With the flexibility of size and layouts and with the ever-demanding requirements for sustainability, green issues and waste reduction, modular buildings have proven themselves time and time again.

State of the art hospitals have recently been built to meet the requirements for sustainability, embodied energy, carbon emissions, and reduction of waste. If you are looking to meet these criteria then off site construction in the form of modular or portable buildings is the answer.

This is an industry that continues to make every effort to convince clients that today’s modular buildings are every bit as good as their traditional counterparts, but have the

advantage of speed and lower cost. Many suppliers have designed complete buildings, and also extensions to buildings that are added to traditional constructed facilities.

Once again we are about to be subjected to new building regulations. Whilst there is always concern with changes, as an industry we believe that with the skills and knowledge that we have developed over the years this should not prove such a great hindrance or issue against traditional construction methods. Over the years manufacturers have had to consider the future when designing buildings, and with the correct maintenance, buildings can last for many years.

AN ACCEPTED ALTERNATIVE To an industry that has been about for some 70 years, we now feel that at last there is a

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We’ve applied the world’s most advanced thinking in fibre cement to cladding

Vivid colours, subtle shades, tempting textures…

As world leaders in fibre cement technology, our rainscreen cladding range combines spectacular good looks with solid, practical virtues such as strength, lightness, durability, workability, easy installation and outstanding fire performance.

The latest addition to the range, Natura Pro, has a UV cured top layer to help protect against many types of staining so aerosols and other paints can be easily removed with common graffiti cleaners.

If, like us, you believe rainscreen cladding should look fabulous and be entirely maintenance-free, send for your copy of Pure Cladding now.

T 01283 722588 E cladding@marleyeternit.co.uk

www.marleyeternit.co.uk

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DESIGN & BUILD

Many of the hospital buildings that have been made available in recent years to overcome the growing need for increased facilities would not have been possible without the modular industry realisation that modular buildings are an accepted alternative to traditional buildings.

We do, however, suffer from frustration at the lack of knowledge with purchasing/ procurement departments that are under the impression that the only way large complex buildings can be ordered, delivered and installed is through tendering or main contractor route. This is no longer the case.

Many of the hospital buildings that have been made available in recent years to overcome the growing need for increased facilities would not have been possible without the modular industry. Manufacturing processes have moved with the times ensuring

that all the correct boxes are ticked.

Progress over the years has been considerable with modular buildings of all types of design and uses now being manufactured and installed. Hotels, hospitals, schools, offices and even prisons are just a few applications â&#x20AC;&#x201C; this industry has come a long way since the original concept. Traditional buildings are no longer the only option available.

As with all products it is a timely reminder however that lack of maintenance means shorter life span. This applies to modular as well as traditional buildings; they are not maintenance free.

MODULAR PRODUCTS Terminology tends to proliferate in any industry and portable buildings is no exception with their multiplicity of designs and uses. For example, buildings can be described as portable, modular, linked, panel, system or volumetric â&#x20AC;&#x201C; take your pick.

Portable buildings can best be defined as those made wholly in a factory and then transported for the installation on prepared foundations. Most but by no means all portable buildings can be removed and relocated to a new site without little or no waste.

The main advantage of this type of building is speed of construction, for example the groundwork can take place at the same time as the building takes shape in the factory. Site assembly quickly produces a weatherproof shell, so progress is rarely delayed by bad weather. Speed of construction also leads to considerable cost savings when compared to conventional building methods.

Modular buildings tend to be larger and more permanent. These are produced in

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Phoenix Building Systems Ltd are a family run nation wide supplier of high quality portable buildings, together we have many years experience working in the modular building industry. Incorporating offsite modular building techniques into your projects offers huge benefits to clients and contractors alike. We will help shape your ideas to ensure that you take full advantage of what offsite modular construction can offer.

Maximise the potential benefits that are available by speaking to the modular building experts.

Our bespoke designed prefabricated buildings take full advantage of modern modular building techniques. If providing flexibility in design and specification, reducing the construction programme, improving the cost certainty and deliverability is important to you - then talk to us first.

Modular Buildings for Office & Welfare Accommodation The Phoenix range of single, two and three storey modular buildings and prefabricated buildings are the ideal solution to meet the growing demand for modern and high quality office and welfare facilities for any construction project.

The Phoenix Range of Prefabricated Buildings can be easily moved from one contract to the next. The internal layout of the modular building can be reconfigured to meet the requirements of the next new project.

The Phoenix Spaceframe and Triple Stack Systems have been designed to meet all of these requirements. Any size and type of facility can be designed and manufactured to meet your specifications.

Both modular systems provide the facility for individual offices and open plan areas. The areas can be fitted out as conventional offices, training centres, toilet/staff amenity areas, changing rooms and catering facilities to all levels.

In addition, they provide an excellent long term investment for contractors and plant hire companies alike. Buildings are delivered to site with all internal finishes and services already fitted. The buildings are installed onto prepared foundations ready for connection to mains services, handover and occupation.

Portable Units / Jackleg Cabins The Phoenix extensive range of portable units are the answer to any instant prefabricated accommodation needs. Designed to a very high specification to meet the requirements of any public or private sector industry, Jackleg / Portable Cabin units are available in sizes from 9ft x 9ftâ&#x20AC;&#x2122; all the way to 60ft x 12ft and delivered throughout the U.K. Contact Us - Phoenix Building Systems Unit 6, Brookbanks Industrial Estate - Tower House Lane Hedon Road, Hull - HU12 8EE Tel Number: 01482 317260 Fax Number: 01482 899252 Web: www.phoenixbuildingsystems.com Email: Michael@phoenixbuildingsystems.com

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DESIGN & BUILD

modular or slices, bolted together on site in a variety of configurations to produce the clientâ&#x20AC;&#x2122;s required accommodation.

System buildings are yet more permanent because they comprise a steel or timber frame, erected on site to which are fixed cladding panels produced by a number of different systems or designs.

Finally, volumetric units are defined as factory built modules to site in madeup form. These are typically residential designs, increasingly sophisticated hotel rooms or toilet and bathroom pods for installation in other permanent buildings.

CHANGING PERSPECTIVES It is probably fair to say that historically, prefabricated buildings have received more than their fair share of criticism; considered by many to be a poor substitute to the real thing. But the fact that thousands of temporary buildings continue to perform their function is a tribute to a largely unsung industry.

It is a well-known fact in our industry sector, yet not well publicised elsewhere, that the use

of pre-owned modular buildings is the most environmental friendly method of construction.

It is also a highly sustainable alternative to new buildings and to the demolition and disposal of buildings in landfill sites. They generate less than ten per cent of the carbon emissions and use less than three per cent of the energy during construction compared to a newly manufactured building of the equivalent size.

Fast track solutions have become increasingly more in demand over the years and so has the need to reduce waste. With buildings manufactured in a controlled factory the industry has the opportunity to take control of these aspects and prove good results.

Modern buildings can be stylish, secure,

economical to heat and maintain, and above all, flexible in their use. Designs can include pitched roof, brick, stone or other decorative finishes as most new building requirements need to be compatible to other buildings in the same location.

EXPERTISE Manufacturers and companies that are specialist suppliers to this industry know more about the specification required to suit a specific building than the clients themselves, for example hospitals, clinics, medical centres, and surgeries.

Suppliers to the industry manufacturers and associate members of the MPBA are all aware of the materials required to meet the

It is a well-known fact in our industry sector, yet not well publicised elsewhere, that the use of pre-owned modular buildings is the most environmental friendly method of construction

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DESIGN & BUILD

demanding specification set by EU legislation.

Many companies now have either a dedicated construction division to deal with groundwork and installation or alternatively work alongside bespoke companies who undertake this and the mechanical service elements.

are sold cost more than necessary when clients do not purchase direct from manufacturers.

Logic tells us that there will always be add on costs, such as management fees or other costs incurred due to payment periods imposed by contractors. This can all be avoided by

Fast track solutions have become increasingly more in demand over the years and so has the need to reduce waste. With buildings manufactured in a controlled factory the industry has the opportunity to take control of these aspects and prove good results Modular businesses and associates have been undertaking this type of work for many years, which again eliminates the need to involve construction companies. But how many people realise that when using a main contractor this inflates the cost of buildings?

End users should take time out to look at the alternatives within our specialist industry and talk to the companies that are dealing with this type of buildings on a daily basis.

We know from experience that buildings that

direct purchasing, which may be worth some thought. The words from the industry is “Come direct, save time and money”.

ASSOCIATION ASSISTANCE If in doubt the Modular & Portable Buildings Association is the independent body funded by its members and only a phone call away. We have personnel with years of experience who are on hand to advise or answer questions.

If we are not sure of the answer we will

always know someone who can tell us.

As the recognised trade association our clients can feel confident that all standards and requirements are met. The association helps members to ensure that health and safety, and technical issues won’t be a problem. Our technical committee works with government to achieve technical requirements and considers the financial aspects that effect us all.

CASE STUDY Hayes Cottage Hospital in Middlesex is a name that conjures up the happier days of the health service. It had been a hospital for local people, staffed by local people since 1875. When the NHS decided to close the facility there was such uproar from the community that the NHS agreed that any future development of the site would be for local healthcare purposes only.

Enter John Fordham and his family who bought the hospital and had it converted it into a delightful 50-bed nursing home. That could have been the end of the story except that there was still one redundant building on the site that was prime for re-development. John was contacted by Hammersmith Hospital’s Renal Department, which is responsible for all renal dialysis in West London. Would he be interested

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Need more space?

In this period of post-recession austerity there is a growing need for cost effective working spaces.

If your building programme is as tight on space as it is on budget, GML has the answer. As specialists in bespoke modular buildings, we can provide flexible, high quality spaces for wards, treatment rooms, offices, kitchens and many more applications.

A bespoke modular building from GML: Q takes half the time of conventional build projects to erect, and creates minimal disruption as much of the building is fabricated off-site Q offers considerable cost-savings over traditional build structures Q is environmentally friendly with high sustainability Q comes with flexible options for rental as well as purchase Q includes a free solar panel system, giving 25 years of free electricity*

7KLV FRXOG EH \RXU QHZ PHGLFDO IDFLOLW\

Functional and attractive

Modular buildings do not need be ugly boxes.

GML is a specialists in creating modular buildings with unusual shapes, combining a choice of low maintenance external claddings â&#x20AC;&#x201C; such as timber, brick, steel, plastic or stone â&#x20AC;&#x201C; with the same high quality internal finishes that would normally be associated with a traditional building.

gmlconstruction.co.uk Orchard House, Westerhill Road, Coxheath, Maidstone, Kent ME17 4DH T - 01622 742 700 E - info@gmlconstruction.co.uk At least 60,000 more primary school places are urgently needed to prevent an admissions crisis according to an official report (Sunday Telegraph 8th August). With 20 years experience GML has the expertise in a wide range of sectors including education, health, sports & leisure and commerce, handling everything from construction to any ground and enabling works required. *conditions apply

Health Business | Volume 10.5

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DESIGN & BUILD

in building a renal dialysis unit on the site? If so, the NHS would rent the unit and provide all the medical staff. They wanted to work together to design a unit based on the latest specifications for a Renal Dialysis Satellite Unit.

After visiting two dialysis units that had been designed and built elsewhere by modular building specialists, John and the Hammersmith team were convinced they had met the right people to design and build their unit. Externally, it had to comply with the requirements of the local council’s conservation department.

Internally, the design had to meet the NHS’s strict guidelines specified in the latest Hospital Building Notes as well as John’s vision of a user-friendly open-plan design that the patients, who have three dialysis sessions a week, would appreciate. At the Hayes site everyone had tried to keep the cottage hospital culture, but with the very latest equipment and facilities.

The chosen manufacturing modular buildings company had the winning fomula to proceed with the building. For their clients there was just one point of contact, the company handled everything from feasibility studies, design and

planning approvals right through to delivery and on-site finishing. The 37 factory built modules that comprise the two-storey, 829 square metres, 24-station dialysis unit were delivered and craned into position over four days. Fitting out took just eight weeks. John considered the end result to be: “Brilliant; the internal finish was vitally important in this environment and the suppliers achieved a look that is aesthetically pleasing, efficient in use and easy to keep medically clean.”

HIGH QUALITY Modular factory assembled units guarantee a consistently high standard of finish. These results in reduced construction time and fewer

skilled craftsmen required on-site as a great deal of the work is completed at the factory.

Most of the plumbing, electrics, heating and wall finishes are factory fitted. The benefits of this were obvious; the building site is less dependent on good weather conditions and is not affected by skill shortages that may dog the construction industry. Modular construction is faster and cleaner on-site than traditional building techniques and causes less disruption to a client’s on-going business; in this case the nursing home and clinic that share the same site.

The healthcare and education sectors still continue to be the most pro-active in accepting modular construction due to the tight time

With the flexibility of size and layouts and with the ever-demanding requirements for sustainability, green issues and waste reduction, modular buildings have proven themselves time and time again

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Dramatically reduced waiting times for healthcare facilities

PremierPlus is a quality, steel framed, permanent building which offers a clean, modern and comfortable healthcare environment in half the usual time compared to traditional build, and at a highly competitive price - using modern methods of construction.

Construction off-site significantly reduces disruption and traffic to site thereby minimising disturbance to staff, patients and visitors.

The building offers excellent acoustic performance and exceeds building regulations.

We can also work with clients to achieve BREEAM excellent ratings.

A concrete floor option is now available which is ideal for use in hospital theatres as it can increase the acoustic qualities and reduce vibration even more.

It’s now clear to see why these modern methods of construction are fast becoming the preferred solution for hospitals and healthcare buildings.

For more details on the remarkable PremierPlus Building System, contact Premier Interlink ( Waco UK Ltd ) Tel: 0800 316 0888 Email: sales@waco.co.uk

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A well established business founded in 1885, specialising in Design & Build projects. With full Mechanical, Electrical and Plumbing Installations. Haydon M&E work in a wide range of market sectors • Education (Schools & Colleges); Local Authorities; • Health Authorities • Main Contractors and Developers; Housing Associations; • MOD Commercial Property Users & Design and Build Projects We can offer: • A comprehensive, competitive, quality service • (ISO 9001: 2008 / 14001; Achilles Accreditation Audit Level 5) • Comprehensive Cost Plans for M&E installations • Full design, Build and technical support for all M&E installations • Response and planned preventative maintenance services • Quality plans • Full operating and maintenance manuals • Fault finding services.

Tel: 0207 537 8552 E-mail: Simon.Walsh@haydonme.co.uk

“We honour our obligations”

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DESIGN & BUILD

and budget constraints that generally feature in their build programmes. Specialist features such as infection control finishes, piped medical gases and bespoke medical equipment required in healthcare buildings are installed on site.

ALDER HEY CHILDREN’S HOSPITAL One of Europe’s biggest and busiest paediatric hospitals, Alder Hey Children’s Hospital in Liverpool, chose recycled and refurbished modular buildings for three

approach allowed this scheme to be sited on a steel gantry above a traditionally built administration block, so the Trust could expand the office accommodation despite the constraints of this busy hospital site.

The second building provides a new main entrance for the hospital’s busiest outpatients department, public facilities, a clinical area, and administrative offices for both the orthopaedics department and the medical division. This created additional space for

The quality is as good as new manufacture, both internally and externally – but the recycling and refurbishment of building modules is far more costeffective and sustainable – John Williams, capital projects manager at Alder Hey Children’s NHS Foundation Trust new facilities. The three contracts totalling more than £1.5m were all completed on time and on budget by a MPBA member.

Working closely with the main contractor, the supplier firstly provided an office building for the hospital’s surgical division. The modular

consultations in the decanted areas.

In just four months from receipt of order, a two-storey facility for the project team managing the £175m redevelopment of the hospital, was also completed.

Commenting on the three projects, John

Safety equipment from Cable Safe Limited ORKING AT HEIGHT

W is never a safe access and egress problem, it is always a safe access, egress and rescue problem.

For this reason Cable Safe Limited, with help from universities and end users, developed all its systems to include inbuilt rescue capability, without the need for putting rescue personnel at risk. This allows rescue in seconds to minutes thus greatly reducing the possibility of suspension stress trauma.

The systems are designed in order to make operatives constantly safe whilst working at height. The operative connects their harness to an inertia reel which travels above the operative along the length of the working platform or roof.

Should an operative fall the inertia reel locks quickly, minimising the fall distance.

The inbuilt rescue equipment is used at ground level or safe area to lower a fallen operative quickly. It can also be used on fixed and portable ladders, machines, inside and outside work shops and loading bays.

Cable Safe Limited is proactive with companies in making its systems as user friendly and practicable as possible. Height awareness and harness training available.

FOR MORE INFORMATION Tel: 01302 726264 E-mail: sales@cablesafe.co.uk Web: www.cablesafe.co.uk

Williams, capital projects manager at Alder Hey Children’s NHS Foundation Trust, said: “This approach achieves the balance between quality and value. The quality is as good as new manufacture, both internally and externally – but the recycling and refurbishment of building modules is far more cost-effective and sustainable given the strategic direction of the Trust.”

The buildings could be in use for up to ten years until the new state-of-the-art Alder Hey Children’s Health Park is completed.

The use of pre-owned modular buildings continues to increase as more clients and contractors recognise the cost, speed, sustainability and quality benefits of this innovative accommodation solution.

Once a modular building has been identified for use, it is reconfigured and completely refurbished to individual project requirements.

The building is then delivered to site where it is craned into position in just a few days, ready for final fitting out, testing and commissioning.

This can reduce programme times by up to 70 per cent for earlier occupation, and because work off site is maximised, the approach is ideal for constrained sites or where disruption would be an issue during construction.

Modular building solutions from Adroit N THE CURRENT economical climate we all have to look closely on how to provide services for our clients.

Health funding is uncertain and therefore the health sector needs to be flexible in how they provide buildings that meet their needs. Changing needs means that the facilities required by the health sector can vary year by year making flexible modular buildings ideal to meet these changing needs.

Adroit Modular Buildings has been providing buildings both for sale and hire to the health sector for 50 years. During this period we have supplied a range of

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buildings from temporary single room units to a permanent full operating plastic surgery building.

At Adroit Modular Buildings we pride ourselves on listening to our clients’ needs in order that their aims are achieved; all our buildings therefore are built bespoke to meet the exact needs of our clients. If you have building requirements for either a permanent or temporary solution, please call us in order that we can arrange a consultation to discuss how we can best meet your aspirations.

FOR MORE INFORMATION Tel: 0800 115544 Web: www.adroitmodular.co.uk

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Visit the website to view the categorised product finder

4m can offer flooring solutions for your needs.

Our service includes: Flowable pumped screeds to corridors Smooth self-levelling epoxy resin to plant rooms Hygienic/decorative floor and wall finishes to mortuaries Anti-static systems Decorative epoxy flooring For more information, case studies and photographs, visit www.4m-flooring.co.uk 4m Flooring uk Ltd, Unit 9, Decade Close, High Carr Business Park, Newcastle-under-Lyme, Staffordshire, ST5 7UG Tel: 01782 576650 Fax: 01782 576651

Flexible Modular Solutions Working with Admorspace, Speedy can provide the perfect hygienic and efficient working environment; suitable for both temporary and permanent sites. The system exceeds all building regulations, can be configured to suit your exact requirements and can be changed over time as needed.

Interiors are also fully flexible and can be supplied with cabelling, internet access and landlines.

Call Speedy on

0845 601 5129 or visit speedyhire.com

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Sustainable modular buildings from waste diverted from landfill FFRESOL LTD has developed a range of truly sustainable, low carbon, prefabricated modular buildings that are both flexible and affordable, and offer health organisations excellent comfort standards, within high quality, modern accommodation.

This modular accommodation is secured by design, sustainable, and environmentally friendly. Each unit is designed using ‘Passive House’ principles around a steel frame. The frame is clad with a TPR™ (Thermo Polymerized Rock) walling system which returns a ‘U’ Value of 0.2.

The TPR™ can be the external finish or it can be additionally clad with a timber, brick, or stone effect, or render finish so as to blend into your existing environment.

TPR™ is a “thermo set polymer” produced from a cold process that takes recycled mixed plastic waste products and waste minerals that have been diverted from

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landfill. These waste materials are processed to produce a mouldable compound which when cured, is waterproof, thermally efficient, fire retardant, and is as strong yet lighter than concrete.

Every modular building is manufactured to your specification, to a set of strict quality controls within the Affresol ISO9001 quality controlled factory premises.

FOR MORE INFORMATION Contact: Scott Phillips Tel: 01792 581197 Mobile: 07837 325716 Web: www.affresolmodular buildings.co.uk

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DESIGN & BUILD

ABOUT THE MPBA The MPBA is an association for the promotion of the modular and portable building industry working on behalf of its Members and Associate Members. Its members consist of companies directly involved within the modular and portable building industry and the Associate Members are companies involved in the supply of products and services to the industry.

Since 1938 dedicated businessmen have associated together to improve their industry, its products and the service they provide to their clients. The MPBA is an association for the promotion and marketing of its Members and Associate Members products and services and has definitive aims, objectives and codes of conduct. Its Members are able to supply for either purchase or hire • New manufactured modular and portable buildings • Quality pre-owned modular and portable buildings Associate Members are companies with strong business contacts within the industry that are able to supply materials, components and services to Members.

Today in a market worth billions of pounds, the Modular and Portable Building Association

has members who specialise in all types of building applications. Many of its members offer a variety of finance packages including hire, purchase and lease purchase. The Association’s members are spread throughout the British Isles and there are also overseas associate members from other continents as well as the EU. The Association holds bi-monthly meetings at various locations around the country and occasionally at member’s premises. On occasions, it has a guest speaker to give a presentation about a subject or matter that is important to the Association. You can apply to become a member of the MPBA to start receiving the benefits that the Association offers.

In addition to the Council for the Association the MPBA has three main committees: • Marketing and Membership – Deals with membership and promotion of the Association • Technical – Deals with building regulations, construction, manufacturing and technical issues • Health and Safety – Deals with all aspects of Health and Safety associated with the industry The Association is represented on the British Standards Committee, which deals with modular and portable buildings of all types.

The MPBA has published several Codes of Practice, some of which have subsequently been incorporated into the British Standards.

It is also consulted by various government advisory committees on changes to legislation, such as the recent updating to the building regulations. This role has proved to be of particular importance as statutory bodies are unable to consult with individual companies and can only take advice from industry associations.

Case Studies provided by the Wernick Group and Foremans.

FOR MORE INFORMATION Tel: 0870 2417687 E-mail: mpba@mpba.biz Web: www.mpba.biz

ELESGO® – tough surfaces High quality cleaning for tough applications for a safer environment N RECENT YEARS hospitals have had to apply increasingly stringent cleaning and sanitisation procedures. One important aspect of keeping surfaces clean is the surface itself.

Surfaces that are porous or prone to scratching will harbour bacteria. Surfaces also need to have good chemical resistance to cope with the wide range of sanitizers/bleach that are applied.

DTS-Systemoberflächen GmbH (www.laminate.de) has developed the ELESGO® range of products which offer excellent physical and chemical resistance – without the use of formaldehyde based chemicals or VOCs. It is possible to formulate these materials in different ways so that they can be used to produce a range of different applications.

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This means you can use ELESGO® – the best chemical resistance on the market – on laminate flooring, door fronts, wrapped profiles and laboratory worktops.

For some applications, ELESGO® can be applied direct from the roll (as delivered) by the laminating company. In other cases (eg. laboratory worktops) ELESGO® has to be combined into a compact laminate in a separate process, prior to the manufacture of the worktop itself.

The special Electron Beam curing technology that DTS is able to employ provides some of the best scratch resistance available on the market.

FOR MORE INFORMATION Tel: 07909 528943 E-mail: snc@essenncee.com

ASE CLEANING & MAINTENANCE delivers high quality, cost effective and reliable services to schools, children’s centres, a range of commercial offices including solicitors, print and design stores, large PLCs and business consultants.

At BASE we pride ourselves on exceeding customers’ expectations and delivering professional services to revitalise and refresh their premises making the environment safer and cleaner.

We apply our 4D model to every contract: Discover, Design, Deliver, Delight. This means that you get a service specifically tailored to your needs and environment.

Our aim to delight shows that at BASE we understand the importance of customer satisfaction and we ensure that service delivery consistently exceeds your expectations.

We research any specific requirements for your assignment and tailor further training for our staff to meet your needs.

Our services include: office/ building cleaning; carpet/

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hard floor cleaning; window cleaning; kitchen deep cleans; and grounds maintenance.

Four great reasons to use BASE: 1. Cost effective and reliable 2. Quality delivered consistently beyond expectations 3. Guaranteed cleaner and safer environment 4. Environmentally friendly, professional cleaning products.

Autumn/winter special offer: • 1 week free office/ building cleaning or • Free carpet cleaning Subject to start of a new regular cleaning contract.

FOR MORE INFORMATION Tel: 020 30939817 Fax: 020 85313165 E-mail: info@base-tqs.co.uk Web: www.base-tqs.co.uk

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Pamper Cleaning Service Limited is much more than just a cleaning company

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UR CHIEF OPERATIONS manager recently had the joy of witnessing the birth of his fourth child at his local London Hospital.

Although being his fourth child she is his first daughter and the excitement has brought a smile to us all in the office.

Carlos had nothing but praise for the hospital staff and the professional care his wife and daughter received. The joyful experience was, however, slightly marred by a member of the hospitalâ&#x20AC;&#x2122;s housekeeping team. â&#x20AC;&#x153;I was visiting my wife and baby girl in their private ward room when in burst this female cleaning operative with mop and bucket in one hand and a single small green jay cloth in the other.

Without so much as a â&#x20AC;&#x2DC;helloâ&#x20AC;&#x2122;, she wet her cloth at the sink and started wiping down the toilet bowl and seat.â&#x20AC;? Carlos reports that she then moved into the main room and wiped various other areas in a very haphazard way using the same green cloth. â&#x20AC;&#x153;I have been training our cleaning operatives for nearly a decade and just could not believe what I was seeing.â&#x20AC;?

When Carlos asked her if she felt it was good practice to clean the toilet first and then, with the same cloth, clean the ward, she abruptly replied â&#x20AC;&#x153;I know how to do my job!â&#x20AC;? Carlos reports that he then watched in disbelief as the operative, again starting in the toilet area, proceeded to pass a sopping wet mop over the floor without rinsing the mop once. She finally made her way

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

out of the door with her green jay cloth tucked in her pocket. â&#x20AC;&#x153;It did concern me that my child was born and being cared for in such an unhygienic environment.

I feel that my child would have been safer in one of our clientâ&#x20AC;&#x2122;s offices that our cleaning operatives clean than in that ward.â&#x20AC;?

With more than 20 years experience in the cleaning industry and active membership to industry important, government consulting organisations (such as BICSc and AHCP), at Pamper Cleaning Services we know the importance of proper training and support for all our cleaning operatives. Our training not only highlights the significance that colour coding systems and â&#x20AC;&#x153;best workingâ&#x20AC;? methods of cleaning have in the prevention of cross contamination, but it also encourages our operatives to view themselves as part of a team, always working along with our clients staff and their patients in a polite, positive way.

Our contract managers work side by side with facility managers ensuring we supply a unified, quality controlled, cost effective approach to the day-to-day hygienic cleaning of premises.

So if your housekeeping staff are letting you and your patients down why not give us a call and experience the difference.

FOR MORE INFORMATION Tel: 0800 9540245 E-mail: info@pamper cleaning.com Web: www.pamper cleaning.com

Health Business | Volume 10.5

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FACILITIES MANAGEMENT

PATIENTS, STAFF & OTHER ASSETS – HOW DO WE KEEP THEM SAFE? Keith Sammonds, managing director of the Healthcare Facilities Consortium, takes a broad look at Asset Management, some of the issues involved and the solutions available IT IS INCUMBENT UPON THE SENIOR officer, normally the CEO, of any NHS organisation to know the assets of the organisation and have adequate processes in place to protect the public investment in them. Whilst the CEO will obviously not carry out basic Asset Management on behalf of the organisation in person the responsibility lies at their door.

It has been interesting in analysing the recent White Paper to note that just about everything it says revolves around clinical delivery, and quite rightly so for, after all, the NHS is here to provide for and protect our health. However, with around a third of healthcare spend being on the facilities that are used to house the delivery of this service it is clear that clinical delivery can only continue while facilities exist to support that delivery. So I find it staggering that so little care seems to be taken of the

assets that the NHS employs day after day to support and enable the core function of maintaining the health of the nation.

SMALLER ASSETS I can hear some of you already huffing and puffing and saying: “What is he on about? We do look after our assets as best we can within the financial constraints we have always had to work under.” Whilst this is generally (but by no means always) true of the buildings and other large assets we do seem to have a very poor track record of keeping tabs on some of the smaller of our assets. For example, how many laptops are being lost in the NHS every week? I don’t actually know but it must be fairly regularly as when we monitor the media for our ‘NHS in the News’ summaries we see laptop thefts reported and, more importantly, the sad cases of patient information or research

data being lost with them. Alongside this, anecdotally, we hear that BlackBerrys are being lost by NHS staff at an alarming rate.

There are many solutions to help protect the valuable assets of IT, communications equipment and data but few are linked in such a way as to automatically protect the data when phone and laptop are separated. We can provide secure housings for IT equipment, but when left in a car or on a table at home laptops are very vulnerable, as proven by recent media reports. We can provide secure access gateways but when someone downloads a file to work on locally it is at risk. We have moved from the era where mobile communication devices were positively banned on hospital premises to where they are the routine communications pathway for staff. All this conspires to provide high value, easily portable kit in a relatively high stress and certainly not interruption free

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FACILITIES MANAGEMENT

environment where kit can be left logged in or on a table and in public access areas where we have no real control over who is in the building.

Recently we have seen a simple solution that works by checking that the phone and laptop are in close proximity; if not then the laptop is electronically locked making it useless to the thief. As an option the hard drive can be automatically wiped if an illegal startup is tried. “Simples” as the Meerkat would say. Add into this the ability to have a remote backup at a secure NHS Net compliant facility and, if triggered accidentally, the process can be reversed providing the laptop returns in full working order.

One of the older technologies that can easily and cheaply be used to protect such relatively high value and easily portable assets is security marking or tagging. The use of smart water in its various forms is well known but seems

Recently we have heard of an increase in trips and slips resulting in staff being off work with injuries but as yet have not seen any statistics to back this up. Slips and trips incidents are recorded through normal accident reporting but the outputs nationally from such reports can take some time and often will not include the potential cause of the incident. To help us see if a change in cleaning processes, for example, has exacerbated this issue we are asking for direct feedback. If you are aware of what may appear to you to be isolated incidents do please let us know and we will coordinate the reports.1 We are constantly being told that we have to make savings, to be more efficient but some of the simpler tasks to keep assets more secure and avoid the consequential costs of loss or theft are not being enacted; improved staff safety and security can reduce costs by not having staff away from work after injury and

With around a third of healthcare spend being on the facilities that are used to house the delivery of this service it is clear that clinical delivery can only continue while facilities exist to support that delivery. So I find it staggering that so little care seems to be taken of the assets that the NHS employs day after day to support and enable the core function of maintaining the health of the nation to have been little implemented in the NHS as a whole. Passive chips can be implanted into very small equipment and these will be shown as present by the use of a hand held reader.

As all UK Police forces use this technology any stolen and recovered equipment can be checked and returned to its rightful owner.

Alongside this the labelling of such assets to warn of the use of such technologies provides a real and effective disincentive to the casual opportunistic thief. Through membership discounts organisations like the Healthcare Facilities Consortium make for easier and cheaper access to these technologies.

LOOKING AFTER STAFF One of our biggest assets is our staff and yet taking care of them often seems to be a relatively low priority. In recent years we have seen workplace massage and laughter sessions demonstrated at conferences to good effect and yet take up by the NHS has been very low.

We set up internal award schemes to motivate yet we tend to ignore things like preventing avoidable back injury by installing bed hoists in new builds. The Fable Hospital project showed the cost savings that could be achieved by this simple expedient but I have yet to see a new build with this implemented.

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replacing them with bank or contracted in staff.

Savings made this way cost little or nothing but can significantly reduce our outgoings.

MANAGING CAR PARKS We all know that car parking is a pain. It is a problem to manage an often limited resource and have plans in place that cope with the high points of visits to main out patient clinics.

It causes stress to patients and visitors but also to staff who have to commute between premises or be off site for part of their role and then return to base. Car parking on hospital premises is a real problem as it costs the NHS in broken and delayed appointments.

Recently I had to drop a patient who requires positive assistance off at a doorway and then drive almost all the way round a large hospital site in order to park the car, then walk back the full length of the hospital main corridor in order to collect the patient where I had left them and escort them to their appointment. At least one other person saw the same problem and after making the obvious comments simply drove their aged relative straight out of the hospital.

When visiting non NHS premises around the country I often benefit from technology that allows me to be pre-allocated a car parking space. These spaces are then

managed for use through the day increasing the overall occupancy rate. It should not be beyond the capabilities of our car parking contractors to implement this in hospital car parks to patients who need this type of support. A pre-booked car parking ticket is a relatively easy solution but may require some infrastructure changes so that the users of such a system do not get caught in the routine visiting hours queues into the main car parks. The same technology would be of real use to independent but vehicle reliant patients. How much do we value the patients and their carers who visit our premises?

Not as much as we should it appears.

Automatic Number Plate Recognition (ANPR) is slated by those who wish to break the laws relating to maximum speeds on the roads and perhaps drive without road tax or insurance but it can be employed in a wide range of ways to help patients and visitors as they access our premises. Perhaps it might be good use of a manager’s time to have a quiet chat with their car parking contractor or the British Parking Association (BPA) and see what could be done instead of simply saying the car park needs to be patrolled and the existing barriers kept working. It would certainly make a good story for the first NHS body to issue a press release showing how they have used income from car parking to benefit their patients.

BENEFITING PATIENTS For many of the problems we face in managing healthcare facilities for the benefit of our patients and visitors there are a range of solutions. Some are relatively high tech and may have a significant cost or require infrastructure changes. For these a full and proper cost benefit analysis needs to be carried out to ensure that any money we do spend is used wisely and to good effect, and in today’s climate will pay their own way.

Other solutions are just plain common sense or use of relatively simple technologies, like marker pens or engraving on high value portable assets, or keeping the office door shut and not allowing people to tailgate through.

These simpler and more routine solutions are often overlooked as we assume that they are already in place or we are too busy dealing with the fire fighting situations to step back and carry out a base level review. However, there are real benefits to be achieved and savings to be realised by making sure that our assets, of all sizes, are properly protected.

Note 1. Slips and Trips: Please consider informing the HFC Help Desk of such incidents on 08540 349645 or e-mail info@hfc.org.uk with Slips and Trips in the subject line.

FOR MORE INFORMATION Web: www.hfc.org.uk

Athena Locker Range elegance without compromise

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www.garranleisure.co.uk email: sales@garranleisure.co.uk telephone: 08456 588600

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Interactive, anti-bacterial Kaba showcases expert signage from Innova products at IHEEM 2010 NNOVA SOLUTIONS, a leading supplier to the signs and graphics industry, is pleased to announce the launch of two new cutting edge technologies aimed at NHS and public sector buildings and sites.

Both products are the result of in-depth research and feedback from within the healthcare sector.

NovaDura™ – an innovative and highly durable process available as a finished product or as a coating system, suitable for signage, cladding and other architectural structures. The NovaDura range offers unbelievable anti-graffiti and anti-bacterial protection, and has been independently tested and approved to ISO 22196 (formerly JIS Z 2801), an internationally recognised standard for the effective reduction in viable cell count of hygiene critical microorganisms.

Based on a revolutionary process incorporating a direct to substrate printing method and specialised

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patented inks, we are able to offer a five-year warranty against anti microbial activity, graffiti and fading when used indoors.

NovActive™ – a custom fit solution to make your signs talk. The latest innovation in micro speakers and software means that you can fit it to your finished signage or assemble in house to provide an aesthetically pleasing slim-line sign that can relay bespoke messages to passersby to inform of safety procedures or potential hazards.

The audio message can be activated by multiple trigger options such as motion detection, rendering it an ideal solution for gel hand cleansing stations or washrooms. Messages can be recorded on any PC and can be stored on the internal SD card.

FOR MORE INFORMATION Tel: 01282 867390 Fax: 01282 861077 E-mail info@innova solutionsonline.com Web: www.innova solutionsonline.com

ABA DOOR SYSTEMS will be exhibiting at IHEEM 2010 due to take place 5-6 October at Manchester Central.

Kaba can be visited on stand D33 where they will be showcasing their expertise in door automation both commercial and industrial, and their nationwide repair and maintenance services demonstrating core strengths and technological leadership.

Kaba aims to consistently exceed customer expectations in the delivery of its products and services and by offering a comprehensive range of technologically advanced solutions. Extensive experience and industry knowledge mean you can trust Kaba to give unbiased guidance and advice, working in partnership with customers to ensure individual needs are met and expectations exceeded. Kaba’s quality accreditation and industry association memberships give assurance of the high standards of service and workmanship you can expect to receive. Additionally,

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membership of bodies such as Constructionline, CHAS and SafeContractor give assurance of health and safety excellence.

Kaba Door Systems has over 80 years international experience in the design, manufacture and installation of a leading range of commercial and industrial door systems. Kaba also offers a nationwide 24 hour, 365 day emergency repair service together with maintenance services.

FOR MORE INFORMATION Tel: 0870 0005252 E-mail: marketing@ kdt.kaba.com Web: www.kabadoor systems.co.uk

Clean ventilation systems – never more essential ICHARD NORMAN, managing director of Indepth Hygiene Services, the UK’s leading provider of specialist cleaning of ventilation systems explained at a recent seminar why there has never been a previous time when those responsible for the maintenance of ventilation systems had more reason to ensure they are maintained in a clean and safe condition.

His company’s experience of working with the NHS has shown that regular cleaning of general ventilation systems is an essential component of any programme to combat the spread of hospital acquired infections, notably MRSA. Organic compounds, including human hair and skin flakes, are invariably found in ventilation ductwork to provide an excellent environment for the growth of micro-organisms.

It is not only general extract and supply systems that warrant special attention. Ductwork cleaning of grease extract system is legally required to remove flammable grease deposits to ensure they do not present a

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

Major fire in London’s Liverpool Street Burger King restaurant’s extract ducting (image courtesy of Nicholas Adams of www.guerillaphotography.co.uk)

fire risk to building occupants.

In providing their services to the healthcare industry, Indepth follows the HVCA’s Guide to Good Practice “Internal Cleanliness of Ventilation Systems”, TR19. This sets out clearly the required compliance standards and how effectively ventilation systems should be cleaned.

FOR MORE INFORMATION To assist management to assess risk Indepth provide an Assessment of Risk report for ventilation systems free of charge.

Tel: 020 86617888 E-mail: ductclean@ indepthhygiene.co.uk Web: www.indepthhygiene.co.uk

Health Business | Volume 10.5

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FACILITIES MANAGEMENT

AUTOMATIC WASHROOMS Dorset County Hospital NHS Foundation Trust (DCH) improves hygiene and saves water with No-Touch products from Dart Valley Systems THE ESTATES DEPARTMENT AT DCH headed up by Keith Butler is keen to provide first class facilities that are energy and water efficient. Such focus not only helps with the DoH emission and sustainability objectives but also reduces the hospitals’ costs for utilities. One of Keith’s initiatives was to invest in a bore hole that provides 20 per cent of the hospital’s water – a second bore hole is now under consideration.

Keith invited Dart Valley Systems Ltd [DVS] to carry out a water survey throughout the site with focus on the washrooms, patient ensuites and clinical hand washing.

WASTE Water audits on the DoH estate have indicated historically that circa 11 per cent of hospital water is used for hand washing. DVS considered that, taking everything into account, the use of no-touch taps may reduce the hand washing water by circa 30 per cent giving a total reduction of around 3.3 per cent, which equates to around £5,000 per year. The savings per hand wash are nearer 55 per cent but due to the ease of use DVS believes that hand washing compliance normally increases thus taking some of the savings. This was the view of Linda Horton, infection control manager at James Paget Hospital where they have had over 600 no-touch taps in operation for around eight years. A site trial conducted by DVS at another hospital also indicated a significant increase in hand washing compliance.

The second opportunity was on the WC flushing. The DVS no-touch WC Flushvalve efficient operation can generally reduce water used when replacing siphons by around 30 per cent. Audits have suggested that 24 per cent of hospital water is used for flushing WCs. Using these calculations the water saving would be 7.2 per cent equating to around £11,000 per year.

BENEFITS DCH decided to carry out an initial installation of DVS No-Touch products in March 2005 to establish the benefits in terms of water savings, ease of use, reliability and infection control.

Following this installation the response from all staff and in particular infection control was extremely positive and the hospital embarked on a programme to retro-fit no-touch products throughout the hospital over a number of years subject to availability of funds. This programme is now well advanced with no-touch products fitted throughout most of the hospital.

DCH is very focused on patient safety and the importance of combating HCAI (Healthcare Associated Infections) which is a high profile topic within the UK and at DoH.

Whilst the introduction of no-touch products was initiated by a desire to reduce water, DCH regard the major benefits relate to assisting the infection control team combat HCAI. It is universally acknowledged that hand hygiene is the single most important infection control discipline to reduce HCAI. IMPROVED HAND HYGIENE Clearly effective infection control involves a whole series of disciplines and no-touch taps and toilet flushers alone will not achieve the required standards of hand hygiene. They are, however, one step in making it easier for healthcare workers and others to improve it.

If it is easier to use taps then it encourages hand washing. There is no argument, if you do not have to touch levers with hands or arms it reduces the risk of cross contamination.

The No-Touch taps have safe pre-set water temperature using TMV3 [D08] approved thermostatic mixing valves. There is no need to touch any part of the tap, just place hands under the spout and water is delivered at the required hand washing temperature for as long as required.

Whilst the complexities of a large building with variable water requirements make it difficult to exactly quantify water savings the indications have been that the reductions in water use have been more or less as predicted. Having significant amounts of Reverse Osmosis and a hydrotherapy pool that uses 42M3 adds to the total water requirements of the hospital, nonetheless, DCH has achieved an efficiency that is in the

lower quartile for small acute hospitals.

With regards to the views from an infection control perspective, Anne Smith, infection control nurse consultant, stated: “I am very impressed with the No-Touch products. They are easy to use for clinical hand washing and help to avoid cross contamination. They are also very good in patient areas and ideal for sluice areas where we have replaced pull chains for flushing with no-touch sensors and lever taps with no-touch taps.”

Not surprisingly the handles on sluice equipment can be a prime source for harbouring bacteria and this is a good example of further use of no-touch products to help reduce cross contamination.

DCH has achieved some reduction in HCAI during the last three years and continues to strive to reduce further and the hospital has ambitions to be one of the most highly regarded NHS healthcare providers in the UK.

FOR MORE INFORMATION Tel: 01803 529021 Fax: 01803 559016 E-mail: sales@dartvalley.co.uk Web: www.dartvalley.co.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Are you meeting the latest Health and Safety regulations for Asbestos?

We have over 25 years’ experience of asbestos removal and management. Call us now 0800 093 7810 for advice on: • Asbestos Surveys and Sampling • Management of your Asbestos containing material • Asbestos Removal • Asbestos Waste Management We are fully licensed by the Health and Safety Executive and are registered by the Environment Agency.

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Health Business | Volume 10.5

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ASBESTOS MANAGEMENT

MANAGING THE HIDDEN KILLER Many buildings used by the healthcare sector are likely to contain asbestos.

Jill Joyce, senior policy and technical manager at the Institution of Occupational Safety and Health, looks at the steps we can take to minimise the risks ANY BUILDING, from your local GP’s practice to hospitals, built before the year 2000 could contain asbestos; and if in good condition and undisturbed, this isn’t a problem.

However, where it is disturbed or in poor condition, it can pose serious health risks, and dealing with it can also cause disruption.

For example, in April 2009, four operating theatres at a London hospital closed for three days while previously identified asbestos was removed from a nearby plant room, so a burst pipe could be repaired, meaning 15 operations were postponed.

This illustrates the importance of knowing whether your building contains asbestos and also the implications of decisions made about its management for your service delivery.

Before deciding whether to leave asbestos in place, careful consideration should be given to the likelihood of it being disturbed e.g. for access or repair purposes; and how the situation should best be handled.

Adverse publicity can also be an issue for organisations – the Health and Safety Executive (HSE) has issued improvement notices against several NHS and Primary Care Trusts relating to the management of asbestos. And it doesn’t just make financial and legal sense to manage asbestos – exposure to asbestos can lead to chronic suffering for individuals and to premature death.

WHAT IS ASBESTOS AND WHERE CAN WE FIND IT? Pre-2000 buildings may contain asbestos and asbestos containing materials. Asbestos has been used for insulation around boilers and pipework, partition walls, wall panels, lift shaft linings, fire doors and air conditioning and ventilation systems.

Asbestos composites can even be found in toilet cisterns, seats and bath panels.

The most dangerous types, crocidolite (blue asbestos) and amosite (brown asbestos) have been banned since 1985, while chrysotile (white asbestos) has been banned since 1999.

There is also a ban on the second-hand use of asbestos products. However, it’s estimated that around half a million non-domestic buildings still contain asbestos, although some asbestos containing materials such as floor tiles, asbestos cement roofing, guttering and textured coatings are considered a lower risk.

If asbestos is not disturbed and remains in good condition, then it does not present a risk. But problems can arise if asbestos deteriorates, or is damaged or interfered

with, allowing fibres to be released into the air and people to be exposed.

Past exposure to asbestos causes around 4,000 deaths a year in Great Britain and we have the world’s highest death rate from the asbestosrelated cancer mesothelioma (2,156 in 2007).

The figure for male deaths from this disease is predicted to peak around the year 2016.

There is no known safe level of exposure to asbestos. The more you are exposed, the greater the risk of developing an asbestosrelated disease. Inhaling asbestos fibres can lead to serious conditions, such as asbestosis (a non-malignant chronic fibrosis of the lungs), asbestos-related lung cancer and mesothelioma (a cancer of the lining of the lung and lower digestive tract). Mesothelioma is believed to be caused almost exclusively by exposure to asbestos and can take between 30 and 40 years to develop. It’s almost always fatal with those affected dying with one or two years of diagnosis. Asbestosrelated lung cancer also has a long latency period – typically at least 20 years and people who also smoke have an increased risk.

If workers are unaware that materials contain asbestos, then they may accidentally disturb them during construction or routine maintenance or repair work. Those most likely to do this are therefore contractors working on the fabric of the building such as roofers, data cablers, electricians, painters, plumbers, heating and ventilation engineers.

WHAT THE LAW REQUIRES The Control of Asbestos Regulations 2006 (CAR) bans the importation, supply and use of all forms of asbestos. CAR regulation 4 requires those who own, occupy or manage a building or are responsible for managing its maintenance and repair, to manage any asbestos within it.

So, if you have responsibly for maintenance or repair of premises, you need to know whether they contain any asbestos, where it is, what condition it’s in, what the risk is and ensure that it’s managed properly – including telling anyone who may disturb it that it’s there.

If you find asbestos in good condition where it’s unlikely to be disturbed or damaged, then it can be left in place and monitored regularly to make sure it’s still OK. There is plenty of free guidance and online tools on the HSE website; for example, an online version of their 2002 guide ‘A comprehensive guide to managing asbestos in premises’ (HSG227) is now available to help those responsible for managing asbestos risks

on how to best protect any workers who may disturb it. It also includes a case study from a NHS community and mental health service trust.

A new publication, ‘Asbestos: the survey guide’ (HSG264) aims to help those commissioning asbestos surveys, the surveyors who carry them out and those who use them, such as architects and demolition or removal contractors. It sets out the role of surveys in ensuring that builders or maintenance workers have all the information they need to minimise their risk of exposure to asbestos and put the right precautions in place.

MANAGING THE RISK If you’re the person responsible for maintenance or repair, your first task is to decide if you (or one of your staff) is able to carry out your own asbestos assessment inspection. If not, you should engage someone competent to assist you. If doing it yourself, you need to find out which parts of your building were constructed or refurbished before 2000 and whether your building is on a brownfield site – land previously used for industrial or commercial purposes that may have asbestos buried on it. Also, whether there is any old equipment in use such as ovens, insulating mats, fire blankets, oven gloves, ironing surfaces, which can be assumed to contain asbestos.

Get together information you already have, such as building plans and previous asbestos surveys (though beware, these may have missed the asbestos). It can be also be useful to contact tenants or the builder or building’s architect to see if they have any relevant information.

The next task is to inspect the building and create an asbestos register to record where asbestos may be present (presuming that asbestos is present in the absence of evidence that it’s not). The register should be a table listing the following: • Where the asbestos has been found • What type of asbestos product it is – e.g. pipe insulation or ceiling tile • How much there is • If there is any coating over it e.g. paint • What condition it is in • How easy it is to access • What type of asbestos it is • The material and priority scores you obtained using the HSE online tools (see below for more details).

You need to determine your priorities for dealing with any asbestos you find and decide how to manage it depending on its type (if known), form, condition and location. For example, are you dealing with old pipe lagging

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Health Business | Volume 10.5

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ASBESTOS MANAGEMENT

or asbestos cement? The HSE has developed an online tool to help you assess the risk of the asbestos you have found and also a tool to help you decide how to manage it.

If you decide you need help with this, it is important to find a competent surveyor to carry out an asbestos survey. Surveyors need to be appropriately trained, have relevant experience and follow good practice. Look for accreditation by the United Kingdom Accreditation Service, UKAS, or personnel certification by the Asbestos Building Inspection Certification Scheme, ABICS. MAKE A PLAN Once your asbestos register is complete, you can devise a plan for managing asbestos. Your plan should include: • A site plan showing where asbestos has been found • The register which you prepared earlier • An action plan for dealing with the asbestos, showing who will do what and the time frame • A schedule for monitoring the materials’ condition • A communication plan to tell people who may be working near the asbestos • A plan for emergencies where asbestos contamination might occur.

Getting competent help is important. The HSE publishes a list of companies licensed to work with asbestos, which is updated every fortnight. Depending on the materials and type of work being done, you may need to use an HSE-licensed asbestos contractor. If this is not needed, you must use a contractor who is competent to deal with asbestos.

RECORDS AND INSPECTIONS It’s essential that you keep your records up to date. Make sure you update your asbestos register every time you have work done on asbestos materials or carry out an inspection.

Asbestos materials should be inspected at least yearly to check they haven’t deteriorated and any changes should be noted. Include these inspections in your action plan and say who is responsible and when they are going to make the checks. Ensure they have the necessary training to help them do this.

Tell your employees and contractors about your asbestos register and where you have found asbestos and display warning signs if appropriate. Help workers to recognise what asbestos may look like; where they need to take care; and what to do if they come across asbestos materials unexpectedly.

When planning maintenance work, carry out a risk assessment to ensure that any contact with asbestos is identified and the risk of exposure to workers and or others is properly managed. If more extensive maintenance or repair is needed, then a localised ‘refurbishment survey’ is required, where the ‘management survey’ hasn’t been intrusive. If you have several contractors involved in maintenance work, appoint someone to ensure they are communicating effectively with each other.

Safe maintenance is the subject of the Healthy Workplaces Europe-wide Campaign for 2010-2011 (see the HSE website for more information). The campaign encourages an integrated and structured approach to maintenance, which affects every area of safety and health. Poor maintenance standards are a major cause of occupational disease.

So the key message is, don’t ignore asbestos or be tempted to take a chance – people’s future health is at stake here. Make sure you are complying with the law and have good procedures in place. If in doubt get expert help. Effective management of asbestos in your building will ensure that today’s healthcare staff, contractors and building users, don’t become tomorrow’s asbestos victims.

FURTHER INFORMATION IOSH runs a one-day CPD course ‘Asbestos: the hidden killer’ for health and safety professionals, facilities managers and anyone who manages risk programmes involving asbestos. www.iosh.co.uk/ training/training_for_professionals.aspx IOSH has a Healthcare Group of around 1,800 members working in public and independent healthcare, including primary care, acute services, mental health, ambulance services, social services and learning disabilities. For more information about their work visit www. iosh.co.uk/groups/healthcare_group.aspx 2010-11 Healthy Workplaces European Campaign on Safe Maintenance – see HSE website at www.hse.gov. uk/safemaintenance/index.htm The United Kingdom Accreditation Service www.ukas.com/ The Asbestos Building Inspectors Certification Scheme www.abics.org/ HSE ‘Checklist’ www.hse.gov.uk/asbestos/ managing/checklist.pdf HSE ‘Material and Priority Scoring tool’ www.hse.gov.uk/asbestos/managing/ flashtools/priorityscores.htm HSE ‘How to deal with the different types of asbestos’ www.hse.gov.uk/asbestos/ managing/types.htm HSE ‘Asbestos licence holders list’ webcommunities.hse.gov.uk/connect.ti/ asbestos.licensing/view?objectId=196

25 years experience in asbestos removal ITY ENVIRONMENTAL SERVICES (EU) is licensed by the Health and Safety Executive for all aspects of work involving asbestos.

We offer a comprehensive range of services, including asbestos removal, collection and disposal of hazardous waste, environmental cleaning, salvage and demolition.

Licensed disposal facilities are available for a wide range of hazardous waste products, including asbestos, laboratory smalls, sharps and syringes, gas cylinders, refrigerators, tyres and fluorescent tubes, and of course, we take care of the detailed paperwork required by the Regulations.

Dealing with the unexpected discovery of asbestos is an area that presents special

associated with a wide range of clients throughout the United Kingdom, including hospital trusts, universities, the Ministry of Defence, the National Trust and many others.

Through our sister company, City Environmental Services (Wales) Ltd, we provide comprehensive asbestos surveys, non-licensed asbestos removal, and asbestos training (as members of the United Kingdom Asbestos Training Association).

C

FOR MORE INFORMATION problems, especially in sensitive areas such as hospital and healthcare premises. However, we are fully equipped and able to respond at short notice and at very competitive prices.

Over the years, the company has been

Tel: 01633 613882 Mobile: 07967 649822 E-mail: admin@ceseu.co.uk Web: www.city environmentalservices.com

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UserGroup International

Protecting your Campus?

It is fundamentally important that both staff and management are fully versed in the latest security systems and methodologies that can be employed to reduce risk and the costs of maintaining a safe and secure environment.

presenters from many of the most respected companies and organisations in the industry, the schedule includes Technical Seminars and Master-classes, Case Study presentations and Hands-on break-out sessions within the product showcase area.

IP UserGroup International is the only organisation in the world dedicated to the latest Security, Life Safety and BMS Technologies. Presenting world-class networked and digital Security and Life Safety solutions to an eager and commercially aware audience, the IP UserGroup unlike other forums is focused on technology and its application. Sign-up today FREE and start your journey of understanding. www.ipusergroup.com

The two half day sessions cover subjects such as: Surveillance & CCTV, Access Control, Time & Attendance, Intruder Detection & Alarms, Fire Detection & Evacuation, Integrated Safety Solutions, Audio, Intercom & Messaging, Transmission & Comms Systems and Building Management Systems.

An environment for learning The IP-in-Action LIVE Educational Programme reflects the needs of a professional audience keen to learn more about networked security and safety solutions. Delivered by expert speakers and

FREE to attend, we urge managers from all public sector organisations to invest a few hours to gain additional knowledge about this fast moving technology. Places are limited so register early. Delegates will receive an attendance certificate and a light lunch will be provided. Details of forthcoming events can be found at www.ipusergroup.com/live

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UserGroup International

Health Business | Volume 10.5

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ASBESTOS MANAGEMENT

GETTING TO GRIPS WITH ASBESTOS Those who own, occupy, manage or have responsibilities for buildings that may contain asbestos have legal responsibilities, informs Steve Sadley, chief executive, ARCA

ASBESTOS MUST STILL BE CONSIDERED as an important issue for all those charged with responsibilities for facilities management or maintenance. The Health & Safety Executive estimates that over 1.5 million commercial buildings still contain asbestos materials, and that 60 per cent of all asbestos imported into the UK has been used to produce building materials. Asbestos is likely to be present in a building if it was constructed between 1940 and 1980, and can sometimes be found in buildings constructed in the 1990s.

HOW ASBESTOS IS USED The main uses of asbestos are as a reinforcing agent in asbestos cement sheeting used on walls and roofs; in asbestos cement building products, such as tiles, cold water tanks, pipes and gutters; in insulating board used as wall partitions, fire doors, ceiling tiles, etc; in yarns and textiles, in lagging and in sprayed coatings for insulation and decorative purposes.

Employers of building maintenance and repair workers are required to carry out a risk assessment before undertaking any work which exposes, or is liable to expose, employees to asbestos. They must take the appropriate steps required by the Asbestos Regulations to prevent or reduce these risks. However in many cases the employers and their workers have little or no information about the premises where they are going to undertake work, and are not aware if asbestos containing materials are present. Consequently, it is difficult for them to consider the risks, or if precautions may be needed. A duty to manage the risk from asbestos in non-domestic premises was

therefore added to the Control of Asbestos at work Regulations in 2002 to address this. These requirements have since been brought forward unchanged in the Control of Asbestos Regulations 2006 as Regulation 4.

Those who own, occupy, manage or have responsibilities for premises that may contain asbestos, will either have: • A legal duty to manage the risk from asbestos material • A legal duty to co-operate with whoever manages that risk They will be required to manage the risk from asbestos by: • Finding out if there is asbestos in the premises, its extent and what condition it is in • Presuming the materials contain asbestos, unless you have strong evidence that they do not • Making and keeping up to date a record of the location and condition of the ACMs or presumed ACMs in their premises • Assessing the risk from the material • Preparing a plan that sets out in detail how they are going to manage the risk from this material • Taking the steps needed to put their plan into action • Reviewing and monitoring their plan and the arrangements made to put it in place • Providing information on the location and condition of the material to anyone who is liable to work or disturb it.

WHO CAN WORK ON ASBESTOS? At some point somebody has got to work with asbestos containing materials, but who

is allowed to do this? In the United Kingdom work on asbestos has by law to be carried out by a contractor who holds a licence under the Control of Asbestos Regulations 2006, although there are exceptions.

Normally, non-licensed work includes work on asbestos-containing textured coatings, asbestos cement and certain work of short duration on asbestos insulating board.

Short duration means any one person doing this type of work for less than one hour, or more people doing the work for as total of less than two hours, in any seven consecutive days.

The total time spent by all workers must not exceed two hours. This includes time setting up, cleaning and clearing up. It must be borne in mind that even non-licensed asbestos work is still subject to the strict requirements of the Control of Asbestos Regulations 2006.

Following the publication of the CAR 2006 the decision as to whether an asbestos removal project needs to be undertaken by a contractor who holds an HSE Licence to Undertake Work with Asbestos is now based upon a risk assessment, as opposed to the previous material assessment. In order for the decision to be made as to whether a Licence to Undertake Work with Asbestos is required, the risk assessment must determine whether certain criteria, regarding exposure and the type of work involved, will be met or not, these criteria are detailed in Regulation 3 of CAR 2006.

The risk assessment must be undertaken by a competent person, i.e. someone who has received adequate information, instruction and training for the task and can demonstrate an adequate and up to date understanding of the work, required control measures and appropriate law. In addition they must have sufficient experience to apply this knowledge.

Failure to carry out an adequate risk assessment may lead to licensed asbestos work being carried out by an unlicensed contractor. This is an offence under CAR 2006 and can lead to prosecution by the Health and Safety Executive.

THE RIGHT INSURANCE Contractors engaged in any type of work with asbestos, whether licensed or unlicensed, require appropriate insurance cover relating to asbestos; asbestos cover is automatically excluded from most contractors’ company insurance policies. All licensed contractors will have Public Liability Insurance which provides specific cover for the removal of asbestos containing materials written back into the policy. The client should make the appropriate checks in order to ensure that they are adequately protected from any future claims arising out of the work. These claims

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Visit the website to view the categorised product finder

Make your windows safer with specialist films from Glass Protection (Essex) Ltd

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LASS PROTECTION (ESSEX) LTD is a company based in Havering, Essex that supplies and applies all types of window films. The company was formed in 1986 and has been involved in many jobs for high profile clients in the UK and other countries.

The owner directors are Mike Wray and Paul Bowyer. Between them they have 55 years experience in window filming. They also do most of the site work and deal with all enquiries and surveys, and give the best advice to the client.

The company covers all aspects of window filming including safety, security, solar control, vinyls, manifestations and graphics. Only the best quality materials are used and the workmanship is exceptional.

Much of the safety film work is carried out in schools, colleges, hospitals, care homes and any workplace where there is a need to bring the glass up to the required safety standard. Solar film is also used in any environment where there is a need to reduce heat and glare or fading, and thus making the workplace or classroom a more comfortable place to be in. In recent years the need for energy and cost savings have risen.

Solar film offers some solutions in this field.

Glass Protection has recently completed several jobs for councils for energy and cost savings needs. This particular field is expanding and a bigger proportion of the company time is devoted to this problem. Glass Protection has worked for some of the largest companies and institutions in the world, including: banks, insurance and oil companies, Metropolitan Police, the Home Office, main contractors,

councils, schools, colleges and many private companies.

Glass Protection has worked abroad on many occasions where the client has needed a professional job from an accredited supplier and installer. Some of the countries include: France, Belgium, Germany, Algeria, South Africa and Malaysia. These jobs were for large private companies or the British Foreign & Commonwealth Office. Glass Protection works throughout the UK and extensive works have been completed in every home country. Many of these jobs were in military or government installations, mainly using safety film for protection against terrorism.

Where required all films are tested to British and European Standards.

Glass Protection is an accredited supplier and installer of Madico & Opalux films and any other film is obtainable if specified.

FOR MORE INFORMATION Tel: 01708 745907 Mobile: 07860 206027 Fax: 01708 753658 E-mail: mike.wray@btconnect.com

GLASS PROTECTION (ESSEX) LTD Glass Protection (essex) Ltd has many years of experience in supplying & installing all types of window films, vinyls & graphics. Our materials, services & workmanship is of the highest quality.

The benefits of window films are as follows: Enhances Safety & Security.

Safety film will make glass antishatter therefore making it safer.

Can be used in any glazing environment.

Protects against bomb blast allowing business to continue in the face of terrorism.

Energy Savings In Buildings.

Solar films can save energy & costs.

Extensively used for local councils.

U/V Protection.

Specialist u/v filter films offer u/v reduction and lessens fading. Widely used in museums, art galleries etc.

Privacy.

Frosted films offer privacy while allowing light. Many shades available.

Schools, hospitals, offices & homes all enjoy the benefit of safety film.

Manifestations & Graphics.

All types of vinyl used for logos, graphics & manifestations for health & safety requirements.

Comfort In The Workplace.

Solar film reduces heat & glare making a more comfortable working environment.

Free Quotations & surveys available.

Distance no object for site work. Top quality before and after sales service.

01708 745907 Mobile: 07860 206027 Fax: 01708 753658 E-mail: mike.wray@btconnect.com

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Health Business | Volume 10.5

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ASBESTOS MANAGEMENT

could either be for asbestos related health problems or for contaminated property.

The duties imposed by regulation 4 of the Control of Asbestos Regulations 2006 supplement the provisions of some of the duties imposed by other sets of regulations, in particular the Construction (Design and Management) Regulations 2007. This requires the client to provide designers and contractors who may be bidding for the work or who they intend to engage with the projects specific health and safety information needed to identify hazards and risks associated with the design and construction work.

TRAINING The Control of Asbestos Regulations 2006 place legal duties on employers and employees with regards to asbestos in the workplace. Regulation 10 states that: “Every employer shall ensure that adequate information, instruction and training is given to those of his employees who are or are liable to be exposed to asbestos or who supervise such employees...”

Therefore those who employ construction workers to carry out demolition or refurbishment work have a legal duty to ensure that they have adequate information,

instruction and training regarding asbestos, as those tradesmen are always liable to be exposed to asbestos as a result of the type of work they carry out.

In fact the Approved Code of Practice which accompanies the Control of Asbestos Regulations 2006 states that: “Asbestos awareness training is required to be given to employees whose work could forseeably expose them to asbestos. In particular it should be given to all demolition workers and those workers in the refurbishment, maintenance and allied trades where it is foreseeable that their work will disturb the fabric of the building because asbestos containing materials (ACMS) may become exposed during their work. Exemption from this requirement would apply only where the employer can demonstrate that work will only be carried out on buildings free of ACMs. This information should be available in the client’s asbestos management plan.”

An Approved Code of Practice has special legal status; it is the accepted way of complying with the law. If you do not comply with the Approved Code of Practice you must demonstrate that you have complied with the law in some other way, to an equal or better standard.

From the above it can be seen that asbestos awareness training is a legal requirement for most employees and supervisors working in the construction industry. In addition to initial training, the Approved Code of Practice which accompanies the Control of Asbestos Regulations 2006 also states that refresher training should be given at least every year.

Therefore, there is an ongoing annual legal requirement for refresher training to be carried out for the identified employees.

ARCA is the leading supplier of asbestos awareness training aimed at building and maintenance workers.

ARCA trainers have considerable experience within the asbestos removal industry and understand the issues that are faced every day. The range of courses which ARCA have available is comprehensive. Each has been designed to ensure that your staff acquires a real depth of knowledge and capability.

FOR MORE INFORMATION To find out more or to arrange a no obligation meeting to discuss your employees’ asbestos awareness training needs please contact ARCA on 01283 531126.

Antec – the specialists in asbestos removal

The experts in asbestos abatement services

NTEC CONTRACTING Services (Anglia) Ltd was established in 1991. We offer a fully licensed and insured, safety conscious service in asbestos removal and surveying. With a wealth of knowledge gained from extensive experience and training. Antec is able to advise and assist in all phases of the control and elimination of asbestos from the identification of problem areas to the completion of remedial measures.

Antec holds a full licence (4910603507) to remove asbestos issued and regulated by the HSE (Health and Safety Executive) under the Asbestos (Licensing) Regulations 1983.

Alongside the remedial services

SBESTOS ABATEMENT Services is a family owned company who has been involved in the Asbestos Abatement Industry for over 30 years. They are a licensed contractor with full asbestos specific insurance cover and are also members of A.R.C.A (Asbestos Removal Contractor Association).

Asbestos Abatement were one of the first to gain the prestigious Site Audit Accreditation Scheme Award and are holders of ISO9001, ISO14001 and the Health and Safety standard OHSAS 18001.

There is a legal duty to manage asbestos in buildings and requires very explicit undertakings by building owners/occupiers of non domestic premises.

Asbestos Abatement Services has always taken a professional approach to the issues surrounding asbestos and has provided support and advice to many local and national companies regarding the management of asbestos in their buildings which can be an extremely

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provided by Antec, our surveying team offer extensive knowledge and experience in locating and identifying asbestos containing materials (ACMs). All our surveyors have been trained to BHOS P402 standard depending on the need of the client. Clients range from RAF sites, councils, building/demolition contractors and numerous commercial premises both large and small.

FOR MORE INFORMATION Unit 2 Ashwellthorpe Industrial Est, Ashwellthorpe, Norfolk, NR16 1ER Tel: 01508 481630 Fax: 01508 481631 E-mail: antec@antecasbestos.co.uk

A

daunting and legally complex process for individuals outside of the industry to understand.

They offer a full service from consultancy and advice to carrying out any required asbestos survey.

After the findings of the survey have been reviewed and areas of repair/removal have been identified, Asbestos Abatement Services is able to offer estimates for any work required and provide the full risk assessment, notifications, method statements and take care of the waste disposal issues in order to carry out a complete turnkey package.

FOR MORE INFORMATION For further information please call Asbestos Abatement Services on 01922 644712 or visit our website: www.asbestosonline.co.uk

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Visit the website to view the categorised product finder

Flexible testing and certification services

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ALL 365 ON DEMAND SOLUTIONS who are a national company focused on all areas of statutory compliance for property owners and facility managers.

Whatever the testing and certification need for a premise, our multi-skilled engineers are trained and equipped with the latest electronic equipment to test and certificate to ensure that your premises are compliant.

Services include PAT, periodic inspection and testing of electrical installations, fire alarms, fire extinguishers, emergency lighting, re-lamping, gas safety, gas servicing and water hygiene.

Our consultancy team offering practical advice on energy saving, fire risks and life cycle replacement

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supports all of the above services.

We can also assist with complying with the recent legislative requirements for air conditioning and refrigeration (F-Gas), which demand action on several levels.

The Kyoto Protocol drove these changes and in order to assist our clients we have had to review our existing procedures and policies.

We trained our multi-skilled engineers to be able to test equipment for F-Gas leakage and compliance whilst they were on site on site carrying out other statutory tasks. This ensures total statutory compliance for the premise with the minimum number of visits and minimal disruption to operations.

FOR MORE INFORMATION Tel: 08702 600247

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Air conditioning and cold storage specialist ICS takes a giant leap towards a green future

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NOWN IN THE COOLING INDUSTRY for their innovative and comprehensive product range, ICS has been at the forefront of chiller design and application to the process industry for over 30 years. Following a series of CPD accredited presentations entitled â&#x20AC;&#x2DC;Energy Efficient Refrigerantsâ&#x20AC;&#x2122; to over 200 design engineers over a 9-month period, ICS has confirmed that their research and development on energy and natural refrigerants has been well received. This has culminated, with their manufacturing company Tricool Thermal developing their use of natural refrigerants, in the launch of their first range of Green Cooling Hydrocarbon Chillers.

The range provides a choice of ozone-friendly hydrocarbon refrigerants; Propane, R290 and Propylene, R1270. These are naturally produced and non toxic with a global warming potential (GWP) of less than 3. This Green Cooling range is currently being manufactured in a range of duties 50-650kW, offering a wide temperature choice of -30oC to +20oC water leaving.

Commenting on the launch Mike Jones, director of ICS, said: â&#x20AC;&#x153;Our Green Cooling range is a very positive step in assisting designers with a natural alternative to HFCs. â&#x20AC;&#x153;The EU has passed a directive to phase out

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HFCs in mobile air conditioning systems and a regulation addressing their use in stationary applications, the regulation will be reviewed in 2011, although there is a view that further applications may be included, thus following the progressive stance of Denmark and Austria.â&#x20AC;?

The Green Cooling range will be manufactured by Tricool Thermal at their UK manufacturing facility in Southampton.

All units are built to the requirements of stringent EU specifications and all products are manufactured to meet CE approvals under ISO9001 quality control certification.

With over 30 years of manufacturing

experience and refrigeration expertise ICS can offer their Propane and Propylene chiller technology with specialist options such as low profile, low noise, atex specification and bespoke size and orientation, built to suit the available space on site.

Furthermore, ICS has local engineers nationwide who are experienced at engineering a solution to customersâ&#x20AC;&#x2122; requirements and with an established contracts team can project manage an installation, giving complete peace of mind.

ICS is one of Europeâ&#x20AC;&#x2122;s leading specialists in temperature equipment and services.

With regional sales and technical support operations nationwide, ICS Industrial Cooling provides engineered solutions for industrial processing, refrigeration and air conditioning applications. ICS is a pan European organisation with a reputation for product build quality, reliability of design and excellent customer service, all of which is supported by our 24-hour on call service organisation, ICS Service.

FOR MORE INFORMATION Tel: +44 (0)23 80527300 Fax: +44 (0)23 80428366 E-mail: info@icstemp.com Web: www.icstemp.com

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AIR CONDITIONING & REFRIGERATION

COMPLYING WITH FLUORINATED GREENHOUSE GASES LEGISLATION F-Gas Support takes a look at forthcoming changes affecting the qualifications and certification your contractors need

BY JULY 2011 contractors or employees who install, maintain or service stationary refrigeration, air-conditioning or heat-pump (RAC) equipment that contains or is designed to contain F gas refrigerants1 need to hold a full F gas qualification, and the business that employs them need to hold a FULL Company Certificate.

PERSONNEL QUALIFICATIONS Currently all personnel that carry out installation, maintenance and servicing, leak testing, and refrigerant recovery on equipment that contains or is designed to contain an F gas refrigerantmust at least hold an interim F gas qualification, also referred to as an interim personnel certificate. The list of qualifications that an engineer may hold includes interim qualifications and new full qualifications that have been developed to meet the minimum requirements of the EC Regulation.

The EU is allowing the stationary RAC sector an interim period that runs until July 2011.

This was to give personnel time to gain the new qualifications. During the remainder of the interim period personnel that only hold an interim F gas qualification urgently need to plan to gain a full qualification.

Interim qualifications are either City & LEVEL

Guilds 2078, or CITB J01. For those only working on equipment that contains less than 3kg the options also include an interim personnel certificate (issued by DASA or WTA), or an in-house qualification.

Time is running out and the end of the interim period – 4 July 2011 – is not that far away. All personnel that want to carry out the activities listed above must obtain a full qualification that meets the minimum requirements specified in Commission Regulation 303/2008. For example, the relevant full F gas qualifications for personnel wanting to undertake installation, maintenance, servicing on equipment containing or designed to contain 3kg or more of an HFC refrigerant are City and Guilds Level 2079-11 or Construction Skills CITB J11.

There are in fact four levels of qualification that meet the minimum requirements that those working on RAC systems can hold.

These are known as Categories I to IV. The table below describes the activities for each Category and lists the providers’ references.

COMPANY CERTIFICATION Since 4 July 2009 all businesses that employ qualified personnel to carry out installation,

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.

Category II

Certificate holders may carry out refrigerant recovery, installation, maintenance and servicing, in relation to RAC systems containing less than 3kg of fluorinated greenhouse gases (or less than 6kg for systems that are hermetically sealed and labelled as such).

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.

2079-12

J12

Category III

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

2079-13

J13

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.

2079-11

J11

servicing or maintenance of any stationary refrigeration and air-conditioning (RAC) systems containing F gases must hold a Company Certificate. This includes sole traders as well as larger contractors. It also includes operators that employ in-house qualified staff.

The law requires that relevant businesses must hold at least an interim Company Certificate now and a full Company Certificate by July 2011, making it an offence to carry out installation, servicing and maintenance on RAC systems using HFCs without a Company Certificate.

QUALIFICATIONS To obtain a full Company Certificate, businesses must ensure that all of their engineers hold one of the following full F gas qualifications: • City & Guilds 2079 -11 /12 • CITB J11 -12 • an equivalent European qualification.

Once the engineers are qualified a business must apply to one of the certification bodies to gain a Company Certificate: • Refcom: www.refcom.org.uk, 01768 860409, info@refcom.org.uk • Quidos: http://fgasregister.com, 01225 318400, fgas@quidos.co.uk • Bureau Veritas: www.bureauveritas.co.uk/fgas, 020 76610726, fgas.mail@ uk.bureauveritas.com If you use contractors to undertake work on any F gas containing air-conditioning or refrigeration systems you should check they hold at least an interim Company Certificate and ask them about their plans to gain full qualifications and Company Certification.

References 1. Common F gas refrigerants are HFCs such as R134a, R404A, R407C, R410A; a full list of F gases can be found at www.defra.gov. uk/fgas. Users of F gases are affected by the EC F gas Regulation as these refrigerants have a very high global warming potential that is up to 3,000 times higher than CO2.

F-Gas Support is a Defra funded team that provides advice and information on all aspects of the EC F gas and Ozone Regulations.

FOR MORE INFORMATION 2079-14

J14

Tel: 0161 8743663 E-mail: fgas-support@enviros.com Web: www.defra.gov.uk/fgas

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Reduce your energy bills With our cost-effective Energy Surveys and thermal insulating Energy Saving Jackets Designed for valves, flanges, boilers, generators and other temperature sensitive equipment our energy saving jackets: • Are highly resistant to thermal transactions • Provide minimal heat loss from your building’s pipe work • Can withstand temperatures of up to 1200°C • Protect external valves and flanges against frost protection • Quick and easy to unfasten using multiple fastening systems We have an experienced team of engineers who can visit your site to carry out an energy survey and

calculate your potential carbon emission savings.

With projects completed for many plant rooms throughout the UK our clients include hospitals, universities, local authorities, the Ministry of Defence and many other blue chip organisations.

Call us on 0115 978 0554, or email energy@cordtape.co.uk to find out how much we can help you save on your next energy bill.

Cordtape Energy Management Systems Ltd www.cordtape.co.uk

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ENERGY

FACING UP TO THE CHALLENGES OF AUSTERITY Money is tight – and will get tighter – that has been made very clear. But there are still opportunities to reduce energy consumption while meeting regulatory compliance targets, as Alan Aldridge, executive director of the Energy Services and Technology Association explains WHILE THE HEALTH SERVICE may be protected from the worst of the public spending cuts that are due to be implemented over the coming years, it has been made clear that some savings will still have to be made. Furthermore, the burden of regulatory compliance is not likely to diminish and in some areas, including those related to energy and climate change, the expectations are almost certain to increase over the coming 18 months.

The coalition government, as well as other administrations across the European Union, is currently calling for a tightening of the targets for emissions reductions. The argument goes that, post-recession, the cost of achieving a 30 per cent cut against 1990 levels is not much more than that of a 20 per cent cut proposed before the recession began. The 20 per cent target was always ambitious; a 30 per cent figure is going to be hugely challenging – and the public sector will be expected to take a lead. Indeed, the leading role of the public sector is clearly set out in several of the energy-related directives approved by EU lawmakers in recent years.

While new targets may take a while to filter down from European level to the UK domestic agenda, others are already in the pipeline. Importantly, the revised Energy Performance of Buildings Directive (EPBD) has to be “transposed” (in official terminology) into UK law by July 2012. The EPBD legislation encompasses such elements as Energy Performance Certificates (EPCs), Display Energy Certificates (DECs) and the Building Regulations.

DISPLAY ENERGY CERTIFICATES One area of immediate relevance to the health sector is a tightening of regulations on the application of Display Energy Certificates. These are currently required for all buildings with more than 1,000m2 of useable floor space that are owned by publicly-funded organisations and frequently visited by the public.

Two changes are included in the recast of the Directive. First, DECs are being extended to include private sector buildings and secondly the 1,000m2 threshold is being reduced in two stages to 250m2. That means that virtually all health sector buildings open to the public, from both public and private sectors, will have to produce DECs every year from July 2015 (January 2013 for buildings of more than 500m2).

Now in theory, Display Energy Certificates are relatively easy to produce – much more so than Energy Performance Certificates (EPCs).

This is because they are essentially a record of how efficiently a building is being run and so rate the annual energy consumption against a benchmark figure for the type of building (no long searches for building plans in order to compile an asset rating for an EPC).

Clearly, the essential data are accurate meter readings for energy consumption. Conversion factors to arrive at emissions levels and benchmarking figures are standard terms.

In practice, though, they typically require a great deal of time for engineers and energy managers who have to read the meters, validate billing information, complete the calculations and produce the reports. With the revised Directive extending the reach of the DEC regulations to almost all buildings, a solution needs to be found over the coming months that streamlines the collection and processing of this information – otherwise the task will become a great deal more

can still be achieved with less reliance on automation. The recent launch of a European standard for energy management provides a means for establishing a common framework across the UK. EN 16001 is the product of negotiations between the member states of the EU. Several members of ESTA represented UK interests on the technical committee.

This standard outlines a common framework within which to position energy management procedures and technologies.

The new standard will provide a common template for reporting and evaluating performance. For public sector organisations, the ability to compare and contrast across the whole sector has an obvious appeal.

This platform will also make it simpler to exchange best practice – and there is a great deal of this around which can be adopted, adapted and exploited for specific circumstances. As EN 16001

The leading role of the public sector is clearly set out in several of the energy-related directives approved by EU lawmakers in recent years cumbersome very quickly. And the growth in the volume of reports that needs to be completed also raises the issue of guaranteed data quality and consistency. As DECs are legal requirements, finding such a solution is urgent.

The arrival of automatic Monitoring & Targeting systems (aM&T) over the last few years has proved an effective way for organisations with a variety of sites and/or processes to adapt to increasing demands in terms of quality and quantity of information.

The latest aM&T systems will even produce DECs automatically – and that must surely be attractive to the hard-pressed energy and facilities manager. However, although the costs of these systems are coming down, driven both by a continuing fall in the cost of electronic components and also the increased numbers in which these systems are being sold, they still cost money and that may not be readily available. It should be noted, though, that all the evidence shows an attractive payback period for investment in this technology.

A SYSTEMATIC APPROACH One thing that aM&T provides is a high degree of consistency of reporting. Yet this

becomes better known (it was only launched a few months ago), systems and services providers will link in to it.

Importantly, the standard ushers in a new, systematic approach to the management of energy, bringing together all the processes, procedures and responsibilities that may sometimes seem only superficially connected.

It will therefore be a powerful tool for coordinating both energy efficiency campaigns and proposals for further investment. As it is based on existing management systems standards such as ISO EN 9000 Quality Systems and ISO EN 14001 Environmental Management Systems, the structure will be easily accessible to other parts of an organisation, which will make it easier for energy professionals to explain and justify their proposals.

THE CRC ENERGY EFFICIENCY SCHEME Most larger organisations in the health sector are currently getting to grips with the CRC Energy Efficiency Scheme, which involves not only carbon trading but also league tables for energy performance. These tables will have on-going financial implications for participants.

A robust, structured framework such as EN

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Health Business | Volume 10.5

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ENERGY

16001 will make the tasks of forecasting expenditure on emissions allowances, reporting and reconciliation much easier.

For the first couple of years, early action metrics will play an important part in league table position. The two qualifying measures are (a) the installation of aM&T and (b) formal membership of a scheme that provides for continuing improvement in energy performance. Until recently, only the Carbon Trust Standard (formerly the Energy Efficiency Accreditation Scheme, developed originally

by ESTA) counted under the second metric, but BSI has now launched a Kitemark scheme based on EN 16001 and the government has approved this as an equivalent, and therefore equally acceptable, scheme. We believe that giving organisations a choice about the route they take to demonstrating continuing improvement can only be a good thing.

In the first few years at least, the costs associated with carbon will be small compared with the overall energy bills.

When full market trading comes in, that may change, depending on how aggressively the carbon agenda is being pursued.

CAPTURING BEST PRACTICE Two further initiatives should soon help health sector managers to optimise performance by encouraging the sharing of best practice. An international standard on energy auditing is currently being developed. Within the EU, the UK is widely recognised as having taken the lead in developing energy audits; hence several ESTA members are involved in drafting this standard.

Unlike EN 16001, which does not have global reach (the USA has been drawing up its own version and any eventual ISO standard will have to take both into account), the European committee is working closely with its American counterparts to achieve a common auditing process that will work on both sides of the Atlantic – and well beyond. We hope that the auditing standard

will be in place within the next couple of years as this will allow users to commission energy audits knowing the standard, consistency and quality they can expect.

Ultimately, though, we all need to know that the savings we are making are accurate and that the methods used for assessing and quantifying these savings are robust.

Equally, when examining the claims for projected savings made by suppliers of products and services, it is important to have some way of validating those claims.

One method, developed primarily for the evaluation of service delivery contracts in the USA and then introduced into continental Europe, is called the International Performance Measurement and Verification Protocol (IPMVP). It provides a standard format for identifying and confirming savings that result from the installation of specific products or even from a project involving multiple systems (such as a new energy centre).

ESTA believes that such a system will give energy users confidence in the figures for projected savings offered by suppliers of energyefficiency products and services. It is therefore taking a leading role in the introduction of the scheme to the UK. One of ESTA’s members, powerPerfector, is already using IPMVP to quantify the effectiveness of its services and we expect this to become a widely adopted evaluation technique over the coming years.

FUNDING PERFORMANCE IMPROVEMENTS Despite energy efficiency improvements traditionally offering rapid payback and excellent value for money, they have rarely if ever been among the top investment priorities for most organisations. With the expected cutbacks on spending, funding will be even scarcer.

Before abandoning projects in the face of a refusal from the finance department, it is worth looking at some of the other routes to funding. There are still grants available

from central government for energy audits and for some renewable energy projects.

But there are also a number of wellestablished Energy Services Companies (ESCOs) and Contract Energy Management (CEM) providers. Provided schemes meet their acceptance criteria, they will provide the necessary plant, equipment and (often) staff to achieve the savings. Payment is through either a service fee or through an arrangement whereby money saved by the investments is shared between provider and client.

For the in-house facilities manager, this provides a way of accessing both funding and specialist expertise without incurring up-front costs. And in terms of risk, the health sector represents one of the more secure sectors with which to work.

We are moving into a period of austerity so savings will be increasingly important, especially given the continuing priority the government is giving to climate change.

There are still opportunities to achieve greater efficiency, lower emissions and cuts in energy consumption. However, realising them may require greater use of all the various resources available to the energy and facilities manager.

The Energy Services and Technology Association (ESTA) represents over 100 major providers of energy management equipment and services across the UK.

FOR MORE INFORMATION Web: www.esta.org.uk

Induced Energy launches its invisible keep hot iPlate K INDUCTION hob manufacturer Induced Energy has introduced a new induction keep hot system, the iPlate. Invisible under a Swanstone counter, a food preparation area can become a hot servery at the flick of a switch when using induction-friendly containers.

Ideal for small kitchens or long servery counters, the iPlate remains cool except where the container is in contact with the surface. This means patients and staff are at much less risk of burns and scalds compared with traditional keep hot systems.

With seven power settings there is no problem in keeping food hot. At the end of

hot unit under Ceran glass or Swanstone.

This new addition continues Induced Energy’s commitment to energy saving technology. With no waiting for the surface to heat up and power only used when the hot food container is placed on the iPlate, energy use is kept to a minimum.

Keeping hot while keeping cool, iPlate is the green alternative to traditional keep hot systems.

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FOR MORE INFORMATION service the iPlate is easy to clean and once again can revert to a food preparation area.

The iPlate is also available as a visible keep

Tel: 01280 705900 Fax: 01280 705270 E-mail: rosie@inducenergy.com Web: www.inducedenergy.com

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Visit the website to view the categorised product finder

Looking for answers to your energy questions?

Find out how to reduce energy costs by: • Using existing, economic technology • Improving site management, operations, maintenance • Using legislation like Carbon Reduction Commitment to your advantage • Gaining funding for good projects

Ask ESTA how to identify approaches that will work on your sites and reduce costs now.

For the all advice and guidance you’ll need visit us at www.esta.org.uk

PowerSave Dynamic Voltage Optimisation

Energy consultancy from The Mccaul Group

OWERSAVE™ is an innovative technology that helps organisations make some of the biggest financial savings possible on their energy bills by reducing and regulating the mains voltage used to power electrical equipment. PowerSave™ products deliver energy savings of up to 25 per cent – they are proven, highly efficient, and achieve a return on investment with minimal ongoing maintenance requirements.

PowerSave™ is a division of UK based Claude Lyons, the longest established company specialising in voltage control technologies.

Backed by more than 75 years of experience in the field of high quality power control solutions, the technology is very much of its time as organisations look for new ways to save money and demonstrate their commitment to the environment.

With extensive experience in the global medical industry, Claude Lyons works with companies such as Toshiba Netherland, GE China, Varian and Elekta, and hospitals

HE MCCAUL GROUP is an independent and fully accredited energy consultancy company employing qualified and experienced building services engineers and energy consultants. Two companies make up the McCaul Group; Patrick McCaul Environmental Consulting Engineers, highly qualified and experienced M&E consultants, and Renewable Building Technologies Ltd., dealing specifically with energy management, energy efficient design and renewable technology installations for all commercial sectors. The Group is focused on providing high quality, high value professional services by creating strategies for success tailored to suit client needs.

The introduction of the CRC Energy Efficiency Scheme means that it is now even more important that the healthcare estate becomes increasingly focused on reducing energy consumption, associated

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across the UK rely on its voltage stabilisation technology to protect sensitive medical equipment from power supply fluctuations.

Through a comprehensive site survey that includes an equipment assessment, power supply analysis and three-phase electricity logging, PowerSave™ develops a bespoke energy saving strategy for each site that achieves maximum efficiency and stability without disrupting day-to-day operations.

FOR MORE INFORMATION Contact: Oznur Lawrie Tel: 01992 701556 Fax: 01992 788000 E-mail: olawrie@ claudelyons.co.uk Web: www.powersave technology.co.uk

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costs and carbon emissions. There must be robust strategic energy plans in place to deliver CRC. We can provide the specialist support and advice that is needed to help reduce energy consumption and carbon emissions and with the added value of achieving financial savings on a recurring basis. We can help with the energy management and planning that will now be required.

FOR MORE INFORMATION Address: Bankmore Business Park, Omagh BT79 0BE Tel: 02882 251155 E-mail: energy@pmccaul.com Web: www.pmccaul.com

Health Business | Volume 10.5

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ENERGY

SHRINKING FOOTPRINTS, GROWING OPPORTUNITIES An increasing number of NHS organisations are taking part in 10:10, a national campaign to reduce greenhouse gas emissions by 10 per cent a year, writes Luke Malcher THE NHS IS COMMITTED to a ten per cent reduction in its carbon emissions by 2015, in line with the 2008 Climate Change Act. However, since the carbon footprint of the NHS has increased by 40 per cent since 1990, a strong, early response will be necessary to reverse this trend and achieve these goals.

Many NHS leaders are already meeting the challenge head-on by implementing decisive carbon reduction plans. As well as helping to meet regulatory requirements, plans for reducing emissions also present an opportunity for extraordinary financial savings: the NHS Sustainable Development Unit (SDU) estimates that the NHS can save at least £180 million per year just by reducing its carbon emissions.

TALKING ABOUT CARBON A strong communications strategy can help to unlock the full value of a carbon reduction plan.

Beside investment-led measures to improve equipment and infrastructure, NHS organisations can save ten per cent on their energy spend simply by encouraging staff to take everyday action to cut energy usage. Energy awareness campaigns have reduced carbon emissions by focusing staff attention on the use of lighting, heating and lifts in the workplace, by promoting low-carbon travel, and by encouraging home working and better use of technology.

Longer-term reputational benefits also accrue from a well-communicated carbon campaign. The NHS is a major player in the debate on carbon emissions and climate change. Engaging staff and the wider community in a discussion about climate change enhances the reputation of the NHS among patients, partner organisations, existing and prospective staff, and external suppliers.

THE 10:10 CAMPAIGN Founded in 2009 by the makers of climate docu-drama ‘The Age of Stupid’, 10:10 has swiftly become the foremost dedicated climate change campaign in the UK. Conceived with the aim of getting all sectors of society to cut their carbon by ten per cent in 2010, the campaign has so far attracted the support of around 90,000 individuals, 3,000 businesses and 4,000 public and non-profit organisations.

10:10 is set to continue into 2011 with the same central message – that anyone can cut ten per cent off their carbon footprint through simple everyday actions and energy awareness.

The campaign’s inclusive approach helps to bridge the gap between carbon-cutting in

the workplace, and the more personal eco commitments made by individuals. This makes it an invaluable tool for sustainability coordinators and communication officers alike. 10:10’s focus on everyday actions can help to translate the sometimes arcane language of sustainability into one that is easily understood by everyone.

TRAVEL Implementing travel plans across the NHS could reduce its carbon footprint by around 90,000 tonnes a year. Adjusting the way we get around can cater to the so-called “triple bottom line”; improving health, the environment and departmental finances. The SDU estimates that if five per cent of business miles travelled by NHS were displaced by video and teleconferencing, the NHS could save £14 million in time, petrol and parking costs.

John Simpson, director of estates and facilities, the Nottingham University Hospital Trust said: “As part of our 10:10 pledge, we’ve aimed to reduce the amount of travel required of staff and patients moving between the trust’s two busy campuses. We have put on a free bus service in partnership with the council, linking it with Nottingham’s tram system and its park-and-ride scheme. When a nearby multistorey car park was closed, it provided a wellestablished alternative transport infrastructure that helped prevent 800,000 car journeys, or the equivalent of 300 tonnes of CO2 a year.

“We’ve also introduced sustainable procurement. Now each of the 7,000 pints of milk consumed by the hospitals each week is sourced through contracts with local farmers, which has reduced its food miles by at least 90,000 miles.”

PROCUREMENT Without a doubt, the most carbon-hungry activity for the NHS is procurement. Carbon associated with the extraction, processing, assembly, packaging, transport, storage and handling of products and materials accounts for 60 per cent of carbon emissions for the whole of the NHS. Selective purchasing and waste minimisation in pharmaceuticals alone can produce £90 million a year in cost savings, as well as saving the equivalent of 22,000 tonnes of CO2 every year.

Trevor Payne, University College London Hospitals said: “At UCLH, procurement accounts for around 76 per cent of our carbon footprint. We have sought to embed carbon considerations into our purchasing

activities. In particular, we work with so called neutral vendors who collect, store and distribute efficiently from a central hub.”

ON SITE ENERGY USE Any NHS organisation with an energy spend over £50,000 will qualify for a free energy audit from the Carbon Trust. This will show up the opportunities for energy saving measures, either in the form of “invest to save” schemes, or lower cost staff engagement. The opportunities are huge. Simply reducing the NHS thermostats by one degree could save it £2 million a year and nearly 50,000 tonnes in carbon emissions.

Trevor Payne said: “We estimated that computers left on overnight waste up to 75 watts of electricity per machine. Across a network the size of ours, this adds up. Although our energy awareness projects have had considerable success, some employees forget to switch their computers off at the end of the day. Energy wasted by unused computers costs around £300m and produces 3m tonnes of CO2 a year. On top of this, the heat generated by unused computers puts an unnecessary extra burden on the air conditioning system.

Our solution was to install an automated power management system, designed to turn off PCs when they’re not in use.”

STAFF ENGAGEMENT As well as producing surprisingly large cost and carbon savings through behavioural change – the SDU estimates that staff energy awareness could save the NHS £5 million a year – communications campaigns such as 10:10 generate ideas and foster a sense of pride and involvement among staff, patients and the wider community.

Jilla Burgess-Allen, NHS Stockport said: “We’ve put staff engagement at the heart of Stockport’s 10:10 campaign. We’ve drafted a team of 20 voluntary ‘green champions’, to share carbon cutting ideas and support their colleague’s efforts. Staff can find a green office guide, an eco-footprint quiz as well as all kinds of carbon tips on our intranet, as well as getting a 10:10-themed bulletin e-mail which gives them some monthy ideas to cut their ten per cent.

We’ve found incentives and rewards to be more effective than punitive approaches, so this year we are introducing a new green staff award.”

FOR MORE INFORMATION Sign up at www.1010uk.org/organisations

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FIRE SAFETY

RAISING THE STANDARD The highest standards for fire protection systems in healthcare premises are needed, says Graham Ellicott, chief executive officer of the Fire Industry Association IT WAS KENNETH OLSEN, the founder of Digital Equipment Corporation, who in 1977 said: “The nicest thing about standards is that there are so many of them to choose from.” Well, the Fire Industry Association disagrees with this statement! There may be a lot of different standards but for fire protection systems there is only one choice and that’s the highest possible standard.

With this in mind, the Fire Industry Association (FIA) has long chosen to set its sights on increasing the standard of fire protection installations in the UK, so that they are raised to the highest possible level and become the automatic choice for clients and specifiers.

FIRE PROTECTION COMPANIES So what does it take to be a fire protection company? Well, perhaps surprisingly, anybody can set themselves up as a supplier and installer of fire protection systems. Get yourself a white van, access to the job, a credit card to purchase products and you’re in business!

The one other thing that you will need, of course, is a computer so that you can print your own certificates that infer that your work is of the highest standard and these typically might read “We at Friendly Fire take a pride in our work at ‘I Curem Healthcare’, so much so that we stand behind it and the proof of its quality is evidenced by this piece of paper”. Some of these certificates may even have a legible signature on them.

The word irony is defined by the Little Oxford Dictionary as “expression of one’s meaning by language of opposite or different tendency” and the previous paragraph should be read

with that in mind. That’s not to say, however, that the above scenario doesn’t happen.

ASSURING HIGH STANDARDS So how do you assure that the fire protection systems in your hospital or medical centre are of the highest standard?

In the UK there are Third Party Certification schemes for suppliers, installers and maintainers of fire protection systems.

The government acknowledges these and says in Approved Document B (the Fire Safety guidance document) of the Building

Regulations of such schemes: “Building Control Bodies may accept the certification of products, components, materials or structures under such schemes as evidence of compliance with the relevant standard.

Similarly, Building Control Bodies may accept the certification of the installation or maintenance of products, components, materials or structures under such schemes as evidence of compliance with the relevant standard.”

Similarly within the government guidance documents for existing buildings published in support of the Regulatory Reform (Fire Safety)

A company in which you can place your trust IRE AND RISK Management Support Services has an excellent track record of working with NHS Trusts providing a full range of cost effective fire safety support services. This includes fire risk assessment, fire safety training, and technical fire safety advice and consultancy services.

FARMSS will provide tailored fire safety support packages that are designed to meet your legislative responsibilities and at the same time reduce the financial impact of delivering these services. FARMSS will ensure that resources are focused firmly on those areas of highest organisational risk.

Our electronic Premises Asset Management System provides an extremely powerful tool

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for managing all aspects of fire safety across your building portfolio. This integrated system provides a structured overview of prioritised fire safety improvement action

plan requirements together with associated costs providing ease of management control.

The system also produces management reports highlighting progress and flags poor performance, these facilities are not available within conventional systems.

FARMSS provides a full range of specialist fire safety and health and safety support services.

FOR MORE INFORMATION Old Wool House 58 Old Wool Lane, Cheadle Cheshire SK8 5JA Tel: 0161 4884863 E-mail: info@farmss.co.uk Web: wwww.farmss.co.uk

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Visit the website to view the categorised product finder

4281 - Health Business Mag Ad XC1_Layout 1 08/07/2010 11:42 Page 1

Eton Fire Ltd – specialists in fire protection systems TON FIRE LTD is an LPCB approved and highly respected fire protection company with a proven track record in new build, alterations and maintenance in all market sectors.

Our recent projects and clients include Castleoak Care Partnership (Care Homes and Supported Housing), Kent’s Building Schools for the Future (BSF) Programme, Wembley Stadium, Bluewater Shopping Centre, Marston Aerospace, HSBC and Canary Wharf to name but a few.

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approach to business. The corner stone of our success comes from developing strong relations with our clients from the very beginning and our hands-on approach promotes excellent cooperation ensuring we provide the best solution to meet your specific requirements every time.

We are confident in our ability to under-take projects of any size or complexity, and will be delighted to discuss how we can be of assistance to you.

FOR MORE INFORMATION Please visit www.etonfire.com or call 0207 517 6300 for further information.

Your one-stop-shop for fire protection services OUR CHOICE of fire protection supplier and contractor is critical. That’s why Fire Lining Systems Ltd carries out all aspects of structural and passive fire protection and firestopping throughout the UK. We provide up to four hours fire protection to new builds, care homes, refurbished premises and Grade 2 Buildings for all sectors of the community. We have over 35 years experience in the construction industry and our commitment is backed by an experienced staff of engineering professionals, technicians, and project managers.

Our Services include: • Structural steel protection • Firestopping • Cavity fire barriers • Intumescent spraying • Wood and timber fire protection • One and two hour steel fire walls • 1/2 an hour and one hour partitioning • Grade 2 buildings protection

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• Fire doors As well as servicing our existing clients, we, of course, wish to establish new working partnerships with companies such as yours.

We are always available to meet and discuss current or proposed fireproofing and protection requirements. Fire Lining Systems Ltd is an ISO 9001, ISO 18001, CHAS, FIRAS and Constructionline Accredited company.

FOR MORE INFORMATION Should any of our services be of interest, please contact us on 0191 4165732 or e-mail info@firelinings.co.uk.

Alternatively, please visit our website: www.firelinings.co.uk

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FIRE SAFETY

Order they stipulate: “Third-party certification schemes for fire protection products and related services are an effective means of providing the fullest possible assurances, offering a level of quality, reliability and safety that noncertificated products may lack. This does not mean goods and services that are not thirdparty approved are less reliable, but there is no obvious way in which this can be demonstrated.

“Third-party quality assurance can offer great comfort to employers, both as a means of satisfying you that goods and services you have purchased are fit for purpose, and as a means of demonstrating that you have complied with the law.”

Under these schemes the competence of the companies and its operatives to supply, install, and maintain a particular type of fire protection system is assessed.

CERTIFICATE OF CONFORMITY For new construction work at the end of the installation, the fire protection contractor supplies a ‘Certificate of Conformity’ to his client along with the specification and details of the work done. The FIA believes that any Certificate of Conformity that is not backed by a third party certification scheme

where appropriate should be treated with some distrust. Since April 2007 this supply of information has been formalised in Building Regulation 16B, the rationale of this being that the information can then be used by the Responsible Person as designated in the Regulatory Reform (Fire Safety) Order to operate and maintain the building in reasonable safety.

For routine maintenance work you as the hospital fire officer or medical centre manager should look carefully at the documentation that you are supplied by the fire protection company to see if it references a Third Party Certification Scheme. If it doesn’t, you should ask why not as without this you only have the word of the company that did the work that it is of the appropriate standard, and they would say that, wouldn’t they?

As a building gets older, occupiers will make changes and these may mean that the fire safety measures are weakened. A new tenant may, for example, increase the fire load in a certain part of the building or put in new offices that require extra smoke detectors. In theory all of these changes should be documented in the CDM (Construction, Design and Management) file. This provides a record of all matters to do with the health and

safety of those concerned in the construction, management and use of a building.

In summary, the FIA believes that: • The highest possible standard of fire protection is the only acceptable choice for all involved in the design, construction and maintenance of the UK’s healthcare premises • To raise the standards in the UK, the industry should use only those companies that are third party certificated • A complete CDM file will enable the building’s fire protection to be properly maintained to meet the requirements of the Building Regulations.

Back to Kenneth Olsen, who also said in 1977: “There is no reason for any individual to have a computer in his home.” Well, he certainly got that one wrong.

Similarly the FIA strongly suggests that for your hospital or medical centre you will also get it wrong if you accept anything less than the highest standard of fire protection, and that this should be evidenced via third party certification.

FOR MORE INFORMATION Web: www.fia.uk.com

Eurotech Fire Systems Limited: New fire industry player – new detection protocol

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EHIND A NEW NAME, Eurotech Fire Systems Ltd., is one of the most experienced teams in the fire industry.

Our stated aim is to save lives and property by changing the way fire detection products are designed, manufactured and procured.

Traditionally, the choices available to health care providers in purchasing fire detection systems were either through a closed or open protocol. Eurotech has developed MESH, Making Every System Happen, offering fullyapproved, leading-edge, single-brand detection technology to fire and security installers worldwide without on-going contractual ties.

Since its launch, Eurotech has introduced industry-leading, patented technology.

For example, the Optical Detector offers a unique, patented design combining optical detection with a built-in sounder; simplifying installation, reducing cabling and integrating critical detection components with or without an isolator.

Eurotech has focused much of its research and development on expanding detection system capacity. The result is a range of detection systems that offer up to 254 addresses per loop for detectors and/or modules or sounders, the highest per-loop address volume in the industry.

All Eurotech fire detection products are offered under its MESH protocol, providing

independent or in-house installers with the reassurance of fully-approved technology under a single brand, but without being tied to the manufacturer for all system components or maintenance contracts.

Hampshire-based Eurotech Fire Systems Ltd. has been established by former Apollo sales and marketing director Michelle Agius, who has put together arguably the most experienced team in the fire detection industry, including export sales manager Tim Williams, UK sales manager Phil Walford, Vincent Agius sales manager, Fiona McGregor office manager, operations manager Terry Huppler, and design manager Alan Capaldi-Tallon who has some 10 individual US and UK fire patents to his name.

Working with world class suppliers Nittan and Advanced Electronics, Eurotech has already established a sales network in the Middle East, Mainland Europe and Eastern Europe, with further partnerships currently being agreed.

“We are determined to revolutionise the fire detection industry,” states Agius. “What really matters to us is saving lives and businesses and we believe the best way to do this is to provide unfettered access to the latest technology for architects, specifiers and installers.

“Public building design has changed dramatically, particularly in the health and education sectors, and fire detection technology has to match those changes.

This means that a totally reliable, approved single source of technology is important, but other elements such as design and installation are often better sourced elsewhere. If that combination saves a life, that is what really matters and Eurotech’s MESH protocol allows that freedom.”

FOR MORE INFORMATION Tel: 020 31410999 E-mail: enquiry@eurotechfire.com

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Visit the website to view the categorised product finder

Plant displays from Europlants Interiors UROPLANTS INTERIORS LTD is a leading company in the provision and maintenance of interior plant displays in the South of England and our experience is in both the private and public sectors.

We currently design, install and maintain many projects, from individual plant displays in offices, waiting rooms and receptions, to group plantings in atriums, indoor planting beds and bespoke planters.

The combination of plant and container is vital, we feel, to create a healthy atmosphere and sense of well being in the work place.

Once you have contacted Europlants Interiors Ltd, we will enhance the environment for patients, visitors and staff alike, to promote faster recovery and improved working conditions. We will work closely with the client and where necessary, guide you in the right direction, for the choice of plant and/or container.

The presence of interior plant displays, not only bring

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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 us as it is to our customers so all vehicles are prominently liveried, staff uniforms are distinctive and

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a breath of fresh air into the building, but also softens it and gives an improvement to the aesthetics of the the space. Once installed, Europlants Interiors Ltd. will maintain your displays to the highest standard, at a most competitive price.

In addition to interior plants, Europlants Ltd. carries out all forms of commercial exterior landscape maintenance, from mowing, weed killing, hedge cutting, green waste removal and seasonal plant displays.

FOR MORE INFORMATION Tel: 01825 890811 Fax: 01825 890754 E-mail: henry@europlants.ltd.uk Web: www.europlants.ltd.uk

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.

Botanica Nurseries Ltd Visit our website to see the fantastic range of plants and flowers available

www.botanicanurseries.co.uk Plants are proven to:

Plants can improve:

Reduce air pollution Increase oxygen levels Reduce noise levels Increase happiness Reduce stress

Staff productivity Patient recovery Hospital dĂŠcor Visitor satisfaction Air quality

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Choose the best plants Keep them healthy Minimise costs Give a personal service Keep accurate records

Great plants Fantastic fresh flowers Beautiful Xmas trees Realistic replica plants Grounds maintenance

Welcome to Avon Landscapes ltd, we are a Bath based landscaping company, providing a quality service for the surrounding areas.

Established in 1985 Avon Landscapes Ltd is one of the leading landscape construction companies in the Bath Area. We carry out both hard and soft landscaping projects within a 40 mile radius of Bath, as well as Commercial and Industrial Landscape Maintenance and enhancement works on numerous sites throughout the South West.

Greenacres, Woolverton, Nr Bath, Somerset Tel: 01373 830789 Fax: 01373 830902 E-mail: prh@avonlandscapes.co.uk www.avonlandscapesltd.co.uk

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Contact Botanica 01753-647476 07774-972939 enquiries@botanicanurseries.co.uk

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HOSPITAL GROUNDS

HEALING THE NATION, ONE PLANT AT A TIME A well thought-out interior planting scheme in healthcare settings has a value beyond aesthetics, writes Kelly Conway from the British Association of Landscape Industries FACED WITH THE COMPLEX, long and costly process of the design and build of a health facility, planners may often consider gardens and indoor planting schemes as desirable but nonessential. However research suggests plants in healthcare may have a value beyond the aesthetics. Let’s look at the benefits of a well thought out interior planting scheme as well as review successful cases.

The inclusion of gardens and planting schemes in health facilities has been around for many years, dating back even as far as the middle ages where monasteries created gardens to soothe the ill. The traditional view of hospitals and health facilities as perceived by patients

extensive planting scheme to ensure children have access to views of nature in the hospital.

The architects Hopkins Architects of London wanted to create the perfect environment for children to recover so many children who were treated at Guy’s were consulted about the layout, design, colour schemes and themes for the interior of the hospital. It was decided the third floor would have the theme of ‘Beach’, and included in this was a planting scheme which involved the installation of five 1m x 1.2m brushed aluminium containers containing quad-stemmed Veitchia palms reaching 4.5m high in total. Each completed planter weighs in at 1.5 tonnes each; the planters have been

Creating a calming and less clinical environment in health facilities can also benefit a patient’s thoughts and feeling towards hospitals in general, creating a less daunting environment especially for children is clinical, unwelcoming places which carry great stigma, a well thought through design combined with clever use of planting can provide a calming effect, pleasant nature and create a escape from more clinical settings.

A SOOTHING AFFECT A study in 1984 by Roger S. Ulrich, Ph.D, Professor of Architecture at Texas A&M University, examined whether a view of vegetation had a direct effect on health and recovery from illness. Randomly placed patients who had a view of vegetation and plants had significantly reduced recovery times and also more positive notes in their records compared to those who simply had a view of a brick wall and no planting.

Creating a calming and less clinical environment in health facilities can also benefit a patient’s thoughts and feeling towards hospitals in general, creating a less daunting environment especially for children. Visiting a clinical, stressful environment can have an adverse effect on a child’s development and recovery, creating a fun, playful environment with plants could be a solution to this.

A planting scheme on the third floor of Evelina Children’s Hospital won a BALI National Landscape Award in 2009. It was installed by BALI Members Gavin Jones.

The Evelina Children’s hospital was opened in 2005 and is designed as a modern, fun space for children to be treated and recover.

A crucial part of the design process was an

placed on the grid line above the structural pillars to distribute the extra weight evenly.

The installation of the plants proved to be very testing process and careful planning by Gavin Jones Ltd was needed with each palm having to be craned up to the third floor with delicate manoeuvring. To dress the planters, the company decided to continue the hospitals fun and colourful theme and place light-weight hollow plastic balls, 50mm in diameter, on top of the compost. This was not only a great way to include some blasts of colour but also from a more practical view to prevent the children from digging in the soil. A protective layer was then put on top of the balls to stop the children removing them or throwing them around.

The balls also allow the maintenance team to water the palms without any difficulty while providing an architectural finish to the project.

BENEFITS FOR STAFF AND VISITORS It is not only the patient’s recovery who may benefit from the introduction of planting schemes but also visitors, family and staff who can often find themselves in stressful, painful emotional situations at health establishments and feel the need for the calming effect or escapism of planting schemes and gardens.

Great Ormond Street Hospital in London understood the value of a private garden for staff after two of its members of staff had been lost in the 7/7 bombings. The hospital wanted to create the opportunity for contemplation in recognition of the victims and also a space

as an antidote to the hospital environment to improve the working experience for staff.

BALI Registered designer member Andy Sturgeon designed the roof garden on the seventh floor of the newly built Octav Botnar wing of the hospital. The design solution needed to be flexible and multi functional, with semi private areas for sitting and relaxing, socialising and eating, as well as having the ability to host large functions. The design solution created by Andy Sturgeon makes clever use of level changes and planting to create horizontal planes within the garden. These help define separate areas, whilst ensuring good circulation and easy access. The end result is an area where 3,000 hospital staff have access 365 days a year to an oasis of calm in there otherwise stressful day to day jobs.

FOR MORE INFORMATION For more information about garden and planting scheme design and installation in health establishments please contact the British Association of Landscape Industries www.bali.org.uk, contact@bali.org.uk

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CLINICAL WASTE

WHAT IS HEALTHCARE WASTE? The regulatory and legislative requirements surrounding the management of clinical waste can be confusing at times. The Scottish Environment Protection Agency clarifies THE REGULATORY AND LEGISLATIVE requirements surrounding the management of clinical waste can be confusing at times. This confusion can be further compounded by the differing legislative and regulatory regimes experienced across the UK’s devolved administrations.

Although there are a few subtle differences in the way The Scottish Environment Protection Agency (SEPA) regulates the management of healthcare waste in Scotland, the majority of the guiding principles are consistent throughout the UK. In the UK, clinical waste or healthcare waste is the term used to describe waste produced from healthcare and similar activities that may pose a risk of infection or may prove hazardous.

DIFFERENT MEANING It can have different meanings to different people and can be defined in different ways, however, the most commonly used definition, can be found in the Controlled Waste Regulations 1992. In practice, healthcare waste can be divided into two categories of waste materials: • waste which poses a risk of infection • medicinal waste.

There is no specific legislation pertaining to healthcare wastes other than paragraph 28 (use of autoclaves) and 39 (secure storage) exemptions found in the Waste Management Licensing Amendment (Scotland) Regulations 2006. Non-hazardous healthcare wastes will be subject to the usual Duty of Care whilst hazardous healthcare waste will be subject to the provisions of the Special Waste Regulations 1996 as amended.

CLASSIFICATION AND ASSESSMENT UK waste producers (except those producing domestic waste) have a legal requirement (Duty of Care) to describe any waste it produces or disposes of using a classification system called the European Waste Catalogue (EWC).

This catalogue classifies waste materials and categorises them according to what they are and how they were produced. Healthcare wastes can be found in sub chapters 18 01 (wastes from natal care, diagnosis, treatment or prevention of disease in humans) and 18 02 (wastes from natal care, diagnosis, treatment or prevention of disease in animals) of the EWC. The codes assigned by the waste producer should reflect the practices that give rise to the waste. If a container contains a number of wastes then care must be taken to assign the most appropriate code, normally the absolute hazardous waste code if any such waste is

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present. Assigning the most appropriate code is essential to ensuring that the waste is handled, treated and disposed of appropriately.

Clinical or healthcare waste may be hazardous or non hazardous and like all wastes it must be classified and assessed appropriately. Guidance on the classification and assessment of clinical waste as special (hazardous) waste can be found in the guidance document ‘Hazardous Waste: Interpretation of the definition and classification of hazardous waste (WM2)’.

SEPA takes the view that unless it can be satisfactorily demonstrated that healthcare wastes, i.e. those described by Chapter 18 of the EWC and EWC 20 01 31, have been adequately segregated and categorised then its default position is that “healthcare waste should be assumed to be special (hazardous) waste until and unless proved otherwise”.

PRESCRIPTION ONLY MEDICINES Since July 2004 most prescription only medicines (POMs) ceased to be special waste, although they may still fall under other regimes, e.g. be controlled drugs, only cytotoxic and cytostatic medicines are now classified as

special (hazardous) waste. However, each individual medicine should be assessed fully as other dangerous substances may be present potentially making it hazardous or special waste.

Hygiene wastes, which generally comprise of used sanitary towels, disposable nappies from toilets and baby changing areas in places of work, leisure and entertainment facilities etc. are neither clinical nor hazardous waste.

This is because these wastes are assumed to arise from a generally healthy population and hence the risk of infection is very low. This is very important as there is often pressure to (mis)classify san-pro waste as hazardous healthcare waste for aesthetic reasons.

The Scotland and Northern Ireland Forum for Environmental Research (SNIFFER) has produced a guidance document, which provides assistance to those managing hygiene waste produced as a direct result of healthcare and non-healthcare activities.

MANAGEMENT OF HEALTHCARE WASTE Clinical waste should be segregated from other types of waste and be treated and disposed of appropriately in suitably permitted,

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CLINICAL WASTE

licensed or exempt facilities on the basis of the hazard it poses.

The majority of clinical or healthcare waste producers will devise and implement their own policies and procedures however the NHS, the biggest producer of clinical/healthcare waste in the UK, is an excellent source of guidance.

NHS Scotland has produced the Scottish Hospitals Technical Note 3 (SHTN3) guidance on the segregation arrangements for all wastes, healthcare and otherwise, arising at NHS Scotland premises.

In brief, SHTN3 specifies that NHS Scotlandâ&#x20AC;&#x2122;s wastes (not only healthcare/ clinical wastes) are segregated into colour coded groups as follows: â&#x20AC;˘ Green â&#x20AC;&#x201C; recyclable waste (newspapers, drinks cans and bottles etc) â&#x20AC;˘ Black â&#x20AC;&#x201C; mixed municipal (non hazardous) waste â&#x20AC;˘ Orange â&#x20AC;&#x201C; â&#x20AC;&#x2DC;low riskâ&#x20AC;&#x2122; special waste â&#x20AC;˘ Yellow â&#x20AC;&#x201C; â&#x20AC;&#x2DC;high riskâ&#x20AC;&#x2122; special waste â&#x20AC;˘ Red â&#x20AC;&#x201C; â&#x20AC;&#x2DC;irregularâ&#x20AC;&#x2122; special waste.

Elsewhere in the UK, guidance is taken from a Department of Health (DH) document entitled â&#x20AC;&#x2DC;Health Technical Memorandum 07-01: Safe Management of Healthcare Wasteâ&#x20AC;&#x2122;. This document has been produced by the DH as a best practice guide to the management of healthcare waste.

In Scotland, and elsewhere in the UK, infectious wastes from any source is prohibited from being landfilled, i.e. pre-treatment (be rendered safe) prior to landfilling is required. In practice pre-treatment will involve either incineration or the use of alternative technologies such as microwaves, autoclaves and hot oil or steam injection augers etc.

SPECIAL WASTE V HAZARDOUS WASTE The majority of healthcare waste produced in Scotland is likely to be classified as special waste, elsewhere in the UK and the EC it will be referred to as being hazardous waste. In Scotland, the terms special waste and hazardous waste mean the same thing and are interchangeable.

Under Scottish law, special waste is any waste that is defined as hazardous by the European Hazardous Waste Directive. Special waste has hazardous properties that may make it harmful to human health or the environment and, consequently strict laws control how it is managed.

The Special Waste and hazardous regimes differ across the various UK borders. The key differences being that in Scotland there is no need for premises producing special waste to register with SEPA as producers of hazardous waste. Furthermore, the requirement to pre-notify for some movements of special waste still exists. Further guidance on the UKâ&#x20AC;&#x2122;s hazardous waste or special waste regimes can be found on the NetRegs website.

In Scotland all movements of special waste must be accompanied by a Special Waste Consignment Note (SWCN). The SWCN consists of five different coloured, self carbonising pages, each with five sections, which refer to a different aspect of the waste transfer.

CHANGING FACE OF WASTE MANAGEMENT Earlier this year the Scottish Government published their plans for a zero waste society. Itâ&#x20AC;&#x2122;s a vision where all types of waste are dealt with, regardless of where they are produced, from households to businesses to public sector organisations.

Everyone has their part to play in this vision, including those producing hazardous and non-hazardous healthcare waste, and make sure Scotland benefits from the economic and environmental advantages to be gained from zero waste. Zero Waste Scotland is the organisation created to support delivery of the Zero Waste Plan. It will serve as a one-stop-shop for businesses and individuals looking for advice or support on how to use resources more efficiently, reduce waste and recycle more.

Achieving zero waste will make a positive contribution to Scotlandâ&#x20AC;&#x2122;s climate change and renewable energy targets as more waste is prevented, less waste is sent to landfill, and more resources are reused, recycled and recovered. A zero waste society will also support sustainable economic development as new waste facilities mean new investment and job opportunities and as businesses become more resource efficient, costs are reduced and a competitive advantage is gained.

Managing waste through modern and effective regulation is essential

to Scotlandâ&#x20AC;&#x2122;s success both now and for the future. In order to reduce waste production and to significantly increase the reuse, recycling and sustainable treatment of Scotlandâ&#x20AC;&#x2122;s waste, a modern and effective approach to regulation is required. We also need a system that people and businesses can trust and respect, however, the situation is complex as there are local, regional, national and global issues to consider.

Nevertheless, both SEPA and the Scottish Government wish to simplify the current system and maintain our current high levels of environmental and human health protection.

SEPA and the Scottish Government remain committed to the principles of better regulation. A regime designed around better regulatory principles should: â&#x20AC;˘ eliminate outdated or unnecessary provisions in legislation â&#x20AC;˘ consolidate, streamline or merge regulatory regimes where possible â&#x20AC;˘ base regulatory permitting, inspection and enforcement on sound risk principles â&#x20AC;˘ ensure where companies break the law that enforcement can be swift and effective â&#x20AC;˘ minimise the administrative burdens on companies and regulators wherever possible â&#x20AC;˘ empower regulators to enforce regulations in a fair, consistent and proportionate manner â&#x20AC;˘ promote best practice and advice to regulated companies wherever possible.

FOR MORE INFORMATION Web: www.sepa.org.uk

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INFECTION CONTROL

PUTTING PATIENTS FIRST Patients and the public need to be placed first and foremost in the fight against hospital infections, says the Patients Association’s chief executive, Katherine Murphy “NO DECISION ABOUT ME, WITHOUT me.” So says the government’s white paper on health, Equity and Excellence: Liberating the NHS. According to the government, this means a new shared decision making model with patients at the heart of healthcare. Our work suggests this is particularly urgent in infection control.

The Patients Association’s history of high profile work involving healthcare associated infections (HCAI) started over five years ago when our President, Clare Rayner, wrote in a major newspaper about acquiring an MRSA infection. Following this, we were overwhelmed by a deluge of letters, phone calls to our helpline and e-mails from patients and carers wanting to share their experiences. This has provided a rich source of information from which we have shaped our activity on infection control.

BEST PRACTICE Using this evidence provided directly from the patients and carers affected by HCAI, we developed media activity with Clare leading from the front. With national press coverage, this helped place the issue of HCAI firmly on the agenda of the NHS. The Patients Association held three national summits on the issue and ran several surveys, including one with infection control nurses which highlighted their struggles in trying to get all staff to adhere to the very best of practice.

The infection control campaign became more media driven than any other healthcare area. The media pressure clearly helps to generate action and results. However, the issue of infection control remains in the news with a new so called superbug, prevalent in the Indian subcontinent, and infecting people coming back to the UK. This is a new front in the fight against HCAI – but there is also news that existing infections remain a difficulty for hospitals with 12 per cent of Foundation Trusts declaring themselves at risk of missing targets for MRSA and C. difficile infection.

In the midst of this news, and worries about budget cuts, it is crucial that we do not forget the terrible impact of HCAI on patients’ lives. We believe that patients should remain at the forefront of infection control in the health service.

A STRONG PATIENT VOICE Patient voice and feedback is always important and the proposals in the government’s white paper attempt to tap into this. The government proposes an “information revolution”, with a vast expansion of the use of patient-related outcome measures (PROMs) and patient surveys,

The helpline is a port of call for people with questions and concerns about their healthcare – through this we see patients not just as numbers but as people with lives and experiences, some of which have been drastically altered as a result of avoidable HCAI as well as an expansion of patient choice to include both GPs and consultant-led teams. By using patient feedback and choice it is hoped that patients will drive up the standards of care received by all users of the health service.

To achieve this, however, the information collected must be meaningful for patients and the public. The Patients Association wants data, not on Trust level but on ward or department level. This includes asking questions such as: “What infections did you have on your ward or department this week?” not just measuring MRSA and C. difficile.

Counting MRSA and C. difficile alone, will not help patients and the public make effective choices. The last National Audit Office report (in 2009) on infection control identifies other key barriers to infection control such as a lack of information on antibiotic prescription and patient records. So along with information on infection rates and treatment provided we want to see the following data made readily available to patients: clinical outcomes of individual consultants and their teams; staffpatient ratios, the skill mix of staff on wards;

complaint numbers and what these complaints were about; risk assessment of complaints; and outcomes and experience for patients.

Furthermore, the information revolution is already occurring – the younger generation’s greater use of the internet means they have better access to information and awareness of their rights in terms of healthcare.

Therefore they have greater expectations of healthcare services and demand the very best clinical practice to be carried out and by experts in the field. With time, this will hopefully drive up standards in healthcare.

THE HELPLINE With the increase in media coverage of hospital infections, more and more people decided to voice their concerns to The Patients Association Helpline. The helpline is a port of call for people with questions and concerns about their healthcare – through this we see patients not just as numbers but as people with lives and experiences, some of which have been drastically altered as a result of avoidable HCAI. HCAI is an area where many patient-centred

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Health Business | Volume 10.5

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INFECTION CONTROL

issues converge – including dignity, listening to patients, and keeping patients and families informed. These concerns have appeared time and again in the HCAI context: last week a caller whose partner was not screened for MRSA on admission to hospital went on to develop an infection. The hospital denied any responsibility for this and maintained that the patient could have arrived at the hospital already positive for the bacteria. It seems incredible that the hospital tried to rely on their failure to screen the patient as justification for blaming the patient for carrying the infection into the hospital environment. This sort of example shows the disregard for patients by hospital staff, that is unfortunately still commonly reported to us.

ADDING TO THE PROBLEM What the helpline also shows us is how HCAI is linked with other health problems.

People have often called with a concern about a separate area of care, and have said that poor care in this area meant that they acquired an infection at hospital or in a care home. Two particular examples are bed sores (pressure ulcers) and incontinence.

Bed sores are unfortunately commonplace.

Approximately 412,000 people develop a pressure ulcer annually in the UK and research carried out by The Patients Association shows that care and staffing levels vary massively according to a patient’s location. One third of Primary Care Trusts (PCTs) had no information about pressure sore incidence, and acute trusts showed a tenfold difference in incidence in hospitals with the same staffing level. These findings confirm what our helpline tells us – staff are stretched so thinly in some areas that patients sometimes go without essential attention to their needs.

Incontinence has a similar picture of variable care as reflected in the complaints to our helpline. Last year, we published a series of accounts of patients who had suffered poor care. One of the patients was told that, because of a lack of continence facilities, she would have to wet the bed. Another patient’s family noticed that toilets were not cleaned. If left unaddressed, these problems can contribute to the breeding environment for bacteria. Simple measures – universally applied – which consider patients as people and listen to their needs, would avoid such serious violations of dignity and prevent the cost of treating large numbers of HCAI. FOCUS ON PATIENT SAFETY At The Patients Association our focus remains on patient safety. This is the driving force behind a number of our campaigns – such as those addressing complaints, care of the elderly and HCAI. In 2008 we held a summit on infection control with the following call to action: for hospital trusts to end the culture ignoring infection control guidance; break the vicious cycle

whereby increased bed occupancy leads to more infection, which in turn leads to higher bed occupancy; and for infection control to become part of all staff appraisals.

From the patient’s perspective, in 2007 the Patients Association MRSA focus group highlighted numerous factors adding to the problem. The participants identified that even though there were huge numbers of news stories on the issue, information about hospital infections was hard to come by. People did not know what they could do to reduce HCAI incidence. They also highlighted that staff often ignored patients’ complaints or did not take sufficient action. Treatment at home was shown to be weak, a problem whose effects are particularly bad as most patients wanted to go home at the earliest opportunity.

These factors are crucial in maintaining patient safety.

NDM-1 New research shows that another type of antibiotic resistance has emerged. Dr Andrew Pearson, Vice President of the Patients Association, and Dr David Livermore led a team of investigators in research on a new form of resistance. In August, the group published their findings, which showed the bacteria E. coli and Klebsiella pneumoniae displaying resistance to the powerful class of antibiotic, carbapenem.

The resistance was conferred by the gene New Delhi metallo-beta-lactamase 1 – NDM-1.

The authors concluded: “the potential of NDM-1 to be a worldwide public health problem is great, and coordinated international surveillance is needed.” The gene gives the bacteria resistance to all front line antibiotics.

Though transmission of bacteria with NDM-1 resistance is still relatively low, the threat is clear: the number of possible forms of acquiring an infection resistant to antibiotics has increased.

MONEY The news of new infections should not take attention away from the existing threats.

Recent years have seen the introduction of strict infection control targets for MRSA and C. difficile and infection rates have decreased significantly. However, in annual plans for 2010-11 submitted by the 129 NHS Foundation Trusts to the Foundation Trust regulator, Monitor, 15 declared themselves at risk of missing these targets in the next year.

Monitor should use this information to keep track of the trusts, and enforce sanctions if they do indeed fail to meet the targets.

The same review saw Monitor rate 54 per cent of Foundation Trusts at moderate financial risk for 2010-11, compared to just 32 per cent in the beginning quarter of 2010. It is clear that financial constraints will hit hospitals. What is worrying is that many hospitals see a possible effect of this is a reduction in patient safety.

POLICY The government’s white paper introduced large change to the NHS. One of the most significant proposals was to reduce management costs by 45 per cent. The government hopes that another headline change – that of abolishing PCTs and placing healthcare commissioning in the hands of GPs – will help to achieve a significant part of this saving.

The other major driver of management savings is through the reduction of arms-length bodies (ALBs), associated with the NHS. In a report published in July, the government proposed to abolish between 8 and 10 of the 18 ALBs associated with the health service, with many of their functions consolidated to existing organisations. It is proposed that The Health Protection Agency (HPA) and the National Patient Safety Agency are to be abolished.

Judgment on the reforms clearly cannot

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Seating That Fights Infection!

A BETTER CLEAN EVERY TIME. BettaClean (UK) Ltd was founded in 2006, with the logo “a better clean every time” chosen to echo the company’s ethos and values.

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Health Business | Volume 10.5

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INFECTION CONTROL

be made until the changes come into force but at this stage we can say there is a risk that the activities of key bodies for HCAI, such as the Health Protection Agency (HPA) and the National Patient Safety Agency may not adequately be replicated. This risk needs to be guarded against with the utmost care to avoid the public suffering as a result.

PUBLIC HEALTH SERVICE The white paper also proposes establishing a Public Health Service – under the control of local authorities. The functions of the HPA will transfer to this new service.

Again we cannot be sure of the effects of this until consultation on the service is finished and changes are in place. However, it may represent an opportunity for infection control – if research such as that on NDM-1 occurs within the remit of the same organisation responsible for public health messages, the hope is that the message will be clear, strong and up-to-date.

ACTION – PUTTING PATIENTS FIRST So what can be done to maintain and improve infection control? And what do we mean by putting patients first?

We need to approach infection control from all sides – not as an isolated problem.

This means addressing all of the threats highlighted above, with a constant regard for the effect on patients and the public.

To help create a joined up approach, The Patients Association recently hosted a series of roundtable meetings in three related areas: continence care, tissue viability nursing (TVN) and HCAI. The aim of this was to bring together experienced professionals working on the ground, policy makers, professional organisations and patients to get to the heart of improving care.

The first two meetings were clear examples of the benefits of addressing the wider factors

that contribute to the issue of infection control.

The ideas discussed and proposals put forward aim to address the root causes of infection which often lead to HCAI. With this background environment for infection reduced, fewer people will become positive for drug-resistant bacteria, and fewer cases of HCAI will result.

The meeting on HCAI was chaired by Dr Pearson and involved leading figures from the HPA, research groups, patient and professional groups and the Department of Health. At the meeting, Dr Pearson focused on three questions: What should be the measure for avoidable risk? How should this information factor in patient choice? What affect can this information have on patient involvement in healthcare? These factors centre on the information needed to address the issue and highlighted how the lack of information – particularly on infections other than MRSA and C. difficile – is hindering patient safety.

The meeting launched a working group on HCAI, to meet again in December. The group will use examples of good practice, and leading healthcare professionals’ experience, to create the advances we need across the NHS. Dr Pearson said: “We need to identify and stamp out unsatisfactory and dangerous practices to bring down infection rates across the NHS.” MAXIMISING RESULTS The Patients Association always stresses that the patient must be at the centre of the health service, with as many avenues as possible used to improve patient care. For infection control this means seeing HCAI as a problem with many causes, all of which need to be acted upon.

This is at the heart of our way of thinking.

To have maximum effect, this approach needs support from many sectors – the independent sector, in funding research and facilitating meetings such as ours; and the government, through organisation of the

NHS. Commissioning of the health service must continue its efforts to become smarter.

If more effective pressure ulcer care can reduce the burden of HCAIs, Primary Care Trusts (and soon, GP consortia) should factor this into commissioning formulae and as a result commission services appropriately.

Currently, the severe lack of information hampers commissioners’ attempts at providing the smart commissioning required.

If the proposed information revolution includes patient-centred outcome measures, comprehensive clinical outcomes, staff ratios and incidence levels by ward or department, then commissioners can use this to create the right skill mix on each ward to provide the highest quality and safest care at all times. Progress to the goal of safe and high quality care must be the driving force in implementing changes to the health service.

Policies aimed at finding the £15-£20 billion savings in the NHS, such as closing down ALBs, should also support this process. It is no use if advances are being made on one front, only for ground to be lost on another.

And opportunities for a unified approach with the Public Health Service should be seized – with research, public health education and patient information going hand in hand.

Most importantly, the approach of placing the patient first means that advances should take the whole country forwards together. This means redoubling efforts to reduce the variation in outcomes currently seen. With HCAI primarily picked up in hospitals, we must not allow the misfortune of being at the wrong hospital to dictate a patient’s health, care and even survival.

FOR MORE INFORMATION Tel: 020 84239111 E-mail: mailbox@patients-association.com Web: www.patients-association.org.uk

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INFECTION CONTROL

QUALITY SOLUTIONS FOR SAFER SURGERY Fusing technology and intelligence to improve patient care AT CAREFUSION we help our customers measurably improve patient care by focusing on two of the biggest issues affecting healthcare, medication errors and healthcare associated infections (HAIs).

With its headquarters in San Diego, California, CareFusion was officially launched on 1 September 2009 and employs 15,000 people in more than 20 countries worldwide bringing together a range of products and services trusted by hospitals around the world.

INFECTION PREVENTION HAIs are one of the biggest issues affecting healthcare today and a core focus for our business. One in seven of all HAIs in the UK are surgical site infections (SSIs)1.

ChloraPrep is a sterile, single patient use skin antisepsis system. It delivers the gold standard solution of two per cent chlorhexidine gluconate in 70 per cent isopropyl alcohol to the skin via a unique applicator which optimises the effectiveness of the solution.

It is available in two formulations, clear and with tint. A recent landmark study in The New England Journal of Medicine showed that ChloraPrep reduced the incidence of surgical site infections by 41 per cent, compared with povidone iodine2. The tinted formulation of ChloraPrep allows clinical staff to see where they have prepped, which makes it particularly suited to use in surgery.

The benefits of ChloraPrep with Tint for surgical procedures are consistent with previous clinical studies which have demonstrated reductions of 62 per cent in catheter related bloodstream infections following the introduction of ChloraPrep3. ChloraPrep is currently the only two per cent chlorhexidine-based product licensed for skin antisepsis prior to medical and surgical invasive procedures in the UK. OPTIMISED PROTECTION SYSTEM CareFusion introduces its new surgical gown portfolio that allows you to “optimise” your gown usage according to your clinical needs.

Our extensive customer research has told us that comfort, protection and cost are the most important criteria when selecting a surgical gown.

Every hospital has a unique combination of clinical requirements based on the procedures it performs. That’s why CareFusion has created its new Optimised Protection System OPS ™ to give you the ideal portfolio that makes choosing the right gown simpler and more cost-effective: • ESSENTIAL™ – adequate protection at lowest cost.

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CAREFUSION CLIPPER SYSTEM CareFusion Clipper System – now you can glide through hair removal while helping to minimise the risk of surgical site infections with CareFusion Surgical Clippers. You will feel the difference as CareFusion Surgical Clippers remove hair in a single pass for less patient skin irritation

SURGICAL GLOVES Surgical gloves – the Esteem range offers a unique polyisoprene formulation for fit, feel and performance comparable to latex without natural rubber latex proteins or allergens.

Esteem is 100 per cent latex and powder free, made without natural rubber latex proteins or allergens to provide extra safety for you and your patient. This range has recently been increased by the introduction of the Esteem Ortho. The Protegrity range offers a unique protection with three-layer design. It is made of natural rubber latex and nitrile The anatomical design is shaped on a Porcelain mould with independent thumb reduces thumb and palm strain.

TRAINING CareFusion provides full nurse led training and clinical support, as well as online educational material that will help you learn more about our products.

Notes 1. House of Commons Public Accounts Committee. Reducing Healthcare Associated Infection in Hospitals in England. 10th November 2009. London: The Stationery Office Limited.

2. Darouiche R et al. N Engl J Med 2010; 362: 18-26.

3. Garcia R et al. Manage Infect Control 2003; 10: 42-9.

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Health Business | Volume 10.5

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PATIENT SAFETY

DELIVERING SAFER CARE FOR EVERY PATIENT IN WALES 1000 Lives Plus is a new national programme to improve patient safety and reduce avoidable harm across NHS Wales 1000 LIVES PLUS, a new national programme, seeks to improve patient safety and reduce avoidable harm across NHS Wales, building on the work of the 1000 Lives Campaign, which ended in April 2010. The Campaign aimed to save an additional 1,000 lives and prevent 50,000 episodes of harm in Welsh healthcare during its two-year period.

FOCUSING ON PATIENTS “It has enabled us to focus more closely on our patients and reminds me of why I went into the NHS – to save lives.” These words from a frontline member of staff show how the improvement agenda has captured the imagination of staff in NHS Wales.

1000 Lives Plus will align with several other national programmes in the five year Strategic Framework for NHS Wales. The programmes are the central delivery mechanisms for the Welsh Assembly Government’s vision for world class healthcare by 2015.

The inclusion of 1000 Lives Plus indicates just

how far the patient safety and improvement agenda has come since the original Campaign was launched in 2008. Patient safety is now an integral part of the mainstream long-term plans within NHS Wales.

With an increased emphasis on patientcentred care, a commitment to working across primary and secondary care and several new clinical areas targeted for improvement, 1000 Lives Plus will have a transformational impact on Welsh healthcare.

A year on from an extensive reorganisation of

the NHS in Wales, its seven Health Boards and three Trusts are all committed to 1000 Lives Plus. At the launch of the programme, medical directors outlined their local aims to reduce mortality and harm in their organisations.

This has been made easier by the emphasis on measuring and reporting on mortality. “In the old days, hospitals would not have known what their death rates were,” says Mr Hamish Laing, director of Acute Care at Abertawe Bro Morgannwg University Health Board.

“But everyone knows that in order to

The new programme is committed to accelerating the pace of change to spread the new ways of working introduced by the Campaign from ward to ward, practice to practice and organisation to organisation – Dr Alan Willson, director of 1000 Lives Plus

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PATIENT SAFETY

With an increased emphasis on patient-centred care, a commitment to working across primary and secondary care and several new clinical areas targeted for improvement, 1000 Lives Plus will have a transformational impact on Welsh healthcare make improvements you have to be able to benchmark where you are and identify areas of concern. Only then can you begin to measure the quality of the services you are delivering.”

SPREADING AND EMBEDDING BEST PRACTICE “The new programme is committed to accelerating the pace of change to spread the new ways of working introduced by the Campaign from ward to ward, practice to practice and organisation to organisation,” says Dr Alan Willson, director of 1000 Lives Plus.

“Every Health Board and Trust is involved, with the focus on patients having the right to expect the same high quality of care – wherever they receive their treatment in NHS Wales.”

Many of the proven success stories have become mandatory in healthcare settings across Wales, including measures to tackle pressure ulcers, the introduction of the WHO safer surgery checklist, and measures to address normothermia.

1000 Lives Plus is supporting clinical staff in making these mandatory changes. For example, over 200 frontline staff from across Wales attended a conference on reducing hospital acquired pressure ulcers in June 2010.

Conference delegates were shown how pilot wards in Wales had virtually eliminated pressure ulcers – the treatment of which, makes up four per cent of the entire NHS budget. They were encouraged to implement

best practice in their workplaces to end the lottery that made it more likely to develop a pressure ulcer in one hospital than another.

NEW AREAS OF WORK – AND WAYS OF WORKING 1000 Lives Plus incorporates several new areas of work which will minimise waste, harm and variation. In total, there are over 20 programme areas which are being phased in over the next 12 months. These include: • preventing falls in community care • enhanced recovery after surgery • improving maternity services • offering better treatment to those suffering from depression • improving quality of life and care for those with dementia • reducing patient identification errors Much of this work is preventative, such as installing new practices to prevent thrombosis, reduce the likelihood of chronic heart failure, prevent harmful medication mix-ups, and treat the warning signs that precede stroke.

Many of these areas involve both primary and secondary clinical organisations, with a definite agenda to institute quality “from board to ward to home”. In patient-centred care, consideration needs to be given to every interaction with patients, including preparing for surgery before hospital admission, and after discharge, for example by continuing treatment.

One of the newest areas being developed

in 1000 Lives Plus is providing better mental health services. This includes engaging GPs to screen for depression during consultations as a preventative measure. Mental health initiatives also take the concept of patientcentred care to a wider level; involving the family of dementia sufferers is an integral part of improving care, both during hospitalisation and in coherent discharge planning.

The work to improve stroke services also focuses on preventative and post-event services.

Action is being taken to initiate prophylaxis after Transient Ischaemic Attacks to mitigate against subsequent full-blown strokes.

There are also attempts to improve acute stroke care and start stroke rehabilitation early; again, with an emphasis on robust transfers of care into the community setting. Patients are expected to be involved in the planning stages for their transition back into the community, based on individually tailored treatment plans.

Non-clinical improvements can also enhance the quality of patient care. Work on improving data to ensure patients are correctly identified involves retraining staff to ensure data input is to the highest standard, and also that electronic data systems interface efficiently.

Patient identification is an area where human and technological errors can be compounded.

MAKING SURE THE CHANGES HAPPEN The methodology introduced by the Campaign will continue to be used – applying small tests of change before wider implementation. The template for this evidence-based change movement is the 100,000 Lives Campaign developed by the Institute for Healthcare Improvement (IHI) in the US. A collaborative model is bringing together staff from across the country, and across clinical and managerial settings, to learn new ways of working, which can then be put into practice and evaluated. These mini-collaboratives focus on distinct areas of improvement, seeking immediate change. They use learning sessions to discuss and plan activities (and later report back on progress), and action periods, during which the plans are enacted and tested.

Using the Model for Improvement, each change is tested through a Plan-Do-StudyAct (PDSA) cycle, which ensures the change is evaluated. At the end of the cycle, those introducing the change can choose to adapt it and retest, adopt it across the wider organisation, or abandon it and try something different. When the collaborative re-convenes, staff can learn from one another’s successes, and begin to spread the ideas that have proven to work.

Frontline staff are well placed to identify solutions to problems and deliver the change that patients need. 1000 Lives Plus will continue to engage, support, equip and motivate frontline staff, recognising that NHS staff save lives every day and the programme will help them save even more.

This “hearts and minds” approach

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PATIENT SAFETY

Since 1000 Lives Plus was launched, the need for substantial expenditure savings has become apparent. However, quality improvement does offer opportunities for greater efficiencies. In many cases, it is believed that higher quality can actually be achieved at a lower cost to the NHS. Enhanced Recovery after Surgery is being funded on an invest to save basis, with savings gained from shorter hospital stays and fewer cancelled operations. This enables the investment to be paid back. However, there is a recognised need for whole system change to reflect the improvements in clinical care.

In the case of pressure ulcer reduction, the potential savings are not being fully realised as the processes to discharge patients are not updated to reflect the improvement.

worked well for the Campaign. Ailsa Dunn, consultant physician in Powys Teaching Health Board, said: “The 1000 Lives Campaign is easily the best initiative that I’ve ever been asked to participate in. It’s exactly aligned with what we needed to do in Powys to ensure that our services were safe.”

EMPOWERING PATIENTS One of the key elements of 1000 Lives Plus is patient involvement. Patient stories are used at board level to keep patients central to the improvement work, and a new commitment to put the patient central is key to many of the initiatives.

“We can, and will, be held to account by our patients, for it is our hands in which they place their trust and it is our obligation to hold it,” says Mary Burrows, chief executive of Betsi Cadwaladr University Health Board, which covers North Wales.

Patients also play a vital part in ensuring that improvements work – their compliance

with treatment can be the determining factor in success. Educating patients about their treatments, and encouraging patients to feel able to question the care they receive is vital.

“Patients need to feel they can ask a doctor to wash their hands, or request a risk assessment for thrombosis,” says Dr Alan Willson. “When we begin to see patients as partners in treatment – someone we work with, rather than do things to – then we will see better recovery rates, and earlier discharges.”

Some programme areas are very reliant on patient-partnership. Enhanced Recovery after Surgery, for example, requires patients to follow nutritional guidelines and other preparatory measures in the run-up to surgery, in order for quicker healing afterwards.

Other interventions aim to shape patient behaviour in quite simple ways – one surgical initiative asks patients not to shave their body hair before surgery and another encourages people to report falls that have not resulted in injury, to help prevent further falls.

WIDER SYSTEM 1000 Lives Plus can help connect the dots to show how improvement must be integrated into a wider system. The clinical achievements will also offer an opportunity to generate financial savings for NHS Wales.

These savings should escalate through embedded best practice that ensures that safer care and more cost-effective processes become the norm, and the benefits are felt in subsequent financial years.

“1000 Lives Plus is designed to ensure that new ways of working are embedded in everyday practice, enabling everyone to meet the shared vision of putting patients and patient safety above all else,” says Dr Tony Jewell, chief medical officer for Wales.

“We look forward to continuing the national effort to deliver improvements that will help deliver world class healthcare every time, to every patient wherever they live in Wales.”

FOR MORE INFORMATION Web: www.1000livesplus.wales.nhs.uk

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Health Business | Volume 10.5

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PATIENT SAFETY

TECHNOLOGY’S ROLE IN IMPROVING PATIENT SAFETY Dr Jean Challiner, chief medical officer at Clinical Solutions, discusses ways to harness technology’s potential as a means of ensuring safety whilst promoting more efficient processes PATIENT SAFETY has been a priority of the NHS and wider healthcare industry from conception. Yet in recent years, the increase in media headlines has detailed instances of patient safety falling through the gaps. A series of reports, commissioned recently by the Department of Health, estimated there are 43,000 deaths in the NHS each year that could be avoided with better treatment, a move away from the target culture which has developed in many areas of the NHS, and a renewed prioritisation of patient safety.

The reports highlight the need to embrace learning, innovation and enthusiastic participation in improvement. Technology has a vital role within the NHS when it comes

clinicians to consistently carry out a high quality and complete assessment, document their encounter and offer evidencebased care and advice to patients.

Use of decision support software in no way takes away the decision making powers of a clinician. It is there to prompt and support good practice and does exactly what it says on the tin – namely support for decision making NOT decision replacement. Critical thinking based on experience and clinical judgement is essential for the best outcomes to be achieved.

AUDITING ACTIVITY Technical solutions can prompt good practice, including auditing. Intelligent use of data

As with many healthcare related issues, prevention is better than cure and audit of practice, identifying near misses and supporting healthcare professionals in their decision making process is an area where technology has the power to lend a hand to streamlining processes and replacing paper-based administration functions, but can it really make a difference to clinical quality and patient safety standards?

And is there scope for technology’s role to play a bigger part in the process?

PREVENTION IS BETTER THAN CURE As with many healthcare related issues, prevention is better than cure and audit of practice, identifying near misses and supporting healthcare professionals in their decision making process is an area where technology has the power to lend a hand.

In addition, one of the most risky areas for a patient is the interface between healthcare providers where there is potential for failure in communication with incomplete or inaccurate information being passed on from one provider to another or for no information at all to be exchanged.

DECISION SUPPORT Whether in a face-to-face patient encounter or telephone-based setting, intelligent decision support technology can enable

collected during an encounter can help pin point gaps and identify changes that need to be made to reduce risk. But failing to set up an electronic record to capture data means it cannot be reported against efficiently and essential elements of clinical encounters may not be captured every single time.

JOINING UP SERVICES Patient journeys can be complex: beginning at appointment booking, moving to GP investigation and potentially referral for specialist investigation. With so many steps to be mapped out and different interfaces to be navigated, opportunities for breakdowns in communication or duplication of effort are abundant. There is also plenty of room for inconsistency. If appropriate records are not created or existing information is not available, continuity of care is lost and a patient’s safety compromised. Each component of a patient’s pathway may perform to a high standard but if the components are not joined up the overall care pathway can be poor.

Technology has the potential to join up the dots and provide patients with the continuity of

care needed, and clinicians with the knowledge and tools they need to optimise care for an individual. For technology’s potential to be realised, interoperability across the vast variety of systems used by different providers on a patient’s pathway must become a reality. As commissioning moves from providers to deliver elements of a pathway to commissioning whole patient pathways, interoperability must be a key element. Making the most of existing technology and prioritising reporting capabilities will improve patient safety and help support healthcare interventions by providing the much needed visibility.

REALISING TECHNOLOGY’S POTENTIAL Provision and capture of quality information, exchange of information and quality reporting are key elements of safe patient care and elements that appropriate technology can deliver. With the general election and cuts in NHS funding anticipated, now is the time to harness technology’s potential as a means of ensuring safety whilst promoting leaner and more efficient processes. And this should be the priority.

ABOUT CLINICAL SOLUTIONS Clinical Solutions provides a comprehensive range of software, solutions and services that help healthcare professionals and the general public make more informed and better healthcare decisions. In doing so, we enable healthcare providers to reduce waiting times, increase patient numbers, allocate resources more efficiently, meet rigorous clinical governance regulations, and save money. All the while, helping them maintain the highest standards of care. And where necessary, our solutions empower patients to take a safe and active role in their own care.

FOR MORE INFORMATION Visit www.clinicalsolutions.com for more information or call 01256 337300 to speak to one of our regional consultants, quoting “Health Business”

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BACKGROUND CHECKING

HOW WELL DO YOU KNOW YOUR STAFF? The new government has halted the vetting and barring scheme until further review. Shirley Wright, partner at law firm Eversheds considers what this means THE VETTING AND BARRING scheme for people who work with children or vulnerable adults was introduced in England, Wales and Northern Ireland on 12 October 2009 with considerable impact on the health sector. From the outset, the scheme suffered widespread adverse publicity which resulted in some significant changes to it as originally conceived. However, those changes were not far reaching enough for the new government, who in their coalition agreement stated their intention to “review the criminal records and vetting and barring regime and scale it back

to common sense levels”. Subsequently, on 15 June, it announced that the scheme was to be halted pending review.

CONTROVERSIAL SCHEME The government’s decision was welcomed by the Royal College of Nursing, which had only just announced that it would seek a judicial review to delay implementation of the scheme. However, there remains some disappointment that the controversial scheme has not been withdrawn in its entirety, not least because of fears that it could lead

There remains some disappointment that the controversial scheme has not been withdrawn in its entirety, not least because of fears that it could lead to nurses being struck off for ten years for relatively minor disciplinary issues

to nurses being struck off for ten years for relatively minor disciplinary issues.

The first phase of registration was to have begun on 26 July 2010 when it was planned that workers, or volunteers, who began a new job or who switched jobs to work in “regulated” activity were to be able, but not obliged, to register with the Independent Safeguarding Authority (ISA). Regulated activity includes many, if not most, roles in the health sector as it covers specific activities and certain situations where individuals have the opportunity to have contact with children or vulnerable adults where work is carried out on a frequent, intensive or overnight basis.

The government’s announcement made it clear that not only would the first phase of registration not go ahead, but also that no further elements of it would be introduced until the scheme has been remodelled.

Consequently, the legal requirements for any individuals engaging in regulated activity to be registered by 1 November 2010 and for employers to check the status of

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Health Business | Volume 10.5

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BACKGROUND CHECKING

ABOUT THE AUTHOR Shirley Wright is a partner at law firm Eversheds. She specialises in all aspects of employment law and acts for private and public sector employers handling a broad range of contentious and non-contentious matters.

Shirley is a member of Eversheds’ local government, education, and health sector groups. Her practice has particular emphasis on complex areas of employment law such as equal pay, transfer of undertakings and discrimination issues.

Shirley has written articles on equal pay for the Lawyer, the Association of Public Sector Excellence, Health Service Journal and Health People Management Association Magazine.

Shirley has lectured on all aspects of employment law and has delivered an element of Durham University’s Business School’s MBA programme.

individuals before they commence work in relevant roles by carrying out an ISA check will not go ahead for the time being.

BARRED LISTS There are, however, aspects of the vetting and barring scheme which had been brought into force prior to the review and which remain.

Consequently, the ISA, which was created to vet and register all individuals wanting to work or volunteer with children or vulnerable adults, will continue to maintain the two barred lists, which have replaced the previous statutory lists (POCA and POVA). Those barred from regulated activity with either children or vulnerable adults must not work, or seek work, in regulated activity with that group. For those who employ people or use volunteers in regulated activity, there is a duty not to knowingly employ, or use as a volunteer, a barred person in regulated

activity and a duty to refer individuals to the ISA for consideration for barring in relevant circumstances and to provide information to the ISA on request. The duty to refer applies if an employer dismisses a worker or a volunteer because they have harmed a child or vulnerable adult, or if the employer would have been dismissed had the worker or volunteer not left.

For the time being, an employer who employs, or engages as a volunteer, a person to work with children or vulnerable adults must check to see whether the person’s name appears on the appropriate barred list. There must also be a CRB check. Since 12 October 2009, there has been a right to ask for an enhanced disclosure in respect of anyone who works in a “regulated” or “controlled” activity. Controlled activity applies to certain work which gives the worker the opportunity to have contact with children or vulnerable adults in health,

social care or further education or where workers have access to records of children or vulnerable adults kept by specific bodies.

The terms of reference for the review will become available imminently, and further details are likely to be known by the end of November. Given that the legal framework remains in place, one might guess that the scope of the scheme (and therefore the definitions of regulated and controlled activity) will be the most obvious candidate for review.

Finally, it is worth noting that the Protecting Vulnerable Groups Scheme in Scotland, which is similar to the vetting and barring scheme, is still due to go ahead on 30 November with an estimated four year period before it is fully operational.

FOR MORE INFORMATION Web: www.eversheds.com

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social workers to drivers, giving all access to the fast e-Bulk CRB database. It is now a criminal offence for individuals barred by the ISA to work or apply to work with children or vulnerable adults in a wide range of posts – including most NHS jobs, Prison Service, education and childcare care homes etc.

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BACKGROUND CHECKING

HOW TO NAVIGATE THE BACKGROUND SCREENING JUNGLE Eyal Ben Cohan, MD, Verifile Limited, explains how to check who you employ INTERNATIONAL BACKGROUND screening is rising in prominence and is becoming ever more critical to businesses as borders open up and the battle to hire the best talent intensifies. This article provides an overview of international background screening and an insight into the importance of conducting thorough international employee checks correctly and legally.

So picture this scenario, Mark has been appointed to a new senior role and his employer wants to check his background. He has had an international education and career path that has enabled him to work abroad. He studied in Switzerland and Germany and enjoyed a successful career in Australia, Malaysia and the UK before moving to the US. This will not be a completely unusual scenario to many readers. But how can we effectively check

have access to it. For example, it is illegal under European Data Protection laws to send personal information outside EU borders unless certain criteria have been met (e.g. if the recipient of the information is in the US, they would need to be Safe Harbor certified).

Another situation could arise where consent is needed to allow third parties other than the company ordering the checks or the screening provider to review the results of a background check. For example, if an employment agency orders the checks but then wishes to share the results with the actual employers.

CRIMINAL RECORDS Each country has its own system for collecting and releasing criminal records data. For many, carrying out a national search is perfectly feasible. However, it’s important to take local

Screening internationally has a number of challenges.

Not only are there different procedures and policies in each country, there are language barriers too Mark’s credentials to ensure he has been honest and truthful in his application for the role?

Evidently we are going to have to screen Mark in each of those countries mentioned, but how should we do this? Many screening companies are experts on the rules and regulations of their own countries, but many do not know to what extent regulations or background checks differ abroad. Before starting any checks we need to have a clear understanding of the local laws and cultures in each country.

For example, in the US criminal records are obtained from county and Federal courts, but it is impractical to conduct a national check by going to every court in the US. And this does not mean that the rest of the world uses the same process, for example in the UK, national checks are possible through official government bodies set up for this purpose, and indeed by law it is illegal to obtain criminal records in any other way, for example by trying to copy the US approach by going to a local court.

When faced with an international check, there are six key areas to consider: CONSENT & RELEASE OF INFORMATION This is not as straightforward as would seem at first sight. Consent forms need to have a dual purpose. They need to show how information will be treated and who will

regulations into consideration. In Malaysia criminal data is only accessible for specific positions such as security. Yet in Australia and the UK, basic information can be released for any role, and for those working in specific positions such as the financial or health sectors, even more details can be accessed.

In Germany criminal records can only be released to the candidate, and third parties are not allowed to request the Certificate of Good Conduct on behalf of the candidate.

CREDIT CHECKS Rules on the release of consumer credit information also differ from country to country.

In the US, obtaining credit information through a credit bureau is normal, legal and widely understood. Yet in countries such as Italy or Malaysia, credit information is not available for pre-employment screening purposes even though credit bureaus do operate there. In the UK, South Africa and Australia, credit bureaus will only provide basic information on court judgments and bankruptcies for pre-employment screening purposes. Credit information is therefore restricted in those countries to lenders and similar organisations.

In fact, guidelines published by the Information Commissioner in the UK prohibit companies that have access to consumer credit information

due to their business from using it for recruitment purposes. In many other countries there are no credit bureaus at all to provide any type of financial information on consumers.

EMPLOYMENT VERIFICATION/ EMPLOYMENT REFERENCES The US approach to employment verification is to carry out a verbally conducted check or to use online services (such as The Work Number) to obtain employment information.

This is quite often very different to the rest of the world. In Europe, written requests for employment references are preferred. Many employers will actually refuse to discuss these matters over the phone and ask instead to receive a written response. In other European countries such as France and Germany employers provide confirmation letters to all leavers and therefore do not have to deal with requests for verifications or references.

EDUCATION The National Clearing House provides the US with the ability to check the majority of academic degrees. A similar system is available in South Africa. By contrast, in Australia institutions tend to include graduate information on their university websites. Elsewhere, for many universities, a written request is the most effective way to conduct a check and to source additional revenue too. In India and China, a copy of the degree certificate is essential to help confirm it is legitimate. In many African countries due to the lack of infrastructure, such as electricity and telecommunications, one has to visit the university in person in order to get confirmation of the degree.

SUPPORTING THE GLOBAL WORKFORCE As you can see, screening internationally has a number of challenges. Not only are there different procedures and policies in each country, there are language barriers too. It is easy to see how this can become a time intensive and lengthy process. But as we continue to develop as a global workplace, it is critical to understand cultures and laws in other countries so that we continue to be effective and earn respect for the comprehensive service we provide today’s organisations.

Eyal Ben Cohen, managing director, Verifile Limited, United Kingdom.

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

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Health Business | Volume 10.5

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FRAUD PREVENTION

CONFRONTING THE PROBLEM The NHS Counter Fraud Service focuses on the threat of fraud in the healthcare sector and on what can be done to tackle it SIMON, A NURSE in the gastroenterology department of a large teaching hospital, was highly respected by his colleagues for his competence and hard work. In need of money to keep up with his mortgage, he managed to secure a better-paying position at a trust in the same city. He was having leaving drinks with his team when a thought flashed through his mind: “Perhaps I can get some help with my mortgage from my old employer as well.”

As he walked home in the evening, the thoughts started racing through his head: “All I have to do is make photocopies of the timesheet, fill them in every week and drop them into the finance tray at reception. But what about the authorisation signature?

Well that’s not a problem, I can write Kay’s signature better than she can by now.

And no one checks these things anyway; they’re all too busy with their jobs.”

He dropped the first timesheet into the tray early in the morning of his first day at the new job, and for several months he kept going back, as the money flowed into his account.

He hadn’t told anyone of course, and kept telling himself he would stop in a couple of months in case someone found out.

NO HARM DONE Margaret had been manager of a high street GP practice since it was founded seven years ago.

She was a close friend of the partners, who trusted her implicitly. They also admired her pragmatic approach, which meant all problems were sorted quickly and without headaches.

As they all stood outside court on a hot summer day, no one dared tell the others that perhaps they should have kept an eye on her, and that a check every now and again would have certainly done no harm. The reason they were in court was that soon after starting work at the practice, Margaret had found ways to sort out her own financial problems quickly and without hassle. At first she took to siphoning off money from petty cash: that made her £9,500 over the years, but this was not enough for her.

She went on to divert £75,000 from the staff pension fund to her bank account, and finally gave herself a pay rise of £45,000 per year. No one noticed. And who could notice anyway?

INSIDER FRAUD These are only two examples of fraud that can be committed by staff in the health sector – both are based on real cases. Staff fraud (sometimes known as insider fraud) is a growing problem across many industries, and employers are increasingly taking action against it. This article will focus on the threat in the healthcare sector and on what can be done to tackle it, both locally and on a wider

scale. To do this it will draw on the experience of the NHS Counter Fraud Service (NHS CFS), which has lead responsibility for tackling fraud and corruption in the NHS in England and Wales. If you’d like to know how Simon and Margaret’s stories ended, please read on.

WHAT IS STAFF FRAUD? Under the Fraud Act 2006, a person can commit the offence of fraud in three main ways: by making a false representation, by failing to disclose information when there is a legal duty to do so, and by abusing a position in which they are expected to safeguard another person’s financial interests. In each of these cases, fraud is committed if the person acts dishonestly and with the intention to make a gain, or to cause a loss or the risk of a loss to another. The intention is enough: no actual gain or loss needs to have occurred.

Staff fraud is, quite simply, fraud committed by a member of staff against their employer, whether they are employed directly or indirectly (for example through

The healthcare sector is certainly not immune to the problem. Of the 482 cases taken up by the NHS CFS in 2009-10 (a figure which excludes cases investigated locally within NHS organisations), almost one fifth involved payroll fraud, which includes various types of staff fraud, from submitting false timesheets to using false documents in an employment application. As Margaret’s case illustrates, staff fraud can have a significant impact on the bottom line of the individual healthcare organisation, and recent cases involving larger organisations only reinforce this point.

In March 2010, a former estates director at an Essex acute trust was found to have fraudulently earned over £245,000 as a result of making false claims about his credentials.

In healthcare, staff fraud is made even more serious by the fact that fraudsters appropriate resources, most often public resources, which are meant for patient care. Frequently the fraud is committed by people who have a professional duty to care for patients and have been entrusted with the resources for this purpose.

The healthcare sector is certainly not immune to the problem. Of the 482 cases taken up by the NHS CFS in 2009-10, almost one fifth involved payroll fraud, which includes various types of staff fraud, from submitting false timesheets to using false documents in an employment application a recruitment agency). Some of the most common types of staff fraud are: • using false documentation to obtain employment • submitting false claims, eg timesheets or expenses claim forms • diverting cash from employer/ employee/customer accounts to own or third party account • working while on sick leave.

CONFRONTING THE PROBLEM According to reports published by CIFAS, a fraud prevention service with a wide membership across the financial services and other sectors, a sharp rise in cases of staff fraud and a growing awareness of its consequences has led employers to confront the problem more openly and energetically in recent years.

This is understandable, as fraud by members of staff can not only have a considerable financial impact: it can also have a lasting effect on morale and mutual trust within the organisation, as well as on its reputation.

In healthcare more than in other sectors, then, it is not only the employer or other parties immediately affected who pay for staff fraud: we all pay, as taxpayers and as patients.

A COMPREHENSIVE APPROACH Employers across all sectors have found that staff fraud, like all types of fraud, is best tackled with a comprehensive approach. This includes not only a reactive element, responding to fraud when it is discovered, but crucially also a proactive one, addressing the root causes of that behaviour at the level of both the organisation’s culture and the individual employees’ incentives and motivations.

The NHS CFS has employed such a comprehensive strategy ever since its creation in 1998, and the same approach is used locally and at national level. Counter fraud work within NHS organisations is undertaken by Local Counter Fraud Specialists (LCFSs), trained and supported by the NHS CFS and reporting to their respective director of Finance. Nationwide, the NHS CFS develops policy and guidance,

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FRAUD PREVENTION

undertakes research on the nature and scale of fraud to build an evidence base for its work, and works directly on cases of fraud that are large, complex or require specialist knowledge.

PROACTIVE MEASURES The first step in any strategy to counter staff fraud is creating a strong anti-fraud culture at all levels within the organisation. Ideally, Simon and Margaret should not even have contemplated committing fraud in the first place, because they saw fraud as entirely unacceptable and knew that everyone around them thought the same.

However, if the idea of topping up their salaries by deception did cross their minds, they should have been held back by the thought of what might happen to them as a consequence. This is deterrence, the second part of the strategy.

Both a strong anti-fraud culture and effective deterrence are achieved by promoting awareness of fraud, its unacceptability and its consequences among all staff through an active communication strategy.

Media coverage of high-profile cases can also make an important contribution.

Unfortunately, there could still be some members of staff who are not impressed by the anti-fraud message or by the deterrents, and who decide to attempt fraud. For these cases, the counter fraud strategy has a third element, called prevention: putting measures in place to stop fraud from succeeding if it is attempted.

Before Simon and Margaret decided to defraud the NHS, a lot of things could have been done that would have frustrated their efforts.

In Simon’s case, the health body could have checked timesheets against rotas to ensure that shifts claimed for had actually been worked.

At Margaret’s GP practice, the partners could easily have spotted that something was wrong had an audit procedure been in place to check her activities. Looking at new and existing rules,

policies and procedures to identify any fraud risks they may present, evaluating existing fraud prevention measures, and developing and introducing new ones if needed: all these are important elements of fraud prevention.

Both the NHS CFS and the network of LCFSs apply these in their daily work, affecting anything from the development of new national policy by the Department of Health to the design of timesheets in a hospital.

REACTIVE COUNTER FRAUD WORK Even with the best preventative systems in place, some members of staff will still succeed in their attempts to defraud their employers. It is vital to make sure that their actions come to light as soon as possible and are investigated quickly and professionally. The detection of ongoing fraud and its investigation are the first two steps on the reactive side of counter fraud activity and form another important part of the work of LCFSs and of the NHS CFS. But let’s see how our two stories unfolded.

Simon was right to think he might be found out. One day, a clerk in the finance department, while processing the week’s timesheets, did a random check of a few of them against the health body’s personnel records. It was easy to spot what was wrong: one of those employees had stopped working at the health body four months before. Unsure what to do, the clerk talked to his manager, who after a quick enquiry immediately decided to refer the matter to the LCFS: their investigation established that the trust lost over £15,000 in salary for hours that had never been worked.

In Margaret’s case, no one at her practice was checking what she did. It was only when NHS Pensions questioned why no payments had been received for some practice staff that the partners realised something was wrong.

They called the NHS Fraud and Corruption

Reporting Line, and the case was taken up by one of the NHS CFS’s operational teams, which normally investigate cases with a value above £15,000, or of regional or national significance.

Both stories ended in court and resulted in criminal convictions. Margaret was sentenced to 18 months in prison. Simon was given a suspended prison sentence and ordered to pay back the salary he had fraudulently claimed. Securing appropriate sanctions, from a range of criminal, civil and disciplinary measures available, is the logical next step in reactive counter fraud work.

RECOVERING FUNDS The final part of the NHS CFS’s comprehensive strategy is seeking redress, i.e. the recovery of money lost to fraud. This can be done locally

by LCFSs, using the administrative procedures of the health body or the civil law: in 2009-10, over £2 million was recovered by civil recovery or voluntary repayments. In the most serious cases, the NHS CFS can apply to the courts to make a restraining order or a confiscation order.

In 2009-10, the NHS CFS recovered £2,666,067, bringing the total recovered since 1999 to over £65 million. This is all money that goes back to the defrauded NHS organisations and can be returned to its original destination: patient care.

At a time when the NHS is asked to achieve significant efficiencies in its use of resources, and at the same time bring the control of those resources closer to clinical staff and patients, it is more important than ever to guarantee that abuse of resources through fraud and corruption is reduced as much as possible. With robust arrangements set within a comprehensive strategic framework, comprising both proactive and reactive measures, this goal can be achieved.

FOR MORE INFORMATION Web: www.nhsbsa.nhs.uk

A leading provider of counter fraud services ORSET AND SOMERSET Counter Fraud and Security Management Service (DAS) is the leading provider of counter fraud and security management services in the NHS South West region. With an unrivalled breadth of experience we offer the best protection for our clients through high quality counter fraud and security management work, backed with excellent service.

What makes DAS different from other service providers is that we do not sell off the shelf solutions to potential clients. Instead, we pride ourselves in understanding our clients’ requirements and working with them to identify the nature and scale of the risks. Our experience has been gained from over ten years of providing a high quality counter fraud and security management services to NHS clients.

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If you are thinking of market testing your current service provider, we would be pleased to explore any common ground between the requirements that you may have, and the potential services on offer from DAS.

Our philosophy is to provide the highest quality of service at the most competitive price.

FOR MORE INFORMATION Web: www.dascfs.nhs.uk

Health Business | Volume 10.5

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FRAUD PREVENTION

CARD PAYMENT FRAUD IN THE HEALTHCARE SECTOR FIS Merchant Payments looks at ways of reducing payment fraud and data theft ON THE FACE OF IT, an article with a headline like this one would seem to be offering ways to tackle the problem of receiving fraudulent credit and debit card payments from fraudulent clients. And yes, there are solutions to that problem that this article will point to.

However, there is also the additional problem of card data fraud. This can be perpetrated from inside an organisation, or it can be the result of card data being stolen from your card payment terminals or your computer systems by criminals who hack their way in.

Stolen card data can be very lucrative to those who receive it and the problem has been escalating in recent years. Any organisation that accepts and processes card payments must adhere to the Payment Card Industry Data Security Standards (otherwise referred to as PCI:DSS): these are the rules that are laid down by the card scheme providers (VISA, MasterCard etc.) and which apply whether you operate one card terminal or process thousands of payments through a website.

Help and advice is at hand to reduce payment fraud or data theft. There are payment specialists out there whose experience and technical capability can make accepting, processing and storing card payment data more secure.

FRAUDULENT PAYMENTS First, to fraudulent payments. If you are not a supplier of goods, but if you are a healthcare provider, then there would seem to be little sense in making a payment to you by using a stolen card. After all, a connection would be formed between an act of criminality and the records that you already hold for that client. It makes no sense for the criminal to identify themselves in this way or to leave a trail that leads, literally, to their front door.

For suppliers of goods and services, the reality is somewhat different. The combination of high value and high demand for medical products and supplies can tempt fraudsters to use stolen cards to make payment. This is made easier if payment is not made in person but over the phone or via an internet site as no PIN is required. This type of Cardholder Not Present (CNP) payment is particularly open to fraud and is a growing problem. According to official figures released by UK Payments Administration (the body that manages payment infrastructure), CNP fraud amounted to £266 million in 2009. This type of crime ranges from ad hoc stolen cards through to the wholesale theft of card data, later used in CNP transactions via internet or phone.

If you accept a high volume of CNP type

payments you may consider processing these through a fraud detection solution from a payment processing specialist. Such a solution will automatically screen payment transactions for potential fraud and can easily be embedded in your website or your call centre environment.

For instance, ClearCommerce from FIS Merchant Payments already processes and filters over 500,000 CNP transactions every day.

CARD DATA THEFT Now to the second issue: the problem of card data theft. Every organisation that processes card payments must store the data securely. This is true whether you operate a stand-alone card terminal from a merchant services provider or a website that processes thousands of payments each year. The card data from every transaction must be stored securely, either in house or with a third party such as FIS Merchant Payments.

The PCI:DSS requirements relate to card payment processing and data storage, and the need for self or external assessment. Much of your PCI:DSS obligation can be alleviated if your payments are processed securely through TRANSAXion – a compliant card processing and card data storage solution from FIS Merchant Payments. Already being used by many well known names in the retail, hospitality and fuel industries, TRANSAXion will ensure that your client’s card data cannot be breached either internally or externally.

In addition, TRANSAXion also offers a higher security “tokenisation” option by which you can store your customers’ card data in lieu of card detail but payment processing and debiting of further and future payments can still be processed by you.

TRUST THE EXPERTS So, there are many ways to reduce card fraud whilst protecting your clients and your organisation from the damage it can cause. Forgive the pun, but it will pay you to talk to the payment experts. Talk to FIS Merchant Payments, one of the world’s leading payment specialists.

FOR MORE INFORMATION Contact: Mike Bradley, sales support manager, FIS Merchant Payments.

Tel: 0121 4104357 E-mail: mike.bradley@fisglobal.com Web: www.fismerchantpayments.com

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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LEADERSHIP MANAGEMENT

LEADERSHIP MATTERS – NOW MORE THAN EVER The Institute of Leadership & Management’s David Pardey discusses what it means to be a good leader and the positive affect good leadership has on staff performance and wellbeing IN THE 18 MONTHS between the second quarter of 2008 and the fourth quarter of 2009, UK GDP fell nearly five per cent. Six months later, at the end of the second quarter of 2010, the economy had regained a little of that loss, but was still three per cent down from its high point. What this downturn meant in real terms was that hundreds of thousands people had lost their jobs, a lot of businesses went broke and many families lost their homes. At the same time, employment in the NHS rose; between June 2008 and June 2009, some 61,000 more people were added to the payroll. One of the main factors preventing unemployment from falling even more precipitately was the growth in public sector employment.

PREPARE TO SURVIVE Of course, this won’t last. Although health service funding is supposed to be protected, there will be enormous structural changes taking place and different patterns of funding allocation will have an impact on

the many organisations which comprise the NHS. Jobs are already being lost and uncertainty is increasing as the government’s spending review reaches its conclusion. So what role does leadership play in all this?

Last year, the Institute of Leadership & Management undertook its first survey into leadership trust (The Index of Leadership Trust 2009). This summer we repeated the survey, and are in a position to report on the impact that the recession has had on leadership trust, and show how strong, effective leadership during this difficult time has enabled some organisations to survive and prepare for the future. Conversely, weak leadership has meant that some organisations are poorly prepared and will pay the price as the economy slowly grows.

NHS managers can learn from the experience of private sector managers as they cope with the pressures that they will undoubtedly face.

Leadership is about followership – the willingness of people to follow their leader, no matter how uncertain the outcomes are.

In fact, when times are hard and the risks are great, the strength of an organisation’s leadership may be all that enables it to survive, as it harnesses the skills and commitment of the people who work for it.

LEADERSHIP AT ALL LEVELS Leadership is needed at all levels in the management structure – from team leaders to chief executives. This is sometimes described as ‘distributed leadership’. What it means in practice is that the organisation recognises that managers who rely on their position to get people to do things will only get minimal support – employees will do what they are contracted to, and no more.

Leaders who use their personal power to motivate and inspire people get higher levels engagement and performance, and this is just as important for team leaders and first line managers as it is for the chief executive.

The ability to engage people was described by the MacLeod Review (Engaging for success

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LEADERSHIP MANAGEMENT

by David MacLeod and Nita Clarke) as the key to creating by high performance workplaces, but it requires strong, effective leadership at all levels if it is to be achieved, especially in the troubled times we now face right across the public sector. The commitment to the organisation that results form engagement is voluntary – people choose to give that extra, because of the leader. What’s more, when times are hard and risks are high, it’s even more important for them to trust their leaders if they are to follow them into the unknown.

The recession provides a real live case study to illustrate this. Many private sector companies had to contract last year. Some did it by shedding staff and closing premises.

Others looked for creative ways to respond.

They dropped to four day weeks, they asked for everyone to take pay reductions, and they encouraged people to switch to parttime or flexible working. In those companies that reduced the number of employees, trust in their managers fell; where they kept employment numbers up but reduced the

cognitive psychologist K. Anders Ericsson) has suggested that true mastery of a role requires 10,000 hours of practice. That’s the difference between an Olympic sportsperson, Nobel scientist or great musician and the rest of us – we don’t practice enough! Leadership isn’t easy.

Putting into practice what has been learnt about effective leadership requires practice and the willingness to question behaviours that you have spent a lifetime developing. What makes people effective leaders is that they think about the effect that their behaviour is having on others, are prepared to change what they do and how they do it, and see the responses of others as the measure of success in their endeavours.

SEIZING THE OPPORTUNITY Many of the people who reach the top of organisations started on the road to leadership very early on, at school, at the sport club or in the scouts or guides. Their first steps on the leadership ladder may have been pure chance, but those who seized the opportunity had the chance to learn and develop, giving them a

When times are hard and the risks are great, the strength of an organisation’s leadership may be all that enables it to survive, as it harnesses the skills and commitment of the people who work for it amount of working, trust levels rose.

Many senior managers led the way. Some took 20 per cent pay cuts and asked their employees for 10 per cent. When the working (and paid for) week was cut to four days, many senior managers cut their salaries as well but continued working five days. Leadership is not about words, it’s also about actions, and effective leadership demands a set of positive behaviours not rhetoric. People judge their leaders by their perceived ability (how well they do their job), their personal integrity, their fairness and openness to others’ ideas, their consistency and their understanding of others’ roles. These are qualities that can’t be faked, and require time and effort before the effects are felt.

THE THREE DIMENSIONS OF EFFECTIVE LEADERSHIP At ILM we talk about a triadic model of leadership, a model that has three dimensions – knowing, doing and being. Knowing is the easiest bit to acquire – there are plenty of books, training programmes and conferences about leadership, so it’s not hard to learn about it. An understanding of leadership – what it is, why people respond to effective leadership, and the behaviours that encourage people to follow a leader – is essential for any manager keen to be an effective leader.

Doing is a lot harder. Popular science writer Malcolm Gladwell (drawing on the work of

head start in the workplace. Those who missed out at an early age need to catch up by working hard on developing their leadership behaviours.

If doing is hard, being is even harder. Being is about your values, attitudes and beliefs.

It is what defines your relationship with the world, the way that your life so far has shaped who you are. Being mediates your knowledge and your behaviour – you use your values, attitudes and beliefs to shape your understanding of others and your responses to situations you face. Your values tell you what is important, and in the health service they will often have led you to work there. Your attitudes shape how you perceive the world and interpret experiences. Your beliefs help you explain your own and others’ behaviour.

Effective leaders have an insight into their own and others’ values, attitudes and beliefs and use that to adjust their behaviour to ensure that they have the desired effect, that they “do the right thing”, as Peter Drucker described it.

Poor leaders allow their values, attitudes and beliefs to control their responses unwittingly, and fail to recognise what others value and believe in and how they see the world.

CREATING TRUST Trust is created by leaders who work on all three of these dimensions. Effective leaders know about their own job’s demands, and work hard to meet them. They also understand

the demands of other people’s job roles and do what they can to help people meet those demands. They behave consistently, allowing people to see that they adhere to the principles and practices that they advocate (without doing so slavishly), and they welcome other people’s ideas. Strong, effective leaders treat people fairly and show personal integrity in decisionmaking, even when their decisions may make them unpopular. It is through these behaviours that they become trusted and through that trust they can lead people through whatever challenges the world throws at them.

EFFECTIVE LEADERSHIP CAPACITY The NHS needs effective leadership. It always has done so, but with the uncertainties of the next few years, it has never been more important. Leadership starts at the top and chief executives with poor leadership abilities will inhibit the development of leadership at other levels. On the other hand, good role models encourage others to develop their own leadership effectiveness.

Developing strong, effective leaders isn’t about expensive training programmes. Training helps, but the development of appropriate leadership behaviours is more likely to happen if there are internal development and support systems to help translate knowing into doing. Line manager coaching, peer mentoring, action learning sets and similar techniques may require a commitment of time, but are an investment that can pay off quickly in improved performance.

Weak leadership needs to be challenged.

Often it is the result of inadequate training coupled with poor support. Many people move into management positions reluctantly, as the only way to further their careers, and this lack of motivation doesn’t help build strong leadership qualities. An organisation that tolerates weak leadership is a weak organisation, and accountability for allowing this to happen lies squarely at the top. Senior managers must be prepared to help those they supervise when they need it, but they must also take action when they have given help but it has been refused or it has failed to change the poor behaviour.

Most importantly of all, leaders at all levels must be ready to look for innovative ways of enabling their organisations to get through the next few months and years. Strong, effective leadership is about challenging accepted ways of doing things, identifying novel approaches that are best of the patients and service users, and enabling the changes required to put them into practice.

David Pardey is senior manager of research & policy at the Institute of Leadership & Management.

FOR MORE INFORMATION Web: www.i-l-m.com

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We are accredited by Leading Specialists in the field of Personal Safety Training including: • The National Federation for Personal Safety (NFPS Ltd) • NHS Counter Fraud Security Management Service (NHS CFSMS) • Blauer Tactical Systems Inc All of our Instructors hold nationally recognised teaching qualifications as well as the Btec Level 3 Advanced Award in Coaching & Instruction in Physical Restraint Practice, which is the only nationally recognised level 3 coaching award in UK & Europe specific to Physical Restraint & Breakaway Training. They have also attended National Syllabus Familirisation Seminars with the NHS CFSMS on the subjects of Conflict Resolution and Promoting Safe & Therapeutic Services.

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Challenges at work?

Learn to cope with wellwise4me.com S AN NHS MANAGER you have the wellbeing of your staff as one of your concerns. Who is there to have concern for your wellbeing?

Challenges at work can be motivating as well as debilitating, so healthy coping strategies at times of overload are essential and indeed essential to our health.

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When you contact us we will listen to your experience and help you make sense of what is happening. We will then design a programme with you to help you learn the tools and techniques that

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To achieve sustained cost reductions, improved efficiency, commercial transformation and to keep employees engaged and willing to accept huge and fundamental change in the NHS will demand resilient, purposeful and insightful leadership skills. Is this achievable? Yes, through selecting the right ILM training partner with the creativity and ability to deliver consistent, effective and high

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PETA Ltd. gives you the assurance of over 40 years proven experience in the delivery of bespoke management and leadership solutions. Behavioural change comes from knowing and recognising the need for change. From “light touch” facilitated sessions, through to structured programmes aligned to competency models or ILM qualification outcomes, we deliver impactful training so you achieve your strategic targets.

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Scheduled courses and bespoke training UR TRAINING CENTRE is at Ower, just off the M27 at junction 2 alongside Paulton’s Park. Easy to find it provides a lovely, peaceful environment for training. Trainers also go to the clients’ site to deliver training on standard software or clients’ own specialist software.

We offer top quality, flexible training in standard computer applications, internet, graphics, technical, programming and bespoke software from new users to advanced and development levels.

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We provide excellent training at keen prices, course notes for every delegate, 30 day support after training, skilled trainers, small classes, refreshments throughout the day, buffet lunch at the nearby Mortimers Hotel.

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FOR MORE INFORMATION Tel: 023 80811680 Fax: 023 80811780 E-mail: sales@manortraining.co.uk Web: www.manortraining.co.uk

Flexible training solutions for the NHS HE WORKPLACE TRAINING COMPANY prides itself in delivering demand-led and flexible training within the health sector. We have been successfully running a management programme for NHS staff since 2007 and provide training at a time and place suitable for the needs of busy staff.

We are a small company, which was established in 2006. We are able to support staff to achieve work-based qualifications in management, business and administration, IT and customer service NVQs. We have a team of dedicated teachers and assessors who are able to meet candidates at work whenever is suitable. We have had the pleasure of seeing our candidates achieve and gain formal recognition for the valuable and skilled work they perform.

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lots of things I didn’t know but with the help from my assessor from the Workplace Training Company I really got my claws into it! It made me feel more confident and I learnded lots of things other than the NVQ – things about myself – things I didn’t know I could do. I felt very satisfied when it was complete and I felt very proud when we’d all done it,” said Janice Vass, housekeeping team leader, The Royal Berkshire Hospital Trust, NVQ Level 3 in Management.

FOR MORE INFORMATION Catherine Sweet Tel: 0118 9462881 E-mail: cath@ workplacetraining.org

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Health Business | Volume 10.5

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TRAINING

THE FUTURE OF GOOD PATIENT HANDLING Employers have a duty of care to protect employees and patients from harm where patient handling is concerned

IN 1981 the National Back Pain Association (now known as Back Care), published the First Edition of The Guide to the Handling of Patients. This publication outlined what was then regarded as best practice for nurses and carers involved in assisting patients to move.

This initial guide book has since been regarded as the foundation stone upon which subsequent publications have been based; current back care advisors and patient handling practitioners now eagerly await the publication of the Sixth Edition. The Guide to the Handling of People (HoP), is generally regarded as the Industry Standard, and forms the basis upon which professional healthcare practitioners work.

A decade later when the Manual Handling Operations Regulations 1992 (MHOR), were adopted under European health and safety law, it further supported patient handling practitioners in their quest to improve handling techniques and encouraged healthcare workers to make better use of the ever increasing range of equipment becoming available on the market.

Together with the Health & Safety at Work etc. Act 1974, the MHOR (92), placed additional specific responsibilities on employers to undertake moving and handling Risk Assessments, highlighting appropriate control measures that would reduce any identified risk of injury down to the lowest levels reasonably practicable. Historically, the employer’s duty to provide appropriate training has always formed

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part of this risk reduction strategy and to date remains a requirement under the 1974 Act, in so far as he is required to provide Information, Training, Supervision and Instructions.

CONSEQUENCES It goes without saying that failure to comply with statutory health and safety requirements will inevitably lead to an increase in accidents, injury, sickness absence, damage to corporate image and the likelihood of hefty legal costs.

A legal case may be found for the claimant if they are able to demonstrate that: • they were owed a particular duty of care • the duty of care was breached • the breach resulted in injury or harm Clearly, where patient handling is concerned, employers have a duty of care to protect employees and patients from harm; failure to adopt adequate risk reduction strategies resulting in injury encourages claims for compensation and may constitute a criminal offence.

However, it is often personal costs that tend to go unappreciated. Research and anecdotal evidence has shown that patients are often injured or frightened by inappropriate use of handling techniques and/or equipment, for example toileting slings and standing hoists being used for patients with low muscle tone or limited cognitive ability.

The Nursing and Midwifery Council (NMC)

has a professional code which all Nurses and Midwives are required to abide by. It states: “The people in your care must be able to trust you with their health and well being. To justify that trust, you must....provide a high standard of practice and care at all times.”

Standards of practice observed by non-registered carers should not fall below these expectations.

In 2001 the Department of Health (DoH), set National Minimum Standards for care; Standard 18 requires all those in receipt of care to be protected from abuse, including poor handling practices that may result in injury, harm or loss of dignity and choices. One such handling technique, the ‘Drag Lift’, (conducted by placing the carers arm underneath the patient’s axilla and dragging them into the required position) has been shown to tear soft tissue and is capable of causing joint dislocation for the patient. However, evidence suggests this technique is still widely popular as it does achieve the desired outcome, does not require any equipment and therefore is often considered quick and inexpensive to implement. But at what cost to the patient?

Not to mention the long term effects upon the carers who often take the full weight of the patient through their musculoskeletal system?

FROM HOP 1 TO HOP 5 Since the Guide to the Handling of People was first published nearly three decades ago, safe patient handling techniques and equipment has developed dramatically. In 2010 the emphasis lies very much in promoting patient choice and inclusion with a fantastic range of equipment options to choose from.

Much research has been conducted resulting in a more informed assessment of risk when undertaking patient handling activities and the identification of techniques which no longer pose a threat of injury to patient and carer.

Many patient handling speciality sub sections now exist, such as handling in operating departments, handling the bariatric patient, and safe handling practices in midwifery, radiography and paediatrics to name a few.

Today most care organisations of any size will have access to one or more back care advisor, employed to effectively manage risk and reduce the possibilities of harm and injury. For organisations that do not employ their own advisor, a range of external options exist. Universities across the UK now run several formal programmes of study aimed at improving patient handling for care practitioners and for those who do not wish to study the subject in such depth, several independent organisations run four or five day courses for managers and supervisors.

It is, however, worth noting that unlike First Aid training, patient handling training remains unregulated: anyone regardless of occupational background, education or skill is able to advertise as a patient handling advisor/

Health Business | Volume 10.5

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TRAINING

trainer. These “practitioners” often charge their services well below their professionally qualified and experienced counterparts and hence are an attractive option for any commissioner.

The National Back Exchange, an organisation with a membership made up of committed, professional back care practitioners and patient handling equipment manufacturers has recently released a publication entitled ‘Standards in Manual Handling’, Third Edition (2010), which outlines the recommended standards which should be adopted in order to meet with legal compliance and promote standards regarded by the membership as evidence based current best practice.

OPTIONS FOR TRAINING Patient handling is by definition a practical skill that should be performed to the best standards possible by staff in possession of

organisation regardless of size or speciality.

There appears to be an increasing move towards DVD, e-learning and computer based systems when it comes to staff training.

However, like driving a car, the practitioner is engaging in a high risk practical activity capable of the most disastrous consequences should any degree of failure occur – would we be happy to let someone have the keys to a vehicle if their training programme was delivered by watching a DVD or via a computer based system? Research has identified some programmes that allow the participant to gain a certificate of completion (not competency), although all questions answered at the end of the so called course were incorrect.

When commissioning the delivery of patient handling knowledge and skills for care, healthcare staff and managers must be vigilant when it comes to the standards of delivery

Where patient handling is concerned, employers have a duty of care to protect employees and patients from harm; failure to adopt adequate risk reduction strategies resulting in injury encourages claims for compensation and may constitute a criminal offence the appropriate underpinning knowledge and the practical hands-on abilities to work in accordance with the standards recommended by expert practitioners.

However, good practice also depends upon effective management systems being in place to support these standards. Staff who have undertaken extensive training will have great difficulty putting their knowledge and skills into practice without adequate management support. It is imperative for a holistic ergonomic approach to be adopted within in any care

they are purchasing. Employers may choose to engage a competent practitioner as an advisor/trainer, but will then need to ensure the practitioner is able to keep abreast of current trends and practices in safe patient handling techniques and equipment. Alternatively, outside agencies may be commissioned to undertake risk assessments and/or programmes of training. This clearly places a professional responsibility upon the agency to ensure their knowledge and skills are up to date. The Standards in Manual Handling Third Edition,

(2010), is an invaluable guide in determining what to look for when engaging a practitioner.

Poorly supported, educated and skilled staff can result in disastrous consequences.

Thought for the day – What at first can appear to be an expensive option often turns out to be the most cost effective one in the long run!

CONCLUSION Legal requirements in the UK and Codes of Professional Practice for all healthcare workers are the driving force behind safe patient handling and as such cannot be ignored or compromised. Compliance failure could result in significant losses to corporate image, a down grade or loss in registration by the Care Quality Commission, expensive legal costs fines, and removal from a professional register for registered healthcare practitioners.

Every patient has the right to expect care based upon current best practices, delivered with a high standard of respect and consideration. This can only be achieved by staff who are well informed and skilled in the delivery of patient handling practical techniques and the use of appropriate equipment to meet the agreed outcomes for that individual patient.

Identifying suitable and sufficient safe systems of work and the underpinning risk reduction strategies is of paramount importance in ensuring legal compliance reflecting high standards of care.

About the author

Paul Titcomb P.G.C.E., M.S.F., M.A.B.Phys., M.InstL.M., NBE(RM) is managing director of ARC Learning, a consultancy and health and safety training company.

FOR MORE INFORMATION E-mail: info@arclearning.co.uk Web: www.arclearning.co.uk

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STAFF INCENTIVES & MOTIVATION

MOTIVATIONAL MEDICINE FOR HEALTHCARE STAFF During times of healthcare budget cuts, it is vital to keep staff engaged and motivated so that patient care does not suffer, writes Andrew Johnson, director-general of the UK Gift Card & Voucher Association IN RESPONSE TO THE POST-BUDGET announcement that the Department of Health is to save up to £555m by reducing staff sickness absence, The Chartered Institute of Personnel and Development (CIPD) advised that driving-up the quality of people management across the health services, as well as improving absence management policy and practice, was essential in moving forward.

Budgets, therefore, should include an allocation for employee motivation and engagement spend. Andy Philpott, marketing director at Edenred, explains: “With the healthcare sector feeling the pinch of budget cuts, the challenge for companies is to reduce cost while enhancing employee relations and performance. Employee benefits are needed now more than ever in order to address this issue. They play a vital role in keeping staff engaged with the sector during times of change.”

To this, Iain McMath, managing director at Sodexo Motivation Solutions, adds: “During such turbulent times, management can often lose its focus on employee motivation. If employers simply push their staff to perform better without providing them with the appropriate incentives to do so the effect on productivity and staff morale can be devastating.”

INCENTIVE REWARDS A common practice within the private sector for improving staff performance and engagement has been to offer incentive rewards. While reaching sales targets is the obvious goal when setting up private sector incentive programmes, incentive rewards can also be appropriated for all manner of different staff improvement objectives. In the public sector, this could mean rewarding staff for high levels of attendance, for going beyond the call of duty, for offering new ideas that improve services and systems or for reaching long service milestones. They can also be used for rewarding staff across the organisation for their contributions to achieving bigger goals that form part of longterm strategy, such as reducing waiting lists or making significant efficiency savings.

Performance management professionals such as Andy Philpott and Iain McMath, as well as many other members of The UK Gift Card & Voucher Association, are often tasked with advising public sector departments on different types of targets, incentives and rewards that

can be used to acknowledge a whole range of objectives. So what are the options?

According to Jock Jordan, group sales director at The Gift Voucher Shop: “An effective reward scheme must be devised with the intention to increase the discretionary effort of the target audience, drive performance improvement, and encourage the recipient to repeat the behaviour that earned them the reward.” He argues that cash rewards simply do not fulfil this: “People are generally unlikely to remember what they spent a cash reward on, while only a very small proportion of employees will actually spend it on something special for themselves. More often than not the money is absorbed into paying for groceries or household bills, which is hardly memorable for the employee.”

Iain McMath continues this argument against using cash incentives: “In the current economic climate, extra cash for bonuses can be hard to find. However, senior managers do have access to a wide range of alternative, cost-effective incentives and flexible benefits to offer to their staff.”

Jock Jordan looks to a better solution: “The reality is that for any organisation hoping to encourage certain behaviours, be it public or private sector, they should now look to at least part rewarding a bonus or merit reward with an appropriate non-cash incentive such as gift cards or vouchers.”

The UK Gift Card & Voucher Association (UKGCVA) represents all of the key players in this market, with many of them ready to offer specialist advice into employee motivation programmes and explain why vouchers and gift cards work so well as incentive rewards.

GIFT CARDS AND VOUCHERS Mark Towler, head of House of Fraser Business Incentives, says: “Prepaid cards and vouchers have a proven track record when it comes to staff reward, having been used successfully to reduce staff absenteeism and attrition rates, improve loyalty and increase productivity. With discounts available on bulk purchases they’re a great way of getting the best return on your staff reward investment and are extremely simple to administer. Gift cards and vouchers provide exceptional choice for the recipient and deliver a cost efficient approach to meeting the aspirations and desires of a diverse audience.”

Choice is clearly an important consideration when trying to appeal to a wide workforce.

Andy Philpott continues: “The healthcare

Andrew Johnson

sector employs a range of staff at different levels and with different interests. Therefore what motivates one employee will not necessarily motivate another, and companies need to consider this when introducing an incentive scheme. Employee benefits are not a ‘one size fits all’ package but a range of options enabling the incentive to be tailored to suit each employee.”

This element of choice is one of the key attractions for offering Tesco’s incentive rewards scheme, argues Venki Nayani, commercial manager for Tesco Gift Cards. He said: “We have several clients in the health sector as part of Tesco’s corporate incentives business. The ubiquitous nature of the Tesco Gift Card makes it popular as recipients can redeem it against any products found in store and online, including groceries, clothes and electricals. It is important to offer an employee reward scheme with choice and ease of use in order that staff get the most out of it.”

PAPER OR PLASTIC? Having decided that giving recipients choice is important, managers then have to decide whether paper vouchers or gift cards are more suitable for their schemes. The voucher option includes those which can be redeemed at a wide variety of outlets such as The Voucher Shop’s Voucher Cheques, National Garden Gift Vouchers and spa offerings from SpaFinder Europe, or store specific vouchers from leading retailers and leisure outlets. The gift card choice is similarly between store gift cards such

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STAFF INCENTIVES & MOTIVATION

as the Tesco Gift Card and those that are widely redeemable, including P&MMâ&#x20AC;&#x2122;s Spree Card and Edenredâ&#x20AC;&#x2122;s Compliments range.

On the popularity of paper vouchers, Paul McRae, business development manager at The Voucher Shop, comments: â&#x20AC;&#x153;One of the most popular options being used by NHS Trusts today for both ad-hoc awards and long service awards is the Voucher Cheque. The blank Voucher Cheques can be printed with the Trustâ&#x20AC;&#x2122;s name or logo and then personalised to individuals for any amount. The cheque can be provided in a stylish envelope, along with a personalised letter or other appropriate message that makes a real impact when it is presented.â&#x20AC;?

Another provider of paper vouchers, David Butler, general manager of National Garden Gift Vouchers, said: â&#x20AC;&#x153;Rewards and incentives that allow choice, have a perceived value or â&#x20AC;&#x2DC;cashâ&#x20AC;&#x2122; appeal such as vouchers, but at the same time encourage physical and holistic activities that could be family inclusive, have become a favourite option. They also provide employers with simple but cost effective wellbeing motivational solutions.â&#x20AC;?

Gilles Coccoli, managing director, PrePay Solutions, takes the view from the gift card stance: â&#x20AC;&#x153;Gift cards are a simple solution

as they are cost efficient and can be easily integrated into a company. The key to the success of gift cards is simple. Prepaid cards offer a cost-effective resource that boasts the same legal framework as a bank account. With little outlay cost per card and the ability to load and re-load funds onto them electronically, the costs â&#x20AC;&#x201C; both financial and resource-wise â&#x20AC;&#x201C; can be minimal when compared with cheques and direct deposits.â&#x20AC;?

CASE STUDY P&MM Motivation has already taken the prepaid card solution to the NHS with an innovative savings benefit utilising prepaid technology. Teaming up with NHSCashback. co.uk, P&MM created the NHS Cashback Card using its Spree Card platform. This incentive reward card enables staff to receive cashback on their high street purchases and enjoy saving of between 3.5 per cent and 5 per cent at a range of top UK retailers.

The card works by allowing the cardholder to top it up with funds using a debit card and then when the card is used to make purchases at participating retailers, they receive cashback. Cashback is tracked seamlessly and the savings are added back onto the card. â&#x20AC;&#x153;We estimate that the average person will

save between ÂŁ200 and ÂŁ300 per yearâ&#x20AC;?, said John Sylvester, of P&MM Motivation. â&#x20AC;&#x153;The card also doubles as a discount card allowing the user to get money off at over 4,500 local retail locations across the UK. This includes health clubs, pubs, taxis, restaurants, takeaways, clothes shops and nightclubs. Itâ&#x20AC;&#x2122;s a great way to incentivise staff without needing to give them a pay rise as the saving earned will make a salary go considerably further.â&#x20AC;?

So in summary, vouchers and gift cards offer a versatile incentive reward that caters for wide tastes and allows the recipient to choose their own gift. They can also be appropriated to fit any budget and the range of vouchers on the market, from the high street to experiences to gardening, Filmology cinema vouchers, spa days and more, provides more than enough solutions to cater for all tastes. These benefits should offer an attractive solution to health sector HR departments seeking to implement changes in staff attitudes and behaviour over the coming year.

FOR MORE INFORMATION For full information on the options available in the UKâ&#x20AC;&#x2122;s gift card and voucher market, visit: www.ukgcva.co.uk

Your one stop shop for corporate gift vouchers HEN IT COMES TO

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W choosing a reward, benefit or gift itâ&#x20AC;&#x2122;s hard to please everybody.

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At The Voucher Shop we have something for everyone â&#x20AC;&#x201C; our wide portfolio comprises of over 40 different high street vouchers and experiences for you and your audience to choose from, including single store and multi store gift vouchers.

With over 20 years experience working with large blue chip clients, The Voucher Shop can provide you with a one stop shop for: â&#x20AC;˘ Reward schemes â&#x20AC;˘ Staff recognition programmes

â&#x20AC;˘ Flexible benefits solutions â&#x20AC;˘ Long service awards â&#x20AC;˘ Gift cards â&#x20AC;˘ Spot rewards and bonuses We offer competitive discount rates on bulk orders, a dedicated voucher fulfilment team, clear processes and ISO regulated procedures to ensure accuracy, quality control and solutions capable of evolving with our clients.

FOR MORE INFORMATION The Voucher Shop Rockingham Drive Linford Wood Milton Keynes MK14 6LY Tel: 0845 050 9533 Web: www.thevouchershop.co.uk

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

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Making well-being work for you and your organisation

Healthy Insights

As an ISMA member and approved trainer LifeCraft can support you to implement health and well-being initiatives with many benefits including: • delivering both long-term savings and improving patient care • making well-being an integral part of a managers/leaders role • targeting and reducing absence and supporting employees to return to work Investing in the Champion in Health and Well-being Management programme will help achieve the above ensuring you profit from healthy and well staff We would be pleased to talk in more detail about how we can draw upon our NHS experience to support you in this area.

Contact: Heather Girling Email: heatherg@lifecraft.co.uk Phone: 01239 711799 Visit www.lifecraft.co.uk for more information and to register for the FREE Workplace Well-being Newsletter

London: Gable House, 18-24 Turnham Green Terrace, Chiswick, W4 1QP Wales: The Copse, Carmarthen Road, Newcastle Emlyn, SA38 9DA

At The Best Organisation we specialise in providing new insights into consumers' and stakeholders' motivations, language and behaviour in both the public and private sectors.

Using leading edge research techniques, we don't just focus on the people that you wish to understand and influence, but also reveal what they are focusing on and what drives their behaviour at both a rational and emotional level.

We advise you on how to get onto their wavelength and 'speak their language' in your external and internal communications.

We also specialise in tracking consumer journeys, identifying critical 'touch points' within the experience and in helping you to deliver an excellent service at each step of the way.

For more information contact: Di Tunney The Best Organisation Tel: 0115 982 6563 Email: diana@thebestorganisation.com Web: www.thebestorganisation.com

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Start building a safety culture and join the thousands of other users.

View an online demo and register for a FREE, no obligation, trial at www.praxis42.com Or, why not undertake a pilot with a user group in your organisation?

Call 0870 446 4201 or email training@praxis42.com

Why Praxis42 eLearning? s Significant cost savings s Accessible training and assessment records s Training delivered at the trainees convenience s Optimal training time s Reduced environmental impact

Health Business | Volume 10.5

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STRESS MANAGEMENT

WHEN PRESSURE BECOMES STRESS It is a management responsibility to ensure pressure is kept to a manageable and motivational level so that it does not have an adverse affect on staff wellbeing, writes Ann McCracken, Chair of the International Stress Management Association dealing with workplace stress and identified the key workplace hazards that would become the basis for a risk assessment.

Responsibility for managing stress was placed on managers. This means that managers need to be trained to deal with of the effect of too much work related pressure on their staff. They were introduced in 2004 and act as guidance and best practice for managers at all levels to focus on the six workplace risk factors. Further guidance and clarification was issued in 2007 HSG 218 revised (see the HSE website).

FOR MANY YEARS STRESS has been seen as a weakness, but the many case studies and legal precedents clearly indicate it can happen to anyone in the pressurised workplace of the 21st century.

There can be little doubt that many staff in the NHS are experiencing serious pressure in several areas of their work and it is a management responsibility to explore this and work with staff to reduce the pressure to a manageable, motivational level. There are many factors at play here, however, including staffing levels, staff competencies, staff expectations, patients expectations, remuneration, professionalism, resources, politics, and so on.

According to the NHS Employers (2008), stress is believed to account for over 30 per cent of sickness absence in the NHS, costing the service £300-400 million per year. The Healthcare Commission’s 2007 staff survey found that 33 per cent of staff questioned said they had felt unwell because of workrelated stress over the past 12 months.

The first thing most of us need to clarify is the meaning of the term ‘stress’. Stress is one of those words that everyone uses but it seems to mean something different every time it is used. People talk about experiences being stressful – everything from getting up late to getting divorced. They describe themselves as stressed when they often mean busy or being prevented from doing what they want to do.

WHAT IS STRESS? The International Stress Management Association (ISMA) in conjunction with the Health and Safety Executive (HSE) defines stress as “the adverse reaction people have to too much pressure”. The key word in this

definition is adverse. An adverse reaction is not good, especially when related to health. Therefore, stress is not good for you.

In training sessions run by ISMA approved trainers, delegates are asked if they think stress is good for them and around 60 per cent think it is – until they read the definition. This poses the question: what is it they think is good for them? The answer to this is pressure.

Challenges and pressures are part of life and we need them to motivate and stimulate us. Interestingly, some people really thrive on pressure and feel low and below par (stressed) if they are not being pushed or pushing themselves.

We can, however, all experience too much pressure and this is what is meant by stress.

It is interesting to note that not enough to do, creates stress as well as too much pressure. The trick is to get the right amount of pressure for you. This makes stress a very personal response.

LEGAL COMPLIANCE There is no specific law relating to stress.

In 1974, the Health and Safety at Work etc Act placed duties of care on employers and employees. For example, section 2 (1) placed the duty on employers to ensure the health and safety of all employees at work, as far as is reasonable and practicable. In 1988 a further amendment to this stated “ill health resulting from stress caused at work has to be treated the same way as ill health due to other physical causes present in the work place.”

1999 saw The Management of Health & Safety at Work Regulations, which required all employers of five or more people to carry out regular risk assessments, identify hazards and take action. In 2001, HSG 218 was produced which offered practical advice on

THE COST OF STRESS From the NHS Employers statement above, the HSE and CIPD, it is clear that absence due to stress cost organisations like the NHS huge amounts of money. Public sector organisations have a higher absence rate than the private sector and at an average of ten days per annum, sickness absence among the 1.3 million NHS employees is significant. Not all sickness is due to stress but typical symptoms of stress are susceptibility to minor ailments like headaches, migraines, irritable bowel, anxiety and musculoskeletal problems as well as high blood pressure, heart conditions and other life threatening illnesses.

DEALING WITH WORK RELATED STRESS There is a clear process in place for organisations to deal with stress: • Create a workable policy for managers to follow • Train senior management in the reasons and method of measuring stress/wellbeing • Train managers to implement the Management Standards for stress • Train employees to understand what stress is and how to manage it at a personal level • Implement a confidential organisational risk assessment and identify areas of concern and best practice • Talk to staff and find out more about the best practice and if it can be spread • Celebrate best practice • Talk to staff in areas of concern and find out if they have solutions to their concerns • Brainstorm solutions and get buy in for the one(s) chosen • Implement staged solutions and test effectiveness by polls/audit.

This puts the onus on managers at all levels to listen, implement and measure agreed solutions to local issues identified within the organisation.

Harrogate and District NHS Foundation Trust have used this method successfully: “We can see notable improvements in the 2008 audit” is a quote from the work done which can be seen as a case study on

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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

Health Business | Volume 10.5

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STRESS MANAGEMENT

the HSE website www.hse.gov.uk/stress/ casestudies/harrogate-nhs-trust.htm You will notice that there is no mention of Indian Head massage, Reflexology or Reiki.

These and other holistic interventions are excellent to energise and rebalance the body but can be of limited effect if the employee returns to the situation which is causing them to display symptoms of stress. If there is a work related issue, there should be clear guidance to all staff to indicate their concerns to their manager, using the six Risk Factors in the HSE Management Standards and for the manager to respond by discussion possible solutions.

EMPLOYEE RESPONSIBILITY The employee has a responsibility to identify and manage stress as well. Each individual has their own life blueprint created by life experiences and resultant beliefs as well as the values which have been instilled since childhood.

It is important to remember that they were employed for a set of appropriate skills which they still have but under excessive pressure may be demonstrating changed behaviour.

If a situation is perceived as a challenge their body biochemistry will immediately change (increase in adrenaline/nonadrenaline/cortisol).

This is a natural response to challenge and if the individual deals with the situation all will return to ‘normal’. If, however, the individual continues to worry or replay the scenario(s) in their head for hours/days/weeks, further biochemical changes will occur affecting mood, behaviour and health.

This may eventually result in absence and chronic ill health. They may be able to change the unhelpful behaviour themselves or can be signposted to help within the organisation or seek a qualified stress management practitioner.

This will result in developing resilience as they will learn how to limit the thinking style which ‘winds them up’ and attempt to think about situations differently resulting in balanced body chemistry.

In summary, the way forward is to: • have a good, clear stress management/wellbeing policy • train all managers to apply the management standards (based on the six risk factors) • encourage managers at all levels to take stress seriously and look at the work factors that may be causing too much pressure.

• train managers to employ coaching techniques – using skilled questioning and listening will help both parties to identify perceived pressures and this can be enough to clarify a potentially stress inducing situation

Make wellbeing work for you, your managers and your organisation HE WELLBEING of staff is essential for a happy, productive workforce able to efficiently handle the demands of busy organisations.

This can be achieved through good management that improves productivity and ensures individuals are able to perform – and want to perform – to their full potential, as those who are empowered, engaged and well supported provide better patient care.

Engaging managers in the wellbeing strategy will move the focus to prevention rather than cure. This will enable them to consider root causes such as job design or management culture, and improve the physical and mental health of their workforce.

A well established and proven training programme that supports managers is the ‘Champion in Health and Wellbeing Management’, developed

by LifeCraft and accredited by the Institute of Leadership

T

and Management, it delivers numerous returns on investment, as one participant commented: “Sickness absences were reduced within a few weeks and will be an ongoing benefit.”

LifeCraft can help you to achieve results demonstrated by increased motivation, confidence and skills, following through to a quantifiable business impact.

We would be pleased to talk in more detail about how we can draw upon our NHS experience to support you, your managers and your organisation.

FOR MORE INFORMATION Contact: Heather Girling Tel: 01239 711799 E-mail: heatherg@lifecraft.co.uk Web: www.lifecraft.co.uk

• regularly (every 12-18 months) carry our a risk assessment for stress, communicate the results, devise action plans and work the plan • listen to staff – even minor adjustments in work load, flexibility in timing and personal encouragement can reduce perceived pressures and enhance commitment • refer staff to professional support systems which are focused on coping outcomes and resilience.

Why not take part in National Stress Awareness day (NSAD) 3 November 2010?

There are lots of free downloads on the ISMA site and you may be able to get a free Stress Adviser for your NSAD activity. Visit www.nationalstressawarenessday.co.uk And why not take part in the National Stress Management Awards. For more information see www.isma.org.uk/national-stressmanagement-awards/index.html

FOR MORE INFORMATION Useful websites: www.hse.gov.uk/stress www.isma.org.uk www.nhs.uk/Conditions/ Stress/Pages/Causes.aspx

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

I

foundations of their organisation will 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 8331597 Fax: 01242 603226 E-mail: info@orghealth.co.uk Web: www.orghealth.co.uk

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Increase your sales and your margin!

We at Grosvenor Continental understand the pressures you face in setting up and running a successful catering operation, particularly during these challenging times.

Unlike our competitors, we take an entirely different approach. Not only will we be able to deliver a first class design, planning and installation service, but we go that bit further... t We will design, plan and install a market leading solution that would rival any you might find on the High Street. t We can help you sell in the solution, up the line, with a thorough and complete Business Plan presentation t We will work with you to refine the sales operation and increase sales volume and margin

In short, where our competition’s service ends, ours just begins and we’ll help you make smarter decisions faster and easier.

Whether you require a mobile coffee pod, a café or a full food court, we have the resources and approach to meet your expectations.

AND, so confident are we that you will be 100% satisfied with our service, we will offer you, ABSOLUTELY FREE OF CHARGE, our state of the art EvolutionTM coffee bar for a three week trial period (terms and conditions apply).

Put your plans into reality and watch the money roll in!

Health Business | Volume 10.5

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CATERING

IMPROVE FACILITIES AND MAKE A PROFIT Grosvenor Continental understands the pressures you face in setting up and running a successful catering operation and will work with you to design and build beautiful yet practical retail solutions, which will offer a return on investment quickly THE NEED FOR ALL PUBLIC SECTOR services to tighten belts and brace themselves for a storm has been well documented in the media recently. With one third of healthcare spending going on facilities, there is to be massive pressure on facility teams to drive down costs.

Key areas in which costs have risen in the past 10 years are occupancy, operations and utilities, and with increased costs expected due to climate change levies, now is the time for action.

Previously the approach was to close wards or not to use areas within the hospital but this has proven to be ineffective as reducing the number of patients treated, increases the cost per patient as overhead costs increase. Too often though in the past, patient feedback suggested that maintenance and contract cleaning schedules were the areas where cost cutting exercises were most noticed. Recently, owing to a shameless style of journalism, this issue has been given unfavourable exposure in the press. This can obviously have a negative impact on customer satisfaction and enjoyment of existing or new catering facilities.

DRIVING DOWN COSTS The focus of the facility teams will need to be on driving down costs, especially on annual energy spend but more importantly to develop new revenue streams within the resources they currently have.

We are all aware of how important it is to think about our energy efficiency, about how we adapt to restrictions placed on us in the way we recycle our waste

and how we should think more about our consumption choices on a daily basis.

This major shift in the public psyche has been most keenly noticed during the last five years, through awareness campaigns and high profile summit meetings but it is only now that serial offenders and those who have poor energy efficiency standards will start to feel the penalties in real and financial terms. By September 30, it will be mandatory that all UK businesses with energy consumption of more

Carbon Trading initiatives. April 2010 saw the start of ‘The Footprint Year’, running until March 2011. This will give a bench mark reading, against which future readings will be taken to track the carbon consumption efficiency of the public sector and other industries. It is said that by 2013, 90 per cent of our energy consumption must be accounted for.

Carbon Trading Allowances are designed to encourage organisations to lower their carbon emissions and reduce overall costs.

We should all now expect that ‘sustainability’ and ‘Green Credentials’ will be as much part of the way we do business in the future as ‘profit margins’ and ‘bottom line’ are to the current business model than 6,000MWh (energy bills of over £500,000) must register themselves to the Carbon Reduction Commitment Energy Efficiency Scheme (CRC). Any organisation operating below that level (between 3,000-6,000MWh) must provide proof of their consumption or else incur penalties of up to £5,000.

THE FOOTPRINT YEAR These types of schemes and minimum requirement league tables will become increasingly more common place in the future, with strict levies being placed on poorly performing individuals and corporations. We have also seen a rise in

The rate will be fixed at £12 per tonne until 2013, and further incentives will be available as profits will be re-distributed to the best performers, through the introduction of a Carbon Emissions League Table. Full details of this scheme and more are available on the Environment Agency website and on the CRC EES pages on the Defra website.

We should all now expect that “sustainability” and “green credentials” will be as much part of the way we do business in the future as

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www.healthbusinessuk.com

Visit the website to view the categorised product finder

Gluten free has never been so easy HEN SIMPLY-FREE’S

W founder, Louise Skelton was diagnosed with Coeliac disease seven years ago, her life changed.

Endless and frustrating years of badly-stocked supermarkets, unpalatable food and a general lack of understanding, led her to take her life back with the launch of her online store, Simply-Free.

Simply-Free has very quickly become the place for Coeliacs and organisations providing gluten free alternatives to buy. Working in partnership with key gluten free suppliers this innovative business is bridging the gap between diagnosis and normal lifestyle.

Simply-Free is very proud to be this year’s sponsor of the Coeliac UK Youth Champion award.

Simply-Free has finally been able to give choice back to Coeliacs. Under one umbrella you will find leading providers

JJ – the first choice in food service OR MORE THAN 20 years, JJ Food Service with its range of ambient, chilled, frozen foods, packaging and cleaning products has excelled within the food industry. As a result we were recently awarded The Grocer Gold Award 2009 for Wholesaler of the Year.

Our service not only provides for all your catering needs, but also offers courses such as the L2 Food Safety Award.

JJ Enfield is a registered Royal Institute Training Centre.

All of our goods are meticulously tested for quality, we also use the expertise of our development chef Gino D’Acampo to make

F

of free-from foods including the largest range of mouthwatering delicious products from Mrs Crimbles, Hale&Hearty, Livwell and Doves Farm.

Catering for Coeliacs has never been easier with so many gluten and wheat free products all under one roof.

sure that every product we sell not only tastes good, but is of the finest quality.

The Lloyds Register Quality Assurance Environmental Certification ISO14001:2004 recognises JJ Food Service and its commitment to minimise the company’s impact on the environment.

All our certifications are available on request or through our website in the ‘about us’ section.

FOR MORE INFORMATION Tel: 01992 701 727 Fax: 08719 730 888 E-mail: admin@jjfoodservice.com Web: www.jjfoodservice.com

FOR MORE INFORMATION Tel: 01582 793822 E-mail: enquiries@ simply-free.co.uk Web: www.simply-free.co.uk

Providing hospitals with refreshment solutions for over 40 years E HAVE BEEN PROVIDING

W refreshment solutions for

over 40 years and have become a leading provider of drink, food and snack refreshments, generating sales in excess of £8m. An independent business owned by the second generation of the Balmforth family, we have established a reputation for quality, timely and trusted service.

Our high standards and dedicated workforce have contributed enormously to our success.

We can serve all our customers’ needs whether they require a fully operated service or specialised coffee equipment. Supplying a wide range of machines, we also offer a wide range of branded ingredients, such as Kenco, PG tips and Cadburys.

Building on our success, we have continued to explore other opportunities. With consumers

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looking for high street quality drinks at low cost, we launched Café Amore. A coffee shop concept that includes a vending machine which serves perfectly prepared drinks into a 9/12oz cup – like you would find on the high street. We exhibited at the latest HEFMA exhibition, showcasing how our products and services can fit in healthcare environments, keeping costs down whilst generating a profit. More recently we were awarded as the supplier of hot beverages at the Whittington Hospital, London.

FOR MORE INFORMATION Address: 31 Bolling Road, Bradford BD4 7HN Tel: 0800 9153046 E-mail: info@refreshment systems.co.uk Web: www.refreshment systems.co.uk

THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

Hagesud Bosse – help for your food budget AGESUD BOSSE (UK) Ltd is an established manufacturer and supplier of spices, herbs, seasoning blends, soups and sauces.

The company was established over 30 years ago and is able to offer NHS hospitals a range of soups and sauces that offer the catering departments a convenient and cost efficient product range that is well liked by patients and good for your budgets.

The range includes gluten free products that meet specific dietary needs without any loss of flavour or performance. The product range is also good for ward application.

H

The products are produced here in the UK to BRC Higher Level Accreditation. Packaging is from sachet packs through to bulk packs depending upon site requirements.

Our products are backed up by a dedicated sales team covering the whole of the UK. Please contact us to request product samples and further information.

FOR MORE INFORMATION Company Name: Hagesud Bosse (UK) Limited Tel: 01989 565971 Fax: 01989 767684 E-mail: bosse@hagesud.co.uk

Health Business | Volume 10.5

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CATERING

“profit margins” and “bottom line” are to the current business model. At Grosvenor we believe in helping our clients find the right solutions to these challenges. By taking the time now to identify the areas in our day-today operations that could be improved upon and by embracing carbon waste reducing technology, we can help our clients to be better prepared for a green future that is as financially profitable as it is effective, within the framework of the Energy Efficiency Scheme.

There are obvious savings that can be made but inevitably they require investment. The only way such changes can really be effective is by having them built into new build or major refurbishment schemes, seeking to remove poorly performing facilities and replace them with carbon efficient profitable locations, that are designed to be future proof and beneficial in reducing energy wastage.

Grosvenor Continental will work with you to design and build beautiful yet practical retail solutions, which will offer a return on investment quickly. Our team include industry experts to help guide you through the process of adapting for the future. Whether it’s advice on catering operations, business model development or statistical analysis to identify new revenue streams or retail opportunities, we stay with you every step of the way.

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HEALTHIER CHOICES – A CATERING DILEMMA The humble vending machine is it a Saint or Sinner? With thousands of people now classed as morbidly obese what positive action can vending companies take to support the health sector?

BALANCING CONSUMER DEMAND for unhealthy high fat, salt and sugary foods versus healthy choices and a good return on investment puts constant pressure on catering teams to make the right decisions. How do they overcome this difficult challenge and still deliver high quality, healthy snacks and drinks without compromising consumer choice?

There have a been a number of articles over the years about the part vending plays in hospital catering, many arguing that it does not fit in with the healthy image that hospitals should portray to their customers. After all, shouldn’t hospitals practice what they preach?

Many still have pre-conceived ideas that traditional beverage and snack vending machines promote unhealthy food and offer only high fat, sugar and salt products. The truth, however, is that the humble vending machine as we know it is only the receptacle that the goods are sold through. Vending machines can be filled with any choice of product but do consumers really want healthier options?

With so much controversy about obesity in children and adults, diabetes, heart disease and the cost to the NHS in treating people with symptoms associated with unhealthy eating it is no wonder hospital caterers feel they need to take the lead in providing healthy options to customers. So what products should be served? And how can this be managed?

There is no doubt that vending machines play a vital role in delivering a fundamental service when cafeterias and restaurants are closed or when high volume puts demands on the catering team. So what part can vending suppliers play and how can we encourage a more positive image?

EMOTIONAL REFRESHMENT Firstly, let us consider the emotional choices that consumers make when wanting light refreshments. We have all heard or have said some of the following: “It’s really what I fancy.” “I really want some comfort food.”

“I am in need of a chocolate fix.” “I am in desperate need of a cuppa.” “I need a coffee to keep me going.” The truth is that beverages and snacks are not only refreshment but are also used to support an emotional need when we are sad, when we celebrate, or when we want a pick-me-up to get us through the day. Taking that opportunity and choice away from someone when they are unhappy, stressed or elated is in fact denying them support at their most vulnerable time.

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Put yourself in the situation where it’s late, the restaurant or canteen is closed, you may be waiting for news, have received bad news or you have just finished a difficult shift. Who is going to comfort you?

FLORENCE NIGHTINGALE OR DEVIL IN DISGUISE We are drawn to the alluring soft lighting and the colour display of the menu, we ponder for a while, taking precious moments to make our choices and, once made, feel a little excited and uplifted that our selection is on the way.

We are teased by a visual display that engages us and confirms that our product is about to be poured. Once dispensed we hold our drink carefully caressing the cup and staring gently at the warm liquid, we taste those exotic flavours of coffee beans from far off lands, with names we can hardly pronounce, or we feel refreshed by the fresh leaf tea that tantalises our taste buds and remind us of home. We select our preferred choice of snack and at that moment we want a product that is familiar to us as well as names of companies that we have grown up used to and trust.

POSITIVE ACTION At Vendia, we know firsthand how to manage this difficult and sometimes emotive decision process without compromising the choice for healthier alternatives and supporting the social responsibility of many people today.

We fill our vendors with products that give choices and we clearly mark the product selection area with clear distinct green and yellow labelling, marked HO (healthier option).

We can even add calorific values or Weight Watchers points on the display for the healthier items. We often place healthier products in a prominent position in the vendor so the eye is drawn to them allowing the consumer to make healthier choices, if preferred.

In an effort to support healthier lifestyles and social responsibility without compromising consumer decisions, Vendia has for many years now included healthier choices of nuts, muesli bars and light savoury snacks and bakes in its vending machines, having found that this keeps the balance between consumer preference for recognised brands of confectionery and a healthy return on investment for catering departments.

In 2004, in the spirit of corporate and social responsibility, Vendia launched its own premium range of fair and ethically traded

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hot beverages under the Cafe Joe brand.

The Cafe Joe product range has a fully fairtrade range of ingredients from coffee beans and instant coffee to tea and hot chocolate.

In addition, one of our longstanding favourite products has been our Bogota Joe coffee, which is produced with the finest blend of ethically sourced Arabica beans from 100 per cent Colombian coffee, sourced through the Federacion Nacional de Cafeteros (FNC), which consists of over 500,000 cafeteros.

Through this foundation more money is going back to the farmer and is made available for infrastructure improvements, as well as for other areas of the community.

Vendia’s preferred selection of milk is Regilait, which is a revolutionary product consisting of granulated skimmed milk. This offers the best of both worlds – beautiful consistency in coffee and specialty drinks plus an excellent cup of tea with the authentic taste of fresh milk. On a healthy note, Regilait does not contain any added chemical products, nor

any of the trans fats or saturated fats that are found in traditional whiteners. The Cafe Joe brand has a strong following and is the preferred hot beverage option of thousands of satisfied customers throughout the UK. COMMON SENSE APPROACH Vendia’s philosophy on the products we supply and sell through our managed vending machines is simple – we keep our vendors clean, well stocked and replenished at all times. We have good lighting and an inviting visual display, highlighting healthier choices and using only the best industryrecognised brands. We actively encourage and make it easy for our customers to adopt good corporate and social responsibility by using our Cafe Joe range, which support the farmers and their families helping them to improve the quality of their lives.

So returning to some of our original questions: Do consumers really want healthier options? And what part can

vending suppliers play and can we dispel vending’s undeserved negative image?

To summarise, consumers need to make their own choices but be educated at the same time to make the right choice to benefit them.

There are thousands who have always used vending machines and are not overweight.

Vending operators such as Vendia do take a socially responsible position and provide both recognised brands and offer healthier choices by identifying them accordingly.

And the humble vending machine, in a hospital late at night when you need some comfort, could most definitely be deemed as Florence Nightingale in disguise.

FOR MORE INFORMATION We would love to hear your thoughts and learn how you manage this process.

So give us a call on 0800 072 0100 or e-mail sales@vendia.co.uk or info@vendia. co.uk and tell us what you think.

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Š Kodak 2010. Kodak is a trademark of Kodak

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MOBILE HEALTH IN THE NHS Nick Hunn, Vice Chairman of the Mobile Data Association looks at local mHealth initiatives to demonstrate the potential for mobile health applications in the wider health sector OVER THE PAST FEW MONTHS I’ve looked at the potential for mHealth in the NHS. This month I’d like to cover some of the applications which are already in use. As yet, there’s no central policy for mHealth, and it’s debatable whether much of the good practice using mHealth is even acknowledged, but that doesn’t mean it’s not providing benefit.

Much of mHealth is invisible. It’s not the high tech monitoring that we find in glossy medical device brochures, but far simpler, everyday applications. Many of these use SMS, but mHealth extends through voice and video, and we’re already seeing local use of applications on iPhones and Android. However, almost all that is happening is as a result of local initiatives.

LOCAL LEVEL MHEALTH Let’s look at some of the examples. Where better to start than midwifery – at the start of life itself? Portsmouth NHS Trust has produced an excellent example of the benefits from giving staff access to patient’s medical records whilst they’re on the move. The system uses a digital pen which the midwives use to write up case notes in a preformatted notebook when they visit the pregnant mothers-to-be. The

data from the pen is sent to their BlackBerry using a Bluetooth link, and is then transmitted back to the hospital. The information is automatically entered into the patient’s notebook, providing a record of the pregnancy.

The system can alert the hospital staff to any problems in real time. The application was developed by the trust, with input from physicians to help develop the notebook.

What brought it to life was when the project leader saw a digital pen being used and realised that it could transform the application. He demonstrated the possibility to hospital staff and it was the midwives who

stood up to express interest in trialling it. Like most successful implementations of mobile health projects, they were closely involved in designing how it worked. The result is that it still follows established practices, but makes them much more efficient and is claimed to be a “wild success” amongst the 130 midwives who are using it.

It cost the trust around £150,000 to develop and they believe it has already saved them over £220,000.

The Portsmouth example is an interesting one as most people would consider digital pens to be quite high tech. One of the reasons

Portsmouth NHS Trust has produced an excellent example of the benefits from giving staff access to patient’s medical records whilst they’re on the move.

The system uses a digital pen which the midwives use to write up case notes in a preformatted notebook when they visit the pregnant mothers-to-be

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that it’s done so well is that the technology just works. It’s not changing the way that the midwives work – it’s just letting them do the job more efficiently. That’s an important message for anyone rolling out an application – those who will be using a solution need to be able to see that it helps them.

The best way to achieve that is to involve them in its design. If users see the benefits, they’ll be enthusiastic about taking it up.

TEXT SUCCESS The same applies for applications that are directed at patients. That’s why there has been spectacular success with SMS. At the most basic level, SMS is being widely used for appointment reminders. All sorts of claims have been made for how much this is saving the NHS. Not as much is being written about what it’s doing to improve patients’ lives.

People miss appointments for all sorts of reasons. Some because they start feeling better and don’t remember to cancel, others because

A similar strategy is being used by Sandwell Primary Care Trust to remind parents of under-fives to bring them to immunisation clinics. The MMS saga has left the UK with an unfortunate legacy of low immunisation rates and services like this can help to redress that.

The point to emphasise about SMS is that people respond to messages that arrive on their phone. They’re seen as personal, so they’re more likely to act upon them. Having a text on a phone is much more immediate for most people than a letter that drops onto the doormat. A campaign by the Heart of Birmingham Primary Care Trust recruited 24 GP surgeries to send out messages promoting health checks to an audience of 40 to 74 year olds. That’s not a demographic that’s normally associated with testing, but over 1,850 patients responded, representing a staggering 44 per cent response rate. The lesson is that if it’s well constructed and targeted, patients respond to messages on their phones. iPhone and Android apps stores may have

People miss appointments for all sorts of reasons. Some because they start feeling better and don’t remember to cancel, others because they forget, some because they’re worried about what the diagnosis might be, and some because the condition has worsened and prevented them attending. Reminders work for all of these, whether it’s just by clearing the appointment for another patient, or helping to ensure that they attend they forget, some because they’re worried about what the diagnosis might be, and some because the condition has worsened and prevented them attending. Reminders work for all of these, whether it’s just by clearing the appointment for another patient, or helping to ensure that they attend. The latter is important, as delayed diagnosis can make it more difficult and expensive to provide a cure, adding cost to the subsequent treatment. SMS reminders can help by catching a disease earlier and ensuring patients don’t delay or prevaricate in being seen.

SMS really comes into its own where it plays to the privacy and personal nature of a mobile phone. Companies like iPlato have been instrumental in using this to assist a large range of trials sending personal medical notifications.

SMS REMINDERS In August, Tower Hamlets started sending SMS invites to women in the borough to attend cervical screening sessions at their local GP surgery. The number of preventable UK deaths from cervical cancer is estimated to range from 900 to over 4,000 each year. Delivering personal messages is an effective way to get women into their GP surgery and reduce that number.

several thousand health apps available, but as yet there’s little integration into the NHS. They’re certainly being used by patients, and a growing number of GPs and consultants are suggesting them for helping to manage long term chronic conditions. The Wilmslow Health Centre website is a good example, listing useful apps for their patients. One NHS trust in Bristol went further and developed an iPhone application which gave users information on their local health services, while providing a rudimentary electronic health record.

There are fewer cases of remote monitoring using mobile phones, but that’s likely to change in the next 12 months. The medical device market is at a point of inflection, where it’s moving from proprietary interfaces to standardised wireless connections, based around Bluetooth and Continua standards. That is going to have two effects. It will be much easier to connect devices to phones and thence to medical records, and the resulting competition will bring prices down, turning some of these into consumer high street products. Once that happens I’m expecting to see rapid evolution in mHealth applications as consumers become capable of monitoring their weight, heart

rate and glucose levels, automatically storing the results on a personal health record.

What will be interesting is to see whether this results in patients sharing data with the NHS, keeping it on their own web record, or sharing it more widely with others who have the same condition. mHealth also extends to remote consultation, of which the most popular example is the service offered by 3G Doctor, allowing patients to contact a GP when and where suits them.

The advantage of this particular service is the way that it integrates with the NHS. EVERYWHERE AND NOWHERE I used the title “everywhere and nowhere” because there are lots of really useful and productive local implementations of mHealth taking place, but as yet they’re not joined up.

For patients, it means that the technology is arriving in small chunks, often initiated by an individual doctor or consultant who’s at the technical end of the spectrum. For solution providers it means that they need to repeatedly go through the same sales process, convincing another unrelated department of the efficacy of their solution. As a result, very few of these target more than a thousand users and many are considerably smaller than that, so are still just a drop in the potential ocean of mHealth, albeit very important drops.

We need to be careful about the question of whether any of these initiatives will save the NHS money in the short to medium term. Many have demonstrably resulted in increased efficiency: staff have managed to see more patients, attracted more people into the surgery or reduced wasted time.

An important fact about these applications which is often overlooked is that they’re pulling people with diseases, or at risk of disease into the NHS for immunisations, check ups and earlier diagnosis. They’re also helping to share patient records, so that treatment is more effective because it’s more joined up. In other words they’re spearheading a move towards preventative care, with a take-up that is way beyond anything that has been achieved in the past. It may not save money today, but it is likely to pay dividends in the future.

We need to applaud these pioneers and encourage others to follow suit. The mobile networks in the UK – Vodafone, O2 and Orange have all announced major investments for mHealth, which are likely to appear during the course of 2011, and which promise to accelerate this deployment. The reality is that mHealth, even in its simplest forms, is helping to address the future health problems of tens of thousands. The task for suppliers, GPs and PCTs is to expand that coverage a thousand-fold, bringing those benefits to the whole population.

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DRIVING QUALITY AND PRODUCTIVITY IN THE NHS The increased use of technology has the opportunity to transform many aspects of the NHS ensuring that healthcare in England is amongst the best in the world, says the NHS Technology Adoption Centre THE RECENTLY PUBLISHED White Paper Equity and Excellence: Liberating the NHS, makes 90 references to quality and productivity and 23 to efficiency, but only mentions technology three times. Given the NHS’s need to release up to £20 billion of efficiency savings to enable reinvestment to support improvements in quality and outcomes, innovative, proven healthcare technologies can make an invaluable contribution to the delivery of the quality and productivity agenda.

COORDINATING INNOVATION The NHS Technology Adoption Centre (NTAC) has experience of working with over 70 NHS organisations to coordinate the adoption of technology-led innovation at a national and regional level.

“Evidence based technology has a pivotal role to play by facilitating change in the NHS with the express aim of improving patient care which in turn drives improvements in efficiency,” says Sally Chisholm, NTAC chief executive.

Based in Manchester and launched in September 2007, NTAC exists to help organisations to identify technologies that will provide cost effective improved patient outcomes and to navigate the complexities of the NHS adoption landscape. NTAC works with a range of NHS organisations to support the sustainable implementation of new technology as an integral part of service and system solutions, identifying where changes to the patient pathway or service may be needed to unlock the full benefits of the technology.

TECHNOLOGY IMPLEMENTATION PROJECTS Sally points to the success of NTAC’s pioneering Technology Implementation Projects (TIPs) which cover a broad spectrum of clinical areas including cardiology, diabetes, urology and cancer. The experiencee from these projects have enabled NTAC to develop a phased programme, led by an NTAC project manager who works collaboratively in the chosen NHS setting, be it primary or secondary care, to equip clinicians, managers and stakeholders with the tools and resources to put innovation at the heart of their organisation.

Each TIP takes place at three or more host organisations in order to expose the technology to different adoption issues and enable the NHS to gain an improved understanding of the impact of implementation for patients, clinicians and managers. At the end of each successful project NTAC produces a detailed online How to

Evidence based technology has a pivotal role to play by facilitating change in the NHS with the express aim of improving patient care which in turn drives improvements in efficiency – Sally Chisholm, NTAC chief executive why to Guide, which provides comprehensive, relevant information for clinicians, managers, key decision makers and other stakeholders, on how to implement specific technologies.

These highly accessible road maps set out the evidence base in addition to the benefits to both patients and organisations that can be achieved. They provide an overview of the impact on key policy areas from quality of

care to improved patient outcomes, advice on procurement and even a template business case.

Over the past two years NTAC has reviewed more than 200 healthcare technologies from NHS partners and medical technology companies through its TIP programme.

Ten technologies have been selected for implementation and to date three guides have been produced covering perioperative fluid

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HEALTHCARE IT

management, insulin pump therapy and a new technique for suprapubic catheterisation, which enables the procedure to be carried out in an outpatient setting and so reduce hospital stays for elderly, vulnerable patients.

Another five guides are due out shortly covering an innovative breast lymph node assay, 12 lead ECG in primary care using telemedicine, cardiac resynchronisation therapy for patients with moderate to severe heart failure, non invasive bladder analysis for men, and photodynamic diagnosis of bladder cancer.

EXPERTISE IN ACTION NTAC’s systematic approach to implementation and development of local capability is graphically illustrated by its work to implement an innovative technique to guide fluid management known as oesophageal Doppler monitoring (ODM), which improves patient outcomes following major surgery.

Despite a comprehensive evidence base comprising eight randomised controlled trials demonstrating significant improvements in surgical outcomes, uptake of the technology has been poor across the NHS with only five per cent of major operations using ODM. “We wanted to see if the outcomes achieved in clinical trials could be replicated in the real world and to explore the barriers to facilitating national adoption, if the project was successful,” explains Colin Callow, NTAC’s programme director.

A model of TIP in action, the project involved three implementer sites representing a broad spectrum of clinical practice; Manchester Royal Infirmary, Derby Hospitals NHS Foundation Trust and Whittington NHS Trust. Each organisation incorporated ODM into routine clinical and operational practice through a structured programme of implementation.

PATIENT BENEFITS NTAC set out not only to measure the impact of the technique but also to identify the potential benefits, costs and practical issues associated with the routine implementation of Doppler guided perioperative fluid management.

“We also wished to provide relevant information to help providers and commissioners make informed choices about how the technique could make a positive difference to the wellbeing of patients and NHS performance while at the same time offering significant potential to reduce healthcare costs,” says Colin.

The results from the three implementer sites clearly demonstrated that the effectiveness of the technique had indeed improved patient outcomes, achieving a 3.5 day decrease in post-operative length of stay, a 23 per cent reduction in the use of central venous catheters, and a 30 per cent decrease in re-admissions and re-operation rates. The direct benefits to patients were equally

significant – minimally invasive monitoring, low risk of cardiac complications, reduced risk of catheter related infection, shorter hospital stays and fewer post-operative complications.

“If these findings were replicated across the NHS, it has been estimated that overall financial savings would be between £170-£370 million per year realised by accuring the above benefits.

This equates to financial savings of between £300 and £700 per patient. Alternatively, the released hospital beds could provide the capacity for the NHS to undertake an additional 140,000 major surgical procedures a year,” says Colin in a powerful counter to the common stumbling block for many trusts when it comes to adopting new technologies – lack of evidence of their effectiveness in routine clinical and operational practice.

NATIONAL EXPERIENCE, LOCALISED RESPONSE NTAC’s work with SHAs through the Innovation Adoption Procurement Programme (iTAPP) is funded by the Department of Health and aims to bring coherence and clarity to technology adoption. Part of the ambitious National Innovation Procurement Plan, iTAPP involves NTAC in supporting innovation and commercial support unit leads in SHAs to collaborate with partners across their own health economies with the aim of identifying, understanding and dismantling systemic and commercial barriers to adoption. The work will be underpinned by robust programme leadership, a systematic management approach and rigorous coordination of the innovation adoption processes in participating SHAs. The initial focus will be on the rapid adoption and diffusion of selected technology-driven innovations that already exist and are proven to bring benefits in efficiency and quality of care. Technologies have been identified by the Procurement Investment and Commercial Directorate at the Department of Health, in collaboration with NTAC and the medical technology industry, as having the most potential for helping the NHS to meet the quality and productivity challenge.

TAKING TECHNOLOGY FORWARD Independent insight into the potential barriers and delays to their adoption will be provided by stakeholder groups, established by each SHA which will select technologies to take forward to implementation. To help ensure the most appropriate technologies are being selected for implementation within each region, a number of key criteria are being considered within the local assessment and selection process which respond to White Paper imperatives.

These include: the potential to enhance productivity and efficiency through improved quality; better health outcomes; the delivery of personalised care; the potential to reduce the burden on acute services; and the opportunity to empower GP led commissioning of new

services and provide care closer to home.

To ensure sustainability and efficiency into the future each SHA will share learning, with NTAC’s support, from the commissioning and implementation of innovative medical technologies. They will work collaboratively to provide initial and ongoing assessment of innovation submissions from the medical device industry with a view to selection for implementation. They will also agree an initial list of technologies to take forward to implementation and develop and agree concurrent procurement and implementation plans. Using a systematic approach and reporting they will achieve widespread adoption of selected technologies and undertake benefits relisation analysis, tracking and reporting. In addition, they will carry out health economic analysis and modelling, develop clinical utility evidence and an adoption and diffusions methodology to ensure successful diffusion across all areas in the NHS. FORGING EFFECTIVE PARTNERSHIPS NTAC is working with a wide range of partners both inside and outside the NHS in order to overcome the barriers to technology adoption.

These include the NHS Information Centre, NICE, ABHI and BIVDA, Trustech, the North West’s Innovation Hub, The National Innovation Centre (NIC) as well as NHS procurement organisations and NHS and Government quality, regulatory and performance agencies.

In conjunction with academic partners NTAC is establishing a professional development programme to increase the capacity and capability of managers so that they can support frontline clinicians with rapid adoption of innovative healthcare technologies.

In partnership with health economies NTAC is assessing the current levels of adoption of a range of healthcare technologies to enable them to determine the level of adoption required to realise maximum efficiencies and improvements in service.

NTAC also has its eye firmly on the future following the setting up of 17 Health Innovation and Education Clusters (HIECs). The aim of the HIECs is to encourage innovation in the NHS through partnerships with higher education and industry. Established in nine SHAs and backed by more than £11 million in funding, they will also provide professional education and training.

“We are already actively collaborating with these clusters to ensure the successful implementation of selected technology-driven innovations proven to bring benefits in efficiency and quality of care,” concludes Sally Chisholm.

FOR MORE INFORMATION Tel: 0161 276 5263 Web: www.technologyadoptioncentre. nhs.uk

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Health Business | Volume 10.5

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HEALTHCARE IT

EXPLOITING THE INFORMATICS POTENTIAL BCS, The Chartered Institute for IT, invites all health informaticians to HC2011 SUB-THEMES OF HC2011

HC2011 IS THE UK’S LARGEST event for health and social care informaticians, ICT professionals and clinicians. It is run by BCS Health, part of BCS, The Chartered Institute for IT, and after the success of this year’s event, which was held for the first time at the ICC in Birmingham, work on next year’s conference and exhibition is well under way.

The event, which combines a three day conference, exhibition, innovative events and opportunities, is designed to challenge and engage all those working in health informatics and social care, including commercial organisations and other major stakeholders.

KEY ISSUES Mike Sinclair, Chair of BCS HC2011 organising committee, says: “HC2011 is going to take place against a very interesting backdrop.

By April next year, the re-structuring and transformation of parts of the NHS should be clearer, along with how the new initiatives around GP commissioning, increased focus on Public Health, regulation and accountability will impact on healthcare in general and health informatics in particular.

“Our aim is to bring together key political, government, and NHS leaders as well as clinicians and health informaticians against this backdrop to discuss, and debate the essential issues of the day.”

The exhibition element of the three day event, which is managed by Citadel

Events on behalf of the Institute, provides delegates the opportunity to explore the many cutting edge solutions on offer in the field of health informatics from around the globe. To date over 70 per cent of the floor space at the venue has been reserved.

Citadel Events urges companies to ensure their place at HC2011, by visiting the website at www.hcshowcase.org, navigate to the floorplan, identify stand space (including the blue reserved stands) and discuss your preference with Dennis Wheatley at 01423 526971.

Meanwhile, plans for the conference programme are well under way; the theme for 2011 is ‘Exploiting the informatics potential’. This will be broken down into four sub-themes: Informed Society, Informed Commissioning, Informed Healthcare, and Informed Care.

“Work began on HC2011 as soon as we finished this year’s event. The programme is still being developed as we work to secure speakers and obtain papers and posters,” Mike continues.

BUILDING ON SUCCESS “However, apart from the very obvious attention to the shifting environment and priorities for the NHS, we really want to build on the success of the 2010 event. Some of the ideas we are developing for 2011 include: • increased focus on personal and professional development with practical sessions for individuals to learn new skills. This will be

The Informed Society – understanding how lifestyle choices impact on care needs and how individuals make care choices and navigate around the care system. This requires information delivered to society through a variety of media covering both health and care conditions and service options, choice, access, experience and expectations.

Informed Commissioning – the right care must be planned, sourced and delivered efficiently to meet the needs of society, within available resources. With more and increasingly complex care needed by society, and a larger and more diverse market for provision, commissioning bodies will need more and better information to base their decisions upon.

Informed Healthcare – advances in healthcare technology, processes and knowledge continue at pace, as does the volume of patients interacting with the healthcare system. Clinicians and patients need information to enable quality, efficiency and value, and to support navigation through the complex healthcare system.

Informed Care – the boundaries between health and care only exist for organisations funding and providing it; they are both artificial and fluid.

Information needs to span all aspects of care, irrespective of who plans or provides it; public or private, health or social care, and needs to address quality, efficiency and value. strongly supported and driven by ASSIST who will make this the theme of their Annual Conference (an integral part of HC2011) • a whole day session on leadership for health informatics, with senior keynote presenters from across the NHS • a NHS East Midlands regional showcase • special focus on how information flows will work differently in the new NHS both for the service, patients, carers and citizens • a focus on open source and open data.

“Much more content will be added in the next few months, particularly as the new Information Strategy begins consultation, and I urge people to keep and eye on the web site to see how our keynote speakers and leading themes develop,” Mike concludes.

FOR MORE INFORMATION Full details can be found at www.hc2011.co.uk

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DATA DESTRUCTION

SAFE HANDLING OF DATA – ARE YOU DOING IT? Russell Harris, chairman of the British Security Industry Association’s Information Destruction Section, reports on the risks and the solutions accosiated with data disposal NEW RESEARCH HAS ISSUED a stark reminder about the importance of effective security among organisations holding sensitive data about individuals and nowhere is the issue more critical than in ensuring the confidentiality of personal medical information.

A recent study by the Ponemon Institute has revealed that the cost of UK data breaches has increased by 36 per cent in the past two years. Many incidents arise from a failure to properly dispose of confidential documents, such as the 11 high street banks reprimanded by the Information Commissioner for dumping customers’ statements in bins on the pavement outside branches. Such blatant negligence is an extreme example of a wider problem that causes financial loss for organisations and individuals alike. Another recent study – sponsored by data protection firm, PGP Corporation – showed that every lost item of data costs UK organisations an average of £64 in 2009, plus, of course, the incalculable cost of reduced consumer confidence.

HEALTHCARE DATA Healthcare organisations face particular risks, as well as legal obligations. The sector necessarily holds vast amounts of sensitive personal information and the Data Protection Act specifically requires that when making decisions about information destruction, organisations should consider the effect upon the data subject if their information was misused as a result of it falling into the wrong hands.

Nevertheless, examples of lax controls continue to be reported in the press, including patients’ x-rays dumped for anyone to find, wholesale data losses and even the sale of a PC on eBay, complete with its files of medical records. As these cases illustrate, the risk extends beyond the obvious realm of paper documents and the BSIA’s Information Destruction Section has been established to provide a source of help and expertise on the subject.

Members of the section recognise that the need for secure disposal extends beyond physical documents to include information held on computers and storage devices, as well as the potential – and often overlooked – means of access to data such as staff identity documents and uniforms.

Computer equipment, for example, must never be disposed of until all the personal information has been securely removed, such

as by destroying the hard disk. Simply deleting files is not an adequate response. Modern cyber criminals know how to manipulate systems and recover deleted information in order to steal identities, conduct fraudulent transactions and even commit blackmail.

IDENTITY THEFT Almost any kind of information is valuable to criminals, for example, patients’ records, financial reports, payroll information and personnel data. The unlawful use of such information contributes to an explosion of identity theft crimes that are now estimated to cost in excess of £2 billion every year.

Offenders target both public and private sector providers, including the use of stolen identities to fraudulently obtain prescription medicines and state benefits. Crucially, the careless disposal of confidential data often allows them to do this without anyone knowing the information has been compromised and if that happens, it is obviously impossible to take appropriate countermeasures.

The law addresses this threat by demanding the use of effective means to prevent misuse by destroying personal information at the point of disposal. The most effective way to do this is by employing a professional information destruction service, but despite the ready availability of this commonsense solution, companies and organisations continue to be prosecuted for improper practices.

Many more escape prosecution because their carelessness is never discovered.

SECURE HANDLING It is known, for example, that only a small fraction of organisational waste paper and data processing products such as hard drives, CDs, memory sticks and DVDs are destroyed by professional firms. By far the majority of such material continues to be disposed of via municipal refuse collection or waste paper reprocessing. Neither method generally involves any kind of secure handling, yet it is inevitable that much confidential data is included in this general waste and therefore a significant cause of avoidable risk. It is not surprising in these circumstances that the rubbish bin is a regular source of prosecutions under the Act, just as it has long been a core element of the private detective’s trade.

The law sets clear rules for the destruction

of personal information. It should be carried out by a company which guarantees under contract that destruction is done securely and effectively. The process consists of waste collection by secure transport, inspection, removal and destruction of rubbish, and the shredding, pulping and recycling or incineration of other material. European Standard EN 15713:2009 describes the essential requirements and operating procedures for a professional information destruction company, including employment practices such as the security vetting of all staff members and details relating to the security of its premises by means of monitored intruder alarms and CCTV systems.

Detailed rules are set down for the actual destruction of data, incorporating materialspecific shred sizes, and requirements for the security of vehicles used both for the collection and on-site destruction of confidential waste.

SETTING THE STANDARD As well as helping to ensure the highest standards, EN 15713:2009 therefore provides a valuable new benchmark to assist users in choosing a provider. All BSIA information destruction section members are inspected to the European standard, as part of the audit procedure for their obligatory ISO 9001:2008 quality accreditation.

Another significant development in the sector has been the publication of National Occupational Standards (NOS), which encompass all key activities undertaken within the sector. The BSIA worked closely with Skills for Security in developing the NOS, which all member companies incorporate into their training practices. In short, the risks of careless or ineffective data disposal are high but the solution is readily available. To find out more about the BSIA’s work in information destruction visit www.bsia.co.uk/shredding.

The British Security Industry Association (BSIA) is the professional trade association of the UK security industry. Its members produce over 70 per cent of the country’s security products and services to strict quality standards.

FOR MORE INFORMATION Tel: 0845 3893889 Web: www.bsia.co.uk

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Health Business | Volume 10.5

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THE SMART WAY TO SAFER HOSPITALS Holly Sacks, senior VP at HID Global, looks at how smart card technology is making hospitals safer

OVER THE PAST FEW YEARS, the healthcare sector has become increasingly dependent on information technology.

Contactless smart card technology has been used during many years in other industries, and is now helping to solve some longstanding thorny issues in the healthcare sector: safeguarding patients and staff, and protecting confidential patient information.

Hospitals in Scandinavia were early adopters of this technology, and Germany has recently issued healthcare smart cards to its entire population. In the UK, many hospitals are now waking up to the benefits of using contactless smart cards to control physical access to their buildings and logical access to the IT systems that house confidential patient data.

SECURITY In the past, it was relatively easy for an intruder to walk unchallenged around a hospital, accessing areas meant only for authorised staff.

Contactless smart cards address this physical access problem by using encryption to offer differing levels of building access to certain staff.

For example, a surgeon would require access to the operating theatre, while a registrar might need access to all the wards in the hospital.

Medical professionals can also use their smart card to access sensitive patient data on a network. So as well as safeguarding the

security of patients’ personal information, using a smart card for logical access can also save time. If a doctor can access crucial IT systems with just a smart card, this saves time otherwise wasted in remembering and entering usernames and passwords, which in turn frees up more time for patient care. It also helps healthcare professionals to demonstrate that they are storing and managing patient details in a safe and secure way in order to comply with the Data Protection Act. Smart cards can come in contact or contactless form, and can offer three levels of security: single, dual or three-factor authentication. With single-factor authentication, using only the card will give access to a system or open a door.

Dual-factor authentication – the most common level of smart card authentication in UK hospitals – adds an extra level of security in the form of a PIN code. Three-factor authentication goes a step further, using a PIN and an extra security measure such as a biometric scan.

Contactless smart cards are traditionally used for physical access control and are now being adopted for logical access control as well.

and no one can have missed the government swine flu posters that landed on every doormat across the country. Just think about a doctor on her morning ward round. In just a few hours, she could see as many as 20 patients on five different wards, accessing different areas of the hospital and different computer systems. With this many potential touch points, it’s easy to see how infection can be spread. Contactless smart cards – where the card is passed in front of a reader – are playing a key role in limiting this spread of infection. After all, if your card never touches the reader, it can’t spread germs.

With so many advantages, adopting contactless smart card technology seems like a no-brainer. But some hospitals are still using the most basic form of secure access control: the magnetic stripe – or mag-stripe – card, where magnetic data is stored on the back of the card.

While mag-stripe cards are cheap to produce, they can cost more in terms of maintenance.

Magnetic stripe cards come in contact with the reader when inserted, and any debris that collects on the card ends up inside the reader and on its contact pins. They are also susceptible to magnetic interference and wear and tear: constant swiping through the card reader causes the stripe to deteriorate and eventually fail. This type of card is also very restricted in terms of its data storage capacity compared to that of smart cards.

Perhaps their biggest disadvantage is that they are very easy to clone. You can even buy a mag-stripe reader from a high-street store that will let you take data off of these cards and use it to create an unlimited number of clones.

OUTSTANDING VALUE It’s fair to say that the cost of upgrading to contactless smart cards can be a barrier to deployment for some hospitals, where funding priorities can mean that management has to choose between upgrading physical and logical access systems and having another 30 patient beds.

However, when you weigh the costs of contactless smart card technology against the benefits, it can offer outstanding value to the healthcare sector, saving time and money, protecting patients and staff and safeguarding their personal data. Portable and secure, contactless smart cards are fast becoming a valuable tool for safeguarding physical security and guaranteeing the privacy of sensitive electronic information.

FOR MORE INFORMATION Web: www.hidglobal.com

HYGIENE One surprising area where this technology is making an impact is infection control. We’ve all seen the bottles of antibacterial hand gel that stand at the doorway to every hospital ward,

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All our staff are security vetted and with 24 hour CCTV surveillance at our headquarters, situated in a security controlled zone which ensures optimum security at all times.

FOR MORE INFORMATION Tel: 0845 6010551 Fax: 02380 867475 E-mail: operations@ premiershredding.co.uk Web: www.premier shredding.co.uk

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QUESTION:

HOW DO YOU ACHIEVE EFFECTIVE CLINICAL AUDIT WITH LESS RESOURCES? ANSWER: OVER 300 NHS TRUSTS USE FORMIC FUSION

According to the Government’s whitepaper, Liberating the NHS, knowledge is power.

NHS Trusts and Commissioners are about to come under growing pressure to provide accountability and choice to patients by publishing results of specific outcomes and metrics. Subsequently, Clinical Audit Departments will need to acquire more data in less time and under efficiency measures, will have to do so with fewer resources.

The accuracy and relevance of clinical audits, revalidation and PROMs, and the subsequent decisions taken, are only made possible if backed up with reliable and up-to-date information.

Formic has 20 years’ experience in developing data capture solutions for the NHS and is already helping over 300 healthcare customers meet their auditing challenges.

Up to 50 times faster than manual data inputting, Formic Fusion software can scan, process and analyse data from any form – be that on paper, on the web, on a tablet PC, touch-screen kiosk or PDA. For more information call 0870 197 5622 Email: sales@formic.com www.formic.com

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ACHIEVING CLINICAL OUTCOMES John Morley, CEO at Formic, explores the challenges and benefits of clinical audit and revalidation following measures outlined in the government’s White Paper: Liberating the NHS FORMIC IS THE LEADING DEVELOPER of data capture solutions for the NHS, helping to efficiently collect, manage and analyse data for clinical audit and revalidation. Customers range from physicians and administration personnel through to Clinical Governance Departments working on some of an NHS Trust’s most complex auditing projects.

The company has 20 years’ of experience and its software is in daily use by more than 300 NHS Trusts, Primary Care Trusts, Mental Health Trusts, Strategic Health Authorities and private healthcare organisations across the UK. COST EFFECTIVE DATA CAPTURE Formic recognises the importance of the changes outlined in the Government’s White Paper, ‘Equity and excellence: Liberating the NHS’ and the company’s experience has led them to believe that accurate, efficient and cost-effective information

criteria and the implementation of change.

Achieving unprecedented gains in efficiency, combined with the government’s White Paper directive to demonstrate a “relentless focus on clinical outcomes... with results that really matter” will drive a requirement for Trusts to automate their data capture and, with the removal of PCT’s and many middle management, place accountability of this in the hands of the clinician.

The new measures that will empower patients to rate hospitals and clinical departments, according to the quality of care they receive, will also require hospitals to be open about mistakes and inform patients if anything goes wrong.

Complete data capture will be at the point of care, information will be clear and more importantly, medically accurate, helping to meet the rigor of clinical audit and revalidation, both of which will help inform decisions on quality improvement and promote patient involvement.

This will motivate a shift in recognition that

Already at Formic we are seeing an increasing demand amongst our existing NHS customers to move from traditional paper based information capture systems to our electronic solutions that utilise modern devices such as touch screens, patient kiosks, clinical assistant PCs, Personal Digital Assistants, Smartphones and the web capture, management and sharing will soon play a critical role as an enabling factor for many of the changes outlined.

John Morley, CEO, Formic, explains: “This White Paper outlines radical changes which will need to take place within NHS Trusts.

Patients will become at the heart of everything that a Trust does and there will be much more emphasis on research and analysis to help increase productivity and efficiency within the service. At the same time the NHS is asked to improve its efficiency with the goal of reducing management costs by 45 per cent over the next four years.”

POTENTIAL Compared to other sectors, healthcare is in its infancy in putting the customer first. Accurate information is pivotal to better care, better outcomes and reduced costs. Clinical audit has a key role to play in achieving this as it extends its application to include patient feedback as part of the process that systematically reviews outcomes of care against explicit

the data needed for accountability will be the same data that is clinically useful.

Information generated by patients themselves will also be critical to the process and by the government’s own admission, it is not something that the NHS has been historically good at. More widespread use of effective tools like Patient Reported Outcome Measures (PROMs), patient experience data, and real time feedback will be expanded to support clinicians across a much wider range of treatments and conditions, and it will extend PROMs across the NHS wherever practicable.

The White Paper suggests that more PROMs will be developed for other surgical and nonsurgical procedures. In the future they will be designed for routine use as part of day-to-day patient care, and ultimately it will be possible to evaluate the pathway of care for each patient, from start to finish from GP surgery or A&E, through to post-operative and at-home care.

The challenge with these programmes is that significantly more information will have to be collected at a time when the NHS is targeted

with reducing the administrative resources that would typically be responsible for capturing and processing this information. The implication for NHS Trusts is that they will need to innovate in the way that they do this, moving away from the outdated and longwinded methods currently being used and applying up-to-date solutions and systems to what has historically been labour intensive activities.

Clinical audit departments and the like will see a dramatic increase in both the volume and breadth of support they are expected to provide without receiving a corresponding increase in resources. Given the scope of these requirements Trusts are likely to seek to identify an overall approach for the electronic capture and processing of outcome and clinical audit data.

INCREASED DEMAND At Formic we are seeing an increasing demand amongst our existing NHS customers to move from traditional paper based information capture systems to our electronic solutions that utilise modern devices such as touch screens, patient kiosks, clinical assistant PCs, Personal Digital Assistants, Smartphones and the web. These enable the whole process of information capture to be more efficient and accessible by clinicians and patients alike.

Formic’s range of solutions already provide many NHS organisations with these capabilities.

As well as facilitating the capture of information on the frontline in real time, they also provide tools to assist with consolidation, analysis and reporting, leading to much faster feedback to clinicians, trust management and patients.

With the accompanying reduction in manual effort, professional staff are able to focus on using the information to drive improvement in clinical outcomes. As the White Paper admits “too often the patients are expected to fit around the services, rather than the services around the patient”. Getting the right proven solutions in place will help towards achieving a patient-led, accessible service that will go a long way in helping the NHS deliver the productivity and efficiency to which it aspires.”

FOR MORE INFORMATION Tel: 0870 1975608 E-mail: sales@formic.co.uk Web: www.formic.co.uk

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Health Business | Volume 10.5

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EMERGENCY SERVICES

ENSURING EFFECTIVE SERVICES IN CHALLENGING TIMES Promoting multi agency collaboration at The Emergency Services Show 2010 THE IMPACT OF CHANGING POLICIES and departments alongside reduced budgets mean these are challenging times for providers of all healthcare services. These ever tougher demands mean service providers and agencies employed to offer healthcare and medical services are put under increasing pressure.

In light of the current economic climate and the changing, more localised management of budgets The Emergency Services Show 2010 will be especially relevant, with opportunities to speak to contemporaries and exhibitors to discuss the latest business methods and the latest procurement practices that combine to offer efficient gains while better serving citizens.

Registration for is now open for this unique event. Relevant to everyone involved in the health service from emergency responders through to Primary Care Trusts, NHS Acute Trusts, Ambulance Trusts, Foundation Hospitals, Strategic Health Authorities, government departments and independent hospitals and Clinics, this annual event brings together your colleagues, contemporaries and suppliers.

The free to attend exhibition provides access to innovative technology and medical advances enabling you to hear about the latest ideas and initiatives all in one place.

This is the one event that you and your colleagues shouldn’t miss this year.

SEE THE WHOLE PICTURE • Source the latest equipment in the free to attend exhibition.

• Network to discuss resources, framework agreements, income generation and outsourcing – especially in light of the current uncertain economic climate.

• Meet with emergency services from around the UK within the Blue Light Zone to learn about initiatives, experiences and examples of best practice.

• Have face to face contact with a wide range of organisations including Category 1 and 2 responders, professional, government and voluntary organisations in the Emergency Response Zone promoting multi agency collaboration.

• New Hall 3 incorporating larger displays of specialist equipment and vehicles previously shown outside.

SUPPORTING CONFERENCE The two day CPD accredited conference will provide delegates with the opportunity to join like minded professionals to discuss the latest news, developments and strategic advances

from a range of high profile speakers.

The challenges presented by the 2012 Olympics will be a major focus at this year’s conference, which will include a special Olympics session on the first day. Featured speakers will include Peter Thorpe, head of Olympic Planning for London Ambulance and Chair of the UK FRS Olympic Planning Group Jim Monk, London Fire Brigade, who will be presenting a national perspective of the challenges posed by the Olympics.

As part of a special overview looking at building relationships through training and interaction, there will be a number of presentations: Derek Luff, development manager at the

AT A GLANCE The Emergency Services Show 2010, sponsored by Community Resilience UK, takes place on Wednesday 24th and Thursday 25th November at Stoneleigh Park, Coventry. The event attracted over 4,000 attendees last year and 2010 will build on the success of the previous four years, promising to be the best yet.

The full conference programme is available at www.ess2010.com. Conference registration is now open and 2009 costs have been frozen for this year: Day 1 @ £195 + VAT, Day 2 @ £165+ VAT, Both days @ £290 + VAT.

The free to attend exhibition provides access to innovative technology and medical advances enabling you to hear about the latest ideas and initiatives all in one place - the one event that you and your colleagues shouldn’t miss this year Fire Service College, with Dr Helen Higham, consultant anaesthetist at the John Radcliffe Hospital, Oxford, will be looking at casualty management and explaining the Casualty Management Centre (CMC). This is a new collaborative partnership between the Fire Service College and the University of Oxford’s OxSim Medical Simulation Centre to demonstrate to all agencies the use of the latest medical simulation technology on scene, within a realistic and challenging incident environment.

Chief fire officer, Roy Wilsher, Hertfordshire Fire & Rescue Service, will be speaking about Exercise Orion, a EU Civil Protection (EUCP) Mechanism exercise that took place in September to test cooperation on the ground, command procedures, national coordination up to government level and communications.

Dr Ben Weston, MoD in partnership with the CCS and NPIA, will be looking at Project Radiance in his presentation ‘Steps towards a resilient, integrated approach to first responder communications and interoperability’.

Day 2 of the conference will focus on resilience and the national critical infrastructure and will be followed by a series of focused workshops discussing ‘Improving the Resilience of the Critical Infrastructure’, hosted by The Cabinet Office.

The first Integrated Pre-hospital Care Conference will also take place at The Emergency Services Show 2010. Relevant for all practitioners of pre-hospital care including emergency service personnel, doctors, nurses and other practitioners from both civilian and military backgrounds, the conference brings together five of the leading organisations involved in prehospital care in the UK: 999 Research Emergency Forum; British Association for Immediate Care (BASICS); College of Paramedics; Faculty of PreHospital Care (FPHC); and Joint Royal Colleges Ambulance Liaison Committee (JRCALC).

The programme will be delivered by national experts and is designed to cover new protocols and policies, clinical challenges and experiences as well as contemporary research with half day themes including prehospital pain management and major incident management. In addition, the conference will be addressed by Professor Matthew Cooke, who will discuss the issue of unscheduled care.

FOR MORE INFORMATION To register for the Integrated Prehospital Care Conference and The Emergency Services Show 2010 or to learn more visit www.ess2010.com.

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Visit the website to view the categorised product finder

Emergency training from Amputees in Action INCE 2005 Amputees in Action have been at the forefront of emergency medical care for HM Forces, civilian emergency services and other agencies both domestic and foreign, becoming an integral and essential resource for programmes such as pre-deployment training and other crucial preparations.

Our service is to enhance crucial medical training at individual, team, unit or service level in the development, practice and perfection of medical skills. The combination of an amputee actor and special effects (SFX) produces a Trauma Casualty Amputee (TCA) providing realism, shock, horror and vital sense of urgency in exercises involving medical trauma.

The amputees have acting skills developed within the film industry and most with real life experience of traumatic amputation. All of our amputees are trained in the cause and effect

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THE BUSINESS MAGAZINE FOR HEALTH MANAGEMENT

of a wide range of injuries and are able to portray the signs, symptoms and its consequences.

They will deliver a Casualtyâ&#x20AC;&#x2122;s Eye View when required.

Our teams of qualified SFX artists have developed techniques and applications unique to this field.

They use durable and re-useable special effects makeup which can recreate any blast, gunshot wound, blunt trauma, or other injuries and illnesses, this includes exclusively designed prosthetics for more advanced training.

Amputees in Actionâ&#x20AC;&#x2122;s service is extended to include our involvement at the earliest point in the planning and preparation of exercises and role play scenarios, large or small and in all environments.

FOR MORE INFORMATION Tel: 01635 31890 Fax: 01635 38001 Web: www.amputees inaction.co.uk

Lawrence Webster Forrest â&#x20AC;&#x201C; fire consultants AWRENCE WEBSTER Forrest Ltd is a fire safety engineering consultancy with over 20 years experience in the development of fire engineering technology and the application of fire safety standards.

As the UKâ&#x20AC;&#x2122;s leading independent fire consultant, LWF provides building managers, owners, occupiers, developers and designers with innovative solutions to the problems of establishing an integrated premises fire safety strategy.

Such solutions are individually designed to each building considering relevant constraints such as structure, occupancy, use, operation and cost.

The company has been providing these service since 1986 and has built up an impressive client list which includes architects, developers, government departments, project managers, consulting engineers,

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building owners, facilities/ building managers and owners.

Services offered include, fire safety training, fire safety management and procedures, fire risk assessments, fire safety audits/ surveys, fire alarm and detection system design, fire suppression system design, emergency lighting system design, fire engineering design solutions, fire strategy development, evacuation modelling, fire and smoke modelling, design review and appraisal.

FOR MORE INFORMATION Peter Gyere, marketing manager Tel: 020 8668 8663 Fa: 020 8668 8583 E-mail: fire@lwf.co.uk Web: www.lwf.co.uk

Visit the website to view the categorised product finder

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AccuFACE – innovative biometric access control solutions for the healthcare industry

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ONSIDERING THE EVER PRESENT threat of cross contamination and access issues within the health industry, SystemWare Europe is pleased to introduce the AccuFACE facial biometrics system.

AccuFACE answers the real need for a door access or workforce management system that is fast, reliable, easy to use, and perhaps most importantly, avoids cross contamination issues whilst maintaining a high level of security.

One of the advantages of AccuFACE over traditional access solutions is that it is totally hands free. The entire process from enrolment, to access and entry, avoids any physical contact and so eliminates cross contamination.

There is no need to search for a key, a swipe card, nor remember a pin number. Cards can be lost or misused and it is wellknown that pin numbers can be compromised in any number of ways, but you cannot “borrow” someone else’s face. However, AccuFACE can be used in conjunction with all of the above, particularly for higher security zones.

AccuFACE enrolment, which takes around 40 seconds, generates an encrypted biometric template of the face, which on subsequent visits is recognised by the system, a process which takes less than one second. To create the template, AccuFACE measures the distance

between key points of the face and the depth of features and creates a digital representation that is stored on the device. This 3-D data prevents access by unauthorised individuals and because it is infra-red technology you cannot fool it with a photo. Each event, whether a pass or a fail, is recorded on the AccuFACE log along with an infra-red image. This log can be retrieved and used to analyse activity and can also be imported into other systems such as payroll.

One of the great benefits of AccuFACE is that it is possible for every individual to have specific date time access limitations, whereby entry is only permitted into particular areas at particular times. This is ideal for the access control of contract staff; any changes in staff take only a short time to either be enrolled

or removed from AccuFACE. AccuFACE is a 24/7 infra-red system able to operate in varying light conditions. Direct sunlight could flood the infra-red sensors but with the addition of an enclosure AccuFACE can be used outdoors, however, the ideal location is in a foyer or for internal access points.

The ease of installation, simplicity of use and accessibility of the logged data make AccuFACE the perfect reassuring solution for the requirements of the health industry.

FOR MORE INFORMATION Tel: +44 (0)1462 732800 Fax: +44 (0)1462 835777 E-mail: enquiries@sysware-europe.com Web: www.sysware-europe.com

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CONFERENCES & EVENTS

MEET IN THE SOUTH WEST OF ENGLAND

Bath, Bournemouth and Bristol are three destinations on the South West coast that offer a unique collection of conference and event venues, excellent dining options, and idyllic scenery

BOURNEMOUTH MEANS BIG BUSINESS and the proof is in the pudding! The Bournemouth International Centre announced that in 2009/10, conference, exhibition and business events held in the Bournemouth conurbation, had injected approximately £122 million into the local economy.

During the period April 2009 - March 2010, the BIC and Pavilion alone hosted 92 conferences, exhibitions and business events attracting over 81,000 conference delegates and exhibition visitors, which in turn generated 214,000 overnight stays in local accommodation. With smaller conferences, meetings and events held in other venues and hotels throughout the town, Bournemouth’s place in the UK as one of the leading destinations for business tourism has, once again, been firmly secured.

So why is Bournemouth proving to be so popular? Here is just a taster.

THE DESTINATION Bournemouth – winner of Best UK Resort at the 2008 & 2009 Group Leisure Awards – is the jewel on England’s south coast.

With its idyllic location, mild climate, seven miles of award-winning beaches, acres of luscious Green Flag gardens and bustling cosmopolitan bars and restaurants, it is the perfect choice for event organisers.

For delectable dining, the Crab at Bournemouth has recently opened directly opposite the BIC and on the menu is Snow Crab, Blue Crab, Lobster and Langoustine.

It is under the same ownership as the multi award-winning and acclaimed celeb-haunt The Crab at Chieveley.

Edge Restaurant is the newest restaurant, in Alum Chine, offering fine-dining with panoramic views for 100 covers, including an outside terrace and is reachable by a glass lift. The top floors offer modern European cuisine in a setting with bespoke furniture, exclusive fabrics and a private dining experience with 360º views.

NEW DEVELOPMENTS Bournemouth is rapidly emerging as the must see new cosmopolitan destination to visit, boasting an impressive choice of new design-led and cultural developments.

The Green House Hotel is Bournemouth’s first eco-hotel and pitches itself as the UK’s greenest. The new £5.5 million hotel features 32 rooms and is just minutes from the sandy beach. The Grade II Victorian Villa has been extensively renovated while minimising its impact on the environment.

The creation of a new dance centre means the Bournemouth Pavilion will host a world-

Bournemouth is rapidly emerging as the must see new cosmopolitan destination to visit, boasting an impressive choice of new design-led and cultural developments class dance centre. The £3.29 million Pavilion Dance scheme will be for everyone and the best regional, national and international dance companies will also perform there. The project includes a 1,249m² dance centre, a large entrance foyer, community and professional dance studios, changing rooms, and a studio theatre with retractable seating for up to 200, backstage facilities, first class lighting and audio visual equipment including cinema projection. The facilities will open this month.

The two Dorset resorts of Bournemouth and Poole have jointly launched a new campaign, the Coast with the Most, to highlight the wealth of water sports they offer. With their golden sands, eight blue flags and a choice of more than 25 water sports all within ten miles, the two holiday resorts can rightly claim to be the UK’s premier water sports capital.

OUT OF TOWN On the border of Dorset and Hampshire, the region enjoys some of the most charming and unspoilt countryside in Britain.

To the west lies the famous Jurassic Coast, which has joined the Great Barrier Reef and the Grand Canyon as one of the wonders of the

natural world. To the east of Bournemouth you can find the beauty of the New Forest National Park. All of which is easily accessible by train, bus, car or for the adventurous, pedal-power.

Whether you are organising an event for thousand of delegates or a smaller more intimate gathering, Meet Bournemouth, the towns official Conference Bureau, can offer the local knowledge and expertise to make your event an unforgettable experience.

From traditional hotels to funky venues and entertainment options, creating the ideal package is easy. Bournemouth hotels were recently voted the best value in the world, and with accommodation ranging from boutique guest houses to an array of 4-star hotels, there’s more than enough to suit any budget.

HISTORICAL BATH Bath and the surrounding area is an ideal choice for business events. Designated a World Heritage Site by UNESCO, Bath is a truly unique destination for any conference, meeting or corporate event. The wonderful backdrop of heritage and beautiful surrounding countryside is combined with a range of exceptionally high quality, character and unusual venues.

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CONFERENCES & EVENTS

With elegant Georgian architecture a-plenty, there isn’t a shortage of character venues in Bath. The Assembly Rooms serve as Bath’s premier conference venue, providing a prestigious setting for up to 500 delegates. This stunning Grade 1 listed building is also perfect for exhibitions, AGMs and gala dinners. The building dates back to 1771 and is still adorned with its original Whitefriars crystal chandeliers and exquisite portraits by Gainsborough and Hoare within its interconnected rooms.

Head outside of the city and you’ll discover Center Parcs, hidden away in Longleat Forest. Its purpose-built conference suites can accommodate up to 400 delegates and on-site accommodation is available with a choice of one to four bedroom villas.

Center Parcs also offers an excellent range of motivational team building activities.

Bath is very much a sporting centre with a rugby team, racecourse and top sporting facilities at the University of Bath. The University has large meeting facilities in its lecture theatres and syndicate rooms as well as a range of accommodation at competitive rates.

If you’re looking for a venue with a difference why not host an event at Bath Racecourse?

The Racecourse is a versatile venue ideal for any business or social event, set in acres of beautiful countryside and offering a variety of both indoor and outdoor space.

ROOMS FOR ANY SIZE MEETING Bath has a large stock of small meeting rooms available within the city and beyond. From luxury hotels to purpose built facilities, Bath offers a range of small meeting rooms at exclusive venues.

There are also a number of unusual places to meet in Bath – ideal for evening meetings and events. The Roman Baths is a popular and extraordinary venue serving as a perfect location for an evening drinks reception.

Whilst visiting Bath on business it is worth taking time out after the work is done to explore the beautiful city of Bath. Bathe in the Thermae Bath Spa, explore the ancient Roman Baths or visit one of the city’s many interesting and diverse attractions. Shopping is also at the top of the list for any visitor to Bath with a high number of independent and boutique shops along with all the usual high street names you would expect from a top shopping destination.

Bath city centre is incredibly compact, and you can walk from one side of the city to the other in under 20 minutes – ideal for delegates arriving by train or coach.

If driving, the city is equally easy to reach and only a short drive from the M4.

The conference and events team at Bath Tourism Plus offer an efficient, professional and free service based on excellent knowledge of the area and its venues to help ensure that your conference or meeting is a success.

MEET IN BRISTOL As the closest major city to London and the gateway to South West England, Bristol has excellent access from three motorways, two mainline rail stations and an international airport. Even better – the city prides itself on sustainability and is often referred to as the ‘UK Green Capital’ since Bristol was the only UK city shortlisted for the 2010-2011 European Green Capital.

In addition to its green credentials, Bristol offers a wide selection of exciting and unique venues for event organisers. These range from purpose built hotels and conference centres to more unusual and unique facilities.

Bristol is home to two major universities, each providing a range of venues. The University of West England offers a new 4,000 square metre exhibition space. There are also a number of other educational establishments suited to smaller events. Residential venues range in size from 30 to 300 rooms with both internationally recognised brands and small independent properties. Sport stadia such as Ashton Gate Stadium boast a variety of function rooms and can accommodate up to 900 delegates in the Dolman Exhibition Hall, in addition to smaller events.

Combine Bristol’s commitment to sustainability, quality venues, attention to customer service and one can see how the city offers a competitive destination for government events. Event organisers can also rest easy knowing Bristol provides sustainable travel, accommodation, unique venues and dining options whilst in the city.

Bristol’s city centre offers a compact area for event attendees with an array of hotels, unique venues, attractions and dining options all within walking distance. Bristol is best seen by foot, but residents and visitors alike often rely on the city’s excellent public transportation, including a ferry boat system which travels along Bristol’s popular Harbourside to major shopping, dining and attraction venues. The city is home to over 450 parks and green spaces, many of which are within walking distance from major event venues.

Event organisers and attendees can rest easy knowing that Bristol hotels are committed to green tourism, with 14 Bristol accommodation venues are accredited by the Green Tourism Business Scheme. The 275-room Mercure Bristol Holland House Hotel was recently awarded Gold by the Scheme, making it the largest hotel in the South West to receive such achievement.

MEET GREEN Several unique Bristol meeting venues also show a devotion to sustainability. Bristol Zoo Gardens is well known for its commitment to conservation and accredited by the Green Tourism Business Scheme. The world’s fifth oldest zoo also received a Big Tick Award recently for its green achievements. the venue offers event organisers over 12 acres of beautiful grounds and its popular Clifton Pavilion can accommodate 10 to 120 guests

including a purpose built lecture theatre with tiered seating for 119 delegates.

Brunel’s ss Great Britain is another unique venue with a devotion to sustainable business practise. The world’s first luxury liner is also an award-winning event location, recently awarded Gold from the South West Tourism Excellence Awards for its venue hire service. With three unique conference spaces and capacity for 140, Brunel’s ss Great Britain provides an unforgettable event location and is accredited by the Green Tourism Business Scheme.

New to Bristol in 2011, the M Shed history museum will provide added conferencing space for the city and features a number of green energy initiatives including a bio-mass boiler and solar panels, along with amazing city views. Other unique venues like Blue Reef Aquarium, At-Bristol, The CREATE Centre and Bristol’s Watershed media centre also show devotion to sustainability, whilst providing an interesting environment for attendees.

EAT GREEN Bristol is host to a variety of green dining options for event organisers. Internationally recognised for its contribution to sustainable development and environment efficiency, the popular Bordeaux Quay restaurant on Bristol’s Harbourside has carefully considered every aspect of how its building functions from light sensors in the toilet to a rain water harvesting system, sustainably sourced materials and a comprehensive recycling and composting scheme.

Also in Bristol’s city centre, the eco-friendly Glassboat Restaurant provides a unique dining venue with meeting space and an interesting story to tell. The floating converted barge was created with only recycled materials from various Bristol locations. The founder scrounged scrap materials which included pine from the flour mills, toilet doors from the then derelict Royal Hotel, window glass from the keg store of the former Georges Brewery and marble slab from the Bristol fish market. The Glassboat and sister restaurant, Spyglass, offers salad and vegetables grown in the company’s own local kitchen garden.

Destination Bristol offers a free venue finding service in which a dedicated, professional team can find the perfect green event venues and organise site visits for peace of mind and any budget. The team also offers support through suggested itineraries and delegate programmes, providing a one stop shop for all event planning needs.

FOR MORE INFORMATION Bath: www.bathconference.co.uk Bournemouth: www.meetbournemouth.co.uk Bristol: www.conference-bristol.co.uk

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The ideal venue for your event At Brighton Centre we have been playing host to Medical conferences for over 30 years and have been proud to welcome and work with the following conferences recently: International Haematology, International Iymphoedema, British Medical Association, British Haematology society, British Medical Ultrasound, British Geriatric Society, British Orthodontic Society, College of Occupational Therapists, Royal College of General Practitioners. The combination of dedicated management, professional staff and flexible venue right in the heart of the vibrant City of Brighton, within easy walking distance of the Cityâ&#x20AC;&#x2122;s hotels shops and restaurants make our venue a favourite with delegates and conference organisers.

Q 2,000m2 primary exhibition space Q 4,450 plenary meeting capacity Q 18 syndicate rooms Q Experienced operational team with the ability to run high security and prestigious international events.

Brighton Centre, Kings Road, Brighton, East Sussex, BN1 2GR. 01273 292671 01273 779980 debbie.matthews@brighton-hove.gov.uk www.brightoncentre.co.uk/conference

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CONFERENCES & EVENTS

A CONFERENCE IN THE GARDEN OF ENGLAND As well as being surrounded by breathtaking countryside, Kent offers a selection of remarkable conference and event venues in both new and traditional settings KENT, KNOWN AS THE GARDEN OF ENGLAND, has breathtaking countryside dotted with orchards, vineyards, hop gardens, oasthouses and more famously the White Cliffs of Dover.

The County is steeped in history and heritage, stunning gardens and world famous buildings including Leeds Castle where Henry VIII visited frequently in Tudor Times, and Hever Castle, the childhood home of Anne Boleyn.

The South East region offers a selection of remarkable conference venues in both new and traditional settings including modern hotels, purpose built conference centres and historic houses and well as unusual venues.

In Kent you will find some of the most recognised chain hotels such as the Marriott, Hilton, Ramada and QHotels. Kent towns

Leeds Castle

range from the seaside resorts of Herne Bay, Folkestone, Dover and Hythe, which are great locations for team away days. More urban areas include Ashford, Maidstone, Canterbury and Tunbridge Wells, all easily accessible from the UK motorway network.

KENT CONFERENCE BUREAU Kent Conference Bureau is the official award winning organisation charged with promoting the county as a first class destination for conferences, incentives and events. The bureau represents over 65 of the countyâ&#x20AC;&#x2122;s top venues and suppliers, and provides a variety of free services to help ensure each and every event is a success from beginning to end.

The friendly team at Kent Conference Bureau are dedicated to making life simpler by offering

free, impartial, practical advice, and a written personalised proposal detailing rates and availability within one working day. In addition show-rounds of venues within Kent can be arranged to ensure the site of your choice meets your specific needs and requirements.

All Kent venues have something different to offer facilitators, speakers and delegates. Your next meeting could really be the one your delegates remember.

A RANGE OF ACTIVITIES If you are looking for something to freshen up your next meeting, why not enhance communication skills, improve office relationships, boost moral or maybe just reward the workforce with some team building activities? Activities can vary from a

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+,16/(< +$// â&#x20AC;&#x2DC;Best Hotel 2010â&#x20AC;&#x2122; Northern Hospitality Awards â&#x20AC;&#x2DC;Hotel of the Year 2010â&#x20AC;&#x2122; - The Mersey Partnership Annual Tourism Awards â&#x20AC;&#x2DC;Isambard Kingdom Brunel meets Carrie Bradshawâ&#x20AC;&#x2122;. 10/10 The Sunday Times â&#x20AC;&#x153;â&#x20AC;Śthe hope street hotel, a boutique hotel, a symbol of Liverpoolâ&#x20AC;&#x2122;s renewed prosperity as potent as the new arena down by the old docksâ&#x20AC;?. Culture Company Government day delegate rates are ÂŁ39 per person including room hire, lunch, coffee and tea breaks, stationery and presentation facilities. The 24 hour government rate is ÂŁ158 per person which includes a king standard room, breakfast and a three course dinner in The London Carriage Works. 2 AA Rosettes.

For a closer look visit www.hopestreethotel.co.uk or call Laura on 0151 709 3000

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CONFERENCES & EVENTS

Sundridge Park Manor

quiet round of golf, a simple treasure hunt, a high wire forest adventure at Go Ape, to an adrenaline fuelled multi-activity day.

The Kent Conference Bureau also arranges familiarisation visits, covering each area of Kent, which offers conference and event organisers the opportunity to speak to venue staff, collate information and meet other service users. If you would like to be added to our mailing list so you are notified when the next familiarisation visit is taking place, please do not hesitate to contact the team.

SUSTAINABLE EVENTS Sustainability and green issues are now very much mainstream, with governments, businesses and individuals all involved.

Catering for meetings and conferences is one area in which organisations can help to reduce their impact on the environment.

Kent is keen to work towards a reduced carbon footprint and your contribution can help with this. Produced in Kent promotes local and seasonal produce and provides support and services to some of the Kent Conference Bureau venues.

The Kent Conference Bureau operates under an environmental policy within Maidstone Borough Council, and recognises that the conference and events industry can impact on the local and global environment. In order to show continued commitment wherever possible, Kent Conference Bureau recommends local suppliers with good records for using recyclable materials, sustainable products and environmental policies in place.

When placing your enquiry, feel free to ask for more information about the sustainable and greener venues in Kent.

WELL CONNECTED With new high speed trains able to run at up to 140mph through Kent, rail connections have significantly reduced journey times across the region. A trip from London to Ashford takes on average 37mins (previously 80 minutes) and to Canterbury 60mins (previously 100 minutes), making Kent easy to reach for your next meeting or event.

Request a copy of the brand new A5 Conference Venues Directory, it contains all the contact information and venue capacities you need when searching for a conference venue in Kent. You can get your free copy by e-mailing

Port Lympne long room

Bradbourne House

The South East region offers a selection of remarkable conference venues in both new and traditional settings including modern hotels, purpose built conference centres and historic houses and well as unusual venues info@conferencekent.co.uk or by logging onto www.kentconferencebureau.co.uk.

Kent Conference Bureau has recently partnered with Kent County Council, the country’s largest authority to act as their external venue booking agent. This partnership strengthens the support offered to Kent venues from the Bureau.

NEW DEVELOPMENT In Autumn 2011, Kent will see the development of a 55,000 sq ft (5,200m2) events and exhibition venue at Bluewater. Once complete, the Bluewater Events Venue will be the UK’s focal point for retail and leisure led events, shows and exhibitions. It will complement Bluewater’s retail offer whilst meeting the continued demand for specialist consumer events in a purpose-built environment.

The 5,200m2 Events Venue at Bluewater is an exciting and innovative purpose-built development. It is being developed and managed by Lend Lease on behalf of Bluewater’s owners.

The latest venue additions to the Kent Conference Bureau membership include Port Lympne Mansion, perhaps one of the most beautiful and memorable settings for all types of conferences and corporate functions. At Port Lympne you will enjoy breathtaking views of the Romney Marsh and the 15 acres of landscaped gardens. Tours of the grounds and safaris can be arranged with prior notice.

Another recent addition is Sundridge Park Manor, a stunning Grade I listed Manor House, set in six acres of grounds on the edge of a golf course. Each of the meeting rooms have high ceilings, natural daylight, period features and excellent views. It is arguably one of the most convenient venues for London and Kent.

A RANGE OF VENUES The Winter Gardens, celebrating its 100th year in 2011 is Kent’s largest non-academic venue. The Gardens provides a wide range

of technical and catering facilities, making it the premier entertainments, conference and banqueting venue in Kent.

Hever Castle has a variety of event spaces available all year round on an exclusive use basis for conferences, day meetings, company away days, receptions, private lunches and dinners. In addition to the superb range of meeting and dining rooms, the Astor Wing also offers 21 bedrooms.

All are individually designed to a very high standard with en-suite facilities.

Bradbourne House is set among 20 acres of beautiful parkland complete with a private lake, surrounded by ancient trees. The venue provides you with a unique and historical location in which to hold all your business and corporate events. The impressive Grade I listed building dating back to Tudor times can provide you with exclusive venue hire for the day in elegant surroundings for all your executive business meetings, seminars, training and team building events.

TREASURE TROVE Dover Cruise terminals, set against a backdrop of Dover Harbour, Dover Castle and the White Cliffs, provide a unique venue to host your conference or exhibition.

Two luxurious terminals offer a variety of large open spaces that can be configured to meet your needs, providing one of the largest, flexible exhibition areas in Kent.

Oxon Hoath is a treasure trove of history and nature, set in 73 acres of its own private grounds. This historical, character venue offers a genuinely unique setting for meetings, conferences, training and team building days that your staff won’t forget.

FOR MORE INFORMATION Tel: 01622 602485 E-mail: dawnbowen@maidstone.gov.uk Web: www.kentconferencebureau.co.uk

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ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service 14 Services

25

Eton Fire

68

Newbury Data Recording

365 On Demand Services

58

Eurocom CI

91

Organisational Health Psychologists

113

4M Flooring UK

42

Europlants

70

Outback Imaging

135

ACS BPS

28

Eurotech Fire Services

68

P&MM

109

Action Assist

86

F16 Consulting

17

Palmer Training Associates

100

Affresol

42

FARMSS

67

Pamper Cleaning

44

Aid Call

84

Fiat

Paraid

IBC

Air Control & Development

58

Fire Lining Systems

68

Parking Control Services

18

27

First Signs & Labels

66

Pass Training Consultancy

Alpha Parking Amputees in Action

140

136

Peta Training and Consultancy Services

20 103

AMS Group

10

Garran Lockers

47

Phoenix Building Systems

Adroit Modular Buildings

41

Gemeni Parking Solutions

29

Phoenix Private Ambulance Service

Anglo-Tech

94

GID-Quantor

Another Level Car Parks

29

Glass Protection

56

Premier Shredding

135

Antec Contracting Services

57

GML Construction

38

Project Consultancy

29

Asbestos Abatement Services

57

Grosvenor Continental

Proshot Sport

94

At-Bristol

Puricore

79

128

Rap Industries

48

Base Cleaning & Maintenance

43

HID Corporation

133

Red Professional Locums

12

Bettaclean

78

Hinsley Hall

148

Renault

Botanica Nurseries

70

Hope Street Hotel

148

Simply Drinks

118

British Independent Utilities

62

ICS Cool Energy

58

Simply Free

116

Broadwood International

27

Indepth Hygiene Services

48

Sodexo Motivation Solutions

109

Business Furniture Online

78

Induced Energy

63

Solarvista Software

124

Cable Safe

41

Innova Solutions

48

Speedy Asset Services

CAPITA Recruitment Vetting Service

90

Insight Management Solutions

Capital 2 Coast Security

23

Investigative Data Mining

94

Stobart Stadium

146

Car Park Management

29

IP UserGroup

54

SVM Europe

108

Carefusion

81

Jabra

90

Swan Analytical

102

Jackpad

42

Sykes Waterfield Taylor

97

The Brighton Centre

146

The Emergency Services Show

139

Kaba Door Systems

130

Kodak Kroll Life Craft

48 120 90 110

The UK Parking Patrol Office Tourism Ireland

64

London Borough of Camden

Clinical Solutions

87

M&J Bowers

134

Transcend Group

50, 60

26

The Scientific Instrument Centre

Claude Lyons Cordtape Environmental Services

52

105

122

Clarks Archive Storage

9

141

Cherwell Software

53

42

Systemware Europe

JT Training

City Environmental Services

Static Systems

116

108 6

102

16

JJ Food Service

Charity Gift Vouchers CitroĂŤn

40

2 73

HC2011

135

Haydon Mechanical & Electrical

114

Polkacrest

70

Certegy

146

126

34

Avon Landscapes

Castle Document Management

TPS Parking Solutions

78 27 144 26 100

Manor Training

103

UKPC

27

Courtney-Thorne

82

Marley Eternit

32

Variable Message Signs

22

Dart Velley Systems

49

Mercedes Fleet

14

Verifile

92

Dorset and Somerset Counter Fraud and

150

Formic

OBC

24

Metartec

126

Vero Screening

88

106

Village Hotels

142

Security Management Service

96

Micro P

Dyson

76

Mitrefinch

98

Waco UK

E-co

74

Modular Buildings

30

Weblight

Entry Parking Post

25

Monodraught

8

Weee London

36, 132

Environmental Consulting Engineers

64

MRG Systems

124

Welwise 4 Me

103

Environmental Water Systems

84

MĂźller Dairy

Workplace Training

103

Essenncee

43

Nalco

80

XPO IT Services

135

Energy Services and Technology Association

64

New Generation Parking Management

24

Yani Montoya Consultants

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40 24

52

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Call 0844 6623626 for more information www.alfaromeo.co.uk

Model shown: Alfa Giulietta 1.4 TB 120bhp Turismo at £17,485 OTR including optional Ghiaccio White special paint at £490. Range of official fuel consumption figures for the Alfa Giulietta range: Urban 26.2 – 51.4 mpg (10.8 – 5.5 I/100km); Extra Urban 48.7 – 76.4 mpg (5.8 – 3.7 I/100km); Combined 37.2 – 64.2 mpg (7.6 – 4.4 I/100km). CO2 emissions 177 – 114 g/km. BIK for model shown is 18%. Prices correct at time of going to press.

Business users only: Above rentals based on Alfa Giulietta 1.4 TB 120bhp Turismo on Contract Hire payment profile of 3 rentals in advance (equivalent to £777) followed by 35 monthly rentals of £259. All rentals exclude VAT and maintenance. Based on 10,000 miles per annum.

Excess mileage charges apply. Vehicles must be registered with Alfa Romeo Contract Hire before 31st December 2010. Offer subject to status, a guarantee and/or indemnity may be required. Offer correct at time of going to press and may be varied or withdrawn at any time.

Subject to availability. Alfa Romeo Contract Hire 240 Bath Road, Slough SL1 4DX.