Health Business Volume 11.1 by Public Sector Publishing

VOLUME 11.1

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HB AWARDS

PATIENT HANDLING

AMBULANCE SERVICES

MOBILITY SOLUTIONS

Protecting the health and safety of patients as well as staff

WASHROOMS â&#x20AC;&#x201C; Identifying infection risks and eliminating cross contamination PLUS MORE

HB Dear Reader

VOLUME 11.1

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The Health and Social Care Bill has been laid before Parliament, with Health Secretary Andrew Lansley commenting that the reforms set out a vision for an NHS led by patients and professionals, not by politicians. He said: “Modernising the NHS is a necessity, not an option, in order to meet rising need in the future we need to make changes.” Ambulance services already see a rise in demand with a yearly increase in calls of 5 per cent. Jo Webber, director of the Ambulance Service Network, explains on page 41 its work with local communities to ease the pressure and provide the best care possible. It is hoped that the NHS reforms will save money, which is welcome news, but you don’t have to wait for the proposed changes to take effect to do that. For example, by implementing simple and inexpensive energy management solutions you will not only save money but also carbon, says the Carbon Trust on page 69.

HB AWARDS

PATIENT HANDLING

AMBULANCE SERVICES

MOBILITY SOLUTIONS

Protecting the health and safety of patients as well as staff

WASHROOMS – Identifying infection risks and eliminating cross contamination PLUS MORE

Also in this issue we look at conflict management, how to manage the increasing problem of obesity, and manual handling of people. Enjoy the issue. Sofie Lidefjard, Editor editorial@psigroupltd.co.uk

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

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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CONTENTS HEALTH BUSINESS VOLUME 11.1

07 NEWS 13 HB AWARDS We present the winners of the 2010 Health Business Awards

21 FINANCE The Institute of Payroll Professionals looks at the key aspects of the Chancellor’s spending review and their likely impact on payroll departments

23 INFECTION CONTROL Scientists at Edinburgh Napier University are testing how GPS in mobile phones can be used to track how people spread infectious diseases The British Pest Control Association explains the link between pest control and infection control

29 PATIENT HANDLING Manual handling of people is the biggest cause of injury to both staff and service users in the care sector, so make sure it’s done correctly, urges the Royal Society for the Prevention of Accidents

33 MOBILITY SOLUTIONS Darren McDonald, chair of IOSH’s Healthcare Group discusses the dual challenge of catering for those with both mental and physical disabilities

41 AMBULANCE SERVICES The Ambulance Service Network outlines how ambulance services can adapt to meet the challenges ahead

45 OBESITY MANAGEMENT Professor David Haslam, Chair of the National Obesity Forum, explores the financial costs associated with obesity

49 HEALTH & SAFETY The Health and Safety Executive discusses slips and trips, and how to reduce this risk within a healthcare setting

55 FACILITIES MANAGEMENT Are your premises functionally suitable? asks the Healthcare Facilities Consortium We preview HFC’s Annual Conference – the longest running healthcare FM themed conference in the UK

61 HOSPITAL INTERIORS We look at how the Design Council has used design-based solutions to improve patient dignity and reduce the spread of infection

65 WASHROOMS Would you use healthcare premises toilets? asks the British Toilet Association

69 ENERGY Carbon management is a simple and effective way for the healthcare sector to reduce costs, says the Carbon Trust The Energy Services and Technology Association examines the comprehensive spending review and its impact on energyrelated measures

76 SECURITY

78 CATERING Vending machines provide a wide choice and can help consumers make healthy choices, argues the Automatic Vending Association

83 RECRUITMENT/HR The Chartered Institute of Personnel and Development discusses managing employee absence through uncertain times

84 BACKGROUND CHECKING Lawfirm Eversheds stresses the importance of knowing who you employ

87 CONFLICT MANAGEMENT NHS Security Management Service looks at the importance of ensuring a safe working environment for staff, and explains the roll-out of its programme of 30,000 lone worker devices

91 HEALTHCARE IT Many hospitals are capitalising on wireless technologies in order to deliver against the challenges they face, says Jon Lindberg, Intellect Healthcare programme manager

101 CONFERENCES & EVENTS NewcastleGateshead offers a huge choice of state-of-the-art venues, cutting-edge cultural facilities

104 PARKING Preview of Parkex 2011 – Europe’s largest dedicated parking exhibition

Achieving effective security is a priority as well as a challenge, says the British Security Industry Association

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5 05

The Cleaning Industry’s unmissable

EVENT A visit to The Cleaning Show 2011 is essential if you are a healthcare manager. No other UK exhibition offers the very latest cleaning products and services available to you in one convenient location.

This is YOUR event. Don’t miss out – Register NOW for your FREE PRIORITY PASS giving you quick and easy entrance to the show.

Visit www.cleaningshow.co.uk

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Visitor’s charter is introduced in Bristol orth Bristol NHS Trust has drawn up a charter to encourage responsible visiting from people coming into hospital to see patients. The visitor’s charter is a set of guidelines for visitors to Southmead and Frenchay Hospitals. It highlights how they can play a vital part in the recovery of their family or friends during their stay in hospital, for example, by minimising the risk of bringing infections into hospital from the community as well as ways to help staff. Marie-Noelle Orzel, director of nursing at North Bristol NHS Trust, said: “For many patients the highlight of their day is visiting time and visitors are the links to life outside of hospital which really help to boost their recovery.

Director of Nursing Marie-Noelle Orzel with nursing staff

“Visitors have an equally important role to play in reducing the risk of bringing and spreading infections to patients in hospital. That is why we hope that this charter will set out ways that visitors can help us as well as their loved ones with a few simple tips.”

New courses help carers take control eople in Crediton, Exeter and Kingskerswell who help relatives or friends who are ill, disabled, elderly or in need of emotional support are being offered free support from trained tutors. The free Looking After Me (LAM) courses, run by NHS Devon, will benefit adults, who may not realise they are carers, but look after people with many long-term

health conditions such as diabetes, asthma, MS, arthritis and Alzheimer’s disease. The course deals with communicating with family, friends and healthcare professionals and planning for the future, and uses relaxation techniques, exercise, healthy eating, and problem solving. It is led by trained tutors who themselves have experience of caring for a relative or friend.

NEWSINBRIEF New trial to help housebound patients A trial has begins in Carlisle to keep housebound patients out of hospital for as long as possible. Under a three-month trial local clinics for more able patients will be set up in GP surgeries, health centres and other local facilities, freeing up extra community nursing time for genuinely housebound patients who are at greater risk of being admitted to hospital. Chris Fell, a community nursing manager who helped design the pilot scheme, said: “Under the trial, each individual patient will be properly assessed and prescribed the right care, in the right place for their condition. For many of these patients, home visits can be counterproductive by restricting exercise and healthy interaction with the outside world – both of which can aid recovery. “Housebound patients will receive more intensive support to spot problems before they occur and help them remain at home for longer and out of hospital.”

Attracting people to a nursing career NHS Careers has launched a new website, Nursing Careers, to promote the wide range of nursing careers available, challenge misconceptions and encourage people to consider a career in nursing. The website is launched as nurse training shifts from a mixture of diploma and degree courses to an allgraduate entry profession by 2013. In the next three years, the nursing profession needs to attract enough applicants to fill thousands more degree places.

Home service saves trust 261 bed days Medway NHS Foundation Trust is piloting a new service that cares for patients who need hospital treatment for certain conditions in their own home. Since the Hospital @ Home service launched at the beginning of November, it has cared for 47 patients and saved the trust 261 bed days. Patients who are stable but still need some form of treatment such as oxygen, blood monitoring or medication can receive the inpatient care they need from nurses and physiotherapists in their home. The service runs seven days a week, from 8am to 6pm, and outside of those hours patients can call and speak to a member of staff who can offer medical advice or re-admit them if necessary. Louise Dennington, senior sister, Hospital @ Home Team, explained: “The feedback we’ve received so far from patients has been very positive. They are more at ease when they are in their own surroundings, which helps them recuperate faster, but they are still able to access the inpatient care that they need. It’s also easier for relatives because it means they don’t have to try and fit their work and personal commitments around visiting times. “We’re auditing the service weekly to make sure we’re delivering effective, safe care, and so far the service is proving a real success. We’ve not had to re-admit any patients, and because we’ve managed to save more than 260 patient bed days, it means we’ve been able to treat more patients in the hospital.” The service will run until April 2011 and is staffed by a senior sister, two senior physios, five nurses and two admin assistants, seven days per week.

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Accessible one-stop health shop opens in Chorley one-stop health in Chorley has opened for people to drop in for a free mini-MOT by health experts, and get help and advice on a wide range of health issues. Local boxer Michael Jennings, pictured with NHS Central Lancashire’s managing director Mark Hindle, cut the ribbon at the new shop where local residents can have their blood pressure, lung capacity, cholesterol and weight checked, and discuss a wide range of health issues and find out more about the many free local health services available. The shop has been developed as a partnership between NHS Central Lancashire and Chorley Council and follows the success of a health kiosk that operated last year in the town centre. Councillor Peter Goldsworthy, leader of Chorley Council said: “The kiosk we had last year proved so successful with such a high number of people coming along we needed bigger premises so we could offer a wider range of tests and information. “The health of our residents is important

to us but it’s not always convenient to get checked out which is why we are working with the NHS Central Lancashire to provide somewhere more accessible for people to drop in to whilst they are in town.”

New prescription service piloted in Blackburn wo surgeries in Blackburn with Darwen have been the first in the country to utilise a new clinical system to pilot a revolutionary electronic prescription service. The service, known as ‘EPS release 2’, has allowed GPs at St. George’s Surgery and Brown Hill Surgery to send patients’ prescriptions electronically to pharmacies paired with the practices. Patients wanting a repeat prescription no longer have to visit their surgery as GPs are instead able to prescribe drugs for up to 12 months electronically. This has cut down the need for paper prescriptions and waiting times at the two surgeries have

been significantly reduced as a result. For the two nominated pharmacies the new system has also proved beneficial. It has allowed them to keep better stock control as they know when each patient will need their next batch of medication and exactly what they will need, so, where practical, it can be ready and waiting for them when they arrive. The system can also stop patients fraudulently collecting two lots of the same medication. At present prescriptions for approximately 1,500 patients are being processed using the system with 4,000 items being prescribed and dispensed.

NEWSINBRIEF No waiting for older people in Gateshead Older people in Gateshead with mental health problems no longer have to wait for an appointment with Gateshead Primary Care Trust’s specialist occupational therapy service. Four years ago, the waiting time was anything up to six months. Now, patients can be seen as soon as it’s convenient for them – even on the day of referral – following changes to the way the team works. Electronic patient notes have replaced paper reports, which often took a long time to prepare and formulate. This, coupled with more flexible working patterns, has freed up staff to see more patients, more quickly. Also, a new system was introduced to offer the patient an appointment with an occupational therapist immediately rather than having to cope with their difficulties until an appointment time was available. Senior occupational therapist Tony Williamson said: “Because we now have no waiting list, capacity has increased and we are seeing twice as many patients as we previously could. Furthermore, those who are discharged from our caseload can immediately selfrefer back into the service if their situation changes.”

App helps find right sexual health service Coventry sexual health services are now easier to find on the move thanks to an updated phone app. NHS Coventry launched its iPhone app in December 2010 to help patients find the right service locally. The ‘sat-nav to services’ has now been updated to include details and locations of sexual health services, including where free condoms are available, where to access emergency contraception and STI and pregnancy testing. NHS Coventry is only the second primary care trust in the country to launch this kind of iPhone app, which also includes details of nearby hospitals, GP surgeries, pharmacies and the city walk-in centre. The app, which is available from iTunes, uses GPS to signpost patients to their nearest service.

NHS Bolton helps kids get fit for free NHS Bolton is giving away places on the MEND programme to give more children and families the chance to become fitter, healthier and happier. MEND stands for mind, exercise, nutrition…do it. It is a group programme for children aged 7-13 who are over the healthy weight range for their age and height, and aims to help them become healthier and active with the support of their parents or carers. The programme is free and lasts for ten weeks. It includes nutrition, physical activity and behaviour change.

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Cancer strategy could save 5,000 lives a year etailed plans to transform cancer care in England have been announced by Health Secretary Andrew Lansley. Overall these plans will drive up England’s cancer survival rates so that by 2014/15 an extra 5,000 lives will be saved every year. ‘Improving Outcomes – A Strategy for Cancer’ sets out how the government, NHS and public can prevent cancer, improve the quality and efficiency of cancer services and move towards achieving outcomes that rival the best in Europe. The strategy will be backed with more than £750 million over four years. It sets out a range of actions to improve cancer outcomes, including diagnosing cancer

earlier, screening more people, introducing new screening programmes, and making sure that all patients have access to the best possible treatment, care and support. The strategy will also help people to live healthier lives to reduce preventable cancers.

Free courses for patients with long-term conditions HS Blackpool is working with the Expert Patients Programme (EPP) to offer free courses for adults living with long-term health conditions. The EPP course aims to help patients take more control of their health by learning new skills to manage their conditions better on a daily basis, including relaxation techniques, healthy eating, action planning and problem solving. The course lasts six weeks and is run by trained tutors, many of who are also living with long-term conditions.

The EPP is also offering a free online course, which is designed to improve quality of life, reduce feelings of loneliness and isolation, improve relationships and help patients learn how to manage their condition. Patients simply visit the online learning centre each week for six weeks, where they can explore topics to help them make plans and solve problems they may have in relation to their condition, at a time that suits them. Course tutors are also available to offer support and advice to patients.

Flagship training saves NHS thousands of pounds ash savings and substantial improvements in patient care have been made to frontline NHS services in Derbyshire thanks to a unique training programme. Derbyshire Community Health Services trains groups of staff in project teams of four consisting of senior managers, frontline clinical and administrative staff to challenge how things are done, make savings and improve processes – all for the benefits of patients. New and innovative ways of working have resulted in significant savings across different specialist areas – ranging from £20,000 for mechanical devices used to support or supplement weakened or abnormal joints or limbs to £125,000 for dental services. Helen Short, business development manager for Derbyshire Community Health Services, said: “This programme is designed to equip staff to problem solve without

reinventing the wheel – because they focus on real-life situations and use the support and knowledge of the other team members to make substantial improvements and significant cash savings to patient care. “The programme is delivered by our own staff, not external consultants, and has been specifically tailored to be taught in a way which is relevant to the NHS.” So far over 120 members of staff have participated in the programme, which was developed with the help of management consultancy firm McKinsey and Company.

NEWSINBRIEF Parking attendants to improve safety in hospital car parks In order to improve the safety of its hospital sites, Scarborough and North East Yorkshire Healthcare NHS Trust is introducing car park management. Two car parking attendants have begun working across both sites at Scarborough and Bridlington, issuing enforcement notices where appropriate. Penalty charges will be £60, or £30 if paid within 14 days, and will be administered by an external company. James Hayward, director of Facilities, explained: “The trust has received many comments from patients, visitors, bus companies and staff regarding the difficult and sometimes dangerous parking at Scarborough Hospital. “In order to improve the safety of both drivers and pedestrians we decided to introduce proper management controls, which includes the creation of two car park attendant roles.”

New helpline advises on best place for treatment A new health helpline has been launched for patients in the Great Yarmouth and Waveney area. Members of the community who have a nonurgent health problem can call the helpline 24 hours a day, seven days a week to get help, guidance and to find the best place for treatment. Dr Jamie Wyllie, medical director for NHS Great Yarmouth and Waveney, said: “Many people don’t realise it but there are more options available than A&E for urgent care needs. The call handlers will be able to offer help and guidance as well as tell the patient or carer where they could be looked after best.” The helpline, which is a pilot project, will be running until the middle of July.

£20 million to improve battlefield trauma treatment The Department of Health, the Ministry of Defence, University Hospitals Birmingham and University of Birmingham are investing £20 million in a new initiative to improve the treatment of trauma sufferers. The initiative will involve both military and civilian trauma surgeons and scientists sharing innovation in medical research and advanced clinical practice in the battlefield to benefit all trauma patients in the NHS at an early stage of injury. The new National Institute of Health Research (NIHR) Centre for Surgical Reconstruction and Microbiology will be set up at the Queen Elizabeth Hospital Birmingham, where all injured service personnel are currently treated after evacuation from the frontline in Afghanistan. For every trauma fatality in England, there are two people who are left with severe and often permanent injuries. Currently, research into trauma care means advances are not always shared across the NHS. The new NIHR centre will form a central point in England for trauma research where knowledge can be translated into real improvements in care for all NHS patients. It will be the first and only research centre of its kind in the UK to focus both on military and civilian care and treatment.

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HB AWARDS

2010

TOP AWARDS FOR DESERVING HEALTHCARE PROFESSIONALS The winners of the 2010 Health Business Awards have been announced at a special ceremony and champagne reception NOW IN ITS FOURTH YEAR, the Health Business Awards is establishing a reputation for showcasing success stories in the healthcare sector. Held at Arsenal’s Emirates Stadium, the awards were presented by BBC Breakfast host Bill Turnbull and recognised a range of projects from different business areas in the NHS. Over the last decade, real strides have been made in improving the performance of the NHS. Partially through investment and reform, we have seen reduced waiting times, progress in combating Hospital Acquired Infections and an increase in patient satisfaction. The demands of an ageing population will put more pressure on the NHS at a time when it faces budgetary change and the coalition government is pressing forward with plans for a further period of restructuring. Many of the proposals in its ‘Liberating the NHS’ white paper have the potential to improve services, but these will rely heavily on the dedication of doctors, nurses, facilities managers and other healthcare professionals that will be placed at the business end of delivering these reforms. The private sector also has an increasingly important role to play, both in the provision of healthcare services and in the supply of equipment. BUILDING WINNERS Like many organisations, it is the individuals that work inside the NHS that make it what it is. Congratulations to all of the trusts nominated for the hard work and innovation demonstrated by their most important asset – their staff. The Hospital Building Award was won by Royal Manchester Childrens Hospital with architects Anshen and Allen. With 371 beds, including 17 intensive care and 12 high-dependencies, the RMCH is the largest single-site children’s hospital in

hospitals at Pendlebury and Booth Hall, and unites them in a single building. Despite its size, RMCH has been designed to retain a sense of the human-scale, thus minimising the anxiety of patients and families crossing the hospital threshold for the first time. NSS Health Facilities Scotland took home the new award for Estates and Facilities Innovation, sponsored by Focused FM, for its development of the AROMA coffee brand. It provides NHS Boards with a means to reduce subsidy, improve standards and provide a high street quality branded coffee. Phase one of the project is the Aroma Coffee Bar, a profit driven, high quality specialty coffee. The brand, wholly owned by NHS Scotland, will offer an opportunity to generate income for frontline care without the need to use franchise or concession operators. HEALTHY ENVIRONMENTS The Hospital Cleaning Award, sponsored by Kärcher, went to Ipswich Hospital NHS Trust, where patient safety, including reducing the number of infections patients acquire when in hospital, remains the number one priority. A series of anti-infection measures have been introduced across all departments including reduced visiting times in a bid to stop the spread of infections, a new isolation ward, regular deep cleaning of wards and a major hand-washing campaign. Opened in 2008, The Garrett Anderson centre boosted the hospital’s infection control crackdown as it

includes four isolation rooms where air pressure can be controlled to care for patients with or susceptible to infections. Each of the isolation rooms has an antechamber sterile area for gearing up, and enhanced ventilation. One has been designed for children and has space for a bed for their parent/carer. These are also linked to a sophistictated patient monitoring system. Patient Environment Action Team data reports a high level of cleanliness throughout the hospital. In 2009/10, there was a 49 per cent fall in C.diff cases and a 25 per cent reduction in MRSA bacteraemia. Ipswich Trust was also named by Doctor Fosters Research at its top medium sized hospitals trust for 2010. Peterborough and Stamford Hospitals NHS Foundation Trust was given the Hospital Security Award, sponsored by HID, for its lone worker protection system. With incidents of violence and aggression on the rise towards members of staff, Peterborough and Stamford Hospitals NHS Foundation Trust decided to evaluate what measures could be taken to add to the protection of staff who had been assessed as being at high risk of attack whilst on duty both within the hospital campus and the wider community. The trust conducted a trial involving a small number of staff before purchasing protection units for all its lone workers. This generated positive feedback and identified that they felt far more comfortable

the UK. It replaces two children’s

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Kärcher’s compact scrubber drier reduces costs and improves hygiene and safety BR 30/4 C Bp – cable-free cleaning Simple • as easy to operate as an upright vacuum cleaner • scrubbing and drying in one pass Effective • thorough, hygienic cleaning results every time • no slip hazards from wet ﬂoors or mains cables

No more slippery floors Traditional wet mopping may seem like a low cost method of floor cleaning but over time it can actually cost a lot more than investing in floor cleaning machines. Besides the extra time taken to clean floors effectively, mop and bucket cleaning leaves floors wet, encouraging bacteria to spread and creating slip hazards. Emptying, filling and moving of open mop buckets poses a health risk to operators, and dirty water is often reused. By investing in a professional BR 30/4 C floor scrubber-drier machine from Kärcher, consistent cleaning results are guaranteed, and floors are left instantly dry and reusable without risk. Because floor cleaning is so much faster than with a mop, cleaning staff can be deployed elsewhere and therefore whole life costs can be dramatically lower than mopping.

Versatile • compact enough to ﬁt into around toilets and under furniture • powerful lithium-ion batteries for daytime cleaning brush can be changed in an instant to use on a different floor surface

Deep or maintenance clean from one machine – and at any time The 30/4 gives consistently high quality cleaning results on a variety of hard floor surfaces and is ideal for locations such as wards, kitchens, WCs and even reception areas. Because of its powerful lithium-ion batteries, there is no need for a mains cable meaning the machine can be used at any time of day without posing a safety risk. The machine also features a vacuum-off function for deep cleaning of very dirty floors or stubborn stains, as well as a range of quick-change brushes to best suit each floor type – including Kärcher’s unique microfibre roller pad which gives an incredibly thorough, hygienic clean with little or no detergent.

The BR 30/4 only uses clean water for cleaning, and ensures that operators don’t come into contact with dirty water or detergents during filling and emptying. The BR 30/4 C scrubs and dries floors in a single pass, saving time, giving better results and increasing safety when compared to mop and bucket cleaning.

Battery power – high performance without cables • • •

20 minute running time from two batteries (included with the machine) The machine automatically switches from one battery to the other, meaning extra batteries can be used to extend the run time 4-bay fast charger as standard, charges up to 4 batteries in only 40 minutes

To find out how Kärcher can make a difference for you call 01295 752 142 or email healthcare@karcher.co.uk or visit www.karcher.co.uk

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HB AWARDS

Hospital Building Award. Winner: Royal Manchester Childrens Hospital

Estates and Facilities Innovation Award Winner: NSS Health Facilities Scotland

Hospital Cleaning Award Winner: Ipswich Hospital NHS Trust

Hospital Security Award Winner: Peterborough and Stamford NHS Trust

Hospital Procurement Award Winner: NHS CPC - Clinical Waste Contract

Sustainable Hospital Award Winner: Guy’s and St Thomas’ NHS Foundation Trust

with a solution where their movements were monitored by an external organisation. Managers can access the secure web based software platform at any time to instantly update staff details or change the speed-dial programming of individual units. Utilising GPS based technology, which interacts with alarm receiving software, the system lets employers know exactly where their lone workers are whenever they need assistance. NHS Commercial Procurement Collaborative scooped the Hospital Procurement Award, sponsored by Red Procurement, for its innovative clinical waste contract. This is set to save up to £1.7 million per year for the next five years with further benchmarking activities included to ensure the contract remains competitive over its 10-year life. A buying consortium between trusts in the Yorkshire and Humber region, and the Commercial Procurement Collaborative (CPC), handled the procurement process. Described by one of the region’s supplies managers as “the jewel in the CPC’s crown”, the clinical waste contract is one of the biggest in the country and brings valuable opportunities to the region and significant cost savings to participating trusts. SUSTAINABLE FUTURES The Sustainable Hospital Award, sponsored by Monodraught, was presented to Guy’s and St Thomas’ NHS Foundation Trust, which uses an innovative Combined Heat and Power (CHP) system that has led to a £1.5m cut in its annual energy spend and a 20 per cent year-on-year reduction in its projected carbon dioxide emissions – the equivalent of taking over 3,500 cars off the road every year. Guys’ and St.Thomas has worked with the Carbon Trust on its public sector carbon management programme for the last three years. As a result, the trust invested £10m in CHP engines, which have brought substantial savings on energy costs while providing heat for the hospital wards and hydrotherapy pools among other uses. In January last year, Guy’s & St.Thomas’ was the first hospital trust to be granted the Mayor of London’s Green500 Platinum Award for outstanding accomplishments in carbon reduction. Royal Bolton Hospital NHS Foundation Trust left the Emirates Stadium with the Hospital Catering Award, sponsored by Nestlé Professional. The catering department at the Royal Bolton Hospital provides healthy menus with great

Hospital Catering Award Winner: Royal Bolton Hospital NHS Foundation Trust

variety and regularly receives compliments. Serving over 850 patients, the catering team designs a range of menus that are changed daily, providing a choice of express foods, restaurant dining and choices for different cultures and dietary requirements. Catering manager Margaret Meadows was this year named ‘Healthcare Caterer of the Year’ in the annual Cost Sector Catering Awards. EFFECTIVE RESPONSES The Ambulance Trust of the Year, sponsored by Airwave, went to South Western Ambulance Service NHS Trust. During recent Care Quality Commission (CQC) inspections, the trust attained the highest possible score for one and very highly on another, with some procedures seen as best practice. SWAST is also the first in the UK to successfully admit a stroke patient directly to a CT scanner for door to CT scan time of just 10 minutes. This compares to an average of 50 minutes. The door to needle time was just 32 minutes, compared to standard performance of 1 hour and 15 minutes. The Cordtape-sponsored Environmental Practice Award, was won by Chesterfield Royal Hospital NHS Foundation Trust for its Sustainability Action Plan. The Sustainability Committee at the trust has gone from strength in recent years. As well as implementing phase three of the Carbon Trusts’s Carbon Management Scheme, Chesterfield has also tackled food procurement by stipulating that all food for their main hospital canteen be sourced from within 50 miles of the hospital. This is also being introduced into tender documents for other goods and services. Newham Whole Systems Demonstrator, a two-year research project to help residents with long-term health conditions live in their own homes, was presented with the Telehealth Award, sponsored by Alvolution. The project, run by Newham Council and Primary Care Trust, monitors 400 patients, each provided with diagnostic equipment, such as an SPO2 meter for blood oxygen, which clips on the patient’s finger. Information is then reported back through the phone line. The Newham trial includes patients with diabetes, heart disease or breathing problems. Part of the project is a trial of TeleHealth based on mobile phone technology called Think Positive (t+). The study aims to examine the impact of the t+ application on outcomes such

Ambulance Trust of the Year Winner: South Western Ambulance Service NHS Trust

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Primary Care Trust calls for knowledge sharing to inform telehealth procurement T’S IMPORTANT that all telehealth users and their clinicians share feedback on these technologies, so that we as purchasers, can see how they can be applied, their potential for cost savings, and then evaluate this evidence.” This is the view of Helen Rowney, telehealthcare project manager at South Staffordshire PCT following its successful pilot of Alvolution’s new telehealth product comparison website (www.alvolution.co.uk/compare). Now, GPs, local authorities and healthcare providers can avoid pricey commissioning mistakes by using the comparison site, which signed up more than 500 new users in its first month. Created in partnership with health and social care commissioners from the West Midlands Strategic Health Authority, the website is operated by assisted living specialists Alvolution, a division of MedilinkWM. A free resource to relevant professionals, the comprehensive and unbiased website saves on research time and shares best practice. Professionals can choose from a huge range of multi-functional telehealth and telecare products on the UK’s largest database. The site has the potential to make significant savings for the NHS and improve the lives of more than 17 million people in the UK. Thanks to the comparison site, patients with

“I

chronic disorders in South Staffordshire are now benefiting from greater access to lifechanging equipment and technology at home. Helen Rowney added: “Our main focus is to provide our patients and their carers with as much choice as we can. We have been using Alvolution’s product comparison website to give us more telehealth options, rather than simply choosing from a stock cupboard.” Alvolution’s manager Rob Chesters explains: “We are delighted with the early success of our product comparison site. With over 17 million people in the UK with a chronic disease or long-term condition, telehealth has a big role to play in our future treatment. But it can prove impossible keeping abreast of developments with so many

technologies, capabilities and functionalities available. That’s why a free website that enables professionals to share knowledge and access accurate, impartial reviews of technology, is being so eagerly embraced.” This professional tool can be used to signpost users to all the technologies that are available to meet their needs. User friendly, it helps with both specific need-generated enquiries and more general welfare searches. Searchable by condition, scenario, or technology, a range of options is presented, clearly highlighting product uses and benefits.

FOR MORE INFORMATION Try the service by visiting www.alvolution.co.uk/compare

Too many Technology choices?

Make the right choice with the UK’s freshest, largest and most up-to-date database of assisted living products at your ﬁngertips. Alvolution’s technology ﬁnder is an independent, unbiased, comprehensive product comparison website, developed by health and social care commissioners to help with the selection of assisted living technologies for their service users/patients.

If you are responsible for prescribing individualised packages for service users/patients, you can search by condition, equipment area, technical area, or scenario, then compare and contrast individual products on screen.

With this online service you have access to constantly updated information wherever and whenever you want: in the oﬃce, from your laptop or on your PDA.

MedilinkWM

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HB AWARDS

Environmental Practice Award Winner: Chesterfield Royal Hospital NHS Foundation Trust

Telehealth Award Winner: Newham Whole Systems Demonstrator

Healthcare Recruitment Award Winner: Newham University Hospital NHS Trust

IT Innovation Award Winner: Great Western Hospitals NHS Foundation Trust

Healthcare IT Award Winner: St Helens & Knowsley Teaching Hospitals

Outstanding Achievement in Healthcare Winner: Airedale NHS Foundation Trust

as blood pressure and body weight. It will also examine the impact of t+ on factors such as diabetic patients’ quality of life, health status, self-care and perceived control of diabetes. The 2010 Healthcare Recruitment Award, sponsored by Hays, also went to east London, to Newham University Hospital NHS Trust. Partnered with NHS Professionals, Newham has achieved a substantial reduction in agency staffing, saving a projected £2.5m per annum. After five years of outsourcing flexible staffing needs, Newham University Hospital NHS Trust has benefited from a dramatic reduction in expensive agency use, which is down from 26.6 per cent in 2004/05 to only 3.8 per cent in 2008/09. Hard-to-fill specialisms are subject to individual workflows set jointly by the trust and NHS Professionals and then passed across for subsequent managing in conjunction with general clinical staff demands. A single system handles both bank and agency usage with 100 per cent and timely compliance required for online bookings. eTimesheets and ePayslips also allow transparency and enable bottlenecks to be quickly identified and remedial action taken. TECHNOLOGY ADVANCES The IT Innovation Award, sponsored by Anoto, was presented to Great Western Hospitals NHS Foundation Trust for its pharmacy robots. The trust dispenses more than 200,000 items a year and when fully implemented 80 per cent of those items will go through its pharmacy robots. When patients or members of staff take a prescription to the pharmacy, the robot scans a prescription code. It then links this to a database that logs the location of the drugs on the shelves. A robotic arm selects them, places them on a conveyor belt and sends them to be checked by pharmacy staff before being given to the patient. St Helens & Knowsley Teaching Hospitals NHS Trust has completed its project to deliver health records electronically and has stopped using paper records in operational practice, and this achievement was recognised with the Healthcare IT Award, sponsored by Ubisys. Following a 22-month roll out, all 27 hospital departments have now gone live with over 500 clinicians and 130 medical secretaries trained to use its document management system. Access will be extended to GPs via a voice and data network, which interconnects 340 sites in Merseyside. Airedale NHS Foundation Trust took home

Transport & Logistics Award Winner: Winchester and Eastleigh Healthcare NHS Trust

the Outstanding Achievement in Healthcare, sponsored by Dawson Foodservice Equipment. Airedale achieved Foundation Trust status in June 2010, and continues to deliver an outstanding level of care for patients across West Yorkshire. The trust has also been commended at the National Patient Safety Awards for two projects, which involved data collection and surgical safety briefings. In November 2009, Airedale was named ‘Small Hospital Trust of the Year’ in the Dr Foster Hospital Guide for the fourth time in the last five years. The travel planning at Winchester and Eastleigh Healthcare NHS Trust won them the Transport & Logistics Award. The trust continues to reduce its environmental impact, particularly in respect of staff travel. It has worked with the local authority over a number of years to develop a park and ride service that is safe, convenient and economical, and many now use this to manage their journeys to work. A route review exercise enabled the trust to reduce the fleet of light commercial vehicles from nine to four whilst still providing the same level of service. REACHING OUT The NHS Publicity Campaign Award went to Coventry PCT for an innovative take on a tough subject. Coventry has big problem with alcohol and it was clear that effective communication was needed to raise awareness of alcohol abuse. NHS Coventry, together with film makers Matthew Cooke and Vincent Lund, created a cinema advertisement entitled ‘Shaken and Slurred’ in the style of a James Bond spoof. It shows James Bond getting a bit too drunk and ejecting his Russian girlfriend out of his Austin Martin. The local cinema has estimated admissions of 12,000 per week with a mix of demographics and the trust got a deal to have the advert on every screen over a week period at a special rate. The film ends with the title: ‘Excessive Drinking Affects Others, Drink responsibly’, (www.youtube.com/watch?v=jdla8cQvl6M). Thank you to all organisations that entered the 2010 Health Business Awards. Entry to the 2011 event, taking place 8 December, opens later this year – watch this space.

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

NHS Publicity Campaign Award. Winner: Coventry PCT

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Monodraught – natural light and ventilation ONODRAUGHT LTD

M seeks to explore, develop and create innovative low energy concepts and building services solutions in response to the need to reduce energy consumption of buildings and for their users to reduce energy costs. Accordingly, by maximising natural available energy from the wind and the sun, Monodraught’s products help users reduce their energy consumption, costs, and carbon footprint. Monodraught’s extensive R&D department is key to the successful development of products such as the WINDCATCHER® natural ventilation systems that provides a controlled quantity of fresh air into a room from roof level, whatever the wind’s direction, and without mechanical assistance; the SOLABOOST® solar assisted natural

ventilation systems that uses the WINDCATCHER technology in combination with a solar powered fan to guarantee additional ventilation on sunny days; and the SUNPIPE® natural daylight systems that delivers daylight to areas that windows cannot reach. The latest technology to benefit from this dedicated R&D resource is the range of PCM (phase change material) systems that provide extremely low energy consumption cooling and ventilation systems and provide a stable room temperature environment. Armed with all of these systems Monodraught can provide the optimum low energy solution to the client.

FOR MORE INFORMATION Tel: 01494 897700 Web: www.monodraught.com

ID GLOBAL is a leader in providing solutions for the delivery of secure identity for customers worldwide. Recognised for product quality, innovation and leadership, HID is the supplier of choice for OEMs, system integrators and developers serving various markets, including physical and logical access control as well as healthcare. Headquartered in California, HID Global has over 1,700 employees and operates offices that support more than 100 countries. One of HID’s product lines encompasses OMNIKEY® readers. This portfolio comprises contactbased, contactless and multiinterface readers for logical access. Contactless smart card technology is increasingly being used in healthcare to safeguard patients and staff, and to protect confidential patient information. Examples of use in healthcare: • The OMNIKEY® 5321 CR USB Reader is designed for contactless applications in

hygienic environments, such as hospitals. This reader allows users to log-on to Windows®, networks, websites and applications for the secure storage of user names, passwords and personal information. • The OMNIKEY® 2061 Bluetooth® Reader, when used with HID Global Crescendo® smart cards, for example, offers high-speed, portable, hands-free authentication for log on to personal computers. The device can be worn beneath surgical clothing.

FOR MORE INFORMATION HID Global is an ASSA ABLOY Group brand. For more information, visit www.hidglobal.com

Red – passionate about procurement

Dawson – customised and modular food service equipment

T RED PROCUREMENT we simply impact your bottom line. Full stop. Whether it is just to buy better or restructure your procurement processes we guarantee a rapid return on investment. We offer an innovative approach where we complement your existing procurement team providing lean solutions across both core and non-core spend areas. Our powerful suite of procurement tools underpin our proven category management process enabling us to support simple or complex projects. Having experience in both private and public sectors, we have a strong track record of delivery. Our team of professionals are both strategic thinkers and hands-on practitioners that engage with your organisation at all levels. Together we tackle the whole spectrum of business costs to improve your total cost of ownership. As procurement professionals we believe we can impact your bottom line regardless of where you are in

NTELLIGENT INNOVATION AND ecological efficiency without compromise is the philosophy of Dawson Foodservice Equipment (DAWSON MMP LTD). We are an independent UK Division of the ALI Group, one the world’s leading designers and manufacturers of customised and modular food service equipment. We have provided catering equipment solutions to the UK public sector for over 50 years. Our four world renowned brands are all market leaders in their respective fields, supplying powerful, robust, technically advanced and ecologically efficient products for today’s catering facilities. Our commitment to improved performance, in line with ecological responsibility ensures that our latest product portfolios meet and comply with all present EU and Environmental Legislation. Our brands and products include: COMENDA – one of the world’s most respected manufacturers of ware washing equipment.

HID Global – secure identity solutions

the procurement lifecycle. In our experience a 4:1 ROI is achievable and with some clients the ROI has been greater than 10:1. All we ask is that you work with us and provide recent spend data. We will identify opportunities and build a savings pipe line for you and also highlight the associated risks. We are prepared to guarantee an ROI on any engagement where we are supporting or leading the savings delivery programme. All very straightforward really.

FOR MORE INFORMATION Contact: Tim Carrier Tel: 07881 942230 Fax: 0333 3210430 E-mail: tim.carrier@ redprocurement.com Web: www.red procurement.com

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LAINOX – one of the world’s leading designers and manufacturers of combination ovens. ROSINOX and MARENO – two of the world’s premier producers of modular heavy and medium duty prime cooking equipment. SERVICE – our highly respected service infrastructure operates throughout the UK, providing comprehensive cover through our in-house national network of certified and multi-skilled engineers.

FOR MORE INFORMATION For further information on our range of products and services call Dawson Food Service Equipment on 01226 350450, or visit our website www.dawsonmmp.co.uk

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Airwave, delivering critical communications to the health sector

Proventec Healthcare – for all your hygiene and patient safety needs

IRWAVE DELIVERS critical communications services to organisations with public safety responsibilities. Customers include all the emergency services and healthcare providers on every level from SHA’s, PCT’s and Acute Hospital Trusts to GP practices. We design and integrate communications solutions that help our customers increase efficiency, and improve operational performance leading to improved patient outcomes. Our solutions range from providing Ambulance Trusts with TETRA radio or multi messaging communications and lone worker monitoring for single crew paramedics, to flexible e-learning solutions for

ROVENTEC HEALTHCARE is the growing name for infection prevention and patient safety within the healthcare environment. Using proven technologies integrated into a single portfolio, Proventec Healthcare provides hospitals, care homes and primary care facilities with a comprehensive range of microbiologically validated hygiene solutions conveniently available from a single source. Through field researched, clinically proven and innovative product developments by subsidiaries Contico and OspreyDeepclean, Proventec Healthcare is making ever greater strides in the prevention and control of HCAIs. The company’s latest ergonomically designed Dry Steam Vapour equipment, utilising task-specific cleaning tools and advanced ‘3D’ microfibre, elevates routine cleaning into daily decontamination procedures. The award-winning Healthcare Steam Cleaning Tools have been validated in cleaning and

general nurses caring for critically patients in hospital wards or providing community healthcare nursing teams with electronic versions of patient notes. By operating and managing the world’s largest public safety communications network and serving over 300 public sector organisations means we are perfectly placed to offer healthcare organisations communications solutions that fully meet their needs.

FOR MORE INFORMATION Tel: 08000 113399 E-mail: health@airwave solutions.co.uk Web: www.airwave solutions.co.uk

decontamination performance for all typical hospital surfaces and against a host of HCAI pathogens including MRSA and Clostridium difficile spores. Due to its high degree of “grab” and adsorption, the new 3D microfibre demonstrates superior performance in soil removal without the use of environmentally damaging biocides. Disposable versions provide the optimum performance with no need to launder and no concerns about possible cross contamination. Combine the two systems, microfibre and steam, and it is clear that no other approach to healthcare cleaning and hygiene even comes close.

FOR MORE INFORMATION Tel: 0845 6029981 E-mail: sales@proventec healthcare.com Web: www.proventec healthcare.com

From strategic consultancy to regular maintenance schedules GSG can help SG IS AN INTEGRATED facilities maintenance company, managing assets, properties and workspaces within the private and public sectors. Delivering all the day to day services required to ensure working environments run seamlessly. Adrian Gilbert, FM contracts manager, highlights the GSG promise whereby “everything we do makes our clients day-to-day operations smooth and as worry free as possible.” Adrian states: “Our presence is nationwide, this enables our customers with buildings or assets to centralise all their maintenance in one trusted partner. This provides our customers reassurance that everything is being maintained to the same high standards.” GSG has experience within the healthcare FM sector, working with a portfolio of clients including partnerships with InHealth, Alliance Medical and Euromedic. GSG are also recognised as UK agent, dealer and after sales provider for Dutch based Lamboo Mobile Medical (provider of mobile medical trailers such as mobile MRIs, mobile X-ray units, mobile PET/CT and relocatable clinics). GSG has built a reputation within the healthcare sector as mobile trailer maintenance specialists. The recognition as provider of mobile trailer maintenance for InHealth was recently

highlighted as finalist within the 2009 PFM Awards within the Partners In Healthcare FM category (runner up to eventual winner, Interserve). Managing director, Duncan Jones highlighted: “Recognition within the industry proves the quality service we deliver and our overall performance. Our expertise within the mobile medical sector

enables us to add value and support to our clients and more importantly peace of mind that a project is being taken care by the right people with the right expertise.” GSG’s forward looking approach also enables a team of energy experts who clients can call on to help reduce their carbon footprint and improve ways of sustainability. GSG always works to promote energy conservation, reduce waste and protect the environment. This makes it easy to introduce building log books, building energy metering and inspection of air conditioning systems to comply with current building regulations. From a depth of knowledge in key areas such as power supply and air conditioning to high quality general maintenance and consultancy, clients can rely on GSG’s professional attitude. To sum up the GSG delivery, Adrian comments: “With our ability to deliver the widest remit of FM activity, clients can select a full 360 degree service or cherry pick the areas of support they require. It’s our reliable approach that takes our clients forward.”

FOR MORE INFORMATION Tel: 01202 331605 Fax: 01202 331606 E-mail: adrian@thegsgroup.co.uk Web: www.thegsgroup.co.uk

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Acheive efficiencies and cost savings with sQuid Card’s cashless payment solutions

EALTH PROFESSIONALS are always on the lookout for new ways to introduce efficiencies and cost savings in to their sector. In the current climate, where cuts are inevitable, one such way to facilitate this is through cashless payment systems. An exciting and innovative new way to enable cashless payments is through sQuid. sQuid’s cashless payment solution has already been widely adopted by councils, transit authorities, schools, colleges, universities, campus environments and retailers alike. sQuid is the new convenient way to pay for small value items instead of using cash, for example catering, printing, schools trips, photocopying, and online payments. sQuid payments are made through biometric identification or by using contactless smart cards, or online using a pre-pay account or purse that users can easily top up. Because it’s a pre-pay account, sQuid can be made available to all, you don’t need a bank account and you can’t get into debt. sQuid can be used by health professionals in a number of ways: from ensuring healthy meals are delivered to school children by making their purchase history available to parents; meals on wheels for ensuring customers have paid for and received their meals; for allocating rewards for positive initiatives such as smoking

cessation projects, to name but a few. sQuid is flexible, affordable, and easy to use, money is held securely and account holders can protect their account balance, for example if a card is lost or stolen. Simply register your details online, where you can also top up your account with money, check your balance and view your transactions. sQuid can be set up either stand alone with terminals and readers provided, or linked to existing till and EPOS systems. Mobile Wi-Fi GPRS contactless reader terminals, bring a new level of mobile receipt and payments options, where health professionals can accept sQuid payments in the field.

sQuid is easy for children to use, for parents and customer to manage, while saving administrators time also providing them with reports and visibility of all transactions. Beneficiaries are catered for as are duty staff, visitors and other interims. With top ups managed online, there is no need for cash on campus, which removes the need for cash handling with all of its associated costs.

FOR MORE INFORMATION Tel: 020 83382111 Fax: 020 83988785 E-mail: bfeltham@squidcard.com Web: www.squidcard.com/education

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FINANCE

PAYROLL – NEGOTIATING THE LEGISLATIVE LANDSCAPE Elaine Gibson, senior policy officer at the Institute of Payroll Professionals (IPP) examines the key aspects of the Chancellor’s spending review and how they may impact payroll departments WHEN CHANCELLOR GEORGE OSBORNE delivered his spending review it contained a mixed bag of pending changes. In keeping with its commitment to providing up-to-date news for employers’ payroll departments, the IPP Policy team has extracted the key points from the review that will likely affect those working in this sector. PAY SCALE DISPARITY The government asked Will Hutton to lead a Review of Fair Pay in the public sector, making recommendations on tackling disparities between the lowest and highest paid in public sector organisations. The Review published its interim findings at the end of last year. The Independent Public Service Pensions Commission (IPSPC) led by John Hutton published an interim report on October 7. The report highlights the importance of providing good quality pensions to public servants and concludes that there is a clear rationale for public servants to make a greater contribution if their pensions are to remain fair to taxpayers and employees, and affordable for the country. In response to the Commission’s interim recommendations, the government will: • Commit to continue with a form of defined benefit pension • Await Lord Hutton’s final recommendation before determining the nature of that benefit and the precise level of progressive contribution required • Carry out a public consultation on the discount rate used to set contribution rates in the public service pension schemes • Implement progressive changes to the level of employee contributions that lead to an additional saving of £1.8bn a year by 2014-15, equivalent to three percentage points on average, to be phased in from April 2012 • Exempt the armed forces from this increase in employee contributions • Seek engagement with all stakeholders including trade unions. STATE PENSION Increasing longevity and demographic change pose challenges over the longer term. In response, the government will speed up the pace of State Pension Age equalisation for women from April 2016 so that Women’s State Pension Age reaches 65 in November 2018. The State Pension Age will then increase to 66 for both men and women from December 2018 to April 2020, six years earlier than planned. Following the faster increase to 66, the government is also considering future increases to the State Pension Age and will

bring forward proposals in due course. The Basic State Pension will be uprated by a triple guarantee of earnings, prices or 2.5 per cent, whichever is highest. Bringing forward the date at which the State Pension Age will start to rise to 66 to 2018 will ensure this is fiscally sustainable. WELFARE REFORMS Over the next two parliaments the current complex system of means-tested working age benefits and tax credits will gradually be replaced with the Universal Credit – an integrated payment that will ensure work always pays, with less scope for fraud and error. £2 billion has been set aside in DWP’s DEL settlement over the next four years to fund the implementation of the Universal Credit. Further details will be set out in DWP’s forthcoming White Paper. To provide a fair and affordable platform for the introduction of the Universal Credit the Spending Review also announced a package of lower case to the existing

saving £385 million a year by 2014-15; Eligibility rules will be changed so that couples with children must work 24 hours a week between them, with one partner working at least 16 hours a week in order to qualify for the WTC, saving £390 million a year by 2014-15. The basic and 30 hour elements of the WTC will be freezed for three years from 2011/12, saving £625 million a year by 2014-15. Lastly changes include increasing the child element above indexation by a further £30 in 2011-12 and £50 in 2012-13, in addition to the £150 and £60 increases provided in the June Budget. This will ensure that the overall outcome of the Spending Review will have no measurable impact on child poverty in the next two years. OTHER POINTS OF INTEREST The government is committed to the implementation of the devolution of Scottish income tax as laid out in the Calman Commission Report, and will introduce a Scotland Bill in the current Parliamentary session.

Increasing longevity and demographic change pose challenges over the longer term. In response, the government will speed up the pace of State Pension Age equalisation for women from April 2016 so that Women’s State Pension Age reaches 65 in November 2018 welfare system which will deliver net AME savings of £7 billion a year by 2014-15. Changes include capping household benefit payments from 2013 at around £500 per week for couple and lone parent households and around £350 per week for single adult households, so that no family can receive more in welfare than median after tax earnings for working households. All disability living allowance claimants, war widows, and working families claiming the working tax credits will be exempt from the cap. Changes also include withdrawing child benefit from families with a higher rate taxpayer from January 2013 so that people on lower incomes are not subsidising those who are better off, saving £2.5 billion a year by 2014-15. The costs of tax credits will be controlled by reducing the percentage of childcare

costs that parents can claim through the childcare element of the Working Tax Credit (WTC) from 80 per cent to its previous 70 per cent level in April 2011,

HMRC has published new guidance and a Q&A for employers (and also one for employees) on the forthcoming changes to Employer Supported Childcare. It includes details of the basic earnings assessment which employers will need to carry out on any employee who joins a childcare voucher scheme on or after April 6, 2011. HMRC has also published further guidance for employers on Additional Statutory Paternity Pay. It explains who is eligible, how much you must pay and how to calculate before April 2011. Full details of the qualifying conditions for Additional Statutory Paternity Leave and Pay can be found on the Business Link website. Business Link has also published new guidance leaflets for employers and employees on maternity and paternity rights which includes new guidance on Additional Statutory Paternity Leave and Pay.

FOR MORE INFORMATION Web: www.payrollprofession.org

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INFECTION CONTROL

TRACK INFECTION SPREAD WITH A SMARTPHONE Professor Bill Buchanan, Institute of Informatics and Digital Innovation at Edinburgh Napier University, introdues new GPS technology, which can help in the battle against infection UNTIL RECENTLY IT HAS BEEN almost impossible to accurately predict the spread of an airborne infection. We at Edinburgh Napier University have been working with Imperial College London using smartphone location tracking technology to address this challenge. The resulting model will help provide important clues about how quickly a pandemic might occur by recording the nature and frequency of interactions between individuals.

TRACKING INFECTED PERSONS With location-tracking technology in handheld devices, such as smartphones, it is now possible to track the path of an infected person and their contact with others with one metre accuracy. Wireless technologies such as Wi-Fi and Bluetooth, mobile phone network assisted GPS and radio frequency identification tags (RFID tags) as well as ultra-wideband are key factors in allowing us to develop this infection spread model.

With location-tracking technology in handheld devices, such as smartphones, it is now possible to track the path of an infected person and their contact with others with one metre accuracy

The technology helps overcome the challenge of tracing the original infection source from within a large geographical area. For instance, patient turnover in hospitals is so high that it is often difficult to establish where and when patients become infected, allowing a contaminated area to continue to spread the infection. A GLOBAL ISSUE Healthcare Associated Infections (HAI) is a global problem as highlighted by The Medical Ward of the 21st Century from the University of Calgary. The annual cost of HAI is estimated to be around $30 billion across the whole of the US alone. There is increasing pressure from governments to adopt RFID technology to improve patient safety. The e-Health agenda added to the increasing pressure from Connecting for

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INFECTION CONTROL

Health and the National Patient Safety Agency (NPSA), plus the rise of infections such as MRSA and Clostridium difficile (C.Diff) shows that there is also an increase in pressure in the UK to improve efficiency and patient safety. PRIORITISING We aim to create a system using this tracking technology to identify, track and audit factors that could cause infections such as MRSA in a healthcare environment. The model we are proposing will potentially allow emergency health providers to prioritise who may have come into contact with an individual exposed to a serious airborne illness, such as influenza during an outbreak. At present most companies in the infection control sector focus on disinfectant solutions. This is important but does not give the full auditable solution compared to RFID tagging. It may also lead to resistant strains. RFID technology has been used to monitor employees and patients washing their hands but again this does not give a complete picture of the whole of the healthcare infrastructure. IDENTIFYING RISKS In order to prevent infection and reduce mortality it is vital to identify avoidable risks at an early stage by tracking down contaminated areas within the hospital and implement changes to the existing practices wherever possible. Various epidemic models have been used in the past for risk analysis related to MRSA, but their application is not easy, results must not be expected in a timely manner and data

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In order to prevent infection and reduce mortality it is vital to identify avoidable risks at an early stage by tracking down contaminated areas within the hospital and implement changes to the existing practices wherever possible collection is one of the biggest challenges, as staff are already burdened with a huge variety of administrative tasks and documentation. Often responses to outbreaks of dangerous infections in hospitals, though, are not based on scientific analysis but are more undirected and based on worst case scenarios. This usually leads to ward closures and results in a loss of functionality of the hospital for days or sometimes even weeks. It’s worth noting, however, that some risk factors are related to an individual’s condition such as immune competence, general physical condition and past medical history. In fact the typical infection pattern for hospital acquired C.Diff, for example, is that patients pick up the bacteria from the hospital environment, in particular from surfaces, which then manifest an attack within the patient’s body. This is why outbreaks of certain infections do not occur everywhere in the hospital, but are usually related to a particular unit or procedure. The key Healthcare Associated Infections (HAI) studied in our research were Urinary Track Infections Surgical Site Infections, which account for 16 per cent of all HAI

infection for surgical patients, as well as Pneumonia and Bloodstream Infections. LOCATION DATA The new software will record and playback location data with high-precision. It uses Susceptible Infectious Recovered (SIR) modelling and the epidemiological technique of contact tracing to predict the spread of a disease through a network of people, taking account of parameters such as transmission and recovery rates. Our experiments show that the technology gives location readings that are sufficiently accurate to monitor the movement of individuals and their contact with others. This will provide important clues about how quickly a pandemic might occur. The tracking has been used with a lab environment, allowing for a deep understanding on how health care entities might interact and thus how infections could spread.

FOR MORE INFORMATION Web: www.iidi.napier.ac.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. • SMART™ – high comfort & high protection. • SMART™ IQ – breathable membrane technology, reacts to increasing body temperature by increasing water vapour transmission DRAPE TECHNOLOGY Tiburon – Tiburon was designed to provide a sterile barrier that is able to withstand robust handling and stress during surgery • Impervious – a unique three layer material construction that provides superior strength and puncture resistance during use. • Enhanced Fluid Control – highly absorbent, with strong tensile reinforcement ensures prolonged and robust barrier performance • Puncture Resistant – a unique three layer material construction that provides superior strength and puncture resistance during use • Abrasion Resistant – an abrasion resistant fabric created by a unique top layer to film bonding, reducing the threat of cross contamination to you and the patient • Lower Lint – a low linting fabric is created by a unique top layer to film bonding. 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.

FOR MORE INFORMATION Tel: 0800 1513587 E-mail: info@carefusion.co.uk Web: www.carefusion.co.uk www.bugsonyourskin.com www.chloraprep.co.uk

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ACTIVE ANTIMICROBIAL BUILT IN

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Setting the standard in water quality At Mouchel we’re always looking at ways to help our clients improve the standard of their water quality. We’re the third largest provider of consultancy services to the UK water sector. Legionella Bacteria is present in all water systems and lies dormant until suitable conditions are achieved. On average there are approximately 200 – 250 reported cases of Legionellosis or Legionnaire’s Disease each year in the UK.

Handheld thermometers for legionella risk management and the prevention of Legionnaires’ disease

That’s why we offer our clients: Legionella risk assessments; Hot and cold water monitoring; Cleaning and disinfection of tanks and down systems; Sampling and facilities management services.

• High accuracy waterproof thermometers • ACOP L8 Compliance • Dual purpose surface/immersion probes • Mobile test kits - manual/logging • Barcode reading thermometers • Bluetooth to PC/PDA • Open source software • Guide to log book creation +44 (0)1903 700651

For more information, please contact our Water Quality team: T: +44 (0)1274 694381 E: commercial.services@mouchel.com

sales@tmelectronics.co.uk www.tmelectronics.co.uk

www.mouchel.com

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INFECTION CONTROL

FIGHTING DISEASE WITH EFFECTIVE PEST CONTROL Richard Moseley, technical manager, the British Pest Control Association, explains how a healthcare environment free of pest species can help prevent spread of infection PEST SPECIES are well known for carrying infection and disease, which is one of the primary reasons for the need of effective control. With the changes that occurred in infection control legislation in April 2010, we need to consider how pests affect hospitals and how we prevent them. HOW INFECTION IS SPREAD Firstly, we need to be aware pests can transfer infection in two ways. Infection can be transferred by pest species from within the body. Rats for example transfer Leptospirosis (Weils disease) via their urine, but they may also transfer infection such as salmonella on their body as they come into contact with waste in sewer systems. Mice do not live in sewers, but are incontinent, urinating and defecating wherever they go. Rodent infestation is not acceptable in any medical setting, and the thought of a rat emerging from a sewer into a hospital should fill us all with dread. Insects also have the potential to spread infection and disease on a potentially massive scale. The common housefly for example will feed on waste and detritus and then enter a medical or food preparation area, contaminating every surface they land on. Pharaohâ&#x20AC;&#x2122;s ants are another insect directly associated with disease transferral in hospitals due to their habit of feeding on suppurating wounds and penetrating sterile packaging. A ROACH PROBLEM The most common insect pest associated with hospitals and nursing homes are cockroaches. Fortunately, cockroach activity has become less common in recent years due to the availability of better products and better training for pest controllers. However, hospitals often offer perfect conditions for cockroaches with warm, damp ducts running for hundreds of meters beneath the ground. Cockroachesâ&#x20AC;&#x2122; habit of feeding on anything organic, including cat faeces, make them a potential host of disease. The Oriental Cockroach can also be incredibly difficult to eradicate, as its egg case (ootheca) can remain dormant for several months, with young insects hatching out long after treatments have concluded. PREVENTION IS CURE So, what can we do to prevent the possibility of pests spreading infection? Good standards of hygiene are of vital importance when it comes to preventing pest activity. If you can

Rodent infestation is not acceptable in any medical setting, and the thought of a rat emerging from a sewer into a hospital should fill us all with dread remove what pests feed on, you remove one of the key reasons why they are there. Tie this in with good maintenance regimes for properties to prevent the access of pests, and you have removed a second necessity for pest species, harbourage (a place to live). To show due diligence you should also employ the service of a professional pest control company that has suitably trained staff who understand the pest they are dealing with and the process for dealing with them. The British Pest Control Association has

approximately 400 servicing members who meet our membership criteria and are subject to regular assessment visits from the BPCA. If you would like more information on visit frequency, scope of contract or suitably qualified companies that are servicing members of the British Pest Control Association, please contact us.

FOR MORE INFORMATION Tel: 01332 294288 Web: www.bpca.org.uk

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Acute Ambulance & Medical Services Providing a range of options to satisfy your patient transfer needs. 3 Specialise in Renal Transport 3 Excelling in Transfer of Care 3 Inter Hospital Transfers 3 Post Treatment Transfers 3 Repatriation Work 3 Out of Hours Transfers 3 Cardiac Transfers (including monitoring) 3 Paediatric Transfers 3 Out Of County Transfers 3 Wheelchair Transfers A.A.M.S tailor our services to meet your specific requirements, utilising a range of highly trained staff, including Technicians, Nurses and Paramedics. Our rates are competitive and we are regulated by NAPAS.

Please call 0845 686 0301 for a quote today. On call 24 hours a day 365 days a year and respond within 90 minutes (subject to availability). Ambulance Stations: Bletchley & Andover Head Office: Arrows Business Centre, 39a Barton Road, Bletchley, Bucks MK2 3HW www.aams-amb.co.uk

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PATIENT HANDLING

A SAFE ENVIRONMENT ON YOUR PREMISES The Royal Society for the Prevention of Accidents looks at manual handling, its associated risks and how to prevent them MANUAL HANDLING of people is the biggest cause of injury to both staff and service users in the care sector. The financial costs across the public and private sector and to the taxpayer are incalculable – not to mention the cost in terms of human suffering. Few people realise that back pain causes more hours of suffering than all other causes put together. Of course, some pains are more intense but they are usually of shorter duration. The problem with back pain is that, though the pain from an injured back can be eased, it can rarely be cured. So, regrettably, back pain is often for life. If these simple facts were better known, more individuals would take far better care of their backs. NOT MANAGING RISKS An accident that leads to back pain is often not as dramatic as something like a roof cave-in, or terrible burns, so it is perhaps not surprising that back care does not receive the attention it deserves. This does not make the topic unworthy of conversation, however – just the opposite. People should be talking about the risks of manual handling, and taking steps to mitigate them. It could save a lot of pain – and money – in the long run. Safer people handling falls within the wider sphere of an organisation’s health and safety management system – and the importance of maintaining an excellent health and safety record cannot be overstated, particularly during tough economic times. When businesses in all sectors have to tighten their belts, the last thing they can afford is an accident or incident of ill health. FINANCIAL STRAIN Musculoskeletal strain or injury accounts for more days off work than all other causes put together. At least 120 million such days – and many more hours – are lost every year because of it. The most up-to-date figures show that musculoskeletal disorders cost society around £5.7 billion each year. About one third of all accidents reported to the Health and Safety Executive involve manual handling. In the health services manual handling injuries account for 40 per cent of sickness absence, and there are more than 5,000 manual handling injuries reported each year in this industry. Approximately half of these happen during the handling of patients.

Increasingly, civil actions taken against employers because of back injuries result in large awards being made to the sufferers. If employers, both large and small, understood this then they would treat the subject far more seriously. But it is not only carers who are at risk from manual handling injuries; those in their care are also susceptible to injury. PATIENT SAFETY No matter whether in primary care, acute care, care of the elderly or any another sector, how people are moved and handled is vital in promoting recovery, maintaining independence and providing a feeling of wellbeing. To be treated with dignity and respect during the handling process is a basic human right, as well as being a legal requirement. The vast majority of people employed in the care sector show more concern for those they care for than they do for themselves. They often put themselves at risk for the good of their service users. It is clear that all workers would benefit from training and education in this vital, day-to-day aspect of their vocation. APPROACHES TO PEOPLE HANDLING When it comes to handling people safely, many approaches or models exist, including biomechanical, neuromuscular, neurodevelopmental and haptonomic – all have something positive to offer and can be appropriate in the right circumstances. Recent research carried out by the Institute of Occupational Medicine (IOM) reviewed the array of existing models and found that while they each had their own specific techniques, all were founded on the same principles. The Manual Handling Operations Regulations (MHOR) 1992 (amended in 2002) recognise that lifting and handling loads can cause MSDs, and they set out steps for reducing the risk. Until fairly recently, training staff in traditional manual handling practices was generally seen as the best way of preventing back injury. However, this has not been as successful as hoped – injury rates remain extremely high in the health and social care sectors. Training remains very important, but practitioners and professionals have begun to realise that an holistic approach to people handling and effective risk management is key. Some ways of minimising risk are: avoid lifting patients manually; patients

encouraged to assist in their own transfers; and thorough evaluation of equipment and furniture before it is purchased. Haptonomy is a relatively recent social science based on human behaviour and feelings. By applying these principles to the safe moving of people, carers will be adopting a holistic approach, developed to reduce the risk of physical injury to those assisting in the movement of others, and designed to afford the patient or client dignity and as much autonomy as possible. Traditional manual handling advice instructs us to use our leg muscles rather than our backs to take the weight of the load; to keep feet close and adjacent to the load; to lift squarely; and to move in the direction of the load. However, while this is true and is good practice when dealing with inanimate loads, there are many loads – especially those involving people and animals – which make this impossible. The tasks in the field of health and social care (one handed lifts, kneeling, having to bend over etc.) and the environmental constraints (such as people trapped in vehicles or in confined spaces with difficult access) plus the possible unwillingness or inability of the person concerned tend to conspire to make the lifter disregard manual handling training. People tend to take the easier and most natural option – if manual handling guidance doesn’t suit the task in hand, people will not follow it. It is vital for staff to understand how to minimise the risk to their backs and advisable for residential homes and authorities to purchase appropriate handling aids. JOINED UP THINKING Moreover, the assessment of care workers’ health and safety must be go hand in hand with patients’ needs, and there is now more of a focus on a holistic approach to people handling. There can be conflict between protecting staff and preserving the independence and dignity of patients – for instance, some residents find hoists dehumanising. There is a need for joined up thinking between the various caring agencies, not only in training and selection of equipment but in how the use of handling aids should be negotiated between agencies and clients. It is important to involve staff in the purchase of lifting and handling aids. Too often, equipment is acquired that is not fit for purpose. A proper risk assessment should be carried out to ensure that all equipment purchased is suitable for the task for which it will be used. WHAT CAN BE DONE? Training in the area of people handling is vital to ensure that risks are managed and injuries and incidents are minimised. It is a very complex area, and one size does not fit all. It is useful for carers to learn about human movement patterns and how to apply

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A bespoke nurse call system helps the team a pleasing price tag helps the bottom line When staff are under pressure, every second counts. The touch-screen nurse call system is an invaluable support structure giving priority to emergency calls. The touch-screen unit offers management accountability for staff’s response to patient calls. And because the 08 system is bespoke, your working practices will be integrated to ensure a safe and reliable nurse call system. The system goes beyond being the ultimate in wireless radio nurse call. Its allows for add on facilities such as products for dementia care and mains switch control. Don’t be misled into thinking such cutting edge technology must have a heavy price tag. This unique system is surprisingly affordable without compromising results.

Antimicrobial

Unique features include: ■ Instant caller location with on screen map ■ Future-proof system can be extended and updated ■ Safe, reliable and easy to use ■ Class 1 standard ■ Pan European frequency

For a demonstration and no-obligation quotation

call free on 0800 068 7419 email info@courtney-thorne.co.uk

www.courtney-thorne.co.uk

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PATIENT HANDLING

these to assist in transfers, both active and passive, using a variety of small handling aids as well as hands-on techniques. During difficult economic times, tough judgement calls about where to direct resources have to be made. But how should health and safety training, such as in safer people handling, be treated? It would be unrealistic to say that health and safety budgets deserve special treatment. But we must not turn our back on health and safety. Not only does the law say you must train your employees and contractors, but training also makes good business sense. Safer people handling training can prevent musculoskeletal disorders, meaning you’ll reduce the number of working days lost and all the associated costs. The Royal Society for the Prevention of Accidents offers a five-day people handling course that uses the Welsh Passport Scheme as the model for the techniques taught. The Institute of Occupational Medicine’s model of the principles to be applied is taught in the course, and it references recognised literature such as ‘The Guide to the Handling of Patients’ by Back Care and ‘The Handbook of Transfers’ by Arjo. RoSPA’s five-day course is a “train the

trainer” course, making it exceptional value for money. Not only do delegates leave the course with the skills and knowledge necessary to do their jobs to a very high standard, they are also able to deliver awareness training back in the workplace, stretching training budgets and minimising staff down-time. ASSESSING RISK It is vital that suitable and sufficient risk assessments are carried out in health and social care settings wherever people handling activities take place. The implementation of suitable risk controls at ward, department or home level, for people and objects, will help to ensure that the safety and health of service-user and carer are safeguarded. The effective management of risk is central to providing a safe work environment, wherever that may be, and a risk assessment course based on the specific requirements of the health and social care sectors is the ideal way to start managing those risks. Other specialist courses can be taken, enabling those working in the health and social care sector to improve their skills in other areas – for example, in the use of hoists and other handling aids. The specialist equipment

available is no use to anyone if staff are not trained to use it safely and comfortably. Courses based on haptonomic principles are now easily available, ensuring that an holistic approach to care is sought and implemented. A FLEXIBLE APPROACH RoSPA’s approach to people handling is principles led; a flexible approach suitable for all care sectors and one that is focused on the person. A blend of the best of the different approaches mentioned above is used, enabling delegates to solve problems themselves and develop their people-handling abilities. The benefits to both carer and service user can be almost immediate with this flexible, leading edge approach. RoSPA’s people handling safety courses can be held either in-company or at our fully-equipped skills centres, providing delegates with a modern, relevant and realistic training environment.

FOR MORE INFORMATION For more information visit www.rospa. com/occupationalsafety/training/ saferpeoplehandling/ or call our knowledgeable team on 0121 2482233.

MSoft’s innovative blood-tracking system

Courtney-Thorne leads the way in technology

HEALTHCARE technology specialist is setting its sights on further expansion following a series of major contract wins with hospitals in the UK. MSoft’s innovative blood-tracking systems have proved a hit with NHS Trusts with a number of projects including the Royal Liverpool and Broadgreen University Hospitals NHS Trust, Plymouth Hospitals NHS Foundation Trust, and the Royal Hampshire County Hospital going live in recent weeks. Ellesmere Port-based MSoft’s full web-based electronic bloodtracking system allows hospitals to control access to and from all blood fridges as well as ensuring safer bedside management. Its Bedside Management system allows each barcoded blood unit to be matched with a patient’s barcoded wristband in a matter of seconds. The MSoft systems provide further enhanced security and safety by ensuring that only approved

CCOUNTABILITY for care products and staff performance are imperative factors within today’s healthcare industry. Courtney-Thorne is passionate about producing care products that maximise staff performance whilst adhering to budget demands. The need to justify spend is a constant battle for hospital boards and managers. So where does the “money watching” leave front line staff and patients? Nursing staff and managers must have the products they need to ensure that day-to-day care is costeffective yet never compromised. Courtney-Thorne, the market leader in wireless nurse call technology, offers the groundbreaking wireless radio 08 Touch-screen system, which is more than just a nurse call

staff are allowed to access blood. The firm’s Blood Tracking Solution provides positive patient identification of users and patients and in depth auditing of all throughout the tranfusion process – to help get the right blood into the right patient. MSoft is also in discussions with a number of hospitals about introducing the latest iPad technology on to wards to further improve efficiencies. Managing director Matt McAlister said: “We are delighted with a number of recent bloodtracking client wins and we are now looking to grow our customer base in the UK and Europe. “We pride ourselves on quality of service coupled with a constant desire to innovate to improve efficiencies and reduce costs.”

system. It also provides absolute accountability for managers in one touch-screen unit. In an environment where hygiene is crucial, the touch-screen itself and associated products such as the call point and the patient handset, are all manufactured with lifetime antimicrobial properties. Courtney-Thorne’s awareness of front line needs extends to their waterproof patient handset which can withstand complete immersion in liquid to IP67 standard; an ability to fight infection in the radio market unique to Courtney-Thorne.

FOR MORE INFORMATION For more details about all the products and services from Courtney-Thorne, call 0800 0687419 or visit www.courtney-thorne.co.uk

FOR MORE INFORMATION Tel: 0844 2511704 E-mail: matt.mcalister @msoft.co.uk Web: www.msoft.co.uk

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Cut your wheelchair costs

but broaden your range The challenge and expense of having a suitable wheelchair for every possible user is all set to change. The Vario wheelchair makes things simpler than they’ve ever been before. It also cuts costs without sacrificing the quality of your wheelchair provision. This is because Vario combines 8 wheelchair models into 1. Its innovative adjustable width from 39-50cm means that 1 Vario wheelchair covers 80% of user requirements. And its lightweight, rugged construction makes it good for years of reliable service. Available exclusively from Nursing Hygiene, Vario is revolutionizing the wheelchair world, making quality provision straightforward and cost-effective. Now you can eliminate the headache of maintaining stock of all wheelchair sizes – with Vario you know you’ve got it covered.

Request more information, a price or a demonstration – ref. Vario wheelchair. Call 01403 825825 Email sales@nursinghygiene.com

Vario:

the new and unique wheelchair with adjustable width

Adjustable width from 39-50cm // 8 standard wheelchair sizes in 1 // Lightweight durable aluminium frame Complies with EN12182:1999, EN12183:1999 and European Medical Devices Directive 93/42/EEC Nursing Hygiene Charwood House, Oakhurst Business Park Southwater, West Sussex. RH13 9RT.

T: 01403 825825 F: 01403 825826 E: sales@nursinghygiene.com

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MOBILITY SOLUTIONS

THE RIGHT FACILITIES FOR A SPEEDY RECOVERY As a health and safety manager at a psychiatric hospital, Darren McDonald understands the challenges of catering for those who suffer from both mental and physical disabilities ANYONE WITH A DISABILITY should be confident that whether they provide care, or are on the receiving end of care in a hospital, the facilities they use on a daily basis cater for their needs. Disability solutions not only need to meet health and safety standards to give patients the best chance of speedy recovery, but they also need to allow disabled staff to do their job. CATERING FOR DIFFERENT DISABILITIES At a hospital which offers treatment and rehabilitation for people with mental health difficulties, a health and safety manager’s considerations about how to provide the best solutions for disability become more complex. Health and safety and disability solutions must, in this situation, work as a carefully thought out double act that balance together to cater for various combinations of mental and physical disability.

Darren McDonald is chair of the Institution of Occupational Safety and Health (IOSH) Healthcare Group. He also works as health and safety manager for Llanarth Court – a Partnerships in Care medium secure forensic

detained under the Mental Health Act. Darren’s job is to make sure the facility is run in a way that protects the health and safety of patients as well as staff. And his professional knowledge and experience with

Disability solutions not only need to meet health and safety standards to give patients the best chance of speedy recovery, but they also need to allow disabled staff to do their job psychiatric hospital in Abergavenney, Wales. The hospital provides care in medium secure, low secure and open environments for men and women with mental illness or personality disorders, men with mild learning disabilities and those who have been

IOSH both provide him with the right tools to cope with the environment he works in. SHARING IDEAS At IOSH, his role is to ensure the Healthcare Group committee and its members are at the

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MOBILITY SOLUTIONS

heart of championing best health and safety practice in the industry. Through organisation of events, seminars, and meetings that encourage thought development, the benefits of innovative thinking in this area filter through to practical situations in all types of healthcare settings, for the benefit of patients and staff. He said: “Having a disability can make every day activities we take for granted quite difficult and often frustrating. That means, in terms of occupational safety and health, the consideration and provision of simple measures can make a huge difference to many people. “Far fewer accidents occur if the environment has been well-evaluated to make it appropriate for everyone’s needs and so that everyone – patients and staff alike – can complete simple tasks with the assistance of equipment provided.” Accidents reported by the Health and Safety Executive (HSE) regularly show a significant number of injuries caused by slips, trips and falls – many of those in the healthcare sector. And any considerations which help to reduce

these incidents – especially for patients with learning disabilities or mental illnesses who may find coping with injury more difficult – mean a hospital is able to focus on its central aim of curing, or managing illness and injury. By making simple changes to

naturally come with working in a secure mental health unit like Llanarth Court. He said: “There are specific and unique health and safety issues that need to be considered in a hospital like ours, more so perhaps than in comparison to other healthcare settings.

Far fewer accidents occur if the environment has been well-evaluated to make it appropriate for everyone’s needs and so that everyone – patients and staff alike – can complete simple tasks with the assistance of equipment provided the local environment, workplace accidents can be reduced. FOCUSING ON PATIENT NEEDS Darren’s job, together with his professional development with IOSH, means he is able to mitigate the additional considerations that

“My job is to ensure that we consider the needs of patients with learning disabilities and sometimes physical disabilities, both in regard to the physical environment they live in and the way employees interact with them. “The job of the team of specialist nursing and medical staff is to make sure they always

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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

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MOBILITY SOLUTIONS

understand the patient group. Through that knowledge, the care plans they draw up for each patient are able to account for all types of disability, whether that’s through physical adaptation, psychology or learning programmes.” Darren says that any part of providing facilities for disability involves regular review to account for change in patient or staff situations, the law and any other external considerations. He believes it is essential that disability provisions are robust, but also safe in the sense that they successfully minimise other risks where patients might use facilities or equipment to harm themselves. COVERING ALL RISKS When certain fixtures and fittings are provided for disabilities, other risks associated with security often arise and must be accounted for accordingly, to ensure patients remain in the correct area of the hospital, or staff safety is not compromised. There is also the potential for infection from equipment or facilities that must be subject to problem solving. Darren added: “In particular, handrails are certainly useful to someone with a particular form of disability, but a well-fixed and secure handrail may also prove to be another type of hazard in the form of a ligature point. “Part of our role is to account for any potential to use fixtures or equipment in a violent manner. And it’s in these types of situation where health and safety and disability solutions really do go hand-in-hand. “It’s critical we take a holistic approach to risk management and to do this, we need to make sure we are integrating clinical and non-clinical risks. This means considering how best to avoid infection and further harm in tandem with normal day-to-day activities that for someone with a disability may present a risk of injury,” he said. Risk management must consider all aspects of being a patient or a member of staff – this helps aid understanding of both clinical and nonclinical environments in the hospital. By looking at these factors thoroughly, a secure mental health unit can then make sure it adheres to corporate accountability and clinical governance.

Anyone who works with a disability would view the correct solutions as those that give them a means of carrying out their job in the normal working environment – that means that any of the equipment they use will allow them to perform their role well

MEETING STAFF AND PATIENT NEEDS Darren’s position as a chair of one of the groups of the world’s leading health and safety organisation for professionals means he’s also acutely aware of both sides of the coin. He knows how best to provide for patients, but on the other side, he must also ensure that employees with disabilities are able to work in an adaptable environment. He said: “Considering the nature of our work, a realistic and reasonable approach needs to be taken. Employees have a right to be provided with facilities and a work environment that meets their needs, enabling them to perform their jobs in a comfortable and safe manner. “Anyone who works with a disability would

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Total Parking Solutions: The UK’s leading car park management operator “With over 30 years’ combined experience for Total Parking Solutions managing is not simply about fulfilling a contract, but 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 operations, we can therefore, make available our extensive knowledge and experience to provide an economically efficient operation and high quality service to our Clients. What distinguishes TPS is our genuine commitment to the continuous improvement of our services and the range of products being offered to our clients”. “The company has achieved a reputation as one of the leading providers of car park management services, operating extensively throughout the UK. We differentiate ourselves from other operators not just in our open approach but in the comprehensive bespoke services we can offer our clients. Parking solutions have been developed around a well-established client base to deliver a complete parking management, tailoring our services to

each of our clients and their respective customers. “Our company focus from an early stage has ensured that all our operations comply with the British Parking Association Code of Practice. Recognising the importance of customer satisfaction, we engaged consultants to implement a best practice quality management structure around the BSI ISO 9001 standard accredited to our company. All our team members understand the company’s quality policy and objectives, all our processes are clearly documented to ensure consistency and competency. Operational staff are fully trained for professional performance and regularly monitored with management reviews to identify actions for continual improvement.” “By adopting this philosophy has enabled us to provide an effective parking service to the NHS across numerous public Pay & Display, Pay on Foot , restricted, limited waiting and permit only parking areas. Throughout the contract length the company understands the sensitive nature of the services, striking a balance between efficiency and professionalism.

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

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MOBILITY SOLUTIONS

view the correct solutions as those that give them a means of carrying out their job in the normal working environment – that means that any of the equipment they use will allow them to perform their role well.” IOSH encourages a sensible approach to health and safety measures in all workplaces and that requirement is never more so essential than in a hospital environment where health is a goal. “Because of the higher risk to the safety and health of disabled patients and employees, it’s even more important to make sure dayto-day tasks can be carried out easily to help reduce accidents and incidents,” he added. In a mental health unit, anyone concerned with occupational safety and health recognises that it goes without saying that the organisation must be able to cater for all types of mental disability. But for its patients, it must understand and provide for the complexity of those who suffer from both mental and physical disabilities. The role of a health and safety manager is central to a facility being able to cope with this type of person. PATIENT ASSESSMENT At Llanarth Court, patients have his or her own key nurse, psychologist, medical doctor, social worker, occupational therapist, sports therapist, activity coordinator and other relevant people to help aid them in their stay. This multidisciplinary team carries out assessments for each patient and identifies any specific needs. Darren said: “The assessment forms part of the patient’s care plan and identifies specific facilities or equipment that they’ll need, such as a profiling bed, or a type of hoist to enable bathing or standing. “Upon assessment it might also be expected that if a patient is suffering from poor mental health as well as some form of physical disability, they might get frustrated more easily. “From here, you have to take on extra

Provision of facilities and equipment must be planned for right at the outset of any hospital and any building expansions that may follow. To stay within the law – these considerations must be designed into each and every part considerations in addition to that person’s physical needs, where any frustrations with their condition might be a precursor or trigger to violence or self harm. By identifying those issues, the clinical team is more equipped to spot potential incidents and diffuse or de-escalate a situation effectively.” LEGAL OBLIGATIONS As you would expect, any hospital is bound by law to provide an adequate level of disability solutions. The Disability Discrimination Act, Ergonomic Standards for Equipment and Workplace and Environments, and the Workplace (Health, Safety) and Welfare Regulations all take into consideration the environmental issues relating to this. That means provision of facilities and equipment must be planned for right at the outset of any hospital and any building expansions that may follow. To stay within the law – these considerations must be designed into each and every part. Where Llanarth Court is concerned, if existing buildings are purchased or extensions added, the provision of these types of facilities is always well thought out in advance and integrated into the design or refurbishment. “New buildings are designed with the needs of patients and employees in mind and where we purchase an existing building with the intention of making it a patient environment,

disability provisions are always explored prior to that. The refurbishment always includes those measures as required by all of the minimum care standards,” he added. Disability solutions and adaptations obviously come at a large, albeit essential financial cost to any healthcare setting. Darren says that any specific facilities or equipment that may be required are sourced using the budgets of the director of nursing or medical director, and in many cases the capital expenditure of the hospital. But a well planned hospital will have many of the possible disability solutions it may need to provide accounted for and designed into the hospital building and its total cost at the outset. “In a secure mental health unit – just as any hospital which finds it takes in patients for a length of time – we can sometimes find that an existing patient develops reduced mobility whilst in our care, which then needs providing for. That means we have to be flexible, but that’s also part of what healthcare is all about. “I think working in occupational safety and health in this type of environment helps you to understand that whatever the disability, the key is that there is always a solution. For a hospital, that is an absolutely vital motto because our sole focus is that the people are able to care for patients in the best possible way, and the patients who are being cared for are given the best platform from which to manage, or cure their condition.”

Audio visual and digital signage solutions HARM PROVIDES fully tailored and off-the-shelf audio visual, digital signage and content solutions to hospitals, surgeries, schools and businesses throughout the UK. From sophisticated conference hall and training rooms to complex signage network facilities or stand alone information screens, we’re here to help. Digital signage is quickly replacing static signs, notice boards, banners and posters as the most effective method of communicating key information. Used correctly it can help convey detailed messages to almost any audience, anywhere, anytime. Unlike traditional printed signs, digital signage can be updated instantaneously, allowing

to build a brand, influence behaviour or simply provide useful information to visitors, staff or patients, the dynamic visual experience created by digital signage helps get your message across. Our Signage Servers are based on established and extremely stable technologies designed to be active 24/7. They require little or no maintenance once installed – a true “fix and forget” service. To learn more about how Charm can help please get in touch.

you to capture current events and suit the demands of the moment. It also eliminates the high ongoing cost of creating and distributing printed ad campaigns. Whether you intend

FOR MORE INFORMATION Tel: 0854 4502012 E-mail: rod@charmoffice.co.uk Web: www.charmoffice.co.uk

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AMBULANCE SERVICES

RISING TO THE CHALLENGE Jo Webber, director, Ambulance Service Network, outlines how ambulance services can adapt to cope with increased demand AMBULANCE SERVICES, like the NHS as a whole, face substantial challenges over the next few years. Health services have to save £15-20 billion over by 2014. As the health select committee pointed out, this is an efficiency challenge at a level no health service anywhere in the world has ever achieved. At the same time, they are going through a huge re-organisation that will fundamentally alter the balance of power and accountability in the NHS system. MAJOR CHALLENGES This will be a major cultural challenge for both the NHS and the people it treats as decisions on the use of limited NHS resources are moved down to primary care and GPs. While pushing through this reorganisation, the government has also taken out, as part of its desire to cut costs, much of the management capacity that will be able to make these reforms work. The NHS Confederation supports the aims of the reforms but, as can be seen from the list above, there are a number of serious challenges that need to be addressed in order to get there. It is for this reason that we have said the coming year is likely to be one of the toughest the NHS has ever faced. All hands will need to be on deck to help the service through. Ambulance services, meanwhile, face the additional challenge of rising demand. Each year sees an increase in calls to the ambulance service of around 5 per cent. Last year there were 7.87 million calls to ambulance trusts in England, which resulted in 6.42 million category A (highest priority) responses. This year we will almost certainly go past 8 million – almost one in six of the population of England. At the moment, the way ambulance services are performance managed is via a series of time targets. 8 minutes for the most serious (category A), 19 for urgent but non-lifethreatening (category B) and for the least serious cases (category C) time targets are set locally. In a perfectly flat world, where population density is equal and transport links between everybody are equally good, meeting targets such as these would be a very simple question of matching resources to demand and then having the appropriate triage system in place to make sure people got a response corresponding to their need. In reality, transport links are variable – especially when the weather is bad – with varying levels of population density and demand. SERVICE DEMAND This poses very specific issues for ambulance trusts in areas where demand – and often correspondingly population density – tends

Each year sees an increase in calls to the ambulance service of around 5 per cent. Last year there were 7.87 million calls to ambulance trusts in England, which resulted in 6.42 million category A responses to be lowest. Ambulance targets are set at a trust level and most of them cover a region sized area. The largest trust is the North West Ambulance Trust, which covers 5,500 square miles and includes both highly urbanised areas such as Liverpool and Manchester along with more remote areas such as the Lake District. The level of resources it would take to ensure ambulances meet their time targets uniformly across all parts of their patch is not realistic. There is also the issue that in urban areas where demand tends to be highest, the volume of calls is such that demand is relatively predictable. Ambulances can generally be put in the most appropriate place to ensure that most calls are answered within the target time. The lower demand, coupled with poorer transport links and lower population density, in rural areas makes predicting demand very much more difficult. PERFORMANCE MANAGEMENT In order to get around this, ambulance trusts need new models for providing care and a new system of performance management. They are already putting in place and developing both. The government under its white paper

proposals, made it clear that the NHS was to move to a system of performance management based on outcomes rather than brute process measures. It is important at this point to recognise that targets, for all the problems associated with such a brute measure, have helped improve performance across the board in the ambulance service. Trusts are now getting to more people, more quickly and offering better care than ever before. However, we know the future rests in being assessed against what matters for patients – the quality and the clinical outcomes of the care they receive. It is for this reason ambulance trusts were pleased to see the government announce recently that the category B time target was to be removed and replaced by a series of 11 clinical indicators. While the category A target does have some clinical justification – especially for the most acute cases such as stroke – the B19 target has no clinical basis and is therefore extremely inflexible. While time will still be an important part of the mix of indicators it will not be the only one. Service, quality of care and safety will be included to offer the potential for a more rounded and accurate picture of the level of care offered

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AMBULANCE SERVICES

by ambulance services. The indicators are due to be published at the start of this year as the government’s emergency medicine tsar refines them. It is also worth pointing out that these new targets will not come without possible extra bureaucratic costs in terms of collecting all the necessary extra data. WORKING WITH LOCAL AGENTS The second part of the mix is changing the model of care provided. In rural areas where demand tends to be lowest this has to mean

Not only do they help save lives but they also contribute to the overall resilience of often quite isolated communities, and generate enormous goodwill for health services in general. For example, South Central Ambulance Service runs 200 different first responder schemes with over 1,500 members in total. In 2008/09 they contributed in responding to 11 per cent of the trust’s most urgent calls and there are plans to grow this number with a further 550 volunteers. Many lives have been saved as a result of their work and all for a relatively

There are 18 air ambulance charities in England and two air ambulance services funded by the Scottish Ambulance service. While they are also extremely good at flying over traffic in big cities and as a result of large road traffic accidents, they are a key part of the emergency service provision for rural areas working together with the local population and other public services. Again, ambulance services are already on the case working with local communities to deliver the best possible care to the most remote parts of the country. There are approximately 12,000 volunteers working with ambulance services in the UK. This is equivalent to the total number of staff in a large city centre hospital. The most common example of volunteer staff is the community first responder. While they are not intended to replace ambulance services, they play a vital role in making sure help gets to urgent cases quickly and people can be stabilised until a professional ambulance crew arrive. These community responders are drawn from ambulance staff, the coastguard, RAF and the fire service, and local communities more widely.

minimal investment by ambulance trusts. There is potential to take this work further and work with a much wider range of potential services in hotels, opticians, pharmacies, dentists, schools and post offices. Many ambulance trust are already pursuing these options. For example, in a remote part of Northumberland, the ambulance service has teamed up with a local GP practice to provide a community paramedic service which is available 24 hours a day, 7 days a week. UP IN THE AIR At the same time there is, of course, the air ambulance service. There are 18 air ambulance charities in England and two air ambulance services funded by the Scottish Ambulance service. While they are also extremely good at

flying over traffic in big cities and as a result of large road traffic accidents, they are a key part of the emergency service provision for rural areas, especially for the most urgent cases, flying over 19,000 missions per year. Air ambulances estimate that they have contact databases containing over a quarter of a million donors. Ambulance Services, however, are not only focusing on how they deliver services. They are also working to help improve public health. Ambulance trusts take staff into schools, farm shows, shopping centres and a range of public events to educate people what to do in case of an emergency. All ambulance trusts fully support the FAST stroke campaign, which helps people identify the signs of stroke more quickly, and many work with the Stroke Association at their ‘know your blood pressure’ events to mark national stroke awareness day. BIG SOCIETY By working with other organisations, encouraging volunteering and focusing on public health ambulance services are not only striving to offer the best possible care with limited resources, but they are also weaving themselves into the fabric of local communities. While the Big Society is a relatively new term, it is clear that, for some time, ambulance services have recognised that in areas such as rural ones where demand is low and time critical responses are such a challenge, a different relationship between health services and individuals is required. The way they have gone about this through empowering local communities and increasing the overall resilience of communities is totally in keeping with the Big Society ethos.

FOR MORE INFORMATION Niall Smith, senior meda relations officer Tel: 020 70743304

Southern Country Ambulance Service ITH THE A33 literally passing our front door and the M3 the back, Southern Country Ambulance Service is ideally located from our base in Micheldever between the historic city of Winchester and the ever growing town of Basingstoke, to serve our current and new clientele, being only 45 minutes from the heart of London and within easy reach of the main UK airports, and main shipping ports on the South coast. Our comfortable vehicles are fully equipped, regularly maintained and serviced and carry the latest in satellite navigation technology, but more importantly they are crewed by competent qualified personnel. In their distinctive Blue and Yellow uniforms our qualified technicians undertake a range

membership we agree to uphold and maintain the high standards of the organisation. Southern Country Ambulance Service is a family run business dedicated to offering a service of excellence, if you feel that we can be of assistance to you then please give us a call, we will be more than happy to discuss your requirements with you in confidence.

FOR MORE INFORMATION of services for both the NHS and PHS hospitals and clinics which include Patient Transport Services (PTS) – both local and long distance, high dependency transfers, maternity transfers, ICU/ITU transfers etc. In line with our British Ambulance Association

Contact: Jimmy Ball Address: Highways House, Highways, Micheldever, Winchester, Hampshire SO21 3DW Tel: 01962 774999 Fax: 01962 774266 E-mail: scas999@yahoo.co.uk

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Specialists in Bariatric Transport n Purpose built ambulances for bariatric transport n Purpose built support vehicles n Specialist equipment for moving and handling bariatric patients n Staff intensively trained to handle complex patients

All Ambulances & support vehicles routinely carry: 3 Ferno Stretchers inc Harrier XL (450kg capacity)

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3 Hoists with accurate weight readings

3 Lifting and slide sheets

3 Patient Monitoring

3 Winches

3 Defibrillators

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T: 0208 329 2999 / 0845 000 9999 F: 0208 336 0319 / 0845 000 9998 E:enquiries@astambulance.com www.astambulance.com Apsley House, Apsley Road, New Malden, Surrey KT3 3NJ

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OBESITY MANAGEMENT

SHEDDING POUNDS Professor David Haslam, GP and Chair of the National Obesity Forum, explores the wider financial costs associated with obesity, how much is being spent on obesity management and how cost-effective it is to manage the condition agents, lipid regulators, adrenoreceptor drugs, drugs affecting the renin-angiotensin system, calcium channel blockers, antibacterial drugs, sulphonylureas, biguanides, NSAIDs, fibrates, and thyroid drugs. The impact on prescribing volumes in obese patients is from numbers of patients treated, greater dosages and longer duration of treatment in those who are obese. It concluded that obesity more than doubles prescribing costs in most drug categories.

OBESITY IS WREAKING HAVOC on the UK population’s health, and on its bank balance, yet the evidence suggests that it can be managed successfully and cost-effectively. The Public Health White Paper ‘Healthy Lives, Healthy People’ threatens to derail the medical management of obese individuals, by diverting funds from NHS treatment into localised prevention initiatives, despite the fact that a quarter of the adult population already suffer from obesity and for whom prevention has long been irrelevant. GP consortia will have the autonomy to decide whether or not to prioritise the identification, screening and management of obese individuals, or to save money in the short term by ignoring obesity, turning a blind eye to its delayed but expensive complications such as diabetes, heart attack and stroke. HEADLINE MAKING NEWS “£80m bill for obesity: Benefit claims by those too fat to work have soared under Labour,” reported the Daily Mail. “Fat people will cost £75 more to bury than those who are thinner, because they take up more space in a cemetery,” reported the Daily Telegraph. Obesity is headline news, because of the effect is has on all aspects of life, including the financial costs to the individual and the tax-payer. Obesity prevalence in the United Kingdom has tripled over 25 years, a quarter of UK adults possessing a Body Mass Index (BMI) >30kg/m. The most recent reported official figures from the Department of Health (DoH) in 2010

estimate the financial impact of obesity on the NHS at £4.3bn. The DoH reported that: “Around ten per cent of all cancer deaths among non-smokers are related to obesity. The risk of coronary artery disease increases 3.6 times for each unit increase in BMI, and the risk of developing type 2 diabetes is about 20 times greater for people who are very obese (BMI >35), compared to individuals with a BMI of 18-25. These diseases can ultimately curtail life expectancy. Some studies have shown that severely obese individuals are likely to die on average 11 years earlier than those with a healthy weight.” HIDDEN COSTS Obesity increases drug prescribing in all the most expensive categories. In a cost-economic analysis by the Counterweight team a higher percentage of patients who were obese, compared with those of normal weight, were prescribed one or more drug in the following disease categories: cardiovascular (36 per cent versus 20 per cent), central nervous system (46 per cent versus 35 per cent), endocrine (26 per cent versus 18 per cent), and musculoskeletal (30 per cent versus 22 per cent). All of these categories had a P-value of <0.001. Other categories, such as gastrointestinal (24 per cent versus 18 per cent), infections (42 per cent versus 35 per cent), skin (24 per cent versus 19 per cent) had a P-value of <0.01, while respiratory diseases (18 per cent versus 21 per cent) had a P-value of <0.05. Total prescribing volume was significantly higher for the obese and was increased in the region of two-to-fourfold in a wide range of prescribing categories: ulcer healing

A TIME BURDEN Counterweight also demonstrated the increasing burden obesity puts upon GP, nurse and hospital time, whether or not co-morbidities are present in an individual. For every co-morbidity category, and at similar ages, obese patients visit the GP more often than their normal weight counterparts. Even when no co-morbidities are present, the obese make more visits to the GP and PN. Obese individuals make significantly more visits to hospital outpatient units than normal weight patients, and are admitted to hospital more often. So obesity is a major health hazard and a massive expensive to the NHS and wider economy. Even a decade ago the National Audit Office assessed how dire the situation had become: citing 30,000 deaths a year and 18 million sick days attributed to obesity. However in 2001, £480 million was spent on treating the consequences of obesity, but only a paltry £9.5 million was spent on treating obesity. Similarly in Scotland only two per cent of the total obesity-related expenditure is spent on treating obesity and 98 per cent is consumed by the treatment of co-morbidities . Healthcare provision is at a crossroads thanks to the imminent abolition of PCTs. Although the management of obesity, including identification, screening for co-morbidities, global risk reduction and management of co-morbidities, will be in the hands of GP consortia (and could be transformed for the better and arguably save the NHS from future bankruptcy), funding for interventions is actually at high risk because of the delay in savings appearing on the balance sheet. But the price of doing nothing is far too high. The resulting NHS costs attributable to overweight and obesity are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year according to the Foresight report. ANTI-OBESITY REMEDY Bariatric surgery is a good example of an antiobesity remedy to demonstrate the financial benefits; weight loss is sufficiently rapid and

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OBESITY MANAGEMENT

clinically meaningful for its economic impact to be assessed within a short time span. In its report Shedding The Pounds, the Office of Health Economics looks at wider societal savings, rather than simply health costs taking into account the potential of patients to return to work post-bariatric surgery: “The contribution of additional paid work generated following bariatric surgery off-sets the costs of surgery. This is achieved one year after surgery. There are also benefits through reductions in benefits paid and, although the evidence base is limited, savings for the health service that can also be realised. Around one and a quarter billion in savings to the economy could be achieved if twenty five per cent of eligible patients received bariatric surgery. In addition, from the Government exchequer point of view, around £150m per year in benefits would be saved.” Additionally, although the gastric band and the Roux-en-Y gastric bypass cost around £7,000 and £12,000 respectively, the clinical costs of the reduction of drug prescribing, clinician visits and the reduction of disease and health risks offset the cost of surgery within three and a half years of surgery being undertaken.

To understand this it should be considered for example that with the insertion of a gastric band, up to 73 per cent of cases of newly diagnosed type II diabetes achieve remission, and around 80 per cent of all cases of type II diabetes with gastric bypass thereby avoiding the massive costs of hypoglycaemic agents, and of cardiovascular and microvascular complications such as myocardial infarction, stroke, blindness and amputation. One paper demonstrated cost savings of £1,500 per patient in diabetes management alone after surgical intervention after ten years compared to conventional treatment, a sum which would be much higher if cost savings for other conditions was taken into account. BARRIERS TO OVERCOME Yet PCTs are routinely ignoring NICE guidelines by turning down patients deemed appropriate for surgery by NICE, using their own, arbitrary, non-evidence-based thresholds. Some patients are therefore denied life-saving treatment, others are even being forced to deliberately gain weight to meet strict local criteria. Lifestyle interventions alone for weight loss can achieve impressive results, thereby

Achieving weight loss with hypnotherapy ITH OBESITY reaching

W epidemic proportions, and the NHS already struggling to cope, there is another way. As hypnotherapists we have successfully worked with many problems such as confidence, fears, phobias and, the most common, weight. Working one-to-one or in group the majority of clients successfully lose the weight, using hypnotherapy, NLP and CBT. We became licensed practitioners of the Hypno-Band, originally developed by John MacClean, for his own practice in 2009. This also involves working on the reasons for the weight and eating habits and changing them, using CBT and hypnotherapy, and then getting the brain to believe there was an operation to fit a gastric band to the stomach.

This gives the same results as the operation, reducing the amount of food that could be consumed. Usually completed in four sessions, with a choice of extra sessions to keep clients on track. The advantages of dealing with the reasons for overeating are long-term results with clients not trying to override the band or returning to old habits or diets and feel happier within themselves.

FOR MORE INFORMATION For more information or to book a session please contact us on 023 92595226, e-mail: pete@hampshire hypnotherapist.co.uk or lorraine@hampshire hypnotherapist.co.uk or visit www.hampshire hypnotherapist.co.uk

reducing future costs; the Diabetes Prevention Programme induced only 4kg sustained weight loss at four years, but reduced the cumulative incidence of diabetes by 58 per cent over that period. Mean weight loss in attenders on the Counterweight programme of diet and lifestyle intervention in General Practice, was 3kg and 2kg at 12 and 24 months, both 4 kg below expected weight given the normal 1kg/year background weight gain in the general population. Counterweight delivery cost is £59.83 per patient, and therefore costdominant proving that it is cheaper to treat an obese patient than not to. GP consortia will have the power to ensure weight management in obese patients is prioritised, to commission a wide variety of weight management services and to remove the barriers to bariatric surgery. This approach would save a vast amount of money in the long term, but there is a danger that commissioners might be too myopic to appreciate long-term gains.

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

Scalesexpress offers expert advice on scales for obese patients CALESEXPRESS IS the UK’s leading online retailer of scales, with an extensive range of body fat analysers, health and activity monitors, bed scales and hoist weighers, from manufacturers including Tanita, Salter, Seca, Salter Brecknell and Marsden. The website offers a carefully selected range of body composition analysers that are NAWI Class III approved and suitable for healthcare professionals when dealing with obesity, such as the Tanita SC240 MA. The large platform scale is light and highly portable and instantly calculates body fat, body water and BMI with clinically proved accuracy. Calibrated up to 300,000 uses, the monitor can monitor ages 5-99 with a 200kg weight capacity and has a USB port to allow data to be easily transferred to a computer.

The Marsden MPHW 200 lightweight patient hoist weigher with BMI is also NAWI Class III approved and can fit most types of hoists that have the ‘coathanger’ style sling support. Scalesexpress offers easy, convenient shopping and is focused on giving customers the best advice, the best choice and the best price. You can get tailored advice on a wide range of products from our team of expert customer service advisors. Scalesexpress can also provide full account terms for hospitals and local health organisations, health authorities, emergency services and councils.

FOR MORE INFORMATION Contact: Dan Brough, sales advisor Tel: 01204 590231 E-mail: dan@wardworth.com

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HEALTH & SAFETY

SAFE SURFACES TO WALK ON The Health and Safety Executive discusses slips and trips, and how to reduce this risk within a healthcare setting IN 2009/10, in the health and social care sector alone, there were more than 2,000 major injuries caused by slips, trips and falls in the workplace and more than 3,600 that resulted in workers having to take more than three days off work. Failing to manage risks effectively can leave employees and their families to pick up the pieces and businesses paying a heavy price. Slips, trips and falls in this sector cost British society around £50 million every year. SAFETY MEASURES The Health and Safety Executive wants to reduce unnecessary slip, trip and fall incidents in the workplace by encouraging managers and duty holders to do more to stop them happening by taking simple, often cost effective, measures. Although, there has been a sustained reduction in the number of fatalities caused as a result of falls from height in the workplace over the last ten years, it still remains the most common cause of fatal injury, with slips and trips the most common cause of major injury.

The Health and Safety Executive wants to reduce unnecessary slip, trip and fall incidents in the workplace by encouraging managers and duty holders to do more to stop them happening by taking simple, often cost effective, measures Peter Brown, HSE’s head of Division for Work, Environment, Radiation and Gas, said: “Making improvements doesn’t need to cost the earth and we are encouraging people to visit our website, where they will be able to get simple and cost effective solutions to help manage slips, trips and falls hazards in their workplace.” HSE has developed two e-learning tools to identify risks and manage hazards in the workplace, both can be accessed from its website. STEP deals with slips and trips and WAIT with work at height. Taking sensible measures to keep

workplaces safe, protects staff and helps to give patients a good level of service. The cost of incidents may affect the delivery of high quality patient care and viability of the business. For example: • patients being seriously injured through falls leads to additional medical costs and an increased stay in hospital, with implications for waiting lists and service delivery • staff sickness absence due to slips, trips and falls at work, and other associated costs, such as staff replacement costs, will have a detrimental effect on budgets

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• people may experience hardship as a result of loss of wages, as well as pain and suffering. These incidents can be cut dramatically through planning and positive management during refurbishment and new build, together with good housekeeping. Employees should be consulted at an early stage, as they will have useful experience of areas where problems arise. CAUSES OF SLIPS AND TRIPS The main causes of slips and trips incidents in healthcare are: slippery/wet surfaces – caused by water and other fluids; slippery surfaces caused by dry or dusty floors; contamination, such as plastic, lint or talcum powder; obstructions, both temporary and permanent; uneven surfaces and changes of level, such as unmarked ramps. Other factors include poor levels of lighting and external glare; human factors such as employees rushing; running or carrying heavy/cumbersome items; the wearing of unsuitable footwear; or the use of improper cleaning regimes. In order to reduce slips trips and falls, it is recommended that you: • follow the free practical guidance offered by the e-learning tools, STEP and WAIT • depending on the degree of risk and the size of business, develop a policy document and ensure practical arrangements are in place, such as quickly cleaning up spillages and better still preventing spillage of water, oils, cardboard, waste etc onto the floor in the first place • remove any obstructions • avoid creating trailing cables • store goods safely • keep workstations clear of obstacles. • make sure flooring materials are level and secure • mark slopes and changes of levels • ensure you have adequate lighting • wear sensible footwear • think about visitors to your workplace, what do they need to know? Do you need to do more to protect them?

Failing to manage risks effectively can leave employees and their families to pick up the pieces and businesses paying a heavy price

TACKLING THE PROBLEM After monitoring health and safety records, bosses for Winchester and Eastleigh NHS Trust recognised they had problems with slips and trips on wet hospital floors. Between 2002-2004 the trust had to tackle in the region of 100 slips and trips from staff, all of which could be blamed on floors left wet after cleaning. The Trust’s safety adviser had attended a HSE slips, trips and falls workshop, which reinforced the belief that more could and should be done. This prompted the trust to look again at the areas where falls were occurring to identify trends. Around the same time the trust was unfortunate enough to have a member of staff fall in a ward area after the floor had been mopped.

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T DIRECT TRAINING SERVICES has had great success in its 10+ years of operation. HT Direct Training Services was started in 2000 by Emily Hewitson-Townley who began work as a cook and worked her way to catering management. Her greatest ambition was to teach so in 1968 she embarked on a one-year teacher training course. A friend suggested that she should apply for a part time position at the local college, which soon grew to full time. Then circumstances changed and she took her courage in both hands and set up the company, which has grown to what it is today. During her time at the local college, Emily had the opportunity to study for Advanced Food Hygiene and Health and Safety Certificates enabling her to teach these subjects and associated topics. HT Direct Training Services grew and is still expanding with many associate teachers and assessors. We cover all the statutory topics to business of all types including construction, nurseries, and motorway service areas both locally and nationally. These include First Aid for the Workplace, Emergency First Aid for the Workplace, Food Safety CIEH levels 1 / 2 and 3, Health and Safety CIEH levels 1 / 2 and 3, Manual Handling Principles and Practice CIEH, COSHH CIEH, Risk Assessment CIEH, Paediatric First Aid (to EYFS and Ofsted guidelines).

HT Direct has expanded into events cover at stadiums and other venues both great and small with a team of qualified first aiders and nurses. We have covered The Shay Stadium in Halifax for football and rugby league as well as bonfire parties and Christmas fairs. The feedback from these has been very encouraging. We offer a First Aid Supplies Service to all companies and we now have added our online shop, which is performing very well in its first month of operation. We supply

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An inspector from the Health and Safety Executive recommended that changing the way mopping was done could reduce the risk of slips and trips. He suggested using a dry mopping system using micro fibre, which would limit the amount of fluid on the floor. Micro fibre mops are designed to pick up dirt and cling to it. Rather than saturating the mops, the mops are placed into a bucket and left

to soak up the water and cleaning fluid. This reduces the amount of residue that is left on the floor during and after mopping. The staff were also advised to mop and dry the floor in sections before moving onto the next part of the ward, to provide safe access around the area. Dean Bailey, trust safety advisor for Winchester and Eastleigh NHS Trust, said: “At first the housekeeping staff were reluctant to change to

a system that they believed would take much longer. However, once we started to see a decrease in the number of people slipping and how easy it was to implement, they were more than happy with the new way of working.” DRAMATIC IMPROVEMENT The trust purchased 11 systems and trialed them for four weeks. The results were so dramatic they bought another six so they could roll the method out across all wards. Since the trust implemented the system in April 2005 it has received one report of a slip/trip to date as a result of wet floors, which was reportable under RIDDOR, and an 85 per cent reduction in falls from the 100 reported in the previous two years. Dean Bailey said: “Using HSE’s online risk assessment tools and having HSE on board was fundamental in reducing the slips and trips within our organisation. Without these tools and HSE support we wouldn’t have seen such dramatic results and made our wards safer for our members of staff and patients whilst maintaining our clean environments.”

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ARE YOUR PREMISES FUNCTIONALLY SUITABLE? Keith Sammonds, managing director of the Healthcare Facilities Consortium, highlights some lessons to be learned when it comes to interpreting statistics and interacting with the media

A circulation space being incorrectly used for the storage of trolleys – not functionally suitable. © Copyright Healthcare Facilities Consortium

HAVING PICKED UP ON SOME nationally released information in November 2010 the BBC issued Open Information (OI) Questions to trusts in England asking the above question with some more detail. The response from NHS organisations was quite interesting and generated not a little radio and television debate. During this I was asked to respond to the issues on radio programmes and to the paper media. Read on for a summary of the points raised by this debate. NHS PREMISES November was a very interesting month starting as it did with the annual Scottish Healthcare Conference I reported on in the last article1. With my mind buzzing from all the ideas and potential problems that event highlighted, I was looking at the consequences for our subscribers of the current and coming financial constraints and considering how some of the ideas could be implemented as cost saving measures when a call came in from the BBC. They wanted to discuss the fact that a fifth of the NHS premises in England were not functionally suitable for the provision of healthcare2. The BBC researcher and I had a lengthy chat around where the figures they were quoting had come from and how much (or perhaps more truthfully – how little) they understood of what the data set they referred to meant and why it was collected. There were several points of interest that came out of that initial discussion including the fact that they had not even looked at the definition of the functional

suitability return. Having gone through the more obvious bits of the topic a number of other points of understanding became clear: • The actual figure was not a fifth (20 per cent) but 17 per cent of the healthcare estate • Functional suitability measures do not mean “unsuitable for use” • Not all of the healthcare estate is used for patients • Some responses from NHS Trusts showed naivety in dealing with the media • The BBC were not interested in any of the good news from the report. I will look at each of these points in turn as they highlight some interesting lessons for the NHS and indeed the Department of Health (DH) and The Information Centre (IC) to learn. THE STATISTICS The actual figure was not a fifth but 17 per cent of the healthcare estate: In all their TV and radio reports that I was either involved in or subsequently heard or saw the BBC reported as the headline that a fifth of NHS premises in England were not functionally suitable for the provision of healthcare. Only in the detail did they say that the figure was 17 per cent. This 17 per cent figure is NOT from the DH or IC reports. It has presumably been calculated by the BBC and this would require some detailed analysis of different elements of the reports. The actual statement that the BBC used in its reports is: “The Department of Health figures show that 17 per cent of the NHS estate is classed as ‘not functionally suitable for use’.

There are 142 sites with 50 per cent or more of their estate falling into this category, including 33 acute or specialist hospitals.” Having run the report from the IC website myself I find that of 387 reported NHS organisations only 23 report a figure of 50 per cent or greater. Of these six are Primary Care Trusts, four are Specialist Acute, five are Large Acute, two are Medium Acute, three are Small Acute, two are Mental Health and Learning Disability Trusts and one is an Ambulance Trust. My point: You can make statistics say what you want. I have deliberately highlighted the information by organisation (as we tend to deal with the NHS as organisations) where the BBC chose to deal with it by sites (meaning hospitals) as that would catch the public eye. Quite valid and correct but it does sensationalise the figures and also loses the fact that a good proportion of the healthcare estate is not used for patient care but for support and management. Interestingly of course SHA premises are not included in the returns so there is no measure of the pure management element of the NHS for the statistics. SUITABLE OR UNSUITABLE Functional suitability measures do not mean “unsuitable for use”: There was a clear belief in the questions being asked of me that the functional suitability measure meant that the facilities were UNSUITABLE for use. The actual definition of the data collected is: “Percentage of occupied floor area that is below Estatecode Condition B for functional suitability (i.e. below an acceptable standard, or unacceptable in its present condition, or so below standard that nothing but a total rebuild will suffice).” To properly interpret this you need to understand Estatecode and also what the relevant “standards” are. There is a huge gulf between below an acceptable standard and so below standard that nothing but a total rebuild will suffice. With revisions in the space around beds in recent years as an example, there will be many areas that do not quite match this standard but are still quite capable of being used effectively for patient care. The NHS would very much like to match this standard for reasons of patient comfort and infection transmission but the value judgement has to be made – close the ward because of a small failure in space requirement or continue providing care in the same space as has been used for years until such time as funding allows for improvement. One specific response from a trust will be highlighted later.

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Not all of the healthcare estate is used for patients: One of the measures in the ERIC returns is Patient Occupied Floor Area. From the figures on the IC website this is showing as 44 per cent of the total internal floor area of all reported organisations. Interestingly 24 organisations failed to report data in this important field and 15 reported zero – i.e. they have no Patient Occupied Floor Area. Unsurprisingly these are mainly Ambulance Trusts and their floor area is made up of offices, control centres, training facilities and ambulance stations. However, there are also two Primary Care Trusts, one Acute Teaching Trust and one Mental Health and Learning Disability Trust. I would be interested to know if the Department of Health has approached these for their data. Within the data collected there is no way of linking the amount of patient occupied floor area with the functional suitability figures. As the fail points can be standards or condition related and there is no way of evaluating by how far the fail misses the Estatecode Condition B target or how much this could affect patients or patient related areas, this is a really difficult topic to deal with and this showed up in the way the BBC approached the issue. As an example of an area that is not functionally suitable I took a photo of a corridor in a major acute hospital recently. This is not functionally suitable because it is a circulation space being incorrectly used for the storage of trolleys. DEALING WITH THE MEDIA Some responses from NHS Trusts showed naivety in dealing with the media: As noted above the topic is difficult to deal with from the statistics as they can be interpreted in any number of ways and in our discussions I pointed out to the BBC reporter and later in their radio programmes that the only real use of the figure would be to measure improvement over time. Because of this the BBC quite understandably wanted to use examples. They kindly shared several of the responses to the OI questions they sent to NHS Trusts with me and these show some cause for concern in the way the NHS responds to media questions. This information was shared with me anonymously so that I could help the BBC understand what was being said; I do not know which trusts the specific comments relate to. Looking at one in particular immediately triggered a counter question back from me that the NHS organisation should have thought of and couched its response to avoid: “Wards at a children’s hospital half the size of what is needed for modern health care. Trust admits staff and families who are forced to deal with the ‘cramped and inconveniently laid out wards and a lack of privacy’.” For wards to be half the size required this must have been a growing problem over many years. The changes in bed space requirements cannot account for this degree of mismatch. My counter question is why the trust is

fitting twice as many patients into the area than is recommended? The other obvious question is what the trust is doing to ensure that adequate facilities and privacy will be provided in the short and long term future? RATIONALISE ACCOMMODATION Another related issue that I picked up myself came out of BBC Radio Shropshire’s interviews with midwifery staff at their local hospitals. There has been an ongoing move to rationalise accommodation within the Shrewsbury and Telford Hospital NHS Trust area; currently many services are split across their two main sites. The long term aim is to rationalise and provide more effective and efficient single site based services whilst maintaining two functional hospitals. Last year one element of the proposal was to move all consultant led maternity services to the Royal Shrewsbury Hospital but when looking at the functional suitability issue an interview was conducted in a treatment room used for scans; the comments then being that it was old and too small for the volume of equipment needed for the modern service provision. Deliberately looking at this too simply, the obvious conclusion is that the proposal was to move services to an out of date and not functionally suitable building. Knowing several of the estates and facilities team at this trust I know that this would not have been the case as there was a large refurbishment programme in the proposals and also a major new building project already on the site. As always it is the way the facts appear that registers in people’s minds and so we have to be very careful about how what is said can be seen or (mis)read in the context of other things already in the media spotlight. NO NEWS IS GOOD NEWS The BBC was not interested in any of the good news from the report: I found it fascinating that the BBC chose to look at the functional suitability issue instead of any of the other issues that were actually in the DH report3. Functional suitability does not even appear in the DH report, so perhaps that was the motivation? Some of the key points that come out of the report are (referring to change from the previous year): • Floor area has grown by 2 per cent and land area has decreased by 4 per cent • Backlog maintenance has increased by a small amount (0.29 per cent) • Spending on hospital cleaning increased by 9.45 per cent • Patient food costs increased by 11p per day • 2.4m additional main meals (1.84 per cent) were provided • The NHS Estate costs £6.6bn not including depreciation and the cost of capital This makes estates and facilities one of the three highest cost items to the NHS along with staff and drugs – but of course the estates and facilities costs include staff costs.

So the estate and related issues are really important to the NHS and clearly will be under significant pressure to reduce costs so the likelihood of further reducing the functional suitability figures looks remote. There is a lot of really good news in the report as the rationalisation of the NHS estate continues, cleaning is improved and better resourced to assist in the drive towards reducing HAIs but this was not picked up on by most of the media. LESSONS TO LEARN Having said that there were lessons to learn I will close by highlighting some of these: There needs to be a clear and easy to use link between nationally issued statistics and the definitions that underpin the data. It is vital that the issue of national information is notified to all interested and related organisations so that we can be properly primed to answer media questions. Staff responding to media questions need to be trained on how to handle the media and also to think about the wider issues than the questions being put to them. Responses need to be double or treble checked and tested against possible alternative use of the information provided. Plan to build an ongoing relationship with local media so that they know to come to you for a response on local issues. This was done to great and positive effect by the previous CEO of the Shrewsbury and Telford Hospital NHS Trust with a regular appearance on BBC Shropshire. Pre-empt issues by producing your own regular press releases on key issues. Finally one of the lessons for me came from the BBC 5 Live Breakfast interview: I was given a 20 minute briefing by the programme researcher on the previous day. Having been kept hanging on the phone from 06:30 to 06:48 while they changed the running order the presenter did not touch on one of the areas I had been briefed by the researcher to expect. Thankfully I had done my own research and from comments received managed to handle the interview well enough. The second interview was with BBC 3 Counties at just after 07:00 the same day; a very different and more comfortable experience but rather spoiled by the local NHS body failing to put a representative forward. Opportunity lost! References 1. Health Business Magazine 10.6 Page 45 2. The BBC News Web article is at http:// www.bbc.co.uk/news/health-11769182 3. The Department of Health summary is at http://www.dh.gov.uk/prod_consum_dh/ groups/dh_digitalassets/documents/ digitalasset/dh_120811.pdf

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

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BRING YOUR ORGANISATION INTO THE PREMIER LEAGUE ‘Doing More with Less – Fact or Fiction? Reality or Hype?’ is the theme of this year’s HFC Conference, the longest running healthcare FM themed conference in the UK THE RECENT WHITE PAPER and the economic downturn have placed enormous challenges on the NHS. However, the chief executive of the NHS, Sir David Nicholson, recently said that this was time for investment not cut backs. The white paper proposals are far reaching, if enacted in law. So the question arises, exactly what is happening and how will it affect you for the future? The HFC Conference will challenge, question and help clarify the fact or fiction, the reality or hype. The HFC Conference is the longest running healthcare FM themed conference in the UK. With key speakers and topics, this event will not only help you deal with long term matters but everyday occurrences that effect your organisation and more importantly in some cases you as an individual. CONFERENCE PROGRAMME The conference will be chaired by HFC director, professor Peter Woolliscroft who has a wealth of NHS experience and knowledge, currently employed as managing director for Cyntra. The conference runs over two days and provides a full programme of events. Day one includes: • Liz Jones, head of Patient Environment, Department of Health – New Cleaning Standards PAS5748 Cleanliness in Healthcare Facilities. • Paul Donlevey, National Counter Terrorism Security Office (NaCTSO) – Project Argus Health. • A three streamed breakout session to tease out the issues relating to ‘Fact or Fiction’: Stream 1 Management/Knowledge: Chaired by Alan Connor who runs the Management Development Centres for the NHS Facilities staff; Stream 2 Built Environment/Buildings: Chaired by John Kelly from E C Harris; Stream 3 Staff Management Solutions: Sian Thomas, Synuron. At the end of day one networking opportunities will continue into the evening at the Gala Dinner in the Old Trafford Suite overlooking the stadium. The evening will provide an after dinner speaker, entertainment by Lesley Davis, an introduction to the Fitta4life session on day two and HFC’s Annual charity auction, raising money for the Community Heartbeat Trust, which is a national charity focused on the provision of life saving defibrillation services to local communities. HFC will also be hosting a blind auction for a signed football donated by Old Trafford. Day one will also consist of an ice breaker tour of the Old Trafford Stadium and Museum,

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which is a fantastic opportunity for all. Day two includes: • Kevin Oxley, director of Operations, North Tees and Hartlepool NHS Foundation Trust – Revising Management and Technique to Improve Performance. • Eddie McLaughlan, assistant director, Engineering and Environment, Health Facilities Scotland – Carbon and Sustainability. • Chris Green, partner and business centre manager, Weightman LLP – Criminal Implications and Crisis Management. • Patrick Troy, chief executive, British Parking Association (BPA) – The Hospital Parking Charter, The Reality. • Luke Kavanagh, director of Fitness and Business Owner, Fitta4Life – Improve your working life through fitness. The conference is open to all facilities management personnel and anyone looking

everything from the conference sessions to the exhibition, ice breaker event and the conference Gala Dinner. Accommodation is also available adjacent to the venue. The Healthcare Facilities Consortium has been the leading support service to the E&FM sector for the past 15 years offering not only the NHS designed and funded, and therefore cost effective, estates and facilities software solutions, including the now standard Credits 4 Cleaning (C4C®) cleaning management and audit system, but also a range of other money saving services. These include access to discounted services from third parties for HFC subscribers, and also the best and most comprehensive libraries of NHS policies, procedures and other guidance documents. This alone in 2010 saved the NHS a conservative £52 million in costs! We also run the leading benchmarking

With key speakers and topics, this event will not only help you deal with long term matters but everyday occurrences that effect your organisation and more importantly in some cases you as an individual for solutions to assist their organisation in day to day tasks and improve their own knowledge and understanding of healthcare facilities management. UNIQUE EXHIBITION Alongside the conference sessions HFC runs a unique exhibition with an extensive range of exhibitors, which include Advanced Sterilization Products, Ambinet Ltd, Asckey Data Services, Fitta4Life, Focused FM, Focused FM TV, Hospital Bulletin, Institute of Healthcare Engineering and Estate Management (IHEEM), Integrated Handheld Solutions (Main Sponsor of the event), Medical Services, Meridian Health, Pierce Management Services and Premier Software. The exhibitors will be on hand to provide services and products that will assist in managing your organisation. HFC’s main focus has always been to provide quality, value for money solutions to the everyday problems faced by estates and facilities professionals in healthcare. With that in mind pre-funded places are available to all HFC subscribers and discounted/ sponsored places to non–subscribers. Delegate places at the conference cover

service for E&FM, a key feature of the needs for healthcare provider organisations for the future, and one of the leading conferences addressing key issues in this sector. The Healthcare Facilities Consortium is the only UK national organisation supporting and representing E&FM, and is an active campaigner for new policies, procedures and services, representing the interests of E&FM at government level and to all four Departments of Health. To undertake our work we levy a subscription fee, which at only £2,500 per annum represents a very good investment for healthcare providers, and is significantly cheaper than other membership offerings. We estimate every subscriber organisation will get at least £25,000 of benefit per annum from their membership, with benefits extending beyond E&FM into organisation wide services, such as HR and insurance reviews. Programme subject to change without notice.

FOR MORE INFORMATION Book now at www.hfc.org.uk or contact the conference team at conference@hfc.org.uk

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FACILITIES MANAGEMENT

Qube modular buildings Terrapin applies for the healthcare sector innovative approach to offsite construction H EALTHCARE BUILDINGS in the UK tend to range from the new style sterile, soulless boxes that bolt together like a child’s giant Meccano toy set, to the old imposing brick buildings that are tired, run down, out dated or worn out. Neither of these types of buildings is conducive to the very best healthcare services, for patient or client treatment or recovery environments. Patient and client services are best served in a well designed, modern, light, comfortable space that has the patient and client needs and services built in to the design and fabric of the building. Embracing new building methods and technologies, Qube Structures have an alternative building solution that cannot only satisfy the needs of the organisations or clients commissioning and managing these healthcare buildings but also service and satisfy the specialist

ERRAPIN, the offsite construction specialist, has secured a major new contract in the healthcare sector to create a new outpatient suite, as part of a major hospital extension at Lewisham Hospital in South London, on behalf of Kier London. Terrapin’s managing director Adrian Day explains: “This project is testament to the versatility of our system. There are a number of stringent criteria that this project needed to meet – for aesthetics, performance and environmental factors, and the flexibility of our bespoke service means that we can achieve this perfectly.” The three storey building was specified to a non-standard width, demonstrating the flexibility of Terrapin’s Unitrex system and suitability for this type of build. The innovative structure is built with a mix of timber and steel, using Unitrex Wall Panels throughout and features a circulation tower,

needs and requirements of the patients that rely on the function of these health care buildings. All Qube Structures are not only rapid build, fast track and cost effective but they are bespoke in design to meet the challenges of each and every individual health services requirement or application. No two buildings are the same because in most cases no two health buildings house the exact same set of patient or client services.

FOR MORE INFORMATION Tel: 01604 785786 E-mail: info@theqube.co.uk Web: www.theqube.co.uk

which links the new and the existing building. This tower boasts an innovative design, including concrete floors and roofs, which means hospital staff and patients can easily move between the existing and new building, as access is provided at all three levels, providing even greater convenience. The building has been designed to achieve BREEAM Very Good, which means it must meet high performance requirements for air tightness and energy efficiency. The architect provided an A-rated specification, which is testament to the quality of Terrapin’s offsite systems.

FOR MORE INFORMATION For more information from Terrapin, telephone 01908 270900 or e-mail: info@terrapin-ltd.co.uk or visit the website www.terrapin-ltd.co.uk

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Panther Interiors

For striking receptions and contemporary offices Call 0845 634 1458

T. 0845 634 1458 E. sales@pantherinteriors.co.uk W.www.pantherinteriors.co.uk

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HOSPITAL INTERIORS

RE-THINKING THE PATIENT ENVIRONMENT Revolutionary bed pods, modular washrooms, and ‘intelligent’ mattresses. These are just some of the design-based solutions to improve patient dignity and prevent infection spread that came out of two pioneering Design Council projects AS PART OF THE DEPARTMENT of Health’s HCAI Technology Innovation Programme, the Design Council were tasked to come up with new designs for hospital furniture and equipment that would help the fight against MRSA and other Healthcare Associated Infections (HCAIs). DESIGN BUGS OUT The project was called Design Bugs Out and in April 2009, prototypes of innovative new designs were unveiled. The prototypes used cutting edge techniques to rethink the bedside environment, patient transport and everyday medical equipment, making them much easier to clean. They are also designed to influence patient and staff behaviour to reduce the likelihood of exposure to HCAIs. A ‘21st century commode’ (portable toilet) was designed to be easy to take apart for cleaning, and which practically eliminates the hard-to-clean gaps and joins that characterise current designs. A redesigned porter’s chair was created which is durable, comfortable, and cleverly uses design to make it easy to clean while reducing the number of obvious user ‘touchpoints’ where infection can be spread. Also in the collection was an ‘intelligent’ mattress which changes colour when it becomes compromised by body fluids. In addition, a patient bedside system comprising bedside storage and over-bed table which eliminates hard-to-clean corners, is made of special durable, scratch-resistant materials, and is easier for patients to use unaided. What’s more, a unique new patient chair has been developed which pioneers a system of magnetised, removable cushions with easy-change laundered covers that make the chair clean, safe and comfortable. A curtain clip was designed which through a unique design and magnetic mechanism, provide an easily sanitised ‘grab-zone’ and also keep the curtains securely closed. A wipeable, polythene-covered bloodpressure cuff with magnetic closures which can be used instead of hard-to-clean Velcro fastenings was also developed. TOP DESIGNERS Through a national competition the Design Council appointed some of the UK top designers and manufacturers, renowned for design icons from Virgin Atlantic’s Upper Class airline seats to Herman Miller chairs and

Parker pens, to work on the furniture and porter’s chair. A specialist healthcare team from the Helen Hamlyn Centre, Royal College of Art developed the designs for everyday equipment, such as the self-timing cannula, blood pressure cuff and ‘intelligent’ mattress. Teams of designers and manufacturers, were asked to set out how they would tackle the design challenges, which were identified following extensive research in hospitals across the UK involving nurses, patients, cleaners, porters and other healthcare staff. A panel of the UK’s most respected experts in the fields of design, healthcare, microbiology, nursing and patient care was assembled to assess which items in the hospital environment, if redesigned, could have the most potential to reduce patients’ exposure to HCAIs through contact with their immediate surroundings. INFECTION CONTROL So what evidence is there that new furniture and equipment will help in the battle against HCAIs? A study entitled ‘Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning’ (Lancet Vol 8 Feb 2008 101-113) concluded that: “The greatest risk for patients is contaminated near-patient hand-touch sites in clinical areas. This is borne out by studies that have seeded viral or other molecular fragments onto a door handle or a telephone, and then charted their

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HOSPITAL INTERIORS

design-based solutions to some of the privacy and dignity issues that patients experience. “When people are ill they can feel anxious and deprived of their confidence and self-respect. That is why it is so important to be treated in a safe and healing environment where trust and dignity can be sustained. Simple, elegant solutions such as those launched could help restore peace of mind and thereby improve chances of recovery,” said Majorie Wallace, chief executive of mental health chairity Sane.

movements over the course of a few days. Such studies show the importance of sites that human hands touch more frequently, and can be used as an indicator for what might happen regarding the spread of MRSA.” Anecdotal research among healthcare staff who regularly clean ward-based furniture and equipment indicates that redesigning furniture and equipment to enable better cleaning could have two benefits. Firstly it will improve the efficiency of cleaning – creating items which are easier to clean, for example by eliminating crevices, joins and hard-toreach contours. Secondly it overcomes inertia around cleaning awkward items – if items which have previously been difficult to maintain are made easier and quicker to clean, the regularity of cleaning is likely to increase. DESIGN FOR PATIENT DIGNITY The Department of Health also teamed up with the Design Council to help improve the experience of patients in hospitals. The Design Design for Patient Dignity project involved designers, manufacturers, healthcare experts, staff and patients to design a variety of

solutions which enhance and promote privacy and dignity in hospitals. They include patient clothing, new ward layouts, washing and toilet facilities and systems to help patients feel more secure as they move between wards. DESIGN CONCEPTS The design concepts and prototypes included a Bed Pod which creates a private, patientcontrolled bed environment; a Capsule Washroom to rapidly refit wards to create single-sex toilet and washing facilities; and a Reclining Day Chair – a unique hybrid between a wheelchair and a bed which provides greater comfort and security for patients being moved around the hospital. Other prototypes included Novel Screening Systems to enhance privacy and dignity and a Flexible Signage System to allow staff to designate same-sex areas. A Universal Patient Gown was also created to keep the wearer’s body covered while being warmer and more comfortable. The Department of Health asked the Design Council to run Design for Patient Dignity to help encourage innovation in the way care environments are planned and to help find

LISTENING TO PATIENTS The work followed extensive research into what issues matter most to patients, staff and experts, such as being able to discuss personal details without other patients hearing, being in a same-sex ward or bay, having same-sex toilet and washing facilities, having personal control over their environment, and improving hospital nightwear and gowns. Patients contributed their experiences and ideas to the design process, meaning that the prototypes have been developed to meet the needs of the people using them. The result is prototypes that provide workable solutions to privacy and dignity issues that matter the most to patients. The teams were appointed following a nationwide search for designers and specialist manufacturers who could together develop designs, as well as create prototypes and put them into full-scale production for introduction to hospitals. The teams were judged by a panel of the UK’s most respected experts in design, patient care, hospital management and nursing. Several of the above-mentioned designs, such as the commode developed for the Design Bugs Out project, have been put into production following successful feedback from hospitals.

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

The Quasar HD-LED – “by far the best operating theatre light” EN CHARLES, theatre manager at Airedale Hospital in West Yorkshire, commented: “Quasar HD-LED is by far the best operating theatre light we have ever used. The overall performance, maneuverability and design of the lights make Quasar a step ahead of the rest. Brandon Medical has supported our theatre needs where possible and I am thrilled with our choice.” Brandon Medical’s award winning Quasar HD-LED operating theatre lights were installed within the hospital. HD-LED is a brand new technology with vastly superior performance compared to standard definition LED. Quasar HD-LED has three distinctive benefits that differentiate it from other products in the

light intensity across the entire illuminated area. The beam size can also be adjusted to suit a particular working area to eliminate any peripheral distractions. Quasar HD-LED also has the highest R9 (visible red) colour rendition of any product thus providing the optimum visualisation of red tissues. Brandon Medical were delighted to work with Airedale hospital and were pleased that Quasar was well received and recognised as being “a step ahead of the rest”.

market. Full spectrum colour rendition makes it the only surgical light with near perfect colour rendition across the full visible spectrum. Fat Beam Illumination provides high

FOR MORE INFORMATION Tel: 0113 2777393 E-mail: enquiries@brandon-medical.com Web: www.brandon-medical.com

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WASHROOMS

MAINTAINING SAFE FACILITIES Mike Bone, director of the British Toilet Association takes a look at hospital washrooms and how to keep them clean and hygienic PUBLIC HEALTH AND HYGIENE issues are often in the news, with increasing media interest in all matters relating to publicly accessible toilets. Unfortunately, many healthcare premises toilets do not conform to best practice. Toilet hygiene is particularly critical as infection risks must be identified and any opportunities for cross contamination eliminated. Toilet design, functionality, facilities, cleaning practices, maintenance and monitoring of hygienic conditions all form parts of BTA Best Practice Advice. INFECTION RISK Infections which may be found in healthcare toilets include streptococcus, staphylococcus, E. coli and shigella bacteria, hepatitis A virus, the common cold virus, and various sexually transmitted organisms. It has been quoted that between about 20 per cent and 70 per cent of HAIs are preventable. It is vitally important that clean and hygienic healthcare premises toilets are available to provide facilities for all types of toilet users: males, females, children, babies, the aged and those with a disability. Toilet hygiene is particularly critical in hospitals and clinics as infection risks must be identified and any opportunities for cross contamination eliminated. Education about infection control in toilets is an important tool in the war against superbugs and hospital infections. There are measures that hospitals and clinics can take to prevent the spread of infection in toilets. It is not sufficient for hospitals just to provide the means to wash hands. We know from experience that many men, women and children fail to wash their hands after using a toilet (up to 40 per cent in healthcare premises). Displaying signs telling users to wash their hands helps but education is also needed to ensure that toilet users and toilet providers understand why it is absolutely essential that hands are germ free before they leave the toilet. 84 per cent of people that wash their hands don’t wash them effectively. Signs should be displayed indicating the effective way to wash hands. DESIGN & BUILD Toilet designers and managers of healthcare premises need to consider what the infection risks are in a toilet and how to avoid any opportunity for cross contamination. The building materials used inside toilets need to be hygienic and easy to clean. Intelligent design and built-in durability will reduce long-term maintenance and cleaning costs. For use in

public areas, however, it is also important, that they are resistant to graffiti and vandalism. Toilets should be designed with a view to easy cleaning and maintenance from the start (with smooth surfaces and avoiding little gaps and crevices). All drains and waste pipes should be easily accessible for cleaning and maintenance including concealed systems. Continuous flooring should be used in preference to material with joints. Tile grouting absorbs urine and is more difficult to keep clean and odour free. Surfaces can be coated with antiMRSA agents, which reduces stains and odours while killing bacteria, fungus, and microbes. Wall hung lavatory pans should be used in preference to pedestal lavatory pans. This makes the facilities easier to clean as there are fewer places for dirt and germs to collect on the floor. NON-TOUCH FACILITIES It has been recorded that 80 per cent of infectious illnesses are transmitted by touch. Cross-contamination occurs when germs are spread from one person to another simply by touch – directly or indirectly. Once a surface is touched, bacteria are transferred to it, regardless of the length of time the surface was handled. Measures can be used to prevent the spread of infection in toilets such as non-touch facilities and the coating of must touch surfaces with substances that kill germs, for example hands free lighting, toilet tissue dispensing, cistern flushing, wash basin taps, soap dispensing

and hand drying. Hospitals can also consider supplying toilet seat covers that are replaced after each use, or sanitizer sprays to protect the otherwise “must touch” toilet seat. Toilet seat covers act as a physical and protective barrier between the user and the toilet seat. The door at the entrance to and exit from the toilet is normally a must touch surface. Coatings are now available, that are invisible and can be applied to must touch surfaces, including door handles, and destroy both micro-organisms, and foul odours, using nanotechnology. Products are also available that provide a fresh sleeve door handle cover for each user or spay a germ kill solution on the handle before each use. EFFECTIVE CLEANING It is important to ensure effective cleaning and eradication of germs in toilets. Organisms that can be harmful to health can survive on environmental surfaces. Viruses, in particular, can be excreted in large numbers in respiratory secretions and stools, and can stay on surfaces for hours and even days. In addition to hand washing, hygienic toilet and hand washing facilities are vital to prevent the person-to-person spread of infections. The importance of high quality cleaning in all hospital toilets cannot be overstated. Higher standards of cleaning are achieved by having clear cleaning specifications and properly trained staff. Cleaning requirements must be set out in a cleaning specification –

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WASHROOMS

including cleaning procedures and specified cleaning materials to be used and their frequency of use. The cleaning specification will detail the daily, weekly and monthly tasks that must be completed in each toilet. Cleaning solutions are available for all surfaces that provide 99.9 per cent effective sterility and germ kill. They are effective against MRSA, E. coli, and other forms of bacteria. New cleaning products and systems are available which kill bacterial cells and inactivate pathogenic viruses without using chemicals. Training course should be provided for operatives and supervisors in toilet washroom cleaning. It is highly recommended that the people charged with the cleaning responsibilities are suitably trained to the British Institute of Cleaning Science (BICSc) level of competence; and that they have attended and completed the Cleaning Operators Proficiency Certificate (COPC).

should be located in the toilets, dated and signed by the inspecting cleaning supervisor at regular intervals throughout the day. A faults and repair audit checklist should also be maintained. These records must be regularly scrutinised and managed by the cleaners’ supervisors. Healthcare premise deep clean programmes should include use of products recommended by the Health Protection Agency to fight the bugs such as MRSA and Clostridium difficile during the deep clean that was, effectively, put in place to combat them. Even the most careful cleaning can leave traces behind. Black Light technology can be used to show residual splashes and stains. It reveals proteins that the eye can’t see and not only uses a scientific process to establish the degree of cleanliness but also helps cleaning supervisors to understand what surfaces need more effective cleaning.

MONITORING & INSPECTIONS Monitoring of cleaning activities through daily or weekly inspections is considered essential to maintain high standards. Toilets should be monitored regularly as part of a documented rota and policy. A cleaning audit checklist

MAINTENANCE It is important that healthcare staff know what to do immediately when a toilet is not working properly. Sound preventative maintenance programmes and proper programme performance monitoring will

ensure that operational problems are minimised along with reduced closure periods. Supplies of toilet paper, soap, and paper towels must be re-stocked throughout the day. Emergency repairs must be done promptly to minimise disruption to the service and planned maintenance should take place outside of normal toilet opening hours whenever possible. The British Toilet Association’s ‘Where can I go?’ campaign focuses attention on the need for high standards of public or away from home toilets in all areas, and this includes healthcare environments such as hospitals and clinics. BTA welcomes new members from the healthcare sector and can provide help and advice with all of their toilet provision enquiries. The British Toilet Association is recognised as the unique expert source of information and support in all matters related to away from home or public toilets across all market sectors including private and public healthcare locations.

FOR MORE INFORMATION Tel/Fax: 01403 258779 E-mail: enquiries@britloos.co.uk Web: www.britloos.co.uk

Portable hand wash Commercial and units help stop infection domestic cleaning HE INTRODUCTION of TEAL Hygienius® portable hot water hand wash units by infection control staff at the Royal Free Hospital in London has helped to stop the spread of C-difficile and Norovirus. “Having the units, which we can put into place immediately we get an outbreak, is a huge part of why historically we don’t have the severe problems reported by some other trusts with these infections,” says lead infection control nurse, Debbie Barry. Her team won the Infection Control category in the 2009 Nursing Times Awards for their work, which focused on delivering a more effective service for both patients and staff. The Infection Control team manage the use of the Hygienius® units and are responsible for checking and cleaning them. As well as being used on wards placed on lockdown the units are available to provide hand washing facilities in temporary clinics and while areas are being upgraded. They are also

BACUS-MAIN is a company of expert contract cleaners supplying a high quality professional cleaning service in Brighton, Sussex, Surrey and South London. The company is known not only for being value for money, but also for its reliability, discretion and customer friendly attitude. With its superb reputation for business to business and office cleaning services, our customer base is wide ranging, and currently drawn from the following sectors: hotels, universities, retirement homes, office cleaning, property management services, residential letting agencies, golf clubs, housing associations, local authorities, and as a subcontractor to other national cleaning companies. Stately homes and historic property are also valued clients, and indeed some residential customers are taking advantage of our professional and discreet approach to cleaning, whether as regular customers or one-off spring cleans. Abacus-Main is a well established firm of contract cleaners, with over 10 years’ experience of providing

regularly used for hand washing training in the hospital. The floor standing Hygienius® needs no mains water or plumbing connections to operate and is ready to use as soon as it is plugged in to a 13 amp socket. It is lightweight and has rollers so can be positioned exactly where required.

FOR MORE INFORMATION To find out more log on to www.washyourhands.co.uk or phone 0121 7700593.

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Stainless steel equipment Medical consumables – the hygienic choice for the health sector OR ORGANISATIONS that by necessity need to function within a clean and hygienic environment, the choice of products are often restricted due to the limited materials suitable to meet operational and legislative requirements. Teknomek is a leading specialist manufacturer of stainless steel furniture and equipment, and can lay claim to many years of extensive use within the health and pharmaceutical sectors. We use 304 grade stainless steel as standard in our products as it possesses excellent hygienic characteristics in that it is easy to clean and maintain. It also possesses an unusual feature in that the surface self-heals after damage. This occurs due to the reformation of its passive layer of

chromium oxide after scratching or gouging which maintains the hygienic integrity of the surface. These characteristics, together with advanced design and manufacturing techniques, allow Teknomek products to meet all relevant microbiological regulations. Stainless steel is an extremely cost-effective and durable material and offers an excellent return on investment due to its long life span. Our full product range can be found by going to our website or phone us to get a copy of our latest 112 page catalogue.

UNZL HEALTHCARE is one of the UK’s largest distributors of leading brand and own brand medical consumables to all areas of the healthcare market. Whether it is supplying examination gloves into acute hospital trusts; vital care home equipment to independent care homes; or personal hygiene products into other healthcare related businesses, Bunzl Healthcare has it covered. A winning combination of tailored supply chain solutions, backed up by leading edge technology,

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FOR MORE INFORMATION Teknomek Limited Tel: +44 (0)1603 788833 E-mail: mail@teknomek.co.uk Web: www.teknomek.co.uk

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IN CONTROL OF YOUR ENERGY ENVIRONMENT THE POWER TO KEEP YOUR BUSINESS MOVING

3 Saving You Money 3 Reducing Your Costs 3 Protecting the Environment 3 Cutting Your Carbon Emissions

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ENERGY

WHY CARBON MANAGEMENT IS STILL GOOD FOR YOUR HEALTH Richard Rugg, head of Public Sector at the Carbon Trust, makes the case for healthcare organisations to stay focused on carbon management as a way to cut costs and make efficiencies IF YOU ASKED THE UK’S HEALTHCARE sector for a list of key priorities, the chances are that carbon management would not feature prominently. However, considering that the annual energy bill for the UK healthcare sector is about £600 million, and given the spending constraints across all areas, carbon management is a simple and effective way for the healthcare sector to reduce costs. In fact, if cost cutting targets set out by the government are to be met, it is vital that healthcare boards place cutting carbon and energy costs at the top of their agendas. The good news is that the vast majority of

healthcare organisations could save significant amounts of money by introducing simple carbon saving measures. It’s not just large organisations that can benefit – the average doctor’s surgery could save up to 20 per cent on its energy costs through taking action. FEELING HOT, HOT, HOT Many of these measures are not complicated or costly to implement. One easy win is to avoid waste on heating bills. This can be done by ensuring that heating is only timed to come on when needed, and by checking all thermostats regularly and ensuring they

The vast majority of healthcare organisations could save significant amounts of money by introducing simple carbon saving measures. It’s not just large organisations that can benefit – the average doctor’s surgery could save up to 20 per cent on its energy costs through taking action

are set to an appropriate temperature. Even one degree of overheating can increase fuel costs by around 8 per cent. Hot water is another area that benefits from scrutiny. In warmer weather, turning off boilers altogether might be an option if there is low or no demand for hot water. Or, if an organisation has several floorstanding boilers, only one might provide hot water while the others provide heating. If this is the case, the unnecessary boilers could be switched off altogether. Lighting is often overlooked but offers lots of easy ways to save money. Given that in a typical hospital, lighting can account for more than 20 per cent of total energy use, it’s an area that merits attention. Simply by encouraging employees to maximise natural light where possible and only switching on lights when they are really needed, healthcare organisations can save up to 15 per cent on electricity bills. Or, if an organisation is prepared to invest in an upgrade, more effective lighting systems can both reduce costs and improve the quality of lighting for staff and patients. But the situation is not simple. Last year’s

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ENERGY

mean that it will pay for itself within eight years, whilst reducing energy consumption by 11.7 per cent. The business case for this type of investment speaks for itself. Another initiative includes reviewing lighting across the hospital to make it as efficient as possible without compromising patient care. In store rooms, where lights tended to be left on accidentally, automatic switches now turn the lights off after a fixed amount of time. The dining area has been fitted with sensors that recognise daylight and movement so that if an area is unoccupied and natural light is bright enough, the lights will remain off. This not only reduces energy use, but the trust has found that people are more likely to congregate in the lit space, which makes it easier for catering staff to clear.

CHP unit at Medway Maritime Hospital

Equity and Excellence white paper means that the NHS currently faces a fundamental change to parts of its structure. Primary Care Trusts, often the primary driver in carbon reduction, are being abolished, with their functions transferred to other NHS Trusts, GP surgeries, local authorities and the private sector. These changes have resulted in many organisations waiting to see where and how the dust will settle before picking up the baton and driving forward carbon reduction initiatives. For organisations that choose to press ahead, the rewards are there for the taking. The Carbon Trust’s public sector customers have identified potential total savings of £1.1 billion from energy efficiency projects – delivering financial benefits as well as reducing carbon emissions from those organisations by around 46 million tonnes over their lifetime. This is no small amount of carbon – it’s roughly equivalent to the annual carbon emissions of London. At the Carbon Trust, we are working with more than 2,700 public sector bodies to help them cut carbon emissions. Of these, 272 are healthcare organisations. This is a significant number but there are hundreds of other healthcare bodies across the UK that could benefit from better carbon management. Our NHS carbon management programme provides technical and change management guidance to help organisations identify practical carbon and cost savings. For those organisations we are already working with, existing projects are expected to save over £153 million. SAVINGS IN MEDWAY “Hospitals have to run fast just to stand still. A typical ‘rule of thumb’ increase in electrical consumption in acute hospitals over a 12-month period is an increase of three to five per cent per year, partly driven by the

increased use of specialist medical equipment that generally relies on electricity,” comments Paul Evans, environmental manager at the Medway NHS Foundation Trust. The Medway NHS Foundation Trust is responsible for Medway Maritime Hospital, the largest hospital in Kent, treating around 400,000 patients a year. Through the Carbon trust’s carbon management service, the Trust is adding energy efficiency to its targets, resulting in expected savings of approximately £300,000 a year. A former naval hospital, Medway is an acute hospital providing intensive care, maternity and outpatient facilities, as well as operating theatre space. Its main site covers a heated footprint of 83,000 square metres and presents some interesting challenges as some buildings are more than 100 years old. When the hospital appointed an assistant to the position of environmental manager in 2006, it increased the number of hours it had available to dedicate to energy efficiency projects and turned to the Carbon Trust’s carbon management service for help. COMBINED HEAT AND POWER The most significant project implemented to date is the installation of combined heat and power (CHP) to provide a large proportion of the heating and hot water demand for the hospital as well as generating sufficient power to cover 75 per cent of the site’s total electrical load. The new CHP installation replaces 56 standard hot water gas-fired boilers that were split between eight different boiler rooms. Many of the boilers were “a maintenance nightmare and not very efficient” so replacing them made a lot of sense. The new system has required an investment of £2.9 million to install, but the expected annual cost savings

EMPLOYEE ENGAGEMENT Internal champions are integral to the success of the project. Since 2006, the Medway NHS Foundation Trust has relied on volunteer environmental champions drawn from across the hospital to raise employee awareness of the costs of energy use. There are now 40 champions in place, who meet regularly to share ideas and come up with new suggestions. Other schemes encourage staff to reduce emissions from transport on their way to work. A partnership with a local bus company gives employees a discount on buses, and staff are also entitled to a loan to buy a bicycle to cycle to work. New staff who live within a mile and a half of the hospital are not granted a parking permit at all, while those who live further away can use a hospital park and ride facility via a minibus operated by the hospital. Staff using this facility benefit from reduced parking charges compared to those who park on the hospital site. “To begin with the changes were fairly low key, but we’ve really increased our activity. We’re definitely making progress,” says Paul Evans. The Medway NHS Foundation Trust is just one example of a healthcare organisation that is reaping the financial and environmental benefits of cutting carbon. Support is available to help healthcare organisations of all sizes seize the opportunities presented by carbon management and make potential cost and carbon savings a reality. The rewards are well worth it. From a baseline rate of 13,000 tonnes per year in 2007, the hospital has reduced emissions by 10 per cent in 2010, and is on target to make a further reduction of 8 per cent during 2011 – the first full year of operation for the new CHP plant. Medway has spent some £3 million on its combined projects, which are predicted to deliver annual savings of £300,000 from 2011.

FOR MORE INFORMATION Tel: 0800 0852005 E-mail: customercentre@carbontrust.co.uk Web: www.carbontrust.co.uk

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Energy - Find your way …at the aM&T conference & exhibition Legislation

Smart meters

Active energy management

Security of supply

Energy procurement

Carbon reduction

Whatever direction your energy management needs to go… …start with automatic Monitoring & Targeting The ninth national aM&T conference & exhibition Thursday 3rd March 2011, E.ON Lounge, Ricoh Arena, Coventry

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ENERGY

THE GREENING OF THE HEALTH SERVICE? The comprehensive spending review contained a number of decisions about energyrelated issues. Alan Aldridge, executive director of the Energy Services and Technology Association, outlines some of the opportunities and challenges outlined in the review WITH A TARGET TO BE THE “GREENEST GOVERNMENT EVER”, the present government has to put into action concrete programmes to achieve that accolade. The previous administration had already committed the country to a “low carbon revolution” but it would take time before it became apparent how the new government set out its own priorities in this area. The comprehensive spending review has set out some of the main themes and further measures, such as December’s Energy Bill, are now beginning to fill in the detail. Perhaps the first thing to note is that, while the government may have changed, the context in which it operates has not. Climate change continues to be a major global issue and security of energy supply is a priority for all industrialised

economically efficient. Participants purchase emissions allowances or reduce emissions through performance improvements, whichever is cheaper. With the overall total number of emissions capped, a market develops between those who have managed to improve performance more cheaply – and so have surplus allowances to sell – and those that cannot become more efficient so easily. Clearly, those in the scheme will only choose to invest in energy efficient or low carbon technologies if the price of the allowances is sufficiently high to make it worthwhile. Now, the first few years of the EU ETS have seen significant emissions reductions – despite a low carbon price. There were clearly some easy wins. However, in 2009 UK firms in

While the government may have changed, the context in which it operates has not. Climate change continues to be a major global issue and security of energy supply is a priority for all industrialised nations nations. The 2008 Climate Change Act places a statutory duty on the government of the day to reduce carbon emissions in line with a path to a total reduction of at least 80 per cent by 2050. In addition, the UK has obligations under the Kyoto Protocol to reduce emissions. In parallel with this, there is a continuing rise in energy prices around the world as developing nations like China and India need more and more energy to service their growing economies. Geo-political issues – such as the disruption to gas supplies from disagreements between Russia and transit countries like the Ukraine – also mean that supplies cannot always be guaranteed. Even with consortia purchasing arrangements, the health service is not immune from volatile rising prices and the impact this has on already scarce operational funds. EMISSIONS TRADING SCHEME To help achieve the significant reductions in carbon emissions necessary to meet its 8 per cent target under the Kyoto Protocol, the European Union introduced an emissions trading scheme (ETS) for heavy industry. This kind of scheme is particularly popular with economists because it is deemed to be

the scheme actually bought 13 million allowances (one for each tonne of CO2) suggesting that easy gains are running out. Yet the price of allowances on the spot market remains stubbornly low – much too low to persuade power companies in particular to invest in new nuclear plants. So the government is now consulting on introducing a floor price for carbon and ensuring it is high enough to make the economics work in favour of new investment. The principle is that carbon will be bought at the current market rate but if that rate is below the floor price the purchaser will have to pay the Treasury the difference. This will gain the Treasury a good deal of money while at the same time making energy efficiency investments viable. In ESTA’s view the rate will need to be around £40-50/tCO2 to be effective. Now, apart from the fact that this is also likely to feed through into the prices consumers pay for energy, it may also affect participants in other schemes like the CRC Energy Efficiency Scheme – although the CSR has injected a large amount of uncertainty into the future operation of that particular programme. In addition, the re-negotiation of Climate Change Agreements (CCAs) – an alternative to the ETS for certain

industrial sectors in the UK – has now been suspended until the finalisation of the carbon price support mechanism later this year. CRC ENERGY EFFICIENCY SCHEME The CRC EES is an emissions trading scheme modelled on the EU ETS. It aims to capture energy consumers with large energy bills but who are not within an energy-intensive industry. So the health service, along with higher education, were among the groups specifically included in the scheme. It was originally designed to be revenue-neutral with all the funds obtained through the sale of allowances being recycled to participants. However, there was an incentive to improve energy efficiency because a league table was to be produced each year and those at the top received more money back than those at the bottom. Early action in the form of adoption of automatic Monitoring & Targeting (aM&T) systems or membership of a thirdparty performance assessment scheme (like the Carbon Trust Standard or one based on BS EN 16001 and the BS Kitemark) would move an organisation up the table. The CSR has taken away the financial impact of this incentive. Funds will now just go to the Treasury and not be recycled. There will still be a league table but will serve as a reputational driver only. The first sale of allowances will also be delayed for a year and the shape of Phase 2, when full trading was due to begin, has been delayed as well pending further consultation. In effect, the scheme has become a carbon tax and the only way to mitigate the impact is to reduce emissions in absolute terms. It could be argued that even in its original form as an incentive scheme, it was flawed. An allowance to emit one tonne of carbon costs £12 in the first phase. You would need to spend £170 on energy to incur that obligation. So the reduced consumption from energy efficiency investment is worth far more than the savings from needing to buy fewer allowances. It should, however, be noted that the ultimate aim of the CRC EES was full carbon trading within a few years. A significant floor price for carbon would have increased the incentive value of the scheme. As Phase 2 is now subject to further consultation, we will have to wait and see what impact the scheme has in the long run. Speaking of carbon taxes, the Climate Change Levy is also to be reviewed. Added

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ENERGY

to all consumer electricity bills, it was supposed to provide an incentive to energy efficiency but experts have long argued that it is too small – a fraction of one per cent – to make any difference to behaviour. BUILDING PERFORMANCE The re-affirmation of climate targets by the government comes at the same time as the latest revision of the Building Regulations came into force in October. This latest version raises performance requirements for both new and refurbished properties by 21-40 per cent depending upon type. With existing commitments on zero-carbon domestic new build by 2016 and non-domestic by 2019, the next revisions will be even more stringent. However, a major question remains about how well enforced the regulations will be. Past experience does not provide much confidence and the planned reduction in local and central government staffing levels may hinder this process further. Time will tell. While the Regulations are addressing national targets, they are also being driven by European legislation, notably the Energy Performance of Buildings Directive (EPBD). This may be more familiar to health service professionals through a couple of other measures it has brought in – notably Energy Performance Certificates (EPCs) and Display Energy Certificates (DECs). The latter, a snapshot of current energy performance, have to be renewed annually. Until now, they were only for large public sector buildings visited by large numbers of the public. A revised Directive has now been approved that extends the process to buildings down to 250m2. DECs will also be required for private sector as well, bringing in many private health facilities for the first time. While that change is still a year or more away, 4 January 2011 marked the date at which all air-conditioning units producing more than 12kW of cooling were required to have an inspection under the first version of the EPBD (250kW units should already have been given a formal performance inspection).

ENERGY BILL TIMETABLE. SOURCE: DECC December 2010

Introduction of the Energy Bill to Parliament

Pre-Autumn 2011

Officials engage stakeholders as they develop the technical details for secondary legislation

Autumn 2011

Formal consultation on secondary legislation

Early 2012

Secondary legislation laid before Parliament

Spring 2012

Detailed industry guidance prepared

Autumn 2012

First Green Deals appear

GREEN DEAL AND GREEN INVESTMENT BANK Two eagerly-awaited initiatives that were promised in the Conservative Party manifesto were the Green Investment Bank and the Green Deal. The CSR and recent parliamentary activity are starting to put some flesh onto the bones of these programmes. The publication of the Energy Bill in December set out how the government aims to deliver substantial improvements in energy efficiency across the built environment via the Green Deal. Originally aimed at the domestic sector, its scope has now been extended “enabling smaller businesses to access funding for energy efficiency improvements, and larger businesses to meet their obligations under existing schemes at lower cost, such as Climate Change Agreements or the Carbon Reduction Commitment Energy Efficiency Scheme” as one of the background documents explains. One of the main benefits of the Green Deal is that organisations do not need to find the money upfront for investments. The cost of the measures installed is paid back over a period of time through the energy bill. However, this is structured in such a way that customers will see an immediate drop in their bills from the installation of the energy saving measures, notwithstanding a repayment component. And the debt associated with this investment stays with the property (or the meter point) not the owner. So if a health sector organisation re-locates to newer premises and

disposes of an existing site, the repayments are picked up by the new owner (issues like demolition etc will be dealt with in detailed guidance issued when the scheme goes live). It should perhaps be noted that for the banks and finance houses that will ultimately finance the package, this kind of investment programme is very low risk. Nor is it new. There is third-party finance available today for good-quality energy efficiency projects – ESTA members are among the financing organisations. So if you don’t want to wait till the end of 2012, please get in touch! The Green Investment Bank on the other hand is likely to be a vehicle for funding new technologies or very large projects. Energy infrastructure and generating capacity come to mind but it is understood that larger energy-saving projects may also be considered. We await further details on how this will work – and how it will be funded. 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

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where waste is occurring. Together we will set up action plans to minimise cost and waste. We provide best value telephone services, mobiles, internet, and gas electricity. And without locking you into useless customer service or long term contracts and poor invoicing.

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provided with no capital cost or installation of further automated metering. We will help you to highlight when and

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WindTronics Wind Turbines – you can have the power where you need it EW TECHNOLOGY captures the dynamics of wind. Andy Sowden, managing director of WindTronics Ltd, discusses the challenges of harnessing wind power and how, with the right technology solution, it can play a pivotal role in generating our future energy needs, at home and for organisations such as yours.   The challenge is that wind power is an increasingly important part of our future and all efforts to reduce carbon emissions are critical. In order to facilitate this process, we need to start discussing energy creation in terms of the wind we have, when we have it and how much energy can be converted at these intervals.   Traditional wind turbines have struggled to harness these dynamics and the public’s connotation of ‘turbine’ elicits large dominant structures with associated expensive transport, planning and safety issues, or smaller systems that are unreliable and inconsistent in their energy output.    The problem is that these turbines use blades which are attached to a mechanical shaft. This technology involves a high level of mechanical resistance, which in itself absorbs

some of the wind energy and therefore requires higher speeds in order to work.    It is the case that organisations want to control their energy but it is also certain that energy costs will rise – some estimates say as much as 43 per cent by 2020. We are getting close to no choice. So new technology must be available to address public concerns while producing a solution that is capable of grabbing

the maximum amount of energy from the available wind and providing it directly to where it is needed.   Created to solve the problem of low wind speed and recently awarded a Gold Edison Award for Energy and Sustainability in New York, the WindTronics BTPS6500 addresses all these concerns.   The WindTronics BTPS6500’s gearless design eliminates all resistance by generating power at the blade tips in wind speeds as low as 2 mph and as high as 38 mph, without typical noise, size, weight and vibration issues. The new ‘Smartbox’ controlled Blade Tip Power System ensures the blades just keep turning, creating the most effective wind generator in its class.   The WindTronics BTPS6500 is truly a wind energy solution that not only has a performance which outshines traditional wind turbine systems but with such flexibility it can be applied wherever it is needed.

FOR MORE INFORMATION Tel: 01494 557355 E-mail: info@windtronics.co.uk Web: www.windtronics.co.uk

Energy Institute – energy professionals

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you at your home or workplace at a date and time to suit you. With interest rates remaining low and the stock markets worldwide still unpredictable it is difficult for people to know where they can safely invest to get a good return without risking their capital. The UK Government’s Clean Energy Cashback Scheme (feed in tariff) is the answer. It provides you with a guaranteed, tax free, index linked income for 25 years and can equate to a return on capital of between 8 per cent and 12 per cent. Simply put, there is no better investment vehicle available anywhere else.

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FOR MORE INFORMATION Contact: Simon Price Tel: +44 (0)20 74677146 E-mail: sprice@energyinst.org Web: www.energyinst.org

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SECURITY

CARING FOR YOUR PREMISES – SECURITY IN THE HEALTH SECTOR With effective security a priority for healthcare providers, James Kelly, chief executive of the British Security Industry Association, examines measures available to the health sector WITH LARGE PREMISES and expensive equipment held on site, hospitals often face a number of security threats. While ensuring the safety of staff, patients, visitors and assets is always a top priority, achieving effective security is also a challenge, especially in face of the recently announced cuts to public spending. From an operational perspective, buildings such as hospitals can be easy targets to intruders, as they constantly face a natural flow of people entering or exiting buildings. In addition, the fact that these premises hold expensive equipment and machinery as well as confidential patient data and medications means that they can be extremely attractive to thieves. As a result, a combination of different security measures is often used to protect the sites, ensuring that patients can receive the best care and feel safe. ROUND THE CLOCK SECURITY CCTV is particularly effective in enhancing the security of hospitals, by acting as a deterrent to criminals and trespassers, while monitoring the activity of authorised personnel such as staff, patients and visitors. A specific element of CCTV, known as Video Content Analysis (VCA) is increasingly being employed. VCA is the name given to the automatic analysis of CCTV images, which is used to create meaningful information about the content. For example, it can be used to automatically detect intruders or count the number of people entering or leaving an area. If the area that needs protecting is particularly extensive and will require multiple screens to be monitored at once, there are also ways to be as efficient as possible, especially at night. Recent advances in technology mean you could streamline this process by employing either motion sensors for the CCTV, where the cameras only start rolling when there is movement, or by using fencemounted vibration detectors that trigger an alert in the security control room. Another element of CCTV that can prove invaluable for the health sector is BS8418, the British Standard for remotely monitored, detector-activated CCTV systems. When deployed, BS8418 compliant solutions consist of cameras and detectors placed strategically around a site, linked together by specialised transmission equipment to a Remote Video Response Centre (RVRC). Here, operators can visually confirm what is happening, call up on-screen plans of the site and even issue verbal warnings to intruders via on-site speakers. If

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necessary, the RVRC operators can also alert the police who, as the incident is confirmed visually and is associated with a URN (Unique Reference Number), should provide a rapid response. The ability to provide a rapid response when incidents occur is a priceless feature that should convince health sector premises to employ this technology more widely. The presence of security guards is essential for responding to intruder detection. Security officers can man access points and be on hand should visitors, patients or staff require any kind of assistance. They are often also responsible for managing technological aspects of a site’s security strategy, such as CCTV or access control. MAKE YOUR MARK Hospitals and care homes hold very expensive and specialised equipment, and loss of such items could cost establishments thousands of pounds. Property marking can reduce the risk of theft by discouraging criminals and allowing the institution to trace back any lost or stolen piece of equipment. Property marking may be defined as the permanent identification of items to deter thieves by providing evidence that links them to the scene of a theft and enables stolen goods to be returned to their rightful owners. This is achieved either by marking the owner’s name and address or, increasingly, by the use of technology to enable property to be traced to its origin through a database register. The object is to render stolen goods useless by enabling the police to catch and convict criminals and the BSIA has established a dedicated Cash and Property Marking Section to help owners to make the best use of this powerful deterrent. Members of the section have recorded significant progress, both in ensuring criminal convictions and deterring crime by the use of warnings advertising the use of property marking technology at particular locations. The Royal Hospital in Belfast was among the first healthcare providers to employ the system to tackle the theft of thousands of pounds worth of property including medical equipment. The effectiveness of such initiatives is based on the sound principle that marked property is easily traceable and difficult for criminals to explain. INFORMATION DESTRUCTION The healthcare sector holds vast amounts of sensitive patient data and keeping it out of the wrong hands involves not only comprehensive

in-house protection but also established procedures for its secure disposal. The risks are wide ranging, which is why the need for secure disposal extends beyond physical documents to include information held on computers and storage devices, as well as other potential 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. The health sector is increasingly looking towards professional information destruction companies to ensure that their confidential material is disposed of in a legally compliant manner. Each

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SECURITY

individual record lost cost UK organisations an average of £64 in 2009, according to the third annual UK study sponsored by data protection firm, PGP Corporation. The BSIA’s ID section’s remit is to assure good practice through established standards for the collection, transportation and destruction of confidential material. Its members collect confidential waste at source and provide a fully traceable service up to the point of destruction. 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. ACCESS CONTROL Effective security technology that’s easy to use is a feature of smart access control systems, which represent the next layer of protection for health sector buildings. Depending on the location and sensitivity of the building or area involved, access control measures can range from paper-based logging systems for temporary visitors’ permits through to

access control cards using radio frequency identification (RFID) chips for more convenient proximity reading of card details and activation of gates, turnstiles and vehicle barriers. Most hospitals and care homes now use access control systems such as electronic ID cards to identify staff, and ensure access to certain areas is allowed to authorised people only. In addition, systems such as Automatic Number Plate Recognition (ANPR) and fire roll-call software can prove valuable as well. ANPR is particularly useful on larger sites where a high volume of staff, patients and visitors are driving in and out of the premises. ANPR will monitor the entry of vehicles on-site using CCTV-style cameras and computer software, which identify number plates. Some systems will also store photographs of the driver and vehicle for subsequent analysis. This sophisticated software will draw attention to on-site (or off-site) security staff and will enable them to identify any returning cars that are considered suspicious. Furthermore, it allows critical information to be passed to the police to assist in the pursuit,

identification and capture of offenders. Fire roll-call software, on the other hand, automatically generates a report containing vital information as to the whereabouts of individuals inside a building in the event of a fire. This software operates via the access control smart card or fob that an employee uses to gain access or exit a building. In the event of an emergency the fire roll-call software alerts occupants while simultaneously activating the report at a safe pre-determined remote point. EXPERT ADVICE The nature of work conducted onsite and the individual threats and risks that the premises may face, determines what security measures will be required for each individual hospital. Making the most of technology and choosing methods that will do the job properly is important but this can be a daunting task, particularly for those who are not familiar with the technologies that are available on the market. Security consultancies can guide whoever is in charge of procuring the security solutions for hospitals or care homes towards the best security measures that will be of most use. A consultancy will conduct a thorough risk assessment, providing essential advice on security reviews and audits, development of security polices and strategy, guarding services, systems design, tender management and security awareness training. They will work with their client to identify threats and ensure that business continuity is addressed, therefore eliminating the chance for corners to be cut. Based on this assessment the security consultancy will then suggest various measures that could benefit the premises. These may differ depending on the requirements and risks faced by each client but they could include the likes of CCTV and access control. With the government’s proposed public sector budget cuts in people’s minds, it is vital that security is not ignored and corners are not cut, and although it may not seem so at the beginning, taking advantage of the expertise offered by a quality security organisation can lead to future savings and efficiencies. BSIA members meet strict quality criteria and as such, the Association’s website is a great place to start when considering your next security investment. To locate a supplier in your area, or to find out more about the solutions mentioned in this article, visit our website. 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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CATERING

TIME FOR A SNACK AND A HEALTHY DISCUSSION Vending offers healthy flexible refreshments 24/7, ideal for the healthcare sector, argues the Automatic Vending Association

A lifestyle that combines regular physical activity with consumption of a wide range of food choices is the key to healthy living HEALTHY EATING REMAINS high on the government’s agenda as the debate on obesity amongst the population and the importance of a balanced diet continues to rumble on. As it does so, the vending machine has been singled out and criticised unfairly. When Jonathan Hilder joined the Automatic Vending Association (AVA), the trade body representing the £1.65bn refreshment vending industry, at the beginning of 2010 he quickly become involved with government at the highest level on this issue. Vending offers healthy flexible refreshments around the clock, ideal for the healthcare sector and Jonathan is keen to set the record straight. He explains: ”I inherited a problem imposed by Edwina Hart (Minister Of Health for Wales) who, in 2008, imposed restrictions on the products that could be sold through vending machines in Welsh hospitals. The reasoning behind the ban was the claim that ‘it will improve patients’ health’ but this falls flat on two counts; firstly vending in hospitals is used predominantly between 8pm and 2am by hospital staff who understand the importance of

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diet and who surely do not need any guidance from the Minister on what to eat. Secondly, the nearby shops selling the banned foods have remained open so to have the effect of merely moving the point of purchase.” FREEDOM OF CHOICE In response to the restrictions, the AVA formed the Vending Choice Coalition (VCC), which is a group comprising of key food and beverage associations, major brand manufacturers and operator companies. Their goal is to ensure that vending has its say and consumers have freedom of choice to purchase a wide range of food and beverages through the vending channel in order to achieve a balanced diet. Various meetings have taken place and having written to Edwina Hart with copies to the entire Welsh Assembly (all parties), there has been considerable support for the AVA, VCC and its objective. As the AVA and VCC continue to lobby for choice, it is worth noting that vending is the only channel subject to very strict nutritional controls and restrictions. Jonathan,

who is championing the debate, comments: “Vending must not be demonised and isolated from any other sales channel.” EDUCATING THE NATION Advice from expert speakers at a recent Vending Choice conference revealed that hospitals are the wrong place to enforce a change in diet. It starts with education and an understanding that variety and moderation is the key to making informed choices. The nation has been eating snacks and confectionery for many years without issue. Vending machines provide a wide choice and the items on sale reflect consumer tastes and demand; including fresh fruit, low fat and low sugar products as well as a range of drinks to rival the high street coffee shops. Vending is only one sales channel and to put the debate into some context, the UK snack and confectionery market is worth £39bn of which £7.8bn is chocolate and snacks. Only 5 per cent of the snack intake goes through the vending channel, so to attack and try to ban the vending machine will do little to affect the health of the nation. A HEALTHY CHOICE A lifestyle that combines regular physical activity with consumption of a wide range of food is the key to healthy living. It is vital that consumers are able to make that choice for themselves. To make the right choice, consumers must be educated and understand the meaning of a balanced diet. This education starts at an early age and we must look to the schools to provide this. The British Heart Foundation (BHF) has argued that obesity rates in children were soaring, however, recent studies by the National Heart Forum found evidence that the rate of childhood obesity may be starting to slow and the reported projections had been greatly exaggerated. Scotland’s largest teaching union threw its weight behind a campaign to amend the law to allow Aberdeen pupils to sell chocolate in their school, arguing that any legislation that denies pupils the opportunity to make balanced decisions “negates” what educationalists are trying to achieve. Healthy lifestyles cannot be forced on youngsters, and a balance must be struck because they would only go to nearby shops to buy chocolate and sweets that are not available in school. Chocolate will be part of their lives forever and they need to be educated to be able to properly make choices. This view is supported by the FSA who in their publication BITE, cited the view from youngster Toby that “whilst carrots, pasta and cheese were healthy you can eat chocolate too, provided it is part of a balanced diet.” Jonathan Hilder points out: “When you impose restrictions on choice, all that happens is that the point of purchase moves to another

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CATERING

place which often can’t be controlled. “The vending machine is not the problem, we need to look at lifestyles and make some changes that will really impact on us.” WHAT IS HEALTHY? The AVA has asked for advice on what was deemed healthy but to date has been unable to get clarification from those who have criticised vending. The Food Standards Agency (FSA) has commented that there is no such thing as unhealthy food, only unhealthy diet, and the BHF would not commit themselves to what they regard as healthy or indeed the level of choice they want to see in a machine. Jonathan comments: “If they are unable to quantify it, then it is difficult for the AVA and the VCC to help implement change. Also if change is made, the BHF would be unable to endorse it as they are unable to endorse any product or industry.” THE RIGHT LABEL There are currently three recognised labeling systems operating to educate consumers and encourage healthy eating, namely; GDA, the traffic light system and calorific value. Jonathan believes that the calorie system is

the simplest to follow, most people understand that if they consume more than the average recommended number of daily calories without burning them off then they will gain weight. He acknowledges that nutrition is a complex area but says we have to start somewhere. This view is supported by Gill Fine, FSA director of consumer choice and dietary health, who commented recently: “The battle between GDA and traffic light labels has been deeply unhelpful.” She went on to explain her work with caterers; where 21 companies have put calories on menus, consumers have found this useful and she summed up by saying “its excellent news for consumers”. THE BENEFITS OF VENDING Keen to implement guidance to his members, Jonathan is looking to develop the recommended healthier shelf. AVA members are regularly introducing new products and Jonathan’s aim is that vending will maintain consumer choice and make that choice easy. Whilst the dialogue with the Minister of Health will continue it remains clear that that a lifestyle that combines regular physical activity with consumption of a wide range of food choices is the key to a healthy lifestyle. It is vital that consumers, whether they are

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

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 our 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 701727 Fax: 08719 730888 E-mail: admin@jjfoodservice.com Web: www.jjfoodservice.com

AVEX 2011 To discover the benefits of vending and a face to face experience with the vending industry put a date in your diary for 15-16 June when AVEX 2011 will be at the NEC Birmingham. AVEX is the premier international vending and water cooler exhibition. Visit www.avex2011.co.uk for more details. in hospitals, schools or the workplace, are able to make that choice for themselves. Vending machines reflect consumer demand and allow the widest range of products to be made available and can also be used to reinforce good lifestyle messages. Vending can provide wholesome, fresh nutritious meals for microwaving for daytime or late night. When blood-sugar levels are dropping it can provide a boost either from a drink or confectionery. It can provide a warming cup of coffee or tea in A&E or something to fill the gap because dinner is going to be later than anticipated.

FOR MORE INFORMATION Tel: 020 86611112 Web: www.ava-vending.co.uk

Providing hospitals with refreshment solutions for over 40 years E HAVE BEEN

W PROVIDING 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 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

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CATERING

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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RECRUITMENT/HR

LOOKING AFTER YOUR EMPLOYEES The Chartered Institute of Personnel and Development discusses managing employee absence through uncertain times EFFECTIVE ABSENCE MANAGEMENT and a persistent focus on employee wellbeing are crucial elements for a healthy and productive workforce. The CIPD’s 2010 Absence Management survey, in partnership with Simplyhealth, confirms the importance of maintaining this focus through difficult and uncertain times, particularly in the public sector. Although the survey shows that overall, organisations are increasing their focus on absence management, there is still more that can be done. The increased focus on cutting costs whilst maintaining productivity and service levels presents further challenges for organisations. Recent public sector budget cuts highlight absence levels as an area in need of attention from HR and the wider business. MONITOR NON-ATTENDANCE The first step in effectively managing absence is to monitor the rate of non-attendance. The survey shows that more organisations (82 per cent) are recording their annual absence rate compared to 2009 (70 per cent). Across the sectors, absence levels remain low at 7.7 days per employee, but there remains a marked difference between public (9.6 days) and private sector (6.6 days) absence levels. A possible explanation for the difference between public and private sector absence could be the nature of job roles in the public sector. There are a high proportion of challenging, public-facing roles such as those in policing, nursing, teaching and social care, where people often face emotionally-charged and stressful situations. Differences in workforce composition could also be a contributory factor to the gap between public and private sector absence levels. Research by the Health and Safety Executive found that public sector organisations tend to have a higher proportion of female and older workers who typically record higher absence levels. In addition, management culture is very different between the sectors, with public sector organisations more commonly adopting best practice in absence management procedures and being less likely than private sector employers to use disciplinary procedures or restrict sick pay in managing absence. COST OF ABSENCE Despite the increased pressure on organisations to cut costs, fewer than half actually monitor the cost of employee absence. Larger organisations and public sector

organisations are more likely to monitor this. The median annual cost of absence is £600 per employee, but costs vary significantly across organisations. However, the survey shows that the cost of public sector absence per employee (£889) is noticeably higher than in the private sector (£600) and in manufacturing and production (£400). Part of the increased cost could be accounted for by public sector organisations generally offering more generous occupational sick pay, for longer than compared to private sector organisations. Over 2/3 of public sector employers provide full pay for more than 20 weeks, compared to around 1/3 of manufacturing and production and notfor-profit employers, and just over a fifth of private sector services. In addition, public sector employers are less likely to restrict sick pay as a method of managing absence. SUPPORT & ACTION It is important for organisations to strike the appropriate balance between providing support to help employees with health problems, stay in, and return to work, and taking firm and consistent action against employees who try to take advantage of an organisation’s Sick Pay Schemes. This action is vital as non-genuine absence clearly reduces an organisation’s productivity. Disciplinary procedures were rated as one of the most common and effective methods used to manage absence, although less so in the public sector than the private sector. However, if employees are genuinely ill, they should be encouraged to stay at home. People coming into work ill can have negative effects for the organisation as illnesses can spread to colleagues and when people are ill they are more likely to make costly mistakes. CAUSES OF ABSENCE The survey shows that the most common cause of short-term absence is minor illness, such as colds, flu, stomach upsets, headaches and migraines. The next most prevalent causes are musculoskeletal injuries, back pain and stress. For long-term absence, the most common causes are acute medical conditions (stroke, heart attack, cancer) musculoskeletal injuries, and again stress features highly. The most common causes of stress at work were reported to be workloads, external relationships, organisational change/ restructuring and management styles.

An increase in stress at work was also identified, with a third of employers saying that stress-related absence had increased over the previous year, compared with just 15 per cent seeing a decrease. In addition a significant increase in mental health conditions in the workplace over the past 12 months was found. As well as nearly four in ten employers saying that there had been an increase in reported conditions such as anxiety and depression compared with just two in ten employers reporting an increase the year before. STRESS MANAGEMENT The increase in stress and other mental health problems highlighted by the research is perhaps not surprising given the tough economic conditions facing the country. The last year has been a challenging one for both employers and employees as the UK economy has slowly emerged from recession. The CIPD’s Autumn 2010 Employee Outlook survey found that four out of ten employees said they are under excessive pressure either every day or once or twice a week and that one in five staff think it likely they will lose their job. The findings show that people concerned about job security are more likely to say they are under excessive pressure at work. Joint research by the CIPD and the Health and Safety Executive into the link between line management behaviour and stress at work has highlighted the management competencies which are key to managing stress. These fall into four main categories: • Managing and communicating existing and future work • Managing the individual within the team • Reasoning/managing difficult situations • Managing emotions and having integrity The competency framework emphasises that managing stress is not a distinct activity but is an integral part of managing people effectively. Managers also need to be able to spot the early warning signs that might indicate that all is not well with an employee such as: working excessive hours; taking recurrent days off sick with minor illnesses; uncharacteristic emotional behaviour; poor relationships with colleagues; and under-performance. Efforts to reduce employee absence levels or boost employee engagement will be fatally undermined if line managers are not equipped with these core people management skills. The key to managing stress and other mental health problems is good people management - particularly on the part of line managers. Line managers can either prevent or mitigate stress or they can cause or exacerbate stress.

FOR MORE INFORMATION The CIPD’s 2010 Absence Management Survey report can be accessed by visiting www.cipd.co.uk/2010a bsencemanagementsurvey

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BACKGROUND CHECKING

DO YOU KNOW WHO YOU EMPLOY? Shirley Wright, partner, and Helen Rice-Birchall, associate professional support lawyer at law firm Eversheds, look at the importance and potential pitfalls of background checks RECRUITS INTO THE HEALTH SECTOR are diverse. Many, but not all, potential recruits into the sector, whether employees or volunteers, must undergo background checks before being offered work. Where the recruit is being employed, or engaged as a volunteer, to work with children or vulnerable adults in certain types of activity, the employer must check to see whether the person’s name appears on the appropriate barred list and perform a Criminal Records Bureau (CRB) check. The Independent Safeguarding Authority (ISA), which was created to vet and register all individuals wanting to work or volunteer with children or vulnerable adults, maintains the two barred lists, which have replaced the previous statutory lists (POCA and POVA). For those who employ people or use volunteers to work with children or vulnerable adults, there is a duty not to knowingly employ, or use as a volunteer, a barred person in regulated activity. Regulated activity covers specific activities and certain situations where individuals have the opportunity to have contact with children or vulnerable adults and work is carried out on a frequent, intensive or overnight basis. In order to comply with this requirement, those who employ or engage volunteers to work with children or vulnerable adults must check the barred lists, which will reveal whether or not the applicant is barred from working with people in those categories. CRB CHECKS Employers are able to apply for a CRB check in respect of certain eligible positions including those which involve working with vulnerable adults or children in regulated activity. Unless workers fall within one of the eligible positions, an employer should not request such a check and indeed the NHS has been criticised in the past for applying for CRB checks in respect of workers who are not eligible because they do not have access to vulnerable adults (or patients), such as administrative, technical and laundry staff. Since 12 October 2009, there has been a right to ask for an enhanced, rather than a standard disclosure when performing a CRB check in respect of most individuals whose work does involve regulated activity, such as nurses and midwives. The enhanced check is the highest level of check available. Where background checks are required, employers should make it clear to prospective employees that any provisional offer of employment will be subject to the checks being carried out and satisfactorily completed. It should also have a clear policy on what

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satisfactory completion means, as it may be that different roles have different requirements. Not only is it crucial to make the appropriate background checks, but it is also important that the checks should be carried out in a timely and effective way, as highlighted by a claim made recently against an NHS Trust. The trust concerned carried out CRB checks in advance of confirming the appointment of staff and, in common with usual practice, made an offer of employment conditional upon satisfactory CRB clearance. In this particular case, the claimant, who had applied for a number of other positions with the trust and, on one occasion had been offered a role but declined that offer of employment, applied

a previous position, which he had declined, having passed the risk assessment upon receipt of the CRB check on that occasion. The Employment Tribunal had to consider whether or not the claimant had been discriminated against. As it is rare that there is ever any direct evidence of underlying discrimination, the tribunal had to consider whether it could infer from the behaviour of the parties that there have been discrimination. It is often the case in discrimination claims such as this one that a tribunal is invited to draw an inference that there has been discrimination from the circumstances of the application and the subsequent progression of the matter. The Employment Tribunal was persuaded, in a

Not only is it crucial to make the appropriate background checks, but it is also important that the checks should be carried out in a timely and effective way to be a medical secretary in a hospital. The CRB check showed that the claimant had a cautions for drug use and assault. Upon receipt of the CRB check, and the subsequent risk assessment which was then undertaken, his conditional offer of the medical secretary position was withdrawn. There was some delay whilst the CRB was received and the risk assessment undertaken. During this period the claimant attended the department and met some of his proposed future colleagues. EMPLOYMENT TRIBUNAL The trust received an Employment Tribunal claim, in which the claimant alleged that the real reason the offer of employment had been withdrawn was his sex and/or sexual orientation and/or disability. His claim was made on the basis that, having applied for previous positions within the trust, it already had information relating to his cautions and so the withdrawal of the offer must have been on other, namely discriminatory, grounds. He also referred to his perception about the attitude of one particular member of staff at the trust whom he met during his visit to the department. The fact that the trust was already in possession of the relevant information relating to the cautions before the offer was made left the claimant with the impression, when the offer was subsequently withdrawn, that his criminal record was not the real reason for withdrawal of the offer. This was exacerbated by the fact that the claimant had been offered

full hearing, that there was no discrimination in this case, and that the reason for the claimant’s rejection in respect of this particular role, when compared to the previous role for which the claimant had applied, was the nature of the convictions and the role to be performed which resulted in different risk assessment results. The case against the trust was therefore successfully defended but not before the trust had been put to the trouble of defending the matter in an Employment Tribunal, with all the associated costs and management time which legal proceedings brings. This case therefore serves to highlight the importance, when the information is already in the possession of the trust, of progressing statutory checks before making formal offers of employment and before progressing visits to the proposed working environment. Even where statutory check information is not immediately available, it is important to ensure that the processes adopted are made clear to the potential recruit and are progressed without undue delay. THE FUTURE FOR BACKGROUND CHECKS Both the criminal records regime and the vetting and barring scheme are currently under review. The vetting and barring scheme was intended to improve the safeguarding of children and vulnerable adults by ultimately requiring all workers or volunteers working in a “regulated” activity to register with the ISA. The first phase of voluntary registration

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BACKGROUND CHECKING

under the scheme was to have begun on 26 July 2010, but this phase was halted by the government pending the review. Notwithstanding the review, the government announced that aspects of the scheme which were already in place should remain so. Consequently, the ISA, which was created to vet and register all individuals wanting to work or volunteer with children or vulnerable adults, continues to maintain the two barred lists and to accept referrals (see below). The legal obligations introduced in October 2009 also continue to apply. So, 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 are two duties. 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 dismissed had the worker or volunteer not left. Note that the equivalent Scottish scheme, the Protection for Vulnerable Groups scheme, has also been put on hold. THE CRIMINAL RECORDS REGIME The review of the criminal records regime is looking at: • the broader issues around the disclosure of criminal records • the balance between civil liberties and public protection in relation to the current use of the Criminal Records Bureau service • ensuring that the systems are proportionate and less burdensome • the use of Police intelligence as part of CRB Checks. The final recommendations for these schemes will be announced in the coming months and will inevitably have some impact on recruitment in the health sector. It will be interesting to see just how far reaching the review will be.

Online CRB Disclosures saving you time and money As one of the leading providers of CRB and other pre-employment checks in the UK, Capita Recruitment Vetting Service has introduced e-Bulk - an ultra efficient online CRB checking system. E-Bulk allows complete management of CRB Disclosures; guiding you through the process of capturing the applicant’s disclosure data online, completing the ID check and countersigning the application. The system is fully integrated with the CRB’s own system (so all data transfers are completed electronically), but requires no integration with your own secure systems, offering you total peace of mind. Key Benefits ✔

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To arrange a demonstration, or for further information on any of our pre-employment checking services, call us today on:

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CONFLICT MANAGEMENT

YOU ARE NOT ALONE Sue Frith, deputy head of the NHS Security Management Service, discusses employers’ responsibility to make sure staff are able to work in a safe and secure environment THE NHS IS A VAST ORGANISATION with a diversity of working environments. Each of these presents its own security risks – from the tension of A&E to the remoteness of out-ofhours and community-based work. Addressing these hazards helps ensure the highest standards of clinical care for patients and the proper protection of NHS staff and property. The organisation committed to achieving this across the health service in England is the NHS Security Management Service (NHS SMS). A high-level aim of NHS SMS is to ensure that NHS employers meet their legal and ethical responsibilities for providing a safe and secure working environment for all staff, regardless of their roles or responsibilities. Every employer is bound by this duty of care and the NHS, as the UK’s largest, requires a comprehensive approach to fulfilling it. The NHS SMS’s remit covers all NHS trusts in England, including primary care, acute, mental health and ambulance trusts. It also extends to other NHS areas, such as community pharmacies, dental surgeries, opticians and outof-hours services. As a result, the NHS SMS’s work to protect staff affects the whole spectrum of NHS workers – both directly employed staff and those who deliver care as contractors. PROTECTION FROM VIOLENCE Top of the NHS SMS’s priorities in this area is ensuring that all those who work in and for the NHS are protected from violence and abuse – and from the fear of such behaviour – at all times in the course of their duties. This is despite the fact that they may be at greater risk of violence and verbal abuse than many other professionals. Figures released last year show that during 2009-10, there were 56,718 reported assaults against NHS staff working in all care sectors. Since 2004, the NHS SMS has implemented various measures to promote safer working environments. Underpinning them all is the message that abusive behaviour must not be accepted as “part of the job” in any part of the health service. Until recently, health bodies were required to report all physical assaults on staff to the NHS SMS. In April 2010, this requirement was extended to encompass all security incidents. Underlining this development was the introduction of a new national Security Incident Reporting System (SIRS), which now provides a more accurate picture of the nature and scale of security incidents across the NHS in England. Also key to the NHS SMS’s work is ensuring that appropriate action is taken against those who assault NHS staff. Its Legal Protection Unit works closely with the police and Crown

Prosecution Service to pursue a range of sanctions. More recently, the organisation made a number of recommendations in response to the public consultation on the Code for Crown Prosecutors, successfully arguing that the public interest factors in favour of prosecution should be expanded to ensure that offences against anyone providing NHS services are taken more seriously. PROACTIVE MEASURES Clearly, it is essential that there are mechanisms for dealing with the security incidents that occur. But the NHS SMS also works pre-emptively on policies and guidance to reduce the number of incidents. Another of its proactive measures is the national syllabus for conflict resolution training for frontline NHS staff. Launched in April 2004, it teaches staff to recognise and defuse potentially violent situations. More than 428,000 have been trained already and the syllabus continues to develop, with programmes tailored for mental health and ambulance settings running in parallel. Given the variety of staff covered by the NHS SMS’s remit, it is important to remember that work-related violence can take place in the community, on the way to and from work and out of hours. As well as requiring employers to ensure, as far as possible, a safe working environment, legislation directs them to address health and safety risks before allowing staff to work alone. For some time, the NHS SMS has worked with NHS trusts to address the specific vulnerabilities of lone workers – a wide variety of staff who work, regularly or occasionally, without access to immediate support from colleagues, security staff or others. It published ‘Not Alone’, a guide for the better protection of lone workers in the NHS in 2004, and recently revised and reissued this guidance to provide further direction on policymaking in this area. LONE WORKER SOLUTION While lone workers may not be able to depend on immediate support if a security incident occurs, it is important that these risks are not over-emphasised. Work to minimise them must be based on fact, balancing the need to provide a high standard of care for patients with the responsibility for protecting staff. In 2007, funding was announced for a project to procure just such a lone worker solution for the NHS. The requirement was for an alert system that could be activated discreetly in a potentially violent or intimidating situation and which could summon help – from a nominated escalation point or from the

Sue Frith

emergency services if necessary. The technology also needed to have the potential to provide evidence for any subsequent prosecutions. Procurement was conducted by the NHS SMS and the commercial unit of the NHS Business Services Authority on behalf of the Department of Health and a framework agreement for NHS lone worker services introduced in April 2009. This gives subscribers – more than 200 trusts across England so far – dedicated lone worker devices that not only function as an alarm in threatening situations but which should also be used as part of normal preparations for lone working. By recording an ‘amber alert’ – a short message about their location and how long they expect to be there – a lone worker can maximise the efficiency of an emergency response should one be needed. Their message is retained by an alarm receiving centre and listened to if they subsequently raise a ‘red alert’ because they feel at risk. A red alert creates an open voice call to an operator who will assess the situation and notify the relevant NHS body’s escalation points and/or emergency services as required. Recordings are stored securely and used as required for the purposes of criminal, civil or local sanctions against offenders. Within the trust, only the local security management specialist – trained in areas such as evidence gathering and witness interviewing, and responsible for investigating security incidents along with the police – can access the recordings, and must do so in line with standard procedures. The preferred supplier, Reliance Secure Task Management, and the NHS SMS’s lone worker team have delivered more than 30,000 subscriptions under the agreement. In the last 12 months, there have been over 200 genuine red alerts, more than 20 of which have initiated a response from the emergency

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ROM THE EARLY DAYS, gift vouchers were the ideal present, giving a choice of goods and retailers, as previously some of us would purchase the wrong colour or size present. As the gift voucher market matured the customer choice expanded with even greater choice offered by the multi-store gift vouchers. This choice and flexibility made the gift voucher ideal as a retiring or leaving present, and the company Christmas bonus. The issuing of a gift voucher was a simple procedure and market research companies and competition operators chose giving gift vouchers as a preferred option to cash. With the growth of staff and customer reward programmes the gift voucher was ideally placed to fulfil these programmes with inspirational products such as balloon rides, holidays, high street shopping and the luxury goods that would not normally be purchased. Gift vouchers were seen as a personal treat rather than cash, which easily disappeared into the household budget. With almost every purchase experience covered by gift vouchers the value of the reward or incentive programme was enhanced by the feel good factor of the reward. Gift vouchers have also been used to encourage difficult sections of the community such as teenagers and smokers to enrol into programmes that not only help themselves

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but reduce the long term cost to the nation. With the development of the gift card and associated technologies new areas became available with gift malls opening wherever the public had access. These new technologies have allowed reward programmes that are able to top-up the value of the gift card as performance is achieved, giving quicker access

to the rewards and a greater satisfaction to the customer or staff member. Recent technologies have been able to reduce the administration costs of reward and incentive programmes, and reduced the delay between achieving the reward and actually receiving the gift voucher or gift card. By the use of a secure code, which is issued to the staff member and an associated secure website, staff members can activate and select from a vast range of gift vouchers to the value of their secure code, giving the greatest choice possible and as quick a delivery as possible. Gift vouchers and cards can now provide an almost instant reward, incentivising where necessary, rewarding for achievement and as a thank you. And let’s not forget their original purpose, as a gift for Christmas or birthdays. Many of those working abroad or with the British Forces find sending a gift voucher with the word of sentiment the most satisfying method of sending gifts to family and friends. The level of choice, variety of values and methods of delivery really do make gift vouchers and cards the true “Flexible Friend”.

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CONFLICT MANAGEMENT

services. One case is pending prosecution and the audio recording has been used as evidence. All genuine red alerts are monitored by the NHS SMS and details of follow-up action recorded centrally to ensure that each one is dealt with according to agreed procedures. LONG-TERM ADVANTAGES All NHS organisations can recognise the benefits for lone workers but may be slower to acknowledge longer-term advantages of such systems. The NHS Lone Worker Service not only helps staff feel safer and provides a means of summoning assistance if needed; it is also expected to contribute significantly to deterring assaults, as well as providing a means to pursue prosecutions. There is also the potential for reduced costs arising from litigation if trusts can demonstrate they have fulfilled their duty of care to their staff. In recognition of these comprehensive benefits, the NHS Lone Worker Service won the Safer Workplace category of the National Personal Safety Awards 2010. Given by the Suzy Lamplugh Trust, the UK’s national charity for personal safety, the awards celebrate work across the UK to keep people safe from violence and aggression. As well as highlighting best practice, the award was a useful reminder that

even staff based in large, busy workplaces can find themselves in vulnerable lone working situations – something no employer should overlook when conducting risk assessments. COST OF FAILURE The NHS, for one, knows the cost of failing to manage such risks. An NHS SMS report on the economic cost of violence against NHS staff for 2007-08 presented the results of an exercise to measure the costs incurred by the health service as a result of violent physical assaults. It considered direct and indirect costs, such as litigation and damages, staff leaving the NHS and anti-violence policing. The exercise suggested that physical violence against NHS employees cost the NHS £60.5 million during the year. It is a sobering figure and one that explains why, especially in the context of shrinking budgets and plans to increase the number of community-based NHS services, organisations are showing a growing interest in lone worker technology. The NHS Lone Worker Service promotes greater responsibility for staff and its success hinges on user engagement and correct usage. It is important to remember that it is intended for use alongside existing processes and should be viewed as an add-on to regular risk

assessments. There are processes to monitor and manage this centrally but NHS trusts must also be proactive to ensure effective usage. A bespoke training package, developed jointly by the NHS SMS and Reliance, is compulsory for all users. This training ensures that staff understand the limitations of the devices as well as the importance of correct and continued use. This balancing of acknowledged risks and achievable safeguards doesn’t only apply to lone workers but reflects the NHS SMS’s approach to security management more generally. Ensuring that all NHS staff and patients are properly protected means gathering data to assess vulnerabilities and decide where action and resources are best focused. In addition to organisational input, this requires effort at an individual level – whether in terms of reporting incidents, attending training, reading the relevant guidance or making use of appropriate technology. In every area of the NHS, as well as the right to a safe working environment, staff have a responsibility for their own safety, whether they are lone workers or not.

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do you do when a contract fails? You can’t just walk away from it – the dispute has to be resolved. The Centre for Effective Dispute Resolution (CEDR) is here to help. All standard NHS contracts now contain the same dispute resolution provisions: to negotiate, to mediate and to adjudicate. Are you acting in accordance with these provisions and, if so, do you know how to get the best results from each method? CEDR has been nominated by the Department of Health as a preferred provider of these

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THE DIGITAL AGE OF HEALTHCARE Many Trusts and other care providers are exploring ways of capitalising on wireless technologies in order to deliver against the complex and daunting priorities they face, says Jon Lindberg, Intellect Healthcare Programme Manager WIRELESS SOLUTIONS are transforming every aspect of our daily routines. We are increasingly accustomed to interactive, on-thego access to information and immediate communication through a variety of channels wherever we are and whenever we want. The trend, driven by an explosion in consumer adoption of digital technologies, means that care providers are having no option but to consider how best to harness the largely untapped potential of wireless. ACHIEVING THE VISION Andrew Lansley will only be able to deliver his radical programme of reform which he believes

will liberate the NHS if digital technologies can provide patients, clinicians and commissioners with access to the right information at the right time to enable better more informed decision making. With this in mind the government has announced its intention to set an â&#x20AC;&#x2DC;NHS Information Revolutionâ&#x20AC;&#x2122; in motion, one that will pave the way for improved health outcomes, productivity gains and efficiency savings. Information has traditionally been used in the NHS to support diagnosis and manage ill health. But ensuring that patients and clinicians have access to information can help prevent ill health by promoting wellness, healthy lifestyles and understanding about particular conditions.

Wireless technology can enable more efficient and effective collaboration in the clinical environment, allowing people to share important information in new and meaningful ways

If the NHS is to survive the next decade and reinvent itself as a more sustainable entity its emphasis will increasingly need to be on preventive care and the dissemination of knowledge that raises awareness. Information and technology will play crucial roles acting as vehicles for stimulating behavioural change allowing individuals to empower themselves to make informed choices about their own care. SHARING INFORMATION Wireless technology in particular can enable more efficient and effective collaboration in the clinical environment, allowing people to share important information in new and meaningful ways. With new applications supporting the convergence of e-mail, messaging, audio, teleconferencing and telephony on to single devices and platforms, both care professionals and their patients will have more control than ever before about when, where and how they are communicating.

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which enabled ‘real time’ patient monitoring. Similarly York Hospitals NHS Trust utilises its wireless network, mobile phones and EPRs to dramatically improve the patient emergency admission process. Southampton University Hospital Trust has extended its secure wireless network for offsite access which has improved patient care, increased efficiency and improved the reach of its services in remote geographic areas. St Helens and Knowsley Teaching Hospitals NHS Trust became a completely paper free hospital by delivering health records electronically, with information about patients accessed and entered directly onto the system with keyboards, digital pens and mobile devices. Portsmouth Hospitals NHS Trust saves £220,000 a year by using digital pens from PaperIQ and BlackBerry devices that met the requirements of secure, easy to use mobile solutions for its midwives. Ultimately, technologies of this kind need to be developed in collaboration with the full range of care professionals as well as the involvement of patients. And these examples have something in common: the business cases behind them identified the benefits of supporting patient care more effectively, providing flexible service delivery and gaining the support of front line staff. As wireless technology gains traction in the health sector new developments and innovations will continue to feed propositions and make investment more attractive. This momentum will mean that smartphones, tablet computers and new apps will continue to move clinicians closer to the patient at the same time as tech savvy patients are becoming ever more sophisticated information consumers.

This will support the shift in care provision from expensive hospitals and clinics to the community and the home generating cash savings at the same time as transforming the patient experience. BEST PRACTICE Across the UK we’re seeing trusts and other care providers exploring ways of capitalising on wireless technologies in order to deliver against the complex and daunting array of priorities they face. Some have seen significant success, but as is so often the way good stories don’t tend to make the news. For this reason the NHS will need to identify new ways of promoting and sharing stories of success and best practice to demonstrate the benefits of

wireless and mobile solutions, emphasising the productivity and financial gains that demonstrate a clear return on investment. The full benefits of Electronic Patient Records (EPRs) and Picture Archiving and Communication Systems (PACS), for example, can only be obtained with the introduction of wireless solutions that increase the flexibility and mobility of clinicians. MOBILE AND FLEXIBLE WORKING Examples of mobile and flexible working in healthcare settings include the University Hospitals of Coventry and Warwick NHS Trust, who gave software solutions on handheld computers to clinical staff who use these to record patient observations electronically,

THE FUTURE What does the future hold? Unfortunately, or some might say fortunately, none of us has a crystal ball but here’s a quick glimpse of what we might expect to see. The University of Florida has developed a sensor that detects glucose in your breath and which can wirelessly relay this to healthcare professionals. The designer claims just one breath can provide a pH or glucoseconcentration reading in less than five seconds. The Dutch are developing necklaces that take electrocardiogram readings and transmit the data to users’ phones which can then be forwarded to doctors. A California based company is pioneering ingestible chips that can monitor drug dosage and track the body’s response. This “digital medicine” can pass data to your smartphone via a high frequency signal to a patch that’s worn on or implanted in the body.

FOR MORE INFORMATION Web: www.intellectuk.org

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TIME FOR CHANGE? This year’s revision to the NHS Operating Framework has seen announcements on the end of NHS targets and removed or relaxed central monitoring. Does this mean “Business (Intelligence) as usual” for NHS Trusts or could it represent a new opportunity for improvement? TRUST INFORMATION DEPARTMENTS spend much of their time preparing and providing data for external bodies on data they want to measure, using their rules; the infamous ‘Feeding the Beast’. This is a bit like a hotel that focuses on booking procedures and queues at reception; there’s a loss of focus on what people actually want – good service delivery and cleanliness in the rooms. This external focus, often shared by senior managers who have seen their colleagues dismissed for “under performance”, has distracted from the use of Business Intelligence (BI) to help run the business. There has been little time to gather detailed information about what is going on within the trust, to help operational managers with the services they run, or to provide analyses on costs and outcomes. Could the change in central control also see a change in local management? INFORMATION FOR SERVICE IMPROVEMENT Ced Bufton, managing director of Bidetime, welcomes the shift from central target chasing to local outcome monitoring. “There is no doubt that some trusts bought Business Intelligence for target monitoring or for centrally driven initiatives like 18-week waits. But few have really done a lot to widely deploy the information,” he says. “Our key reference sites are now using BI to go deep into their data because they want to use it to deliver a better service. But even they have been distracted by constant changes in NHS targets so the removal of these, and the returns that go with them, is potentially very exciting.” Information analysts have a lot of experience of NHS performance and issues, and they understand what a complex system healthcare is. If they’re given modern reporting and analysis tools that automate the periodic, repetitive processing they can focus on the data they have to start building operational key indicators, show the links between them and examine the utilisation of resources like clinics, beds and theatres and start flexing this capacity to match demand – true performance management. Bufton would also like to see national comparators established that are not subject to frequent change, have a transparent methodology and represent best practice. “Trusts will then know that their own, internal, monitoring will match published outcomes and can start to use them to engage clinicians in improving efficiency and quality. Less political and complex central definitions would also allow use of international experience; surely hospitals are similar all over the world?

International benchmarks and models could also be shared with colleagues outside the NHS.” A SINGLE INFORMATION BASE FOR ALL “I’d also like to see a move away from national initiatives implemented as ‘point solutions’. For example, patient-level costing has helped trusts understand costs but without integration with, and deployment to, operational managers such projects run the risk of repeating the mistakes of past initiatives like management budgeting and resource management. Integrating finance and HR into performance management provides much better insight and allows the identification of unusual patterns of activity and deviation from best practice, rather than just trying to explain why Ward 6 is more expensive than Ward 7,” says Bufton. “National initiatives help establish best practice, do provide some direction and, usually, funding. We’ve been building on these over

for them. They can view analyses and make necessary decisions more quickly than before. A good system also helps the more technically able staff, such as those within the information department, to perform faster manipulation of data for ad-hoc analysis and helps them to respond to more complex enquiries. As well as reporting, analysis, scorecards and dashboards the best tools also include another important element – integrated planning. As well as traditional budget and service level planning, good tools should allow users to model, for example, outpatient capacity against demand. Integration allows staff to see the effect of proposed changes before implementing them, the classic “What if?” It becomes very easy to visualise change through existing reports and to implement changes quickly and easily. In the wider marketplace BI tools are also being enhanced to provide not only

There is no doubt that some trusts bought Business Intelligence for target monitoring or for centrally driven initiatives like 18-week waits. But few have really done a lot to widely deploy the information the years to ‘bend them’ for local operations as well – we’ve built on the collection of events required for PLC costing, not only to examine efficiency but also for clinical practice. And we’ve been using theatre utilisation to provide clinical information as well, like surgical logs.” INVOLVING GPS Another major change is GP Commissioning, not just because it changes the purchaser but also because it involves GPs more intimately in the information flow. Of course the current commissioning processes need to continue, but closer GP involvement in commissioning has led to requirements for interfaces to GP systems, not just to monitor referrals and subsequent secondary care activity but also to help GPs use BI in primary care of patients. We’ve seen our clients developing primary care dashboards for clinical monitoring, for example in heart disease, and also for delivering decision support, for example monitoring cholesterol and dosage and prescribing of statins. Linking primary pare like this will have a major impact on “joined up” delivery of healthcare, Bufton believes. A good BI system will allow managers to self serve so that they are no longer reliant on the information department to run reports

retrospective information but also predictive analytics, spawning a new breed of products for Business Analytics. These add to the “Where are we?” of monitoring and the “Why are we here?” of analysis, allowing clients to see “Where should we go next?” Bufton says: “IBM’s recent purchase of SPSS and its integration into the Cognos toolset means that we’re now able to offer our clients full ‘Predictive Analytics’. We’re already planning to model causes of DNAs and to investigate how prevention could save significant time and money. We’re in the process of building other models, like readmission predictors, into the main trust Information base. It’s a very exciting future.”

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HC 2011 ATTRACTS HIGH PROFILE SPEAKERS Health Informatics Congress, run by BCS, The Chartered Institute for IT, will once again push the boundaries when it comes to addressing the issues facing the health informatics community

CHANGE HAS NEVER BEEN MORE CENTRAL to the providers and users of health informatics services than in 2011. The change of government in 2010 means that this year’s HC conference can’t just be about applying IT more effectively to support health and social care services. It’s more fundamental than that: not only structural change and new policy, but new ways of implementing policy, delivering services, and managing resources. To reflect this, this year’s conference has attracted some high profile speakers, including the Rt. Hon Andrew Lansley CBE MP, Secretary of State for Health, who will address the conference on the opening day. THE IMPORTANCE OF INFORMATION Mike Sinclair, Chair of BCS HC2011 organising committee says: “We are very pleased that a sitting Secretary of State is attending our event for the first time. This reinforces the importance of information and informatics in supporting and enabling the NHS to deal with the challenges and changes that it is now experiencing.” Mr Lansley will be joined by Department of Health CIO Christine Connelly, who is charged with shaping and directing the informatics effort across health and social care. Other keynote speakers for the first day are Matthew Swindells, chair of BCS Health, who will add his perspective as a key player in health informatics for many years, and Mike Farrar (CEO NHS NW), who brings a wealth of NHS management experience, reminding us that strong and clear-sighted leadership will be crucial. The first day’s presentations explore new

policy and the informatics implications. It will include a set of presentations on how value added information services will be sourced in the new environment, led by John Higgins of Intellect. Leaders from four Public Health Observatories in England will discuss and debate the issues of the renewed focus on public health and the relocation of responsibility to the local authorities, and the drive for further integration of health and social care. In addition, a series of presentations in the R&D stream will look at what actually happens when patients get direct access to their records and have more say in their care, and examine the implications for clinical education and culture. A tutorial organised by the Nursing Specialist Group, will work through the implications of practitioners becoming more effective co-users and co-producers of information. The presence of Roy Lilley guarantees a stimulating look at these themes, as they influence new and changing care settings and social care. Leadership is a key theme running through the opening day of the conference, with Michael West following up his well received workshop at last year’s event, and, accompanied by Aidan Halligan, bringing a clinical perspective as well as experience of informatics leadership. John Rayner (director of the Health Informatics Service) and Rachel Munton (director of the East Midlands Leadership Academy), will cover how to make leadership work ‘on the ground’. Personal development is the focus of this year’s ASSIST Annual Conference, which takes place on day two, with professional leaders setting out ways to combine personal success with delivery and performance. Workshops

focused on particular aspects of personal development and effectiveness, will offer the opportunity to sample different approaches. Innovation – in technology, services and organisation – is the key theme for day two. The opening plenary session is guaranteed to get you seeing and thinking differently, starting with a view of the future for public sector IT from James Gardener, CTO at the Department of Work and Pensions. A provoking analysis of what progress really is, and what it means, complements a look at the nature of innovation and the changing role of IT in healthcare – these will be given radical examination by Professors Andrew Stirling from Sussex and Terry Young from Brunel respectively. A major theme of the whole event will be how information requirements will change for both the service, the patients and the public. Two streams will run on day two and day three, culminating in a debate that will form the closing plenary: “How Do We Deal With The Tension Between Opening Up Data And Delivering Effective Services?” chaired by Alastair McLellan, editor of the Health Service Journal, with a panel of leading lights from the DH/NHS, the supplier market, private and voluntary (third) sector and patient and the public representatives. ANTICIPATION There is now a real sense of anticipation surrounding the exhibition at HC2011, with some 90 per cent of companies already secure in their stands. Organisers, Citadel Events and BCS are delighted to see so many companies returning following a successful HC2010, and are particularly pleased to see many new exhibitors, who will be experiencing HC for the first time. To reserve exhibition space contact Dennis Wheatley on 01423 526971. The Career & Professionalism Zone which was launched in 2010 makes a welcome return, with new ideas and initiatives for those wishing to enter or enhance their career in the HI profession. UK Trade & Investment are organising a delegation to attend HC2011 and wish to hear from UK companies with names of suggested overseas buyers to approach to be part of the delegation. Please contact Richard Lewis on richard.lewis@ukti.gsi.gov. uk or 020 7215 4823 with any suggestions.

FOR MORE INFORMATION HC210 takes place from 5-7 April 2011 at the ICC, Birmingham. Conference delegate and exhibition visitor registration is now open at www.hcshowcase.org

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HC2011 – Health Informatics Congress is the UK’s largest, most powerful & rewarding event for health & social care informaticians, ICT professionals & clinicians. A three day conference & exhibition, combined with an innovative range of events & opportunities, is designed to challenge & engage all those working in health informatics & social care, including commercial organisations & other major stakeholders.

HC2011 attracts high profile speakers

HC2011 Exhibition

• The Rt. Hon Andrew Lansley CBE MP, Secretary

• Many new companies will be attending HC2011

of State for Health, will address conference on the opening day • Christine Connelly, CIO, Department of Health • Mike Farrar, CEO, NHSNW Conference themes and topics • New policy and the health informatics implications • Special focus on leadership and professionalism • Implications of patient choice • Personal development and effectiveness • Innovation in technology, services and organisation • Changing face of information and

• Significant numbers make a welcome return based on successful outcomes of HC2010 • Meet high quality, decision making delegates What’s on at HC2011 • Gala dinner, Wed 6 April - ideal networking opportunities • UK Trade & Investment - unique forum for 1-2-1 meetings with international buyers from the ICT healthcare sector • Career & Professionalism Zone -advice around career pathways within the NHS and informatics

communication requirements

Visit the website at www.hcshowcase.org to register and for regularly updated information.

Contact Dennis Wheatley, Sales Manager, Citadel Events T 01423 526971 E dennis.wheatley@citadelevents.co.uk

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NHS Direct offers a tailored online service with health and symptom checkers

HS DIRECT’S improved digital services, developed by Eduserv, provide patients in England with easy access to online health and symptom checkers and are now easy for their web content team to keep up-to-date. NHS Direct were faced with the challenge of improving the tailored health information they provide online. Their previous digital services were time consuming to update and required input from technical staff. The new and improved digital services – based on the leading Content Management System (CMS), Sitecore – incorporate smart clinical decision support tools known as health and symptom checkers as developed by InferMed. These allow patients to check their symptoms and, in the future, will allow NHS Direct to deliver tailored and personalised patient advice depending on the answers given by the user. The online health and symptom checkers have proved highly effective tools for NHS Direct. During the first four months of this service, over three million usages of the health and symptom checkers were recorded. More importantly, 1.5m

A&E attendances and 1.9m GP consultations were avoided last year through patients’ use of NHS Direct’s web and telephone services, helping these vital services remain available for people who really need them. Through reducing attendances at A&E, GP practices and other face-to-face services, NHS Direct saved the NHS an estimated £213m in 2009/10. In addition to this, it is now much easier for staff to update the web services as minimal training is required to use the CMS for publishing new content online.

Stream UK – digital media specialists TREAM UK is the largest independent streaming company in the UK and we offer a range of tailor made webcasting solutions, allowing you to connect with a global audience, whatever the event. Webcasts offer an affordable solution for events to expand the viewing audience to anyone that has an internet connection. In the past Stream UK has webcast a variety of events including conferences, trade shows, training, executive announcements in a variety of locations and venues. Stream Connect, our software as a service product is a complete webcast administration tool that allows you to administer a webcast programme yourself. We also offer an end-to-end webcasting service

covering onsite audio and visual production and live delivery on the Stream Connect interface. Stream Connect has a number of interactivity options if administering your own webcast. The webcast control tool allows you to accurately match slide changes to streams in multiple formats. Stream Connect can also be controlled directly by your speaker, thanks to intergration with Interspace Industries cueing system. Other interactivity options also include questions submission, voting, and chat and intergrated social networking platforms.

FOR MORE INFORMATION Tel: 020 74191820 E-mail: sales@streamuk.com Web: www.streamuk.com

The Sitecore CMS makes for easy integration with other technology such as the clinical decision support tools. It also allows syndication of content so that NHS Direct can share the health and symptom checking content with partners such as pharmacies and charities, who will be able to incorporate it into their own digital services. The NHS Direct web services were developed by Eduserv, a not-for-profit web technology company that specialises in websites for health, education and the public sector. They have previously developed websites for NHS Hammersmith & Fulham and NHS Great Yarmouth & Waveney, and OpenAthens, their Access and Identity Management service, is used by over 250,000 NHS staff to access online health information resources.

FOR MORE INFORMATION See NHS Direct’s web services at www.nhs.uk/nhsdirect or find out more about Eduserv’s web development at www.eduserv.org.uk/hb

The smart way to produce personalised exercise handouts HYSIOTOOLS is the global market leader in exercise prescription software. It is a vast knowledge base of high-quality images combined with expertly authored instructional texts translated into over 20 languages. PhysioTools can be installed on individual computers, on a local fileserver, terminal server or hosted securely on PhysioTools’ own servers accessed through MS Internet Explorer or Mozilla FireFox. PhysioTools is software that taps into the knowledge base in order to create a personalised instructional document that can be delivered on paper or securely to any browser including handheld devices. PhysioTools can be deployed with MS AD and has been designed to be seamlessly integrated with EMR software with a minimum of fuss. It can also be deployed as-is across a

complex organisation while respecting organisational structures and work groups; PhysioTools allows local administrative tasks to be optionally delegated. PhysioTools provides not only quick and convenient access to a vast and growing exercise library – the largest of its kind – but can also facilitate and simplify collaboration within and among departments through fine tuned but easy to use data access controls. In these ways PhysioTools enables promotion of practice standards across an organisation while accommodating needs that vary among departments.

FOR MORE INFORMATION Contact: Gail Milne Tel: 01749 890870 Fax: 01749 890871 E-mail: gail.milne @physiotools.com Web: www.physiotools.com

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Brady Arts and Community Centre 192-196 Hanbury St, London E1 5HU The Brady Arts and Community Centre is the flagship venue for arts and events within the London Borough of Tower Hamlets. Spaces are available for hire for a variety of events. Facilities include a recently refurbished Studio Theatre (with state of the art PA, lighting rig and projection equipment), meeting rooms and fully equipped kitchen. There is also an extensive range of sound, light and ancillary equipment available for hire. The Centre has wheelchair access and is ideally located in Spitalfields, a short distance from Whitechapel and Brick Lane. For further details please contact Reception.

Telephone: 020 7364 7900

william.cooper@towerhamlets.gov.uk

FUNCTION ROOM AVAILABLE FOR HIRE

London

Training Meetings Conferences T: 020 7631 8306 E: conference@pccc.co.uk W: www.pccc.co.uk

magnificent venues stunning artwork in the heart of edinburgh Five magnificent Gallery venues in the very heart of Edinburgh. For corporate dinners, cocktail receptions, meetings and seminars surrounded by the Nationâ&#x20AC;&#x2122;s outstanding collection of art.

CONFERENCES, MEETINGS, WEDDINGS & PARTIES For more information call our events team now on

01708 381108

Hospitality & Events Team T: 0131 624 6239 E: events@nationalgalleries.org www.nationalgalleries.org/venuehire Scottish Charity Number SC003728

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CONFERENCES & EVENTS

DESTINATION WITH A DIFFERENCE Creative conferencing can be found in NewcastleGateshead with world-class festivals and attractions at its heart A REDUCTION IN BUDGETS has been a familiar story across the conference and meetings industry in recent years, yet the value of meeting colleagues, clients and stakeholders to discuss everything from strategy to staff training has never been more vital, and with this the need for creative solutions and value for money is perhaps more in demand than ever before. NewcastleGateshead is a vibrant cultural destination with world-class festivals and attractions at its heart. As a growing destination catering for meetings and conferences of up to 1,700 delegates, it offers top-quality conference spaces and service providers at competitive rates, competing with established brands across the UK and Europe. SPECTACULAR VENUES As well as a mix of museums, galleries and theatres, the compact destination is home to some of the country’s most spectacular, creative, historic and unusual venues, including an international centre for music in The Sage Gateshead, unique contemporary art gallery with BALTIC, and

the Art Deco Tyneside Cinema; all offering a range of experiences for delegates and unusual spaces to hold the perfect event. The bustling urban heart lies just minutes from coast and countryside, and provides meeting organisers with a range of options for delivering high-quality events with that little something extra. Add 2,000 years of history, the famous Geordie welcome, and an award-winning Convention Bureau to the mix, and you’re left with a destination with a difference, an inspiring place set to animate and stimulate brilliant minds. IT’S ALL ABOUT EXPERIENCE Spanning the life-blood of the destination, Newcastle and Gateshead are stitched together by seven magnificent bridges over the River Tyne. In the last decade the destination has built an impressive reputation for delivering high-quality and high-profile corporate, association and public sector events, these have included the three main political parties in England with Labour, Conservative and Liberal Democrats all choosing the destination

for their spring conferences, as well as the leaders of tomorrow with the National Union of Students in 2010 and 2011. NewcastleGateshead Convention Bureau offers free advice and guidance to a range of national and international clients, their local knowledge helping to save conference organisers time and deliver experiences that go above and beyond what is expected from the average conference destination. Famous for its open and welcoming nature, “friendly” hits the top spot for words used to describe the destination in the Convention Bureau’s most recent delegate survey; one delegate even used the phrase “Crème de North!” Just 20 minutes from Newcastle International Airport and less than three hours from London by train, the convenient and well developed infrastructure combines to deliver exceptional events. The compact city centre is well signed with easily accessible mapping making NewcastleGateshead a walkable destination; 95 per cent of those surveyed said the destination was easy to get around, largely thanks to

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TIGHT BUDGET?

TRY OUR EXCELLENT VALUE MEETING ROOMS FROM JUST

£15PP*

Holiday Inn Leeds - Garforth at a glance: • FREE car parking • FREE wireless internet access • Fully equipped meeting rooms from 2-400 delegates • NEW Simply Uplifting menus and buffet alternatives among choice of dining options • Triangle Heath & Fitness Club • Restaurant and bar • Large public areas • Accessible areas To book please call 0113 286 6556 hileedsgarforth.com Holiday Inn Leeds - Garforth Wakefield Road, Garforth, Leeds, LS25 1LH *Prices subject to change and availability, new bookings only. Lead price based on ½ day meeting per delegate.

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 City’s hotels shops and restaurants make our venue a favourite with delegates and conference organisers.

n 2,000m2 primary exhibition space n 4,450 plenary meeting capacity n 18 syndicate rooms n 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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frequent Quaylink and Metro services. Major developments in the creative sector have seen the arrival of international music and art facilities alongside the growth of smaller venues all poised to deliver a unique experience for business and leisure visitors alike. The depth, breadth and variety of activities open to meetings organisers mean that every event can have that little something extra: a staff away day topped off with a drumming workshop at The Sage Gateshead; a training programme with a theatrical presence at Northern Stage; a medieval banquet in the UK’s oldest dining room at Blackfriars; or a grand evening dinner set within the beautiful late Victorian former Co-operative Wholesale Society Headquarters, Discovery Museum. Its Great Hall is a site to behold and an inspiring setting for a magnificent evening. The destination’s rich history is evident on every corner; delegates can enjoy state-of-theart facilities and venues set against the backdrop of wonderfully preserved and reinvented post-industrial landscapes, a concentration of Georgian and Victorian architecture in Grainger Town, which is home to 244 listed buildings, and of course, the iconic Quayside. With its seven bridges this stretch of the River Tyne acts as a monument to the twin cities magnificent engineering feats demonstrated throughout the ages, including the present day with the award winning Gateshead Millennium Bridge. This mix of historic presence, cultural reinvention and openness has seen both the leisure tourism and the conference and meetings industry boom across NewcastleGateshead and North East England. The twin cities attracted 19.28 million visitors in 2009, a 3 per cent rise on the previous year. PLACE FOR BUSINESS When considering an unusual space or creative venue a lack of associated bed space can cause concern. Yet NewcastleGateshead has a wealth of accommodation offers that is set to grow with planned hotel developments from top international brands across 2011 and 2012. Already home to brands including Jurys Inn, Malmaison and Hilton, plans include proposals for Sandman Signature, Sleeperz, Euro Hostel and Crowne Plaza hotels. Taking a chance on an unusual venue can be very rewarding, especially in a destination like NewcastleGateshead where the meetings industry works together to ensure fantastic service right from arriving into the destination, through to checking in at the hotel, and finally, saying farewell to colleagues and new-made friends. THE CASTLE GATE The Castle Gate is a uniquely historic and impressive facility built in 1902 to generate the power for the tram network in Newcastle and Gateshead. After extensive refurbishment, it is now an inspiring venue for

conferences, events, meetings and training. A wide selection of rooms is available catering for up to 500 delegates. The impressive Turbine Hall is the venue’s stand-out space; the striking 18m high vaulted ceiling is truly awe inspiring. The open floor plan makes it the ideal space for exhibitions and larger conferences. NORTHERN STAGE Northern Stage is one of NewcastleGateshead’s best loved arts venues, celebrating its 40th birthday last year. It offers a range of spaces to host meetings and conferences in a creative yet business-like environment. The venue also provides performance spaces capable of presenting anything from poetry readings to awards ceremonies and the efficient and friendly team is equipped to tailor-make packages to suit individual needs up to 440 delegates. TYNESIDE CINEMA Set in Newcastle’s historic Grainger Town, the Tyneside Cinema is your first stop for a stylish and original event. The Tyneside has held a place in the heart of the region for over 70 years as a newsreel cinema and as the city’s main independent cinema; in 2008 it reopened its doors after an award-winning £7 million restoration. All of the cinema’s spaces are filled with possibilities to deliver brand messages across a range of mediums, to host a training workshop or even if it’s just to celebrate. A stylish and exciting venue, it can cater for up to 260 people, and really adds some cinematic magic and Art Deco grandeur to all it delivers. SEVEN STORIES: CENTRE FOR CHILDREN’S BOOKS Recognised as a new national home for children’s literature, Seven Stories celebrates the nation’s best loved children’s books, with an exploration of creativity, literature and art. Housed in a multi-award-winning converted grade II listed Victorian mill in the heart of

the Ouseburn Valley, Seven Stories is just a stone’s throw from Newcastle’s famous Quayside in the heart of the city. Step into a storybook setting, in a unique venue that offers an inspirational location for corporate hire. From small gatherings to larger tailormade events, the team offers fresh and home cooked catering accompanied by friendly and professional staff for up to 100 delegates. RIVER ESCAPES With a fleet of three luxury equipped vessels, the River Escapes Latis, the River Escapes Fortuna and the River Escapes Coventina, a trip down the iconic River Tyne will not only invigorate up to 180 people, it will provide a memorable setting for any event, delivering changing sights of the River Tyne from the best vantage point in the city – the river itself! WANT TO KNOW MORE? A convention bureau should always be the first point of contact for anyone looking to organise a conference, particularly in a place they are unfamiliar with. NewcastleGateshead Convention Bureau is a one stop shop offering impartial, unbiased advice and unrivalled local knowledge about the whole destination. The team offers a wide variety of services, all completely free of charge, including: help to identify the most suitable conference or meeting venue; organisation of site visits; negotiation of rates and securing accommodation; provision of an online delegate booking service; and advice on local suppliers, partner programmes and making the most of the destination.

FOR MORE INFORMATION NewcastleGateshead Convention Bureau will be at International Confex 1-3 March at Earls Court, London; visit them on stand B220, or to learn more about the destination go to www.NewcastleGateshead.com/Meet or e-mail conventionbureau@ngi.org.uk

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PARKING

PARKEX 2011 TAKES OVER THE NEC Parkex 2011, Europe’s largest dedicated parking exhibition organised on behalf of the British Parking Association, will take place in Hall 4 at the NEC Birmingham 29-31 March PARKEX 2011 will once again co-locate with Street Design, the leading event for urban design in the public realm, and Traffex, the leading international trade exhibition for traffic management, road safety and highway maintenance professionals, which will be celebrating its 25th anniversary. Parkex has secured high profile partners representing the parking industry spectrum with the British Parking Association there to promote the best interests of the parking and traffic management sectors, Equita, offering the UK’s largest certificated bailiff service for local authorities, and NSL, providing nationwide parking and transport services. SEMINAR PROGRAMME The popular free-to-attend seminar programme will be back, featuring over 25 CPD accredited seminars in two theatres. Organised in association with the British Parking Association, leading parking experts will give visitors an industry insight into a

year saw a change of government and as a result new approaches to our profession, so now it is more important than ever that we work together to deliver a fair and equitable parking service. Parkex and Traffex offer the best in parking and traffic management both through the exhibition and the excellent seminar programme we have organised.” EXHIBITORS Over 120 leading UK and international companies specialising in on and off street parking, access control, parking management, software, refurbishment, enforcement, training and payment processing will use Parkex as the launch-pad for their latest products and services. Highlights include: Amano will launch Xparc, a fully IP enabled parking solution. Xparc has state of the art design, combined with the use of the latest technologies in software and hardware. The product is based on a fully networked solution using barcode as its basic card technology

Parkex 2011 will once again co-locate with Street Design, the leading event for urban design in the public realm and Traffex, the leading international trade exhibition for traffic management, road safety and highway maintenance professionals, which will be celebrating its 25th anniversary wide range of topical issues for both on and off-street parking. Topics will include: • Public sector partnerships • Private parking – What happens now? • Management and procurement • Environmental/green agenda • University and campus parking • Hospital parking • Managing parking structures • Innovation in parking • University parking case studies • Management of parking on private land • Safer Parking Scheme Patrick Troy, chief executive, British Parking Association, explains the importance of staying up-to-date with the industry: “The parking and traffic management sector continues to grow both in size and profile, and affects every road user in the UK. Last

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and supports full IP integration of video and intercom, which allows the customer to use the Xparc system to fully manage the car park from one system. The software has been developed to offer solutions for customers in most market segments without customisation. Xparc‘s IP solution offers ease of use, flexibility, customer satisfaction and low operating costs. RingGo Corporate is one of the most successful recent additions to the RingGo digital parking portfolio. Local authorities that own and operate parking are heavy users of the service. When authorised employees park in a council bay, they can pay using RingGo Corporate, rather than having the unnecessary cost and administration of paying and claiming back the fee, the session is recorded by the system and costs are allocated internally to the relevant cost

centre. RingGo cashless parking is now offered at 3,000 sites across the UK, covering a quarter of a million parking spaces. 54 local authorities provide the service, including 11 London Boroughs, 13 separate rail operators and major private parking companies. RentAlite is an innovative research and development centre specialising in energysaving projects. Their main focus is new, highly innovative lighting technology specially designed for companies. At Parkex, they will present Premium Power LED (PPL), the robust fixture and power LED in one, made in Europe and the USA. The Premium Power LED is specially developed for parking garages, metro and train stations, airports, etc. RentAlite’s LED fixture saves, on average, 65 per cent on light energy and CO2 compared to a T8 fixture, has a lifetime of over 60.000 hours

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PARKING

Organised in association with the British Parking Association, leading parking experts will give visitors an industry insight into a wide range of topical issues for both on and off-street parking and generates a beautiful light display. SEA will be demonstrating its ROADflow digital, automatic, civil traffic offence enforcement system. The ROADflow product line has three variants – Mobile, Flexi and Fixed. All offer low operational costs, delivering a total enforcement solution by use of the latest GPS, Automatic Number Plate Recognition (ANPR) and imaging technology. ROADflow Flexi will also be on show, highlighting that

customers can choose the most suitable and cost-effective option for their needs. The systems are flexible and efficient and deliver a proven technology that improves road safety, reduce traffic congestion and helps combat environmental crime. Spur Information Solutions (now owned by ACS, a Xerox Company) is one of the UK’s leading providers of software and support services for the management of parking,

traffic and infringement control in the local authority, health and private market sectors. Spur specialises in providing solutions to deal with on-street parking, car park and permit management, handheld ticket issuing, notice processing, CCTV enforcement, hosted services, DVLA bureau and Blue Badge administration. Their enterprise class enforcement software, Si-Dem, is the preeminent notice processing solution in local government, operating in over 100 sites throughout England and Wales, including some of the largest authorities in the UK. Town and City Parking will be demonstrating the latest intelligent parking solution. The system combines a sensor, installed on the surface of each parking bay, with state-ofthe-art RepNet software. The world’s most powerful parking analysis tool, RepNet is fully configurable and can be customised for specific operating environments. Mark Underwood, CEO, NSL, says: “Parkex is the premier event in the parking industry and NSL is again supporting our industry through event partnership at the 2011 event. With major challenges facing organisations, particularly in the public sector, I am convinced that companies like NSL have a huge part to play. Parkex is the ideal event to bring people together to discuss these challenges, find intelligent and innovative solutions, and drive real change that will benefit everyone.” Melissa Jones, sales & marketing manager, Equita, knows the importance of Parkex for the entire industry: “Equita is delighted to be an event partner for Parkex for the third year running. With Parkex being held in conjunction with Traffex at the NEC, I have no doubt that the event will continue to be a success. Our commitment and support to the parking industry and its education within the sector remains as prominent as ever.” MUST-ATTEND EVENT Bill Butler, Traffex 2011 event director, comments: “Following on from the success of the 2009 event, this year we will once again combine Parkex, Traffex and Street Design under one roof. The event provides an integrated overview of the transport, parking and street design sector and is a must-see for anyone working within these industries. “Also, securing influential companies as partners reinforces the importance of Parkex to the industry. Having partners, rather than traditional sponsors, offers companies the opportunity to build a longer term relationship with the private and public sector attendees in the run up to Parkex rather than focusing on just the three open days of the exhibition.”

FOR MORE INFORMATION To find out more and register for a free visitors badge visit www.traffex.com

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ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service 1st 4 solar Abacus Main Acute Ambulance & Medical Services Aid Call Airwave Solutions Alvolution AST Ambulance Service Bidetime Brady Art Centre Brady Corporation Brandon Medical Company Bunzl Healthcare Business Furniture Online Call Systems Technology Capita Group Carefusion CEDR Charity Gift Vouchers Charm Office Solutions Cherwell Software Cineworld Cinemas Clarendon House Hypnotherapy Practice Clean Earth Energy Cordtape Environmental Services Courtney-Thorne Dawson MMP De Montfort University Haigh Eduserv Energy Institute Energy Services and Technology Association

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75 66 28 86 19 16 44 94 100 50 63 67 62 96 85 25 89 88 39 90 10 44 68 12 30 18 64 26 99 75 72

ParAid Medical Fenn Wright Formica Grudon Waste Management Gully Howard Technical HC2011 HID Holiday Inn (Leeds Garforth) HT Direct Training Services Hypnotherapy and Training the Natural Way IT Cleaning James Spencer & Co JJ Food Service KAD Environmental Consultancy K채rcher Lowell Group MCL Energy Mitrefinch Monodraught Msoft eSolutions National Galleries of Scotland Natural Earth Technologies New Generation Parking Management No Fear Nursing Hygiene OKI Printing Solutions Panther Interiors Park Crescent Conference Centre PhysioTools PJ Locums PK Care

40 56 22 56 53 98 18 102 50 47 92 67 79 48 14 20 72 OBC 18 31 100 72 34 89 32 70 60 100 99 82 82

Powermaster (Wakefield) Premier Life Skills P&G Professional Progress Through People Qube Structures Red Procurement Refreshment Systems Rentokil Specialist Hygiene Scottish Power Simply Drinks Southern County Ambulance Services sQuidcard SRCL Stapleford Abbotts Golf Club Systematic Energy Teal Patents Teknomek Industries Terrapinn The Cleaning Show The Finance House TME Electronics TPS Parking Solutions Transaction Analysts Variable Message Signs Volvo Wardworth Willbrook Education Windtronics Yani Montoya Consultants

68 82 4 53 59 18 79 8 68 80 43 20 62 100 74 66 67 59 6 56 26 38 42 36 2 47 54 75 52

“As a consequence of fully implementing TMS, we have realised in excess of £40k of annual recurring cost savings.”

Intelligent Employee Management Time and attendance systems are now widely acknowledged as a key management tool, helping businesses reduce costs, increase productivity and gain greater operational control. With a time and attendance solution in place, you can streamline administration, manage and deploy staff with greater efficiency and gain greater insight into working patterns and behaviours.

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You could eliminate the time consuming manual calculation of working hours, resulting in an average weekly saving of 7 minutes per employee and avoid the miscalculation of time which can account for 1.2% of total payroll costs. Interfacing your existing payroll system would reduce payroll processing time and allow your staff to focus more on activities that bring strategic value to your organisation. Using the extensive reporting features found in more capable systems could transform time and project information into valuable corporate assets; helping you plan and forecast with greater accuracy as well identify inefficiencies and trends over extended periods of time. Your business would ensure it has the right people in the right place at the right time, minimise overpayment and eliminate ‘buddy punching’ which could save you up to 2.2% of your annual payroll costs and, in turn, increase your profitability. With over 30 years time and attendance expertise and over 3,000 customers worldwide from a diverse range of industry sectors, Mitrefinch has established itself as one the leading providers of intelligent employee management solutions. Our solutions deliver immediate results and are proven to provide a return on investment within 12 months, achieved through significant payroll and efficiency savings.

Contact Mitrefinch today and let us demonstrate the substantial benefits we can deliver to your business and introduce you to similar customers who are already benefiting from using our time and attendance solutions.

Online: www.mitrefinch.co.uk/health Email: sales@mitrefinch.co.uk Call: 0845 619 0070