VOLUME 11.9
www.healthbusinessuk.net
CATERING
HB AWARDS
LEGIONELLA
INFECTION CONTROL Vaccinating the NHS front line against flu
ASBESTOS MANAGEMENT – keeping the hidden killer at bay
HEALTH BUSINESS MAGAZINE VOLuME 11.9
www.healthbusinessuk.net
CATERING
HB AWARDS
LEGIONELLA
INFECTION CONTROL Vaccinating the NHS front line against flu
ASBESTOS MANAGEMENT – keeping the hidden killer at bay
Main cover image copyright NHS Confederation
Comment
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
DEAR READER The Health & Safety Executive (HSE) has embarked upon a campaign to get thousands of tradesmen free asbestos awareness training in a bid to tackle ignorance about the hidden killer. The HSE set a target of 4000 hours of face-to-face training to be donated during September – one hour for each life lost to asbestos-related illnesses in an average year. But thanks to an overwhelming response from training companies, the target has been beaten by more than 50 per cent. 7987 hours of classroom training have been offered up along with 5570 web-based hours. As many healthcare facilities use old buildings or have new extensions attached to old sites, there is a significant risk that asbestos is present. On page 31, the Institute of Occupational Health and Safety explains how hospital management has a responsibility to keep staff, patients, contractors and visitors safe from the harmful effects of asbestos. There’s not long to go until this year’s Health Business Awards on 8 December at Emirates Stadium London. If you believe your hospital has achieved great things in healthcare then upload an entry statement to www.hbawards.co.uk by 28 October.
Angela Pisanu
P ONLINE P IN PRINT P MOBILE P FACE TO FACE If you would like to receive 12 issues of Health Business magazine for £95 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:
www.healthbusinessuk.net PUBLISHED BY PUBLIC SECTOR INFORMATION LIMITED
226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: www.psi-media.co.uk EDITORIAL DIRECTOR Danny Wright ASSISTANT EDITOR Angela Pisanu PRODUCTION EDITOR Karl O’Sullivan PRODUCTION DESIGN Jacqueline Grist PRODUCTION CONTROL Julie White ADVERTISEMENT SALES Jasmina Zaveri, Beverley Sennett, Kim Fouracre, Amanda Frodsham, Ren Brannigan, Jeremy Cox SALES ADMINISTRATION Jackie Carnochan, Martine Carnochan ADMINISTRATION Victoria Leftwich, Alicia Oates SALES SUPERVISOR Marina Grant PUBLISHER Karen Hopps GROUP PUBLISHER Barry Doyle REPRODUCTION & PRINT Argent Media
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www.satra.co.uk
Contents
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
CONTENTS 07 NEWS
31 ABESTOS MANAGEMENT
46 FINANCE & LEASING
09 HB AWARDS
Many UK healthcare organisations still have to manage the harmful legacy of asbestos for years to come, writes IOSH
Could more collective buying power between NHS Trusts drive significant NHS savings?
35 ENERGY
49 LEADERSHIP & MANAGEMENT
Have you nominated your hospital for a Health Business Award at Arsenal’s Emirates Stadium on 8 December?
13 CATERING Local hero and celebrity chef James Martin takes on the difficult task of redesigning Scarborough Hospital’s patient and staff menus
15 HEALTHCARE IT How can IT make large savings by improving processes, reducing errors and delivering evidence-based care. Professor Matthew Swindells, chair of BCS, the Chartered Institute for IT, investigates
19 INFECTION CONTROL Brahadeesh Chandrasekaran explores the uptake of decontamination equipment in Eastern Europe NHS Employers has launched the first ever national NHS staff flu vaccination campaign to protect them, their patients and their families, against flu
27 LEGIONELLA The new guidance BS8580 provides a framework to raise quality standards in the delivery of legionella risk assessments
Alan Aldridge from ESTA explains the economic value of energy efficiency programmes
36 INTERIOR DESIGN A well thought-out interior planting scheme in healthcare settings has a value beyond aesthetics, writes Kelly Conway from the British Association of Landscape Industries
39 FACILITIES MANAGEMENT Keith Sammonds, MD, Healthcare Facilities Consortium, looks at cost concerns surrounding private finance initiatives, following recent negative news stories
41 CLEANING The new specification (PAS) 5748:2011 is a tool for Trusts to mitigate the cleaning risks identified in their particular organisation
45 MEDICAL EQUIPMENT The Association for Perioperative Practice explores how technology has revolutionised surgical care
Strong leadership training is vital if the NHS organisation is to produce the world-class managers it needs to deliver effective patient care, urges Mike Petrook, of the Chartered Management Institute
51 PATIENT HANDLING sponsored by Moving & Handling People 2012 will keep visitors informed on the latest health and safety issues surrounding people handling
55 MARKET RESEARCH The Market Research Society outlines how in times of change research can lead to a better informed and more efficient health sector
57 EMERGENCY SERVICES The Emergency Services Show and Conference 2011 is the key event for anyone involved in emergency planning, response or recovery
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News
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
NEWS IN BRIEF New online tools to help patients make more informed health decisions A set of innovative online tools that can help patients make informed decisions about their healthcare has been launched by Health Secretary Andrew Lansley. Eight online Patient Decision Aids (PDAs), commissioned by NHS East of England, give patients information on the pros and cons of different treatment options available to them. As a key product of the Right Care programme, part of the NHS’s work to improve quality, innovation, productivity and prevention, these aids personalise services for patients to make sure they get the right treatment the first time. Developed by NHS Direct and available on its website for patients to use anywhere across England, the online tools help patients learn more about their condition and the options for tests and treatments on conditions such as cataracts and breast cancer. Patients are able to see what choices are available to them, input their personal preferences and have an informed discussion with their clinician about their options. TO READ MORE www.healthbusinessuk.net/n/021
Pilot scheme targets improved dementia care Improving care for older people with dementia has been the focus of a joint pilot project between East Sussex Healthcare NHS Trust and Canterbury Christ Church University. The project has seen nurses, therapists and support workers from the Trust complete a six-day learning programme which covered areas such as understanding more about different types of dementia and how this affects people in their day to day lives, how to communicate to people living with dementia, how unfamiliar environments and stressful situations can influence people with dementia, and how to offer care and therapy that is respectful and dignified. Following the success of this pilot, the Trust is now looking at how the programme could be offered to more staff in the future.
Hospitals score top marks for food Food at Queen’s and King George hospitals, part of the Barking, Havering and Redbridge University Hospitals NHS Trust, has been rated as ‘excellent’ by assessors – the highest possible rating. Scores for Trusts across the UK were published in September by the Patient Environment Action Team. The team reviews key areas including cleanliness, infection control and the patient environment, such as bathrooms, lighting, floors and patient areas. The food section looks at menu, choice, quality, quantity, temperature, presentation, beverages, service and support. The scores see an improvement for King George Hospital, which was judged last year to be ‘good’.
New communications head at DoH Sam Lister, health editor at The Times, has been appointed as the new director of communications at the Department of Health. Lister brings to the department a wealth of experience on health policy and also extensive experience as a senior manager. He is expected to join the department towards the end of the year. Lister was appointed following an open competition under the provisions of the Civil Service Commission’s Recruitment Principles. A Civil Service commissioner chaired the selection panel.
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HEALTH BUSINESS MAGAZINE | Volume 11.9
MENTAL HEALTH
Stephen Fry new president of mental health charity Mind Stephen Fry officially took up his new role as president of leading mental health charity Mind at a gala dinner held at London’s Imperial War museum in September. The dinner, which Fry co-hosted with his predecessor Lord Melvyn Bragg, was held to launch a new, fundraising art exhibition entitled Mindful. Stephen Fry has long been an advocate for mental health issues, producing a documentary about his experience of bipolar disorder in 2006 and fronting Mind’s anti-stigma campaign Time to Change. Fry said: I am honoured and delighted to become the new president of Mind. The mind, like the body, is prone to disease or disorder. We must end the stigma of mental health problems. “The mental health sector is the most amazing place to work at the moment and it is a privilege to follow in the footsteps of Lord Melvyn Bragg. I can only hope to live up to the standard that he has set in his 15 successful years at the helm. The exhibition encouraged people to question their own views on, and associations with, mental illness, while helping to break down the stigma and discrimination so often faced by the one in four people who will experience a mental health problem in any year. Proceeds from the sales of the work started a new fund for local Minds to provide creative therapies, such as art therapy, across England and Wales.
News
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PHARMACEUTICALS
Better access to drugs for rare disease patients Health Secretary Andrew Lansley has announced help for patients with rare diseases, whose doctors may not be able to provide them with unlicensed or ‘off label’ medication. Most drugs are licensed for use in conditions where the drug manufacturers are able to recruit enough patients into clinical trials and where they will yield enough sales to justify running the trial. This presents a consistent problem for patients with rare diseases, whose access to medication is limited because not enough patients are available to run a clinical trial. Similarly, NICE cannot normally appraise drugs outside their licensed indication, which means they cannot be recommended for use on the NHS. At local level, the NHS often does not have the evidence it needs to make an informed decision. Evidence on the scale of the problem is limited, but it is estimated that around 1,000 specific requests for off-label drug use are made to NHS commissioners in England every year. Many rare conditions can be treated with drugs outside their licensed indication.
NHS ESTATES
Surplus NHS land strategy published
The Department of Health has published its strategy to accelerate the release of public sector land to help local communities and the NHS. Health Minister Simon Burns said: “There is potentially over 430 hectares of surplus land within the NHS estate which is not being used for patient care or to benefit the local community. This is equivalent to over 600 football pitches which could provide an estimated 11,000 new homes. “This represents a huge cost when mapped out across the NHS which is why we need to be smarter with our resources. Selling underused land means that the NHS is able to reduce its costs and reinvest money into front line NHS care, whilst the available land can benefit society and go towards building new homes. A more productive and modern NHS is vital if we are to create a health service that is sustainable, cost effective and can cope with the increasing demands in the future.” The strategy is available for viewing on the Department of Health website.
Examples include rarer cancers and autoimmune conditions. Unlicensed or offlabel drugs may also be considered for some patients with more common conditions. Under the plans, the Department of Health will commission expert assessments of the evidence on the use of off-label medicines,
including in rare conditions. These assessments will be designed to inform doctors’ decisionmaking and patients’ choices, not to provide a yes or no recommendation. TO READ MORE PLEASE VISIT... www.healthbusinessuk.net/n/022
MEDICAL RESEARCH Research partnerships set to improve patient treatments and boost economic growth The government has launched the first two National Institute for Health Research (NIHR) partnerships for early stage health research. The research will usher in a new era for clinical trials – accelerating the development of innovative treatments from the lab to patients, as well as providing a real boost to the growth of the life science sector. The NIHR translational (early stage) research partnerships will allow NHS, university clinical researchers and life science companies to work together to focus on inflammatory respiratory diseases like asthma and jointrelated inflammatory diseases like arthritis. The companies will be able to discuss their early breakthroughs with some of the country’s world-leading scientists. This new collaborative approach will give new therapies the best
possible chance of rapidly advancing into treatments for major health conditions. The partnerships will attract investment from pharmaceutical companies in these important areas of health, by providing access to a unique network of top clinical scientists in government-funded research facilities, leading universities and the NHS. These combine world-class research expertise, technologies and infrastructure, as well as cohorts of well-characterised patients. The government is providing £1.3 million to the partnerships to help set them up. This is one of the key commitments in the government’s Plan for Growth, published in March 2011. TO READ MORE PLEASE VISIT... www.healthbusinessuk.net/n/023
COMMUNICATION Foreign doctors must prove ability to speak good English All doctors who want to practise in the NHS in England will have to prove they can speak a good standard of English before they are allowed to work, under strict new rules. The new proposals will ensure that patients and doctors understand one another. Currently only doctors from outside the European Economic Area (EEA), for example, doctors from Pakistan, Canada or Australia, are
routinely scrutinised for their language skills before being able to register with the General Medical Council (GMC). European law prevents the GMC from vetting the language skills of doctors from within Europe. The Department of Health will give the GMC explicit new powers to be able to take action against doctors when there are concerns about their ability to speak English.
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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Estates & Facilities Innovation Award As an organisation dedicated to providing quality value for money Facilities Management Solutions, management support services and software to healthcare professionals working in Facilities, Estates and related functions the Healthcare Facilities Consortium is proud to again sponsor the Estates and Facilities Innovation Award through its Focused FM brand. Information & management support for FM professionals Focused FM provides a wide range of subscription benefits covering such areas as policy in the exclusive FM Document Exchange, run the leading NHS FM Benchmarking service, works with its partners and associated companies to provide software solutions and services, hosts the longest running FM conference, along with one day seminars and training courses and also runs an online TV channel ‘Focused FM TV’ with exclusive interviews from leading Healthcare Professionals.
By subscribing to Focused FM it is estimated that a healthcare organisation can save up to ten times their subscription fee per annum.
Tel: 08450 349645 Email: info@focused-fm.co.uk Web: www.focusd-fm.co.uk
• • • • • • •
Subscription includes: FM Document Exchange the benchmark collection of policies and procedures worth in the region of £2m The leading Health FM Benchmarking Services FM themed day events and seminars for networking with colleagues Regular e-News bulletins with all the latest developments within Focused FM Access to exclusive subscriber discounts on an extensive range of FM related services and products A delegate place at our long running FM themed Flourishing FM Conference Open to all healthcare provider organisations with Commercial, Corporate and Personal subscriptions also available for those allied to healthcare … with new subscription benefits being added
EVENT PREVIEW
HB Awards
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
REWARDING INNOVATION IN HEALTHCARE With the media all too quick to focus on the perceived failings in the NHS, the Health Business Awards focus on the many examples of innovation, dedication and teamwork evident in the sector Being held on 8 December at Arsenal’s Emirates Stadium, the Health Business Awards will recognise and celebrate the significant contributions made this year by organisations that work inside and alongside the NHS. Hosted by BBC presenter Juliet Morris, the Award categories incorporate technology, human resources, hospital management and transport, as well as the Outstanding Achievement in Healthcare award, which is presented to an NHS organisation that has achieved success and brought benefits to the wider NHS through its dedication and expertise. Airedale NHS Foundation Trust scooped the Award for Outstanding Achievement last year. Airedale achieved Foundation trust status in June 2010 and continues
to deliver an outstanding level of care for patients across West Yorkshire. The Trust was recently commended at the National Patient Safety Awards for two projects, which involved data collection and surgical safety briefings. In November last year, Airedale was named ‘Small Hospital Trust of the Year’ in the Dr Foster Hospital Guide for the fourth time in the last five years. SAVING ENERGY Chesterfield Royal Hospital NHS Foundation Trust scooped the Environmental Practice Award last year for tackling 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. The Trust has also implemented phase three of the Carbon Trusts’s Carbon Management Scheme. The winner of the 2010 Sustainable Hospital Award was Guy’s and St Thomas’ NHS Foundation Trust, for its use of an innovative Combined Heat and Power (CHP) system. The CHP 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, Guys & St.Thomas was the first hospital trust to be granted the Mayor of London’s Green500 Platinum Award for outstanding accomplishments in carbon reduction. E
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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HB Awards
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
High-end security solutions from Nedap Nedap’s security management system – AEOS – is one of the most comprehensive amongst the leading high-end security solutions on the market today. Being the first to introduce IP-based and web-enabled integrated security management solutions, AEOS raises the bar even further by incorporating functionality for future trends and requirements. Years of experience and an impressive track record of high-end applications have by now turned new and innovative developments into proven technology. Every day, Nedap security management systems are used by millions of people in banks, airports, hospitals, governmental buildings and industrial facilities
in countries all over the world. Always the first to apply the latest technology, Nedap has built a solid reputation as a recognised leader in the field of high-end security systems. Nedap – founded in 1929 and employing approximately 660 people world-wide – is a solution oriented, knowledge based organisation with an extensive range of products, systems and services. The company is built upon innovation, entrepreneurism and highly successful cooperation with our customers. FOR MORE INFORMATION Tel: 0118 9821038 Mob: 0773 6956498 www.nedapsecurity management.com
Bond Air Services Ltd – providers of emergency helicopter services Bond Air Services, part of the Bond Aviation Group of companies, is one of the largest, most experienced helicopter service providers in Europe. The company operates 26 rotary aircraft in a variety of testing roles and environments ranging from air ambulance operations to police air support, from light house support to offshore wind farm operations. In the UK there are 33 air ambulance helicopters, 18 of which are operated by Bond. Bond introduced the first of these air ambulance operations in 1987 in partnership with the Cornwall Ambulance Service. ‘First Air’ involved the provision of a dedicated Bolkow BO105DB, that had been specially modified for air ambulance operations and it paved the way for air ambulance operations as we know them today. Over the years, Bond, together with its customers,
have developed standards and best practices that are now commonplace across the world. With a focus on availability, no other operator comes close in delivering the levels of uninterrupted service necessary from such a crucial service. Looking to the future, Bond continues to strive for excellence, in search of continual improvement and the development of pioneering standards that benefit this critical emergency service and the people misfortunate enough to have to need it. FOR MORE INFORMATION Tel: 01452 856007 enquiries@bondairservices.com www.bondairservices.com
Learn how to communicate better with patients for better healthcare at a Dialogics workshop If you could listen in when your patient describes your latest meeting to his or her partner, what would you hear? “They really understood what I was talking about and helped me see what might be the matter. It’s complicated but they explained it so clearly and made sure that I’d got it. I feel so relieved – even though my condition is more serious than I thought.” Or might it be something like this: “They’re very busy so I didn’t get much time. I don’t think they really know what’s going on. I tried telling them but they just said it’s something else. I don’t really know what it is but I’m pretty cut up about it.” I’m sure you have total confidence in the professional knowledge of your service’s health professionals. But are you equally confident about their abilities as communicators? After all, knowledge is only part of the skill set. Just as important is being able to interact well with patients on a human level. The two don’t necessarily go hand in hand. Good two-way communication between a patient and a health care professional isn’t just nice to have; it’s been shown to improve health outcomes. Patients who are anxious, stressed or angry can be difficult to
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HEALTH BUSINESS MAGAZINE | Volume 11.9
work with and it takes a level of advanced communication skills to get these patients actively involved in their own healthcare. ‘How To Listen So Patients Will Talk And Talk So Patients Will Listen’ is a workshop that equips healthcare professionals with the enhanced interpersonal skills needed for great patient communication. Based on the work of professor Gerard Egan, author of the world’s most widely used counselling psychology textbooks, the workshop reveals a range of techniques for having productive conversations, no matter how complex or challenging the issue. For example, we show how asking
questions is often not the most effective way to help patients express their concerns clearly and fully. In fact, asking the wrong kinds of question can easily close patients down. We show how an approach based on prompting and empathic responding is far more effective. Since doctors and nurses need to be clear communicators as well as great listeners, the workshop also reveals ways to eliminate misunderstanding on the patient’s part, particularly when the subject is complicated or emotionally charged. The principles and practices delivered by the workshop are equally valuable in communication across teams of colleagues. The workshops take place at your setting or a convenient nearby location and are suitable for all levels of staff, from consultants to healthcare assistants. They are highly interactive sessions combining theory and practice so you will leave with a new set of skills you can put to use immediately. FOR MORE INFORMATION Contact us now to book a workshop for your service. Tel: 020 8960 6069 dialogue@dialogics.com www.dialogics.com
HB Awards
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Award categories Air Ambulance Service Award sponsored by Bond Air Service Ambulance Trust of the Year Environmental Practice Award Estates and Facilities Innovation Award sponsored by Focused FM Healthcare IT Award Healthcare Recruitment Award E THE IMPORTANCE OF NUTRITION The Hospital Catering Award is presented to the NHS Trust that has strived to improve the standard of food and its nutritional value for the benefit of both patients and staff. Last year’s winner was Royal Bolton Hospital NHS Foundation Trust which regularly receives compliments for its varied and healthy menus. 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. TECHNOLOGY The Healthcare IT Award recognises an organisation that is responsible for implementing a ground breaking IT project that demonstrates clear cost benefits to the wider NHS. Last year’s winner was St Helens & Knowsley Teaching Hospitals which completed a project to deliver health records electronically and has stopped using paper records in operational practice. Following a 22 month roll out, all 27 hospital departments have now gone live with over 500 clinicians and 130 medical secretaries now 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. Meanwhile, the IT Innovation Award is presented to the most innovative introduction of new technology for storing, retrieving and distributing data throughout the NHS. The 2010 winner was Great Western Hospitals NHS Foundation Trust for its Pharmacy Robots project. 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. ASSISTED LIVING The Telehealth Award recognises the organisation that demonstrates the most innovative use of information and communication technology to deliver health services, expertise and information over distance. Newham’s two year research project Whole Systems Demonstrator was last year’s winner as it allows residents with long term health conditions to be assisted in their own homes. Some 400 patients are being monitored. Each is 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 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. Hospitals across the country can enter their projects in the 17 categories. Entry is free of charge and requires a 500 word statement to be submitted online before 28 October. L
Hospital Building Award Hospital Catering Award Hospital Cleaning Award sponsored by Admiral Cleaning Supplies Hospital Procurement Award Hospital Security Award sponsored by Nedap Security Management IT Innovation Award NHS Publicity Campaign Award Outstanding Achievement in Healthcare Sustainable Hospital Award Telehealth Award Transport & Logistics Award
FOR MORE INFORMATION www.hbawards.co.uk
The Healthcare IT Award recognises an organisation that is responsible for implementing a groundbreaking IT project that demonstrates clear cost benefits to the wider NHS. Volume 11.9 | HEALTH BUSINESS MAGAZINE
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MENU DESIGN
Local hero and celebrity chef James Martin has taken on the difficult task of redesigning Scarborough Hospital’s patient and staff menus. With support from catering manager Pat Bell and her team, early indications suggest the project has been a success Hospital Food is a topic close to James Martin’s heart. He reveals: “Watching my grandmother dying in hospital was heart-wrenching. Here was someone who cooked every day, who taught me how to cook and was the most amazing influence on my life – and I saw her practically starve because of the food.” BBC’s Operation Hospital Food, which aired during August and September this year, saw Martin trying to tackle the many problems facing catering teams in hospitals across the UK. These include the cost of meals, patient feedback, and nutritional standards. Martin worked alongside the catering team at Scarborough Hospital to create a new weekly menu, which has now been rolled out to patients and staff. Feedback has, so far, been positive. It is worth noting that the catering team only has a budget of £3.49 per person per day to play with. In an ideal world, they would love to be serving seabass, but one portion would use up the budget for three meals. PAT’S NEW PLACE The hospital restaurant was also refurbished and renamed ‘Pat’s Place’, after catering manager Pat Bell, who has worked at the hospital for 21 years. She commented: “I don’t think that James knew what he was getting himself in for. However, our staff have worked tirelessly in order to introduce a brand new menu that not only offers patients more locally grown seasonal food, but food that meets their nutritional needs as a hospital patient.” A patient and staff survey produced comments including ‘wonderfully prepared and creative food’ and ‘compared to other hospitals the food standard is very good.’ So far, it would seem that the efforts of Martin, Bell and the staff at Scarborough have been fruitful. Bell continued: “We are delighted to see staff eating in the restaurant that we haven’t seen for years.” Martin, 39, was brought up in a farmhouse in Yorkshire. After being ‘Student of the Year’ for three years running at Scarborough Technical College, he was noticed by top chef Anthony Worrall-Thompson and went to work
in his Kitchen in London. He then honed his skills in France, before returning to the UK to become head chef at the Hotel and Bistro du Vin in Winchester. Here, Martin changed the menu every single day, and the restaurant enjoyed an eight week long waiting list. FOOD AS A MEDICINE A stellar television career soon followed with frequent appearances in Ready Steady Cook and Saturday Kitchen, the show which he now heads up. His first book, Eating in with James Martin, proved popular and was followed by The Deli Cookbook, Great British Dinners, Easy British Food and the Great British Winter. A BBC TV series focusing on desserts, Sweet Baby James, was backed up by a best-selling book, and aired in 2008. Earlier this year, James took the decision to have a go at improving hospital food, a feat
attempted by many, including Lloyd Grossman. Four hospitals turned the idea down, worried about negative press, before Scarborough agreed and the BBC’s ‘Operation Hospital Food’ aired in August and September in five parts. On hospital food, Martin commented: “I see food as a medicine. It’s an essential part of the healing process. I think everyone’s got a story to tell when it comes to hospital food.”
Photos courtesy of BBC/SplashMedia
MARTIN STARS IN SCARBOROUGH’S MENU MAKEOVER
Catering
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
PRODUCTIVE WARD PROJECT Mike Proctor, chief executive at Scarborough and North East Yorkshire Healthcare NHS Trust, said: “Over the past few months our catering, dietetic and procurement teams have worked tirelessly alongside James. As part of the Productive Ward Project we are also looking at our approach to how food is served to patients and what we can do to improve the process to provide a more holistic approach, reduce wastage and improve the patient experience.” Catering manager Pat Bell concluded: “We have been very touched by the positive comments that we have received following the airing of the programme.” L
“I see food as a medicine. It’s an essential part of the healing process. I think everyone’s got a story to tell when it comes to hospital food.”
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Healthcare IT
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
90 per cent energy and Electronic whiteboards from Deep Red Technology cost savings with Silent Cubes from GID-Quantor Finalist for the 2011 E-Health Insider awards category, ‘Innovation in healthcare interoperability’ for its implementation at Trafford General Hospital, the electronic whiteboard software solution by Deep Red Technology provides a highly customisable, user friendly and cost-effective information portal for use in hospital wards. By unifying the data held in disparate administrative, clinical and departmental applications the boards give users a single focal point for information that can be customised to each ward or even to an individual’s needs leading to significant cost, time and efficiency savings for all staff roles. Clinicians can use the boards to plan their rounds, quickly view alerts about patients, such as infection control warnings, and store fully audited notes and custom data elements that core systems may not cater for, e.g. a realtime ward dependency score.
Simultaneously, bed managers can monitor metrics like patient length of stay and track delays in discharges after the patient is declared medically fit. The whiteboards can also interface back to the core applications meaning users can quickly perform tasks such as bed transfers without multiple logins and repetitive patient searches. This single interface can improve the accuracy and punctuality of clinical and administrative data leading to smarter decision making in all areas. FOR MORE INFORMATION Tel: 0845 0946378 info@deepredtechnology.co.uk www.deepredtechnology.co.uk
Microsoft Word for clinicians – we’ll fix your documents Writing patient reports and letters is time-consuming and can be frustrating wrestling with Microsoft Word. Our custom Word templates and tools greatly speed up document production and deliver accurate, good-looking documents. Features include: • Documents automatically populated with patient information read from databases • Content inserted from your personal library or a shared library of standard paragraphs Our message is that there is no need to retype any data that exists elsewhere – we make it easy to locate and import that information. Added to that we set up your base templates using Word best practice to create documents that are reliable, easy to use and carry your brand image and logos. We have created a number of clinical report systems in use around the world. These produce detailed documents very quickly and are a huge
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boost to productivity. 17 years experience working with the world’s largest and most successful companies gives us a proven track record – we will exceed your requirements and expectations. There is nothing we don’t know about Word and how to get the best out of it. We’ll happily troubleshoot your Word problems and unlock the full potential of Word in your organisation. FOR MORE INFORMATION Tel: 02380 740990 info@cdev.co.uk www.cdev.co.uk
HEALTH BUSINESS MAGAZINE | Volume 11.9
GID-Quantor is part of the G.I.D. Group that also has operations in Europe and North America supplying information management and data archiving solutions. Our very latest solution is Silent Cubes and is already in daily use at over 60 hospitals/medical centres in Europe for archiving PACS, patient medical records and e-mails. The system is designed to provide the very highest possible security for long-term data storage. It is disk based and offers IT management a very different but non-proprietary solution with which to tackle the challenge of ever increasing volumes and longer data retention periods. A single Cube of less than 1 cubic foot can store up to 16 terabytes and the system is scaleable from just 2 terabytes to thousands (i.e. petabytes). Compared with other data archiving options, Silent Cubes is lower in cost and delivers up to 93 per cent
savings in energy costs and associated carbon footprint. Another of our business solutions is OnBase from Hyland Software Inc. which, using its Application Enabler facility, can deliver ECM and document workflow to users by ‘image-enabling’ their existing LOB applications. OnBase is used extensively within healthcare in North America and already by a number of healthcare providers in the UK. FOR MORE INFORMATION Tel: 01444 882258 Fax: 01444 882282 info@gid-quantor.co.uk www.gid-quantor.co.uk
Off-site backup solutions from Backup Data Ltd Most businesses have a backup in place, but how many have the correct protocol or test both the backup and the restore process? Peace of mind: No one likes to contemplate a catastrophic failure, but if you have one, we will get you back in business as soon as possible. We offer a complex solution mix; virtualisation of your computer resources on central NAS / SAN storage with block replication to a secure data centre, where your virtual environment is rebuilt. Off-site backup to data centre in Cambridgeshire is a must. Local backup (especially to a local drive of the same server) can be very dangerous. We use very good software - which you can either purchase from us, or simply rent. We offer online backup for the United Kingdom, Switzerland, United States – solutions for everyone, from personal backup to big corporations, here we are quite specific. You will be
invoiced only for space you have used, unlike other online backup companies which sell space in pre-determined chunks of 5GB or 50GB. Depending on location you can use open source / free software of your choice, or you may simply synchronize on daily basis. We do not offer free space because we send data not to the cloud, but to secured locations. All data is encrypted during transmission time and in storage. An annual, bi-annual or monthly test restore will prove that the backup of data and system is working as it should. FOR MORE INFORMATION Tel: 0844 5424 500 support@backup-data.net www.backup-data.net/
HEALTHCARE SYSTEMS
Healthcare IT
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
THE RIGHT REMEDY FOR HEALTHCARE EFFICIENCY
With the scrappage of the previous government’s ‘failed’ information strategy, the ball is back with local health service managers to determine what they want to do with information technology, argues Professor Matthew Swindells, chair of BCS, the Chartered Institute for IT The word ‘fail’ may be harsh when Spine and Choose and Book are widely regarded as global prototypes and NPfIT investment has helped transform a bunch of very good GP systems into comprehensively deployed world leaders. And the word ‘scrap’ may be inappropriate when the aforementioned Spine and Choose and Book will rightly continue and there is no clarity about what happens to the remaining years of the LSP contracts. However, what is clear is that the vision of digitising and sharing medical records across all the hospitals in the country has not materialised, with only a few dozen making substantial progress. The decision NHS leaders need to make is whether, given the history of the national programme, should they now focus on information technology locally or forget about it until a quieter day. PRODUCTIVITY The impact of the global recession on NHS funding has placed the Quality, Innovation, Productivity and Prevention (QIPP) programme at the top of every chief executive’s agenda. The reduction in real funding growth, from a historic four per cent per annum, and a recent seven per cent per annum to zero will be very painful. In the past ten years productivity has only improved in two of those years (2005/06 and 2006/7) and the Secretary of State was booed at the Royal College of Nursing Annual Conference. Therefore, unless the NHS reverses its typical behaviour, we can expect a deficit of up to £20bn in five years and/or quality and service failures. Furthermore the key drivers of cost inflation in the NHS are relentless. Technology is getting more expensive, lifestyles more sedentary and the population continues to age. A Dutch study in 2006 showed that a 90 year old consumes ten times as much healthcare as a 50 year old. An American study from 2003 shows that the over 75 population costs 5.65 times as much in healthcare costs as the 34-44 year old cohort. In the UK the number of people over the age of 65 is forecast by the Government Actuary Department to grow from 10 million to 15.5 million between 2010 and 2030. If the NHS is to face up to this challenge, some of its great assumptions will need to be overturned. The NHS holds it to be axiomatic that cost is a function of quality and access.
If funding falls, either quality must fall and/ or access must be reduced, either by longer waiting or rationing the services offered. No other industry could take this attitude. Yet, the data shows that this cannot be true. Through the power of benchmarking we can see that the in-hospital mortality rate for an emergency stroke admission varies four times between the best and worst hospitals in London, six times for an acute aortic aneurism and ten times for a heart attack (2005 data). If you compare this superficially to the apparent financial standing of the organisations concerned, there appears to be no correlation. If you take a slightly more scientific approach and plot it against the reference cost index for intensive care, you again see no correlation. And, if lifted to a much more strategic level, the Dartmouth Health Atlas in the US has demonstrated year after year that there is no correlation been higher health spending and better outcomes; it depends how you spend the money. IT TO THE RESCUE So, if the assumption that cost and quality are intrinsically linked is flawed and the data suggests that it should be possible to reduce costs and improve services in many organisations, what approaches might work? By looking more widely than health you can see that industries which have transformed their productivity, have generally applied one of two approaches. Either they have shifted their workforce to part of the world with lower labour costs – not a strategy available to the average general hospital; or they have applied information, technology and process redesign to transform the way they do business. If the NHS is to emerge from this recession as a stronger, fitter institution, not decimated for the 21st century, it must deliver what the National Programme failed to do – the deployment of information and technology to create a better, cheaper NHS. This paper looks at the potential to use information technology in hospitals to simultaneously raise quality and cut costs by improving process flows, safety and the application of evidence-based care. In the interests of focus, the use of technology to transform a health system deserves an article of its own.
IMPROVING PROCESS FLOWS Too much of the NHS has suffered from the delusion that IT systems would in some way fix underlying operational problems in their organisations. As a consequence, the NHS has computerised an awful lot of bad process and proved conclusively that if you lay expensive technology on top of poor process, you simply get expensive, poor process. However, used as a tool to support the transformation of organisational processes, information technology can be the vital ingredient. Algorithms such as those developed by Oak Group in their MCAP tool and McKesson in Interqual have been widely used in retrospective reviews and shown that, in most hospitals, between 25 per cent and 40 per cent of the patients could be cared for in a lower intensity setting. But, real change will only come when these algorithms are built into an electronic patient record and can impact on real-time decision making. As the NHS focuses on reducing length of stay and inappropriate admissions, it seems reasonable to assume that the sickness level of those patients still in hospital will go up. Therefore, as wards are closed, the staffing levels of those remaining may need to rise to reflect the changing case mix. Tools such as Clairvia’s workforce tool, when integrated into an EPR, can reflect the acuity of the patients on a ward in the recommended staffing levels allowing a safe and efficient balance to be maintained. Studies show that a significant proportion of a nurse’s time is spent documenting the status of patients. In large part, this is no-longer necessary. Tight integration between devices and an EPR reduces errors and saves time. But these and many other opportunities to use technology in health to transform working practices have been known for a long time. They have always foundered on the size of the change management challenge and the difficulty in driving out the costs. Technology needs to do more than allow a hospital to become efficient if there is to be general acceptance. IMPROVING SAFETY The cost of errors within the NHS is widely understood, but little has changed. Adverse drug reactions account for some three per cent to five per cent of all hospital admissions and cost the NHS £500m per E
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E year. The National Patient Safety Agency estimated the cost to the NHS of medication errors in 2005-06 at £750m per annum and reported that between 2005 and 2007 the number of medication incidents reported had doubled and that at least 100 patients are dying or suffering serious harm per year. IT based closed-loop medicines management has been shown capable of having a dramatic impact on this. A study led by David Bates MD, chief of General Medicine at Boston’s Brigham and Women’s Hospital, demonstrated that Computerised Physician Order Entry (CPOE) reduced error rates by 55 per cent. Rates of serious medication errors fell by 88 per cent in a subsequent study by the same group. The prevention of errors was attributed to the CPOE system’s structured orders and medication checks. Another study, conducted at LDS Hospital in Salt Lake City by David Classen MD, demonstrated a 70 per cent reduction in antibiotic-related ADEs after implementation of decision support for these drugs. The NHS is just beginning to realise the potential role of medicines management in challenging the cost-quality paradigm. But, there are still only a handful of hospitals like Newcastle, which have gone down this route. Medication is only one area where harm is inflicted on patients and the cost wasted through error. Everyone in hospital knows about the risks of transcription errors, hand-over errors and the simple failure of communication in a complex organisation. Technology can transform this and deliver quality and cost savings simultaneously. EVIDENCE-BASED PRACTICE The benefit to the patient and the budget from delivering evidence-based care is well known and it is here that the power of information technology offers the greatest potential to transform medicine and the cost and quality of healthcare. Numerous studies show that evidence-based care is cheaper and better. Here are some examples.
A study in the US hospital chain Ascension Health, looking at evidence-based practice in the treatment of pneumonia between 2000 and 2005 considered 25,000 patients treated on an evidence-based pathway, and 35,000 who were treated outside of the pathway, and demonstrated that: • Patients on the pathways had a five per cent to seven per cent mortality rate, compared to a nine per cent to ten per cent mortality rate for those not on the pathway • Length of stay was around six days compared to seven days • Average cost case in the final year of the study was $4,721 compared to $6,841. At the high-tech end of healthcare, a study into the cost effectiveness of evidencebased treatment guidelines for the treatment of non-small-cell lung cancer in the community setting showed that on the pathway the annual cost of care was around $15,000, whereas off pathway it was more like $25,000 without altering the overall morbidity or mortality in patients. The difficulty is ensuring that evidence-based care is followed when the NHS still delivers ‘memory-based care’. W Stead wrote in 2005 that a doctor who finished medical school and residency knowing everything and from that day onwards read and retained two articles a night would find themselves only 1,225 years behind after 12 months. This is why, as highlighted in the Yearbook of Medical Informatics in 2000, the time taken for half the doctors to have incorporated a new piece of knowledge into their practice is 15-17 years. It is beyond unreasonable to expect clinicians to always know what current best practice is and impossible for a paper and memory based system to ensure that all the members of a care team know the care pathway they should be using and follow it. Only information technology can provide the support that clinicians need, and studies are clear about what works. A study published in the BMJ in 2005 showed that the provision of decision support significantly improved clinical practice in 94 per cent
of cases and that ‘automatic provision of decision support as part of the workflow’ is seven times as effective as the second best approach – ‘provision of decision support at the time and location of decision making’ (not embedded in the workflow). The most advanced EPR systems do not just give access to evidence-based guidelines, they push it into the workflow at the crucial moment. And some are able to go even further than that, moving beyond embedded decision support to real time monitoring of patients. 2010 saw Cerner launch its Sepsis detection system – an evidence-based, real-time algorithm that monitors all patients and brings together the latest vital signs with historic diagnoses and recent organ dysfunction data to determine whether the doctors and nurses should be warned that a patient is about to go into septic shock. Time is of the essence for the clinical intervention, and here the IT is helping the clinical team avoid a medical disaster and helping to reduce the long-term cost of care. HEARTS AND MINDS So, at a time of complex challenges facing the NHS, the service needs to adopt a bold strategy. A productivity gain of 20 per cent will not come from a series of paper cuts, it will only come from a fundamental reengineering of the way medicine is practiced. We know that very large savings can be made by improving processes, reducing errors and reliably delivering evidence-based care. We know that information technology can not only help achieve these changes, but that they cannot be achieved without information technology. Therefore, the NHS leadership, clinical and managerial, needs to be bold enough to say they love the NHS enough to make it change and that means transforming working practices and embedding information technology deep into the day to day working of hospitals. FOR MORE INFORMATION Web: www.bcs.org
JAC – the UK’s leading supplier of medicines management solutions JAC provides pharmacy stock control, e-prescribing and medicines administration as a single integrated solution along with ward-based automation technologies for the safe & secure storage of medicines and medical equipment. With the largest installed base of Electronic Prescribing and Medicines Administration systems in UK hospitals, the JAC solution improves patient safety by reducing prescribing and administration mistakes that could result in medication
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errors and adverse drug events. EPMA also facilitates wider improvements in clinical practice, including: reductions in paperwork and transcriptions; improved audit trails for medication; performance monitoring and intelligence; reporting greater consistency and continuity of care between primary and secondary care settings; and more effective communication between hospital departments and pharmacies. The system incorporates the UK’s leading
Clinical drug database (FirstDatabank Multilex), to support safe and effective electronic prescribing through its clinical checking, reducing the risk of medication errors and increasing patient safety. FOR MORE INFORMATION Tel: 01268 416348 info@jac-pharmacy.co.uk www.jac-pharmacy.co.uk
DON’T LET YOUR PRIVATE DATA GO PUBLIC. The BlackBerry® Enterprise Solution is the only mobile data solution that’s approved by CESG to handle RESTRICTED data*. It not only gives healthcare professionals access to email, but also lets them view and update patient records at the point of care – ultimately allowing them to provide better care to more patients. All in the knowledge that any data they view or send is secure*.
To find out more about how BlackBerry® could achieve efficiencies and improve patient care, email publicsector@rim.com or visit blackberry.co.uk/healthcaresecurity
The only mobile data solution approved by CESG *Approved versions only, when configured and used in accordance with CESG Security Procedures. Security assured to IL3. Contact enquiries@cesg.gsi.gov.uk or visit cesg.gov.uk for further information. ©2011 Research In Motion Limited. All rights reserved. BlackBerry®, RIM®, Research in Motion® and related trademarks, names and logos are the property of Research In Motion Limited and are registered and/or used in the U.S. and countries around the world. All other trademarks are the property of their respective owners.
New Guidance New GuidanceNew Guidance New GuidanceNew Guidance New Guidance New Guidance New GuidanceNew Guidance New GuidanceNew Guidance New Guidance New Guidance New Guidance New Guidance New Guidance New Guidance The Department of Health has recently updated its highNew Guidance New Guidance New GuidanceNew Guidance New GuidanceNew Guidance New Guidance impact intervention care prevention of New Guidance New Guidance New Guidance Newbundle Guidancefor Newthe Guidance New Guidance New Guidance Guidanceto Newinclude Guidancepre-operative New GuidanceNewskin Guidance New Guidance surgical siteNew infection 1 New Guidance New Guidance New Guidance NewinGuidance New Guidance New Guidance preparation with 2% chlorhexidine 70% isopropyl alcohol
Based on evidence from a recent study reported in The New England Journal of Medicine conducted using ChloraPrep,2 pre-operative skin preparation has been included in the High Impact Intervention for the prevention of surgical site infection for the first time.1 CareFusion offers advice on meeting infection prevention requirements as well as support and training in skin preparation techniques. To find out more, please visit
www.chloraprep.co.uk
The
and only
licensed and evidence-based skin preparation system that allows you to meet these new guidelines3
Prep the skin. Protect the patient. Prescribing Information ChloraPrep® (PL31760/0002) & ChloraPrep with Tint (PL31760-0001) 2% chlorhexidine gluconate w/v / 70% isopropyl alcohol v/v cutaneous solution. Indication: Disinfection of skin prior to invasive medical procedures Dosage & administration: ChloraPrep – 0.67ml, 1.5ml, 3ml, 10.5ml, 26ml ; ChloraPrep with Tint – 3ml, 10.5ml, 26ml. Volume dependent on invasive procedure being undertaken. Applicator squeezed to break ampoule and release antiseptic solution onto sponge. Solution applied by gently pressing sponge against skin and moving back and forth for 30 seconds. The area covered should be allowed to air dry. Side effects, precautions & contraindications: Very rarely allergic or skin reactions reported with chlorhexidine, isopropyl alcohol and Sunset Yellow. Contra-indicated for patients with known hypersensitivity to these constituents. For external use only on intact skin. Avoid contact with eyes, mucous membranes, middle ear and neural tissue. Should not be used in children under 2 months of age. Solution is flammable. Do not use with ignition sources until dry, do not allow to pool, and remove soaked materials before use. Over-vigorous use on fragile or sensitive skin or
repeated use may lead to local skin reactions. At the first sign of local skin reaction, application should be stopped. Per applicator costs (ex VAT) ChloraPrep: 0.67ml (SEPP) - 30p; 1.5ml (FREPP) - 55p; 1.5ml – 78p; 3ml – 85p; 10.5ml - £2.92; 26ml - £6.50 ChloraPrep with Tint: 3ml – 89p; 10.5ml £3.07; 26ml - £6.83 Legal category: GSL Marketing Authorisation Holder: CareFusion UK 244 Ltd, 43 London Road, Reigate, Surrey RH2 9PW, UK Date of preparation: July 2011 References: 1. Darouiche R et al. N Engl J Med 2010; 362: 18-26. 2. Department of Health (2011) High Impact Intervention: Care bundle to prevent surgical site infection. Available at: http://hcai.dh.gov.uk/files/2011/03/2011-03-14-HII-Prevent-Surgical-Site-infection-FINAL.pdf. Date accessed: 12.04.11. 3. UK PL 31760/0001 CHL158A Date of preparation: September 2011
DECONTAMINATION EQUIPMENT
UNITING INFECTION CONTROL STRATEGIES ACROSS THE EU Brahadeesh Chandrasekaran, healthcare research associate at Frost and Sullivan, examines ongoing concerns over infection control and the uptake of decontamination equipment in Eastern Europe The rise of new diseases and the increased number of fatal infections, including Severe Acute Respiratory Syndrome (SARS), Acquired Immuno Deficiency Syndrome (AIDS) and Tuberculosis (TB), have highlighted the importance of infection control in every healthcare setting. Furthermore, the high expenditure due to nosocomial infections or hospital acquired
infections (HAI) emphasises the need for effective infection control and hygiene strategies in hospital settings. HAI can be fatal because they are caused by bacteria, fungi and viruses that are mostly resistant to common antibiotics used for treating infections. HAI is a rising concern for healthcare facilities around the world and has a direct economic impact on a country’s healthcare system.
Infection Control
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
According to a report published in the USA, the overall direct annual medical costs of HAI to US hospitals ranged from $28.4 billion to $33.8 billion in 2007. Some of the ways to control infections in healthcare settings include cleaning, disinfecting, and reprocessing reusable equipment, as well as proper healthcare waste management, and protection of healthcare workers from transmissible infections. Decontamination is one such method applied for infection control. It includes cleaning, disinfecting and reprocessing of devices and tools used in the healthcare E
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T +44 (0) 1803 529021 E sales@dartvalley.co.uk W www.dartvalley.co.uk
Infection Control
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
E facilities. Such procedures not only help infection control but also minimise hospital costs by enabling devices to be reused, rather than having to be purchased anew. THE IMPACT OF HOSPITAL INFECTION Nosocomial infections have significant impact, especially in countries with poor resources. HAIs impact the financial conditions of a country by increasing the length of hospitalisation, increasing treatment costs through expensive medicine (eg antibiotics and antiretroviral drugs in case of AIDS), and increasing the overall costs by other services (including laboratory tests, diagnosis and transfusions). Through commitment from countries and their healthcare facilities, controlling HAI has been successful in recent years. The best example is the reduction of central line-associated bloodstream infection (CLABSIs) by 70 per cent by simply following the infection control guidelines. However, plenty of work is yet to be done. THE CHALLENGE Eastern Europe’s decontamination equipment market is characterised by high price sensitivity – mainly due to lack of sufficient funding. In order to contain costs, hospitals prefer low cost products, especially in a state funded system. Another challenge faced by manufacturers in this market is the lack of evidence or support statistics with respect to nosocomial infections or HAI in Eastern Europe. The average HAI rate in eastern European countries ranges from two to four per cent, while in the United States and
forces for the decontamination equipment market. The recent trend in Eastern Europe is to have fewer but more sophisticated hospitals. This will further increase the demand for new equipment and also increase the purchasing power of hospitals. Furthermore, an ageing population is highly susceptible
Eastern Europe’s decontamination equipment market is characterised by high price sensitivity – mainly due to lack of sufficient funding. In order to contain costs, hospitals prefer low cost products, especially in a state funded system. other developed countries, it is around five to ten per cent. This does not mean that the healthcare standard is high in Eastern Europe. There is no proper monitoring unit in hospitals to track the number of cases related to HAI. Hence, it becomes difficult to increase the awareness of hygiene practices in hospitals. THE TREND New Eastern European member states of the European Union (EU) are improving healthcare-related infrastructure and equipment to match EU-mandated standards. Outdated systems are rapidly being replaced by modern equipment within the Central Sterile Supply Department (CSSD). This modernisation and replacement of the current equipment is one of the main driving
to infections due to low immunity and is more prone to HAI. According to the UN’s World Population prospects report, the population aged above 65 years in the EU 27 is estimated to grow from 16 per cent in 2000 to 25 per cent in 2030. THE EQUIPMENT MARKET The decontamination equipment market earned revenues of $97.5 million in 2010 and is estimated to reach $128.3 million in 2017. The price of the decontamination equipment is comparatively lower than that of their western European counterparts. One of the significant challenges in Eastern Europe is the lack of adherence to manufacturer guidelines which often affects the optimal functioning of the decontamination equipment. This
is an opportunity for manufacturers to increase their market by providing services like training, and educating healthcare professionals about infection control and the role of decontamination services. THE LAST WORD Healthcare indicators for eastern European countries, such as life expectancy rates and death rates at birth, are far below the average in Europe. The lack of monitoring units in hospitals makes it difficult for the manufacturers to increase the hygiene and infection control awareness in these facilities. Manufacturers can join hands with the healthcare professionals in monitoring and raising the standards in the healthcare settings. Most of the nosocomial infections can be prevented with simple and less expensive strategies like adhering to proper infection control practices, such as hand hygiene, and adhering to guidelines established by the manufacturers in decontamination services. The outbreak of swine flu in 2009 has further increased the concerns over infection control and prevention strategies. The increase in the ageing population in Europe will further increase the need for stringent guidelines. The focus in the European Union is to ensure that the member states follow the established guidelines and support in the prevention of nosocomial infections. L FOR MORE INFORMATION Tel: 020 7343 8383 E-mail: enquiries@frost.com Web: www.frost.com
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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
NHS-developed KwickScreen room divider is an international hit WASTE SOLUTIONS FOR THE
HEALTHCARE SECTOR As the UK’s leading healthcare and specialist waste management company we’re trusted by healthcare customers nationwide to provide compliant; comprehensive and cost-effective waste solutions. We work with NHS and private hospitals, GPs, care homes, dentists, pharmacies, community patients, needle exchange services nationwide. Using our experience, resource and expertise we work in partnership with our customers providing guidance and advice, full legislative compliance and a range of effective waste management and recycling options.
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KwickScreen is a portable, retractable, room-divider that provides isolation or privacy solutions in hospitals. Their tiny footprint makes KwickScreens ideal for storage and use in openplan wards. They are simple to transport and wipe clean. KwickScreens enable hospitals to make the best use of available space, offering flexibility to quickly change a room’s layout. Designed on the NHS Smart Ideas Design Bugs Out Programme in 2009, and drawing on ideas from patients and staff, KwickScreen has been an immediate success since its introduction in 2010. Already used in numerous scenarios in over 30 NHS trusts, KwickScreen is also solving privacy and infection control problems in Europe, North America and the Middle East. Customised printed versions are becoming increasingly popular
as, depending on the print, they have an immediate visual impact to either stimulate or relax. Designed and manufactured in the UK, using cutting-edge British material technology, KwickScreen has received a number of awards including the Shell LiveWIRE and the 2011 UK James Dyson Foundation Design awards. Contact KwickScreen quoting promotional code HBP1011 for a special discounted price or to arrange a free trial. FOR MORE INFORMATION Tel: 020 75904292 info@kwickscreen.com www.kwickscreen.com
FLU VACCINATIONS Tips for getting the message out
Over 600 people died from flu in the UK last year and there is strong evidence that some patients die from flu caught in hospital. Healthcare staff are therefore being encouraged to be vaccinated against flu, to protect them and their patients NHS Employers, the organisation responsible for negotiating pay and terms and conditions in the NHS and promoting good people management practice, has launched the first ever national NHS staff flu vaccination campaign. It is supported by the Department of Health and NHS trade unions such as Unison, the BMA and the Royal College of Nursing. The campaign started in September when NHS
trusts throughout England were filled with lively posters, guides and other resources aimed at helping and encouraging more NHS staff to get flu vaccinations and to become ‘Flu Fighters’. Also, the campaign has been helping trusts to plan and prepare for the flu season for many months. LOOKING AFTER STAFF Vaccinations are extremely important to ensure a safer environment in the NHS. Over 600 people E
Give out flyers with receipts from the staff canteen. Promote at shift handovers.
Written by Dean Royles, director of NHS Employers
VACCINATING THE NHS FRONT LINE
Infection Control
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Promote at team meetings/team briefs. Attach messages to payslips to encourage staff to get vaccinated. Discuss at your staff forum/council. Add messages to email footers: “I’ve had my flu jab, have you?” Work with local and regional media for features and editorial. Send text messages to colleagues with work mobile phones. Use social media (Facebook, twitter, LinkedIn, YouTube, etc). Keep your intranet page up to date with information about when and where to get vaccinated. Use screensavers and pop-ups on all computers.
Copyright NHS Confederation
Cost-effective hygiene solutions for the health sector? Just ask Vectair Vectair Systems is an award winning, world leading manufacturer of hygiene products and consumables, which sells within 95 countries worldwide. The world class range of coordinated hygiene equipment and consumables provided by Vectair are healthcare professionals’ one stop shop for hygiene provision. Among the innovations, Vectair offers users the ultimate solution for hand hygiene. Requiring just one small dose, long lasting and gentle on the skin, Sanitex® refills for the Sanitex® soap dispenser are the ideal solution to keep hands hygienic.
Through its sleek and push to dispense system, Sanitex® is a unique soap dispenser that brings optimal hand hygiene to a variety of locations, especially hospitals and care homes, and ensures hands remain clean. The unique pouch feature reseals each pouch ensuring servicing of the Sanitex® soap dispenser is quick, simple and contamination free. All Sanitex® soap refills are pH balanced and gentle on the skin. Only one dose is required – enabling soap to last longer. Available in three soap options: • luxury (liquid, foam or spray)
• antibacterial • hand sanitiser FOR MORE INFORMATION Tel: 01256 319500 info@vectair.co.uk www.vectair.co.uk
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E died from flu in the UK last year and there is strong evidence that some patients die from flu caught in hospital. Only one third of front-line NHS staff (34.7 per cent) were vaccinated against flu last year. This was higher than the previous year (26.4 per cent) but it is still far too little to give confidence to vulnerable patients. It needs to increase. If we are to rely on staff to prepare care, it’s important that we help them look after their own health and well-being. Sickness rates climb during the flu season, so reducing absence through flu vaccination is an important element of maintaining staff health. The Boorman Review said that £555 million could be saved if current NHS staff absence rates from any cause were reduced by a third through improvements to health and well-being. However flu’s impact on patient health is the primary concern for the NHS and its staff. This is where Flu Fighters focuses its attention. Frontline NHS workers are passionate about patient care and many of them joined the NHS because of their desire to help people. Employers, supported by the campaign, are working hard to encourage staff to be vaccinated to protect them, their patients and their families. MYTH BUSTING Like all workplaces there is some myth busting to do. Our research shows that staff give a number of reasons for not having jabs. Some worry that having a jab will make them sick and unable to perform their role. Others worry that it will temporarily give them virulent, live flu that they could pass on to patients. These concerns are based on myths,
not facts, and need to be dispelled. Flu vaccinations actually cause only minimal symptoms and are very safe and effective. This campaign is slamming the myths with its posters and other resources that can be found throughout staff areas in the NHS in England. Employers are lending their support to these important messages even if this means explaining to some staff that their beliefs about flu are wrong. Some staff also say they didn’t get vaccinated before because it was difficult to find the time during busy work days. The campaign has been giving advice and examples of best practice to HR directors, flu leads and other key staff to help them make it more convenient to get the jab. This is especially important for staff who may not work centrally. COMMUNICATION Innovation is essential to help get the message out. To staff the campaign is helping trusts to experiment with a wide range of communications, many of which were used with great success by the North West SHA’s flu campaign last year. Telephone text messages and computer screen savers, social media and podcasts are examples that the campaign is using. This has led to more than 5,500 hits in the first few weeks on www.nhsemployers. org/flu as trusts view and download helpful guidance, toolkits and materials. However, we all know the value of leadership and probably the most essential piece of communication is the explicit support of senior managers. This is a great project for senior managers to use as a platform to engage workers that will endure beyond the winter flu period. L
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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Ideas to make it easier for staff to be vaccinated Set up clinics in staff rooms or areas close to wards∙setting up in the staff canteen Hold drop-in clinics in main staff entrances, especially at times staff are starting and finishing work, offering vaccinations out of hours. Send vaccinators to wards and departments to catch staff who are traditionally difficult to access, for example A&E staff. Run clinics and drop-in centres across other sites. Run clinics at places you are likely to find community-based staff∙ Offer a cup of tea and biscuit to all staff who attend to get vaccinated. Allow staff to drop-in to a clinic at any time that suits them. Use peer vaccinators to vaccinate colleagues. Train ward managers to vaccinate their own staff (or, if this poses an issue, to swap with another manager and vaccinate their staff).
Healthcare waste collection and disposal PHS Wastemanagement specialises in the collection, disposal and recycling of healthcare, clinical, dental, pharmaceutical, chemical, hazardous and non-hazardous wastes. We are capable of processing waste as diverse as industrial solvents, laboratory chemicals, aerosol cans and fluorescent lighting recycling through to the recovery of silver from dental X-ray waste. The field of waste management is a highly regulated and complex area with new regulations and government guidance regularly being issued. Ensuring the legal compliance, both of our own organisation and our customers, is therefore of the highest priority for us. For this reason, we employ a network of highly trained and knowledgeable team members. As well as our dedicated SHE (Safety, Health and Environment)
department who are responsible for ensuring the safe and legal operation of all our services, we also employ highly skilled waste experts and qualified chemists, who are always on hand to offer advice and support to help you navigate the often complex field of waste management. Visit our website to download our simple
legislative guides. You will also find other training and support information provided which can be downloaded free of charge. FOR MORE INFORMATION Contact us now on 02920 809090 e-mail: services@phs.co.uk or visit www.phswastemanagement.co.uk
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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Legionella
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
HSE L8 Legionella management specialists Tritec Environmental Services Limited has many years’ experience in the field of water treatment and air hygiene management. Established in 1986 our aim is to provide a safe and healthy environment, with legislative compliance to all types of building. Water Treatment Services include the following: • legionella management contracts • risk assessments to HSE L8 guidelines. • disinfections of cooling towers • disinfections of tanks and water services • water sampling (TVC Coliform/E.Coli/Legionella) • water softener service Air system management Services include the following: • air system condition reports • air quality monitoring • air quality investigations
• ductwork cleanliness surveys • airborne analysis • thermal comfort audits We also offer a number of installation and refurbishment services associated with the above service and management tasks.
Three Counties Water Limited – the legionella control specialists Three Counties Water Limited is a friendly, competent and fully equipped team that deal with all your requests. Whether it is in our office or out in the field our team will assist you from the initial query through to the completion of any work undertaken. All of this and our hard work has ensured that all our clients meet their statutory obligations at all times. We have a wealth of experience within the industry and specialise in all aspects of water hygiene, treatment and environmental services that the modern building requires. If a Legionella risk assessment determines that a control scheme is required to control Legionella bacteria, Three Counties Water
has managers experienced in designing an effective Legionella control regime, whilst our technicians are there to ensure that these are managed and implemented correctly. We are currently category one members of the well respected and recognised Legionella Control Association. The Legionella Control Association was set up to help satisfy the client that their supplier can do works they want carrying out to a standard they require and expect. FOR MORE INFORMATION Tel: 01933 426108 admin@threecountieswater.co.uk www.threecountieswater.co.uk
FOR MORE INFORMATION Scott Harvey, commercial director Tel: 01923 202085 Mob: 07768 542711
scott@tritecuk.com
Building Service Engineers, registered with the Legionella Control Association, our water hygiene services include... n Risk Assessment surveys
n Routine monitoring & management of water systems n Water storage tanks & systems cleaned/chlorinated n Water storage tanks replaced/refurbished
n Water quality sampling via UKAS accredited laboratories n De-scaling of all types of systems and plant n Water storage tanks relined
For a no obligation quote, contact Kevin Andrews Newton Abbot, Devon 01626 363668 www.wemco.co.uk
Legionella Risk Compliance from RPS The Healthcare Sector’s Partner RPS provides solutions for all requirements relating to legionella risk management. As an independent consultancy, with no affiliations with organisations that undertake water treatment services, our clients can be assured of impartiality and integrity in all aspects of our consultancy services, complying with one of the key requirements of the recently published BS8580:2010 Water quality – Risk assessments for Legionella control – Code of practice. RPS can assist and advise on: Risk assessments in compliance with BS8580: 2010 Water quality – Risk assessments for Legionella control – Code of practice Prioritised management plans, with clearly identified remedial actions, meeting the requirements of HTM 04-01 and L8 Web or paper based management systems, to record monitoring and inspection tasks, including associated procedures and escalation plans Routine monitoring of all types of water system Flexible outsourcing contracts, either full-time or part-time basis Competent person support, including training Full microbiological and chemical analysis by UKAS accredited laboratories
To find out more on the range of services we provide, Free Phone 08000 85 84 83 for further information
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HEALTH BUSINESS MAGAZINE | Volume 11.9
rpsgroup.com
HEALTH & SAFETY
Despite the risks of Legionnaires’ disease being well known, many organisations still fail to apply appropriate preventative measures. A new code of practice addresses the guidance gap
Knowledge of Legionnaires’ disease has grown considerably since the first recognised outbreak in the USA during 1976. Despite this there are still around 350 cases of Legionnaires’ disease reported annually in England and Wales, resulting in 30-50 deaths. The development of suitable preventative measures are driven by the information gathered during the risk assessment process. Historically though there has been little guidance on how a risk assessment should be undertaken. As a result, the risk assessments produced were of variable quality. The introduction of ‘BS8580:2010 Water quality. Risk assessments for Legionella control, Code of Practice’, addresses this guidance gap, providing invaluable support for everybody involved in the management of water systems within the healthcare sector. The risk posed by the legionella bacteria is increased within the healthcare sector due to the presence of people with compromised immune systems. Additionally, investigations into outbreaks of Legionnaires’ disease have shown that men are more susceptible than women, and that people aged over 50 are more likely to contract the disease. Children are rarely infected. The risk of contracting Legionnaires’ disease is further increased in people who smoke. DISEASE TRANSMISSION To acquire Legionnaires’ disease it is necessary to inhale an aerosol containing the bacteria, with the extent of the infection primarily determined by the number of bacteria present within the aerosol. There is no evidence to show that the
disease can be spread from person to person. The source of the aerosol is critical in assessing the potential number of victims. The largest outbreaks are almost invariably associated with cooling towers. These water systems pose a significant risk due to their ability to disseminate an aerosol over a wide area.In contrast, within a building, the number of people exposed to an aerosol produced by a shower or tap will be significantly less. Nevertheless, the risk posed by showers within the healthcare sector, especially within hospitals, should not be underestimated. Whilst the number of people who could be exposed is relatively low, the risk posed to them is greatly increased due, primarily, to the likelihood that they will be more susceptible. Although cooling towers and showers pose the most significant risk, other systems pose a risk too. These include misting machines, whirlpool spas, hot tubs, fire hoses and sprinklers, irrigation systems and water features. The identification of all potential risk systems within a building is a fundamental part of the assessment process. It is therefore essential that the person undertaking the assessment has access to all areas of the building and that they have the competency and experience to identify and evaluate the risks posed by the systems. BACTERIAL GROWTH The legionella bacteria is commonly encountered within environmental water sources such as lakes and rivers. In these situations the risk of infection is insignificant since the bacteria are present in very low levels and at temperatures that limit their growth.
It is only in conditions conducive to bacteria growth that a potential risk occurs. These conditions can, if not suitably controlled and managed, develop in engineered water systems. The bacteria will grow in water temperatures between 20 and 45°C. Below 20°C the bacteria may be present but will not multiply and therefore the risk is significantly reduced. Above 45°C the bacteria starts to die, once it reaches 60°C the bacteria will not survive. A temperature of 37°C is the optimum temperature for legionella growth. Any water systems with temperatures close to the optimum should therefore be treated with a higher degree of concern. The bacteria also thrive in stagnant water or low-flow sections of pipework. These conditions are typically encountered in cold water storage tanks with poor water turnover, redundant plant and deadlegs. Under these conditions biofilms (colonies of bacteria attached to a surface which is in contact with water) are more likely to develop, providing an ideal habitat for legionella growth. Biofilms can be particularly critical in the growth of the bacteria, as they provide an environment rich in nutrients, while also protecting the bacteria from temperatures and biocides that would kill the bacteria if it was suspended in water. In these conditions it is possible for the bacteria to rapidly grow and potentially colonise a water system. The presence of sediment and sludge also increases the risk of legionella proliferation within a water system. These are typically encountered in areas of a water system that allow solids to settle out. These include: cold water storage tanks, calorifiers and cooling tower sumps. In each of these cases it is essential that a routine inspection programme is instigated to monitor the build-up of materials that assist the growth of the bacteria.
Written by Mike Rose, commercial director, RPS Health, Safety and Environment
LEGIONELLA CONTROL: THE NEW STANDARD
Legionella
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
EMPLOYER’S RESPONSIBILITY The employer is responsible for managing the risk – specifically the person or people in control of the premises, referred to as ‘the responsible person’. The first requirement, before development of appropriate preventative measures, is to clearly identify and assess the risk of exposure to the legionella bacteria from work activities and water systems. A risk assessment should be performed on any water system where the temperature of the water falls between 20-45°C. Where a risk has been identified, the E
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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HEALTH & SAFETY E assessment should address how the risk is to be prevented or, if prevention is not reasonably practical, the means by which the risk is to be controlled. In identifying a risk system, the first option must be to investigate the potential to remove the risk. Where replacement is not reasonably practicable, then the risk has to be accepted – but a management system, sometimes referred to as the written scheme, must be put in place. The written scheme will provide details, amongst other information, about the range of monitoring and inspection that needs to be undertaken to control the risk. This information is to be found in the site log book and forms a vital element in demonstrating to enforcement authorities that the risk from Legionnaires’ disease is being controlled. APPROVED CODE OF PRACTICE The most significant document is: Legionnaires’ disease: The control of legionella bacteria in water systems, Approved Code of Practice and Guidance (L8), issued by the Health and Safety Commission. It came into effect 8 January 2001. Since then there have been minor revisions, but essentially it remains identical to the original version. The Approved Code of Practice provides practical advice on how to comply with the Health and Safety at Work etc Act 1974 (HSWA) and the Control of Substances Hazardous to Health Regulations (COSHH) 2002 (as amended.) concerning the risk from exposure to legionella bacteria. There is no statutory requirement to follow the provisions of the L8 document. However, the code has a special legal status. If, following a breach of health and safety law you are prosecuted, a court will use this document to determine if the law has been broken. Simply put, if you follow the advice detailed in the L8 document you will be doing enough to comply with the law. If you do not follow the provisions of the code you will need to demonstrate to the court that you have complied with the law in some other way. If not, a court will find you at fault.
HEALTH TECHNICAL MEMORANDUM 04-01 Recognising the unique risks presented by the legionella bacteria within the healthcare sector, ‘HTM 04-01: The control of Legionella, Hygiene, ‘safe’ hot water, cold water and drinking water systems’ expands on the requirements detailed within L8. The document is split into two parts, with ‘Part A’ outlining the principles involved in the design, installation and testing of the water systems. Meanwhile ‘Part B’ details the requirements with regards to the operational management. The document applies to both new and existing systems. First published in 2006 by the Department of Health, HTM 04-01 replaced both HTM 2027 and HTM 2040. NEW DEVELOPMENTS The introduction of BS8580 is the most significant change in legionella risk management in the last decade, affecting all organisations that have a duty to manage and control the risk posed by the legionella bacteria. There are many excellent documents available, providing guidance and best practice advice in relation to the control of the legionella bacteria, including the well established L8 document. However, there is very limited detail within L8 with respect to performing a risk assessment. The document sets out a clearly defined process for the risk assessment of artificial water systems that pose a risk of legionellosis. It excludes the assessment of risk presented by natural waters, additionally it gives no recommendations for the preparation of the scheme of control for identified risk systems. One of the first requirements is to define the terms of reference for the assessment. Too often risk assessments are prepared that do not meet the expectations of the organisation commissioning the risk assessment. This can be traced back to a lack of clarity within the original specification or in the subsequent proposal developed by the organisation undertaking the risk assessment.
Legionella
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
INDEPENDENCE The ability to undertake the assessment with impartiality and integrity is a key requirement of the new standard. The inclusion of this clause seeks to provide clients with assurances that the recommendations made are valid and reflect actual site conditions. Where an organisation, for example a water treatment company, provides risk assessment and other services such as cleaning and chlorination services, they should have safeguards in place to ensure that there are no conflicts of interest. While the duty holder or employee of the duty holder can undertake a legionella assessment, in many cases it is an external contractor who undertakes this task. In each case, they should be able to demonstrate specialist relevant knowledge of the legionella bacteria, water treatment and water systems – and be competent to undertake surveys, measurements and sampling. BS8580 – THE FUTURE The introduction of BS8580 provides a framework to raise quality standards in the delivery of legionella risk assessments. This is further enhanced by the opportunity for organisations to achieve formal accreditation against the standard, assisting the procurement process during the technical and quality evaluation of potential suppliers. Through defining the risk assessment process the standard provides clear levels of expectation for clients, providers and enforcement authorities alike, removing any ambiguity in determining what constitutes a suitable and sufficient risk assessment. Ultimately however our goal is to improve public health through a reduction in the number of incidences of Legionnaires’ disease. The introduction of BS8580 can be viewed as a major step forward in achieving this goal. L FOR MORE INFORMATION www.rpsgroup.com
Laboratory and technical services from Latis Latis Scientific is a specialist in the provision of laboratory and technical services within the healthcare industry. With over 20 years’ experience in various aspects of infection control, such as sterile services, operating theatres, hydrotherapy, dialysis and Legionella control. With our team of chemists, microbiologists and consultants we provide both investigative site work whilst ensuring compliance with all of the latest guidance and regulation, including the recently and soon to be published, new Health and Technical Memorandums.
Our UKAS accredited laboratories are based in central London and we work in conjunction with three partner laboratories across the UK. In order to ensure that samples arrive at the laboratories in a fast, efficient and controlled manner we operate a fleet of temperature controlled vehicles. Our laboratories are modern state of the art facilities with the latest technology, using the most innovative methodology. Our capabilities include the provision of chemical purity assays and the isolation of microbiological contaminants that cause concern within the
healthcare industry, such as Mycobacterium, Clostridium, Staphylococcus, Pseudomonas, and emerging pathogens such as Ralstonia pickettii. FOR MORE INFORMATION Tel: 020 88533900 www.latisscientific.co.uk
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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BUILDING CONTROL
CLOSE CONTROL STILL VITAL FOR ASBESTOS LEGACY While asbestos use in construction is, thankfully, now a thing of the past, many of the UK’s healthcare organisations will still have to manage its harmful legacy for years to come, writes IOSH It’s been over a decade since the use of any type of asbestos in building materials was banned. Unfortunately, its widespread use in the past means it still exists in many organisations today, posing a very real risk that is a long way from extinction. Health and safety has a huge role to play in asbestos management. But the Institution of Occupational Safety and Health (IOSH) believes the picture need not be entirely bleak. This naturally occurring fibrous mineral was perhaps most popular during the 1970s because of its strength and heat resistance, and can still often be found in insulation materials around pipes and tanks, or in tiles and other materials. But when knowledge of its huge risks grew, much-needed legislation was put in place. Now, where asbestos remains in buildings, any removal is subject to strict guidelines that protect workers and anyone else in the vicinity. This protection means that law-abiding organisations are no longer risking the health of patients or staff during their day-to-day activities, nor are they placing the short or long term health of construction or maintenance workers in jeopardy.
MANAGING THE RISKS IOSH senior policy and technical adviser Jill Joyce said: “For so many years asbestos was an unknown killer, but through all the tragedy there is now a brighter future because we know of the risks it poses. “The sad fact is that it was only just over a decade ago when it was actually completely banned for use in buildings. So, for some years to come, we will be hearing more cases of people losing their lives to disease [acquired as a consequence of asbestos exposure].” Breathing in the substance’s fibres can cause potentially fatal conditions such as asbestosis – a disease where lung tissue becomes irreparably damaged, mesothelioma – a type of cancer that affects the lung lining or lining of the lower digestive tract; asbestos-related lung cancer, or Diffuse Pleural Thickening, which again affects the lungs. Asbestos-related deaths do count for a significant proportion of work-related fatalities recorded by the Health and Safety Executive (HSE). More than 40,000 people have died from the asbestos-related cancer
Asbestos Management
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
mesothelioma in the last 40 years. Figures show that in 2008, there were 429 fatalities where the death certificate mentioned the disease. Mesothelioma rates are expected to reach a peak of 2038 around the year 2016, but it has also seen a huge rise in numbers of deaths annually from 153 in 1968 to 2249 in 2008. Many people who have died from the condition have been listed as carpenters and joiners, plumbers, heating and ventilating engineers, electricians and electrical fitters. Asbestos-related lung cancer statistics are thought to be significantly lower and disablement figures show that there were 335 new cases of disablement in 2009 because of the condition. Joyce added: “These figures will probably shock people because we often think of asbestos as something we now know about and how to deal with. But we have to remember that many of these new cases are from people who were exposed in their jobs many years ago. “We do expect this picture to eventually improve, in line with the fact that we’ve been putting into practice protection measures for dealing with the substance for a number of years now. And that’s encouraging, especially for those people who work in occupations that previously might have been at risk of some of the diseases that are associated with asbestos.” While a lot of asbestos remains in existing buildings, proper management of the substance means that in the future workers will come into contact with asbestos less and less. The legal duty placed on employers to manage health risks that the substance creates is also helping the situation and is expected to have a positive impact on statistics in years to come. In fact, a legal duty is placed upon non-domestic premises like healthcare facilities to manage asbestos. E
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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E MATERIAL CONTROL The Control of Asbestos at Work Regulations 2006 combined all of the previous requirements on asbestos use, banning the importation, supply and use of all forms of asbestos. Crocidolite (blue asbestos) and amosite (brown asbestos) have been banned since 1985, while chrysotile (white asbestos) has been banned since 1999. There’s also a ban on the second-hand use of asbestos products, such as asbestos cement sheets and tiles. The HSE is currently consulting on proposals to revise these regulations to ensure that some maintenance and repair activities comply with the requirements to notify work, carry out medical examinations and keep accurate records. “It’s difficult to evaluate how well healthcare businesses are managing asbestos. But the HSE has a health and safety plan for the health sector that perhaps suggest more consistency is needed in how they deal with it,” Joyce added. The HSE plan suggests healthcare organisations should be ‘ensuring consistency in dealing with asbestos duty to manage issues’ and ‘proactively seeking examples of poor asbestos surveying work with a view to bringing to account those that manifestly fail in their duties’. She said: “In terms of the issues healthcare institutions might face in meeting that benchmark, their first hurdle is to find out whether they actually have asbestos in the building. They will also have to put together a good management plan to tackle the substance, keep an asbestos register that is current and fit for purpose, and train workers to handle the risks.” And it’s not just managers of old buildings that need to be aware of asbestos. Joyce confirms that brownfield sites may also have the substance buried within them. A lot of healthcare facilities use old buildings or have new extensions attached to sites that contain asbestos. Some doctors’ surgeries or care homes may occupy leased buildings that need checking. All of these types of facilities will need to take an in-depth look at their plans, finding any records of asbestos work and recording anything they find. Joyce suggests that previous owners, equipment suppliers or companies that have carried out building or maintenance work are a good source, but added: “This isn’t failsafe though as records from the past might not be so rigorous, simply because people didn’t know the risks back then. The only way to find out is to take samples.” Asbestos surveys will help healthcare organisations find whether they have the substance in their midst. There are two types – the management survey and refurbishment and demolition survey. The former provides information for ongoing managements of the premises, letting them know where asbestos might be. The latter aims to locate and describe all asbestos
Asbestos Management
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
While we might not have a complete picture of the wholesale damage asbestos has done to our workforces and workplaces, we do know that we haven’t seen the worst yet. containing materials in the part of the building that is being refurbished, or throughout the whole building if it’s being demolished. As a rule, all surveys locate any materials where asbestos is present, making a record of what it is, where it is and how much there is. They also document how accessible the asbestos materials are and what condition they’re in, as well as what type exists within those materials. CORPORATE RESPONSIBILITY The role of any company is to keep staff, contractors and visitors safe from asbestos. Perhaps that duty is even more important in healthcare institutions, whose job it is to actually make people better. Joyce said: “If asbestos exists within a material that’s in good condition and isn’t likely to be damaged, worked on, or disturbed, we’d urge employers to leave it well alone, as the fibres won’t be released. But it’s their responsibility to let maintenance workers and contractors know where it is to allow them to take measures to protect themselves and others if they could potentially disturb it. “When asbestos materials are removed or worked on, proper control measures should minimise fibre release. But if work is shoddy and areas contaminated, people may be exposed,” she warned. Any possible work to the building must be assessed for its potential to disturb asbestos. Healthcare building duty holders should also inform anyone working in the premises that they must not disturb the fabric of the building without permission, and tell maintenance teams and outside contractors where asbestos is located. In addition, warning signs or labels should be displayed. Training courses must be provided for people who manage the healthcare property,
maintenance supervisors and staff to let them know of the health risks, where asbestos is located, how to handle and dispose of it safely, and how to maintain records. IOSH provides safety awareness training for managers and employees, as well as professional courses for health and safety practitioners, facilities managers and anyone who manages risk programmes involving asbestos. The HSE has also launched a training pledge to provide 4,000 hours of free asbestos training to help tradesmen protect themselves. This training will be available during October and November.“It doesn’t end here,” Joyce added, “organisations might need to carry out minor repairs, enclosure or encapsulation of materials that contain asbestos. And apart from minor works with a very low risk of exposure, any asbestos work must be done by companies licensed by the HSE.” It’s important that any work that might disturb asbestos is compliant with the Control of Asbestos Regulations 2006, so the job doesn’t expose those doing the work, or anyone else, to risk from the material. Joyce concluded: “While we might not have a complete picture of the wholesale damage asbestos has done to our workforces and workplaces around the UK, we do know that we haven’t seen the worst yet. What is encouraging is that good management of the substance, together with better knowledge, is improving the picture for employers and employees of the future. And one day, asbestos-related health problems might be a thing of the past.” L FOR MORE INFORMATION Tel: 0116 2573100 Fax: 0116 2573101 Web: www.iosh.co.uk
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Ready for the climate change challenge? Worried about the rising cost of oil, gas, electricity or water? Not sure what to do with energy surveys/advice? Looking for a realistic energy saving plan from INDEPENDENT experts? The McCaul Group employs highly experienced and fully accredited energy consultants and building services engineers to provide value-for-money energy saving solutions that will protect your organisation against the rising cost of energy. We will examine all aspects of your business’s energy consumption and immediately highlight any ‘high impact - low cost’ solutions. Remember, saving energy can release resources to frontline services. As an engineering consultancy business we don’t manufacture, supply or install energy saving equipment. We are dedicated to providing you with INDEPENDENT engineering solutions that are specifically suited to your organisation and its budgetary needs. So talk to us now about our innovative Step by Step approach to help YOU achieve a new standard in energy performance for your organisation. Tel: +44 (0) 28 8225 1155 email: energy@pmccaul.com Web: www.pmccaul.com
Western Power Distribution’s long established metering business has been refocused to help our customers face the challenges of climate change and increasing productivity. The WPD Smart Metering team provide metering solutions to business customers on a national basis. With a strong reputation for operating HH sites, we now also offer a national solution for NHH sites to deliver to businesses: • automatic remote meter readings and accurate to the minute billing • energy management data and reporting with notification of overconsumption • a consistent national metering service, e.g. to manage the new connection process • integration of remote logging from sub-metering and other utility meters. When you choose the Western Power Group for your
smart metering, you have the confidence of working with a company with many years’ experience of helping UK organisations manage energy more efficiently. As an independent company, WPD Smart Metering works with your supplier on behalf of your business to deliver a firstclass service – from low cost installation of the latest smart meter technologies through to full maintenance and support. FOR MORE INFORMATION Tel: 08457 448900 smartmetering@ westernpower.co.uk www.wpdsmart metering.co.uk
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HEALTH BUSINESS MAGAZINE | Volume 11.9
REDUCING ENERGY BILLS
How many healthcare organisations realise that ROIs of more than 30 per cent are available from energy efficiency programmes? Do you get more than 30 per cent interest on your bank account? Well, I don’t either but that kind of rate of return is achievable on energy efficiency investments, so it pays (literally) to take a closer look. We are all being urged to cut emissions and become greener, but often this is associated with long term investment. Looking at government schemes for promoting on-site renewables like the Feed In Tariffs (FITs), these are based on a Return on Investment (ROI) of just eight per cent so you would be looking at periods of more than ten years to achieve payback. The proposals for the Renewable Heat Incentive (RHI) look a little more generous – the ROI is about 12 per cent – but even here most organisations are unlikely to see a return before the decade is out. Compare that with energy efficiency investments and the difference is striking. For example, the Carbon Trust, where most of their recommendations have paybacks of less than three years. And where ESTA members are involved in investment proposals, these regularly have an ROI of 30 per cent or more. A report by the Carbon Trust suggests that all the organisations with an energy bill of over £1 million a year in the UK could save a cumulative total of £1.6 billion a year from energy efficiency. That is a great deal of wasted money. UNDERESTIMATING Another very telling finding in the Carbon Trust report is that chief financial officers (CFOs) consistently underestimate the Internal Rates of Return (IRR) on energy efficiency investments. The average IIR of recommendations made to large organisations by the Trust was 48 per cent. By contrast, when CFOs were asked to estimate the average IRR of energy efficiency improvements, the average response was just 19 per cent, less than half the real figure. In fact, almost two-thirds thought that returns would be less than 20 per cent. Clearly, if senior financial officers are so unaware of the economic value of energy efficiency they are unlikely to be pre-disposed to requests for investment. This will then impact heavily against energy efficiency when capital programmes are constrained anyway. There will be a predisposition against such investments when in
reality they offer astoundingly good returns. The moral from this report: make sure that you have your figures right and be prepared to challenge misconceptions. When evaluating energy efficiency improvements and equally when preparing proposals for senior management, it is essential to have reliable figures on payback, ROI or IRR, depending on the metric used to prioritise spending. Show a comparison with other projects that have been approved. This will make it more difficult to reject projects. It is also worth looking at the typical rates of return achievable for different technologies. And let us not forgot the most cost-effective (but sometimes the most difficult to maintain) action programmes. These are the ones involving change of behaviour. SUPPORT FROM TECHNOLOGY Energy saving campaigns amongst staff are not sufficient on their own – they become far more effective when they are supported with technologies to manage and control consumption. In addition, to be really effective, they need to become embedded into everyday operational practice. However, the big advantage of such campaigns is that the capital cost is virtually zero. But unless fully embedded in organisational practice and unless continually refreshed, such campaigns can lose their edge. Furthermore, lighting, heating and other technologies need to be optimised and controlled. Getting systems to work most efficiently will require financial investment. Energy efficiency covers a whole range of technologies and the typical payback periods on the investment vary. Projects can range from simpler measures, like the installation of automatic Monitoring & Targeting (aM&T) through lighting controls, to major items such as Combined Heat & Power (CHP) and renewable energy. Monitoring & Targeting systems are essential
A SYSTEMATIC APPROACH While individual measures can secure significant cost (and carbon) savings, effective energy management requires a comprehensive approach to the challenge of controlling energy bills. For example, while replacing lamps with low-energy versions will certainly save money, adding controls at the same time to ensure that they are only on when needed will act as savings ‘multiplier’. Reduced electrical loads often results in less heat gain and therefore lower air conditioning requirements. Energy efficiency measures typically open up other opportunities for more savings. With so many choices available, financial metrics offer a simple way to distinguish which ones will be most cost-effective. The finance department will have its own preferred metric and it is important to take this into account as it will affect the financial attractiveness of different projects. Finally, a word about renewables. By tackling energy wastage and reducing energy demand, the cost of switching to onsite renewable energy – whether CHP, photovoltaics or windpower – can also be significantly reduced. Energy efficiency and renewable energy should not be regarded as an either/or choice. But it is important to address them in the right order. Energy efficiency will reduce demand and this means that the size (and cost) of the renewable energy capacity can also be reduced. L
Written by Alan Aldridge, executive director of the Energy Services and Technology Association (ESTA)
THE ECONOMIC VALUE OF ENERGY EFFICIENCY
components of any systematic approach to energy management. Although the exact payback will depend on the size and complexity of the operation, aM&T systems typically have a payback of less than a year in terms of energy costs saved. Lighting controls may take longer to achieve payback – between one and four years – but a comprehensive programme can reduce the energy required for lighting by up to 30 per cent. In many buildings, lighting can in fact be one of the main electrical loads. Another area where quick and substantial savings can be achieved is in the choice of motors. Many items of equipment have motors and while modern units will have variable speed drives (VSDs) or inverters, older versions may not. VSDs allow motor output to be aligned with load. Motors are traditionally inefficient at part load, yet since most purchases are made on the basis of maximum likely requirement they operate at part load most of the time. So make sure that equipment like air conditioning systems with motor-driven fans are fitted with these devices.
Energy
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FOR MORE INFORMATION www.esta.org.uk
While individual measures can secure significant cost (and carbon) savings, effective energy management requires a comprehensive approach. Volume 11.9 | HEALTH BUSINESS MAGAZINE
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Interior Design
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
PLANTING SCHEMES
HEALING THE NATION, ONE PLANT AT A TIME
A well thought-out interior planting scheme in healthcare settings has a value beyond aesthetics, writes Kelly Conway from the British Association of Landscape Industries Faced with the complex, long and costly process of the design and build of a health facility, planners may often consider gardens and indoor planting schemes as desirable but nonessential. However research suggests plants in healthcare may have a value beyond the aesthetics. This article will look at the benefits of a well thought out interior planting scheme as well as review successful cases. The inclusion of gardens and planting schemes in health facilities has been around for many years, dating back even as far as the middle ages where monasteries created gardens to soothe the ill. The traditional view of hospitals and health facilities as perceived by patients is clinical and that they are unwelcoming places which carry great stigma. A well thought through design combined with clever use of planting can provide a calming effect, pleasant nature and creates a escape from more clinical settings. A SOOTHING AFFECT A study in 1984 by Roger S. Ulrich, Ph.D, Professor of Architecture at Texas A&M University, examined whether a view of vegetation had a direct effect on health and recovery from illness. Randomly placed patients who had a view of vegetation and plants had significantly reduced recovery times and also more positive notes in their records compared to those who simply had a view of a brick wall and no planting. Creating a calming and less clinical environment in health facilities can also benefit a patient’s thoughts and feeling towards hospitals in general, creating a less daunting environment especially for children. Visiting a clinical, stressful environment can have an adverse effect on a child’s development and recovery, creating a fun, playful environment with plants could be a solution to this. REAL LIFE EXAMPLE A planting scheme on the third floor of Evelina Children’s Hospital won a BALI National Landscape Award in 2009. It was installed by BALI Members Gavin Jones. The Evelina Children’s hospital was opened in 2005 and is designed as a modern, fun space for children to be treated and recover.
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HEALTH BUSINESS MAGAZINE | Volume 11.9
A crucial part of the design process was an extensive planting scheme to ensure children have access to views of nature in the hospital. The architects Hopkins Architects of London wanted to create the perfect environment for children to recover so many children who were treated at Guy’s were consulted about the layout, design, colour schemes and themes for the interior of the hospital. It was decided the third floor would have the theme of ‘Beach’, and included in this was a planting scheme which involved the installation of five 1m x 1.2m brushed aluminium containers containing quad-stemmed Veitchia palms reaching 4.5m high in total. Each completed planter weighs in at 1.5 tonnes each; the planters have been placed on the grid line above the structural pillars to distribute the extra weight evenly. The installation of the plants proved to be very testing process and careful planning by Gavin Jones Ltd was needed with each palm having to be craned up to the third floor with delicate manoeuvring. To dress the planters, the company decided to continue the hospitals fun and colourful theme and place light-weight hollow plastic balls, 50mm in diameter, on top of the compost. This was not only a great way to include some blasts of colour but also from a more practical view to prevent the children from digging in the soil. A protective layer was then put on top of the balls to stop the children removing them or throwing them around. The balls also allow the maintenance team to water the palms without any difficulty while providing an architectural finish to the project. BENEFITS FOR STAFF AND VISITORS It is not only the patient’s recovery who may benefit from the introduction of planting schemes but also visitors, family and staff who can often find themselves in stressful, painful emotional situations at health establishments and feel the need for the calming effect
or escapism of planting schemes and gardens. Great Ormond Street Hospital in London understood the value of a private garden for staff after two of its members of staff had been lost in the 7/7 bombings. The hospital wanted to create the opportunity for contemplation in recognition of the victims and also a space as an antidote to the hospital environment to improve the working experience for staff. BALI registered designer member Andy Sturgeon designed the roof garden on the seventh floor of the newly built Octav Botnar wing of the hospital. The design solution needed to be flexible and multi functional, with semi private areas for sitting and relaxing, socialising and eating, as well as having the ability to host large functions. The design solution created by Andy Sturgeon makes clever use of level changes and planting to create horizontal planes within the garden. These help define separate areas, whilst ensuring good circulation and easy access. The end result is an area where 3,000 hospital staff have access 365 days a year to an oasis of calm in their otherwise stressful day to day jobs. L FOR MORE INFORMATION www.bali.org.uk
The inclusion of gardens and planting schemes in health facilities has been around for many years, dating back even as far as the middle ages
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Facilities Management
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Quality stainless steel medical equipment from Norton Scientfic We pride ourselves on creating products that are not only fit for purpose but also meet your requirements, whether that means standard or bespoke designs. Our main areas of medical expertise include endoscopy, aseptic suites, clean rooms, theatres and bed side. We have a range of products from our highly successful transfer hatches, with an unrivalled selection of door options and variations, such as radiation environments, fire resistant glass and door seals. We offer large trolley hatches, compact dental hatches, under cupboards and supports, all made and installed to meet your needs. Other products include IV drip stands, either self supporting on wheels, or wall mounted options. Our electrical multiextension sockets for theatres,
have found favour amongst users, as do our trolleys of varying dimensions, step-over benches, chairs and stools with high quality anti-bacterial coatings. New to our range are the variable height sinks as used in endoscopy decontamination suites, which are now available. Norton Scientific is a limited company registered in England and all our products are designed and manufactured in the UK.
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ignored? Great signage is noticed, read and understood; Lasting Impressions offers clear, concise lettering on a striking backdrop in order to make sure your message is received loud and clear every time. We believe that our first class service will leave you with a Lasting Impression. FOR MORE INFORMATION To browse our full range of products or request a copy of our 92-page brochure. Please visit www.lastingimpressions online.co.uk or call our sales team today on 01308 456721.
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PRIVATE FINANCE INITIATIVES
Costs from Private Finance Initiatives have again put the health service in the headlines and highlighted the importance of meaningful information management and control Having suffered an interrupted night’s sleep I was listening to BBC Radio 5 Live in the early hours when the story about the rising cost of Private Finance Initiative (PFI) arrangements for the health service first started being broadcast. By morning this was the lead story on BBC news and national radio. The gist of the story is that the cost of PFI arrangements is rising faster than the healthcare budgets that have to fund it and so there is fear of funds having to be diverted from patients to cover this increasing cost. FUTURE PLANNING It appears, according to the BBC article and statements from government, that there is a concern that some Trusts in England have not budgeted for the index-linked nature of the agreements they have entered into. Obviously the current economic climate is not helping with the RPI, for example, above the inflationary increases in funding being provided and the drive for cost savings biting hard on already tight budgets. Concerns about
why an early PFI based Trust was showing premises costs some 18 per cent higher than the median for equivalent sized organisations. I said I felt they were doing well as I knew, from my experience working with a large civil engineering contractor in the early part of my working life, overheads and profit would account for some 21 per cent or more of contracted services costs. I appreciate that some may feel this might be a simplistic view but across my 30 plus years in the healthcare sector this has been borne out. From our own analysis of available information on the NHS, there are some interesting points to draw on. As one example, in 2004/05, the NHS Cleaning Manual was issued to drive up cleaning standards in the health service. Having looked at the cost of cleaning services across the intervening time there has been an understandable increase. As NHS organisations realised, through using tools like the HFC’s Credits for Cleaning (C4C) System, they were underfunding their cleaning services when compared with the
Buildings and equipment suffer wear and tear so maintenance costs climb. This is all predictable so why is surprise expressed now? Is it that, locally, financial management and Boards didn’t allow for the longer term costs? PFI and the long term costs were being raised by facilities managers from the outset. Way back, when PFI was being introduced to the health sector, PFI consortia approached us at the Healthcare Facilities Consortium (HFC) asking if we could help them with whole life costing figures for hospital-specific items as well as general items, such as lifts, in the healthcare environment. COST CONSIDERATIONS What has been indentified over the years was that the costs for a contracted-out service or PFI type arrangements soon overtook the previous costs for the in-house provision. There does have to be a cost to improving the facilities and this can come in two forms: interest payments on borrowing or profit and shareholder dividends to commercial companies providing the premises and services. When visiting Quarry House several years ago I was asked if I could help explain
new standards and budgets were increased. The benefit of this work is that HCAIs have reduced significantly. We are not so naive as to claim that this is the only reason for the reduction; there has been a raft of measures of which the improvement in cleaning funding and monitoring is but one. However, we now have a concern that the drive for cost savings on ‘back office’ costs has the potential to undo a great deal of the good already achieved. Another concern is that some of the Key Performance Indicators with which we have worked for years in the HFC benchmarking information service, and which have provided real trend analysis of healthcare premises management performance and costs, have been rendered incomplete by recent changes in the statutory data collection. As an example car parking costs and related information is no longer collected but it is clear from surveys carried out by Which?, for example, that there
is great public interest in such emotive issues. With changes in the data set relating only to Foundation Trusts (in England) removing many data entities that contribute to the overall costs of occupancy we are having to place caveats on our information as Foundation Trust costs start to appear low compared to the remainder. At a time when managing costs is a very real issue, it is incongruous that such action means it is now more difficult and time consuming to make realistic comparisons around the service as a whole. HOW DOES THIS RELATE TO PFI? The cost of providing healthcare to the nation is made up of lots of small parts. Government grants an overall budget which is handed down through various (changing) channels. Ultimately significant parts of this budget end up with our local hospitals. Some of the service provision is made in PFI premises and the rest is not. We need to be able to accurately compare like with like in order to see if the cost/benefit of PFI is worthwhile. A new hospital should be easier to clean and maintain and major plant and equipment should not need replacement in the early years so these costs would naturally be lower, balancing out to some degree the overall cost of the PFI development through the contract fees. However, life moves on and buildings suffer wear and tear and equipment starts to wear out and require work and so the maintenance costs start to climb. But all of this is predictable so why is surprise being expressed now? Or is it that, locally, financial management and boards had not allowed for the longer term costs? For me, a great deal of this is summed up in a comment posted on the BBC website: ‘Paying in instalments for something is always going to be more expensive than paying up front. If PFI had not been used, where would the money have come from to build these hopsitals? Are we saying it would have been better NOT to have built them rather than use PFI? How would we have got these hospitals in a way that would not have added to government borrowing?’ Is the real issue simply that the costs have not been properly predicated and built into the business cases, or has the economic situation caught boards and finance managers by surprise? I suspect that the answer is both.
Written by Keith Sammonds, MD, Healthcare Facilities Consortium
PFI PERFORMANCE SLIDES BACK INTO THE SPOTLIGHT
Facilities Management
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FOR MORE INFORMATION www.hfc.org.uk
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CLEANING STANDARDS
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EVIDENCE OF CLEANLINESS How can healthcare organisations critically evaluate, plan, apply and measure cleanliness provision? David Griffiths investigates In June 2011 the British Standards Institution (BSI) published the Publicly Available Specification (PAS) 5748:2011, a specification for the planning, application and measurement of cleanliness services in hospitals. Sponsored by the Department of Health (DH) and the National Patient Safety Agency (NPSA), the PAS is designed for use on a voluntary basis by healthcare organisations in England, but may also be of interest to other organisations. The PAS was written by David Griffiths, Director of David Griffiths Associates Ltd (DGA), an independent consultancy specialising in assisting healthcare organisations to improve the provision of cleanliness and other facilities management services. However leading organisations involved in healthcare cleanliness have also contributed valuable input to the specification, such as the the Association of Healthcare Cleaning Professionals and the British Institute of Cleaning Science (BICS). Dr Liz Jones, head of patient environment at the Department of Health, who launched the PAS at the annual conference of the Association of Healthcare Cleaning Professionals, said: “PAS 5748 is a major milestone along the road to clean, safe hospitals and healthcare environments. It represents the culmination of a process to identify and standardise healthcare cleaning processes and procedures which started a decade ago.” Clearly, this new specification is intended as a landmark document for the NHS in England, and indeed its very number commemorates the founding of the National Health Service on 5 July 1948. This article looks at what this important new system seeks to do, why
it was needed, how it was developed, what challenges its implementation will create for NHS organisations, and how its principles might be employed beyond England. A SAFE ENVIRONMENT A key priority for all healthcare organisations will always be the provision of a clean and safe environment in which clinical activity can take place. This is important not just for the control of infection, but also because a visibly clean environment promotes patient, public and staff confidence. Moreover, in England, healthcare organisations are required to register with the Care Quality Commission (CQC). In order to do so, they must meet requirements specified in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. A major part of these requirements relate to cleanliness and infection control. PAS 5748 seeks to provide healthcare organisations with a risk-based system with which to critically evaluate, plan, apply and measure cleanliness provision. Its adoption by a healthcare organisation is likely to be used as part of a healthcare organisation’s evidence of intent to comply with the registration requirements of the CQC. GUIDANCE It is important to stress that PAS 5748 has not arrived out of the blue. It is, rather, the culmination of many years of work in this difficult field. Specifically, it builds on the experience and content of the National Patient Safety Agency’s ‘national specifications for cleanliness in the NHS’ (NSC), the most recent version of which was published in April 2007. Healthcare organisations will remain free to continue to use the NSC, although it will
no longer be updated by either the NPSA or Department of Health. The new PAS is expected to be used in conjunction with May 2009’s ‘Revised Healthcare Cleaning Manual’ – developed by the National Patient Safety Agency in conjunction with the Association of Healthcare Cleaning Professionals – and of which David Griffiths was the lead editor. The PAS also draws on work from the management of cleanliness performed outside of a healthcare setting, and is consistent with the existing British Standard for the measurement of the quality of cleaning services, BS EN 13549:2001. WHAT DOES AS 5748 DO? Essentially PAS 5748 provides a detailed methodology for: • the governance of cleanliness provision • the assessment of cleanliness risk • the planning and provision of the performance of cleaning tasks • the measurement of cleanliness • the implementation of corrective actions • the analysis of performance and the implementation of systematic improvements to cleanliness provision • the reporting of cleanliness performance. So, for example, with regard to governance, PAS 5748 clearly describes the way in which a healthcare organisation must document: • its cleanliness policy • the accountability of named persons for cleanliness within each ward or department • the accountability of named persons for the provision of cleaning services performed by a group of staff, such as nurses, cleaners, and estates personnel • cleaning method statements, work schedules and pro formas. A RISK ASSESSMENT TOOL The PAS’s innovative approach to the assessment of cleanliness risk is perhaps the E
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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Cleaning
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Accuro: Wellbeing begins with a clean environment
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Visiting a hospital or healthcare centre and discovering it is not the cleanest place to be is not a good start on the road to recovery, and creates doubt about all aspects of the care on offer. Accuro believe the healthcare environment is critical to the wellbeing of any patient, regardless of the level of care received. Unsatisfactory or unpleasant environments can ruin the experience of care completely, making the feeling of ‘overall wellbeing’ hard to obtain. Patient satisfaction is measured by the whole care experience and environment and cleanliness has a great impact. Accuro has always achieved excellent levels of service within healthcare, in all areas such as methods, standards, cleanliness and infection control and has consistently received high scores, commendations
Vileda Professional offers a wide range of innovative cleaning products including mopping systems, trolleys, cloths, scourers, floor maintenance pads, and gloves for use within the contract cleaning, public sector, healthcare and catering markets. The latest addition to the hugely successful Swep preprepared mopping range is Swispo, a disposable microfibre moping system ideal for hygiene critical environments. Together with Microroll, disposable microfibre cloth, they provide the ideal solution to reduce cross contamination between areas at a ‘throw away price’. In addition, we have also introduced mops and cloths containing silver antibacterial technology to reduce bacterial growth. This also helps to reduce cross contamination and keeps them fresher
and awards for its results. Advice: A service provider must be able to integrate their management and systems with yours and prove their standards via audit results and industry reporting. Big and well known is not always best. Your provider needs to understand your space intimately, see itself as part of the healthcare provision, and tailor its services in real time to fit the demands on your environment, as Accuro does. FOR MORE INFORMATION Stephen Goodall Tel: 020 78811888 stephen.goodall@ accuro-fm.co.uk www.accuro-fm.co.uk
and in-use for longer. With over 30 years’ experience in the cleaning industry we know that professional users in different environments have different needs so we provide a complete service from initial site survey to implementation and training, to ensure you have the best solution tailormade for your requirements. FOR MORE INFORMATION Tel: 01706 759597 Fax: 01706 751757 vileda.professional. uk@fhp-ww.com www.vileda-professional.com
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HEALTH BUSINESS MAGAZINE | Volume 11.9
CLEANING STANDARDS E clause likely to attract the most attention. The PAS contains a clause describing in detail the required risk assessment methodology. In what amounts to a synthesis of previous practice the framework gives equal value to infection control risk on the one hand, and public, patient and staff risk on the other. Moreover, the framework is subtle enough to recognise that an element (i.e. any item which needs to be cleaned), may carry a different risk rating dependent on where it is located. The expectation is that this will arm healthcare trusts with a standard, stateof-the-art risk assessment tool which will permit it to make an accurate assessment of the actual cleanliness risk which exists in each area of each trust, and to use this information to make informed and minutely-detailed decisions about frequencies for the performance of cleaning tasks and for the frequencies with which cleanliness is monitored. WHY WAS THERE A NEED FOR THIS NEW SPECIFICATION? Clearly a major driver was to give Trusts a tool which would allow them to make an informed decision about the allocation of resources required in their particular organisation to mitigate the cleaning risk identified in their particular Trust. The aim is to move away
intention to comply with the CQC’s requirements for registration. There is also, however, a further potential benefit to healthcare organisations choosing to comply with PAS 5748. It is highly likely that patients making an informed choice about which healthcare organisation to use will use cleanliness as part of their decision-making process. The new specification, which carries with it the prestige of the trusted BSI brand and of the sponsoring and contributing bodies, is likely to assist healthcare organisations compliant with the PAS in giving confidence to and attracting potential patients. A MEETING OF MINDS How then, was the process of creating this landmark specification approached? Its genesis came in a meeting of minds between experienced officials at the DH, NPSA and BSI, who identified a potential need for a strictly unambiguous specification carrying the imprimatur of all three bodies. Very quickly, a series of study days was set up to which a huge variety of stakeholder organisations were invited. From these initial study days the basic outline of the new specification was developed. A steering group was then set up, comprising the DH, NPSA, BSI, representatives of key stakeholder
PAS 5748 is a major milestone along the road to clean, safe hospitals and healthcare environments. It represents the culmination of a process to identify and standardise healthcare cleaning processes and procedures which started a decade ago. from the one-size-fits-all, centrally-imposed directive which was a characteristic of previous specifications for cleanliness. These specifications sought to generally drive up cleanliness standards. Whilst they did not impose precise standards as such, they included what were styled ‘indicative aims’. We are now witnessing a development in approach. This recognises that a more detailed and location-specific approach is needed, recognising that each healthcare organisation is itself best placed to assess its own particular risks, and to decide how most effectively to mitigate them. In light of this, it is expected that PAS 5748 will be particularly attractive to Foundation Trusts, which will want to sculpt service delivery in a way which is appropriate to its own local requirements within a nationally-recognised framework. This concept of national recognition is, of course, very important. We have already touched on the role of the PAS in demonstrating a healthcare organisation’s
organisations and the technical author, and then a series of drafts were developed. These early drafts were governed by clear principles set by the steering group. One such principle was to retain the best elements of the existing specifications, and where changes did prove necessary, to keep them to a minimum. So, for example, the familiar basket of 49 representative measured elements (items whose cleanliness is measured), was kept at a similar level, increasing to 50, and the composition of the elements was amended slightly to ensure that the new standard would be appropriate for use in mental health and continuing care, as well as in acute settings. The result is that a familiar and recognisable concept has been retained, but refined and improved upon. STAKEHOLDER FEEDBACK Once the first round of drafting was complete, a public consultation was conducted, and this drew in several hundred comments from a large range of stakeholders. In addition,
Cleaning
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an important series of trial implementations at the fourteen participating NHS trusts was undertaken. Both processes fed into the content of the development of the document and led to a number of simplifications designed to make compliance with the specification easier to achieve. Finally, the draft was put through a further round of revision, designed to ensure total compliance with the BSI style, and the ruthless removal of any potential ambiguity. The systematic avoidance of ambiguity has clearly been an absolutely key priority throughout, and, as stated earlier, was certainly one of the major factors which led the sponsors to seek to work with BSI at the commencement of the project. This has a particular relevance for the auditing of cleaning. In just one example, the PAS makes it quite clear that ‘the cleanliness of each scored element shall be assessed as it appears on first inspection. If the element does not conform to the cleanliness criterion, it shall be scored 0, irrespective of whether it is immediately cleaned thereafter.’ Moving to the more tightly specified process set out in the PAS will provide trust boards with the challenge of agreeing a cleanliness performance level for the organisation. So that patients and the public can be assured that high standards are being maintained, the PAS also requires that information about the achievement (or otherwise) of that level be made available on request. This will pose one of several challenges to implementation. CHALLENGES What other issues are likely to face healthcare organisations wishing to implement PAS 5748? As we have seen, the specification is admirably clear and well-written, so interpretation and ambiguity should not be a problem. However, the process of implementation will require a root and branch review of current cleaning service delivery, and the governance, risk assessment and documentation processes will require commitment and input at senior and operational level within organisations. It is anticipated that implementation of the provision of this PAS will be entrusted to appropriately qualified and experienced people for whose use it has been produced. Undoubtedly PAS 5748 will in due course be used by the majority of healthcare organisations within England. But what is its future elsewhere? At this moment it is difficult to say, but it seems likely that other organisations will wish to adopt some of the principles contained within it, perhaps utilising the risk assessment tool without adopting the governance requirements, and may even wish to comply fully with it. This would be warmly welcomed by the creators of the PAS. L FOR MORE INFORMATION www.ahcp.co.uk
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Spend leSS AND
get more Discover a smarter solution for medical equipment maintenance When times are difficult saving should be about getting more for your money, not reducing quality. That’s why Asteral’s equipment management programmes are designed to generate significant savings on your maintenance contracts, while providing a more responsive and efficient service that uses only OEM engineers and spare parts. Premium quality, delivered at reduced cost, enabled by smarter thinking. To find out how you can spend less and get more go to asteral.com/getmore or call a member of the Asteral team on +44 (0)118 900 8100
SURGICAL TECHNOLOGY
Technology has revolutionised surgical care through advances in procedures, monitoring, infection prevention, training, safety standards, less invasive intervention – the list is endless Innovation in surgery has meant that more people’s lives are being changed or indeed saved. During a recent visit to the Thackray Medical Museum in Leeds I was reminded of how far we have come in such a short space of time. Technology has revoluntionised surgical care through advances in monitoring, infection prevention, training, safety standards, and less invasive intervention. Technology has also provided our patient population with the wherewithal to understand better the care/interventions required and with this has come high expectations and the knowledge to be able to question and challenge the care provided. At The Association for Perioperative Practice (AfPP) our aim is to advance health by improving patient care in the perioperative environment. We do this through determining standards and promoting best practice through training and education for our membership which is made up of theatre practitioners working in operating departments, associated areas and sterile services departments. INNOVATIONS As part of the event AfPP2010 we challenged our medical device partners to show us their best innovations and we were pleased to see that even in the 21st century there are changes and improvements still being made to ensure safer surgery for patients. Our winning entries included efficiency
use tray made from recycled products. The BUPA Foundation recently awarded a grant of over £200,000 over three years to a study that is seeking to develop an endoscopic instrument for keyhole surgery that will give surgeons information they can usually only obtain by touch when performing conventional open surgery. If successful, this will dramatically increase the diagnostic value of keyhole surgery. As I touched upon above, information technology is also assisting surgical outcomes and patient efficiencies through the use of SMS messaging surveillance, and studies have shown that this has decreased the outpatient waiting times and increased the quality of post surgical care. ROBOT-ASSISTED SURGERY When I was a girl I watched a TV programme called the ‘The Six Million Dollar Man’, about a man who was rebuilt following an horrific accident – he was said to be ‘bionic’. They used robotic techniques to put him back together which left him with the ability to, amongst other things, leap great heights, run amazingly fast and lift cars. Today we use the word robotic freely when referring to medical innovation and robotic prostatectomy is real procedure for patients with prostate cancer. Robotassisted surgery was developed to overcome limitations of minimally invasive surgery. Instead of directly moving the instruments
When I was a girl I watched a TV programme called the ‘The Six Million Dollar Man’, about a man who was rebuilt following an horrific accident – he was said to be ‘bionic’. They used robotic techniques to put him back together. gains through collaborative working; a retractor used in gynecological procedures to improve patient safety and reduce needle stick injury; an infection prevention solution to cut down on surgical site infection; a single use intubating scope; and a single-
the surgeon uses a computer console to manipulate the instruments attached to multiple robot arms. The computer translates the surgeon’s movements, which are then carried out on the patient by the robot. Other features of the robotic system include,
for example, an integrated tremor filter and the ability to scale movements (changing of the ratio between the extent of movements at the master console to the internal movements of the instruments attached to the robot). The console is located in the same operating room as the patient, but physically separated from the operative workspace, or in another place. Since the surgeon does not need to be in the immediate location of the patient while the operation is being performed, it can be possible for specialists to perform remote surgey on patients. We now have the technology to put people back together in ways similar to those experienced by Steve Austin the Bionic Man. I heard an amazing story this week about a woman who lost both her legs in the 7 July 2005 London bombings. In an attempt to bring communities together she walked 200 miles from Leeds to London over a period of a month. Only in my lifetime has healthcare become so advanced. Truly amazing.
Written by Dawn Stott, managing director, the Association for Perioperative Practice
TRANSFORMING SURGICAL CARE WITH INNOVATION
Medical Equipment
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
DEVELOPING THE SERVICE In his latest missive about the NHS reform plans, Andrew Lansley has stated that sticking to the status quo for the NHS is not an option. By 2030, the number of over-85s requiring expensive healthcare is projected to reach 3.5 million, or one in 20 of the UK population, said Mr Lansley in an article for the Daily Telegraph. As a result, the NHS will have to perform an additional two million operations a year and health spending will double to £230 billion – the equivalent of £7,000 a second – in real terms, a figure the UK “simply cannot afford,” he said. These comments only enhance the need for surgical procedures; whether they are interventions, care pathways or processes, to be better and more efficient to ensure that patients are getting the best possible care available. L FOR MORE INFORMATION www.afpp.org.uk
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Finance & Leasing
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
COLLABORATIVE PROCUREMENT
BUYING TOGETHER FOR BETTER VALUE Exercising more collective buying power between NHS Trusts could drive significant savings, argues NHS Supply Chain NHS Trusts face replacing half of all CT and MRI scanners over the next four years at a time when they have to deliver a 17 per cent cut to their equipment budget, a Public Accounts Committee (PAC) inquiry heard in September. In a report on this issue published by the National Audit Office (NAO) earlier this year, it was recommended that in order to maximise taxpayer value and secure best prices, NHS Trusts should collaborate in their purchasing of expensive capital equipment, such as scanners. This was a view echoed by NHS Supply Chain in their evidence at their inquiry. Appearing in front of the Committee, Andy Brown, NHS Supply Chain’s managing director, diagnostics said: “Trusts were already making savings but could achieve greater value by grouping together requirements for new machines.”
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LIFECYCLE COSTS Brown said: “NHS Trusts need to look at the whole lifecycle cost of their medical equipment in order to plan efficiently and to buy at best price. Implementing a significant budget cut at a time when half of scanning and imaging equipment reaches the end of its lifecycle is a major challenge, but is nonetheless achievable if trusts decide to work with NHS Supply Chain and exercise their joint buying power. There is no mandate to do this, so it is down to every Trust to recognise the significant economic benefits of collaboration through working with NHS Supply Chain.” The committee was convened to discuss the conclusions reached in the earlier the National Audit Office report which found that efforts to drive value for money from the NHS equipment budget was being frustrated by Trusts’ failure to
collaborate. The National Audit Office report, Managing High Value Capital Equipment in the NHS in England, examined NHS trusts planning, procurement and use of expensive medical equipment in three areas: Computed Tomography scanners used for diagnosis, Magnetic Resonance Imaging (MRI) and Linear Accelerator (linac) machines for cancer treatment. SPENDING RESTRICTIONS The National Audit Office report stated that Trusts were having to replace expensive machines over the next few years during a period where there was a 17 per cent reduction in capital spending within the NHS. The report also acknowledged that three quarters of trusts were already using the NHS Supply Chain framework agreements to lower the costs but that more could be done if they worked together. Brown added: “Buying and maintaining equipment during times of budgetary restraint will provide a significant challenge for NHS trusts and our range of frameworks to plan, aggregate, purchase or lease and maintain high end equipment will be invaluable to the NHS. If Trusts adopted good asset management practices for their medical equipment, this would enable them to plan better and buy better. E
COLLABORATIVE PROCUREMENT
“Buying and maintaining equipment during times of budgetary restraint will provide a significant challenge for NHS trusts and our range of frameworks to plan, aggregate, purchase or lease and maintain high end equipment will be invaluable to the NHS” E BULK BUYING OPPORTUNITIES “The NAO report acknowledged that 75 per cent of the NHS trusts are utilising NHS Supply Chain frameworks and are enjoying lower acquisition costs and equipment cost savings. Naturally Trusts get the benefit of NHS Supply Chain’s national pricing and we are already providing services to support a number of the recommendations in the Report. “However, there is no reason why the bulk purchasing arrangements we have already implemented could not be applied further with support from the NHS to co-ordinate and aggregate requirements. We have invested heavily in capital planning and leasing contracts to support Trusts and this facility, if adopted widely, will lead to more and more bulk buy opportunities for the Acute and Commissioning sectors.” L FOR MORE INFORMATION www.supplychain.nhs.uk
About NHS Supply Chain
Finance & Leasing
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
NHS Supply Chain is operated by DHL as Agent of the NHS Business Services Authority. It supports the National Health Service (NHS) and other healthcare organisations in England and Wales by providing end-to-end supply chain solutions. The organisation was formed in 2006 from the NHS Logistics Authority and parts of the NHS Purchasing and Supply Agency (NHS PASA). NHS Supply Chain aims to provide over £1 billion of savings to the NHS by 2016. NHS Supply Chain manages the sourcing, delivery and supply of healthcare products and food for over 1,000 NHS Trusts and healthcare organisations. It provides a single point of access to over 600,000 products ranging from baked beans to sutures, from gloves to implants, and even diagnostic equipment such as MRI scanners. Its management of the procurement process negates an NHS organisation’s need to tender through the Official Journal of the European Union (OJEU). Costs can also be reduced through its one-route solution that consolidates all products onto one invoice and delivery – this saves up to £1 per product in back office administration costs and removes up to 40 deliveries going into a trust compared with ordering goods separately. To ensure that its products are fit for today’s healthcare market, NHS Supply Chain works with suppliers of all sizes to ensure its range embraces high quality and innovative products. It engages with clinicians, the Department of Health and academic institutions to make sure that it is aware of the current requirements and latest developments in clinical practice.
Architecture, space planning and strategic space management The practice has over 13 years’ experience working in-house for large public and private sector institutions across London and the South East. We are equally at home preparing briefs, feasibilities and detailed proposals for any size of project, however large or small, and have the capability to manage complex, multi-sited property portfolios between 500 and 500,000 sq. ft. We pride ourselves in a professional and timely delivery of high quality information in a variety of formats to suit individual organisational technology platforms and communication methods. Benefits to an organisation of this working model can be summarised across rapid response and refinement of proposals, on-call service delivery and economic, high quality delivery. Professional and trade body
affilliations include RIBA Chartered Practice Federation of Small Businesses Approved Contractor – Chelmer Housing Partnership and Chelmsford Approved Contractor – St Georges Community Housing, Basildon. FOR MORE INFORMATION Glynn Williams Tel: 01245 222692 Fax: 01245 222692 Mob: 07973 835067 glynn.williams@tesco.net www.glynnwilliams architects.com
Expand the boundaries of healthcare by making it more affordable and accessible Cisco Capital® bridges the gap between the technology you need and the budget you have You want to deliver the best healthcare possible. That’s why we have tailored our flexible financing packages especially for you. With Cisco Capital you can spread the costs of your Cisco® technology over time with repayment terms to suit your budget. And to make sure you are always one step ahead, we can build-in a cost-effective technology refresh. Don’t let legacy technology hold you back. Talk to Cisco Capital so you and your patients can start reaping the benefits of the very best technology, without breaking your budget.
For more information visit www.ciscocapital.com/emea or contact capital_uki@cisco.com
32722_ad_healthcare_v3.indd 1
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Transcend Group Ltd Management Specialists
Going Beyond, Excelling, Exceeding Expectations What is Leadership? The journey to organisational Transcendence begins with you. As an Executive you have a fantastic opportunity to create a winning culture, a “can do” belief amongst your people. So develop your Leadership style into a Strategic and Humanistic approach and get the very best from your Team. We often get asked “What is the difference between a Leader and a Manager?” The graphic below answers this question. Managing
Leading
Plan Organise Direct Co-ordinate Control
Vision Empower Coach Care
Doing Things Right
Doing The Right Thing
Getting Results
Improving Systems
At Transcend Group we can help your organisation with its Leadership, whether it’s at Team Leader or Senior Executive level. We are a fully approved ILM Centre offering Level 2 to Level 7 Leadership development in NVQ, Award, Certificate & Diploma qualifications. Why don’t you phone me now Roger G. Edmonds and let’s start discussing your requirements? I would be pleased to visit so we can more fully present our Company and detail how effectively we work with our customers through our Project Based Learning system. T: 01386 446100 M: 07860 654904 F: 0870 7052886 info@transcend-group.com www.transcend-group.com De Montfort House, Enterprise Way, Vale Park, Evesham, WR11 1GS
Leadership – Strategy - Productive Ward - Coaching
Short courses for management & professional development The ideal opportunity to mix & learn with managers & professionals from all sectors PASS Training is a leading training company with experience of delivering a broad range of in-house training courses, including Civil Enforcement Officer, Health & Safety, First Aid and Notice Processing training and many more. We work in both the private and public sector including Local Government, the Parking Industry and Security. Our CIPD training consultants engage with our clients to ascertain their real training and development needs and provide bespoke training programme’s that seamlessly fit your company’s requirements and culture. Within these training programme’s we offer the use of a variety of tools including Psychometric testing. These assist in producing self-managed learning resources and facilitate group learning, with training courses designed to meet your staff and organisations needs. We provide training consultancy services in the UK and have within our team over 30 years experience in providing high quality industry leading training solutions. info@passtraining.co.uk Tel 0843 2895581
October 18-19 20-21 21
Finance for Non-financial Managers Strategic Thinking & Business Planning Managing Remote Teams
November 1 8-9 28-29 30-1
Writing Reports & Proposals Managing Change* Managing People & Performance* Time Management & Personal Effectiveness*
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Speaking & Presentation Skills Introduction to Management*
All courses central London. In-company and tailored courses also available. Take learning further—courses marked * can be linked to CMI Qualifications at Levels 5 & 6
www.proseminar.co.uk Your partners in management development
TRAINING
High levels of patient care is the ultimate aim of the NHS, and strong leadership training is vital if the healthcare organisation is to produce the world-class managers it needs to achieve this aim There has been much discussion in recent months about changes within, and the future of, the NHS. During these debates, high levels of patient care have been lauded as the ultimate aim. However, in order to achieve this during these turbulent times it is imperative that the NHS is led by strong managers who are able to raise their game to unprecedented levels. They are being asked to take on a wider variety of tasks and to achieve more stretching targets with less support and resources. In many cases, even their own jobs are under threat. This has big implications for the way that managers approach their role and for the skills they will need. Ensuring they are supported with training will be imperative. THE NEED FOR STRONG MANAGEMENT The Chartered Management Institute (CMI) has worked with a range of employers and individuals in the NHS on the link between good management and leadership, and patient outcomes. The results, which are supported by the findings of government sponsored research (Assuring the Quality of NHS Senior Managers research report by PriceWaterhouseCoopers (February 2010)) show that improving leadership and management skills, including good employee engagement, leads to better staff performance, which in turn leads to more satisfied patients and better communication so that mistakes are avoided. In other words, good leadership and management practice means better outcomes for patients. What’s more, improving leadership and management skills ultimately saves the NHS money as problems and mistakes are avoided and efficiencies gained. For example, the NHS Institute for Innovation and Improvement estimates that its work has potentially saved the NHS £6bn over the last few years. For this reason alone, all NHS managers, whether clinical or non-clinical, should have the opportunity to develop and professionalise their leadership and management skills. By doing so, they will be better equipped to deliver the ambitious reforms being introduced by the government and ensure that patients’ needs are met. A major new report into the state of leadership and management in the NHS, published in May by The King’s Fund’s Commission on NHS Leadership and Management looked at the effect of ‘arbitrary’ cuts to NHS management and supported this view. The report concluded that plans to cut managers and leaders in the health sector will lead to financial failure instead of improved patient care.
training. It’s a worry when there are a variety of qualifications already in existence which can be easily applied to the healthcare environment to equip managers with the skills they need and help to justify their position within the health service. Ultimately, every manager and leader ought to have access to the best available learning materials so that the right skills are developed and patient-centred care becomes a reality. If the planned refocusing of NHS resources is to be successful, it is vital that we have a health service where leadership and management standards are consistent, no matter what part of the country a patient is in or whether the people they come across are clinical or general managers. CMI’s research found that some three-quarters of healthcare managers think they should be judged by an agreed set of professional standards. So there is clearly a thirst for standardisation within the NHS. And with King’s Fund report rightly making it clear that the priority for the future NHS is to deliver the best possible patient care, staff will be better engaged in an NHS where all managers are trained and developed to national professional standards. L FOR MORE INFORMATION www.managers.org.uk
Written by Mike Petrook, head of public affairs, the Chartered Management Institute
ROBUST LEADERSHIP DELIVERS EFFECTIVE CARE
Leadership & Management
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
THE IMPORTANCE OF QUALIFICATIONS Managers and leaders are much more than bureaucrats there to tick boxes; they are essential to drive change, identify opportunities and set a vision of where the NHS is going – more important than ever under the current reforms. The fact that managers and leaders do not work on the front line can also help give them the objectivity needed to make vital decisions that directly impact those who are ‘on the ground’. The government says it wants to make ‘the NHS work for patients, not bureaucrats’. They’re right to have this as an aim, but the fact is that managers and leaders have a vital role to play in nursing the NHS back to health. Only by having managers who meet a professional and consistent set of skills standards up and down the country, will we have leaders who can make a difference, and help the NHS perform successfully. Encouraging take-up of professional management qualifications in the health service is an important step in this process. Yet research by CMI, which represents 3,000 health sector managers across the UK, shows that just 37 per cent of healthcare managers believe they have had sufficient
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NEW from Nordic Care Services Ltd. Nordic Care Services Ltd are proud to announce the launch of our new Moving and Handling Training Packages Designed and created by Gavin Wright, winner of the best practice award for moving and handling in the official 60th anniversary of the NHS publication, these packages have been produced in line with the most recent advances in moving and handling practise and can be tailored to include local and specialist needs. Train the Trainer A 5-day comprehensive Train the Trainer course including How to Teach, Duty of Care, Legal Requirements, Risk Assessment, REBA, Anatomy and Unsafe Systems of Work. Delegates will receive course materials worth £300 including the “Mini Masterclasses” DVD containing 22 mini lectures from some of the leading Manual Handling Practitioners and related professionals working in the UK today. This production is only available from NCS Ltd. This course complies with the minimum standard that any key trainer should be at according to the latest “Standards in Manual Handling” published in 2010.
Induction Training We will cover moving and handling of people and of objects and will have a greater emphasis on the aspect that is most relevant to the course attendees. Annual Refresher A 1-day update course, which can be designed for trainers or staff depending upon the requirements of the organisation. Understanding REBA Intended for Managers and Supervisors, this instruction in Rapid Entire Body Assessment will allow them to make a qualified assessment of the risk involved in performing manual handling tasks. Delegates will have access to the online REBA tool for quick and easy assessments PTLLS Can be incorporated into the courses above, should the trainer require a formal teaching qualification. A requirement if teaching in colleges and many other establishments. E-learning We can now offer E-learning courses for students as well as instructors. These courses will cover the theoretical aspects of Moving and Handling, allowing instructors and students alike to concentrate on practical training within the classroom. Coursework can be monitored to ensure that the required theoretical topics have been completed to an acceptable level before covering the related practical training. For more information on the courses above, our CPD accredited Moving & Handling workshops or our ranges of Hygiene, Daily Living and Moving & Handling products, please contact Nordic Care Services Ltd. on 01227 479293 or e-mail us at info@nordiccareservices.co.uk. Alternatively contact Gavin Wright direct on 07896 744051 or by e-mail at gavin@nordiccareservices.co.uk Nordic Care Services Ltd. 307 – 309 Lombard House Business Centre, 12 – 17 Upper Bridge Street, Canterbury, Kent CT1 2NF Web: www.nordiccareservices.co.uk Tel. 01227 479293 Fax. 01227 477958 E-mail: info@nordiccareservices.co.uk Registered in England and Wales No. 4486082 VAT No. 797 6774 43
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
EVENT PREVIEW
PEOPLE HANDLING BEST PRACTICE Moving & Handling People 2012 will keep visitors informed on the latest health and safety issues surrounding people handling
The provision of healthcare is changing and consequently setting many challenges for service providers. With further financial restrictions likely, the one thing that remains constant is the need to provide services which are responsive to organisational and individual client needs. The format for Moving & Handling People 2012 is designed in three parts in order to provide delegates with up-to-date information and thinking on areas of DoH strategy, legislation and policy. This will take place in a series of plenary and concurrent sessions, four interactive practical problemsolving workshops and a comprehensive exhibition, as well as a Professional Resource Centre and New Products Poster Gallery. The annual CPD accredited Moving & Handling People is now in its 18th year and has become the recognised professional update for those working in or involved in this area of practice, designed for both hands-on practitioners and managers with a strategic role in organisational risk management and moving and handling. It takes place 2-3 February with the Preconference New Products Workshops on 1 February at the Business Design Centre, Islington, London. The event is run by and organised by Disabled Living Foundation (DLF).
Patient Handling
Sponsored by
HEALTH AND SAFETY The key to safer people moving and handling is not only an awareness of handling techniques and the use of equipment but also understanding how moving and handling is part of health and safety for everyone – carer, patient and client. These issues will be examined and discussed throughout conference with a question panel at the end of the event. Professionals who would benefit from attending the event are those that produce health and safety policies and procedures for their organisation and staff that are involved in an organisation’s risk management strategy and ergonomic assessments of handling tasks. Those that provide education, training, advice and information to workers will also benefit. The event is CPD accredited and provides an enjoyable and stimulating environment in which to learn.
The main two day programme is designed so that delegates have the opportunity to attend all the plenary and concurrent sessions and workshops, as well as spend time at the exhibition identifying relevant products and discussing equipment and moving and handling issues.
LEARNING OPPORTUNITIES The event provides a range of learning opportunities designed to help delegates and organisations reduce the risk of work related musculoskeletal injury whilst improving client care, offering new and up-to-date information. The Pre-conference New Product Workshops provide an opportunity to view a range of products new to the UK market for use in the home, social care and acute environments for children and adults, including bariatric clients. The workshops are facilitated by experienced moving and handling practitioners working in a range of settings. Visitors can view and discuss products E
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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Phoenix Private Ambulance Service Ltd
Specialised Passenger Transport Based in Warwickshire we provide a uniformed and specialised private ambulance service to meet the needs of those with impaired mobility for whom safe and comfortable travel is difficult. This includes stretcher and wheelchair passengers. For example: n Transfers to and from hospital outpatient appointments n Transfers to or discharges from hospitals n Moves to and from care, retirement or nursing homes n Local and long distance disabled and patient transport nationwide Our CRB checked team pride themselves on providing a careful, understanding, prompt and comfortable service and we have gained a reputation for providing consistently high standards. We are registered with the Care Quality Commission, our vehicles are regularly inspected and are maintained to a high standard. Our stretchers and lock systems are tested to meet BS EN 1789:2000 standards and wheelchair restraints conform to the dynamic test requirements of ISO 10542. Our fleet is based in Leamington Spa and although most of our work is centred around the Midlands we are able to provide transport anywhere in the UK.
For more information go to www.phoenix-ambulance.co.uk or call 01788 816192.
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SwiftTech Hoists – support for less-mobile patients At SwiftTech™, we have over 20 years experience in providing innovative lifting and hoisting equipment to assist in the lifting of patients, disabled people and those needing support with bathing and mobility, especially those who are obese. Our hoists and lifting equipment products are designed, built, supplied and maintained to the highest standards and according to your specific needs. SwiftTech offer an extensive range of ceiling hoists, patient hoists, tracking hoists, lifting equipment from SwiftAir, BHM, Liko, Invacare and other leading suppliers worldwide. Hoist and lifting equipment services provided by SwiftTech include product advice, cost management and consultation for ceiling and tracking hoist and lifting systems. We also provide ceiling, tracking, and mobile hoist demonstrations and
evaluations, as well as the planning and design of lifting and hygiene equipment. Equipment installation and after sales maintenance and support is also offered. Strategically situated in the South of the UK with easy access to London, the midlands and the south and the south west, SwiftTech™ can offer this specialist market place an honest, on time, reliable and professional service to all within its ever increasing customer base. FOR MORE INFORMATION Tel: 01225 792650 sales@swifttechhoists.co.uk www.swifttechhoists.co.uk
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
EVENT PREVIEW E in development and bespoke equipment with suppliers in the workshop’s display area between sessions. This part of the programme is a focused set of workshops for manual handling practitioners and strategic leads responsible for identifying new products designed to enhance care and reduce the risk of work related musculoskeletal injury to workers. The main two day programme is designed so that delegates have the opportunity to attend all the plenary and concurrent sessions and workshops as well as spend time at the exhibition identifying relevant products and discussing equipment and moving and handling issues. The New Products Poster Gallery highlights new equipment, which you can then view and discuss. Then using some of the information you can enter the conference competition to win a three day/two night trip to Prague for two. NETWORKING There are numerous opportunities to network with other professionals and suppliers and the chance to swap information and ideas throughout the event. Post conference, delegates will receive one year’s free access to a portal of equipment for moving and handling people – this represents an invaluable tool when identifying products to assist clients and carers in reducing the potential for work related musculoskeletal injury. The Practical Interactive Problem Solving Workshops are structured around ‘real life’ scenarios to develop assessment skills and systems of work to promote safe practices.
These four workshops will consider paediatric and adult moving and handling issues and solutions in home, social care and acute environments. They are focused on: • Designing safe systems of work for handlers • Use of equipment in emergency situations • Practical skills in complex handling situations • Falls management and retrieval ENHANCE LEARNING The event is designed to support personal and organisational learning aims for delegates and encourages active participation in the problem-solving workshops and discussion following the presented sessions. DLF encourage all delegates to consider how they can use attending this event to influence best practice in their workplace. Come along and discuss your own issues and handling problems and take the opportunity to discuss these with your peers, colleagues and representatives in the professional resource centre. Recognising that budgets are undoubtedly under strain, DLF has held delegate rates at 2010 prices with a three-for-two offer and early bird discount. So join up with two colleagues and save over £145 + VAT each on your places. (Based on booking an early bird place for the main two day conference + Pre-conference New Products Workshops with the three-for-two offer compared to the cost of a standard rate place). L
About DLF
FOR MORE INFORMATION www.movingandhandlingpeople.co.uk
Feedback from past attendants
These four workshops will consider paediatric and adult moving and handling issues and solutions in home, social care and acute environments.
Patient Handling
Sponsored by
DLF is a national charity that gives impartial advice and information on all types of daily living equipment that helps older and disabled people to live independently at home For help and information about equipment and gadgets to make life easier, visit DLF’s impartial advice website ‘Living made easy’ www.livingmadeeasy.org.uk
Pre-conference New Products Workshops “Very useful to see that manufacturers have listened to the people using the equipment” – Pam Parker, Chase Hospice for Children “An event to introduce new innovative products with full explanation and demonstration” – Sharon Surtees, Newcastle City Council “A fabulous opportunity to road test and evaluate competing products” – Jo Meaton, Hereward College
Main two day event “Very useful update on techniques, equipment and broader issues concerning moving and handling” – Pauline Harris, M&H co-ordinator, Islington Council “The conference has achieved the aim of providing opportunities for ongoing learning and networking” – Sheryl Anton OT, Kingston Hospital “Good combination of practical M&H skills/technical info and management considerations/issues”– Richard Tomlin, quality manager, London Borough of Tower Hamlets
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Market Research
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Statistics Unmasked – a free guide to bringing your data to life
mruk – putting local health matters under the microscope
About three years ago a client asked us to summarise all the numerous analysis techniques we use. When completing this task I realised that many of the learned documents were not written to be easy for you to understand and use. ‘Statistics Unmasked’ has tried to address what is clearly a gap between the providers of these techniques and the users. Comments have been encouraging: “This is absolutely brilliant – really interesting stuff and a great magnum opus.” “It was a great piece of work which I passed on to the team.” In it I cover most of the popular techniques that help you obtain greater understanding of your data and therefore enhancing the value. It covers topics such as conjoint, key driver analysis, and segmentation; concentrating on the techniques we have found most useful. Many of the
With over 20 years’ experience in market and social research, we at mruk pride ourselves in delivering flexible and insightful solutions to meet your healthcare research needs. Because of our grounding in the local community we know how to get answers from the audiences that matter. We have expertise in health and wellbeing related issues, primarily for local and national NHS organisations but also on behalf of support groups. In particular we specialise in health programme evaluations, patient experience research, understanding barriers to healthcare services and evaluating communications and marketing campaigns. We know how critical it is to reach the right audiences.
techniques discussed can often be applied to your existing data. If you would like a free copy please e-mail me, with your name, job title and organisation and I will send you a pdf. FOR MORE INFORMATION Ed Newton, Prospect Consulting UK Ltd, Tel: 0844 561 7116 enewton@prospectconsulting.co.uk
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HEALTH BUSINESS MAGAZINE | Volume 11.9
PATIENT SURVEYS
RESEARCH: AT THE HEART OF HEALTHCARE PERFORMANCE
Market Research
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
An informed view from research helps healthcare professionals make critical decisions on issues ranging from budget allocation to information campaigns, writes the Market Research Society NHS reform remains at the top of the political agenda. It’s a period of uncertainty for healthcare managers and frontline staff alike but one thing is clear – change is coming. What won’t change, though, is the health sector’s need to understand the requirements of patients, and have insights into how services can be delivered most effectively. With politicians and public scrutinising how every penny is spent, this knowledge is vital. This is where research can add real value. It gives decision makers the understanding they need to deliver an effective service. An informed view from research helps healthcare professionals make critical decisions on the basis of solid evidence. CREDIBILITY For best results, organisations that want to truly benefit from research should use accredited suppliers who keep to professionally agreed guidelines when they conduct their research. In this way, it can be ensured that findings are accurate and stand up to scrutiny. The research sector is proud of its robust methodologies and professional credibility, which is reflected in the MRS code of conduct and guidelines. These set out the ethical principles which underpin good research practice. MRS members have to abide by the MRS code of conduct, which provides a step-by-step guide to providing effective, fair and ethical research. The MRS code is also fully compatible with the requirements of the Data Protection Act. The MRS code and the act together offer a strict set of frameworks which can help prevent ‘cowboy’ research. Vanella Jackson, MRS chairman, says: “Some people still have a view that market researchers are people who stop you on the street, asking a series of ‘tick box’ questions and writing the answers on a clipboard. That’s outdated. Modern market research is about understanding what questions to ask, who to ask them of, and how to ask them so as to get accurate, meaningful and useful results. “Some organisations can be tempted to take shortcuts and go for ‘quick and dirty’ research but all too often that means they spend money on the wrong sort of service.” SUPPORTING HEALTHCARE The ways in which research can support the health sector are many. Mark Speed at IFF Research highlights how it can help in the
decision-making process and understanding where to prioritise resource. “These are fundamental issues for the health sector and getting the opinions of users can be crucial when formulating policy,” he says. “Attitude and behaviour change is another important area. Campaigns which encourage better health and lifestyle choices must be targeted at the right people, using language they understand, with a message that they can find salient. If you end up speaking to the wrong people, or in the wrong way, it’s potentially money down the drain.” THE FUTURE How will reform in the health sector change the role of research? For Mark Speed, the industry is responding to a changed financial landscape: “Some health providers may consider taking their research in-house to save money but this can be a false economy as the cost of employing new staff or buying in research software can wipe out any potential savings. There’s still a strong role for MRS-accredited agencies who have the sector expertise and infrastructure to deliver insightful health sector research and it is important that both the agencies and health providers work closely together to facilitate this.” Richard Kunzmann, lead research manager at market research agency FreshMinds, says: “The NHS will be undergoing sweeping reform and, while the details are to be finalised, it seems likely that there will be GP commissioning to some degree. Responsibility for purchasing will evolve. However, what will remain the same is the importance of understanding patient journeys, and identifying potential hurdles and a breakdown in service – not necessarily related to the care itself. Research will provide support by identifying what’s really happening in their area and signposting how patient access and services could be delivered better, faster, cheaper.” CASE STUDY From April, 1 2011, the management of community health services in Lambeth and Southwark transferred from the local Primary Care Trusts to Guy’s and St Thomas’ NHS Foundation Trust. FreshMinds Research has worked very closely with Guy’s and St Thomas’ NHS Foundation Trust Community Health
Services (formerly known as Lambeth Community Health) over the last three years to run a service user opinion survey. The survey was designed not only to help the customer services team collect customer satisfaction information, but also to provide a unique opportunity to measure service delivery performance across 28 different service lines and understand areas for improvement. A customer satisfaction survey is not the most innovative concept in market research but, as is often the case, innovation lies in the incremental changes and unique thinking that is applied to a study, which refreshes the methodology and provides clients with the insight they need. In this case, the research was about making sure that comparable information could be collected from widely disparate service lines that included anything from adult community nursing – a relatively easy service to access – through to the more difficult services such as the Brixton Prison pharmacy and homeless support teams. The success of the survey was also partly about staying nimble in the researchers approach – from working flexibly with service providers that changed location on a daily basis, to mixing research methodologies by combining telephone interviews, face-to-face interviews and paired interviews with children and parents. FreshMinds also worked with the team to interview refugees in its Refugee Health centre, which required special interpretation services to be present, as very few of the refugees could speak English. As a result of the study, Guy’s and St Thomas’ NHS Foundation Trust Community Health Services has been able to better understand discrepancies in service level performance and take appropriate action to provide additional support to teams that needed it. “The personal stories included in the report really highlighted what patients needed from us, which often didn’t have anything to do with the customer service metrics we’d set out to measure,” says Siobhan McCollum, head of customer services. “For example, the Children’s Physiotherapy Unit is now involving patients more in their care plan, and they’re focusing on delivering more of their services after-hours and during school holidays.” L FOR MORE INFORMATION www.mrs.org.uk
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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e• c n a bul e and t m A n im e • Marit rnme u c e s Re Os • l Gov lience • d an • NG oca Resi ities iness e r or Bus Fri ctor y • L nal h • t • l o u c e i icevery S gen Reg lO t A ercia rities ice r o o / A a P l rd cal dP mm tho Po unt Vol stgua s •sLo ort an • Co lth Au OD • ary r s a ea • M olunt d Co horbitiiteoransp enc•ieProfessional H for category 1 • V24/7 365 iesService •spec uardays a year uxt hi s • T t Ag usts as•sFull g e A t A&E vehicles s s• Eeam men re Tr •EBlue and 2 responders anc Coafor mb lightulinsurance t n T tie stransfers a b r • riurgent por nd experienced m trained o ve ry C tors a n A h • FULLY crews o t e • ra cies G ima Aucontracted tim ent for • T ework era scue a•riDiscounts n p s The Emergency Services Show • Pr g O sts e m A m M u y a • Cars/Ambulances and 4x4 vehicles means R r t n t i e • T r l n T e work is the key event for anyone Uti e and GOs Gwe weather me Cconditions are ovcan ce in all n n • r r e i N l i e involved in emergency ary tors • scue me • F tor • Loca Resil Gincluding ov imsnow! planning, response or Re members riti al ies • • Pr pera d Corporate a n Sec ncy • Contact o details: n M t s O it gi Sturt, e recovery, in the UK n hor sines tility Fire a Osof •AREMT-UK Ag al/Re Wayne t u u G rnme s WANT Services, • U A Medical • c B N t and abroad. e o l r m 0844 357r 8214 • ove s Tel: L Po Douglas ciaHouse, olicinfo@wantmedical.co.uk o rStreet, itie Pemail: Tea ent t East Portslade, r d e G c e o n l m Sussex, a Se oca lienc rnm are D • Web: uth BN41O1DL y www.wantmedical.co.uk om East This FREE to attend exhibition r A C a M h t • L Resi • lt n ove ary C • • y a u l G c s l e provides you with the opportunity to: o n e a • i H im s V e • ass ce • rd Ag egion rities s • Pr rator • b e n o m R p th ines Limited cue im O • view the latest equipment and services E bula stgua ocal/Pro s uMedicus e y A s u Medicus rt ilit nd R Marit asBPro Am Coa s • L PoTrading t l U a s• ia &sParamedic • ire Service • network with like minded people erc Director and horitie rt and mAmbulance e ent i O F t i G m Medical Dr. Alan Stranders MB. BS. • r t s o m n N o thLRCPoDRCOG Au ansp • Co MRCS • share best practice ice or • over Team l u A t r • T ncies ealth D • P y Sec ocal G ence nme • discover ways of making vital cost i ge s • H • MO ntar • L Resil over ry A y u t a l G s saving efficiencies c s ProruMedicus sisiean • Vo Agen ional ies • Prim to T s a t Independent Ambulance e g • a b nc uard l/Re thori ess • learn from the UK’s industry experts per c Em offering Service a O ula aswide n u g i c t b y A s s range of essential Am oa s • Lo Port al Bu Utilit d Re C services to both the i • • d ritie d an rc an Public and Private o ort an mme rities Fire NGOs n h t u are sp sectors.AWe Co Autho lice • tor • over n • a r registered with the Care s Po Sec cal G lthstaff are • T ncieand a D Quality Commission all our trained e yto a highLo e H MO utonenhanced tar y level. • • Agall staff standard and are Police checked • s t l s c s o e n i u V We are available 365 days ofgthe e year. We Tr 24 ahours ss a day A sporting events e •and amateur bprofessional cover all manner of c d r n m a guofaTraining Courses. E a wide and we also offer t bul selection m A oas C d Business Centre, Unit 2, Thrales n aEnd
23-24 November 2011 Exhibition and Conference
0 5 3
REGISTER NOW!
www.emergencyuk.com ESS 2011 Ad 255 x 86_general.indd 1
29/06/2011 16:08:15
Thrales End Lane, Harpenden, Herts AL5 3NS Email pro.medicus@ntlworld.com Tel: 01582 969313 Web: www.promedicus-harpenden.co.uk Mobile: 07778 211771 Fax: 01582 645774 Companies House Registration Number: 06498390
BUSINESS CONTINUITY
EMERGENCY PLANNING, RESPONSE AND RECOVERY
From strategic planners and first responders to equipment manufacturers and suppliers, the Emergency Services Show and Conference 2011 brings together everyone involved in an emergency The last couple of years have seen unprecedented incidents take place in the UK – the riots, adverse weather conditions, spates of domestic and wild fires – all of which provide a natural wake up call for organisations to update business continuity plans in case of an emergency. To ensure effective plans can be made to protect the UK from threats, both natural and manmade, communication between the parties who play a critical part in emergency planning and response is vital, however, making the time to facilitate this networking can be hard. The Emergency Services Show and Conference 2011, promotes multi agency collaboration by bringing together everyone involved in emergency situations. With over 380 exhibitors and approximately 4,000 visitors attending the successful show last year, the Emergency Services Show and Conference 2011 is the key event for anyone involved in emergency planning, response or recovery, both in the UK and abroad. This year’s show and conference will be taking place on Wednesday 23 and Thursday 24 November at Stoneleigh Park, Coventry. Following recent national emergencies, the Emergency Services Show and Conference 2011 is proving more relevant than ever. DOING MORE WITH LESS At a time when budgets are being squeezed, this free to attend exhibition provides the perfect opportunity for visitors to research methods of doing more with less. Visitors will be able to speak to exhibitors about how they operate more effectively and efficiently, thereby resulting in the highly desirable outcome of more for less. David Brown, show organiser, Emergency
Services (MMC) Ltd, comments: “In these uncertain times it is more important than ever for all emergency professionals and associated agencies to communicate with one another, this may allow resources to be shared and budgets to be maximised. The Emergency Services Show offers the unique opportunity to meet with specialist equipment and service suppliers from the UK and abroad to facilitate mutually beneficial buying arrangements and discuss new important innovations and products.” WHO SHOULD ATTEND? The Emergency Services Show 2011 is considered critical for those with a role in emergency planning and business continuity. From buyers and specifiers, emergency planners to responders, this show unites colleagues, contemporaries and suppliers. Every year emergency and resilience professionals with a role in operations, procurement, training, recruitment, emergency planning and business continuity, attend. Exhibitors will be displaying all manner of products and services including: personal protective equipment, communications and IT, first response equipment, station equipment, training and education, vehicles and vehicle equipment, medical equipment, business continuity and outsourcing. David Brown, remarks: “As well as allowing exhibitors to showcase their latest products and services, the exhibition provides an ideal way for professionals to discuss cooperation, ideas and initiatives and learn from each other in preparation for major events taking place over the coming years and to prepare for the unexpected.” There will also be approximately 100 end users exhibiting within the Emergency
Emergency Services
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
Response Zone. This zone (essential for operational staff and emergency planning officers) is made up of category 1 and 2 responders, professional, government and voluntary organisations, and hence offers perfect networking opportunities to affiliated organisations. The Emergency Planning Society, Flood Forecasting Centre, the Health Protection Agency, Inland Flood Rescue Association (IFRA), Institute of Civil Protection & Emergency Management and the British Red Cross are just a few of the organisations exhibiting in this specialist area. There is also a dedicated UK Search and Rescue Zone including Mountain Rescue and the Association of Lowland Search and Rescue (ALSAR). CONFERENCE This year, the two-day conference will be hosted in the dedicated conference centre (opposite the exhibition centre) at Stoneleigh Park. To help organisations cope with a markedly different environment and overcome the challenges of the future, the show’s organisers have taken the decision that the conference will be free of charge to attend. This is in recognition of organisations’ budgets having been cut and in many cases restrictions put in place regarding individuals attending events. However, it is vital that emergency and resilience professionals continue to learn and network amongst one another to allow both professional development and learning, with the overall aim of improving public safety. Each day of the conference will be targeted at different job roles. Day one will be aimed at senior management, whilst day two will be directed at operational personnel. The conference will be CPD certified. For more conference information visit the website. L FOR MORE INFORMATION www.emergencyuk.com
Volume 11.9 | HEALTH BUSINESS MAGAZINE
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Advertisers Index
58
BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net
ADVERTISERS INDEX
The publishers accept no responsibility for errors or omissions in this free service Accuro Facilities Management
42
GID Quantor
14
Phoenix Private Ambulance Services
52
Apollo
28
Glynn Williams
47
PHS Wastemanagement
25
Asteral
44
Hagesud
12
Professional Clothing Awards
04
Backup Data
14
Healthcare Facilities Consortium
08
Proseminar
48
Beacon Medaes
38
Jac Medicines Management
16
Prospect Consulting
54
Best Companies
42
KwickScreen
22
Qualitis Healthcare Solutions
40
Bond Air Services
10
Kyocera
Rocom
IFC
Brand Speak
54
Lasting Impressions
38
RPS
26
Business Furniture Online
37
LatisScientific
29
Shield Environmental Services
32
Marmot Resources
34
SRCL
22
OBC
Canopies UK
IBC
Care Fusion
18
Mccaul Group
34
SwiftTech Hoists
52
CDEV
14
McGee
30
The Emergency Services Show
56
Chase Medical
49
mruk Research
54
Three Counties Water
26
Cisco Systems
47
Nedap
10
Transcend Group
48
Dart Valley Systems
20
Nordic Care Services
50
Tritec Environmental Services
26
DDC Dolphin
32
Norton Scientific
38
Vectair Systems
23
Deep Red Technology
14
Parker Consultancy Services
37
Vileda Professional
42
Dialogics
10
Pass Training
48
Wemco
26
Eastwood Park Training
22
Phillips
52
Western Power
34
HEALTH BUSINESS MAGAZINE | Volume 11.9
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