Health Business Magazine 12.3

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HOSPITAL PLAY AREAS

DESIGN & BUILD

STAFF SAFETY

SECURITY

CARBON REDUCTION

ENERGY

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Reducing efficiency increasing ok for in lo - what to cilities fa t s te la the ment e g a n a m software

INFORMATION TECHNOLOGY

CYBER SECURITY

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HOSPITAL PLAY AREAS

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STAFF SAFETY

SECURITY

CARBON REDUCTION

ENERGY

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INFORMATION TECHNOLOGY

CYBER SECURITY

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Comment

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

DEAR READER As we go to press, news has just come in that consultants have defied British Medical Association chair Hamish Meldrum to pass a motion of no confidence in the Health Secretary Andrew Lansley.

And as the debate about NHS reform continues, the government makes plans to overhaul the NHS constitution, appointing Professor Steve Field, chair of the NHS Future Forum, to head it up. Field believes resistance to reform is futile. It seems reform is destined to go ahead, despite the protestations of several health bodies and many NHS workers. The NHS Consitution document, introduced in 2009, has already had a swiftly-introduced amendment to support whistleblowing (see page 7 for details).

WASTE MANAGEMENT | INFECTION CONTROL | NEWS | PLUS MORE INSIDE

Reducing instances of violence against NHS staff requires support from the top.

Simon Whitehorn of the National Association of Healthcare Security points out that the process of keeping staff safe is no different from dealing with any other risk (see page 13). In Design & Build (page 37) the Association of Play industries makes the point that early intervention is a key method to encourage healthier lifestyles among children, and discusses the best way to create play spaces in hospitals.

In IT, we hear that US-based supplier CSC has done a government deal which is good for both sides – the government says £1 billion will be saved, and CSC gets an opportunity to claw back some of its losses (page 41). Health Secretary Andrew Lansley has also launched the CCIO Leaders Network, saying it will help to bridge the gap between the IT that clinicians use in their day to day lives and the IT they have to use in the NHS (see page 7).

Danny Wright Editorial Director

P ONLINE P IN PRINT P MOBILE P FACE TO FACE If you would like to receive all 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 Dawn Peer, Mo Paloba, Kylie Glover ADMINISTRATION Victoria Leftwich, Lucy Carter SALES SUPERVISOR Marina Grant PUBLISHER Karen Hopps GROUP PUBLISHER Barry Doyle REPRODUCTION & PRINT Argent Media

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Volume 12.3 | HEALTH BUSINESS MAGAZINE

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Contents

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CONTENTS 07 NEWS

29 ENERGY

NHS Constitutional amends; CCIO network launched; care home concerns; HIV treatment for foreigners

Sir Neil McKay promotes sustainable healthcare at global summit; Barnsley’s carbon cutting recognised

13 SECURITY

31 INFECTION CONTROL

The process for keeping healthcare staff safe from the risks they face at work, including the risk of violence and aggression, is arguably no different from the approach to dealing with any other risk, writes Simon Whitehorn of the National Association of Healthcare Security

Highlights from NICE’s quality improvement guide on preventing and controlling healthcare associated infections

37 DESIGN & BUILD Hospital play areas can make a big difference to patient recovery.

Adam Steiner from the Association of Play Industries, discusses the size, content, design and installation of play facilities in hospitals

19 HEALTH & SAFETY More than 2,000 people attended the UK’s biggest annual event in health and safety, the IOSH 2012 conference in Manchester on 6th & &th March

41 HEALTHCARE IT NEWS A government deal with CSC will see Lorenzo continue to play a (albeit regional) part in a National IT Stategy; Telehealth savings identified; O2 launches Help at Hand mobile telecare system

21 FACILITIES MANAGEMENT Paul Lloyd, technical director at the Healthcare Facilities Consortium, looks at specifying FM software and ways to reduce costs when choosing and implementing a new or replacement FM system

47 INFORMATION ASSURANCE In recent years, NHS handling of information has been highly scrutinised.

BCS, The Chartered Institute for IT, has been working with Information Assurance (IA) specialists from across government to pilot its new BCS CESG Certified Professional scheme

25 CLINICAL WASTE In transforming the environmental credentials of one of the busiest hospitals in the world, the waste management team at Guy’s & St Thomas’ was awarded the Peter des Roches Sustainability Award for its excellence

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NHS REFORM

Constitution overhaul – new amendment to support whistleblowing The NHS Constitution, first introduced in 2009, is to be reviewed, the government has announced. Professor Steve Field, leader of the NHS Future Forum, is to bring together a special working group to provide advice.

The working group includes patient representatives, members of clinical commissioning groups, Royal College of Nursing and British Medical Association representatives and hospital directors.

Professor Steve Field said: “Throughout the work of the Future Forum, we have consistently said the NHS Constitution should be embedded into how the NHS works, and so I am pleased that we have been asked to contribute to this review. The experience and, crucially, the independence, of the group will ensure a thoroughly professional and balanced insight into what effect the NHS Constitution has made and how it can be improved”.

A new commitment has already been included in the constitution to support whistleblowing

NEWS IN BRIEF

Professor Steve Field

– hospital managers must pledge to support whistleblowing staff. The change follows repeated concerns over staff being given ‘gagging orders’ to stop them raising concerns outside their trusts. In January the GMC issued new guidance aiming to ban doctors from signing gagging clauses with regulators. A report due in the summer will look at the impact the constitution has had on patients and staff.

Dr Charles Alessi, chair of the National Association of Primary Care, said he would be pressing ministers to ensure clinical commissioning groups had flexibility to address local priorities. He told Pulse: “There needs to be some flexibility. Some processes are mandatory, but everything can’t be mandatory otherwise what are Clinical Commissioning Groups for?”

NEW CONSTITUTION CHANGE tinyurl.com/7xbofaf

Over £100m to support clinical research Over £100m will be invested in NHS clinical research facilities to develop new treatments. The money, provided by the National Institute for Health Research, will be spent on research nurses and technicians at 19 of the facilities around the country. A number of new treatments for conditions including cancer, diabetes, stroke, dementia and obesity will be developed by researchers at the facilities.

Secretary of State for Health, Andrew Lansley said: “These researchers will push forward the boundaries of what is possible.

These are the people and the facilities where the very best new treatments will be developed for a huge range of conditions – from cancer to diabetes and heart disease. NHS patients are the ones who will see the benefit of their work.”

Professor Dame Sally Davies, Chief Medical Officer and Chief Scientific Advisor at the Department of Health, said: “These are very exciting times for clinical research in the UK, and this funding is a reflection of the commitment we have to supporting worldclass experimental medicine. The Clinical Research Facilities will play a key role in

INFORMATION TECHNOLOGY

Lansley launches CCIO Leaders Network Health Secretary Andrew Lansley has announced the formation of the Chief Clinical Information Officers network – a development in partnership with the RCP and the British Computer Society to support the seven CCIOs that have already been appointed, and to help identify and promote more.

“In the past doctors and nurses have had to bend over backwards to fit in with the needs of the systems introduced to their workplaces.

They were shackled with rigid, expensive IT contracts that failed to deliver as intended.

We are now putting local clinicians in the driving seat, able to reap the benefits of the explosion in information and technology.”

News

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Speaking at the Royal College of Physicians, Lansley confirmed that NHS Connecting for Health will cease to exist after April 2013 and be replaced by a ‘leaner’ delivery organisation to run N3 and national applications and services.

Healthcare IT website eHealth Insider has long campaigned for the network.

Editor Jon Hoeksma said: “The response to the campaign has been terrific and the momentum it has generated will get the CCIO Leaders Network off to a flying start”.

Imperial College awarded over £10M for research at new centre Imperial College Healthcare has been awarded £10,885,958 to develop new treatments to benefit thousands of patients. The trust successfully bid for the funding from the National Institute for Health Research (NIHR) to support its newly refurbished research facilities at Hammersmith Hospital – the Wellcome Trust McMichael Clinical Research Facility.

The award – one of the highest in the country – will fund research nurses and technician posts and support studies into treatments for conditions like cancer, diabetes, stroke and obesity.

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CLINICAL RESEARCH supporting advances in treatments for a wide variety of diseases and supporting collaboration with industry. Thousands of people will benefit right across the country”.

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Home deaths should save cash, says Cancer Trust Marie Curie Cancer Care estimates that cutting the hospital stays of just 12 per cent of all people who currently die in hospital in England each year could save the NHS millions. At present, just over half of all deaths happen in hospital.

Imelda Redmond, director of policy and public affairs at the charity, said: “The NHS has to save £20 billion by 2015. Savings on the scale required can only be achieved through service redesign that can be rapidly implemented across the NHS. Ensuring that more people who are terminally ill are able to be cared for and die at home can release funds.”

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Volume 12.3 | HEALTH BUSINESS MAGAZINE

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HIV TREATMENT

News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

NEWS IN BRIEF SCAS achieves Foundation Trust status

Plans for NHS-funded HIV drugs for overseas visitors should cut costs NHS-funded HIV treatment should soon be available to overseas visitors who have lived in the UK for at least six months. The principle, originally put forward as an amendment to the Health and Social Care Bill, has been accepted by the Department of Health and will bring practice in England in line with that in Scotland and Wales.

Despite being reported in the mainstream media as ‘free treatment’, a prescription charge would still apply; HIV diagnosis is not an exemption criterion. People will qualify for treatments costing up to £7,000 a year after living in England for more than six months.

Public health minister and former nurse Anne Milton said: “This measure will protect the public and brings HIV treatment into line with all other infectious diseases. Treating people with HIV means they are very unlikely to pass the infection on to others”.

Critics claim the decision could prompt so-called health tourism and put the NHS under further financial pressure. Milton added: “Tough guidance will ensure this measure is not abused”. The government believes that early diagnosis of people with HIV will ultimately help cut costs. However, according to Ana Nicholls, healthcare

analyst at the Economist Intelligence Unit, no cost benefit analysis has been carried out. Nicholls stated: “The measure is bound to be controversial given the pressures on hospital budgets and given that it will not only mean more spending on HIV treatment but also more administration to ensure that patients are entitled to such treatment. The risk is that this will cause a backlash, with some people calling for HIV testing at the border (as happened in the US until 2010).

That said, I suspect that a cost-benefit analysis would come out clearly in favour of the measure. It is in everyone’s interests for those people needing HIV treatment to be given it, partly for humanitarian reasons, partly to avoid further costs in treating them, and partly to help contain the spreading of the disease. It also has to be remembered that Britain anyway spends £60m a year on foreign aid for HIV/ AIDS, although this is due to fall to £41m by 2015 as the aid focus shifts to reproductive, maternal and newborn health.” The new rules should come into force in October.

FURTHER INFORMATION http://www.aidsmap.com

COMMUNICATION

Language skills guidance published NHS Employers has published detailed to help NHS trusts ensure new staff have the language skills needed to provide safe, quality care to patients.

‘Language competency: good practice guidance for employers’ is published by the NHS Employers organisation and was produced in consultation with key partners, including the professional regulators and the Department of Health.

Dean Royles, NHS Employers director, said: “This new publication will provide employers with good practice guidance when carrying out an assessment of an individual’s language competency, clarifies the role of the professional regulators and describes the current European law”.

Royles continued: “Attention has been focused in recent times on doctors but the assessment of language competency is important for all

staff working in the healthcare sector. The guide will help employers develop a system to be assured that all new recruits can communicate clearly with both patients and others members of staff at a level that reflects their role and responsibility. It also recommends employers check that agreements with suppliers of temporary staff include an obligation to supply employees to the organisation with satisfactory language competency”.

Niall Dickson, chief executive of the General Medical Council (GMC), said: “The GMC welcomes this new guidance, which should help employers to ensure that their healthcare professionals have the necessary language skills to practice medicine safely. Patients must have confidence that the doctor who treats them has the necessary communication skills for the job”.

The full guidance can be downlaoded here: tinyurl.com/6wtcu5g

South Central Ambulance Service (SCAS) NHS Trust has been awarded foundation trust status.

SCAS, which provides ambulances across Berkshire, Hampshire, Oxfordshire and Buckinghamshire, began the process at the end of 2010. Following the announcement, chair Trevor Jones said: “Achieving foundation trust status means that SCAS will be more accountable to local people and we will have more freedom to decide how to run and deliver our services”. tinyurl.com/84ngu2p

Pension scheme calculators launched Calculators have been developed to enable members of the NHS Pension Scheme to estimate their future benefits and see any changes to their current scheme benefits, under the government’s proposed new scheme from April 2015. These calculators are based on the NHS Pension scheme specific discussions and have been developed, shared and discussed with the NHS trade unions. There are separate calculators for Agenda for Change staff and medical and dental staff in hospital and community health.

Calculator for Agenda for Change staff tinyurl.com/cm4chlo Calculator for medical and dental staff tinyurl.com/7v9bfk5

Increase in VTE screening hailed a success Patients are now almost twice as likely to be screened in hospital for venous thromboembolism (VTE) than in 2010, helping save thousands of lives. Figures for October to December 2011 show that 91 per cent of patients were screened.

Colchester Hospital has implemented a number of initiatives to prevent VTE, such as ‘VTE Walkabouts’, and has established ‘VTE Champions’ on every ward tinyurl.com/7db4oj4

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CARE HOME REVIEW

CQC report raises concerns about access to services in care homes

Disabled and elderly people in care homes are not getting the health services that they need quickly enough, according to a report by the Care Quality Commission (CQC) published in March.

The report looked at whether residents of care homes are getting access to healthcare services, whether they have choice and control over their healthcare and whether the care they received was safe and respected their dignity. Inspection teams visited 81 care homes within nine PCT areas, found that access to some services was too variable.

Despite care home residents having higher levels of dependence on services than the rest of the population, basic health needs were unmet in some areas. The report found that in just under 40 per cent of homes for older people, those who need an initial continence assessment wait more than two weeks for it, which is considered too long and is likely to have an impact on their welfare.

A quarter of residents did not feel they were offered a choice of male or female staff to help them use the toilet. Thirty-five percent of homes reported they had problems getting

medicines to residents on time ‘sometimes’.

Staff at 38 per cent of care homes indicated GPs made routine visits and 10 per cent of care homes said they paid for their GP surgeries to visit.

The inspection teams interviewed managers, residents and staff, observing care and examining case files. CQC director of operations Amanda Sherlock said: “While we have identified good practice in areas, this review suggests some providers have fallen short of delivering effective care by considering the healthcare needs of residents as a secondary requirement. Despite having a disproportionately high level of dependence on health services, this group appears to be more disadvantaged than the rest of the population in accessing these services”.

The CQC is planning further inspections.

Ana Nicholls of the Economist Intelligence Unit, commented: “A number of reports have advocated better co-ordination between GP practices and care homes, preferably via regular visits covering several patients at a time (rather than different GPs being called out for each case separately) and with better follow-up. More use of nurse practitioners and, increasingly, telemedicine, could help to reduce the costs of this. Lessons could also be learnt from the experience of other countries, such as the Netherlands and Germany, which have tried to introduce more co-ordinated systems to improve access to care by the elderly”.

NHS PEOPLE Three new generals at DoH The Department of Health has appointed three new directors, chosen following a national open competition. Dr Felicity Harvey CBE, currently director of the Implementation Unit in the Cabinet Office, will take up the post of Director General for Public Health.

She will lead the department’s public health teams and work closely with Public Health England, the NHS commissioning board, and local government. Charlie Massey, currently director for Ageing Society and State Pensions at the Department of Work and Pensions (DWP), will take up the post of Director General for External Relations. He will be responsible for the department’s relations and communications with external stakeholders – from members of the public, to health unions and Parliament. Karen Wheeler CBE, currently director for the Department of Health’s transition programme, will take up the post of Director General for Group Operations and Assurance. She will be responsible for delivering change within the department itself, as well as human resources and corporate services, and for managing the overall performance and capability of arm’s length bodies.

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Commission recommends using NICE quality standard for adult services The Commission on Improving Dignity in Care for Older People has recommended that NICE’s quality standard for patient experience in adult services should be used across health and social care settings in the UK. Set up by Age UK, the NHS Confederation and the Local Government Association, the commission has published 48 draft recommendations which will be consulted on over the next month before a final action plan is published later this summer.

Among them is the recommendation that the NICE quality standard on patient experience in adult services, which includes dignity, should be used to provide a consistent standard by which to define and measure performance. The commission adds that NHS organisations should be required to include their performance on this quality standard as part of the ‘quality accounts’ they now produce.

The NICE quality standard, published last

News

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month, outlines ways to improve the quality of the patient experience for adults using NHS services. It sets out 14 quality statements to make sure patients are treated with dignity, kindness, compassion and respect, and ensuring patients are given the opportunity to discuss their health beliefs, concerns and preferences to inform their individualised care.

Other quality statements involve ensuring that patients experience care tailored to their needs and personal preferences, and allowing them to have their physical and psychological needs regularly assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety.

Further information: NHS Confederation Commission on improving dignity in care: tinyurl.com/6y5kzg5 NICE Quality Standard: tinyurl.com/7b9zpgc

TO READ MORE NEWS PLEASE VISIT

www.healthbusinessuk.net NICE appoints two new directors

Professor Mark Baker will become director of the Centre for Clinical Practice at NICE from 2 April, and Alexia Tonnel will be NICE’s Director of Evidence Resources from 12 March. The appointments follow the departure of Professor Peter Littlejohns to take up an academic post, and the retirement of Dr Fergus Macbeth.

Jane Ramsey is to be the new chairman of Cambridge University Hospitals NHS Foundation Trust, succeeding Dr Mary Archer who is stepping down in October after 10 years of service. Her three-year term begins on 1 November 2012.

Volume 12.3 | HEALTH BUSINESS MAGAZINE

11

What Honeywell and Lenel would love to achieve; but will never do.

Security Redefined Not only are some names behind security big, but so are their system constraints. There’s a high price to pay when you think there is a solution that promises to be customer oriented and is genuinely conceived as a scalable suit-yourself-solution. Nedap’s AEOS is based on open standards – all its components are compatible and can evolve with the change and growth of your company. To find out how AEOS assists in a 30% decrease in TCO, see www.nedap-securitymanagement.com

STAFF SAFETY

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Reaping the rewards of violence reduction measures

The HSE is clear: ‘If risks from violence and aggression are to be managed successfully, there must be support from those at the top of the organisation, no matter what size’. This can be expressed in a clear statement of policy, supported by organisational arrangements, to ensure that the statement is implemented.

Key elements include recognition of the risks; commitment to introducing precautions to reduce that risk; a statement of clear roles and responsibilities; an explanation of what is expected from individual employees, and a commitment to supporting people who have been assaulted or suffered verbal abuse.

Paterson, Leadbetter & Miller (2005) suggested three groups for measures that address violence and aggression: primary, secondary and tertiary.

Primary or proactive risk reduction measures include organisational policies and procedures, details of roles and responsibilities, assessment of risks, provision of adequate staffing levels, provision of training to individuals commensurate with their s es en role, assessed level of risk and training ar aw n “A can s needs analysis; alarm systems and er g ig tr at h of w n o ti technical solutions, and the provision ra st u fr cause anxiety, ecked, of appropriate environments. This and, if unch e vital last factor is reinforced by recent nb work by the Design Council (2011) aggression, ca ertaking which identified nine triggers for staff in unduce the for violence in A&E departments, efforts to red that seven of which can be influenced likelihood of ting directly, either positively or negatively, la ca es n o ti ra frust by the physical environment. into violence” Undertaking work in the areas outlined above particularly in combination can have a positive effect on the incidence of violence and aggression in an organisation and by their pre-emptive nature can be invisible to users of the service in question if appropriately implemented.

Secondary responses to violence and aggression refer to the interpersonal skills that staff can bring to the often escalating situation caused or exacerbated by an organisation failing to address issues highlighted above. An awareness of what triggers can cause anxiety, frustration and, if unchecked, aggression, can be vital for staff in undertaking efforts to reduce the likelihood of that frustration escalating into violence.

It is easy to appreciate how factors such as fear, pain, embarrassment or confusion could occur in a healthcare setting but other factors, such as rudeness, being patronised E

Volume 12.3 | HEALTH BUSINESS MAGAZINE

Written by Simon Whitehorn, National Association of Healthcare Security

The process for keeping healthcare staff safe from the risks they face at work, including the risk of violence and aggression, is arguably no different from the approach to dealing with any other risk

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STAFF SAFETY E or feeling ignored clearly have no place in an environment intended to promote healing. Staff awareness of emotional triggers can be demonstrated by displaying an empathetic approach to individuals, maximising positive communication by employing a communication model such as LEAPS and being fully alert to the potential barriers to communication that can exist in any interpersonal exchange and which can be exacerbated by the intense emotions that can be triggered in healthcare settings with their hierarchical nature and often by necessity, procedurally-focused approach.

PHYSICAL ASSAULT Despite an organisation focusing on primary measures and staff displaying positive awareness of all the attributes required to be a positive, effective communicator, situations will occur where frustration and aggression spills over into violence; either in the form of verbal abuse or direct physical assault.

When this situation is reached it is necessary to focus on the third tier of measures. These focus on physical responses, which may include staff physically extricating themselves from potentially dangerous situations or in certain circumstances employing appropriate physical intervention techniques, (which of course will be documented in an organisation’s primary risk reduction measures along with the provision of appropriate training).

Simply making a situation safer by removing yourself from it or employing risk-assessed safer holding/breakaway/physical intervention/ restraint techniques or equipment is only one element of the necessary tertiary measures.

It is crucially important that following an incident a number of activities take place.

These can include providing post incident support to the victim; reporting and recording details of the incident; rebuilding relationships, (particularly important in settings where delivery of care to the individual will continue), and learning from what happened and sharing good practice.

Most large organisations will have processes in place intended to cover these aspects but we should consider just what some of these tasks entail. Post-incident support for victims covers a range of things, from supporting an individual through immediate reactions, such as shock, anger or embarrassment, to simply ensuring they get any treatment for physical injuries they may have sustained.

It is important to acknowledge that there is no ‘right’ or ‘wrong’ way to react, and support will need to be tailored to an individual’s needs. Medium term responses to an incident can last for a number of days or even weeks and can include feelings of anxiety about returning to work or encountering similar situations, or even the perpetrator.

Other individuals may deny any effect and be keen to get back to work. Where individuals suffer longer term reactions to workplace violence then organisations should

ensure that they have adequate measures in place to support these individuals and professional support can often be accessed via occupational health departments or providers.

When reviewing incidents it is helpful to use the experiential learning cycle to discover what happened, why it happened and why it happened in the way it did, as well as how things could be improved if it happened again.

One NHS trust uses a system based on questions as its basis for developing learning from incidents. What was expected?

What actually happened? Why was there

Security

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But these figures only account for the NHS. Whilst the NHS is the largest employer of staff involved in health and social care in the UK, employing in excess of 1.3m staff, a substantial additional number of staff are employed in the delivery of healthcare by private companies and other providers, including local authority social care services, raising the figure above four million people employed in the sector according to figures published by the ONS in Feb 2012. If the cost to the NHS of £69m is extrapolated that gives a potential cost

Simply making a situation safer by removing yourself from it or employing risk-assessed safer holding/breakaway/physical intervention/ restraint techniques or equipment is only one element of the necessary tertiary measures. It is crucially important that following an incident a number of activities take place. a difference? What can be learned? The key factor here is that learning from incidents is then shared in such a way that it contributes to the primary risk reduction measures that are in place and ensures they develop over time to meet developing needs, identify trends or highlight deficiencies in practices or procedures.

Often experiential learning at a team level is relatively simple to achieve but as the team grows in size or complexity and involves multiple smaller units with their own specific roles, as is common in large healthcare organisations, the ability to communicate effectively and ensure best practice is effectively shared becomes increasingly complex.

WHY IS THIS PROCESS IMPORTANT? The cost of keeping healthcare staff safe from the risks they face is not insubstantial.

In 2010 NHS Protect put the cost to the NHS of physical violence at £60.5m – a figure that cannot include the emotional cost to the staff involved. In 2011 the published figures for physical assaults on NHS staff in FY 2010/11 stood at 57,830.

In 2003 The NAO published figures suggesting that the cost to the NHS caused by physical violence and verbal abuse was some £69m which, given inflation and the fact that it incorporated physical and non physical violence suggests that the NHS Protect figure fails to account for the full potential costs to the NHS of violence towards staff. In the year before the NHS Protect figure was collated, the BBC Panorama programme put the figure at over £100M per year, and stated that this was enough to fund the salaries of over 4500 nurses.

to the healthcare sector from violence and aggression of approximately £214m per year.

Given the vast cost of violence in healthcare settings it is clear that costeffective, evidence-based and targeted solutions could have a substantial role to play in times of pressure on budgets.

As has been shown above the areas encompassed by primary risk reduction measures include environmental design, communication and information systems, alarm and other technical safety solutions, risk management solutions, staffing, equipment and training. For businesses operating in the healthcare sector with products or services in these areas they may find that the recession is affecting budgets in the healthcare sector not violence but if they can demonstrate deliverable results which reduce the impact of violence both at an individual and organisational level they may well have a persuasive argument for spending to save.

Simon Whitehorn is a member of the National Association of Healthcare Security. http://uk.linkedin.com/in/siwhitehorn L REFERENCES: Paterson B, Leadbetter D, Miller G (2005) British Journal of Nursing, Vol 14 No 14.

A Safer Place to Work: Protecting NHS Hospital and Ambulance Staff from Violence and Aggression, published by NAO, March 2003. http://tinyurl.com/844gzjt http://tinyurl.com/782chrp http://tinyurl.com/77zmqg2 http://tinyurl.com/6nzm8ab http://tinyurl.com/7e8hymt http://tinyurl.com/7k677ve http://tinyurl.com/yjlqha5

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VIOLENCE AGAINST STAFF

Violence in the NHS: high profile groups unite to fight back NHS Protect has signed a three-way agreement with the Association of Chief Police Officers (ACPO) and the Crown Prosecution Service (CPS) to curb violence and anti-social behaviour in the NHS. The joint working agreement will promote and support local arrangements and seek to implement best practice.

‘Tackling violence and antisocial behaviour in the NHS’ will help the three organisations to develop closer working relationships and solutions at a local level. It will also enhance communication between them.

The agreement took effect at the end of October 2011 and will be reviewed every two years. By setting out some areas where examples of best practice have been identified and agreed at a national level, it is hoped that local partners will have a starting point for dealing with topics requiring improved cooperation in their area.

Richard Hampton, Head of Local Support and Development Services at NHS Protect, said: “This welcome agreement ensures that the commitment made at the top of our three organisations is put into practice locally, so that we act together to support NHS staff, who have a right to a safe and secure working environment.

Violence and abuse against them is highly disruptive for the delivery of treatment to patients and cannot be tolerated”.

The nature of the health service and the extensive range of locations where services are provided mean that NHS staff and premises are vulnerable to violence and anti-social behaviour. These have implications not just for those directly involved, but for the public as a whole. Not only can incidents delay the

provision of treatment, including life saving treatment, but they can also have a significant financial cost to health bodies, reducing the resources available for patient care.

While there are many examples where NHS staff, often in conjunction with the police, work well to prevent crime, it is impossible to eradicate it completely. It is vital then that the NHS works closely with the police and the CPS to respond to those incidents which cannot be prevented.

The key objectives in building a local communications network between the NHS, CPS and police are: to improve the protection of NHS staff; to strengthen the investigation and prosecution process, by improving the quality of information exchanged, and to improve victim and witness care.

All of the national organisations involved in this agreement recognise that in many areas close working is already in place. By examining examples of best practice from throughout England, it is clear that joint working is at its best when it is developed and owned locally. It is also apparent that there are differing problems in different parts of the country and that the solutions cannot be imposed at a national level.

NHS Protect, ACPO and CPS agree that there is strong public interest in prosecuting those who assault NHS staff or commit offences that disrupt NHS services.

Clearly, NHS staff should not have to face violence and abuse at work, and all parties encourage individual police services, CPS areas and NHS bodies to seek the strongest possible action against offenders.

Chief Constable Brian Moore, ACPO Lead for Violence and Public Protection, said:

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“We are committed to working together as a three-way partnership to facilitate exchanging information and good practice in securing NHS property and assets. We will also share ideas on potential weaknesses in systems and controls. Though each organisation has a distinct remit, their roles do overlap, and we will work to support each other more effectively.”

Pam Bowen, senior policy advisor at CPS, said: “NHS staff do a very difficult job in challenging circumstances. If they are subjected to abuse or violence during the course of their work they deserve to know that offenders will be prosecuted wherever possible. This agreement should reassure healthcare workers across England that such abuse will not be tolerated and that their own welfare is just as important as that of the patients they treat.”

Incidents involving mentally disordered persons are another key area where improvements in joint working may be required. Cooperation is essential, not just to deal with the offender and support the victim, but to seek to reduce levels of violence in order that the majority of patients receiving mental health services, who are not violent or abusive, can receive care in a safe and therapeutic environment.

As is made clear in the document the content of local agreements is a matter for local negotiation. All three organisations are committed to supporting the development of local agreements at whatever level proves to be best for the parties involved.

This latest agreement replaces the existing memorandums of understanding between the NHS Security Management Service (now renamed NHS Protect) and ACPO and between the NHS Security Management Service (now NHS Protect) and the CPS. It does not supersede existing examples of other joint working (e.g. Crime and Disorder Reduction Partnerships).

POLICE COLLABORATION

Norfolk hospitals see benefits of increased security NHS Hospitals in Norfolk have increased security after it emerged an allegation of rape and the possession of a firearm were among the incidents investigated by police. One trust has installed panic alarms, another has hired a private security firm and officers at the Norfolk and Norwich University Hospital (N&N) say they are working closer than ever before with the police.

The majority of reported incidents are theft (some by hospital employees) also include assaults, sexual offences and criminal damage. Since April 2009, the number of reported crimes has been driven down at the N&N, the James Paget University Hospital (JPH) in Goleston and the Queen Elizabeth Hospital (QEH) in King’s Lynn.

Police data, released under the Freedom of Information Act, shows the number of reported crimes fell from 59 in 2009-10 to 15 in 201011, and 19 in 2011-12 at the N&N; from 20 to 18 to 10 at the JPH; and from 19 to 15 to 13 at the QEH. Police say they are working with NHS security bosses to make hospitals as safe as possible. Among the reported crimes are an offender charged with possession of a firearm with intent at the JPH in February 2011. In a separate incident, an offender was charged

with possession of a blade in November 2011. The majority of offences, however, were theft, with 23 incidents since April 2009 including theft by an employee in November 2011. A spokesman for the JPH said: “It’s a delicate balancing act between having open and accessible services to the public and maintaining passive and active security measures that can deter, and help detect crimes should they be committed.” The JPH uses proximity cards, has keypad access to key areas and uses CCTV in and around the hospital.

“We also have staff trained in security techniques to help prevent and deal with any criminal activity and ensure our hospitals are as safe as they can be,” added the spokesman. Officers at the N&N say they have approximately 10,000 people on site in a day and have at least seven security officers on duty at any one time to ensure a safe environment. There are 70 CCTV cameras both internally and externally which are monitored all the time, and more than 250 access doors which are controlled by swipe card technology.

A spokesman for the N&N added: “Working closely with Norfolk Constabulary has helped us to significantly reduce the number of criminal offences on site in the last three years”.

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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IOSH 2012

SAFETY FIRST

evidence-based policy-making and would welcome this committee and its vision of increasing the use of science to support health and safety regulations. We want to see that regulations are only introduced when they are based on good research and a genuine need”.

The committee will look at all directives and amendments which are aimed at protecting people from harm, including health and safety.

she said. “Your job is to make everyone as passionate about health and safety as we are. Once we have done that, our job is done. But we do that by motivating them, not by burdening them with paperwork, or boring them with tedium.”

Fellow panellist Neil Budworth described practitioners as both the cause and the solution to the problem of how to change negative perceptions of health and safety.

He said the profession is, to the Daily Mail, the ‘new British Rail sandwich’, while Jeremy Clarkson wears his desire to challenge health and safety like a ‘coat’. He also expressed an air of bemusement at David Cameron’s recent comments to ‘wage war’ on health and safety.

DO YOURSELF OUT OF A JOB HSE chair Judith Hackitt urged delegates at the IOSH12 conference to make health and safety as easy to understand as possible for the people they work with, so that they can get on with their jobs. Speaking as part of a panel debate, which explored whether health and safety practitioners are the cause or the solution to negative perceptions of the profession, Hackitt said she was more hopeful than at any point in the ‘journey’ that the image of health and

CLOSER TO HOME However, he also admitted that sometimes, the problem lies closer to home, within the profession itself: “We need to be strategic partners and work with business to deliver benefits. We’ve become process and policy-obsessed”. The future, added Budworth, can be different, but it’s up to the profession to shape it.

Echoing these sentiments, James Wolfe, deputy director for health and well-being at the Department for Work and Pensions,

More than 2,000 people attended the UK’s biggest annual event in health and safety, the IOSH 2012 conference Manchester Central conference centre was the venue for IOSH 2012 conference and exhibition on March 6 and 7, as safety and health practitioners from around the world gathered for two days of networking and business-critical learning.

Almost 840 delegates attended the conference, and many more took part in the Core Skills+ workshops or visited the exhibition. The theme of the conference and exhibition was ‘changing perceptions,’ as delegates were challenged by IOSH president Subash Ludhra to ‘re-cast’ health and safety in the minds of politicians, journalists and members of the public.

CROSS PARTY COMMITTEE Professor Ragnar Löfstedt, who led a government-commissioned review of health and safety regulations in the UK, was among 60-plus expert speakers. Professor Ragnar Löfstedt announced a new cross-party parliamentary committee of MEPs to promote evidence-based policy making in the EU. The informal committee, to be launched at the European Parliament, in Brussels, in June, was one of a number of recommendations made by Professor Löfstedt in his review of health and safety regulations last year.

He said: “We feel it’s very important to promote evidence-based policy making in Europe. At the present time, we feel that the European Parliament is not always evidence-based in its policy making.

With this committee, we have a welcome opportunity to look at this more closely”.

The Institution of Occupational Safety and Health (IOSH) will support the launch of the committee. IOSH chief executive Rob Strange OBE said: “We have always welcomed

Health & Safety

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Where you want to be and where you want to be seen to be is a question you have to ask yourself. safety will soon change for the better.

She said: “This profession is at a very important point of its evolution. Where you want to be and where you want to be seen to be is a question you have to ask yourself.”

She added that all too often she hears health and safety practitioners demonstrate their knowledge by referring back to specific clauses of legislation – an approach she described as unhelpful in trying to win hearts and minds.

“Your aim is to do yourself out of a job,”

urged delegates to take advantage of the momentum that currently exists to reclaim the reputation of health and safety as a force for good. He summed it up simply: “There’s no smoke without fire. If people stop making poor decisions in the name of health and safety, then [these negative stories] will go away, so it’s important that we challenge them”. L FURTHER INFORMATION View videos from the IOSH conferencewww.youtube.com/shponline

Judith Hackett, HSE chair: “This profession is at a very important point of its evolution”

OSH president Subash Ludhra, right, addresses delegates at the day one breakfast briefing

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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FM SYSTEMS & SOFTWARE

Facilities Management

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PURCHASING FM SOFTWARE: REDUCING COSTS AND INCREASING EFFICIENCY

Paul Lloyd, technical director, Healthcare Facilities Consortium, looks at specifying FM software and ways to reduce costs when choosing and implementing a new or replacement FM system Our industry longevity means we have completed many tenders for FM systems of various sizes and complexities, and we have seen many changes to the way in which FM services are delivered and monitored.

By their nature, most FM systems cover the same basic functions. Some are available as a single all-inclusive package whilst others are sold on a modular basis. Most contain a lot of the same modules but some contain additional peripheral modules, usually at an additional cost for this added functionality.

When choosing a new FM system, always be absolutely sure that the system you are shown is the system you are buying. Many healthcare organisations have complained to us about suppliers who demonstrate a working system which has then been purchased only to find that what is considered essential functionality is only available as an optional add-on module at additional cost. Ask specifically

what is included at the price it is being offered to you. If the base system is being offered at the price quoted, it is likely that the functionality you need and have possibly even been shown during presentations is only available at additional cost. HFC has known healthcare organisations where, anecdotally, this has resulted in a price increase of as much as 50 per cent post-purchase.

YOU GET WHAT YOU PAY FOR Another area that may require some clarity is the cost of extra services, postinstallation. In the same way it is important to know what is included in the software package itself, it is equally important to be clear about what is included in the accompanying support package.

FM systems either have an up-front purchase cost in year one and a lower service cost for support and upgrades from year two

onwards or, in some cases, such as with our software, there is no initial purchase cost, just an annual support fee. Be sure you know what is included in the annual service charge. Upgrades? Amendments of existing reports? The writing of new reports? Bugfixing and software updates?

If so, how many per annum? Are site visits to correct reported faults included (if required)? If the supplier claims to offer remote support, is it, like our Eclipse-fm software, provided securely and at no extra charge through the NHSnet (n3) system?

All of these things are likely to occur at some point during the early stages of the system’s lifecycle and if they are not included in the support package provided with the system, will incur an additional charge. In this scenario, what appears to be the cheapest option at the tender stage is probably nearing or exceeding the cost of a rejected system E

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l ica ed og /m bl m k/ co .u e. co m e. p4 4m bc c p w. b w w. w w w

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HEALTH BUSINESS MAGAZINE | Volume 12.3

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FM SYSTEMS & SOFTWARE E that included some or all of these costs as standard in their support package. Be absolutely clear what you could be charged for after you have committed to your chosen system.

PROVIDE SOME CLARITY FM systems are usually quite wide-ranging and encompass many different aspects and functions of facilities management. It is because of this requirement that most tender documents are written by a group of FM professionals from these various functions brought together to compile the complete document and ensure every element is adequately covered.

Being absolutely clear about what you require and what is being supplied is not just a one-way street; suppliers also need to understand your requirements. Chances are that many FM system providers have completed many tender returns for similar systems and they are familiar with a majority of the terminology used. However, because you understand the workflows and internal workings of your estates or facilities department, don’t assume that the supplier will too. Ensure that the tender requirements are as clear and unambiguous as you can make them. Too often we see questions or requirements in tender documents that could be interpreted in any number of ways to an outsider. Likewise, if you use your organisation’s standard tender document template, double-check that it does not request proof of standards compliance that is not relevant to either estates and facilities or the supply of software and related services.

INCREASED EFFICIENCY Gone are the days when a team of staff worked day in, day out inputting job card data into FM systems. Modern FM systems now include PDA or tablet devices that allow tradestaff to input their job card information live into the system in real-time, thus completely removing the need to input the data back at base and free up resource to work in other areas. The financial and efficiency savings to be made from this are huge – not only in staff inputting time and resource, but in the availability of data for monitoring and performance analysis.

The quicker data can be collected, the quicker it can be monitored and analysed, and the quicker corrective action can be taken if there is a problem. The efficiency of this method of feedback is so good that some systems allow for the monitoring of activity in real-time.

While this is a powerful tool for estates and facilities managers, the instant availability of data can be regarded by tradestaff as a threat and care has to be taken when implementing such systems for the first time to ensure their immediate ‘buy in’. The easiest way is to achieve this is to bring tradestaff online with the PDA/tablet technology in groups, either a trade at a time or in smaller groups if

there is any resistance within the wider trade group. All healthcare organisations meet some initial resistance to the introduction of PDA/ tablet technology as it may be seen a ‘Big Brother’ way of monitoring their activities.

It is best to select the most pro-active and ‘tech savvy’ members of the team as early adopters in such situations. Once other members of the workforce see how quick and easy it is to use the technology to receive and process their daily work, more will want to switch over until they are all online.

The healthcare maintenance environment requires robust devices. It may be worthwhile spending a little more to purchase ruggedised

can incur extra cost but can be done locally if the right system is selected. Another question for the tender stage is: can reports supplied with the system be amended locally? If they can, there is likely to be a need for local training, but the benefit is a cost saving through keeping the process in-house and the opportunity to develop new reports to meet local requirements using an in-house resource. The cost of staff training will be more economical than paying a contractor every time an amendment is required.

The use of a Business Intelligence tool such as Dynamic AI, with your FM system will provide an even more powerful set of tools to

Facilities Management

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Once other members of the workforce see how quick and easy it is to use the technology to receive and process their daily work, more will want to switch over until they are all online.

PDA or tablet technology. Cost savings can also be made through the use of web-based job reporting and monitoring. Such facilities enable them to raise new jobs electronically 24/7 and monitor the status of previously reported jobs without the need to refer back to the estates and facilities department. Though such functionality may require some training, it is usually easy to pick up. The benefit to the department is the saving in helpdesk time and, with minimum staff effort, improved service.

REPORTING AND ANALYSIS Being able to report and analyse data from a new FM system can be fundamental to its success. It doesn’t matter how much the system cost to purchase if the data it contains cannot be accessed, reported or analysed easily. However, this is often not the fault of the software or its supplier. The key to a good FM system is the way in which the data it contains is structured, particularly when it comes to code files. Well-structured, simple and flexible coding philosophies can make all the difference to the uptake of the software.

A successful coding philosophy combines easy-to-understand structure with the ability to expand that structure in future when new buildings, departments or sites are brought online. Getting this right and not over-complicating the structure is the basis of a strong and reliable system capable of adapting to future needs without consuming time, money and resource to recode everything at a later date.

As discussed earlier, the writing or amendment of reports from any FM system

display and analyse your data, both graphically and statistically. The purchase of the software is likely to require more investment than simple report generation software but it does provide a considerably more powerful set of analysis tools with the ability to drill down through the data to examine finer detail.

A good business intelligence tool will also allow you to combine data not only from your FM system but also from any number of other databases in different formats into a single report for combined analysis.

The added beauty of such systems is that interactive executive dashboards are inherent in the functionality of the software so that sets of custom reports can be provided for healthcare professionals at different levels and for different purposes to allow them to monitor data and performance in real-time, highlighting potential problems or areas of concern at the earliest opportunity.

New or replacement FM system selection differs from organisation to organisation and depends on individual needs and requirements.

Sometimes it is not the system that is at fault but a reluctance to streamline internal processes to adapt to the way the software works and therefore increase efficiency.

As software developers we try to make our software as flexible and adaptable as possible to meet the varied working scenarios we encounter. No single software package will ever be flexible enough to be everything to everybody so there also needs to be some willingness to modify working methods a little to improve the effectiveness of any FM system. L

“Gone are the days when a team of staff y , da worked day in b out inputting jo FM card data into systems”

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WASTE MANAGEMENT

LEADING THE ‘REDUCE, REUSE AND RECYCLE’ CRUSADE

Clinical Waste

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Guy’s & St Thomas’ is one of the largest NHS Foundation Trusts in the country and is recognised for setting the benchmark in clinical research, patient care and most recently, sustainability Indeed, the waste management team, in partnership with SRCL and Bywaters, was recently recognised at the Trust’s annual awards for significantly reducing waste sent direct to landfill and increasing recycling by 34 per cent in 2010/11. For these achievements, they were awarded the Peter des Roches Sustainability Award.

The two hospitals that form the trust, located on the banks of the Thames in central London, treat more than one million patients each year combined and produce approximately 2,000 tonnes of domestic and clinical waste per annum. The trust is passionate about operating to the highest environmental standards and is dedicated to encouraging its staff to do so, too.

From introducing schemes for more sustainable transportation and lunchtime walks, through to combined heat and power (CHP) engines and a network of sustainability champions, it hopes to make a significant improvement across all its operations. And it’s already delivering significant results; the CHP engines, which are located on

both sites, save nearly £2m per year and have reduced carbon emissions by 16 per cent – or 11,000 tonnes – a year.

Waste is an important focus for improved sustainability and the trust is actively trying to implement the waste hierarchy of ‘reduce, reuse and recycle’ across all its hospital sites, including its satellite units.

REGULATIONS The nature of work conducted on site requires extremely stringent regulations to maintain public health and prevent the spread of infection. This has, however, led to much of its waste being classed as clinical and being heat treated or incinerated to eradicate all infection risk. In reality, much of the waste Guy’s & St Thomas’ produces is actually easily recyclable – paper, card, plastics, food and flowers – all of which can all be turned into new products if kept separate from clinical waste streams.

“Looking back, just four years ago, near enough all our waste, which didn’t require specialist treatment, went to landfill,”

says trust waste manager Alan Armstrong.

“We’ve made significant progress in the interim, but the main challenge is educating our 12,000 staff members to instil recycling into their everyday work lives. It’s a difficult challenge, especially in this environment, but by undertaking waste audits within different wards and departments and providing guidance on how to improve sustainability we’ve seen significant achievements in a short time.”

Armstrong heads up a 34-strong team that includes representatives from its two waste management partners, SRCL and Bywaters.

In a relatively unique arrangement within the NHS, Guy’s & St Thomas’ has appointed SRCL to undertake overall management of its waste contracts with overriding objectives to reduce waste going direct to landfill and improve segregation to ensure waste goes to the most appropriate solution.

Armstrong adds: “Working in partnership with our waste management providers has helped us deliver results more quickly. E

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HEALTH BUSINESS MAGAZINE | Volume 12.3

FEATURE SUB SECTION

E We operate as one team; we have representatives from both companies based within the NHS team. Consequently, we are all striving for a common goal and we know that we can rely on their service delivery”.

Bywaters has strategically placed blue recycling bins, known as the ‘bycycler’ throughout the hospital, to collect mixed dry recyclables such as paper, cardboard, cans and plastic bottles. Office supplies, such as toner cartridges, electronics and batteries, are also recycled via separate collection processes.

Steady adoption of the blue recycling bins is helping the hospital on its way to its 2012 target of 40 per cent recycling. Meanwhile, a good relationship between the waste team and housekeeping is helping to identify areas where more recycling bins can be placed, and also areas of non compliance.

By educating staff through waste awareness sessions, leaflets and training, participation and engagement have increased across all departments. Armstrong adds: “Women’s services have been a key success for us.

Across 15 departments, we’ve removed around 200 black bag bins and replaced them with the bycycler. Key to achieving this level of engagement has been a passionate recycling champion who has helped change behaviour on the ground and encouraged people to put recycling first.

“However, we also encounter, and overcome, resistance; a lot of it can be solved by education. For instance, at a recent waste awareness day on more than one occasion staff said to us that the segregated recycling actually ended up in landfill, which is categorically not the case. In a hospital with over 12,000 staff, ensuring a good level of understanding is a difficult task to achieve and there are inevitable misunderstandings and urban myths about

our recycling processes,” Armstrong explains.

When it comes to furniture, the waste team has achieved hospital-wide behavioural change. Indeed, no department is able to order new furniture without first consulting with the waste team and its furniture reuse scheme is in high demand. “We’ve been pleasantly surprised by how the furniture reuse scheme has been embraced across the trust. We take all unwanted furniture and find it a new home. Often demand outstrips supply, especially when it comes to chairs, but even with items that are broken beyond repair we salvage the usable parts – like wheels – and reuse them to fix other items.” It is believed that this scheme has saved the trust in excess of £60,000.

CLINICAL WASTE Changes in staff behaviour when it comes to waste have improved recycling rates and had an important impact on the amount of clinical waste Guy’s & St Thomas’ produces.

Through more stringent waste segregation, clinical waste levels have dropped significantly giving further evidence to the Royal College of Nursing’s estimates that between 40 to 50 per cent of waste ending up in clinical waste bags is domestic waste that doesn’t need such stringent treatment.

In the first half of 2011, clinical waste sent for incineration – the most costly and carbon intensive of disposal options – fell by 48 per cent, despite an increase in the amount of overall clinical waste produced by the hospitals, while recycling increased by 34 per cent compared to the same period in 2010.

Armstrong adds: “We’re delighted with the achievements we’ve made to date. However, we’re not sitting on our laurels. Looking forwards we are focusing on segregating offensive waste from clinical streams”.

Clinical Waste

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

The CHP engines, which are located on both sites, save nearly £2m per year and have reduced carbon emissions by 16 per cent – or 11,000 tonnes – a year.

Offensive waste has recently been recategorised to enable its disposal to deep landfill or through waste to energy processes as it has minimal infection risk compared to clinical waste. However, infection control will err on the side of caution to eliminate all risk. Therefore, Armstrong and the team will be identifying departments where the offensive waste can be easily separated – for example special care baby units. This has already been rolled out to the trust’s mobile endoscopy unit where all waste is suitable for the offensive stream.

However, the team recognises that there will be limitations and for some departments – such as ward areas – it may be safer from an infection control perspective to treat all waste as clinical.

The dedication of the team and all Guy’s & St Thomas’ staff has made a significant difference in transforming the environmental credentials of one of the busiest hospitals in the world. The achievements and practices that have been developed here are, like their medical results, setting the benchmark for UK healthcare providers. L

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HEALTH BUSINESS MAGAZINE | Volume 12.3

10/11/2010 09:32

NEWS IN BRIEF

Energy News

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Sir Neil McKay promoting sustainable healthcare at global summit

ENERGY REDUCTION

£4m potential savings for NHS energy bill on Merseyside NHS organisations on Merseyside plan to save a huge £4 million each year from their combined £12 million energy bill. Recognising that the 50,000 NHS staff across the trusts have a big role to play in reducing energy use and waste, the organisations will soon be sharing a campaign to highlight the difference that individuals can make.

Liverpool Primary Care Trust (PCT), Liverpool Women’s Hospital, Royal Liverpool and Broadgreen University Hospitals, Alder Hey Children’s Hospital, Aintree University Hospitals, Liverpool Heart and Chest Hospital, Mersey Care and Liverpool Community Health started working together on energy saving projects in 2010.

The trusts aim to reduce the carbon and costs from buildings energy use, waste and water, and business travel. This work has already started – Liverpool PCT’s ‘New Health Service Liverpool’ programme has used renewable energy technology, such as wind turbines, in new health centres to save energy and money. The Royal Liverpool Hospital has asked suppliers to redesign surgical packs, cutting both waste and time

to prepare for procedures. Software which automatically shuts down computers at the end of the day has already saved thousands as it is rolled out across several trusts.

Gideon Ben-Tovim, chair of Liverpool PCT said: “We all have a responsibility to use resources wisely both to reduce carbon emissions and costs to the NHS. We have laid out extremely ambitious plans to reduce carbon emissions by 37 per cent over the next two years. I am delighted that across Merseyside the NHS is working together on this important aspect of the Decade of Health and Wellbeing goals to make Merseyside more equal, well and green”.

Alan Yates, Chief Executive at Mersey Care NHS Trust leads the collective Merseyside approach to ‘greening’ the NHS. He said “If money spent on energy bills and dealing with waste can instead be spent on looking after patients, everyone benefits. And the size of the NHS means that if we can show how to do it here on Merseyside then it could make a huge difference across the country”.

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CARBON REDUCTION

Barnsley’s carbon cutting recognised Barnsley Hospital has been awarded the Carbon Trust Standard after taking action on climate change by measuring, managing and reducing its carbon emissions by 3.9 per cent.

In November Barnsley Hospital came top of the Environment Agency’s Carbon Reduction Commitment (CRC) performance league table. It is the only hospital in the North of England set up to monitor 100 per cent of its electricity using Automatic Meter Reading (AMR), and this helped to earn it the Carbon Trust Standard award.

“We’re delighted to have achieved the Carbon Trust Standard,” says Mick Bailey, lead for reducing carbon emissions, “as it is a great way of showing that we are on the front

CEO lead for Sustainable Development Sir Neil McKay has been promoting the importance of sustainable healthcare in the NHS to a high profile worldwide audience.

Sir Neil, who is also CEO for NHS Midlands and East, was invited to attend a global summit in New York on sustainable business growth in an economic downturn.

Taking part in the event were former US President Bill Clinton and former UN Climate Change executive secretary Yvo de Boer.

Sir Neil made a keynote speech at an international conference for Rio+20 participants, who will be making recommendations to input into the upcoming Rio+20 global summit this June. He explained how progress in sustainable healthcare was being made across the NHS in England and explained the importance of providing sustainable healthcare and improvements in public health whilst managing the impact of the world economic downturn.

He also detailed the need for more focus on illness prevention strategies and better use of technology to improve patient care, along with the most recent evidence detailed in the NHS SDU’s publication Sustainability in the NHS: Health Check 2012

foot when it comes to carbon management best practices. It also boosts our reputation, and gives us an opportunity to communicate our environmental credentials with integrity to our patients, staff and stakeholders.

“We are committed to reducing our emissions by 10 per cent by 2015. Going through the assessment process to achieve the Carbon Trust Standard helped us to not only quantify our footprint, but also benchmark our performance and identify areas for improvement bringing tangible and significant cost savings across our operations.”

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Solar savings Solar energy is now helping to power Ilkeston Community Hospital in one of the largest new environmentallyfriendly initiatives of its kind in the NHS. It is believed that this is the largest single solar photo voltaic installation on a NHS building, with only one other solar project for a clinic in Cumbria to match it in size. Since the start of the year, a total of 212 solar panels have been installed on the hospital roof at Ilkeston and, in the first few weeks since switch-on, are proving effective in generating electricity.

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INFECTION CONTROL

GUIDE TARGETS HCAI REDUCTION THROUGH SYSTEMIC IMPROVEMENT

Infection Control

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The National Institute for Health and Clinical Excellence (NICE) has published a quality improvement guide on preventing and controlling healthcare associated infections (HCAIs) in secondary care settings The 2009 National Audit Office report on reducing HCAIs identified four systemic issues that still needed to be tackled locally and nationally to reduce infection rates. It highlighted the need for a culture of continuous improvement; for a wholesystem approach, with clear structures, roles and responsibilities; to ensure staff compliance with good infection control practice, and to monitor and record hospital prescriptions and the use of antibiotics.

Produced in partnership with the Health Protection Agency (HPA) as part of a pilot project, the latest guide identifies the organisational characteristics, arrangements and practices that describe excellence in care and practice to prevent and control HCAIs. It was developed as a pilot project, based on processes and methods used by NICE to develop other types of guidance. A topic expert group led by an independent chair was set up. This consisted of practitioners from the NHS, local authorities and the voluntary sector, as well as academics and patient and public representatives.

The group then worked with NICE and the HPA to develop the guide, and its resulting quality improvement statements are based on recommendations from seven source guidance documents. These were then further refined through stakeholder consultation and committee discussion.

The guide is aimed at board members working in (or with) secondary care. It may also be of use to senior managers, those working elsewhere in the NHS, as well as those working in local authorities and the wider public, private, voluntary and community sectors.

WHAT ARE HCAIS? Healthcare-associated infections (HCAIs) can develop either as a direct result of healthcare interventions such as medical or surgical treatment, or from being in contact with a healthcare setting. The term covers a wide range of infections, the most well known being those caused by meticillin-resistant Staphylococcus aureus (MRSA), meticillin-sensitive Staphylococcus aureus (MSSA), Clostridium difficile (C.difficile) and Escherichia coli (E.coli).

HCAIs cover any infection contracted as a direct result of treatment in, or contact with, a health or social care setting as a result of healthcare delivered in the community outside a healthcare setting (for example, in the community) and brought in by patients, staff or visitors and transmitted to others (for example, norovirus).

HCAIs pose a serious risk to patients, staff and visitors. They can incur significant costs for the NHS and cause significant morbidity to those infected. As a result, infection prevention and control is a key priority for the NHS. What action has been taken?

Following National Audit Office reports highlighting concerns about HCAIs, the Department of Health introduced a range of policies and measures designed to

have been successful in helping the NHS reduce rates of MRSA bloodstream infections and CDI, but HCAIs remain a significant financial burden for the NHS and as a result, infection prevention and control continues to be a key priority for the NHS. NICE and the HPA recognise that a range of factors associated with infection prevention and control have the potential to impact on health inequalities (for example, in relation to age, ethnicity, gender and disability). However, the relative impact of different factors will vary for different organisations. NICE and the HPA expect trusts and other secondary care organisations to consider local issues in relation to health inequalities when implementing the guide.

The quality improvement guide is aimed

The guide is aimed at board members working in (or with) secondary care. It may also be of use to senior managers, those working elsewhere in the NHS, as well as those working in local authorities and the wider public, private, voluntary and community sectors. reduce rates of infection. For example, mandatory surveillance for meticillin-resistant Staphylococcus aureus (MRSA) was introduced in 2001. In 2004, a target was introduced to reduce MRSA bloodstream infections by 50 per cent by 2008 in all NHS acute and foundation trusts. With the introduction of the Health Act in 2006, for the first time it became a legal requirement to have systems in place to minimise the risk of HCAIs. In 2009/10 there were nearly 2000 reported incidences of methicillin-resistant staphylococcus aureus (MRSA) and over 25,000 reports of clostridium difficile infection (CDI) at a cost to the NHS of around ÂŁ260 million. In addition, in 2009, 77 trusts reported 831 outbreaks of norovirus, the majority of which led to some form of ward closure.

A range of policies and measures introduced by the Department of Health

at trust boards and senior management in secondary care settings including commissioners, auditors, managers and providers. The guide consists of 11 quality improvement statements describing a level of excellence in infection prevention and control at a management or organisational level. Evidence of achievement markers accompanying each statement allow trust boards to assess their compliance or progress towards each statement. In addition, the guide provides practical examples of the types of management and structural processes and associated interventions that need to be in place in order to reduce harm from infection.

Each of the 11 statements is supported by examples of the type of evidence that could be used to prove the organisation has achieved excellence, and examples of what this would mean in practice on a day-to-day basis. E

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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0FEATURE

SUB SECTION

E The 11 areas are as follows:

1. Demonstrating leadership in infection

prevention and control to ensure a culture of continuous quality improvement and to minimise risk to patients.

2. Using information from a range of sources to inform and drive continuous quality improvement to minimise risk from infection.

3. Having a surveillance system in place to routinely gather data and to carry out mandatory monitoring of HCAIs and other infections of local relevance to inform the local response to HCAIs. 4. Prioritising the need for a skilled, knowledgable and healthy workforce that delivers continuous quality improvement to minimise the risk from infections. This includes support staff, volunteers, agency/locum staff and those employed by contractors.

5. Ensuring standards of environmental cleanliness are maintained and improved beyond current national guidance.

6. Working proactively in multiagency collaborations with other local health and social care providers to reduce risk from infection.

7. Ensuring there is clear communication with all staff, patients and carers throughout the care pathway about HCAIs, infection risks and how to prevent HCAIs, to reduce harm from infection.

8. Having a multi-agency patient admission, discharge and transfer policy which gives clear, relevant guidance to local health and social care providers on the critical steps to take to minimise harm from infection.

9. Using input from local patient and

Infection Control

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public experience for continuous quality The guide is aspirational and aims to improvement to minimise harm from HCAIs. engage trust boards and clinicians to improve 10. Considering infection prevention and the quality of care and practice in the area control when procuring, commissioning, of infection prevention and control over planning, designing and completing new and and above current mandatory standards. refurbished hospital services and facilities (and Dr Bharat Patel, lead consultant medical during subsequent routine maintenance). microbiologist at the Health Protection Agency 11. Regularly reviewing evidence-based and member of the Topic Expert Group, said: assessments of new technology and “This guide represents aspirational other innovations to minimise harm quality improvement statements in from HCAIs and antimicrobial infection control and achieving re ca “Health resistance (AMR). these standards is something s n io ct Professor Mike Kelly, that all Trusts should aim associated infe le, b director of the Centre for for. It complements the are unaccepta be n Public Health Excellence existing guidelines ca d n a avoidable at NICE, said: “There on the prevention of s a d ce u d re have been major healthcare associated significantly by the improvements within infections and offers demonstrated s in n io the NHS in infection practical suggestions ct u d re recent s control, particularly in on how trusts can best ia m e ra e ct MRSA ba relation to Clostridium manage 11 key areas m difficile and MRSA of quality improvement. and Clostridiu bloodstream infections,

“The HPA has difficile” in the last few years, but collaborated closely both with HCAIs are still a very real threat to members of the expert group and patients, staff and visitors. Indeed, evidence colleagues from NICE on the production of suggests there is wide variability in trusts’ these statements. We are confident that all success in reducing the impact of HCAIs. trusts will find them invaluable in planning

and implementing their strategies to ASPIRATIONAL APPROACH preventing healthcare associated infections.”

Therefore, it is important that there is advice in Professor Roger Finch, consultant in place that can help trusts achieve excellence Infectious Diseases, Nottingham University in management and organisational practices Hospitals Trust and chair of the Topic Expert in order to prevent and control infections.

Group which developed the advice, said: Based on the best available evidence in this “The control and prevention of healthcare area, the guide illustrates how secondary associated infections is essential to ensuring care organisations can take a whole system patient safety. The nature of HCAI is complex approach in tackling the problem. and demands leadership and systems E

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HEALTH BUSINESS MAGAZINE | Volume 12.3

INFECTION CONTROL E that are supportive and continuously refined. These quality improvement statements take an organisation-wide approach to support hospital Trusts achieve excellence and meet the high public expectations of healthcare delivery.”

Cheryl Etches, director of Nursing and Midwifery, Royal Wolverhampton Hospitals NHS Trust and member of the Topic Expert Group, said: “The NICE guide is a useful and important set of principles that are aimed at supporting boards in delivering their infection prevention responsibilities.

It should be used to offer assurance to boards of their strategic direction on this subject and also to drive a culture of continuous quality improvement. Irrespective of where an organisation is on its HCAI improvement journey it can use the guide to agree their next steps to improvement”.

Paul Unsworth, area director London, NHS Institute for Innovation and Improvement, and member of the Topic Expert Group, said: “I am delighted NICE has developed this guide. Healthcare associated infections are unacceptable, avoidable and can be significantly reduced as demonstrated by the recent reductions in MRSA bacteraemias and Clostridium difficile. If implemented, this quality improvement guide, to hospital clinicians, managers, patients, carers and commissioners of healthcare, will result in a better understanding of what infective organisms exist in hospitals and the community and will be a crucial step in taking the initiative to collectively reduce the spread of infections throughout hospital, community and social care.

Graham Tanner, chair, National Concern for Healthcare Infections and patient/lay member on the Topic Expert Group, said: “This quality improvement guide provides an opportunity to demonstrate that the NHS can deliver exemplary services for patients. The quality improvement statement relating to NHS trusts working proactively with multi-agencies to reduce HCAIs within local health and social care organisations is of particular importance. This will support the development of integrated health and social care services, support development of patient centred care and potentially provide substantial cost savings to the NHS”.

HOW SHOULD THE GUIDE BE USED? This guide is not mandatory. Rather, each quality improvement statement describes a level of excellence that could be achieved to prevent and control infections. Key areas of practice that underpin infection prevention and control, such as hand hygiene, antimicrobial stewardship and environmental cleanliness are included as measures and examples, where appropriate.

Organisations wishing to use the guide for quality assessment and improvement may choose a selection of the most appropriate measures for their setting as potential

Glossary Accountability framework

Link practitioners

The policies, procedures and lines of accountability for specific areas within an organisation.

Local leaders and role models – either within a trust, or working in settings that link to that trust – promote the principles of safe, clean care or good prescribing practices during the dayto-day operation of their service. Link Prevention and control of healthcareassociated infections practitioners may have a clinical or lay background. An example of the former could be a nurse or pharmacist. An example of the latter could be a patient liaison officer.

Adverse event An unplanned or unanticipated event involving actual (or potential) risk or harm to patients. In the context of this guide, this would be an infection occurring as a result of medical or surgical intervention or contact with a healthcare setting.

Continuous quality improvement (CQI) Improving the provision of services and practice by using a range of audit and statistical tools to assess the current situation, identify areas for improvement and measure the results.

Hand hygiene The use of soap or solution (nonantimicrobial or antimicrobial) and water, or a waterless antimicrobial agent, to remove transient or residual organisms from the hands.

Key performance indicators (KPIs) Measures that provide an indication of performance in key areas.

Learning methodologies Techniques and approaches that provide an opportunity to evaluate current practice, identify areas for improvement and disseminate the findings.

evidence of achievement. In organisations where, for example, tertiary care services are provided alongside secondary care, senior management should consider the applicability of each statement to their setting.

The examples of measures that could be taken may not be appropriate in all cases – and secondary care organisations may identify and use alternate measures as evidence of achievement, as necessary.

Performance in each statement area will depend upon healthcare professionals and other trust staff who have HCAI prevention and control – and public health, generally – as part of their remit.

Much of the information required to support the measures is already available and a range of other guidance can be used alongside this guide to assess and improve quality in secondary care settings. Overlaps between the statements and certain aspects of the code of practice are highlighted. In addition, where data routinely collated may help trusts monitor progress in an area covered by one

Infection Control

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Medical device A product used to diagnose, treat or prevent disease or injury.

Planned preventive maintenance The scheduling of planned maintenance to prevent damage, breakdown and functional failures.

Surveillance Active monitoring of infection at patient, ward, trust or national level.

This involves counting cases over time and recognising and controlling outbreaks and adverse trends. It also involves producing complete epidemiological records of infection outbreaks and adverse incidents which describe and summarise all cases.

Trust estates All the buildings and grounds that fall under the management and control of the trust.

of the statements, this is also highlighted.

It’s hoped that the guide will help secondary care and other healthcare organisations improve the quality of care and practice, reduce the risk of harm from HCAIs to patients, staff and visitors and reduce the costs associated with preventable infection.

The 11 quality improvement statements provide clear markers of excellence in infection prevention and control at a management or organisational level.

The aim of the guide is to help boards assess current practice in relation to the prevention of HCAIs, identify areas for quality improvement, monitor progress and provide leadership and support to infection prevention and control teams and other staff working to implement the guide. Its authors also believe it may have a role informing investment decisions.

Importantly, it will also give patients and the public information about the quality of care they can expect, and how secondary care organisations can improve patient safety and outcomes by improving quality in key areas. L

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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HOSPITAL PLAY AREAS

Design & Build

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Play as a pathway to health Early intervention is currently being praised as a key method in encouraging healthier lifestyles among children and their parents. What better environment to explore the benefits of play than in the design and installation of play facilities in hospitals, asks Adam Steiner of the Association of Play Industries Hospital play under the NHS has a long and diverse history of working to improve the hospital experience for child patients as well as providing a recovery activity that should be a part of every child’s daily life.

Hospital wards and corridors can be scary places for children suddenly injured or suffering from long-term illness. There is a relative degree of shock at being thrust into a strange new place, away from friends and family. Therefore the design and facilities of a hospital, as well as the contributions of its staff, must be geared strongly towards the needs and requirements of the child, not solely from an adult perspective.

While there is little to be done in making an operating theatre or hospital bed a less functional or more comfortable place, play provision can make a big difference and comes in many forms, all of which can make hospital a better place for children.

Play facilities have long been a part of hospital life under the NHS. The first hospital play schemes were established in 1957 at St Bartholomew’s and St Thomas’s Hospital in London, followed by the Brook Hospital in London in 1963. But the hospital play movement really gained force in the late-

1970s, with a particular emphasis on outdoors play in 1991 after the then Conservative government’s Department of Health introduced guidelines recommending that every major hospital introduce high quality indoor play facilities with the aim of providing play specialists for every child hospital bed in order to improve patient care and recovery times.

company to visit the site and assess the most appropriate equipment. For example, outdoor play spaces have become increasingly popular with larger hospitals as they enable patients to escape the closed internal space of the ward and spend time in a more natural open space; to help them briefly forget the artificiality of the hospital environment. However, due to the rough and tumble nature of outdoor play, not all hospitals “The size ch ea f o t and their patients will require n te n co and ding such a space and as such en ep d es g an area ch outdoor play is often cited e th f o re upon the natu ly the as a strong accompaniment ward, how easi le to use to the more common indoor ab facilities and generally children will be lative to re make the hospital grounds es ti li ci the fa at feel more welcoming. ndition and wh

PLAYABLE SPACE So, how is a playspace created in a hospital?

Generally speaking, the size and content of each area changes depending upon the nature of the ward, their co how easily the children space age group the r” will be able to use the API MEMBERS will cater fo facilities relative to their The advantage of using an condition and what age Association of Play Industries (API) group the space will cater for. This member company is that their long line enables hospitals to allocate space for play of experience and knowledge of children’s play according to those child patients who have and play specialists’ needs, qualify them to the greatest need, or would benefit most. isolate the level and nature of play provision A key part of the process is consultation and required for a particular ward and offer a wide using an experienced and safety-qualified play range of equipment options. E

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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HOSPITAL PLAY AREAS E A popular movement in some hospitals is to divide a space between hard and soft play appropriate to different children’s abilities. This offers a progressive play system for children who are gradually recovering and can move on to more advanced equipment as their condition improves. It also allows child visitors to play, often supervised by hospital play specialists, while their family members move on to the adult wards. If the child is a patient, they can be assisted to work with the soft equipment, depending upon their condition.

At Victoria Hospital in Blackpool, there are several indoor play spaces, including a crèche, designed and installed by API members, including an outdoor playground, all of which cater for children across several age ranges.

and the health benefits that can be derived from it. It is the hospitals themselves and the staff caring for children who are the most important influence, firstly, having play accepted within the environment and then advising us on how to find new ways for the children to benefit from its inclusion”.

MAKING PLAY HAPPEN Hospital play specialists provide a vital role in encouraging patients and visiting children to play which is carried out at several stages.

Firstly, there is what is described as normal play, where child patients, particularly those just admitted to hospital, are given the opportunity to forget about their condition and focus on the natural child activity of play. This

Play is a highly inclusive form of therapy and can provide a calming effect both for patients and their families visiting hospital, as play is such a natural activity for children it helps to ground the hospital experience and provide some sense of normality.

These facilities are backed-up by a six person play specialists team who work to support the children at play by helping them to use the play equipment. There are possible plans to expand the hospital’s play facilities to make more space for children in a wider age range.

Graham Robinson, an API member, commented on the work done at Victoria Hospital: “We are always excited to explore how play can be integrated in hospitals

is carried out with all child patients, especially those who are unable to leave their beds as play specialists come to them directly and spend dedicated time helping to improve their hospital experience. Another play stage for children is pre and post-procedural play where the play specialists use play and photographs to explain a forthcoming operation to a child, or to detail their post-op recovery plan. This enables the child to relate to the

Design & Build

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

procedure but also helps to remove much of the anxiety and fear that might arise from it.

THERAPEUTIC VALUE Play can become an important part of hospital life and one of the most valuable contributions it can make is for child patients with special educational needs, or a disability. Sensory experience rooms offer these children a quiet space away from the hustle and bustle of a busy ward and enable them to relax with calming music and light effects that give an added dimension to their recovery.

Play is a highly inclusive form of therapy and can provide a calming effect both for patients and their families visiting hospital, as play is such a natural activity for children it helps to ground the hospital experience and provide some sense of normality.

The key benefits of creating better play facilities and more play opportunities for child patients in hospitals is that it eases their journey through the healthcare environment.

This reduces the shock of being thrust into what can be a very disorientating environment and lessens the level of trauma a child may have had through illness or injury, leaving them with a positive experience of the modern healthcare system. This is certainly something worth investing in for the future of children’s health. L FOR FURTHER INFORMATION www.api-play.org To read more about the value of hospital play, HPSET and the CPIS have produced a useful factsheet: tinyurl.com/7xrmyds

Volume 12.3 | HEALTH BUSINESS MAGAZINE

39

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NATIONAL PROGRAMME FOR IT

NEWS IN BRIEF

CSC’s Lorenzo could still form part of a National IT Strategy In a move that could see a partly-resurrected National Programme for IT, US-based supplier Computer Sciences Corporation (CSC) has announced that it has signed a non-binding Letter of Intent with the UK Department of Health, which lays out CSC’s path in delivering services and solutions to meet the NHS reform agenda.

The Virginia firm, which has struggled to deliver Lorenzo-based electronic patient record systems to the NHS, took a £1 billion write down on its contract at the end of last year, as it looked like the government would pull the plug. The company is currently planning to make nearly a third of its entire UK healthcare employees redundant.

It is understood that the deal will secure savings of £1 billion from its disputed £3.1 billion deal for the North, Midlands and East of England.

CSC has been negotiating with the NHS since mid-November over the scope and value of an electronic patient-records system. The company says that, should a new binding agreement be reached, the NHS would commit to a minimum number of trusts that would take the Lorenzo system, including some that would be named. Services will be focused primarily in the Midlands, North and East England.

The signing reflects the focus of the NHS’ reform agenda to deliver more localised projects while implementing

iPhone app launched for chronic fatigue sufferers

budgetary controls and greater devolution in decision processes and at the same time meeting high quality standards and improving overall patient care.

The Letter of Intent is intended to establish the broad principles of an agreement between the CSC and the Department of Health, with the agreement set to be completed by the 31st of March 2012.

Alan Perkins, NHS Connecting for Health resources director, told the Government Efficiency Expo event in London: “We are going to make information available widely. Where there is a need for a national solution, we will have one”.

He continued: “We’ve got to stimulate a vibrant health marketplace, rather than forcing national solutions on people as a matter of course,” he said. “Each health trust will be responsible for understanding and explaining their own requirements and they may collaborate with other trusts to sign frameworks.”

Beyond Lorenzo, CSC provides a wide range of other solutions and services to the NHS, including general practitioner, ambulance, and community systems, and digital imaging, and these services will continue. The Department of Health is due to publish its Informatics Strategy IN THE MEDIA The Guardian later this year, setting the tinyurl.com/7cje3cf latest direction for its IT.

An iPhone application has been launched to help patients with chronic fatigue syndrome / ME keep track of their energy levels. ActiveMe was created by the Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, the Northern CFS / ME Clinical Network and Indigo Mulitimedia. It focuses on controlling the “boom and bust” energy cycles that people with chronic fatigue syndrome go through by monitoring and tracking their activity and energy levels. This data can be recorded within the application, providing the patient with a visual representation of their information, which they can then use to plan activities on an hourly basis. ActiveMe is available on the Apple iTunes store for £1.49.

Healthcare IT News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

TO READ MORE PLEASE VISIT...

tinyurl.com/7l9uzo5

OUTSOURCING

Alder Hey and Liverpool Womens seek large scale IT partner In what could be the first major IT outsourcing deal to be agreed by NHS Trusts, Alder Hey Children’s and Liverpool Women’s NHS, which already share IT services and a chief information officer, are looking for a supplier to provide ICT to support patient care, as

well as technology for the new Children’s Health Park hospital, due to open in 2014.

A 24-hour service desk, unified communications, including telephony, paging, bleeps and mobiles, plus networks and servers, will all be covered by the contract.

TO READ MORE PLEASE VISIT...

tinyurl.com/732m6xa

Pocket Health app gives access to choice Since its launch in September 2011, a ‘Pocket Health’ app developed

by CSC for NHS Choices has been downloaded an estimated 5,400 times. The app, which was featured at the Department of Health’s maps and apps showcase event last week, gives users access to choice and treatment information from the government’s flagship health website. The app allows iPhone, iTouch and iPad users to find their nearest hospital, clinic, pharmacy, doctor, dentist or opticians through its service finder. This uses geolocation technology to show them the services they are looking for on a map.

Pocket Health also provides users with a screen image of the human body, which allows them access to a wide range of information on ailments and injuries and their relevant symptoms from NHS Direct.

TO READ MORE PLEASE VISIT...

tinyurl.com/7mhtwhx

Volume 12.3 | HEALTH BUSINESS MAGAZINE

41

TELEHEALTH

O2 Health launches Help at Hand complete mobile telecare service O2 Health has launched Help at Hand, a complete mobile telecare service that encompasses an easy to carry mobile-enabled pendant or wristwatch connected to a secure website and 24/7 alarm receiving centre. The service is developed specifically for health and social care settings where there is a major focus on using technology to improve care services, provide greater patient choice and manage healthcare resources more efficiently.

The use of telecare is proven to help delay or avoid unnecessary admission to care homes, reduce emergency call outs and days in hospital and, importantly, reduce risk to the user. In addition, where the cost benefit of existing telecare solutions has been assessed, it is estimated that a total of £5.8 million has been saved in care services – across just 1,722 service users in England.

However, only 1 per cent of available telecare solutions in the UK are mobile-based. Keith Nurcombe, managing director of O2 Health, says: “The health and social care landscape in the UK is changing rapidly – more people require long term care, resources are under pressure, patients are demanding more choice – providers are being asked to do a lot more with a lot less. We believe there is huge potential for technology to help – in terms of giving patients more independence as well as reducing the cost and resources required for building-based care”.

A discreet pendant or wristwatch connects users to a 24/7/365 alarm receiving centre with specially trained staff. Features of the pendant or wristwatch include a fall down detector and GPS so the user’s location can be identified. Safe zones can also be defined; and if the individual moves out of this zone the receiving centre is alerted and staff can take the appropriate action.

Guidelines for the user’s care are set up via the secure Help at Hand website.

Nurcombe continues: “For many groups of patients now being considered for telecare services, being confined to their homes is no longer acceptable. They want to be able to go about their daily lives with the reassurance that help is quickly available should they need it. Mobile technology is a natural fit – this is where we have identified a need and developed Help at Hand to meet it”.

Help at Hand was developed in conjunction with Telefónica Digital’s Health Research & Development team in Granada. eHealth is one of the key digital service focus areas for Telefónica’s new digital business, which has been formed to create new opportunities in the digital world.

The Help at Hand TO READ MORE service will be PLEASE VISIT... available from April.

tinyurl.com/7eax9se

WSD PROJECT

Telehealth could save £1.2 billion over five years, according to early Whole System Demonstrator findings At the international congress for telehealth and telecare, Care Services Minister Paul Burstow revealed the ‘staggering’ headline findings from the Whole System Demonstrator project, which include a 45 per cent difference in the mortality rate between those using telehealth and those in the control group.

Other findings include a 20 per cent fall in emergency admissions, 15 per cent fewer visits to A&E, 14 per cent fewer elective admissions and an 8 per cent reduction in tariff costs.

Burstow said: “The widespread adoption of telehealth and telecare as part of an integrated care plan will mean better quality of care and greater independence for people with long-term conditions. Delivered from the front line it could save the NHS up to £1.2 billion over five years. This new approach is not about the technology, it is about a revolution in personalised healthcare that can improve the lives of three million people, increase their independence and dignity as well as reduce the time they spend in hospital.

The Department of Health set up three Whole Systems Demonstrator projects in June 2009 to assess the benefits and impacts of telehealth and telecare technology on the NHS and social care services. According to e-Health insider, Burstow agreed there was “a lot of appetite to see the full results” which he described as “compelling”. He expects papers to be published in peer reviewed journals over the coming weeks and months, and believes “all of this will play a big part in the soon-tobe-published Information Strategy. The way that a patients records can be accessed, added to and shared electronically will be one of the key benefits of telecare and telehealth. Giving people control of their own information, and building that information around the individual rather than having numerous separate records dotted around all over the place, SEE THE FULL SPEECH will offer real tinyurl.com/6mhnopt 3 million lives campaign clinical benefits”.

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NEWS IN BRIEF Dell has launched its Unified Clinical Archiving solution in the UK

Healthcare IT News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Beginning in the late first quarter of 2012, the company plans to offer its cloud-based medical archive platform, supported by a new data centre located in Slough.

Since acquiring InSite One in December 2010, Dell has developed a complete clinical archiving solution that enables easy and secure data retrieval and sharing for the clinician.

The main focus will be the NHS picture archiving and communications system market – which is beginning a market refresh as trusts look to replace or extend contracts from the era of the National Programme for IT in the NHS. DELL’S NEW DATA CENTRE

tinyurl.com/7vwb3wu

Nine London trusts seek EPR/PAS system An electronic patient record system and patient administration system worth up to £400m is sought in a collaborative tender between nine NHS trusts. St Georges Healthcare NHS Trust is leading the procurement exercise.

Suppliers will be required to include licensing and maintenance, transition and deployment services, application support and solution monitoring.

The collaboration is between Barts and the London, Croydon Healthcare, Imperial College Healthcare, Kingston Healthcare, Newham University Hospital, Royal Free Hampstead, South London Healthcare, St Georges Healthcare, and Whipps Cross University Hospital NHS trusts.

TO READ MORE PLEASE VISIT...

tinyurl.com/8xub3uw

South Tees puts AGFA in the picture in seven year deal South Tees Hospitals NHS Foundation Trust has signed a seven year deal with Agfa to update the Trusts’ picture archiving and communication system (PACS), radiology information system (RIS), Computed Radiography (CR) and Cardiovascular Information System (CVIS). The seven-year contract will replace the Trust’s existing Agfa HealthCare PACS, RIS and CR with fully-integrated IMPAX solutions.

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tinyurl.com/738l9s6

Volume 12.3 | HEALTH BUSINESS MAGAZINE

43

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

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44

HEALTH BUSINESS MAGAZINE | Volume 12.3

VIDEOCONFERENCING

Video technology brings stroke expertise to bedside in minutes NHS Surrey’s stroke service uses Polycom Video Collaboration Solutions to save lives through remote treatment.

Linking five, far-apart stroke units, the Polycom Practitioner HD video cart is helping stroke patients get treatment from remote physicians within a critical three-hour window.

The NHS is currently facing the biggest spending cuts in its history with budgets reduced by £21 billion over the next four years. To help ease the burden, NHS Surrey has turned to videoconferencing. After a successful pilot, Polycom’s telestroke solutions were installed across five different trusts, and stroke victims are already benefiting from the earlier intervention this system allows. So far 11 cases have involved the use of Telemedicine and three patients were assessed and were suitable for Thrombolysis.

The timely intervention of thrombolysis, as a result of the videoconferencing solutions, has helped improve health outcomes.

The solution makes it possible for patients to get round-the-clock, specialist consultant-led care with faster treatment times and improved outcomes. The system incorporates mobile Polycom Practitioner carts for each of the five hospitals, plus laptop software for on-call stroke physicians.

A remote-controlled camera then allows them to see the detailed clinical examination performed by the clinician at the bedside.

Stroke patients no longer have to travel long distances to receive treatment and expert advice. And bringing the specialist to the patient enables more accurate diagnosis and quicker access to treatment, which reduces the number of patients left with a disability post-stroke.

By treating patients at their local hospital it makes it easier for family and carers, ensures continuity of rehabilitation and reduces the length of stay. For the Surrey Heart and Stroke Network, the introduction of the technology not only massively reduces the costs and call-

out hours of consultants, it reduces the length of hospital admission and reduces the costs of long-term care. Further still, hospital staff feel confident and supported in the knowledge that expert advice is only a click of a button away and allows staff to share knowledge between providers in the network, resulting in better treatment and further cost savings.

The DH National Stroke Strategy Impact Assessment identified the average 10year cost of a dependent stroke victim as £56,381, and that currently just one patient in nine makes a full recovery. Based on 2009/2010 figures of stroke admissions, using the Polycom telestroke solutions will allow approximately 150 patients to make a full recovery with a further significant proportion with greatly improved mobility.

Dr Youssif Abousleiman, Clinical Lead for Stroke at Surrey and Sussex Healthcare

NHS Trust, says: “Time is brain: after an acute stroke millions of brain cells die every minute. Getting the right treatment quickly is absolutely vital. If thrombolysis is given within four and a half hours of the symptoms, then there is a much greater chance of an improved outcome and less brain damage”.

Colin Lee, senior project manager at NHS Surrey, says: “With only a three hour time window from the onset of symptoms of a stroke to the possible need for thrombolysis, the time saved due to the newly installed telestroke units can mean the difference between life and death or greater levels of disability. Within 60 minutes of arrival at A&E, a patient can have had a CT scan, be seen by triage, assessed by the stroke team, and by the stroke consultant if the case is complicated or may require thrombolysis, and a clinical assessment provided – all while the consultant is at his or her own home.”

Healthcare IT News

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TO READ MORE PLEASE VISIT...

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HEALTHCARE INFORMATICS 2012 Social networking and information goverance hot topics at HC2012 Caring for and communicating with the Facebook generation and information governance are just two of the hot topics at this year’s HC 2012, the health informatics conference, run by the BCS Health Executive of The Chartered Institute for IT, in association with The Guardian. Keith Pollard of Intuition Communication will present on the impact of social networking and the internet on the care of future generations. His talk, on the first day of the conference, will be followed in the afternoon by a presentation from Tony Cobain who will argue that information governance in healthcare is a help not a hindrance.

Keith explains: “Since the birth of the internet, patients have been sharing their healthcare problems and experiences online. Patient forums were one of the first examples of the use of the internet as ‘social media’. Now the patient’s voice is being expressed through Facebook, Twitter and the like. We need a strategy for dealing with this now and in the future”. Both presentations will feature in the stream entitled ‘Care across settings’, which will look at the integration of information and technical systems to support the vertical integration agenda, covering work-flow, day-to-day practice and the delivery of care and treatment to patients and the public across health and social care sectors and agencies.

HC2012 will be free for delegates this year and takes place at the Business Design Centre, London, 2-3 May, 2012. The conference has a number of key partners including NICE, the NHS Confederation, the NHS Information Centre, UKTI and Intellect’s Healthcare Council.

HC2012 will also play host to the ASSIST Annual Conference.

FURTHER INFORMATION hc2012.bcs.org

Think tank advocates smart phone and tablet use for health workers Demos has recommended that health visitors, social workers and anyone working on the public sector frontline should be given a smart phone or iPad style device to keep them updated on the specific needs of members of the public. Releasing its new report on the government’s use of data, the think tank said government needed to adopt a ‘Tesco Clubcard’ mentality to capture data from the public and then use real-time data to avoid costly errors.

It said constantly updated information on at-risk families could prevent serious mistakes, and called for an encrypted database combining health and social care services in order to limit system abuse, stop public sector workers overlooking serious problems, and to put an end to “burdensome form-filling”. Max Wind-Cowie, author of the report, said: “The public understands the benefits they get by handing over personal information to Tesco and Google – it should be the same with government services. Whether it’s keeping track of frequent truants, or recognising that a child has had unusually frequent trips to the doctor – avoiding another Baby P scenario – the value of joining-up services is incredibly high.” The Data Dividend shows how government could achieve a revolution in public services.

DOWNLOAD THE REPORT tinyurl.com/85avytu

Volume 12.3 | HEALTH BUSINESS MAGAZINE

45

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INFORMATION ASSURANCE

Healthcare IT

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

INFORMATION ASSURANCE WITHIN THE PUBLIC SECTOR

BCS, The Chartered Institute for IT, has been working with Information Assurance (IA) specialists from across government to pilot its new BCS CESG Certified Professional scheme. When it goes live later this year, the full scheme will focus on developing and delivering an IA specialist certification scheme for anyone working in any government department or those working on government contracts Over recent years, government organisations and their handling of information has been highly scrutinised by the media and the public. The public sector is accountable to parliament for protecting a vast array of sensitive data supporting many public services.

The sophistication of the threats to that data, the complexity of the information systems and the high potential business impacts of data loss, leave the public sector increasingly dependent on Information Assurance (IA) specialists to manage information risks.

Whilst there is substantial overlap between public sector IA requirements and those of other sectors, the combination of threats, business impacts and public expectations make the public sector distinct from them. The public sector needs to articulate the competencies required of the IA specialists working within it, to formally recognise the IA skills of those who have them and to encourage their continuous professional development.

DATA LOSSES In a recent BCS video debate, Chris Ensor, Head of Profession for Information Assurance, CESG (the information assurance arm of the government communications headquarters and the UK’s national technical authority for information assurance), pointed out that: “Recent public sector data losses and the increasing numbers of attacks we see against government systems prompted a step change in the way we look at professionalisation of information assurance within the public sector”.

Being funded by tax-payers, everyone looks to the public sector for best practice when it comes to things like IA. In November 2011, the government published the UK Cyber Security Strategy. The publication sets out how the UK will support economic prosperity, protect national security and safeguard the public’s way of life by building a more trusted and resilient digital environment.

In September 2011 it was announced that BCS, The Chartered Institute for IT, was one of three organisations awarded a contract to provide an IA certification scheme to CESG to certify the competency of IA specialists to E

Volume 12.3 | HEALTH BUSINESS MAGAZINE

47

Brought to you by:

TEND T A O T FREE ER NOW! k T .u REGIS tics.co a .in4m www

DOING MORE WITH LESS A FREE to attend 2 day event designed to meet the needs of healthcare practitioners, information users, information and IT professionals and solutions suppliers. The title says exactly what the event is about, bringing together the business of managing and delivering healthcare with the world of informatics.

Why should you come to H+I 2012?

HEALTH+IN4MATICS 2012 is designed to help you, presented in a way that will lift the lid on informatics and to give you an insight into the tools and techniques that will help you in your day to day job. + Practical demonstrations: Over 100 suppliers present in the exhibition alongside practitioners from NHS organisations, highlighting the changes and improvements to patient care achieved through the innovative use of information and technology. + Practical focus: You hear first hand about solutions that really have delivered a return on investment or have successfully changed clinical pathways. + Learning & Networking: We want you to get the most out of your time at H+I 2012. In addition to the exhibition, keynotes sessions, ROI workshops and Case Studies, you will be able to participate in many more activities including the Walk in Clinics, Icebreakers and Peer to Peer meetings – and you will be able to enhance your CPD folio too.

9-10 MAY 2012 ICC BIRMINGHAM HEALTH+IN4MATICS 2012 is FREE to attend and registration is just a few clicks away at www.in4matics.co.uk

Thinking of exhibiting?

Limited space remaining Contact Ben Webber, Sales Manager ben.webber@citadelevents.co.uk T. 01423 526971 M. 07766 022 144

Visit www.in4matics.co.uk or call Citadel Events on 01423 526971 In Association With:

Event Partners:

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PACC-UK

Professional Association of Clinical Coders UK

INFORMATION ASSURANCE

Healthcare IT

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Security and beyond

E perform common public sector IA roles. The aim is to improve the matching between public sector requirements for IA expertise and the competence of those recruited or contracted to provide that expertise. The BCS CESG certified professional scheme will provide an independent assessment and verification process for those working in IA, along with a clearly defined career development path.

The Institute already has experience in promoting the benefits and importance of cyber security, data protection and information assurance and is able to build on its proven expertise in certification and the assessment of IT excellence and experience.

The BCS CESG Certified Professional scheme will focus on developing and delivering an IA specialist certification scheme for anyone working in any government department or those working on government contracts. The scheme reflects some of the government’s priorities in their UK Cyber Security Strategy, specifically: “building the UK’s crosscutting knowledge, skills and capability to underpin all cyber security objectives”. The strategy states that one of the key actions is to improve levels of professionalism in information assurance and cyber defence across the public and private sector which

the skills and understanding they need to help keep them and their business secure”.

IT professionals appear to share the interest in developing this professionalism; since the pilot scheme was launched in November 2011 the institute has seen over 300 people register their interest in preparation for the full launch later this year.

When the full scheme is launched, it will be offered at three levels of certification: practitioner, senior practitioner and lead practitioner, and currently covers six roles identified by CESG within IA including: security and information risk advisor, security architect, accreditor, IA auditor, IT security officer (ITSO) and communications security officer (ComSO).

The BCS CESG certified professional scheme will be based upon written submissions, examinations and expert interviews to ensure only those with the right skill set achieve certification. It will also support those who are currently working in the profession.

However, the institute is equally concerned about the skills shortage across the IT sector, with IA and security divisions struggling to get the right people into the profession.

“You have to look at the pipeline right from school – even from GCSEs, A levels, degrees

Cyber security is as much about protecting and even accelerating our economic growth as it is arm wrestling in cyberspace which is reflected in the strategy. The emphasis on cross-cutting knowledge, skills and capability needed to underpin all our cyber security objectives is particularly important. includes “establishing a scheme for certifying the competence of information assurance and cyber security professionals”.

Adam Thilthorpe, Director of Professionalism for the Institute, explains: “Cyber security is as much about protecting and even accelerating our economic growth as it is arm wrestling in cyberspace which is reflected in the strategy. The emphasis on cross-cutting knowledge, skills and capability needed to underpin all our cyber security objectives is particularly important. We need to ensure that individuals and business leaders have

– that pipeline may not be working as well as it might,” says Chris Ensor. “ICT doesn’t seem to have the sexiness it had 10 or 15 years ago. Since Y2K there has been a drop-off in numbers joining the profession. You need people who understand IA at all levels in the organisation, right up to the board. The board are very good at making business decisions, but information is far more intangible.”

All of this means that not only do we need to develop the skills of those already in the IT profession but we also need to encourage youngsters into the profession and help

Information Assurance is the confidence that systems will protect the information they handle and that information assets are accurate, secure and available when required. Although closely linked with information security, IA has a broader remit and includes strategic risk management and reliability. The scheme currently covers six roles identified within IA by CESG including: Security and information risk advisor Security architect Accreditor IA auditor IT security officer (ITSO) Communications security officer (ComSO) For each role, certification is available at three levels: practitioner, senior practitioner and lead practitioner.

individuals to understand their own role in personal cyber security. Thilthorpe explains: “It’s vital that we continue to encourage a cadre of cyber security professionals.

This strategy needs to be underpinned by significant improvement in the teaching of mathematics, and in particular computer science in schools. While we’ve seen some commitment to this recently, we need to ensure it does come to fruition so that there is a pool of young people in the UK – both to draw into the profession and to ensure, in the long term, that the overall understanding of basic cyber security by the public is such that everyone can safely access government services and conduct business online.”

“With so much information now being digital, it is vital that we ensure that those working in Information Assurance have achieved the high standards members of the public would expect for such a sensitive role,” Thilthorpe says. “As the Chartered Institute we are constantly working to exceed those expectations and ensure our qualifications are suitably rigorous. Working with CESG to launch and implement the BCS CESG Certified Professional scheme is a real and positive step in the right direction for information assurance.” L FOR MORE INFORMATION Further information about the BCS CESG Certified Professional scheme, including details of how to register your interest, can be found at www.bcs.org/IA

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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A new and revolutionary range of postural seating suitable for hospitals and care environments...

chair Aalborg chair is ideal for a wide range of applications including waiting areas,nursing stations, reception and admin use, and as bedside seating.

• Encourages an alert and upright posture, easy to get up from.

• Available in several heights, including versions with detachable upholstery and arms.

• Supplied on rails, gas lift or fixed bases.

• Strong and damage resistant.

• Moulded in antimicrobial plastics, the seat provides comfort and wipe-clean hygiene.

• Compact storage.

saddle The benefits of saddles have been recognised over many years and include: • Comfort both when in use and after long periods of use.

• Promotes a balanced and upright posture.

• Reduces back pain.

• Can be mounted on fixed height (with or without footrests), or to gas lift bases.

• Stores usefully under a desk or table.

The Aalborg saddle can be used by young or old, by large or small as a single component for simplicity, durability, low cost and hygiene.

For news and details... www.aalborgdk.com

The Aalborg range of furniture is available worldwide. Please contact us • To arrange a product demonstration • For detailed product information • For details of your nearest approved stockist.

T: +44 (0)7768 931016 or +44 (0)7800 912426 E: info@ah07.com www.ah07.com

HOSPITAL FURNITURE

Bad posture needs speedy correction to lessen the huge and costly expense to both to the lives of the population and the NHS. Today there are a number of exciting furniture ideas available Many hospitals use furniture and basic equipment designed many years ago, often bought on restricted budgets. Today there are increasing numbers of exciting ideas and innovative solutions based upon an understanding of the importance of good posture. Which is just as well since it’s clear that the consequences of bad posture are evident and need speedy correction to lessen the huge and costly expense both to the lives of the population and the health service.

HOSPITAL SEATING Seating in hospitals has to accommodate the needs of the elderly and infirm. Many find difficulty in sitting and getting up from conventional chairs without assistance and frequently softly upholstered chairs are even worse. Whilst a ‘one height suits all’ approach cannot work, nevertheless it’s much easier to rise from a higher chair, and one with arms will help the elderly.

A chair having a sloping front, called a ‘waterfall’ in the trade, will provide comfort for a much larger range of heights than one without and not restrict blood flow from the lower legs, causing the heart to work harder, which could be a disbenefit to some with heart problems. Sitting higher and upon a firm, more carefully contoured, base can also affect posture to assist lordosis, which is the hollow back seen on young children and reducing the slumped shape of the growing majority.

Movement and exercise is best for most of us, and not sitting in one posture for longer than twenty minutes. This may not be possible for the elderly or infirm, for whom support may be crucial if pain and distress is to be avoided.

Reducing the spread of infection requires seating and frames to have a bacterial resistant finish and be easy to clean. A means of swift and inexpensive replacement of detachable upholstered panels is preferred in the event of soiling or damage.

Seating for a range of size and age of persons, with or without disabilities, must be available in waiting areas where both patients and carers may have to wait for long periods at a time.

A different but urgent need is for new mothers to be able to breast feed in comfort,

embracing a new born child in the most comfortable position without the chair or support restricting essential bonding. Most wards have precious little space for most of special chairs currently available, many of which have no alternative role. Seats with adjustable supports could provide a very simple and inexpensive solution accommodating both normal sitting and the more relaxed posture for breast feeding.

Use of many currently-used chairs can and does interfere with proper bonding, and at worst can cause pain

and lasting discomfort to the mother who may well be discouraged from breast feeding altogether. There’s also a propensity for psychological damage to the child, resulting from a lack of initial child/mother bonding.

This is clearly seen as a difference between children with the same mother whose post natal routine has differed. There is an obvious and widespread need for an innovative, low cost solution for a suitable chair, as most midwives will attest.

Toilet seats are not always associated with postural requirements. Most of us have no problems with the majority. In hospitals or for the elderly however most toilet seats are too low to sit upon or get up from in comfort. Postural needs are the same as for regular sitting with the additional need for the user to be able to strain. This is not possible when seated higher.

The solution is to have footrests located at the point of balance which is the norm, and often beneficial to enable a lower squatting posture, used in ‘the wild’, in camping and commonly in French toilets.

This can be accommodated in hospitals but alternatives are usually needed in homes for the elderly where an over toilet seat is needed to swiftly fit onto or around a standard toilet seat. Again, simple low-cost solutions are possible but not often seen in the marketplace.

INNOVATIVE APPROACH There are so many more hospital furniture needs. One design organisation having worked upon a large range of innovative and elegant solutions is the Renfrew Group of Leicester which has recently been awarded a prestigious design award by the MoH. And there are so many more areas in need of an innovative approach to provide elegant, safe and immensely beneficial results. Design and production technology, using new materials, are available. In the UK we produce world class designers and have both the companies and the understanding to make immense strides and cost savings. As has been so commonly the case we lack the courage of supportive banks and investment agencies. The reason why so many brilliant UK companies are now owned by outside beneficiaries. L

Written by Anthony Hill DesRCA FRSA Managing director, AH07.com

HOSPITAL FURNITURE CAN AFFECT WELLBEING

Hospital Furniture

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FOR MORE INFORMATION To find out more please visit: www.ah07.com www.aalborgdk.com www.renfrewgroup.com

Volume 12.3 | HEALTH BUSINESS MAGAZINE

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Technology that prevents the spread of fire Visit stand C6 at the Firex South Exhibition to see the unique DSPA-5 fire knockdown tool.

The DSPA-5 allows a trained fire officer to safely attack a fire without entering the room or compartment where the fire has broken out. In a large site such as a hospital or a university a fire can spread quickly in the time it takes for the emergency services to arrive. The trained first responder can deploy the DSPA-5 by throwing it into the room and leave it to do its job whilst he/she executes the emergency evacuation procedures.

The active compound in the DSPA-5 is a non-toxic aerosol that fights the fire at a molecular level. It does not deplete the oxygen level and is environmentally friendly.

See the DSPA-5 in action on Youtube.com/user/thedspa5

Patient TV just got smarter.

Welcome to the future.

Complement your patient’s TV with Bedside Video Calling, Internet, Meal Ordering, Secure EMR/EPR access and X-Rays – all at the bedside.

Choose a Smart Patient TV package to promote both patient well-being and improve hospital efficiency.

For a free demonstration and professional advice, please contact us at: info@airwave.tv

Visit us at www.hospitaltv.co.uk or call us on 0845 555 1212 52

HEALTH BUSINESS MAGAZINE | Volume 12.3

Used by both professional fire fighters and trained first responders around the world, the DSPA-5 has saved millions of pounds by preserving property and valuables by reducing the damage that fire and water can cause. The DSPA-5 is now available in the UK through DSPA.uk Limited.

FOR MORE INFORMATION Tel: 01342 310107 Mobile: 07917 769133 info@dspaltd.com www.dspaltd.com www.afgflameguarduk.com

Lateral vehicle access equipment and specialist compact conversions Lateral specialises in vehicle access. It offers a diverse range of innovative, durable and cost-effective access products and specialist conversions, designed to solve the problems of loading people and goods in to and out of vehicles whilst minimising manual effort and maximising operator and passenger ergonomics, safety and ease of use.

Its range of precisionengineered ramps and lowering suspension systems offers optimal access for walk-on, wheelchair and stretcher passengers. Lateral products are fail-safe and inexpensive to operate, without the need for costly repeat certification.

Lateral has served the emergency services since 2001 when it produced its first ambulance ‘wedge cassette’ ramps. It now offers the complete access equipment package for specialist vehicles, with its latest range including ingeniously designed side step and winch-assist devices.

The company’s state of the art design and manufacturing

facility offers fast, dimensionallyperfect production. New products are developed using advanced computer aided design and CNC rapid prototyping techniques – all rigorously tested to latest industry standards.

Its new multi-role transfer vehicle – OmniWAV – offers a fresh, fuel-efficient and environmentally-conscious way for ambulance operators to deliver patient transport.

Launched at the Emergency Services Show to great acclaim in November 2011, the vehicle is now available to trial – contact Lateral for further details on this next generation PTS vehicle.

FOR MORE INFORMATION Tel: 01535 662244 www.lateraldc.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Space saving storage for Routes to fully-accredited medical records by Qubiqa health and safety training Qubiqa mobile and static storage systems has traded in the UK since 1984. The business has a range of storage systems which are suitable for many applications including medical records, health centres, hospitals, archive storage, pharmacy storage, office storage and X-ray storage.

Customers can choose from a state of the art system which is electronically operated with units that move at the press of a button, mechanical mobile units, or static shelving. Qubiqa’s success is due in no small part to the quality of the storage product which is well known for reliability and durability.

Aesthetically the systems are very pleasing on the eye and flatter the working environment.

Qubiqa specialises in spaceeffective storage solutions that provide up to three times additional space. Its

unique, two-tier system in particular suits areas with height available, making it ideal for archive applications Qubiqa tailor-made storage allows customers to make use of otherwise wasted space, such as under a low ceiling or beneath staircases.

Easy to relocate, re-configure and upgrade, Qubiqa’s solutions provide the ultimate in terms of flexibility and sustainability.

With hundreds of installations in hospitals, health centres, offices, government departments, banks, financial institutions, universities, libraries, museums – Qubiqa has the experience and a range of storage solutions for your requirements.

FOR MORE INFORMATION 01444 237220 salesuk@qubiqa.com www.qubiqa.com

SecuriCare has been delivering training since the early 90s.

One of its specialist areas of provision is in the prevention and management of challenging, disruptive and violent behaviour, including breakaway/ disengagement skills, and physical intervention.

The business delivers the NHS National Conflict Resolution Programme to staff throughout the UK – training that is accredited by several awarding bodies, including: Edexcel; the Institute of Conflict Management (ICM); and the British Institute of Learning Disabilities (Bild).

It is also ISO9001 compliant.

Additionally, the SecuriCare Online Academy provides a flexible, cost effective training option which supports the company’s classroombased training and other organisational training needs.

The training courses can be

accessed 24/7 from home or work, and include: occupational health and safety; common induction training; safe handling of medicines; equality and diversity; food hygiene; palliative care, and many others.

Its online and classroombased training programmes provide a high quality, blended approach to meeting customers’ training needs.

FOR MORE INFORMATION Tel: 01904 492 442 Fax: 01904 492 608 trainers@securicare.com www.securicare.com

health+in4matics 2012 – a fresh new event Cost-effective label and signage systems MLPS was established in 1988, and though based in Grantham, Lincolnshire, covers the whole of the UK – from John O’Groats to Land’s End. Its success is built on an ability to listen to its customers’ requirements and then recommend the correct solution to satisfy their needs.

MLPS provides labelling and identification solutions to a diverse range of industries including, electrical, electronics, warehousing, distribution, automotive, aviation and manufacturing to name but a few.

Whether it’s barcode labels, asset labels, rating plates, health and safety signs you require, the company has the solution to produce professional

labels and signs on demand.

It supplies the latest range of equipment and software for all applications, from entry level through to high volume industrial models. It is an authorised dealer and partner for Lighthouse, Zebra and Kroy label printers.

FOR MORE INFORMATION Tel: 01476 590400 Fax: 01476 590400 sales@mlps.co.uk www.mlps.co.uk

health+in4matics 2012 will be held at the International Convention Centre (ICC), Birmingham between May 9-10, 2012.

Organisers say that the event is a fresh, new event aimed at bridging the gap between the world of informatics and the business of delivering health and social care; the result of research with end users, delegates and suppliers. It has been designed to meet your needs in a comfortable, businesslike and constructive environment.

The event is much more than just ‘another conference alongside another exhibition’ – it’s loaded with features and activities. With leading suppliers packing the exhibition, the show is focused on practical issues. It also includes big name speakers such as Stephen Dorrell MP, Chair of the Health Select Committee, and broadcaster Dr Hilary Jones. Visitors can expect a real ‘hands on’ insight into solutions and what works

through real life ROI workshops and case study presentations.

Located at The ICC in the Midlands, health+in4matics 2012 is easily accessible from around the country, offering a range of transport options, a choice of local overnight accommodation and lively informal networking options.

The event is free to attend – delegates will have access to all areas and free refreshments, too. Register online now to be assured of your place.

FOR MORE INFORMATION Are you a supplier and want to exhibit? Contact Ben Webber at Citadel Events Tel: 01423 526971, ben. webber@citadelevents.co.uk www.in4matics.co.uk

Volume 12.3 | HEALTH BUSINESS MAGAZINE

53

THEARAPY n CT n MRI n X-RAY

Advertisers Index

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

DEVON MEDICAL LTD Unit 6, Stile Way Business Park lower Strode Road clevedon, BS21 6UU, UK Phone 08445710012 | Fax 01275 873436 Mobile 07801 901808 enquiries@devonmedical.co.uk

Project Management Service for the Sale and Disposal of Medical Equipment Devon Medical offer an efficient service which not only includes the sale and disposal of ct + MRi, but also co-ordinates removals and returns of leased equipment.

Further benefits include: • Method, risk, health and safety statements • Low cost cold storage of magnets • Purchase of equipment and removal costs • CT scanner rental in appropriate x-ray rooms - from 1 to 25 weeks • Mobile x-ray rental available • Low disposal and removal costs of x-ray room

78 units purchased or disposed of in 2008, including 12 MRI scanners Devon Medical disposes of equipment in accordance to new guidelines introduced in January 2007 for Waste electrical and electronics equipment (WEE) Certification from the Environment Agency.

Over 96% recycling of materials recovered including plastics and glass at premises that have iSo BS en9001/14001/18001 accredited facilities. these premises also have ea aatS at all treatment plants.

VAT Registration No: 728-7487-84 Member of the Federation of Small Businesses Environment Registration No ENW/032276/CB Lloyds of London Public & Employers’ Liability Insurance £10 million/£10 million; Marine Insurance £150,000

ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service Aalborg

DSPA

52

Pass Training Consultancy

28

Advanced Power Technology Ltd

40

Econix Ltd

24

Patrick McCaul

Airwave

52

ESTA

28

Phoenix Building Systems

36

AJF Waste Management

24

Evac + Chair

20

Pivotal Performance

18

Graphic Mail Ltd

42

Qubiqa

53

Johnson & Johnson

30

Reflex

28

Reliance High-Tech

14

ROSPA

16

IBC

SecuriCare

53

Asckey Data Services

34, 44

6

Asteral

OBC

Brodex

22

Kyocera

Business Furniture Online

34

Lateral Design Concepts

Call Systems Technology

26

Mash Direct

Cardiac Science Corp

10

Misco

46

Sempermed

IFC

Citadel Events

48

MLPS

53

Spacebuilder

42

Cooper B-Line

44

Nedap

12

Twyford Bathrooms

38

Nu-Phalt

22

Yeoman Sheild

32

CR Swift

54

50, 51

HEALTH BUSINESS MAGAZINE | Volume 12.3

8

4 52

Award Winning Mash Direct enter Health Service Variety of sizes available chilled and frozen including Bulk and Gastronorm Good Food Fast Packed with vitamins, nutrients, taste and texture.

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get more Discover a smarter solution for medical equipment procurement When times are difficult, saving should be about getting more for your money, not reducing quality. Asteral’s procurement programmes are designed to reduce whole life costs for high value diagnostic and imaging equipment, with a full service arrangement that simultaneously enhances productivity and clinical outcomes.

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To find out how you can spend less and get more go to asteral.com Or call a member of the Asteral team on +44 (0)118 900 8100