Health Business 15.1 by PSI Media

VOLUME 15.1 www.healthbusinessuk.net

WORKPLACE SAFETY

FACILITIES MANAGEMENT

INFECTION CONTROL

HEALTHCARE IT

CARING ABOUT INFORMATION

Changing perceptions of information governance in healthcare

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Labour looks towards another round of reforms

INFECTION CONTROL

HEALTHCARE IT

CARING ABOUT INFORMATION

Changing perceptions of information governance in healthcare

PATIENT HANDLING

HANDLE WITH CARE

How to reduce the number of manual handling injuries

HEALTH BUSINESS AWARDS

AWARDING EXCELLENCE A look at the winners of the 2014 Health Business Awards

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Around May the 7th, the country goes to the vote again. As usual, in the run-up the NHS is being tossed around the political battleground like a rag doll, with Big Ed Miliband revealing his intention to ‘weaponise’ the NHS (politically speaking, of course) to the BBC’s Nick Robinson as early as November last year. Over Christmas, figures showed that the NHS has experienced its worst emergency performance in a decade. Almost 21,000 patients waited between four and 12 hours on trolleys. Using this as leverage, Labour’s ambitious and wide-ranging 10-year programme to merge health and social care was announced by both the shadow health secretary (Andy Burnham) and Party leader (Ed Milliband) almost simultaneously. As Miliband finished his speech in Salford, Andy Burnham stood up at the King’s Fund, in London. Both speeches were met with mixed reviews, with many wondering exactly where the money will come from for these new reforms (see page 7), and whether the organisation will be able to stomach another round of reforms. Miliband is also facing a backlash by Tony Blair supporters who have warned that his plans risk playing into Tory hands and could lead to repeating the campaign mistakes of 1992, when Labour lost the general election under Neil Kinnock. All of the major Westminster parties have now pledged what they say is enough money to maintain NHS services in the next Parliament. The Conservatives say they would ring-fence and ‘protect’ the NHS budget while the Liberal Democrats have promised to meet ‘in full’ the £8bn extra that NHS managers say is needed by 2020. UKIP has said it would commit an extra £3bn a year to the service, but its no secret that some of the fledgling party’s spokespeople are keen to push through more privatisation. Danny Wright

P ONLINE P IN PRINT P MOBILE P FACE TO FACE If you would like to receive all issues of Health Business magazine for £120 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:

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226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: www.psi-media.co.uk EDITOR Angela Pisanu EDITORIAL ASSISTANT Michael Lyons EDITORIAL DIRECTOR Danny Wright PRODUCTION EDITOR Richard Gooding PRODUCTION CONTROL Jacqueline Lawford, Jo Golding WEBSITE PRODUCTION Reiss Malone ADVERTISEMENT SALES Jeremy Cox, Ben Plummer, Alexander Baker, Patrick Dunne ADMINISTRATION Victoria Leftwich, Vickie Hopkins PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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CONTENTS

07 NEWS

35 INFECTION CONTROL

Labour reveals 10-year plan to integrate health and social care; Health Select Committee says more needs to be done on whistleblowing; Scotland’s largest hospital completed

Measures to control the spread of infection are widely practiced, but an added measure could be to integrate antimicrobial additives into surfaces to make them inhospitable to bacteria. BioCote’s Dr Andrew Summerfield explain’s how

11 TRAINING

Growing evidence shows that clinical leadership improves quality and outcomes for patients. The need to encourage this development is clear but more training in management is required if it is to become a reality

15 FINANCE

Paul Briddock, director of policy at the Healthcare Financial Management Association, discusses the growing importance of local system leadership in healthcare organisations

19 FACILITIES MANAGEMENT

Building owners have to improve their knowledge of building maintenance techniques or face serious cost and legal problems, says Simon Carter, of Building & Engineering Services Association

23 ENERGY

Rising energy costs and strict legislation on carbon emissions are making renewable energy more appealing to hospitals. Here is a look at some hospitals embracing a greener type of energy

27 FIRE PREVENTION

In recent years in Great Britain there have been approximately 40 fires per week in hospitals and healthcare premises and unbelievably 20 per year are arson attacks, reports the Fire Industry Association’s ceo Graham Ellicott

31 MARKET RESEARCH

Jane Frost, ceo of the Market Research Society, explains how research can be used to solve some of the most pressing issues in the health sector

Contents

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

41 HEALTHCARE IT

Why is information governance often seen as an obstacle – and can perceptions be changed? David Willis, head of information governance at Wrightington Hospital shares his thoughts

45 EHI LIVE 2014

For anyone involved in the use of information in healthcare, EHI Live provided a golden opportunity to update knowledge, get answers to questions, meet the experts and think about the future of Healthcare IT

53 HEALTH BUSINESS AWARDS 2014

Held in December, the Health Business Awards recognised examples of best practice and excellence throughout the NHS

57 HEALTH & SAFETY: WORKPLACE SAFETY

Slips, trips and falls at work are collectively the single most common cause of injury in UK workplaces. Rob Burgon of the Royal Society for the Prevention of Accidents discusses how hospitals can protect their staff from such harm

63 HEALTH & SAFETY: PATIENT SAFETY

With the correct training and a good policy and monitoring system in place, the number of manual handling injuries could be substantially reduced, writes Mary Ogungbeje, research and development adviser at the Institution of Occupational Safety and Health

68 PRODUCTS & SERVICES Products for the healthcare sector

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NHS REFORM

Labour reveals 10-year plan to integrate health and social care

Ahead of the general election in May, Shadow Health Secretary Andy Burnham has set out Labour’s ambitious and wide-ranging 10-year programme to merge health and social care. Addressing a King’s Fund think tank, Burnham revealed details which include an investment in staff, including 8,000 more GPs. This will be financed by a £2.5bn ‘Time to Care’ Fund raised from the proposed mansion tax, cracking down on tax avoidance and a new levy on tobacco firms. The reform, first mentioned by Labour three years ago, is to integrate care from home to hospital, bringing physical, mental and social care together in a single service. Patients will receive new rights to access care, including guaranteeing a GP appointment in 48 hours, or on the same day if they need it, as well as cancer test results within a week. Investment in mental health is to be prioritised, particularly for young people. The 10 year plan will also bring in tougher controls on hospitals increasing their focus on private patients to ensure they always put NHS patients first, and will repeal of section 75 of the Health and Social Care Act (2012), which Labour says forces the NHS to waste money on tendering. Burnham said:“If we don’t change course, the crisis we are seeing now in A&E and the ambulance service will become entrenched in the NHS” “If elected, Labour will introduce a Bill to repeal the Health and Social Care Act 2012 in our first Queen’s Speech. We do this not because Labour is turning its back on reform. We do it to enable the radical reform of services that is now urgent” Responding to Burnham’s speech and Labour’s ten year plan, Chris Ham, chief executive of The King’s Fund, said: “It throws down the gauntlet to the other parties to set out their plans ahead of the general election. “While he was at pains to stress that his plans would not result in another structural reorganisation, it is not clear how change on this scale could be achieved without some changes to structures, particularly to commissioning structures. As our own research shows, although health and wellbeing boards are making good progress in some areas, the jury is still out on whether they can take on

responsibility for commissioning on this scale. While many will welcome the commitment to repeal some aspects of the Health and Social Care Act, it is not clear how far Labour intends to go in dismantling the architecture it established. It also remains to be seen how easily his commitment to roll back competition in the NHS can be squared with EU competition law. “The elephant in the room is how this will be paid for. Labour has not yet committed to finding the additional £8 billion identified in the NHS five year forward view as being needed to close the NHS funding gap by 2020. While Burnham’s plans to improve social care and increase the pay of care workers are very welcome, they will come with a hefty price tag, which Labour will need to balance with its commitment to reduce the deficit.” Following the announcement, Burnham faced Kirsty Wark on the BBC’s Newsnight in a difficult interview. When asked about the role he sees for the private sector under the proposed reforms, Burnham said private companies would not be entirely excluded: “There is still a role for private and voluntary providers but I also did say very clearly that the market is not the answer.” Presented with a graph showing how private sector outsourcing grew to four per cent under Labour, but rose two per cent under the coalition, Burnham said: ‘There isn’t a right percentage. I’m very clear that the NHS should be our preferred provider so I don’t see a role for the private sector where it can replace core public provision at the heart of every community.” All of the major Westminster parties have pledged what they say is enough money to maintain NHS services in the next Parliament. The Conservatives say they would ring-fence and “protect” the NHS budget while the Liberal Democrats have promised to meet “in full” the £8bn extra NHS managers say is needed by 2020 while UKIP has said it would commit an extra £3bn a year to the service. Labour has promised to keep the NHS ring-fence and spend an extra £2.5bn a year across the UK by 2020. READ LABOUR’S TEN YEAR PLAN tinyurl.com/mf3753f

News

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NICE issues guidance to tackle misdiagnosis of asthma More than one million adults in the UK may have been wrongly diagnosed as asthmatic and be receiving unnecessary treatment for the condition, the National Institute for Health and Care Excellence (NICE) has warned. The watchdog said that over 4.1 million people in the UK are currently receiving treatment for asthma, but studies show that almost a third (30 per cent) of adults with the condition do not have clear evidence of asthma. NICE added that there is currently no ‘gold standard’ test to diagnose asthma and in current practice healthcare professionals mainly check for signs and symptoms. In order to tackle potential misdiagnosis, NICE has issued a draft guideline for England, published for consultation before final approval. READ MORE: tinyurl.com/lgb2nef

£10m to incentivise new doctors to become GPs Newly-qualified doctors are to be incentivised to become GPs as part of a £10m plan to expand the general practice workforce. The scheme is part of a new package of measures designed to boost the number of GPs joining the profession, deter early retirement and encourage those who have taken a career break to rejoin the workforce. NHS England in collaboration with Health Education England, the Royal College of GPs and the BMA, has developed a 10 point GP workforce action plan. Dr Mike Bewick, deputy medical director at NHS England, said: “We need greater investment in GP services, extending to community nursing, pharmacy and eye care service and this £10m will start a range of initiatives so the community has GP services that best meets its health needs.” READ MORE: tinyurl.com/lgb2nef

NHS England consults on prioritising specialised services NHS England has launched a consultation about how it will prioritise which specialised services and treatments to invest in. NHS England directly commissions around 145 specialised services. Patient groups asked it to consult on changes to the principles and process by which it makes these decisions. The consultation will last for 90 days from 27 January 2015. READ MORE: tinyurl.com/k2fue8d

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WHISTLEBLOWING

Health Select Committee says more needs to be done on whistleblowing A Health Select Committee report has claimed that the treatment of whistleblowers remains a stain on the reputation of the NHS, and has not only led to “unwarranted and inexcusable pain” for some people but has also undermined the willingness of others to come forward. MPs have warned this has ongoing implications for patient safety. Despite progress, the system for handling complaints and raising concerns remains variable; too many complaints are mishandled, with people encountering poor communication or, at worst, a defensive a complicated system which results in a complete breakdown in trust and a failure to improve patient safety, says the Committee. The MPs call for a single gateway for raising issues and concerns, with clearer and adequately-resourced arrangements for advocacy and support. In addition, they find that the removal of primary care complaints handling from local areas has resulted in a disconnection from local knowledge and learning and has led to unacceptable delays, and say this needs to be rectified. “We do not feel that complaints related to primary care should be investigated in an entirely different part of the country, or plagued by delays,” said the Committee’s chair, Dr Sarah Wollaston, Conservative MP for Totnes. The MPs also suggest that in moving to a culture which welcomes complaints as a way of improving NHS services, the number of complaints about a provider may highlight a service which has developed a positive culture

of complaints handling, rather than being an indicator of failure. It will be important for both system and professional regulators to be able to identify the difference. In its report, the Committee emphasises that it is not seeking to undermine the commitment of NHS staff, rather to make sure that where poor standards do occur, these can be identified and put right at the earliest opportunity, for the benefit of patients and staff alike. “Patients and staff do not complain for financial redress but because they seek an acknowledgement and explanation, a timely apology if appropriate and for the NHS to reduce the chance of avoidable harm to others. They and the NHS deserve our support to make sure that this can happen,” READ MORE said Dr tinyurl.com/khfo8qo Wollaston.

HUMAN RESOURCES CONSTRUCTION

News

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

CCG finance bosses concerned over balancing the books At a time when they are looking to take over responsibility for the GP contract, a third of CCG finance leads are worried about achieving financial balance in 2015/16, according to the latest King’s Fund quarterly monitoring report, which was based on 51 responses from CCGs. Seven said that they were ‘fairly concerned’ about balancing their books while nine said that they were ‘very concerned’. Around 30 per cent of CCGs also said they were ‘very concerned’ about achieving their quality, innovation, productivity and prevention (QIPP) targets. The King’s Fund report, ‘How is the NHS performing?’ also highlighted the fact that waiting times for cancer treatment continued to worsen in the second quarter of 2014. READ MORE: tinyurl.com/jwcjgw4

Tower Hamlets CCG lead to be knighted Dr Sam Everington, who chairs Tower Hamlets CCG. has been knighted in this year’s New Year’s Honours. His knighthood citation further said he was ‘a cutting-edge innovator’ who has improved GP services in one of the poorest areas of the country. It said: “Beyond his own practice, he has improved health services across east London from the transition between GP services and acute care in one of London’s poorest boroughs, while delivering the highest rate of MMR immunisation in London.” Dr Everington said: ‘It’s a wonderful surprise and privilege for my work to be recognised. I feel incredibly lucky to have the opportunity of working with fantastic partners, colleagues and patients in Tower Hamlets, including the local CCG and the Bromley-By-Bow Centre.’ READ MORE: tinyurl.com/o7lhhvh

Loneliness and heating checks planned by Labour

Scotland’s largest hospital completed Scotland’s largest hospital, the new £842m South Glasgow University Hospital, has been officially handed over ahead of a planned opening in May. It hosts the 1,109-bed South Glasgow University Hospital for adults and 256‑bed Royal Hospital for Sick Children. The campus, which was delivered under budget and ahead of schedule, replaces the Royal Hospital for Sick Kids at Yorkhill,

the Southern General Hospital, Western and Victoria. The health board’s chief executive, Robert Calderwood, said: “With the exception of critical care, all of the patient areas in the adult hospital are single en-suite rooms. 80 per cent of the 256 beds in the childrens hospital are single, en-suite, with parents’ accommodation READ MORE: in the surrounding tinyurl.com/q46gh2v area.”

GPs will offer vulnerable elderly patients regular ‘safety checks’ and sign-post those at risk of loneliness and depression to social activities, Labour leader Ed Miliband has pledged. The measures, as part of Labour’s 10‑year NHS plan, are aimed at cutting avoidable hospital admissions and will see GPs identifying hazards in the home and helping patients access support to heat their homes. READ MORE: tinyurl.com/lgj7ff9

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TRAINING MANAGEMENT

ENGAGING CLINICIANS IN QUALITY IMPROVEMENT Health managers and clinicians in healthcare are dedicated professionals working in an increasingly demanding and complex world. Their end goal may be the same but tensions in the relationship can threaten progress in driving forward service improvement to improve patient outcomes. The Griffiths Report of 1983 heralded the age of general management in the NHS. A move towards managers having operational control at every level of the organisation and relieving clinicians of strategic responsibility was seen as the way to transform health care to resemble successful private and commercial organisations. However, along with an endless cycle of reforms since then, there has been a change in emphasis. In more recent years, increasing importance has been placed on clinicians working in multidisciplinary teams and across professional and organisational boundaries. Indeed the High Quality Care for All (2008) report from Lord Darzi put clinical leadership at the heart of improving the NHS. This move is supported by a growing body of evidence highlighting that clinical leadership improves quality and outcomes for patients (Mountford and Webb, 2009). Veronesi et al (2012) found that those NHS hospital trusts with larger proportions of doctors on their boards were more likely to achieve high quality ratings, lower morbidity

rates and higher patient satisfaction. Evidence also shows a clear link between an organisation’s performance and a good level of engagement between clinicians and managers (Medical Engagement Scale; NHS Institute of Innovation and Improvement, 2010). DIFFERENT WORLDS In its 2007 review of the literature on healthcare professionals’ views on quality improvement initiative – Are clinicians engaged in quality improvement? – The Health Foundation noted: “Different health professional groups largely inhabit separate hierarchies and networks, often with surprisingly little inter-communication”. The need to change this may have been recognised but making better communication a reality is not as easy as it sounds. This is particularly true during periods of reform. The NHS is almost constantly re-inventing itself as it teeters on the edge of a financial crisis and struggles to meet the challenges of an aging population with costly co-morbidities. Structural change within any organisation almost invariably leads to tensions and one of these strains has been on the relationship between clinicians and managers, which has been described as ‘fraught’ and ‘tense’ (Health Service Journal, 2012). A small survey of just over 200 managers carried out by IHM recently suggests that, in

some areas at least, this remains the case. Nearly three-quarters of managers (73 per cent) said they thought the relationship between the two groups of professionals could be defined as ‘a partnership with areas of tension’ or ‘a relationship of tolerance with frequent tensions’. A similar number (73 per cent) thought the relationship would stay the same or get worse over the next five years. The existence of tension is hardly surprising as, despite their common goal, the context, structure, parameters and limitations that both set of professionals work within are very different. MAKING PARTNERSHIP A REALITY An organisation as large and complex as the NHS cannot be run without high-quality management and leadership, and people in those roles must be trained, empowered and valued whatever their background. So how do we make this happen? Clinicians and managers have both highlighted a number of facilitators to fostering a positive relationship. They include; trust, mutual respect, support, accessibility, visibility, good communication, close proximity, mutual interdependence and friendship (HSJ, 2012). None of these, however, can be plucked out of thin air and the IHM is making a number of ‘calls to action’. One of these is for clinicians and E

Volume 15.1 | HEALTH BUSINESS MAGAZINE

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TRAINING MANAGEMENT  managers to explore each other’s roles and responsibilities through paired learning and shadowing initiatives, such as those piloted at Imperial College Healthcare NHS Trust during 2010-11. Clinicians and managers were invited to spend time learning about each other’s roles and responsibilities. ENHANCED ENGAGEMENT The initiative aimed to create a better understanding and new ways of working between clinicians and managers; support the personal development of each of the participants in achieving specific educational objectives around leadership and management and create an environment where enhanced engagement between clinicians and managers was role-modelled within the organisation. An evaluation of the programme in 2012 stated that paired learning had ‘significantly increased preparedness for leadership roles for both Specialist Registrar doctors and managers across a wide range of domains’. The qualitative analysis demonstrated that the co-development of managers and doctors had ‘a powerful impact on the personal learning, attitudes and behaviour of participants’. IHM believes that this is the way forward, supported by joint management training programmes and events. Clinicians, like managers, need development and support. Just over half of respondents to the IHM survey felt that currently clinicians in the NHS

lack the management experience to make the right decisions. They suggested that they would benefit, in particular, from training in leadership and accountability, people and line management, performance and appraisal, and operational and business planning. It is worth noting that current thinking on managerial effectiveness emphasises managerial behaviours, not just competencies, which was the state of play in the 1990s. This is why the IHM has introduced its Professional Practice Framework which provides a way to establish common core values and behaviours that healthcare managers demonstrate on a daily basis and that are an integral part of the service re-design and transformation needed to improve the public’s health. It is equally applicable to clinicians as, increasingly, they move into management roles. CLOSER WORKING RELATIONSHIPS IHM believes that the involvement of doctors, nurses and other clinicians in leadership roles, working closely alongside their managerial colleagues, must be a priority for the current and successive governments. The ultimate beneficiaries of closer working relationships between managers and clinicians will be the patients. Improved patient care is – and always has been – the shared ground. L FURTHER INFORMATION www.ihm.org.uk

Training

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About the author Shirley Cramer is chief executive of the Royal Society for Public Health and Institute of Healthcare Management. An experienced voluntary sector leader in both the UK and the USA, Shirley has also held non executive positions in both countries in the public and voluntary sectors. She was Chief Executive of Dyslexia Action, the UK’s leading independent provider of services for individuals with dyslexia and other specific learning difficulties for over a decade. Most recently she has been Interim Chief Executive of Alzheimer’s Research UK and working on the ‘Dementia Challenge’. She was awarded a CBE in the 2009 New Year’s Honours for services to education.

Atrainability – the premier health and social care human factors training provider Atrainability is recognised as one of the premier training providers of specialist human factors and non-technical skills across the NHS and private healthcare organisations in the United Kingdom. The company now provides bespoke training programmes across the spectrum of health and social care from primary healthcare teams in general practice, through acute and secondary care to mental health teams both hospital and community-based. The team has a unique understanding of many of the issues pertaining to these areas around threat and error management, essentially avoiding, trapping and mitigating hazards and error. Many healthcare providers, both NHS and private have engaged Atrainability to train all their trainers, leaders and managers in an understanding of the human condition to examine and where appropriate, develop procedures and processes that enhance safe team working by design, not by good fortune. The realisation that human factors play a crucial part in patient safety outcome is rapidly becoming apparent amongst medical educationalists across the world. The focus on training medical staff has risen to the fore in

recent times. The Atrainability team has been at the vanguard of developing human factors across the healthcare spectrum since 2002 after many years experience in commercial and military aviation and latterly elite sports. The company has provided team training modules in a number of major research projects that have resulted in published papers such as the Productive Operating Theatre programme and this is continuing, currently with the Royal College of Surgeons. With the introduction of operating theatre check-lists mandated by February 2010, effective use is vital to maintain high levels of patient safety. Atrainability has unparalleled experience in introducing and sustaining effective team-working procedures. Understanding of the error traps inherent

in standard protocols and using skills to avoid them is crucial to maintaining patient safety. These skills will be professional, calm and assertive with a focus on maintaining mature discussion and avoiding inappropriate behaviour. In 2014 Atrainability were the preferred provider of Human Factors training for a growing list of NHS trusts, heath education England deaneries and major private providers and the company is frequently invited to speak at major conferences internationally. Atrainability’s ethos is to strive to provide training best suited to the local site and culture and work with the professionals present to achieve sustainable safe working practice. Atrainability has a cadre of trainers all experienced in human factors training and coaching in healthcare and other high performing professions including aviation and nuclear power generation. FURTHER INFORMATION Contact: Trevor Dale Tel: 01483 272987 contact@atrainability.co.uk www.atrainability.co.uk

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Advertisement Feature

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JOINED-UP SERVICES

INTEGRATION, INTEGRATION, INTEGRATION

Recent reports from Simon Stevens, CEO of NHS England and Sir David Dalton, Chief Executive of Salford Royal NHS Foundation Trust are clear about the priorities for the NHS in 2015 and beyond The pressure on NHS providers to improve performance by embracing rapid transformational change shows no sign of abating. With the NHS Five Year Forward View, and the review from Sir David Dalton published before Christmas, there is significant momentum behind the latest drive towards major restructuring of services to drive up quality, efficiency and patient satisfaction. Greater integration in health and social care is vital in achieving these goals but, with the final shape of integrated services as yet uncertain, there will inevitably be challenges to be faced and overcome. MULTIPLE SOLUTIONS Both reports stress that there is no ‘onesize-fits-all’ solution and that alliances and collaborations between organisations will vary from place to place. The Dalton Review sets out a number of recommendations focussed on achieving a greater consistency of quality across NHS service provision, assisted by speeding up the transactions required to implement new models of care. Such changes may or may not yield major financial savings (so far a halt to cost escalation has generally been the best outcome). Indeed, Health Minister Norman Lamb recently told reporters that evidence that integration will save money was at an “embryonic stage”. However, these changes are designed to ensure money is spent in the right place on the right services. Major structural change and greater integration across the NHS, social care, social housing and public health, with novel alliances, will be required. Gradually, bonds are being formed between these previously discrete and sometimes cautious, or even antagonistic, groups or sectors. Acute Trusts and GPs, local authorities and community, primary and secondary health services, and even housing associations are beginning to work together or are at least talking about ways to deliver a more joined-up service. Mergers and acquisitions may drive improvements, but alliances, collaborations or networks are also seen as being vital to providing a more efficient service where the patient, not the organisation

HEALTH BUSINESS MAGAZINE | Volume 15.1

providing care, is the central focus. DAC Beachcroft partner Anne Crofts said that people should be disabused of the notion that integration will deliver immediate savings: “That is not going to materialise in the short term but there are potentially savings to be made in some areas. Integration may have implications for the way we train people and the way that systems organise themselves – for example regulation and training of healthcare and social workers is currently siloed.” She also cautioned against too much emphasis on organisational form: “I think we will see a move to create more diverse NHS organisations, bringing together services such as primary care and mental health with acute and community care, for example. But the statutory framework is complex because the current organisational structures in acute, primary and social care have been created under different statutory regimes, which is a challenge to bringing organisations together.” In terms of integrated care, she felt that we are some way from having one organisation

Anne Crofts

are both robust and flexible enough to accommodate mergers or new entrants.” READ ON – THE VIEWS OF OTHERS DAC Beachcroft has gauged the opinion of senior figures across the health and social care spectrum, from senior figures in acute and community trusts, to private and third sector providers, GPs and primary care managers, all of whom are engaged in the complex work of forming new and improved ways of delivering healthcare. Encouragingly, many of these people feel that integration is already having a positive effect on the delivery and quality of care. However, the jury is still out on whether the changes will deliver financial savings. DAC Beachcroft’s contributors examine the pros and cons of using mergers and acquisitions to engineer integration, and the importance of engaging in clear and unambiguous dialogues with stakeholders in formulating or at least agreeing structural changes. Much has been said about the obstacles presented

Greater integration in health and social care is vital in achieving these goals but, with the final shape of integrated services as yet uncertain, there will inevitably be challenges to be faced and overcome. providing all the complex needs for one individual: “The real conversation needs to be around the boundaries and interfaces between organisations rather than one organisation necessarily providing the whole lot, even if that may be a long-term ambition.” “Our approach to designing the legal and governance structures in projects such as North West London Whole Systems Integrated Care and primary and acute care services in Northumbria, is to start from where the local health economy currently is in terms of organisations and relationships. We then work with that to build governance structures and information sharing protocols across organisational boundaries, which

by regulatory issues such as competition or procurement law. DAC Beachcroft’s research offers insight into where such obstacles may occur and how they may be avoided. The report also examines the current drive towards pooled NHS and social care budgets, discussing the optimum organisational size for pooling budgets, and ways of sharing risk and resolving potential conflict.  FURTHER INFORMATION The full report is available at www.dacbeachcroft.com/forwardview. If you would like to discuss any of the issues raised in this article in more detail, please contact: acrofts@dacbeachcroft.com

SYSTEM LEADERSHIP

Finance

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Written by Paul Briddock, director of policy, HFMA

IMPROVING LOCAL SYSTEM LEADERSHIP

Paul Briddock, director of policy at the Healthcare Financial Management Association, discusses the growing importance of local system leadership in healthcare organisations

Over a year after the abolition of the main commissioning and oversight bodies in the English NHS, which saw the creation of a new system of commissioning healthcare and GPs given greater decision-making powers as part of clinical commissioning groups (CCGs), the Health Finance Management Association (HFMA) has surveyed almost 200 NHS finance directors in order to understand the challenges local health economies currently face. The results showed that 107 out of 129 provider trust finance directors and 43 out of 63 CCG chief financial officers (CFOs) flagged ‘system leadership’ as something that was giving them cause for concern within their local health economies. But what exactly is ‘system leadership’? Though it seems difficult to define, fundamentally it is about the people and organisations in an area using their influence to get consensus about a way forward and how to positively support change. HFMA has been working with senior NHS finance directors to consider the role of system leadership, the aspects that are missing or not working well in the current system and what practical steps finance directors can take locally. LACK OF SYSTEM LEADERSHIP The company are all aware that the NHS faces a challenging future, and organisations need to adapt and support transformation to ensure that the health and care system

is fit for the future. There have been several reorganisations in recent years and experienced several layers of system leadership, from regional offices to SHAs. The survey, however, pointed to an overall lack of system leadership to coordinate transformation schemes across a number of organisations, which we believe, should be of significant concern as these are considered to be where the biggest cost savings will now be found. Changes to regional and local management in the NHS are considered by some

other providers had not taken place’. The abolition of SHAs has not been followed by a single strong source of system leadership. But some finance directors questioned whether the problem is that the current system is just too new and it needs longer to make it work. Local NHS organisations have previously been used to centralise planned decisions around large transformations of care pathways, reconfigurations of hospitals and how to deal with financial deficits.

HFMA has been working with senior NHS finance directors to consider the role of system leadership, the aspects that are missing or not working well in the current system and what practical steps finance directors can take locally finance directors to be contributing to the challenge to provide high-quality care with the money available through service transformation and integration. In the same survey, in some instances respondents ‘felt the reasons for slippage in cost savings plans were out of their control because planned system reconfiguration by commissioners or

RELATIONSHIP MANAGEMENT This kind of top-down management has removed, to some extent, the need for a key aspect of system leadership – relationship management. Relationships need to have a chance to mature and develop to the point where all parties trust each other to have each other’s organisations’ best interests at the front of their minds. E

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SYSTEM LEADERSHIP  In what are times of severe financial pressure, many organisations may seek to protect their own financial position before working in partnership with others. But finance directors are clear that service transformation and dealing with financial difficulty can be managed locally and do not need to include national organisations. RESPONSIBILITY System leadership also needs clear areas of responsibility and lines of accountability. The English NHS remains, after the recent reorganisation, a complicated mix of organisations that need to work together. The Scottish, Welsh and Northern Irish systems arguably remove one of the main barriers to change as integrated systems of commissioning, provision and social care, in some cases, mean the people with decision‑making responsibility either work for the same organisation or there is only one person. System leaders understand the need to put patients first and this priority comes ahead of individuals loyalty to their own organisations. But to allow this there needs to be clear understanding about responsibility for services and money and where it lies. Leadership flows from this and needs to be localised wherever possible in the new system but with a clear escalation policy, recognising that some problems are regional, so cannot be handled locally.

Finance

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how to keep multiple partners signed up to delivering shared objectives, especially in a tough financial environment. A clear system of local accountability and responsibility would ensure local leaders are rewarded for the right things and are not punished for things that run counter to the objective of high-quality healthcare. Ultimately, finance directors felt that although many organisations work together extremely successfully, the individual sovereignty of organisations can sometimes be the overriding factor in partnership working.

There needs to e tiv be collecy across ilit responsibisations to all organ ise every incentiv er and manag n clinicia

IMPROVING PATIENT SERVICE There was also a perception among surveyed finance directors that change is often only driven by a ‘burning platform’ rather than evidence-led and part of a defined strategy. Finance directors discussed the dangers of unclear leadership, concluding it can lead to uninformed decision-making or avoiding difficult decisions. For instance, they highlighted that tendering out services is often seen as the solution where the problem is a lack of leadership or ability to identify or bring together local service leaders. While this approach may reduce the unit price of a service through economies of scale, the real goal should be collaboration to review and improve patient services. CHANGING PARTS OF THE SERVICE To fix this, it is crucial that there is joint work between commissioners, managers and clinicians to change parts of the service that are no longer working properly. It may also involve sharing financial risk and requires all the key people to be willing to trust and talk to each other. Some respondents also felt the NHS market concept is contributing to the lack of system leadership and joint working – providers are looking for revenue growth and commissioners are seeking to reduce unit costs without a joint consideration of how to improve services for patients. This aspect of system leadership needs commissioners to consider the healthcare value-for-money equation (health outcomes per pound spent), something that was raised in the recent joint briefing ‘Two Sides of the Same Coin’. It argues that services need to be operationally, clinically and financially sustainable and notes that ‘NHS boards need to work in partnership to agree how to spend the resources available to best effect, rather than individual organisations making cost savings in isolation’. LOCAL ACCOUNTABILITY The HMFA believe that finance staff need to be at the forefront of local change, supporting clinical transformation through costing the different options available and appraising their merits, rather than taking leadership decisions based on prioritising costs ahead of quality, capacity concerns or the overall benefit to patients and the local health economy. Their members highlighted a number of barriers to effective system leadership, such as the difficulty of CCGs working together in the current legal framework to make joint decisions; the effectiveness or influence of health and wellbeing boards; and

STRONGER TOGETHER In conclusion, in order to improve local system leadership, a number of things need to be addressed. Firstly, revising pricing for services through locally agreed prices and payment mechanisms. Additionally, examining the totality of healthcare spending in an area, rather than individual organisations, and allocating resources in the optimal way can greatly improve local system leadership Strengthening CCG commissioning leadership and making sure the legal structures and CCGs’ powers are sufficient, can also provide improvements. However, the strongest message is that there needs to be collective responsibility across all organisations to incentivise every manager and clinician, so that if one organisation fails then every organisation fails. Simply put, organisations are stronger together. L FURTHER INFORMATION www.hfma.org.uk

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ENERGY

THE BURDEN ON BUILDING OWNERS

If buildings are to remain fit for purpose and up to the challenge of tackling rising energy costs, their owners will have to take a closer interest in how building services systems are maintained. There is also plenty of legislation now in place that places a heavy burden of responsibility on building owners and maintainers to remain within the law. Properly trained and accredited facilities managers (FMs) can help building owners deal with issues such as building regulations, fire risk assessments and mandatory air conditioning inspections. These are things required by law, but which are also designed to ensure the building in question operates more efficiently throughout its operating life. The new Energy Savings Opportunity Scheme (ESOS), which comes into force next year,

is also expected to apply to around 10,000 organisations employing 250 people or more or with a turnover in excess of £50 million. It will require them to provide four-yearly reports on their energy use and plans for cost-effective energy efficiency improvements – starting next December. SAVINGS As many as 200,000 buildings are expected to be included in the ESOS and, therefore, will need to carry out energy audits. This is the mechanism chosen by the UK government to implement Article 8 of the EU Energy Efficiency Directive, and could lead to cost savings of £1.6 billion across the affected businesses. By incentivising building owners to address the opportunities for energy savings, the government

There is plenty of legislati o n in place that p burden laces a heavy of on build responsibility i to remang owners in w the law ithin

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Written by Simon Carter, Building and Engineering Servives Association.

Building owners have to improve their knowledge of building maintenance techniques or face serious cost and legal problems, says Simon Carter, of Building & Engineering Services Association

is hoping to close the gap between how many buildings were designed to work and how they do actually perform. That gap is often alarmingly wide and means the building consumes far more energy than it should. 80 per cent of the value of a building is realised during its operating lifetime, but the biggest effort to modernise and reform working practices has, historically, been focused on the design and installation phases, which accounts for just 10 per cent of the value (the other 10 per cent being at decommissioning). Clients need to be better educated about the value of their built assets during operation. The modern FM company has a fantastic array of modern tools at its disposal to tackle energy efficiency and extend the operating life of equipment, so saving the building owner significant amounts of money. We can also keep owners out of jail by ensuring they fully comply with legislation. However, too many companies fail to sell their expertise properly, preferring simply to compete on price rather than promote innovative maintenance techniques that may require a little more upfront investment. ‘Non-invasive’ techniques like thermal imaging and vibration analysis could revolutionise the way buildings are serviced. These techniques, along with increased use of BMS intelligence, means maintenance programmes can be based on usage rather than frequency. This, in turn, allows the FM 

Facilities Management

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Can we really harness technology to build the GP-patient relationship? The problems are all over the headlines: we don’t have enough GPs, they are at the end of their tether, and they are fed up of being dumped on. Sorry, wrong headlines: we can’t get to see the GP, we have to wait three weeks, it’s getting worse and now the Daily Mail has pictured a queue of us in the cold and dark at 7.11am, just trying to get an appointment. Two sets of headlines, one huge headache for anyone involved in the NHS, from patient to politician. We need to do different, as more of the same isn’t going to work, and I think we all recognise that. Well, Simon Stevens has proposed ‘New models of care’ with different structures for primary care which might work – we don’t know until they’ve been tried. But central to them is technology – which might work, we don’t know until it’s tried. Let’s get back to some fundamentals. People trust their GP, and when they are sick and they’ve tried all the avenues of self help like NHS Choices, they want to consult a professional. GPs for their part love helping patients, are very good at their job (95 per cent of contacts are resolved within the practice, very few need referral to

hospital, however urgent), and equally value the relationships with patients. Sometimes these go back decades, sometimes they are only one episode but with the full medical record to hand, GPs are in the best position to provide expert, local and personal care. Now, how can technology help? 80 per cent of us have a smartphone and buy, book, and share with it every day. So far health care has lagged behind other areas on how to use the technology, because it’s good at transactions for example with banks and shops, but not so good with complexity, inherent in our health concerns. The secret is to use online interactions for amazing service, but personal interactions with your own trusted GP, which enhances the relationship. Digital is good for asking questions and collecting data, doctors are good at giving advice and planning treatment. The new askmyGP service from GP Access is doing just that by putting both parties in control. Patients can go in 24/7, doctors can work within their hours but respond fast so patients gain trust in the service. They won’t be fobbed off, and the doctor will always see them same day if needed.

Harry Longman

Case Study

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So New Models of Care get personal, that’s the present and future for the NHS. FURTHER INFORMATION Tel: 01509 816293 Email: harry@gpaccess.uk Web: askmyGP.uk

She can pay a bill, order a meal, or book a flight. She lives online. But she can’t tell her GP that her husband noticed frequent changes in mood, and she’s worried. But frankly she doesn’t have time.

Until now. With askmyGP she can connect with her own GP practice, and choose a named GP she trusts. Entering her concern, she answers a series of questions which let her explain the problem in detail. It’s confidential, and crucially it’s convenient, so she can do it any time, and send it to the GP. Within minutes, the practice is in touch, the GP has taken a look and offered her a telephone call or an appointment later today. Just as they would for all their patients. And with 80% of us now owning a smartphone, more and more are going to find askmyGP is the future.

Faster, easier access to your own GP.

Contact askmyGP. Visit online: askmygp.uk | Email: info@askmygp.uk | Tel: 01509 816 293

HEALTH BUSINESS MAGAZINE | Volume 15.1

ENERGY  service provider to pre-empt equipment failures; save clients money and disruption; while also ensuring buildings perform more energy efficiently. The use of condition-based monitoring of building services systems is well understood, but not as widely used as it could be. As a result, clients miss out on the lower costs and reduction in down time for critical equipment delivered by a maintenance service that also does not disrupt their working patterns. With modern non-invasive monitoring there is no need to shut down parts of a building. Work can also be carried out during normal working hours, which also means the maintenance team can see how the building is really operating under load. It should also be standard practice to provide more system automation by using the sophisticated IT networks that are already installed in commercial buildings as a platform. Increased occupancy monitoring of local lighting and HVAC systems can be delivered this way. In an attempt to extend the reach of this kind of best practice in building maintenance, the Building and Engineering Services Association (B&ES) has updated the industry’s building maintenance specification SFG20. This is being increasingly adopted by government building specifiers and operators, in particular, to establish strategic maintenance programmes for many building types including prisons, schools and commercial offices. It is now available as a dynamic online tool and is accessible via mobile devices. COMPLIANCE By customising the core task library, building managers, consultants and contractors can ensure relevant statutory/regulatory compliance and prevent the costly over-maintaining of assets. Inclusion of RICS new rules of measurement completes the build, maintain, replace standard life‑cycle costing model, and new criticality ratings enable clear prioritisation of maintenance tasks to streamline budget and project management. The SFG20 ‘Customiser Compliance’ tool allows users to create a bespoke building maintenance task library, including adding new non-core tasks such as fabric maintenance, and printing bespoke booklets of applicable standards. It includes links to all relevant statutory/legal obligations and references, together with regular updates to define compliant maintenance and an ‘asset criticality rating’ system which flags up, with a red warning, if a user is missing a maintenance task necessary for legal compliance. Providing this kind of support is important because many clients simply don’t know what they are buying when they acquire a building and have no idea of what is now possible in terms of improved performance and the enhancements the industry can provide. Regrettably, despite the upturn in the economy the main focus remains on the bottom line cost and not the long term gain. There are many ways for building owners and operators to reduce their carbon footprint and cut energy costs that are simply not being exploited because many building operators are unwilling to make the relatively modest upfront investment in a more strategic maintenance programme. However, awareness is improving and initiatives like ESOS are helping to make the link between maintenance improvements and monetary value. Many of the remedial actions are extremely simple. For example, buildings are progressively de-commissioned because the owners and operators are not well informed about how control systems should work. Temperature set-points are regularly ‘tweaked’ by individual occupants in a misguided attempt to change comfort levels in their section of the building. This can easily lead to the heating and cooling systems operating at the same time and ‘fighting’ against each other with the consequent negative impact on energy usage. This situation is often exacerbated by people also opening windows to cool down overheated areas so all that expensively tempered air is simply thrown away. SETTINGS Most buildings would benefit from re-commissioning and a regular survey of their energy consuming plant. Many of the adjustments required to put equipment back on track are simple changes to control settings and, therefore, are easy to do and extremely low cost, but with significant running cost paybacks.

The government is hoping to close the gap between how many buildings were designed to work and how they do actually perform. That gap is often alarmingly wide and means the building consumes far more energy than it should

Facilities Management

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With energy prices still on an inexorable upward slope this will become a greater priority for the budget holders and it is important to deliver the message that managing energy costs is not just about shopping around for the best tariff, but getting consumption down. The building engineering services industry has the tools to take a far more proactive and far sighted approach and, by making adjustments to installed equipment and replacing or upgrading key components, the building will deliver much better long term value. These are exciting and challenging times for the facilities management industry and an amazing amount is now achievable by combining our traditional expertise and modern IT tools. This also makes it an attractive and worthwhile career for any young person weighing up their options. Making buildings work better can be a very rewarding exercise – we just need to make sure building owners and operators recognise this and, therefore, ask the right questions of their FM providers.  FURTHER INFORMATION www.b-es.org

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Cut your energy costs and meet carbon reduction targets

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 producing 208,224 kWh of energy a year  reducing the business’s CO2 emissions by 112 tonnes a year

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 reducing the business’s CO2 emissions by 83 tonnes per year

 giving a 15% return on investment.

Energy

RENEWABLES

Pilgrim Hospital in Boston has delivered one of the largest, most complex and successful biomass heating projects in the UK

GREEN ENERGY FOR HEALTHCARE

Rising energy costs and strict legislation on carbon emissions are making renewable energy more appealing to hospitals. Here is a look at some hospitals embracing a greener type of energy The carbon footprint of the NHS in England is 25 million tonnes of carbon dioxide equivalents (MtCO2e). The footprint is composed of procurement (61 per cent), building energy (17 per cent), travel (13 per cent) and commissioning (9 per cent). This is based on the NHS Sustainable Development Unit’s latest report which was published in December 2013 and is based on 2012 data. Rising energy costs and strict legislation on carbon emissions are making renewable energy more appealing to hospitals. And where it was onced perceived as a group of niche technologies, improved funding, incentives and technology have allowed renewable energy to enter the mainstream and be more affordable to hospitals. Renewable energy comes from resources which are naturally replenished such as sunlight, wind, and rain. SOLAR PV There are two types of solar panels; photovoltaic panels capture the sun’s energy and convert it into electricity and solar thermal collectors use the sun’s energy to

heat glycol which passes through a coil. The roof of the Princess Alexandra Hospital in Harlow, Essex, now has what is believed to be the largest array of solar panels currently in the NHS. The project was driven by a need to reduce energy spend and a grant of nearly £400,000 was secured from the Department of Health’s Energy Fund in 2007. Work started on installing two new energy efficient boilers and solar panels in summer 2008. The solar panels use solar radiation and sunlight, so they work constantly, only slowing on really dull days when traditional energy sources are used to run or supplement the boilers. The solar panels heat up the sites water prior to it reaching the boilers therefore the boilers have to do significantly less work. This has resulted in a 50 per cent

reduction in the number of times the boilers have to fire up to heat the water to the safety levels specified. The savings achieved by the solar panels and new efficient boilers equate to a reduction of 8,000m3 of gas and 16 tonnes CO2 per year. SOLAR FOR SOLIHULL Solihull Hospital and Heartlands Hospital, Birmingham, part of the Heart of England NHS Foundation Trust (HEFT), have installed Solar PV panels from Ecolution. The installation is predicted to deliver over £2 million from energy savings and Feed-in-Tariff payments (FIT) within the next 20 years. The 2,000 panels were installed on over 28 roofs of varying pitch, orientation, height and covering. In addition, accommodation of the electricity supply back-up generators, which are a vital lifeline when there is an electricity malfunction, presented an extra challenge. If the PV arrays ever produced more than the electricity load on the generator, the following back feed into the generator would cause a rise in voltage, which would prevent it from engaging. The generator would also feed the supply with the PV system causing potential damage to the PV array and generating equipment. To negate this potentially life threatening problem, Ecolution connected a radio E

Pilgrim l Hospita has n in Bostone of the do deliveremost complex largest, successful and eating h s s a m bio s in project K the U

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RENEWABLES  frequency module into a relay that provided it with a radio signal whenever the generator was about to engage. The PV distribution board contactor then receives a signal to stop sending the electricity supply to the PV system, ensuring that the generators and PV systems do not operate simultaneously. With HEFT spending over £1m per annum on energy, this installation will be saving them over 10 per cent on their current expenditure, with the benefit expected to rise even further as electricity prices rise in due course. It has been conservatively estimated that HEFT should receive over £2,000,000.00 in benefits from the installations over the next 20 years, with approximately 50 per cent from energy savings and 50 per cent from feed-in-tariff revenue. BIOMASS The Renewable Heat Incentive (RHI) is the world’s first long-term financial support programme for renewable heat. It pays participants of the scheme that generate and use renewable energy to heat their buildings, and is a good option for NHS buildings. Pilgrim Hospital in Boston has delivered one of the largest, most complex and successful biomass heating projects in the UK. In April 2008, capital funds were made

Energy

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The Renewable Heat Incentive is the world’s first long-term financial support scheme for renewable heat and is a good option for NHS buildings available from the Department of Health’s Energy and Sustainability Fund and Lincolnshire County Council, under their Green Heat scheme. A solution was designed that made best use of the limited gas supply, whilst delivering significant further benefits. The technology selected was a 3MW biomass boiler integrated with a 526kWe gas fired reciprocating CHP engine (combined heat and power) and conventional steam oil boilers. The installation gives Pilgrim Hospital complete diversity of fuel supply with the base load being met by the biomass boiler and gas CHP engine, and peak demands met by standby fuel oil steam boilers. The control system enabled the complex arrangement to work effectively. The technology combination met all the challenges, providing the Trust with fuel flexibility, a reduction in carbon emissions and operating costs. Energy savings in the order of £400,000 per annum are predicted for Pilgrim Hospital. Biomass heat is also ‘zero rated’ under the Carbon Reduction Commitment (CRC), so the hospital is saving 265kg of carbon dioxide for

every MWhour of oil displaced. The benefits of this are currently £42,000 per annum and are expected to exceed £60,000 per annum. A new biomass boiler of a similar size to Pilgrim Hospital would be eligible for 2.0p/kWh payment from the RHI. This could equate to £200,000 per annum (depending on boiler run hours), which is additional to the significant financial savings already achievable through biomass heating. The wood fuel used in the biomass boiler comes from either local woodlands that are managed to increase biodiversity or from clean recycled wood sources. The sale of wood chip fuel provides a stable, long term income to the rural economy, helping us to better manage and protect our fragile natural resources and can reduce the volume of waste wood going to landfill. L FURTHER INFORMATION www.pah.nhs.uk www.heartofengland.nhs.uk www.ulh.nhs.uk

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Fire Prevention

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Written by Graham Ellicott, ceo, Fire Industry Association (FIA)

FIRE PREVENTION

ARE WE IN NEED OF MORE FIRE PROTECTION? In recent years in Great Britain there have been approximately 40 fires per week in hospitals and healthcare premises and unbelievably 20 per year are arson attacks, reports the Fire Industry Association’s ceo Graham Ellicott At a fire seminar that I attended, a risk manager from an insurer commented that fire losses, including those from healthcare, continue to increase, with those from large fires leading the way. Currently these losses from fire stand at approximately £4 million per day. He went on to say that insurers are now dealing more with buildings

buildings or the owner of an existing building may want to go further and increase the level of fire protection installed in the building so as to give the fire services more time to extinguish any fire that might occur. This could lead to a reduction in the amount of damage caused and thus, in the consequent insurance claim. This addition will provide extra comfort

Another good reason to make sure that the fire protection systems in buildings are properly installed and maintained is the Corporate Manslaughter and Corporate Homicide Act 2007 on fire rather than fires in buildings. The rationale of the Building Regulations in the UK is that, ‘in an emergency the occupants of any part of a building should be able to escape safely without any external assistance’. However, in many cases the designer of the

to insurers and also to the fire‑fighters, who may have to enter a fire-ravaged building after the occupants have escaped. Surely in buildings that are critical to the community, such increases in the amount of fire protection are to be applauded as nobody

wants to see a walk-in centre destroyed or a hospital badly damaged, do they? ABOUT THE AESTHETICS Increased levels of fire protection in buildings don’t all have to be red, unwieldy and ugly to look at. For example, many building users are concerned about excessive use of wiring for alarm systems and unseemly trunking and conduit. Well those days are gone as wireless systems with stylish multi detectors that are easily hidden can be quickly and economically installed. Indeed, it’s not just fire detection systems that can be sympathetically incorporated into any design but in general most modern fire protection products are designed to blend in with the background. For example, recessed sprinkler heads, flush control panels, bendable fire resistant partitions, concealed door closers, and the list goes on and on. Whilst it’s all very well specifying an increased level of fire protection for a building, it is equally necessary to ensure 

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FIRE PREVENTION

Fire Prevention

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About the author Graham Ellicott was appointed as the first ceo of the Fire Industry Association in April 2007 when the BFPSA and FETA joined forces to form the new Association. Prior to this Graham was CEO of the Association for Specialist Fire Protection (ASFP) and Managing Director of the Mandoval Group. Graham was educated at Bristol University where he attained a BSc (Hons) and latterly at Heriot-Watt University gaining an MSc. He is a Chartered Chemist, a Chartered Scientist and a Member of the Royal Society of Chemists. The FIA is a not‑for-profit trade association with the aim of promoting the professional status of the UK fire safety industry.  that the systems are properly installed and maintained. At the end of the relevant phase of construction, the fire protection installer will issue a Certificate of Conformity, which will claim that the product has been installed in accordance with the terms of the contract. But what does the Certificate of Conformity mean? Is it worth the paper it is written upon? The Fire Industry Association’s view is that its worth is greatly enhanced if it is issued under the auspices of a third party certification scheme. Such schemes mean that competent operatives have correctly installed the specified products and that independent inspectors have randomly inspected the work. DON’T BE LIABLE Another good reason to make sure that the fire protection systems in buildings are properly installed and maintained is ‘The Corporate Manslaughter and Corporate Homicide Act 2007’. This states that an organisation will be guilty of the offence of corporate manslaughter if the way in which

its activities are managed or organised causes a person’s death and amounts to a ‘gross breach of a relevant duty of care owed by the organisation to the deceased’. An organisation that is found guilty of corporate manslaughter will be liable for an unlimited fine. The act also allows the court to call for a publicity order that requires the organisation to publicise details of its conviction. In summary, the FIA believes that designers and building owners should consider the use of more fire protection in buildings that are critical to the community, such as public buildings including schools, hospitals and community centres. The value to the country of keeping these buildings operational far outweighs the small additional cost of an extra level of fire protection. Extra fire protection is not just a ‘nice to have’ exercise; it could mean the difference between a community critical building surviving or not in the event of a fire. Third party certification breeds good practice and means worthwhile Certificates

of Conformity are issued. This will give confidence to the specifier, client and the enforcer that the job has been carried out to the highest standard. Additionally in the event of a disaster, lawyers will come looking for the person with the biggest pockets. It is highly likely that the use of a third party certificated company would be seen as a basis for a sound defence in the event of a lawsuit concerning the performance of the fire protection systems. In the worst case where somebody is killed in a fire, the possibility of a breach of the Corporate Manslaughter and Corporate Homicide Act becomes a distinct possibility and again the use of a third party certificated company could be highly beneficial to the accused organisation defending such an action.  FURTHER INFORMATION www.stoparsonuk.org www.fia.uk.com

Fire risk assessments for nursing homes, care homes and surgeries Under the Regulatory Reform [Fire Safety] Order 2005, all healthcare premises need to have an up to date fire risk assessment document which demonstrates that their healthcare premises meet the fire safety requirements of the current law. FIRE-STAT International is an award winning specialist fire safety consultancy with 25 years business experience staffed by highly experienced ex-senior fire officers who are both accredited fire risk assessors and qualified fire consultants. FIRE-STAT International is also fully insured for professional indemnity, public liability and employers liability and is a member

of the Association of Fire Consultants and the UK fire protection industry. A fire risk assessment from FIRE-STAT International will extend to 40 pages, include plans, photographs and an action plan of essential fire safety precautions. The managing director of FIRE-STAT International is Gary Whitworth, former chief

fire officer – Kent Fire and Rescue Service and former government fire advisor. FURTHER INFORMATION Tel: 01293 823044 Tel: 01293 823921 Mob: 07949638071 www.Fire-Stat.co.uk

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www.kantarhealth.com/insights-perspectives

Jessica Santos, Ph.D.

We publish regularly at ISPOR, ASCO, ESMO

Kantar Health is a global market research and healthcare consulting firm for the world’s leading pharmaceutical, biotech, and medical device/ diagnostic companies. We connect science with research to resolve business challenges across the healthcare product lifecycle. ■ Over 600 professionals dedicated to

As practitioners and individuals, it is our Big Responsibility to foresee possible consequences while enjoying the advantages of Big Data and demonstrate the benefits of Big Data to data subjects so they understand “what’s in it for them.” While the industry is arguing “one-time consent”2 could be the solution, maintaining Big Data security and accuracy is certainly favored by the Big Privacy lobbyists.

healthcare-focused consulting ■ Broad disease experience ■ Footprint in more than 40 countries; presence in 81 countries

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One of the key aspects of Big Privacy is “explicit consent” from the data subject. But how can we know for sure whether clicking “I agree” to a lengthy privacy policy will prevent all future and potential harm? Strong advocates against, and an increasing amount of fines for, Big Data misuse show that the “Big Privacy” movement is building momentum.

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Over 1,000 publications in peerreviewed journals and congresses

Affiliated with ZEG Berlin Center for Epidemiology and Health Research

In this battle of Big Data versus Big Privacy, individuals do not need to be “identified” in order to be placed in a disadvantageous position. For example, if all de-identified medical records were openly available, would health insurance premiums increase simply because one lives in an area with a high prevalence of smoking and obesity? Even when medical records are available only for public-sector research, a sharp drop of women reporting postnatal depression has been observed because of the fear that their babies may be taken away by social services. Or will we refuse to be treated by an HIV-positive nurse or not go near a hospital with a higher-than-average rate of hepatitis infections?1 Given enough money, resources and time, all de-identified data can be identified again. Yet nobody wishes to be the victim of Big Data, which we have come to rely on in our daily jobs.

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Healthcare practitioners, scientists and providers may perceive that privacy stands in the way of, or at least hinders, scientific discoveries and technological advances. Who can dispute the advantages of having Big Data at our fingertips to answer any healthcare, regulatory or business question? Of course, the flip side is any discoveries we make could reveal unfavorable truths about certain population segments that happen to include us.

We have heard these buzzwords before, but what do they actually mean to us? For industry practitioners who have been craving data ever since the dawn of time, Big Data seems to be the answer to all our prayers. For the average citizen, however, Big Data could be an irreversible and unstoppable juggernaut into the pillar of our fundamental human rights. And the Big Privacy movement may just be our only chance to regain our dignity in this unprecedented conflict.

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MARKET RESEARCH

RESEARCH IN TODAY’S HEALTHCARE LANDSCAPE In light of the recent political party conferences, and in the run up to the general election next May, a torch is being shone on the future of the NHS. Never has it been more important for policymakers and healthcare decision-makers to use research to evidence decisions. Policy, procedures and processes which are not based on hard evidence are unlikely to prove successful or be long-lasting. With resources stretched ever more thinly, it has never been more important to have solid facts at the heart of decision making. CARING CONVERSATION Significant evidence has appeared in a number of publications regarding the power of the placebo effect and many sectors have also

experienced the power of trust in steering decisions and supporting behaviours. This leads the question, as to whether or not the healthcare sector is applying these lessons sufficiently in managing their interactions with patients and their families. There is a real opportunity to explore and learn by understanding the lead indicators created from the factors driving trust. Qualitative and quantitative techniques could be used

to identify problems much earlier than most performance metrics currently used. Talking and listening to how patients, relatives and visitors feel, and respecting qualitative feedback is a lot cheaper than purchasing expensive hardware for monitoring. We should assume that research participants understand the, generally unwanted, reason for being in the healthcare system and the difficulties under which the system 

Mentally degenerative diseases such as dementia and alzheimers are on the rise and it is increasingly difficult to get a sense of how such patients are feeling about the quality of their care

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Written by Jane Frost, CBE, ceo of the Market Research Society

Jane Frost, ceo of the Market Research Society, explains how research can be used to solve some of the most pressing issues in the health sector

Market Research

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MARKET RESEARCH  operates. Likewise, that they know when they are being treated with respect and well looked after. Evidence from the US suggests that doctors with a good manner receive fewer legal actions against them than those without, showcasing that ‘soft’ metrics are early warnings of deeper problems and delivering in these areas can save valuable financial resources. The placebo effect can be used as a premise on which to drive and structure research and planning in hospitals to improve levels of care. Amid criticism over care quality in the NHS, the government should look to address perceived failings starting first with patient satisfaction. According to the placebo effect, if patients believe that they are being treated well, and are being well looked after, their health should improve as a result. Patients are at the centre of the healthcare system and understanding their attitudes towards, and perceptions of, the service provided by practitioners will help hospitals and doctor’s surgeries address confidence in care. As issues are addressed, patient confidence in the treatment they are receiving will improve which, in theory, should lead to improved results for patients if positive attitudes arise as a result.

to be less fearful of speaking with patients and conducting more qualitative research to engage with the public. Patients will feel more cared for if they believe that time is being taken to listen to them, and that the system is truly interested in them and their experiences. This can enhance their mood and positivity about getting better. In turn, this can have a marked impact on the success of treatment and recovery time, as evidenced by the placebo effect. This form of qualitative research is excellent at providing real time insight into how inpatients are feeling about their treatments while they are occurring. It allows healthcare professionals to rectify problems before they become more prevalent and ultimately, more costly. Research is a good early indicator of whether or not things are going well and it can help to keep an eye on lead indicators to stop mishaps in the future too. RESEARCH BEFORE MAKING A DECISION Resolving issues in the health sector can be extremely expensive and conducting research prior to, and during, implementation of new practices or processes can really help to ensure that precious time and financial resources are not wasted. With the industry more stretched than ever before, getting it right first time is essential and research will help decision makers to do this. Earlier this year, the Care.data scheme was postponed due to the public’s reaction to the sharing of personal data. This could have been avoided had research been conducted to provide insight into public sentiment on this issue, enabling these concerns to be addressed head on before its proposed roll out. While the appeal is certainly there for government bodies to use data and research to retrospectively justify decisions, decision makers must implement schemes that are entrenched in evidence, particularly as there are so many techniques now available to gain fast and reliable guidance before developing costly policy or systems. The Care.data scheme is now being ‘trialled’ as pilot schemes in six areas covering over 250 GP surgeries across Hampshire, Blackburn, Leeds and Somerset. While it is important to trial the scheme to help inspire confidence about the safety of the data, the government must listen to the results and feedback from those involved in the pilots. There is no point in commissioning these trials if the research results are going to be ignored. The government must recognise that the public want to be equipped with all of the necessary information before agreeing to the scheme, such as how easy it will be to opt out and

ng Accordi cebo la to the p patients f effect, i at they are h t believe reated well, t being alth should their he ove as a impr lt resu

ELDERLEY PEOPLE Recent news stories have highlighted that the quality of care received by elderly people is not up to standard. Mentally degenerative diseases such as dementia and alzheimers are on the rise and it is increasingly difficult to get a sense of how such patients are feeling about the quality of their care. This often falls to the families of those who are unwell and so the comfort of relatives should be an area of focus for hospitals and care homes. Extreme measures have recently been discussed in the media, such as the Quality Care Commission’s proposals for the potential use of hidden surveillance to test the quality of care provided. Such measures won’t work as well as sitting down and listening to relatives’ opinions or the opinions of the patients themselves. Observation is all well and good, but it is engaging with people that will make the biggest difference and really pinpoint areas for development. The effect of surroundings, comfort and perceived care quality are also hard to ascertain without recognising consumer behaviour. Patients are consumers of care. Surveys are all very well, but some inpatients won’t provide honest answers for fear that levels of care might decline or not improve if they are critical of the service they are receiving. This method also often doesn’t allow for issues to be addressed immediately. Healthcare professionals need

Market Research

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About the MRS With members in more than 60 countries, the Market Research Society (MRS) is the world’s largest research association serving all those with professional equity in provision or use of market, social and opinion research, and in business intelligence, market analysis, customer insight and consultancy. Its members have commissioned and provided evidence that has helped to win elections, launch brands and understand trends in society. guarantees that their personal information won’t be passed on to insurance companies. For the scheme to be successful the pilots must use social research to track unease and issues in response to problems to make sure that citizens feel confident in how their data will be used and stored. Feedback mechanisms should be put in place, in the same way that they are in hospitals regarding care satisfaction, to make sure that the public’s voice is being heard and actually being responded to. The government’s job now is to prove that the scheme is robust and that concerns have been recognised and acted upon. INDUSTRY PRESCRIPTION Healthcare relies on trust and confidence to run throughout it. The system can only work to get better if it is perceived to be doing its job. In the case of the health sector, this perception can’t purely be down to the placebo effect. It has to be followed through with the actions of key decision and policymakers. The industry can learn a lot from research and can improve if it listens to its patients and implements changes based on the feedback it receives. Qualitative research is essential to the success of projects, and feedback loops must be implemented to ensure that all viewpoints are considered. The public must have confidence in the changes that policymakers are implementing in order for them to be successful. In the run up to the election next year, politicians will need to navigate their way through challenges on patient data, elderly care and general quality of care. They need to work hard to gain the trust of citizens and convince them that their proposed reforms to the healthcare sector are the best treatment options. Research will help them to identify areas for improvement and ultimately recognise the voices of citizens who rely on the healthcare system every day.  FURTHER INFORMATION www.mrs.org.uk

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Adverisement Feature

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INFECTION CONTROL

DECORATIVE PANELS CLEANS UP WITH BIOCOTE

There are plenty of benefits to be had from a product manufactured from a sheet material with high abrasion and antibacterial resistant properties. After many months of research and development at Decorative Panels Lamination (DPL) dp-BioCote Quartz is here and ready to clean up in the market place. Working as a partner company with BioCote®, DPL have launched commercially available sheet materials that offer exceptional abrasion and antibacterial properties. The manufacturing process of the surface material and the addition of the BioCote® additive results in the surface being highly abrasion resistant, in fact it far exceeds the abrasion resistance of a standard high pressure worktop. When tested against resistance to clinical cleaning products, dpBioCote Quartz sees excellent results in all areas. Testing the parameters with regards to wet and dry heat, as well as a number of liquid’s that commonly leave distinctive marks the product also passes with flying colours. EXCEPTIONAL ANTIMICROBIAL PROPERTIES But high abrasion resistance is not the full story…far from it…by working as a partner company with BioCote® Decorative Panels Lamination has launched a range of commercially available sheet materials that also offers exceptional antimicrobrial properties. By including the BioCote® additive into the surface of the product, dp-BioCote Quartz is able to give up to a 99.9 per cent germ free surface* by inhibiting the growth micro-organisms such as bacteria, fungi and mould. This means that the product surface is protected against the growth of staining and odour causing microbes which may prematurely degrade the material. Both in laboratory and real life conditions BioCote® has been proven effective against a wide range of clinically significant bacteria including MRSA, MSSA, E.coli, Legionella pneumophila, Pseudomonas aeruginosa, Salmonella typhimurium and enteritidis, Listeria monocytogenes, VRE, Campylobacter, and Novovirus. Tests have shown that within just 15 minutes microbrial contamination has reduced by up to 80 per cent and that after two hours reductions of up to 99.9 per cent can be expected.

HEALTH BUSINESS MAGAZINE | Volume 15.1

Tests have shown that within just 15 minutes microbrial contamination has reduced by up to 80 per cent and that after two hours reductions of up to 99.9 per cent can be expected. In choosing to work alongside BioCote® Decorative Panels will be able to draw on the knowledge and support of a company that are recognised as being pioneers in the global provision of antimicrobial solutions. LASTING A LIFETIME Very significantly BioCote® not only acts in minutes, it also works continuously and lasts a lifetime – it does not degrade. In terms of product range dp-BioCote Quartz is launched as a range of six decors, three popular woodgrains and three unicolours available for lamination across the extensive range of substrate materials available from Decorative Panels Lamination. A sheet material with so much to offer – we believe the potential for this product extends over an array of market areas.

Initial customer contact and presentations has proved very positive with a high degree of interest and enthusiasm being shown for the product. Market areas such as hospitals, health centres, schools, care homes, student accommodation, and of course office and contract furniture would, all benefit from product manufactured from a sheet material with high abrasion and antibacterial resistant properties. L FURTHER INFORMATION For more information, and access to full technical reports and performance criteria please contact us on 01484 658341, or email us at info@decorativepanels.co.uk

*Tested in accordance with ISO22196:2011

ANTIMICROBIAL SURFACES

INHOSPITABLE TO BACTERIA

Healthcare Associated Infections (HCAI) continues to be a problem globally. In the UK, since 2009 monitored organisms such as Clostridium difficile and MRSA have displayed marked reductions in associated patient infections. These reductions are attributed to improved clinical and public awareness of infection control as well as improved implementation of these control measures. Hand washing, spatial and temporal control of infected personal (and articles) have all largely contributed. Penalties for noncompliance with HAI targets can be severe. Although the figures are moving in the right direction reductions of HAIs should persist. When existing control measures have been Antimicrobial wall cladding. Image courtesy of Bioclad Ltd

optimised alternate mechanisms for the control of pathogenic bacteria in hospital environments should be explored, to ensure numbers for hospital acquired infections continue to fall and future patient health is continued to be safeguarded. One such option is the integration of antimicrobial additives into polymers or other materials to imbue them with properties which make surfaces inhospitable to bacteria and other microorganisms. ENVIRONMENTAL MICROORGANISM CONTROL Control of bacteria in the hospital usually

Written by Dr Andrew Summerfield, BioCote Ltd

takes place via the use of antimicrobial agents of varying efficacy depending on the hygienic requirements of the environment. Highly efficacious cleaning agents utilising, for example strong oxidising agents, may offer both bactericidal and sporicidal solutions but can, in the long term, provoke material damage. Common disinfectant active substances based on quaternary ammonium compounds can provide immediate antibacterial action, but residual effects are limited due to evaporation or removal from disinfected surfaces and the risk of subsequent recontamination. There is then, the continuous requirement for knowledge of appropriate cleaning and disinfection products within the hospital environment to ensure use of chemical products is optimal for both controls of problem organisms, and to protect surfaces from material damage. Bacterial populations are displaying increased resistance to disinfectants based on quaternary ammonium salts (QUATs) and that resistance to QUATS may evoke further resistance to antimicrobials such as antibiotics. Despite these concerns, disinfectants remain the primary non‑antibiotic medicated control mechanism for areas of hygiene concern. E

Infection Control

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e Effectiv well as cleaningt and staff n as patiess of infection e awarenrol measures cont the primary remains thod of me action

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ANTIMICROBIAL SURFACES Antimicrobial wall cladding. Image courtesy of Bioclad Ltd

 INTEGRATED PROTECTION Inorganic agents such as silver are evidenced to provide long lasting effective antimicrobial effectiveness. By deploying such technology as a manufacturing additive, materials which can usually support microbial growth can be imbued with antimicrobial properties and provide protection from microbial growth. Although the antibacterial effects of silver have been known since ancient time’s deployment of these materials antimicrobial properties as additives is relatively new. This technology is increasingly understood, and its potential beginning to be realised, in sectors including food production/packaging, medical environments and the home. SAFE USE OF ANTIMICROBIAL PRODUCTS Biocidal products including antimicrobials are regulated globally, to protect humans and the environment from substances which may pose a risk. In the EU, control of biocidal product use and sale is achieved via the Biocidal product Regulation, and in the US via FIFRA (Federal Insecticide, Fungicide, and Rodenticide Act) under the justification of the Environmental Protection Agency (EPA). Biocides when incorporated into plastics can be considered ‘treated articles’– that

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By deploying antimicrobial technology as a manufacturing additive, materials which can usually support microbial growth can be imbued with antimicrobial properties and provide protection from microbial growth is articles which have been treated with a biocidal substance but are not actually biocidal products. This classification waives many of the regulatory requirements present for biocidal products and active substances. Within the EU, treated articles and are indirectly regulated through the requirement for treated article labelling information which specifies information should be provided relating to the nature of the active substance utilised. This labelling requirement was put in place to protect people and the environment from the effects of hazardous substances which when incorporated into articles may evade chemical compliance monitoring systems. TESTING/PROOF OF EFFICACY One of the requirements for making a biocidal or indeed antimicrobial claim within the EU

is substantiation. We should then be able to backup any claim we make for a treated article or product. Antimicrobial polymers are usually assessed via the international standard ISO22196 Measurement of antibacterial activity on plastics and other non-porous surfaces. Testing to this standard allows generation of reproducible and comparable results when assessing the antibacterial properties of products incorporating an antimicrobial substance. PATHOGENIC (DISEASE CAUSING) MICROORGANISMS Bacteria can be broadly divided into two groups, Gram positive and Gram negative, and this division is based on the structure of the bacteria’s cell wall (external membrane). This grouping also gives excellent indication of the innate properties of these organisms. 

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ANTIMICROBIAL SURFACES  Both Gram positive and Gram negative bacteria contain species which cause major issues in healthcare. MRSA, which is a multi‑drug resistant variant of the Gram positive Staphylococcus aureus, is perhaps the most infamous. This organism is responsible for a range of complications such as skin infections and more seriously blood infections. Klebsiella pneumonia is another significant problem in the health care environment, causing a range of problems including pneumonia as well as a variety of other disease such as surgical wound infection. The Gram negative Klebsiella pneumonia is also further complicated by widespread multi‑drug resistance, with CRE (Carbapenem‑resistant Enterobacteriaceae) resistant to many antibiotics of the penicillin family. In the UK, the problem of multi drug resistant E.coli increases, with Extended Spectrum Beta Lactamase (ESBL) bacteria providing another example of multi drug resistance problems in a healthcare setting. ESBL E. coli are perhaps best known for disease related to the urinary tract and can be a problem related to catheters. Antimicrobials such as silver work in a different manner to traditional actives present in disinfectants as well as antibiotics. Silver, in an ionic state, exerts multiple deleterious effects on the microbial cell including damage to the cell wall/envelope, protein denaturation, potential DNA damage and general free radical mediated toxicity. With no specific site of attack (which is, for example, the means by which antibiotics exert their antibacterial action) evolution of resistance is considerably difficult, with no significant clinically significant resistance reported. A NEED FOR ANTIMICROBIAL POLYMERS? Articles within the hospital environment are known to harbour pathogenic bacteria or other microbes for extended periods of time. The H1N1 virus genome has been reported to survive on surfaces for as long as 24 hours (3). A recent study examined various articles within an operating room and measured percentages of these articles which harboured bacteria. 23.3 per cent yielded growth, whilst 57 per cent of these organisms were identified as clinical pathogens. Long term persistence of bacteria is also a problem. Bacteria such as Enterococcus spp. (including VRE another multi drug resistant pathogen Staphylococcus aureus (including MRSA) are evidenced to survive for many months on hard surface. Gram negative species such as Actinobacteria, E.coli, Pseudomonas spp. and Klebsiella spp. are also reported to survive for extended periods. In another study, during a two year assessment, a total of 290 environmental samples were analysed, in three different wards. The percentage of equipment in each ward that displayed contamination level varied between 22 per cent and

38 per cent, and more than 50 per cent of the equipment sampled was highly contaminated. P. aeruginosa was repeatedly isolated from sinks (10 times), from the taps’ biofilm (16 times), and from the showers and bedside tables (twice). Effective cleaning and disinfection as well as patient and staff awareness of infection control measures remains the primary method of action for control of environmental contamination. Working alongside these measures, integrated antimicrobial protection can provide a second line of defence against the effects of contamination of articles and surfaces both within the hospital environment and in any hygiene sensitive location generally. Having material which performs well in laboratory based antimicrobial results for antimicrobial incorporating materials is the first stage in validating any associated claims for an antimicrobial product. Although these test requirements have stringent conditions and procedures by which the tested material and organisms are subjected, the question of how treated materials may perform in the ‘real world’ is a common one. BioCote have published a series of case studies which address the concern of how antimicrobial surfaces behave in environments including, but not exclusive to, healthcare. A peer reviewed study, published in the Journal of Infection Prevention demonstrated a 95.8 per cent reduction in bacteria between two wards, where ‘ward A’ contained BioCote treated products and ‘Ward B’ contained non‑treated products. BioCote have also performed a similar study in a care home, demonstrating a 94.8 per cent reduction in total microorganism

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counts when comparing a unit with and without BioCote treated products. BioCote have also demonstrated antiviral performance of treated surfaces, proving the ability of BioCote technology incorporated into a variety of substrates such as polycarbonate and ABS to deactivate the Influenza H1N1 virus by up to 99.99 per cent. A further study demonstrates visually, via epiflourecent microscopy and molecular dyes, the ability of BioCote’s antimicrobial technology to inhibit biofilm formation of treated plastic. These case studies, plus others, can be download at www.biocote.com/library. ANTIBIOTIC RESISTANCE – AM POLYMERS A PART OF THE ANSWER? The concern over antibiotic resistant bacteria continues to grow. Current statistics shown in the UK antibiotic prescription actually increased by six per cent between 2010 and 2013, and consequent the target is to bring prescription levels back down to their 2010 levels. As reported numbers of AMR bacteria continue to grow and the discovery void for new drugs, in the short term, is persisting the pharmaceutical industry must (perhaps with government or other bodies assistance) act. The discovery of the new drug teixobactin has raised hopes, however in world where methods to control multi drug resistance pathogenic bacteria are more limited, the exploration of integrated antimicrobial protection in surfaces in a health care environment should be explored.  FURTHER INFORMATION www.biocote.com

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Need wi-fi? CloudRuckus provides a cloud based solution removing the need for onsite wireless controllers Hospitals, clinics, and other healthcare facilities face an exploding demand for wi-fi, whether to meet the needs of the 90 per cent of physicians with smartphones or to connect the multitude of medical devices that increasingly are networked over wi-fi to provide real time monitoring, precise locating and support patient-centred workflows. CloudRuckus provides a cloud-based WLAN controller removing the need for traditional onsite wireless controllers. The solution is fully versatile providing enterprise grade features, such as location based services, advanced guest management and superior network analytics. A fully featured, multi-tenanted wi-fi management solution for hospitals that desire superior performance. The technology creates a scalable and resilient alternative to traditional on-site wireless controllers for managing their Ruckus Wireless deployments. The solution enables you to build wi-fi networks starting with a single access point that can grow to a network of thousands of access points spread across multiple sites. ZoneManager is virtually limitless in its capabilities and allows customers

to scale at unprecedented levels. An intuitive online dashboard provides simple access to tracking of user movement and historical analysis of footfall trends. With built-in floor plans and google maps as standard, CloudRuckus allows you to locate your access points and clients in a friendly dashboard. Deployed across a highly available and resilient platform, CloudRuckus operates over multiple data centres to eradicate any single point of failure, providing a network that continues to serve clients even if communication with a node is lost. A traditional controller approach would require a full physical redundant

onsite controller at additional cost. ZoneManager provides a built-in guest management system to offer a flexible way to on-board patients and guests, allowing a fully customisable user experience. Whether required at a site or across multiple locations, its simplicity provides a complete solution for every organisation. Built-in basic analytic and reporting engine offers information on your access points and clients for up to 30 days as standard and application visibility provides a detailed view of your wi-fi usage. When all of the different elements of CloudRuckus are taken into consideration, hospitals could have a cloud-managed wi-fi solution that empowers them to grow and expand at their desired pace with ease. Further information about CloudRuckus wireless management options can be found on the company’s website, this includes details that may be of interest to existing users of Ruckus Wireless technology products. FURTHER INFORMATION Tel: 0203 6 70 80 90 sales@cloudruckus.net www.cloudruckus.net

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Healthcare IT

THE INFORMATION WE HANDLE Why is information governance often seen as an obstacle – and can perceptions be changed? David Willis, head of information governance at Wrightington Hospital shares his thoughts What’s the point of information governance? This was a question overheard on the rush hour train from Preston to London on 1 October 2014. This is actually a good starting question. As an information security professional within the NHS, the first thing I had noticed when I started the job of head of information governance, was that information governance within the NHS always seemed to be perceived as an obstacle. My fellow passenger certainly seemed to consider it so, but why? Information governance as a concept was introduced into the NHS by the Department of Health in 2003. Its basis was a statutory administrative return based around a performance assessment tool with supporting guidance and training. So what, in the NHS, is information governance? The Health and Social Care Information Centre (HSCIC) supplies this current definition:“Information Governance ensures necessary safeguards for, and appropriate use of, patient and personal information.” information governance includes all aspects of information legislation, information statutes and principles, records management, IT security and information security. The six original Caldicott Principles instruct; don’t use patient identifiable information unless it is necessary; use the minimum necessary patient‑identifiable information; access to patient identifiable information should be on a strict need‑to‑know basis; everyone with access to patient identifiable information should be aware of their responsibilities; understand and comply with the law. And the three principles of information security are confidentiality, integrity and availability.

KEEPING IT SIMPLE The scale of information governance is a lot to handle for an information security professional never mind a busy doctor, nurse, domestic or carer. Can this all be simplified and made into one clear message that is relevant to NHS staff? For the last 18 months I have been asking two simple questions to groups of clinicians, administrators, ancillary staff, mangers and NHS senior staff. Firstly, what is information governance? Staff generally answer this question as: “It is about keeping information secure, not losing or revealing it inappropriately.” This response shows that 11 years of information governance training and communication has raised awareness about confidentiality. And secondly, what is information? Now this question had a much more interesting response. A large number of blank faces, occasionally “It’s your clinical record”, and on just two occasions, “it’s everything”which is not wrong. Information is like gravity, it is all around you, it affects absolutely everything you do and it is only really noticed when sensitive information is released inappropriately, when critical information is inaccurate, leading to serious incident or when relevant information is not available when required. If individuals don’t know what information is, how can information professionals be confident that we are governing it appropriately? At this point do

we, as information professionals, care? After all people seem to understand confidentiality. CARE IS A GOOD WORD As a noun it is the fundamental basis of the patient based work carried out by the NHS, and it is fundamental to the appropriate governance of information. If you return to the three information security principles, information governance seems to have successfully covered confidentiality. However the principles of integrity and availability have thus far not been commented on. Within my organisation, integrity is handled through a dedicated data quality work stream, with regular information governance involvement as a stakeholder. Our data quality work stream has been running for over twenty years, and it significantly predates the IG toolkit. However, what about availability? Where an individual service requires information that is not passed to them, they simply collect it again by asking the patient, or phoning the GP, or the care home. This does produce data duplication but it does facilitate patient care in spite of the administrative overhead. But when care moves out of individual organisations, we have all witnessed incidents where appropriate information is not supplied. This failure to share information with appropriately authorised individuals has led to very serious adverse patient incidents. So why don’t we share information? I have asked the question, and received a selection of answers: the information is in a paper-based system and we do not have the resources to duplicate it; we do not have the technical ability to share electronic information or the resources E

Written by David Wallis, head of information governance, Wrightington Hospital

INFORMATION GOVERNANCE

tion Informaravity, is like g und you, aro it is all s everything t it affec and is only you do ticed when o really ntive data is sensi ased rele

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Healthcare IT

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Hospital intelligence solutions based on solid, practical working experience within the NHS Provision of healthcare is a complex undertaking, and therefore governance within the NHS is itself complex; it has many aspects. There are levels of governance, such as from running safe wards up to summary reporting on overall trends in patient safety, and areas of governance such as information, risk, incidents, and quality. Redwing has provided assistance in quality and performance reporting for the Vale of York CCG, incident analytics for Greater Manchester West Mental Health Trust, and put in place comprehensive information security and governance processes for the London Commissioning Support Service. The company’s work on information governance provided the framework; incorporating legal rules, best practice, and other guidance, to ensure patient confidentiality was properly protected. Redwing understands that specific areas of governance are vital; integrated governance is also crucial. The company’s primary focus is on acute trusts, and over the last eighteen months has created a new service. It is a set of analytics for integrated governance monitoring and reporting for hospitals. This grew out of

Redwing’s work for Greater Manchester West. The purpose of these analytics is to let people know how we’re doing in relation to patient safety, safeguarding, risks and other indicators. The company has demonstrated its analytics at such events as the National Patient Safety Congress, and Patient First in London. The primary business users of these analytics are hospital Integrated Governance Teams who are charged with helping to promote high quality care at the Trust. High quality care is effective, safe and ensures a positive patient experience. It’s our experience that Trusts strive hard to improve the quality

of care they provide, and Trusts do put quality at the heart of their activities. Measurement is a key component of assessing whether quality care is being provided and quality improvement supported and it must underpin all quality governance processes. Trust Board members need to be able to understand trends and benchmarks; the team needs to be able to drill into the details. The key areas here are incidents (particularly safeguarding), risks, and communications. Redwing’s dashboards and scorecards provide information visualisations – very high level indications of status, trends, and exceptions, that can be drilled into as required to gain maximum insights to ensure proper visibility of timely information to the right audience. Raven, the company’s Rapid Analytics of Events service, gives trusts the right governance information in a simple, timely and straightforward manner. FURTHER INFORMATION If you would like more information, please contact Chris Kelly on 0798 598 8033 or email chris@redwing-bi.com for a briefing sheet on the Raven service.

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INFORMATION GOVERNANCE  to implement new technology; it is not cost effective to implement an electronic solution; information governance says that we can’t. The final answer also answers our starting question – ‘information governance says that we can’t’ – it does not matter if this answer has been provided by a professional or has been assumed by a member of staff in the name of ‘confidentiality’. Information governance has effectively become an obstacle, potentially a toxic brand. So can one turn the governance agenda from security and confidentiality to a basis of information being shared appropriately? Do we have the vision to facilitate the delivery of better, more economically sound patient care whilst ensuring appropriate, efficient, information controls? The Wrightington, Wigan and Leigh Information Governance Service made a start at the recent ‘Think Information Day’ held at the Trust’s Education Centre in Wigan. The term ‘Information Governance’ was mentioned only twice. People were encouraged to think where the organisation is with regards to its current information, how things will change with the introduction of electronic information systems in the future and how this impacts on patient care across a wider health economy where the Trust must share patient information with partner organisations. Staff were encouraged to think about how they use information, and how the information they handle effects the

operation of the organisation and the care of their patients. We were proud to announce a Wigan Borough information‑sharing programme under the “Share to Care” branding, which will start with appropriate legal protection and build information sharing on what will be a secure digital platform. THE INFORMATION YOU HANDLE Sharing information to facilitate care is vital for the future of the NHS as a whole. So, if information governance is to be effective going forwards, should we consider moving away from pressing the message of security and confidentiality? Instead should we encourage people to consider the information they handle, the impact the information has on the organisation and our ability to revolutionise patient care by providing the right information to the right person at the right time? By making care the driving terminology can we better engage with those people who do not recognise information for what it is and who may not perceive information governance in a positive light. We could start by updating the information governance definition: information governance ensures the appropriate use and sharing of clinical and personal identifiable information with appropriate safeguards. We could rearrange the three information security principles; availability, integrity and

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confidentiality. In doing this, information governance becomes a facilitator rather than a restrictor. We do not have to, in any way, abandon our principles of confidentiality and integrity, instead we prioritise principles, assess the requirements and offer solutions that will ensure appropriate, auditable, information sharing. Finally, we could re-publicise the recent 7th Caldicott Principle; that the duty to share information can be as important as the duty to protect patient confidentiality. Now we can start two new staff questions? As a member of staff, do you have easy access to appropriate, accurate information to allow you to perform your job? When you have finished your job and the on-going tasks have become the responsibility of the next service or person in the chain of care, do they have the information they need to carry out their job? Health and Care organisations need to care about information as much as we do about patients. Through a slight alteration to definitions and a simple re-prioritisation of principles we can build a governance structure that will be able to provide confidence to everybody about the state of health information for the foreseeable future? L FURTHER INFORMATION www.wwl.nhs.uk

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Black Pear Software Our customers use our software to reorganise document production processes. This means patients and GPs get information they need faster. Don’t keep doing what you’ve always done. Get in touch today to see how we can help you try something new. Visit our website at www.bighand.com T: +44(0)20 7940 5900

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11.11.2014 15:19:36

EHI LIVE

EHI LIVE 2014: MORE THAN JUST A CONFERENCE

For anyone involved in the use of information in healthcare, EHI Live in November provided a golden opportunity to update knowledge, get answers to questions, meet the experts and think about the future of Healthcare IT EHI Live 2014, at the NEC Birmingham on 4th and 5th November, delivered as the UK’s largest digital health conference and exhibition. More than 3,800 visitors streamed through the doors to listen to the excellent speakers and to learn at an exhibition packed with innovation. The National Information Board plays an increasingly central role in NHS IT in England; as shown by the constant mentions of its forthcoming IT strategy. Opening the show, NHS England’s national director of patients and information Tim Kelsey was keen to present the document as a turning point for IT in the NHS. He commented: “I am optimistic. The NHS is speaking with a single voice on how to build the future, and that is a new

tone on what we have had before. The digital revolution is upon us. We must embrace it.” BRIDGING THE GAP Kelsey, who also chairs the NIB, promised the plan would address the recently released ‘Five Year Forward View’, which sets out to explain how the £30 billion funding gap that could open up between NHS funding and demand by 2020-21 can be bridged. Speakers following Kelsey were keen to share his confidence about the framework’s impact. Andy Williams, chief executive of the Health and Social Care Information Centre, spoke about ‘a revolution coming’ in health IT saying it will provide a guiding light at a national level without stifling local innovation.

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Will Cavendish, the Department of Health’s director general of innovation, growth and technology, said a digital transformation is “absolutely crucial to a high-quality health and social care system that delivers great care within budget.” FROM RHETORIC TO RESULTS Of course, transforming the ideals into reality is another matter. First, the twin pitfalls of bureaucracy and managing implementations and contracts must be navigated, demonstrated by Beverley Bryant and Mary Barber. Bryant, NHS England’s director of strategic systems and technology, apologised for the delay in announcing which trusts have secured grants from the second round of NHS England’s technology fund. Barber, the HSCIC’s CSC local service provider programme director, outlined the risks facing trusts moving off their LSP contracts, with the transition set to unleash significant demand for systems that suppliers might struggle to meet. While NHS England and the HSCIC are working on a number of initiatives, Barber was not shy about outlining the scale of the task ahead. “I have been involved in change management for many years and if I really thought about this I would not sleep at night,” she said, adding that the only way forward was for trusts to work together, to make sure that not only the “headline” grabbing organisations ended up with the IT they need. E

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BDS Solutions – your partner in technology

Captive Health – in tune with the keynote

BDS Solutions enjoyed overwhelming interest in their Directory Manager™ and SpecOps™ identity management and self-service password reset solutions and the topic of XP support end of life brought their Windows 7/8 Desktop Migration Services to the fore at EHI Live. BDS is a leading technology partner for public sector organisations throughout the country, delivering quality IT products and services to enable organisations to fully harness the potential of today’s technologies. The company’s main market focus is the NHS, where it has earned a strong pedigree and reputation, with experienced solutions architects and consultants delivering a diverse range of projects ably supported by an N3 enabled service desk providing 24x7 third and fourth line support services. The company is ISO9001 accredited and all project work undertaken is delivered

Speaking at EHI Live, the Keynote speaker Tim Kelsey gave a passionate address on innovation in healthcare. Considering the ways in which people can take control of their wellbeing, he called for a technology revolution that has the mission of putting people first, at its heart. Captive Health is proud to be at the forefront of this trend. With the platform Patient Connect already getting the attention it deserves, the company is at EHI Live for the launch of Staff Connect, the suite of innovative staff engagement solutions. Captive Health is proud to share the podium at EHI Live. Speaking on behalf of Mike Meers, Chief Information Officer at The Ipswich Hospital NHS Trust, Captive Health’s Andrew Cockayne addressed the audience on the topic ‘Apps in Use’. Staff Connect provides an important staff engagement mechanism, helping the Trust get it right for every patient who walks through

using proven methodologies and best practices based on PRINCE2. Key partners such as Microsoft, VMware, Citrix and Dell provide strong alliances, to ensure BDS have long-term working relationships to help plan for business change and future proof technology. FURTHER INFORMATION Call 01884 33440 to schedule your on-site Directory Manager™ presentation that will demonstrate how ESR integration can help manage your IT infrastructure. Web: www.bds-solutions.co.uk

the hospital’s doors. About half of the Ipswich Hospital Trust’s staff members regularly work away from a desk or PC. Trusts need to find creative ways of communicating with their staff, and make sure they have the tools to do the job. Staff Connect provides a solution to this problem. Bold and innovative future plans include adding Staff Insight and Staff Portal. With Patient Connect and Staff connect it is clear that The Ipswich Hospital and Captive Health are in tune with the keynote. FURTHER INFORMATION Tel: 0207 422 8260 info@captivehealth.co.uk www.captivehealth.co.uk

Mazepoint: Helping to improve performance

RFiD Discovery performs well for EHI Live visitors

Mazepoint has been improving performance for organisations such as NHS Trusts since 1998, with easily deployable and intuitive business intelligence solutions such as Tableau. The overiding objective of this system, as well as Mazepoint’s comnsultancy service, is to collect performance data from multiple sources and systems, model it and use it to create informative reports, dashboards and analysis that customers can use to solve problems and reveal insights that drive value. Mazepoint also enables customers to do this for themselves. Ella Worsdale of the Pennine Care Trust said of Mazepoint: “Since meeting Mazepoint at EHI Live, we quickly decided

Harland Simon had a successful EHI Live event promoting radio frequency tagging in the healthcare sector based upon an increasing number of acute hospitals using its RFiD Discovery solution to track mobile medical devices. It was no surprise to find that the tracking and efficient utilisation of beds and mobile medical devices was a topic of discussion with NHS visitors. RFiD Discovery system is an active and passive RFiD tracking solution which has grown in popularity with the acute sector over recent years. It has an attractive price tag and offers NHS hospitals the opportunity to use radio frequency technology and get tracking projects started to help drive improvements in performance, safety and deliver financial benefits. Cambridge University Hospitals NHS Foundation

that Tableau was the right solution for us to speed up our analysis processes. Combined with Mazepoint’s consultancy we have immediately gained value from our data and it will also help us to design the path forwards for the entire Trust”. Steve Adams, General Manager at Mazepoint says: “At EHI Live 2014 we met a number of NHS organisations, all with a common desire to do things better and quicker by putting information and analysis into the hands of the people that can make a difference”. FURTHER INFORMATION Contact: Steve Adams Tel: +44 (0)20 7348 7600 www.mazepoint.com

HEALTH BUSINESS MAGAZINE | Volume 15.1

Trust was an early adopter of RFiD solutions and has a number of projects running at Addenbrookes Hospital. The medical device team there use a combination of active and passive RFiD to track their equipment and now have over 6,500 active tags attached to mobile medical devices including; beds, pumps, mobile monitors, infusion pumps and rental equipment. FURTHER INFORMATION Tel: 01908 276752 andrew.james@ harlandsimon.com

EHI LIVE  TWEET TALK Outside the conference theatres the exhibition hall was buzzing, with a new area hitting big. EHI Live 2014 witnessed the birth of a new measure of success in the rapidly expanding sphere of social media in healthcare. The ‘selfie stakes’ – which speakers were most in demand for pictures that could be Tweeted to excited followers? Tim Kelsey, long seen as the champion of new digital services, hardly came near the top. Instead, visitors were lining up for selfies with Dr Ranj, star of CBeebies’ ‘Get Well Andy Soon’ and social media together with tweets chief enthusiast. Dr Ranj, a from exhibitors and Williams, of the e iv London paediatrician, delegates made Twitter t u c exe ial c o admitted his ‘addiction’ coverage of the show S d n a Health rmation to social media came on soar to the point where after he started taking are Info about ‘a #EHILive was trending C on TV appearances while above Taylor Swift! oke Centre, spion coming’ The show delivered working in a children’s intensive care unit. something for everyone, revolut alth IT “I started thinking from the variety of in He about social media as a debates on topics such promotional tool. I thought I as whether ‘the skills and would use it so people know what attributes required to be an expert I do. It was only when a friend said: ‘Why Informatics Professional are mutually don’t you turn it around and offer something incompatible with those required to provide to people?’ that it really took off.” the transformational Leadership necessary Roaming tweeters from @WeNurses, to take the NHS into the Digital Age’ to

the Care Pathway Challenge, Open Source Skunkworks and the HANDI App Café. Feedback has been very positive. Exhibitors comment on the quality of conversations it enables with one remarking; “We’ve searched for years for a great exhibition to exhibit at and EHI Live is the one for us. We have cut back most events to so we can plough efforts into this. The level of decision makers are great”. And one delegate summed it up nicely as the place for ‘meeting old colleagues and new products’. L FURTHER INFORMATION Next year’s show takes place at the Birmingham NEC on 3-4 November. For further information, visit www.ehilive.co.uk

Ethitec – achieving paperless through IT

Bespoke medical apps for a more connected world

One of the dominating themes of EHI 2014 was how to meet the Health Secretary’s challenge to ‘go paperless’ by 2018. This was the subject of a pipeline seminar given by Frimley Park Hospital’s Occupational Therapy (OT) Manager, Val Sharples. Here, Sharples explained how the introduction of the Tiara9 clinical information management system allowed OT to dispense with paper completely, and is enabling the Trust’s wider Therapy services to deliver on this goal. In fact, Tiara9 has enabled a diverse range of healthcare organisations to operate in an entirely paperless way for over a decade. Tiara9 supports full EPR (electronic patient records), providing each patient with a single record that can be viewed by multiple clinicians and constantly updated (including after community outreach sessions). Real-time clinical information and reports also facilitate more effective service

Black Pear Software is a market‑leading provider of interoperable, smart clinical applications for iPads, tablets and desktops, currently integrated with GP and other healthcare systems. Building on their successes of GPSoC Lot 1 and 2 contracts and the development of Vision Anywhere, the first native iOS app for GPs, Black Pear is now delivering ‘First of Type’ integrated care projects across CCGs, supplying service‑specific apps with data access, sharing and eReferral services. These new services are aligned to the objectives set by the Prime Minister’s Challenge Fund and the new National Information Board strategy. For example, Black Pear’s Urgent Care Centre eReferral service, aimed at extending primary care availability, enables the secure seamless booking of appointments from any GP practice or location into one or more Urgent Care Centres

management. For example, by monitoring which wards were busiest and when, OT was able to halve its response times without increasing staff, through more effective deployment. Tiara9 is fully Choose & Book (CaB) e-Referrals accredited (key to the paperless strategy), and is currently being used by GPs to book appointments with Frimley Park therapy services directly. FURTHER INFORMATION Tel: +44 (0) 116 2470 806 www.ethitec.com

EHI Live

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

or home visit services. Patient records are sent at the time of booking and consultation outcomes returned to the referring GP immediately post appointment. This powerful simple process is easily adapted for use across many different health care services including additional pathway-based apps to capture data anytime anywhere, e.g. telehealth, dementia and palliative care EPaCCS services connecting GPs, ambulance services, out of hours, hospices, acute trusts and community nurses. FURTHER INFORMATION www.blackpear.com

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The power of together.

C O L L A B O R AT E AC R O SS T H E T E A M

IT powered the teamwork that helped save Sarahâ&#x20AC;&#x2122;s life. Remarkably, it was an IT platform that brought the right team of healthcare professionals together for Sarah. They were able to collaborate with full access to her diagnostic data. The result? Sarah got the life-saving care she needed in a timely, efficient and cost effective manner.

Thatâ&#x20AC;&#x2122;s the power of together.

Experience the power of collaboration at carestream.com/together

PATIENT RECORDS

CARESTREAM PLATFORM TAKES VNA TO NEW LEVELS OF PERFORMANCE

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Consolidate islands of storage and present a single point of access to entire patient clinical records with a true vendor neutral archive from Carestream Health UK Many healthcare providers today jump from one data island to the next, laboriously capturing and analysing information as they go. Vendor Neutral Archives (VNAs) promise to bridge those islands with a single point of access to varied and different sources of clinical data. But to make healthcare truly efficient and patient care more effective, VNAs must offer an open architecture that can combine multiple sources of different kinds of clinical data and do so easily, reliably and securely. They must allow data access not only to those who care for and manage patients but to those who receive care and reimburse for it. And they must provide access without interrupting each departmental workflow. VUE FOR CLINICAL COLLABORATION PLATFORM At EHI Live 2014, Carestream Health showcased a solution that consolidates multiple silos of information, reduces costs, and helps improve patient care. Called the Vue for Clinical Collaboration Platform, this platform intelligently collects and exchanges data to create a patientcentric record for healthcare providers, as well as managers, third party payers, and patients. It provides this access securely and quickly without changing departmental workflow. Differentiating Carestream’s approach is the extension of data access beyond traditional bounds. With MyVue, patients can securely access their own data and share data with other physicians. Built from zero-footprint technology, MyVue can also be deployed as a stand-alone viewer or embedded into an EMR patient portal. Building on this concept of extended access, Carestream’s Vue Beyond gives healthcare providers the operational data they need to submit quality or reimbursement reports. Presented as a real-time dashboard, this insight enables administrators to make timely decisions and gauge departmental performance with such indicators as study volume and modality mix. Other metrics include report time, service delivery, or critical results notification, all of which can now be obtained through the Clinical Collaboration Platform. Embedded in this Platform is Carestream’s Vue Motion universal clinical viewer, which allows providers access to clinical data as

it facilitates teleconsultancy with remote specialists. Multi-media reports can be accessed through embedded hyperlinks to key findings, which are accessible trough mobile devices using Vue Motion. The Platform also expands information exchange by allowing clinical images to be shared outside a health system, and can be used as part of regional exchanges or Healthcare Information Exchanges. Vue Archive is the cornerstone of the Vue for Clinical Collaboration Platform. This highly advanced VNA seamlessly merges DICOM and non-DICOM data from disparate imaging systems into a single repository using the latest interoperability standards. The zero-footprint Clinical Acquisition Management portal supports ingestion from mobile devices (such as a web-camera used during tele-consultancy for dermatology), and can be embedded within an existing EMR or even medical video grabbers. Paired with Vue Motion, the portal enables access and display across and beyond the enterprise of all types of clinical data, including 3D/MPR images, reports and streaming video. BENEFITS Several organisations are already reaping the benefits of this Platform. Among them is Reggio Emilia Hospital (A.O. Santa Maria Nuova IRCCS), a 900-bed research institute and reference hub to five satellites in Northern Italy. Together they conduct more than 220,000 imaging exams annually. More than 160,000 are non-DICOM. Since installing the Platform, the hospital and its satellites can manage all types of media throughout the enterprise with no changes in departmental workflow. Our Vue for Clinical Collaboration Platform manages the life cycle of these

patient records, not just the files. Tiered storage and back-up ensures performance according to the value of the clinical data. Its VNA, Vue Archive, utilises CrossEnterprise Document Sharing (XDS), as well as XDS-i, DICOM, and HL-7. To ensure data integrity, Vue Archive supports Master Patient Index (MPI), Patient Identifier Cross-Reference (PIX) and XDS Registry. Recognised by IHS as the third largest global VNA, Vue Archive can minimise the cost for migration when deployed on-site or in the cloud, since there is no exit fee. Its patient-centric records can include imaging exams, reports, videos and JPEG images generated by diverse clinical areas including dermatology, endoscopy, radiology and cardiology. This is done through data work at the meta-data level, using a web-based Clinical Acquisition Management portal (works in progress) to integrate with existing solutions and ingest data via XDS-adapters, HL7, DICOM, File Share or standards-based Web Services. In summary, Carestream’s Vue for Clinical Collaboration Platform stores a variety of clinical data; accommodates multiple ancillary systems; and manages large volumes of clinical data quickly and easily. Clinical data is shared within and outside the enterprise with healthcare providers, managers, third party payers and patients. This helps avoid data replication, minimises exam duplication, and puts information in the hands of those who need it when they need it. This helps make healthcare both more efficient and more effective. L FURTHER INFORMATION www.caresteam.com

Volume 15.1 | HEALTH BUSINESS MAGAZINE

ELECTRONIC OBSERVATIONS

MOBILE HANDOVER

CLINICAL ASSESSMENTS

Nervecentre helps support clinical processes to improve patient safety and outcomes

TASK MANAGEMENT

HOSPITAL AT NIGHT

Nervecentre Software uniquely provides a whole hospital platform that can deliver electronic observations, handover, task management and clinical assessments; and allows governance and escalation management to be added to any hospital process. Our solutions are platform independent and integrate into a hospitalâ&#x20AC;&#x2122;s existing IT and PAS systems. The innovative handset independent applications function with all mobile devices.

Using Nervecentre Software on electronic devices has enabled University Hospitals of Leicester NHS Trust to significantly improve communications and enabled improvements in the care and management of patients.

INSTANT MESSAGING

BED MANAGEMENT

JULIA BALL, Assistant Chief Nurse, University Hospitals of Leicester NHS Trust

For more information or to arrange a demo please contact us.

sales@nervecentresoftware.com

0118 974 0128

www.nervecentresoftware.com

PAPERLESS TECHNOLOGY

TECHNOLOGY TO SUPPORT NURSES UNDER PRESSURE During 2013/14, University Hospitals of Leicester NHS Trust (UHL) treated 1,194,000 patients (or 3,271 patients per day). With the volume of patients set to rise year-on-year, we need to better equip our staff to cope with the additional pressures that will bring. As in many other trusts, our staff are feeling the pressure of the NHS constantly being in the media spotlight. The media focus for many trusts is too often on poor outcomes. It is almost forgotten that the vast majority of hard working staff provide excellent world-class patient care. The media have been blinded by the string of high profile cases which have brought our great service into disrepute. What they fail to pick up on, is the really positive work that many trusts such as UHL are doing, not only to improve patient care but to better support their staff without which there would be no NHS. 15 months ago our chief executive, John Adler, took on the challenge of boosting morale. He recognised that in order to achieve our strategy to become ‘paper light’ and with government targets to consider, we needed to listen to our staff on the frontline. In 2013 he introduced ‘Listening in to Action’ forums. These forums, which he personally chairs, invite staff to give direct feedback on what they find good and bad about their jobs, so that the trust can make things better for staff and their patients. The overwhelming feedback has been frustration about the amount of time spent on paperwork and the subsequent impact on patient care. Staff want less paper and more technology to support them in their roles.

FUNDING PROGRESS We had already started to look at improving workflow processes by implementing new technology but funding was limited, so when the Nursing Technology Fund was announced, we immediately applied. We received over £600,000 from the first tranche, which was set up to allow trusts to buy technology for nurses, midwives and care staff. This boost of funds has allowed us to accelerate our ability to deliver on our ‘paper light’ promise. Our application focused on using mobile technology to change working lives. The funds are being invested in the provision of mobile devices, such as iPads and iPhones for staff use, as well as Nervecentre mobile application software, designed to record vital signs. One of the biggest challenges facing staff in the NHS is effective and efficient recording of observations as well as handover at the end of shifts. This is particularly prevalent during out of hours where ensuring consistency and continuity is often more challenging. Our initial project, to deploy Nervecentre’s electronic observations, handover and Hospital at Night solutions has already seen a number of key benefits but the mobile aspect of our new solution is absolutely crucial. Nurses can now carry out routine observations using a handheld device, with that data being instantly available to all staff responsible for that patient’s care. The key benefit is targeted messaging to services and clinicians who can use that information to identify deteriorating patients.

as they are able to better use their skills for caring, and our patients are happier as they feel they are getting a better service. What has made UHL’s approach so successful is the involvement of our staff. Clinical engagement is imperative when implementing a major change to working practice. We achieved this by selecting five ‘pioneering wards’, to work closely with our project team to provide suggestions and feedback in how best to use the software for their needs. You can never underestimate how good it makes people feel to be involved in projects that are going to make a fundamental difference to providing care. Our staff had tried to make the best of our existing workflow, working around any difficulties rather than instigating change. By acting upon their feedback and demonstrating our commitment to them, we have an incredibly powerful message – we have listened and have acted. That simple change in culture to focus on better support for our staff has helped us boost morale and as a result has had a positive impact on patient outcomes. By focusing on getting the implementation right within the pioneering wards, we anticipated that the roll out across other areas of the hospital would be very rapid. Staff from these wards are ‘champions’ for the new system. Nursing and medical teams on some wards are ‘buddying up’ with our champions to draw on their knowledge and experience of deploying a new system whilst they themselves go through the implementation. This is a very powerful way of working which has produced strong advocacy for the new system. We have also been proactive in our formal internal communications activities and together the results have been staggering – the number of system users is continually increasing in frequency and I have found consultants and nurses knocking on my door asking when they are going to get the software. L

Nurses can nowutine u t ro carry o tions using observaheld devide, a hand t data being a with th tly available instan l relevant to al ff sta

SUCCESSFUL ENGAGEMENT Nurses no longer have to spend hours chasing updates by phone. As a result staff are more visible to their patients, spending more time at their bedside. Our staff feel content

Written by Julia Ball, assistant director of nursing at University Hospitals of Leicester NHS TRust

With one million patients every 36 hours and continual pressure from national targets, are NHS staff given enough support to deliver high quality patient care? Julia Ball of University Hospitals of Leicester NHS Trust shares how listening to staff calls for less paper and working closely with clinicians on IT implementations can lead to better outcomes for patients

Mobile Technology

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FURTHER INFORMATION www.leicestershospitals.nhs.uk

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HB Awards 2014

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Medical billing for Decorative Panels healthcare professionals Lamination cleans up with made easier by Medibooks dp-BioCote Quartz Introducing Medibooks Medical billing for Healthcare Professionals. In an ever changing NHS landscape saving time and money are of significant importance to Practice Managers and GP’s. Medibooks is a way for practices to streamline a very paper led process while enabling anyone in the practice to create an invoice and locate prices. Have you ever lost track of payments and found out you have not charged for a bill you should or could have? Medibooks shows you how to never miss another bill or payment again and stay in control of your aged debt. Most practices charge for travel vaccinations, LGV licence renewal, Pre-employment medicals and many more services.

Medibooks can help you streamline and manage these charges allowing you to save time with a fully integrated system customised to your individual practice needs. Medibooks is fully integrated with EMIS which removes any double entry requirements and you can create invoices in three clicks. FURTHER INFORMATION For more information about a 30 day trial or to view a demo of the software contact: Mark Cobby on 01534 761795 or email sales@medibooks.net

Telephone-access ready around the clock Voice Connect is a specialist integrator of computer and telephony solutions. Working in partnership with EMIS, INPS, SystmOne, FrontDesk and Microtest, Voice Connect has been providing original cost saving systems to the NHS since 1991. Its products are also deployed in the public, charities and business sectors. Patient Partner, Voice Connect’s 24/7 automated booking system has become an essential part of any practice’s access strategy, proven to reduce DNAs, extend out of hours options, improve patient access and reduce A&E attendances. It works to support hardworking reception teams, reducing the amount of calls they take, freeing them to help patients at reception. Recent developments such as telephone triage and GP card payment solutions continue to support Voice Connect’s reputation as an innovative, cost saving solution provider to the healthcare sector.

Voice Connect’s product range also includes Medical Messenger, an enhanced email and texting service which automatically sends appointment confirmation and reminders and is perfect for mass campaigns. VC SmartMail (a GP specific letter mailing service), Patient Echo (call recording for practices), VC LoneWorker (a staff safety service), Automated 24/7 telephone repeat prescription ordering and a sexual health triaging system, are all part of the large range of healthcare specific Voice Connect products. FURTHER INFORMATION Tel: 0116 232 2622

HEALTH BUSINESS MAGAZINE | Volume 15.1

During 2014, working as a partner company with BioCote, Decorative Panels Lamination launched a range of commercially available sheet materials that offer exceptional abrasion and antibacterial properties. The manufacturing process of the surface material and the addition of the BioCote additive, results in the surface being highly abrasion resistant. When tested against resistance to clinical cleaning products DP-BioCote Quartz sees excellent results in all areas. Tests have shown that within just 15 minutes microbrial contamination has reduced by up to 80 per cent and that after two hours reductions of up to 99.9 per cent can be expected. BioCote has been proven effective against a wide range of clinically significant bacteria including MRSA, MSSA, E.coli, Legionella

pneumophila, Pseudomonas aeruginosa, Salmonella typhimurium and enteritidis, Listeria monocytogenes, VRE, Campylobacter and Novovirus. Very significantly the BioCote additive not only acts in minutes, it also works continuously and lasts a lifetime – it does not degrade. The DP-BioCote Quartz range comprises of three decors – Oak, Maple, Beech and three unicolours – White, Grey and Cream. This is available for lamination across the extensive range of substrate materials. FURTHER INFORMATION 01484 658341 info@decorativepanels.co.uk

Specialist patient transport and courier services from ERS ERS Medical provides a range of specialist patient transport and courier services to the NHS and the wider healthcare sector. One of the UK’s largest independent healthcare service providers, ERS Medical completes over 1.5 million journeys a year and delivers a nationwide service from over 30 operational bases across the UK. A comprehensive fleet of ambulances and medicars and the expertise of over 1,500 staff – including paramedics, technicians and nurses – provide healthcare organisations with a suite of flexible 24-7-365 transport options and clinical expertise. ERS Medical delivers a national, 24-hour, 365 days a year urgent response service for the movement and care of people with mental health illness. The ERS team has over 20 years’ experience in providing a professional, reliable and compassionate service

managing vulnerable and challenging behaviour safely and with dignity and respect. All transport requirements are met with highly trained, dedicated crews and vehicles to ensure a safe, comfortable and timely transfer of service users. Its specialist teams consist of healthcare assistants, registered mental health nurses and escorts with expertise in areas including learning difficulties/ disability, autism and aspergers, dementia, plus child and adolescent mental health. FURTHER INFORMATION Visit: www.ersmedical.co.uk Tel: 0333 240 4999

HB Awards 2014

NHS DOES THE BUSINESS

Held in December, the Health Business Awards recognised examples of best practice and excellence throughout the NHS Before the NHS began to experience what has turned into a difficult winter. the winners of the 2014 Health Business Awards were revealed at the Grange Hotel, London in early December. Sixteen NHS organisations were recognised for their progress across a range of categories. Presented by practising GP Dr Sarah Jarvis, also the health and medical reporter for BBC’s The One Show, the Health Business Awards promotes examples of excellence and best practice in Hospitals, Trusts, Clinical Commissioning Groups and other organisations that work inside and alongside the NHS. Frimley Health NHS Foundation Trust was presented with the Outstanding Achievement in Healthcare Award after becoming the first NHS organisation to receive an Outstanding rating following the new style Care Quality Commission inspections. Other winners included Chorley and South Ribble Clinical Commissioning Group, which was the first recipient of the Clinical Commissioning Award after partnering with Greater Preston CCG. The collaboration has helped deliver patient care closer to home by enabling minor operations to be carried out in local GP surgeries, reducing the number of lengthy hospital stays. ESTATES AND FACILITIES INNOVATION Winner: North Bristol NHS Trust – Hospital Move project This Trust oversaw the successful move of a major hospital from Frenchay to the Brunel building at Southmead Hospital Bristol. Clinicians working in the Trust have praised the state of the art Brunel building, which has the potential to improve privacy and dignity for patients with single rooms, en-suite

facilities and a dedicated route through the hospital which means they do not have to be taken past members of the public before or after their operations. This complicated procedure involved the transfer of services including a major trauma centre, accident and emergency, neurosciences, plastics and adult burns. Most elements of this move were staggered in key stages over the month of May, with the closure of Frenchay A&E and opening of the new department in Southmead done on the same day. HEALTHCARE IT AWARD Winner: University Hospitals Birmingham NHS Foundation Trust UHB has won much praise for its Prescribing, Information and Communications System (PICS), allowing patients and carers to access information through the use of technology. PICS is a rules-based clinical decision support system that operates throughout the Trust in all inpatient, outpatient and daycase areas, including ITUs. It is regularly updated with input from clinicians. HEALTHCARE RECRUITMENT AWARD Winner: Plymouth Hospitals NHS Trust The Trust’s Recruitment and Resourcing Team has worked hard to redesign their approach to recruiting Healthcare Assistants, which resulted in the appointment of more than 120 new members of staff; many of these staff have achieved a qualification and full clinical competence sign-off, a reduction in the recruitment time and also a reduction in the amount spent on agency staffing. The strategy involved an external advert placed on NHS Jobs, supported by coverage in local media, which led to open days where

applicants were assessed for their suitability. The semi-annual campaigns reduce the recruitment time spent by Clinical Nurse Managers by two thirds and the vacancy to appointment time has been reduced by six weeks, thus reducing agency spend. HOSPITAL BUILDING AWARD Winner: Morgan Stanley Clinical Building: Great Ormond Street Hospital The Morgan Stanley Clinical Building is an important element of Great Ormond Street’s redevelopment plan to ensure patients receive world-class care in 21st century facilities. It is hoped that the new building will enable the hospital to treat up to 20 per cent more children and advance pioneering translational research programmes. The building spans 18,500m2 and forms an important element of Great Ormond Street’s major redevelopment plan to ensure patients receive world-class care in 21st century facilities. HOSPITAL CATERING AWARD Winner: Nottingham University Hospitals NHS Trust 77 per cent of NUH’s raw ingredient spend is now on local ingredients. Meat, fresh produce, bakery products and milk are all sourced locally, ensuring security for local suppliers and helping the local economy. Switching to local suppliers has been cost neutral and allowed the Trust to invest £2 million per year in local sustainable businesses and improved focus on patient health. INNOVATION IN MENTAL HEALTH Winner: Pennine Care NHS Foundation Trust: Flo telehealth text / Healthy Minds The Trust has done much to improve mental E

Volume 15.1 | HEALTH BUSINESS MAGAZINE

HB Awards 2014

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Austco – delivering state of the art nurse call Austco is a leading global provider of nurse call communication technology and software solutions for environments where communication is critical. Founded in 1986, Austco serves over 8,500 sites across 60 countries. With solutions designed to comply with global Healthcare standards, Austco aims to maintain the highest level of integrity and dedication, using reliable hardware and forward thinking software solutions, to help its customers improve efficiency, cut costs and successfully exceed duty of care requirements. The company’s flagship solution Tacera, helps facilities provide the highest level of

care and service, through the advanced use of technology, real-time conversational interactions and the introduction of intelligent operational processes. The flexibility of Austco’s solutions allows the company to integrate together various technologies enabling its customers to benefit from a truly complete care communication and management solution. Headquartered in Melbourne, Australia, Austco has offices in New Zealand, Singapore, the UK, North America and Canada, with manufacturing facilities in Perth and Dallas USA. FURTHER INFORMATION Tel: 01527 877 778 sales.uk@austco.com

Providing cost effective and scalable solutions for your information Designed and built with NHS practitioners using Microsoft’s latest .NET technologies, CCube’s award-winning solutions deliver electronic health records to clinicians, secretaries and administrators in the format they require, when and where they are needed. CCube is already delivering measurable benefits to over 25 NHS Trusts, helping to deliver paperless healthcare within 18 months. CCube’s suite of Electronic Document & Records Management (EDRM) products include modules which can be tailored to suit Trust needs and can be expanded from departmental to hospital and Trust-wide solutions for scanning, managing and accessing patient notes, with automatic classification. This includes integration with multiple back-end clinical systems. With Workflow and Electronic Forms, the solutions are designed to

automate defined processes, including data entry, without any dependency on paper. The .NET technologies support use of mobile tablet devices for access and for data entry. Developed with the NHS and utilising an open, client/server architecture, the CCube suite is customisable, fast to deploy, easy to integrate, scalable, standardsbased, feature rich and compliant with current legislation and data protection rules. The system supports full security controls, document retention & disposal, and comprehensive auditing. FURTHER INFORMATION Tel: 01908 677752 info@ccubesolutions.com

Adding flavour to the food service providers

Park Mark: Parking made safer for everyone

Bosse Interspice source, blend and distribute a multiplicity of food seasoning and flavour ingredients, and culinary herbs and spices. It also makes and distributes a range of foodservice products and instant food mixes suitable for application at ward level. The range of products include soups, bouillons, gravy mixes, coaters, breaders, glazes, marinades, flavouring and decorating sauces, salad dressings and desserts. Bosse Interspice’s instant soups, sauces, gravies, and custard mixes are low in salt and sugar and are gluten free, including instant cakes mixes. The instant products are renowned for their great taste and mouth-feel and visual appeal. They’re quick and easy to use and ready to serve in just two minutes at ward level and CPU.

The Safer Parking Scheme is an initiative of the Association of Chief Police Officers aimed at reducing crime and the fear of crime in parking facilities. Safer parking status, Park Mark, is awarded to parking facilities that have met the requirements of a risk assessment conducted by the police. These requirements mean the parking operator has put in place measures that help to deter criminal activity and anti‑social behaviour, thereby doing everything they can to prevent crime and reduce the fear of crime in their parking facility. In the UK, a quarter of car parks have achieved the Park Mark Award. That’s 5,000 of an estimated 17,000 - 20,000 car parks across the country where people regularly park

Customers are offered an array of ‘added-value’ services from food preparation, cooking tips, and recipe ideas to advice on food technology, processes and methodology for customers in the food processing and manufacturing industries. Bosse Interspice regularly works with NPD teams to help them formulate new and exciting recipes for specific product applications and ethnic flavour formats for those competing in home and export markets. FURTHER INFORMATION www.bosse-interspice.co.uk

HEALTH BUSINESS MAGAZINE | Volume 15.1

their vehicles. Most car parks are safe places, most of the time. But not all of them are. Park Mark helps you tell the difference. Accredited car parks can be found at train stations, hospitals, universities, town centres, shopping centres, leisure centres, airports, supermarkets, banks and office blocks. The smallest car parks have 10 spaces, whilst the largest have up to 13,000. You can find them in cities, towns, villages and tourist attractions. FURTHER INFORMATION Tel: 01444 447 300 www.parkmark.co.uk

HEALTH BUSINESS AWARDS  health services in the Pennine region, with the Healthy Minds scheme helping sufferers of depression and anxiety to access online self-help courses, therapy sessions and group workshops. Attendees are given between‑session support with homework tasks. Service users in Tameside and Glossop have also benefited from a text message‑based support system, which saw mental wellbeing self-rating shoot up by 22 per cent. NHS COLLABORATION AWARD Winner: East Lancashire Hospitals NHS Trust / Lancashire Constabulary: A&E Liaison This partnership has seen two highly trained and skilled police liaison officers being placed in the A&E department of Royal Blackburn Hospital. This forms part of a project which aims to deal with frequent attendees and better improve the individuals’ access to health and care services which best meet their needs. PATIENT DATA AWARD Winner: North West Ambulance Service NHS Trust: Electronic Referral Information Sharing System NWAS’ Electronic Referral Information Sharing System (ERISS), which now has over 2,000 registered users, aims to transform the ways in which patient information is shared between doctors, clinicians and ambulance crew, meaning patient care can be delivered at the right time in the right place. The system helps to protect vulnerable patients and reduces the number of unnecessary ambulance calls by making it easier for doctors and clinicians to flag up any conditions or care plans a patient may already have. PATIENT SAFETY AWARD Winner: Great Ormond Street Hospital Foundation NHS Trust The team at Great Ormond Street has won accolades for its project, ‘Pursuing zero by building hospital foundations for safety’. The programme is an attempt to reach ‘zero harm’ in healthcare, an ambitious target. It is led by 10 senior members of staff, who are given a day a week to work on patient safety. Staff work to achieve a range of outcomes, including to reduce unnecessary delays, maintain high levels of medication safety and eliminate hospital acquired infections. TELEHEALTH AWARD Winner: Stoke on Trent Clinical Commissioning Group/Partners Stoke-on-Trent CCG’s Simple Telehealth (STH) is an intuitive, personal, self-monitoring and alerting tool which uses familiar mobile phone SMS text messaging to collect patient observational data and offers real time advice or guidance to the patient according to the information sent in. Simple Telehealth is affordable and deployable on an unequalled scale across an unrivalled

Dr Sarah Jarvis

range of conditions and pathways with the SMS text messaging free to patients signed up. Simple Telehealth and its licensed service ‘Florence’ (Flo) is a multi-award winning NHS innovation developed and owned by the NHS. The system helps to: improve adherence with treatment regimes through encouragement, reminders and interactive contact and to boost clinical productivity. TRANSPORT & LOGISTICS AWARD Winner: St Helens and Knowsley Teaching Hospitals NHS Trust St Helens Hospital has taken steps to improve the visitor and staff car parking experience and to help create a more sustainable, user‑friendly parking regime. The system uses a new IP- based operating system architecture that enables it to simply and directly connect with multiple technologies being deployed in hospitals and their car parks both now and in the future. This technology has cash and card handling options and can accommodate newer payment technologies in addition to barcoded tickets, staffsmart cards and automatic number plate recognition (ANPR). It offers a streamlined, regular parking service to patients, visitors and staff, and frees up parking staff to perform vital tasks. The ability to integrate control of the St Helens Hospital parking with the future parking needs of Trust was a key consideration. AIR AMBULANCE SERVICE OF THE YEAR Winner: Dorset and Somerset Air Ambulance In Spring 2013, DSAA paramedics began an educational programme to obtain a post‑graduate qualification in Advanced Paramedic Practise (Critical Care), with training taking place locally. Hospitals provided short placements to enable paramedics to gain first-hand experience of conditions and treatments that they do not necessarily come across on the air ambulance. AMBULANCE TRUST OF THE YEAR Winner: West Midlands Ambulance Service West Midlands Ambulance Service has a reputation as one of the leading NHS organisations in the UK. Formed in 2006 following a merger of four ambulance

HB Awards 2014

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

services in the West Midlands, the Trust has progressed to a high performing emergency service attaining foundation trust status in 2013. WMAS serves a population of 5.6 million who live in the areas of Shropshire, Herefordshire, Worcestershire, Warwickshire, Staffordshire and the Birmingham Coventry, Solihull and Black Country conurbation. Successful projects include the implementation of an ambitious £10 million ‘Make Ready plan throughout the region which has resulted in clinicians having their vehicles refuelled, cleaned and restocked in readiness for duty, and the introduction of a range of services that drive down A&E admission rates. NHS PUBLICITY CAMPAIGN AWARD Winner: NHS West Suffolk CCG – Emergency Department Cinema Campaign West Suffolk teamed up with NHS Ipswich and East Suffolk CCG to put together an advertising campaign screened in an Ipswich cinema that encourages people to use hospital emergency departments appropriately and consider other healthcare options, such as pharmacies, GP surgeries and the NHS 111 phoneline. The hard-hitting film shows the possible consequences when a hospital emergency department is used by patients for the treatment of minor injury and illness, highlighting what could happen when emergency department staff are treating minor health issues instead of a seriously ill young girl. The advertisement was commissioned to run at the Cinema during the busy winter period when there is extra pressure placed on the NHS and its staff. 2015 EVENT The Health Business Awards will continue to recognise examples of excellence in the NHS. For 2015, the event will once again be held in December. Entry is free of charge to all NHS organisations, and requires the submission of a 500-word NHS statement, which can be completed online. Entry is open from January 31st and closes on October 1st. For further information, visit the event website at www.hbawards.co.uk

Volume 15.1 | HEALTH BUSINESS MAGAZINE

Two-way radio systems with ‘more than just voice’ Direct Telecom Services are an award‑winning provider of two‑way radio solutions. Established in 1988, Direct Telecom Services supplies, integrates, hires and maintains two‑way radio solutions throughout the UK. Committed to meeting customers’ needs in a fast, but safe and effective manner, a dedicated team of professionally trained staff with a comprehensive knowledge of the vast product portfolio often exceed our client expectations. Whether you need simple radio to radio communication system, or a system featuring GPS, lone worker protection, fire alarm and telephone integration, detailed advice can be obtained from a member of our team.

Direct Telecom Services Ltd, Barham House, Barford Road, St. Neots, Cambridgeshire PE19 6YQ T: 0800 542 7860 E: info@dts.solutions W: www.dts.solutions

WORKPLACE SAFETY

WHAT ARE THE OBSTACLES TO WORKPLACE SAFETY?

Slips, trips and falls at work are collectively the single most common cause of injury in UK workplaces. Health and Safety Executive (HSE) stats for Great Britain for 2012/13 show that there were an estimated 5.2 million working days lost due to workplace injury, and many of those will be slips, trips and falls. A simple trip or fall at work may be considered as a minor problem to many supervisors and managers – but that couldn’t be further from the truth. Whether you work in a depot, warehouse, factory or office, it’s important to remember that every site is brimming with potential slip and trip hazards. It could be a spillage, a wet or uneven floor, or cleaning equipment and cables left lying around. According to the HSE, the majority of trips are caused by obstructions in walkways, while the rest are caused by uneven surfaces. The good news is that preventing these accidents is often simple and cost-effective.

THE STEPS TO TAKE Essentially, employers have to ensure, so far as is reasonably practicable, the absence of risk to the safety and health of workers and others affected by their undertakings. There are certain basic principles that, if implemented effectively, enable organisations to achieve this. Firstly, have a system in place to manage health and safety. You need to be able to show how you plan, organise, control, monitor and review preventative measures, and you need a competent person to help you understand and respond appropriately to your legal duties. Your main hazards (things that could cause harm) should be identified, and risk should be assessed to make sure your risk control measures are adequate and that they are used and maintained. Safety measures have to be sensible and balanced. You do not need to go over the top. But if necessary,

ing Somethple as sim sure ing as mak s are kept y walkwad keeping an clear an t for trailing eye ou es could wir many preventents accid

put in place back-up measures such as emergency procedures. Inform, train and supervise employees. Do certain things consistently like: consulting your workforce; conducting regular health and safety checks; reporting, recording and investigating accidents and near-misses; and providing employees and others with certain basic information. Also make sure you have provided suitable first aid and welfare facilities and have employers’ liability insurance, and make time periodically to review performance and then feed back any lessons learned to improve controls and management arrangements. A risk assessment will help you identify the slip and trip hazards that exist in your workplace and their potential for causing people to slip or trip. The assessment should also have given you some ideas for how to prevent these accidents. Remember, you cannot eliminate all risks – you need to implement control measures that are proportionate to the risk in question and a good approach to health and safety balances E

Volume 15.1 | HEALTH BUSINESS MAGAZINE

Written by Rob Burgon, workplce safety manager, RoSPA

Health & Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

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WORKPLACE SAFETY

The majority of organisations are also unaware of how much they are losing due to safety failures, or how much could be lost if their controls fail  control measures sensibly against other needs. As we saw earlier, people tripping over obstructions on the floor is also a common cause of accidents. Therefore, something as simple as good housekeeping – for example, making sure walkways are kept clear and keeping an eye out for trailing wires – could prevent many accidents. CHANGING CULTURE As with health and safety in general, continuous improvement in preventing slips, trips and falls cannot be achieved by one-off interventions such as a single memo requesting that spilt drinks are mopped up quickly. Prevention strategies have to be bedded in deeper than this so they are sustainable. Therefore, before you start hunting for hazards, assessing risks and reviewing your precautions, make sure you have a robust ‘system’ – the policies, people and procedures – in place for managing health and safety on an on-going basis. Underpinning such a system should be a positive safety culture, encompassing everyone from board-level directors and on-site managers, supervisors and team leaders to the

frontline workforce – employees or contractors. Working together to develop a good health and safety culture has to be a team effort, with ownership and commitment to safety built throughout the workforce. What sets a safety conscious company apart is having employees with trained eyes to spot these hazards, and prevent the hundreds of major injury accidents caused by slips and trips every year. Good reporting of near-miss slips and falls can make a huge difference, as they help you build up a picture of where problems are happening so you can then decide what to do next to prevent them. The vast majority of accidents and ill health can be prevented by good health and safety management. The Health and Safety at Work Act 1974 requires employers to ensure the health and safety of all employees and anyone affected by their work, so far as is reasonably practicable, which means balancing the level of risk against the measures needed to control the risk in terms of money, time or trouble. This includes taking steps to control slip and trip risks. STRATEGY At RoSPA, we know that risk assessment is a lynchpin of health and safety management

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and our courses emphasise the simple and cheap measures every company can take to protect the workforce, while also complying with the law. In this case, developing a slip and trip map of your premises is a good way to target problem areas and understand what may be causing these accidents. The last thing an organisation needs is an accident that could keep a key employee off, or bring adverse publicity when competition is stiff, so the focus should always be on preventing serious injuries connected with work activities. After all, safe and healthy working is the foundation upon which everything else in business is built – not just because it is the morally correct way for businesses to work, but because it is also the most cost-effective and efficient. The majority of organisations are also unaware of how much they are actually losing due to safety failures, or how much could be lost if their controls fail. Many are also unaware how much they need to spend to demonstrate reasonably practicable (strategic or operational) compliance. So, do yourself a favour and get in-step with this issue before it costs your company in sickness, lost time, higher insurance premiums and, ultimately, profit. L

Health & Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

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OKI

GOING PAPERLESS

2018 The business of delivering healthcare is becoming increasingly complex. Providers are being tasked to deliver quality care whilst cutting costs and meeting strict targets yet still ensuring patient safety and improved operations. OKI provides solutions that support fast and easy integration into a variety of Hospital Information Systemsâ&#x20AC;&#x2122; platforms, thus improving the overall efficiency of operations and ensuring the most productive use of technology.

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PAPERLESS NHS

THE JOURNEY TO PAPERLESS

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Why OKI, a company that manufactures and sells printers, wants to help the NHS and other health organisations to go paperless?

Written by Rob Brown, Head of Key Accounts, OKI

It’s a good question. In reality, we believe that there will still be a need for printing and printers in the future. Certainly from a legal perspective we have not seen paper based documents diminish. In a recent OKI survey of 2000-plus office workers across all industry sectors, 92 per cent of those polled said that they still printed at least one document every day. There’s no reason to assume that the health sector is any different. Even if patient records and referrals become paper-free, nobody can stop people sending letters or wanting hard copies of documents for legal reasons. So, although we recognise that paperless is the ideal, we can also see that it isn’t practical right away. Most departments are still progressing through various hybrid states before reaching the ultimate, paper-free goal. OKI Systems UK’s business is to help organisations manage printing and documents more effectively – helping save costs and energy usage, while also enhancing productivity and document security. The NHS is under pressure on all these levels with rigorous targets to become paperless by 2018, to cut carbon emissions by 10% by 2015 and to make £20 billion of efficiency savings by 2015. Buying printers and printing in the right way can drastically cut paper use and help significantly towards the latter two goals. COMPLETE MANAGED PROCESS The complete managed process begins with an OKI audit of existing printing practices, measuring outputs and assessing printing types. This gives the audited organisation or department a transparent view of what is really happening and where budget is being spent. OKI then uses the audit results to develop a long-term plan. Top of the agenda will be to ensure that the right printers are being used for the right job. For example, replacing multiple desktop printers and scanners with a smaller number of multifunction printers can cut energy consumption and costs and accelerate workflow. New OKI multifunction printers come with an open platform enabling the customisation of the user interface to integrate all documentrelated tasks into an organisation’s document workflow. This enables a move from a manual to an automated workflow, making it easier to track and reduce printer usage. Documents can also be stored prior to printing on the printer’s hard disk drive or Secure Data (SD) card. It is only possible to access this content with a four digit, user-defined pin and only with the right credentials can the document be printed.

Rob Brown

OKI’s managed document solutions comprise an integrated suite of software, technologies and tools to improve print and document workflow, management and security within an organisation This reduces the amount of paper being printed and ensures data security is in place. Significant costs can be saved by having just the one contract for all printing and document needs, including printers, supplies, technical support and maintenance. This enables easy monitoring of on-going costs, reduces capital investment and helps control budgets. In turn, this also frees up the time of internal staff to focus on core tasks. FLEXIBLE STRATEGY Working closely with a managed document services provider such as OKI will help develop a flexible strategy, making way for mobile printing when needed. There are now ranges of multifunction printers

with wireless connectivity. Smartphone and tablet users can find these and print from them via an app which can be downloaded directly from the mobile device. Newer printers typically use far less energy than these older devices, include significantly more capability and take up far less space. When documents and printing are managed more carefully and expertly, paperless becomes less of an issue. Working with a managed document services supplier can mean a smooth and realistic evolution towards this ultimate goal.  FURTHER INFORMATION Tel: +44 (0)1784 274 300 www.oki.co.uk

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Reduce Operational Costs and Improve Patient Care

Speed reimbursement by generating highly accurate bills Automate end-to-end medical claims processes Automatically capture, extract and route patient information into EHR Unlock data to make better decisions through analytics Become 100% paperless with e-signatures Meet compliance requirements For further information, please email: contactus.emea@kofax.com or visit: www.kofax.com

HEALTH & SAFETY

HANDLE WITH CARE

Patient Handling

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

The cost of manual handling injuries is high. But with the correct training and a good policy and monitoring system in place, the number of injuries could be substantially reduced, writes Mary Ogungbeje, research and development adviser at the Institution of Occupational Safety and Health

Nurses, ambulance staff and care and nursing assistants are among those who report the most accidents as a result of manual handling in the workplace. Health and Safety Executive (HSE) official handling statistics reveal that 15 per cent of all reported handling cases are made up from the injuries sustained in the occupations listed above. Tasks that involve manual handling include transporting or supporting a load by carrying, pulling, lifting and pushing. In the case of a healthcare professional, this could include lifting patients, pushing wheelchairs and even simply lifting a box. Often manual handling if not done correctly can result in musculoskeletal disorders (MSDs). Over the last decade the total number of new cases of MSDs in Great Britain dropped from around 216,000 in 2001/02 to 141,000 in 2011/12. However, it’s still the most common work-related illness reported to GPs and when

GUIDANCE ON HANDLING Over half of the moving and handling injuries in healthcare involve the handling of people. Safe lifting techniques for objects can’t always be applied in the same way when the load is a person. The European Agency for Safety and Health at Work has produced guidance for those working in the healthcare sector, which highlights why handling patients in different environments and circumstances can be particularly hazardous. The guide includes a lot of food-for-thought. It looks at the task in hand and the amount of physical effort that is needed to carry it out, or keep control of equipment and tools. It also highlights whether a member of staff will be repeating the same motion or a number of motions frequently throughout their working day and how this can have an impact. According to the guidance, a patient cannot be held close to the body, they do not have handles which can be used to ‘pick up’ and they may be unpredictable, so it could be difficult to know what will happen whilst handling them. Also, the guidance encourages staff handling the patients to actually pay attention to the environment they are carrying out a task in. Assessing whether slip, trip and fall hazards may be present and if there are any limitations in the work area such as the size of the E

Tasks e olv that invandling h manualransporting t include pporting a or su carrying, load by lifting and pulling, shing pu

handling patients, care must be taken at all times The HSE’s latest provisional figures reveal that those in the health and social care sector have the highest number of reported handling injuries such as strains, sprains, cuts and trapped fingers. The figures also suggest that these injuries account for 40 per cent of work-related sickness absence.

THE LAW The Health and Safety at Work Act of 1974 places an overarching, general duty on employers to ensure the health and safety of their workers and those affected by the nature of their business, in this case patients. As part of this, employers must have a health and safety policy and arrangements put in place to ensure they are able to abide by the law. There is also a general duty on employees, they must work with the employer to take care

Volume 15.1 | HEALTH BUSINESS MAGAZINE

Written by Mary Ogungbeje, research and development adviser, Institution of Occupational Safety and Health (IOSH)

of their own safety, and also that of others. The Manual Handling Operations Regulations 1992 (as amended) deals specifically with manual handling risks. Written within the regulations employers must; avoid the need for hazardous manual handling, so far as is reasonably practicable; where hazardous manual handling can’t be avoided assess the risk of injury; and reduce the risk of injury from hazardous manual handling, so far as is reasonably practicable. On the other hand it is written in the regulations that employees must; follow appropriate systems of work put in place for their safety; make proper use of equipment provided; co-operate with their employer on health and safety matters inform the employer if they identify hazardous handling activities; and take care to ensure that their activities do not put others at risk.

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HEALTH & SAFETY  room, or equipment that may be in the way. Other issues can also apply in a busy environment where there is not always assistance on hand, whereby staff may feel the pressure to just ‘get on with it’. The individuals capability should also be taken into account. This may include whether the job requires unusual height or strength, if it puts those with a health problem or those who are pregnant at risk and whether the job requires specialist knowledge or training to complete it safely. Jane White, research and information services manager at the Institution of Occupational Safety and Health (IOSH), said: “Employers shouldn’t think that managing the risk is simply a matter of sending workers on a training course and buying some equipment.” Back in August 2008, a care assistant won £8,000 in compensation because she suffered a back injury and consequently lost her job. This came after having to hold the full body weight of an elderly resident while lifting her to get her dressed. It was reported on the Thompson solicitor’s website that when commenting on the case Mrs Yates said: “Very often we were dealing with very frail residents who simply couldn’t help themselves. On this occasion my colleague and I had to support the full bodyweight of this very elderly lady and I did my best under the circumstances as I would for any of the residents. If I’d known how to dress her or any other of the residents properly, or been given access to training, I would have adopted a safer method instead.” Miss White, added: “The Department for Work and Pensions state that the number of employer cases, recoveries and compensation settlements have steadily declined in the last five years. However, this does not mean employers and employees can afford to be complacent when it comes to managing the risks. It is always a good idea to involve employees and safety representatives when carrying out an assessment and considering possible solutions.” POLICY Policies are a good place to start with if you want to know about the general organisational position and strategy over matters. Healthcare providers may need to develop one for moving and handling if carrying out a wide range of these types of activities. This would fit within the overall health and safety policy and clearly include who is responsible for what, the training arrangements, the risk assessment and action plan processes, the system for reviewing and monitoring compliance with the policy and information for staff regarding how to report injuries and health issues. The big challenge for organisations is turning what is written on paper into something that is live, active and very much effective in practice. A survey carried out by the Royal College of Nursing showed that the main barriers to compliance were due

The HSE’s latest provisional figures reveal that those in the health and social care sector have the highest number of reported handling injuries such as strains, sprains, cuts and trapped fingers to a lack of supervision or enforcement and a perception that it is quicker to handle patients manually when there are low staffing levels, or time pressures. Therefore, adequate resources should be made available and addressing incorrect thinking as well as practices during training and refresher courses will help. It is also important that any policy is monitored regularly to incorporate change. RISK ASSESSMENTS When looking at patient handling, the HSE advise that two types of risk assessment are usually needed – a generic assessment and an individual assessment. The generic assessment would consider factors such as staffing, the type and frequency of moving/handling tasks (including during emergency situations), equipment needs and the environment. Whereas an individual risk assessment would take account of the specific moving and handling needs of care service users and form part of the process for their care plan. The person carrying out any assessment should be correctly trained and competent to do so. Assessments should be reviewed periodically or when circumstances change. It is also useful to record the risk assessment main findings, though this is not necessary if it’s a simple activity that’s easy to explain or the manual handling task is low risk and will be very quick to finish. TRAINING Training in moving and handling is important for anyone having to lift, carry or even move patients. In this case, a moving and handling foundation course should develop staff understanding and ability in a number of areas. Strong evidence points to effectively reducing manual handling injuries using ergonomic interventions which adopt a multidimensional approach. This would entail an organisation having in place steps or initiatives which aim to make sure that tasks, information, equipment and the environment suit the workers. It would also involve the participation of workers and managers, the tailoring of training to suit the person and specific task requirements, along with equipment or task design/redesign. So, just as it is important for workers to know what correct safe techniques are, it is also key for a training course to emphasise changing attitudes, habits and behaviour and promote risk awareness among workers and managers.

Patient Handling

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

EQUIPMENT When selecting equipment to help with patient handling, the needs of the patient and the needs of the employee should both be taken into account. Where possible, equipment should be tested on a trial basis before a purchase is complete, as this will ensure the product is fit-for-purpose. By involving employees that will be using the equipment and asking for patient feedback, a clear picture of whether the equipment is of use will soon materialise. Other factors to take into consideration when choosing lifting equipment are where the equipment will go and whether there is enough room for the equipment, is the equipment CE marked and how much maintenance the equipment could need going forward. EMERGING ISSUE With worldwide figures more than doubling since 1980, one very real and growing global concern is obesity. This presents obvious implications for health and social care service providers. According to the Department of Health website in Britain, if the trend continues and no action is taken 60 per cent of men, 50 per cent of women and 25 per cent of children would be obese by 2050. In research report 573, the HSE look into the manual handling risks and process planning for bariatric patients. In their research, they found 40 - 70 per cent of Trusts did not have a bariatric policy. The manual handling of these patients presents a specific challenge partly due to individual factors but also due to the lack of policies, space, equipment and vehicles for safe care, treatment and transportation. In addition to shaping strategic policies to equip the NHS, recommendations included; ensuring that the design of vehicles and buildings accommodate bariatric patients; designing equipment to suit the range of bariatric sizes and shapes; training to support the assessment of bariatric patients and use of specialist manual handling and clinical equipment; and operational policies to lead on process planning, assessment and management of manual handling for bariatric patients. As you can imagine, the cost of manual handling injuries is high. Every situation where manual handling is involved is different and may require a unique solution. With the correct training and knowledge and a good policy and monitoring system in place the number of injuries could be substantially reduced. L FURTHER INFORMATION www.iosh.co.uk

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TO REQUEST YOUR 2015 REINTEC CATALOGUE TEXT REINTEC TO 64121

reintec.com / 08456 02 82 71 Safety / Value / Availability / Support

WASTE MANAGEMENT

SUSTAINABLE WASTE MANAGEMENT SOLUTIONS

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Emma Wood of PHS Wastemanagement was recently invited to participate in an NHS conference in the North West to explore with some of the decision makers of these trusts whether new environmental technologies or behavioural changes in attitudes are the key to creating a sustainable NHS. Here she outlines the outcomes from the session How do we create sustainability in our work places, our homes and as we go about our daily lives? It may feel like the million dollar question, but the answers are often not quite as difficult as we think. Talking about becoming more environmentally friendly and how to minimise the impact from our actions tend, in most cases, to get people thinking in terms of introducing new lighting, heating systems and technologies such as solar panels. But is that actually the right place to start? Contrary to the phrase, our words can often speak louder than our actions, perhaps then encouraging shifts in attitudes and the way we approach sustainability, is a more productive approach. This is a question we posed at the start of a workshop with 70 delegates all of whom had a responsibility for sustainability in the NHS. We asked the delegates to vote on the question “What is the key to creating a sustainable NHS” and asked them to vote on three choices – technology, behaviour change or not sure. We then organised group discussions to form opinions around three key things that could help the NHS become more sustainable and we questioned whether technology could help stimulate a behavioural change for example using social media or videos to communicate and influence behaviour change. KEY CHALLENGES Unsurprisingly, the topics and the priorities were shaped according to the role of the people involved in the discussions. Frontline nursing staff discussed the key challenges of getting people to commute sustainably and use public transport, when they are so attached to travelling by private cars and if it was possible to make a change occur through encouragement rather than enforcement. Whereas the facilities teams talked more in terms of technological changes, such as recycling rainwater to flush toilets or using on-site incinerators. What is clear is that to achieve ambitious targets is not as simple as installing the latest technology. One example given by a delegate cited the presence sensors being turned to face the wall and overridden so that they are constantly on which shows a poor understanding of the reason for the installation in the first place as well as the required behaviour.

This is why PHS Group’s approach to waste management is a combination of offering both technology solutions and behavioural solutions – to ensure waste is collated and collected as efficiently and sustainably as possible. The company invests a lot of time, particularly with NHS staff, delivering training to explain the importance of waste segregation, the knock-on benefits of both cost and environmental and it has devised new educational tools to help improve understanding of the healthcare waste colour coding system which makes handling waste simpler and easy to implement. PROPER SEGREGATION Clearly, proper segregation of clinical waste into infectious and non infectious waste is vitally important. Therefore, reviewing your waste management strategy regularly is a worthwhile and essential exercise in terms of identifying cost savings and to check that your impact on the environment is as positive as possible. Following a waste audit of an NHS Trust, PHS Group identified that 100 per cent of its clinical waste was being included in the

infectious waste yellow bags and incinerated. By introducing segregation, 54 per cent of the waste is now identified as suitable for orange bag alternative technology treatment, and 46 per cent is suitable for offensive waste disposal, yellow and black tiger bag. The potential cost savings are significant - based on one tonne of clinical waste being disposed of as in the example above, could save more than £700 per month in waste disposal costs. Waste segregation training is key to ensuring segregation is properly maintained and PHS Group’s online interactive waste segregation training tool is proving popular, as a useful way to educate healthcare professionals and improve waste segregation. At the end of the discussions the group took a re-vote on the original question “What is the key to creating a sustainable NHS?” which showed a new score of 80 per cent believing a mixture of technology and behaviour change is needed if the NHS is to become truly sustainable.  FURTHER INFORMATION www.phs.co.uk

Volume 15.1 | HEALTH BUSINESS MAGAZINE

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

FACILITIES MANAGEMENT

Rapierstar – Breakthrough Spacevac launches new generation of gutter and in performance high level cleaners For over 22 years, Rapierstar has led the market in the design, development and supply of technically advanced fixings and building maintenance solutions. Rapierstar’s award winning specialist screws and fasteners include the Starfix plug-free masonry fixings, StarTurn universal timber screws and StarPVCU carbon steel and corrosion resistant stainless steel window screws, which are specified on many leading PVCU, aluminium and wooden window manufacturing systems. Many of the specialist wood and masonry screws feature the patented StarForm thread, which lowers drive in torque and reduces assembly time without pre-drilling. Latest innovative products include ProShield, a water repellent, environmentally friendly masonry treatment that is quick and easy to apply. It penetrates to provide breathable, invisible protection from damaging water

FACILITIES MANAGEMENT

ingress, maintaining appearance whilst reducing maintenance costs. ProShield can improve the thermal efficiency of an exposed wall structure on average by 35 per cent without expensive and feature changing additions, such as cladding and other intrusive insulation systems. Rapierstar has undertaken extensive research and testing, proving the effectiveness and longevity of ProShield when applied to a range of masonry block constructions and can offer a full 25 year warranty of performance. FURTHER INFORMATION info@rapierstar.com www.rapierstar.com

A new generation of high reach and gutter cleaning equipment has been launched by Spacevac Technologies. Operated from ground level the system has four major features. It removes operational guesswork as it has a close circuit TV camera on the cleaning head; it reaches higher than any other product – 4 storeys (16 meters) indoors or outdoors; has greater suction power from a Nilfisk Alto vacuum; and its carbon fibre tubes make it much lighter than any other. It’s 40 per cent quicker than any product and the poles have a new locking system to eliminate tube blockages. Unlike traditional high reach cleaners, it’s extremely lightweight

and can be assembled on the ground by one person. To the many health and safety benefits and the elimination of costly scaffolds or cherry pickers, Spacevac is economical on assembly time – a mere three minutes. The high powered vacuum ensures that gutters and high beams are cleaned faster and more efficiently with less operator time. You can see how effective the system is by viewing activity on a laptop or smartphone. FURTHER INFORMATION Tel: 01604 760282 info@space-vac.co.uk www.space-vac.co.uk

ENERGY

Saving Energy Limited: Choose the Green Way

SEESUN – sharing the secrets of solar energy

Experienced in delivering large projects on time and on budget, in both the domestic and commercial sector, Saving Energy provides a holistic approach to reducing energy consumption and lowering energy bills. They have delivered solutions for the majority of London borough councils and national housing associations as well as serving the private market. Solar PV is an essential technology to enable homeowners and businesses to not only save vast amounts of money on their electricity bills but also still provides unrivalled returns on investment through the Feed in Tariff. At the same time, culling a carbon footprint enabling businesses to promote the further reach of their CSR and provide unique relations within the communities of which they serve. Saving Energy has installed over 1MW worth of photovoltaics and are well versed from rationale to handover.

Reducing your energy costs while taking a massive step toward meeting your sustainability goal has never been easier. Switching to clean, more affordable energy is simple and straight forward. Understanding the financial benefits given by utilising the suns energy is key. Once understood, smart decisions become easy. SEESUN is a fullservice solar provider. Local installers design the entire project from start to finish. SEESUN is part of a national community energy interest initiative to deliver better and fairer energy deals for homes and businesses in your area. Finding ways to

Having already installed PV panels on the roofs of high dependency ambulances for a private ambulance company in the South East, Saving Energy has extended the service life of the vehicles and has drastically reduced both the running costs and its carbon footprint. It delivers smart, safe solar on or off grid, as well a number of other measures all with the same goals. To reduce consumption, reduce costs and help save the environment. Saving Energy are able to offer financed and, in some cases, free installations. FURTHER INFORMATION Tel: 0800 954 9689 www.savingenergyuk.co.uk

HEALTH BUSINESS MAGAZINE | Volume 15.1

benefit the wider community with new UK projects is core to SEESUN business goals. Meeting your needs is the company’s goal and adaptable programs with little or no upfront cost means everybody can be part of the solar revolution. SEESUN provides reports and reviews on all options and find what works best for you. To understand what Solar PV could do for your organisation, SEESUN have leading industry specialists ready to give you free advice on your next step. FURTHER INFORMATION Tel: 01376 503680 freedesign@seesun.co.uk

DOCUMENT MANAGEMENT

RECRUITMENT

MISL: Striving towards a cheaper paperless future

The fast growing medical recruitment agency

The current drive towards the paperless NHS has made it clear that information, and how we use it, is the key to providing intelligent services that are responsive to a changing population with diverse needs. If health records are accessed digitally there can be significant increases in productivity and improvements in security. Digital information can be shared securely and leveraged far better than acres of paper sitting in your medical records library. Leading document management company, MISL limited, is pioneering a new approach to the paperless NHS challenge by providing a complete solution. The best approach varies according to each organisation’s context. Scanning everything might be the best approach or maybe the focus should be

Pertemps Medical is a specialist medical recruitment agency, providing bespoke recruitment solutions to its clients, providing both locum and permanent doctors throughout the country and internationally. As an approved Buying Solutions NHS supplier, the company is dedicated to the provision of salaried and locum doctors to its nationwide list of clients within the public and private sectors. Pertemps Medical recruits doctors for all specialties and grades from house officer to consultant. With over 100 branches operating out of 61 towns and cities across the UK, Pertemps is one of the largest and most successful privately owned recruitment consultancies in the country. The company employ circa 550 people as permanent staff, payroll a staggering 18,000 flexible employees a week and last year

on selectively scanning some records while storing others and focusing more on capturing information digitally at source. MISL provides a range of services from storage and large volume scanning (offsite or onsite) to day-forward document capture. MISL also offers a state of the art, secure, EDRM system that can be provided via the cloud or installed on your servers. Your move to being paperless, with MISL’s help, can deliver huge benefits in a cost effective way. MISL’s mantra is simple: Your data, your way. FURTHER INFORMATION Tel: 01992 470 060 info@misl.co.uk

ICT

placed an incredible 6,000+ people into permanent roles. Pertemps traditional core business covers all industrial, driving and commercial roles, from support functions to management. It has sector specific teams in niche markets including social care, healthcare, IT, HR, legal, technical, finance and executive search. Over 50 per cent of business is under formal contracts where Pertemps operate as the master vendor, preferred supplier or sole supplier of temporary and permanent staffing solutions. FURTHER INFORMATION Tel: +44 1908 533 240 www.pertemps-doctors.co.uk

DECONTAMINATION

Providing workflow management to companies globally Winscribe has been providing speech enabled workflow solutions to thousands of NHS doctors for over 20 years. In over 90 Trusts in the UK, Winscribe is dedicated to developing credible solutions that improve patient safety and the way they work. In the recent years, Winscribe’s core mission has been to help Trusts alleviate paper heavy processes and comply with the paperless agenda. It has made great strides in helping hospitals of all sizes to achieve this aim, and there remains lots of hard work to be completed. Improving the process has enabled several Trusts to exceed their financial savings targets. Specifically, Leeds Teaching Hospitals NHS Trust has saved £1.2 million annually, since utilising Winscribe’s Clinical Workflow and Speech Recognition solutions. A member of the Trust said

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after the deployment: “The implementation of Winscribe has been seamless, and the trust is experiencing the full benefits of an improved process.” With over 20 years of experience, Winscribe is able to advise and recommend the best solution for your organisation. User-friendly and integrable with key clinical systems, such as Patient Administration Systems and Electronic Patient Records, Winscribe can make productivity and financial savings along with improving clinical safety. FURTHER INFORMATION Tel: 0207 471 0100 sales@winscribe.com www.winscribe.co.uk

Leader in the touch-less disinfection business Sanondaf provides a touchless disinfection system that kills 99.99 per cent of harmful bacteria, viruses, fungi and mould. This is delivered using an innovative leading edge hydrogen peroxide fogging and electrostatic spraying system, combined with patented and approved disinfectants. Used as a supplement to traditional infection control measures, such as manual ‘spray and wipe’ cleaning, Sanochem is 100 per cent environmentally friendly and poses no threat to humans, animals or plants. It is also non corrosive which means it is safe to use and ideal for use on medical and electronic devices and healthcare equipment at an affordable cost. Sanondaf effectively eradicates over 280 pathogens including MRSA, Norovirus, E-Coli, H1N1, C-Diff, Salmonella and is completely effective against high risk pathogens such as Hepatitis, Legionella, HIV, Polio and Ebola.

Sanondaf has a wide range of uses in every sector including hospitals and healthcare, childcare and education, residential care facilities, hotels and leisure, work and office environments. The service is highly portable and can be deployed quickly to be used as an emergency response to any outbreak situation and can also be used as a preventative treatment on surfaces and locations to prevent the growth or spread of dangerous micro organisms. FURTHER INFORMATION Tel: 01236 702028 www.sanondaf.uk.com

Volume 15.1 | HEALTH BUSINESS MAGAZINE

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MARKEY RESEARCH

DOCUMENT MANAGEMENT

Medical sector research delivered by experts

MISL: Striving towards a cheaper paperless future

The Telemarketing Company (TTMC) Research holds IQCS, MRS, AITS and ISO9001 accreditation and operates from its 200 seat offices on the Brighton sea front. Experts at delivering medical and pharmaceutical sector telephone research services, TTMC has a proven track record of 25 years of delivery. TTMC provide both small and large scale projects (into the tens of thousands of completed surveys) focusing on clinical practitioners, healthcare management contacts, pharmacies and patients for a broad range of public and private sector clients. They are consultative, cost effective, flexible and professional. Driven by ethics, compliance and best practice, the research team were finalists in the ‘best field force’ category at the 2014 Market Research Society operations awards.

TTMC works for organisations including TPP, Siemens Medical, Roche Diagnostics, InHealth, Asteral, Barco Voxar, Alliance Medical and many other clients in this specialised sector. The TTMC website holds numerous case studies with client testimonials for your review. Call today and discover how TTMC can deliver insight, measurement, data and market information to help you to achieve your goals. FURTHER INFORMATION Tel: 01273 765 000 info@ttmc.co.uk www.ttmc.co.uk

ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service Advanced Electronics 26 Asckey Data Services 43 Atrainability 13 Austco 54 BDS Solutions 46 BeaconMedaes 34 Big Hand 44 Black Pear Software 47 Bosse Interspice 54 British Parking Association 54 BTS Biogas 25 BW Legal 17 Captive Health 46 Carestream Health UK 48, 49 CCube Solutions IFC, 54 Certuss (UK) 21 CFH Docmail 4 Chas 2013 58 DAC Beachcroft 14 Decorative Panels Lamination 6, 36, 52 Digital Air Wireless 40

HEALTH BUSINESS MAGAZINE | Volume 15.1

Direct Telecom Services 56 ERS Medical 52 Ethitec 47 Fiat 12 Fibre Grid 59 Fire Stat International 29 Focus Games 10 GP-Access 20 Harland Simon 46 Human Reliability IBC Kantar Health 30 Kofax 62 Lark Energy 22 Living Space UK 38 Mazepoint 46 Medibooks 52 Medline International B.V. 34 Melia Whitehouse Hotel 10 MISL 32 Mount International United Services 64 Nervecentre Software 50

OCNWMR 10 OKI Systems UK 60 Olympus Medical 16 Pertemps Medical 69 Peugeot BC PHS Group 67 Rapierstar 68 Redwing Business Intelligence 42 Reintec 66 Sanondaf UK 69 Saving Energy 68 Seesun 68 Spacevac UK 68 Sync Interactive 42 The Telemarketing Company 70 Toyota 24 Voice Connect 8 Wilo UK 44 Winscribe 69 Yeoman Shield 18 YPO 28

Human Factors in Medical Device Design Patient Safety and Pharmaceutical Manufacturing Human error is the main source of adverse events in healthcare. Human Factors is the key discipline required to minimise this risk. Human Reliability has 30 years of experience in providing training, consultancy and research services in this discipline. Medical Device Design The FDA and the European regulators require human factors issues to be addressed throughout the medical device design cycle. Our Human Factors Risk Manager software tool can proactively predict device use errors during design to ensure that regulatory requirements such as IEC 62366:2007 for design and ISO 14971:2012 for risk assessment are met. Patient Safety In our research for the UK National Health Service, the Health Foundation and the National Patient Safety Agency we applied innovative methods for reducing human caused risks in areas such as medication safety, shift handovers and surgical team performance. Our SHERPA (Systematic Human Error Reduction and Prediction Approach) methodology provides a systematic process for managing risks, and developing improved protocols and training to achieve clinical excellence. Pharmaceutical Manufacturing Pharmaceutical manufacturing is required to demonstrate very high standards of safety and quality in order to comply with strict regulatory requirements. Our Human Factors Risk Manager software uses the SHERPA process to demonstrate to regulators that all credible human caused failures have been identified and minimised. Further information Contact us to provide further information for our services in the following areas:  Training courses in human factors  Human Factors Risk Manager software tool  Consulting services