Health Business 17.5 by PSI Media

VOLUME 17.5 www.healthbusinessuk.net

FIRE SAFETY

MODULAR BUILDINGS

HB AWARDS

TOP 10

PURSUING PAPERLESS AMBITIONS

Which NHS trusts are leading the way towards a paperless NHS

TECHNOLOGY

HOW THE NHS IS HARNESSING TECHNOLOGY Exploring vanguards, care models and the digital solutions helping the NHS meet increasing demands

PLUS: DATA SECURITY | EHI LIVE | FACILITIES MANAGEMENT | RECRUITMENT

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HEALTH BUSINESS MAGAZINE ISSUE 17.5

VOLUME 17.5 www.healthbusinessuk.net

FIRE SAFETY

MODULAR BUILDINGS

Comment

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Data dilemmas and paperless promises

HB AWARDS

In his Keynote Speech at the Health and Care Innovation Expo, Health Secretary Jeremy Hunt announced new promises on patient access to online care.

TOP 10

PURSUING PAPERLESS AMBITIONS

Which NHS trusts are leading the way towards a paperless NHS

TECHNOLOGY

HOW THE NHS IS HARNESSING TECHNOLOGY Exploring vanguards, care models and the digital solutions helping the NHS meet increasing demands

PLUS: DATA SECURITY | EHI LIVE | FACILITIES MANAGEMENT | RECRUITMENT

Closing the annual NHS England event, Hunt revealed that his plans, set to be in place by the end of next year, included patients being able to access their own GP medical records via an app, as well as the ability to detail how they do and do not want their information being shared. To tackle the data dilemma, Hunt is also expected to launch the MyNHS Open challenge. With intentions to eventually ‘marry’ apps and medical records, this issue has taken on a prominent technology theme. Our latest Top 10 list, on page 15, looks at the trusts leading the NHS fight to become paperless, whilst the NHS Confederation European Office writes about data protection on page 34. Following the recent release of the New Care Models: Harnessing Technology report, we also have an explorative article on the five vanguards which are implementing innovative digitals technology solutions in their approaches to modern day care. Read more about the report on page 19.

Follow and interact with us on Twitter: @HealthBusiness_

As always, enjoy the issue.

Michael Lyons, editor

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 Michael Lyons EDITORIAL ASSISTANT Marianna Christou PRODUCTION EDITOR Richard Gooding PRODUCTION DESIGN Jo Golding PRODUCTION CONTROL Ella Sawtell WEBSITE PRODUCTION Victoria Casey ADVERTISEMENT SALES Jake Deadman, Jeremy Cox, Lucy Rowland, Damian Emmins ADMINISTRATION Vickie Hopkins, Charlotte Casey PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Volume 17.5 | HEALTH BUSINESS MAGAZINE

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CONTENTS 15

07 NEWS

Labour demands £500 million emergency NHS fund; Jeremy Hunt names NHS ‘fast follower’ trusts; and CQC chief says that the NHS is not fit for 21st century

15 HB TOP 10

NHS England announced its ambition to be paper free at the point of care by 2020. This has consistently been regarded as unachievable. In our penultimate Top 10 list of 2017, Health Business recognises the UK trusts that are leading the pack in pursuing paperless ambitions and continuing to be digital examples for other trusts to learn from

19 TECHNOLOGY

There is potential for digital technology to significantly impact on the NHS Five Year Forward View ‘triple aim’ of providing better health, better care, and better value. HB examines the development of digital technology, as expressed in the new New Care Models; harnessing technology report

25 EHI LIVE 2017

ehi LIVE is the UK’s number one show for all those involved in digital health, hospital information, cyber security and healthcare innovation. As part of our preview, Dr Neil Paul discusses technology and GP practices

31 CYBER SECURITY

NHS Digital highlights the importance of protecting information and data in the NHS and why all hospital staff must be trained in knowing system vulnerabilities

34 DATA SECURITY

Sarah Collen, at the NHS European Office, looks at why changes to data protection legislation are important for the NHS – as well as the key changes on the horizon for data privacy and regulation

55 ENERGY

Jerome Baddley of the Sustainable Development Unit writes about the opportunities for sustainable procurement to save money, help the environment and boost local communities and economies

59 LIGHTING

LED lighting is now widely considered as the logical choice for almost any lighting application. Peter Hunt analyses the benefits of LED lighting, including the less well-being benefits

61 MODULAR BUILDINGS

The Modular Buildings Framework is the only national agreement of its type, covering off-site building solutions for purchase, hire and lease. Health Business revisits NHS Shared Business Services’ article on the benefits for the healthcare sector

64 RECRUITMENT

Neal Suchak, policy advisor at the Recruitment and Employment Confederation, analyses the workforce challenges facing the NHS in the provision of mental health services

67 HEALTHCARE ESTATES

75 UK HEALTH SHOW

The government issued its response to the third Caldicott report over the summer. Highland Marketing’s Lyn Whitfield looks over the report and the response with Dr Alan Hassey, a member of the National Data Guardian panel, following his appearance at this year’s UK Health Show

38 DOCUMENT MANAGEMENT 79 HB AWARDS 2017 South Tees Hospitals NHS Foundation Trust has taken a further step towards introducing paperless patient notes – a move which will ultimately make health records more secure and accessible. Health Business looks at the digital innovation which is improving the utilisation of data

41 FACILITIES MANAGEMENT 79

Contents

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As demand increases, Peter Akid of NHS SBS, describes how the newly-launched Hard Facilities Management (FM) framework provides value-for-money and legally-compliant access to a huge range of essential goods and services

45 FIRE SAFETY

Fire safety might seem like a basic topic to the initiated, but it is actually incredibly important to get it right. For hospitals, this can be a difficult challenge to overcome, says Will Lloyd of the Fire Industry Association. Plus; a look at the controversial cladding on hospital buildings following Grenfell Tower

Health Business

The NHS has once again been portrayed negatively by the media in 2017, with financial shortcomings, excessive workloads, staff shortages, STP confusion and bed blocking all contributing to an image of a care system in disarray and desperation. The Health Business Awards have established a reputation for showcasing the success stories in the health sector, and the 2017 event will be no different

83 INFECTION CONTROL

Reducing Healthcare-Associated Infections can only be achieved by NHS estate managers being more open to technology that provides innovative property solutions, writes Dr Michail Karavolos

87 PATIENT FIRST

Patient First, the UK’s largest patient safety event, will return to London’s ExCeL on 21-22 November 2017. Health Business examines the conference programme and details what to look out for at the show

www.healthbusinessuk.net Volume 17.5 | HEALTH BUSINESS MAGAZINE

Providing The Human Touch to award winning customer service

WINTER FUNDS

News

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Labour demands £500m emergency NHS fund The 2017 Labour Party Conference has heard calls for a £500 million ‘winter bailout fund’ for the NHS over the coming months. Jonathan Ashworth highlighted how patients suffered their worst winter on record last year, suggesting that, unless a large government investment is made

soon, 10,000 people a day will wait at least four hours for A&E treatment this winter. The Shadow Health Secretary told BBC Radio 4’s Today programme said that he had consulted with senior NHS leaders to compile the ‘right figure’ for funding to help ease the winter months. The

NHS PRESSURES

TECHNOLOGY

NHS not fit for 21st century, says CQC chief

Innovative digital technology solutions to improve care

Professor Ted Baker, the new chief inspector of hospitals in England, has warned that the NHS has not adapted to deal with the growth in the population. Speaking in the Daily Telegraph, Baker, who started his role with the Care Quality Commission (CQC) in September, claimed that the current NHS model is the same as it was in the 1960s and that it had not modernised due to a historic lack of investment. He said: “One of the things I regret is that 15 or 20 years ago, when we could see the change in the population, the NHS did not change its model of care. It should have done it then – there was a lot more money coming in but we didn’t spend it all on the right things. We didn’t spend it on transformation of the model of care.” As part of his interview, Baker also revealed that he had written to all hospital chief executives calling for action to improve safety on accident and emergency wards. READ MORE: tinyurl.com/y7uosbkn

A new publication has investigated how vanguard-implemented digital solutions are helping the NHS respond to the needs of patients, rising demand for services and constraints on funding. In 2015, 50 vanguards were selected to take the lead on the development of new care models, with some focusing on implementing digital solutions. The aim of the vanguards is to show the potential for technology to enhance, rather than replace, existing services. New Care Models: Harnessing technology explores, jointly produced by the NHS Confederation, NHS Providers, NHS Clinical Commissioners and the Local Government Association, looks at the work of five vanguards: East and North Hertfordshire; Better Together Mid Nottinghamshire; Better Care Together Morecambe Bay; East Midlands Radiology Consortium; and Salford Together. The examples showcase the successes of digital projects being developed by vanguards, showing how such innovation can encourage more efficient, integrated and personalised care.

Labour party had pledged £7 billion for the health service in their 2017 election manifesto, but warned that it was sensible to ‘manage the public finances prudently’. READ MORE: tinyurl.com/y6vsv7sc

The paper finds that new technological solutions need to be considered within the context of local needs, and anchored to wider change programmes across organisations and whole health and care systems. Helen Arthur, NHS England’s new care models harnessing technology lead, said: “The report recognises the success of vanguards in using technology to enhance, rather than replace, existing services. Working with the vanguards, we have developed a technology model to help other health and care organisations to think through what can be a complex process of change. “We have identified some of the key challenges which encompasses the user experience, digital literacy, culture and return on investment. The examples of innovation, led by vanguards, in this report not only provide inspiration but learning and evidence that others can use. ‘Steal with pride’, as the report says.” READ MORE: tinyurl.com/y7rpmtt4

FAST FOLLOWERS

Hunt names NHS ‘fast follower’ trusts Health Secretary Jeremy Hunt named the second wave of 18 NHS digital ‘fast followers’ at the NHS Innovation Expo, who will partner with the 12 Global Digital Exemplars (GDEs) announced at the same event last year. The fast followers are, on the whole, matched geographically with GDEs. For example, South Tyneside NHS Foundation Trust is to become a ‘fast follower’ in City Hospitals Sunderland’s digital footsteps. Ken Bremner, chief executive of South Tyneside and Sunderland Healthcare Group, said: “This is fantastic news for South Tyneside District Hospital and for our community teams and means we can accelerate learning from Sunderland to develop world class digital systems that will benefit patients in South Tyneside for many years to come. For over 25 years we’ve recognised the critical role

that technology now plays in delivering worldclass healthcare services and in Sunderland we have set the bar in terms of investing in our digital footprint to improve the quality of patient care. Our new Emergency Department is now completely paper-free at the point of care and uses technology that can move around with the patient. As a group, we can now build on this success to further transform our digital capabilities in South Tyneside and the ‘fast follower’ status is testimony of what can be achieved with the two trusts working together.” However, this is not the case for all partnerships. Royal Liverpool and Broadgreen University Hospitals NHS Trust has been matched with North Tees and Hartlepool Hospitals NHS Foundation Trust as its fast follower.

Jeremy Hunt, Health Secretary

As part of the announcement, the Department of Health also confirmed that there will also be a wave of up to seven mental health fast followers, each receiving up to £3 million in national funding. READ MORE: tinyurl.com/yc8oojh7

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News

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MENTAL HEALTH

A&E

Mental health bed occupancy levels rise

£13 million to help A&Es prepare for winter 19 more hospitals across England have been given over £13 million for emergency care in the latest wave of winter funding. About £13 million has been awarded to improve patient flow through A&E so as to make sure departments are prepared for busy times during winter time. The additional funding brings the total given to hospitals since April to over £90 million, part of the dedicated funding announced in the Spring Budget. It will be used to help hospitals finalise preparations ahead of winter, particularly to handle the large volumes of patients attending A&E. By investing in the necessary equipment or infrastructure, hospitals will be able to target improvements to patient flow and relieve pressure on A&E. The funding supports NHS England’s wider plans to improve A&E performance in England

by 2018. It will help hospitals hit the target of admitting, transferring or discharging 95 per cent of patients within four hours. Philip Dunne, Minister of State for Health, said: “Thanks to the hard work and dedication of staff, the NHS has put in place strong plans ahead of winter – ensuring patients continue to receive safe and efficient care as demand rises over the coming months. “This funding will give more hospitals the boost they need to streamline patient flow in A&E, freeing up A&Es to care for the sickest patients and helping make sure all patients get the right treatment in the right place as quickly as possible.” READ MORE:

tinyurl.com/y8e42zyx

tinyurl.com/yacwu6h4

RECRUITMENT

10,000 EU workers have quit NHS since Brexit

STAFF RETENTION

Recruitment and retention commitments outlined Health Secretary Jeremy Hunt has announced a number of commitments to support recruitment and retention in the NHS, including a 25 per cent increase in nurse training posts. Building on the commitment of 10,000 more training places for nurses, midwives and allied health professionals, announced in August this year, the government will provide funding for the clinical placements required for an additional 5,170 pre‑registration nurse degrees from 2018. A further 5,000 nursing associates will be trained through the apprentice route in 2018, with an additional 7,500 being trained in 2019. The Health Secretary also announced plans for the introduction of a new shortened nurse degree apprenticeship route for qualified nursing associates who wish to work towards full Nursing Midwifery Council registered nurse status. Speaking at the Conservative Party Conference, Hunt discussed also

A new briefing has argued that the number of acute inpatient beds for adults with mental health problems has fallen, despite no change in people admitted. Adult and older adult mental health services 2012-2016 analysed data collected by the NHS Benchmarking Network since 2012/13 up to the publication of the Five Year Forward View for Mental Health, and found that bed occupancy levels have risen to an average of 94 per cent. The Centre for Mental Health and the NHS Benchmarking Network has warned that while psychiatric acute inpatient beds for adults fell by 15 per cent between 2012 and 2016, and staffing levels fell by 20 per cent, the number of people admitted and the time they stayed in hospital did not change. During the same time period, the number of people on community team caseloads reduced by six per cent, staffing levels fell by four per cent and contacts reduced by seven per cent. In contrast, access to psychological therapies rose rapidly, reaching some 900,000 people a year by 2015/16. The paper also reported that the proportion of people admitted under the Mental Health Act rose from 25 per cent in 2012/13 to 35 per cent in 2015/16, and that at least half of inpatients are detained under the Act at some point during their hospital stay.

measures to support affordable housing and flexible working. NHS Confederation and NHS Employers have been urging the Department of Health to commit to using NHS land to build additional affordable housing for NHS staff, and welcome Hunt’s intention to do so. The so-called ‘Homes for Nurses’ scheme plans to give 3,000 NHS workers first refusal on affordable housing generated through the sale of surplus NHS land. The NHS bodies are also encouraged by the commitment to a 25 per cent increase in placements for student nurses, and the tripling of the number of nursing associates providing care to patients. Hunt also announced increased support for offering flexible working for all NHS staff, through a new mobile app to support more flexible access to bank working, which will be piloted initially across 12 trusts. READ MORE:

tinyurl.com/y9wljfey

According to new figures, approximately 10,000 EU nationals have quit the NHS since the Brexit referendum. NHS Digital found that 9,832 EU doctors, nurses and support staff left the NHS workforce in the 12 months to June, with more expected to have left in the months since. Broken down, this means that 3,885 nurses and 1,794 doctors have left the NHS between June 2016 and June 2017, an increase of 22 per cent on the previous year and 42 per cent on two years previously. The figures match research by the British Medical Association, who reported that four in 10 EU doctors were considering leaving, with an additional 25 per cent unsure about what to do since the referendum. READ MORE:

tinyurl.com/ybtwcocn

Volume 17.5 | HEALTH BUSINESS MAGAZINE

Case Study

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

A global pioneer in the field of patient safety, Datix explains why it has created Datix Cloud IQ Datix Cloud IQ is a safety and quality improvement system. It enables healthcare organisations to generate and implement strategies to optimise delivery of efficient, targeted and effective care. The system reflects the ‘Plan – Do – Study – Act’ process of continuous operational improvement; its main purpose is to provide a clear path to learning from instances of poor or sub-optimal care, taking users from the initial capture or identification of incidents, feedback or surveys through a range of techniques focused on delivering insight, understanding problems, devising cost-effective improvement strategies, implementing those strategies and then measuring their effectiveness. Maintaining an approach established during the 30 years that Datix has been a global pioneer in patient safety improvement, Cloud IQ is the result of Datix’s continued drive for innovation; a culmination of academic collaboration, extensive research and continuous user engagement. It introduces a wealth of new capabilities, significantly extending the value and

HEALTH BUSINESS MAGAZINE | Volume 17.5

benefit of its software and offering many key new features requested by its users. Advancements in software capability in general, and cutting-edge data analytics in particular, mean that we have been able to produce a cohesive range of incredibly effective tools that drive forward the company’s mission to give its customers opportunities to learn from things that go wrong. Cloud IQ is grounded in the wealth of research that surrounds quality improvement in general and healthcare quality improvement in particular. In his 2000 report ‘Organisation with a Memory’, Sir Liam Donaldson pointed out that ‘the lessons must be learned’, but the evidence suggests

the NHS as a whole is not good at doing so. He called for better incident reporting and analysis and a wider, system approach to learning from error and poor outcomes. This report led to the creation of the NRLS and NPSAS, but despite clear effort from such organisations and from the NHS itself, more recent inquiries have identified ongoing shortcomings in implementing and maintaining improvement. Similar experience has led to similar statements elsewhere – such as Don Berwick’s comment that ‘the biggest issue facing the American healthcare system is our inability to improve’ and Lucian Leape’s reflection that ‘the single greatest impediment to error prevention is that we punish people for making mistakes’. Cloud IQ responds to these issues by providing a framework within which problems can be analysed in an open and transparent forum, generating and embedding effective improvement strategies to overcome them. FURTHER INFORMATION datix.co.uk/IQ

AMBULANCES

News

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Ambulance services begin new response times Four of England’s ambulance services have begun the roll out of new response times, announced in July this year. The Ambulance Response Programme (ARP) trials, approved by Health Secretary Jeremy Hunt, show that the new system could bring faster treatment for those needing it and save 250 lives a year, provide an immediate response to 750,000 more calls a year, and drive improved care for stroke and heart attack patients. Speaking at the Health and Care Innovation Expo, Jonathan Benger, NHS England’s National Clinical Director for Urgent

Care, said that a further four ambulance trusts would be switching to the new target times before the winter begins. He said: “Giving call handlers more time for triage doesn’t impede the response to the sickest patients and the ambulance service becomes more efficient as a result. We already have the North West, Yorkshire, West Midlands and South West services working to the new response targets and more will be moving to the new standards in October. “Rather than sending multiple vehicles to one call and having to stand crews down, we are now sending one vehicle

and giving the patient the right response. This is freeing up paramedics and ambulances to attend other calls. “There is now a response standard for every patient and this will focus services on the less urgent calls while not affecting responses to the most serious calls. From now on the bar will set at 90 per cent of calls to be reached in the target times rather than 75 per cent under the old system.” READ MORE: tinyurl.com/yb5okdu8

FLU JAB

ROYAL STATUS

Papworth Hospital granted royal title Papworth Hospital NHS Foundation Trust will receive a royal title following approval from Her Majesty The Queen. The Royal Papworth Hospital, which carried out the UK’s first successful heart transplant in 1979 and the world’s first successful heart, lung and liver transplant in 1986, will become the first royal hospital in the East of England. The hospital is one of the leading cardiothoracic hospitals in Europe, treating more than 100,000 patients each year from across the UK. Stephen Posey, chief executive officer at the trust, said: “We are absolutely delighted to receive this honour from Her Majesty The Queen at such an exciting time in our history. The royal title is a fitting tribute to the many talented, committed staff members who have made Papworth what it is today, and I hope it will inspire more people to join us and be part of our future. We have a busy year ahead as we prepare to move into our new hospital and we look forward to celebrating this news properly as part of our centenary celebrations in 2018.” The name will officially change in 2018. The hospital will also move to a brand new, state-of-the-art hospital on the Cambridge Biomedical Campus next year.

READ MORE: tinyurl.com/y8lkso28

500 patients to trial ‘universal’ flu vaccine Researchers at the University of Oxford are looking for 500 NHS patients to test a new ‘universal’ vaccine against seasonal flu that offers better protection. The vaccine targets part of the flu virus that does not change, as opposed to regular vaccines which are remade to target the type of flu that is expected to be present that year. Because the new vaccine targets the unchanging element of the virus, in theory, it should protect against human, bird and swine flu. The vaccine used last year cut the risk in adults aged under 65 by approximately 40 per cent. However, as people age their immune systems weaken and their bodies respond differently to vaccination. The same vaccine that cut risk by 40 per cent

in under-65s barely worked in over-65s. The research team behind the new vaccine, as well as the National Institute for Health Research (NIHR), who is supporting the project, believe that using it alongside the current one could help bridge the effectiveness difference. Sarah Gilbert, Professor of Vaccinology at the university, said: “Every year, flu in older adults causes serious illness and sometimes death. We want to improve the situation, but in order to do that we need volunteers to help us test a new vaccine. If you are invited to take part, please consider doing so.” READ MORE: tinyurl.com/yacaqohc

MENTAL HEALTH

CCGs plan to halve spending on mental health Liverpool MP Luciana Berger has revealed that half of local clinical commissioning groups (CCGs) plan to reduce the amount of their budget spent on mental health. 64 of the 129 CCGs who responded to a freedom of information request plan to reduce the proportion of their finances spent on mental health, despite the government promising to increase funding in mental health services. NHS England’s planning guidance for 2017-19 stated that all CCGs are required to increase spending on mental health by at least as much as their overall budget increase.

Berger, a campaigner for mental health, said: “Theresa May claims to be committed to improving mental health but her cuts are harming mental health services. Ministers must ask themselves how long this can be allowed to go on for. They are overseeing a system which puts patients at risk and staff under unbearable pressure. Enough empty promises. At the very least [Health Secretary] Jeremy Hunt must urgently introduce a ring‑fence around mental health budgets.” READ MORE: tinyurl.com/y8rqm9ro

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We’ve cut splashing by over 90%* to reduce the spread of waterborne infections. Nobody looks deeper into infection control than Armitage Shanks. Every detail of our MARKWIK 21+ mixer and CONTOUR 21+ basin has been designed in collaboration with infection control experts. Our new clinical mixer and basin solution includes: • Patented HydroFin to reduce splashing by over 90%* • Antimicrobial SmartGuard+ hydrophilic glaze • Simplified waste to improve water flow and reduce water retention • High levels of brass and a reduced waterway bore in the tap to minimise biofilm formation Visit armitage-shanks.co.uk or email BusinessSupport@armitageshanks.co.uk to find out more about our complete range of hospital solutions. *Splash reduction recorded during development testing

Our patented HydroFin reduces splashing by over 90%*

INFECTION PREVENTION

NEW PRODUCTS LAUNCHED TO BATTLE IN‑HOSPITAL INFECTION

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Bacteria has nowhere to hide as new sanitary products are launched to battle in‑hospital infection. Healthcare bathrooms can, if not carefully managed, provide virulent breeding grounds for the growth of bacteria and the spread of infection Luckily, new innovations from sanitaryware brand Armitage Shanks can help to fight bacteria and provide optimum hygiene and infection control within hospitals. Here, the iconic British brand discusses its new Markwik 21+ fittings and Contour 21+ clinical ceramics ranges. ABOUT MARKWIK 21+ Features are used throughout Markwik 21+’s design to maximise antimicrobial effect. A manual thermal flush feature allows maintenance staff to override the thermostat and flush the fitting through with very hot water, preventing bacterial depositing. An integral thermostat enables water to be mixed closer to the point of discharge – eliminating the cold water ‘dead leg’ and minimising warm water areas. Auto-flush technology ensures electronic fittings that are irregularly used are flushed with water every day, preventing bacteria formation. A ‘hydro-purge’ facility flushes water through the pipework and inlets to ensure a debris free system after installation and enable flushing after chemical disinfection. Detachable spouts, one piece designs and demountable body components allow for complete washer disinfection, reducing the risk of Pseudomonas aeruginosa and Legionella. ABOUT CONTOUR 21+ The Contour 21+ clinical basin features advanced drainage to combat water pooling, a common source of bacterial growth. Its simple waste assembly ensures water drains instantly and vertically, through a smooth pipe system, free of steps Contour 21+ basins feature thinner, more angular rims, steeper slopes and a smaller back area—all designed to avoid water pooling and facilitate easy cleaning. Research shows high levels of splashing occurs when taps run into clinical basins, spreading bacteria and viruses as far as two metres. Contour 21+’s HydroFin – an innovative fin on the product base to deflect splashing and reduce it by 90 per cent. The Contour 21+ range includes integral SmartGuard+ antimicrobial additive technology. This antimicrobial protection

reduces possible cross-contamination and maintains surface cleanliness and hygiene across its lifetime. Further, the ultra-smooth glaze of SmartGuard+ has been designed to make it more difficult for bacteria to cling to the surface. A SEAMLESS FIT – AND IDEAL FOR SPECIFIERS The Markwik 21+ and Contour 21+ ranges fit seamlessly together, providing a fully integrated system and the optimum in clinical hygiene. Aside from the healthcare benefits, the products also fulfill the entire supply chain’s exacting criteria. The easy and flexible

installation options of the new Markwik 21+ and Contour 21+ ranges makes them simple to install and maintain. Contour 21+ can be installed by one person in seven minutes compared to the current basin taking two people 18 minutes. Furthermore, the product design makes both ranges easy to use. Hospital environments mean that infection can never be entirely eliminated. However, the use of intelligent sanitaryware can help to effectively battle bacteria and keep infection at bay. L FURTHER INFORMATION For more on Armitage Shanks’ products, visit: www.idealspec.co.uk

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Case Study

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ISS World demonstrates how working in partnership reaps the rewards This year’s PLACE (Patient-Led Assessments of the Care Environment) scores were recently revealed, which had everyone reaching for the league tables. It isn’t just the individual trusts that pay special attention to the results; those who are aligned to the in-house services are equally committed to the trend of continual improvements. ISS Healthcare, sponsors of the Health Business Awards, was quick to compare the scores from its contracts up and down England to see how they matched up against the national standard and this year, once again the news was very good. The aggregated ISS cleaning score showed 98.9 against the national 98.4, both of which should be considered as outstanding but one very special trust had good cause for celebrating. The Walton Centre NHS Foundation Trust, situated in Liverpool, has achieved incredibly high marks in the three years since PLACE inspections were introduced. This year it excelled once again across all areas of scrutiny. The hospital’s average across all seven areas of the assessment was 99.9 per cent; 1.5 per

cent above the national average and on a par with their scores last year. Paula Bamber, Head of Facilities and Developments, was delighted with the results. She said: “It’s a fantastic achievement yet again by our staff. Year on year we consistently achieve outstanding results on this inspection, which is obtained through the hard work and dedication of the Estates and Facilities Department, the Infection Control team, and our partners in ISS Healthcare.

“When the trust consistently achieves high results on this inspection it becomes more difficult each year to retain such a high level, but our staff succeed every time. So to achieve it again is brilliant. I couldn’t be more proud of our hardworking teams.” Andrew Carter, ISS general manager, said: “It’s an incredible set of scores and a fantastic national position which I think everyone here can be truly proud of. “We all work hard to provide the highest quality service for patients, visitors and staff. Being recognised in this way makes it all worthwhile! ISS works shoulder to shoulder with The Walton Centre and it couldn’t be a better partnership. The scores are proof of this.” To ensure the test is as impartial as it can be, members of the public who take part in the assessment fill out confidential questionnaires. The PLACE assessments are managed nationally by NHS Digital Workforce & Estates. FURTHER INFORMATION Tel: +44 845 0576300 info@uk.issworld.com www.uk.issworld.com

Providing The Human Touch

ISS Facility Services Healthcare Velocity 1, Brooklands Drive, Brooklands, Weybridge, KT13 0SL - Phone: +44 845 057 6300 EMail: enquiries@uk.issworld.com

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PAPERLESS NHS

Health Business Top 10: pursuing paperless When NHS England announced its ambition to be paper free at the point of care by 2020 it highlighted the potential of full digitisation to generate billions of savings, essential to keeping the health service sustainable. In our penultimate Top 10 list of 2017, Health Business recognises the UK trusts that are leading the pack in pursuing paperless ambitions There is no doubt that better use of data and technology can be an overwhelmingly positive move for the NHS, and is therefore unsurprising that the Department of Health and NHS England have been so keen to limit the amount of paperwork and increase the dependency on technology within UK hospitals. Technology not only reduces the administrative burden for care professionals, but will also give patients more control over their health and well-being. Launched in February 2016, NHS England set out a wide‑ranging strategy to transform the records of its trusts, naming 16 Global Digital Exemplars that would lead the way in reducing the paper burden on the NHS and promote digital records and patient information. Digital Health Intelligence’s CDMI+36 NHS technology adoption report, published earlier this year, argued that Jeremy Hunt’s

NHS ‘Paperless 2020’ target would not be met by trusts, and warned that all NHS hospitals would not be paperless until 2027 by the earliest. This furthered the view of Dr Robert Wachter, who’s NHS commissioned review recommended that the ‘unrealistic’ 2020 target be relaxed, and instead suggested that a target should be set for all trusts to be ‘largely digitised’ by 2023. However, while the 2020 target remains understandably contentious, the progress that some trusts have made digitising their records and implementing new technologies should not go unnoticed. South Tees Hospital NHS Foundation Trust South Tees Hospital NHS Foundation Trust is gradually introducing a new electronic document management system across all of its wards at The James Cook University Hospital and the

Friarage Hospital. First to benefit will be children’s services which will start piloting the new digital e-forms soon. The Evolve Clinical Noting system will eventually replace all healthcare records at the trust. Clinicians will still have access to past paper records, but any new information will go onto the electronic system so they can securely access it from any NHS site. Benefits of going paperless include that it is more secure, it’s live, it’s efficient and it improves reporting. As part of the project, 1.5 million case notes have been digitally created and 18 months of historic letters are being migrated into the system. Any paper documentation that is received in future will be scanned onto the system. Ian Whitehead, consultant in anaesthesia and critical care and clinical project lead, said: “Patient records are currently paper based and can be located across numerous places in our hospitals or community health services. This E

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PAPERLESS NHS  can often mean that the complete picture of a patient’s health and care is not immediately available to a clinician at the point of care. “Evolve will enable colleagues to have access to all the information they need at all times and in all locations, with the digital record available 24 hours a day, seven days a week. It’s a stepping stone toward a complete electronic record.” Lisa Lizzio, clinical noting project manager, said: “It has taken a lot of hard work to ensure we are delivering a system that is safe and fit for purpose but it’s very exciting to be able to roll this out across our hospitals starting with our children’s services. Over time patients will see a more streamlined service with clinicians having improved access to clinical records.” tinyurl.com/y89gph5v County Durham & Darlington NHS Foundation Trust In September this year, County Durham & Darlington NHS Foundation Trust and Sherwood Forest Hospitals NHS Foundation Trust announced that they were now processing all of their hospital referral appointments electronically via the NHS e-Referral Service. Electronic referral appointments reduce a hospital’s paperwork, saving millions of pounds for the NHS in the process, while also allowing patients to decide on an appointment at a date and time that suits them and at the hospital of their choice, limiting the likelihood of cancelled appointments or patients not turning up. Old paper methods are being phased out across all trusts and, from 1 October 2018, providers will no longer be paid for activity which results from referrals made other than through the NHS e-Referral Service. There are approximately 60,000 referrals made across the NHS every day. Sarah Perkins, director of performance at County Durham and Darlington NHS Foundation Trust, said: “We’re delighted to be pioneers in the introduction of e-referrals which have many benefits for our patients. Following their appointment with a GP at which the need for a referral to see a consultant is agreed, patients can choose to take a unique booking reference number home and make the appointment themselves. This enables them to see the availability and make an appointment for the date and time of their choosing, receiving instant confirmation. When patients prefer not to do this themselves, GP practices can make the booking for them.”

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Taunton and Somerset NHS Foundation Trust Partnering with IMS MAXIMS, Taunton and Somerset NHS Foundation Trust

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became the first NHS trust in the country to go live with an open source electronic paper record (EPR) in 2015, before its newly announced ‘Fast Followers’ Wye Valley NHS Trust and Blackpool NHS Foundation Trust adopted the system this Autumn. The trusts were named at the recent NHS Expo. Having been named as a Global Digital Exemplar by the government in 2016, the trust worked with IMS MAXIMS to implement an open source EPR and provide an effective digitisation model for the wider NHS. Stuart Hill, deputy chief information officer at Taunton and Somerset NHS Foundation Trust, said: “We look forward to working with Blackpool and Wye Valley in making the most of digital technology to drive better and safer patient care. In using IMS MAXIMS open source technology, we are creating a more effective hospital environment, where informed clinicians have crucial information at their fingertips. “We will be working with IMS MAXIMS, Blackpool and Wye Valley to continue the improvements to this system, so that they can be passed on at no cost to other parts of the NHS. This has always been part of the mission.” tinyurl.com/y83raomh Plymouth Hospitals NHS Trust Plymouth Hospitals NHS Trust is the largest hospital in the south west peninsula, with a secondary care catchment population of 450,000 and a wider peninsula population of approximately 2,000,000 who use its specialist services.

the trust, said: “The trust has supported an open standards approach to solutions development and delivery for many years and the implementation of a class leading ePMA solution based on this, new to the NHS, openEHR platform represents a significant step towards true data and system independence. “We see this as the core building block of our paperless Integrated Digital Care Record and, in collaboration with local and National partners, will encourage the development of a vibrant eco‑system which supports local development, promotes organic innovation and application development by SMEs and creates robust partnerships with major commercial partners to implement and support the solution.” tinyurl.com/y7zcrmts University Hospital Southampton NHS Foundation Trust Back in 2015, clinicians and IT specialists in Southampton were awarded £1.35 million by NHS England to develop a revolutionary electronic health records system to enable immediate access to health records and allow the sharing of information with clinical colleagues from secure computers and tablets. At the time, University Hospital Southampton NHS Foundation Trust planned to scan any remaining paper documents about a patient’s care before closure of the health records library in 2017. The system, it was hoped, would save the trust more than £1 million a year.

If patient records remain paper based, they remain located across numerous places in our hospitals. This could mean that the complete picture of a patient’s health and care is not immediately available to a clinician when needed In September 2017, the trust announced plans to implement the paperless prescribing and medications administration (ePMA) system, OPENeP, becoming the first trust in the country to do so. In the ‘first of type’ implementation in the UK, the system will replace time consuming manual administration processes, and instead will allow different technology systems to interoperate and for data to seamlessly flow. The Code4Health clinical community, supported by NHS England and NHS Digital, has collaborated on the project to assure the safety standards are correct. The trust, which is a best of breed trust which implemented an EPR in 2005, plans to start wholly using the system from June 2018. Andy Blofield, Director of IM&T (CIO) at

In 2016, the trust was named a digital centre of excellence by the Department of Health, following the success of a number of digital initiatives, including the development of My Medical Record – a personal online patient health record – electronic blood tracking via wristbands, a mobile vital signs early warning system and a full electronic record in all critical care units. Adrian Byrne, director of informatics at UHS, said: “We are at a very exciting stage in digital technology development in the health service, empowering patients to take more control over their healthcare and working towards the development of personalised medicine, as well as safer practices.” tinyurl.com/yc42goc9

Imperial College Healthcare NHS Trust Over 75,000 patients at Imperial College Healthcare NHS Trust are now able to receive their appointment notifications via email rather than traditional post, as part of a project to improve how the trust communicates with patients. This compares to the 1.5 million patient appointment letters sent via post the previous year. By switching to emails, patients get their appointment details more quickly and conveniently, with the move expected to save £1 million over four years on postage costs – money that can be redirected to patient care. The trust is also leading the development of a Care Information Exchange which will give patients access to key aspects of their records through a secure online portal, allowing them to take a greater role in managing their own health and care. As John Kelly, head of systems solutions at the trust, acknowledges: “Once you have digital records, other improvements start to become possible. When you have your blood pressure, pulse and temperature taken on a hospital ward, the usual process has been for the results to be written down and then transferred into your records. Now, a combination of wireless technology and digital records allows those measurements to go straight from the monitor into your record. This increases accuracy and gives the healthcare professional precious extra time to devote to patient care.”

tinyurl.com/ya3a3o4p Kent & Medway NHS and Social Care Partnership Trust Kent and Medway NHS and Social Care Partnership Trust (KMPT) has received national recognition at the Public Sector UK Paperless Awards, for the trust’s Electronic Discharge Notification Project (EDN). The project, which is having a positive impact on patients, was one of five finalists from across the UK in the ‘Paperless Project of the Year’ category and won the main sponsor prize from Wacom Clipboard. The EDN Project gives information about a patient’s hospital care to the GP’s patient record system and has greatly improved both patient experience and care quality. The previous method was to physically send hard copies of records to services. Dr David Chesover, clinical lead for mental health, West Kent CCG, said: “The work done for KMPT on the patient electronic discharge notification project was very well led with excellent attention to detail, collaborative with West Kent CCG Mental Health team and delivered an excellent product. The project delivered on time using digital technology to significantly enhance patient care, note keeping and patient

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Over 75,000 patients at Imperial College Healthcare NHS Trust are now able to receive their appointment notifications via email rather than traditional post – this compares to the 1.5 million patient appointment letters sent via post the previous year safety on discharge from hospital. It was a pleasure to undertake this important piece of work with KMPT.” tinyurl.com/y8nu9tue Oxford University Hospitals NHS Foundation Trust As one of the largest NHS teaching trusts in the UK, Oxford University Hospitals is well placed to discover how new technology can improve efficiency and safety at its four hospital sites. Through the System for Electronic Notification and Documentation (SEND) project, staff have replaced bedside paper charts, which record adult patients’ vital signs, with tablet computers – meaning that information about patients can be shared more quickly around the trust, saving crucial time that was previously spent looking for and transporting paper charts. Alongside the Real-Time Blood Transfusion Data and Decision Support project and the integrated electronic patient record system, the trust saves at least £500,000 a year. Oxford University Hospitals NHS Foundation Trust was named as one of government’s 12 initial digital exemplars, having won funding from the Safer Hospitals, Safer Wards NHS Technology Fund in 2013 for an iPad-based early-warning system for patient monitoring and an ‘electronic prescription’ service that allows patients to leave hospital sooner.

tinyurl.com/jszz8ue City Hospitals Sunderland NHS Foundation Trust In September 2017, South Tyneside and Sunderland Healthcare Group welcomed news that South Tyneside NHS Foundation Trust was to become a ‘fast follower’ in City Hospitals Sunderland’s digital footsteps. Announced at the NHS Innovation Expo, South Tyneside NHS Foundation Trust will now partner with City Hospitals Sunderland NHS Foundation Trust, which was chosen by NHS England as one of 16 digital exemplars in September 2016 in recognition of being one of the most digitally advanced trusts in the country. Through the alliance, both organisations are working towards the national ambition of patient records becoming paperless by

2020, with Sunderland being one of the first trusts to adopt electronic paper-free working within its new Emergency Department and maintaining electronic health records across its hospitals. Further plans have already been suggested for more online access to electronic records which will let the patient take more control of their health and well-being. Ken Bremner, chief executive of South Tyneside and Sunderland Healthcare Group, said: “This is fantastic news for South Tyneside District Hospital and for our community teams and means we can accelerate learning from Sunderland to develop world class digital systems that will benefit patients in South Tyneside for many years to come. “For over 25 years we’ve recognised the critical role that technology now plays in delivering world-class healthcare services and in Sunderland we have set the bar in terms of investing in our digital footprint to improve the quality of patient care. Our new Emergency Department is now completely paper-free at the point of care and uses technology that can move around with the patient.” tinyurl.com/y9rmdbtx Wirral University Teaching Hospital NHS Foundation trust In 2014, prior to becoming one of the Department of Health’s digital exemplar hospitals, NHS England awarded Wirral University Teaching Hospital £3.5 million to help catapult it to become one of Europe’s leading users of healthcare IT. Part of the Safer Hospitals, Safer Wards Technology Fund, the investment encouraged the development and full roll-out of paperless integrated digital care records, something the trust uses through the Millennium software system, which allows patient information to be securely accessed from anywhere within the trust at any time. This then also reduces duplication of information and replaces paper-based working practices. Mark Blakeman, director of Informatics for Wirral University Teaching Hospital, said: “Safe, digital record keeping is the way forward for the NHS. In order for the trust to continue to provide high quality and effective care for all, information must be able to flow securely in our hospitals allowing data to follow patients throughout their entire healthcare journey.”

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VANGUARDS

Technology

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Discovering the right digital tools There is potential for digital technology to significantly impact on the NHS Five Year Forward View’s ‘triple aim’ of providing better health, better care, and better value. Health Business examines the development of digital technology, as expressed in a new paper

A new report from NHS Confederation, NHS Clinical Commissioners, NHS Providers and the Local Government Association explores how five vanguards are implementing innovative digital technology solutions at the heart of a new approach to care. In 2015, following the publication of the NHS Five Year Forward View the previous year, 50 local health and social care systems, otherwise known as ‘vanguards’, were selected to take the lead on the development of these new care models, with a number of them specifically focused on implementing digital solutions at the heart of a new approach to care. New care models: harnessing technology analyses how East and North Hertfordshire, Better Care Together Morecambe Bay, Better Together Mid Nottinghamshire, Salford Together and East Midlands Radiology Consortium are overcoming myriad challenges in adopting digital technology in health and care, and are instead using it to enable more efficient, integrated, precise and personalised care. According to the authoring bodies, the starting point for any project introducing

The rds are vangua digital g adoptin y to enable og technol e efficient, mor d, precise te integra rsonalised and pe are c

new technology should be the perspective of the end users. This means that any digital programmes should be ‘co‑produced with people who use services’ so as to ‘ensure that the solutions are anchored in their needs and experiences’. The report finds that technology should always aim to enhance, rather than replace, existing services. This is an area where technology adoption often falls short. NHS trusts must analyse how solutions will support existing systems, processes and ways of working, and make use of learning and evidence from other areas. EAST AND NORTH HERTFORDSHIRE Enhancing health in care homes is a project that has been undertaken by East and North Hertfordshire Clinical Commissioning Group

(CCG), Hertfordshire County Council and Hertfordshire Care Home Providers Association (HCPA). In an age where the social care crisis is threatening to overspill, and consequently damage an already oversubscribed health system, the vanguard aims to help health and social care providers in Hertfordshire work together to provide greater levels of support for care home residents and avoid unnecessary trips to hospital. HCPA implemented a Quantitative Timed Up and Go (QTUG) package within its residential care home exercise visits in 2015. The technology sees a tablet, installed with QTUG software, and two medical-grade sensors, attached below the knees, monitoring a patient’s walking. Measuring criteria such as gait and stride length, the sensors can E

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HEALTH & CARE

IMPROVING HEALTH AND PATIENT CARE BY DIGITAL TRANSFORMATION In December 2015, the NHS published NHS planning guidance which was dominated by Sustainability and Transformation Plans (STPs). These are five-year plans that layout a new ‘place based’ approach to procuring and delivering services The scope of the STPs is broad but key themes include improving productivity and addressing variations in care. This is where digital transformation can have a positive impact if the right systems are used in conjunction with each other. There is a major drive within the NHS towards Electronic Care Records (ECRs) to allow different services to access the entire patient record for Health Care Professionals (HCPs) to save time and improve care. The challenges to this are many and varied, as outlined in the recent NHS IT Leadership Survey Report, 2017, which looks at the priorities and concerns of health CIOs, CCIOs and NHS IT leaders. BUILDING A SUSTAINABLE FUTURE ECRs, accessible by different services and patients themselves, remain a top priority, as reported by the same survey last year. Central to this project is the aggregation of the plethora of information about a patient, which crosses numerous specialist applications within a trust and beyond. These applications deliver numerous benefits to individual departments. Many have been developed by software vendors working in partnership with leading clinicians to ensure that they deliver exactly what the department requires to manage patients in their specialty. To underpin such a major undertaking there are several sub projects that need to be addressed to guarantee success. The survey highlights infrastructure upgrades as an essential component of progress towards achieving the end goal. With more departments going paperless, the strain on the

existing networks and servers is growing and needs to be reviewed with sufficient capacity that can cope with the increased usage. With Paperless 2020 fast approaching, pressure is building and confidence in meeting this target has slipped. Cyber security is also high on the list – even though the survey was completed before the WannaCry outbreak, which exposed weaknesses in an aging infrastructure. Making so much data available more widely also presents challenges in the area of Information Governance (IG). MAKING PROGRESS MORE SIMPLE With so many interconnecting challenges, it might seem almost impossible to quickly make progress. Fortunately, alternative solutions are already having significant impact. Leading provider of clinical information software, Hicom, is working with the NHS to precipitate a shift towards a more modern IT infrastructure and provide sustainable and affordable high-quality services that are supported with efficient processes that drive better health outcomes. Hicom supplies 100 trusts with diabetes patient management solutions, which can integrate directly with a hospital’s main Patient Administration System (PAS), pathology system and into its electronic medical records, and with the introduction of patient portals, mobile applications and clinical workflow tools, Hicom is helping to facilitate faster, safer and better care. Interoperability is another NHS watchword and one example of this is Health and Social Care in Northern Ireland (HSCNI), where Hicom

is delivering interfaces that have overcome historic obstacles to silo’d information. Interfaces have enabled the Northern Ireland Electronic Care Record (NIECR) to be populated with data captured through each of its five trusts’ diabetes information management systems, which incorporate Hicom’s adult diabetes management solutions, Diamond, which has been developed with leading clinicians and healthcare specialists. Hicom’s paediatric diabetes solution Twinkle is also being deployed. Twinkle is hosted by Hicom, thereby removing the headache of maintaining infrastructure from the trust. Diamond, traditionally a larger installation on trusts servers, is also now offered as a hosted service; proving attractive to procurement and IT teams alike. UNLOCKING DIGITAL TRANSFORMATION Having access to patient information at the point of care empowers HCPs and community-based professionals to make the most appropriate treatment decisions that can alleviate avoidable hospital admissions and enhance health outcomes. Digital technology is certainly proving to be a powerful stimulus for this and for enhancing communication and the move away from silo’d working within the healthcare industry. Based on over 30 years of working with the NHS, Hicom is acutely aware of the pressures trusts face in meeting the current healthcare strategy and the overarching feedback is the need for integration, and high-quality data that is accessible at any time, and at every touch point along a patient’s journey. Local NHS organisations are compelled more than ever to explore new, secure ways to harness the information revolution and take the necessary steps to improve patient care even more. The NHS’ strategy, along with GDEs, are helping trusts to migrate in the right and same direction. System integration and exploiting available technology such as cloud computing will help to further advance the progress being made. L FURTHER INFORMATION www.hicom.co.uk

HEALTH BUSINESS MAGAZINE | Volume 17.5

VANGUARDS  calculate a person’s risk of falling. The data collected can then be cross-referenced and compared to data for people in the general population of the same height and weight to calculate falls risk. More immediately, the technology allows Hertfordshire care home staff to build a more rounded picture of each person and their specific needs. HCPA has reported that the use of the QTUG device has resulted in a reduction in falls risk in 15 of the 19 nursing homes for residents who attended more than half of the association’s exercise classes. Interestingly, there was no change for those attending less than half of the classes, highlighting to HCPA staff, and the care home residents themselves, the importance of regular exercise. As a result of the success of the care home pilot, and additional funding from NHS England, the HCPA team have been able to roll out the technology and exercise classes into community settings. BETTER CARE TOGETHER MORECAMBE BAY The Better Care Together telemedicine project seeks to reduce unnecessary journeys taken by the public and ambulances in South West Cumbria. The town of Millom has a population of just 8,500, and generates over 22,900 one-hour journeys to Furness General Hospital each year, combining to over 1,000,000 miles travelled. The project team believe telemedicine has the potential to transform health and care in a rural part of the country, hoping for telemedicine to account for 20 per cent of outpatient activity at University Hospitals of Morecambe Bay (UHMB) Foundation Trust within three years, with patients receiving the same level of care but in more convenient locations. A video link between a GP surgery in Millom and Furness General Hospital Emergency Department has been set up, enabling for a triage to be remotely undertaken digitally. If travel to the hospital is required, this is immediately arranged. Virtual out of hours appointments and telehealth links have now been established between Millom Community Hospital and GPs at Cumbria Health on Call (CHOC) and between the hospitals and the Category C prison in the area. BETTER TOGETHER MID NOTTINGHAMSHIRE More than 15 million people in England live with at least one long-term health condition, accounting for 70 per cent of NHS spending, representing 55 per cent of GP appointments and 77 per cent of inpatient bed days. The Better Together Mid Nottinghamshire telehealth project, which uses a Florence telehealth tool, was adopted in response to widespread interest from clinicians in tackling these issues. Florence is an automated telehealth tool that uses SMS text messages to help

people manage their own health conditions at home, using biometric devices such as blood pressure monitors. The system sends text messages to prompt patients to stick to tasks that they have agreed with their clinician, such as sending in vital sign readings. Patients reply to Florence via text message and the system responds in accordance with protocols agreed by the clinical team. The Nottingham Assistive Technology Team first rolled-out Florence in 2012 within heart failure services. The project proved that hospital admissions were being avoided, in some cases by up to 35-48 per cent, as a result of detecting signs of deterioration earlier. In fact, at least 80 per cent of respondents from each patient group reported less frequent usage of GP services after they started using Florence. Since the heart failure trial, Florence has been deployed across a range of areas, including diabetes, hypertension and blood test reminders. The system is continuing to be rolled-out across Nottinghamshire and across even more types of health conditions, including pain management and a project looking at cancer pathways and use of telehealth cognitive behaviour therapy. SALFORD TOGETHER Salford Together is a partnership between Salford City Council, NHS Salford Clinical Commissioning Group, Salford Royal NHS Foundation Trust, Salford Primary Care Together and Greater Manchester Mental Health NHS Foundation Trust. It aims to deliver £27 million of recurrent savings by 2021 through reducing hospital admissions and eliminating duplications across the health and social care system.

Technology

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offers a framework that enables healthcare organisations to address their specific population health priorities through, for example, predictive analytics, care coordination and patient engagement. Salford Royal also uses the Allscripts Sunrise Clinical Manager, an electronic health record solution, in areas such as A&E and critical care, departments which previously relied on paper. This has enabled staff to electronically record and track decisions about patient care, which has been integral to the trust’s strategy to be the safest organisation in the NHS. EAST MIDLANDS RADIOLOGY CONSORTIUM The East Midlands Radiology Consortium (EMRAD) covers over six million patients and eight trusts in the region and aims to deliver timely and expert radiology services to patients across the East Midlands, regardless of where they are being treated. Figures show that the East Midlands has the lowest number of radiologists per 100,000 people out of all the regions in the UK. A five per cent growth in the number of consultant radiologists between 2012 and 2015 was matched by a 30 per cent increase in the number of CT scans over the same period. Outsourcing radiology cost over £88 million in 2015 alone. EMRAD, working with GE Healthcare, has created a Cloud-based, shared, radiology IT system capable of handling of millions of patient events, which allows clinicians to access the complete radiology imaging record for all patients across the East Midlands, regardless of where they are based. This brings greater flexibility in the use of the radiologist workforce, resulting in additional capacity.

As the social care crisis is threatening to overspill, the Hertfordshire vanguard aims to help health and social care providers collaborate to provide greater levels of support for care home residents and avoid unnecessary trips to hospital The Salford Together vanguard is pursuing plans to become an Integrated Care Organisation (ICO) with intentions to bring a workable IT system and the right technology in place. A lot of work was undertaken to coordinate approaches to IT and get council and trust networks together. The ICO, which is delivered by Salford Royal, encourages the development of a shared care record system across many diverse systems – from GP, hospital and social care records. In March 2016, Salford Royal selected Allscripts CareInMotion population health management platform to supersede their existing shared integrated record system. The platform shares data across disparate systems within clinicians’ workflows and

Over the first pilot, six neuro-radiologists looked through 1,160 images and helped 939 patients, and were able to significantly reduce the backlog of radiology images in a few weeks. Since then, Nottingham University Hospitals and Sherwood Forest Hospital have now implemented the IT system as a sustained live service (business as usual), proving there is the appetite, and capability, to make use of the technology across large teaching hospitals and smaller general hospitals. The IT system will also be rolled out to Chesterfield Royal Hospital in the near future. L FURTHER INFORMATION tinyurl.com/yb2r2gz3

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IMPROVING HEALTHCARE

THE BIGGEST AND BEST IN THE WORLD NEEDS WORLD CLASS SUPPORT

There is little doubt that the UK NHS provides some of the finest care in the world. Babies born at 25 weeks survive and thrive. Older people, fixed up and able to enjoy independent life for many more years. Diseases that killed in the 1950s have been eradicated or controlled A huge workforce of highly educated, compassionate clinicians instil confidence and provide care to patients. Supported on the outside by an army of inventive companies producing ever better pharmaceuticals and medical devices or equipment. But wait. The inventors, doctors and angels don’t do it all alone. Behind the scenes, there are thousands of NHS staff in support roles. Doing the important job of making sure their organisation keeps running. That supplies, food, cleaning, maintenance and all the other services flow well. Letting the carers care. Look around you. World class behaviour abounds. In the high street, on the industrial estates. Go-ahead organisations have invested heavily in technology. Why? – to stay in business of course. The NHS must do the same. Now. NHS support services need to be dragged out of the last century. Why? – added efficiency and savings. There is huge room for improvement. Millions upon millions of savings can be made. HOSPITALS CAN IMPROVE SAFETY, ENHANCE CARE AND SAVE COST AT THE SAME TIME Investing in world class systems will have a positive impact on care as well as saving cash for more frontline services. And it must start now. So where’s the fat, how can the NHS become lean? In commerce, times have never been more competitive. Nor more cost conscious. To survive and prosper, the world’s biggest and best commercial organisations have been forced to look down the barrel of this same gun. Their answer, embrace more efficient systems. If Walmart can do it, so can the NHS. Savings in processes and supply chain management. Every process put under the microscope. Potential savings calculated. Ranked, with the best return on investment top. The NHS doesn’t need to invent new technology. Take what’s already tried and tested. Adapt and adopt. Barcoding

HEALTH BUSINESS MAGAZINE | Volume 17.5

for instance. The Department of Health e-Procurement Strategy has outlined best practice. GS1 compliance is now mandated for all hospitals. Non-clinical staff released from fire-fighting with paper based systems. Moving down a proactive, systems-driven, paperless pathway. Clinicians cease administration tasks which add little value, gaining bedside time. Accurate, electronic, easy to interrogate records. No more PIP implant scandals, where thousands of patients are still vulnerable and at-risk because of poor record-keeping procedures (nothing whatever to do with clinical competence). Simply scan the patient wristband and scan the material used is all that is required. Automated reordering. Accurate recording. Informed management. A business case for our inventory management software is easy to create. Investing less than £60,000 per annum with Assistive Partner is likely to deliver savings of well over £400,000 per annum in a hospital’s operating theatre environment alone. Integrate finance and catalogue systems with effective inventory management systems like UNIQUS HIM from Assistive Partner; use PEPPOL and the resultant end-to-end (P2P) system means you’re a long way to delivering a digital future and a future-proof operating system. USING THE UBIQUITOUS SMARTPHONE In private, we order online, realtime updates on our smartphone. Live digital data, regardless of distance. It’s 2017, the NHS must make full use of similar technologies. Several trusts are leading the way.

Working with Assistive Partner and their UNIQUS logistics software, and UNIQUS GO mobile workforce app. Using the smartphone camera to scan barcodes. Capturing recipient’s signatures on-screen digitally. Using GPS to track and record location coordinates in realtime. Live status reports on the whereabouts of vital hospital supplies or important pathology samples on route to the laboratory. Internal package distribution managed with the same software tools. Assets have a barcode added and their whereabouts or service requirements are tracked and recorded easily. Peace of mind. Effective, safe controls to ensure that the most efficient support services are in place. Enabling clinical staff to focus on patients. Without the worry and distraction of chasing ‘stuff’. EXTENSION OF USE TO COMMUNITY HEALTH Embracing commonplace technology need not be confined to hospitals – Julian Cobbledick, Assistive Partner director says: “We’ve been involved in local NHS viability studies showing the positive impact these software tools have in ensuring accurate tracking of things like community clinical waste. Supplies to district nursing and continence teams are also coming under the microscope, ideal candidates for efficiency gains”. NHS support services must embrace the benefits from the paperless digital revolution which we all take for granted in our daily lives. L FURTHER INFORMATION www.assistivepartner.co.uk

ACCELERATING DIGITAL MATURITY IN THE HOSPITAL AND BEYOND

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Supporting the ambitions of Global Digital Exemplars and fast followers, whilst joining up wider health economies

SUPPORTING THE IMMEDIATE AIMS OF GDES Hospitals across the world are working with InterSystems to achieve the highest global standards of digital maturity, including Stage 7 of the Healthcare Information and Management Systems Society’s (HIMSS) Electronic Medical Record Adoption Model (EMRAM). This level of commitment is being reflected strongly in England, where InterSystems is working with NHS customers to reach advanced levels of digital maturity at pace – key aims of the Global Digital Exemplars (GDEs) and fast followers. Harnessing information for better patient care is fast becoming reality, with a sharp growth in technology adoption now anticipated as GDEs lead the way. InterSystems has the means to help NHS trusts quickly deliver effective, proven technology at scale, in order to achieve genuinely integrated care across the enterprise and beyond. CONNECTING CARE, CONNECTING VISION Look past the impetus for digital innovation in the hospital, and national drivers have created the need for future reaching strategy. Hospitals must now not only look inwardly as they break down silos of care, but they must work to realise the aspirations of sustainability and transformation plans (STPs), and of joined-up care. InterSystems is already working with the NHS and the wider care community to join-together their visions and meet the complimentary aims of national objectives together. There is a need for interoperable solutions in order to integrate care across

boundaries. Professor Bob Wachter’s landmark review of NHS digitisation insisted that ‘interoperability should be built in from the start’. As we support hospitals on their internal digital journey, we will also give them the means to prepare for their outward care partnerships so that patient centric care becomes reality. WHERE WE ARE ADVANCING DIGITAL MATURITY Hospitals using InterSystems technology have proven that digital maturity can be advanced rapidly for improved clinical practice and better patient care. Helping thousands of hospitals and laboratories across the world to make the most of information for their patients, our customers are already achieving the standard now being set by GDEs to pave the way for NHS digitisation. Look overseas, and King Khaled Eye Specialist Hospital reached HIMSS EMRAM Stage 6 just five months after deploying TrakCare electronic patient record technology. In less than two years, it became the first hospital anywhere in the Middle East to reach Stage 7. The same advanced clinical functionality is now being used in hospitals in England to move towards the same goals. At Yeovil District Hospital NHS Foundation Trust, for example, some £27.5 million of benefits are expected as a result of deploying TrakCare, and by the end of the trust’s phase two deployment, it too anticipates moving closer to Stage 7, with one of the most clinically advanced systems anywhere in the UK allowing thousands of patients to receive safer and better coordinated care from professionals.

HOW WE ARE ENABLING INTEGRATED CARE AMBITIONS Our technology is being put to the test by frontline staff today in England, Scotland, Wales and Northern Ireland, to make a real difference to patient care, and we are working with some genuine pioneers, in hospitals and other care settings, to help them join together services across a full range of health and social care environments; a prerequisite to advancing the wider STP agenda. Interoperability and integration is fast becoming a reality alongside digital maturity, offering important food for thought for GDEs at the onset. Whether that’s the Coordinate My Care service, which has used InterSystems HealthShare technology to enable patient choice for end of life care and to help avoid people spending their final days in hospital, by sharing information between London’s multiple health and care providers. Or our work with Lincolnshire Health and Care, which has brought together 13 health and social care organisations to enable preventative, co-ordinated care across the county. Or whether that’s aggregating and integrating patient healthcare information across health and social care services to deliver an integrated digital care record in South Devon; the evidence is there to learn from. For more than 35 years, InterSystems has been the engine behind the world’s most important applications. In financial services, healthcare and government and wherever lives and livelihoods are at stake, millions of people worldwide depend on the power, scale integration and performance of InterSystems – the power behind what matters. L FURTHER INFORMATION InterSystems.co.uk

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The time is now for interoperability Unlock patient information from diﬀerent sources with powerful interoperability tools. Fully compliant with open standards, while patient privacy is managed.

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EVENT PREVIEW

Where the e-health community meets

ehi LIVE 2017

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ehi LIVE is the UK’s number one show for all those involved in digital health, hospital information, cyber security and healthcare innovation. Health Business previews the show The ehi LIVE show takes place from 31 October to 1 November 2017 at the NEC Birmingham, with more than 4,000 professionals dedicated to IT healthcare in attendance, coming together to discuss the frontline use of healthcare technology and just what products will shape the future of the healthcare industry. Over 150 exhibitors will be also be present to showcase leading solutions and products that are shaping the future of the healthcare industry. WHY ATTEND EHI LIVE 2017? ehi LIVE 2016 welcomed 4,000 attendees and saw a 15 per cent increase in the number of NHS attendees compared with previous years as well as a 25 per cent increase in private hospital attendance. The movement towards a paperless NHS has driven an increase in demand for technology to support healthcare, and this was clearly demonstrated in the discussions that took place at this year’s show. If you work in health informatics or have a close interest in the use of information in health care, ehi LIVE 2017 is a must-go event for you. While IT professionals are at the heart of our audience, we also expect to see healthcare leaders, managers and clinicians involved in the specification, procurement, management and front line use of information systems. ehi LIVE is also where CIOs, CCIOs, CEOs and board members meet and discuss how concepts such as Cloud, wearables, informatics, Big Data, security and social media can improve patient care and create smarter hospitals. It is the go-to-event for people with real buying power in the UK to search for new solutions in IT healthcare. CONFERENCES AT EHI LIVE 2017 The conference line-up for this year will feature more exciting and topical tracks than ever before. Brand new is the addition of the Primary Healthcare and Community and Population Health Management tracks, as well as Imaging and Diagnostics and the NHS Future Leadership Forum.

Revamped tracks include the CIO & CCIO roundtables, Cyber Security and the Acute Health & Social Care Integration conferences. We have made sure to give some variety to the sessions this year, allowing for optimum learning and debate with keynote presentations, real life case studies, debates and interactive panel discussions. This year the speakers have all been handpicked for their ability to demonstrate the theme of ‘bridging the gap between clinicians, technologies and patients’. This will give our delegates the opportunity to hear from CIOs, CCIOs and IT directors as well as clinical leads, specialist consultants and GPs, reinforcing that ehi LIVE is the place to be for both IT experts and clinicians alike. SHOW FEATURES Here are just some of the elements that make ehi LIVE 2017 a must visit event. Located at the heart of ehi LIVE, the Knowledge Hub features leading e-health experts imparting their insights on the latest technologies that are changing the industry. The Knowledge Hub will present key experts in the e-health field covering a comprehensive list of topics, including cyber security strategy for healthcare, healthcare Intelligence for federations and paperless options, to name a few. Additionally, the ehi LIVE Cyber Security Zone, new on the show floor, will showcase the latest technology in protecting the NHS from cyber crimes with real industry case studies. Back by popular demand, the Big Red Networking bus will sit at the centre of the EHI exhibition floor where our visitors, speakers and exhibitors will be able to network, connect and do business. The 2017 show will feature a brand-new layout with conference rooms located directly among the stands, allowing attendees to swiftly connect between the conference content and the cutting‑edge innovations being

The ent movem aperless sap toward s driven an NHS hae in demand increas chnology for te port to sup are healthc

showcased at the exhibition. October’s event will also present the ehi Business Intelligence section to share the latest industry news from the digital technologies applied to healthcare industry. Accessible online on the ehi LIVE website, the articles explore a variety of subjects including cyber security, the WannaCry randsomware attack, paperless options, and mental health; as well as topics trending in digital healthcare across the UK. THE EHI AWARDS The ehi Awards are the UK’s only dedicated flagship event within the healthcare IT calendar that recognises innovation and achievements in the healthcare technology sector. The 11th edition of the ehi Awards will take place on 31 October at the NEC Birmingham. Judged by a panel of industry leaders, the ehi Awards will acknowledge the exceptional accomplishments and contributions of individuals and organisations from across the healthcare IT industry. It will bring together the country’s top IT and clinical professionals from the NHS along with supplier companies hosting their key customers. The aim is to bring the digital healthcare community together this year, and as such for 2017 the ehi Awards will be hosted during ehi LIVE. This is to recognise the great work being done by healthcare IT teams across the UK whilst providing an excellent opportunity to network with industry peers, engage in healthy debates, discuss industry trends in addition to source new IT solutions. The categories for the ehi Awards include: Healthcare Industry Leader – People’s Choice; CIO of the Year; and CCIO of the Year in the Individual Award Categories. The Team Award Categories consist of: Best System or Initiative Adoption/Roll-out; Best Mental Health Initiative; Best Nursing Technology; Best Global Digital Exemplar; Best App for Clinicians; Best App for Patients & Carers; and Trust/Board of the Year. L FURTHER INFORMATION www.ehilive.co.uk

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THE UK’S LEADING DIGITAL HEALTH EVENT What is ehi LIVE? 

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9 CPD Certified conferences led by industry leaders over 2 days

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EVENT PREVIEW

How can GPs get the IT they need?

ehi LIVE 2017

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Dr Neil Paul, a GP in Sandbach and well-known columnist on primary care IT, says technology can help general practice to meet the pressures on it. However, he says this will take scale, funds and skills – issues that he will explore further at ehi Live 2017 General practice is facing two major challenges; demand and recruitment. Lots of people talk about the ageing population, and worry about frailty and co‑morbidity, but our population is exploding and its mainly younger patients with high levels of health seeking behaviour. It’s consumer-driven demand, and it’s unremitting. We are growing by almost 1,000 patients a year and 87 per cent of our practice list came through the door last year at least once. Some people visited over 40 times – that’s almost once a week. Yet our medical workforce is reducing; GPs are retiring, going part time or moving abroad. The Ashfields Medical Centre, where I am based, has never had a problem recruiting. We are a modern practice, with a nice building, and lots of additional services. We are high earning and we don’t do on call. Yet we advertised recently and had no response. Other places are just giving up and handing

back their contracts. In Stoke, which is just down the road, single-handed GPs have been going under for some time, but now it looks like it’s happening around us. Even some big practices are merging, because they can’t cope. FEDERATION MAY BE THE FUTURE Federations are often held out as a solution. People mean different things by federation. To my mind, there are three goals that federations are usually setup to achieve; and different federations place a different emphasis on them. One goal is to be very entrepreneurial, and some federations have gone out and won lots of contracts for traditional secondary care services. One goal is to deliver sustainability and transformation for primary care, which may include reducing variation, improving quality, and focusing on issues like drug spend. Clinical commissioning groups tend to like this. But there is a third goal which is what most GPs seem to be interested in, which is about banding together to generate savings and

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to work as efficiently as possible. I have helped to set up a federation, which covers 30 local practices, that got engagement by helping them; but got funding from the CCG by also looking at service delivery. One of the things we have done is invest in IT support. My federation now employs three IT support people; and it makes a huge difference to the lives of our GPs and their staff. However, it’s also helped improve the services to patients by implementing projects that otherwise wouldn’t have happened. Skype has a role, but not the one that’s often suggested. Of course, in addition to the demand and the vacancies, there are all the traditional problems that get three letter acronyms, like CEP and STP, which just mean ‘there’s no money’ or ‘secondary care spends lots of money, so could primary care step in and save us?’. But how can primary care be the solution when its drowning in work that it doesn’t need to do, hasn’t got the workforce to cope and has no free money to invest or change? We need to free up resource. Which brings us back to efficiency. If there are four surgeries in an area, do they all need a practice secretary or a clinical coder? Could savings be put into E

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ehi LIVE 2017

EVENT PREVIEW  new clinical staff? If so, can we change the skill mix? We have advanced nurse practitioners and pharmacists, but they often need supervision or mentoring – and how do you provide this efficiently? There’s a massive role for IT there. My idea for Skype-type services is not to use them as yet another way for patients to call me, but for providing support to these kinds of people; or for getting everybody together without the hassle of commuting. OUR IT IS NOT FIT FOR THE FUTURE The difficulty with saying that there’s a massive role for technology in solving our problems is that it’s not doing that at the moment. Our commissioning support unit does not invest, and our infrastructure is falling over. My PC crashes all the time – and I’m the IT lead! My wife, who is also a GP, emailed recently to say that it was taking eight minutes to print a prescription – in a ten-minute consultation. Even when they are not falling over, our systems don’t do what we need them to do. It would be great if a reception that is not busy could take on some of the work of one that is overwhelmed; but our telephone and appointment systems don’t make that easy. I have all sorts of technical problems accessing my GP system when I am away from my practice; whether I’m in another NHS building or at home. And systems don’t have open application interfaces, so they can’t link into anything new that’s worth having without a huge amount of cost and trouble. One of the endocrinology specialists at our local hospital has resigned, so it wants to push that work onto primary care. I’m sure a simple app could help up manage it, but developing that app and integrating it into our clinical system is almost impossible to do; even at a CCG level. We think we could make it work; but then we think: ‘It will mean talking to the GP system supplier, and it will want a lot of money to build something’ or: ‘we could get a company in to do it, but then it would have to go to the system supplier and become an API-partner and that will take ages’ and it all feels too hard. IT could also help us with the demand issue; but the big problem there is that companies don’t really target the health market, even though they say they do. Wearables are a good example. Wearables are not targeting health, but wellness. And that creates a lot of new, health seeking behaviour. They tell people things like: ‘You can use our project to measure your blood pressure every ten minutes, and then send the results to your GP’; but what am I supposed to do with them? We do not need more alerts. We need more thinking about how to get people to use less resources not more. We need more services that offer practical advice, while taking proper account of risk. GETTING PARTNERSHIP BACK INTO THE MARKET So, how do we move forward? First, we need to get out of the current mess, and then we need to find a way of getting good ideas from innovation to product to deployment faster. That means we need to get partnership back into the market. One of my patients is the head of IT for a large engineering firm. He has a huge IT budget, and if somebody in the company has a good idea, they can develop it, test it in their own testing environment, and roll it out. We can’t do that. As a federation, we managed to build a sharing platform that is a bit like Stack Overflow, so people could pose questions and get them answered by other users. We hired a programmer, and put it on a server, and we’ve just about managed to keep it running; but no one practice could do it, and as a federation it wasn’t easy. So, sorting things out will need scale, and it will need funding, and it will take putting GPs back in charge of that funding. Back in the primary care group days, every practice had an IT budget that they could spend or top-up, and most people topped up, so if they needed new PCs or printers they just bought them. Now, you could argue that it was not very efficient to have a lot of practices going out and buying printers at high street prices; and that’s why the budgets were pooled and given to CCGs and CSUs. But GPs stopped thinking about IT, because it was supposedly being done by professionals.

Hospitals have made a big investment in chief clinical information officers and I really think we need something similar for primary care; because we need people who are excited by IT and know how to make it work for them. FALLING BEHIND ACUTE IT People often say that primary care is a long way ahead of hospitals when it comes to IT; and it’s true that they have struggled to catch up to where primary care has been. But now I think they are starting to look very sorted. The IT lead at my local hospital has a decent budget, a good team, and she can get the big companies in. So, if we are not careful, hospitals will accelerate past general practice. However, we need to find a way to get back in the game, because we need that technology to help us meet the pressures on us. L

Dr Neil Paul is an honorary senior lecturer at the University of Liverpool in the school of Management. He will be speaking in the primary care stream at ehi Live 2017, a two-day conference and exhibition that is taking place at the NEC in Birmingham from 31 October to 1 November. FURTHER INFORMATION www.ehilive.co.uk

Software to help STPs improve patient care

Forcare understands the challenges you face in today’s complex healthcare environment, and the company has made it its mission to help you address them. Streamline your workflow by enabling smooth data transfer – within a healthcare institution, but also across an STP. Forcare envisages a seamlessly connected suite of information systems that create, manage and share clinical data – driving efficiency and ultimately enhancing quality of care. As a world leader in interoperability, Forcare’s goal is to enable healthcare professionals to provide

high quality care in a more efficient way. Health care organisations around the world are using Forcare’s solutions to manage their data exchange and streamline workflows. Adhering to open standards while managing patient privacy, Forcare ensures maximum connectivity between existing systems and delivers and maintains a future-proof platform. Visit the company at ehi Live at booth E34 to learn more about Forcare’s solutions, where you can get all questions answered in a live demo. FURTHER INFORMATION www.forcare.com/uk

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DATA

Data security isn’t just a technology issue NHS Digital highlights the importance of protecting information and data in the NHS and why NHS staff must be trained in knowing system vulnerabilities Whilst NHS organisations can, and should, have solid cyber security measures in place, no system is completely impenetrable, as seen by the recent high profile attacks on major global companies. The cyber security attack on 12 May 2017 affected a wide range of countries and sectors across the globe, and the fact that it affected more than 40 NHS trusts was a stark reminder of the vulnerability of inadequately updated IT systems. It also reinforced the importance of being vigilant and not opening emails that look suspicious or are from unexpected sources with links or attachments. A small number of organisations in the NHS were infected by the ransomware, but news of the cyber attack had a wider impact as other services closed down their systems as a precaution. Most of these

organisations, whether they were trusts or GP practices, followed NHS Digital’s guidance and put the ‘patches’ in place to protect systems. Although there is always more to learn, doctors, nurses and backroom professionals pulled together and worked incredibly hard to keep services running and to get everything back to normal as swiftly as possible.

it provides the intended benefits of delivering better and safer care more efficiently. Manpreet Pujara is the clinical director for Patient Safety at NHS Digital. Together with the clinical safety group, he is responsible for ensuring that the health IT systems that are developed and deployed for use in England meet the recognised SCCI safety standards. He is also a member of the RCGP Health Informatics Group (HIG), which advises the college and other professional bodies on issues relating to the development and use of information management and technology in general practice. E

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@e ca s e r v i ce s

E CA S e r v i c es L t d

DATA  The Wanna Decryptor malware, that was the culprit of the May attack, spread across the world infecting computers in 74 countries in Europe and Asia. For the NHS, some patient records, appointment systems and medical equipment were rendered inaccessible. As a safety measure many GP surgeries were advised to switch off their systems and disconnect them from the network. Manpreet said: “There are several lessons we can learn from this. Chief among them is the role of practices and individual users in keeping the system safe. Every single device needs to be patched with the latest software. IT provided by CCGs and Commissioning Support Units should be maintained by them, but if GPs have bought other systems, for example telephone systems that run on PCs, then that’s their responsibility. You can’t just install something and forget about it – particularly if it’s connected to your network. “And while filters remove the majority of malicious emails, occasionally one gets through, so we all need to be sensible. Though Wannacry was not the result of a spam email, it’s important that we ask ourselves ‘Was I expecting this email? Does it make sense? Does the sender normally send an email like this?’. If the answer to any of these questions is ‘no’, then don’t open it, and don’t click on any links within suspicious emails. Don’t get tempted to look. ‘If in doubt – block it out’ and forward as an attachment to spamreports@nhs.net.” CYBER SECURITY However, keeping patients safe isn’t just about preventing cyber attacks – it’s also about employing best practice in how IT is used. Manpreet explains: “We heard of one organisation that was using NHSmail to cancel

CT scans. Whilst NHSmail was never designed for this purpose or for referring patients, an organisation may think it is a reasonable use of the system, but only if they have considered adequate business continuity processes and assessed the clinical risk should NHSmail not be available as happened in November 2016. “In one instance a CT scan booked for 3pm was cancelled by email at 2.55pm without assessing and considering the risk that the email may not be read and acted upon in time. In this case the scan went ahead, and a patient was needlessly exposed to radiation. This is why patient safety must always be considered and the SCCI standards met by those that develop and deploy health IT.” Manpreet has some ideas on how to ‘professionalise’ IT use – encouraging every member of staff with access to IT to undergo regular information governance and security of IT systems training. Consideration should also be given to enabling ‘fixed’ desktops across the practice so that unauthorised software cannot be installed without prior approval. He says: “These sorts of measures are necessary, not least because of ‘Personalised Health and Care 2020’, a set of programmes commissioned by the Department of Health, NHSE and the National Informatics Board to ensure that by 2020 the NHS minimises its use of paper and is ready for a digital

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world. IT is changing the way we work, and clinical informatics is central to keeping our patients safe. If we don’t keep our systems up to date, and if we don’t use them properly, we can’t look after our patients.” Since the attack happened, NHS Digital’s cyber teams have continued to listen, learn and offer support, working closely with provider organisations to ensure that they listen to their experiences and use this feedback to strengthen their services. Manpreet explains: “We need to invest in people, across all disciplines, because data security isn’t just a technology issue or just something the ICT team have responsibility for. Leadership is key in ensuring data security is embedded across an organisation, we all have a part to play but those in senior roles can have a significant influence to make sure that things are put in place sooner rather than later. “However, cyber security is the responsibility of everyone in the NHS. You wouldn’t leave your front door unlocked, but not having a secure password on your computer is the cyber equivalent to doing just that. It’s important that all staff within the NHS take some basic and sensible steps to keep digital information safe.” L FURTHER INFORMATION digital.nhs.uk

Modern healthcare relies on good IT, which has been developed in partnership with end users and clinical informaticians, so that it provides the intended benefits of delivering better and safer care more efficiently

Volume 17.5 | HEALTH BUSINESS MAGAZINE

Data Security Written by Sarah Collen, senior policy manager, NHS European Office

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GDPR

New European rules for privacy in the digital age Sarah Collen, at the NHS European Office, looks at why changes to data protection legislation are important for the NHS, as well as the key changes on the horizon for data privacy The use of data is essential to the NHS. The UK government’s recently published Life Sciences Strategy has underlined the importance both of the NHS and of making better use of data in delivering a flourishing life sciences sector in the UK post-Brexit. Reflecting on this, the chief executive of the NHS Confederation noted that ‘industry and the NHS must embrace the digital future – and that means linking data between the different parts of the healthcare system’. He went on to say that ‘the UK’s comprehensive healthcare system could capture data, measure outcomes and provide evidence that in turn could help industry market innovations across the world’. The idea that the use of data by the NHS is important is by no means new. In 2016, the Wachter Review of the NHS made it clear that although there are many ways to

HEALTH BUSINESS MAGAZINE | Volume 17.5

transform service provision and care delivery, healthcare is mostly about information, and therefore managing data is a key to successful system transformation. It said: “It is about the A&E doctor having an accurate medication list when she evaluates a delirious patient, the oncologist having access to the results of a new clinical trial, and the ward nurse being alerted quickly that a patient’s changing vital signs may represent early sepsis. An information-rich healthcare system is also about ensuring that all of the relevant carers have the information they need to transfer the care of a frail patient from hospital to home care or to hospice. Moreover, the increasing importance of genomics in healthcare, patient access to new information via the Internet and social media, and our deepening understanding

of the potential from big data analytics all place a growing premium on information.” The report goes on to state that it would be a costly mistake to try and pursue the aims of the NHS’s Five Year Forward View, to deliver better health, better care and lower cost, in a non-digital NHS. ‘Simply put, the NHS will be unable to achieve its goals without digitising effectively’. Indeed, the use of data is critical not only for providing quality care to individuals, but also for the management of health and care systems, and making life-saving medical discoveries. Those working in hospitals and other health and care settings not only use data for direct care purposes but also to: better understand diseases and improve treatments; understand patterns and trends in public health and disease; plan services that make the best of limited resources; monitor the safety of drugs and treatments; and compare the quality of care provided in different areas. WHY ALL THE FUSS ABOUT DATA PRIVACY? As the majority of data collected by the NHS is personal and sensitive, it goes without saying that data privacy is a critical and necessary element of any data strategy. It is important to ensure the right balance is struck between safeguarding privacy and protecting the interests of individuals, while enabling health and care systems to collect and connect information to benefit us all. Data sharing, and the necessary protection of privacy associated with this, are becoming increasingly important for health systems as they try to adapt and create new models of care delivery. One of

the most significant challenges to creating person-centred networks of care is getting to grips with information governance. New models of care must understand not only the legal requirements on privacy, but also the information and communication channels at work in their networks, and the purposes for which the data are being shared, in order to understand the new frameworks and infrastructures that need to be put in place.

our data protection web page) It is also important to maintain alignment with EU law on data so that the NHS can continue to conduct collaborative research and clinical studies with partners in the EU in the future. The top changes for NHS organisations will see them now being obliged to demonstrate that they comply with the new law. This is an important and significant shift change from passive to active compliance and one that data controllers in the health sector should take note of. It is now mandatory for all public authorities, which will include all NHS organisations, to appoint a data protection officer. Additionally, Data Protection Impact Assessments are required for high risk processing (a hospital processing health and genetic data will fall under this category of high risk). Data protection issues must be addressed in all information processes, while charges, in most cases, will be removed for providing copies of records to patients or staff who request them.

Heal is mostthcare informa ly about therefo tion, and re m data is anaging success key to f transfo ul system rmation

WHAT CHANGES IN LAW ARE ON THE HORIZON? As NHS organisations grapple to enable the best, safest and most effective ways of data sharing, the other side of the coin is managing data privacy. In this area, NHS organisations must start to prepare for changes in the law which will come into force in May 2018. The EU has revised its data protection legislation, to bring it up to date with advances in technology (the previous law was agreed before the rise of the internet, social media etc). This law will come into force before the UK leaves the EU, so the UK is planning to implement this in full. (for more information on this, see

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Additionally, there are specific requirements for transparency and fair processing, a legal requirement for security breach notification and organisations will be required to keep records of data processing activities. There are tighter rules where consent is the basis for processing (although there are alternatives to using consent as a basis for processing) and there could be significantly increased penalties for any breach of the new legislation – not just data breaches. As the NHS prepares for these changes in the law, what is most important is to make use of this new opportunity to place information governance at the heart of activities, ensuring the most effective and efficient use of information, whilst protecting privacy. As the new legislation comes into place, our office is supporting NHS England’s data support unit, which is working with the Department of Health, the Information Commissioner’s Office (ICO) and all health and social care arms-length bodies (ALBs) to produce helpful guidance on the top changes the NHS and other health and care organisations should prepare for. L FURTHER INFORMATION https://digital.nhs.uk/ information-governance-alliance/ General-Data-ProtectionRegulation-guidance

Healthcare cyber security and the GDPR: why compliance is critical for NHS organisations With evolving cyber threats facing the NHS and other healthcare organisations, as seen in recent Petya and WannaCry ransomware attacks, and with the UK government promising patients secure healthcare services, addressing cyber security must be a priority for all organisations handling patient records and sensitive data. To keep pace with the digital landscape and address cyber security needs, compliance with the General Data Protection Regulation (GDPR) will be required from May 2018. The Regulation’s main objective is to strengthen data protection for individuals. It stresses that misusing healthcare data can have serious long-term repercussions for data subjects. In the event of a security breach, organisations that fail to demonstrate appropriate technical and organisational compliance with the Regulation can expect fines of up to four per cent of annual global turnover or €20 million – whichever is greater. The definition of ‘data breach’ includes data not being available for the purposes for which it was collected – a ransomware attack is a data breach because it means a patient’s operation has to be postponed. This will have to be reported, and could trigger a complaint

from the data subject and legal action for damages against the controller and processor. The GDPR provides guidelines and suggestions for data security actions that are ‘appropriate to the risks’, to ensure the ongoing confidentiality, integrity, availability and resilience of processing systems and services, and the availability of and access to personal data in a timely manner. It also encourages organisations to implement a process for regular testing to assess and evaluate the effectiveness of technical and organisational measures that ensure the security of the processing. Healthcare organisations will be required to appoint a data protection officer (DPO) and report data breaches to the relevant authorities within 72 hours. Although initiating GDPR compliance is a decision made by senior management and the board, organisations will rely heavily on the DPO to perform a wide variety of tasks, such as educating employees, training staff who are involved in data processing and serving as a point of contact for the supervisory authority. The UK government has also confirmed that healthcare organisations will need to comply with the Network and Information

Security (NIS) Directive, which is set to strengthen cyber security across sectors that rely heavily on information systems and technology to deliver essential services. The Directive sets specific requirements for breach reporting procedures and incident response management, and warns of additional fines for failing to prevent cyber breaches and implement appropriate protection mechanisms. The NHS and healthcare organisations looking to achieve and maintain GDPR compliance can take advantage of IT Governance’s accredited GDPR training courses and qualifications, as well as GDPR books, documentation toolkits, compliance software and consultancy services. FURTHER INFORMATION servicecentre@itgovernance.co.uk www.itgovernance.co.uk +44 (0)845 070 1750

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OPEX

EFFICIENTLY IMPROVING PRODUCTIVITY FOR A PAPERLESS NHS The NHS is seeking innovative solutions that address tough workflow challenges, increase productivity and lower costs. OPEX’s document scanning solutions offer all three In light of the call to move to paperless care provision in the NHS, the principle challenge for UK hospitals is to essentially convert a huge quantity of legacy paper medical records within their trust and also be able to competently handle the conversion of paper documents, which are created daily by virtue of outpatient clinic visits and inpatient note sets, in part utilising the £1.3 billion ‘Paperless 2020’ funding which Health Secretary Jeremy Hunt first announced in February 2015. This mammoth task historically would have required a physical footprint the size of an aircraft hangar, requiring a small army of additional staff to work through the labour intensive document ‘prep’ process in advance of the arduous task of trying to image these records using expensive hi-speed document scanners not originally designed to handle aged, damaged and stapled content. OPEX is fast becoming the dominant force in digital conversion of hard copy patient files within the complex arena of scanning NHS medical records, seeing the key UK service providers selecting OPEX Falcon as the scanner of choice for capturing patient files. NHS hospitals themselves also realise the labour saving benefits achieved through the Falcon, seeing over 25 trusts and health boards already adopting the OPEX model

HEALTH BUSINESS MAGAZINE | Volume 17.5

as their preferred solution, principally to help them process ‘day forward’ physical medical notes utilising the trust’s own in-house records management staff. By creating a unique solution that’s significantly different to all other hardware manufacturers in this space, OPEX has identified and solved the key issues surrounding this monumental task faced by an already overstretched NHS. REDUCING LABOUR REQUIREMENTS Utilising state-of-the-art combined drop feed and bulk feed technologies, the OPEX Falcon allows a single operator to scan direct from patient medical records folders without the traditional upfront, labour-intensive and costly document preparation. This unique one-touch secure process developed by OPEX is revolutionising the way that UK medical records are now being scanned – through virtually eliminating slow and labour-intensive separate document preparation altogether, so allowing the operator to scan and index medical files at a rate up to three times faster than a traditional ‘prep only’ process. Embedded Kofax VRS technology automatically performs multiple essential background tasks including content‑based rotation, automatic colour detection, background smoothing and image

enhancement - all aimed at speeding up the scanning process whilst simultaneously delivering a high-quality end product. OPEX’s innovative one-touch scanning approach significantly increases process speed while creating a unique capability to manage information direct from source, being the physical medical record file or folder. Offering a fully auditable environment whist maintaining transaction integrity, OPEX’s Falcon document scanning workstations allow hospital and healthcare customers to attack the most difficult and daunting workflow challenges on-site. SMALLER PHYSICAL FOOTPRINT When choosing OPEX Falcon to form the bedrock of a hospital’s digitised medical records process, the significantly reduced labour profile means that finding a home within the squeezed hospital environment becomes a considerably simpler undertaking. When NHS trusts and hospitals compare potential solutions, the conclusion quickly realised is that in order to compete with each OPEX Falcon, a traditional ‘prep then scan’ process requires three more preppers sat at desks, plus an additional desk or similar footprint production scanner required to maintain an image output aligning with that prep team. NHS Trusts recognise the valuable work that is undertaken by large internal teams in the medical records department, but awareness is fast growing that transforming processes through utilising technology as an enabler will allow them to function very differently going forward. Given that OPEX Falcon workstations are comparable in size to a traditional single desk within the prep area, the square footage footprint in medical records typically becomes 75 per cent smaller when adopting the OPEX solution. In simple terms, this solution allows valuable NHS real estate to be better utilised for its primary purpose – the provision of care. That’s all well and good in theory, but the reality which hundreds of OPEX customers in the UK have already concluded is that the OPEX Falcon allows operators to ‘prep and scan’ documents considerably faster than traditionally separate ‘prep then scan’ processes whilst utilising less

space within the hospital premises to achieve this – meaning that internal labour costs are significantly reduced, which frees up precious budget for deployment elsewhere within the hospital or Trust. PROCESS MANAGEMENT With the traditional ‘prep then scan’ approach, we have already noted the need for a large document preparation team and a separate dedicated scan team. In order to maintain consistent workflow throughput, the process requires team leaders to collate and capture manually logged batch information, preparation rates, scan rates and maintain overall process accuracy. When combined with the need to collate and monitor this critical information, it’s easy to establish the necessity for this additional overhead. Translate that into the OPEX Falcon ‘one touch’ process, and we see embedded technology accurately capturing all of this vital information. Ideally positioned for scanning medical files, OPEX Falcon processes everything from single sheets to multiple stacks of documents, from thick paper to onion skin and fragile or damaged pieces, from envelopes and file folders to receipts and small forms, X-rays to three-dimensional objects – nearly any format or type of document can be scanned. Operators can view captured images in real-time to ensure proper capture and identification – so reducing time-consuming and costly rescans later in the process. The OPEX Falcons’ base model and package ensures that for every record scanned, the hospital will be capturing the patient information and create the taxonomy of that file to accurately recreate the consultants preferred view. Meanwhile, in the background we’re automatically gathering additional critical MI – identifying who processed that file, when they processed it, how many pages were within the file, the number of pages contained within each section, how fast the operative processed the file, how many rejects or jams occurred… even drilling deep down to understanding the idle time accrued in processing, and so highlighting if an operator is reading the

file rather than productively scanning it. This impressive suite of MI data is held locally or shared to a real time OPEX platform called ‘Insight’. Insight enables an easily visible overview of the live production process, combined with a historic review of both process and individuals, virtually eliminating the need for additional management overhead. INCREASING PROCESS SECURITY In a world where security of data is absolute, how can we manage that data when it remains in a physical form, and open to the elements? In legacy ‘prep then scan’ processes, it’s perfectly conceivable that from shelf or box the patient record could well have been handled by four different individuals. During the prep and scanning process, the potential risks around loss or damage to the patient record is high, and becomes extraordinarily difficult to monitor and police. When processing medical records scanning work through the OPEX Falcon machines, the process is designed in such a way that only a single ‘touch’ is required by the operative, and that ‘touch’ is being fully audited in the background for security and process management requirements. Ultimately this results in less risk and improved outcome for the digitized patient record – whilst creating a referenceable, compliant audit trail in the event that the file is scrutinized for patient care purposes or legal reasons once the hard copy patient file has been securely destroyed. Our value proposition is simple – OPEX Falcon significantly reduces labour costs by creating a combined prep and scan process, unique to OPEX hardware, allowing a single operator to prep, scan and index at a rate up to three times faster than traditional prep only rates. This combined with our proprietary CertainScan capture and transformation software creates a secure one-touch process, delivering custom digitized contents and metadata into our client’s EDRMS platform. The resulting outcome is the only market solution able to reduce capture costs by 250 per cent or more against all other prep-then-scan processes.

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Paul Keefe, OPEX sales manager, says, “OPEX’s hardware offerings have always aimed to significantly save labour costs within a scanning process, but the benefits we bring to the conversion of NHS patient records goes far beyond that. We have seen our market share grow year on year in this space not only in new projects but also replacing traditional scanning processes within trusts looking to make a financial saving and I believe that really tells a story. As the deadline for a paperless NHS moves ever closer we are still investing in developing OPEX technologies in this area, whilst our competitors seem to be moving away to a more software only focused model.” ABOUT OPEX CORPORATION: With over 40 years’ experience OPEX Corporation is recognised as a cutting‑edge innovator and global technology leader within complex document imaging and high-speed mailroom automation arena – providing performance enhancing workflow solutions with measurable cost‑effective results to thousands of customers in the UK and around the world. OPEX has focused on delivering high-quality innovative solutions to customers across multiple industries including healthcare and government, and direct to business processing organisations who themselves serve the exacting demands of the UK Healthcare scanning market. With proven technologies and unique ‘prep then scan’ processes, OPEX’s combined hardware and software solutions deliver state of the art and cost effective solutions that exceed their client’s demands. OPEX’s growing customer base return time after time, understanding the value of how OPEX technologies automate manual processes by streamlining the traditional processes associated with medical records imaging and sorting to reap the benefit from their investment by reducing labour, yet increasing security. A winning combination. L FURTHER INFORMATION www.opex.com pkeefe@opex.com

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Document Management

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DIGITAL

Turning patient notes digital and pursuing paperless South Tees Hospitals NHS Foundation Trust has taken a step towards introducing paperless patient notes – a move which will ultimately make health records more secure and accessible. Health Business looks at the digital innovation which is better utilising data Writing for Health Business magazine at the start of 2017, Andy Kinnear, chair of the BCS Health & Care Executive, wrote that ‘digitising the health service is no longer simply about improving the efficiency of its day-to-day mechanics or about ensuring information flows to support planning and financial management’. Instead, we have ‘passed the point whereby providing services ‘online’ is considered a value-add, it is simply the norm’ and patients rightfully ‘expect to interact digitally for the services they receive’. Long before the start of the year, the NHS recognised the benefits of digitising its patient records and managing its documents in a more efficient manner and has invested millions in trying to achieve it. Paper files can take time to locate, access and move, whilst physical notes can be hard to care for, and can be illegible, incomplete or untraceable – both of which create a slower, more frustrating health service. Simply put, technology has changed and public expectation has changed with it. Back in March, nursing staff at Weston General Hospital partnered with Perfect Ward to switch to smartphone‑based technology to replace their current paper‑based systems. Previously, nursing audits were paper-based which meant staff spent a significant amount of time writing up findings and analysing results. The new system, an app which uses technology to simplify nursing audits that review the quality of the care patients receive, allows staff to capture ward inspections on their smartphones or tablets which provide instant feedback, allowing results to be instantly shared with colleagues. In July, Kent and Medway NHS and Social Care Partnership Trust received national

recognition at the Public Sector UK Paperless Awards as one of five finalists from across the UK in the ‘Paperless Project of the Year’ category, eventually winning the main sponsor prize from Wacom Clipboard. The trust’s Electronic Discharge Notification Project (EDN) gives information about a patient’s hospital care to the GP’s patient record system and has greatly improved both patient experience and care quality. SOUTH TEES HOSPITAL NHS FOUNDATION TRUST More recently, South Tees Hospital NHS Foundation Trust announced that it was gradually introducing a new electronic document management system across all of its wards at The James Cook University Hospital, Middlesbrough, and the Friarage Hospital, North Yorkshire. The first department to benefit from the move has been children’s services which began piloting the new digital e-forms towards the end of September. However the plan is for the Evolve Clinical Noting system to eventually replace all healthcare records at the trust. Clinicians will still have access to past paper records, but any new information will go onto the electronic system so they can securely access it from any NHS site. As part of the new project, 1.5 million case notes have been digitally created and 18 months of historic letters are being migrated into the system. Any paper documentation that is received in future will be scanned onto the system. Ian Whitehead, consultant in anaesthesia and critical care and clinical project lead, said: “Patient records are currently paper based and can be located across numerous places

Outside ital, osp of the hng of data ri the sha es patients provid ge scope of u with a hties that could i possibilo a significant g lead t of care bein portionministered ad re elewhe

HEALTH BUSINESS MAGAZINE | Volume 17.5

in our hospitals or community health services. This can often mean that the complete picture of a patient’s health and care is not immediately available to a clinician at the point of care. Evolve will enable colleagues to have access to all the information they need at all times and in all locations, with the digital record available 24 hours a day, seven days a week. It’s a stepping stone toward a complete electronic record.” Lisa Lizzio, clinical noting project manager, added: “It has taken a lot of hard work to ensure we are delivering a system that is safe and fit for purpose but it’s very exciting to be able to roll this out across our hospitals starting with our children’s services. Over time patients will see a more streamlined service with clinicians having improved access to clinical records.” UTILISING DATA If the NHS is going to achieve its target of being a wholly digital institution by the early 2020s, as outlined by the government, it will need to evaluate how it utilises data in order to improve the delivery of care, as well as, in the face of a projected £2 billion deficit by the end of this financial year, create new metrics by which it measures its performance and efficiency. We live in a time where our lives are inextricably connected to the internet, and data in its infinite forms can be recorded and transmitted instantly to the Cloud – what is referred to as ‘big data’. This opens the door for medical professionals to be able to assess statistics and indicators, in huge volumes, from a bird’s eye view like never before. It’s important to be able to differentiate the various classifications of data in order to make best use of its applications to healthcare, and, broadly speaking, there are three considerations to take into account that can help extrapolate the potential benefits and pitfalls of data in healthcare. As the NHS continues its initiative to become paperless, there are new technologies that allow nurses to carry out assessments and calculate early warning scores digitally,

through mobile technologies and bedside terminals. This data is recorded and then transmitted to a central system, which is accessible to doctors and nurses across the hospital, who then get notified of any developments in the patient’s condition in real time. Having remote access to this kind of data means that caregivers can not only react more efficiently in clinical terms, but as the data is available to all hospital staff, it can improve on the often complicated rota system, which promotes better time management. Outside of the hospital, the sharing of data provides healthcare professionals and patients with a huge scope of possibilities that could lead to a significant portion of care being administered elsewhere. Mobile apps that are centred around fitness and well-being collect data on how active the user is, often in conjunction with a wearable device, and can be useful on a superficial level in helping combat diseases, such as obesity and diabetes. Online therapy apps for mental illnesses also monitor interactions with the user and flag worrying results

As technology advances, there is more anticipation surrounding projects that promise to provide clinicians with more detailed information about their patients relating to illnesses that can’t be treated by patients themselves back to clinicians for assessment, leading to potentially life-saving interventions. As technology advances, there is more and more anticipation surrounding projects that promise to be able to provide clinicians with more detailed information about their patients relating to illnesses that can’t be treated by patients themselves. At the turn of last year, The King’s Fund highlighted ‘eight technologies that will change health and care’, one of which noted the potential of ‘portable diagnostics’, such as the AliveCor ECG, which records ECGs and heart rates through an attachment to a smartphone accurately enough for clinical use.

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The landscape of innovations that harness health data is constantly shifting and evolving, but one constant factor that remains is skepticism from the public as to whether they trust the NHS – and the broader government – to handle some of their most intimate details. As such, it is important to take into account, and create a specific strategy for handling and using these two separate tiers of data in order to make them clinically and operationally beneficial. L FURTHER INFORMATION www.southtees.nhs.uk

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CLADDING

KINGSPAN – PASSING THE FIRE TEST Fire in any building is a serious matter, but when it comes to hospitals it becomes critical to have a building construction that will perform well, giving vulnerable patients time to escape in the first instance, and ultimately helping to protecting assets, such as valuable equipment and the building itself Consideration must be given to a wide range of factors to ensure the best protection, and insulated panel systems can provide a highly effective building envelope solution. Fire is a complex phenomenon. So much in predicting how a building will perform depends on a combination of the materials used, the quality of the installation, fixings, cavities and the design of the building itself. Regardless of whether the insulation core is considered to be ‘non-combustible or of limited combustibility, it is the interaction of all of these factors that will determine how a specific system will perform in a real fire scenario and whether or not it contributes to fire propagation. When it comes to simply applying the rulebook, it has become apparent that there are several issues with the current system of regulation. The first is the assumption that ‘non-combustible’ materials automatically provide a ‘safe’ construction, yet mineral fibre insulated panels with a non-combustible core use a relatively large quantity of combustible PU adhesive to glue the fibres to the steel sheets, for example. The only reliable way of assessing panel system combustibility therefore is to base a judgement on testing the entire system. TESTS AND STANDARDS The existing Building Regulation tests and the Euroclass Reaction to Fire Tests do not fully assess panel performance and should not be taken in isolation. Because insurers take a different approach, having an interest in property conservation, they recognise the limitations of the small-scale reaction to fire tests used to demonstrate simple Building Regulation life safety compliance, and have developed their own large-scale tests. Of these the two most well known and widely recognised are LPCB (Loss Prevention Certification Board) and FM (Factory Mutual – now known as FM Global). LPCB’s LPS1181 test, sometimes referred to as the ‘garage test’ comprises a 10m long, 4.5m wide, 3m high enclosure clad in the materials under test. The enclosure is open at the front and has a ventilation window at the side. A wooden crib, which generates a 1MW fire load, is ignited in the corner and the fire development

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is monitored. Although there are several pass – fail criteria, the key parameter is that there should be no fire propagation beyond a 1.5m zone around the crib. FM has a quite different test standard for assessing reaction to fire to the Building Regulations. The test standard is FMRC 4880 (1994) Approval requirements for Class 1 fire classification. There are various levels of performance with the key level being with no height restriction. Achievement of Class 1 with no height restriction is dependent on performance in a number of tests that include: ASTM E84 Surface Burning Characteristics; ASTM D482 Ignition Residue tests; ASTM E711 Oxygen Bomb tests; UBC 26-3 Room Test; FMRC Room Corner Test (25/50ft test); FM 16ft parallel-panel test. The 50ft wall test is very severe. Two walls 15.24m high with a small ceiling are lined with panels and a large fire source (345kg dry timber) is positioned in the corner. To achieve approval without any height restriction, there has to be no flame spread or fire propagation to the extremities of the panel construction. PIR‑insulated panels have performed well in all these tests, characteristically forming a stable protective char and demonstrating no flash over, flame spread or fire propagation, no panel collapse, relatively small and acceptable smoke levels and high levels of fire resistance. This performance has been borne out by a number of case studies, which have proved the strong correlation between the large-scale

insurer tests such as LPS1181 and the actual performance of panels in a fire scenario. CASE STUDY: WHARFEDALE HOSPITAL In 2003 a fire broke out at Wharfedale Hospital, which was under construction at the time, and was partially clad with LPCB/FM approved PIR core insulated panels. The fire was started via an arson attack, when some adhesive was ignited, resulting in a very high fire load, distorting intumescent coated beams and cracking the adjacent compartment floor. At its peak, there were 10m high flames impinging directly onto PIR core panels. Investigation into potential damage to the steel columns led to the insulated panels being cut into by fire fighters, revealing the PIR core, which appeared to have been virtually unaffected by fire. The independent investigation reported that the insulation cores: did not ignite, and did not promote fire spread within the core or to the eaves. NO COMPROMISE At a time when energy efficiency, ease of construction and durability are all important aspects of investment into healthcare buildings, there must be no compromise on fire safety. LPCB approved PIR core panels tick all of those boxes. L FURTHER INFORMATION +44 (0) 1352 717 251 www.kingspan.com info@kingspanpanels.com

PROCUREMENT

Saving money through FM services Over the next four years – the length of the framework agreement – around £100 million of public sector spend is expected to go through our new Hard FM framework. And with the organisations that purchase via NHS Shared Business Services (NHS SBS) frameworks expecting to save a minimum of five per cent, compared with buying direct from a supplier, the potential cost saving to the public sector stands at over £5 million.

rod was int ospitals and h provide ctices with a GP pra sy and legally a quick, eliant route to comp for Hard FM market ice lines serv

Volume 17.5 | HEALTH BUSINESS MAGAZINE

Written by Peter Akid, director of Procurement at NHS Shared Business Services

efficiently, and, in an increasing number of cases, to expand to meet growing demand, are available to buy via these carefully‑negotiated and free to access agreements. THE HARD FM FRAMEWORK The Hard Facilities Management framework was introduced to provide hospitals, GP The latest framework agreement adds to our practices, schools and local authorities – and comprehensive estates and facilities portfolio, any other public body for that matter – with which also includes Modular Buildings, a quick, easy and legally‑compliant route to Construction Consultancy Services and Soft market for Hard FM service lines. It includes 85 Facilities Management. It means that different suppliers across 45 different the majority of goods and services lots, covering everything from within the estates and facilities building management The field, which NHS and other systems and removal k r o public bodies need to services; to fire safety w e fram uced to function safely and equipment and E

As demand increases and pressure to deliver more for less continues to grow in the NHS and wider public sector, Peter Akid describes how the newly-launched Hard Facilities Management (FM) framework provides value-for-money and legally-compliant access to a huge range of essential goods and services

Facilities Management

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Is your building ‘mobility friendly’? As detailed in the Equality Act (2010) places of employment, schools, clubs, shops, offices and public buildings must provide adequate access and egress facilities for all persons with disabilities who may enter or exit a building.

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PROCUREMENT

The new Papworth Hospital Cutting-edge technology and unprecedented sustainability are underpinning one of the UK’s biggest health sector construction projects.

 training; electrical sundries and components, to catering equipment maintenance. Within each lot there is also a broad range of specialised services. For instance, if an NHS trust is moving to a new hospital site, suppliers providing ‘removal services’ can offer support around the removal of office furniture and equipment, transporting expensive and unwieldy medical equipment, any storage issues, and the full project management around such a move. The framework also provides the scope for organisations to procure the more every day services they need to operate. High quality providers of roofing and guttering, ventilation and air conditioning, painting and decorating, and flooring and plumbing, are all included within the framework. Like all of the frameworks managed by NHS SBS, this one was launched following a robust procurement process, which included upfront financial checks and evaluation of quality assurance. Crucially for many of the public sector organisations across the country that will use it, the negotiated contracts are OJEU (Official Journal of the European Union) compliant. This gives public sector organisations the confidence that they are not only purchasing in a way that saves them time and money, but at the same time

Daikin Applied UK successfully bid to work with Skanska on the design and build of 60 air handling units and 3off water cooled chillers for the £165 million new Papworth Hospital project, one of the biggest health sector construction projects in the UK. Spatial restrictions are always an issue for AHU’s particularly on hospitals where the strict HTM requirements need to be maintained. Each unit of the 60 air handling units were designed to provide a tailor made solution for optimising guarantees their compliance with complex UK and EU procurement legislation. It also means that framework users have the flexibility to either purchase directly from a listed supplier, or run mini-tenders as per their individual requirements, whilst there is even the option for a fully managed service, where one provider is awarded to perform all services across the scope of the framework agreement. Elsewhere, measured term contracts can also be put in place via the framework for the maintenance of building, electrical, mechanical, and painting and decorating. A good mix of

Daikin Applied Air Handling Units, with their plug and-play design and inherent flexibility, can be configured and combined specifically to meet the exact requirements of any Healthcare sector project. Our systems are engineered to be the most environmentally friendly and energy

air conditions throughout multiple spaces, allowing design flexibility with no limitations. A key development proposed by Daikin Applied was the selection and use of the latest high efficiency EC fan and motor solution which currently provides the best overall drive efficiency in the market. These fan arrangements used single fans, twin fans and multiple fan arrays which allow for increased resilience and rapid service. Read more at tinyurl.com/y8qycrfm

Facilities Management

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large national providers and regional SMEs on the framework, meanwhile, ensures it is reactive to local needs. In total, NHS SBS manages over 100 framework agreements that cover a huge range of products and services used by the NHS and wider public sector. Like the Hard FM framework, they are available quickly through contracts with NHS terms and conditions, which achieve economies of scale cost savings without compromising on quality. L FURTHER INFORMATION www.sbs.nhs.uk

Bespoke AHU Solutions Specifically Designed for the Health Sector

efficient on the market, thus reducing their ecological impact, while, at the same time, keeping costs down through the minimisation of energy consumption.

AHU Professional Airflow from 0.4 m3/s to 50.0 m3/s › Health Technical Memorandum compliant › Scottish Health Technical Memorandum compliant › Optimal indoor air quality › Dimensions to any size in 50 mm increments › Bespoke production, design & testing › Hygienic ,Corrosion resistant systems available

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Volume 17.5 | HEALTH BUSINESS MAGAZINE

Simplify your Fire Safety Management Systems Strategy > Documentation > Systems > Maintenance

All your Fire Safety Management and Systems in One Place FMS Documentation Set

Integrated Fire Management System

Fire Strategy - 1

Documentation - 2

Systems - 3

Maintenance - 4

As a part of the overall fire management strategy, our works are able to produce a report outlining key areas relating the fire management strategy to the Fire Management Systems. This report will draw on the fire risk assessment and fire strategy, to deliver a plan summarising the key objectives and all requirements to ensure the safe protection of all occupants and properties.

By drawing all the key Fire Management System (FMS) documentation together, a comprehensive and streamlined FMS Documentation Set is established and links clearly how the Fire Strategy is implemented on site and to the Fire Management Systems and equipment along with the staff response actions. All documentation can then be clearly presented and maintained within a dedicated documentation portal.

Design of all Fire Management Systems to ensure total implementation of the fire management strategy. All design works are to the requirements of the respective standards including BS5839 Pt.1 and HTM-05 for Healthcare premises. Works include for the implementation of new and upgraded Fire Systems including risk-free installation and implementation of systems within existing and live Hospitals and Healthcare Buildings.

Provision of comprehensive Planned Preventative Maintenance to an Asset based register ensuring all systems are performing to the required fire strategy. Includes full certification to BAFE standards and includes third party auditing of existing systems where required to BS5839 Pt.1 & BAFE standards. Ongoing documentation upkeep and client training is also fundamental to ensure the continued implementation of the Fire Management Strategy.

Please call or email us for more information or for a free initial assessment

info@firesystemsconsultancy.co.uk | www.FSC-Autronica.com | 0845 6262 777

HEALTH & SAFETY

Fire Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Reduce your false alarms Fire safety legislation in the UK places the responsibility of ensuring the people within the premises are safe from fire. There are various fire safety laws that vary slightly depending on location, but they all ostensibly say the same thing. For the sake of accuracy and preventing any confusion, here is the full list: Regulatory Reform (Fire Safety) Order 2005 – applicable in England and Wales; Fire (Scotland) Act 2005; Fire Safety (Scotland) Regulations 2006; The Fire and Rescue Services (Northern Ireland) Order 2006; and The Fire Safety Regulations (Northern Ireland) 2010. Each piece of legislation refers to the ‘responsible person’, ‘appropriate person’, or ‘duty holder’. All these terms are different depending on what piece of legislation you are reading, but they all mean the same thing: the responsible person is the person who will

oversee all the fire safety and fire prevention usually made worse with the installation strategies for the building and be liable should of automatic fire detection systems, which there be a failure to comply with the law, or will automatically call the fire brigade out if there is a fire. That person is usually the to the site in the instance of the alarm employer or building owner. In the case of being activated (whether this is through a hospital, this is whoever has the highest the detectors activating or whether responsibility and ownership over the hospital. someone presses the manual call point Whilst protecting the hospital and the button to activate the alarm). persons within with appropriate fire Recent government statistics protection is vastly important, have revealed that as much In it is also vital to maintain as 40 per cent of Fire premise a close watch on false and Rescue Service s such as alarms, as these can have a callouts are false h ospitals false al detrimental effect in many alarms which create , arm inc ways – taking staff away unwanted fire i d w e nts ere com from patients and causing signals, so it really monly triggere unnecessary hassle whilst is imperative that d the alarm is switched off. everyone with striking by trollies the sid The problem is responsibility for a e a manu building makes the al call of necessary changes point to manage their own systems more effectively to prevent further detriment on the time and resources of an already stretched Fire and Rescue Service. The false alarms problem is further compounded by the absence of a single automatic fire alarm (AFA) Fire & Rescue Service attendance policy in England. Some Fire and Rescue services will attend AFA incidents, whereas others may not – or there could potentially be a charge for unwanted fire signal callouts after the Localism Bill of 2011. This lack of consistency makes it difficult for both end users and fire alarm maintenance companies; whereas in Scotland there is one policy and this has been further reinforced by the setting up of a single fire service. With that in mind, the ‘responsible person’ should make an active effort to stay abreast of all the major changes within the realm of fire safety (e.g. changes in the law or other guidance issued) and take appropriate action. There are a number of different pieces of guidance available to hospitals, particularly on the topic of false alarms.

Written by Will Lloyd, technical manager, Fire Industry Association

Fire safety might seem like a basic topic to the initiated, but it is actually incredibly important to get it right. For some difficult buildings, such as hospitals, this can be a challenge, says Will Lloyd of the Fire Industry Association

CUTTING FALSE ALARMS The UK’s largest not-for-profit trade association for fire protection, the Fire Industry Association (FIA), has a dedicated section on its website for cutting false alarms and unwanted fire signals, as E Volume 17.5 | HEALTH BUSINESS MAGAZINE

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Brookside Fire Service Ltd offers a wide range of fire protection and fire safety products and services within the country. Listed below are the main product sectors all of which are backed up by our teams of Specialist Service Engineers. • • • • • • • •

Fire extinguishers supplied & serviced Fire Alarm & Emergency lighting systems supplied installed & serviced Nurse Call and Door Access Systems, supply, installation and maintenance Portable Appliances Testing Fire Training Fire signage Risk Assessments Sprinklers, Dry Riser and Hydrant Maintenance

CONTACT DETAILS Tel: 0121-457-8484 Email: sales@brooksidefireservice.co.uk Website: www.brooksidefireservice.co.uk

Fire Damper Maintenance – preventing the spread of fire Our experience and knowledge shows that, as the ducting is hidden above ceiling tiles and is out of sight, the maintenance and cleaning is often forgotten until an issue occurs. As a result; Fire Dampers (FD) are not inspected or tested in accordance with the HTM code of practice. Fire Dampers are used in heating, ventilation and air conditioning ducts to prevent the spread of fire inside the ductwork through fire-resistance rated walls and floors.

How we can help: • Identify and locate each fire damper • Modify and retrofit access hatches where access is difficult • Carry out fire damper testing, cleaning and drop testing • Provide accurate records and photographic evidence of fire damper testing, cleaning and drop testing • Provide detailed report on problem areas and recommend remedial actions

In the event of a rise in temperature; the fire damper closes, usually activated by a thermal element. This melts at a temperature higher than ambient but low enough to indicate the presence of a fire allowing springs to close the damper blades. Fire dampers are activated when an electrical signal from the fire alarm system is activated by detectors remote from the damper, indicating the sensing of heat or smoke in the buildings occupied spaces or in the duct system. In a normal working environment, the dampers are open, however it is vital to ensure that they will close effectively when required. By providing a barrier beyond which the fire cannot pass, effective fire dampers save lives; so regular damper testing (known as drop testing) as well as fire damper cleaning and maintenance is both a legal requirement and a critical part of the building fire safety management. In accordance with BS9999:2017, now specifies that all fire dampers should be drop tested, cleaned and tested at least every year. This is because normal use of the ventilation system gathers an accumulation of contamination on the fire damper and its operational parts. This must be removed and the fire damper tested regularly to ensure that its operates as designed, should a fire occur.

• Carry out remedial works where required.

For more information on how we can help you comply with the HTM Code of Practice contact: Meritas Fire and Security Protection Ltd Website: www.meritas.co.uk | Email: info@meritas.co.uk | Telephone: 01376295060

HEALTH BUSINESS MAGAZINE | Volume 17.5

HEALTH & SAFETY  well as resources to help manage the fire protection of the building as a whole, covering a wide range of information – from fire risk assessment and management, to alarm testing and maintenance, as well as portable fire extinguishers (and more). However, one of the key areas that the FIA covers is funding vital research into fire protection methods, products, and false alarm prevention. This research is then used as a basis to create further guidance on the subject of fire protection. One of the most recent advances in this area is in false alarm reduction. The FIA, along with other stakeholders, helped fund a research project conducted by the Building Research Establishment (BRE) back in 2014‑2015 called ‘Live investigations of false fire alarms’, which was an investigation into the causes of false alarms at a range of different locations – including hospitals. The investigators noted down the different causes of false alarms and the frequency of these events between December 2014 and March 2015. Whilst many of these events were caused by simple human mistakes, such as burning toast, cooking, or

Fire Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Whilst protecting the hospital and the persons within with appropriate fire protection is vastly important, it is also vital to maintain a close watch on false alarms, as these can have a detrimental effect in many ways smoking, a surprising amount came from accidental activation of the alarm system. BRITISH STANDARDS In the incidents of false alarms by accidental activation, the report highlighted that in premises such as hospitals, incidents were commonly triggered by trollies striking the side of a manual call point. In a busy hospital environment, this can all too easily be done but the research recommended that protective covers be fitted to prevent false alarms in these cases. The research recommendation was so strong that the FIA then used the research to change the British Standards (codes and guidelines that are best practice and should ideally be adhered to) to include getting covers

fitted on manual call points as standard. Therefore, if false alarms are an issue – it could potentially be down to accidental activation in this manner. As such, having covers fitted may be a useful step towards reducing false alarms. This should also prevent people mistaking the manual call point for the door release button (surprisingly, this is a common error, since the two are often installed next to each other by the door; we recommend correct signage to help with this issue as well as installing covers). The change to the British Standards only officially rolled out this September, so now is the perfect opportunity to reassess the fire protection within your building and see if it needs updating to be more in line with the new guidelines. However, you don’t have E

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HEALTH BUSINESS MAGAZINE | Volume 17.5

15/08/2017 08:50:36

HEALTH & SAFETY  to be an expert in the British Standards yourself to know what changes to make to reduce false alarms – you can speak to a professional. The FIA is comprised of over 700 member companies who have been independently audited and checked to assess their quality and professionalism. This is known as Third Party Certification. Companies that have been certificated in this manner have undertaken rigorous checks to ensure that they are able to work on life safety systems such as fire detection and alarm systems safely. Third Party Certification also applies to a range of other fire safety services, such as portable fire extinguisher installation and maintenance, fire extinguishing system design, installation, maintenance, and commissioning, as well as to companies that perform and manage fire risk assessment. The FIA undertakes rigorous checks to ensure that only those with Third Party Certification can join and become members of the association. These member companies will be able to give you a professional service and will be able to advise you on the best action to take. A full list can be found on the FIA’s website under the ‘Find a Member’ section, where you can search the list by location and by service, to quickly locate the service you need. The website also has a section under the ‘Resources’ tab labelled as ‘Fire Safety Advice’. Head to this section of the website to learn about fire safety legislation, fire risk assessment, and further advice on how to reduce false alarms. The information is designed to help you (if you are the responsible person) to understand your responsibilities and what actions you should take in order to protect your building. L

Fire Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

The FIA helped fund a research project in 2014-2015 called ‘Live investigations of false fire alarms’, which was an investigation into the causes of false alarms at a range of different locations – including hospitals

FURTHER INFORMATION www.fia.uk.com

Fire chief calls for sprinklers in all high-rise buildings Dany Cotton, commissioner of the London Fire Brigade, has warned that the Grenfell Tower fire should be a ‘turning point’ in UK fire safety and has called for sprinklers in all high-rise buildings. Speaking to the BBC on 13 September, Cotton said: “I think Grenfell should be a turning point. I support retrofitting – for me where you can save one life then it’s worth doing. This can’t be optional, it can’t be a nice to have, this is something that must happen. If that isn’t one of the recommendations (of the Grenfell Tower inquiry) then I will be so very disappointed.”

Volume 17.5 | HEALTH BUSINESS MAGAZINE

CPD Workshops Fire Performance of Insulated Panel and Webinars

and Façade Systems

Kingspan Insulated Panels is running a series of CPD workshops and webinars, focusing on the fire testing and real-life fire performance of external envelope systems. These will cover the following learning objectives:

– The difference between metal faced insulated panel systems and siteassembled built-up systems including rainscreen. – Fire testing of insulated panels for life safety and asset protection. – Property insurance requirements and relevant Building Regulation requirements across the UK and Ireland. – The behaviours of insulated panels in real fire scenarios.

CPD Webinar

Date

Numbers will be limited, so act now to secure your place. To register for the above event, book a face-to-face workshop, or for more information including dates of further webinars, visit:

Friday 13th October 2017

kingspanpanels.co.uk/fire

Time

or contact us by phone or email on:

Fire Performance of Insulated Panel and Façade systems

11:00

Tel: +44 (0) 1352 716100 Email: fireinfo@kingspanpanels.com

CLADDING

Ensuring safety through cladding checks In July, three hospitals were found to have combustible cladding after Health Secretary Jeremy Hunt ordered routine fire safety checks on all hospital buildings following the Grenfell Tower fire. Health Business reports on what hospitals are doing to ensure their building materials are safe Cladding made from an aluminium composite material is thought to have contributed to the rapid spread of the fire which engulfed Grenfell Tower in June, which is thought to have killed up to 80 people. Documents, obtained by the BBC at the end of June, revealed that contractors working for Kensington and Chelsea Council were asked in 2014 to replace zinc cladding with a more economical aluminium version. The aluminium type, which was less fire resistant, saved the council nearly £300,000. On 4 July, buildings at London’s King’s College Hospital, Sheffield Children’s NHS Foundation Trust and the North Middlesex Trust were found to have combustible cladding. The fire safety checks, initiated by Health Secretary Jeremy Hunt in the aftermath of June’s Grenfell Tower fire, prompted each site to undertake steps to improve safety. After identifying the material that was found to be combustible, Sheffield Children’s NHS Foundation Trust immediately began work

to remove it from the building’s structure. The Stephenson Wing, a five‑storey building on Western Bank which has two floors of cladding on its upper levels, reported that the areas with cladding did not have patients within. Staff who work in the area also received enhanced fire safety training from the South Yorkshire Fire and Rescue to make sure everything is in place to protect the safety of patients and staff. JOHN RADCLIFFE HOSPITAL More recently, a hospital in Oxford shut its trauma unit after fire safety checks carried out after Grenfell Tower revealed that its cladding was dangerous. In August, the John

Fire Safety

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Radcliffe hospital became the first to have to transfer patients to other buildings as a result of fire safety checks, reporting that it is moving 52 patients to other sites. The trauma unit will be shut for up to a year while remedial work is carried out. Less seriously ill patients will be discharged to free space for the trauma patients. In a statement, the Oxford University Hospitals (OUH) NHS Foundation Trust, which runs the hospital, said the trauma unit had to close because it had been judged to be ‘currently unsuitable for patients’. EDINBURGH ROYAL INFIRMARY In September, the Scottish government revealed that some panels of combustible material had been found in cladding at Edinburgh Royal Infirmary, although, following safety audits, the Scottish Fire and Rescue Service confirmed the building is safe. Nonetheless, NHS Lothian is putting further safety measures in place, as a precaution. This followed NHS Greater Glasgow and Clyde saying that cladding, similar to that used in the Grenfell Tower, was to be removed from the Queen Elizabeth University Hospital building. WHAT ARE THE MAIN RISKS FOR FIRE? Hospitals can be very large and complex buildings. The main risks for fire in a hospital are the main risks of fire everywhere, but with hospitals there are more risks. There’s the risk of patients with limited mobility as well as all the flammable substances that most buildings do not contain, such as chemicals and oxygen supplies, and all the flammable materials within a pharmacy or an operating theatre. Even if one simply considers E

O 4 July, b n at three uildings English hospita l s w e re f to have combusound tible claddin g , a f t er failing fi re safet y checks

Volume 17.5 | HEALTH BUSINESS MAGAZINE

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS â&#x20AC;&#x201C; www.healthbusinessuk.net

D2 Fire and Security Ltd have developed a range of Fire Compliance Gap Analysis Programmes that provides business owners with the peace of mind that their Life Safety systems are comprehensively serviced, functioning correctly and that they have robust emergency plans in place. If you would like further information on Compliance Gap Analysis or any aspect of the D2 design, install and commission products please CALL: 01634 713000 or EMAIL: jordan@ d2fireandsecurity.co.uk

015

SP203 â&#x20AC;&#x201C; Part 1 Modular Scheme

T L Fire Ltd is an independent fire alarm installation, maintenance and servicing contractor established in 2003 and based in South London. We work predominately in London, the South East and South West of the country although we do work further North as and when required. We also supply, maintain and service of Fire Extinguishers, Hose Reels and Dry Risers. We install, maintain and service various different types of Fire Alarm systems from small conventional systems to large networked addressable systems. We also supply Wireless systems which can be installed much quicker and without the disruption caused by running unsightly cables and this can be very beneficial to the end user, particularly in busy occupied premises. We have experience in working in a wide range of building types and premises and can upgrade your current Fire Alarm system and Fire Safety equipment. We are accredited to BAFE and the FIA and operate a Quality Management system to BS EN ISO 9001:2008, and are currently in transition to the 2015 standard. We work to the latest British Standards and to Industry recognised good practice. Contact T L Fire for a friendly, personal and efficient service at a competitive price.

For more information, advice or for a no obligation quotation please contact us:

Email: info@tlfire.co.uk Telephone: 020 8288 4842 Website: www.tlfire.co.uk

HEALTH BUSINESS MAGAZINE | Volume 17.5

Fire Safety

CLADDING  the sheer volume of curtains and bedding within a hospital, that presents a risk too, because naturally cloth is flammable. The Department for Health has published a wide range of guidance for hospitals on the potential risks involved, called ‘Fire safety measures for health sector buildings (HTM 05-03)’. This guide is essential reading for a responsible person as it outlines some important factors to consider in terms of fire safety, and is both thorough and comprehensive. The guidance outlines almost everything that one should consider in terms of fire safety – from general fire safety, to more specific aspects such as provisions for textiles and furnishings, escape lifts, and fire detection and alarm systems. All of these guides are available to download from gov.uk, but the Fire Industry Association (FIA) is also available for practical and technical advice and guidance regarding fire risk assessments and fire alarm systems over the phone. Of course, a great consideration is the patients themselves and the danger present to them in the event of a fire. Due to limited mobility, a plan should be drawn up for progressive horizontal evacuation, whereby each floor or section of the hospital acts as a different ‘compartment’ for a fire. When the fire approaches a nearby compartment, staff and patients should evacuate that compartment, rather than evacuating everybody from the whole building at once. This is why passive fire protection – insulation from fire within the walls, doors, and windows is vital – as it blocks fires from travelling from one compartmented area to another. This is the reason that fire doors are such an important part of trying to contain the fire in the room behind the doors. Fire doors are designed to help stop the spread of fire beyond the doors; it helps in the event of an evacuation situation to keep the fire contained within the designed ‘compartment’ of the building. However, in a hospital, fire doors are often propped open or bashed into by hospital trolleys. But this can be exceptionally dangerous as it increases the risk of fires spreading through the building. Keeping the doors closed keeps the fire safely behind the door, allowing for a greater escape time. Therefore, it is vital not to prop fire doors open with hospital trolleys or cause damage to them as this reduces their effectiveness. Additionally, hospital trolleys banging into manual call points (the button that activates the fire alarm) is one of the prime causes of false alarms in hospitals. Research sponsored by the FIA from earlier this year, entitled ‘Investigations into the causes of false fire alarms’, highlighted that despite this problem being exceptionally common, it is something that can easily be remedied. The solution is to ask a specialist fire alarm company to install a special plastic cover to go over the call point, which should protect the it from getting banged or knocked by busy staff with trolleys.

Hospitals can be very large and complex buildings. The main risks for fire in a hospital are the main risks of fire everywhere, but because of the size and complexity of a hospital building, the risks can be more serious Not only do false alarms cause time to be lost investigating the cause, they also cause distress to patients who may be worried that there is a real fire on the premises. It is therefore recommended that alarms have a delay before sounding. During this time, a team should investigate the cause of the alarm – and confirm if the fire is real or false. If a fire is confirmed, the evacuation plan including progressive horizontal evacuation should be followed. FIRE SAFETY LEGISLATION Let’s take stock for one moment and sort out the mess of confusion that surrounds fire safety legislation and what it actually says. It is absolutely vital that everyone fully understands what the law says and what that actually means for buildings across the country, and for the people that own and manage these buildings. In the UK, there are various fire safety laws that vary slightly depending on location, but they all ostensibly say the same thing. For the sake of accuracy and preventing any confusion, here is the full list: Regulatory Reform (Fire Safety) Order 2005 – applicable in England and Wales; Fire (Scotland) Act 2005; Fire Safety (Scotland) Regulations 2006; The Fire and Rescue Services (Northern Ireland) Order 2006; and The Fire Safety Regulations (Northern Ireland) 2010. Fire safety legislation applies to all non‑domestic properties such as businesses,

shops, schools, hospitals, church buildings, festival halls, and leisure centres, for example. But it can also apply to housing associations, landlords, student halls of residence, and care homes. This is not an exhaustive list but it gives an idea of the scale of the need for everyone to understand, apply, and comply with fire safety regulations. Each piece of legislation refers to either a ‘duty holder’, ‘appropriate person’ or a ‘responsible person’ but they mean the same thing. This is the person who will be held liable if there are any failings in the fire safety of the building, and the person who ultimately makes the decisions about the requirements for the building. This could be the employer of a business, or a landlord, or the appropriate body responsible for managing a house of multiple occupation (HMO). All of these pieces of legislation are freely available to download and read from the gov.uk website at the stroke of a keyboard – simply search the relevant piece of legislation. This article couldn’t possibly cover the full breadth of the legislation in one go, so reading through the legislation is recommended. L

The Fire Industry Association also has a number of resources available to help break down the legislation available on the association’s website. FURTHER INFORMATION www.fia.uk.com

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Advertisement Feature

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ENERGY

REDUCING ENERGY CONSUMPTION AND SAVING COSTS

The latest ERIC report from October 2016 reported that the total annual energy usage from all energy sources across the NHS Estate amounted to 11.9 billion kWh, an increase of 3.5% from 2014/15. In this article we demonstrate how reductions can be made to help the NHS lower energy consumption and save costs. But where do you start? Public sector organisations such as the NHS can often find themselves with an out of date portfolio making utilities difficult to manage. Difficulties often arise due to incomplete site lists, estimated utility bills and default unit rates. This leads to overpayments being made and utility invoices not being investigated fully. This is when issues tend to crop up, such as being billed for sites you are no longer responsible for. The NHS also face staff reductions and cut backs which can affect in-house expertise when looking to save energy and reduce costs. The solution to these issues is to have a consolidated portfolio and a customised outsourced bureau service. The first port of call, is to establish exactly what supply points are in your organisation (including water) and create a cleansed database of all utilities. This in itself can highlight opportunities for savings, such as identifying non-consolidated supplies billed on out of contract rates. CUSTOMISED BUREAU SERVICE – ONLY PAYING FOR WHAT YOU USE As a specialist energy management consultancy, STC Energy, part of the Inspired Energy Group, deliver utility bureau services to a wide range of large complex organisations, including the NHS. Apart from obvious cost saving opportunities, our bureau service is focused on helping you to achieve significant efficiency gains within your accounts, estates, energy, procurement and building management departments. We offer a complete range of services that can be fully tailored to your specific requirements, and our service level agreements can be amended at any time to match changes in your needs. The key features of STC’s standard bureau service are: L Energy portfolio database set-up and management L Utility invoice collection and preparation of electronic invoice files L Bill validation, correction and query management L Production of invoice payment files and cataloguing of paper invoices

HEALTH BUSINESS MAGAZINE | Volume 17.5

L Management of changes of occupancy L Handling of all invoice reminders

and threats of disconnection L Online energy reports and dashboards L Online meter reading service L Half-hourly and AMR profile data collection and management.

MONTHLY EXECUTIVE REPORTS – HAVING THE RIGHT DATA AT YOUR FINGERTIPS The Estates Return Information Collection (ERIC) is the main central data collection for hospital estates and facilities services for the NHS. ERIC is a resource of valuable data that enables the analysis of Estates & Facilities information from NHS Trusts and PCTs in England. STC Energy can assist you with your statutory reports through our bill validation service, which validates your utility invoices, including gas, electricity and water to ensure your bills and consumption is correct. The data captured from your utility bills then goes on to create a Monthly Executive Report (MER) which provides a clear and concise breakdown of all your utility costs and usage. Our MER can provide the information you need about your electricity, gas and water consumption all in one place. This data can then be used to complete section 7 (energy) and section 8 (water) of your statutory ERIC report with accuracy and ease. MULTI-SUPPLIER FRAMEWORK FOR GREATER CHOICE As well as being a supplier on the NHS Shared Business Services (SBS) Framework, STC offers an OJEU compliant multi-supplier framework which gives public sector organisations the opportunity to choose from 12 utility suppliers and not just the big six. This ensures that your energy is competitively priced and benchmarked against other suppliers. L

ADDED VALUE SERVICES STC Energy offer a wide range of added value services to help further reduce your energy consumption and save costs:

B I L L VA L I D A T I O N Fully managed utilities bureau service, invoice validation with tailored account payable files, query resolution and historic invoice audits

EN ERGY M A N A GEM EN T Monitoring and targeting, energy alerts, surveys, energy efficiency advice and sustainability reporting

S I T E O P ERA T I ON S

P R O FI L E A L ERT S

5 6

Meter installations, full infrastructure management, supply alterations and meter operator contracts

Identify and reduce energy wastage

B U D GET S Calculated at the individual level and combined to produce a single budget figure for each utility at each site

A C C RU A L S Providing each account and accrual value to allow easy transfer into your financial systems

FURTHER INFORMATION If you would like to find out more simply call us on 0208 466 2900 or email info@stcenergy.com. Alternatively, visit www.stcenergy.com or www.inspiredenergy.co.uk STC Energy are part of the Inspired Energy Group.

SUSTAINABILITY

Jerome Baddley, of the Sustainable Development Unit, writes about the opportunities for sustainable procurement to save money, help the environment and boost local communities and economies The health sector is facing major challenges with growing demand for services and increased financial pressure. This calls for new approaches and new ways of thinking that combine financial efficiency with improved delivery of health outcomes. Additionally, public authorities have a legal duty to operate with regard to their environmental, social and economic impacts and should endeavour to improve their performance on all three. Sustainable procurement is one of the ways that the system can support these objectives. Procurement decisions driven by cost savings can often have unintended, unrecorded and unrewarded environmental benefits, such as the associated air pollution reduction benefits of telecare. The reverse is also true; environmentally preferable options can often result in financial savings, such as energy saving measures aiming to reduce an organisation’s carbon footprint frequently results in a reduction in costs. Financial savings can also come from identifying innovative approaches to social, environmental and local economic challenges; such as a community share issue to pay for NHS energy generating technology. Integrating a wider ‘triple bottom line’

view in procurement can benefit or reveal hidden benefits to public health, patients and local communities – ensuring that the pressure on NHS finances supports high quality care for all, now and in the future. The importance of procurement to the carbon reduction agenda has been well established since the Sustainable Development Unit (SDU) published the first NHS Carbon Reduction Strategy in 2009. The carbon embedded within the goods and services procured by the NHS and wider sector are estimated to be two thirds of the system’s total carbon emissions. This is the largest contribution to the system’s overall footprint, greater than energy use and travel combined. Measuring and reducing the carbon footprint of procured goods and services is one way to demonstrate a more sustainable procurement approach across the system. Indeed the leadership of the NHS locally and nationally in this area is essential. The NHS is one of the largest procurers in the country, spending over £20 billion per

year on goods and services. The SDU recently estimated that the health sector could save over £400 million and cut one million tonnes of carbon emissions every year by 2020 through making changes that also benefit people’s health. The Securing Healthy Returns report identified 35 areas – including some specifically focused on areas of procurement such as theatre kits in hospitals and furniture reuse – and calculated their financial and environmental benefits. The work clearly showed that there does not have to be a compromise between financial, environmental or social sustainability. Early progress has already been made in decarbonising the NHS and wider sector’s supply chain. The sector exceeded its 10 per cent reduction target by 2015. However given the size of the challenge to further reduce emissions by 80 per cent the opportunity for reduction in procurement emissions provides a huge target to aim at. In parallel to the increasing pressure on health sector spending, there has been a rapid growth in the size of the UK’s low carbon and environmental goods or ‘Cleantech’ sector. This has been in part driven by the 2008 Climate Change Act, but also by a push for organisations to manage rising utility and natural resource costs. In 2015 the Department for Business Innovation and Skills calculated this sector to be worth over £26 billion; 2.5 times the size of the pharmaceuticals sector. In the UK we already have world class expertise in our low carbon economy to help us address some of the pressing financial and environmental impacts in the health sector supply chain. In saving money for the NHS could we also support job creation in an innovative low carbon and resource efficient healthcare products and services sector?

Written by Jerome Baddley, Sustainable Development Unit

Pursuing procurement to lower NHS emissions

Energy

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Procu decisionrement by cost s driven often h savings can ave and unr unintended e environ warded me benefit ntal s

IDENTIFYING OPPORTUNITIES Procuring for Carbon Reduction (P4CR) was a programme initiated to address the commitment to reduce emissions. E

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Advertisement Feature

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HEALTH CARE

AEROGEN WIN 2017 ZENITH AWARD FOR RESPIRATORY CARE

Aerogen, the global leader in aerosol drug delivery, has been selected by members of the American Association for Respiratory Care to receive the prestigious 2017 AARC Zenith Award. This award, which is presented to only six companies out of more than 300, is a way for AARC members to recognise manufacturers and service organisations that have done outstanding work for them and their employers Thomas J. Kallstrom, executive director of Aerogen, said: “Aerogen typifies the qualities represented in the criteria and, because of this; we salute you and your employees.” John Power, managing director of Aerogen, added: “We are honoured to receive our fourth Zenith Award from the over 47,000 respiratory care professionals in AARC. Aerogen is proud to have allied with respiratory care professionals in the United States and around the world to deliver superior aerosol drug delivery capability to patients who need critical drugs to breathe better and survive their acute conditions. This award is evidence of the support we work hard to give them every day, with every product they use, and I wish to thank them for their continued vote of confidence in using our products. I could not be more proud of the outstanding team at Aerogen that has worked to develop the technology and improve it for better patient results and easier use.” Aerogen will officially receive the Award on Wednesday 4 October at the Association’s 63rd International Respiratory Congress this October in Indianapolis, IN. REDUCING ADMISSIONS Aerogen technology reduces emergency department admissions by 32 per cent when compared to a standard jet nebuliser.1 Data released reinforced Aerogen’s credentials as global leaders in high performance aerosol drug delivery. The results from this study showed a 32 per cent1 reduction in the admission of patients to hospital from the emergency department when treated with their vibrating mesh technology compared to traditional jet nebulisers. The same research also showed that patients treated with Aerogen technology in the same setting required 75 per cent1 less medication compared to those treated with traditional small volume jet nebulisers. Secondary analysis also confirmed a significant reduction in median length of stay of 37 minutes.1 Commenting on the results, John Power said: “This large clinical study demonstrates

HEALTH BUSINESS MAGAZINE | Volume 17.5

the impact Aerogen technology can have in the emergency department and is further evidence of the outstanding clinical results we’ve seen when Aerogen technology is used in critical care units all over the world. “When patients feel better and can go home faster, without an extended hospital stay, it benefits everyone. This is truly great news for patients, clinicians and hospital administrators alike.” Robert Dunne, study author and vice chair of Emergency Medicine at St. John Medical Centre, Detroit, added: “The study results prove what we saw everyday treating patients in our emergency room: people who needed treatment with a bronchodilator got better faster, with less medicine, and required fewer admissions when using the Aerogen Solo and Ultra than patients receiving treatment with a traditional small volume jet nebuliser.” RCSI STUDY A new clinical efficacy study by the Royal College of Surgeons in Ireland (RCSI) provides further proof that treatment by Aerogen Ultra enhances patient outcomes.2 When comparing a single standard bronchodilator dose delivered by the Aerogen Ultra versus an SVN, there was a significant improvement in FVC and improved patient symptom score. The Aerogen Ultra also was proven to improve lung response which has been associated in other studies with enhanced exacerbation recovery.3 ABOUT AEROGEN Aerogen is the world’s leading medical device company specialising in the design, manufacture and commercialisation of aerosol drug delivery systems. Aerogen’s patented vibrating mesh technology turns liquid medication into a fine particle mist, gently and effectively delivering drugs to the lungs of critically ill patients of all ages. Aerogen’s innovative products, such as the Aerogen® Solo and Aerogen® Ultra, significantly improve aerosol drug delivery resulting in better patient

care throughout the Hospital. Founded in Galway, Ireland in 1997, Aerogen has grown to become the global leader in high performance aerosol drug delivery and has partnered its technology with the leading mechanical ventilation companies. Aerogen technology is used by millions of patients and caregivers in over 75 countries worldwide and, it has partnered its technology with world leading companies including Philips Healthcare, GE Healthcare, Covidien, Maquet, Drager, Hamilton and ResMed. L

Dunne R et al. Aerosol dose matters in the Emergency Department: A comparison of impact of bronchodilator administration with two nebulizer systems. Poster at the American Association for Respiratory Care. 2016. 2Cushen B, Alsaid A, Abdulkareem A and Costello RW. A Pilot Study To Assess Bronchodilator Response During An Acute Exacerbation Of COPD Using A Vibrating Mesh Nebuliser Versus Jet Nebuliser For Bronchodilator Delivery. ITS poster presentation. 2016. 3Cushen B, McCormack N, Hennigan K, Sulaiman I, Costello RW and Deering B. A pilot study to monitor changes in spirometry and lung volume, following an exacerbation of Chronic Obstructive Pulmonary Disease (COPD), as part of a supported discharge program. Respiratory medicine. 2016;119:55-62. 1

FURTHER INFORMATION www.aerogen.com

Energy

SUSTAINABILITY  In addition to the various guides and tools, P4CR introduced the Hierarchy of Interventions which forms the backbone of the SDU’s methodology and solutions in lowering the sector’s carbon footprint. Reducing demand offers the most easily demonstrable cost savings as well as environmental/carbon benefits and is where the system has the biggest influence. The most environmentally sustainable solution is to look for opportunities to reduce the need and demand for goods and services. A sustainable procurement approach constantly questions whether procured products are necessary, supports interventions that reduce demand for products or uses them more efficiently ensuring procured products are not wasted. The system can exert direct control over its resources and carbon emissions by buying products, equipment or services that consume less and have a lower environmental impact throughout their ‘in use’ life and at their disposal and recycling. Additionally, understanding the environmental and social impact of procured goods in more detail can help identify opportunities to improve sustainability. Where appropriate, alternative products, materials or approaches can be used that have less impact on the global environment and are more sustainable. This offers opportunities to work with the market to create carbon efficient alternatives. Improvements in the performance of suppliers and their supply chain can be achieved by setting clear expectations through procurement process, and working closely with suppliers to find solutions that deliver sustainability benefits. Performance on carbon reduction in procurement is improving. The SDU’s Health Check 2016 showed that carbon emissions in relation to procurement have reduced by 16 per cent since 2007. A large part of this is due to pharmaceuticals’ carbon footprint (through both carbon intensity and spend reductions). Attitudes amongst procurement professionals are also shifting. A survey into the state of sustainable procurement implementation published in 2016, concluded that most procurers (88 per cent or respondents) now take sustainability considerations into account, in varying degrees. It also indicated there is strong demand for greater, more visible and accessible support for sustainable procurement. MOVING BEYOND CARBON Whilst carbon is a good indicator, it does not fully capture what sustainability is for the health and care system. The SDU’s interests and remit include wider social and ethical issues, such as, for example, managing labour standards in health supply chains. The health and care system has an ethical duty to protect and promote health and well-being. It is important that suppliers of

Improvements in the performance of suppliers and their supply chain can be achieved by setting clear expectations through procurement process, and working closely with suppliers to find solutions that deliver sustainability benefits goods and services operate in a socially responsible way. Buying goods or services from suppliers which damage public health through poor environmental practices or promote social inequality through their employment practices is a breach of that duty. Equally the health co-benefits of buying goods or services from providers that take sustainability, staff health and well-being and environmental impacts seriously will deliver savings and improve health outcomes through linked environmental, social and financial considerations. The products and materials used in delivering health and care are procured from all over the world. An environmentally and socially responsible procurement approach provides an opportunity to enhance health and well-being globally as well as in the UK. The recently reviewed Ethical Procurement for Health Workbook offers a mechanism for extending our wider sustainability principles to global supply chains, with benefits not only for the system but also for workers worldwide 2018 HEALTH CHECK In January 2018, the SDU will publish its 2018 Health check including a full carbon footprint of the NHS and wider care sector. At that point the scale of the carbon reduction challenge will be updated and the opportunities presented by sustainable procurement will come into clear focus. We are increasingly seeing how partnerships can deliver benefits to heath and care organisations, the public and businesses. By encouraging collaboration with suppliers organisations can draw in private investment in to solving the sustainability challenge we face in the NHS. The NHS and wider health sector in the UK is well regarded around the world for the care it provides and the steps it has taken to address carbon reduction and climate change. If approached with a wide enough lens, the sustainability challenge is a huge business

opportunity and an opportunity to save money for the sector, whilst also delivering health benefits, through social and environmental gains, both at home and internationally. EFFICIENCY SUCCESS STORIES Royal Liverpool and Broadgreen University Hospitals worked with their supplier of surgical devices – to optimise the way in which theatre packs were supplied and used. In doing so they improved staff efficiency and patient safety whilst reducing waste and carbon. By moving from individually wrapped items to specially designed pre-prepared packs containing core items for a given procedure, the trust almost halved the set up time per operation, increased consistency and simplified stock management processes. This has saved valuable staff time and improved efficiency. This initiative has also reduced associated packaging waste by 90 per cent (around 2.6 tonnes) helping the trust to reduce its carbon footprint by five tonnes. NHS Supply Chain has let a contract for examination and surgical gloves, products with known and documented labour standards risks, using the Labour Standards Assurance System, a risk management tool that relies on early engagement with the supply base, to articulate their expectations to the market and set a robust framework with clear objectives on labour standards for the successful suppliers to adhere to, as part of their contract. This approach did not lead to an increased price. In fact, an impressive £782,000 of savings have already been achieved withe further price reductions anticipated. This is because ethical and labour issues were not ‘bolted on’ but rather they were considered from the outset, as an integral part of the products required and as an expectation of responsible suppliers. L FURTHER INFORMATION www.sduhealth.org.uk

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Case Study

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B.E.G. launches the world’s first occupancy sensor which can save energy and improve your health Lighting controls specialist B.E.G. has launched an occupancy sensor which saves on energy costs and improves the well-being and productivity of UK health workers. The B.E.G. PureColour Wellness Sensor is designed to control the room’s light intensity and light colour based on time and movement using human centric lighting (HCL). This can reduce overall energy consumption resulting in substantial savings for the health sector including hospitals. The new ground-breaking product adjusts its colour and light according to the amount of natural light required at specific times of day using HCL to specifically mimic true daylight. It does this by regulating the colour temperature of all connected lighting and producing artificial white light which corresponds almost identically to daylight. This provides the occupants of the room with all of the brightness and vitality that natural light provides. The B.E.G. PureColour Wellness Sensor is aimed at UK health authorities, NHS trusts, clinical commissioning groups (CCGs), ambulance trusts and government laboratories. Research has found that using HCL helps

to regulate the body clock, promotes sleep and improves overall health and well‑being, calling it a ‘life-light-balance’. In our modern ‘around the clock’ society, where people frequently live and work in artificial light and often during the night or in windowless environments, the influence that daylight can have on our body clocks is much reduced. As our body clocks become more confused, sleep and wake times are less effective and this has a negative influence on our circadian rhythms and ultimately our health. Scientists identified a third light receptor in

LUXOMAT ® net

addition to rods, twilight vision, and cones, colour vision, back in 2002. These cells are both photosensitive, meaning that they respond to light but are also non-visual; they only react on the ambient brightness and regulate your body clock as a result. Artificial lighting, therefore, has a huge role to play in assisting the body clock with determining what time of day it is and ultimately in stabilising our biological rhythms. German-owned B.E.G. is the first lighting controls manufacturer to develop a wellness multi-sensor with a ‘tuneable white function’. Over a 24-hour period, the colour temperature adjusts from warm white to daylight white and the illumination intensity from 500 to 1500 lux. The dimming of the individual lights is continuous and harmonious so that the change is not directly visible. This improves the quality of the artificial light, mimicking daylight and therefore improving well-being and health, whilst also optimising energy consumption. FURTHER INFORMATION Tel: 0870 850 5412 info@beguk.co.uk www.luxomat.com

A scalable system for well-being

The first occupancy detector which controls the light intensity and colour based on time and depending on movement

0870 850 5412

HEALTH BUSINESS MAGAZINE | Volume 17.5

info@beguk.co.uk

www.beg-luxomat.com

EFFICIENCY

Lighting

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Putting the LED revolution in the spotlight LED lighting is now widely considered as the logical choice for almost any lighting application. Peter Hunt analyses the benefits of LED lighting, including the less publicised well-being benefits We spend on average 87 per cent of our time inside buildings which means we are shielded from a major part of the effect of daylight. It therefore seems logical that we should emulate the effect inside the built environment. We know that the colour and amount of light we use and how long we are exposed to it are important considerations. Daylight is not static, it changes throughout the day. It produces bright blue-rich light in the morning to send us a ‘wake up’ signal but exposure to that same blue light at night can be disruptive to sleep. In the evening daylight provides a lower level warm light which prepares us for rest. Light is a form of medicine and we should use it wisely. This understanding is relatively new but already we are able to develop light ‘prescriptions’ that can alleviate symptoms of Alzheimer’s disease and help reduce depression. L Most of us can recognise bad lighting in a space through dim work areas, glare, cold colour and inadequate or no controls. On the other hand whilst we recognise a good feeling when we walk into certain rooms, we may not be consciously aware that it is due to good lighting. Nevertheless, little is known in public and politics about human centric lighting. A general consensus in society that good lighting is essential for a person’s well-being has prevailed for a long time. But discussions have been superficial and are often not driven by facts. This is the result of the challenges of separating causes and effects, which often seem vague and depend on individual appraisal of surrounding conditions. After the 2001 discovery of a third photoreceptor in the human eye, in addition to rods and cones, it emerged that effects on circadian rhythms could be related to specific light conditions. This represented a major leap forward, facilitating further research and development activities by both academia and industry. Today, specific lighting solutions can be produced and installed in ways that specifically support the human circadian rhythm, enhance concentration, prevent sleeping disorders and improve overall well-being.

This article is part of a wider piece, written by the Lighting Industry Association. It originally appeared in Government Business magazine. FURTHER INFORMATION www.thelia.org.uk

THE RHYTHM OF REST The non-visual effects of lighting can be classified into three groups – feelings, functioning and health. Feelings include our mood, vitality or state of relaxation. Functioning refers to our state of alertness leading to increased concentration and vigilance and cognitive performance including memory, comprehending languages, reasoning, problem solving, creativity and decision making. Health effects relate to the sleep-wake cycle, the rhythm of rest and activity controlled by our biological clock which is essential for optimised functioning by day and good recovery sleep by night. SAD, ADHD and schizophrenia have all been linked to biorhythmic disturbance. In schools for example, specific lighting solutions can significantly improve concentration and cognitive performance and lead to improved test results. For example, research suggests that error rates dropped from a first to a second test by about 45 per cent (comparison group with conventional lighting only 17 per cent) and cognitive speed improved by nine per cent (comparison group only five per cent). In addition, such lighting solutions can reduce motor restlessness, support alertness in the morning and improve social behaviour. Furthermore healthcare costs were reduced by 10 per cent due to reduced ADHD effects, efficacy of treatment for mental disorders improved by 18 per cent and staff turnover was reduced.

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Building the future of Healthcare The use of off-site construction is on the rise within the public and private healthcare sectors, as it brings many benefits. The engineered and factory assembled products offer significant advantages in many areas: Faster return on investment due to reduced programmes. As the modules are manufactured on a flow line there is no risk of late delivery due to inclement weather or site restrictions. At Premier Modular’s East Yorkshire manufacturing hub, 20 modules a day can be produced, approximately 2500m2 per week. As much as 75% of a building is manufactured offsite, this reduces construction traffic and noise in the sensitive health environment - meaning a hospital can maintain its high quality day to day care standards whilst expanding its service offering. Premier Modular’s range of high quality modular building systems are a range of long-life, steel-framed or cost-effective timber-framed buildings, for either permanent or temporary use in single or multi-storey applications. Ideal for single-storey GP surgeries, through to complex multi-storey ward accommodation, operating theatres, x-ray rooms and MRI facilities – all of which can incorporate our concrete floor option. The company is a Client-focussed solution provider with a strong commitment to R&D, ensuring the most innovative products are available to the market.

• • • • • • • • • •

Surety of cost and programme Significantly faster build programmes compared to traditional build Minimal site disruption Designed to be DDA, HTM & HBN compliant Durable and resilient building system Using BIM for more efficient and collaborative ways of working Easily relocated, extended or modified, purchased or hired as required Environmentally friendly – using sustainable materials and timber that is harvested from approved FSC managed forests Excellent acoustic performance Available for hire or sale

0800 316 0888

sales@premiermodular.co.uk www.premiermodular.co.uk @premier_modular Linkedin.com/company/premier-modular

SUSTAINABILITY

A framework for greener building solutions The Modular Buildings Framework is the only national agreement of its type, covering offsite building solutions for purchase, hire and lease. Health Business revisits NHS Shared Business Services’ article on the benefits for the healthcare sector All public sector organisations could achieve an average of five per cent savings compared to purchasing solutions direct via a new Modular Buildings framework – the only national agreement of its type, launched by NHS Shared Business Services (NHS SBS). NHS SBS, founded in 2014, is a unique joint venture between the Department of Health and Sopra Steria. As the leading provider of business support services to the NHS in England, it works with over a third of provider trusts and 100 per cent of commissioning bodies, as well as a range of

other NHS organisations. NHS SBS’ mission is to deliver £1 billion savings back to the NHS by 2020, having already delivered audited savings of over £400 million. This has been achieved by providing Finance & Accounting, Procurement and Employment Services to hundreds of NHS organisations. The NHS SBS strategic procurement team offers a large number of national

framework agreements that are available to all NHS organisations. The new Modular Buildings framework adds to its growing Estates and Facilities portfolio, which includes Construction Consultancy Services, Electrical Sundries, Estates Services, Facilities Management and Waste Management Services to name but a few. Modular construction is a process in which a building is constructed off-site, under controlled plant conditions, using the same materials and designing to the same codes and standards as conventionally built facilities but in about half the time. The efficiency gains from manufactured, modular solutions support the delivery of the government’s construction and industry strategy targets, which include time and cost savings as well as whole life cost benefits and in use savings.

Modular Buildings

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PROCURING MODULAR BUILDINGS The new NHS SBS Modular Building framework provides a compliant route for the procurement of all types of modular buildings, covering off-site building solutions for purchase, hire and lease with specific lots for healthcare, education, catering and bespoke solutions. The Healthcare Lots have been further divided to cover hire projects and purchases or leases under and above £1 million. This ensures that only the right mix of specialist providers E

The ability t o purch wards a ase or hire theatre nd operatin with infls quickly to d g ea u is key f xes in demandl especia or the NHS, lly in monthswinter

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Case Study

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Fire Risk Assessment – an experienced-based overview outlined by ASAP Comply Recently, many ‘duty holders’ are looking at their fire risk assessments (FRA) and asking just how good it is and what it should be compared against. Each FRA should follow code of practice ‘PAS 79:2012 Fire Risk Assessment – guidance and a recommended methodology’ as a minimum. Published by the British Standards Institute, this code was produced in partnership with the Chief Fire Officers Association, Fire Protection Association, Institution of Fire Engineers and other recognised bodies. In paragraph 5 viii it states that the ‘fire risk assessment can only be validly carried out on premises that are in use, so that the actual working conditions, practices and procedures can be taken into account’. Clients repeatedly look at comparative FRAs to try and drive costs down. The cheapest is certainly not the best in this context. Lower cost FRAs are invariably not PAS 79 compliant and can omit fundamental issues. The FRA Competency Council has defined those who are qualified to be ‘responsible’ to carry out an FRA as trained, knowledgable and experienced. Former high-level fire service members, although

well-qualified, often miss key issues, while assessors who are highly qualified on paper often struggle to deal with the practical and operational aspects of an FRA. The top 10 issues ASAP Comply sees in its action plans are as follows: failure to carry out drills, testing and periodic maintenance checks; damaged compartmentation/lack of fire stopping around services; missing compartmentation in riser ducts; no fire alarm in higher risk commercial premises; missing/incorrect directional signage; insufficient/damaged emergency lights; damaged and badly fitting fire doors; missing/damaged intumescent strips and mechanical door closers; lack of joint visual/audible alarms in areas accessed

Property Compliance is our business - delivering a quality service within budget, on time, every time.

by the public; and lack of fire training. It has been found that many ‘duty holders’ repeatedly fail to carry out some, if not all, the prescribed remediation works. Many ‘duty holders’ fail to resolve issues raised in the FRA year after year. Clients believe that by completing the FRA they are compliant. Who is responsible for policing completion of the prescribed actions raised in the FRA? In the light of recent tragic events, is a lack of funds sufficient reason to ignore them? To find out what a fire risk assessment is, please visit the website. FURTHER INFORMATION Tel: +44 151 363 2333 www.asapcomply.com

One StOp ShOp for property ComplianCe and due diligenCe SolutionS fire risk assessments asbestos Surveying and reinspections energy Services fire extinguisher Servicing disability & equality access Surveys premises Health & Safety audits tm44 air Conditioning reports electrical and pat testing legionella risk assessments data management Solutions project management of remediation Works

for a no obligation quote contact us on 0151 363 2333 @asapcomply aSap Comply ltd, unit S3 oaklands office park, Hooton, Cheshire, CH66 7nZ

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Modular Buildings

PROCUREMENT  have been awarded under each Lot. Although governed under the NHS Terms and Conditions there is also the option of using more specialist construction contracts such as the JCT and NEC3 where appropriate. The framework has been awarded following a fair and open competition; with the specification developed through consultation with the market and experts in the field. Suppliers have been awarded based on a mixture of quality and price criteria and have all passed stringent checks on their financial status, quality standards, health and safety policies and environmental credentials. Participating organisations can choose to perform a further competition under the agreement to drive further savings, or simply direct award to a preferred supplier, which further speeds up the procurement process. The idea for the framework itself came from the growing number of enquiries from NHS trusts looking for an off‑site construction procurement route. With limited procurement options available and EU procurement regulations to adhere to, many organisations faced severe delays in their projects that negated against modular’s main advantage, which is its speed of delivery. The scope of the framework itself is broad, covering any off-site solution including operating theatres, wards, GP surgeries, office space, catering facilities and specialist units. The expertise in the off-site construction market means that any new or temporary building project now has the potential to be built off-site. With only specialist off‑site construction suppliers with full turnkey capabilities being awarded, there is the opportunity for early collaboration and no need for the further sub-contracting of work. The NHS Five Year Forward View has encouraged efforts to deliver more healthcare out of acute hospitals and closer to home, with the aim of providing better care for patients, cutting the number of unplanned bed days in hospitals and reducing net costs. The framework can look to support this anticipated demand shift, by providing new GP surgeries in much shorter timescales than through traditional on-site build methods. Off-site construction can also be used to quickly establish new temporary or permanent facilities in the case of emergencies such as flooding. CONSTRUCTING SOLUTIONS TO HIGH DEMAND Another area of interest to the NHS is the ability to purchase or hire wards and operating theatres quickly to deal with influxes in demand, particularly during the winter period. These are built to the equivalent, if not higher, standard than traditional on-site construction. This is because up to 80 per cent of the building is produced in a controlled factory setting. Any potential issues can therefore be ironed out in advance in the factory rather than on-site. The framework also encourages

There are huge benefits to off-site construction, particularly within the NHS where there is often limited onsite space, urgent requirements and squeezed capital budgets the use of Building Information Modelling (BIM), which is a process that involves creating and using an intelligent 3D model to inform and communicate project decisions. Popular non-medical building types include office space, staff accommodation and modular kitchens, which can be a great way to introduce a new kitchen facility to any site quickly, or to continue catering operations for sites that are undertaking a refurbishment. A temporary modular kitchen can be specified to make sure that a site can carry on serving meals to patients, staff and visitors while the work takes place. Temporary kitchens can be specified in a range of different sizes, can be used to cater for menus of any type, and can provide anything from a few hundred, to many thousands, of meals each day. They arrive fully equipped and can be up and running on site in a matter of hours. Permanent modular kitchens offer a number of advantages over traditional build, such as: speed of construction (they can be constructed in as little as six weeks); reduced disruption to your site (as most work takes place in a factory controlled environment); the ability to expand the kitchen once on site by simply adding more units, as well as the ability to move the kitchen to a different location at a later date. While some site preparation work may be required to ensure the relevant services are in place, the modular kitchen units arrive complete with equipment and services installed, meaning that the installation time on site can last just a few days. GREEN CREDENTIALS There are huge benefits to off-site construction, particularly within the NHS where there is often limited on-site space, urgent requirements and squeezed capital budgets.

This framework aims to solve these issues through an easy to use procurement route with specialist suppliers who can all provide full turnkey solutions. With projects nearly always running on time and on budget, and different financing models available, modular solutions are already starting to become more common place within the health service. One final area of benefit of modular buildings is their environmentally friendly and green credentials, which makes them more sustainable than traditional construction methods. The manufacture approach used in modular building construction ensures that strict factory quality control systems are adhered to and this in turn leads to a more efficient construction process. By utilising sustainable materials and minimising material wastage, environmental and social responsibilities are accounted for without imposing onerous cost implications on the budget. For healthcare environments, modular construction scores highly, not only in combining lower embodied energy use and consumption, but also cleaner sites and reduced waste. L

There has already been substantial interest in the new framework from across the NHS in the UK including Northern Ireland. If you do require any further information, including details on how to access the agreement, please contact the NHS SBS contract enquiries team at NSBS.contractenquiries@nhs.net or 0161 212 3940 FURTHER INFORMATION www.sbs.nhs.uk

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Recruitment

MENTAL HEALTH

Recruitment in the mental health sector

Written by Neal Suchak, policy advisor, Recruitment and Employment Confederation

Neal Suchak, policy advisor at the Recruitment and Employment Confederation, analyses the workforce challenges facing the NHS in the provision of mental health services For decades the NHS has struggled to fill vacancies across the board, creating severe workforce challenges. This is mainly as a result of long-term underfunding, inefficiencies and poor planning. Between January and March of this year there were more than 86,000 vacant NHS posts, a rise of almost 8,000 compared to the same period in 2016. Nurses and midwives accounted for the highest proportion of shortages – 11,400 vacant posts in March 2017, and the Nursing and Midwifery Council (NMC) has reported that departures have risen by 51 per cent in four years. Fewer doctors and nurses are entering the system than are required to meet demand, and a significant number of nurses in particular are reaching retirement age. On top of this is the reality that Brexit has started to hit home, meaning there are fewer nurses willing to work in the UK. According to the NHS European Office, five per cent of nurses and 10 per cent of doctors come from the EU. Since the Brexit vote, the NMC has reported that there has been a 96 per cent drop in EU nurses registering to work in Britain, and only 46 nurses came to work in the UK in April, down from 1,304 last July.

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MENTAL HEALTH FOCUS Against the backdrop of these staffing shortages, mental health has become a top priority for the Department of Health, with the government focused on achieving parity of esteem for physical and mental health conditions. The Secretary of State

for Health, Jeremy Hunt, has said he wants people with mental health conditions to receive better treatment, and part of that means having the right NHS staff. As part of this focus, Hunt has announced a new plan to recruit enough nurses, therapists and consultants to treat an extra one million patients by 2020-21, with a particular emphasis on child and adolescent mental health services, therapists delivering talking therapies for adults, and nurses working in crisis care. The government has said that an extra £1 billion already promised for mental health services in England would fund the scheme, as part of the £1.3 billion committed in 2016 to transform provision. The government’s strategy also includes plans to improve staff training, encourage returnees to the NHS, as well as tackling the high dropout rate among trainees. Under these plans, the NHS intends to recruit 2,000 more nurses, consultants and therapist posts in child and adolescent mental health services, as well as 2,900 additional therapists and health professionals supporting adult talking therapies. The plans also include 4,800 additional posts for nurses and therapists working in crisis care settings, 570 extra consultants, better mental health support for women around the time they give birth, and early intervention teams working with people at risk of psychosis.

HEALTH BUSINESS MAGAZINE | Volume 17.5

WHAT IS THE PROBLEM? It’s not surprising that these ambitious plans have come under scrutiny. In light of current

workforce shortages, as well as the efficiency savings that the NHS has to make, many have questioned how realistic these government’s workforce plans are. Janet Davies, chief executive and general secretary of the Royal College of Nursing (RCN), has highlighted the dangerous lack of workforce planning and accountability, and has questioned the lack of detail in the Health Secretary’s plans. She said: “It is clear the government will need to work hard just to get back to the number of specialist staff working in mental health services in 2010. Under this government, there are 5,000 fewer mental health nurses and that goes some way to explaining why patients are being failed.” The evidence suggests that the mental health sector is already on the back foot when it comes to finding staff to fill current vacancies. Jordan Mitchell, head of mental health at TFS Healthcare, one of the largest suppliers of mental health staff to the NHS, reports that from March 2010 to March 2017 there were 145 fewer psychiatrists (a drop of 1.64 per cent) and 5,161 fewer mental health nurses (a drop of 12.63 per cent). To put this in context, in this same period there has been a 40 per cent increase in the number of people in touch with mental health services, and there has been an 8.9 per cent increase in the number of patients detained under the Mental Health Act in 2016/17 compared to 2015/16. Annette Sparks, Senior Clinical Nurse Lead for Meridian Health says that is increasingly hard to fill the gaps in staff cover for local Mental Health Trusts and particularly cites demoralised Registered Mental Health Nurses (RMNs) giving up work because of low pay and poor working conditions. She says: “Conditions are very difficult, many [hospitals are] poorly staffed and some are staffed purely by agency workers. Since the announcement about Brexit, overseas

nurses are concerned about working in the UK and we have seen a significant drop in applications from overseas staff.” ROLE OF RECRUITERS Health and social care recruiters are experts in the workforce planning and see first-hand on a daily basis the shortages that the NHS has to contend with. In addition, recruiters are perfectly placed to identify where the problems lie and to offer solutions to government. Many recruiters are specialists in the mental health sector and are acutely aware of the challenges that the NHS faces in providing safe care to patients with mental health problems. Agencies, such as HCL Workforce Solutions, who work with the charity Rethink Mental Illness, have a view of the big picture. Gary Chatfield, managing director at HCL, predicts that the lack of home-grown talent coming through the pipeline, as well as the NHS’s reluctance to use locums, means there will be the requirement to source a lot more workers from abroad to meet demand. However, with the barrier of Brexit and current concerns over the requirements of the International English Language Test System (IELTS), this is not going to be an easy task. In addition, there are currently very few international degrees recognised by the NMC for mental health, meaning that international recruitment is incredibly difficult.

Recruitment

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The pay rise cap and the removal of the nursing bursary in favour of a tuition loan, which, in many cases, will run into the region of £50,000, will have a profound effect on the numbers of home-grown nurses entering the profession THE WAY FORWARD Not enough students are a considering nursing as a career, and it is becoming increasingly difficult to attract specialist mental health staff from overseas due to the uncertainty around Brexit. In addition, the UK is now competing with other countries which offer a better ‘package’ to its healthcare staff. The NHS needs to look at the obstacles currently faced by individuals wanting to embark on both permanent and a flexible careers in mental health nursing, and to make it a more attractive profession. It’s not just about having the right numbers, it’s also about having a motivated and skilled workforce in place to care for patients in a sector that is notoriously demanding. The pay rise cap and the removal of the nursing bursary in favour of a tuition loan (which in many cases will run into the region of £50,000) will have a profound effect on the numbers of home-grown nurses entering

the profession. Creating an environment in which all staff are paid appropriately for the work they do, are made to feel valued, and receive the training, flexibility and support they need, will be crucial in producing a workforce that is healthy, happy and able to deliver the best possible outcomes for patients. The Recruitment and Employment Confederation (REC) will continue to work closely with agencies supplying vital staff into the NHS mental health sector, as well as working with NHS Improvement and the Department of Health to come up with solutions to the current workforce crisis. Patient safety is always paramount, and it starts with safe staffing levels. If the Department of Health is to truly level out the inequalities between physical and mental services, they must start with investment and staff retention. L FURTHER INFORMATION www.rec.uk.com

Established in 1988, Coyle Medical is one of the largest independent agencies in the market place. Our team of specialist recruiters has worked in the medical and healthcare recruitment industry for over 20 years. We have a dedicated team working in each specialty ensuring a continuous and reliable service for every doctor. We pride ourselves in being able to offer some of the best hourly rates available in today’s market, coupled with a wide variety of locum work covering all specialities and seniorities.

Coyle Medical is an approved supplier of medical locums to the NHS. This means we work with numerous clients who are continually looking for locums for short and long term cover including full time, part time, evenings, nights and weekend assignments. If you are available for locum work, then we want to hear from you.

As a framework agency we are able to supply to the whole of the NHS. To apply or find out more, select APPLY NOW today and one of our team will be in touch shortly. Visit our website to apply. Web: www.coyles.co.uk. Email: coylemedicaldrs@coyles.co.uk Tel: 01245 254740

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Case Study

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New Bradford Royal Infirmary ICU features Touchsafe Pro wireless Nurse Call system The new £28 million hospital wing at Bradford Royal Infirmary was opened in June 2017 by Bradford Teaching Hospitals NHS Foundation Trust and features the Touchsafe Pro wireless nurse call system, which is designed, manufactured and supplied by Aid Call, a brand of Legrand Assisted Living & Healthcare. Aid Call has supported specialised installations at many NHS sites, and in 2015, the leading wireless nurse call provider began designing a system for the large project that includes a 16-bed intensive care unit (ICU), two children’s wards, a dementia-friendly elderly care ward and a retail concourse. The Aid Call Touchsafe Pro nurse call system was the obvious choice for the new ICU because its wireless configuration meets the requirements of any project no matter the size or scale, offering complete flexibility and mobility. The system can facilitate individual patient requirements, adapt to change and be added to over time. It can also be installed quickly and specifically to each site because there is no need to rely on cables and stationary wiring points. Building Services Consultants DSSR drew

HEALTH BUSINESS MAGAZINE | Volume 17.5

up the specification for the new wing with support from the Aid Call and Bradford Teaching Hospitals Project Manager, Shane Embleton. A bespoke system that could be proven to benefit the staff and patients needed to be designed, and the specifications were adapted as the requirements of the hospital altered. Once the plans were in place, a tender was released and Aid Call quoted 24 contractors for the project before meeting with the winning contractor in April 2016. Stuart Barclay, Senior Business

Development Manager, said: “The Aid Call team worked with many contractors and suppliers throughout the phased installation of our Touchsafe Pro system. We collaborated with third party bedhead trunking suppliers to make sure our products could be mounted to the bedhead correctly with sufficient capacity remaining to fit the light relays. Bradford Teaching Hospitals also wanted to connect third party telecare products to our Touchsafe Pro system, and although they would normally be plugged in to the bottom of the call points, we worked to make them speak wirelessly to one another from wherever the product was being used.” Aid Call additionally carried out training with the Bradford Royal Infirmary staff over a three week period prior to the opening, and the company continues to provide support to the hospital on a monthly basis to meet the staff’s needs and management requirements. FURTHER INFORMATION Tel: 01670 357 431 sales@aidcall.co.uk www.aidcall.co.uk

EVENT PREVIEW

Improving efficiency within the NHS estate

Healthcare Estates

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This year’s Healthcare Estates conference theme aims to tackle key topics in three streams: strategy and leadership; engineering and facilities management; and planning, design and construction. Health Business examines the three in more detail Healthcare Estates is attended by over 3,500 highly engaged, curious visitors with a passion for new solutions, technology and answers at the industry’s foremost event for the healthcare sector. It is the ideal event for meeting face-to face with industry colleagues, discussing the key issues within their sectors while finding out about latest technologies at this festival of ideas and discovery in the healthcare sector. The show features six enlightening and challenging seminar theatres which focus on key areas in the healthcare sector – each zone offers free to attend theatres delivering specialist content and case studies, while exhibitors showcase a range of specialist products and services. Steve Webb, Healthcare Estates show director, said: “Following recent events in the UK – a terrorist attack, the devastating fire at Grenfell Tower, and the NHS cyber attack – NHS estates and facilities directors are understandably concerned about their requirement to ensure corporate governance and assurance to their board. Healthcare Estates has gathered key figures from the NHS, including Simon Corben, past president of IHEEM, Paul Kingsmore, director of services at Manchester Metropolitan

University, and Kevin Oxley, director of Estates, Facilities and Capital Planning at South Tees Hospitals NHS Foundation Trust, to discuss and consider the highly topical subject of corporate governance assurance and give their individual standpoints.” The conference opens with keynote speaker Simon Corben, director of NHS Estates and Facilities at NHS Improvement, who will reflect on his first six months in office, and discuss the need for stronger and more robust corporate governance assurance, a subject that will be picked up in the panel discussion session that follows. STRATEGY AND LEADERSHIP There has been little real attention given to how the NHS estate could help to improve efficiency, move more care out of hospitals and exploit new technologies. The discussions in the ‘strategy and leadership’ stream look at how models of care are still designed around buildings, and asks whether re-thinking the way that the NHS uses its estate could catalyse change’. The NHS workforce will require significant transformation across all disciplines to keep pace with the changing service

and financial environment. The new national Apprenticeship Levy creates opportunities, but has significant cost and organisational implications alongside. Brighton & Sussex University Hospitals NHS Trust is pursuing a multi‑dimensional approach to workforce transformation – creating coherent career development pathways for NHS staff, delivering sustainable pay cost reductions overall, and ensuring improvements in the quality and safety of patient care. The need for workforce transformation is made more urgent by the £486 million redevelopment of the Royal Sussex County Hospital in Brighton, the first major stage of which opens in 2020. This will deliver a step-increase in capacity in clinical services known to have national and local supply‑side/ recruitment challenges, and significant changes in physical design (proportion of single rooms, size, layout of facilities), for which innovative approaches to staffing models and role design will be critical. The ‘Efficiency in Workforce Development’ presentation, hosted by Duane Passman, director of 3Ts at the trust, will highlight the approach being taken and how it is being developed and implemented in practice. It will identify key learning points and the experiences of developing this programme in a dynamic and operationally-pressured environment whilst ensuring clinical leadership and engagement.

The NH is a hig S hly energ organis y intensive trusts a ation with all ROYAL LIVERPOOL trusts snd foundation THE UNIVERSITY HOSPITAL pending The construction project for the new o £560 m illion onver Royal Liverpool University Hospital energy includes an innovative sustainable each communities programme. The programme year consists of three key areas: reducing worklessness, local economic regeneration and community. Reducing worklessness includes targets for apprenticeships and work experience opportunities. One of the successes of the programme has been the upskill programme, which has supported long-term unemployed people through training to get the ‘construction site ready’. Local economic regeneration has been supported through working with Liverpool in Work (the city council’s employment arm) to ensure that local businesses are aware E

Volume 17.5 | HEALTH BUSINESS MAGAZINE

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EVENT PREVIEW  of upcoming opportunities. Community regeneration has been supported through a programme of community volunteering, which has provided construction support for local charities. Carillion also provided £100,000 for a Liverpool Community Fund. Ian Stenton, the trust’s head of Sustainability will host this session alongside Carillion’s community regeneration manager. John Simpson, ex-estates and facilities director at the Royal Stoke University Hospital, will also present in this theatre on ‘Mergers & Acquisitions - Lessons learnt’, providing a reflection on the 2014 acquisition and merger of Mid-Staffordshire NHS Foundation Trust and University Hospital North Staffordshire. ENGINEERING AND FACILITIES MANAGEMENT The NHS is not unique in finding estates and property difficult to manage, and this task is increasingly being outsourced. While all of this means that there are unexploited opportunities for improving value for money, perhaps the most important concern is that opportunities for new models of care are not being maximised and that the existing estate is an obstacle to innovation. There needs to be more ambition in the way the NHS estate is used. The current model of ownership and operation needs to be challenged and new methods of financing

Following the UK terrorist attacks, the Grenfell Tower fire, and the NHS cyber attack, NHS estates directors are understandably concerned about their requirement to ensure corporate governance and assurance to their board need to be developed that avoid the very significant downsides of PFI, in particular, the associated intergenerational transfer of debt. As part of the ‘engineering and facilities management’ sessions, Malcolm Thomas will present a seminar on ‘Operating Theatres – The surgeon’s panel’. All operating theatres should have an information display colloquially known as the ‘Surgeon’s panel’, whose primary function is to bring together information on the operational state of the facility so that the surgical team can decide whether it is safe to commence a surgical case. Traditionally these panels used coloured lights, meters and clocks that were hard wired on a stainless steel plate. Today most panels are touch screen with menu driven displays. While they have many advantages they can suffer from presenting too much information in a confusing way. Lack of clarity has resulted in surgery being undertaken when the ventilation was not operating or was in ‘set

Healthcare Estates

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back’ resulting in increased infection rates. The Specialised Ventilation for Healthcare Society (SVHSoc.) have produced a paper that itemises the information that should be present on a surgeon’s panel and clarifies the method of display. Malcolm’s presentation will launch that paper and explain the thinking behind it. There are a number of physical and biological tests described in HTM 03-01 for both validation and verification of critical ventilation systems. In conventional theatres microbiological sampling is required at validation only. However carrying out sampling at verifications can indicate where there are problems which can go unnoticed by normal visual inspections. Surely it is better to do simple active air microbiological sampling annually rather than wait until problems manifest in infection rates. This second presentation, delivered by Jerry Slann, of the Institute of Occupational Medicine, will highlight E

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Healthcare Estates

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EVENT PREVIEW  the advantages of carrying out some additional tests during verification which the author believes to be invaluable to estates, infection control and users.

to showcase best-practice examples of projects that provide quick paybacks on investment, creating both significant carbon and financial savings for NHS trusts.

OVERCOMING FINANCIAL BARRIERS The NHS is a highly energy intensive organisation with all trusts and foundation trusts spending over £560 million on energy each year. The installation of energy efficiency technologies is at the centre of the action to not only decarbonise the UK but also reduce energy spend for the NHS. In this session, Mark Hogan, energy and environmental manager from Wrightington, Wigan and Leigh NHS Foundation Trust will be joining Salix to discuss the trust’s previous and current energy efficiency projects and how they have utilised over £2.6 million of Salix funding across their hospitals. Their projects include boiler retrofit economisers, replacing steam plate heat exchangers and heat recovery systems and are estimated to save the trust over £590,000 each year. Salix Finance provides interest-free government funding to trusts and foundation trusts to improve their energy efficiency, reduce carbon emissions and lower their energy bills. Salix will draw on its extensive experience of funding over £48 million of energy efficiency projects in over 55 NHS trusts and foundation trusts across England

PLANNING, DESIGN AND CONSTRUCTION The third theme of the show offers a packed programme, focusing on Hopewood Park – Northumberland, Tyne and Wear NHS Foundation Trust’s exemplary new 122-bed inpatient facility for adults and older people. The redevelopment forms part of a wider scheme known as PrIDE (Providing Improved Mental Health and Learning Disability Environments) in Sunderland and South Tyneside. The trust’s long-term strategic approach to managing and upgrading the estate infrastructure sets them apart. From the outset, each individual project was always undertaken with full knowledge of the wider context and future-proofed to be sustainable for the changing needs of the trust for years to come. The rest of the world has sat up and noticed, too; these award‑winning developments attract international interest from those eager to learn. This presentation will look back on the achievements of this partnership, including: the background to the Trust and the starting point of their estates redevelopment; the

Final Advert - healthcare Estates 2017.indd 1

history of the partnership; the estate’s geography; the projects leading up to Hopewood Park; and the lessons learned. Health service estate requires improvement and change on an on-going basis to meet the challenges of changing patient demand and financial constraints. Modular buildings have a number of advantages over traditional build, including speed of delivery, quality, control of costs and timescale. The ‘Lessons Learned: Modular Installation of Laminar Theatres at Daisy Hill Hospital’ presentation will detail the modular installation at Daisy Hill Hospital of two laminar-flow theatres, an endoscopy suite and a 28-bed recovery facility, including the following key issues, and explain how the building was connected to an existing theatre block on the third floor, on a severely sloping hillside. EVELINA LONDON CHILDREN’S HOSPITAL Informed by ethnographic and design research into reducing violence and aggression in A&E, the art scheme for Evelina London’s Children’s Emergency department aims to bring reassurance and stimulation to families and children, ensuring they feel well-cared for throughout their journey, as well as promoting role model behaviours and acceptance of information. E

Volume 17.5 | HEALTH BUSINESS25/09/2017 MAGAZINE 15:30:50

Healthcare Estates

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Safer, healthier, more sustainable buildings

ADEY – heating system maintenance/protection

BSRIA is a consultancy, test and research company who is working with organisations to deliver safe healthy sustainable buildings and rooms whilst improving the built environment. BSRIA’s services are fully independent. We do not distribute profits but invest in our on-going research programme. This independence means that we provide:an objective approach and the most appropriate solution for you; authoritative reports that are widely recognised and accepted; innovative solutions to help give you a competitive edge.

ADEY will be exhibiting at Healthcare Estates on stand G27 with its full range of commercial water treatment products. Since pioneering magnetic filtration technology, ADEY continues to lead the adoption of best practice in heating system maintenance and protection. Its best-selling range of MagnaClean filters have been installed in nearly four million UK homes. This is supported by ADEY’s own range of premium quality chemicals which have recently won the 2017 Queen’s Award for

BSRIA provides a range of services for critical environments and the Healthcare industries, including the testing and validation of isolation rooms ensuring that best practise is adhered too for infection control. BSRIA offers a unique blend of technical and marketing capability which means that we not only understand technical issues but also products and services. FURTHER INFORMATION www.bsria.co.uk

Leading suppliers of washroom equipment

Dudley Industries realises the high demand for washroom accessories is one that must be met with superior quality and high performance products. The company makes every effort to offer the best stainless steel washroom accessories in the industry. Leading suppliers of washroom equipment to the top five Blue Chip washroom consumable companies worldwide, Dudley Industries has a reputation with its UK and EU customers for providing high quality, durable stainless steel products at competitive prices through an effective short supply chain ensuring an efficient delivery service within the marketplace. The company is recognised as a provider of attractive,

functional and competitively priced commercial and public washroom products. Dudley Industries is confident that its contemporary designed facility exceeds the standards for producing high end stainless steel sheet metal products that are rated superior at every level of performance. Industries of all types take advantage of the products that the company manufacturers with state of the art machinery, such as washroom and restroom equipment. Contact the company for more information via phone or email. FURTHER INFORMATION Tel: +44 (0) 1253 738311 sales@dudleyindustries.com www.dudleyindustries.com

HEALTH BUSINESS MAGAZINE | Volume 17.5

Enterprise in Innovation. ADEY’s recent product innovation has been designed to protect light commercial heating systems and bridges the gap between the domestic and commercial range. The MagnaClean DualXP can be fitted to 1 ½” and 1 ¼” pipework and won the H&V News Awards Commercial HVAC Product of the Year – Components, Controls and Peripherals category earlier in 2017. FURTHER INFORMATION www.adey.com

Launching TotalAlert infinity medical gas notification systems BeaconMedæs, part of the Atlas Copco Group, launches its new TotalAlert Infinity™ Medical Gas Notification Systems for increased patient safety. The system is the first monitoring device to offer customised instructions, taking the confusion out of emergency response. Every minute is crucial during a medical gas emergency, and TotalAlert Infinity™ notification systems ensure no time is wasted while patients are taken care of and a solution is found. With this state-of-the-art medical gas alarm, facilities can be sure the right instruction gets to the right person at exactly the right time. Through Ethernet, TotalAlert Infinity™ alarm panels can replicate, or ‘mirror,’ another TotalAlert Infinity™ alarm located elsewhere in or outside the facility. Through the TotalAlert network, a facility’s medical gas equipment can be monitored

24/7 from one central location. TotalAlert Infinity™ panels can easily up-fit older alarms, including the BeaconMedæs MP125, Penlon PA6 and other models. Retrofit kits are available for almost any existing alarm system, including the most competitive panels. TotalAlert Infinity alarms also include Biomaster, an additive that has been proven to inhibit bacterial growth. Disclaimer: Use of this product does not protect user from disease-bearing and food-borne pathogens. FURTHER INFORMATION www.uk.atlascopco.com

EVENT PREVIEW  John Criddle, paediatric emergency medicine consultant at the Evelina London Children’s Hospital, will be joined by Martin Jones, director of Art In Site, to discuss the project that ensures that children and families feel well looked-after throughout their hospital journey.

Healthcare Estates

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REDUCING CARBON FOOTPRINTS The Energy & Sustainability Theatre will showcase the latest techniques and innovation in reducing the carbon footprint across the NHS, allowing the NHS to meet its legal targets set out in the Climate Change Act. In-depth content will also be delivered by the Carbon and Energy Fund (CEF), specifically created to fund, facilitate and project manage complex energy infrastructure upgrades for the NHS. Sessions confirmed for this theatre include ‘The future of energy use in the NHS – How modern steam plants can save energy, lower carbon emissions and reduce utility costs’, and ‘Increasing efficiency of steam and hot water systems’, which will be delivered by Mark Hogan, Energy and Environment Manager at the Wrightington, Wigan and Leigh NHS Foundation Trust. The Facilities Management Theatre will run a two day programme focusing on hard and soft facilities management in healthcare. Topics to be explored in this theatre include: ‘The cost of slips, trips and falls within healthcare’; ‘The Internet of Things – digital disruption in FM’; ‘The importance of food standards in the NHS’; and ‘The importance of cleaning within healthcare environments’. HEALTHCARE DESIGN Each year, the Healthcare Design Management theatre is a ‘must attend’ destination for architects, contractors and clients as it features the latest case studies, findings from post occupancy evaluation as well as the sharing of best practice in healthcare design. This year the theatre will feature presentations from Architects for Health, BIM4Health, ProCure22, specifiers and many more. Philip Ross and Jeff Bartle, board members at the Design In Mental Health Network, will address quality control for mental health environments in their session on ‘Independent Product Performance Testing’. Jenny Gill, chairman of the Design in Mental Health Network, will also present ‘Best Practice Guidance’ on the second day of the conference. The Hospital Engineering Theatre will feature presentations by leading NHS trusts on recently completed innovative engineering projects. The theatre is supported by IHEEM and NAHFO and will feature examples of engineering excellence, case-studies and best practice. Elsewhere, NHS estates and facilities professionals can listen to and meet companies that provide solutions for water safety across the NHS in the Water & Infection Control Theatre. This covers specialist subjects such as rapid microbiology, existing and emerging water pathogens and the challenges of infection control and engineering. NEW FOR 2017 There are significant changes on the horizon within the health sector, including the introduction of new roles and changes to how training will be funded. Many trusts are looking at NHS apprenticeships as a way of meeting the challenges that lie ahead. Apprenticeship and traineeship programmes can be a cost-effective way to create a skilled, flexible and motivated workforce and can help employees keep pace with developments in technology and working practices within healthcare. In light of this, the 2017 edition of Health Care Estates will host an Apprentice Today Leaders Tomorrow Theatre. IHEEM AWARDS DINNER The annual Healthcare Estates IHEEM Awards Dinner takes place on the first night of Healthcare Estates, 10 October 2017 at the Mercure Manchester Piccadilly. The Awards Dinner is a fantastic occasion, celebrating the best in the industry whilst networking with the biggest names in the healthcare sector. The awards are highly competitive and winning is a great achievement. Former professional snooker player Steve Davis has been revealed as the after‑dinner speaker. L FURTHER INFORMATION www.healthcare-estates.com

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The government issued its response to the third Caldicott report over the Summer. Highland Marketing’s Lyn Whitfield looks over the report and the response with Dr Alan Hassey, a member of the National Data Guardian panel, following his appearance at this year’s UK Health Show Talk about data use or data security in the NHS and one topic invariably comes up: care. data. The project, launched the best part of five years ago, set out to expand the Hospital Episode Statistics and combine them with new data sets, starting with GP data. The idea was to create a resource within the ‘secure safe haven’ of the Health and Social Care Information Centre (now NHS Digital) that would be available to ‘researchers and others’. Unfortunately, the idea went down badly with privacy campaigners and medics, who worried that the information could be sold to private companies, and that the public was not being told enough about the proposals to give informed consent to them. Alan Hassey, a retired GP who sits on the National Data Guardian panel, says there is no doubt that the episode was a ‘low point’ in attempts to make use of the ‘fantastic resource’ of health data.

technology, and led to the introduction of Caldicott Guardians at NHS organisations to protect and advise on the use of patient information. The second, in 2013, revisited the earlier report and updated the six Caldicott Principles that it had also introduced for handling identifiable patient information. Importantly, it added a seventh principle: that the duty to share information was sometimes as important as the duty to protect patient confidentiality. In her third Review of Data Security, Consent and Opt-Outs, published last year, Dame Fiona says it is ‘frustrating’ that this has led to ‘little positive change’ in the amount of legitimate information sharing that is going on across health and social care. However, she also says that there is now ‘a very significant opportunity to improve the use of data in people’s interests’ while also improving ‘transparency for the public about when their data will be used and when they can opt out of such usage’. Dr Hassey says the theme underlying all of Dame Fiona’s work has been this issue of building

There ic tast are fan ies in the nit opportuata; but Dame use of d conviction is Fiona’s need to take that wepublic and s the s with u t n e i t a p

INFORMATION GOVERNANCE As it became clear that care.data could not proceed, Health Secretary Jeremy Hunt asked Dame Fiona Caldicott, the National Data Guardian, to conduct a review of information governance and security in the NHS. Dame Fiona had already conducted two similar reviews. The first, in 1997, was launched as the NHS started to use information

Written by Lyn Whitfield

Exploring Caldicott: data security standards, cyber and care.data

UK Health Show

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trust in how personal, sensitive information is being used. He says: “We know that people want their records to be available to professionals at the point of care, but we also know they want to exercise some control over how their data is used beyond direct care. With the development of new areas of research, and genomics, and artificial intelligence, there are fantastic opportunities in the use of data; but Dame Fiona’s conviction is that we need to take the public and patients with us.” ADOPTING NEW DATA STANDARDS The government published its response to Caldicott on 3 July. At the same time, it accepted the findings of a Care Quality Commission report on data security that was published last summer, but given new impetus by the WannaCry ransomware attack that hit the NHS in May. In effect, therefore, the response falls into three parts. The first agrees to ‘adopt’ ten data security standards set out in Caldicott 3, and to take positive steps to ‘promote’ them in the NHS. The response says they will include making a named member of the board responsible for data and cyber security and drawing up an annual Statement of Resilience to confirm that the standards are being implemented. In addition, the Care Quality Commission will build compliance with the standards into its new inspection regime, there will be a new Information Governance Toolkit, and new training programmes for staff. The second part of the response deals with cyber security. It says £21 million of capital funding will be spent to ‘increase the cyber resilience of major trauma centres’ and another £50 million will be spent on ‘addressing structural weaknesses’ such as the widespread use of out of date IT systems in the NHS. It also flags up further investment in NHS Digital’s CareCERT service, which is responsible for sending out E

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06/07/2017 12:10

HEALTHCARE INFORMATION  alerts about major threats and issuing advice to health and social care organisations. Dr Hassey says the WannaCry attack has made the response ‘timely’; and he is confident that it will be acted on. He says: “If there is something good to come out of the attack, it is that the NHS had the chance to test itself in a situation that had not been war-gamed, and to learn the lessons from that. We know there are a number of reviews going on, and they will come up with checklists of things for organisations to do, and not do, next time. But the most important thing, and the thing that the government response recognises, is that this has to be owned ‘at the top of the house’. This has to be a board-level responsibility.” ANONYMISED DATA: OUT OF THE OPT-OUT The third part of the government’s response deals with the bigger and more contentious part of Caldicott 3; how to make sure that the public and patients are both informed about what is happening to their health data, and how to make sure they have some control over it. Dame Fiona’s Review of Data Security, Consent and Opt-outs discusses this in the context of both identifiable information and information that has been anonymised or, strictly, de-identified (that has had some elements removed or changed so that what remains cannot be linked to an individual). Some critics of the care.data scheme objected to anonymised data being included; on the grounds that this is still patient data and that it is possible to re-identify it in some circumstances. However, Dame Fiona argues that this

When it comes to patient identifiable data, Dame Fiona’s report says there should be a new, national opt-out model, that gives people the chance to opt-out of whether their information is used for research and regulate the health service kind of data is so important to the NHS and to researchers that it should not be covered by her new opt-out rules. However, her report also argued there should be tough new penalties for ‘the deliberate and negligent re-identification of individuals’. The government’s response accepts this. However, to address some of the concerns that GPs raised about care.data, it says ‘NHS Digital will develop and implement a mechanism to de-identify data on collection from GP practices’ – instead of doing this within the NHS Digital ‘safe haven’. IDENTIFIABLE DATA Dr Hassey admits that, as a former GP, this move is close to his heart: “GPs are in a different position, both because they are data controllers in their own right, and because they have the interests of their patients very much to heart. So I can completely understand where GPs are coming from.” When it comes to patient identifiable data, Dame Fiona’s report says there should be a new, national opt-out model, that gives people the chance to opt-out of whether their information is used for research and/ or activities to run and regulate the health service. Again, the government’s response accepts this. It also promises that ‘people will

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be able to access a digital service’ to see who has accessed their NHS Summary Care Record from December next year and how other services are using their data from March 2020. IS THE RESPONSE POSITIVE? Dame Fiona’s latest proposals, and the government’s response, have been given a cautious welcome by privacy and medical groups. A group of charities that argued strongly in favour of care.data, because of its potential benefit to research, issued a letter saying: “Now the hard work can begin, to address the detailed questions needed for effective implementation.” MedConfidential, which led the privacy charge against care.data, issued a statement saying: “We welcome the clear commitment that patients will know how their medical records have been used, both for direct care and beyond. Some of the details remain to be worked out, but… it is now up to NHS England and NHS Digital to deliver.” Interestingly, Dr Hassey feels much the same: the government’s response is good, but ‘the devil in terms of the opt-out will be in the detail of exactly what it will look like’. Specifically, he wonders how people will be informed about where their data is going, since there is plenty of evidence that public understanding of even big and important data stores, such as the cancer registries, is limited at the moment. Also, how this information will be presented, given that public consultations and citizens juries have shown that people are reluctant to give their information to companies – until they are shown that they will use it for public benefit. So, is information governance and data security in a better place than it was two-years ago? Dr Hassey thinks it is, because ‘we have a government that knows this is important’ and lots of organisations are on board with the idea that ‘the lessons of care.data have to be learned’. However, there is still work to be done, and some of it won’t be easy. He asks: “We need to take people with us: but how do you have a conversation with 65 million people? What are their expectations, do the public and patients think the same, how does their knowledge of IT affect their views? The opt-out is a journey, not a destination. In some ways, that journey has only just begun.” L FURTHER INFORMATION ukhealthshow.com/

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AWARDS PREVIEW

UK MEDICAL RECORDS SUCCESS

Once again the Headline Sponsor of the 2017 Health Business Awards, CCube Solutions’ award-winning solutions deliver electronic health records to clinicians, secretaries and administrators in the format they require, when and where they are needed IN-HOUSE BUREAU: ST HELENS & KNOWSLEY TEACHING HOSPITALS NHS TRUST St Helens & Knowsley Teaching Hospitals NHS Trust started a project in 2009 to remove paper medical files to guarantee notes availability, improve the quality of patient care and, of course, save money. Its IT resource – called St Helens Health Informatics Service (HIS) – created its own in-house scanning bureau along with CCube Solutions’ EDMS. The results are impressive: first trust in the UK to stop using paper medical files in clinical practice; £1.4 million annual savings from £1.2 million investment; 500 doctors and 130 secretaries trained after a staged rollout taking 22 months; over 135,000 medical records digitised equating to 41.3 million pages scanned which stops 7,000 files per week being hand delivered; and innovative scan‑on‑demand model developed so that only files needed for patients are actually scanned. OUTSOURCED BUREAU: AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST This project was handled completely differently. At first, Aintree University Hospital considered creating its own scanning bureau but then decided to outsource to specialists, Capita Total Document Solutions. Again, CCube Solutions software was installed; first trust to use forms recognition technology including OCR to automate the process of recognising pre-printed medical forms which make up 95 per cent of medical files; £1 million annual savings from £1.5 million investment; first trust to use scan-on-demand with a third party with 282,000 patient files digitised; 30 per cent space gained in a new £45 million building from removing paper records so a £13.5 million estate benefit; and three or four clicks to information. HYBRID MODEL: MILTON KEYNES HOSPITAL NHS FOUNDATION TRUST Milton Keynes Hospital approached the whole transition from paper to digital medical records by both setting up its own in-house scanning bureau and working with a third party outsourcing specialist, Hugh Symons Information Management, to do the back scanning. Unlike St Helens

HEALTH BUSINESS MAGAZINE | Volume 17.5

& Knowsley, which rolled out electronic records department by department, Milton Keynes went for a ‘big bang’ approach where all departments went live on a specific day. The in-house bureau is used for dayto‑day scanning and just like the other trusts listed above, returns from the project have been significant: over £1 million cumulative savings since the project went live from a £2 million investment; 35 per cent reduction in records staff headcount; 287,000 patient records scanned equating to around 57.4 million pages; 24/7/365 notes availability for multi disciplinary clinical teams; project delivered on time and to budget with the only cost over run due to VAT increasing from 17.5 per cent to 20 per cent; and auditing and information governance improved as medical records are tracked. AVOIDING SCANNING LEGACY PAPER IN THE FIRST PLACE – THE PAPWORTH HOSPITAL MODEL Tertiary Trust, Papworth Hospital, installed an EDRM, workflow and eForms solution from CCube Solutions to create an electronic medical records system (EMR). Unlike other trusts who have digitised patient records, Papworth’s EMR is not concerned with scanning legacy records which is costly, complex and time consuming. The focus has been to concentrate on the patient’s pathway from the moment an individual is referred to the hospital so that referral paperwork and medical notes are indexed, shared and information automatically routed to boost efficiency, reduce costs and enhance patient care. Return on investment has been significant. The whole project including software, scanners and project management cost under £100,000 plus an annual software licence fee of £13,000.

This contrasts with other trusts who have spent over a £1 million back scanning their libraries; significant reduction in operational costs by removing physical paper records storage and management which cost £200,000 per annum; assists Papworth in meeting government targets to see patients within the set timeframe of 18 weeks from GP to final treatment; and the first deployment of a registration and referral system where letters are scanners and then handled electronically within the trust using workflow. MEDICAL RECORDS IN PRIMARY CARE – THE GPS The above examples have focused on records management in hospitals. Turning to GPs, CCube Solutions is involved in a significant primary care initiative called eLGS; Capitalising on its experiences digitising records at its two hospital sites, St Helens and Whiston, St Helens & Knowsley HIS – working with CCube Solutions – took the pioneering step to offer its know-how in primary care. In April 2013, it launched a fully managed service to digitise all the patient records which GPs have to keep in their surgeries – colloquially called Lloyd George notes. Costing just 60p per record per year, the eLGS service includes collection, digitisation, hosting, training, and the software GPs then use to access the information on their desktops. This initiative is about releasing more space in primary care, enhancing GP and practice staff productivity and removing a whole paper shuffling industry in primary care which in itself costs millions and millions. To date, four CCGs have purchased the service with around 140 GP practices now using the system. L FURTHER INFORMATION www.ccubesolutions.com

EVENT PREVIEW

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Showcasing success in the health sector The Health Business Awards have established a reputation for showcasing the success stories in the health sector, and the 2017 event will be no different The Health Business Awards recognise and celebrate the significant contributions made each year by organisations and individuals that work inside and alongside the NHS. Held once again this year at the Grange Hotel, London, the event takes place on 14 December and includes a champagne drinks reception and a three course luncheon, followed by the presentation of awards in 21 categories, focusing on hospital management, facilities, outstanding achievements and innovation. The award categories also incorporate the sectors of technology, human resources and transport as well as the Outstanding Achievement in Healthcare award, which is presented to an NHS organisation that has achieved success in their role and brought benefits to the wider NHS through their dedication and expertise. Last year’s ceremony recognised Hinchingbrooke Health Care NHS Trust for the Outstanding Achievement in Healthcare Award, sponsored by CCube Solutions, the headline sponsor once again in 2017. After returning to NHS management on 1 April 2015 after a period in private control, Hinchingbrooke Hospital left special measures, with the Care Quality Commission report from August 2016 rating all of the trusts’ services as Good. As well as several areas of outstanding practice, patient survey reports from the same year showed improvements in food quality and an exciting merger with Peterborough and Stamford Hospitals, which was planned for April 2017.

THE NHS AND HEALTH BUSINESS The NHS has once again been portrayed rather negatively by the media in 2017. Financial shortcomings, excessive workloads, staff shortages, STP confusion and bed blocking have all contributed to an image of a care system in disarray and desperation. But while more money, staff and space are all necessary to tackle these growing issues, little has been done in the media coverage to emphasise, congratulate and celebrate the success stories that have been lost behind the headlines. Unprecedented turn-arounds, recruitment triumphs, energy savings, new successes with technological advances and the many other strides forward that the NHS has managed, despite its constraints, are the headlines that should be, and will be, broadcast at the Health Business Awards. THE CATEGORIES The Air Ambulance Service Award recognises the hard work and dedication of the air ambulance sector, which operates as 18 separate charities that raise over £35 million per year in funding. Winners in the last two years are London Air Ambulance, recognised for its use of a pioneering balloon procedure, known as REBOA, to prevent a road crash victim bleeding to death and East Anglian Air Ambulance, for establishing a working group that developed a consistent communications strategy to build awareness of critical care. Also returning for the 2017 awards is the

Ambulance Trust of the year category, which is presented to the ambulance trust that has embraced change and demonstrated a decrease in response times, the ability to provide treatment at the scene of an accident, and the provision of outpatient services. Sponsored by the British Parking Association, the Transport & Logistics Award is given to the NHS trust that has seen improvements in operational logistics, including: emergency services transport and coordination; fleet management; green transport; car parking and traffic management; postal services; and the supply of materials and goods. Recognising the CCG sector, the Clinical Commissioning Award is presented to an organisation which has quickly made an impact to reduce hospital admissions through preventative practice, and last year was given to NHS Barnsley for the RightCare Barnsley initiative. Over 1,000 patients have avoided being admitted into hospital in the first 10 months of the service, which is staffed by both community and hospital nurses. The Environmental Practice Award, won in 2016 by Barts Health NHS Trust, recognises NHS projects that further the progress of environmental practice in the NHS, whether that be via the smarter use of energy, more efficient transport systems of innovative waste management processes. Similarly, the Facilities and Estates Innovation Award recognises NHS and other healthcare organisations that have developed innovative procedures for E

Recru triumph itment savings s, energy a technol nd new advanc ogical em the hea ents are that sho dlines u broadcald be st

EVENT PREVIEW  managing and maintaining healthcare facilities. In 2016, Burton Hospitals NHS Foundation trust won the award for improving patient safety and efficiency for its Endoscopy Decontamination services. The environment in which people live and work has a key influence on their health. The Sustainable Hospital Award recognises the NHS hospital that has made progress towards sustainability through the smarter use of energy, transport and waste management, in order to strive towards a reduced impact of healthcare facilities on the environment. Last year’s winner was the West London Mental Health NHS Trust for the Broadmoor Hospital redevelopment project, which features ongoing ecology work and sees hundreds of animals relocated to safer environments in surrounding areas. IT INNOVATION The wider use of computer technology in the NHS is evident throughout the world, with many countries citing NHS projects as examples of good practice. The Healthcare IT Award will recognise an organisation that is responsible for implementing a ground breaking IT project that demonstrates clear cost benefits to the wider NHS. The 2016 trophy was shared by Cornwall Partnership NHS Foundation Trust, Plymouth University, Royal Cornwall Hospitals and SUDEP Action,

for the EpSMon app that provides a seizure safety checklist to support people with epilepsy, allowing patients to monitor their risk for free to keep themselves safer. Also representing the technology field, the Patient Data Award will recognise the most innovative introduction of new technology for secure storage, retrieval and distribution of data throughout the NHS. As evidenced by Royal Cornwall Hospital Trust’s success in 2016, the need for timely, effective information in healthcare is key to realising the benefits of the huge investments in NHS staff and buildings. COLLABORATIVE ACHIEVEMENTS Recognising a hospital trust which has developed prudent financial practices and represents good value for the taxpayer, the NHS Finance Award was awarded to Bolton NHS Foundation Trust in 2016 for recording a much improved performance, emerging from financial adversity to record a surplus in just one year. The Hospital Procurement Award, meanwhile, rewards the success of partnerships and collaborations to achieve procurement excellence and cost effectiveness. Improving patient access and choice depends on the quality and availability of staff in all areas of the hospital practice. The Healthcare Recruitment Award will recognise the NHS organisation that has developed a

robust recruitment policy that delivers both safety and continuity to patients. Last year, the award was presented to Guy’s & St Thomas’ NHS Foundation trust, who actively created opportunities for candidates with learning difficulties, dyslexia, dyspraxia, health issues and complex family backgrounds have been promoted. The trust also won the previous year for its inclusive recruitment policies. The NHS Collaboration Award is presented to the NHS trust which has worked with other public/private sector organisations, such as local government, police, fire, charities, schools etc to engage the local community, in preventative campaigns. It was won in 2016 by Yorkshire Ambulance Service NHS Trust, South Yorkshire Fire & Rescue and South Yorkshire Police. The Outstanding Achievement in Healthcare Award is presented to an NHS organisation that has achieved success in its role and brought benefits to the wider NHS through the dedication and expertise of its staff. Other categories include the Hospital Building Award, the Hospital Catering Award, the Hospital Cleaning Award, the Hospital Security Award, the Patient Safety Award, the Innovation in Mental Health Award and NHS Publicity Campaign Award. L FURTHER INFORMATION www.hbawards.co.uk

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British Parking Association is the largest, most established and trusted professional association representing parking and traffic management in Europe and the recognised authority within the parking profession. The company represents the best interests of its members and the parking community. British Parking Association engenders collaboration between stakeholders, members and government to support growth for its communities, improve compliance amongst those managing and using parking facilities, and encourage fairness and consistency to achieve its vision of excellence in parking for all. The Professionalism in Parking Accreditation (PiPA) is an audited accreditation for organisations in the healthcare sector. PiPA recognises and celebrates the highest standards of professionalism in parking and organisations

compassionate understanding. This is at the core of ISS Healthcare’s understanding and is embodied within the company motto ‘People serving people’, as the company strives to provide excellence with long‑term sustainable goals. It is, therefore, entirely appropriate that ISS Healthcare is the proud sponsor of this year’s Health Business’ Estates and Facilities Innovation Award. To find out more about ISS Healthcare visit the company website. FURTHER INFORMATION Tel: +44 845 0576300 info@uk.issworld.com www.uk.issworld.com

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that hold the accreditation are nationally recognised role models for parking professionalism and excellence. PiPA celebrates the high standards that already exist, and the accreditation also helps to raise levels of customer service for patients, visitors and staff, increasing car-park user satisfaction and improving the reputation of healthcare landowners. This is an accreditation that will make your organisation proud. FURTHER INFORMATION Tel: 01444 447 300 info@britishparking.co.uk www.britishparking.co.uk

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Chroma-HYD This model is designed for the patient. It has a large seat pad and back rest and is fitted with secure arms. This chair has proved very popular with Eye Clinics for use with the slit lamp. However it has also been used in other clinical departments where the patient needs to be raised and lowered by a clinician.

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ANTIBIOTIC RESISTANCE

Silver lining in war against superbugs

Infection Control

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Reducing Healthcare-Associated Infections can only be achieved by NHS estate managers being more open to technology that provides innovative property solutions, says Dr Michail Karavolos Public Health England has predicted that increasing antibiotic resistance could lead to 10 million deaths by 2050 worldwide, whilst leading economist Lord Jim O’Neill has said that it could cost the global economy $100 trillion. Reducing Healthcare‑Associated Infections (HCAIs) can only be achieved by NHS estate managers being more open to technology that provides innovative property solutions. The current HCAI regime of infection prevention and control strategies (including hand hygiene, cleaning and training procedures) has long proven to be ineffective. According to the European Centre for Disease Prevention and Control, this contributes to 37,000 attributable deaths in Europe each year, plus annual financial losses of approximately €7 billion in Europe and 16 million extra days of hospital stay required, according to the World Health Organisation (WHO). What’s more, the built environment is playing a major part in spreading the infection. Healthcare settings particularly, along with other highly populated environments, are a breeding ground because of shared facilities and enclosed environments, circulated air, common contact surfaces and extended mixing. Common disinfectants have limited residual effects and bacterial populations are rapidly displaying increased resistance to them. BioCote Silver Ion Antimicrobial Technology makes all kinds of surfaces inhospitable to pathogenic microorganisms. It has a multi‑modal action and is effective against a wide range of leading superbugs (including MRSA and ESBL-producing E. coli, Clostridium difficile and Klebsiella pneumoniae, plus carbapenemaseproducing Enterobacteriaceae or CPE) destroying up to 99.99 per cent of bacteria,

fungi (including invasive Candida species) and even viruses like H1N1 and H7N9 – through proven protein and oxidative damage, membrane disruption and DNA interference. Along with Acinetobacter and Pseudomonas, CPE has been classed as the most ‘critical’ group of bacteria by the WHO, because it poses a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. CPE also encompasses the likes of Escherichia, Shigella and Salmonella and having been evidenced to survive for many months on hard surfaces can cause sometimes deadly, infections like septicaemia and pneumonia. ANTIMICROBIAL TECHNOLOGY With the numbers of antibiotic resistant bacteria continuing to grow, current methods to control them are increasingly limited. However, antimicrobial technology can successfully be combined with thorough hand-washing practices and regular cleaning to minimise cross-contamination and become an essential and proactive element of healthcare infection control. Because it does not wear out or wipe off surfaces, it can provide a

continuous decontamination effect and in a ‘live’ 18-month hospital case study, BioCote antimicrobial protected materials regularly demonstrated reductions in bacteria of up to 98 per cent. Indeed, results also indicated lower numbers of bacteria on other untreated surfaces too, due to the fact there are fewer bacteria being transferred – so using a number of antimicrobial objects in hygiene conscious settings even helps reducing the chance of pathogen spread to the wider untreated environment and causing disease. Since antimicrobials first appeared, there is now the capacity to treat a plethora of material types and silver ions, especially since their very high efficacy and non-toxic properties can quite easily be manufactured into plastics, polymers, paints, textiles, fabrics, ceramics, paper and board. Lots of real data is also available from surfaces prevalent in a host of environments, confirming that the efficacy of antimicrobial technology in real-life healthcare settings is comparable with that shown in laboratory validation testing. Healthcare facilities looking to adopt the technology should choose a product containing a regulated antimicrobial that is compliant with BPR/ EPA regulations, plus the additive contained within the product needs to be appropriate for the E

Wit the numh of antib bers resistan iotic continu t bacteria current ing to grow, m control ethods to th increas em are ing limited ly

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ANTIBIOTIC RESISTANCE  market sector. It should also be continuously quality control tested to guarantee high levels of antimicrobial performance – and not just during the initial development of the treated product/surface/material. The additive manufactured into the product is best supplied by an experienced and trusted antimicrobial solutions provider too, while the product has to be correctly labelled in line with the classifying, labelling and packaging guidelines for treated articles. Dr Karavolos says: “Even hospitals and healthcare facilities with a restricted budget can benefit, because apart from being environmentally and ecologically acceptable and completely harmless to people, it’s surprisingly cost effective and affordable too – simply integrated into any product or surface at the time of manufacture. “If a facility was to embark on a refurbishment program of a particular department they could quite simply make a big starting difference with antimicrobial treated paint. Key touch points, like door handles, soap dispensers, grab rails, etc, could also be cost effectively converted and as this type of technology significantly reduces the potential for stains and odours caused by microbes, it also keeps susceptible medical products fresher for longer and makes them much more hygienic.

A study has found sterile operating conditions are key to cutting infections A new US study has found that skin preparation, wound hygiene and sharing data on outcomes are more important than adherence to dress codes for reducing infections following surgery. The study, which analysed lead Writing in the Journal of the American surgeons at 20 Texas hospitals, noted College of Surgeons, the report that polices on operating room attire, authors said: “This analysis suggests which had been adopted in an effort that the subset of infection control to reduce surgical site infections practices that focus on perioperative (SSI) rates, had few benefits and patient skin and wound hygiene were ‘costly, time-consuming, and and transparent display of SSI data, detrimental to provider morale’. not operating room attire policies, More important to reducing SSI correlated with SSI rates.” rates, they argued, was proper Lead author Dr Thomas Aloia, skin preparation, wound hygiene from the University of Texas in and sharing data on outcomes. Houston, suggested that the study As part of the study, the surgeons findings could assist hospitals to were asked to rank staff adherence ‘appropriately scale’ what they to 38 practices in six categories – were going to emphasise in their attire, pre-operative preparation, attire policy and other standard during-surgery protocols, antibiotics, operating procedures. post-operative care, and outcomes reporting. They found that attire FURTHER INFORMATION practices had no impact on SSI rates. bit.ly/2yCUFoa

“Granted, antimicrobial technology doesn’t remove the need for regular cleaning, but it is the best complementary strategy – with integrated antimicrobial protection providing a much more comprehensive and robust solution to

Infection Control

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contamination within hospitals, schools, care homes and an array of other highly populated environments.” L FURTHER INFORMATION www.biocote.com

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Volume 17.5 | HEALTH BUSINESS MAGAZINE

EVENT PREVIEW

First things first: let’s address patient safety Patient First, the UK’s largest patient safety event, will return to London’s ExCeL on 21-22 November 2017. Health Business examines the conference programme and details what to look out for at the show Patient safety is the biggest single issue in the NHS and UK healthcare. The legacy of the Francis report (and the government’s formal response) into Mid Staffordshire, the Keogh review into trusts with unusually high mortality rates and the Berwick review on behalf of the Prime Minister is system-wide acknowledgement that patient safety must be the driving force for commissioners and providers. A report by NHS Providers in June this year revealed that NHS trusts in England are deeply concerned about their ability to respond to mounting pressures next winter.

The report, Winter Warning, highlights the worries of many NHS trusts that extra funding for social care, partly allocated to ease winter pressure on the health service, is not consistently getting through to the NHS. Despite the extraordinary efforts from staff last winter, the health and care systems struggled to cope under sustained pressure, with delayed transfers of care causing extra difficulties and the inability to line up suitable social care creating heavy bed blocking. NHS Providers

Patient First

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argues that the government’s £1 billion of extra social care funding is not easing pressure and that only 28 per cent of trusts have had a specific commitment that the funding would help reduce delayed transfers of care. Furthermore, 34 per cent of responders to the report said their local authorities were giving a high priority to supporting the NHS reduce delayed transfers of care as opposed to other social care needs, while 44 per cent thought the money would have no impact on their ability to manage winter pressures. Despite Health Secretary Jeremy Hunt announcing weeks before that £20.74 million worth of funding will be awarded to hospitals to ease pressure on A&E departments in preparation for winter, the report called for a funding injection of £350 million by the end of July to: put in place extra beds in community and mental health services as well as in hospitals; help pay for more doctors, nurses and care home staff; enable the ambulance service to take more of the patient load; and strengthen mental health crisis care to prevent hospital admissions. NHS Providers has since warned that, although last winter was widely regarded to be the most challenging winter in recent times, the NHS is currently on a trajectory towards a, at best similar, but more likely worse, performance this coming winter with heightened patient safety risks. E

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Volume 17.5 | HEALTH BUSINESS MAGAZINE

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Effective human waste management is an essential part of improving infection control. We engineer and manufacture bedpan washer disinfectors and pulp macerators for the safe and complete disposal of human waste. Our machines offer:h Hands free operation reducing the risk of cross infection h Antimicrobial surfaces eliminating growth of harmful bacteria h Anti-blockage systems to ensure complete waste removal

We provide:h Servicing for all makes of washer disinfectors and macerators h Customised service & maintenance packages h On site staff efficiency training

DDC Dolphin Ltd. Tel: 01202 731555 | Email: info@ddcdolphin.com www.ddcdolphin.com

Patient First

EVENT PREVIEW

 PATIENT FIRST 2017 Patient First, taking place on 21-22 November 2017, will once again be supporting those operating within the NHS and independent healthcare sectors, aiming to provide practical advice needed to create action for change. With seven conference theatres hosting industry leading content, social and networking events, and the largest sourcing floor in patient safety in a sector actively looking for solutions, Patient First is unmissable for anyone involved in the improvement of patient care nationwide. Healthcare Associated Infections (HCAIs) are estimated to cost the NHS £1 billion a year and healthcare professionals are constantly looking for ways to improve patient care, reduce infections, and reduce associated cost. Yet providers are being pushed more and more to reduce costs and find savings, without impacting on patient safety. Patient First and the Infection Prevention Conference will provide the community of healthcare professionals desperately seeking solutions with practical solutions they can implement immediately and for the future. This year, the conference programme is being led by an advisory board of leading IPC experts to help deliver a dedicated programme of the very best infection control content. The board includes: Linda Dempster, head of Infection Control at NHS Improvement; Karen Shaw, control lead of the HCAI Programme at Public Health England; Neil Wigglesworth, IPS chairman and deputy director of Infection Prevention at Guy’s & St Thomas’ NHS Foundation Trust; Rose Gallagher, professional lead for Infection Prevention and Control at the Royal College of Nursing; and Elizabeth Beech, national project lead for HCAI and Antimicrobial Resistance at NHS Improvement. Lucy Pitt, event director, said of the IPC panel: “Infection prevention remains a hugely important part of Patient First, which serves to support and address the key issues surrounding patient safety. Working with NHS Improvement’s national IPC team together with an expert advisory panel from Public Health England and

The West Midlands Patient Safety Collaborative is leading a Quality Improvement programme in 35 care homes across Walsall and Wolverhampton with the aim of strengthening safety culture and reducing adverse safety event rates the Infection Prevention Society will help direct the content and learning necessary to support many hundreds of IPC leads and professionals with fully subsidised passes.” SAFE PATIENT ENVIRONMENTS Patient safety is an unarguable fundamental of healthcare services. Or it should be. The reality is that interaction with health services results in avoidable harm. Unfortunately, this harm is all too frequent. It not only creates poorer health outcomes – including mortality – but also results in higher costs. By attending Patient First you will come away with practical solutions that can be implemented into your organisation now and in the future to protect your patients in the most efficient way possible. The Infection Prevention & Control Theatre, being run in association with NHS Improvement, will cover infection control across the whole health economy. IPC leads and nurses from hospitals, primary care, hospices and CCGs will benefit from attending this dedicated two day conference that not only delivers the latest national guidelines but more importantly offers practical solutions and ‘how-to’ advice that delegates can put into practice. Topics to be discussed include: sepsis and patient perspective; surgical site infections; the prevention of UTI; catheter passports and the use of bladder scanners; pseudomonas chronic wounds; infection care bundles; places with low E.coli BSI rates; and local best practice IPC case studies. The standout session from the Plenary Theatre on day one of the conference is Celia Ingham Clark’s session on NHS

Improvement’s approach to patient safety. The interim director of Patient Safety at NHS England will provide an overview of the work of the national patient safety team. Last winter saw all parts of the NHS struggling to cope with record levels of demand. The CEO panel session will explore, from an NHS provider CEO and system perspective, what the service learnt from last winter and what we should be doing for this winter. Chaired by NHS Providers’ Chris Hopson, the speakers in this panel include Claire Murdoch, CEO of Central and North West London NHS Foundation Trust, Matthew Hopkins, chief executive of the Barking, Havering and Redbridge University Hospitals NHS Trust, Will Hancock, CEO of South Central Ambulance NHS Foundation Trust and Pauline Philip, CEO of Luton & Dunstable University Hospital. SHOWCASING BEST PRACTICE The West Midlands Patient Safety Collaborative is leading a Quality Improvement programme in 35 care homes across Walsall and Wolverhampton over 24 months. The programme is training staff and managers in quality improvement techniques, with the aim of strengthening safety culture and reducing adverse safety event rates. This will enable an assessment of the extent to which care home staff training can effectively improve safety culture, lower the incidence of adverse safety events such as falls and pressure ulcers, and potentially reduce care home resident’s use of acute services. The team will be speaking on 21 November about the SPACE programme – Safer Provision and Caring Excellence. The Yorkshire & Humber AHSN Improvement E

Volume 17.5 | HEALTH BUSINESS MAGAZINE

Patient First

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

Product innovation for health care sectors

DDC Dolphin – advice, support and planning

Amity is a speciality chemical manufacturer located in the United Kingdom and the USA with an excellent reputation for product innovation in the healthcare sectors. In recent years, Amity has focused on the development of alternative products specifically designed to overcome the environmental, financial and safety restrictions which the healthcare sector faces. Amity offers products for: Instrument (including flexible endoscopes) cleaning & High Level Disinfection (HLD); ScopePro – Replaces manual decontamination of flexible endoscopes; High Level and

DDC Dolphin is the only UK manufacturer dedicated to providing complete sluice room solutions and a complete range of state of the art equipment. The company’s clients and customers cover the full spectrum of healthcare establishments from large internationally renowned hospitals through to independent care homes. Over 25 years of experience allows the company to provide comprehensive and meaningful advice and support throughout planning, design and specification processes for new or existing facilities, allowing it to tailor solutions to your requirements and enable you to meet

routine surface and environment disinfection / cleaning; Lubricants for medical devices; Automated and manual dosing systems; Hand sanitizers; Absorbents for body fluid spillages; Whole Room Decontamination System – HPV & UVC; Air purification units – 40 times more efficient than hepa-filtration. Come and visit Amity on stand K60 at Patient First or email sales@amityinternational. com to arrange a meeting. FURTHER INFORMATION www.amityinternational.com sales@amityinternational.com

modern infection control standards as efficiently as possible. DDC Dolphin’s comprehensive after sales service and support is reinforced by an extensive team of fully qualified engineers. The company’s engineers are specialists in the installation, testing and maintenance of all sluice/ dirty utility room equipment. DDC Dophin offers regular service contracts and maintenance on all leading brands of bedpan washers and macerators plus HTM validation testing. FURTHER INFORMATION www.ddcdolphin.com

Join the fight against Hospital Acquired Infections (HAIs) Our philosophy is simple, patient safety is paramount, so don’t risk it, bin it!

Opal Health disposable curtains are the quick, efficient, hygienic alternative to traditional cubicle curtains. Established in 2005, we have been manufacturing and supplying our curtains to NHS Trust hospitals, GP Practices and medical centres across the country for over 10 years.

No curtain can offer 100% protection against infection so we promote the regular disposal and replacement of curtains as the best way to maintain a safe, hygienic environment. Our curtains are so fast to replace that regularly changing your curtains is the only way to ensure they aren’t harbouring bacteria.

•Our patented and national awarded winning systems can drastically reduce the time taken to carry out curtain changes providing a cost effective solution to the management of hospital curtains. •We are the only company to offer bulk loading disposable curtains for for all types of cubicle track for the fastest fit on the market •We only use 120gsm fabric for enhanced durability and patient privacy •We can offer bespoke colours and prints Call us today to find out more about our products and services, we are so confident in our products that we are happy to set up a free sample area for you: Lucie Reeve BSc Hons / Healthcare Key Account Manager M. 07464 547878 E. lucie@opalcontracts.co.uk W. www.opalhealth.co.uk Nechells_HP_17.5HBv4.indd 1

HEALTH BUSINESS MAGAZINE | Volume 17.5

Glides around corners

Logging the next schedule change

02/10/2017 11:59

EVENT PREVIEW

As technology advances, more opportunities for removing human tasks from processes in health care delivery are available, as well as improved, timely access to information  Academy is supporting frontline teams to integrate multi professional safety huddles into their routine clinical care as part of a systematic approach to reducing harm. Team huddles involve all levels of trained and untrained staff and provide important space for discussion of patient safety issues. Alison Cracknell, Alison Lovatt and Anna Winfield will be speaking in the Best Practice Theatre about the successful ‘Huddle up for Safer Healthcare (HUSH)’ programme. Since 2014, the team have supported over 150 frontline teams to develop, test and integrate safety huddles into their daily ward routines. This includes mental health teams, acute hospital ward teams, care homes and district nursing teams. They have supported scale up to frontline teams across whole organisations, including Leeds Teaching Hospitals, Scarborough Hospital and Barnsley Hospital with demonstrable impact on safety culture and harm reduction. In June 2016, Somerset CCG launched a Quality Improvement Network for the GP primary care services across Somerset. The South West AHSN presentation on 22 November in the Best Practice Theatre shares the learning, experiences, challenges and outcomes from the work of the network in its first year. It shows how Somerset CCG has harnessed a range of local and national resources and incentives to support practice to improve sustainability, quality and safety. MAINTAINING SAFETY THROUGH MEDICAL DEVICES Sarah Jennings, decontamination lead for Salisbury NHS Foundation Trust, will lead a session on Scan4Safety and medical device procurement. Her seminar will outline what benefits can be realised through Scan4Safety implementation and what progress is being made by a demonstrator site for the programme. This will include how, as a demonstrator site, the trust is developing Scan4Safety for inventory management and product recall and future developments for performance management, medical device tracking and user training. The error in information technology session will provide insight into the challenges associated with patient safety following the introduction of digital medicines solutions and the potential benefits. Ann Slee, ePrescribing lead for NHS England, and David Gerrett, national MSO for NHS Improvement, will also provide insight in to the type of reports coming in to the NRLS. NHS England has also been working with the medical equipment and pharmaceutical industries to develop a national register of industry representatives. This will ensure quality of training and a code of conduct for all industry representatives when they access NHS staff and so improve patient safety. The session on manufacturer rep credentialing will look at what the Healthcare Industries Register is, how it has been developed, how the NHS will embed checking the register into good practice and what the implications are for patients, medical staff and healthcare industry employees. SAFETY THROUGH TECHNOLOGY Can technology improve patient safety? This is the question that will be explored by Mark Ryan, clinical safety officer at Rotherham NHS Foundation Trust, in the Safety Through Technology Theatre. Human error is an often-cited cause for patient safety incidents. As technology advances, more opportunities for removing human tasks from processes in health care delivery are available, as well as improved, timely access to information. Can, or does, this automation of process improve the overall safety to the care of patients? Ryan will explore the strengths and weaknesses of humans vs technology, and how

Patient First

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

each may contribute to the ‘safety’ of the overall patient experience. In the afternoon of 21 November, Stuart Harrison, head of Safety Engineering at NHS Digital, will lead an exciting session on the SMART way to develop safety cases for health IT. The session seeks to examine the challenges faced by users presenting their safety cases and the obstacles we are trying to overcome, as well as help delegates understand the underlying methodology behind SMART and the rationale for enforcing this, understand the potential for SMART to revolutionise the way in which safety analysis is undertaken, and provide insight and feedback into the development of future iterations of SMART to shape the way in which it is developed. Day two in this theatre will begin with a panel discussion on the barriers to technology uptake, challenges of deployment and successes supporting patient safety in real life wards. Technology has played a major role in dramatically improving patient safety in hospitals over the past five years. Electronic prescribing, vitals ‘track and trigger’ and electronic contemporaneous records have reduced medical errors and improved early intervention for when patients become unwell. This panel will explore the experience the NHS has had so far in using technology to improve patient safety, from disasters like the National Programme for IT, to successes stories such as Cambridge University Hospitals’ Epic system, Salford Royal’s AllScripts and James Paget University Hospitals’ PatientSource. The panel also explores the barriers to technology uptake and the challenge of deploying such systems in real life wards. The panel consists of: Adrian Byrne, CIO at University Hospital Southampton; Chris Farmer, consultant in renal medicine at East Kent Hospitals University NHS Foundation Trust; Ian Abbs, chief medical officer for Guy’s & St Thomas’ NHS Foundation Trust; and Rachel Dunscombe, CIO of Salford Royal NHS Foundation Trust. L FURTHER INFORMATION www.patientfirstuk.com

Efficient, hygienic and safe curtains for hospitals Opal Health’s disposable curtains are the quick, efficient, hygienic alternative to traditional cubicle curtains. Established in 2005, the company has been manufacturing and supplying curtains to NHS trust hospitals, GP practices and medical centres across the country for over 10 years. Opal Health is the only company that can offer bulk loading fast-fit curtains for any type of cubicle track for the fastest fit on the market and you can easily switch to its curtains any time you choose whilst avoiding the need for costly modifications to your existing tracks. The company’s patented and nationally awarded winning systems can drastically reduce the time taken to carry out curtain changes providing a cost effective solution to the management of hospital curtains. Opal Health can supply both pandemic and day-to-day supplies and can also offer a

fully managed service, including recycling of all curtains, including those classed as clinical waste. The philosophy is simple: patient safety is paramount – so don’t risk it, bin it. Changing your curtains is the only way to ensure they aren’t harbouring bacteria. Opal Health’s curtains are so fast and easy to replace that a regular and responsive programme that makes hospitals safer may be within your reach. FURTHER INFORMATION www.opalhealth.co.uk

Volume 17.5 | HEALTH BUSINESS MAGAZINE

Products & Services

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

PRODUCTS & SERVICES

Mr. Fire Safety employs some of most qualified and experienced fire safety officers currently operating in the UK – each with over 30 years’ experience in the fire safety sector, and active members of the Institute of Fire Safety Managers. Specialising in reasonable cost, high quality fire risk assessment and bespoke training packages, the team covers the whole of the UK from its base in the heart of the Midlands. The company comes from an enforcement background so are fully conversant with the most recent fire regulations to ensure your business meets its regulatory obligations. Working directly with you, Mr. Fire Safety helps your business to stay safe from fire, putting in place strategies and processes to reduce risk. There may be many ways to meet the requirements of regulation; the company will discuss a variety of

SWA’s Firefly fire clips are probably the easiest‑to‑fit low-cost range of cable clips in the UK. This unique product is designed to save lives, resisting temperatures of up to 970ºC for at least two hours. Eight successful Warrington fire tests have proven this. Better still, Firefly fire clips are fast-fit, saving on installation time too. Created to support cabling inside trunking, Firefly clips bury themselves deeper into substrate as trunking melts around them, giving cables additional support. No other clips can do this. But Firefly can also be used generally, supporting surface installations anywhere with ease and speed with fire-resistance built in. The clips are 100 per cent compliant with BS7671:2015 amendment 3. The range consists of: internal trunking clips, surface mounting clips, external

Helping your business to stay safe from fire

options, allowing you to make informed decisions. Having worked with local authority fire and rescue services and other fire safety consultancies, Mr. Fire Safety understands fire and why many people need help with fire safety. That’s why it has created a fire safety ‘one stop shop’, providing support services including fire door repairs, sign surveys, supply and fitting, fire extinguisher supply and maintenance. The company’s engineers also install emergency lighting and fire alarm systems. FURTHER INFORMATION Tel: 07951 098 662 info@mrfiresafety.co.uk

FIRE SAFETY

Leading fire alarm and care systems provider Aquarius Fire is a specialist in the provision of life safety systems throughout the UK. With the increased awareness of the need for fire alarm systems growing daily, Aquarius Fire offers a complete solution to ensure your compliance with the relevant British Standards. The company supplies systems from only a couple of devices to highly specialised networked analogue and addressable systems. It also offers fire risk assessments conducted by professionals, ensuring that your staff, residents and premises are fully protected. Did you know that since the introduction of the Regulatory Reform Order it is the responsibility of the business operator to ensure that an up‑to-date fire risk assessment is in place for every premise? Aquarius Fire prides itself in the provision of a complete package encompassing design, supply, installation and on‑going

maintenance. Its areas of expertise extend to the provision and support of fire extinguishers, emergency lighting, call systems, induction loop, attack systems and access control solutions. The company’s new website allows customers to shop securely online, whilst informing customers of recent changes in legislation through a newsletter and catalogue which provides information on all the products Aquarius fire offers. To get your copy, email or call the company. FURTHER INFORMATION Tel: 0800 644 0019 sales@aquariusfire.uk www.aquariusfire.uk

HEALTH BUSINESS MAGAZINE | Volume 17.5

Save lives with SWA’s Firefly fire clips

trunking clips and conduit clips. Firefly clips are available nationwide through SWA’s network of electrical stockists. They are fast and easy to install and guaranteed to outlive the lifetime of the cables they hold in place. Firefly clips fit all makes and sizes of plastic trunking and conduit and are recommended by leading trunking manufacturers as standard. FURTHER INFORMATION Tel: 01453 844 333 sales@swaonline.co.uk www.swaonline.co.uk

FIRE SAFETY

Experts in fire protection and security equipment

Fireout Protection Ltd was formed in 2003 by Eddie Rivers and is a BAFE and FIA approved fire protection company. Fireout Protection carries out free surveys for installations and maintenance works, and has a 24 hour call out cover for contracted customers. A selection of its current customers include the NHS, Five Guys restaurants, Cote Brassiere, Jewson builders merchants, Hythe Imperial Hotel and Bromley shopping mall, as well as carrying out all types of works in all types of buildings. Fireboat Protection carries out comprehensive risk assessments

also on request and all fire extinguisher maintenance. Based in Erith in Kent, the company can service almost anywhere in the UK and have been servicing throughout the UK for some time now. All engineers are friendly and knowledgeable and are fully trained to the current regulations that cover the industry BS5839-1 2017. For any enquires please call the office or visit the website. New customers welcome. FURTHER INFORMATION Tel: 01322 445 408 info@fireout.co.uk www.fireout.co.uk

LIGHTING

FIRE SAFETY

LED lighting has saved businesses and organisations millions in energy costs. LED Hut has replaced over 1,000,000 standard lights with energy efficient LEDs, resulting in customer savings of over £3,500,000 and also leading to the reduction of over 3,000 tonnes of carbon emissions. Your organisation could greatly profit from upgrading your lighting, benefiting from energy bill savings, superior light quality and options, smart lighting controls, five year warranty and extended lifespan. LED Hut offers a full lighting services, starting with a free site survey. The company will

T F Installations Ltd, founded in 2012, is a dedicated specialist company in fire detection, fire alarm system design and security systems. It has quickly become one of the most respected fire system companies in London and the South East following a series of high profile installations and has developed a founding reputation for providing innovative products and superior services that meet and exceed its clients’ expectations. The company predominantly works directly for end user clients in the commercial sector, offering a complete range of services to its clients; from sales, fire alarm system design, installation, testing, commissioning through to ongoing maintenance and technical support. This includes identifying client needs, determining options and designing systems at the most competitive cost without compromising quality.

LED Hut: Join the green light initiative

visit your location and assess what savings you could make, put together a bespoke lighting plan, then organise payment options and installation. You don’t need to worry about any element of upgrading. LED Hut stocks a wide range of lighting products meaning there will be a replacement for whatever existing lighting you have. Relux trained staff can also help with any queries you may need. FURTHER INFORMATION Tel: 0333 772 0491 GLI@ledhut.co.uk www.ledhut.co.uk/GLI

The fire detection and security specialists

LIGHTING

CLEANING

Glamocell is committed to reducing energy costs and carbon emissions through providing sustainable LED lighting to its commercial and public sector clients. As the technology continues to develop, LEDs have become more affordable and energy efficient with improved lighting quality. All Glamocell’s lights incorporate the finest components to produce a high performance range of safe and robust lighting products. The products are 95 per cent recyclable, 48 hour quality‑tested and are easy to install. They also have a dimmable option and come with a three to five year warranty. LEDs not only reduce your lighting bills dramatically but also produce mainly light, not heat, are free from harmful toxins, typically have a 50,000 hour life cycle equating to 5.7 years if on 24 hours a day. They

With over 20 years experience in the healthcare sector, ServiceMaster Clean (Staffordshire & Cheshire) Ltd is equipped to support healthcare units, medical centres and GP surgeries in providing a safe and clean environment for patients and staff. The company is fully compliant to CQC standards and have a proven track record to give you the assurance you need that the cleanliness and hygiene of the premises will be the least of your concerns. ServiceMaster Clean takes full responsibility for the effective operation of cleaning systems designed to assess the risk and to prevent and control the spread of bacteria, leaving a clean and healthy environment. The company understands that management have an awful lot to think about regarding the maintenance of CQC standards, but can genuinely take all the cleaning and infection control

Products & Services

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In 2012, T F Installations Ltd was appointed an Engineered Systems Distributor (ESD) for Notifier Fire Systems, a subsidiary of Pittway Corporation of America, one of the world’s leading fire systems manufacturers. The company’s partnership with Notifier ensures that it is able to offer the best service possible – having become a specialised company with a strong reputation for the quality of installations with personal service as a local company backed by a multinational company leading the way in fire prevention technology. FURTHER INFORMATION Tel: 01727860657 www.tfinstallations.co.uk stevem@tfinstallations.co.uk

Reducing lighting costs by Experts in cleaning in the up to 90 per cent healthcare sector

are durable, shock resistant and reduce air conditioning and maintenance costs. Healthcare professionals are under growing financial pressure, and lighting upgrades are not only smart economics but also help boost staff productivity, enhance patient experience and make a visible commitment to sustainability. LED lighting provides a more natural light which has an important effect on our body’s internal clock. When you incorporate more natural light into the healing environment it keeps our body in balance improving our mood and health. FURTHER INFORMATION Tel: 0843 289 3753 rtemple@glamocelluk.com

requirements and manage them completely – allowing you to focus on other areas. ServiceMaster Clean’s cleaning package provides: defined cleaning specifications; cleanliness audits; proven cleaning methods; CQC compliant colour coding scheme; staff DBS checks; trained staff; flexible hours of work; and BS EN ISO 9001 &14001 accreditation. FURTHER INFORMATION Tel: 01270 875 855 info@smcontract.co.uk www.smcleaning contractors.co.uk

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Advertisers Index

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PRODUCTS & SERVICES

FIRE SAFETY

While discipline in engineering design and manufacture has its place alongside method and procedure, the freedom of expression needed in artistic design and engineering innovation may often be sacrificed for the organisation. The ability to turn around quick ideas has been helped enormously by the availability of 3D design software and 3D printing. These represent a coming together of decades of evolving technologies that has moved from drafting to wire frame layouts, surface modelling, solid modelling and the modern hybrid design tools with specific add-on applications. However the dental sector, whilst being significantly advantaged by virtue of the small end product size, has been slow to grasp the advantages. 3D printing technologies have moved from the toxic and brittle constructions of the past to the present professional MoonRay

Established in 1985 Welwyn Garden Alarms Limited are a NSI (NACOSS) Gold fire & security installer, our objective throughout years of trading is to provide high quality reliable systems with a dedication to customer service. Driven by our reputation, 95% of our business leads come from recommendations from existing satisfied clients. We are proud of our reputation and continually strive to meet the demands of our clients through an active customer care program with any feedback gratefully received. Our offices are Located on the grounds of Hatfield House, Hatfield, Hertfordshire. Although our humble beginnings and preceding 18 years of trading were born out of two earlier premises in Welwyn Garden City (hence the name).Â We have a team of engineers

Making apps work the way you want them to

3D printer solutions offered by Awesome Apps Ltd that can retain details down to a 20 micron resolution for a range of new biocompatible materials and in a highly attractive package. A specific version for dentistry and orthodontics now brings same day provisions of bridges, caps, implants and customised medical solutions into reach. For the right combination of software, scanners and 3D printers for your business, call Awesome Apps Ltd. FURTHER INFORMATION Tel: +44 (0)1242 370453 info@awe-apps.com www.awe-apps.com

High quality, reliable gold fire & security installer in UK

who install and maintain a number of security systems including Intruder Alarms, CCTV, Access Control, Fire Alarms and Emergency lighting We have a substantial client base, that range from small domestic properties with basic intruder alarms to large commercial sites with multiple security and fire systems. FURTHER INFORMATION 01707 266306 welwyngardenalarms.co.uk sales@wgalarms.co.uk

ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service Adey Innovation 70 Aerogen 56 Agfa Healthcare 18 Aggress 30 Amity International 86 Aquarius Fire and Security 92 Asap Comply 62 Assistive Partner 22,74 Awesome Apps 94 BeaconMedaes 68 B.E.G 58 British Parking Association 81 Brookside Fire Service 46 BSRIA 71 Ccube Solutions 78 Checkfire Group 52 Coyles Medical 65 D2 Fire and Security 52 Daikin Applied 43 Datix 10 DDC Dolphin 90 Dudley Industries 68 ECA 32

HEALTH BUSINESS MAGAZINE | Volume 17.5

Evac Chair International 42 Fire Systems Consultancy 44 Fireout Protection 92 Forcare Holding 24 Glamocell 93 Gojo Industries 84 Havas PR 12 Hayes Garden World Inside Back Cover Hicom 20 Informa Life Sciences 26 Intersystems 23 ISS Mediclean 6, 14 IT Governance 35 Kingspan Insulated Panels 50 LED Hut 93 Legrand Electric 66 Lightning Fire Safety Systems 48 Meritas Fire and Security 46 MJog 8

Mobex 28 Mr Fire Safety 92 Murray Equipment 82 Nechells 90 Omnicell Back Cover Opex Corporation 37 Paessler 28 Premier Modular 60 ProcessFlows 76 RSR 48 Safety Technology 48 Sajas Group 69 ServiceMaster 93 Stanley Healthcare 4 Static Systems 73 STC Energy Management Inside Front Cover SWA 52 TF Instillations 93 TL Fire 52 Vivilite 59 Vygon 85 Welwyn Garden Alarms 94

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