Health Business 18.3 by PSI Media

VOLUME 18.3 www.healthbusinessuk.net

HEALTH & SAFETY

WASTE MANAGEMENT

INFECTION PREVENTION

CYBER SECURITY

CYBER SECURITYâ&#x20AC;&#x2122;S MULTI-MILLION FUNDING NHS cyber security has been given a major boost through a multi-million pound deal with Microsoft

RECRUITMENT

VACANCIES AND VISA PROBLEMS What challenges are facing the NHS post-Brexit?

PLUS: COMMUNICATIONS | DESIGN & BUILD | DIABETES | FACILITIES MANAGEMENT

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VOLUME 18.3 www.healthbusinessuk.net

HEALTH & SAFETY

WASTE MANAGEMENT

INFECTION PREVENTION

CYBER SECURITY

CYBER SECURITY’S MULTI-MILLION FUNDING NHS cyber security has been given a major boost through a multi-million pound deal with Microsoft

RECRUITMENT

VACANCIES AND VISA PROBLEMS

£150 million to improve NHS cyber resilience It has been one year since the NHS became the highest‑profile victim of a global ransomware attack which resulted in operations being cancelled, ambulances being diverted and patient records made unavailable.

What challenges are facing the NHS post-Brexit?

PLUS: COMMUNICATIONS | DESIGN & BUILD | DIABETES | FACILITIES MANAGEMENT

According to the National Audit Office, the WannaCry cyber attack, which struck on 12 May 2017, affected over a third of trusts in the UK and led to the direct cancellation of nearly 7,000 appointments. At the end of April, the Department of Health and Social Care announced a £150 million agreement with Microsoft to ensure all NHS organisations are using the latest Windows 10 software, with updated security, and £21 million to be spent upgrading network infrastructure at major trauma centre hospitals and ambulance trusts, as well as new powers for the Care Quality Commission to inspect NHS trusts on their cyber and data security capabilities. The importance of helping to protect the NHS from the growing threat of cyber attacks cannot be overstated, and with NHS Digital reassuring that this is one of a suite of measures being deployed to protect the service from cyber attack, the digital future of our healthcare system should be in safe hands. Follow and interact with us on Twitter: @HealthBusiness_

Read our article on the Microsoft agreement on page 87, where NHS Digital’s Peter Dyke explains the details of the deal and the benefits to NHS organisations. Michael Lyons, editor

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Volume 18.3 | HEALTH BUSINESS MAGAZINE

Contents

Contents Health Business 18.3 07

07 News

57 Diabetes

17 Waste management

60 Health & safety

NHS to award Health and Care’s Top 70 Stars; £300 million cash target met five months early; and new Microsoft deal to strengthen NHS cyber security Jerome Baddley and Clare Topping analyse a number of solutions that have been widely adopted in the health sector to solve NHS waste issues

21 Energy

An article looking at ways of monitoring, measuring and reporting on energy use to improve understanding of consumption and promote efficiency and future plans for further efficiency savings

25 Fire safety

Fire extinguishers are a vital part of fire protection, but all too often they get misused or forgotten about. Robert Thilthorpe explains the importance of regular maintenance

31 Facilities management

Air conditioning systems are fundamental to the operation of many healthcare buildings. Mark Walker explains the importance of good design in keeping these systems bacteria-free

57 63

35 Health & Care Innovation Expo

As the NHS celebrates its 70th birthday, NHS England’s Health & Care Innovation Expo will look at how it will continue to develop in the future

37 UK Health Show

The UK Health Show returns on the 25-26 September for two days as it grows into its new home of ExCeL London for 2018

45 Design & build

A design-led approach can really improve outcomes for staff and patients in hospitals across the country. The Design Council reports on the work undertaken at the Whittington Hospital pharmacy

49 Infection control 87

It is only by staff, patients and visitors working together that healthcare environments can win the fight to reduce Healthcare Associated Infections

Health Business magazine

Diabetes UK is encouraging the use of technology to improve diabetes management and save the NHS vital funds. Here, Nikki Joule explains why Karen McDonnell looks at how good management of health and safety can ward against slip and fall-related injuries

63 Recruitment

Neal Suchak analyses the workforce challenges facing the NHS post-Brexit, including the need to retain and ensure agency staff feel rightly valued

67 Document management How will GDPR change the responsibility of the Data Processor and what impact will Brexit have on this? Steve Mellings explores

71 Health GB

More than 3,000 healthcare professionals attended the launch edition of the Health GB Exhibition & Congress at Manchester Central at the end of April

77 Connectivity

Created to be a ‘network of networks’, the HSCN is a new data network for health and care organisations, replacing N3

83 Communications

Peter Akid says the patient communications technology framework can help reduce the almost £1 billion cost wasted on ‘Did Not Attends’

87 Cyber security

NHS cyber security has been given a major boost with the announcement by the Department of Health and Social Care of a new multi-million-pound deal with Microsoft. Peter Dyke explains how

90 e-Procurement

Ed Palferman explains how PEPPOL can simplify business and can reduce costs for the healthcare system

92 Public Sector Show

The Public Sector Show 2018 has questioned over 700 UK public servants, giving a picture of their views on the health of the nation’s public services

www.healthbusinessuk.net Volume 18.3 | HEALTH BUSINESS MAGAZINE

“Keeping patients safe and helping their recovery ” The ISS Healthcare Team

ISS is celebrating its 50 th Anniversary of operating within the UK in 2018. It has been providing a key role in Healthcare since 1984 and is proud to still be seen as a dependable and loyal partner to the NHS. Every day ISS employees work as an integrated part of each Client NHS Trust, ensuring that service value is created through ‘The ISS Way’ of customising and delivering our service solutions.

FACILIT Y MANAGEMENT

CLEANING

SUPPORT

PROPERTY

C AT E R I NG

SECURITY

uk.issworld.com

News

70TH BIRTHDAY

NHS to award Health and Care’s Top 70 Stars As part of the NHS’s 70th birthday celebrations, health staff who have ‘gone over and above the call of duty’ will receive UK-wide recognition in the Health and Care’s Top 70 Stars. Patients, staff and the public have been invited by NHS Confederation to nominate employees that have made an exceptional contribution to patient care, health and care services and local communities over the last 70 years, with the successful nominees culminating in a shortlist after this month’s voting. Danny Mortimer, deputy chief executive of the NHS Confederation, said: “Since the

first NHS hospital was opened in 1948, heroic staff have toiled around the clock to provide the best possible care to the population of Britain. Whether living or passed on, their tireless efforts to provide the best possible treatment and care to every single patient should not be forgotten. By recognising members of our NHS workforce through the decades, we wish to both celebrate the past and shape the future of our health and care system.” Steve Powis, medical director at NHS England, added: “The NHS employs staff from over 350 different professions, from doctors, nurses and paramedics to

electricians, scientists and cleaners. These awards are a great way to acknowledge and thank the people who stand out today, as well as those who have made their mark over the last seven decades.” The list of the UK’s ‘Top 70’ standout staff will be revealed at the NHS Confederation’s annual conference on 13-14 June, three weeks before the NHS celebrates its 70th anniversary on 5 July. Nominations are open until 17 May and voting until 29 May. READ MORE tinyurl.com/ybk3539g

SOCIAL CARE

VISAS

£2.3bn NHS levy could revitalise social care

‘No sense’ in turning away trained doctors

A report from the Intergenerational Commission has argued that the struggling social care system could be ‘rescued’ with a funding boost of £2.3 billion. Incomes and Inequality considers a number of ideas to help fix the ‘broken’ intergenerational gap between millennials and baby boomers, recommending that every person in the UK should receive a £10,000 ‘citizens inheritance’, which could be raised by abolishing inheritance tax and replacing it with a lifetime limit for recipients of £125,000 before taxes kick in, and the introduction of ‘user charges’ on assets so wealthier individuals contribute towards their social care costs in England. This NHS levy would introduce a charge on employee and self-employed National Insurance contributions on the earnings of workers over the State Pension age, raising £0.9 billion in 2020, as well as raising a charge that mirrors employee National Insurance

contributions on private occupational pension income, but initially at half the main rate and with a higher starting threshold. The report strongly emphasises the need for ‘giving older generations the health and care they deserve, need and expect’. David Willets, who chaired the commission, told the BBC: “We’ve got a very serious problem of ensuring there’s a fair deal across the generations. Older people are worried about a properly funded healthcare system, people in middle age still haven’t been able to buy their own home, and for younger people their pay is no better than it was 10 or 15 years ago. So the different generations in the UK all face different pressures. But we can tackle them, we can do something about it.” READ MORE tinyurl.com/ycuvzpc3

INTEGRATED CARE

Berwick said: “I think the NHS probably has a better chance to truly integrate care than almost any other health care system in the world. We’re not our diseases, we’re not a broken arm or diabetes we’re whole people who are making journeys through our lives and the care system has to honour and respect that. “There’s no reason the NHS can’t have the best care in the world, why you can’t take an appropriate proportion of your efforts and move them upstream to the causes of illness and use social determinants to prevent illness. There’s no reason why you have to waste money; you have limited resources and you can use those resources increasingly wisely.” READ MORE tinyurl.com/ybnqokyq

Labour has said that the Conservative Party’s controversial decision to refuse foreign doctors visas is directly damaging NHS patient care. Recent reports have suggested that Prime Minister Theresa May rejected calls by senior ministers to relax the rules on migration, after it was discovered that 100 medical professionals from India, who were due to start work in hospitals in the north-west, were refused entry even though NHS trusts said they needed them to help staff their wards. Jonathan Ashworth, Labour’s Shadow Health Secretary, said that the ban, which could possibly cover at least 400 doctors since December, is now directly damaging NHS patient care and highlights May’s ‘hostile environment’ policy. Ashworth has now written to new Home Secretary Sajid Javid urging him to radically overhaul the system to benefit the NHS. Ashworth said: “It makes no sense whatsoever that the government is turning away trained doctors who want to come and work here in the UK. Theresa May’s hostile environment policy is now directly damaging NHS patient care. “The NHS is facing a massive workforce crisis. More than 100,000 NHS posts are now unfilled and vacancy rates for nurses and doctors are rising year on year, yet the government is refusing visas for trained staff from overseas because of the rules drawn up during Theresa May’s time as Home Secretary. The visa rules clearly aren’t working in the best interests of NHS patients. Ministers ought to be doing more to keep patients safe and their priority should be making sure hospitals can get the right numbers of staff in place.” READ MORE tinyurl.com/yd8ws5qj

Volume 18.3 | HEALTH BUSINESS MAGAZINE

News

RESEARCH

Clinical trials to be fast‑tracked A number of NHS organisations are to implement new processes to simplify the NHS research set up process and cut delays, producing greater certainty and reducing administrative costs. Working with the National Institute for Health Research, Health Research Authority and NHS Improvement, NHS England will introduce the new arrangements to eliminate variation and delays in set up and reporting for commercial contract research and ensure the process for reimbursements for excess treatment costs in non commercial research are simplified and streamlined.

According to NHS England, there can be a difference of up to nine months between each hospital taking part in a multi-site trial being confirmed, delaying the trial beginning. Therefore, patients should benefit from quicker access to trials, making the NHS will become a more attractive place to undertake research. Dr Sam Roberts, director for innovation and life sciences at NHS England, said: “The NHS has a long history of scientific breakthroughs and, in the NHS’s 70th year, we are committed to breaking down the barriers clinicians face when

trying to set up new research projects. “In implementing these new arrangements NHS England are fulfilling the first of our commitments to improve how the NHS supports and applies research. Cutting the current bureaucracy, variation and eliminating delays will increase patient’s access to research and the latest treatments, and support the life sciences industry.” READ MORE tinyurl.com/yc5arruk

EMERGENCIES

Emergency alerts double in last year

FINANCE

£300 million cash target met five months early NHS Business Services Authority and NHS Supply Chain have reported that its £300 million cash-releasing target has been achieved five months ahead of plan. Set by the Department for Health and Social Care, and forming part of the Carter Initiative, the savings have been made through price reductions, savings programmes, such as the NCP programme, and commitment discounts. Gerry McGeary, head of Supplier Management, NHS Business Services Authority said: “This is a significant achievement and I would like to thank everyone who has contributed to its success. The voice of the customer is important to us and is at the core of the NHS Supply Chain’s procurement strategy which provides products that meet the expectations of our customers whilst contributing to the delivery of these significant savings. “We are currently transitioning into the new NHS Supply Chain Operating Model which aims to deliver savings of £2.4 billion over the next five years. This model will leverage the collective buying power of the NHS to provide clinically assured products at the best value whilst meeting the diverse needs of NHS organisations.”

LBC has revealed that the number of hospitals operating at the highest emergency alert level has nearly doubled in the last year. Having obtained data from freedom of information requests, LBC says that at least 54 per cent of NHS acute trusts declared emergency measures on at least one day between December and March, representing an increase from just 28 per cent in 2016/17. Equivalent to the old ‘black alerts’, the Operational Pressures Escalation Level 4 (OPEL 4) emergency measures see all those involved in the regional healthcare system summoned to a teleconference, meaning

hospitals can start redirecting patients, particularly ambulances, and cancelling elective operations. This scenario could be called as the result of no capacity across the trust, severe ambulance handover delays, unexpected reductions in staffing numbers or significant increases in A&E waiting times. According to LBC, the worst offending trust was Royal Cornwall, which declared an OPEL 4 on 80 days in the winter period. READ MORE tinyurl.com/y7q5y37z

MAINTENANCE

Patient safety at risk due to maintenance backlog The Labour Party has said that patient and staff safety at an increasing number of NHS hospitals are at risk because of costly, outstanding maintenance work. A freedom of information request, which gained responses from 143 out of 229 health trusts in England, found that 71 per cent of trusts that responded experienced leaking or broken roofs, 60 per cent had experienced broken or leaking sewer pipes, while 95 per cent brought in pest control services to deal with rodents, wasps, ants and cockroaches. According to the party, one trust called in pest control more than 700 times in two years. Labour also revealed that trusts with the

highest numbers of incidents included Birmingham and Solihull Mental Health NHS Foundation Trust, who experienced 777 pest control incidents and Airedale NHS Foundation Trust which reported 314 incidents with leaking roofs. Furthermore, Royal Cornwall Hospitals Trust has reported over £4 million in maintenance backlog, with Western Sussex Hospitals Trust also reporting over £3.3 million in fire and roof maintenance work. READ MORE tinyurl.com/yamxyrcr

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Volume 18.3 | HEALTH BUSINESS MAGAZINE

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News

PATIENT SAFETY

Independent hospitals must ‘get their house in order’ Following a damning report by the Care Quality Commission (CQC), Jeremy Hunt has written to independent healthcare providers ordering urgent action on patient safety. The Health and Social Care Secretary said that independent hospitals needed to ‘get their house in order and improve safety’, giving chief executives of independent healthcare providers two weeks to respond and set out what action they will take. The CQC rated a third of independent hospitals as ‘requires improvement’ following examples of poor practice

and unsafe care, citing patient safety as the biggest concern it had. Hunt said: “If the sector is to partner with the NHS and benefit from our world-leading medical training, we need urgent assurances that the independent sector will get its house in order on safety, as well as a commitment to take rapid action to match the NHS’s world-recognised progress on transparency.” READ MORE tinyurl.com/ycrjck8y

PUBLIC HEALTH

90 per cent of councils cutting public health services A Pulse investigation has revealed that 90 per cent of councils have cut spending on sexual health, alcohol misuse and weight management services. Having analysed data from 80 local authorities as a result of freedom of information requests, the investigation found that some authorities are cutting services completely. Sexual health funding has been cut by two per cent this year, and substance misuse by three per cent. Smoking cessation funding has been maintained at the same level as last year, but this was following a 2.4 per cent cut from 2016/17. Pulse says that a £1 million weight management service in Rotherham has

been scrapped, leading to an increase in patients being referred inappropriately for surgery before they are ready. Furthermore, despite a warning from NHS North East Essex CCG that it posed a significant risk to patient safety, a fall prevention service in Essex is set to be cut from next month in a bid to save £2.2 million a year. Approximately half of the 620 GPs in England who responded to a separate Pulse survey said that their practices are directly feeling the impact of the cuts. READ MORE tinyurl.com/yazpo53e

LIVER

Liver technology to become routine at Addenbrooke’s 50 years after Europe’s first successful procedure at Addenbrooke’s Hospital, the hospital has announced that it has become the first in the UK to bring state‑of‑the‑art liver technology into routine use. The perfusion machine at Addenbrooke’s Hospital in Cambridge maintains a donor liver outside the body by pumping it with blood, nutrients and medicine, rather than the traditional method of keeping the liver in ice. Marking the 50th anniversary alongside Professor Sir Roy Calne, who led the first transplant on 2 May 1968, Addenbrooke’s Charitable Trust has launched a £250,000 appeal to run a state-of-the art ‘liver perfusion’ machine. The support, which will fund machine consumables, means that Addenbrooke’s Hospital becomes the only liver transplant centre in the UK to use the perfusion technique as part of its standard clinical practice.

The procedure could mean a further 54 liver transplants over two years. Shelly Thake, chief executive of Addenbrooke’s Charitable Trust, said: “When Professor Watson and his colleagues told us about their incredible cutting edge work with liver perfusion we wanted to do all we could to help. The liver perfusion machine will allow potentially up to an additional 50 transplants to be carried out over two years. That’s 50 people being given the chance of a better quality of life. “It is apt that this appeal coincides with the 50th anniversary of the first successful liver transplant in Europe and we think the public will embrace it.” READ MORE tinyurl.com/yc45jtcz

WALES

Waiting times having ‘devastating’ effects on patients The Board of Community Health Councils (CHCs) in Wales has found that long waiting times for treatment is having an alarming impact on patients and their families, including the risk of long-term reliance on painkillers, mental health problems, unemployment and family breakdown. Gathering feedback from patients on Wales, the report said current waiting times targets were ‘not meaningful’ and that the failure to meet targets is fast becoming ‘an accepted norm’. Patient’s experiences included: feeling ‘powerless and distressed’ by waits of 100 weeks, poorly affecting mental health and creating a sense of loneliness; hindered mobility, with many patient’s unable to carry out day-to-day activities; relying on others for intimate personal care, which some described as a loss of dignity; a negative affect on family relationships; and younger people waiting for surgery expressed concern over the impact delayed transfers can have on their career. The Welsh Government said progress was being made on waiting times, but figures show that there are currently 420,000 patients waiting for treatment in Wales. There are still more than 19,000 who have been waiting more than nine months and around eight per cent of patients have been waiting between six and nine months. READ MORE tinyurl.com/ydar6jbd

Volume 18.3 | HEALTH BUSINESS MAGAZINE

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News

CYBER SECURITY

New Microsoft deal to strengthen NHS cyber security The Department of Health and Social Care has announced an agreement with Microsoft to ensure all NHS organisations are using the latest Windows 10 software, with updated security. Having invested £60 million to address cyber security weaknesses since 2017, the government has revealed that a further £150 million will also be invested over the next three years to improve the NHS’s resilience against attacks. As part of the plans, a new digital security operations centre will be created which will allow NHS Digital to respond to cyber attacks more quickly, as well as enable trusts to

detect threats, isolate infected machines and kill the threat before it spreads. Additionally, £21 million will be spent to upgrade firewalls and network infrastructure at major trauma centre hospitals and ambulance trusts, while new powers will be given to the Care Quality Commission to inspect NHS trusts on their cyber and data security capabilities. To help clinicians when internet and email services are hindered or unusable, a new text messaging alert system will be deployed to ensure trusts have constant access to accurate information. Jeremy Hunt, Health and Social Care

ROBOTICS

TECHNOLOGY

NHS to be trained in use of AI and robotics

Doctor witness space technology potential for NHS

Health Secretary Jeremy Hunt has announced a review into how NHS staff can be trained to use artificial intelligence, genomics and robotics. Led by Dr Eric Topol, the review will look at technologies such as artificial intelligence, robotics, genomics and digital medicine and the future opportunities where the NHS could invest in training for existing staff. Topol, who previously led a US research programme on using technology and data for more precise, tailored patient treatment, will begin with a visit to Moorfields Eye Hospital to understand how the organisation is exploring how machine‑learning technology can analyse eye scans, giving eye care professionals a faster understanding of eye disease. Hunt said: “Every week we hear about exciting new developments surfacing in the NHS which could help provide answers to some of our greatest challenges such as cancer or chronic illness. These give us a glimpse of what the future of the whole NHS could be, which is why in the year of the NHS’ 70th birthday I want to empower staff to offer patients modern healthcare more widely and more quickly. I’m delighted that Dr Topol is kicking off this review – ensuring the NHS is at the forefront of life-saving, life-changing care across the globe for decades to come.” Topol said: “While it’s hard to predict the future, we know artificial intelligence, digital medicine and genomics will have an enormous impact for improving the efficiency and precision in healthcare. Our review will focus on the extraordinary opportunities to leverage these technologies for the healthcare workforce and power a sustainable and vibrant NHS.” READ MORE tinyurl.com/y9bjtfwg

Professor Tony Young led a delegation of leading doctors to witness demonstrations of space technology that could be adapted for use in the NHS. Visiting the UK Space Agency and the Satellite Applications Catapult at the Harwell Campus in Oxfordshire, the delegation saw examples of environmental monitoring, whereby sufferers could make informed decisions about care as a result of air quality in their area, and satellite broadband, which could give ambulance services real time patient information that allows them to send vital details ahead to hospitals. Furthermore, technology originally developed to explore the solar system is already in use in the NHS, such as a wearable monitor that helps elderly and vulnerable people avoid falls uses microelectromechanical (MEMS) gyroscope equipment and cancer screening vans, which beam images directly back to assessment centres in a trial funded

Secretary, said: “We know cyber attacks are a growing threat, so it is vital our health and care organisations have secure systems which patients trust. We have been building the capability of NHS systems over a number of years, but there is always more to do to future-proof our NHS against this threat. This new technology will ensure the NHS can use the latest and most resilient software available – something the public rightly expect.” READ MORE tinyurl.com/y9qq7gpm

by the UK Space Agency’s Space for Smarter Government Programme. Young said: “In the NHS’s 70th year we are using satellite technology to revolutionise breast cancer screening by beaming scans back to hospitals from mobile screening units next to shopping centres and speeding up diagnoses.” Emily Gravestock, UK Space Agency head of Applications, said: “Technology from space is already improving our daily lives, and health is no exception. The NHS breast screening vans are a great example of how Britain’s world-leading space industry has come up with an innovative solution to support vital public services. As our space sector continues to grow, with support the support of government’s Industrial Strategy, these opportunities will only increase.” READ MORE tinyurl.com/yd7ma4wb

EMERGENCY SERVICES

GoodSam app allows paramedics to view 999 patients Kent, Surrey and Sussex Air Ambulance and Great North Air Ambulance Service are currently testing a new app which allows air ambulance services to view patients before they arrive to treat them. The ‘game-changing’ GoodSam app sends a link to the 999 caller’s mobile phone, with live streaming allowing paramedic staff to assess a patient before setting off, with the services trialling the technology reporting promising results. Kent, Surrey and Sussex Air Ambulance and Great North Air Ambulance Service have been trialling the app for two months. Richard Lyon, associate medical director of Kent, Surrey and Sussex Air Ambulance,

said: “Time is critical in saving a person’s life or reducing long-term disability, and often we have limited information from bystanders about a patient’s or multiple patients’ injuries to make decisions. “Being able to see the scene of the incident, not only the patients, but how many cars are involved for example, can help us decide what additional resources we might need to send, assess who we might need to treat first or what medication we might need to give.” READ MORE tinyurl.com/y83modm7

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There is no such thing as waste. Waste largest procurer of goods and contributing is a failure of imagination, or, if viewed 10 per cent of GDP, we have a huge role to commercially, a failure of the market. In the play in addressing UK waste and driving a natural world all materials are recycled, reused more circular, resource efficient economy. and repurposed. Nature is exceptionally Commercial pressures and policy frugal. We do after all live within a closed developments over the coming year will also planetary system with limited natural bring NHS waste treatment under closer resources. There is an old Yorkshire expression: scrutiny. The decision by China to no longer ‘Where there is muck there is brass’. Indeed import plastic waste is likely to increase all waste has inherent value and the waste disposal costs; the development of the UK management sector is an exceptionally Waste and Resources Strategy will challenge important part of the UK low carbon our approaches to resource use; and environmental goods sector. and there is increasing Waste processing, energy from public interest in plastics An waste and biomass in the UK waste, climate change improved was identified in 2015 as and air pollution. employing almost 150,000 Focusing on circular approach to staff, with a turnover of economy, waste segregation has £54 billion, almost 50 per reduction and shown some real cent of the low carbon material replacement and environmental results, 85.5 per cent solutions in goods sector. With product and service of NHS provider the NHS as the UK’s specification,

waste now avoids landfill

Written by Jerome Baddley, acting director, Sustainable Development Unit & Clare Topping, Northampton General Hospital NHS Trust

Every waste, sustainability or environmental manager within the NHS is open to innovative solutions to their waste issues. Jerome Baddley and Clare Topping analyse a number of solutions that have been widely adopted in the health sector

The Safe Management of Healthcare Waste The starting place for all NHS Waste Management is HTM07-01 – The Safe Management of Healthcare Waste, and the creation of a risk assessment and appropriate waste policy. However, waste management and reporting is also integrated into mandatory Sustainable Development Management Plans (SDMPs). The SDU recently produced a new resource to support NHS organisations to develop their SDMPs: SDAT (The Sustainable Development Assessment Tool). Waste is covered as one of 10 key themes under the heading ‘Sustainable Use Of Resources’ to underline the fact that waste is potentially unsustainably managed resource. NHS providers currntly produce at least 224 million tonnes of solid waste a year. This is not including packaging waste, from NHS supply chain or prescription goods packaging disposed at home, or primary care. The waste arising from care and nursing homes was also estimated in 2012 to be over 450 million tonnes each year. The last ten years have seen major changes in waste management and segregation for NHS hospitals. Gone are the days when if it was clinical it went into a yellow bin, if not it was put into a black bag. Now clinical waste is segregated into a myriad of colours: purple, yellow, blue, red, orange and yellow and black stripes – depending not only on waste type, but also potential infection status of the patient. For non‑clinical waste there are recycling and reuse targets – resulting in further segregation requirements, with particular streams for confidential and other hazardous waste. E

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Waste Management

Ensuring a circular economy, reducing waste and then dealing with any residual waste in the most environmentally benign way saves money, creates jobs and protects health  Nationally this improved approach to segregation has shown some real results, 85.5 per cent of NHS provider waste now avoids landfill. We are successfully moving waste up the waste hierarchy, though the new solution is often incineration or Energy from Waste (EfW). While this is certainly good progress, it may not be sustainable in the longer term to continue to burn it in EfW facilities. While plastic may only contribute 10-15 per cent by weight of commercial waste it can represent 30-40 per cent of the calorific value. As we get better at reducing and recycling other materials, EfW facilities are increasingly plastic fired power stations. For Northampton General Hospital NHS Trust (NGH), in common with a large number of acute trusts across the country, this increased segregation has presented a number of issues; space, infection prevention and control, education and finance. However, it also requires a degree of pragmatism to ensure that legal requirements are met. For a trust like NGH, that has occupied the same site for over 250 years, having sufficient space represents a major challenge. Accommodation is needed for bins on the wards, in clinics and in public areas, as well as space for collation and distribution or storage for reuse. The waste management operations of trusts will differ depending on size, resources and historical practices. Best practice involves having a dedicated team to collect, collate and manage the waste and bring it to a central area for onward transport for disposal. Very few hospitals in the UK still incinerate waste on site. Support from infection prevention and control teams is vital. Having an enthusiastic waste guru on this team who comes to interdisciplinary waste meetings and helps audit on wards has been key to NGH ensuring compliance and getting initiatives embedded in the trust. They can ensure that the correct messages are given in all training and during other ward audits. Reverse vending and other innovations Increasingly creative and innovative companies are finding ways to create a market for organisations’ waste. Kettering General Hospital worked with the company Flute Upcycling to exchange the hospital’s cardboard waste for cardboard office furniture. Reverse vending in hospitals like Barts incentivises return of plastic bottles. The Barts initiative has particularly supported return and recycling of haemodialysis acid bottles saving around £13,000 per year. However, in Bradford they have gone a step further and removed the need for these bottles entirely, through designing a central delivery system for

the fluids into tanks saving £23,000 per year. The co-operation of suppliers and waste management companies is key. As many companies manage waste from more than one hospital, whether through separate contracts or through collaborative tenders, then there are potential wider collaborations to be gained using economies of scale with low value high volume wastes. For example, NGH is in a collaborative contract with Kettering General Hospital, but the same domestic and clinical waste companies manage a further three hospitals in close proximity. Specifying wider KPIs in the contract with the waste provider and including an annual improvement plan, can leverage both an improved day to day service and ensure ongoing support for staff engagement such as posters, information boards, awareness days and competitions. Every waste, sustainability or environmental manager within the NHS is open to innovative solutions to their waste issues, but usually they require an investment of time, money and space. Despite this there are a number of solutions that have been adopted widely across the NHS. Examples include: baling/compacting – most trusts can receive an income from baling their card; reusable sharps bins – can prevent tens of tonnes of single use plastic being incinerated with 80 per cent lower lifecycle carbon emissions; recycling of X-Rays to recover silver; bag to bed systems – removing clinical waste bins from patient areas, improving the patient environment; food waste collections or food digesters, replacing macerators, cutting fats going to sewers; coffee cup discounts for reusable cups; and reuse websites, such as the widely used WarpIt scheme ensure unused goods find a useful home. However, the relatively small size of individual organisations often limits the viability of some schemes – without bulk storage, collections of segregated waste can become prohibitively expensive if not impossible. Local STP or NHS-wide schemes may be the answer to this. A proactive approach Whilst innovations grab the headlines, getting the basics correct, regular auditing, engagement and training can deliver the greatest savings. At Northampton a high degree of compliance, costs reduction and sustainability has been assured through weekly audits, attendance at ward and theatre meetings; particularly face to face work with healthcare assistants, domestic and nursing staff. Northampton had always baled card and separated out metal to receive the maximum rebate, as well as providing mixed recycling

for several years, however, recycling levels had remained static. In the last two years however, segregated recycling weights have increased by more than 40 per cent through taking a more proactive approach. Engaging with staff and harnessing the enthusiasm that many have for recycling and doing the right thing for the environment. The SDU carried out a staff survey in 2017, to be published later this year. The headline from the 6,200 responses was that overwhelmingly (98 per cent) NHS staff see the importance of environmental sustainability in the NHS and want to support financial savings. The 1.4 million NHS staff are keen to be engaged to address these challenges, whether it be through segregating waste or helping to design waste out of healthcare entirely. Our natural environment, economy and society are three critical life support systems. Ensuring a circular economy, reducing waste and then dealing with any residual waste in the most environmentally benign way saves money, creates jobs and protects health. The eventual goal of course should be a zero waste NHS. L FURTHER INFORMATION www.sduhealth.org.uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

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Energy

Monitoring environmental impacts and measuring sustainability NHS staff awareness of sustainability is high with 93.6 per cent considering it important. However, only 71 per cent state that their own organisation actively supports the environment. So how can trusts monitor and measure improvements of sustainable development? The Sustainable Development Unit’s Health Check 2018 Report looks at the progress of sustainable development across the health and care system. Published earlier in the year, the organisation found that NHS organisations are cutting their carbon footprint and saving money through increasingly efficient use of natural resources, particularly evidenced in reducing energy and water use, as well cutting waste costs. This is further proof that sustainable development is increasingly becoming a core part of hospital plans and day-to-day operations. Furthermore, rising numbers of organisations are reporting annually on their work to the minimum standard up from 69 per cent to 85 per cent and now 45 per cent or organisations’ reports are rated as excellent. However, although staff awareness of sustainability is high with 93.6 per cent considering it important, only 71 per cent said that their own organisation actively supports the environment. The majority of progress continues to be made in reducing carbon emissions, with a 0.5 per cent decrease in the building energy carbon footprint between 2013/14 and 2015/16, a

reduction which has saved £66 million. Whilst welcome, the SDU argues that progress in carbon reduction will need to be made at more ambitious levels over years to come. Other areas of energy efficiency that have been recorded include water use, which has increased by 3.5 per cent, waste costs, which has witnessed a nine per cent increase, in large part due to high-cost routes such as landfill and incineration (86 per cent of costs).

Operating from six different sites, Newcastle upon Tyne Hospitals NHS Foundation Trust is one of the largest NHS organisations in the UK, offering a wide range of services to patients in the north east. With such a large and multi-site estate, the trust pursues a sustainability strategy to efficiently and considerately use resources, outlining its plans to reduce waste as a key part of this strategy a few years ago. The introduction of the paper‑based Bio‑bins offered a more environmentally friendly and cheaper alternative to the plastic containers that were previously used to dispose of medicinal waste. To highlight this point, the trust spent over £1,000,000 in 2011/12 on clinical waste disposal, accounting for approximately 1,370 tonnes of CO2. At the time, it was estimated that the disposal of E

N organis HS at cutting ions are their carbon f o o t p saving money rint and th increasi ngly effi rough cie use of n atural nt resourc es

Delivering savings The value of sustainable development action across the health and care sector has been shown again with approximately £90 million saved in the last year through energy, water and waste efficiency. The work that the SDU has supported has delivered carbon saving of 330,000 tonnes, with the system also demonstrating cost avoidance through reducing the impact of travel on health, avoiding over £13 million in health and care treatment cost since last year.

Case Study

A solution to the housing crisis: ZEDpods proposes an answer for NHS Key Worker Housing Housing costs are a major issue. Each year 33,000 nurses leave the NHS and, according to the Royal College of Nursing, 40 per cent are considering leaving London over the next five years. Of these, 75 per cent would be more likely to stay in London if their housing needs were met. Therefore, ZEDpods, a company set up to build and install high quality one-bedroom homes for key workers, is announcing a practical solution to benefit NHS trusts and estates managers. The ZEDpods’ secret is separating housing provision from land prices by using air rights over car parks. By removing the cost of land, ZEDpods offers almost instant affordable, one-bedroom houses close to hospitals and public transport, without the land and site issues associated with conventional new build. So while car parks continue to function, ZEDpods housing can generate long term revenue without selling off NHS trusts’ valuable real estate. Modular construction means the houses are manufactured off-site and then erected in a fraction of the time of comparable solutions. Once a pod is delivered to site, construction and installation is completed within 24 hours, once the groundworks are finished, ready for immediate occupancy.

These ready-made, quality homes are built to higher standards than conventional houses, being super insulated, triple glazed, with heat recovery ventilation and lots of daylight, and are in fact low-carbon. The solar roofs generate more energy than the houses consume and are designed to have the lowest running costs possible. Indeed, excess energy generated by the pods in the summer could be fed directly to the hospitals to reduce the hospital’s energy costs. Built to higher standards than conventional homes, ZEDpods are constructed from quality fireproof, durable and robust materials and designed to last as long as traditional build. With a variety of design options covering single or multi-occupancy

sites, ZEDpod homes can be tailored for a range of accommodation needs. The company behind ZEDpods has been set up to build cost effective housing for key workers and first-time buyers, taking advantage of the UK’s 200,000 city centre car parking spaces. Modular construction and low carbon design are important to the quality of the build and this approach enables rapid and easy onsite installation to make effective use of windfall sites. The new space standard ZEDpod was launched this year at Ecobuild 2018. FURTHER INFORMATION www.zedpods.com

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Energy

Sustainable Health and Care Awards The newly launched Sustainable Health and Care Awards, which will take place in November as part of the Sustainable Health and Care conference and exhibition, will highlight and celebrate the outstanding sustainable practices taking place which are making real benefits for health and the environment such as cutting carbon, air pollution and promoting green space.

The majority of progress continues to be made in reducing carbon emissions, with a a 0.5 per cent decrease in the building energy carbon footprint between 2013/14 and 2015/16, a reduction which has saved £66 million  the rigid plastics containers alone accounted for 30-40 per cent of the trust’s incineration bill. The Bio-bin is considered more environmentally friendly because it is 96 per cent paper, and almost 50 per cent lighter than the equivalent plastic container – reducing transport emissions and waste incineration emissions for the same amount of waste. The trials at Newcastle upon Tyne Hospitals NHS Foundation Trust showed that switching to Bio-bins for non-sharp medicinal waste reduces the carbon footprint of this element of waste disposal by 46 per cent. The SDU noted that, should the trust adopt the Bio-bin for the disposal of all non-sharp medicinal waste then it would likely result in an annual reduction of 30 tonnes of waste being incinerated, saving over £13,500 and a reduction of 66 tonnes of CO2. James Dixon, trust waste manager, said: “The BioBins are a real success story. From our point of view they have provided nothing but benefits to the trust. They save us money, they reduce our waste disposal bill, they take up less storage space and they are more environmentally friendly than the plastic alternatives. I’d urge all NHS trusts to give them a try.” Sustainable energy sources Nottinghamshire Healthcare NHS Foundation Trust decided to replace an existing coal fired

boiler system at its Rampton Hospital with a state of the art ‘Energy Centre’, utilising a number of energy sources. There were four key reasons: to increase resilience, radically reduce CO2 emissions, improve efficiencies and reduce energy revenue running costs. The Energy Centre consists of a 1.2MWe CHP unit, a 999kW biomass boiler using woodchips as fuel, with a backup heating system consisting of three 750kW gas/oil dual fuel boilers. This will save 8,098 tonnes of CO2 per year and be a major contributor to the trust’s carbon reductions enabling it to make significant steps towards meeting the government’s 34 per cent reduction target by 2020. As part of the works, the site converted to Low Temp Hot Water District Heating, lowering temp from 115oC to 90oC, making the high grade energy system safer, more efficient and easier to operate. The scheme will generate around 87 per cent of the site electricity needed from the CHP plant requiring only a small amount of top up imported electricity from the grid. Site resilience is also further assured with a backup supply from existing emergency generators. The capital equivalent is around £5 million, and will generate contracted guaranteed savings of £52,000 per annum, on top of a further £730,000 per annum direct fuel savings which arise by moving from coal to a combination of other fuels. This scheme also enabled the trust to remove around

There are a total of 12 awards, ranging from water and energy, building design efficiency, successful staff engagement, and carbon reduction, and are based on the 10 themes of the Sustainable Development Unit’s Sustainable Development Assessment Tool which are closely aligned to UN’s Sustainable Development Goals, as well as also two awards to celebrate and recognise inspirational individuals. Health Minister Stephen Barclay said: “The NHS is a world-leading organisation in many areas and I am keen to ensure that sustainability is one of them. Given the NHS employs 1.5 million people, it has the potential to play a leading role in contributing to a sustainable future. That is why I’m delighted to support the Sustainable Health and Care Awards, celebrating the trusts and care providers which are not only delivering excellent services but innovating ways to cut carbon, waste and pollution. In its 70th year, these pioneers are paving the way for a greener and more sustainable NHS for future generations.” FURTHER INFORMATION tinyurl.com/yah3xyhj £5 million of maintenance backlog liability. The Carbon and Energy Fund framework, associated financing and Engie expertise, enabled the trust to expand the scheme to include the Effluent Treatment Plant replacement. The project received national acclaim at the NHS Sustainability Awards 2016 winning the Carbon category. Robert Jones, head of Capital Projects, said: “The new Ray Crampton Energy Centre provides the trust with a significant step change in energy efficiency and sustainability whilst making recurring financial savings, which in turn can be invested back into services for patients. The scheme delivery strategy utilised an innovative financing/ delivery option ensuring precious capital resource can be directed to patient care.” L FURTHER INFORMATION www.sduhealth.org.uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

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Fire Safety

The importance of well‑maintained fire extinguishers Fire extinguishers are a vital part of fire protection, but all too often they get misused as door stops or worse – left in a corner and forgotten about. But ignored fire extinguishers have a hidden risk: a failure

between a small localised incident that is quickly put out, or the fire and rescue service arriving to When find a raging inferno which is putting life, property and a fire environment at risk. extingu isher Fire extinguishers are technic provided to give first aid extingu ian visits, each fire-fighting capability, is to a str her is subjec and, in the event of ingent t a fire incident, you’d 2 0 check b certainly want the efore it -point ca extinguisher to work be sign ed off n as expected. As such, as safe there is a need for proper to maintenance. For example, use if the safety pin in the extinguisher has corroded, it could mean that the pin cannot be removed, rendering the fire extinguisher inoperable. Annual checks by a competent fire extinguisher technician, who has the relevant training, qualifications, experience, tools, equipment, and access to refills and components, would identify and rectify this type of issue, cleaning and lubricating, or replacing the pin if necessary. When a fire extinguisher technician visits, each extinguisher is subject to a stringent 20‑point check before it can be signed off as safe to use. They will be able to identify any extinguisher which has reached end‑of‑life before you end up with an extinguisher that won’t work or, worse, becomes a danger to your or your employees. When selecting a service provider to inspect and maintain your extinguishers, it is essential to ensure the competence of the company and/or individual being employed to carry out inspection and maintenance, as not all service providers will be the level of competency you’d expect and hope for. This means that you could have extinguishers that may have been ‘serviced’ but may still not operate correctly. In Article 17 of the Regulatory Reform (Fire Safety) Order (Maintenance section), which is the relevant fire safety legislation for England and Wales, it states: “Equipment and devices provided in respect of the premises under this Order or, subject to paragraph 6 (General Fire Precautions) under any other enactment, including any enactment repealed or revoked by this Order (RRO) are subject to a suitable system of maintenance and are maintained in an efficient state, in E

to operate if not properly maintained. Fire extinguishers play a very important role in first aid fire‑fighting. They can mean the difference

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Written by Robert Thilthorpe, technical manager, Fire Industry Association

Robert Thilthorpe, technical manager of the Fire Industry Association, explains why you should have them maintained regularly by a competent person

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Since 2015, when the UK’s first private finance initiative (PFI) hospital, Cumberland Infirmary, was found to have a poor standard of passive fire protection, several prominent, newly built hospitals have made headline news because their standard of protection had been found to be inadequate. Tens of millions of pounds have been spent trying to make good poorly constructed buildings. National attention has further highlighted this issue with the devastating fire at Grenfell Tower in North Kensington. It has made people think ‘when is the construction industry going to learn from these mistakes and build compliant buildings?’ Inadequate passive fire protection is not limited to new buildings. From firsthand experience, Total Fire Safety has seen significant and widespread failings in existing buildings where a lack of inspection has led to years of building services maintenance, healthcare equipment upgrades, and IT infrastructure eroding protection from fire and smoke spread. However, standards are changing, and for the better. Total Fire Safety, a trusted solution provider by several NHS Trusts and

19/03/2018 16:02

healthcare facilities management teams, is part of this improvement. Specialists in the field of passive fire protection and fire door inspection and remediation, the company has competent surveyors that understand healthcare construction and HTM guidance. Its remedial teams have extensive experience working in live healthcare buildings providing compliant installations. Total Fire Safety recently completed its first new build project, being part of Birmingham Childrens Hospital new hospital construction. The company was delighted to be awarded this contract and to support this building from design through to completion, ensuring the Trust was

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

left with a safe and compliant building. What type of company should you look for to protect your estate? A competent company who can demonstrate delivery in a healthcare environment. Third party certification such as FIRAS should be classed as essential. Membership to the Association for Specialist Fire Protection (ASFP) demonstrates commitment to higher standards. Total Fire Safety meets these recommendations and more. ISO9001:2015 and health and safety accreditations are also part of its commitment to providing a quality service. Now in its eighth year of trading, Total Fire Safety is delighted to have healthcare at the heart of our business. The organisation would welcome the opportunity to talk to you and see how it can help protect your estate. Let’s turn a bad situation into something safe. FURTHER INFORMATION Tel: 0330 660 0460 info@totalfiresafety.com www.totalfiresafety.com

Who is a competent person? The Health and Safety at Work Regulations require a competent person to carry out the inspection and maintenance of extinguishers. The definition of a ‘competent person’; is detailed in BS5306 part 3, exerts from this document are below: “A competent person is one who has undergone an initial programme of training which includes ‘on the job’ experience and attendance of a training course, followed by the successful completion of an examination administered by an independent examination body. To maintain competency, ongoing professional development is considered essential and is covered by the provision of refresher training at three-year intervals together with an examination.” The document also goes on to give criteria for initial training, details of course content for theory and practical training, too detailed to list here. An employee who has been instructed to check the gauge, or gauges on a fire extinguisher annually is not a competent person for the purposes of maintaining life safety equipment. The annual attendance of a professionally trained and competent fire extinguisher technician to inspect and maintain your equipment, will ensure each extinguisher is in good working order, ensuring you have the appropriate number and types of extinguishers to protect you from the risks present, and should you need the

Fire Safety

 efficient working order and in good repair.” In Scotland and Northern Ireland other fire safety legislation applies, but the message is broadly the same: maintenance of fire protection equipment is paramount. Due to the complex nature of the legislation, the Chief Fire Officers Association produced a guidance document for enforcing authorities. Within this document, section 17 maintenance states that where equipment is ‘provided and installed to a British Standard; it is reasonable to expect that the standard be met by the responsible person in terms of maintenance and recording systems’. Fire extinguishers are manufactured to BSEN3 and installed in accordance with BS 5306 part 8; therefore, fire extinguishers should be serviced to BS5306 part 3. If all of these codes sound confusing, just know that these are the relevant British Standards (a type of best practice regulation), which the industry uses to deliver fire protection services. Knowledge of these codes is absolutely necessary for fire extinguishing professionals – which is why these individuals should have proper training and you should check their credentials, not just the price. When selecting a service provider to inspect and maintain your extinguishers it is essential to ensure the competence of the company and/or individual being employed to carry out inspection and maintenance; as it is the responsibility of the ‘responsible person’ to ensure the service provider is competent to carry out the work.

Fire extinguishers are provided to give first aid fire-fighting capability, and, in the event of a fire incident, you’d certainly want the extinguisher to work as expected extinguisher it will work and keep you safe. You also rely quite heavily on the organisation behind the technician. For your own protection, they should be third-party assessed, carry the right liability insurances, and provide the technician with tools, the correct replacement parts and refills for your extinguishers. They should also be members of a recognised trade association (such as The Fire Industry Association) who alert their members to extinguisher‑manufacturer safety notices and recalls. Third Party Certification Third Party Certification means that an independent body has inspected the company and assessed them thoroughly. It is designed to give consumers peace of mind when selecting a fire protection company as those with Third Party Certification are more likely to have the demonstrable skills, knowledge, experience, and competence to do the necessary works in your premises and to provide you with recommendations should any changes be required (for example if you have had any recent building work or an extension to the building – this would likely affect your fire protection). Third Party Certification is obtained on a company basis, not to individuals – so you can rest assured that once you a have selected

a certified company, that the individual that arrives on site will be compliant with the relevant British Standards and legislation. However, the easiest and simplest way to check if a fire protection company has been certified is just to check if the company is listed under the ‘Find a Member’ section of the Fire Industry Association (FIA) website. The FIA is the UK’s largest fire protection trade association, with over 750 member companies. Membership to the association is subject to strict competency rules, and all members carry Third Party Certification – so you can be assured that those listed as members on the FIA website are fire protection companies that have been certified for specific areas of fire safety provision, helping the end user to be confident of the services provided. To find a list of competent fire extinguishing service companies, visit the FIA website and click ‘Find a Member’. There, you will be able to filter the list of companies by service and by location and be reassured that all of the listed companies have had sufficient training and are certified to do the job correctly. L FURTHER INFORMATION www.fia.uk.com

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

For Award Winning Services ISS has it covered News columns have been filled recently with some significant healthcare soft FM contracts being awarded to ISS Healthcare. The company has been around since 1982 and has always had a fine reputation for service delivery and the ability to create strong customer relationships The latest announcement saw the Fulham Road Collaborative (FRC) awarding a new five year contract, worth over £100 million, following an extensive market testing exercise. This was the second contract the Collaborative has presented to ISS, the first one running from January 2012. The collaborative of NHS establishments along the Fulham Road in West London,

and their associate hospitals, include the Chelsea & Westminster NHS Foundation Trust, the Royal Marsden NHS Foundation Trust, the Royal Brompton and Harefield NHS Foundation Trust, who together represent some of the world’s leading clinical facilities. The new contract will see ISS extend their presence to include waste management, whilst still providing a wide range of services

including healthcare cleaning, patient catering, portering and logistics, linen and laundry, reception and car parking. With the exception of laundry, all the services are self-delivered by ISS, something that makes them almost unique in the Integrated Facility Services market – most providers seek to sub-contract services that are not core to their own business. Just as this award was announced, South Warwickshire NHS Foundation Trust commenced their new Soft Services contract, worth an estimated £45 million over the initial five years. The award was made through the LPP Framework and will see ISS providing patient catering, cleaning, linen, logistics and security services across four sites, including the impressive new Stratford Hospital. Both these contracts also separately market tested their retail services for staff, visitors and patients and again it was ISS who came up with the best proposals for the locations included. The South Warwickshire award marks a return of ISS to the trust as they provided services to them up until 2010. This is the second NHS trust who has returned to ISS this year, closely following South London and Maudsley NHS Foundation Trust. So why is it that one of the largest collaborations and two other very different NHS foundation trusts decided independently to return to their former supplier – ISS? One of the main reasons is that ISS works really hard to fully understand the individual customer needs. The company recognises that every healthcare site is different: it has specific needs and serves its own community, be that at a local level or one that provides treatment for specific ailments. Because of this, the service delivery has to be created around that need and every attention given to maintaining the highest level of service at all times. Customer Experience Survey For the last seven years, ISS has conducted a global Customer Experience Survey, covering almost 50 countries. The on-line survey invites the customer to comment on a wide range of questions that, when put together, provides a deep insight into the relationship between the customer and the provider. This helps to identify where improvements can be made and, equally importantly, it allows for recognition of where things are also going very well. One of the questions asks: ‘How likely is it that you would recommend ISS to a friend,

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An essential part of healthcare It is far too easy to forget the critical role that the support services play in the smooth running of a busy hospital. The current terminology is Soft FM Services but we are really talking about catering, cleaning, logistics, security and associated services like switchboard, receipt and delivery, waste management as well as retail, be that for staff, visitors or even patients. If these essential services were to be withdrawn the hospital would quickly grind to a halt with no clean linen for the beds, no sterile supplies to treat the patients, who will soon become very hungry as no meals would arrive at the ward door. Who would be there to answer the thousands of calls that are made through the switchboards? And what would happen to the mountains of waste that is generated in such a hectic environment? These unsung heroes are there 24 hours a day, 365 days of the year as every patient makes their journey through the hospital. Firstly, they may arrive by car which will be parked in the car park. It may be their first visit to the hospital so they may be unclear of where to go, or even be apprehensive about their appointment. This is where a car park attendant or security officer becomes significantly different to their counterparts on the high street or shopping mall, as we should expect a heightened awareness of individual stress and the need to react swiftly when needed – if somebody is rushing to A&E, the last thing they have on their mind is to remember to park within the designated bays and to display the correct ticket but it is something that should be taken in the stride of somebody trained to handle every eventuality. Once the patient comes through the front door they may be met by a receptionist.

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colleague or customer?’. This is known as the Net Promotor Score (NPS) and is scored from 0 – 10, where 0 means that you are ‘not at all likely’ to recommend, and 10 means that you are ‘extremely likely’ to recommend. When all the responses are put together an overall NPS is calculated, this can range from -100 (where nobody is happy) to +100 (where everyone is completely satisfied). The principle is widely used and accepted as a strong measure of performance. Any score above +40 is considered to be world class. This year 91 per cent of the customers of ISS Healthcare responded to the survey and together gave an amazing score of +75, up from the previous year’s +50. There was also a very strong endorsement in the management at local level, who are widely recognised as being proactive with the ability to make decisions to improve performance. To bring this back to the day-to-day service delivery, the customer, i.e. the person responsible for the safe and reliable delivery of non-clinical services, needs to be sure that they are working alongside a team that really knows what they are doing and shares the same goal of providing the best possible service, each and every day. When they have ISS onboard, they know that this is just what they have.

They are still apprehensive, so a friendly face with a warm welcome goes a long way to allaying some of their fears. At the Royal Liverpool University Hospital there was a famous gentleman, George Wickham, who for many years, until his recent retirement, stood just inside the door and instinctively knew who needed assistance, or just a kindly word. His gentle approach was recognised with several awards from the trust and his employers but when it came to the attention of a wider ISS audience, George was crowned at the ISS Employee of the Year – a great honour as ISS employ over 500,000 people across more than 50 countries. Once inside the hospital the patient may be required to be conveyed to X-Ray, theatre or other departments. This is where a hospital porter can help ease the journey, with comforting words and reassurance – the porter will have known that the patient required transportation because a controller received a call from the ward and instigated the instruction, either by radio or increasingly by using modern technology. Because of their global reach, ISS are able to share best practice from anywhere and IT systems that were originally developed in Singapore have now found their way into hospitals up and down the country. Meanwhile, throughout the hospital, probably the second largest workforce behind nursing, the healthcare cleaning team are ensuring that all areas are being kept clear of dust and debris. A modern day healthcare cleaning professional is armed with an array of ergonomically designed equipment, again the result of research and development from across the globe. ISS were the first to introduce microfiber cleaning into the NHS and nowadays it is widely used in all walks of life. For many patients the cleaner and the ward hostess are the frontline staff who they can confide in and perhaps exchange a few words with from time to time. The hostess

stands on the ward as a representative of the catering department where another large work group ensure that a steady supply of food is provided for patients, staff and visitors alike. The Hospital Caterers Association (HCA) has a slogan that ‘food is the best form of medicine’, and so it is. Good quality food, well produced and transported to the bedside depends on teamwork. The Power of Three campaign, which ISS supports, brings together catering (the HCA), dietetics (the British Dietetic Association) and nursing (the National Nutrition Nurses’ Group) to help improve nutritional outcomes for patients. Together they ensure that nutrition and hydration is recognised as a crucial part of patient’s care plan, and that nutritious food continues to be available. All this activity generates a huge amount of dirty linen and waste materials, all of which needs to be removed from site as efficiently as possible, so again the receipt and delivery team are there to ensure that fresh linen is available, that the provision cupboards are well stocked and all refuse and waste is sent to the correct destination, be that recycling, incineration or other. Reducing the level of landfill is something that everyone in the NHS is working hard to achieve and again companies like ISS are playing their part in developing better ideas. If everything goes well, the patient will be ready to leave one day and their route back home will start with a return to the front door, perhaps by porter or under their own steam. Either way, it is to be hoped that they spare a little thought for all those unsung heroes who have made the whole stay possible. ISS strongly believes that their teams play a vital role in the wellbeing of the patient and are proud to be the market leader in facility services for the NHS. L FURTHER INFORMATION www.uk.issworld.com

Volume 18.3 | HEALTH BUSINESS MAGAZINE

ffuussTM , is a company of OTS Group : a vertically integrated Industrial holding, expert in plastic injection. Out of this industrial know-how, we present the FFUUSS HAND DRYERS, a combinations of creativity and technology to provide an optimal user experience.

Features • Low energy consumption at 1100 w. Typical running costs of £12.00 per year. Cost savings. The Hand Dryers will pay for themselves within 12 months compared to paper towels. • No water spillage from the dryer (So no wet floors or walls). The water collection tank can be plumbed into the mains drainage system.

• Choice of Colors and finishes.

• 5 year warranty. Guaranteed for over 250,000 activations (model HD-1) and 200,000 (model HD-2). • The design* and distribution of the air outlets, create an “air hugs” effect on the whole Surface of the hands. The lateral air outlets create a “curtain effect” that prevents water from splashing out of the drying cavity.

• Low noise level under 74Db (with hands in the unit). • Activation system that utilizes a capacitive sensor in the perimeter of the drying cavity of the unit, allowing for lateral activation of the dryer, in this way facilitating the use to children and disabled people, this is unique to FFUUSS, and as such the units are DDA Compliant and can be used in disabled Toilets.

• HEPA H13 Filter built in to both units & antibacterial additives based on silver ion technology as hygiene is most important.

• Pre-heat warm air drying with the HD-1. Cold air hand drying with the HD-2.

Contact: les.reeder@ffuuss.com 07582 053445 www.ffuuss.com www.handdryerffuuss.com

The development of air conditioning systems has come a long way since the inception of the modern hospital, but how clean are these systems and can they be kept free from bacteria? Before answering this question, it is important to understand some of the engineering terminology used and the types of bacteria under consideration. The term ‘air conditioning’ can encompass a variety of systems: from a single ‘split ‘air conditioning unit, which may only serve one room, to a full air handling system with cooling, heating, filtration, humidification, ductwork and terminal units serving an entire building. This article is based on the latter. In it, the terms ‘ventilation’ and ‘air conditioning’ are interchangeable. The primary role of ventilation in a healthcare environment is to dilute and control airborne pathogens, provide thermal comfort and supply fresh air to occupants. Air conditioning systems can take many forms. For example, in general wards areas they will provide fresh air and help in maintaining comfortable conditions for the occupants. However, in isolation rooms and operating theatres the air conditioning system will be part of the infection control solution. Health Technical

Memoranda (HTM) 03-01 Specialised Ventilation for Healthcare Premises provides guidance on the design, installation and maintenance of air conditioning systems. Although this document is over seven years old, it still provides an outline of the general principles and philosophy of healthcare ventilation. It is also worth considering that healthcare buildings are a place of work and so the air conditioning systems also need to comply with the Health and Safety at work Act 1974. The Act places a duty on an employer to maintain plant and systems so that they are, as far as is reasonably practicable, safe and without risks to workers’ health. The trace of bacteria When talking about bacteria in air conditioning systems, it is important to remember that all air conditioning systems will contain traces of bacteria and other organisms. In a well maintained system the levels of bacteria are likely to be so low that healthy people are, generally, unlikely to be affected. However, in a healthcare building, where there are potentially many vulnerable people, some with compromised immune systems,

It is nt to importar that all be remem ditioning air con ill contain w systems of bacteria traces other and ms organis

Written by Mark Wheeler, chair, CIBSE Healthcare Group

Air conditioning systems are fundamental to the operation of many healthcare buildings. Mark Walker, chair of the CIBSE Healthcare Group, explains the importance of good design and regular maintenance in keeping these systems bacteria-free

Facilities Management

The importance of well-ventilated hospital estates

the issue of bacteria in air conditioning systems can be much more serious. There are many forms of bacteria that can be found in an air conditioning system including MRSA, C. Difficile and Legionella, along with Aspergillus spores in the air itself. In healthy people its spores do not normally cause any harm. However, in a hospital setting with immunocompromised patients, Aspergillus can result in serious diseases including: invasive aspergillosis, allergic bronchopulmonary aspergillosis, chronic pulmonary aspergillosis and aspergilloma. To minimise the risk of Aspergillus spores, it is particularly important when considering the design or refurbishment of an air conditioning system not to locate the air intakes in the vicinity of compost heaps or any areas where decaying vegetation is present. Legionella is a bacterium which thrives in warm water in dark and dirty conditions, so it is important to ensure that no pools of water are present within an air conditioning system. Generally the occurrence of water will be due to poor system design rather than any shortfall in the maintenance and ductwork cleaning regimes. Split air conditioning units or comfort cooling units can be particularly susceptible to Legionella. These units are allowed by HTM 03-01, but only for non-critical areas. In reality they should be limited to office type accommodation or seminar rooms because split units produce condensate. There can be an issue with these units when small quantities of condensate are produced, which can lead to pooling and puddling of water which can then become stagnant and can increase the possibility of Legionella developing. To avoid this, the condensate drains from the split air-conditioning units should comply with the requirements of HTM 03-01. Inspection and installation HTM 03-01 Part B requires all ventilation systems to be subject to at least one visual inspection annually. In the case of critical care ventilation, these systems should be inspected quarterly with their performance measured and verified on an annual basis. Air conditioning systems should be designed as a series of smaller systems specific to a department or area rather than one giant system so that they can be E

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Critical power provides a lifeline to health sector Working with both NHS and private facilities throughout the country, DTG designs, supplies, installs and maintains diesel generator power systems to ensure reliable back-up power for both new and refurbishment projects The UK health sector is a core market for Dieselec Thistle Generators and the business has developed a strong track record in delivering large NHS energy centre projects, including installations at the Royal Hospital for Children in Edinburgh, New Queen Elizabeth University Hospital in Glasgow, Northumbria Specialist Emergency Care Hospital in Cramlington and West Cumberland Hospital. A further £4 million of work is also already in progress at the Midland Metropolitan Hospital, University Hospital of North Tees, East Lothian Hospital and Orkney Hospital. The company’s power solutions team is technically expert in this area, and it has really gathered momentum. Working with both NHS and private facilities throughout the country, DTG designs, supplies, installs and maintains diesel generator power systems to ensure reliable back-up power for both new and refurbishment projects. Providing customers with products, support and advice throughout the life cycle of their generator set means DTG has forged successful, long-standing relationships within the health sector. Working collaboratively with specifiers, consultants, construction firms and facilities managers ensures health sector customers find the most cost-effective and resilient stand-by power systems to meet their specific requirements. Operating from its 6.3 acre HQ near Glasgow, DTG has an 80,000 sq ft warehouse space accommodating workshops, a parts distribution depot, the biggest load test cell in the country as well as the largest stock of generators in the UK. From

six to 3,000kVA – the stockholding is available for immediate dispatch to ensure customers can quickly be provided with the right solution for their power needs. The team provides a comprehensive design service ensuring the most challenging and complex of projects are handled with professionalism, and delivered in the best possible way. The design service includes survey and consultancy, in-house auto CAD to BIM, technical submissions and complete turnkey packages. Once designed, the installation process can begin. From delivery of equipment, to onsite electrical and mechanical engineering work, the project management team will work alongside customers to ensure a seamless installation including flue, silencer and noise attenuation, fuel delivery systems, and AMF to multi-synchronising controls. The project management team will ensure that the system is fully tested and commissioned prior to handover. This is supported by the technical department which has unrivalled knowledge and experience in the commissioning of standby power systems. This process can include testing at the UK’s largest test cell, located at Dieselec Thistle HQ, as well as on site testing and then project handover. DTG continues to support customers throughout the life-cycle of their equipment. This includes bespoke service contracts to meet specific requirements as well as remedial work, upgrades and 24/7 emergency response. As an authorised FG Wilson dealer, the business has a wide range of the most commonly used spare parts in

stock, including a wide range of genuine parts for all FG Wilson generators. Not only this, but the business recently invested £250,000 in its hire fleet – competitively-priced, rental equipment available to customers who are in need of back-up power supplies, either during an emergency, whilst routine maintenance takes place or throughout the course of a new installation. New Queen Elizabeth University Hospital The new Queen Elizabeth University Hospital in Glasgow is one of the largest hospital complexes in Europe with an atrium big enough to house a 747 jet, and it has its own team of robots. Home to major specialist services, the super-hospital is operated by NHS Greater Glasgow Clyde. The hospital comprises a newly built 1,631 bed adult hospital, a 256 bed children’s hospital and two major A&E departments, in addition to buildings retained from the former hospital. Power supplied: Ten 2.5MVA sets at 11kv complete with 65dba attenuation, split across two packaged plant rooms on level two of the energy centre. This highly complex project involved overcoming access challenges to transport safely, install and integrate the whilst maintaining the power supply to the existing hospital functions. With careful planning and a robust testing procedure complete, the installation provides a complete back-up supply for the entire complex. DTG was selected for this project due to its ability to meet the stringent criteria set by the client including demonstrating a robust track record in supply and installation of powerful, resilient systems and run-up synchronisation. DTG has successfully delivered projects for more than 30 NHS hospitals across the UK – security of supply is critical, and our experience here is proven. The client said: “DTG was chosen as our specialist to supply, install and commission the standby generation package as their ability to take the complex design and turn this into a working solution was second to none. The team’s expertise in designing the generator control system made it easy to test and commission the system while maintaining the back-up supply to the laboratory building.”L FURTHER INFORMATION www.dtgen.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

In order to reduce the build-up of bacteria in the ventilation system the appropriate ductwork cleaning is required before the system is brought in to use and while the system is in use areas in hospitals and high quality offices. The standard also recommends a system assessment frequency. The standard states that an inspection frequency should be specified and not a cleaning frequency to allow for changing conditions that may actually alter the frequency at which a system needs to be cleaned. Providing correct filtration to the appropriate standard and class for the area served will reduce the possibility of bacteria in the air conditioning system. Filters should be inspected and maintained in accordance with the recommendations of the manufacturers taking into account the location of the hospital and the air intakes. For hospital environments, it is recommended that air handling units (AHUs), ductwork and air terminals be inspected annually, in line with HTM 03-01 for annual inspection and verification of ventilation systems. Cleanliness quality class In order to reduce the build-up of bacteria in the ventilation system the appropriate ductwork cleaning is required before the

Facilities Management

 easily managed. In the case of operating theatres, for example, one air conditioning system should be dedicated to each theatre. This will contain any bacteria and reduce the need to close more than one theatre when maintenance is required. Outside air intakes to the air conditioning system must be located in a suitable position and kept clean. The Chartered Institution of Building Services Engineers’ (CIBSE) document TM21 Minimising Pollution at Air Intakes provides designers with the information that will help in locating ventilation inlets. Air exhausts should be a minimum distance of 4m from an air intake and, ideally, 10m apart to stop the exhausted air recirculating into the supply air intake. Air conditioning systems incorporate filters to remove particulates from the air. If the correct filters are used and these are correctly installed then it should not be necessary to clean ductwork on an annual basis. If ductwork is dirty, that would usually signify that the filters are not working correctly or that the filtration is inadequate or has not been properly maintained. Correctly installed filters should keep ductwork clean for up to 10 years. The British Standard, BS EN 15780:2011 categorises the level of cleanliness in ductwork into the three quality classes: Low, such as rooms with only intermittent occupancy e.g. storage rooms and technical rooms; Medium, such as offices, schools restaurants and general areas in hospitals; and High, such as laboratories, treatment

system is brought in to use and while the system is in use. Dust can also carry the spores of Aspergillus, so cleaning new installations to reduce the presence of dust is vital at both the installation and commissioning stages of an air conditioning installation. In addition to providing a safe and clean system, ensuing that ductwork is clean from new helps reduce energy use. Apart from obvious clinical benefits it makes good business sense. Keeping air conditioning systems bacteria free (or as bacteria free as possible) is down to good design, installation and maintenance. In a well-designed system, ductwork cleaning should only be considered where the annual inspection has highlighted a need. Finally, it is worth considering that bacterial contamination in healthcare facilities is far more likely to come from the people in that environment than from a well-designed and maintained air conditioning system. L FURTHER INFORMATION www.cibse.org

Lift Consultants Our Lift Consultants provide independent advice on all aspects of lift engineering, from conceptual design through to final build. We have expertise on compliance and advice on existing lift portfolios we undertake condition surveys to assist with forward planning and budget management. Phone: 08003029331 Web: www.hemsworthassociates.co.uk Email: info@hemsworthassociates.co.uk Address: 86-90 Paul Street London EC2A 4NE

Volume 18.3 | HEALTH BUSINESS MAGAZINE

The biggest NHS-led event of the year 5 and 6 September 2018, Manchester Central www.england.nhs.uk/expo | @ExpoNHS | #Expo18NHS Welcoming more than 5,000 delegates each year, Health and Care Innovation Expo is the biggest NHS-led event of the year. It is a unique celebration of innovation, enterprise and collaboration, uniting NHS and social care leaders, commissioners, clinicians, voluntary sector partners, innovators, industry leaders and many more. This year it will be even more special as the NHS celebrates its 70th anniversary.

Register Now Tickets are selling at a record rate for Expo 2018, so make sure you claim your place as soon as possible. NHS and wider public-sector staff can claim free-of-charge tickets and early-bird rates apply to ticket purchases until the end of May. To register and check your eligibility for complimentary tickets: Visit: www.england.nhs.uk/expo Email: healthexpo@dodsgroup.com

“There’s a lot happening in the NHS that we don’t always hear about except at Expo” 2017 delegate

Innovation Expo

How is the NHS committed to cross-sector collaboration? As the NHS celebrates its 70th anniversary, it’s a great time to reflect on how much our health service has transformed since 1948, and how it will continue to develop in the future The Health and Care Innovation Expo returns on the 5-6 September 2018 at Manchester Central and will bring together over 5,000 leaders from across the health and social care sector. Last year’s Expo was our biggest yet, and Expo 2018 promises to be even better. We’re expecting over 5,000 delegates again and around 150 hours of speakers, workshops and sessions exploring the latest developments and innovations across health and social care. Expo 2018 will include: keynote speeches by Simon Stevens, NHS England chief executive, Secretary of State for Health Jeremy Hunt, and other health and care leaders; clinical leadership panels and professional seminars led by Chief Nursing Officer for England Prof Jane Cummings, NHS England Medical Director Prof Steve Powis; collaboratively-led sessions focused on system transformation across the NHS, local government and social care; and more than 80 professionally-led workshops exploring specific innovation and development projects from across the health and care sector at local, regional and national level. Feature Zones at Expo 2018 Running up the spine of the exhibition hall, feature zones are key building blocks of Health and Care Innovation Expo. They provide targeted focus and deep discussion of major NHS-led innovation and development,

celebrating and sharing success as well as exploring issues and challenges. They each run mini-conferences throughout the two days, focused on learning, collaborating and networking. National leaders manage talks and discussions, while pioneering local and regional leaders are available for in-depth chats about their work. Mental Health Zone For the first time, Expo will present a mental health feature zone. It will showcase the actions being taken across the health and care sector to deliver the Five Year Forward View for Mental Health and transform services to meet the needs of people with mental health problems. By 2020/21, our goal is to invest £1 billion additional funding each year by 2020/21 to provide access to high quality care for an extra million people.

England are working together to help people live healthier lives. Digital Technology Zone We will once again showcase the best new digital innovations in health and care and demonstrate how they help patients and the public to live healthier lives and support the work of frontline staff. We will illustrate the value of digital innovation in sustaining the NHS for the next 70 years. We will celebrate patient‑centred use of technology and information to improve health and care, and support visitors to adopt and implement the innovations they have seen at the show in their own organisations. The Digital Zone will also demonstrate the progress that has been made over the last 12 months to implement Digital Transformation programmes throughout England.

Diabetes and Obesity Zone This zone will focus on the Healthier You: Diabetes Prevention Programme (NHS DPP); the first national diabetes prevention programme anywhere in the world. It will also explore the challenges presented to health and social care services by obesity, By and the ways 2 0 2 0 the NHS and our goa/21, Public Health l

Improving Care Zone NHS RightCare is working closely with two other national programmes, NHS Elective Care and NHS Improvement’s Getting it Right First Time (GIRFT) to provide full system patient care that ensures the best possible outcomes for patients while securing the most efficient use of resources. Their feature zone will showcase how the three programmes complement one another across commissioning and provision invest £ is to 1bn to build better outcomes for additio patients by ensuring that each ye nal funding people see the right person ar by 2 020/21 to pro in the right place, first time.

v high quide access to al an extr ity care for a mi people llion

Join the conversation and register your place for Expo 2018 Tickets are selling at a record rate for Expo 2018, so make sure you claim your place as soon as possible. NHS and wider public‑sector staff can claim free‑of‑charge tickets and early-bird rates apply to ticket purchases until the end of May. L FURTHER INFORMATION To register and check your eligibility for complimentary tickets: Visit: www.england.nhs.uk/expo Email: healthexpo@dodsgroup.com

Volume 18.3 | HEALTH BUSINESS MAGAZINE

THE UKâ&#x20AC;&#x2122;S LEADING LIVE EVENT PLATFORM CONNECTING SENIOR HEALTHCARE DECISION MAKERS, INFLUENCERS AND BUYERS FROM ACROSS THE NHS AND THE ENTIRE UK HEALTHCARE SECTOR FOCUSED ON FOUR KEY THEMES:

FEATURING:

ENQUIRIES: SHARON AZAM, SALES DIRECTOR

T: 0161 211 3057 E: SHARON.AZAM@UKHEALTHSHOW.COM

UK Health Show

Four leading healthcare shows under one roof

The leading event for the whole of the UK’s healthcare sector returns on the 25-26 September for two days as it grows into its new home of ExCeL London for 2018

The UK Health Show is the UK’s leading live‑event platform connecting senior healthcare decision makers, influencers and buyers from across the NHS and the entire UK healthcare sector. Its mission is to connect the NHS, private healthcare providers, national bodies, partners and suppliers through thought‑provoking and educational content and a trade-show platform focused on the key opportunities and challenges in healthcare today. This is because the healthcare team at GovNet Exhibitions, the organisers of the show, understand the need for a sustainable and forwardthinking business model for both the NHS and private healthcare, which continues the UK’s provision of world leading healthcare services that ensure of the best possible patient outcomes.

and opportunity. In 2018, the UK Health Show will enter its third year following its hugely successful launch in 2016. Born out the Healthcare Efficiency through Technology show (launched in 2011) and Commissioning in Healthcare (launched in 2013) the show brings a rich legacy of being at the forefront of the industry. This year it will be growing to two days and to reflect its growth plans, moving to its new home of ExCeL London. Alexander Rushton, event director and head of Healthcare at GovNet Exhibitions, explains: “Through the UK Health Show, we want to celebrate the leaders and the progressiveness, innovation and diversity from across the UK healthcare sector by focusing on four key opportunities and challenges facing the health sector today. “These are digital technology, commissioning, procurement and cyber security. Having started my career in a trust, before moving to the NHS Confederation and also spending a year working with the World Health Organization, I’ve seen first-hand the challenges facing the healthcare industry not only in the NHS and UK systems, but also the global systems. “However, with that comes great opportunity and that is what we promote with the UK Health Show – the opportunity E

Procur transforement m initiative ation s are enablin g t h eN leverag e its sig HS to nificant purchas i n g p o to achie ve the bwer value fo e r goods st and ser vices

Facing challenges The show covers the unprecedented challenges facing the NHS and healthcare systems in the UK, but also demonstrates its resilience and appetite for innovation

Integrating care successfully will heighten NHS Professor Don Berwick has said that the NHS is better placed to ‘truly integrate care’ than any other global health system and has encouraged it to pursue partnership working. Former adviser to Barack Obama, Berwick claimed that the current fragmented nature of services could be improved and solved if all local health and care organisations worked in partnership and pooled resources, encouraging the progression of a ‘system that supports an individual’s complete needs’, rather than treating care problems ‘in isolation’. Additionally, Berwick said the health sector should use the wisdom and experience of existing NHS staff, of whom it would be ‘smart to earn from’. The King’s Fund advisor also said that new care models programme had generated a faculty of knowledgeable clinicians, managers, nurses and doctors who could become teachers to the country. Berwick said: “I think the NHS probably has a better chance to truly integrate care than almost any other health care system in the world. We’re not our diseases, we’re not a broken arm or diabetes we’re whole people who are making journeys through our lives and the care system has to honour and respect that. “There’s no reason the NHS can’t have the best care in the world, why you can’t take an appropriate proportion of your efforts and move them upstream to the causes of illness and use social determinants to prevent illness. There’s no reason why you have to waste money; you have limited resources and you can use those resources increasingly wisely.” FURTHER INFORMATION tinyurl.com/ybnqokyq

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Award winning power protection systems from 400VA to 6MVA

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Bringing you the whole of the healthcare sector UK Health Show visitors represent the whole of the healthcare sector. The show attracts a senior audience of the most important people shaping and providing the health services of the future. The event brings together the NHS, private hospitals, independent providers, local authorities, central government, national bodies and academia. Rushton said: “This gives our exhibitors, sponsors and all attendees access to the full spectrum of buyers, specifiers, decision makers, influencers and stakeholders in the healthcare sector. We ensure of representation from across the UK giving you access to the full geographic healthcare market. Thanks to this market penetration, you can conduct a years’ worth of ‘on-the- road’ meetings in just two days, saving thousands of pounds and hours of time travelling the UK meeting and entertaining clients.” What’s on Following extensive feedback from exhibitors, sponsors, partners and attendees, this year

The UK Health Show presents an opportunity for the whole of the NHS, industry and the wider sector to meet, discuss, connect and find solutions to take advantage of the opportunities for success and overcome the challenges faced today the UK Health Show will be growing to two days and with that moving to its new home of ExCeL London. With a strong content offering, the show will feature 11 content theatres delivering over 80 hours of content with a speaker faculty of over 200 leading experts and case studies. In 2018, there is also the opportunity for exhibitors and sponsors to take advantage of the Healthcare Buyers Programme, private breakfast and roundtables discussions, the central networking lounge and a range of sponsorship packages to meet all needs. Healthcare Efficiency through Technology Healthcare Efficiency through Technology provides a unique opportunity for leaders in healthcare to share ideas with leading companies in health informatics, clinical technology, apps, medical devices,

UK Health Show

 for the whole of the NHS, industry and the wider sector to meet, discuss, connect and find solutions to take advantage of the opportunities for success and overcome the challenges faced today.”

data analytics and data security as the NHS enters the digital age. This year’s speaker faculty includes senior healthcare executives in information technology, clinical informatics and procurement from NHS trusts; Clinical Commissioning Group (CCG) accountable officers and board members and national leaders from NHS Digital, NHS England and the Department of Health and Social Care, all supported by a wide-range of industry and wider sector partners. The faculty will deliver over 75 hours of CPD accredited content with up to 14 CPD points available. Speakers include Juliet Bauer, Chief Digital Officer at NHS England, Dr Simon Eccles, National NHS CCIO at NHS England, Will Smart, Chief Information Officer at NHS England and Lord Carter of Coles, non‑executive director at NHS Improvement. The Digital NHS Stage, forming the plenary conference theatre for the E

Volume 18.3 | HEALTH BUSINESS MAGAZINE

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UK Health Show

 technology stream of the show, will focus on the big strategic initiatives and key investment areas of digital innovation and implementation for the modern healthcare system. With the help of world leading technologists, this stage will feature those driving the latest national strategies and programmes for the NHS and is a must‑attend forum to be part of the digital revolution in healthcare. As new models of healthcare delivery continue to evolve, so does its staff. The Workforce of the Future Theatre will address the universal issues surrounding regeneration of the NHS workforce by looking at adapting skill-sets, training and development needs and optimising staff retention levels. Sessions will also look at flexible working models in support of integrated working and what Brexit means for international colleagues. Additionally, the Interoperability and Infrastructure Theatre is the place to be to hear from those that have encountered, tackled, and overcome challenges with interoperability, systems integration and NHS infrastructure. These sessions will explore practical case studies relating to systems interoperability and infrastructure remodelling, including how to maximise the use of physical assets and estates. Procurement in Healthcare Procurement transformation initiatives are enabling the NHS to leverage its significant purchasing power to achieve the best value for goods and services. With cost saving now more critical than ever, sessions here will focus on the transformation of the strategic and operational elements of NHS procurement to maximise operational procurement productivity and efficiency within NHS trusts. The Procurement in Healthcare stage allows you to hear from senior strategists, policy specialists and innovators leading the way in delivering efficient and effective procurement strategies. Cyber Security in Healthcare Cyber Security in Healthcare is a unique opportunity for senior IT leaders, risk owners and clinicians to access information about security and data storage solutions from a reliable source and dedicated companies as the NHS enters a new digital age of healthcare. The Cyber Security Symposium will focus on NHS cyber and data security strategies and their practical implementation. It will provide learnings from a range of key, non-healthcare focused industries who will demonstrate how they have prepared for the digital age and the ensuing challenges of securing data and systems and implementing robust and effective information governance. E

Professor Don Berwick: “I think the NHS probably has a better chance to truly integrate care than almost any other health care system in the world”

Reducing avoidable harms in healthcare environments Talley Group is the UKs largest, privately-owned manufacturer of specialist pressure area care (PAC) support surfaces for preventing and managing pressure ulcers. The company also manufactures Venturi NPWT products, Synchro IPC systems for DVT prevention and offers TECcare antimicrobial products to reduce the risk of infection. To deliver safe and effective patient care and reduce avoidable-harms, Talley feels that responsible medical device manufacturers must play their part by delivering the safest, most effective products to patients. Although specialist support surfaces are only one piece of the patient care jigsaw, the company recognises that should any PAC surface prove unsafe or ineffective this can increase the risk of patient harm. So what have we done about it? Talley has voluntarily registered all of its powered

PAC support surfaces as Class IIa medical devices. In simple terms, all of its product safety and performance claims are now independently audited, demonstrating our commitment to putting safety first. Furthermore, Talley offers flexible and comprehensive rental, service and decontamination solutions across the UK with staff also qualified to service and maintain a wide range of equipment from other manufacturers. Contact Talley group to discuss how the company can help you.

FURTHER INFORMATION Tel: 01794 503500 www.talleygroup.com

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Eliminate your print servers with PrinterLogic

Keeping electronic healthcare data secure

PrinterLogic’s software allows you to centrally manage your entire print environment without the need for any print servers. PrinterLogic gives you driver and profile management, floor plan maps for self-service printer installations, and support for advanced features including pull printing, mobile printing, print job reporting, support for EMR printing systems, and support for printing in VDI environments. Focus on patients, not printing, with PrinterLogic. Healthcare has always been an important customer base for PrinterLogic. In the words of long time customer Ohio Health: “Now that we use PrinterLogic, we can simply

LapCabby has ideal solutions for the growing deployment of mobile devices within the healthcare community. Mobile devices play a huge part in delivering 21st century healthcare and enable staff to enhance patient care. LapCabby delivers space saving solutions to keep devices with private patient data secure and away from prying eyes yet easily transportable and fully charged for when they are needed most. The company’s solutions for health are compact to save space in surgeries, labs and on the ward and are designed to be easily transported, secured and cleaned. One of the biggest hospitals in the UK has successfully reduced food waste from 12 per cent to below five per cent by using iPads to take orders on wards. All patients now get a choice when it comes to meal times and food stock can be held for an extra week

push one update and it will be automatically taken care of across all servers and printers. This has drastically reduced the time spent troubleshooting, and has eliminated the need to check every print server. Our deployment time for new printers is now incredibly fast—we just push once, and it’s done.” Whether you have one facility or multiple facilities, PrinterLogic software can give you the tools you need to centrally manage your printing without the headaches of print servers.

FURTHER INFORMATION Tel: +44 (20) 38749352 www.printerlogic.com

without increasing wastage. LapCabby has been developing innovative products for over 20 years that its customers love, such as portable storage trolleys and charging solutions for tablets, mini devices, Chromebooks, laptops and notebooks. Whether users have employee owned or institutionowned devices, LapCabby has a variety of secure charging solutions that can improve the workflow of deploying your iPads, mini devices, phones and laptops. It’s the smart way to keep your tech safe.

FURTHER INFORMATION Tel: 0115 982 1771 askus@lapcabby.com www.lapcabby.com

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Mobile device and tablet charging and storage soultions. Easy to clean units ensuring your devices are ready to go when you are. FOR MORE INFORMATION PLEASE CONTACT MARVIN DOUGLAS - UK SALES MANAGER M: 07890 478 403 E: marvin.douglas@lapcabby.com

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

GENERAL ENQUIRIES W: www.lapcabby.com E: askus@lapcabby.com

UK Health Show

 Furthermore, the Cyber Security Solutions Stage will provide the practical solutions to the challenges and opportunities discussed in the Cyber Security Symposium. Case studies and experiences from those working within healthcare settings will integrate with those from the leading companies protecting health data and systems and creating a cyber-savvy workforce. Commissioning in Healthcare The commissioning of healthcare services is undergoing significant transformation with renewed emphasis on system integration and new partnerships. Set against the backdrop of Sustainability and Transformation Partnerships and Integrated Care Systems, this stage will bring together national NHS leaders and key stakeholders to discuss and debate new policy, national strategies and practical roadmaps towards health and social care integration. A leading event and expo placing emphasis on NHS organisations working together to develop sustainability and transformation plans. From national vanguards, to individual pilots to local initiatives, the Commissioning in Practice Theatre will showcase the best examples of commissioning excellence from across UK. Sessions will showcase the most innovative ideas and projects via an interactive platform for attendees to learn, takeaway and be inspired. L FURTHER INFORMATION www.ukhealthshow.com

The commissioning of healthcare services is undergoing significant transformation with renewed emphasis on system integration and new partnerships. The Commissioning in Practice Theatre will showcase the best examples of commissioning excellence from across the UK

Stressing the importance of UPS in healthcare

A simple and affordable solution for NHS suppliers

In mission critical medical environments like an operating theatre, A&E department or laboratory, a robust and reliable electricity supply isn’t simply desirable, it’s non-negotiable. Even the slightest fluctuation to the quality of the mains supply can ruin vital research, scupper crucial patient scans, or cause crucial IT systems to crash. It can literally be the difference between life and death. An uninterruptible power supply (UPS) is your ultimate insurance policy, protecting your power supply against disruption and minimising your risk of downtime. And if the worst ever happens and you do suffer an outage, a UPS gives you priceless breathing space that keeps your medical equipment and IT systems running safely until the back-up power kicks in. Riello UPS has a proven trackrecord of providing critical power protection to clinical

B2B Router has been a certified PEPPOL Access Point since 2012. The company’s Premium Business service is the simplest and most affordable solution for suppliers to become PEPPOL compliant for the NHS e-Procurement program. With B2B Router, suppliers can reach all their NHS buyers through one single PEPPOL Access Point connection, sending PEPPOL invoices easily, by entering invoice details into a simple web‑portal template or creating them from incoming orders. The B2B Router portal sends e-mail notifications when PEPPOL orders are received and provides a facility to flip orders into invoices, ready to send out at

commissioning groups, health boards, local authorities, GP surgeries, the emergency services and private healthcare providers. The company’s award-winning product range spans 22 solutions suitable for all medical environments and eventualities. In addition to manufacturing industryleading power protection products, Riello UPS offers the most comprehensive package of UPS installation, servicing, and ongoing maintenance support to guarantee quality, continuous power throughout the medical sector.

FURTHER INFORMATION Tel: 0800 269 394 www.riello-ups.co.uk

the touch of a button. All activity can be monitored through the portal, while invoices, orders and other documents can be downloaded in PDF or other formats, for internal use. Clients can expand their use of the portal to include non-NHS buyers or suppliers, as multiple formats are supported - or they can upgrade at any time, if volumes increase, to send or receive electronic files directly to and from their ERP systems, supported by Invinet’s excellent team of integration experts.

FURTHER INFORMATION info@b2brouter.net www.b2brouter.net/uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

‘Being patient is difficult when you are the patient’ says chief pharmacist, Dr Helen Taylor, who opened the doors to the new pharmacy at The Whittington Hospital, north London last July. Here, Taylor shares the success of embracing a design led approach to improve patient outcomes in a busy London hospital. Until recently, collecting a prescription was not a pleasant experience for many patients entering the pharmacy department at the Whittington. Patients entered a space dubbed by many staff and patients as the ‘bus

shelter’. It was cold, confined and lacking in any warmth. Most people coming to the pharmacy were unwell and anxious, and for most, the pharmacy represented the last leg of an already long journey through the hospital system. Efforts had been made over the years to try and improve the situation. The hospital regularly

Written by the Design CCouncil

Embracing a design-led approach can really improve outcomes for staff and patients in hospitals across the country. The Design Council reports on the work undertaken at the Whittington Hospital pharmacy to improve the patient experience

Design & Build

Improving the patient waiting experience

asked patients to share their views on how to improve the pharmacy but little feedback was received and very little changed. In 2016, the department received a scathing letter from a patient who described her experience visiting the pharmacy. Taylor said: “I used this as an opportunity to engage this patient and ask her to help me and the team improve the waiting experience. I also wanted to improve the working environment for pharmacy staff. It was difficult and confined.” Taylor felt sure the answer lay with design, so she turned to Design Council’s public services transformation programme to bring about change at The Whittington Hospital. Design Associates Anna White and Sean Miller were parachuted in to the pharmacy to work alongside Taylor and her team to analyse the service and pinpoint areas where improvements could be made. Taylor commented: “We engaged with the Design Council who enabled us to engage with designers, architects and our patients, to explore how best to use the space and speed up the process inside the pharmacy. “The collaborative design process made us stand in the shoes of patients and think about what it was like to be a patient in our pharmacy and this was really insightful.” E

Embrac designing approa led really imch can outcom prove e and pa s for staff hospita tients in ls the cou across ntry

Whittington Hospital Pharmacy – Pharmacy counter

Volume 18.3 | HEALTH BUSINESS MAGAZINE

15-16 MAY 2018 National Conference Centre

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

The patient experience One of the key insights identified early in the process was a lack of clear communication between the pharmacy and the patient. Many patients wondered how long they would have to wait and this was frustrating to patients and caused further anxiety. Working together, the change team made up of staff, patients and design experts came up with new ideas for how the space could work. Ideas were tested and retested, first in model form, then at half scale, and finally at full scale. Patients provided real-time feedback as they interacted with the new prototype elements in the pharmacy. The full-scale prototype developed from a model and an idea into a new look live pharmacy in July last year. Taylor and the team have been overwhelmed with compliments and positive feedback from staff and patients since they re-opened. Taylor says: “The feedback from patients has been extremely positive. Our pharmacy has transformed from a cold and unwelcoming place to a professional modern pharmacy service that patients like to visit. It is open, patients can see staff, communication is clear and information is presented more visually and therefore more clearly. It is bright, clean and you can get coffee and purchase items while you wait. The pharmacy is a calm place now. Patients can see staff working. Previously they were hidden away. The relationship between staff and patient is much improved.” Following the success of the Whittington Pharmacy re-design, importantly for the hospital, it has also produced a design model that can be applied to other spaces within its walls, and a willingness to experiment. The hospital was so pleased with the success of this project it applied the same co-design process to help create their major new ambulatory care centre at the hospital. Since the design, build and launch of the centre, the ambulatory care given to patients in this environment has been rated as outstanding by the CQC. The Whittington has also been commended on how they manage medicines in their pharmacy and their overall outpatients rating has improved since the service re-design. Taylor said: “As we get funding for different projects, we implement the design approach. The hospital’s management team feels strongly that we should just push work like this through because it has such a good effect on patients.” Meanwhile, in other NHS hospitals, design thinking is being adopted to improve the waiting experience in A&E. Design Council’s ‘A Better A&E programme’ uses a design approach to reduce hostility and aggression in A&E departments in order to prevent lost productivity and reduce security costs which is believed to cost the NHS millions of pounds every year. Design Council partnered with three NHS trusts across the

Design Council’s ‘A Better A&E programme’ uses a design approach to reduce hostility and aggression in A&E departments in order to prevent lost productivity and reduce security costs which is believed to cost the NHS millions of pounds every year

Design & Build

 A co-design approach Working together the team identified three aims for their change programme: improving the experience for patients, using every intervention as a health promotion opportunity and developing a retail offer to offset expenditure. The team engaged a specialist design agency to assist and they adopted a co-design approach, which focused on enabling pharmacy users to collaboratively create a space that would work best for them. This began by establishing a programme of workshops with representatives from patient, staff and management groups. Taylor comments: “As pharmacists, we know what is important but the designers brought the principles of design, and taught us to think about it as a design process. They made us think in a different way. We would probably have done something quite conventional if the designers had not been engaged, but by applying the co-design process we were able to gather feedback from patients in real time. We also engaged with people we have traditionally struggled to engage in the past, so we could get feedback from a more diverse group of people, including those who do not traditionally respond to these surveys. This allowed us to obtain a broad range of new insights that I am convinced we would never would have been able to get if we applied the same methods we have used before.” The unhappy patient who contacted Taylor with her concerns was invited to the project: “I asked the lady who complained to became actively involved. She did, and she presented to the trust board and secured buy-in from senior management. She has since become an advocate for the project which is fantastic.”

country (Chesterfield Royal Hospital NHS Foundation Trust, Guy’s and St Thomas’ NHS Foundation Trust and University Hospital Southampton NHS Foundation Trust) to research, develop and test solutions in operational A&E departments. A team, led by design studio PearsonLloyd, worked with specialists in organisational dynamics and clinicians to create ideas for new communication systems, staff support services and secure spaces. The design team sought to create solutions that would improve the patient experience. For patients, this meant being better informed at every stage of their journey through A&E and remaining in control of decisions. For staff, the focus was on creating safe secure environments to work in. Embracing a design-led approach can really improve outcomes for staff and patients in hospitals across the country. Design Council supports the NHS and health sector across the UK. L FURTHER INFORMATION www.designcouncil.org.uk

creative thinking and practical know-how

Making complex journeys simple Our hospital wayfinding consultancy provides an intelligent and holistic solution that makes use of our broad expertise in signage, interiors and wayfinding design. 20/20 are specialists in Wayfinding Consultancy Signage Interior Design Values Communication Find out more… www.2020projects.co.uk info@2020projects.co.uk 01326 372520 , Tregoniggie Ind. Est., Falmouth, Cornwall TR11 4SN

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Gastrointestinal Endoscopes Do we need to Shift From Disinfection to Sterilization? The Crisis:

www.anderseneurope.com

Hundreds of patients in US hospitals have fallen ill and more than 150 have died after contracting a superbug infection. Patients were infected with a drug‑resistant bacteria known as carbapenem‑resistant Enterobacteriaceae (CRE) between 2012 and 2014, a result of contact with contaminated endoscopes. Duodenoscopes, were cleaned in compliance with the manufacturer’s instructions but still carried traces of the bacteria which matched cultures taken from ill patients.

The Response: In response to the contamination and infection concerns US FDA released new recommendations on how to enhance the reprocessing of complex endoscopes including: Ethylene Oxide (EtO) sterilisation following cleaning and high‑level disinfection. Whilst the BSG recommendations don’t currently include sterilization using EtO, the three‑hour usage restrictions mentioned in the document don’t apply when sterilizing with ethylene oxide since the endoscope is wrapped in a sterile barrier system.

Going forward: No additional cases of CRE were encountered when reprocessing was switched to gas sterilisation with Ethylene Oxide. Andersen is the first company in the world to achieve FDA registration for an Ethylene Oxide sterilizer that uses a flexible sterilization chamber. The Andersen Series 4 sterilizer, as pictured. The sterilization cycle runs at 50°C with a three hour cycle and uses just 17.6g of EtO and does not require the use of deep vacuum or steam injection. An optional abator is available, that will remove in excess of 99.9% of the EtO. Flexible chamber technology has established itself in the low volume, low temperature sterilization market.

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Infection Prevention

Inexpensive measures to reduce the risk of HCAIs It is only by staff, patients and visitors working together that healthcare environments can win the fight to reduce Healthcare Associated Infections, says Veronica Johnson Roffey result in the development of resistance such as meticillin-resistant Staphylococcus aureus (MRSA) making treatment with common antibiotics difficult. The increase in patients with chronic illnesses, such as diabetes, heart and kidney problems, and the increase in the elderly population are also contributing factors that predispose

patients to infections. Infection preventionÂ andÂ control measures, such as appropriate hand hygiene, environmental cleanliness, basic precautions during invasive procedures, and education of staff, patients and visitors, are simple and inexpensive measures to help reduce the risk of HCAIs.

Infectio preven n and contion tr measur es are sol imple and in measurexpensive e reduce s to help the of HCA risk Is

How infections are spread When healthcare staff are educated about the ways E

Written by Veronica Johnson Roffey, Infection Prevention and Control Commissioning Nurse at Warwickshire North CCG

Healthcare Associated Infections (HCAIs) can occur following direct contact within healthcare settings or following surgery. These infections, the majority of which are preventable, can cause significant harm to those affected, increase hospital stay and put added pressure on the NHS. There are many reasons a patient may develop a HCAI, including weakened immune defences due to treatment for cancer or leukaemia, complex surgical operations, insertion of medical devices such as catheters, or the over-use of antibiotics. The latter can

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 infections are spread it helps them to decide what preventative measures they need to take and they are better placed to inform patients. Spread of infection requires three elements. The first is an infectious agent – a bacteria, virus, fungi or protozoa. The source may be the patients’ own flora, other patients, staff or visitors, or contaminated equipment. The second element is a susceptible host –someone prone to infections because of an underlying disease, surgical procedures or indwelling devices, and the final factor is a means of transmission. There are four main routes of infection transmission: Contact transmission (direct or indirect): Direct body surface to body surface contact and physical transfer of microorganism between an infected or colonised (carrier) person to another or from one site to another in the same individual. Indirect: contact between a person and contaminated surface or object. Airborne/droplet transmission: Droplet transmission – large droplets produced during coughing, sneezing, talking and suctioning generate droplets that land on surfaces which when touched can contaminate hands. Airborne transmission – smaller micro‑organisms, contaminated water particles or airborne dust particles containing the infectious agent are dispersed by air currents then inhaled or deposited onto horizontal surfaces, equipment etc. Food and water (Faecal–oral) transmission: Organisms can be transmitted via the food we eat and handle e.g. Campylobacter on raw chicken, by inappropriate handling of contaminated raw food or inadequate cooking. Cross-infection can occur via contaminated surfaces or infected food handlers if their hands are not cleaned after using the toilet. Water provides an ideal breeding ground for some micro- organisms, which can then be ingested, or as in Legionella, inhaled. Vector borne transmission: These are infections transmitted by, flies, mosquitoes, and rats, and is rare in the UK. Hand hygiene Hand hygiene is the single most important measure in reducing the risk of transmission of micro-organisms from one person to another or from one site to another on the same person. The World Health Organisation advises that cleaning hands promptly and as thoroughly as possible between patient contacts and after contact with blood, body fluids, secretions, excretions and contaminated equipment, is essential in order to minimise the risk of cross-infection in healthcare. The Infection Prevention Society advises

that effective hand hygiene involves the use of soap and water or alcohol hand rub. Liquid soap and warm running water can be used to mechanically remove transient micro-organisms from the hands and is perfectly acceptable for the vast majority of healthcare interventions. An alcohol‑based product can be used for general hand hygiene in place of a hand-wash but only if hands are visibly clean. Alcohol rub, soap, water and paper towels must be available to encourage hand hygiene, and sinks for handwashing should be used for only that and not washing tea cups, dentures etc. A poster demonstrating the correct hand wash/rub techniques should be displayed at each clinical hand wash basin and a poster encouraging hand washing should be displayed in all patient and visitor toilets. When building or refurbishing any health care environment provision of proper handwashing facilities must be a priority, therefore the Infection Prevention and Control Nurse (IPCN) should be involved at planning stage. Environmental cleanliness in healthcare Contaminated healthcare surfaces play a huge role in the transmission of dangerous pathogens, including Clostridium difficile and MRSA. These pathogens are capable of prolonged survival on surfaces, therefore appropriate cleaning of those surfaces and equipment which patients and healthcare staff touch, is necessary to reduce transmission. Frequently touched surfaces, such as taps, door handles and light switches are more likely to harbour and transmit micro-organisms, so it’s important to ensure these surfaces are cleaned frequently in line with specifications for cleanliness in the NHS (England only, 2007). Public perception is very important and if the environment in which patients or their relatives are cared for appears unclean, it can lead to the perception that care is equally bad. Patients and preventing HCAIs While it is commonly perceived that HCAIs are attributable to healthcare staff, it is worth remembering that patients and their visitors also contribute. There are some simple things that patients and visitors should be encouraged to do in the fight to prevent transmission of infections. Patients can: wash hands after using the toilet and before meals; cover mouth and nose with tissue when sneezing or coughing, bin the tissue and wash hands; if socialising at another patient’s bed space, clean hands afterwards; ask staff if they have washed their hands and/or changed their gloves before doing your care; wash/

As part of Hand Hygiene Awareness Week, University Hospital Southampton has revealed that infection rates have plummeted as a result of the hospital’s good hand hygiene education.

Infection Prevention

Hand hygiene is the single most important measure in reducing the risk of transmission of micro-organisms from one person to another or from one site to another on the same person

Southampton leading the way in infection control

Keeping your hands clean is the simplest and most effective way to prevent the spread of illness, and educating staff and patients of the simplicity and effectiveness of it has led to a dramatic decrease on serious infections on site. In 2005/6 there were 92 cases of MRSA bloodstream infection contracted at University Hospital Southampton, compared to the two that were recorded in the last year. Additionally, rates of C-difficile infection have dropped with 741 cases confirmed in 2005/6 falling to 34 cases in 2017/18. As part of the national hand hygiene initiative, a team of University Hospital Southampton staff have been talking to patients and staff about how important it is to keep your hands clean, distributing hand hygiene goodies in the process. Dr Graeme Jones, Southampton’s lead consultant in infection prevention and control, said: “It is so simple but easy to forget so our job is to raise awareness and make it easy and accessible for people to adopt good hand hygiene. That means having visible reminders and hand gel dispensers at strategic points alongside regular awareness events like this one.” FURTHER INFORMATION tinyurl.com/y8nvxdm2 shower daily using own toiletries; keep locker and table top tidy and free from clutter to help with cleaning; do not interfere with drips, drains or dressings; and report any concerns about cleanliness or care standard. Additionally, visitors can: use the hand sanitiser when entering and leaving the hospital ward or department; not visit if you are unwell especially with colds/flu or stomach upsets; avoid bringing very young children to visit; no not bring in fresh flowers or plants; speak to staff before bringing food into the hospital; and report any concerns about cleanliness or patient care. It is only by staff, patients and visitors working together to do their bit that we will win the fight to reduce HCAIs. L FURTHER INFORMATION www.warwickshirenorthccg.nhs.uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Bringing sepsis out of the shadows Sepsis, the body’s overactive and toxic response to an infection, is life-threatening and reported to affect more than 30 million people worldwide every year, yet it is a relatively unknown issue. Chris Wakefield, vice president, European Marketing and Product Development, GOJO Industries-Europe Ltd, looks at what the healthcare industry can do to help tackle it Sepsis is a rare but serious complication of an infection and without quick treatment, it can lead to multiple organ failure and death. The World Health Organization (WHO) has prioritised addressing sepsis through increased awareness and strengthened preventative measures. The WHO’s response to sepsis spans a range of programmes, including efforts to tackle healthcare associated infections (HCAIs) as well as global neonatal, paediatric and maternal mortality and epidemic-prone infections. The WHO also has an annual global campaign called ‘Save Lives: Clean Your Hands’, which aims to highlight the importance of hand hygiene in healthcare. The 2018 focus for this initiative is ‘It’s in your hands – prevent sepsis in healthcare’. A hidden, but serious, threat to public health In the UK alone, sepsis is believed to be the cause of around 44,000 deaths every year. That’s a greater number than bowel, breast and prostate cancer combined. This serious threat to public health therefore requires concerted action, especially from the healthcare industry. The hands of healthcare workers, patients and visitors are on the front line in the fight against the spread of infection in hospitals, clinics and other health-related environments. As a member of the Private Organizations for Patient Safety group, we are a strong supporter of the annual ‘Save Lives: Clean Your Hands’ campaign and urge the healthcare industry to use it as a launch point to take all possible actions to reduce the risk of sepsis. Hand

hygiene compliance is a cornerstone of this effort, helping to break the chain of infection. Making hand hygiene second nature Hand hygiene should be second nature to everyone in a healthcare setting and we advocate taking a holistic approach to make this happen. This means everyone understanding the importance of hand hygiene and having the right products available in the right place, at the right time, to carry it out. Ensuring appropriate signage and correctly positioning hand washing, and sanitising solutions in healthcare settings, should be a priority for all healthcare and hospital facilities managers. For example, putting notices and posters up in key germ hotspots, including washrooms and waiting areas, is fundamental to improving hand hygiene behaviours. Good hand hygiene companies will offer sound advice on the most effective approaches, and provide support materials, based on their knowledge and market insight. Fit the best To ensure people can put their healthy hand hygiene behaviour knowledge into practice, having the right systems is crucial. The most successful will combine good aesthetics, accessibility and ease of use, whilst being equipped with pleasant and effective hygienically advanced formulations. It is particularly vital that there are adequate, appropriately positioned, hand hygiene facilities at the point of care. Hand hygiene products (for example, alcohol-based hand rubs, if available) should be easily accessible

and as close as possible; ideally within arm’s reach of where patient care or treatment is taking place. Importantly, point-of-care products should be accessible without having to leave the patient zone. Innovative technology also helps. Touch-free dispensers are popular as they sense the presence of hands and dispense just the right amount of product every time. The fact that they are touch-free also increases their hygiene rating. Independent scientific testing The efficacy of soap and sanitiser formulations being dispensed is also central to the issue. Suppliers should be able to prove the effectiveness of their soaps or sanitisers against germs through independent scientific testing. Formulations that have been tested and passed in accordance with key hospital norms EN 1500, EN 14476 and EN 12791, provide assurance that they are safe for use in healthcare locations. This hospital-grade product efficacy is only part of the solution. A wide range of hand washing and sanitising options, which are kind to healthcare workers’ skin, located throughout a healthcare facility can help boost hand hygiene behaviours. An additional issue to consider is that bulk soaps can become contaminated, undoing all the good work of healthcare professionals and hand hygiene campaigns. Factory-sealed refills for soaps and sanitisers are protected from contamination as they are sealed at the point of manufacture. This means that the soap or sanitiser is never open to the environment and so cross contamination from the air or other sources is prevented. Bringing it all together Healthcare-associated infection prevention and control isn’t down to one person or product; it’s everyone’s challenge. The effective prevention of problems such as sepsis requires education, and awareness of good hand hygiene behaviour and its consequences for patient protection. From dispenser design to formulation efficacy and compliance with good hand hygiene practices, a holistic approach to hand hygiene can bring real clinical benefits and help improve hygiene in hospitals and other healthcare settings. L FURTHER INFORMATION http://www.who.int/infection-prevention/ campaigns/clean-hands/en/

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Infection Prevention 11th ANNUAL CONFERENCE

SUNDAY 30th SEPTEMBER – TUESDAY 2nd OCTOBER Scottish Event Campus Glasgow, United Kingdom Join the Infection Prevention Society for our annual conference, Infection Prevention 2018, the premier event for all those involved in infection prevention and control. The three-day conference will welcome many world leading experts to impart their knowledge and share what they are doing to tackle current issues relating to infection prevention and control.

Professor Wing Hong Seto

Dr Ron Daniels

Professor Jennie Wilson

Professor Shaheen Mehtar

Professor Andreas Voss

Highlights to include: • Innovative programme including dedicated one-day conferences on Infection Prevention in Care and at Home and Infection Prevention and Antimicrobial Resistance • E.M. Cottrell Lecture to be presented by Professor Jennie Wilson and the Ayliffe Lecture by Professor Shaheen Mehtar • The largest UK infection prevention exhibition • Infection Prevention Show – New for 2018 • Networking opportunities with like-minded colleagues • Invitation to submit your research at conference as an oral presentation or poster • Full social programme including: A Sunday Fun-Night, Annual Awards Ceremony and A Gala Dinner

If you are a healthcare professional with an interest in any aspect of infection control then you will benefit from attending this conference.

Online registration is available at

www.ips.uk.net/conference

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Infection Prevention

Infection prevention and antimicrobial resistance Taking place in Glasgow at the end of September, the 2018 iteration of the Infection Prevention Society Conference will examine, debate and seek solutions to the latest current and emerging threats in infection prevention

work providing services Dr Phil will for people in care and those d n receiving care at home. Hammo platform a The programme will focus e provid wcase the on achieving excellence in infection prevention to sho novative n i practice to reduce the t s n e o t i a t l n e v e risk of infections for this r p n vulnerable population. infectioologies and Infection prevention is techn ducts high on the agenda for pro every healthcare organisation

At this IPS Conference leading experts in their field will present on the latest current and emerging threats and state-of-theart research to help improve your team, your practice and your patients’ outcomes. There will be a comprehensive series of presentations, meet-the-expert sessions and specialist streams of: wound care, paediatric care, mental health, audit/surveillance and international engagement. Also, there will be one-day conferences dedicated to Infection Prevention in Care and at Home and for the first time Infection Prevention and Antimicrobial Resistance. (Delegates attending the main conferences will also enable entry to these specialist days). Your Scientific Programme Committee (SPC) has prepared this conference in furtherance of the IPS Mission Statement: No patient is harmed by a preventable infection. Secondly, the programme has direct relevance to your practice; you will have learning opportunities that will motivate and inspire you to consider how your local infection prevention and control programmes could be modified to improve care and reduce infection risks. Finally, the conference is designed with you in mind. All presentations are mapped against the IPS competences to facilitate your personalised‑development and career progression. In Care and at Home The Infection Prevention in Care and at Home conference is tailored for those who

and finding expert affordable training for you and your team can be problematic. However, the Infection Prevention Society is offering this study day which will discuss some of the 21st century challenges we face in care homes and care at home looking at the latest evidence and applications for practice. This day is relevant for all staff and in particular those senior staff with the accountability for infection prevention within the organisation. Furthermore, the Infection Prevention and Antimicrobial Resistance conference will take an in-depth look at infection prevention and antimicrobial resistance by applying a coordinated, collaborative, multidisciplinary and cross-sectoral approach to address potential or existing risks from the perspectives of environment, animal and human. The programme includes a wide range of scientific and national strategies regarding antimicrobial resistance. The IPS annual conference showcases the largest infection prevention exhibition in the UK. The IPS exhibition hall is dedicated to infection prevention, showcasing innovative products and services from about 100 companies. Attendees enjoy exclusive exhibition hours each day to learn about new science, technologies,

advances, and products that provide solutions to infection prevention challenges and strengthen infection prevention programs. New to Infection Prevention 2018 Thought-provokingly and in a departure from previous years, the event will present the first ever Infection Prevention Show. Hosted by Dr Phil Hammond – NHS doctor, BBC broadcaster, Private Eye journalist and comedian, this exciting event will allow the audience to discuss the challenges we are increasingly facing in a financially challenging time and provide a platform to showcase the latest innovative infection prevention technologies and products. Commercial organisations are crucial to the health of the IPS and we embarked upon a corporate affairs programme which seeks to ensure that they get great value for their continued support. Such value usually comes in the forms of having mutually collaborative opportunities to present to IPS members on their technologies, forming personal relations with opinion leaders and decisions makers and keeping live intelligence systems into the NHS to determine how best to frame and focus their sales activities. This exciting event on the 1 October will provide a platform for showcasing the latest innovational technologies and products. The audience will be able to interact with experts and personalities whilst learning of the exciting possibilities offered by these latest innovations. The Infection Prevention Show will be open from 10:00am to 4:30pm but will form part of the main conference between 10:30am – 1:00pm. L FURTHER INFORMATION www.ips.uk.net

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

25 per cent of NHS trusts have strategy to reduce outpatient waiting times Most NHS trusts are failing to monitor the amount of time patients spend waiting for appointments, and two thirds do not have targets for patient wait times The latest research from patient journey management expert Qmatic has revealed that a significant majority of NHS trusts are failing to implement a comprehensive outpatient journey management strategy, and monitor outpatient waiting times. The data has emerged following a Freedom of Information request sent to 80 NHS foundation trusts to gather information on the strategies and technologies that these organisations have implemented to reduce waiting times, welcome and guide patients through healthcare facilities, and how they are measuring the success of these deployments. The key findings of the report see that just 25 per cent of respondents have a strategy in place to reduce outpatient waiting times and there is currently low adoption of patient journey management technology, with just 21 per cent of trusts using selfservice kiosks, and 14 per cent using queue management displays. In terms of performance measurement, of the 32 per cent of respondents who provided data on their waiting times, the majority reported that they aimed to see outpatients within 30 minutes. This means that the vast majority of NHS trusts are not monitoring their performance against those targets, with just 12 per cent reporting their success in meeting targets. Reducing stress in healthcare facilities Analysing the findings, Vanessa Walmsley, managing director at Qmatic UK, said: “We all know that attending an appointment at the hospital can be a stressful experience. The last thing that patients want is a confusing

experience to the right place, followed by a long wait to be seen by the appropriate clinician. We have seen from our research that not only do most NHS trusts not have an effective strategy in place to ensure that people attending outpatient appointments have as short a wait as possible, many do not even monitor how long people are waiting for outpatient appointments. “While we found that 32 per cent of trusts reported having waiting time targets, which is the first step towards developing a strategy to reduce outpatient waiting times, just 12 per cent of trusts were able to report their success in meeting these targets. The NHS is under significant budgetary pressure but it has a responsibility to its patients to provide the best possible healthcare including the overall patient experience, and this starts with developing a strategy to manage the patient journey.” What is an effective patient journey management strategy? An effective patient journey management strategy starts before the patient has even reached the hospital. NHS trusts need to look to integrate technology into their appointment scheduling, allowing patients to book appointments online, delivering reminders to patients via SMS and enabling them to cancel appointments online, to reduce the incidence and impact of missed appointments. On arrival, patients should have the option to check in to the hospital in the way they find easiest, whether that is using a smartphone check in system, a self-serve kiosk or in‑person by a mobile enabled member

of staff or reception point to notify staff of their arrival. They should also have the option to leave feedback on their experience after their visit, via their mobile device, which can then be analysed by the hospital. Vanessa concludes: “Healthcare authorities must also consider that patients may have to visit multiple reception areas during a single appointment and make this experience of transitioning from one to another as seamless as possible. A seamless patient journey can make a huge contribution to the comfort which patients experience when they arrive at a hospital, potentially improving outcomes and reducing stress.” Improving the patient experience Qmatic provide a platform called Orchestra which is a modular, scalable and world-class platform for patient journey management where you only pay for the value you need. Orchestra enables you to offer online appointment booking and self-serve check-in, patient and staff notifications, real-time BI dashboards and reporting, digital displays with waiting time information, voice announcements, patient apps and integrates with other systems and existing infrastructure. Waiting for appointments virtually via mobile devices Qmatic’s new Mobile Ticket enables you to significantly improve the experience of patients by enabling them to use their mobile device to select a service and join a virtual queue, giving them all the information they need about their appointment and ensuring that they are guided to the right place within the healthcare facility. Patients can simply open a web app, or scan a QR code if they prefer, and receive all the details they need regarding their appointment. This eliminates the friction of patients having to wait in line to see a receptionist and gives them information about where to go and which clinician to see, efficiently guiding patients to the right place and ensuring that they are fully informed about the status of their appointment. To download the full report, visit www.qmatic.com/healthreport. L FURTHER INFORMATION Tel: 012 3475 7110 Info.uk@qmatic.com www.qmatic.com/uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Living with Type 1 or Type 2 diabetes is not easy. Managing the condition well requires vigilance, and 365-day-a-year management that can, in many cases, take a heavy toll on the physical and mental health and well-being of not only the person living with the condition, but also their families and those close to them. However, technologies designed to help manage the condition exist and, for those who are able to access them, they are making a significant difference to the lives of people living with diabetes. We know that technologies such as insulin pumps, continuous glucose monitors (CGM) and flash glucose monitoring (Flash GM) help people with Type 1 diabetes better manage their blood glucose, improving their quality of life overall and, equally important, reducing short‑term and long‑term complications. Despite these clear benefits, the fact is that

for too many people living with diabetes across the UK, access to these life-changing technologies remains a real issue, and variation in access means that people’s clinical needs are not being met, despite the obvious benefits that these technologies could have. The NICE guidance for CGM and pumps is clear, but we know that many people, both children and adults, who meet this guidance are, for many reasons, still not able to take advantage of technology that would make managing their condition easier. Equally, despite being approved for prescription on the NHS late last year, many thousands of people who’d benefit from access to Flash GM are still either having to self-fund – at considerable personal cost – or simply go without.

For t many p oo living w eople across t ith diabetes to thes he UK, acces e life s techno -changing remain logies s a re issue al

An expensive condition A large reason for this is cost. Diabetes is an expensive condition to treat; £10 billion a year is currently spent on diabetes, which

represents around 10 per cent of the entire NHS budget. For newer technologies like Flash GM, dozens of Clinical Commissioning Groups (CCGs) across England have decided they cannot afford to make it available because they simply cannot afford to do so. The irony is that a significant chunk of this spend goes towards the treatment and management of the complications of diabetes that these technologies can actually help to prevent. Both the long and short term complications of diabetes are incredibly serious. In the short term this can mean extended periods of severe hypoglycaemia – and hyperglycaemia which can lead to hospital admission, missed days at work and loss of productivity. In the long term, however, the complications can be deadly; poor management of the condition can lead to heart disease, renal failure, amputations, blindness and even death. In addition to fears concerning cost, the other reason for lack of, and variation in, access is awareness among clinicians about the benefits these technologies can have on both the daily quality of life, and the reduced risk of complications. Frustratingly, E

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Written by Nikki Joule, policy manager, Diabetes UK

Diabetes UK is encouraging the use of technology to improve diabetes management and save the NHS vital funds. Here, Nikki Joule puts the available technologies into context, explaining not only why they are important for helping people living with diabetes manage their condition, but also why decision makers should recognise the very real difference they can make to the NHS

Diabetes

Making life-saving technologies more accessible

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www.dexcom.com/littlethings *For a list of compatible smart devices, please visit www.dexcom.com/compatibility. †Dexcom refers to Dexcom G5® Mobile CGM System. ‡Internet connectivity required for data sharing. Following requires the use of the Follow App. Followers should always confirm readings on the Dexcom G5 Mobile App or Receiver before making treatment decisions. §If your glucose alerts and readings do not match your symptoms or expectations or you are taking medications containing paracetamol/acetaminophen, you should perform a finger prick to confirm your blood glucose level. A finger prick is needed every 12 hours to calibrate. © 2018 Dexcom UK & Ireland. Dexcom UK (Distribution) Limited, Watchmoor Park, Camberley, GU15 3YL (10040080). VAT 241 2390 40. LBL015328 Rev001.

Diabetes

 in other parts of Europe, we’re seeing far more enthusiasm for these technologies, and far less variation in access. In Germany we know there are significantly more people using pumps and CGM technology, while in France, for example, we also know that there is notably broader access to Flash GM. Diabetes technology To challenge this, Diabetes UK is working with NHS England, diabetes patient organisations JDRF and INPUT, and diabetes specialists to develop a diabetes technology pathway. This new consensus guidance, to be published later this year, will help inform clinicians about the use of technologies in the management of Type 1 diabetes, and will in turn help them consider these technologies when designing treatment and management support for people living with the condition. Specifically in relation to Flash GM, in September of last year we published a consensus statement in partnership with JDRF, the Primary Care Diabetes Society, INPUT, the diabetes inpatient specialist nurses (DISN) group and the Association

A reason for the lack of, and variation in, access is awareness among clinicians about the benefits these technologies can have on both the daily quality of life, and the reduced risk of complications of British Clinical Diabetologists. In it, we outline our recommendations for the use of Flash GM, outlining the clinical evidence, what it offers to people with diabetes in terms of managing their condition, and the role healthcare professionals, and service funders and providers, can play in making this technology available. Diabetes UK believes everyone with diabetes should have access to the right technology to support them, not just those who can afford it. That’s why we campaigned Flash Glucose Monitoring to be free on the NHS. However, nearly six months on, access to this life-changing technology is still very much a pipe dream for many thousands of

people, while CCGs and health boards decide whether to fund Flash GM in their areas. Ultimately, it is up to local health decision makers to create local policies so people can access these technologies. But Diabetes UK will continue campaigning, and raising awareness among healthcare professionals, decision makers and budget holders; the very clear benefits not only to the health and well‑being of people living with diabetes, but also to the NHS budget, cannot be ignored. L FURTHER INFORMATION www.diabetes.org.uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Health & Safety Written by Karen McDonnell, occupational safety and health policy adviser for RoSPA

Creating safe working environments

Slips, trips and falls at work are collectively the single most common cause of injury in UK workplaces. RoSPA’s Karen McDonnell looks at how good management of health and safety can ward against such injuries Slips, trips and falls are a major issue in the health and safety industry, both in the workplace and in day-to-day life. According to Health and Safety England (HSE), there were around 5.5 million working days lost in 2016/17, with falls making up a significant

amount of that total. Within that time, there were 40 falls from height that resulted in a fatal injury, and 111,000 non-fatal reported slips, trips, or falls on the same level. Slips, trips and falls are collectively the single most common cause of injury in UK

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

workplaces, which is cause for employers to ensure they are creating the safest possible environments for their employees. This proves a challenging task when the ageing workforce has significantly risen in recent years. In the over-65s there are around 255,000 falls-related emergency hospital admissions in England alone every year, and in 2015 more than 4,500 people in England in this age bracket died as a result of a fall. RoSPA aims to promote a ‘whole life’ approach to safety, seeking to assure freedom from serious accidental injury from early years and throughout life. Good management of health and safety by organisations can help to support safety across all stages of life, not least by being an arena in which people learn about the importance of recognising hazards, assessing risks, and choosing the right preventive/protective measures to stay safe. A particular organisation that requires additional safety measures for falls due to the high risk levels of hazards is hospitals. Hospitals cater for thousands of people of different circumstances on a

daily basis, which means a more intense approach to safety should be taken. A health and safety culture Falls represent a significant problem in hospitals. Efforts to improve fall prevention require a system approach that achieves organisational change through modifications to workflow, communication, and decision making. This type of organisational change can be difficult to achieve, but can be done through following basic principles, implementing schemes, and changing the culture of health and safety within the workplace. There are certain basic principles that, if implemented effectively, enable

organisations to achieve the absence of risk. Hospitals should have a system in place to manage health and safety, in which they plan, organise, control, monitor and review all preventative measures. Main hazards should be identified and risks assessed to ensure the risk control measures are sufficient. These measures, however, will only be used and maintained if employees are informed, trained and supervised. In order to maintain a healthy and safe workplace certain things should be checked regularly, like: consulting your workforce; conducting regular health and safety checks; reporting, recording and investigating accidents and near‑misses; and providing employees and others with certain basic information.

Slip trips an s, are coll d falls single m ectively the cause o ost common workpl f injury in U ac K 255,00 e, with aroun emerge0 falls-related d ncy admissi hospital every y ons ear

Health & Safety

It is also beneficial for employers and employees to make sure suitable first aid and welfare facilities are provided, and employers’ liability insurance. Time should be made periodically to review performance and then feedback any lessons learned to improve controls. A risk assessment will help you identify the slip and trip hazards that exist in your workplace and their potential for causing people to slip or trip. Through this assessment, employers should have some ideas of how to prevent these accidents. While risk assessments provide the opportunity to identify risks and solutions, you cannot eliminate all risks. It is essential that organisations implement control measures that are proportionate to the risk in question, and a good approach to health and safety balances control measures sensibly against other needs. With hospitals, the added factor of patients makes for a challenging task for creating a healthy and safe environment for the thousands of people that are in and out of them every day. The most significant factors of patients falling in a hospital are: walking unsteadily; confusion; being incontinent or needing to use the toilet frequently; a history of falling; and taking sedatives or sleeping tablets. Small tasks such as good housekeeping can offer much protection in the way of falls. Keeping walkways clear from clutter, removing or tying trailing wires, and immediately mopping up spillages are some simple responsibilities that should become a habit for employers and employees in the workplace, and could prevent accidents, especially for hospital patients that you know are vulnerable. Stand Up, Stay Up While there are simple steps you can follow to ensure you are creating a safe work environment, there are also schemes that can be implemented in the workplace and in everyday life. RoSPA offers a programme funded by the Department of Health, called Stand Up, Stay Up, which aims to unite a network of health professionals and falls prevention practitioners to share best practice, knowledge and advice. Stand Up, Stay Up is a scheme that contributes to the fight against fall injuries, by learning from one another and being hands on with finding the root cause of falls, so as to find the solutions. Safe and healthy working is the foundation upon which organisations’ are built – not just because of it being morally correct, but because it is the most cost‑effective and efficient. It is often missed, just how much employers lose out on due to safety failures, and so prioritising a healthy and safe working environment can only prove beneficial. L FURTHER INFORMATION www.rospa.com/home-safety/ stand-up-stay-up

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Hiring talent – selecting, securing and retaining in‑house expertise Hiring talent presents various obstacles to any organisation, and it’s a time-intensive process regardless of industry. The healthcare sector, however, faces unique challenges when it comes to selecting, securing and retaining in-house expertise The Doom/Gloom BMA stats released in Q1 of 2018 show that junior doctor applications are down for another consecutive year, and only half of those completing foundation training in 2016 went on to continue training within the NHS. This is the lowest stoop in a steady five year slide from 71 per cent in 2011 and it’s a trend which, in spite of several hotly-debated revival strategies from NHS England, has not enjoyed any tangible signs of improvement. The scene is not dissimilar in nursing, suffering a 30 per cent slide in training applications following the removal of the nurses and midwives’ bursary last year. Stories of care homes closing due to an inability to secure qualified staff are commonplace. The Boom Whilst deflating, these statistics only confirm the anecdotal hubbub that those who have been operating a business in the health and social care sectors have been privy to over the past few years. This trend is not new. So why are we discussing something we all know already? Because despite enduring the same severe pressures on the healthcare workforce talent pool as the rest of us, more than a few healthcare businesses have enjoyed rapid growth and stable success over the same time-period. ‘Remote’ providers in the primary care sector have enjoyed impressive growth in the last two-three years. Perhaps the most notorious, Babylon Health has secured pilots to deliver 111 triage through its app-based software and reports to have already processed over 250,000 patients by this time last year. In more ‘traditional’ primary care, the last two-three years have seen the rapid ascension of several entrepreneurial GP federations and healthcare alliances – a lucrative response by the more commercially-minded practices, GP partners and health executives keen to scoop up myriad contracts issued by NHS England for delivering all variety of services. These groups generally require high volumes of clinicians across multiple disciplines/sub-specialities. High-quality workforce planning alone has not been the making of these success stories. Savvy contract-bidding, tech-awareness and stable management are key factors. However, there are obvious links between profitability

and growth and an organisation’s approach to its recruitment process. Bid‑writers and managers are well-selected ingredients in this recipe for wider success. So, what are those businesses making lemonade doing differently when it comes to their workforce planning? Permanent versus temporary 33 per cent of NHS expenditure on nonpermanent staff is spent on medical locums, with approximately £1.1 billion per year paid to locum clinicians. Permanent workforces are inarguably conducive to your sustainable growth, team satisfaction and patient experience. The introduction of perplexing IR35 legislation in 2017 handed a terrific advantage to healthcare businesses seeking to reduce their locum dependency, by closing down options for expensive Locum clinical staff to charge higher rates than their substantive counterparts. This change, combined with 2016/17’s Monitor rate framework for trusts has tightened the gap in earning potential between temporary and permanent clinical staff to a level not seen in years. There hasn’t been a better time for healthcare businesses to ‘meet in the middle’ – offering some flexibility on salaried/substantive remuneration and packages is an approach on which more progressive providers are capitalising heavily. For example, offering a GP a salary of £10-11k per session plus benefits might seem high. However this is invariably cheaper than their locum equivalent, with all of the discussed benefits of a permanent hire. Predominantly because the earning gap has been closed, talented clinicians are considerably more open to taking a realistic permanent package in favour of security; not to mention peace of mind when it comes to the revenue. Innovative packages As well as offering realistic remuneration, successful Providers find innovative ways to stand out from their workforce-starved competitors. Investing in clinicians’ development is a double-edged sword; for example, offering paid CDP or courses as part of a package is a sure-fire way to attract those clinicians who are serious about developing their skills. These schemes in turn engender loyalty amongst the staff you really want to keep.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Sourcing smart Where health businesses advertise their vacancies can make all the difference, both from quality and cost-efficiency standpoints. Many fast-growing providers steer clear of major job boards and channels in favour of more contemporary approaches. When using paid job boards (there are some household name websites which are for some the only go-to channel) extreme caution needs to be taken. Many of these publications are awash with locum/temp agencies, which buy your candidate’s CV from the publication. So, if you get a response at all (not guaranteed despite hefty up-front fees), the chances are your new hire will have had their CV sold to agencies or even your competition, annihilating your retention. New talent pools Whilst we are seeing an exodus of healthcare professionals leaving for Dubai, Canada and the like, there are literally hundreds of thousands of qualified, committed prospects in Europe and beyond. Shrewd employers unable to fill posts are registering for Visa Sponsorship permits. Their reward comes in the form of dedicated permanent staff, often with drastically lower remuneration expectations than their British colleagues. 15 per cent of all UK jobs advertised overseas in 2017 were in healthcare. This confirms International recruitment as a substantial and viable solution to the UK’s shortages. Openminded providers large and small are already reaping the benefits. The industry as a whole is facing contemporary workforce challenges, but those healthcare businesses willing to embrace novel recruitment strategies, and utilise legislative and societal developments to their advantage when building their workforce are able to not just survive – but thrive. L FURTHER INFORMATION Tel: 0203 744 9434 www.medmatch.co.uk

The problems facing the NHS never seem to go away. A lack of funding, cancelled operations, the annual ‘winter crisis’ and questions about the viability of delivering a true seven-day service are ever-present. But arguably the most significant issue underpinning these challenges is the skills and recruitment crisis. It has now been almost two years since the UK voted to leave the European Union, and we need to consider the serious implications for the NHS and the wider social care workforce. So what does Brexit mean for them? Brexit means less money Even if the Brexit referendum had not happened, the NHS would still have faced increasing demand, predominantly due to a growing and ageing population. The Office for Budget Responsibility (OBR) recently projected that NHS spending

would need to increase by 5.3 per cent of national income over the next 50 years in order to meet demand for its services. However, leaving the European Union may mean less money for public services in general, and with the lower economic growth and continued poor productivity predicted with Brexit, this will mean less money for medicines, new health technologies and investment in staff. There is also a risk that the UK could become a lower priority market when it comes to the launch of new drugs, meaning the UK could fall behind European competitors, with patients not getting access to the latest treatments and trials. Brexit means fewer staff The NHS and the wider

social care sector face the triple challenge of retaining the skilled staff it already has, filling immediate vacancies and attracting sufficient numbers to fill projected vacancies. The NHS has never been able to produce enough doctors and nurses from within the UK. The health and care sector has had to rely upon the skills of European staff for decades. The latest Office for National Statistics data shows that approximately 200,000 EU27 nationals work in the wider health and care sectors – about five per cent of the total workforce. The percentage in London and the South East is considerably higher. A UK in a Changing Europe report found that around 28,000 doctors are non-UK nationals, around a quarter of the total. E

The UK s to need simply re staff of o train m , and work its own r to retain harde e-train and r f that f the sta as it h

Written by Neal Suchak, policy advisor, the Recruitment & Employment Confederation

NHS recruitment has been back in the spotlight after the government’s controversial decision to refuse foreign doctors visas. Neal Suchak, from the Recruitment & Employment Confederation, analyses the workforce challenges facing the NHS post-Brexit

Recruitment

The NHS workforce: challenges post-Brexit

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Recruitment

 NHS England alone depends on around 11,000 doctors from the EU, which amount to about 10 per cent of all doctors, with a further 20,000 nurses and around 100,000 social care staff coming from EU countries. Prior to the 2017 election, the government promised to ‘make it a priority’ during the Brexit negotiations to ensure that ‘staff from EU countries can carry on making their vital contribution to our health and care system’. However, the Joint Report by the European Commission published in December shows that Article 50 only outlines provided protection for staff already in jobs, and not those who might be employed in future. Unless NHS and other healthcare workers are given a special category, they could be caught up in wider measures designed to limit immigration. The uncertainty posed by Brexit is already starting to affect staffing levels. According to a 2017 British Medical Association (BMA) survey of EEA doctors working in the UK, 45 per cent said they were considering leaving the UK, with 18 per cent having already made plans to leave. The Royal College of Nursing (RCN) reported a 92 per cent drop in registrations of nurses from the EU27 in England in March 2017, and attributed this, at least in part, to the failure of the government to provide EU nationals with any security about their future. Brexit means we need to plan now The UK simply needs to train more staff of its own, and work harder to retain and re-train the staff that it has. However, self‑sufficiency from training UK healthcare staff could take ‘somewhere in the region of 10 or 12 years’ according to Ian Cumming, the chief executive of Health Education England, quoted in the Health Committee’s 2017 report into Brexit and health and social care. There are some positive and encouraging signs. The NHS is about to celebrate its 70th birthday this summer, and to coincide with this, a major consultation has been undertaken to look into its workforce strategy – the first in over 20 years. In addition, Theresa

The NHS and the wider social care sector face the triple challenge of retaining the skilled staff it already has, filling immediate vacancies and attracting sufficient numbers to fill projected vacancies May is planning to invest billions of extra pounds a year into health spending as part of a ‘birthday present’. This is expected to lead to up to £4 billion extra annually for the health service over the next 10 years and a special NHS tax is ‘still on the table’. In addition, the NHS has already invited bids for a £100 million contract to recruit overseas doctors into general practice. Many of these measures are a real step in the right direction to ensure that the NHS and wider social care system is sustainable in the long-term. However, we still need to address the immediate problems. Brexit means we need agency staff No matter how good the NHS’s workforce planning is, there will always be gaps in rotas. The REC’s monthly Report on Jobs consistently shows that nursing, medical and care employees are the most in‑demand type of short-term staff. Agency staff have provided a vital life-line to the NHS for decades and continue to provide the NHS with the extra support that it needs in times of increased demand, and are vital in ensuring patient safety. The REC’s research with the National Institute of Economic and Social Research (NIESR) found that agency staff have skills on a par with substantive staff, often with many years’ experience working in the NHS. It is essential that these staff are recognised for their professionalism and contribution, are treated fairly, are valued and are made to feel part of the NHS family. Recruiters are experts in workforce planning,

and those working in the health sector see first-hand the shortages that the NHS has to contend with on a daily basis. Recruiters are perfectly placed to identify where problems lie, and are able to offer immediate solutions. Many recruiters specialise in particular areas such as the mental health sector, radiography or dentistry, and their knowledge of these sectors can be used by workforce policy makers. Recommendations Without an adequate supply of highly skilled and trained doctors and nurses, the NHS simply couldn’t operate. It is therefore essential that the NHS invests properly in recruiting the next generation of workers, as well as retaining the staff that it already has. The need for agency staff is not going to go away, particularly in light of heightened demand from patients, and so the NHS must ensure that it seeks to create a working environment that is favourable to all staff, regardless of how they choose to work. 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. L FURTHER INFORMATION www.rec.uk.com

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Advertisement Feature

Scanning solutions for healthcare in the UK Discover how to mitigate the risk of data breaches and reduce costs by an average of £50,000 per annum, as well as how to comply with GDPR Article 15: the Right to Access; Article 20: the Right to Data Portability; and Article 32: the Security of Processing Our impressive scanning solution, incorporating iDocs Bindr SafeSend, will enable you to improve your efficiencies of production, de-risk your processes and increase security of delivery of your Subject Access Requests. The healthcare industry faces enormous challenges, including rapidly changing regulatory, financial, and technical issues. Electronic medical records (EMR) systems help in addressing these challenges, but organisations should also consider electronic content management (ECM) solutions for even greater improvements in practices and processes. Skyrocketing costs, historic regulatory changes, patient demands for instant access to their records, GDPR and freedom of information (FOI) concerns, bureaucracy and security concerns have all helped define the healthcare industry landscape. In recent years, countless medical organisations from small practices to major hospitals have implemented EMR solutions to replace inefficient paper‑based practices. Indeed the upcoming GDPR that becomes law on the 25 May poses several challenges, not least the ability to be compliant with stricter data protection rules but also to be able to prove it in a court of law. The challenges The pressure on healthcare organisations today is unprecedented. For decades, the industry has faced constant and growing criticism about costs and as such organisations are constantly being pushed to find ways to cut costs and improve efficiencies. At the same time, providers are continually looking for ways to improve the quality of—and access to—patient care and the information associated with it. This is particularly challenging in an era of patient rights, ubiquitous online connectivity and the information expectations driven by

social media and freedom of information. Patients are more knowledgeable than ever before and are demanding greater participation in their healthcare decisions. Complicating these challenges are new and evolving technology advances such as mobile, cloud, and analytics, which healthcare organisations need to embrace to remain competitive. The solution Countless medical providers are implementing electronic medical records systems as one obvious way to cope with challenges of modern medicine. At the level of individual organisations, practices are and can benefit from cost efficiencies and enhanced patient services by digitising their medical records. However, healthcare practices do not run on medical records alone, and EMRs were not designed to handle the broader range of enterprise information that supports these businesses. For example, standalone EMRs are insufficient for reducing operational costs, ensuring full compliance with mandates and guidelines, or improving patient outcomes and engagement. ECM solutions can provide important functionality such as: capturing and creating content in a wide variety of formats, including paper and electronic documents, email, and images; organising information with metadata which is used for indexing and classifying documents; enabling collaboration using information that is easily located and shared; expediting search and retrieval of documents for enhanced business processes and better patient services; and supporting publication and delivery of documents. Vital for healthcare success Healthcare is an information-intensive industry, and not just from myriad types of documents,

charts, images, and other data directly related to a patient’s health. For example, there is email and web content, instant messaging, policy procedures, and financial reports. Because a lot of patient information often comes from external sources—paper remains a significant part of the overall mix. Healthcare, as a heavily regulated industry, also produces voluminous policies, reports, and performance measurements. Providers also must adhere to mandates for data security that, if violated, can result in significant penalties. Organisations need systems that will help them securely store and manage regulatory documents. Additionally, medical organisations are at the forefront of ‘big data’ trends. ECM can help organisations aggregate all content types for their business processes and for their patients, including scanned images, email, imaging files, and financial data. ECM can pull information from diverse information systems such as radiology and laboratory to establish a single repository where content can be accessed or cross referenced. The result is a single point of access to an all-inclusive patient record. Implementing an effective ECM solution By deploying an ECM system alongside other line-of-business applications, including EMRs, healthcare organisations gain a strategic hub for managing all content that flows through the enterprise. Key benefits include: centralised storage with enhanced security for all information, including patient records; business process agility that can lead to productivity gains and cost savings; enhanced compliance throughout all departments with all regulatory guidelines; faster access to patient information, potentially leading to improved patient outcomes, better patient engagement, and better access to critical information across the care continuum; and a notable ROI from the ECM investment, with most hospitals reporting a full return on their ECM investment within 18 months of implementation. With the benefits and rapid return on the investment, ECM deployments can provide core systems that will allow healthcare organisations to tackle the challenges facing the industry in the coming years. L FURTHER INFORMATION marketing@uk.fujitsu.com

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

TThe current hyperbole surrounding both GDPR and Brexit is at times reaching frantic proportions as the demands for column inches seems to surpass the need for insightful commentary. Add into this mix the recent ‘exposure’ of data harvesting from free-to-use social media platforms and is it no wonder that many within organisations are a little punch drunk and are left thinking….now what? With many marketeers using this environment to peddle fear to aid their sales process, I’m often left to wonder if this is indeed Y2K all over again where the facts seemed to be an inconvenient truth. However, unlike Y2K, the changes on our business horizon are not going to go away in an instant once all those count down clocks hit 00:00.00. Yes, 25 May is a seminal date – when the GDPR will be shrined into UK law – but the real work starts and continues each and every day after that point. Compliance to this piece of law doesn’t require a sprint up to a specific date, it doesn’t require one of the many pop up GDPR compliance services and some generic policy documents; it requires a business wide undertaking where data creation, management and protection is embedded into employee’s psyche, business process and third-party management. My article looks specifically at Data Processors,

designated third parties who process data on behalf of organisations and the impact which GDPR is going to have on them and those who use them. The Brexit impact To start, let’s address one of the myths regarding GDPR concerning its adoption and the relationship with Brexit. First and foremost, we have already committed to adopting GDPR and so don’t believe that it will go away once terms for leave have finally been agreed and the UK and EU part ways. Furthermore, the draft legislation for its UK replacement – the UK Data Protection Bill – is already going through Parliament and within that, GDPR is prominently featured with the ICO recommending that the two are read alongside each other. The rationale here is sensible and logical; the law itself is actually very good and took a number of years to craft and fine tune, to restart from scratch would be expensive, time-consuming and ultimately fruitless. Furthermore, as the UK will be classed as a Third Country under GDPR it is essential for us, if we are to be permitted to transfer data from the EU into and out of the UK without complex structures in place, to offer equivalent approaches not only to law, but also its application. So, GDPR and the UK Data Protection Bill are reality and whilst many organisations are adopting

The current challen made b ges being y on the regulators compan big tech ie the bat s is where tle are beinlines g drawn

New obligations for Data Processors A starting point is the acknowledgement of current behaviour. Whilst this may come as a surprise to many, it is already a requirement of UK Data Protection Act 98 for Data Controllers to have a contract in place with Data Processors and yet we know many do not. In fact, a freedom of information study, undertaken by ADISA, was able to evidence that approximately 66 per cent of local authorities and police forces did not have a contract in place with Data Processing partners. So what will change under GDPR? Under GDPR, Article 28 outlines a wide range of requirements for Data Processors to comply with. The most obvious is that it E

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Written by Steve Mellings, founder of ADISA and COO of DP Governance Limited

How will GDPR change the responsibility of the Data Processor and what impact will Brexit have on this? Steve Mellings explores

Document Management

Data processing and GDPR – the business case

a watching brief or playing lip service preparation, the risk associated with this stance is quickly playing out in front of us. The current challenges being made by regulators on the big tech companies is where the battle lines are being drawn. It’s heartening that it seems no company is out of reach of the regulators or is going to be permitted to ignore the rights and freedoms of data subjects which is the ethos underpinning much of the GDPR – at least not publicly. One key change within GDPR is the relationship between the Controller and Processor. At times this can be complex, depending on data flows as each party, on specific data sets, may be controller whilst the other is a processor and visa versa. What I’ve seen helping several organisations in their preparation for GDPR, is that during the creation of their ‘Records of Processing Activities’, several partners have been identified as being a Data Processor which were previously hidden away from both Infosec and Compliance and largely managed by Contracts/Procurement. Bringing all Data Processors into scope is critical for GDPR as the controller is required to behave in a specific way when selecting, engaging with and then managing Data Processors. Historically, the Processors themselves have been governed by their own due diligence or by terms within contracts, but under GDPR they are brought firmly into scope with a series of explicit requirements for them to comply with.

 is now a legal requirement for a Data Processor to have a contract in place with their controllers. This completes the circle as all parties are now under the same obligation which, in brief, is to ensure they work with each other in a formal and structured way where the services undertaken are detailed and roles and reasonability’s agreed. It’s perhaps interesting to note that a Data Processor cannot process data unless under the written direction, and prior approval, of their controller. In situations where they do process data without this being in place they are not only breaking the law, but, this behaviour would see the Processor being viewed as a controller in their own right (A28 10). The partner process Another difference is that Data Controllers are required to show far greater controls over the selection and management of data processing partners. There is now a requirement for Data Controllers to screen their data processors prior to use. Looking for sufficient guarantees of the service being

provided including evidence of ‘appropriate technical and organisational measures’ (Article 28 1). It’s here where Data Processors will be required to look to accreditations to evidence this in place. This will typically be general data security standards like the ISO 27000 family or specific industry accreditations to reflect the service being undertaken – such as the ADISA Standard. In addition, their behaviour will be governed by defined requirements agreed with the controller and also their willingness to sign up to industry code of conduct. (The latter is currently a moot point as the UK ICO is yet to release guidance on what such codes of conduct will require.) Data processing Another change is regarding the use of sub‑processors. Data Processors are not allowed to use subprocessors without the prior written approval of the Data Controller. Complex data processing downstreams is something we’ve seen in various clients at DPG. For one recent GDPR engagement, we helped identify over 40 previously unknown sub-processors within an organisation’s

data processing partner network. The issue stemmed from poor or non-existent contracts and service specifications being in place and many of these sub processors were completely unknown to the Controller. All of these are now in scope and subject to proper onboarding, management and assessment. Without this type of granular review, a data breach in any one of these would leave the data controller almost certainly, holding the liability on their own. With any law change, organisations will fear the impact it will have on their operations and rush to buy services which offer wrap‑around comfort. GDPR is something different. No external company or software can make you GDPR compliant, only your organisation can do that. The extension of requirements specifically applying to Data Processors is an excellent move as it makes sense that those third-party organisations to whom data is entrusted are brought firmly into scope. It is unfortunate that many data processors might be smaller and they will view these changes as a huge cost burden. However, that does not need to be the case. The ethos behind the requirements is really about accountability, transparency and structure. In short, formalise what you do, how you do it and ensure that the way you do it protects the data sets which you are processing L

Document Management

With any law change, organisations will fear the impact it will have on their operations and rush to buy services which offer wrap-around comfort. GDPR is something different

FURTHER INFORMATION www.adisa.global www.adisa.global/adisa-conference-2018

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Safe. Simple. Fast.

Safe-T enables fast, simple protection from needlestick injury during blood collection.

Automatic needle retraction and safety storage system. Safe-T® significantly helps protect patients, nursing staff, and all handlers of contaminated medical materials from needlestick injury caused by used needles during blood collection. Blood collection preparation and process using Safe-T is the same as standard Vacutainer® blood sampling, using the same collector tubes and standard needles. Also the Safe-T tube holder looks similar to any standard holder. Therefore operation is intuitive, requiring minimal training. After blood collection in the usual way, a Safe-T plunger is inserted into the Safe-T tube holder and pushed down until a ‘click’ indicates that the needle has automatically retracted. It is instantly contained and fully protected within the tube holder and plunger. With the needle protected, the health worker is protected, as is anyone who handles the device from here on in. Simple and safe.

Discover more, including a demonstration video, on the Safe-T website: www.safe-t.co.uk

Safe-T Ltd | www.safe-t.co.uk | sales@safe-t.co.uk | Tel: +44 07624 421 471

Health GB

Doing business with the UK healthcare sector

More than 3,000 healthcare industry professionals attended the launch edition of the Health GB Exhibition & Congress at Manchester Central at the end of April. As media partner to the show, Health Business looks back at its conferences and educational content technologies during the three-day trade show. According to Dave Panther, vice president of Global Sales for Informa Life Sciences Exhibitions: “As the UK prepares to undergo a significant period of change international companies from across the globe are looking to manoeuvre themselves into a favourable position to capitalise on any changes to existing market agreements. The potential this offers for both UK companies looking to export their products, as well as for those non-EU providers hoping to enter the UK market, is exponential. Health GB has been launched at this critical time as a platform to facilitate this conversation and to bring together our customers and partners, under one roof, in the UK.”

Health en be manufacturers to enter GB hasd at this the market, or grow e h c their existing n a u s a l a e m market share; and a i t l critica to facilitate cheaper GBP could d m n r mean cheaper a o f t n pla nversatio alternatives for UK r o healthcare buyers this c ring togethe looking to import. to b mers and Informa Life Sciences custo tners Exhibitions, the world’s r a p leading publishing and

The NHS operates more than 1,200 hospitals, as well as 3,000 other treatment facilities, 10 ambulance trusts and 7,875 GP practices. Over 12 million people in the UK are covered for private healthcare, with total private healthcare expenditure equaling £26.5 billion. The UK government is investing £10 million into facilitating better partnerships between the industry and the NHS through the testing of new technologies and innovations, with NHS expenditure on goods and services approximately £9 billion per annum, including £2 billion on medical consumables and £3 billion on high-cost medical devices. However, following the UK’s vote to leave the European Union, a lot of questions will remain unanswered until a Brexit strategy is announced on whether they will leave the single market. For now, though, we can guarantee the following will affect future healthcare trade in the UK: the pound sterling (GBP) is at an all‑time low, meaning that UK firms have a big exporting opportunity through high quality products at a cheaper rate; the potential move away from the FTA (Free Trade Agreements) of the single market creates a huge opening for non-European

exhibitions company with a stellar portfolio of global events such as Arab Health, Africa Health and Asia Health, celebrated the launch of the Health GB Exhibition & Congress on 30 April this year, with the show running until 2 May. As the latest exhibition in their global series, it welcomed more than 3,000 healthcare industry professionals to Manchester Central to meet, learn and do business with the UK healthcare sector. With future NHS expenditure due to increase to £120,151 billion by 2019/20, and with 12 NHS hospitals selected to receive £10 million of funding to trail blaze new ways of using digital technology to drive improvements to patient care, Health GB presents a huge opportunity for healthcare manufacturers, dealers and distributors and service providers to introduce their products to the market. More than 150 companies from 10 countries, including Italy, Germany, China, Turkey and the US, showcased their latest healthcare and pharmaceutical innovations and

Educational content In addition to functioning as a trade platform, Health GB also fulfilled its ambition to deliver world-class educational content through its three non-clinical conference programmes. The one-day CPD accredited Medical Engineering Conference, chaired by Dr John Sandham, chairman of the EBME Society and the director of TBS GB Telematic and Biomedical Services Ltd, discussed the dynamic future of clinical engineering and healthcare technology management whilst also presenting the latest advancements in medical devices. Carefully developed in partnership with the EBME, the Medical Engineering conference discussed the dynamic future of clinical engineering, healthcare technology management whilst also presenting the latest advancements in medical devices. Key topics covered included: transformation and the future of clinical engineering; healthcare technology management; innovation and transformational technology; and advances in technology transforming healthcare delivery. The new direction of healthcare technology management was expertly delivered by Dr Richard Scott, head of Clinical Engineering, Medical Physics & Clinical Engineering at Sheffield Teaching Hospitals NHS Foundation Trust, while Salford Royal NHS Foundation Trust’s David Mulvey challenged delegates on the commercially astute clinical engineer: emphasising optimal engagement with suppliers as a way to optimise value for money. Purchasing capital equipment Meanwhile, the Healthcare Procurement Conference, developed in partnership with NHS Commercial solutions and chaired by CEO Alyson Brett, provided advanced insight into how revolutionised healthcare can E Volume 18.3 | HEALTH BUSINESS MAGAZINE

Integrated Care Systems Centred on the theme of ‘Integrated Care Systems – Primary Care leading the way’, the agenda for the CPD-accredited Primary Care Conference provided progressive updates and covered the latest information concerning integrated healthcare provision.

Health GB

 improve operation productivity of nationwide NHS organisations. The seminar topics and exhibitors helped attendees better understand commercial changes within the NHS and how they will impact procurement and asset management, as well as identify how NHS finances will affect procurement strategy. As part of his review of NHS efficiency, Lord Carter of Coles said: “We believe the quickest way to solve the problem of poor procurement data on prices and volumes is to accelerate the implementation of a single NHS electronic catalogue.” Alongside Alyson Brett, the conference also heard from Howard Blackith, programme director, Department of Health, who presented a review and update on NHS procurement, before NHS Improvement’s Mark Gronow discussed the transformation taking place in the NHS procurement industry, outlining the joint improvement vision in action. Highlighting a case study on effective managed equipment services, Philip Spicer, associate procurement director for NHS Commercial Solutions, as part of a wider discussion on purchasing capital equipment and asset management.

More than 150 companies from 10 countries, including Italy, Germany, China, Turkey and the US, showcased their latest healthcare and pharmaceutical innovations and technologies during the three-day trade show Attendees at this one-day conference heard expert speakers share unique insights on topics such as NHS landscape and primary care development, workforce modelling, population health management and integrated care and accountable care organisations and a keynote by Andy Burnham, Mayor of Greater Manchester. Following Burnham’s keynote, Dr Charles Alessi, senior advisor Public Health England, looked at primary care leading the way before Rick Stern, director of the Primary Care Foundation, analysed the five year forward view, specifically investment, improvement

and service provision revolution. Looking at the NHS workforce, and the contentious issue of recruitment and retention, Samantha Sherrington, head of Stakeholder and Cultural Transformation for NHS England, established the role of nurse leadership in the reformed NHS, before sessions on the challenges of educating a workforce and job satisfaction came to the fore. L FURTHER INFORMATION www.healthgbexhibition.com

www.daudjeemfg.com

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MAY 2019

ADAPT TO ADVANCE, TOGETHER Journey into the digital future

Call us on 0800 052 0800 www.virginmediabusiness.co.uk/HSCN

Connectivity

A new data network joining health and care The Health and Social Care Network is a new data network for health and care organisations, replacing N3. Created to be a ‘network of networks’, Health Business looks at the network and the general integration of health and social care services

NHS Digital outline the recently-created Health and Social Care Network (HSCN) as a new data network for health and care organisations, providing the underlying network arrangements to help integrate and transform health and social care services by enabling health and social care organisations to access and share information more reliably, flexibly and efficiently. Health and care providers will be able to obtain network connectivity from multiple suppliers in a competitive market place and in collaboration with other health and social care organisations. N3, a single-supplier service, primarily designed for NHS providers to access national applications, was designed in response to requirements that are now over 12 years old. This is where HSCN differs, due to it being designed to meet the requirements of an integrated and evolving health and social care sector. Being a standards‑based network, HSCN enables multiple suppliers to provide connectivity services and health and social care organisations to create shared networks, which help deliver shared and integrated IT services.

HSCN enables m supplie ultiple Transformation Plans and Digital Roadmaps. connec rs to provide Local It will: establish t i v ity s and he network arrangements alth an ervices that support the d socia care org l transformation and a n i to creat sations integration of health e share and social care services, d networ regional collaboration and ks flexible work patterns; enable

Comprehensive security monitoring and analysis functionality is featured, providing a central capability to detect irregular traffic volumes or flows, in near real time. Whilst these capabilities undoubtedly enhance network security, like N3 previously, HSCN should not be considered a purely ‘secure’ network. All connected organisations must risk assess their use of the HSCN, and employ their own security controls to protect any data for which they are responsible. The HSCN will not automatically encrypt any data, or guarantee the security of data or communications by default. HSCN is not suitable to exchange patient or sensitive data without additional security safeguards. HSCN has been designed to support the delivery of key health and social care initiatives such as National Information Board ‘Paperless 2020’, NHS England Five Year Forward View, Sustainability and

safe, reliable, flexible and efficient information sharing between health and social care organisations; create a competitive marketplace for network services – improving consumer choice, delivering improved value for money and enabling organisations to access faster and cheaper network telecommunications services; and reduce duplication and improve collaboration between organisations by enabling them to reuse and share existing network services. Furthermore, the potential benefits of joining HSCN are: the ability to send and receive secure data between health and social care organisations, supporting service sharing; cheaper connectivity than previous N3 services; simpler network E Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature Written by James Smedley, Senior Data Architect

Improving the efficiency, reliability and security for healthcare data AIMES is a health Cloud provider to the NHS and has an established track record in delivering innovative and transformational IT hosting services in complex healthcare environments using a collaborative approach with both vendors and NHS trusts We are always creating new innovative solutions that will benefit UK healthcare through data analytics, most recently through the Trustworthy Research Environment (TRE). TRE enables data analytics utilising strict standards of research, data security and privacy - ideal for analysts who are looking to access NHS datasets and produce algorithms for learning health systems in an ISO27001 and IG Toolkit compliant cloud-based e-infrastructure. The TRE enables the data owner to grant access to duly authorised individuals in a ‘walled-garden’ which provides analysts with all of the software tools required to analysis and visualise the data on behalf of the data owner in a cloud-based ISO27001 environment. The TRE comprises three zones. Interoperability Provisioning Zone (IPZ) The IPZ includes the data source systems at NHS trusts, GP practices and secondary services such as NHS Digital, DSCROs and standards based Integrated Healthcare Enterprise (IHE) technologies for sharing data with the TRE, via the NHS HSCN network. Data Provisioning Zone (DPZ) The data-provisioning zone enables data to be safely stored in accordance with IG toolkit and ISO 27001. The DPZ provides a data workflow infrastructure, enabling the production of data pipelines, which automates the extract transformation and loading of datasets into the data warehouse. Analytics Provisioning Zone (APZ) The APZ, secured using two-factor authentication over VPN, provides analysts with a data science virtual desktop, typically comprising eight cores and 32GB RAM and access to a wide-range of software packages including common statistical packages such as R and R studio and geospatial software. A TRE can be used in many areas of the clinical pharmacology research domain including collaborative drug target prioritisation, medication repurposing and stratification of populations into cohorts for personalised medicine, adverse event registration, comparative treatment effectiveness and pharmacovigilance. The design of AIMES TREs assumes re-use

(large-scale hosting) of existing cohort data (for retrospective studies) but anticipates development paths to admit electronic health record system data for prospective studies. In the future, these approaches will also help develop a rational, secure approach to use of artificial intelligence (AI) as it is widely recognised that AI will contribute to more reliable diagnoses and prognostic indicators. Moreover, predictive markers and algorithm development in a research context will be boosted from input data of increasing diversity derived from whole genome sequences, personal device outputs and novel biochemical tests. Initiatives such as the 100,000 Genomes Project already show the power of data combination governed by common data models from across multiple settings. Cross-site combination has also been shown essential in rare disease research requiring large scalable populations of patients to be able to match study criteria. A core value proposition of the TRE is to allow research in highly-specialised advanced fields to be brought close to NHS input and other data resources by provision of secure zones and networks. Existing resources such as large clinical trials or disease-based registries have produced legacy datasets that are difficult to access (the silo problem), TREs can be applied to re-use these expensive datasets to realise their value. AIMES TRE design is agnostic to application – common tasks of data analysts will include cohort identification, longitudinal datasets, determinant of outcomes, epidemiology etc. A TRE can act as a disease registry (if standard formats for data collection are agreed) and data processing modules included

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

in the build to adapt any native (e.g. EHR) data sources to the common model. The security standards and legal compliance checks give capabilities for hosting of personal identifiable data where this is justified for purpose. A more usual mode of operation is to anonymise or pseudonymised data. Regular analytic functions within a TRE (e.g. indicators of efficacy and safety of medicines) are configured through hosted tooling within the TRE design. This is almost always bespoke and reflects personal preferences of researchers to get the job done. The emphasis of learning health system TREs is application of analytic insights into local clinical populations through inbound messages to host systems either in the form of standardised clinical documents manageable by NHS systems (e.g. HL7 CDA) or as ‘actionable analytics’ that place the context of the patient’s status in the context of the population. The long‑term goal is to allow a small set of interface standards to become pervasive so any use case can be managed with the same formats. Applying the extended analytic EHR into research needs to exploit multi‑omic personalised data, this requires special strategic consideration. Existing local and national data initiatives need to be considered as inputs, such as 100,000 genomes, LIMS, e-prescribing data, biomedical tests, inpatient and outpatient pharmacy data, consents, free text processing, medical imaging etc. L FURTHER INFORMATION www.aimes.net

A network of networks HSCN is an interoperable ‘network of networks’ provided by multiple suppliers who will adhere to common and open standards. It acts as a single network provided by many suppliers, meaning health and care providers can access services and share information, regardless of their location or network supplier. The HSCN programme will deliver the central infrastructure and capabilities required to manage the safe and reliable operation of the multiple-supplier HSCN network environment. The level of central capability required may vary over time as the HSCN environment matures but NHS Digital will ensure sufficient capability exists to support business continuity, migration and early operation. The network will establish a reliable and accessible network to enable the sharing of innovative and flexible enterprise services. By collectively moving onto the HSCN, health and social care service providers will be able to cost effectively exploit telecommunications and business services across locations and organisational boundaries. Regional networks can generate savings through aggregated procurement and shared service initiatives. They can also help maximise the potential for sharing information, services and assets across health and social care providers within a

defined area such as a Sustainability and Transformation Plan (STP) area. The HSCN approach enables different supplier networks to interoperate with one another. Health and social care organisations are able to consume nationally, regionally and locally hosted services and collaborate on shared service initiatives, with their service delivery partners, regardless of their network provider. Improving cyber security Patients, service users and staff have a right to expect that information about them is held securely. HSCN customers have a duty under the law to protect information. Increasingly, information is at risk from

enhance network security, like N3 previously, HSCN should not be considered a ‘secure’ network. All connected organisations must risk assess their use of the HSCN, and employ their own security controls to protect any data for which they are responsible. The HSCN will not automatically encrypt any data, or guarantee the security of data or communications by default. So, like N3 or the internet, HSCN is not suitable to exchange patient or sensitive data without additional security safeguards. Where patient or sensitive data needs to be exchanged it must be encrypted in transit. National applications like NHSmail and Spine do this by encrypting the communication

Connectivity

 Information Governance requirements; helping staff across health and care work together; standardised networks; and simpler access to NHS Digital’s national applications, making it easier to confirm NHS numbers, share care plans and access Summary Care Records.

Patients, service users and staff have a right to expect that information about them is held securely, especially as information is increasingly at risk from malicious activity, such as hacking and computer viruses, commonly called malware malicious activity, such as hacking and computer viruses (often called malware). HSCN will feature comprehensive security monitoring and analysis functionality, providing a central capability to detect irregular traffic volumes or flows, in near real time. HSCN consumers will benefit from this capability as potential problems can be detected and resolved promptly. Whilst these capabilities undoubtedly

between the application and end user device. One of the ways in which HSCN will improve the cyber capabilities of the network will be through improved internet capacity. Instead of having a single connection to the internet via the Transition Network, organisations will connect via one of a number of HSCN Consumer Network Service Providers (CN‑SPs) who all provide internet connectivity. As a result they will be able to E

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Advertisement Feature

HSCN: An evolution in healthcare technology It is full speed ahead for HSCN as healthcare providers devise plans to migrate away from legacy N3 connections and modernise their connectivity, which is a hugely positive step UKFast provides secure, accredited cloud hosting and managed services to the UK public sector. With more than 18 years’ public sector experience, UKFast provides technology platforms from which you can deliver enhanced communication, collaboration and real cost efficiency. Our end-to-end flexible service means that we are available to support you every step of the way. UKFast is one of the UK’s leading managed hosting providers with the Cabinet Office, the MoD and NHS trusts amongst its many clients. We own, manage and operate our government-accredited data centre complex, which offers 30,000 sq ft of enterprise-grade facilities, enabling us to guarantee security. UKFast provides modern, tailored solutions to the entire public sector and those looking to support it. We design and supply solutions for local and central government, including the police force and the fire service, health and social care organisations, educational institutions and the defence sector and understand the processes and relationships that are required for change. Full speed ahead HSCN is facilitating the NHS and other health and social care providers in adopting new services and delivering true digital transformation. The new network means organisations across the healthcare community will soon be sharing information more reliably, flexibly and efficiently. HSCN has been in the pipeline for 18

months and is a significant upgrade on N3. With organisations adopting more and more online services, in line with the NHS’ digital transformation aspirations, the old network just isn’t delivering the necessary performance. Transitioning from N3’s single-supplier network, HSCN has created an open marketplace for certified suppliers. This means users can now better align their particular needs and objectives to take advantage of a more competitive marketplace and a wider range of products and services. We’re seeing local councils teaming up with trusts under the new joint Health and Social Care remit and plugging their systems straight into our data centres. Even at this early stage, HSCN is already proving to be a huge enabler. One of the key aims of HSCN is to deliver more competitive and cost effective connectivity across the board, and that can only be a good thing for the health service. Delivering cloud through HSCN It’s now accepted that cloud technology is driving public sector IT forward and delivering significant efficiencies and improvements in service. The capability to collect and analyse massive amounts of data in an affordable way is revolutionising the healthcare environment. In most large healthcare organisations there are huge numbers of devices and touch points generating data and reporting back. Connecting this data to a cloud and analysing it is now a priority, and having a central point with unlimited

processing power is the key factor that’s enabling organisations to take advantage of their data for the first time. Every day, more of our clients and partners speak to us about delivering applications and services to the NHS over a private network. There is huge demand out there for access to this network, particularly at the price we’re able to offer. By connecting HSCN straight into our government-accredited datacentres, we’ve removed the waiting list for organisations to be connected to the new network. You can now jump the queue and get ahead of the competition by connecting solutions straight into HSCN through a UKFast data centre. Our cloud is enabling SMEs to enter this market and bring innovation to the NHS, where previously it’s been a relatively closed shop. A disruptive partnership The type of relationship our clients now want is a true business partnership. It’s about round-the-clock support, it’s about building bespoke solutions and it’s about helping organisations turn their digital aspirations into something tangible. Receiving support in a timely fashion is one of the key requirements of the NHS and it’s an area where providers need to go the extra mile. HSCN is a step-change in what healthcare services demand from their providers. This isn’t just a case of buying a product; it’s about entering into a new partnership to deliver a genuine lift in service for the benefit of the NHS and its patients. Thanks to a string of investments in our infrastructure, UKFast is in position to deliver HSCN at a much more competitive rate than the average provider. We’re already seeing a trend for the existing N3 providers offering connectivity to HSCN, which is cheaper for them to provide, without reducing their existing pricing. Is that acceptable when taxpayers’ money is paying for this connectivity? We’re confident about the value of our proposition in this area. UKFast is known for its outstanding level of service and support, and now we’re delighted to be able to roll that offering out for the whole NHS through HSCN at an extremely competitive price. Start your journey to greater efficiency and connectivity with UKFast. Find out how you can gain a year’s free. L FURTHER INFORMATION 080 0231 5908 www.ukfast.co.uk/hscn

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 obtain faster and cheaper internet connectivity via their CN-SP and avoid the need to obtain additional local internet connectivity that is less secure or less monitored. Additionally, the HSCN Advanced Network Monitoring (ANM) service inspects all Internet traffic from CN-SPs and instantly blocks any known malicious content, and also includes a new advanced threat detection capability designed to identify brand new or ‘zero day exploits’. It operates as a cloud based service meaning all CN-SPs benefit from the same high level of high performance protection. Social care connections Health and social care organisations need to share information and services electronically in order to provide coherent, joined up services to the public. HSCN enables all organisations involved in the provision of health and care services to share information with one another and to access national and local health applications and systems reliably and efficiently. See examples of how HSCN could help social care organisations deliver services. HSCN is also designed to enable NHS and non-NHS social care organisations to collaborate with one another more easily on the procurement and operation of shared, place-based, data networks. HSCN provides highly reliable and available private network connectivity required for accessing the numerous national and local health and social care systems today. It also offers internet connectivity with enhanced security over the same connection. HSCN has enhanced, centrally managed security capabilities to protect against escalating cyber threats and to ensure high levels of network

reliability and availability are maintained. Because HSCN is provided by multiple, competing suppliers, to a defined set of standards that are aligned to existing industry practice, network connectivity will cost broadly the same as standard broadband connectivity and significantly less than it did under the previous National NHS Network (N3) arrangements. HSCN standards are designed to enable a broad range of suppliers to offer network services that use the latest technology and innovation without compromising seamless interoperability. While HSCN connectivity alone will not transform health and care services, we’ve listed some practical examples of how HSCN could help improve the services your organisation offers. Care homes and other care providers such as domiciliary care could benefit greatly from having a consistent electronic transfer of medical discharge summary (typically sent to a GP within 24 hours), enabling them to fully prepare their service for supporting people discharged from a hospital. At present, the medical discharge summary is often sent to care homes by post or by the person who has been discharged. This can create a delay between the discharge and the care home understanding the person’s needs, which may have changed significantly in that time. HSCN can also provide social care organisations an access to national applications, such as Summary Care Records (SCR) and locally held data sources like GP records, to obtain information on prescriptions, allergies and end of life care preferences. L FURTHER INFORMATION https://digital.nhs.uk/

Plans announced by NHS Digital in February will see NHS staff able to communicate with each other through better integrated systems, eventually seeing users being able to log into a range of applications and services, integrated with Microsoft Azure Active Directory (Azure AD), using their NHSmail credentials. The initiative will integrate NHSmail, which uses Microsoft Exchange and Skype for Business to securely share patient information, with Office 365. All NHS employees can use NHSmail, as can those organisations commissioned to deliver NHS services. The first part of the journey will be the synchronisation of the NHSmail directory with Azure AD, which was expected to be completed by April. This will be quickly followed by integration with Office 365 services – commonly known as O365. This should be completed by August. Neil Bennett, Service Director for NHS Digital, said: “This synchronisation of NHSmail to Azure AD and integration with O365 is part of our long-term vision to bring about greater collaboration across the wider health and care system. It means information can be more readily and securely shared between health and care organisations and teams can collaborate more easily. “Ultimately it will enable NHS staff to access multiple applications and services using their NHSmail user name and password which makes their job easier. This benefits patients because it makes the NHS more efficient and they can be assured that their confidentiality continues to be strictly maintained.”

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Conectivity

HCSN acts as a single network provided by many suppliers, meaning health and care providers can access services and share information, regardless of their location or network supplier

NHS connectivity services

Advertisement Feature Written by Katie Fulcher, Marketing Communications Coordinator

Quartz partner with leading nurse call provider to deliver new build hospital Quartz Electrical and Mechanical Services Limited provide electrical and mechanical services to industrial, commercial and residential customers throughout the UK, which frequently involves the design and build of large scale hospital projects for the public and private sector In 2016 the company was commissioned by Tolent Construction Limited to facilitate the design and build of a new hospital in Teesside, which joins their client’s network of 36 private hospitals across the UK. The brief for Tees Valley Hospital included a 19-bed patient ward, three medical theatres, x-ray and endoscopy departments, and two stage recovery areas, with medical gas services where required. The project required Quartz to design, install and test all of the mechanical and electrical services within the hospital to ensure they comply with Healthcare Technical Memorandum (HTM) guidelines, as well as the client’s specific requirements. This included the supply and installation of a nurse call system, for which Quartz released a tender. Nurse Call Gavin Kendall, electrical operations director for Quartz, said: “After receiving quotations from a number of leading Nurse Call providers we decided to move forward with Aid Call. The wireless offer and the adaptability of the system were, in my opinion, the best solution for the project.” Aid Call’s Touchsafe Pro system does not rely on cables or stationary wiring points, making it infinitely expandable and allowing for complete flexibility and mobility. The wireless configuration allows the system to adapt to the ever changing priorities and demands of the healthcare sector, which is reassuring at a time of increased pressure on resources and environments. Gavin commented: “After sending our enquiry to Aid Call, Quartz liaised with their senior business development manager, Stuart Barclay, to discuss the requirements of the system and its operation. From this initial stage, we felt comfortable that the proposal put forward by their team was the best solution for the project. “We received good support from Aid Call during the design process, and this enabled us to produce complete comprehensive layout drawings and literature to present to our client. The offer of the nurse call system was then agreed and approved by the client.”

on the installation of the Nurse Call system at Tees Valley Hospital in July 2017. Gavin explained: “Aid Call was quick to assist with all our requests throughout the installation process at the Teesside site. We carried out first and second fix, testing and commissioning works together, all of which were completed within the required timescales to allow us to meet the project completion date.” Adaptability Gavin added: “Aid Call also assisted later in the project, as the client required additional items to be added to the nurse call system. The adaptability of the wireless system provided by Aid Call really proved its value at this point.” Additional panels, call points and assistive devices can be added to Aid Call’s Touchsafe Pro system at any time during installation, and once the system is operational. The nurse call provider offers an extensive range of assistive technology such as fall detectors which facilitate individual patient requirements.

Installation Aid Call and Quartz Mechanical and Electrical Services Limited began working in partnership

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Stuart Barclay, said: “Working with a design team and contractor is great for us, as we can plan from the drawing stage. However once the system becomes operational, sometimes clients like to add an additional panel or audio visual lights. “After the installation at Tees Valley Hospital, the client requested an emergency paging system for all the wards to attend emergency calls, as well as a remote call point which could be attached to a mobile MRI unit which visits the hospital on a weekly basis. Installing our Touchsafe Pro system at Tees Valley Hospital was a brilliant project that allowed Aid Call to work in partnership with Quartz to deliver a quality building.” Tees Valley Hospital was completed in December 2017, and opened to its first patients in February 2018. L FURTHER INFORMATION 01670 357 431 www.aidcall.co.uk katie.fulcher@legrand.co.uk

In the last decade the total number of hospital outpatient appointments in England has almost doubled to nearly 94 million. The figures from NHS Digital, meanwhile, show the percentage of ‘Did Not Attends’ or DNAs has headed slowly in the opposite direction. A number of initiatives have been introduced across the NHS in recent years to tackle the ongoing problem of missed appointments – with varying levels of success. Overall, the level of DNAs in hospital outpatient clinics has decreased from 8.4 per cent in 2006/07 to 6.7 per cent in 2016/17. But the fact that this currently equates to almost eight million wasted appointments, at a cost of more

Written by Peter Akid, director of procurement, NHS Shared Business Services

With almost eight million hospital appointments missed last year, Peter Akid, director of procurement at NHS Shared Business Services, says the patient communications technology framework can help reduce the almost £1 billion cost to the NHS wasted on ‘Did Not Attends’

Communications

Cultivating efficiency by cutting missed appointments

The adoptio n of new te c h n has ena ologies organis bled some atio the numns to cut of appo ber int missed ments b patient y s

than £950 million to our NHS hospitals, highlights the need for further action to address this costly issue. When these hospital figures are considered alongside an estimate last year from the General Practitioners Committee (GPC), that around five per cent of GP appointments, equating to more than 10 million, are missed every year in the UK, the potential for huge NHS

savings becomes even more apparent. Undoubtedly, the adoption of new technologies in recent years has enabled some forward-thinking organisations to cut the number of appointments missed by patients. Reminders via text message, for example, have become fairly common and – according to NHS England – can reduce DNAs by 10 per cent. E Volume 18.3 | HEALTH BUSINESS MAGAZINE

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 23/04/2018 16:32:47

As one of the largest UK trusts in the UK, Leeds Teaching Hospitals has over 1.3 million appointments made annually, but loses out on £7 million of income through missed appointments.

Although letters in the post are still essential for reaching many NHS patients, a modern healthcare service can longer rely on this traditional method of communication alone  More efficient services But other parts of the NHS must follow suit and invest in finding the right technology to improve the situation for their own patient populations. Greater investment in new innovative technologies should lead to lower DNA numbers and bigger savings for health and social care services across the country. Patients, meanwhile, would experience the same high standards of interaction they have come to expect from service providers in other industries. As well as the obvious cost of the appointment itself, which is around £120 for a hospital outpatient consultation, DNAs can often have a knock on negative impact in other areas. Treatment for other patients, for instance, may be unnecessarily delayed. Using technology to communicate with patients and, crucially, making it simple for them to confirm, cancel or reschedule appointments, means slots can be reallocated if necessary and clinics can run more efficiently. CARAS 2 In September last year, NHS SBS launched a new procurement framework for the NHS and wider public sector, known as Communication Appointment Reminder Alert Services 2 (CARAS 2). It was the latest in a series of similar framework agreements we have developed over the last nine years, providing a legally-compliant and cost-effective way for organisations to purchase the most up-to-date and innovative

technologies on the market in this area. The products and services available on CARAS 2 are separated into six specialist lots. They include SMS Managed Services, particularly effective for communicating with young adults who are arguably most likely to forget about appointments, Managed Email Solutions, intended for personal computers and hand held devices such as smart phones, Interactive Voice Response (IVR) Systems – for landline and mobile telephones – and Internet Communications, to reach patients via online services such as smartphone apps. The framework also has a lot for Agent Calls, which uses decentralised remote agents to make outgoing calls only, and a lot for Hybrid Mail, which allows for mail to be sent from an on or off site location to be printed and sent using digital data. Running until 31 August 2021, the agreement allows organisations to specify their exact needs and tailor services to get best value and ‘fit’, as well as the opportunity to bundle service areas together to deliver efficiency and enhance savings. Furthermore, organisations can access innovative solutions and products through suppliers known for technological advancements. Modern communications The chief executive of the TaxPayers’ Alliance said recently that ‘any trusts still relying on letters in the post should look to methods used elsewhere that are cutting

Communications

DNAs reduced to 7.2 per cent in Leeds

In 2013/14, nearly 130,000 patients did not attend appointments with the trust not having a formal patient reminder system in place. With approximately 50 per cent of patients missing appointments simply because they forgot, the trust DNA rate was 12.2 per cent, four per cent higher than peer average, increasing administration resource with rebooking of missed appointments. Working with Healthcare Communications, one of the organisations in Lot 1 of the Communication Appointment Reminder Alert Services 2 framework, Leeds Teaching Hospitals introduced SMS and IVM appointment reminders, using the most cost efficient contact mode first and automatically switching to IVM if the message is not received or land line only patient details are held. At the end of the first year, DNA’s were recorded at 7.2 per cent, which is 0.8 per cent below peer average, whilst attendance is now over 91 per cent, with 23,000 more patients attending in comparison to the previous year. In 2015/16, the trust generated £1.5 million in efficiencies. A key project success factor was giving patients the opportunity to respond digitally with CANCEL or REBOOK. Replies are reported in real time, meaning slots can easily be rebooked with advance warning. Read more at: tinyurl.com/ yc4wmeap missed appointments and saving taxpayers’ cash’. And he was right! Although letters in the post are still essential for reaching many NHS patients, a modern healthcare service can longer rely on this traditional method of communication alone. More NHS organisations should look closely at the technology being used by those at the forefront of addressing the issue. The CARAS 2 framework makes it cheap and easy to purchase bespoke solutions – without having to carry out complex in-house procurement – that suit the individual needs of an organisation and lead to year on year continual savings. L FURTHER INFORMATION www.sbs.nhs.uk/proc-frameworkagreements-support

Volume 18.3 | HEALTH BUSINESS MAGAZINE

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Awesome Apps â&#x20AC;&#x201C; 3D printing finds its mark Like many technologies, 3D Printing has taken its time to find its true vocation where the gains in digital processing are discovered by both leaders and followers. Often, new technologies need time to be matched with other skills and processes in order to be fully efficient. The advances in software, 3D scanners and 3D printers and light sensitive resins has now certainly reached this point Awesome Apps Ltd is a European distributor for the new MoonRay series of DLP printers that are revolutionising the worlds of dental production, investment casting applications and rapid prototyping, among others. A lot of our work is actually adapting and explaining where 3D printing fits within the modern workflows and while the health sector has experimented with 3D printing, it is less clear and how to use it in everyday processes. The dental sector is now starting to use the tools on a daily basis but the needs of implants and tools is yet to be fully addressed. The MoonRay 3D printer works using the newest technology with an LED based light source of defined wavelength. It uses an array of microscopic and individually controlled mirrors to project an ultra violet light onto very thin slivers of a UV resin held in a shallow tray. The layer is cured and begins to solidify before the light is re-focused on the next layer and cured in the same way. The layers can be as little as 20 microns in height or about a quarter of the width of a human hair. The detail produced is more than enough for many applications and there are three differing resolution versions to match the applications. The technology prints particularly

accurate models that are dimensionally consistent across the entire build platform and items are not distorted by where they lie on the platform. Driven by easy to use software for the Mac or Windows platforms, the user can position, scale, rotate and duplicate the model at the click of a button. The software runs on a perfectly normal PC or laptop and requires no specialist training to operate. For parts requiring supports during the process the software automatically generates these, such that they are both easy to remove and useful in ensuring a correct solidification process. The system is commanded by the software via an Ethernet or wireless link and is free to perform other tasks during the actual printing. This type of 3D printing technology has the net advantage that its is faster than the earlier laser driven (SLA) printers and can produce multiple parts in the time that the laser generation printers take to produce just one and is much less fussy in its handling and life span requirements. Within the health sector 3D printers have been used largely to demonstrate how they work and nearly all using a technology that is related to fusing an already solid material. These printers have

the benefit of relatively low costs but suffer in terms of speed and precision Resins available for model making or rapid prototyping not only include the full range ofÂ normal plastic type materials in a full range of colours but also bio compatible resins that are certified and come from a range of suppliers. These resins match exactly the wavelengths cured by the MoonRAY and are suited to aÂ range of applications from ear implants to dental crowns and bridges to podiatry. There are variable material strength properties as well as flexible resins allowing movement. Prototypes are not just confined to engineering. For example, the speed requirements of producing new medical devices and one off solutions to urgent problems can be tested and honed within hospital, clinic, design or support premises. With very tight deadlines to adhere to and restrictions on the number of times something can be tried the medical sector is often beyond normal engineering methods. Fast and Reliable The 3D printing speed of the design to make process or the scan to make process makes many of the medical applications feasible. Many health sector entities have rightly prioritised the digital connection between departments, populations and suppliers but there are areas where greater digital communication can be further enhanced by more tactile productions. Pictures and presentations are all good for getting the points across but to really get the feel of a new process or new device an in-house 3D model not only provides a realistic rendition of the idea but also details with room for improvement or modification. While such investments were initially restricted to outside of the office environment and often costed as major capital spend items, todays 3D printers cost less than a communications server or a web site update. What seems like a technology leap that is difficult to integrate and even more difficult to relay to administrators students and colleagues can often become straightforward when demonstrated in the form of a realistic model. The rapid turnaround of ideas into concrete examples is the essence of 3D printing and applicable to many more enterprises than are currently in use. The MoonRay 3D printer offers a compact, speedy, professional and elegant solution backed by the software and thirty year, technology expertise of Awesome Apps Ltd. L FURTHER INFORMATION www.awe-apps.com

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The deal between the Department of Health and Social Care and Microsoft will not only strengthen resilience against cyber attacks, but it will also mean that unsupported Microsoft systems in the NHS will become a thing of the past. Our role at NHS Digital is to support individual health and care organisations to best protect the data they hold and to ensure their own cyber‑preparedness. The new deal, signed at the end of April, gives local organisations the ability to do just that by enabling them to detect threats, isolate infected machines and kill malicious processes before they spread. The detail: A key part of the new centralised Windows 10 agreement is that it will offer local NHS organisations Microsoft Windows operating system licences, which include Windows Defender Advanced Threat Protection (WDATP). This WDATP facility gives local organisations better cyber security protection in their own right, but also links in with NHS Digital’s Data Security Centre, which improves cyber security protection for local health and care communities, and the NHS as a whole.

The deal will run for five years until 2023 and is free of charge to all local NHS organisations who agree to implement the Advanced Threat Protection facility. The Windows licences allow local organisations to use either Windows 7 SP1, Windows 8.1 or Windows 10 Build 1607 and above, so organisations do not need to wait until their full migration to Windows 10 is complete in order to benefit.

How does WDATP work? WDATP works by monitoring the Microsoft Windows operating system on a PC or laptop device for any abnormality in its working. If it sees an abnormality, it alerts local management and, if configured The benefits: by the local organisation, it can quickly There are a great many benefits when it provide response actions to prevent comes to this new deal, but it is especially a malware infection spreading. advantageous for local NHS organisations, Put simply, WDATP knows how Windows who will no longer have to pay for should be working, so if anything abnormal Microsoft Windows client software out happens, it knows that something is wrong. of their own revenue funding, releasing Because WDATP is an integrated part of money for direct patient care. the Windows operating system, The good news is that any it can respond immediately organisation delivering y n A to address the issue predominantly NHS‑funded n tio before it spreads. care can be part of the rganisa ng o i r As WDATP is provided service, including trusts, e v i del ly t as part E clinical commissioning n a n i groups, GPs, predom d care can commissioning ce, funde

Written by Peter Dyke, NHS Digital Programme Head, NHS Windows Managed Service

NHS cyber security has been given a major boost with the announcement by the Department of Health and Social Care of a new multi-million-pound deal with Microsoft. NHS Digital’s Peter Dyke explains how

Cyber Security

A window of opportunity for NHS cyber security

support units and arms-length bodies. It also includes community interest companies and commercial providers who are providing IT services for NHS organisations. The service does not currently extend to local authorities, care homes, community pharmacies, dentists and opticians, or independent sector provider non-NHS activities. The software also includes local device encryption (Bitlocker) as well as the Windows Defender Antivirus product, which can replace other locally purchased alternatives, saving further local cost. It means that eligible organisations can be assured that their desktops are running on modern, secure software. Using the ATP portal, these organisations will be able to monitor the security status of their infrastructure against cyber threats. It also means that the NHS has a real time understanding of cyber threats at national level and is therefore better equipped to respond to cyber threats as they occur; ensuring that the right interventions are taken to protect the wider system.

NHS‑ of the servi s, be part g trusts,CCG includinommissioning GPs, c rt unites and suppo s‑length arm ies bod

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Revolution in NHS smartcard authentication driven by virtual smartcard Isosec You can discuss physical NHS smartcards with almost any NHS trust to instantly get the picture. It’s a tale of how day-to-day life is made difficult by business processes and management overhead from trying to issue physical smartcards to all staff, permanent and agency, in a world of ever-increasing estate size and technical complexity Whether it’s how to issue physical smartcards to a cohort of new junior doctors at 4pm on a Saturday or how to replace lost cards in the middle of the night without compromising patient care – this NHS process was crying out for innovation. Isosec has heard these scenarios (and worse) time and time again from customers and wanted to deliver the necessary innovation to improve efficiency whilst ensuring both security and the strong identity check remained vigilant. Having over 10 years experience with NHS authentication and a background in IT security, Isosec were ideally placed to work with over 50 NHS trusts who are using the tried and tested Isosec Identity Agent iO for authentication. It was clear that customers wanted to keep all the great functionality that physical smartcards provided, yet needed a more virtual and workable solution,where the physical smartcard could be replaced by a virtual one, kept securely in the cloud, and deliver fast, safe and seamless authentication and experience for users. It also needed to embrace and support new and upcoming functionality, like ePrescription and robot automation, which are both coming online later in 2018. During the past year, Isosec combined the ingenuity of the development team with customer feedback to design, develop and deliver the Isosec Virtual Smartcard solution. After working closely with Barnsley Hospital NHS Foundation Trust, the formal launch took place in January 2018. Since then, Isosec has six new NHS organisations on board, with many more adopting Virtual Smartcard in the coming months. Tom Davidson, ICT director, Barnsley Hospital NHS Foundation Trust, said: “Isosec and the Virtual Smartcard solution has solved a huge problem for us and has actually directly impacted our patient care. We’re getting nurses turning up, getting what they need to access systems straight away in the right place so that they can get on with delivering the care that they need to deliver. I highly recommend this technology to any NHS organisation.” Virtual Smartcard addresses a multitude of inefficiencies the NHS is currently facing from managing physical smartcards. Issuing physical

cards takes a long time and requires specialist printers for production. Common issues and inefficiencies around issuing physical cards arise particularly when recruiting. Clinicians have to travel around the trust to register for cards so Virtual Smartcard is a big time saving for them as well as avoiding any unsafe workaround tactics like leaving cards in readers or card-sharing that can pose huge information governance risks to patient data. So, what are the key components and why is the Isosec Virtual Smartcard so beneficial to the NHS? Virtual RA Smartcards are issued by a trust’s Registration Authority. Issuing physical cards takes time and requires specialist printers. With the Virtual RA a manager can issue a Virtual Smartcard in the Virtual Smartcard Cloud where it is stored securely and never leaves. Other methods of authentication that can be easily associated with Virtual Smartcard include HR cards, AD accounts and even biometrics. Self-Service A Virtual Smartcard can be reset using self‑service to avoid issues surrounding locked cards. After visiting the self-service portal, a user enters their NHS email address to which a reset web link is promptly provided. The

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linked page asks the user to answer security questions specified during registration. This allows the user to unlock their Virtual Smartcard and reset the passcode. Each reset saves approximately 30 minutes of clinical time and can be done whenever, wherever. Analytics Every use of a Virtual Smartcard is audited, geotagged and digitally signed giving the trust an unequivocal view of when and who authenticated, which apps were used and for how long. Spine clinical applications also show the actual Spine user details, not a generic name in the case of generic physical smartcard usage. Security Virtual Smartcard requires two-factor authentication to national apps as per NHS standards known as eGIF level 3. As the Virtual Smartcards are cloud based, they are more secure as there is nothing for a user to lose or leave in a reader. In the event of smartphone loss, Virtual Smartcards can be instantly deregistered using the Virtual RA preventing any breach. L FURTHER INFORMATION www.isosec.co.uk/vsc

Jeremy Hunt, Health and Social Care Secretary, said: “We know cyber attacks are a growing threat, so it is vital our health and care organisations have secure systems which patients trust.

Cyber Security

“Cyber attacks are a growing threat”

“We have been building the capability of NHS systems over a number of years, but there is always more to do to futureproof our NHS against this threat. This new technology will ensure the NHS can use the latest and most resilient software available – something the public rightly expect.”

 of an NHS national system, an alert of an abnormality is shared with NHS Digital’s Data Security Centre in near real time – allowing NHS Digital to more quickly and effectively co-ordinate the overall NHS response to cyber threats as they evolve. The national picture is also shared with other NHS entities (e.g. other partners within an accountable care system) so they all have the visibility of a developing threat enabling them to take the appropriate response.

The WDATP facility gives local organisations better cyber security protection in their own right, but also links in with NHS Digital’s Data Security Centre, which improves cyber security protection for local health and care communities, and the NHS as a whole

Local input: A great deal of planning and research has been undertaken to ensure that this is the right deal for the NHS. We have worked with an advisory group of approximately 90 local organisations (trusts, CSUs, CCGs, CICs etc) to develop the service offering. More than 20 of these organisations have committed to act as early adopters for the WDATP element of the service. A user group will also be maintained as a focal point for ongoing development of the service during its life.

What happens now? Though it is not mandatory for organisations to take up this service, we are expecting the majority to do so. Central funding for Windows operating systems licenses will not be available to organisations who are not part of the service. All NHS organisations joining the service must commit to migrating from their current Windows 7/8 estates to Windows 10 by no later than 14 January 2020,

as the Windows 7 operating system will be unsupported after that date. NHS organisations have already successfully migrated more than 100,000 NHS devices to the Windows 10 operating system, and guidance and support to help trusts with their migration will be provided as part of the service. L FURTHER INFORMATION http://digital.nhs.uk

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e-Procurement Written by Ed Palferman, lead for Stakeholder Engagement for the Scan4Safety Programme, Department of Health & Social Care

PEPPOL: a single, digital market Ed Palferman, lead for Stakeholder Engagement for the Scan4safety Programme at the Department of Health, explains how PEPPOL can simplify business and can reduce costs for the healthcare system PEPPOL (Pan-European Public Procurement On-Line) is the culmination of a multi-year project that started in 2008, co-funded by the European Commission and 11 member states. It is a set of technical specifications that aim to harmonise and simplify electronic procurement processes, reducing ‘digital’ barriers of trade across the EU. At its core is the aim to be the de facto way for buying and selling organisations to exchange business documents. The specifications were established and are now managed by OpenPEPPOL, a not-for-profit organisation funded by its members. It designed and maintains a set of standards that enable business documents, such as purchase orders and invoices, to be electronically exchanged without manual intervention between buying and selling organisations through interoperable commercial PEPPOL ‘access points’. PEPPOL set out to ease

the burden of doing business with public sector organisations across Europe. Different standards and business requirements had emerged over time and meant that suppliers to the public sector across Europe had to accommodate many different ways of working, including sending invoices in multiple formats. The impact of this extended to creating virtual business silos across Europe, where some suppliers were able to trade electronically with public sector organisations in one region or country easily and not with others. This fragmented the market and empowered electronic trading service providers. The work of OpenPEPPOL includes establishing and growing the PEPPOL network. The network prioritises functionality that ensures interoperability on the

Implem e the PEP nting standar POL integra ds is an NHS ePl part of our r Strateg ocurement create sy and will ig efficien nificant quality cy and gains

principle of ‘set up once and use many times’. Within country regions, the set up and growth of the local PEPPOL network is delegated to ‘PEPPOL Authorities’. In the UK, the Department of Health and Social Care is the designated PEPPOL Authority, and the growth of the network is being driven largely through the work of the Scan4Safety programme. Advantages For suppliers to public sector organisations in Europe, PEPPOL provides the opportunity to establish a single point of connection and single contract with an electronic document transmission service provider. This simplifies business and can reduce costs associated with trading with the public sector. The benefit increases significantly with the growth of the network. When that single point of connection enables a supplier to do business with public sector organisations across Europe, the costs associated with electronic trading and the ease of expanding business opportunities, PEPPOL becomes an attractive option for any forward-thinking business. The principal model on which PEPPOL is structured avoids duplication of effort,

space for years and others are much newer to the scene but all are playing a vital role in turning these benefits into reality. A core principle of electronic networks today, from banking to eProcurement, is interoperability. The power of the Internet is a massive expansion of business horizons and ambitions. Trading electronically no longer need be a complex and labour-intensive

In the UK, the Department of Health and Social Care is the designated PEPPOL Authority, and the growth of the network is being driven largely through the work of the Scan4Safety programme organisation with which a supplier wished to trade. The result was duplication of services and duplication of fees. Through PEPPOL, suppliers and public-sector organisations have freedom of choice to choose whichever PEPPOL provider they wish. Furthermore, whichever service provider they choose will not limit their ability to trade with any other organisation also trading over PEPPOL. Making it happen None of these advantages could be realised without the support and cooperation of service providers that are enabling the network’s growth and functionality. Some of these companies have worked in this

exercise. PEPPOL is the next, phase of interoperability in eProcurement. Technology service providers that embrace this principle and assist with the rollout and delivery of an effective PEPPOL network are undoubtedly set to prosper and grow along with the network. Realising the future of the single, digital market Today, PEPPOL is in use in 19 countries across Europe and growing all the time. There are also ‘Certified PEPPOL Access Points’ – providers of PEPPOL-compliant electronic trading services – in the USA and Canada. In the UK, a commitment to the adoption of PEPPOL by NHS trusts and suppliers to

the NHS was made in the NHS eProcurement Strategy, published in 2014. The NHS is leading the way in driving the adoption of PEPPOL standards, with six Scan4Safety ‘Demonstrator Sites’ and a group of compliant suppliers spearheading efforts to increase the rate of growth of the PEPPOL network, guided by the team at the Department of Health and Social Care. NHS Supply Chain is also steadily increasing the number of suppliers with which it is doing business via PEPPOL. Steve Graham, eProcurement lead at the Department of Health and Social Care, said: “Implementing the PEPPOL standards is an integral part of our NHS eProcurement Strategy and will create significant efficiency and quality gains that will ultimately benefit patients and taxpayers. We have collaborated with European colleagues to demonstrate that PEPPOL will work in the NHS environment, and we are now moving ahead in our plan for wide adoption.” In February this year, The Office of Government Procurement Ireland released a Request for Information relating to the provision of PEPPOL services. Norway is now conducting a huge proportion of its public-sector business online using PEPPOL. More than 110,000 public and private sector entities are part of the PEPPOL network, resulting in over six million electronic invoices and other eProcurement documents exchanged via the network each month. L

e-Procurement

lowering the barriers to trade for new or small and innovative suppliers. It simplifies access to a huge market and avoids roaming fees, which have been a significant disincentive for suppliers. Before PEPPOL, suppliers were frequently required to connect to multiple electronic trading service providers. Their choice of service provider was often dictated by the

FURTHER INFORMATION www.peppol.eu

Inventory management efficiency Salisbury NHS Foundation Trust faces the challenge of meeting increased demand for operational efficiencies in the supply chain. Prior to the upgrade of the inventory management system, there was no methodology to track stock wastage, which resulted in a highly manual expiry management process. However, through Scan4Safety, Salisbury NHS Foundation Trust has increased visibility of its inventory and stock wastage, reducing wastage in orthopaedics by 96 per cent. New procedures and processes were implemented for receipting, rotating stock and proactively managing inventory. This enhances the management of supply chain flow coming in and out of the trust. Furthermore, with increased visibility of stock through the inventory management system, and setting procedures for receipting and rotating stock, the trust can accurately forecast savings over £100,000 in orthopaedics by the end of the 2017/18 financial year. Through increased understanding and management of expiring products, the trust developed better relationships with its suppliers. For example, with consignment stock,

suppliers would be notified months in advance of their products reaching expiry, in order negotiate terms and conditions for an exchange. Together with suppliers, utilisation trends could be analysed to rationalise inventory and implement appropriate stock levels. The trust is now looking to roll this out across all areas of the hospital so 100 per cent of all implantable devices can be tracked.

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Public Sector Show

Creating smarter and more efficient public services Exclusive research from the Public Sector Show 2018 has taken the temperature of over 700 UK public servants, giving a picture of their views on the health of the nation’s public services. In light of this, Health Business looks at the findings and ahead to June’s show The State of the Public Sector report sets out the views of those leading, delivering and managing core public services in the UK on the key challenges facing the sector in the months and years ahead. Top of the list of public servants’ concerns in the second edition of the publication is finance and resources, with 71 per cent of respondents identifying this as an issue as the sector confronts the challenge of doing more with less. The potential impacts of Brexit are not far behind, with 59 per cent of respondents citing it among their concerns. It is too soon to say with any certainty what impact leaving the EU will have on the UK’s public services, but as the date of our departure edges closer, public servants are aware they need to be preparing now for what the future may bring. Key to high-quality public services are the people who deliver them, something acknowledged by the 38 per cent of respondents who cited staff shortages as a key challenge, while over half (54 per cent) expect the s challenge of building and Sessionar’s maintaining a workforce e y at this ector with the right skills and S experience to get harder. Public l include These issues, and il Show wed discussion others identified in the -l report, will apply across an NHS w the public different parts of the on ho an develop a public sector to varying degrees. However, with sector commerciallydebates ongoing about more c cused NHS capacity and funding, fo the future of EU nationals t mindse working for the health service and the pay and working conditions of NHS workers, their relevance to the healthcare sector cannot afford to be ignored. Technology and automation The report makes clear that those providing the public services we all rely on face some acute challenges. However, it also explores potential solutions, including how technology is set to become more fundamental to public sector operations. There is significant optimism that technology and automation will enable better and more efficient public services – however, this may be something of a ‘double-edged sword’, with a majority (64 per cent) of public servants also expecting it to cost jobs. Corby Ganesh, portfolio director for The Public Sector Show, said: “There’s no doubt that digital technology provides exciting opportunities for the public sector to ‘work

smarter’ when it comes to delivering the services we all rely on. But building a workforce with the right people and skills will be just as vital as technology in ensuring our public services are fit for the future. That’s why we’re delighted to be welcoming an exceptional line-up of speakers and exhibitors to the Public Sector Show to showcase their innovative products and share their experiences and insights into the future of public service delivery.” The State of the Public Sector report also highlights instances where the public sector is already putting innovative solutions into practice, such as the Braunstone Blues project in Leicester, which is pioneering a collaborative approach to information sharing between local blue light (emergency) services, local authorities and local health services to enable more targeted support for high‑demand emergency service users. Learn. Procure. Deliver. Insights from the report have been used to shape the agenda of this year’s Public Sector Show, the must-attend event for those involved in delivering public services in the UK. Helping public servants cope with the ever-present resource challenge is one of the key objectives of this year’s show. Sessions will include a discussion on how the public sector can develop a more commercially-focused mindset, where Alyson Brett, managing director of NHS Commercial Solutions, will speak on a panel exploring the pioneering approaches being taken by public sector organisations to find new sources of revenue without compromising the sector’s values. Panelists will also consider how best to support staff to develop their commercial skills. Speaking ahead of the show, Brett said: “The NHS and local authorities are facing many challenges linked to the fact that we’re all living longer but new technologies including AI could help take some of the strain out of the system. Worryingly, there’s a growing trend for people to ‘DIY diagnose’ using Google. The technology of the future could stop that by providing people with access to an app that triages them around the health system based on an initial diagnosis.” Ensuring that UK public services can continue to meet the needs of citizens will be another key theme of the show, with sessions exploring the important role that technology can play here. Eve Roodhouse, director of Implementation at NHS Digital, will speak on a panel exploring how

digital change can help revolutionise the interactions between state and citizen, including digital procurement solutions. Focusing on themes including leadership, estates, infrastructure, technology and finance, the show will bring together over 2,000 senior public sector budget-holders and decision‑makers to hear from over 140 leading speakers – including Chris Grayling, Secretary of State for Transport; Deborah McKenzie, Chief People Officer for Public Health England; Dave Sweeney, director of Transformation and interim chief officer at NHS Halton Clinical Commissioning Group; and Robert Jenrick, Exchequer Secretary to the Treasury. A theatre showpiece The centrepiece of the content on the day will be The State of the Public Sector Theatre, delivering strategic messages from political heavyweights as well as leaders from government departments and other leading public sector bodies. The theatre delves into overriding top-line themes that pose cross-sector challenges for the public sector, including delivering value for money, transforming digital services and leading organisations to meaningful change. Additionally, now in its third year, the National Infrastructure Forum combines thought-leading content, top-level policy briefings and insights into the future of

public sector, providing the opportunity to delve in conversation into the most prominent topics in the sector with some of its most influential voices. Returning to digital and technology advances, the Digital and Technology Theatre provides a platform for local digital leaders and path-finding technology providers to present and share the latest ways to deliver digital transformation, digital services and a digital government. Some of the key themes include improving user experience, automation, AI, the cloud, digital skills, data, and next steps for digital transformation and change across the public sector. Focusing on leadership and assembling the foremost leaders of the public sector to discuss the essence of good leadership and HR management, the agenda in the Workforce and Leadership Theatre discusses how it is they can attract, train and retain the most talented employees in the UK. Key topics include fostering inclusion and diversity, improving staff productivity, effective recruitment, upskilling employees, and overcoming workforce barriers to change. Bringing together leading facilities and assets management professionals to share policy and practice in delivering rational and sustainable estates, key topics in the Assets and Estates Management Theatre include: the rationalisation and commercialisation of the public sector estate, new ways of working through shared services and hubs, creating modern workplaces through smart and remote working, and delivering local government rationalisation through the One Public Estate programme. Delegates will also be able to interact with over 150 exhibitors –

Public Sector Show

Alyson Brett, managing director of NHS Commercial Solutions, will speak on a panel exploring the pioneering approaches being taken by public sector organisations to find new sources of revenue without compromising the sector’s values. Panelists will also consider how best to support staff

With debates ongoing about NHS capacity and funding, the future of EU nationals working for the health service and the pay and working conditions of NHS workers, their relevance to the healthcare sector cannot afford to be ignored the sector. Bringing together the most prominent figures and influencers in the industry, the forum creates the opportunity to discuss and debate the key issues in UK infrastructure, dealing with challenges such as delivering the infrastructure pipeline, Britain’s new industrial strategy, Brexit, expanding the supply chain and embracing the future of infrastructure. The Hot Seat agenda provides an engaging and interactive forum for attendees to gain insights from the most compelling and thought-provoking leaders in the

including Specsavers, Toshiba, HP, Lyreco and KPMG – whose innovative products and solutions can help support the delivery of improved public services. L

The Public Sector Show takes place on Thursday 26 June at ExCel London and is free to attend for those working in the public sector. FURTHER INFORMATION https://psshow.co.uk/

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Products & Services

First choice for events, conferences and meetings

Specialists in commercial fire safety and security

Carnegie Conference Centre is conveniently located just 15 minutes from Edinburgh International Airport with train and bus links nearby to all of Scotland’s major cities. From full scale conferences to one-toone training sessions, Carnegie Conference Centre has the rooms, flexibility and technical equipment to meet your needs. The centre’s main hall comfortably holds up to 300 delegates with a further 22 conference and breakout rooms of varying sizes, including a Video Conferencing Suite and IT Training Suite. Whether you require a meeting room for an hour or five days, for two people or 300, for an assessment day or corporate dinner, the organisation’s professional events team are on hand to offer advice and guidance every step of the way, ensuring your event is a huge

Zone 10 Protection Ltd is a leading commercial fire safety specialist in the UK. The company is BAFE SP203-1 accredited in fire alarm design, installation, commissioning and maintenance. The Zone 10 team has a wealth of experience in designing quality systems from small ‘one out all out’ through to some highly complex ‘cause and effect’ systems for some of the largest global companies in the UK. The organisation’s systems are professionally designed to British Standards BS5839, and to suit purpose, property type and environment, therefore reducing

success. The dedicated IT Support Team will also be on hand to assist before and during your event if required and Carnegie’s outstanding chef can provide tailor-made menus just for you. Situated in Dunfermline, just off the M9 motorway and only 25 minutes from Edinburgh, Carnegie Conference Centre is in an ideal location for delegates travelling from all over Scotland. Free parking is available on-site and there are excellent public transport links for bus and rail.

FURTHER INFORMATION Tel: 0344 248 0142 www.carnegie conferencecentre.co.uk

ENERGY

FIRE SAFETY

costly and unwanted false alarms in your premises. Other services include: maintenance contracts; emergency lighting; building access control; CCTV/security systems; fire risk assessments; fire door installation and upgrades; fire safety signage; fire extinguishers and fire warden training. Its engineers are experienced and fully vetted with DBS & ECS health and safety checks.

FURTHER INFORMATION Tel: 01908 822416 www.zone10.co.uk

FACILITIES MANAGEMENT

Providing cost effective energy solutions

Leaders in energy control for the public sector

Watt Energy Saver is an industry leading specialist energy engineering company based in Nottinghamshire, which delivers design, installation, commissioning and registration across a broad market sector. The company has strong supply chain links in the UK and Europe with a track record for successful delivery to commercial, industrial, educational and healthcare customers. Focusing on energy conservation, renewable technology and the integration of mechanical and electrical services into both new and existing buildings, Watt’s diverse range of skills ensures it delivers best value and a quality installation time after time. As one of the few companies able to deliver all renewable technologies, Watt Energy Saver is able to offer a considered approach to

CP Electronics is recognised worldwide as a leader in energy saving lighting controls. The company’s systems minimise energy use and cost without affecting user convenience. CP Electronics can work with any light source, in any building and any space, from a sports stadium to a CEO’s boardroom. It works with both private companies and public sector organisations. Its UK-based production team works to BSI/ISO standards, using advanced production techniques. CP Electronics is so confident of its quality and testing regime that it offers a five year warranty across the range. Marcus Martin, managing director of CP Electronics, commented: “When CP Electronics was founded in 1970, awareness of climate change was in its infancy.

which the most appropriate technology for your project, offering a range of installations including solar photovoltaics, ground source and air source heat pumps, energy efficient boiler upgrades, lighting, energy storage, generators, electric vehicle charging and metering and monitoring systems to keep track of how efficient you are. The company’s highly driven individuals form an enviable team of building services professionals.

FURTHER INFORMATION Tel: 0845 475 7710 info@wattenergysaver.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Yet even then it was clear that the age of cheap energy was coming to an end. Our vision - to design and make reliable energy-saving controls - found a receptive market. “The drive for innovation, cutting edge technology and ongoing expertise in the energy controls sector are our tools to help you take control of your energy costs and your carbon footprint. “It’s this drive that made us the perfect fit for Legrand, and in 2016 we became part of the Energy Controls business unit of Legrand UK & Ireland.” FURTHER INFORMATION www.cpelectronics.co.uk

ENERGY

Comms and sustainable energy solutions provider

Energy management and procurement services

With over 25 years of experience in the IT industry, UCS Technologies has continued to broaden its business to meet the growing needs of a modern work place, supporting organisations by providing connectivity through wireless, network infrastructure & AV solutions. The company’s sustainable energy division continues to be a MCS installer of solar photovoltaic arrays, reducing energy costs throughout the UK. Installing in all environments from commercial sites, residential developments, new builds and the health sector, the organisation’s focus is on establishing itself as a leading installer of EV charging solutions for commerce as well as residential.

Energy Renewals is a specialist in energy management for businesses from SME to large corporations, multisite companies, retailers, public sector organisations and charities. The company understands that no two businesses are the same and tailors its solutions to maximise savings and deliver the very best return on investment. Its team of energy experts make sure that customers buy at the right price, use no more energy than is needed and eliminates unnecessary usage to deliver true cost savings that go straight to your bottom line profit, and at the same time support your corporate and social responsibilities by reducing your carbon emissions and meeting with environmental targets. From smart energy procurement, account management, bill validation, energy audits and site assessment through to smart billing

Partnering leading providers of EV chargers such as EVBOX & Rolec, UCS Technologies is ideally placed to offer you the best service and the right solution. With further advancements in the energy sector, such as battery storage and the adoption of electric vehicles and more devices being powered over structured cabling, there is definite convergence between both divisions and synergy to its offering. Speak to UCS Technologies today and plan business solutions that work for your organisation.

FURTHER INFORMATION Tel: 01642 242567 www.ucs-technologies.com www.ucs-renewables.com

ENERGY

and consumption reduction, Energy Renewals embraces technologies such as BMS control systems, LED lighting, biomass, combined heat and power, renewable solutions, voltage and boiler optimisation to mention but a few. The organisation offers a suite of products that can be supplied and installed on either a Capex or Opex basis to meet with your financial policy and risk assessment. Identify energy waste using the company’s tried and tested six step SMART process, with its key objective to achieve total energy efficiency with minimal impact to operational and financial costs.

FURTHER INFORMATION www.energyrenewals.co.uk

INFECTION CONTROL

Advanced software for managing energy data

Gloves and consumables for the healthcare industry

Optima energy management software saves it’s users both time and money through better analysis and management of their energy and water data. Established in 1988, Optima’s software is used by public and private sector organisations and energy consultants to manage the energy data for over 22,000 organisations and 380,000 sites. Data is fundamental to understanding how and where energy is used, along with accounting for the associated costs and greenhouse gas emissions. Optima validates all types of utility data and provides a suite of modules to generate savings in energy and costs, including: monitoring and targeting; bill validation; tariff analysis; budgeting; tenant billing; and regulatory compliance (e.g. CRC). Optima Visualizer is the

Over the past 14 years Gloveman Supplies Ltd has grown to become one of the leading suppliers of quality, disposable, medical products into the healthcare industry, including those essential in preventing the spread of healthcare-associated infections. Every year lives are lost as a result of the spread of infections in hospitals and Gloveman’s well established range of branded gloves, extensive range of PPE and infection control products can be relied upon to ensure that your workplace is maintained to the highest possible hygiene standards. Additionally, the organisation’s portfolio of products has increased over the years to include trusted brands such as

company’s web-based reporting platform that delivers stunning reports and dashboards to provide users with powerful insights designed to highlight both the risks and opportunities relating to utility consumption. Built on a massively scalable cloud-based analytics platform, users can report and analyse their Optima data quickly and easily. Dashboards are fully configurable to ensure the content is 100 per cent relevant to each user. Accredited to both ISO 27001 and Cyber Essentials Plus, Optima has considerable experience in working with public sector organisations including the NHS.

FURTHER INFORMATION www.optimaenergy.net

Products & Services

ENERGY

Clinell, Purell and Gojo, to name but a few. Gloveman stocks a full range of soap and hand sanitisers with dispensing options as well as paper and polythene disposables, patient wipes, continence products, first aid, cleaning chemicals and janitorial supplies. The new online ‘Gloveman VIP’ system has been developed so you can order at your convenience 24/7, not just during office hours. Alternatively, Gloveman’s friendly customer service team are on hand should you have any questions.

FURTHER INFORMATION Tel: 01209 314759 info@gloveman.co.uk www.gloveman.co.uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Products & Services

FIRE SAFETY

A service for all your fire safety requirements

Over 40 years of fire protection experience

Managed by a serving fire officer with over 25 years’ experience, Red Fire Safety Services Ltd regularly witnesses the devastating aftermath of fire and its effects on people and businesses, which is why they are passionate about fire safety. The company’s mission is to make its clients safe from fire. Red Fire Safety Services engineers are industry approved, undertake regular refresher training and are constantly assessed so that the organisation can provide the best possible service. The company has a number of existing healthcare client’s, so their engineers understand the unique challenges facing healthcare professionals and their responsibilities under the Regulatory Reform (Fire Safety) Order 2005 including the requirement for annual and bi-annual servicing of fire safety equipment. Client’s safety is Red Fire’s

Newflame has been protecting industrial companies, businesses, schools, hospitals, prisons and farms from the menace of fire since 1975. A family-run firm, the Newflame team are members of the British Fire Consortium. Newflame has recently invested in new premises in Yaxley, which gives the engineers easy access to their main customer base. Four times bigger than the previous base, the Yaxley site includes a new dedicated training suite, where offsite courses are run for a wide variety of customers. Newflame operates mainly within a 75-mile radius of Peterborough. However, because of its excellent location close to the central motorway

business, so the company offers a range of products and services to healthcare providers, large and small, from supplying a single fire extinguisher to providing complete fire safety solutions. Services are tailored to meet client’s specific requirements and include the design, supply, installation and maintenance of all fire safety equipment including emergency lighting and hard wired/wireless fire alarm systems; they also provide fire risk assessments, fire stopping and fire safety training.

FURTHER INFORMATION Tel: 01689 493641 www.redfiresafety.com

PATIENT SAFETY

FIRE SAFETY

network, the company has the ability to cover all parts of the United Kingdom. As a result, Newflame provides service solutions to over 4,000 customers. These range from single units to large companies and those with multiple locations. This area of focus includes Cambridgeshire, Lincolnshire, Norfolk, Leicestershire, Northamptonshire, Bedfordshire, Hertfordshire, Nottinghamshire and Derbyshire.

FURTHER INFORMATION Tel: 0800 542 2057 www.newflame.co.uk

SECURITY

Privacy screens to improve the patient experience

Security providers in Southern England

Tired of hospital curtains? Looking for a flexible, state of the art alternative? KwickScreen has the solution with their portable, retractable, printable, medical partition screens. KwickScreens enable you to adapt your space to the ever changing requirements in modern healthcare. When you need flexibility, KwickScreens not only allow you to create private and dignified spaces adaptable to multiple uses, but to make them personal too. You can choose from a wide range of images, chosen by our designers, and bring the healing benefits of art into your patient experience. KwickScreen medical screens are infection control approved, and provide a hygienic and easyto-clean alternative to hospital curtains. The medical privacy

Frontline Total Security Ltd is one of the main security providers in Southern England and proud to be a part of the Security Industry Authority (ACS) Approved Contractors Scheme. Frontline Total Security like to feel that it is able to offer all its clients the complete security solution. The company’s main area of operation is the supply of security officers to large organisations and blue chip companies. Specialising in security services to the adult care and support marketplace, Frontline services also include event staff for festivals and music events along

screen allows for effective isolation of patients, which both enhances infection control and allows for greater privacy and dignity for the patient. Do you have a space that needs to change to fit different scenarios? Do you want to give your patients the best possible quality of care? Make the move to diversify and modernise your space today. Give KwickScreen a call, and see how the company can help you transform your space with a flexible, personal, innovative solution.

FURTHER INFORMATION Tel: 0208 452 5972 info@kwickscreen.com www.kwickscreen.com

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

with high volume locations within the leisure industry. Frontline Total Security currently holds SIA Approved Contractors Scheme (ACS) for the provision of Security Guarding, Keyholding A Door Supervision operating from offices in Cornwall & Oxfordshire. FURTHER INFORMATION Tel: 01726 338287 info@frontlinetotalsecurity.com www.frontlinetotalsecurity.com

CONFERENCES & EVENTS

First choice for events, conferences and meetings

A unique conference venue in the West Midlands

This venue is eight miles from the M6 at Stafford, yet in the quiet countryside with no buildings in the view, giving complete privacy. Sugnall Hall is a traditional country house with four acres of garden. Inside it has several reception rooms, and can accommodate up to 80 seated in the Billiard Room, which has a large digital screen suitable for presentations and with full access to Wi-Fi. There is also the Dining Room which seats 14 round a table, the Drawing Room which seats up to 20 in relaxed informal manner, and a first-floor sitting room that seats six. Overnight accommodation can be provided in its 14 double bedrooms, 12 ensuite, and free parking is

FURTHER INFORMATION Tel: 0344 248 0142 www.carnegie conferencecentre.co.uk

ICT

also available. Catering can be tailored to your event. Rates will depend on your requirements, with delegate day rates and 24-hour rates available. Sugnall Hall is willing to discuss any aspect of your event with you. Team-building activities can be arranged with local suppliers, and details available on local walks and restaurants. FURTHER INFORMATION Tel: 01785-851711 dlj@sugnall.co.uk www.sugnall.co.uk

ICT

The complete software solution for healthcare

Best practice care for medication management

Pandora X is a software company that initially created a care management system that could deal with all the day-to-day operations within both clinical, community and residential care services. Since inception, the system has progressed to include multiple modules that provide solutions within healthcare and other industries. These enhancements contribute to creating a complete care management software ensuring efficiency in operations, human resources and most importantly care for service users. The need for effective functioning technology is on the rise in the care industry. One of the main reason for this is improving the quality of care, increasing productivity and saving money. Pandora Care system ticks all those boxes by being a complete care

Earlier this year, the Department of Health found that 237 million mistakes occur at some point in the medication process in England. A new report, SAFE: Banishing Medication Errors in Secondary Care, has been launched by Omnicell UK & Ireland, the world-leading provider of automated healthcare and medication adherence solutions. The report is part of a campaign to raise awareness and promote best practice for the management of medication to help drive change and improve patient safety across healthcare settings in secondary care. Authored by a leading pharmaceutical expert, the report found that within secondary care settings the implementation of automated medication administration systems alongside ePMA systems would dramatically reduce the risk of medication errors. By putting the

solution available via desktop and mobile application. It includes: electronic patients records; incident reporting; rota management; employee records; task engine; financial matters; live dashboards; and In Mail. Implementation is one of the most important stages of introducing technology into your organisation. Pandora X has three key implementation stages: planning, development and management.

FURTHER INFORMATION Tel: 01603 937648 www.pandoracare.co.uk

Products & Services

CONFERENCES & EVENTS

two systems in place together, trusts will be able to strengthen patient safety from the moment the drug is prescribed to when it is administered to the patient. Over three quarters (79 per cent) of medication errors within secondary care happen during the administration process and it is vital that trusts put systems in place to safeguard against this. You can support the campaign with the hashtag #BanishMedErrors.

FURTHER INFORMATION Tel: 0161 413 5333 www.omnicell.co.uk

Volume 18.3 | HEALTH BUSINESS MAGAZINE

Advertisers Index

If you’re looking for a cost-effective alternative in a city steeped in history, Edinburgh is the obvious choice Famed for its listed buildings, Michelin star restaurants and as one of the UK’s leading cultural hubs, Edinburgh offers an attractive destination for those organising a conference or event. The International Congress and Convention Association (ICCA) has ranked the city as the most popular conference destination in Scotland and the secondmost visited in the whole of the UK. It continues to have an international influence in science, business and education, and hosts the world’s largest annual arts festival. As part of the University of Edinburgh, Edinburgh First offers first-class conference options for those travelling to Scotland’s capital. Based in the heart of the city – just 20 minutes away from Edinburgh Airport by train – Edinburgh First can cater to meetings of all sizes, from small meetings to large conferences for 1,000 delegates. Edinburgh First has 15 venues across the city, providing more than 70 meeting rooms for delegates. They range from historic venues, such as the 19th century McEwan Hall and the neoclassical Playfair Library Hall, to the state-of-the-art John McIntyre Conference Centre. As well as

conference rooms, each venue offers relaxed breakout areas for delegates to unwind. Additionally, Edinburgh First also offers conference accommodation in Edinburgh, with 153 en-suite bedrooms available year‑round plus an additional 1,885 bedrooms from June to September. It has private dining rooms, restaurants, bars and cafés too – as well as all of Edinburgh’s attractions right on your doorstep – offering plenty of opportunities for post-conference team-building and networking. Edinburgh First’s event management service provides a one-stop-shop service to host, deliver and manage events at

any one of its facilities in Edinburgh. The service can help provide advice as guidance, as well as designing and supporting events through website building, event registration and payment handling. With a choice of historic mansion houses and modern conference facilities, Edinburgh First delivers an efficient and cost-effective solution for any event in Scotland’s historic capital city. FURTHER INFORMATION Tel: 0131 651 2189 www.edinburghfirst.co.uk

ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service 2020 Projects 47 Agfa Healthcare 8 Aimes Management Services 78 Armstrong Fluid Technology 20 ASE Corportate Eyecare 16 Awesome Apps 86 Bosse Interspice Inside Front Cover Bridge Master Medical 74 Carnegie Conference Centre 97 Caterpillar (NI) 32 Centre for Strategy 18 CP Electronics 94 Daud Jee Mfg 73 Dexcom UK 58 Dods Group 34 ECA 14 EDSB Fire and Security 26 Energy Renewals 95 ERS Connect 84 Evac Chair International 10 FFUSS UK 30 Fitwise Management 53 Frontline Total Security 96

Fujitsu Gloveman Supplies Gojo Industries H W Andersen Products Hemsworth Associates HIMSS

66 95 52 48 33 Inside Back Cover Illumino Ignis 24 Informa Life Sciences 75 Invinet Systemes 43 Isosec 88 ISS Facility Services 6, 28, 29 Kwickscreen 44 Lapcabby 42 Legrand Electric 82 Medmatch Medical 62 Newflame Fire Equipment 96 Nortek Group Back Cover Octopus Healthcare 46 Omnicell 97 Opex Corporation 4 Optima Energy Systems 95 OrthoD Group 54 Pandora X Software 97

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PrinterLogic 42 QMatic 56 Red Fire Safety Services 96 Red Technical Services 26 Riello 18 S2S 68 Safe-T 70 Safety Technology 84 Step Exhbitions 46 Sugnall Estate 97 Sumo Technologies 72 Talley Group 40 Total Fire Safety 26 TRACE Systems 18 Trimedika 50 UCS Renewables 95 UKFast.Net 80 Unwin 18 Virgin Media Business 76 Voice Connect 12 Watt Energy Saver 94 XPO IT Services 69 ZEDPods 22 Zone 10 Protection 94

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Nortekgroup design and manufacture a full range of furniture solutions for maintenance, repair, testing and servicing areas. We can produce bespoke solutions to fit your individual requirements and provide a complete service from design through to installation. Get in touch with us today to discuss your project needs in more detail. Discounts available for large volume orders on all of our products. Please visit our website to view our extensive range of furniture.

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