Health Business 18.5 by PSI Media

VOLUME 18.5 www.healthbusinessuk.net

ESTATES

AMBULANCES

BARCODING

FIRE SAFETY

FIRE SAFETY AND REFURBISHMENT How can hospital buildings plan and build structures intended to slow or prevent the spread of fire?

PARKING

TO CHARGE OR NOT TO CHARGE? What is the best way to charge for hospital parking and treat patients and staff sensitively at the same time?

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Sleep

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Connectivity

Masks

Comment

VOLUME 18.5 www.healthbusinessuk.net

ESTATES

AMBULANCES

BARCODING

FIRE SAFETY

FIRE SAFETY AND REFURBISHMENT How can hospital buildings plan and build structures intended to slow or prevent the spread of fire?

Is there a need for nationwide ‘nature prescriptions’?

PARKING

TO CHARGE OR NOT TO CHARGE? What is the best way to charge for hospital parking and treat patients and staff sensitively at the same time?

PLUS: DIGITAL | FLOORING | LEADERSHIP TRAINING | PATIENT EXPERIENCE

Doctors working in the 10 GP surgeries on the Shetland Islands are to begin issuing ‘nature prescriptions’ for patients to treat chronic health conditions and supplement ongoing treatments. While NHS Shetland has stressed that the new move will not replace conventional medicine and normal GP appointments, there is merit in thinking that involving and empowering people in their own health can make a real difference to the way that they monitor and maintain their well-being. The concept of mindfulness is not universally appreciated, but there is no denying that nature is good for our health. As Makena Lohr, from the Centre for Sustainable Healthcare in Oxford, said: “The physical and mental benefits of connecting with nature have been very well evidenced by numerous studies. It’s high time that the healthcare sector became aware of that.”

Follow and interact with us on Twitter: @HealthBusiness_

This issue features two articles on the NHS estate, firstly from the Nuffield Trust’s Helen Buckingham and then in our preview to the fast-approaching Healthcare Estates event at Manchester Central. One point that has not been touched on, but which all estate managers and NHS property professionals should consider is, can we increase access to green space on or near to NHS land? And, if we can, could the benefits reach beyond therapeutic purposes and improve health from an earlier stage? Michael Lyons, editor

P ONLINE P IN PRINT P MOBILE P FACE-TO-FACE If you would like to receive all issues of Health Business magazine for £150 a year, please contact Public Sector Information Limited, 226 High Road, Loughton, Essex IG10 1ET. Tel: 020 8532 0055, Fax: 020 8532 0066, or visit the Health Business website at:

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226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: www.psi-media.co.uk EDITOR Michael Lyons PRODUCTION EDITOR Dan Kanolik PRODUCTION DESIGN Sophia Mew PRODUCTION CONTROL Lucy Maynard WEBSITE PRODUCTION Victoria Casey ADVERTISEMENT SALES Jeremy Cox, Lucy Rowland, Damian Emmins, Lucy Maynard, Ben Plummer ADMINISTRATION Isabelle Hayes PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

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Volume 18.5 | HEALTH BUSINESS MAGAZINE

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Contents

Contents Health Business 18.5 07 News

£240 million emergency bed fund to ease social care; the NHS recruitment drive is being widened to Australia; and Royal Liverpool Hospital construction to restart

19 Innovation

It’s crucial that managers and leaders foster a culture of innovation and creative thinking within their teams. Gabriella Goddard explores five ways public sector managers can become better innovators

23 Technology

Following the government’s announcement of a funding boost for the NHS, Barbara Harpham, chair of the Medical Technology Group, argues for a thorough review of healthcare spending on medical technology, linking it to tangible outcomes for patients, the economy and society

26 Digital

Building the perfect healthcare data-sharing platform means helping clinicians to build the perfect system for patients. Saduf Ali-Drakesmith explains why

28 Patient records 39 58

The pressure of reaching a paperless health environment has dropped off the radar in recent months. But, to what extent are current electronic solutions cutting away the system’s paper backlog?

33 Barcoding

Salisbury NHS Foundation Trust shares the progress, learnings and significant benefits being made as one of the six Scan4Safety Demonstrator Sites

36 Leadership training

What can we do to ensure people in positions of influence role model inclusive leadership, with dignity and compassion? Stephen Hart explores

39 Fire safety

How can hospital buildings plan and build structures intended to slow or prevent the spread of fire, and will this promote a better fire safety culture in at-risk buildings?

Health Business magazine

47 Estate management

Helen Buckingham looks at the importance of estates strategies and why healthcare infrastructure is the key enabler to the delivery of better care

53 Healthcare Estates

Healthcare Estates is the preeminent opportunity for estates professionals to learn from their peers and share ideas and solutions

56 Flooring

ROSPA’s Ashley Martin looks at why installing and maintaining appropriate flooring is key in preventing falls and trips, especially among the elderly

58 Ambulances

What will new ambulance funding enable and how will expanding the ambulance fleet improve patient care and deliver efficiencies to the NHS? Health Business explores

61 Patient experience

The Design Council explains how an innovative partnership between health and social care leaders, social entrepreneurs and the public could relieve pressure on stretched services and improve the experience of later life for everyone

65 Parking

The British Parking Association explain how hospital parking charges can be managed sensitively by taking into account the needs of patients and visitors

68 DPC 2018

Following record attendance at last year’s event, Diabetes Professional Care will return on 14-15 November. Health Business previews the show

70 Infection prevention What steps should be embraced in hospitals to fight infection and how can these help to eliminate the risk of illnesses?

81 Audio assistance

Andrew Thomas looks at why NHS trusts should assess their hearing loop provision and the potential costs of not listening to those who can’t hear

www.healthbusinessuk.net Volume 18.5 | HEALTH BUSINESS MAGAZINE

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News

SOCIAL CARE

£240m emergency bed fund to ease social care Health Secretary Matt Hancock has told the Conservative party conference that the government will provide an emergency £240 million to enable more elderly people to be cared for at home. The social care funding will help councils pay for measures like housing adaptations and care packages and ease pressure on the NHS this winter. This past January one in five patients faced long delays for a bed, with NHS England figures showing that the number of seriously ill patients facing delays for a bed reached record highs, with 1,000 waiting more than 12 hours. The £240 million, to be channelled through local authorities according to

their relative adult social care needs, could buy 71,500 domestic care packages or 86,500 ‘reablement’ packages. Other actions being taken to boost support over the winter include: ensuring extended access in primary care is in place across the country, with an additional nine million appointments per year; rolling out NHS 111 Online nationwide; taking action to safely reduce ambulances conveying patients to hospital through increased ‘hear and treat’ and ‘see and treat’; expanding the provision of ‘same day’ emergency care; and setting an ambition to reduced long stays in hospital (over 21 days) by 25 per cent to free up 4,000 beds. Hancock said: “I want to help the NHS

through this winter. I have already provided funding for hospitals to make upgrades to their buildings to deal with pressures this winter, and I can announce that today I am making an extra £240 million available to councils to pay for social care packages this winter to support our NHS. “We will use this money to get people who don’t need to be in hospital, but do need care, back home, back into their communities, so we can free up those vital hospital beds. And help people who really need it get the hospital care they need.” READ MORE tinyurl.com/y8r4awhp

FINANCE

RECRUITMENT

£2.7bn cuts to NHS after pension miscalculations

NHS recruitment drive is being widened to Australia

New analysis by the House of Commons library has estimated that the NHS will suffer cuts worth £2.7 billion after the government miscalculated the pension costs of public sector workers. The Labour Party, which released the research, said that the money, the result of underestimating the pension costs of all public sector workers by as much as £4 billion a year, could otherwise have paid for the salaries of over 61,900 nurses. The government has offered to cover departments’ additional costs for one year only, leaving the NHS to soak up two years’ worth of additional pension costs totalling £2.7 billion before the next election. Peter Dowd, Shadow Chief Secretary to the Treasury, said: “Billions of pounds are being quietly cut from our NHS, due to a poisonous cocktail of disastrous economic mismanagement and spiteful behaviour. These cuts are the equivalent of paying the

salary of over 61,000 nurses a year. Nurses whom we desperately need after eight years of crushing austerity in our NHS.” “The Chancellor must immediately own up and commit to meeting these extra costs, not just push them on to slashed and struggling public services. All this just goes to show, you cannot trust the Tories with our NHS.”

READ MORE tinyurl.com/yc8vmqk4

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Power For Our Generation

There are many ways to store or produce energy but when it comes to guaranteeing standby or emergency electrical power, in terms of cost, flexibility and responsiveness, thereâ&#x20AC;&#x2122;s no better option than a generator set from FG Wilson. Our products range from ready-to-run generator sets to complete bespoke turnkey power systems with remote monitoring, all with lifetime product support from our dealers. Based in the UK for the last 50 years, weâ&#x20AC;&#x2122;ve worked together with a multitude of customers in all environments globally and since 1990 have installed more than 625,000 generator sets around the world, with as much combined power generation capacity as the entire UK power grid.

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Generator sets have been around for a long time and the simple economics of securing power mean that they are a strong consideration for many customers in many different situations

FG Wilson has been manufacturing generator sets for more than 50 years, installing more than 625,000 units since 1990 (as far back as their computer records can search). Paul Creighton, managing director of FG Wilson, can see why they are a popular choice: “When it comes to guaranteeing standby or emergency electrical power, in terms of cost, flexibility and responsiveness, for many people, the best option is a generator set.” In its simplest form, a diesel generator set has an engine driving an AC generator or alternator which produces an electrical output. The engine and alternator are fixed to a rigid steel chassis which may contain a fuel tank, there’s a control panel which may be for manual start, auto start on mains failure or remotely operated and the entire package is often contained in a sound-attenuated enclosure which protects it from weather and reduces noise to comfortable levels in urban environments. That’s been the basic principle for a long time and for several decades FG Wilson have been at the forefront in driving efficiency of generator sets to new levels. Diesel engines are the most common prime mover for generator sets and the reasons have always been practical: diesel engines are more economical to run, typically easier to service and maintain, fuel is safer to store and transport than petrol or gas fuel and

engines are durable. Because the engines operate at relatively low RPM in power generation applications, they can expect a long working life and in countries where usage is high, examples of generator sets with 30,000 operating hours are not uncommon. Paul notes: “In the UK, around 80 per cent of generator sets are bought as a source of standby power and most of the remainder for temporary power, often running continuously at construction sites, events or providing prime power when mains supply is down, for example after storms or during maintenance. This high percentage of standby applications is driven by increased safety and power security needs: meeting legislation and due to increasing reliance on internet technology and connectivity in business. 20 years ago, most businesses could at least partially function with pen and paper when electric power failed, but today everything comes to a standstill without electricity.” Fuel economy Today, emissions from combustion engines are something of which we are all more aware. FG Wilson engines are sourced from UK-based manufacturer Perkins, designed in the UK and among the most modern and fuel-efficient engines available. All meet or surpass standards wherever the engines

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Powering on – economics of securing power for customers are being used. Rightly, there’s growing interest in renewable sources of energy. Paul says: “We’re seeing this in many of our export markets where a generator set may be running for four or five hours a day and customers are seeking to reduce operating costs. We’re working with telecoms networks in regions such as South-East Asia and Africa and supplying hybrid generator sets with solar panels as part of the package. “Thinking ahead, in countries where generator sets may be running for several hours a day, we can see solar panels, batteries, wind turbines and generator sets all linked and capable of powering remote settlements. In regions like Africa and Asia, this has huge potential. In other regions where mains supply is more secure and power outages less common, energy storage is also starting to become an option for some users. These are usually domestic or other light users of electricity, who may have enough electrical energy stored to see through short outages. “But where you have a facility which requires substantial electric power, like data centres or hospitals, current renewable and energy storage technology is not sufficiently well developed to be a commercially viable option for standby power. For guaranteed continuity of power, you still need a generator set.” UK dealers A wide dealer network across the UK represents and supports the entire FG Wilson range. For some customers, this means picking a ready-to-run generator set, while for others it means working together on load requirements, finding the right generator set, designing the complete layout of the generator set including cooling and fuel systems, installation and commissioning. Dealers also offer full 24/7 support with warranty with rapid parts availability, supported by a major parts operation based in Desford in Leicestershire, carrying more than 11,500 product lines and shipping up to three million parts a year. Paul says: “If you have a critical power need, the economics add up. In the UK, a generator set might run for only a few hours a year but in those hours, it can more than pay for itself in terms of ensuring business continuity and health and safety.” L FURTHER INFORMATION www.fgwilson.com

Volume 18.5 | HEALTH BUSINESS MAGAZINE

6th December 2018, Grange St. Paulâ&#x20AC;&#x2122;s Hotel, London

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Innovation

Five ways public sector managers can ignite innovation It’s crucial that managers and leaders foster a culture of innovation and creative thinking within their teams, writes Gabriella Goddard Artificial intelligence and digitisation Here are five ways public sector managers are transforming the public sector, with can become better innovators: procedures, data-collection, analysis and even decision-making becoming increasingly 1. Encourage curiosity automated. In the face of this change, The reality for most managers is that they creativity and innovation are more important spend their time fire fighting, working than ever for government workers. through their busy to-do list, and delivering Leaders in the public sector can help short-term goals. Problems often get improve services and better engage workers solved with the first answer that comes by encouraging a culture where fresh ideas, to mind. However, with the fast pace of new ways of working and innovation can technological change, we also need develop thrive. However, a recent research report by new ways of working and thinking. YouGov and Microsoft showed that while Curiosity is about questioning the status 73 per cent of British workers surveyed quo, assumptions, and established beliefs. This considered themselves creative, they felt involves encouraging exploration outside your their workplaces were stifling innovation. field, researching best practice for inspiration, Furthermore, the report showed that British and new technological developments. For companies are at risk of falling behind example, how could we use block because of a failure to encourage chain technology to transform Improv creativity among their staff. government practices and The good news is experiences? Or, how can service ing s to the that managers can be the Internet of Things p ublic d proactive in enabling (IoT) make cities smarter on an i epends greater creativity in their by improving public employees by enhancing transport unders nnate t their own creative and a n d i o n f their innovation leadership changi g skills. This will create a ng and un met halo effect on the people needs around them.

or drainage systems? Or how can machine learning technologies lead to earlier diagnoses within the health system? 2. Take a coaching approach Employees, especially those working at the coalface, are often brimming with good ideas on how to improve things. However, they may not feel confident sharing their ideas, especially if they are unproven and could fail. In order to empower employees to think for themselves and boost their confidence to develop their best ideas further, managers can take a coaching approach. This involves keeping an open mind, practicing active listening and asking more exploration questions like ‘what about?’ and ‘how might we…?’ For example, Sean Frayne, chief officer at Derbyshire fire service, decided to listen to employee ideas and feedback,E

Volume 18.5 | HEALTH BUSINESS MAGAZINE

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Innovation

 saying: “Some people still think managing people is about telling them what to do. From my experience it is about motivating, coaching them and encouraging them to be the best they can be.” After he inspired a change in the culture, independent assessors found that even in the face of budget cuts, they could not find a single employee nor partner who would say anything negative about the service. 3. Develop user centricity Improving services to the public depends on an innate understanding of their changing and unmet needs. Design Thinking is an approach developed by Tim Brown, founder of IDEO innovation consultancy. At the heart of this approach is empathising with your user or key stakeholder, understanding how their world is today, and how it could be in the future. So spending more time researching your primary users’ views and experiences will quickly reveal new opportunities for improvement and innovation. For example, Hanover Housing Association, which manages homes for older people for multiple local authorities, conducted detailed research with their staff. They found that their employees knew little about dementia and that other residents had little empathy or patience with dementia sufferers. This led them to develop a range of solutions to improve their services for dementia patients, such as awareness campaigns, and training for staff and residents. 4. Stimulate the work environment The YouGov and Microsoft research showed that the three main obstacles

The reality for most managers is that they spend their time fire fighting, working through their busy to-do list, and delivering short-term goals to creative working were uninspiring workplaces (41 per cent), a stressful atmosphere (34 per cent) and a lack of appropriate spaces to focus (28 per cent). Managers can help shift this creative apathy by encouraging their team members to get out of the office, and take a walk in the fresh air. Incubating ideas is a key part of the creative process, so for extra challenging problems, giving people time to ‘sleep on it’ can actually be highly productive. In addition, exposing employees to talks, conferences and new sensory stimuli is great for sparking new ideas and improving motivation. For example, when Canadian Deputy Municipal Clerk Natasha Letchford saw a TED talk entitled The Antidote to Apathy, it inspired her to re-think the design of local government signs and notices in order to make them clearer. 5. Adopt an experimental mindset As the landscape of public service changes, what works today may not be the best solution for tomorrow. But doing things differently in a way that has never been done before is risky, which can invoke the fear of failure in some managers. Adopting an experimental mindset means testing concepts early and often.

By making prototypes, sharing these with users and getting feedback, teams can quickly learn what is working and what is not. Refining concepts in smaller stages reduces risk by converting potential failures into opportunities to learn. For example, Finland, where an experimental mindset is official government policy, systematically tests new policies, such as a basic income, before deciding whether to introduce them on a larger scale. As our world rapidly changes, so too will the demands and expectations citizens have of public services. To stay ahead of the curve, it’s crucial that managers and leaders foster a culture of innovation and creative thinking within their teams. Training courses can be useful for developing skills and capabilities, but to be most effective in practice, the workplace needs managers who are better innovators themselves. L

Gabriella Goddard is the coaching director at the Brainsparker Leadership Academy, specialising in developing innovation and creativity capabilities in the workplace. She is also a member of the Forbes Coaches Council. FURTHER INFORMATION www.brainsparerkacademy.com

Volume 18.5 | HEALTH BUSINESS MAGAZINE

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Technology

Link healthcare spending to patient outcomes and wider benefits Following the government’s announcement of a funding boost for the NHS, Barbara Harpham, chair of the Medical Technology Group, argues for a thorough review of healthcare spending on medical technology, linking it to tangible outcomes for patients, the economy, and society The government’s planned annual £20 billion injection into healthcare, announced in the year that the NHS celebrates its 70th anniversary, is a very welcome and positive step forward. Despite a projected fall in healthcare spending in relation to our overall GDP, the additional funds – representing a 3.4 percent increase in real terms over the next five years - will bring England’s healthcare budget closer in line with other Western European economies. However, without a thorough review of the way the NHS currently procures products and services, much of this capital could be wasted. Instead, the increased investment should be accompanied by a shift in approach that links additional funding more closely to the impact it has on patient outcomes, and the savings it generates for the healthcare system. In addition, with pressure on the NHS mounting and only forecast to increase, combined with turbulent times ahead for the post-Brexit UK economy, it is time to think carefully about the

broader economic and societal value any additional spending could generate.

impact of sickness, absence and worklessness associated with working age illness costs the UK economy over £100 billion a year. Linking investment to Meanwhile individuals collectively miss out measurable returns on £4 billion a year of lost earnings and over Around five per cent of current healthcare 300,000 people take up health related benefits. spending - just over £6 billion - is currently The report examined just eight technologies invested in medical technology. Much to assess the impact they had on of that technology, from artificial reducing the need for further Around hips to the diagnosis of sepsis treatment and hospitalisations, and coronary angioplasty, has limiting welfare and social five per a tangible impact on patient security payments, as well cent of c outcomes, preventing as their ability to return u r r e h nt ealthca the need for further individuals of working r e spendin - just o treatment and hospital age to employment as g v e stays, while enabling tax-paying members of is curre r £6 billion ntly inv people of working age to society. It also explored in med ested return to the workplace. the less quantifiable i A study by the Medical benefits, such as improved techno cal logy Technology Group ‘Keeping quality of life for patients Britain Working - How medical and the impact on the growing technology can help reduce the number of unpaid carers, who cost of ill health to the UK economy’, are subsequently able to to work or published in November 2017, reported that the contribute to society in other ways. E Volume 18.5 | HEALTH BUSINESS MAGAZINE

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Efficiency drives should focus on increasing provision of cost effective treatments. Failure to do this means benefits to the overall economy will never be fully realised and patients will continue to lose out

Technology

 The research concluded that £476 million in savings could be generated in reduced long-term health costs and benefit payments from these eight technologies alone. Therefore, an extra £1 billion, or five per cent of the additional healthcare settlement spent on valuable medical technologies, could generate even greater savings for the wider economy, in terms of reduced healthcare costs, lower welfare spending, and increased tax revenues. Investing for patients and society However, to give confidence that this new cash injection is spent on the frontline on treatments and procedures which benefit patients, the MTG would like to see a thorough review of NHS spending. For example, ensuring the NHS purchases best value is a top priority. Its current approach of buying the cheapest possible products urgently needs to be reformed. Instead, a greater emphasis should be placed on value-based healthcare and associated commissioning where the NHS only pays when the desired outcome is delivered. It’s vital that this shift in approach, which is currently largely absent in NHS reimbursement systems, accompanies any extra funding to ensure value for the tax-paying public, sustainability of the NHS, and access for patients to the most appropriate medical technologies. Staying at the forefront of access and adoption Moving to a revised payment system linked to outcomes valued by patients and policymakers alike will also ensure the NHS is at the forefront of medical technology access and adoption for the next 70 years. For instance, improved payment mechanisms are required to fund more of the treatments we need to keep the English population healthy and able to work for as long as they need to. Rather than rationing access and reducing commissioning budgets as we’ve witnessed over the past decade or so, NHS efficiency drives should focus on increasing provision of cost effective treatments.

Barbara Harpham, chair of the Medical Technology Group

Failure to do this means benefits to the overall economy will never be fully realised and patients will continue to lose out. Better decisions, less rationing Of course, outdated treatments do exist and are sometimes identified. When this happens, they need to be quickly replaced with much improved gold standard treatments rather than stopped as in the case of the recently publicised list of ‘ineffective treatments’. These treatments, which are often very valuable and affect thousands of patients with conditions such as varicose veins, carpal tunnel syndrome,

or bone spurs for example, can be critical to restoring health and quality of life. It’s therefore essential that the NHS does not confuse rationing access to healthcare with prudent decision-making. Rationing access is not a solution and delaying treatment, as we have seen with growing waiting lists, only results in increased costs and poorer outcomes for patients in the long run. It also forgoes the enormous benefits of early intervention and rapid return of patients to their daily lives and activities. An opportunity too good to miss The additional investment by the government is the largest single boost to the NHS in decades and presents an enormous potential opportunity, not just for the health service, but for wider society. But unless this funding is accompanied by radical reform to the way the health service operates, the opportunity will be lost. Achieving this requires a change in culture and practice within the NHS and government, a joined-up approach that considers the broader impact of the investment. If adopted, the initiatives outlined here will help make the most of the potential benefits and ensure all valuable medical technologies make a tangible difference. Thankfully, the medical technology sector is already leading this shift internationally and is ready to support and partner the NHS on this much-needed transformation. L FURTHER INFORMATION www.mtg.org.uk

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Digital healthcare

User-driven processes for digital integration Building the perfect healthcare data-sharing platform means helping clinicians to build the perfect system for patients. Saduf Ali-Drakesmith explains why The data-driven revolution that is sweeping all spheres of business is especially exciting for healthcare: not only should significant efficiencies be possible, but major advances look likely in terms of early diagnosis capabilities and patient outcomes as well. In order to be ready for these advances, healthcare organisations need total interoperability within their records systems, so that all data can be accessed at any time by suitably authorised personnel or systems. Currently, most hospitals and care establishments are nowhere near this level. Most departments still operate with a mixture of paper records and proprietary data storage systems. The Electronic Patient Record (EHR)

but this approach can never produce the kind of 360-degree view that a digital healthcare system requires. In order for patients to benefit from the diagnostic possibilities - which machine learning applications are starting to offer - full interoperability is essential. It is helpful to define interoperability in a healthcare context. According to HIMSS, interoperability is the ‘ability of health information systems to work together within and across organisational boundaries in order to advance the effective delivery of healthcare for individuals and communities’. These fully interoperable systems should be developed with the patient in mind, and with care needs and excellence of practice at their centre. However, the real key to designing and implementing these are the practitioners who currently use data systems and already have a need for improved sharing capabilities.

system cannot carry this information, and this inevitably means that practitioners only have a partial view of a patient’s Patient information records. The remaining data For most organisations, the Introdu is often located in silos, biggest stumbling block c i n g a ny new accessible only to those centres on imaging. is more IT system along a ’vertical axis’ Departments, including that is a specialist cardiology, radiology, technic than just a a department’s treatment ophthalmology and l c h a the wh of individual cases. gastroenterology, ole pro llenge: gramm That is not to say manage their images should e be abo that there is no will to in siloed systems, ut develop share data. Clinicians such as radiology i n go out of their way to picture archiving new wa g share appropriate patient and communication ys worki of information with colleagues, systems (PACS), the

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cardiology PACS or other ‘mini’ PACS. The challenge with a PACS-focused strategy is the proprietary design and codesets of these systems. While DICOM has been widely adopted as the defacto standard, PACS vendors continue to use proprietary extensions to make interoperability within and outside the enterprise complicated and costly. This problem is compounded when organisations try to incorporate specialty images that fall outside traditional PACS parameters. This is hardly an insignificant amount of patient information: today, 75 per cent of healthcare data is in the form of non-DICOM medical imaging assets. This 75 per cent includes video, photos, oncology treatment

plans and other file types that the PACS cannot manage. As a result, they wind up as silos of data, scattered throughout the organisation and inaccessible from the EHR. If clinicians cannot view imaging and specialty assets from the EHR, they are not obtaining a complete picture of their patients. Healthcare can no longer afford this lack of transparency and its associated costs. The best enterprise imaging solution is one that can be implemented in a phasedapproach. Some organisations begin with a vendor neutral archive (VNA), while others choose to link their PACS systems using an enterprise viewer. No matter where or how you start, it’s important to keep your eye on the goal of an enterprise class vendor-neutral strategy that facilitates the removal of silos, while giving you ownership over your data. Remain committed to that goal and you’ll be well on your way to interoperability that has a direct and measurable impact on patient care and outcomes. Unfortunately, there is frequently resistance to new technology by staff who are wary of disruptive IT projects that often don’t serve their needs. That shouldn’t be the case. Most clinicians do want to have full access to their patients’ data, and they should be an asset in the delivery of an effective patient-centric data sharing platform. Bringing healthcare practitioners on board early in the process requires a change of culture: technology should be perceived as an enabler, not a threat. This means a commitment to design the new system around user needs, working patterns and devices - rather than building or buying systems to a management concept and then persuading staff to adapt. The development process Introducing any new IT system is more than just a technical challenge: the whole

Digital healthcare

Clinicians go out of their way to share appropriate patient information with colleagues, but this approach can never produce the kind of 360-degree view that a digital healthcare system requires programme should be about developing new ways of working that are designed around the clinician, and all stakeholders should be closely involved in the development process. Once the project and management teams are confident they have staff onside and a clear understanding of how and why clinicians use information sharing systems, they can target an outcome that directly improves work within the organisation. That outcome should be at the heart of driving implementation. Such a bottom-up approach to technology development and implementation lends itself to small-scale, which can then be scaled up once problems have been ironed out and successful features identified. While it is tempting to embark on a large-scale project where potential savings or improvements can be expected, it’s wiser to exercise caution and start small. There are untold numbers of failed projects that promise much, but fail to deliver the outcomes. On a similar note, it is unwise to trial potentially disruptive systems in key operational areas, even though these may offer the biggest potential rewards or returns should the technology be successful. Tweaking a new IT system in a live context places stresses on staff and the business, and many efforts are simply abandoned because disruption becomes too much. Instead, systems can be trialled in smaller teams where there is the highest chance of success - ideally ones committed to the new technology. When it comes to identifying and nurturing sections that will be willing ambassadors and trial developers of an organisation’s IT, it is useful to have close contacts with frontline staff. Every project should have a clinical champion who can bring the medical perspective to the table, providing representation for stakeholders and advising on patient interests too. This person or people will be enthusiastic and committed to the project, and can help define what constitutes high-quality care and the factors required to deliver it. Through this user-driven process, in which IT specialists and management could be said to play a facilitating role for clinical staff committed to using technology, digital integration and other advances can be made in a way that is not only efficient but also highly effective. Clinicians will build the best system for their patients, and implement it gladly. From a business perspective, the benefits of such an outcome will follow. L FURTHER INFORMATION www.hyland.com

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Patient records

The electronic solution to the Lloyd George problem The funding pressures in the NHS are widely reported, meaning that the weight of reaching a paperless environment has taken a back seat in terms of priorities. But, to what extent are current electronic solutions cutting away the system’s paper backlog? paperless health system at some point in the next decade, e-LGS is an important factor in making this dream a reality, promising to revolutionise the paper flow process in surgeries with regards to patient records. On a basic level, it allows for a patient’s health record to be quickly and easily accessed if requested and provides the necessary fast access to historical patient information for GPs and practice staff. Economically, it saves money on external storage and boosts practice income by re-utilising space, at the same time removing the risk of paper in files being misplaced or lost, or damaged. As such, last month the NHS Business Services Authority launched a scanning service for GP practices to digitise old patient records, also offering to upload patients’ Lloyd George envelopes to the practice’s IT system. The authority claims that 35 per cent of practices making use of the service in a pilot scheme expect to open a new consultation room with the space that has been freed up, with the system holding the capacity to scan over 20,000 prescriptions in an hour and can scan one practices’ entire archive of Lloyd George envelopes in a week.

Reports suggest that the average GP practice has, on average, 10,000 Lloyd George wallets with roughly 132 pages per wallet. This means that there are approximately 1,320,000 pages per practice, meaning that each practice may spend half a day every week managing and copying files which has a knock-on effect on administration costs. The overheads of managing and storing physical records can be significant, and they take up huge amounts of space and staff time whilst risking being damaged or mislaid. However, the records cannot be destroyed or ignored, despite being very rarely needed, as GP practices are required by law to retain and store Lloyd George envelopes and their contents. To combat this backlog, a number of NHS trusts are implementing bespoke scanning and archiving solutions to limit the need for storage of bulky documents. For example, the e-Lloyd George Service (e-LGS), available to all GP and CCG’s throughout the UK,

35 cent of per makingpractices the ser use of vi to opence expect a new consult a t i o nr with th e space oom has bee that freed u n p

revolutionises access of records by turning them into electronic data, saving staff time, and making use of space within the practice more efficient, whilst ensuring faster access to and better security of patient records, via our secure online portal. Having imported the system back in 2013, once the Lloyd George record is scanned, the paperwork is destroyed and the original envelope is returned to the practice. The digital record is split into four chapters; patient correspondence; continuation cards; results; and summary reports.

Paperless ambitions With Health Secretary Matt Hancock continuing the progress made at the Department of Health under his predecessor Jeremy Hunt in relation to achieving a

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Summary care records Delivering a keynote speech at the 2017 UK Health Show in London, NHS Digital executive director Eve Roodhouse heralded progress in use of Summary Care Records (SCRs), and outlined some of the work already being done to incorporate more information into them. The SCR is an electronic record of important patient information, created automatically through clinical systems in GP practices and uploaded to the Spine, which allows information to be shared securely through national services. It is currently used by 98 per cent of practices. At a minimum, the SCR holds important information about current medication, allergies and details of any previous bad reactions to medicines, as well as the name, address, date of birth and NHS number of the patient. The patient can also choose to include longterm conditions, significant medical history, or specific communications needs.

To combat the worrying paper backlog in the NHS, a number of trusts are implementing bespoke scanning and archiving solutions to limit the need for storage of bulky documents Darlington NHS Foundation Trust were the first to achieve paper switch off for outpatient appointments. On 6 September 2018, NHS Digital revealed that a total of 150 acute hospital trusts and 7,110 GP practices had made the move to sending and receiving all first outpatient appointments through the NHS e-RS, beating it’s October deadline. Steve Firman, the senior responsible owner for the e-RS programme at NHS England, said: “The NHS e-Referrals service works safely and quickly, it is a fantastic achievement all 150 acute hospital trusts are now on board ahead of the 1 October deadline. This is a result of months of hard work by trusts, their healthcare communities, CCGs and staff at NHS England and NHS Digital who have worked tirelessly to ensure that the system is ready in time.” Linking records Back in April, a project which linked the electronic patient record (EPR) systems at West Suffolk NHS Foundation Trust and Cambridge University Hospitals NHS Foundation Trust (CUH) went live in a UK first. Both recognised as Global Digital Exemplars by NHS England, the two trusts are now able to easily and securely access clinical information on a patient that is held

Patient records

Data within the SCR is protected by secure technology, as users must have a smartcard with the correct codes set. Each use is recorded and a patient can ask to see the record of who has looked at their SCR, from the viewing organisation. Furthermore, each organisation using the SCR has at least one privacy officer who is responsible for monitoring access and can generate audits and reports. With organisations becoming more and more aware of the need to join-up care, for both safety and efficiency, it makes sense that services like Spine, the Electronic Prescription Service, e-referrals and NHS Mail are delivered centrally as standardised, secure products. The long-awaited ‘Citizen ID’ project, part of NHS England’s new digital roadmap, will be piloted in alpha form in the Spring in a bid to make access to patient records and online health services easier. The full Citizen ID service is scheduled to follow in 2019-20. Furthermore, the Share Your Care programme, in place in West Berkshire, electronically includes information on up to 855,000 residents and enables up to 12,000 health and care professionals to have a consented access to the core information about patients. According to NHS Digital, 45,000 people a day use its Electronic Referral Service with the department reaching its target to have all first outpatient referrals made electronically by October 2018. Patients are able to change or cancel their appointments through the system, with analysis showing that use of electronic referrals has halved the rate of patients missing appointments from 10 per cent to five per cent. Sherwood Hospitals NHS Foundation Trust and County Durham and

within the other trust’s EPR system. This is the first link in the UK between hospitals’ electronic health record systems, provided by two different suppliers - Epic at CUH and Cerner Millennium at West Suffolk Hospital. Clinicians in the accident and emergency departments can access real-time, digital information if a patient has been treated at the opposite hospital within a 12month period. This is fairly common given the hospitals’ proximity. Dermot O’Riordan, chief clinical information officer at West Suffolk Hospital, said: “Many of our patients’ healthcare is shared between both of our hospitals, in areas such as cancer care, vascular surgery and emergency care. This innovation is a natural extension of our partnership, and is already making noticeable improvements and efficiencies to the care we provide our patients. “I am also very proud of our teams for creating this innovative and exciting link, and would like to thank them for their continued hard work. This national first shows the benefits that our e-Care program, using Cerner Millennium, has enabled. I look forward to delivering further enhancements to patient care as part of our Global Digital Exemplar program; the potential is huge.” L

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Advertisment Feature

CCube ePaper – paper to digital without scanning Digital technology within the healthcare sector aims at improving patient experience and data handling whilst saving costs. CCube has developed ePaper software to streamline processes and modernise the way information is recorded

CCube ePaper key features & benefits Use existing paper forms and create digital versions using tools provided Organisations benefit from archiving and accessing digital documents Patient information The healthcare sector manages a wealth of patient data, from medical notes and clinical records, patient consent forms to new patient documents. The capture and processing of this information must ensure that sharing and interoperability can be streamlined and must be compliant with established guidelines for Information Governance and data-sharing standards. Paper-based processes With a long history of working with paper‑based processes, the healthcare sector has been hindered by methods of working that are time-consuming, expensive and prone to human error. These legacy systems can be a significant drain on healthcare’s resources. They can also prevent the level of digital maturity needed to meet the Five Year Forward View and healthcare’s overall goals for change. Healthcare’s digital technology must provide the step change needed to streamline processes, share information, improving the patient experience and to dramatically reduce costs. Healthcare must digitise in order to achieve its goals in providing high quality, safe, accessible, patient-centred care. Electronic solutions Good progress has been made and continues to innovate, minimising dependency on paper. However, paper is not going away in a hurry. Electronic forms that can be used on many different types of devices including smartphones are on the increase and do enrich the user experience. Where processes remain dependent on use of paper, developments in writing technology are paving the way forward – to allow users to continue using paper and pen for recording information and seamlessly create digital records, without scanning. Digital pens have been around for some time, but these are costly and require special paper.

ePaper software CCube Solutions has developed the ePaper software which uses Wacom’s Clipboard. This solution allows users to use existing paper forms to complete and sign documents using an ink pen (included with the clipboard). It then converts the documents to a digital version in real-time – the user can fill out the paper form as they normally would. All the strokes made by the pen on the clipboard are captured and streamed to the host device and immediately applied to the digital document. Biometric handwritten signatures can also be captured and attached. The digital documents can then be saved as read-only documents (eg. PDF) and sent into any IT system, including EPR, Clinical Portals, and document management systems. With the introduction of the CCube ePaper, hospitals can maintain their patient-facing processes – patients still fill out existing paper forms, such as consent forms – the completed forms are automatically saved as a digital record, without scanning. The paper form can be handed to the patient as their signed copy – no need to keep or scan the paper in the hospital. With the introduction of the Wacom Clipboard, businesses can maintain their customer-facing processes – having their customers still fill out familiar paper forms, either A4 or letter size. However, they can easily gain efficiencies of digital document management without scanning. FURTHER INFORMATION www.ccubesolutions.com

Customers can fill out familiar paper forms on the electronic clipboard Secure, biometric eSignatures can be included with the digital document Forms can be completed over time Can be used standalone or with any IT system Supports Open Standards for data capture, eg. HL7 FHIR Completed forms can be sent electronically into any IT system Supports standards-based data sharing

The Wacom Clipboard key features & benefits Authoring tool makes it easy to lay out forms or documents and create a corresponding digital version Organisations benefit from archiving and accessing digital documents Customers can fill out familiar paper forms on the electronic clipboard Secure, biometric eSignatures can be included with the digital document Handwritten data can be captured and converted using handwriting recognition The barcode scanner integrated into the Smart Pad helps automatically syncs the paper form with its digital version

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Rob Drag, Scan4Safety programme manager at Salisbury NHS Foundation Trust, shares the progress, learnings and significant benefits being made at one of the six Scan4Safety Demonstrator Sites as it nears completion of the initial phase of the Department of Health backed Scan4Safety programme Scan4Safety is a pioneering programme single day, barcodes are everywhere and these led by the Department of Health that systems have developed to a point where we is improving patient safety, increasing all simply take it for granted that they work. clinical productivity and driving operational However barcoding has had limited use in efficiency in the NHS. Scan4Safety is taking healthcare to date. There are pockets of great learnings from other sectors, such as retail, to examples of barcoding being used effectively improve traceability and efficiency through in some trusts, but until now this has not been the use of international barcoding standards consistently applied across the whole NHS. (GS1 standards) and common ways of doing business (PEPPOL). A world first in healthcare Barcodes have already transformed supply When barcodes were first introduced in retail chain management across a number of in the 1970s, retailers and suppliers had sectors, hugely improving efficiencies to work together. They understood and providing greater visibility that one way of working was Weâ&#x20AC;&#x2122;ve and traceability of products needed so they could all right through the supply reap the benefits. What is nearly chain. With over five billion ground-breaking about the comple t e barcodes now scanned Scan4Safety programme, d t h e initial p across the world every and what will ultimately hase

of t program me, bu he tw is excitin g is tha hat t believe this is re we ally just the start

Barcoding

Scan4Safety Insight from a demonstrator site

ensure its success, is that the selection and mandated use of a common set of barcoding standards, GS1 standards, for both trusts and suppliers, is a world first in healthcare. By mandating the use of a common set of standards, for the first time the NHS will be using a common language to identify patients (Global Standard Relation Numbers - GSRNs), places (Global Location Numbers - GLNs) and products (Global Trade Item Numbers â&#x20AC;&#x201C; GTINs). By being able to better identify and match patients, products, and locations, this in turn will improve how effectively products are recalled and also improve operational efficiencies, freeing up valuable clinical resource and delivering direct cost savings. At Salisbury NHS Foundation Trust we were therefore delighted to be chosen as an early adopter of these standards, one of only six trusts to be selected as a Scan4Safety Demonstrator Site in January 2016. Since our selection, we have been implementing GS1 and PEPPOL standards across the trust and as we now approach successful completion of the initial two year programme, the benefits we are delivering to the trust are significant and exceed our initial predictions. Improving patient safety Prior to Scan4Safety, we faced the problem of managing product recalls quickly and efficiently to safeguard patients from avoidable harm. Although the trust had product recall processes in place, like so many other trusts, these were manual and extremely time-consuming. There was no process or single system in place for identifying or capturing implants used with a patient in a consistent or repeatable way. Whilst hard to quantify the exact amount of time spent on E

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Medical Devices Directive Approved

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The Advance Range is a multifunctional range of seating, providing a solution for most needs within theatres and other clinical areas.

The new Capricorn from Murray’s has been designed to give full support for body and spine in a sedentary position for dentist and dental nurse.

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It has seamless upholstery and all mechanical parts are encased in a durable plastic shell for hygiene. The stool features an adjustable seat and back tilt, with a ratchet style back height adjustment. It is available in all dental manufacturers’ material at an additional charge.

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

Posture Range Designed for the operative who needs to work close to the patient, the Posture range has a cut away to encourage the legs to drop sideways rather than reaching forward.

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Enabling clinical productivity Prior to implementation, 32 per cent of staff in orthopaedic theatres were spending more than one hour a shift on stock-related duties. By scanning products at point-of–use, stock is now automatically replenished, releasing time for our clinical staff to care who previously had to complete these stock orders manually. For example, in cardiology two hours a week of a band six radiographer’s time has now been released. The system also provides the hospital with accurate patient level costings. By scanning all consumables, implants, and staff to a patient, detailed costs of a procedure are now available at the touch of a button. This helps provide clinical staff with more accurate and timely data, helping them to make better informed decisions. Our consultant cardiologist Tim Wells said: “The recent implementation of the Scan4Safety project in Cardiology provides us for the very first time complete traceability of products such as implantable medical devices used with our patients. Knowledge is power – not only does this provide us with a level of data and insight that can be used to better challenge clinical practice and variation, helping us to reduce inefficiencies and improve patient experience and outcomes – more importantly it ultimately helps to safeguard our patients from avoidable harm. In the event of a product recall, we can now easily and quickly track an affected product to the right patient.”

Barcoding

 a product recall, anecdotal feedback suggested product recalls could take ‘many hours’ of trawling through patient records and often involved highly skilled and senior members of clinical staff. Through the programme, the trust has introduced point of-use scanning in operating theatres, enabling implantable devices to be accurately tracked to a patient. In October 2016, the trust launched a new Inventory Management System, Genesis Automation. This offered the ability to scan at point-of-use, so review and labelling of our entire catalogue was completed to understand which departments implanted the most. We subsequently prioritised cardiology and orthopaedics to cover 97 per cent of the trust’s implantable devices. This was followed by all remaining theatre specialties in November 2017 and will shortly be going live in day surgery, endoscopy and radiology to reach 100 per cent traceability. With 154 members of staff fully trained, the trust’s theatre staff now scan the barcodes at point-of-use on all the inputs to patient care – alongside implants (with batch and expiry information), this also includes patient ID, consumables, sterile instrumentation and staff. In the event of a future product recall, the affected product can now be automatically traced to the patient and appropriate action quickly taken. And if an affected product is scanned at point-of-use, the handheld device alerts the surgical team that the product has now been recalled to prevent it being used on a patient. The same applies to expired products, further safeguarding patients.

Since our selection, we have been implementing GS1 and PEPPOL standards across the trust and the benefits we are delivering to the trust are significant and exceed our initial predictions Driving supply chain efficiency Through the programme, we now have a much better understanding of our inventory profile and visibility of our stock – for example consignment versus trust owned stock. We can also better track expiring stock and wastage, including identifying the reasons why items are being discarded. This enables the trust to reduce waste in the future. We have already delivered over £1.2 million in savings, primarily as a result of improved management of our stock. Engagement with key stakeholders from the outset has been hugely important. Clinical engagement is vital and our executive clinical sponsor, our director of Nursing, Lorna Wilkinson, has played an active and pivotal role in driving internal clinical engagement. Likewise, supplier engagement has also been important to ensure the provision of accurate product related information into the trust and so we adopted a collaborative and partnership approach to encourage early adoption, building long-lasting relationships with key suppliers. Building capability within the NHS, for the NHS As a Demonstrator Site, we are committed to sharing such learnings with other trusts and alongside our fellow sites have developed

a range of resources to support future trusts. From hosting regular site visits, to publishing ‘How to Guides’ and case studies, to developing a dedicated website, there is a wealth of useful information now available to support other trusts in their Scan4Safety implementation journey. Working with GS1 UK, Salisbury NHS Foundation Trust has also developed a suite of bitesize webinars to introduce trusts to Scan4Safety, which will be launching soon. We may have nearly completed the initial phase of the programme, but what is exciting is that we believe this is really just the start. By implementing the standards, we’ve laid the foundations for transformational change and we’re confident the trust will now be able to continue to unlock further benefits and other use cases – for example medical equipment management. If you apply the benefits we’ve seen at Salisbury and those being delivered from across the other Demonstrator Sites, and multiply these across all acute trusts, that’s when you can really understand how impactful the Scan4Safety programme will be to the NHS. L FURTHER INFORMATION www.salisbury.nhs.uk

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Leadership Written by Stephen Hart, national director for leadership development, Health Education England & managing director, NHS Leadership Academy

The importance of leadership training in the NHS What can we do to ensure people in positions of influence role model inclusive leadership, with dignity and compassion? Stephen Hart explores the importance of leadership training in the NHS Leadership in the NHS has been reviewed, revised, studied and addressed throughout the past 70 years. Leadership approaches and styles have evolved and changed in the NHS as they have across society and business. Heroic, transactional, and competitive leadership approaches have each come, and gone. Each change has taken our service forward, but like other parts of the public and private sector, the NHS is still searching for leadership nirvana; a leadership strategy that unlocks the vast resource of individual and collective potential held within the staff of the NHS. Pursuit of such an aim is more than wistful; it is in keeping with the high ambition and societal status of the NHS. However, despite

investment of huge global resource and creation of a ‘leadership development industry’ to meet demand, there remains scant evidence of which leadership approaches work, and even less for how to develop ‘successful leadership’ in individuals or groups. In recent research only 20 per cent of globally surveyed CEOs believed that leadership development had any clear business impact, and only 11 per cent of surveyed

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executives strongly agreed with the statement that ‘leadership development interventions achieve and sustain the desired results’. Despite this lack of confidence in the impact of leadership development, the global industry is worth over $50 billion and is still growing. The evidence that establishing cultures of outstanding leadership is at the heart of delivering long-term organisational success is clear. This link has also been explicitly made for NHS organisations. Cultures of outstanding leadership lead to improved staff engagement, and improved staff engagement results in improved outcomes. For the NHS there’s a strong argument for the link between outstanding leadership and patient safety. This is something that came into stark focus in the Francis report following the shocking events in Mid-Staffordshire. In fact, these events - and the subsequent recommendation for improved leadership to help avoid future incidents - led in 2012 to the creation of the NHS Leadership Academy. The Academy is charged with supporting the NHS to develop cultures of outstanding leadership across NHS-funded services that improve health, enable efficiencies, and lead to better lives in communities. My view is that developing outstanding leadership across a system requires progress in four areas.

Effectiv leaders e develop hip about e ment is nr explora iching, and im tive p develop actful opportu ment nities

Following on from identifying and developing leadership behaviours linked to the NHS’s strategic priorities, it is also important to develop those behaviours in a way that is designed to transfer learning

Transfer learning Following on from identifying and developing leadership behaviours linked to the NHS’s strategic priorities, it is also important to develop those behaviours in a way that is designed to transfer learning. The Academy has created a suite of development programmes for leaders at all levels. These internationally award-winning programmes focus on the implementation of improved leadership. Our measurement of their impact isn’t assessed through the satisfaction of participants with the programme - important though that is - it’s on assessment of the impact of these interventions on organisation performance. Recent findings show that over 80 per cent of the NHS leaders who responded judged that the Academy had had a positive impact on leadership in the NHS. But there’s scope for better in this dimension of leadership development performance. Training that transfers learning must be linked to the roles that colleagues do while they’re on - and especially once they’ve completed - development programmes. The local and national system talent management approaches required to enable such a link aren’t currently in place. The Academy is developing such approaches and has piloted a Regional Talent Board in the Midlands and East Executive Team scheme. Early results are encouraging.

www.leadershipacademy.nhs.uk

Leadership

Developing leadership behaviours The NHS has made great progress, but there is more to be done. Firstly, progress is needed in identifying and developing leadership behaviours linked to the NHS’s strategic priorities. These have been identified through evidence and published by the Academy and 12 other Arm’s Length Bodies - including the Care Quality Commission, Department of Health, NHS England and Public Health England - in the Developing People: Improving Care Framework. This framework describes the inclusive and compassionate leadership behaviours needed to ensure that staff and patients are listened to, understood and supported, and that leaders at every level of the health system truly reflect the talents and diversity of people working in the system and the communities they serve. The framework also identifies: the need for leaders who are able to collaborate across traditional boundaries and create new partnerships and alliances; and the need for leaders at every level to have knowledge of improvement techniques and how these can be applied. Of the behaviours described in the framework, it’s worth dwelling on those required to create cultures of inclusion. Despite sustained attention, the pace of change around equality, diversity and inclusion across health and care has also been too slow. For example, it’s estimated that the NHS would need to recruit a further 500 women for NHS boards to become representative by 2020. NHS WRES survey data also paints a deeply concerning picture of the NHS’s approach to ethnicity and race. It’s clear that there’s a need for new knowledge in the fields of leadership practice, and leadership development practice to support progress on inclusion. To develop this knowledge, the Academy is embarking on a major project: ‘Building Leadership for Inclusion’. Based in five pilot sites in health and care systems across the country, the research will share evidence and knowledge on how leaders can create cultures of inclusion. This work is exciting, challenging, and necessary. The 2017 Cabinet Office Race Disparity Audit challenged us all to show leadership, take accountability and identify where we need to do things differently’ – Building Leadership for Inclusion is the Academy doing just that.

demonstration of great leadership. Effective leadership development needs the right systems and processes to lock in change. Here too the NHS is on a journey to even better. The NHS is not a single organisation; it’s a complex and interconnected system of systems, organisations, supporters, and enablers. Creating and embedding process across this network of networks is no easy task and cannot, as in other industries, be done by dictate or declaration. The Academy, in partnership with stakeholders and influencers across regions, is convening and enabling Regional Talent Boards to bring together those whose collaboration is necessary to embed change. Progress is furthest advanced in the Midlands and East region, but these are planned for every region in England. Effective leadership development is about enriching, explorative and impactful development opportunities. But there’s so much more. Given the known impact of outstanding leadership on the performance and outcomes in health and care, the effort and resource required to create outstanding leadership development offers a rich return on investment. L FURTHER INFORMATION

Sufficient scale and reach The NHS has some distance yet to travel in this area. There are currently 276,000 NHS colleagues working at Band 6. These front-line leaders are at the ‘bleeding edge’ of leadership in the NHS and too many are taking on leadership roles having had insufficient or even no - development support. While seminars, masterclasses, and leadership toolkits all have their place; they’re no replacement for focused and deliberate personal development that supports leaders to develop the behaviours that really matter and to transfer this learning into practice. The Academy is currently scaling up development programme offers so that capacity matches service. This also means the Academy letting go of responsibility and providing leadership development programme content to frontline organisations and systems. This enables team leader development, and from later in 2018 mid-level leader development, to be done in-place. Furthermore, it is worth highlighting the significance of implementing processes and structures that support the

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Fire system challenges in healthcare premises Hospitals and healthcare premises present many unique challenges when it comes to fire safety. Senseco Systems Ltd underline the potential solutions

In healthcare premises there are patients who need assistance and cannot easily be evacuated, critical operations being carried out that cannot be disturbed and members of the public unfamiliar with their surroundings. The premises are often on sprawling sites with a mix of old and new buildings that have been added to over the years. Reliable fire systems and competent companies to install and maintain them, to ensure they remain operational and compliant are of paramount importance. We have highlighted some of challenges that hospitals face and potential solutions to them. False alarms A false alarm in any environment can be disruptive, costly and lead to complacency which puts lives at risk in the event of a genuine fire. But in a hospital environment there are added challenges of disruption to operations, patients and the risks of moving them. There are many measures that can be taken to reduce false alarms using technology such as advanced detection but also reviewing detector locations and processes which could be causing the problems. Life safety and safe evacuation of patients In addition to reducing false alarms, it is essential that you have systems in place to keep staff and patients safe in the event of a genuine fire and provide safe means of

evacuation if it is needed. There are specific standards relating to operation of fire doors linked to the fire systems where there is a sleeping risk, it is important to check compliance as many fire systems do not meet these standards. Intelligent emergency lighting systems to allow people to evacuate or move to other areas of the hospital in the event of a fire could be considered. These are constantly monitored and self-testing to ensure they operate when you really need them, and they use a fraction of the energy of a traditional emergency lighting system. Water mist systems to protect the building and escape routes to provide a safe means of escape should also be considered. Systems visibility and networking As most hospitals are spread over multiple buildings it is important that you have visibility of the whole site in the control room and that links between buildings/systems are secure. Computer graphics packages that can connect to different systems in different buildings are available, so from a user point of view everything is shown in a central location in a consistent format. It is also important that any networked systems comply with the latest EN54 standards for fire alarm networks. Compliance, competence and maintenance Fire systems and equipment should meet and be approved to the relevant

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British and European standards and they needs to be regularly maintained by a certificated service provider to ensure they are fully operational and to ensure you comply with your legal requirements. Senseco Systems Senseco Systems have a wealth of experience in the hospital and healthcare sector and as an independent company familiar with most systems on the market, are ideally placed to support this important area. We are LPS1014 certificated to prove our competence to design, install, commission and maintain fire systems. We have carefully installed and upgraded fire systems in working hospitals causing minimal disruption to patients, staff and normal operations. We even offer systems where we guarantee against false alarms with our FAITH (False Alarm Immune TecHnology) guarantee. We maintain many hospitals on either a periodic visit, weekly attendance or manned site basis. We would be happy to advise on all issues covered in this article and fire related queries. L FURTHER INFORMATION Lee Thompson â&#x20AC;&#x201C; head of strategic marketing, Senseco Systems Ltd Website: www.sensecosystems.com Tel: 0845 644 2888 E-mail: sales@sensecosystems.com

Fire safety

Current fire safety legislation and hospital refurbishment plans How can hospital buildings plan and build structures intended to slow or prevent the spread of fire, and will this promote a better fire safety culture in at-risk buildings? We revisit some advice from the Fire Industry Association and explore the current fire safety landscape Last month it was revealed that the new regulations, that the issue would be top of £335 million Royal Liverpool Hospital, which every organisations to-do list, especially must be wishing for a break from national given the large estates and multiple headlines following the collapse of Carillion buildings that NHS trusts operate. at the start of the year, was built with unsafe In 2016, the Sun reported that a hospital cladding that does not meet fire in Coventry was hit with £380 million safety regulations. Replacing bill after builders had failed to firethe cladding not only incurs proof it. This is no fault of the Passive extra costs for the trust, doctors and other medical fire pro but again raises the staff working in the building, te question of building but it does highlight the is vital action protection nearly dangers that a fire could s it blocks fi 18 months after do to a building and how r e from travellin the Grenfell Tower important it is to comply compar g from one fire took 72 lives. with fire regulations. tmente You would think Hospitals can be da of a ho that given the very large and complex spital to rea devastation in west buildings. The main risks anothe London, with local for fire in a hospital are the r authorities issued a list main risks of fire everywhere, of instructions that must but with hospitals there are more be taken if insulation within risks. There’s the risk of patients with cladding ‘is unlikely to be compliant with limited mobility as well as all the flammable the requirements’ of current building substances that most buildings do not contain,

such as chemicals and oxygen supplies, and all the flammable materials within a pharmacy or an operating theatre. Even if one simply considers the sheer volume of curtains and bedding within a hospital, that presents a risk too, because naturally cloth is flammable. Patient safety Of course, a great consideration is the patients themselves and the danger present to them in the event of a fire. Due to limited mobility, a plan should be drawn up for progressive horizontal evacuation, whereby each floor or section of the hospital acts as a different ‘compartment’ for a fire. When the fire approaches a nearby compartment, staff and patients should evacuate that compartment, rather than evacuating everybody from the whole building at once. This is why passive fire protection, insulation from fire within the walls, doors, and windows, is vital as it blocks fires from travelling from one compartmented area to another. This is the reason that fire doors are such E Volume 18.5 | HEALTH BUSINESS MAGAZINE

Fire protection experts Fire Response UK now have a partnership agreement with Ultrafog. This builds on the already substantial offering from Fire Response UK who are BAFE accredited for the design, installation and commissioning of new fire alarm systems including wireless and early warning systems. They can also interface or integrate with older existing systems. Ultrafog have developed their high-pressure sprinkler system for fighting fires with water mist. Water mist sprinkler systems are more effective than conventional sprinklers and all kinds of fires are suppressed / extinguished rapidly. Fire Response UK can install an Ultrafog water mist system as a standalone system or integrate it into the fire alarm system as part of a wider ranging fire action plan.

For more Details please contact Fire Response UK Fire Response UK Limited - Unit 24. 106A Bedford Road. Wootton. Bedfordshire. MK43 9JB. Tel: +44 (0845) 5213510. Fax: +44 (01234) 766166 sales@fireresponse.co.uk | www.fireresponse.co.uk www.ultrafog.com

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T F INSTALLATIONS LTD is a dedicated specialist company in Fire Detection, fire alarm system design and Security Systems, founded in 2012. It has quickly become one of the most respected fire system companies in London and the South East following a series of high profile installations and has developed a founding reputation for providing innovative products and superior services that meet and exceed its clients’ expectations. T F INSTALLATIONS LTD predominantly works directly for end user clients in the commercial sector. We offer a complete range of services to our clients; from sales, fire alarm system design, installation, testing, commissioning through to ongoing maintenance and technical support. This includes identifying client needs, determining options and designing systems at the most competitive cost without compromising quality. In 2012, T F INSTALLATIONS were appointed an Engineered Systems Distributor (ESD) for Notifier Fire Systems, a subsidiary of Pittway Corporation of America, one of the world’s leading fire systems manufacturers. Our partnership with Notifier ensures that we are able to offer the best service possible – having become a specialised company with a strong reputation for the quality and reliability of installations with personal service as a local company backed by a multinational company leading the way in fire prevention technology.

• Round-the-clock help desk to limit your building risk. • Replacement doors supplied within a maximum lead time of 10 days as opposed to the typical industry standard of 6-8 weeks.

Fire Door Inspection Solutions inspect and advise on the technical and legislative compliance of fire doors. We offer a full service solution comprising of the repair, maintenance and replacement of fire doors. We also have unlimited access to themanufacturing facilities of our sister company, Integrated Doorsets (IDSL). Our extensive experience in the healthcare sector and our partnership with IDSL enable us to offer fast, effective repair of fire doors and robust maintenance plans. This ensures the absolute safety of those in your building, as well as full compliance with legislation. “It’s a legal requirement to have properly functioning, well-maintained fire doors in your building.”In addition, we can assist you with: Control of budgets through the repair of existing doors backed by our third-party Field of Application report through IFC, fully backed by historical and current test evidence.

• Dedicated supply chain ensuring delivery of product at the appropriate time. • 24 hour emergency call out service offering fully compliant repairs or like-for-like replacement doorsets. • Unique tablet based app ensures instant reporting of maintenance issues and recommendations for rectification; inclusion of photos in the report for clarification. • Wide range of product offering ensuring existing doorset specifications can be replicated.

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Fire safety

 an important part of trying to contain the fire in the room behind the doors. Fire doors are designed to help stop the spread of fire beyond the doors; it helps in the event of an evacuation situation to keep the fire contained within the designed ‘compartment’ of the building. However, in a hospital, fire doors are often propped open or bashed into by hospital trolleys. But this can be exceptionally dangerous as it increases the risk of fires spreading through the building. Keeping the doors closed keeps the fire safely behind the door, allowing for a greater escape time. Therefore, it is vital not to prop fire doors open with hospital trolleys or cause damage to them as this reduces their effectiveness. Additionally, hospital trolleys banging into manual call points (the button that activates the fire alarm) is one of the prime causes of false alarms in hospitals. Research sponsored by the FIA entitled ‘Investigations into the causes of false fire alarms’, highlighted that despite this problem being exceptionally common, it is something that can easily be remedied. The solution is to ask a specialist fire alarm company to install a special plastic cover to go over the call point, which should protect it from getting banged or knocked by busy staff with trolleys. Not only do false alarms cause time to be lost investigating the cause, they also cause distress to patients who may be worried that there is a real fire on the premises. It is therefore recommended that alarms have a delay before sounding. During this time, a team should investigate the cause of the alarm – and confirm if the fire is real or false. If a fire is confirmed, the evacuation plan including progressive horizontal evacuation should be followed.

Due to limited mobility, a plan should be drawn up for progressive horizontal evacuation, whereby each floor or section of the hospital acts as a different ‘compartment’ for a fire Fire safety laws Let’s take stock for one moment and sort out the mess of confusion that surrounds fire safety legislation and what it actually says. It is absolutely vital that everyone fully understands what the law says and what that actually means for buildings across the country, and for the people that own and manage these buildings. In the UK, there are various fire safety laws that vary slightly depending on location, but they all ostensibly say the same thing. For the sake of accuracy and preventing any

confusion, here is the full list: Regulatory Reform (Fire Safety) Order 2005 – applicable in England and Wales; Fire (Scotland) Act 2005; Fire Safety (Scotland) Regulations 2006; The Fire and Rescue Services (Northern Ireland) Order 2006; and The Fire Safety Regulations (Northern Ireland) 2010. Fire safety legislation applies to all nondomestic properties such as businesses, shops, schools, hospitals, church buildings, festival halls, and leisure centres, for example. But it can also apply to housing associations, landlords, student halls E

Volume 18.5 | HEALTH BUSINESS MAGAZINE

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Fire Door Inspection DoorCheck Certified Inspectors provide a professional and expert check of all your fire doors on-site to ensure they are safe, compliant and effective against protecting occupants against smoke and flames in the event of a fire. This enables our clients to have a full and comprehensive LPCB (Loss Prevention Certification Board) certified fire door inspection certificate on completion. Phone: 0208 553 3307 | Email: info@door-check.co.uk

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Fire safety

 of residence, and care homes. This is not an exhaustive list but it gives an idea of the scale of the need for everyone to understand, apply, and comply with fire safety regulations. Each piece of legislation refers to either a ‘duty holder’, ‘appropriate person’ or a ‘responsible person’ but they mean the same thing. This is the person who will be held liable if there are any failings in the fire safety of the building, and the person who ultimately makes the decisions about the requirements for the building. This could be the employer of a business, or a landlord, or the appropriate body responsible for managing a house of multiple occupation (HMO). Take action First and foremost, the legislation – regardless of which country you’re in – imposes on the responsible person (or appropriate person/duty holder) an obligation to ensure that general fire precautions are in place to ensure the safety of any of his/her employees, or of any other relevant persons who may be on the premises. This means that a fire risk assessment must be carried out to identify and evaluate the hazards and risks within the building. The key word here is ‘evaluate’ – because every aspect of the building (including the people within) must be thoroughly considered and analysed. Following that detailed analysis, recommendations for improving the safety of the building must be made, based on the hazards and risks that the fire risk assessment identified. The important thing here is to act on these recommendations. Make the necessary changes as soon as possible; failure to act could be seen as a breach of the law. It is also vital to note that a fire risk assessment is not a ‘once and done’ document – it must be reviewed regularly and kept up to date. Alongside these periodic reviews, the fire risk assessment must also be reviewed whenever any construction or renovation project is planned – and throughout the life of the renovation project (especially since plans can change). Knowing when the legislation applies Knowing and understanding what fire safety legislation means for businesses and the public can get complicated. However, it is vital to understand and comply with fire safety legislation as it is in place not only for the safety of everyone within the building, but also for the security of the business. Falling foul of fire safety legislation can mean thousands of pounds in fines that could have been avoided if the correct steps were taken. At worst, failure to comply with legislation may lead to an actual fire that could devastate not only the building, but the lives of those inside.

The key thing to remember here is that fire safety legislation must be complied with at all times. This means considering the legislation at the beginning of a construction project, during any maintenance work or alterations to the building, and during any installation or maintenance work on the fire protection systems in the building, such as fire extinguishers, sprinklers, fire doors, or fire alarms. It is important to note that the responsible person or duty holder must adhere to the legislation throughout the entire life of the building – letting checks lapse may cause breaches to the legislation which could result in a fine or even a prison sentence. Article 45 of the Regulatory Reform (Fire Safety) Order 2005 (for England and Wales) is the ‘duty to consult enforcing authority before passing plans’. This piece of legislation is aimed at local authorities who may be wishing to create new plans for a building, or otherwise refurbish or remodel a building. Regulatory Reform (Fire Safety) Order 2005: Guidance Note No. 1: Enforcement (a government guidance note issued in 2007) states: “The article provides for consultation between local authorities and enforcing authorities for the Order in respect of plans deposited with local authorities in accordance with Building Regulations. The provision is necessary to ensure appropriate consultation between those authorities involved at the construction stage and later stages of the life of a building. Regulation 13 of the Building (Approved Inspectors etc) Regulations 2000 (SI 2000/2532) makes similar provision for consultation by Approved Inspectors. “The consultation should clearly identify those fire precautions they believe are

Not only do false alarms cause time to be lost investigating the cause, they also cause distress to patients who may be worried that there is a real fire on the premises

necessary and the rationale for those fire precautions. This consultation process should, therefore, ensure that there will be no significant increase in the number of occasions when additional fire precautions will be required after Building Regulation approval has been given. Guidance to enforcing authorities on the consultation process is provided within the Procedural Guidance 9 document issued by Communities and Local Government. “Where enforcing authorities are consulted and are of the view that likely changes to the premises when they come into use may require additional fire precautions (e.g. introduction of racking into a speculatively built warehouse) it will be helpful if details can be passed back as part of the consultation process.” Therefore, it is important that the local authority adheres to the need to consult the enforcing authority before any changes are made. Using a professional’s help It may also be worthwhile employing the services of a professional fire engineer and/or a fire risk assessor at the point of planning a refurbishment or refit, to aid in the consultation process, and to ensure the fire safety of the building. However, all the above-mentioned legislation states that anyone involved in the fire protection of a building must be ‘competent’. The Fire Industry Association has guidance on how to choose competent risk assessors and fire engineers on its new ‘Fire Safety Advice’ page on its website. This page contains links to freely downloadable documents that highlight the competencies that fire risk assessors and fire engineers should have. The guidance is quite extensive to cover the core common competencies and should be consulted before hiring a professional. L FURTHER INFORMATION www.fia.uk.com

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Innovation Smart Technology. Innovative Fire Protection Solutions.

Johnson Controls is a global leader in fire suppression and detection systems. Count on us for innovative solutions that lead to safer, smarter building environments that you can rely on.

Discover more at www.johnsoncontrols.com

Over the last 70 years, the NHS has transformed the health and wellbeing of the nation. While delivering invaluable care and treatment, the safety of staff, visitors and patients alike is of paramount importance

When designing a system for a hospital, a key priority is to ensure building occupants have a quick and obvious means of escaping the space to temporary safety in the event of a fire. This could be alternate space within the building where a further escape route can be followed, or directly out of the building to an evacuation zone. Once this route has been designed, the requirements of the fire detection and alarm system can then be determined. Evolving technology As healthcare delivery is constantly evolving and buildings are required to adapt to changing facilities and requirements, this presents new challenges for fire detection and safety systems that must be innovated and adapted, to keep pace. Our new Visual Alarm Devices (VADs) and Visual Indicating Devices (VIDs) have been designed to ensure evacuation responses occur quickly during a real fire event,

especially in locations with vulnerable building occupants, such as hospitals. The range features an innovative LED light output with a pulse width lower than 20 milliseconds – proven to be more effective at alerting people because of the light frequency – meaning reaction to an alarm activation is faster. The devices use a new and highly sophisticated self-testing technology, developed by Johnson Controls, to assess real light and sound output. Reflective Sound Monitoring (RSM) and Reflective Light Monitoring (RLM) features also enable facility managers to test and maintain the devices much faster than before. During an automatic test, the VAD’s real light and sound output levels of all sounders are checked in a fraction of a second per device and recorded. Data on their output levels is sent back to the fire control panel to highlight if devices are not functioning as required, making it simpler and quicker to see if any need replacing. This remarkable self-testing means the device’s output can be tested without causing disruption to occupants and reducing desensitization of a genuine activation. In addition, all Johnson Controls’ technology has been developed with longevity in mind, and the reliability and future-proof assurance we provide with our products is perfect for the NHS, where long-term investments need to be carefully considered. For example, our

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Excelling in fire protection for healthcare environments new ZETTLER PROFILE Flexible range of panels are scalable and expandable, meaning as building requirements change, the systems too can be adapted, to meet every need. Minimising false alarms Not only do false alarms cause unnecessary disruption, NHS trusts now face hefty fines for fire brigade false call outs. Alongside the obvious financial implications, false fire alarms can cause unnecessary disruption and panic for patients and staff alike, halting essential care and medical procedures, and putting additional pressure and worry on those who are already vulnerable. Whether a real or false alarm, evacuation is essential, meaning that both patients and equipment need to be moved to safe locations. Our triple sensing detection technology has been developed specifically to reduce unwanted alarms and provide a fit for purpose solution for hospital environments where there is high exposure to factors that could trigger alarms, without due cause. An example of this could be if a kitchen door is left open. Heat can escape, typically triggering detection systems and a fire alarm. With triple sensing technology, the detector is sensitive to three main elements of a fire: heat, CO2 and smoke. The levels of sensitivity can be programmed to suit the environment – making it less likely to activate where this is only one element of fire present. Johnson Controls expertise At Johnson Controls, our experts have a comprehensive understanding of Health Technical Memoranda – the government’s official advice and guidance on the design, installation and operation of specialised building and engineering technology used in the delivery of healthcare services. We take a collaborative approach, working with our customers to design and develop systems that are truly fit for purpose. We have worked in close partnership with the National Association of Health Care Fire Officers to understand the standards of fire safety required in hospital settings, ensuring we deliver effective fire suppression and detection solutions for multiple NHS organisations that have needed to overcome a range of fire safety challenges. In addition, we remain determined to help improve the standard of fire safety in healthcare through our technology and expertise. L FURTHER INFORMATION For more information about our product ranges suitable for healthcare settings, visit www.zettlerfire.com, or contact our experts: www.zettlerfire.com/enquiry.asp

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Estates strategies

How to get NHS estates fit for the future Helen Buckingham, director of Strategy and Operations at the Nuffield Trust, looks at the importance of estates strategies and why healthcare infrastructure is the key enabler to the delivery of better care Let’s stand back and think about why estates use of their combined estate and other issues matter to the NHS. It’s not just a matter infrastructure, such as IT, as a significant of changing the lightbulbs on time (important enabler to partnership working, and the though that is). Getting the future health care creative use of estate can release funds estate right is of similar strategic importance to be reinvested in patient care. Most to boards as getting the workforce importantly, getting the estate right, and poses some significant right makes a difference T he but different challenges. to patients. As well as owners An effective organisation improving the experience hip of the N ensures that people of care, we know that HS estate is with the right skills and being cared for in a experience are able to good environment across 2 scattered 5 work in an environment can actually improve 0 t r u s f oundat t that makes it easier for health outcomes. ion trus s and ts, NHS Propert them to do their job Over the last year, y Servic properly. An effective we asked a number e s and Commu system sees the efficient of people about the nity

Partner Health ships

issues that local teams and national bodies need to consider when agreeing estates strategies, and give us their thoughts on current problems and the potential solutions. Alongside the Realisation Collaborative, we also brought together teams from a small number of local areas and national experts to help develop viable, implementable place-based estate plans, and where necessary propose changes in the wider policy and regulatory environment. Why does the NHS find it so difficult? It’s not that people don’t think about it. A number of parts of the NHS have bold plans to change services, reconfigure hospitals E

Volume 18.5 | HEALTH BUSINESS MAGAZINE

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quodi blaborum aut ationse nos eumque laboribus The UK health sector is aut coremolorem market six to 3,000kVA – the stockholding is for Thistle dolo Generators available fornitibusdae immediate dispatch to ensure et Dieselec quoditiat quiand dethevolecab orerisqui nullacianti business has developed a strong track customers can quickly be provided with rest, sitiatis ut idem quodi consequat facimagnime pernatemquae record in delivering large NHS energy centre the right solution for their power needs. nimusincluding earibus, tem ipsaest esprovides net eta comprehensive design projects, installations at the moluptatium The team Royal Hospital for Children in Edinburgh, service ensuring the most challenging xoxoxoxo New Queen Elizabeth University Hospital and complex of projects are handled in Glasgow, Northumbria Specialist with professionalism, and delivered in Emergency the best possible way. The design service FURTHERCare Hospital in Cramlington INFORMATION and West Cumberland Hospital. includes survey and consultancy, in-house xxx A further £4 million of work is also already auto CAD to BIM, technical submissions in progress at the Midland Metropolitan and complete turnkey packages. Hospital, University Hospital of North Once designed, the installation process Tees, East Lothian Hospital and Orkney can begin. From delivery of equipment, to Hospital. The company’s power solutions onsite electrical and mechanical engineering team is technically expert in this area, work, the project management team will and it has really gathered momentum. work alongside customers to ensure a Working with both NHS and private facilities seamless installation including flue, silencer throughout the country, DTG designs, supplies, and noise attenuation, fuel delivery systems, installs and maintains diesel generator power and AMF to multi-synchronising controls. systems to ensure reliable back-up power The project management team will for both new and refurbishment projects. ensure that the system is fully tested and Providing customers with products, support commissioned prior to handover. This is and advice throughout the life cycle of supported by the technical department their generator set means DTG has forged which has unrivalled knowledge and successful, long-standing relationships within experience in the commissioning of the health sector. Working collaboratively standby power systems. This process can with specifiers, consultants, construction include testing at the UK’s largest test cell, firms and facilities managers ensures located at Dieselec Thistle HQ, as well as health sector customers find the most on site testing and then project handover. cost-effective and resilient stand-by power DTG continues to support customers systems to meet their specific requirements. throughout the life-cycle of their equipment. Operating from its 6.3 acre HQ near This includes bespoke service contracts to Glasgow, DTG has an 80,000 sq ft warehouse meet specific requirements as well as remedial space accommodating workshops, a parts work, upgrades and 24/7 emergency response. distribution depot, the biggest load test As an authorised FG Wilson dealer, cell in the country as well as the largest the business has a wide range of the stock of generators in the UK. From 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

Estates strategies

 and develop primary care. Trust board risk registers also frequently show issues with backlog maintenance that pose a significant threat to services in some places. A common response to these challenges is that there is very little public sector capital available. A large proportion of the annual allocation is already given to a small number of schemes, and the Department of Health will continue to make capital to revenue transfers to support day-to-day NHS running costs until 2019/20. However, as the report, published by Robert Naylor illustrated, there are some wider issues to consider. Perhaps most fundamentally, successive reorganisations have significantly affected the in-house strategic capability of the NHS to think about estates. Getting the design and financing of new buildings and changes to the existing estate right requires a great deal of technical expertise and experience, and an understanding of clinical and support service delivery. This is particularly important given the complexity of estates ownership and leadership in the NHS. The ownership of the NHS estate is scattered across 250 trusts and foundation trusts, NHS Property Services and Community Health Partnerships. In addition, the NHS leases estate from local authorities, private companies and PFI (Private Finance Initiative) providers, and hundreds of individual GP practices own their own premises. Unlike workforce development, no organisation has strategic responsibility for estate development across a system, and few individual organisations have board- or executive-level strategic estate leads able to engage effectively across a system or

We hope for a different vision for the NHS estate of the future – one that maintains its position at the heart of the community, and one where the NHS estate positively contributes to improving health with other partners. Notwithstanding this, we found that that plenty of technical expertise is available to the NHS, although as Naylor reflected, it may no longer all be ‘inhouse’. The creation of the Strategic Estates Planning function will be a step forward in helping local systems to make best use of the multiplicity of advice available. But capital constraints are real, and so there is also an important question about how to supplement the capital resources of the NHS in a cost-effective, straightforward way, which avoids some of the real or reputational pitfalls associated with previous attempts such as PFI. Solutions also need to comply with the complex rules about what constitutes a call on the Department of Health’s capital expenditure limit. Organisations don’t do things: people do things Perhaps the most important message from our work is that people must be at the heart of every estates strategy. Focusing entirely on the technical aspects of the location, size and funding of buildings, seeking to fit an off-the-shelf solution to a complex local problem, is likely to fail.

A strategy with a much greater chance of success will be one developed by system leaders who truly connect with the needs and potential of the population they serve and the staff they employ, who have a deep understanding of the benefits that can be realised through partnerships with local authorities and industry, and who work with advisors that bring creative solutions to well understood challenges. Technical expertise is not enough. One of the greatest challenges for the local teams we worked with was finding the time to work together effectively, and to connect with the people around them. For many, our workshops provided their only opportunity to spend time with each other away from the cut and thrust of the day job. Our workshops were held over winter, and by the second and third time they met, teams said they had made much less progress than hoped. System leaders, and indeed estates departments themselves, were entirely focused on managing the extreme pressures in urgent care – there was literally no time to think about the longer term, or space to build relationships with other groups of people. E Volume 18.5 | HEALTH BUSINESS MAGAZINE

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As well as improving the experience of care, we know that being cared for in a good environment can actually improve health outcomes only deliver the anticipated benefits if staff also adopted new approaches, such as mobile working. Estates strategies need strong organisational development input, just as much as they require input from estates professionals. Local people Finally, the trust of local people is critical. The partners with whom local systems need to work include the public. NHS buildings – hospitals in particular – are iconic symbols of the NHS. Public opposition to change affecting the buildings that people identify as places of safety and security can be significant, and the NHS has not historically been terribly successful at working with local communities to see such change as a gain rather than a loss. One of the most widely read papers in the compendium supporting our work was an article by Andy Cowper setting out what NHS buildings can mean to local people. Andy drew out three lessons for leaders: appreciate the underlying relationship between the NHS

Estates strategies

 And those relationships are critical. Again and again in our discussions we came back to how vital it is – from a very early stage – that a wide range of people are engaged in developing estates plans. For that engagement to be really effective requires a great deal of trust, and trust takes time and space to build. A particular challenge for the NHS is to build trusting relationships with new partners. Not just between NHS partners, but across the health/local authority divide too. The NHS often views local authority relationships through the lens of social care provision, but as Michael Wood’s article points out, local authorities have much more to offer estates strategies than that. From a metropolitan or unitary authority perspective, it can be easy to forget that in many places the authorities granting planning permission and enabling access to other sources of funding are the district councils – bodies with which, historically, the NHS has had relatively little interaction. A second group that NHS organisations need to spend time with is their own staff. Where significant changes are proposed, staff will be concerned if they affect their daily travel or other practical arrangements. And of course, staff who are working in the estate every day are well placed to identify inefficiencies and suggest improvements. The teams recognised that many of the developments being discussed would

organisation and the population it serves; accept that service change is politically sensitive; and explore disagreement. Building trust in a relationship needs honesty and openness from both parties. We have to be able to say difficult things, hear difficult things, and work through them together. We also need to have a shared vision for what can be achieved through building trust. We hope for a different vision for the NHS estate of the future – one that maintains its position at the heart of the community, and one where the NHS estate positively contributes to improving health, rather than being a place for the treatment of ill health. L

Helen Buckingham is Director of Strategy and Operations at the Nuffield Trust. They published their report Developing robust estates strategies: Challenges and opportunities in June. FURTHER INFORMATION www.nuffieldtrust.org.uk

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Healthcare Estates, taking place on 9-10 October at Manchester Central, is the pre-eminent opportunity for estates professionals to learn from their peers, share ideas and solutions, and network across the profession. Health Business looks ahead to the show Healthcare Estates is only a week away and from Eta Projects, that is aligned to one of preparations for the celebration of IHEEM’s IHEEM’s initiatives, in discussing women 75th anniversary are really ‘hotting’ up. The in engineering, and a new initiative to conference this year will begin with something enhance diversity and equality in healthcare a little bit different – 70 Years of the NHS, 75 engineering, and the role of the apprentice. Years of IHEEM – a Look Back in Time, will dramatise the healthcare events of the last Estates and Facilities Surgery 70-75 years, to celebrate IHEEM’s anniversary, The conference is divided into three and also to mark the milestone 70th birthday parallel streams that run across both days of the NHS. The conference theme of the of the event; Strategy and Leadership, anniversary is ‘Our Heritage, Your Future’, and Engineering and Facilities Management, the future is indeed looking exciting, with new and Planning, Design and Construction. technology, innovation, and streamlining of Fiona Daly, sustainability lead at NHS processes and working methodology Improvement, Hospital & Health in the NHS, to save money, Care, said: “On day two, NHS There increase efficiency, and enhance Improvement will hosting are mo and improve the patient a two-hour Estates experience and patient care. and Facilities Surgery NHS tru re The conference will focused on the future sts represe n be opened by outgoing of the NHS Estate. t e d on the speake IHEEM President Pete The surgery is being r p anel th ever be Sellars, and keynote led by the national a n presentations will start team and will give projectsfore, discussin g delegates an insight and init with an address from ia in their Simon Corben, director into the national workin tives landscape; and head of Profession a conduit to g environ NHS Estates and Facilities, actively contribute ment NHS Improvement. The second toward shaping keynote presentation from Nick the national Hulme, chief executive for East Suffolk programmes and North Essex NHS Foundation Trust, STP going forward and lead for Suffolk and North East Essex STP will focused time be followed by a panel discussion including with the keynote speakers, and Rose Gallagher, professional lead for Infection Prevention and Control, Royal College of Nursing. The second day’s keynote presentation is from Dr Hyaatun Sillem, chief executive of the Royal College of Engineering, and will be preceded by a presentation by Kim Philips

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Healthcare Estates

Celebrating the past and looking to the future

the National work-streams leads. The team are also uniquely offering bookable oneto-one consultations with NHS estates and facilities staff over the entire two days. These are bookable on the NHS Improvement collaboration hub or visit them on stand H42 in the Apprentices in Healthcare area, opposite the theatre.” Within the parallel conference streams, dDay one of the conference is subdivided to cover the following themes: Strategy; Sustainability; Procurement, Risk and Funding; Energy; Well Buildings; Light in Healthcare Environments; and a module each from Architects for Health and ProCure 22. ProCure 22 are featuring Design for Efficient Operation, and Architects for Health will be running a panel session on Procuring Design. The conference on the 10 October will cover: Technology, both for operational efficiency and patient treatment; Compliance, Regeneration and Planning; Design for Clinical Service; and Safety and the Built Environment. With over 26 million meters squared of floorspace spread across 1,200 sites nationwide, the NHS needs to ensure that its facilities thrive just as well as the occupants. Complexity of buildings requires innovative solutions to manage the energy and operational needs. Enlighted, a Siemens company, uses a dense sensory grid, cleverly incorporated in lighting fixtures, to collect, process, communicate, and analyse rich streams of data to optimise the health and efficiency of buildings. The system provides actionable insights of facility usage while giving occupants a game changing Real Time Location Services system. Even better than this, the huge energy savings that Enlighted produces means that facilities can become connected for free, by using the energy savings as the trojan horse for deployment. Guests can learn how this technology is currently being developed and applied, the challenges, along with predictions for the future. The company’s Jamie Cameron will discuss this in his session on creating vibrant estates. E

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Urbis Schréder has been providing high quality lighting products since 1977 and has grown to be one of the UK’s largest suppliers of street lighting and exterior LED lighting equipment. Technical quality and aesthetic design are at the heart of the company’s philosophy and coupled with its customer focused work ethic, this has led Urbis Schréder to develop the most cost effective, energy-efficient exterior lighting innovations on the market today – including the Shuffle, Britain’s first Wi-Fi connected streetlight. The company works in partnership with customers and contractors to create the perfect balance of efficiency, connectivity and performance and deliver stunning projects that go far beyond traditional lighting. In 2018 the company has continued its success, being responsible for illuminating some of the UK’s most iconic sites –

Proactive Technical Training (PTT) is an independent electrical engineering consultancy that specialises in electrotechnical training, courses for City & Guilds and EAL, medical locations, power quality and electrical safety training and management. Based in Tring in Hertfordshire, the company provides on- and off-site courses in the 18th edition, testing and inspection as well as medical locations and other specialised electrical sectors. PTT can also produce bespoke courses tailored to your individual requirements. An approved training provider for City & Guilds and EAL, the organisation is also a

including the redeveloped London Bridge station, Tees Newport Bridge and the award-winning St Blaise Court in Bradford. Urbis also has an extensive portfolio of work in the healthcare sector. Most recently its LED luminaires played an important role in the multimillion pound development of the new Dumfries & Galloway Royal Infirmary, as well as being installed at Atherleigh Park hospital in Manchester. To find out more about Urbis Schréder and its award-winning products, please contact the company via the details below.

FURTHER INFORMATION Tel: 01256 354446 www.schrederled.co.uk

member of the Electrical Contractors Association (ECA) and the safecontractor scheme. PTT has the latest ISO 9001 Quality Standard. The company’s trainers have a deep and extensive knowledge of electrical engineering gained in various aspects which allows it to offer specialist services to support clients in all aspects of electrical installation development and diagnostics.

FURTHER INFORMATION Tel: 01442 828754 info@ptt-training.co.uk www.proactivetechnical training.co.uk

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Static Systems Group is renowned for the provision of industry-leading bedhead services solutions for the acute healthcare sector; incorporating trunking, nurse call and other associated systems. The company’s Design & Innovation Centre (D&IC) houses the P22 Repeatable Room and new Concept Ward. Supported by a number of leading suppliers, the facility can be used by clients and the wider industry to trial conceptual ideas and innovative solutions, with the ultimate aim of supporting improved health care outcomes for all. Key to Static Systems’ proven track record and prolonged success is their close collaboration with client teams who play an important role in helping shape product development and design. Visitors to Static’s stand (C3) at Healthcare Estates this year will be able to find out more

For over 45 years, Barons has provided quality contract furniture to businesses all over the UK. From the company’s base in Lytham on the Fylde coast, Barons has earned a reputation for outstanding contract furniture at competitive price points. All furniture is UK-made by trained craftsmen and the company works hard to provide each customer with a superior level of service. This customer-first approach – paired with outstanding furniture for every room – keeps many returning to time and again. From bedrooms to display and dining furniture, Barons has everything you need to give your rooms a beautiful finish. Each year, the Barons team exhibits at the Healthcare Estates event. 2018 is no different, and the organisation can’t wait to get started at the Manchester Central exhibition centre on the 9-10 October. Why not

about the latest initiatives and developments being introduced to improve patient experience and patient safety, enhance workflow efficiency and support engineering teams. Experts will be on hand to give demonstrations, and visitors will be able to arrange to visit the D&IC or book to use the facility for their own event or research.

FURTHER INFORMATION Tel: 01902 895551 sales@staticsystems.co.uk www.staticsystems.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

drop by Stand C18 and speak with a member of its team who’ll be ready to answer any questions on the company’s furniture ranges, including brand-new products developed specifically for challenging behaviour environments. Be the first and register now for a copy of the latest Challenging Behaviour Brochure, full of all the very latest Barons has to offer!

FURTHER INFORMATION Tel: 01253 741940 sales@baronsfurniture.co.uk www.baronsfurniture.co.uk

Healthcare Estates

 New builds Chase Farm Hospital is a £150 million new build elective are acute hospital based in north London. From a standing start, the scheme has taken just four years from the acquisition of the Chase Farm site in July 2014 by the NHS Royal Free NHS Foundation Trust to a planned opening in autumn 2018. This presentation, hosted by IBI Group, will outline the hospital’s complexities, the response to the site and the brief, demonstrating what is possible with strong leadership, clearly defined direction, and a truly collaborative working ethic between disciplines which allowed for the delivery of such a complex building at unprecedented speed within the NHS. Designed as the new ‘heart’ of the Chase Farm redevelopment, briefed to offer a level of service and ambience more like a ’hotel’ than a hospital, it is one of the newest and most digitally advanced hospitals in the NHS, with only the third ‘barn theatre’ built in this country. This is an excellent opportunity to discover the latest thinking in healthcare design and procurement methodologies. Emma Smyth from Cowan Architects has written an academic paper on the topic of pharmacogenetics and architecture. Her session in the Design & Construction Theatre will introduce the topic, outlining the future potential and where the current research is focused. She will talk about three distinct phases of change in order to provide an environment where pharmacogenetics has a place within the treatment pathway, including the inclusion of genetics departments alongside pathology and pharmacy services. This presentation will take a close look at the current service layout, and discuss future design implications for new and existing facilities. She will debate what the use of pharmacogenetics mean for architecture.

The future is indeed looking exciting, with new technology, innovation and streamlining of processes, to save money, increase efficiency, and enhance and improve the patient experience and patient care Energy intensive The NHS estate is highly energy intensive and costs over £8 billion a year to run. Both the Carter Report and Naylor Review highlighted the importance of investing in the NHS estate to continue to deliver a highquality healthcare service. With improved energy efficiency notably identified as an area that can reduce wasted energy and save the NHS millions of pounds. Recent research estimates over £130 million is lost on wasted energy due to inefficiencies in the healthcare sector each year, this highlights the vast opportunities available for the NHS to achieve financial and carbon savings through investment in energy efficiency. Salix Finance provides NHS Trusts and Foundations Trusts with 100 per cent interest-free government funded loans to support the installation of energy efficient technologies. Since 2007, Salix has provided £71 million for 589 projects across 63 trusts and foundation trusts, leading to savings of over £19 million per year and £290 million over the lifetime of the projects. In their session on interest-free finance for investment in energy efficiency, Salix Finance will discuss opportunities for NHS trusts and foundation trusts to drive down their energy costs by implementing new energy

efficient technologies. Salix will include examples of NHS clients’ projects through Project Knowledge Slides containing best practice and lessons learned on a range of technology types which include; LED lighting, combined heat and power and heat recovery technologies. Salix will also provide tips from client’s experiences on how to gain internal approval for energy efficiency capital projects. There are more NHS trusts represented on the speaker panel than ever before, discussing projects, initiatives, and case studies in their working environment. The topics are diverse and include linking public transport for easier hospital access, managing the estates property and land holdings, reducing energy consumption through a rolling programme of sustainable behaviour change, introducing new technology to improve workflow, building refurbishment, and state of the art treatment technology, and the building, planning, and management required to deliver that new treatment. All the estates professionals delivering these presentations have invaluable first-hand experience of the projects that they have been involved in at their trust. L FURTHER INFORMATION www.healthcare-estates.com

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Flooring

Flooring and reducing fall injuries Ashley Martin, public health project manager at The Royal Society for the Prevention of Accidents, looks at why installing and maintaining appropriate flooring is key in preventing falls and trips, especially among the elderly

Poo fitting srly or slipp hoes been in ers have many fa volved in l fit well ls. Shoes that support protect and t improvehe feet will b and sta alance bility

For many years, The Royal Society for the Prevention of Accidents (RoSPA) has campaigned to prevent falls, particularly among older people. Although falls can cause injuries at all ages, figures start to increase dramatically as we get older. One in three people over 65 will experience a fall that requires hospital treatment. The most recent figures showed over 316,000 hospital admissions and 4,500 deaths as a result of a fall, with over 75s being the most at risk of serious injury. Different types of more slip resistant flooring may play a role in preventing falls, while there is some evidence that flooring which has some level of shock absorbency, or â&#x20AC;&#x2DC;compliantâ&#x20AC;&#x2122; flooring, as it is sometimes known, may reduce injuries from falls. A recent review of studies into flooring has shown that there are potential benefits of

shock absorbent surfaces. However the evidence is not clear and additional research is needed to confirm whether this would be a cost effective strategy in reducing falls. While introducing compliant flooring may have some application in the nursing and care home setting, further research is needed to establish whether such flooring would result in increased physical demands for workplace staff. Additional research would also be required to determine whether this is a solution that can be applied cost-effectively in the homes of those who still live in the community, where the majority of falls occur. There has been some research indicating that installing underlay under carpets can help to reduce impact in the event of a

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

fall. In addition, a research programme at the University of Otago has found that Low Impact flooring reduces the severity of injury compared to vinyl flooring. There are steps in relation to flooring that can be taken in the home to reduce the risk of a fall occurring. Carpeted floors may provide a more secure footing as long as they are in good condition. Worn or frayed carpets will inevitably provide tripping hazards. Stair carpets need particular attention bearing in mind the potential seriousness of a fall on stairs. Avoiding the use of rugs on polished floors is very important. Rugs may also present tripping hazards if they are not secured down as inevitably they make a floor surface more uneven. Mopping up spillages will also help to prevent slips and trips. While installing flooring that helps to cushion a fall when it happens may be a useful passive measure to reduce physical injury, this may not help reduce the fear of falling and is unlikely to prevent falls from happening. The best key messages need to be the things that people can do to prevent falls.

1 - Take steps to maintain and improve strength and balance Exercises that improve our strength and balance will help to develop the right muscles to protect us from falling. We naturally lose muscle strength as we get older but simple exercises will help us to retain this.

Although falls can cause injuries at all ages, figures start to increase dramatically as we get older. One in three people over 65 will experience a fall that requires hospital treatment

Flooring

Here are five key tips:

2 - Check the environment for falls hazards This includes: good quality flooring; good lighting; safe steps and walkways with handrails on both sides of stairs and steps; and removing any confusing visual patterns that reduce the distinction between changes in levels. 3 - Check medication For those who take medication, perhaps for long-term conditions, the number of items we take can mount up over time, sometimes without us really noticing. It is known that when we take four or more types of medication that we are more at risk of falling. Regular Medicine Use Reviews are essential. 4 - Check eyesight Regular eye tests are a vital part of any health routine, and can be important in helping to diagnose outstanding health problems which would otherwise go

undetected as well as in protecting people from falling. If you are over 60 you are entitled to a free NHS eyesight test as often as you need one.

have been involved in many falls. Shoes that fit well protect and support the feet will improve balance and stability. L FURTHER INFORMATION

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Volume 18.5 | HEALTH BUSINESS MAGAZINE

Ambulances

Time to refresh an ageing and outdated fleet What will the latest funding for ambulance fleets enable and how will expanding the ambulance fleet improve patient care and deliver efficiencies to the NHS? Health Business explores In July, Health Minister Stephen Barclay announced that a £36.3 million investment would enable 256 state-of-the-art ambulances to be added to the current NHS fleet across the country this winter. As part of this financing, an extra 25 double-crewed ambulances will be supplied to London Ambulance Service as a result of £3.85 million investment, while Yorkshire Ambulance Service will increase its fleet with 62 double-crewed ambulances, due to £7.5 million in funding. From December last year to March this, the health service struggled to meet waiting time targets despite tens of thousands of elective or

non-urgent operations and procedures being postponed to help hospitals deal with pressure. Then Health Secretary Jeremy Hunt labelled the situation as the ‘worst ever’ for the NHS, and many leading healthcare figures predict that this winter will follow a similar pattern. The funding should help quash some of the concerns raised in a recent NHS Improvement report, which warned that the service’s ageing fleet and slow uptake of technology is limiting the ability of the NHS to answer 999 calls quickly.

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Meeting targets With eight out of 10 services missing their seven-minute target for answering the most life-threatening emergencies in July, announced prior to Barclay’s announcement, the review stresses that it will be more difficult for ambulances to hit their targets if the current problems are not addressed. This is echoed by London Ambulance Service, who found through local polling that 72 per cent of Londoner’s feel that people use the ambulance service when they don’t need to. For example, 23 per cent of 18-24 year-olds stated they would call an ambulance because they couldn’t get an urgent GP appointment, while more than half of 18-24 year-olds would call an ambulance in a non-emergency situation because they have no other way to get someone to hospital. This is despite ongoing efforts by NHS England and NHS Digital to promote and raise awareness of NHS 111, the free number to call when you have an urgent healthcare need which isn’t a life threatening situation. Lord Carter, who carried out the NHS Improvement review, has backed calls for an overhaul in approach to the productivity of the ambulance services, arguing that an ambulance

It wi more d ll be for amb ifficult trusts to ulance hit t targets if the cuheir rrent problem s a re not add ressed soon

Lord Carter has backed calls for an overhaul in approach to the productivity of the ambulance services, arguing that an ambulance is ‘not a taxi to A&E’ and stating that, with the use of technology, patients should often be treated at the scene is ‘not a taxi to A&E’ and stating that, with the use of modern technology, patients should often be treated at the scene. However, the current ‘ageing ambulance fleet means that this is not always possible’. Lord Carter has therefore identified that tackling the current problems surrounding efficiency could save £500 million a year by 2021, which could then be reinvested in the service. With demand predicted to increase by 38 per cent over the next 10 years, the review found that auto-dispatch technology to speed up responses to cardiac arrests was not yet fully implemented 12 years on and that the use of digital technology to access patients records remains in its infancy. Responding to the report, Will Hancock, chief executive at South Central Ambulance Service NHS Foundation Trust, said: “The Carter report provides a valuable roadmap to England’s ambulance service of the future and although SCAS compares well to other trusts, we also recognise the need to remain committed to delivering the continuous improvements that are required for patients, staff and taxpayers. As a Global Digital Exemplar we are introducing new technologies into our organisation and service; we are already working with our neighbours in London and the Isle of Wight – a partnership approach that Lord Carter recommended all trusts should adopt; and we have developed a range of innovative services both on our own and in partnership with other health and social care providers, that means more of our patients get the most appropriate care they need rather than transportation to A&E.” Martin Flaherty, managing director of the Association of Ambulance Chief Executives, added: “We welcome Lord Carter’s report, which highlights how ambulance staff continue to work extremely hard to provide excellent patient care at the front line of the NHS despite rising demand and pressures elsewhere in the system that are often beyond the ambulance service’s control. We also note his confirmation that during last winter, delays at busy hospitals cost the ambulance service £50 million. This still remains our biggest issue and resolving this will add the greatest increase in capacity for ambulance services this winter. “We are also pleased that Lord Carter recognises the need for the wider NHS Infrastructure to continue to improve to enable ambulance staff to have more opportunities to treat and refer patients safely rather than take them to an Emergency Department. It is clear that the current lack of clinically suitable referral pathways in some areas contributes to the differences in the percentage of patients being transferred to hospitals.”

Ambulances

Make Ready July’s funding announcement also detailed how the Department for Health & Social Care will finance ‘Make Ready’ hubs at ambulance trust headquarters, where specialist staff will be able to re-stock, refuel and clean vehicles to get them back out faster to treat patients. Already a feature at a number of ambulance headquarters, Make Ready is proven to contribute towards improved infection control rates, where the repetitive cleaning undertaken at every shift in the Make Ready Centre produces a higher standard of cleanliness. In fact, according to the South East Coast Ambulance Service, 100 per cent of vehicles are deep cleaned every six weeks, while the percentage outside the Make Ready system is 75 per cent. Joint working On 25 September, South Central Ambulance Service NHS Foundation Trust and London Ambulance Service NHS Trust announced that they have established a partnership to look at potential efficiencies through projects like joint procurement of vehicles, equipment and IT systems. The two trusts, which provide urgent and emergency care services for about 16 million people between them, are also committed to working more closely together and learning from each other’s best practices. This is the second collaborative effort from South Central Ambulance Service in a matter of months, after the trust announced that it would be seeking opportunities to collaborate in a number of common areas with the Isle of Wight NHS Trust. Both organisations recognise that improving the quality and performance of services for patients whilst achieving greater value for money, can be achieved through potentially sharing resources and best practice working. A key area of immediate collaboration is the implementation of a new computer aided dispatch (CAD) system for the Isle of Wight Ambulance Service. The Island’s current CAD system has been in use for nine years and needs to be updated. The new system will ensure that the Isle of Wight Ambulance Service will be ready to move over to the new Emergency Services Network (ESN) when it goes live starting at the end of this year, and will also provide economies of scale for the Isle of Wight NHS Trust’s finances. L

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Volume 18.5 | HEALTH BUSINESS MAGAZINE

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Patient experience

Designing a better care experience for an ageing population Chris Finnegan, communications manager at the Design Council, explains how an innovative new partnership between health and social care leaders, social entrepreneurs and the public could relieve pressure on stretched services and improve the experience of later life for everyone For the first time in history, Britain’s over-65s Transform Ageing is the Design Council’s outnumber people under the age of 16. What’s cross-sector initiative. It brings together people more, it’s predicted that almost half of in later life, social entrepreneurs and the adult population will be over health and social care leaders to We the age of 50 by 2020. It’s not define, develop and deliver just that people are living innovative new solutions must longer; people are living that support the needs create a s longer with increasingly and aspirations of people y s t e m that is m complex health conditions. in later life. Ultimately, ore persona This creates pressure on an its goal is to help design l already stretched health a better experience of connec ised, more t e and social care system, ageing, for everyone. d a n d, above a while the number of people To meet this challenge, ll of working age will stagnate we need to broaden prevent , more ative or shrink, causing gaps in the the notion of ‘care’. job market and further pressure It’s a challenge of wider on public finances. In short, one of collaboration between individuals the triumphs of the previous century – a and carers, family and friends, neighbours, vastly improved life expectancy – looks set to volunteers and professionals. New solutions be one of the great challenges of this one. are required to support the delivery of Established more than 70 years ago to effective products and services that meet improve the industrial output of Britain, much people’s needs and tackle causes rather than of what Design Council now does is centred symptoms. We must create a system that on how design can help to is more personalised, more connected and, improve people’s health above all, more preventative. and well-being. This more radical approach requires real imagination.

Transform Ageing Last summer, the Big Lottery Fund recognised the potential in our ambition, and the Transform Ageing programme was awarded £3.65 million under its Accelerating Ideas programme to be delivered in Devon, Cornwall and Somerset. Since then, Design Council has worked alongside UnLtd, the South West Academic Health Science Network and the Centre for Ageing Better to launch the programme in Cornwall, Devon and Somerset. Together, this partnership brings unique expertise and a collective track record in supporting community-led responses to ageing challenges. We are now recruiting delivery organisations in those localities to get the programme off the ground, directly connecting with local people to help shape and design solutions. For innovation to take root, we need the belief that change is possible and the confidence to commit to a process. The success of this programme depends on the creativity of individuals to inspire change, determination of local communities to embrace change, and recognition from health and social care leaders that change is healthy, necessary and sustainable.E

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Philips Dream Family: One family, multiple solutions A comfortable, patient-driven design to help you give your patients the sleep they need Obstructive sleep apnoea is very common in the UK, with 4.1 million1 British adults suffering from the condition (0.9 million1 diagnosed), and as most health care professionals will know, it can be difficult to treat. With a further three million1 people suffering with Chronic Obstructive Pulmonary Disease (COPD) (1.2 million1 diagnosed) and a steady rise of obesity hypoventilation, it is becoming increasingly more important for medical professionals to be able to diagnose, assist and treat patients for respiratory diseases. The Philips Dream Family range from Philips Respironics offers innovative, comprehensive sleep therapy technology with sleek, patient-led design, and personalised tools to keep your patients engaged and therapy compliant. Patients can look forward to a peaceful night’s sleep with ground-breaking sleep apnoea technology, that includes the Philips DreamWear full face mask, the Philips DreamMapper app and the brand-new travel CPAP system, Philips DreamStation Go. Philips DreamWear under the nose nasal & full face masks Sleep apnoea masks can be uncomfortable and restricting. However, the Philips DreamWear patient interface range has been designed to give patients end-to-end treatment and allow them comfortable and unrestricted sleep. The innovative designs prevent red marks, discomfort and irritation on the nose bridge and is the closest thing to wearing no mask at all2. The masks combine the innovative hose on the top of the head with a full face cushion or soft silicone frame to help patients get a better night’s sleep. Recent trials reported that users were more satisfied with the comfort and freedom of movement of DreamWear masks than with their previously prescribed mask3. The DreamWear patient interface range benefits healthcare professionals and patients by saving valuable resource on fittings and refits, as well as potentially reducing the number of masks needed

to set up a patient. This is because of the flexibility of the system – patients can easily switch between nasal, full face and gel pillows to suit their mask to their needs, without having to change the mask itself. Philips DreamStation Go For patients with sleep apnoea, a night away from their own home can be a dreaded prospect. Packing all their treatment equipment can be a nightmare and taking a holiday ‘off the grid’ such as camping can be a complete no-go. Philips DreamStation Go is an ultra‑portable continuous positive airway pressure (CPAP) therapy system designed for the frequent traveller. Patients can rely on its unique blend of connectivity, packability and powerful, convenient features. The device has a slim profile, compact footprint and revolutionary micro-flexible tubing, which offers high performance CPAP therapy in a product that easily stows in existing baggage. It’s designed to facilitate easy airport screening and offers discretion while traveling. The system is incredibly easy to use and is navigated with familiar swipe and tap gestures, making it simple for you to instruct patients on how to use it. Your patients can also use DreamStation Go ‘off the grid’ with an option for an integrated overnight battery, offering patients protection from power interruptions. Philips DreamMapper The free Philips DreamMapper mobile app allows patients to track their therapy results wherever they go with multiple DreamMapper-enabled devices, including the DreamStation Go. Saving you time and supporting your sleep service By giving patients greater insight into their therapy data and providing the tools they need, they can troubleshoot common problems themselves, freeing up your team’s time to see more new patients as well as manage those who may need extra attention. It’s very simple

to communicate the benefits of DreamMapper to your patients – as our patient-specific website allows them to access information about the app and log-in or create an account. DreamMapper is our best sleep apnoea engagement tool ever: 58.3 per cent more people used their therapy every night when they used DreamMapper4, and research found a 283.3 per cent higher success rate for users struggling with adherence to sleep therapy5. To make treating your patients even simpler, the app works with our EncoreAnywhere compliance data management system solution to offer you a cohesive package of therapy and compliance solutions. One family, multiple solutions With the Dream Family range, you can see that your patients benefit from a comfortable user-driven innovation that helps them get the best sleep they need in every possible way. Designed to increase patient adoption, long term use and enhanced efficiencies so you can better attend to patient’s needs, the Dream Family can help your patients get the sleep they need while supporting your business goals. L

Philips research, 2017, data on file. Design claim – the design of the mask is such that it does not contact the nasal bridge. 3 Data analysis of Aug 2017 Patient Preference trial where n = 85 and prescribed masks include Resmed Airfit F10 and F20, Respironics Amara View and F&P Simplus; based on 10 days of use. 4 19 per cent of DreamMapper users used their therapy 100 per cent of the nights over 90-days versus 12 per cent for the Standard Care users, a 58.33 per cent increase. In a retrospective review conducted by Philips Respironics of the EncoreAnywhere database (see DreamMapper whitepaper) that compared DreamMapper patients (n=85,077) to users who did not use it (n=87,602). 5 46 per cent 90-day adherence rate for DreamMapper patients versus 12 per cent for the Standard Care group, a 283.33 per cent increase. In a retrospective review conducted by Philips Respironics of the EncoreAnywhere database (see DreamMapper whitepaper) of struggling patients (n= 24,378). 1 2

FURTHER INFORMATION www.philips.co.uk/healthcare/solutions/ sleep-and-respiratory-care/dream-family

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Patient experience

This programme has the potential to deliver new, scalable and sustainable solutions that meet the needs and aspirations of our ageing communities across the UK. It could make a real difference to people in their later lives  We hope that Transform Ageing will inspire creative ideas, ranging from new services, products, environments – or perhaps something else entirely. Anything that could make a real and lasting difference to the experience of later life will be considered. Why design? In 2014, we saw the proposal to appoint a head of design in every UK government department and a chief user officer on all large government infrastructure projects. The use of strategic design is becoming intrinsically linked with good foresight and managerial skills. Through first-class research, collaborative working and rigorous design, Transform Ageing will help local communities to influence how their care needs are handled. By directly engaging with local people, we can identify the key health and social care challenges they face. In turn, care leaders and social entrepreneurs can combine to generate tangible, creative and lasting solutions to meet the needs of the south-west. These, we hope, can then be adapted and rolled out elsewhere in the UK – and even beyond. We must start by breaking down the barriers between different stakeholder groups and involving everyone from the outset. This creates collaborative environments that

encourage a user-led approach. Not least, we must help health and social care leaders find opportunities to try new ideas while managing risk, and help them to understand the core design principle that ‘iteration’ does not necessarily mean ‘failure’. The programme has been welcomed by health and social care leaders as an important step in improving services for people in later life. Professor Paul Burstow, former Minister of State for Care, said: “Transform Ageing offers a practical approach to making communities in the south-west more ageready. Using design innovation that starts with the experience of people in their later lives and taps into the energy of social entrepreneurs and the insight of health and local government to devise practical solutions. “Above all, this programme has the potential to deliver new, scalable and sustainable solutions that meet the needs and aspirations of our ageing communities across the UK. It could make a real difference to people in their later lives.” Strategic partnerships and preventative services It’s essential to support commissioners to feel more confident in incorporating new services and interventions into mainstream

care supply chains, and social entrepreneurs to scale their solutions and provide evidence of their impact to enable them to be commissioned. In order to do this, local communities, individuals, carers, family, friends and professionals in each of these regions need to be at the heart of the process. People who are closest to the issues faced in our ageing communities are often best placed to identify the challenges that need to be addressed. By reframing these challenges, we hope to identify the specific challenges and support innovative solutions to help provide everyone with healthier and active later lives. It’s Transform Ageing’s job to work with local organisations to make that happen. That’s why the partnership’s first steps are to recruit up to four delivery organisations (or consortia of organisations). Ideally, we will recruit one each in Cornwall, Somerset, north-east and west Devon, and south Devon. Over the coming months, the partnership will be engaging local health and social care leaders, VCSE organisations, social entrepreneurs and people in later life and their support networks to become involved in the programme. We are looking for committed groups and individuals who would like to support new thinking and approaches develop new and exciting products and services that will transform people’s experience of later life. Time is of the essence. We want the best health and social care innovations, services and products to reach people in later life as quickly as possible. Working together, we can achieve just that. Our vision is that by creating services better aligned to real-life needs and issues, everyone’s experience of ageing will be improved. L FURTHER INFORMATION www.designcouncil.org.uk

Volume 18.5 | HEALTH BUSINESS MAGAZINE

YOUR PARKING AND ACCESSIBILITY PROBLEMS SOLVED Whether you need to find a solution to your car parking shortages, increase your revenue, navigate a site redevelopment or improve sustainable travel for your staff, our small team of experts has the answer. Welcome to The Parking Consultancy.

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The British Parking Association explain how hospital parking charges can be managed sensitively by taking into account the needs of patients and visitors Only hospitals in England and Northern Ireland charge for parking now, with the latest figures revealing £174 million was made last year from parking charges in England. In Scotland, and now Wales, hospital parking is described as free, however there is no such thing as free parking; it costs to maintain, manage, keep clean, light and equip car parks. Much of what is taken in charges is invested back into maintaining the car parks. If there were no charges these costs would come from somewhere; most probably out of the healthcare budget, which is an expensive drain on the NHS. With charging it is also possible to manage the high demand for parking spaces at hospitals, give concessions for patients and carers who are frequent or

Parking

The conflict of charging for hospital parking

from the outsourced parking operator. This finding is from 81 out of 120 foundation trusts answering a Freedom of Information request. The British Parking Association (BPA) has long been interested in hospital parking and worked with our members and the Department of Health to produce an excellent guide to support NHS trusts in managing their parking: NHS patient, visitor and staff car parking principles – Rules for managing car parking in the NHS. Here is a great example of how hospital parking charges can be managed sensitively taking into account the needs of patients and visitors as well as the need to pay for the maintenance and upkeep of the car park itself.

Listening to hospital patients and visitors The association between charging for parking and, at the same time, caring for hospital long term visitors, and prevent commuters patients and visitors is not often made, and shoppers from using the car parks. however Melanie Ray and Lisa Redfern are The Patients Association in Scotland, where a dynamic parking management duo who parking is now free, have said that patients are on a mission to achieve just that, at the sometimes struggle to find spaces and University Hospitals of Derby and Burton consequently miss appointments or park Teaching Hospitals. With over 15 year’s elsewhere and walk to the hospital. Research experience between them they manage the this year on how foundation trusts in England continual demand for parking spaces. manage their car parks reveals 15 It is an in-house contract so trusts don’t charge to park, If they are hospital employees 48 charge and keep all the there w as opposed to working for income after maintenance e r no cha e a car park operator. The costs are paid for, eight are r operation does make a given some money from these c ges o surplus and all of this the outsourced parking s t s would one third of the revenue operator, and just 10 c o m e from somew collected from E don’t receive any income h

probab ere; most l the heay out of lthc budget are

Volume 18.5 | HEALTH BUSINESS MAGAZINE

When was the last time you ran a health check on your print costs?

As a Director, Manager or Administrator of a department, clinic or surgery, within the Health Sector, managing your budgets can often give you quite a headache. At Olivetti we have made it our business to provide our customers with the best, but most costeffective, print and document workflow solutions available so, before we even recommend any of our multifunctional printer-copier-scanners or desktop printers to you, we will carry out a *FREE NON-INVASIVE Print Audit on your current print infrastructure to see exactly how much your current equipment is costing and show you where you can make valuable savings. The report you receive from the Print Audit will provide a CLEAR DIAGNOSIS of which machines are costing you the most, which ones are not being utilised to their full potential or if any are being abused and GIVES YOU THE CHOICE to manage your print and CONTROL YOUR PRINT COSTS. (*Usually worth ÂŁ600.00)

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Research reveals 15 trusts don’t charge to park, 48 charge and keep all the income after maintenance costs are paid for, eight are given some money from the outsourced parking operator, and just 10 don’t receive any income from the outsourced parking operator  car parking - is reinvested into patient care and the remainder is spent on car parking maintenance and security, land rental and rates.

of £3.20 per visit; clinic and outpatients reduced charge when the department stamps the ticket; and a reduced evening rate.

How big are the car parks you manage at Derby and Burton Teaching Hospitals? We have 1,200 patient and visitor car park spaces divided over eight car parks.

This is an amazing array of concessions. Why did you feel a need to introduce them and how to you publicise them? Once again we listened to what the patients and visitors were making comments about, in our Patient Experience in-house surveys. We publicise these concessions on the internet and the hospital web pages. They are advertised in the clinics and departments on notice boards in all of the waiting and sub-waiting areas. There is also information displayed on pull-up banners at the entrances to the hospital.

What would you say is key to the way you manage the car parks? We listen to what patients and visitors are saying when they tell us they are not happy we try and figure out how we can make parking a little easier for them. What is special about Derby and Burton Hospital? We have the extra challenge of having thousands of frequent visitors who come especially to the hospitals nationally renowned clinics and the demand for parking is round the clock every day of the week. For example, we have thousands of renal patients that come to our awardwinning renal departments each year. What concessions have you implemented at the car park? We have devised many concessions which we have rolled out one at a time over the last few years, including: 33 free spaces for disabled drivers; 40 renal patient permits and reduced annual permits for renal patients; 17 wide access vehicle spaces for wheelchair users; £1 charge per visit for radiotherapy patients; chemotherapy patients flat rate

How do you manage the high demand for daytime parking? Many of the hospital clinics run every day which means the demand for spaces often out strips supply during the day. So we introduced a cheap evening tariff to encourage visitors to come during evening visitor hours. Why did you introduce a clinic and outpatients reduced charge? We found talking to patients, that many have more than one appointment within the hospital. These can often take more time than they expect, so we devised a system whereby patients can ask for the clinic or outpatient department to stamp their tickets and they are charged a reduce rate. Patients really appreciate having the peace of mind that they will not be expected to pay more than two hours for an appointment.

Parking

How do you manage parking charges for hospital staff? We have an incentive scheme for staff to car share or have a parking partner as well as a bike scheme for those who cycle and walk. What would you say is your most innovative concession? We are particularly proud of what we have called our Carers Comfort Packs which supports relative whose loved ones are at the end of their lives. It contains two parking tokens, a meal voucher, leaflets (on the chaplaincy, preparing for losing your loved one and the pop-up bedroom and volunteer sitters) and an open visitor card. This card will exclude the visitor from having to visit during the normal visiting times, enabling them to visit at any time and stay as long as they want to. Visitors are grateful of this, explaining that it is very difficult to leave a loved one that is very anxious or at the end of life. Are you ready to take electric vehicles? Yes, so far we have invested in two onsite and four offsite charging points and our Transport and Sustainability Officer is seeking funding to increase the charge points as the number of EV owners increases. What do you like most about your job? No two days are the same and we meet people from all walks of life, including new parents. We come to work at 8am, hit the floor running and often find ourselves helping people and having conversations with patients every day. How can other hospitals learn from your experience? A few hospitals who have car parks that are contracted out have spent a day with us recently to see how their car parks can be managed in-house and how it works in practice. It’s definitely an investment, however with about a third of the car park income going back into paying for patient care it is certainly an attractive prospect for hospitals. The BPA recognises hospital car parking charges can disproportionately affect some groups, such as motorists with disabilities, frequent outpatient attendees and relatives of long-term patients who need to visit regularly. BPA agrees that concessions, including free parking or reduced or capped charges, should be available for these groups, and are working with government on this issue. Where they are available, be it the NHS Healthcare Travel Costs Scheme or as concessions for patients with long-term illnesses or conditions that need ongoing treatment, we believe it’s the role of the NHS trust to communicate this information to patients and visitors and encourage them to do so. L FURTHER INFORMATION www.britishparking.co.uk

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Diabetes

Accessible education for diabetes healthcare professionals Following record attendance at last year’s event, Diabetes Professional Care will return to Olympia, London, on 14-15 November. Health Business previews the show The UK’s only free-to-attend, national diabetes conference and exhibition for healthcare professionals (HCPs) saw visitor numbers more than double at last year’s Diabetes Professional Care (DPC), to 3,235, compared to its launch in 2015. And DPC2018 is set to attract even more HCPs, eager to discover the latest advances, update their skills and knowledge, and interact with others working in diabetes care. With the rapid rise in new diagnoses of type 2 diabetes (T2D), along with the huge financial burden on the NHS and the worrying trend in people being diagnosed at a younger age (nearly half those diagnosed in the last 12 months were under 35), there is a greater need than ever for the accessible, real-world education that DPC provides. In the UK, an estimated 4.6 million people are living with diabetes, with around 700 diagnosed every day, at a cost of £10 billion to the NHS – 10 per cent of its budget. Furthermore, an estimated 12.3 million people are at risk of developing T2D, even though 90 per cent of cases are largely preventable, with obesity the leading preventable cause in most cases.

Maggie Meer, DPC’s founder, said: “People with diabetes aren’t receiving the care and support they need to understand and manage their condition so they increase their risk of life changing complications. Better access to education is needed to address the decline in specialist diabetes staff, and the gaps in knowledge and skills of those working in primary and secondary care.” Maggie launched DPC following her own experience of diabetes healthcare. Her objective was to help to improve the lives of people with diabetes by educating HCPs, and arming them with the skills and latest knowledge to better understand patients and provide the best possible care. She also wanted to address the budgetary constraints on NHS staff by running a free-to-attend event, and create an educational programme strong enough to provide HCPs with CPD credits. DPC attracts a broad spectrum of HCPs with responsibility for delivering diabetes care – from commissioning services and products, through specialist diabetes teams, to GPs and nurses in primary care.

In the an estimUK, ate 4.6 mill ion peod ple are diabete living with 700 dias, with around gn day, at osed every a £10 bill cost of io the NHn to S

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Conference to address key concerns DPC2018 will again address the most pressing issues in diabetes healthcare – including childhood obesity, reversal of T2D, the psychological impact of the condition and care funding. The comprehensive, multistream conference will bring together top diabetes practitioners and thought leaders to share their learning and expertise, across eight separate streams: Commissioning for Better Diabetes Care; Prevention & Obesity in Practice; Diabetes Co-morbidities; Primary, Community & Specialist Care; Diabetes Technologies; Paediatric to Adolescent & Crossover Care; T1 Diabetes; and TREND-UK & Injection Technique Theatre. Maggie says: “DPC2018 will create a unique environment where diabetes HCPs can learn about many topics and specialisations under one roof, on the same day. It provides an unmissable opportunity to access the information and expert advice they need to deliver care for the full range of medical issues involved in diabetes.” The high calibre of speakers at DPC reflects the enormous regard in which the event is held. Opening the conference, NHS England’s Professor Jonathan Valabhji and Dr Partha Kar will present their keynote on ‘An update from NHS England Diabetes’,

Diabates

followed by a Q&A session. Professor Sir David Haslam, chair of NICE, will also deliver a keynote. In ‘Excellence across the care pathway: NICE and diabetes’, he will include information on how NICE’s recommendations for diabetes care can help visitors to commission and provide high quality, person-centred care. In a DPC2018 exclusive, visitors will get a first look in the UK at outcomes data from a large study on the impact of SLGT2 inhibitors on diabetes patients with high CV risk. Cardiovascular outcomes with SGLT2 inhibitors in type 2 diabetes – update from AHA conference, will be presented by John Wilding, professor of Medicine and Honorary Consultant Physician, Obesity and Endocrinology Research, theme lead for Metabolism and Nutrition, Institute of Ageing and Chronic Disease, University of Liverpool. Award-winning GP Dr David Unwin will also address the DPC2018 conference, sharing his practical ‘nuts and bolts’ approach to T2D drug-free remission: hope for primary care? Commissioning for better diabetes care Finding time to access information about the latest diabetes care pathways, best practice and innovations can be difficult for commissioners, prescribing advisors, and other healthcare managers and senior policy makers. So DPC2018 will include a dedicated Commissioning for Better Diabetes Care stream, with speakers presenting case studies and sharing outcomes data, to demonstrate best practice and cost-effectiveness in diabetes care. Sessions will include: Innovation in care – cranking up care pathways for better outcomes in diabetes management; STPs – North West London – Reality of delivering transformation in diabetes care – toolkit for success; setting up an integrated care service in practice – onestop session to help bring together the MDT and commissioning team; and how to deliver patient self-management and behaviour change at scale; 2017-18 outcomes data with key lessons for the NHS. Focus on diabetes co-morbidities Around 80 per cent of diabetes costs are associated with treating serious complications of the disease, including CV disease, amputations, sight loss and renal failure. So DPC has extended its Diabetes Co-morbidities stream to two days, with a dedicated focus on Renal Disease, Cardiology, Retinopathy, and Mental Health & Wellbeing. The stream will also feature the Office of the Chief Dental Officer (OCDO) England’s launch of its Diabetes Commissioning Standard for dental care of patients with, or at risk of T2D. In their session on The periodontitisdiabetes paradigm – launch of Diabetes Commissioning Standard, Janet Clarke and Professor Iain Chapple will explain what the standard is, and how it will benefit HCPs and people with, or at risk from, T2D.

Finding time to access information about the latest diabetes care pathways, best practice and innovations can be difficult for commissioners, prescribing advisors and other care managers and policy makers Informal and interactive sessions Alongside the conference, informal, interactive workshops and special features will give participants an opportunity to examine particular issues more closely while sharing real life examples and discussing practical solutions. Workshop sesions will include: diabetes management – considerations for patients with serious mental health/learning disability; and biosimilars – prescribing in practice. At the TREND-UK & Injection Technique Theatre, experienced diabetes nurses will present a programme of interactive sessions on a variety of subjects, including substance misuse, dementia and end of life care. Attendees will receive a DPC Injection Matters toolkit, one of several toolkits available for the first time at DPC2018. DPC Toolkits are handy, takeaway ‘cheat sheets’ that visitors can use back in practice and share with their teams. Other sessions where they will be available include Consulting Skills, and Mental Health & Wellbeing, Launched last year, the dedicated DPC Foot & Wound Clinic will return to DPC2018 with the latest information and practical skills to help HCPs support patients in looking after

their feet and lower limbs. Led by Graham Bowen and his clinical podiatry team at Solent NHS Trust, sessions will take participants from basic screening to more advanced care, helping to address the urgent need for better education on diabetic foot disease. The opportunity to network with colleagues is another key attraction of DPC, and the Diabetes Village will again provide a focal point where visitors can share their concerns and experiences over a complimentary coffee or tea. Register now for free Feedback from DPC’s visitors helps to ensure the programme continues to cover their education pathways. Their responses to the DPC2017 post-event survey were extremely positive, with 98 per cent saying they’d attend again, 98 per cent saying they view DPC as place to learn about new and existing innovations and products, and 95 per cent saying DPC met their learning objectives. L FURTHER INFORMATION www.diabetesprofessionalcare.com

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Infection prevention

Achieving a bacteria-free hospital ward What steps should be embraced in hospitals to fight infection and how can these help to eliminate the risk of illnesses? It is a well-known fact that hospitals are some of the most potent sources of germs if they are not cared for in the appropriate manner. A perfect example of this observation can be seen in the recent emergence of MRSA and other potentially serious infections.

This is why staff and management need to take cleaning procedures very seriously. What steps should be embraced and how can these help to eliminate the risk of hospital-related illnesses? Hand and environmental hygiene The best approaches will embrace a proactive mindset. It is critical that all staff members regularly wash their hands and properly disinfect any surfaces that may have been exposed to potential hazards. Common examples include laboratory instruments, door handles, railings and patient waiting areas. These locations can easily transmit germs from one individual to another, so extra precautions should always be taken.

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The bottom line is that a bacteria-free ward is everyone’s responsibility. By appreciating the risks involved and through targeted training methods, it is possible to mitigate potentially serious threats. This is also why a checklist should be drawn up so that each worker can take an active role. An ounce of prevention can tackle even the most challenging of situations. L

Infection prevention

It is critical that all staff members regularly wash their hands and properly disinfect any surfaces that may have been exposed to potential hazard

FURTHER INFORMATION www.cleanhire.co.uk

10 hospitals with the most e.coli cases (Aug 17-18) Heart of England (761) Sheffield Teaching Hospitals (760) Frimley Health, Surrey (758) Barts Health, London (740) Leeds Teaching Hospitals (721) Nottingham Uni. Hospitals (711) Uni. Hospitals of N. Midlands (659) East Kent Hospitals University (620) London NW Uni. Health (606) York Teaching Hospital (599)

10 hospitals with the fewest e.coli cases (Aug 17-18) Salisbury (100) Weston Area Health (119) Establish a cleaning schedule Bacteria-free wards will only arise as the result of a team effort. All personnel must be made aware of their responsibilities. They should be positively encouraged to watch others and make certain that coworkers are adhering to the proper protocols. If a cleaning schedule is posted, the chances of hospital-borne infections arising will be dramatically reduced. It should also be pointed out that management must also take part in such efforts. A topdown maintenance approach will ensure safety and efficiency while keeping the needs of patients in mind at all times.

Surveillance and antibiotic stewardship Closed-circuit television systems and similar surveillance equipment can be used to monitor the condition of a hospital ward. This is why security personnel should likewise be made aware of the associated cleaning protocols. A mistake or an oversight can be quickly corrected before it represents a danger to the public (or other staff members). This type of stewardship also helps to raise interdepartmental accountability; an excellent means to increase in-house responsibility. A healthy environment is the combined result of hard work and diligence.

Wye Valley (125) Burton Hospitals (126) The Whittington Health (134) East Cheshire (137) Homerton University Hospital (137) Isle of Wight (151) George Eliot Hospital (157) Kingston Hospital (157)

Volume 18.5 | HEALTH BUSINESS MAGAZINE

A flexible room system designed for growth

Maquet VARIOP Modular Room System

Maquet Variop in comparison with average conventional OR*

Healthcare is changing rapidly. Infrastructure must be designed with growth and adaptation in mind. Modular room systems are the key to a cost-effective facility that accommodates change. Later, rooms can be quickly and cost-effectively retrofitted to meet new requirements. The modular wall and ceiling elements of Maquet Variop allow quick access, with easy disassembly and reinstallation without special tools. www.getinge.com *Obermeyer Planen + Beraten GmbH Âˇ ROI: Modular vs. conventional building methods This document is intended to provide information to an international audience outside of the US.

Construction period

40% faster than conventional Retrofitting

60% faster than conventional Retrofitting

23% less expensive (excluding downtimes costs)

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An investment in a future-proof healthcare facility Well-designed rooms can do more than enhance workflows and efficiency. They can create an atmosphere that improves the overall wellbeing of patients, families, and staff Getinge is built on a genuine compassion for people’s health, safety and well-being. Founded in 1904 on the Swedish west coast, the company has grown to become a leading global provider of products and systems that contribute to quality enhancement and cost efficiency within healthcare and life sciences. Getinge employs more than 10,000 people and have operations in over 40 countries around the world. The company is listed on the Nasdaq Stockholm Large Cap list since 1993. Within the healthcare segment you can find Getinge’s products and solutions in operating theatres, intensive care facilities, SSD and cardiology departments – with the aim to support better clinical outcomes and rapid recovery. Here you also find Getinge’s advanced IT systems for more efficient workflows and management of sterile equipment, enhancing productivity and minimizing the risk of getting a hospital acquired infections. Getinge also offers both common and highly specialised processes for contamination prevention in biopharmaceutical production, biomedical research and medical device manufacturing for the Life Science business. Your trusted partner for large healthcare projects Whether investing in a new building, a modernisation or expansion, selecting the right partner is crucial for smooth implementation. Getinge offers complete design concepts that take today’s needs and tomorrow’s growth into account. The long-sighted planning and workflow analysis makes use of all current resources while leaving plenty of space for future changes. With flexible tailor‑made financing solutions, we help you provide best-in-class care and grow your business in a competitive environment. Building in the sensitive areas of a hospital can be a challenge. Not only do you need to focus on official requirements, such as fire protection, but also the unique challenge of implementing and combining the many individual elements into a fully-functioning complete system. An experienced Getinge project manager acts as your trusted partner, coordinating,

planning and supervising each project in order to achieve efficient results in the specified time frame. As your personal contact, this coordinator gains agreement and coordination among all involved specialists, handles project management tasks, and ensures the smooth implementation of all project phases. Even the most complex projects are clear and traceable at all times. With a combination of careful planning and professional project management, Getinge lays the foundation for your investment assurance and future-proofing, including designs that are economical and flexible. This means you are always in a position to respond quickly to trends, technologies and requirements VARIOP – A flexible room system designed for growth Healthcare is changing rapidly. Infrastructure must be designed with growth and adaptation in mind. The modular room systems Maquet Variop, the Glass Wall system and Variward are the core of our project business. They consist of a substructure, the wall and ceiling elements, doors and the optional integration of built-in element. Modular room systems are the key to a cost-effective facility that accommodates change. Later, rooms can be quickly and cost-effectively retrofitted to meet new requirements. The modular wall and ceiling elements of Maquet Variop allow quick access, with easy disassembly and reinstallation without special tools. Variop offers an operating theatre with modular metal wall and ceiling elements with no significant maintenance costs. When comparing Variop to conventional walls and ceilings, the only the advantage

of conventional construction is lower investment costs – after the first downtime due to refurbishment or small retrofits, the lower investment costs will be dissolved. While the modular operating theatre with metal wall and ceiling elements will generate savings in modification and retrofitting measures, as well as to reduce of downtime and cost of refurbishment1. The individual elements are sealed to the substructure for effective pressure regulation. They are easy to install, and can be quickly disassembled for rapid access to medical gases and cabling. VARIOP fully meets all construction requirements in terms of fire, radiation and sound insulation, and its surfaces can withstand any hospital-approved cleaning agents and disinfectants. Plus the wide selection of available colors and prints is perfect for creating an appealing working environment and improving the patient experience The prefabricated, modular components of Maquet Variop are designed to assemble with ease, anticipating the evolution of cutting-edge technologies in the operating theatre, CSSD, and ICU. Construction projects can be completed 40 per cent faster than projects that utilize conventional construction materials1. This keeps project timelines on track and on budget, with less downtime, noise, dust, and disruption. . Obermeyer Planen + Beraten GmbH · ROI: Modular vs. conventional building methods 1

FURTHER INFORMATION Tel: 01773 814730 uk.marketing@getinge.com www.getinge.uk

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Construction consultancy

Maximum value from capital spending projects NHS Shared Business Services’ Phil Davies explains how a new, free-to-access Construction Consultancy Services Framework is helping NHS trusts achieve maximum value from capital spending projects, whilst saving the public sector around £16 million over the next four years Construction is not just about bricks and buying from suppliers direct. And last month, mortar. There are a whole host of consultancy due to increased demand, we re-launched a services – like project management and new and improved version of the Agreement. civil engineering – required to ensure It now includes more than 200 suppliers capital projects, such as refurbishment ranging from SMEs to national providers – and design and build, are successful. split by service provision, geographical region To support the NHS and other public sector and project value band – and offers access organisations in this area, NHS Shared to a much greater range of specialisms, such Business Services (NHS SBS) has managed a as fire safety and principal designer services. framework providing access to these services since 2014. The Construction Consultancy Cost savings as standard Services Framework is one of more than 65 Use of this framework can help NHS OJEU compliant frameworks we offer procurement and estates teams be more in total, covering a huge range effective in several ways. Most of products and services, obviously, it can assist them The which – from this month in trimming project costs. provide onwards – are all Savings can be generated r s we wo free to access for through a range of discount with ge rk any NHS or other structures and pricing n erate conside public sector body. options, for example, for the rable saving Since its inception, prompt settlements, i this particular volume discounts and meanin r organisatio s g more n, specialist framework volume spend rebates. m can be has saved the public The use of Level 2 BIM diverte oney technology purse in excess of £12 – collaborative d to fron tline million, due to typical working between different care savings of between 10-15 teams and underpinned by per cent when compared to digital technologies, which enables

teams to develop more efficient methods of designing, delivering and maintaining buildings throughout their lifecycle – further reduces spend. Another major advantage is that suppliers are all already vetted in key areas like financial standing, public liability and professional indemnity. The wide range of suppliers and specialisms is another major benefit to procurement teams, as finding the right supplier for the right job is where a lot of public sector organisations struggle. Many have told us that while they often might have preferred to use a local supplier on a project, they simply did not have the time – and often the specialist knowledge – to identify and assess local SMEs, meaning they have usually been reliant on the major national players. Trying to identify suppliers of more niche ancillary services, such as acoustics experts or town planners, has also caused them similar problems. The right supplier, every time And this, they felt, often meant projects did not perform optimally. First there were often hefty travel expenses associated with hiring a national supplier, pushing up costs. Second, there is a perception that national suppliers working on smaller projects have a tendency to send in what one of our partner organisations described as ‘their B or C team’. Use of the framework avoids this by enabling procurement teams to pinpoint the right team for the job, using a variety of very precise criteria to ensure they are working with the ‘A Team’ every time. E Volume 18.5 | HEALTH BUSINESS MAGAZINE

ENGINEERING DESIGN PARTNERSHIP TM

 Another advantage of the framework is the flexibility it offers in relation to different procurement routes. Organisations can either directly award projects or run minicompetitions depending on the needs of their project. When a project is likely to have very specialist requirements – for example the refurb of historical buildings – a competition may be the most appropriate way to source the right skills. Procurement teams can also make use of a number of model contracts, making it easy to mix and match their requirements or tailor something more individual, with NHS SBS’ category experts on-hand to provide the necessary guidance. It is no wonder then that our Construction Consultancy Services Framework has already been used to draw together the right team for a number of projects in the NHS, ranging from those that have attracted international attention, to the more ‘business-as-usual’ requirements of a busy NHS trust. One of the UK’s leading specialist trusts, for instance, sourced project management and quantity surveying services on a new landmark cancer treatment centre.

An NHS hospital in the Midlands, meanwhile, generated savings of around £5 million in a £50 million scheme, and we supported a major trust in the South of England as it refurbished sections of office space. Outside of the NHS, we have also helped a diverse range of public sector organisations access the expertise they need. For example, a major transport authority used our framework to source project management support, while the V&A Museum in London contracted with a Quantity Surveyor as part of a £12 million refurbishment programme of the Museum of Childhood. In using the framework, these organisations have not only ensured they can access precisely the right suppliers in a cost-effective, simple and streamlined manner, they have also been able to save time and effort for their procurement teams. And, perhaps most crucially for our healthcare system, the providers and local authorities we work with generate considerable savings for their organisation, meaning more money can be diverted to frontline health and social care.

Framework to save public sector millions A new procurement framework launched by NHS SBS is expected to save the public purse more than £25 million over the next four years. Providing an easy, cost-effective and legallycompliant means of accessing a wide range of consultancy expertise, the Consult 18: Multidisciplinary Consultancy Services is free to use for any public sector organisation and offers cost savings of around 10 per cent compared with purchasing direct from a supplier. With upwards of £250 million expected to be spent via the framework by 2022, the savings across the public sector are expected to be in excess of £25 million. Phil Davies said: “Understandably, many NHS and public sector bodies do not always have the in-house skills, experience or resource needed for time-consuming and complex projects. Therefore, the requirement to engage specialist consultants, with unique expertise in a particular field, can be an essential part of guaranteeing success. Our aim is to ensure that when public organisations need external support, they can access high-quality services in a way that saves them significant time and money. Those awarded a place on this brand new framework have been evaluated against a number of criteria and are considered to provide best value to the NHS and wider public sector.” L

Construction consultancy

The wide range of suppliers and specialisms is another major benefit to procurement teams, as finding the right supplier for the right job is where a lot of public sector organisations struggle

FURTHER INFORMATION www.sbs.nhs.uk/ica-constructionconsultancy-services

We offer a full range of integrated engineering services Established in the UK 40 years ago, Cundall are a 900-strong global multi-disciplinary engineering consultancy. Cundall were the world’s first One Planet endorsed Consultancy and has been successful in winning a place on the NHS SBS Construction Consultancy Services Framework, making our services available to all public-sector clients.

Volume 18.5 | HEALTH BUSINESS MAGAZINE

4C Strategies is an independent technology consultancy helping clients to develop their communications and networking systems to meet today’s business challenges.

We have worked for over 50 NHS Trusts and CCG’s helping them to:

Take a look at our web site for more details and case studies, www.4c.co.uk

• Secure their telephony and communications systems against the risks of withdrawal of systems support and market change

For a no obligation discussion on how we can help your organisation to meet today’s challenges contact us at:

• Implement Unified Communications applications to support agile and mobile working

E: NHS@4c.co.uk | T: 01858 438938

• Implement SIP and Cloud services to improve resilience and deliver revenue savings Our services can now be procured through the new SBS Consult 18 framework and we are also a GCloud 10 awarded supplier.

Delivering Integrated Procurement and Transformation Healthcare Solutions

You’re not alone!

Some of the trusts and frameworks we work with:

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Andrew Mellish discusses the initial benefits of decision of the Crown Commercial Services to push G-Cloud 10 live in June, and how it has provided opportunities for new cloud suppliers to pitch for government work According to UK government figures, sales through the G-Cloud framework reached over £2.8 billion at the end of 2017. SME vendors played a big role in this figure, accounting for 47 per cent of total sales by value and 73 per cent by volume. Overall, 83 per cent of total business was from central government and 17 per cent from the wider public sector. These figures support the fact that the G-Cloud framework has facilitated the increase in cloud adoption and broadened the pool of SME suppliers for public sector organisations. It is why we welcomed the Crown Commercial Services’ (CCS) decision to push G-Cloud 10 live in June, which provided the opportunity for new cloud suppliers to pitch for government work and existing ones on the framework to update their service offering.

G-Cloud and its opportunities for SMEs Since it launched in 2012, the G-Cloud framework, with its sleek procurement processes, has created opportunities for SMEs to provide innovative, cloud-based IT solutions for the public sector. It reduces time, cost and risks for suppliers and customers, resulting in an attractive solution being procured within a much shorter timeframe. Essentially, the G-Cloud framework has been the gateway for many SMEs to work in the public sector, securing key business that in many instances has helped to shape them, their offerings and their market approach. But, while G-cloud has done much to open opportunities, create transparency and level the playing field to a large degree, it hasn’t always been smooth sailing.

Sin it launc ce 2012, t hed in he framew G-Cloud ork has created o p for SME portunities innovat s to provide ive IT solut , cloud-based ion public s s for the ector

Procurement

G-Cloud – the impact of moving from 9 to 10

The importance of the CCS’s about-turn The framework agreement for the current G-Cloud 9 was supposed to expire in May this year. But the government took the decision in November 2017 to extend it by another 12 months to give the CCS and the Government Digital Service (GDS) time to ‘deliver a revolutionary transformation to the platform to meet more user needs – both central government and wider public sector’. This was met with a barrage of criticism from SMEs, who as suppliers are unable to alter prices or update their service offerings, because of the constraint of having to wait until the next iteration is available to make updates. This seems to work against the very essence of what G-Cloud is supposed to represent and enable. If we consider that most of the innovation is being driven by SMEs, by locking down the framework for two years and blocking technological advances the government is effectively working against SME suppliers and ultimately hindering change and progress. The good news is that the CCS has now subsequently reversed its decision, announcing earlier in March that a new iteration of G-Cloud will be delivered in June. Oliver Dowden, minister for implementation acknowledged that ‘small businesses are the backbone of our economy, so it’s crucial we listen to them when shaping policy’. Challenges may not change in the near future So, while public sector suppliers have welcomed the government turnaround, some argue that the high proportion of suppliers still not engaging with the framework suggests a radical overhaul to G-Cloud is required to make it work better for all, and a year’s delay is a price worth paying for getting it right. There is some merit in this argument, as many suppliers agree that with G-Cloud there’s no visibility of tenders and opportunities – knowing if you’re in the running for an opportunity is a key area for improvement. Another issue already mentioned is the fact that the framework is inflexible when it comes to suppliers needing to adjust pricing, particularly third-party price increases that are out of the control of suppliers. Leaving the framework ‘as is’ however would also likely have a detrimental effect on new suppliers to the public sector market, to those developing new services and any that need to make pricing changes. Delaying changes by 12 months means the buyer (and, by extension, the tax payer) is being denied innovation and the positive effect of increased competition. That is why the benefits of moving G-Cloud from iteration 9 to 10 far outweighs the disadvantages of simply extending the current framework. And we’re hopeful that the challenges will be ironed out as iterations progress. L FURTHER INFORMATION https://ccs-agreements. cabinetoffice.gov.uk/g-cloud-10

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Advertising Feature Written by

Heading Isosec launches on twoPassword or three lines ResetasService tight as – fully possible secure please self-service for Windows Active Directory

Udae nonsend icidisquid quam elisimincim facepro et et, sed quodi blaborum ut molorem aut ationse nos eumque laboribus et quoditiat dolo qui de volecab orerisqui nitibusdae nullacianti rest, sitiatis ut idem quodi consequat facimagnime pernatemquae nimus tem aipsaest moluptatium es netNHS et IT helpdesks are regarding Did youearibus, know that third of all calls to many forgotten passwords? Historically forgotten Windows Active Directory passwords xoxoxoxo have been not only a drain on resources for NHS IT staff, but can also be an SUBHEADERS L high-risk process inefficient and FURTHER INFORMATION Isosec Password Reset Service xxx The Password Reset Service from Isosec adds a simple and user-friendly functionality to the Windows login screen that allows a user to reset their own password with self-service, using pre-formatted and agreed secure recovery processes. The Password Reset Service is delivered from Isosec’s Secure Hub, a dedicated SaaS enabled secure platform confirming to the latest NHS UK and international security and authentication standards, including Cyber Essentials accreditation. If an NHS user forgets their Windows password and they’re not using the new Password Reset solution, they have to call their helpdesk and ask them to reset their password. This is not only wasting their valuable time that could be better spent with patients or on other tasks, but with our leadership position with IT security solutions for the NHS, we would have to question how secure password reset is when the user’s identity is checked over the phone? As well as potential security risks with a manual password reset process, it also

ties up valuable time and resources for both helpdesk and the password owner. This new solution from Issoec will help free up valuable time that can be better spent on more important and critical tasks. Michael Latimer, Isosec CEO, said: “Isosec operate at the frontline of innovation to the NHS. Our new Password Reset Service is the latest solution we have delivered to our NHS customers that solves real world problems with a best in class, secure software service. At the centre of the service is our Secure Hub, ensuring our customers have peace of mind with total digital security.”

Password recovery There are multiple ways a user can recover their password with the Isosec Password Reset solution; such as setting a minimum of five security questions and answers, registering an alternate email address, push notification or biometric validation. Users of the NHS Smartcard can also use them to authenticate the reset process. Isosec Cloud Service Using the Isosec Cloud Service, the Password Reset solution is easily deployed across large IT estates and automatically updated without the internal IT team having to spend their valuable time on updating it for every individual machine. This allows for a fast, easy rollout, even across multiple physical sites if necessary. The service is optimised to work in any IT infrastructure deployment model. This latest announcement follows the successful launch of the Isosec Virtual Smartcard in January 2018. Today, Isosec has more than 75 NHS trust customers and more than 90,000 users who are already successfully using the full range of Isosec solutions and services. L FURTHER INFORMATION For any more information please contact: info@isosec.co.uk or call 0161 376 3570

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Audio assistance

Creating inclusive environments for patients with hearing loss Andrew Thomas, chair of the International Hearing Loop Manufacturers Association, looks at why NHS trusts should assess their hearing loop provision and the potential costs of not listening to those who can’t hear A healthcare setting is one of the places where it’s vital to be able to hear; from being called to an appointment to understanding a diagnosis, how to take medication to options about treatment and after care. One in six of the population, approximately 11 million, live with a hearing impairment and more than a quarter of them wear a hearing aid. But the provision of induction loops in hospitals is far from standard. People with hearing loss are the largest disabled group in the UK. With an everageing population, their numbers are expected to rise and it’s estimated 14.5 million people in the UK will have some form of hearing impairment by 2031. Access to services within the NHS is governed, like anywhere, by the Equalities Act 2010 which requires ‘reasonable’ adjustments to be made for those with hearing loss and obliges trusts to ‘provide auxiliary aids and services’ including hearing loops. And since 2016, trusts have been legally required to follow the Accessible Information Standard (AIS) to identify, record and meet the communication needs of patients with a sensory impairment. While hospitals will no doubt have installed induction

loops in efforts to meet these requirements, The role of hearing loops this doesn’t automatically ensure patients or Hearing loops can benefit those who wear a their families are able to hear more clearly hearing aid or cochlear implant. Rather than and the effects can be considerable both making everything louder, loops amplify the for the individual and the hospital itself. sound a person wants to hear above the In 2013, a report by the charity Action on background noise. They convert sound picked Hearing Loss found that 14 per cent of people up by a microphone into a magnetic signal. This with hearing loss had missed an is transmitted by a loop aerial and is picked appointment due to not hearing up by the telecoil in a wearer’s hearing their name being called in aid and converted back to speech. the waiting room. The As well as meaning patients clearly The respons report showed that 28 hear the information they need, ib il it per cent of people in a healthcare setting loops y to ensure with hearing loss had can also maintain dignity and e v e r y w one ho ente left their GP unclear confidentiality as staff can r about a diagnosis, has the s a hospital speak normally and be heard. a and 19 per cent had People may not always want hear lie bility to been unclear about to disclose an inability to hear, s their medication. especially if it isn’t the reason much wvery ith The implications for for the consultation, and when trusts their health are obvious a loop is in place, and working, but the financial impact for it means they don’t have to. trusts is equally concerning. But it is crucial for trusts to get the As described in the Accessible right advice when it comes to installation Information Standard; if 14 per cent of the in order to select the right loop for the 11 million people with hearing loss miss right job, and to meet newly an appointment, that is 1.5 million missed revised guidelines. E appointments. Even at the lowest estimated cost of an appointment in primary care (£10), missing just one appointment a year through not being able to hear is costing the NHS £15 million annually.

Volume 18.5 | HEALTH BUSINESS MAGAZINE

EIE 2018 - McEwan Hall, Edinburgh, Scotland: A 19th century landmark and ceremonial hall EIE (Engage Invest Exploit) is an annual technology investor event that highlights up to 60 of the most promising and innovative data-driven high growth companies, seeking funding from seed to Series A. The event brings together hundreds of investor and business guest delegates to network and help these young companies seek funding from investors. Dr Steve Ewing, director of operations at Informatics Ventures, said: “We have been organising EIE in Edinburgh for 10 years now and we feel it is important to pick a venue that not only is large enough to host several hundred delegates but also offers a unique and memorable experience. “When we first launched EIE in 2008, we held the event at a University of Edinburgh venue, so we were keen to bring it back to where it started, and the iconic and newly-refurbished McEwan Hall couldn’t have been a better fit. “The event started at 8am and delegates didn’t begin to leave McEwan Hall until 6pm, and during this time we had to organise presentations, Q&A sessions, as well as exhibition stands for 60 companies looking for investment. We

needed a large screen set up in the main room, as well as 60 pods for exhibitors. “ Fortunately this went without a hitch thanks in no small part to Edinburgh First. We also had fears about how easy it would be to cater for hundreds of delegates in a quick and orderly fashion, but Edinburgh First allayed these and we had all of the high‑quality meals out of the kitchen and into the hands of our guests in a matter of minutes. “A number of delegates have since commented on how unique and stunning the venue was, made all the more impressive by the fact it’s just a short walk from the train station, historic Old Town, and more. I was wholly impressed by McEwan

Hall and the support we had from the fantastic venue team at Edinburgh First.” Lyndsay Wilkie, Assistant Director for Business Development at Edinburgh First, added: “After a three-year, multi-million pound refurbishment, we reopened McEwan Hall in 2017 with state-of-the-art conference, exhibition and break out spaces. This means we are able to provide an even greater service for organisers, such as Informatics Ventures, who want to host large-scale events at a unique and historical venue.” FURTHER INFORMATION Tel: 0131 651 2189 www.edinburghfirst.co.uk

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28/09/2018 15:28

Get specialist advice The range of loops available shows the importance of seeking specialist knowledge to both understand where a loop is needed and which one is most appropriate. Looping

a hospital represents an investment of hundreds of thousands of pounds for a trust and, as has already been discussed, the cost of getting it wrong and patients not being able to hear, could be equally significant. For those trusts involved in building new premises or refurbishing existing ones, it’s essential to get advice from a specialist installer at the earliest stage. If plans are going out to tender, make sure the loop design is specified to avoid having to rectify costly mistakes further down the line. An expert will know how to factor in possible interference from sources such as air conditioning systems or equipment, and the impact of the building’s fabric on a loop’s performance. Correct installation is one thing but regular maintenance and staff training are two equally important elements. The cost of getting it wrong Having recently been asked to visit two hospitals in London to audit their hearing loop provision, I could see that many parts of the hospitals were covered. However, after further inspection and testing we found just 10 per cent of the loops were actually usable. A number had not been correctly specified for the space they were intended for so provided little benefit to patients with hearing loss. Some were simply not working because they hadn’t been regularly tested or maintained and counter loops that staff could move from desk to desk were either missing or staff had no knowledge of how to use them.

Of course, rectifying these issues is a far greater challenge when the loops have been installed some years ago. Flooring has to be taken up, wall panels removed, wiring re-laid, all causing disruption and expense that could have been avoided had the trusts involved been given the appropriate advice at the time. Now the trusts realise the condition of their loops, it’s not something they can ignore. By not offering working loops hospitals are failing to meet their legal obligations. The revisions to the BS8300 also represent a benchmark against which patients can measure a trust’s provision, or lack of it.

Audio assistance

 ‘Accessible’ vs ‘inclusive’ The British Standards Institute recently revised its BS8300 guidelines for creating premises fit for the future that are inclusive and welcoming to all members of society. The guidelines have shifted their emphasis from offering an ‘accessible’ environment to one that is ‘inclusive’ meaning patients with a disability should have their needs accommodated within a general space and not set apart in a separate area. They have also shifted the onus for accessing services and information from the individual to the premises – so in a healthcare setting, the responsibility lies with the trust rather than the patient or service user. For the first time, the guidelines contain an annexe that covers in detail how premises should meet the needs of those with a hearing impairment, including how to specify, locate and maintain loops. For example, the guidelines state that communal rooms such as waiting rooms should have a large area loop so that names or a number in a queue system called via a microphone can be clearly heard. Reception desks need a counter loop to allow patients booking an appointment to clearly hear the staff member. And consultation rooms, if a patient is likely to be more than two metres from the health professional, should have a counter or small area loop.

The importance of staff training Creating an ‘inclusive’ environment means those with disabilities or impairments are offered the same standard of service and can access the same information. Staff are the interface between the hearing loop and the patients so it’s vital they know what assistive listening technology is available and how to operate it. Hearing loss is a ‘hidden’ disability and the fact that patients may not make their impairment known, let alone complain they can’t hear, could mean gaps in provision are not highlighted. The responsibility to ensure everyone who enters a hospital has the ability to hear lies very much with trusts. L FURTHER INFORMATION http://ihlma.org/

Using technology to extend access and enhance training within healthcare

Access to high quality training and professional development is a key part of the process to maintain standards of care within the NHS. Approved on the NHS Shared Business Service Framework, Pure AV works alongside healthcare trusts to help improve the quality and capacity of the training facilities available to staff. The training spaces involved range from traditional classroom or lecture theatre environments to complex simulation suites designed to create realistic clinical or workplace scenarios. Whatever the environment, the challenges for many healthcare trusts are familiar ones. The need to reduce costs but deliver an enhanced service, to respond to increased demand for training capacity without a meaningful increase in funding. Pure AV recognises the pressures within the healthcare system which is why, whether

working on a traditional classroom, lecture theatre or a complex simulation suite, the company focuses its activity on the delivery of cost-effective solutions that help to maximise available resources. Pure AV has helped education centres within the NHS to increase access to specialist training through the introduction of lecture capture and live streaming solutions. The Christie Education Centre offers just one example of how the use of lecture capture can enable training to be made available to a much greater number of people than could be accommodated in the physical training environment alone. Simulation suites are another area in which AV plays a big part in the quality of and access to training. Pure AV worked with The Pennine Acute Hospitals NHS Trust on a new, award nominated, Simulation and Clinical

Skills Centre at Royal Oldham Hospital. Featuring two simulation bays with hightech manikins, a consulting room and two debriefing rooms used to recreate realistic clinical settings for medical skills training. The system installed by Pure AV allows all aspects of the training undertaken to be analysed and detailed feedback to be given to delegates, helping them to develop the skills needed to deal with the challenges faced on a daily basis within a real hospital environment. The company also works with healthcare clients on solutions for MDT rooms, bedside TV, signage and wayfinding, and telemedicine. Its solutions are designed to help improve communication, maximise resources and achieve successful, cost-effective collaboration in the delivery of patient care. The Pure AV team will work in partnership with you to create reliable, easy-to-use systems that support your day-to-day activity and prioritise your healthcare aims. FURTHER INFORMATION Tel: 0845 602 2861 sales@pureav.co.uk http://bit.ly/PureAVHealthcare

Volume 18.5 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

With its cultural vibrancy, Edinburgh proves an appealing destination for any event organiser With more than 70 meeting rooms across 16 venues in the city, Edinburgh First delivers a cost-effective management service for any event the excellent education facilities that Edinburgh is widely renowned for. 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.

Services 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 and guidance, as well as designing and supporting events through website development, event registration and payment handling. With a choice of historic mansion houses and modern conference facilities, we offer a blend of professionalism and flexibility that makes us equally suited for events of all sizes. Ultimately, Edinburgh First delivers an efficient and cost‑effective solution for any event. L

Edinburgh City 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 second‑most 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.

Playfair Library and McEwan Hall. As well as offering unique conference spaces, we also provide high‑specification conference facilities, private dining rooms, restaurants, bars and cafés that can cater for your every need.

Edinburgh First As part of the University of Edinburgh, Edinburgh First offers first‑class conference options for those travelling to Scotland’s capital. It can cater for events of all sizes, from small meetings to large conferences for 1,000 delegates. Edinburgh First boasts more than 70 meeting rooms across 16 distinctive venues in the city, from its state‑of‑the‑art conference facilities at the John McIntyre Conference Centre (JMCC) to the scholarly environs of the historic

Facilities Similarly, while we operate two year‑round hotels and self‑catering apartments, our ability to open up our Halls of Residence during the summer period allows thousands more delegates to spend time in the heart of Edinburgh, all within walking distance of our many conference venues. The added bonus is that any profits generated from our conference venues and accommodation go straight back into the University, so future students continue to benefit from

FURTHER INFORMATION www.edinburghfirst.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

FIRE SAFETY

Smarter anticoagulation management model

Compliant fire door access for the NHS

INRstar provides a fully integrated solution for the induction, dosing and review of all your anticoagulation patients, supporting you to deliver diagnostic-led care based on accurate, fast and up-to-date information. Designed by clinicians for clinicians and hosted on the secure NHS network, INRstar is easy to use and offers: clinical decision support software, award-winning population health analytics and connected patient self-care app. The company’s patient app supports you to offer safe, remote care. Data flows securely between INRstar, monitoring devices and engage, keeping you in touch with patients and helping to free-up clinic time. INRstar’s patient self-care programmes include: warfarin self-testing – approved to join the NHS App Library; DOAC

Holding open heavy fire doors is essential in health care buildings to allow ease of access by staff and patients; however, this must only be done safely and legally, in accordance with fire safety regulations. Using a radio frequency to communicate, these Category A or critical devices hold open fire doors. When the fire alarm sounds, the Salamander devices close the doors automatically, protecting patients, visitors and NHS staff in the event of a fire. Designed and manufactured in the UK by Geofire, the Salamander fire door holders and closers are connected wirelessly to a central mainspowered Salamander controller unit, which is connected to the existing fire alarm system. As the devices are battery powered, installation time and costs are reduced with minimal

support – keeps you in touch with your DOAC patients so they’re not lost to follow-up; and digital dosing diary – gives patients helpful education tips about their medication as well as their dosing schedule. Bill, 61, Yorkshire, engage self-tester, said: “It’s one of the best things that I’ve ever been given. It has made everything so much simpler.”

FURTHER INFORMATION Tel: 01209 710999 hello@inrstar.com www.inrstar.com

FLOORING

disruption. Due to the innovate and compact design, Salamander holders and closers preserve the lifetime of the doors as they are held open safely out of the way in heavy traffic areas. The devices are hygienically and neatly tucked away at the top of the door, preventing damage to the flooring and door.

FURTHER INFORMATION Tel: 01388 770 360 enquiries@geofire.co.uk www.geofire.co.uk

FACILITIES MANAGEMENT

Where craftsmanship meets creativity

Achieving energy consumption objectives

Established in 1984, Falcon Contract Flooring is a family-owned carpet and vinyl specialist. From its beginnings as ‘basically two men in a van’, it has grown to a nationwide flooring contractor with over 20 internal office staff and over 100 installers on the road. Falcon’s early trajectory was shaped by its relationship with Whitbread, which hired the ‘two guys in a van’ to supply and install the floor coverings of its first ever Travel Inn in 1985. The business developed from there and, as the Whitbread’s estate grew, Falcon Contract Flooring grew with it. The company also won some big contracts since then, and now works directly with companies such as Whitbread which owns Premier

Approximately 20 per cent of the world’s electricity is used for lighting. Much of it is wasted. Unoccupied offices, factories and public spaces often remain brightly-lit, squandering money and energy. It’s bad for the bottom line - and the environment. Yet there is a solution. CP Electronics are recognised worldwide as leaders in energy saving lighting controls, with the company’s systems minimising 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. The organisation works with both private companies and public sector organisations and has made an international reputation for energy-saving lighting controls. With its commitment to innovation, CP

Inn, Brewers fayre, Beefeater, Table Table, Hub by Premier Inn , Bar+Block and also big brands like BMI Healthcare, HCA Healthcare, Travelodge, Marriott, Audley Retirement and Busy Bees. Falcon currently operates nationwide from its HQ in Bromsgrove Worcestershire. The organisation is looking to the future to innovate and inspire staff, clients, suppliers and anyone that its comes into contact with. A bar setter that can be followed but never reached.

FURTHER INFORMATION Tel: 01527 919 988 www.falconcontractflooring. com

Products & Services

CLINICAL CARE

Electronics holds a number of patents and has a relentless focus on quality and reliability. The company’s UK-based production team works to high quality standards, using advanced production techniques and offers a five-year warranty across the range. Products are backed by dedicated sales and technical support teams: on site, on the phone and online. The 2015 Paris Agreement focused the eyes of world leaders on climate change. But the reality is that wasting energy costs us all.

FURTHER INFORMATION Tel: 0333 900 0671 www.cpelectronics.co.uk

Volume 18.5 | HEALTH BUSINESS MAGAZINE

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ADVERTISERS INDEX

The publishers accept no responsibility for errors or omissions in this free service 4C Strategies

Falcon Contract Flooring

Philips IFC,62

Olivetti 66

FDIS UK

Pri-Med Global Exhibitions

Barons Contrat Flooring Ltd

Fire Response UK Limited

Proactive Technical Training

52,54

22 52,54

BeaconMedaes 60

Fujitsu 12

Pure Audio Visual

FG Wilson

Getinge Group

Renray Healthcare

CCube Solutions

16,17,48 30,31

72,73

Green Building Design

Retearn 78

CDW Ltd

Ice Locker Group

Selectamark Security Systems

Cherrill Scheer & Associates

In2 Design Engineering

Senesco Systems

Coopers Fire

Isosec 80

Static System PLC

IBC,54

Cundall Johnston & Partners

ISS Mediclean

Stephenson Gobin

Diabolo Ltd

Johnson Controls

44,45

Sumo Technologies

DoorCheck Limited

LumiraDX Care Solutions

TF Installations

EDF Energy

M E D P T S Ambulance

The Parking Consultancy

Unique Floorcare

Edinburgh First

82,84

Medstrom Healthcare

OBC

Envirosigns Ltd

Murray Equipment Co

ERS Connect

National Autistic Society

Evac Chair International

Nationwide Air Conditioning

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Urbis Schreder

52,54