Health Business 19.4 by PSI Media

ISSUE 19.4 www.healthbusinessuk.net

CATERING

AIR QUALITY

TOXIC AIR AND THE NHS Amid climate emergencies and election debates, how important is it to explore air pollution and the NHS?

HB AWARDS

TECHNOLOGY

HEALTHCARE IT

THE FUTURE OF HEALTHCARE IT Health Business has asked its readers 10 questions spanning hot topics in healthcare IT

PLUS: DATA MANAGEMENT | FACILITIES MANAGEMENT | WAYFINDING

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ISSUE 19.4 www.healthbusinessuk.net

CATERING

TECHNOLOGY

HB AWARDS

AIR QUALITY

TOXIC AIR AND THE NHS Amid climate emergencies and election debates, how important is it to explore air pollution and the NHS?

HEALTHCARE IT

THE FUTURE OF HEALTHCARE IT Health Business has asked its readers 10 questions spanning hot topics in healthcare IT

Celebrating the success behind the headlines As we go to print, Health Business is finalising all the details for the 2019 iteration of the Health Business Awards - the annual event showcasing the success stories of the NHS

PLUS: DATA MANAGEMENT | FACILITIES MANAGEMENT | WAYFINDING

Following the 70th anniversary celebrations of last year, the NHS has once again been under the spotlight, receiving ‘record’ levels of funding from the last two Prime Ministers but also seeing health targets missed by wider margins that ever before. However, much of this scrutiny is now being conducted under the banner of an imminent General Election, the results of which will be declared a week or so after printing. Nonetheless, behind the negative headlines, the NHS should once again be commended for its achievements this year. Despite falling staff numbers, recruitment campaigns up and down the country are bucking national trends, buildings are becoming more energy efficient as the UK targets Net Zero, technology is changing the way in which care is administered and collaboration between organisations is making care safer and more streamlined.

Follow and interact with us on Twitter: @HealthBusiness_

The 2019 Health Business Awards, which will be hosted by The Chase’s Paul Sinha, recognises these success stories, and more, across a number of categories. Best of luck for all those shortlisted and we look forward to acknowledging further achievements in 2020. Michael Lyons, editor

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226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Web: www.psi-media.co.uk EDITOR Michael Lyons PRODUCTION MANAGER Dan Kanolik PRODUCTION DESIGN Joanna Golding PRODUCTION CONTROL Lucy Maynard WEBSITE PRODUCTION Victoria Casey ADVERTISEMENT SALES Tara Oakley, Shelley O’Neill SALES SUPERVISOR Damian Emmins PUBLISHER Karen Hopps ADMINISTRATION Charlotte Boudaboussa REPRODUCTION & PRINT Argent Media

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Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Contents

Contents Health Business 19.4 17

07 News

43 HB Awards preview

Corbyn reveals unredacted documents for US trade deal; analysis highlights how support staff from abroad are plugging shortages; and overworked nursing staff report being stretched to breaking point

The NHS organisations shortlisted to receive a Health Business Award on 5 December have been announced. This article reveals the shortlist

12 Healthcare IT Survey

GDPR has caused much anxiety within the health sector. Steve Mellings discusses why the most critical part of compliance is the approach to data protection itself

Employing roughly roughly 1.5 million people and with an annual budget of ÂŁ114 billion, the NHS is a unique organisation with unique IT requirements. Health Business asked its readers 10 questions spanning hot topics in healthcare IT

17 Technology

Sponsored by

November marked one year since techUK published itâ&#x20AC;&#x2122;s Manifesto for Matt. Here, we analyse each of the three priorities outlined in the manifesto and how DHSC is progressing with its digital plans

23 Technology

Sponsored by

Indi Singh writes on how to directly support operational and transformation staff to ensure that the NHSX missions play an effective role in delivering the ambitions in the Long-Term Plan

Effective interpreting delivered by professionals who are registered and regulated provides better outcomes for patients. Mike Orlov of NRPSI explains why

59 Rental equipment

Sponsored by

Leasing is extremely flexible and could be the perfect solution if much-need new equipment would otherwise be unaffordable, writes the Finance and Leasing Association

61 Frameworks

Russell Beattie tackles the issue of indoor air quality and the importance of heating and ventilation systems in ensuring buildings are as energy efficient as possible

33 Air quality

73 Conferences & events

Clean air is expected to form a key element of the ongoing election campaign. Pauline Castres, air pollution policy officer at the British Lung Foundation, looks at the Toxic Air at the Door of the NHS report and the urgent need for action

37 Catering 61

55 Wayfinding

The NHS is heading into this winter with significant staffing and performance challenges. Earlier this year, the Crown Commercial Service launched a new framework agreement, RM6160, to give NHS contracting authorities the ability to secure quality candidates regionally and nationally across the UK under a variety of specialisms

29 Facilities management

49 Data management

Current dietary patterns are harmful to both planetary and human health. Dietitian Heather Russell, from The Vegan Society, explains why the time for change is now

Health Business magazine

Is it all about location, location, location? Using advice from sister publication Government Business, HB provides a holistic analysis of what the public sector should look for when booking facilities for conferences and events

77 Value based care

Diane Bell looks at how value-based care can happen at a greater scale and what steps healthcare leaders should follow to transform lives and create a positive human future

www.healthbusinessuk.net Issue 19.4 | HEALTH BUSINESS MAGAZINE

News

TRADE DEAL

Corbyn reveals unredacted documents for US trade deal Boris Johnson the NHS is on the table and will be up for sale’. According to Corbyn, the reports cover six rounds of talks running from July 2017 until just a few months ago, with meetings having taken place in both Washington DC and London. Amongst the findings that the opposition leader declared were finished initial discussions on lengthening patents for medicines, emphasising that big US corporations want to force up the price our NHS pays for drugs. He highlighted the drug Humira for Crohn’s disease and rheumatoid arthritis as examples. The drugs costs our NHS £1,409 a packet. In the US, the same packet costs £8,115. Corbyn highlights this as a ‘green light for breaking open Britain’s public services so corporations can profit’. The papers also show a US desire for a No Deal Brexit to facilitate a deal.

Labour leader Jeremy Corbyn has revealed unredacted documents about secret US-UK trade talks putting the NHS on the table in any trade negotiations. Speaking at a press conference, Corbyn dramatically showcased a huge sheaf of leaked papers that he claimed proved

that Boris Johnson’s claim that there were ‘no circumstances whatsoever’ in which a Conservative government would put the NHS on the table in any trade negotiations as false. The 451 pages of unredacted documents and information showcase that ‘under

NHS BURSARY

STAFF SHORTAGES

NHS bursary scrap costs students £1bn in fees

Support staff and nurses from abroad plugging shortages

Labour analysis of HESA statistics has revealed that the scrapping of the NHS bursary in 2016 meant students were faced with £9,000 a year in tuition fees. This means that the first cohort of students who started their degrees in 2017 will graduate next year with £1 billion in tuition fee debt for a three-year course. As part of their election campaigning, the Conservatives said that they will bring back the NHS bursary for nursing students, but Labour claims that this would only cover living costs, not tuition fees, and doesn’t extend to students studying other courses that were previously covered under the NHS bursary scheme. Unsurprisingly, Labour has said that it will bring back the bursary in full, including free tuition fees for nursing, midwifery and allied health profession undergraduates. Jonathan Ashworth, Labour’s Shadow Health Secretary, said: “Boris Johnson and Matt Hancock forced through the scrapping of the nurses bursary and it has led to a crisis of nurse shortages. And it means nurses, midwives and other health professionals today are racking up extortionate debts. It’s time for an apology from the Tories both their deceitful claims they will recruit 50,000 new nurses and for lumbering so many hardworking new nurses with this massive financial burden.” which grew by almost a quarter (23 per cent) between 2010/11 and 2016/17. READ MORE https://tinyurl.com/wcd9rst

New analysis by the Health Foundation shows that the health service is increasingly having to rely on less-skilled clinical support staff to fill gaps in services when there aren’t enough nurses. Figures also show that, in response to a severe drop-off in the supply of EU nurses since 2016, the UK has significantly ramped-up its recruitment of nurses from non-EU countries over the last year as it struggles to train enough nurses domestically. The Health Foundation’s new research report, Falling short: the NHS workforce challenge, reveals that between March 2018 and March 2019, the NHS saw the biggest annual increase this decade in its overall workforce. But the independent charity warns that this growth masks an ongoing shift in the mix of clinical staff employed in the NHS – while numbers of doctors have increased, muchneeded growth in the number of registered nurses has been outstripped by increases in clinical support staff, including health

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NHSX – ‘same same but different …’ Indi Singh looks at how to directly support operational and transformation staff to ensure that the NHSX missions play an effective role in delivering the ambitions in the Long-Term Plan At the recent NHS EXPO, NHSX re-iterated its five key missions - reducing the burden for staff, giving citizens the tools to access services directly, safe and digital access to clinical information, improving patient safety and increasing productivity. These missions make absolute sense and are strongly supported across health and care. At the same time, these are not new and arguably reflect existing expectations from the public and care professionals. The key challenge then for NHSX and digital leaders is how we learn from past mistakes and make sure the same problems don’t stand in the way of future digital progress. This requires an incremental approach to delivery but also much stronger working with operational and transformational colleagues to provide pragmatic solutions rather than ‘jam tomorrow’. This means providing digital services iteratively – starting with something simple, getting early wins and buy-in from care professionals and citizens. A good example

of this approach is the work at Nuffield Using digital services Health, where a new digital At the same time, we need to service was introduced support and enable our every six weeks covering transformation colleagues The key booking appointments, in changing how care can challen finding services, be provided - both in the accessing records ‘shift to the left’ and at we lear ge is how n and creating a the interface of health f r o m past mistake digital front door and care. To do this, s a nd mak sure the for citizens. digital solutions don’t e same p This requires need to be overly r d o on’t sta blems a change in the technically complex. n d in the way of methodology, using One example of this f u ture ‘target experience’ is the Argenti initiative, progres digital techniques which which uses technology s bring different user (from low level telecare perspectives together and to Amazon Echo) to enable allows thinking to be tested people to live independently continually by using minimum within their homes. These provide viable products. All these initiatives need prompts, medication reminders, control to be underpinned by work to ensure domestic appliances in their homes and call digital services are safe and that sharing alerts for assistance. In areas that have used of a citizen’s information is decided by these technologies, such as Hampshire County the citizen and is not just assumed. Council, 98 per cent of citizens say they E Issue 19.4 | HEALTH BUSINESS MAGAZINE

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 would recommend the service and the initiative has provided net savings of over £9.8 million in the first five years. We also should be looking to use digital services to support our operational colleagues and to make the lives of care professionals easier and to help them do their job more effectively. This doesn’t necessarily mean complex tools that take years to implement. Digital tools for workforce planning whether in primary care, hospitals or at an integrated care level can use the data captured in clinical systems and/or activity-based data and use this to forward plan for the skills needed and also allocate resources in a more responsive way. Smart scheduling in hospitals can, for example, improve theatre productivity by enhancing clinical triage processes and dynamically allocating slots to patients where their needs match. This saving over 135 hours per month. Within hospitals and using outpatient departments as an example, these digital tools have led to over 5,000 additional patient appointments becoming available in one year, a reduction in DNAs of over 24 per cent and First to Follow Up by 13 per cent. Robotic Process Automation (RPA) can support operational teams such as outpatient booking teams. Time spent on cumbersome repetitive tasks can be reduced that releases staff to focus on high-value patient facing tasks such as co-ordinating their care. Administrative tasks such as transferring patient details or referral letters from an external system to an internal system are rules-based and repetitive and so perfect for RPA. In one hospital automating just five administrative processes for a centralised outpatient booking team released 880 hours of staff time per month.

Technology

Sponsored by

All these initiatives need to be underpinned by work to ensure digital services are safe and that sharing of a citizen’s information is decided by the citizen and is not just assumed We should also be making more of the existing investments. For those with Microsoft licences, we’ve already seen the use of collaboration tools such as Office 365 enabling care professionals to safely and securely run multi-disciplinary teams and share clinical documents. This is leading to significant increases in productivity and savings of six weeks per annum. Avoiding the pitfalls The move to cloud also provides real benefits in service efficiency and security but organisations must be clear about their processes for the transition and how they can do this in an incremental manner. It will be important to avoid the pitfalls in other sectors where they have dived into cloud services and ended up paying more. Clearly one of the most important requirements of healthcare providers is access and sharing of data. That means there is a need to complement strategic initiatives such as the Local Health and Care Records and gain early data insight that can then be applied and to also support less mature areas to also progress. Existing technologies can be used to create cloud-based data labs, define and test information governance in real-time with hypothesises tested, and improvements made. Several ICSs are already

looking at these approaches to support primary care networks in identifying repeat attenders at GP practices and for hospital to address repeat attendances at A&E. All these efforts will need to embed a security by design approach at provider level and across an Integrated Care System. This means they need a clear understanding of their operational readiness and the processes they need to follow, and where individual and collective responsibility lies, as well as the technology safeguards needed. NHS Digital provides Cyber Operational Readiness Support as one of the services to help the sector manage their cyber vulnerabilities and we would strongly encourage all organisations in taking up this suite of services. By delivering incrementally, looking for pragmatic solutions that can directly support operational and transformation staff, we can ensure that the NHS X missions play an effective role in delivering the ambitions in the Long-Term Plan. L

Indi Singh is an IT transformation expert at PA Consulting, the global innovation and transformation consultancy. FURTHER INFORMATION www.paconsulting.com

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Power For Our Generation

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The perfect prescription for power problems As digitalisation continues to transform our health services, Leo Craig, Riello UPS general manager, explains why a reliable uninterruptible power supply is the perfect prescription to prevent power problems failure. Proactive maintenance can extend the lifespan of some UPS components by as much as 50 per cent too.

Continuous power plays a pivotal role in our increasingly digitalised healthcare system. Electricity keeps devices like scanners and heart monitors online. It powers the IT and comms networks that manage patient records, schedule appointments, and perform other vital admin functions. And it enables the data produced by wearables and diagnostic devices to play its part in helping patients manage a range of ailments. When there are problems with the power supply, the consequences can be catastrophic. During August’s big blackout, Ipswich Hospital lost power after a faulty battery prevented its backup generator kicking in. A few weeks before, a similar generator failure hit Southampton General during a power cut. While Ninewells Hospital in Dundee had to discard emergency blood supplies after a power cut knocked out crucial fridges. There are countless other similar examples of electrical failures that lead to disruption. Uninterruptible power supplies (UPS) are the ultimate insurance against such damaging downtime. UPS systems offer ‘no-break’ battery backup when there’s a power problem, ensuring medical devices can keep working. They also act as a bridge until your generators kick in. This gives computers and IT servers time to shut down without losing critical patient data. It also allows emergency lighting, lifts, and ancillary equipment to remain operational. Prevention is better than cure Just like MRI scanners or sensitive lab equipment, UPS systems are complicated devices in their own right. Batteries, capacitors,

and fans suffer wear and tear and need replacing at regular intervals. Electrical components can unexpectedly break down too. New UPSs are covered by standard warranties. Much of Riello UPS’s range comes with an extended five-year warranty as standard. But warranties only ever offer a best endeavour response. And what if you’ve got a legacy UPS where the warranty’s expired? Ongoing UPS maintenance provides far greater peace of mind for missioncritical healthcare environments. They spell out the guaranteed time frames for getting you back up and running. Proactive maintenance also reduces the risk of downtime happening in the first place. Nobody working in healthcare should need reminding that ‘prevention is better than cure’. That famous saying certainly rings true when it comes to looking after your UPS. Regular servicing has a positive impact on its performance. Preventive Maintenance Visits (PMVs) are the equivalent of giving your UPS an annual ‘health check’. Engineers give your unit a thorough examination, upgrade software, and identify components – such as fans, capacitors, or batteries – that are approaching the end of their service life and need replacing. This TLC lessens the likelihood of your UPS breaking down. And because your system is running at optimum performance, it’ll waste less energy, cutting your electricity costs. Preventive maintenance also promotes improved future-planning and budgeting. For example, proactively scheduling battery or capacitor replacement is far more costeffective than dealing with an unexpected

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Doing your due diligence Unfortunately, all UPS maintenance plans aren’t created equal. Like many formal contracts, they can be packed with confusing legal jargon, caveats, and get-out clauses. It’s crucial to do your due diligence. Get prospective providers to clarify several key points. The first – and most important – is how fast will you get help if your UPS breaks down. Most UPS companies claim to offer 24/7 support and a range of emergency response times. But what does a ‘response’ mean? Is it an engineer onsite fixing the fault? An automated reply acknowledging the issue or a brief chat with tech support? There’s the world of difference when your lifesaving equipment is offline. We introduced our Diamond UPS maintenance plan to provide more clarity for mission-critical customers. We’re the first provider in the UK to guarantee both a four hour response time and a fix inside a further eight hours. Speedy access to spare parts is essential too. It’s no good if your maintenance company doesn’t have equipment in stock, or if it’s hundreds of miles away from your hospital or facility. Riello UPS has the largest stockholding of UPS and parts in the country, not just at our HQ in North Wales, but at several strategic hubs throughout the UK. This enables us deliver next-day or in some cases even the same day customers report the fault. Finally, you need to know who will be working on your UPS. You wouldn’t let an unqualified surgeon carry out a life or death procedure. The same principle applies here – competence is key! UPS systems are complex pieces of kit, so it’s crucial the service engineer is fully trained and certified. That’s even more important if you opt for a third-party maintenance provider, rather than the unit manufacturer. All Riello UPS engineers, whether our in-house nationwide network or from an authorised service partner, must complete a challenging Certified Engineer training programme and undertake regular refresher training to keep their approved status. L FURTHER INFORMATION www.riello-ups.co.uk

Facilities management Written by Russell Beattie, chief executive at FETA

Ensuring all buildings are as efficient as possible Russell Beattie tackles the issue of indoor air quality and the importance of heating and ventilation systems in ensuring buildings are as energy efficient as possible It is often said that a good football referee is work places in England. Many office premises one that is barely noticed during the game. had already voluntarily banned smoking We could apply a similar logic to indoor air years before amid public fears over passive quality (IAQ), which refers to the air quality smoking, but the Wetherspoons pub chain within and around buildings and structures received a mixed response to its decision and how it affects the health and well-being to make its pubs go smoke free in 2005. of building occupants. Whether we are in It’s worth remembering that smoking an office, factory, hospital, supermarket or indoors was once commonplace in the UK, restaurant, we expect the air we’re breathing not just in pubs. Some seasoned journalists to be fresh and clean, keeping us healthy and may hark back to the days of working in busy alert. If the indoor air is maintained at an Fleet Street newsrooms clouded in smoke, appropriate temperature, filtered and suitably and anyone who has visited the Churchill humidified, we are comfortable. If it is not, War Rooms will have a reasonable idea of however, the signs are soon noticeable. how key decisions during the Second World 20 years ago we thought War were made from dark, largely nothing of walking into a unventilated bunkers beneath pub or restaurant and the streets of London, during We stro experiencing the thick a time when you were more ngly aroma of fresh cigarette likely to be considered in the believe smoke mixing with the minority if you didn’t enjoy indoor that both old, stale fumes of the a cigarette at your desk. and ou tdoor air qua past, with the smell still We can confidently lingering on our clothes conclude therefore that be conslity should idered a when we got home IAQ was not particularly linked i s later. We are now more high on the agenda when ssues than a decade on from it came to workplace design, the introduction of the compared to its growing smoking ban, which made it significance today. Smoke, illegal to smoke in all enclosed however, is not the only factor that

can affect IAQ. The World Health Organization (WHO) guidelines for IAQ, developed under the coordination of WHO/Europe, address three groups of issues that are most relevant for public health: biological indoor air pollutants (dampness and mould); pollutantspecific guidelines (chemical pollution); and pollutants from indoor combustion of fuels. Effects on health Poor IAQ can cause symptoms and illnesses ranging from minor irritation of the eyes to nausea. For many people, these symptoms may be little more than inconveniences that make them feel unhappy with their place of work or employer. For others, it can lead to more serious problems. Asthma sufferers are particularly vulnerable to many of the active factors that cause what is commonly known as Sick Building Syndrome (SBS), when people in a particular building or part of it feel their health is being affected by the building’s environment. These may include inadequate fresh air ventilation, uncontrolled temperature or relative humidity, emissions from office equipment and fluorescent lights, chemical pollutants, painted surfaces and synthetic furnishings. Other well known allergens in the workplace include dust E Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Taking responsibility There is a responsibility on employers to maintain good IAQ by reducing the number of potential sources of pollutants and by eliminating as much pollution as possible close to its source through adequate indoor air treatment. Studies have found that as much as 90 per cent of the day is spent indoors where the levels of some air pollutants are often far higher than outside. Consider the heat output of office equipment; all electrical equipment is marked with the electrical power it uses, which gives an indication of the amount of heat it will generate while in use. If possible, select equipment that has a ‘sleep’ mode which automatically reduces power consumption during periods of inactivity. There are simple, practical steps that we can all take to reduce our exposure, such as ensuring buildings are adequately ventilated, and making informed choices about the products we use: make sure that ozone filters are fitted to equipment where appropriate; specify soft furnishing and carpets with low emissions of volatile organic compounds; dedicated extraction equipment should be used to control fumes and emissions. The location of the exhaust vents should ensure that the fumes are not drawn back in to the building through the ventilation system. Consider using printing equipment that can

Asthma sufferers are particularly vulnerable to many of the active factors that cause what is commonly known as Sick Building Syndrome, when people in a particular building feel their health is being affected by the building’s environment use reduced solvent or solvent free inks; ensure any HVAC plant that recycles air is fitted with suitable filters to remove any pollutants that could have a detrimental effect on IAQ; and when specifying equipment, consider the ease of access for cleaning and maintenance, and also the ‘cleanability’ of the equipment. Follow the manufacturer’s instructions and recommendations with regard to maintenance and cleaning. By committing to cleaner technologies and making behavioural changes we can reduce the threats to health significantly. In our article last year on IAQ we explained the complexity in the regulation for IAQ, with various departments and organisations, including the Ministry for Housing, Communities & Local Government (MHCLG), Public Health England, the Department for Business, Energy & Industrial Strategy (BEIS), the Department for Environment, Food & Rural Affairs (DEFRA), Department for Transport (DfT) and the Health and Safety Executive and the Department for Education all collaborating on the issue, but with no real obvious lead responsibility being taken. Clean Air Strategy There was encouraging progress last year with the Clean Air Strategy consultation. The Clean Air Strategy consultation took place between May and August and invited views on actions to improve air quality by reducing pollution from a range of sources. Responses were submitted from 393 organisations and 207 individuals as well as 111 campaign responses and the finalised clean air strategy was published by DEFRA on 14 January 2019, with a foreword by Michael Gove MP, Secretary of State for Environment, Food and Rural Affairs. Although the Clean Air

Facilities management

 and dust mites from carpets and office furnishings, dusts from wood, grains, leaves and other substances in a factory or shopfloor environment as a result of the manufacturing process, and also allergens carried into the workplace by other employees. Improving the quality of indoor air in the workplace means improved wellbeing and better health not just for asthma sufferers, but for everyone in the building. Studies on SBS have indicated a relationship between ventilation and air conditioning systems and the prevalence of SBS symptoms. Natural or mechanically ventilated buildings that do not use air-cooling or humidity control tend to have among the lowest recorded occurrences of SBS. This suggests that poorly maintained air conditioning systems may have an influence on SBS, possibly due to microbial growth within humidifiers and cooling units.

Strategy is about air pollution as a whole rather than just IAQ, it is evidence that the impact of poor air quality on people’s health is being given the attention it merits, and Section 6: Action to reduce emissions at home, goes into some detail to raise awareness of the causes of indoor air pollution. This chapter highlights the main forms of indoor air pollution: particulate matter (PM) and Non-Methane Volatile Organic Compounds (NMVOCs). PM is produced by many forms of cooking and home heating, most notably from combustion in open fires and stoves. NMVOCs are emitted by a wide variety of chemicals that are found in carpets, upholstery, paint, cleaning, fragrance, and personal care products. While we commend DEFRA for focusing on the issue of outdoor air quality, we strongly believe that both indoor and outdoor air quality should be considered as linked issues. EVIA’s ‘Call to Action’ We have spoken previously of our support for the European Ventilation Industry Association’s (EVIA) hard work to push for the development of an assessment method for determining the impact ventilation systems have on IAQ. EVIA has recently produced an infographic and an eight-page EU manifesto titled ‘Good Indoor Air Quality Is A Basic Human Right’. The manifesto has been produced ahead of the EU elections being held in May with aim being to raise the issue of IAQ with prospective new MEPs and Commission officers. FETA correspondence with government In December 2018 FETA wrote to various government departments, including MHCLG, BEIS, DEFRA and PHE to bring attention to an internal group created by FETA which aims to determine how we, as industry, can contribute to making real improvements in tackling some of the issues surrounding IAQ. This is undoubtedly a complex issue but we are pleased to see that, as part of the forthcoming review of Part F of the Building Regulations (the consultation for which has just been released), the government is planning to review the evidence on indoor pollutants (such as non-methane volatile organic compounds and smoke from domestic burning) and recalculate ventilation rates to reflect any changes in this evidence. We are also pleased to see the formation of the Office for Environmental Protection, which will, we are told, hold the government to account for meeting air quality standards. L FURTHER INFORMATION www.feta.co.uk

Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Air quality

Exploring air pollution and health Clean air is expected to form a key element of the ongoing election campaign. Pauline Castres, air pollution policy officer at the British Lung Foundation, looks at the Toxic Air at the Door of the NHS report and the urgent need for action It might be invisible, but air pollution poses an immediate threat to the health of the 12 million people in the UK who live with a lung disease, such as asthma, COPD and lung cancer. People with a lung condition face worsening symptoms, exacerbations and increased hospitalisation just from breathing the air around them. Nine out of ten patients we support at the British Lung Foundation (BLF) have told us that they struggle to breathe during high pollution episodes. For these people, air pollution has a very real and serious impact on their quality of life, interfering with every day activities including going to work, shopping and meeting with friends and family. It’s not just anecdotal either; there is evidence of a clear link between high levels of air pollution and increased numbers of patients with breathing problems presenting at hospitals and GP surgeries. In a recent study carried out by the University of Dundee and funded by the BLF, researchers studied nearly 15 years of data for air pollution levels in Dundee, Perth and the surrounding area. They matched air pollution levels to medical records of 450 patients who suffer from bronchiectasis, a long-term chronic condition which can cause a persistent cough and breathlessness as well as frequent chest infections. They found that on days when air pollution levels spiked, there was a large increase in admissions to Ninewells Hospital and Perth Royal Infirmary with breathing problems and visits to GP’s with exacerbations of their symptoms.

whose lungs haven’t properly developed Children’s lungs are also disproportionally because they were born prematurely, are vulnerable to air pollution as their little lungs also more at risk. This is an unacceptable are still growing. Children exposed to severe additional burden on their fragile health. air pollution are up to four times more likely If all that’s not convincing enough, there’s to have poor lung development compared to also an economic argument to clean up our those growing up in less polluted areas, and air; lung disease is the UK’s third biggest children with smaller lungs are more likely killer, costing the NHS £9.9 billion a year to face further health problems in later life. and business £1.2 billion through work days And for the one in 11 children in the UK who lost. At the same time, air pollution costs have asthma, air pollution is an immediate more than £20 billion every year to society. danger. For the first time this year a report described the ‘striking association’ between Toxic Air at the Door a child’s emergency hospital of the NHS admissions and recorded In October 2018, the BLF spikes in air pollution. The For the published a report called case of Ella Kissi-Debrah, one in Toxic Air at the Door of who died in 2013 after children 11 the NHS to highlight the experiencing three urgent need for action. years of asthmawho ha in the UK We decided to look at induced seizures, ve asth ma, air pollu levels of particulate has been described matter (PM2.5) around as the first reported an imm tion is health centres as many of ‘pollution’ death. The ed danger iate the groups that are most report concluded that vulnerable to the effects of there was a ‘real prospect air pollution - such as children, that without unlawful the elderly and people with a lung levels of air pollution, Ella or heart condition - often must visit and would not have died’. Children spend long periods of time in these places. who have reduced lung capacity, such PM2.5 refers to tiny particles with a diameter as children with cystic fibrosis and those 30 times smaller than the average human hair. They are particularly harmful to our health, as they are small enough to pass through the lungs and into the bloodstream. E

Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Air quality

 The particles come from various sources with the majority coming from road transport in urban areas - and are linked to multiple health concerns including asthma, chronic obstructive pulmonary disease (COPD), heart disease, stroke and lung cancer. Existing air pollution data mainly focuses on city-wide levels, and rarely looks at specific locations; so local authorities often lack specific data about PM2.5 levels in their local area. We hoped that by providing new analysis, we could highlight the immediate threat of dirty air. Using existing modelled data, we asked Cambridge Environmental Research Consultants (CERC) to find out how many health centres across the UK are currently exposed to PM2.5 levels above what the World Health Organization (WHO) recommends. The analysis revealed that in 2018, 2,220 GP practices and 248 hospitals are in areas that exceed the WHO’s safe air pollution limits. This includes major teaching hospitals, two of the biggest children’s hospitals in the country, small clinics, and GP surgeries. This represents a third of GP surgeries and a quarter of hospitals in England. We also found out that many cities including Birmingham, Cardiff, Leeds, Leicester, London, Nottingham, Hull, Chelmsford and Southampton have at least one large NHS trust in an area with unsafe levels of pollution. The findings really are worrying. It’s not right that vulnerable people with NHS appointments are being exposed to toxic air that could make their health worse, and that

In 2018, 2,220 GP practices and 248 hospitals are in areas that exceed the WHO’s safe air pollution limits, including major teaching hospitals, two of the biggest children’s hospitals in the country, small clinics, and GP surgeries hospital staff and GPs must care for people in environments that could be putting them and their patients at risk of a whole range of health problems further down the line. Current PM2.5 limits The UK is currently meeting legal limits for PM2.5. However, this is because the legal limit is more lenient than the limit recommended by the international health community. The UK legal limit for PM2.5 is more than twice as high as the WHO recommendation, 25µg/m3 instead of 10 µg/m3 for the annual average. At the BLF we have increasingly focused our air pollution work on PM2.5 as research in recent years has strengthened the evidence that both short-term and long-term exposure to PM2.5 are linked with a range of health outcomes, including lung disease. What now? While clean air formed part of the Environment Bill earlier this year, the BLF want further action, including the WHO

recommended limit to be included in the Bill so that it becomes UK law. We also want to see charging Clean Air Zones in cities and towns with the highest levels of air pollution across the UK, and greater investment in air quality monitoring for places where vulnerable groups gather, so that where appropriate people can make an informed choice about where they receive care. Children are also a priority. Alongside ClientEarth, we’ve set up the Clean Air Parents’ Network to help give parents and carers who are concerned about the affect dirty air is having on their children’s growing lungs an outlet to campaign for change. We believe that one day we can all breathe clean air with healthy lungs. L

This article first appeared in Government Business magazine. FURTHER INFORMATION www.blf.org.uk

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

The Last Nine Yards, the critical path to Great Food & Beverage Services In June, the Secretary of State for Health, Matt Hancock ordered a ‘root and branch’ review of hospital food following the deaths of six NHS patients who were linked to an outbreak of listeria. The NHS serves more than 140 million meals to patients across the country, but the quality and nutritional value of these meals can vary substantially the patient catering services. It can be read, referred to and used by all members of the ward team including health care assistants (HCAs), nursing and volunteers.

Since the announcement, which initially is looking at England only, attention has been firmly on the hospital caterers, and not just those directly employed by the NHS but with the external suppliers like ISS Facility Services, Healthcare, who are the market leaders in the provision of soft FM services such as patient catering, serving over 40,000 patient meals each day. Great Food & Beverage Services Guide ISS has a continuous improvement philosophy, so the launch of their latest Great Food & Beverage Services Guide is very timely. Hospital catering is a complex business, feeding so many people, many of them in a vulnerable state and demanding the widest range of therapeutic and lifestyle diets, calls for strong management and well-trained employees who can work well as a team. There is a phrase that is used within the NHS that refers to ‘The Last Nine Yards’ of the food’s journey from farm to fork - research suggests that the average distance from the ward door to the bed side is approximately nine yards (8.23m). It can be the finest food, cooked to perfection but if it is not delivered

to the ward in a timey fashion, or allowed to stand unserved, any meal with deteriorate quickly, therefore the team work that is required within this last nine yards plays a critical part in the patient meal experience. ISS took a year collaborating with their operational teams, clients and customers – patients, dietitians, nursing and facilities management colleagues to ensure every base was covered. The new ward guide, which is considered to be the first in the sector, is a reference book containing all the information the ISS Hostess, or Host, needs to know to carry out their role from the importance of nutrition and hydration to special diets, dietary codes, different menus, special patient groups and a focus on the ‘Last 9 Yards’ by way of protected meal times, support with packaging, food safety, service preparation and presentation. The guide emphasises how important the host(ess) role is in relation to the wider team that delivers care to the patients and how their attitude and actions make such a difference to the patients in our care. The guide is designed to be displayed in every ward kitchen where ISS Facility Services - Healthcare are responsible for

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

My Guide A smaller ‘Z Card’ has also been designed to be within handy reach for the Hostess as they go about their duties. The Pocket My Guide reflects the messages in the ward guide but is an abridged version focusing on the most important safety messages i.e. allergens, nutrition and food safety, understanding your patients and how to provide a great food and beverage service. ‘My Guide’ is designed to be kept on the person whilst on the ward so they can use it as a simple and clear reference point at any time of the day to support knowledge and patient safety. Speaking about the launch of the Guide, Lauren Bowen, head of Patient Catering and Dietetics at ISS, explained: “The main reasons for developing the resources are to provide knowledge to our teams, supporting them in carrying out a quality, safe and nutritious food and beverage service but really it was also to remind everyone that the food and drinks they provide are vitally important to help patients in their recovery and that they (the food services team) are such valuable members of the ISS and Client Hospital’s teams.” The NHS Food Review will be considering how food can help aid faster recovery, considering the unique needs of vulnerable groups. It will be looking at how the NHS can be a standard-bearer for healthier choices for patients, staff and visitors with more healthy food options for healthcare staff, particularly for those working overnight shifts. Sustainability and the environmental impact of the whole supply chain are also under the spotlight and how more locally sourced produce can be introduced. The Review’s Report is due to be published in the New Year, but the ISS Healthcare team will know exactly what their role is in delivering a quality service across those ‘Last Nine Yards’. L FURTHER INFORMATION isshealthcare.commercial@ uk.issworld.com

Catering

What are the benefits of plant-based food? Current dietary patterns are harmful to both planetary and human health. Dietitian Heather Russell, from The Vegan Society, explains why the time for change is now Next year, Glasgow will host the United Nations climate change conference. Across the world, organisations and individuals are realising that there is an urgent need to challenge the status quo and execute solutions. Climate change is a crisis that we have to tackle from a number of angles, including food system changes. A growing body of evidence suggests that shifting towards more plant-based diets is beneficial for both planetary and human health. A strong vegan offering can help institutions like hospitals to provide nutritious, sustainable and inclusive food for staff, visitors and service users. This year, climate emergency declarations have been hitting the headlines. Organisations throughout the UK have been formally recognising the global impact of climate change, including NHS trusts. Immediate and significant action is required to reduce our impact on the environment and food production and consumption are key topics. The UK’s Eatwell Guide is designed to shift people towards more plant-based diets for both health and sustainability reasons, and the need to make this a reality has never been so great. Environmental benefits Research has linked increased consumption of plant-derived foods with lower environmental impact. Environmental benefits include reforesting opportunities and reduced greenhouse gas emissions and water usage. The Vegan Society’s Plate Up for the Planet campaign promotes the message that switching to a vegan diet can reduce the carbon footprint associated with food production by up to 50 per cent, highlighting the power of dietary changes.

planet-friendly plant foods following the A 2017 report by The World Wildlife Fund publication of the ‘Future 50 Foods’ report (WWF) called ‘Eating for 2 degrees’ found by the WWF and Knorr Professional. that the dietary model with the lowest The NHS Sustainability Campaign is carbon footprint was the vegan one. employing a number of approaches to raise When it comes to sustainability, public awareness of sustainability issues sector caterers can set a great example in the world of healthcare, because their outlets provide including roadshows nearly a third of all UK meals. aimed at increasing staff A recent Imperial College W engagement. During London report for the you’re chen the NHS Climate Committee on Climate a t e ring for a w Change Summit Change has highlighted i d e range of requ in October, Vegan that broadening iremen Society Campaigns the meal choices t s h o i n spital, d Manager Mark available in hospitals ish that ca Banahan presented and other institutions rry mul es tiple our Catering for can help shift people dietary c Everyone campaign, towards lower impact o d e s are valu which calls for good and healthier eating able vegan food on every public habits. The report calls sector menu. In addition to for regulation requiring that protecting vegans’ rights, this public sector menus carry at approach has the potential to bring least one fully plant-based option about huge environmental and public health that is available to everyone, which has benefits by normalising this type of food. already been implemented in Portugal. NHS action With the climate emergency in mind, it’s necessary to examine the role that the NHS can play in increasing people’s familiarity with sustainable and nutritious food. Food service companies and caterers can help hospitals to realise their sustainability ambitions by supporting staff, visitors and service users to eat more plant-based diets. In September, Sodexo announced their commitment to serving more

Public and planetary health The British Dietetic Association’s guide to sustainable diets highlights that current dietary patterns are harmful to both planetary and human health. The National Diet and Nutrition Survey shows that UK diets contain too much saturated fat and too little fibre and fruit and vegetables. Nutrition experts across the world agree that healthy diets are based on minimally processed plant foods like wholegrains, fruit and vegetables. The UK’s Eatwell Guide encourages people to consume more of these health-promoting foods and draws attention to beans, peas and lentils, which count towards one of your five-a-day as well as providing good quality protein. E

Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Catering

 It’s easy to create tasty and nutritious dishes that are high in fibre, vegetables and fruit and low in saturated fat when you make room for plant foods. This kind of cuisine is particularly valuable for patients focusing on healthy eating as well as visitors and employees. In fact, you can argue that effective marketing of tasty plant-based dishes to staff has the potential to be a great way of boosting workplace wellbeing since the NHS is one of the biggest employers in the world. The British Dietetic Association’s Nutrition and Hydration Digest devotes an entire chapter to catering for staff and visitors. However, hospital nutrition isn’t just about standard healthy eating. It’s important that menus carry higher calorie and protein vegan options in order to meet the needs of nutritionally vulnerable patients. For example, the high quality protein found in soya-based products and Vegan Quorn can make a particularly valuable contribution to nutritional intakes in this context. Inclusive menus When you’re catering for a wide range of requirements in hospital, dishes that carry multiple dietary codes are valuable. Vegan food isn’t just for vegans; balanced plantbased dishes can be enjoyed by people who include animal products in their diets.

Hospital nutrition isn’t just about standard healthy eating. It’s important that menus carry higher calorie and protein vegan options in order to meet the needs of nutritionally vulnerable patients This type of cuisine may be easily adapted to suit the needs of people who react to animal allergens like egg and milk. It may also be acceptable to people who avoid animal products for religious reasons. Therefore, there are multiple advantages of making vegan meals available to everyone without having to make a special request. For catering services running cookchill/freeze operations, vegan provision is influenced by the products offered by manufacturers. The Vegan Society has supported Anglia Crown with the development of their products, and the Vegan Trademark is a beacon to services looking to expand their vegan offering. Ruth Smith, company dietitian, commented: “Working with The Vegan Society during the enhancement of our vegan range was really insightful and helped provide practical tips on how to easily create tasty vegan suitable dishes that are popular across the

board. It was also helpful to ensure that nutritionally these products achieve the necessary energy and protein levels.” Take-home messages Here are four key messages for you to remember. Firstly, increasing consumption of plant-derived foods is a key element of the fight against climate change and other environmental threats. Next, making vegan options available to everyone helps to normalise plant-based food, as well as protecting vegan rights. Thirdly, remember that it is easy to develop vegan dishes that can meet a wide range of dietary requirements. Lastly, a strong vegan offering can help hospital caterers to promote sustainability and good nutrition. L FURTHER INFORMATION vegansociety.com

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Air hugs technology â&#x20AC;&#x153;Everything you never knew you wanted in a hand dryerâ&#x20AC;?. With ffuuss you will save time on washroom upkeep and reduced janitorial and maintenance cost.

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Electric hand dryers: economical and efficient The ffuuss hand dryer claims to be a combination of creativity and technology that provides an optimal user experience. Having installed a number of HD-1 Pearl Grey Hand Dryers, Public Sector Information explains why electrical hand drying is environmentally beneficial, and how ffuuss can help

Hand hygiene is widely considered to be an important practice in reducing the transmission of infectious agents that cause healthcare-associated infections. Each year it is estimated that more than 300,000 patients acquire a healthcare‑associated infection while being cared for by the NHS in England. Each one of these infections means additional use of NHS resources, greater patient discomfort and a decrease in patient safety. The promotion of good hand hygiene practice has been the subject of various campaigns over the years, in particular the Department of Health’s Clean Your Hands Campaign, which had a significant impact on the healthcare environment. Your hands naturally have germs on them. Some live naturally on the hands, others are picked up on a daily basis as a result of touching objects or surfaces. But there is one misconception about hand hygiene that is often overlooked: hand hygiene involves not only washing your hands, but also drying them thoroughly. This is because, although washing your hands thoroughly removes the problem germs, if you then walk away with your hands still damp, more germs will attach themselves and your effort will have been wasted. HD-1 Hand Dryers Numerous independent studies prove that electric hand dryers are hygienic. The air the user breathes is the air that is used to dry his or her hands. Touchless operation, modern antibacterial materials and HEPA filter technology prevents the spread of germs and breathable dust. Our initial reaction to the newly-installed HD-1 Pearl Grey Hand Dryers from ffuuss confirms the blend between modern technology and environmentally friendly systems. The hand dryers offer a unique user experience for a range of audiences, with the capacitive sensors incorporated to ensure that the dryers operate from both a lateral as well as medial perspective. Located all around the perimeter of the drying cavity, the sensors are designed to allow children and people in wheelchairs to comfortably use the ffuuss hand dryer with ease. Additionally, using the ffuuss-patented Preheat system, the hand dryers are controlled by environmental sensors to avoid

a constant and unnecessary consumption, making the ffuuss hand dryer safer and more efficient. Preheat works without the need for conventional resistors that have a high consumption and entail certain risks. The authentic ‘air hugs’ have been designed to ensure that the air covers as much of the area of the hands as possible and the combination of their different sizes minimises air noise. In regards to the previously mentioned lateral hand drying option, the ‘air hug’ outlets have been incorporated to produce a ‘curtain effect’, to prevent water from spraying out of the drying area. Modern electric hand dryers need less energy per use (starting at circa 150 uses/ day). With regard to their whole life cycle, electric hand dryers have a positive energy balance and only high quality materials that meet current scientific standards are used in assembling electric hand dryers. Additionally, in comparison to paper or fabric towels, waste production is zero. During service, electric hand dryers reduce operating costs. Refilling and

recycling paper is not necessary and rooms can be cleaned less frequently. The costs for electricity are far below costs for towels, cleaning, and waste disposal. Specifications The colour and finishing of the ffuuss hand dryer can be customised according to the taste and needs of the customer. Any colour from the universal colour charts can be selected (we chose Pearl Grey) and the company promises that a logo, brand name or any other design the customer requires can also be included. The hand dryer is treated with Biomaster Silver Ions antibacterial additive and is mounted with galvanised steel. During operation, the HD-1 Hand Dryers have an approximate hand drying time of 12 seconds, with a blocking time of 25 seconds. L FURTHER INFORMATION www.handdryerffuuss.com/en/handryer1

Issue 19.4 | HEALTH BUSINESS MAGAZINE

5th December 2018, Leonardo Royal London St Paulâ&#x20AC;&#x2122;s Hotel, London

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HB Awards

Shortlist announced for the Health Business Awards The NHS organisations shortlisted to receive a Health Business Award on 5 December have been announced. See who has been nominated below Best known for his role as a regular Chaser services, with Guys and St Thomas NHS Trust on ITV’s award-winning quiz show The recognised for maintaining its ‘Good’ Care Chase, medically qualified Paul Sinha will be Quality Commission rating, it’s ‘Outstanding’ presenting the awards, mixing his stand-up rating for community services and its new humour with his healthcare knowledge. mental health strategy. Continuing the CQC This year, the award categories incorporate rating theme, Newcastle upon Tyne Hospitals facilities, technology, human resources, NHS Foundation Trust, also nominated, is hospital management and transport as well deemed ‘Outstanding’ in six out of nine key as the Outstanding Achievement service areas, with the health in Healthcare award, which trust also amongst the top is presented to an NHS performing in the country T he awa organisation that has for A&E targets. categor rd achieved success in Also shortlisted ies incorpo their role and brought are Kent benefits to the Community techno rate facilities, logy, hu wider NHS through Health NHS resourc man their dedication Foundation e s manag , hospital and expertise. Trust, another Beginning with of the 23 transpo ement and the aforementioned provider trusts rt as we the Ou l l headline award, to be rated a s t the Outstanding ‘Outstanding’ Achievestanding Achievement in overall in ment in Healthc Healthcare category England, and West are is sponsored by laptop Midlands Ambulance a ward experts Dynabook. Five Service University organisations have been NHS Foundation Trust, shortlisted for their excellent which received it’s second

‘Outstanding’ rating this year. Making up the five-strong shortlist is University Hospitals Bristol NHS Foundation Trust, the first NHS trust to go from ‘Requires Improvement’ to ‘Outstanding’, with the trust’s culture praised by inspectors. Last year, the award was presented to Kingston Hospital NHS Foundation Trust. As the first acute trust in the region to receive a Care Quality Commission ‘Outstanding’ rating for being well-led, the 2018 winner was chosen to be part of a pilot which aims to reduce waiting times further. Ambulance Trust of the Year West Midlands Ambulance Service University NHS Foundation Trust also make the shortlist for the Ambulance Trust of the Year Award, sponsored by ParAid. Alongside WMAS hoping to win this Award, are the North West Ambulance Service, who have witnessed a reduction in hospital conveyances for the first time ever, North East Ambulance Service, recognised for employing people with disabilities, London Ambulance Service, now out of Special Measures, and East Midlands Ambulance Service NHS Trust, who has moved from ‘Requires Improvement’ to ‘Good’, E Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Skyrocketing costs, historic regulatory changes, patient demands for instant access to their records, compliance to GDPR, SAR and freedom of information implications, bureaucracy and security concerns help define the healthcare industry landscape. Indeed GDPR that became law this year poses several challenges, not least the ability to be compliant with stricter data protection rules but also to be able to prove it in a court of law. By deploying a scanning solution alongside other lineof-business applications and embracing digital transformation, healthcare organisations can gain a strategic hub for managing all content that flows through the enterprise. Key benefits include: centralised storage with enhanced security for all information, including patient records; business process agility that can lead

status information for all SmartScan standard and emergency luminaires. This information is displayed on the SmartScan website which can be accessed from anywhere using a computer, laptop, tablet or smart-phone. Thorlux offers a wide range of lighting solutions for the healthcare sector. Projects combining Thorlux LED luminaires and smart controls frequently benefit from energy savings in excess of 70 per cent when compared with conventional technology.

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

to productivity gains and cost savings; enhanced compliance throughout all departments with all regulatory guidelines; faster access to patient information, potentially leading to improved patient outcomes, better patient engagement, and better access to critical information across the care continuum; and a notable ROI from the investment. With the benefits and rapid return on the investment, moving from paper to digital processes will allow organisations to tackle the challenges facing the industry in the coming years.

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 as well as the first dementia-friendly ambulance launch in the UK. London Ambulance Service, unfortunate not to win in the Outstanding Achievement category last year, was the recipient of the Ambulance Trust of the Year Award in 2018, having carried out a successful pilot over seven months to decrease the number of falls and reduce demand on both the ambulance service and hospitals, as well as improving outcomes in later life. Sponsored by EDM Healthcare Consulting, the Patient Data Award recognises the most innovative introduction of new technology for secure storage, retrieval and distribution of data throughout the NHS. Shortlisted in this category are: Royal Cornwall Hospitals Trust for the urgent and emergency RADAR PRISM dashboard; NHS Doncaster Clinical Commissioning Group for the Web based Analytics system; NHS Arden & GEM CSU’s Population Health Management System; the Midlands Partnership NHS Foundation Trust for its Robotic Process Automation, which reduces time spent manually uploading scanned health records; and Nottingham University Hospitals NHS Trust for it’s groundbreaking Digital Outpatient Project. Collaborative working The NHS Collaboration Award, sponsored by the British Parking Association, a regular contributor to Health Business magazine, is presented to the NHS trust which has worked with other public/private sector organisations, such as local government, police, fire, charities, schools etc to engage the local community in preventative campaigns. Three organisations will be hoping to win the award this year. Lancashire Teaching Hospitals NHS Foundation Trust has been shortlisted for its collaboration with the Lancashire Enterprise Advisor Network to inspire the future NHS workforce. Guy’s & St. Thomas NHS Trust has been working with London Ambulance Service to provide Point of Care Testing, while George Eliot Hospital NHS Trust and Warwickshire Fire

& Rescue Service are also shortlisted for its pilot with the county’s reablement service. This year the Telehealth Award is sponsored by Voice Connect and four organisations are in the running to take home the trophy. Royal Liverpool and Broadgreen University Hospitals NHS Trust is shortlisted for it’s Livernerds Lab, believed to be the first digital testing space of its kind in the NHS, while Airedale NHS Foundation Trust is hoping to win for its telemedicine Digital Care Hub. Meanwhile, Kent Community Health NHS Foundation Trust is hoping that its telehealth app, trialled at The Last Care Home in Maidstone, will win after it helped reduce hospital admissions by 100 per cent, as well as a 59 per cent reduction in calls to 111. Moorfields Eye Hospital NHS Foundation Trust completes the shortlist for its remote referral system, which is proven to reduce unnecessary ophthalmologist referrals. Endorse Jobs are the new sponsor of the Healthcare Recruitment Award and four health organisations will be hoping to receive the award from them on 5 December. The recruitment team at the Royal Free London NHS Trust have begun using a ‘robot’ to help recruit nurses, reducing the average length of time it takes to recruit staff by five days. Meanwhile, The Royal Wolverhampton NHS Trust is shortlisted for its Clinical Fellowship Programmes. Also shortlisted, the free tool launched by Health Education England and the Royal College of Nursing aims to help registered nurses identify news areas of practice that may suit their skillset. Completing the shortlist, University Hospitals of Morecambe Bay Trust will be showcasing it’s Global Learners Programme, which also uses Health Education England support. Environmental pressure Moving into 2020, hospitals will continue to come under mounting pressure to increase their environmental credentials and help the UK government achieve net zero emissions. In light of this, the Sustainable

HB Awards

Lancashire Teaching Hospitals NHS Foundation Trust has been shortlisted in the NHS Collaboration category for its collaboration with the Lancashire Enterprise Advisor Network to inspire the future NHS workforce

Hospital Award, sponsored by Thorlux Lighting, is a great opportunity to recognise those trust’s already leading the way in lowering emissions from NHS buildings. Manchester University NHS Foundation Trust has been shortlisted following its £10.9 million investment in energy technology, while East London NHS Foundation Trust has been recognised on the list for its Renewable Energy contract, after becoming the first trust to register with the Crown Commercial Service to secure a 100 per cent renewable electricity contract. NHS Tayside is also on the shortlist for its self funding sustainability measures, while Royal Devon and Exeter NHS Foundation Trust completes the shortlisted organisations in recognition of its energy reduction plan. Similarly, the Estates & Facilities Innovation Award, sponsored by WPS, recognises NHS and other healthcare organisations that have developed innovative procedures for managing and maintaining healthcare facilities. The shortlist for the 2019 Estates & Facilities Innovation Award contains: NHS Property Services for its NHS Open Space solution; Barts Health NHS Trust, the first UK trust to be awarded the Carbon Trust Standard for waste management; Royal Free London NHS Foundation Trust for its recent Chase Farm Hospital Redevelopment; and University Hospitals of North Midlands NHS Trust, in recognition for the organisation’s in-house/outsourced FM partnership. In the Hospital Building Award, The Christie NHS Foundation Trust will compete against University College London Hospitals and the Royal Papworth Hospital NHS Foundation Trust. Health technology Moving on to technology, the Healthcare IT Award, sponsored by Fujitsu, has a shortlist of five organisations. Bradford Teaching Hospitals NHS Foundation Trust has been included for its real-time Command Centre, Imperial College Healthcare NHS Trust for its Patient Comments algorithm, Newcastle upon Tyne Hospitals NHS Foundation Trust for it’s successful eRostering System, the Summary Care Records application (SCRa) pilot has seen London Ambulance Service shortlisted, while Nottingham University Hospitals NHS Trust completes the shortlist in recognition for its Digital Nursing Team. The 2019 Patient Safety Award is another strongly contested category. Sheffield Teaching Hospitals NHS Foundation Trust is hoping that the success and innovations of its diabetes team will be enough to take the award home, while Northumbria Healthcare NHS Foundation Trust has been shortlisted for its infection control across surgery. Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust are also shortlisted for its Pathway Support Programme, as are Croydon Health Services NHS Trust for quicker decision marking and improved safety for patients thanks to a new A&E imaging system. Recognising a hospital trust which has developed prudent financial practices, representing good value for the taxpayer, the NHS Finance Award will be awarded to one of: Medway NHS Foundation Trust; Western Sussex Hospitals NHS Foundation Trust; or NHS Shared Business Services. E Issue 19.4 | HEALTH BUSINESS MAGAZINE

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A safety-first approach The critical assets of a hospital - its people, property, information and reputation must be protected. The Hospital Security Award will recognise hospitals that have made significant steps towards a safer

In the Hospital Building Award, The Christie NHS Foundation Trust will compete against University College London Hospitals and the Royal Papworth Hospital NHS Foundation Trust environment for patients and workers through the implementation of a security policy which incorporates the latest advancements in CCTV, access control and other monitoring technologies. This year one of Southern Health NHS Foundation Trust, Norfolk and Suffolk NHS Foundation Trust or University Hospitals Birmingham NHS Foundation Trust will win the accolade. The Innovation in Mental Health Award has a four-strong shortlist, including Oxford Health NHS Foundation Trust; North Tees and Hartlepool NHS Foundation Trust; Midlands Partnership NHS Foundation Trust: the Wellbeing Matters service; and Sherwood Forest Hospitals NHS Foundation Trust. The Hospital Catering Award is presented to the NHS trust that has strived to improve the standard of food and its nutritional value for the benefits of both patients and staff. Nottingham University Hospitals NHS Trust has made the list for the launch of its Memory Menu initiative, alongside Lewisham and Greenwich NHS Trust,

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HB Awards

 Good publicity for the NHS The NHS Publicity Campaign Award is awarded to the campaign which can demonstrate success in achieving its objectives, whether that be via press, radio, television and outdoor advertising. Five organisations have been shortlisted. NHS Arden & GEM CSU has made the list for its modern Slavery awareness campaign, while NHS Mid Essex Clinical Commissioning Group has been recognised for its Your Medicines, Your NHS campaign, which aims to tackle the approximately £2 million spent each year in unused medication. Also on the shortlist, South West Yorkshire Partnership NHS Trust has been nominated for its Flu Fighter Campaign, NHS England for its publicity campaign ‘Men in Nursing’, and North Tees and Hartlepool NHS Trust for its ongoing Violence against Staff campaign. Sponsored by Dynabook, the Hospital Procurement Award has three potential winners. Medway NHS Foundation Trust is shortlisted for its new inventory management system, Nottingham University Hospitals NHS Trust for its use of one provider for clinical waste containers, and Royal Cornwall Hospitals NHS Trust for improving the efficiency of existing material management processes.

recognised for its freshly prepared menu, that won Soil Association accreditation. The Royal Marsden NHS Foundation Trust is shortlisted, as is the University Hospitals of Leicester NHS Trust, who recently switched to the NHS Supply Chain Food framework. The Transport & Logistics Award will be won by one of three NHS organisations: East of England Ambulance Service NHS Trust; Northumbria Healthcare NHS Foundation Trust; and University Hospitals of Derby and Burton NHS Foundation Trust. Last year, Yorkshire Ambulance Service NHS Trust was recognised in this category having introduced three new hydrogenelectric support vehicles to its fleet and for working with a low emission technology company to build a prototype hydrogenelectric ambulance. Solar panels were also installed on more than 100 ambulances. L FURTHER INFORMATION www.hbawards.co.uk

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Issue 19.4 | HEALTH BUSINESS MAGAZINE

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UK medical records success Designed and built with NHS practitioners using latest technologies, CCube’s award-winning EDRM solutions deliver electronic health records to clinicians, secretaries and administrators in the format they require, when and where they are needed With a proven track record of project success and expertise working with the NHS over 18 years, providing cost effective and scalable solutions, tailored to meet individual requirements. When asked what our mission statement is, we provide a simple answer: to deliver digital healthcare in the NHS. In-house scanning: St Helens & Knowsley Teaching Hospitals NHS Trust St Helens & Knowsley Teaching Hospitals NHS Trust started a project in early 2009 to digitise and deliver electronic patient records files to guarantee notes availability, improve the quality of patient care and - of course - save money. Its IT resource - Health Informatics Service - created its own in‑house scanning bureau along with CCube Solutions EDRMS. The results are impressive: First trust in the UK to stop using paper records in clinical practice; £1.4 million annual savings from £1.2 million investment; 500 doctors and 130 secretaries trained after a staged rollout taking 22 months; Over 175,000 medical records digitised (c.52 million pages) stopping 7,000 files per week being hand delivered; Innovative scan-on-demand model developed - only files needed are actually scanned, resulting in huge cost savings. Outsourced scanning: Aintree University Hospital NHS Foundation Trust Aintree University Hospital at first considered creating its own scanning bureau but then decided to outsource to an external scanning services provider. Again, CCube Solutions EDRM software was installed and used to deliver the digital records at the point-of-use:

First trust to use forms recognition technology to automate the recognition and classification of pre-printed medical forms which make up 95 per cent of medical files; £1 million annual savings from £1.5 million investment; Scan-ondemand with a third party - 290,000 patient files digitised; 30 per cent space gained in a new £45 million building from removing paper records so a £13.5 million estate benefit; Access required information within three mouse clicks. Hybrid model: North Bristol NHS Trust North Bristol NHS Trust approached the whole transition from paper to digital medical records by both setting up its own in-house scanning bureau and working with a third-party outsourcing specialist, to do the back scanning. The in-house bureau is used for day-to-day scanning. Returns from the project have been significant: A scan-on-demand model to digitise patient medical records will save over £1.3 million within four years; EDRMS is an ‘invest to save’ initiative with the system paying for itself based on a reduction in operating costs; Outsourced digitisation of over 235,000 active patient records, amounting to c.35 million pages; In house scanning of day-forward patient records; 24/7/365 notes availability for multi-disciplinary clinical teams; Project delivered on time and to budget; Auditing and information governance improved as medical records are tracked. Avoiding scanning legacy paper in the first place – the Papworth Hospital model Tertiary Trust, Papworth Hospital, installed EDRM, workflow and eForms from CCube Solutions to create an electronic medical

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

records system (EMR). Papworth’s EMR is not concerned with scanning legacy records. The focus has been to concentrate on the patient’s pathway from the moment an individual is referred to the hospital so that referral paperwork and medical notes are indexed, shared and information automatically routed to boost efficiency, reduce costs and enhance patient care. Return on investment has been significant: The whole project including software and project management cost under £190,000; Significant reduction in operational costs by removing physical paper records storage and management (cost over £200,000pa.); Assists meeting government targets to see patients within the set timeframe of 18 weeks from GP to final treatment; The first deployment of a registration and referral system where letters are scanned and then handled electronically using workflow. Medical records in primary care - the GPs Turning to GPs, CCube Solutions launched our eLG solution – a secure and hosted electronic Lloyd George (LG) platform. LG envelopes contain reference material required when GPs write letters to solicitors, employers, insurance companies or when they have to provide a historical view on a patient. LG envelopes are commonly stored in huge racks in reception areas, storage rooms or off site in third party facilities. Practices are required by law to retain LG envelopes as they follow patients around the NHS when they change practices. A typical practice with 11,000 patients is likely to have around 13,000 wallets given some patients will have more than one. And, on average, each wallet will contain around 80 pages. This means over one million sheets of paper per practice - in larger surgeries, the numbers will be considerably higher. CCube Solutions has deployed a secure and hosted platform for the storage, access and lifecycle management of electronic LG records. This is a scaled down version of its EDRM technology implemented in 30 acute NHS trusts throughout the country. The upload process of Lloyd George files is free, fully automated, and meets agreed SLAs. Access to this information is via a standard Internet browser using any device. L FURTHER INFORMATION www.ccubesolutions.com

Data management

Secure data destruction in the health care sector GDPR has caused much anxiety within the health care sector. Steve Mellings explains why the most critical part of compliance is the approach to data protection itself With the hyperbole surrounding the General care. However, GDPR and the UK Data Data Protection Regulation (GDPR) beginning Protection Act are here to stay and 18 to dissipate, the stark reality of the need months since the law was implemented we to comply with a law which is not going are beginning to see data subjects make to go away is only now really beginning use of their rights and the regulator take to dawn on many organisations. For those an interest in those companies who are operating in the health care sector, where not on their journey towards compliance. data is key to providing patient care, many One organisation I’m involved with, Clinical of the requirements under GDPR are DPO, operates as an outsource Data viewed as cumbersome and an Protection Office (DPO) for over operational burden, leaving 100 health care organisations many to question the need and my experience here Despite to change the way in tells me that the health some o which patient care has care sector has some exampl bvious traditionally been way to go where financia es of the delivered. This stance compliance to l risk po is further supported GDPR and the UK t h sed by is busin by the complex Data Protection we’re s ess process way in which data Act is concerned. t , is shared between practiceill seeing poor multiple entities, w destruc here data each necessary tion is to provide patient c

Despite being mandated by law to have a DPO as a result of the large-scale processing of Special Category data, we’re still seeing many large and smaller independent heath care practitioners adopting an internal tick box approach to compliance, which is leaving many obvious GAPs waiting to be identified by both patients and regulators. With many overwhelmed, it is sensible to try to break the compliance project into specific tasks. One area where the health sector has traditionally struggled is that of secure data destruction. Two of the largest five fines, in excess of £500,000 (pre-GDPR), were levied on the heath care sector were as a result of improper destruction of data. Despite these obvious examples of the financial risk posed by this business process, we’re still seeing poor practice where data destruction is concerned. E

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Issue 19.4 | HEALTH BUSINESS MAGAZINE

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itself. Whilst the act of data sanitisation is often mentioned in contracts, the control over inventory is not. Loss of the physical asset is a far greater risk than an overwriting toolset not being used properly. It would make sense that if you are releasing your assets into a supply chain that you understand what assets you have released, which in turn will enable you to reconcile what was processed. This is an imperative under GDPR as Article 24 make it very clear that it is the responsibility of the controller (the health care organisation releasing the assets) to take ‘Appropriate Technical and Organisation Measures’. Not only is it the opinion of the author that it would be appropriate to know what you have released but, and of course more importantly, it is also the opinion of the UK Information Commissioner’s Office. Within their penalty notices for the two health authorities fined for improper disposal, both listed a lack of inventory as a key contributory factor to permitting a breach to happen. Using a contract A recurring and frustrating issue for ADISA members is the inability to put a contract in place between themselves and their customers. Under the Data Protection Act 1998 it was illegal for a controller to use a processor without a contract and this has been further emphasised under GDPR by making it illegal for either party to conduct business without a contract being in place. That contract is used to provide compliance to a range of GDPR requirements which are listed in Article 28 and forms a key component in the controller/processor relationship. It would seem obvious that a transaction with such a large amount of data would be

Compliance with GDPR is not a one-time process. It is about the business building processes into its day to day operation which have data protection at the core and support staff in making the right decisions to maintain a compliant position

governed by strict written authorisation, but sadly that is often not the case. Even where written authorisation is in place, it is often not fit for purpose and the addition of standards which are not relevant, merely shows the authors have no proper grasp on the process. The frustration for ADISA members is that the Standard they are certified to, has made it mandatory since January 2016 to have contracts in place, but all too often an audit we have seen email evidence from the customer saying: ‘I’m not going to sign your contract and if you don’t collect I’ll get someone else to’. This for many transactions is the commercial reality but is fundamentally illegal and as one member says: ‘Our certification saves our customers from themselves, if only they would let us lead them’. Finally, a common mistake is data controllers not knowing what to look for in their suppliers. A smart website with impressive claims and credibility built by statements about compliance or approvals is commonplace in an industry which is largely unregulated. Article 28 (1) states that you should only use a processor which provides sufficient guarantees to implement appropriate technical and organisational measures. Unless during your due diligence you dig beneath the claims and assess them on their own merits by physically inspecting their facility and their processes then there is no way you can be compliant with this. Unless, of course, you use a vendor who voluntarily gets screening by an independent certification body such as ADISA.

Data management

 Secure data destruction It’s perhaps pertinent to start by outlining what we mean by secure data destruction. There are various times within the data lifecycle where erasure is required and that is usually managed on a file basis using system tools which remove the file index keys rendering the data unaddressable, but still in existence. Generally over time the data is overwritten by new saved data and as such becomes unrecoverable. The risk here from this activity is low but that changes significantly when the whole device is released from control, generally at end of life. Healthcare organisations seek suppliers to provide brokerage, recycling or ITAD services and it is here where the real problems begin. Since starting ADISA − a certification scheme for companies who recovery IT assets and perform data sanitisation services − we’ve carried out over 500 audits of this business process and as a result of this experience we see common mistakes organisations make when disposing of assets which are relatively easy to fix. The first common mistake is to underestimate the need for secure data destruction, which means the whole process is treated dismissively. You would hope that the previously mentioned financial penalties would ensure renewed focus is given but it appears, particularly in health care, that retired assets with data on and also hard copy files, get identified as waste and treated as such. In addition to the fines for failing to dispose of old PCs we have seen pre-GDPR fines for the improper disposal of filing cabinets containing patient records. All of the issues which causes these fines were easy to fix if the proper focus had been applied to this business function. Operationally, a common weakness is a complete lack of control over the process

Concluding comments So is this another article lambasting bad proactive? And if it is why should you care? The truth is that GDPR has caused much anxiety within the health care sector, as it has in most sectors, compounded by companies wishing to sell silver bullet solutions to compliance. The reality is that the most critical part of compliance is the approach to data protection itself. There are many, many aspects which are simple to implement and easy to maintain if the data controller is motivated to approach this properly. Compliance with GDPR is not a one-time process and it isn’t a bolt on solution, it is about the business building processes into its day to day operation which have data protection at the core and support staff in making the right decisions to maintain a compliant position. Secure data sanitisation is one area where you can apply some basic and sensible principles to manage your risk and become compliant. If you have any doubts about what you are doing speak to an ADISA members directly www.adisa.global as they have been well versed in helping organisations manage this one part of the overall GDPR compliance project. L

Steve Mellings is the founder of ADISA and a consultant at Clinical DPO. FURTHER INFORMATION https://adisa.global/

Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Digital Healthcare – why haven’t you got started? Health Business (HB) talks to Vijay Magon (VM), managing director of CCube Solutions, about the current state of digital transformation within the NHS and how EDRM systems can support greater patient engagement with health records HB: Amid the wider digital healthcare push, why is now the right time for health organisations to make the paperless shift? VM: Technology is not just making its presence felt in operating theatres and hospital wards - NHS trusts and PCTS are quickly becoming aware that being able to access, store and share patient records is as crucial to improving patient care as the latest breakthroughs in medical science. The need for an efficient and effective information management system manifests itself across all levels of modern healthcare provision. It encompasses everything from consultants and surgeons accessing x-rays and scans from workstations across a hospital complex, ending the need for cumbersome transfer of paper records from site to another, with the incumbent risk of them being misplaced or lost; to administration staff saving time by using templates and electronic forms pre-populated with a patient’s details when sending out appointment letters; and by capturing electronic patient information at source, make a real impact on the production and dependency on paper. Most NHS sites still hold patient related data on a variety of different media, such as paper, microfilm and digital. It is currently very difficult to identify exactly what information may be held on a given patient. This has resulted in falling standards for maintaining the patient’s acute medical record; increasing risk and leaving patients and clinicians at a disadvantage. Furthermore, there are many well-known issues related to paperbased delivery of care, such as: physical handling and transport of paper records; lack of audit on who looked at any record; only one person can see a record at any time; cannot easily share records without copying; lack of compliance, especially GDPR; lost records; and escalating costs associated with handling physical records. The implementation of an electronic system turns around the culture of information. Much

like the founding principle of the NHS, the modern information management system provides a ‘cradle to grave’ auditable trail of legacy documents such as patient records and correspondence. Implementing an electronic information management solution delivers the proverbial ‘double whammy’ of improving accessibility, whilst ensuring that healthcare providers like NHS trusts and PCTS are fully compliant with their legal obligation in storing healthcare records. HB: Digital transformation can become a never-ending ambition for organisations. How important is managing the transformation? VM: Lessons have been learnt through careful application of the available technologies. Given the consumerisation of IT, systems have become more affordable and are delivering real and measurable benefits. There are three key points to keep in mind: Firstly, it is vital to understand that simply digitising paper records is not enough – the solution must offer facilities to stop producing new paper through generation, management, and integration of ongoing (electronic) records - in order to minimise or eliminate the paper chase. Secondly, patient information resides on many disparate systems within trusts – information that is relevant to the patient and should be presented along with the digital record, at the point of care. The electronic medical record cannot sit in a document management system that remains un-connected with other hospital systems and processes – information must be exchangeable and shareable. This includes sharing with primary care – access to primary care data by users in acute trusts as well as access to the acute record by GPs. Lastly, to be optimally effective the electronic record has to be delivered to key users when and where they need it. A solution which offers a standard interface for all users will provide limited functionality to most users.

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NHS trusts must adopt a more holistic approach for content management - to develop and provide integrated solutions that use EDRM as the underlying technology to capture and deliver electronic patient information at the point of care. The returns from investments in EDRM are being realised through careful application of this technology to address the needs of key users who deliver medical care rather than shortterm measures to solve paper problems. Key users include clinicians, secretaries, administrators, etc. Each places specific demands on the medical record, and each of these demands must be addressed. HB: What are the key considerations that must be addressed before being digitising records and processes? VM: Organisations looking to digitise legacy records have to meet a variety of business objectives which may include: cost related to maintaining existing record libraries; pressure on storage space, especially if moving to a new site; operational costs - finding and delivering records, especially across a number of geographically distributed sites; strategic objectives related to operational performance and efficiency gains; and customer services, among others. Each organisation will assign its own priorities for scanning and build a business case within an agreed cost framework. If this points to digitising a given volume of existing records, a budget will be agreed. Note that new information does not fall into this category – this includes the increasing proportion of information generated and accessible electronically. The benefits seen from application of document management technologies for new and ongoing information are real, tangible, and beyond debate. However, it is important to align digitisation of legacy records with specific processes within a trust, rather than simply digitising records to alleviate problems related to storing and using paper. For example, the ‘scan-ondemand’ approach applied to the Outpatient process has enabled some trusts to realise very tangible benefits including year-on-year cost savings while delivering ‘paperlite healthcare’ – a good example of process mapping and application of the right IT solution. Advances in recognition and classification technologies offer a way forward for trusts to keep the cost of digitising legacy case

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notes to a minimum and provide a more acceptable solution for practitioners, ie. systems that take away paper from users must provide clear advantages and a compelling case for not using paper rather than simply replacing paper with an electronic image. Key considerations include streamlining and minimising dependency on paper. Electronic solutions cannot replace all paperbased processes. While the exponential rise in apps, mobile and wearable devices, and electronic recorders is making a serious dent on our dependency on paper, these do not offer practical solutions for everything. Interoperability is also a key consideration. Once existing paper and electronic repositories are captured and managed, it is important to ensure that systems no longer feed storage sub-folders, ie. new patient information can be captured at source, managed, and delivered without resorting to paper. Integration between multiple IT systems and devices that generate patient information must be mandatory. This include medical devices that record vital signs – a key area of concern as currently, most medical devices work autonomously, ie. data from medical devices is (manually) transcribed and re-keyed into IT systems for reuse, or simply printed and saved on paper, adding to the scanning volumes. Covering data collection, hospital data systems hold a wealth of patient information, yet data entry is duplicated on a daily basis. Electronic Forms extend the functionality offered by current paper forms - to design and publish web based forms which contain intelligence in the form filling process. The completed forms are automatically captured and saved in an electronic repository where they can trigger workflows for post-capture processing. Furthermore, and specifically with eForms, data captured within forms is available as electronic and machine-readable data which does not require recognition and which can be re-used multiple times within backend systems. This offers the potential for huge savings in administration and for automating clinical workflow processes. HB: How do EDRM systems help to improve efficiency in primary care? VM: The above examples have focused on records management in hospitals. Turning to GPs, CCube Solutions is involved in a

significant primary care initiative called eLGS. Capitalising on its experiences digitising records at several hospital sites, CCube Solutions partnered with one of the trusts to offer its know-how in primary care. We launched a fully managed service to digitise all the patient records which GPs have to keep in their surgeries - colloquially called Lloyd George notes. The eLG service includes collection, digitisation, hosting, training, and the software GPs use to access the information on their desktops. This initiative is about releasing more space in primary care, enhancing GP and practice staff productivity and removing a whole paper shuffling industry in primary care which in itself costs millions and millions. To date, four CCGs have purchased the service with around 120 GP practices now using the system. HB: What are the financial advantages for cash-strapped health organisations? VM: Given the bad press about large scale IT implementations, two valuable lessons must be learnt. Firstly, not all trusts are ready for the top end solutions – each must accommodate the technology and its implementation gradually to suit a number of local conditions including budgets, IT infrastructure, user training, etc.; and, secondly, a core application cannot be driven top-down without involving the people who will actually use it and who will be held accountable. While it is good to see that government directives are accompanied by a financial commitment, each trust must make its on case for improvement and demonstrate willingness to change. Simply throwing money at a problem will lead to yet another IT failure. The bottom-up approach means that the digital revolution in the NHS is achievable - gradually and over time rather than committing astronomical sums on large scale IT projects. The NHS has set a target to be paperless – many trusts, Health Boards, and primary care practices working with CCube Solutions have already digitised hundreds of millions of records, saved time, money, and improved patient care, and are now ready for the next exciting wave of digital transformation, which will include: sharing of information using established Open Standards, between systems, professionals, and patients; the use of AI for understanding the huge volume of digital content now available; the use of

Electronic Forms for data capture at the point of care; and access to digital records using Smartphone Apps – anywhere, anytime. The outcomes are impressive – several trusts using the CCube EDRM have shown real savings to the tune of c.£1 million per year per site after Go Live. Collectively amongst such sites we estimate savings of tens of millions of pounds delivered back to the NHS! The invest-to-save strategy is working! HB: How can EDRM support greater patient engagement with health records? VM:: This is definitely the next step and its starting to happen. At CCube, we are working on patient-portals that will help improve patients’ access to their own medical history, care, etc. and help patients get involved in their own medical treatments – improved patient engagement means trusts have to spend less reaching out to patients. HB: What further improvements and innovations are likely to be introduced? Where will they sit if we reach a stage where the majority of organisations have a full electronic patient record in place? VM: EPR systems are designed to deal with structured information – not unstructured content which resides in documents. EDRM systems deal with un-structured content. This leads to a union of the two systems, a happy marriage where EDRM can ‘serve’ unstructured records into EPR systems – we have developed click-through functionality from EPR to EDRM and from EDRM into other patient repositories, helping to deliver a unified patient record. EDRM provides all the established services including life-cycle management and compliance with legal guidelines (such as BS10008) – both structured and unstructured content. Its ideal for providing content services, it is rule-based and very flexible. It is also Cloud based offering SaaS capabilities – both Cloud and Hybrid-Cloud - opening up possibilities of sharing records between organisations, care centres, …. ‘Blockchain’!. L FURTHER INFORMATION www.ccubesolutions.com

Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Wayfinding

NHS and interpreting services Effective interpreting delivered by professionals who are registered and regulated provides better outcomes for patients. Mike Orlov of NRPSI explains why Individuals who do not speak or understand it was cancelled because a foreign language English should not be hindered from speaking cleaner (a bilingual deemed fit accessing the NHS and need to be provided to practice but with no qualifications or with effective interpreting. Language experience) had arrived who could carry out barriers contribute to health inequalities ‘interpreting’ for free, we would then have and can exacerbate specific ailments an indication as to why so many interpreters due to poor communication between are leaving the profession and why the NHS patient and medical practitioner. is suffering with poor interpreting services. And the NHS also needs to be protected to What chance is there of a mother being ensure less crippling and costly misdiagnoses honest about her ailments if her ‘interpreter’ when poor interpreting takes place due is her 14-year-old son or daughter? When to the use of below-par, under-trained, illbilinguals with no training, qualifications equipped or inexperienced bilinguals and or experience are deployed, much to linguists. It is a false economy to deploy the annoyance of medical professionals, free or cheap pseudo-interpreting. then risk is built into the system. Given interpreters provide a key service When many newly qualified interpreters who for patients, carers and clinicians, helping have no or little experience find themselves in them understand each other when they difficult circumstances in a consulting room, do not speak the same language, the NHS we might ask what we should do to attract has to be committed to providing qualified and experienced people high quality, equitable, effective back to interpreting in the interpreting so healthcare NHS. Even an experienced services are responsive interpreter, but lacking Ma to all patients’ needs. qualifications, does not use of bking When in a hospital, a guarantee quality or i l i or lingu nguals procurement manager risk-free situations. tells a trained, As outlined by no inte ists with rpreting qualified, accredited, advice from NHS q uali registered and England (Guidance experie fications or regulated interpreter for Commissioners: n c e threa not to bother turning Interpreting and t the pub e up for their poorly Translation Services lic and ns the NH remunerated engagement in Primary Care), face S we should explore why the to face interpreters engagement was cancelled. If should be registered

with the National Register of Public Service Interpreters (NRPSI). The same document states very clearly that all interpreters must be registered with an appropriate regulator, be suitably qualified and should have the skills and training to work in health care settings and have undergone appropriate checks and clearance in line with Disclosure and Barring Service (DBS) guidelines; the only appropriate independent and not-for-profit register and regulator in the UK is NRPSI. Relevant qualifications Appropriately qualified interpreters should be sourced and provided for use by the NHS where life and death decisions are often made given feedback from patients to doctors, nurses and allied health practitioners. Relevant qualifications confer status as a recognised, registered and regulated professional practitioner; acceptable public service interpreting qualifications are the most robust and reliable measure of interpreter quality and all interpreters working in the health sector need to be qualified to a minimum level where it is recognised the interpreter is safe to practice and will not potentially cause untold harm through miss-interpreting. Those newly qualified without experience ought to be mentored by experienced public service interpreters to embed the code of conduct and aid in navigating the issues, problems and challenges of public service interpreting in the NHS. E

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Wayfinding

 As NRPSI states, 400 hours of experience ought to be required for those working in organisations where the most serious potential consequences might occur, such as the NHS where life and death decisions are a daily occurrence. NHS practitioners should not accept pseudo-interpreters delivered by procurement management whose only concern is controlling costs. But when this advice is not followed and untrained, unqualified ersatz-interpreting is delivered by bilinguals then it is no surprise why registered and regulated interpreters do not wish to work for the NHS for low engagement fees. As an NHS senior manager, procurement manager or a medical practitioner, do not allow unqualified and inexperienced interpreters not only hinder but possibly harm you, your reputation and the quality of your work with patients. Do not accept: bilinguals with no language or interpreting qualifications and no public service interpreting (PSI) experience; bilinguals with no language or interpreting qualifications but with PSI experience; linguists with language A level (or lower grade) but no interpreting qualifications; linguists with language A level (or lower grade) and with interpreting qualifications; linguists with language degree level (or above) but no interpreting qualifications; linguists with language degree level (or above) with interpreting qualifications; interpreters with level 3 or 4 community level interpreting qualifications without PSI experience; or interpreters with level 3 or 4 community level interpreting qualifications with PSI experience. Senior NHS management, procurement management and practitioners in the NHS should demand as a minimum: interpreters with 400 hours or more PSI experience and passed some of the required level 6 modules; interpreters with level 6 DPI or DPSI Law or DPSI Health or DPSI Local Gov or equivalent degree level but with less than 400 hours experience but are at least trained to do the job; and interpreters with level 6 DPI or DPSI Law or DPSI Health or DPSI Local Gov or equivalent degree level with more than 400 hours experience but not ascribing to the Interpreter Code of Conduct. Ideally you ought to be engaging those interpreters who are registered, regulated, have the requisite clearances and have signed up to the Code of Conduct of the National Register: Registered and Regulated Public Service Interpreters (RPSIs) who have level 6 qualifications, all the required experience, approved clearances and ascribe to the Code of Conduct; a NRPSI Registrant. The National Register was set up in 1994 following a Royal Commission which recommended a register of the most highly qualified interpreters be established to protect the public from the consequences of poor and inappropriate interpreting in the public sector. This remains its core purpose; when an interpreter is working in a public service setting, usually in a potentially life-changing or life-threatening interview situation, they are the only person who understands what both the other parties are saying.

Given interpreters provide a key service for patients, carers and clinicians, the NHS has to be committed to providing high quality, equitable, effective interpreting so healthcare services are responsive to all patients’ needs The potential for abuse of the public’s trust is clear if the professional ability and integrity of the interpreter cannot be relied upon. NRPSI was set up with help from the Home Office and the Nuffield Foundation to ensure those used as interpreters in the public sector were: appropriately qualified; with the right levels of experience; and are ready to carry out interpreting assignments. NRPSI’s core function is to protect the public, and the public-purse, from poor practice in interpreting; risk and complexity cannot be forecast therefore highly qualified and experienced public service interpreters need to be deployed in doctors’ consulting rooms as well as other NHS settings. The majority of Registrants are on Full Status, qualified to honours degree level (level 6) or above in the skills required to work in a public service setting with the requisite relevant experience. The National Register contains a substantial proportion of the eligible, trained, qualified and regulated interpreters in the UK. Hitting cost-targets and supply-requirements by procurement management at the expense of quality are not achievements, causing confusion and miscommunication for medical professionals with their non-English speaking patients. More funding for interpreting services is desperately needed and would mitigate against the inherent risks and high levels of compensation when interpreting goes wrong due to poor service-delivery by inadequates. No amount of saved pounds-sterling will guarantee effective high quality interpreting needed by doctors, nurses, allied health professionals or indeed, the individual who cannot speak English and needs to communicate. It is critical the NHS sets funding for interpreting services on the basis of commitments to best-guidance, to principles and indeed to law; not based on expedient parsimonious frugality. Such attempts to save money have negative domino effects. A threat to the NHS Making use of bilinguals or linguists with no interpreting qualifications or experience threatens the public and the NHS.

Pseudo-interpreters, bilinguals, and ersatzinterpreters with no or low grade interpreting qualifications and limited public service experience are not acceptable replacements for safe and effective interpreting conducted by registered and regulated professionals. Interpreting engagements in the NHS need to be carried out by those who are fit-topractice; interpreters with level 6 Diplomas in Health Interpreting with more than 400 hours experience, with clearances and who ascribe to the Interpreter Code of Conduct. Well-trained, qualified and experienced public service interpreters contribute to the safeguarding of human rights. Registrants who voluntarily accept the NRPSI Code of Conduct are inspirational beacons to professionalism in language service provision for the public sector. While NRPSI regulates those interpreters who display the professional self-regard to be on the National Register, NRPSI is powerless to deal with complaints against unregistered interpreters. Were it statutory for interpreters working in the NHS to be registered and thus regulated and if it was mandatory for the NHS to use only registered and regulated interpreters, then the public, and the public purse, would be better protected. NRPSI has proved to be a necessary tool for safe-guarding the quality of public service interpreting; it needs to be a ‘must’ not just a ‘like to have’ for the NHS. Effective interpreting delivered by professionals who are registered and regulated provides better outcomes for patients, allowing them to manage their conditions and also frees-up medical practitioners to handle more cases. It is simply about providing the best possible care to all in the UK. It is also about helping people to become productive and integrated members of society. The NHS needs to spend money wisely on interpreting so the NHS can be proud of meeting the needs of all British citizens. L FURTHER INFORMATION www.nrpsi.org.uk

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Medstrom Healthcare continues to lead the way as an innovator in specialist equipment rental solutions for the NHS Medstrom Healthcare, one of UK’s leading providers of bed management services to the NHS, manages over 20 per cent of the bed and mattress fleet. The company offers a unique range of specialist equipment rental solutions, all designed to deliver exceptional added value to its NHS customers At a time when bed occupancy levels are remaining at unsafe levels all year round, patient vulnerability is increasing and capital funding is under extreme pressure, specialist equipment rental offers a valuable short or longer-term solution to these challenges. Medstrom’s rental offering includes adhoc daily equipment rental, longer-term bed rental and the unique Medstrom Now, all flexible and cost-effective options to improve patient outcomes. Need to rent beds in an emergency? Speak to Medstrom Medstrom’s new long-term bed rental offering has been designed to address both the financial challenges and high bed occupancy issues which are being faced by the NHS now and will continue to cause challenges throughout the coming months. Medstrom have invested significant capital funds in a large fleet of hospital beds and offer free, next-day delivery seven days a week, including delivery of each bed to the ward and full user training by highly trained technicians. This means that even if a hospital identifies an urgent need for escalation beds at 5pm on a Friday afternoon, Medstrom will deliver on Saturday. This outstanding service level is offered to hospitals in mainland England, Wales and most parts of Scotland. Delivery to other

areas of UK may take a day longer. With a minimum requirement to rent just 10 beds for at least a three-month period, this provides a superb and accessible solution, the only one of its kind in the industry. Announcing Medstrom Now Another new and innovative rental service offered by Medstrom is Medstrom Now, designed to remove all barriers to accessing a specialist equipment rental service. It is a transparent, flexible and cost-effective service which eliminates many of the challenges hospitals currently face with their service providers. Medstrom Now removes unrealistically high delivery and collection charges that are applied by many service providers and guarantees immediate access to equipment by ensuring that products are always available on-site. In an increasingly cost-conscious market, this unrivalled rental service offers a way to make significant cost savings as well as improve patient outcomes by eliminating waiting time for specialist equipment. Ad-hoc rental of specialist equipment Medstrom also offer an ad-hoc rental service, which offers a third, cost-effective approach to accessing specialist equipment. A range of specialist beds and mattresses are available to rent including the unique

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Dolphin Therapy surface, specialist ultra-low beds and equipment for plus-size patients. As with all Medstrom’s services, 24-hour clinical support from their national team of NMC-registered Clinical Nurse Advisors is offered to ensure appropriate product selection and best possible patient outcomes. Delivery and installation of equipment is always done by Medstrom technicians, who are City & Guilds qualified and DBS checked. Ongoing training is supplied by Clinical Nurse Advisors post-patient placement and throughout product usage to ensure desired clinical outcomes are achieved. Rachel Apsey, sales & marketing director, sees their range of rental solutions as real testament to Medstrom’s mission to be the most innovative, clinically-oriented provider in their sector. She comments: “All of our rental services have been developed to provide our customers with genuine added value and are designed to address all financial and non-financial challenges that they may be experiencing with their existing rental service. We believe these services are real game changers.” L FURTHER INFORMATION www.medstrom.com

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Leasing is extremely flexible and could be the perfect solution if much-need new equipment would otherwise be unaffordable, writes the Finance and Leasing Association As the NHS celebrated its 70th anniversary There are two main types of lease: an last year, the government’s announcement operating lease and a finance lease. An of £20 billion in additional funding by 2023 operating lease would be appropriate if the was widely welcomed. But the birthday business does not need the equipment for gift included a stern warning – that the the entirety of its working life. The leasing NHS would need to be more efficient or company will take it back at the end of the funding increase would be swallowed the agreement and will be responsible for up before it reached the frontline. maintenance throughout the lease period. One way to ensure that patients feel the A finance lease would be appropriate if the benefit of the extra funding is to make business intends to keep the equipment every pound work harder. In a sector where for most or all of its working life. As such, medical and technological innovations can finance leases transfer all the rights and render high-value equipment obsolete within obligations of ownership (like maintenance a relatively short period, leasing and insurance) to the lessee, frequently makes more sense and over the lifetime of the than buying outright. It’s agreement, the lessee Leasing simply not efficient to will have pay at least continue using broken 90 per cent of the is extre or slow technology fair value, or market flexible mely a in an effort to value of the asset. n d be used can justify the original Leasing is extremely t o fu asset, e investment cost flexible and can speciall nd any needed y if mu of the equipment be used to fund chnew eq – especially any asset – from uipmen would when the clinical telephones and t o outcomes of statephotocopiers to be una therwise ffordab of-the-art equivalents specialist medical le would improve equipment or NHS productivity IT – and it could be and patient care. the perfect solution if much-needed new equipment What is leasing? would otherwise be unaffordable. Leasing usually involves paying a regular Over 90 per cent of asset finance (leasing charge for the use of the asset over an agreed and hire purchase) providers in the UK period of time, so avoiding the full cost of are members of the Finance & Leasing buying it outright. The leasing company Association (FLA) and you’ll find them listed (lessor) buys and owns the equipment in our Annual Review. Doing business with on behalf of the customer (lessee). The an FLA member means you are dealing customer pays a rental for the use of the with a reputable firm, whose agreements equipment over a predetermined period. are subject to the FLA’s Business Code.

Procurement NHS Supply Chain has been tasked with implementing the Future Operating Model, set up by the Department of Health as a solution to the problem of NHS trusts paying a variety of different prices for the same basic equipment. Part of this model includes Category Towers of procurement consortia that have been contracted by NHS Supply Chain to provide particular types of products. The kind of leasing undertaken by FLA members falls primarily under Category Tower 7, (Large Diagnostic Capital Devices including mobile & consumables). While supportive of the new procurement process, the FLA will be liaising closely with the Department of Health and NHS Supply Chain to keep them apprised of our members’ feedback on the ongoing implementation. IFRS 16 Early in 2017, the EU endorsed the new international accounting standard for lessees, IFRS 16 – with an implementation date of January 2019. We have been discussing with the government the possible effects of aligning public sector accounting with IFRS 16, and our main point is that any changes must improve the current situation which treats finance leases as debt – so their use by schools and non-trust hospitals is only allowed with the permission of the Secretary of State. The government consultation paper on public sector accounting, published a few years ago, contains proposals that would have the effect of putting all leases on the lessee’s balance sheet, and which would abolish the old distinction between finance and operating leases. While, on the face of it, this measure looks like it ought to allow all kinds of leases to be used by the public sector, we need to make absolutely sure that this is what the government actually intends, and we are pursuing the point with them at the moment. How big is the market? In 2017, FLA members provided £128 billion of new finance. £32 billion of this was provided to businesses and the public sector, representing over a third of the UK investment in machinery, equipment and purchased software. L FURTHER INFORMATION www.fla.org.uk

Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Frameworks

NHS recruitment: A new approach on hiring temporary staff The NHS is heading into this winter with significant staffing and performance challenges. Earlier this year, the Crown Commercial Service launched a new framework agreement, RM6160, to give NHS contracting authorities the ability to secure quality candidates regionally and nationally across the UK under a variety of specialisms Health leaders across England have warned that a lack of staffing and failure to address the pensions crisis is putting care in hospitals at risk. The NHS Confederation survey found that workforce, reforming social care, and addressing capital investment feature as the most critical priorities for action. The NHS Confederation said that 76 per cent of health leaders surveyed said that supporting and growing the NHS workforce should be a critical priority, ranking it highest at a time that there are more than 100,000 vacancies among clinical and nursing staff. Beyond this, 90 per cent of the health leaders claimed that understaffing was putting patient safety and care at risk, whilst more than four in five health leaders who took part in the survey believe that the NHS Pension Scheme is having a detrimental impact on workforce pressures, with 69 per cent saying it is damaging patient care.

A further 58 per cent of health leaders surveyed â&#x20AC;&#x153;The views from our members should send by the NHS Confederation believe this winter a clear message to whoever forms the new will be the worst on record for waiting times government on the scale of the challenge and performance across the NHS. This follows facing the NHS and how to make the service news that one in six patients waited fit for the future. Workforce gaps, the longer than four hours in A&E in growing social care crisis and England during October - the historic underinvestment worst-ever performance are the biggest threats The REC since the target was to improving care has sou introduced in 2004. for patients and an alarm nded Niall Dickson, the chief transforming executive of the NHS services, and each of the NH bell over Confederation, said: these issues needs mainta Sâ&#x20AC;&#x2122;s ability to in high â&#x20AC;&#x153;The NHS is heading attention, as do the quality care at into this winter with pension rules which afford significant staffing and are discouraging prices able performance challenges. some doctors from It is therefore little wonder taking on extra work and that health leaders are deeply encouraging others to take concerned about its ability to early retirement. Alongside cope with demand, despite frontline these issues, health leaders are staff treating more patients than ever. clear about the need to reassess E Issue 19.4 | HEALTH BUSINESS MAGAZINE

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Frameworks

 how we measure NHS performance with realistic targets that support staff to focus on the right patients at the right time. “Targets have been a force for good and should not be abandoned, but we need to move away from the current cliff-edge approach where several minutes either side of a target represent success or failure. Any changes must underline the need for rapid access to treatment but in a way that ensures patients with the most urgent needs are given priority. There is no quick fix for all the challenges facing the NHS in England but there is a direction of travel laid out already in the Long Term Plan, and it is at least encouraging that no political leaders are proposing further reorganisation.” With the general election around the corner, a number of parties have pledged to improve NHS recruitment. Despite failing on it’s 2015 pledge to introduce 5,000 new GPs by 2020, the Conservatives are again pledging to recruit 6,000 more GPs in England by 202425 and 6,000 further nurses, physiotherapists and pharmacists in surgeries. This will help produce 50 million more appointments in GP surgeries every year under a Conservative majority government. Labour has said it wants to expand GP training places from 3,500 to 5,000 a year to ease the burden on GPs. The NHS workforce The NHS is one of the top five largest employers in the world. In England alone it employs around 1.3 million people, with a further 300,000 across Scotland, Wales and Northern Ireland, and it is estimated that around two thirds of the health service budget is spent on staff salaries. At first glance, these

The NHS is heading into this winter with significant staffing and performance challenges. It is little wonder that health leaders are deeply concerned about its ability to cope with demand, despite staff treating more patients than ever numbers look healthy, and many would be forgiven for thinking that we should be in a good position to cope with current and future demand. However, the underlying workforce challenges facing our health and social care system are huge, complex and now with Brexit uncertainty, critical. Staffing shortages and rota gaps have been an ongoing issue for the NHS for decades and workforce management has always been under the spotlight. With over 4.5 million people having contact with the NHS every week – and this being forecast to rise with an ever-ageing population – we simply don’t have enough staff. NHS Improvement has reported that over the last year, on average, one in 11 NHS posts in England were vacant, accounting for more than 100,000 staff; in the nursing sector, the vacancy rates are even higher. A survey of recruiters looking at the next five years, reported in the REC’s Public Sector 2025 whitepaper, found that 77 per cent of specialist health and social care recruiters expected staffing shortages to increase significantly. Data from global jobs site Indeed found that jobseeker interest in nursing has not kept up with the rise in demand, and interest

in social care has declined. If these trends continue, recruiting nurses and care workers may become more difficult in the future – at a time when we need them more than ever. Brexit means we need agency staff Self-sufficiency from training UK healthcare staff has been estimated to be in the region of 10 or 12 years, so we need to look at immediate, as well as long-term solutions. No matter how good the NHS’s workforce planning is, there will always be gaps in rotas. The REC’s monthly Report on Jobs consistently shows that nursing, medical and care employees are the most in-demand type of short-term staff. Agency staff have provided a vital lifeline to the NHS for decades. They continue to provide the NHS with the extra support that it needs in times of increased demand, and are vital in ensuring patient safety. Agency staff have skills on a par with substantive staff, often with many years’ experience working in the NHS. It is essential that these staff are recognised for their professionalism and contribution, are treated fairly, are valued and are made to feel part of the NHS family. E Issue 19.4 | HEALTH BUSINESS MAGAZINE

Spencer Clarke Group – First choice for recruitment – sourcing the perfect candidate for any requirement Spencer Clarke Group, one of the UK’s fastest growing temporary and permanent staffing agencies, have recently been awarded a place on the latest CCS and NHS Procurement in Partnership’s Non-Medical, Non‑Clinical framework (RM6160). Spencer Clarke’s expertise is sourcing the perfect candidate for any requirement within the public sector, with temporary staffing teams and buyers already benefiting from their successful bid to supply into the following lots within this framework; Lot 1 - admin and secretarial; Lot 2 - corporate functions; Lot 3 - IT. Spencer Clarke’s devoted staff have more than 60 years’ cumulative experience in placing candidates in temporary and permanent positions within both the private sectors. Their dedicated Weand do public things different here consultants delve deep into first the core Allow us to be your of the client’s business to develop a choi profound understanding about which qualities are essential in candidates. Its team are genuine specialists in their respective fields and have been instrumental in filling positions within 100’s of local authorities, NHS trusts, schools, charities and businesses across the UK.

All clients receive a personalised service, and Spencer Clarke’s innovative, professional and energetic approach, guarantees a first-class service every time. Using the latest, market-leading technology and pro-active approach, they are able to significantly reduce the time it takes to resource a candidate, alleviating the time and pressure faced by their clients, a huge benefit to all within the public sector. Spencer Clarke – which has its

headquarters in Preston – also provide superb post-placement aftercare to all clients and candidates, with a market leading loyalty reward scheme offered to all its agency workers. For candidates and clients, Spencer Clarke is first choice for recruitment. FURTHER INFORMATION www.spencerclarkegroup.co.uk

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Framework ID is RM6160 Lot 1: Admin & Secretarial Lot 2: Corporate Functions Lot 3: IT

 Furthermore, health and social care recruiters are experts in workforce planning, and those working in the health sector see first-hand on a daily basis the shortages that the NHS has to contend with. Recruiters are perfectly placed to identify where problems lie, and are able to offer immediate solutions. They are able to supply staff up and down the country, and often to regions that are less appealing to other workers, as well as offering immediate help in critical situations. The way forward Without an adequate supply of highlyskilled and committed health and social care professionals, the NHS simply couldn’t operate, and certainly won’t be able to operate in the future. It is therefore essential that the NHS invests properly in recruiting the next generation of workers, as well as retaining the staff that they already have. The need for agency staff is not going to go away, particularly in light of heightened demand from patients, and so the NHS

must ensure that it seeks to create a working environment that is favourable to all staff, regardless of how they choose to work. Creating a workforce model that uses a joined-up hybrid of substantive, bank and agency staff will be needed in order to ensure that patient safety is maintained, and that we are able to deliver a health service fit for the future. Staff Bank Services At the start of the year, the Crown Commercial Service (CCS) and NHS Procurement in Partnership began working together in collaboration to deliver the Flexible Resource Pool – Staff Bank Services contract for the NHS and other public. From April, customers and suppliers have been able to benefit from a strong partnership that brings together CCS, as the biggest public procurement organisation in the UK, combined with the extensive expertise and experience that NHS Procurement in Partnership has in the NHS. NHS Procurement in Partnership

is a four hub collaboration between NHS Commercial Solutions, East of England NHS Collaborative Procurement Hub, NHS North of England Commercial Procurement Collaborative and NHS London Procurement Partnership, previously known as NHS Collaborative Procurement Partnership (CPP). The government’s procurement team intended for the two organisations to work closely together, focusing on the forward strategy for the health workforce sector, starting with the re-procurement of Flexible Resource Pool – Staff Bank. Together, they are exploring the whole portfolio of health workforce services, including temporary clinical and non-clinical agency workers, with the intent to partner on the procurement, delivery, and management of these services. A full schedule of the planned phases of procurement will be communicated to our customers and suppliers in due course. Running until July 2021, the agreement will focus on providing staff bank services to NHS contracting authorities but is open to all UK public sector bodies with staff bank needs. Included in the scope of the agreement: set up a flexible resource pool (staff bank); operating and managing an existing flexible resource pool (managed staff bank); operating, managing and employing or engaging a flexible resource pool (fully outsourced managed staff bank); and managing contingent labour. As well as providing support for the procurement development programme for the NHS, the agreement also further E

Frameworks

A survey of recruiters looking at the next five years, reported in the REC’s Public Sector 2025 whitepaper, found that 77 per cent of specialist health and social care recruiters expected staffing shortages to increase significantly

Digital transformation has become a way of life for an ever changing NHS CCS Non Clinical Temporary and Fixed Term Staff Framework gives ICT departments access to IDPPs Project management, statement of works and contingent recruitment services enabling you to deliver your ICT projects in-line with NHS Improvement.

Specialists For Any IT Project Whatever your needs - from a single IT contractor off-site for a day, to a dedicated team of experts to take on a project through FTC, IDPP have the experience and resources to deliver. We are here to work with you throughout the digital lifespan, ensuring that your requirements are always met and that both you and the contractors are able to concentrate on the important tasks. We will be on hand throughout the term to support both sides with any advice needed.

IDPP, Experts In IT Project Delivery Supporting NHS trusts with digital transformation projects, project management and statement of works delivery we also offer risk mitigation and support on delivering ICT projects on time and within budget, all through the CCS framework, making it easy for you to access our recruitment services for ICT recruitment workforce.

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Issue 19.4 | HEALTH BUSINESS MAGAZINE

group

EXECUTIVE RESOURCE GROUP (ERG) PUBLIC SECTOR RECRUITMENT SPECIALIST

ERG are a highly regarded and respected workforce partner to the public sector, assisting authorities and departments to drive efficiency savings through the deployment of key hires. We work with clients to improve and enhance the delivery of their services into the communities in which they serve. We view compliance as an essential ingredient to aid our clients and we work through the primary frameworks that exist to onboard interims, including NMNC, PSR, DOS, G-Cloud and MSTAR. Our consultants are grouped into vertical service streams aligned to the public sector; Central and Local Government, Healthcare, Blue light, Housing and Education. At the heart of what we do runs a spine of transformation and change. If you are a candidate that is regarded as an expert in your field and/or an organisation in need of a critical hire, ERG would love to hear from you.

As a Crown Commercial Services Provider, Graham Matthews is a leading supplier of non-medical, non-clinical staff to the NHS. If you are an NHS Trust, CCG or private healthcare organisation, get in touch to learn how we can support your temporary staffing. www.graham-matthews.co.uk nb@graham-matthews.co.uk 0207 183 4587

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Frameworks

Health leaders across England have warned that a lack of staffing and failure to address the pensions crisis is putting care in hospitals at risk  supports NHS England and NHS Improvement in their ongoing initiative to reduce agency usage, expanding the use of staff banks, in particular for medical staff. The NHS recruitment challenge Writing in October to Secretary of State for Health and Social Care, Matthew Hancock, the Recruitment and Employment Confederation sounded an alarm bell over the NHS’s ability to maintain high quality care at affordable prices. Neil Carberry, chief executive of Britain’s leading recruitment body, said that if the frameworks that the NHS uses to procure temporary staff remain focused only on buying the cheapest option, quality of care may suffer. Firms with high standards are increasingly finding they can’t afford to work with the health service. Furthermore, agencies leaving the market would mean staff shortages that will cost more to fill through high cost, emergency routes. Delivering high standards of patient care at good value is at the heart of what NHS staffing firms do. But there comes a point where firms simply cannot supply at the prices offered, leading to market exit – a trend we have seen in social care and public sector infrastructure already.

Pointing to the high level of cost savings that agencies have already delivered for the health service, Carberry said that ‘agency providers deliver at rates below those of NHS banks’ and noted that ‘fees paid to agencies have come down substantially as we reach the fourth year of caps’. In the letter, the REC points out that where government enforces unrealistic frameworks it creates instability and an unsustainable market. This always ends up leading to higher costs for the taxpayer in the long term: The letter reads: “The government learned from the Carillion collapse what happens when unsustainable contracts are forced through by public procurement – only firms willing to take uneconomic business remain... Some recent procurements are pitched at levels that are likely to drive firms to exit NHS on-framework supply.” This could have especially serious consequences as we run up to high demand winter months. According to the REC’s latest Jobs Outlook report, employers’ confidence in the UK economy has dropped to the lowest level since mid-2016, with confidence levels having fallen to a net figure of -34 in the run up to the general election.

RM6160 As part of the Workforce Alliance, NHS Procurement in Partnership and CCS launched a new framework agreement, RM6160 – Non Medical Temporary and Fixed Term Staff (NCS), in July. This framework is made up of six lots. Lots 1-6 give NHS contracting authorities and all UK public sector bodies, such as local government, universities, charities and blue light services the ability to secure quality candidates regionally and nationally across the UK under a variety of specialisms including, but not limited to: lot 1 - administration and secretarial roles; lot 2 - finance, accounts and audit roles; lot 3 - IT technicians, analysts and technical engineer specialist; lot 4 - legal secretaries, paralegals and lawyers; lot 5 clinical coders and health records secretaries; and lot 6 - caterers, drivers, security, estates and maintenance roles, such as general labour, specialist labour e.g. electricians and surveyors, environmental and scientific roles for example EA and senior assistant scientists. Quality assurance inspections are carried out to make sure all temporary and fixed term workers are compliant in accordance with NHS Employers Check Standards and Skills for Health NHS roles. Contracting authorities will be able to specify what pre-employment checks are needed, for example Baseline Personnel Security Standard (BPSS). The following methods of hire can be used under this framework: temporary staff, fixed term staff and nominated worker. A temporary worker employed on an hourly or daily charge rate, whilst fixed term staff will be paid through your payroll but have a fixed end date to their employment. E

Issue 19.4 | HEALTH BUSINESS MAGAZINE

NISI Staffing - Clinical & Non-clinical staffing agency NISI Staffing are one the providers of Medical and non-medical staffing into the public sector. Clients from public and private sectors can access support, expertise and highly effective recruitment for the following resources under national framework agreements: •Medical Locum and Nursing Staff • Admin & Clerical Supply • Ancillary Staff We are really pleased to announce that NISI Staffing has been named as a supplier on RM6160 – Non-Clinical Temporary and Fixed Term Staff Framework, released by The Workforce Alliance in August 2019. NISI Staffing is also part of the current H.T.E and CPP frameworks for the supply of medical locums and nursing staff. NISI Staffing offers innovative medical & Non Medical recruitment solutions and provides bespoke solutions with a personal touch, tailored around client requirements.

We focus heavily on our professional service, consistently delivering quality professionals nationwide. As a successful provider in the provision of locum doctors, nurses, and non-clinical staff, NISI Staffing continues to strive for excellence. Our core focus is on raising the standard in medical locum provision and we have developed an organisation-wide philosophy of continual improvement to ensure we always exceed client and candidate requirements.

For further information and to discuss opportunities please contact the following: Aneesa Hameed Tel: 0116 2795175 Mobile: 07525353196 Email: aneesa.hameed@nisistaffing.co.uk

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Rate cards There are two different rate cards for customers, both giving the same values but one is personalised for NHS customers to account for NHS E/I caps while the other is for the rest of the public sector to use. Customers can type in a candidate pay rate and the rate card will calculate a full charge rate for whichever supplier is selected. This will include all costs for hiring a temporary worker using this agreement. This rate card will also give information on costs for hiring a fixed term worker or transferring a worker onto a permanent contract. As part of these rate cards the Workforce Alliance have included an award support tool which will help customers to find suppliers who can provide different roles in different regions. This will rank the eligible suppliers that fulfil the criteria, in price order, to help customers to select the most economically advantageous tender. If it’s clear from all the contract documents which supplier is making the most economically advantageous offer, you can direct award. The service you are getting, its supply and cost would all need to be accurately and completely defined. Identify all suitable suppliers, going from the lot descriptions and regions supplied with services. CCS offers a simple tool to help with this, matching the staff you need to the suppliers offering them. You can then rank them according to how economically advantageous their offers are. Go to each in turn until you’ve filled the position. Further competition The Workforce Alliance can help customers to work out their requirements and best route to market through the framework, offering advice and help to put together a further competition based on your needs. You’ll

need to run a further competition where the contract documents don’t accurately define the service you need, its supply and price. Although basic terms cannot be renegotiated, they can be added to, where your particular service requirements could not have been foreseen when the agreement was written. To run a further competition: identify which suppliers can meet your needs; then invite all suppliers who can to bid; send further competition documents to all capable suppliers, leaving reasonable time for them to return their tenders. You cannot introduce new award criteria, but you can modify them if they are taken from the original award criteria. You will need to let the suppliers to know you are doing this; evaluate the returned tenders against the award criteria; you can adjust your evaluation plan and weightings within the range limits to reflect your circumstances and requirements; award the supplier with the most economically advantageous offer

over the lifetime of this framework award.” Utilising the existing NHS workforce According to official figures, there were six per cent more staff across the NHS at the time of the last election than there were three years previous to 2017. However, writing for Health Business at the time, APSCo’s Nick Bowles said that this is not reflective of what recruiters are seeing on the ground. The staffing firms that APSCo work with reported that trusts are continuing to struggle to recruit the volume and quality of clinical and non-clinical professionals they need to keep abreast of ever increasing demand. Candidate pools, meanwhile, are subsequently shrinking in response to ongoing legislative changes and other external factors – not least Britain’s decision to leave the EU. There is no escaping the fact that the NHS is facing a recruitment crisis, with an

Frameworks

 Listed amongst the benefits of the framework are the wide range of suppliers available, including SME’s, specialist niche suppliers and managed solution options. This is in addition to knowledge that framework rates are set to a maximum, meaning they cannot be increased but may be negotiated to a lower rate between both parties, and that signing up to the framework is free of charge: you don’t need a membership and there are no hidden or additional charges. Furthermore, transparent rates and costs show charges for both PAYE and limited company temporary workers, including fixed term appointments, and there is the ability to direct award, giving choice and flexibility to hiring managers and reducing time to hire by avoiding competing for all requirements. Additional savings are also achievable through a range of discounts, including nominated worker, volume-based level, prompt payment and length of placement discounts. The NCS framework is primarily focused on the provision of non clinical temporary and fixed term staff to NHS contracting authorities; however, the framework is accessible to all UK public sector bodies such as local government, universities, charities, blue light services and central government.

Targets have been a force for good and should not be abandoned, but we need to move away from the current cliff-edge approach where several minutes either side of a target represent success or failure (the highest score); if the supplier can’t deliver, you should go to the supplier with the next highest score, and so on, until your requirement is met; whether by direct award or further competition, you can contract for a defined period of time, provided it starts within the duration of the agreement. Nigel Tucker, regional director for Europe at Spinwell Global, said: “Winning a place on this framework is a great achievement for Spinwell Global and very much part of our strategy to assist the government’s policy to provide cohesive support to both the organisation and SME’s and continue the Spinwell Global growth and efficacy. “Spinwell Global already has many years’ experience of having successfully supplying other frameworks for government contingent labour and hope to be accelerating this as demand grows in the coming years and beyond - helping government reduce the cost of resources whilst ensuring a flexible workforce continues to enable essential projects effectively. This win really does help cement the Spinwell Global aspiration of growing as a resource supplier.” John Laycock, partner at Anderson Quigley said: “We are delighted to have been named as a preferred supplier on this important public sector framework; it will allow us to provide both existing and new clients, working across the entirety of the public sector, with proven Non Clinical temporary and fixed term staff to help deliver on the government’s public sector agenda. We are particularly delighted that the framework will allow public sector clients to choose Anderson Quigley on a direct call off basis and we look forward to partnering with all parts of the public sector

estimated shortage of at least 50,000 doctors and nurses across the health service. Data shows that the number of health visitors working in the NHS in England dropped by 18 per cent since local councils became responsible for commissioning public health services in autumn 2015, while England needs 20,000 extra nursing staff, according to the Royal College of Nursing (RCN). This number has increased in the years since, with the UK also needing more doctors. Sourcing the right skills It is no great surprise, then, that NHS trusts are also finding retaining existing staff to be problematic. In 2017, the Nursing and Midwifery Council (NMC) published shock data showing its register had shrunk in size for the first time in recent history – from 692,556 in 2016 down to 690,773 in March 2017. The figure dipped again to 689,738 in the September, representing a loss of 1,678 registrants in the space of a year. Since the introduction of pay caps for agency workers in the NHS, which were introduced in 2015, trusts are still being forced to go off-framework, or ‘break glass’, to source the skills they need. As Poturicich notes, NHS trusts are also placing healthcare professionals on assignments in areas that they are not always experienced in, or comfortable doing, such as putting general nurses in A&E – to the detriment of patient safety. Prioritising cost over patient well-being is unfortunately becoming more common-place. The most effective and ethical recruiters are ensuring that they are able to continue to provide the trusts they work with the talent they need through superior candidate E Issue 19.4 | HEALTH BUSINESS MAGAZINE

proud to be a supplier on

flexible resource pool - staff bank. reach out to our experts today to find out more. We can support with: • • • •

randstad public services.

setting up a flexible resource pool operating and managing an existing flexible resource pool operating, managing and employing or engaging a flexible resource pool managing contingent labour

juliett.shackleton@randstad.co.uk carol.brooder@randstad.co.uk

Frameworks

 engagement strategies. However, offering professionals support with revalidation, CPD or relocation only goes so far. It’s a zero sum game - overall supply simply doesn’t match demand – and things could be about to get much worse. Aside from frontline healthcare professionals, the APSCo members also frequently report difficulties in recruiting non-clinical contractors into the NHS. This is largely due to the fact that public sector organisations are shouldering the costs of recent changes to legislation around ‘Off-Payroll’ working. Hirers in the public sector have been responsible for determining the status of an assignment to supply services through a Personal Services Company (PSC). Contractors deemed to be working ‘inside’ IR35 legislation are taxed in the same way as employees, even though professionals operating through this model have no employment protection rights and have no certainty of continuity of work. Bowles says that 45 per cent have witnessed the costs of resourcing contractors increasing since the new rules were introduced. Of these, 46 per cent reported that rate rises were in excess of 15 per cent. As well as increasing spend, public sector organisations are also having to contend with shrinking talent pools, with the majority (70 per cent) of respondents reporting that contract numbers in the public sector have decreased since April 2017. The increase in rates which has been noted can be attributed to two factors: the scarcity of resource created by candidates moving into the private sector and the

The Workforce Alliance and Crown Commercial Service can help customers to work out their requirements and best route to market through the RM6160 framework market adjusting by passing on additional tax and NI costs to the public sector client. Reports that non-clinical specialists are abandoning contracts - including a highprofile multi-million pound NHS IT project - may not have the immediate impact on patient safety that shortages of clinical staff bring, but they will no doubt impact longterm budgets and operational efficiency. The number of staff working within the NHS may be up six per cent since 2014, but during the same period, emergency admissions have increased by ten per cent, ambulance calls

are up 15 per cent and demand for diagnostic testing has risen by around a fifth. We need to ensure that the health service has access to the skills it needs to manage this increase in demand moving forwards, and that relies on not only solid talent pipelining strategies, but also a commitment to valuing and retaining the valuable skills of the existing workforce. L FURTHER INFORMATION www.crowncommercial.gov.uk/ agreements/RM6160

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THE

GARDEN ROOM

AT HAMPTON COURT PALACE

Our history, your story Host your next conference, away-day or corporate party in this unique and inspiring venue set in Henry VIIIâ&#x20AC;&#x2122;s former jousting arena. hrp.org.uk/hire 020 3166 6507

Conferences & events

Where to look when you are about to book Is it all about location, location, location? Using advice from sister publication Government Business, HB provides a holistic analysis of what the public sector should look for when booking facilities for conferences and events Many cities claim to be the ideal venue destination, and many facilities encourage clients to look no further than their array of offerings – but what exactly should someone be looking for when seeking to book an event for their company or organisation? It it all about best value for money? Is simple best? Can scenery be overlooked? Or are the views all that matter? The answer comes down to the purpose of the meeting and the rest becomes easy. The days when clients were happy to sign off expenditure without question of its relevance are over. Every penny has become accountable, especially within the healthcare sector, and there is a determination to optimise every minute of venue hire time. For the events sector, this has led many to make their offerings cheaper. For others, it has meant singling in on one aspect of its offerings that will make future clients book their facilities – and it is these specialities which you should be encouraged to seek. The scenic route With many eyes focused beyond the wintry nights of December, January and February, there is an understandable appeal to conferencing venues which have just as much to enjoy outside as in. A Spring setting can be a weighty appeal. While the event or meeting can take place inside or outside, depending

business trips to the UK coast is estimated at on weather, purpose and preference, there is around 3.3 million a year, bringing with it an something about a picturesque setting that estimated spend of just under half a billion draws in clients, particularly if the event is pounds. Of course, coastal resorts have not being hosted over a number of days with been immune to recent economic spare time allotted for exploring the pressures but nonetheless, surrounding areas. Price and these figures clearly illustrate availability are key factors There the scale and worth of in decision making, but is plent business tourism in research has shown seaside resort towns.” that, more often than be gain y to e The promise of not, location is given d f r c o h m oosing fresh sea air and a higher preference to have meetin when choosing a relaxed ambiance a g , or even conference has always been meeting venue. t in a cu a natural draw for Places to walk, explore hot spo ltural visitors to the British and spend time outside t coast. Much of the of the venue lead many popularity stems from the clients to places such as connotation of coastal areas Brighton and other seaside as relaxing, a trip of escaping locations. Frequently heralded the busy normalities of daily work. as the sunniest place in the UK, Many less formal events will involve staff Brighton’s Eastbourne setting presents a undertaking fun, social and interactive premier conference destination on the south activities – such as team building exercises. coast. Just an hour and a half from London, the iconic white chalk cliffs of Beachy Head and the acres of spectacular South Downs Considering culture National Park countryside that surround it If the seaside is not quite the location that are just two images that come to mind. is desired, there is plenty to be gained from Peter Hampson, director of the British Resorts choosing to have a meeting, conference or event & Destinations Association, also explains that: in a cultural hot spot. Arena and Convention “According to the United Kingdom Tourism Centre Liverpool (ACC Liverpool) is a state-ofStatistics (2008), the volume of overnight the‑art, international conference centre situated at the heart of Liverpool’s Waterfront and just a stone’s throw from the popular Albert Dock area, which has revolutionised the city’s conference offering since it opened in 2008. As the city of The Beatles, UNESCO World Heritage site and host of the International Festival for Business in 2014 and 2016, culture is one thing that Liverpool has never lacked. Liverpool is a world-class destination for both leisure and business travellers, with more national museums than any other UK city outside of London. What is less well known is that all of these museums can be hired for meetings and conferences, offering some truly unique backdrops for your event. One of the E

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Modern events with heritage Placing sustainability at the heart of everything we do For almost 100 years BMA House has sat in the heart of London. Designed by Sir Edwin Lutyens and opened by King George V, our remarkable, Grade II listed building makes today’s special occasions all the more spectacular. Whether it’s a conference, social event or wedding we have a true history of hospitality. Sustainability is a way of life for us and our Gold Green Tourism accreditation proves we are experts in this field. We are incredibly passionate about food, placing delegates’ wellbeing at the forefront of all menus. Bringing seasonal food to your event; we support British farmers meaning a delegates’ carbon footprint is lower. With years of experience in corporate hospitality, our team is here for you to ensure that your event surpasses all of your expectations. Get in touch and start your journey with us...

BMA House Tavistock Square London, WC1H 9JP

T: 020 7874 7020 E: events@bma.org.uk bmahouse.org.uk

@bmahousevenue /bmahouse /company/bma-house

The pull of the Capital London has a unique environment that nurtures talent, a work ethos that supports business growth and a unique diversity that allows innovation to thrive – there is no denying that London has all the key ingredients to allow every person or business to excel to new extraordinary heights. Many are attracted by London’s dazzling culture and its unparalleled heritage whilst others are drawn to London’s constantly changing physical and economic landscape. But why does London have such a pull over event planners? Many businesses, local, national and international, have there offices or headquarters in London and are therefore already aware of it’s array of meeting spaces, buzzing media industry and catering capabilities. For those residing and working away from London, the capital can be something of a treat – from sight-seeing to shopping, and green parks to eating out. London offers visitors the best of the old and the new. Historic landmarks and contemporary venues sit side-

by-side and many can be hired for meetings or private events. The Shard, the London Eye, Tower of London, St Paul’s Cathedral, Kew Gardens and the Olympic Park are just some of the headline acts. Another major benefit of London’s cultural offering is that many of the events or museums in the capital are free – which is a huge cost saving to any delegate and a perfect way to compliment any business programme or offer a huge cost saving in your own downtime. With ever-rising numbers of business and leisure visitors to London, a variety of new hotels are opening across the capital. Going green Following the success of the Olympic Games in London in 2012, the events industry took a bold approach to creating their own legacy. Large events now have ISO 20121 to help them bring sustainability to their supply chains and event planning – considering energy output and monitoring waste and water usage. The ‘green tourism’ brand is becoming increasingly well-known across the country, with venues reducing the environmental impact of the meeting for their clients. For organisations aiming to reduce their energy output on a day to day basis, such an incentive can be very appealing. As such, since it was first set up in 1997, the Green Tourism Business Scheme (GTBS) has been championing the cause of sustainable tourism in the UK, and with over 1,800 UK based members, it is the most successful scheme of its type in the world.

Conferences & events

 most visible is the Museum of Liverpool itself, a stunning £72 million structure at the heart of the waterfront, which, with its modern galleries overlooking the Mersey, can host up to 1,000 for a drinks reception or 200 in theatre style. Comparitively, Glasgow, not short of culture itself following the Year of Food and Drink and the upcoming Year of Innovation, Architecture and Design, is host to the Edinburgh International Conference Centre (EICC) and the SSE Hydro, two of the most recognisable destinations across Scotland.

Sustainable venues can be spotted in a number of ways. It may originate in the menu they supply, with local, seasonal foods being cooked, or it could be the sponsor or donation that they recommend. ACC Liverpool, completed in 2005, was designed to produce half the CO2 emissions it would without any environmentally-friendly measures, whilst using 20 per cent less electricity. The venue has been a GTBS Gold holder since 2008. Lighting is high efficiency and controlled by motion detection, while the rainwater collected on the roof is used to support flushing toilets, accounting for about 40 per cent of the water used for toilets in the venue. Furthermore, five, 20-metre low noise wind turbines on the river side of the venue contribute to their electricity supply. This means that they have a reduced impact per attendee and they continue to develop projects to ensure all events have sustainable features. Corporate responsibility is influencing the market, and a lot of clients will book again the following year, or even later that same year, if they find the venue to their liking. When people buy into events and venues it’s often because of the stories they can share or become a part of. We see this regularly with concerts, sports events or high profile restaurants. Being part of an ongoing success story can be very good publicity for a company, and green tourism thrives on that particular aspect of their venue. L FURTHER INFORMATION www.governmentbusiness.co.uk/features/ where-look-when-you-are-about-book

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visual equipment. Meeting, event hire for up to Meeting, event hire for up to 60 people with catering. Meeting, eventMeeting, hire for up tohire for up to event 60 people with catering. 60 people with catering. 60 people with catering. Please telephone 0208 305 4188 Please tephone 0208 305 email us at Please telephone 0208 or email us4188 at305or4188 Please tephone 0208 305 4188 or email Thamesbarriertheview@environment-agency. Please telephone 0208 or email us at 305 4188 us at Please telephone 0208 305 4188 Thamesbarriertheview Please tephone 0208 305us4188 or email us at gov.uk for more details. tephoneThamesbarriertheview@environment-agency. 0208 305us 4188 or email at atusfor more details. Thamesbarriertheview @environment-agency.gov.uk or email ator email Thamesbarriertheview@environment-agency. gov.uk for more details. Thamesbarriertheview @environment-agency.gov.uk for more details. sbarriertheview@environment-agency. Please note there is no access on the Thames Barrier Structure. Thamesbarriertheview Please note there is no access onto the Thames Barrier Structure. gov.uk for more details. @environment-agency.gov.uk for more details. Please note there is no access on the Thames Barrier Structure. gov.uk for more details.

Whitefoot Photography

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with the option of ownership thereafter. Specialising in the highly efficient and intelligent conversion and control of energy for over 70 years, Fronius has partnered with some of the UK’s biggest brands to deliver financial savings, carbon reductions and energy independence. Beate Ruebig, managing director of Fronius UK, said: “We recognised that the upfront cost associated with a Solar PV installation was prohibiting companies from achieving enormous savings with the technology. Our vision is to see a future powered 100 per cent by renewables, so we wanted to open up the opportunity to businesses so they can produce their own green electricity and this spurred the creation of our unique lease offering that offers customers savings from day one and greatly reduces their carbon footprint.” Throughout the duration of the lease, the monthly fixed payments will be lower than the cost of that same electricity if purchased from the energy supplier at today’s rate kWh for kWh. (This is based on consumption remaining as per the original calculations in the quote and the accuracy of data provided to us). This enables you to make huge savings from the outset and protects you against increasing energy prices for years into the future. Furthermore – there is a production guarantee for the duration of the contract. This means that if the system produces less than guaranteed, a reimbursement will be issued for the underperformance – a risk-free arrangement.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Gone are the days of feed-in tariffs where the aim was to send as much electricity back to the grid as possible in exchange for a nice sum. Instead, the system should be sized to generate as precisely as possible the amount of electricity required to run the building within peak hours during the day. After completing a thorough analysis of the roof or land space available and current electricity usage, the optimal size and set-up can be established. A certified Fronius Service Partner will install the PV system to the highest specification. High quality engineering drives everything that Fronius does, so you can rest assured you’ll be getting the highest quality products from the very best manufacturers. There are no ongoing maintenance costs, this is all included. You won’t need to worry about maintenance or insurance of the system throughout the duration of the lease. It really is a win-win. Please note, the lease does not replace your electricity bill completely. Although the system is optimally sized for your building’s consumption, electricity required above that generated, or used in non-daylight hours will still be taken from the national grid and billed via the energy supplier. The message here is clear: Don’t miss out on the benefits of photovoltaics for your organisation because investment priorities lie elsewhere right now. More about Fronius Headquartered in Austria and established almost 75 years ago, the technology company has over 1,200 granted patents and over 4,760 employees worldwide. In the UK, Fronius has a large technology centre in Milton Keynes that houses their warehouse, tech support team, classrooms, product showroom and offices. The vision of the company is ‘24 Hours of Sun’ – with the goal to create a future where 100 per cent of the energy needs of the planet come from renewable sources. Dedicated to building products that will last a lifetime in the harshest conditions, all Fronius products go through extensive tests. Its high standards have named them quality leader in solar electronics since 2002.

Find out how much you could save now by calling 01908 512300 or visit www.solaryourbusiness.co.uk L FURTHER INFORMATION www.fronius.co.uk

Diane Bell looks at how value-based care can happen at a greater scale and what steps healthcare leaders should follow to transform lives and create a positive human future Value-based care (VBC) – the ability to improve outcomes using the resources available – is recognised worldwide as a laudable ambition for healthcare services. Having seen VBC used to great effect with clients to improve people’s lives, we believe patients would benefit from its widespread adoption in the NHS. And yet, even though VBC has been discussed and promoted for over a decade, only pockets of providers have embraced it. So, how can VBC happen where you are? We recently spoke with global healthcare leaders to understand their perceptions of VBC, and how they differed across global regions. Results revealed that value in healthcare was perceived to be increasing,

Patient outcomes

Making value-based care happen

less likely to focus on improving population health, compared with other global regions. This may be because we take for granted that the NHS is a population-based service because it is funded and arranged in that way, unlike in the US and Nordics. However, it also suggests a relative disinterest in the NHS in prevention and early intervention – key tenants of the population health approach – compared with other global healthcare systems. Finally, we found that, while respondents are aware of the existence of VBC case studies and approaches, there continues to be appetite for learning to be shared. So, as the early adopters mature in their use of VBC, information about their experiences needs to continue to be made available, demonstrating not just how to establish VBC but how to make it flourish.

regardless of geographic location. This was due to improving patient satisfaction and quality of life, and not necessarily from reducing healthcare costs. While this was celebrated by participants in regions such as the US and Middle East, it seemed to Making VBC relevant be less appreciated by UK participants We all need to be smarter about making working in a system where the emphasis is VBC relevant to NHS professionals on cost-control and population-based and managers. And this doesn’t approaches are taken as standard. have to be complicated or According to the research, difficult. For example, in the UK was more likely to We all a West Midlands NHS focus on the operational need to trust, patients referred issues relating to VBC b e smarter to their outpatients – integrating care a b making out physio clinic are and streamlining to NH VBC relevan asked to complete E processes – and

and ma S professiona t ls na doesn’t gers, and this ha complicve to be or difficated ult

Issue 19.4 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

GOJO Industries – How to stay well this winter Handwashing is critical to preventing winter infections. Healthcare workers already make this part of their daily lives, but more must be done to influence healthy hand hygiene behaviour amongst visitors and patients themselves, says Chris Wakefield, Vice President, European Marketing & Product Development, GOJO Industries-Europe Ltd

Statistics have revealed that 25 per cent of people don’t wash their hands after using the washroom, while a recent poll by the Royal Pharmaceutical Society reported that an alarming 84 per cent don’t wash long enough to be effective Winter is a time when infection rates traditionally peak. The strain of influenza (‘flu’) last year, for example, was so virulent that it left people who were previously fit and healthy critically ill – in fact more than 2,000 Britons needed life-or-death treatment in intensive care units. The flu jab helps people to avoid contracting this particular dangerous illness, however there isn’t preventative medication available for all the different and unpleasant germs that are prevalent during the winter season. Norovirus (more commonly known as the winter vomiting bug), coughs and colds are just a few of the other viruses that often strike at this time. Fortunately, there are other precautions you can take. Hundreds of studies have proven that the simple act of handwashing can break the chain of infection. It is therefore critical that healthy hand hygiene is practised, especially in GP surgeries, clinics and hospitals. After all, viruses thrive in closed environments where people come into constant contact with each other. Doctors, nurses and health care workers already practise healthy hand hygiene frequently and effectively, yet more must be done to educate the wider public to play its part too. Shocking statistics have revealed that

25 per cent of people don’t wash their hands after using the washroom, while a recent poll by the Royal Pharmaceutical Society (RPS) reported that an alarming 84 per cent don’t wash long enough to be effective. Furthermore, the smart devices carried into healthcare facilities by patients, visitors and staff are also rife with germs. Research has found that smartphones could be covered in up to ten times as much bacteria as a toilet seat and that people check them every 12 minutes of the waking day. When you consider that contaminated hands can sequentially transfer some viruses to up to seven surfaces, and that fourteen people can be contaminated by touching the same object one after the other, it’s clear to see how infections can spread so easily. To help people stay healthy, everyone has a responsibility to keep their hands hygienically clean. Influencing healthy behaviour As a member of the World Health Organization (WHO) Private Organizations for Patient Safety group, GOJO is a strong advocate of the ‘total solution’ approach to making hand hygiene second nature to everyone in a healthcare setting. This approach recognises and combines three key strategies to

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

successfully influence behaviour: signage; accessibility; and formulations. Firstly, placing educative signage is a good start when it comes to raising awareness and increasing hand hygiene compliance. Notices and posters located at key germ hotspots, such as washrooms and waiting areas, are very effective as a prompt. Not only do they remind people to wash or sanitise hands, they can also illustrate the correct technique to achieve best practice. Secondly, facilities must be accessible and simple to use – it must be easy for patients, visitors and health care workers to clean their hands. According to WHO recommendations, an adequate number of appropriately positioned hand hygiene facilities should be readily available at the point of care, ideally within arm’s reach of where patient care or treatment is taking place. As well as in these ‘patient zones’, it is a good idea to position hand washing or sanitising facilities at other critical points, such as patient waiting areas, and the entrance to the building. Research has revealed that one single contaminated door handle can infect up to 60 per cent of the occupants of a building within just four hours. The GOJO PERFECT PLACEMENT™ programme also advocates placing a sanitising dispenser at washroom exits. This offers an additional opportunity for hand hygiene. Thirdly, the formulations of soaps and sanitisers are crucial. The high frequency with which hands should be washed or sanitised means that the formulations must be gentle yet effective against germs, complying with key hospital norms EN 1500, EN 14476 and EN 12791. When selecting a hygienic hand rub, a popular choice in many healthcare settings, ensure it is formulated with at least 70 per cent ethyl-alcohol, which has been clinically proven to kill germs within seconds. Having an effective hand hygiene system in place should be a key infection prevention strategy in healthcare settings, particularly in the winter months when seasonal viruses peak. Encouraging patients and visitors, as well as staff, to practise hygienic behaviour is the first step to a healthier winter germ season. L FURTHER INFORMATION Tel: +44(0)1908 588444 www.GOJO.com

 and return a short questionnaire that is then used to categorise their risk of a poor outcome. Based on which category a patient falls into, the clinic staff decide which type of practitioner is best suited to meet their needs. The result? Patients get to see the right professional for their needs from the outset, junior staff aren’t overwhelmed with complicated cases, and senior staff feel their skills are being put to best use. A win-win for patients and staff alike, and a simple example of taking a VBC approach. Alongside this, we need to do more to celebrate our successes and, with that, promote better value healthcare as being just as important (if not more) as cost savings. For example, since 2014, all musculoskeletal (MSK) care in Bedfordshire has been delivered by

Patient outcomes

As the early adopters mature in their use of VBC, information about their experiences needs to continue to be made available, demonstrating not just how to establish VBC but how to make it flourish a single integrated service called Circle MSK, which is free to NHS patients. Over the last five years, it’s improved patient outcomes, reduced waiting times, improved satisfaction, invested in technological innovation and biomechanical treatments as alternatives to surgery, as well as delivering an estimated £19 million in cost savings. Such experiences are not unique to Bedfordshire either – the first two years of a similar model in Greenwich are producing similar results. And this is without falling into the traps of cream-skimming or reducing quality of care. In Bedfordshire, the integrated MSK system managed 14 per cent referral growth on a fixed budget, and received a highly positive report from the Care Quality Commission after its inspection in September 2018. Getting started It can be done. To get started, there are six simple steps: 1. Just do it There will always be plenty of reasons not to start such as ‘it’s not the right time’ or ‘I need permission to do this’ but, as the examples illustrate, the benefits you stand to achieve will outweigh any potential reasons not to start. 2. Build trust by being realistic Start small with a few passionate people and grow. Be sensitive to the burden of change on already stretched clinicians. Describe the benefits to them from their perspective and from their patients’ viewpoints.

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3. Organise the change around patients Find out more about who your patients are and what matters to them, so you know how to design care that makes a positive difference in their lives. This can be as simple as talking to them and asking them, making patient engagement activities meaningful. 4. Get a grip on data Work out what’s important to know about and what isn’t, when you need to know it and when you don’t, and how you can simply and easily capture it. 5. Learn from those a step ahead The networks and case studies are out there, through LinkedIn or through organisations such as the International Consortium for Health Outcomes Measurement (IHCOM). Tap into them and don’t be afraid to ask. 6. Remember why you’re doing this Don’t get lost in the details of actions and plans. Keep aiming to improve the outcomes of those you serve. With the benefits of VBC recognised globally, there is clear appetite to make it happen at a greater scale. By taking the steps above, healthcare leaders can make VBC happen across the NHS – transforming lives and creating a positive human future. L

Diane Bell is a healthcare expert at PA Consulting. FURTHER INFORMATION www.paconsulting.com

Issue 19.4 | HEALTH BUSINESS MAGAZINE

www.healthbusinessuk.net Published by

020 8532 0055 www.psi-media.co.uk

ASBESTOS

RENTAL EQUIPMENT

Property surveying and consultancy services

Innovating in NHS equipment rental solutions

Pennington Choices has worked with asbestos for over 30 years, helping clients across a host of sectors including: healthcare, transport, local government, blue light services, social housing, construction and retail. The company is an expert in asbestos management not by its own words but by its clients. Asbestos services at Pennington Choices include: surveying, air monitoring and four stage clearance testing, sampling and laboratory analysis, project management and remediation, auditing, procurement, consultancy, asbestos management plans and training. The organisation is accredited to ISO17020 and ISO17025 by UKAS and UKATA accredited for training. Pennington Choices has dedicated UKAS accredited laboratories, provides an emergency out of hour’s asbestos service, which operates

Medstrom Healthcare manages over 20 per cent of the bed and mattress fleet. The company offers a unique range of specialist equipment rental solutions, all designed to deliver exceptional added value to their NHS customers. At a time when bed occupancy levels are remaining at unsafe levels all year round, patient vulnerability is increasing and capital funding is under extreme pressure, specialist equipment rental offers a valuable short or longer-term solution to these challenges. Medstrom’s rental offering includes ad-hoc daily equipment rental, longer-term bed rental and the unique Medstrom Now, all flexible and cost-effective options to improve patient outcomes. Another new and innovative rental service offered by Medstrom is Medstrom Now, designed to remove all barriers to accessing a specialist equipment rental service. It is a transparent, flexible and cost-effective service

24/7, and offers nationwide coverage meaning that, no matter where you are in the UK, its expert teams can help you. Alongside providing a wide range of asbestos services, Pennington Choices’ teams also deliver: fire risk assessment services; electrical and gas auditing; legionella services; stock condition surveys; energy performance certificates (EPCs); strategic consultancy and chartered building surveying services. The company’s full breadth of services makes it unique and provides its clients with a cost and time effective solution.

FURTHER INFORMATION Tel: 0800 883 0334 www.pennington.org.uk

WASTE MANAGEMENT

Tackling the challenges of mattress recycling

They said it couldn’t be done – many companies have tried to develop an automated solution for recycling mattresses and bulky waste, but up to now none have yet succeeded. Textek has invested 18 months into the research and development of the first Bespoke Mattress Shredding Line, that will divert a staggering one million mattresses a year from landfill. Its design enables the successful separation of the flock from the steel, ensuring 100 per cent of the mattress can be recycled. Textek believes that this line provides a stable

future for mattress recycling and reduces the hard, often dangerous, manual work that is required when stripping a mattress by hand. On average a skilled person can strip a mattress in around seven minutes. The Textek Shredding Line is able to dismantle a mattress in under 30 seconds. The company plans to install more TexTek plants around the country to help with the on-going challenges of mattress recycling.

FURTHER INFORMATION Tel: 01948840251

which eliminates many of the challenges hospitals currently face with their service providers. Medstrom Now removes unrealistically high delivery and collection charges that are applied by many service providers and guarantees immediate access to equipment by ensuring that products are always available on-site. In an increasingly costconscious market, this unrivalled rental service offers a way to make significant cost savings.

FURTHER INFORMATION Tel: 0845 371 1717 info@medstrom.co.uk www.medstrom.com

SIGNAGE

Environmentally friendly NHS signage solutions

NovaDura offers a range of highly-durable, vandal-resistant printed signage solutions with anti-bacterial and antimicrobial protection available for hospitals and the health sector. Antimicrobial protection signage is intended for the protection of surfaces in hospitals or areas that require an equally high degree of hygiene. Whilst not a substitute for good hygiene/ cleaning practice, during testing incorporated coatings led to significant decreases in microbial contamination within just 15 minutes and reductions of up to 99.5 per cent in two hours against a range of clinically significant bacterias including: MRSA, MSSA, E. coli, Legionella

pneumophila, Salmonella and H1N1 virus amongst many others. NovaDura also offers anti-graffiti, printed wayfinding signage, heritage interpretation panels, cladding, totems, decorative and bespoke street furniture products with 100 per cent recyclable and anti-bacterial options for a plethora of industries. NovaDura products are used by organisations including RNLI, Transport for London, United Utilities, RSPB, English Heritage Projects and throughout the education and health sectors across the UK.

FURTHER INFORMATION Tel: 0128 222 7550 www.novadura.co.uk

Issue 19.4 | HEALTH BUSINESS MAGAZINE

RECRUITMENT

DESIGN & BUILD

Delivering flexible workforce resources

A new guide to reducing ligature risks

JGR Group has been appointed as a supplier of non-clinical staff to NHS through Crown Commercial Services. Established in 1969, JGR Group has successfully supplied staffing solutions for more than 50 years across Wales. Having been appointed as a supplier, JGR Group will continue to offer temporary staffing solutions for all administrative, secretarial and clerical cover on a full-time or part-time basis to NHS trusts. A combination of dedicated, approachable, responsive, and highly experienced recruiters allow JGR Group to provide a personal touch and point of contact to department managers. REC members with ISO 9001:2015 accreditation, Cyber Essentials certification and the wealth of recruiting experience, make JGR Group an ideal and reassuring

A new guide on antiligature solutions in mental health and secure sectors is now available to download. A need has arisen for psychiatric wards, high-security units, and prisons to reduce ligature risks, which is currently accounting for 77 per cent of suicide cases in the UK. Despite this alarming statistic, there is a lack of information on regulations and best practices. Contour have aimed to address this in their free guide, which covers key definitions, statistics, official guidance and risk control. Providing the safest care to those who are at most risk is a top priority for those working within the mental health sector. Quite often, itâ&#x20AC;&#x2122;s difficult to put yourself in the shoes of someone who is suffering

option for customers. JGR Group meets with all candidates in person as a key part of a standard registration process. The company prides itself on its in-depth knowledge and understanding of the local job and candidate markets. Honesty and great service continue to be at the heart of everything JGR Group does.

FURTHER INFORMATION Tel: 01656 767778 jgr@jgr.co.uk www.jgr.co.uk

from suicidal thoughts. Those who are most vulnerable will look for any opportunity to inflict self-harm, or worse. Assessing ligature risks from any height is the first step in controlling potential fatalities. This will then dictate the types of solutions to specify to address these possible risks. Download your copy today.

FURTHER INFORMATION Tel: 01952 290 498 sales@contourheating.co.uk www.contourheating. co.uk/your-anti-ligatureebook-download-page

ADVERTISERS INDEX The publishers accept no responsibility for errors or omissions in this free service 3 Man Factory

OBC

Medstrom 58,81

AEC People

MET UK

Anderson Quigley

NISI Enterprises

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BMA House

Office Depot

Opex Corporation

Pennington Choices

Phishing Tackle

Randstad Solutions

Caterpillar (NI)

74 26,27

CCube Solutions

Contour Heating

Daikin Applied (UK)

DCRS 34 EIT Health UK-Ireland

Endorse Jobs

ESTS GB

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Executive Resource Group

FFUUSS UK & EIRE

Fronius Renewable Energy

Fujitsu 4,44

Restore Technology Riello UPS Secure IT

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Signwaves 54 Spanish Inspirations

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Spinwell Global

Textek 81

GoJO Industries-Europe

Thames Barrier

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The Oyster Partnership

Thorlux Lighting

Voice Connect

Historic Royal Palaces Idpp Consulting

Legrand Electric

Advance 10

44 6,44

ISS 36

WCS Environmental Group

JGR Group

Wellsky International

JKE Security

WPS United Kingdom

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