Health Business 21.3 by PSI Media

ISSUE 21.3 www.healthbusinessuk.net

FINANCE

CATERING

TECHNOLOGY

PARKING

FREE PARKING CONCESSIONS Looking at the long-awaited, full definitions of the concessionary parking groups

PLUS: CYBER SECURITY | PANEL OF EXPERTS | PATIENT SAFETY

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ISSUE 21.3 www.healthbusinessuk.net

FINANCE

CATERING

TECHNOLOGY

PARKING

FREE PARKING CONCESSIONS Looking at the long-awaited, full definitions of the concessionary parking groups

Vaccine programme success paving over cracks? This week, NHS chief executive Sir Simon Stevens announced that all adults can now book a life-saving coronavirus jab vaccine.

PLUS: CYBER SECURITY | PANEL OF EXPERTS | PATIENT SAFETY

From 18 June, veryone aged 18 and over is being urged to arrange a jab if they have not had one as the NHS Covid Vaccination Programme begins the final push to protect the country. Approximately eight in 10 adults have had their first dose while more than half having had their vital second dose, meaning they have maximum protection from coronavirus. The NHS in England has delivered over 60 million vaccinations just six months after making history when Margaret Keenan received the first approved vaccine in Coventry. However, despite the undeniable success of the vaccine effort, the toll on staff remains. The BMA recently reported that doctors are suffering ‘moral distress’ and even ‘moral injury’ because they cannot give their patients the care and support they want to when they feel they need it.

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Hospitalisations may be less of a concern for politicians than this time last year, but the constraints on NHS staff have not eased. As many as 78.4 per cent of respondents stated that moral distress resonated with their experiences at work, which is a deeply concerning statistic. 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/DESIGNER Dan Kanolik PRODUCTION CONTROL Lucy Maynard WEBSITE PRODUCTION & ADMINISTRATION Victoria Casey SALES SUPERVISOR Damian Emmins ADVERTISEMENT SALES Azad Miah, Maziar Movassagh PUBLISHER Karen Hopps

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Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Contents

Contents Health Business 21.3 07 News

Half of trusts still unclear on decarbonisation targets; cancer backlog threatens ‘devastating health crisis’; and health service must strengthen the diversity of NHS boards

15 Finance 25 37

The pandemic has created a radical change in working practices across the country, with remote working and virtual meetings becoming the norm for many. The NHS finance function, and other corporate services, are no different, writes Sarah Day

20 Panel of Experts: Technology

The NHS has been forced to change its working patterns over the last 18 months. How has technology enabled this? And what steps are now needed to expand the use of digital post-pandemic? Our latest Panel of Experts share their thoughts

25 Technology

With growing backlogs of patients waiting for surgery, the NHS must quickly grapple with how to treat those patients, writes Ashley MacNaughton and David Thorpe

29 Technology 49

There are four key principles healthcare leaders should follow to embed and embrace system level transformation, writes the healthcare experts at PA Consulting

33 Cyber security

We revisit an article from NHS Digital in which the organisation highlight the importance of protecting information and data in the NHS and why NHS staff must be trained in knowing system vulnerabilities

37 Parking

Sponsored by

45 Infection Prevention Disappointed not to deliver its annual conference in 2020, and mindful of the ongoing pandemic, everything is being organised for a successful IP2021 this September

49 Modular build We revisit the thoughts of Simon Taylor, head of Portfolio Optimisation at NHS Property Services, as he discusses how the NHS and wider healthcare system will need to optimise its facilities post-coronavirus

52 Patient safety Although considerable improvements have been made in the safety of patients undergoing surgery, never events continue to present a significant challenge nationally for those working within the NHS and independent sector in the UK, despite existing national guidance. Here, Lindsay Keeley looks at never events within the operating theatre

55 Medical equipment The Department of Health and Social Care recently announced that 38 new pioneering artificial intelligence projects will help revolutionise care and accelerate diagnosis

63 G-Cloud The Crown Commercial Service has decided to extend G-Cloud 12 for 12 months from its original end date of 27 September 2021 to 27 September 2022

Sarah Greenslade, Public Affairs and Communications Officer at the British Parking Association, explains the full definitions of the concessionary parking groups

41 Catering 52

NHS Supply Chain supports the outcomes of the Independent Review of NHS Hospital Food with the Chef’s Academy

Health Business magazine

www.healthbusinessuk.net Issue 21.3 | HEALTH BUSINESS MAGAZINE

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News

DECARBONISATION

Half of trusts still unclear on decarbonisation targets New figures have revealed that half of NHS trusts are charging ahead with EV infrastructure, but remain off track on overall decarbonisation targets. According to data released by Eaton, 51 per cent of NHS trusts in the UK have installed EV Charging Infrastructure (EVCI) on-site for their staff, patients and the wider community. While this is a positive step towards a low-carbon future, a similar proportion (53 per cent) of NHS trusts are either behind on decarbonisation targets or do not have a clear set of emissions reduction goals in place.

While half of NHS trusts already have EVCI onsite, a further 43 per cent either plan to install charging facilities on-site within the next five years or are in early stage planning around how best to integrate such capabilities. In fact, just six per cent of NHS trusts had no plans to introduce EVCI at the moment. However, the FOI also revealed that 53 per cent of NHS trusts are currently behind on their decarbonisation targets or do not have clear emissions reduction targets in place. Just two fifths (38 per cent) are on track to meet their goals while only five per cent are tracking ahead at the moment.

LONG COVID

HEALTH CHECKS

Specialist long Covid services set up for children

NHS to roll out health checks at vaccine appointments

The NHS is setting up specialist long Covid services for children and young people as part of a £100 million expansion of care for those suffering from the condition. NHS England says that the 15 new paediatric hubs will draw together experts on common symptoms such as respiratory problems and fatigue who can directly treat youngsters, advise family doctors or others caring for them or refer them into other specialist services and clinics. Approximately £30 million will also go to GPs to improve diagnosis and care for those with long Covid while the new investment will also boost online services. There is already a network of specialist long COVID clinics which have been given £34 million of funding. Some £70 million of the new investment will extend these clinics and set up the paediatric hubs. Estimates suggest that 340,000 people may need support for the condition including 68,000 who will need rehab or other specialist treatment. More than one million people have reported suffering from long COVID, according to the Office for National Statistics. READ MORE

Amanda Pritchard has set out how the health service will make ‘every contact count’ by rolling out opportunities for health checks at times when patients already have other appointments. NHS England’s Chief Operating Officer told the NHS Confederation conference that the NHS will offer a range of targeted tests including blood pressure, heart-rhythm and cholesterol checks when people drop in for top-up covid jabs or flu vaccinations this autumn. She said: “The NHS is not just a sickness service but a health service which is why we want to make every contact count, using every opportunity to keep people well rather than just seeking to make them better. We want to offer a fully integrated care system, where we can reach out to people in the communities they live

When asked about the decarbonisation measures currently in place, the vast majority of NHS trusts reported that they have either already installed, or will be installing, lighting upgrades (93 per cent), increased building control and automation (90 per cent) and upgrades to insulation (69 per cent) within their facilities over the next five years. Only one responding NHS trust reported having no initiatives in place or planned at all. READ MORE

in – not just diagnosing and treating conditions, but working in partnership with the public and intervening before advanced disease occurs, keeping people healthy and well. “The hugely successful NHS vaccine programme has given us the opportunity to make every contact count by going out into peoples’ communities to beat coronavirus while also catching other killer conditions. The checks – like the jabs – will be available in convenient locations in local communities including village halls, churches, mosques and local sports centres and prevent people becoming seriously ill.” READ MORE

CARE HOMES

Mandatory vaccinations for care home staff in England Coronavirus vaccinations are to become mandatory for care home staff under plans to be announced by ministers, as they consider extending the move to all NHS staff. According to media reports, ministers will confirm they are pushing ahead with compulsory vaccination for most of the 1.5 million people working in social care in England, despite employer and staff organisations in the sector warning that it could backfire if workers quit rather than get immunised.

Care organisations have warned that compulsory vaccinations could cause significant difficulties in a sector that already struggles to recruit enough people. Under the plans those working with adults will have 16 weeks to get vaccinated or face losing their jobs. There are concerns within Westminster that the controversial measure could see the government being sued under European human rights law or equalities legislation.

The Department of Health and Social Care will soon launch two separate consultation exercises into making Covid and flu jabs mandatory for NHS staff. The British Medical Association warned that while they want all NHS staff to get jabbed, ‘compulsion is a blunt instrument that carries its own risks’. READ MORE

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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News

WELL-BEING

Doctors are suffering ‘emotional’ and ‘psychological’ distress Research has revealed that doctors are suffering ‘moral distress’ and even ‘moral injury’ because they cannot give their patients the care and support they want to when they feel they need it. The British Medical Association has undertaken the first ever pan-profession survey of its kind and surveyed UK doctors during March and April of this year. Almost 2,000 doctors took part and, whilst the majority said they were experiencing distress when they weren’t able to provide the care they knew was needed, many did not realise they were suffering what is identified as ‘moral distress.’

Moral distress can be understood as the feeling of unease stemming from being unable to undertake an ethically correct action due to institutional or resource constraints. As many as 78.4 per cent of respondents stated that moral distress resonated with their experiences at work. An even greater proportion of critical care doctors and foundation year junior doctors stated that moral distress resonated with their experiences at work (88.9 per cent and 88.5 per cent respectively). The research also examined the notion of moral injury as the BMA found some doctors

are experiencing longer-term psychological harm – or moral injury. More than half of respondents reported that moral injury resonated with their experiences at work. The doctor’s union also asked respondents if they intend to change their career plans for the next year with almost two thirds (62.4 per cent) saying they would work fewer hours and over half (51.3 per cent) saying they would consider taking early retirement. READ MORE

DIABETES

Artificial pancreas for Type 1 diabetes patients on NHS Sir Simon Stevens has announced that an ‘artificial pancreas’ designed to revolutionise the life of people with Type 1 diabetes will be provided by the NHS. Speaking at NHS Confederation’s conference, the NHS England chief executive said that up to 1,000 patients will benefit from a pilot of the innovative ‘closed loop technology’, which continually monitors blood glucose and automatically adjusts the amount of insulin given through a pump. It can eliminate finger prick tests and prevent life-threatening hypoglycaemic attacks. He said: “Living with diabetes is a daily challenge for millions of people across England, and this closed loop technology has the potential to make a remarkable difference to their lives. In a year that marks a century since insulin was discovered – which revolutionised

the world of diabetes – this innovation is a prime example of the NHS’s continued progress in modern medicine and technology.” The NHS Long Term Plan committed to making non-invasive glucose monitoring technology available to 20 per cent of diabetics and all pregnant women with Type 1 diabetes. The health service delivered on these ambitions, with maternity services across the country now able to offer non invasive glucose monitors

to expectant mothers and over 40 per cent of people living with Type 1 diabetes benefiting from flash glucose monitoring. Hybrid closed-loop insulin delivery systems automatically balance blood sugar levels by constantly measuring glucose and delivering insulin directly to the bloodstream when needed. Not only does this offer better glucose control and significantly reduce the risk of hypoglycaemia, it can also relieve some of the mental burden on patients and caregivers, who otherwise must remain constantly vigilant to blood sugar levels. Up to 1,000 patients from around 25 specialist diabetes centres in England will benefit from the pilot programme. READ MORE

BLOOD DONATION

Landmark change to blood donation eligibility rules

New eligibility rules that will allow more men who have sex with men to donate blood, platelets and plasma come into effect this week. To mark World Blood Donor Day, the move is set to make blood donation more inclusive

while keeping blood just as safe. It means that the questions asked of everyone when they come to donate blood in England, Scotland and Wales will change. Eligibility will be based on individual circumstances surrounding health, travel and sexual

behaviours evidenced to be at a higher risk of sexual infection. The change will see any individual who attends to give blood - regardless of gender - asked if they have had sex and, if so, about recent sexual behaviours. Anyone who has had the same sexual partner for the last three months will be eligible to donate. The changes follow an evidence-based review into individualised criteria by the FAIR (For the Assessment of Individualised Risk) steering group led by NHS Blood and Transplant. FAIR concluded on a new donor selection system which is fairer and will also maintain the UK’s status as one of the safest blood supplies in the world. The findings were accepted in full by the government last December. READ MORE

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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News

PELVIC CLINICS

New pelvic health clinics to be set up by NHS Tens of thousands of pregnant women and new mums will receive support to prevent and treat incontinence and other pelvic floor issues, thanks to new clinics set up by the NHS. The new services will be initially rolled out in 14 areas of the country with up to 175,000 women set to benefit from the additional support every year. The clinics will offer a one stop shop for women with symptoms, bringing together midwives, specialist doctors and specialist physiotherapists under one roof. NHS England says that every woman receiving maternity care in the pilot sites will be able to access the service throughout their pregnancy, which includes providing exercises

that can help to prevent problems from developing in the first place. Clinics will also provide training and support for local clinicians who are working with women, including GPs and midwives. Research shows that one in three women experience urinary incontinence in the first year after having a baby and up to three quarters of these women continue to experience this in the following 12 years after giving birth. A further one in 10 women experience faecal incontinence and another one in 12 will have a pelvic organ prolapse. READ MORE

DIVERSITY

VACCINATION SITES

Service must strengthen the diversity of NHS boards

£20m boost for vaccination sites across country

NHS organisations can create a ‘sustainable pipeline’ of senior leaders that properly reflect the diversity of their staff and communities by refreshing their processes for appointing chairs and non-executive directors. An independent taskforce, commissioned by NHS England and Improvement and led by the NHS Confederation, has published its report, Strengthening NHS board diversity, as part of the annual NHS Confed conference, to improve diversity of NHS chairs and other NEDs. The report found that while there are pockets of innovation, the current NHS appointment process for NEDs would benefit from a standard, more transparent procedure. Other key recommendations from the taskforce include: the requirement for NHS organisations to consider how to make board

roles more attractive; the suggestion of a new ‘compact’ between the NHS and executive search firms (ESFs) setting out expectations on behaviours, data collection and a set targets for underrepresented groups who are shortlisted and appointed; and improved succession planning for NHS boards and their ESFs to build links and seek alternative networks to help build up databases of candidates from underrepresented groups. Data from last year shows that the percentage of women holding non-executive director and chair roles is 41 and 37 per cent respectively, and for people that disclose their ethnicity as BME, that figure drops to 10 and five per cent, respectively. READ MORE

WAITING TIMES

Leak suggests fixing NHS waiting times could cost £40bn The government may have to spend up to £40 billion to try to repair NHS waiting times and end the long delays being faced by patients, according to unpublished Downing Street estimates. The figures, disclosed by Whitehall sources, underline the huge scale of the challenge in getting NHS waiting times back to manageable levels before the next election. The calculations highlight how the Prime Minister may have to commit anywhere between £2 billion and £10 billion a year for up to four years, on top of core NHS funding, to tackle hospital waiting lists. The total number of people waiting for hospital treatment, especially surgery, had topped five million for the first time. The figure stood at 5,122,017 in April, the highest since records began in 2007. NHS England plans

to give Downing Street a detailed analysis soon of how long it will take to start providing care again within its existing set of targets, to help inform No 10’s thinking before the comprehensive spending review in the autumn. The leaked projections were put together by the Cabinet Office as part of its work looking at the scale of post-coronavirus support needed in health, education and justice. Of the 5.1 million, almost 400,000 people have had to wait more than a year for treatment for conditions including cancer and heart problems, hip and knee replacements and cataract removals. A small number – 2,722 – have already been waiting longer than two years. READ MORE

An extra £20 million will be invested in the rollout of the coronavirus vaccine in England as a result of a rise in coronavirus cases across the country. NHS England says the funding will be used to provide extra support for GPs, pharmacists and local services at vaccination sites around the nation. The investment will also help increase staffing numbers at sites over the next month to help with the ongoing jabbing efforts, with NHS England calling it the ‘drive for the finish line’. Local vaccination sites are also being urged to ensure second dose appointments are brought forward for those over 50 where possible. Approximately six in every seven people in England aged 50 and over are now fully vaccinated against the virus, according to new figures. Dr Nikki Kanani, NHS England medical director of primary care, said: “Our local GP and pharmacy sites have been an integral part of the vaccination programme, delivering around 75 per cent of the jabs administered so far, and we are incredibly thankful for them going above and beyond to keep our families and communities protected from Covid-19. “This additional funding gives these essential local institutions, like general practices and pharmacies, the resources to bring more staff on board and help the country drive for the finish line as we enter the final stages of the vaccine rollout.” READ MORE

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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News

CANCER CARE

Cancer backlog threatens ‘devastating health crisis’ Nearly 70 MPs, heads of medical colleges and leading oncologists are urging the government to deliver a new ‘radical’ national plan to tackle the cancer backlog. The open letter sent to Prime Minister Boris Johnson from the chairs of all-party parliamentary groups, former cabinet ministers and a former cancer minister, calls on him to consider the seven recommendations put forward by the cancer community and cross-party MPs. It warns that ‘without urgent action we face

a second devastating health crisis as the Covid wards empty and the cancer wards fill’. The recommendations include the need to recognise the urgency of the backlog and deliver a new radical national plan, driven from ministerial level and backed by investment in equipment, technology, IT and workforce and to sweep away bureaucracy that restricts cancer care capacity. READ MORE

ARTIFICIAL INTELLIGENCE

£36 million to use AI technology in NHS care Thousands of patients and NHS staff will benefit from dozens of new pioneering projects awarded a share of £36 million to test state-of-the-art AI technology. Making the announcement at CogX Festival, Health Secretary Matt Hancock said that the 38 trailblazing projects backed by NHSX and Accelerated Access Collaborative will help the NHS to transform the quality of care and the speed of diagnoses for conditions such as lung cancer. The projects include: an AI-guided tool to help doctors and nurses to diagnose heart attacks more accurately; an algorithm to fast-track the detection of lung cancer; an AI-powered mental health app to help tackle symptoms of anxiety and depression while also identifying people experiencing severe

mental health difficulties; and technology to help spot undiagnosed spinal fractures. The AI in Health and Care Award aims to accelerate the testing and evaluation of AI in the NHS so patients can benefit from faster

and more personalised diagnosis and greater efficiency in screening services. READ MORE

DATA

Hospitals announced for national ‘whole-practice’ data pilots

The first providers taking part in ADAPt, a national data alignment programme between the NHS and private sector, have been confirmed.

Jointly led by NHS Digital and the Private Healthcare Information Network, the pilots will lead to the creation of the first comprehensive national dataset of ‘whole

practice’ information for doctors and hospitals providing both NHS and private hospital care in England. The providers which have volunteered as the first to take part in the ADAPt pilots are: Epsomedical; GenesisCare UK; HCA Healthcare; London North West University NHS Foundation Trust (private patient unit); Schoen Clinic; and Spire Healthcare. The ADAPt pilots will test the technical changes and governance requirements needed to transfer the collection of private admitted patient data from PHIN into NHS Digital. It is envisaged that the new national dataset will be made available through NHS Digital’s data sharing services to regulators and public bodies, to assist monitoring of safety and help drive service improvement, and to PHIN to support its legal requirement to publish whole-practice performance measures for hospitals and consultants offering private healthcare services. READ MORE

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature Written by Andrew Cushion, Managing Director of Twice2much

Addressing the increased financial risk from the global COVID-19 pandemic Background and challenges faced As a result of the COVID-19 pandemic, organisations have had to rapidly implement changes to their normal invoice processing/payments to Suppliers. Common challenges have included working from home and in some instances working from home whilst home schooling, poor internet connection, issues with invoice scanning and resource issues due to sickness and furlough. COVID-19 created a unique situation that required the UK Public Sector to rapidly source goods and services, sometimes in high volumes and from previously unused Suppliers. Additional pressures were also brought about by unfamiliar home working restrictions and in many cases there was a requirement across the Public Sector to support financially struggling supply chains. In particular at the beginning of the pandemic there was huge urgency to procure goods and services i.e. PPE to protect staff. This expenditure was obviously never subject to normal budgetary controls and as a result represented an increased risk of overpayments and fraud occurring. Along with the race to procure urgent supplies often came the need for payment upfront, predominantly via credit cards or in the form of pro forma invoices, both creating additional financial control challenges. Impact and pressure of resources Every organisation will be different in how the pandemic has impacted on them financially, the challenge is to identify any issues suffered and to quantify the impact of those issues.

All organisations without doubt are going to be under significant resource pressure both now and for some time to come. The use of resources, both internal and external, to identify and address these issues must therefore be appropriate and effective. Crown Commercial Services solution Due to the increased risk of fraud and error during the COVID-19 pandemic period, Crown Commercial Services established a variation to the existing Spend Analysis and Recovery Services Framework (RM3820). This variation provides a mechanism for organisations to procure an audit of their invoices and transactions (COVID-19 related spend) to identify instances of suspected fraudulent activity or erroneous payments to Suppliers. Benefits to organisations from the variation to the Framework are expected to be: • A shorter procurement process and legally compliant route to market through the framework agreement. • A cap to potential supplier costs, due to the limited duration of the COVID-19 review. • A professional review of COVID-19 invoices and transactions from audit professionals to identify potential fraudulent activity.

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Finance

Covid-19 and NHS financial governance processes The pandemic has created a radical change in working practices across the country, with remote working and virtual meetings becoming the norm for many. The NHS finance function, and other corporate services, are no different, writes Sarah Day The changes wrought by Covid-19 are well became impossible. Instead, organisations documented, with every part of the economy received block payments, based on the most feeling the impact of a disease that nobody recent financial information that NHS England was expecting. We know that the pandemic and NHS Improvement had – the costs of has caused fundamental change in the NHS running the NHS as of December 2019. and the after effects will be felt for many years Suddenly a significant area of potential to come. NHS Providers has predicted that conflict was removed and, instead of the backlog of treatment could take up to five worrying about whose responsibility it was years to recover in some areas. to pay for what, NHS organisations But the impact on the health across all sectors were working service was not just towards a common goal, with felt on the frontline, the certainty that any costs Propose d with rapid and incurred as a consequence, structur significant changes would be covered by the must be al changes also made to the government’s commitment s u p p o an appr financial regime. to supporting the opriate rted by regime financia On 11 March NHS. This removal of that en l 2020, the financial barriers clearly c ou and inc Chancellor of demonstrated how well entivise rages the Exchequer organisations can work correct s the announced that together and is driving some behavio ‘whatever extra of the financial changes that urs resources our NHS we are seeing now. But this needs to cope with funding change did not happen coronavirus – it will get’, in isolation. Additional resources for signalling a period in the financial social care allowed people to be discharged history of the NHS like no other. With from the NHS much more quickly. Financial the cancellation of most elective activity assessments were paused which enabled to prepare for the Covid-19 surge and a placements to be found more rapidly and repurposing of many facilities, the traditional the discharge process became much simpler method of moving money around the NHS for many. Across the country, organisations through payments for contracted activity, in both health and social care have reported

improved relationships and system working as a result of these combined changes. The relaxation of financial rules and organisational boundaries enabled staff and equipment to move to where they were most needed. The mutual aid approach to ensuring that resources were in the right place, meant that organisations could easily call on their neighbours for assistance when needed. And it wasn’t just clinical staff who worked in new areas. Members of finance teams were also redeployed, distributing PPE, supporting testing centres and, more recently, getting involved in the vaccination programme. Directors of finance were involved in the command-andcontrol structure that was implemented across local systems, supporting clinical colleagues to make rapid decisions around the resources and equipment needed to tackle the pandemic. But it wasn’t a free for all. Financial governance processes remained in place, but staff were authorised to make quick decisions and seek approval simultaneously. The national capital expenditure process was streamlined to enable organisations to make the changes that they needed, without having to wait for the normal length of time. Throughout the pandemic, boards have continued to meet, albeit virtually, to discuss and oversee the financial performance of their organisations and assess the decisions taken. One unexpected benefit of the move to E

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

ISS welcomes government Green Paper The government recently released their long-awaited Green Paper on transforming public procurement. It marks a significant step forward in the government’s continued efforts to increase the value and efficiency of public service delivery

As a Strategic Supplier to the government, ISS has a major presence in the delivery of facility services, offering soft and hard FM to public sector organisations, including the NHS, hospitals, government departments, defence establishments, schools and colleges across the United Kingdom. With the backdrop of Covid and everchanging economic trends, Eddie Fairish, Senior Commercial Director for ISS shares his thoughts on how the FM industry is adapting and further enhancements that are required in the future. He said: “The market needs to change. Contractual terms and conditions need to be aligned to levels of risk shared – whether it be along the Outsourcing Playbook principles as Policy or in a ‘Vested’ style model.” Those procuring services need to be aware that the uncertainty and subsequent risks beyond the suppliers control simply cannot be passed over without understanding the need to share those specific risks. This pandemic has been a sharp reminder of this maxim. The Green Paper has been welcomed across the industry; however, we need public sector clients to take a more inclusive approach by encouraging engagement from the outset, where a transparent pipeline is essential, allowing everyone to place their resources in the right place. Open dialogue should be encouraged from the outset with aligned bid documents, containing accurate information and clearly laid out aims and objectives helping to streamline the bidding process and allow for direct comparisons to be made – judging apples with apples. The public sector market has matured It is apparent that within the core public sector services of NHS, central government and local authorities, outsourced contracts have previously been based on delivering input-based specifications. Over the past decade, we have seen the market mature to output based specification with the majority of the commercial risk sitting firmly with the contractor.

Covid has really shown both clients and service providers that we need to act differently. Partnership, collaboration and flexibility whilst keeping stay safe and delivering assurity has become key. The Government Outsourcing Playbook, now in its second edition, has developed into a strong tool helping to align contractual terms, giving NHS trusts the confidence to move away from long held concepts, that are now outdated, however, the principles of the playbook really need to be adopted across the wider government community contracts. Ideally, all public sector bodies should follow the Playbook as Policy with standard agreed terms and conditions, allowing both parties to work collaboratively whilst reflecting a modern service delivery. This will allow the focus to remain on delivering outstanding service rather than continual contractual commercial discussions. Business post-Covid ISS, along with others, has been working closely with the NHS throughout the pandemic but the return to the ‘new normal’ remains unclear. The pandemic has identified stress lines in the conventional arrangements of private sector involvement, much of which has been beyond the control of any supplier. Contractual terms should share these risks and allow for partnership. The Green Paper has a raft of positive changes in how procurement could operate including a swifter, streamlined tender process, however, it is equally important to allow the suppliers an insight into the client’s aspirations, their budget thresholds and to have access to accurate key information and data to help ensure any tenders deliver the best value.

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Therefore, as mentioned before, transparency with the public sector pipeline is key. Preengagement with clients and ongoing regular dialogue with senior stakeholders is fundamental to allow suppliers to assess the opportunity, understand if they can deliver the customer requirements, and to ensure a cultural fit. Too often tenders share a lot of detailed documentation, much of which is either out of date or contradictory, which do not align with their client’s overall aspirations. Open dialogue helps reduce these false markers and encourages more long-term strategic planning. As a business ISS is open to challenge the status quo and offer different contractual models. We are seeing more clients starting to embrace the Vested Model, whose benefits offer improvements in quality and service innovation, increased staff retention and cost saving as well as addressing the needs of today and tomorrow. As businesses bounce back from Covid and seek to return to previous revenue levels, it really is important that the race to the bottom mind-set does not happen again as it will impact quality, service standards and not achieve ‘best value’. Partnership, collaboration, and having aligned risk profiles will allow sustainable solutions. Eddie concludes: “We believe that people make places and places make people. From strategy through to operations, we partner with customers to deliver places that work, think and give. They choose ISS because we create, manage and maintain environments that make life easier, more productive and enjoyable.” L FURTHER INFORMATION enquiries@uk.issworld.com www.uk.issworld.com

Finance

 virtual board meetings has been the necessary shortening of meeting time which means that organisations have had to consider what is really important to discuss at the executive level and which issues could be dealt with differently. And subsequently, NHS England and NHS Improvement have held a number of Covid19 audits to review financial processes during the various waves of the pandemic. But what does all this mean for NHS finance now and in the future? Prior to the pandemic, the NHS was already thinking about moving away from activitybased payments. The approach did not fully support the intended move to more integrated working, as it potentially encouraged trusts to keep doing more of the same, rather than thinking about pathway transformation. The pandemic has accelerated this change. Payments since March 2020 have been, and continue to be, on a block basis for all providers. There is widespread agreement that nobody wants to go back to how it was. The certainty of income levels that a fixed payment affords, enables trusts and their wider systems to consider new ways of providing care or delivering it in new settings. The transformtaional ambitions that the NHS set out in the Long term plan in January 2019, are more likely to be realised in a simpler payment system. The proposed aligned payment and incentive system to support the NHS going forward, recognises that a fixed element of income supports change. However, the new methodology will also include a smaller variable element to continue to provide that financial lever to meet national priorities. Currently that is around recovering the levels of elective care and addressing the backlog of waiting lists. There are other small, but significant, changes that have arisen through the approach taken to the financial regime during Covid-19. The move away from activity-based payments and organisational boundaries, meant that the monthly process of raising

Additional resources for social care allowed people to be discharged from the NHS much more quickly. Financial assessments were paused which enabled placements to be found more rapidly and the discharge process became much simpler for many invoices between NHS organisations, was paused. Many of these invoices relate to patients who are treated away from their home county or area and accounted for around 340,000 invoices annually. The associated transactional costs both nationally and in local workforce requirements, were significant. Removing this unnecessary administrative burden freed up staff to support the pandemic response and, in the future, will give finance staff more time to support transformational change in their organisation and system – a much more beneficial use of scarce resources for all concerned. The pandemic has created a radical change in working practices across the country, with remote working and virtual meetings becoming the norm for many. The NHS finance function, and other corporate services, are no different, with many staff working at home for some, or all, of the time. As a consequence, NHS organisations have seen overhead costs drop and many are questioning how to best use their estate in the future – could a hybrid working model be the future for corporate functions, freeing up more space for clinical care at a time when social distancing means that more room is needed for even the most routine appointments. The recent white paper Integration and innovation: working together to improve health and social care for all sets out a vision for the NHS which removes many areas of traditional competition and seeks to create statutory integrated care systems (ICSs)

across the country. This was an ambition in the Long term plan but the learning from working together closely during the pandemic and the relationships created, mean that this vision is already well on its way to becoming reality. But ICSs must be supported in their endeavours by the government. The NHS not only needs certainty of funding over the next few years, the whole health and social care system requires sufficient investment to really build on the learning from Covid-19 and tackle the challenges that were already in the system. The NHS has been at the forefront of the country’s response to Covid-19 but, arguably, faces an even more challenging time to recover from it. ICSs present an opportunity to do things differently, building on what we have learnt about what supports, or hinders, system working. But the proposed structural changes must be supported by an appropriate financial regime that encourages and incentivises the correct behaviours. Early signs are promising, and the will is there at a national level and across all sectors to maintain the beneficial changes caused by the pandemic. We all have a responsibility to keep up the momentum. L

Sarah Day is Policy and Research Manager at the Healthcare Financial Management Association. FURTHER INFORMATION www.hfma.org.uk

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Using technology to ease the pressure on the NHS It’s no secret that the pandemic put the NHS under monumental pressure. And the repercussions are impacting an array of services within the healthcare sector. But we have seen an acceleration in the adoption of technologies to help with this pressure. Here we take a look, up and down the country, at some of the ways that NHS trusts have used tech to improve healthcare

At Rotherham NHS Foundation Trust (RFT), the hospital and community services all work together to provide integrated care. When COVID-19 arrived, the team quickly arranged remote working and many employees began working from home. Being cloud-based, the system supported the remote workers over night and everyone carried on as usual in the new, sociallydistanced situation. Liberty Converse, Netcall’s omnichannel contact centre solution, manages calls in the remote working environment and the RFT management team can see what is happening in real-time. The trust has tweaked the system’s screen pops, giving agents more information to manage the pressure of incoming calls. James Rawlinson, Director of Health Informatics, said: “Implementing social distancing would have been very difficult for us if we didn’t have Converse. Fortunately, we had the new system in place before COVID hit us. It also meant that our staff could ‘shield’ where they needed to.” Hampshire Hospitals NHS Foundation Trust (HHFT) provides acute hospital services to a population of 600,000 patients across Hampshire and west Berkshire. Previously, HHFT used 8,000 templates to post appointment letters to all patients. There was no guarantee any letter would arrive on time. Often, patients phoned the hospital to rearrange their appointment, with some appointment slots potentially going to waste. HHFT implemented Netcall’s Patient Hub, to make it easier for patients to manage their appointments. Plus, they now have only 3 letter templates enabling consistent quality. Patient Hub is a secure online digital portal, available 24/7. Patients just need their phone or computer and their date of birth to confirm, or request to rebook or cancel appointments at the touch of a button. In just three months, an average of 65 per cent of patients invited to join Patient Hub use the online portal. A recent patient case study showed the whole process, from sending the appointment to the reschedule, takes less than 10 minutes.

Leeds Teaching Hospitals NHS Trust (LTH) is one of the UK’s largest and busiest acute hospital trusts. Since COVID, their call volumes have increased, typically peaking at about 1,400 calls per day. When there were a limited number of lines, patients had to wait, so some would just hang up in frustration. The call-abandon rate was as high as 40 per cent. Now, they have reduced this to low single figures. LTH is taking its first steps towards digital appointment management using Patient Hub. The trust needs to use every available appointment, and managing appointments and reminders digitally helps to achieve this. Plus it offers significant savings in postage and paper. Digital also gives patients clear, real-time visibility of their appointment. “We want our workforce to be digitally empowered and to provide a good experience for staff and patients, using IT which just works.” Richard Moyes, General Manager of Outpatients. Chesterfield Royal Hospital NHS Foundation Trust, along with the rest of the NHS, has faced a challenge with outpatient appointments for some time. The process is often frustrating for patients. Letters can get lost in the post, arrive after the appointment is due to take place, or the time is not convenient and then has to be rescheduled.

Then there’s the queue for the call to be answered – all of which contributes to a poor patient experience and missed appointments. The trust’s decision to adopt a digital solution will give patients control over their own appointments – helping to reduce DNAs. Patient Hub is a secure, online portal, providing one place for patients to go for self-service appointments from their mobile, smart phone or computer, to confirm, rebook or cancel appointments and access important information. Ian Hazel, Director of ICT and Informatics, said: “This development is about giving our patients an improved experience and more control over their appointments and how they manage them. Patient Hub integrates with our booking and telephony systems, making it more convenient for patients and faster for staff to manage a rebooking or cancellation. Re-allocating freed appointments to other patients shortens their waiting time and reduces DNAs. The trust is committed to going paper-light, where it means better care and services for patients. The digital portal is expected to cut our postage bills in half.” For other stories of how NHS trusts are transforming patient experience using Netcall, please visit us below. L FURTHER INFORMATION www.netcall.com/nhs

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Panel of Experts

EXPERT PANEL TECHNOLOGY The NHS has been forced to change its working patterns over the last 18 months. How has technology enabled this? And what steps are now needed to expand the use of digital postpandemic? Our latest Panel of Experts share their thoughts

Ikenna Emenyonu, Netcall

Richard Gibson, Pinpoint Limited

Simon Townsend, IGEL Technology

Ikenna works as a Solution Specialist manager at Netcall. He has deep experience in delivering transformation projects within the NHS. He has been pivotal in understanding the goals, agreeing outcomes and working through challenges within many NHS trusts. His speciality is developing and implementing cost-effective patient experience solutions. Ikenna has been with Netcall for over 15 years.

Richard has a BS. (Hons.) degree in Electronics and Electrical Engineering from Edinburgh University. He spent 10 years in design/ development at Ferranti/GEC (Marconi) working on radar and navigation systems for MoD. In the same period, he graduated with a MSc in Digital Systems Engineering from Heriot Watt University. Richard joined Pinpoint in 1997 and has over 24 years of experience in the design and development of the Pinpoint Staff Personal Alarm product portfolio.

Simon Townsend is IGEL’s chief marketing officer. With more than 20 years experience delivering IT infrastructure and cloud services in both the public and private sector, Simon has spent most of his career in a technical capacity, helping organisations adopt cloud technology and more recently helping firms to embrace the work from anywhere revolution.

More so than his predecessor Jeremy Hunt, Matt Hancock has used his role as Health Secretary to signal the importance of increasing the pace of digitalisation across the whole NHS estate. Whether it be the promise that outdated and obstructive NHS IT systems will become a thing of the past, evident in the Axe the Fax campaign, or higher use of apps in the NHS as he follows his ‘passion’ of digital innovation, it is clear that the Department of Health and Social Care has a heightened technology agenda under his premiership. Speaking last July at the Royal College of Physicians, Hancock outlined his firm belief that better tech means better healthcare. Technology has been involved

in healthcare for many years, and it is fair to say that improvements in technology have been reflected in the health service. So how has the pandemic shown this? Simon Townsend, Chief Marketing Officer at IGEL Technology, points to the fact that technology has been at the forefront of developing vaccines, played a vital role in enabling continued and integrated healthcare services, and facilitated a large percentage of the population to safely work from home throughout lockdown. He says that, without the power of the internet and the ability to share data globally, there is no doubt that the vaccines we have today would have taken considerably longer to create and roll out.

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Ikenna Emenyonu, Solution Specialist manager at Netcall, says that, just as importantly as the above points, increasing digital use has shown it’s potential to make patient lives easier. A digital approach, Emenyonu writes, also opens the way for two-way comms, online symptom reporting, bite-sized education and shared records. All of which save time and help patients to get the care they need. The pandemic pressure also encouraged internal process changes, resulting in many teams improving utilisation and reducing waste, proving that tech frees valuable resources. All agree that it is essential that the NHS continue this momentum. As new variants of the virus continue to arise, technology and the

Panel of Experts

ability for the world to communicate quickly and effectively is fundamental to how we adapt our global vaccine response strategy and delivery. Townsend says that technology, such as 5G, the cloud, unified communications, end-user computing, security and more, continue to play an ever increasingly important role. It enables us to work from anywhere, in the safest possible way, while allowing our healthcare professionals to engage with patients at the point of need. Emenyonu suggests that some pandemic projects will drop away or be repurposed, but the significant question is how teams can move from ‘getting by’ to ‘getting ahead’ of their next big issue. This is a belief shared by Pinpoint Limited’s Richard Gibson, who cautions that any possible advances should always be carefully weighed up against any potential downsides. While certain sectors of technology have reacted rapidly and positively during the pandemic, and should be lauded for doing so, he argues that this momentum should not be at the expense of maintaining appropriate standards. According to The NHS Long Term Plan, face-toface outpatients’ appointments are set to reduce by a third by 2024. Simon Townsend starts our conversation on this topic by stating that there is no doubt that digital practices can help assess people more effectively without them having to visit a local GP practice in the first place. This helps with wait times, overcrowding and obviously, in the midst of pandemic, ensures infection rates are kept at bay. Richard Gibson is of the belief that it is unlikely that hospitals will ever be ‘free from infection’, as they are primarily centres where people experiencing health problems which include infectious conditions can be treated. The goal, he writes, should be to minimise the level of infection present, and this can be assisted by using such digital practices to diagnose, and in some cases provide

treatment, for certain conditions remotely. This reduces the need for people with infectious conditions to congregate at a single point. However, he goes on to suggest that overcrowding is a very subjective problem – different locations, different health crises, or even different departments of the same hospital can all be a factor in the level of overcrowding. As with infections, digital practices can be used to limit those actually attending a hospital to ‘essential cases’ – with the remainder still being treated effectively, but remotely. For Simon, technology needs to play a greater role in testing for infections and to provide more effective and faster results. Highlighting the role of smart watches and other smart technology in providing valuable data on an individual’s oxygen levels, heart rate and more, he hopes that such technology will develop in the future so that this kind of technology will become commonplace to identify and manage health issues. This is also favoured by Ikenna Emenyonu, who suggests that an easy-to-use pre-appointment symptom checker helps to keep patients safe by screening and helping symptomatic patients to stay at home. Hospitals using an arrival app can enable receptionists to manage patient flow from the car park into their clinic, preventing overcrowding. Similarly, traffic through a hospital can be managed using an app. This helps the flow of patients through appointments, coordinating appointments on a day. Treating patients remotely has proven both convenient and cost-effective, with video and telephony appointments easy for patients to attend with the added benefits of improving available clinical time. Emenyonu says that clinical teams have discovered that virtual workshops add value too. Using group consultations for patients with common clinical

concerns makes it easier to share experiences and learn from each other. Importantly, it saves the clinician from repeating information. Potential risks Returning to Gibson’s warning that any possible advances should always be carefully weighed up against any potential downsides, we asked our panellists is there are any possible risks and downsides to the speed of technology adoption that we have seen during the pandemic. The response to coronavirus should be applauded. All organisations in both the public and private sector had to respond quickly to introduce IT so that staff could continue to work but remotely from home. Changes in the use of technology always introduce some level of possible risk, but, Gibson says, these should be minimised by means of adequate testing. When changes are rushed in ‘at an incredible pace’, the threat can be that shortcuts are taken in the testing/verification process – this can greatly increase the associated risks. Especially in the medical/healthcare field, where lives can literally be in danger, it is essential that the requirement for a rapid solution does not override the need for safe progression. Simon Townsend says that the impact of the clarion call – to provide computers to staff as fast as possible - is that the areas that IT departments are normally hawklike about such as security, day-to-day management and cost became a lower priority. By providing a high performance endpoint operating system, which can repurpose PC and laptops, Townsend’s company, IGEL, has been laser focused on this, assisting its customers which include many NHS trusts to secure remote workers and reduce IT capital expenditure. Many have stated that the pandemic has accelerated digital transformation, with some E Issue 21.3 | HEALTH BUSINESS MAGAZINE

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 organisations even going so far as to say they have achieved in weeks and months what would have normally taken years. This applies to healthcare, too. But, to repeat the point, the outsourcing of technology and programs, coupled with the need to adapt quickly has raised questions around cost and security moving forward. IT departments need to focus on this now, stresses Townsend. Another risk of moving at pace is that there isn’t time to explore other possible uses of a specific piece of technology. Typically, it was bought to do one thing. Emenyonu says that it’s essential to explore other uses and extract more from the investment. For example, a Covid Test Result solution may be able to be repurposed for use with other test results. Deployment under crisis is also rapid, carrying the risk that too much change is brought to the stakeholders. Crisis adoption often falls back to ‘normal behaviour’ after the pressure lifts, as people revert to comfortable ways. But sustainability of the NHS depends on continual improvement. Post crisis, changes that were made should be revisited. But the consultation group should be widened, using their involvement to embed forward movement. By promoting inclusivity, managers will build on their change success. Will we see a return to old working patterns? For Gibson, it seems unlikely that there will ever be a complete return to ‘old working patterns’. Townsend agrees, saying that it is highly unlikely we’ll go back to where we were, but stressing that nor will the

NHS loose the personal, face-to-face touch shifting to engagements with healthcare professionals which are mostly online. He says that self-evidently there is a substantial need for many who are extremely sick, cannot access technology or aren’t comfortable using it to see clinicians in person. For Townsend, simply put, the future is hybrid. Emenyonu tends to view the progress made as a continuation post-pandemic. On one hand, naysayers of digital can’t deny its adoption across all demographics, patients and staff. Secondly, behind the scenes the efficiency gains and cost savings have become part of operations as usual. Unlike before, when technology was always seen as a time-consuming project, the NHS now has the data to confirm what can be done and where extra patient support may be needed. While there can be some advantages in the technology introduced, as already mentioned under digital practices, there is also a concern that the overzealous aplication of such technology ignores the basic needs of many of the patients. For Emenyonu, the next challenge is in managing high waiting list numbers. He believes that teams can capitalise on the progress they have gained, to flexibly deliver optimal patient pathways at lower costs. However, pandemic or not, he emphasises that digital transformation is here to stay. Single technology platforms Even in a future without coronavirus, if that is feasible, hospitals will still have to cope with ever-increasing demands for services. So, how

will single technology platforms help address process needs within the health service? Richard Gibson writes that the ability to share information quickly and effectively undoubtedly assists in the provision of any service, and health is no exception. Single technology platforms should make this process more efficient. As with other technology advances though, he warms that this advance needs to be properly introduced and managed – the data that will be accessible is private and, in some cases, extremely personal. ‘Single platforms’ have, at their core, the ability to integrate, collect and share bidirectional data. Many wrap these terms into one - ‘interoperability’. Done well, Emenyonu says, it allows users to see end-to-end health processes, as if they were from a single platform. Unified data and process flows are impossible with standalone systems. Our Netcall panellist says that future plans must not accept anything less. Projects must demand open interfaces from all suppliers. The ongoing goal of seamless patient and user journeys will drive this, resulting in a reduction of cost and resource efficiency. However, digitising paper processes, without open data, is only automating manual work. Hospitals need appropriate visibility of any data from any system, wherever it’s needed. For this, you need ease of integration and suppliers that uphold standards and work well together. Simon Townsend looks at the question with a focus on the older generation. An ageing population in the UK will continue to place increased demands on the NHS, with the ONS stating in 2019 that in 50 years’ time there’s projected to be an additional 8.2 million people aged 65 years and over in the UK – a number roughly the size of present-day London. However with an increasingly techliterate population, modern IT, and in particular the consumerisation of it with Zoom, tablets, mobile apps and cloud services, he believes that technology will play an important and ever growing part in enabling self-diagnosis. L

Panel of Experts

Technology has been at the forefront of developing vaccines, played a vital role in enabling continued and integrated healthcare services, and facilitated a large percentage of the population to safely work from home throughout lockdown

FURTHER INFORMATION www.healthbusinessuk.net

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Cloud and IT managed service solutions Ogel IT Ltd works with organisations to help build their confidence in adopting cloud services where appropriate by reviewing business requirements and cost analysis to global remote access, reduces capital expenditures on physical storage location and software purchases, and provides back up and recovery solutions for those unexpected disasters.

We guide organisations to adopt cloud based solutions that maximise productivity and simplifies day to day system management. Our systems are designed specifically to transforms current digital services, and provide access to additional capabilities and expertise, by utilising cloud and ‘off the shelf’ technologies and easing pressure on in house IT teams and the challenges they face in keeping up with the constant evolving change in cloud platforms. Cloud Technology The ‘cloud’ is a perplexing enigma for most people. It is a term widely used, but often misunderstood. Simply, cloud technologies allow access to digital resources (Virtual machines, storage accounts, web apps, databases, etc.) stored in a virtual space (off site server) and accessed by means of networks. It allows shared resources without the restrictions of a physical location and in fact, eliminates the need for physical data storage locations all together. In short, cloud technology will provide organisations with limitless storage capacity, operational agility based on individual needs, better collaboration with users due

Technological innovation and digital transformation – public sector In a recent study conducted by CIF (Cloud Industry Forum), the UK Cloud adoption rate now stands at 88 per cent. With 67 per cent of those looking to increase their currently cloud based services. It was also noted that there has been a significant increase in cloud adoption rates within the small and public sectors. The public sector alone saw an increase as high as 62 per cent within a year. In 2013 the government introduced the ‘Cloud First’ policy for all technology decisions which outlines, ‘When procuring new or existing services, public sector organisations should consider and fully evaluate potential cloud solutions first before considering any other option. This approach is mandatory for central government and strongly recommended to the wider public sector’. Followed by the Secretary of State for Health’s policy paper - The future of healthcare: our vision for digital, data and technology in health and care’ in October 2018, where he states that ‘the gap between where we are and where we want to be is only getting bigger. We need to take a radical new approach to technology across the system and stop the narrative that it’s too difficult to do it right

in health and care. The UK has the chance to lead the world on healthtech’. Further reading of the policy paper outlines the benefits the NHS will procure when adopting the ‘Cloud First’ policy which falls in line with the guidance published by NHS Digital in January 2018 and states how the NHS will benefit from the Cloud based services on multiple levels including the support, resilience, back up and expertise of some of the most cyber aware providers, the ability to grow projects that work with an infinite amount of data and unpredictable processing needs, the capability to instantly share and access data globally increasing productivity and the daily management of the system and software to prevent massive migration projects resulting in delays, system downtimes and high cost. How can we help? We specialise in helping organisations establish flexible, secure and cost-effective IT services. We help our customers understand their business requirements and then design and deliver a solution that is right for them. We cover a wide range of IaaS, PaaS and SaaS offerings and have a wealth of experience with legacy infrastructure migrations. We can help you make the right decisions at the most appropriate pace for your business. Azure and Office 365 As a Microsoft Gold Partner and CSP (Cloud Service Provider) we can offer customers access to certified technicians to support them in their journey to the cloud or transition to a modern could managed secure desktop service. For organisations looking to migrate to or between office 365 tenants we have a tried and tested migration process underpinned by market leading migration software. Networks and security We have a wealth of experience in delivering secure and flexible campus networks that can support multiple organisations. Our interest is in making sure our customers get the best possible solution for their operation at the best price. Please get in touch for a free no obligation discussion. L FURTHER INFORMATION Tel: 01438 300335 info@ogelit.com www.ogelit.com

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Technology

Shared patient waiting lists: How to manage NHS capacity as a system With growing backlogs of patients waiting for surgery, the NHS must quickly grapple with how to treat those patients, writes Ashley MacNaughton and David Thorpe Covid-19 has had a profound impact on during winter), it is less common in elective the NHS’ ability to deliver healthcare. NHS care. This is unsurprising due to the frequent waiting lists are at their highest level since lack of dynamic, real-time and usable data to 2008, so hospitals need to quickly find ways support agile decision making with regards to maximise the utilisation of available to hospitals’ elective activity and capacity. capacity without compromising patient Too often, hospitals see sharing a patient outcomes and experience. waiting list as a sign of failure – an To support efforts to optimise inability to effectively plan and utilisation in the wake of manage their own resources. W hile NH the pandemic, the NHS But this perception has S hospita renewed its guidance prevented the NHS from ls r o u tinely ‘share’ on integrated care taking advantage of its n systems in January economies of scale to patient on-elective s to ma 2021, asking trusts maximise its resources pressur nage es on b to collaborate and while delivering ed capa especia share patients where cost-effective and highc lly ity, quality appropriate. But outcomes. it is less during winter, commo while NHS hospitals To overcome this n in elective routinely ‘share’ and fast track elective care non-elective patients recovery post-Covid-19, to manage pressures the NHS needs to digitalise on bed capacity (especially a shared patient waiting list.

What is a shared patient waiting list? A shared patient waiting list must be more than just a combination of Patient Tracking Lists (PTLs) from multiple trusts. It requires an easily accessible digital platform containing all relevant information about patients. This ensures that anyone managing the treatment of elective patients can make a fully informed decision, not only to make best use of upcoming capacity, but also to achieve the best outcomes for the patient. How can the NHS implement a shared patient waiting list? In our experience, there are five key requirements to make shared patient waiting lists a success:

• Align vision, deliverables and goals Collaborating to deliver patient care across multiple organisations isn’t straightforward. E Issue 21.3 | HEALTH BUSINESS MAGAZINE

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• Incentivise collaboration The financial stability of acute trusts often relies on their ability to treat elective patients efficiently, as do several key performance metrics such as Referral to Treatment waiting times. This is true whether they are commissioned via Payment by Results (PbR) contracts or block contracts. Often, organising additional sessions at a premium staffing rate is a more cost-effective way of managing long waiting lists than sending patients to other providers. Establishing system-level performance management to reward those working collaboratively is vital to improving access to high quality care for the greatest number of patients. By looking at innovative payment mechanisms which are linked to low waiting times or costs per operation across the system, trusts can be supported to move from focusing on balancing their books to maximising the utilisation of their available resources. • Devolve governance to the system Sharing patient waiting lists means the performance of individual organisations can sometimes come second to the greater good. If a single provider leads the governance model, they’ll find it difficult to remain impartial and altruistic, especially when

A shared patient waiting list must be more than just a combination of Patient Tracking Lists (PTLs) from multiple trusts. It requires an easily accessible digital platform containing all relevant information about patients making difficult decisions that adversely affect their organisations and surgeons. Devolving governance to either a Provider Collaborative or an Integrated Care System (ICS) governing body mitigates any conflicts by making the leadership agnostic to organisational finances and performance metrics.

• ‘Pull’ patients to where there’s capacity Too often, shared waiting lists result in hospitals with limited capacity sending patients to other providers at short notice. This puts more pressure on the receiving organisations, disincentivising collaborative working and resulting in a poor patient experience. Rather than hospitals with capacity waiting for other hospitals to send them patients to treat, sharing waiting lists will mean that they can proactively identify where there are suitable patients to fill their upcoming capacity. By creating an operating model in which hospitals ‘pull’ patients on the waiting list when they have capacity, they can maximise their productivity and build long term partnerships without negatively impacting their performance metrics. • Embrace digital Sharing patient waiting lists needs to be more than a spreadsheet. Every patient, operation, surgeon and hospital is different – and the risk with sharing patient waiting lists is that this is lost, leading to improved productivity at the expense of high-quality patient outcomes. Therefore, it is crucial that decisions on which

Technology

 But the motivation for doing so is to treat all patients as quickly as possible in the most cost-effective way while achieving the best possible outcomes. By adopting clear, functional and jointly agreed metrics to guide decision making and objectively measure success, organisations can embrace the benefits of sharing their waiting lists. For example, having clearly defined metrics to measure whether patients are being treated in priority order will enable all participating organisations to manage, engage and reassure their teams effectively. Supplementing this through inclusive governance forums to transparently review progress, evaluate decisions and reflect on whether the sharing of waiting lists is having the impact expected, will also serve to maximise this.

patients to share, which surgeon to share with and what hospital to operate from is evidence based and fully informed, with the data to back it up. The solution must be dynamic, real-time and customisable to complement individual teams, their booking processes and their ways of working. Without this, efforts to share patient waiting lists will continue to be underwhelming. The NHS must embrace shared patient waiting lists Shared waiting lists can be difficult to manage and overall, there is a lack of real incentive for an already exhausted hospital in the midst of the Covid-19 recovery. But by focusing on shared aims, incentivising collaboration, devolving governance, shifting the operating model, and embracing digital, the NHS can successfully design, implement and embed them effectively. System leaders need to build on the heroic response to the pandemic and make that level of collaboration and partnership the blueprint for how the NHS operates on a dayto-day basis. Now is the time to be brave and embed shared waiting lists to improve access and choice for patients and help clear the NHS backlog. L

Ashley MacNaughton and David Thorpe are healthcare experts at PA Consulting. FURTHER INFORMATION www.paconsulting.com/ industries/healthcare/

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature As case loads increase, digital dentistry shows a way forward to streamline the dental workflow and provide fast and efficient in-house solutions to the most complex of problems. At its heart, Awesome Technology Ltd provides the ability to provide ‘same and next day’ production of accurate dental appliances. This often-vaunted dream is now a reality in many dental clinic situations both inside and outside the laboratory environment. By substituting the traditional plaster cast shapes with digital models produced by an intraoral scanner, the dentist is able to speedily produce a highly accurate dental model around which items like crowns, bridges, retainers, aligners and retainers can be made. Using readily available software for treatment planning and design the final appliance can be produced inhouse, thanks to a range of modern 3D printers. This has been made possible by the evolution of biocompatible resins that are not only acceptable to modern day demands but also speedy in being cured from the liquid form to a durable solid in short rapid time. The 3D printers use a range of ultraviolet technologies to cure the resin layer by layer that finally forms the intricate and complex shapes required in dentistry.

The 3D Printing process now has specialisations in orthodontics, dentures, implants and temporary teeth production as well as their design an fitting. In addition items such as bleaching trays, surgical guides, temporary restorations, indirect bonding trays, splints and guards can also be made quickly available. Largely dependant on the resins used, we can advise and supply for any solution. We distribute world famous SprintRay, Shining 3D, Exocad software and other digital dentistry solutions around Europe, through our Feniqx subsidiary and qualified resellers. In all cases we stock parts and accessories for all the products in both the UK and Italy. Awesome Technology supplies, warrants and repair their devices carrying both spares and consumables such as resins and tools needed to wash and cure the resultant appliances. We make our own tests on machines, materials and software to bring fist hand experiences to end users as well as trialing new solutions. The drawback to rapid changes in technology and processes can be that their full comprehension, the advantages of one type over another and the range of materials seen as a little daunting. Awesome Technology are very used to the typical (and sometimes abnormal) multiple questions for which answers are normally needed to progress.

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Technology

Four principles of successful system-level transformation in healthcare There are four key principles healthcare leaders should follow to embed and embrace system level transformation, writes the healthcare experts at PA Consulting Optimising healthcare can be a complex efficiently and effectively answer both challenge for any transformation and short- and long-term population health advice for those involved can sometimes priorities such as the patient backlog and feel contradictory, and offer incomplete or shortages in workforce across the system. changing requirements. For example, how do If ICSs are to be successful and truly you provide an individualised service of the transform healthcare services, our experience highest quality to an ageing and expanding has taught us there are four key principles population while cutting costs year on year? healthcare leaders should follow to embed In the UK, the NHS has undergone multiple and embrace system level transformation: reorganisations since its inception. At local, regional and national levels, leaders Think beyond have repeatedly tried to solve the cyclical organisational boundaries challenge of volume, cost and quality. System-level transformation requires The latest change calls for health organisations to work and care organisations to collaboratively to deliver Simplify come together to form the bigger picture. They’ll i n g Integrated Care Systems need to share insight, govern (ICSs). Legislation is resources and risks to a n c e structu to enforce these ICSs build and maintain the res and modelli from April 2022 as relationships required n g the out them arou NHS leaders try to to deliver complex drive collaboration change across a will allo comes requi nd red w tra in a bid to diverse range of

teams t nsformation quickly o respond an deliveri d focus on ng valu e

stakeholders. These relationships are crucial aspects of any system-level transformation as leaders will find themselves having to make decisions in the best interest of the system, even if they’re detrimental to their own organisation. Healthcare leaders need to ensure they carefully consider how to manage this continual balance of short-term risk and long-term reward, ensuring organisations aren’t penalised for doing the right thing for the system. In the Black country, we brought together four NHS trusts to redesign IT systems that would let their shared pathology service better provide for the region’s 1.4 million patients. By working beyond traditional organisational boundaries to collaborate on the new system, we’ve been able to free capacity by reducing over testing and reduce costs by £52 million over 10 years, all of which will improve services for both patients and staff across the region. E

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Technology

 Empower organisations and teams It can seem counter-intuitive, but creating rigid and wide-reaching governance structures to oversee, manage and drive system-level transformation is more likely to hinder than help. System-level transformation requires a partnership built on trust, where organisations and teams can take decisions quickly as everyone understands they’re working towards a clear goal. Simplifying governance structures and modelling them around the outcomes required, rather than an arbitrary governance mechanism for reporting or assurance, will allow transformation teams to respond quickly and focus on delivering value. Adopting such an agile approach offers many benefits when working on complex, system wide programmes. Consider the national responses to the Covid-19 pandemic, such as the UK Ventilator Challenge. Responding to the call from the UK Government in March 2020, quickly mobilised and coordinated a national programme to produce enough ventilators to meet unprecedented demand within the NHS, bringing together organisations across the public and private sectors. It was vital to align these disparate stakeholders around a shared mission so each could make effective decisions at pace to stay on track to achieve the ambitious goal. Stay true to the overarching vision and outcomes Transformation at a system level can quickly become overcomplicated, causing the programme to drift from the initial objectives. Leadership teams must establish a clear vision from the outset to unify collaborating organisations and teams. Maintaining a relentless focus on a vision throughout a transformation programme will help manage the natural evolution that happens as you overcome obstacles and find new opportunities. It’s also an important stabiliser to sustain system-level partnerships, ensuring all organisations remain aligned even

If ICSs are to be successful and truly transform healthcare services, our experience has taught us there are four key principles healthcare leaders should follow to embed and embrace system level transformation when competing priorities threaten to derail the transformation. In South East London, for example, transforming the pathology services to fit a new ‘hub and spoke’ model had the opportunity to improve diagnosis and treatment for millions of people across the ICS. By maintaining a clear and consistent vision across the primary and secondary care providers involved, we were able to agree a 15-year contract that should save the ICS more than £100 million while improving access to services. Design for simplicity and build to evolve System-level transformation requires an approach that’s adaptive, flexible, iterative and reflective by its very nature. Continuous evolution needs to be at the core of its design, especially when competing against other programmes and projects for time, energy and resources. Creating a complicated and detailed project plan can be time consuming, and latter stages are often out of date by the time teams come to implement them. Complement high-level roadmaps and a clear vision of the required outcomes with shorter horizons that focus on incremental goals. Breaking down the transformation into smaller, more attainable milestones means the transformation team can effectively manage and prioritise the critical path, often achieving the transformational aspirations sooner than expected. And celebrating each incremental milestone keeps the teams

motivated, organisations enthused, and transformation on track. This is what PA did with the North Central London Cancer Alliance, a partnership of NHS organisations, as they strived to reduce waiting times in the wake of the Covid-19 pandemic. By creating a vision for more efficient, sustainable endoscopy services, we were able to prioritise the most valuable projects, delivering them in parallel where possible, and launched them as they were ready. This simple system of constant evolution let the Alliance hit its goal four weeks ahead of schedule. Healthcare can undergo successful system-level transformation Successful system-level transformation will require ingenuity, strong leadership and a willingness to listen, learn and adapt. Keeping the structures, processes and governance simple, agile and responsive are key ingredients to maintaining and sustaining collaboration across organisational boundaries. Combined with a relentless focus on the overarching vision and outcomes, optimising the provision of healthcare to meet both shortand long-term health priorities is possible. L

By Ashley MacNaughton, Oliver Excell and Nina Stanley, healthcare experts at PA Consulting. FURTHER INFORMATION www.paconsulting.com/ industries/healthcare/

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Cyber security

Data security isn’t just a technology issue We revisit an article from NHS Digital in which the organisation highlights the importance of protecting information and data in the NHS and why NHS staff must be trained in knowing system vulnerabilities Whilst NHS organisations can, and should, organisations in the NHS were infected have solid cyber security measures in place, by the ransomware, but news of the no system is completely impenetrable, as cyber attack had a wider impact as other seen by the recent high profile attacks on services closed down their systems as a major global companies. The cyber security precaution. Most of these organisations, attack on 12 May 2017 affected a wide whether they were trusts or GP practices, range of countries and sectors across the followed NHS Digital’s guidance and put globe, and the fact that it affected more the ‘patches’ in place to protect systems. than 40 NHS trusts was a stark reminder Although there is always more to learn, of the vulnerability of inadequately doctors, nurses and backroom professionals updated IT systems. pulled together and worked incredibly It also reinforced the hard to keep services running and importance of being to get everything back to normal Keepin g vigilant and not as swiftly as possible. patient opening emails that s s a f e isn’t ju look suspicious Safer, more prevent st about or are from efficient care unexpected Modern healthcare attacks ing cyber h sources relies on good IT, which o w e a v lso abo with links or has been developed in ut emper. It’s loying attachments. partnership with end users best pr act A small and clinical informaticians, how IT ice in number of so that it provides the

used.

intended benefits of delivering better and safer care more efficiently. Manpreet Pujara is the clinical director for Patient Safety at NHS Digital. Together with the clinical safety group, he is responsible for ensuring that the health IT systems that are developed and deployed for use in England meet the recognised SCCI safety standards. He is also a member of the RCGP Health Informatics Group (HIG), which advises the college and other professional bodies on issues relating to the development and use of information management and technology in general practice. The Wanna Decryptor malware that was the culprit of the May attack spread across the world infecting computers in 74 countries in Europe and Asia. For the NHS, some patient records, appointment systems and medical equipment were rendered inaccessible. As a safety measure many GP surgeries were advised to switch off their systems and disconnect them from the network. E

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Two + two really makes four – get connected, get more Do you use a job management software application to manage your day-to-day operations? Do you use radio on-site? Connect the two and have tasks managed and delivered to your radios

When accepting the job you go through a series of simple key presses to confirm attendance to the job and then job complete. These key presses send a message back to the operator logging the change in status and the time. The timestamp is important when undertaking time analysis activities for business KPI’s.

Work still needs to be done Many people have seen a dramatic change in their workplace; large swings in the number of people on-site, varying from a reduced skeleton staff to large recruitment drives - both bringing with them their challenges. What remains constant is the need for business operations to carry on with everyday tasks and activities. To aid operational management businesses often deploy a task/job management application to support their endeavours, with operators receiving, logging and allocating jobs to colleagues. Often there is a disconnection when allocating the jobs, which means this part of the process can be time-consuming because it requires human intervention. That’s where the integration with your radio network can help save time and money. Getting Connected Using our Gen2 application linked with your existing task management software allows an operator to receive a job, find the resource, allocate the job and receive acknowledgement back. Utilising the connection with your radio network helps the process to be automated - enabling efficiency and retrospective analysis of time management from the reports available.

The benefits to using a radio with your job management software If you have a large workforce on-site, then the likelihood is that they will carry multiple devices with them; a radio, mobile phone, PDA, scanner by integrating your radio network with your job management software. Remove the need for copious amounts of hardware and get more out of what you have got. Utilising a radio but enabling it to have a PDA type function gives you a device that doesn’t have to rely on cellular or Wi-Fi coverage – engineered to work in the trickiest of spots on your site. It is robust, simple to use, won’t get used for personal use, offers a host of functions to aid health and safety whilst importantly still providing instant one-to-many voice calls, which you don’t get with other devices. If it’s not broken, don’t replace it You don’t have to replace your existing job management software, saving you not only time and money but also training on getting your team familiar with yet another new application. Simply connect to our Gen2

Work Flow The radio will receive an allocated job via a text message containing details of the job. The radio user can choose to accept or reject the job by simply pressing a button on the radio. Rejecting the job will send an acknowledgement back to the operator where the job can be re-allocated to another colleague.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

application and start sending jobs from your existing software to your radios. More than just a link if you want it Gen2 along with providing a valuable link to your existing job management software can also integrate into your fire, security, BMS and access control systems delivering messages, alarms and alerts to your radio, pager or smart device. This integration allows colleagues to become aware quickly of an escalating situation and provide the ability to review via the Gen2 reports. We aim to help people to work smarter not harder Our ethos is to provide solutions to aid people with their communication. Whether this is delivering a job to a team of Porters, alerting security staff of tamper alarm or engineers to a machine breakdown, we work with our customers to provide a solution to help business efficiencies, aid health and safety and site security. Our 25 years of business excellence, working with customers from a range of sectors has honed our problem-solving skills enabling us to share our knowledge and expertise with our valuable customers to ensure we offer the best solution we can. L FURTHER INFORMATION Tel: 020 8381 1338 solutions@call-systems.com www.call-systems.com

Cyber security

 Manpreet said: “There are several lessons we can learn from this. Chief among them is the role of practices and individual users in keeping the system safe. Every single device needs to be patched with the latest software. IT provided by CCGs and Commissioning Support Units should be maintained by them, but if GPs have bought other systems, for example telephone systems that run on PCs, then that’s their responsibility. You can’t just install something and forget about it particularly if it’s connected to your network. “And while filters remove the majority of malicious emails, occasionally one gets through, so we all need to be sensible. Though Wannacry was not the result of a spam email, it’s important that we ask ourselves ‘Was I expecting this email? Does it make sense? Does the sender normally send an email like this?’ “If the answer to any of these questions is ‘no’, then don’t open it, and don’t click on any links within suspicious emails. Don’t get tempted to look. ‘If in doubt - block it out’ and forward as an attachment to spamreports@nhs.net.” Cyber security Keeping patients safe isn’t just about preventing cyber attacks however. It’s also about employing best practice in how IT is used. Manpreet explains: “We heard of one organisation that was using NHSmail to cancel CT scans. Whilst NHSmail was never designed for this purpose or for referring patients, an organisation may think it is a reasonable use of the system, but only if they have considered adequate business continuity processes and assessed

Whilst NHS organisations can, and should, have solid cyber security measures in place, no system is completely impenetrable, as seen by the recent high profile attacks on major global companies the clinical risk should NHSmail not be available as happened in November 2016. “In one instance a CT scan booked for 3pm was cancelled by email at 2.55pm without assessing and considering the risk that the email may not be read and acted upon in time. In this case the scan went ahead, and a patient was needlessly exposed to radiation. This is why patient safety must always be considered and the SCCI standards met by those that develop and deploy health IT.” Manpreet has some ideas on how to ‘professionalise’ IT use - encouraging every member of staff with access to IT to undergo regular information governance (IG) and security of IT systems training. Consideration should also be given to enabling ‘fixed’ desktops across the practice so that unauthorised software cannot be installed without the system administrator’s approval. He says: “These sorts of measures are necessary, not least because of ‘Personalised Health and Care 2020’, a set of programmes commissioned by the Department of Health, NHSE and the National Informatics Board to ensure that by 2020 the NHS minimises its use of paper and is ready for a digital world. IT is changing the way we work, and clinical informatics is central to keeping our patients safe. If we don’t keep our

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

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Debt recovery services for the private parking industry Debt Recovery Plus (DRP) is the leading provider of debt recovery services to the private parking industry, providing debt recovery and back office solutions to 90 per cent of the industry, handling over 120,000 unpaid parking charges each month

Based in a call centre environment, we have a core telephony team who can handle incoming and outgoing calls to motorists to help resolve any issues, answer questions and ultimately settle any unpaid parking charges. We can handle client payments 24/7 via our web/automated services along with our dedicated team of advisers. Debt Recovery Plus has been the chosen provider of debt recovery services to the leading parking operators for over 10 years, helping our clients grow along the way. By working closely with the operators, we have helped to strengthen the parking industry through educating and challenging each other with new ideas.

and review their parking management strategy to ensure that they are offering their client a suitable solution. At DRP we create bespoke recovery strategies for all our clients, which helps them to deliver an educated recovery model designed specifically for the industry which they are working. We can provide recovery for clients on commercial, residential, retail, rail, airport and NHS sites. Our aim is to deliver an ethical approach to debt recovery to help our clients capture any unpaid parking charges whilst at the same time allowing the motorist an opportunity to discuss their case. Within our group our

Delivering a one stop enforcement solutions Debt Recovery Plus, alongside litigation specialists Credit Style Limited, is part of the Bristow & Sutor Group, which is one of the largest debt recovery providers in the country. The group aims to deliver a one stop enforcement solution to all our clients whilst also utilizing cutting-edge technology. With over 40 years of enforcement experience within the group, we can offer our clients advice based upon our knowledge of all debt recovery sectors along with tried and tested solutions to help our clients maximise revenue recovery whilst protecting their data and reputation. Data reports At DRP we know how important each and every one of our client’s parking charge notices are, which is why we employ client specific teams to analyse the data and report back on any trends, unfamiliar patterns and unusual cases. This helps our clients and landowners to identify persistent offenders

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

priority is our client’s data, when making any decisions on strategy, reporting or collecting on a case Compliance is our first thought. When GDPR was introduced we decided as a group to implement a GDPR team at both of our offices. Our GDPR teams implement compliant processes and practices at each office along with helping our clients with any GDPR questions which they may encounter along the way. L FURTHER INFORMATION www.debtrecoveryplus.co.uk

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During normal times, trusts can have up to two thirds of parking spaces dedicated to staff which means trusts are looking at the practical options open to them to reduce demand for spaces space in and removing grass verges. We have also been using off-site parking at a local university to provide free staff parking.” Making the parking experience seamless There is wide support amongst trusts for the government to make capital funding available to invest in much needed new parking technology. It would make the whole hospital parking experience more seamless and hassle free for all, which has got to be a good thing. Access control, connectivity to patient services, real-time reservation of spaces and so much more would be technically feasible. However, this can only be done with appropriate planning, procurement, and implementation of new parking management systems. As Aldridge puts it ‘the aim is for people with concessionaries to turn up on site and leave the car park without going through an arduous process of proving that they have been to an appointment’. New systems could allow for clinics to pre-register people for the frequent outpatient concession removing the need to claim back after the appointments. It could even remove the need for paper permits - a common feature in hospital parking. The extra funding was included in the 2021/22 government Spending Review but it is not known yet what capital funding will be made available. Challenging times The other immediate challenge for hospital parking, aside from implementing the concessions is catering for increases in visitor and patient numbers, whilst continuing to meet the demand for staff parking, which has been free throughout the pandemic. During normal times, trusts can have up to two thirds

of parking spaces dedicated to staff which means trusts are looking at the practical options open to them to reduce demand for spaces. For example, the extension of agile and flexible working which has been one of the more positive outcomes of Covid. Many non-clinical staff are working from home, such as HR and admin, which helps to ease demand for staff parking and trusts are looking at how this might work in the longer term. Predicting the future Speaking in his position as BPA Healthcare interest group chair, Fowler is also thinking longer-term and what might happen to hospital parking in five to ten years’ time. With the NHS long term plan and the bigger economies of scale with the introduction of Integrated Care Systems, he predicts there will be reduced need for parking. ‘There will be more short-term stay, more pick-up and dropoff, a greater emphasis on green and social prescribing, active travel, more agile working especially with admin staff, an increased need for ambulances and the creation of travel networks where public transport is integrated with the future Integrated Care Systems.’ So watch this space, things are changing fast in many sectors and hospital parking is no exception. L

*On 1 April 2021 new government NHS car parking guidance 2021 replaced the ‘NHS patient, visitor and staff car parking principles’ that was originally published in 2015. The Health Technical Memorandum (HTM) 07-03 remains in place. FURTHER INFORMATION www.britishparking.co.uk

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Facilities management made simple Facility management software is certainly an investment, but one that can create many long-term gains. However, it’s all about finding the right application for your organisation

Asckey specialises in facilities management software and has been supporting and developing applications for the FM sector for over 25 years. From supporting and upgrading the WIMS task management system within the NHS to developing our own fmfirst® Estates CAFM software. We’ve been continually developing our product portfolio to support the growing responsibilities of facilities managers. Computer-Aided-FacilitiesManagement software (CAFM) There are many CAFM software solutions on the market but what Asckey pride themselves on is always keeping the client in mind. This was the drive behind becoming ISO9001:2015 (Quality) and ISO27001:2013 (Information Management Security) accredited as we know quality and data security are important to our clients. Our customer-centric approach to the development of our applications is what makes it so easy to use. We ensure that each step follows a logical approach that makes it easier to navigate compared to other CAFM software providers. Intelligent Information flow and availability is at the heart of fmfirst® Estates. The intuitive system design and functionality simplifies user operation with a variety of key modules which include; • Help-desk • Asset, task and PPM management • Compliance and document management • Reporting

The simplified task management system helps users to better collate and analyse data. By doing so, resources can be allocated better, life cycle of assets can be extended and overall costs can be reduced. Put simply, it allows users to digitally manage tasks, maintenance and track/update jobs instantly. The best part is, this application can be integrated with our cleaning and survey applications. It can also be integrated with third-party applications, helping you to collect and analyse data across platforms to gain the big picture. Cleaning audit software Cleaning audit software allows users to digitally conduct cleaning audits in line with the National Standards for Healthcare Cleanliness 2021. Asckey’s fmfirst® Cleaning application is designed to speed up the process of these audits. fmfirst® Cleaning has been purposefully built to have minimum click-through options and be an easy-to-use application. It’s also designed to automate report emails once audits have been completed with any corrective actions that are required. This method of providing instant fault reporting and the options for rectifying, allows users to take action right away. Being a cloud-based application, you achieve cost-savings and its intuitive design makes it multi-platform and device compatible. Easy to use, ability to create audits quickly and saves you money, fmfirst® Cleaning could be the software you didn’t know you needed.

Asckey Data Services was the first company to gain SFG20 Approved Provider status. SFG20 schedules can be integrated with our CAFM system, fmfirst® Estates, giving organisations increased control over maintenance schedules and costs. With over 500 maintenance schedules covering over 60 equipment types, subscribers can choose the specific schedules they require for the buildings and assets they manage. The SFG20 schedules will give you the optimal maintenance instructions, frequencies and required skillsets for the work required. Task management We recognised that our CAFM system can be too complex for the needs of some of our clients and for smaller FM providers. So, in 2020 our team developed fmfirst® Tasking. This application offers an alternative, costeffective, stand-alone task management solution to help streamline internal and external tasking processes.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Survey software Survey software is a great addition to facilities departments who only require the collection of data for individual tasks e.g., fire risk assessments, patient feedback etc. Asckey’s fmfirst® Survey has a tailored software design meaning it can be adapted for any survey or audit type. We can build your existing templates into the application or we can create new ones to ensure you get what you need. This can include a variety of data entry options including creating conditional question sets. Again, our cleaning audit software can be too complex for those requiring cleaning audits outside of the National Standards. And this is where fmfirst® Survey can step in. Facility management software removes the need for spreadsheets, brings consistency and gives the right people, the right information at the right time. It can help reduce or remove human error as work orders are less likely to be duplicated. The digital records also provide an audit trail of work that has been carried and review dates can be easily tracked. But facilities management applications don’t have to be complicated. They should be simple enough to ensure there is a smooth transition for staff from one way of working to another. We continue to enhance our internallydeveloped facilities management software based on feedback from clients. This means that we have every confidence in our software and the benefits it offers to our clients. L FURTHER INFORMATION www.asckey.com

Catering

Sharing best practice in a kitchen setting

on relevant areas of nutrition. So far, this has included the fortification of meals for malnourished patients and how to adapt recipes to suit different dietary requirements. For example, ensuring alternative vitamin and protein sources are present in plant-based or vegetarian dishes. The recipes used in the sessions have been developed by our culinary teams specifically for NHS use and are all mapped to our NHS Supply Chain supports the outcomes of the Independent approved ranges of products on our Multi Temperature Distribution (MTD) Framework. Review of NHS Hospital Food with the Chef’s Academy From November 2020 to November 2021, we are launching six culinary concept ranges. Each concept is centred around a culinary theme In October 2020, the report from the staff, marketing and recruitment that is crafted with insights from consumer Independent Review of NHS Hospital for hospitals chefs and recognising trends, with the objective of providing greater Food was published. The report focuses excellence amongst catering staff. variety to consumers whilst also increasing on the main challenges for NHS catering NHS Supply Chain: Food launched the Chef’s revenue within retail environments. and makes recommendations in eight Academy in 2020. The programme invites The first three of these culinary concepts areas for system-level change. NHS hospital chefs to free training days have already been launched. The ‘Khana The report’s recommendations include with live demonstrations, hands-on cooking, Khana’ range, which includes Indian streetinvestment in the professional development and guest speakers. It gives NHS caterers food inspired vada pav’s (Indian-style burgers) of NHS chefs and catering staff, working the opportunity to network with peers and and traditional curries, the pan-Asian inspired towards healthier food for NHS staff, share best practice in a kitchen setting. ‘Bamboo’ range and our latest ‘Root Kitchen’ patients and visitors, and ensuring that The events are hosted by the NHS range, which consists of plant-based vegan and nutrition and hydration is a mandatory part Supply Chain: Food team’s culinary vegetarian dishes. The further three upcoming of health and care professionals’ training. specialists and are designed to inspire culinary concepts will be launched over the The outbreak of Covid-19 and the innovation and professional development next six months and will be demonstrated subsequent impact on the NHS has further amongst NHS chefs and catering staff. at future Chef’s Academy sessions. highlighted the importance that nutritious Nick Vadis, Culinary Specialist at NHS Supply The dishes prepared also come with food is widely available throughout Chain, said: “By giving this opportunity to nutritional analysis and have been designed NHS hospitals, both for the recovery of NHS chefs we hope to encourage a better to complement hospital food standards. Of patients and for the well-being of staff. world for staff and for those enjoying our main dishes launched to date, 75 per cent NHS Supply Chain is committed to providing food at NHS hospitals – something are 600 calories or less, 70 percent meet with trusts with products and services that supported by the Independent Review salt reduction targets, and 95 percent improve hospital food. We have introduced of NHS Hospital Food 2020.” meet with sugar reduction targets. various initiatives, such as developing our Nutrition and well-being We will soon be providing NHS nutritionally balanced culinary concepts and are important premises “By giv chefs with a tool that provides inviting NHS chefs to take part in our Chef’s of the Chef’s Academy this opp ing a nutritional overview of Academy programme, which directly support sessions. Either our recipes, allowing chefs to the recommendations within the report. in-house nutritionist to NHS ortunity c h easily search for dishes or our in-house e f s h w ope to e with specific nutritional About the Chef’s Academy dietician join each e nc a bette values, such as high Recommendations 1C, 1D and 1F from the of the sessions to r worldourage fibre or low sugar, to review include career-long professional provide a 40-minute f o r and for staff suit patient needs. E development for NHS chefs and catering presentation tho

se enjoyin NHS hog food at spitals.”

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Completed sessions Due to Covid-19 restrictions, the Chef’s Academy programme was placed on hold at the start of this year. After consideration, it was decided not to replace the sessions with virtual events as they are designed to involve interactive cooking demonstrations and hands-on learning with culinary experts. Since lockdown restrictions have eased, we have held nine Chef’s Academy events in culinary colleges across the UK so far.

The outbreak of Covid-19 and the subsequent impact on the NHS has further highlighted the importance that nutritious food is widely available throughout NHS hospitals, both for the recovery of patients and for the well-being of staff

These include: • Squarefood Foundation Kitchen, Bristol, 30 October 2020 • Harborne Food School, Birmingham, 24 March 2021 • University of West London, Ealing, 30 March 2021 • West Herts College, Watford, 8 April 2021 • South Downs College, Waterlooville, 13 April 2021 • Foodsorcery Cookery School, Didsbury, 27 April 2021 • Leeds City College, Leeds, 12 May 2021 • University of West London, Ealing, 24 May 2021

Following up with attendees The follow-up after each academy event is important to us, as we intend for the recipes and skills developed at each Chef’s Academy session to be reflected by our attendees in NHS kitchens around the country. Therefore, we develop all of our recipes and demonstrations to suit an NHS kitchen environment. All attendees receive a recipe sheet with the necessary information and support to embed the new recipes into their workplaces. Where appropriate, we also have discussions about pricing in staff and visitor restaurants in order to increase revenue in retail environments. Phil Shelley, chair of the NHS Food Review attended the Chef’s Academy session alongside the NHS Supply Chain team in Ealing. He said, “It was a great session. Seeing things like menu plans, nutritional analysis and the expertise of NHS Supply Chain’s Culinary Lead Nick Vadis resulted in excellent plant-based meals from the Root Kitchen range created by the NHS chefs on the day. There’s no doubt that the Chef’s Academy has created a buzz.”

A total of 82 NHS chefs and culinary staff have joined the sessions to date, and the response from our attendees has been overwhelmingly positive, with an average feedback score of 9.6 out of 10. Robbie Deeming, from Essex Partnership University NHS Foundation Trust, said it was ‘a brilliant course, I gained a lot of knowledge’ whilst Paul Sibley from Dorset Healthcare University NHS Foundation Trust said the course was ‘very interesting and enjoyable’.

Summary The Chef’s Academy events have inspired innovation amongst NHS chefs and culinary staff. The sessions have already supported a move towards positive change in food in NHS environments by introducing new and exciting dishes. The recipes are ambitious but achievable, with an understanding of the limitations that NHS kitchens may face. We are hopeful that Chef’s Academy sessions can begin to bridge the gap in culinary training,

Catering

 The Chef’s Academy programme is our response to a gap in training and resources available to NHS chefs. By offering these opportunities to chefs we can assess the positive affects that this could have on staff retention, motivation, and importantly, the impact on the food produced in NHS environments.

as outlined in the Independent Hospital Food Review of 2020, as NHS Supply Chain aims to encourage professional development amongst NHS chefs through the sessions. Nick Vadis, our Culinary Lead, explained: “We have been so pleased with the passion we have seen from attendees. There is a definite appetite for learning and development from NHS chefs. The academy events provide a necessary space to pause, reflect, and grow.” We are currently finalising a selection of venues and dates for the second block of Chef’s Academy sessions available across the country from July onwards. If you are interested in joining a session, please join the waiting list here and one of our team will be in touch. About NHS Supply Chain NHS Supply Chain manages the sourcing, delivery and supply of healthcare products, services and food for NHS trusts and healthcare organisations across England and Wales. Managing more than 4.5 million orders per year, across 94,000 order points, 17,465 locations and delivering 25 million lines of picked goods to the NHS. NHS Supply Chain system consolidates orders from over 800 suppliers, saving trusts time and money and removing duplication of overlapping contracts. Lord Carter’s report into efficiency and productivity in the NHS, published in 2015, identified unwarranted variation in procurement across the NHS, resulting in the need to improve operational efficiencies to transform a fragmented procurement landscape. To undertake this transformation the Department of Health and Social Care established the Procurement Transformation Programme (PTP) to deliver a new NHS Supply Chain. The new NHS Supply Chain was designed to help the NHS deliver clinically assured, quality products at the best value, through a range of specialist buying functions. Its aim is to leverage the buying power of the NHS to negotiate the best deals from suppliers and deliver savings of £2.4 billion back into NHS frontline services by the end of the financial year 2022/23. The new model consists of eleven specialist buying functions, known as Category Towers, delivering clinical consumables, capital medical equipment and non-medical products such as food and office solutions. Two enabling services for logistics and supporting technology and transactional services which underpin the model. L FURTHER INFORMATION www.supplychain.nhs.uk

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Hand hygiene – pandemic necessity or everyday habit? Chris Wakefield, Vice President, European Marketing & Product Development, GOJO Industries-Europe Ltd. examines how daily habits have changed in the wake of the Covid-19 crisis At the start of 2020, all eyes were on hand hygiene. Media outlets around the globe were running stories about handwashing, signs promoting good hand hygiene cropped up everywhere, and walking five metres without encountering a sanitiser dispenser seemed impossible. Yet one year on, how much have hand hygiene habits really changed? PPE usage Though official recommendations relied heavily on hand hygiene precaution, anecdotally the use of gloves was high through the first few months of the pandemic. Worryingly, this was often associated with poor practices, including extended use of gloves, decontamination with hand disinfectants, and reuse.1 A study has found that viruses can survive on gloves for two to four hours, so some of these practices may have contributed to the relatively high rates of Covid transmission within hospitals. One in six SARS-CoV-2 infections among hospitalised patients with Covid-19 in England during the first six months of the pandemic could be attributed to nosocomial transmission.2 As sanitiser availability increased, and the damaging impact of overzealous PPD use became clear,3 5 Moment hand hygiene practices appeared to stabilise at a higher level than pre-pandemic.

Establishing best practice As restrictions ease, many trusts have been able to re-implement hand hygiene audits, and arrange awareness activities, such as events to celebrate World Hand Hygiene Day. Working with trusted partners such as GOJO Industries, IPC teams have been working hard to make sure that doctors, nurses and patients are all aware of the importance of adopting effective hand hygiene practices as a daily habit, and not just a knee-jerk reaction to an impending threat. Habit-forming for the long term There are a few things healthcare providers can do to make sure that increased hand hygiene compliance can become a long-term feature of their establishments. Install innovative, easy-to-use and accessible dispensers Whether wall-mounted or free-standing, pushactivated or touch-free, reliable, attractive and easy-to-use soap and sanitiser dispensers are a must. Touch-free dispensers are increasing in popularity as they dispense just the right amount of product every time, reducing wastage and reducing the likelihood of irritant contact dermatitis occurring through over-application of product.

Select gentle but effective, scientifically advanced formulations With increases in occupational dermatitis caused by incorrect PPE usage and frequent handwashing, particular attention should be paid to the formulations of products selected for healthcare usage. Gentle, dermatologically tested formulas that are pleasant to use will have a positive impact on compliance levels. Any sanitiser selected should be fully virucidal with short contact times, and clinically proven to keep skin healthy. Choose formulations, in gel or foam format, which have been tested and have passed key hospital norms EN 1500, EN 14476 and EN 12791 to ensure efficacy in real-life scenarios. Raise awareness Signage and informative leaflets for staff, patients and visitors alike can be very effective as a prompt, especially at key germ hot-spots such as washrooms and waiting areas. A comprehensive suite of signage indicating, where, how and when hands should be cleaned provide a vital service in helping to keep hand hygiene top-of-mind on a daily basis. Ensuring hand hygiene is a practice that is adopted daily is central to GOJO’s mission of saving lives and making life better through well-being solutions. As part of this, GOJO is committed to creating products which deliver results that are also kind to the skin. After all, hand hygiene is only an effective infection control measure if everybody in a facility practises it. And ultimately, it’s not just about killing germs; it is about protecting the health of workers, patients, visitors, and our wider community. L FURTHER INFORMATION Tel: +44(0)1908 588444 infouk@GOJO.com www.GOJO.com Kampf G., Lemmen S. Disinfection of gloved hands for multiple activities with indicated glove use on the same patient. J Hosp Infect. 2017;97:3–10. 1

Healthcare-associated COVID-19 in England: a national data linkage study Alex Bhattacharya, Simon M Collin, James Stimson, Simon Thelwall, Olisaeloka Nsonwu, Sarah Gerver, Julie Robotham, Mark Wilcox, Susan Hopkins, Russell Hope medRxiv 2021.02.16.21251625; doi: https://doi. org/10.1101/2021.02.16.21251625 2

Atzori L., Ferreli C., Atzori M.G. COVID-19 and impact of personal protective equipment use: from occupational to generalized skin care need. Dermatol. Ther. 2020 doi: 10.1111/dth.13598. 3

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Infection Prevention

The world leading conference on Infection Prevention Disappointed not to deliver its annual conference in 2020, and mindful of the ongoing pandemic, everything is being organised for a successful IP2021 this September elements come together to provide We were all disappointed not to deliver our delegates and our industry partners with an annual conference in 2020 but are looking excellent environment in which to further ahead to Liverpool 2021 with the hope that build relationships and exchange ideas we will be able to meet in September as concerning products and technologies. planned. We are, of course, mindful of the Topics this year include, but are not limited ongoing pandemic and will continue to review to: what happens to infection prevention and adjust plans if necessary. We are already and control during a pandemic?; drivers provisioning for a hybrid element to allow those of pandemics; compassion in infection who will be unable to join us physically and prevention and control; PPE challenges; hope that you will save the date for #IP2021. Covid-19 reflections and learning; infection Over the last decade we have developed prevention outside of acute care, and more. a reputation for an outstanding scientific There will be a practical workshop in leadership programme, with a wide range of international and an opportunity to take part in research. and UK based speakers. Feedback from delegates in the past has Infection positioned us amongst Over th Prevention 2021 the worlds-best for the e last dec Microorganisms and range and quality a d e we have de healthcare continually of educational a reputa veloped evolve, IP2021 is your and industry best opportunity to content. These outstan tion for an stay up to date. The program ding scientifi three-day conference, c range ome, with a wid will present the latest f in e scientific evidence from and UKternational around the globe to enable based attendees to recognise, speaker understand and address s current and emerging risks. A

hybrid element has been provisioned for 2021 to allow those who will be unable to join physically to still enjoy the conference. As well as networking opportunities, the annual awards ceremony, and the exhibition, the show all boats a range of renowned national and international speakers. These include: Dr Dawne Garrett, Professional lead older people and dementia care, Royal College of Nursing, who will present on the risks, rights and ramifications for older people living with dementia in care homes; Martin Kiernan, Clinical Fellow at the Richard Wells Research Centre at the University of West London, who will present on the unintended consequences of PPE; a session on the burden of device related infections - the use of a collaborative approach for improvement; Professor Sally Bloomfield, Honorary Professor, London School Of Hygiene And Tropical Medicine, who will address the topic of how we re-engage the public to play their vital role in preventing spread of infection; and a seminar on ‘The Forgotten Menace? The Danger for Measles Reemergence in Healthcare’. Covid-19 safety measures At Infection Prevention 2021, the organisers have endeavoured to make the conference E

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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D A VF E

A letter from Public Health England and the Health and Safety Executive has urged hospitals to protect frontline staff wearing PPE amid a warning about the risks of heat stress.

The three-day conference, will present the latest scientific evidence from around the globe to enable attendees to recognise, understand and address current and emerging risks. A hybrid element has been provisioned for 2021 to allow those who will be unable to join physically to still enjoy the conference  safe for all face-to-face attendees by putting in place relevant Covid-19 safety measures, where required. These include items such as: social distancing within session rooms and around the conference centre; one-way systems; hand sanitising stations throughout; enhanced cleaning

and operation of the venue; and online registration options available for those unable to travel to the conference venue. L FURTHER INFORMATION

Infection Prevention

Hospitals told to protect staff working in PPE during warm weather

Sent to hospital trusts, GPs and pharmacies, the letter said that doctors and nurses should be given regular breaks and recommends that a buddy system be established with people urged to watch for the signs of heat stress, which can lead to more serious heat stroke. The memo also indicates that NHS managers should expect staff productivity to be affected while warning that demand for discardable PPE would grow since staff must discard their masks and gowns between each break, which they are being encouraged to take more regularly. In 2018, around half of NHS hospital trusts reported at least one incident of overheating, and close to one in 10 (eight per cent) reported more than 50 incidents. Heat stress has similar symptoms to heat exhaustion and can lead to heat stroke if the person is unable to cool down.

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Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Arts-based initiatives: vital to the positive mental well-being of NHS workers Drawing on ideas and techniques used in the arts sector, executive director Jo McLean explains how Performing Medicine has supported the mental health and well-being of the NHS workforce throughout the pandemic

• Managing stress • Self-care • Effective communication • Diversity and inclusion • Working in PPE • Team building • Presentation skills and presenting online

Focus on: Social prescribing workforce development programmes Our newly developed workforce development training programme was piloted in Southwark and Merton and focuses on how arts and culture can play a key role in healthcare and social prescribing. The programme supports this complex, cross-sector workforce to develop understanding, as well as practical skills to help foster better communication with each other as well as with the people being referred. Due to the success of the pilot, the programme is ready to be rolled out nationally, and Performing Medicine welcomes new collaborations across social prescribing; using our skills and knowledge to help everyone involved work together more effectively. Focus on: Free mental health and wellbeing resources Developed specifically for those working in a healthcare environment, Performing Medicine has a suite of free resources. Recovery Room guides healthcare workers through a series of movements that can be completed individually to help refocus and reenergise, and all you need is a chair! From advice on orientation and spatial awareness, and non-verbal communication, to breathing techniques and body-scans, ‘Coping with PPE’, developed for University College London Hospitals NHS Foundation Trust (UCLH), addresses the issues around

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wearing PPE. It includes tips from professional actors and performers, including War Horse and Star Wars, who are used to wearing heavy restrictive costumes, masks, puppets, animatronics, and prosthetics. NHS bespoke programmes Co-designed by the Performing Medicine team who is passionate about the sector, directly with individual healthcare organisations, our bespoke programmes are made to match your specific environment and include courses, one-to-one coaching, forums, and drop-in staff wellbeing sessions. Forums: bringing the arts world to healthcare Our forums accommodate staff groups of up to 500. These bespoke interactive scenarios draw on research and interviews with staff to create situations performed by expert actor-facilitators. NHS staff teams are an active audience, and are invited to stop the action, respond and modify behaviour to influence outcomes. This type of learning experience is a non- threatening and unique way to encourage staff to become actively involved with a challenging ‘real-life’ situation where they can replay different approaches to test outcomes. This technique is a highly effective means of support during times of uncertainty and disruption. L Experts in the field of arts-based initiatives in healthcare, Performing Medicine, an initiative founded by charity Clod Ensemble, provides art-based training programmes to support the mental health and wellbeing of the NHS workforce, driving recovery from the pandemic.

FURTHER INFORMATION Tel: 020 7749 0555 www.performingmedicine.com @PerformingMed1 © Benedict Johnson

Healthcare professionals have faced sustained, intense pressures from working in an environment hit by the major shock of Covid-19, resulting in a rising number of staff experiencing work-related stress, anxiety and burn out. These pressures have taken a significant toll on exhausted NHS staff, impacting mental health and well-being, which is reflected by an increase in staff absences. The mental health and well-being of NHS staff is high priority; it is vital to ensure that our workforce is in a strong position to continue delivering patient care, and vital to the future efficiency and effectiveness of the healthcare system. At Performing Medicine, our focus is to drive transformation and change in this area; to demonstrate the valuable role of arts-based initiatives for the workforce in a healthcare environment. The arts and health sector has provided muchneeded support throughout the pandemic, providing mental health and well-being support and resources to many NHS teams. Today Performing Medicine associate artists continue to deliver high impact sessions to help NHS organisations take positive action to ensure the mental wellbeing of their teams in the aftermath of the pandemic. Throughout our 20 year history of working in the sector, Performing Medicine has built robust partnerships with NHS organisations using arts-based approaches for creative healthcare training and research programmes. Our unique work uses ideas and techniques from the performing and visual arts to support more than 18,000 health professionals and medical students with practical skills; to use their bodies and voices for effective communication and to better look after themselves and their colleagues. Our unparalleled training courses are designed to allow clinical and non-clinical staff to learn together, with content to challenge existing mindsets. Key topics include:

Focus on: staff mental health programmes Our highly interactive workshops empower staff to cope better with work-related stress, and help staff deliver compassionate care, using techniques that are likely to be new to many whilst creating engaging experiences for everyone. Our recent work with Swansea Bay University Health Board led to an increased awareness into the importance of self-care for the workforce, and highlighted the impact that staff’s own wellbeing, nonverbal behaviour, pace and posture has on other people. During the pandemic our workshops have been delivered virtually, and as restrictions begin to lift, delivery of face-to-face sessions is commencing, where appropriate, along with continuing online sessions to fit around the schedules of busy teams.

Buildings

Meeting the ever-changing and urgent demand for space We revisit the thoughts of Simon Taylor, head of Portfolio Optimisation at NHS Property Services, as he discusses how the NHS and wider healthcare system will need to optimise its facilities post-coronavirus From offices to health centres, the way we use space is changing. The Covid-19 pandemic has prevented many from entering the spaces that we have become accustomed to working in and, as a result, we have all had to adapt to new ways of working. While offices have been closed for months - allowing managers time to reimagine how space will be used when the pandemic inevitably relents - hospitals, clinics and health centres have remained very much open. Because of this, they have had to rapidly adapt their spaces to protect other patients and NHS staff from Covid-19. At NHS Property Services (NHSPS), we have been working alongside the NHS to help them meet the ever-changing and urgent demand for space; a challenge that we will continue to face beyond the Covid-19 pandemic. Optimising the NHS estate When thinking about optimising the NHS estate, one of the main challenges is knowing your estate and who it is allocated to. It is therefore vital that organisations are aware of the parts of their estate that are mostly occupied, partially occupied and empty. It

optimisation is understanding the demands of is possible to gather this intel in a variety the people and services occupying the space. of ways, and one easy example of this is by This can become difficult when one building has looking to the people on the ground. We multiple stakeholders with different priorities, were able to do this effectively through our but by asking customers about their current ‘empty spaces’ campaign, encouraging our and future requirements and the challenges facilities management teams who work they face, it is possible to better understand across our estate to report to the facilities their actual needs and consider all of the management helpdesk about how the spaces available property options. It is important to within NHSPS’ properties were being used. clearly set out all requirements and challenges Technology can also help organisations to from the start, so that all stakeholders can gather this kind of intel. For example, there visualise the best option for everyone involved. are simple solutions that can be utilised, Taking the time to understand our customers’ such as installing a sensor in the main foyer space requirements enables us to identify of a building that will capture footfall going creative solutions to build capacity through the building, providing a in the space that they already rough estimate of the number of occupy, or nearby. This may people accessing a property. Taking provide them with lower By gathering occupancy t he time cost options and quicker data, combined with to underst delivery compared to local knowledge and a custom nd our building something technological inputs, new. For example, we we can then better require ers’ space m e were approached by a assess how space is n t se us to id GP who needed more being used; a key step entify c nables reative space, with the initial to optimising space. solution request being to build The next important capacit s to build y in th a new primary care E stage in estate

e sp that the y alreadace y occupy

Issue 21.3 | HEALTH BUSINESS MAGAZINE

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Using vacant space well Allocating space differently, as well as using technology to facilitate the booking of space for temporary use, can also help with the process of estate optimisation. For example, if a health centre has an unused room, a local physiotherapist could book the room for the hours that they need to work, with other essential healthcare providers booking the room at different times throughout the day. This allows patients to have a range a healthcare services available to them in their area – services they may not have had access to in the past. If however, there is vacant space that neither the building occupiers nor other professionals are using, we can then consider how it can be used to support social prescribing opportunities in local communities.

Through a new initiative called ‘Healthy Places’, we plan to adapt the aesthetics of a space so that it can become more functional and suited to the occupier’s demands, while simultaneously benefitting the welfare of all those who use the space In addition, it’s also possible to adapt existing buildings to change the space internally, particularly if the building is older and structurally sound but its interior needs reconfiguration or an update. We have been able to use this approach successfully over the past few months, transforming under-utilised clinical space to provide additional bed capacity to support Covid-19 wards at low cost. It is also important to bear in mind the interior or aesthetic of a property and how this impacts the way the space and the staff within it function. Through a new initiative called ‘Healthy Places’, we plan to adapt the aesthetics of a space so that it can become more functional and suited to the occupier’s demands, while simultaneously benefitting the welfare of all those who use the space. This is particularly important for hospitals, clinics and health centres as the interior of these spaces will impact the mental

Buildings

 centre on the grounds of a nearby hospital. By having a detailed discussion with them to understand their specific requirements, we were able to help the GP and Commissioner consider how much space was really needed and advise them on a range of alternative options. This resulted in identifying the more straight-forward solution of reconfiguring and refurbishing unused hospital space. Similarly, following the Covid-19 pandemic, it seems likely that a significant number of healthcare consultations will continue to be digital which may mean that different types of space will be needed. If this is the case, additional reconfiguration projects may be needed in order to save the estate money, but also to adapt to new ways of working.

wellbeing of patients, in addition to the people that work in the buildings. Covid-19 has undoubtedly changed the way that both office space and healthcare estate are used. The social distancing guidelines brought about by the pandemic have made the standard metrics of how many employees there are in a space somewhat irrelevant for now, while on the other hand, healthcare centres have had to increase their capacity and space in order to treat and protect additional patients. In the post Covid-19 world, as we continue to support the delivery of the NHS Long-term Plan, workspaces will continue to have a different purpose than before, and we must endeavour to optimise space according to the ever-evolving demands and requirements of this country’s patients and staff. L FURTHER INFORMATION www.property.nhs.uk

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Patient safety

Never events within the operating theatre Although considerable improvements have been made in the safety of patients undergoing surgery, never events continue to present a significant challenge nationally for those working within the NHS and independent sector in the UK, despite existing national guidance. Here, Lindsay Keeley looks at never events within the operating theatre A surgical never event (NE) analysis of NHS England NE data from April 2012 to February 2020 identified a total of 797 surgical NEs categorised under three main headings: 427 wrong-site surgery, 355 retained items postprocedure and 15 wrong implants or prosthesis. These are considered wholly preventable because there are guidance and safety recommendations in place at a national level, that all providers should implement in the health care system. Comparable data from NHS Improvement showed 496 reported NEs in the public sector between 1 April 2018 and 31 March 2019, most of which had been identified as wrong-site surgery. These statistics, figuratively speaking, are alarming, demonstrating that the safety systems in place due to human error are not robust enough to provide a protective barrier from harm.

Surgical Safety Checklist The operating theatre is one of the most The WHO ‘Surgical Safety Checklist’ common locations for adverse surgical incidents 2008 provided a designated core set of and harm to occur. Yet, as we know, never safety standards to reduce risks events are recognised as a system associated with surgery. or process failure that can lead “As Providing three individual healthcare professionals to healthc stages of checks serving to make mistakes, leading either trigger a process to patient harm or profess are io check of a critical step, even death. n a ls, we mu act as a prompt to Implementing s t c o n tinue to prom discuss a patient’s a robust clinical ot surgical plan or identify governance framework of repo e a culture r t any potential problem within organisations in g and transpa that could arise should prevent r e n c y, w patient during a procedure. NEs from occurring, safety c here In 2019 ensuring that adequate o n c a e r r e not b the WHO celebrated risk management rushed ns ten years of the ‘Surgical systems are in place aside.” Safety Checklist (SSC) and should be practised, tool’, which was updated and thus safeguarding patients. mandated in 2009. This provided a

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Responsibility and accountability In September 2015, NHS England responded to the challenges faced in delivering safe care for patients by introducing a set of National Safety Standards for Invasive Procedures (NatSSIPs 2015) to support organisations implementing their own harmonised Local Standards for Invasive Procedures referred to as (LocSSIPs). Nevertheless, the rates of NEs continued to occur within healthcare organisations. NHS Improvements latest Never Event report between 1 April 2020 and 31 March 2021 revealed an alarming 364 NEs.This included 142 wrong-site surgery, 31 wrong-site blocks,

The most recent summary from NHS England shows 30 never events occurred between 1 April - 30 April 2021, including 17 wrong-site surgery and six retained foreign objects post-surgery 27 wrong lesions removed and 15 wrong tooth or teeth removed, 30 wrong implants or prosthesis of which 10 were lenses, 80 retained foreign objects, 15 surgical swabs, and 23 vaginal swabs being retained post-procedure. When looking at the statistics provided above, the rates of error and harm, in particular, demonstrate enormous responsibility and accountability for those healthcare professionals working in the perioperative environment. The most recent summary from NHS England shows 30 never events occurred between 1 April - 30 April 2021; this included 17 wrong-site surgery, six retained foreign objects post-surgery, of which two were vaginal swabs, and two wrong implants or prosthesis. Having reviewed the most recent NHS England and NHS Improvements NE reports, particular categories are recurring. However, the Care Quality Commission (CQC) stated, on the whole, the NHS has checklist compliance greater than 90 per cent with some variability. There are standards and recommendations available to support local organisational policy to address local and national standards across all theatre environments.

Patient safety

more robust standardised approach for all patients undergoing a surgical procedure or surgical intervention both globally and nationally across the United Kingdom. However, feedback from the revised checklist suggested a further two steps were required, a briefing and a debriefing to reduce patient harm. This led to the three-point checklist being converted to the ‘Five Steps to Safer Surgery’ implemented by the National Patient Safety Agency. Although this simple but effective tool has saved countless lives and improved the outcomes of many patients undergoing surgery both globally and nationally, never events continue to be a challenge for healthcare professionals and patients. The most essential aspect of the WHO Surgical Safety Checklist to be considered is the timeout where the perioperative pause is initiated involving all the surgical team. This must take place when the patient is on the operating table before surgery begins. The timeout should ensure the correct site, correct procedure and correct patient to minimise patient harm and costly mistakes.

Never event statistics reported by NHS England and Improvement are ‘alarming’ considering standards and guidance have been introduced to reduce their occurrence. This represents an opportunity for significant changes and the need for improved education in perioperative practice, as this document has highlighted. Lindsay Keeley, Patient Safety and Quality Lead from AfPP, states: “As healthcare professionals, we must continue to promote a culture of reporting and transparency, where patient safety concerns are not brushed aside.” L

Lindsay Keeley is patient safety and quality lead for the Association for Perioperative Practice (AfPP). The AfPP has been supporting theatre nurses, ODPs, HCAs and all those working in and around operating departments for over 50 years, setting standards and guidance on best practice. AfPP aims to enhance the quality of care and patient safety in the NHS and the independent sector throughout the UK. FURTHER INFORMATION www.afpp.org.uk

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Mail: hello@schneider-medical.com Web: www.schneider-medical.com

Schneider Medical GmbH ǀ Robert-Bosch-Straße 7 ǀ D – 77866 Rheinau / Germany ǀ T:+49 7844 7051 ǀ F:+49 7844 4535

Our customer pledge – our name stands for this:

High Quality Products – Made in Germany At Schneider Medical GmbH, our core business is producing and selling gel and powder products for cold and warm application. In particular, this involves reusable compresses, one-time instant compresses, orthopedic bandages and bottle coolers for use in the fields of medicine, wellness, sport, household and thermal transportation. Furthermore, we produce numerous white label products under the manufacturer’s brand for well-known internationally-operating wholesalers in the medical product sector.

Schneider Medical GmbH is Headquartered in Rheinau a town in southwest Baden-Würrtemberg, Germany which belongs to the Eurodistrict Strasbourg-Ortenau. Situated in the northern Black Forest at the eastern edge of the Upper Rhine Valley. Approximately 11km from the Eurocity Strasbourg and 130km from the pharma capital Basel, Switzerland.

Medical equipment

AI technologies to revolutionise NHS care The Department of Health and Social Care has announced that 38 new pioneering artificial intelligence projects will help revolutionise care and accelerate diagnosis Thousands of patients and NHS staff will benefit from dozens of new pioneering projects awarded a share of £36 million to test state-of-the-art AI technology. The projects will help the NHS to transform the quality of care and the speed of diagnoses for conditions such as lung cancer. Health and Social Care Secretary Matt Hancock announced the winners of the second wave of the NHS AI Lab’s AI in Health and Care Award at CogX Festival on 16 June. The AI in Health and Care Award aims to accelerate the testing and evaluation of AI in the NHS so patients can benefit from faster and more personalised diagnosis and greater efficiency in screening services. The 38 trailblazing projects backed by NHSX and Accelerated Access Collaborative (AAC) include: an AI-guided tool to help doctors and nurses to diagnose heart attacks more accurately; an algorithm to fast-track the detection of lung cancer; an AI-powered mental health app to help tackle symptoms of anxiety and depression while also identifying people experiencing severe mental health difficulties; and technology to help spot undiagnosed spinal fractures. More than 17,000 stroke patients and over 25,000 patients with diabetes or high blood pressure have already benefited from the first round of the AI in Health and Care Award since September, where £50 million was given to 42 AI technologies. Hancock said: “AI has the potential to completely revolutionise every part of how we approach healthcare, from how we diagnose diseases and the speed at which our doctors and nurses deliver treatments to how we support people’s mental health. The 38 projects we are backing reflect the UK’s trailblazing approach to

innovation in the healthcare sector, and could help us take a leap forward in the quality of care and the speed of disease diagnoses and treatment in the NHS. “Confronted with this global pandemic, our tech sector has risen to the challenge and upended how we do things through innovations to support people to test from home, complete remote consultations and diagnose issues safely.” The successful projects The 38 projects which are being supported by the second wave of the AI Awards include: an algorithm from BeholdAI that can identify suspected lung cancer in chest X-rays to increase the numbers of cancers diagnosed and reduce the time patients wait for scans; the Paige Prostate cancer detection tool to help pathologists identify cancers and their spread in digital images to improve diagnostic accuracy and help tackle rising caseloads; Zebra Medical’s Bone Health Solutions tool to analyse existing CT scans to look for previously undiagnosed spinal fractures that could be a sign of osteoporosis to find more patients living with this undiagnosed disease, ensuring they receive appropriate advice or medication; and mental health app Wysa – an AI-powered chatbot and series of self-care exercises which will provide mental health support, helping people manage their mental health. Patients will be given access to the app during the referral process for mental health services, to explore whether the app can ease symptoms of anxiety and depression before patients receive assessment and treatment. The AI award package also includes funding to support the research, development and

testing of early phase, promising ideas which could be used in the NHS in future. This includes: an AI-guided tool that could diagnose heart attacks more accurately and quickly through better interpretation of blood analysis; using AI with home monitoring equipment to predict sudden dips in the health of cystic fibrosis patients, aiming to prevent them occurring; developing AI to measure the volume of brain tumours from scans to assess which are at risk of growth to ensure those patients are monitored more frequently; and using data from 20 years of previous kidney transplants to improve the decision-making process for a patient to receive less-than-perfectly-matched donor kidneys or wait for the next available one. The AI in Health and Care Award will distribute £140 million over three years, with the next round of applications set to open in late June. Four categories of AI products are being supported: phase 1 – to support the demonstration of the technical and clinical feasibility of the proposed concept, product or service; phase 2 – to support the development and evaluation of prototypes and generate early clinical safety and efficacy data; phase 3 – to support the first real-world tests in health and social care settings of AI products or tools to develop evidence of efficacy and preliminary proof of effectiveness; and phase 4 – to support the spread of AI products or tools that have market authorisation but insufficient evidence to merit largescale commissioning or deployment. L FURTHER INFORMATION www.nhsx.nhs.uk/ai-lab/

Issue 21.3 | HEALTH BUSINESS MAGAZINE

SunVit-D3 manufacture one of the widest & most cost-effective ranges of vitamin D supplements on the UK market with over 30 preparations from 200IU to 50,000IU, including tablets, capsules, liquids, soft gums & calcium combination products. While SunVit-D3 products are marketed as food supplements & do not hold medical licenses, they have been included in the prescribing guidance of many CCGs & used in many hospitals, especially at strengths & in preparations where there is no licensed alternative.

In fact, SunVit-D3 is currently the 6th most prescribed vitamin D brand in England & Wales. Though the wide & inclusive range of SunVit-D3 branded product can benefit the UK population the most when it is recommended to patients to purchase to prevent vitamin D insufficiency, deficiency & all the health risks that are associated with low levels.

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There truly is a SunVit-D3 product to suit almost everybody 10,000IU 20,000IU 50,000IU CAPS CAPS CAPS

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CCS

Helping the NHS workforce recover from the pandemic Now more than ever we need to acknowledge that additional support is needed for those who have spent the last 12 months caring for patients under the most difficult circumstances. The Crown Commercial Service detail some of the support on offer Coronavirus has shown that our and mentally well is vital to bringing physical and mental health and welldown these waiting lists and ensuring being is more important than ever - and the highest standards of care. nowhere more so than in the NHS. As Hilary Winch, chair of the NHS Health Without a healthy workforce the NHS at Work Network, commented: “There is cannot provide the high quality and increasing demand for occupational health effective service that is so essential to services within the NHS and trusts should be helping tackle the backlog of patient thinking about ensuring they have sufficient care that has built up during proactive occupational health support. the pandemic. According Now more than ever making sure our to a report by the workforce is healthy and supported “There British Medical post Covid is key to our recovery is no qu ick Journal, 4.7 million and building and retaining fix for a people were a resilient workforce.” s u c c e ssful health a waiting to begin being p nd welltreatment at the NHS Staff Survey end of February The annual NHS Staff requires rogramme, it 2021. This is the Survey results, which were engage highest number published in March this time an ment, since records year, highlight concerns over commit d began in 2007. the well-being of the NHS ment.” workforce and the impact the Impact of Covid pandemic has had on staff. on health and well-being Yet it is expected that many NHS workers will need vital support to deal with the toll the pandemic has had on their health – especially frontline staff who have been faced with traumatic situations on a regular basis for many months now. Supporting all NHS staff to ensure they are physically

The survey found that: 44 per cent of staff had reported feeling unwell due to workrelated stress in the last 12 months – a 3.7 per cent increase from last year; and 46.6 per cent of frontline staff reported stress compared to 41.7 per cent in 2019 – an increase of 4.9 per cent. However, as NHS Employers say on their website: “There is no quick fix for a successful health and well-being programme, it requires engagement, time and commitment.” Occupational health This is where the new Occupational Health, Employee Assistance Programme and Eye Care framework from the NHS Workforce Alliance could be a crucial support tool for NHS trusts. The framework gives you access to a wide range of proactive and preventative services, as well as treatments, designed to help you support your employee’s health and wellbeing. This includes dealing with issues such as stress, burnout, anxiety, domestic abuse and bereavement. Enhanced psychological support services, mental health screening and psychological surveillance are all new features of the framework, and these are services that may be particularly helpful for supporting staff who have been subject to traumatic events in their roles. E

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Advertisment Feature

Cyber security innovation in healthcare and pharmaceuticals Threat protection and risk management are the pillars of security. Rethink your approach to cybersecurity with the help of Medicare Network Understanding the Risk Landscape Today’s threat actors are more equipped and capable of achieving their nefarious goals than ever before:

In recent years, the healthcare and pharmaceutical industries have been increasingly targeted by sophisticated and intelligent cyber attacks. Faced with on-going threats to medical records, trade secrets and financial data, as well as critical infrastructures and life-critical medical equipment that are vital to day-to-day operations and ultimately, patient care. Health and pharmaceutical industry The global pandemic has put a spotlight on cybersecurity from supply chain risks, the convergence of critical infrastructures (e.g. Information Technology (IT) with Operational Technology (OT) networks), to a lack of visibility, unmanaged Internet of Things (IoT) and insecure devices. But that’s not all, cybersecurity risks are now moving beyond traditional IT assets to connected life-critical medical devices and technologies. As the healthcare and pharmaceutical industries continue to embrace digital transformation, enterprise security is becoming more critical. These industries are built on innovation, with significant investments in research and development (R&D) and intellectual property (IP) on drugs, medicines and patient health data. Hence, bridging the gap between business and healthcare, has become a hot spot in the health data threat landscape.

• • •

State-sponsored – nation-state Hacktivist – political social, or religious justice Criminal – ininfiltrate systems with malicious intent

In addition to threat actors seeking financial gains or causing disruption, pharmaceutical companies in particular also have to contend with the full capabilities of Nation-States and other pharmaceutical companies with state sponsorship. Therefore, this makes cyber attacks on the healthcare and pharmaceutical industries inevitable. Today’s traditionally security efforts and compliance requirements are no longer viable to demonstrate comprehensive security and compliance to address as digitalisation takes hold. Rethinking the approach to cyber With the increase in cyber attacks, hospitals, medical institutions and pharmaceutical companies are starting to consider nextgeneration security technologies to improve their overall security postures. Deploying Artificial Intelligence and Machine Learning (AI/ ML) enabled security technology solutions, will intelligently identify and predict any potential cyber threats to critical infrastructure and lifecritical medical devices. Yet innovation without a secure foundation can lead to various challenges. This is because IT and OT teams have entirely different priorities in terms of defined objectives and risks.

IT uses the Confidentiality, Integrity and Availability (CIA) triad model to prioritise data protection. This allows systems to be regularly taken offline for patching, updating, and slowing down to appropriately encrypt and inspect as a reasonable trade-off. OT management turns the CIA triad model on its head. Availability of systems and the safety of workers and citizens are the highest priorities of OT. Process integrity runs a close second to safety to ensure that systems perform as expected. Confidentiality, which is the number one priority for IT, comes in as a distant third in favor of safe and continuous OT operations.

Leveraging AI/ML powered security technologies can counter and respond to the most sophisticated and targeted cyber attacks. It provides the capability for threat hunters, helping to protect systems, medical devices and critical infrastructures long before a threat is identified and classified by a human security researcher. The foremost advantage of using AI/ML in security technologies is its intrinsic ability to scale. Therefore, establishing an assured efficiency that cannot be achieved through labour-intensive systems operating in isolation. The healthcare and pharmaceutical industries face numerious threats every day, making it impossible to quickly analyse and categorise the data. AI/ML will simplify the process of identifying, predicting and responding to cyber threats. Another advantage of AI/ML is that it can simultaneously undertake multiple tasks, monitor and protect a large number of disparate systems and medical devices. This, in turn, will diminish false positives and cyber attacks on a large scale in a manner that traditional security systems cannot achieve. AI/ML security technologies are not a silver bullet or here to replace humans, but to empower them in order to survive and mitigate malicious behaviour of complex and intelligent cyber attacks. To get the most out of AI/ML in cybersecurity, the healthcare and pharmaceutical industries need to recognise what tasks systems, devices and machines do best and what tasks people do best in a digital world. L FURTHER INFORMATION +44 (203) 355-3785 clientservices@mednetsec.com www.mednetsec.com

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

CCS

 You can also access new services such as return to work assessments and management of Covid-19 in the workplace, including how to deal with long Covid. Overstretched resources Crucially the framework enables you to select just the services you need, providing the ideal solution to complement any existing in-house provision you may have – particularly if it is overstretched right now. Bethan Flynn, Commercial Agreement Manager at Crown Commercial Service, led the procurement of the new framework on behalf of the NHS Workforce Alliance. She has said: “The impact the pandemic has had on all of our lives is immeasurable, and NHS frontline colleagues have worked tirelessly to save lives. Now more than ever we need to acknowledge that additional support is needed for those who have spent the last 12 months caring for patients under the most difficult circumstances. This framework will help trusts to source additional capacity and make sure their staff can access the services they need quickly.” It is also worth noting that all the suppliers available through the framework are flexible in their delivery methods, and offer remote options wherever possible – and where clinical governance allows. Suppliers must also ensure their services meet accessibility requirements, giving you peace of mind that your inclusion and diversity needs will be met. For example, any websites, portals or apps used must be equally accessible for all.

Now more than ever we need to acknowledge that additional support is needed for those who have spent the last 12 months caring for patients under the most difficult circumstances. This framework will help trusts make sure their staff can access the services they need quickly The NHS Workforce Alliance The NHS Workforce Alliance is a team of experts from the NHS Procurement in Partnership and Crown Commercial Service. We are motivated by a genuine desire to make the NHS better. You can

trust us to act in the best interests of the NHS – always putting patient care first. L FURTHER INFORMATION www.workforcealliance.nhs.uk

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Cyber security

How can we improve cyber security in healthcare? This event, taking place online on 23 September, will provide valuable insight into what steps organisations across the healthcare supply chain are taking to improve cyber security The NHS is made up of more than 8,000 organisations, with many more across the wider health and care sector. The sheer size and scale of the sector makes maintaining robust cyber security a challenge, which is only further exacerbated once you consider the complexities and sensitivity of the data involved. There has been a surge of new digital technologies being used in healthcare in the last few years and ever-larger quantities of data are being generated. This provides opportunities to improve health and care

demonstrated its vulnerability to this type services, but it also presents enormous of threat. It brought hospitals and GP risks in protecting data and maintaining surgeries across England and Scotland safety, privacy, and trust of patients. to a standstill for several days, costing In 2017 the WannaCry global the UK an estimated £92 million. cyber attack affected over The Covid-19 pandemic has 200,000 computers in A varie caused a significant increase 150 countries. While t y o f comp in cyber criminals targeting not specifically le x and coordin healthcare organisations with targeted at the a ted cyb attacks scams and phishing emails UK, the attack e r have ta over the past 15 months. compromised r h g ealthca eted The impact of lockdowns IT across the r e provide across t forcing healthcare staff NHS and rs h

ew the star orld since to pandemf the ic

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

The Covid-19 pandemic has caused a significant increase in cyber criminals targeting healthcare organisations with scams and phishing emails over the past 15 months

Cyber Security in Healthcare 2021 Cyber resilience in healthcare is now a high priority and organisations are being encouraged to take a proactive rather than reactive approach to securing networks, devices and data. The Institute of Government & Public Policy will be hosting the Cyber Security in Healthcare 2021 virtual conference on 23 September. This timely event will bring together heads, directors, senior managers and chiefs of information security, technology, cyber security, data protection, digital and security strategy from private healthcare, medical device manufacturers, NHS, and the voluntary sector to discuss pertinent issues facing the sector today.

This event will provide valuable insight into what steps organisations across the healthcare supply chain are taking to improve cyber security. It will detail the latest resources and support that is available from government and NHS agencies to support their initiatives and help to mitigate the risks of increased data and technology use in the NHS. Best practice examples of innovative cyber security projects will be also detailed through case study presentations. Delegates will learn from senior representatives from across the NHS and wider healthcare sector. Stuart Hosking-Durn, head of Resilience and Patient Flow at University Hospitals of

Cyber security

to work from home demonstrated that many organisations were not adequately prepared for the enforcement of this digital revolution. This meant they were, and some continue to be, vulnerable to a wide range of cyber threats. Since the outbreak began, a variety of complex and coordinated cyber attacks have targeted healthcare providers across the world.

Morecambe Bay NHS Foundation Trust, will speak at the event. Stuart will present a case study on lessons learned from the WannaCry cyber attack, and how the Morecambe Bay NHS Foundation Trust prepared to respond. In his presentation, Stuart will share insight into the use of IT systems to constantly monitor the health of the network and routing firewall systems that look for signs of attack, and how the trust dealt with 150 cyber attacks in five years, identified by a rigorous reporting system. He will share details of the response to the WannaCry cyber attack and implementing measures to protect the IT infrastructure in the organisation. Stuart will be joined by fellow healthcare leaders and representatives of leading organisations from across the sector sharing their own insights, learnings, resources, and guidance. Through the learning opportunities and sharing of best practice, attendees will be able to implement improvements in the workplace. We will identify and assess the key factors that make the health and care sector particularly vulnerable to being targeted by hackers. Attendees will also find out how to effectively increase cyber security awareness and embed cyber security into quality systems and organisational culture. Network opportunities Cyber Security in Healthcare 2021 will provide an opportunity for delegates to network and engage in question and answer sessions with speakers throughout the day. The virtual coffee lounge is a great way to connect with other attendees and continue the discussion between the live sessions. Sponsors of the event include Bitdefender, Osirium, Synopsys, and One Identity by Quest. The virtual conference exhibition will provide an opportunity to connect with representatives from the event partners, understanding what they can offer and how they are supporting the NHS and wider healthcare industry to tackle cyber security challenges. Meet other like-minded professionals beneficial to your network, and form part of the conversation and debate that will impact the wider agenda for future planning. L

Find out more about the event and secure your place with a Health Business member discount using the code HBCYBER20 at the checkout: www.igpp.org.uk/hbcyber FURTHER INFORMATION www.igpp.org.uk

Issue 21.3 | HEALTH BUSINESS MAGAZINE

Designing digital health services for real people

As patients and service users of the NHS, many people are used to managing their lives online: entertainment, shopping, socialising, banking and, over the last 15 months, learning and working online. But the ability to manage health and well-being online has been fragmented at best. Not only do people expect more, the NHS can benefit significantly from cost-savings and improved outcomes by combining a digital approach with traditional service delivery. Personal health records (PHRs) and patient portals give users a secure space to access information such as care plans, prescriptions and test results, and carry out transactions, eg booking appointments, joining video consultations or ordering repeat prescriptions. PHRs also allow people to take ownership of managing their health with trackers, goal setting and viewing meaningful data to support selfmanagement, as well as accessing approved, personalised resources to educate, inform

and support. All these tools and information can be shared with others and users can communicate securely with their care team. Almost overnight, the Covid-19 pandemic showed the vital importance of using digital tools to manage our lives and healthcare is no exception. PHRs offer an incredible opportunity to provide resources, tools and information to a population en masse at low cost as well as the ability to provide face to face services online where it is appropriate and safe to do so. One of the biggest changes the sector has seen is in attitudes to digital tools but patients, service users and clinicians who were previously reluctant, have now embraced digital. This is particularly crucial as PHRs will be an essential tool in responding to the ongoing impact of Covid-19, whether it’s reducing the load on overstretched services through self management and increasing efficiency, or supporting people dealing with long-Covid-19 symptoms.

Mindwave currently provides PHRs/patient portals in 2 ICS regions and 8 trusts, projecting roll out to ~20 more orgs in the next 2 years.

Connects patients to their records

Connects patients & care team

including diagnoses, appointment

via a circle of support, allowing

details, access to virtual appointments,

users to share their PHR with others

clinical letters & results, health history

& communicate via messaging &

& forms

notifications

Tracks health and wellbeing including

Provides tailored resources

mood, sleep, pain, alcohol, smoking

such as infomation, events & stories.

etc. Graphs to show overviews &

Auto-personalised for users, eg

comparisons. Integrated with third

diabetes specific apps. Integrated with

parties to sync data.

third parties for clinically approved content. Maia PHR Find out more

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Mindwave designs digital health services for real people and is one of the leading NHS approved PHR developers in the UK. Designed with and for patients, carers and clinicians, Mindwave’s PHR, ‘Maia’, brings a person’s health information into one easy to manage, easy to access place. Maia is deployed in two regions and eight NHS trusts, integrating with clinical systems and other third party tools to provide a seamless experience with the best functionality available on the market. As digital development partners to NHS organisations, Mindwave is agile, Government Digital Service compliant, open source, interoperable and committed to keeping users at the heart of everything the company does.L FURTHER INFORMATION https://mindwaveventures.com/

G-Cloud

G-Cloud 12 framework extended until September 2022 The Crown Commercial Service has decided to extend G-Cloud 12 for 12 months from its original end date of 27 September 2021 to 27 September 2022

G-Cloud 12 went live on 28 September Since its launch in 2012, over £7 billion of 2020 for an initial term of 12 months. The cloud services have been purchased using extension gives CCS the time to make the G-Cloud framework. With 5,224 suppliers improvements to the customer journey awarded a place on G-Cloud 12, over 38,000 including accessibility, search services are available for customers to functionality, and the access. Highlighting that CCS has presentation of the been successful in broadening Digital Marketplace the framework’s appeal, the Since it s platform, before organisation reports that launch i n the next iteration there was growth of over 2 0 12, over £7 of the agreement 25 per cent from G-Cloud b i l l i on of cloud s is delivered. It 11 to G-Cloud 12. er is anticipated been p vices have that these Cloud-based services using th urchased enhancements The G-Cloud framework e G-Clo will also help facilitates the purchase of ud framew ork to increase commoditised, cloud-based opportunities services. Services are off-thefor suppliers. shelf with many pay-as-you-go, CCS has said that it is up-to-date and innovative solutions. consulting with suppliers and More than 90 per cent of the suppliers customers over the planned changes, and on G-Cloud 12 are SMEs, providing easy updated information regarding G-Cloud 13 will access to a range of smaller suppliers and be provided in the near future via the Digital supporting the government’s commitment to Marketplace and the Upcoming Deals page. spend £1 in every £3 with small businesses.

G-Cloud is a move away from long term contracts, with a maximum duration of 24 months with the option to extend twice by up to 12 months each time (subject to approval for central government customers). G-Cloud 12 is split into 3 Lots: Lot 1 Cloud Hosting, Infrastructure as a Service (IaaS) and Platform as a Service (PaaS); Lot 2 - Cloud Software, Software as a Service (SaaS); and Lot 3 - Cloud Support, Cloud support to help set up and maintain cloud software or hosting services. Patrick Nolan, Technology Pillar Director at Crown Commercial Service, said: “G-Cloud continues to be a great public sector success. It encourages innovation and improves services for UK citizens, by allowing customers and suppliers to find each other easily. Now, more than ever, SMEs have a crucial role to play in our economy, and G-Cloud is a proven method through which they can grow their businesses and support the national recovery.” E

Issue 21.3 | HEALTH BUSINESS MAGAZINE

DIGITAL PATHOLOGY SOLUTIONS BY TRIBVN HEALTHCARE TRIBVN Healthcare is pioneer and leader in supporting pathologists in the transition to digital pathology. This transition involves the digitization of glass slides into digital slides using slide scanners. It substitutes the conventional microscope with a digital workstation to facilitate the workflow of pathologists. We support hospitals, universities, and research centers by equipping them with our flagship IMS (Image Management System) CaloPix which allows to view, analyze, annotate, and share histopathology slides. The IMS is interfaced with the LIS (Laboratory Information System). It is a specialized integrated management software that offers a better working organization and a full case traceability from gross imaging to whole slide imaging. TRIBVN Healthcare is at the heart of the digital transition with vendor-neutral solutions for the entire digital pathology workflow. Thus, our software solutions are compatible with all scanners, LIS, archiving solutions and Artificial Intelligence (AI) algorithm providers. We propose today our own solution dedicated to archiving: CaloPix Archive. This solution allows a full slide life-cycle management from hot to cold storage at a cost-effective price.

We also provide a second opinion platform, TeleSlide TeleMedecine which allows exchanges and interaction between pathologists in a short time frame and remotely. It is an online platform dedicated to gross, microscopy imaging and digital slides sharing as well as tele-expertise and remote sub-specialty screenings. It centralizes telemedicine protocols and workflows to develop collaborative networks anywhere in the world. On the other hand, to assist professors on the development of complete educational curriculums we created TeleSlide MultiMedia. It is an online platform on which teachers can create practical and clinical cases by uploading and sharing files, while assessing the knowledge of their students. Our team is also working on creating AI algorithms to help to streamline pathologists’ workflows so that they can focus on making diagnosis. Our AI algorithms are robust thanks to rich data sources, time saving on routine tasks for pathologists and are easy-to-handle. Furthermore, our software is Granted with CE marked for primary diagnostic use and all our solutions are referenced on G-CLOUD 12 and are therefore government approved. Lastly, we continuously develop products with partners to evolve in line with your requirements.

Contact us at : +33 1 89 20 00 07 info@tribvn-hc.com https://www.tribvn-hc.com/ 2 rue du Capitaine Scott 75015 Paris FRANCE

G-Cloud

 Cloud Compute In May it was announced that public and third sector organisations that want to purchase high volume cloud hosting solutions flexibly can now do so through a new CCS commercial agreement - Cloud Compute. Cloud Compute lets customers rapidly scale up or down their usage as and when required, with longer call-off options than other cloud agreements and more flexibility over taking on new service offerings during the contract term. The products offered through the new agreement are defined as Infrastructure-asa-Service (IaaS) and Platform-as-a-Service (PaaS), which can scale rapidly to meet any change in demand. As part of the tender process, bidders were asked to provide evidence of how they would support customers to achieve social value through their contracts – boosting sustainability and economic inequality. CCS is launching Cloud Compute to complement G-Cloud, which has shorter call-off terms and a wider pool of suppliers able to offer more diverse services. Cloud Compute focuses on flexible (‘hyperscale’) compute environments, used for the development of new software applications or where large and complex data sets need to be modelled, for example. Being able to rapidly scale up or down the service offered is crucial, and unavailable through G-Cloud. The framework will run for four years and is available to the whole public and third sector. Call-off terms are up to three years, with two possible extensions of up to 12 months each.

In May it was announced that public and third sector organisations that want to purchase high volume cloud hosting solutions flexibly can now do so through a new CCS commercial agreement Cloud Compute ‘Off-the-shelf’ digital services This advise from Jos Creese, CEO of digital consultancy business CCL, was provided for Government Business last year in which he looked at why digital public services means a move away from ‘off-the-shelf’ solutions. The digital service requirements of public sector organisations are increasingly difficult to define. This is one of the reasons why agile development is such an important methodology, and also why a move away from wholly predefined software solutions (‘off-the-shelff’ – OTS) is inevitable. This is an interesting departure from past IT strategies: for as long as I can remember the mantra of IT departments and public service organisations developing their digital and IT strategies, has been ‘off-the-shelf only’ – no bespoke, no tailoring, and no customisation. The point was, that in the past, IT departments had tailored and customised every IT solution to the nth degree, often in response to the needs of individual departments. ‘The business leads, not IT’ we were told as IT leaders, and IT performance was measured on the ability to design

application for every and any requirement, without question. This created a complex and expensive legacy nightmare, as well as locking public services into inflexible and long term IT contracts where pre-defined SLA metrics were quickly a poor indicator of true performance. Today’s public services need better applications and technology tools if they are to meet digital ambitions and potential. Most of the traditional OTS solutions from the traditional vendors are just not sufficiently innovative, adaptable, or functionally rich. They are also prone to the problems of lock-in and bundling. At the extreme are the traditional IT outsourcing models that have proved to be so problematic and ineffective, often holding back progress rather than powering it. Unique solutions It does not mean that there is no place for large, OTS solutions, but it means that they will in future play a smaller part in the mix of cloud and bespoke solutions, where low-code and small modular apps are in the ascendancy. This is pushing public service organisations to develop their own, or to work with E Issue 21.3 | HEALTH BUSINESS MAGAZINE

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G-Cloud

 suppliers who can provide bespoke solutions. This is as true in cyber protection as it is in application development. But it is also not a move back to the past where IT departments were developing unique solutions. More, it is about using modular IT components in a more flexible way. A good analogy would be buying a new car. You can buy a standard car from a manufacturer, or, you can ‘bespoke’ your purchase in terms of most of what is ‘under the bonnet’ (gearbox, engine size and type), other components, colour and interior fittings. But it’s still a standard car from a manufacturer that does not compromise any warranty or safety standards and is readily serviced and maintained, with available spare parts. That is the sort of bespoke that we need to see in IT development in the public sector. Digital maturity This, however, does put greater emphasis on the importance of relationships with IT suppliers, especially in pre-tendering engagement. A partnership approach is necessary, rather than depending solely on a detailed and fixed specification through a tender cycle. This can help IT suppliers to understand better the changing nature of public services requirements, and for the public service organisation to be clear on the risks and technical opportunities proposed. More critically perhaps, it also depends on the digital maturity of public sector organisations, especially in being able

to understand and establish new risk models in a digital world where there is less predictability, and a greater need and willingness to experiment and innovate. IT requires public bodies to have a clear digital vision, based on digital policies, standards and architecture. This is the basis for engaging with suppliers and developing bespoke solutions that complement OTS yet do not create a ‘free for all’ and a fragmented

digital landscape. Without this foundation, public services risk compromising the potential value of data, restricting shared services, and limiting wider interoperability. Where public service organisations get this right, it opens up some new and exciting possibilities for tech SMEs in particular, since innovation and flexibility become key competitive advantages that are harder for the larger traditional incumbents to match. L

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Issue 21.3 | HEALTH BUSINESS MAGAZINE

SECURITY

Improved safety for people, assets and infrastructure

Enabling the analysis of data on real time

For the first time ever, the science of ultrasonics can now reduce airborne contagion spread, and maintain critical sterilisation, in hospitals and pharmaceuticals, via the Portascanner® COVID19. Coltraco Ultrasonics applied 30 years of expertise to design a solution to help the NHS fight COVID-19 having won a UK Government grant. A December 2020 study showed that 56% of air samples taken from hospital hallways contain high levels of coronavirus (JAMA Network). Existing methods for achieving

pressurisation are disruptive, costly, ineffective – user cannot identify specific areas of leakage, leaving remedial action to inaccurate speculation. The Portascanner® COVID19 improves air quality and protects staff and patients against the spread of airborne diseases, such as SARS-CoV-2 and beyond. This is a hand-held, non-invasive, easy to use instrument, allowing

the user to locate and quantify leaks as small as 0.5mm in diameter. The air flow rate can then be calculated, generating an air permeability value for an entire cleanroom or hospital ward. The healthcare sector can now go above and beyond standards, with the ability to photograph, record, and export test reports, all in the tap of a finger. FURTHER INFORMATION sales@coltraco.co.uk www.coltraco.co.uk

The go to consultancy for technology projects Monochrome Consultancy believes that projects should be predictable, reliable and, most importantly, that commitments made should always be kept. Monochrome is a UK based consultancy which is trusted by some of the largest organisations in the world, supporting both public and private sectors. The company specialises in delivery of IT projects, transformation and change that has always been on time, within budget and exceeds client expectations. This is achieved by providing project managers and consultants who act as an expert extension of your delivery teams. Recent case studies include leading the fastest deployment of ServiceNow in NHS history on behalf of Bucks Healthcare NHS Trust, and transforming

the IT service within London Borough of Harrow Council, improving customer satisfaction and SLA performance. Additionally, Monochrome led a 335 per cent increase in speed of delivery for a cyber security team at a large oil and gas company. If you are looking to start some transformation or even just a project, talk to one of the team at Monochrome Consultancy who will guide you through the best approaches and methodology to make it a success. FURTHER INFORMATION Tel: 0203 923 9843 contactus@ monochromeconsultancy.co.uk monochromeconsultancy.co.uk

the cloud. Nifty follows the best practices industry standards in providing the BigData and DevOps services to the client and aims to provide best quality solutions to clients. Nifty Systems internally audits all the areas in which it provides services starting from prerequirement phase till the post implementation phase, and the organisation assures that the best quality of solution has been established, including starting from the prototype phase till the platform becomes capable enough to enable the live services. Nifty Systems provides support based on the client needs, including feedback management to improve the service and fulfilling the client’s requirements.

Nifty Systems specialises in providing services to various government sectors, focusing primarily on providing data analysis using cutting edge technology so that clients can get the benefit of analysing live data in real time. Nifty Systems also focuses on automating the IT infrastructure and provides consultation on different technologies in DevOps. The company’s expertise includes delivering the client’s project from scratch and migrating the existing applications/software from both on-premise or off-premise to

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