Health Business 21.6 by PSI Media

ISSUE 21.6 www.healthbusinessuk.net

HB TOP 50

FIFTY INSPIRING PEOPLE Our ranking of the most influential healthcare professionals in 2021

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PLUS: ESTATES MANAGEMENT | FINANCE | HB AWARDS | NET ZERO

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ISSUE 21.6 www.healthbusinessuk.net

HB TOP 50

FIFTY INSPIRING PEOPLE Our ranking of the most influential healthcare professionals in 2021

WE SCAN THE MOST DIFFICULT MEDICAL RECORDS, LET US SHOW YOU visit www.digitiseyourdocuments.co.uk

PLUS: ESTATES MANAGEMENT | FINANCE | HB AWARDS | NET ZERO

Recognising those who are transforming the NHS In this issue of Health Business we not only share the winners of the 2021 Health Business Awards, but we also detail our first HB Top 50 NHS Professionals list. The Top 50 list is our pick of the people that have had the greatest impact on the health system in England over the last few years. Please do take time to read the list, which begins on page 34, and join me in congratulating those who continue to work under the banner of our wonderful National Health Service. A special congratulations also to those who were recipients of Health Business Awards on 9 December. Whether it was in recognition for a new hospital building, a mental health initiative or an inspiring response to the coronavirus pandemic, our winners fully deserve their accolades.

Follow and interact with us on Twitter: @HealthBusiness_

Aside from our winners and Top 50 listing, we have some very worthwhile reading in this last issue of the year, with the HFMA writing on financial stability (page 18), NHS Property Services on a net zero NHS estate (page 25) and NHS Digital on digital services during the pandemic (page 41). Enjoy the issue, have a wonderful festive period and a safe start to the New Year. 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 21.6 | HEALTH BUSINESS MAGAZINE

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Contents

Contents Health Business 21.6 07 News

51 Technology

12 HB Awards

55 Barcoding

£700 million to support NHS this winter; fresh approach vital to maintain healthcare workforce; and experience of vital mental health services poorest for years The winners of the 2021 Health Business Awards were revealed by Dr Mark Porter on 9 December, online for the second year in a row following the coronavirus pandemic

12 Sponsored by

18 Finance

Sarah Day, Policy and Research Manager at the Healthcare Financial Management Association, discusses the recent Health and Care Bill and what it means for NHS finances and financial sustainability

21 Net zero

NHS Supply Chain examines tackling the NHS’ environmental impact by changing supply chain operations, and the organisation’s Sustainable Development Strategy

25 Estate management

Cameron Hawkins, head of Energy and Environment at NHS Property Services, explains how the NHS remains a core pillar in the UK’s net zero strategy

31 Facilities management

The NHS Staff Council’s Health, Safety and Wellbeing Partnership Group (HSWPG) has developed guidance to support NHS organisations to improve their provision of staff welfare facilities. Health Business summarises the guidance

34 HB50 Most Influential Welcome to our first Health Business Top 50 NHS Professionals list - our pick of the people that have shaped the national health service over the years

41 Digital

Melissa Ruscoe, Programme Head at NHS Digital, discusses the benefits of online healthcare through NHS services during the Covid-19 pandemic

47 Technology

A step change in the way we approach digital implementation and transformation is needed if it is to protect our health and care service from irretrievable decline, writes Lord Victor Adebowale

Health Business magazine

PA healthcare expert Gareth Fitzgerald discusses the ways in which we can seize the opportunities of integrated care systems and how new approaches of lasting value can be created Patient information can be seamlessly shared between systems and organisations to enable interoperability via GS1 standards, writes Glen Hodgson, head of healthcare at GS1 UK

59 Fire safety

The inclusion of a sprinkler system can prevent major financial and equipment losses for UK businesses. The Business Sprinkler Alliance explain how to mitigate against the risk of fire damage, both immediate and long term, and how sprinklers can enhance business continuity and responsibility

63 Translations

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

67 Cyber security

The NHS Counter Fraud Authority look at the cyber fraud awareness resource, launched earlier this year, as well as the key cyber threats NHS organisations should be wary of

73 Cyber security

Keep I.T Confidential aims to help NHS staff understand more about cyber security and know what to do to reduce the risk. New content was recently added and HB takes a look at the campaign

81 Medical technology

James Feindt, Marck Aghnatios and Alistair Fleming look at the benefits and opportunities of migrating care from hospital to the home environment, as well as the Medtech challenges it creates

85 Medical equipment

A new Information Standard has been published by NHS Digital to support improved medication and allergy/ intolerance information sharing across healthcare services in England

89 Frameworks

In this blog, Andrew Smith, Pillar Lead Research at CCS - Environment and Sustainability, reveals some of the ways the NHS can achieve sustainability

www.healthbusinessuk.net Issue 21.6 | HEALTH BUSINESS MAGAZINE

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News

FUNDING

£700 million to support NHS this winter

The Department of Health and Social Care has announced that hospitals will benefit from a share of £700 million to help tackle waiting lists and improve care. The funding, to be split across all regions in England, will help reduce waiting times

for patients by expanding the number of operating theatres and beds, including new day surgery units to prevent people staying overnight and investment in technology to improve their experiences of care and help them manage their conditions. The allocations for the £700 million include £330 million for upgrading NHS facilities, £250 million for new technology and £120 million for any supporting revenue costs. In total, 785 schemes have been approved. It will cover the costs of: additional day surgery units to boost activity and avoid patients having to stay overnight or longer; additional permanent and modular theatres and surgical hubs in multiple trusts to drive up the number of operations which can be carried out; expanding outpatient space for those not staying overnight, to increase the numbers of

SOCIAL CARE

BOOSTERS

New support package to protect care sector this winter

NHS to offer booster booking to every adult by end of December

A package of new measures have been announced to help protect the social care sector from coronavirus, including £300 million to help recruit and reward the workforce. Specialist vaccination teams are being expanded and deployed to guarantee all care home residents and staff, as well as people who are housebound and their caregivers, are offered the booster – with those most at risk prioritised for the jab. Care homes will be able to request follow up booster visits from vaccination teams for staff and residents and home visit payments for GPs will be increased to further ramp up the home care programme. Care workers will benefit from a £300 million extension, in addition to the £162.5 million announced in October, to support recruitment and retention. It can be used to pay for bonuses and bring forward planned pay rises for care staff, fund overtime and staff banks increasing workforce numbers up until the end of March. In light of a new wave of the virus, visits to care homes will continue under updated guidance that permits three visitors and an essential care giver per resident, in order to balance the current coronavirus risk and the need to keep people safe in line with clinical advice. Care settings will also be given extra guidance for infection prevention and control measures and PPE. READ MORE

The NHS vaccination programme will offer every adult the chance to book a coronavirus booster vaccine by the end of the year in a race to protect the nation against the Omicron variant. Online bookings are now available for all those in their 30s and above from 13 December. The national booking service will then open up to everyone aged 18 and over from Wednesday this week. The NHS is prioritising bookings for boosters and is urging people to book a slot to guarantee their vital jab. Some vaccination sites may offer a walk-in service for 18s and over from tomorrow if they have spare capacity. The NHS has asked every local area to dramatically increase the number of appointments they have in place for vaccinations. Over the next week, opening hours for vaccine centres will be extended and

patients that can be seen; and upgraded or new imaging equipment, including MRI and mobile breast screening units. The government is also publishing a document setting out the key challenges facing NHS and social care services this winter, including coronavirus and the potential threat of variants, preparations being undertaken to keep people safe and healthy, as well as the actions the public can take. The investment is part of the £5.4 billion already announced to support the NHS response to the pandemic in the second half of the year. In total, the government is investing over £34 billion of additional funding in health and social care services this year. READ MORE

every area of the country should have centres available that are open seven days a week. More pop-up sites will be coming online with local areas looking at the most convenient sites for their communities – from trucks and buses in parks and shopping centres to sports stadiums and leisure centres. GP teams will be asked to clinically prioritise their services to free up maximal capacity to support the Covid-19 vaccination programme, alongside delivering critical appointments such as cancer, urgent and emergency care. This might mean that for some people, routine appointments are postponed as part of the national mission to roll out boosters. READ MORE

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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News

NHS WORKFORCE

Fresh approach vital to maintain healthcare workforce

Long-standing staffing and service culture issues have been made worse by the impact of the pandemic, with the GMC warning that a fresh approach is vital to maintaining the healthcare workforce. The GMC’s annual The state of medical education and practice in the UK report says

that, despite current pressures, now is the time to retain and embed positive changes to ways of working that were a key part of UK health services’ initial response to coronavirus. Otherwise, the paper warns, exhaustion and disillusionment will grow even more rapidly and more doctors will quit the profession,

blunting the effects of initiatives to boost recruitment. The GMC report reveals that high workloads are associated with doctors feeling unable to cope, and then resulting in an increased risk of dissatisfaction and burnout. There is also evidence of a sustained increase in the proportion of doctors taking ‘hard steps’, such making enquiries about a career change or applying to move, to leave the profession. Excluding retirement, more than 80 per cent of those planning to leave cited the impact of work on their well-being as a factor. READ MORE

RECRUITMENT

Government must acknowledge scale of workforce problems NHS leaders have called on the government to publicly recognise the scale of the NHS’ current workforce problems as the first step to solving them. As trust leaders prepare for what is already becoming the most difficult winter in NHS history, workforce issues are now, by far, trusts’ biggest problem. Trust leaders point to six different workforce challenges currently being faced across the health and care system. These include: difficulties in recruitment with nearly 100,000 NHS vacancies; growing numbers of staff choosing to retire early or return to their countries of origin; increasing levels of sickness absence due to the consistent, high, level of pressure staff are under; and difficulty in securing staff to work bank and agency shifts on which the NHS has become worryingly reliant. Some trusts are reporting that they are now having to close wards due to absence of staff,

rather than risk patient safety. This is deeply worrying as the NHS heads into winter when the service needs as much capacity as possible. Trust leaders also fear that if the push for mandatory vaccination is mishandled,

potential further loss of additional frontline staff could jeopardise the safety and viability of ‘pockets’ of vital services. READ MORE

NURSING

Record numbers to study nursing and midwifery Latest data shows that record numbers of students accepted places to study nursing and midwifery in England for the second year running. According to the latest data on university

admissions published by UCAS, the final figures from this year’s admission cycle show there were 30,185 acceptances. This is an increase of 1.5 per cent (445) compared to last year when there were 29,740 acceptances.

In September 2020 the government introduced training grants for eligible nursing, midwifery and many allied health profession students of at least £5,000 a year, which do not need to be paid back. Additional payments of up to £3,000 a year available for students studying certain specialisms and to help with childcare. It was recently announced that Health Education England would be merged with NHS England, ensuring long term planning and strategy for healthcare staff is at the centre of the national NHS agenda. READ MORE

Issue 21.6 | HEALTH BUSINESS MAGAZINE

PROTECTING PATIENTS IS ABOUT MORE THAN JUST THEIR HEALTH. As digital transformation efforts to enhance patient care add complexity to already hyperconnected environments, healthcare organisations require a proactive IT and infrastructure strategy to ensure their efforts remain patientfocused and mission-critical. What’s more, these increasingly intricate yet distributed environments operate 24/7/365 and must remain secure and resilient with limited resources. ExtremeCloud™ IQ administered by Daisy delivers the clinical-grade cloud infrastructure management solution that healthcare organisations require – built on a 4th generation cloud platform and offering a flexible, agile, scalable and intelligent solution.

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News

MENTAL HEALTH

Experience of vital mental health services poorest for years

An annual Care Quality Commission survey has found that people’s experiences of mental health care continue to be poor, with people’s experience of some areas of care at their lowest point in eight years.

The Community Mental Health Survey shows that nearly half of respondents reported that their mental health had deteriorated due to changes made to their care and treatment due to the pandemic.

People with more challenging and severe non-psychotic disorders, as well as those with complicated cognitive impairment and dementia disorders, consistently reported worse than average experiences when compared with those with psychotic disorders. Those aged 18-35 also reported worse than average experiences compared to those aged 66 and older. The survey found people who received telephone-based care reported worse than average experiences in the key themes of overall experience, access, communication and respect and dignity. In contrast, people who received care using video conferencing technology reported better than average experiences in these areas. READ MORE

INTEGRATION

DISCHARGE

Benefits of integration of health and social care over-estimated

Healthy patients ‘stranded’ in hospital wards rises by 80 per cent

There is limited evidence that the different policies to integrate health and social care services have made a difference to patients, or to how well services are integrated. According to a new Nuffield Trust report, more than 20 years of reforms to better join up health and social care services across the four UK nations have made little difference to patients and service users, or the extent to which services are integrated. There is limited evidence that policies, such as pooling budgets and creating new integrated boards and committees, have dramatically improved patient experience, quality of services or supported the delivery of more care outside of hospitals. Integration policies have failed to lead to any meaningful improvement in satisfaction with care and support, improvements in delayed transfers of care have not been sustained and the age-adjusted rate of emergency admissions to hospitals has not fallen. These efforts have failed to overcome longstanding barriers to support more joined up working, or provide for the resources, infrastructure and necessary

staff to meaningfully integrate services and move more care out of hospitals. As the government’s proposals for integrated health and care services continue their journey through parliament, the report warns without concurrent investment in social care and broader public service it is very likely the latest reforms will not yield the results ministers hope for. The report highlights that varying levels of financial resources in health and social care in each of the four countries has slowed efforts to reform, there has been falling investment in housing, education and wider public services which all play in part in people’s health and well-being. To overcome the cycle of failed initiatives, the authors urge policy-makers to shift focus away from organisational and structural reform and instead focus on the behaviours, incentives, skills and resources needed to integrate services at the front line. READ MORE

The number of patients stuck in hospital in England despite being medically fit to leave nearly doubled between February and November this year. NHS England data shows that the number of times hospital trusts were unable to discharge a patient who no longer met the criteria to stay in hospital increased from 223,593 in February to 402,211 in November – a rise of almost 80 per cent. The data shows the extent of ‘stranded patients’ – people who are clinically fit to leave hospital but cannot be discharged, often because of a lack of adult care or NHS community health provision. As a result, patients find themselves stuck in an environment where they pick up infections, while hospitals are unable to free up bed space for new admissions. The Observer has also obtained data on delayed transfers of care (DTOC), which measures the number of days individual patients stayed in hospital after they were ready to be discharged. NHS England stopped collecting DTOC statistics at the start of the pandemic, but a freedom of information request found 26 hospital trusts that are still recording these figures – with DTOC numbers rising by nearly 75 per cent between February and October. For example, University Hospitals Dorset NHS Foundation Trust saw acute care DTOC numbers increase from 2,701 on 1 April to 4,452 on 1 October. READ MORE

Issue 21.6 | HEALTH BUSINESS MAGAZINE

HB Awards

Celebrating the NHS in the midst of coronavirus The winners of the 2021 Health Business Awards were revealed by Dr Mark Porter on 9 December, online for the second year in a row following the coronavirus pandemic The NHS is a truly unique and highly complex in Healthcare award, which is presented organisation. Responsible for over £150 to an NHS organisation that has achieved billion of public sector spend, the sixth largest sustained success in its role and has employer in the world is at the heart of the brought benefits to the wider NHS battle against the coronavirus pandemic. through dedication and expertise. Throughout the current crisis, the NHS has excelled in providing essential care to the NHS Publicity Campaign Award UK’s 66 million residents. Its vaccination The NHS Publicity Campaign Award programme is already being used as an recognises a campaign which demonstrates example of best practice as the world remains success in achieving its objectives. in partial lockdown. More than ever, it is vital The winning campaign can be either that the dedication of its amazing doctors, internal or external and can combine nurses and support staff is recognised. media including press, radio, television Since 2010, the Health Business Awards and outdoor advertising. have been staged annually in order The winner of the NHS to recognise the many examples Publicity Campaign of innovation and excellence Award for 2021 is The that happen every day in NHS Blood and Health the NHS. Supported by Transplant for a B Awards usiness new campaign Health Business magazine, urging families the award categories the ma recognise ny exam to talk about incorporate facilities, of inno ples organ donation. technology, human resources, v Research hospital management and excellenation and showed that transport as well as the happen ce that more than a Outstanding Achievement eve

ry the NH day in S

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

quarter of adults felt it would upset their family or make them feel uncomfortable. The Leave Them Certain campaign highlights the impact not knowing has on the families who are left behind and encourage people to talk about their decision. The scheme is to be extended over winter. The commended organisations were: Mid and South Essex Health and Care Partnership, NHS England and Coventry and Warwickshire Partnership NHS Trust. Healthcare IT Award The Healthcare IT Award, sponsored by Philips Monitors, recognises a ground breaking IT project that demonstrates clear cost benefits to the wider NHS. The winner of the Healthcare IT Award is NHS Arden & GEM Commissioning Support Unit. The Data and Systems Development team at NHS Arden & GEM had already built a similar system to capture vaccinations for the flu immunisation programme, which had been used extensively in schools. Its new National Immunisation and Vaccination System offers a high level of interoperability with existing

patient records and reporting systems. David O’Callaghan, Chief Data Officer at Arden & GEM said: “NIVS has played a key role in the safe and effective implementation of the Covid-19 vaccination programme and we are hugely honoured to receive this award. Rapidly mobilising this system last winter required close partnership working with the national programme team and hospital hubs and, as a result of that constructive collaboration, we now have an NHS developed system which has captured real time data for more than 10 million Covid vaccinations.” Commended organisations for 2021 were: London Ambulance Service, Cardiff and Vale University Health Board, Bradford Teaching Hospitals NHS Foundation Trust, Cambridge University Hospitals and Royal Papworth Hospital NHS Foundation Trust. Telehealth Award The Telehealth Award recognises an innovative use of information and communication technology to deliver health services, expertise and information over distance. The 2021 winner of the Telehealth Award is TEC Cymru & Digital Health Wales. TEC Cymru’s new NHS Wales Video Consulting Service was rigorously evaluated to ensure that supporting their patients virtually would be a success. The initiative was unprecedented and fast-paced. In the first seven weeks, 87 per cent of GP practices were technically enabled, trained and ‘live’. It has now surpassed over 260,000 consultations across more than 100 specialties. Commended organisations this year were: Kent Community Health NHS

HB Awards

Sponsored by

The Estates & Facilities Innovation Award recognises NHS and other healthcare organisations which have developed innovative procedures for managing and maintaining healthcare facilities Foundation Trust, Newcastle Hospitals NHS Foundation Trust and Liverpool City Council / Medication Support Company. Hospital Building Award The Hospital Building Award, which is sponsored by Honeywell Commercial Security, is made to the new hospital building project that raises the standard of the healthcare environment and demonstrates value for money and project management excellence. The winner of the Hospital Building Award this year is NHS Frimley Health NHS Foundation Trust for the New Heatherwood Hospital. In a build that was considered essential works and allowed to continue through lockdown, and despite flooding difficulties during construction, the new Heatherwood hospital will be a flagship facility for Frimley Health, with the potential to double patient activity at over the next 10 years. Healthcare Recruitment Award The Healthcare Recruitment Award, which recognises NHS organisations with robust recruitment policies which can help deliver both safety and continuity to

patients, was won by Liverpool University Hospitals NHS Foundation Trust. With 541 apprentices across a range of roles including clinical, admin, IT, pharmacy and management, Liverpool University Hospitals NHS Foundation Trust is just one of three NHS Trusts to have been named in the Top 100 apprenticeship employers ranking, developed by the National Apprenticeship Service. Last year, 50 new healthcare assistant apprentices and six business administration apprentices were recruited. NHS Collaboration Award Moving onto the NHS Collaboration Award, which is presented to the NHS Trust which has worked with other public and private sector organisations to benefit the local community, Dr Mark Porter announced the 2021 winner as Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust for the Collaborative Newcastle initiative. Collaborative Newcastle’s vision is to work collectively and creatively to improve the health, wealth and well-being of everyone in Newcastle. The partnership, which also includes Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle City E Issue 21.6 | HEALTH BUSINESS MAGAZINE

HB Awards

 Council, Newcastle Gateshead NHS Clinical Commissioning Group, will see efforts targeting social prescribing at scale, new ways of delivering mental health support, a joint system leadership training programme and the Integrated Covid Hub North East, which transformed test and trace capabilities for the region. Alane Bould, head of Patient and Carer Involvement, said: “It is thanks to the hard work of a small but dedicated group of people that we have made such fantastic progress establishing an innovative, highly respected Peer Support service throughout CNTW. They thoroughly deserve this national recognition.” Commended organisation this year were: Royal Berkshire NHS Foundation Trust, Cardiff and Vale University Health Board, Bristol, North Somerset and South Gloucestershire CCG and Manchester University NHS Foundation Trust. Transport & Logistics Award The Transport & Logistics Award recognises NHS trusts that have seen improvements in operational logistics, including emergency services transport and coordination; fleet management; car parking and traffic management and the supply of materials and goods. The winner of the Transport & Logistics Award is Manchester University NHS Foundation Trust. The first elevated Helipad of its kind in the North West opened at Manchester University NHS Foundation Trust in May 2021, enabling critically ill or injured

babies, children and adults to be airlifted straight to Manchester University NHS Foundation Trust hospitals in Manchester city centre. It is believed that the landing site could allow as many as 300 patients to be airlifted to hospitals each year. Also in the running for 2021 were NHS Fleet Solutions (Northumbria Healthcare), The Hillingdon Hospitals NHS Foundation Trust, Oxford Health NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust. Estates & Facilities Innovation Award The Estates & Facilities Innovation Award recognises NHS and other healthcare organisations which have developed innovative procedures for managing and maintaining healthcare facilities. The 2021 winner of the Estates & Facilities Innovation Award is Northern Lincolnshire and Goole NHS Foundation Trust. Work is underway to make Scunthorpe General the first NHS hospital in England to use renewable geothermal power for its heating and hot water, helping to reduce the hospital’s carbon foot-print by 60 per cent. The £40.3 million programme of works across sites in Scunthorpe, Grimsby and Goole is expected to save over £1 million in cash and over 5,000 tonnes of carbon every year. Jug Johal, director of Estates and Facilities at the trust, commented: “Reducing our carbon footprint is really important to us. We’re not only here for you if you become ill – we want to help prevent illness in the first place.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

“Poor environmental health is known to contribute to a number of major diseases, including cardiac problems, asthma and cancer. We’re delighted that the work we are doing has been recognised by the Health Business Awards and I would like to take this opportunity to thank everyone who has been involved in developing this scheme. It’s thanks to your innovative thinking, creativity and ideas that we’ve been able to take this programme forward and I’m incredibly proud of what we have achieved.” The shortlisted organisations were: Bolton NHS Foundation Trust, Hull University Teaching Hospitals, Hillingdon Hospitals NHS Foundation Trust and Cambridge University Hospitals. Patient Safety Award The Patient Safety Award, presented to an NHS organisation which has made great strides in providing a safe hospital environment for patients, and has taken action to reduce Hospital Acquired infections and mortality rates, was awarded to Hull University Teaching Hospitals.

The decision to introduce body worn cameras at Chelsea and Westminster has been successful in reducing acts of aggression. The devices have helped to de-escalate many incidents, and have made staff feel more confident at work Wards at Hull Royal Infirmary and Castle Hill Hospital were among the first in the country to use patient safety equipment made from recycled materials. The eco-friendly ‘slide sheet’ is wrapped in biodegradable packaging and will help staff move people with mobility problems including bariatric patients, those recovering from surgery and patients with frail or fragile skin Also shortlisted were: University Hospitals of Derby and Burton NHS Foundation Trust, Bolton NHS Foundation Trust, Midlands

Partnership NHS Foundation Trust and Norfolk and Norwich University Hospital. Patient Data Award The Patient Data Award recognises the innovative introduction of new technology for secure storage, retrieval and distribution of data throughout the NHS. The winner of the Patient Data Award is South Tyneside and Sunderland NHS Foundation Trust. The Great North Care Record project safely and securely connects patient information across a range of health and social care

organisations, covering 3.6 million people living in the North East and North Cumbria. Since its launch last year, the project has enabled over 400 GPs, five NHS trusts and the North East Ambulance Service to share records with frontline staff. Shortlisted in this category were: NHS Arden & GEM CSU, Midlands Partnership NHS Foundation Trust, East Lancashire Hospitals NHS Trust and East Sussex Healthcare NHS Trust.

HB Awards

Sponsored by

Hospital Security Award The Hospital Security Award, sponsored by Honeywell, recognises hospitals that have made significant steps towards a safer environment for patients and workers through the implementation of a security policy which incorporates the latest advancements in CCTV, access control and other monitoring technologies. The winner of the Hospital Security Award is Chelsea and Westminster Hospital NHS Trust. A 2020 Survey revealed that 26 per cent of NHS staff had experienced at least one incident of abuse or harassment in the last 12 months. Despite initial concerns, the decision to introduce body worn cameras at Chelsea and Westminster has been successful in reducing acts of aggression. The devices have helped to de-escalate many incidents, and have made staff feel more confident at work. Royal Manchester Children’s Hospital, Guy’s & St Thomas NHS Foundation Trust and London Ambulance Service were also shortlisted for the Hospital Security Award. E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

HB Awards

 Ambulance Trust of the Year Award The Ambulance Trust of the Year Award is presented to the Ambulance Trust which has embraced change and demonstrated a decrease in response times, the ability to provide treatment at the scene of an accident, and the provision of outpatient services. The winner of the Ambulance Trust of the Year Award was named as Yorkshire Ambulance Service NHS Trust. Demand for services at Yorkshire Ambulance Trust has been increasing month by month since January this year. Recognising that the needs of mental health patients can often be met in their own homes, in the community or with alternative care or services, the trust has piloted a mental health response vehicle to provide dedicated support to those in crisis. Also shortlisted were: West Midlands Ambulance Service, Welsh Ambulance Service and South Central Ambulance Service. COVID Response Introduced last year to recognise the NHS’s swift response to coronavirus, the COVID Response Award looks at NHS organisations which have implemented swift and successful measures in order to cope with the Covid-19

The Hospital Procurement Award recognises an NHS organisation which has de-livered value for money and increased efficiency through smarter procurement practice pandemic. The 2021 winner of the COVID Response Award is Bolton NHS Foundation Trust. Having to adapt to national requirements around vaccine supply, new booking systems with little training, ever changing clinical guidance and also short notice stakeholder reporting, the Bolton NHS Foundation Trust Covid Vaccination Team pulled together from various areas of the trust in order to provide a highly successful service. The team were instrumental in ensuring that local health and social care services were protected, making people feel as safe as possible. Mid and South Essex Health and Care Partnership, NHS Shared Business Services, Barnsley Healthcare Federation and University Hospitals of Derby and Burton NHS Foundation Trust were shortlisted.

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Sustainable Hospital The Sustainable Hospital Award, sponsored by Philips Monitors, recognises NHS organisations which have made progress towards sustainability through the smarter use of energy, transport, and waste management in order reduce the impact of healthcare facilities on the environment. The winner of the Sustainable Hospital Award this year is Leeds Teaching Hospitals NHS Trust. Since April this year, Leeds Teaching Hospitals NHS Trust’s Sustainability Team has been working closely with the Carbon Literacy Project as part of a new initiative to deliver the first Carbon Literacy training specifically focused on healthcare and the NHS. The trust is now developing plans a plan to decarbonise the heating and hot water across the hospital sites.

Northumbria Healthcare, Hillingdon Hospitals NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust were shortlisted in this category. Hospital Procurement Award The Hospital Procurement Award recognises an NHS organisation which has delivered value for money and increased efficiency through smarter procurement practice. The winner of the Hospital Procurement Award is Bolton NHS Foundation Trust. Bolton NHS Foundation Trust is working with NHS Supply Chain on analysing purchasing data, patient requirements and product taste testing. This can identify areas where food and packaging waste can be reduced. By switching suppliers and using menu options that received the most positive feedback from both staff and patients, the trust has seen food waste at ward level reduced to six per cent annually, which is estimated to save £100,000 per year. Innovation in Mental Health The Innovation in Mental Health Award is presented to organisations which have made strides to improve the experience and overall care of patients with mental health diagnosis. The winner of the Innovation in Mental Health Award is Mersey Care NHS Foundation Trust for the Life Rooms initiative. The service provides a safe and welcoming space to meet others, access opportunities and learn about community resources. Within two weeks of lockdown being introduced, Life Rooms transferred their health and well-being programmes

HB Awards

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The landmark merger of Western Sussex Hospitals and Brighton and Sussex University Hospitals took place in April. The recent success of the previous two trusts has left the new organisation in a strong place to move beyond the challenges of the coronavirus pandemic online, supporting patients and the local community via telephone and guiding them to clinical support when necessary. Medway NHS Foundation Trust, Nottingham University Hospitals NHS Trust and South Tyneside and Sunderland NHS Foundation Trust were shortlisted. Outstanding Achievement in Healthcare Lastly, every year the Outstanding Achievement in Healthcare Award recognises an NHS organisation which has achieved success in its role and brought benefits to the wider NHS through the dedication and expertise of its staff. The NHS is an outstanding achievement as a whole, and there are many parts of it that could be considered worthy winners of this Award. This year, the winner of the Outstanding Achievement in Healthcare Award is University Hospitals Sussex NHS Foundation Trust. The landmark merger of Western Sussex Hospitals and Brighton and Sussex University

Hospitals took place in April 2021. Both a university hospital and a foundation trust, the recent success of the previous two trusts has left the new organisation in a strong place to move beyond the challenges of the coronavirus pandemic. Before the merger, Brighton and Sussex University Hospitals became the fastest improving acute hospital trust in England, emerging from special measures and earning a Care Quality Commission rating of Good overall and Outstanding for caring. Meanwhile, Western Sussex Hospitals maintained its own Outstanding status and also became the first non-specialist acute trust to achieve Outstanding ratings in all key inspection areas. The other organisations shortlisted in the final category were Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Northern Care Alliance NHS Foundation Trust, Bolton NHS Foundation Trust and University Hospitals Birmingham NHS Trust. L Issue 21.6 | HEALTH BUSINESS MAGAZINE

Finance

NHS finances and the issue of financial sustainability Sarah Day, Policy and Research Manager at the Healthcare Financial Management Association, discusses the recent Health and Care Bill and what it means for NHS finances and financial sustainability As we move ever closer to a new financial year and the next iteration of the NHS structure, finance staff are once again grappling with new organisational forms, retaining corporate memory, and ensuring that systems are in place to allow all necessary payments to be made on 1 April 2022. Many in the NHS will be used to these changes, restructures are commonplace, but this time it is against a backdrop of high demand, elective backlogs, staff shortages and the ever-present threat of Covid-19. Although the Health and Care Bill is still working through normal parliamentary process, the preparations for next year cannot wait for it to pass. Restructuring is carried out by many on top of their day job and establishing a new organisation takes time. But what do the changes mean for the future financial sustainability of the NHS and the wider health and care system? Covid-19 demonstrated what could be achieved when organisational boundaries were removed and the bill seeks to build on that, by putting collaborative behaviours into legislation. While local systems have been attempting to work in this way for some time, the current requirements under the 2012 Act limited how easily parts of the NHS could work with one another and local authority colleagues. However, fundamental to the success of the

the need for contract reconciliations and a multitude of invoices. Many welcomed this approach as it not only freed up staff to undertake more value-added activity, it also gave a certainty of income (and expenditure for commissioners). The aligned payment and incentive approach will be made up of Developing system working fixed and variable elements to build on this System funding envelopes seek to provide experience. The majority of payments will be a way to allow organisations to work on a fixed basis, using agreed activity and together to meet a common financial target. costs, with a much smaller variable Assuming that the Health and Care element to incentivise particular Bill is passed, from 1 April, priorities, such as addressing integrated care boards (ICBs) the backlog of care. The will become the statutory System process of agreeing body that manages funding these payments will this envelope, with envelop require organisations national allocations e s seek to prov in all parts of the NHS going directly to ICBs. to work together Financial flows within allow o ide a way to r g to collectively systems will still be a n i sa work to agree upon the linked to contracts gether tions to to a comm healthcare priorities and organisations on fina meet for their population. will retain their own n cial Relationships and statutory duties to target transparency will break even. However, be key to success. the aligned payment and Many local systems incentive system, expected to already recognise that working be introduced in April, will support together is the way to better address a more transparent way of working. population need, in health, social care, The simplified payment system during the and the wider determinants such as pandemic saw organisations receiving block housing and employment. The concept of payments to cover all activity, removing Covid-19 regime was the removal of financial constraints; it is a lot easier to work together when you don’t need to argue about who is paying for what. But that is clearly not a sustainable approach in the long term.

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The challenge of social care funding It is widely accepted that social care is underfunded and in need of wider reform. As local government funding has fallen, the pressure to fund social care through local means has increased. This means that many local authorities have needed to raise eligibility criteria for care and cut services, which often include those that support good health and well-being. At a time when the NHS is seeking to invest more resource in the prevention of ill health, local authorities are often being forced to do the opposite. It was hoped that the government’s plan to Build back better would at least begin to address some of these issues. But the political focus was on preventing individuals from incurring ‘catastrophic costs’ in order to pay for care. This was set out explicitly in the plan, with the extension of capital limits in the means test and the cap on care costs. Even though this pledge is now not what it first seemed, with changes to the cap in recent days, it increases the burden on local government as it means that more people will be eligible for publicly funded care, so increasing overall costs. While the plan is accompanied by a new health and social care levy to cover these additional costs, the plan states that existing pressures must continue to be met from short-term measures such as council tax and the social care precept. Therefore, the plan does nothing to help the sector onto a more sustainable financial footing in the short term, with the extra funding raised through the new levy being initially targeted at the NHS. The Budget set out £4.8 billion of new grant funding for local government, but this was for all council services, not just social care – a long term settlement to address the challenges in social care still seems a long way off. Local systems recognise the interdependence between health and social care. Investment in the latter is essential to support the whole population as it enables people to receive the care that they need in the right place. However, at a national level, the two remain resolutely separate with the wider implications of funding decisions largely ignored.

Fundamental to the success of the Covid-19 regime was the removal of financial constraints; it is a lot easier to work together when you don’t need to argue about who is paying for what are a number of conditions that limit local discretion around how the resources are used. Making long-term, sustainable, changes to services can therefore be challenging. The Budget also set out a three-year capital settlement which will address a number of concerns around capital planning; projects can rarely be initiated and completed within a single year. Within the capital settlement are earmarked funds to tackle the elective backlog, through development of surgical hubs, community diagnostic centres, and investment in digital technologies. All welcome developments, but not quick fixes for those already waiting for a long time for treatment. The majority of NHS spend is on workforce and this is becoming a significant challenge. The Budget was silent when it came to the NHS workforce, with no identified settlement for Health Education England (HEE), and no certainty over the future pipeline of staff. A plan is expected in the spring but, with the expected merger of HEE with NHS England in the summer, it is possible that timings could change. The workforce challenge limits what can be achieved, even if the health and care system had sufficient funding. New services need new staff, often with different skills. Without sufficient staff, investment that is earmarked to transform services risks destabilising core provision as

Finance

a ‘local pound’ is widely used. This enables organisations to nominally combine resources and consider where public money can be spent to best effect.

staff choose to move to new roles, without the people being there to replace them. Opportunities for the future While there are many challenges for the health and care sector, there is much to be positive about as we look to the future. Putting integrated care systems onto a statutory footing will remove many of the barriers to joint working, making it much easier to collaborate. This should create a more seamless experience for patients, as they move between organisations. Provider collaboratives will see trusts working together to deliver care that has been designed as a whole system, rather than in organisational silos. Financially, this has got to be a better approach, enabling new efficiencies to be found through working together, delivering care in the most appropriate setting, and reducing duplication. Shared financial targets will support finance teams to work together to get the most value from the allocated resources. It is these networks and relationships, across the whole of the NHS and social care, that will ultimately make integrated care systems work, despite the challenges. L FURTHER INFORMATION www.hfma.org.uk

Long term NHS financial sustainability Key to long term NHS financial sustainability is the ability to plan, as well as having access to the resources that are needed. The recent boost to revenue funding in the Budget, is welcomed. However, the way in which funding arrives with local systems does not always support long term planning. Much of the additional resource is allocated on top of baseline funding and arrives at different points in the year. It is not always clear whether the funding will be recurrent or not, and sometimes there

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Advertisement Feature

Addressing the challenges of becoming net zero Zenergi is a customer service company specialising in energy, and built on the belief that there is a better, brighter way forward for the energy industry

There is no doubt that the last 12 months has been extremely challenging. The reality is that we have probably taken several steps back in terms of reaching our ambitious climate change targets. Single-use plastics, pandemic priorities, and hospitals at full capacity are all contributors but, if we are really honest, infrastructure investment has taken a back seat for too long. We now need a clear plan and strategy that delivers future resilience. The scale and pace needs to be accelerated if we are to reach net zero by 2045 and to meet our ambition to be the first Net Zero national health service, setting a pathway for others to follow. But where do we start? Decarbonisation, moving away from gas heat networks and embracing emerging technology are challenges the NHS will need to overcome. Most of our work will be focused on existing buildings and infrastructure. A lack of funding and resource has meant that we are now dealing with a backlog of energy projects. But rather than address legacy issues, let us invest in solutions that support a new energy revolution. We cannot do this alone. We need help, guidance and finance packages to support our ambition. We also need an energy system that can meet this demand. We know we have vulnerabilities in our national grid, so this is going to take a concerted effort by all stakeholders to get us to net zero.

Where we are now With that said, recent decades have not been at a standstill. Thorough surveys and maintenance of existing buildings has improved conditions and minimised energy wastage. Substantial funding has been delivered to enable some decarbonisation movement. Previous Salix funding has allowed the implementation of LED lighting, heating management and ventilation around NHS facilities. However, this has proved to be not enough. Following the rise in emissions and global warming, we have moved into a stage of code red for humanity. With this has followed a detrimental increase in natural disasters. Recent reports from the IPCC warn us that if the earth warms by just two degrees, the world will struggle to cope with the environmental repercussions. Planning ahead When beginning your journey to Net Zero, it is essential to have your baseline data and a maintenance plan to help with an understanding of your current energy usage and when upgrades are due. Once established, the ability to reflect on operational controls and behaviour change can be analysed. This could include retraining staff on good energy habits, ensuring all lights and electrical items are turned off when not in use. Revaluating heating and cooling schedules, ensuring they are planned and utilised in the most effective way, could also eliminate wastage. However, with rising temperatures, this may be difficult to navigate. Traditional seasons are altering, with summers now crossing over into autumn months. We need to

become more self-efficient and work smarter to adapt to these changes. Acquiring a good decarbonisation plan or energy audit will also help prepare a thorough business plan, partnered with carbon reduction targets and cost savings that meet a satisfactory payback period. Having this ready will help you to act quickly when funding launches. Integrating Renewables and Energy Storage Fast approaching is the ban on production of new petrol and diesel vehicles from 2030, meaning the reliance on electric vehicles will soon be inevitable. For health facilities, more capability is needed to support the electrification of the whole fleet and catering for visitors. To achieve this, major investment must be undertaken to carry out the implementation of electric vehicle charging. However, the issue of capacity must be considered. By scaling up on battery storage around NHS sites, better utilisation will be enabled for those visiting with an electric vehicle. Additionally, the demand for renewables is increasing the closer we approach our net zero targets. To deliver this, a growing pressure is leaning on the efficiency and turnaround of the supply chain. And with most materials being shipped from China, this poses a delay on renewable projects. To combat this, the government has granted an extension period on projects, however, it is still leaving uncertainties. As a result, we must be prepared to launch plans as quickly as possible once the supply chain picks up. Going forward There is no longer a choice but to accelerate plans in order to remain on track to reducing carbon emissions. However, decarbonising a whole estate comes partnered with several challenges. Without a well thought out, strategic plan, with a backbone of funding, experience and expertise, this will not meet our targets. It is essential to prepare plans that can be executed promptly and efficiently. L Visit or contact Zenergi below to understand more about measures to support your net zero journey. FURTHER INFORMATION zenergi.co.uk bepositive@zenergi.co.uk

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Net zero

NHS Supply Chain tackling environmental impact NHS Supply Chain examines tackling the NHS’ environmental impact by changing supply chain operations, and the organisation’s Sustainable Development Strategy October 2021 marked one year on from the NHS becoming the world’s first national health system committing to become ‘carbon net zero’ by 2045. With COP26 taking place this year, we have acknowledged how we need to work with all our stakeholders to raise awareness of the relationship between health and climate change, the NHS Net Zero ambition, and its alignment with core-purpose activity – the improvement of health now and for future generations. Working alongside all our NHS partners, we are keen to build understanding among the workforce of how greener measures are improving patient care today and saving money, as well as reducing carbon emissions – and therefore improving health now and in the future. Andrew New, NHS Supply Chain CEO, says: “As NHS Supply Chain, we are trusted by our stakeholders to deliver clinically assured, value for money products that meet the needs of our NHS colleagues and patients. We deliver a critical service every day to the NHS and we have a responsibility to deliver this sustainably and with the upmost consideration to the impact on the environment. In line with the wider NHS mission to be carbon neutral by 2040, we are working with our suppliers, service providers and trusts to optimise our impact both today and for the future.” During the recent Net Zero Health and Care Committee in October 2021, NHS Supply

Chain committed to specific actions that we will take to deliver Net Zero. This pledge to achieving Net Zero acknowledges our collective support and action across the health and care sector. Our commitments are as follows: NHS Supply chain will promote and champion hybrid working, using technology as our standard solution for working with all stakeholders; NHS Supply chain will reduce our direct CO2 emissions, eliminate single use plastics (where possible) and reduce all packaging used in our operations; and NHS Supply chain will champion the supply of environmentally sustainable products and services to the NHS, including these requirements in all future tenders.

and Labour Standards; Waste and the Circular Economy; Plastic Products and Packaging; and Climate Change, Energy and Greenhouse Gas Emissions in our own Operations. Our Sustainable priority ensures we support NHS sustainability goals. NHS Supply Chain has a unique role in supporting the NHS’s objective of becoming the world’s first net carbon zero health system. By delivering wholesale sustainability initiatives, we can deliver on behalf of all NHS trusts across the country that work with us. Our sustainability strategy reflects our ongoing support for sustainability, and focuses on four pillars of activity: reducing single-use plastics; supporting the circular economy; reducing our greenhouse gas emissions; and improving human rights and labour standards including our commitment to social responsibility.

Our Sustainable Development Strategy Making changes, Our Sustainable Development Strategy, making a difference ‘Delivering health sustainably’, Becoming the world’s first captures our commitment to We are carbon net zero national operating as a compliant keen to health system by 2040 and responsible business, underst build will require big changes but our ambition to arm anding among for the NHS and for NHS trusts with sustainable the wo Supply Chain. initiatives aligned with r kforce of how So, what will a greener the targets set out in g NHS look like and how the Net Zero Report. measur reener can NHS Supply Chain At the heart of our improv es are ing pat support trusts to deliver strategy are four strategic ient care on this ambition? E pillars: Human Rights

today

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Clean air reduces fallow time According to the WHO, Covid-19 is mainly spread through the air in aerosols. Rensair’s portable, hospital-grade air purifier combines H13 HEPA filtration with germicidal UVC light to trap and destroy such airborne viruses. In a test to determine Rensair’s performance in reducing the concentration of MS2 bioaerosols as a proxy for SARS-CoV-2, a particle reduction rate of 99.98% was recorded in 15 minutes and above 99.99% in 30 minutes.

Developed to meet the strict standards of Scandinavian hospitals, our patented technology meets the UK SAGE committee guidelines and is fast becoming the preferred choice for NHS Trusts across the country. Much of the NHS is structurally under-ventilated. Rensair is proving highly effective and economical in bridging the gap, thereby restoring capacity, reducing fallow time and tackling the backlog. Clean air matters more than ever. Read our NHS Voices blog to find out how Rensair can help.

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Net zero

 To drive better health outcomes and create economic, social and environmental value for our stakeholders, NHS Supply Chain is committed to leveraging the strength of its people and operations to deliver health sustainably. We are proud to share some examples of what we’ve been doing to make a difference. 1. One ton of plastic saved across the North West NHS Supply Chain has backed the NHS pledge, launched in October 2020 to dramatically cut the amount of single-use plastic (SUP) across the NHS. Since them our teams have been working hard to procure items that support trusts in reaching their sustainability goals as well as contributing to the greener NHS agenda. Over the last three months several North West trusts, from three Integrated Care Systems; Greater Manchester Health & Social Care, Cheshire & Merseyside, North Cumbria and Lancashire & South Cumbria; have saved a ton of plastic, the equivalent of four dolphins. How did they do it? Our Customer Relationship Management (CRM) team in the North West have raised awareness, provided analysis, insight and encouragement to trusts to use the Catering Consumables and Equipment framework. The framework provides 99 sustainable single-use plastic alternatives for the NHS to purchase and trusts have been able to swap plastic cutlery for bamboo alternatives. Gareth Harvey, Regional Lead – North, said: “This small change in behaviour has led to the removal of one ton of plastic from the supply chain in three months. This is really encouraging news that these simple changes can quickly impact on our sustainability goals. During 2019/20 the NHS bought 184 tonnes of Plastic Catering Consumables, it’s fantastic that we can now offer the NHS a proactive alternative to these single use plastics.” 2. New Sustainable Fleet servicing NHS trusts across England With our Logistics supplier, Unipart Logistics, we are transforming our fleet for a more sustainable future, whilst also delivering financial savings and with continued assurance on reliability and quality. In the first phase of this far-reaching programme, we have recently rolled out a new fleet of environmentally friendly vehicles that offer the lowest level of carbon emissions to date. The sustainable vehicles are the latest addition to NHS Supply Chain’s transport fleet, supporting a 200 strong final mile fleet delivering to NHS trusts. The new fleet is operating with lower emissions, allowing a CO2 reduction of 2.1 tonnes per vehicle per year. Additionally, the engines in the new fleet are HVO ready, which means they can run on Hydro treated vegetable oil in the future, which could reduce fleet emissions by as much as 80-90 per cent and reduce local air pollution. The switch to HVO is part of longer-term planning to meet our 2040 goals. Claire Salmon, Category Tower Director, NHS Supply Chain: Logistics (Unipart Logistics), said: “We are evolving our entire fleet as part of our sustainability and carbon reduction commitments within Unipart, and

as a provider to the NHS Supply Chain. The additional benefits of increasing fuel efficiency and having an HVO ready fleet, as well as introducing other safety specifications as standard truly demonstrates the ‘delivering value to the NHS’ brand on the fleet is more than just a logo.” Logistics commitment to carbon neutral operations Our logistics provider, Unipart, has signed up for the United Nations Race To Zero campaign as part of a commitment to be carbon neutral by 2030 and net carbon zero by 2050. This is a global UN campaign that emphasises the critical importance of reaching science-based net-zero emissions as quickly as possible, and this will include NHS Supply Chain: Logistics activities. Beyond our transport fleet, we have already started work with Unipart to reduce the carbon impact within our logistics warehouses, as well as futureproofing new sites, such as NHS Supply Chain Suffolk Park, which opened in May 2020 and was built to support our sustainability agenda, maximising the use of natural resources, including rain water. Unipart has also worked with us to switch our sites to 100 per cent renewable electricity, and is currently looking at the latest technologies to reduce our gas consumption and switch to green gas in 2022, as well as installing LED lighting. 3. Tower 5 Sanitary Products have a Green Range and Continence Products More than 600 new washable and recycled continence products have been added to a national framework launched by NHS Supply Chain. The full range of washable/reusable adult and children’s products are available in a choice of colours and styles. The recycled products are available across our range of procedure pads (formally known as underpads). The clinical and procurement teams within NHS Supply Chain: Rehabilitation, Disabled Services, Women’s Health and Associated Consumables, responded to customer feedback for more sustainable products when developing the framework. Lisa Charlesworth, Clinical Engagement and Implementation Manager, commented: “There has been a real push from our suppliers to go green, and coupled with what our customers are

telling us, we are delighted to be able to add so many washable/reusable and recycled products to our framework. This is just one example of how NHS Supply Chain is supporting the NHS to be Carbon Net Zero by 2045. We are working with suppliers on some new and exciting ideas, including offering more eco-friendly, sustainable and biodegradable disposable products. Just some of the initiatives include suppliers using recycled ocean plastics, fully recyclable packaging and using innovative technology.” There are more than 2,000 products on the Disposable and Washable Continence Care and Associated Products framework, including 1,200 new products from new and incumbent suppliers. Disposable and washable continence products are used throughout the NHS in both acute hospital wards and for patients in their own home or a care home. 4. Sustainability Snapshots of How We Are Supporting the NHS Over the last year we have launched several sustainable initiatives across our four strategic pillars which have already seen great results. Read on for some sustainability ideas that your trusts can take advantage of today. Speak with your local CRM for further information on any of the sustainable initiatives mentioned in this article. • Human rights and labour standards We now have 500 suppliers who have signed up to our NQC portal. The great news for the NHS is they can now see sustainability data from these 500 suppliers for free! Saving you time and resource while creating your Green plans. Trusts can follow the easy steps on our Human Rights webpage to sign up and take advantage of the information available to your trust. • Climate change, energy and greenhouse gas emissions in our own operations NCP (Nationally Contracted Products) During 2019 the NHS have already saved huge amounts of carbon by switching to our recycled copier paper, to put it into context CO2:- Saved is equivalent to 80,706.00 (eighty thousand, seven hundred and six) Round trips from London to Glasgow returns based on an average sized family car. L FURTHER INFORMATION www.supplychain.nhs.uk/sustainability

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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ISS to take a scientific and behavioural approach to healthcare cleaning March 2021 saw ISS launch their healthcare cleaning strategy and focus for 2021/2022. ISS Healthcare has now taken its approach one stage further by commissioning a groundbreaking project that will take a scientific and behavioural approach to healthcare cleaning. ISS’ strategic ambition centres on a groundbreaking project, a scientific approach to cleaning Collette Sweeney, Head of Healthcare Cleaning at ISS, explains: “the application of cleaning science and the impact of behaviour is intrinsically linked to environmental infection control. The purpose of the project is to use science to determine the efficacy and appropriateness of the healthcare cleaning process to deliver evidence-based safe systems of cleaning.” Collette and her team, who worked closely with NHS England and NHS Improvement in the development of the recently published National Standards of Healthcare Cleanliness 2021, believe that by using science to validate the cleaning process it will build confidence throughout the NHS, support shorter patient stays, and ultimately

provide a safe clinical environment to help save lives, not just during the COVID pandemic but beyond. Collaborative approach The successful delivery of this project centres on a collaborative approach with the NHS, and in particular the hospital the ISS research and development team are working with. Heather Cracknell, ISS Healthcare Cleaning SME stated that: “There has never been a better time to demonstrate not just being visibly clean, but clinically clean.” Donna Brown, Managing Director concludes: “This new project is not only ground-breaking but will lead to a positive step forward in healthcare cleaning for everyone, we would be delighted for other collaborators to come on board.” ISS has been at the forefront of healthcare cleaning for over 30 years now and has a long track record of delivering innovative solutions – they were the first company to offer scientific evidence that introducing microfibre into the NHS was a possible improvement. This new project is not only groundbreaking but will lead to a positive step forward in healthcare cleaning standards for everyone.

www.uk.issworld.com | enquires@uk.issworld.com

Estates management

Tackling the NHS’ environmental impact by transforming the NHS estate Cameron Hawkins, head of Energy and Environment at NHS Property Services, explains how the NHS remains a core pillar in the UK’s net zero strategy In the aftermath of COP26, we have seen as it is responsible for approximately four the most ambitious global climate per cent of the UK’s carbon emissions every commitments to date, including a landmark year. The NHS estate is an integral part of pledge from all four UK health services to the health system’s efforts to become more achieve net zero and build climate resilience. sustainable and reduce its carbon footprint. This is a huge opportunity to cut the global As owners of approximately 10 per cent of carbon footprint as health systems the NHS estate, including hospitals, account for approximately five per health centres and clinics, cent of global emissions – if they we at NHS Property were a country, they would be Services (NHSPS) The the fifth largest emitter in have welcomed this govern the world. challenge to support m e has com nt The NHS therefore the NHS to reduce to build mitted remains a core pillar in its environmental ing 40 the UK’s net zero strategy, impact and realise hos n

pitals, ew must b all of which carbon e net zero building s

its ambition of becoming the first net zero national health system. Prior to the net zero commitments from COP26, we launched our three-year energy and environment strategy in 2019 to spearhead our efforts to reduce our organisation’s carbon footprint, which included around 200 actions, such as improving transport efficiencies, increasing recycling, reducing waste and single-use plastic, improving water efficiency and, importantly, reducing carbon emission. We recently undertook a ‘Greener NHS Review’ and identified substantial improvements that have been made across the estate which we will explore further in this article. E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Paraid launches their first powered transfer chair Paraid understands that acute care environments are highly complex and can require an individually tailored transportation solution

Paraid has launched a new 24V, LithiumIon battery operated, motorised transfer chair, to further complement its wide range of products. The IBEX Power is designed for one-person operation, its Powered Belt Track System reduces manual handling and facilitates a smooth, safe and quick method of upward or downward patient transfer. One full battery charge provides enough power to last for 150 flights of stairs, providing plenty of operational time. The IBEX Power has an easy-to-use control pad enabling the user to control the speed and direction (whether that be upward or downward) of the transfer. The head support, arm and foot rests provide additional support and comfort to the patient and with a payload capacity of 160kg (25 stone); the IBEX Power can accommodate a wide range of patients with ease. Quick, compact and easy to operate, it is designed to safely and effortlessly move patients up and down stairs in hospitals, care homes and ambulances.

With over 35 years of UK design and manufacturing experience, Paraid is the recognised global leader of innovative neonatal, paediatric and adult critical care transportation equipment. Paraid understands that many transfer situations are extremely challenging and aim to deliver solutions that protect both patients and clinicians, during this critical stage of patient care. The Paraid product range includes the highly-acclaimed ACR (Ambulance Child Restraint) - the widest age and weight range paediatric harness in the world, the NeoRestraint which helps reduce movement of a neonate during transfer and a range of critical care trolleys. Paraid offers a bespoke design service enabling medical teams to work directly with their R&D specialists, to design products that meet their precise requirements. The team will take a brief and then applying their skills, experience and knowledge, will design a solution that meets the medical team’s exact needs. Using the latest 3D CAD design software and rapid-prototyping technologies, a prototype will be produced which can be tested and signed off ahead of production, ensuring that the final product provides the optimum transfer solution. Operating to the highest standards, all Paraid products are subject to a wide range of quality checks throughout the entire manufacturing process, which includes a comprehensive quality management system to control all procedures and processes; ISO 9001 for Quality Management standards and ISO 13485 for Medical Device Quality Management. Adhering to these standards provides complete peace of mind, that every product is manufactured using the highest quality components and processes and will meet the demands of any medical environment. In 2020 the company moved to a new state of the art head office in the heart of the UK. The 38,223 sq. ft purpose-built site has allowed the manufacturer to continue to grow and develop its world-leading products.

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Paraid provides nationwide UK coverage for training, maintenance and servicing providing customers with the reassurance, that their IBEX Power will be fully supported throughout its lifetime. It is recommended that all operators carry out training to ensure they are competent and confident in deploying and using the chair. Paraid offers two training courses; the Operator Training Course and the Key Trainer Masterclass. The Operator Training Course provides practical training on how to correctly use and deploy an IBEX Power. The Key Trainer Masterclass, known as ‘Train the Trainer’ provides knowledge for key members of a team to train others. On completion of both courses, all delegates that meet the training standards are certified and deemed competent. As outlined in the PUWER Regulation – Provision and Use of Work Equipment Regulations 1988, it is recommended that an IBEX Power should be regularly serviced and maintained to ensure its safe operation. To assist in meeting this legal requirement, Paraid offer 12-month, three- and five-year maintenance contracts. Power your patient transfers with the Paraid IBEX Power. L To book your FREE product demonstration or to find out more, please contact Paraid FURTHER INFORMATION Tel: +44 (0) 121 700 7455 www.paraid.com info@paraid.com

Estates management

 Net zero new builds Alongside the need to decarbonise the health estate, it is crucial that the NHS estate’s capacity continues to increase in order to accommodate the UK’s ever-growing population and the ongoing pressures of the Covid-19 pandemic facing the health service. To ensure extra capacity is provided, the government has committed to building 40 new hospitals, all of which must be net zero carbon buildings. We are therefore reviewing how to make our newly built health centres, clinics and GP surgeries net zero moving forwards. This is not a new concept for us however, as we are in the process of developing a net zero health centre. Construction began on Devizes Health Centre earlier this year, and, once the development is complete, the centre will become one of the first net zero health centres in England. Upon completion, this important project will provide space for the Wilshire Clinical Commissioning Group to offer primary care to the local community. Heat pumps and solar panels will be among the green technology used at the site and will enable the building to generate its own heating and electricity respectively, leading the way in sustainable design. These renewable technologies are hugely beneficial not only in terms of conserving resources and optimising energy efficiency, but are highly reliable and will sustain the site for years to come. Energy For hospitals that run 24 hours a day, 365 days a year, a reliable, uninterrupted source of energy is essential. It was crucial for us to consider this when making the switch to renewable energy. Last year, we arranged a new energy supply deal that introduced 100 per cent renewable energy across our building portfolio. The move to a flexible trading

strategy, and the negotiation of these new energy supply contracts, has meant this has been achieved at no additional cost to tenants. These changes have helped offset more than 37,000 tonnes of carbon dioxide a year, and reduced costs by 12 per cent, equating to around £8.9 million over the first two years; money that can be invested back into the NHS. In addition to switching to 100 per cent renewable electricity, we are in the process of integrating LED lighting across our sites, with over 70 sites already benefitting. Over two years, we have invested more than £6 million in stand-alone LED projects, as well as maintaining existing installations, saving £2 million and offsetting 2,500 tonnes of carbon a year. Reducing the overall energy consumption of the NHS estate is a complex process which requires communication and collaboration with our customers, the building occupiers, as these occupiers will play a key role in ensuring efficient energy usage. Most of our tenants are healthcare providers, whose primary focus will be on patient care. While this should absolutely be the primary concern of healthcare providers, ensuring we reduce our carbon footprint will also impact the lives of patients both today and tomorrow. Highlighting the importance of sustainability to our customers is integral in ensuring we meet the net zero goals of the NHS. In order to ensure we are reaching our customers, we launched an engagement programme that involves upskilling engineers and providing them with energy packs that they can use to work with tenants and advise them on the steps they can take to be more energy efficient in how they occupy our buildings. The first two years of this programme resulted in a significant saving of 11,800 tonnes of carbon and over £3 million. We are passionate about ensuring that this momentum continues.

Heat A further challenge we have faced is how to decarbonise the NHS estate’s heat sources, particularly in old hospitals that are designed to run on steam boilers. It is particularly difficult to implement technologies such as solar power and heat pumps with an ageing estate, as the condition of existing buildings often limit the feasibility of installing these alternative heat sources. There is no perfect solution, but we are committed to identifying the best ways to reduce our footprint, nonetheless. For example, we are exploring power purchase agreements (PPAs) as a promising way to support decarbonising the estate. PPAs are long-term electricity supply arrangements, which are usually made between a generator and a customer. They are a cost-effective way of increasing supply on site if installed locally, removing carbon from the grid, and ensuring running costs are kept to a minimum. This is because under a PPA, we will lease roof space to an energy supplier to install solar panels and buy the energy produced back. As such, we can further utilise our assets and support the move to green energy, without the need of a large capital outlay. Although the end goal would be to remove gas entirely, we know this is unlikely until hydrogen or a high-temperature electrical heat source becomes a widely available, cost-effective option. While we await this, we are committed to finding ways to reduce our reliance on gas. On behalf of myself and the whole NHSPS team, we look forward to completing our three-year energy strategy and continuing to implement sustainable improvements across the NHS estate to transform the NHS into a net zero health system. L FURTHER INFORMATION www.property.nhs.uk

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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The sturdy Vacumatic vacuum bags are 110-micron thick and have a patented safety structure, they are 100 per cent odourless and airtight using moisture wicking material. For the collection of waste and for use with our Vacumatic waste bags, the Hygenex Vacumatic trolley is made of a seamless stainless steel frame with a rubber clamp spring closure action which is operated by a foot pedal, and therefore needs no lid. This means that the waste bag never stays open and will close itself promptly with minimal air displacement. The Vacumatic is very simple to operate, you just place your foot in front of the floor sensor to open the vacuum chamber, place the bag you want to seal on the vacuum plate within the placement markers, and remove your foot from the sensor. The vacuum chamber closes automatically and begins the vacuum cycle. When complete, it hermetically seals the contaminated material in the bag ready for safe and easy disposal in the appropriate bin. This quick and easy process compacts the waste into tightly sealed packages for safe and easy disposal. The benefits include: • •

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Bad odour is nature’s alarm bell, letting you know that a vessel for bacteria is exposed. When managing waste, these smells are a stark warning of an infection risk. Keeping your facility odour-free isn’t just about cleanliness. It’s about respect and dignity. Providing a clean, fresh environment is your duty. It helps those in your care to thrive, while your clinical team can carry out their work with pride. L FURTHER INFORMATION www.ddcdolphin.com

Facilities management

Welfare facilities for healthcare staff The NHS Staff Council’s Health, Safety and Wellbeing Partnership Group (HSWPG) has developed guidance to support NHS organisations to improve their provision of staff welfare facilities. Health Business summarises the guidance The ongoing coronavirus pandemic has been a stark reminder of the importance of good welfare facilities for staff working in healthcare. From lockers to store clothes, facilities to change out of worn uniforms, and rooms in which to relax, they are all key elements that contribute to the wellbeing and safety of staff and the prevention and control of infections. However, in the context of the pandemic, it is also important that welfare facilities are made Covid secure for example, in terms of capacity and spacing of seating. Far from a nice to have, there are specific legal requirements on organisations to have suitable and sufficient physical welfare facilities for staff. The new guidance, published by the NHS Staff Council’s Health, Safety and Wellbeing Partnership Group, includes the case for improving and providing welfare facilities and the legal requirements for organisations to have suitable and sufficient facilities for staff. These are supported by partnership principles which HSWPG would like organisations to adopt.

outlook has drastically changed in the last The work is supported by case studies few years, employers are still expected to care outlining how organisations have made for staff and to support and enable them to improvements. In healthcare environments, it maintain their health and well-being. is essential to work in partnership with local The NHS is committed to promoting staff union representatives to ensure that staff are health, safety and well-being. In turn this kept safe and healthy at work. Subsequent enables staff to be more energised, productive improvements in staff health, safety and and engaged at work, leading to decreased well-being will have a positive impact on sickness absence and presenteeism. Evidence patient safety and the quality of care. links healthier, valued staff to better Working in a health and social patient/client outcomes. This is care environment, while Far from vital for us to be one of the often rewarding, can safest, most effective frequently be challenging a nice t o have, and compassionate health physically, mentally and t h ere are and social care emotionally. This has s pe legal re organisations. been exacerbated by quirem cific ents on organis The NHS People Plan the global pandemic, a calls on organisations to with staff on the suitable tions to have have safe spaces for staff frontline working and suf ficient physica to rest and recuperate: under conditions and lw “Employers should make pressures not seen facilitie elfare sure that staff have safe since the Second World s for spaces to manage E War. Whilst the health sta

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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Facilities management

 and process the physical and psychological demands of the work, on their own or with colleagues.” Employers, as a minimum, have a legal duty to ensure the welfare of their employees at work. Providing a safe and healthy environment will also help to motivate a workforce. Adequate welfare facilities for staff are a measurable indicator of how valued staff feel in the workplace and will also help to increase employee wellbeing and motivation. The lack of suitable places for staff to rest, eat a meal and have time to decompress and engage with colleagues during breaks can be detrimental to morale, performance, and overall staff satisfaction. Legalities The Workplace (Health, Safety and Welfare) Regulations 1992 and the Workplace (Health, Safety and Welfare) Regulations (Northern Ireland) 1993 places a number of legal requirements on organisations in terms of welfare facilities for staff. Regulation 22 to 25 are the key regulations that apply. Some of these legal requirements include: organisations having a ‘readily accessible’ supply of drinking water and a supply of vessels/cups to use to drink the water; organisations providing suitable and sufficient facilities, that are readily accessible, to allow workers to rest and eat meals away from their working environment to avoid the contamination of food; having facilities for staff to store their clothing when they have to change into a uniform for work; providing suitable and sufficient sanitary conveniences and washing facilities at readily accessible places and workers should be able to use them without unreasonable delay.

The NHS People Plan calls on organisations to have safe spaces for staff to rest and recuperate: “Employers should make sure that staff have safe spaces to manage and process the physical and psychological demands of the work, on their own or with colleagues.” Partnership principles HSWPG suggests that an important first principle towards the improvement of welfare facilities is having a clear statement from the chief executive and the board that recognises the legal framework and importance of providing the best staff welfare facilities. The business case for caring for staff is high on the NHS agenda and each organisation should have a policy/policies relating to staff health, safety, and well-being. The group also states in the guidance that it is important to ensure that staff welfare facilities are integral to any refurbishment or new build a d that the needs of community staff must also be recognised, especially in terms of access to sanitary conveniences and somewhere to rest, that isn’t their own car or public transport. The final point recommended is for employers to ensure sustainability. Employers should continue to provide and maintain facilities, beyond the pandemic to ensure they are compliant with relevant legal requirements and continue to work to

promote staff well-being and improve morale. Organisations should seek feedback from staff on what facilities have worked well during the pandemic. Where staff have difficulty accessing facilities due to their location and the length of breaks, employers should work in partnership with staff to develop sustainable solutions to such problems. Cleaning protocols should be in place for rest, showering, changing, and locker facilities including systems for the control of legionella. L

HSWPG is a sub-group of the staff council and was established to: raise standards of workplace health, safety, and wellbeing in healthcare organisations; promote a safer working environment for all healthcare staff; and promote best practice across the NHS and independent sector. FURTHER INFORMATION www.nhsemployers.org/publications/ welfare-facilities-healthcare-staff

Issue 21.6 | HEALTH BUSINESS MAGAZINE

HB Top 50 NHS Professionals

Health Business: Top 50 NHS Professionals Welcome to our first Health Business Top 50 NHS Professionals list - our pick of the people that have shaped the national health service over the years. Now, perhaps more than at any other time in its history, our reliance on and gratitude towards the NHS has never been greater. The overwhelming pressures of the coronavirus pandemic have pushed the nation’s health workers to the brink, with the ongoing efforts to tackle the virus, and the new Omicron variant, expected to worsen again this winter. Hospitals are treating more patients, with an ever increasing variation of illnesses, whilst operating under tighter infection prevention measures and shrinking budgets. The record funding, announced under Theresa May’s premiership, did not account for a global health disaster and the ‘kick it down the road’ attitude towards addressing the social care crisis leaves even more burdens on the doorstep of the country’s largest employer. Nonetheless, the ability to provide the best care possible to all patients, no matter where they live in the country, remains unrivalled. Those that work for, within and alongside the NHS have rightly deserved our claps, our thanks and our ongoing appreciation. Our first HB Top 50 NHS Professionals is our pick of the people that have made an impact on the health system in England. This includes government officials, hospital management, leadership within NHS representative organisations and so forth. Because of the coronavirus pandemic and the unscheduled disruption that has been caused, you will find that some on the list have gained prominence during the last few years, whilst others have seen the stress of the pandemic as the right time to take a step away from the profession they have served so brilliantly. Undoubtedly, views will be varied. There are names that many readers will feel should be on the list that do not appear, as well as figures placed lower on the list than many think they deserve. It is our hope that these rankings will be reproduced regularly to accurately reflect the changing landscape of the healthcare sector. Please join me in congratulating those on the list, as well as thanking all those who continue to work under the banner of our wonderful National Health Service. Lastly, I hope that you have a wonderful festive period and a safe and healthly start to 2022. Michael Lyons, Editor, Health Business magazine

50 Lucy Chappell chief executive of the National Institute for Health Research

In August 2021, Professor Lucy Chappell took up her new post as chief executive of the National Institute for Health Research, where she will lead the NIHR as part of her wider role as Chief Scientific Adviser to DHSC. On secondment into government, while continuing some of her clinical and academic work, Chappell will oversee the NIHR’s £1.3 billion budget for health and social care research.

49 Roland Sinker chief executive of Cambridge University Hospitals NHS Foundation Trust

Roland Sinker has served as chief executive of Cambridge University Hospitals NHS Foundation Trust since 2015, as well as the accountable officer role for ICS partners in Cambridgeshire and Peterborough. CUH is a high performing centre for clinical care and patient experience, rated as Good overall and Outstanding for well-led and Caring by the CQC, as well as deemed one of the most digitally developed hospitals.

48 Jane Tomkinson chief executive of Liverpool Heart and Chest Hospital NHS Foundation Trust

Jane Tomkinson has been CEO at Liverpool Heart and Chest Hospital since 2013 and oversaw the organisation becoming the first specialist trust to be rated Outstanding by the CQC in 2016, with a second Outstanding rating in 2019. The CQC’s 2020 Adult Inpatient Survey saw LHCH score highly compared to the national average, with an ‘overall experience’ score of 9.07 out of 10.

47 Ann Marr chief executive of St Helens and Knowsley Teaching Hospitals Trust

Ann Marr has been chief executive of St Helens and Knowsley Teaching Hospitals Trust since 2003. In 2019 the trust was rated as Outstanding by the CQC, with particular praise directed towards the governance within the organisation and the clear structures of accountability that are in place.

46 Timothy Ferris Director of Transformation at NHS England

Timothy Ferris, who has served as a non-executive director of NHS Improvement for almost three years, was appointed as Director of Transformation for NHS England and NHS Improvement earlier this year. In this role, he leads the new Transformation Directorate, bringing together the organisation’s operational improvement team and NHSX, the digital arm, to maintain the pace of innovation seen during the pandemic.

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45 Paul Bentley chief executive of Kent Community Health Foundation Trust Paul Bentley has held the position of chief executive of Kent Community Health NHS Foundation Trust since March 2016. KCHFT has held an Outstanding rating by the CQC since 2019. In 2021, staff rated the organisation among the best in the country to work for and as one of the highest performing community trusts in the country in five areas.

44 Dame Cally Palmer chief executive of The Royal Marsden Dame Cally Palmer leads the work of The Royal Marsden and serves as a trustee of the Institute of Cancer Research and Royal Marsden Cancer Charity. The Royal Marsden and ICR are currently ranked in the top five cancer centres globally for research impact, with the former also rated as Outstanding by the CQC. Palmer is also NHS England’s National Cancer Director, leading the implementation of the NHS Cancer Taskforce’s five year strategy for cancer care improvement.

43 Lesley Watts chief executive of Chelsea and Westminster Hospital NHS Foundation Trust Lesley Watts is chief executive of Chelsea and Westminster Hospital NHS Foundation Trust, leading the organisation to receive a CQC rating of Outstanding for being well-led and for use of resources. When she became chief executive in 2015 the trust was Requires Improvement overall.

42 Michael Brodie CEO of NHS Business Services Authority Michael Brodie has been CEO of NHSBSA since 2019, having previously held the role of Finance and Commercial Director at Public Health England since its inception. Brodie rejoined PHE as interim chief executive in August 2020, before the organisation was dissolved to enable the creation of the UK Health Security Agency.

41 Navina Evans chief executive of Health Education England Dr Navina Evans joined HEE in October 2020 from East London NHS Foundation Trust where she had been chief executive since 2016. Evans has more than 20 years of clinical experience as director of operations, as well as Clinical Director for CAMHS at ELFT.

40 Richard Murray chief executive of The King’s Fund Richard Murray has been chief executive of The King’s Fund since 2019, having previously been chief analyst at NHS England, as well as holding a number of roles at the Department of Health. Now, Murray leads on the day-to-day management of the charitable trust, which aims to be a catalyst for change and to inspire improvements in health and care.

39 Angela Hillery chief executive of Northamptonshire Healthcare NHS Foundation Trust In 2019 Angela Hillery was appointed chief executive of Leicestershire Partnership Trust, in a shared role with the same position at Northamptonshire Healthcare NHS Foundation Trust, which she has held since 2013. In 2018, NHFT achieved an overall rating of Outstanding from the CQC, having been Requires Improvement in 2013, and Hillery is using her shared role to help LPT move towards improvements in its CQC ratings, which currently sit as Requires Improvement.

HB Top 50 NHS Professionals

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38 Tracey Fletcher chief executive of Homerton University Hospital NHS Foundation Trust Tracey Fletcher became chief executive of Homerton University Hospital NHS Foundation Trust in 2013. She re-joined the trust in 2010 as COO and has extensive experience in health care management, having begun her career in a mental health trust followed by a community trust. Homerton University Hospital NHS Foundation Trust was rated Good by the CQC in its 2018 inspection, across all areas, with Homerton University Hospital rated as Outstanding.

37 Sean Duggan chief executive of the Mental Health Network Sean Duggan is dedicated to raising standards of care and treatment of mental health services and improving lives of those who use services and their carers, and has been chief executive of the NHS Confederation’s Mental Health Network since 2016. Duggan supports multi-sector service delivery and has ensured this is reflected in the network’s membership, which has grown to include independent and third sector organisations, including digital providers.

36 Joe Harrison chief executive of Milton Keynes University Hospital NHS Foundation Trust Professor Joe Harrison has been an NHS acute hospital chief executive for almost a decade. He joined Milton Keynes University Hospital in 2013, transforming its record in quality, performance and finances. Under his leadership the trust has gained teaching hospital status and pioneered digital advances that have revolutionised patient care and experience. He has championed NHS expansion, overseeing significant development across the hospital estate.

35 Martin Steele chief executive officer of NHS Property Services

Martin Steele was appointed acting chief executive officer of NHS Property Services in April 2020. Particularly important during the current pandemic, Steele is responsible for overseeing the management and operations of NHSPS’ significant portfolio, which comprises over 3,500 properties with 7,000 customers across England, representing approximately 10 per cent of the total NHS estate. E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

HB Top 50 NHS Professionals

34 Tim Kendall National Clinical Director for Mental Health, NHS England 

Professor Tim Kendall is NHS England’s National Clinical Director for Mental Health, a role he has held since 2016, providing clinical advice and strategy in mental health across government and the NHS. He chairs a number of national committees to implement the Mental Health Five Year Forward View and The Long Term Plan.

33 Stephen Posey CEO of the Royal Papworth Hospital Foundation Trust

With more than two decades experience in the health service, Stephen Posey joined Royal Papworth Hospital NHS Foundation Trust as its chief executive in November 2016. Prior to this, Posey was the deputy chief executive at East and North Hertfordshire NHS Trust where he successfully delivered a £150 million investment programme to reconfigure acute services across East and North Hertfordshire.

32 Tom Cahill chief executive of Hertfordshire Partnership University Foundation Trust

Tom Cahill has been chief executive of Hertfordshire Partnership University Foundation Trust since 2009, and has overseen the development of new models of care, new facilities and the trust’s culture. Under his leadership, HPFT was rated as Outstanding by the CQC in 2019. He is stepping down from his role at the end of 2021.

31 Dame Marianne Griffiths chief executive of Western Sussex Hospitals NHS Foundation Trust

Dame Marianne Griffiths has led the Western Sussex Hospitals from its creation from a merger in 2009 to being awarded Foundation Trust status four years later and in 2019 becoming the first acute trust to be rated Outstanding in all five areas inspected by the CQC. She now leads UHSussex, which employs nearly 20,000 people across five main hospital sites in Sussex, with an operating budget of more than £1 billion.

30 Michael Wilson chief executive of Surrey and Sussex Healthcare NHS Trust

After serving 11 years as chief executive of SASH NHS Trust and 41 years in the NHS, Michael Wilson is stepping down this year. Under Wilson’s stewardship, SASH has been transformed from an organisation with significant challenges to one of the top performing NHS trusts in the country. SASH is regularly among the top performing NHS trusts in the national staff survey, is often in the top ten trusts in the country for ED waiting times and has delivered a financial surplus for many years.

29 Ian Trenholm chief executive of the Care Quality Commission

Formerly chief executive of NHS Blood and Transplant from 2014-18, Ian Trenholm is the chief executive of the Care Quality Commission, the independent regulator of health and adult social care in England. Under his guidance, the CQC ensures that health and social care services provide people with safe, effective, compassionate, high-quality care and encourages care services to improve. His prior roles include chief executive of the Royal Borough of Windsor and COO at the Department of Environment Food and Rural Affairs.

28 Matt Hancock Conservative backbencher

Matt Hancock served as Health and Social Care Secretary between July 2018 and June 2021, encompassing the handling of the coronavirus pandemic and the vaccine rollout. At the end of 2018 he promised to introduce minimum technical standards that digital services in the NHS will have to meet, pledged to tackle the world’s largest collection of fax machines, and sought to end to non-disclosure agreements.

27 Edward Argar Minister for Health

Edward Argar was appointed Minister of State at the Department of Health and Social Care in September 2019, having first been elected as Conservative MP for Charnwood, Leicestershire, in 2015. Amongst other areas, the Minister of State for Health leads on NHS operational performance, NHS capital, land and estates, NHS England mandate, the NHS workforce and the Long Term Plan Bill.

26 Rob Webster West Yorkshire and Harrogate Health and Care Partnership

Earlier this year it was announced that Rob Webster would leave his post as chief executive of South West Yorkshire Partnership Foundation Trust to become the full-time lead of the West Yorkshire and Harrogate Health and Care Partnership. Webster joined South West Yorkshire Partnership Foundation Trust in May 2016 from NHS Confederation, where he was chief executive for over two years.

25 Julian Hartley chief executive of Leeds Teaching Hospitals NHS Trust

Holding the role of chief executive since 2013, Julian Hartley has led the Leeds Teaching Hospitals NHS Trust to become the most improved acute trust in the country in the national staff survey across the board, showing significant improvements to staff engagement year on year. Hartley’s work is particular noticeable in the local area, introducing The Leeds Way and embedding the Leeds Improvement Method as a culture of continuous quality improvement. Hartley was asked by NHS Improvement to work on the national NHS People Plan.

24 Nick Watts Chief Sustainability Officer Dr Nick Watts is the Chief Sustainability Officer of the NHS, responsible for its commitment to deliver a worldclass net zero emission health service. Based in London, he leads the Greener NHS team across the country, which focuses on improving the health of patients and the public through a robust and accelerated response to climate change and the broader sustainability agenda.

23 Ted Baker Chief Inspector of Hospitals, Care Quality Commission

Having first joined the NHS in 1973, Ted Baker has enjoyed a career encompassing clinical and academic medicine and hospital management. Since 2017 he has held the position of the Chief Inspector of Hospitals at the Care Quality Commission, the independent regulator of health and social care in England, having previously held the Deputy Chief Inspector of Hospitals position for the three years prior.

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

22 Lord David Prior chair of NHS England A former MP, Lord Prior was chairman of Norfolk and Norwich University Hospitals NHS Foundation Trust from 2002-2012 before becoming chairman of the CQC. In 2015, he was appointed Parliamentary Under Secretary of State for Health and created a Life Peer, before becoming chairman of University College London Hospitals at the end of 2017.

21 Matthew Gould CEO of NHSX Having been the government’s Director General for Digital and Media Policy for three years, Matthew Gould was appointed CEO for NHSX in May 2019, the year in which the department was established. His main priority is the advancement of NHS and social care transformation, driven by technology, in line with the NHS Long Term Plan and the Secretary of State for Health and Social Care’s technology vision.

20 Sir Michael Deegan chief executive of Manchester University NHS Foundation Trust Michael Deegan has been chief executive of Central Manchester University Hospitals NHS FT since 2001, before the merger to Manchester University NHS FT in 2017. MFT is one of the UK’s largest acute trusts, running nine hospitals across six sites. At CMFT, Deegan oversaw the £520m PFI redevelopment of its Oxford Road campus; attained, in partnership with the University of Manchester, Biomedical Research Centre designation in 2008; and managed the transition to Foundation Trust status with effect from January 2009.

19 Tracy Allen chief executive of Derbyshire Community Health Services NHS Foundation Trust Tracy Allen has been chief executive of Derbyshire Community Health Services NHS Foundation Trust since 2011, having led the creation of Derbyshire Community Health Services from the provider arms of six predecessor PCTs, its successful development into an APO and its establishment as a Community NHS Trust. Under Allen’s leadership, DCHS has achieved the highest Outstanding rating from the CQC.

18 Robert Woolley chief executive of University Hospitals Bristol and Weston NHS Foundation Trust Robert Woolley was appointed chief executive of UHBW in 2010 and plans to leave the role in March. During his tenure, the organisation has moved from a rating of Requires Improvement straight to two successive ratings of Outstanding in 2017 and 2019 respectively. At the time, the trust was the first to be rated Outstanding by the CQC after a previous rating of Requires Improvement.

17 Chaand Nagpaul council chair of the British Medical Association Chaand Nagpaul is a GP and senior partner in his practice in Stanmore, North London, where he has practised for 28 years. He was elected as chair of BMA council in July 2017, and has been a council member since 2008. In recent years Nagpaul campaigned against the immigration cap on overseas doctors from outside the European Union, argued against the proposal to privatise the NHS and stressed the urgency to tackle health inequalities as a means to improving population health outcomes in Britain.

HB Top 50 NHS Professionals

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16 Glen Burley chief executive of South Warwickshire NHS Foundation Trust A former director of Finance for South Warwickshire Mental Health Services NHS Trust, Glen Burley joined South Warwickshire in 2006, initially as interim chief executive, before his formal appointment two years later. Under his leadership, SWFT has moved through financial turnaround, achieved Foundation Trust status in 2010, completed the successful acquisition of Warwickshire Community Services in 2011 and gained Outstanding ratings for quality and use of resources in late 2019.

15 Jonathan Ashworth Former Shadow Secretary for Health and Social Care Jonathan Ashworth became Shadow Secretary of State for Health in 2016, and took on the extra responsibility for social care in 2020. Serving under both Jeremy Corbyn and Sir Kier Starmer, Ashworth was praised by then Health Secretary Matt Hancock for his help devising government policy on the coronavirus pandemic. He has recently become Shadow Work and Pensions Secretary.

14 Chris Whitty Chief Medical Officer for England

Head of the public health profession in England, Professor Chris Whitty is Chief Medical Officer and the government’s Chief Medical Adviser, as well a practising NHS Consultant Physician at University College London Hospitals. Since the start of the pandemic, Whitty has appeared in public information adverts on national television and led the social-distancing strategy to reduce the spread of the virus during the pandemic.

13 Ian Dodge executive director, NHS England Ian Dodge has worked for NHS England since 2014, and currently has the portfolio responsibility of national director for strategy and innovation. In his 20 years working for the Department of Health, Dodge worked under ten different Secretaries of State. His current directorate leads the NHS’ work on strategy, sustainability and transformation, implementing the Five Year Forward View and giving power to patients through personalisation and choice. E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

HB Top 50 NHS Professionals

12 Claire Murdoch National Director for Mental Health at NHS England

Claire Murdoch has more than 20 years NHS experience holding various clinical and managerial posts in inner London mental health services, including the inaugural chair of the Cavendish Square Group of the 10 London NHS trusts responsible for mental health services, and currently holds the position of chief executive at Central and North West London NHS Foundation Trust. Alongside this, Murdoch is national director for mental health at NHS England.

11 Chris Hopson chief executive NHS Providers

Chris Hopson was appointed as chief executive of NHS Providers in September 2012, a role which sees him act as the principal public voice of the organisation and represent the provider sector on a range of NHS system level committees. NHS Providers is the membership organisation for all of England’s 217 ambulance, community, hospital and mental health trusts.

10 Dame Jackie Daniel chief executive of Newcastle Hospitals

Dame Jackie Daniel has been chief executive at Newcastle Hospitals since 2018, having previously held the same role at University Hospitals of Morecambe Bay NHS Foundation Trust, which she led out of special measures. Recognised in the Queen’s New Year’s Honours in 2017, Daniel began her NHS professional career as a nurse before moving into NHS management. Daniel has seen Newcastle Hospitals rated Outstanding for the second time in a row by the CQC, the largest NHS organisation to receive the accolade twice. She also chairs the Shelford Group, which represents the ten largest teaching and research hospitals in the NHS.

9 Ruth May Chief Nursing Officer

Ruth May took up the post of Chief Nursing Officer for England in January 2019, the most senior advisor on nursing matters in government, and before this enjoyed national appointments with NHS Improvement and Monitor as well as regional and trust leadership roles. More recently, she was appointed the national Covid-19 response lead for the nursing, midwifery and care professions in England. In 2019, NHS England set out her three key priorities as establishing a workforce that is fit for the future, renewing the reputation of the NHS profession for the future and creating a collective voice for nursing.

8 Jeremy Hunt chair of the Health and Social Care Select Committee Jeremy Hunt is the current chair of the Health and Social Care Select Committee, a Commons Select Committee overseeing DHSC operations. Inquiries led by Hunt have examined the management of the coronavirus outbreak, lessons learnt from the pandemic and workforce burnout and resilience in the NHS and social care. Hunt was appointed Health Secretary in 2012, becoming the longest serving MP to hold the role in 2018. His length of service and success in securing £20bn in NHS investment prior to the NHS’s 70th Anniversary mean he is likely to be remembered fondly.

7 Stephen Powis National Medical Director of NHS England

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A familiar face from Downing Street’s coronavirus press briefings, Stephen Powis is the National Medical Director of NHS England and Professor of Renal Medicine at University College London. In his National Medical Director role he is the most senior doctor within the National Health Service in England. Before taking up his current role with NHS England in 2017, Powis was medical director of the Royal Free London NHS Foundation Trust and is a past non-executive director of North Middlesex University Hospital NHS Trust.

6 Emily Lawson chief commercial officer of NHS England Earlier this year it was announced that Emily Lawson would begin an open-ended secondment arrangement to lead Prime Minister Boris Johnson’s new delivery unit after drawing praise for her role as NHS England’s executive lead for the national vaccination programme. Since November 2020, Lawson has led the operational delivery of the Covid-19 vaccine across the NHS in England, responsible for ensuring that vaccine is rolled out in line with the vaccine prioritisation agenda set by the Joint Committee for Vaccination and Immunisation and in a way that ensures fair and equitable access.

5 Danny Mortimer chief executive of NHS Employers Danny Mortimer has been chief executive of NHS Employers since 2014, leading work relating to workforce policy and practice, as well as being deputy chief executive of the NHS Confederation. Mortimer, who first worked in healthcare as a porter and CSV care assistant, worked in the NHS in Bath and Brighton before taking up his first director post for Royal West Sussex NHS Trust and Western Sussex PCT. He then worked in executive roles in hospitals in Hertfordshire and Nottingham before joining NHS Employers. As well as being a trustee of the Employers Network for Equality and Inclusion and the NHS Retirement Fellowship, Mortimer currently chairs the Cavendish Coalition of social care and health organisations.

4 Sajid Javid Secretary of State for Health and Social Care Although only in the role since June, as Secretary of State for Health and Social Care, Sajid Javid is responsible for the overall financial control and oversight of NHS delivery and performance, as well as the oversight of social care policy from the Department of Health and Social Care. Upon becoming Health Secretary, Javid announced that he was in favour of an end to public health restrictions, brought about by the coronavirus pandemic, but warned the public that ‘we are going to have to learn to accept the existence of Covid and find ways to cope with it’. Alongside Prime Minister Boris Johnson, he announced that £36 billion will be invested in the health and care system over the next three years, to ensure it has the long term resource it needs.

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3 Sir James Mackey chief executive Northumbria Healthcare As part of a two year secondment as chief executive of NHS Improvement, which began in 2015, Sir James Mackey oversaw the creation of the organisation that has brought together NHS regulators Monitor and the Trust Development Authority. Responsible for overseeing NHS trusts, NHS Improvement supports providers to ensure patients are given consistently safe, high quality, compassionate care within local health systems that are financially sustainable. Prior to that role, and again since 2017, Mackey has been serving as chief executive of Northumbria Healthcare, an appointment which, at the time, made him one of the youngest chief executives of a hospital trust in England. Northumbria Healthcare is now widely recognised as one of the best NHS organisations in England for its high quality patient care.

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2 Amanda Pritchard chief executive of NHS England Amanda Pritchard has been chief executive of NHS England since August 2021, having previously served as COO of the same organisation, as well as NHS Improvement, before replacing Stevens in the most senior role. As COO, Pritchard has overseen NHS operational performance and delivery, as well as implementation of service transformation and patient care improvements set out in the NHS Long Term Plan. Following the coronavirus pandemic, Pritchard will be responsible for an annual budget of more than £130 billion and says that the service’s successes over the last 18 months have meant that ‘we can face the future with confidence’.

1 Sir Simon Stevens former chief executive of NHS England At the end of July, Sir Simon Stevens formally stepped down as chief executive of NHS England after more than seven years as it’s chief executive. Having first joined the NHS in 1988 through its graduate management programme, Stevens became head of the health service in April 2014 and has most notably led the NHS through the most testing period of its history. Prior to the coronavirus pandemic outbreak, Stevens also oversaw the development of the Five Year Forward View, the introduction of an NHS Workforce Race Equality Standard, a £20.5 billion funding boost to celebrate the NHS’ 70th Anniversary and the launch of the NHS Long Term Plan.

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Innovating in diagnostics with new models of out of hospital care A lot of the healthcare needs could be addressed without ever stepping foot inside a hospital. The time has clearly come for innovative new models of care, starting with out-of-hospital solutions

There’s a tension at the structural centre of healthcare today. More pressures are being exerted on hospitals; bricks and mortar environments were not designed to manage healthcare’s needs in the 21st century. Fast forward to 2021 and hospitals are delivering care with limited resources, and staff are under pressure to treat more patients. According to NHS figures1, hospital waiting list numbers in England have doubled since last year and are expected to continue to rise, due to aged equipment, workforce shortages and Covid-19 pressures. The time has clearly come for innovative new models of care, starting with out-of-hospital solutions; a need also identified in the NHS Long Term Plan2 and Professor Sir Mike Richards’ report, ‘Diagnostics: Recovery and Renewal’. Diagnostics are central to efficiency of care Diagnostics are central to effective care and yet there are increasing challenges. Ageing equipment, an increasing diagnostics demand, Covid-19 implications and workforce shortages all combine to paint a grim reality. Chronic workforce shortages permeate virtually all parts of radiology departments, and healthcare more broadly. Radiology is of particular concern. The growth in the use of medical imaging and interventional techniques has resulted in a huge gap between the demand and supply of radiologists. Between March 2019 and March 2020, NHS hospitals in England performed 44.9 million imaging tests, including 23.2 million X-rays and 10.3 million ultrasounds3. Worryingly, the Royal College of Radiologists asserts that the UK radiology workforce is currently understaffed by 1,876 radiographers, and is forecast to rise to 3,331 (43 per cent) by 2024 4. The impact on a hospital’s operating costs of radiology workforce shortages is massive: in 2018 the NHS spent £116 million to

outsource patient scans due to the radiologist shortage. Outsourcing costs doubled in three years in the UK (to 2018) from £58 million to £116 million5. COVID-19: the urgency to reimagine healthcare The need to innovate diagnostics is one of the key lessons to emerge from the Covid-19 pandemic, which fast-tracked the impetus behind new models of care which envisaged diagnostic services – or hubs - outside of the hospital walls. Patient behaviours and the consumerisation of care have also driven healthcare’s steady shift away from the hospital. Proximity to care is becoming a key demand, with around 50 per cent of healthcare-related Google searches on mobile devices including the words ‘near me’, reinforcing that healthcare is now about service and convenience6. Partnering in diagnostics through Community Diagnostic Centres With government funding and the recommendations for public-private collaboration as evidenced by Professor Sir Mike Richards’ report, total market commitment has started to, at last, fall into place. One such example is the way that Philips is partnering with healthcare providers to pioneer Community Diagnostic Centres (CDC), together with the NHS. This accelerated out of hospital model looks likely to transform current care models by bringing ‘first time right’ medical imaging and other treatment services closer to where patients reside. ‘One stop shops’ in the community, CDCs are modern facilities with evidence-led design and the best technologies intended to improve patient outcomes and patient and staff experiences. As well as supporting learning and development, the ultimate vision is that these centres will specialise in providing services that meet cardiovascular, fitness, wellness and health themes across Radiology, Cardiology, Oncology, Respiratory and Sleep health spaces.

This approach enables the extension of diagnostics and addresses the unmet need of patients, while reducing the burden on hospitals. More low acuity patients can be directed to a local diagnostic centre and leave hospitals to manage higher risk patients. Jeevan Gunaratnam, Community Diagnostic Centre lead at Philips U&I, explains: “A lot of the healthcare needs could be addressed without ever stepping foot inside a hospital. If you do that across the board, you will reduce traffic inside the hospital and can reconfigure that hospital to deliver the more complex care and procedures that really add value. Patients also won’t have to travel great distances for scans. Ultimately, this model supports the NHS and health providers to spread resources, knowledge and learning across the country.” Professor Sir Mike Richards’ report7 recommends expansion take place as soon as possible, estimating a need for three hubs per million population initially. In addition to this, the review also recommended the doubling of CT scanning capacity and that tests for heart and lung disease be enhanced, given the link to the coronavirus. Jeevan Gunaratnam concludes: “The benefit of growing imaging services beyond the hospital is momentous. They have the potential to ease staff burdens, improve patient outcomes, with more diagnostic care services closer to where the patient resides. It will allow for skills to be spread more evenly across large geographical spaces and potentially breathe new life into communities in duress. Community Diagnostic Centres can’t happen soon enough. Healthcare should, after all, be accessible to everyone.” L FURTHER INFORMATION www.philips.co.uk/healthcare/ References: 1.

2. 3. 4.

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Source: NHS Consultant Led Patient Referral to Treatment Waiting Times Dec 2019 - Dec 2020,https://www.england.nhs.uk/ statistics/statistical-work-areas/rtt-waiting-times/ NHS Long Term Plan - https://www.longtermplan.nhs.uk/ Document template (england.nhs.uk) NHS Diagnostic Imaging Dataset 2019-20 The Royal College of Radiologists, Clinical Radiology Worforce Census Report 2019 https://www.rcr.ac.uk/system/files/publication/field_publication_files/clinical-radiology-uk-workforce-census-2019-report.pdf The Royal College of Radiologists, Clinical Radiology Worforce Census Report 2019 https://www.rcr.ac.uk/system/files/publication/field_publication_files/clinical-radiology-uk-workforce-census-2019-report.pdf Using New Technologies to Improve the Prevention and Management of Chronic Conditions in Populations Brian Oldenburg, School of Population and Global Health, University of Melbourne, C. Barr Taylor, Adrienne O’Neil, Fiona Cocker, and Linda D. Cameron Diagnostics: Recovery & Renewal - Report of the Independent Review of Diagnostic Services for NHS England (October 2020)

Digital

Digital services and the Covid-19 pandemic Melissa Ruscoe, Programme Head at NHS Digital, discusses the benefits of online healthcare through NHS services during the Covid-19 pandemic using just one email address and password. Patients can access multiple services with a single point of access wherever the NHS login button is displayed. Through the NHS App, people can access their NHS COVID Pass, book appointments, view their health record and register their organ donation decisions, as well as access a range of other heath and care services. The ever-increasing numbers Around half of England’s population – Since the launch of NHS Digital services such almost 28 million people – have as NHS login and the NHS App in 2018, registered with NHS login millions of people have registered since the service was to access healthcare services Millions launched in 2018, digitally, with demand of peop up from 2.2 million for digital healthcare le have re this time last year increasing during the g is tered to acce (September) There Covid-19 pandemic. have also been more NHS login, an online services ss healthcare digitally than 16 million service managed by NHS , with deman user registrations Digital, provides people d f or digit healthc recorded for the with a quick and secure a l a NHS App, making single point of access to during re increasing the Cov it England’s most a variety of digital health id-19 popular free app. and care websites and apps pan The demand for digital healthcare services provided by the NHS, such as those accessed via the NHS login service and the NHS App, has been greater than ever during the coronavirus pandemic – and these digital services are bringing an array of benefits to patients and clinicians alike.

demic

A peak in numbers of registrations for NHS login and the NHS App took place in May, coinciding with the launch of the NHS COVID Pass – which can be used for travel abroad and domestic events. On 17 May alone, when the NHS COVID Pass launched, around 220,000 people created an NHS login. There were also more than 2.8 million new registrations to use the NHS App within the first month following the addition of the COVID Pass. An array of benefits, including saving lives A total of 45 apps and e-health services are now available through NHS login, including e-Referral services, Covid-19 support and advice, maternity and child health services, online pharmacies, and services to monitor and improve health and wellbeing. NHS login is also now one of the biggest digital identity verification services in England and provides users with a range of secure methods to verify themselves – including selfie videos and face scanning. Of the almost 28 million people currently registered with an E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

Scaling up to support extra user registrations To ensure the service could cope with the influx of people managing their healthcare needs digitally during the pandemic and,

Around half of England’s population – almost 28 million people – have registered with NHS login since the service was launched in 2018, up from 2.2 million this time last year specifically, the additional volume of users generated by the NHS COVID Pass, the NHS App team had to scale up their services and meet the challenge of increased capacity head on. To make sure waiting times for setting up an NHS login were kept at an acceptable level, the number of manual ID checkers had to increase significantly to handle the sudden surges and increases in user volumes. To ensure people wanting to use the NHS App were fully supported, the customer service team also needed to be increased. The teams, with support from suppliers, scaled up both technical and operational capacities. To assist users visiting the NHS App help and support pages on the NHS website in even faster timeframes, the team introduced an automatic chat function using Zendesk customer support software. The automatic chat function anticipates what the user is trying

Digital

 NHS login, around 57 per cent are now fully verified. Users are encouraged to complete identity verification to have complete access to the full range of services available via NHS login. People registered with the NHS App are also benefiting from easier access to healthcare services online. During the past four months, almost 3.2 million repeat prescriptions were ordered and over 268,000 GP appointments booked via the app, saving valuable time for patients and clinicians, and providing patients with a simple and efficient way to take control of their healthcare and access services securely online. The increase in app downloads could also have a life-saving impact as 1.5 million people have now used the NHS App to manage their organ donation decision, with 265,000 users registering their organ donation for the first time via the App. Over 150,000 of these new registrations have taken place in just four months since May 2021. Registering a preference on organ donation helps NHS specialist nurses to quickly understand people’s wishes, which can ultimately save lives.

to ask about the NHS App and provides an immediate response. Making the most of the NHS App – for GPs All GP practices are now linked to the NHS App. To ensure patients can make the most of all the varied features via the App – such as accessing health services on behalf of a family member or viewing their full medical record, practice staff must enable access within their clinical system. Doing so is mutually beneficial as staff will then reap the rewards of digitally savvy patients being able to access NHS services without the need to contact their GP – freeing up valuable time for clinicians to focus on other aspects of patient care. L FURTHER INFORMATION https://digital.nhs.uk

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How OPEX is providing superior digitisation solutions for the NHS OPEX® continues to bolster its one-touch solution to help overcome pressures of staff shortages and demands of an evolving work environment

As we readjust and revaluate best business practices instigated by the coronavirus pandemic and other changes in the workplace landscape, it has never been more crucial to address the digitisation of healthcare records. Staff shortages, social distancing and a new way of working have brought on additional challenges to the NHS - and OPEX has the solution to help minimise these pressures. As a results-driven, solutions-based organisation, OPEX has already helped over 30 NHS trusts across the UK streamline inhouse medical records digitisation by making the process as seamless as possible. With an innovative and ever improving approach, OPEX is best placed to supply a variety of unique, automated solutions with proven experience in the healthcare industry. Key benefits of digitisation for both providers and patients include creating additional physical space and increased work-flow efficiency. Digitalisation not only saves time, reduces the margin for human error, eliminates missing or misplaced files but also provides round-the-clock access to healthcare records. In the end, digitisation leads to overall improved healthcare. Digitisation can significantly help hospitals with regulatory compliance and the elimination of warehouses full of records, creating a substantial cost saving on operating expenses. Eradicating physical paper will free up valuable space

needed for patient care and will allow doctors to instantly view records and files directly from their computers. While digitisation can feel like a daunting task, having the right equipment and business partner makes the entire process a lot easier than anticipated and will have a tremendous impact on patient care and internal efficiencies. By working with industry experts who understand digital transformation challenges and who have successfully delivered both onsite projects within hospital premises and offsite projects, many of the unexpected or unplanned for scenarios experienced by other implementation teams are planned for and mitigated before they arise. OPEX uses next generation technology and state-of-the-art equipment on both the hardware and software front that can easily handle the most challenging of tasks. While some hospitals have completely transitioned to electronic medical records, many others are overwhelmed by the formidable task of digitising warehouses full of patient records. However, the sheer costs, risks and inefficiencies of using a paperbased system are not sustainable, and many government and public sector bodies are mandating the use of digital medical records. It was for those precise reasons that North Bristol Hospital NHS Trust (NBT), one of the largest hospitals in the UK with 1,300 outpatient and 200 inpatient attendances, decided to embark on the journey to digitisation. Over the past five years, successive government Ministers for Health have been driving a digital agenda, initially setting an NHS goal of going paperless by 2020. The current long-term plan encourages all NHS organisations, from large hospital trusts to small practices, to reduce and ultimately eliminate the trail of paper that follows every patient’s journey through the healthcare system. Before they embarked on their digitisation strategy, NBT stored a total of 400,000 medical records in two warehouses, as well as 800,000 additional records at off-site storage

facilities. The hospital received daily deliveries of approximately 850 paper files to prepare for upcoming appointments. On occasion, patient records were not delivered or found in time, which meant that the clinicians were unable to access historical information during the appointment. To address the excess costs and barriers to effective patient care, NBT introduced an Electronic Document Management System (EDMS), which would provide instant access to patient medical records for the hospital’s 6,000 clinicians, nursing and administrative staff. The NHS Business Services Authority (NHSBSA), an organisation that provides back-end support to the NHS, determined that OPEX Falcon scanners were the best available product in the market for the complex, challenging task at hand. The scale of the digitisation process was enormous and many of the legacy documents were in poor condition, ripped, torn or worn with age and in an unstructured format. Such difficult-to-scan documents could not quickly and easily be captured by a typical scanner however the OPEX Falcon scanning solution handled the entire process efficiently and with ease. Commenting on the digitisation, Vinny Butler, head of Scanning Services, NHS Business Authority, said: “We recognised that OPEX’s Falcon is the go-to product for scanning medical records and patient files, due to the significant labour savings, increased security and document integrity, combined with a powerful chain of custody associated with all records.” Digitisation will help to create a more efficient NHS, which in turn will improve care and outcomes for patients. OPEX currently deals directly with 30 NHS customers across the UK, and many more BPOs. Each captures and transforms a vast array of unstructured paper workflows into structured digital output for onward ingestion into back-end systems, with hundreds of OPEX’s machines already installed across the UK and Ireland, creating billions of images annually. OPEX offers live virtual or in person demonstrations of medical record scanning. To book a demo or chat more on how OPEX can help with your digitisation, please contact us below. L FURTHER INFORMATION www.digitiseyourdocuments.co.uk DMA_EMEA@opex.com

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Managing assets and tasking Asckey: Working to keep facilities management simple and helping the right people get the right information at the right time

Facilities managers have always faced challenges as they seek the most effective way of managing their assets. This includes keeping asset information up to date and easily accessible; particularly in terms of asset availability, maintenance status and acquisition/disposal. Many of these challenges have been overcome by replacing the traditional ‘Excel’ style spreadsheets with digital platforms which offer significantly greater functionality. Modern asset management software has, therefore, in many cases evolved into a wider facilities management system. This has resulted in increased efficiency and reliable

access to asset information that has become as important as the asset itself. Such integration means that asset information can be woven throughout an entire FM system. This enables organisations to seamlessly marry traditional asset management functions such as recording of and tracking an asset’s lifecycle with other key FM operations such as Tasking, PPM and Mobile functionality. Compliance Such integrated functionality has now enabled it to have a major impact in the increasingly sought-after area of Compliance

Management. A facilities management package can help organisations manage and mitigate risks associated with asset use. As part of our commitment to effective asset management, we are also partners of The Building Services Association (BESA). This partnership means we can provide a direct link between an asset, BESA’s standard/HTM range of maintenance schedules and the subsequent maintenance activity. From buildings to equipment, the purpose of such software is to help organisations manage their assets in a more cost-effective, efficient and informative way. By having such a system in place, organisations can prove compliance with regulatory, industry and local standards. It can also allow them to benchmark their performance, identify opportunities for development and growth. In addition, it can assist organisations who have or are considering embarking on achieving and managing ISO 55001 accreditation. What can Asckey offer? Asckey’s asset management functionality is part of our comprehensive CAFM system, fmfirst® Estates. The software is used by NHS Trusts up and down the country. We also recognise that some organisations may not require a full CAFM system but instead, need elements of one to help manage their facilities effectively. This is why, over the years, Asckey has begun converting some of the modules within their CAFM software into stand-alone cloud-based applications. This includes fmfirst® Survey and fmfirst® Tasking, with more to follow as part of our fmfirst® product suite. Each application is developed with the option of integrating, where relevant, with others from the suite or even third-party applications. As a result, organisations can pick and mix the applications they need to build their own facilities management toolkit. At Asckey, we aim to help keep facilities management simple; helping the right people get the right information at the right time. To discover more about our applications, then please get in touch. L FURTHER INFORMATION www.asckey.com

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Technology

Why it’s time to change the focus on digital A step change in the way we approach digital implementation and transformation is needed if it is to protect our health and care service from irretrievable decline, writes Lord Victor Adebowale We all learnt pretty quickly during the Shift the focus from acute care pandemic that digital solutions can be used to Take brain injury, including stroke, as a case provide a quick resolution to health and care in point. Digital platforms in this pathway delivery. Within weeks we saw technology already have a proven track record on the platforms installed to help professionals acute end. This is not surprising as this is and clinicians to respond in a proactive and where the investment is - and always has effective way. been. There are excellent examples of high However, what Covid has also demonstrated, quality, clinical grade digital platforms is that the introduction of rapid technology supporting a virtual health and care system, at provides only temporary relief to the highthe acute phase of this pathway. pressure health systems are facing, and, to Over the last ten years, we have seen some sustain this momentum and provide long-term real benefits in the East of England using gain, we need a different approach to digital digital solutions to deliver ischemic stroke implementation. The ‘stop-gap’ solutions have treatment, therefore improving outcomes. led to many conversations about whether Lives have been saved by digital can protect health and care from having access to accurate its gradual decline. diagnosis and The On its own, I do not believe it treatment at the introdu can. In order to be the redeemer, point of need and it needs the collaboration of through smart rapid te ction of chnolog all its stakeholders - clinicians, ambulances provide y commissioners, innovators to speed-up tempor s only and patients. It also needs to acute care. a deliver interventions in each But we really the hig ry relief to h part of the patient journey, need to shift p r e s health providing opportunities for the focus and systemssure digital care, from one end to the concentrate on a r e facing other; it needs a sustainable and designing and holistic solution – and one which implementing digital puts people first. interventions in other

segments of the pathway. There is a massive digital opportunity to optimise outcomes for people – especially in recovery - and provide a blueprint for other interventions to follow. Accelerate the recovery plan Sadly, when we refer to the basic conversations we have had, it’s very clear that treatment and recovery programmes are pretty inconsistent. This is apparent across the world and not just in the UK. A report from the charity SameYou, captures and shares hundreds of real life stories and provides insight into people’s experiences of recovery and rehabilitation following an acquired brain injury or stroke. Their stories have shown that outcomes are much more positive for those with multiple interventions, including remote monitoring, access to therapies, centralised services in specialist units and peer-to-peer support. We really should be showcasing those stories, to enhance the digital offer and accelerate the introduction of virtual rehabilitation platforms, which in turn will reduce the need for longer-term care. The savings could be E

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Closing the virtual circle Integrated health and care delivery cuts across the whole system – bringing in both formal and informal care.

By taking the lessons learned from the pandemic to speed up digital collaboration and to organisations to commission technology as part of a complete operating model, not as an addition to an existing model, we can truly make a difference Our communities, including digital ones, can play a key role in lifestyle changes and choices. Prevention and recovery is not even a technology challenge, it is a societal one. Race, geography and politics has a huge effect on the possibility of suffering from long term conditions and access to treatment, however, we need to capture the data and information throughout the pathway in order to change that. At the moment the data sets are not being passed on and do not discern between people from one end of the pathway to the other, therefore a patient is not seen as the same person, rather as a different episode. This lack of integration often is the missing link to complete pathway design and needs to be addressed. We should also be encouraging innovative strategies and technologies to detect and address physical and socio-economic risk factors for stroke, and the impact of health inequalities when managing high risk groups. Only then can we identify what interventions are high cost and high impact. So where to from here? Firstly, we need a digital footprint to follow the patient, and focus on the whole person. If we have this, we will then see the shift and impacts on all other pathways.

Technology

 substantial, but more importantly, it could have a profound impact on people’s lives. Yet despite the evidence and efforts, we still seem to fall short. With the initiation of 21 Integrated Stroke Delivery Networks (ISDN) in the UK, there is hope that there will be some co-ordination of innovations within and between the Integrated Care systems (ICS), to facilitate a sustainable cohesive response. However, there is no evidence that this is starting to take shape anytime soon. In fact, the continued focus on Acute Stroke Units seems to reiterate the treadmill of investment in crisis management, rather than prevention and rehabilitation. It was also hoped that the post-Covid learnings would re-ignite the ambitions of the NHS Long Term Plan, to improve posthospital rehabilitation models - but again this is happening at a slow pace. As innovators and influencers, we need to accelerate this plan. By supporting people at home and providing earlier intervention we can help prevent deterioration, particularly as people are faced with long waits for care. This in turn will reduce readmissions and exacerbation, but also reduces unnecessary low value follow-ups. The benefits are therefore substantial; with a focus on health promotion and wellbeing and lifestyle optimisation, it will reduce demand on primary and community care as well as overall healthcare utilisation. And, what’s more, the information captured can feed back into the overall pathway design in order change clinical practice and inform systems for future population health management.

By optimising the platforms we have and focusing on rapid treatment and effective recovery, we can build the evidence on prevention and contribute to the debate. In addition, the advent of digitally enabled rehabilitation with patient centred care at its heart, can reduce the costs of rehabilitation hugely, and thus enable the NHS and care system to properly fund this element of the pathway. By taking the lessons learned from the pandemic to speed up digital collaboration and to organisations to commission technology as part of a complete operating model, not as an addition to an existing model, we can truly make a difference. And it needs to be more than just in acute care, and with more than just clinicians. It is time to shift focus and invest in people; helping them to be well and stay well. Digital can help - it can be lifesaving and lifechanging in so many ways - but it can’t do it alone. L

Lord Victor Adebowale is a member of the House of Lords, chair of NHS Confederation and co-founder and chairman of Visionable. FURTHER INFORMATION www.visionable.com

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Technology

Seizing the integration opportunity PA healthcare expert Gareth Fitzgerald discusses the ways in which we can seize the opportunities of integrated care systems and how new approaches of lasting value can be created The new Integrated Care Systems (ICS) legislation is part of the first Health and Care Bill since the controversial 2012 Lansley reforms. It undoes the competitive principles from 2012, and the focus is instead on collaboration within healthcare and between health and local government to improve population health and reduce health inequalities. Given the additional pressures placed on the NHS during the pandemic, the new legislation has come at what appears to be the worst time - but could also potentially be the best time. The NHS and local government are staring down the barrel of an exceptionally challenging winter, and services are already stretched across acute, primary and community services as well as social services. The pandemic continues to put a strain on A&E and wards, and hospitals

leadership, embedding data sharing need to address growing waiting lists solutions, and using insight to to reduce clinical harm. The NHS address the root causes of is on a war footing. There patient demand. is a risk that integration W hilst it i and population health s not a le Bringing together will be side-lined with g require islative leaders operational pressures across sectors running so high. identify ment, i Whilst it is not a However, there n g and suppor legislative requirement, is an alternative t i n based l g Place identifying and path for ICSs where e supporting Place based rapid integration and critical aders is a action f leaders is a critical population health or action for ICSs. These approaches are put to ICSs local, cross-sector leaders work to address these can proactively remove pressures directly. To make barriers that their teams face to this alternative vision a reality doing the right thing. We have all met and seize the integration opportunity, the sorts of fearless local leaders needed. there are several key things that need to They think patient and population first, E be done in bringing together cross-sector

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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

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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

Technology

 followed by team, then system, then organisation. To deliver the change, they will need support to create fully integrated operational approaches and daily management routines as the way of working heading into Winter. This will help bring different insights and resources together from across places into more joined up plans and actions. Integrated resilience hubs are increasing in prevalence. Often organised at a Place level, but also at ICS and regional levels, they are bringing together teams from across sectors and organisations to look at data from the back door, front door, primary care and the wider system and create whole system solutions. Embedding data coordination and digital mindset We are also seeing rapid developments in data driven understanding of populations, underpinned by linked data. Where once few systems were linking data across acute and primary care, we are now seeing a greater number achieving this and advancing towards linking wider data sets from local government. The sharing of data across acute, primary, community and social care generates insight which helps target support to specific cohorts of patients and citizens. This data sharing may be expedited through emergency Covid-19 measures where necessary. By supporting GPs, community services, hospitals, and social care to work together, sharing daily data and assessing patient needs in multi-disciplinary teams, we can avoid more admissions and speed up discharge. This frees up precious beds and

We are seeing an increase in multidisciplinary review of the waiting list, to understand the holistic needs of those waiting, sometimes on multiple waiting lists, facing wider challenges such as anxiety and depression resources to deliver waiting list recovery. ICSs can accelerate this through investment in proven digital infrastructure solutions. Using insights to delve into root causes We are seeing an increase in multidisciplinary review of the waiting list, to understand the holistic needs of those waiting, sometimes on multiple waiting lists, facing wider challenges such as anxiety and depression. Linked data can be used as a part of wider assessment to understand the holistic needs of patients on one or more waiting lists, who may otherwise come to harm and may require multiple emergency admissions. This is especially critical to support early stage interventions, and for systems to operate in a pre-emptive capacity, to prevent clinical harm Equally, in seeking to manage GPs’ frequent flyers more proactively as a system, we can reduce the extreme pressures that primary care is facing. The voluntary, community and social enterprise (VCSE) sector will play a key role, and Place and ICS leaders will need to actively support and engage these

local groups to achieve better outcomes for individuals with multiple support needs. This is an alternative vision, and not just an armchair fantasy. This is integrated care and population health management at the coalface. Real, data driven decisionmaking and service adaptation at Place and Neighbourhood level, with clinical and care leaders at the heart of the process and properly supported to manage their population differently. ICSs have a lot to do to achieve the requirements of the legislation between now and April. However, for those systems that can align addressing the requirements of the legislation and addressing the immediate operational challenges that face us, new approaches of lasting value can be created. This is what we mean by seizing the integration opportunity. L

Gareth Fitzgerald is a healthcare expert at PA Consulting. FURTHER INFORMATION www.paconsulting.com/ industries/healthcare

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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Legrand: We are stronger together Legrand launches Legrand Care, its new global brand specialising in the assisted living, health, and social care sectors Legrand, global specialists in electrical and digital infrastructures launches its new consolidated brand for the Assisted Living and healthcare market called Legrand Care. This new powerful brand allows the company to be stronger in the international market of connected care, taking advantage of synergies and improving the value of products and services for the care sector. Legrand Care was born from the integration of the brands that make up the Assisted Living and Healthcare (AL&HC) business unit of Legrand: Intervox, Tynetec, Aid Call, Jontek and Neat. Chris Dodd, CEO of Legrand Care, states: “The coming together of five highly regarded, customer centric, long established assisted living and healthcare brands into Legrand Care is a significant milestone in our journey.” Likewise, Arturo Pérez Kramer, who has assumed his new role as Deputy CEO of Legrand Care formerly CEO of Neat, explains that ‘this relevant union of forces responds to the objective that Legrand established in 2020: To improve people’s lives’. This great challenge ‘is the essence of our commitment and our consolidated strategy in the new brand, Legrand Care’ Pérez adds. Caroline Mouminoux, Sales Director of Legrand Care and Silver Economy manager in France, formerly Silver Economy representative for Legrand France and Director of Intervox, declares that they are

‘very proud of this announcement’ and that, with the launch of this new brand, ‘Legrand confirms once again that assisted living and healthcare is a strategic market for the Legrand group, and we see this as a great opportunity to address some of the social and economic challenges this sector faces’. This alliance reinforces Legrand’s strong commitment to ‘the connected care market and the silver economy and opens the doors to accelerate developments and innovation’, Íñigo Ruiz Cossío, Director of Product and Marketing of Legrand Care says. Thanks to the creation of Legrand Care, more than 40 years of knowledge and experience of the members of this division are put into joint value ‘under a common strategic vision, with a coherent image in the market, the five brands will cease to operate as segmented entities and will concentrate their strengths to position Legrand as the leader in connected care worldwide’, Ruiz highlights. In this sense, Mouminoux affirms: “This new Legrand Care division is excellent news for all our customers, partners and stakeholders in the health and social care sector and will give us even more capacity for innovation, to anticipate technological challenges and will allow us to confirm that we are a key player in this market.” All the members of this division feel very motivated by this alliance and share the deep conviction that our shared resources,

solutions, interests, and vocation will make them stronger and will allow them to work together in the development of ‘proactive and preventative agendas, always placing people at the heart of our services. We will be more innovative because we will concentrate our efforts into achieving our shared objectives’, Ruiz remarks. Dodd assures that all members of this new brand firmly believe that ‘this strategic union will facilitate the fulfilment of the mission and vision of this entity’. Mission: A tireless commitment to truly understand customer needs, enabling innovative digitally connected care solutions to be delivered. To be the technological partner of clients, offering comprehensive and fully managed solutions that allow them to efficiently deploy improved care services. Vision: To empower and help people live the healthiest and most fulfilling lives they want in the place of their choice. Dodd concludes: “Together we will be better able to channel our combined resources into new product development and will continue to remain nimble and be proactive to the changing needs of our customers with the strength, resources and quality controls of Legrand, the global specialist in electrical and digital infrastructures in support.” L Legrand is the global specialist in electrical and digital infrastructures, offering high-valueadded products and solutions that improve lives by transforming the spaces where people live, work, and meet. Operating worldwide, Legrand works to enhance electrical and digital infrastructures, embracing the shift to digital technologies while contributing to reduced carbon footprints. Legrand solutions are used in residential and nonresidential buildings, care facilities, as well as in datacentres, industrial spaces, and infrastructure. Its new brand Legrand Care specialises in the innovative development of connected solutions for the health and social care sector. The Group’s technological expertise, its leading positions, the scope of its offering, its international presence and the power of its brands combine to make Legrand a global leader. With a presence in close to 90 countries and a workforce of over 36,700 Legrand generated total sales of €6.1 billion in 2020. FURTHER INFORMATION www.legrandcare.com

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Barcoding

Right patient – first time, every time Patient information can be seamlessly shared between systems and organisations to enable interoperability via GS1 standards, writes Glen Hodgson, head of healthcare at GS1 UK On 25 November 2021, The Healthcare Safety Investigation Branch (HSIB) published a safety report into the impact of incorrect patient identification. Following an urgent care transfer from the ambulance trust to the hospital trust, the report highlights shortcomings in the process used to accurately verify a patient’s details – not just at the point of transfer, but at various touchpoints throughout the patient’s admission. It was at the initial point of contact when registering the patient details that the error occurred. Ambulance call handlers had captured the patient name and date of birth for verification however, a different patient record was picked up. The patient encounter was registered under the wrong NHS number. The record was in fact for a patient with a similar name and an identical date of birth. It was only after seven days that the error was realised and rectified.

Doing so, provides a greater level of Accurate positive patient accuracy, but the NHS number is only identification sufficient in isolation for patients Unfortunately, though likely in England and Wales which rare, this case is not It is clea use the NHS number as the isolated. Using two r to see t primary identifier. As the data-points to validate he valu HSIB report states: “The a patient’s identity G e S1 stan NHS number is a unique is simply not dards provide identifier for people sufficient enough f living in England (and to guarantee an identifi or patient cation a Wales). There is a accurate positive u ltimate n chance that a patient patient ID. This is ly patie d nt may be incorrectly where emphasis safety, identified when the NHS needs to be placed interna in an number is not used.” on a three-point tional However, beyond these verification process. arena boundaries, a wider challenge As a minimum, three is posed where the NHS number data-points should be crossalone is used as the primary means referenced at each transfer or of identification. intervention to validate identity, which Though unique at the local level, the should then be matched appropriately to the NHS number is not globally unique as the E NHS number. Issue 21.6 | HEALTH BUSINESS MAGAZINE

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The top three challenges of medicines management Robert Tysall-Blay, CEO of Careflow Medicines Management, and Markus Bolton, joint CEO of System C and Graphnet Care Alliance, discuss the world of medicines management in the UK’s healthcare system

System C Healthcare recently announced that it had acquired medicines management specialist WellSky International from its parent company WellSky Corporation. WellSky International is best known in the UK for clinical software in Pharmacy and Electronic Prescribing and Medicines Administration (EPMA). WellSky’s EPMA is the most widely used EPMA solution used by a large number of NHS trusts and health boards across hospitals in Scotland and England, whilst in Wales WellSky Pharmacy is being rolled out as a countrywide solution. This acquisition was hailed as a great strategic step, will broaden System C’s product portfolio and is a highly strategic addition to the company’s integrated cloud EPR suite. System C has made a commitment to invest significantly in product innovation, maintain interoperability with all hospital software systems and third-party suppliers. Also announced was the plan for a close integration of WellSky International’s products into System C’s CareFlow electronic patient record software, which includes clinical collaboration, care planning, electronic observations and patient flow. WellSky International was renamed CareFlow Medicines Management (CMM). Part of the System C & Graphnet Care Alliance, Graphnet’s CareCentric software combines a shared record with communitywide assessment, workflow, care planning, and specialist apps for long term conditions. Robert Tysall-Blay, CEO of CareFlow Medicines Management, and Markus Bolton, joint CEO of System C and Graphnet Care Alliance, have shared their views on the world of medicines management in the UK’s healthcare system. They have put forward for discussion what they believe are the top three challenges of Medicines Management in Healthcare environments: incomplete patient medication histories; care transition breakdowns; and access to actionable data – ability to report on medication use/ outcomes/population level data flow.

Incomplete patient medication histories Robert Tysall-Blay: “When a patient arrives in hospital injured, or unwell, clinicians often lack basic information about the patient’s medication histories and care can be compromised as a result. The creation of a patient record that travels with them wherever they go is obviously the nirvana, but medicines reconciliation at admission and discharge can play an important part in ensuring the patient’s care is optimised. “What a good medication management system like CMM’s Electronic Prescribing and Medicines Management (EPMA) offers is the ability when moving patients within the hospital from high dependency units to general or specialist wards to ensure the prescription record and care history moves seamlessly with them throughout the hospital.” Markus Bolton: “It is crucial to support busy clinicians with a comprehensive view of a patient in their care. CareFlow’s full medicines management capability provides an essential piece of the jigsaw in many care settings including theatres, ICU and wards. The ability for clinicians to access detailed information regardless of setting supports sound clinical decisions, as well as the obvious benefit of first-class patient care.” Care transition breakdowns Markus Bolton: “We all have lived experience ourselves or of a family member’s care journey being complex, and a mixture of GP to acute hospitals, mental health organisations, community hospitals and respite or care home experience. Healthcare systems and providers are fragmented, partly due to the evolution of the care systems themselves, technological and regulatory changes over the years have also played a part. “The move to regional Integrated Care Systems (ICS) is driving care towards more interoperable systems and whole of region solutions. One of the main reasons behind the acquisition of CMM by System C was to capture the opportunity to extend the benefits of medicines management outside traditional hospital settings and into the community and care homes. By pulling in data from all pharmacy and prescribing systems used in an ICS and providing prescribing and administration functionality, it means that workers in care homes, which

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may not have existing electronic solutions available to them, are now able to access this crucial information. We are very excited to be able to offer seamless transition between a wider variety of care settings.” Rob Blay: “The move towards regionalisation is very interesting indeed, Wales has just implemented a whole of Wales CMM Pharmacy solution across all its Health Boards. North of Scotland is also combining seven Health Boards on a single CMM instance of Pharmacy and EPMA. We are really seeing a lot of interest in the provision of regional solutions.” Access to actionable data Rob Blay: “Regional systems in all health and care settings allows an ICS to measure the effectiveness of medicines being used in the ICS. It allows the ICS to see where medicines are not being taken correctly or at all allowing targeted approaches to reducing wastage of medicines which is estimated to be at least £300 million a year. Additionally, patient focussed, comprehensive, actionable data, will facilitate better medicines optimisation, and improve outcomes.” Markus Bolton: “Whilst efficient resupply chains for medicines prevent over ordering of medicines and allows the ICS to realise further savings by consolidating the medicines procurement pathways across multiple Trusts. With CareFlow Medicines Management comprehensive financial auditing tools the wider health economy is able to release further savings to invest in care. L FURTHER INFORMATION www.careflowmm.com

(Above Right) Robert Tysall-Blay, CEO, Careflow Medicines Management, (Above Left) Markus Bolton, Joint CEO, System C and Graphnet Care Alliance

Globally unique identification Built on a system of globally unique numbers, GS1 standards allow for the unambiguous identification of every person, every product, and every place throughout the patient pathway. And for NHS trusts in England, GS1 standards are available for use at no direct cost to the trust as part of an agreement established in 2019, between GS1 UK and NHS Digital. To identify patients and staff, the GS1 Global Service Relation Number (GSRN) is used. The GSRN for a patient is comprised of an individually allocated GS1 Company Prefix which sits alongside the patient’s NHS number as well as a check digit, to make it truly unique. As defined by the NHS Digital information standard DCB1077 automatic identification and data capture (AIDC) for patient identification, the GSRN is then encoded into a GS1 DataMatrix, a type of 2D barcode, alongside NHS approved patient identifiers such as the patient’s full name and date of birth. Scanning this barcode at the point of care, allows this information to be captured accurately, and in real time, at each patient interaction to ensure positive patient identification and prevent errors. Any information can then be captured and logged directly into the electronic patient record. Enabling interoperability The nature of GS1 standards and the composition of GS1 identification keys such as the GSRN, enables patient information to be captured in a standardised format which is both system and device agnostic. As a result, patient information can be seamlessly shared between systems and organisations to enable interoperability. Data can be captured once at the point of care and made available for multiple stakeholders when needed – a one to many approach which improves patient safety, saves clinical time and prevents delays to patient care. Perhaps the best example of this significance can be noted in The Independent Medicines and Medical Device Safety Review (IMMDS Review, or The Cumberlege Review). In response to what has been observed as a series of failings surrounding traceability in healthcare, Baroness Cumberlege proposed the following recommendation: “A central patient-identifiable database should be created by collecting key details of the implantation of all devices at the time of the operation. This can then be linked to specifically created registers to research and audit the outcomes both in terms of the device safety and patient reported outcomes measures.”

Designed to act as a patient-identifiable database, MDIS intends to capture procedural-related data gathered from healthcare provider organisations across the UK To meet this requirement, NHS Digital are in the process of developing a centralised Medical Device Information System (MDIS). Designed to act as a patient-identifiable database, MDIS intends to capture proceduralrelated data gathered from healthcare provider organisations across the UK. The success of such a database will rely heavily on the capacity to precisely distinguish between patients in order to prevent the risk of identification errors arising. Failure to do so, will result in not just an inaccurate dataset, but also one that would pose a patient safety risk – undoing the very objective it has been established to avoid. The bigger picture Beyond the boundaries of the UK’s various national health systems, it is clear to see the value GS1 standards provide for patient identification and ultimately patient safety, in an international arena. Take for example the proposition for the International Patient Summary (IPS). The IPS is defined as ‘a minimal and non-exhaustive Patient Summary, specialty-agnostic, condition-independent, but readily usable by all clinicians for the unscheduled (crossborder) care of a patient’. The idea behind the IPS is to be able to present clinicians with a basic patient summary of key clinical information in the event of urgent cross-border care being required. With the progress made with

Barcoding

 same number may be used to identify a patient in another neighbouring UK country. Once information is exchanged as part of a shared care record, or national registry, this is no longer guaranteed to be distinctive and records may get mismatched. GS1 standards serve to mitigate this risk.

open standards and interoperability in recent years, it would not be unreasonable to suggest that this would be a very real possibility in the near future. The importance of having globally unique standards in place would be a key driver to make this possible. Going full circle What can, in this case, be acknowledged as a locally isolated incident, incorrect patient identification can in fact pose a larger challenge for healthcare on both the national and international stage. To fully enable transparency and interoperability of patient data, we need to ensure the widespread adoption of unambiguous, open data standards. L

GS1 standards provide the means to make this a reality – driving traceability in a clinical setting. To find out more about GS1 standards in healthcare visit: gs1uk.org/industries/ healthcare or to read more about GS1 standards in action visit: healthcare.gs1uk.org. You can also contact the GS1 UK healthcare team directly on: healthcare@gs1uk.org. FURTHER INFORMATION healthcare.gs1uk.org

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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Fire safety

Sprinklers ensure resilience for businesses The inclusion of a sprinkler system can prevent major financial and equipment losses for UK businesses. The Business Sprinkler Alliance explain how to mitigate against the risk of fire damage, both immediate and long term, and how sprinklers can enhance business continuity and responsibility From healthcare facilities to hotels, offices The loss of £20 million of stock was felt by to industrial buildings, the impact of a major retailers who rely on their more than 4,000 fire can be devastating and many businesses lines of garden products. There were disruption never recover. To reduce the risk to life and smoke warnings issued following the and the degree of damage in a fire event, fire while fire water run-off needed to be automatic sprinkler systems are proven time monitored by the environment agency. There and time again to be both effective and was the environmental impact of disposing efficient in a wide range of fire scenarios of the damaged property, where the costs, and building types, affording greater levels resources and materials required to rebuild it of fire protection to people, property and the would be in excess of £30 million, significantly environment. This is why they are chosen to more than the cost to install sprinklers which protect buildings and businesses, ensuring would have been in the region of £850,000 to continuity and productivity. In the event of £1.2 million. Whilst thankfully there a fire, many businesses with sprinkler was no loss of life, the lasting systems find they are back up-andeffect is undeniable. running in a matter of hours. Th In the early hours of 12 Financial loss inclusio e March 2018, a devastating fire Sadly, fires such as sprinkle n of a destroyed a recently-opened this damage and unsprinklered warehouse in destroy businesses can pre r system vent m Daventry. Despite more than on a regular ajor financia 50 firefighters tackling the basis. Businesses blaze, the Gardman garden that do recover equipml and en supplies distribution centre was only do so at losses t completely destroyed, impacting great cost to their not only the business and its clients, suppliers employees, but also retailers, the local and their reputation. economy and the environment. Fire remains the leading

cause of commercial property loss with the Association of British Insurers predicting that UK businesses could stand to lose £10 billion between 2010 and 2020 as a result of fire. However, businesses should take note of findings from the Chartered Institute of Loss Adjusters which found that 79 per cent of businesses under insure their property by 20 per cent or more. At the same time, they under estimate business interruption after a fire by 50 per cent. Home Office figures show that there have been 22,800 fires in industrial and commercial buildings (ICBs) in the past three years. But the costs of fires in industrial and commercial buildings go far beyond the costs and impacts on individual businesses and insured costs. Fires are the cause of significant economic, environmental and community costs which are ultimately borne by the taxpayer. Out of business In the worst case scenario, the effect of a fire is the closure of a business. This is not uncommon. It can prove impossible for small businesses and some medium sized ones to recover from the effect of fire; and evidence shows larger businesses choose to consolidate operations in other sites following the loss of a site to fire. Both productivity and jobs are lost in these cases. In either case, the resulting fire has an impact on a number of businesses within the supply chain. Companies supplying the fire damaged business will lose business temporarily or even permanently; businesses which depend upon products or services from the fire damaged business have to find other means of supply; businesses surrounding the fire-affected business will often have to cease trading for the duration of the fire and sometimes even longer. Nearly all fires in ICBs cause transport disruption, while many also require residential evacuations and school closures. E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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Fire safety

 The cost to the environment All fires in ICBs create environmental impacts and costs including carbon emissions. A study by Bureau Veritas has calculated that up to 350,000 tonnes of CO2 a year are emitted because of fires in ICBs. Furthermore, the same study has calculated that more than nine billion litres of water are needlessly used by the UK fire service each year to extinguish fires in ICBs (equivalent to 15 million UK households’ daily water use). This vast amount of water used each year to put out fires in ICBs could be avoided if the buildings were fitted with sprinkler systems. While the impact is incalculable, the smoke and emissions generated from a fire are pollutants which can lower the quality of the air that we breathe. Fire-water run-off can, in certain situations when buildings contain pollutants, contaminate watercourses which is costly to treat. Furthermore, there is significant unnecessary waste and use of resources to rebuild destroyed property. The sensible approach As a small, family-run food manufacturing company that prides itself on continuity of supply and guaranteeing deliveries to its customers, including national supermarkets, Birmingham-based Cleone Foods must ensure the company manages risk by minimising potential threats and disruption to its business. With fire continuing to be one of the biggest threats to businesses, Cleone Foods have recognised the resilience benefits of fire sprinklers, and fitted them to their premises. The single-site manufacturing and distribution facility, close to Birmingham’s jewellery quarter, produces Jamaican patties, a traditional Caribbean snack derived from a Cornish Pasty. Since the company was formed in 1988, expansion has been rapid and it has achieved an excellent reputation, enabling it to secure significant contracts supplying leading national food retailers. With 70 staff running two shifts, there are fixed

Automatic sprinkler systems offer the business owner reliable, long-lived and proven technology which can reduce the risk to life and degree of damage caused in a fire event financial penalties in place for the company if it fails to satisfy its orders, which in the event of prolonged disruption, would impact profitability and worse still, could affect the survival of the business. Simon Noble, project manager at Cleone Foods Ltd, said: “We are a small food company supplying major supermarket chains and they are very big on maintaining continuity of supply. We have to keep them happy and cannot afford to have any disruption to our day-to-day operations. As part of our continuity strategy, we have reviewed all of our internal and external processes and one of the areas that we identified that could dramatically affect our business is that of a fire at our premises. To address this risk and effectively protect our business, thereby safeguarding jobs, we have installed sprinklers throughout the facility.” To ensure continuity and productivity, a sprinkler system has been installed throughout the 1,000m2 site. Contrary to the myths that exist about sprinklers, the site team understand well that in the event of fire only the sprinkler heads that are directly above the fire will be triggered. The water from the sprinkler heads will have the effect of containing or even extinguishing the fire without causing damage to non-affected areas. The alarm and sprinkler system are tested weekly, and servicing is completed once a year by a specialist contractor. The weekly test involves checking the water pressures, carrying out an alarm test and checking the interlocks of the fire alarm system. Further fire protection

measures at the site include a full multi-zone fire alarm with remote monitoring, which will automatically call the local fire brigade to attend in the case of an activation. The inclusion of a sprinkler system can prevent major financial and equipment losses, containing what could be a potential major disaster and ensuring it is only a minor inconvenience. Proven time and again with consistent reliability, it is a small price to pay to prevent a business’s hard earned success from going up in flames. Noble adds: “As a business we have to be prepared. Sprinklers form part of our resilience strategy, the success of which is highlighted by impressive growth figures and minimal disruption to the business since its implementation in 2009. It’s about being a responsible business and the inclusion of sprinklers is part of our commitment to our customers, our staff and our local community.” Automatic sprinkler systems offer the business owner reliable, long-lived and proven technology which can reduce the risk to life and degree of damage caused in a fire event. These systems make buildings and businesses resilient to fire incidents because they control or extinguish a fire before the fire and rescue service arrive. The impacted business can be back up-andrunning within hours, avoiding the economic and social costs. L FURTHER INFORMATION www.business-sprinkler-alliance.org

Issue 21.6 | HEALTH BUSINESS MAGAZINE

What makes Enable2 so cost-effective for healthcare professionals? Our technology and our drive

We want the healthcare you provide to have maximum impact, improving the lives, health and wellbeing of every patient you see, including those whose first language is not English. We know interpreting budgets are tight. Our innovative language support uses advanced booking technology, which means we can examine data to find money-saving ways to deliver your interpreting. Did you know telephone interpreting is highly cost-effective, and almost instant? We support you to combine interpreting sessions, providing interpreting for more than one patient within one appointment.

We also help you get a handle on bookings, ending late cancellations that drain your budget. We work with you and your staff to save money. We work with you and your team to control your interpreting bookings. We train your staff and put protocols in place. We don’t charge you for this, it’s simply part of our account management service. No more late cancellations; no more unnecessary face-to-face interpreting; and no ad-hoc appointments ‘just in case’. The proof is in the savings you make. With proactive account management, education of staff on charges, how interpreters work, and the benefits of telephone and video interpreting, we have delivered ongoing, substantial savings for many organisations. We helped one NHS provider save over £90,000 a year; we reduced a local authority’s interpreter booking cancellations by over 50 per cent; and we reduce many health service providers annual costs by half. Language transforms lives. A commercial approach delivers it. We believe no one should face language barriers when it

comes to accessing services. It’s why we have developed our commercial approach to be the budget-saving language lifeline it is today. Our social return builds on equality of opportunities. Our support to people whose first language is not English doesn’t stop at interpreting. Every year, we dedicate support to those social return projects within our communities to help non-English speaking people and families access vital networks, activities and help. From farm trips for asylum seeking families to confidence-boosting, therapeutic choir sessions, we are always looking for ways to help increase the quality of life for the thousands of people who struggle to access the support that they need. We want everyone whose first language is not English to enjoy the same health, happiness and wellbeing as everyone else. L FURTHER INFORMATION Tel: 0333 220 1717 bookings@enable2.com https://portal.enable2.com/portal/

Are language barriers hampering the healthcare you provide? Are you constrained by tight interpreting budgets? NHS spin-out social enterprise Enable2’s efficient, cost-effective patient and service user interpreting for health service professionals is available now through the NHS Shared Business Service framework and the NOECPC framework.

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Translations

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

appropriate independent and not-for-profit register and regulator in the UK is NRPSI. Relevant qualifications Appropriately qualified interpreters should be sourced and provided for use by the NHS where life and death decisions are often made given feedback from patients to doctors, nurses and allied health practitioners. Relevant qualifications confer status as a recognised, registered and regulated professional practitioner; acceptable public service interpreting qualifications are the most robust and reliable measure of interpreter quality and all interpreters working in the health sector need to be qualified to a minimum level where it is recognised the interpreter is safe to practice and will not potentially cause untold harm through miss-interpreting. Those newly qualified without experience ought to be mentored by experienced public service interpreters to embed the code of conduct and aid in navigating the issues, problems and challenges of public service interpreting in the NHS. As NRPSI states, 400 hours of experience ought to be required for those working in organisations where the most serious potential consequences might occur, such as the NHS where life and death decisions are a daily occurrence. NHS practitioners should not accept pseudo-interpreters delivered by procurement management whose only concern is controlling costs. But when this advice is not followed and untrained, unqualified ersatz-interpreting is delivered by bilinguals then it is no surprise why registered and regulated interpreters do not wish to work for the NHS for low engagement fees. E Issue 21.6 | HEALTH BUSINESS MAGAZINE

Part of your team…

At Topp Language Solutions we don’t just provide high quality, fully registered and insured interpreters. We provide enhanced services that mean that your deaf patients or community members can gain that all important equal access to services. Our values of Integrity, Mutual Respect and Customer Service Excellence mean that we work hard to let all parties know that we value their skills and needs. We encourage your service users to contact us directly and can provide all important support and reassurance to let them know that their communication needs are supported. Most of all we

work collaboratively with our clients, interpreter network and service users to make sure that we place them at the centre of what we do. We work ‘day in day out’ with NHS trusts, Public authorities, CCG’s, Educational Institutes and more. Our commitment to Deaf individuals means that we are a trusted provider, developing broader services that truly empower and assist. As far as we are concerned, we are part of your team. In some instances – we really are a part of your team, working alongside sensory support services to ensure that your deaf community have a

single point of contact, with a dedicated contact line. We offer communication channels that are accessible and are available across the working week, across a time frame that mirrors the availability of services for the hearing. It sounds expensive, but it is an economic model, protecting budgets and chargeable on a solved ‘case by case’ basis. Our enhanced services empower and engage service users, through a range of offers including BSL support services and fully produced BSL video productions, demonstrating your commitment to equality and inclusivity. We can produce BSL QR Coded videos, improving public access to events and exhibitions, deaf awareness training to support you and your colleagues in understanding the practical issues with real-world tips and skills for supporting deaf colleagues, customers and patients. We would love to talk to you about what we can do for you and more specifically for your deaf service users. L FURTHER INFORMATION www.topplanguagesolutions.co.uk 0113 512 0350

Deaf Patient Support and Communication Services We have long-standing partnerships within the NHS and a focus on providing the right service in the right place and at the right time. Our services include: • British Sign Language Interpreters • Face-to-Face and Video • Lip-Speakers • Note-Takers

• Deaf Awareness Training • Communications Reviews • Buildings Audits • BSL Signed Video Production

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Given interpreters provide a key service for patients, carers and clinicians, the NHS has to be committed to providing high quality, equitable, effective interpreting so healthcare services are responsive to all patients’ needs  As an NHS senior manager, procurement manager or a medical practitioner, do not allow unqualified and inexperienced interpreters not only hinder but possibly harm you, your reputation and the quality of your work with patients. Do not accept: bilinguals with no language or interpreting qualifications and no public service interpreting (PSI) experience; bilinguals with no language or interpreting qualifications but with PSI experience; linguists with language A level (or lower grade) but no interpreting qualifications; linguists with language A level (or lower grade) and with interpreting qualifications; linguists with language degree level (or above) but no interpreting qualifications; linguists with language degree level (or above) with interpreting qualifications; interpreters with level 3 or 4 community level interpreting qualifications without PSI experience; or interpreters with level 3 or 4 community level interpreting qualifications with PSI experience. Senior NHS management, procurement management and practitioners in the NHS should demand as a minimum: interpreters with 400 hours or more PSI experience and passed some of the required level 6 modules; interpreters with level 6 DPI or DPSI Law or DPSI Health or DPSI Local Gov or equivalent degree level but with less than 400 hours experience but are at least trained to do the job; and interpreters with level 6 DPI or DPSI Law or DPSI Health or DPSI Local Gov or equivalent degree level with more than 400 hours experience but not ascribing to the Interpreter Code of Conduct. Ideally you ought to be engaging those interpreters who are registered, regulated, have the requisite clearances and have signed up to the Code of Conduct of the National Register: Registered and Regulated Public

Service Interpreters (RPSIs) who have level 6 qualifications, all the required experience, approved clearances and ascribe to the Code of Conduct; a NRPSI Registrant. The National Register was set up in 1994 following a Royal Commission which recommended a register of the most highly qualified interpreters be established to protect the public from the consequences of poor and inappropriate interpreting in the public sector. This remains its core purpose; when an interpreter is working in a public service setting, usually in a potentially life-changing or life-threatening interview situation, they are the only person who understands what both the other parties are saying. The potential for abuse of the public’s trust is clear if the professional ability and integrity of the interpreter cannot be relied upon. NRPSI was set up with help from the Home Office and the Nuffield Foundation to ensure those used as interpreters in the public sector were: appropriately qualified; with the right levels of experience; and are ready to carry out interpreting assignments. NRPSI’s core function is to protect the public, and the public-purse, from poor practice in interpreting; risk and complexity cannot be forecast therefore highly qualified and experienced public service interpreters need to be deployed in doctors’ consulting rooms as well as other NHS settings. The majority of Registrants are on Full Status, qualified to honours degree level (level 6) or above in the skills required to work in a public service setting with the requisite relevant experience. The National Register contains a substantial proportion of the eligible, trained, qualified and regulated interpreters in the UK. Hitting cost-targets and supply-requirements by procurement management at the expense

Translations

of quality are not achievements, causing confusion and miscommunication for medical professionals with their non-English speaking patients. More funding for interpreting services is desperately needed and would mitigate against the inherent risks and high levels of compensation when interpreting goes wrong due to poor service-delivery by inadequates. No amount of saved pounds-sterling will guarantee effective high quality interpreting needed by doctors, nurses, allied health professionals or indeed, the individual who cannot speak English and needs to communicate. It is critical the NHS sets funding for interpreting services on the basis of commitments to best-guidance, to principles and indeed to law; not based on expedient parsimonious frugality. Such attempts to save money have negative domino effects. A threat to the NHS Making use of bilinguals or linguists with no interpreting qualifications or experience threatens the public and the NHS. Pseudo-interpreters, bilinguals, and ersatzinterpreters with no or low grade interpreting qualifications and limited public service experience are not acceptable replacements for safe and effective interpreting conducted by registered and regulated professionals. Interpreting engagements in the NHS need to be carried out by those who are fit-topractice; interpreters with level 6 Diplomas in Health Interpreting with more than 400 hours experience, with clearances and who ascribe to the Interpreter Code of Conduct. Well-trained, qualified and experienced public service interpreters contribute to the safeguarding of human rights. Registrants who voluntarily accept the NRPSI Code of Conduct are inspirational beacons to professionalism in language service provision for the public sector. While NRPSI regulates those interpreters who display the professional self-regard to be on the National Register, NRPSI is powerless to deal with complaints against unregistered interpreters. Were it statutory for interpreters working in the NHS to be registered and thus regulated and if it was mandatory for the NHS to use only registered and regulated interpreters, then the public, and the public purse, would be better protected. NRPSI has proved to be a necessary tool for safe-guarding the quality of public service interpreting; it needs to be a ‘must’ not just a ‘like to have’ for the NHS. Effective interpreting delivered by professionals who are registered and regulated provides better outcomes for patients, allowing them to manage their conditions and also frees-up medical practitioners to handle more cases. It is simply about providing the best possible care to all in the UK. It is also about helping people to become productive and integrated members of society. The NHS needs to spend money wisely on interpreting so the NHS can be proud of meeting the needs of all British citizens. L FURTHER INFORMATION www.nrpsi.org.uk

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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Cyber security

Tackling cyber enabled fraud within the NHS The NHS Counter Fraud Authority look at the cyber fraud awareness resource, launched earlier this year, as well as the key cyber threats NHS organisations should be wary of The NHS has been under great strain for the last 18 months, dealing with the pandemic and all the challenges it presented to NHS staff and patients alike. Here at the NHS Counter Fraud Authority (NHSCFA), our work has never been more important in ensuring NHS funds are not misappropriated so that they are used for its intended purpose- patient care. During the Covid-19 pandemic, the NHSCFA saw new fraud risks appear that posed a threat to the NHS. One of them being cyber fraud. Over the past 18 months, there has been a wave of cyber crime affecting the public and the public sector. Criminals saw opportunities to take advantage of the pandemic, preying on patients and the NHS by stealing money from them through falsified means. Cyber Fraud resource The NHSCFA launched its cyber fraud awareness resource in July 2021, a comprehensive extension of the NHS Fraud Reference Guide that categorises different aspects of cyber crime, such as cyber

threats and cyber security. The resource was developed by the NHSCFA’s Fraud Prevention Unit (FPU) in response to the crossgovernment effort to better understand the risks of cyber fraud. It is a detailed guide for NHS organisations, NHS staff and the public on cyber crime, providing advice on how to protect themselves against the threats and how to stay safe online. The layout of the resource has been designed for easy use, splitting into six different areas: • An introduction: explaining what cyber crime is and the differences between the cyber offences to help users understand the difference between cyber dependant crime and cyber enabled crime. • A glossary: Over th common cyber e past 18 crime terms and associated there h months, a s definitions to b e wave o en a enable users to f c y b er crim affectin understand the e g terms used within and thethe public the content. pu

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• Key cyber threats: setting out five sections that relate to Social Engineering, Passwords, Malicious Websites, Payment Diversion Fraud and Malware. • Cyber Security information: includes security tips on keeping devices and data secure. • Cyber Quiz: designed and produced to complement the cyber fraud to test people’s knowledge of cyber fraud. • Reporting: includes how to make NHS related and non-NHS cyber fraud and cybercrime reports. Mandate fraud (payment diversion fraud) Mandate fraud (NHS) is a type of third party payment diversion fraud, where someone outside of the NHS attempts or succeeds in extracting payments from within the NHS by asking for bank details to be changed under the guise of an NHS supplier. Social engineering is a significant part of the payment diversion fraud process, with fraudsters posing as trusted and recognised patrons that give them a sense of authority that they use to manipulate individuals and E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

Advertisement Feature

Is the greatest threat to the NHS only a mouse click away? Net Consulting has recently written an e-book highlighting the first steps to take and key considerations to make when strengthening your cyber security posture. Threats to the NHS have come in various forms over recent years, whether it’s the devastating impact of Covid-19, or murmurs of privatisation, there’s no doubt this bastion of British identity is something that everyone strives to preserve. But there’s one danger that lurks in the shadows on a daily basis which, with a literal click of a button, could bring a health trust to its knees. That threat? – A cyber attack. The resounding message from IT industry leaders, technology suppliers and managed service providers is that when it comes to cyber attacks, organisations need to move very quickly from a thought process of ‘if’ to ‘when’. With Gartner stating that within just three years, 75 per cent of organisations will have faced one or more attacks, it’s imperative that if health boards aren’t 100 per cent certain they’d be able to withstand an attack and guarantee that all critical data is protected from unauthorised access, they take action to address that fast. Steve Heneghan, Head of Cyber Security at Net Consulting Ltd. agrees with this but explains how it isn’t always that easy: “The issue we find with organisations we’ve worked with is that they often don’t fully appreciate the scale of the risk, or just how wide their attack surface is. More often than not, they believe they’re quite well prepared, because they’re unaware just how many gaping holes exist in parts of the network they either hadn’t considered or didn’t know existed.” Steve adds that it’s this surface level understanding of a network that can often be the greatest threat to a trust’s security posture because it leads to a situation where many stones are left unturned. Dave Bloom, Solution Architect at Armis explains how health boards he’s worked with are often astonished just how many internet

connected devices exist on their networks: “A lot of organisations today are simply unaware of how many unmanaged devices they have on their network. If you ask a CISO ‘how many internet connect devices do you have’, they’ll quote you x number of laptops, x number of servers and this many CCTV cameras, but then you’ll ask ‘how many telephones do you have, how many door badge readers? What about the building management system – air conditioning, thermostats?’ And that’s before you even consider the situation with BYOD (bring your own devices).” Dave adds that it’s this big unknown that contributes most greatly to the risk, because if you don’t know what’s on your network, you won’t know who’s on your network either. He concludes by saying that in some cases, it’s the sheer scale of overcoming this challenge that’s preventing organisations from taking the necessary action. Dave and Steve are both alluding to the same thing here, they’re both agreeing that like so many things in life, the greatest challenge is knowing where to start. Cyber security is a huge and complex thing with many varying aspects and being able to truly get a grip on it requires time, focus, expertise, and the right technology - things that IT departments across the land are frequently short of. Implementing, maturing, or outsourcing security operations centres (SOCs) features prominently in Gartner’s ‘Top Security and Risk Management Trends’, and the reason for this is two-fold. Firstly, it’s due to just how sophisticated cyber attacks are becoming, and therefore, certain levels of experience and resources are required to both prevent and remediate. Secondly, security teams are realising that effective cyber defences now require an integrated approach. A lot of security teams are effectively built around Security

Incident and Event Management (SIEM) systems. A SIEM is a good starting point, but it’s always reliant on the quality of the data it’s fed, as well as the skill levels of the operators that are analysing it. It also only provides threat detection, not threat response. These days, for a security team to effectively cover all angles, they need to also incorporate Endpoint Detection & Response (EDR) tools, which help to detect under-the-radar threats that evade traditional defences and in some cases provide an automated response, stopping the threat. They should also complement all of this with security orchestration and automation response (SOAR) tools, which are designed to help remove some of the burden on security analysts by orchestrating and automating response playbooks. These tools essentially act as additional members of the security team, but ones who can monitor more data than any human could and act instantaneously, should the need arise. To introduce the technology required to carry this sort of detection and remediation, as well as the talent to effectively operate it comes at enormous cost to most organisations. This is why there’s been such an increase in outsourced SOC capabilities in recent years. Steve says: “Organisations we work with, both within the NHS and in the private sector are recognising that they need to invest in the right technology and resources to maintain a strong cyber security posture, but the cost of doing this in-house is becoming harder and harder (and in some cases outrightly impossible) to justify.” This, coupled by the fact that they often don’t even know where to start is what’s putting organisations at daily risk of attack, but it’s also where Net Consulting is able to help them best. By outsourcing their cyber security practice to a managed service provider like Net Consulting, organisations are able to remove much of the day-to-day burden on their already stretched team. They can benefit from state-of-the-art technology and highly qualified analysts, while at the same time focus their in-house talent where it really matters, whether that’s on innovation projects which frequently find themselves on the ‘nice to have list’, or on niche threat areas that require the in-house team’s full attention. Net Consulting has recently written an e-book highlighting the first steps to take and key considerations to make when strengthening your cyber security posture. It can be downloaded here and you can contact the team below. L FURTHER INFORMATION Tel: 029 2097 2020 www.netconsulting.co.uk

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Cyber security

 employees into making a bank transfer or providing confidential information. An example of mandate fraud is an ongoing investigation that the NHSCFA is leading on. An NHS body was the victim of a sophisticated mandate fraud which resulted in a loss of just under one million pounds. Working in partnership with a variety of law enforcement agencies, the NHSCFA investigation has revealed that a sophisticated money laundering network was used to disguise and dissipate the stolen funds. Responding to payment diversion fraud: • If you believe you might have revealed sensitive information about your organisation, report it to the appropriate people within the organisation, including network administrators. They can be alert for any suspicious or unusual activity. • If you believe your financial accounts may be compromised, contact your financial institution immediately and liaise to secure any accounts that may have been compromised. Watch for any unexplainable charges to your account. • Immediately change any passwords you might have revealed. If you used the same password for multiple resources, make sure to change it for each account, and do not use that password in the future. The NHSCFA has guidance on invoice and mandate fraud to help NHS organisations mitigate the risks. Action Fraud have further information on mandate fraud where you might be the victim. Working together The resource has come at a time where the new Government Cybercrime Strategy should

Cyber crime has continued to rise in scale and complexity through the years, with criminals using new and advanced technology and methods via the internet to commit their crimes be coming out soon that will set out a plan for how to protect the UK in cyber space. Cyber crime has continued to rise in scale and complexity through the years, with criminals using new and advanced technology and methods via the internet to commit their crimes. The NHSCFA worked with external stakeholders on the development of the project, adopting some of the methods used by other organisations such as the National Cyber Security Centre, Police Digital Security Centre and NHS Digital who are doing similar counter fraud and cyber crime work. Additionally, the NHSCFA’s FPU collaborated with internal colleagues from different business units, such as Intelligence, Digital and Organisational Development, ensuring that the project is all encompassing and comprehensive. Collaborative working is essential in countering fraud, and it will be no different in mitigating the risks associated with cyber crime. The cyber fraud awareness resource is the first step the NHSCFA have taken in joining in that fight. It has been designed around the overarching themes of ‘Prevent, Protect and Prepare’, keeping the target audience in mind (NHS Staff, Local Counter Fraud Specialists (LCFS) and members of the general public).

It helps them understand how to prevent instances of cyber crime, how to protect themselves, and by providing details of the various threats and risks, prepares them by helping them understand the subject area. Reporting If you have information concerning fraud against the NHS, please report it to us either via our online report at https://cfa.nhs.uk/ reportfraud or by calling our fraud and corruption reporting line on 0800 028 4060. If you have been a victim of fraud or cyber crime, please report it to Action Fraud. Next steps The NHSCFA is currently working on a video to complement the project involving the local NHS counter fraud community and counter fraud colleagues such as Crimestoppers, National Cyber Security Centre and Police Digital Security Centre. The aim of the video is to raise awareness of cyber crime and provide clarity on remits for reporting. The video will be published on our website in the next couple of weeks so keep your eyes peeled. L FURTHER INFORMATION www.cfa.nhs.uk

Issue 21.6 | HEALTH BUSINESS MAGAZINE

Advertisement Feature Written by Kristina Holland, vice president sales, UK & Ireland, RevBits

RevBits® adopts a holistic approach to help secure the healthcare sector RevBits understands the cyber security issues facing the healthcare industry and has developed a range of products and services to address these. Kristina Holland, RevBits’ vice president for sales in the UK & Ireland, explains how the sector can protect itself RevBits understands the issues facing the Healthcare industry and has developed a range of products and services to address these. RevBits core portfolio: Email Security; Endpoint Security/EDR; Privileged Access Management (PAM); Deception Technology; Zero Trust Networking (ZTN) and Cyber Intelligence Platform CIP/XDR. The CIP provides a 360-degree view, automating and integrating RevBits security modules to detect, lure, alert, respond and intelligently analyse multi-layered security data across the stack.

Who are RevBits? RevBits are a dynamic cyber security firm with the broadest range of core cyber products on the market today from any one stack. Originally founded in 2016 as a Tier 3 cyber security service provider, RevBits solved those issues deemed unsolvable. This ‘from the trenches’ period led to the development of a core portfolio of Next Gen patented solutions, designed to mitigate the clients ‘pain points’ and those gaps left by incumbent suppliers. Information assurance and the interplay between an organisation’s business critical information assets, vulnerabilities and risk is baked into the RevBits portfolio.

What is RevBits approach? Cyber security needs to embrace people, process, culture – supported by Information & Communication Technologies (ICT). Breaking down the divide between technology, culture and information governance (IG) is crucial if organisations are to mount a successful defensive. It is no longer acceptable to attribute blame to the technology department when ‘human error’ is repeatedly recognised as a leading protagonist. The market is flooded with well-intended suppliers offering everything from awareness training, healthchecks and a million different ground-breaking technologies to address the various identified vulnerabilities. What tends to be lacking is an affordable means for organisations to identify the ‘most likely risks’ and to translate

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

this into a finite number of governance and technology control measures. While no single organisation can have all the answers, it is believed that with the integration of RevBits Next Gen technology; a pragmatic logical business approach; alignment to complimentary organisations and improved cultural awareness, it is possible to significantly reduce risk and improve an organisation’s cyber security posture. The diagram provides a view of the interplay between IG and IT, effectively both sides of the same coin. Such a holistic approach will significantly improve an organisation’s efficacy, efficiencies and enhanced digital assurance for better security outcomes. Why might the NHS appear to be particularly vulnerable to cyber-attacks? The NHS is the single largest integrated healthcare provider in the world employing circa 1,319,400 full time employees (NHSD workforce statistics 2020), in addition to a raft of contractors. Furthermore, the NHS ‘supply chain’ consists of more than 80,000 suppliers providing anything from medical equipment, through to food and office goods. The amalgamation of different estates, a multiplicity of legacy systems and a diversity of technology, people, processes and culture, makes for a hugely complex environment.

How lucrative? Every individual domicile in the UK (circa 55 million) has a medical record from birth to death. These include such detail as patients’ names, addresses, birthdays and medical diagnoses. “Many hackers recognize the potential value of health data on the dark web, potentially upward of $1,000 per record in the current climate,”…(Health IT News Feb’21). Patient data is estimated to be 10-15 times more valuable than credit card data on the dark web. How prevailent are attacks on the Healthcare sector? Ponemon 2020 reports: “The healthcare sector suffers four times more cyberattacks than other industries with medical breaches up 55 per cent in 2020.” Ransomware attacks are becoming increasingly common in the Education and Healthcare sectors, with Health Service Executive (HSE) of Ireland suffering a major ransomware cyberattack earlier this year. A Securelink report suggests that in the last 12 months, 44 per cent of healthcare and pharmaceutical organisations experienced a data breach caused by a third party. Other recent high profile ‘supply chain’ attacks to hit the news include: Kayesa ransomware attack, the Colonial Pipeline breach, SolarWinds. What are the cyber criminals targeting? Information. Healthcare is constantly widening access and opening up systems whilst simultaneously collecting an ever-greater range and depth of data. Patient care relies heavily on digital delivery - whether updating patient records in primary care to complex integrated care solutions utilising CT scans, digital pharmaceutical records and heart monitoring. Sensitive patient records may be attained for extortion, disruption or resale on the dark web. How are they ‘getting in?’ Cyber criminals will exploit any vulnerabilities within the network, people and processes in order to gain access to critical assets. Typically, phishing attacks open the door to credential harvesting and ransomware. Access might be: via ‘People,’ exploiting their lack of cyber awareness and the prevalent intentional/ unintentional ‘human error’; via ‘VPN,’ attaining access privileges from a thirdparty for remote access e.g. the ‘supply chain’ or remote/hybrid workers; or by exploiting the ‘Covid catalysed digitisation program’ where, due to the required haste in deployment, there may be a comparative lack of security measures, policies and processes in place for remote/hybrid workers.

What immediate governance and technology control measures would RevBits recommend to address such vulnerabilities? It is essential that the integrity, assurance, and availability of information and data in healthcare records are properly managed in a cyber secure manner. Supportive actions and messaging from ‘the top down’ should emphasise the value of information, alerting staff to the threats and the potential impact on patient safety. Phishing campaigns, ransomware and credential harvesting enable hackers to access, monetise, steal, change, deny availability of or manipulate patient records and information. RevBits IT and IG controls can provide Healthcare organisations the tools to prevent, mitigate and remediate such attacks and help ensure only the right people gain access to critical assets at the right time. RevBits strong partnerships with firms expert in IG encourage organisations to adopt a culture of good information assurance through direct links to the most pertinent online National Cyber Security Centre (NCSC) certified training courses. To combat sophisticated phishing attacks, page impersonations and raise cyber security awareness It is acknowledged that phishing is responsible for well over 92 per cent of all cyber-breaches, ransomware and credential harvesting attacks invariably commencing life as a phish. There is also acceptance that leading incumbent SEGs have a 24 per cent email ‘miss rate.’ RevBits Email Security provides patented endpoint-based algorithmic analysis which detects and blocks the more sophisticated phishing attacks and page impersonations. This complimentary second layer of protection blocks the ‘miss rate’ from the incumbent SEG gateway solution. Training & Awareness (T&A.) To address the other half of the phishing issue, human error, RevBits are finalising a complete and comprehensive phish simulator awareness solution which will mimic likely attack paths and techniques and provide advanced reporting capability. Users will be directed to an online NCSC certified cyber-awareness training course. To combat third party access vulnerabilities e.g. supply chain and remote/hybrid worker Inappropriate access privileges may be provided to staff, contractors and third-party suppliers. This enables unauthorised and often unaudited access via the VPN to critical assets on the healthcare estate. Given the perceived value of patient sensitive data on the dark web it is important to trust adaptively, based on the security profiles of staff and third parties requiring access. RevBits ZTN focuses on protecting resources by ‘trusting no one’ by default - whether inside or outside the network. ZTN provides granular, auditable access to specific assets and applications to identify, isolate and monitor remote network connections in real-time. Moving the network perimeter to the endpoint RevBits ZTN helps isolate and protect internal

assets without the necessity of implementing complicated network segmentation. Implementation of ZTN is relatively simple. T&A. Users directed to online NCSC certified courses: e.g. Supply Chain & Procurement; Hybrid working; Information Asset Owner To combat Ransomware attacks Ransomware attacks on the Healthcare sector are growing exponentially. RevBits Endpoint Security/EDR conducts ‘triplephase’ analysis on new executables to block any ransomware attempts. Recent independent ICSA results for Q1 and Q2 show over 99.3 per cent threat detection and 0 false positives. The EDR component is considered the most robust in the market. Patented technology affords visibility and operation at the kernel level. T&A. Users directed to an appropriate online NCSC certified training course.

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Psychology also plays a part in many cybercrimes, the more vulnerable the target - the greater the chance of a successful attack. Covid accelerated digitisation programmes (remote working), the speed and scale offered by today’s hi-tech interconnectedness and the increased attack surface offered by the Health sector workforce and supply chain makes the NHS a very lucrative target for Cyber-criminals.

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RevBits officially launched last year. Since, numerous awards have been achieved for innovation and efficacy, including recognition as the Top Cybersecurity Solution Provider in 2021 by CIO Applications; multiple best in class awards across the product range from the Cyber Defense Magazine (CDM) and named Winner of the Coveted Global InfoSec Awards during RSA Conference 2021. A recent Q&A article in CRN channelweb describes RevBits approach to the UK and Ireland. RevBits also featured in Cyber Exchange October issue of Spotlight. FURTHER INFORMATION kristina.holland@revbits.com www.linkedin.com/company/revbits-inc www.revbits.com

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Cyber security

Keep I.T. Confidential: Healthcare cyber threats Keep I.T. Confidential aims to help NHS staff understand more about cyber security threats and know what to do to reduce the risk. NHS Digital has launched new content for the awareness campaign Keep I.T Confidential is an online cyber After a successful first launch in 2019, new security awareness toolkit, which is available information has been added on data security for free, to help NHS trusts and other and being aware of the impacts of sharing too healthcare organisations learn about commonmuch information. sense security practice and the impact it can Neil Bennett, NHS Digital’s Chief Information have on patient safety. It includes practical Security Officer, said: “Taking small simple steps that staff can adopt into their everyday steps such as setting a strong password and job, such as setting secure passwords, keeping keeping your screens and devices locked devices locked when they’re not in use, and when they’re not in use, are vital for the NHS being aware of phishing, email scams and and patient safety. Considering cyber security social engineering. in your day to day lives can make a huge Launched by NHS Digital’s Data Security difference and help to keep ourselves and Centre, the materials have been patients protected online and in designed to help NHS our workplaces. organisations run their “We know how busy own cyber security NHS staff are, so we The NCSC p awareness campaigns want to help them rovided unprec at a time and in understand the edente a way that suits importance of cyber d suppor over th them. security and how it t e pa

st year organis to those o ations, includin n g the pan the front line of de and vac mic response cine roll out

can benefit their working lives in a quick and simple way.” Keep I.T Confidential There are simple steps we can take to protect ourselves from cyber threats and keep unauthorised people away from sensitive or confidential information such as patient data, health care records or details of our IT systems. Keep I.T. Confidential aims to help us understand more about these cyber security threats and know what steps we can take to mitigate risk and protect our patients and their data. These cyber security threats have been identified as a risk to the NHS and our patients. Be aware Sharing NHS information in public spaces and social platforms puts patient data, confidentiality and, therefore, potential E

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HOLISTIC CYBER SECURITY SERVICES AND SOLUTIONS

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Thank you for the great Clinical workshop, lots of great thought-provoking content and insights on why cyber is so important for our clinical teams.

Templar Execu�ves is an award winning, interna�onal Cyber Security company. We work with organisa�ons across the health sector including NHS Trusts, CCGs, NHS Digital, ALBs, Primary and Social healthcare and other NHS agencies. In an increasingly connected, evolving and digitalised NHS integrated care system, we are commi�ed to providing Cyber Security solu�ons that improve the pa�ent journey and outcomes.

I am sure as a Trust we would not be in such a good position as we are now in terms of our cyber posture and compliance with the DS&P Toolkit without all your hard work and commitment to us.

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Cyber security

 treatments, at risk. Criminals know this and they are watching and listening. Data NHS data is valuable to criminals, whether that be so that they can sell it or use it fraudulently. Data breaches can lead to fines, disruption to services and reputational damage for the NHS. Organisations should make sure that staff understand and follow the latest guidance around data sharing, including the hospital’s data protection policy, as well as mandatory training, such as data security awareness training. Phishing Phishing is when hackers and criminals send unsolicited emails that contain attachments or links to try and trick people into providing access to information. To avoid phishing, staff should be encouraged to check the sender’s email address to see if it looks legitimate, before checking the contents of the email for spelling mistakes, poor grammer and suspicious domain names. Staff should also be made aware that should not provide sensitive personal information, like usernames and passwords, over email.

To help protect the healthcare sector, the NCSC extended the PDNS service to over 1,000 additional organisations within the health and social care sector to support of vaccine development and supply chain organisations Tailgating Tailgating is when unauthorised people gain entry to a building by following a staff member through physical security facilities, such as doors, barriers and gates, to avoid detection. Letting unauthorised people in could lead to them taking patient data or accessing systems. To stop tailgating, hospital staff should query the status of strangers, if it is safe to do so, especially if they try to follow staff into staffonly areas of the hospital. NHS staff should wear their building pass or ID if issued and ensure it is visible, so as not to be mistaken and to make monitoring easier for security staff. Finally, as silly as it sounds, staff should make sure that their have shut and locked

doors and cabinets where necessary, and maintain a clear desk policy. Unlocked screens Unlocked screens are an open invitation to patient data theft. Keep your screens and devices locked when they’re not in use. Social engineering Social engineering involves criminals using tricks or deception to manipulate people into giving access to information such as patient data, health care records or details of IT systems. Giving unauthorised or suspicious people access to information or places could risk someone swiping patient data. E Issue 21.6 | HEALTH BUSINESS MAGAZINE

NENE CYBER SECURITY PENETRATION TESTING AND CONSULTANCY

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Tackling ransomware The NCSC provides a range of free cyber security tools and services to eligible organisations as part of the Active

ACD helps organisations secure aspects of their IT that are frequently exploited to deliver ransomware and also helps to disrupt ransomware that makes it through the first line of defence onto an organisation’s network Cyber Defence (ACD) programme. These initiatives help organisations to find and fix vulnerabilities, manage incidents or automate disruption of cyber attacks. Some of our services are designed primarily for the public sector, whereas others are made available more broadly to private sector or citizens, depending on their applicability and viability. ACD helps organisations secure aspects of their IT that are frequently exploited to deliver ransomware and also helps to disrupt ransomware that makes it through the first line of defence onto an organisation’s network. Lindy Cameron, CEO of the NCSC, said: “I’m proud of the way the NCSC has responded to what has been another hugely challenging year for the country as we all continue to navigate our way through the pandemic. The support and expertise we have provided for stakeholders from government all the way through to the general public during the pandemic has been vital to keeping the country safe online. “Undoubtedly there are challenges ahead, but the upcoming National Cyber Strategy combined with the continued engagement from businesses and the public provides a solid foundation for us to continue reducing the impact of online threats.” National Cyber Strategy A new National Cyber Strategy has been announced, setting out how we will protect and promote UK interests in rapidly evolving online world.

Cyber security

 Pandemic cyber risks The National Cyber Security Centre provided unprecedented support over the past year to organisations, including those on the front line of the pandemic response and vaccine rollout. The NCSC’s annual review highlights how the GCHQ organisation expanded its online defence of the UK by managing an unprecedented 777 incidents over the last twelve months – up from 723 the previous year – with around 20 per cent of organisations supported linked to the health sector and vaccines. The health sector and in particular the vaccine rollout was a major focus for the NCSC, with the organisation’s world-leading services protecting NHS, healthcare, and vaccine supplier IT systems from malicious domains billions of times. The Annual Report says that cyber criminals exploited the pandemic landscape to steal vaccine and medical research, as well as to undermine other nations that were more deeply hampered by the crisis. As highlighted across all sectors, the pandemic has undoubtedly accelerated the shift to more digital ways of working. This has been the case throughout the NHS, which the NCSC argues has broadened the surface area for attacks and has made cyber security more challenging for organisations. To help protect the healthcare sector, the NCSC extended the Protective Domain Name System (PDNS) service to over 1,000 additional organisations within the health and social care sector to support of vaccine development and supply chain organisations. This extension represented protection of an additional three million employees in the sector, from essential workers providing and supporting front line care to those working to develop and deliver vaccines to citizens across the country.

Marking the first major milestone following the publication of the government’s Integrated Review earlier this year, the strategy builds on the significant progress made on cyber over the last five years which has seen the UK cyber security sector grow rapidly, with over 1,400 businesses generating revenues of £8.9 billion last year, sup porting 46,700 skilled jobs, and attracting significant overseas investment. Through the strategy, the government is calling on all parts of society to play their part in reinforcing the UK’s economic and strategic strengths in cyber space - this means more diversity in the workforce, levelling up the cyber sector across all UK regions, expanding our offensive and defensive cyber capabilities and prioritising cyber security in the workplace, boardrooms and digital supply chains. The strategy also sets out the government’s plan to keep citizens safe in cyber space and stamp out cyber crime by: bolstering law enforcement with significant funding so that they can ramp up their targeting of criminals; increasing investment in the National Cyber Force which represents the UK’s offensive capability to counter, disrupt, degrade and contest those who would do harm to the UK and its allies; and expanding GCHQ’s National Cyber Security Centre’s research capabilities, including the new applied research hub in Manchester. L FURTHER INFORMATION https://digital.nhs.uk/keep-it-confidential

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Enabling GS1 instrument-level tracking Enabling instrument-level tracking 2DSurgical haveGS1 enabled hundreds of hospitals worldwide to successfully introduce GS1 instrument-level tracking Enabling GS1 instrument-level tracking systems. By understanding and addressing the concerns of managers and operators they have designed their 2DSurgical have enabled readers hundreds worldwide to successfully introduce GS1 instrument-level tracking SurgiScan 2D barcode to of be hospitals quick, reliable and easy to use. 2DSurgical have enabled hundreds of hospitals worldwide to successfully introduce GS1they instrument-level tracking systems. By understanding and addressing the concerns of managers and operators have designed their systems. By understanding and addressing the concerns of managers and operators they have designed their SurgiScan 2D barcode readers to be quick, reliable and easy to use. SurgiScan 2D barcode readers to be quick, reliable and easy to use.

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Healthcare events

Prepare for the Future of Healthcare Learn about some of the IGPP’s key upcoming healthcare conferences and find your exclusive Health Business member discount code and booking link below As another challenging year comes to an end, it’s time to look ahead to 2022 and how the healthcare industry can continue to rebuild and develop over the next 12 months and beyond. Knowledge sharing and allowing open communication and collaboration continues to be integral in the development of healthcare services and making improvements across the industry as a whole. The Institute of Government & Public Policy is here to support your learning journey, hosting a diverse range of virtual and face to face events to enhance knowledge, disseminate excellence, facilitate collaboration, and prompt ongoing discussions around healthcare governance and public policy. IGPP’s events and courses are known for their high level of professionalism, expertise, depth and for leading on the new directions and challenges within the sector at hand. Through a deep expertise and grounded knowledge, provided by renowned leaders in their field, we aim to enrich those who attend our events and courses with balanced with inspiring information. Learn about some of the IGPP’s key upcoming healthcare conferences and find your exclusive Health Business member discount code and booking link below. Improving NHS efficiency The Covid-19 pandemic has had a profound negative impact on the NHS. To tackle these issues, the government has increased NHS funding by £6.3 billion in 2021-22, with a further £3 billion to support NHS recovery from the impact of Covid-19. Join us at the NHS Efficiency 2022: Maximising Funding, Finances, Productivity and Effectiveness conference to get a comprehensive overview of the latest policy

updates and case study examples of how organisations have successfully achieved transformative change in an increasingly pressured environment. Topics to be discussed include delivering the move to integrated care and system working; achieving efficiencies through digitisation; streamlining processes and implementing new financial models.

pandemic has had a significant negative impact on NHS workers in particular. In October 2020, NHS England and NHS Improvement invested an additional £15 million to provide mental health support for healthcare workers. In February 2021, as part of the health service response to the need for mental health NHS worker support, it was announced that staff will be offered access to evidence-based mental health services at one of 40 dedicated support hubs. Join us at Supporting the Mental Health of NHS Staff 2022 to discuss the means of supporting NHS staff by providing, health, wellbeing and hardship support, assessing effective safety and wellness policies and protocols, and making sure that NHS workers have the technology and capability to access learning.

Developing Integrated Care Systems Integration and the ‘joining up’ of the NHS alongside local government services such as social care, mental health and public health advice in mandated by the bill with every part of England having an Integrated Care Boards and Integrated Care Partnerships to oversee this collaborative approach. The Department of Health and Social Care Improving detection, treatment argues that this restructuring will ‘dispose of and outcomes of sepsis unnecessary bureaucracy that has held the Sepsis is a common and potentially lifehealth service back’ and ‘level up health across threatening condition, claiming more lives the country’ which will be critical in dealing than lung cancer and is the second biggest with health inequalities and the current killer after cardiovascular disease, it can backlog as a result of the Covid-19 pandemic. have a severe and long-lasting impact Developing Integrated Care Systems for the on the lives of survivors. This issue has Future will provide delegates with insights been compounded by the on how the reforms will work in practice, the coronavirus pandemic implementation and formation of integrated with the UKST care boards, the statutory duties for It’s estimating that the NHS and local authorities to t ime to close to 100,000 collaborate with a mixture of high look ah people are level keynote address and best e a d to 2022 a going to be practice case studies. healthc nd how the discharged from hospital Supporting the mental can con are industry t having had health of NHS staff i n u e to rebu and de and, Mental health is one of the i ld ofCovid-19 vel these, 20 per most significant challenges next 12op over the cent are likely for the UK and the Covid-19 m and be onths to develop sepsis yond within the first 12 months. Improving Detection, Treatment and Outcomes of Sepsis 2022 will address both the long-term challenge of sepsis as well as the acute challenges posed by covid. Learn from a mixture of high-level keynotes alongside practical case studies in outstanding sepsis practices to improve resilience, improve treatments, save lives and effectively improve the quality of life of the survivors. L

Use the code HB2021 at checkout for an exclusive discount. FURTHER INFORMATION www.igpp.org.uk/health-business

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Medical technology

MedTech leaders and the shift from hospital to home James Feindt, Marck Aghnatios and Alistair Fleming look at the benefits and opportunities of migrating care from hospital to the home environment, as well as the Medtech challenges it creates Traditional healthcare is increasingly taking Rethink engagement to deliver place in patients’ homes, as it offers the directly to the new buyers potential to reduce costs, deliver more The hospital setting offers advantages flexible care, and provide better access for for patients including continuous patients. monitoring and immediate access to Pre-pandemic, significant indicators like health professionals, but the pandemic has the length of stay and inpatient visits accelerated care into virtual and hybrid per capita had been declining, while the models. Remote care involves different number of outpatient visits were rising. health professionals and new ways of Better treatment options have diminished interacting, with more choice for patients the volume of invasive procedures and who can now interact directly with product consequently the length of recovery time. providers. Patient engagement and market Medical technology innovations have access models are likely to continue to paved the way to continue this shift postchange as medical device companies pandemic through connected devices develop new technologies which allow patients to be treated that enable quality care and monitored outside a to be delivered in a Techno hospital setting. home setting. l innovat ogical This shift in the point For device of care brings about developers, the opened ion has complex challenges, opportunity a p a forward th including adapting exists for their our hea to evolve solutions to a home products l t setting, the absence or services and ma hcare system of in-person clinical to be sold improv ke significa ements nt support, and increased directly to the to care by reliance on the patient transitiopatient as a user and increasingly from ho n as a direct consumer. spital toing MedTech companies that can home navigate these changes have an opportunity to be at the forefront of an emerging health care industry.

patient rather than providers. Patients are becoming increasingly savvy and educated on their care options, and a shift to patientcentric care is placing patient needs and wishes centre stage. MedTech will need to radically rethink existing business models to find ways to engage directly. This may involve approaches such as partnering with community clinics, providing leasing models, enriching solution provision with interaction and advice, and building more diseasecentric offerings that entrain and retain loyalty. The opportunity is for radical, not incremental change Covid-19 was a catalyst for a marked step forward in remote health provision. It has been stated that telehealth uptake has been accelerated by around three-five years due to the pandemic. Before this, solutions were emerging around connected devices and digital support tools. Many of these represent small but significant steps, while some sit at the more disruptive end of the scale such as the implementation of data E

Issue 21.6 | HEALTH BUSINESS MAGAZINE

DEHAS - WE THINK IN PRESSURE AND FLOW in EMERGENCY CARE | CLINICAL | HOMECARE | AVIATION Products around medical oxygen, application, dosage and mixing, display and measurements of the resulting vital parameters, service and consulting for customers, special construction in series or individual pieces for customer-specific requirements. LIQUID OXYGEN EQUIPMENT – Portable liquid oxygen devices and reservoirs GAS BLENDERS – Oxygen and Air, Oxygen & Nitrous oxide

Contact details: For HOMECARE (Liquid Oxygen Equipment): Baywater Healthcare, Wulvern House ,Electra Way, Crewe, CW1 6GW, www.baywater.co.uk Dolby Vivisol, Southpoint Floor 2, Old Brighton Road, Lowfield Heath, Crawley,West Sussex, RH11 0PR, www.dolbyvivisol.com For CLINICAL (Gas Blenders): Therapy Equipment Ltd, Unit 1 Cranbourne Avenue, Cranbourne Industrial Estate, Potters Bar, Herts, EN6 3JN, www.therapyequipment.co.uk English homepage: www.dehas.de/index.php/home-en-5

Value-based care and data sharing opportunities are promoting greater collaboration The emphasis from governments and Insurers on optimising care provision through outcomes-based reimbursement is driving strategies focused on disease and patient rather than symptom and product. This mindset promotes preventive solutions, increased diagnostics and monitoring and better connectivity. In the context of transitioning point of care, MedTech can help to bridge the physical gaps between care settings by seeking deeper patient engagement across the care-pathway.

In the context of transitioning point of care, MedTech can help to bridge the physical gaps between care settings by seeking deeper patient engagement across the care-pathway This might be achieved through the expansion of complementary services, acquisitions or partnerships to gain access to a more comprehensive coverage of disease stages. Improved visibility and influence over the patient journey should lead to better decisions, more effectively targeted interventions and more efficient allocation of resource. It is equally important to consider the impact of vertical integration. We have seen an explosion in patient data generation in recent years, but our healthcare systems and regulations are still evolving to accommodate best use of the opportunities this offers. Such limitations are emphasised as care provision becomes more physically spread. Whereas historically, one provider may have been the originator and custodian of requisite patient data, in today’s world, this could be spread between primary and secondary care, local clinic, home care providers, patients and consumer health companies. For MedTech companies, it can be a bewildering landscape to navigate. Data regulation is far from harmonised, and while there is a growing sector offering data translation between the electronic medical records and hospital information

Medical technology

 aggregation to predict hypoglycaemic events with Medtronic’s IBM collaboration project SugarIQ. There are signs of dramatic shifts in the capabilities of communications, power and processing technologies that open a realm of new possibilities. Wider trends are also evident – a future home healthcare landscape may be hyperconnected, prevention-focused, precision targeted and holistically informed. We have also witnessed the pace of innovation increase significantly in the past 18 months. As we look to the future, we believe that the opportunity exists for more fundamental change. By utilising futuresight strategic tools such as business wargaming or scenario planning, MedTech companies can place themselves in worlds five or ten years into the future, and explore how evolving technologies, markets and attitudes could shape their ability to meet the needs of tomorrow.

systems providers, challenges remain albeit with success stories. Once again, the pandemic has shown how a common purpose can unlock powerful collaborative networks such as the COVID-19 Clinical Research Coalition. Looking forward Technological innovation has opened a path forward to evolve our healthcare system and make significant improvements to patient care by transitioning from hospital to home. This transition will be increasingly complex as more care moves to a patient’s home, but it will also be the solution to improve healthcare coverage with increasing demand. The pandemic has forced regulatory, medical device, healthcare and pharma into action and these industries stand to benefit if they can meet the call to offer value in the new model for care. L

Jointly authored by James Feindt, healthcare expert, and Marck Aghnatios and Alistair Fleming, MedTech experts at PA Consulting. FURTHER INFORMATION www.paconsulting.com/ industries/healthcare

Issue 21.6 | HEALTH BUSINESS MAGAZINE

SP Medical is a Danish company with more than 30 years’ experience and knowledge in the field of development, manufacturing and sales of Guide Wires for the medical industry. Over the past 30 years we have built up our knowledge of PTFE coated semi-products and medical devices for leading OEM companies and distributors worldwide. It is SP Medical’s goal to offer our customers a complete Guide Wire programme of high quality and, if required, with special features Primarily we focus on the core competence within the discipline of Guide Wire programmes to perform, at all project stages, optimal professional consultancy, and development to our customers.

Champion - PTCA Guide Wires • For cardiology or CTO • Straight or J-formed tip • Diameter 0.014” • Stainless steel with PTFE coating • 3 cm platinum tip hydrophilic coated • Tip stiffness cardiology: extra floppy, floppy, intermediate or standard • Tip stiffness CTO: 3 gf, 6 gf or 12 gf • Shaft stiffness: Standard or stiff • Length 195 or 300 cm

WE PRODUCE GUIDE WIRES UNDER OUR BRAND NAMES ACCOAT, POSEIDON AND CHAMPION. Poseidon - Hydrophilic Nitinol Guide Wires • Polyurethane coated Nitinol core with hydrophilic surface • Straight, angled or reshape able tip • Diameter from 0.018” to 0.038” • Shaft stiffness from standard to extra stiff • Tip stiffness: standard, soft or floppy • Lengths ranging from 80 to 260 cm

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For further information, please download brochures or certificates from our homepage www.sp-medical.dk or contact us directly on e-mail: gw@sp-medical.dk

Medical equipment

Reducing medication errors and improving patient safety A new Information Standard has been published by NHS Digital to support improved medication and allergy/intolerance information sharing across healthcare services in England The new Information Standard will standardise medication message content, enabling transfer of prescription information across health and care settings in England to help reduce medicines related errors and improve patient safety. The Standard will enable medicines information to be more efficiently shared between NHS and social care organisations, including primary and secondary care – from hospitals and GP practices to residential care homes, mental health trusts, and pharmacies. It will be particularly beneficial in reducing medication errors when patients transfer between care locations. As well as providing clinicians with a more detailed and consistent source of medicines related information across all care settings, the Standard will also enable healthcare professionals to obtain medicines information in a quicker, more efficient manner, saving valuable time and improving patient care. Shahzad Ali, NHS Digital Clinical Lead for the Interoperable Medicines Programme, said:

consultation with INTEROPen, The Professional “Having access to good quality information is Record Standards Body, UK FHIR and The critical for clinicians when making decisions Interoperable Medicine Standards Working about the patients in their care. As a Group which has over 150 members from the practising clinician, I have seen first-hand the NHS including users, developers, and IT burden clinicians can face when medicines system suppliers. information is incomplete or inconsistent. The purpose is to ensure that medication This new Standard will save healthcare and allergy information is transferred professionals valuable time accessing key between systems and locations in a machinemedicines information, provide clinicians readable format. This will be achieved with access to a richer source of information, by: transferring medication information consistent across all care settings, and, in turn, using the newest UK version of FHIR (Fast help reduce potential medicines related errors Healthcare Interoperability Resource), using and improve patient safety.” either ‘Medication Codable Concept’ The Standard came into effect in or ‘Medication Resource’ as is October 2021 and NHS and most appropriate to the use social care organisations The case; usage of dose syntax will need to be Standa to transfer the amount of compliant with it by medication per dose as a 31 March 2023. The enable rd will medicin simple coded quantity; Standard was informa es and transferring allergy/ commissioned t io n more e intolerance information by NHSX and fficient to be ly share using SNOMED CT and developed by NHSX betwee d n NHS dm+d codes. E and NHS Digital in

social c and organis are ations

Issue 21.6 | HEALTH BUSINESS MAGAZINE

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Overprescribing review Alongside recent NHS England funding, the government has announced action to prevent medicines being prescribed unnecessarily,

This new Standard will save healthcare professionals valuable time accessing key medicines information, provide clinicians with access to a richer source of information, consistent across all care settings, and, in turn, help reduce potential medicines related errors and improve patient safety following a new review led by the Chief Pharmaceutical Officer for England. The review into overprescribing has found that 10 per cent of the volume of prescription items dispensed through primary care in England are either inappropriate for that patients’ circumstances and wishes, or could be better served with alternative treatments. It is believed that around one in five hospital admissions in over-65s and around 6.5 per cent of total hospital admissions are caused by the adverse effects of medicines. The more medicines a person takes, the higher chance there is that one or more of these medicines will have an unwanted or harmful effect. Some medicines, such as those to reduce blood pressure, can also increase the risk of falls amongst the frail and elderly. The review sets out a series of practical and cultural changes to make sure patients get the most appropriate treatment for their needs

Open development platform for medical wearables

Medical equipment

 Reducing overprescribing Before stepping down as NHS England chief executive, Sir Simon Stevens announced a new Innovative Medicines Fund and £680 million of ringfenced funding which would build upon the success of the reformed Cancer Drugs Fund by supporting patients with any condition to get early access to the most clinically promising treatments where further data is needed to support NICE in making final recommendations around their routine use in the NHS. An estimated one in 17 people will be affected by a rare disease in their lifetime, and the Innovative Medicines Fund now supports the NHS to fast-track patient access to treatments which can demonstrate substantial clinical promise but still have significant uncertainty around their clinical and cost effectiveness and hence long term value for taxpayers. Along with the existing £340 million Cancer Drugs Fund which will be guaranteed its current funding levels, this new £340 million initiative means a total of £680 million of ringfenced NHS England funding will be available to deploy on fast-tracked drugs. In the past five years the Cancer Drugs Fund provided more than 64,000 people access to life-extending or potentially life-saving drugs which might otherwise not have been available for years.

while also ensuring clinicians’ time is well spent and taxpayer money is used wisely. This includes shared decision making with patients about starting or stopping a medicine, better use of technology, ways to review prescriptions more effectively, and considering alternative medicines which would be more effective. This is likely to see the introduction of a new National Clinical Director for Prescribing to lead a three-year programme including research and training to help enable effective prescribing; as well as system-wide changes to improve patient records, improve handovers between primary and secondary care, develop a national toolkit and deliver training to help general practices improve the consistency of repeat prescribing processes. L FURTHER INFORMATION digital.nhs.uk

Movesense is an open, programmable, wireless ECG and movement sensor, classified as a Class IIa medical device accessory (MDD 93/42/EEC). It enables innovative health companies develop new wearable health solutions that improve patient outcomes and increase healthcare efficiency. Programmable – Tailor the sensor for your use case with a custom application. Open API, developer tools, sample code and technical support are available. Cost-efficient – Focus on delivering customer value through your own application instead of developing, testing, and certifying new hardware. Comfortable – The small and lightweight sensor fits for user’s daily life and is unobtrusive to wear and easy to attach. Flexible – Sensors made in Finland and delivered with your own branding and firmware is a smart way to bring your own sensor idea to market.

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Issue 21.6 | HEALTH BUSINESS MAGAZINE

Are You Prepared? ISDN / PSTN Switch-Off 2025 Have you considered what exposure or risks the ISDN / PSTN Switch-Off 2025 poses to your organisation? Your telecoms network will have been built historically on these technologies. However, what you are using and where it is located may be an enigma. Voice calls, security, well-being and any equipment reliant on these services will be affected. The longer action is delayed, the more problematic the situation may become. From a completely independent viewpoint, Segmentation Group, with our depth of knowledge in legacy services, can help you gain clarity and remain in control.

Call us on 03300 240480 for a free consultation or email us at info@segmentationgroup.com www.segmentationgroup.com/isdn-/-pstn-switch-off-2025

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BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS | www.healthbusinessuk.net

Frameworks

How the sustainable domino effect will help the NHS In this blog, Andrew Smith, Pillar Lead Research at CCS - Environment and Sustainability, reveals some of the ways the NHS can achieve sustainability To achieve sustainability within the NHS will feel like moving a mountain with a teaspoon, it is possible but it will be a long and hard journey. The tasks are endless each with their own unique problems and firmly underlined with the central core value that what they do is save lives. A change can be ideal in a sustainable target, but detrimental to the area in their role in patient care. While looking at what needs to be done it is often thought that answering in-depth riddles on the creation of the universe could be easier. When you look at the NHS as a single entity the task becomes too large. Instead, by breaking it down into the component parts, it helps to make it less intimidating, but what these components are is yet to be decided. When you mention the NHS to anyone the initial thought is the large trust led hospitals, but what about all of the health centres providing local GP care to the community, the nurses, care professionals and admin teams that keep these areas running? Let’s look at one of these areas as an example of what could be changed. The first thing that people think of when it comes to carbon net-zero is power. Looking at this from one aspect would be a move to a green sourced power supply, maybe including carbon offset certificates. In an ideal world, it would be a mix of solar and air source heat pumps, if the property is in a more rural area and has the available space then a small wind turbine would complement the building’s requirement. Theoretically, this could create an off-grid generation of supply, albeit I would never suggest that a health centre is fully offgrid the risk is too high. Lights, computers, administration and waste are all areas that need to be readdressed. Lights can be changed to LED systems that have a much lower per hour cost and better longevity, plus they are much brighter than previous energy saving bulbs. With the computer systems, it is more common to see medical notes on a computer system compared to the old style paper records. Laptops are more environmentally friendly than desktop systems but they do have a theft risk connected with them. Having a server system located off site would help to reduce the building CO2 further. One aspect of administration is the number of paper letters sent to patients. The majority of citizens now have email addresses so a simple email would be ideal and at zero cost. Hospital sites can encompass all of the same plans as a health centre, but one area that requires additional thinking is waste, which is

getting more attention in recent times. Would it not be better for the standard and recyclable waste to be collected from one location avoiding the need for the collection lorry to travel around a site? Offensive waste is a different matter entirely and needs a country wide approach. A circular economy None of the ideas mentioned here are new; the NHS has multiple areas of interest and targets such as all NHS buildings must have LED lights by 2030, low emission generators and cooling systems with emergency generators being battery powered by 2025, along with electric vehicle charging stations in all car parks again by 2025. The plans are in place, the technology is available and getting better all the time. It is no surprise that we all have to look towards a circular economy in order to stop the reliance on a limited resource of natural materials. How we can achieve this in an organisation that has to dispose of some of its waste for infection control is another matter. In light of recent events with the Covid-19 outbreak and the quantity of PPE that was required and then destroyed, it is understandable that calls for washable PPE are the way forward but the question remains how can this be controlled in a medical arena? This is where we have to embrace change, to encourage innovation with clear routes to market. There is no doubt that there are companies that can and have developed washable PPE, but will this product have additional requirements around it? Will it require specially developed washing machines, with new detergent? And what would the wastewater be like, would it be safe or would that then have to go through a cleaning process? As always in sustainability, every

question is subsequently answered by two more questions. Right now it is procurement’s time to shine, the world has changed and one thing that Covid-19 has brought to the attention is being greener, the call for a greener rebuild and how air quality improved during the lockdown. Procurement can help achieve this target goal but it is down to all of us to look into each project and see how it can be improved, we need to stop the phrase of ‘business as usual’ and embrace the thought process of reimagining everything with a green sustainable tint to it. Data produced by both the NHS and the British Lung Foundation have shown significant improvements in air quality during the lockdown, that asthma sufferers found their symptoms were better and that we all noticed a cleaner environment. The domino effect This is where the domino effect can come into play, by all of us making a transition to a more sustainable cleaner lifestyle it eases the burden on the NHS. Moving to walking or cycling to work, reducing the journeys taken with cars by working from home, purchasing electric vehicles and clean air zones, all of which will not just reduce harmful emissions and particulates but will help with the overall health of the citizen, which will in turn reduce the demand on the NHS. Prevention instead of cure is a phrase that has done the rounds a number of times, and sustainability is exactly that. A council making a decision to close off an area to traffic to reduce pollutants can have a positive domino effect on the area, as the chances of citizens young and old developing breathing related issues can drastically reduce, and all of the health care required for this illness is no longer under the same pressure, so less trips to a hospital will mean less car journeys, along with all of the administration for the appointment and subsequent care. A two pronged approach to NHS sustainability is going to be required. Yes there are the standard changes required like the LED lights and battery powered generators, but a wider picture has to be taken into account by the local area, by making the towns and cities cleaner and sustainable the effect will be felt by the local NHS which will by proxy become more sustainable. L FURTHER INFORMATION https://bit.ly/3yxImtj

Issue 21.6 | HEALTH BUSINESS MAGAZINE

INFORMATION TECHNOLOGY

4C Strategies – Independent ICT Consultants 4C Strategies is an independent ICT consultancy specialising in technology and infrastructure projects. The company covers all aspects of technology and infrastructure in the enterprise environment, with consultants showing demonstrable experience in helping clients to procure new technologies to meet their business requirements, providing endto-end support on ICT projects by delivering a portfolio of consultancy services to meet client requirements, from audit and strategy through to procurement, implementation and resourcing. 4C Strategies has been assisting organisations in the healthcare industry for over 20 years. Expertise covers

all aspects of IT technology and infrastructure, including: digital strategy, IT and technology strategy, data centres, servers and storage, patient data security, desktop telephony, Microsoft Teams and wide area networks. Trevor Nelms, Director from West London Mental Health Trust, said: “4C Strategies has assisted in a range of complex ICT projects, from inception through to deployment, and demonstrated a rare ability to bring together technical expertise with business acumen and tight project management skills.” Contact one of 4C Strategies’ qualified healthcare technology consultants today. FURTHER INFORMATION Tel: 01858 438938 nhs@4c.co.uk www.4c.co.uk

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temperatures that affect the stability of pharmaceuticals. Data loggers for vaccine monitoring include the costeffective Tinytag Talk 2 medical data logger, designed for use in vaccine fridges. The small data logger can be placed directly alongside vaccines in cold storage to precisely monitor the conditions that vaccines experience. At the end of the monitoring period, recorded data can be viewed and assessed using easy-to-use data logging software. For fuss-free, costeffective vaccine monitoring, Tinytag data loggers are the simple choice. To find out more, please contact Gemini Data Loggers or visit the website below. FURTHER INFORMATION sales@tinytag.info 01243 813000 www.geminidataloggers.com

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Every adult in the country now needs to get a Covid-19 booster vaccine, because two doses does not give you enough protection against catching Omicron.

GET YOUR COVID-19 BOOSTER VACCINE NHS.UK/COVIDVACCINATION